Full transcript below
In this final episode of the ADHD miniseries Paula discusses ADHD and burnout with Dr Floriana Reinikis, a Clinical Psychologist specialising in neurodivergence, and an ADHDer herself. They discuss the connection between ADHD and burnout, including the impact of workplace environments, over-compensation, perfectionism, and emotional regulation. Dr Reinikis also highlights the importance of understanding your own unique needs to support self-advocacy at work and identify strategies for preventing and responding to burnout.
About the speaker:
Dr Floriana Reinikis is a Clinical Psychologist specialising in neurodivergence, with extensive experience in conducting ADHD and Autism assessments and providing post-diagnostic support. She is passionate about delivering neuroaffirmative care that recognises and builds on individual strengths. In addition to working directly with neurodivergent individuals, she also trains mental health professionals in the assessment and diagnosis of ADHD across the lifespan.
You can get in touch with Floriana at Oasis Psychological Services or on LinkedIn
Other links:
I’d love to connect with you so do come and find me on LinkedIn or at my website and do check out the ACP-UK and everything it has to offer.
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Transcript
Paula Redmond (00:37)
This is the final episode in this ADHD mini series and its focus is on burnout. I explored this issue with clinical psychologist, Dr Floriana Reinikis, a specialist in neurodivergence and an ADHDer herself. We spoke about the connection between ADHD and burnout, including particular risk factors and vulnerabilities, as well as strategies for preventing and responding to burnout.
Paula Redmond (01:08)
Welcome, Floriana, and maybe we could start by you telling us a bit about the work that you do?
Floriana Reinikis (01:15)
Thank you for inviting me first of all, it’s really a pleasure to be here. It’s always an honour because it’s something I’m really passionate about. So I have been working with individuals who present with different kind of neurodevelopmental conditions, mostly autism and ADHD across the lifespan for over 20 years, and I just I think enjoy being with them as also I feel like I’m quite close to these individuals as in the last two years, about two years ago, I was also diagnosed with ADHD so all of a sudden everything made more sense, not only for me in my personal life, but also professionally why I felt so aligned with individuals who presented with similar challenges and differences and strengths. So yes, so that’s what I do on a daily basis. I meet for either an assessment, that’s something I do weekly, or for post therapeutic support. And yeah, that’s in a nutshell, me.
Paula Redmond (02:40)
Yeah. And you also do training for professionals, don’t you?
Floriana Reinikis (02:43)
Yeah, thank you for reminding me that. It’s something quite new. I started last October, so actually it’s been a year that I’ve been training other mental health professionals in ADHD assessment and diagnosis from a more kind of neuro-affirmative point of view, but also in post-diagnostic support. And yeah, there are a few kind of online workshops and training that currently are either being ready on the shelf and people can join or yeah, as my mind is never kind of stopping thinking, there are new ones on the pipelines as you can imagine, yes.
Paula Redmond (03:33)
Great. And I really wanted to talk to you, particularly about the issue of burnout and ADHD. And I think for me, that is the way I came to wanting to work more with ADHD is because in my work with burnout, I was finding that coming up more and more, people either kind of coming with a recent diagnosis of ADHD and really needing that to be an important piece of the puzzle in understanding their struggles with work, you know, their struggles with burnout, how that contributed and how we needed to think about recovery and getting back into work and what that needed to look like with an ADHD kind of understanding. Or in doing kind of burnout recovery work, starting to recognize things that might look like ADHD. And so that was just becoming more and more kind of prevalent and more apparent to me and felt like a really important thing that I needed to get to grips with and understand more about. And so I think it’s an important thing, particularly when we’re talking about the workplace and what it’s like to experience that as someone with ADHD. I think burnout is something that comes up a lot in that context. And I wonder if, I’d really be interested to hear Floriana about your clinical experience around that in terms of what you’ve come across in your work with people with ADHD.
Floriana Reinikis (05:23)
Absolutely. And I’m glad we’re having this conversation because I feel that the work around ADHD and burnout is just kind of starting to be understood a bit more. So I think we need to really talk more openly about the difficulties that ADHDers may encounter and how this can then lead to burnout. So I do not think we understand everything at the moment compared, for example to autistic burnout. I think there is much more research, much more clinical understanding, but we definitely need to continue this conversation. And in my experience, what normally has happened in my kind of clinics is someone requesting an assessment for ADHD at this stage or when I am working with someone already at therapeutic level, and maybe I haven’t diagnosed them, I haven’t really followed them through, so it’s the first time I start working with them. So any of these two stages, at times I’ve met individuals where I just felt it was much more than just ADHD as presenting with a level of exhaustion, mental, physical, a cognitive load, a social kind of withdrawal that felt possibly as burnout. And I feel that often we are still missing it and we are overlooking burnout in ADHDers. Therefore, it’s really important we actually consider what else is going on for these individuals in order for us then to think of how can we support them, not only therapeutically but also in the workplace. So definitely I agree with you that when you start working with someone you may start thinking something else is going on for this person. And I mean, if we think about it, we shouldn’t be that surprised because I think ADHD can really lead to burnout in many ways, not only when it’s not been even diagnosed or even when it’s been recognized as a neurodivergent condition, I think often we are missing the burnout part and we may consider it’s possibly anxiety or possibly depression or just executive functioning skills. So definitely I find that very often in my clinical practice and I can think of several individuals I have seen over the last few months. What I find is interesting is that yes, the majority are adults who talk about burnout in the workplace, but I have definitely seen several university students who as ADHDers or undiagnosed ADHDer talk about what we would consider burnout. So, yeah.
Paula Redmond (08:41)
What do you think it is about ADHD that might create more risk for people to develop burnout? What are the kind of traits that come along with ADHD that might make people vulnerable to developing burnout?
Floriana Reinikis (08:59)
I suppose if we think with the idea of what burnout in neurotypical may look like, thinking of this complete mental, physical exhaustion, withdrawal from social relationship, disconnection, cynicism, but also this inability to do tasks that in the past were easy, ability to organise, stay focused, manage. If we think of burnout in this way, and then we think of what ADHD presents as a kind of a problem with self-regulation in general where everything from attention, focus, memory, hyperactivity, impulsivity, emotional regulation. So we think of it, it’s not surprising that you are already, as an ADHD, predisposed to possibly develop burnout because your executive function difficulties are already quite taxed by an environment that possibly puts a lot of demands on you. Therefore, you may find that even normal daily tasks are for you really a challenge. And when you have done that for a long time, and that’s I think why we see mostly in older teenagers, young adults and adults, when you have done it for a long time this constant battle for some of us behind closed doors or for others a bit more evident in catching up with life, it’s not surprising that ADHDers are so much prone to burnout because they already have challenges in the areas that we would consider problematic. And I suppose the other thing we need to consider is that also ADHDers don’t just come with exactly functioning challenges, but they also come with other challenges that possibly are the byproduct of being an ADHDer. So, imposter syndrome, overcompensation, overcommitment. Many ADHDers will say, you know, I will commit to do longer hours or coming to work earlier, finishing later, taking work home because they know their attention is so dynamic, so fluctuating that during the day they cannot manage. But add it every single day, and then you go home and you still have to manage a whole house whether you have children or maybe other people to look after or even just yourself. That accumulation I think if not understood and supported, it’s likely to lead to burnout. So I feel like there is a compounded effect there between the ADHD intrinsic challenges and differences, and then the stress of everyday life.
Paula Redmond (12:23)
And do you think in your experience that burnout presents differently for ADHDers than for neurotypical people?
Floriana Reinikis (12:33)
I think there are definitely elements that are different. think the normal, if that is a word, but the typical, as I said, typical presentation of burnout, feeling so exhausted, feeling like no energy level, at a mental level or physical level, or this kind of cynicism, this kind of detachment from others. I think that is probably what is quite similar, but I suppose the differences are that all the normal differences and challenges that we encounter in ADHD are exacerbated, are magnified. So someone who neurotypically encounters burnout and may struggle with attention and concentration and remembering things and organising time, from an ADHD point of view, ADHDers will have a magnified effect of those difficulties. So things that maybe in the past they were able, tasks that they were able to focus a bit better, stay longer, and manage maybe with some difficulties but they completed, they would have much bigger problem. The other difficulties that ADHDers I feel are more encountering is for example things like hyperfocus. I think as ADHDers we are really able to give so much passion on something and hyperfocus on something at the point of maybe creating or being incredibly proactive when we are in our in our vibes, in our passion. But when you’re in burnout, that hyperfocus that generally already leads to mental tiredness and physical tiredness, I think in burnout becomes a complete forgetful of the rest of your life. So you may go hours and hours without self-care, without recognising that actually you need a break and you need to maybe eat something. Maybe without drinking any water, going to the toilet, complete withdrawal from people around you. And people, I remember several individuals I have in mind thinking, I came out of these hours of work, which probably I enjoyed it as well, but I’m so tired, exhausted that then I have to spend two days, three days not doing anything else. So I think that’s another thing that is quite typical of ADHD, the burnout. And then on top of that there is this kind of vicious cycle of then procrastivity. I prefer the word procrastivity to procrastination because I find ADHDers are never not doing something even when they’re procrastinating they’re doing something okay. So procrastivity makes me think of the fact that they are avoiding a task that they find emotionally triggering for some reason, but they are busy doing something else. So in burnout what we see is differently from neurotypical, that they may still look like quite hyperactive, quite restless, while in neurotypical we find a burnout tends to slow people down. In ADHDer we see still that kind of hyperactivity coming out but I feel almost when I speak to people about it, it almost feels like a sense of agitation. That sense of agitation that comes out in doing so many things but not doing what they need to do and in the end the complete again, mental and physical exhaustion that comes with it. Okay so these are the kind of things I think that are more typical of an ADHDer compared to a neurotypical.
Paula Redmond (17:02)
Yeah, and I guess as you’re talking, I’m kind of, you know, thinking about the people that I’ve worked with, who have ADHD. There’s seems to be, I suppose, a couple of patterns, like one, a sort of real sense of overwhelm with like this kind of administrative stuff. I work a lot with health professionals, so that kind of aspect of the work that isn’t, you know, the core reason they went into the profession, but those things that get piled on and added on and that just becomes so overwhelming. People getting behind, you know, getting disciplined, you know, it seems like an impossible task to ever catch up and then that’s never motivating. So you’re, you know, stuck in this horrible cycle. Or people who are absolutely kind of enthralled with their work, throw themselves into it and maybe don’t notice the early signs of it being too much and kind of push themselves beyond, you know, kind of healthy limits and only realize too late that they’ve exhausted themselves.
Floriana Reinikis (18:12)
Absolutely, absolutely. I think what you’re saying is really important because what normally happens for an individual with ADHD, I think normally, as become part of who they are, they’re really overcompensating and overcommitting, very often. These are individuals that are not lazy, let’s be quite clear about this idea that we are lazy or we make careless mistakes. We are exactly the opposite, we care very much. And because we are so aware of the difficulties we have with our executive functions, what do we do as a consequence? We tend to find ways to mask them, compensate for them and therefore will take on more work, will accept to do more things, will create rigidity in order to remember that I’m going to do something. But then there is the demands of a workplace, like whether it’s a mental health or a physical health environment as in hospitals or services that, you know, if you’re a doctor or if you are an anesthetist, there’s a lot of research on NHS workers that are actually constantly under stress and burning out. Now, consider the difficulties you have as an ADHDer. Being put in an environment with high demands, because these are environments with high demands, things may happen quickly, you need to be quite organised, you need to be quite able to manage time. Your resources will soon be depleted and you constantly are in this kind of hamster wheel of trying to keep up, and I think that is a problem. Trying to keep up becomes impossible. You burnout, it becomes almost impossible. And then you see people, as you said, either taking too much on, or I think the other opposite, and I suppose it’s maybe phase four or five of burnout, is going off sick and not being able to manage any more. And then when you meet them, I’ve got a client I’m thinking of at the moment who has gone off after exactly doing what we were describing. Extremely successful, because these are individuals that can be extremely successful, they’re really good at what they do. But taking on so many responsibilities, not being able to set boundaries, that’s another big problem of ADHDers, we are not able to set boundaries for many reasons, for self-management but also because we want to compensate and show that we are able to do things. So he was doing this for a long time and all of a sudden he found himself working from home, working weekends, working all the time. Consequently, his whole life became just work. So that’s, you know, again, self-management, difficulties in understanding where I finish work and when I start personal life. And relationship went through the window, his mental health and physical health. Okay, these are other big, big things in ADHDers. The physical health, you were asking me earlier about other specific characteristics that we should consider for ADHDers here but now. It’s not something we talk a lot, but we know that there is a lot of research on somatic conditions, physical health, for example, migraines, allergies, and many others. But when I think of the clients I’ve been working on, they also have additional physical difficulties that are also impacting, that compound effect as ADHDers. So I see it as a cycle. You have the executive function difficulties, then the demands of a workplace, demands of home, your need to compensate whether you become a perfectionist as a consequence or you want to just mask constantly because you want to come across as someone able, inevitably the outcome would be at some point burnout if the cycle is not broken.
Paula Redmond (23:04)
And I guess I can also think of, of kind of examples of people who actually are managing, you know, to mask very well at work. So no one at work is picking up on any problems, but you know, home is tricky because as you say, they’re not able to kind of attend to other things that are important, you know, relationships or physical health or you have to go home and go to bed at 7pm every night because they’ve used up, you know, everything at work. And so I guess it can, from the outside, not, you know, be a bit of a, I guess a spiky profile in terms of where the problems might show up that, you know, for at least a while work might look okay, but other areas might be suffering.
Floriana Reinikis (23:55)
Absolutely. And I suppose another thing about, as we are talking, I’m thinking more and more about the ADHD that I’ve encountered throughout my professional life. And the other thing we need to consider is the emotional dysregulation, which we know is a core feature, is part of being an ADHDer. And not that all ADHD become easily emotionally dysregulated, but we know many do. When we think of burnout, this emotional dysregulation is even more affected. So if we think of, in general, of how emotions will go up and down, even during the day, you know, you just, you leave your keys indoors and you have just closed the door and you think, oh why didn’t I think about it? Why didn’t I put the keys in the right place? That will already create it. And then you go to work and someone says something and you feel like, was that directed to me? Did it mean anything? So your emotions go so up and down in ADHD. Little things, we are quite sensitive. They’re sensitive people. They will still remember times when they were 12, 14 and teachers made comments and they are now in their 50s so they will hold on to these comments made to them. So that emotional dysregulation that we see as part of ADHD, when burnout kicks in it becomes intensified. So again it’s not only the frequency, it is the intensity. And as part of that, obviously the impact is also again on relationships. So very often clients will bring their partners or their husband, wives, and you will hear these narratives on how more difficult it has become to be together because everything is so easily escalating. Okay. So the emotional dysregulation is another big thing we need to keep in mind when we think of ADHD and burnout.
Paula Redmond (26:09)
And you mentioned some research that you’ve come across. I wonder if, but you also said that it’s kind of in a really emerging area, and I just wonder if there’s anything useful to add there about what the research into burnout in ADHD does say?
Floriana Reinikis (26:27)
Yes, I think we’re still very much at the beginning. I was reading recently a research on ADHD and the mediation between ADHD executive functions and burnout in employees. Okay, this was quite a recent, 2024. I can’t remember when exactly. So most of the research, which is still quite limited, is about highlighting the impact that executive functioning difficulties of self-management at work, like time management, planning, organisation have on employees who are ADHDers. So that’s the majority of the research. I feel It’s much more than just that. I feel that it’s exactly what we’ve been talking about, that ADHDers also present with all the other difficulties that we are recognising being part of it as the imposter syndrome, not feeling able, feeling like I’m always the one who, why I cannot do this, underperforming constantly, the sense of underachieving, then the masking. So these are the other kind of things that they’re not considering at the moment when they’re doing research. They’re just looking at the impact of how the executive functioning are amplified by being in a work environment where support is not there. But what about the rest? What about the other things? What about the hyperfocus? That’s something I haven’t really read about, how the hyperfocus and the difficulties when someone is in such a hyperfocus, it doesn’t recognize anymore the signal of, oh my goodness, it’s been two hours, three hours, I haven’t had any food, and then, you know, the difficulties of going on. Many of my clients will say I go on all day without eating and drinking water or going to the toilet. I don’t think research is actually yet looking at all the different layers that can affect burnout in ADHD. So I’m hoping that there will be more understanding. In your experience of working with burnout, it seems to me that you encounter lots of ADHDers in the workplace?
Paula Redmond (28:59)
I think there’s something about healthcare that when you get it right, you know, can really be a great fit for ADHDers in terms of, you know, the passion that is needed, the kind of variety of the work and, you know, the hyperfocus that is needed at times, you know, to get through training, so I think there is something about this field that can attract people with this, you know, neurotype. And, you know, for some people that can be a great strength and, you know, find your way and a way of working that fits that, then people can really flourish and thrive. But I think there are, you know, particularly in big systems like the NHS, there are a lot of real challenges. I mean, it’s challenging for anybody, but I think particularly if your environment doesn’t support your natural way of being and thinking, then it can be very difficult. One of our listeners put in a question that sort of touches on this about the move in recent kind of years, and you know, it’s been for a long time, but I guess COVID really accelerated a move to much more digital working. So the listener kind of used the example of keeping track of things when you can’t see physical files. So everything being, you know, digital data, both, you know, tricky in terms of you keeping track of stuff, but also making it easier for people to keep track of you. And, you know, there’s a big emphasis on data collection. So that’s one part, but also, you know, a move to, again, accelerated by COVID, you know, hot desking, you know, online working, hybrid working. And I wonder what your thoughts are on how that contributes to ADHDers experiences of the workplace?
Floriana Reinikis (30:59)
I think that’s a brilliant comment and question from your listener and I agree with you that actually it’s pre-COVID. COVID just accelerated things and I remember during COVID I was already in my independent practice, so I had already left the NHS. So if I think of me in the NHS, I remember the time when we were introduced into the idea of smart working. And before that we were introduced to open offices. I’ve always had, I was lucky I suppose, I always had an office for myself and then all of sudden I had to be in an open office. So open office, smart working, online working. I loved my paper diary, and then all of a sudden I had to keep an online diary. So all of these things, remember even on myself as an NHS clinician at the time, pre-COVID, was already like, oh my God, how am I going to manage? But I have to think about it as actually there were pros and cons in the end. So for example, I found that smart working, so having a computer that I could use at home, meant even more difficulties with boundaries and even more I need to compensate because I’ve not been able to do all the things I had to do compared to my very organised colleague who managed to do everything, you know like all your emails or your paperwork or your reports, and I was like so actually having a computer to take home meant not having time for me for my family. I remember sitting in my dining room and working on it while the children were kind of playing around and saying, you know, can you please be quiet? So that definitely I felt was a problem if we were not able to set boundaries. But also expectations, because then the expectation is that you can do, maybe is self-expectations, I don’t know, the ADHDers may have, I’m going to do more, I’m going to work more, I don’t know. But that’s the kind of cons, I believe. The pros about smart working, I felt was the ability then to be allowed with some difficulties at the beginning, I think now with COVID things have been accepted, being allowed to work from home. So some flexibility in where I work. But again as ADHDers we need to be very careful because the environment where we work will inevitably make us more or less distracted, more or less focused. So being able to say I’m working from home but I’m going to work in an area of my house that is not definitely my bedroom like many people did during COVID because they didn’t have enough rooms at home, or I can work in my bed. ADHDers don’t do well with that because they get immediately sidetracked doing other things. So you can see flexibility, great, but then you have to self-manage and that’s the problem with ADHD, self-management. Once you have started, you know, self-managing that flexibility, I think smart working could work. Also, I think could work as, I remember often I had to travel between sites which created some problems again in terms of managing time. How long is it going to take me from this place to this place? Okay. And that was also part of smart working. And if you’re not good at managing thinking, I may find traffic at this time of the day, you arrive late and then you become panicky, anxious. But it means that you come to a desk that’s less cluttered. Let’s be honest. I remember having my own office and thinking, I’m just going to leave stuff here. You know, obviously not confidential stuff, not files, but my own bits and pieces. And clutter is not helpful for ADHDers. So there are pros and cons. But then other things like open offices, I loved the social part of it because as ADHDers we like that, we like being with people, we are chatty, we like the interactions, but to the detriment of then working and staying focused. Or overstimulatory – an open environment for me is often full of too many stimulation, people talking on the phone, I can’t focus on writing a report if my colleague is having a conversation and that’s not because I am curious what they’re talking about, it’s just I cannot filter so easily. So I know other people have talked to me about an open office being really hard to be in, not having enough previously when you think okay I really want to do this work, I really need to do it now but then being like a magnet as soon as there is a noise, as soon as someone comes in through the door you get immediately distracted and what is the problem? Refocusing. It’s just so hard for ADHDers to refocus. So open offices, I’ve never been in favour of open offices. So I think there are lots of cons there apart from the social side of it, which is also good. I think we need that. The other problem, for example, is out of sight, out of mind. So everything online. So I remember the time when we went on to these systems, Rio and all this system. I was like, oh my god, I’m not sure where things are, how I’m going to search for them. Well, I remember going into a filing cabinet, taking the file out and chronologically things were there. So I quite like, and I think still today, I find whenever I need to do something important, I will have a physical thing. I always talk to my ADHDer clients and say what works for you? And many of them say actually I need to see to remember. So that’s something that could be a problem when you have everything online and it’s not immediately there and also you don’t remember what you may have read the day before and you have to reopen your file and blah blah. But on the other side I find that possibly online calendar, online files could be also helpful if you are someone who tends to… let’s say an online calendar. I remember having this beautiful diary, let’s be honest many of us like our diaries and I used to buy every year a new diary, I used to love them. You know they gave it to you in the NHS, now I want that really nice fancy one because I liked it. But the problem was often writing at the same time two appointments because one had cancelled and then I had forgotten to remove it and I was thinking my goodness, or booking, double booking and then your secretary calls you and say there are two people waiting for you, I think oh my god I didn’t delete it, I forgot to delete it. Well online diaries, very difficult to do that. Now I love my online diary. So there are pros and cons. I suppose I always say to ADHDers is routines and structures are so important for us because I don’t want to rely on my brain or my mind to remember things, to do things, I need to have something external. So it’s really how we use them for our benefit. But there are definitely pros and cons for both. I remember as an NHS clinician, I used to go often to A&E to do assessment of individuals that were suicidal. And oh my goodness, I found it so difficult because the busyness of A&E with so much noise, so many things happening, people coming in, I had to always ask, can we have a quieter place? Because not only for the privacy of the person, it was also for me. I didn’t have this knowledge I have of myself now. So I think that’s what we tend to become able to self-advocate when we understand ourself as ADHDers, an environment that is conducive and supportive of our differences rather than against us.
Paula Redmond (40:03)
I was just wondering whether you think any other sort of things that people might be useful to think about in terms of what they could ask for in a workplace to help support them to prevent burnout?
Floriana Reinikis (40:17)
I think the first step, the importance of a possibly a diagnosis not because we are supporting the idea of labels and that’s a very old kind of a message I remember in the past, we don’t like labels. It’s not about that, I think it’s about this understanding of who you are and therefore stopping many things that before would be more like self-critical thinking, lots of self-critical beliefs but then strategies that were not working. And then the environment around you not knowing how to support you. So I think a diagnosis can be helpful in many ways, personally but also from a work kind of placement or education placement. So when we think about it, having a diagnosis will mean hopefully that you feel comfortable to discuss this with your manager or your employer. I still think there is a lot of stigma that goes with the diagnosis of ADHD and I know many individuals who for a long time don’t talk about it. I mean it took me a year to become open about it because I felt comfortable talking to my clients about, oh I know what you’re talking about, you know, I get it. But it was with my colleagues, with your employers. I mean, at the time of my diagnosis, I didn’t have, but still I had colleagues. And with your peers. Okay, so the first thing is, are you at that stage of having accepted the diagnosis because that I think is the first step. And then the second part is can you discuss this with your employer and then hopefully discuss a way forward. A way forward would be really in how the environment can be adjusted and I know there is a lot of criticism at times from others saying you know why should we adjust the environment to you and not to others. I totally disagree, I think a flexible environment would increase productivity, would increase loyalty, would increase the sense of I like my job. Okay. So I think flexibility should be probably applied more generally, but definitely to neurodivergent and ADHDers. So having a conversation of what works for you, what is it that could work for you? So an open office, actually, most of the time really distracts me and I don’t manage to get anything done. Can we look at another way? Can you work maybe a certain amount of hours a week? So creating even a plan. Okay, we’re not really good with planning. And I always say to my clients, find someone to help you plan and put things in place, rather than trying to do it yourself. Because if you had already tried many times, not working, just you need to change tactic, maybe someone else could help you. I remember sitting with my manager and talking about my diaries. So I was someone who will do exactly that. I will be able to see as many clients as a day, no problem, because I love that part of my job. Absolutely. I adored the idea of being in the session with my clients thinking of what they needed and the support I could provide back to back, often forgetting actually you need a break Floriana. So my manager will come and say this is your lunch time you have a break okay. I just needed someone to give me permission as well, and that’s also this part of your diary has to become admin, which I know you don’t like it, I know you find difficult, but actually when you do it, you do it really well. Okay. But I almost needed someone to help me with that. So I think discussing these things with your manager would be great. What can we do to help you? What can we put in place? Maybe if open offices are not possible because unfortunately there are some situations where, you know, there are no other offices, do you feel comfortable with noise-cancelling? I think it’s become quite fashionable these days. So it’s not really seen as a problem. So I’m hoping that people will feel comfortable to go into work and not to feel like maybe my colleague is thinking I don’t want to interact with them. And if that’s the case, can we have an open conversation with our colleague, which means for me having an environment which is neurodivergent friendly, it’s okay to have noise-cancelling earphones or headphones because I find it easier to concentrate. I also think the other important thing to consider is adjustment in terms of physically what kind of things work for you in an environment. So for example, some of my clients have been able to… I remember this research many, many years ago, even before I was aware of these things as ADHDers, some of my clients starting having standing up desks. So even things like this, think should be discussed and considered. Having a break and being able to go out of your workplace rather than staying in your workplace. I remember how it affected me remaining in my workplace because I felt I could never get out of work. So I was constantly in this agitated state of okay I’m gonna have lunch but I’m gonna be so quick, I’m gonna eat while I am looking at a report. Well if I was feeling comfortable, I almost didn’t feel comfortable because maybe it wasn’t what was happening or maybe it wasn’t what normally we did. If I was allowed to leave the building and it happened at some point, I moved to another building and we were very close to the town centre and people in that building used to take their lunch out. So I decided, oh my God, I’m going to do it. I realised that the ability to come back and refocus was so much better for me. I mean, this was pre-diagnosis for me. So even those kinds of things, again, that’s a kind of really friendly neurodivergent environment that allows people to have, you know, this is kind of, again, flexibility of what works for you. And we know research on productivity, we know that people will feel more able to give the best of themselves when they feel supported, they feel understood, they feel heard, and adjustment has been made around them. And when that is not the case, we see long-term sickness, we see people changing jobs, and I find ADHDers, maybe for other reasons, but it should again be considered, why do ADHDers change so often jobs? Could it be impulsivity? That could be impulsivity as I’m not happy here, I don’t feel supported, so I’m going to move to another job, thinking that by moving somewhere else things will change. So yeah, quite a lot to consider. I feel there is a much more open dialogue and discussion on organisations that value these things. Whether they do happen, that’s another issue. And I’m sure there are some systems that are still very rigid. So it’s exactly the opposite of what we’re saying, the flexibility against a system that’s rigid. You come to work, nine to five, this is your desk, and you don’t move, you just kind of go from one room to another, or things like that. It’s the ability for managers to think a bit beyond what culturally we have been used to. I suppose the other important thing to keep in mind is that another part of the research, maybe not specifically on ADHD, but in general on neurodivergent conditions and burnout, is that we know that the right support, the right therapeutic coaching, support for whatever the person needs, the workplace adjustments and support, possibly anything as also medication. We know that that will prevent possibly burnout or speed up the recovery. So I think it’s really crucial that organisation managers, systems understand that it’s not the person. Yes, the person may engage in a personal therapeutic journey, but when the mismatch between the environment and the person happens, so the rigidity of the environment, that’s where things go wrong. And we know the opposite is true when things are there to support the individual, even the ADHD differences are less problematic. They still exist, but the person just feels more fulfilled, feels more able to work, feels more able to be themselves, which is another important thing. And maybe even their masking, coping strategies kind of get a bit less intense and they can be dropped. So definitely a lot of work on how others can support.
Paula Redmond (51:06)
And I think that you’re right, that message around workplaces really needing to actively engage with this stuff is, you know, good for work place wellbeing, but it also makes sense for productivity and retention and sickness levels. You know, there’s just such a clear business case for know, workplaces to really actively engage with this. And I’m always just shocked and horrified that it doesn’t happen, which is, you know, a big driver for this podcast, let’s think, let’s talk about this stuff. And these issues, I think that we’ve been talking about today are relevant to anybody in the workplace, but I guess for people who have, you know, who have ADHD, face, you know, particular challenges that are not you know, it’s not, you know, the kind of accommodations and, you know, adjustments that you’re talking about are not like rocket science, you know, they don’t require huge restructuring or huge funding to put in place. You know, it’s quite straightforward, I think, you know, to just allow people to, be able to advocate for, you know, the kind of environment that allows them to flourish and you know, I don’t think it’s the huge barrier that, you know, it often feels like it is for workplaces can be quite, you know, defended against this stuff.
Floriana Reinikis (52:34)
I think because, even surely from a financial point of view, which is obviously something that the organisation system has to keep in mind. So they may think of financially what it would mean to make this adjustment. I have never seen anything written and I’m sure there’s probably something, but surely if you can prevent burnout and you can therefore prevent sickness, that will cost much less than, you know, supporting someone who is off sick for a long time. Okay. And will support and prevent, sorry, will prevent also the possible, while likely development of mental health problems or physical problems which comes with burnout ,which also would put even more strain on resources and financial commitment. I think it shouldn’t be too complicated. So I don’t know why sometimes this seems to be such a big problem that we encounter still in workplaces. But hopefully this conversation that you and I are having today are becoming much more what happens, the conversation that everyone has openly, frankly, and therefore becomes easier to accept that yes, we need to change something.
Paula Redmond (54:06)
Floriana, I wonder for anybody listening who either has a diagnosis of ADHD or who suspects they might, what advice you might have for them to help them prevent or respond to burnout?
Floriana Reinikis (54:22)
Okay that’s a very important question. Okay the first step for me is awareness, self-awareness because you may be in a stage of burnout when you’re not yet realizing. We know from the phases of burnout that have been described that some of them you’re still in this kind of drive to do things, to achieve, you feel also quite satisfied but it’s starting to become difficult. Becoming self aware is the first step. So asking yourself what is different? Is my attention, my focus, my memory, my organisation, my hyperfocus, my emotional regulation, my feelings, are they more or less the way they have always been? Being an ADHDer or there is an intensification of them? So if there is something you start thinking, something is not right with me, then you may want to start considering, could it be burnout? So self-awareness. And I suppose the next step would be, who could I talk to? I suppose it could be someone you trust and you feel comfortable, but it could also be then a professional if that needs to go a bit further whether you’re not getting anywhere and people may actually know, family and friends I think most of the time want to do the best for you and they may say you know maybe you just need to try a bit harder and maybe you need just maybe to have a holiday, take a few days off, and maybe you already try these things and if it’s still not working, I will then request maybe a conversation with someone, someone like you who specializes in burnout or a GP. But other things you think are very important you could do even before that is, for example, when burnout kicks in, we said about this kind of detachment and disconnection from life. I will say to my clients who are in that kind of phase, I actually would like you to make an effort and I know it’s going to be a very difficult effort, but an effort to even book just a coffee once a week with your friend and go out and meet, I don’t know in a coffee shop somewhere, and just talk about anything that comes to mind. Or having some time with your partner out of the house but almost regularly because I find that the more they don’t do these things the less they will be in contact with others and we as human beings we need others. So re-establish some connection. The other thing is be realistic in what is possible to achieve and accept it. Sometimes less is better rather than constantly being on, I want to do this this and this and that everything else, less is better. If you can manage your hyperfocus, so if you start realizing your hyperfocus has become so intense and you pass the whole day without leaving your room or your bedroom, your office, because it could be someone who is becoming so work-holic, they don’t leave, okay, put reminders for yourself. Work with someone in your family and your friends and say, can you help me out? Can you come and knock on my door or give me a ring and accept it as the offer of, I need to stop it, because it’s definitely not helpful. So, put some external reminders that are great for ADHD as well. Also you need to increase that, work with someone, body doubling, get someone to help you to say, we’re gonna go for a walk now. That’s the other important thing I would like to reiterate. Some self-care. Self-care is another alarming bell. If you realise that actually, even as an ADHDer, you’ve always had quite good self-care and that’s not happening, ask yourself what’s going on. So start maybe on purpose having some self-care. self-care means a lot of things, means not only looking after yourself, putting some nice clothes on in the morning, having a shower, whatever it is that is your self-care, but also means going for a walk, get some fresh air, whatever the weather, whether it shines or rains, I always say to people that will increase your dopamine, will make you feel better, will make you feel more able to come back and focus but also will relax you. So these little things. Sleep, keep an eye on your sleep. ADHDers are very renowned for difficulties with sleep. As your sleep becomes worse, so you’re so exhausted during the day but still you can’t sleep, when before actually you could at some point fall asleep. Okay, that’s another alarming bell. Maybe discuss with your GPs or anything that you can do because lack of sleep will just increase problems and have some regular meals as well. You know, look after yourself even in the very basic way. These are basic but they’re so crucial. I suppose the last thing I would like to say from a clinical psychology point of view is what can you do to help your nervous system, who is so at the moment kind of overwhelmed, to go into a state of slightly, gradually, because it’s not going to happen over a night or over a week or a month, if you’re in burnout, it’s going to take time. But what can you do to help your nervous system? And obviously all the things I spoke about will already help your nervous system. But is there any way to help you with things we know work for ADHDers like mindfulness? And I always say to my ADHDers who look at me like, I hate mindfulness, I always say, yeah, I get it, but you don’t need to sit still, you don’t need to do a very, what I call the classical mindfulness. We can do a very informal, and your informal could be go out and just feel the rain on your skin, or listening just the sound of the birds around you while you’re walking. Just mindful of how you’re walking in a different way or a different kind of place or just enjoying a cup of tea outside in your garden and just kind of very slowly having it and thinking about it and smelling it. These are exercises I think ADHDers find easier to implement because they don’t need to stop their mind which is obviously quite a difficult thing to do and we don’t want that, it’s never going to happen to anyone anyway, but you can do it as suits you and it’s more practical and feels more realistic. So these little things could become really part of your daily life and could be very helpful.
Paula Redmond (01:02:05)
Yeah, and I often think about things like, this idea of active rest. So being able to, I mean, for me, that is knitting. You know, something that, you know, you’re keeping yourself, you know, physically active, you know, tapping into a creative part of your brain, but at the same time, it’s soothing the nervous system. So I always like to have those conversations around, you know, creative pursuits that, both help with connection, you know, it’s the opposite of burnout to be able to connect to something alive and creative, but also just so good for our nervous system.
Floriana Reinikis (01:02:45)
Yeah, I like, I love that. I call them with my clients restorative breaks. And I always say restorative breaks is not about you going on your phone or going to another hyperfocus. Okay. It’s actually moving your body in some ways, whether you are knitting or I had this question, I remember with my children often when they were little, how do you know mom needs to take a break from something, maybe because she’s feeling a certain way? And I was so pleasantly surprised when they said, you go out in the garden. Okay, because that’s my way of being active, using my body to calm my mind and just being in touch and maybe doing some work in the garden, trying to pull the weeds. Actually, that is so helpful and my nervous system, I always send to my clients what is it that could be an equivalent? Okay you may not be a gardener, I’m not a gardener, I just like being in the garden, you need but what is it for you? And that’s a restorative break, yeah. So that’s the kind of things we really would advocate for. They don’t need to be a lot a long holiday, at the end of the day we, most of us don’t go on holiday every two months. No, it’s not possible. But you can do these daily things to restore your nervous system.
