Episode 004: All About ADHD - Part I

(Part I of David’s Lecture Series) Isabelle & David welcome Isabelle’s husband, Bobby, and their friends, Christina, AJ, and Gabe, to listen and learn from David’s tried and tested presentation on ADHD, which he normally gives to fellow clinicians. ADD and ADHD are the same thing. ADHD is not a learning disability, it’s a brain difference. People with ADHD don’t automatically qualify for accommodations in schools, need to prove they are struggling hard enough. ADHD is all about the forebrain—the roses of our brain—everything that makes you, you, and makes you unique. Blood tends to flow into the forebrain when you are making decisions. For people with ADHD (see below!), being directed to do something is not doing it. You can look at a red dot, for example, just under different environmental contexts. It’s not a deficit of attention, it’s variability of attention. As you’re demanding more focus, you lose the ability to focus, unless there’s a crisis. The root word for patience is suffering. But someone with ADHD experiences much more distress (physiologically) when they are understimulated. Boredom/waiting without structure is the worst. Response cost (see definition below) makes it hard for us to know when we’re doing something that has a consequence further on down the road. The act of debating gives you dopamine. Dopamine deficiency? See more about dopamine deficiency below. Do you ever hear someone get angry when they look away from the screen (WHAT?!) It’s because they’re being starved from dopamine when you’re already starving. What elicits hyperfocus instead of distraction? The environment: safety, comfort, consistency, the person’s experience/mastery. With ADHD, they need greater levels of stimulation (hyperactive type) or structure (inattentive type) to attend? Again, ADHD is best not thought about as a deficit of attention: attention variability. We have an overabundance of attention. A neurotypical person can attend to whatever in whatever environment, and if they can’t, much easier for them to identify and advocate for what’s interfering with that (for example, “I can’t hear you, the fridge is making a weird noise!”) Whereas for someone with ADHD, it connects to self-esteem, much more difficult to ask for what you need because it makes you think you’re different or deficient or you missed the thing that’s interfering to begin with. It’s the ability to have self-esteem to advocate for the learning environment.

Click here for slides from David’s lecture.

ADHD types explained through how we buy a printer we need:

  • inattentive type: struggles to buy the printer, doesn’t take into account the cost of a lack of a printer, buys one six months later

  • impulsive type: buys two printers, means to put the other one up for sale, forgets to, sits in a corner for six months

  • combination type: see above and experience BOTH, often depending on your level of mastery/comfort (more impulsive). Oh, it’s fun.

Forebrain skills that are harder for folks with ADHD (no matter the type): 

Response Cost: neurological skill that helps you know the consequences of your actions later on down the road 

Delay of Gratification - receiving the reward or win, well after the behavior occurs.

Black and White Thinking - believing or acting as if there are only two ways of thinking right or wrong. Black and white thinking makes it harder to see middle paths during an argument

Time and Organization Skills - knowing how long tasks will take, planning transition times into tasks, appropriately guessing how long something will take, or all parts of time and organizational skills.

Dopamine deficiency? ADHD is often understood as neurobiological (brain) difference, that includes lower levels of dopamine, the neurotransmitter (messenger chemical) in our brain that gives us feelings of satisfaction and reward—the feeling of YOU DID IT…ahhhhhhh. Keep in mind that dopamine is just one of the neurotransmitters doing some fun other stuff where ADHD is concerned.

The Red Dot Study… is sadly lost to the sands of whatever that random book was on David’s colleague’s bookshelf. But here is a study with similar findings: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763932/

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cover art by: Maria Sol Vazquez Bellmunt