“I Was Gasping for Breath, Drowning in Negativity. Then CBT Became My Lifeline.”
I was sure I had ruined everything. I would be fired. My life was over. Negative thinking — and the peculiarly ADHD trait of making mountains out of molehills — was sending me into spirals of anxiety and rejection sensitive dysphoria. Then I discovered cognitive behavior therapy (CBT) and began the slow, steady process of convincing myself the sky wasn’t falling.
Like many people with ADHD, I suffer from comorbidities — namely, panic disorder and rejection sensitive dysphoria (RSD). It makes the ADHD roller coaster a bumpier ride than it would be otherwise.
After more than two decades of self-criticism and negative self-talk fed by my ADHD brain — and compounded by well-meaning family members — it’s hardly surprising that I eventually wound up in a therapist’s office.
I wasn’t diagnosed with ADHD until the age of 24. Panic disorder followed six years later at age 30 (I’m 35 now). It took this long to get diagnosed with ADHD because, well, it just never occurred to me that I might have ADHD until a friend was diagnosed. Hearing her describe her symptoms got me thinking that maybe all my annoying tendencies weren’t character flaws after all.
ADHD and Emotional Distress on the Job
Frequent and uncontrollable crying fits are what drove me to finally book an appointment for cognitive behavior therapy (CBT). Therapy has helped me understand that emotional distress and anxiety often trace their roots back to a childhood of constant criticism. In my case, my ADHD traits meant I was always doing something “wrong;” they were always getting me “in trouble.” Things like being forgetful and disorganized, losing car keys, missing appointments…that sort of stuff. Due to RSD, I’m also very sensitive and this sensitivity was spilling over into my job.
Insensitive comments made by my boss — either in person or via email — always triggered an overblown response. I became convinced that dire consequences would result from a small mistake. Whenever my boss provided feedback, I took it as criticism, which triggered my anxiety. “I’ve ruined everything” or “My boss hates me and I’m going to get fired because I said this one stupid thing in a meeting”.
Not too long ago, I lost an important work document. For the life of me, I couldn’t remember what I had done with it but was fairly certain it never left the office. I eventually concluded that I’d thoughtlessly disposed of it while distracted by tidying my desk. Oops, there goes my ADHD brain again… not recording that tiny portion of tidying. When I discovered the document was gone, I became extremely anxious and was convinced that it would lead to job loss.
My therapist helped me recognize this as distorted thinking and explained there are a few different types of cognitive distortion. Here are the ones that plagued me most:
- All or Nothing Thinking. If something isn’t done perfectly, it’s a complete failure.
- Fortune-Telling. Predicting things will fail.
- Magnification and Minimization. Exaggerating the significance of small problems while trivializing your accomplishments.
Therapy helped me learn to recognize and counter that faulty thinking with a few valuable truths:
- Most people don’t lose their jobs as a result of accidentally misplacing a piece of paper.
- It’s impossible to predict a person’s reaction or even know if management will be bothered.
- There are worse mistakes than misplacing a document.
CBT for ADHD: Not As Easy As You Might Think
Like learning a new sport or artistic technique (painting is one of my hobbies), CBT can be challenging at first. While my therapist was excellent — understanding, patient, not at all judgmental — the beginning months were tough.
CBT is all about recognizing your thoughts, the ways in which they are distorting your view of reality, and then coming up with more realistic statements to replace and counter those distortions. My therapist guided me through a few of these. He helped me see that I hadn’t actually “ruined everything.” It’s true that my boss may not have liked what I said at a meeting, but one harsh comment doesn’t mean my job is in jeopardy. Understanding this helped me feel much calmer.
For me, knowing when to apply the CBT techniques took a lot of practice. In the beginning, all I could hear was the familiar refrain of my parents telling me I was lazy and too easily distracted. Once you’re in that whirlpool of negativity, it can be hard to pull yourself out.
I had painful flashbacks to private music lessons and of my parents complaining that I wasn’t improving enough between lessons due to a lack of dedication and practice (because I kept getting distracted, of course). At this point, my therapist suggested adding medication to help me work through these difficult emotions.
How Medication Can Augment the Therapeutic Process
My psychiatrist prescribed an antidepressant. Taking it was like being thrown a floatation device at the moment you think you’re drowning. Instead of feeling overwhelmed by all the emotion therapy was revealing, the skies cleared. The water felt calmer and I could breathe. My doctor also encouraged me to go back on Ritalin for my ADHD. Once that was added to the mix, even more air was added to the flotation device. I was keeping my head above the water consistently.
The psychiatrist told me that, in addition to helping ADHD symptoms, stimulant medication increases the brain’s neuroplasticity, making it easier to learn new things — truly awesome when you’re in CBT.
Change Can Be Scary But Sometimes Necessary
About 18 months after I started therapy, I moved back home to Australia (I had been living temporarily in China), which meant saying goodbye to my therapist. Working with someone new felt a little weird at first but here’s what I’ve learned: No two therapists approach therapy the same way, even if they both specialize in CBT.
Some will get right down to the task at hand while others prefer to spend some time asking questions and listening. It’s okay to decide that a therapist isn’t right for you, but it’s important to go in with an open mind and give a different therapist and different approach a fair try. I’m glad I did because my new therapist has introduced me to new techniques that have helped me adjust my new surroundings.
Because of my positive experience with CBT — with or without medication — it’s my number one recommendation to anyone with ADHD who is having trouble coping with symptoms. The process of finding a therapist may vary from country to country, but in general, it’s not as scary as I thought it would be and the benefits — while they take time to see — are more than worth the money, time and effort required.
Therapy has changed my life. At 35, I can honestly say I’m finally thriving. I just wish I had tried therapy sooner!
Updated on March 2, 2020