Hello, welcome back to another episode of Seeker+ and our series on ADHD, I’m your
host Julian. This is episode 2 and once again we’re featuring our guest experts, Licensed
Professional Clinical Counselor Micah Caldwell and Neuroscientist Dr. Alie Caldwell. They
co-authored a book on brains called Brains Explained and in our last episode that’s
exactly what they did. We learned a bit about how the ADHD brain is structured and how it
functions differently which really laid the groundwork for what we’re going to talk
about today. And we talked about how scientists gave zebrafish ADHD symptoms, it was wild.
Be sure to check that out if you haven’t already. If you’ve already seen part 1 and
you’re ready for us to get on with it already then let’s dive in and talk about how those
brain differences manifest themselves. What are the symptoms of ADHD? How are they different
from difficulties many people have with attention and hyperactivity? And how do they overlap
with other disorders? Most people experience many symptoms of ADHD to some degree, one
of the most well known is the inability to stay focused. While most people can ignore
distracting stimuli when they’ve got something they have to do, people with ADHD often struggle.
Often, but not always. People with ADHD can also have an ability to dial into certain
tasks with the intensity of a laser beam. This so-called hyperfocus can be confusing
for their parents, teachers, or co-workers who don’t understand how they can be totally
absorbed by one task and then seemingly absent for many others. Part of the issue with ADHD
is since it affects executive functioning, certain things become very unimportant and
you lose focus on those, and then certain things become extremely important, right?
Because you're interested in them and you get absorbed into them. So, you can have bills
to pay and those are uninteresting and they fall by the wayside. But then, video games
are like super-interesting and you get sucked into it and suddenly five hours passes by
and you don't know what happened. Now of course everybody would rather pay attention to things
that interest them than things that bore them. Who among us would rather pay bills than play
video games? The reason ADHD is a disorder though is that inability to focus on important
tasks can be so persistent it disrupts daily life. If you eschew paying your electricity
bill for too long in favor of playing video games, well then eventually you won’t be
able to play video games either. Oftentimes the only thing that can keep someone with
ADHD on task and doing that uninteresting thing they don’t want to do is the knowledge
that if they don’t do it this second, the near future will be very unpleasant. To an
observer that can make it seem like focusing on other tasks that aren’t red-alert, all-hands-on-deck
levels of urgency maybe that’s just a matter of discipline or willpower, but it isn’t.
Because of how it’s wired the ADHD brain’s ability to focus isn’t under voluntary control.
That is one major symptom but there are many more, and ADHD is split into three subtypes
with different associated symptoms. There’s the inattentive type that’s characterized
by that inability to focus, or to finish tasks or even start them. It’s also associated
with forgetfulness or the tendency to make thoughtless mistakes or misplace important
items. There’s the hyperactive / impulsive type, which is associated with an inability
to sit still or to stop talking, or a tendency to interrupt others or blurt out the answers
to questions before they’re completed. And then there’s the combined type, the chocolate
and vanilla soft-serve swirl of the other two. Symptoms of the hyperactive / impulsive
type are pretty easy to spot, but the inattentive type is less obvious, and interestingly it
seems to have a big impact on how we diagnose people depending on their gender. For the
longest time, ADHD was specifically focused on the hyperactivity side of things. And as
a result of that, most often it was diagnosed and continues, I would say for the most part
to be diagnosed in boys, in young boys, because it tends to manifest in these very obvious
ways, right? Being loud and talking over other people, not being able to stay seated, being
wild and just having all of these symptoms that we associate with hyperactivity versus
girls, where in general, there's still more research that needs to be done, tends to skew
more towards the inattentive type. But actually what there seems to be some evidence for is
that societal expectations and pressures often play the biggest role in terms of how it's
demonstrated and expressed between boys and girls growing up. Girls get a lot more pressure
at a younger age to be well behaved and be quiet and sit still. Whereas boys will be
boys and they can be louder and more active. Exactly. So, if you have hyperactive type
ADHD as a girl, you might still not demonstrate in the same way or in the typical way since
it's been normalized often to boys and go undiagnosed or underdiagnosed or it's misdiagnosed
frankly, as something else. Girls are diagnosed, when it comes to ADHD diagnosis, it's about
two boys for every one girl being diagnosed right now. But there is starting to be some
shifting as we recognize more the inattentive subtype and what that looks like. ADHD is
a developmental disability, meaning symptoms often appear in childhood. But that doesn’t
mean it goes away when people become adults, instead many people with ADHD learn ways to
cope with it and there are several ADHD adults who are thriving. Gymnast Simone Biles and
swimmer Michael Phelps are two examples, and I was diagnosed with ADHD last year, but despite
that we have 27 Olympic gold medals between the three of us. Justin Timberlake, Will.i.am
and Adam Levine have also been diagnosed with the condition and don’t get me started on
how many Grammys we have. There are people with ADHD who have found success in all walks
of life. They learn strategies to cope with it or find jobs that fit with how they operate
and it’s not just generational athletes or musical talents like myself. So with adults
versus kids, obviously when we think of ADHD, we think that that's sort of a childhood disorder
and it's true, it starts in childhood versus a lot of other mental health diagnoses where
we see that manifest typically after puberty or in early twenties is typically when a lot
of mental health issues arise, but ADHD is something that happens from a very young age
and for a long time people would say, oh, you can grow out of it. And it's true. Some
people do. Some people gain the skills and the coping methods to overcome whatever difficulties
they're facing in those regards. But what we're finding is that a lot of adults continue
to have ADHD and frankly, a lot of adults are able to assess themselves later in life,
too, and be like, oh yeah wait yeah, hang on a second. It may help those adults to learn
that there are a bevy of other common symptoms not often discussed when people talk about
ADHD. Dr. Thomas Brown of the Brown ADHD Clinic describes how his patients usually lack the
ability to get organized either with their stuff or their time. Many have trouble getting
to sleep at a reasonable hour, they stay up until they’re completely exhausted, but
once they’re asleep they’re like a comatose rock. They might have energy once they’re
up and about but if they have to sit still and focus their eyelids get heavy and they’ll
start to nod off. People with ADHD can have fantastic long-term memories and recall specific
events or movie plots or song lyrics with total clarity, but then have problems with
their short-term working memory to the point they can't remember things that happened just
a few minutes ago. They often struggle with writing because they have difficulty putting
their thoughts on the page in a coherent way. And many times Dr. Brown says his patients
have trouble managing their emotions. They might get frustrated and irritated easily and have trouble with moodiness.
Or they can become fixated on something they want to do and feel a push to do it immediately,
consequences be damned. Or they might worry a lot and then be unable to put that worry
out of their minds and fixate on what’s troubling them. Now if as I’m describing
all these symptoms you find yourself saying “Hey, that’s me!” over and over, I have
two important things to consider. One is that everybody experiences all of these sometimes,
so the important question is how much do these things interfere with your ability to function
day-to-day. If some or many of these issues pose a real problem, it’s also important
to know that many different disorders can manifest in similar ways, or can also be present
alongside ADHD. Part of the issue is you sort of have to figure out which diagnosis is the
primary and because a lot of people with ADHD also, there's a high comorbidity with anxiety,
too. And obviously that makes sense. If you have ADHD and you're struggling with daily
life tasks, that's going to make you anxious, right? It's not like you might come across
as sort of this spacey person or inattentive or hyperactive or whatever. That doesn't mean
that you're not aware of the difficulties that you face. And so there's a lot of other
stuff that can go along with that, anxiety, self-esteem issues. It's interesting to see
how there are linked pieces. And so finding the core root issue and knowing that it's
ADHD can be hard sometimes. Children with ADHD sometimes exhibit related conditions
like Oppositional Defiant Disorder where they don’t play nice with authority figures;
conduct disorder where they have a tendency to steal, vandalize, or fight others; or learning
difficulties like dyslexia. About 15% of Children with ADHD also have depression and up to 30%
have anxiety. For adults those numbers are much closer to 50%. Depending on the diagnosis
the treatments can be very different. So how do mental health professionals diagnose if
a person suffers from ADHD, a related condition, or some combination? We’ll get to that in
our next episode. For now I’d like to thank Micah and Alie again, and if you like their
stuff be sure to check out their channel Neuro Transmissions. If this brain-talk is feeding
your noggin and you’d like to see more, let us know in the comments and we’ll set
our minds to the task. I’ll see you for the third and final episode on ADHD in the next Seeker+