ADHDifference

S2E41: Why Self-Care Feels Harder Than It Should (ADHD Edition) + Dr Matthew Campbell

• Julie Legg • Season 2 • Episode 41

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Julie Legg sits down with clinical psychologist Dr. Matt Campbell, co-creator of the Our Primal Five framework, to explore why self-care feels so hard especially for ADHDers and why the basics matter more than we realise.

Rather than promoting productivity hacks or aesthetic routines, Matt brings the conversation back to foundational human needs: sleep, sunlight, movement, social connection, and mindful consumption. He explains how modern life constantly pulls us away from these essentials, and why structure, not motivation, is the real key to sustainable change.

This episode is a great reminder that self-care isn’t indulgence. It’s replenishment. And for ADHD brains in particular, small, structured, repeatable shifts can be far more transformative than grand, short-lived resolutions.

Key Points from the Episode:

  • Why “knowing” what to do doesn’t automatically lead to “doing” it
  • The difference between motivation and structure, and why structure wins
  • Why ADHDers struggle with the basics like sleep, hygiene, and routine
  • How perfectionism and all-or-nothing thinking sabotage change
  • Why guilt and self-criticism actually block behaviour change
  • The concept of Our Primal Five: sleep, sunlight, movement, social connection, and consumption
  • How stacking habits makes change sustainable
  • Why exercise can rival antidepressants for mood regulation
  • The hidden cost of digital “junk” consumption — social media, news, and overstimulation
  • The power of understanding ADHD to dismantle narratives of laziness or failure
  • Sustainable self-care as structure, not indulgence

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ℹ️ DISCLAIMER: This podcast is for informational purposes only. The views expressed are those of the guests and do not necessarily reflect those of the host or ADHDifference. Read More

MATT: What we're dealing with is, we're dealing with a world that has advanced so much that doing the basics often gets overlooked. There are so many things that distract us. There are so many things that give us more of a short-term boost that we can often miss the smaller things and those things that are absolutely foundational for our success, and for our health, and for helping ourselves with ADHD.

JULIE: Welcome to Season 2 of ADHDifference. I'm your host, Julie Legg, ADHD advocate, author of The Missing Piece (a woman's guide to understanding, diagnosing, and living with ADHD), and an unapologetic doer of many things. This season, we're turning up the volume with a global lineup of brilliant guests, bringing their lived experiences, insights, research, strategies, and resources. And of course, along with a healthy dose of humour and humility. Whether you're neurodivergent yourself or just curious, there's something here for every curious brain. Let's dive in. Today, I'm joined by Dr. Matt Campbell, a clinical psychologist who helps people build sustainable self-care without burnout, guilt, or perfectionism. Matt's work centers on a simple but powerful idea. Most people aren't failing because they lack motivation. They're struggling because the structures they're trying to use don't match how humans actually function. Matt is the co-creator of Our Primal 5, a framework based on five foundational areas of health, sleep, sunlight, movement, social connection, and what we consume, not just food, but media and substances as well. Rather than pushing people to do more, this approach helps people feel better first so change becomes possible. Thank you for being on the show, Matt. Lovely to see you. Thank you. [Thanks for having me.] Most welcome. Today we're all, we're talking about self-care and often it feels harder than it should, especially with ADHD. I can completely resonate with that. But when we talk about self-care, we often think about the big things. But for many ADHDers, it's very basic care that can fall away. You know, the regular showering, brushing teeth, trimming your toenails, you know, changing the bed sheets for goodness sake, you know. Why are these everyday tasks so much harder than they appear? And what's really going on beneath all that? 

MATT: Well, I think that what we're dealing with is we're dealing with a world that has advanced so much that doing the basics often gets overlooked. There are so many things that distract us. There are so many things that uh give us more of a short-term boost that we can often miss the smaller things and those things that are absolutely foundational for our success and for our health and for helping ourselves with ADHD. 

JULIE: So is it that there are too many other things to do and the basics fall away? Is that how it works or is there anything else from an ADHD perspective? What else is in there that gives us a hard time? 

MATT: Sure. Well, I think that the perspective that I take is that we have these bodies, these bodies that have been around, you know, that, you know, our ancestors, we go very far back. And for our ancestors, the things that were part of their daily life, the way that our bodies, what our bodies were made for, things like getting outside, moving, sleeping, being connected with others, taking in things both mentally and physically that are natural, that are from the world, these things they had no choice to do and that's the way our body is made. But we live in a time where there are so many things that can get us off track with these things that are absolutely foundational for our wellness, you know, both physically, mentally, emotionally. And so with ADHD, I actually do in my practice quite frequently I do evaluations for people with ADHD. And how often for example perhaps the one that comes to mind the most is sleep. How often sleep is a difficulty with ADHD? There is, you know, it can be difficult to be organized and have structure. And, you know, we benefit from structure. It's not, it's not I guess you'd say, it's not sexy, you know, it's not, you know, fun. But we benefit from it. But we have these phones with us and we, you know, they're instant stimulation and they just you know, they kind of suck us in and you know, we'll stay up and it really interrupts it. And of course when we don't sleep, attention, these kind of things, how we handle emotions, it particularly with ADHD is hugely affected. So many people genuinely want to feel better and even know what helps and what they're meant to do yet struggle to stay consistent with the self-care. 

JULIE: So in your experience, why does this gap between knowing and doing exist? 

MATT: That is such a fantastic question because I think that when we talk about these things, even the workbook I have it even describes it as the simple you know, guide for self-care, we know these things. And then when we look at the numbers in terms of how well we do at them, basically with each of these areas, 50% or more in general of us are struggling and are not kind of hitting the marks that we want to take care of ourselves. I think that there are a number of reasons for that. I think that you know, first of all as I said, there are other more exciting things to do. I think that sometimes you know, we know what we know. We are our basis of comparison and so we get accustomed to being sleep-deprived. We get accustomed to what it feels like to have a bad diet or be isolated or all number of things. And so that's our normal. And so sometimes it's even it's hard to appreciate what it might be like if we're healthy and so I think that those are a few. I also think that sometimes we try to be too perfect. I think when we're trying to make changes, we don't we don't give ourself grace. We don't recognize that part of change is making mistakes. Part of change is plateauing for a bit. And so we think of that as failure and then we stop trying. And so you know, trying to do too many of these things at once, perfectionism, those are the enemies of change. 

JULIE: We're often also told we just need more motivation. And you talk about structure being far more important. So how would you explain the difference between motivation and structure and why structure is what actually carries people over the time? 

MATT: Absolutely. So we often, one of the things... and when I speak with my clients about it I really try to encourage people to recognize that if we are relying on feeling like doing something, we're in trouble because we may be excited about making a healthy change for a little while but that excitement is going to wane and when it wanes, we were relying on that to get us there. So the most you know, I think easy to access example of that is someone does a New Year's resolution and I'm going to go to the gym. I'm going to get healthy and at first they're really excited. This is going to be great. And so they hit the gym for a week or two and maybe they're doing it after work. And then, you know, I'm kind of tired today, just not feeling it. I'll do it tomorrow, you know, and then it becomes tomorrow and tomorrow and tomorrow. One day slip in, you know, maybe we slip two days. That's okay. That's part of it. But we're waiting to want to. And what structure provides is that routine and that habit. I give the example a lot of times that every morning I take my, I have two dogs and I take them for a walk each morning. I don't ask myself do I want to take them for a walk because the answer would usually be "This bed is very comfortable and I'm going to take that extra 45 minutes to sleep." But instead it's part of my structure and routine and that's what I do. I'm not asking myself if I want to. I'm just throwing my legs down and getting to it. So the more we have a pattern and a routine, the less we have to rely on want to. Want to is hard. 

JULIE: Yes, enthusiasm does wane quite quickly at times. 

MATT: We can also help ourselves though in terms of having our goals be a bit shorter term and so you know, we're trying to make an improvement. And so, if I am trying to eat more healthily, I look at how many meals that I'm eating that are natural, that are not processed, and I use that as a baseline. And this week I'm trying to do a few more. I'm trying to improve it, you know, or stay the same. And then just trying to get that momentum going. 

JULIE: But breaking things down into shorter goals can really help us from being overwhelmed because we know with ADHD how often how easy is it to get overwhelmed by, you know, especially if we have multiple goals. That's a lot. And so I think that yeah, I think that breaking it down into parts and short-term goals is one of the ways to go, right? And also celebrating those small wins as you know, rather than waiting to the big grand goal to be completed these little micro wins along the way. 

MATT: Yes. And Yes. And you know, it's all about progress. It's all about you know, we're making moves forward like you said and not minimizing them. You know, not minimizing improvement because you know, that again if the only time we can feel good about it is when we're at the goal that we've met it we probably aren't going to get there because we need to celebrate like you said, the victories along the way gain momentum. You place a lot of emphasis on foundational behaviours like sleep, sunlight, and movement. How do these basics support mental health in ways people tend to underestimate or overlook perhaps? Well, they really have profound physical and you know, of course, my field, emotional effects. A tired brain, we're going to be more irritable. It's going to be more difficult to handle feelings, our focus. You know how quickly we can think you know, and process information is going to be greatly impacted. Our diet if we're having you know, our food you know, the processed food is you know just filled with sugars that are going to spike mood and bring energy back down very quickly. You know, and so movement and being outside of course that's what we're made for. But let's use movement and of course we're addressing ADHD, but you know, there are studies that indicate that exercise is as effective as an anti-depressant. That's what we're made for. And so kind of lethargy it can really lead to some really negative consequences being isolated and so on and so forth. And you know, I think that it's... and there is data out there. I believe you had a speaker, it may have been the last podcast that you had published who was talking about the benefits of getting outside, you know, and movement and it's... and I'm always, I have a lot of clients who maybe, particularly parents of children with ADHD, but also adults, and they really would like to have a non-medication option when of course, you know, we know medication is effective and a good treatment approach, but they're often looking for something. And so I try to go through the literature to give them you know, other possibilities as well as noting medicine. But there's literature out there. Exercise you know, that movement. Just moving our body even if it's not hitting the gym, we're moving, we're outside and those benefits and they benefit people with ADHD a great deal. 

JULIE: You touched on it before Matt about often having too many goals at once and I guess that really stretches us. So many of us try to change everything whether it be routines, habits, diets or productivity and then feel defeated when it all falls apart. So why does that approach so often backfire especially for people already dealing with overwhelm and burnout, right? 

MATT: And so we're asking too much. It's something where we're setting ourselves up for failure by trying to do too many things at the same time. Now, one of the things that can be great sometimes is if we... if we stack things like in terms of the things that I talk about a lot is stack them. So, how about having, you know, getting a routine of a walk with a friend? Okay. Well, now we're getting movement. We're getting time outdoors. We're getting social connection with people. So, we can do things like that. But, you know, the overall is that it really helps us to is you know, to kind of isolate and work at one thing at a time because we're... change is difficult. You know, change is difficult and we tend to stick with what we know. And so, you know, for humans, we know that there's, you know, any area of change, it requires that energy. And so, we have a certain amount of energy to do this. Let's not to try to do it with everything. Let's use that energy towards this at this time. And then, and then once we create that, you know, some strength there, then we can go to others. 

JULIE: Yes. And I guess each of us as individuals have different energy cycles as well. And going with the flow and working with our brains and still having structure would be ideal. 

MATT: I imagine if you're an early morning person, that probably is the best time to structure your day around you and how you work. Whereas a 'set and forget, this is a great structure for everyone' might not work in fact for everyone based on those yeah energy levels. No I you know, I again I love that insight. We have to work with us you know, we have to work with what you know is a... it clicks with us, you know. So like for example I'll often when I'm talking to people about ADHD and I'm talking about different coping techniques and you know, processing and memory approaches and things like that. I'll give them suggestions and then I'll say "Don't do what I'm telling you to do exactly like I'm suggesting to do it. Find what works for you. My goal is to offer you some ideas on approaches." But what's going to really help them work and be sustained is that you make them your own. As you're saying, you know, different times of day, you know, we have different levels of energy. And you know, there's a lot of variability with that between people. And so what works for me is the key. Yeah, you know, just those differences means there's no cookie cutter approach. We have to, you know, find these things you know, consider these things, work on them, but do it in a way that works for us. In so far as stacking is we're trying to things that we already do. We're trying to attach them or do them with something healthy as well. So, if I like to get up and have a cup of coffee, you know, when I wake, how about I do it on a porch? How about I do it, you know, somewhere that I'm getting some sunlight, you know? How about I do that? That is ideal. Morning sunlight is the ideal. It sets our circadian rhythm. It's gonna help with sleep at night, you know, let's do that. And so, you know, different ways of things that we're already doing, trying to add or put, you know, connect something that's healthy for us, you know. You know, I like playing with my dogs. Well, is there a park nearby? You know, is there somewhere, you know, that I can move around with them? Things like that. So, let's attach things yeah with our psyche, you know, with what we're already doing. I love that. So, it isn't the grandiose "I've got all of these goals and I'm going to jam them all in at the same time." 

JULIE: We're talking about really simple shifts here with the coffee on the porch in the sunlight, right? 

MATT: And it's absolutely, absolutely better to do it that way and in a gradual way because you're going to firm up these changes. And you know, it's rather than like cramming for the test and then forgetting it afterwards. You know, we're taking it progressively. You know, we're connecting, we're adding things, we're stacking things together and it really strengthens changes that we make. 

JULIE: Hence the structure building on something already solid and just adding. [Right, that's exactly right.] Beautiful. You're very clear that guilt and self-criticism don't actually help people change. Why do those approaches make behaviour change harder rather than easier? 

MATT: I think it goes to something even a little bit broader. Punishment is not an effective long-term behaviour management technique because we typically want to escape or avoid those things. And so, as I, you know, I talk about a good bit, you know, guilt and shame are pretty toxic emotions and they really don't you know... Emotions motivate us in some direction and those emotions are generally unfair because we want to... My belief is that change involves empathy and understanding and then action. You need both. And if it's criticism to kind of whip ourselves into doing something, there's a lot of negative fuel there. And we're more likely to try to escape a bad feeling rather than seek something positive. So, and the other thing that self-criticism does, it lacks understanding. Like, we're not trying to understand why is this difficult for me or why did I make these choices or I'm sorry, punishing myself for doing that. Rather than figuring out, okay, what what's making that difficult for me? 

JULIE: And self-criticism it's so easy to do, quite a knee-jerk reaction that isn't well thought out. 

MATT: Often times people are you know, unfortunately they're accustomed to that, you know. Their environments may have been that way. Maybe that's what they're so used to doing to themselves that doing something else takes some takes some time. You know, they're so accustomed to trying to be motivated by criticism, not failing rather than succeeding. And that's what is to me is health is we're focusing on how can I succeed rather than how can I not fail? 

JULIE: When you strip away the aesthetics and the social media version of self-care, what does sustainable self-care actually look like in real life? 

MATT: Yeah. So, sustainable self-care and as you said, self-care has been kind of, you mentioned social media, it's been pretty commercialized and that's really unfortunate because that has led to people seeing self-care as indulgence. And no, it's replenishment is what it is. People get depleted by not engaging in healthy self-care. And so it is undoubtedly not self-indulgence. It's saying, "Okay, this is what my body needs and I'm going to be better for myself, better for others if I do that." And so what it looks like is it looks like, as you mentioned, structure and an intentional way of living. It looks like you know, something where you know, I am kind of monitoring, I'm noticing my sleep. I'm noticing these different things and they're more on the forefront of my mind. When I slip, I notice it. But when we're not keeping it on the you know, on our mind or having that that idea and that thought, that's when it really can deteriorate and deplete us. 

JULIE: Would you be able to share more about Our Primal Five you earlier talked about the guides. Could you share with us more about the framework around that? 

MATT: Right. And so I in my work I, you know, it came to be in my work I've done this for over 20 years now. And so I've always found it interesting to see what common issues and themes we as humans, you know, struggle with. And over time I just wrote down so many different things that I noticed that yeah, you know, as these are things that as humans we struggle with. And I try to come up with catchy, you know, little phrases, you know, to describe them. But what I, you know, I thought to myself, if I put together something, if I take a one shot, let me take one shot to see what would be most helpful to people. I kept coming back to the Our Primal Five, that the idea behind it is that so much our lives can be so improved mentally and physically if we take this structure we recognize. We're humans. Our world has changed, our bodies have not. And so if I take that and so the approach with Our Primal Five is weekly. So I take you know, the first week is sunlight, then week of sleep. And so what we do in the workbook is we're trying to give the background of okay, this is why that area is important. You know, these are the emotional and physical impacts of both doing well and struggling in these areas. And here is a way, as you and I have discussed, to you know, try to improve it and improve it and improve it. And so we focus on each one for a week and then we're trying to take stock. Okay, where am I on these things? And I can always go back to that workbook with the ideas with, you know, we have behaviour change ideas that are in there. I'm really big on replacement behaviours so we're not focused on not doing something. We're finding something else that's healthy that can fill in for where I was, maybe have I had some bad habits. But that's the idea behind Our Primal Five is you know, let's recognize these things are challenging. Yes we know them but there's a reason why, as I said earlier, 50% of us or more are struggling in these different areas. So may be simple but putting it into practice obviously isn't. Part of it is really assessing what we consume whether you... not just food but media and substances as well. 

JULIE: Would you briefly be able to talk about the kind of issues and challenges around this consumption generation that we're living at the moment? 

MATT: Yes. Yes. So what the way we phrase it in the workbook is junk, is we don't want to be consuming junk. And so we know junk food. We're familiar with that. You know, we're familiar with, you know, drinks and things like this that are junk. But you know what has really accelerated at an incredibly rapid pace is the junk mentally that we're consuming. And so the areas that we focus on, the first one is the one that maybe is talked about the most, is social media and screen time generally speaking. And so what the research shows us is that, you know, up until we're about 18, problems start happening around when we get above 2 hours of consumption of screen time, and that's going to usually be phones and social media. When we're adults, you know, we don't include work time. With adults the negative effects start happening maybe after about 4 hours or so of that consumption. But it's something where you know, there's obviously the negative effects. We know this particularly for the teenage you know, population and such the comparison and the amount of time that is spent is... it's mind-boggling how much time is spent because you know, they those algorithms, they know us. You know, they're pushing our primal buttons, right? Fear, outrage, sex, you know, different things that are very primal to us and or things that they notice that we pay attention to and then they feed us more and they just get that, you know, we're hooked. We're hooked. Even when we know it is unhealthy for us because it's addictive. So, you know, that's one. And then there's the a misconception that social media is social connection and of course nothing can take the place of being in the room with someone. So you know, and sometimes you know we have to use perhaps texting people, calling people that's good. But the social media is not going to be that social connection. So there's that. You know, one thing that has again in the past 20 years or so become increasingly... the consumption of junk is news. Our news is just can be so toxic. The more that we consume of that news and of course there's you know, very biased one-sided news out there. You know, so much. So that you can if you look you can find information on what are the most fair you know, and kind of middle of the road more accurate news sources. I know I did that. And so we really I you know, what I encourage people is, you know, at most we want about 30 minutes of news, you know. Break it 15 and 15, you know, in the evening, or not in the evening, late afternoon, and you know, mid-morning that we can look at it. We're informed. A lot of times people are like, well, I need to take in the news because I need to be an informed citizen. You can be an informed citizen with, you know, 15 to 30 minutes of news consumption, for sure but it really can really agitate and upset. And then of course there are these conspiracy like extreme news sources. And then finally one of them you know, that's kind of a little bit not well, it's not spoken about enough but pornography. I mean these are easily the most popular websites out there. And I don't think it's discussed enough what a negative effect that these have on people. Again, as the primal human, we're not made, you know, just like with news, we're not made... We were, we knew what was going on in the village around us and our village and things like that. That was our capacity for news intake. 

JULIE: Junk comes in many forms and I really appreciate you explaining that today, Matt. That's very insightful. 

MATT: One of my passions is ADHD. I, you know, do a good deal, or frequent assessments. I you know, physicians will refer someone and so what I'll do is I'll do you know, get information and then tests of attention and symptom checklists and validity checks to make sure we're trying and then personality emotional functioning measures. And so I take those and what my favourite part is to talk about people to have a feedback session and describe things and really try to explain what is happening with ADHD, how real it is and how it's really actually quite fulfilling how often in giving feedback to people that when we talk about why we procrastinate and just waiting on the stimulation, when we talk about the difficulty in the daily management, the putting the need to before the want to, you know, when we're when our demands increase, and such. It’s such a fulfilling thing to see someone recognize that it's not their fault, you know, that this wasn't this bad character trait of theirs. Or the biggest one is they're not lazy. You know, it's not that there really this is a real thing and there really are things that we can do to help ourselves with it. And of course with adults and teenagers with the parent, their parent, how often they wish they would have known sooner you know, that there were things that were... that might not have been as difficult as they as they ended up being. But it's you know, and it's really something with adults that for myself I find there's generally one of two situations for an adult coming to my office. The first is someone who their some part of their life, usually their work, became a lot less stimulating and a lot less interesting. So maybe it's someone who was out doing things and they were in a group of people doing certain kinds of work and now they're now they're at a desk job. And that stimulation and interest just dropped off a cliff and ]they're finding all of these difficulties that they may not have noticed before. And the other that I see quite often, and I tell people this all the time, not sure why it is in my office, that it's so often women that fall into this where they're very, you know, intelligent, high achieving people and they tend to have some anxiety, you know. And they get to a point at which that anxiety which kind of pushed them forward and stimulated them in that way, they're juggling so much all of a sudden that it's not working for them anymore. You know, that anxiety isn't enough to push them or stimulate them. But it's a very fulfilling thing to do evaluations and most especially feedback and talking to people about ADHD and what we can do to help ourselves. 

JULIE: Thank you. I love hosting this podcast because I get to talk to so many people about ADHD and their own personal journeys, or their clients’ journeys, and it looks so very different. But what I'm loving is the more we can talk about it, the more we can openly share this conversation, it no longer becomes a mystery. For example, the DSM, a lot of it is behavioural triggers that can be seen and observed, but it's only when you really get inside our minds and hear our feelings and our thoughts, those things that you would never see from an observational point of view. So this feedback loop, being able to verbalize how we're feeling inside and letting the world hear that, I think is so important because that's another way help identify or resonate with ADHD as a condition or as a difference. So the more people talk about these hidden feelings I think is fabulous and I'm so glad you're really enjoying that as part of your passion to actually get inside the heads of your clients. 

MATT: Well, and I... and it's just it really, I can't articulate enough or express enough how fulfilling that is when you can offer something to someone that helps them. As I said earlier, change I believe occurs through understanding and then action. Both are necessary. And so often people come in, they don't have that understanding. They don't recognize they haven't been, hasn't been taught, explained, recognized that these this is what you're having trouble with. And so let's actually address that rather than as you mentioned earlier, the self-criticism and and viewing having a narrative about ourselves and that's really heartbreaking for me. It's really heartbreaking for me when people develop a narrative about themselves because they don't know what's actually causing those difficulties. 

JULIE: And the reality is the narrative, their self narrative, is probably so far from the truth you kind of wonder how did they get there? But we know how we get there. 

MATT: Yeah. Right. Right. And I mean it's very costly not knowing and you know, when you see someone and they're really bright but they really have trouble managing the demands or having to initiate more things themselves and so they don't perform well. And now I'm not good at school. Now I'm not smart. These things that are just not accurate whatsoever, but we're not addressing the problem understanding and action. 

JULIE: Matt, we'll have links in the show notes to how to find you, the link to Our Primal Five and a whole bunch of other ways to follow you and to get more involved and to hear more. So, I just want to say thank you so, so much for your time today, very much appreciated talking about self-care and its different forms and how we can go about positive change in these small incremental achievable ways. So, thank you so much. 

MATT: I've enjoyed it.

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Julie Legg

Host
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Jel Legg

Co-host
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Dr Matthew Campbell

Guest