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January 3 - January 5, 2022
Ignorance regarding ADHD costs lives. Literally. ADHD can be a scourge, an unremitting, lifelong ordeal, the reason a brilliant person never finds success but rather limps through life in frustration, shame, and failure, amid catcalls to try harder, get with the program, grow up, or in some other way reform. It can lead to suicide, addictions of all kinds, felonious acts (the prisons are full of people with undiagnosed ADHD), dangerously violent behavior, and a shorter life.
Compared to other killers from a public health standpoint, ADHD is bad. Smoking, for example, reduces life expectancy by 2.4 years, and if you smoke more than 20 cigarettes a day you’re down about 6.5 years. For diabetes and obesity it’s a couple of years. For elevated blood cholesterol, it’s 9 months. ADHD is worse than the top 5 killers in the U.S. combined. Having ADHD costs a person nearly thirteen years of life, on average. Barkley adds, And that’s on top of all the findings of a greater risk for accidental injury and suicide….About two-thirds of people with ADHD have a life expectancy
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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.
We are the problem kid who drives his parents crazy by being totally disorganized, unable to follow through on anything, incapable of cleaning up a room, or washing dishes, or performing just about any assigned task; the one who is forever interrupting, making excuses for work not done, and generally functioning far below potential in most areas. We are the kid who gets daily lectures on how we’re squandering our talent, wasting the golden opportunity that our innate ability gives us to do well, and failing to make good use of all that our parents have provided. We are also sometimes the
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Indeed, our minds are here and there and everywhere—all at once—which sometimes manifests as appearing to be somewhere else, in some dreamy state.
“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 don’t choose not to conform. We don’t even notice what the standard we’re not conforming to is!
We’ve got an overabundance of attention, more attention than we can cope with; our constant challenge is to control it.
it helps to 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.
High degree of creativity and imagination. People with ADHD—at any age—often possess intellectual effervescence. Unfortunately, this natural sparkle can be snuffed out by years of criticism, reprimands, redirection, lack of appreciation, and repeated disappointments, frustrations, and outright failures.
We tend to operate on a “fire, aim, ready” basis instead of “ready, aim, fire.” But remember, the flip side of impulsivity is creativity. Creativity is impulsivity gone right. You
Uncannily accurate intuition, coupled with a tendency to overlook the obvious and ignore major data.
Having a metaphorical lightning rod and weather vane. For whatever reason, people with ADHD often are lightning rods for whatever can go wrong: being the one kid caught with weed when twenty others had it; the adult or kid who gets scapegoated, blamed, and disciplined more than anyone else; the one who disrupts the family event, or business meeting, or class discussion without meaning to. But at the same time, the lightning rod quality can lead the person with ADHD to receive ideas, energies, premonitions, and images from who knows where that lead to amazing success. Similarly, the internal,
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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.
While on the one hand, creativity depends upon the ability to imagine a different reality, to “distort” the ordinary into something better, on the other hand, this “distorter” can create one of the most painful aspects of ADHD, which is very low self-regard. We look at ourselves as if in a house of mirrors, not seeing ourselves as others do, seeing only what we regard as failures and shortcomings, all but blind to the upside, which is typically considerable. We suffer shame as we misread ourselves and misread others’ responses to us. We hold back on opportunities and relationships out of that
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But Hank is also tortured, and that’s not too strong a word for the mental miseries he endures. He spends chunks of time—fifteen minutes here, an hour there, sometimes an entire Saturday morning and even longer—brooding. Troubling, jagged thoughts, images, ideas, and feelings pop up unimpeded in his mind like rocks in a river’s current as he desperately tries to steady his mental raft. They keep on coming, smashing against his mind over and over while he bravely tries to survive another trip down the relentlessly moving rapids within.
He’s tried antidepressants, which did nothing but reduce his libido, diminishing one of the few pleasures in his life.
We’re starting to understand the genetics behind brain function, as well as the epigenetics, the varying impact of environment upon the expression of genes. For example, it is because of epigenetics that you may have been born with genes that predispose you to depression, but because of loving parents and a nurturing school system, those genes never get expressed. You go through life never suffering from depression, even though you carry the genes that might have led you there. On the other hand, if you had unloving parents, if you never received nurturing and positive connections, or, worse,
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This fixed-brain notion begat a host of homespun clichés and conventional wisdom to the effect that you simply cannot teach an old dog, or even a middle-aged dog, new tricks; that from age thirty the leopard does not change its spots, that you are who you are and you better get used to it because no amount of therapy, life experience, or other magic can make a significant dent in the architecture of your brain or your personality, except by changing it for the worse, through disease, stroke, cancer, poisons, alcohol, drugs, or dementia.
This is the hyperfocused state that people with ADHD can fall into. Far from being helpful, it can keep you stuck in one task, unable to shut down the screen, turn off the TV, or move from one paragraph to the next. This is the often unrecognized downside of focus.
For neurotypical people, toggling over to the DMN periodically allows you to get some intellectual rest and relaxation—daydreaming time, for instance, which isn’t necessarily bad. But highly imaginative, creative people—like those of us who have ADHD or VAST—often get stuck in the DMN, leading to horribly negative, gloomy, and self-critical thoughts like the ones we saw in Hank’s experience earlier.
While we are all wired to feel fear and imagine disaster far more than to feel comfortable and secure (along with our five senses, the imagination is our chief evolutionary danger detector), people who have ADHD or VAST are also particularly prone to head toward gloom and doom in their minds because they have stored up in their memory banks a lifetime of moments of failure, disappointment, shame, frustration, defeat, and embarrassment. Given a moment to reflect on what’s likely to happen next, life has taught people with ADHD to imagine and expect the worst. Too many facts are readily
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To paraphrase Gabrieli, the problem when ADHD enters in is twofold. The first is what’s called the anticorrelation property of the two networks. Imagine a seesaw. 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.
“If there is one takeaway in distilling down the complexity of the DMN and the TPN, it boils down to the fact that the toggle switches between them are off in those with ADHD.” In other words, in most people the DMN does not slip so easily into the TPN; the gears mesh well and are not glitchy. But in people who have ADHD, the gears get stripped, so to speak, and so you’re left with this dangerous/wonderful curse/gift. This is truly a malfunction of the imagination, and it explains the confluence of the creative and depressive we so often see within the same person, even within the same hour.
While this hunger can lead to magnificent achievements of many kinds, in the extreme, this exact same hunger drives addiction. That’s why addictions of all kinds are five to ten times more common in people who have ADHD than in the general population. We live with an itch at our core that can only be scratched in certain ways. Creative achievement is perhaps the most adaptive, worthwhile, and sustainable, while addictions—of all kinds—are the most maladaptive and destructive.
One year, in celebration of the arrival of spring after a cold winter, Ron and Gretchen set out to the hardware store to get flowers and plants for the front yard, along with a few other supplies for the house. Pulling in to the parking lot, they got out of the car and decided to divide and conquer, with Ron getting the plants and Gretchen setting off to the plumbing department. With enthusiastic zeal, Uncle Ron made a beeline for the gardening section. He jumped deep into his DMN, envisioning how each type of flower and foliage would look in the front yard, making mental notes on where his
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It took a minute to sink in. Uncle Ron suddenly realized that he had left Gretchen at the store. When he left the parking lot, he was so focused in the front part of his DMN, planning for the future, envisioning his garden, that he didn’t connect to the back part of his DMN, the history that revealed he had a wife he adored, and the memory that they had driven to the store together.
Another extremely common problem when caught in the DMN is what we call “pirouette syndrome,” a circling back to make sure you’ve done something you’ve already done. Some people pirouette to be sure they’ve locked the front door, or didn’t leave eggs boiling on the stove; others circle back to find something they are sure they’ve forgotten: sunglasses, a wallet. When you aren’t paying attention in your TPN, it takes a lot of energy to check and double-check to make sure you didn’t pull a royal screw-up.
Still another curse of the Demon is catastrophic thinking. We refer to this as Chicken Little syndrome, as it’s easy to believe the sky is falling. A young attorney confessed she has a tough time starting new cases as she immediately jumps to the future part of her DMN and stays there, endlessly envisioning and obsessing
catastrophic thinking is a form of rumination.
The rear part of the DMN spins into overdrive, looking back at what she said, taking it apart, wondering what you did to deserve that.
the front part of the DMN, where you ruminate on plans and make lists. You go over and over and over what you will say to your boss to straighten things out, or how you will chastise her and quit, stressing about her reaction, your cowardice, and the fallout.
In other words: Spend more time in the TPN focusing on a single task. We know what you might be thinking: The whole point is that I can’t focus on a single task! But you can—you are already a master of distraction, so now distract yourself. Productivity isn’t the point here. Moving the toggle switch is.
the minute you start to ruminate and slip into brooding negativity, look elsewhere. Do anything.
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!
In other words, just as the cerebellum had long been known to act as a kind of gyroscope or balancer of gait and movement, he explained, “so does it regulate the speed, capacity, consistency, and appropriateness of cognition and emotional processes.”
Based on Schmahmann’s research, and based on the findings from other MRI studies that show that the central strip down the midline of the cerebellum—called the vermis—is ever so slightly smaller in people who have ADHD than in people who do not,*1 it makes sense to think that stimulating and challenging the cerebellum/VCS, the way lifting a weight stimulates and challenges a muscle, might help reduce the negative symptoms of ADHD.
It was also important that they understood the “race car brain with bicycle brakes” model of ADHD, because it is accurate but not shaming. It allowed Samuel to aspire to become a champion if he worked on his brakes, but it reminded him that there was work to be done. The key here was to use the model consistently. Instead of saying “You’re a bad boy!” or “Shape up!” Lily said, “Your brakes are failing you.” She still intervened, making it clear that certain behaviors needed to stop or change, but she did not do this via shame. This is critical to the long-term growth and success of the child.
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Why this matters so much in our story of ADHD is because, as you probably can guess, ACEs scores run much higher in families where there is ADHD, either in a parent or in a child, or both. Because the negative side of ADHD, the bad brakes, causes impulsive behavior often out of control, the parent is more likely to mistreat or abuse his child, and the child is more likely to provoke, alienate, or assault his parent. It’s a dangerous setup on both sides, parent and child.
If there was ever any doubt, the ACEs study proves once and for all that bad stuff in childhood—abuse, neglect, violence, drug use, loneliness, poverty, chaos—begets really bad stuff in adulthood. But there is an equally clear antidote. Connection, positive connection, which at its most distilled is called love, has incredible healing power.
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.”
In his book The Globalization of Addiction, Bruce Alexander uses the term “dislocation” (which was coined by the political economist Karl Polanyi) to refer to the loss of “psychosocial integration.” Dislocation, he explains, is psychologically toxic and untenable. An individual will crack in any number of ways: disruptive behavior; extreme anxiety; withdrawal; school refusal; the beginnings of substance use; depression and thoughts of suicide; the development of an eating disorder; cutting; poor performance at work; loss of job; marital difficulties. The dismal list goes on.
How terrible it is that millions of children with ADHD suffer similarly from the lack of sustaining connection simply because they are different, because their minds run like race cars with bad brakes, and because others fail to understand. Those of us with ADHD are usually pretty sensitive, so we begin to put up defenses, and before you know it we’re loners, being teased, put off, or, if we’re adults, not climbing the ladder, and people are wondering why, and not in a helpful way.
it was all she needed to do. With that arm—with the power of connection—she cured the real learning disabilities, which are fear, and shame, and believing that you can’t do something. To this day I am a painfully slow reader—my wife teasingly says she can’t believe I know anything—but I read well enough to have majored in English at Harvard, to have graduated with high honors, and to make part of my living now by writing books, none of which would have happened without Mrs. Eldredge and the loving connection her arm gave me.
Take heart. Hearts heal. Unlike the ship synonymous with sinking, the titanic power of connection rises up from the deep every time it sinks, as long as we are brave enough to board her again. Once she knows we are ready to jump on, she rises, ready to welcome us once more.
How would you feel if you were criticized all day long, as so many of these children are? Fear is the major learning disability, fear and shame.
Make a point of having meals with your family—family dinners have been proven to work wonders, even to improve SAT scores—and have meals with other people you know. It’s wonderful to introduce children to people from out of town, even from out of the country, and make dinner a big deal where people meet to eat and greet. The more you do this, the more meals turn into events that take on meaning beyond merely a chance to refuel.
Unless you or someone in your family is allergic, or your physical layout makes it impossible, get a pet!
Make a daily stop at a favorite coffee shop with hellos all around. And get into the habit of giving hellos and nods to people you don’t know. This kind of passing acknowledgment gives a quick dose of Vitamin Connect, and it prods you out of the habit of anonymity most of us slip into.
