ADHD Paralysis and ADHD Treatmnent

Many people talk about “ADHD paralysis”, describing it as times where they are unable to initiate tasks or stay focused on goals, and may be having racing ideas but lacking clarify to make decisions.  Hours go by without being able to be productive.  Guilt and shame can follow, with the avoidance that often goes hand in hand with shame.
While “ADHD paralysis” is not a diagnostic term, it can be thought of as part of the executive dysfunction of ADHD.  This can include difficulties in organization of self and life tasks which includes initiating tasks (Roselló et al., 2020).   Those diagnosed with ADHD need to learn what contributes to symptom severity and what helps cope with or improve things.  Sometimes people with ADHD experience mental fatigue and less goal directedness because of being somewhat dysregulated (Isaac et al., 2024).  The ups and downs of energy and mood itself can be tiring. 
Interestingly, emerging evidence suggests that low ferritin levels are more common in individuals with ADHD and may contribute to the severity of symptoms through impact on  dopamine (Wang et al., 2017; Tseng et al., 2018).  Low ferritin can contribute to poor concentration, brain fog and memory problems as well as irritability, anxiety, and symptoms of depression. These effects may even occur in the absence of clinical anemia, making it super important to consider ferritin levels in managing ADHD symptoms and evaluating any unexplained mood-related or cognitive concerns.  This can be identified if blood tests look at serum ferritin (iron stores) which can be low even when hemoglobin is normal.
Experienced therapists who work with clients with ADHD understand the importance of being part of a care team and helping clients to develop good self care habits.  They may encourage clients and help with skills to organize.  They may promote self-acceptance around the ebbs and flows of energy levels. They may help clients recognize the importance of rest when mental or physical fatigue sets in, instead of wrestling with guilt and shame.  Therapists may collaborate inter-professionally to ensure that ferritin levels and overall nutritional status is monitored.  They are familiar with the science and evidence-based treatment, which is not aimed at eradicating ADHD - a neurological condition - but instead understanding what skills, coping and self care can be enhanced to support clients.
At our clinic we have several experienced therapists with expertise in working with clients to have ADHD to enhance executive function, self care and coping.  Reach out and speak with the clinic director to see how we can help with ADHD. 
 
Beard, J. L. (2003). Iron deficiency alters brain development and functioning. The Journal of Nutrition, 133(5 Suppl 1), 1468S-1472S. https://doi.org/10.1093/jn/133.5.1468S
McCann, J. C., & Ames, B. N. (2007). An overview of evidence for a causal relation between iron deficiency during development and deficits in cognitive or behavioral function.
The American Journal of Clinical Nutrition, 85(4), 931-945. https://doi.org/10.1093/ajcn/85.4.931
 
Falkingham, M., Abdelhamid, A., Curtis, P., Fairweather-Tait, S., Dye, L., & Hooper, L. (2010). The effects of oral iron supplementation on cognition in older children and adults: A systematic review and meta-analysis. Nutrition Journal, 9, 4. https://doi.org/10.1186/1475-2891-9-4
 
Isaac, V., Lopez, V., & Escobar, M. J. (2024). Arousal dysregulation and executive dysfunction in attention deficit hyperactivity disorder (ADHD). Frontiers in Psychiatry, 14, Article 1336040. https://doi.org/10.3389/fpsyt.2023.1336040 [frontiersin.org], [doaj.org]
 
Roselló, B., Berenguer, C., Baixauli, I., Mira, Á., Martinez-Raga, J., & Miranda, A. (2020). Empirical examination of executive functioning, ADHD associated behaviors, and functional impairments in adults with persistent ADHD, remittent ADHD, and without ADHD. BMC Psychiatry, 20(1), 134. https://doi.org/10.1186/s12888-020-02542-y
 
Tseng, P. T., Cheng, Y. S., Yen, C. F., Chen, Y. W., Stubbs, B., Whiteley, P., Carvalho, A. F., Li, D. J., Chen, T. Y., Yang, W. C., Tang, C. H., Chu, C. S., Liang, H. Y., Wu, C. K., & Lin, P. Y. (2018). Peripheral iron levels in children with attention-deficit hyperactivity disorder: A systematic review and meta-analysis. Scientific Reports, 8, 788. https://doi.org/10.1038/s41598-017-19096-x
 
Wang, Y., Huang, L., Zhang, L., Qu, Y., & Mu, D. (2017). Iron status in attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. PLOS ONE, 12(1), e0169145. https://doi.org/10.1371/journal.pone.0169145 [pubmed.ncb...lm.nih.gov], [journals.plos.org]