CEASELESS MENTAL ACTIVITY
The overt physical hyperactivity of childhood is replaced by a “restless brain” in adulthood. People with ADHD describe their brains as ‘always-on-the-go’ or ‘having no-off-switch’.
Due to their inability to stop unwanted thoughts entering their minds, those with ADHD cannot clear their brains out and so have problems meditating.
When their brains are under-aroused, it feels like fog that they have to wade through like treacle. When they are over-aroused, they describe a “flooding of ideas” i.e., being bombarded by many thoughts simultaneously.
Those with ADHD spend less time thinking about their goals and how they are going to achieve them. They may ruminate about something that has happened, or catastrophise the worst-case scenario of something that is coming up. They may fantasise about being rich or famous, without working through the steps needed to get the end result.
A DIFFERENT TYPE OF CONSCIOUSNESS.
Adult humans have what is called Autonoetic Consciousness, that is, at any moment they see themselves on a timeline, they know what they have done, and they know where they are going. However, for individuals with ADHD, every day is groundhog day and they continue to make the same mistakes over and over. Those with ADHD tend to have a present time perspective and tend to think in the “here and now”, having especial difficulty in remembering to do a task at a time in the future, e.g., remembering to post a letter on the way back home from work.
It is inaccurate to describe ADHD as a “disorder of inattention”. It is better to describe it as a problem with distributing the available attention in the right places. Adults with ADHD hyperfocus on tasks they are interested in, e.g., if fixing motorbikes is their thing, they will continue doing this throughout the night until the task is finished and ignore everything else (time, the need to sleep and eat etc).
This has become one of the most intensively studied topics in psychology over the last 20 years and describes the way the ADHD brain drifts off when trying to finish mundane or boring tasks. The ADHD brain does not go blank when it wanders off, instead, another thought has come into the mind and taken over. As different thoughts enter their brains, the mind wanders from one topic to another aimlessly, losing sight of the overall goal of what they were trying to achieve. This is best described when they have lost interest in the text they are reading – their eyes scan the words, but their brains do not take in the meaning.
All emotions are exaggerated in the ADHD individual, as they cannot modulate them downwards to the right level. This not only covers anger outbursts or temper tantrums, but positive emotions such as laughing really loudly. Many individuals with ADHD spend a lot of effort in preventing these emotions escaping to the outside, whereas non-ADHD people can do this automatically.
Anxiety is a common symptom of ADHD. Because individuals with ADHD cannot modulate their levels of fear, they tend to go from fear to fearlessness with nothing in between. Interestingly, anxiety, although not very pleasant, often suppresses ADHD as it produces adrenaline, which reduces ADHD symptoms. This explains why so many individuals with ADHD partake in risk-taking activities, e.g., shoplifting, speeding, gambling, risky sex, entrepreneurialism, as it works like medication in paradoxically calming the brain.
Nearly everybody with ADHD suffers with unstable moods during the course of a day, going from feeling quite low to being mildly elated. This can come out of the blue or be due to an environmental trigger. These mood shifts can easily be differentiated from bipolar disorder as they do not last as long and are not so severe. They can easily be differentiated from Borderline Personality Disorder, as they occur in both the negative and positive parts of the spectrum.
The most common pattern of sleep disturbance (70%) is a chronic delayed sleep phase disorder i.e., they go to sleep late and wake up later. If they study or work in the week, this leads to a big catch-up at the weekends. They have problems going to sleep because they cannot switch their brains off at night. Most adults with ADHD need background noise to get off to sleep, either music or the TV (to give them something to focus on) or white noise (raises background arousal levels).
The less common pattern of sleep disturbance (30%) is a narcoleptic picture in which they can easily fall off to sleep in the middle of the day. Some of these patients have an afternoon siesta. Interestingly, when these two groups are compared, there is no difference in their other ADHD symptoms.
FLUCTUATING AROUSAL LEVELS
Some people with ADHD say they know what kind of day it will be when they wake up. They might be feeling really sluggish or feeling full of beans. This explains why so many with ADHD are self-employed because they are able to work to their own schedule and not somebody else’s.
The reason why they fidget or pump their legs up and down underneath the desk, is in order to increase adrenaline production, which will in turn help them keep aroused – “fidget to focus”.
Many adults with ADHD have hypo-activity which is why there is such a correlation between morbid obesity and ADHD. Some very active adults have periods where they are paralysed and cannot get off a sofa, despite having a lot to do. Many individuals with ADHD need background noise in order to raise their arousal levels so they can do mundane tasks.
DISORGANIZATION WITH ISLANDS OF PERFECTIONISM
Adults with ADHD will fluctuate between being completely disorganised and being completely perfectionistic. It is important to differentiate perfectionism from OCD. Perfectionists stop when things are perfect (hyper-focussing). Those with OCD keep doing the task again and again, with no end point (over-focussing). Again, in a person with ADHD, perfectionism is seen in the areas where their emotions lie. So, a houseproud housewife will be perfectionist in keeping a spic and span house, others will be perfectionist at work. A lot of individuals with ADHD develop rigid inflexible routines in order to cope with their disorganisation.
An individual with ADHD can easily spend 6 hours watching TikTok videos without realising any time has passed at all. Whereas when a person has to wait a few seconds more than they expected, they will feel like it is the end of the world. They will often need to play with their mobile phone or read a book even for the shortest delays, waiting in a queue or sitting on a toilet, as time doing nothing feels so unbearable.
There are a whole gamut of addictive (compulsive) behaviours that are linked to ADHD. Shopping, sex, exercise, eating, skin picking, hoarding, smartphone addiction, social media etc. Workaholism can give rise to very disturbed work-life balance. Many individuals with ADHD go from one addiction to another.
There are other ways that these extremes can present; individuals with ADHD have problems with budgeting, most feel like money burns a hole in their pockets, and they cannot spend it quickly enough. Others know their bank balance to the penny. Some are completely socially disinhibited, whilst others strike up conversations with strangers in out-patients, and others suffer with social phobia. There is a third group that switches between the two!! Some drive really fast, others drive too slowly.