Do You Have ADHD? | Dr. Mark Bertin
Dr. Mark Bertin, a developmental pediatrician, discusses the difference between ADHD and normal human distractibility, emphasizing that ADHD is a medical disorder disrupting executive function. He shares actionable strategies for managing ADHD that can also improve focus and resilience for anyone.
Deep Dive Analysis
16 Topic Outline
Defining ADHD: Terminology and Executive Function
Distinguishing ADHD from Everyday Distractibility
Historical Context and Prevalence of ADHD
Identifying ADHD in Adults: Persistent Patterns and Subtle Impacts
Understanding Types of ADHD: Inattentive vs. Hyperactive-Impulsive
Six Aspects of Executive Function Affected by ADHD
Causes of ADHD: Genetics and Medical Factors
Strategies for Supporting ADHD: Educational and Non-Medical Approaches
The Role of Cognitive Psychologists and ADHD Coaches
Mindfulness for ADHD: Stress Management and Resilience
The Importance of Self-Compassion in ADHD Care
Health Impacts and Lifestyle Changes for ADHD
Understanding ADHD Medication: Safety and Effectiveness
Navigating ADHD in Professional Relationships
Promoting Neurodiversity in the Workplace
Resources for ADHD Management
6 Key Concepts
ADHD (Attention-Deficit/Hyperactivity Disorder)
ADHD is a medical disorder that disrupts a wide skill set called executive function. It is now used as a blanket term for both the inattentive type (formerly ADD) and the hyperactive type, recognizing its variability over time and situations.
Executive Function
This is a self-management skill set that includes attention, behavior, long-term thinking, goal setting, planning, and coordination. In childhood, ADHD is practically understood as a developmental delay in these skills, which can impact various aspects of life.
Impairment (in ADHD Diagnosis)
To receive an ADHD diagnosis, the condition must chronically and significantly impact an individual's life. This could manifest academically, professionally, socially, or in terms of stress, distinguishing it from common distractibility.
Time Blindness
A core issue in ADHD, time blindness refers to difficulty managing time, keeping track of its passage, and breaking larger projects into smaller, manageable parts. This can chronically undermine daily tasks despite an individual's intentions.
Attention Mismanagement
For individuals with ADHD, attention is not necessarily short, but rather mismanaged. This often results in hyper-focus on tasks that are highly engaging or easy for them, while struggling to focus when demands increase or to shift attention between different tasks.
Externalizing the System
This concept in ADHD care for task management involves recognizing that struggles like procrastination are symptoms of ADHD, not a lack of desire. It emphasizes direct skill-building and creating external supports to manage tasks, rather than simply trying to 'start sooner.'
9 Questions Answered
The term ADHD is now used as a blanket term for all types, including what was formerly known as ADD (the predominantly inattentive type) and the hyperactive-impulsive type, due to the variability of symptoms over time and situations.
To qualify for an ADHD diagnosis, the condition must be a chronic pattern that significantly impacts your life in areas like academics, work, stress, or relationships, going beyond typical human distractibility.
No, ADHD has been described in various forms for over a century, with historical accounts resembling its symptoms. It is primarily a genetically programmed medical condition, and its prevalence rate is consistent globally.
The two main types are the hyperactive-impulsive type (characterized by fidgeting, constant movement, impulsive, and impatient behavior) and the inattentive type (characterized by distractibility, daydreaming, and struggles with organization, planning, and time management).
ADHD disrupts executive function, which is a self-management skill set, impacting attention, action (impulse control), task management (organization, planning), information management (working memory), emotional management, and effort management (neurologic endurance).
The largest cause of ADHD is genetics, making it a genetically programmed disorder. While societal and lifestyle factors can make living with ADHD harder, they are not the underlying cause.
Yes, mindfulness can help with ADHD by improving stress management, resilience, and attention, and by fostering self-compassion to counter self-criticism. It supports the ability to manage challenges, though it doesn't replace other forms of care.
No, if used appropriately for a diagnosed individual, ADHD medications are considered safe and effective, with a high success rate. Taking medication for ADHD is medically comparable to treating asthma or using glasses for vision correction.
Parents can reframe problems by imagining them as executive function challenges, recognizing that a child's struggles are often symptoms of ADHD rather than intentional defiance, which helps remove blame and fosters compassion.
16 Actionable Insights
1. Seek Expert ADHD Diagnosis
If you suspect you have ADHD, consult an expert clinician to confirm the diagnosis, as significant impairment is key and self-diagnosis from online checklists is insufficient. This ensures appropriate support and understanding of your condition.
2. Understand Executive Function Skills
Learn about the six aspects of executive function (attention, action, task, information, emotional, effort management) as they are the core skill set affected by ADHD. This knowledge helps you identify specific areas of struggle and target interventions effectively.
3. Reframe Behavior with Compassion
For yourself or others, view struggles like procrastination or emotional reactivity through the lens of executive function challenges rather than moral failings or lack of motivation. This fosters non-judgmental awareness and opens the door for effective strategies.
4. Work with Psychologist or Coach
Engage with a cognitive psychologist or an ADHD coach to develop specific executive function skills, such as attention management, task organization, and planning. These professionals provide direct skill-building support tailored to individual needs.
5. Externalize Task Management Systems
To overcome procrastination and improve task management, create external systems like reminders, checklists, or breaking projects into smaller parts. This strategy acknowledges that difficulty with task initiation and time management are symptoms of ADHD, not a lack of desire.
6. Practice Mindfulness for Resilience
Integrate mindfulness into your daily routine to manage stress, reduce overwhelm, and build resilience, as ADHD can be an exhausting and stress-producing disorder. This practice helps develop patience and a skilled response to life’s challenges.
7. Cultivate Self-Compassion Daily
Actively practice self-compassion to counter the inner critic and self-judgment often experienced when living with ADHD. This involves acknowledging suffering, recognizing common humanity, and offering yourself kindness and support.
8. Prioritize Foundational Health Routines
Maintain consistent sleep, exercise, and healthy eating habits, as these foundational routines directly support executive function and overall resilience. Neglecting these basics can undermine your ability to manage ADHD symptoms.
9. Consider ADHD Medication
If medically diagnosed with ADHD, discuss appropriate medication options with your doctor without guilt or judgment. When used correctly, medication can be a safe and effective tool to significantly aid ADHD management alongside other strategies.
10. Explore Movement-Based Meditation
If traditional sitting meditation is challenging due to hyperactivity or difficulty sitting still, consider alternative movement practices like yoga or walking meditation. These methods offer equally valid ways to cultivate mindfulness and attention.
11. Structure Meditation Practice for Success
To establish a consistent meditation habit with ADHD, focus on scheduling, setting reminders, and seeking support. This addresses the inherent difficulty with habit formation and planning that can accompany ADHD.
12. Implement Educational/Workplace Accommodations
For children with ADHD, utilize educational supports (e.g., preferential seating, extended time); for adults, explore work accommodations that create a supportive environment for learning and task completion. These accommodations act as a ‘safety net’ for skill development.
13. Communicate Collaboratively and Compassionately
When working with colleagues or a boss who display executive function challenges, focus on clear, non-judgmental communication, define shared goals, and suggest small, realistic steps for improvement. This approach fosters understanding and better outcomes.
14. Strategic Disclosure of ADHD
Exercise judgment when deciding whether to disclose ADHD to a boss. In supportive environments, explaining how your brain works (e.g., challenges with time management, specific strengths) can lead to better collaboration and accommodations.
15. Reframing Meditation Expectations
Approach meditation with the understanding that thoughts will inevitably arise, and the goal is not to stop them but to develop awareness and patience in returning to your anchor. This perspective reduces frustration and makes practice more sustainable.
16. Recognize Unmanaged ADHD Health Risks
Be aware that unmanaged ADHD can indirectly lead to long-term physical health risks due to difficulties in maintaining healthy habits, substance abuse risks, and impaired relationships. This highlights the importance of comprehensive management.
5 Key Quotes
ADHD is a medical disorder that disrupts executive function.
Dr. Mark Bertin
The bottom line is you don't have it if it's not really causing a problem.
Dr. Mark Bertin
ADHD is not a disorder of not knowing what to do. It's a disorder of not doing what you know.
Dr. Mark Bertin
No one responds to yelling by becoming calmer.
Dr. Mark Bertin
ADHD is a planning disorder. So if you have ADHD, you're undermining the plans to manage your own ADHD almost inherently.
Dr. Mark Bertin
2 Protocols
Self-Compassion Practice for Suffering and Self-Criticism
Dr. Mark Bertin (describing Kristen Neff's work)- Be mindful and aware of the moment of suffering you are experiencing.
- Recognize that you are not alone; tens of millions of people are likely feeling a similar struggle, connecting you to a larger community of sufferers.
- Actively send yourself good wishes, which can include supportive self-touch (e.g., hand on heart, hug) and talking to yourself kindly, as you would to a friend or child.
Mindfulness Practice for ADHD
Dr. Mark Bertin- Reframe the meditation process: Understand it's about developing awareness and patience, not stopping thoughts. Whatever your mind is doing is fine; there's no 'bad' meditation.
- Consider movement practices: If sitting still is difficult, equally valid options like yoga or walking meditation can be simpler and more comfortable.
- Prioritize scheduling and reminders: Due to executive function challenges, actively plan and set reminders to establish a consistent meditation routine, treating it like any other habit.