- [Announcer] Major support for this program was provided by: Nancy and Nyle Maxwell, (bright music) Emerson, Kathy and Charlie Izard.

Additional support was provided by: Amanda Jensen and Scott Bonneau, Amado DeHoyos, Georgetown Health Foundation, Kristen and John Nelson.

And by... And also by... For more information and a full list of funders, please visit us at howarewetoday.com or aptonline.org.

The information provided in this program is for general educational purposes only and is not intended to constitute medical advice.

This is not a replacement for therapy and does not constitute therapeutic services or a therapeutic relationship.

For personalized medical guidance or in the case of an emergency, please contact a healthcare provider.

(bright music) (bright music continues) (gentle music) (thunder rumbling) (Tyler sighing) - Oh.

Hey, there.

How are we today?

Hope you're doing okay.

It's raining cats and dogs outside, as you can see, but it's the perfect day for Tyler Tea Time.

It's something I like doing every week, regardless of the weather, as a reminder to take a breather, to take stock, give myself pause, refresh, you know, prepare myself for the week ahead, if you will.

And luckily, today's pretty chill, probably because it is filled with really good company.

- Thank you, Tyler.

(cups clanging) - Ooh, you even got those fancy little sugar cubes.

- Don't forget about the milk or honey, Madam.

- [Both] Ooh.

- Thou art the most gracious of hosts.

(Mariel laughing) - Thanks for inviting us over.

I just got back from a work trip.

I'm exhausted and I haven't, I haven't even had a chance to... - Haven't unpacked yet?

- You know me too well.

- Yeah.

- Hey, I'm kind of the same.

I mean, I'll leave my luggage hanging around for days after a trip.

- I have the opposite problem.

My house is full of clothes and unopened packages.

Spring cleaning is on hold in my household.

- You'll get to it eventually, but for now, guys, (deep breathes) let's kick back and relax.

(everyone breathing deeply) (door knocking) Well, I guess that's getting put on pause.

Who could that be in this weather?

- I think I know.

- Uh, my friend Barry asked if he could come over, and so I left a note on my door saying I'd be over here and to tell him to come over here, if you don't mind.

- Ah, not a problem.

- Come on in, Barry.

(door creaking) (playful music) (door creaking) - Hey, guys!

Ooh, nice place you got here, Tyler.

- Uh, thanks.

Barry's a beaver?

- Yeah, I'm pretty sure I mentioned that.

I think I told you that.

Okay, no, I know I told you that.

Barry, holy smokes, you are soaking wet, my guy!

- Oh yeah, I guess my fur's a little damp.

- Um, let me grab you a towel real quick.

(sighs) A talking beaver puppet on a mental health show?

Eh?

Why not?

- Let's get you cleaned up.

- Yeah, thanks.

- Yeah.

- Here you go.

- Thanks, buddy.

Here you go.

- Man, you are soaked, Barry.

Uh, is it raining heavy at your place?

- Sorta.

It rained up river and, well, my dam kind of flooded.

- Oh, Barry.

- Oh, Barry, I'm so sorry.

- Honestly, it wasn't so much rain, and I knew the storm was coming, and I had more than enough time to finish my dam and patch all the leaks, but I just, I just didn't.

- Oh, don't beat yourself up about it, Barry.

- It happens.

- Well, it's my fault it didn't get done, and now my dam's leaking and all my dam stuff is wet.

- Barry, language?

- Oh, sorry.

I just feel so overwhelmed right now and really frustrated that I let this happen.

- I'm sorry, Barry, but why don't we go help you patch things up?

- Really?

- Yeah.

- Oh, that would be amazing.

That would be so helpful.

Thank you.

- Absolutely.

(bright music) - Barry, you're quite coordinated, my friend.

- Well... - Sometimes.

- Actually, I have ADHD, which makes me hyper fixated on occasion, haha, as you can see.

- Well, it's funny, I know the feeling 'cause I'm bipolar myself.

- Oh, so you must know what it's like... - [Both] To obsess on one task while neglecting others.

(both laughing) - Yeah, really.

Really, yeah.

Yeah.

- That's too good.

By the way, obsessing over one task is more associated with hypomania than it is manic episodes.

Just for the record.

Barry, I know it can be hard to see what gets neglected when you're obsessing over a task, because oftentimes it kind of feels like you find your flow.

- It's really a double-edged sword though, right?

Because sometimes it makes me feel really productive and other times, huh, keeping priorities in order can be a struggle for me.

- Yeah, but we all get busy sometimes, right, Barry?

- But that's the thing, Barbara, I wasn't busy.

I had the time.

I just couldn't organize my time enough to fix my house even when I knew the rain forecast.

- That's odd.

I mean, I know you have ADHD, but I figured you had a pretty good system in place to kind of give you the structure that you needed in your life.

- Yes, I had one when we were all working remote, but ever since we shifted back to the office a few weeks ago, it's thrown my whole system out of whack.

- Barry works for a successful log firm.

- A what?

- It's a law firm for loggers.

Barry here is one legal, eager, busy... - Beaver.

Yes, you guys are hilarious.

Ha-ha.

But yeah, I got used to logging on from home to being back at the firm.

And my life system can be hard enough with smaller changes, a longer commute up the river, for example, but this change has thrown my whole daily structure off its axis.

And for a beaver with ADHD, that can be really tough.

- Yeah, Barry, you know, it kind of seems like you not fixing the dam isn't the problem.

It's more of a symptom of larger disorganization because of a major lifestyle change.

- Tyler, you summed it up perfectly.

I just can't seem to adjust to this new normal.

(clock ringing) My mornings used to be pretty orderly.

Not perfect, but, you know, functional.

I got up by 7:45 every morning with a few snoozes baked in for safety.

(bright music) (faucet creaking) (Barry singing) I always gave myself a little extra time in the shower in case I wanted to sing an extra song.

I still needed some reminders to stay on track, but I built a nice little net to catch me any mornings I felt a little lost or overwhelmed.

(bright music) (pans clanging) (egg cracking) (oil sizzling) I remembered to eat, so I'd have plenty of energy for the day.

And that left me with the rest of my day to focus on work with as little stress as possible.

And for the most part, it really worked.

There's always a little bit of chaos, but I controlled it as best I could.

For example, I always had baskets around the house to put things I didn't know what to do at that moment.

Maybe tasks like paying a bill or sorting things that I needed more beaver brainpower that I could muster in that moment and didn't want to derail myself.

And so the chaos wouldn't spill out into my routine, I set up the chaos baskets to literally contain the chaos, and they really worked.

But as I said, the firm transitioned away from remote work, and I was back in the office once again, logging on.

Which I don't mind, overall.

I'm an extroverted beaver, and it's been great to see everyone.

But after several years working remote, my life system just isn't built for this.

(Barry yawning) (clock ringing) I can't seem to get out of bed when I want.

And when I finally get up, I have to drag myself every furry step of the way.

Ha, and forget about making the bed.

I'm too unfocused to keep my tasks straight even with some help.

The confusion, indecision, and frustration costs me time.

A 20-minute bathroom routine becomes 40, and I even forget to sing.

And on the really bad days, I can even forget to take my ADHD medication.

(somber music) (pans clanging) If I remember to eat, it's rarely as healthy.

Because I feel stressed and unfocused, I compensate with more coffee, which, well, just makes me feel more stressed and jittery.

But it seems like a good idea at the time.

As for the life stuff, I saw the place needed some patching up and... Well, you know the rest.

And look at my beautiful chaos baskets.

The chaos is no longer contained!

Oh.

And as silly as that sounds, it just creates one more mental block to getting anything done.

I had systems, they worked, and now everything is off.

- Well, what if you just, you know, woke up a little bit earlier in the morning, bought yourself some extra time to get some stuff done?

- I know it seems simple from the outside.

"Why can't you just do things that obviously need to be done, Barry?"

But I already know I can't because of my ADHD.

I thought I'd made a routine.

I got a mental health provider, I made a treatment plan, including medication.

And it was all working.

But once it felt like I'd fallen behind, it now feels like I'm in this perpetual state of playing catch up.

I feel like I'm in this hole that I just can't dig myself out of.

- Hey, listen, Barry, I actually know the feeling.

With bipolar, I know I get lost in my thoughts all the time and I start to spiral.

- Well, with my ADHD, it's a little bit different.

It's not necessarily emotional at first, but I just get so frustrated that I can't get organized.

And the lack of organization is really a neurological issue.

- You know, it kind of seems like we have similar symptoms, but just in different buckets.

- Yeah, and my disorganization is like, well, if you think about your brain as a filing system, right?

Like when I'm filing things in my log firm, should be straightforward, okay?

But with the neurodevelopment issues caused by my ADHD, my filing system is out of whack.

- You mean like your chaos baskets?

- Ugh.

As you can see, that can make my life incredibly stressful and overwhelming.

At work, even if I make one deadline, the next is waiting there for me to miss, because it's easy to just misfile the information and forget.

And then if I'm not remembering to remember, I just don't remember.

- That sounds so tough, Barry.

What happens next?

- Well, when I miss a deadline, that frustration becomes embarrassment and shame.

And then I get hyper fixated on work assignments because now they're already late and they have to be perfect to justify the lateness.

It's basically an endless loop of trying to do everything and accomplishing nothing.

(Barry sighing) I just don't know how to get back on track, guys.

(everyone sighing) (doorbell ringing) - Hey, everyone!

- Dr. Erin!

- Dr. Erin!

- Oh, Dr. Erin!

- You know Barry?

- It's pretty hard to miss a talking beaver that lives in your neighborhood.

- (laughs) Yeah.

- I brought as many towels as I could find.

Let's get this place cleaned up.

- All right, all right.

Yeah, hey, Barry, come here real quick.

You got something there.

- With the leak and the log firm and everything else I got going on in between, I just don't know what to do, Dr. Erin.

- I know it can be so frustrating.

You know, managing my own ADHD for years has presented numerous challenges, especially when I fall off track.

- It's so frustrating.

- But the good news is you already know what you're supposed to be doing.

You and I both have systems that work.

So what we really need is a nudge to get us back on track.

- Wait, wait, wait, wait, wait.

Don't tell me you got another one of those fancy awareness or noticing thing you try out, don't you?

Don't you?

- How did you know?

I think it's really helpful for everyone to take some time every now and again to just pause and notice what's showing up.

- Okay.

- Notice your thoughts, your feelings, your actions, or even action urges, and just notice what's showing up for you.

Sometimes with distraction, we need to pause so that we can figure out what we're supposed to be doing or what we want to be doing.

- Mm.

- Oh.

- With ADHD, it isn't actually a deficit in attention, it's a deficit in shifting and controlling attention.

- Wow.

I didn't know it that way.

- It's an important difference, yeah.

- Yeah.

So you might be paying attention to a lot of different things, but the shifting from task to task is what is causing problems.

So if you're feeling a little bit off your axis, sometimes it's helpful to pause and notice what's showing up so that we can figure out what to do next.

- Well, how do we notice that, Dr. Erin?

- Well, it's not just about noticing what you used to be doing or what you're supposed to be doing, but noticing in a more concrete way.

So that's what the things like the reminders, or the calendars, or even journaling can help with.

We're noticing in a really tangible way.

- Yeah.

- Now, once we've noticed, the next step, what I usually do, is whether it's for work or home is I like to make a list of all the things that I'm supposed to be doing.

But then the trick is we're gonna break the list between things that we have to do right now, like as in today, and things that can wait until later.

- Oh, okay.

Yeah, yeah, yeah.

- So maybe for Barry, number one would be fixing the dam, and then number two, doing the dishes.

- Yes, exactly.

- Okay.

- Yeah, fixing the dam might come first.

- Yeah.

- I think I didn't need to... - Yeah.

- Yeah.

- Once we have our list figured out and we know what we're focusing on, then it's about figuring out when and how we're gonna get those things accomplished.

- Okay.

- The problem with distraction is that sometimes even when we have a really good list, the shifting from task to task, that can be tricky.

That's what medication helps with.

It increases our ability to shift and control our attention.

But even without medication, I have lots of things that'll make it easier to keep track of what our attention is doing.

- For me, it's not just about knowing what I need to do, but knowing what I'm supposed to be doing, if that makes sense.

- Yes.

And it's all about the awareness in the moment to come back to what our brains are doing.

(phone buzzing) And I have my favorite trick that I wanna teach you for keeping track of my own attention.

- Oh.

- Okay.

- Some cool games on there?

(playful music) - Even when we have a good list, sometimes things don't go as planned.

Or actually, usually things don't go as planned.

That's true whether you have ADHD or not.

One of the biggest factors for distraction and procrastination is actually our emotions.

For example, I know for me, when I get really overwhelmed, I have a hard time even starting tasks.

So sometimes I have to work through the feeling of overwhelmed first before I can figure out how to get back on my task list.

The key here is noticing and pausing and realizing what's showing up.

What I'm thinking, feeling, and doing, or what I feel like doing so that I can figure out what to do next.

Having a check-in can help us to pause and notice what we're thinking, feeling, and doing, or supposed to be doing so that we can get back on track.

- Which, for me, is especially tough when I have trouble remembering what I was supposed to remember to do.

- Exactly.

That's why a tool like this to help us pause and notice what we're thinking, feeling, and doing, and maybe even to help us remember, can be so helpful.

- Hmm.

- So what we wanna do is schedule a check-in.

- Alright, everybody at home, take out your phone, pull up your calendar, and schedule a check-in with us.

- So you'd think that it would make sense to schedule a check-in for a time when you're feeling calm or motivated, but actually you wanna schedule the check-in for a time when it's really high stress or high emotion, or when you're likely to get distracted.

Think of a time when you think back and say, "If I had intervened differently, if I had noticed what was going on, I might have done something to change my behavior."

- Oh, okay.

- Makes sense.

- Okay.

- Oh, yeah.

- For me, one example of that would be in the middle of the afternoon after lunch, I tend to get a little bit distracted.

- Oh, super sleepy, right?

- Me too, yeah.

- Exactly.

And then it's hard to get your tasks done.

So that would be a good time to have that alarm go off to say, "Wait a minute, what am I doing right now?

What am I thinking?

What am I feeling?"

Another example for me would be in the evening when things are less structured, I tend to get more overwhelmed and feel a little bit chaotic.

So the check-in is going to help us to pause and notice what we're feeling and what we're doing in the moment.

Really notice what's showing up.

- Okay.

- The key here is that it isn't necessarily a reminder to do something, it's just a reminder to pause and notice what's showing up.

It's sort of like a big stop sign.

What are you thinking, feeling, or doing in that moment?

In order for us to figure out what we're supposed to be doing or what we need to be doing, what to do next, we have to notice what's showing up first.

The roadmap of what we're gonna do, whether I'm gonna pick up a skill or an activity, or think a different thought, that comes after I have that stop sign.

- So when do we do then, Dr. Erin?

- Well, when we have the alarm that goes off, it can be our cue to say, "Wait a minute, what am I thinking?

What am I feeling?

What am I doing?"

And then we can figure it out.

So for example, if it's a moment where I'm feeling unmotivated, maybe I get up and go for a walk around.

Or if it's a moment where I found myself distracted, I might check back in with that list to see what I'm supposed to be doing.

- [Tyler] Okay.

- If I'm feeling really overwhelmed, I might actually even need to take a break.

- Yeah.

- That sounds nice.

(everyone laughing) - And even sometimes if I'm feeling like I've gotten really distracted, like I don't know what I'm supposed to be doing, or I know what I'm supposed to be doing, but I'm doing something different, this can be a clue to help me check back in with that task list from earlier so that I can figure out what I'm supposed to be doing first.

- That's what happens to me all the time, Dr. Erin.

- Yep.

So having this reminder to help you check in and say, "What am I supposed to be doing right now?"

can be really helpful.

- Okay.

So would we put some in?

- Yeah.

- Okay.

- Oh, okay.

Let's start with you.

- All right, Barry, how about we set something, okay?

- Oh yeah, yeah, let's do it.

- What do you think?

- Uh, I think maybe like two o'clock, chew on some wood.

- Okay, we can put that down- - Yeah.

Yeah, okay.

- but wait, Dr. Erin said that we should focus on noticing during that time, not a task.

- Exactly.

Just to pause and notice what am I feeling right now?

What am I doing right now?

Maybe you're supposed to be chewing wood, and that's great.

Maybe you're actually supposed to be fixing the dam and then that's your cue to get back on track.

- All right, the dam.

Oh geez.

This is what happens to me.

- Oh, it's okay, Barry.

I'm just gonna put 2:00 PM, check-in for Barry.

- Okay, great.

Thanks, I love that.

- Then when we have our alarm that goes off, we can pause and notice what's showing up, and sometimes we can figure out what to do next.

Although I will say the check-in isn't a magic fix to motivation.

So for today, I have an extra double activity that can help with our motivation.

- Two?

- Two.

- What else?

- Okay, Okay.

- Barry, grab those chaos baskets and let's head back to Tyler's apartment and get started.

- All right, let's go get 'em.

- Let's go, gang.

- So it's important to note that sometimes just having something on the calendar isn't a magic fix for motivation.

Sometimes we need a little extra nudge to move us in the right direction.

For that, I like to use a skill called "5, 4, 3, 2, 1, go!"

- Alright, so all I need you to do for this one is sit.

Sit down where you're at.

Or stand in place.

Just be where you are.

She's gonna explain in just a second.

- Sometimes when we have so many things that we wanna be doing or things on our task list like, "I should be doing this," or, "Oh, I really need to go do that, we can actually get stuck in the not doing.

It can even start to feel kind of overwhelming, and I don't know about you, but when I start to feel that way, I have a really hard time just doing anything.

- Yeah.

- Right?

It's hard to get going.

So this skill is really all about getting moving.

It's not actually about the task that you're going to do.

That's a small piece of it.

It's more about initiating movement, so we don't get stuck just sitting and thinking about all the things we need to do.

So how it works is we're gonna count down from five, and then on go, we'll say, "5, 4, 3, 2, 1, go!"

we're gonna actually just jump up and go do one of the things.

So for practice, what we're gonna do is countdown from five, and then think of something that you can go do.

It can be really small, really simple.

Think of like the first step of something that you wanna accomplish.

We're gonna countdown from five, and then on go, we're gonna get up and just say the thing that we would do.

- Okay, so this is just for practice, but then later on, I'm gonna have to go and do that thing.

- Yep.

On go, you would actually go do the thing.

- All right, Dr. Erin, only because you said so.

- It can be really helpful, I promise.

It feels silly, but it's helpful to just get moving.

- Okay.

- Right?

So we can get unstuck.

- Let's do it.

- Makes sense.

- Okay, ready?

- Okay.

So this is all about breaking the cycle of inaction.

And by the way, if you're not able to physically stand up, that's totally fine.

Any forward motion is what we're looking for.

Ready?

You're gonna count down with us.

Here we go.

- [Everyone] 5, 4, 3, 2, 1, go!

- I think I'm gonna send one email.

- Mm, I think I'll go home and unpack one bag of luggage.

- I think I'm gonna pick out at least one thing to donate.

- I'm gonna show it a chaos basket.

- I think I'm gonna do nothing.

(Barry laughing) - Oh, Tyler.

- Of course.

- [Tyler] But that's okay, right, Doc?

- That's perfect.

- That felt like good practice.

I'll remember that when I get home and eventually unpack my luggage.

- Say, Dr. Erin, after you send that email, you wanna help me unpack a chaos basket?

- Yeah, sure, let's go.

- Okay, I'll see you guys later.

- Okay.

Good luck.

- See you, Barry.

- And like a relaxing cup of tea, all of us could use more moments to take a moment to see what we're up to and how we're feeling.

(phone buzzing) - Tyler, I thought we were supposed to set the alarms during times of high stress.

- This is a time of high stress.

Both you guys are chugging my tea.

- You invited us over.

For tea.

- Until next time, take heart, and take care.

- Not even hot anymore.

- I know.

Well, next time, can we put in an order for like...

I mean, this tea's pretty good, but like... - I mean, it's not my fault we left.

I mean, you guys said we wanted to go help Barry, which I was happy to do.

And he's a really nice guy, by the way.

I kind of... - Isn't he the best?

- Look, I don't wanna get ahead of myself, but I kind had a bromance here.

- Okay.

Yeah!

- Were you guys feeling that?

- Okay.

That should make a good eye contact.

- I mean, he's a cool dude.

(bright music) - [Announcer] Major support for this program was provided by: Nancy and Nyle Maxwell, (bright music) Emerson, Kathy and Charlie Izard.

Additional support was provided by: Amanda Jensen and Scott Bonneau, Amado DeHoyos, Georgetown Health Foundation, Kristen and John Nelson.

And by... And also by... For more information and a full list of funders please visit us at howarewetoday.com or aptonline.org.

(light airy music) (playful music) (bright music)