For years, I have taught people how to manage time, tasks, email, and distractions. I have systems in place for almost everything, and those systems have worked well for me for a very long time. I plan my day, use a task list, batch process email, protect focused work time, and rely heavily on routines. Those habits have helped me manage ADHD and stay productive in a demanding profession.
In February, I had major surgery that removed roughly half of my liver, along with 5 large cysts. What followed was a long problematic recovery. I dealt with complications, pain, fatigue, anemia, poor sleep, additional procedures, and months of trying to regain my strength, stamina, and even my ability to speak. I pushed loved ones and friends away as I fell into a deep depression. My normal routines disappeared, and with them went many of the systems that had kept me on track for years.
Here’s what I learned the hard way: My systems depended on routines and conditions I had come to take for granted. When those disappeared, the systems stopped working the way they once had.
If you have ADHD, routines do a lot of heavy lifting. Even if you don’t have ADHD, routines cut down on decisions and give the day a shape. I call that shape my scaffolding. When a routine is working, you do not have to decide when to exercise, when to review your calendar, when to look at your task list, or when to begin focused work. The routine has already answered many of those questions.
When the routine disappears, your brain suddenly has to work a lot harder. That can be particularly difficult for someone with ADHD because task initiation, prioritization, working memory, and shifting attention often require significantly more effort. You haven’t forgotten how to do any of it. The structure that made it easy is just gone.
My situation involved a major health event, but it does not take something that serious to create the same problem. It might be a major project, a two-week trial, a major deal closing, several weeks of business travel, or a long vacation. It could be moving, caring for someone who is ill, the holidays, or some other event that temporarily takes you out of your normal rhythm. It doesn’t matter whether the disruption is good or bad. Either way, your normal scaffolding is gone.
One of the biggest lessons for me was that maintaining a routine and restarting a dormant routine are different problems. When a behavior is already part of your day, it benefits from momentum. You wake up, exercise, review your calendar, look at your task list, and begin your work without having to make a series of fresh decisions. Restarting a routine is different. You must consciously initiate behaviors that previously happened almost automatically. You must decide when to begin, overcome resistance, and face whatever has piled up while you were away. That requires more executive function. Restarting feels like trying to start pedaling a bike halfway up a steep hill.
Then there’s the emotional side of all this. When your systems stop working, it is easy to become frustrated with yourself, particularly if you are someone who has spent years being organized and productive. You know what you are supposed to do. Like me, you may even teach other people how to do it, and still, you can’t get yourself moving.
It turns into a vicious cycle fast. The backlog grows. You feel overwhelmed. You avoid the task list or inbox because looking at it makes you feel worse. Then you feel guilty for avoiding it, which creates even more resistance.
At some point, I realized that I could not simply time-manage my way out of everything I had been through. Therapy helped immensely. Sleep was huge. Movement mattered. Getting outside in the sun and fresh air mattered. So did accepting that recovery itself was a large project.
If the disruption was a painful one, like a death, a frightening diagnosis, or some kind of trauma, getting back to your routines can bring up more than resistance. It can bring the memories right back. I know this one firsthand. Even simple things that reminded me of the months after surgery could pull me back into that dark place. Opening the task list you abandoned or the calendar still frozen on the week everything fell apart can put you right back in that moment. A certain date, a song, or even the smell of a hospital can do the same thing. When that happens, you are not being lazy or undisciplined, and you can’t time-manage your way through it. If you’re dealing with grief, trauma, or depression, please talk to a therapist or your doctor. It also helps to give yourself a fresh start: begin a new task list instead of reopening the old one, rearrange your workspace, or move your planning to a different time of day. Go easy on yourself on the hard days. Grant yourself some grace.
Another mistake that I made was trying to restart everything at once. That was my instinct. I wanted to get back to normal, which meant rebuilding every routine, catching up on every task, clearing the inbox, exercising, fixing my sleep, and resuming every project.
That just made me more overwhelmed. What worked better was a minimum viable routine. I started with a few anchors that gave the day some shape again. This might mean waking up at a consistent time, getting some movement in the morning, reviewing the calendar, choosing three meaningful tasks, and getting enough control over email to identify what truly matters.
Don’t try to optimize yet. Just get things moving again. For me, getting my rhythm back mattered just as much as getting my workload back to where it was. If your life has been disrupted, you may have a mountain of work waiting for you. Rebuild the things that make the work possible: sleep, movement, planning, a trusted task list, and a predictable start to the day.
Once those pieces begin to return, the workload becomes easier to manage. I also learned that having someone hold me accountable was a huge help. During my recovery, tasks involving another person were often easier for me to start than open-ended tasks I had assigned to myself. When someone else is involved, you get structure, a deadline, and a little social pressure. For those of us with ADHD, that helps. Schedule a work session. Tell someone when you will send the draft. Ask a colleague to check in. Use a coach. Put a real deadline on the calendar. Hire a personal trainer. There’s no shame in borrowing a little structure from other people.
The backlog also needs to be treated realistically. When you return from a major disruption, everything can look overdue, but not everything is equally important. Some things truly matter now, and some things can wait. Some can be delegated. Some no longer need to happen at all. Don’t skip that last one. We often drag old tasks forward because they once seemed important, even when circumstances have changed. A disruption is a great excuse to take a hard look at what still belongs on your list.
I also think we underestimate the need for a re-entry period. We tend to think there’s the event, and then there’s normal life. But there’s almost always a very messy middle. Someone who finishes a three-week project out of the office on Friday should not expect Monday to feel like a normal Monday. There may be hundreds of emails waiting, other matters that need attention, an outdated task list, disrupted sleep, and routines that have disappeared. Monday may need to be used for triage, planning, calendar review, delegation, and rebuilding the week. That’s not wasted time. Give yourself that day to get your bearings.
So how do you know when you’re actually back? It’s not when everything is caught up. It’s when your systems start supporting you again. You are no longer relying primarily on urgency, panic, or memory. Your task list feels useful instead of threatening. You can begin ordinary work without needing a crisis to activate you. Your days feel more directed and less reactive.
Most importantly, you begin to trust yourself again. It’s ok to still have a backlog. Most busy professionals do. You may not be exercising as much as you once did. Your inbox may not be clean. That is fine. Being back does not mean everything is perfect. It means you are moving forward under your own systems again (or newly revised systems) rather than simply reacting to whatever is loudest.
Whatever knocked you off track, don’t try to rebuild everything in one day. Put one piece of scaffolding back in place, then another, then another. Give the routine enough time to regain momentum.Eventually, your systems will begin to carry you again!