“If someone told me you could be normal or you could continue to have your ADD, I would take ADD.”
—David Neeleman, airline executive
ADHD IS A CONFUSING, CONTRADICTORY, INCONSISTENT, AND FRUSTRATING CONDITION. IT IS OVERWHELMING to people who live with it every day. The diagnostic criteria that have been used for the last 40 years leave many people wondering whether they have the condition or not. Diagnosticians have long lists of symp- toms to sort through and check off. The Diagnostic and Statistical Manual of Mental Disorders has 18 cri- teria, and other symptom lists cite as many as 100 traits.
Practitioners, including myself, have been trying to establish a simpler, clearer way to understand the impairments of
ADHD. We have been looking for the “bright and shining line” that defines the condition, explains the source of impairments,
and gives direction as to what to do about it.
My work for the last decade suggests that we have been missing something important about the fundamental nature of
ADHD. I went back to the experts on the condition—the hundreds of people and their families I worked with who were diagnosed with it—to confirm my hypothesis. My goal was to look for the feature that everyone with ADHD has, and that neurotypical people don’t have.
I found it. It is the ADHD nervous system, a unique and special creation that regulates attention and emotions in different
ways than the nervous system in those without the condition.
The ADHD Zone
Almost every one of my patients and their families want
to drop the term Attention Deficit Hyperactivity Disorder,
because it describes the opposite of what they experience
every moment of their lives. It is hard to call something a
disorder when it imparts many positives. ADHD is not a
damaged or defective nervous system. It is a nervous system
that works well using its own set of rules.
Despite ADHD’s association with learning disabilities, most
people with an ADHD nervous system have significantly
higher-than-average IQs. They also use that higher IQ in
different ways than neurotypical people. By the time most
people with the condition reach high school, they are able
to tackle problems that stump everyone else, and can jump
to solutions that no one else saw.
The vast majority of adults with an ADHD nervous system
are not overtly hyperactive. They are hyperactive internally.
Those with the condition don’t have a shortage of attention.
They pay too much attention to everything. Most people
with unmedicated ADHD have four or five things going on
in their minds at once. The hallmark of the ADHD nervous
system is not attention deficit, but inconsistent attention.
Everyone with ADHD knows that they can “get in the zone”
at least four or five times a day. When they are in the zone,
they have no impairments, and the executive function deficits they may have had before entering the zone disappear.
ADHDers know that they are bright and clever, but they
are never sure whether their abilities will show up when
they need them. The fact that symptoms and impairments
come and go throughout the day is the defining trait of
ADHD. It makes the condition mystifying and frustrating.
People with ADHD primarily get in the zone by being interested in, or intrigued by, what they are doing. I call it an
interest-based nervous system. Judgmental friends and
family see this as being unreliable or self-serving. When
friends say, “You can do the things you like,” they are describing the essence of the ADHD nervous system.
ADHD individuals also get in the zone when they are challenged or thrown into a competitive environment. Sometimes a new or novel task attracts their attention. Novelty is
short-lived, though, and everything gets old after a while.
Most people with an ADHD nervous system can engage in
tasks and access their abilities when the task is urgent—a
do-or-die deadline, for instance. This is why procrastination
is an almost universal impairment in people with ADHD.
They want to get their work done, but they can’t get started
until the task becomes interesting, challenging, or urgent.
How the Rest of
the World Functions
The 90 percent of non-ADHD people in the world are referred
to as “neurotypical.” It is not that they are “normal” or better.
Their neurology is accepted and endorsed by the world. For people with a neurotypical nervous system, being interested in the
task, or challenged, or finding the task novel or urgent is helpful,
but it is not a prerequisite for doing it.
Neurotypical people use three different factors to decide
what to do, how to get started on it, and to stick with it until it
1. the concept of importance (they think they should get it
2. the concept of secondary importance—they are motivated
by the fact that their parents, teacher, boss, or someone they re-