‘It’s not your fault; it’s simply how your brain functions,’ — ADHD Awareness Week at Twinkl

Last week, I didn’t know much about ADHD (Attention Deficit Hyperactive Disorder). I only ever really heard the term in casual conversation, deployed by people that were not experts. In these situations, it was usually used interchangeably with ‘badly behaved’ and described young boys. But I’ve learned a lot this week. While symptoms might be most obvious in restless children, ADHD affects all kinds of people. It’s a complicated condition, and it can make life difficult, but it’s definitely not all negative.

Alex Campbell is a BACP registered Integrative Therapist. He was also one of the first 40 people to be diagnosed with ADHD in the UK, in 1990.

‘The 90s were a tough time to be a kid with ADHD,’ says Alex. ‘There was a lot of negative press. Though experience and knowledge are useful, they’ve come with challenges.’

In a talk to Twinkl team members, Alex broke down exactly what ADHD means, its symptoms, and its effect on people living with it.

In a nutshell, ADHD is all about inattention, hyperactivity and impulsivity. ADHDers don’t necessarily have to exhibit all three — there’s a sliding scale, from hyperactivity to inattention. Generally, boys and men tend to be towards the ‘hyperactive’ end, while women tend to fall somewhere more towards inattention. There’s also a category in the middle for people that display both sets of behaviours. People like Alex.

Before becoming a therapist, Alex spent 15 years in the film industry, jetting back and forth between London and Los Angeles. The experience burnt him out completely. Now, he thinks this was partly a result of having ADHD, as he ‘drowned’ in the atmosphere. He left, went into therapy, and ended up having a career in mental health.

‘I wouldn’t say I’m an expert in ADHD as that’s quite a big label,’ Alex says. ‘But I think it’s a specialism of mine.’

ADHD isn’t a great name for the condition, it turns out. The words ‘deficit’ and ‘disorder’ aren’t really accurate. It isn’t a lack of attention but an inability to focus that attention that makes things difficult for people with ADHD. And in some cultures, ADHD traits aren’t seen as negative at all. For example, in Māori, the word for ADHD is aroreretini, which means ‘he who focuses on many things.’ In that context, ADHD sounds pretty handy.

Rebecca is the UK Business Development Team Leader on the Schools team at Twinkl. She also has ADHD. Sometimes, it’s convenient.

‘I have this thing called hyperfocus, which is really useful,’ she tells me over Google Meet. ‘I took a day off work yesterday to work on my degree and, because I’m really interested in the subject, I was able to completely block out the rest of the world. It got to 3:30 in the afternoon and I’d done all the work I needed to do and hadn’t even noticed that time had gone by. It’s super-useful when you have to get something done.’

But ADHD also makes life frustrating. If Rebecca isn’t interested in the subject, it can be very difficult to concentrate for any length of time. She also finds it hard to remember things. Though she can learn new facts and skills, she can’t then relay them in a way that’s easy for other people to understand.

This is a common ADHD trait. It’s not the same as being disinterested in a subject. We all have subjects or activities we find difficult to engage with, and others we enjoy. But people with ADHD have an imbalance of chemicals in their brains — it’s tough for information to get from one part of the brain to another.

If someone with ADHD is inattentive, it’s because a neurotransmitter isn’t emitting enough dopamine. Dopamine is often thought of as the ‘pleasure’ neurotransmitter, but it’s actually much more about motivation and interest.

‘You can think of dopamine as little taxis that leave the rank (the transmitter) and go on a journey to the receiver,’ says Alex. ‘Inside that taxi is information. That information has to reach the receiver before it can go back to the transmitter. If you have ADHD, there aren’t enough taxis. The information isn’t going, so you can’t get involved in the task. Then, if you’re hyper-focusing, there are too many taxis. The place is being flooded with taxis and the receiver goes ‘Ok, we’re really doing this thing.’’

ADHD is a biological condition. It’s also hereditary. If one parent has ADHD, there’s a 1 in 3 chance that their child will have ADHD too. And if both parents have ADHD, there’s a 2 in 3 chance that their child will have it as well.

Sarah is a content writer at Twinkl. During the lockdown, she noticed her son displayed some symptoms associated with ADHD and they’re now in the process of getting his behaviour assessed.

‘One of the things is fidgeting,’ Sarah says. ‘He really couldn’t sit still; he was always jumping around. The other thing was that he found it so hard to get focused, particularly on a writing task. Being a teacher, you know what to expect from different ages, but I did make some allowances because it was lockdown and everything was different. We were at home and I’m his mum, so it wasn’t going to be the same as being at school. But there were other things too. He would become hyperfocused — once he was enthralled in something, if it was of his choosing, be it Lego or drawing, he just couldn’t break away from it. That was one of the main things I noticed that made me think it might be something more.’

Once Sarah spotted this behaviour pattern with schoolwork, she started to see it everywhere. Getting dressed in the morning, transitioning between tasks — lots of everyday tasks were difficult because of traits that seemed to fit the symptoms of ADHD. Sarah even started to notice these tendencies in her own behaviour. When reading lists of symptoms, she found characteristics that she assumed were normal, problems she experiences herself.

This is quite common with mothers of children diagnosed with ADHD.

‘Most of my new clients are women in their 40s,’ says Alex. ‘Their children got diagnosed, they go through the process with them and, along the way, they go ‘Ah, this is me.’ It provides a whole new lens on their lives.’

There’s a steering group at Twinkl, set up for team members diagnosed with ADHD, who think they probably should be diagnosed, or have people with ADHD in their lives that they need to support.

‘It’s so interesting to hear other people’s experiences,’ Sarah says. ‘A lot of the women have talked about the fact they were all diagnosed later in life. It seems like there could be a lot more awareness in schools about girls. I don’t think there are always the same signposts with their experience as there are with boys.’

Women and girls tend to experience ADHD differently than boys. In his talk, Alex Campbell mentions common nicknames like, ‘little miss chatterbox’, ‘daydreamer’ and ‘airhead’ that quite often correspond to lesser-known ADHD traits.

‘Girls often mind-wander to stimulate their brains,’ Alex says. ‘I once spoke to a teacher who was frustrated by girls daydreaming in his class. I told him that, the next time it happened, he should ask them what they were daydreaming about. He did, and he was amazed at their answers. It was incredible, the way they were thinking about the subject, and then the whole class had an amazing discussion about a thought this girl had. He said he’d never seen her so engaged. So yes, you should follow the trail — you might find some gold.’

Alex’s patients are in a very privileged position; they’re able to speak to a therapist that has the condition himself and can truly empathise with their experience. It’s not like this for everyone.

‘Getting a diagnosis and treatment is a really long, drawn-out process,’ says Rebecca. ‘I was diagnosed with some other conditions a while ago, and the possibility of having ADHD was first mentioned to me then. But the people that did those assessments weren’t paid to assess for ADHD, so they wouldn’t do it. I went to my GP and the GP’s response was, ‘If you had ADHD, you’d know by now.’ That was the end of the conversation.’

But then, earlier this year, Rebecca decided she needed a proper answer. She wrote a list of everything she’d experienced and was ready for a battle. But, this time, she spoke to a different GP.

‘He was really nice,’ she says. ‘As I was explaining everything, he kept telling me to stop and take deep breaths. Then he asked me some simple yes or no questions. After that, he put me through for diagnosis. But it could be up to two years before I see a specialist.’

NHS waiting times are incredibly long at the moment, not just in mental health, but in every field. However, Rebecca says that simply having someone listen to her and not immediately dismiss or second-guess her experiences, was incredibly affirming. When she found out she qualified for an assessment, she burst into tears.

But why is diagnosis so important? With assessments and long waiting lists, you can see why some people would forgo the formality. However, aside from the obvious benefits of treatment, be it in the form of treatment or therapy, a diagnosis brings the comfort of certainty — you haven’t made the condition up. You’re not going mad.

Going undiagnosed can be dangerous. In his talk, Alex brings up some sobering statistics. A Canadian survey conducted by Professor Esme Fuller-Thomson in 2020 compared suicide statistics between those with ADHD and those without. The survey found that, of the people surveyed, 1 in 37 people without ADHD have attempted suicide but that this figure shrinks to a terrifying 1 in 7 when you look at the population with ADHD. Zooming in closer, 2.1% of men without ADHD have attempted suicide but, this increases to 8.5% of the male population with ADHD. 3.3% of women without ADHD have attempted suicide, but, of the female population with ADHD, this skyrockets to 23.5%. That’s almost a quarter of women with ADHD that have tried to take their own life.

A lot of people in this study did not realise they had ADHD when they tried to end their lives. Faced with the symptoms and left to fight them alone, things that are possible to treat can spiral into long-term anxiety and depression. Studies like this can also show the disparity between the diagnoses of men and women. Though the 2014 NICE (National Institute for Health and Care) Guidelines place the male to female ratio at 4:1, most of the research was carried out on boys, so this statistic is unsurprising.

So what to do?

A good place to start is recognising the key symptoms. According to Dr Russell Barkley, a psychologist and ADHD specialist, there are nine symptoms that strongly differentiate people with ADHD. People with ADHD tend to:

1. Make decisions impulsively.
2. Have difficulty stopping activities when they should.
3. Start projects or tasks without reading or listening to directions carefully.
4. Show poor follow-through on promises or commitments to others.
5. Have trouble doing things in proper order or sequence.
6. Drive with excessive speed.
7. Daydream when they should be concentrating.
8. Have trouble planning ahead.
9. Struggle to engage or persist in activities they are not interested in.

If you recognise these symptoms in your behaviour or the behaviour of someone you’re close to, assessment is likely to be the next logical step to take. You can find plenty of information about the assessment and diagnosis process on the ADHD UK website. Alex also has a website about ADHD - ADHD Alex — and a podcast, Sorry, What Was The Question?, where he discusses the condition with a wide range of guests.

For more information about ADHD, you might want to check out ADHD 2.0, a book by Edward Hallowell M.D. and John Ratey M.D, two leading psychiatrists diagnosed with ADHD. There’s also Divergent Mind, by Harvard & Berkeley-educated writer and entrepreneur, Jenara Nerenberg.

Ted Talk speaker Jessica McCabe has a popular YouTube channel, How to ADHD, and TikTokker Connor DeWolfe makes lots of videos about living with ADHD.

To end, I’ll leave you with some words of wisdom from Alex. It’s a message for anyone that has ADHD:

1. It’s not your fault. It’s not your parents’ fault. It’s simply how your brain functions.
2. You’ve struggled all your life with a difficult temperament.
3. Your brain works slightly differently from those who don’t have these challenges.
4. This is why you have found life so difficult.
5. There are others like you who have similar brains. You are not alone.
6. It is possible to understand and elevate a great number of the struggles.
7. There is always hope.