Why Does Your ADHD Make Things So Hard?

Summary

The transcript discusses ADHD, highlighting its spectrum nature and the varied experiences individuals with ADHD have. It emphasizes the disorder's impact on attention and focus, where passion can lead to hyperfocus and significant achievements, but a lack of control over this focus can be detrimental. The conversation includes addressing myths about ADHD, the potential for creativity, and the importance of understanding and treating the condition for a balanced and productive life. The speaker advocates for a personalized approach to mental health, recognizing the spectrum of ADHD experiences and the potential for individuals to adapt and thrive with appropriate treatment and support.

Takeaways

• 🔥 ADHD is a spectrum, not a homogenous disease, leading to diverse experiences and perspectives on its impact.
• 🎯 The concept of 'hyperfocus' in ADHD is often misunderstood; it is actually perseveration, which is a symptom of the disorder, not a gift.
• 💡 Some individuals with ADHD may experience increased divergent thinking, which is associated with creativity, but this is not the same for all.
• 🌟 ADHD can manifest differently depending on the individual and their environment, affecting their professional, academic, and personal life uniquely.
• 🧠 There is a need for more research on the positive aspects of ADHD, especially in adults with high levels of ADHD symptoms.
• 📈 The prevalence of ADHD and its perceived benefits can be influenced by societal and environmental factors, such as student-teacher ratios in schools.
• 🤔 Mental illnesses like ADHD can have certain advantages in specific situations, but overall, they tend to be more detrimental than beneficial.
• 🧬 Genetic predisposition and environmental triggers can lead to the development of mental illnesses like ADHD, depression, or bipolar disorder.
• 📚 Studies on ADHD often focus on the most severe cases, which can skew our understanding of the disorder and its potential positive aspects.
• 👩‍⚕️ It is crucial for individuals concerned about ADHD to consult with a licensed clinician to understand their specific situation and appropriate treatment options.

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Outlines

00:00

🎯 ADHD and Passion: The Double-Edged Sword of Hyperfocus

This paragraph discusses the contrasting experiences of individuals with ADHD when they are passionate versus uninterested in a task. The speaker shares their personal experience of being able to work tirelessly for hours on a project they are passionate about, highlighting the ability of ADHD individuals to hyperfocus. However, this hyperfocus can be a challenge when the task at hand is not of interest, making mundane tasks like washing dishes difficult. The speaker acknowledges the humor in memes that depict this struggle and the relatability of such content within the ADHD community. They also mention a community post that raises concerns about the portrayal of ADHD as an advantage, leading to a discussion on the complexity of ADHD and its varied impacts on individuals.

05:00

🧠 The Misunderstood Aspects of ADHD: Disordered Attention and Myths

The speaker delves into the concept of disordered attention in ADHD, clarifying common misconceptions. They explain that ADHD involves not only an inability to focus but also an inability to disengage from a focus point, even when it is detrimental. The speaker critiques the popular notion of ADHD-related 'hyperfocus', citing expert Dr. Russell Barkley, who argues that what is often labeled as hyperfocus is actually perseveration, a symptom of frontal lobe injury. The speaker also discusses the difference between perseveration in ADHD and hyperfocus in autism, and addresses the controversy around the positive portrayal of ADHD traits in media and personal experiences.

10:01

🤔 Navigating the ADHD Spectrum: Diverse Experiences and Perspectives

The speaker explores the spectrum of ADHD, emphasizing that it is not a homogeneous condition affecting everyone in the same way. They discuss the diverse perspectives on ADHD, from those who view it as a disorder to those who see it as a source of personal achievement. The speaker acknowledges the validity of both viewpoints and suggests that ADHD is a spectrum with varying degrees of severity and benefit. They also mention the need for more research to understand the positive aspects of ADHD and the importance of recognizing ADHD as a spectrum rather than a binary condition.

15:02

🧬 The ADHD Conundrum: Disorder vs. Advantage

This paragraph examines the complex relationship between ADHD and its potential advantages. The speaker discusses the existence of a spectrum within ADHD, where some components can be beneficial to individuals. They cite examples from other mental illnesses, such as how certain conditions can provide advantages in specific contexts. The speaker also addresses the importance of treatment, even when there are perceived advantages to an illness, as the overall impact of untreated mental illness is generally negative. They emphasize the need for a balanced view of ADHD, recognizing both its challenges and potential benefits.

20:03

📈 Research Gaps and the ADHD Narrative: A Call for Balanced Inquiry

The speaker calls for more research on the positive aspects of ADHD, acknowledging the bias in current studies that often focus on the most severe cases. They discuss how this bias can skew our understanding of ADHD and its impacts. The speaker also highlights the need to study subclinical populations with ADHD, those who may not meet the full criteria for the disorder but still experience its effects. They argue that the current research tends to overlook these individuals, which can lead to an incomplete picture of ADHD's role in society.

25:04

🎨 Creativity and ADHD: The Artistic Temperament and Treatment

The speaker shares personal experiences with artists who have ADHD and how their mental health contributes to their creative output. They argue that mental illness, including ADHD, is not entirely negative and can be a part of one's identity. The speaker emphasizes the importance of treatment, reassuring that it does not strip away one's creativity or personal strengths. They suggest that while treatment may require individuals to rediscover their creative process, it ultimately leads to a more fulfilling and healthier life.

Keywords

💡ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. In the context of the video, ADHD is discussed as a spectrum with varying degrees of impact on individuals, where some may experience it as a significant impairment while others may find ways to harness certain aspects of the disorder to their advantage.

💡Hyperfocus

Hyperfocus refers to an intense concentration on a specific task or interest, often to the exclusion of other activities. In the video, hyperfocus is presented as a common experience for individuals with ADHD, where they can become deeply engrossed in an activity, potentially leading to significant achievements in areas they are passionate about.

💡Disordered Attention

Disordered attention is a term used to describe the inattention aspect of ADHD, where individuals have difficulty maintaining focus on tasks that are not inherently interesting or engaging to them. This concept is central to the video's discussion on ADHD, emphasizing that the disorder involves not just hyperfocus but also an inability to direct attention as desired.

💡Neurodiversity

Neurodiversity is the concept that variations in the human brain, including those classified as mental disorders, should be recognized and respected as natural differences rather than as pathological conditions. The video touches on this idea by discussing the potential positive aspects of ADHD and the growing movement within mental health to consider such conditions as part of a broader spectrum of neurodiversity.

💡Perseveration

Perseveration is the act of persistently repeating a particular response when a change is required, often associated with difficulties in shifting attention. In the video, it is used to clarify the misconception that hyperfocus in ADHD is actually a form of perseveration, which is a symptom of the disorder rather than an advantage.

💡Cognitive Dynamism

Cognitive dynamism refers to the ability to adapt and change one's thinking in response to new information or changing circumstances. In the context of the video, it is one of the potential positive aspects of ADHD, suggesting a form of cognitive flexibility or adaptability that some individuals with ADHD may exhibit.

💡Spectrum

In the context of ADHD, a spectrum refers to the range of symptoms and severities that the disorder can present in individuals. The video emphasizes that ADHD is not a one-size-fits-all condition and that people experience it in diverse ways, with varying degrees of impairment and potential advantages.

💡Treatment

Treatment in the context of ADHD refers to the various interventions, such as medication, behavioral therapy, or coaching, aimed at managing symptoms and improving the quality of life for individuals with the disorder. The video discusses the importance of treatment and the potential for individuals to continue to lead fulfilling lives even with ADHD.

💡Stigma

Stigma refers to the negative attitudes, stereotypes, and discrimination that people may face because of a mental health condition. In the video, the discussion around ADHD as both a disorder and a potential source of creativity touches on the stigma associated with mental health conditions and the importance of understanding and challenging these perceptions.

💡Personal Experience

Personal experience in the context of the video refers to the individual narratives and subjective accounts of people living with ADHD. The speaker emphasizes the importance of considering personal experiences when discussing ADHD, as these stories can provide insight into the disorder's impact and the strategies that individuals use to cope or thrive.

Highlights

ADHD and passion can lead to hyperfocus, allowing individuals to accomplish tasks in a fraction of the time it would take others.

The challenge with ADHD is that hyperfocus is not always on something productive, and can lead to imbalances in attention allocation.

Memes about ADHD experiences resonate because they reflect the shared struggles and triumphs of those with the condition.

ADHD is a disorder of attention, characterized by both an inability to focus and an inability to disengage from focus once it's been allocated.

Russell Barkley's work emphasizes that hyperfocus in ADHD is actually perseveration, a symptom of frontal lobe injury, rather than a beneficial trait.

There is a growing movement in mental health that considers neurodiversity and the potential positive aspects of conditions like ADHD.

Research on ADHD and creativity suggests that individuals with high ADHD scores may exhibit increased divergent thinking, but this doesn't necessarily translate to those with a clinical diagnosis.

The perception of ADHD as an advantage is influenced by personal experiences and the severity of one's symptoms.

ADHD is a spectrum, and experiences of it can vary widely from person to person, affecting different aspects of life in different ways.

Some individuals with ADHD may find that their condition provides certain advantages, such as the ability to hyperfocus, which can contribute to their achievements.

The binary nature of Western medical diagnosis may not fully capture the nuanced experiences of individuals with ADHD.

The potential positive aspects of ADHD, such as cognitive dynamism and creativity, are areas that require more research to better understand and utilize.

Treatment for mental illnesses like ADHD can lead to improved overall well-being, even if it feels like certain advantages are lost.

Mental illnesses can confer certain advantages in specific contexts, but on balance, they tend to impair functioning more than they help.

The experience of ADHD is highly individual, and treatment should be tailored to the unique needs and experiences of each person.

ADHD is not a homogeneous condition; it affects people in diverse ways and can manifest as both a disability and a source of unique strengths.

Transcripts

so let's talk a little bit about adhd

so adhd when you are passionate about

what you're doing i've been working on

this project for 10 hours straight i've

accomplished in one day what would take

a normal person an entire week nothing

can stop me i'm a god

an adhd when you aren't passionate about

what you're doing washing dish is very

hard right so this is like a pretty

funny meme

i think that part of the reason that

these memes get made and the reason that

they propagate right and get a bunch of

upvotes

is because people can

really uh

um identify with this experience like

that so a lot of people with adhd will

be aware that their attention can

sometimes get hyper focused on a

particular thing

and if that thing happens to be

something good for them

they like can really do an awesome job

like if they can get super caught up in

particular things learn a lot about

stuff

um you know like get super into crypto

for example and then like read crypto

stuff for like 10 hours and like learn a

ton about crypto

and then the the challenge though is

that it's not really your choice what

you choose to hyper focus on and so it

feels a little bit like a roll of the

dice where like if it's if it's a good

thing to get hyper focused on that's

awesome right and then we're over here

on the left and if it's not a good thing

to focus on then you kind of wind up on

the right

so we're going to talk a little bit

about this phenomenon but before we do i

want to share actually a post um which

we're not going to go over the whole

thing because it's it's relatively long

uh but i think that it's actually like a

really good post so someone in our

community a few days ago mentioned that

they had serious concerns about your

adhd is it actually an advantage video

and so um

you know they go on to sort of talk a

lot about myths some of which i kind of

talk about they also cite

um you know dr russell barkley who's an

expert on adhd

and and so they're sort of sharing some

of the concerns about the ways that we

represent adhd or we talk about adhd for

what it's worth i i kind of responded to

the post and stuff like that and some of

the things that i sort of said about

some of the other videos and i sort of

said i completely understand your

criticism for what it's worth we're

going to be like revisiting or we've

already started the process of

revisiting how we title our videos

um so that feedback has been really

really useful because i think this

person had a super super valid point

and so hopefully as a result of this

feedback um you know we'll improve and

therefore we'll be able to help more

people so we're always open to feedback

for people who are sort of telling us

hey we think you should be doing this

better um and we have concerns about

this and this and as long as it sort of

supports the mission of what we're

trying to accomplish at hg we're more

than happy to receive it in fact we

depend on it right that's how we've

gotten to where we are today is based on

the feedback of of the people that

support them the work that we do

so um

so then part of what this kind of comes

down to is there's this idea that

if we kind of go back to this meme that

like if you have adhd and you're

passionate about something and if you

get kind of like

into something that you can spend 10

hours straight doing it

so this is where it's really important

to remember that adhd is a is a

diagnosis of disordered attention right

so disordered attention what most people

think of with adhd is that you can't

focus on a particular thing and that

your mind is very distractible and

wanders

but when we talk about disordered

attention and this is really common i

remember talking especially to parents

who have adolescent kids

who when i mentioned adhd

as a potential diagnosis the parents

would be super surprised they're like

well you know

we didn't

he can our kid can like sit down and and

read comic books for like eight hours

straight so if he's capable of doing

that like doesn't that mean it's not

adhd

and so adhd is a disordered attention

and what we mean by disordered attention

is not only that you can't force your

mind to focus on what you want it to and

instead it gets distracted but the

opposite is also true which i think

we've mentioned several times on stream

is that sometimes you get stuck on a

particular thing and you can't shake

that thought

when it's really a good idea to shake

that thought

and at the same time we also have you

know some interesting um

perspectives on this so like here's a

here's an example of so

the person thankfully you know mentioned

russell barkley and i was somewhat

familiar with his work but as a

consequence of of um the posters

feedback so i looked at a lot more of

his work and i i kind of uh uh i want to

share with y'all a quote from russell

barkley or i think can we watch youtube

or does it get banned we can watch

youtube right so here here's

also another popular phrase in some of

the adult adhd trade books adults with

adhd are good at hyper focusing this too

is mythology

hyper focusing is actually perseveration

you are unable to interrupt what you're

doing

when you should have shifted to doing

something else

it is like the child who continues to

play the video game

long after they should have been getting

dressed for school and out to the bus

you want to call that hyper focusing

that's fine but that is a classic sign

of a frontal lobe injury and it is

perseverative responding

you should have stopped what you're

doing

and you didn't there were other more

important goals to have been

accomplished and you ignored them

this is no gift it is in fact a symptom

of this disorder

hyper focusing goes with autism

perseveration goes with adhd

there's a little bit of a context there

which is he i think he's answering a

question about the difference between

perseveration and hyper focusing but i

think he brings up a really excellent

point

the challenge is that you know if you

talk to people with adhd and i've

certainly been in this camp

um

despite the fact that

hyper focusing is an attribute of a

disorder

you're going to have people who have

this experience right whatever you call

it this injury gift has been responsible

for every single achievement in my life

and this is also why we have these kinds

of memes because the experience of

people with adhd

is um

for some of those people the hyper

focusing seems to be an advantage

and as we sort of start to look a little

bit at the research um you know there's

some talk about neurodiversity for

example so like there's a growing

movement within the mental health field

that um some of these things may not be

you shouldn't it's not appropriate to

categorize them as illnesses but this

this is a situation of neurodiverse

versus neurotypical

um i have my reservations about some of

these concepts which i'll kind of get to

in a second but you know there seems to

be like some exploration of what we've

traditionally thought of is is mental

illnesses and whether some of these

mental illnesses can possibly have

good effects right so we have some

experts like russell barkley that say

that this is hands down

kind of uh the myth of hyper focus is is

in a sense false um this is a sign of

like it's it's correlated with a frontal

lobe injury which is absolutely correct

um so there's there's a lot of you know

useful stuff that he has to say but

there are different perspectives

so this is a paper that was um published

in neuroscience and behavioral reviews

that sort of examined creativity and

adhd

and was sort of looking at was a review

that looked at 31 studies and sort of

like went over you know what is the

relationship between adhd and and

creativity

and essentially like there's a lot of

like mixed stuff in here i think a lot

of the conclusions that they come to are

somewhat questionable

but there are a few interesting findings

from from this study so one is that

most studies find evidence for increased

divergent thinking for those with high

adhd scores but not for those with the

disorder clinical

so what does this mean so we're going to

unpack this statement a little bit so

divergent thinking is essentially

correlated with like or that's how they

sort of describe or try to measure

creativity so when i sort of have a

particular i'm faced with a particular

problem generally speaking we tend to

um

you know approach it a particular way

and people who think divergently will be

able to like draw on different kinds of

perspectives or think about it in in a

non-standard way so this is sometimes

used in the literature as a correlation

for um

uh

creativity

and so what one of the main findings of

this review

is that like

there are people who score highly in

terms of adhd symptoms that don't quite

meet a clinical threshold so we're going

to talk a little bit about what that

means

um but when you sort of cross over into

the clinical threshold the apparent

benefits of adhd aren't really

measurable

so

another sort of major movement in the

realm of adhd research is sort of this

general call for

more research opportunities to boost the

knowledge needed to better understand

the potential positive side of adhd and

this is something that is not

you know this is these are not the only

people that are sort of saying this

so

this is another paper that sort of looks

this is qualitative research so these

were people that were kind of doing

instead of like administering

instruments and stuff like that um they

sat down with i think just a handful of

people like a really small sample size

and they sort of asked them questions

about you know like what is your

experience of adhd and like you know

what are some of the advantages things

like that and so what they sort of

discovered is that

you know there's some amount of

divergent thinking or creativity that

there is a hyper focus element

that there's a cognitive dynamism which

is sort of like a positive thing like

sort of a sense of adventurousness so

this is another example of um you know

some of the research that's sort of

starting to explore potential good sides

of adhd and we'll talk a little bit

about you know what exactly adhd is and

why there are these

disparate perspectives

so there are lots of papers about this

kind of stuff

and so

you know what i'd like to share with you

all today is just how i understand adhd

and why i think there are so many

different perspectives so let's start by

sort of summarizing what are the

different perspectives so on the one

hand you have people like russell

barkley or a lot of clinicians including

myself sort of

that clearly acknowledge that adhd is a

disorder right so like in the field of

psychiatry we diagnose things that are

disorders and by definition they're sort

of impairments of function

now the interesting thing is on the

other side we've got people who um like

so we'll have people on the internet

right so like like the random person

which is not data it's just like one

person's experience who says it's my

ability to hyper focus that has allowed

me to like achieve everything that i

have in life and i've certainly worked

with patients who

have that perspective as well where

they've really found that kind of

getting control of their adhd and sort

of playing to the benefit of their

capacity to hyper focus there are even

some papers but i really didn't think

these were very rigorous that sort of

equate the hyper focus of adhd to the

flow state which i think is actually

quite different

but there are definitely a lot of people

myself included who have um somewhat

adhd minds like i'm pretty sure that if

i was a kid and i ever got evaluated for

adhd like i'm pretty sure that i would

have been diagnosed with adhd

so just thinking through the diagnostic

criteria like i think i check a lot of

those boxes but i think that i fall

under the category of people who are a

little bit more subclinical and so what

does that mean

so i think a lot of the reason that we

have such a diverse perspective on adhd

is because

when we think about adhd in the western

medical sense when you think about

western medical diagnosis

it's binary right so what we do in in

psychiatry is like we diagnose you or we

don't diagnose you so this is just the

structure

of our

medical field it's not necessarily true

it's just how we've organized medicine

so if i were to ask you like you know

like if we're investigating like let's

say someone who's passed away and

someone will say what was the cause of

death

and like the coroner will say it was a

myocardial infarction it was a heart

attack so this is the kind of thing

where like in medicine we tend to label

things in a binary way whether you like

meet criteria for the disorder or you

don't meet criteria for the disorder

practically clinically it's not quite as

binary right so if you diagnose with

someone with depression everyone knows a

major depressive disorder

everyone knows both patients and

clinicians especially that there's

severities of major depressive disorder

right not all major depressive disorder

are created equally and similarly with

adhd i think a big part of this problem

is that adhd is actually a spectrum

it isn't a homogeneous disease that

affects people homogenously so as a

result like this is sort of an

artificiality artificial

binary like imposement that we're doing

on adhd and so then what happens is we

get disparate perspectives because we've

actually got a bell curve of adhd

symptoms and people are at different

places in terms of the severity of their

adhd how beneficial their adhd is and

we'll kind of talk about that in a

second

and so i think the simplest reason that

we get some of these these disparate

perspectives it's not that one person is

right and one person is wrong i think my

experience as a clinician has been that

you know people tend to experience

mental health in a very individual way

but that there's actually a perspective

you know there's a scale of different

perspectives and this is part of the

reason that you know when i first

started talking about adhd i talked a

lot about ayurveda because i had

personally found that the ayurvedic

conception of adhd

fit

better

was a better fit for people's

experiences than actually like the

western binary sort of perspective on

adhd

part of the reason that we've sort of

scaled back on our ayurvedic discussion

recently is there was once again another

post that offered a lot of really good

criticisms about some of the scientific

studies we were citing and the low

quality of those studies so i don't know

if you all have noticed but we've sort

of taken a step back from ayurveda that

doesn't mean that we aren't we're

actually actively revisiting it so we're

sort of looking through the research and

really trying to to read tons and tons

of articles to really figure out okay

what is it what can we say let's like

sort of scientifically valid and like

you know what is like more of our

interpretation which by the way i'm

totally fine doing right so i'm totally

fine on stream and i i hope you know i

make this pretty clear that sometimes

what i'm saying is very supported by

science sometimes what i'm saying is

more supported by clinical experience

and sometimes what i'm saying is not

based on medicine or science at all but

is more personal or spiritual in nature

and i think a lot of the people that

appreciate our community are ones that

sort of appreciate the spectrum because

there are different ways of looking at

things

and so kind of going back to adhd i

think that the challenge is that there

are you know a spectrum of different

experiences

as a result people are going to have

different perspectives on how impairing

adhd is

and so i think the the important thing

to kind of remember there are a few

important takeaways the the first is

that adhd

is a spectrum

um and the part of the reason that you

know this spectrum exists is because

there are some

components of

adhd that may be or of the adhd spectrum

let's let's not even call it the the

adhd spectrum so there are components of

the attentional spectrum which can be

beneficial to human beings

and this is where even if you look at

other illnesses there are cases where

illnesses can form advantages for people

now we're not i don't think for example

that

it's necessarily good to have an illness

i think generally speaking if you get

diagnosed with a psychiatric disorder on

balance that is going to hurt you

significantly more than it will help you

that being said there are some

advantages so for example when i was

working in the massachusetts general

hospital emergency room we saw a lot of

students from harvard and mit and what

we sort of observed is i don't know if

there's published research about this

but talking to people at mit health

services and harvard health services is

that they're the prevalence of type 2

bipolar disorder

at ivy league institutions or very

competitive institutions seem to be

significantly higher than the average

population and when i talked to these

kids who were like you know undergrads

at mit like

they were terrified of of getting their

bipolar disorder treated why is that

because their bipolar disorder type 2

bipolar allowed them

to

sleep for two to four hours a night and

be able to be like focused and very like

action oriented and study a lot and

things like that and a lot of them were

actually really reluctant to engage in

treatment because they had found some

advantages to the way that their bipolar

disorder worked

now once again on balance it was my kind

of experience and generally speaking you

know i would recommend strongly

recommend treatment to these people

because

even though there may be particular

situations in which a particular mental

illness offers an advantage on the whole

it's like it hurts more than helps so

like sure you're sleeping two to four

hours a night for the two weeks before

finals because you're hypomanic and it

helps you do well on your finals but

then for the next three months six

months

you're you crash you go into a deep

depression and your grades the next

semester are absolute trash because like

you know you're depressed so so even

though an illness may have particular

advantages in particular cases that on

balance has been my overwhelming

experience as a clinician

that you don't really it's not worth it

essentially

and so the kind of the next thing that i

want to talk about so just to review a

little bit about what we talked about so

the first is why is there you know why

do people share these different

perspectives um and that's because i

think that you know illnesses are not

homogenous right and depending on

who you're talking to and what the

experience of that person is

um there you're gonna get sort of

different answers the second point is

that i think there is some evidence that

irrespective of what the mental illness

is that there are some components of

those fundamental functions

which can be beneficial so even if we

look at something like depression in the

default mode network so one of my one of

the hypotheses that i kind of subscribe

to

is that major depressive disorder

involves hyperactivation of this part of

our brain called the default mode

network and the default mode network is

the part of our brain it's not really a

place it's a network

so it's not localized to like a

particular anatomical region

is responsible for self-reflection so it

gives us the ability to think about

ourselves and when people get depressed

they get stuck thinking about only

themselves themselves in a negative way

so it's sort of a hyperactivation of

that but the default mode network is

actually a really useful part of our

brain and if we look at what mental

illness is it tends to be that our brain

sort of functions a particular way

and then if parts of our brain become

hyperactive or hypoactive or even

the

as a human being we interact in a

particular social circumstance or an

environmental circumstance

that sort of

exposes some of the vulnerabilities of

of however our brain functions then we

can get diagnosed with a disorder

a good example of this for example is

that you know kids are more likely to be

uh diagnosed with adhd if the ratio of

students to teachers in a classroom is

bad so if there's tons of students and

very few teachers you're more likely to

diagnose kids with adhd than if the

student-teacher ratio is more favorable

right so that sort of suggests to us

that people will present

for psychiatric help it's not just

what's going on in your brain it's brain

plus circumstance and that theory by the

way i think is relatively well supported

so when we think a little bit about

psychiatric illness even things like

major depressive disorder oftentimes

what we'll find is that there's a

genetic predisposition or maybe a family

history and then a particular

circumstance triggers the depression

right so like you were totally fine

until the age of 26 when you got fired

from your job and then you know your

partner broke up with you and then you

had to move back home with your parents

and that sort of triggered the

depression

now did those sort of cause the

depression sure but then then what

happens is like there's an independent

neurochemical process which starts in

your brain which may go beyond the

circumstances so then let's say you

start dating again and you find a new

job and you move out of your parents

place but you still feel

super depressed that's a good example of

separating out you know the disease from

the general

trigger from the disease

another thing about the researcher on

adhd is that i think that

as people sort of pointed out when they

were kind of um if you look at some of

these papers on you know creativity and

stuff one of the things that they point

out is that research opportunities to

boost the knowledge needed better better

understand the positive potential

positive side of adhd there are almost

always calls for you know more um

uh moreover the sizable prevalence of

hyper focus in adults with high levels

of adhd symptoms symptomology leads to

the need to study it as a potential

separable feature from adhd

right so generally speaking a lot of

people are call calling for more

research on the positives of adhd

and why is that it's because generally

speaking

when we look at studying an illness

the first kind of selection bias tends

to be towards the sickest people so

another good example of this is like if

you look at the research on sociopathy

a lot of the conclusions that we draw on

sociopathy are based on populations

where you can find and recruit

sociopathic individuals

and can anyone guess where is the

largest most consistent population of

sociopathic

individuals

that you can easily recruit for studies

prisons

right

and so as a result what we've got in our

research is that we're studying like the

our inclusion criteria and stuff like

that right because you've got to think a

little bit about the perspective of a

researcher if i want to conduct a study

on adhd

am i

more likely to take

someone who's definitely got adhd or

someone who's kind of on the border

right so i'm my inclusion criteria are

going to be like relatively strict

in terms of like i definitely want

people who

i know have adhd because that's how

we're going to learn about the illness

and the truth is that somewhere in that

middle ground those people may actually

have adhd but it's just less of a

clear-cut decision requires like a full

clinical evaluation which by the way

when people are recruiting for studies

they don't do usually do full clinical

evaluations with neuropsyc testing and

all that kind of stuff right so usually

like we'll use some kinds of

standardized instruments you fill a

couple forms and if your numbers are

super high you get enrolled in the study

drug manufacturers by the way also do

this because there's evidence that shows

that for example the sicker you are the

more antidepressant medication helps

and so what they'll tend to do is if

they want to show a big benefit if they

say that this is going to make your

depression you know way better the

larger largest benefits are going to

tend to be seen in the sickest number of

people so another simple example of this

is let's say i've got you know a 101

fever

and a 103 fever and i take antipyretic

medication

both of those in both of those cases

chances are the antipyretic medication

is going to break my fever and bring me

back down to 98.6 but if i'm a drug

manufacturer

i can say that the effect size is way

better if i recruit people who are like

103 right so now i can show a larger

magnitude of change

so i think another big bias that is in

our research i don't blame it like this

is where we've got to start somewhere

right

is that if you look at like studies on

adhd they tend to focus on the sicker

people they tend not to focus on this

kind of subclinical population if you

call it subclinical that means that they

may not even meet the disorder the

criteria for the disorder or they may

meet the criteria for the disorder so i

personally as a psychiatrist have seen a

ton of people who um meet criteria for

the disorder but can actually manage and

and even utilize some of the dynamic

nature of their mind it's something that

i myself have sort of learned how to

manage

and by the way um you know there's

studies that show that kind of

behavioral interventions or

psychotherapy interventions like

cognitive behavioral therapy can be just

as efficacious as medication and

treating adhd and i've had a lot of

experience with people who you know once

they sort of understand how to manage

their adhd can actually like perform

really really well and i will hear these

kinds of things where people will say

you know i'm really glad actually my you

know the dynamic nature of my mind

really manages helps me keep up with a

lot of stuff so i'll give you guys just

one quick example of a friend of mine

who um you know we went to medical

school together and then they really

found they struggled a lot because they

had adhd and so they actually left

medicine and moved into the field of

commercial real estate and what they

really found is that like all of the

ways in which

their difficulties sitting there and

reading a book

was a handicap in the field of medicine

which it absolutely was their brain was

not functioning the way that most of

their colleagues were

actually seemed to them subjectively to

be an advantage in the field of like

commercial real estate because they

could manage like a thousand different

tasks they were really good at

multitasking

interestingly enough they could also

read contracts that were 50 pages long

so i don't really understand what

happened there

but

the point here is that you know people

have diverse experiences i've also had

patients who are the very opposite of

that and that adhd for them is

absolutely a disorder absolutely an

impairment and absolutely like wrecks

every dimension of their life so this is

not just like affecting their

professional life or academic life but

really impacts their relationships

because when their partner tells them

hey are you going to go to the grocery

store and they're not paying attention

and they say yeah i'm going to go and

they're like can you please pick up

these three things and they said yeah

okay sure

they think they're paying attention but

they're not paying attention and then

like six hours later

when it's dinner time and then the sp

like partner asked them hey like where's

that stuff and they're like what stuff

and they're like the stuff that you said

you were gonna go get what what are you

talking about

right so this is where it's like it's

okay for adhd to be sort of a spectrum

and it's okay for people to have

different experiences of it

and if you are someone who is concerned

that you have adhd what should you do

about it right so like what do i know

what should i believe should i believe

russell barkley a random person on the

internet this paper that talks about

adhd is a potential source of increased

creativity like what should i believe

and this is where i'd say at the end of

the day like you have to kind of decide

for yourself right because it is a

spectrum not all all illnesses are the

same within all people

so depression is going to manifest in a

discreet and unique way in every single

person that's ever lived because the way

that that that illness manifests

is shaped by your personal experiences

your history you know your background

your coping mechanisms your strengths

your support structures and that's why

we have clinicians at least so far

instead of robots

why do we have clinicians it's because

it takes a human being to integrate all

of this research

and sort of apply it to you

and sort of figure out okay for your

individual situation which are the

research studies that are the most

applicable

and so what i'd recommend to anyone out

there who is you know concerned that

they may have adhd is i wouldn't default

to believing that this is necessarily

going to be an advantage there's also a

lot of like psychological stuff about

you know like not wanting to believe

that you are ill in some way or coming

to terms with the fact that if you do

have an illness like that just sucks and

it's a straight negative and this is

where like we want to believe you know

that the world is an equal place we as a

society should we strive to make it

equal absolutely but you know as a

medical doctor like

i don't know if i believe that the world

and the universe is an equal place

i mean i've seen like kids

eight-year-olds diagnosed with cancer

and i don't think that like buying the

childhood cancer flaw during character

creation necessarily gives you like

points elsewhere sometimes those kids

happen to be poor sometimes those kids

happen to have an abusive parent and

it's not like i really wish it was i

wish that every human being on the

planet had the same pool of points for

character creation but the sad truth is

that that's not how it is

and so some people really want to

believe that like there's some silver

lining to their experience and there may

be i don't i don't really know

but i think at the end of the day what

you've really got to do is if you're

concerned about it first of all go see a

licensed clinician right i talk a lot

about the benefits of our coaching

program but this is not really

appropriate for coaching

go see a licensed clinician someone

who's actually trained in mental health

stuff and try to figure out okay like do

i actually have do i meet the threshold

for a clinical diagnosis

furthermore

even if you do meet the clinic of the

threshold for a clinical diagnosis that

does not

you know that's not that doesn't set

your life in stone

like there you you may fall into the

category of people who first of all

don't need medication or can manage

their symptoms without medication you

may be able to you know get control of

the hyper focus in a way that i've seen

my patients sometimes do for lack of a

better term

or you may be part of the the group that

you know

can't get control of your hyper focus

and your hyper focus is a straight

negative or which is more much more

common and i'd say the most common is

that at times the hyper focus works in

your favor and at times the hyper focus

really doesn't work in your favor kind

of like the example that russell barkley

was talking about which is like yeah

you're playing video games and you

really should have gotten up and and

gotten onto the bus

and so at the end of the day adhd is is

in my opinion a much more diverse and

poorly understood disease than we

sometimes give it credit for i

absolutely believe that there is you

know a threshold beyond which it is a

disorder and on balance negatively

impacts your life

but just because it on balance negative

and negatively impacts your life doesn't

mean that you can't learn to live with

it

learn to either reduce the symptoms or

even develop or extract some kinds of

positives from your illness experience

and the last example about that that

i'll share with y'all is i've worked

with a couple of people who are artists

and sometimes as i talk to them about

you know their experience of depression

i'll sort of

describe them as having what i call the

artistic temperament that i genuinely do

believe that a lot of the the wonderful

creative work that is done by musicians

i've worked with um budding authors i

should say

um you know and and

i really hope they become successful

authors one day but what i really come

to appreciate about some of their work

is that their personal experiences of

mental health allow them to describe

like emotionally and limbically like the

experience the difficult experience of

being a human being

and so that translates into their music

that translates into their writing that

translates into you know filmmaking

and so as a result like it's not that

it's all negative i mean they're they're

definitely it's part of who you are

right and this is i think ultimately the

way that i view mental illness

which is that it's not like discrete

like sure does it impair your function

absolutely but as a human being you are

a constellation of all of your pieces

and some of your pieces are going to

screw you over more than other pieces

you're going to have some advantages

you're going to have some disadvantages

and just because something is an illness

doesn't mean that it can't be you know a

part of your life and the only solution

is to like rip it out root and stem i

know a lot of people who have come to

live with their mental illness in a very

healthy and productive way

not saying that it should be untreated

in fact the majority of those people who

do learn how to like you know live

healthily with their mental illness do

so through treatment and just as in a

quick you know reminder of a source that

we've already mentioned

um

i want to just highlight this sentence

here so we found no evidence for

increased convergent thinking abilities

in adhd nor did we find an overall

negative effect of psychostimulants on

creativity so i think this is a really

important statement to understand and

this is what you know for all the people

that i worked with who were undergrads

you know in boston

that were had type 2 bipolar disorder

this is the main conclusion is that you

may think that treatment of your thing

will you will lose the advantages but in

my overwhelming experience getting

treatment for your mental illness is

going to be like a net positive right

it's not like you're gonna lose the

person that you are it may take a little

while so this is like my experience with

people with bipolar disorder who are

artists

it takes time and more effort to find

your creative process again right like

just because you're an artist who goes

on manic binges and like paints a bunch

of like really drastic stuff and then if

you start treating your bipolar disorder

like the people will come to me and

they'll be like i can't paint anymore

and it's like

it can feel that way and then sometimes

they make the mistake of going off of

treatment but in my overwhelming

experience it's just about

re-accessing that that part of yourself

because mental illness is about a loss

of control of the mind

right being able to focus for 10 hours

is not a bad thing it's the inability to

choose

what you focus on when you focus on it

for 10 hours that's the bad thing that's

when the illness gets the best of you

right

so a big part of learning to live with

mental illness is

sometimes our mental illness gives us a

shortcut and can give us advantages we

see that with the type 2 of bipolar

disorder do where it's like these people

are relying on the the hypomania to help

them study whereas like if you start

treating your bipolar disorder the

hypomania won't let you study but it's

not like you can you can't study without

hypomania right it's just like you're

gonna have to learn some new skills

because it's almost like you've been

using a little bit of this automatic you

know type 2 main type 2 bipolar disorder

crotch or this adhd crutch or whatever

so it can definitely be an uphill battle

it can be difficult but at the end of

the day it's almost always or just just

about always worth getting treatment

because the truth is you're not going to

lose the good parts of you if you enter

into psychiatric treatment in fact

what's probably going to happen is the

opposite is that it may be a little bit

of an uphill climb for a little while

there may be a little bit of a learning

curve but it's been my overwhelming

experience that at the end of that climb

people are way happier and really glad

they engaged in treatment

you