7 Ways to Explain ADHD

Rick Green: Folks who don’t have ADHD but may know someone who has been diagnosed or someone who ought to look into Attention Deficit Hyperactivity Disorder have a lot of questions about the exact nature of this neurodevelopmental disorder.

They may be curious and seek to understand with questions such as “what’s your freaking problem?”, “why don’t you just do it?”, “what’s going on with you?”, “are you kidding me?”, “what the devil were you thinking?”

All valid questions and basically they’re variations on “as a neuro-typical person I find it difficult to appreciate or envision how you experience the world, how your mind works and how that manifests in daily life but I’m hoping you can enlighten me” or the more succinct “what the hell is wrong with you?”

Tricky, my immediate reaction is usually there’s nothing wrong with me I’m just a fighter jet in a passenger jet world, which actually is not a great analogy because I’m the one who keeps getting shot down in the fighter jet.

So one analogy doesn’t capture it for everyone or even for one person or even one person over the course of a day.

As Dr. Steven Kurtz says:  “But here’s something interesting, I came here from private practice and the average kid in my practice had 1.8 diagnoses, the average kid here has 2.3 diagnosis, so by the time you come to a major medical center you’ve already exhausted some other resources, so it’s important for families to know that depending where you go there’s sort of different samples of ADHD kids.

Every ADHD kid is not like every other ADHD kid in fact one of the greatest things I ever heard was you’ve seen one kid with ADHD you’ve seen one kid with ADHD, as opposed to you’ve seen them all.”

Rick Green:  So no single analogy can really capture all of this. No one metaphor will cover the experience.

So here are seven analogies and together they may give you a sense of what’s going on with us and again not always with all of us just some of us.

(02:16)

Number one!  Perhaps the most quoted analogy comes from Dr. Edward Hallowell author and co-author of a number of books on ADHD, he calls it the Ferrari brain with the Model T brakes. One doctor told me that she tells girls you have a race horse for a brain, because apparently girls like horses, I know it’s sexist but

I’m not a doctor.

Of course for model railroaders you might say you have a lash up of ac 6000 cw’s with screw in linkage, and driven brake blocks!

(2:52)

Number two:  we are sprinters, not marathoners. Remember the Tortoise and the Hare we are the Hare, go, go, go, and then we hit the wall and need a nap. We don’t pace ourselves, yeah I know slow and steady may win the race that’s okay we aren’t necessarily staying in this until the end of the race, and we’re just interested in a quick start. So we may be quick out of the gates, take the early lead but then decide to join a more interesting new race.

One caveat not all of us have this driven overly eager hyperactivity some people just struggle managing their focus and their attention.  Sometimes it’s too little, sometimes too much, regardless of what’s urgent or important or easy.

(3:35)

Number three!  The on off switch, the ADHD brain is either on or off. We tend to be engaged and/or lethargic. We either love it or loathe it, but again not everyone, some folks who have the uneven attention, the problems with focus, but not the hyperactivity, the impulsivity, may be quieter lost in thought, daydreaming.

(4:00)

Number four:  squirrel!  Or birdbrain!  Or butterfly.  I like butterfly, we flutter like a butterfly and that leads to all kinds of creative solutions of links or patterns.  It’s a bit like a jazz band in the brain, riffing off each other unlike a symphony where everybody’s playing exactly…This is more like someone singing scat, not a choir. It’s not linear, we can get there but not in a beeline, which you know why do they call it a beeline? The bees around here flit from flower to flower although they are on a particular mission that they stick with, which is getting the honey. We’d get distracted and start collecting flowers.

The point is, we’re easily distracted from internal distractions, from thoughts, from memories, emotions that arise, ideas.  And then there are the external distractions, the sounds, the noises, someone touching us, a conversation happening 40 feet away, yes sorry what did you say?

(5:05)

Number five!  My mind is like a TV with 100 channels and somebody else has the remote.  They’re changing it constantly changing, it’s not in my control. it’s crazy making, or maybe it’s a radio station that’s not quite on the channel so you’re getting a little bit of that other station coming in.

As Kate Kelly explained:  “We were in a restaurant and the waitress was taking our order and then she left and my ex-husband said hey Kate you didn’t deck the waitress. I’ve never decked a waitress but what he was referring to was I used to be real irritable and it’s in a situation like that and the irritability was I couldn’t hear.  It’s not about being deaf in the sense of you know your auditory nerve or something, with ADD there’s the filter in the brain doesn’t work so well, so we talk about the grounds getting mixed up with the coffee and sound, you can’t distinguish foreground and background in terms of sound. So a crowded restaurant could drive you crazy. It’s like fingernails on the blackboard and he noticed that I wasn’t irritable.”

Rick Green:  So a noisy office or a noisy classroom or a big party can be a problem.

(6:33)

Number six – we are the folks who respond when you call 911 not 411. We can thrive under pressure, danger, and risk. Excitement! it wakes up the brain it provides the dopamine and the norepinephrine that we are low on, we actually crave the stress, the pressure, the danger, cops, firefighters, emergency room staff, soldiers, athletes, entertainers, and stunt performers.

As one paramedic told me – not all of my colleagues have ADHD but the best ones do, the ones who don’t burn out, leave, or end up in administration. Basically we find ways to wake up the brain.

Alan Brown “Then I got into the road racing about seven eight years ago, and this is a this is just a whole other world of sensations and risk-taking and satisfaction and also quieting of the mind. When you’re doing 170 miles an hour and you’re doing that in a straight line, you’re not doing that necessarily in the curve, but you can do 110 – 115 fully leaned over with your knee running along the ground, and you can crash at that speed too I’ve done that, but there is a real quieting of the mind.  And as I say, it opens the window to creativity, the thoughts and ideas come to me when I’m doing this, at the same time I have to be very focused on what I’m doing.”

Rick Green:  We may leave things to the last possible moment to create that pressure, which can drive our parents and the teachers crazy at school or we take on a dozen things we fill our plate so we’re never bored. Lots on the go.  Finishing any of them? I’ll just go do this one for a little while because…

I don’t know if science fiction writer Isaac Asimov had ADHD but I know he had seven typewriters each with a different article, a book, or a short story on the go and when he got stuck on one he’d swivel his chair around and start typing on a different document because ideas would jump out… this was before word processors when you can have a dozen documents okay three dozen documents open, or if you have ADHD 137, and he probably would have had 137, they would have been great. I got to meet Isaac Asimov once at a new york…

(8:59)

Number seven!  Executive Function Disorder, I love this one. Think of a company with great workers but terrible management. What do the executives at a large company do? They do the long-term planning, they set the goals for everyone to focus on, and they prioritize the tasks. We need the frame of the car before we can start adding the body parts, good thinking that should get at the top. They’re budgeting the time, the energy, the expenses, the labor, they’re tracking the progress, and how it’s going? Where are we at? They’re checking the details, they’re following up, they’re building the structure and the routines, the consistency, the predictability, so that the right color door arrives on the right colored car at exactly the right time…and that is not us.

On the other hand if you want 74 ideas on how to improve a car!

So those are seven analogies, I’m sure there are others like the movie projector…

(10:04)

7.5 – We can experience life like the old-fashioned movie projector you know with the two reels, the one where the movie is and this is the take-up reel, so this is the future, this is what’s coming. this is the past, this has been through the shutter.

We are stuck at the shutter, at the gate; we’re projecting one frame at a time. For us it’s always now, now, now. Of course they don’t have movie projectors today we have Instagram, totally unrelated one after another, our mind hopping around, dopamine, dopamine. Well that’s interesting, that’s interesting, that’s interesting. They’re all over the place; the take up reel has come and gone – what did we learn from the past?  Yeah not now, I’m busy with the shutter, the past is the past it fades, no wonder so many people with ADHD wonder if they have dementia because they can’t remember stuff.

“What was your childhood like?” the doctor will ask, yeah I don’t know and I was there. Then that feeder reel up top what’s yet to come, what’s going to happen in our lives so we can have great goals, wonderful dreams but not think about the steps we’ll need to take to get where we want to go.

I want to retire at 50. Uh-huh what are you doing about it? You know I’m thinking about retiring at 50 and dreaming of all the things I’m going to do when I’m retired, and I have enough money saved to retire, and I don’t know how I’m gonna…

You see we may not be pondering the potential roadblocks or the steps we have to take to get where we want to go, or simply thinking ahead enough to go should I actually blurt this out to my boss?

Ironically we are in the now and yet we’re often not present, we’re zoned out, we’re tuned out.  So we can appear to be listening… uh-huh…we’re not listening.

(12:00)

So there they are seven analogies or seven metaphors that capture some but not all of the experience of ADHD.

1.  Ferrari brain

2.  Sprinter

3.  On-Off switch

4.  Butterfly

5.  Remote

6.  911 not 411

7.  Execs

Some may ring true for you, others not so much… oh, and the movie projector so:

7.5 Movie Projector

But that’s it.  Oh, actually there’s one more… (closing animation)