Attention Magazine February 2022

Establishing and maintaining routines can be difficult for individuals with ADHD. They are also especially prone to being thrown off easily by deviations from routine, and often experience increased trouble getting back on task. While everyone’s experience with ADHD is not the same, it is probably safe to say that many people—whether they have ADHD or not—have had trouble adjusting to the frequent and sometimes unpredictable changes in their schedules, routines, and obligations during the course of the COVID-19 pandemic.

As we enter the second winter season of the pandemic (it is only the second one, right?), we’ve had different experiences with school, work, socializing, emotions, economics, and so many other aspects of life over the past twenty months. Being a few months shy of two years of living with the pandemic is a double-edged sword. On the one hand, some routines are fixed, and we have some understanding of what to do if things shut down or move online again. At the same time, the uncertainty about changes that could occur based on fluctuations in COVID-19 numbers may make it difficult to settle into routines. Small shifts in consistency (such as your child being out of school for three days unexpectedly or having to work from home for a week due to a positive case at the office) can throw you off when it’s not easy to establish and maintain routines to begin with.

Given that we are in the current new normal, which could shift back and forth between being closer to pre-pandemic life one day and then transition suddenly back to early pandemic lockdown mode, how do adults, especially those with ADHD, manage this unpredictability and still function successfully in day-to-day life?

Let’s look at routines in a few common domains to help answer this question.

Occupational
It is most important to start by mastering a routine for your current work situation, whether you are working completely from home, at the office, or in a hybrid model. From there, your next step is to identify the common changes that could occur, such as moving back to 100 percent telework, increased time at the office, or full time at the office with occasional days at home when needed.
To help you deal with expected or unexpected changes in your work structure, here are a few general principles to keep in mind.

1. Maintain access to important documents, planning tools, and so forth in multiple locations, or routinely bring anything that is physical back and forth with you every time you go into the office and then return home. Related to this, if you do not have seamless access to documents in multiple locations, and this is not feasible to set up, it’s important to ensure that you keep careful track of which version of a document is the current one. If applicable, as permitted by your employer, using systems such as Dropbox, Google Drive, or One Drive to organize files can work well, because then you can access documents in folders you set up across devices and locations.
2. If you use a whiteboard or paper planning system, consider using something that is portable. Another option would be to use a physical system (such as a whiteboard) in each location, take a picture of it at the end of each day, and then duplicate everything at the other location. Related to this, keeping a master list of tasks in a computerized way and relying on physical items for daily planning may make it easier to plan more easily in multiple locations.
3. If you are moving back and forth between multiple locations (or even workspaces within your home or office), having a good bag in which you could keep all important materials in one place and easily move, set up, and pack those items back up each time your work time is finished is another way to simplify having multiple workspaces.

Family
Flexibility is going to be especially important for parents, especially parents of younger children or those with more frequent needs. As with the work category, it is important to master a routine for the current family needs (school in person normally, for example, or after school activities). Under “normal” conditions, unexpected issues arise with kids being sick and needing to stay home. With the pandemic, however, whereas a child used to be able to go to school with a common cold, any such symptoms may now necessitate their staying home. There may also be times when your child has to quarantine and attend school online or when the whole school system shifts to a hybrid or virtual model for a period of time. Here are some strategies for navigating this changeable situation.

1. Make sure your plan for the current needs is effective (for example, have a clear plan for who does drop off, pick up, and that you have coverage if you have multiple kids who need to be at different places at the same time).
2. Make a plan for how you will handle unexpected changes, such as needing to pick up your child early, or be home with them for days at a time without much notice. One of the most common issues here is managing things with work. One idea, if you have a significant other or family members who could help, is to coordinate days where each person serves as the backup childcare person. For example, John serves as the backup childcare person for his kids on Mondays and Fridays. To simplify things with work, he schedules most meetings on Tuesdays through Thursdays. This makes it easier to drop what he is doing to help should unexpected changes in school and childcare occur. Jane, his wife, schedules her main work obligations on Mondays and Fridays so that she can adjust her schedule easily on Tuesdays through Thursdays if she needs to be off with her kids at the last minute. Obviously, not all jobs offer this kind of flexibility, but it could be helpful to keep this idea in mind when planning to the extent that you can.

Social
The pandemic definitely opened up more opportunities to stay connected virtually with people, especially when they live far away. Some people like these interactions, but others struggle with online socializing. For some people, navigating COVID-19 protocols and comfort levels may add to their stress, anxiety, or social issues. If a child or adult often had trouble paying attention to social cues before the pandemic, there are now even more potential social challenges to manage. Here are a few suggestions to help with routines around social interactions.

1. Develop a system for managing social interactions and related planning that could be used under normal circumstances (such as a checklist of involved tasks or reminders to make plans with specific people).
2. As relevant, include in a plan as needed social distancing guidelines and rules that should be followed.
3. To help mitigate issues around social interactions, create a backup plan for important events, such as making them virtual, holding them outside, or getting a tent or portable heater if the weather might not be ideal.
4. If you and your significant other have different comfort levels with socializing during the pandemic, it could be useful to discuss them and write down agreed-upon rules or guidelines.

Economic
This domain will vary a lot based on individual needs and experiences during the pandemic. For some people, their finances stayed the same. Others improved their finances by naturally cutting down on some unnecessary expenditures. Some people suffered severely economically due to being laid off, earning less in a commission-based job, or having increased expenses due to the pandemic. In the long term, flexibility in budgeting for fluctuations in income and expenses may be necessary for some people. Here are a few tools to help with routines related to finances.

1. Develop a solid system for tracking expenses, paying bills, etc. that would be helpful regardless of the pandemic’s impact on finances. You may find it helpful to use an electronic program such as Mint.com or one through your bank, or to hire a financial consultant. Many banks offer free budgeting assistance if you ask.
2. Identify how the pandemic is affecting your finances and determine if the effect is constant or fluctuates. From there, apply the same principles you would normally employ for managing finances, but take into account that you may have to plan for uncertainties or extra expenses (such as extra childcare). In many ways, this kind of planning is similar to what professionals who work on commission have to do. If you know the summers are slower financially, you may find it helpful to put money aside to subsidize your budget during those months or to cut expenses during those months to compensate for the seasonal fluctuation in income.

HAVING SOLID PLANS AND SYSTEMS in place can create a better baseline from which you can adjust as things change because of the pandemic. As you navigate these routines, you can also plan for the expected or highly possible. Don’t be afraid to set up a system during times of uncertainty, because being able to implement and maintain systems will improve your ability to successfully modify them as circumstances change.

Carey A. Heller, PsyD, is a licensed psychologist based in Maryland. He specializes in the evaluation and treatment of ADHD and executive function issues. Learn more at hellerpsychologygroup.com. The coordinator for the Montgomery County chapter of CHADD, Dr. Heller also serves as co-chair of the editorial advisory board for Attention magazine.