MHM Magazine

Issue 2 | 2022 | MENTAL HEALTH MATTERS | 15 MHM hurricane” In considering the symptomology of ADHD, it’s clear that the very nature of the behaviours associated with the condition can make parenting difficult. Challenging symptoms and behaviours such as impulsivity, low frustration tolerance, distractibility, poor self-control, and emotional dysregulation may be experienced as deliberate defiance. This may require parents to manage their own emotional responses in order to respond in a calm and constructive manner. Similarly, symptoms such as distractibility, difficulties with initiating and completing tasks, difficulties following instructions, and disorganisation can make necessary day-to-day family tasks and activities seem impossible to achieve. In addition to the normal running of a household, parents of children with ADHD also need to keep track of regular doctor appointments, prescriptions, ensuring their children are adhering to the recommended treatment plan and keeping track of symptoms and behaviours to provide reliable feedback to their healthcare providers. As a result of all these factors, parents can feel overwhelmed, hopeless, anxious, or frustrated leading to self-blame, and may develop secondary conditions such as depression and anxiety. “Forgetfulness, managing my emotions, and lack of focus makes parenting pretty tiring” Professionals working with and treating ADHD commonly express instances of parents having an “aha” moment during the process of their child being diagnosed with ADHD. Parents reflect on their own childhood and their current functioning and come to the realisation that they themselves also have ADHD. For some, this may bring a feeling of resentment and sadness for having led of life with untreated ADHD, which may have made things more difficult than they needed to be. Conversely, some adults’ express relief and a feeling that suddenly everything makes sense as to why they find normal tasks so challenging. One of the responsibilities which can be experienced as particularly difficult is parenting. The nature of parenting requires many skills and processes to run smoothly and concurrently to reduce stress and improve overall emotional and physical wellbeing within a family. Parenting demands high levels of impulse control, planning, patience, multi-tasking, problem solving, keeping track of multiple variables and the inhibition of immediate responses for longer-term gain. Everyday tasks such as cooking, cleaning, supervising homework and leaving the house to attend after-school activities requires a sustained and consistent level of executive processing, planning, time management, task initiation and follow-through. Mokrova et al. (2010) found that parents with ADHD reported increased chaos in the home, inconsistent discipline, and non- supportive responses to their children’s negative emotions. Increased home chaos and lack of structure was linked to a decrease in overall wellbeing for both parents and children, as well as externalising behaviour. Difficulties in consistent discipline appears to be linked to the need for sustained attention and monitoring of a child’s behaviour and being able to institute consistent consequences for unwanted behaviour. Speaking at the 2nd Southern African Multidisciplinary ADHD Congress, hosted in 2021, clinical psychologist, Dr Angela Vorster highlighted specific ADHD-related challenges which make parenting difficult, including working memory deficits, communication problems, struggling to maintain attention on tasks which seem tedious, emotional dysregulation, and inability to implement structures and discipline in a consistent manner. However, importantly, Dr Vorster stressed that parental ADHD does not imply a lower level of warmth or attachment compared to neurotypical parents. Creating the scaffolding for families to grow Living in a home with structure both facilitates organisation and creates less uncertainty, which in turn creates a better sense of security for a child. This is important in all households but is especially essential in a home where ADHD is present in both the child/children and parent. Structure can be imagined as a type of family scaffolding which creates a supportive framework around which everyone can grow in confidence and competence. Morning and bedtime routines are notoriously difficult for individuals with ADHD. Something which appears simple such as getting ready for school requires remembering and sequencing multiple tasks in a logical order without getting distracted or overwhelmed. The tips that you can provide parents to improve daily routines include: • Using visual prompts such picture-based schedules for younger children and post-it notes or reminders for older children and adults. • Use clear, manageable instruction which eliminates confusion and provides clear guidelines of what is expected. For example, “pack away toys into their allocated space” is easier to understand and follow than “tidy your room”. • Making use of a shared family calendar (physical or phone- based application) • The use of timers can also aid in managing disorganisation and time-blindness, as well as aiding in motivation to get tasks done. • Reducing clutter and simplifying the home environment is also beneficial. Using clear storage containers where items can be easily