ADHD: Activation! Motivation! Anxiety!

Motivation! Activation! What shiny, alluring words these are to a person diagnosed with ADHD! Yet they can provoke anxiety. Try as we might, we who share this diagnosis often feel very little control over whatever mysterious process enables us to come up with an idea or a goal, formulate a plan to achieve it and then go out into the world and… just do it, as they say.

Here’s another thing “they” say: people with ADHD are “consistently inconsistent.” Having treated this condition for 27 years and been diagnosed and treated for it myself, I know this truth to be self-evident. You probably know it too. We have our enthusiasms, build up heads of steam, and then get distracted, but have accepted that part of ourselves—that our motivation comes in fits and starts. Imagine if we just picked ourselves up after each disappointing outcome, repeated a few positive affirmations and got back on that horse. Well, it’s an interesting vision, but it ain’t gonna happen. What stands in our way—what I’ve devoted most of my professional life to the study of—is something I call the Emotional Distress Syndrome.

A quick definition: The Emotional Distress Syndrome (EDS) is the cumulative effect of living life with ADHD. It’s a chronic state of emotional stress that breaks down emotional tolerance, stamina and the ability to maintain a strong sense of well being and spiritual health. The chronic, lifelong nature of ADHD–related stress can increase to such a level that it becomes a syndrome akin to post-traumatic stress disorder (PTSD).

As with other ADHD symptoms, there’s good news and bad news, and you have choices to make:

    • It won’t disappear on its own. One way or another, you’ll have to manage your emotional distress for the rest of your life.
    • If you choose not to manage the emotional distress, the EDS will continue to erode your sense of emotional, mental and physical well-being.
    • But don’t despair–the Emotional Distress Syndrome can be navigated.
    • You are not broken.
    • You can live a full, interesting, potential-reaching life.

If this rings true for you or someone in your life, you might want to check out my book Focused Forward: Navigating the Storms of Adult ADHD. For now, though, let’s just know that Emotional Distress Syndrome is real, and if we don’t confront it head on, it can derail everything from simple plans to big ideas and lifelong dreams. It can certainly gunk up our motivation and activation skills.

Here’s an example: a young mother with ADHD came to me for help carving time out of her life to write a children’s book. I’ll call her Karen. All her responsibilities—raising two kids, helping her husband run a small business, and more—were precious and meaningful to her. But her secret dream of writing wouldn’t die. In fact, not getting around to it was making her miserable. How could I help Karen find the motivation to begin? Next, how would she activate—in other words, get going and keep going? Stay with me here.

Here’s another example, from my own life. I’ve spent the past four months deep in the process of launching my first book, the one I mentioned a few paragraphs back. Taking a longer view, I see it actually took twenty years to dream it, write it, publish it and make sure people knew about it. Plenty of motivation and activation were involved, and the result has been rewarding almost beyond words. But that doesn’t mean my ADHD disappeared. In fact, there’s a storm on my horizon. In the course of all this activity, my habit of regular, vigorous exercise dropped off the radar.

Now I’m getting nervous. It’s hard to get off the couch—even though every checkout line fitness magazine runs an article about how, exactly, that is done. Those articles leave me cold. I know myself. I know exercise is good for me. I know that not exercising is bad for me. I know I won’t tolerate boredom for more than a nanosecond. Like Karen, I need motivation and activation.

How? It’s a long story, but I’ll leave you with a few key ideas:

Kick the judge and jury out of the room. The Emotional Distress Syndrome tells us that when we miss the mark, we really need to pay for our transgressions. EDS can show up as a nasty shaming voice presenting evidence that you’re a bad, flawed person. Okay. Hear out this voice, but realize that it’s not the expert. Thank it for its input, and then kick it out of your strategy session.

Remember the advantages of ADHD. Once you’ve decided to take a break from self-recrimination, you can be open to ideas—something people with ADHD have very little trouble coming up with. Pay attention to your impulses, especially when they’re directed at the issue you’re struggling with. For example, a few days ago, I woke up thinking about swimming and rowing. Bodies of water. Somehow, I thought they were headed my way, into my life. I decided to be open to the possibility of it answering my couch problem

Karen’s answer came to her almost instantly. “Time,” she said. “Time set aside to start writing my book. Time no one else can claim.” How much time, I asked. “Six hours,” she replied. Free from having to justify the relative importance of her writing work—she’d kicked the judge out of the room, remember—she didn’t have too much trouble finding those first six hours. I suggested she stay open to whatever happened during that time and not saddle herself with expectations of what “real” writers do. To make a long story short, Karen began. Will she get stuck from time to time? Sure. Will she finish the book? I’d bet on it.

Ask yourself: What would give me a significant, positive feeling about this challenge I’m facing?

Here’s how the steps played out for me: I spent a little time letting my negative visions of failing health and mounting weight gain play out. Then I ended that episode and realized what significance meant to me, in regard to physical exercise. Being out of breath and/or sweating. That’s all. No minimum time commitment, no gym membership. I let this idea roll around in my brain for a while. I stayed curious.

Then I began to brainstorm with a friend who also has ADHD, which saved us both the effort of trying to make logical sense. I did a quick presentation about all the kinds of exercise that sound lousy to me—claustrophobic, windowless gyms, intimidating boot camp instructors, riding a stationary bicycle while staring at a wall. Then we launched into a vivid discussion of all the types of physical exertion that sounded non-lousy. Fun, even. They didn’t have to be practical, or even possible. (I could build a trapeze in my backyard and hire a ring master to train me. I could buy a cliff-side estate and take up bungee jumping.) We just kept spitting out possibilities.

And here’s the thing: I live less than one mile from Barton Springs—a gigantic, all-natural spring fed oasis. Admission is free from 5 to 8 am. Hmmm. If I went tomorrow morning, I’d wake up to the sensation of that perfect water. I’d surely run into some smart fellow therapists, one of whom calls herself Lady Godiva—because she dives. I could time myself with the waterproof lap-counting watch I just happen to own. I could wear my mask and snorkel and see a lot of fish. And I’d arrive at my ten a.m. coffee meeting sharp as a tack and cooler than everyone else at the café, on the first truly hot day of the year.

The odds of me showing up to swim tomorrow for anywhere from three to sixty minutes are extremely good. Might I have trouble swimming three times a week for the foreseeable future? Sure. But I have a few ideas about how to make the future more compelling, and at the moment, I’m more interested in tomorrow anyway.


James Ochoa is a therapist, writer and speaker who investigates the conundrums, challenges and rewards of adult ADHD—all of which he’s experienced first hand being a diagnosed “ADHD-er” himself. Equally grounded in neuroscience and intuition, his personal brand of therapy is uniquely empathetic, often transformative.

© 2016 James M Ochoa, LPC, The Life Empowerment Center, Austin, Texas. Focused Forward: Navigating the Storms of Adult ADHD, by James M. Ochoa, LPC and published by Empowering Minds Press, is now available on 


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      • Camellia Ford
      • August 15, 2018

      Hahaha I had difficulty getting through the article too. I have tried many things to overcome my lack of motivation. Nothing seems to work anymore. I simply need to clean the house and color my hair. Have had 2 days off and accomplished nothing. Feeling depressed. Now have to go to work in a few and then come home to nothing done. The next few days I’ll work long hours and won’t have time to do what I need to. Vicious cycle.

      • June Walker
      • November 10, 2016

      I found you through ADDitude magazine and lived that you brief article above gave me some much needed hope. I can’t wait to read your book!

      • Marie Wilson
      • October 13, 2016

      Wow!! I came online to try and help myself find some motivation to start cleaning for a quick move. My EDS as you call it, which I just knew it as extreme anxiety will not allow me to read that entire article. I can barely focus on getting through the first couple paragraphs. Thank you though

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