ADHD 2.0 : New Science and Essential Strategies for Thriving with Distraction—From Childhood Through Adulthood

by Edward M. Hallowell

The abbreviation ADD has been updated to ADHD, adding the word “hyperactivity” to the mix in order to reflect a more accurate description of the highs and lows of the lived experience. We use this more modern—and more official—shorthand throughout this book.

we now know that people don’t grow out of it—it is as much an issue for adults. The people who seem to grow out of it actually learned to compensate so well that they appear not to have it.

We also know that ADHD can crop up for the first time in adulthood. This often happens when the demands of life exceed the person’s ability to deal with them.

the organizational demands of daily life skyrocket and the person shows the symptoms of ADHD that he or she had been able to compensate for in the past.

Still others—even less charitably—think ADHD is a fancy term for laziness and that people who “have it” need some good old-fashioned discipline! In fact, “laziness” is a word about as far from accurate as it could be. The mind of someone with ADHD is in fact constantly at work. Our productivity may not always show it, but this is not because of a lack of intent or energy!

It occurs in at least 5 percent of the population, though we believe that that number is much higher because there are people who seem to be doing well in life (but who could be doing so much better) who do not get diagnosed.

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.

About two-thirds of people with ADHD have a life expectancy reduced by up to 21 years.

ADHD is the most treatable disorder in psychiatry, bar none. We have more medications with…larger effect sizes, greater response rates, and more delivery systems that change people’s lives more than any other disorder. They’re some of the safest medications in psychiatry.

if mastered, it brings out talents you can neither teach nor buy. It is often the lifeblood of creativity and artistic talents. It is a driver of ingenuity and iterative thinking. It can be your special strength or your child’s, even a bona fide superpower. If you really understand it and make it your own, ADHD can become the springboard to success beyond what you ever imagined and can be the key that unlocks your potential. As we’ve said, we see this in our practices every day.

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.

be one of the people who is different and feels darn good about it.

We are the seemingly tuned-out meeting participant who comes out of nowhere to provide the fresh idea that saves the day.

if you were to climb up into our heads, you’d discover quite a different landscape. You’d find ideas firing around like kernels in a popcorn machine: ideas coming rat-a-tat fast, and on no discernable schedule.

because we can’t turn this particular popcorn machine off, we are often unable to stop the idea generation at night; our minds never seem to rest.

our minds are here and there and everywhere—all at once—which sometimes manifests as appearing to be somewh...

The great mathematician Alan Turing summed us up when he said, “Sometimes it is the people no one can imagine anything of who do the things no one can imagine.”

We’re at ease where others are anxious.

“Creativity,” as we use the term in connection with ADHD, designates an innate ability, desire, and irrepressible urge to plunge one’s imagination regularly and deeply into life—into a project, an idea, a piece of music, a sandcastle. Indeed, people with ADHD feel an abiding need—an omnipresent itch—to create something. It’s with us all the time,

Even awake we’re dreaming, always creating, always searching

the word “deficit” in the name of our condition is such a misnomer. In fact, we do not suffer from a deficit of attention. Just the opposite. We’ve got an overabundance of attention, more attention than we can cope with; our constant challenge is to control it.

Whatever your vision, you go at it like you never have before.

we have a pronounced intolerance of boredom; boredom is our kryptonite. The second that we experience boredom—which you might think of as a lack of stimulation—we reflexively, instantaneously, automatically and without conscious thought seek stimulation. We don’t care what it is, we just have to address the mental emergency—the brain pain—that boredom sets off.

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.

Unexplained underachievement. The person is simply not doing as well as innate talent and brainpower warrant.

A wandering mind.

people continue to cite lack of effort as the cause of the disorganization and poor attention. The biological fact is that, in the absence of stimulation, they can’t. Not won’t. Can’t.

Trouble organizing and planning. In the clinical jargon, this is called trouble with “executive function.”

walking past the trash, like hundreds of other acts of seemingly selfish disregard for others, stems not from selfishness or another character defect but from a neurological condition that renders attention inconsistent and immediate memory so porous that a task can be forgotten in a heartbeat. What compounds these problems, and makes some people doubt the validity of the diagnosis, is that these same people can hyperfocus, deliver a brilliant presentation on time, and be super-reliable when they are stimulated.

High degree of creativity and imagination. People with ADHD—at any age—often possess intellectual effervescence.

this natural sparkle can be snuffed out by years of criticism, reprimands, redirection, lack of appreciation, and repeated disappointments, frustrations, and outright failures.

Trouble with time management, and a tendency t...

Those of us who have ADHD experience time differently ...

we lack an internal sense of the arc of time; we’re unaware of the unstoppable flow of seconds into minutes into hours, days, and so forth.

In our world, we have little awareness of the seconds ticking by; few internal alerts, alarms, or cues; no judicious allocation of chunks of time for this, then that, and then the next thing.

we recognize only two times: “now” and “not now.” We hear “We have to leave in a half hour” as “We don’t have to leave now.” “The paper is due i...

Our truncated sense of time leads to all manner of fights, failures, job losses, disappointed friends, and failed romances,

positive energy that comes and goes. But when it comes, we are the most generous people you’ll ever find, the most optimistic, the most enthusiastic.

You have to be a savvy parent, teacher, spouse, supervisor, or doctor to pick up inattentive, non-hyperactive ADHD in a girl or woman.

Unique and active sense of humor. Quirky, offbeat, but usually rather sophisticated too.

As much as we can get down in the dumps over a minute criticism, we can fly high and put to great use even small bits of encouragement or recognition.

Creativity is impulsivity gone right. You do not plan to have a creative idea, a eureka moment, a sudden revelation. These all come without bidding or warning. They come to us impulsively.

An itch to change the conditions of life.

coupled with a tendency toward lassitude, often mistaken for laziness.

Uncannily accurate intuition,

Transparency, to the point of being honest to a fault. The person who is incapable of “kissing up,” intolerant of hypocrisy,

From drugs and alcohol, to gambling, shopping, spending, sex, food, exercise, and screens, we who have ADHD are five to ten times more likely than the person who does not have ADHD to develop a problem in this domain.

if you find the right creative outlet—start a business, write a book, build a house, plant a garden—you can scratch the itch that way, rather than develop a bad habit or an outright addiction.