I’ve been contemplating the ADHD question. In addition to that MetaFilter thread, there’s one on the Lines forum, with several suggestions for books, meditations apps, fidget toys, things that have helped people and other things that didn’t, and perhaps the most valuable, just sharing experiences and feelings about it. I can definitely point out things from my childhood, from younger adulthood, and more recently which fit the pattern to a T — and also a few things that don’t really.
Because of that thread, I read ADHD 2.0: New Science and Strategies for Thriving with Distraction from Childhood through Adulthood, by Hallowell and Ratey. It describes more recent scientific findings, treatment breakthroughs and potential breakthroughs, and the experiences these two psychologists (both of whom also have ADHD) have had with their patients.
The book explains the basic mechanism of ADHD in terms of the Default Mode Network (DMN) and Task-Positive Network (TPN), different networks within the brain that have been observed with differing activity levels depending on the kind of attention a person is using. The TPN is more associated with concentration and focus on a task, goal-oriented thinking, executive function and so on. The DMN is more primarily associated with imagination, memory, thinking about oneself and others, curiosity, and mind wandering. Normally, when on task, the TPN is the more dominant network and the DMN rests. With ADHD, the DMN just keeps going and can divert attention and demand stimulation.
The authors say that this is not solely a disadvantage, not a “disease” per se — there are positive aspects of being impulsive and/or a dreamer. Explorers, inventors, scientists, certain kinds of entrepreneurs, the one who points out the Emperor’s clothes aren’t real, etc. It’s just a question of coping with it and providing the right kinds of stimulation and connection so this doesn’t turn into self-destructive thoughts, inability to function in society, addictive behavior and so on.
They also point out that it’s not a “deficit” of attention — the DMN is just as busy as the TPN, and people with ADHD have a tendency to hyperfocus when they’re getting a particular kind of mental stimulation. They have described this as “Ferrari engine brain with bicycle brakes.” So they’ve introduced the acronym VAST, for Variable Attention Stimulus Traits. And they point out that many people have VAST without meeting the DSM’s clinical requirements for an ADHD diagnosis — this is where I seem to be. I was thinking of myself as “high functioning” and that seeking an official diagnosis of ADHD is unlikely to be that helpful. I don’t have serious problems with work, relationships, addiction, emotional extremes, executive function in general etc. — I’m basically okay, I just have a lot of browser tabs open sometimes.
(VAST, not being a unique acronym, is terrible for internet searches. You pretty much have to use “vast adhd” or “variable attention stimulus traits” to find it. It was also a band in the 90s, Visual Audio Sensory Theater; VAST Dynamics is the name of a company that makes synthesizer plugins and I have a vague recollection of another synth company using the acronym VAST for something; there was also a 2023 Nathan Moody album A Vast Unwelcome whose title hits a little different now; also a Linda Nagata novel from 1998.)
For a clinical ADHD diagnosis, the DSM lists two sets of criteria — one for “inattention” and one for “hyperactivity/impulsivity” — and adults who meet 5 of 9 of them in either or both categories officially has it.
Inattention:
a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).
That was absolutely true in childhood! But I feel like I have functionally overcome it, and it works out much more to “sometimes” rather than “often”.
b. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
Yes, 100%.
c. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
Yes. There are times when someone is talking to me and I’m just not absorbing what was said — I may realize this with some embarrassment, or I may not. And there are times when I ask “what?” and then a second or two later, it comes to me — I heard them but was a little bit behind and had to pull it out of short-term memory.
d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).
No — I am literally the best at getting stuff done at work! I temporarily lose focus but I get it back, and accomplish things really quickly in general.
e. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
This isn’t a hard no, but it’s more no than yes. Missing deadlines isn’t a problem and I’m not particularly disorganized about work/tasks. I do sometimes realize I’ve spent an hour and a half on the clock keeping busy without actually doing useful job-related stuff, and I do sometimes want to perform multiple stages of a serial task simultaneously. But overall, things work out, and the timing and quality of my work don’t suffer.
f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).
Yes. Not to the extent that I had this in childhood. But sometimes I just really don’t want to be sitting there solving a particular software bug.
g. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
No. Things I need regularly have places where they go so I don’t have to remember where I left them this time, but where I always leave them. I have a strong urge to make things are where they should be. Things I need less often might have an organized place for them, but otherwise they may be at risk of getting lost.
h. Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
Squirrel! I mean, yes absolutely. More the unrelated thoughts, and tangents. And having the entire internet right there in my pocket…
i. Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).
This was more of a yes in childhood, but no now. Bills have a spot on my desk, appointments have a calendar, other things have notes or just habit. Non-critical household chores may get neglected and delayed but I feel like that’s more of a lack of physical energy and/or motivation… including defining “non-critical” more broadly than some people might. 🙂
And the hyperactivity/impulsivity side:
a. Often fidgets with or taps hands or feet or squirms in seat.
Yes.
b. Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place).
No. I actually kind of have this horror of being disruptive, of calling attention to myself — I would prefer to be invisible/unnoticed/”small” in social situations. I do get up and take breaks from work, but that’s expected and healthy. I don’t walk out of meetings or just go wander when I’m specifically expected to be somewhere.
c. Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless).
Feeling restless, yes. I don’t have the energy for running or climbing…
d. Often unable to play or take part in leisure activities quietly.
Nope.
e. Is often “on the go” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).
No.
f. Often talks excessively.
No. I am usually “the quiet one.” When I’m with a very few people that I’m comfortable with I might jabber more, or in specific situations where I’m a certain kind of nervous but expected to talk. I do post a lot on certain forums or this blog, to get my thoughts out there, but I feel that writing is fundamentally different from talking, in terms of social context.
g. Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for turn in conversation).
No, in fact, the opposite. Often I do not see an opportunity to engage in a conversation — maybe I take too long trying to decide how I’m going to say it, or I just plain get talked over. I’m “one of the quiet ones.” My spouse is like this too, and sometimes one of us does end up talking over the other, though we both try to avoid that since we both experience it so much elsewhere.
h. Often has trouble waiting his/her turn (e.g., while waiting in line).
Nope. Especially if there’s a clear order to the queue, I might get a little impatient but who doesn’t? If the cause of the delay is unknown and it’s not a matter of turns, that’s far more likely to bug me.
i. Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).
No (and I feel like this is just another way to restate g).
So… definitely not “hyperactive,” no surprise there. But close on the “inattentive” side. Generally though, I think VAST is a better fit than saying “undiagnosed, high-functioning ADHD probably” so I’ll stick with that.
I don’t feel like I need OTC medication or therapy or a coach for it. Recognizing it in myself is an insight though. And geez, I really should try to get some regular exercise because that’s supposed to be helpful. We’ve also been talking about getting back into Qi Gong (we took a class several years ago), and there’s some evidence that working on physical balance is helpful to regulate the DMN/TPN balance. So, yeah.