Being a caregiver to a friend or loved one is hard—add ADHD to the mix, and it’s a whole different challenge. Self-care and ADHD Coach Stephanie Antoine joins us to talk about what it’s like caring for our loved ones while managing executive dysfunction, burnout, and more. She also offers a few mindfulness practices to help us recenter when the stress feels like too much. If you’ve ever struggled to care for someone else while trying to keep yourself afloat, this one’s for you.
Being a caregiver to a friend or loved one is hard—add ADHD to the mix, and it’s a whole different challenge.
Self-care and ADHD Coach Stephanie Antoine joins us to talk about what it’s like caring for our loved ones while managing executive dysfunction, burnout, and more. She also offers a few mindfulness practices to help us recenter when the stress feels like too much. If you’ve ever struggled to care for someone else while trying to keep yourself afloat, this one’s for you.
Related resources
Timestamps
(02:59) Why did Stephanie start helping others in caregiving roles?
(04:52) Executive function and caregiving, and beating yourself up
(07:51) How do we manage big feelings like frustration and resentment while caregiving?
(12:33) Perfectionism and caregiving
(17:14) The one thing Stephanie wants you to hear today
(19:09) A short guided meditation exercise from Stephanie
For a transcript and more resources, visit the Sorry, I Missed This show page on Understood.org.
We love hearing from our listeners! Email us at sorryimissedthis@understood.org.
Cate: Hi, everybody. Welcome back to "Sorry, I Missed This," the show where we talk about all things ADHD, relationships, intimacy, and communication. Now, today, we are going to look at a really interesting type of relationship: the caregiving relationship. And in particular, we are looking at caregiving for aging parents, aging relatives. That kind of thing. Especially for a lot of us millennials, our parents and our relatives are getting older, and a lot of us are finding ourselves in the caregiver position for the first time. And so, I am really excited to introduce you to today's expert, Stephanie Antoine, who does a lot of work in the ADHD community, teaching folks mindfulness and meditative practices in order to facilitate healthy relationships and mental health for caregivers.
I do wanna let you know, dear listeners, that this episode is another one that is pretty close to my heart because very recently I saw my mom naked. And when I say that, I mean I became my mom's caregiver and, and the change in that relationship and the jokes that I tell about, you know, "I had to see my mom naked. I had to rescue my mom off of the bathroom floor," that kind of stuff, I make light of it because I think it can be really challenging. It can be really challenging for a number of reasons.
Number one, because with ADHD, I think, caretaking is just more difficult, but two, processing the emotions of the change in that relationship and what it's like to have to help your mom in and out of the shower or, you know, in and out of the bathroom, these deeply personal and deeply private things that, especially in my family, really didn't happen until my mom couldn't do it, by herself. You know, getting the phone call that your grandma couldn't get off the floor, getting the phone call that your grandpa is gonna need to go into long-term care. Those are really difficult.
And when you combine that with executive functioning, when you combine that with emotional dysregulation, when you combine that with rejection sensitivity, I really do think that caregiving with ADHD is a little bit of a different beast, and so, I wanted to talk to an expert about what those relationships can look like, how we can set ourselves up for success, and what it's like to navigate through changing relationships.
I was the full-time caretaker for my mom for about three months after she had a really serious spine surgery. But over the course of those months, my relationship with my mom changed. The way that we interact changed, the way that we, I think, relate and think about each other changed. And so, in preparing for this episode, I was really curious about that, those relationships, how we support our own mental health, how we support the burnout of caregiving.
And so, dear listeners, I'm really excited for this one. Stephanie Antoine has some really beautiful and really creative insights about this topic, and so, I'm excited to welcome you to this episode. Here we go.
Stephanie, thank you so much for being here. Welcome to the show.
Stephanie: Thank you so much, Cate. It's a delight to be with you.
Cate: I'm curious about what made you curious about pursuing ADHD and caregiving and caregiving roles?
Stephanie: I think it was self-preservation, really. I've always been a very stressed person. I find it kind of amusing, actually, that I'm a person that teaches, you know, stress reduction and self-care. I find it so hard to do myself.
Cate: Yeah.
Stephanie: Like everything that I offer to others, is because it's been hard fought for me. It's not theoretical. I literally had to understand, like really understand viscerally that if I didn't take care of myself, I couldn't take care of anyone else. ADHD makes it such that, you know, if you aren't tending to your own stress reactivity, you don't have the capacity to be present to support another person. And it's particularly cruel in that way because it both makes us more reactive and more vulnerable around that reactivity.
You know, as I was preparing for today, I could feel my heart rate going up. I could feel my tummy like doing things. I could feel that my hands got cold, and part of me wanted all of it to go away. Like, "Can we just fix that? Can we just make it better? Can we just be better? Like be perfect, preferably." And it's like, "Yeah, sorry, love. That's not actually going to happen."
Cate: That idea of we have to be able to take care of ourselves, that is such a lesson that I know so many women with ADHD have hard learned. Like we hit that burnout point, and then that's a lot of times the catalyst for seeking help and seeking supports. And so, I love the idea that right at the top of the episode, we're saying "It's really important to take care of ourselves first."
I think one of the really interesting things about ADHD is how much our executive functioning is tied into our experience and how that works. And I know even from my own personal experience, because my mom actually just had some pretty serious surgery, and I wound up being her full-time caretaker for about three months. I felt changed after that experience. I felt like I had a different relationship to my mom. I felt like I had a different relationship to myself and that our sort of mother-daughter relationship had shifted in a lot of ways. But a big thing for me was just the executive functioning. The managing appointments, the medication, my medication, her medication. How does ADHD impact our ability to manage these day-to-day tasks? And then sidebar question, what strategies can help us?
Stephanie: Well, so the sidebar is: don't do it alone. Caregiving already is very lonely just because of this back and forth, up and down. Like for example, a friend might say, "Will you meet me to go and have a cup of tea?" And you might say, "Oh, I'd love to." And then five minutes before, an hour before, you're like, "Oh, I have to bail because I have to do this thing."
So, I think in the same way that it impacts everything else, the fact that we struggle with distractions continuously, the fact that we have challenges initiating and sustaining and completing boring tasks, the challenges of, you know, having stress spikes when you are on hold for the umpteenth time with for an hour and a half with the insurance company. Like all of these things that you have to track. Multiple doctors, multiple prescriptions, multiple appointments. It is unbelievably overwhelming to have all of these streams of information, knowing that if you don't show up for those streams of information, your loved one is not going to get the care that they need. It is overwhelming, and you're kind of co-regulating a person.
So, that's the other piece is this piece around co-regulation. Like, just regulating your own nervous system when you have ADHD is a challenge. And then, you know, imagine that you are now in the hospital or at the doctor's office with your carry who might be very anxious, very afraid, co-regulating another nervous system. The result is fatigue.
And so, I think one of the most difficult things is that, well-meaning neurotypical family, friends, supporters don't know how hard we're working because we don't really know how hard we're working, and so, you can get into this incredibly overwhelmed, fatigued state and then be beating yourself up constantly about, "Well, I should be able to do more. I can't understand why I'm so tired. How can I be in such a state when my carry is in so much more difficulty?"
Cate: Especially knowing that fatigue and executive functioning and, and frustration tolerance, all of that stuff, how do we manage big feelings like the frustration, the guilt, the grief, even sometimes, and, and I just want to name this 'cause I think it's really important, but resentment towards the carry? How do we manage that when we are caregiving for someone we love?
Stephanie: MBSR really helped me. MBSR is mindfulness-based stress reduction, and it is a eight week protocol designed by Jon Kabat-Zinn. And it's a way for people to practice certain aspects of mindfulness practice where you kind of come into the present moment and have these various lenses of seeing what's happening moment to moment. He started the program because there were people, where he was that, you know, the doctors had given up on because they all had like really, really bad pain. They're dying from cancer and all this kind of stuff, and nobody knew what to do with them. And so, one of the things that you kind of learn in MBSR is that sometimes there literally is nothing we can do about a situation. The only thing that we can change is how we view it.
So, for example, if I'm super, super tired and I just snapped at my carry because I'm so tired and I'm like trying to cook dinner, and it's like this is an absolute disaster. And then right now, right now there's a lot of frustration. Right now, frustration is arising, frustration is here. Oh, let's get interested in frustration. What is the felt sense of frustration? And it's almost like as if in that moment a wise parent took a brand new toy out of their pocket and said, "Here, what's this?" And the kid goes "Huh?”
Cate: That moment of distraction, right? That moment of reframing.
Stephanie: It's moment of, and it's a distraction, and yet it's also a shift in experience, right? And so, what MBSR does is it kind of trains us to come into the moment and to go to an object of attention. This works both in the moment of frustration, but it also needs to be practiced so that you have more capacity to recognize that there's a whole lot more going on than your frustration, so that you don't get identified with it.
You know, you're not saying, "I am so frustrated. I am become frustration," right? You're like, "Wow, this is a big wave of frustration," instead. Building this muscle of recognition of like arriving in the moment and really knowing what is happening in that moment, it gives us so much more choice in how we experience things.
Cate: Can you talk us through a moment of frustration, like, if I find myself getting frustrated at my mom, 'cause you know, who doesn't get frustrated at their mom every so often, but if you do, what does, what does that actually look like?
Stephanie: In that moment of frustration, you turn to the body and you say, "Right now I might feel my feet on the floor to change my own internal weather, to change where my attention is." It's like, "Let me feel into the weight of the body as it stands here." Because we can only really attend to one thing at a time, even though as ADHDers we are incredibly good at splintering our attention in a million different spaces at once. Really, the attention can land on either like this big emotion, or it can go to the body, and it can be with a body sensation.
Cate: What type of body sensations am I looking for?
Stephanie: So, often the weight of the body can be really powerful, and different ADHDers have different needs for input, for sensory input. And so, you can use that. You can learn your own kind of vocabulary of "How much sensory input do I need so I can stay? So, my attention can land, and so it can stay."
Cate: Yeah.
Stephanie: Some people need to hear less. Some people need to hear more, you know, bright lights, dark, all of these things. We all have a profile, a sensory profile.
Cate: It's so funny 'cause that is directly, I could say that verbatim at a lot of like the intimacy and, and like relational workshops that I teach. Is that idea of knowing what your body needs and playing around with that discovery and giving yourself the freedom and permission to say, "OK, I'm gonna try a new thing today. Maybe it's grounding, maybe it's lying down, maybe it's doing some stretching, maybe it's doing some like frenetic dancing." None of those are wrong answers. It just may be that one of those works really, really well for you. But it allows us to sort of process those big emotions, get through that moment without stopping, and then say, "OK, what's the next thing that we, you know, we need to do?"
Something that I run into a lot with a lot of women with ADHD is the perfectionism, is the I, it is my job to hold everything together. I'm the one, I'm the caretaker. I'm the mom. I'm the parent. I have to do it all. So, how do we let go of that perfectionism, especially when it comes to caregiving?
Stephanie: I think the first step with things like that is really to recognize the fallacy of it. You know, somebody listening to us today might think, "Oh, well, they've got it all figured out. Like they know what they're doing."
Cate: That's not, dear listener. That's not true. That's not true.
Stephanie: That's not how it works. No. The thing is that we live in a culture in a time where, you know, we have all this Instagram, like all this externalized perfection. And that is not reflective of people's lives. There is a woman that wrote this great book. Is it "Cleaning While Drowning" or something?
Cate: Oh, KC Davis. "Keeping Household Drowning."
Stephanie: Yeah.
Cate: Big friend of the podcast, KC Davis, she's been on the show. She wrote the introduction to my book. We love KC Davis around these parts.
Stephanie: There is something in that book that said something about having a clean house is not a moral choice or something. Like, there's a lot of projection that we have, I think, around how things should be, and I think with perfectionism it's really important to recognize the demand that is coming from that, from whatever the flavor of perfectionism is. What is the unreasonable demand that is coming?
Like for me it was, I grew up in a time when, you know, women were supposed to have it all. You're supposed to have it all at the same time. And the women that were saying "You should have it all," they were very wealthy people who could afford nannies and trainers and so yeah, they were gonna have perfect nails and bubble butts and have, you know, they, they were still suffering. It's not that they didn't struggle.
But, comparison really is the thief of joy. I mean, it just will not work. Even if a person is well-resourced. You know, I've worked with people who even when they get the break, they can't enjoy it because perfection is kind of anchored in how things should be. It's anchored very firmly in judgment, in this kind of brittleness around shoulda, woulda, coulda. Things must be going a certain way for me to be OK with them.
Cate: Is there a way that we can utilize mindfulness meditation to work on letting go of perfectionism?
Stephanie: So, you know, there are different objects of attention. So, before we were speaking about, you know, in the body coming to the body, but I think this is about watching the mind and how it thinks. The mind thinks very habitually. Sometimes the worst types of thinking can feel very familiar and very easy, and so, it's kind of going against the type of thinking. It's not believing your own stinky thinking. You kind of have this practice of like when the thought comes up, "Well, you should." It's like you kind of like "Really." Because the mind will think, the mind thinks it's its job.
We don't need to accept every view that we come across. So, what mindfulness does, and it's not very comfortable, I don't wanna make this sound like, you know, it's a bunch of hearts and flowers. It does mean that we build our capacity to have well-being with non-well-being, to have things be unpleasant, but still be OK with it.
So, what I do with people is to have them practice recognizing these types of thoughts and how they keep recurring, how they keep coming back. And what's happening right before that type of thinking, like it might be that you start thinking a certain way when you get really tired, that doubt starts to come up, and then you start berating yourself.
Often it can be the unpleasant naggings of an adult that was in charge when you were younger that are particularly difficult to hear, and sometimes it's really awful things that have happened to people. You know, really difficult things that have happened to them that kind of continue to dog them into the future. You know, times when they weren't very skillful or when somebody else caused them harm, and now these things are kind of repeating, repeating and repeating, and repeating. Because what can be really alarming is when well-meaning people dismiss or deny or mislabel the experience. Or accuse them of being selfish because they're expressing a need.
Like, people will come to me and I'll be like, "No, no, that's a real thing. You should be able to feel rested in your own home. It's not OK if you are very, very tired and you lie down to rest. And then somebod in your home says 'Why are you lying down?'"
Cate: So, Stephanie Antoine, thank you so much for being here with us today as you leave us, if someone is listening who is in the thick of caregiving and they're feeling alone, overwhelmed, guilty, ashamed, all of the above, what's one thing that you want them to hear today?
Stephanie: I want them to know that they're not on their own. There are millions of people around the world. Caregiving is largely invisible, ignored, and every single person on the planet needs care. And so, know that whatever it is that you are doing that is frequently too much for you, not enough for the person you are caring for, dismissed or criticized by everyone else that's, you know, says that they know better, it is the most profound thing that we can offer to another person, our presence, our care. It is the biggest gift we can offer. And so, knowing that to do what you need to do to take care of yourself so that you can be present for the people that you care for, the people that you love.
Cate: Beautiful advice.
Stephanie: I find it so cruel. It's like there's this big kind of elevation of motherhood is like being, you know, this amazing thing, but then what you see is that actually there's very little real support and I think that's the case for many caregivers also, it's a very invisible, very expensive, very time consuming role, and it's very hard to get recognition from others.
So, we have to really kind of hold for ourselves and to not give up on looking for resources for you, for your carry, that you are worthy of getting a break, that things like stopping and resting have to be practiced. They're not easy. They feel really unfamiliar if you haven't been doing enough for a while, but you are worthy, you're worth it.
Cate: Really quick before you go.
Stephanie: Yeah.
Cate: Do you have like a three-minute mindfulness exercise or like, you know, centering exercise that you could like guide our listeners through?
Stephanie: Yeah, so the practice that I do, it starts with arriving. And you don't need to be in any particular state to arrive. We are arriving all the time, so as you're listening to this, you can just arrive into this moment just as you are.
I think one of the things that people who want to practice mindfulness or meditation more often feel like they have to be a certain way to show up, and that's not true. You arrive just as you are. So, if you just feel now, like Cate, you were arriving into the last few moments that we have together, if we have capacity, we can sense into availability to feel the weight of the body as it sits here.
We can sense into stillness because stillness is here, even with all of the movement, even with all of the sounds. And if you can imagine if somebody is listening to this and somebody is screaming in their ear or telling them off, it's like stillness is still available even in the midst of all the other stuff that's going on.
And so, as I'm sitting here and I'm practicing this arriving and being available, I am feeling into the weight of my body as it sits here. I'm feeling my sit bones. I'm feeling the weight of my legs. I'm feeling the touch of my palms on my knees. I'm feeling my eyes, the softness of my eyes. I am feeling the shoulders sliding down my back, and I'm knowing that things are well, even if they are not well.
That ease is available even in the madness of our daily life. And if ease is not available, that it's fine. That maybe what you find when you arrive is tension and jarring. And that is fine too because Dana likes to say "all parts are welcome." When we practice in that way, it means that we're available for when things are really not OK and that we are also have more capacity to recognize those moments when things are OK, like you know, those periods of sunlight between storms. And then when we have a choice that we can choose to turn towards ease and availability.
Cate: Thank you for listening. Anything mentioned in the episode will be linked in the show notes with more resources. Have a question, comment, burning story you'd like to share? Email us at, sorryimissedthis@understood.org. This show is brought to you by Understood.org. Understood is a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. If you want to help us continue this work, donate at Understood.org/give.
"Sorry, I Missed This" is produced and edited by Jessamine Molli and Margie DeSantis Video is produced by Calvin Knie. Our theme music was written by Justin D. Wright, who also mixes the show. Samiah Adams is our supervising producer. Briana Berry is our production director. Neil Drumming is our editorial director. For Understood.org, our executive directors are Laura Key, Scott Cocchiere, and Seth Melnick. And I'm your host, Cate Osborn. I'll see you next time.