By 
The Neuroscience Behind ADHD
I know all about ADHD. You know all about ADHD. We all know ALL about ADHD. Sort of. Let’s be honest. Since Attention Deficit Hyperactivity Disorder (aka ADHD or ADD) is still not well understood by neuroscience, what you and I ‘know’ about ADHD in adults probably contains some erroneous assumptions, outdated clichés, and a few gaps. Possibly some major gaps.
I mean, it was over a decade after I was diagnosed that I really started to confront the fact that my own particular combo of ADHD issues included being ‘overly’ sensitive. (Blush!)
Hypersensitivity, Highly Sensitive or Overly Sensitive
Overly sensitive emotionally? Okay. Fair enough. (Is ‘Drama King’ a thing? If so, I’ve had a long and prosperous reign on that throne.) But when we were making our video on Emotional Sensitivity, coaches, doctors, and researchers also talked about physical sensitivities. That’s right, physical sensitivities. As in, your five senses. Which, in no particular order, are Sight, Sound, Touch, Smell, and uh… Feeling? No, that’s Touch… Oh, right, Taste. I eat so fast taste isn’t a big one for me.
While it was a bit of an eye-opener to learn that ‘Dis-regulated Emotions’ could be a challenge for me, ‘Sensory Overload’ wasn’t even on my radar. Which is a bit ironic, since the subject had come up in our documentary ADD & Loving It?! and it filled a whole chapter in our book, ADD Stole My Car Keys. Why hadn’t I noticed?
Distractibility, Procrastination, Overwhelm
One reason I hadn’t noticed I was overly sensitive to physical stuff? I was born this way! It is my normal. I just assumed life was dramatic and tumultuous for everyone. But there’s another reason… Basically, I was too busy dealing with my other ADHD issues: Distractibility, procrastination, over-committing, losing things, failing to finish tasks. (The task could be writing a 30 page television script or simply loading the dishwasher.)
But now the issue of Overwhelm, Over-sensitivity, and Emotionality seem to be hot topics. Dr. Thomas Brown’s great book Smart But Stuck, and Terry Matlen’s latest, Queens of Distraction delve into the subject. And more and more of the experts we interview want to talk about it. And to my surprise, a lot of what they are saying resonates with me.
ADHD Brain vs ‘Regular’ Brain
It’s not that I’m weird. It’s how I’m wired. Here are four esoteric examples of the ways ‘Overly Sensitive to Physical Stimuli’ can show up in daily life:
1. I can hear a conversation three tables away… and tune out the one at my table.
How many adults with ADHD have gone to an audiologist convinced they are losing their hearing from all those Black Sabbath concerts they went to, and are told they have perfect hearing?
Turns out, struggling to filter out noisy environments so you can follow a conversation may not be a problem with your ear drums but how your brain processes and filters sounds. ADHD people can have problems listening in noisy environments.
As Terry Matlen, author of Queens of Distraction, told us, when she is trying to converse with one person, “Even if there’s two other people in the room, I cannot filter out the noise from the other conversation.”
For those around us, figuring this stuff out can get complicated. For example, when someone has music or a TV running somewhere in the background, I cannot tune it out. And I get more agitated by the second. And yet… if I put on music or a program that I like, one that I choose, it helps me focus.
2. Someone says boo. We hear BOOOOO!!!
That’s a classic oversensitivity to emotions. Me? I don’t watch scary movies. I know, “It’s just a movie.” I know you think it’s fun to be spooked, but I’ll be seeing that alien popping up and snarling until the day I die. (And I almost died when I saw it the first time!)
3. I hate the beach!
This is an example of a physical sensitivity. And I’m not talking sand finding its way into some sensitive crevice. For me, just having wet sand on my feet or calf feels like I’m covered in ants—thousands of ants!—each one with a bit of sandpaper.
So when I’m on the beach, I’m on a towel. Or sitting in a beach chair. Or better still in a chair by the pool. Or better still, inside, on the couch, reading.
4. Tag, you’re IT!
Yes, I know that little Levis label is fabric. I am aware that it is not a hot piece of jagged aluminum. But I’m telling you, to me, it feels like it. For others it’s certain fabrics. Or high necklines. Neck ties.
This is also why we buy 10 pairs of things that feel good, and don’t know why. If you’re not able to figure out, “I only wear flannel pajamas because everything else drives me nuts,” you learn to come up with reasons. A University of Memphis study found that adults with ADHD scored higher on 11 standard tests for creativity when compared to their peers. So when we can’t explain what’s going on… we get creative.
This is another aspect of ADHD: We may not be particularly in tune with our emotions and feelings. When life is a constant distraction, racing from idea to idea, there’s no pause to consider and reflect and take stock. (Which is why Mindful Meditation can be so powerful for ADHD adults.)
Knowledge Is King!
In the past, my method of dealing with these issues was simple. I religiously avoided situations where they were a problem, often unconsciously. That’s not uncommon: One way adults with ADHD cope with their challenges is to simply avoid triggering them. “I don’t do parties.” “I only wear cotton.” “I work at home where it’s quiet.”
If someone suggested a trip to the beach, I’d have a vague, undistinguished feeling of “Ugh.” Then I’d find reasons that made sense to others, and to me. “The beach is boring.” Or, “I worry about skin cancer.” (Both of which are true… up to a point.) But saying, “The very idea of touching sand drives me crazy,” sounds, well, crazy. Even to me.
There were foods I avoided because they were like fingernails or a chalkboard. Or in this case, olives on my tongue. “Not really what I enjoy,” was my way of saying, “Yuck! Yuck! Yuck!” followed by severe shuddering.
Now that I know it’s an issue’, I’m noticing more and more examples. I know a lot of guys don’t like wearing neckties, but I feel like I’m being choked. And tags on clothes? When we ordered women’s ADHD T-shirts for our shop, we found ones that come without labels. Perfect!
Here’s the moral of the story, for me at least… If you have ADHD and hadn’t considered this realm of issues, you may be thinking, “OMG! This is why everyone calls me a Drama Queen! This is why I can’t stand scary movies. And why a sad news story can ruin my week. Well, not my whole week. But for a few minutes I’m a mess. Then I watch a good news story and I’m weeping with joy, shouting, ‘What a wonderful world!’ And then that passes and I go have ice cream.”
The key takeaway is… It’s good to notice. Because then you can do something about it.
And on that note… Ice cream!
Thank you for reinforcing the sensitivities that I now know are part of my son’s ADHD, but wish I had realized sooner. My son, now 12, diagnosed at 6, used to be a nightmare to get dressed — he hated zippers and buttons, tags, seams, and even exposed elastic. It felt like he was being too picky and impossible to dress. After a lot of reading about ADHD and SPD, I finally realized it was sensory. He now wears only tagless clothing, no buttons or zippers, definitely no jeans, seamless socks, and the soft-waistband, tag-free, nearly seamless underwear. {Phew!} I just wish everyone could understand these “quirks” as well as you and I do. ;)
Penny Williams
Author of “Boy Without Instructions: Surviving the Learning Curve of Parenting a Child with ADHD” and “What to Expect When You’re Not Expecting ADHD”
ParentingADHDChildren.com
Thank you so much for this post! It certainly resonates with me. I’m terribly sensitive to strong scents, especially if they are manufactured, rather than natural scents (which most are). I can’t watch anything scary, and reading it is even worse. I once read a book by Steven Koontz. It was over 20 years ago, and I still remember it. As for #1, I have had my school nurse check my hearing 3 times over the last 2 years. Yes, I tested fine. Thank you for explaining that!
My favorite bit is that last paragraph. That emotional roller coaster is so real!
Thank you for making feel a lot less weird. Now, what to do about this stuff?
There is a serious epidemic of TVs being left on during social gatherings. Are we here to watch TV or be social? Because I don’t like watching scary movies. Why? I don’t like being scared. Seems legit.
“I have tattoos on my back. I don’t want them to fade, so I can’t go to the beach!”
Is what I say. Feel free to get a tattoo and use it.
The tags are viciously removed upon entry into my home…I don’t think wearing women’s clothes is going to cut it for me.
Avoiding those situations is what I do too, but I will try to notice more examples.
On the topic of ice cream: Have you tried Moose tracks? That is some tasty stuff!
For those of you who take medication for your ADHD, do you find these “odd things that freak out [your] brain” are equally irritating when your meds are active versus when they are not? I would like to know more about how we differentiate, “I have a more intense feeling than you have to a tag on a shirt” from “I can’t put that tag into ‘the background’ of attention because ‘everything is foreground’ for me”.
Yes, yes, yes! Thank you for highlighting this – A supplementary aside to the sensory perspective of having ADHD, is the sense of being at home and free to be myself, and being in the ‘outside world’. I dislike the feeling of heavy jewellery around my neck, but will wear it for my ‘ performance’ at work, in addition to a watch and rings. As soon as I get home, I remove every article of adornment, Whew – that’s over for another day.
I don’t like the feeling of anyone else sitting close to me and avoid sitting on sofas in my private life – I feel constrained and trapped, and actively avoid sitting in a row or against a wall when at work. The hyperactive side of me shivers at any situation that means I can’t get up and move around ( or escape )
Tight polo neck sweaters? Horrible. Dresses are complicated because of the following decisions about footwear. Too problematic. Tight clothing? Okay for jeans, but hours of difficulty around tops and layers of clothing – I can’t cope. Tags and labels are sorted by cutting them out – I have done this for many years without knowing why, except that they always irritated me.
I like sand and beaches! But have hours of thinking about what to wear, because I don’t want to walk around in a swim suit, I just want to either lie down and/or swim. Anything else involves covering up, and therfore planning….it gets so complicated that I don’t go at all.
I get overwhelmed by subtle layers of sound information, and can be so distracted that I may as well not be with my friends.
This is a fascinating topic and I look forward to learning more.
I have a tiny exquisite wren in my garden – wow!
So many of these things also occur on the autism spectrum. I’m ADD and hubs is Asperger’s. We each have our sensitivities, some the same, some different or to varying levels of sensitivity. However, we’re both brilliant and make quite a pair!
I am delighted to see someone else in the same situation as us. I have ADHD and my husband is on the spectrum. We work so perfectly together and sometimes I wonder if that’s why. I was also thinking that the things in this article seem to point more towards autism than ADHD. But I haven’t really seen a solid way to differentiate the two in my research.
Yeah, shirt tags are the bane of my existence – whoever invented the t-shirt with the tag printed on the inside of it (instead of a sewn-in tag) needs to have a statue erected in their honour. Heh, erected. Sorry.
Oh, and as for touch – velvet and similar fabrics. Can’t stand them. Sends shivers up my spine just thinking about touching them.
And now I know why I don’t like horror movies! :-)
As a kid I dreaded going to the barber because they put that sandpaper ring around your neck and pulled it so tight. That was the worst. I still need to lecture them to leave it as loose as possible and damn the hair down my back! I’ve also been extremely ticklish to the point that it’s painful. Forget turtleneck sweaters .And at times even a light touch if it’s unexpected sends me jumping. There are times when that can be quite disconcerting… Even doctors have lost their patience with me when trying to give me a physical exam! As far as sound goes, I’m extremely sensitive to tone of voice, and hear anger or disdain when it just wasn’t there.
Thanks so much for bringing up this topic. It really helps put things in perspective.
I saw your show in Ottawa at the Marriott on February 13. Loved it. Great meeting you.
::sigh::
If only my ADHD husband would realize that being “overly emotional” and “hyper sensitive” is a real thing and not an insult, then maybe he could quit believing that everyone is out to get him, that he is being abused and taken advantage of in every transaction or conversation with another human being, that people do thoughtless things *on purpose* just to hurt or spite him, and that asking him a neutral question for information (“Honey, did you take the trash out yet?”) is an accusation and a verbal slap in the face. Because, ya know, if that’s your experience with every single person on this planet, there really only is one common denominator… YOURSELF.
I take Vyvanse for ADD and it definitely filters auditory distractions a bit. I’ll realize I forgot my pill when I start getting thrown off by more than one person talking in the room. I’ll start getting irritated by little noises (ie: clock ticking, kids tapping something or someone chewing or slurping their food;). Then I’ll realize I forgot my meds:)
Meds don’t seem to help with physical sensitivities, in my case. Tags in clothing drive me CRAZY, to the point of distraction, as do seams, snug collars, watches that don’t sit right, and the tiniest pebble in my shoe or crumb underfoot. I can’t even focus on what someone’s saying until these things are dealt with. I’m sure I look like a complete nutjob trying to find the random loose hair down the back of my shirt that I KNOW is there, all the while smiling and pretending I’m listening;)
I relieved to hear I’m not the only one with weird emotional turns, too. I cry at both sad AND happy things—embarrassing at school concerts when kids (any kids, not just my own!) do something cute and I spend the whole time trying not to blink so the tears don’t start rolling!
These are things non-ADDers simply wouldn’t understand;)
to Bonnie – Televisions – doesn’t matter if my meds are active or not – I CANNOT concentrate on a conversation if the television is on. (I don’t have a television because of this). Meds seem to help a bit to stay on tasks I don’t like much – like paperwork!!! As long as there isn’t something distracting going on around me. My meds really only seem to help me get back on task quickly when I get distracted.
I like sand, but MANY tags are bothersome.
Scents – especially cigarettes & strong perfumes – are a problem. Meds don’t help there either.
Great article, Rick. To your point about emotional intelligence, I find that ADHD folks are also prone to oversensitivity with social computing (i.e., social media, and any digital technologies that provide a platform or community for sharing between people). Along with the triggers that digital stimuli create for heightened emotional reactions, we have the additional challenge of being provided less cues in a digital ecosystem.
I did an article on this topic that hopefully you and my fellow TotallyADDs will find interesting:
https://www.linkedin.com/pulse/emotional-intelligence-stupid-why-digital-context-matters-crowell
My biggest issue was always the TV. I cannot bear the sound of a TV or radio playing in the background while the people in the room are talking. It makes the inside of my brain feel like its being squeezed and pulled at the same time.
Chipping in here; everyone’s unique.
In my case, I use my ADHD to timeslice effectively, and so can keep abreast of three, or even four, things at once. TV on, conversation with my wife, conversation with my son on another topic, and reading a book – and if someone walks in and calls my name (even if it’s not for me), I’ll fit that in, too. That can be a problem when my wife is trying to get my personal attention.
Now, music and math – can’t do both at once, it has to be one or the other.
For me it’s not just scary movies – romantic comedies do almost exactly the same thing. Can’t watch, I get too involved. Even animated movies with a rom-com subplot do that. Which pretty much limits me to sci-fi or certain fantasy movies.
I’ve just had one of my worse ADD days ever. Where I felt mentally and physically impaired. Every sensory was triggered. I have been on and off medication for most of my adult life but I’ve never felt so discombobulated. I new where I was but I didn’t every car light traffic light seemed so bright I dimmed my phone to the lowest setting with little effect. For the first time in my life I felt that my condition untreated could result in me harming myself or others. I didn’t feel competent.
Beyond the common behavioral symptoms one would expect from an ADD person I didn’t know that hypersensitivity was or could be linked my whole life I was titled with such things as the pickiest eater. Nearly every food texture was unbearable to the extent the the pediatricians told my parents, If she will only eat item A or item B then give it to her for every meal.
I was also very aware and sensitive to a multitude of other things that has forever labels me a black sheep as for the rest of my family was on the extreme opposite of the spectrum. I was first labeled as physically and emotionally very sentive or delicate. That title matured into moody, then particular, now I’m reminded that I’m picky and high maintenance.
Florescent lights or other blue, gray hued lights have irritated me for as long as I can remember.
Im an artist in realism paintings and hope to be recognized as master realism artist at some point of my life or death. I summed up all the light and color sensitivity to an artist mind.
My sentivity to most other things….. common sense , Right? Tags are awful. I don’t care how expensive or if it’s a high end designer remove the tag or it’s drab. Itchy clinging clothes, enless you have done something so terrible that you believe you deserve to torture yourself for a little redemption go for it, if you are going that route might I suggest adding A cilice /ˈsɪlɪs/, also known as a sackcloth to your wardrobe.
I love people, animals and nature but I find myself isolating myself and becoming more and more nomadic. I don’t watch the news anymore nor am I envoled or active in any social media. It seems that over the years in a means to protect myself, I’ve been filtering out all things that I find disagreeable. As a result I continue to regress
Plus those that don’t suffer with ADD and have abused the medication and treatment process have made it so difficult for those that truly need it.
Every time I move or travel I have to show all my medical records from several doctors and specialist and even after doing so I have had doctors reluctant to prescribe.
I eat healthy, I take high quality vitamins that are known to aid in treatment, I don’t partake in any drugs or excessive drinking, I stay physically fit and I still struggle
Glad to revisit this that you posted about 6 months after i became aware of my condition and 70 years after I was born.. Those sesitivites and others are very familiar to me and i will add one more wet clothing especially Socks drive me crazy.
Certain medications make this immeasurably worse. Thyroid problems are prevelent among ADHD population and one of the Meds for Hyperthyroidism is Methymazole is a scream induced disaster. I didnt put it together until this second read of your column but 10 years ago I wa hospitalized for a thyroid storm. The symptoms were so bad that i was started on a maximum dose of 6 pills a day, and slowly weaned down to a maintenance level. While i could go to sleep on flannel sheets comfortably I would wake up in the middle of the night in hell bursting out of bed cursing. Flannel was the worst but any type of brushed cotton was not much better. I eliminated, perfumed soaps and dryer sheets, Chlorine Bleach, and a host of other products with slight improvement but it wasnt til i was down to one pill a day that i overcame this. And yes as a previous comment mentions I blamed my third ex wife and became paranoid for years after until hyper became Hypo ..thyroid, and starting Eefixxor, ( Venlafaxine)
My goodness, we could be siblings, for I have the same kind of reactions. Someone sneaking up on me feels like I’m at risk for a heart attack, most of my tags are gone, I have trouble formulating my part of the conversation when I can hear loud laughter or conversations across the room, and beaches I can only tolerate for a short while and it feels like I’m constantly trying to get the sand off me! I’d rather be home reading than reading on the beach.
My weird sensitivity is black jeans and darker colored blue jeans. I have no problem with lighter colors, though. I figure it must have something to do with the dye. The brand doesn’t matter, though. I’m not sure why I’m sharing this except maybe to find out if I’m the only one. ;)
I finally gave up on creating plausible sounding excuses for why my kids were late to school when I had to go sign them in. Honesty is the best policy, right? So now, I just write “Socks!” because seriously, that’s exactly why we were late. Six dozen clean pairs of socks in our house were completely unwearable for at least one of the three kids on that day. I tried explaining to a preschool teacher once that we were late because I put a striped shirt on my son, and he rolled on the floor like we were boiling him in acid. And he needed some recovery time. It made perfect sense to me, because I had the same reaction to turtlenecks. Apparently she didn’t. Who knew?!? Ha ha ha… Don’t even get me started on sunblock application around here.
Um, has anyone else noticed that our soon to be president, Donald Trump seems a bit scattered, oversensitive, awake all night doing stupid things like tweeting his “thoughts,” (primarily because he can’t communicate normally) getting caught doing and saying impulsive things and speaking without thinking first?
Does anyone else think he might have ADD??? He’s so sensitive, how on earth could you ever explain it to him and get him to: a) see a psychiatrist b) get diagnosed c) use medicine in an attempt to rein some of that impulsivity. and d) get a therapist/coach?
Gee, I’ve never considered it before, but maybe even I can grow up to be president!
Wow. I have a coworker who asked me after 5 months of working with me if I had sensory issues. I said no. She said, “Ummmm I think you so.” This article helps. I’ve definitely gotten those hearing tests. Apparently I can hear well but I avoid conversations when it’s noisy on my side. And I’ve been known to hear conversations from across the room and hear nothing about what’s in front of me.. and yet I can’t tolerate a person talking near me loudly.
This cracks me up, because after seventeen years of marriage to my non-ADHD husband, I learned the shocking fact that he is not bothered—not remotely—by tags. Of course, I thought to ask him this in the midst of a tag-itching frenzy that led me straight to the scissors, and his answer continues to blow my mind.
Ice cream.!!!! The very thought of that bone chilling concoction touching my teeth aaaarargh. I know it tastes great, but: COLD!!!!
Then there’s ties, yes, them nooses used to strangle people. And shoes. And tight fitting clothes. Well clothes in general. Solved that by taking to wearing kilts and construction workers clothing as these have adjusting belts. Needless to say the kilts need not adjust.
Well, yes to quite a few, and then some others. What’s great is that the past two years I have come to realise the problem is not me! It’s just me! Not a problem at all, unless you need to survive in the real world. Details.
It’s really awesome now to be able to talk to other superhumans that have some kryptonite issues. None of that scientific medical mumbo jumbo by them who don’t get it at all. But real world facts and issues and tricks to avoid kryptonite. Such as, not visiting the planet Krypton.
Thanks a million
Koen
I’m still reeling, not handling it well…. I’m reading these posts and every few lines I’m saying OMG that’s meeee…. followed by a childish wail ‘no-no-NOOO I don’t want it I DON’T WAAANT IIIIIIIIT…’ followed by fear, for the future, facing the big “so no now what?” And I have one contribution to add to the fabric discussion…… corduroy……
To the person who asked about darker clothing – yes, they do have more dye in them, so that might account for it.
About auditory sensitivity – holy cow! I thought I was the only one! If someone is talking to me and the TV is on in the background, my brain cannot process it. I actually get nauseous. Fortunately, my husband knows to mute the TV before talking to me.
I’ve tried to explain this auditory situation to people without ADD/ADHD in the past as well as auditory fatigue from having to focus so hard. The closest I’ve gotten so far is “I only hear sounds, not words”.
Like I know that there is some pattern of syllables and I know a couple of the sounds that go in and then I have to put those together like a puzzle in my head until I find something right for the context.
Corduroy! Yikes. Wool sweaters or scarves of anything, ugh.
Jewelry? Rings? Distracting.
Melissa Tex. My experience reflects yours exactly. I have been married a long time and it is still a struggle how to speak without upsetting my husband. This site has helped me so much. I’m wondering if there are any ideas of how we can approach our ADHD loved one about them getting tested.
As an 18 year old girl who got diagnosed with ADD (ADHD Inattentive Type) only two months ago things like this are so important.
It took so long for doctors to take me seriously because I’m a high achieving student and I have never been disruptive during class.
Apparently that means I can’t have ADD even though I suffer through all of these things everyday. Being able to talk about different symptoms and challenges of this disorder is amazing because for once I can look at a “Just ADD Thing” and go MEEEEEEEEEEEEE.
I can’t sleep if I’m in a room with a ticking clock or work if the toilet is running or a faucet is dripping. Flashing lights drive me crazy. I have to look at my computer screen every time it flashes or changes even if it is just the screen saver.
I’m a physician but didn’t figure out I had ADHD until my residency in spite of I don’t know how many lectures I heard or patients with ADHD I saw. Now I’m trying to make sense of why I have to pay attention to these things when most people don’t even notice them. I see a lot of colleagues with ADHD and have tried to read up on the research. One study using virtual reality testing shows that ADHDers don’t learn to ignore certain repetitive signals like they are supposed to but every ADHDer seems to have different stimuli that there brains focus on.
The ideas that have helped me understand and have a little patience with myself — my brain — are that ADHD is about our brains prioritizing attention to surveillance stimuli in general and certain stimuli in specific and then does not learn to accommodate or ignore the repeated stimulus. For me that means my brain is wired to listen for certain noises with my attention being drawn to that noise when it occurs and every time it occurs because my brain thinks that is more important than anything else I’m doing.
Since every time my brain focuses attention on something it resets short term memory to go along with the new focus, every thing I was doing before getting distracted is lost. And somehow my keys ended up in the freezer.
At least that is how it makes sense to me.
P.S. The only reason I was able to write all of that above was because I took my meds this morning. But even with the meds my brain thinks writing this was more important than getting caught up on my patient notes. And the thought of going back to look for grammatical or spelling errors is overwhelming.
I have always ran hot since puberty, like my thermostat is set higher than a normal persons- in the heat and humidity my brain shuts down. There is the continual drip of sweat everywhere on my forehead, getting into my eyes, and the perspiration dripping down the back of my neck, and really, no kidding, I get anxious and I cannot think. I cannot focus on anything but how hot I am and getting into the AC, where it always took a long time to cool down. I’m older now, in menopause, and it’s a trifle better (and I’m on ADD meds) but man, cold weather was my friend.