How to Boost Time Awareness in ADHD
Do you ever have the feeling that a whole day has gone by, but you can’t quite pinpoint where it’s gone or even what you have to show for it?
Are you often late for appointments, even the ones you look forward to?
Do you underestimate the time it takes to complete a task—sometimes by a mile?
If the answer to these queries is yes, you likely contend with what the ADHD field calls time blindness and I prefer to call “time asynchrony.”
Time asynchrony is a hallmark of ADHD. It refers to difficulty sensing the passage of linear time, which makes it challenging to estimate the time that both small and large (and simple and complex) tasks require. Time asynchrony creates the sense that we’re out of tempo with everyone else. It can result in residual feelings of shame and a decreased sense of self-efficacy and agency.
The opposite of time asynchrony is time awareness, which includes three elements: time perception, time sequencing, and time reproduction.
Time perception entails the capacity to estimate how much time has passed or how much is left before an upcoming event.
Time sequencing refers to the ability to recount accurately the order in which events occurred or to anticipate the best way to sequence tasks.
Time reproduction describes the aptitude to repeat a task in the same amount of time that you did it previously.
All three of these abilities—time perception, time sequencing, and time reproduction—can go awry in ADHD.
Like other areas of medicine, the ADHD field often perpetuates a mind-body split. It tends to offer cues for time awareness—think post-its, timed tasks, and alarm setting—that boost mental awareness and working memory but overlook the intelligence of the body.
Yet time awareness isn’t just a mental or brain-based process. At its root, it’s a sensory issue.
This means that time asynchrony takes place not just in the mind and brain, but in the world of our bodies.
How might we harness the wisdom of the body to grow more in sync with chronological time when we want to be, and out of sync when we don’t?
The Alchemy of Time Awareness
Thanks to an amalgam of internal and external cues, the human body is naturally adept at sensing time.
Our main internal cue-sensing superpower is interoception, the ability to receive, interpret, and respond to signals that come from our bodies. (You can read more about what interoception is, how it works, and why it matters here.)
Among its many capacities, interoception allows you to estimate how many times your heart beats in a single minute—in other words, your heart rate. Accurate interoception therefore also helps you estimate when one minute has passed, and therefore larger chunks of time as well.
Interoception facilitates time awareness through heartbeat perception. But that’s not the only way it does so.
We all have internal time keepers called circadian (approximately 24-hour) clocks. These internal “body clocks” generate and shape daily cycles in our physiology, emotion, and behavior—all of which are important in ADHD. (For more on how to support your body clocks, see this section of our Topic Index on Substack or our online Body Clocks Masterclass.)
Most organisms inherit the ability to track time on this 24-hour scale. For example, bees use their clocks to visit flowers at the appropriate time of day so they can feed when flowers are open. Birds use their biological clocks during migration to compensate for the changing position of the sun throughout the day. Other mammals rely on them to forage at the ideal times for avoiding predation.
You can think of these clocks as a form of cellular nutrition that trickles up to the mind and brain.
Your circadian clock is always figuring out “when” you are in time--and along with it, how to be in the (cellular) moment—that is to say, in tune with your biology, psychology, and the natural world around you.
Without contextual information from the outer world, you have a daily rhythm that is closer to 24.2 hours. Getting sunlight adjusts your behavior to a solar day; otherwise, your rhythm would be off. In just five days, for example, you’d be off by a full hour. In one month, you’d be off by a full six hours. The effects of being out of sync show up at the level of cells, tissues, and behavior.
Our internal body clocks attune to cues like sunlight, body temperature, digestion, the rise and fall of cortisol, and the ebb and flow of energy and fatigue.
As it turns out, many scientists now think that attunement to these circadian rhythms (and the shorter ultradian ones as well) fall squarely in the domain of interoception.
These cues are part of time awareness. They enable your brain to map an accurate sense of the time of day, the passing of time, and the time that remains before a future event.
And this makes me wonder whether one catalyst for the rise in adult ADHD could be the prevalence of artificial light everywhere—the way it takes us out of time, out of the cellular moment, and out of sync with Nature.
I love the concept of rhythmicity, the way it connotes the ADHD superpowers of musicality and improvisation.
Personally, I’m ambivalent to the way culture privileges chronological (clock) time and marginalizes chirotic, or non-linear (and often magical) time.
I don’t mind having time asynchrony if I’m deeply and passionately engaged in an activity. It’s just that I’d just prefer to retain agency over when I lose time, and over what I’m doing when I lose it.
To sum up so far: The capacity to sense sunlight levels, time of day, hormonals fluctuations, and the ebb and flow of bodily sensations and functions are part of interoception. These capacities regulate physiology, emotion, and behavior.
Time awareness—and therefore physiology, emotion, and behavior—all get funky in ADHD.
As it happens, other nodes of interoception pose a challenge for people with ADHD as well.
In a 2019 study, researchers had 14 adults with ADHD and 16 volunteers perform a heartbeat detection task—which we learned is a method used to measure accuracy of interoception. The cohort with ADHD performed significantly worse on the task than the control group. They were less aware of internal bodily signals in general and, at the same time, had difficulty regulating their behavior. (And emotional regulation is also an aspect of interoception.)
Let’s zoom out on interoception in other emotionally-mediated illnesses (which I call diseases of disembodiment).
A 2020 study found that alterations of interoception are a key hallmark of many other mental disorders that are marked by deficits in time awareness such as autism.
Difficulties with interoception (and therefore with detecting hunger, satiety, gastric distention, and functions of digestion) also help explain why people with ADHD often have disordered eating patterns.
But there’s a surprising upside to the time awareness challenges inherent in ADHD.
There’s one condition under which people with ADHD actually do better than others in time perception.
This holds the key to methods we might engage to improve it.
The Link between Emotional Stress and Time Perception
In neurotypical people (those without ADHD), strong emotional stimuli can distort the perception of time.
For those with ADHD, however, the opposite is true.
In a groundbreaking study, researchers at the University of Tabriz in Iran conducted an experiment to test time perception in emotionally laden situations.
They looked at 34 children with ADHD and 31 controls. They gave participants an emotional time discrimination task in both neutral and emotionally laden situations.
In emotionally laden situations, neurotypical participants had to split their attention between the time perception and emotional discrimination tasks. In the process, their time awareness decreased.
Now for the cool part: When the children with ADHD had to distribute their resources between time processing and emotional processing in emotionally laden situations, they showed greater awareness of time.
In other words, dividing attention in emotionally laden situations increases the accuracy of time perception in children with ADHD, but decreases the same skills in neurotypical children.
What, then, are the implications of these studies, and of the way interoception and time awareness intertwine, for improving the synchrony we have with time when we want to do so?
How to Boost Your Time Perception
As a foundation for building time awareness, we can improve interoception, or mindful attention to bodily signals across the board by practicing it.
What makes interoception such a rich avenue for investigation in ADHD is that it helps with challenging aspects of ADHD secondary to time perception.
For instance, psychiatrist Gabor Mate has theorized that people with ADHD perceive that time is slipping out of their grasp. This, he says, causes distress that then leads to distractibility and impulsivity.
Cultivating interoception enables us to become emotional detectives.
It helps us detect distress—the kind that Mate talked about, the kind we experience as time slips away from us.
It helps us recognize the internal sensations that accompany agitation and cause impulsivity: the I’m-going-to-jump-out-of-my-skin feeling, the revved-up engine sensation, the exploding outward of distress.
These detection skills give us the chance to learn to be present with and tolerate agitation and other difficult experiences without discharging them through behaviors that come back to bite us. This is sensory resilience, which translates directly to the brain as emotional resilience, and which is a key factor in managing ADHD. (Read more about the research on sensory resilience here.)
We can then employ our sense of agency by engaging inhibition (not acting). We can also choose movement or connective tissue work in a brief (5 to 15-minute) practice to discharge the agitation and return to the task at hand.
These tools work well in conjunction with the “Sensory Breadcrumbs” technique I outlined in an earlier piece. In boosting time perception, you can jot down a few notes on what you were working on before you felt the agitation secondary to time slipping away, and note how it feels in your body when you ground back into the work after a quick practice.
Extra Credit for Time Awareness
Remember that study on time perception and emotionally laden situations?
Those of us with ADHD often do better under emotional pressure, when we have to divide attention between time processing and emotional processing.
If this applies to you, you can voluntarily (and therefore with agency) add emotional intensity to a task by priming its emotional meaning, which can be as simple as recognizing and amplifying its inherent meaning.
You can employ interoception as you do this, by cultivating awareness of the sensations underneath the emotions you feel.
You can register the stress and anxiety: how they feel in your body, where you feel them, and the distinct quality and color and tone of the sensations.
And I’ll share my favorite tool for getting in the rhythm of time in a way that works for me.
I intentionally build in “eustress” (small amounts of positive stress) to a task by dialing up slightly the activation in my nervous system—of course, early in the day and far removed from sleep.
My favorite ways to do this include small amounts of caffeine before 9:30 in the morning and cold water therapy, around the time of sunrise, so I get a two-for-one with light exposure.
I also make sure I get morning sunlight as many days of the week as I can, to prime my awareness of where I am in the light-dark cycle and with it, my perception of time on a cellular level.
These body-centered tools are powerful and effective. They remind us that we can “train” our bodies to change our mind and brain. They help us build in awareness of time and, when it works for us, synchrony with the rhythms of a rapidly changing world.
Sources:
And you likely have a key symptom of ADHD known as time blindness: Barkley, R. A., Murphy, K. R., & Bush, T. (2001). Time perception and reproduction in young adults with attention deficit hyperactivity disorder. Neuropsychology, 15(3), 351–360. https://doi.org/10.1037//0894-4105.15.3.351
In fact, accurate interoception helps us estimate when one minute has passed: Meissner, K., & Wittmann, M. (2011). Body signals, cardiac awareness, and the perception of time. Biological psychology, 86(3), 289–297. https://doi.org/10.1016/j.biopsycho.2011.01.001
And a 2020 study found that alterations of interoception are likely a key hallmark of a series of mental disorders: Vicario, C. M., Nitsche, M. A., Salehinejad, M. A., Avanzino, L., & Martino, G. (2020). Time Processing, Interoception, and Insula Activation: A Mini-Review on Clinical Disorders. Frontiers in psychology, 11, 1893. https://doi.org/10.3389/fpsyg.2020.01893
In a 2019 study, 14 adults with ADHD and 16 volunteers performed a heartbeat detection: Kutscheidt, K., Dresler, T., Hudak, J., Barth, B., Blume, F., Ethofer, T., Fallgatter, A. J., & Ehlis, A. C. (2019). Interoceptive awareness in patients with attention-deficit/hyperactivity disorder (ADHD). Attention deficit and hyperactivity disorders, 11(4), 395–401. https://doi.org/10.1007/s12402-019-00299-3
This difficulty with interoception also explains in part why people with ADHD often have disordered eating patterns: Martin, E., Dourish, C. T., & Higgs, S. (2023). Interoceptive accuracy mediates the longitudinal relationship between attention deficit hyperactivity disorder (ADHD) inattentive symptoms and disordered eating in a community sample. Physiology & behavior, 268, 114220. https://doi.org/10.1016/j.physbeh.2023.114220
The children with ADHD had greater sensitivity to time in situations that were emotionally laden: Nazari, M. A., Mirloo, M. M., Rezaei, M., & Soltanlou, M. (2018). Emotional stimuli facilitate time perception in children with attention-deficit/hyperactivity disorder. Journal of neuropsychology, 12(2), 165–175. https://doi.org/10.1111/jnp.12111
For instance, the psychiatrist Gabor Mate has theorized that people with ADHD: Maté, G. (2000). Scattered: How attention deficit disorder originates and what you can do about it. Penguin.