Some of the Parts, or Sum of the Parts?

One thing I find fascinating about ADHD is the connection among various features of the disorder, and how that reality parallels the connectedness, or lack thereof, among parts of the ADHD brain. The seemingly separate features of ADHD are all part of one whole, just as separate musical instruments are coordinated as one symphony performance. The brain’s conductor (executive function) coordinates activity in a typical brain, like a symphony conductor coordinates activity of musicians. But an impaired conductor cannot coordinate a musical performance. 

Features of ADHD include forgetfulness, disorganization, inattention, impulsivity,  emotion disregulation, and difficulty activating and sustaining effort. These are parts of one disorder. 

Memory and attention are interactive. You may forget what your partner told you and get accused of not caring, but that might not reflect a simple memory problem. You might not have been present enough to process what your partner said. When your attention is pulled this way and that way, with no inhibition or regulation of input from many sources, you may hear the words without processing a message. The same outcome may occur when your attention is laser-focused on something that overrides your partner’s words. Then she asks you the dreaded question, “What did I just say?” If you have a sense of humor, you might improvise a creative answer to make her laugh. If you have no sense of humor, you might get angry that she is quizzing you like an attorney in court.

If you are not mindfully present enough to process and file a message in your memory, there will be nothing in the memory bank to pull up later. 

Activation (opposite of procrastination) and attention are interactive. If you cannot effectively inhibit attention to all that is vying for it in the moment, you may become immobilized and appear indecisive. If all tasks are equally important, choosing where to start is complicated, and prioritizing is inconceivable. Either way, you fail to start, or you jump impulsively into whatever grabs your unmanaged attention with no regard for priorities. 

Impulsivity and emotional reactivity are interactive. You may get hooked into believing that something external to you caused your emotional reaction. So the fix is external, with no regard for the internal problem (reasoning hijacked by emotion). The meaning you make is not recognized as problematic, as thoughts have become facts. Being impulsive, you react aggressively or defensively to the person or situation that you believe caused your arousal.

I’m often asked, “Isn’t everyone like this?” Most people have some of the parts some of the time. Adults with ADHD are the sum of the parts. They have been like this much of their lives, and are like this in different settings, to the extent that the sum of these features impairs their daily lives. Learning may be affected, or relationships may suffer. Adults with ADHD may underperform at work or become workaholics who neglect their families. Impulsivity may lead to financial or legal problems, or injuries from accidents. 

 We are like cats. All cats are alike in some ways, but I’ve never had one cat who was just like another. Observe a group of adults with ADHD, and you will see individuals who might share little in common except for the features that affect them. Effects can vary widely. ADHD grows up in different homes with different parents, different siblings or no siblings, different levels of support or rejection. It marries different people, some who are understanding and supportive, some who are inflexible and critical. 

I can say with confidence, after 13 years of leading an ADHD support group, that group members recognize each other as being in the same “family” despite our differences. We accept our differences because we are different and wish to be accepted. When people tell me, “You don’t look like you have ADHD,” I still don’t know what to say…but I never thank them.