ADHD Brain: Unraveling Secrets of Your ADD Nervous System – By William Dodson, M.D. Medically reviewed by ADDitude’s ADHD Medical Review Panel on Oct 2019
My sensory over-sensitivity from EDS seems very similar to ADD and I’ve been diagnosed with both. I wonder how many other people with EDS also suffer from such mental effects.
Attention deficit disorder (ADHD or ADD) is a confusing, contradictory, inconsistent, and frustrating condition. It is overwhelming to people who live with it every day.
The Diagnostic and Statistical Manual of Mental Disorders has 18 criteria, and other symptom lists cite as many as 100 traits.
My work for the last decade suggests that we have been missing something important about the fundamental nature of the ADHD brain.
I went back to the experts on the condition — the hundreds of people and their families I worked with who were diagnosed with it — to confirm my hypothesis. My goal was to look for the feature that everyone with ADHD has, and that neurotypical people don’t have.
I found it. It is the ADHD nervous system, a unique and special creation that regulates attention and emotions in different ways than the nervous system in those without the condition.
The ADHD Zone
ADHD is not a damaged or defective nervous system. It is a nervous system that works well using its own set of rules.
The vast majority of adults with an ADHD nervous system are not overtly hyperactive. They are hyperactive internally.
Those with the condition don’t have a shortage of attention. They pay too much attention to everything.
This is definitely my problem. I’m hyper-aware of any changes in the environment around me, both physically and in what I observe, hear, or feel.
People with ADHD know that they are bright and clever, but they are never sure whether their abilities will show up when they need them.
The fact that symptoms and impairments come and go throughout the day is the defining trait of ADHD. It makes the condition mystifying and frustrating.
This is also part of the inconsistency of EDS symptoms, making it impossible to predict what condition I’ll be in, what limitations I’ll have, or what my mood will be on any given occasion.
The 90 percent of non-ADHD people in the world are referred to as “neurotypical.”
Neurotypical people use three different factors to decide what to do, how to get started on it, and to stick with it until it is completed:
- the concept of importance (they think they should get it done).
- the concept of secondary importance — they are motivated by the fact that their parents, teacher, boss, or someone they respect thinks the task is important to tackle and to complete.
- the concept of rewards for doing a task and consequences/punishments for not doing it.
A person with an ADHD nervous system has never been able to use the idea of importance or rewards to start and do a task
The inability to use importance and rewards to get motivated has a lifelong impact on the lives of individuals with ADHD:
I see ADHD stemming from a nervous system that works perfectly well by its own set of rules.
Indeed, EDS makes “its own set of rules” for how we travel through our lives and these restrictions are constantly accumulating as I age, forcing me to make internal shifts in response to external circumstances.
- People with ADHD do not fit in the standard school system, which is built on repeating what someone else thinks is important and relevant.
- People with ADHD do not flourish in the standard job that pays people to work on what someone else (namely, the boss) thinks is important.
- People with ADHD are disorganized, because just about every organizational system out there is built on two things — prioritization and time management — that individuals with ADHD do not do well.
- People with ADHD have a hard time choosing between alternatives, because everything has the same lack of importance. To them, all of the alternatives look the same.
- People with an ADHD nervous system know that, if they get engaged with a task, they can do it. Far from being damaged goods, people with an ADHD nervous system are bright and clever. The main problem is that they were given a neurotypical owner’s manual at birth. It works for everyone else, not for them.
Don’t Turn Individuals with ADHD into Neurotypicals
The implications of this new understanding are vast. The first thing to do is for coaches, doctors, and professionals to stop trying to turn people with ADHD into neurotypical people.
Level the neurologic playing field with medication, so that the ADHD individual has the attention span, impulse control, and ability to be calm on the inside.
How about leveling the playing field with opioids for those that are suffering from intractable chronic pain?
For most people, this requires two different medications.
- Stimulants improve day-to-day performance for a person with ADHD, helping him get things done.
- They are not effective at calming the internal hyperarousal that many with ADHD have. For those symptoms, the majority of people will benefit by adding one of the alpha agonist medications (clonidine/Kapvay or guanfacine/Intuniv) to the stimulant.
Author: William Dodson, M.D., is a member of ADDitude’s ADHD Medical Review Panel.