Daily Archives: July 23, 2017

Trying To Believe In Something Better

BELIEVEWell you all know how the job search has gotten me down.  No one in the security field will even contact me in response to my resume.  But, I can’t believe that these certifications mean nothing!  I have 25 years’ experience (lots of starts and stops, thank you Bipolar Disorder) but still I do have the experience in the IT field.  So, I thought, maybe I should shoot for an entry-level Systems Engineer job, because Systems Engineers become Security Engineers!  I mean, I have to be strategic here and play the long game.  So, today I have been applying for every single entry-level Systems Engineer job I can find.  Maybe I will have a better shot at getting a response.  I don’t know.  But I can’t just give up and go back to my old field.  I didn’t work so hard these past few months on these certifications just to go back to Desktop Support.  There HAS to be a way forward!!!!!

“Believe” is my faith word and it is what has gotten me through many a hard time.  Believe things can be better.  Believe you can get through this.  Believe you can rise above.  I have to Believe.  Bipolar Disorder doesn’t have me beaten.

P.S. – I put this “BELIEVE” sign in every room of my house to remind me 🙂

 


Filed under: Bipolar, Bipolar and Work, Bipolar Disorder, Mental Illness, Psychology, Psychology Shmyshmology Tagged: Bipolar, Bipolar Disorder, Blogging, Hope, Mental Health, Mental Illness, Psychology, Reader

Lawyers Hope to Do to Opioid Makers What They Did to Big Tobacco

Considering the rate of opioid addiction and the rising death toll, this is good, very good. Mr. Moore, who, as Mississippi’s attorney general in the 90’s sued big tobacco companies and won, is now going after drug companies who make opioid pain killers. My very good friend’s adopted son, at only 26 years of age, overdosed on prescription opioid laced street drugs. A tragedy of gargantuan proportions. How many times has that repeated itself with young people in this country. I live in a pretty upscale neighborhood in Louisville, yet they have opened up a suboxone clinic quite close to us due to the magnitude of the opioid addiction crisis. So this is good, very good! More power to you, Mr. Moore!

https://www.wsj.com/articles/lawyers-hope-to-do-to-opioid-makers-what-they-did-to-big-tobacco-1500830715?mod=e2fb

The legal front widening against makers of opioid painkillers has something in common with landmark tobacco litigation of the 1990s: attorney Mike Moore.

As Mississippi’s attorney general in 1994, Mr. Moore filed the first state lawsuit against tobacco companies, saying they harmed public-health systems by misrepresenting smoking’s dangers. He helped marshal the subsequent spate of state litigation and then the talks that led to a $246 billion settlement.

Now Mr. Moore is a private attorney encouraging states to sue pharmaceutical companies, alleging they helped spark an addiction crisis by misrepresenting the benefits and addiction risks of opioid painkillers.

Mr. Moore pressed Mississippi and Ohio to sue drugmakers and is helping them with the suits they have since filed. The affable 65-year-old is tapping coalition-building skills he honed in the tobacco litigation to urge other states to sue, too. Recently two additional states, Missouri and Oklahoma, filed suits.

“When he’s motivated, you don’t want to be on the other side,” said James Tierney, a former Maine attorney general who later worked with Mr. Moore during the tobacco wars.

Mr. Moore is among many tort lawyers flocking to help government bodies seek damages from makers of opioid painkillers. More than a dozen cities and counties are suing, in addition to the four states, assisted by outside attorneys who include Paul Hanly Jr. of Alton, Ill.-based Simmons Hanly Conroy LLC and Linda Singer and Joe Rice of Motley Rice LLC, based in Mount Pleasant, S.C.

Like Mr. Moore, Mr. Rice has strong ties to the tobacco litigation, having been outside counsel to two dozen states and a lead negotiator in the settlement talks. Mr. Rice said he expects attorneys helping with opioid litigation to stay in close touch with each other, just as in the tobacco suits. In many cases they stand to win up to 25% of settlements or judgments.

Government bodies’ use of outside lawyers to sue for damages is criticized by the suits’ targets and by some conservative voices in the legal profession, who say the states are improperly outsourcing law-enforcement powers to firms that have a profit motive.

In New Hampshire, where the state hired an outside law firm to help investigate opioid marketing and potentially pursue litigation, the targeted companies filed a court challenge to the firm’s involvement, saying the contingent-fee arrangement “tainted” the investigation. The state’s supreme court last month rejected that challenge, allowing the law firm to keep working.

Mr. Moore, right, then attorney general of Mississippi, testified before the Senate in 1997 about a settlement between a group of states and the tobacco industry.
Mr. Moore, right, then attorney general of Mississippi, testified before the Senate in 1997 about a settlement between a group of states and the tobacco industry. PHOTO: DOUGLAS GRAHAM/CONGRESSIONAL QUARTERLY/GETTY IMAGES

Attorneys general who use outside lawyers say a contingent-fee arrangement can help them pursue worthwhile litigation they haven’t the resources to mount alone. In most such arrangements, outside law firms bear the cost of the litigation and are paid only if it succeeds.

More than 300,000 Americans have died of opioid overdoses since the late 1990s, according to the Centers for Disease Control and Prevention. Many public-health officials maintain that aggressive pharmaceutical-company marketing and lax prescribing helped cause addiction that for many people progressed to heroin and other illicit drugs.

Deadly Problem

As prescriptions opioid sales have increased, so have opioid-related deaths.

Prescription opioid sales in the U.S.*

$10

billion

U.S. opioid-related deaths per 100,000†

*Wholesale revenues †includes illicit opioids such as heroin

Sources: QuintilesIMS (sales); Centers for Disease Control and Prevention (deaths)

Drug companies targeted by the state, city and country suits include Purdue Pharma L.P.,Johnson & Johnson , Teva Pharmaceutical Industries Ltd. , Allergan PLC and the Endo Health Solutions unit of Endo InternationalPLC.

Asked by the Journal about the suits, Johnson & Johnson and Purdue denied the allegations. Both companies, as well as Allergan and Teva, said they are committed to the appropriate use of opioids. Endo declined to comment.

Ten years ago an affiliate of Purdue Pharma called the Purdue Frederick Co. and three of its executives pleaded guilty in federal court to criminal charges of misleading the public about the addictive qualities of Purdue’s painkiller OxyContin. Purdue Frederick and the executives agreed to pay $634.5 million in government penalties and costs to settle civil litigation.

The Mike Moore Law Firm of Flowood, Miss., is one of six retained by Ohio to work on an opioid civil suit that state filed in May. The firms are entitled to 25% of any settlement or judgment up to $10 million and smaller shares of amounts above that, to a maximum fee of $50 million, according to their contract with the state.

Mr. Moore said he isn’t pursuing the opioid litigation as “a money grab.” He said he is spending a lot of time advising on cases in which he has no financial stake because he wants to share his expertise to bring about a resolution. A young relative’s struggles with addiction also motivated him, he said.

“I want there to be a huge amount of resources available for treatment, and I want the industry to change its practices,” he said.

There is money to be had. Opioid painkillers are a $9 billion-a-year market in the U.S., and pharmaceutical companies have earned many billions from their sale.

Mr. Moore has been crisscrossing the country to meet with what he calls a coalition of two dozen lawyers to coordinate arguments and work with government lawyers. He has been reaching out to some state attorneys general and fielding calls from others.

On a recent morning, he convened a meeting with five other lawyers in Grayton Beach, Fla., a quaint seaside town on the Gulf of Mexico where three of them live.

Mr. Moore, right center, met with other lawyers in Florida in June to discuss ways to help cities and states sue pharmaceutical companies for costs associated with the opioid epidemic.
Mr. Moore, right center, met with other lawyers in Florida in June to discuss ways to help cities and states sue pharmaceutical companies for costs associated with the opioid epidemic. PHOTO: BRYAN TARNOWSKI FOR THE WALL STREET JOURNAL

Gathered in one lawyer’s home, the group discussed the potential for painkiller suits in the state. “We’re not sure if the AG of Florida is going to file litigation,” Mr. Moore said. He encouraged the lawyers to think more broadly. “Miami should file a case. Orlando should file a case. Panama City should file a case,” he said.

Mr. Moore noted that Florida’s Republican attorney general, Pam Bondi, is on a commission formed by President Donald Trump to address the opioid crisis. Mr. Moore advised one lawyer present— Bo Rivard, who is active in the state Republican Party—to get in touch with Ms. Bondi to see if there were ways the commission could help work toward a settlement with drugmakers or ways the lawyers could help the commission.

“If you could talk with Pam Bondi about it, I’ll call Roy Cooper, ” Mr. Moore said, referring to North Carolina’s governor, who is also on the Trump commission.

Mr. Cooper’s spokesman said the governor did speak with Mr. Moore about “strategies to address the opioid crisis” but they didn’t discuss litigation. Ms. Bondi’s office didn’t respond to a request for comment.

During the Grayton Beach meeting, Mr. Moore’s phone rang. “Hmmm, Mobile, Alabama,” he said, glancing at the number, one he didn’t recognize. He answered anyway, eliciting chuckles. “Mike always answers his phone,” said JoJo Tann, who grew up playing baseball with Mr. Moore’s son.

The caller wanted advice on filing personal-injury suits on behalf of people who became addicted. Mr. Moore listened patiently and then said, “The other thing I’d look at is opioid-addicted babies. In your town, in Mobile, there are probably hundreds, and people really care about it.”

He added, “There are people I know of working on those cases and I’d be happy to connect you.”

During the tobacco years, Mr. Moore used to pepper other attorneys general with calls and visits to prod them to sue cigarette makers, said Grant Woods, an Arizonan who was the first Republican state attorney general to file such a suit. Now his firm, Grant Woods Law, is among the six helping Ohio with drug-firm litigation.

Scott Harshbarger, a former Democratic attorney general of Massachusetts, remembers Mr. Moore urging him to sue the tobacco industry. Once he did, he said, Mr. Moore pressed for a meeting—during Mr. Harshbarger’s vacation—to discuss initial signs of a settlement. Mr. Moore says he wore a suit and tie to it; Mr. Harshbarger wore shorts.

“Mike was a real pioneer—he was very convincing,” said Mr. Harshbarger, who is now at the Boston firm Casner & Edwards and isn’t involved in opioid litigation.

Mr. Moore had gained national attention in 1994 when, as the Democratic attorney general of Mississippi, he filed the first state suit against cigarette makers. He helped popularize states’ use of outside counsel, a practice whose critics included the Republican governor of his own state at the time, the late Kirk Fordice. Mr. Fordice called it a gravy train for lawyers.

Among outside lawyers Mr. Moore hired was a law-school classmate and friend of his, Richard Scruggs, who went on to represent 30 states against tobacco companies, earning his law firm fees Mr. Scruggs estimated at $1.2 billion.

Lawyer Richard Scruggs, on left in 1998, was hired by Mr. Moore to work on tobacco litigation.
Lawyer Richard Scruggs, on left in 1998, was hired by Mr. Moore to work on tobacco litigation. PHOTO:DOUGLAS GRAHAM/CONGRESSIONAL QUARTERLY/GETTY IMAGES

Mr. Scruggs, who a decade later was imprisoned for conspiring to bribe a judge in a matter unrelated to tobacco, said the tobacco litigation was a risky undertaking, as previous plaintiffs had had little luck suing the industry. It was “really high-risk but high-reward litigation,” he said.

Mississippi ultimately received a $4.1 billion settlement from the cigarette industry. Mr. Moore said he hadn’t agreed to let the outside lawyers have a share of any settlement, and they ended up being paid separately by the tobacco companies.

Mr. Moore left the attorney general post in 2004. He got involved in opioid-painkiller litigation soon after, he said, when Simmons Hanly Conroy hired him to help with its cases against OxyContin maker Purdue Pharma. The 5,000 Simmons Hanly clients said they had become addicted after taking the medicine as prescribed. They settled with Purdue for $75 million in 2007, according to the law firm, around the same time Purdue’s affiliate and the three executives pleaded guilty to criminal charges.

Mr. Moore said his experience with the law firm’s opioid cases prompted him to push Mississippi to consider litigation.

His successor as Mississippi attorney general, Jim Hood, remembers Mr. Moore bringing up the topic when they were at a law-enforcement conference in 2007. They listened to a talk addressing Rush Limbaugh’s painkiller addiction, which the conservative radio host had said he developed after taking the pills for pain following back surgery. Mr. Hood recalls Mr. Moore saying, “Man, this is just going to be a huge epidemic,” and suggesting the state consider litigation.

Mr. Hood said that at first he couldn’t understand how “you sue someone for something that is FDA-approved.” After talking to physicians, he said he became convinced drugmakers were soft-pedaling the addiction risk.

In December 2015 Mr. Hood filed a suit that was drafted largely by Davidson Bowie PLLC, a Flowood, Miss., law firm run by a friend of Mr. Moore, John Davidson. The law firm’s agreement with the state entitles the firm to fees similar to those in Ohio but with no maximum.

Mr. Moore is consulting on the case. He said he had no agreement specifying how he would be paid. It “doesn’t concern me,” he said.

Mr. Moore donated $13,500 to Hood campaigns between 2008 and 2016, state campaign-finance records show.

Mr. Moore sought to persuade other states to sue, including Ohio. There the attorney general is Mike DeWine, a former Republican senator Mr. Moore knew from the tobacco-litigation days.

Mr. Moore and Mr. Woods flew to Ohio to talk to him. According to Mr. Moore, Mr. DeWine said he would get in touch if and when he was ready to move. Ohio filed an opioid-maker lawsuit on May 31.

Mr. DeWine said opioid addiction has sparked a huge public-health crisis in Ohio. Drug companies “helped create the problem, they misled people, and they need to be part of the solution,” he said.

Mr. Moore described Ohio’s lawsuit as a “clarion call to others that it was safe to jump in the water—Republicans, everyone.”

At the meeting in Grayton Beach, he said he was considering ways to bring suits against pharmaceutical distributors, too. Some states and counties have already targeted them for allegedly failing to control painkiller distribution.

Earlier this year, two distributors, Cardinal Health and AmerisourceBergen , agreed to pay West Virginia a total of $36 million to settle the state’s litigation alleging they didn’t adequately control distribution of prescription drugs including painkillers. Cardinal Health denied the allegations. AmerisourceBergen said it was working to “support appropriate access to medications.”

Mr. Moore said he is in touch with addiction-treatment experts to find out what they need to extend treatment to more people. The model for a settlement, Mr. Moore said, “has got to be all the company officials, the treatment community, everyone sitting around a table.”

The tobacco settlement was hastened across the finish line in part because industry whistleblowers stepped forward to say companies weren’t being truthful about nicotine’s addictive nature. The deposition of one such person, former Brown & Williamson Tobacco Corp. research chief Jeffrey Wigand, helped bolster Mississippi’s case. Mr. Moore played himself in the 1999 tobacco-litigation movie “The Insider,” re-creating scenes where he shuttled Mr. Wigand to court.

Asked whether any whistleblowers have surfaced to aid the opioid cases, Mr. Moore was cryptic. “There are some marketers and advertisers who have been helpful to us,” he answered. “That’s enough said.”


Scientists Have Reversed Brain Damage in a 2-Year-Old Girl Who Drowned in a Swimming Pool

This is incredible, a little girl drowned. She was in the water for 15 minutes before her mother found her and started administering CPR. She had no heartbeat for 2 hours afterwards! And she “showed deep grey matter injury and cerebral atrophy with grey and white matter loss after the incident.”

After treatment with Oxygen and Hyperbaric Oxygen, the brain damage has been reversed, she is walking, smiling, she is herself again!

This is truly amazing! Oxygen! Also considering her young age and the ability of her brain to also heal on its own, I believe she will be as right as rain!

Amazing, and miraculous! Oxygen!

https://www.sciencealert.com/scientists-have-reversed-brain-damage-in-a-2-year-old-girl-who-drowned-in-a-swimming-pool

She was in the water for 15 minutes.

PETER DOCKRILL
19 JUL 2017

Researchers in the US have reported what they believe is a first-of-its-kind reversal of brain damage, after treating a drowned and resuscitated toddler with a combination of oxygen therapies.

The little girl, whose heart didn’t beat on her own for 2 hours after drowning, showed deep grey matter injury and cerebral atrophy with grey and white matter loss after the incident, and could no longer speak, walk, or respond to voices – but would uncontrollably squirm around and shake her head.

Amazingly, thanks to a course of oxygen treatments – including hyperbaric oxygen therapy (HBOT) – administered by a team from LSU Health New Orleans and the University of North Dakota, doctors were able to significantly reverse the brain damage experienced by the toddler.

“The startling regrowth of tissue in this case occurred because we were able to intervene early in a growing child, before long-term tissue degeneration,” says hyperbaric specialist Paul Harch from the LSU Health New Orleans School of Medicine.

The drowning occurred in February of last year, when two-year-old Eden Carlson slipped through a baby gate while her mother took a shower, then made it past a heavy door, before eventually falling into the family swimming pool.

She was in the water for 15 minutes before being discovered and had experienced cardiac arrest, and while her mother immediately began CPR, Eden wasn’t successfully resuscitated for 2 hours, being eventually revived by doctors at Washington Regional Medical Centre in Fayetteville, Arkansas.

After receiving critical care in hospital for 48 days, the little girl was discharged, but due to the extent of her brain injuries and their physical side effects, Harch proposed treatment with oxygen therapies in an attempt to “wake up” Eden’s damaged brain.

Hyperbaric oxygen therapy works by administering oxygen to a patient at an ambient pressure higher than atmospheric pressure, through the use of a sealed, pressurised chamber.

By doing this, the amount of oxygen in a patient’s blood supply is increased, which can restore normal levels of blood gases and repair damaged tissue.

In this case, Eden wasn’t located close enough to a hyperbaric oxygen therapy chamber, so the team began a bridging course of normobaric oxygen treatments – delivered at sea level pressure – at fifty-five days after the drowning.

The treatments, given for 45 minutes twice a day through a nasal cannula, saw Eden recover alertness and reduced her squirming, giving her back increased movement of her arms and hands.

She also regained part of her ability to eat orally, and could speak short sequences – and laugh.

About three weeks later, the researchers moved Eden and family to New Orleans, where she began a round of new treatments in a hyperbaric chamber.

After just 10 sessions, Eden’s mother observed that the toddler was back to “near normal, except for gross motor function”, and so the little girl began physical therapy in addition to the hyperbaric treatment.

Once 39 hyperbaric sessions were completed, Eden’s walking had improved, and her speech level was assessed to be now greater than it was at the time of the drowning. She demonstrated improvements on all neurological abnormality tests, and showed near normal motor function and cognition.

At the conclusion of the treatment, some 162 days after she drowned, MRI scans revealed that Eden still bore a mild residual injury to her brain, but had experienced a near-complete reversal of cortical and white matter atrophy.

The team studying her recovery say that to their knowledge, this kind of reversal is “unreported with any therapy”.

And while they don’t fully understand the exact breakdown of this amazing revival in Eden’s fortunes, it’s clear that normobaric and hyperbaric oxygen treatments combined to reduce inflammation and promote brain cell survival.

“Although it’s impossible to conclude from this single case if the sequential application of normobaric oxygen then HBOT would be more effective than HBOT alone, in the absence of HBOT therapy, short duration, repetitive normobaric oxygen therapy may be an option until HBOT is available,” Harch says.

“Such low-risk medical treatment may have a profound effect on recovery of function in similar patients who are neurologically devastated by drowning.”

The findings are reported in Medical Gas Research.


Good Things – A Bipolar Writing Challenge

The other day I was challenged to write about “a bipolar experience that was good/great and worth remembering.” I’ll give it a try.

Photobombed by a Lego dragon!

First, of course, there are good/great moments during spells of hypomania – a trip to DisneyWorld with friends (http://wp.me/p4e9Hv-2K) stands out in my mind. Despite my aversion to crowds and children, I found that I could have a good time at “The Happiest Place on Earth.” We swam, we dined, we rode, we visited, we watched fireworks, we laughed, we took pictures, we bought souvenirs. We avoided “It’s a Small World.” I won’t say I felt like a kid again, especially since my childhood was so eaten up by depression, but I enjoyed, romped, and was delighted on an adult level. With proper attention to self-care (food, rest), no anxiety attacks. We plan to go again, someday, maybe to the flower and garden exhibition.

Another time I had a significant insight was when my husband and I were cleaning out the garage. I found an old box of photos and other reminders of my college days. I started crying. I was thinking of all the bad experiences I had back then, from a rotten relationship, to time and opportunities wasted because of my disorder, to the year I took off when it all became too much.

My husband acknowledged that what I was saying was true, but added, “If you hadn’t been through that, you couldn’t have been as good a friend to Hal and Robbin and your other Prozac Pals.” It was the exactly right thing to say, and definitely worth remembering. It’s one of the reasons I started blogging – to use my sometimes calamitous experiences to understand and communicate with and maybe even help people in similar situations.

And blogging is a pleasure and an experience directly tied to my bipolar disorder. Writing every week about my illness and reading others’ comments have been a source of satisfaction, insight, and pride. I have another blog, but it provides nothing like the personal rewards of this one.

But most of all, bipolar disorder has caused me to realize that I married the right man. I’d say we have even grown closer in many ways because of my illness.

When we got married, I was undiagnosed, and my husband had some problems of his own. I was depressed, massively insure, with low self-esteem, and plenty of anxiety, just as you’d expect. There were plenty of times that we clashed and fought, just like any married couple. But we stayed together.

I had hideous depressions and devastating anxiety attacks. My husband held me, hugged me, asked if there was anything I needed, and if there was, made sure I got it.

Then came the big crash – a major depressive episode that flattened me, took away everything that was good in my life. Except Dan. He stayed with me.

When I couldn’t work, he paid the bills. When I couldn’t do housework, he cleaned and shopped and cooked. When I couldn’t bear to read, he didn’t complain about the mindless TV shows I watched. When I felt no sexual desire, he did without. He drove me to my psychiatrist appointments and picked up my meds at the pharmacy.

He still does a lot of that, even though I’m improving. Every day he proves he knows what it means to love someone “in sickness and in health.”

He’s not a saint. Sometimes he sits around in his underwear. He won’t use the GPS I got him for Christmas, even though he really needs it. He tells jokes that only an 11-year-old would find funny. He gets cranky when I won’t go somewhere with him.

But he cares for me, in both senses of the word. He demonstrates and teaches me patience, and tenderness, and understanding, which I try to give back to him. And I can’t think of anything better than that to have come from my bipolar disorder.

 

 

 

 

 


Filed under: Mental Health

Living well with bipolar disorder

Over three years ago when I first started blogging, I never shared my blog post on Facebook, I had not given a talk on mental illness and I was a ways from living well.  I was still angry I had been dealt the Bipolar card and I was struggling to accept myself.

I wanted desperately to feel apart of a community.  It meant something to me to be involved in helping other people.  I had a vision for what I wanted my life to look like, but getting there was a ways off.

Now, a month away from launching my book “Bipolar Disorder, My Biggest Competitor,” I can honestly say my vision has become a reality.  I feel free from all the baggage from the past.  I have learned to accept myself and all the things I am proud of and all the things I am not.  

I love helping other people learn about mental illness and I enjoy the mental health first aid classes I teach.  This week I’m teaching a group of principals.  I’m excited to continue shedding light on mental illness.

But what has changed for me in the past few months is that I now have a drive to also have some fun.  I realized more aspects of myself were coming to life.  I’ve been spending more time outdoors and really loving it.  Things have been coming together and I’ve felt blessed.

When I wrote that blog post three years ago about recovery-this is the life I had imagined.  I’m more than grateful I get to live the dream.  And excited to say recovery is possible and living well is a realistic dream.  

I love it when things work out the way I imagined they could.


ADHD Survival Guide: How I Stopped Procrastinating and Got My Sh!t Together

For much of my adult life, trying to get organized felt like a code I couldn’t crack, no matter how many fancy planners I bought. I struggled to do work that I knew I was capable of, missed appointments and blew deadlines, and my self-esteem plummeted as I wondered, “Am I just really bad at being an adult?

I fell into a serious slump. Just the idea of having to get something done made me anxious, making it even more difficult to focus, and that anxiety fueled my procrastination. After years of struggling with depression and lack of concentration, I was finally diagnosed with ADHD. But rather than looking for solutions, I initially took that diagnosis to mean, “I’m never going to be effective and productive like everyone else.”

ADHD, for me, has been a frantic, real life Tetris game. Desperately trying to get everything to fit together, watching your tasks stack up until it starts to feel out of control. Take your eyes off the prize for one minute, and suddenly, the whole thing comes undone. I had the responsibilities and challenges of a twenty-five-year-old, but the focus, patience, and concentration of someone twenty years younger.

The frustrating thing is, I knew I was smart. I knew that I was capable of so much more. But I kept coming up against a wall, and no matter what I did to try to scale it, I was never able to get to the other side. Knowing that you’ve got potential, but being thwarted in every attempt to realize it, is its own kind of hell. ADHD, for me, has been a slow burn in that personal hell for as long as I can remember.

I finally hit a breaking point last year, when my life became so unmanageable, I stopped working. My fear of failure, my lack of concentration, and my anxiety had made it nearly impossible to be effective at any job — even jobs that, by all accounts, I was more than qualified to do. At every moment, I was overwhelmed to the point of paralysis. That’s when I knew: I didn’t want to live like this anymore.

So I started researching and reflecting. I compiled a list of all the things that stressed me out and brainstormed possible solutions. I was methodical and determined. I focused on apps in particular, seeing as I spend so much time on my phone. I figured, if boring dudes in suits can use these apps, why can’t I use them to make my work and my life more accessible to me?

First, I had to rethink ‘productivity.’

Instead of looking at these strategies as a way to become more “productive” in a capitalistic society, I reframed it — my new objective was to become more effective in accomplishing whatever goals I set for myself, however small they might be.

From all my research, it quickly became evident that ADHD thrives on a lack of structure. This article, then, is a guide that talks about how I created a sort of structure in my life that helps me to become more effective.  

“Structure,” meaning a system of organization that helps me both set and meet my goals. And “effective,” meaning that whatever I put in place is helping me to reach the goals that I set — based on whatever standard makes sense to me. Society often defines “productivity” as completing as many tasks as possible; I define “productivity” as creating the circumstances (and structures) that allow you to be effective and balanced as you do the work.

I think reframing these words can be really helpful for folks with ADHD. Rather than creating structures that serve the work (i.e. I have to work quickly to please my boss), it’s better to create structures that serve us (i.e. I want to feel effective and meet my personal goals). Paradoxically, when we set goals that serve us rather than the work, we’re usually better at getting the work done anyway. Who would’ve thought? ¯\_(ツ)_/¯

So this is a really, really long guide…

As someone with concentration issues, I get that lengthy articles are intimidating. That in mind, I highly suggest bookmarking this, and tackling these suggestions on a timetable that makes sense for you! I’ve also broken the piece down with headings and formatting that will help make it more readable.

Lastly, this guide was made possible with donations via Patreon! None of the products or apps I mention here have sponsored this post in any way — which means it’s 100% paid for by my readers, rather than by the companies that developed these apps. With your help, I was able to take the time to thoroughly research everything that you see here, and write it in a way that’s (hopefully) very useful to you. If you appreciate the work I’ve done here, please consider becoming a patron so I can keep creating content like this!

If you’re struggling with ADD/ADHD, I want you to know that it’s not impossible to create the kind of external structure you need to be effective in your life. I’m going to share with you the steps I’ve taken — including every single app that helped me get there — that’s made a significant difference in my life, with the hopes of inspiring you to take some steps of your own.

Ready? Let’s do it!

1. I Created a Project Management System (I’m a Nerd, I Know…)

I think most adults — not just folks with ADHD — know the feeling of juggling a million things at once, hoping that you won’t end up dropping the ball. Without a real system, I held a lot of my to-do list in my head, and this created a lot of unnecessary stress; it practically guaranteed that I was going to mess something up (and I often did, yikes).

And then one day, I got super fed up. I reached out to my friends with ADHD, and I asked them what apps or systems they use to keep all their tasks straight. And one really stood out to me: Todoist.

Friends described this app as having a “second brain,” which was exactly what I needed. I needed another brain to hold all my various tasks, projects, and events in one place. So I downloaded the free app and browser extension, read practically everything I could on the Todoist blog, and started creating a system that worked for me.

Todoist, in a nutshell, is a productivity app that manages tasks for you. It has a priority feature that lets me flag which tasks are most important, a scheduler that gives tasks a due date (static or recurring), projects that can hold different types of tasks, and all sorts of ways to customize it to suit whatever my needs are.

How did I organize my Todoist system?

I customized a system that could manage basically… every aspect of my life. Because I clearly have a lot going on.

I have a Self-Care tab to make sure I’m prioritizing mental health, including seeing friends. I have a Work project, which includes pitch ideas (articles I eventually want to write), Events & Interviews, Waiting/In Progress (this is where I keep track of what articles are currently in progress), and Consulting (I coach people sometimes, this is where I list the clients I’m currently working with!).

I have my Adulting tab, where I schedule any of my appointments and errands that I need to do. I also have a housework and bills section that I share with my partner, and a Daydreams tab, where I list out things that I want to eventually buy and a bucket list of things I want to do. And lastly, I have a Personal Brand section, where I manage anything related to my blog and social media.

My system literally holds every freakin’ part of my life, which works really well for me. But everyone can decide how to use it best for their own needs. I have a chronically ill friend that organizes it by “spoons” which I think is really interesting (a project for things that take a lot of energy, a medium amount of energy, and low amount of energy, and based on how she feels when she wakes up, she’ll decide how many spoons to use from each project).

Don’t be afraid to customize it!

The cool thing about Todoist is that they have templates you can download and try, if you aren’t really sure how to organize it. And Todoist has a really awesome blog, including an article about someone who uses Todoist and has ADHD!

The ultimate goal of creating a system like this is to build up a structure that helps you organize the tasks floating around in your brain. Folks with ADHD often don’t have the internal organizing they need, so it’s helpful to create that externally. There are other systems available for this too (like Asana and Trello), but Todoist has been my favorite by far.

What I love about Todoist in particular is that it has a “smart scheduling” feature, in which it recommends what day to schedule something on based on your productivity habits, how busy your week looks, and the research the platform has done. I know that I’m not always the best judge of when I should set a due date, so this feature has been life-saving in teaching me to set more realistic goals for myself.

The key here is to read these blogs, try out different systems, and see what works best for you. It takes a little bit of work upfront, but it’s been totally worth it for me. Two brains are definitely better than one.

2. I Tackled the Nightmare That Was My Email Inbox

One of my biggest sources of stress was my email inbox. I had over 7000 unread emails, and thousands upon thousands of emails that I’d never got around to archiving… going years back.

I kept telling myself, “Maybe I need to set aside a weekend to go through and take care of it.” Dreading the hours that I’d spend archiving and digging myself out of that very deep hole, I eventually conceded that I may never have that coveted Inbox Zero.

The theory behind “Inbox Zero” suggests that because people are using their email inboxes as a to-do list, their inboxes become unmanageable, and it’s easy to get sucked into them and waste time. But once I created an actual system to hold my tasks with Todoist, I realized I was in the best possible position to clear out my email inbox and start using it as the communication channel it’s intended to be.

How did I get to Inbox Zero?

That’s when I discovered the app Chuck. Chuck is designed to help you get to Inbox Zero by automatically sorting your emails and helping you to mass archive them as necessary. And it’s no joke, friends: In less than an hour, I had archived over 100,000 messages.

Chuck can sort your emails by person, by time, or by subject. In my case, I started out by sorting it by time, which allowed me to mass archive any emails that I received prior to 2017. Boom. Thousands upon thousands of emails, all archived at once. I then organized it by sender, and archived any emails that were sent to me by folks I no longer needed to be in contact with (newsletters included).

How did I keep my inbox clean afterward?

Once my inbox was mostly cleared out, I downloaded an app called Spark to help keep my inbox manageable for the future and clean up what remained. It’s a “smart” inbox that organizes your mail for you, floating the most essential emails to the top of your inbox and then categorically sorting the rest. With an ADHD brain, it can be easy to get distracted by the stuff that’s less important, so it’s amazing to have a system that organizes things for you.

In the process, I started creating folders in my gmail, so that, as I found emails that I needed to save, I had a place to put them! This included things like “finances,” “freelance,” and “job hunt” (for saving contracts, correspondences with editors, and job opportunities respectively). Spark also allows me to “snooze” emails so that they are resent to my inbox after a certain amount of time — lifesaving for emails you know you need to get to, but aren’t immediately critical.

Taking control of my inbox was a huge weight off of my shoulders. I no longer dread signing into my email, knowing that there’s only a few emails in there, and they’ll be sorted quickly and effectively. It’s an awesome feeling.

(If you have Android, Chuck and Spark aren’t available to you — but you can always research these inbox zero apps to find one that is best for you!)

3. I Started a Productivity Diary (Let Me Show You How!)

One thing that came up continually in my research on productivity is the importance of being self-aware as you set goals and to celebrate your victories. A lot of people talked about bullet journals being super great for this, but I much prefer to have something I can just keep on my phone.

griddiaryGrid Diary became my saving grace for this. Grid Diary is almost like a quiz colliding with a journal. It offers you prompts to answer, a mood tracker, and a weather tracker as well (to help you remember the day a little better).

I specifically tailored mine to give me four questions that I answer at the start of my day, and four questions that I answer at the end of my day.

In the morning, I ask myself:

  • What’s the plan for today? What do I hope to accomplish? I usually write about three goals, and then I hop over to my Todoist app to add them and prioritize them.
  • What are some strategies I can use to be effective today? This encourages me to reflect on how I’m actually going to get shit done. This helps me feel more motivated to get started.
  • What’s one way I can support my mental health today? To make sure I stay balanced, I set a self-care intention right at the beginning of my day.
  • What’s one thing I’m excited about? This gives me something to look forward to!

At the end of the day, I ask myself:

  • How did my day go? How is my mood? Reflecting on my day encourages me to celebrate my successes and reflect. Naming my mood helps me keep track of my mental health, and keep an eye out for any red flags I might need to address (useful especially because I deal with depression and anxiety).
  • Name 3 things that I’m grateful for. There’s a lot of research that backs up the value of a gratitude practice!
  • Am I worried about anything? Let’s make a list. Sometimes we have so many anxieties floating around in our head, it can keep us up at night. One strategy for combating this is to make a list of what’s bothering us, and if necessary, commit to revisiting it the next day when we’re able to act.
  • What are some goals I have for tomorrow? Instead of staying up all night thinking about what I need to do tomorrow, I find it best to write it down and look at it again in the morning.

When starting up a productivity diary, it’s good to assess what you hope to get out of it. For me, I wanted to work on goal-setting, self-care, gratitude, and stress management. I knew that focusing on these things would help me with my overarching goals of becoming more focused and effective.

I’ve shared my questions here because I think they’re really useful prompts! You can choose to write it out or find a diary app to help you keep track of it. Grid Diary is my absolute favorite (so much so that I eventually caved and bought the premium/paid version) because the interface is so lovely, but you really can’t go wrong. The point is to get writing!

4. I Got a Pomodoro Timer And I Actually Use It

The “Pomodoro Technique” is all the rage — many of my friends with ADHD insisted that I try it, but I was initially reluctant. The idea is breaking up your work day into intervals (usually 25 minutes of focused work, followed by a short break, repeated four times until you then take a longer break).

I finally caved and downloaded Tide. Tide is multipurpose — it’s a timer that helps you measure your pomodoros and your break time, AND it’s a white noise generator that gives you different background sounds to choose from to boost your focus. It also keeps track of how often you use it and for how long, which can be really motivating!

One of my biggest pitfalls in my work was not having structured break time, which led me to become super distracted and waste a lot of time. But since pomodoros are essentially “work sprints,” it was much more effective (not to mention, easier) to commit to working for 25 minutes, knowing that there would be a break at the end of it.

Did it work? (Spoiler alert: Beautifully.)

And I was… blown away… with how tweaking my workflow with this app helped me focus and get more done. It also allows you to customize how much time you spend working and breaking, so if pomodoros aren’t your thing, you can experiment with the timing to find what works for you.

Most people will tell you that the hardest part of getting work done is the “getting started” part. I found that committing to 25 minutes was a lot less daunting than telling myself to just sit down and work until five (to someone with ADHD, it’s pretty impossible when you think about it).

There are a lot of different timer apps out there, so don’t hesitate to Google around and see what you find!

5. I Downloaded Every Guided Meditation App On Earth, Basically

The idea of sitting still and not doing anything sounded awful to me. But lots of folks I knew raved about how meditation had helped them, blah blah blah — even if that meditation was just five minutes when they first woke up. Apparently, the research backs this up, too: Meditation is proven to increase mental focus. Hm. Intriguing.

But as someone whose mind is moving a thousand miles a minute, sitting in silence was a no-go for me. So I was really excited to discover that there are actually some guided meditation apps, many of which have specific meditations geared towards boosting productivity and focus! Sitting and listening to someone walk me through a meditation was much easier to swing with my ADHD brain than the alternative.

One of my favorites for this purpose is Headspace (bonus: on their blog, they have an excellent article on ADHD and mindfulness, if you’re curious). I’ve also really enjoyed using Simple Habit (which has different meditations based on different life situations, including work stress, boosting focus, and improving sleep).

I’ve already noticed that my ADHD is more manageable when I set aside the time to meditate, especially when I’m feeling overwhelmed or wired. It might seem counter-intuitive, but it’s definitely worth a try.

6. I Started Scheduling a Planning Hour

With ADHD, planning ahead is not my natural impulse. I’m the sort of person who always had a cloud of chaos swirling around them. But every Friday afternoon, I set aside half an hour (sometimes more, sometimes less) to open up my Todoist app, look at my next seven days, and plan out what I need to get done and how I’m going to do it.

Doing this accomplishes two things for me. Firstly, it ensures I’m not wide awake Sunday night, worrying about the week ahead. And secondly, it forces me to slow down and consider what’s on my plate. My tendency is to avoid, avoid, avoid — because thinking about everything I have to do makes me anxious. But the only real way to address that anxiety is to tackle my schedule head-on, so I create a dedicated time to do so every week.

In this planning hour, these are the things I try to get done:

  • Go through my email inbox (see #2 if the thought of this freaks you out!) and grab any lingering “tasks” and plug them into Todoist (or whatever task system you have set up — remember, your email inbox shouldn’t also be your to-do list!).
  • While I’m in my inbox, I choose any emails that need to be responded to that I can’t or shouldn’t reply to immediately, and I “snooze” them to be resent to me at a more appropriate time. (For example: If I need to touch base with someone about an event in two weeks, I “snooze” that email so that it comes back to me in two weeks.)
  • I look at my tasks for the next week and flag which ones are high priority. I schedule them accordingly. (For example: There should never be a day with more than three high priority tasks — if there is, I know I have to reschedule or delegate.)
  • For every high priority task, I schedule one small step I can take to get started (more on this in #7).

My planning hour isn’t about creating the exact schedule that I’ll follow. No doubt, it’ll change throughout the week as new things come up! The point is to get organized and make your Monday morning less of a headache. Being overwhelmed is the arch nemesis of ADHD and of procrastination generally, so this helps minimize that as much as possible.

7. I Took Up Eating Frogs and Elephants

Of all the advice I found, the cheesiest bits of advice also seemed to hold most true. I wanted to include it in this guide because as cliche as it is, it’s been very helpful to me.

“Sometimes you’ve got to just eat the frog first.”

The idea of eating the frog is basically starting with the task that you’re dreading most, and getting it out of the way at the start of your day. Sometimes you have to hold your nose and just do it. There’s an entire article here on why it’s such an effective way to get stuff done, which I found incredibly helpful.

The basic theory is that we procrastinate most often when we’re dreading something (it’s an avoidance behavior, after all) — but if we can eliminate the thing that we’re most anxious about, we’ll have a big victory at the start of our day, and less anxiety to fuel our avoidance. We’re also less likely to get pulled into other projects and distractions that would delay us further if we do it first.

Having trouble motivating yourself to start? That’s why you need to…

“Eat the elephant one bite at a time.”

I honestly don’t know why both of these sayings involve eating critters, but ANYWAY. Eating the elephant one bite at a time is another way of saying, “To tackle something big, you have to start small.” You may have also heard this as “one step at a time,” which is the same idea, more or less.

There are two tried and true methods to eating the elephant, which are:

  • Commit to just five minutes. It helps to remember that motivation sometimes comes AFTER you start something, not before. Set a timer for five minutes. You don’t need to do any more than that if you don’t want to, but getting started is often the more difficult part, and that motivation you need to continue often kicks in after you’ve started.
  • Start with the smallest possible bite. It can be hard to start something if the task in front of us is just too daunting. If that’s the case, break it down! For example, “write an entire ADHD survival guide” is a huuuge undertaking… but “download a to-do app” is not. If your tasks aren’t “bite-size,” this could be adding stress that you don’t really need.

For folks with ADHD especially, making our tasks smaller and more manageable allows us to accumulate little “victories” that keep us on track, rather than allowing us to become overwhelmed and unfocused. This advice, while it seems really simple, takes a lot of practice — but it can make a huge difference.

 8. I Started Procrastinating ‘Productively’

We always procrastinate for a reason. Unstuck, which includes a free web-based app (bookmark it, seriously!), helps us figure out where we’re stuck and what we can do about it. And it’s basically the best thing ever.

You tell Unstuck what you’re feeling, and the app will guide you through some problem-solving exercises and prompts. Whenever I found myself stressed and not knowing what to do, I opted for procrastinating “productively” — meaning that I used tools like Unstuck to step back from the work, rather than away from the work.

Screenshot 2017-07-22 at 4.00.10 PM

Unstuck is designed to help you “fight procrastination, stop negative thinking, boost productivity, and get more creative.” The whole idea is that every “stuck” moment is an opportunity to get creative and do some effective problem-solving. And the whole interface is kind of fun, so it never feels tedious. It’s a great approach to thinking through whatever emotions and issues might be coming up for you when you lose your focus or motivation.

9. I Started Reading ADHD & Productivity Blogs

My favorites include ADDitude Mag and Todoist Blog. Productivity blogs sometimes fall into the more traditional, capitalistic ideas of what productivity is (here’s what “successful” people do, you peasant!), but the key here is to take what’s useful to you and leave the rest.

Trying new apps and learning new tricks has been a particularly fun part of this journey for me, so much so that “productivity” has become something of a geeky hobby for me! Figuring out how my brain works has been exciting, and crowdsourcing that knowledge with other geeky people? Even better.

leslie

(Oh god, It’s really happening… I’m turning into Leslie Knope…)

10. I Assembled An Awesome Support Team

ADD/ADHD is not a battle I’d recommend that anyone take on alone. To finish off this resource, I wanted to offer some suggestions on folks that you could consider bringing onto your “team” to help you meet your goals!

  • Pomodoro Buddy: We talked about pomodoros at #4 on this list. One way to boost the efficacy of your pomodoros is to find a pomodoro buddy — someone that you can text or message during your break time to share what you’ve accomplished, cheer each other on, and brainstorm next steps with! The lovely Elizabeth Cooper first introduced me to this idea, and it’s great for those of us who find we work best with a little encouragement and accountability.
  • Therapist or Life Coach: Enlisting the help of a trained professional to support you in this process is never a bad idea. While this guide can be a great starting place, a therapist or life coach that’s familiar with your particular circumstances can help craft a system and schedule that’s unique to you.
  • Psychiatrist: Getting a diagnosis of ADD/ADHD can be crucial, especially since a lack of mental focus can be attributed to so many different mental health issues. Knowledge is power! Medication can also be a useful tool for folks struggling with concentration (this includes folks with ADD/ADHD, but also issues like anxiety and depression as well). I personally take an antidepressant called Wellbutrin, which addresses both my depression and my ADHD, but there are lots of options that a clinician can help you sort through.

So listen…

This world? It’s not exactly made for people with ADHD. I learned pretty early on that if I didn’t start creating a system that worked for me, I’d never be able to hold down a job or feel balanced in my life. Nonstop anxiety, procrastination, and stress used to be the norm for me. And for many people with ADHD, that’s all they’ve ever known.

That’s why I’m a big fan of taking these tools and reclaiming them for neurodiverse folks like us: I want us to lead more effective lives, adapt to jobs that are otherwise not accessible to us, and achieve our personal goals.

And while these tools weren’t necessarily made with us in mind, we can use them to get back in the driver’s seat of our lives. I hope this has given you a place to start. Because honestly? My only regret is that I didn’t realize sooner that my life didn’t have to be so hard.

signature

HEY, YOU! PLEASE CONSIDER DONATING AS LITTLE AS $1 PER MONTH TO MY PATREON CAMPAIGN TO HELP FUND MORE FREE RESOURCES LIKE THESE, AND ACCESS EXCLUSIVE CONTENT WHEN YOU DO!