If you seek persistence, try psychological distancing. Research has shown both kids and adults can benefit from it. Check it out ye of little faith:

The Batman Effect (video from understood.org)

The Batman Effect article (understood.org)

What about adults?

If you seek better decision-making

Bonus: Interpersonal Uses

Practice to Reduce Conflict

Portland, OR: trials.ohsu.edu and https://www.ohsu.edu/octri (or email: octrirecruitment@ohsu.edu)

All over the U.S.: clinicaltrials.gov

What is ADHD?

• The name ‘ADHD’ is misleading and now considered by many scholars of ADHD to be a misnomer. Why? 1) It’s really considered a regulation disorder rather than a deficit disorder; and 2) It’s no longer seen as being so much about attention and instead to include action, motivation, energy, intention, emotion, etc. So much of self that Russell Barkley, PH.D., says let’s call it a self-regulation disorder. (Really the same as calling it an Executive Function Disorder, as Thomas Brown, Ph.D., might call it, but who knows all the affected Executive Functions by heart? See the ones affected by ADHD here: https://www.brownadhdclinic.com/the-brown-model-of-add-adhd)

• What the heck then are we talking about when we say self-regulation? Think of regulation related to ADHD as 4 S’s.
  • Starting and Sustaining (attention, action, motivation, etc.)
  • Stopping and Shifting (attention, action, motivation, etc.)

• Regulation differences between those with and without ADHD show up as two biases for those with ADHD:
  • A bias toward what’s most interesting, exciting or, all things considered, the least mind-numbingly dull, boring, tedious, effortful; and 
  • A bias toward immediate gratification (what is most rewarding, least punishing right now).

• What are the costs of these biases?
  • Neglect and procrastination of the boring, tedious things that save us money and time and keep others around us happy with us (less inclined to nag, throw things away, direct us regarding what to do) so that we keep our jobs, get the diplomas we want and otherwise achieve what we want to achieve
  • The rewards that come with delayed gratification (e.g., graduating from college, job promotion, building your own business, buying a house, saving for retirement, going on vacation, and healthy body and mind — via exercise, enough sleep and healthy eating)

What are the causes of ADHD?

Research indicates the causes are a combination of genes and environment. The genes are necessary but insufficient. You have to inherit the genes, and ADHD is highly heritable (if you have the genes, your chance of having it may be over 70%). But this still leaves environmental factors. They turn our genes on, off, up and down. And, with ADHD, research indicates there are actually different kinds of ADHD that may have different combinations of genes and environmental “causes.” It’s complex, and some scholars suggest it is most useful to think of a spectrum (vs. categories).

What Brain Differences are there?

Research shows various differences between the brains of individuals with ADHD and without ADHD, including those related to the task-positive network(s) and default mode network (see MIT McGovern Institute research on adult ADHD), brain waves, and chemicals, with dopamine as a big chemical player. For more on dopamine, see the disrupted dopamine pathway hypothesis (or this video) and research supporting it…essentially, lower levels of dopamine for two dopamine receptors; dopamine is a neuromodulator that promises reward and motivates action. There are many other brain differences, but this is a sample.

What to do? Practice working with your brain instead of against it.

Resources

On ADHD:

OHSU’s Center for Mental Health Innovation

MIT’s McGovern Institute

Understood.org

Jessica McCabe’s How to ADHD (Russell Barkley gave her the thumbs up a few years ago; I have found her mostly accurately reflecting the science)

tonyalippert.blog (this site)

adhddd.com/comics (Dani Donovan’s images on having ADHD; she is diagnosed with ADHD)

On the Brain(s):

Hubermanlab.com

Brainrules.net Videos

On Well-Being:

Harvard Health Publishing

Greater Good Science Center at U.C. Berkeley

For Research Studies:

Pubmed.gov

Nature.com

Below are highlights of an Oct. 2022 review: https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13696.

ADHD Over Time

For most individuals diagnosed with ADHD, symptoms first appear during childhood even if the diagnosis comes later.

For most, disappearance of symptoms for good is rare. It seems to persist though it may at various times appear to fade (i.e., you may no longer meet criteria for the diagnosis at various times over the course of your life).

What factors determine persistence are still unclear.

Current debate includes whether ADHD includes a late-onset variant. Estimates vary widely regarding how many people first present with ADHD as adults: from 30% to 87% (see how widely they vary?).

Still, it’s become clear that fluctuating symptoms and impairment are common. Moreover, there’s a lot of heterogeneity when it comes to ADHD (think of variants having overlap but also differences when it comes to how they present, their particular combination of causal factors, their courses/trajectories, and their outcomes).

Finally, we still know relatively little about later-life ADHD.

Co-travelers

Emotion Regulation Difficulties (ERD), as the researchers call them, are estimated to affect 40-50% of children with ADHD, presenting as being susceptible to anger/irritability/low frustration tolerance. One question then is whether it’s part of a particular ADHD variant/profile of ADHD.

Sleep Difficulties commonly travel with ADHD at ALL AGES. Kids, teens, and adults with ADHD have higher odds of getting too little or poorer quality of sleep compared to their peers. Some researchers are exploring the causal role that inadequate/poor sleep may play.

This may be surprising, but the authors note that for females there are no increased odds of anxiety or depression, as females already have higher rates of anxiety and depression than males even without ADHD being added to the mix.

Living with ADHD

What is noted to be true across cultures? A negative impact on relationships with peers and siblings, higher rates of teen pregnancy, gambling, accidents, and premature death, with impairment persisting into adulthood for over 50% of individuals. The researchers admit, however, that research and practice have neglected “the performance and capacity of” individuals with ADHD. It focuses on shortcomings versus strengths, on disadvantages versus advantages.

Heritability

It’s high: estimated to be 74% for general population twin samples. So, if your identical twin has ADHD, there’s about a 75% chance you do, too. What gives? It’s believed that ADHD arises from an interplay between genetic and environmental factors.

“New Leads” Regarding Genes

1. Different genes may account for childhood, persistent adult, and late-onset ADHD.
2. Genetically-based sex differences may exist.

Environments

The paper references an “umbrella review of meta-analyses” that “identified nine associations as having high credibility (random effects p < .000001, or p < .000001, n > 1,000; Kim et al., 2020).”

Most were “maternal pre- and perinatal factors including prepregnancy and pregnancy overweight and pregnancy hypertension, gestational hypertension, preeclampsia, acetaminophen use, and smoking.”

“Two were child factors – childhood eczema and low serum vitamin D.”

All were of “modest” effect size “(Odds Ratio(OR) < 2.0).”

“Several other smaller associations were also deemed reliable (p < .001) including child blood lead level, child blood magnesium level, maternal stress during pregnancy, and maternal selective serotonin reuptake inhibitor (SSRI) exposure during pregnancy.”

Concluding Remarks

After going through “new leads” across various areas of research, including on the brain, the scholars acknowledge a shift of perspective that has mostly come from outside academia and research labs as the “most radical challenge to the ADHD paradigm.”

“Perhaps the most radical challenge to the ADHD paradigm comes […] from a new socio-cultural rights-based concept that has emerged outside the clinical and scientific sphere – neurodiversity (Pellicano & den Houting, 2022). This both casts ADHD as part of a wider spectrum of naturally occurring variation and challenges the DSM assumption that ADHD is a disorder caused by dysfunction within the individual – replacing it with the assumption of ADHD as neuro-divergence (Sonuga-Barke & Thapar, 2021).

May you find this reading of use.