Climbing Out From Under the To-do List

About the Author

Dania Jekel, MSW is co-founder and former executive director of AANE. She was one of the first people to develop programs to train professionals about the needs and strengths of people on the autism spectrum, especially adults, women, and those who receive a diagnosis later in life. She also served on the Massachusetts Autism Commission.

Many Autistic individuals are plagued with a recurring thought:

“Why can’t I get anything done?” 

No matter the age, Autistic individuals often feel overwhelmed when they think of the number of things they need to do. Add to this any changes in routine or responsibility and feelings of anxiety, sleeplessness, and paralysis surrounding the “to-do” list can soar. In many cases, it leads to inertia, both in home and work life. A person may watch videos, play games, or sleep — anything to avoid thinking about accomplishing what needs to be done. Unfortunately, this inactivity can result in more anxiety and guilt.

Why This Happens

Many neurotypical people are puzzled and don’t understand this particular challenge. They assume it is a result of laziness or lack of trying. They may think, “How hard can it be? Start with the first thing on your list and just do it!” But this problem can be more complex.

Keep in mind that depression can cause or aggravate a person’s ability to get things done, and can even make it difficult for a person to get out of bed. If depression is an issue, it is important to seek professional therapeutic help.

Another possibility is that it could be rooted in executive functioning challenges, which is common for Autistic individuals. These challenges include:

• Paying attention
• Organizing
• Starting tasks
• Managing emotions
• Keeping track of what you are doing

Without these skills, even every-day chores balloon into insurmountable tasks. Avoiding them just means they become more ominous, and soon more items are added to the list. Anxiety can also be a significant factor; it can act both as the barrier to start a task or manage emotions, and it can also heighten a feeling of worry and panic as tasks remain undone. Shutting down or escaping into preferred activities feels safe and deflects negative thoughts, but only temporarily. Eventually, the self-blame returns in greater force and affects how you feel about yourself.

Previewing Power

If executive functioning challenges and/or anxiety are the issues, I want to make a concrete recommendation: Preview the day in detail and focus on those activities which are absolutely necessary. This could be done before bedtime to prevent insomnia and worry, or first thing in the morning before getting out of bed. The key is to go beyond the basic “make a list and follow it” idea. What I am suggesting is a thorough analysis of the tasks through a personal lens, which is not only a full understanding of what it will take to accomplish each item, but to comprehend the impact the activity will have on you. As you understand your own capacity, you can create a realistic plan you can manage without becoming overwhelmed. Parents of children and teens can also use this technique to help their child.

Here are some ideas for what a preview might look like: 

1. Make a list in your head (or preferably, write it down) of the things that HAVE to happen that day. This could be work, a dentist appointment, and grocery shopping.
2. Go over the steps needed to accomplish each task and consider how much energy it will consume. Think about the amount of time it will take, how to prepare, what to bring, etc. but also consider what it will take out of you: the sensory input, the anxiety you may feel if you have to navigate a new place or new people, especially when the social rules may not be clear. This takes practice. Sometimes visualizing going through the steps of the task will help you understand all of the necessary components and the effort needed. 
3. Analyze and adjust your list if necessary. If you preview your day and it feels overwhelming, see if you can add enjoyable activities or schedule in downtime in between the items on your list. Could you have an hour of reading between your dentist appointment and grocery shopping? Could you walk back from work to unwind instead of taking the bus? If that wouldn’t work, could you possibly modify one of the items on your list, like doing the grocery shopping at a closer, smaller store, or reschedule it for the weekend? On the other hand, if it feels like there is room in your day to do more, consider adding one or more items that you would like to get done, but that you might have been putting off. Is there some cleaning you have been ignoring? Could you open and sort your mail? 

If this process doesn’t work and you are still feeling like you are going through a day and aren’t accomplishing or doing anything, here is what I would suggest: pick one activity you would like to accomplish, and break it down even further into manageable steps. Then decide how many of the steps you will be able to do each day. If you have to mail a package, make your one task that day to find a box that is the right size, put the item in the box, and tape it shut. The next day, you can address it and take it to the post office.

The key is to create a process that forms a clear, achievable plan for you. And most importantly, remember this can be a difficult process so don’t punish yourself if you don’t finish all of the things you wanted to do. The more you understand your capacity and integrate that knowledge into previewing the day, the more closely you can create realistic expectations. You will find as you begin to accomplish even small tasks, you will feel better.