AreasFocus, starting, and ADHDSystems for daily life

LongerAny ordinary dayMedical and treatmentFocus, starting, and ADHD

If you are pulled towards risk, you will do better giving that pull somewhere with a floor under it than trying to switch it off. Fast, high, cold, loud: choose the planned version rather than the one that turns up at two in the morning.

Work out what the appeal actually is. Speed, height, cold water, a crowd, the edge of fear. Then find the form of it that has brakes: a climbing wall with ropes, sea swimming with a club, a track day, an actual roller coaster. The aim is not to become a sensible person. It is to have the need already met, so it is not being met at midnight by a decision you would never make in daylight.

Qur’an and Sunnah

Eat and drink but do not be extravagant (Quran 7:31). The appetite itself is not the trouble; the shape you give it is.

۞يَٰبَنِيٓ ءَادَمَ خُذُواْ زِينَتَكُمۡ عِندَ كُلِّ مَسۡجِدࣲ وَكُلُواْ وَٱشۡرَبُواْ وَلَا تُسۡرِفُوٓاْۚ إِنَّهُۥ لَا يُحِبُّ ٱلۡمُسۡرِفِينَ

Children of Adam, dress well whenever you are at worship, and eat and drink [as We have permitted] but do not be extravagant: God does not like extravagant people

Qur’an 7:31read it in the library

Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.

What the research says

The nearest evidence here is a randomised trial in 119 people who had both ADHD and a substance use disorder, comparing CBT that tackled both together with CBT for the substance use alone, in a group where the usual ADHD medicines are not a good option. It shows that the overlap is taken seriously enough to be treated as one problem. It does not test whether swapping one source of intensity for a safer one works, so hold this as reasonable harm reduction rather than as something proven.

van Emmerik-van Oortmerssen K, Vedel E, Kramer FJ, Blankers M, Dekker JJM, van den Brink W, Schoevers RA. (2019). Integrated cognitive behavioral therapy for ADHD in adult substance use disorder patients: Results of a randomized clinical trial.. Drug and alcohol dependence doi

Strength of evidence: one line of research. A single study, or a theoretical account.

Why it works

The wanting does not vanish when you refuse it, so it is safer to have somewhere planned for it to go.

When not to

If the risk taking already runs through drink, drugs, driving or money you cannot afford to lose, this is past self management and worth taking to a professional.

This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.

Near this one

More on focus, starting, and adhd

If you are pulled towards risk, you will do better giving that pull somewhere with a floor under it than trying to switch it off. Fast, high, cold, loud: choose the planned version rather than the one that turns up at two in the morning · Inshirah