Productivity versus Procrastination in the Remote Work Environment

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Working from Home

Working from home sounded great at first. The idea of not having to get up early (in theory), wear uncomfortable clothes and shoes, and drink horrible breakroom coffee all day sounded appealing to many former office workers. Now that some – or a lot – of weeks have passed, it hasn’t turned out to be the pajama party you thought it would be. With those perks come distractions: television, your personal phone, social media, kids, errands that are easier to run during the day, household chores to get done. And let’s not forget that fridge and pantry full of snacks. 

If you are struggling to maintain productivity while working remotely, you are not alone. These easy, but effective tips may help:

  • Make a list. Start your day by making a to-do list. Write down everything you need to get done each day or use an electronic list or app. Put everything in order from most important to least important. Checking them off as you finish will also provide you with a sense of accomplishment, which helps fuel motivation to keep working.
  • Reward yourself. Sometimes it helps to keep yourself accountable by putting a reward system in place for yourself. For example, after you complete five tasks from your list, you get to treat yourself to a snack break, one (short) episode of your favorite show on Netflix, reading a chapter of a book, taking a quick power nap, or anything that will keep you motivated to keep going. 
  • Switch it up. Many people recommend having one designated space for your home office. You’ve probably heard not to work in the same room you sleep or watch TV. However, sometimes switching to a more comfortable chair with your laptop and getting a change of scenery is just what your brain needs to stay productive. Weather permitting, take that laptop outside for a bit while you soak up some energy boosting Vitamin D.
  • Get dressed. It doesn’t have to be a suit and tie or a skirt and heels. It doesn’t even necessarily need to be jeans. Just don’t wear what you wore to bed last night when you work. The routine of grooming and getting out of sleepwear is needed to switch your brain from sleep mode to work productivity mode.
  • Take breaks. It’s important to get up and stretch your legs every once in a while. Stand up, drink some water, walk around, grab a snack. It can even be helpful to go outside for a couple minutes and get some fresh air. While there may not be time to take a walk around the whole block, exercise is very beneficial to a brain with ADHD. Also, sitting for extended periods is harmful to your health in many ways.
  • Take your medication. Adult ADHD medication works best when taken regularly. Just because you’re working from home in a familiar and comfortable environment does not mean you can skip a day of taking your medication. 
  • Stick to a routine. Set your alarm and get up at the same time each day and go to bed at the same time each night. Set your work hours. Eat meals and snacks at roughly the same times. Do not perform any chores or errands you would not be able to perform if you were working in an office, which will throw off your entire work routine.

Learning from Home

Online learning for children is another big adjustment many people have had to make. It can seem overwhelming to parents who had to transition from working in an office, uninterrupted by the needs of school and childcare, to working at home while facilitating a learning environment and being constantly interrupted for snack demands to needing help getting back on Zoom. 

To help lighten the load, many of the steps listed above for working from home also apply to learning from home. Also, remember that even though your child is usually spending around seven to eight hours at school, they really don’t need to spend that much time hitting the books at home. They had lots of breaks at school, too. These guidelines can help provide a structure for your day:

  • Kindergarten through second grade only need a maximum of 90 minutes of active curriculum learning per day
  • Grades three through five only need a maximum of 120 minutes per day
  • Grades six through eight need a maximum of 180 minutes per day (30 minutes per class)
  • Grades nine through 12 need a maximum of 270 minutes per day (45 minutes per class)

These timeframes can even be broken down into smaller chunks throughout the day. 

Getting your child involved by giving them new age-appropriate responsibilities will help both you and your child. Some ideas include:

  • On the weekend, make up breakfasts and lunches together for the week and refrigerate or freeze them
  • Teach your child how to safely use the microwave
  • Keep healthy snacks within their reach in the pantry or fridge and set a timer for snack times or limits on the number of snacks
  • Set a reading time for each day. Have your child read out loud to you or a pet if they are younger and need supervision.
  • Plan physical activities in advance and offer a choice to your child to avoid them sitting in front of a screen all day.
  • Keep art supplies on hand and an area set up where your child can get their art on. 
  • Give them an age-appropriate chore list. When they are bored, have them pick a chore. This won’t be their favorite activity, but it will help you keep them occupied while getting housework done. Chores also teach responsibility, even though their standards are likely going to be a lot lower than yours.
  • Bless the mess. Most children are messy. Art is messy. Snacks are messy. Having them dance in the background of your work Zoom meeting is messy. As you watch the mess expand like the blob throughout the day, your frustration level will likely rise in accordance. Instead of yelling, ask your children to behave as if they were at school – would their teacher allow them to leave a mess? Learning to accept some degree of messiness is also key. You’ll need to find the balance that works for your home. Just remember to keep your expectations reasonable for your child’s age and development level.
  • Set boundaries (like no dancing during meetings), but remember kids aren’t always going to follow the rules. They don’t at school either. Talk with your pediatrician or look online for ways to keep them engaged so they have less of a chance to break the rules, and a discipline structure for when they do.

If you are still feeling overwhelmed and having difficulty coping with the new arrangements, schedule a session with a therapist here. Online psychiatrists are also available when needed for your convenience. We are here to help.

Daily Life and Coping with Coronavirus

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Life has drastically changed for all of us as a result of the outbreak of coronavirus disease 2019 (COVID-19). At times, all of these changes can result in overwhelming feelings of fear, anxiety, sadness, and also grief. Many of us have experienced many losses over these past four weeks – from the loss of our ability to see our loved ones whenever we wish and the loss of seeing our co-workers in person, to the loss of jobs and the loss of loved ones. Some of us are struggling with the fear of having to go to work at grocery stores, pharmacies, gas stations, hospitals, banks, post offices, etc etc. Those of us who are not essential workers might be struggling with feelings of guilt – of feeling like we’re not doing enough. For parents working from home, it can also be very difficult having to balance your own work responsibilities with your child’s/children’s teaching responsibilities. IT’S A LOT. We, at the ADHD, Mood, & Behavior Center, would like to provide our patients, and anyone else looking for some guidance at this difficult time, with some tips on how to cope with these feelings and how to differentiate between a normal stress response and a response that may require professional help. We are currently offering video appointments with our psychiatrists and therapists for our current patients, as well as anyone else who is looking to initiate care at this time. Please do not hesitate to reach out for help if you need it.

Ways for adults to cope:
• Make sure to take breaks from COVID-19 related news stories or social media stories.
• Try to maintain a daily schedule if your day is now significantly less structured. Have a consistent bedtime and waking time. Have well-balanced and regularly scheduled meals. Exercise regularly.
• Make time to relax and engage in activities you enjoy. Try to get some fresh air when you can, while maintaining social distancing practices.
• Try to maintain social connections using video chats and phone calls. There are many apps now that allow you to have group video chats with friends and family.
• Take space when you feel you need it. Sheltering in place could sometimes result in some of us feeling overstimulated by always having to be around those in our household. It’s important that we all take breaks and get space when we need it.
• Avoid unhelpful coping strategies, like substance use and high-risk behaviors.
• Seek out help from a professional if you are struggling.

Ways for parents to help their children cope:
• Limit the amount of television or news children watch as the news can be frightening and disturbing to them. Instead, find accurate and age-appropriate information and have an honest discussion with them using language they can understand. Answer any of their questions honestly.
• Try to maintain a regular routine, as children feel more secure when there is structure to their day.
• Help facilitate video chats and/or phone calls with their friends and family.
• Make sure children get some fresh air whenever they can, while maintaining social distancing practices. Try to implement some sort of daily physical activity.
• It can be very difficult for children to be stuck inside, especially when the weather is beginning to get nicer. Try to come up with fun activities for the family to engage in. Have game nights. Have children help in meal preparation or menu planning. Encourage them to learn a new skill. There are many free online classes available now.
• Give children choices when possible, as this will give them a sense of control during a time when there is little they can control.
• Give them space when they need it. Sheltering in place could sometimes result in some of us feeling overstimulated by always having to be around those in our household. It’s important that we all take a break and get space when we need it.

Common stress responses in adults:
• Changes in sleep or eating patterns
• Difficulty concentrating
• Changes in energy levels
• Avoidance of activities previously enjoyed

Common stress responses in children and teens:
• Excessive crying, irritability, or acting out
• Regressive behaviors or returning to behaviors they have outgrown such as bedwetting
• Changes in sleep or eating habits
• Poor school performance or avoidance of school related tasks
• Difficulty concentrating
• Avoidance of activities previously enjoyed

When to seek out help:
• If any of these responses persist for longer than 1-2 weeks and/or start to get in the way of an individual’s function, it is likely time to seek out professional help from a psychiatrist or therapist.
• If you or your child becomes preoccupied with or has intrusive thoughts or worries surrounding COVID-19 or death.

How to Talk to Your Child About Disasters & When to Seek Help

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Recent disasters, such as the wildfires in California, the Thousand Oaks shooting, and the shooting at a Pittsburgh Synagogue, can be very frightening for children.  Since children often see or hear about these events either through the different news outlets that are accessible to them or through their interactions outside the home, it can be helpful to talk about the event with them in language they can understand.

The following guidelines can be useful when having these conversations:

  • Try to set aside adequate time and a quiet space.
  • Use a tone that’s calm and language that’s not overwhelming.
  • Ask the child what he/she already knows and what questions he/she has.
  • Be honest as children are very aware of their parents’ concerns and know more than we think.
  • Talk about your worries as well as your abilities to keep your child safe.

In addition to having these conversations, it is also important to look for signs that your child might be struggling after a disaster.  There are different factors that can affect a child’s response to a disaster that can include:

  • The way they experience their parents’ response.
  • How close they are to the disaster/whether there was direct involvement
  • Whether they know anyone that was directly affected.
  • The child’s age.

Behavioral changes that might indicate your child is struggling and may benefit from being evaluated by a mental health professional include:

  • Acting out or misbehaving in school or at home that is atypical for the child.
  • Refusing to go to school or other places the child typically attended without a parent.
  • Fears that persist long after the disaster, jumpiness, nervousness, and a much heightened sensitivity or alertness to danger.
  • Avoidance of people, places, and things that remind the child of the incident.
  • Sleep disturbances or changes that were not occurring prior to the disaster, such as nightmares or bed-wetting.
  • Depressive symptoms that can include low or irritable mood, appetite changes, fatigue, withdrawal from friends and family, decreased interest in activities, feelings of hopelessness, and in some cases suicidal thoughts.
  • Physical symptoms in the absence of a physical injury or illness, such as headaches and stomachaches.

The Video Game Dilemma and the ADHD Child

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Do you sometimes wonder if your child is addicted to video games?  Is getting off or ending video game sessions often the cause of fights or meltdowns for your child?

In an increasingly digital world, children are spending more time in front of screens and parents are left  to negotiate the muddy waters of figuring out how much screen time/video game time is healthy for their child.  This can be particularly difficult for a child with ADHD as video games lend themselves to being ‘time sucks’ and can often distort a child’s temporal awareness.  Here are some tips for setting and maintaining healthy boundaries for video games and screen time.

  1. Communicate clearly with your child about the amount of screen time that is allowed

During a calm period of the day, sit down with your child and discuss your concerns about screen time and present your concerns.  Make sure to listen to your child and reflect their concerns.

  1. Consider the time of day when you agree to schedule gaming/screen time.

Scheduling screen time right before homework or bedtime can be a recipe for disaster especially for children who have very difficult moments detaching.  Try to involve your child in problem solving and ask for ideas of when you can best schedule screen time so that it is not disruptive when it must come to an end.  Be flexible.

  1. Always monitor and preview content before your child views it.

Some games and videos can have violence or sexual content that may be inappropriate or overwhelming for your child.  Always check the suggested ages and consider watching the video game first before you purchase or rent it for your child.

  1. Consider what your child is getting out of screen time.

Playing a video game or watching a youtube video may provide much needed zone out time for the ADHD brain.  Make sure to expose your child to a range of other activities that may also provide relaxation and self-soothing feelings such as yoga, meditation, music lessons etc.

  1. Practice what you preach.

Modeling is one of the most powerful tools of influence that parents possess.  Practice your own healthy boundaries with your cell phone and screen time.  Schedule regular family media -free times or zones, such as meal times, bedtime or family outings.

  1. Use Screen time to build on your child’s strengths

Not all screen time is unhealthy. There are amazing tools available that can help support learning.   Research some great new learning sites or games that support your child’s reading or math and spend some time with your child exploring their interest in art or science by checking out online museums.  Speak to your child’s teacher or the school librarian for recommendations.

 

 

ADHD: Myths vs. Reality

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Attention difficulties commonly occur in children and adults for various reasons. Sometimes they can be related to mood issues, motivational issues, environmental challenges or physical health issues. But, when there are significant and persistent difficulties, with a combination of inattention, overactivity, impulsivity, and distractibility that impairs functioning or development in multiple settings, this can be attributed to Attention Deficit Hyperactivity Disorder in children and/or adults.

Of children aged 4-17 years of age in the United States, 5.1 million or 8.8%, have a current diagnosis of ADHD, with boys (12.1%) more than twice as likely as girls (5.5%) to have ADHD. Approximately half of children with ADHD continue to have symptoms into adulthood, or 4.4% of adults overall.

The exact cause of the disorder is unknown but research shows that areas of the brain are affected and there is a family/genetic connection. The impact of the disorder includes lower academic performance, increased risk of injury, increased risk of traffic accidents, increased likelihood of smoking, poorer social function and lower self esteem. Treatment can reduce the symptoms of ADHD, but it does not completely eliminate the impact of these complications.

When it comes to ADHD, it’s important to separate the myths vs. the facts. Here are some important considerations to keep in mind when thinking about an evaluation, diagnosis and treatment.

Myth


Fact


“ADHD isn’t a real disorder”

  • It is a recognized medical condition
  • ADD = ADHD
  • Exact cause unknown
    • Multiple factors have been implicated in the development of ADHD – family history/genetics, certain environmental factors, problems with the central nervous system /an imbalance of chemical messengers, or neurotransmitters, within the brain.
  • Research has shown that certain brain regions don’t synchronize properly and overall brain architecture is different.

“ADHD is overdiagnosed”

  • Studies show that ADHD is underdiagnosed in minority populations
  • Awareness of the disorder has been growing since the 1990s when it became recognized under special education law as a condition that affects learning.

“ADHD only occurs in childhood”

  • The symptoms of ADHD can occur as early as the preschool years. The intensity of the behaviors and how they are affecting a preschooler’s life, development, self-esteem, and general functioning is considered.
  • Some children with ADHD continue to have symptoms during their teen years and about 50 out of 100 have symptoms into adulthood.
  • Symptoms in adults look different.
  • Hyperactivity tends to diminish
  • Inattentive symptoms become more troublesome
  • Sense of “inner restlessness”

“Children outgrow ADHD”

  • ADHD is a lifelong condition
  • Some children do outgrow their symptoms
  • Most children carry the disorder into adolescence and adulthood
  • Symptoms change as a child gets older and learns ways to manage them

“My child is just lazy or dumb or unmotivated”

  • ADHD has nothing to do with a person’s intellectual ability.
  • A child who finds it nearly impossible to stay focused in class, or to complete a lengthy task may try to “save face” by acting as though he/she does not want to do it or is too lazy to finish.
  • This behavior stems from real difficulty in functioning and possible frustration.
  • They simply work differently.

“My child is a handful or is a daydreamer – but that’s normal”

  • There are variations of “normal”
  • How much behaviors consistently impede a child and their ability to succeed at school, fit into family routines, follow household rules, maintain friendships, interact positively with family members, avoid injury or otherwise manage in his/her environment should be considered

“My child focuses on video games for hours. He/she cannot have ADHD”

  • ADHD poses problems with tasks that require focused attention over long periods of time, not so much for activities that are highly engaging or stimulating
  • Less or unstructured time can be difficult to manage
  • Social situations can also be problematic due to the constant, subtle exchange of social and emotional information

“ADHD is caused by poor parental discipline”

  • ADHD is not caused by bad parenting.
  • Parenting techniques can affect symptoms.
  • Try to stay positive
  • Establish structure and stick to it
  • Set clear expectations and rules
  • Encourage healthy lifestyles – eating, exercise, sleep
  • Teach how to make friends
  • Learn to anticipate potentially explosive situations
  • Be a good role model

“If after an evaluation, a child does not receive the ADHD diagnosis, he/she doesn’t need help”

  • ADHD is diagnosed on a continuum
  • A child may not always show symptoms of ADHD, especially in an unfamiliar setting
  • Monitoring symptoms and behaviors in multiple settings is critical
  • Counseling, home management tools, school behavior management recommendations, social skills interventions, and help with managing homework flow, organization and planning can be helpful

“All you need are medications to treat ADHD”

  • Medications often curb symptoms
    • They help children focus and be less hyperactive
  • Typically a combination of treatments are the most effective way to treat ADHD
    • Behavioral therapy
    • Notes/reminders to prevent self from forgetting tasks
    • Academic help

“Medicine for ADHD will make a person seem drugged”

  • Properly adjusted medicine for ADHD sharpens a person’s focus and increases his or her ability to control behavior
  • Sedation or personality changes are not side effects of the medication

“ADHD stimulant medication leads to addiction”

  • No evidence
  • Research has shown that people with ADHD who take medication tend to have lower rates of substance abuse than people with ADHD who don’t take the medication
  • A long-term study looked at childhood & early teen use of stimulants and early adulthood use of drugs/alcohol/nicotine in males with ADHD and showed no increase or decrease in substance use.

“Treatment for ADHD will cure it. The goal is to get off medication as soon as possible”

  • ADHD is a chronic condition that changes over time
  • Depending on the circumstances and demands as a person matures, the need for continuing medication or other treatments varies
  • TRUE GOAL = function well at stage of development in all environments

Children Who Can’t Pay Attention/ADHD

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Parents are distressed when they receive a note from school saying that their child won’t listen to the teacher or causes trouble in class. One possible reason for this kind of behavior is Attention Deficit/Hyperactivity Disorder (ADHD).

Even though the child with ADHD often wants to be a good student, the impulsive behavior and difficulty paying attention in class frequently interferes and causes problems. Teachers, parents, and friends know that the child is misbehaving or different but they may not be able to tell exactly what is wrong.

Any child may show inattention, distractibility, impulsivity, or hyperactivity at times, but the child with ADHD shows these symptoms and behaviors more frequently and severely than other children of the same age or developmental level. ADHD occurs in 3-5% of school age children. ADHD must begin before the age of seven and it can continue into adulthood. ADHD runs in families with about 25% of biological parents also having this medical condition.

A child with ADHD often shows some of the following:

  • trouble paying attention
  • inattention to details and makes careless mistakes
  • easily distracted
  • loses school supplies, forgets to turn in homework
  • trouble finishing class work and homework
  • trouble listening
  • trouble following multiple adult commands
  • blurts out answers
  • impatience
  • fidgets or squirms
  • leaves seat and runs about or climbs excessively
  • seems “on the go”
  • talks too much and has difficulty playing quietly
  • interrupts or intrudes on others

A child presenting with ADHD symptoms should have a comprehensive evaluation. Parents should ask their pediatrician or family physician to refer them to a child and adolescent psychiatrist, who can diagnose and treat this medical condition. A child with ADHD may also have other psychiatric disorders such as conduct disorder, anxiety disorder, depressive disorder, or bipolar disorder. These children may also have learning disabilities.

Without proper treatment, the child may fall behind in schoolwork, and friendships may suffer. The child experiences more failure than success and is criticized by teachers and family who do not recognize a health problem.

Research clearly demonstrates that medication can help improve attention, focus, goal directed behavior, and organizational skills. Medications most likely to be helpful include the stimulants (various methylphenidate and amphetamine preparations) and the non-stimulant, atomoxetine. Other medications such as guanfacine, clonidine, and some antidepressants may also be helpful.

Other treatment approaches may include cognitive-behavioral therapy, social skills training, parent education, and modifications to the child’s education program. Behavioral therapy can help a child control aggression, modulate social behavior, and be more productive. Cognitive therapy can help a child build self-esteem, reduce negative thoughts, and improve problem-solving skills. Parents can learn management skills such as issuing instructions one-step at a time rather than issuing multiple requests at once. Education modifications can address ADHD symptoms along with any coexisting learning disabilities.

A child who is diagnosed with ADHD and treated appropriately can have a productive and successful life.

Re-printed with Permission from American Academy of Child & Adolesccent Psychiatry