Chapter 2: Many Roads Not Traveled

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Okay,

so diving in today, we're looking at ADD and I know a lot of you have been asking about this and sending some really interesting stuff.

Yeah, for sure.

We're going to try to kind of get to the bottom of like, what is it really?

Yeah, a deep dive.

You know what I mean?

Like the nuts and bolts.

All right, we're not messing around.

We're not messing around, yeah.

We're going deep.

Exactly, and I think from the get -go, like the sources kind of lay out three main things that are always coming up, right?

Like attention, impulsivity, and then you know what we think of is like hyperactivity.

Yeah, the classic.

Yeah, and what's interesting is they say that you only need like two of these to be significant for understanding it.

Oh really?

I didn't realize that.

Yeah, so it's not necessarily like you have to have all three.

Okay, interesting.

Yeah, so let's dive into this attention thing, right?

Like this idea of just tuning out.

Oh yeah, that's a big one.

Huge, yeah, and it's like the material describes it as like almost like a hallmark of it, right?

This automatic, like it's not even on purpose.

Yeah, this unintentional kind of lack of presence of mind.

Yeah, and it's funny because sometimes people think that it's like a choice, you know?

Like you're choosing to not pay attention, but it's not like that at all.

It's just like something that happens.

It just happens, yeah, and it's so frustrating, right?

Like you're talking to someone and then suddenly you realize like, oh shoot, I didn't actually hear anything they just said.

Like what did you just say?

Yeah, or you're looking at something and it's like you didn't even see it even though you were looking directly at it.

Right, it's like your eyes are just kind of glazed over.

Totally glazed over, yeah.

Staring into space.

And even when you're really trying to concentrate, right?

It's like your mind just wanders off.

And you can't get it back.

So annoying, so annoying.

And it really does have a big impact like in the real world, you know?

Like the source talks about missing important instructions or like always losing your keys, you know?

Just constantly searching for things.

I mean think about like how many times you've been, you know, looking for your phone and it's like in your hand or something.

Oh my gosh, all the time.

Right, and then like following conversations too.

Oh yeah, that's a tough one.

It's so tough because it's like you miss a little bit and then you're constantly trying to catch up and it's just exhausting.

Totally.

And it's not just like practical stuff either, you know?

Like it can even affect how much you enjoy things.

Totally.

Like I remember this one example from the material about a high school teacher who loved music.

Okay.

But they said that after like just a few notes, their mind would start to wander.

Wow.

So even though it was something that they were really into.

Yeah, like something they should be enjoying.

Yeah.

But their brain just couldn't stay focused.

And it's like you can't control it.

No, it's not like a conscious decision.

And what's really interesting is how they talk about this feeling of being disconnected, right?

Like from the present moment.

Yeah, almost like a disembodied separation they call it.

Right, like your head is somewhere else.

Exactly, like you're not really there in your body.

They have this analogy of like a human giraffe.

Oh yeah, that's a good one.

You know, like your head's way up there, your body's down here.

Right, like they're not even connected.

And it's more than just being distracted.

It's like a real disconnect.

Yeah, fundamental disconnect.

Yeah.

Okay, so that leads us into this whole thing about distractability and you know, what seems like a short attention span.

Right, but the material makes a good point here.

It does, right?

It's not that you can't focus at all.

Exactly.

It's more like it depends on the situation.

It's situational, yeah.

And they really emphasize that when someone's really interested in something, then that distractability and the short attention span, they're not as noticeable.

It goes away.

They can even be totally absent sometimes.

Really?

Yeah.

Wow.

So it's not like a blanket inability to focus.

Right, right.

It's more like there are certain things that just grab your attention.

That your brain latches on to.

And it's hard to break away from.

Yeah, it's almost like there's this active not noticing going on.

Oh yeah, they talk about that.

Like that example, like you have a new decoration in your house.

Right.

And it's been there for like weeks

and you suddenly notice it.

Like you've never seen it before.

What is this?

I've never seen this before.

Yeah, and it's not that you're intentionally ignoring it.

No.

It's like your brain just doesn't register it.

It filters it out.

Yeah.

And so this distractability kind of leads to this sense of chaos.

Right, for sure.

Because it's like you start doing one thing.

Right.

And then you get distracted by something else.

And then something else.

And then something else.

And it's just like this chain reaction.

They had this great example in the material about trying to clean your room.

Oh yeah.

And it starts with like putting away a book.

Okay.

But then you see a poetry book and you start reading a poem.

And then that reminds you of Greek mythology.

And then you remember that you have laundry to do.

And then the phone rings and you end up on a long phone call.

Oh my god.

And by the end of it, your room is still a mess.

Yeah.

But you've done like five other things.

You've gotten nothing done.

Right.

It's like your attention is just pulled in a million different directions.

Like a pinball machine in there.

Yeah, exactly.

So this kind of ties into this really interesting idea about a lack of a mental template for order.

Oh yeah, that was a fascinating concept.

I've never thought about it like that before.

It's not that you can't picture what a clean room would look like.

Right.

It's more like you don't have that internal roadmap of how to get there.

How to actually do it.

Yeah, like what are the steps involved?

The steps, yeah.

And how do you maintain it once you've achieved it?

Right.

So it's not about not wanting to be organized.

No, it's not a lack of desire.

Yeah, it's like a fundamental difference in

how your brain approaches it.

Exactly.

And I think that's so important because it helps to kind of

destigmatize it a little bit, you know.

For sure, because it's easy to judge someone and think that they're just lazy.

Right.

But it's not like that at all.

No, it's like a real neurological difference.

Yeah.

And that part about like being reluctant to get rid of things.

No, yeah, that's so relatable.

So relatable.

Right, like maybe I'll need this someday.

Even though you haven't touched it in years.

Exactly.

And it creates this feeling of like you're just shifting chaos around.

Yeah, you're not really making any progress.

You're not actually conquering it, yeah.

And even if you do manage to get organized, it doesn't last.

It doesn't last.

Why?

Because you're constantly losing things and having a search for them.

And then you mess everything up again.

Yeah, it's like this ongoing battle.

They call it the law of entropy or something.

Yeah, it's like the universe is conspiring against you.

Totally.

Okay, so let's talk about physical coordination.

Okay.

Because this is another area that comes up.

And it's interesting because they point out that some people with ADD actually have amazing mechanical skills.

Oh, really?

I didn't know that.

Yeah, it's like this kind of unexpected thing.

Yeah, because you tend to think of ADD as being associated with clumsiness.

Right, exactly.

But it just goes to show that it's a really complex condition.

Yeah, everyone experiences it differently.

Right.

However,

like the source does say that for most people.

Yeah.

Difficulties with coordination are more common.

Okay.

Especially like fine motor skills.

Like dropping things.

Yeah, dropping things, bumping into things.

Tripping over your own feet.

That kind of stuff.

And then there's this whole thing about understanding three -dimensional stuff and spatial relationships.

Oh, yeah, that can be a real challenge.

And it's like even when someone explains it to you clearly, it's like your mind just kind of glazes over.

Like you can't picture it.

You can't picture it, yeah.

They give this example of trying to visualize a room layout just from like a verbal description.

Oh, yeah, I can imagine that being super frustrating.

Super frustrating.

Especially if you're trying to like follow directions or something.

Oh, yeah, like getting directions.

Yeah, and you're just nodding along, like you understand.

Right, right.

But really, you're completely lost.

You have no idea where you're going.

Yeah, and it's like asking for clarification doesn't even help.

No, because you can't visualize it.

Right.

They say that like 75 % of the time.

Oh, wow.

If there's like a 50 -50 chance of which way to go, you'll take the wrong turn.

Oh, my God.

75 % of the time.

That's crazy.

So this weak visual spatial sense.

Right.

It kind of explains why order just doesn't stand a chance.

Yeah, it all ties together.

It all ties together, yeah.

Like the distractibility and the spatial reasoning difficulties.

Right, it's like a recipe for disaster.

Pretty much.

Okay, so now we're getting into like a bit of a tricky area because

the material talks about this thing called inconsistent distractibility.

Okay.

But then also talks about hyperfocus.

Right, so how does that work?

Yeah, and this is where like really understanding the nuances is important.

Totally.

Because,

you know, it's easy to see someone with ADD like totally engrossed in a video game for hours.

And you think, oh, well, they can focus when they want to.

Exactly.

But the source makes a really clear distinction here.

They do.

Between that intense,

like, compulsive hyperconcentrated attention.

Right.

And the ability to actually regulate your attention.

So it's not just about being able to focus on one thing.

No.

It's about being able to shift your focus when you need to.

When you need to, yeah.

And to not get so sucked in that you lose track of everything else.

So like even if you're

hyperfocusing.

Yeah.

You're still not really in control.

Right.

It's like your brain is stuck on that one thing.

It's like a runaway train.

And it can't stop.

And the type of attention matters too.

Oh, yeah, for sure.

Like they talk about passive attention.

It's like watching TV.

Yeah, where you're kind of just zoning out.

Yeah, your mind can wander.

Versus active attention, where you're actually like engaged in doing something.

Like working on a project.

Yeah.

And the point is that it's often active attention.

Right.

That's the hardest for people with ADD.

Especially when it's like structured work or something that's not inherently interesting.

Right.

So just because you can focus on something you enjoy.

Doesn't mean you don't have ADD.

Exactly.

It just means that you need a different kind of motivation.

Yeah.

You need that personal hook.

Like they quote this psychiatrist who says that the difficulty is in arousing motivation without personal interest.

Without that spark.

Yeah.

And it's not just about willpower.

No.

It's about how your brain is wired.

Yeah.

And that leads us to this idea that like ADD can look different in different situations.

Oh, yeah, absolutely.

It's not like this consistent across the board experience.

Right.

They give the example of a kid who does really well in some classes.

Right.

But struggles in others.

Yeah.

And that can be confusing for people.

Because it seems like they're choosing when to focus.

Right.

Like they're just being lazy or defiant.

But it's not like that at all.

No, it's more complex than that.

Yeah.

And unfortunately that can lead to people getting judged.

You know.

Oh, yeah, for sure.

Like teachers or parents thinking that the kid is just not trying hard enough.

Right.

But it's important to remember that there are these deeper emotional and neurological factors at play.

Totally.

It's not just a matter of willpower.

Right.

OK.

So let's move on to the second big characteristic.

Impulsivity.

Oh, boy.

And this is both in terms of like what you do and what you say.

Right.

And often with like poorly controlled emotional reactions.

Yeah.

It's like this package deal.

Yeah.

And this is another one that seems to really common.

Super common.

Yeah.

Like having trouble not interrupting people.

Oh, yeah.

Or waiting your turn.

Right.

Or saying or doing things without thinking about the consequences.

Yeah.

Like putting your foot in your mouth.

All the time.

And the source points out that like the consequences are usually negative.

Yeah.

It's like you can predict it almost.

You can totally predict it.

Yeah.

You know it's going to happen.

And they have this quote from this 33 year old guy who says like, Oh, yeah.

What was it?

I want to control myself, but my mind won't let me.

So frustrating.

So frustrating.

And it's not just like words and actions either.

No.

There's this whole thing about impulse of buying, too.

Oh, yeah.

The shopping sprees.

Yeah.

Like that urge to just buy stuff without thinking about it without thinking about it.

Do I need this?

Can I afford it?

Nope.

Don't care.

Just buy it.

Just buy it.

Yeah.

They have this quote that says impulse by the whole world.

I know.

It's like you just want to acquire everything.

Everything.

Yeah.

And it's hard to resist that urge.

It's so hard.

Yeah.

Okay.

So now let's talk about hyperactivity.

Okay.

So this is the third one.

And they point out that it's not always like super obvious.

Right.

It's not always the kid who's bouncing off the walls.

Exactly.

Although it can be that sometime.

It can be.

Yeah.

But it can also be more subtle.

Like what?

Like fidgeting.

Okay.

Tapping your feet.

Chewing on things.

Talking a lot.

Okay.

I get it.

And sometimes it can even be absent.

Really?

Yeah.

Especially in girls.

Yeah.

They might just seem inattentive.

So they might get missed.

Yeah.

They might slip through the cracks.

Because people are looking for the hyperactivity.

Right.

But it's important to remember that you don't need hyperactivity for a diagnosis.

No.

It's not a requirement.

But when it is present,

it can be really intense.

They had this anecdote about a 27 -year -old woman.

Yeah.

Who was constantly speeding.

Oh my gosh.

She just couldn't help herself.

Yeah.

And it's not like she was trying to be reckless.

No.

It was like this internal drive.

And it couldn't slow down.

And a lot of kids with ADD, they're really talkative.

Oh yeah.

Like nonstop talking.

Like little chatterboxes.

Yeah.

There's this one kid they called Talk Bird.

I love that.

And the source suggests that it might be because they feel kind of cut off.

Oh interesting.

And so they're trying to connect with people.

By talking.

Yeah.

Like they need to fill the silence.

And then adults with ADD, sometimes they talk really fast.

Oh yeah.

I've noticed that.

And the source explains that it's because they have so many thoughts.

And they're afraid of forgetting them.

So they just blurt them all out.

They just blurt them out.

Like a fire hose.

Yeah.

So that brings us to this idea of internal restlessness.

Okay.

And an aversion to boredom.

Right.

It's like the ADD mind is always on the go.

Yeah.

It's like a perpetual motion machine.

They even call it that in the source.

They do?

Yeah.

And it's not just like external restlessness.

Yeah.

It's like an internal lack of stillness.

Yeah.

There's this constant background static.

Like white noise.

Yeah.

Never ending.

And they talk about this idea of organic drivenness.

Right.

Like it's just part of who you are.

Yeah.

And this was identical way back in 1934.

So it's not a new thing.

No.

It's been around for a while.

And they have all these personal examples.

Yeah.

Like your experience of never being able to just relax.

Right.

Like I always feel like I need to be doing something.

Even if you don't know what it is.

Exactly.

And your son saying like I should be doing something but I don't know what.

Yeah.

It's like this constant nagging feeling.

It's so relatable though.

Yeah.

I think a lot of people feel that way sometimes.

Maybe.

But for people with ADD it's like all the time.

It's amplified.

Yeah.

And they have this amazing story about this 85 year old woman.

Oh yeah.

Who started taking Ritalin.

Yeah.

And for the first time in her life she experienced stillness.

That's incredible.

It's like her brain finally calmed down.

Wow.

So this restlessness though it kind of coexists with procrastination.

Right.

Which seems counterintuitive.

It does.

Yeah.

But the source explains that it's because people with ADD need this immediate sense of pressure.

Okay.

Or reward.

To get motivated.

Yeah.

Without that adrenaline rush.

It's hard to get started.

And you talk about how you used to do all your schoolwork at the last minute.

Oh yeah.

I was a master procrastinator.

But then if there was something you wanted immediately.

Right.

You wouldn't procrastinate at all.

No.

It was like I had to have it right now.

Yeah.

It's all about the immediacy.

The immediacy yeah.

So another thing that comes up a lot is memory lapses.

Oh wow.

Which can be super frustrating.

Oh totally.

They have a funny example about a guy named Brian.

Okay.

Who would always forget to take bags with him when he walked his dog.

Oh no.

So his dog learned to pick up poop with its mouth.

Oh my God.

And carry it home.

That's amazing.

I know it's like the dog had to compensate for Brian's forgetfulness.

The dog's like well if you're not going to do it I will.

Exactly.

And I have to share this story because it just happened to me the other day.

Oh what happened?

I was at the It's like your brain just doesn't hold on to the information.

It's like a sieve.

Yeah.

Okay so this brings up this question of like how can people with ADD be successful.

Right because clearly a lot of them are.

A lot of them are yeah.

Like they have successful careers and all that.

But the source makes the point that it's not always easy.

Right it can be a real struggle.

And it's important to remember that ADD can range in severity.

Totally.

So some people might have it more mildly.

While others have it more severely.

And it can present differently too.

Absolutely.

And they actually talk about your own experience with school.

Oh yeah.

Like how you got into medical school later.

Yeah.

And you had trouble with studying consistently.

Time.

And they even mention that mixed up with the Shakespearean European literature exams.

Oh my God don't remind me.

I know that's a classic example.

This is so embarrassing.

But it just goes to show like these things happen.

They do.

And it's not because you're not smart.

Right it's just that your brain works differently.

Exactly.

And it's interesting because the source says that once you got into medical school.

Yeah.

You actually became more engaged.

I did yeah.

Because the work was more hands on.

It was yeah.

And there were more deadlines.

Which kept me on track.

So it was like the structure of medical school actually helped you.

It did yeah.

Interesting.

So that kind of brings us to this idea of unfulfilled potential.

Oh yeah.

That's a sad one.

It is yeah.

Like the adult with ADD who looks back on their life.

Yeah.

And sees all these plans that never came to fruition.

All these things they started but never finished.

Yeah there's this quote that says I am a person of permanent potential.

I know it's heartbreaking.

Because it's like you have all this potential.

Yeah.

But you can't seem to tap into it.

It's like this constant cycle of starting things.

And then getting distracted.

Or losing interest.

Yeah and then moving on to the next thing.

And the next thing.

And it's like a trail of unfinished projects.

Unfinished projects yeah.

Like the half built boat in the garage.

Oh yeah.

Or the retainer wall that's been sitting there for years.

Right it's like this monument to unfulfilled potential.

Okay let's talk about social skills.

Okay.

Because this is another area that can be really tough.

Totally.

And it's often not talked about as much.

Right.

It's kind of like the invisible struggle.

And the source talks about ADD can make it hard to understand social boundaries.

Yeah like personal space.

Yeah and they talk about this thing that happens in childhood.

Okay.

Where kids with ADD might have this really strong desire for physical and emotional contact.

Okay.

But it can be overwhelming for other people.

Right.

So they might get rejected or pushed away.

Which can be really hurtful.

And it can kind of set the stage for future social problems.

Because then you start to feel like you don't fit in.

Yeah and you might start to avoid social situations.

And there's also this thing about like

not being able to read social cues.

Oh yeah.

So you might say something that's inappropriate.

Or misjoke.

Or not realize that someone's upset.

And that can lead to people thinking you're rude or insensitive.

Yeah and it's not intentional.

No it's just that your brain isn't processing the information the same way.

Right and it's heartbreaking to think about kids going through this.

It is yeah.

Like being ostracized by their peers.

Just because their brains work differently.

That's not fair.

But the source does point out that some kids with ADD are actually really good socially.

Yeah they might be like the class clown.

Okay.

Or the life of the party.

But they might still be struggling underneath.

Yeah they might be masking their insecurities.

Right it's like they've learned how to compensate.

Exactly.

Yeah.

But even adults with ADD can still have social challenges.

Yeah for sure.

They might come across as aloof or arrogant.

Right.

Or overly talkative or intrusive.

They might joke around too much.

Or interrupt people.

Or change the subject abruptly.

Yeah and they often talk really fast.

And they have this quote in the source that's like.

What is it?

I have never finished a thought in my life.

Oh my god that's so relatable.

I know and they talk about this palpable intensity.

Yeah like you can just feel it.

That can make people uncomfortable.

And use these analogies like being from Mars.

Or being excluded from the nice person's club.

Which really captures that feeling of being on the outside.

Yeah like you're not part of the group.

And they talk about this tendency to like gravitate towards the periphery at social events.

Right like you're not really in the thick of things.

Yeah and they talk about this feeling of not being able to enter into the spirit of things.

Like you're watching everyone else having fun.

But you can't figure out how to join in.

And there are these quotes from patients who talk about like how hard small talk is.

Yeah and how they're always afraid of saying something stupid.

Or they get bored with superficial conversations.

It's like they need more depth.

They need more substance yeah.

Okay so the source also touches on humor and mood swings.

Oh yeah they talk about how people with ADD often joke around a lot.

Right like it's a defense mechanism.

Yeah and they have this funny quote that says one crouton short of a caesar salad.

I love that.

Me too and they talk about how kids with ADD might be the class clown.

Yeah it's a way of getting attention.

But it can also be a way of masking their struggles.

Right like they're trying to make people laugh.

So they won't notice the other stuff.

And then there are the mood swings.

Oh yeah.

Which can be really unpredictable.

Unpredictable yeah.

Like one minute they're happy.

And the next minute they're sad.

Or angry.

Or frustrated.

Yeah and it can be hard to know what triggers it.

It's like a roller coaster.

And adults with ADD they can have mood swings too.

Yeah they might have good days and bad days.

And it's not always clear why.

It's like there's no rhyme or reason to it.

Right it just is what it is.

Okay so to wrap things up.

Yeah.

The source concludes this whole exploration with this really powerful idea.

Oh yeah.

This underlying feeling.

Okay.

That no matter what your symptoms are.

Yeah.

There's often this persistent sense of having missed out on something.

Like you're not living your life to the fullest.

Exactly.

And that's really sad.

It is yeah.

Because it's like you're always striving for something.

Yeah.

But you never quite reach it.

So to summarize everything we talked about today.

Okay.

We looked at the three main features of ADD.

Right.

Attention problems, impulsivity, and hyperactivity.

And we talked about how they can manifest in different ways.

Yeah like distractibility, disorganization, spatial reasoning difficulties,

inconsistent focus, hyper focus, impulsive actions and words,

poorly controlled emotional reactions,

physical restlessness, and aversion to boredom, procrastination, memory lapses, social skills challenges, and mood swings.

It's a lot to take in.

It is yeah.

But hopefully this deep dive has given you a better understanding.

Of what ADD really is.

And how it affects people's lives.

Absolutely.

And we made sure to cover everything in the material you sent us.

Yeah.

No stone unturned.

So for you, our listener.

Yeah.

Think about all these characteristics we've discussed.

Uh huh.

And how they might impact different areas of life.

Like work,

relationships, school.

Everything.

Yeah.

And what other questions do you have about ADD?

That's something to ponder.

It is.

Thanks for joining us for this deep dive.

Yeah it's been a great conversation.

I'm glad we could do this.

Me too.

See you next time.