ADHD and task paralysis: when starting feels impossible

In this episode:

• Purple Ella, hosting the conversation

• Coco, blogger

• Dr Heidi Phillips, Neurodevelopmental Specialist GP

Ella: For someone with ADHD, starting a task can feel disproportionately hard, not because they don't care, not because they're lazy, but because shifting from intention to action can be a challenge. When this is seen as not trying, that's when shame can take hold. Coco, when you struggle to start something, what does it feel like when your brain won't shift into doing mode?

Coco: I guess for myself, when my brain won't shift into that kind of do-er mode, it feels like rejection. It feels like hard work. It feels like sometimes you're not good enough, especially for the simpler things. So, those simple tasks as cleaning your house, as getting up, brushing your teeth, getting ready, going downstairs, that kind of thing.

I think for myself, you sort of hit yourself backwards because you're like, "Why?" And the why comes down to the ADHD. But I guess it's sort of embracing yourself and putting a flip on that. I think it's just reminding yourself that you are wired differently, and there's just other ways around it. So, certain things, they're not a priority for me.

Ella: Yeah, for sure. And what does it literally, physically feel like?

Coco: It feels like someone's just got a stop. So, imagine you're like a puppet master, and it's like someone's holding it. Your arms can't move even though you know you need to. Your brain isn't sending those signals to do, if you like.

So, imagine a car that doesn't start, right? You've got the keys, you've got everything else, but the engine... You're just like this kind of thing, and then you go off to do something else that, to myself, seems more relevant, if you like.

Ella: Heidi, why is task initiation such a common difficulty in ADHD?

Heidi: It really is, isn't it? And I think it's about shifting from that feeling of, "I need to do it," to, "I'm actually doing it." So it's, as you say, it's not about lazy, it's not about not wanting to, it's about actually not being able to. And what we think happens is it's part of the executive function of the brain, so that ability to plan what it is you want to do, to be able to prioritise, so put into place in the right order, to be able to switch from what you were doing to what you need to do, and to be able to maintain focus while you're doing it. And also, I think the organisation to break down that big task into its little chunks.

And when you've got all of that, a glitch can happen at any point in that system, then it can be really hard. So, I think it's a little bit like a filing system. When you open your filing cabinet and you've got all those messy files in there, and you think, "Ugh, I just don't know where to start." And so you can't start, and you don't start, and I think that's how it happens.

Ella: When you experience that task initiation freeze, does that physically impact you? How does that feel?

Coco: Yeah, definitely. I think for myself, too, it can be really overwhelming and emotional with that, and I think when you have all these things happening inside, you feel like a bottle of pop being shaken, and just exploding.

And I think the lower side, I guess, of this kind of thing with ADHD is feeling so overwhelmed that you do feel low, that you do feel down, that you sometimes can maybe come across to someone as having no tact, being a bit, not aggressive, but a bit standoffish, that kind of thing, especially when you're in that mindset. And I know for myself, when I do get overwhelmed, I can become, not aggressive as such, but I'm very short. My wife would probably say not the best to be around in that moment.

So, I think for me and so many people, support is really important because then I have my teammates sort of step in to hold me up and to reassure me that it is okay, and that it's just sort of a momentary thing, that it's not like this forever, and that that's okay to have those moments. It's just sort of how we come out of them and to flip side that into a positive way. And with myself, too, when my ADHD's overwhelmed, my stutter kicks in, then I forget, and I've got motor tics, so then that kicks in. And in public, too, that can feel a bit shameful. I feel a bit embarrassed because then people are looking at, like, "Why is this grown adult acting this way in public?" And I think, again, that's where the support comes in.

So, whether that's my friend, whether that's my wife or family member, even people that I'm around in a different environment, just letting them know how I navigate and how I work, so that they can sort of step in, give me even an eye contact cuddle kind of thing to be like, "You've got this." Like, "It's okay to have these moments, but just remember, we can get out of them."

So, I think that's a moment and a side, I guess, that isn't the most, what's the word, expressed or sort of put in the limelight, I guess. And there is that part of ADHD that many people don't feel comfortable maybe on talking about, and it's just to let people know that we're on that journey with them, too.

Heidi: Something you mentioned there, Coco, is actually having your wife alongside, and a lot of people will say that, that having that sort of buddy, that buddy who kind of motivates you and sort of gives you that clap on the back, that, "Well done, you've done it well."

Ella: What about body doubling?

Heidi: Body doubling, absolutely. That's something where even if they're not motivating you and doing it alongside you, they could be just in the room alongside you, doing their thing, but they're just there to get you started. And once you're in the flow with ADHD, a lot of the time you can stay in the flow. It's just that task initiation that's hard.

Ella: Heidi, it's sometimes said that ADHD brains are interest-led

rather than importance-led. What does that mean?

Heidi: So, for many people, they can get started on a task because it's important or because it's urgent. But for people with ADHD, it's thought that they have this interest-based nervous system in that they can only actually get started on a task that's new or exciting or challenging or meaningful. So they can't do it because of importance. They have to do it because there's this spark that sort of incentivises them to do it.

Ella: Coco, can you relate to that explanation?

Coco: And on the flip side, what's it like when you're engaged in a task that is genuinely interesting? So for myself personally, if it isn't an interest, if it isn't emotional, if it doesn't grab my heart and soul, I can't do it. Like for instance, we were saying I've got a doctor's appointment I need to make. I've been needing to make this for the last month. However, because it doesn't become important, it's that typical adult just routine thing I need to do. It's one of those things that keep falling off my list. So if it's not written down in front of me telling me, today you need to do that, it doesn't get done, and that's like anything at all.

So anything like I love shopping, I love trainers. If I'm like, woo, I can go to town, and remember, if I'm going food shopping, if it's not on that list, I will walk out with a bag of things I don't need just because I'm excited or overwhelmed at the time and my senses are popping off.

But that, like you said, that spark to just do and just grab or just buy is something definitely that I relate to.

Ella: Yeah. And outside of shopping, love that for you, but outside of shopping, if you're engaged in something at home, say, that's more interest led, what does that feel like?

Coco: Yeah, so for me, for a home, let's say, doing the washing is my thing. So washing machine, that kind of thing is my task, but I don't know why, but I find interest in that. I get excitement out of it. It sounds absolutely crazy, but I do. So, and everything else in the house sort of doesn't fall to my wife. However, I might need a push shove kind of thing to say, "Come on, let's do this," because I've still got a house to run. I am an adult. But yeah, certain things around the house, if I love, I'm very like, "This is my domain."

Ella: Coco, when task initiation feels impossible, what actually helps you with the way of getting started?

Coco: Getting started, it needs to have something at the end, let's say like a goal. I think so many people with ADHD relate. We need to have drive, and sometimes a list can be that. Seeing something physical, seeing it written down in front of me sort of gives me that push to know that's my task for today, and it can be little things as pop to the shop, visit my granddad, that kind of thing, or it could be stuff a bit more in depth, and I think that is really helpful.

Ella: So do you find being able to tick stuff off the list-

Coco: Yeah. If it's not on the list, it's not there, and just to tick to know, too, you've done it, and I think with ADHD, too, we can be so hard on ourselves. So I think for myself, just as the ticks then come home and it's like, ooh, I've done what I've meant to do kind of thing, and it gives purpose in knowing you still can.

Ella: Amazing. Have you got any other, like, are there any ways that you fool your brain into getting started with something? So thinking about moving away from the people-pleasing aspect, are there any things that you do for yourself other than the tick list-

Coco: Yeah

Ella: ... that can kind of trick you to get started?

Coco: Yeah. Music for me is definitely one. I feel like it sort of loosens all my senses. That might sound a bit absurd, but yeah, I sort of feel like music is my go-getter for everything. So whether that be out in public, I need to do something with headphones. In the morning, music is always blasted on in my house just sort of to give me that start. Like most people need a shower kind of thing or a cup of coffee in the morning, that's my motivation, if you like. And it sort of resets me, if you like, especially if you've got a shift or you've woken up. As we know with ADHD people, our moods can shift, and we can sort of skip. So I think for me, that sort of sets me in a nice balanced thing to set off with the day, or even if I'm having a overwhelmed moment within doing a task, that sort of, again, resets me and brings me to a space where then I'm like, okay, you've got this. You can sort of go ahead. And I think so many people relate with finding their little thing, if you like, that gives them that go and that push to keep going.

Ella: Coco, what would you want someone who's watching, perhaps blaming themselves, to know about task initiation and ADHD?

Coco: I guess I would want someone to know who's blaming themselves around this situation is to know that it's okay, and it sounds so cliché, it's okay. But it is, and sometimes I always say to people, if you've got to stand in that mirror, if that makes it better, and talk to yourself. Let yourself know there's going to be times like this again because I think we can beat ourselves up so much and put all this pressure and stuff of the world and society how that is anyway. Plus our own minds are like. So I think it's just not to be hard on yourself and to just know that there's so many people in this world that's just like you, and I think in those moments, that's what we forget, that we feel alone. We feel we're the only ones going through this. But just for those people to know it's okay. You're not alone. I'm on this journey with you, and we all are kind of thing.