Imagine your mind is a big whiteboard. All the things you want to do are on the board. By the end of a day the whiteboard is full of the things you thought about. Things you ran out of time to finish. Ideas that want you to come back. Ideas that want interest and attention. When you wake in the morning the whiteboard is blank. So is your memory of all the things you wanted to do yesterday. What do you want to do today? Anything I like!
This is my life on ADHD. Every morning I wake up without stress. It’s wonderful! I wake up to an empty whiteboard. There’s nothing to do today! I am free to do as I like! What a carefree and worry free life I live. This comes at a cost.
A blank whiteboard is also motivation free. Long term goals are hard. Impulsivity to check out what exciting new things have appeared on my radar. New messages, new cat videos on my feed, new cool math problems and neat technology… New things to write on my blank whiteboard! I wonder if… What if that… Maybe I should… I’ll watch that later (if I remember).
I propose a working model of ADHD.
Start with the basic 2 system model of the brain proposed by Daniel Kahneman. System 1 – fast intuition, “instinct” brain. System 2 – procedural stepwise brain. An ADHD neurotype can perform habits and routines and get into procedures. This represents a working S1, without which, a skill like riding a bike is impossible. Without S1 such a skill can’t become intuitive and automatic. Intuition is needed for difficult-human type problems where action is required faster than a procedure strategy can be enacted. While the process of learning to ride a bike may be fraught with distraction. Once they overcome learning, it is possible for an ADHD person to ride a bike.
As an example – “why does the frisbees appear to get bigger as it gets close to my fac– *THUD*”. That would be an example of S2 trying to play/think about frisbee.
I propose that all people are constantly noticing potentially distracting details. Noises that pop up, people moving in the background, ideas that come from being reminded of something, connections to other parts of the brain. A neurotypical person develops s2 control over impulses. S2 can guide a, “oh this reminds me of a time…”, or a “let’s pick that thing up” distraction with self-talk that says, that’s not relevant right now or other various tactics to keep one’s self on topic. For example a phone reminder every half hour to check for yourself what you are working on like tagtime.
In ADHD neurotype, impulse control is deficient. It’s not non-existent but it’s reduced. The impulses that a neurotypical brain might naturally dismiss (as above) are not mediated. That includes emotions that are fast to change, intrusive or creative thoughts, the desire to fiddle or fidget, and several other examples covered in the diagnostic questions below.
Let me be specific about impulse control. When I say impulse I use the concept from the motivation equation model:
Motivation = The desire to do a task.
Expectancy = The expectation that you will be successful at the task.
Value = How important you find the result of doing the task.
Impulsiveness = The distractions that come up when doing the task.
Delay = How far away the reward is.
A quick example. How motivated am I to finish my Science degree?
I expect I will be able to do it aside from the distractions and difficulties studying. I value it very much as an achievement. I am impulsive every time I try to study because I am distracted by reading Wikipedia, talking to friends on my phone and 101 other tasks. The delay is abous 2-3 years away to finish the degree.
In the theory of the motivation equation, we can improve motivation by recognising which factors are the worst offenders and make them better. For example the delay to reward is quite high in the example given but I can improve that with a calendar that I cross off each day, and a reminder that I am working towards a degree every single day that I cross it off. In a neurotypical this strategy may not even be needed. Or the strategy might come naturally. In an ADHD brain, this strategy probably needs to be trained. Then – even if the calendar strategy is trained, it may not work because of other factors.
Impulses are the off topic thoughts that pop into your mind. Impulses are the thoughts that reminds us to also add something else to the shopping list. Impulses help us to notice that there are flies around because someone left a window open (otherwise there are just flies around). Impulses allow us to suggest novel solutions to problems because we see the bigger picture. They allow us to step away from the present stress and daydream for a moment. Impulses also cause us to not be able to study if there is a dirty cup on our desk. They are the extended thought beyond, “there are flies”, to “why are there flies?” and more. They can be trained to be productive, supportive and helpful. Impulses are not good or bad. Most importantly – they just ARE, You can’t fight them, and if you did they would get worse. Making strategies to work with impulses is the best option you have.
In ADHD you don’t get to choose which impulses inspire you and come to your mind. Not unless you train them. Strategies that will work include planning and controlling the environment (workspace, etc) to reduce distractions, training habits of thought or behaviour to manage distraction (set a timer to allow for a quick break), fidget toys, and more.
I have explained above why behavioural strategies would work. Why does medication work? Medication may cause the impulse reduction part of the brain to be louder. The sort of medication that might make someone else anxious can suddenly cause an ADHD person to have impulse control thoughts. For example coffee that will “bring people up” is know to bring ADHD people down to focus. Of course these things are a fine balance and long term exposure to systematically messing with a brain can cause unknown adaptations. Example: when not on medication, everything is worse, and medication dose needs to increase to remain effective. (like how people adapt to coffee)
We know from Autism spectrum that the ability to hyperfocus and have special interests remains in brains that are not neurotypical. But why? I propose an analogy. Imagine (as a neurotypical) you find something really interesting. So interesting and stimulating that you don’t get distracted. That is – a piece of information or something so amusing you can pay attention to it for long stretches at a time because nothing is currently more interesting.
ADHD still has the capacity to be hyper focused but only for very specific or stimulating content. Impulse control is not needed if there are no impulses because the current topic is interesting enough. In this sense an ADHD person has an advantage towards learning if they can teach themselves how to be sufficiently interested in learning hard things. They also have a disadvantage in that sometimes you have to learn boring things before moving to the more interesting things. Like learning how to write before learning how to use new words. Fine motor control of writing may be harder to learn because it’s not interesting enough compared to the novel potential of new words.
This also means if you can reasonably convince someone with ADHD why a skill is interesting, you can probably get them to concentrate on it. (this works for all people – cultivate interest and intrigue)
In Flow theory by Mihaly Csikszentmihalyi, there is an optimum balance point between difficulty of task and skill at the task. If this balance point is found you will be in the flow channel and having enjoyable experiences. If a challenge is too easy for your skill level you will be bored. In ADHD boredom corresponds to impulsive thoughts and without impulse control that means they will no longer be doing the task.
In ADHD it is possible that the “flow channel” is a lot smaller than in neurotypical people. The balance point between hard enough and not too hard might be small or negative in size. That is, a hard task can also be boring at the same time as causing anxiety.
I propose to always try to give an ADHD person stimulating experience. Pay attention for signs of boredom and impulsive thoughts and inspire interest in the topics you would prefer they focus on. It’s not that they don’t want to be doing the thing in front of them. It’s that they might have forgotten why they want to do it.
If this working model needs clarification feel free to ask me.
I have also evaluated this model against the Adult ADHD Self Reporting Scale Question and the criteria in the DSM V and it fits. To read the extra information with good formatting – look at this google document.
Meta: Something about talking about ADHD just lends itself to inspire me to be distracted. I spent the better part of a 13 hour day at my computer not working on this document. And I don’t really understand how I had that many distractions in one day. That’s not counting the 3 hours the day before spent writing it up for the first time.