What is ADHD?

Attention Deficit Hyperactive Disorder, or ADHD, is a mental health diagnosis that affects about 15 million adults in the United States according to CHADD.org. Symptoms of ADHD can include impulsivity, emotional dysregulation, irritability, impatience or interrupting, procrastination, inattention to detail, and disorganization. According to the National Institutes of Health, the numbers could be higher as a result of undiagnosed individuals unaware that their symptoms are related to ADHD. Particularly true for women, whose symptoms are widely underdiagnosed because of the lack of research in that demographic.

Other Signs of ADHD

• Rejection Sensitive Dysphoria (intense negative feelings from perceived or actual criticism/rejection)
• Maturity delays (typically 3 years according to the National Institutes of Health)
• Time Blindness (inaccurate perception of time leading to lateness)
• Sleep disturbances (dopamine plays a crucial role in our circadian rhythm)
• Poor memory
• Hormone-related complications (Premenstrual Dysphoric Disorder (PMDD), Polyendocrine Metabolic Syndrome (formerly PCOS) and endometriosis)
• Learning difficulties
• Overly meticulous/compulsive (can be misdiagnosed as OCD, anxiety – comorbidity with both)
• Maintaining relationships (life-long feeling a lack of belonging with peers, loneliness, trouble finding “your people”)

Coming to terms with my ADHD

In 2023, already having specialized in ADHD, I began my own journey toward a diagnosis. After voicing my need to turn down the car radio to taste my iced coffee (apparently not everyone needs to do this), a good friend, and fellow ADHD therapist, asked if I’d considered having ADHD. I had not. I had never fully understood the hangups I’d been experiencing my whole life.

Until that point I’d been to numerous therapists validate me for the struggles I’d been experiencing, yet never even a mention of possible ADHD and me never really having a meaningful therapy experience. The issue wasn’t “bad” therapists, but a result of miseducation. I was a statistic and didn’t even know it.

So what does it mean to be the population you’re treating?

Being an ADHD therapist while learning that I had been living with undiagnosed and untreated ADHD elicited terrible, irrational shame, so commonly experienced by those with ADHD. How could I be so well-versed in the disorder yet not know I too was struggling with it? How could no one have ever even so much as questioned it? I was angry. I stayed in this anger for about a year, needing to heal an inner child that had been so lost for so long.

Initially the shame led me to want to minimize my symptoms, make myself small and mask that I was someone who could be diagnosed. I was capable, right? Eventually, with proper assessment, diagnosis and treatment, in addition to a very validating psychiatrist, my life changed rapidly. Most of all, it allowed me to see the ways that my brain was amazing at my job. Whereas before I was simply a participant in my life, now I was the (slightly) more patient observer. Here’s what I learned about my ADHD brain and how recognizing my value taught me that I am a great therapist:

Empathy

Most people assume that empathy is a requirement for being a therapist, but it is not. Plenty of therapists struggle to empathize with others with whom they disagree or possess alternate understandings of the world. With ADHD, many people can detect and process multiple facets of situations, are more sensitive to the environment and are able to feel others’ emotions more quickly. While pattern recognition and high levels of emotional processing may have caused significant hangups socially or environmentally in the past, in the therapeutic setting, they excel. Allowing for less intentional thought to use up precious processing energy, the ADHD brain’s natural inclination to exist this way has made it perfect for listening to clients through their lens instead of through my own.

Tracking and memory

As a client recollects and processes a topic in therapy, they’re often emotionally charged, creating erratic shifts in the way their brain accesses neural pathways mapping their thoughts about the information. The result can be a chaotic story that many can’t follow, often resulting in a history of frustration, miscommunication and/or unintentional gaslighting by the listener.

Contrastly, give an ADHD brain something it likes to focus on and watch it work. Able to not only follow messy neural pathway activation, it’s able to remember the smallest details of someone’s story. In addition, the brain can bounce between multiple emotions and thoughts as a result of working this way; storing exponentially more detailed information about a client’s life by simply spending time listening to that person.

Knowledge and Memory

Unmanaged ADHD can be traumatic to the person living with the disorder. The brain’s constant pursuit of stimuli that produce novelty, excitement and intrigue can be exhausting; leading to unhealthy dopamine-seeking behaviors. When a client is talking about what they’ve experienced, the story is emotionally driven. Not only is the listening ADHD brain able to empathize and track, it also happens to possess a great deal of seemingly random knowledge that the brain has sought across its lifetime for the sole purpose of acquiring dopamine. All of that information is just waiting to be accessed in a brain that loves knowledge for its stimulation, making my brain ideal for therapy.

Though it sometimes gets old losing my keys, my innate curiosity and love for my job and clients, I never forget my clients’ lives. As a result of the brain’s lack of dopamine, novelty is key. When I check in with clients on their happenings, I’m experiencing the story for the first time. Novelty! Contrastly, my daily routines are so ritualized that I can too easily never register the information. That need for dopamine always rules.

Things that help my ADHD when executive functioning isn’t working.

The external hard drive

Writing for some folks with ADHD can be exasperating. If writing is supposed to help the brain keep track and slow down to remember and process, what happens when you can’t get yourself to do it. I teach my clients about the importance of maintaining an external hard drive. This isn’t about regular or coherent journaling, it’s about listening for your brain to tell you when it needs to clear space. Signs that writing may be helpful include overthinking, rumination, confusing thoughts and slow processing. I write out competing information to give it a place to reside while other stimuli take up space in the brain. Externalizing the information gives the brain a chance to process.

A way to cheat the system is to go to the notebook aisle in a store and sit quietly. Hold notebooks that stand out to you. Feel their texture. Smell them. Wait for the dopamine to spike. When you find one you’re excited about, reinforce to yourself how excited you are about this notebook. Finally, carry it around with you. Don’t write in it. Wait for the brain to tell you it needs to clear space. The association with intention, dopamine and necessity will help the brain grow accustomed to seeing it as an option for relief. This, in addition to setting down the need to have entries be well-written or sensical, will help writing feel less performative.

Asking what I want

Always start by asking, “What do I want?” This primes the brain for receiving dopamine, whether or not it gets it from the anticipated source, and teaches self-worth by not requiring a need in order to have value and be deserved. For a brain driven by dopamine, what it wants is key. Unfortunately, most of adulting is not something we want, but instead annoying, pesky tasks that are boring and understimulating. One ADHD workaround I often suggest is to organize your day by framing things as “wants” and doing the tasks that bring us dopamine first. Tasks that produce results, involve excitement or learning and are easy will stimulate dopamine leading to a higher likelihood of staying focused and engaged.

While these are just a couple suggestions, real change happens on multiple levels, at Inner Body Works we can help. It can be entirely overwhelming to not understand your own brain, needing an outside source of information, support and perspective can be great first steps. Don’t go it alone. Reach out today!