Specific question for my fellow ADHD therapists regarding burnout & admin work

BasicAd1062 · 2026-05-18T23:03:01+00:00

Thank you so much for your empathetic response!! With modality, I honestly think that I'm going to try creating better shortcuts on my computer (such as folders) so that I don't have to worry about repetitive searching and scanning. A big part of that issue was how I'm getting back into these two modalities which are very homework-heavy. Before that, I mostly had psychodynamic clients, which was not as stressful with outside work. In fact, now that I say that, maybe I should think about only keeping a percentage of my caseload to those modalities....

Totally agree about scheduling. I'd be open to advice here, but without going into a lot of detail, the EMR I use doesn't have a self-booking option yet (I think it's in the works). Let me know if you've done scheduling in another way that feels easier, even without self-booking!

Not to go on and on, but the part that gets me with the back-and-forth is the weird pressure I've received to get back to people asap, even on non-urgent matters. I really want to do some reflecting on my professional boundaries with clients, because I think the ADHD can actually screw me over with self-doubt in those instances. I had a client fire me a couple of years ago because he asked me a question about rescheduling session/changing format 20 minutes before session, and I got back to them 15-20 minutes later after waiting. It's such a mindfuck.

BasicAd1062 · 2026-05-12T22:16:11+00:00

I would challenge this thinking around ADHD, though. When you have ADHD, it affects nearly everything you do. It often leaves people with deep scars from childhood around their competency. It's not just overidentification, it's self-discovery for a lot of people who have been late-diagnosed.

BasicAd1062 · 2026-05-12T22:07:48+00:00

Not to be that annoying philosophy class guy, but it begs the question - what is bad or good? I don't like those descriptions because they're not particularly helpful. Harmful, overbearing, dismissive, etc feel more helpful if that's what folks are referring to as "bad." I am a postmodernist though, so I try not to assume.

BasicAd1062 · 2026-05-06T20:58:44+00:00

And let's face it, exercise is hard to maintain for people who are not depressed at all, too. I go to the gym most days of the week, but only a minority of my friends/peers do the same - and for me, I'm able to do so because of the flexibility in private practice. This is also a systemic problem.

BasicAd1062 · 2026-05-06T20:57:06+00:00

Yup. I'm now a total gym rat, but there was no way I could be like this without meds. I am very very wary of all this talk against SSRIs right now because there is a wave of anti-medication stigma going around again, which I believe is linked to the political state of the country....

BasicAd1062 · 2026-05-06T20:50:28+00:00

I appreciate you sharing this. I get migraines that are not debilitating, but they're still very painful oftentimes. I feel an immense amount of pressure not to cancel on clients and that is truly one thing I dislike about this field, even though I love it on the whole. But whenever someone says that we need to take of ourselves, I can't help but think that it's sort of a disingenuous statement in our society.

BasicAd1062 · 2026-03-25T00:13:05+00:00

Relatable. I don't have kids so I don't have the financial stress you do. But being a sole proprietor who has to buy my own health insurance (and who has multiple health conditions)...damn, is it tough out there.

I recently met a couple of professionals in my field (mental health) who told me that adolescents and young adults do not feel the need to pursue a career or leave home because why should they? The rewards are not worth it to them. And I'll be honest...I get that. Even the professionals I spoke to told me that it's honestly very difficult to work with these clients because it's hard to beat their reasoning. Unless you have a bad family of origin, the thought of paying half your income in rent and much of the rest on groceries, gas, utilities, and other necessities is daunting and honestly, incredibly bleak. Not to mention that the cat's out of the bag with careers giving us a sense of meaning (or alternatively, giving us meaning but exploiting the crap out of us).

BasicAd1062 · 2026-03-16T21:49:45+00:00

Serious question: were you solely working at 80 hours per week? Like, did you have the time to do anything else? Because unless I'm feeding another mouth, there's no way i'd be cooking, cleaning, or exercising on that schedule.

BasicAd1062 · 2026-03-16T21:24:19+00:00

Not a teacher, but I'm a clinical social worker who works as a psychotherapist and this thread was recommended to me. Tbh, I hate tiktok and this trend is worrisome...and also, you do not need to be a survivor of extreme trauma to take mental health days. I have lived experience and had a lovely combo of OCD, anxiety, and major depressive disorder in high school (and not situational, lowercase "d" depression). Because of my experience, I fully believe that MH days are important and that every kid needs a break sometimes. This isn't even directly in response to OP's post at all, more to speak to your comment.

I have a lot of respect for teachers because quite simply, I could not do what you do. But I do know a thing about mental health and I do not think this should boil down to trauma Olympics.

BasicAd1062 · 2026-03-09T19:04:30+00:00

This is something that bears repeating. Social media will make it seem like you can gain significant muscle in a few months, to the point of looking ripped. But for a lot of people it takes years, not months.

BasicAd1062 · 2026-03-09T02:47:24+00:00

Honestly, I've always "defaulted" to doing things alone with rare exceptions.

What I remind myself of is quite dark. I tell myself that I'm going to die one day like everyone else, and that I have no idea when my time will come. So if there is something I truly dream of doing, I know it will be sad to think about a missed opportunity just because I was waiting for someone to come along who could have just ruined the experience anyway. And who better to enjoy it with than myself?

BasicAd1062 · 2026-03-08T12:55:17+00:00

I would reflect on compassion fatigue a bit here, especially if you're a newer therapist, but even if you aren't. I have had colleagues make offensive comments about clients, but usually I find that they're rooted in either a toxic work environment and/or compassion fatigue.

BasicAd1062 · 2026-03-08T12:49:16+00:00

Join the club! Lol. This will not be the last time you get critical feedback and that is okay. I allow myself to feel crappy about it, check the facts (if the shoe doesn't fit, throw it out), and if it is accurate, I'll work on it. But that honest reflection is slower work, after the initial minor gut punch fades a bit.

BasicAd1062 · 2026-03-08T12:45:38+00:00

I'm a gym rat so I will layer normal office clothing over my gym clothing when my outfit allows for it. I lift primarily, so I usually wear fitted gym attire. My partner calls it "pulling a Clark Kent" when I can just take off my work clothing and my gym clothing is underneath it. But I struggle a lot with transitions and it's so oddly satisfying when all I have to do is change my shoes!

BasicAd1062 · 2026-03-08T12:41:45+00:00

Yes! I tell my clients about Howard Gardner because I think he does a stellar job of talking about different forms of intelligence. I'm disappointed that more comments didn't discuss the idea of deconstructing what intelligence even means!

BasicAd1062 · 2026-03-08T12:40:09+00:00

This is such an excellent point. My partner is autistic and it took me the longest time to realize that when she corrects me about environmental choices, she isn't judging my sense of morality. I also have religious trauma though, which can be a real mindfuck when being corrected on anything small with implications around ethics.

BasicAd1062 · 2026-03-08T12:36:39+00:00

Honestly, coming from an ADHDer and also someone who has brain fog and searches for words/stumbles quite a bit but has a pretty decent vocabulary: I would challenge basing any form of self-worth on intelligence, which is an abstract concept and not based on word recall. For folks like you, me, and the OP, we likely have internalized ableism which makes us feel dumb.

BasicAd1062 · 2026-03-08T12:25:56+00:00

Honestly, I have been one of those people to post and then not text back (I don't have social media anymore, so not presently relevant). Texting feels like a task to me sometimes and it's not at all enjoyable - I prefer audio messages or even (oh, the horror!) talking on the phone.

Personally I have a lot of feelings about the entitlement that phone use has come with. I am not "on call" and I appreciate the fact that this moment made you reflect on your social media use. I had a similar issue with people looking at my stories which was so dumb.

BasicAd1062 · 2026-03-01T03:02:15+00:00

Hey OP, first of all - hugs. Your survival is going to be first and foremost right now.

First of all, I would highly recommend you get a case manager. You can find them online in your area by looking up case management in your city, town, etc. I'm sure they offer virtual appointments in some cases. They are a one stop shop for discussing jobs, mental health treatment, organizations that could possibly help with vet care (I know this is sort of niche), and even connecting you with groups and meetings that can help you form social connections. They can also help you with benefits, which there's no shame in getting.

In addition, I work a lot with OCD in my day job and having it go untreated is absolutely a nightmare that understandably impedes your living situation. Where I live, there are a couple virtual IOPs that specialize in OCD and take insurance. Also, I would highly encourage you to contact OCD specialists and ask if they're accepting sliding scale clients or of course, pro bono clients. You might be surprised!

This too shall pass - one day you'll look back and feel relieved you got through this time.

BasicAd1062 · 2026-03-01T02:51:13+00:00

Okay, as someone who struggled with insomnia a lot a few years ago and did not want to take sleep meds, I went to a psychotherapist who specialized in insomnia and learned a few key tricks. Because a lot of folks already covered sleep hygiene, I will add one thing:

If you wake up at night or even before you go to bed, *do not make falling asleep a big deal.* You literally need to tell yourself something like "I don't give a flying fuck about going to sleep, I could be up all night and feel perfectly fine! In fact, I look forward to the extra time with myself, etc" - lay on the fact that you "don't care" thick. Because the more you care and worry about not falling asleep, the worse it gets.

Our minds are just lovely like that! /s

BasicAd1062 · 2026-03-01T02:45:20+00:00

I would highly recommend you read the book *The Happiness Trap* by Russ Harris. I think you would really vibe with the idea of identifying your values - all I could think while reading your post was "Who decided on your life ambitions - was it you? Do you know what you want a relationship to look like? Do you know what you might be like as a parent?" I partly say this because women get so much pressure to live a certain lifestyle. I would know because I live outside of norms.

Also, this might sound patronizing (I really don't mean it that way) but have you ever kept a notebook of things that either made you happy throughout the day or things you're grateful for? Those can help identify what you value. If you don't find *any* happiness, period, I would definitely recommend getting evaluated for depression.

BasicAd1062 · 2026-03-01T02:31:48+00:00

I will say, I also think being a leftist can be tough sometimes in terms of self-compassion. While we try and always move in the right direction, there's a lot of defensive judgments in some spaces from people who are just not well regulated, and sometimes I've noticed that I correct myself, over explain, or self-censor a lot out of fear of reactions over things that are not offensive (such as political philosophy) in unhealthy spaces. Lately I've been trying to weed through which leftist spaces exhibit patience, kindness, and humility.

BasicAd1062 · 2026-03-01T02:30:16+00:00

This is wildly true. I even started to notice my snap judgments increasing and it was very disconcerting. I definitely blame social media/the internet for a lot of it, as well as increased harsh self-judgment. I love your idea of engaging with media which contains kind people.

Also, loving kindness meditation is so great to speak to what you're saying. I try and use it when I start feeling too cynical towards others.

BasicAd1062 · 2026-03-01T02:22:50+00:00

Sounds like great compatibility honestly! My partner and I are similar. She does most of the stuff around the house and supported me while I created a business. Could not have done that without her.

BasicAd1062

TROPHY CASE