For God’s Sake – Please Pay Attention.

The irony of that title will soon smack you right in the face.

ADHD is a condition that leaves the individual with a lifelong experience of feeling misunderstood, experiencing far more negative interactions with others, and can leave them feeling stupid because they’re forced to learn a certain curriculum, a certain way, which just doesn’t jive with their brain wiring. Think for a moment, what if this was you? How do you think this may affect your life trajectory?

There was a video that circulated social media for a while where a teacher took their students out into a field, and tells them they are about to race. The winner is given a $100 bill. He then explains that he is going to make statements regarding the lives of the students, and if they can answer “yes” to these statements, they get to take two steps forward; before the race starts. This creates quite a gap between students who’ve had rather picturesque lives, and those who have struggled the whole way. Video below.

This video could very easily be done with individuals from across the spectrum of neurodivergent (people who suffer with ADHD, Autism, and mental health disorders) and neurotypical (people who have typical brains), and produce very similar results.

Recently, as many of you know, I posted a video from the show 60 Minutes, where comedian and Daily Show Host (2015-2022), Trevor Noah briefly discusses his experience with ADHD. In this interview, he identifies that keeping a rigid routine, being careful about how he eats, getting enough sleep, and getting enough exercise, keeps him from falling into a deep depression because he feels completely overwhelmed. Yes, having all of these elements in your routine is ideal, and the lack of them can contribute to depression and dysfunction in people with typical brains¹, but for people with ADHD brains, the consequences are usually highly exacerbated.

See below for video.

This generated a lot of different responses. Most have been highly positive as they resonated with Trevor’s explanation, of course there were some trolls, but then there were the “just” people. The people who say, “why don’t you ‘just’ (insert simple concept)?”

The problem with these type of responses is they acknowledge ADHD, but only in the sense that we’re “just” not taking care of our bodies. To these respondents, I ask: What is your knowledge on the mechanics of the ADHD brain? Or the depressed brain?

I can speak for both. Both are issues with lower levels of the neurotransmitters serotonin, dopamine, and norepinephrine.² Having studied the ADHD experience and brain better, I can also say that the ADHD brain is physically different from the typical brain, and specifically low on dopamine and norepinephrine. These chemicals are called “feel good” neurotransmitters, leading the people with these conditions to not feel good most of the time, especially those who are completely untreated.

Anyone who is feeling, or has felt, like garbage can probably relate here. What happens when you feel like this? Do you lay around, watch TV, and eat some ice cream? Maybe you just stay in bed, or gorge yourself with cookie dough. Whatever it is, you probably turn to comfort food. Do you feel like drinking? Do you sometimes use other forms of substances as a means of escape? If you felt like this much of the time, how do you expect you would respond?

Studies suggest you’d experience “learned helplessness?”³ Coined by the father of Applied Positive Psychology, Dr. Martin Seligman, PhD., and his associate Dr. Steven Maier PhD., the concept of learned helplessness is that the individual has tried to change course in their lives, and failed enough that they eventually assume that there is nothing they can do to change how badly they feel all the time.

As in the video above, those with heightened levels of privilege just assumed they were on the same level as those without privilege⁴. Just like people without mental health issues or developmental disorders, can think everyone is on their level, and find ways to confirm their thought processes. This is called confirmation bias.⁴” As noted above, those who generally fall into this genre have no ill intent, but lack information which creates the “just” statements. The ADHD brain being sensitive to criticism (Rejection Sensitive Dysphoria),⁵ naturally infers more than what may be intended, concluding that you meant something more like: “what’s wrong with you?” , “why is this so difficult for you?” , and sometimes “how lazy can you be?”⁵ The best part? We ask ourselves these questions all the time, and feel exactly the way you do about it.

A Healthy Diet

It has long been established that not eating a healthy diet is going to make us feel worse. As it does for everyone, and can lead to issues with sleep, and exercise, and then of course routine. Here’s the part that is misunderstood by the “just” people: Many times there is no “just” doing anything with ADHD.⁶

Eating a healthy diet is certainly something that people with ADHD attempt often, but eating salads, while good for the ADHD brain, doesn’t provide nearly the same kick as something high in carbohydrates^7,8, or loaded with high amounts of sugar. While sugar is technically not a stimulant, provides a stimulant-like dopamine rush, and thus, without solid boundaries, leads to over-eating; most commonly junk or sugary foods. For a period, these satiate and we feel alright, but then the sugar crash hits, and this just starts a vicious cycle that can be hard for the ADHD brain (also prone to addiction)⁹ to stop.¹⁰

Approximately 25% of adults that go to a
treatment center for alcohol and
substance abuse also live with ADHD.

Jeffrey Juergens, JD

Exercise

Maintaining a good exercise regimen can really help in a lot of ways. Dr. John J. Ratey says in his book “Spark!: The Revolutionary New Science of Exercise and the Brain,” says that:

“exercise increases dopamine levels in…the basal ganglia…which is responsible for the smooth shifting of…attention…[and creates] new dopamine receptors.”

So the science is solidly there, but again, dopamine is specifically involved in the motivation and follow through of the brain’s reward pathway, and if you begin with a low amount, the likelihood that you’ll go exercise is low, as dopamine is the kick start we need, plus a tiny reward we get as we hit little milestones, and finally the big kick when we are finished.⁶

Sleep

Serotonin Dopamine, and Norepinephrine are directly involved in the natural creation of melatonin in the body¹², so if these are off, the ability to fall sleep can be disrupted, and for people with ADHD, sleep issues abound. This means falling asleep, staying asleep, and even waking up. Yes that’s right, ADHD affects us even as we sleep. The disturbance of sleep from ADHD is thought to create the mental fatigue and fog most ADHD brains experience. Three Quarters of people who have ADHD struggle with going to sleep, which is thought to be created by an imbalance of serotonin. Others experience difficulty staying asleep and feel restless, this can be attributed to an imbalance of dopamine and norepinephrine. Waking up is a real problem for the restless sleepers, as when they finally do fall asleep, they fall into “the sleep of the dead,” which makes it very hard for them to awaken and feel rested. There is also “intrusive sleep.” This is similar to narcolepsy (the two are actually highly correlated and treated similarly). Intrusive sleep is when our minds and nervous systems lose interest and engagement and fall asleep basically due to boredom.¹³

The truth is, it’s absolutely exhausting to have to explain your entire existence to people who’ve already made up their minds about you. Cynical? Unfortunately this is usually true. Honestly, I wish it was that easy, I’m just cynical, but it’s not. In my original draft of the video (which currently has reached 1.75 million Instagram accounts, (ahem)), I mentioned “thick skulls” and “stubborn brains.” Some guy asked why I had to come off like such a dick in my captioning of the video, and I, humble man that I am, said that, “like most people, sometimes I am a dick (not to my clients, of course).” As this is the actual sequence that occurred, I figured I’d finish on a note of hilarity. So I can’t even begin to explain the absolute providence of what immediately followed the “dick” guy’s statement: I shit you not, the very next comment was an over-zealous, “god is energy,” individual, who just spewed miles of bilious nonsense all over the page. I couldn’t help but laugh. Unlike a dick, I very kindly, and coach-like, asked several sincere, open-ended questions, and then promptly tagged the “dick” guy.

References

1. Beutell, C. (2022, December). Health benefits of having a routine. Northwestern Medicine. Retrieved April 19, 2023, from https://www.nm.org/healthbeat/healthy-tips/health-benefits-of-having-a-routine
2. Blum, K., Chen, A. L.-C., Braverman, E. R., Comings, D. E., Chen, T. J. H., Arcuri, V., Blum, S. H., Downs, B. W., Waite, R. L., Notaro, A., Lubar, J., Williams, L., Prihoda, T. J., Palomo, T., & Oscar-Berman, M. (2008, October). Attention-deficit-hyperactivity disorder and reward deficiency syndrome. Neuropsychiatric disease and treatment. Retrieved April 19, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626918/
3. Leonard, J. (2022, September 2). Learned helplessness: Examples, symptoms, and treatment. Medical News Today. Retrieved April 19, 2023, from https://www.medicalnewstoday.com/articles/325355
4. Casad, B. J., & Luebering, J. E. (2023, March 31). Confirmation bias. Encyclopædia Britannica. Retrieved April 19, 2023, from https://www.britannica.com/science/confirmation-bias
5. Dodson, W. (2023, January 20). How ADHD ignites rejection sensitive dysphoria. ADDitudemag.com. Retrieved April 19, 2023, from https://www.additudemag.com/rejection-sensitive-dysphoria-and-adhd/
6. Drake, K. (2021, July 1). ADHD and ‘laziness’: What’s really going on? Psych Central. Retrieved April 19, 2023, from https://psychcentral.com/adhd/adhd-and-laziness-whats-really-going-on
7. Prinz, Robert, et al. “Dietary Correlates of Hyperactive Behavior in Children.” Journal of Consulting and Clinical Psychology, vol. 48, no. 6, 1980, pp. 760–769.
8. Jones, T W, et al. “Enhanced Adrenomedullary Response and Increased Susceptibility to Neuroglycopenia: Mechanisms Underlying the Adverse Effects of Sugar Ingestion in Healthy Children.” The Journal of Pediatrics, vol. 126, no. 2, 1995, pp. 171–177.
9. Juergens, J. (2023, April 13). ADHD and addiction. Addiction Center. Retrieved April 19, 2023, from https://www.addictioncenter.com/addiction/adhd/
10. Avena, N. M., Rada, P., & Hoebel, B. G. (2009, January 1). Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience and biobehavioral reviews. Retrieved April 19, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235907/
11. Ratey, J. J. (2008). Spark: The Revolutionary New Science of Exercise and the Brain. United States: Little, Brown.
12. Vandergriendt, C. (2020, July 16). What’s the difference between dopamine and serotonin? Healthline. Retrieved April 19, 2023, from https://www.healthline.com/health/dopamine-vs-serotonin#sleep
13. Dodson, W. (2023, January 21). ADHD and sleep problems: This is why you’re always tired. ADDitude. Retrieved April 19, 2023, from https://www.additudemag.com/adhd-sleep-disturbances-symptoms/