What does ADHD look like?

It’s not always as obvious as the disruptive noisy child who cannot sit still and interrupts others. It’s more than a child who might be inattentive with directions and instructions, a poor manager of their time, or impossibly disorganized with their personal belongings and responsibilities, squandering their talents and golden opportunities.

In adulthood, ADHD might look like the talented executive who keeps falling short due to missed deadlines, forgotten obligations, and social faux pas. It might be the realization that what seems basic and intuitive for your friends and colleagues requires a tremendous amount of mental effort and energy for you. For both adults and children with ADHD, it might be the tuned-out participant who seemingly comes out of nowhere to provide the fresh, creative idea that saves the day. When those with ADHD manage themselves well, they might be imaginative and dynamic teachers, inventors, entrepreneurs, stand-up comedians or trendsetters. The ADHD brain loves to be challenged because it craves stimulation. Boredom is the ADHD brain’s kryptonite!

There is a broader canvas painting how children and adults with ADHD might present. For every perceived shortcoming of someone with an ADHD-type brain, there is an abundance of assets and strengths: creativity, tenacity for challenges, playfulness, and exuberance, to name a few.

In his excellent book on ADHD, ADHD 2.0, child psychiatrist Edward Hallowell MD shows how ADHD can become one’s superpower with the right knowledge, tools, and a whole-body approach.

Dr. Hallowell brings to light that ADHD is a diagnosis with great paradoxical tendencies. Some examples are:

  • A lack of focus combined with an ability to super focus
  • A lack of direction combined with highly-directed entrepreneurialism
  • A tendency to procrastinate combined with an ability to get a week’s worth of work done in half a day

Some telltale signs are:

  • Unexplained underachievement
  • A wandering mind
  • Trouble organizing and planning
  • A high degree of creativity and imagination
  • Restlessness, which improves with physical activity
  • Extreme sensitivity to criticism or rejection
  • Impulsiveness and impatience
  • High energy and accurate intuition
  • Susceptibility to addictions and compulsive behaviours
  • Distorted negative self-image

What’s happening in the ADHD brain?

A simple description of the ADHD brain might be ideas firing around like kernels in a popcorn machine (ideas coming fast on no schedule) or a race car with bicycle breaks. You get the picture—a rapid-fire brain which needs support fine-tuning its breaks to navigate each situation appropriately and safely. It’s not a paucity of attention, rather it’s an overabundance of attention. By learning to control their attention and become self- aware, those with ADHD can leverage their lateral-thinking minds and work in ways that suit them. Functional MRI studies show that children and adults with ADHD tendencies have different scans than those without ADHD.

When engaged in a task, such as cooking, writing an email, or building a sandcastle, an area in the brain called the task-positive network, or TPN, lights up. The TPN is a get-things-done area. But the ADHD brain can become trapped in the TPN, unable to disengage from the task and becoming hyper focused. This can arise with screens and may be why children with ADHD have a hard time disengaging from screens and just generally changing activities and gears.

Then there’s the default-mode network, or DMN. This is the part of the brain that is active when we are in an imaginative, creative, expansive, brainstorming, or daydreaming mode. We can access memories while also looking forward to pondering and planning for the future.

Both networks are essential for our development and integration. But the ADHD brain often gets stuck in the DMN network once their imagination and creativity take them there. They could be stuck in the doom and gloom of memories. According to MIT professor John Gabrieli, the DMN is the chatterbox of the mind, for better or for worse.

In the ADHD brain, functional MRI studies show that when the TPN is turned on, the DMN is also turned on and is trying to pull you into its grasp and distract you. In simple terms, the gears between the TPN and DMN are switched off in the ADHD brain. There is no toggle switch to keep these networks separate in the ADHD brain. The longer a child is in the DMN, the harder it is to sway them onto a different activity or topic. Sound familiar? The longer the screen has been on, the more resistance and maybe even tears there are, especially if the child is overtired and/or hungry. Just switching activities or getting ready for a new activity can be challenging and exhausting for caregivers.

Our brains can change!

The science of epigenetics has proved that the brain has a wondrous ability to change over the course of our lifetime. Neuroplasticity is one of the major discoveries in neuroscience in the past generation, and our lifestyle is bountiful, dynamic medicine—it can have a tremendous impact on our physical, mental, and emotional health. What we do, how much we move, what kind of stress we experience, if we have a pet, if we laugh a lot … these experiences constantly change our brain in subtle ways, day in and day out.

Like a muscle, the brain needs training and conditioning, and it needs time in the TPN. There is also research learning that shows that treating the cerebellar system in the brain, which controls balance and proprioception, can improve ADHD symptoms.

A child’s brain cannot regulate itself. Some children can regulate their behaviors and emotions better than others, but impulsivity and an inability to delay rewards are the hallmarks of being a child. Adolescents, especially males, are prone to impulsivity. In an ideal world we teach and nurture our child’s ability to manage his desires and impulses, and their behaviors become intrinsically motivated to want to feel good and do good. We model and teach them how to delay rewards until their work is done, and we show them how to stretch for their pleasures—a walk to the ice cream store versus a trip to the home freezer.

Helping a child with ADHD thrive using Lifestyle Medicine

  1. Review the day’s schedule with them more than once. Start the night before, if possible. When children know what to expect, this can foster smoother transitions. Focus on a schedule that is not highly regimented.
  2. Oversee their screen time. Hold out on giving them their own devices for as long as you can. Once you do, write down and review clear time limits for screen use and differentiate between a learning program and video games. It may still be difficult to remove their screen when time is up, but connect and sympathise with them Explain that you realize how hard it can be to have the screen removed, but it’s your responsibility as their parent or caregiver.
  3. If your child is constantly asking for something or someone (screen time, their favourite friend) and cannot change gears, connect with them and guide them into another activity: put on their favourite music and dance, get out a game or a deck of cards, or stroke their hair and just be with them. It takes time, but the reward is a child who can reconnect with themselves.
  4. Emphasize human connection and physical activity when they are restless or in a state of craving. These tonics can stimulate their brains and regulate their emotions, helping them be present and feel connected to themselves and others.
  5. Time outdoors in nature can nourish their creativity and imagination and provide an outlet for their energy and focus, even a simple walk.
  6. Read aloud to your child every night or read together while sitting beside each other. Ensure the sides of your body are in physical contact.
  7. Hug or tickle them a lot, especially if they are reprimanded for impulsive or intrusive behaviour outside of the home in school or classes.

Fun Hacks

  • Get a wobble board with a rounded bottom that is hard to balance on. Have them stand on the wobble board for up to 5 minutes. Then, have them do it with their eyes closed.
  • Have them stand on one leg for 1 minute or until they fall over.
  • Have them do a low plank and hold it for up to 3 minutes.
  • Consider getting a dog, if you can manage the work.
  • Post random numbers on the walls at home or outside on trees and objects, then call out numbers one at a time and have the kids race to find them.
  • Lay out 5 cards on the floor. While standing on one leg, have them bend over and pick up one card at a time.
  • Ask your child to choose a favourite song or make a play list and encourage singing, moving their body, or dancing. You may need to remind them to put the phone down once the song starts!
  • Encourage connection through active listening. Ask about their day, and have them recount stories from the day or tell about something special that happened.

Lastly, excellent resources rounding out a holistic approach to managing ADHD in children and adults is Gabor Mate’s international bestselling book Scattered Minds: The Origins and Healing of Attention Deficit Disorder. It’s not just about our biology, it’s about nurturance and our family environment and culture.

Seek out a healthcare professional who has training in nutritional and natural medicine. Diet and supplements and some gentle herbs can support the ADHD brain and body very well.

Dr. Bryn Hyndman MD