ADHD is a Terrible Name — Understand What it's Really About
ADHD stands for Attention Deficit Hyperactivity Disorder, which is actually a pretty terrible name.
Not everyone who has ADHD shows hyperactive symptoms, and we don't have a deficit of attention at all — rather we have trouble focusing and regulating our attention to just one thing at a time.
The History of ADHD
But it could be worse. What we now call ADHD used to be known by far less flattering names in the past, such as “nervous child,” “hypermetamorphosis,” “mental instability,” “unstable nervous system,” and “simple hyperexcitability” to name a few early attempts.
Eventually came the name ADD—Attention Deficit Disorder—which was established in 1980. Scientists then believed hyperactivity was not a common symptom, so it wasn't included in the name.
The pendulum then swung too far the other way in 1987, when the name was changed to ADHD. Science finally recognised that hyperactivity was a common symptom, but failed to differentiate any subtypes.
This meant that if you didn't exhibit hyperactivity, you couldn't have ADHD—effectively eliminating the diagnosis of anyone with the inattentive form of the condition (including most girls, who are more likely to internalise their hyperactivity).
Finally, in the year 2000, three distinct subtypes of ADHD were acknowledged by science:
Combined type ADHD
Predominantly inattentive type ADHD
Predominantly hyperactive-impulsive type ADHD
These subtypes are still used today. But many would argue that the term ADHD still doesn't accurately reflect the full scope of the condition. For example, the diagnostic literature makes no mention of the emotional aspects of ADHD, despite the fact that emotional difficulties are the number one reported life-limiting issue amongst ADHDers.
So what exactly is ADHD?
At its core, ADHD is an issue of brain chemistry. The different areas of the brain controlling different behaviours and processes communicate with each other via chemical messengers called neurotransmitters.
These neurotransmitters act a bit like oil in a machine, lubricating the gears and allowing everything to mesh smoothly together and the machine to work efficiently.
The ADHD brain either doesn't produce enough of these neurotransmitters, or the neurotransmitters aren't picked up very efficiently by the brain. The result is that the different areas of the brain have a much harder time communicating and co-ordinating with each other to accomplish key tasks.
These key tasks are known as our executive functions and include:
Emotion — regulating our emotional responses to situations
Action — self-monitoring and regulating our actions and behaviour
Activation — initiating, organising, prioritising and planning
Focus — focusing, sustaining and shifting our attention
Memory — holding information in our minds as we work with it
Effort — energy levels, sustaining effort, and processing speed
These executive functions underpin all day-to-day activities. It means it tends to take a person with ADHD more time and effort to accomplish the same tasks as a neurotypical person throughout an average day.
This additional mental effort can take its toll as we overexert ourselves to meet expectations set by ourselves and others. Even trying our hardest can appear to others as doing the bare minimum or not reaching our full potential.
Spending our lives overcompensating and not addressing the underlying cause can mean that we burn out. This is why it's so important to acknowledge, understand, treat, and work with our ADHD brains instead of fighting against them.
I have written about each of these six executive functions, explaining how and why each of them affects us, and detailing some things we can try that may help alleviate their impact on our lives.
Join me next time when we look at Emotion—the first of our executive functions—and how ADHD affects them. See you there!