When it comes to managing adult ADHD, strategies often focus on addressing specific symptoms like attentional difficulties or impulsivity through medication and therapy interventions. However, there is an underlying aspect that is important to address also: basic daily routines. In this post, I describe how setting up and adhering to basic routines can serve as the foundation upon which more complex tasks and responsibilities are built.
The Challenge of Disorganisation
For many adults with ADHD, disorganisation is a constant companion. Forgotten appointments, misplaced items, and struggling to prioritise tasks are challenges that can lead to increased stress and reduced quality of life. In the midst of these difficulties, the idea of establishing a routine might seem either overly simplistic or dauntingly impossible. However, the act of creating a basic routine can serve as the first step toward greater stability. And when I say basic, I really mean basic. I have worked with more than one person on how they can manage to brush their teeth at least once a day.
I see many clients who want to perform high-level tasks, like university study, or operating better at a job, and yet their sleep varies wildly, they forget to eat for half a day at a time (sometimes bingeing in the evening), and they move their body very little. Trying to improve the functioning of higher-level tasks on top of a shifting and unpredictable base can mean that basic physiological needs are not being met. It can feel like building a sandcastle on the shoreline: regular inundation and starting from scratch.
Why Basic Routines Matter
Predictability: Having a predictable structure can lessen the mental load and offer a sense of stability, freeing up cognitive resources for other tasks.
Reduced Decision Fatigue: When basic tasks become habitual, you spend less time deciding what needs to be done, leaving more energy for complex decision-making.
Consistency: With a routine in place, essential tasks are less likely to be overlooked, ensuring that your day-to-day responsibilities are managed.
Self-Efficacy: Successfully maintaining a routine builds confidence, empowering you to take on more challenging tasks and responsibilities.
The Anatomy of a Basic Routine
Creating an effective routine will very much rely on the resources that a person has to put to the task. However, there are some universal elements that can serve as building blocks for almost anyone:
Regular Eating: Schedule time for meals and if you can manage, snacks, throughout the day. Consistent meal timing can help regulate blood sugar levels, which has a direct impact on your mood, concentration, and self-control, and food helps stimulant medications to absorb and therefore work better. I often tell my clients that they need to start their day with breakfast for this important reason, even if they just eat a banana, muesli bar, or a breakfast drink they stash under their bed.
Exercise: Incorporate regular exercise into your routine, ideally at the same time each day. A number of my clients say that exercise in the morning is very important for cognitive performance and general wellbeing. Vigorous physical activity boosts dopamine levels in the brain, and the effects can last for a few hours post-exercise. For some people, exercise is a crucial component for managing ADHD symptoms. Even a brief 20-minute walk (ideally in the morning) can make a significant difference.
Regular Sleep: Aim for a consistent and wake-up and bedtime (even on the weekend). Quality sleep is vital for cognitive function and overall well-being. I know that sleep can be really difficult for people with ADHD. I have blog posts on delayed sleep phase, bedtime procrastination, and the importance of morning light exposure in helping to regulate sleep/wake cycles.
Building Up to Higher-Level Tasks
Once a basic routine is in place, you can begin to layer in more complex tasks and responsibilities, such as study or work strategies, organisation, household management, and managing recurring items like grocery shopping and doing laundry. This is where you can start applying other strategies or tools for managing ADHD, such as task prioritisation techniques or time management apps. By having a stable foundation, these higher-level strategies become more effective because they are less likely to be scuppered by sleep deprivation or losing half the day in bed.
Conclusion
While it may seem counterintuitive to focus on something as small as basic routines when dealing with the complexities of adult ADHD, it's precisely this simplicity that makes it such a powerful tool. A well-designed and personalised basic routine not only helps manage the day-to-day challenges but also serves as a sturdy platform upon which you can build a more fulfilling and productive life.
When thinking about those foundational lifestyle factors for wellbeing, please don’t forget “pleasurable activities”. I think it’s on a par with sleep, nutrition, and exercise. Sometimes we have to schedule it in because we neglect it.