Let’s clear up what ADHD is and what it isn’t.
Everyone has ADHD! It’s Not a Real “Thing.”
While everyone has some of the symptoms of ADHD sometimes- like inattention, hyperactivity, memory problems, trouble focusing- these are often caused by stress, anxiety, depression, lack of sleep, and even lack of physical activity. The diagnosis of ADHD means that a person has at least 6 symptoms before the age of 12 and the symptoms are severe enough to chronically cause problems in a variety of settings. These interfere with the quality of their home life, relationships, self-management and performance at school or at work.
ADHD is not a personality flaw.
Having ADHD is not a weakness of character. Having ADHD does not mean you are lazy, stupid, or crazy (paraphrasing the ADHD self-help book by Kate Kelly and Peggy Ramundo, You Mean I’m Not Lazy, Stupid or Crazy?!)
ADHD is all in your head- it’s actually a difference in your brain.
No two brains are the same. We all have differences. ADHD just happens to be a difference that has a diagnostic label. In a traditional school or work setting, having ADHD may make it challenging to sustain attention or sit still, hence the name “Attention Deficit Hyperactivity Disorder.”
[box] Yes, ADHD is, by name, called a “disorder.” When you come to understand it and learn how to work with this brain type, you may realize that it really is just a difference. A difference that can be maddening at times, but that can also make you a superstar at other times. [/box]
ADHD is not something you can “cure.” ie. ADHD is Not Just for Kids!
Unless you plan to get a lobotomy (please don’t!) or a brain transplant (again, please don’t!), this is how you are wired. While most people develop strategies to manage challenges they face as kids, this does not mean that ADHD goes away. It does mean that many of the “academic” challenges we face as kids may not be so apparent. But with adulthood come the complex and often ambiguous demands of relationships, occupations, and self-management. You still have a brain wired for ADHD, but the symptoms may look a bit different as you get older. You can find more about this in the article About Adult ADHD
Ironically, people with ADHD can also have hyperfocus—or abundance of attention—when they are interested and motivated. As a clinician, I hear this all the time. “My kid can’t have ADHD. He can focus on video games for hours at a time.” Well, your kid likes video games!
ADHD is a paradox of incredible strengths and incredible weaknesses.
An ADDer’s performance is very situationally based. Because people with ADHD are seen as very bright and capable in certain situations, their poor performance in other areas is interpreted as due to lack of motivation or willpower. These have proven not to be the case, but you may begin to appreciate just how badly ADHD can be misinterpreted.
ADHD Can and Will Look Dramatically Different from Person to Person
- ADHD is an incredibly diverse diagnosis, and people can have a broad array of strengths and weaknesses.
- Even two people with ADHD in the same family may look dramatically different in their combination of traits and the severity of those traits.
- The three subtypes as listed in the Diagnostic and Statistical Manual of Mental Disorders are:
- ADHD Predominantly Inattentive Type
- ADHD Predominantly Hyperactive-Impulsive Type
- ADHD Combined Type
There are 18,732 combinations of ADHD symptoms
(This does not account for differences in severity of symptoms and co-morbid disorders)
If you or someone you know has ADHD, it is important to be aware of the unique combination of characteristics and not the preconception of what ADHD is or merely the diagnostic symptoms.
Mash the Awesome button to learn more about the connection between Play and managing ADHD
WHAT CAUSES ADHD?
Researchers have spent inordinate amounts of time and bazillions of dollars investigating the causes and effects of ADHD. Scientists have looked at images of the brain structures of people with and without ADHD. They have considered causes such as your mother smoking or drinking while pregnant, watching too much television (you, not your mother), being dropped on your head, eating foods with red dye (or pesticides or sugar), and plain old “bad” parenting. The consensus is that ADHD is caused by differences in your chemical, genetic, and physical (brain) makeup.
We are complex human beings, each of us made up of interconnected neurological, chemical, unconscious, and conscious systems within ourselves. When we are challenged by an urge to procrastinate, struggling to pay attention, or trying to manage our excitement about a new endeavor, these feelings are caused by and have an effect on all of our systems in different ways, both within ourselves and in our lives. They can result in us being late for important appointments, make us doubt ourselves, cause us to overeat, disrupt our sleep, and cause conflicts in our relationships, to name a few. These same challenges in some situations also cause us to be passionate in our endeavors, creative and open to new ideas, and willing to take risks.
Where Does It Come From?
ADHD has consistently been shown to be among the most heritable of all psychiatric conditions. It has nothing to do with parenting skills. If your child has ADHD, you may (like me!) find yourself looking in the mirror wondering if you are the genetic link. A study conducted in 2012 at UCLA examined 256 parents of children with ADHD and found that 55% of these families had at least one parent affected by the disorder. A number of twin studies have found that the heritability of ADHD is about 76% in the population.
What is Different in the ADHD Brain?
ADHD is a difference in the structure and chemicals of the brain. Specifically, there are differences in the frontal cortex and dopamine system compared to someone who does not have ADHD.
The majority of this evidence suggests that a region known as the frontal cortex (the orange area in the picture below) is involved in ADHD.
Within the frontal cortex resides the prefrontal cortex. The prefrontal cortex helps the brain:
- takes in information
- filters the options
- use good judgment
- strongly suggests the best choice and actions
- inhibits impulsive actions
- focuses attention on what is important
- and helps balance our desire for immediate gratification with good long-term outcomes.
It may be obvious to you at this point that if you have a difference in your prefrontal cortex you might get symptoms of ADHD.
Brain-imaging studies find that the prefrontal cortex of individuals with ADHD is smaller than that of individuals who do not have the disorder. Sometimes size does matter!
In addition to the differences in structures of the brain, research also suggests that inappropriate levels of the chemicals that transmit nerve impulses throughout the brain (neurotransmitters) may also impair prefrontal cortex functions in people with ADHD.
One of the neurotransmitters, dopamine, is often called the “feel good” brain chemical. During pleasurable experiences, dopamine is released into the synapses in the brain.
Research suggests that symptoms of ADHD are related to problems with dopamine levels and the dopamine transport system. There are a few ways to address these problems and ultimately increase dopamine transmission in the brain to a level of normal function. Those ways include:
- stimulant medication
- illicit substances (definitely not recommended!)
- and play.
I’ll let you guess which of these three has the fewest negative side effects.
The next post you may want to read has to do with the symptoms used to diagnose ADHD.
The information in this article is excerpted from PlayDHD: Permission to Play… A Prescription for Adults with ADHD