Talk delivered to OpenWest 2019

1. Attention++: Professional Success
with Adult ADHD in Tech
OpenWest
April 10, 2019
© Daniel Kolkena 1

2. Discuss personal story!
"Gifted" child, underachiver in
adolescence, chronic
underperformer in college and
early in career.
About the Presenter
Daniel Kolkena is a Senior DevOps
Engineer with 10 years of industry
experience in system administration,
software development, and application
support. This, despite dropping out of
college–twice! He’s passionate about
tooling, process optimization, self-
improvement, and music from the
1980s.
© Daniel Kolkena 2

3. It's estimated that 5% of adults are
affected by ADHD
This is an important topic for me
because it's affected my
professional life so profoundly. I'm
happy to share some of the
resources I've found along the way.
Intro
Attention Deficit/Hyperactivity Disorder is a
neurodevelopmental disorder that affects up to 5% of adults.
It’s an often misunderstood condition that can significantly
affect one’s personal and professional life. I’m excited to share
insights from a career full of highs and lows managing Adult
ADHD and some tools for anyone, ADHD or not, interested in
improving their productivity.
© Daniel Kolkena 3

4. I can't diagnose you, and I highly
recommend against diagnosing yourself. If
you feel like you identify enough with these
challenges for a formal diagnosis, talk to
your doctor!
Any recommendations I make are based on
my own experience. I have not been paid for
anything I speak about today. Which kind of
sucks now that I think about it.
Disclaimers
I’m an engineer, dammit, not a doctor!
This talk is not intended to be a substitute
for professional medical advice, diagnosis,
or treatment. Always seek the advice of
your physician or other qualified health
provider with any questions you may have
regarding a medical condition.
I have received no compensation for any
recommendations I make of treatments,
techniques, or products. The information
and advice contained herein is solely the
result of my own research and experience.
© Daniel Kolkena 4

5. Take an informal poll: How many people here know
they have ADHD? How many suspect they might? You
are among friends here.
This talk is aimed at people who know or suspect that
they have ADHD and want help to succeed in the
workplace. I'll talk about what it is, as well as available
treatments and techniques to overcome those
challenges
Reassure audience that they should feel free to take
notes, but there will be links to the slidedeck shared at
the end, including citation and external link info
What will this talk cover?
1. What is ADHD
2. What can I do about it?
© Daniel Kolkena 5

6. What is ADHD?
6

7. What is ADHD?
“A lifelong, persistent pattern of inattention and/or hyperactivity-impulsivity that
interferes with functioning or development across time and settings.”
• Was described as “ADD” in DSM-III in 1980
• Formally defined as “ADHD” in DSM-IV in 1994
• Current definition has 3 subtypes: Predominantly Inattentive,
Predominantly Hyperactive-Impulsive, and Combined Presentation
• The condition onsets in childhood. Up to 5% of children may meet the
diagnostic criteria. 1/3 to 2/3 of children diagnosed will continue to exhibit
symptoms through adulthood.
© Daniel Kolkena 7

8. The Inattention subtype deals with
being easily distracted or forgetful.
Symptoms include things like
daydreaming, struggling to stay on
task, and a general lack of organization.
For adults, at least 5 symptoms from
this list are required.
DSM diagnostic criteria for Inattention
• Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
• Often has trouble holding attention on tasks or play activities.
• Often does not seem to listen when spoken to directly.
• Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g.,
loses focus, side-tracked).
• Often has trouble organizing tasks and activities.
• Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as
schoolwork or homework).
• Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys,
paperwork, eyeglasses, mobile telephones).
• Is often easily distracted
• Is often forgetful in daily activities.
© Daniel Kolkena 8

9. The Hyperactive subtype
deals with feeling restless and
fidgety. This is the "classic"
stereotype of ADD.
For adults, at least 5 symptoms
from this list are required.
DSM diagnostic criteria for Hyperactivity and Impulsivity
• Often fidgets with or taps hands or feet, or squirms in seat.
• Often leaves seat in situations when remaining seated is expected.
• Often runs about or climbs in situations where it is not appropriate (adolescents or adults may
be limited to feeling restless).
• Often unable to play or take part in leisure activities quietly.
• Is often “on the go” acting as if “driven by a motor”.
• Often talks excessively.
• Often blurts out an answer before a question has been completed.
• Often has trouble waiting his/her turn.
• Often interrupts or intrudes on others (e.g., butts into conversations or games)
© Daniel Kolkena 9

10. Further diagnostic criteria
In addition to the previous criteria, you must have
• Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years.
• Several inattentive or hyperactive-impulsive symptoms are present in two or more settings
(e.g., at home, school, or work; with friends or relatives; in other activities).
• There is clear evidence that the symptoms interfere with, or reduce the quality of, social,
academic, or occupational functioning.
• The symptoms do not occur exclusively during the course of schizophrenia or another
psychotic disorder and are not better explained by another mental disorder (e.g., mood
disorder, anxiety disorder, dissociative disorder, personality disorder, substance
intoxication or withdrawal).
© Daniel Kolkena 10

11. Discuss pervasive myths: sugar,
caffeine, the teevee, that dang rock
music that all the kids listen to
Reward feedback loop: our brains don't
feel the same sense of reward as
neurotypical brains
OTOH, for intrinsically motivation
activities, it's easy to hyperfocus
Causes of ADHD
• There’s no scientific consensus on a single cause
• Research points to a heavily genetic component; there’s
evidence for environmental factors as well
• Predominant theory: dopamine and norepinephrine
neurotransmitters don’t work the same way a neurotypical
brain does, so we don’t receive the standard reward
feedback for accomplishing tasks
© Daniel Kolkena 11

12. The prefrontal cortex is responsible for what
we call Executive function: attention control,
inhibition, working memory, time
management, and problem solving.
This is why we might struggle to complete a
simple documentation update or bugfix, but
spend several hours tinkering with bash
dotfiles or tmux settings. Or do all the chores
at home we've been putting off instead of
Areas of Difficulty
Managing Daily
Activities
• Poor self-management relative to time,
planning, and goals
• Poor self-organization, problem solving,
and working memory
• Poor self-discipline (inhibition)
• Poor self-motivation
• Poor self-activation, concentration, and
alertness
© Daniel Kolkena 12

13. Depression: could be reaction to environmental stressors, or sometimes
correlate with bipolar (impulsivity). Imagine the effect of constantly
being told you failed just because you didn't try hard enough etc.
Anxiety: sense of impending doom (exacerbated by procrastination),
mood swings, lack of energy, low self-esteem, imposter syndrome
ODD: refusing to comply with rules, frequent periods of anger/
resentfulness, potentially issues with unhealthy criminal behavior
Tics could include vocal tics, motor tics, nervous habits like nail biting/
nose picking/hair pulling/knuckle cracking/jaw clenching, even
Tourette's
Like ADHD, Spectrum disorders can affect language skills, behavior,
social interactions, and the ability to learn. Share "neurodiversity", share
some elements with ADHD but are a separate diagnosis.
Comorbidities
• Depression
• Anxiety
• Oppositional Defiant Disorder (and
Conduct Disorder)
• Tic disorders
• Autism spectrum disorders
© Daniel Kolkena 13

14. This is a HUGE thing in tech!
A pattern of failure will lead to
internalized low self-esteem
These feelings of inadequacy can
linger despite any evidence to the
contrary or external validation
Imposter Syndrome
• A feeling that any success or achievement is due to luck and
not one's own talent or effort
• A persistent fear of being exposed as a "fraud"
• A feeling that you "don't belong here"
Remember: actual imposters almost never suffer from imposter
syndrome.
You can do the hard thing!
© Daniel Kolkena 14

15. Work: Intelligent but underperformed in school, Project an
incorrect professional perception, Taking all day to
complete a 15 minute task, Procrastinating and poor
planning, Inflating progress during standup
Relationships: Forgetting important dates and info, giving
the perception of ignoring or undervaluing significant other
Finance: Forgetting bills, poor money planning due to
impulsivity
Health: Poor diet due to lack of planning and
impulsiveness, failing to follow through long term with
plans, putting off or forgetting doctor appts
How does this
affect my life?
• Work
• Relationships
• Finances
• Health
© Daniel Kolkena 15

16. Everyone experiences these
symptoms in a limited capacity.
It reaches the level of a
diagnosable illness if it's chronic,
pervasive, and negatively
affects your quality of life
If you’re not sure: get a
professional diagnosis
Your primary care physician can refer you to a licensed
clinician, such as a neurologist or psychiatrist
These tests can be long, stressful, and expensive, but is the
only way to be officially diagnosed
© Daniel Kolkena 16

17. Management
strategies and
mitigation techniques
17

18. First step is understanding and
accepting the diagnosis. There's
no easy cure. Nothing will make
this not a challenge.
CBT focuses on improving habits
and behavior by practicing healthy
coping mechanisms
Professional treatment
• Cognitive Behavioral Therapy (CBT)
• ADHD Coaching
• Medication
© Daniel Kolkena 18

19. Stimulant meds trick the brain into producing chemicals at a rate
much closer to that of neurotypical brains. Many of us already self-
medicate with caffeine!
--Side effects include lack of appetite, restlessness, mild euphoria,
small potential for abuse if not used as indicated by doctor
Non-stimulant medications help by boosting norepinephrine,
decreasing impulsivity – less risk of abuse, take longer to work
There is no single drug that works for everyone! What works for
me might be awful for you, and vice versa. Figuring out drug/
dosage is a process with your doc
It's also possible that no drugs are ideal or worth the side effects.
Some people choose not to medicate, and that's okay!
Medication
• Stimulant: Adderall, Ritalin,
Concerta, Vyvanse, etc.
• Non-stimulant: Strattera, Clonidine,
Guanfacine, etc.
• Everyone reacts differently to
different medications
• Work with your doctor to find what
works for you
© Daniel Kolkena 19

20. Meditation and mindfulness
exercises are also helpful!
Stress management
techniques, supportive
community, etc.
Non-medication treatment
Exercise, sleep, and good nutrition can help but do not
represent a comprehensive treatment plan by themselves
© Daniel Kolkena 20

21. It could be our strengths are
more aligned to reactive work
instead of proactive work - Ops,
Support, etc. Or we may be
good at big picture architecture
rather than routine bugfixes
Optimize your work
• Find roles that leverage your strengths and minimize your
weaknesses
• Our brains thrive on novelty, not routine
© Daniel Kolkena 21

22. Taking on too much leads to a cycle of overpromise/
underdeliver and instills a sense of hopelessness and
failure. Look at your previous successes and failures
and your work throughput. Use that to give yourself a
baseline of what you can reasonably commit to.
2 story points but youʼre not confident in the
implementation details yet? Make it 3 or 5.
Consistently delivering commitments on time–even
if itʼs less than you think you might be capable of–will
give you confidence and develop your reputation.
Be honest with yourself!
• Don't take on more than you're comfortable with!
• Give yourself buffer time to deliver your commitments.
• Don’t be afraid to ask for help!
© Daniel Kolkena 22

23. We're bad at time
management, and any system
we use to fix that needs to take
that into account
Time management strategies
• Pomodoro, timeboxing, pair programming
• Browser extensions/apps to disable or eliminate distractions
(email, social media)
• Physical planner
© Daniel Kolkena 23

24. Being asked for a status update for a task
you've forgotten about is humiliating.
Take notes constantly, this can make all the
difference. Don't be afraid to invest lots of
"overhead" time into writing and reviewing
notes. My productivity went through the
roof once I committed to capturing as
much as possible in meetings.
Organizational tools
• Google Suite, OneNote, Evernote, Trello, Wunderlist,
Workflowy, Airtable, Todoist, Notion.so, even CLI tools
• Physical notebook w/ pen
Don't be afraid to evaluate different tools to figure out what
works for you.
© Daniel Kolkena 24

25. Communications in whatever
manner works best for your
cognition and retention (face
to face/conference calls/group
chat/email)
Workspace changes
• Darker dev environment (Eliminate visual distractions)
• Dark UI, IDE
• Quiet space/headphones
• Work with team to establish optimum communication
channels
• Offsetting your working hours
© Daniel Kolkena 25

26. Being upfront about your needs can be
reassuring to your team and supervisor
However, some people believe it
doesnʼt exist/is an excuse for laziness
--That could give the impression of
laziness or casualness that doesn't
describe the real you
Communication with
management and team
• ADA legally protects “reasonable accommodation” requests
• Can ask for shorter feedback cycles
• Detailed acceptance criteria
• Ask about mentorships (a great resource for a professional at
any stage in their career!)
• Caveat: professional risk
© Daniel Kolkena 26

27. We have cognitive challenges that
affect our lives, but they can also be a
source of our unique creative power
We're patient, empathetic, and
compassionate; able to see big
picture ideas, passionate about what
drives us
© Daniel Kolkena 27

28. Self-improvement is a life-long
challenge. You're going to fail.
But that's okay. We improve by
degrees.
You can do the hard thing!
"And now that you don't
have to be perfect, you
can be good."
— John Steinbeck, East of Eden
© Daniel Kolkena 28

29. Questions?
Feel free to reach out!
Email: daniel.kolkena@gmail.com
Twitter: @dkolkena
This slidedeck is available at:
https://github.com/dkolkena/adhd
This presentation was built in Markdown with Deckset.
© Daniel Kolkena 29

30. Resources
• Taking Charge of Adult ADHD by Russell A Barkley
• The ADHD subreddit /r/ADHD
• Dani Donovan (adhddd.com)
• Jessica McCabe's excellent How to ADHD series
Citations
• https://www.addrc.org/dsm-5-criteria-for-adhd/
• https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
• https://en.wikipedia.org/wiki/Adultattentiondeficithyperactivitydisorder
• https://add.org/adhd-facts/
© Daniel Kolkena 30

31. © Daniel Kolkena 31