Taking action on distraction

A roadmap for overstimulating times

I’ve been planning to sit down and write this one for a bit, though ironically I’ve found myself too distracted to do so.

In the time I started writing this, I:

• felt too hot so I turned on the AC

• logged onto Nuuly to pick out my new shipment

• got up to move a plate from the kitchen table because it was bothering me

• stared off into the distance at a flickering candle

• checked Instagram three times

• listened to an old voicemail from Comcast telling me I could be paying 50% less for my Xfinity account

• felt too cold so I turned off the AC

This is a pretty typical Saturday. Actually on the better side today (when I started writing this) because I’m coming off of a long vacation. After a fair amount of reflection and talking about this in therapy and with my co-workers, here’s what I’ve gathered about these popcorn thoughts.

After a day of work, the thoughts that dance around in my brain feel like a pinball machine. Some of this is nature, and some of this is nurture.

Nature: I have so many different passions and projects going on that my to-do list is always varying. The topics on it are diverse, without much commonality between them, and therefore jumping from one thing to another can be feel abrupt and dizzying. Or just thinking about all of the different things on the to-do list feels overwhelming.

Nurture: At my job as a PA, efficiency, productivity, and multitasking are not only the norm, but encouraged.

For example, I have ~18 patients on my schedule on a full day. I also have my inbox to attend to, which is home to results, patient messages, staff messages, documents from outside facilities, charts CCd from other specialties, etc. I could then be simultaneously getting paged, receiving a reminder to fill out paperwork or prior authorizations, getting a call from the pharmacy to review a medication. Or I may be having a few different conversations with coworkers, hearing children crying/yelling during well child checks, etc. There is a lot of stimulation from multiple different senses occurring all at once.

This is not at all meant as a complaint; this is the reality of many jobs in healthcare - a lot going on and limited bandwidth to focus on a single task at a time. And so when I get home, the silence is absolutely deafening. I cannot sit and do just one thing. My brain is so accustomed to the routine of multitasking and overstimulation, that I feel incredibly distracted and this pull to be doing more than one thing at a time. I’m craving more overstimulation and distraction since that was the baseline of the day.

It is so easy to be lured into social media scrolling when this happens. Sometimes I’m scrolling for the sake of content creation, and other times I’m just pulled there for more of a similar environment that I was just in all day at work, though with even less effort. To be drawn deeper into the various sights and sounds, all occurring at the swipe of a finger, for hours on end.

The two things I do most often (my job as a family medicine PA, and my job/hobby/jobby as a content creator) both play a significant role in encouraging my brain to always be multi-tasking and distracted.

Taking this a step further, it’s interesting to reflect on social media trends over the last 8 years or so (how long I’ve had my account / been dabbling in the land of content creation). Whereas the app used to be mostly photos, often with long form captions, what is now favored is Reels / short form videos. When Reels first rolled out, the videos were slow. Now, what performs well (gets the most views) are videos with super quick transitions - 0.25sec clips strewn together where your brain barely has a chance to process what you’re watching. We’re further priming our brains to think that things are meant to happen impossibly fast. And the pace of which we’re taking all of this in further throws to a place of overstimulation and distraction, making it nearly impossible to focus on just one thing at a time.

As a creator, I fully realize these videos are fun to make. As a consumer, they can be entertaining, though sometimes mindless. As a clinician, I’m cautious about what this constant overexposure to video and scrolling is doing in a longer term way.

Now I know this is not unique to healthcare, nor social media. A lot of different days are filled with overstimulation without time for ample processing (and without the reciprocal training of your brain to focus on just one thing at a time). It makes sense then that I’m seeing a ton of patients presenting feeling like they have ADHD.

My aim here is absolutely not to de-legitimize those with diagnosed ADHD or neurodivergence. I absolutely believe in neuropsychology testing to arrive at said diagnoses as there are many overlapping psychiatric conditions that can present similarly to ADHD (ie if you have a trauma history or history of anxiety or depression, it is quite common for the loudest symptom to be distraction and inattention). And I know quite surely that I do NOT have ADHD; I just have a job that induces a lot of ADHD tendencies.

And I do find it curious that suddenly there is such a higher prevalence of those feeling like they have ADHD (or maybe that’s just the bias of my practice and/or TikTok algorithm). So while I can’t make sweeping assumptions about the general population, I can talk a little bit about my own feelings with this.

It is not a comfortable feeling. It’s like swirling, violent jacuzzi of all the things I need to do in the work day and feeling like there’s just not enough time to do them. And then coming home and thinking about the things I didn’t do, forgot to do, or could/would have done differently. It feels like an emotional tinnitus - a ringing that is really hard to dim or quiet, a silence so loud I want to crawl out of my skin.

When I first started working, it was super common for me to come home, put on a show AND scroll on my phone simultaneously. I needed both of these levels of distraction to feel ‘normal’ or like I could unwind (it was essentially simulating a similar work environment though in a more passive way).

It takes a LOT of emotional regulation on a moment-to-moment basis, and dedicated processing time when getting home in order to not let this seep into the depths of my subconscious and adhere as a permanent personality trait. And it’s hard fucking work, that much I know is true.

In the first few months/years of working, I couldn’t understand why I’d get home and suddenly the smallest things would send me absolutely over the edge. I was really beating myself up for ‘sweating the small stuff,’ though when I put it in perspective (an entire day of barely taking a breath from the amount of overstimulation), of course it makes sense that my sock falling half way off when I’m walking to my car is going to be the straw that breaks the camel’s back.

Now that I’ve had some ample time for reflection, I’m getting curious about what that environment does to my brain over time. And I just deeply know that this combination of things (working a decent number of hours in both patient care and social media), that something has to give. This has been really hard for me to reconcile - that the things I feel the most passionate about are probably doing some long term inflammatory changes to my brain. Does this mean I feel like I need to quit either of these things? No. But I do feel a pull to cut back a bit.

So after 3 years of working full time as a primary care PA (not that much time, I know, but the combination of medicine and social media has made me realize I need to cut back for the health and safety of my brain), I’m dropping my hours in a few weeks so (I’ll be doing 3 days of forward facing patient care).

And I’m (eagerly and excitedly!) shifting into a few new roles that will require slow and dedicated attention, rather than distraction and overstimulation.

One is creating educational copy for a new app called Ayble that I am SO proud to be a part of (started doing this around April to test the waters). The other is deepening my nutrition knowledge as an intern with a dear friend and dietitian Carolyn Brown (and the rest of the amazing Indigo team!!). Both of these will be very part time to just dip my toe into other wells of interest, and a bonus is that they require dedicated attention to just one thing at a time. I am intentionally shifting my work to things that don’t require as much brain bouncing.

I’ve also developed some decent coping strategies along the way that have significantly helped.

Here’s what I’ve found to be helpful:

1. Be aware of the things that you find overstimulating. For me, a lot of physical discomfort is the last straw after a long day. Getting in comfortable clothing without itchy fabric, particularly clothes that are loose so my diaphragm can breathe, is essential.

2. Be cautious and get curious about external triggers. I personally find alcohol and caffeine both to be very heightening. They make it harder to quiet my mind and heart rate, so I like sticking to a 1/2 cup of coffee in the morning, alcohol only when I’m in a place of calm, and mostly water and decaf tea.

3. Drinking water throughout the day is monumentally helpful. It is remarkably challenging to not be dehydrated with a ripping headache by the end of the day when you’re busy and wearing a mask. The only thing I have found to help is the Owala water bottle. And no I will never stop talking about my Owala so DON’T ASK.

4. Keeping my blood sugar stable. I don’t abide by any nutrition rules but when I’m already in a place of overstimulation, keeping my blood sugar stable helps to avoid any further anxiety (especially since my appetite changes when I’m overwhelmed, making listening to hunger/fulness cues more challenging). This means eating at regular times and avoiding skipping meals, and when reaching for meals, ensuring there is a source of fiber, protein, and/or healthy fats.

5. Practicing mindfulness, preferably at a time when I’m not on high alert. I like Insight Timer and the Othership app. But it can also be during something as simple as brushing my teeth, having a bite of a meal when noticing all of my senses, or taking a walk. It can look different every day. Reading is also the ultimate form of mindfulness for me.

6. Doing this combination of things when I get home: I start by watching tv and scrolling on my phone (acknowledging that after a long day I absolutely cannot tolerate the immediate shift into a silent meditation). When on my phone and at a part of the show I don’t care much about (ie in the middle rather than the beginning or the end), I pause the show and continue on my phone. I then blast a song I know I love and lay on the ground as I’m still on my phone (good idea to keep a ‘in case of emergency’ playlist - songs you know get you back in your feels/body). As the song builds, I try to leave the phone on the floor and get back into my body - jumping, swaying, rolling, dancing, etc. After the song, I’ll do something else that gets me back in my body - dry brushing, for example. Then I’ll head into the shower and visualize washing off the stress from the day, followed by locking it all in with a skin care routine or applying lotion. THEN I’m finally in a physically comfortable place where I feel I can emotionally process.

7. Leaning in and knowing that after a hard week, it’s okay that I need a little bit more time to come down. There is no shame in curling up in bed and watching a show; leaning into distraction until I’m ready to come out of the cocoon and nurture in other ways. I really try to greet myself with absolute gentleness; treating myself like a child or pet is helpful.

8. Whenever I experience something that roots me back to me senses, I write it down. Maybe it’s the sound of rain, the smell of freshly cut watermelon, the sensation of burying my face in warm linens right out of the dryer, the taste of a brown butter chocolate chip cookie from La Saison, the appearance of a fresh bouquet of blooms from Rococo. I can then return to this list when I’m feeling overwhelmed or distracted as a way to get me back to the present.

9. Taking breaks in between tasks on the to-do list. This is absolutely essential. If I know I would like to complete a task, having something on the other side of that task to re-orient my brain to the present (ie a mindfulness activity) serves as a lovely refresher. These apps are also helpful for task completion: Motion, InFlow, Amazing Marvin, TickTack, Sunsama.

10. Setting limits on social media apps. I am so much more likely to follow the limit if there’s a reminder for it. If you have an iPhone you can do this in settings, screen time, app limits.

11. Shifting my movement regimen to one that is soothing, rooted in mindfulness/ breath work, and tuning in rather than shutting down/off. I used to do high intensity classes in the Boston area. They were sometimes fun, but ultimately not what my nervous system needed (ie loud music, loud instructor, exercises always changing). I’d leave feeling depleted rather than replenished.

12. Lean into unapologetic rest. This is the antidote.

The above is my recipe so for living a soft life during hard, distracted, overstimulating, and overwhelming times.

As I strive to do, this newsletter is a combination of my personal reflections, though it’s also important to root the musings within the current system. The System isn’t set up for dedicated mindfulness throughout the day; the System is telling us we need to do more, see more patients, and finish the work as quickly as possible, without making any mistakes. *sigh*

Furthermore, this little newsletter here is my act of defiance. Trust me, I know how much attention it takes to read long form items now. And I am just so grateful you’ve taken the time to read these imperfect and distracted words. Thank you, as always.

Happily,

Katie