writing and focusing tips for someone with cognitive complications
February 4, 2016 7:45 PM   Subscribe

I'm trying to finish my PhD thesis. I need help, tips, anything from methods for focusing for someone with probable cognitive issues related to Bipolar I disorder to ADHD or OCD behaviors, and reducing anxiety related to this so that I can function. I would appreciate any advice anyone could offer.

I'm bipolar I with fairly extreme symptoms (rapid cycling, auditory hallucinations, etc.) but I'm medicated and have been for about 10 years. It helps, but it definitely doesn't cancel everything out. I've not ever talked to a doctor about ADHD or OCD and I'm not trying to self-diagnose, but I have always had serious memory retention and focus issues. I have trouble explaining it, but pretty much all of the issues I've read about ADHD writing problems resonate with me (the methods haven't particularly helped). I've had very regular panic attacks, before I started the PhD as well but especially while working on it. For a while it was basically every time I tried to pick up the paper. Honestly I have those mostly under control but the solution is usually to do deep breathing and abandon the task at hand for a little while which is a liitttle counter-productive.

I agonize over this distinction but the issues I'm having feel incredibly 'mental illness'y. I have spent so many hours just trying and getting (literally) nowhere. I feel like I have too much focus and can't focus at all all at once. I'm driving myself crazy.

I'm so incredibly close, I'm down to editing the intro and conclusions, but every time I try to work on it I spend literally hours writing and re-writing the same sentence or thought over and over. I have written easily 15 outlines in an attempt to organize my thoughts for the initial paper writing. If I try to go point by point on an outline and expand on a bullet point I will write the same thought out over and over again and then delete it. If I try to express things verbally to myself I just keep coming around to the same thought as well. And then I get frustrated. So that's where I'm at now.

If we have a conversation I can communicate my ideas clearly. If you ask me to make a figure I could do that for hours. If you ask me to write this shit down couched in scientific language it all breaks down.

I've already defended the thesis. They liked my presentation. The text is the only thing holding me back. I can talk about it with people and it's good work and data at its core but I am having serious trouble handling this, and it's only now that I'm revisiting the paper after defending that I see how persistent this problem is. My advisor knows I'm bipolar but I'm fairly sure he only thinks about the 'mood' part of it. I don't feel particularly comfortable discussing it with him because it is already completely clear he is frustrated with me and thinks I 'don't care' and am being lazy. I don't really hold this against him as I have been a difficult student through all this, but still. I do care or I wouldn't still be in the program. I don't think I'm being lazy but I'm also not getting anything done. This is the end of year 7 of my PhD. Basically I feel like a total failure and disappointment, which also doesn't help.

I listen to instrumental video game soundtracks mostly while writing which I think helps a little bit. Sometimes the same song on repeat seems to help but right now I'm just slamming my head against the wall.

I will not be staying in academia after this. I just need to finish. Please help.
posted by suddenly, and without warning, to Health & Fitness (22 answers total) 17 users marked this as a favorite
Best answer: Can you intersperse your writing with lots of fresh air and exercise? I'm not talking about 1/2 hour 3x/week. I'm talking about multiple fresh air and exercise breaks a day interspersed with the writing.

Also trail mix.
posted by aniola at 7:58 PM on February 4, 2016 [2 favorites]

What about using a dictation utility, so you don't have to write -- you just have to talk? Then, you can edit in small batches, Pomodoro style perhaps, so you don't perseverate on one point for too long. Doing a thesis is damn hard as it is; doing it under the added stress of ADHD and Bipolar is heroic, IMO. You've got this. Keep going.
posted by Hermione Granger at 8:04 PM on February 4, 2016 [6 favorites]

Answering this from the I've-gone-through-the-same-hell-near-the-end-of-defending (it's stressful for everyone), and I now write manuscripts for people. So just some things to think about if it helps.

If you are planning on leaving academia (and not do a postdoc) and you have successfully defended and finished the research...it is not the mountain that you are thinking. If you were going to do a postdoc, needed publications, etc, then yes it is worth polishing it for pubs, but that is not what you will be doing. Also, this is not a bad thing and you might now see it now, but your area is likely only relevant to 10 other people...so it will go on a shelf somewhere in the library. Use this to take the pressure off you - you already defended it.

If you think a boost of mental health (pharmaco, behavioral approaches, stress reduction), you are likely to still be covered by student fees for low to free medical costs. Just an idea.

Now the approach

Grab papers in your field and just look at how they organized (top line, results have these results, this result, figure showing X, etc.) Use it to make a similar outline, but integrating your data. If you are having stress/a hard time focusing, there are often oral apps on computers (if you have a smart phone, you can dictate into your phone and make an outline). If that is how you work to reduce stress and focus, do it (or check in with a buddy if you have someone also going through the end of dissertation stress).

It sounds like the figures are easy for you/not hard to do. So with your list of (talbes needed, figures needed, sections to fill in with results), at the end of each day (or beginning, change your approaches if one doesn't work), do 2 hours of working on the figure.

Also, what I have seen help some students ...not for the "how do I deal with stress" but feedback for your dissertation organization, topics in the paper, etc. can you meet with other committee members? Set an appointment. Bring your outline (or completed sections, etc.) But again, not to ask them to deal with stress, but scienific feedback or feedback related to your field.

Just some ideas.
posted by Wolfster at 8:05 PM on February 4, 2016 [3 favorites]

I used to get with a sympathetic friend on instant messenger and just start explaining to her what I was GOING to say in my paper. Then I'd cut and paste the entire conversation and just edit it down into the text of the paper. Much more conversational-feeling and got me over the hump of composing a first draft.
posted by Eyebrows McGee at 8:13 PM on February 4, 2016 [1 favorite]

Response by poster: Just to clarify, figures, tables, etc. and pretty much all the text is there. It's just that the text is apparently very sub-par for the intro and conclusion (rambling/unfocused I guess, though I have a harder time seeing it), as well as one paper. The underlying concepts are all there, the arguments and data are good, the underlying science is good. But I have a fairly strict committee and it absolutely needs to be much more polished and will ultimately be published (one chapter is already). Just the writing, now.

Thank you for the input thus far.
posted by suddenly, and without warning, at 8:13 PM on February 4, 2016

At this stage if the arguments and data are there and the text just needs polishing, it is okay to hire a professional editor. If you are not comfortable with someone else rewriting your text, you can just get the editor to give you very concrete advice on what needs to happen (at the level of, "Your opening paragraph should be moved to the conclusions, and your first sentence needs to be in the active voice".)

I absolutely think that would be worth it. You need someone familiar with academic writing, though, not just a random proofreader. Preferably someone with some familiarity in your actual field. There are plenty of post-PhD people out there who are currently paying the bills while trying to get an academic job by doing stuff like this on the side.
posted by lollusc at 8:19 PM on February 4, 2016 [5 favorites]

Why not see a doctor and talk about ADHD? I have Bipolar I and ADHD and I would not attempt any writing project without my Adderall.
posted by Biblio at 8:31 PM on February 4, 2016

Response by poster: Although I appreciate the suggestion and I am trying not to thread-sit too much, there is absolutely no way my committee (fairly strict) would sign off on someone else editing what's left of the thesis. I'm a terrible liar and wouldn't be able to sustain doing it that way. I really do have to be the one to do this.

Really I just need writing focus suggestions. And even writing suggestions from people who aren't neurodivergent could possibly be plenty helpful as well. Some of what you guys have offered I will definitely try when I get the chance (which might be pretty soon considering I'm making another go at it), so thank you.
posted by suddenly, and without warning, at 9:25 PM on February 4, 2016 [1 favorite]

Best answer: Okay, if your committee won't be on board with you having help from an editor in polishing the text (although that surprises me - I am an academic myself and apart from PhDs in creative writing, maybe ethnography and other very writing-centric fields, I've pretty much never seen any committee have a problem with outside help with editing for style and polish) --- anyway, if that won't fly, then this is the bit that I still think an outsider can help you with:

It's just that the text is apparently very sub-par for the intro and conclusion (rambling/unfocused I guess, though I have a harder time seeing it)

You can't edit your own prose if you can't really see what's wrong with it, and you say here that you can't really tell what the problems are. No wonder you are going in circles! I really think you need to have someone go through it with you and help you figure this out. I don't see why you couldn't hire someone to do so if your advisor themselves are not down with this level of hand-holding. Note in this case I'm not talking about anyone else making actual revisions to your work for you. I'm just suggesting they help you figure out what you need to do. I don't think any sort of suggestions about focussing strategies will help if you can't get this step out of the way first.
posted by lollusc at 9:35 PM on February 4, 2016 [5 favorites]

(And sorry, I don't mean "hand-holding" to sound derogatory. It's not a bad thing to need an objective eye on your prose. That's why career academics do so many collaborative writing projects, and peer review, and its part of the job journal editors do too. It's just that some dissertation advisors are not willing to provide that level of assistance, even though in an ideal world, they would.)
posted by lollusc at 9:38 PM on February 4, 2016

Try running just those sections through Grammark, Grammarly or the Hemingway App, they all will highlight the issues, and then you fix them. I have dyslexia and adhd I need to use one of these for any paper that I write, because I don't "see" the issues. All of those programs have allowed me to tighten up papers, and make corrections that I never would have made without them.
posted by momochan at 9:52 PM on February 4, 2016 [1 favorite]

You would want to research them first of course, but I have found DMAE and Theanine to be amaaaazingly helpful.

Also, I'd say keep the coffee to a minimum.
posted by Puddle Jumper at 11:22 PM on February 4, 2016

Nthing double checking if an editor is permitted; some faculty even budget money for an editor to work with their grad students, often for students who are ESL (not stating that this is you, just an example of acedemics appoving this).

If an editor is not permitted, have you determined what your writing center can do? Writing centers are not just for undergrads (per the faq for a randomly googled university, they also work with students on dissertations and grants.). Writing centers don't do the work, but review material and provide one-on-one strategies and recommendations.
posted by Wolfster at 12:50 AM on February 5, 2016 [3 favorites]

Yeah, almost every university has a student writing center, and they usually have people experienced with thesis writing. It's not like having a ghost writer, it's someone who will be able to tell you exactly where you lose the thread, or good tools for making the writing flow.

If your school really and truly doesn't have this, send me a MeMail, I have a Ph.D. in a scientific field, was complimented on the clear writing in my thesis, and have helped a few other people with this type of thing as part of my non-writing-focused job. I'd be happy to read through a few drafts.

As for the *just sit down to write* thing, I found that 5-10 minutes of jumping around like a fool every hour or two was the only thing that would help. (I almost thanked the makers of Dance Dance Revolution in my acknowledgements.)
posted by tchemgrrl at 4:00 AM on February 5, 2016 [3 favorites]

Best answer: Hi, been there, done that! Some possibilities to try:

--If you haven't tried composing/editing in longhand and on paper copies, then definitely consider it. Like a million times easier than trying to manage a screen. Paper copies save trees, too!

--Can you get moving while writing? I'd print out sections of MS and just take them with a pen and clipboard on a long (~6-mi) walk. The first mile or so was generally pretty scattered, but after that, something about composing while physically striding forward really helped with focus and flow.

--If you can get hold of a cheap voice recorder, and talk to it (possibly on a walk?) that might help, as well. Something like Dragon Dictate might even transcribe it for you.

--Long bus and car rides can also be great for ADHD writing-- the constant mild stimulation, maybe? Take an outline along and let your mind dwell on it as you're riding, then jot down details as needed.

--Consider starting your editing sessions by reading some other (interesting, well-written, but not directly competing or intimidating) published literature; sometimes that helps to "sync" you with the standard patterns of writing in your field.

Good luck! You can do this!
posted by Sockinian at 4:07 AM on February 5, 2016 [1 favorite]

Response by poster: Note in this case I'm not talking about anyone else making actual revisions to your work for you. I'm just suggesting they help you figure out what you need to do.

Thank you, lollusc... I think for whatever reason I had a different concept in my head than what you were talking about but this really clarified for me.

I looked into the options from my university last night and it looks like they have some really good resources/options for me. Honestly I'm not sure how I never seriously considered the learning assistance center until you guys pointed it out, but I think it's in part I had/have this mentality that if I can just sit down and DO IT then I can... well.... do it. Like if I just try hard enough it will happen. It's taken me way too long to realize that's just not the case. I'm hoping it helps but at the very least it's stopped me from freaking out in the meantime.

There's a lot of weird shame wrapped up in my situation with my advisor/committee and I just have a really hard time showing them anything that sucks. I know it's counter-productive, but it's almost like I physically can't do it. Perfectionism + anxiety + seriously low self esteem isn't helping the issue. So a completely unrelated set of eyes is something I feel like I could do. There's even an online option so I wouldn't even have to look my editor in the face! Major bonus!

Anyway I brought it up to my advisor this morning and he was actually pretty encouraging about it on a limited scale so I think I will give it a try.

Sockinian oh my god are you me. These are suggestions that have probably given me the most success so far but I feel like I've hit a brick wall. Paper copies are absolutely better for me. I haven't ever taken my clipboard for a walk, but I try to stand and sway, do low level movement, etc. Reading other papers is definitely a good way to "sync" my brain, so that has been helpful in the past as well. I'm just... struggling right now. I think it's mostly pressure/anxiety at this point as they've decided on a deadline for me because it's taken so long and it's rapidly approaching.

thank you all so much for your suggestions, guys

all of this is the main reason I don't want to stay in academia. the entire process has been really bad for my general health and detrimental to the main thing that would help, which is a reliable schedule, time for recreation and exercise, and the biggest one: getting a reasonable amount of sleep. 'cause it sure as hell isn't conducive to that kind of thing for me.
posted by suddenly, and without warning, at 5:32 AM on February 5, 2016 [5 favorites]

Hey i just saw this and don't have time to say much now because I'm on a very short break from trying to meet a deadline with my own thesis, and there are a lot of details i wouldn't say publically here anyway, but I've been struggling with very very similar issues as I try to finish my thesis. Diagnosed (and medicated) adhd-pi, and anxiety is a factor too. i'm finally somewhat on track but still feeling pretty failurey and ashamed that it took so long.

So, hit me up if you want to commiserate /share tips privately. Otherwise I'll try to remember to come back here when i have time and give a real answer. You're not alone :)
posted by randomnity at 6:46 AM on February 5, 2016 [1 favorite]

I am a clinician in training, but I am not your clinician in training and am not providing you a diagnosis. That said, I had a patient in assessment this past year who had experiences very similar to what you are describing with your writing process. At the same time that she was an extraordinarily bright woman, she would find herself writing things over and over and over again, spending hours on a sentence or two, because it had to be absolutely correct as it came down on paper. She had other, similar issues she ascribed to "perfectionism," but that when broken down seemed a lot like OCD (e.g. but not her actual example, ironing baby clothes over and over again if they got slightly wrinkled during the day, elsewise she would feel very distressed). She is now in treatment and doing a LOT better. It seemed to be flavor of "just right" OCD. This is A Thing. (She also thought she had ADHD because of these problems, which she did not, though I can't comment on your specific case herein, in which you very well could have ADHD.)

Psychiatrists (in my neck of the woods) are often really bad at diagnosing OCD if it is not some variant of classic cleanliness concerns, but OCD-spectrum problems are really rather polymorphous and about a process rather than the content. As such, if anything of this nature seems a fit, I would strongly recommend finding a cognitive-behavioral therapy clinician who has experience in exposure and response prevention and OCD for further assessment and possibly treatment. I would be happy to provide references over MeMail.
posted by Keter at 7:02 AM on February 5, 2016 [4 favorites]

Nthing what lollusc says about using a resource to help you figure out what you need to do with your writing. As others have mentioned, universities have writing centers for a reason. I once had a long philosophical debate with a friend over whether asking for writing help on a paper was cheating or not. I won the argument - that it was not cheating - when I pointed out that universities often have and pay for a writing center where students can get just this kind of help. That might help you with your shame about it as well - if it's university-sponsored, it can't be cheating/a failure/etc., etc. It's just using the all the resources you have available to submit the best work you can. You wouldn't make yourself not read other papers in your field for some shame-driven reason, like you might be borrowing their ideas and you have to do all the work yourself, right? Of course not! This is the same thing. A writing center is just another resource.

Hermione Granger mentioned the Pomodoro technique, and I'd totally suggest that (with or without dictation) if you're not already using it. One job I used to work for also had the concept of "timeboxing" - you give yourself X amount of time to complete Y task. When X is up, you move on to Z task, whether or not Y is perfect. That might help here if you can get yourself to do it. Maybe it's even as granular as giving yourself five minutes to work on the first sentence in the intro. When five minutes is up, you give yourself five minutes to work on the second sentence in the intro, etc.

Along those lines, Keter mentions "just right" OCD. I have OCD and have struggled with this in various aspects of my life. If you think you might have OCD, in the long run, I'd suggest getting a second opinion from a psychiatrist or other clinician, and, if you seem to be on that spectrum, please look into OCD-specific (and bipolar-friendly, of course) meds and CBT therapy with (as Keter said) someone who specializes in OCD. Those two things have made a huge difference for me.

In the short term, remember that "polished" does not mean "perfect." There's actually no such thing as a perfect thesis or manuscript (it's a crazy idea, I know, but trust me). You need to meet certain levels of acceptability - good grammar, reasonably coherent writing, etc. You do not need to meet your own, probably unreasonable (if you're like me) standards of perfection. This is another place a writing center can help, if you can overtly express this particular issue you're having. Sometimes having an outward "authority" who can say, "Yep, this writing checks all the boxes for acceptability" is really helpful. Is it the best, most scintillating writing ever? Probably not. But you've said yourself it doesn't have to be - it just has to pass muster with your thesis committee.

Good luck and hang in there! Like Hermione Granger said, you're a hero for writing this thesis, especially given your personal situation!
posted by bananacabana at 8:29 AM on February 5, 2016 [3 favorites]

Response by poster: I know this is getting off track a little, but...

It seemed to be flavor of "just right" OCD. This is A Thing.

How are “just right” symptoms triggered?
Personal Expression. Example: A person might need to express himself/herself ‘precisely’ in written or
spoken words (even in his/her own head) – ‘working through’ wording until it meets their own standards of
being ‘just right’.

How much do “just right” symptoms interfere with life?
Academic/Work Life: Again, those with more severe “just right” OCD may become stuck in many
activities – for instance, writing messages (may need to reword – or rewrite, if individual letters seem
‘off’); organizing tasks (i.e., unable to begin, because required objects are not in quite the right place); etc.
Productivity can be greatly affected – as can attention (e.g., if the individual is more focused on the sound
quality of a speaker’s voice, or the rhythm of the words being spoken, than the content of a presentation).


The idea that someone could just post something or write an email without a significant time of consideration and editing is unfathomable to me. Even though I spend a lot of time drafting and re-reading comments for, example, on here or tumblr, I almost always regret and change at least one small thing in completely unimportant posts. I constantly 'correct' other people's posts/comments in my head for very small details (I would have put a comma there, 'sleepy' would sound better than 'tired', x word is a little redundant). Unimportant things (e.g. personal correspondences) have to be formatted correctly for the message that I want to get across. I will triple-check words I already know and know I know the definitions of (dictionary.com/browse/[word] is basically a muscle memory now). If I'm being honest, posting on MeFi is often high anxiety enough that I often wonder if it's worth it and just end up not posting a lot of comments. But then, if I'm actually satisfied in a post I made I will re-read it over and over again too. Like I'll put effort into finding it again and re-reading it multiple times. Close the window. Re-open it and re-read. Rinse and repeat. That's something I hadn't really thought about until now.

Anyway. Probably worth looking into. I will probably be re-reading this comment for a while.
posted by suddenly, and without warning, at 11:26 AM on February 5, 2016 [1 favorite]

I have a different condition. I do freelance writing. Some things that help me:

I have a salt wasting condition. There is a salt-lithium connection. I am getting good results with eating potatoes (they help me retain salt), something salty, and something high in lithium. So, for example, potato chips plus beef jerky or adding extra sea salt to mashed potatoes plus beef or pork.

When my brain is just being wonky, extra B vitamins sometimes help.

Although cholesterol does bad things for your arteries, it is critical to certain brain functions. I sometimes find bacon and eggs is exactly what I need to get things working better.

Addressing any mineral deficiencies helps. If I am symptomatic for needing calcium, magnesium, potassium, etc, I address that. It helps me focus better.

My experience: Exposure to mold promotes OCD like behaviors (like you describe of being unable to get away from the same sentence or idea). Extra vitamins or taking something that kills mold can help. Also, figure out where the mold problem is and resolve it.

When I am struggling to concentrate, taking a short break to eat, drink and get caffeinated helps. Sometimes, I have coffee at lunch when I know I really need the caffeine to have any hope of focusing.

Also, getting enough good quality sleep and doing enough walking. Both of those make a big difference in my ability to be productive.

Best of luck.
posted by Michele in California at 12:31 PM on February 5, 2016

Did you ever figure it out? I have the same problem. I know I spend too much time on my writing, but eventually (and way too late), I admit defeat and know it's time to get someone else to read it and provide feedback. You need beta readers who can tell you if your argument is making sense, and you should be able to work with an editor to polish it. It seems bizarre to me that they wouldn't let you work with an editor.
posted by chaos_theory at 10:35 AM on March 12, 2016

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