ADHD 2.0: New Science and Essential Strategies

by Edward M. Hallowell

A person with ADHD has the power of a Ferrari engine but with bicycle-strength brakes. It’s the mismatch of engine power to braking capability that causes the problems. Strengthening one’s brakes is the name of the game.

“ADHD” is a term that describes a way of being in the world. It is neither entirely a disorder nor entirely an asset. It is an array of traits specific to a unique kind of mind. It can become a distinct advantage or an abiding curse, depending on how a person manages it.

We’ve got an overabundance of attention, more attention than we can cope with; our constant challenge is to control it.

think of ADHD as a complex set of contradictory or paradoxical tendencies: a lack of focus combined with an ability to superfocus; a lack of direction combined with highly directed entrepreneurialism; a tendency to procrastinate combined with a knack for getting a week’s worth of work done in two hours; impulsive, wrongheaded decision making combined with inventive, out-of-the-blue problem solving; interpersonal cluelessness combined with uncanny intuition and empathy; the list goes on.

In adulthood, this translates to seeming gruff, awkward, rude, self-centered, unfiltered, or aloof; but it is really just the undiagnosed and untreated ADHD that is causing the problems. This is why we call ADHD such a “good news” diagnosis: Once you know you have it, and you find the right help, life can only get better, often much better.

Tendency to externalize or blame others while not seeing your role in the problem. This is coupled with a general inability to observe oneself accurately, which naturally leads to more externalizing, since you truly do not see the role you play in the problem.

Distorted negative self-image. Due to the inability to observe oneself accurately, coupled with the heightened sensitivity to perceived criticism and a record of underachievement, people with ADHD usually have a self-image that is far more negative than is warranted.

together called a connectome, “light up” in your brain.

The connectome that lights up when you’re engaged in a task is called the task-positive network, or TPN.

In this state, you don’t consciously know whether you’re happy or not, which is just as good as being happy, if not better, because you’re not wasting any energy in self-assessment.

this other connectome is called the default mode network (DMN). The DMN allows for expansive, imaginative, and creative thinking.

In a neurotypical brain, when the TPN is turned on and you’re on task, the DMN is turned off. But in the ADHD brain, the fMRI shows that when the TPN is turned on, the DMN is turned on as well, trying to muscle its way in and pull you into its grasp, thereby distracting you.

In ADHD, therefore, the DMN competes with the TPN, which in most people it does not do.

Trapped in the past or future in the DMN, you’re likely to abandon projects you once started with enthusiasm, make careless mistakes, or, worse, fall into a state of misery and despair, for no good reason whatsoever.

That’s why addictions of all kinds are five to ten times more common in people who have ADHD than in the general population.

The point is: Focus on anything external to yourself. Activating the TPN will shut down the DMN.

Don’t feed the Demon. Shut off its oxygen by denying it your attention. Do something else that engages your mind. Stay in action!

the adult human brain houses about 100 billion cells. (Our own galaxy, the Milky Way, interestingly enough, contains about 100 billion stars.)

(If you had to rely on your frontal cortex—the front, cortical part of the brain where we do our critical thinking—to calculate those corrections, you’d fall every time, because frontocortical thinking is about a hundred thousand times slower than the cerebellum’s calculations.)

Stand on one leg for one minute or until he falls over. Stand on one leg with eyes closed for one minute or until he falls over. Take off socks and then put on socks without sitting down. Stand on wobble board for as long as he can, up to five minutes, then do it with eyes closed. Sit on exercise ball with feet off the floor for as long as he can, up to five minutes, then do it with eyes closed. Put five playing cards on the floor. Standing on one leg, bend over and pick up one card at a time. Do a low plank hold (elbows down on the ground, feet extended behind) for up to three minutes. Learn to juggle balls, and then spend three to five minutes juggling.

During my years caring for patients, the most common pathology I saw was not heart disease or diabetes; it was loneliness. Loneliness and weak social connections are associated with a reduction in lifespan similar to that caused by smoking fifteen cigarettes a day and even greater than that associated with obesity. Loneliness is also associated with a greater risk of cardiovascular disease, dementia, depression, and anxiety. At work, loneliness reduces task performance, limits creativity, and impairs other aspects of executive function such as reasoning and decision making. For our health and our work, it is imperative that we address the loneliness epidemic quickly.

The single most important factor in predicting health, longevity, occupational success, income, leadership ability, and general happiness comes down to one four-letter word. “It’s love,” Vaillant famously stated. “Full stop.”