I had a video appointment with a new patient this morning.  Video is how I “see” all my patients these days, except those who want to “see” me over the telephone so they don’t have to make themselves presentable, or what they imagine to be presentable.  Video consultation has changed my entire practice, and is changing the whole field of mental health by offering a safe and convenient alternative to in-person meetings.  When the pandemic is over, I intend to continue to offer all my patients the option of video or telephone. For those who want to come see me in person, of course, that possibility will return, but the growth of telepsychiatry it one of the silver linings to the ordeal of the pandemic.

But back to my new patient, whom I will call Jill, and whom I will describe with enough disguise to protect her confidentiality. In her mid-thirties, she described a lifetime of struggling to get organized, do school, manage the details of everyday life, and preserve some semblance of self-esteem despite frequent ridicule, “kidding,” and reprimands from parents, siblings, classmates, teachers, and pretty much the entire world she had to live in every day. Despite all this, she remained upbeat, or at least put up a good front of seeming upbeat.

Recently she’d moved from the deep south to New York to take a new job, while finishing up online classes at the fourth college she’d attended. Despite frequent failing grades, necessitating her leaving one college after another, so strong was her determination and pluck she never gave up on her education. When we met this week she was only two credits away from her degree.  But she was having a ton of difficulty juggling her classwork with the demands of her new job. She’d heard about me from a friend so she booked an appointment.

I described ADHD to her. “I have it myself,” I began, “as well as dyslexia. I wouldn’t trade either for the world. Both of these conditions are vastly misunderstood. In ADHD there is no deficit of attention. Just the opposite. We have an abundance of attention.  Our challenge is to control it. Our minds are always in motion. We have trouble slowing our thinking down. For women with ADHD, the “H” – hyperactivity – may not be there, or it may present differently. The woman with ADHD maybe quiet, appearing like a butterfly with her brain moving between many thoughts, always seeming here and there. And like a butterfly that can float through a field without being seen, her wandering mind and difficulty in focusing may not be noticed, instead she blames herself for not trying hard enough when in fact she is trying so hard.”

Of course, just as with men, women with ADHD have the strengths of the trait too. Like the curiosity which leads to so many wandering thoughts. But that curiosity, once you learn to control it, is a huge asset. You can’t teach or buy curiosity, and we have curiosity in spades. Same with creativity.  We’re naturally inventive, original, outside-the-box thinkers. That’s another asset you can’t buy or teach, creativity, and we are born with it. Once again, the challenge is to control it. And we don’t give up. I see tenacity and a persistence to keep on trying often in my female patients. Things are tough for them, but they keep on going. ”

By now my new patient was smiling ear to ear with tears in her eyes.  “At last I feel understood and seen!” she exclaimed.  We talked on and on, Jill asking me question after question, as her curiosity naturally led her to do.  She was—and is—on her way to a new and much better life.

She was one of millions of adult women who have ADHD but did not know it.  Struggling, never giving up, working all hours, they are doing their best, but they are driving on square wheels.  They manage to get places, but at an enormous expense of effort.  They are underachieving, and they know deep down that they could be doing so much better, if only…

The “if only” is if only their ADHD were diagnosed. But because many doctors do not know much about this condition, and especially how it can present differently in women, if a doctor meets a patient like Jill the doctor tends to diagnose depression or anxiety, which are there to be sure, but both are being created by the undiagnosed and untreated ADHD. The patient gets put on SSRI’s or anxiolytics which help a little bit but do not get to the underlying issue of ADHD.

The largest undiagnosed group in the ADHD population are adult women.  If only practitioners could learn about this, and if only the women themselves could learn about this, huge benefits would follow. They could find out how to tap into their strengths and manage their weaker points. Lost lives would be found, relationships brought back from the brink of failure, and untapped potential finally put to use.

If you know such a woman, or you are one yourself, consider reading my book, Delivered from Distraction, or any of Sari Solden’s books or check out my Distraction Podcast. If you see yourself there, consult with a doctor who does understand ADHD in women or please reach out to one of the Hallowell Centers.

This is such a good news diagnosis, but only if you find it.  Once you catch on to it, your life can only get better, often dramatically so.

Just Wondering…If my understanding of physics is correct, which is a dubious assumption for sure, matter has no matter.  That is to say, materials that have mass, which comprise the category we call matter, are made of bits of energy that have no matter. They weigh nothing.  And yet they make up everything. And everything weighs something. But the component parts weigh nothing. Little (and neither you nor I can possibly imagine just how little) squiggles of energy buzz around and congregate into. . . a rock. Now we all know that you can pick up a rock and throw it at a window, which it will shatter.  But how, I wonder, do odd and ends—which odds and ends I believe physicists call strings–of massless energy combine to create that mass-ive stone I just threw through a window?  How does no-mass create mass?  Of course, I may have it all wrong. . .

I may also not understand this phenomenon either, but I am puzzled how universally accepted is the notion that it is healthy, desirable, and altogether a good thing to love oneself.  Almost every self-help book I’ve ever seen takes it as a given that the more you love yourself, the better off you’ll be.  It is also commonly taken as a proven fact that you can’t love someone else until you love yourself. 

It just makes me wonder, because I know many people who love themselves who. . . really shouldn’t.  I mean, they’re selfish, narcissistic, pushy egomaniacs who add nothing to the world but greed, blind ambition, and self-aggrandizement.  And they love themselves?  What is that love but massive, unattractive, often comical self-deception?  And, I also know plenty of people who deeply love others who can’t find their way clear to loving themselves.  The actual fact is that lots of people can love others but not love themselves.  I dunno, it may just be me, but I think it’s healthier to harbor some lingering doubts about your self than to go whole-hog on how absolutely divine you think you are.

On the flip-side you have the person who truly ought to love him or herself, but just can’t.  I know so many people like this: really awesome individuals who have the hardest time giving themselves much of a break at all.  They’re great people–giving, skilled, contributing to the world—but they only see what they’re lacking, and rarely give themselves a pat on the back for all their wonderful deeds and qualities.  You can offer them compliments and reassurances until you’re blue in the face—as I have done—and they will give a polite “thank you” in reply, but not metabolize what you’ve said at all.  They could read self-help books all day, or go to a Tony Robbins talk every night, but still be left with that gnawing feeling of inadequacy. However, one fact is sure: this group makes for a far better friend than the first group!

Another puzzlement:

We often talk about the problem of evil, but what about the gift of goodness?  Is it just because evil is more interesting than goodness that we give goodness short shrift?  Or is it because goodness is in short supply?  I don’t know about you, but most of the people I know are really good people.  So goodness is not in such short supply.  There are evil people, because I read about them, but I don’t know any personally.  And the fact is, that if you get to know a supposedly evil person, before you know it you’ll probably be finding something you like about him or her. I just wonder why we don’t notice goodness more.

Which again makes me wonder about physics: what are good and evil made of?  Not matter, certainly.  Strings maybe?  But there would be no good or evil without the matter that makes up our brains, so can we say that good and evil depend upon, but are not comprised of matter in real time?

Speaking of which, what’s time? 

Time has no matter, correct?  And it is not comprised of strings, is it?  If a physicist is reading this, please reach out to me and enlighten me.  My question is: What is time? Is it a force, an energy, a wave function, an idea, or what?  We live in time, right? Our time is short, or long, depending on your point of view.  It’s with us always and everywhere.  But where was it before the Big Bang, or whatever started the whole shebang? (And why is it a shebang rather than a hebang?)  Was there time before matter or energy?  And if there was no time, what was there? What comprises nothing?  Nothing?  Ok, then, you know the next question: What’s nothing?

As for time, as of now, we are not able to stop it or speed it up.  Speed it up?  What is the speed of time?  Why do we experience it subjectively so differently, depending on how old we are and what we’re doing?  Sometimes time flies, while at other times each second seems like an eternity.

Okay, I’ll stop.  I just wanted to share with you some of my puzzlements.  I have tons more, but that’s enough for this column.  Thanks for listening, er, reading.  Please email me with your comments and solutions.  I will be most grateful.  I may even love you more than I love myself.

Read Dr. Hallowell’s post “Time Is Precious” to learn how to manage your time.

Listen to Dr. Hallowell’s and learn how to “Stop and Smell the Roses.”

Perhaps you’re asking, why should I worry about feeding my ADHD Brain?  My reply would be, “How many times have you heard it said, ‘You are what you eat?’ “ We know that an unhealthy diet contributes to heart disease, high blood pressure, stroke, cancer and diabetes. It’s ironic, however, that the subject of food rarely comes up when we talk about the mind and the brain – an area where what you eat is as powerful, if not more so, than any medication. It is such an obvious point that it usually goes overlooked.  The most common errors, like skipping breakfast or self-medicating with food, can sabotage the best of treatment plans.

In recent years, the whole field of diet and the brain has really taken off. Gradually, we have come to take nutrition seriously, viewing food as the remarkable “drug” that it is – carrying with it enormous potential to make us well … or to make us sick.

Nutrition and ADHD

When it comes to treating Attention Deficit Hyperactivity Disorder (ADHD) and other cognitive and emotional conditions, diet and nutrition play an important role. If you do not eat properly, you can become distracted, impulsive, and restless, not to mention develop all sorts of other symptoms. You can look like your have ADHD, even if you do not. Therefore, the treatment of ADHD – as well as any effort to lead a healthy life- must now consider diet as an essential component of a proper regiment.

A diet high in carbohydrates, sugar, trans-fatty acids (and all those other ingredients contained in the many processed foods we Americans love to consume) is not beneficial for anyone, least of all people coping with ADHD. People with ADHD need to “feed” their brains with the right kinds of foods. So what are these “right” kinds of foods?

OMEGA-3 FATTY ACIDS

One of the most important recommendations doctors are starting to make to their patients is to supplement their daily diet with omega-3 fatty acids. Current estimates suggest that the average American eats only 125 milligrams of omega-3 fatty acids per day, which is only about 5% of what the average American ate a century ago. Low levels of omega-3 fatty acids lead to chronic inflammation throughout the body, which in turn increases the risk of heart disease, cancer and diabetes. We also know that omega-3 fatty acids increase the levels of dopamine in the brain. Dopamine is the neurotransmitter that ADHD medications act to increase. Therefore, although not yet proven, it is logical to speculate that omega-3 fatty acids may provide a specific nutritional treatment for ADHD.

Tips to “Feed” Your Brain:

1. Always eat breakfast, and eat protein as part of that breakfast. Protein is the best long-lasting source of brain fuel.
2. Eat lots of foods with vitamin C. I say eat because the Vitamin C in pills is not as good as the vitamin C you get from eating fruits and other foods that contain vitamin C.
3. Blueberries and grape-seed extract are rich in antioxidants and may help improve memory.
4. Super blue-green algae may be even better than blueberries for cognition and memory.
5. Eat foods rich in omega-3 fatty acids – like wild salmon, sardines, and tuna.
6. Also take a daily supplement of omega-3 fatty acids, which can be found in fish-oil, as well as in flaxseed, flaxseed oil, and certain other plant sources.
7. Take a daily multivitamin supplement that contains vitamin C, vitamin B-12, folic acid, vitamin E, selenium and others (but be careful not to overdose on the fat-soluble vitamins, which are A, D, E and K).
8. Drink lots of water. This is good for you in many different ways. Eight glasses is a good amount.
9. Finally, eat a balance diet, of course. The meaning of balance changes as we learn more. Avoid junk foods. Try to eat fresh foods, and avoid foods that come in boxes, bags, wrappers, packages or tubes.

NOTE: When it comes to vitamins and any kind of supplements, remember to always consult with your doctor first, who should always supervise what you’re taking.

Wellevate

We want to make it as easy as possible for you to access high quality vitamins and supplements to help you achieve your health goals. That’s why we have opened our own online store called Wellevate. 

With our Wellevate store, you can order the highest quality vitamins and supplements available online and have them shipped right to your home – you can even purchase some of my best selling books including, Driven to Distraction, Delivered from Distraction and The Childhood Roots of Adult Happiness.

Setting up an account with our store is free. Plus we are offering you an exclusive 10% discount and free shipping for orders $49 or more.

Visit our online store: wellevate.me/hallowell

Additional Resources:

Read Dr. Hallowell’s blog post on Family Breakfast.

Click here to learn about “Exercising your ADHD Brain”

Read about Connect: The Other Vitamin C.

This post contains affiliate links.

Most people who discover they have Attention Deficit Hyperactivity Disorder (ADHD,) whether they be children or adults, have suffered a great deal of pain. The emotional experience of ADHD is filled with embarrassment, humiliation, and self-castigation. By the time the diagnosis is made, many people with ADHD have lost confidence in themselves. Many have consulted with numerous specialists, only to find no real help. As a result, many have lost hope. So the most important step at the beginning of treatment is to instill hope once again.

Individuals with ADHD may have forgotten what is good about themselves. They may have lost, long ago, any sense of the possibility of things working out. They are often locked in a kind of tenacious holding pattern, bringing all theory, considerable resiliency, and ingenuity just to keeping their heads above water. It is a tragic loss, the giving up on life too soon. But many people with ADHD have seen no other way than repeated failures. To hope, for them, is only to risk getting knocked down once more.

And yet, their capacity to hope and to dream is immense. More than most people, individuals with ADHD have visionary imaginations. They:

• think big thoughts and dream big dreams;
• can take the smallest opportunity and imagine turning it into a major break;
• take a chance encounter and turn it into a grand evening out; and,
• thrive on dreams

But like most dreamers, they go limp when the dream collapses. Usually, by the time the diagnosis of ADHD has been made, this collapse has happened often enough to leave them wary of hoping again. The little child would rather stay silent than risk being taunted once again. The adult would rather keep his mouth shut than risk flubbing things up once more. The treatment, then, must begin with hope.

Hope is at Hallowell

Come to one of my Hallowell Centers and let us introduce you to my strength-based approach. It begins with a personal connection with you—and your family if appropriate—and one of our clinicians.  We believe in the power of positive connection above all else. Together we turn what you may have thought was a “deficit disorder” into an advantage full of powers that can’t be bought or taught. We open up what you’ve known all along was a treasure chest, but you just didn’t know how to open.

Tips on Managing ADHD

I have ADHD and I understand the struggles associated with ADHD. I know it can take a variety of strategies and tools to manage ADHD symptoms. (And they might not always work.) In this Distraction episode,  I share a few quick insights about how I manage my own ADHD on a daily basis.  One of my tools is self-acceptance. It took me awhile to get there, but now I accept who I am. 

One of the biggest challenges facing people with attention deficit disorder (ADHD or ADD) is maintaining a positive self-view. In this ADDitude article, “All You Need is Self-Love,” Dr. Hallowell, who has ADHD himself, outlines 10 strategies to repair your self-esteem, and ADDitude readers weigh in with their stories of self-acceptance.