That Runaway Brain: What Exactly is ADHD?
Let's get stuck in with some mythbusting and the basics
Hello and welcome to Runaway Brain! The first proper issue.
Through Runaway Brain I plan to help us to understand and appreciate our most excellent selves, by explaining ADHD and neurodiversity through my science background and also my personal experience. If you missed the first post where I detailed (lightly!) my plans for this space, take a look at Runaway Brain: Coming Soon.
Yes, by explaining the deficit and working out how we can better manage it, but also exploring the strengths, because we have those also. It will always be accessible and I will always be honest, even and especially when it is uncomfortable.
This will be useful for those of us with ADHD, particularly but not exclusively women (because ADHD is different in women, but there is a lot of overlap). This will also be useful to anyone who is looking to understand ADHD and Neurodiversity. Whether that is because you have a child, partner, friend with ADHD or whether you are one of those most excellent inclusive people that wants to embrace and include the world all as equals. Because we all are.
I also plan to share productivity tips and tools that are focussed around the ADHD brain but useful for everyone. We can be better organised, we can be super productive and we can do excellent things.
Let’s get stuck in! Starting at the beginning before launching to the details. ADHD friends, bear with me while I get everyone else up to speed.
So, what exactly is ADHD?
If you don’t have ADHD, or you are not yet diagnosed, it is likely that your idea of ADHD is completely incorrect.
That’s not your fault.
ADHD has been the butt of the joke in popular culture and on TV for years. There is so much misinformation and stigma and it is harmful. Misinformation and stigma not only stops people recognising that they have an ADHD brain, it also prevents them from seeking diagnosis and treatment. It also means those of us with ADHD are asked to justify ourselves all the time.
You might think of Bart Simpson when you think of ADHD. A child with behavioural issues that can’t be controlled and disrupts everyone else. (ADHD is biology not behaviour, that child just needs to be allowed to move). This ableist view of ADHD is again not only harmful, it just isn’t true. A thoughtful day-dreaming smart and shy child is as likely to have ADHD, and more likely to be ignored and undiagnosed if they are female.
ADHD tends to be described and managed by how the individual with ADHD affects those around them. So those children that aren’t disruptive can be neglected, and this is usually because most people don’t know what ADHD with an inattentive component looks like. Even doctors.
The 3 types of ADHD
There are three types of ADHD - Attention Deficit Hyperactivity Disorder - which I must state up front is a horribly ableist name that focuses only on the deficit, and in truth is incorrect. We are not great at managing our attention, we are either glued to something with so much attention or we can’t connect at all. (More on that in a bit!).
There are three ADHD subtypes and all ADHD subtypes are ADHD, even if you are not hyperactive and don’t relate to that big ole H (I told you the name was terrible). ADHD is like a selection box, not all may be relevant to you, but once you have 6 of the 9 diagnostic criteria on either or both scales, and it is clear that this has been evident since childhood, then you are usually diagnosed with ADHD.
ADHD is not an illness, it’s just a different way of being. It is described usually from the view of the deficit as seen by people who don’t have ADHD. It’s time to change that, for us and for them.
Hyperactive ADHD - you got it, hyperactive! But maybe not as you think. You can be hyperactive on the inside only and it might affect how you think. Whirling thoughts? Yes. Hyperactive ADHD in your head can manifest as anxiety (and many women with ADHD are misdiagnosed as having depression and anxiety).
It also can manifest as needing to be on the go all the time, having a very low boredom threshold with a constant need for stimulation. Maybe you tap your foot or shake your leg all the time, fidgeting, needing to get up and do things or just leave your seat, finding it difficult to sit in one place or one position for long.
Impulsivity? Yes, and not just in what you do but in how you react. You might find you do things before you have had a chance to consider why you shouldn’t. You can react to people in the moment and that can be difficult and received as socially unacceptable. You can say things and instantly regret them. It also might make you an excellent entrepreneur.
You may talk excessively (yes, yes, I do!), blurt out answers before the questions are finished, find it hard to wait your turn in conversation or elsewhere, and you might be interruptive. You might be on the go, all the time. Try and stop me when I am moving but try and get me off the sofa if I am not (what?! I will explain).
It’s not all bad, and nor is ADHD. Hyperactivity also manifests as determination, stamina, energy and sheer willpower. It translates as passion for things you care about. Curiosity. We will see more of this as we go.
Why all of these contradictions? Well, that is because ADHD is not only about the H.
Inattentive ADHD - Inattentive ADHD was only added to the DSM (Diagnostic and Statistical Manual - the medical handbook that is used to diagnosis everything psychiatric) in 1994 (although non-hyperactive ADHD was recognised earlier).
Most women have an inattentive component and so in general would not have been seen as someone with ADHD or diagnosed before this, as doctors looking for hyperactivity would see that you were able to be inactive for long periods of time and would have discounted ADHD as an issue.
With Inattentive ADHD you may not be good with details (called careless at school or at work maybe), difficulty sustaining attention (unless interested!), people think you don’t listen to them and you know you tune out when people are talking to you, following through on instructions are difficult (especially if delivered orally), you might lose things all the time or never remember where things are, important things too! Like passports, and medication and your phone and your wallet! You may be very easily distracted (you see everything that happens outside the window) .
Familiar? I know, I remember that penny dropping too.
Combination ADHD - the third type of ADHD is combination, which is a mix of both. This is what I have. So, I am both motivated and on the go, chatty and interruptive, curious and driven. I love to daydream and do nothing at all, and just as well as I can’t help it. I love dancing (and I miss it in the pandemic), being active really suits me and clears my head. Yet I also at times find it hard to move. I just want to stay on the sofa or in bed.
My inattentive side loves when I live in my head is how I best describe it. I love good TV and films, I used to read loads (until my ADHD got bad before I realised I had it), now I listen to lots of podcasts, radio and audiobooks. My hyperactive side loves being busy, loves travel, loves learning, loves new things, loves getting out there and loves people.
I like to be busy and I like to be quiet. I am happy on my own and I am happy in company, it depends on the day, sometimes the hour.
On attention and that name
You may not think you have ADHD because you can focus! You can focus better than anyone else. WHEN you are interested in something. That is ADHD folks.
We have so much attention for things that we are interested in. Forget to go to the loo, forget to eat, forget important appointments level of attention. Our attention for things we are interested is so all consuming, it is like we are not even in the room. You just try and interrupt someone with ADHD when they are glued to something, it rarely goes well. It is like pulling us out from underwater at speed.
All that stuff your brain doesn’t care about? That laundry in the machine, get ready for your second go on the washing machine ride! You know! You have been there before! It’s just not important to the ADHD brain. You try to be on time but something happens and then, oh where did the time go, I am late again! Or maybe you are the ADHD type who is so terrified of being late you are always super early.
It’s called hyperfocus and it can make us exceptional at what we do, if we are working on something we are interested in. That’s a crucially important thing for those of us with ADHD. We can and do change the world, when we are interested in it. It also means we can ruminate on things and worry too much about something that happened (likely related to your ADHD, maybe you offended someone).
An aside (and we love a tangent), there is a campaign to change the name. One suggestion is VAST - ADHD Needs a Better Name. We Have One.
Big emotions, RSD and mood swings
Not referenced in the DSM but key, is just how big the emotions are. SO BIG. We can be very sensitive, we feel everything keenly. We can swing from high to low super fast, and back again. ADHD moods look like bipolar moods, with the difference that they always have a trigger and once the trigger is removed, the mood can be restored.
RSD, well this is something that is very hard for many of us and it is particular to ADHD, Rejection Sensitive Dysphoria. Fear of real or perceived rejection, it manifests as an actual physical pain. From friends, family, at work. A call from work? OH NO, THEY SAW SOMETHING I DID WRONG! THEY MIGHT FIRE ME! The phone is in general incredibly triggering. WHY ARE THEY CALLING? WHAT HAS HAPPENED? I think many of the ADHD is a gift folks must not have RSD. (ADHD has gifts, no doubt, though).
With RSD we can’t really handle being the butt of the joke. It really hurts us. Small things can really upset us. Being left out, well that is really hard. Any criticism, well it’s tricky! Well intentioned feedback, well that can go another way. It makes childhood really difficult. It gets easier as we get older.
Shame. Shame is a very common feeling for women with ADHD. We have been shamed for so many things and for so long. Why can’t you pay attention? Why can’t you be on time? Why didn’t you remember that appointment? Why can’t you clean up after yourself? Why are you so messy? Why are you so forgetful? Why are you so impatient? Why don’t you listen when I talk? Why can’t you remember instructions? How did you lose that?
Anger. Well, we can get very angry about the smallest things. Big things too. We can just get very angry. Our reactions can seem disproportionate to others, but it is very real for us. It’s awful and uncomfortable and I don’t even like typing this. It is especially difficult for women as women are socialised to be everything that ADHD is not. So women with ADHD have all of that on top of ADHD itself. Our hormones too, they also mess with ADHD.
Wired for fascination and interest
ADHD simply means that we have an interest based brain. Hard wired for fascination and very poor at anything that is dull or uninteresting. It is not impossible to do the boring things, but the brain barrier is real.
We are creative thinkers. We don’t just think outside the box, we don’t even know where the box is. ADHD brains see solutions where others have yet to spot the problem. We love a challenge and we generally won’t let anything go until we have solved it. Once we are interested, you are starting to see.
We are enthusiasts. We start new hobbies all the time and drop them just as fast. Hello wreath frames from Christmas that I never got round to using, the silver jewellery kit I was obsessed with and had to have last year! All of the embroidery thread that I just had to have only a month ago, I had already moved on by the time it arrived.
Time. We have a different sense of time and we live very much in the moment. I have always said that I am a chronoptimist, now I know why. There is no thought for the future, or future consequences of something that is important in reality, but which our brain perceives as dull. We will let it slide until is is urgent and panic inducing. We are champion procrastinators.
My name is Niamh, I was diagnosed with combination ADHD when I was 45
I am forgetful, I lose everything, I am very distractible, I like to be busy, I like not to be busy, I tap my hands and feet all the time. I find it hard to sit in the theatre or cinema unless it is a really excellent film or play that grabs my attention.
If I am interested I can stay there for hours and hours. If not, I will squirm in my seat or need to go to the bathroom just to move, without actually needing to go to the bathroom, that is just my excuse.
I talk a lot, I interrupt a lot (apologies, I can’t help it). When I am excited about something which I am a lot I get VERY LOUD. I don’t even know I am doing it, it is what ADHD people do. I am desperately impatient.
I am super interested in the world and people. I find injustice very hard to bear (ADHD people are often social justice warriors). I have a deep well of empathy as most of us ADHDers too. That can hurt me, but it also means that I have a deep sense of what is going on for those around me. That can be great too.
ADHD was always there, you just didn’t know it
I have been like this all my life. In childhood I was very shy, forgetful, very emotional, very distractible, always making things, very creative, always able to entertain myself for hours on end.
I was also very careless in school and it was a huge problem as I was always in trouble for things I couldn’t control (my writing is still atrocious). I was bullied relentlessly, as many neurodiverse children were. I was misunderstood all the time. I was rarely disruptive except when I started talking to someone about something, which could happen a lot and then maybe not for ages. I was very very giddy.
I also did very well in school and I was very academic. Once I hear something once, it is locked in forever and when I am interested I am most definitely paying attention, and I want to know more. When I am not? My body is there but my brain has long checked out.
I always tried, I always questioned myself, I was very anxious and I couldn’t understand why that last 10% was just impossible for me.
Wow, that is a lot
This is just the tip, and yes it is A LOT. As I have come to terms with my ADHD brain and understood the benefits as well as the deficit, and how everything ADHD is integrally me, I wouldn’t trade it. More friend than foe, I have grown to love my ADHD brain and its speed, sharpness, enthusiasm and myriad interests. I love my empathy, and it makes life harder too, but I would never want to be without it.
As I understand more about what I need, my life gets easier. I will never be good at maintaining my space, or remembering to take the laundry out of the machine, or remembering to do the laundry in the first place. ADHD is chaotic, but we can learn how to reign it in a little bit. Although not completely, because then we would be bored, and if there is one thing that we just can not tolerate, it’s boredom! It’s the worst thing.
Luckily for us we have so many interests it rarely happens.
I can’t wait to share more with you! Please feel free to comment and share your story, or ask questions.
Thank you for all this. There's so much I could say but I think we perhaps all understand each other anyway. What's been good for me is that this article, along with some other contact with ADHD friends has reassured me that it's not just me.
I do agree that we desperately need another name for this condition and that its benefits need to be recognised. I find it has more advantages than disadvantages but I do get fed up with other people seeing it as a 'deficiency' and a 'disorder'. I love the fact my mind (and life) is so full of detail and variety of interests, and knowledge and experience, and humour and love. I don't want to change it and if I'm honest, I sometimes feel a bit sorry for people whose world view and life experience are limited to a very narrow track in life.
Thank you for sharing. Have you read any of Dr. Daniel G. Amen’s work on ADD/ADHD?
I used to think everyone’s brain worked like mine. Apparently not. 🙄