What is: Attention Deficit Hyperactivity Disorder (ADHD)

“Have you ever walked into a room and suddenly forgotten what exactly it was that you went in there for? It seems to be a phenomenon that most people can empathize with. Now imagine that same thing happening but with practically everything you do. If I put the oven on and don’t keep my focus consciously on the cooking— say I go into the other room to grab something – chances are high I’ll just totally forget I ever put the oven on until I smell something burning.

If something catches my attention as I’m getting out of my car in a parking lot, I might end up leaving the keys in the unlocked vehicle and not realizing until I get back out of the store. If my boss gives me a task and I don’t immediately write it down on the list I keep beside me, I will forget in an instant not only what it was I was asked to do, but that I was even ever asked to do something in the first place. In a way it’s like having a faulty short-term memory.”

The above-mentioned account is from a journal that an ADHD (Attention Deficit Hyperactivity Disorder) patient submitted to his psychiatrist during his cognitive behavioral therapy (CBT), which he later shared on Reddit. I am bringing it here to provide a small scope of view to understand ADHD patients. However, many people do not believe in ADHD. Critics have been claiming that schools and parents are just labeling lazy individuals to have ADHD because they don’t want to deal with them. Or even more, ADHD suffering patients are tagged with a label “Lazy person” in many families. But ADHD exists.

Being lazy is just one of the many symptoms of ADHD. If it isn’t accounted in time, the patient may have a high risk of suffering from major psychological problems as depression, bi-polar disorder, anxiety, and panic disorder. Furthermore, the people who are aware about ADHD also have been mostly reading about the myths that are all over the internet. So, it wouldn’t be an exaggeration to say that most people have no/only vague idea about what ADHD is and what it could entail. Therefore, today, I would like to pour in some light on the facts about ADHD, starting from how it occurs to how we can keep it in check.

Although no accurate cause of ADHD has been known, no one has come closer to understanding ADHD better than the famous clinical psychologist, Dr. Russell Barkley. However, before jumping into ADHD, it is necessary for us to understand about human motivation and its connection to brain. Motivations are a form of emotion. Humans are the only being in the entire planet who can stop for a while and think about future, eventually motivating themselves to step out and fulfill that dream. The frontal limbic circuit in our brain is the part where we think about goals and start motivating ourselves.

Well, Dr Russell Barkley defines ADHD as a disorder where a patient just cannot create the motivation/willpower that is necessary to guide them towards their goals. He has often called ADHD to be Motivation Deficit Disorder. A lack of ability to follow goals in a disciplined way. Even if ADHD patients have a world changing vision, they cannot act on it. It’s almost as if they have no source of willpower. The cause for this has been often liked to anterior cingulate circuit inside the human brain, which is thought to be dormant in ADHD patients.

In addition to it, according to Dr. Barkley, in ADHD patients, the back part of the head and the front part of the head are divided distinctly like a meat cleaver. The back part of the head is used for gathering knowledge and the front part is used to put it in action. However, in our patients, they cannot put in any effort despite the knowledge and skill they gain over time. To gain skills, they attend seminars. They collect necessary notes and even tape it on their refrigerator. They even make routines to start living an organized life.

But right from the next moment, they snap out of it and start living impulsively once again. They forget all about the notes that are dangling on their refrigerator doors. They forget about their routines. They forget about the resolutions they made just 1 hour ago. This is all because the front part of the brain is simply not being able to put those skills into action. Therefore, often besides calling ADHD as Motivation Deficit Disorder, he also has referred to it as a Performance Disorder. 

Moving on, there has been a general conception that ADHD is severely related to inattention. However, Dr Russell Barkley and another prominent psychologist Professor David Gilden, from the University of Texas at Austin, both, strongly disapprove with it.  Prof Gilden’s research on ADHD suggests that for ADHD patients, the time moves a little quicker than for normal people. It is one of the reasons why they are very hyperactive. He has stated ADHD as:

ADHD is not about inattention. It is a disorder in the way people thread moment to moment experiences.

Dr. Barkley also has similar opinions on it. He has countered the myth of ADHD and its relation to inattention stating as follows:

ADHD is not an attention disorder. It’s a blindness to future. People are nearsighted in time. They will wait for time to arrive to them. They will wait and wait until the last moment till everything becomes a crisis.   

Although no one except trained psychiatrists can actually diagnose ADHD, they do tend to show some general symptoms. In most ADHD cases, the individuals are found to be highly emotionally impulsive. They get triggered very quickly and generally are *very, very* impatient. They get excited by little things quickly and at the same time, lose that excitement in an equally fast pace. You could even say that they have a system failure to regulate and suppress their emotions. A normal person, if he/she is being insulted by their supervisor, can stay quite and suppress the boiling emotions within him/her.

However, with ADHD patients, they cannot store it within them for long. They tend to blurt it our as soon as possible out of their head because of their impulsiveness. If they are being insulted, they will go out there and throttle their supervisors. Because of this impulsiveness, they tend to lose their friends very quickly too because society generally doesn’t prefer impulsive individuals. Furthermore, they have a habit of procrastinating and forgetting things. They are unable to stay at a place for long enough and are always on the go as if they run from motors.

Well, you might be thinking the hyperactive nature is never seen in older people/adults. Does it mean they don’t have ADHD? No, they are also very hyperactive but out of their maturity, they tend to have that hyperactivity within them, which leads to restlessness. Furthermore, ADHD patients are impatient to share what is inside them. In classrooms, you might have also noticed individuals who would just blurt out answers before the teacher has even finished asking questions. It’s likely that they have ADHD. 

Another myth that is out in the internet is that ADHD patients hyper-focus as a symptom. However, Dr. Barkley again disagrees with it. According to him, people are glorifying ADHD by linking it to hyper-focus. Hyper focus is something that comes out of preservation. It’s when you have enough willpower to work hard that you enter a state of zone. Not because you have ADHD. ADHD patients, on the other hand, are generally just unable to stop the task they are doing. They aren’t hyper-focusing. There have been so many cases where people just desire for having ADHD because of the focusing abilities. It is necessary to understand that it’s all a myth.

Finally, one more thing everyone has to understand here is that ADHD patients do not stem from the failure of their upbringing. Parents and schools are not to blamed for it. It is neurogenetic and it’s a part of who they are. The society has to accept their imperfections like they accept everyone else’s. So if it’s neurogenetic, is it that it cannot be treated? No, it’s not the case. While saying we can treat it completely might not be possible, we can definitely keep it in check.

Some of the ways we can help an ADHD patient are:

1) Definitely, the most obvious solution is to get a professional support from a trained psychiatrist. Notice how I have been using the word ‘psychiatrist’ not psychologists. Psychiatrists can provide ADHD patients with Cognitive Behavioral therapy (CBT) to help the cope with their disorder. Furthermore, they highly recommend journaling too. One of the ADHD redditors has recorded his behavioral therapy sessions and shared it. If you wish to take a look and help yourself or someone with ADHD, here is the link: https://www.reddit.com/r/ADHD/comments/19yixo/tip_thursday_tales_from_cognitive_behavioral/

2) ADHD patients can use the S.A.F.E (Sustainable, Accountable, Flexible, Efficient) method to help themselves. It involves making long-term sustainable goals and having someone hold the patient accountable for seeing through the task. It is very important to note about accountability. Now that the patient has a goal and an accountability partner, it is necessary to create a flexible routine. For instance, ADHD patients are recommended to create a goal before they go to sleep. The next day, they should have a target of completing 75% of it, all the while equally trying to indulge themselves in fun and leisure activities. It should be broken down into attainable steps and the person shouldn’t move around the routine. Rather, the routine should move around the individual.

Finally, it’s suggested for ADHD patients to add urgency to their tasks. Maybe if you have a deadline to submit your essay in 3 weeks, narrow the deadline to three days. After having narrowed it down, call in your accountability partner to keep track of you. This is suggested because ADHD patients are able to work most effectively under urgency. You could also say that more frequent consequences are necessary for them to be able to complete the task in hand.

3) The most suggested advice for any sort of disorder or diseases has always been to eat, hydrate, sleep, and meditate. ADHD is not a different case. Research has shown that ADHD patients with proper and routined habits perform exponentially better than their counterparts. Also, it is suggested to try the 4-7-8 breathing practice/US Navy Seal breathing practice to calm themselves down during their hyperactivity instance. While using this technique, individuals should inhale the breath for 4 seconds, hold it in for 7 seconds, and finally exhale with a “whoosh” sound from their mouth for 8 seconds. Results have shown that this immensely helps and individual to calm down, even in the most panicking situations.

 4) Finally, in terms for working, besides setting accountability partners, it is suggested to keep timers so that ADHD patients can know how much they can finish in a certain time. Also, it’s a common trait in ADHD patients to be excited in a novel environment or be highly enthusiastic to pick on a new stuff. It has been recorded in certain researches that ADHD patients work better when they are in a new environment. Therefore, it’s suggested for them to keep changing their environment while they are working.

Furthermore, they perform well with instant gratification. Once they complete something, they should have urgent and instant rewards to keep the motivation flowing within them. Adding to that, they could also rotate between their works throughout the day. This keeps the zeal and enthusiasm flowing within them.

Finally, if you are an ADHD patient or know anyone, ask them to work weirdly. They could read hanging upside down from the wall or make a game out of any of their work. The more they gamify and seek adventure, the more work they produce. It is important not to let them indulge themselves in repetitive lengthy tasks. It is something which turns off their cognition abilities entirely. 

As final parting words, our society should soon understand that ADHD is to be taken seriously. If it’s not kept in check, it could yield other further possible disorders like ODD, which eventually could lead ADHD patients to lose confidence in themselves and their emotions. If you’re and ADHD patient, do not fear to take help. If you know someone with ADHD, you should try to help them as much as possible. 

— Bibatshu, Kathmandu

* This is a submitted post *  

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