ADHD
The importance of understanding the condition in order to offer the correct support.
I have just completed a basic training course with the Open University entitled Understanding ADHD. I am particularly interested and quite passionate about finding ways for neurotypical brains to support those with different types of brains. We are all different, but there are some people who need to be identified as requiring support so that they can unlock their gifts and reach their full potential. From experience I have learnt that it is important that support is given within a knowledgeable framework. If the support giver is unable to understand why the person is having problems, the support will almost always be inappropriate.
In an attempt to begin to help those interested in supporting an ADHD sufferer, I have completed the course and written the following notes based on my learning alongside my own experiences.
WARNING
At the end of the course, I was warned that although I should now be able to understand the manifestation of ADHD, there is much still to be understood about the condition. For example, the exact cause is unknown. It is also not yet clear exactly how child and adult forms of ADHD relate to one another, or indeed if they are distinct from each other at all. The exact mechanism of action of current drug treatments to reduce symptoms of ADHD is also not fully understood. With this in mind I have summarised how I think and work as a diagnosed ADHD person, which fits in with my learning on the subject.
ARE WE ALL A LITTLE BIT ADHD?
When people think of ADHD, they generally associate the condition with children rather than adults, and often boys rather than girls. They may think that these children are badly behaved and often will note that they struggle with attention and can’t be bothered to listen. I will return to this phrase ‘can’t be bothered’ throughout this article as it has some important issues related to supporting a sufferer.
I would like to challenge the phrase ‘are we all a little bit ADHD?’. Based on both scientific understanding and personal knowledge, unlike Autism, there is no spectrum for ADHD. It is not only a real condition, it is highly disabling, hereditary and more common than one would think. This is one of the hardest things to understand about ADHD. I hear a lot of people say ‘of course we are all a bit ADHD’, and indeed we are if you add up symptoms. The difference is, true ADHD can cause you to ‘fail’ at what you are actually good at, because your executive functions don’t function correctly, letting you down. This clearly presents more than just a ‘bit’ of a problem.
You can’t ‘pull yourself together’, ‘get a grip’, ‘pay attention’ or ‘try harder’. The neurotypical brain, I presume can, but I personally put 100% into everything I do and then spectacularly fail, time after time as I forget, mislay, lose or make ‘careless’ mistakes unknowingly. We now know that the ADHD brain is scientifically different in a variety of ways including size, the way our brains actually work and the emotional responses that we are capable of due to a clear difference in the processing of fundamental chemicals.
‘CAN’T BE BOTHERED SYNDROME’
Undoubtedly my seemingly ‘can’t be bothered’ actions, make it hard for someone else to have sympathy or understanding as no one is clear as to what is going on in my brain, least of all me. Some people are late for appointments, others lose their car keys. Some people are untidy and disorganised, others struggle to learn words by rote. None of the symptoms that we hear about are original. The problem is that with ADHD, they occur more often and more intensely than a neurotypical brain and the person with ADHD can’t fix them themselves without a great deal of preparation and creative thought.
Some people do not think ADHD is a real condition but rather a label given to badly behaved children, which in turn is caused by poor parenting, another example of a parent who ‘can’t be bothered’.
ADHD, as a condition, has been around since 1902, but it has also been misunderstood and misinterpreted. Some people think that ADHD is a made-up condition to give a reason for bad parenting and in adults to cover for poor organisation and social skills. Already another example of covering for someone who simply ‘can’t be bothered’.
For years I had no idea that I was an ADHD sufferer. Attention Deficit Hyperactive Disorder were not words that I would associate with myself, although I was fully aware of the condition (or so I thought). I can concentrate for hours if I am interested in a subject, so I don’t have a deficit. I am lively, but not as lively as some of my friends, I just like to have fun. I have struggled with my life, but haven’t we all, in our own ways?
I have had to learn what this misnomer ADHD actually means in order to realise that I have the condition and I needed it diagnosed professionally and treated to help me understand the differences that I experience in my brain compared to others. I also had to grieve all over again for my parents as the reality of the idea that is most probably hereditary. Much of my childhood was lived in the shadow of parents who possibly had the condition and I am sorry to say, didn’t give me the happy childhood I craved, but loved me more than I can express, I know that for a fact!
It therefore appears that there is a clear divide between those who genuinely ‘can’t be bothered’ and those who appear to be in that category but actually they can’t cope. Telling the difference is, I would imagine, an impossible task, so without formal diagnosis, why would you be supportive to someone who apparently ‘can’t be bothered’?
ADHD is a complex neurodevelopmental disorder with diverse symptoms and behaviours.
ADHD does not affect how clever we are, rather it affects what we achieve and how we behave. ADHD is a complex neurodevelopmental disorder, it has diverse symptoms and behaviours– anatomically, it structurally looks different and functions differently and the most difficult part to explain to a neurotypical person is that all the struggles are perfectly normal.
We are all diverse, we are all different, but some of us can’t access the school curriculum as it is offered to us, others can’t behave in a way that society expects and demands. A huge number of the prison population have been diagnosed with ADHD. Many of us mask our true selves to attempt to fit in and all of us with neurodivergent conditions identify with the idea that fundamentally we seem to be different.
The most upsetting thing I have noticed in those who are at least trying to understand ADHD, is the fact that at times the neurodivergent individual can fix themselves. Yes, there are times when, if we really really try hard, and we can do it! Sadly, what is misunderstood, is that the intensity and effort involved to do things the way we are expected to, is often more than we are actually capable of. For many years I would make a million New Year’s resolutions – they would work for a while, but as everything became more intense, I would fail, eventually I started an annual pattern of inexorable effort followed by intense burn out after around 3 months. I have only recently realised that there was a clear pattern. Again a neuro can identify with this to some extent, gym membership soars in January, but the clue to the condition lies in the devastation after the effort involved, that’s the link that people haven’t understood.
The complexity of the condition has some fairly unusual traits. In general we are people pleasers, we find it difficult to say ‘no’ to any request and we try, try, try and try again. We have a poor sense of time passing and we have a fractured imagination, causing us to misremember things as they happened. On the upside we appear to be incredibly efficient at times finding others frustratingly inefficient and yet at different times we are totally disorganised and completely lose the plot. This opposition of characteristics is evident in many sufferers who have little sense of normality, get bored easily but strangely thrive in a structured environment with constant routine.
WHY DO SO MANY ADHD SUFFERERS GET DIAGNOSED WITH DEPRESSION AND INCORRECTLY MEDICATED?
ADHD, according to the Open University, is often misdiagnosed, misunderstood and mistreated with anti-depressants, due to the anxiety and low self-esteem build-up of having the condition undiagnosed. Anti-depressants build up your serotonin levels and scientific evidence shows that a lack of this chemical is associated with depression as an illness.
Some scientific research has shown that ADHD sufferers lack dopamine, or possibly an inability to process dopamine in a neurotypical way. Once medicated the depression usually lifts, along with an ability to think and see more clearly, enabling you to respond better to routine tasks, without changing your personality or creativity. I would say that this has definitely been the case for me and will write about my experiences on meds in a different article.
Having been told I was ‘lazy’, ‘untidy’, ‘disorganised’ and ‘too distracted to reach my potential’ as a child, my self-esteem is pretty low. I was once given a poster to remind me of my attitude to life – ‘your single greatest talent is your ability to waste time’ – Not surprisingly this has made me into a manic depressive, or so I was told. For 14 years I was taking drugs to try and build up my low self-esteem. I was given a serotonin booster, an anti-depressant – which, incidentally, didn’t change anything for the better. I became emotionally dead and probably less empathetic to the world around me making me more ‘lazy’, ‘untidy’, ‘disorganised’ and sending my self-esteem even lower.
Some scientists are now uncovering evidence that is pointing to the discovery that the more serotonin you receive, the less your dopamine receptors work, this in turn makes the ADHD worse.
FROM MISUNDERSTANDING TO INAPROPRIATE SUPPORT When you see an ADHD sufferer conquering what was deemed to be a problem, what you don’t see is the silent suffering and damage that the effort required to do this has actually caused. Burn out is a common problem following an intensity of effort required to appear