Is Being Busy Good for People With A.D.H.D.?

In high school, Sophie Didier started falling behind. She found it difficult to concentrate on her schoolwork, felt restless in class and often got in trouble for talking too much.

“I had a teacher that used to give me suckers so that I would shut up,” she said.

At 15, a doctor diagnosed her with attention deficit hyperactivity disorder. Medication helped, but she discovered that having a demanding schedule was also important. In both high school and college, her grades improved when she was juggling lacrosse and other extracurricular activities with her classes. Being so busy forced her to stick to a routine.

“I felt more organized then,” recalled Ms. Didier, now 24 and living in Kansas City, Mo. “Like I had a better handle on things.”

Research has shown that A.D.H.D. symptoms can change over time, improving and then worsening again or vice versa. And according to a recently published study, having additional responsibilities and obligations is associated with periods of milder A.D.H.D. This might mean that staying busy had been beneficial, researchers said. It could also just mean that people with milder symptoms had been able to handle more demands, they added.

Oftentimes, people with A.D.H.D. “seem to do best when there’s an urgent deadline or when the stakes are high,” said Margaret Sibley, who is a professor of psychiatry and behavioral sciences at the University of Washington School of Medicine in Seattle and who led the study.

The study, published online in October in the Journal of Clinical Psychiatry, tracked 483 patients in the United States and Canada who each had a combination of inattentive and hyperactive-impulsive A.D.H.D. symptoms. The researchers followed the participants for 16 years, starting at an average age of 8. They found that about three-quarters of the patients experienced fluctuations in their symptoms, generally beginning around age 12, which included either a full or partial remission of symptoms.

Dr. Sibley said those periods of remission were more likely to occur during demanding times of life. For example, those who worked or attended school full-time, raised children, lived independently or had financial obligations to people besides themselves had greater odds of their symptoms improving.

Not everyone with the disorder will find it helpful to stay busy, cautioned Dr. Craig Surman, the director of the clinical and research program in adult A.D.H.D. at Massachusetts General Hospital, who was not involved in the study. How their symptoms will respond depends on whether a person’s abilities and strengths align well with what is expected of them as a student, employee or caregiver.

A limitation of Dr. Sibley’s study was that the researchers recorded each person’s “environmental demands” at two-year intervals instead of examining them more frequently. In addition, the participants weren’t asked about the coping skills they had picked up over the years — for example, exercising regularly or playing a sport, both of which may help tame A.D.H.D. symptoms.

“Some high school students with A.D.H.D. do better when they are in season for a sport than out of season,” said Douglas Tynan, a child and adolescent clinical psychologist based in Delaware, who did not work on the study. “They are not only busier and have less free time, but also are having a dose of high activity.”

He noted that those with A.D.H.D. can have difficulty with tedious tasks, like household chores, regardless of how busy they are. For these people, using strategies to stay organized, like to-do lists, is also necessary, not only when switching from one activity to another but also when returning to an activity already in progress.

Abby Balderson, 44, who lives in Virginia Beach, said she has tried to build her life in a way that will help her A.D.H.D., which was diagnosed in childhood.

In order to function well, she needs her day to be planned, with brief moments to relax while transitioning from one part of the day to the next. She also functions better with a consistent bedtime and wake time.

“There’s not a lot of chaos,” said Ms. Balderson, who was able to lower her dosage of Concerta a few years ago. “When my schedule is the busiest and the most predictable, I think that my A.D.D. does the best.”

The key, Dr. Sibley said, is figuring out what works for you.

“If you can put the right things in place in your life, you can maximize the likelihood that you’ll keep your A.D.H.D. at bay,” she added.