19. How EMDR Therapy can be used to manage ADHD
Photo by Vlada Karpovich
In previous episodes, I've discussed the stigmas that follow ADHD and how the visibility, or lack thereof, of the condition is why people tend to dismiss it. Some people don't even think neurodivergence is real, unlike other conditions that cause apparent physical manifestations of their symptoms. If part of ADHD's symptoms were a pair of giant antlers growing from either side of your head, people would better understand. " Of course, so and so is always late for appointments or forgetful; they have massive antlers growing out of their head!" How do they drive that Camry? Of course, they are bad at school and work; they must constantly be tremendously preoccupied with overwhelming self-consciousness, seeing as they have massive deer antlers on their heads! What the fuck!? Cut him some slack!
Instead, people often treat symptoms of adult ADHD like laziness or incompetence. That realm of ADHD alone can result in low self-esteem, depression, anxiety, and other comorbid disorders that have nothing to do with the entanglement of inattention, hyperactivity, and impulsiveness.
Comorbid symptoms; or comorbidities; or co-occurring conditions are defined as the presence of one or more additional medical or mental health conditions that occur alongside a primary condition. Comorbidities are common in many medical and mental health conditions and can complicate diagnosis and treatment.
To think of it more pleasantly, you might imagine ADHD as a big buttery stack of pancakes covered in your favorite syrup! Doesn't that sound delicious?; mmmm, yeah, it does. I like blueberry syrup personally; anyways, your comorbidities, which are eggs and sausage, you impulsively ordered on the side because you decided you were starving.
I came up with this analogy from a joke by the late comedian Mitch Hedberg, R.I.P. Pancakes are all exciting at first, but by the end, you're just fucking sick of them. That's exactly how I describe ADHD.
You wake up one morning, and it doesn't seem like much. In fact, bring it on because today, I can do anything! Sometime towards the end of the day, around 2 pm, you're asking why you did it to yourself. The pancakes are enough, almost too much; that's what I'm trying to convey. By the end of the meal, you're likely struggling to put it down! You're going to be stuffed to the brim. The mere sight of sausage and eggs, the thought of another bite--no, thank you! Comparable to extra food, you'll carry it away with you even if you don't want to, as if in a doggie bag. That's what comorbid symptoms are like when stacked on top of ADHD.
Yeah, I'm still making this shitty analogy. If EMDR were to enter this equation, it would be like the nap on the couch or, even better, the walk you take to digest your large meal after gorging yourself. What the hell am I even talking about? I promise to explain everything I'm trying to say without food metaphors; keep reading!
What are comorbid disorders for ADHD?
I promised that I wouldn't describe comorbid disorders with food metaphors again. They're not bacon and eggs; as previously mentioned, they are defined as the presence of one or more additional medical or mental health conditions that occur alongside a primary condition.
ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental disorder often associated with other co-occurring mental health conditions or comorbidities. Some common ADHD comorbidities include:
Anxiety disorders: ADHD is often associated with anxiety disorders, such as generalized anxiety, social anxiety, and obsessive-compulsive disorder (OCD). Individuals with ADHD may experience excessive worry, fear, and difficulty controlling their thoughts or behaviors.
Depression: Individuals with ADHD are also at an increased risk for developing depression. Symptoms of depression may include feelings of sadness, hopelessness, fatigue, and loss of interest in activities.
Learning disabilities: ADHD can also be associated with learning disabilities like dyslexia or dyscalculia. These conditions can make it difficult for individuals to read, write, or do math.
Substance use disorders: Individuals with ADHD may be at an increased risk for developing substance use disorders, such as alcohol or drug addiction. This may be due to a higher likelihood of impulsive behavior and difficulty regulating emotions.
Sleep disorders: People with ADHD may also experience insomnia or sleep apnea. This can exacerbate symptoms of ADHD, making it difficult to focus and concentrate during the day.
See what I mean with the sausage and eggs thing, now? I promise I won't use it; I'm just saying comorbid disorders are a lot! That's all! Learning disabilities aren't too far from the ordinary realm of ADHD symptoms; people with ADHD often perform poorly at school. Hyperactivity also could lead to sleep disorders, especially when you consider that the medication used to treat said hyperactivity can cause one to lose sleep. But anxiety and depression? What does that have to do with anything? Obviously, I'm about to talk about that next.
How do anxiety and depression occur as comorbid disorders with ADHD?
There's a list of reasons why anxiety and depression occur in people with neurodivergence. I'll briefly review the list but then expand on two, in particular, relevant to this discussion:
Biological factors: ADHD, anxiety and depression may share some underlying genetic and neurobiological factors. Studies have found that the same genes associated with ADHD are also linked to anxiety and depression.
Environmental factors: People with ADHD are often exposed to more stressors and adverse life events than those without the condition, increasing the risk of developing anxiety and depression.
Cognitive factors: which we've already talked about. Problems with math, reading, memorizing, etc.
Social factors: Social rejection, criticism, and low self-esteem are more common among individuals with ADHD, which can increase the risk of developing anxiety and depression.
Medication side effects: Some medications used to treat ADHD may cause side effects such as mood changes, which can contribute to the development of anxiety and depression.
I want to expand on environmental and cognitive factors. I don't exclude the other factors because they aren't necessary but because I don't feel I have the knowledge to expand on biology, cognitive science, or ways pharmaceutical drugs affect how you think; Even though I have experience with focus medications, it just affects everyone differently I can only skim the surface of a lot of information. In contrast, I have experience with environmental and social factors that have impacted my mental health with ADHD.
Individuals with ADHD may experience more stressors and adverse life events, such as academic or work difficulties, social rejection, and financial strain. These stressors can contribute to the development of anxiety and depression.
Some examples:
Studies have shown that adults with ADHD are more likely to drop out of high school, have lower educational attainment, and earn less income than those without ADHD (Barkley et al., 2002; Kuriyan et al., 2013).
We are also more likely to have comorbidities such as obesity, cardiovascular disease, and substance abuse disorders (Barkley et al., 2002).
Individuals with ADHD frequently experience social difficulties due to impulsivity, inattention, and hyperactivity, which can lead to social rejection and criticism. Furthermore, ADHD may make it harder for individuals to regulate emotions.
We neurodivergents are also more likely to experience rejection and criticism from peers and family members due to difficulties with impulse control, inattention, and hyperactivity (Barkley et al., 2002).
It's so frustrating!
These factors are like gasoline onto the flame of ADHD, and it's what most people cannot see or understand. The things people say to you at times can be infuriating. I've had supervisors tell me, " maybe you have to be sure to pay extra-close attention next time," or, " remember to double-check your work." On the outside, I'm like, " Y-yeah, of course, sure - heh, no problem!" On the inside, I'm all like :
That's not a healthy way to feel frequently. Everyone experiences emotions like that occasionally, but for it to become a routine part of your life, it's not good for your health. When you look at the word "disease" and realize it is another way to say "dis-ease," it provides a helpful mental exercise to understand that how we feel emotionally contributes to overall health. If you're experiencing depression or anxiety with ADHD, ask yourself if you may also be encountering situations like the ones I just mentioned in your environment or social life that could contribute to persistently feeling those ways.
Hot Take
The standard ways to deal with mental health include seeing a therapist or taking medications. This may be a hot take, but I find very little value in traditional talk therapy. Though people with ADHD struggle with inattention, we tend to be hyperaware. One of the traits of ADHD is superior pattern recognition. Any therapist I've ever visited told me I am very self-aware, even from a young age. I also tend to notice things more than my inattention to boring-ass school would show.
For that reason, I've lost my interest in traditional therapy. Besides the relief you get from talking things out into the open, I don't feel I learned much about myself. I don't need help knowing I'm anxious or depressed, and digging up traumatic experiences and identifying poor habits in therapy sessions did little for me since I had already spent lots of time connecting my behavioral patterns to external triggers and trauma. Even If I did learn something new, there was never a concrete way to deal with it. Sometimes the result of these sessions ends in the doctor providing some techniques to use when you're not feeling great, like taking a deep breath when you feel the onset of anxiety. Still, more often, you are bombarded with possible medication options.
Though the medication helps people with mental dis-ease, it feels like a temporary and negligent solution. It's a very "western"/"American" way of dealing with problems. Again, medication helps thousands and millions of people to manage their symptoms. Still, it also resembles a revolving door that ensures medical practitioners stay in business. As someone with ADHD, I need to know there's some concrete objective and goal in sight to what I'm doing; otherwise, it's just daunting.
It's so frustrating part 2
"So what you're telling me is that to manage my emotions and anger more effectively, I must just keep coming here forever!? If I'm being encouraged to be honest about, um, how things make me feel--that makes me feel like :
"So, there's no end to most forms of therapy in sight!? I'm forced to resign that I'm damaged goods and must attend sessions until I die!?" *Aggretsuko, death metal scream*
Me being the person I am, I got onto google. I was searching for forms of therapy that are specifically good for learning to manage adult ADHD symptoms. This was when I learned about EMDR. I will now bless you with what I learned about this type of counseling and my experience with an EMDR therapist.
Disclaimer about EMDR Therapy to treat ADHD
It is essential to note that this therapy is not for directly managing ADHD symptoms like hyperactivity or inattention. Instead, EMDR will be most helpful in managing comorbidities associated with ADHD, like depression and anxiety. It's not a therapy designed explicitly for ADHD treatment, but it can benefit people with PTSD, depression, anxiety, etc. In turn, this could ease the OG symptoms.
To put it another way, the objective of EMDR is not to help you pay better attention. Moreso, it's mostly about making you feel less shitty about being unable to pay attention, which is healing in other ways to general neurodivergence.
Some new ideas in the mental health field from professionals like Dr. Gabor Mate' suggest that early childhood trauma contributes significantly to conditions like ADHD. Trauma allows for significant structural brain changes to occur. He believes that is the root of ADHD and other mental/emotional precursors for addiction, depression, etc., which makes me wonder if EMDR could directly ease ADHD if we knew more about it, but that's a topic for another day. Anyways. Now, let's finally get into what EMDR is, how it works, how it can help people with neurodivergence, and more.
What is EMDR Therapy?
EMDR (or Eye Movement Desensitization and Reprocessing) therapy is a psychotherapy initially developed to treat post-traumatic stress disorder (PTSD). It was first introduced in the late 1980s by psychologist Francine Shapiro.
Francine Shapiro founded Eye Movement Desensitization and Reprocessing (EMDR) therapy. She discovered it in 1987 while taking a walk in the park. At the time, Shapiro was experiencing personal distress. She noticed that her eye movements seemed to reduce the intensity of her negative emotions. Intrigued, she began experimenting with eye movements while recalling traumatic memories, and she found that the eye movements appeared to facilitate the processing of the memories.
EMDR therapy is based on the idea that traumatic experiences can become "stuck" in the brain, causing ongoing emotional and physical distress. This therapy aims to help individuals process negative experiences and reduce their negative impact.
EMDR therapy typically involves eight phases:
History and treatment planning: The therapist will gather information about the individual's history and symptoms and develop a treatment plan.
Preparation: The therapist will help the individual develop coping skills to manage emotional distress and prepare them for the reprocessing phase.
Assessment: The individual will identify a specific traumatic memory to target for reprocessing.
Desensitization: The therapist will guide the individual through eye movements, taps, or other bilateral stimulation while they recall the traumatic memory. This is believed to stimulate the brain's natural healing processes. This is called bilateral stimulation, and this part of the process specifically distinguishes it from other types of traditional therapy; more on this in a moment.
Installation: In an "inception-like" fashion, the therapist will help the individual develop more positive beliefs and emotions related to the traumatic memory.
Body scan: The individual will scan their body for any remaining physical sensations related to the traumatic memory and work to reduce them.
Closure: The therapist will help the individual feel grounded and safe at the end of each session.
Reevaluation: The therapist will periodically assess the individual's progress and adjust the treatment plan as needed.
How does EMDR work? (Bilateral stimulation)
The eye movements or other bilateral stimulation used in EMDR therapy are believed to facilitate communication between the brain's two hemispheres, which may help process traumatic memories more effectively. It was explained to me as calming down the part of your conscious brain that looks for stressors (amygdala and prefrontal cortex) and keeping it distracted enough to deal with things you may actively suppress.
As mentioned earlier, the most notable component of this therapy is the bilateral stimulation part. During the desensitization phase, the client is asked to focus on the traumatic memory while engaging in a bilateral stimulation (BLS) task, such as following the therapist's fingers with their eyes or listening to tones that alternate between the left and right ear. The BLS is thought to facilitate the processing of traumatic memory. The movent of the eyes reminds me of old cartoons where the doctor would hypnotize a patient by making them watch a swinging pocket watch.
The best part about EMDR therapy is that it has a time limit and is not a treatment that spans into infinity. Typically, the sessions span from about 8-12 weeks! There are many successful cases of people suffering from substantial mental trauma who report improvements in mood after only 9 weeks. The therapy is meant to re-form neural synapses by making new and more positive associations to traumatic experiences.
Example:
One example of an RCT investigating EMDR for PTSD was a study published in the Journal of Traumatic Stress in 2002. In this study, female sexual assault survivors with chronic PTSD were randomly assigned to either an EMDR group or a waitlist control group. The EMDR group received 12 sessions of EMDR therapy over 6-8 weeks, while the control group received no treatment.
The study results showed that the EMDR group had significantly more noteworthy reductions in PTSD symptoms than the control group. For example, at the 3-month follow-up assessment, the EMDR group had an average decrease of 50% in PTSD symptoms, compared to only a 12% reduction in the control group. These differences were maintained at 9-month and 15-month follow-up assessments as well.
Aside from the science supporting it, such a finite timeframe to receive so many benefits is interesting. So I found a place called, Renew Wellness in Columbus, OH, that offers this type of therapy.
My experience
I became fascinated with consciousness and how to alter it early. Not with drugs, the way some may think, but meditation and things like it. My introduction to mediation was from my great-grandmother, Esther. She was a huge proponent of mental health and therapy, also reflection. I had trouble sleeping, and she had these cassette tapes that would be guided meditations I listened to on a walkman while lying in bed.
Pokemon was a massive influence on my career as a meditator. This is random, but around the 5th grade, Pokemon was a viral cultural craze. If you think "Pokemon Go" was big, it had nothing in the early 2000s era. The cards and Nintendo Gameboy games were enough to spark fistfights and theft in my day.
Anyways, there was an episode of the original show. Season 1, episode 22 is titled Abra and the Psychic Showdown. In this episode, Ash faces off against Sabrina, the leader of the Saffron City gym. She specializes in raising psychic Pokemon. One of her monsters, Kadabra, holds a spoon in each of his hands and bends them with his telekinetic powers.
I was an imaginative kid; I believed you could fly from thinking happy thoughts and thought moving things with your mind was possible. I was ten, don't judge me! So, I would sit in my bedroom with my eyes closed for several minutes and concentrate on trying to bend a spoon.
I never managed to bend the spoon with my thoughts. I did, however, consistently start practicing meditation. It wasn't until high school that I could have a transcendent experience with meditation. Lying on my couch after school, it became a regular routine for me to close my eyes and try my best to think of nothing. It wasn't long before I started developing techniques to keep my mind clear; one of those methods was to dart my eyes in every direction to suppress incoming thoughts. Afterward, I would always feel profoundly rested, aware, and calm.
Into my adulthood, I kept practicing and learning about mindfulness. There are many ancient techniques used in Yoga and other cultures. Among them is eye movement. One of the practices is associated with Rajadhiraja Yoga, called "trataka with eye rolling." During this practice, the practitioner gazes at a particular point, such as a candle flame or an image, then rolls their eyes upwards towards the space between the eyebrows (the "third eye") while holding their breath. The eyes are then moved back down to the gazing point while exhaling, and the process is repeated for several rounds.
Eye movement is associated with alpha brainwaves and regeneration. It is no coincidence that a human can get some of the most restorative sleep during the REM sleep stage. I believe tapping into this natural mechanism is what makes EMDR therapy effective.
When I tried EMDR therapy for the first time, the experience was familiar to me. With education from my therapist, I learned that I had unintentionally drifted towards the practice on my own. With guidance, I was able to benefit from EMDR sessions.
Ways to do EMDR Therapy
Suppose you are interested in trying EMDR therapy. In that case, you can start by asking your primary care doctor or mental health provider for a referral to a licensed EMDR therapist. This type of therapy has gained much traction in recent years and has become more available.
Therapy can be expensive, and some healthcare providers might cover the costs of this type of therapy. You can do it online if you can't visit an office.
I checked an online EMDR platform a while ago, and it inspired me to create something similar. If you visit abndtadhd.com/emdr, you can try EMDR for yourself. You can also easily access this page by clicking HERE. It should be noted that the EMDR tool on abundant ADHD is NOT meant to replace professional treatment; it's merely something you can use to get a feel for what it's like. A sampler, if you will.
When you visit the EMDR page, remember that there are several components to this type of therapy. This tool only utilizes the bilateral stimulation part. A brief description provides instructions on using the interface and some information about EMDR that I covered today.
This tool is 100% free and does NOT require that you provide an email address to play around with, but it won't be that way forever. A week after this recording drops, I will likely require signup to the site to use it. So remember to head to abndtadhd.com to check it out. I built it just for you!
In conclusion
EMDR therapy is a powerful tool for relieving comorbid symptoms that accompany ADHD. If you have ADHD and suffer from depression, anxiety, PTSD, or other mood disorders, talk to a professional.
If you'd like to try EMDR yourself to see what it's like, you can click the link to the EMDR page on my website that I designed and coded just for you! When you visit the site, remember to look at the other pages to read the "Attention, Please!" blog. There are also resources like supplements and a workbook I created, The You Testament, which I made as a guided workbook for strategically planning your life.
That's it for this episode. Remember to tune in next week! Much love, D.C. out!