Understanding ADHD
The Ever-Evolving Understanding of ADHD
More than a Clinical Diagnosis
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Ongoing research into ADHD is providing greater insight into the condition from three key perspectives.
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A Clinical and Diagnostic Perspective
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A Neurological and Developmental Perspective
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A Neurodiversity Perspective
This is giving us a much more integrated and multi-dimensional picture of what is a highly complex condition.
ADHD is not a disorder of behaviour nor of willpower.
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Central to this understanding is a move away from the notion that ADHD is a disorder of behaviour.
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Instead, it is being seen as neuro-biological condition at the core of which are developmental impairments of "executive functions".
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This is important in challenging some of the most damaging stigma associated with ADHD, namely that it is representative of character failings, bad parenting, or wilfully disruptive behaviour.
The Multiple Perspectives of ADHD
"A Productivity Disorder"
Leading ADHD researcher Dr Russell A Barclay describes ADHD as
"A disabling condition that arises from neurological and genetic factors and causes problems in every area of life".
He also refers to ADHD as a "productivity disorder" where an individual's ability to get things done is severely compromised by an inability to resist distraction and regulate one's activity levels to the demands of a situation.
"A Cluster of Executive Functioning Impairments"
Dr Thomas E Brown has modelled varying combinations of impairment in six defined areas of "executive functioning" to be central to the challenges presented by ADHD.
According to Brown's model these are categorised as follows:
Activation:
Organising, Prioritising and Activating to work.
Focus:
Focusing, Sustaining and Shifting Attention to tasks.
Effort:
Regulating Alertness, Sustaining Effort and Processing Speed.
Emotion:
Managing Frustration and Modulating Emotions.
Memory:
Utilising Working Memory and Accessing Recall.
Action:
Monitoring and Self-Regulating Action.
"A Brain Wired for Interest not Importance"
Central to this understanding is that the ADHD brain is hot-wired for interest and stimulation to a much greater degree than the non-ADHD brain.
Individuals impacted by ADHD cannot wilfully pay attention to areas of disinterest regardless of their relative importance.
When bored or under-stimulated the ADHD brain either "shuts-down" or endlessly seeks alternative forms of simulation.
"An Under-developed non-linear Sense of Time"
The relationship between ADHD and perceptions of time is producing an increasing body of research.
It is often said that the only perspective of time in the ADHD mind is "now or not now" and that a marked characteristic of ADHD (reflected in many of its core cognitive and behavioural manifestations) is what Dr Russell Barclay describes as "exceptional near-sightedness about the future".
Chronic Procrastination is often cited as the single most pervasive trait of ADHD.
A compromised ability to Recall and Replicate Past Successes to Initiate and Plan Future Goals, accompanied by diminished linear sense of the passage of time from Past to Present to Future, has been cited as a key explanatory factor.
The ADHD brain needs Urgency and Immediacy to Engage.
"A Ferrari Engine for a Brain with Bicycle Brakes."
Leading ADHD expert Dr Ned Hallowell's famous observation captures the contradictions implicit in ADHD.
Living with ADHD involves living with a brain that is "always on the go", always seeking novelty, interest and stimulation.
Often people with ADHD talk about a bombardment of information or a feeling that their mind is "driven by a motor".
Coupled with this is a diminished ability to stop and regulate our efforts and emotions to prioritise tasks in order of importance and systematically apply ourselves to what needs doing.
People with ADHD often talk of "knowing what they need to do" but being "unable to direct their mind to do it" and this is central to the frustration of living with ADHD.
The Paradox of ADHD
"Situational Variability"
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In the right Environment, with the right level of Interest, Support and Stimulation the ADHD mind can be Energised, Attentive, Focused and Productive to such an extent that the core impairments associated with the condition are either much diminished or marked in their absence.
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Similarly, with the right level of Urgency and Immediacy, or where there are clear short-term rewards for doing something, or consequences of not doing something, the ADHD mind can often more reliably access Information, Knowledge, Motivation and Skills.
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Indeed, many successful people with ADHD identify positive attributes intrinsically linked to their ADHD as making a critical contribution to their achievements.
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This is often referred to as the "situational variability" or paradox of ADHD and has promoted increasing research into ADHD from the perspective of neurological difference rather than deficit.
Strengths and Challenges
"The Uneven Skillset of ADHD"
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Critically potential ADHD Strengths are not distinct from the challenges associated with ADHD. They invariably emanate from the same neurological traits which give rise to these challenges.
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Gaining greater insight around the specific situations and contexts in which our ADHD is most impairing, and conversely the exceptions where ADHD strengths are more readily accessible, leaves us better placed to harness these Strengths more reliably and consistently.
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Similarly, pro-actively aligning our life choices, developing habits and strategies, and creating environments which work with, rather than against, the unique wiring of the ADHD brain "levels the playing field" and give us a better chance to thrive.
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Learning to "do things differently" is often critical to increasing both capability and confidence in ADHD because traditional educational, training and office environments often accentuate ADHD challenges.
Core Challenges Associated with ADHD
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Many of the Core Challenges associated with ADHD are rooted in "executive functioning" difficulties and the way in which both practical and emotional information is acquired, processed, consolidated, and accessed.
These include:
Procrastination
("inability to get started"; "incompletions"; "never feeling ready to act"; "not knowing where to start")
Attention
("Paying, maintaining and sustaining attention"; "regulating attention to importance of task")
Momentum and Focus
("Staying on task; limiting focus to immediate task)
Impulsivity
("constantly seeking stimulation"; "acting without pausing to evaluate consequence of actions")
Distractibility
("constantly seeking interest"; intolerance of boredom")
Time management
("non-linear sense of time"; "near-sighted"; "now or not now"; "less reliable sense of past, present and future")
Disorganisation
("cluttered mind, cluttered environment"; "can't find things or access knowledge needed for task")
Transitioning
("shifting seamlessly from one activity to another"; "brain gets stuck in gear")
Emotional Overload
("experience and display emotions more strongly"; "acting impetuously or impulsively"; "lose perspective of the bigger picture")
Sensory Challenges
("specific senses are either dialled-up or dialled down"; "overwhelmed by sensory input ")
Restlessness
("mental and/or physical restlessness"; "driven by a motor"; "bombarded"; "mind and body always on the go")
Planning and Prioritisation
("knowing what to do when?"; "breaking tasks down into manageable steps"; "capturing and remembering progress")
Activation and Motivation
("struggle to access internal drive and motivation"; "can't work in a vacuum - need external factors and feedback to trigger motivation")
Discovering and Utilising ADHD Strengths
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Accessing ADHD Strengths often comes from an increased understanding and acceptance of ADHD challenges rather than endlessly struggling to eliminate or hide these challenges.
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It allows us to better understand "what is missing?" and "what is preventing our strengths from naturally surfacing?"
Potential ADHD Strengths include:
Creativity and Curiosity:
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An ability to think originally and imaginatively in a non-linear way to find unconventional solutions to problems.
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An ability "to join the dots" and link often disparate, or seemingly unrelated, concepts ahead of time.
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Often linked to the distractibility and unfiltered mind wandering of ADHD.
Energy and Enthusiasm:
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A propensity to display high levels of energy, exuberance and enthusiasm which can be motivating and inspiring to others.
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Linked to the spontaneity and inhibition of ADHD.
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Often people with ADHD are more responsive to extrinsic forms of motivation and find themselves more functionally capable when they feel connected with the people around them or their immediate environment.
High Levels of Intuition:
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Quick and emotionally adept at evaluating people and situations.
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Often people with ADHD talk of doing better when they "trust their intuition" or "gut feeling".
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Greater tendency to "reason via feeling and emotion" rather than "logic and facts".
Hyperfocus and Intense Productivity
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An ability to be highly productive in situations which naturally stimulate interest or where there is a strong personal connection or passion.
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Often people with ADHD are "quick thinking", "effective" and "adaptable" in a crisis or when doing something "for real".
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People with ADHD often report that their skills, knowledge, and capabilities never show up as reliably when practicing or preparing to do something.
Compassion and Empathy | Ability to Help Others:
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The "invisible challenges" and intuition of ADHD often increases sensitivity to, and awareness of, the struggles of other people.
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Many people with ADHD talk of being valued for their ability to "solve problems for others" which they "can't solve for themselves".
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Often there is an "external urgency" and "interest" in helping others along with immediate feedback for the contribution you have made.
Resilience and Resourcefulness:
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Often people with ADHD are hugely resilient at finding ways of coping with or compensating for their challenges.
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Similarly, because boredom and routine shut the ADHD mind down, they are often inventive in finding new ways of doing things or challenging the status-quo.
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Often the greater the complexity of the challenge, and the greater the scope to forge their own way of solving it, the more capable the ADHD mind is.
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People with ADHD often report being as disproportionately good at "solving the big puzzles that nobody else can solve" as they are bad "at managing day-to-day routines that seemingly everyone else can manage".