What is ADHD?
You are more than a diagnosis.
Special Note: Diagnoses are abstractions or summaries: sometimes helpful, always incomplete. Also, neurobiology is a continuum; it follows ADHD falls on a spectrum.
Attention Deficit/Hyperactivity Disorder (ADHD) is best conceptualized as a developmental and neurogenic disorder of self-control with impairment or relative weakness in the broad area of executive functions. Executive functions are meta-cognitive abilities that influence various mental and behavioral tasks. These include self-inhibition, task switching, multitasking, working memory, planning, organization, decision-making, cognitive flexibility, and emotional regulation.
Quick Insight…think of ADHD as the neurophysiological misfiring of self-regulation and attention.
The disorder we know today as ADHD consists of ongoing problems with sustained attention and effort, selective attention, and self-regulation (cognitive, behavioral, and emotional) related to widespread difficulties in executive control of one’s life. What other people notice about people with ADHD is their distractibility and difficulty processing the importance of what needs to be done. They may also observe problems with timeliness, messiness, and emotional control.
Russell Barkley, Ph.D., a leading scholar and fantastic speaker on ADHD, captures the ADHD person perfectly when he describes what’s going on inside their head as they experience the outside world in the following self-statement.
“I know what to do; I don’t do what I know.”
Dr. Barkeley’s conceptualization of ADHD instructs that it is better viewed as an executive function disorder (EFD) comprised of five challenges.
Time Management + Organization + Self-Disipline + Self-Motivation + Emotional Regulation
Dr. Barkley has written and spoken extensively about ADHD. A great place to start being inspired by his scholarly research, thoughtful findings, and practical advice is reading his two companion books, “Taking Charge of ADHD” and “Taking Charge of Adult ADHD.” Both books are concise and focused on providing valuable information without overwhelming you with complex science that distracts most readers.
Gabor Mate, MD, in his fantastic book about ADHD entitled “Scattered Minds: The Origins and Healing of Attention Deficit Disorder,” provides valuable insights into the ADHD mind. Dr. Mate states the significant impairments of ADHD - distractibility, hyperactivity, and poor impulse control - reflect, each in its particular way, a lack of self-regulation.
When neurologically explained, the lack of inhibition (an ineffective brake pedal) that characterizes ADHD is due to chronic underactivity of the prefrontal cortex (PFC). More specifically, there is lowered activity in the portion of the PFC responsible for prioritizing, selecting, and inhibiting. This is why stimulant medication (for example, Adderall or Concerta) is prescribed, as it increases the neural activity of this brain region.
In summary, the following findings are generally accepted when the science of ADHD is reviewed.
ADHD features include poor attention span, distractibility and low boredom threshold, poor impulse control, and (mostly in males) difficulty being still.
ADHD primarily involves a difference in neural maturation of the brain's basal ganglia, cerebellum, and frontal lobes.
ADHD appears to be a condition stemming partly from inefficient brain operation relative to task and environmental demands, leading to poor execution of behavior.
ADHD is not a disease or illness but reflects an immaturity or neurological delay in the pace at which children develop self-control and self-discipline.
Poor self-discipline is synonymous with poor self-control, which leads to impulsive behavior. Children display increased inattention under conditions of repetition, effortfulness, and disinterest.
ADHD may be better recognized as an Executive Function Disorder (EFD). Executive function is how efficiently a person does what they decide to do. EF is an umbrella term encompassing self-regulation, sequencing of behavior, flexibility, response inhibition, planning, and organization of behavior.
To learn more about ADHD, it’s strongly recommended that you visit the website of Dr. Russell Berkeley, MD, who has dedicated himself to its education and research.
Press the button below to learn more about how your mind works as described in Dr. Zierk’s book, Mind Rules: Who’s in Control, You or Your Mind?