A quickish rundown on ADHD, Attention Deficit Hyperactivity Disorder.
ADHD is not a Deficit in Attention. It is a deficit in the regulation of attention.
Over the years the diagnosis of ADHD has evolved to include more age groups and changes in symptom counts. But the core has remained the same: ADHD creates difficulties regulating attention - meaning, difficulties in applying effort to select and pursue the important things in life.
This means that if you have ADHD your goals are harder to realize in conventional settings, like classrooms or 9 to 5 desk jobs - even in relationships. This can cascade into lowered self-esteem and reduce the likelihood for you to even try to realize your goals over time. On top of it, other people’s frustrations with you, often coming at as calling lazy or difficult, pile up and internalize. To give a diagnosis is to give a proper label - if you’re calling yourself things anyways, you might as well make sure that you have a label that’s accurate and helpful.
There are criteria in the manual that mental health experts refer to in the DSM-5 (aka the Diagnostic and Statistical Manual of Mental Health, currently in its 5th edition) that determine how the diagnosis is established. But these don’t capture what it feels like to experience living with it.
The subjective experience of ADHD is hard to express to those without the condition. I’ve heard it described as Christmas at the mall, with lots of overstimulation. I’ve also heard it described as driving a car uphill, where the gas (energy) of a person runs out faster because of the effort needed to keep propelling forward. These broadly capture the big picture.
I want to break it down a little further, using different metaphor: lighting in a performance theatre.
First, let’s break Attention down into several of its modes: focusing, diffuse (background environment) awareness, and switching between the two.
Focused attention is like spotlight - it is narrowed, constrained, and very focused. High signal to noise ratio. Think of a theatre with a spotlight on the main actor on the stage. Everything else is in the dark.
Diffuse attention is like house lighting - it is broad and receptive. No selectivity. Low signal to noise ratio. Think of the way the theatre puts on dim lighting at the end of a show. You can see the whole place, but not with any particularly high detail.
Switching is like the lighting control console - it lets you alternate between focused and diffused attention. It’s what lets you choose what is important (goal setting), when to do it (organization and task planning), and aligns your actions with our goals and course corrects if needed (monitoring, execution). Think of a tech managing a circuit board that alternates between stage lighting and house lighting.
Some people struggle with item 1, The Spotlight. Their spotlight may be too dim and so they cannot see what needs their highly focused attention. Or, their spotlight is too strong and won’t let them see anything else.
Some people struggle with item 2, The House Lighting. Their ambient lighting is too bright and so they get pulled to looking at all the things in their environment. They cannot focus entirely in on the main attraction. Or, their ambient lighting is too dim, and they cannot comfortably see what else is around them in the environment, or how big their environment is.
Some people struggle with item 3, the Switchboard. Their spotlight is functional, and so is their house lighting. But the control board that switches between them is “faulty.”
There is, of course, much greater complexity in the human brain. Here I have described visual attention only in basic terms - and there is also auditory (sound) attention, sensory attention (body sensations), and proprioceptive (body positioning) attention. And all of these interact with each other.
To borrow another metaphor, we can describe ADHD as like a lion on a farm. There is nothing “wrong” with the lion, and there is nothing “wrong” with the farm. The issue is that there isn’t a good fit between them. Hence why the term “faulty” is in quotations. “Faulty” is relative to the given production: traditional classrooms are one kind of production, entrepreneurial startups are another. Some places need more or less switching between Spotlight and Ambient lighting. Like a surgical operating room, versus an emergency triage unit.
To regulate your attention, you have to bring your lighting into check (via medications, external resources, internal tricks), but you also need to find the best environments. Like almost anything else and psychology, the question comes down to knowing your strengths and weaknesses, and taking responsibility for them, in the form of: “what are my needs, how can I best express them and to whom, in order to get them met?”
Please also keep in mind that just because you are struggling with attention does not mean that you necessarily have ADHD. Lots of things impact our attentional systems (e.g. metabolic problems, cerebrovascular issues, other neurodevelopmental conditions, mood disorders, and psychiatric conditions). Here is where assessments can be useful, or meeting with a professional who is trained to the right ask questions in order to rule out other things and help you make the right call.
Thank you for your attention :)
-ES
