4 February 2023
This blog is the result of requests from a few participants of the SMART Recovery group for addictive behaviours. Late last year, people began questioning the reality of Attention Deficit Hyperactivity Disorder and it’s cousin, Attention Deficit Disorder. As a psych student, and as a training RP (registered psychotherapist), I have too little expertise in this disorder but a few good sources of information and some research experience. What that experience told me was to check out the spectrum of sources on this matter to arrive at a more satisfying understanding. Methodologically, that meant quantitative (DSM-5) and qualitative (lived experience) sources.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, from which I learned assessment and psychopathology, just last year, is already outdated. There is now a DSM-5-TR, the latter two letters standing for Text Revision. At some point in the next few years, the DSM-5-TR will become redundant with the publication of DSM-6... I am not rattling on about this for academic reasons but to provide a sense of the emerging state of our understanding of such phenomena i.e., the most empirically rigorous understandings of ADHD and ADD are still changing, evolving, and moving. What is being written here is probably outdated but it is a baseline of understanding for me and any interested readers. So let’s take a look.
To receive a formal diagnosis of ADHD or ADD requires the client to show symptoms/behaviours lasting at least 6 months, in at least 2 settings. Symptoms have to have negatively impacted academic, social, and/or occupational functioning. If the patient is under 17 years, they need to manifest at least 6 symptoms, if over 17, at least 5 symptoms are required for diagnosis.
Symptoms for Inattentive Type
What you’ve just read is an abbreviated list from DSM-5. Below are some comments from a young man kind enough to answer my questions about living with ADHD.
A: People without ADHD can often read something or listen to someone even in the presence of background noise; I really struggle to do that. Organization doesn’t come naturally to people with ADHD, we’re often consistently late and forget appointments or instructions even when we’re working twice as hard to be responsible. People without ADHD seem to be able to just “be” or exist with ease and relative satisfaction without constantly looking for stimulation. They don’t interrupt impulsively as much; they don’t need to move around or constantly find novel things to do. They can generally maintain attention and absorb info even when the subject is boring.
Hyperactive Symptoms
A: I wish people knew that even though our lives can look like a sloppy mess it doesn’t mean we aren’t genuinely trying our best. I don’t know how to put it into words how hard it is to cultivate motivation to do something I don’t want to, like the dishes or homework. Other people seem to have an okay time saying “I don’t love it but it needs to be done.” And I hope people know that when I tune out while they’re talking, it’s often just that I have so many thoughts in competition rather than that I’m uninterested in them.
Motivation is also a huge one. Even simple house cleaning tasks feel impossible and can require multiple clever techniques just to keep a room in decent shape. People with ADHD usually wait unintentionally until the last possible minute to complete a task, but when they do, they can “hyper focus” and actually tend to get it done faster than someone without ADHD.
A: As I mentioned, the “hyper focus” could be a bonus. It also helps me to come up with questions during conversation. Often my problem is that when someone says something, 10 possible branches of conversation just appeared and I fail to pay attention to the actual conversation because I’m trying to make sure I remember all the branches. But if I can write it down, it means ideas come quickly. / Sorry for the long response!
Part of the joy of writing these blogs is increasing my own understanding of various phenomena. The voice of the volunteer who spoke of his ADHD has reinforced my conviction that the most useful research in philosophy-psychology is the most lived, honest, and human data available. Thank you to that kind, and thoughtful young man for more help than he may have realized he was providing.
Dan Chalykoff is working toward an M.Ed. in Counselling Psychology and accreditation in Professional Addiction Studies. He works as a supervised psychotherapist at CMHA-Hamilton where his primary focus is trauma. He writes these blogs to increase (and share) his own evolving understanding of ideas. Since 2017, he has facilitated two voluntary weekly group meetings of SMART Recovery. Please email him (danchalykoff@hotmail.com) to be added to or removed from the Bcc’d emailing list.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
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