Let's Chat... ADHD (with Ned Hallowell)

#073. Let’s Chat… Attention Deficit Hyperactivity Disorder (a.k.a. ADHD)

These Let’s Chat episodes are for me (Claire Sandys, host of The Silent Why podcast) chat one-on-one to a guest who has experience or expertise in a particular area that can help us deal with, or prepare for, loss.

In this episode, I’m talking to Dr Edward Hallowell (a.k.a. Ned) from Boston, a child and adult psychiatrist, Harvard faculty member and graduate, and world authority on ADHD. 

Ned has spent the past four decades helping thousands of adults and children live happy and productive lives through his strength-based approach to neurodiversity.

He’s written many books including his Driven to Distraction series and his latest book ADHD 2.0, he’s been featured on many media channels including; 60 minutes, Oprah, CNN, The Today Show, The New York Times, Time Magazine and much more. He has ADHD and dyslexia himself and is the founder of The Hallowell ADHD Centers in across America.

In this conversation we talk about what ADHD is, why Ned refers to it as ADD, the impacts it can have on a daily life, what treatment options are available and why he believes it can be a special superpower.

And with each Let’s Chat guest I'm building a whole tool shed (metaphorically), of tools to help you face and get through loss. So let’s see what Ned adds to my growing list of tools.

For more about Ned and his books visit: https://drhallowell.com/ 

And you can also find him on social media:
https://www.facebook.com/DrHallowell
https://twitter.com/drhallowell
https://www.instagram.com/dr_hallowell
https://www.tiktok.com/@drhallowell

Transcript

Claire : 0:00

Hello there, and thanks for joining me for another episode of Let's Chat. I'm Claire Sandys, host of The Silent Why podcast, and blog writer for www.thesilentwhy.com. A podcast exploring how and where we can find hope through grief and loss. In these Let's Chat episodes, I chat to a guest who has experience or expertise in a particular area that can either help us deal with or prepare for loss. And through them, because I want to capture some useful magic from each chat, a bit like the Herman's on our usual episodes, I'm building a tool shed (metaphorically) of equipment to help us face and get through loss and grief. At the end of each episode, I ask our guest, what sort of tool their subject is, and then I add it to my shed. On this episode of Let's Chat I'm talking to Dr. Edward Hallowell from Boston, also known as Ned. A Harvard graduate and faculty member, child and adult psychiatrist and world authority on ADHD (Attention Deficit Hyperactivity Disorder), which is what I'm talking with him about, in this conversation today. Ned has spent the past four decades helping thousands of adults and children live happy and productive lives through his strength-based approach to neurodiversity. He's written many books, including his Driven to Distraction series and his latest book, ADHD 2.0. He's been featured on 60 minutes, Oprah, CNN, The Today Show, Good Morning, America, The New York Times, The Boston Globe, Time Magazine, and much more. He has ADHD and dyslexia himself, and is the founder of The Hallowell ADHD Centres across America. I was curious to chat to an expert on ADHD because it had been raised as another area that brings a lot of loss with a diagnosis, especially when diagnosed as an adult. And we've also got 101 loss episode on'Loss through ADHD' coming soon with the lovely Margaret, so keep an eye out for that one. I had so many questions for Ned, but unfortunately my time with him was limited, so I chose to focus on gaining an understanding of the condition rather than digging too deep into how it might affect loss and grief. I kicked off with Ned introducing himself but I also asked him to explain what ADHD was off the bat. So grab an apple juice, orange juice, pomegranate juice (is that a thing?!) or just a nice glass of tap water, and relax with me and Ned as we chat ADHD.

Ned: 2:23

My name is Edward Hallowell. But I'm called Ned. I'm coming to you from just outside of Boston, Massachusetts, in the United States. I'm a psychiatrist with a specialty in learning differences, especially ADHD, which I got interested in because I discovered that I have it myself. Back in 1981 when I was doing a fellowship in child psychiatry, and I've been learning about it ever since you could say I've been learning about it my whole life. I'm 73 years old, been married 35 years and I have three children, all of them inherited my ADHD they're now 33, 30 and 27. And all doing wonderfully well. I see this condition as a trait not a disorder. And depending upon how you manage it, it can become a terrible disorder. Or it can become like a special superpower. Usually, it's a little bit of both and my job as a doctor is to increase as much as possible the advantageous side of ADHD and reduce as much as possible the disadvantageous side of ADHD. The condition is widely misunderstood. Even the even the name is misleading - Attention Deficit Hyperactivity Disorder - we do not have a deficit of attention if we did it will be a form of dementia, which it isn't what we have what I have is an abundance of attention. My challenge is to control it. And that's the that's the challenge for everyone with with this condition. It's as if we have a Ferrari engine for a brain a racecar for a brain going a mile a minute or runaway brain with bicycle brakes so we need to strengthen our brakes in order to turn this condition into the asset it truly can be if we if we don't then trouble awaits we can crash we can burn we can you know the prison population is full of people with untreated ADD. So is the population of the unemployed the multiplayer divorced the addicted. That's the downside the upside. Most entrepreneurs have this, there are Nobel Prize winners who have it, there are Pulitzer Prize winners who have it, there are self made millionaires and billionaires who have it. You name a field and I'll name you someone with ADD who's right at the top of it. I still call it ADD by the way because that's what it was called when I learned about it back in 1981. They stuck the H in just to confuse people but I'm still with the ADD. So the trick is, first of all, to destigmatise it, to learn about it, discover that it can be a tremendous asset if you learn about it. And then to set about doing that, and one size does not fit all, everybody's ADD is different from everybody else's. But with education, with structure with coaching, and sometimes with medication, you can achieve dramatic improvement in a very short amount of time.

Claire : 5:27

So would you say you think it's been named wrong? How did that get that name? If that's not really describing what happens? Is that just because they didn't know about

Ned: 5:34

No, no, it emerges out of the medical model, then, you it then? know, I'm an MD, I was trained in the medical model. But we study pathology, we don't study health. So the name emerged from all the negative symptoms, all the seeing it as a deficit disorder. And the positives they forget about. You don't go to the doctor because you feel so good. Maybe you should. So you can focus on preserving and promoting the reasons that you're feeling so good. In fact, I think that would be wonderful direction for the medical field to take, but it hasn't done that as yet. Hence, the condition is given a medical based name, ie pathology based name, hence, Deficit Disorder, Hyperactivity Deficit Disorder.

Claire : 6:23

And are there certain people that are more predisposed to get it?

Ned: 6:25

Absolutely. This is highly heritable. That doesn't mean you you inherit it, per se, but you inherit the genes that increase the likelihood that you will develop it, like virtually everything, it's a matter of nature and nurture, both genes and life experience come into play. But in the case of ADHD genes play an especially high role for a condition in the behavioural sciences.

Claire : 6:54

So how common is it? What are the sort of statistics for people who have this trait?

Ned: 6:57

Well, it depends how you define it. And who you ask. It's like, how common is sadness depends how you define it. Now full blown depression, we have numbers for because the definition is clear. with ADHD, which is, which is on a spectrum, as is sadness and depression, it's hard to say where one leaves off and the other begins. Edmund Burke had a great remark way back in the 18th century said, 'although there's not a clear line that divides night from day, no one would deny there is a difference'. So there is a difference between life with ADD and not ADD. But where do you draw that line is impossible to define, in my opinion, if you define the condition, as a condition that people's lives could be changed for the better, if you made the diagnosis, we're talking 30% of the population. If you define the condition, the way the diagnostic manual does, then we're talking seven to 10% of the population. So because the diagnostic manual is very, very strict conditions of impairment that you have to meet, which would leave out someone like me, for example, and I certainly have ADHD or ADD, but I wouldn't meet the the DSM definition. DSM, is the name for the Diagnostic Manual.

Claire : 8:24

And what are the sort of the usual treatments for it? What would people usually do as a sort of a first stop for this?

Ned: 8:30

Well, the biggest one is education. And most people don't get that they get a diagnosis and a prescription. And that's woefully inadequate. If you want to really reap the benefits of of the diagnosis, and the benefits are completely life changing. There's no condition and all of medicine, that can change a person's life more dramatically, more quickly, for the better than this diagnosis is particularly in adults. So education and by education, I don't mean, you know, read a paragraph and then you know what it is, I mean, taking the time to read a book, and I've written several, but there are many others out there. Beware of books, though, because many of them really heavily emphasise pathology, and skip over the good side. And the good side is really what gets people excited. Do you mean I can do that? I mean, I can do that. Yes, you can win a Nobel Prize. Yes, you can start your own business. Yes, you can become a self made wealthy person. However you define that. Yes, that's all most entrepreneurs habit. So education is the first step and by far the most powerful step. Then based on that you take stock of where you are, what are your What are you good at what do you not good at? What would you like to develop? And you know that that's quite a bit of taking stock. Then based on that you begin lifestyle revision, it could be at the macro level, marry the right person, find the right job, those are probably the two most important high level 30,000 feet decisions, or at the micro level, what kind of organising system do you use for home? What kind of shopping lists do you make? How do you make sure you have time to go to the dentist and the dry cleaner, you know that the sort of micro management and that's that's where that's what people with ADHD struggle with, because if something is not stimulating, we tend to overlook it or omitted altogether. So education, lifestyle revision, and you can get help with the lifestyle revision by working with a coach. Now a coach is pretty much what your mother used to do minus the nag factor. So a coach is someone who without nagging, you can help you get organised, develop strategies to follow through complete undertake, so on and so forth. And then, you know, in that context, you may have a trial of medication. People fear medication, but they don't need to the medication used properly is very safe, very effective. It's been around to treat what we now call ADHD since 1937. Most people have no idea that we have some 80 years of experience with these meds, nothing lasts that long in the field of medication and pharmacology, unless it is a safe and be effective. Now it has to be prescribed by a doctor who knows what he or she is doing, by all means. Because you can make mistakes, and you can have a bad experience on medication. But as long as it's prescribed properly, the side effects are easy to manage. And whatever the meds do is gone within a few hours. So the worst that you can happen is you have a few hours that you know, you don't like and I tell my patients if you turn purple, you'll be right back to your original colour. So far, nobody has turned purple. But it's sort of my way of saying no matter what it does, it's reversible. The meds take about 20 to 30 minutes to take effect. And then depending upon which med you use, they last from four to 12 hours. What they do positive side is very analogous to eyeglasses, they help you focus. They don't make you smarter, but they allow you to use your smarts form far more effectively. They don't organise your kitchen or your office for you. But they make it a lot easier for you to organise your kitchen or your office. So with focus, pretty much everything you do improves from your work life to your golf game, to your cooking to your interacting with others. mental focus improves everything except sleep. You know, it doesn't matter if you focus when you're asleep. And that's pretty magical. I mean, what the meds should change you as much as a no more than eyeglasses. So it shouldn't change your personality. It shouldn't you know, turn you change your political party. It shouldn't change your food preferences or anything else. It simply allows you to focus in a more even way and not overlook things you used to overlook your your boring friend can become interesting, all of a sudden, your boring spouse could all of a sudden become interesting, you know, chores that seemed undoable because they were so boring, become doable. It is a major kind of blossoming when all of those together, diagnosis lifestyle revision coaching medication, when they all work in concert, you really get a new life. And that's that's not overstating it. One of the reasons I love my job is I see this happen in my office every week. I saw I saw a couple this morning where I know what's going to happen. And the only sad part is most people don't know about it, or the ones who think they do know about it, they only have the most superficial understanding. And they think it's something that kids get that makes them jump all over the place and the treatment is to take medication- that's just nothing compared to what the truth is.

Claire : 14:22

For people who are less familiar with it. What are some of the day to day tasks that would be more challenging or different to navigate for someone with this trait?

Ned: 14:29

Anything that involves what we call executive function, planning, organising, prioritising so you know getting to work on time. We are typically late because in our world time is different in our world. There are basically two times there's now and not now. So we say the you know the proposal is due next Wednesday, not now and it's go on until next Wednesday is almost now and then in a panic you get it done. And what happens in a panic It gives your body puts out a lot of adrenaline Well, adrenaline is chemically very similar to the medications we use to treat ADHD. So, so problems with being on time, procrastination is a big issue. Again, we're putting things off until they become stimulating details, you say, something has to be stimulating to grab our attention. Well, the towel you left on the bathroom floor is not stimulating, so you don't even see it. Or the cupboard you left open is not stimulating, so you don't even see it. Even even the car door isn't very stimulating. People leave their car door open, you know, and not because they're bad people, but because they just don't see it. I mean, you know, the extreme is a stop sign, you know, we can see the stop sign, we're not blind, but it doesn't register, we don't comprehend it, turn it into action. When we drive right through the stop sign. Well, that can be lethal. I mean, you know, you can get killed or you can kill someone. Anything that that involves paperwork, boring paperwork, bureaucratic paperwork, we we flub we have trouble with filing tax returns filing, even professionals forget to build their clients, I have several patients who are owed many thousands of dollars, because they haven't sent a bill that customer is perfectly willing to pay it, they just don't send out a bill. And in the other direction, I have many patients who are way behind on owing people, not because they can't afford to pay the bill, but they just forget it's too boring. Anything that's boring, we tend to put off avoid or procrastinate so. And the fact is getting through life in a successful way, requires a lot of attention to boring details. And if you can't do it yourself, then you need to hire someone. And that can be called an administrative assistant, it can be cold a secretary, you can hire a temp, whatever it is, but don't think you can just avoid it. And that's a problem. People with adults with ADHD use avoidance as a coping style that becomes denial. And then you're you're losing it all together in your This podcast is about grief. You know, grief is is something that's notorious for people's tending to deny it, whether they have ADD or not. They don't want to do the feel the pain and who would? Why should you subject yourself to that? It's, it's, it's so painful. But as you know, and your listeners know, you feel so much better if you do and you're showing people that not only is it not to be feared, but it's to be welcomed, because if you don't do it, it tends to spring up years later, you know, someone just goes into a depression out of nowhere, and you look back and oh, yeah, I pretty much ignored my mother's death 20 years ago, you know.

Claire : 18:09

So how do you think somebody with ADHD within, because obviously grief is all in the now it there's a lot of stress hormones flying around, their reaction - how would it potentially differ from somebody who didn't have that trait?

Ned: 18:21

I don't think it would differ at all. It's just that it, it tends to get avoided like anything else. I guess the short answer is there's not a lot of difference. I guess I'm just wanting to emphasise the importance of allowing yourself to feel grief.

Claire : 18:37

And we talk a lot about loss as well. Is there a loss encountered when people are diagnosed with ADHD? Or before they're diagnosed with it? Is there some sort of loss attached to it?

Ned: 18:46

Oh my gosh, a tonne. Depending on how old you are. The immediate reaction, I tell my patients because they have a delayed reaction. And if I'm diagnosing an adult, I say on the way home in the car, don't be surprised if you feel a tremendous wave of of grief and sadness for all the opportunities you missed because of your untreated undiagnosed ADHD. The older you are, the more opportunities you've missed. And then that is often accompanied by a wave of anger. Why didn't someone tell me about this sooner? Why am I 40 years old and just learning about it now? Why didn't I get diagnosed when I was six years old? And so there's loss, grief, and anger. And it's better if you can feel those with someone so you can, you know, not jump out of the way and avoid it. Really feel it. And you know, cry and you know, it's yeah, you missed your chance to go to medical school or you. You missed your chance to become a professional athlete or you missed your chance to ask out that man or that woman that you'd always wanted to ask scout. And it was all because of your ADD or you flubbed your career, because you couldn't show up on time or you went to the wrong meeting. And the instances just pile up of all these things that you missed or did wrong or because you said this huge grief, but you want to deal with it and deal with it means cry over it, grieve over it, mourn it, that's necessary work, just as the anger is necessary. But what you find almost invariably, and this is an interesting thing about ADD, those painful feelings soon give way to a geyser of hope, and excitement, and, you know, wanting to take advantage of the opportunity now that you know what's been going on, and why you've had such difficulty. So it's, if you stay with it, that excitement will come and when it comes new skills, because you'll get your ADD treated. And so you won't you won't be the same person trying to try to do these things all over again.

Claire : 21:06

So just my last question, really, if knowing that having ADHD and that kind of diagnosis was a tool to help people in the last that they've incurred, what kind of tool do you think that is?

Ned: 21:16

I would be eyeglasses, you've been going through life like Mr. Magoo bumping into things not seeing things, missing things, suddenly you get a pair of eyeglasses, and you can see clearly, and that makes a huge difference.

Claire : 21:32

Now, I didn't have time to explain to Ned before we spoke that my tool shed was a garden shed. But fortunately, glasses are something that are useful everywhere, including shed life, especially reading the small print on those tiny seed packets. So I've just added some glasses to my shed for any of you that need those while you're rooting around there. If you want to find out more about Ned, you can check out his website, www.drhallowell.com. And I'll put the link in the show notes. And if you want to hear more about what it's like to live with ADHD and the loss that's encountered through a late diagnosis, then keep listening for our episode with Margaret, which is coming up soon. Thanks for listening to The Silent Why podcast. If you've got a subject you'd like me to chat to an expert on, please get in touch via social media or the website or email thesilentwhy@gmail.com. And let's chat...