The Truth About ADHD with Dr. John Ratey | Being Well Podcast

hey everyone welcome to being well I'm Forrest Hansen if you're new to the podcast thanks for joining us today and if you've listened before welcome back I'm joined today as usual by Dr Rick Hansen Rick is a clinical psychologist a best-selling author and hey he's also my dad so Dad how are you doing today I'm really good and one thing that makes it really good is this opportunity to talk with Dr John Rady who's a world-class expert on ADHD and remarkably a world-class expert on several other things as well so this should be a really good conversation yeah I've been looking forward to this one a lot we've somehow made it this far in the history of the podcast without having a formal ADHD episode a true oversight on our part but we've been waiting to talk about it with somebody like John so Dr John Rady is an associate clinical professor of Psychiatry at Harvard Medical School and internationally recognized expert in neuropsychiatry and the author of 11 books including spark and the driven to distraction series with Dr Ned Hallowell when driven to distraction first came out in 1992 it really truly revolutionized popular understanding of ADHD and John and Ned recently released their newest book in the series ADHD 2.0 which if you're watching the video is right behind me right now and it's probably worth mentioning here that Dr Rady and Dr Hallowell are speaking from their own experience because they themselves have ADHD so John thanks for joining us today how are you doing oh I'm doing fine I'm here in Hawaii and uh loving the weather uh and want to share with everybody but can't do that but yeah no I'm excited about uh about seeing Rick again uh it's been too long so glad to be back with you and your podcast sounds great and your son is wonderful oh thank you John that was like the most Earnest introduction we've like ever gotten on the show that's fantastic uh I've got the atmospheric river by the way going outside of the window right now so if you hear a bit of wind in the background that's what's going on and uh anyways to start the kind of content of the podcast today we have come a very long way in the popular understanding of ADHD since driven to distraction came out roughly 30-ish years ago what do you think remains some of the biggest misunderstandings or misconceptions that people have about ADHD I mean they're they're misconceptions everywhere amongst the populists amongst patients and amongst psychiatrists and other doctors some doctors still say they don't believe in ADHD which is you know freaks us out don't believe in ADHD when when even when we wrote driven instructions it was the most research disorder in all of Medicine and certainly in Psychiatry and certainly in job Psychiatry but people still don't believe it because they they because everybody has a bit of it right everybody doesn't have enough attention and they can relate to it and they just say buck up you know get with it and I think it's still a really big issue with the ADHD because there's so many people that can be helped just by being aware that this is their their quirky kind of brain that has many benefits and many problems or not even problems but difficulties and sometimes problems but the benefits are great and so people need to know that that it is real and it can be helped quite significantly just by understanding and beginning to to make up their own plan for their way their brain works so you mentioned a second ago the word benefits and that gets to something that I really appreciated about your approach because to be disclosing and it's something that she's talked about publicly my partner Elizabeth has ADHD she was diagnosed with that semi-recently relatively late in life and when you first start encountering it as a diagnosis there's a set of symptomology that people commonly attribute to it that for starters can sound pretty dire and can sound pretty negative it could sound like you know you're kind of messed up in the head and hey this is just something that you're gonna have to deal with for the rest of your life but what I really appreciate about your work is that you guys take a really strengths oriented approach in the book and you're very clear about these benefits that can be associated with ADHD even framing it from time to time is like an evolutionary advantage in certain kinds of situations and I was hoping you could take a moment to kind of explain that to people because it was just really helpful for me personally it really can be and it is an advantage many of our I mean a computer for instance what we're talking on right is made by a lot of ADHD people [Laughter] our offices were right next to MIT in Cambridge and this was during the time of the evolution of of the computer and we had a lot of people from MIT both students and professors who sought our services and the MIT Medical Faculty had us come over there to talk to them to educate them about ADHD and this is in the 80s right and beginning the 90s and they we were just sort of recognizing that you didn't have to be a child to have ADHD super bright people like we saw at MIT in at Harvard they could compensate for it so it it never was missed so it was seen as they were quirky or you know four plus brilliant and no one could understand them they they had problems you know even with IQs of plus 160 with getting things done with be getting distracted with getting too angry with getting too overwhelmed with ruminating too much well the problems that we also see with ADHD so I got a copy of your book I was a newly minted licensed psychologist I think when your book came out it was kind of my Bible in a lot of ways and I want to share with you an understanding of this territory and to check it with you okay so I think of normal neurological temperamental variation you know constitutional variation of temperaments and so if we think of three dimensions impulsivity distractibility and stimulation seeking we can think of people on a range of those dimensions and we could think of people who then cluster high on destructibility and then as you well know there's kind of a related cluster high on impulsivity and stimulation seeking and then a cluster of all three high on destructability high on impulsivity and high on stimulation seeking they're just at that end of the normal temperamental range so for me that's how I've thought about it and it's not good or bad it's a it's a matter of functionality and fit and I've reflected that through evolution in which are human and hominid ancestors lived in small hunter-gather bands it was actually adaptive to have temperamental diversity in the bands and um the problem today is one of fit that to be someone who in a hunter-gatherer environment or 100 years ago maybe in a more rural setting was just wonderful creative of kind of impulsive looking for the new thing active that was wonderful but it's tough to be that 10 year old or six-year-old kid in a standard conventional classroom or 30 years later in a corporate cubicle so it's not so much a d for a disorder that's located within an individual it's more like a pragmatic problem of fit and then a question of skillful means in terms of helping people with all that and so anyway that's been kind of a framing for me that's been deep pathologizing it may be skillful means to take medication okay and maybe skillful means to teach a person you know forms of self-regulation executive functions things like that it's not because there's something internally wrong with the person or pathologizing about it so for me anyway this frame has been really helpful and I wonder what you thought about it that's that's a good way to think of it it's it's very close to the way we think of it and uh but you're still right you know in is under gather 80d was very useful because of the high energy because of the exploring need wish drivenness to to do it to try something new uh let's go see what's happening um let's be the first let's push the envelope and uh this is why so many of our innovators have this trait the reason why we have the computer now so much of it was done by dyslexics ADHD people and autistic folks are high on this each of those spectrums and it's all about motive Innovation Innovation looking for something new sticking with it having a good idea and hopefully having enough support to follow it up yeah and so you're speaking here to a couple of things that people might not think of as uh in the image that they have in their head of what ADHD looks like you're talking about Innovation you mentioned earlier I think moodiness or something similar rumination like a ruminatory cycle that somebody can get trapped in so you give a phenomenal list in ADHD 2.0 of a variety of uh I I don't even really want to call them symptoms but like presentations that ADHD can take that people might be a bit less familiar with and I was wondering if you could share a couple more of them because I I just thought that they were really interesting how people think of it as like an attentional trait but really we're talking about a whole brain difference of one kind or another and so that can that can seep into a lot of different areas of life well you know let's look what is confused it's it's confused with depression it's confused with anxiety confused with manic depression the bipolar the swings of mood and you know and the swings down into feeling bad and feeling bad about themselves feeling like their failures when they're certainly not one of the issues that we really focused on in ADHD 2.0 is rumination people can get trapped in these in in these thoughts and uh in in some sometimes it's a good idea you know it leads to them completing uh new new areas but it can also be catch you into repeat again and again of some bad news that you're you're trying to deal with and also they they can be seen as as being insensitive because they're so moving so inside their brain uh from one thing another so they they forget to do things that are commonly expected like being polite and it's not for want of you know thinking they're better than anybody else but it just they they're they're moving on to the next issue the next feeling the next is in the next idea yeah so this list in the book I just think is really fantastic so I'm going to name a couple of things on it because they're all the things that you would expect unexplained under achievement wandering mind trouble organizing and planning trouble with time management sort of the typical things that people say okay that's an image that I have of somebody with ADHD but then you have all these other things that are really beautiful like a high degree of creativity and Imagination generosity a unique and active sense of humor and then you have some other things that are kind of a mixed bag an Exquisite sensitivity to criticism or rejection this rejection sensitivity that you talk about in the book honesty to a fault high energy even things like a susceptibility to addiction people with ADHD are somewhere between five and ten times more likely to develop various addictions in the course of their life than people without um but I just thought there was such an interesting list yeah there there there's a wide variety of things that could go wrong or could as a problem or as a benefit I'm just really struck by something in ADHD 2 2.0 because probably I'm a brain geek and so you were talking about these two systems in the brain the task positive Network and the default mode Network and he talked about issues that can occur for people and I got to tell you as a quick sidebar I reflexively resist that last d because I don't think that it's inherently a disorder I think it's an issue of fit you know um and so forth so I resist that and I I prefer actually more of the spirited end of the spectrum because statistically if someone is in the top one percent or three percent let's say of impulsivity distractibility and stimulation seeking you know they're at a certain point in the normal temperamental range but it's not that there's something wrong with them so I just I'm gonna really what was supposed to Preferred title for it John it was variable attention stimulus trait was it that right vest yeah Rick that's our preface in our book about uh the fact it's not a good name and it's not a good way to pathologize it that it is just what you're saying that that it's a it is a trade in a trade gone wild is a way to think of it as a disorder uh you know too much of it uh can get you and get get people into trouble and a have a diagnosis if it begins to interfere with their living and interfere with them doing well pragmatically I fully recognize the issues of fit but where we locate the the problem and also the language of frankly medicine that's inherently oriented around you know disease and dysfunction and you know and treating it tends to pathologize the individuals so I'm I'm going to waive the banner that I I think you'll support but whoop back to the brain uh can you just unpack for for a general audience the test positive Network the default mode Network and the particular ways that people who are kind of high on the I'll say spirited end of the temperamental Spectrum you know they're how their brains operate yeah now there are lots of different networks in the brain and it's a new way of really thinking about the brain unpacking the brain in general the biggest one the one we know that started the whole issue back in 2006 was something called the default mode Network and and basically it shows on the fmri scan fancy fancy scan when they they put people in the fmri they say just let your mind wander and that becomes the signature right well they notice that these signatures were very sick were similar and exactly the same in some people one to another that one part of the brain the back part of the brain and the front part of the brain uh were all lied and this became known as the default mode when you're not thinking about anything when you're not focused on anything this this area of the brain lights up now in that default mode you have your your your history of what you've done what you care about what what's what's important to you and in the front part that's in the back part of your brain in the front part of your brain is where you make plans so I'm gonna do this I'm intending to do that um and throughout though there's uh a constant chatter it's always talking it's always commenting it's always driving you to something then and there is another key Network for add the test positive Network which is where our attention lies and this is involved with the really the front part of the brain where we talk about we're having our executive functions and and and for a while their ADHD with their add was called executive function disorder which I don't never knew how they were separate but uh because it's so much dependent on one another but anyway we're into making up new diagnoses [Laughter] all the time it's Advanced opportunity for you yeah oh yes good one yeah well and so what you have what we know about the brain is that when you get into this test positive Network your default mode networks simmers dot shuts up the energy seems to go to your attention in the neurotypical case with ADD that's a very different finding that the energy doesn't go away from the default mode most of the time and so it's constantly pulling the the information from the frontal cortex back into the default mode so it pulls it away from the attention and that's that struggle is really what I found so Illuminating by this group of metaphors in terms of our understanding of the brain and how this might impact our understanding of ADHD it's been very helpful to use that metaphor group to explain to patients they they look at that and they say oh my God that's exactly what happens that I'm thinking about something and I'm being pulled back to some irrelevant stuff or some very relevant stuff or oh I forgot to turn the stove off or oh I'm a bad person because I didn't excel in this course or that course or whatever it is and so that's why you get people who can't stay attentive just so you know I I laughingly think of the default mode Network as the simulator or the ruminator right and um one thing you may know interestingly is that when people engage in interoception they tune into let's say the internal sensations of breathing that engages the insula which acts a little bit like a circuit breaker and reduces activity in the default mode Network and maybe later on um well we'll talk more about practical things including getting in touch with the body through exercise and so forth yeah that was super helpful John thank you yeah yeah no the sort of the three ways to shut up the default mode and that's the way I think of it just shut up leave me alone I'm thinking I want to think about this you know let me go quit sucking me back in right exactly it's it it is like a magnet it's pulling pulls you away from that anyway it's it's three ways just in general and it's practical meditation where your interests septum stuff comes in exercise or movement which is a big way to shut the whole default mode up and medication uh you know those are that's what that those are tried and true ways of of allowing your attention to function better and that's all it is and remain in the present because in effect you're saying as soon as we get pulled into the the ruminator you know the default mode we're no longer in present moment awareness yeah no no the default mode is a great great tool right it's a center for Innovation and creativity but when we started looking at the default mode I did and uh trying to understand it they they uh got a group of people who were really sort of far to the to the success of meditators they were they were among the best meditators uh and their default modes when they looked at their fmri was almost absent you know and and it's because they were so trained in meditation where they were just focusing on the present being and and not being bothered not being pulled away by internal BS so you're you're naming these like there are these two different common symptoms that can be associated with ADHD one of them is this uh this suction from the default mode you know being pulled back into the ruminator as you were kind of calling it and then sometimes people can fall into the opposite situation I've certainly seen Elizabeth do this from time to time where it's the task positive Network that gets hyper over activated and you fall into the the hyper Focus trapdoor so you've got this intense over activation of each Network kind of independent of the other if that sort of makes sense that people with ADHD can can get pulled into while more neurotypical brains are a little bit more Adept and please correct me if I'm wrong here John at switching back forth back and forth between these modes or them using them as checks on each other is that more or less accurate well it's more or less accurate but you know and it always gets confusing when you talk about rumination because because that's that's where a person stuck but it's driven by feelings okay but which is you know it's it's it's a feeling State rather than just a focused state yes the beauty of ADHD is you get an idea and if you can really fiber focus on if you can remain on it then you can bring it to completion that's why you'll see ADHD people saying leave me alone I'm thinking about this don't bother me I want to get this down so talking about the role of the feelings that you were mentioning a second ago one of the things that really stuck out to me about the book was how much you and Ned focused on the importance of social connection warm support from other people feeling in relationship all of that that just really stood out to me it is the most important part of life for any of the psychiatric problems any any trip along the wellness pathway the best part of it is is what we call Vitamin C which is connection uh how important that is for else physical health and mental health you know there's nothing stronger than being connected to another person or another group or the family or of the extended family or something larger than oneself I was ruminating over here about about the particular benefits for people at the high spirited let's say end of this temperamental range of social contact and I started I was thinking about polyvagal Theory and the vagus nerve complex and the ways in which the social engagement system when that's really active then is helpful in terms of the earliest branch of the biggest nerve complex in terms of regulating the viscera and calming and centering uh and and with greater you know tone parasympathetic tone activation of the parasympathetic branch of the nervous system so I began wondering about huh in Europe view or understanding uh could there be particular benefits for people at the highest period end of the spectrum of heartfelt experiences in the ways that those are Regulatory and centering and calming and drawing people into the present and thus moderating some of the excesses of kind of being out there at the end of that temperamental range certainly certainly certainly certainly they you go both ways you go from upside down down side up in other words if you calm the viscera down you're gonna be more in a state nice state of equilibrium and and it goes both ways so yeah no they're they're certainly certainly and that's one of the benefits of of meditation of exercise and medication you know they all can help still the the body and that's what I've spent a good part of my life writing about thinking about is is how our body plays such a big role in Consciousness in our feelings and our thinking with exercise and with interest and you know the with connections there's a feeling of you know it's okay your body's okay you're you're feeling less less Jazz less threatened there's a soothing aspect yeah yeah and that then leads to an improvement in our attention that's partly drove me to my my time spent worrying about thinking about writing about exercising in all of our books in our formal 80d exercises always near the top of things that we can do to make our bodies and our brains work better you know obvious Point here if you have a brain that works a bit differently than 90 of the population it's going to be really easy to feel like an outsider and one of the things about ADHD is that it's it's socially punished in a lot of different ways in ways that some other uh points of difference are not necessarily socially punished it tends to be quite obvious it tends to get pointed out in a classroom environment uh it tends to get punished sometimes corporally punished by parents and it can be very hard to to live with in that way and because of that it's very easy like I said a second ago to just feel like an outsider and to feel like you're taking essentially a lot of abuse for just a function of the way that you are and we talk about the podcast pretty regularly about different kinds of you know restorative or reparative emotional experiences and how that can be particularly important for for people who have a deficit of that or who are Maybe taking on more painful emotional experiences than than other people are and so that's maybe another part of the wise connection so important for for people who have ADHD puzzle oh yeah no absolutely and and and that's that's the legacy of so many of our ADHD adults is having that kind of being the Oddball and the feeling that they're having normal uh you know that things are different for them than than the rest of the world uh and they then think that something wrong and usually like you're saying in the classroom and even with parents and and uh certainly in other areas that they're judged as being wrong it's bad it's defective that's why it's so important to rehabilitate the ADHD from the the disorder bin and and look at it as a an extreme of a trade that it becomes a disorder when it disorders or disrupts your life and that that so that's all that it is you know I spend a lot of time in schools John um tip you know mainly elementary schools some high schools secondary schools and routinely as sort of the functioning school psychologist the primary referral source would be this bright third grader who couldn't sit still Etc and when I think about that child or the variation which was more common in girls as you know who is not stimulation seeking and impulsive but was dreamy and inattentive with this wonderfully Rich inner world in the simulator right in that default mode World in either case uh what I would observe in the classroom and I would hear in their home life is that they were getting dinged 20 times a day they were disappointing they didn't get something done they were getting they were annoying they were unruly they were being corrected they were being brought back 20 times a day at least they were having some kind of painful usually mild but it just the quantity was extraordinary and that gradually leaves emotional residues inside people as you well know um by the time they land in adulthood one of the takeaways for me was about being extraordinarily thoughtful about that if if your child is in this more spirited or inattentive you know range of things and balancing you know particularly giving the brain's negativity bias go after that three to one five to one ten to one ratio of positive to negative interactions from the perspective of that child really important so now as adults though there's this backlog there's this residue inside and as you know myself I'm very interested in deliberate internalization of beneficial experiences and engaging evidence-based neurological factors to heighten internalization social emotional learning including to heal that backlog of wear and tear on your sense of who you are and and accumulation of you know emotionally negative experiences which can wear down mood over time the problem though is for someone to actually internalize a beneficial experience they need to typically stay with it for at least a handful of seconds in a row unlike negative experiences that go right in and it becomes a difficulty how do you help people stay with that beneficial experience of accomplishment or inclusion or being valued or being cool Etc when their mind is skittering onto the next thing uh particularly if they have nulls to be very bright and giftedness then masquerades as you said earlier as an issue of attention when in fact they got it already they're on to the next one thing you know and so for me it's actually been really important for people who are more on this end of the spirited range to help themselves really slow it down for a breath or two or longer feeling it in their body and taking it in when they do have opportunities to kind of experience this today that are reparative and antidoting and compensatory for the painful experiences they've had previously the connection allows that to maybe allows that in that's the filters that's the noise that's the The Chatterbox you know oh yeah so oh I would love to oh I'm okay oh I really did this for that person I really was was good you know recently a patient tells me of his parents who didn't understand him at all but you know he's super bright and but he got criticized for not studying but yet getting a pluses you know it was like that was the point of criticism from from a parent saying that's this is UN unnatural and if that happens early enough this is now first grade this was happening to him right so you get these early areas of of oh I'm defective I'm not good I'm you know not normal uh in there and those those Reverb you know verberator out and that becomes part of your default mode and part of the Chatterbox it's always you know they're operating a huge part of your work John has been focused on like you were saying earlier exercise and movement as a tool for people um just for for all kinds of different brains maybe particularly for people who have ADHD but it's applicable broadly of course I mean uh the earliest known medical textbook that we have comes from a Hippocrates and he was writing about exercise as a treatment for depression back in whatever it was 380 or 300 BC I probably got my numbers wrong but whatever it was um and so I wanted to ask you why is exercise particularly useful maybe for dealing with some of the problems that arise with ADHD and then we can get into talking about exercise more in general we handed our book in and and the uh our editor wisely said oh you have to cut at least two-thirds of it uh wow so we did uh but what survived are two of the nine chapters are on exercise so they survived because they're so potent as an intervention as as something to do to help repair the process uh just general exercise and then working on balance and Rhythm and uh coordination in the cerebellum a very important areas that are they're just blossoming today you know I see maybe a month ago or another study out of Australia big study looking at girls uh who exercise versus those who didn't and looking at their attention and by far those who exercise a lot got better attention scores than those who didn't but we're seeing this again and again and again it's not like that's new news but it's regurgitated into the present this is what we see when we we've gone into schools and and shifted around the priorities and maybe even the timing of recess and exercise that uh the first thing that you get when we went into so many of these schools and had them shift where they spent 30 minutes in the morning exercising what happens almost immediately drops disciplinary problems disciplinary problems why because not because the kids are tired they're tired out no their names are more switched on their brains are activated and when their brains are activated they they want to be in the moment more they want to be present more and the second thing that happens is that they do better in in school work and all that you know and and this is what we've seen again and again and again so much of our brain is when you look at it is involved with movement so when you're and so and especially what we think of as a frontal cortex of prefrontal Cortex the thinking part of the brain the moving brain is the thinking brain and this is what we see so that when you're moving you're activating your brain in those parts of the brain that are really activated when you're moving are the parts that are involved with thinking with memory with learning with uh you know succeeding in life are there particular kinds of of exercise that are particularly good for people with ADHD or is it just pick whatever works for you something's better than nothing oh there's something's always better than nothing but uh yeah every individual's so different I mean it it is about it is about moving because your muscles inactivate your brain to move all the way from jump rope to swimming to running to biking to dance which we talk about dances being probably the best exercise you can do because it acts it demands so much of your brain danced us because you have to focus your movements you have to pay attention to the music you have to move correctly and in space with someone usually or with the group you know unless you're doing Boomer dancing you know where you just flail around we love a good wedding dance here John we're not going to look down at a good wedding dance you know you're in the corner you're doing your thing it's all okay so I don't think that you actually know this John uh so this is going to be so fun but um my my hobby background is actually in dancing um I have a serious hobby I do a style of dance called West Coast Swing before then I did I had various styles of ballroom and I actually met my partner Elizabeth through dancing and I'm gonna paint you a kind of case study picture here and you can let me know what you think about it uh Elizabeth for most of her life has been involved in various kinds of dance she started doing hula when she was I think like six seven years old and then she transitioned into other forms of dance as she aged including uh doing Argentine tango and a variety of different uh styles of dance that came along a little bit later for her and then we met uh basically through West Coast Swing which is the dance that we do now and then the pandemic hit all of the dancing shut down every because understandably you know you can't be in close contact with people and uh all of a sudden Elizabeth is starting to feel these different symptoms pop up in different kinds of ways oh maybe I'm having a hard time focusing and it's really tough for me to be kind of like in this closed in space for a long period of time this eventually leads to us getting a formal diagnosis for ADHD and one of the kind of pet theories that we've had is that all of the movement that she was doing was essentially treating a lot of the underlying symptomology and so when that got taken away all of a sudden the symptoms showed up in a in a more thorough way now she's for her entire life had some ADHD symptoms and looking at the the list in your book and other formal lists of symptoms she's been very able to look at that and go oh yeah that's always been me but this was how I essentially medicated myself so I just want to kind of affirm your uh your take your job by giving our own our own case study uh on the podcast it's it's amazing I'm going over to uh Maria of South Korea for uh 12 Days a large part of it is about using movement in schools uh in Korea uh and meeting with the K-pop dancers uh the K-pop very cool uh which is a really a very active dance but yeah no it's it's it's really clear that that if you're moving uh your your brain is so much more active and so much better uh that was my first index Case by the way I've quickly try to describe it when I was a SEC second year out of presidency in 1982 I was talking about ADHD and add at that point in at a cocktail party and I was saying you know I think a lot of adults have it and I was talking about it because I had seen some patients have been taken off their medicine Etc and this guy said can I come see you and I said of course uh he's a very famous professor at Harvard in MIT and then MacArthur fellow so a lot of good credentials he came in and he said look I grew up being a marathoner I'm I'm a marathoner all my life but I hurt my knee and I haven't been running for you know months and months and months and I have all the symptoms of what you talk about of ADHD can I come and see you in fact so he did a little medicine then is rehabbing occurred you know he got better and better and better and and I saw him you know continue to seem for a number of years and he was absolutely fine when he got back to running they did it seven miles a day you know and and didn't need the medicine anymore just as you're is your partner um has the same story but that led me on my Chase for exercise and for ADHD and uh if somebody's listening listening to this and going well seven miles sounds like an awful lot for me and now your partner Elizabeth semi-professional dancer professional dancer for a long time wow that's a that's a big exercise regimen how much is a is a good dose of exercise to you John anywhere from five to twenty minutes just uh you know what I what I tell people especially younger kids and older kids is get a jump rope get a jump rope I just I talk about it in spark uh this this girl who I didn't see the mother who had 80 day and she was very active blood Etc but her daughter was in fourth grade really bright kid but was having trouble with math and I said well give me the scenario so every time she sit down and do her math homework she'd get frustrated and throw everything on the floor and you know have a tantrum and I said ever start off with jump rope so she did five or ten minutes of jump rope and she ended up doing very well in math and she's now a master's level nurse who also was on a regional jump rope team uh love that she traveled all over the United States doing jump rope so that's awesome but it's a great way to do movement to work on balance and coordination just like Dance I mean it it's it's it it really fits the bill for for our brain so you don't have to do a lot of it and those starting on jump rope whatever your age is it takes a while just be patient with yourself so I know we're going to be wrapping up pretty soon but I want to slip in two topics for sure if we can before you go and the first of those has to do with um one of my favorites of your books uh books go wild right and I love the subtitle free your body and mind from the afflictions of civilization and going back to our hunter-gatherer past and obviously we're not going to return to the Stone Age but we can learn lessons from the way people live 97 of the 300 000 years that people like you and I have walked the Earth right until agriculture rolled in around 10 000 years ago um I've been very struck by the ways in which uh I would say this informally people I know who are definitely real high on the spirited end of the spectrum including impulsive simulation seeking even aggressive do really well in Wilderness there's something about the wild that settles and I just wonder what your take is about that being and being in Wilderness even just walking in the park there's a chapter in in go wild about Copa Ophelia which is our our natural love of biology of nature of being in nature and the Asians have developed this over time to a treatment uh the the Japanese call it Forest bathing uh where they've taken all these high pressured Executives from uh Tokyo out into one of the many many forests in in Japan to spend time there not just talking to trees and hugging them but being around them and yeah there is a a nature deficit disorder that we all have uh most of us living in uh you know the cities and and so one of the things we talk about in exercise the best kind of exercise is something that you do with somebody and outside and uh both of which will help bring you back to it uh especially doing it with somebody one thing I speculate about that really briefly here is that uh a lot of the activity in the default mode network is self-referential including in mental time travel reflecting about yourself in the past projecting yourself in the future and one of the things that happens that you may well know already neurologically is that when people move their gaze outward including toward the horizon line that naturally reduces self-referential processing which is going to naturally reduce activity in the default mode Network and that's what happens when you're out in nature your your gaze moves out tends to move up you're taking in a lot more information there's less of that self-referential preoccupation all of which kawush now you're in the present absolutely it's it's not just having your games up but also watching where you're stepping no that's a big plan for being in the present yeah yeah no it's it's a big thing my goodness well it's a great metaphor for uh for life more broadly not getting tripped up by a root but one of the things that I wanted to to ask you about at the end of the conversation here John is something that Elizabeth and I have talked a lot about which is medication um and whether or not people should consider using medication of one kind or another for ADHD a lot of people have concerns about going on a form of medication they're concerned about side effects they're just broadly a little freaked out by Psychiatry just a general which which I understand uh there might be a little fear about interacting with something that's really going to affect how your brain functions there's a lot of stuff out there about the potential to get addicted to a stimulant or whatever it is that's going on there and so I just wanted to ask you broadly how do you think about medication at this point as somebody who's also engaged all of these other more quote unquote holistic interventions for ADHD that's the other side of the coin I mean it because there are a lot of psychiatrists who will sit who will support oh you shouldn't go on medicine if you have ADD you know just [ __ ] up or find another way but if you if you have a serious case of attention problems medicine can be a life changer and it can be very quick don't discount it at all you know if necessary it's it's it's very very useful and then the issues that you raise the side effects and the interests stair step to addiction uh you know the side effects are very minimal it's like a big cup of coffee you know in fact coffee has more side effects than those most of our stimulants okay and there's more side effects uh and uh it's harder to when it wears off then then [Laughter] no really really it's it's no I could speak to that for personal experience I've gotten a good caffeine headache every once in a while it's not fun yeah yeah but but addiction that's very important and we stress this in our book we had a lot in the book that was cut by two-thirds uh even more because addiction is such a big problem with ADHD people almost twice as many people who have the diagnosis of ADD will end up being addicted to one thing or another however when they look at people who were treated that is treated with medicine as an adolescent the numbers get close to normal in terms of those who would actually go on to be addicted whereas the the people that have ADD and they they weren't uh treated they have you know twice as many people involved with addictions of one form or not so there's lots of evidence it's very reassuring I think for people to hear because particularly people frankly who like listen to a podcast like ours were probably interacting with a a higher density of holistically inclined people um and there just can be some fear around medication which you know I get uh but again it's something that we've really considered and looked at a bunch of options and are probably gonna gonna try on at some point uh so I I would encourage people particularly people who have significant symptoms that they're having a difficult time controlling through other mechanisms to really take a look at it if that's a possibility that's available to you because I I mean I have friends who've tried medication who it was just totally transformative for them completely life-changing and um so the the upside is really pretty pretty extraordinary if I could add kind of a perspective on it too um so I'm I'm careful about my license I'm a psychologist not a psychiatrist so I can comment on education but I never render a professional opinion about whether someone should start or stop or change their meds I say talk to your other doctor in that context one thing I've seen pragmatically is that people can bring to bear a person can bring to bear in the life of a child or their own life as an adult a lot of non-medication interventions and those are great and one of your great Services John has a card-carrying medical medication prescribing psychiatrist has been to emphasize these other important interventions which certainly in the life of a child include a lot of nurturance and in the life of an adult a lot of connection partly to balance the dings and bumps and bruises that someone who's more spirited is experiencing as they kind of bang up against tighter controls I think of uh you know metaphorically forced has heard me use this that there's kind of a normal temporary temperamental range between Turtles and jackrabbits with tweeners kind of in the middle and it's tough to be a jackrabbit trapped in a turtle pen you know taught by Turtles who are trying to train you to become Eternal right a lot of wear and tear adds up over time okay so people can do a lot of non-medication interventions that may handle things the issues of fit perfectly adequately on the other hand pragmatically many people will not do all those other interventions which can sometimes include dietary changes lowering inflammatory processes in their body that are distracting and are one more load you know on the person's executive functions things like that they just won't do them they can't sustain them it's not realistic and so it's it's in the context of that that medication becomes pragmatically more useful as skillful means because you're just not going to do all those other things and of course they're people who will do those other things and get a lot of benefit from a psychostimulant medication of one kind or another so for me that kind of range that's pragmatic rather than a binary yes or no do or don't you know as a I found it to be a useful way to think about it oh absolutely we you know if people can can go for it and have enough activity and love and and you know things that they're pursuing in their life then they may not they may not need medicine it's up to them it's up to figuring out how much this this this this difference is affecting their lives but you're right you talk about the jack rabbits and turtles with uh talk about the farmers and hunters and that's that's hard for Hunter to sit in a classroom taught by a bunch of farmers and and expecting you to just be there and and and sit and and not be jump up and want to see what the hell is going on outside on the other side of the Hill yeah yeah well you know John thanks so much for doing this with us today that's squirrel squirrel what a great note to Anton John thank you so much for doing this with us today this was like utterly fantastic you're just a total Gem and and I just really appreciate it and thank you for your work as well it's really helped a lot of people yeah definitely thanks for having me on it it was good to see you again Rick and hope to see you again sometime I really love today's conversation about ADHD with Dr John Rady John is the author with Ned Hallowell of the new book ADHD 2.0 I really couldn't recommend it more strongly if you or someone you know has ADHD which I think probably includes most people at this point or if you're just interested in learning more about ADHD I've found it just a fantastic resource in my own life it's been really helpful for my relationship with my partner Elizabeth and has also just helped me develop such a better understanding of ADHD and that's what we began with what are some of the common misconceptions or misunderstandings that people still have about ADHD even after there's been such an explosion of popular awareness of it as an issue that people have and what John really emphasized is how there's a common framing of ADHD as specifically an intentional problem it's right there in the name of it right attention deficit and hyperactivity disorder but ADHD isn't so much a deficit of attention it's a surplus of it with absolutely no control associated with that it's basically like having a car that has the engine of a race car and the brakes of a bicycle the problem isn't that your engine isn't big enough but that you lack the brakes that most people have to apply that engine as effectively as you cut and even that framing is is a bit of a framing of deficit it's a bit of a framing of ADHD as hey a disorder again right there in the name but the truth is that ADHD has a whole set of of symptoms or presentations or traits that are associated with it that range from definitely inconvenient in a modern world to these completely beautiful aspects and and really wonderful parts of uh of a personality structure that can be incredibly beneficial for people who have it these are strengths like a great deal feel of creativity and Imagination a real ability to sense into the emotions of other people and act as a kind of emotional Weather Vein for a group uh generosity a unique and active sense of humor and one of the things that in the book he refers to as an itch to change the conditions of life and this can be associated with the ability to innovate that we talked about during the conversation as well and in this way John frames ADHD in such a wider and and broader context than the way that most people think about it it's not this narrow ailment that needs to be essentially beaten out of people where people just need to regulate themselves as hard as humanly possible in order to overcome their deficient brain it's not that it's a set of traits there are strengths there are some vulnerabilities it is a whole brain thing what do we do to accentuate the strengths and create a context that supports those strengths and a context we're in those strengths can operate at their maximum power without being as affected by some of the vulnerabilities we talked for a while in the middle of the conversation about what's going on in the brain of somebody who has ADHD and John highlighted these two different networks those are the task positive Network and the default mode Network the task positive network is associated with the feeling of being in the zone or highly focused on something while the default mode network is what your brain defaults to it's right there in the name again when it's not doing anything else it's when you're imagining or daydreaming and maybe when you're ruminating although as John said that's got some interaction with the task positive Network as well and for the brands with people who have ADHD they tend to get sucked into the default mode Network even when they're focusing on something there's like this constant vacuum pull back to it in the brain which is one of the reasons that it can be tough to sustain attention over a long period of time on the other side of the coin because ADHD is all about these two very strong sides of the coin that both exert a lot of influence it's very possible for people with ADHD brains to fall into intense periods of hyper Focus what John John described this as the desire to get to completion the feeling like they just have to finish this thing and they're almost there and if they just finish it then they'll be able to let it go or focus on something else in terms of practically working with ADHD there were three things that we emphasized during the conversation and a fourth one that I'll name here in the outro and the three that we talked about were the importance of social connection the value of exercise and movement and then the possibility of using medication the fourth one that I'll name here in the outro is the importance of setting up an environment a set of circumstances around you that are supportive of your unique brain and this gets to something that ran underneath the conversation as a whole which is the importance of context we have a particular kind of context in Modern Life right you're sitting at a desk a lot you're working at a computer a lot you're staring at a phone a lot uh maybe you're listening to this podcast while you sit in your car and drive to your desk job whatever it is that people are doing and that's one context but that isn't the context that humans existed in basically biologically modern humans existed in for 97 percent of the time that we've been on this Earth and in those different contexts maybe not our modern one having something like ADHD having a uh an excess of energy and excess of interest and excess of imagination could be profoundly useful for a group of people who are trying to survive under very harsh conditions and I would just encourage people who are listening to this who themselves maybe have ADHD or if you're somebody like me who's the partner of somebody with ADHD to really think about ADHD in that way that it is a context-based liability it is a context-based issue and this really takes us out of a framework of it where we're blaming a person for the way in which their unique brain works because really what's going on here is there's an issue of fit there's an issue of fit between the brain of the person and the circumstances that they find themselves in and so a key place of intervention is okay how can we make that fit a little bit smoother a little bit softer a little bit kinder to people I got a ton out of today's conversation I got even more out of reading John's book which again he wrote with Dr Ned Hallowell and I hope you did as well it was great doing this we've been really delinquent in talking about ADHD directly on the podcast I am sure we will have many more episodes that include either a deliberate focus on ADHD or it as part of a different kind of conversation maybe a broader conversation on other topics uh there are some people who I don't want to you know say too much now and we haven't really confirmed them but we have some experts that will probably be coming on the podcast in the near future to talk about ADHD and I'm really looking forward to those conversations as well if you've been enjoying the podcast for a while I'd really appreciate it if you would take a moment to subscribe to it wherever you're listening to it now on if you're watching us on YouTube hey you can subscribe to my channel you can just find me as Forrest Hansen if you're listening on Spotify or listening on Apple podcasts and you haven't clicked the Subscribe button yet well now's a good time if you haven't we'd also appreciate it if you would take a second to leave a rating and a positive review maybe tell a friend about it it's the best way that we have to reach new people and if you'd like to support us another perhaps monetary ways you can find us on patreon it's patreon.com beingwell podcast and for the cost of just a few dollars a month you can support the show and you'll get a whole bunch of bonuses in return until next time thanks for listening and I'll talk to you soon [Music] thank you [Music]

Channel: Forrest Hanson

Views: 15,044

Keywords: Mental Health, Personal Growth, Self-Help, Psychology, Forrest, Forrest Hanson, Being Well, Being Well Podcast, Rick Hanson, Resilient, ADHD, ADHD 2.0, John Ratey, attention deficit disorder, attention deficit hyperactivity disorder, fix my adhd, what to do about adhd, my adhd is out of control, help my adhd, misconceptions about ADHD, exercise for adhd, fitness for adhd, how to fix my adhd, what to know about adhd, meditation for adhd

Id: G2wOvXEkLko

Length: 63min 6sec (3786 seconds)

Published: Mon Apr 03 2023