In people with attention deficit hyperactivity disorder (ADHD), being impulsive is often one of the more challenging symptoms.
It’s also “one of the more challenging aspects to treat and manage,” said Carol Perlman, Ph.D, a psychologist who specializes in ADHD and developed a cognitive behavioral therapy for adult ADHD.
Impulsivity can manifest in many different ways in adults with ADHD. In fact, it can range from seemingly benign to more dangerous behaviors.
For instance, individuals might interrupt conversations or say things they regret. They might hop from one distraction to three others. They might overspend. They might get impatient and drive erratically or engage in other risky behaviors, such as using drugs and having casual sex.
Fortunately, adults with ADHD can learn to manage their impulsivity, so it doesn’t rule their lives. The most important strategy is to get treatment.
“I can’t emphasize enough the importance of appropriate treatment for ADHD, which is usually a combination of therapy – often cognitive behavioral therapy – ADHD coaching and if indicated, medications targeted to treat ADHD symptoms, including impulsivity,” Matlen said.
In addition to treatment, other strategies can help. Here’s five tips to try.
1. Understand how your ADHD functions.
“No two ADHD adults look the same,” Matlen said. That’s why it’s vital to understand “how your particular ‘flavor’ of ADHD affects your life.” For instance, how does your impulsivity manifest? What are the negative consequences?
To help you better understand your symptoms and learn the skills to manage them, Matlen suggested reading about ADHD and attending support groups and conferences.
2. Be mindful.
You also can sharpen your self-awareness by practicing mindfulness. “[B]ring attention to the present moment and observe what is happening without judging it,” said Lidia Zylowska, M.D., a board-certified psychiatrist who specializes in adult ADHD and penned the book The Mindfulness Prescription for Adult ADHD.
For instance, focus on your thoughts, emotions and urges along with how your body feels when you’re impulsive, she said. This may not be easy at first. You might pick up on your impulsivity only after being impulsive. But with practice, you can start identifying what precipitates your impulsive acts.
Mindfulness also helps you gain some distance from your urges. This way you aren’t driven by your impulses but simply observing them, and are able to decide your actions, Dr. Zylowska said.
When you notice an urge, name it in your mind. For instance, “here is anger and wanting to criticize my spouse,” she said. After identifying the urge, practice mindful self-coaching: “I need to relax” or “try to stay calm” or “express my feelings without lashing out.”
Use a supportive, compassionate and encouraging voice, she said. For instance, if you’re struggling with impatience, you might say: “Waiting is hard for you but see if you can be a bit more patient right now.”
3. Challenge negative thoughts, and take action.
Perlman, also co-author of the therapist guide and workbook Mastering Your Adult ADHD, works with clients to pinpoint the inner dialogue underlying their impulsive actions and then challenge them.
For instance, let’s say you were editing an article, but ended up browsing Facebook for an hour. Perlman suggested considering: “What was going on when you started the task? Did it feel doable? Was it interesting?”
Maybe you started looking at Facebook because the thought of sitting at your desk for two hours straight seemed utterly unbearable. If that’s the case, break down the task into bite-sized steps. Instead of two hours, edit your article for 30 minutes, and then take a five-minute break, she said.
To avoid distractibility during your break, “set an alarm and plan short, relaxing activities.” (“If the break is too long, a person may get distracted and move on to other tasks.”)
If you’re worried about being bored, you might consider these questions, according to Perlman: “How bad would that be? Could you coach yourself through this less enjoyable but necessary part?” And keep reminding yourself how good it’ll feel once you do finish.
4. Make it harder to act impulsively.
For instance, does your impulsivity lead to pricey shopping sprees? If so, “leave your credit card and checkbook at home. Put the items you’ve chosen on hold for 24 hours, so you can decide if you really do need or want them,” Matlen said.
Do you regularly blurt out comments in your work meetings? Then bring a notepad with you, and jot down your remarks, Perlman said. Mention them when it’s appropriate.
(You can work on specific strategies with your therapist or coach.)
5. Engage in calming activities.
Sometimes impulsivity might be the result of being stressed out or on edge, Perlman said. Relaxing yourself can help dampen impulsive urges. She suggested trying progressive muscle relaxation, guided imagery, calming music, deep breathing and exercise.
Managing impulsivity is not easy. But by better understanding how your impulsivity manifests and getting effective treatment, you can stop impulsivity from controlling your actions and your life.
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