Holiday Help for the Hyperactive
In last week's SharePost, I discussed the different ADHD subtypes and wrote about the inattentive subtype and how the symptoms specific to those folks can make holiday festivities less than festive.
Today's SharePost focuses on the Combined Subtype of ADHD, which also happens to be the most common of the three subtypes.
The person with the combined subtype of ADHD has symptoms of inattention and six (or more) symptoms of hyperactivity-impulsivity which have persisted for at least six months.
So, in addition to the symptoms seen in Inattentive ADHD, which I described last week, the Combined Subtype of ADHD also includes the following symptoms, which are listed in the DSM (Diagnostic and Statistical Manual of Mental Disorders- a comprehensive classification of officially recognized psychiatric disorders, published by the American Psychiatric Association, for use by mental health professionals to ensure uniformity of diagnosis).
Note that not everyone with the combined type will have all of these symptoms, but they must have at least six in order to qualify for the diagnosis:
(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining seated is expected
(c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often "on the go" or often acts as if "driven by a motor"
(f) often talks excessively
(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
(i) often interrupts or intrudes on others (e.g., butts into conversations or games)
As in my last Share Post, I'm adding a list of more symptoms that I typically see when working with the adult or child with the combined subtype of ADHD. Keep in mind that the combined subtype also includes symptoms of inattentive ADHD.
Along with those listed above, I often see the following in this subtype:
- Poor social skills
- Gets involved in dangerous, risky behaviors, i.e. drugs, drinking, unprotected sex, multiple partners (and early sexual experiences).
- Addictive behaviors, such as gambling, shopping, pornography, eating.
- Drifts from job to job; has difficulty staying in relationships due to boredom.
- Difficulty staying connected emotionally.
- May seem self-centered; becomes bored easily and may not listen well.
...and much more.
Holiday time can create difficulties for many with the combined type of ADHD. Impulsivity can cause embarrassing moments. You may say or do things you later regret. Or perhaps you impulsively invite 50 people for dinner, not realizing the cost and effort involved.
Below are some tips to help the hyperactive/ impulsive ADHD adult or child get through the holiday season:
- Enlist your spouse/partner to help you make a list of what you need to do. Instead of jumping in and later regretting your impulsive choices, your mate can help you with the planning.
- Give yourself and/or your child plenty of physical outlets before embarking on social gatherings. Children can play outside in the snow before leaving for Grandma's house. Pushing furniture and other heavy objects indoors also helps to expel much hyperactive energy.
- For children, have a plan ahead of time for possible meltdowns or other behavioral problems. Discuss the plan with the entire family so that you can cue each other to leave (if necessary) before behaviors or problems escalate.
- Bring fidgets to keep hands busy. That often is enough to keep bodies calmed for a short while.
- Change your expectations. If you know you or your child cannot sit still for long, don't plan on an 8 hour car drive in holiday traffic. If necessary, keep your child home with a sitter; not as a punishment, but as an accommodation, knowing that he, let alone the rest of the family, might feel happier in the long run.
- Loosen up rules while tightening others. It's a fine art, raising children with ADHD. During the holidays and school breaks, most thrive on structure and should stick to, say, bedtime routines. On the other hand, it may also be wise to be flexible with other things, like allowing your child to eat in a different room where he won't become over-stimulated by all the holiday commotion.
- For holiday party planning, use timers and visual cues. If you become overwhelmed, ask for help! Guests love to help if they know HOW to help. If you get thrown off track because you can't cook and clean while guests are talking to you, ask that they socialize in another room; not the kitchen. Save clean up for after guests leave.
- Pace yourself. It's easy to get all wired up and to over-do and over-commit on things. Now is the time to refer to your planner, writing in chunks of down time so you don't become overwhelmed and exhausted during the busy holiday season.
- Find activities that help soothe you: warm bathes, meditation, listening to music, playing computer games, etc.
- Remember to slow down long enough to take in and reflect on the wonders of the holiday: being with friends and family, connecting, communicating and your spiritual, religious and/or meditative meaning of the holiday.