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Video by Dr. Dawn Elise Snipes on integrative behavioral health approaches including counseling techniques and skills for improving mental health and reducing mental illness.

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ADHD, Addiction & Mental Health Interventions
Dr. Dawn-Elise Snipes

~ Explore PACER Interventions that benefit ADHD and comorbid conditions
~ Identify common treatment issues and interventions
~ ADHD is often a life-long condition and predisposes people to the development of mood and addictive disorders.
~ Mood disorders are associated with worse ADHD symptoms.
~ As such, early intervention and a life-span approach needs to be considered
Things to Do if You Have ADD/ADHD
~ Physical
~ Get adequate, quality sleep (7-9 hours)
~ Regulate circadian rhythms to support normal cortisol levels and HPA-Axis functioning
~ Take medication as prescribed
~ Eat healthfully to support dopamine, serotonin and norepinephrine production and brain glucose
~ Exercise to increase dopamine and serotonin
~ Find constructive outlets for excess energy
~ Sunlight via increased D3 increase dopamine availability

Things to Do if You Have ADD/ADHD
~ Physical
~ Get a physical and blood work (T3/T4, gonadal hormones, vitamin D)
~ Get vision and hearing screenings
~ If you are engaged in addictive behaviors, seek treatment

Things to Do if You Have ADD/ADHD
~ Affective
~ People with comorbid anxiety had a significantly poorer response to the stimulant than those without anxiety (HPA-Axis focused on survival/fight-flee)
~ Dysregulation and low frustration tolerance
~ Enhance distress tolerance skills ((BATS) Breathe – Activities – Talk it Out – Sensations)
~ Examine the underlying cognitions related to frustration intolerance
~ Increase positive (dopamine priming) activities
~ Address trauma or other issues contributing to anxiety or depression
~ Identify cognitive themes (rejection, failure, getting in trouble)
~ Address emotional reasoning and anticipatory anxiety
Things to Do if You Have ADD/ADHD
~ Cognitive
~ Enhance self esteem and efficacy
~ What am I good at?
~ Learn how to set (and achieve) SMART goals
~ Learn about your learning style (A/V/K; A/R)
~ Get screened for dyslexia
~ Prioritize
~ What is most important to move you toward a rich and meaningful life?
~ Chunk it!
~ Relate it to something you are interested in

Things to Do if You Have ADD/ADHD
~ Cognitive
~ Create a solutions list and keep it with you to provide options in response to distress/impulsivity
~ When I am feeling upset, I can…
~ 10 things I can do
~ 10 things I can think about

Things to Do if You Have ADD/ADHD
~ Cognitive
~ Plan ahead/Impulse Control
~ Adults with ADHD often have difficulty drawing on past experiences to guide their actions.
~ They’re may not be good at recognizing the subtle aspects of problems, and the various tools that might solve them.
~ Picture a TV and imagine the last time you were in a situation like this playing on the TV like a movie.
~ What did you learn from that experience?
~ What were some of the details that made it similar and different to this situation?
Things to Do
~ Verbalize thoughts, reasoning when there is an urge to act out
~ Train your brain with apps like Luminosity or Elevate that improve focus, memory, and thought organization through practice and repetition
~ See the goal
~ Many with ADHD forget the purpose of their tasks, so they are uninspired to finish them. They may need some prompts to keep moving toward their goal.
~ Imagining the positive consequences of doing something is a potent motivator for most people with ADHD.
~ Hint: Put a medication reminder app on your phone to remind you each morning to visualize your day
~ Imagine how great it will feel to get to your goal. Add visual reminders.
Things to Do if You Have ADD/ADHD
~ Cognitive
~ Motivation (PACER)
~ Physical
~ Affective
~ Cognitive
~ Environmental
~ Relational
Things to Do if You Have ADD/ADHD
~ Environmental
~ Train yourself to become more organized
~ Alarms/push notifications.
~ Write things down on your mobile device and set an alarm to check the notes each morning.
~ Scan in any documents you may need later
~ Envision the steps of your day each morning.
~ Don’t get over organized.
~ Minimize distractions when you need to focus (private space, noise cancelling headphones)
~ Ensure you feel “safe”
~ Keep a toolkit with you to help deal with boredom, restlessness

Things to Do if You Have ADD/ADHD
~ Environmental
~ Teacher/Caregivers
~ Facilitate success in car rides, at restaurants, church, grocery store or when visiting people by bringing a rescue kit to address fidgety behavior, restlessness, boredom
~ Facilitate success in school/work by working with your child to develop checklists, helping them train themselves to pack and check the night before, entering syllabi into their online calendar and helping them plan… i.e. Science fair is on November 12th, when do you need to start working on your project?

Things to Do if You Have ADD/ADHD
~ Relational
~ Develop social skills
~ Caregivers: Focus on your child’s strengths not their mistakes
~ Caregivers: Help your child learn from mistakes.
~ Caregivers/Teachers/Supervisors: Provide or help create to-do lists
~ Know what you need from other people and communicate that to them.
~ Discuss with your SOs what your symptoms are and what they can do to help. (Hold a finger to their lips if you are starting to blurt; call you 30 minutes ahead to remind you they are coming)
~ Practice saying “maybe” so you have time to think about whether to say yes or no.

Things to Do if You Have ADD/ADHD
~ Improve communication skills, esp. blurting
~ Make a list of the inappropriate situations in which you are most likely to behave impulsively.
~ When you are about to enter one of those situations, try following actions:
~ Before you answer someone, inhale slowly, exhale slowly, put on a thoughtful expression, and say to yourself, “Well, let me think about that.” (Caregivers can prompt this)
~ Put a finger over your mouth for a few seconds, as if you’re considering what you’re going to say.
~ Paraphrase what your boss or family member said to you: “Oh, so you want to know about…” or “You’re asking me to….” (Caregivers can prompt this)
~ Imagine locking your mouth with a key to prevent yourself from speaking.

Employment and ADHD
~ Job Accommodation Network
~ ADD/ADHD can negatively impact relationships, work and addiction recovery if not addressed
~ People with ADHD and the people around them need to understand it is not a problem with willpower, but a condition caused by differences in the physical and chemical workings of their brain.
~ As with any other disability, people with ADHD need to learn their abilities and be empowered to make necessary modifications to address their symptoms so they can live a rich and meaningful life.
~ It is more important to identify and address symptoms than worry about fitting particular diagnoses