With the explosion of online therapy, Tik Tok, and an increasingly medicated society, we have become very good at identifying and naming our patterns, but I am not sure we are always very good at asking what comes next.
“I struggle to do anything because I have ADHD.” “I have rejection sensitivity because I have ADHD.” “I can’t concentrate on things because I have ADHD.” “I can’t maintain routines because I have ADHD.
For many people, discovering a framework that helps them understand difficulties they have struggled with for years can be enormously relieving. It can replace “I am lazy”, “I am failing” or “there is something wrong with me” with greater compassion and understanding. And, understanding ourselves cannot be the end of the story. My next question is always: and then what? When you attribute these patterns to this one cause, where does your influence go? To the label, or to yourself?
Human beings have always varied enormously in attention, sensitivity, emotional intensity, impulse control, working memory, sociability, sensory processing, adaptability and how much novelty or structure we need. Some of us need quiet to think. Some need stimulation. Some naturally organise themselves. Others have to work much harder at it. Some nervous systems seem to notice everything happening around them, while others filter most of it out. This is the wonderful and needed variety of our human tribe.
The Biopsychosocial Reality
We also don't develop in a vacuum. Every one of us arrives in adulthood through a completely unique combination of inherited tendencies, temperament, relationships, nutrition, physical health (including the health of our parents), sleep, culture, stress, learning, sensory experiences and what happened to us during development. Our brains grow in constant interaction with all of these things.
There is good evidence that inherited biology contributes to ADHD traits. Large genetic studies find many small genetic differences that occur somewhat more frequently in people diagnosed with ADHD. But there isn't an “ADHD gene”, and these genetic differences are not unique to ADHD. Many overlap with other psychological and developmental traits and conditions. There is also no brain scan, blood test or genetic test that can tell us whether somebody has ADHD. ADHD remains a diagnosis based on a pattern of behaviour and difficulties.
The brain research is interesting too, but again it is much less black and white than it can sound online. Researchers can find small average differences between groups of people with and without ADHD, but there is enormous overlap between the groups. We cannot look at an individual's brain and say, “That's an ADHD brain.” And finding a difference in the brain doesn't tell us how that difference came to be.That last point is important because “brain based” has somehow come to mean “born this way and fixed this way.” But that isn't how brains work.
Learning is brain based. Trauma is brain based. Attachment is brain based. Chronic stress affects the developing brain. Sleep affects the brain. Nutrition affects the brain. Relationships shape developing brains. Practising something repeatedly changes the brain. Our biology influences how we experience our environment, and our environment continually influences our biology. Nature and nurture aren't opposing teams fighting over who gets credit for building a human being. They are interacting from the beginning.
Even the scientific understanding of ADHD is more nuanced than the simple idea of a fixed, inherited brain condition. Current research increasingly describes ADHD traits as existing on a continuum across the population, with many different genetic influences interacting with development and environment. In other words, there isn't a neat biological line separating an “ADHD brain” from everybody else's brain.
None of this means ADHD isn't real or that a diagnosis cannot be helpful. However it does mean that the label cannot possibly tell us the whole story of a human being. And this is where my concern sits, seeing the huge rise in hearing from capable people, 'it's because of my ADHD', which then stops them taking steps to care for their nutrition for their brain, movement for their brain, their beliefs, their ways of digesting life (thinking styles and emotional patterns, mindfulness), that would really bring a lot of support to their unique brain and interface with the world.
This is where I worry about some of the conversations happening online. A diagnosis that initially gives someone relief and self-understanding can gradually become the explanation for almost everything they find difficult and give them blind spots on aspects of their wellbeing that are crucial for focus, regulation, physical health, and ageing well. We can inadvertently move from “this helps me understand myself” to “this tells me what I am capable of.” The former gives us profound internal influence, the latter gives us very little. If somebody tells me they struggle enormously to focus, I am interested in knowing that. Perhaps ADHD is a useful framework for understanding it. But I don't want curiosity to stop there.
Bring It Back To Unique YOU
I want to understand what actually happens for that particular person. Is it difficult to disengage once they are absorbed in something? Does uncertainty create anxiety? Are they depleted? Is there sensory overwhelm? Does perfectionism make starting the next task feel enormous? Does having too many steps overwhelm their working memory? What happens when they are well rested? Is it mostly emotional regulation? What happens with external structure? What happens with support? How are they living? How are they eating? What are their thinking patterns, stress response patterns and ways of responding to life? What is their family history patterns of nature (illnesses, nutrition, mental health) and nurture (how they were raised, parental responsiveness, environment, challenges, buffers)?
Those questions don't invalidate someone's difficulties. They take them seriously enough to investigate them in order to bridge them to support, empowerment, and growth. Once we understand them, we can ask what is under our influence. Perhaps I genuinely need more external structure than another person. Great. How can I create it? Perhaps I need fewer sensory demands. Perhaps I need to stop expecting myself to work in an environment that doesn't suit me. Perhaps there is a skill I have never actually learned. Perhaps anxiety is magnifying the difficulty. Perhaps I need accommodation. Perhaps I need physical support. Perhaps I need more sleep, different nutrition, movement, trauma work, practical systems or a different way of working or studying that suits me.
Usually there isn't one answer because human beings aren't that simple, even though online programs will tell you that in 30 days you too can heal like 5,000 others just like you! There is also an enormous difference between saying, “This is harder for me” and “I cannot do this because of the kind of brain I have.” The first gives us useful information. The second can become a prediction the brain seizes on and runs with. The brain is one giant prediction machine, so what we believe influences what it predicts and which familiar neurological pathways it runs on autopilot. This is one reason we can stay stuck in the same patterns for years.
This doesn't mean dragging ourselves through things that genuinely don't suit us or turning every difference into a self-improvement project. Personal growth isn't about forcing everybody towards some imaginary version of normal, which does not exist, particularly in a profoundly disconnected society. And perhaps that too is a significant factor in the chronically dopamine-disordered mammals we have become, which a label and medication can sometimes gloss over.
Sometimes understanding ourselves means finally stopping something we have spent years forcing, or recognising that we need an accommodation other people don't, and embracing this as part of what helps us flourish. And if that is the case, is that really ADHD, or simply your unique traits expressing themselves and asking you to notice where and how you function best?
Sometimes it also means discovering that something we assumed was simply “how my brain works” can actually become easier with practice, support, healing or a different approach. This takes emotional honesty, and a good look at our daily self-talk, self-esteem, thinking patterns, beliefs, and how much influence we believe we have over our experience of life. The most anxious and stuck people I work with often have deeply entrenched beliefs and autopilot ways of reacting that can be a little challenging to become aware of at first! But once they do, and realise they can feel better through relatively simple practices, they are usually glad to be emancipated from seeing the world through such limiting (shit-tinted) spectacles.
Do Not Give Away Your Influence!
We can hold compassion for why we are the way we are without assuming that everything about the way we currently function is permanent. We can respect biological differences without reducing ourselves to them. We can understand our history without it being our destiny. We can accommodate genuine limitations while still developing capacities.
You are a whole human being with a particular temperament, history, biology, nervous system, body, relationships, strengths, sensitivities and way of meeting the world. Nobody else has exactly that combination. Your difficulties are information about that unique interface between you and your world. They aren't the totality of who you are. You also have strengths, and the ability to grow, should you choose to and have your basic needs for food, shelter and relative safety met.
So yes, let understanding replace shame where shame has never belonged. But do not use your label as a shield against the personal responsibility to grow into the most thriving version of yourself. Not some normative version, but authentically YOU. Ask what helps. Ask what changes things. Ask what your particular system needs. Ask what skills might help you bridge things that are hard for you. Ask what needs accommodating and what might be developed. Ask what happens when you feel safer, stronger or better resourced. Ask what you haven't tried because you already decided you couldn't do it because “this is just how it is.” I know this seems hard when you read it, trust me I have been there. But I promise you that if you are even 5% curious, that you have the gifts inside you, and the capability, to grow.
Self-understanding should open us up, not close down what we believe is possible for us. The longer I do this work, the more fascinated I am by the power of our beliefs about ourselves, and how profoundly they can influence our minds, bodies and lives. There is substantial scientific evidence that our beliefs, expectations and learned predictions can influence both mental and physical health through the brain and mind-body connection.
So stay curious about yourself. ADHD may be a useful part of your story. Trauma might be. Depression might be. Your temperament, sensitivity, biology, relationships and experiences will be too. Let these things guide you towards a deeper understanding of yourself, and towards discovering how you can thrive with all of your beautiful strengths, vulnerabilities, differences and connections to others.
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