The ADHD Perspective

Introduction:

Let me begin by pointing out that I do not claim to be a therapist nor do I possess any formal training or education focused in psychology. What I do have is a keen fascination for learning and understanding why we as humans are the way we are.

Although each of us are unique individuals from different parts of the world, with varying socioeconomic statuses, different upbringings and family dynamics, differing political stances, and in general have our own particular understandings of the world, I think we’re all more alike than we might think, or want to believe. Having said that, I have faith that, now more than ever, we have the ability to recognize our similarities and achieve prosperity, but only when we are all equipped with the knowledge and tools to do so. With the proper support and resources, we all have the ability to be more naturally vulnerable, relate to one another more easily, practice empathy and active listening, and unlearn destructive behaviors. Instead of defending our mistakes and misjudgments, we could see them as learning opportunities to grow from.

Something that I’ve learned about myself is that I feel the most purposeful when I’m able to establish a genuine connection with another person and provide a longstanding and meaningful impact. I know that may come across as one of the most cliché assertions and I’m aware that I’m not unique in that self-discovery. All of that is to say is that when I’m able to exercise empathy and offer another person the space and security to feel heard, seen, understood, and comforted; to give them the confidence to know that they’re not alone, they’re not crazy or an alien, I feel the highest sense of satisfaction and fulfillment.

My reasons for writing this aren’t entirely selfless as I find expressing my thoughts and experiences to be creatively therapeutic, but on the other hand, I hope that they will be of benefit to those in need of feeling a sense of belonging and normality on some level. It is a fundamental prerequisite of human beings — big and small, you and me — to feel accepted and understood. Humans are not meant to stand alone completely, and no one is an exception to that fact.

Why Am I Talking About ADHD?

A topic that I’ve seen gain more traction and attention over the past few years is ADHD. As someone who has been diagnosed with ADHD since middle school but struggled with its effects long before that, I feel a sense of responsibility to share my thoughts, analysis, and perspectives on the matter, along with my own related personal experiences, struggles, and means of managing it.

We live in an age where everything is driven by constant stimulation and distraction, so it’s easy to come to the conclusion that ADHD is nothing more than a product of our fast-paced society that enables short attention spans and instant gratification. It makes many feel worn out, but the complexities of the ADHD experience extends much deeper.

ADHD comes with an incredibly high price tag for a young woman in the United States. The lack of resources and the complex hurdles that one must endure to understand and manage their ADHD is only a fraction of the burden. Western society’s skepticism and the media’s mocking, dismissal, and negative characterizations promote questioning the legitimacy of ADHD and the suitability of its treatment, specifically prescription stimulants, are constantly questioned and criticized. It’s exhausting and frustrating and nearly impossible not to experience some degree of shame, inadequacy, and insecurity

ADHD is a very personal healthcare issue, and its treatment is unique to each individual. However, the manner in which they’re handled contradicts that fact. They have become a topic of public dialogue in which both medically trained and non-medically trained people feel compelled to voice their opinions and stances. What this translates to is an intricate neurological disorder being treated as a polarizing political topic, questioned in the same manner in which minimum wage and taxes are also debated.

This isn’t just my own perception either. In a 2021 published study, Researchers screened over 1,000 ADHD-related articles and 10 ADHD-related case reports, examining the attitudes of broader community samples from the United States, Australia, Sweden, Germany, Finland, Korea, and Indonesia. They found common themes related to negative attitudes (that ADHD is over-diagnosed; that pharmacological treatment is not acceptable; that those with ADHD are more likely to exhibit poor behavior), and a desire for maintaining social distance from individuals with ADHD.

I am confident in saying that every single person with ADHD would choose to function at a “normal” human-level without treatment if they had the option to. People with ADHD face stigmas, prejudices, and discrimination, making the already challenging disorder even more difficult to manage. ADHD is not a choice. ADHD is known for its lifetime persistence and is clinically characterized by traits of inattention, impulsivity, and hyperactivity, impacting most areas of a person’s life. People with ADHD are also at higher risk for additional cognitive and social limitations, like fewer social connections, struggles in intimate relationships, and general difficulties in social functioning.

Something that many people may be unaware of is that ADHD is not just one general disorder. ADHD comes in many different forms and with a wide range of symptom severity. There is also an array of potential causes of it, as well as varying characteristics that it displays in each individual. You can think about it like a fingerprint in the sense that no one person’s ADHD is exactly alike. Nonetheless, these complexities require time and willingness to learn in order to even begin to comprehend, which detrimentally increases the risk of the disorder and its diagnosis, assessment, and treatment being dismissed by the general public.

How do we combat this? That’s a very complex and multilayered question, and easy to find oneself down a harmful rabbit hole in hopes of understanding why ADHD is treated differently than a more traditional and physical ailment like asthma or diabetes. I think that it goes back to the topic I previously mentioned, about equipping people with fundamental skills and knowledge as it pertains to being vulnerable, relating to one another, practicing empathy and active listening, and unlearning destructive ways of acting and believing.

ADHD: A Crash Course

ADHD impacts many areas of the brain and three neurotransmitters, which essentially are special chemicals that our body’s cells use to talk to each other. Those three neurotransmitters that are impacted by ADHD are:

1. Dopamine. Promotes feelings of pleasure, motivation and satisfaction, supports coordination, assists with short-term memory, and encourages impulsive behavior
2. Serotonin. Helps to regulate moods, influences the quality of sleep, hinders impulsive behavior, promotes healthy digestion, and supports blood clotting
3. GABA. Facilitates communication from one part of the brain to another. It also helps to control fear and anxiety.

Overall, this means that ADHD affects the parts of the brain that control the executive functions of:

• Concentration
• Attention span
• Judgment
• Organization
• Planning and impulse control
• Shifting gears and detecting errors
• Memory
• Learning
• Emotional reactions
• Mood stability
• Visual processing
• Setting emotional tone and bonding

The Different Types of ADHD

As I had previously mentioned, ADHD isn’t just one overarching disorder. Dr. Daniel Amen, a well-known physician and psychiatrist who specializes in brain health and who has been studying ADHD for more than two decades, scientifically backs the notion that ADHD is not a single or simple condition. In fact, he asserts that there are seven distinct types of ADHD, each of which requires a specific treatment approach. Dr. Amen’s studies have shown that when each type of ADHD is treated properly, the results are effective.

The following is a breakdown of the seven types of ADHD along with suggested treatment options outside of prescribed medication from Dr. Amen’s studies. I would like to preface that I am in no way a medical professional. All of the information in this piece is for educational and awareness purposes. Please ensure that you consult with a trusted healthcare professional to determine the best care and treatment for you. Additionally, I am a huge advocate of doing what’s best for you, and that applies to taking prescribed medication if you need it, without judgment. These suggested treatments listed are simply more accessible options to live a healthier and happier life, and help to combat any negative impacts that you may struggle with as a result of ADHD.

1. Classic ADHD

Definition: The three primary symptoms associated with Classic ADHD comprise of inattention, hyperactivity, and impulsivity. Classic ADHD is similar to what the American Psychiatric Association describes as the typical hyperactive/impulsive person who also struggles with staying on task.

Cause:

• A shortage of dopamine.
• Decreased blood flow in the area of the brain that is responsible for planning complex cognitive behavior, personality expression, decision making, and moderating social behavior.
• Decreased blood flow in the area of the brain that controls balance for walking and standing, and other complex motor functions.
• Decreased blood flow to formations in the brain that are responsible for motor control and motor learning, executive functions and behaviors, and emotions.

Suggested Treatment:

• Rhodiola (supplement) which is a naturally occurring herb that has been seen to decrease stress, fatigue, depression symptoms, and increase levels of the neurotransmitters serotonin, dopamine, and norepinephrine.
• Green tea (supplement) which has been seen to increase learning and concentration, calm the mind while focusing attention without adversely impacting alertness, and provide restful and deep sleep
• Ginseng (supplement) which has been seen to stimulate brain function and increase energy.
• L-tyrosine (supplement) which can help the body produce dopamine and norepinephrine to improve mood and help combat depression symptoms. It’s also been seen to help improve memory, increase mental alertness, and reduce stress.
• Fish oil that is higher in EPA than in DHA (supplement) which has been seen to help improve behavioral and learning abilities.
• Extra physical activity in order to release dopamine which helps with attention and clear thinking. Additionally, it helps ease stress and anxiety, improve impulse control and reduce compulsive behavior, enhance working memory, improve executive function, and increase learning and memory.

2. Inattentive ADHD

Definition: People with Inattentive ADHD have difficulty with executive functioning such as organization, planning, prioritizing, time management, and self-monitoring. They also easily get distracted and/or lack the mental stamina for completing routine tasks that they don’t consider interesting or exciting. Additionally, they are typically neither hyperactive or impulsive.

Cause:

• A shortage of dopamine.
• Low activity in the area of the brain that is responsible for planning complex cognitive behavior, personality expression, decision making, and moderating social behavior.

Suggested Treatment:

• L-tyrosine (supplement) which can help the body produce dopamine and norepinephrine to improve mood and help combat depression symptoms. It’s also been seen to help improve memory, increase mental alertness, and reduce stress.
• High-protein and low-glycemic carb diet. Protein has been shown to boost focus and concentration, and a low-glycemic carb diet (high-fiber carb) has shown to reduce brain inflammation and help increase focus levels.
• Regular exercise which has shown to increase and regulate the attention system, resulting in being less prone to react out of proportion and reducing irritability.

3. Over-Focused ADHD

Definition: People who are categorized with Over-Focused ADHD have the same core symptoms of Classic ADHD with the addition of difficulty shifting their attention from one task to the next.

Cause:

• A shortage of dopamine.
• A shortage of serotonin
• Over-activity in the area of the brain that is responsible for controlling emotions and behavior.as well as voluntary motor function, which makes flexibility difficult.

Treatment:

• L-tryptophan (supplement) which has been shown to increase sustained attention and strengthen behavioral awareness.
• 5-HTP (supplement) which is used to improve mood and concentration, and help combat fatigue, irritability, and insomnia.
• Saffron (supplement) which has shown to improve cognitive, emotional, and behavioral abilities, as well as sleep patterns.
• Inositol (supplement): which has been shown to help counter agitation and anxiety.

4. Temporal Lobe ADHD

Definition: This type of ADHD can show itself in a person being over-reactive or moody. It’s also associated with memory problems and difficulties with listening skills and abilities.

Cause:

• Disfunction in the area of the brain that is responsible for processing auditory information and storing memory.
• Decreased activity in the area of the brain that is responsible for planning complex cognitive behavior, personality expression, decision making, and moderating social behavior.

Treatment:

• GABA (supplement) which helps regulate self-control, sleep, calmness, relaxation, and behavioral inhibition.
• Magnesium (supplement) which can calm hyperactivity and agitation.
• Ginkgo (supplement) which has been recommended for improving memory and increasing mental sharpness.
• Vinpocetine (supplement) to improve cerebral function, reduce brain inflammation, and brain oxidative stress.

5. Limbic ADHD

Definition: People who are categorized with Limbic ADHD have the same core symptoms of Classic ADHD with the addition of chronic low-level sadness (not depression): moodiness, low energy, frequent feelings of helplessness or excessive guilt, and chronic low self-esteem.

Cause:

• Too much activity in the limbic part of the brain (the mood control center).In other words, the part of the brain involved in our behavioral and emotional responses, especially when it comes to behaviors we need for survival: feeding, reproduction and caring for our young, and fight or flight responses.
• Decreased prefrontal cortex activity (the area of the brain that is responsible for regulating complex cognitive, emotional, and behavioral functioning) whether concentrating on a task or at rest.

Treatment:

• DL-phenylalanine/DLPA (supplement) which has shown to increase energy and mental alertness, as well as heighten the ability to focus.
• L-tyrosine (supplement) which can improve mood, memory, and mental alertness, and help combat depression symptoms and stress.
• SAMe/s-adenosyl-methionine (supplement) which has been shown to reduce symptoms of depression and anxiety.
• Fish oil (supplement) which has been seen to help improve behavioral and learning abilities.
• Physical exercise helps improve memory by counteracting the stiffening of the vascular system, enhances learning by improving brain plasticity, and improves mood and feelings of well-being from the release of endorphins. It improves overall executive function which includes paying attention, managing time, organizing and planning, multitasking, and recalling details.

6. Ring of Fire ADHD (“ADHD plus”)

Definition: This variation of ADHD presents symptoms of sensitivity to noise, light, touch; periods of mean and unpredictable behavior; speaking fast; anxiety and fearfulness.

Cause:

• A ring of hyperactivity around the brain (the entire brain is overactive, with too much activity across the cerebral cortex and other areas).

Treatment:

• Elimination diet, which is an eating plan that involves removing foods from the diet that is suspected that the body cannot tolerate well. If an allergy is suspected, neurotransmitters GABA and serotonin are boosted through supplements, such as GABA, 5-HTP, and L-tyrosine.

7. Anxious ADHD

Definition: People who are categorized with Anxious ADHD have the same core symptoms of Classic ADHD with the addition of being anxious and tense, having physical stress symptoms like headaches and stomachaches, predicting the worst, freezing in anxiety-provoking situations, especially if being judged.

Cause:

• High activity in basal ganglia which is the area of the brain responsible for coordination and movement.

Treatment:

• L-theanine (supplement) which can help improve attention and focus and has a calming effect on the mind.
• Relora (supplement) which has been shown to support the body’s response to stress and nervousness.
• Magnesium (supplement) which can calm hyperactivity and agitation.
• Holy basil (supplement) which helps reduce anxiety and stress.

Debunking ADHD Myths & Navigating Difficult Conversations:

There are a number of misconceptions about ADHD, such as “ADHD isn’t real,” “they just need more discipline,” or “they’re just lazy.” Unfortunately, these misconceptions have existed for as long as the condition itself, and their impact is real — and particularly dangerous. It is essential that we learn the facts about ADHD and equip ourselves with knowledge to respond to and correct the next misleading remark.

When you have ADHD, you understand how real it is and how significantly it impacts your daily life. Yet, if you’ve ever found yourself in a conversation where ADHD has been raised as a topic of debate, you also understand how uncomfortable, intimidating, and frustrating it can be to navigate. The intention behind this section is to provide referenceable information to constructively engage in conversations of this nature and provide insight to those who could benefit from it.

When someone spews fallacies about ADHD, it can be really difficult to remain calm and have a productive conversation. I encourage you to take a substantive approach, which takes practice and working on ourselves in order to be able to properly execute. The same way we often feel uncomfortable at Thanksgiving when our family members have polar opposite political views, conversations about ADHD can be extremely triggering and can cause serious and lasting damage to our relationships if not handled correctly.

So when we find ourselves in these situations, it’s incredibly important to first take a deep breath. As much as we would like to yell, scoff, throw insults or any of the above, that won’t help another person to understand where we’re coming from. Which ultimately is what our objective of participating in a conversation of this nature is. Instead, we have the opportunity to practice self-control, exercise compassion and empathy, and speak from facts rather than from a place of emotion and personal connection.

The best way to open up a dialogue with someone is to validate the other person and their opinions and follow up by providing factual information. You can say something like: Considering how complex ADHD is and how little educational information there is about it, I can understand why you would think that. Our tendency is to dismiss things that don’t directly affect us or those close to us, but in reality…

Myth # 1: ADHD is Not a Real Disorder

• ADHD is recognized as a legitimate diagnosis by established medical, psychological, and educational organizations, like the National Institutes of Health, American Psychiatric Association, and the U.S. Department of Education.
• In most areas of medicine, the underlying cause of disorders are very well defined. Psychiatry, however, is an exception to this. Just like any other psychiatric condition, like anxiety, depression or dementia, experts aren’t able to provide a full understanding of the underlying biological causes, or the exact root origin of ADHD.
• Science also hasn’t advanced enough yet to provide reliable ADHD diagnostic tests in order to confirm if a person has it. In its place, medical professionals use evaluations and other methods to assess signs and symptoms. Something called reliability is often used as well, which is when two different clinicians evaluate the same person and independently come to the same diagnosis.
• Scientists and medical professionals regard the reliability of diagnosing ADHD to be similar to the reliability of diagnosing pneumonia with a chest X-ray, which is an example of an objective diagnostic test.

Myth #2: ADHD is a scam created by pharmaceutical companies

• ADHD is neither new nor a solely American or Western disorder.
• Studies have been done that show the rate of ADHD, where researchers go out into different areas around the world to assess a wide number of people and determine the rates of ADHD. This has been done in the African continent, South America, Asia, North America, and Europe. And it shows us that ADHD is, indeed, found worldwide.
• Furthermore, the rates of ADHD around the world are consistent (between 5%-6% of each population). If ADHD were purely a western society condition, we would see the rates very high in North America and Europe and very low in all other continents. That’s not what the data shows.
• If you go back a century and look at medical literature, you’ll see descriptions of people who look very much like people with ADHD. A century ago, that specific diagnosis didn’t exist yet, but physicians described people that were hyperactive, impulsive, inattentive, and all the things that we would put together to make an ADHD diagnosis today. Some of the earliest reports date back all the way to the 1700s.

Myth #3: ADHD is the result of bad parenting.

• The problem is rooted in brain chemistry, not in parental styles and discipline.
• In fact, overly strict parenting — like punishing a child for things they can’t control — can actually make ADHD symptoms worse. Professional interventions, such as drug therapy, psychotherapy, and behavior modification therapy, are usually required.

Myth #4: Someone who can do something interesting for hours couldn’t possibly have ADHD.

• It is quite common for a person with ADHD to be easily distracted in one setting, but highly focused in other settings because ADHD does not mean no attention. Really, ADHD means dysregulated attention.
• Environments or activities that are highly stimulating can actually lead to hyperfocus. It’s in the more mundane and less stimulating settings where you see the inability to concentrate really come to the surface.

ADHD Myth #6: Children with ADHD eventually outgrow their condition.

• More than 70% of people who have ADHD in childhood continue to have it in adolescence, and up to 50% continue to have it in adulthood.
• Although it’s been estimated that 6% of the adult population has ADHD, the majority of those adults remain undiagnosed, and only one in four of them seek treatment.
• Yet, without help, adults with ADHD are highly vulnerable to mood disorders, anxiety, and substance abuse. They often experience career difficulties, legal and financial problems, and troubled personal relationships.

ADHD Myth #7: Children who take ADHD medication are more likely to abuse drugs when they become teenagers.

• Actually, it’s just the opposite. Untreated ADHD increases the risk of abusing drugs or alcohol. Appropriate treatment reduces this risk.
• It’s certainly true that children who have ADHD are more likely than their neurotypical peers to abuse substances. However, it is not ADHD medication that drives this. We know this through long-term studies that compare children with ADHD who take medication to children with ADHD who don’t take medication. Researchers followed them over time and saw that the ones who took ADHD medication were at no increased risk of substance abuse relative to the ones who didn’t take medication.
• Furthermore, ADHD medications have been proven safe and effective over more than 50 years of use. These drugs don’t cure ADHD, but they ease symptoms of the disorder: They are the first-line of treatment for a reason.
• What drives this misconception is a very, very common mistake — confusing correlation with causation. What drives the risk for substance use is ADHD, not the medication.

ADHD Myth #8: Children who are given special accommodations because of their ADHD are getting an unfair advantage.

• On the contrary, children with ADHD are at a significant disadvantage, and school policies, accommodations, and education policies regarding disabilities are designed to decrease this disadvantage as much as possible.
• ADHD is a real and significant diagnosis. Long-term studies show without a doubt that the diagnosis of ADHD puts people at risk for a number of negative effects.
• The federal Individuals with Disabilities Education Act (IDEA) aims to decrease these risks at least somewhat by requiring that public schools address the special needs of all children with disabilities, including children with ADHD. Special accommodations, such as extra time on tests, simply level the playing field so that kids with ADHD can learn as successfully as their classmates.

ADHD Myth #9: People who have ADHD are stupid or lazy — they never amount to anything.

• Many well-known, high-achieving individuals from the past are thought to have had ADHD, including Mozart, Benjamin Franklin, Abraham Lincoln, George Bernard Shaw, and Salvador Dali. The list of high-achieving people with ADHD in business today includes top executives such as Richard Branson of Virgin, David Neeleman, founder of JetBlue Airways, and Paul Orfalea, founder of Kinko’s.