Taking Charge of Adult ADHD

January 22, 2021

Do you have trouble concentrating, paying attention, getting organized, planning, problem solving, or controlling your emotions? If so, you may have Adult ADHD. Dr. Russell Barkley, Ph.D, is one of the leading researchers on ADHD, and has written many books to help both kids, adults, and therapists or other helping professionals, understand the condition. I just read Taking Charge of Adult ADHD, which is one of the books he’s written. The book talks about some of the scientific reasons that cause ADHD, and offers strategies to both overcome some of the limitations of ADHD and to help you build on your strengths. As a Certified Home Organizer, I regularly engage in continued education so that I can help my clients achieve their goals. I have dedicated myself to learning as much about ADHD as I can, from a wide variety of perspectives. As I read each book, I make sure to put the authors words into context. I look at when the book was written, what kind of training and experience the author has had, what evidence they have to make the claims that they do, whether or not the author has ADHD or not, and if possible, who their major sponsors are. Taking Charge of Adult ADHD was written in 2010 (eleven years ago, as of 2021). Dr. Barkley is a clinical psychologist and professor of psychiatry. He has been involved with ADHD research since the 1970s, written 27 books and over 280 scientific papers. He is truly an authority on ADHD! But while I do recommend reading this book, please do so with a grain of salt. I don’t believe Dr. Barkley has ADHD himself, meaning that his perspective is coming from that as an observer, not someone that has the condition themself. Something else to take into consideration is that he is a paid speaker for the big pharmaceutical companies. The book gives lots of information about the various medications for ADHD (both stimulant and not). I found that section very informative, yet it’s also important to remember that he has a strong bias towards recommending medication. As you all know, there is a strong stigma about taking ADHD medication. It may not be necessary if you have a mild case of ADHD. But if you have a more severe case, medication (along with dietary and lifestyle interventions) can literally be a lifesaver!

I read this book because I wanted to understand his view on what goes on in the brain for someone with ADHD, and why tasks such as reading comprehension, focus, time management, money management, organization, planning, verbalization, task initiation and completion, goal setting, prioritization and emotional regulation, can be so much harder for someone with ADHD than someone with a neurotypical brain. Getting an ADHD diagnosis can be really validating if you have ADHD. Understanding how and why your brain operates differently than others who don’t have ADHD will help you foster compassion for yourself. It will also help you find new strategies for overcoming your limitations, instead of just “trying harder”. You simply need to just “try differently”. It’s important to get your evaluation from someone who is an expert in ADHD. A lot of mental health professionals don’t understand the disorder, as its symptoms can vary widely. It’s not just the trivial disorder of an inability to pay attention. Barkley says “ADHD is more limiting in more areas of adult life than most other disorders seen in outpatient mental health clinics.”-Dr. Russell Barkley But good news, he also says, “ADHD is one of the most treatable psychological disorders.”

The book goes into depth about the signs and symptoms that indicate ADHD. He also describes many of the stories and experiences that people with untreated ADHD have gone through. Most people think that they don’t have anything wrong with them that more willpower wouldn’t cure. Personally, I have an incredible difficulty with reading attention and comprehension, and have been told all throughout school that I just needed to “practice”. If you’ve ever tried to seek help for something and just been dismissed for needing to “try harder”, you may find this book incredibly healing. “We’ve found that finding a name and a neurobiological reason for many of your struggles is, in itself, therapeutic. When you know what’s wrong, you can stop beating yourself up for not being able to just shake off your problems.”- Dr. Russell Barkley

If you’re experiencing ADHD-like symptoms, it’s important to get a professional evaluation to make sure it’s not also another mental health issue (like depression, anxiety, oppositional defiant disorder, learning disabilities, tic disorders, autism, etc.). But it’s also important to get a full health screen from a naturopath or functional medicine doctor, who will check for underlying issues, to see if there isn’t something else going on like a traumatic brain injury, low/high thyroid, low vitamin D, or other nutritional or mineral deficiency. They can also check you for sleep apnea, bacterial or viral infections, or toxic exposure to mold or other allergens, all of which will have an impact on the brain.

In the book, after describing many of the symptoms of ADHD, Dr. Barkley states, “My work and that of others has shown that all these problems seem to cluster together in three categories. ADHD appears to be a combination of:

-Poor inhibition

-Poor self-control

-Problems with executive functions.

…these three areas are interrelated. Poor inhibition leads to poor self-control, and problems with executive functions can produce four different types of self-control problems.” Here are some examples from the book:

Poor Inhibition

“Difficulty stopping yourself long enough to think about what you’re about to do.”

-Difficulty waiting, impatient

-Impulsive decisions

-Comments to others without thinking

-Difficulty stopping behavior when necessary

Poor Self-Control

“Any response or set of responses that you direct at yourself and your own likely behavior that would lead you do do something different than from what you’re first impulse would dictate”

-Difficulty waiting for a payoff or to put off doing things less rewarding for a later goal

-Action without considering consequences

-Starting projects without reading/listening to the directions carefully

Problems with Executive Functions

“Specific self-directed actions that we use to control ourselves…Scientists divide them up and label them differently, but executive functions generally include abilities like inhibition, working memory, emotional regulation, planning, and attention.

-Poor sense of time

-Forgetting what you’re supposed to do

-Difficulty with reading comprehension

-Easily frustrated

[These are the] actions that we use to stop ourselves, think things over, and guide our eventual behavior. We use these actions of the single purpose of controlling our own behavior toward achieving a better future.

-Non-verbal working memory

-Verbal working memory

-Emotional regulation

-Planning and problem solving (Dr. Russell Barkley)

I found his chapter on executive functions so interesting that I had a conversation with another psychiatric professional about this. He is also an expert in ADHD. His understanding of executive functions differed from the one in the book. For example, planning and problem solving are two very different skill sets, whereas Barkley has grouped them together. Nevertheless, I can assure you that if you are struggling with ADHD, this chapter on executive functions will help you understand your mental processes a bit better, even if the information varies from researcher to researcher.

What causes difficulty with inhibition, self-control, and executive functions? It has to do with how developed your brain is, which areas of your brain are developed (or underdeveloped), and which areas of your brain are stimulated, overstimulated, or under stimulated. Medication can help normalize the neurological imbalances that you may be experiencing.

A variety of brain imaging techniques show that ADHD brains are different from neurotypical brains. Here is a passage from Russell Barkley’s book, Taking Charge of Adult ADHD, that I wanted to share, to explain what he means.

• “Certain regions of the brain are different structurally, mainly being smaller than in those without ADHD:

-the right prefrontal region, associated with attention and inhibition

-the striatal region, associated with pursuing pleasurable or rewarding behavior

-the anterior cingulate cortex, which helps you govern or self-regulate your emotional reactions

-and the cerebellum, associated with the timing and timeliness of your actions, among other executive functions.”

“People with ADHD have less electrical activity in the brain, particularly in these regions, meaning they don’t react to stimulation in these regions as much as others.”
“Children and adolescents with ADHD also have less metabolic activity in the frontal regions.”
The brains of those with ADHD seem to be deficient in or show excessive reuptake of norepinephrine and dopamine. Other neurochemicals may also be involved.”

“We do, however, know how to correct the neurochemical imbalance found in those with ADHD, at least temporarily: medication.

When the neurotransmitters dopamine and norepinephrine are not available in the same measure as they are in typical adults, the messages these chemicals are supposed to send don’t get through as they should. Without the help of of these neurotransmitters, the brain does not respond to stimulation (any input, like an event or an idea or an emotion) the way it should. Impulse control doesn’t kick in when it should. Memories of the past and visions of the future aren’t triggered to keep you mentally on track. And even when they are, they cannot be sustained for very long, leading you to forget what it is you were planning on doing. The motor-control brakes don’t keep you from fidgeting with restlessness.

This is why ADHD medications work (through some operate on other neurochemicals). By causing nerve cells to express more of these neurochemicals, or by keeping the nerve cells from pulling them back in once they’ve been released, they increase communication between nerve cells in regions of the brain linked to ADHD . The two basic categories of drugs approved by the US Food and Drug Administration for use with adults who have ADHD- stimulants and a few nonstimulants- boost your mind’s ability to respond to whatever is going on in your day.” (Dr. Russell Barkley)

For more information on ADHD and Organization, please check out a blog post I wrote in 2019 called ADHD and Organization.

If this blog post interested you, I highly recommend checking out Dr. Russell Barkley’s book, Taking Charge of Adult ADHD. If you want to dive even deeper into brain science, check out Dr. Daniel Amen’s book, Healing ADD. And if you have ADHD and want help getting your home organized, please fill out this form.

When it comes to organizing your home, what part is the hardest for you? Send me a message so that I can cater a blog post to your needs.