One things we know about parenting is that while it can be incredibly rewarding at times, at other times it can be extremely challenging. Then you throw in a little attention deficit and hyperactivity with the kids or parents and life gets interesting. Mark Bertin, MD is a board certified developmental pediatrician and respected mindfulness teacher whose latest book is Mindful Parenting for ADHD: A Guide to Cultivating Calm, Reducing Stress, and Helping Children Thrive. Today he is with us to talk about the unique challenges of parenting a child with ADHD, why we’re seeing more ADHD in our culture and a few specific techniques a parent can take home with them today to help themselves and their kids.
Elisha: What are the unique challenges of parenting a child who has ADHD?
Mark: Being a parent is, of course, frequently stressful and full of uncertainty. As a developmental disorder that affects not just attention but life management skills in general, ADHD amps up that experience. When you have a child several years behind in organizing, planning and self-management in general, that can affect everything from morning and bedtime routines to social and academic success. That’s hard for a child, and their parents too.
The challenge around ADHD becomes this: ADHD creates stress by making daily life harder. Too much stress makes us tired, burned out and less resilient. It makes flexible problem solving and communication harder. Which means, living with ADHD makes it harder to manage ADHD.
For any family, a significant step around ADHD is getting a handle on stress. It’s hard to start new routines, manage homework, make tough choices, and support a child who really does need more support than peers. When more grounded, you’ll see things clearer, and stick easier to all the things you want to do.
That’s where mindfulness comes in. Mindfulness isn’t a quick fix, but directly supports almost all of ADHD. It starts with stress management, getting out of that flooded, fight-or-flight driven cycle. It also mixes with behavioral management for ADHD – the ability to pause, refocus, and catch a child being successful is harder than it seems without practice. So is sticking to limits and routines, if we’re too stressed and distracted ourselves.
Elisha: How do we change ingrained parenting styles that aren’t working?
Mark: One of the under-discussed parts of parenting in general, and certainly around ADHD, is how hard it is to change habits. We have ways of thinking and of doing things that begin in childhood. That even includes the fact that, for parents, children influence parenting style. In fact, ADHD tends to push parents away from the exact parenting approaches that best address ADHD.
Our habits become ingrained. They seem fixed, like who we are. There are actually things about ourselves that are more hard wired, but many habits, if we become aware of them in the first place, can change with effort. And a lot of how we handle behavioral issues, school, conversation – much of ADHD care itself – relies on habit and routine.
When a parent starts working with someone around ADHD, they on some level may be advising “yesterday you handled ADHD this way, tomorrow try it this way.” It might be a new behavioral plan, or homework schedule, or thinking differently about some aspect of ADHD. Whatever you’ve done before, now you’re going to try something new. That’s easier said than done. It’s another habit to change. And that’s another place mindfulness so uniquely supports ADHD care.
When we’re more aware, paying more attention, we notice habits. From there, we practice pausing and making more intentional choices. Which may mean changing how we handle ADHD itself – or even ideas we have about ADHD, behavior or motivation.
Elisha: There are so many things pulling our attention these days, is ADHD a product of being too busy in the modern world?
Mark: ADHD has nothing to do with culture. It has been described for at least a century, and the incidence is similar around the world, in spite of books and articles that suggest otherwise. The rate of diagnosis varies, for lots of reasons (sometimes too high and sometimes too low), but that’s not the actual rate. The modern world may seem crazy and causes lots of distraction – but if you have adequate executive function, you feel harried, but you do fine. With ADHD, it becomes a struggle.
ADHD is a specific medical disorder of executive function, mental skills used to coordinate and manage our lives. It potentially affects pretty much anything that requires that type of management. Untreated ADHD has been shown to get in the way of academics, social development, safe driving, healthy sleep and far more. It can be exacerbated by culture or lifestyle, but never caused by it.
Elisha: Kids with ADHD are quick to be pathologized, what are some of the positive aspects of a child with ADHD?
Mark: For anyone struggling anywhere in life, we need to value, identify, and build on strengths. And it’s an interesting and common idea to ask if ADHD itself has positive aspects. But while theories suggest ADHD might have benefits, research hasn’t much backed them up. Someone with ADHD always has strengths, but not because of their ADHD. Tying the ideas together sometimes causes people to avoid seeking support at all.
You can’t be diagnosed with ADHD unless your symptoms impact your life for the worse. For example, creative people with ADHD frequently struggle with being productive. They may have dozens of partially started projects and nothing finished. Taking care of ADHD allows them to be creative, but to finish what they start.
To quote ADHD researcher Dr. Russell Barkley, ADHD isn’t a disorder of not knowing what to do, it’s a disorder of not doing what you know. That’s a tough way to live. You know what you want to do, and don’t get there often enough.
Any child has many, many positive traits. ADHD may mask them with lots of unintentional misbehavior, for example, or academic struggles mislabeled as poor motivation instead of reflections of poor executive function. It wouldn’t be described as a ‘disorder’ if it didn’t cause such intense problems. While we should always emphasize and develop strengths, we need to emphasize and manage the impact of ADHD too.
Elisha: In your book, you write about the toll ADHD can take on a parent. What are a few specific techniques that parents can apply right now to support themselves?
Mark: For any caretaker, you have to take time to care for yourself. Otherwise, the impact of stress, burn out and exhaustion impact the people you’re trying to care for. That’s particularly vital around ADHD, because parenting ADHD has been linked to anxiety, depression, marital strife and more.
Part of the solution is committing to whatever keeps you sane. That’s simple to say, not so simple to do, since demands pull you away from your plans. But prioritize something that gives you strength and hold on as well as you can.
Make sure you schedule time for a hobby or similar outlet. Find time for friends, and for your romantic partner. Schedule fun time with your kids. In the craziness of it all, stay in touch with something that makes you feel more at your best. And then, practice mindfulness. Mindfulness builds traits that help make managing life easier. It can be many things to many people, analogous to physical fitness. Taking a few minutes for a consistent formal practice of mindfulness helps with stress just like going to the gym helps you stay fit outside the gym.
More informal mindfulness makes a huge impact too. Left on its own, stress and chaos ramp up all day long. It’s draining. Pausing for a minute or two observing fifteen breaths, attending as best as you can to the sensation of breathing – instead of all the chaotic stuff going on in and around you – can be a great way to let things settle for a moment. And then, it’s important to recognizing the insidious and broad impact of ADHD. ADHD is not specifically a school problem. If you realize the morning routine, and bedtime, and fighting over screen time, and play dates and more are far too intense specifically because of ADHD, that’s where solutions start. Partnering with a professional who really understands ADHD, and who provides practical solutions for managing all of it, definitely reduces stress too.
Elisha: If you were sitting across the table from a parent who had a child with ADHD, what words of wisdom might you share with them?
Mark: The starting point for ADHD is a practical understanding of what it means to have a developmental delay in executive function. You don’t have to be a scientist, just a concerned parent. It’s related to mindfulness – seeing things as they are.
If someone can’t keep track of their school work, or misbehaves, it’s both frustrating and probably anxiety-provoking. But it also isn’t exactly their fault. They may require discipline, they still have to work hard, but they can’t overcome their ADHD through effort alone.
Knowing what to do starts with seeing how these situations relate to specific, executive-function based skills. So your brilliant twelve-year-old has the management skills of a seven-year-old. Or your fifteen-year-old cannot attend to what you are saying while he watches TV, so it feels like you are being ignored. That’s executive function.
Neither child is lazy or not caring, in spite of how it might look, they just don’t know how to take care of things otherwise. The solution is a non-judgmental approach towards catching up. Realizing that executive function impacts not only attention but organization, remembering, planning, prioritizing, time management and more.
But more important than all that is this: Children with ADHD should thrive with the right supports. When you understand the cause of ADHD, you find solutions.
Elisha: Thank you so much Mark for all you sage wisdom, may this be a great support to many parents.