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A paper published this month in the British Journal of Psychiatry has reignited one of the most reliably circular arguments in all of medicine: “Is ADHD overdiagnosed or isn’t it?”

A team of researchers from Cambridge, Southampton, and Nottingham came down firmly on the isn’t-it side. Overdiagnosis is not the problem, they said. In fact, many people who need a diagnosis still don’t have one.

Waiting times in the UK have stretched to two and three years in some cases, and lack of insurance or the unwillingness of insurance companies to cover psychology or psychiatry are creating a similar crisis here in the US. The real scandal isn’t that too many people are being told they have ADHD. The real scandal is that too many people who have it are still waiting for anyone to notice.

They’re almost certainly right about that, and the waiting list problem is real and serious and deserves the attention they’re giving it.

Undiagnosed and unsupported ADHD carries genuine costs. Academic failure, damaged relationships, substance abuse, the slow erosion of self-worth that comes from spending decades being told you’re lazy or careless or just not trying hard enough.

The researchers are right that those costs are chronically undercounted in the overdiagnosis conversation, and right that the people demanding we slow down and diagnose less carefully are often causing real harm to real people who are already suffering.

But I’ve been watching this argument cycle around for thirty years now, and every time it surfaces I notice the same thing. Both sides are fighting over the same piece of ground, and neither side ever steps back far enough to ask whether the ground itself is worth fighting over.

The entire debate — overdiagnosed, underdiagnosed, the waiting lists, the diagnostic criteria, the DSM threshold, the screening tools, the disagreements between clinicians — every bit of it rests on a foundation that nobody in the argument ever examines.

That foundation is the assumption that ADHD is a disease. A pathology. Something that, in a well-functioning brain in a well-functioning world, would not exist. A deviation from the norm that medicine is correct to identify, label, and treat.

Once you accept that assumption, the overdiagnosis debate makes perfect sense. If ADHD is a disease, then the important questions are how many people have it, whether we’re finding them all, whether we’re finding people who don’t actually have it, and what we should do about it medically once we’ve found them. These are reasonable questions to ask about a disease.

But here’s the question I’ve been asking since before most of the researchers in this debate had published their first paper: if ADHD is a disease, why does ten percent of the human population have it?

Why have we always had it? Why do the genetic variants associated with these traits trace back not just through recorded history but through our Neanderthal ancestors?

Why, when researchers study one of the last remaining nomadic populations on earth, the Ariaal people of Kenya, do they find that the same genetic variants that predict struggle and low status in settled agricultural communities predict better nutrition and higher social standing in the nomadic ones?

Darwin’s natural selection is not sentimental. It doesn’t carry a ten percent disease load across hundreds of thousands of years out of oversight or inertia. When a trait persists in the human genome at that frequency for that long, across that many environments and populations, it’s not persisting because nobody got around to editing it out.

It’s persisting because it does something that works. Because somewhere in the equation of human survival and human flourishing, it is still pulling its weight.

The researchers in the British Journal of Psychiatry are asking how many people have this disease and how do we make sure they get treated. I want to ask a different question. I want to ask what natural selection knows that the British Journal of Psychiatry doesn’t.

The answer, I think, is that natural selection has been running a much longer study with a much larger sample size, and its findings suggest that what we call ADHD is not a malfunction. It is, instead, an alternative operating system.

One that was exquisitely suited to the environment in which human beings spent the vast majority of their existence, and that remains suited to a significant range of environments today, including some of the most demanding and consequential ones we have in our modern world: Emergency medicine. Entrepreneurship. Combat. Crisis response. The arts. Any field where the premium is on pattern recognition, rapid adaptation, tolerance for uncertainty, and the ability to hyperfocus on a moving target.

The mismatch isn’t between a healthy brain and a broken brain. It is between an ancient brain and a modern institution.

The school, the open-plan office, the standardized test, the forty-hour week of repetitive structured tasks: these are extraordinarily recent inventions on the timescale of human evolution.

The brains sitting inside them, however, are not recent inventions at all. Some of those brains were built for a world that ran on different rules, and when you put them in an environment that rewards only the traits they have the least of, they look disordered. Of course they do. If you measure a hawk by its ability to swim you’ll conclude there’s something wrong with the hawk.

What I find most telling — and troubling — about the overdiagnosis debate is how it makes everyone anxious in opposite directions but leaves the basic framework completely untouched.

The people who worry about overdiagnosis are worried that we’re pathologizing normal human variation, which is a legitimate concern dressed in the wrong clothes, because the problem isn’t the rate of diagnosis, it’s the concept of pathology they’re both starting from.

The people who worry about underdiagnosis are worried that suffering people aren’t getting help, which is also legitimate and also dressed in the wrong clothes, because the help available is almost entirely calibrated toward managing the traits rather than understanding and deploying them.

Nobody in this argument is asking whether the measuring stick is the right one. Nobody is questioning whether a world that has organized itself entirely around Farmer virtues — consistency, compliance, linear attention, deferred reward, tolerance for repetition — and then diagnoses as disordered everyone who can’t perform those virtues at an acceptable level, might itself have something to answer for.

The researchers are calling for better funding, better workforce training, faster access to assessment. These are good things. I support them. But they’re just improvements to a system whose operating premise I’ve been challenging since 1993, and nobody in the current debate seems particularly interested in that challenge.

Here is what I know after thirty years of living and working in this field. The Hunters among us don’t need the medical establishment to agree on whether there are too many or too few of us. They need a story about themselves that is true, that is empowering, and that gives them a framework for understanding why certain environments break them and others make them extraordinary.

They need to know that the traits causing them trouble in the waiting room, in the classroom, in the cubicle, are the same traits that kept the species alive long enough to build waiting rooms and classrooms and cubicles in the first place.

That is not a story the overdiagnosis debate can tell. It’s too busy arguing about how many sick people there are to notice that the sickness might be in the diagnosis itself.

I’m not against assessment or even medication; I’ve used both. I’m not against support. I’m not against making people wait less time for help that might genuinely improve their lives.

I am, however, against a conversation that has been running for thirty years without once stepping back to ask the oldest and most important question underneath it:

Not how many people have this, but why, after everything, do we still treat it as a disorder and only offer simplistic solutions?

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My son was 12 years old when we first started seriously wondering whether something was going on with him. 12. And even at 12, even after the testing and the conversations with psychologists and the stacks of papers I collected from university libraries and medical schools, I was cautious about what story I told him about himself.

Because the story you tell a child about who they are has a way of becoming true, in the best and worst senses of that word. At 12, he was old enough to start building an identity. Old enough to hear “there is something different about how your brain works” and make something of it, for good or ill.

He was not four.

A study led by researchers at Stanford Medicine, published in JAMA Network Open, looked at electronic health records from more than 700,000 children between the ages of three and five, seen at primary care practices affiliated with eight major academic medical centers across the United States.

Of the children who received an ADHD diagnosis, 42 percent were prescribed stimulant medication within thirty days.

Not within thirty days of finishing a recommended course of behavioral therapy. Within thirty days of the diagnosis itself.

The American Academy of Pediatrics is not a radical organization. It doesn’t traffic in alternative frameworks or evolutionary hypotheses. It’s about as mainstream as medicine gets, and its guidelines say plainly that children this young should try six months of behavioral therapy before anyone considers medication. Six months.

Nonetheless, the researchers found that only 14 percent of diagnosed preschoolers waited that long before receiving a prescription.

Here is the part that stopped me cold. Among preschoolers whose charts noted some ADHD symptoms but who had not yet received a formal diagnosis, nearly one in four still received medication within thirty days. Children who hadn’t even been formally diagnosed yet were being put on stimulants.

I want to be precise about what I am and am not saying here.

I am not saying that every one of those prescriptions was wrong, or that every one of those physicians was careless. Medicine is practiced in the real world, where waiting lists are long and appointments are short and parents are exhausted and desperate for something that will help their child and their family right now. I understand that desperation. I lived it.

And the researchers who conducted this study understand it too. When they asked physicians informally why they prescribed so quickly, the answer that kept coming up wasn’t impatience or laziness. It was access. There aren’t enough therapists trained in behavioral treatment for young children. Insurance often won’t cover it even when a therapist exists. So the doctor writes a prescription because a prescription is what they can actually provide.

That is a systems failure, and the physicians caught inside it are not the villains of this story.

But I want to talk about the four-year-old, because the four-year-old is the one who can’t speak for himself in any of this.

A four-year-old Hunter is one of the most purely alive human beings on the planet. He is in motion. He is loud. He is curious about seventeen things simultaneously and committed to exactly none of them for more than four minutes at a stretch. He touches everything. He interrupts. He has strong opinions about which direction the walk should go and he will not be easily redirected.

He’s exhausting to be around if you’re a Farmer adult who’s spent twenty years learning to sit still and follow instructions, and yet he is absolutely magical if you can step back far enough to see what you’re actually looking at.

What you are looking at is a brain that is doing precisely what it was designed to do. Not a broken brain. Not a disordered brain. A four-year-old brain that happens to be wired for exploration, novelty, movement, and immediate reward. Farmers call this ADHD. For most of human history, the tribe called it Tuesday.

The diagnosis of ADHD before the age of six is, to put it charitably, an uncertain science. The traits that define ADHD in a clinical setting — inattention, hyperactivity, impulsivity — are also the defining traits of being a young child.

Separating the two requires time, observation, multiple settings, and a clinician who has seen enough children to know the difference between a Hunter and a four-year-old who hasn’t had enough sleep. It requires exactly the kind of careful, unhurried assessment that a fifteen-minute primary care appointment can’t possibly provide.

And yet primary care is where most of these diagnoses are being made, and made quickly, because that is where families end up when they can’t access anything else.

What behavioral therapy actually does, when it’s given the chance to work, is teach skills. It teaches the child’s parents how to structure an environment that works with a Hunter brain rather than against it. It teaches the child, in age-appropriate ways, how to manage transitions and frustration and the gap between what they want to do and what the situation requires.

These are skills that last a lifetime. A prescription doesn’t teach anyone anything. It changes the neurochemical environment inside the child’s brain, and when the pill wears off, the child still doesn’t have the skills, because no one taught them.

There’s also the question of what we’re communicating to a four-year-old when we medicate him. Children that age don’t understand pharmacology. What they understand is that they were a certain way, the adults around them were unhappy about it, and now they take a pill every morning.

The story that writes itself from that sequence of events is not a story about evolutionary heritage and Hunter traits and a mismatch between ancient wiring and modern classrooms. It is a much simpler and much darker story: I was born broken, and the pill makes me less broken.

I spent years trying to give my son a different story than that. Not a story that denied the realities of his situation, because he deserved honesty about the challenges he faced. But a story that started from the premise that he was not broken.

That the friction between how he was wired and how school was structured was real, but that the friction said something about the structure too, not only about him. That the same traits that made fourth grade hard for him and me had made entire civilizations possible, and that if he could learn some new skills and find the right environments, those traits would be among the best things about him.

He was seven when we started building that story. I am genuinely uncertain what version of it can be told to a four-year-old, or how a four-year-old metabolizes a daily pill in terms of self-understanding.

What I am certain of is that we owe it to these children to try to find out before we start medicating them.

Six months of behavioral therapy isn’t a bureaucratic hurdle the Academy of Pediatrics invented to make everyone’s lives harder. It is the minimum amount of time needed to find out who this child actually is, what they actually need, and whether the answer is really a controlled substance or whether it might be a parent who has learned some new tools, a teacher who understands how Hunter brains work, and a little more room to run.

The study found that the families least likely to access behavioral therapy first were the families least able to navigate a complicated, underfunded mental health system.

Which means the children most likely to be medicated before anyone teaches them anything are the children who most need someone in their corner.

That’s not a coincidence: it’s a policy failure with a face on it, and the face is four years old.

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In the early 1990s, when I first started writing and speaking publicly about ADHD through the lens of Hunters and Farmers, the reaction from much of the academic world was swift and vicious. I wasn’t just disagreed with; I was ridiculed. Dismissed. Treated as a crank who didn’t understand “real science.” When TIME magazine put my ideas and my first book, ADHD: Hunter In A Farmer’s World, on the cover, the attacks intensified. Suddenly I wasn’t just wrong, I was dangerous.

No one embodied that backlash more than Russell Barkley, who seemed to make it his personal mission to publicly discredit me. I was accused of romanticizing ADHD, of misleading parents, of undermining serious medicine. The message from the academy was clear: deviation from the dominant deficit model would not be tolerated.

When The New York Times wrote about my theory 26 years ago, noting:

“In his book ‘Attention Deficit Disorder: A Different Perception’ Thom Hartmann, a psychotherapist in Northfield, Vt., proposes an anthropological theory that the traits of the disorder were vital in early hunting societies. To survive, he says, those societies needed distractible, impulsive, quick thinking decision makers. The traits became a mixed blessing only when societies turned agrarian, Mr. Hartmann argues.”

Barkley suggested to the Times that I was absolutely, totally, irredeemably wrong:

“Dr. Barkley, the author of 14 books on the disorder, said: ‘This trend of making A.D.D. seem an advantage is highly detrimental. In hundreds of research studies, there is not one shred of evidence that confers anyone with A.D.D. with an increased ability in creativity, intelligence or motor skills. I categorically reject, among other myths, that people with A.D.D. are better, for example, at multitasking. I understand that this may be an effort to counter a history of low self-esteem among people trying to cope with the effects of A.D.D., but this sort of folk lore is a dangerous thing.’”

But I persisted, not because I had an ideological axe to grind, but because I knew in my gut that the story I was telling matched my own lived reality far better than the one I was being told to shut up and accept.

I’d seen it in myself and my kids. I’d seen it in entrepreneurs, artists, explorers, emergency responders, and people who thrived in chaos but withered in classrooms. The Farmer world was insisting that only one kind of mind counted as normal, and it was obvious to me that this said more about the system than about the people it was labeling disordered.

What I couldn’t prove at the time, at least not to the academy’s satisfaction, was that this wasn’t just metaphor. That it wasn’t just social commentary. That it had deep evolutionary and ecological roots.

Now, three decades later, the academy itself is finally catching up.

A research project out of the University of Cambridge, titled “Attention Profiles in Hunter-Gatherer Societies,” does something that would have been unthinkable when I first advanced these ideas. Instead of assuming that attention traits like impulsivity, hyperactivity, and distractibility are universal deficits, the researchers ask a radically different question: what if those traits only look like deficits in Farmer societies?

The project’s own summary puts it plainly, and powerfully:

“Attention and executive control including traits such as inhibition, impulsivity, and hyperactivity are studied in WEIRD (Western, Educated, Industrialised, Rich, Democratic) societies, where sustained focus and impulse control are highly valued. A deficit in these domains might lead to a diagnosis of a mental disorder such as ADHD. However, in non-WEIRD populations, such traits may have distinct roles or adaptive significance, particularly in environments where exploration, adaptability, and risk-taking behaviours are critical for foraging and survival.”

Read that again. Slowly.

This is not some fringe blog post or pop-psych speculation. This is the academy, in its own careful language, acknowledging the core of what I was attacked for saying in the 1990s. That the behaviors we pathologize in modern industrial societies may be mismatches, not malfunctions. That a Hunter mind dropped into a Farmer world will look broken, even though it may be exquisitely adapted for a different ecological niche.

What’s especially striking is that this research doesn’t just validate the Hunter versus Farmer frame. It expands it.

It suggests that attention itself is not a single universal faculty that some people have “more” or “less” of, but a flexible set of strategies tuned to environmental demands. Sustained focus is valuable if you’re plowing a field or filling out paperwork. Rapid shifting, scanning, and novelty-seeking are valuable if you’re foraging, tracking, or navigating uncertainty.

When I first wrote ADHD: Hunter In A Farmer’s World, I was arguing against a culture that insisted on measuring every mind by Farmer metrics. I was saying, essentially, that we had built schools, workplaces, and institutions optimized for agricultural and industrial efficiency, and then acted surprised when people with Hunter cognition struggled inside them.

What the Cambridge research makes clear is that this isn’t just a cultural critique. It’s an evolutionary one. The Farmer world is historically recent. For most of human existence, adaptability, exploration, and risk-taking weren’t liabilities. They were survival traits. And even today, in moments of rapid change or crisis, those traits often reassert their value.

Looking back, the attacks from the academy make more sense now. Paradigms defend themselves. Once a system defines certain behaviors as disordered, it builds entire professions, funding streams, and identities around that definition. Not to mention billions in drug and therapy sales. Challenging it doesn’t just threaten an idea; it threatens a hierarchy.

But science, at its best, eventually circles back to reality.

I don’t take any pleasure in having been right while being pilloried. What matters is that parents, teachers, clinicians, and policymakers are finally being given permission to ask better questions. Not “How do we fix these kids?” but “What kind of world are we asking them to live in?” Not “How do we suppress this behavior?” but “Where might this behavior actually be useful?”

The most gratifying part is realizing that the Hunter/Farmer frame is even bigger and more explanatory than I imagined thirty years ago: it’s not just about ADHD. It’s about how societies choose which minds to value. It’s about what happens when a civilization optimized for stability collides with a reality defined by rapid change.

The irony is that the very traits the Farmer world has tried hardest to stamp out may be the ones we need the most right now. And after decades of being told I was wrong, it’s quietly reassuring to see the academy finally say, in its own words, that us Hunters were never broken to begin with.

We were just living in the wrong world.

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Burnout in Hunter minds is often misdiagnosed as weakness. And sometimes we even accuse ourselves of it; many times I’ve overcommited and then ended up mentally flogging myself for my inability to finish what I’ve started.

It gets framed as poor resilience, lack of discipline, or a failure to manage stress. As a result, the advice that follows is predictable: better routines, better habits, better boundaries, better time management. Try harder to tolerate what everyone else seems to handle just fine.

But hunter burnout isn’t a failure of endurance: it’s a failure of fit.

Farmer systems are designed around predictability, repetition, and delayed reward. They assume steady energy, consistent attention, and compliance with externally imposed schedules. They reward those who can do the same thing every day with minimal variation and minimal emotional engagement.

Hunter minds evolved for something else entirely.

Hunters are built for vigilance, novelty, pattern recognition, and rapid response. Their attention isn’t meant to be evenly distributed; it’s meant to spike when something matters. Our energy isn’t meant to trickle out on a schedule; it’s meant to surge when conditions demand it, and rest when they don’t.

When you place a Hunter in a Farmer’s system, the problem isn’t effort: it’s chronic misalignment.

At first, many Hunters cope by overperforming. They compensate, mask, and force themselves into routines that feel deadening but are socially rewarded. From the outside, they may look successful. From the inside, though, they’re bleeding energy at a steady rate that even they don’t understand.

This phase is often praised. People say things like “You have so much potential!” or “If you just applied yourself consistently you’d go far.” What they don’t see is the cost. Every Farmer task produces friction and every day demands suppression of the Hunter instincts that once kept humanity itself alive.

Eventually, of course, the Farmer system of our modern society wins.

Burnout arrives not as a sudden collapse but as a steady, inexorable erosion. Motivation fades, executive function frays, and the body grows heavy. The mind becomes foggy or irritable. What once required effort now feels impossible. Shame then moves in quickly, because our culture insists this is a personal failure.

It isn’t.

Farmer systems depend on steady output, butHunter nervous systems don’t produce steady output. Instead, they produce situational excellence. They shine in complexity, uncertainty, urgency, and meaning. They wither in monotony, surveillance, and artificial deadlines.

Modern work environments are especially punishing because they combine the worst features for Hunters: constant low-level urgency, meaningless metrics, endless interruptions, and little autonomy. For a Hunter, it feels like there’s no clear threat to respond to, no hunt to complete, and no resolution, just an infinite field of half-finished Farmer’s demands.

The Hunter nervous system, as a result, never gets closure.

Instead of cycles of exertion and rest, Hunters are trapped in perpetual activation. Cortisol stays elevated, dopamine stops responding, and the system that once made us adaptive turns against us.

Burnout is our nervous system telling us that this sort of environment is unsustainable.

What makes this even worse is society’s moralization. Farmers are taught that consistency equals virtue, so when Hunters can’t maintain it, they internalize the judgment. Lazy. Undisciplined. Broken. They try to fix themselves instead of questioning the environment.

This deepens the damage.

The proof of this is that Hunter burnout often lifts rapidly when the context changes. Put the same person into crisis response, creative work, problem-solving roles, or mission-driven projects and watch what happens: energy returns, focus sharpens, and confidence rebuilds. The problem was never capacity: it was containment.

This doesn’t mean Hunters can avoid structure entirely. It means, instead, that they need different kinds of structure. Flexible rhythms instead of rigid schedules. Bursts instead of marathons. Meaning instead of compliance. Autonomy instead of micromanagement.

It also means rest has to be real. Not performative recovery designed to feed the same system again, but genuine disengagement. Hunters don’t recharge in tiny daily increments; we recover in longer cycles, through novelty, movement, solitude, and purpose.

Burnout isn’t the end of the story. For many Hunters, it’s the moment the illusion breaks. The moment we realize the problem was never that we couldn’t keep up: it was that we were never meant to live this way.

Thus, healing begins not with self-discipline, but with self-recognition.

When Hunters stop trying to become Farmers, their nervous systems finally get permission to stand down.

And that’s when life starts to make sense again.

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There’s a quiet rebellion happening inside millions of people who’ve spent their entire lives being told they’re too scattered, too emotional, too impulsive, too intense, too “unfocused.”

For adults with ADHD, the world has always demanded conformity to a standard that never fit, insisting that worth is measured by how well you can sit still, file reports, meet arbitrary deadlines, and march to the rhythm of the 8-to-5 workday.

But something is shifting now. More and more people are beginning to see that embracing neurodivergence isn’t weakness or failure. It’s an act of resistance. It’s a way of reclaiming an evolutionary identity that corporate culture has spent generations trying to erase.

For most of human history, the people we now label neurodivergent were the ones who ensured the survival of their communities. They were the horizon-scanners, the quick responders, the restless innovators, the ones who didn’t wait for permission to move when something needed doing.

The same traits that make a child wiggle in a classroom or an adult bounce between ideas were once the essential features of the Hunter’s mind. Our ancestors didn’t survive because everyone followed the rules or kept perfect paperwork; they survived because some people noticed the threat nobody else saw, chased the opportunity no one else imagined, or sensed danger before danger had a name.

Modern society has forgotten this. We built a world optimized for predictability and routine, and then demanded that everyone fit into it.

Schools are factories of compliance. Offices are temples of monotony. The 40-hour workweek became not just a schedule but a moral ideal, as if the ability to tolerate boredom were a measure of character.

People with ADHD, whose biology rebels against such artificial rhythms, are told they’re defective for not thriving in systems designed to suppress everything that makes them who they are.

But the rebellion begins the moment you stop seeing your Hunter traits as problems to be fixed and start seeing them as parts of your identity that carry wisdom older than agriculture.

The moment you say, “I’m not going to apologize for my brain anymore,” something profound shifts. You stop trying to be a good factory worker and start being the person your wiring was shaped to support: a creative problem solver, a rapid responder, a meaning-seeker, a human being who comes alive in motion and possibility.

ADHD becomes an act of resistance the instant you stop pretending your brain is a broken version of “normal” and instead recognize that your brain is perfectly adapted for the world humans lived in for 99 percent of our existence.

You resist the idea that your value is measured in emails answered, tasks completed, or hours spent sitting in a chair. You push back against a culture that confuses productivity with virtue. You interrupt the narrative that compliance is the same as competence.

It’s not easy. The world pushes hard. Bosses want predictability. Teachers want compliance. Families want calm. Society wants everyone to color inside the lines so the whole machine keeps running smoothly.

But machines aren’t alive, and humans aren’t machines. When you embrace neurodiversity, you’re resisting not just expectations but an entire industrial worldview that saw individuals as interchangeable parts rather than unique constellations of strengths.

Corporate culture thrives on sameness. ADHD thrives on difference. Corporate culture wants comfort and predictability. ADHD thrives in change, crisis, novelty, and meaning. Corporate culture runs on time. ADHD runs on passion.

These are not small distinctions. They’re evolutionary signals. They reflect what your brain was built to do, and what it resists for good reason.

When you honor your wiring instead of fighting it, something beautiful happens.

You begin organizing your life around bursts of energy rather than shame. You follow curiosity instead of guilt. You choose work that matches your internal tempo rather than trying to force yourself into roles that drain you. You stop seeing yourself as the problem and start seeing the problem for what it is: a culture that was built without people like you in mind.

And when you embrace that truth, you’re not just helping yourself. You’re expanding the cultural imagination for everyone who comes after you.

You’re telling your kids or grandkids—or the adults who still carry the wounded child inside—that there’s nothing wrong with being wired for intensity, imagination, or motion. You’re showing them that resisting conformity is not a failure. It’s a reclamation.

ADHD isn’t just a diagnosis. It’s a lineage. It’s the modern expression of an ancient survival strategy. And embracing it is pushing back against a world that pretends the only good human is a standardized human. You’re not here to be standardized: you’re here to be fully alive.

When you stop apologizing for your wiring, you reclaim a piece of yourself that the world tried to strip away. That is resistance.

When you refuse to measure your worth by how well you perform a job designed for a different kind of brain, you reclaim your dignity. That is resistance.

And when you start honoring your attention not as a failure but as a compass pointing toward what matters, you reclaim your evolutionary story. That may be the deepest resistance of all.

Because the truth is simple: you were never broken. You were never meant to live by factory rules. Your brain carries the wisdom of a million years. And embracing that—fully, proudly, without apology—is not disorder. It is freedom.

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The strange thing about living with ADHD in 2025 is that the world insists on calling it “anxiety.” Therapists call it anxiety. Teachers call it anxiety. Even doctors often reach for that label before they ask a single question about wiring, temperament, childhood, or the basic structure of your day.

But the truth is far more interesting, and far more hopeful: most of what ADHD adults describe as anxiety isn’t anxiety at all. It’s misdirected readiness. It’s an ancient survival system looking for something real to do.

The Hunter brain evolved to scan the horizon, constantly shifting attention between motion, sound, pattern, and intuition. It’s a system built for vigilance, for reading the landscape, for noticing the thing nobody else sees.

For hundreds of thousands of years that vigilance saved lives. It kept the tribe fed, safe, mobile, and aware of danger long before danger reached camp. It meant being tuned into the slightest shift in wind, light, or animal behavior. It meant being the person who woke up at the crack of a twig or the rustle in the grass.

That constant readiness wasn’t anxiety. It was competence.

Now drop that same brain into 2025.

Instead of rustling grass, it gets Slack notifications. Instead of animal tracks, it gets credit card alerts. Instead of a burst of adrenaline that results in action, it gets an email with the subject line “gentle reminder.” Instead of a crisis it can run toward, it gets a calendar ping for a meeting that shouldn’t exist.

The Hunter brain tries to respond to every one of these signals as if they’re meaningful, because in the world that created it, every signal was meaningful. In a forest or a savanna you don’t ignore subtle cues or you could pay with your life. In a modern Farmer’s office you’re supposed to just let them go by.

That mismatch is where the suffering, the “anxiety,” comes from.

It’s not that ADHD adults are more anxious than everybody else. It’s that the modern world produces a constant trickle of micro-threats, tiny little pings that never release, never resolve, never lead to decisive action.

The Hunter brain is firing up the survival system all day long with no way to discharge it. You can’t sprint across the savanna to deal with a calendar reminder. You can’t stalk a problem you’re told not to start working on until the meeting starts. You can’t get resolution from a Slack thread.

So the energy builds. And builds. And builds until it feels like a pending explosion.

People with ADHD often describe a feeling of restlessness, of not being able to relax even when nothing’s wrong. That’s not anxiety. That’s a Hunter’s nervous system trapped in a Farmer’s daily schedule.

Farmers could wait. They could pace life around seasons and cycles. The most predictable thing about a farm is the repetition: same fields, same paths, same routines, day after day.

A Farmer’s brain evolved to thrive on stability and consistency, but a Hunter’s brain evolved to thrive on movement, novelty, surprise, and rapid shifts in focus. One wiring system isn’t better than the other, but put a Hunter in a Farmer’s world and the Farmer’s world will insist he’s broken.

This is why, paradoxically, so many ADHD adults feel calm during real emergencies.

When a car spins out on the highway, when a child gets injured, when something actually requires quick attention and fast assessment, the Hunter brain turns on and everything suddenly feels natural.

There’s no anxiety in those moments. There’s clarity. There’s purpose. There’s competence. That’s the original environment: the moment where sensitivity becomes strength. The Farmer brain may freeze, but the Hunter brain wakes up.

Compare that to a society full of abstract obligations.

Our modern world is built on invisible tasks. Invisible jobs. Invisible pressures. You’re supposed to remember a thousand tiny deadlines, most of which have no sensory reality at all. They exist as words on a screen, as expectations from a boss, as a recurring alarm that means nothing except that somebody wants your attention.

For a Hunter brain, that’s maddening. It’s the neurological equivalent of hearing a twig snap every five minutes but never being allowed to look toward the sound. The body interprets the signal as danger, but the mind is told it’s just Tuesday.

That chronic disconnect is what gets labeled “anxiety.” And then people wonder why medication alone doesn’t fix it. Or why mindfulness apps don’t cure it. Or why telling someone with ADHD to “just calm down” is like telling a smoke alarm to stop being so sensitive when the wiring is literally meant to detect risk before anyone else does.

ADHD adults aren’t anxious people. We’re people living in an environment that keeps tripping a nervous system built for a completely different century.

The way forward is through understanding, not pathologizing. If you have ADHD, you aren’t weak or fragile or neurotically anxious. You’re tuned differently.

You’re hypersensitive to shifting conditions because your ancestors survived by being that way. You experience the world as a field of constant motion because your brain evolved to track constant motion. You brace for things that never arrive because your wiring expects meaningful cues, not phantom obligations.

And the shame that so many ADHD adults carry isn’t the result of their wiring. It’s the result of a society that punishes difference and celebrates conformity above all else.

But once you understand the mismatch, you can start to reclaim your strengths. You can build your life around the way your brain naturally operates.

You can use movement, novelty, challenge, and creativity as tools instead of trying to crush yourself into a mold built for someone else. You can stop mistaking readiness for fear.

And you can begin to see your wiring not as a flaw, but as a different form of intelligence, one that the world desperately needs, even if it doesn’t always realize or understand it.

If the modern world overwhelms you, it’s likely not because you’re anxious. It’s because you’re a Hunter living in a Farmer’s world, like the title of my first book on ADHD.

And once you understand that, you can start living in a way that honors your wiring instead of fighting it.

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When you live as a Hunter—always alert, always scanning, always slightly out of rhythm with the steady Farmer-world around you—you know the thrill of hyperfocus like few do. That moment when everything aligns: your mind lights up, time bends, you’re deep in the task, losing track of dinner, sleep, even the surroundings.

But what comes afterwards is what many don’t talk about enough: the crash. People with Attention‑Deficit/Hyperactivity Disorder often slide from that intense zone of “locked-in focus” into a state of exhaustion, low energy, hazy thinking and mood drag.

If you’re a Hunter who felt that square-peg-in-a-round-hole vibe your whole life, you need to understand this cycle, and you need your partner to understand it too. Because your brain isn’t just “different,” it’s wired for peaks and troughs, and if your partner expects steady Farmer rhythms they’ll miss your map. Worse, you might begin to believe the crash is proof you “don’t fit,” rather than proof you were doing what your Hunter brain does in ways that can really excel (see: Thomas Edison).

Here’s how the sequence plays out: you lock into something that sparks you; maybe it’s building a side project, digging into a passion, or chasing a thread of curiosity. That’s hyperfocus: an intense state of concentration where you might “forget time, surroundings, bodily needs.”

Your brain toggles into a subsystem where the task-positive network (TPN) is fully engaged and the usual background chatter quiets. But then the crash comes. After extended high arousal the brain goes into a rebound: alpha waves increase uncoordinatedly, theta waves rise (signs of fatigue or fuzzy thinking) and you shift from high focus to under-aroused or dysregulated.

So what was once “I’m in the zone” becomes “I’m flat,” “I can’t finish,” “I feel burned out.” The crash isn’t just a hiccup. It hits your sense of self. If you’ve always felt like you don’t quite belong, sliding from your high into the low gives the negative internal narratives most Hunters have absorbed through the years extra fire: “See — you couldn’t last,” “See — you’re broken,” “See — you don’t fit.”

Those of us who identify as Hunters carry early-life wounds. We learned that our rhythm was wrong, our pace too fast or too erratic, our focus misinterpreted. We adapted, we compensated, we masked. The truth is that living in a Farmer’s world can wear down your sense of self, even when you’ve managed to make it this far.

When you hit that zone of hyperfocus — the creative storm that makes you come alive — you feel, for a while, like you’re exactly who you were built to be. And then, sometimes, the crash comes. That post-hyperfocus exhaustion, irritability, or sadness can feel like a failure. It isn’t. It’s a neurological rebound, the brain’s way of resetting after too much stimulation.

Hyperfocus is a state of extreme concentration where time, surroundings, even hunger vanish. It feels like a gift, and it is. The problem comes when the same mechanism that makes you brilliant in that zone leaves you depleted afterwards.

During hyperfocus, the brain’s dopamine systems go into overdrive. When the task ends, those dopamine levels plummet, and you feel the emptiness like gravity itself. Brain activity shifts as well, including the high-frequency focus waves that kept you sharp fade into slower rhythms associated with fatigue and fog. What was high clarity suddenly becomes haze. That’s the crash.

If you’re a Hunter, you know the pattern well. You dive into a project, a passion, a new idea. You skip meals and sleep without even noticing. You feel alive in a way that’s hard to explain to anyone who hasn’t felt it. Then it’s gone, and you’re staring at the mess on your desk, wondering why you feel hollow. You start telling yourself stories: maybe you’re lazy, maybe you lack follow-through, maybe you never finish anything.

The reality is simpler and kinder. You ran your engine hot. You did what your brain was built to do. Now you need to let it cool down.

Understanding that rhythm is one of the most powerful acts of self-care a Hunter can learn. You don’t need to fight the cycle or pretend you’re a steady farmer tending an even row of crops. You just need to know the terrain and plan for it.

When you feel the hyperfocus rising, notice it. Set an invisible timer in your mind. Remind yourself that the crash is part of the same process, not proof of failure. You can even prepare for it: schedule downtime the way a runner plans for recovery after a race. Protect the landing as much as you chase the flight.

Another piece of the puzzle is understanding that hyperfocus and crash aren’t exclusive to ADHD. They can overlap with other conditions, including bipolar disorder, which sometimes gets confused with or misdiagnosed as ADHD. In bipolar disorder, the “high” might come with grandiosity, little need for sleep, impulsivity, or risky behavior, followed by depression and guilt. In ADHD, the high is usually tied to interest or novelty rather than mood, but the surface resemblance can be misleading.

That’s why it’s important to check with a professional if you’re unsure where your cycle fits. You can’t treat what you don’t understand, and misdiagnosis can cause years of frustration.

What matters most, though, is self-awareness. Hunters thrive when they accept their operating system rather than fight it. You were designed to surge and rest, not to grind on a flat line. The key is to learn how to land without self-recrimination.

When the crash comes, instead of asking “What’s wrong with me?” try asking “What is my brain telling me it needs?” Maybe it’s sleep, maybe it’s silence, maybe it’s movement, maybe it’s something that reconnects you to the present moment like a walk, a shower, music that grounds you. You can rebuild your energy faster when you treat the crash as biological, not moral.

You can also train your brain to handle transitions better. Practices like mindfulness, breathwork, gentle exercise, and structured breaks can soften the swing between focus and fatigue. These aren’t about controlling your brain, they’re about befriending it.

You can learn to spot the signs that you’re nearing the red line: your breath shortens, your thoughts start looping, your body gets tense. That’s the signal to step back for a few minutes, not to push harder. If you pause early, you can sometimes avoid the full crash altogether.

It also helps to reframe what hyperfocus means. It’s not just distraction flipped inside out; it’s one of the deepest expressions of curiosity and passion. When you’re in that state, your mind is giving everything it has to the moment. That’s not dysfunction. That’s devotion.

But devotion has limits, and part of self-growth for Hunters is learning that intensity doesn’t always mean sustainability. You can love your work or your ideas without burning yourself up in the process. You can learn to close the hunt before exhaustion hits, saving enough of yourself for tomorrow’s chase.

Over time, you start to build trust in your own rhythm. You realize the cycle is not a flaw; it’s a pattern. You begin to feel less ashamed of the crash and more respectful of it. You learn to plan projects around your peaks and to fill your valleys with rest, reflection, and gentle tasks that don’t demand too much focus. You start treating your brain like a partner, not an adversary. That’s when the self-esteem that ADHD can erode starts to rebuild itself.

The crash after hyperfocus isn’t your enemy: it’s your body’s way of asking for balance. Once you understand it, you can stop fearing it and start working with it.

You can design your life around the truth of your energy, instead of the myth of constant productivity. You can live like the hunter you are: agile, curious, creative, capable of sprinting after what matters and wise enough to rest when the chase is done.

And maybe that’s what healing looks like: not “fixing” yourself, but finally learning to move in sync with your own nature.

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When you live with ADHD, especially if you’ve grown into the role of the “Hunter” in your internal framework — always scanning, always adapting, always slightly out of sync with what seems to work for everyone else — the partner you choose can make or break you in ways that go far deeper than idle relationship advice.

In my writing here at Hunter in a Farmer’s World and my books (particularly ADHD: Hunter in a Farmer’s World) I’ve often argued that most of us Hunters grew up wounded by our life’s experiences, particularly in school.

Maybe you learned early that you didn’t fit in the “round-hole” mold. Maybe you were told to slow down, pay attention, be more organized, or be less “all over the place.”

That kind of message becomes part of your story: you’re the square peg, wondering if you’ll ever stop feeling mis-cast. Many Hunters even describe themselves as “imposters,” pretending to be normal when they know they’re “different” but aren’t sure how or why.

And it gets particularly brutal when your partner uses those differences as a cudgel to win arguments or weaken your own sense of self-worth.

So what do you need, maybe more than the so-called “average” person?

You need your partner to hear you, to understand you, to respect the way you move through the world. And there is one red flag in a relationship that many people brush aside but you and your partner can’t afford to.

In her book, “Love by Design,” psychotherapist Sara Nasserzadeh says that when a partner constantly dismisses your experience, your pace, or the way you need to engage with life, that is a “red-flag behavior.” She says such behavior “could hurt your self-esteem and sense of self.”

Here’s what happens for the ADHD Hunter in that dynamic: you show up with your nervous system humming, your thoughts racing, your ideas sparking, maybe your focus zig-zagging.

If your partner consistently says, “Why can’t you just slow down like everyone else?” or “Why can’t you behave like the typical person in a relationship?” or “Why don’t you get more organized and fit into my schedule?” you begin to shrink. You begin to believe that the reason you struggle is not your wiring, but your worth. That you’re too much. That you don’t belong.

That message eats away at your self-esteem. And when the partner you chose is supposed to be your ally, your safe place, your reflection that you are enough, it doesn’t take long for you to feel “less than.”

What every Hunter with ADHD needs from their partner is this first: listening. Not just hearing the words “I have ADHD” or “I’m different” but listening to how you move, how your mind lands, how your nervous system fires.

Someone who asks “What does your brain need right now?” not “Why are you acting like you can’t sit still? or, “Why were you late?”

They don’t just tolerate your differences, they curiously tune into them, like a student of your process, not a critic.

Secondly, Hunters need understanding. Your brain is wired differently. Maybe you hyperfocus, maybe you flit, maybe you need physical movement, maybe you need to change lanes on the fly. That’s not a defect: it’s a different operating system.

A partner who expects you to act like the standard Farmer program will often say, essentially, “You’re not good enough” even if they don’t mean to. When a partner understands you, on the other hand, they won’t compare you to the “Farmers” around you; they’ll learn how you harvest differently.

And thirdly, Hunters need respect. Respect means they don’t shame you for missing the dinner at six because you were chasing an obsession, they don’t guilt you for a late night when your mind wouldn’t shut off, they don’t suggest you should (or even can) “just behave more normally” as though your wiring is a choice.

Respect is your partner saying: “I see you. I value you. Your difference is part of what attracted me to you in the first place.”

Because if your partner subtly signals you’re wrong because of who you are — if they repeatedly minimize your experience, your brain, your life — then you will internalize that, turning it into destructive self-talk. You’ll believe you should make yourself smaller, quieter, less of a Hunter. And that red-flag behavior is precisely what eats away at your sense of self.

When I say “don’t ignore this,” I’m speaking to you, the Hunter who’s been conditioned to soldier on, to make it through, to adapt no matter what: don’t ignore it when your partner dismisses your reality, downplays the way you think, or repeatedly suggests you should conform so that they feel more comfortable.

It might seem small, like, “He just hates when I fidget,” or “She keeps asking me to stop my racing thoughts so she can keep up.” But the accumulation of those small “requests for change” eventually becomes a verdict that says you’re wrong for simply being you.

And that’s corrosive. You can’t let that slide.

In the world of Hunter-Farmer metaphors, the Farmer might seek regularity, predictable rhythms, the steady dusk-to-dawn schedule, the fields tilled in straight lines. The Hunter is by nature opportunistic, exploratory, shifting.

If your partner is a Farmer who hasn’t learned to partner with a Hunter, you’ll spend much of your relationship being asked to conform. And over time every Hunter knows what that feels like: the feeling of walking in the wrong rhythm, of trying to soften your edges, of dimming your spark so you fit the mold.

But you deserve a partner who thrills at your spark, who listens to your rhythm, who honors your form. And you deserve to spot the red-flag of their implicit criticism of who you are, even when they don’t.

So if you’re reading this and you recognize that you haven’t been heard in your relationship, you haven’t been understood, you’ve been softly told that you should act less ADHD-ish, less Hunter-ish, you owe it to yourself to pause and name that behavior as a warning.

Because your self-esteem isn’t just something that just randomly happens to you, it’s something your partner helps you build or helps you destroy.

Behavior that harms self-esteem and sense of self isn’t minor. It matters. It can’t be excused away.

If your partner says “You’re fine” when you feel unseen, or “You just need to try harder” when you’re depleted, you are not being partnered, you’re being managed. And you’re being asked to make yourself smaller.

The choice facing Hunters is this: align with someone who sees your mind, your rhythm, and your difference not as the problem, but as the territory to walk together.

From your partner you need listening, understanding, and respect. Everything else is secondary to that foundation. Hold onto that truth.

Don’t ignore the red-flag even when the behavior is subtle, because for the Hunter with ADHD, subtle undermining of the self can become the thing that breaks the relationship or even breaks you.

Choose the partner who honors your square-peg shape, or help your current partner understand how your brain works differently. In doing so, you protect not just your relationship, but your self.

Because you’re not just fitting in anywhere; you’re fitting in right, with someone who understands your unique map. And we all deserve that.

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For as long as ADHD medications have existed, there’s been a cultural narrative that they are chemical straightjackets. Ritalin and Adderall, we are told, are about forcing restless kids to sit still, about sanding down the rough edges of people who don’t fit the mold. Parents are judged for “drugging their children.” Adults are warned that taking stimulants is giving up authenticity.

This is the lens of the Farmer’s world, where conformity is celebrated and where attention must be corralled into neat rows like crops in a field. But what if we reframe what medication is actually doing for the Hunter’s mind? What if instead of shackles, occasional use of stimulants can be more like scaffolding, temporary supports that let Hunters climb in environments never built for them?

ADHD is not a disease, it is a difference. The Hunter mind was never designed for spreadsheets, factory shifts, or 50-minute lecture periods. It was designed to scan horizons, track prey, improvise in danger, and follow curiosity to discovery. But the farmer’s world we now live in rewards exactly the opposite: sitting still, following schedules, moving sequentially, producing predictable outputs.

That mismatch creates suffering. Hunters are told their natural instincts are wrong. They internalize failure because they can’t keep pace with structures designed for farmers. In that sense, stimulant medications don’t erase the Hunter’s wiring: they help hunters operate in a foreign environment long enough to survive and even thrive.

The science tells us that ADHD is less about lack of attention than it is about irregular regulation of dopamine, the brain’s motivational currency. Without enough dopamine, ordinary tasks feel unbearably dull, while novel or urgent ones light up the brain like a Christmas tree. Stimulant medications like methylphenidate and amphetamines increase dopamine availability, making it easier to sustain attention on tasks that otherwise seem pointless.

They don’t make the Hunter less of a Hunter; they level the dopamine playing field so the hunter can choose where to focus. In the wild, Hunters never needed medication because the environment itself was stimulating, unpredictable, and rewarding. In a modern office, the environment is the opposite. Medications can, in the right circumstances and with careful use, supply the spark that the environment withholds.

That is why the scaffolding metaphor matters. Scaffolding doesn’t replace the building, and it isn’t meant to be permanent. It provides structure where structure is missing, stability where stability is temporarily needed.

Hunters who take medication aren’t being dulled or diminished. They’re being supported in climbing through a world that would otherwise be impenetrable. When the environment is already stimulating — when the hunter is creating art, solving a crisis, or chasing an idea — the scaffolding isn’t necessary.

But when the hunter has to fill out forms, finish homework, or grind through repetitive labor, the scaffolding holds them up long enough to get through. That’s not a loss of authenticity. It’s survival gear.

There are countless stories of children who, once given medication, finally “discover” they can learn. Not because the drug gave them intelligence, but because it built a bridge between their Hunter brain and a Farmer classroom.

Adults, too, often describe the first time they tried stimulants as a moment when the static cleared. Suddenly they could complete the boring tasks that always eluded them, not because their willpower improved but because their brain chemistry stopped fighting them.

Critics look at that and say, “See, the drug is making you conform.” But for Hunters, the experience is closer to having eyeglasses for the first time. The world comes into focus. You can still choose what to look at, but the blur is gone.

Of course, there are dangers. Stimulants can be misused. They can be overprescribed. They can be treated as magic bullets instead of as tools in a larger toolkit.

But the deeper danger is the stigma that surrounds them. Hunters who could benefit avoid them because they fear judgment, or because they’ve internalized the idea that they must suffer through farmer systems unaided. That stigma robs people of education, of careers, of relationships that might otherwise have flourished.

The truth is, for some Hunters, medication can be the difference between endless failure and the first taste of competence. And competence is what builds confidence. Without it, too many hunters collapse under the weight of shame.

And for some of us, it’s just a tweak: I used to use low-dose (2.5 mg) Focalin when I had to edit a book I’d written, a boring and awful task, but that was pretty much it.

The conversation needs to change. Instead of asking whether medication makes hunters conform, we should ask what hunters are able to build when given scaffolding. Does it help them get through school so they can pursue the careers that ignite their gifts? Does it give them the stability to nurture relationships instead of sabotaging them with forgotten commitments and unfinished tasks? Does it allow them to manage the farmer obligations of bills, taxes, and deadlines so they can free their energy for the hunter work of creativity, exploration, and innovation?

In these contexts, medication isn’t conformity. It’s liberation.

When critics sneer that stimulants are shortcuts, they miss the bigger point. The entire Farmer’s world is built on scaffolding: clocks, calendars, spreadsheets, institutions. Farmers built systems to tame the unpredictability of life.

So why shouldn’t Hunters have their own scaffolding too? If stimulants provide that temporary support, they are simply another tool in the human toolbox, like glasses or wheelchairs or hearing aids. We don’t accuse people of betraying their authenticity when they use a ramp to access a building. Why should we accuse Hunters of betraying theirs when they use medication to access the Farmer’s world?

The ultimate goal is not to medicate every Hunter into compliance. The goal is to create a society where Hunters and Farmers can work together, where each set of traits is recognized as valuable, where environments can be designed to accommodate diversity.

But until then, medication remains one of the only forms of scaffolding available to Hunters in a world not built for them. It should be seen not as an erasure of identity, but as a tool that allows identity to emerge. Because when Hunters can get through the boring tasks, they finally have the energy and freedom to unleash their brilliance. And that brilliance is what our world desperately needs.

For Hunters reading this, the choice to use medication is personal. It isn’t for everyone. But it should never be a source of shame. You are not broken for needing scaffolding. You are a Hunter living in a Farmer’s world, and you are using every tool at your disposal to survive and thrive.

That is not weakness; it’s wisdom. And wisdom is what turns survival into flourishing.

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“He just doesn’t care.”

“She’s lazy.”

“If only they’d try harder.”

Those are the phrases we hear again and again about people with ADHD. And they’re dead wrong. ADHD isn’t about a lack of effort. It’s about a brain wired differently—especially when it comes to motivation.

For decades, science has known that dopamine plays a central role in attention and goal-directed behavior. Dopamine is the brain’s currency of motivation, the chemical that tells us what matters. And in ADHD Hunter brains, the dopamine system doesn’t fire the same way as it does for Farmers.

That doesn’t mean ADHD folks don’t care. It means we care differently. We’re not motivated by vague future rewards. We’re wired to act in the now.

The Now vs. The Later

In hunter-gatherer societies, delayed gratification wasn’t a virtue—it was a risk. If you saw berries, you ate them. If you saw danger, you reacted. Hesitation could be fatal. This is the evolutionary root of the ADHD brain: fast, reactive, tuned to immediate feedback.

The modern world, especially the school and corporate systems, is structured around delayed rewards. Study hard now so you can go to college. Work long hours now so you can retire comfortably. But for many with ADHD, those long-term incentives don’t activate the motivation centers of the brain the same way they do for others.

Interest-Based Nervous Systems

Dr. William Dodson, a psychiatrist specializing in ADHD, coined the term “interest-based nervous system” to describe how people with ADHD function. Unlike the neurotypical brain, which can sustain attention based on importance or future consequences, the ADHD brain is fueled by interest, challenge, novelty, or urgency.

Give a kid with ADHD a workbook? They zone out. Give them a timed scavenger hunt? They’re all in. It’s not about discipline. It’s about wiring.

That’s why so many of us can hyperfocus on a video game or a creative project, yet completely forget to return a phone call. The task wasn’t engaging enough to light up the dopamine system. It’s not a character flaw. It’s brain chemistry.

The Medication Misunderstanding

Stimulant medications like methylphenidate (Ritalin) and amphetamine-based (Adderall) treatments work—when they do work—because they increase the availability of dopamine in the brain. They don’t make a person smarter or more disciplined. They make tasks feel more immediately engaging, more doable. They bridge the gap between intent and action.

But too often, medication is seen as a moral fix rather than a neurological support. Parents are told their child is finally “behaving.” Teachers praise compliance. But the goal shouldn’t be obedience: It should be understanding.

The Burnout Loop

Because we live in a world that doesn’t understand this, many ADHD Hunters live in a cycle of shame and failure. We can ace a test we studied for at the last minute, but fail an assignment that required weeks of incremental effort. We get labeled inconsistent, unreliable.

So we try harder. We push through. We mask. Until we burn out. The self-criticism becomes brutal. Why can I write a novel in three days but can’t mail a letter?

The answer is in the dopamine system. When the brain doesn’t get the chemical reward it expects from an action, it drops the task. No reward, no motivation. It’s not a moral issue. It’s a mismatch.

Rethinking Motivation

The solution isn’t to scold or shame. It’s to restructure tasks and environments. Break work into short, high-stakes sprints. Use timers, competition, novelty. Give real-time feedback. Tap into passion. ADHD Hunters thrive in crisis mode not because we like chaos, but because the urgency finally makes the task feel real.

This is why so many with ADHD end up as paramedics, journalists, entrepreneurs, cops, explorers—jobs with immediate feedback, fast decisions, constant motion. These jobs work with our wiring, not against it.

It’s Time to Ditch the Myths

The dopamine difference doesn’t make us lazy. It makes us different. The kid who won’t do their homework might one day start a company. The adult who can’t handle paperwork might save a life in an emergency. The trick is to stop asking them to act like Farmers and start building spaces where Hunters can thrive.

Let’s stop blaming people with ADHD for their wiring. Let’s understand it, honor it, and design for it. Because once we do, we’ll unlock a world of talent that’s been hiding in plain sight.

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For over three decades, I’ve been saying what the medical establishment didn’t want to hear: ADHD isn’t a disease, disorder, or defect. It’s an inherited trait that served our hunter-gatherer ancestors well for hundreds of thousands of years—and continues to benefit many people today. Now, groundbreaking research is finally proving what I’ve long called the “hunters in a farmer’s world” theory.

The latest study, published in the prestigious Proceedings of the Royal Society B just a few months ago, provides compelling experimental evidence that people with ADHD traits are superior foragers. Using an ingenious online berry-picking game, researchers at the University of Pennsylvania discovered that participants who scored high for ADHD characteristics consistently outperformed their neurotypical counterparts at gathering resources—exactly what we’d expect from evolved hunters suddenly dropped into sedentary, agricultural societies.

The Foraging Advantage

The study’s design was elegantly simple yet profound. Researchers gave 457 participants eight minutes to collect as many virtual berries as possible. Here’s the key: as participants repeatedly picked from the same bush, the number of berries available decreased, simulating resource depletion. Players could either persist with a declining patch or risk valuable time traveling to a new, more productive area.

The results were striking. People with ADHD traits abandoned depleted patches more quickly and gathered significantly more berries overall. Their supposed “impulsivity” and “distractibility”—traits that modern society labels as deficits—translated directly into foraging success. They instinctively knew when to cut their losses and explore new opportunities, a skill that would have meant the difference between feast and famine for our ancestors.

As study co-author Arjun Ramakrishnan noted, ADHD appears to be “a legacy of the hunter-gatherer world.” This isn’t speculation—it’s measurable, experimental proof of what I’ve been arguing since my first book on the subject.

Ancient Wisdom in Modern Genes

The genetic evidence is equally compelling. A 2020 genomic analysis examined ADHD-associated alleles in samples spanning from Neanderthals to modern humans—the largest such study ever conducted. The researchers found that ADHD traits have deep evolutionary roots, stretching back tens of thousands of years. These aren’t random mutations or modern maladaptations; they’re carefully preserved genetic variations that our ancestors carried forward because they conferred survival advantages.

Even more fascinating, research on the Ariaal people of Kenya—one of the last remaining nomadic populations—reveals the hunter-farmer divide in real time. Nomadic Ariaal with genetic variants linked to ADHD enjoy better nutrition and higher social status within their communities. But their settled, agricultural cousins with the same genetic variants? They’re considered unreliable and struggle with malnutrition. The same genes that spell success in a nomadic environment become liabilities in sedentary societies.

The Mismatch Theory Validated

This research validates what evolutionary scientists call the “mismatch theory”—the idea that traits evolved for one environment can become problematic when circumstances change dramatically. People with ADHD aren’t broken; our environment is mismatched to our evolutionary heritage.

Consider the specific advantages ADHD traits would have provided our hunter-gatherer ancestors:

Hypervigilance and distractibility meant spotting predators, prey, or threats from peripheral vision—a crucial survival skill when danger could emerge from any direction.

Impulsivity and quick decision-making enabled rapid responses to fleeting opportunities or sudden dangers, when hesitation meant death.

Hyperfocus allowed hunters to lock onto moving prey with laser-like intensity, tracking animals for hours or days.

Novelty-seeking and exploratory behavior drove the discovery of new food sources, safe shelters, and fresh territories—essential for nomadic survival.

High energy and restlessness suited a lifestyle requiring constant movement, long-distance travel, and physical endurance.

Delayed sleep cycles meant some tribe members naturally stayed alert through the night, providing protection while others slept.

Modern Advantages in the Right Context

The tragedy isn’t that people have ADHD—it’s that our factory-model schools and cubicle-based economy suppress these natural strengths. But in the right environments, ADHD traits remain powerfully advantageous.

Entrepreneurs with ADHD excel at spotting opportunities others miss and pivoting quickly when circumstances change. Emergency responders thrive on the hypervigilance and rapid decision-making that ADHD provides. Creative professionals harness the hyperfocus and innovative thinking that comes naturally to the ADHD brain. Sales professionals leverage their high energy and people skills to build relationships and close deals.

The research confirms what I’ve observed for decades: put ADHD individuals in environments that match their evolutionary programming, and they don’t just function—they excel.

Rethinking Our Approach

This isn’t to say medication doesn’t have its place—for some people in specific circumstances, it provides genuine relief and improved functioning. But we need to fundamentally shift how we think about ADHD. Instead of asking “How do we fix these broken children and adults?” we should ask “What environments would allow these individuals to flourish?”

The new research suggests we’re slowly trying to “edit out” ADHD traits through natural selection as they become less advantageous in agricultural societies. But evolution moves slowly, and millions of people today still carry the genetic legacy of our hunter-gatherer past.

Rather than medicating away these ancient gifts, we need to create more spaces in our society where ADHD traits can shine. This means rethinking education to include more movement, hands-on learning, and opportunities for exploration. It means designing workplaces that leverage rather than suppress ADHD strengths. It means recognizing that neurodiversity isn’t a problem to solve but a resource to cultivate.

The Bottom Line

The science is clear: ADHD represents an alternative human survival strategy that served our species well for the vast majority of our evolutionary history. These traits didn’t persist by accident—they were selected for because they worked.

Our hunter-gatherer ancestors didn’t have ADHD support groups or special education programs. They had societies that valued and utilized the unique gifts these individuals brought to their communities. The problem isn’t the hunters—it’s that we’ve built a farmer’s world and forgotten how to appreciate what the hunters have to offer.

As this new research demonstrates, it’s way past time to stop pathologizing our evolutionary heritage and start celebrating the diversity of human neurological expression. The hunters among us aren’t broken—we’re exactly who we’re supposed to be.

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Probably the most commonly-reported but totally ignored-by-the-psychiatric-community aspect of ADHD is the way Hunters understand and experience time.

My experience of time through my entire life has been that there are basically only two times: “Now” and “Some Other Time.”

“Now” hits me with an adrenaline-producing urgency; I’ve used it throughout my life to spur me to action at the last minute.

When I’m invited to give speeches, I almost always write them a few hours before I go onstage; a day before at the most. (I tell myself that way they’re “fresh,” but it’s really just a rationalization.) When I’m writing a book, the most and best work gets done in the month before the drop-dead deadline for submission when the weight of the job fully hits me. My radio program doesn’t get “real” until my producer points at me and says, “You’re on the air!”

The reason for all this procrastination is that when I’m in “now” — which is pretty much all the time — I don’t have a good grasp of or feel for a future “then” unless I go out of my way to do so. And that takes a lot of effort.

I’ve had friends and co-workers who consider this bizarre: they have no problem planning for weeks or even months in advance and don’t have to trick themselves into being motivated enough to do whatever needs to be done early. They’re the “normal” ones who I call Farmers. But most Hunters will instantly recognize what I’m saying here.

When Louise and I were first married and in our early 20s, I discovered the business-oriented self-help subculture, including the works of Dale Carnegie, Napoleon Hill, Earl Nightingale, Claude Bristol, and W. Clement Stone.

I read everything Carnegie, Bristol, Hill, and Stone had written, went through the life-transforming Dale Carnegie Course, and listened to tapes by Nightingale while driving and to put myself to sleep with a pillow speaker. The Stone Foundation used to give away posters and buttons that said, “Do It Now!” and our home was littered with them.

Every one of these writers, I’m convinced, was a Hunter like me and struggled with understanding time; it’s one of the recurring themes you’ll find all across the self-help world. They’d all figured out ways to overcome their own time-based dysfunctions, like Stone’s obsession with plastering “Do It Now!” all over his office, and I took them like a duck to water.

I learned that the most effective way to overcome my own inability to understand time or methodically plan things out was sheer persistence. An old quote that’s often (and almost certainly incorrectly) attributed to Calvin Coolidge graced a poster that was framed in our bedroom for decades:

“Nothing in the world can take the place of persistence.
“Talent will not; nothing is more common than unsuccessful men with talent.
“Genius will not; unrewarded genius is almost a proverb.
“Education will not; the world is full of educated derelicts.
“Persistence and determination alone are omnipotent.
“The slogan Press On! has solved and always will solve the problems of the human race.”

The reframing and new understandings that came from immersing myself in this world transformed my life. I jumped into each new business venture Louise and I started over five decades with gusto and enthusiasm; we had both spectacular successes and spectacular failures. I learned from them all.

But throughout it all, I struggled with time.

Philosophers throughout history have described time as a river that flows around the rock of one’s self: while many wrote that they could see the river from its headwaters to where it flows into the sea (from the beginning to the end of their lives), all I could see were the few feet (hours/days) around the rock itself.

Until the 1990s, that is, when I discovered NeuroLinguistic Programming, or NLP. This was a revelation as life-changing to me as had been the Dale Carnegie Course: it was a whole new set of tools to use to sculpt and craft my life and my interactions with others.

After reading numerous books on the topic, I hooked up with it’s co-founder, Richard Bandler, and took a series of courses, first becoming certified as an NLP Practitioner, then a Trainer, then a Trainer’s Trainer. On the way I also went through courses on Core Transformation, bilateral therapies, and a dozen other aspect of NLP.

I wrote a book about NLP and politics titled Cracking the Code: How to Win Hearts, Change Minds, and Restore America's Original Vision; then a book about NLP and ADHD titled Living with ADHD: Simple Exercises to Change Your Daily Life (foreword by Richard Bandler); and finally a book about using NLP to self-treat trauma titled Walking Your Blues Away: How to Heal the Mind and Create Emotional Well-Being.

The field of psychology has now heavily integrated some of the best NLP teachings and insights into mainstream therapy. EMDR is a variation on an NLP strategy to “relocate” traumatic memories, and Cognitive Behavioral Therapy is one of the best integrations of NLP into conventional talk therapy out there.

My favorite NLP intervention/strategy, though, has yet to be appropriated by mainstream psychology. It’s called “Timeline Therapy” or simply timeline work. It involves turning time from an abstraction into a real, tangible, visible thing that you can then essentially grab hold of and use to alter and control your own relationship to time.

The exercise is pretty simple and straightforward. It involves entering a somewhat dissociated state to experience the future, and then re-associating back into the present with lessons learned:

It starts by standing alone (or with a coach/therapist) in a room or open space and laying out a 10-foot-or-therabouts physical and visible “timeline” on the floor or ground. You don’t need to mark it; just imagine it vividly when you look down.

Then think of something you’d like to have or accomplish in the future. Ask yourself if this is something that’s really important to you, and, if you get an internal confirmation, continue.

Stand in the middle of the line and bring yourself to the current moment in your life. Imagine on the future part of the line where (when) you’ll be getting or accomplishing your goal: is it a year out, three years, five years? Mark that spot mentally.

Now walk slowly forward into that moment when you’ve reached your goal. Stop there and imagine what your life is like with it. Feel it, see it, hear it. Immerse yourself in it, and the feeling of accomplishment that goes with it.

Now turn around and face the spot where you stood when you were in “Now.” Look at the timeline and notice the various steps through which you had to pass, the things you had to accomplish, to get from that point to the future success. Make a mental note of each: this is your unconscious telling you what it knows about how you can reach your goals.

Then slowly walk back to the “Now” point and again turn around and look at your future self experiencing having accomplished your goal. Bring yourself to the present and let the feeling of accomplishment float out to the future you. (This is important: if you hang on to that feeling, it’ll undo your motivation as you’ll feel like the work is “all done.”) Note the steps you’ll have to take to get there.

Now turn around to your past and look on your past timeline for the steps that brought you to “Now” that will help lead you to your desired future. Spend a few minutes here, learning the lessons from the past that will help you accomplish your future.

Then turn around to face your future again and thank your future self for help setting the goal, and step off the timeline to “break the state” and recover your sense and state of now. Notice how you now feel inspired and guided toward your goal.

After doing this exercise correctly, most people say they feel guided over the coming months and years to their goal, almost as if by invisible hands. Of course, those “hands” are your own.

Good luck and enjoy your “Now” and your goals — and don’t forget to persist!

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One of the key skills that ADHD kids and adults often miss learning when growing up is how to “read” other people. We’re so occupied with our own internal conversation, or concerned that others may be judging us when we first meet them, that we neglect to really study how the get and receive information.

This can lead to misunderstandings of all sorts, and cause many of us to simply “talk past” others instead of communicating at a deeper level.

Many people are shocked when they first discover that not everybody “sees” (or “hears” or “feels”) the world the same way they do. It’s a fact, however, that we each have our own particular ways of experiencing life, and most people have a single sensory system upon which they most heavily rely.

People who have a different perception of the world from ours have interesting and often valuable lessons to teach us. Particularly when we understand our differences, they can help us expand our experience of life in ways that may not other­wise have been available to us.

Check out this simple test, and give it to a few friends and your children. The results will open a window to — or tell you more about — or give you a better feel for — yourself and those close to you.

It will also introduce you to a core concept of NeuroLinguistic Programming (NLP): that people experience the world differently from each other. This is some­times stated as, “The map is not the territory.” After you’ve taken the test and compared your results with some friends, consider which of these possibilities may be at work in your relationships.

Rank each of the three answer-options below between one and three, with three being “most often true” and one “least often true.” When you’re finished, add up all the V’s (visual), A’s (auditory), and K’s (kinesthetic). The numerical scores will tell you (show you? give you a feeling for?) which of the three representational systems you’re most and least comfortable with. Keep in mind that, at least at this point, this is just for your entertainment:

1. I naturally and easily say things like:
V “I see what you mean”
A “That sounds sensible to me”
K “I have a good feeling for that”

2. When I encounter an old friend, I often say:
V “It’s great to see you again!”
A “It’s great to hear your voice again!”
K “I’ve missed you!” (and give them a big hug)

3. I have:
V a good eye for decor and color coordination
A the ability to arrange the stereo and__ speakers so the music is crystal clear
K a special feeling in my favorite rooms

4. I let other people know how I’m feeling by:
V the clothes I dress in and the way I do my hair or makeup
A the tone of my voice, sighs, and other sounds
K my body posture

5. My favorite romantic encounters include:
V watching the other person, or vivid visualization or visual fantasy
A listening to the sounds the other person makes
K touching and being touched by the other person

6. When I want to really totally understand something:
V I make pictures of it in my mind
A I talk to myself about it
K I roll it around until I have a good feeling for it

7. When deciding on an important action, I:
V must see all aspects of the situation
A must be able to justify the decision to myself and/or somebody else
K know when it’s the right decision because my gut feelings tell me so

8. When it’s important to me to influence another person, I pay careful attention to:
V the pictures I paint with my descriptions
A the intonation and pace of my voice
K what kind of emotional impact I can bring to the situation

9. When I’m bored, I’m more likely to:
V change the way I look or how things around me are arranged
A whistle, hum, or play by making sounds in my throat or chest
K stretch, exercise, take a hot bath

10.  My favorite authors:
 V paint vivid pictures of interesting places
A write dialogue that sounds true-to-life
K give me a feeling for the story which is moving and meaningful

11. I can tell what another person is thinking by:
V the look on their face
A the tone of their voice
K the vibes I get from them

12. When I read a menu trying to decide what to order, I:
V visualize the food
A discuss with myself the various options
K read the list and choose what feels best

13. I would rather:
V look at the pictures in an art gallery
A listen to a symphony or rock concert
K participate in a sporting or athletic event

14. When I’m in a room with a band playing, I find most interesting:
V watching the other people or the band
A closing my eyes and listening to the music
K dancing with or feeling close to the other people around me

15. A true statement is:
V “It’s important how you look if you want to influence others”
A “People don’t know a thing about you until they’ve heard what you have to say”
K  “It takes time to really get in touch with another person’s core self”

Most people, when they take this test, will find that there is a definite preference for one system, but that preference is not more than five or ten points away from their least- preferred system.

A well-balanced person will have very simi­lar scores for all three areas, whereas a person with radically high or low scores in any one system may want to consider exploring ways to break up rigid patterns of perception and broaden and enrich his or her view, hearing, and experience in life.

You may also find it interesting that your closest friends — the people you best understand — often score similarly to you on the test. Those you just can’t figure out no matter how hard you try may score quite differently from you on the test.

This doesn’t mean that you should avoid people who have different modality-preference systems: instead it gives you an insight into (voice to? feeling for?) how you can have a wider range of friends and connections with others.

For ex­ample, experiment with using language that matches the lan­guage of those around you, and while doing so try to also experience the sensory realities that such language implies.

In other words, when talking with a primarily visual person, use visual metaphors: “I see what you’re saying.” “I could see doing that.”

With an auditory person you’d say, “I hear you!” “I like the sound of that.” “That sounds like a great idea!”

And for a kinesthetic person: “I get it!” “That feels right to me.” “I can get my arms around that idea!”

When we have this information about our children, it gives us a whole new range of tools for improving communication, and also for understanding their style of learning.

This helps us improve the way we communicate with them, and can also help you help your child’s teachers to better understand how she or he learns — and through that understanding change the way the child is taught. This, in turn, can have a profound impact on your child’s self-esteem.

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I’ve been taking a time-release 10 mg tablet of melatonin every night for about three decades (maybe four); I first learned about it when I was doing international relief work and was constantly whacked by jet-lag. The past years since I’ve cut back on international travel, I’ve just been taking it to help get a good night’s sleep.

Little did I know it may have something to do with the reduction of my ADHD “symptoms”; I’d attributed that to aging. But it may not be that simple.

Scientists have just uncovered an intriguing connection between the body's natural sleep hormone and ADHD symptoms in children. A major study from Japan’s Hamamatsu University School of Medicine suggests that the way our bodies produce melatonin — often called the “sleep hormone” — might play a bigger role in ADHD than we previously thought.

Let’s break this down: melatonin is like your body’s internal nighttime signal. When darkness falls, your brain’s pineal gland starts pumping out melatonin, essentially telling your body “Hey, it’s time to wind down.” It’s the conductor of your body’s sleep orchestra, keeping everything on a steady daily rhythm. But for Hunters with ADHD, this nightly routine often goes off track.

As I noted in the latest edition of my book ADHD: A Hunter in a Farmer’s World, there are multiple studies indicating that people diagnosed with ADHD are often twice as likely to also have difficulties falling asleep or staying asleep. My mom used to joke that I almost flunked kindergarten because I couldn’t take a nap; I don’t recall ever having taken a daytime nap in my entire life.

Now comes this research on melatonin that may explain what’s going on.

Dr. Nagahide Takahashi, who led the research at Tokyo’s National Center of Neurology and Psychiatry, was curious about why so many children with ADHD struggle with sleep. “We see sleep problems all the time in kids with ADHD,” he explains, “but nobody really understood why. We wanted to know if there might be a genetic connection between sleep patterns and ADHD symptoms.”

To get to the bottom of this mystery, Takahashi’s team looked at genetic data from more than 30,000 people across different countries. They tracked melatonin production by measuring its byproducts in urine — kind of like following footprints to find where someone’s been. What they found was fascinating: kids whose genes predicted lower melatonin production typically showed more severe ADHD symptoms, especially when it came to paying attention.

But here’s where it gets interesting. You might think the connection would be simple — less melatonin means worse sleep, which leads to more ADHD symptoms, right? Actually, the relationship turned out to be more complicated. The researchers discovered that genes affecting melatonin production seem to influence ADHD symptoms directly, not just through sleep disruption.

They also found something unexpected: a connection to inflammation in the body. The study revealed that a molecule called interleukin-6, which is involved in inflammation, might be the missing link between melatonin and ADHD symptoms. Kids with ADHD often have higher levels of this molecule, and it seems to be connected to both sleep patterns and ADHD behaviors.

What does all this mean for families dealing with ADHD? According to Dr. Takahashi, it reinforces something many parents and doctors already suspected: good sleep habits really matter. “Creating healthy sleep routines could help manage ADHD symptoms,” he says. The research suggests that helping kids maintain regular sleep patterns might do more than just fight fatigue — it could actually help with their ADHD symptoms by affecting the body's internal chemistry.

Looking ahead, researchers want to explore whether treatments focusing on melatonin might help kids with ADHD. This could include anything from melatonin supplements to new ways of supporting the body’s natural sleep-wake cycle. “We’re excited to see how we might use this knowledge to help children with ADHD,” Takahashi adds.

While the study wasn't perfect — they couldn’t directly measure melatonin in the children’s blood, for instance — it’s a big step forward in understanding how ADHD works in the body. It shows that ADHD isn’t just about behavior or brain chemistry; it’s connected to fundamental processes like sleep and inflammation that affect the whole body.

For parents and healthcare providers, the takeaway is clear: paying attention to sleep patterns could be crucial in helping kids with ADHD. Future treatments might take a more comprehensive approach, considering not just behavior and attention, but also sleep patterns and the body's natural rhythms.

The research team is now planning to investigate how they might use this knowledge to develop better treatments. They’re particularly interested in finding ways to help children with ADHD get their sleep patterns back on track, which could make a real difference in managing their symptoms.

“This isn’t just about telling kids to go to bed earlier,” Takahashi notes. “We’re discovering that sleep, ADHD, and the body's internal chemistry are all connected in ways we never realized before. Understanding these connections could lead to better ways to help children with ADHD and their families.”

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Last week, I wrote at length about how about science has found that about two-thirds of ADHD Hunters have difficulty getting to sleep, staying asleep, or both. As promised, here are a few of the techniques successful Hunters have shared with me (and a few I use, myself) to get enough sleep in this very non-hunter world.

* Sleep hygiene — Sleep hygiene is at the core of most sleep therapies practiced by therapists and sleep clinics. It begins with the NLP concept of anchors.  Just like when you smell your favorite food, you salivate and feel hungry; there are hundreds of specific “anchors” that we all have accumulated throughout our lives.

Anchors are the result of repeated exposure to one thing that links to another. Pavlov’s dogs are the most well-known example, but the reality is much deeper and far more pervasive in our lives. An exposure — whether it be to another person, place, thing, or situation — produces a predictable (conscious or not) response.

For example, when I was a kid my parents had 20,000-plus books in their basement.  Around the age of 8 or 9, I got tired of sharing a bunk-bed and bedroom with my brother (there were 4 boys and my parents in a 3-bedroom, 1-bath house), so dad let me carve a corner of his downstairs library out, using bookshelves as walls, to create my own bedroom down there.

The books smelled like a library or a second-hand-store (where dad and mom had bought almost all of them), and we’d spent most of the weekends of my childhood driving around central Michigan to Salvation Army and Goodwill stores looking for collectible books. And my grandmother owned and ran an antique store in Newaygo, Michigan, where I spent my summers.  To this day, when I walk into a used bookstore, thrift store, or library, I’m instantly transported emotionally and psychically back to being 10 years old.

We not only have these larger anchors, but we all also have hundreds of smaller anchors. Particular foods trigger memories and retrieve emotional states, as do certain old movies or TV shows, music, restaurants, places, and even people.

So, knowing this, the goal of sleep hygiene is to turn our beds from just another place into a powerful and unique anchor specifically for sleep.

The way to do this is pretty straightforward: Only get or stay in bed when sleeping or just about to. At night, stay up sitting in a chair reading or whatever you do (although watching TV or reading the computer can produce blue light that screws with your body’s production of melatonin/serotonin, the neuro-hormones that regulate sleep) until you’re genuinely tired and ready to go to sleep. Then go directly to bed and directly to sleep.

If (when!) you wake up in the middle of the night, get up and retire to your pre-sleep chair or couch or whatever and read or whatever you do to relax yourself enough to get sleepy again.  The key here is not to worry about it and not to put any effort into “getting sleepy” again.

While having anxiety or effort associated with getting back to sleep is a sure way to prevent the sleep from coming, if you just let your body tell you when it’s tired rather than trying to drive the process, you’re guaranteed (sometimes after a few weeks of practice) to end up sleepy again and return to bed.

When you wake up in the morning, get out of bed right away.  The bed should be anchored to nothing except sleep and, if you sleep with another person, sex.  Period.

Another dimension of sleep hygiene is regularity.  As much as possible, always go to and get up from bed at the same time every day. Even on weekends.  This deepens and strengthens the anchor, whereas keeping different bedtimes different nights scatters the anchor all over the place, weakening it considerably.  While our culture tells us it’s fashionable and appropriate to stay up late on weekends and sleep in on those Saturday and Sunday mornings, the reality is that for those with sleep problems such behavior is entirely counterproductive, both short- and long-term.

Other common-sense dimensions of sleep hygiene include sleeping in a quiet and dark room, with the temperature below normal room temperature.  One last thing, that’s used mostly for autistic kids but lots of Hunters report helps them sleep, is to use a “weighted blanket” — you can easily find them online — where the quilted blanket itself has built into it 20 or 30 pounds worth of metallic or stone beads that cause it to rest heavily on the body.

* Rumination — One of the most difficult things for Hunters to overcome when trying to get to sleep is the way the mind can run amok. Rumination is a cousin to worry and anxiety, and broadly defined as obsessing on thoughts of distress or disaster, typically in the future, without any consideration for solutions and often without putting those obsessive concerns into a less-threatening context.

We usually ruminate about terrible things that can happen in the future based on things we’ve done in the past, so there’s often a component of guilt or shame or embarrassment in the mix. When trying to get to sleep, rumination is often focused on the disaster that will happen the next day if we show up for work sleep-deprived or even fall asleep at the wheel trying to get to or home from work.

Cognitive Behavioral Therapy has adopted a number of basic NLP techniques to deal with rumination, and they largely work.

The first is interrupting the rumination itself with internal self-talk.  When you start worrying/thinking about how badly that sales presentation will go in the morning if your brain isn’t working because you didn’t get enough sleep, quite literally say to yourself (inside your head) something like, “Wait a minute!  I can survive this.  I’ve done things before when I’m tired or sleep deprived, and they only rarely turned out badly. I can even use the old Claude Bristol self-talk method of looking myself in the mirror just before the presentation and telling myself that I’m wide awake and alert.  [It’s outlined in my book Adult ADHD: How To Succeed as a Hunter in a Farmer’s World.]  It may not work all day, but it’ll work for the important stuff.”

Perhaps the most important part of breaking rumination is to change your own internal tonality: how you hear your own internal voice when “thinking” or, essentially, talking to yourself while trying to get to or stay asleep.  As we get more and more worked up, our tonality tends to go up in volume, tone, and speed.  Pretty soon we’re talking to ourselves in a tone that both sounds like, and causes, something like a panic response.

So you can even try simply repeating the very words you were just saying in your head, but say them differently. 

For example, consider this typical insomniac internal dialogue: “I have to get up at 7, so I need to be asleep by 11 to get my 8 hours, but it’s already 10:30 and I’m not asleep yet so I’m starting to get worried that I might not fall asleep in time, so when my alarm goes off I’ll wake up sleep deprived and do a terrible job in that morning meeting where I have to make a presentation.”

If yours is like that, try this bit of NLP magic.  Instead of changing the words, simply drop the tone of your internal voice an octave, speak slowly as if you were in a slowed-down movie, and soften the volume with big spaces between words.  Because tonality actually communicates more meaning than do words (which are just abstract representations, whereas tonality is a direct-connect to your brain wiring), these changes can work like magic.  Try it; you’ll be astonished.

You can also remind yourself that while most people think that their sleep-deprivation is obvious to everybody at work or in social situations, the reality is that almost nobody ever notices, and your performance is only rarely diminished in any meaningful way.  To prove this to yourself, and give yourself something to talk with yourself when you begin to freak out about sleep deprivation, try purposely only getting five hours sleep one night this week, and then the next day push yourself through the day with enthusiasm and a smile and don’t mention it to anybody.  You’ll have a new tool to break that most common sleep-disturbing form of rumination.

Another way to interrupt rumination is to engage in problem solving while lying in bed with your eyes closed.  I discovered, when writing my first novel back 30 or more years ago, that when I went to bed and tried to lay out the arc of the novel in my mind, from the inciting incidents to the progressive complications to the crisis, climax, and resolution, the complexity of it all so overwhelmed my brain that it just gave up and went to sleep. Over the years, I’ve discovered that I can do the same thing by simply trying to diagram the story line of the most recent TV show or movie I’ve seen; it nearly always causes my brain to say, “Uncle! I give up! I’m going to sleep!!”

Thomas Edison himself played such mind-games to get himself to sleep. 

As he noted in his diary in July 12, 1885, “Awakened at 5:15 a.m. My eyes were embarrassed by the sunbeams. Turned my back to them and tried to take another dip into oblivion. Succeeded. Awakened at 7 a.m. Thought of Mina, Daisy, and Mamma G. Put all 3 in my mental kaleidoscope to obtain a new combination a la Galton. Took Mina as a basis, tried to improve her beauty by discarding and adding certain features borrowed from Daisy and Mamma G. A sort of Raphaelized beauty, got into it too deep, mind flew away and I went to sleep again.”

An external and more modern rumination-interrupt is to use a podcast. For each of us the content will be different, but — counter-intuitively — choosing a podcast on a topic you care about or need to know about is often best.  Because I do a 3-hour radio show every day, I need to keep up with the news, and because science is also often a part of my program, I usually listen to either the BBC daily podcast or one of the many great science podcasts out there.  At first, I’m fascinated, which instantly breaks the rumination habit.  Once that’s gone, my brain shuts down and when I wake up I only remember the first five or ten minutes of the podcast.

While rumination is a topic worthy of its own book, it’s important to note that excessive or daily rumination is also associated with clinical depression and panic disorders; breaking the habit of rumination, particularly at night, is one of the more commonly successful techniques used to treat those two conditions.  Replacing your bedtime rumination not only facilitates sleep, but is a tremendous help to mental health overall.

Hypnosis

Milton Erickson, MD was one of the most famous hypnotists of the mid-20^th century, and his work formed a large part of the basis of Richard Bandler’s and John Grinder’s compilation/invention of Neuro-Linguistic Programming (NLP).  His wife, Betty, came up with what Milton referred to as “the Betty Technique” to put herself and others to sleep.  It’s a very simple pattern induction for self-hypnosis that leads to sleep.

Betty’s system used three of our senses, and went like this:  First, lying in bed with your eyes closed, notice what you’re “seeing” behind closed eyelids.  After attending to that for a few moments, shift your attention to what you’re hearing, even if the room is largely silent. A few moments after that, shift your focus to sensations in your body, your kinesthetic sense. Then repeat the entire sequence over and over until you’re asleep.  Typically, it takes between three and seven repetitions to knock yourself out.

Working with an actual hypnotist is a good way to learn self-hypnosis with more complexity than the Betty Technique.  Usually a person can learn self-hypnosis in just a few sessions. 

Another option is to use one of the sleep “apps” that are available for smartphones.  Scottish clinical hypnotherapist Andrew Johnson has some of the most popular and effective of these apps, where he guides you through a light hypnotic induction and into a deep, restful sleep. 

Sound-and-light machines

Certain frequencies of brain activity are associated with certain states of mind.  Beta frequencies are associated with thinking and even anxiety, while Alpha frequencies are sometimes called the “bliss” states. Theta is what we experience as we fall asleep and wake up, and appears to have a strong association with creativity. And Delta, the deep, slow-waves in the brain, are associated with sleep.

Neuroscientists have discovered that it’s possible to induce particular brainwave frequencies by stimulating the eyes and ears at these specific frequencies.  Several companies make glasses and headphones that connect to custom-built minicomputers to produce the frequencies in a sequence that imitates the normal process of falling asleep, offering them for both professional and consumer use.

People with any possibility of epilepsy should avoid these devices altogether as they can stimulate seizures.  But for the average, healthy person they can be a useful way to train yourself to quickly fall asleep.

The importance of sleep

While Thomas Edison was convinced that sleep was “wasted time,” we now know that it’s essential to normal mental and physical function.  During sleep, our brain cleans itself of the toxins it’s accumulated through the day’s metabolic process, leading to more efficient function.  During dream-sleep, we integrate the day’s activities and memories and form long-term memory, which is why altering sleep with drugs or alcohol often produces long-term memory failure.

In summary, sleep is important, even critical.  That said, anxiety about sleeplessness is perhaps even more destructive than the sleeplessness itself.  It’s important to develop internal self-talk that shuts down freak-outs about not falling asleep fast enough or waking up at night, and reassures you that no matter how much sleep you end up getting you’ll be just fine over the long term.

And to know what your personal “normal” sleep pattern is…and to do what you can to accommodate it.

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My mom used to joke that I nearly flunked kindergarten because I couldn’t take naps.  She’d point out that I hadn’t taken a real nap since I was 2 years old, and to the best of my knowledge, outside of large time-zone changes or using sleeping drugs, I have no recollection of ever in my entire life having successfully taken a nap.

There have been both ups and downs to this dimension of my Hunter-in-a-Farmer’s world neurology. 

I’m bright and creative — the latter apparently having a large association with ADHD — and have accomplished an astonishing amount for a single lifetime.  Perpetual curiosity and never-ending energy have led me into fields of study and parts of the world that have deeply enriched my life, and saved the lives of thousands of others.

On the other hand, Mrs. Clark, my 2nd Grade teacher, saying “Tommy, an empty wagon always rattles,” and “Tommy, even a fish wouldn’t get caught if it kept its mouth shut,” didn’t do a whole lot for my young self-esteem. Neither did being kicked out of both high school and college (albeit in both cases because of my anti-Vietnam War agitation).  I know the downsides of ADHD, and how devastating it can be to run afoul of your own neurochemistry.

On the third hand, using my Hunter skills for entrepreneurialism has let me raise my family in a way that’s largely only available to the top 10% of Americans, from traveling the world repeatedly to being able to put 3 kids through college and backstop them through the occasional bumps and hiccups of life. Louise and I have been together for over 5 decades, and it’s been a great ride.

Through it all, though, sleep has been my continuous challenge. And, apparently, I’m not alone in that, particularly among people who share my ADHD neurological baselines. 

In the December, 2017 issue of Current Psychiatry Reports, Wynchank, et al, report:

“Three cross-sectional, clinical, and population studies report a prevalence of insomnia in ADHD adults ranging from 43 to 80%. … The mechanisms explaining the relationship between ADHD and sleep problems are incompletely understood, but both genetic and non-shared environmental influences may be involved.”

A 2010 report in Biological Psychiatry digs into possible measurable mechanisms underlying the association between insomnia and ADHD, saying:

“Previous studies suggest circadian rhythm disturbances in children with attention-deficit/hyperactivity disorder (ADHD) and sleep-onset insomnia (SOI).”

For this second study, they evaluated 40 ADHD adults, taking daily measurements of salivary levels of the sleep hormone melatonin and noting exactly when they fell asleep every night, how well they slept, and whether or not they could easily fall asleep like normal people and how they differed from your garden variety insomniac without ADHD.

“Compared with control subjects,” they noted, “both groups of ADHD adults had a longer sleep-onset latency and lower sleep efficiency.” They added that adults diagnosed with both ADHD and insomnia had “a delayed start and end of their sleep period…compared with healthy control subjects,” and “also showed an attenuated 24-hour amplitude in their rest-activity pattern…”

“These findings,” they added, “demonstrate diurnal rhythm deviations during everyday life in the majority of adults with ADHD that have SOI (sleep onset insomnia)…”

Hunters and sleep

My original 1980 hypothesis about Hunters and Farmers posited that most of the behaviors that we associate with ADHD, including distractibility, impulsivity, and risk-taking — while maladaptive in a world of factories and classrooms — were actually assets in the world that our hunter-gatherer ancestors evolved in over the past million or so years. 

Noticing every single sound in the classroom is called “distractibility” today, but in the forests, jungles, and savannahs of old it was an essential survival skill.  Those who didn’t notice the predator sneaking up on them were quickly weeded out of the gene pool, and those who failed to attend to the sounds of small prey animals ended up starving.

While it would be suicide for a farmer to make an “impulsive” decision on what crops to plant — possibly ending up 9 months later during the harvest discovering that ragweed isn’t all that edible — for a hunter chasing a rabbit through the forest there’s no time to do a risk-benefit analysis if a deer wanders into range.

And while risk-taking in a factory or supermarket can be fatal or unwise, the early-day hunter who wakes up knowing — and relishing the idea — that there are things out there that want to eat him as much as he wants to eat them will be a much more likely to bring home food than the hunter who’s so reluctant to take risks that he never leaves the cave.

Not only has science largely proved my hypothesis, it’s even found that the I was right in the prediction I made in the late 1990s that genes regulating the neurotransmitter dopamine would probably be at the core of the biological/genetic basis of ADHD.

But how could sleep — or the lack of sleep — be adaptive for a primitive hunting society? And, like how an ADHD adult can find success in ADHD-friendly occupations like being a detective, author, or entrepreneur, is there any possibility that ADHD-related insomnia might even be useful in today’s world?

Interrupted sleep

Many people wake up at least once during a night, usually somewhere in the middle of their sleep.  The manufacturers of sleeping drugs know this, and have even begun to throw a few extra milligrams of their drugs into a time-release part of the pill, so when someone might be inclined to wake up at midnight, they don’t. 

But what if waking up at night is normal and healthy? What if it’s an important part of our genetic heritage, passed down from hunter-gatherer ancestors, that, for millions of years, helped our ancestors survive?

This is precisely the thinking behind the theory of diurnal sleep (di as in “two parts” and urnal as in “in the night”).

The possibility that we’re not programmed for a straight-through 8-hour sleep every night was first brought into the scientific mainstream by Dr. Thomas Wehr, a clinical psychiatrist who now has his practice in Bethesda, Maryland, and is associated with the clinical psychobiology branch of the National Institutes of Mental Health. Dr. Wehr and his colleagues were examining photoperiodicity in humans – how exposure to light (and the changing length of daylight during different seasons) affect our hormones, sleep, and general behavior.

“It’s a kind of archeology, or human paleobiology,” Dr. Wehr told The New York Times. He explained: “We're looking at what human hormonal, sleep and temperature patterns might have been like in a prehistorical period when there was very little artificial light around.”

What they found was astonishing.

They set a group of volunteers up to sleep in a room with no outside light whatsoever, and gave them 14 hours of darkness every night.  At first, the subjects slept an average of 11 hours a night for a few weeks, although the researchers concluded that this was just their way of catching up from our chronically-sleep-deprived work-driven American culture.

Then things got interesting.

Once people’s sleep patterns normalized, they settled into an average of eight hours of sleep a night, but with a huge caveat: they all woke up in the middle of the night, typically for around between one and two hours.  Some woke up earlier than others, with first sleep lasting typically anywhere from three to five hours, but all in such a way that there was solid sleep at the beginning and end of the evening. With the mid-night awake period, the entire night became an average of 9 to 10 hours time in bed, to produce a net eight hours of sleep.

Which took us from a group of psychiatrists and sleep researchers to Virginia Tech historian Roger Ekirch. He published a paper titled “Sleep We Have Lost: Pre-industrial Slumber in the British Isles” in the American Historical Review, showing that in the time before widespread use of artificial light (be it kerosene or electric) there was a widespread and robust body of literature — from fiction to nonfiction — that documented the norm of people waking up for an hour or two every night.  (The first city in the world to light its streets at night, for example, was Paris in 1667.)

And it wasn’t just that they were awake: there was a whole range of activities that medieval people engaged in in the middle of the night, complete with names and rituals for such behavior. Ekrich found more than 500 reports of what he called a “segmented sleeping pattern” in ancient medical books, personal diaries, literature and novels, and even in court records from the middle ages and Homers Odyssey.  Looking more far afield, he also found that modern African tribes (he specifically looked at Nigeria) who lived without artificial light also had this pattern of segmented sleep: it clearly was a human thing, not a cultural thing specific to ancient Greece or Medieval Europe.

Depending on how people lived and their interests, there were a variety of well documented uses for this “nighttime awakeness” period: religious people used it to meditate or pray (Ekrich found numerous medieval prayer manuals specifically for this period of the night); married couples would use it for sex or even eating a “mid-night meal”; while others (presumably with a full moon or candle or oil lamp) wrote, read, or even got out of bed and met with neighbors or invited people over for a light meal.

Hunter/gatherers and sleep

So why are we all, apparently, genetically wired to wake up for a few hours every night during the dark?

One possible theory ties right into the hunter/farmer hypothesis.  Hunter/gatherer peoples — 100% of all of our ancestors — were not only among the world’s most efficient predators, they were also frequently prey. Lions, tigers, giant reptiles, and, most dangerously, other human tribes all had an interest in tracking and killing our early human relatives.

And many (of the wild animals, at least) are nocturnal.

So for a community or tribe of humans to pretty much always have at least one person up and awake meant that there was always somebody on the alert for dangers to the group.

Much like “distractibility, impulsivity, and risk-taking” helped hunter/gatherers to be more efficient food collectors, similarly, having somebody always awake during the vulnerable night would protect the tribe from other species or other humans looking to make food out of them.

In other words, segmented sleep is part of an ancient survival system that we evolved with for, probably, millions of years that helped insure our survival and success as a species. If one person typically woke up after an hour or so, and another after three hours or so, and another after five hours or so, basically there was always at least one person awake all night.  The tribe or clan was safe.

But, just like the hunter gene helped us be successful hunters but became maladaptive in a world of farming and factories, so, too, the genetics of segmented or “biphasic” sleep helped us survive the dangers of the jungle or savannah but became, in the modern world, a problem.

Night Owls

We’re also told that Ben Franklin’s old aphorism of “early to be, early to rise, makes a man healthy, wealthy, and wise” is the One True Way To Live.  And while that’s the case for about 40% of us, another 30% of us are actually biologically/genetically wired to go to sleep late and wake up late (and about 30% of us are pretty flexible in our sleeping habits).

A relatively recent discovery, Dr. Matthew Walker, Director of UC Berkley’s Center for Sleep Science and author of “Why We Sleep”:

“Night owls are not owls by choice,” Walker notes in his book. “They are bound to a delayed schedule by unavoidable DNA hard wiring. It is not their conscious fault, but rather their genetic fate.”  A difference in the CRY1 gene appears to make the difference, and, again, may well be a Hunter-world/era survival adaptation that guarantees that some of the tribe is always awake and alert to danger.

But the “get up early to get to the factory/school work” is so ingrained in our culture that we’ve even come up with new “disorder” words to describe people who aren’t genetically wired to be early risers, or to be “too-early” risers.  They’re called Delayed Sleep Phase Disorder (DSPD) and Advanced Sleep Phase Disorder (APDP). 

Like a left-handed person trying to fit into a right-hander’s world, or a Hunter trying to fit into a Farmer’s world, when a person who’s genetically programmed to be a night-owl gets a “normal” daytime job, they end up having to rely on all sorts of things to trick their body into sleep, from blackout curtains to high-dose melatonin to sleeping pills.  Ironically, just looking for a night-shift job would have solved most of their problem.

Hunters Sleeping in a Farmer’s World

Which brings us to the problems that people still carrying a highly active version of the Edison Gene face when sleeping.

Thomas Edison himself, in fact, exemplified this. Writing that “evidently I was inoculated with insomnic bactilli when a baby,” he rarely slept more than 4 or 5 hours a night, and often stayed up most or all of the night working on his inventions or reading, but made up for it by taking numerous short naps during the day.

His naps were legendary; he had a cot in each of his workshops, in his factory, and in his home. He went on a picnic in the woods with President Warren Harding and tire baron Harvey Firestone in 1921, and posterity recorded it with a famous (and easily searched on the internet) photo of Harding and Firestone sitting in lawn chairs chatting while Edison slept, head on a pillow, on the ground in a bed of flowers.

As ADHD as they come — so much so, as mentioned in detail in my book ADHD: Hunter in a Farmer’s World, that he couldn’t even survive elementary school — Thomas Edison not only exemplified creativity derived from distractability, but also personified the sleep-interrupted Hunter.

Next week, I’ll share some of the techniques successful Hunters have shared with me (and that I use myself) to get enough sleep in this very non-hunter world.

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When I was the executive director of a residential treatment facility in New Hampshire, I worked with a wide variety of psychologists, psychiatrists, and therapists. One man, in particular, was amazing to me.

Dr. Charles, as he was called by both the children and staff (that was his first name) once confided to me that the ethics of his practice were his greatest impediment to financial success.

“My goal is for my patients to get better, so they no longer need me,” he said. “That doesn’t do much for long-term financial security.”

With the explosion of media attention directed at ADHD, there’s a corollary increase in counselors, psychiatrists, psychologists, therapists, and even fortune tellers (I met one in Atlanta, where it’s legal and licensed, who says she specializes in ADHD!), who are encouraging an odd form of dependency.

Because ADHD is a lifetime diagnosis, it can also represent a long­-term income stream for a practitioner treating it. The voices of people pointing this out as a way of discrediting ADHD and the people who work in the field-are growing.

From rightwing radio hosts to the editorial pages of The Wall Street Journal to people within the insurance industry, critics of the ADHD diagnosis are becoming more vocal. At the same time, a growing number of authors and speakers on the topic of ADHD are becoming more adamant in their assertions that ADHD is a crippling disability, about which little can be done beyond medication.

In a speech to a group of ADHD adults I attended years ago, a psychologist pointed at the audience and said, “You people have an illness. You’re sick. Don’t you get it? Why do you think we call it a ‘disorder’?"

In the midst of it all, though, are the people themselves with ADHD. Many of them are receiving the signal, sometimes from people who have a financial interest in promoting that point of view, that they are dam­aged, defective, deficient, and disordered. In short, they are victims. And, for some people, this is just what they want to hear.

“Eureka!” they say, throwing the notion of personal responsibility or self-improvement to the wind. “I’m a victim of an organic brain dysfunc­tion!”

At the same time, an increasing number of prominent therapists are taking Dr. Charles’ point of view toward ADHD. Instead of fostering a lifetime of dependence, they’re helping people define a specific thera­peutic goal, working toward that goal, and just as in internal medicine, stopping the treatment when the goal is reached.

One example is the “SBT” (Solution-oriented Brief Therapy) ap­proach espoused by students of Milton Erickson and brought into public awareness in 1995 by the best-selling book Fire Your Shrink by psychotherapist Michele Weiner-Davis. One of Weiner-Davis’s key bits of advice is: “Choose a perspective that offers a solution.” That’s a great idea, and it’s largely what I write about in the context of ADHD: choose perspectives that offer insights, solutions, and a path to the future you want.

Another example comes directly from the world of ADHD, and involves one of the most prominent psychiatrists in the field, Dr. Edward Hallowell. Before he became famous from his appearances on network television and co-authoring the best-selling Driven To Distraction, Hallowell was the therapist chosen by a good friend of mine. “Dave” recalls that Hallowell’s emphasis was on understand­ing and on producing results:

“After a few months of regular (but not weekly) visits, one day I came in for my appointment and he told me he didn’t want to see me as a patient any more,” Dave told me. “I wondered if I was a ‘bad patient’ or if he thought I was ‘cured,’ but, no, he said it was neither. Rather, he felt that he’d done as much for me as he could by way of imparting information, that I now had a good understanding of ADHD and what it and I were all about, and that it was now my duty to go out in the world and teach others what I’d learned.”

On the other end of the spectrum is Angela, a 31-year-old aspiring actress in New York City who cornered me after a speech, wanting to tell me her life story. Angela’s parents are wealthy, and she visits her thera­pist every week for her ADHD, and had for over ten years. She won’t date a man, make a career move, or even go out of town on vacation, without first discussing it at length with her therapist. Angela is stuck. By contrast, Dave is unstuck.

And, since her ADHD gives Angela such a convenient excuse for all the problems of her life, it liberates her from the need to do anything for herself. “Why bother trying to learn to pay attention,” she asked when I offered to teach her some of Harry Lorayne’s memory techniques, “when I’m so ADHD?”

Why indeed?

Some people say, “Look at all I’ve been through—I’m a mess, and if I never make anything of my life, it’s understandable!”

And then there are those who decide, instead, to get on with their lives. I remember, for example, Jonathan.

He came into the residential treatment facility where I was executive director when he was fourteen years old. Three years earlier he’d seemed a normal boy, if not a bit too bright and extroverted for his teachers’ liking. His parents one day had found a marijuana plant on his bedroom windowsill. Not knowing what to do, they called the police, who hauled Jonathan off to the juvenile detention facility.

From there, Jonathan was placed in a foster home, but he was now angry, and determined not to give in to what he thought was an inhu­mane system. He ran away. The police caught him and put him in another foster home, and he ran away again. This time when they caught him, they took him to the state mental hospital for observation.

The psychiatrist there diagnosed him as suffering from oppositional-defiant disorder (often a fancy way of saying, “This kid offends me”), and ordered him institution­alized. For the next two years, Jonathan was in virtual solitary confinement.

He spent half of one year tied to a bed, and during the entire time of his institutionalization was daily given huge doses of the powerful tranquilizer Thorazine, which reduced him to a near-vegetative state.

When Jonathan was referred to our program at the age of fourteen, we were told that he was possibly psychotic, that he needed powerful anti-psychotic drugs, and that he might be mentally retarded because all the recent tests done on him showed that he functioned at about an eight-year-old level.

The day Jonathan came into the program, our psychiatrist took him off the Thorazine. At first Jonathan was angry and defiant, but when we learned his history, we understood the source of his anger and worked with him to learn to deal with it.

The Thorazine left him with small seizures, a condition called Tardive Dyskenesia, which is a long-term side-effect of having used Thorazine, and, for many people, is perma­nent. His tongue would leap about his mouth, he’d twitch, and occasion­ally he’d have a full-blown seizure and throw himself to the floor. Over a five-year period, these gradually lessened to the point where he could disguise them.

Jonathan, it turned out, had a near-genius IQ, as well as ADHD.

Four years later, still living at our facility, he graduated from the local public high school at the top of his class. He came back several years later to visit, and even wrote a short piece for one of our brochures, as a “graduate” of the program. And he never, ever, thought or said he was destined to be a failure because of his past or his ADHD.

Jonathan was a fighter, not a victim. He chose a different path from that of the many people who blame their boss, their spouse, their parents, and, of course, their ADHD, for every failure in their own lives.

In Bogota, Colombia, I met Juan, who was the driver for Elizabeth Blinken, the woman who started and ran the Salem program there. He looked like he was at least half South American Indian, and was well-dressed in slacks and sweater, with a friendly smile and dark brown eyes.

Over dinner during one of my first trips there Juan told us his story.

When he was three years old there was a political uprising in the area where he lived and soldiers (he doesn’t know if they were government or rebels) came into his house. They took him and the other members of his family into the living room and tied them up, then raped his ten-year-old sister and mother. Other soldiers came and raped them again.

When his father protested, one of the soldiers shot him in the chest. It took his father nearly an hour to die, Juan said. Later in the day, the soldiers methodically went through the little village and killed every person. Through some bizarre morality that only they understood, they didn’t kill the very youngest children, and so Juan was spared.

He stayed in the house with his dead parents, sister, and two older brothers, for two days until word of the massacre reached a nearby town and he was rescued.

His aunt took him in, but she soon tired of surrogate motherhood and took him to a state-run orphanage, telling him she’d be back for him in a week. She never returned.

At age seven, Juan escaped from the hellish orphanage, where the children lived in huge rooms and were regularly beaten and raped by the guards. For the next two years he lived as a street child, begging and stealing. He managed to avoid the “hunting clubs” of middle-class teenagers, soldiers, and off-duty police who go out at night in much of overpopulated South America with rifles and shoot street children for sport, often even taking pictures of their “trophies.”

But finally, when he was nine, Jose was captured by police and put into another orphanage. Here he was “adopted” as the “foster son” of a family in Germany through one of the many programs where people send a monthly stipend of ten or twenty dollars to a child. This stipend allowed him to attend school for the first time, and he ended up graduating first from high school, then from college with honors, and finally receiving a graduate degree in mechanical engineering.

Juan was not enthusiastic to tell his story; Elizabeth brought up the details after he had spent a day playing tour-guide and showing me around Bogota. He acknowledge the events of his life, but when I asked him how he felt about it, he shrugged and said, “At least I survived. So many here do not survive, and most of those I knew as a child are now dead. I worked hard to stay alive, and I was lucky.”

Juan had a legitimate right to put living and growing on hold and claim victim status, but he chose instead to move forward with his life.

It’s rare that I meet an person who was diagnosed with ADHD as an adult who doesn’t feel frustration and anger about all those lost years, and the pain of growing up as a misunderstood Hunter in a Farmer’s world. Yet a quick recollection of Juan’s story, or Jonathan’s, will help put that pain in a more useful perspective.

Don’t be a victim

Many adult ADHD support groups I’ve visited resemble AA meet­ings, and some I’ve seen are run by people who encourage attendees to yell out, cry, or make a great public drama about the pain of their lives with ADHD.

It’s so easy to fall into the trap of becoming a victim of ADHD. In modern America, it seems, many people want to be a victim of something. It’s so easy, so convenient, so comforting to know that our failures and weaknesses are not because of “us,” but caused by a “them.” Being a victim has even become an excuse for murder, as we saw in the initial acquittal in the admitted shotgun slaying of their parents by the Menendez brothers.

But taking the victim position may be the least effective way for a person to deal with their own ADHD: it is not, after all, alcoholism or the result of abuse.

At a 1990s conference in Santa Fe put on by my late friend Michael Hutchison, author of MegaBrain, I met a psychologist who told the interesting story of one of his patients, a man with all the symptoms of ADHD who’d been through the Battle of the Bulge in World War II.

He saw virtually all of his closest friends die, and his best friend from high school, who’d joined the army together with him, died in his arms. Certainly, one would think, this man had every right to claim victim status and to even walk around with the shakes or a pint of gin in his hip pocket.

But that wasn’t how he viewed it.

“We were working on finding reservoirs of strength that could be drawn from past experience,” the psychologist told me, “and, for this man, that experience was one of the times in his life when he was the strongest. So now, when he’s confronted with difficult emotional experi­ences or the frustrations of his ADHD, that is the experience he brings back to mind, his time during that battle, as the thing that will empower him and pull him through.

“Because he survived, and was able to tell himself that he survived not because he was a coward or ducked bullets, but because he did the very best he could, and perhaps because his luck was just a little bit better that than of some of his friends. He viewed that battle as a positive experience, in retrospect.”

This story illustrates the point of this article: the stories we tell ourselves about the significance of things that happen to us usually create the core meaning of those experiences for us.

In certain middle-eastern cultures, it’s a horrifying and embarrass­ing experience for a woman to have strangers see her bare arms. If you were to rip off her shirt sleeve, or roll it up to look at her elbow, you could create emotional trauma that could last a lifetime.

In American culture, as a contrast, people walk along the beach in bikinis and swimming trunks without feeling any shame or humiliation.

Yet those Americans who wear swimsuits at the beach may feel negative emotions if they were forced to remove their bathing suits altogether, a state of (un)dress that’s “normal” on many of the beaches along the southern coast of France, Monaco, Italy, and Yugoslavia.

So, as much as we have the raw experience of life itself, what we ultimately carry from our living are the stories we tell ourselves about it.

This is not to say that the trauma of growing up with undiagnosed ADHD is not painful or even destructive. In a EEG Neurofeedback training program for physicians that I attended, there was a lot of discussion about the value of using alpha/theta brainwave training to bring up traumatic memories, and then using it to “discharge” the emotions associated with those memories. This is used as a form of therapeutic personality integration and ego-strengthening.

What was most interesting to me was that virtually everybody in the room (most were psychiatrists or psychologists) had traumatic memo­ries themselves, ADHDers and non-ADHDers alike, yet all of us were from basically “normal” middle-class families, without histories of severe abuse.

Nonetheless, even without the life experiences of Juan or Jonathan, we all had terribly painful experiences we could point to in our past.

How do we deal with difficulties?

The bottom line is that life itself is often difficult. And this is particularly true for the Hunters among us, who have suffered through years of trying to fit into Farmer-style schools or jobs, and often experienced years of frustrating failures in their efforts.

Nobody gets out of life unscarred, and we all have times and events we can point to wherein we experienced great pain and stress, often as a consequence of ADHD.

The issue, though, is how we process those events.

Do we nurse them and lick them like a dog with a wound, causing them to blossom and fester? Or do we choose to resolve them (through therapy, EEG Neurofeedback, NLP, Ritalin, reframing, learning new strategies, etc.), and move on with life?

And, perhaps more important in the broader context, how does our culture, and how do our professionals, encourage us to deal with things like growing up with ADHD in a non-ADHD world?

Some people reacted to the initial proposal of my Hunter/Farmer model negatively, because they believed it deprived them of their right to claim victim status. More than one person said, “I’m not a Hunter: I’m the victim of a neurological disorder!” and this debate has persisted for years since the publication of my first book on this topic in 1993.

These people want a “disease” to be responsible for the way they are, and if that disease is treatable by the medical establishment, so much the better. When they’re still disorganized and late for meetings, they can then blame it on the medications not being properly balanced, or on the therapist not yet having completely worked his or her magic, or perhaps even on the therapist’s incompetence.

This is where we see the empowerment of individuals inherent in the Hunter/Farmer model, and the disempowerment intrinsic to the words “deficit” and “disorder.”

Dr. Lynn Weiss, one of the most insightful writers in the field of ADHD, shared with me an important insight. In her opinion many people with ADHD are as harmed by years of living undiagnosed and misunder­stood as they are by the ADHD itself. This includes being told that they, to use Kate Kelly and Peggy Ramundo’s brilliant book title, are “lazy, stupid, or crazy.” In some cases, Dr. Weiss told me, the harm of being misunderstood is greater than the “problem” of the ADHD itself.

In a recent dialogue on the internet, a teacher with little patience or tolerance for kids with ADHD enumerated a long litany of problems she’d encountered teaching ADHD children. These included defi­ance of authority, poor test-taking skills, homework failures, and the fact that many of her ADHD kids were performing below their grade levels. She blamed this all on the children. And, from her personal experience and in the realm of her perceptual reality, many of her points were correct.

But was it the fault of the children, or of the system they were thrown into which was not appropriate for their learning style?

Pete Wright, the attorney who successfully argued the Shannon Carter case before the U.S. Supreme Court, thus forcing public schools to take financial responsibility for educating ADHD children, told me of one of his cases. (Pete, himself, by the way, has ADHD...and is one of the most successful attorneys—and human beings—I’ve ever met.)

A young boy had been failing for years in the public schools, yet he had a very high IQ and, when he was put in a summer program designed to meet the learning style of ADHD kids, he jumped several grade levels in just a few months.

Pete’s wife, Pam, a psychotherapist who’s spent years working with Vietnam veterans, is very familiar with Post Traumatic Stress Disorder (PTSD). When she evaluated this little boy, Pam found that he was exhibiting many of the classic symptoms of PTSD, including sleep disturbance, irritability, temper outbursts, difficulty concentrating, fre­quent nightmares, and fearfulnes.

Yet he hadn’t been in a war: nobody had beaten or shot at him — there was no history of an actual traumatic event or experience that involved death or fear of death which could lead to a diagnosis of PTSD. He had model parents. So what caused the trauma?

“It was his failure in school, as a result of the school not properly handling his ADHD,” Pam said. “His teachers told him that he was lazy, that he was defiant, that he had many deficits, and that he had ADHD, which they referred to as a mental disorder.”

In Pam’s view, this young boy’s trauma was caused by teachers who understood ADHD as a label, but who had little empathy for the lived experiences of individuals with ADHD. She said that this child’s anxiety symptoms, so similar to individuals diagnosed with PTSD, were causally connected to his nega­tive school experiences over a period of years.

One of the problems that people who do not have ADHD (like Pam’s patient’s teacher) experience when trying to define, discuss, or under­stand ADHD is that they’re struggling with a reality that is, for them, entirely conceptual and not at all experiential.

A person whose experi­ence of life and the world is very “Farmer-like” will look at ADHD and ADHD people from their own point of view, scratching their head and wondering how these poor people could ever make it through life.

Overlay that with a smattering of knowledge of current trends in psycho­logical thought, and their observation/confusion often expresses itself with words like “pathology,” “deficit,” and “disorder.”

For a person who has experienced life with/as ADHD, however, the Hunter/Farmer perspective is so gut-level-true that it often evokes an instant and visceral, “Yeah, that’s it!” response. (And no, this isn’t an attempt to put lipstick on a pig. Experienced personal truth and feel­good self-talk are wholly different things.)

“The only truths we can point to are the ever-changing truths of our own experience,” Peter Weiss wrote in 1964 (Marat/Sade). Andre Gide in 1921 wrote that “Each of us really understands in others only those feelings he is capable of producing himself.”

This is at the root of both the debate over how to present ADHD to people with it, and how to respond to it therapeutically and in schools. Several blind men may differently describe an elephant, but only the elephant truly knows its own nature.

Parents of ADHD children must ask themselves if they want their kids to grow up telling themselves, and interpreting all their experience through the filter of, the story that they’re “disordered.” Or would they prefer to know that they’re Hunters, facing specific challenges thrown at them by a Farmer’s world? And those of us who are the adult ancestors of Hunters must make a similar choice.

Both models acknowledge the struggles and difficulties of life with ADHD. The former, however, often disempowers people and provides them with excuses to hand off responsibility for their lives to others. The latter model demands that we learn as much as we can about our true nature and our deficits, and then take personal responsibility for chang­ing our lives.

Virtually everybody will take on one role or another: we require an identification or self-identity in order to function in the world.

Psychotherapist George Lynn told me about a discussion he had on this topic with Marcia Jacobs, MSW, who is the head of Mental Health Services for the United Nations High Commission on Refugees. She’d just returned from Bosnia, and George said of their discussion, and his thoughts on it:

“A subtle force for maintaining victim status for trauma survivors is the self-identification with the role. Marcia pointed out that people will, on one level or another, ask, ‘If I don’t have this status (of victim) what fills the void?’

“This hearkens back to the fact that if a person feels that his life is meaningless, he will cling to some identity. Living without meaning is terrifying. This is why so many people are dying in Bosnia, for they identify the very purpose of their existence with their cause.

“I think that this gets me back to my suggestion for your book [on ADHD] that a Hunter without a mission will see himself as a prisoner of his condi­tion — better this than nothing. This, in turn, argues for techniques that show Hunters how to use their innate intuitive and creative strengths to locate (for want of a better phrase) Right Livelihood.”

So the question: Will we Hunters spend the rest of our lives as victims of our genes, pointing to them as the cause of every ill thing in our past and dragging that past into our future like the chains on Marley’s ghost?

Or will we stand up, take a deep breath of the fresh air of the present, and decide to move forward, as Scrooge himself ultimately did?

The choice is ours.

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There are a few unscrupulous psychiatrists in the country who are using brain scans to “diagnose” ADHD.

With a SPECT (single-photon emission computerized tomography) scan, a child is injected with a radioactive material directly into his bloodstream. Its radiation-emitting particles are carried to every nook and cranny of his body. Like with any unnecessary radiation, this raises the child’s risk of getting cancer later in life.

SPECT scans are dangerous to children or adults, and can cause cancer 10 or 20 years down the road even when only used once to “diagnose” ADHD. Here’s how it works.

Imagine you’re in one of those huge hotels with hundreds of windows facing out onto the parking lot. You walk to the window and look down and see a man with a rifle, waving it around as if he were thinking of spraying the entire building with bullets. And then you see the muzzle flash at the end of the rifle’s barrel, hear the crack sound of the shot, and, a half-second later, the shattering sound of glass somewhere off to your right on that huge wall of glass.

Given that situation, would you get away from the window? Would you feel “safe”?

What if the hotel had a thousand windows instead of a few hundred, and you knew the shooter could only fire a few bullets before he ran out of ammunition?

What if the shooter was actually doing something that the hotel had requested — say, shooting pigeons off the roof because they were pesky or carried disease — and every now and then he missed the pigeons and hit a window? Would you feel safer because there was a reason for his shooting? Would you continue to stand in the window, knowing the odds were low that you’d be hit and the shooting was useful for the hotel’s bird problem?

Better yet, would you put a child in the line of fire?

In order to make sense of this analogy, consider for a moment how radiation causes cancer.

The replication of cells is controlled by a small segment along a DNA double-helix. When something hits or damages the DNA in the cell, usually the cell simply dies. This is happening right now in millions of cells in your body as you read these words. The body is all set for it, with scavenger systems in place that recycle the cell’s nutrients.

Occasionally, however, instead of DNA being hit in ways that kill off the cell, that one little window on the DNA strand that controls its reproduction gets damaged. The cell loses its ability to know when to stop reproducing, and starts dividing as fast as it can. This is called cancer.

The four main things in our world that “hit” DNA in ways that cause it to become non-reproducible (and also leading to the cell’s demise) or super-reproducing (cancer) are oxygen-bearing chemicals (called “free radicals” or “oxidizers”), DNA-toxic chemicals (called “carcinogens,” with the chemicals in cigarette smoke being the most familiar to most people), DNA-reproduction-stimulating compounds (called “hormones” and the hormone-mimickers such as those found in certain plasticizers, pesticides, and sun-blocking chemicals), and ionizing radiation (the most well-known being UV radiation in sunlight, which causes skin cancer, and X-rays, which can cause cancer anywhere).

In part because our sunlight has become more lethal in the past 50 years (a thinning ozone layer) and our environment and foods are now filled with industry-created carcinogens and hormones, one-in-two men and one-in-three women will get cancer in their lifetimes. We take anti-oxidant vitamins like C and E to reduce the damage, eat natural foods to avoid the chemicals, and wear sun-block, all in efforts to avoid damage to our DNA that might flip “on” the reproduction switch in a cell so it turns to cancer.

I remember when I was a child, walking home from school in the first grade in 1956. There was a shoe store on the way, and they had a really cool machine that I stuck my feet into dozens of times so I could see the bones in my toes and how the tissues of my foot fit my shoe. A friend of mine, now deceased from thyroid cancer, had radioactive radium pellets put into her sinus’ to stop recurrent sore throats and tonsillitis. My mother was encouraged to step out of the house and into a truck that traveled around giving women breast x-rays back when those machines produced massively more X-radiation than digital systems do today. And they were exploding bombs above the ground in Nevada so frequently that more radiation was released on America than we released on Hiroshima and Nagasaki combined.

We’ve learned a lot since 1956. The shoe-store fluoroscopes are banned, doctors don’t use radium anymore to treat sore throats, and almost all above-ground nuclear testing has been halted worldwide. We’re even recommending that women under 40 not get annual mammograms, in part because of concern that the radiation from the x-rays may cause more cancer than it would find. A study cited in Science News a decade or more ago reported a correlation between the number of dental x-rays a person had as a child and the development of cancers of the mouth and neck in adult years, leading dentists to begin wrapping people’s necks with lead aprons and to use tighter-beamed x-ray machines now in most dental practices (with a square, adjustable “gun” instead of a round scattershot beam).

Much of our current knowledge of the impact of radiation on humans comes from pioneering work done by Dr. John Gofman, Professor Emeritus of Medical Physics at the University of California at Berkeley, and Lecturer at the Department of Medicine, University of California School of Medicine at San Francisco. In the 1940s, while still a graduate student at Berkeley, Gofman made an international name for himself in the field of nuclear physics when he co-discovered protactinium-232 and uranium-232, protactinium-233 and uranium-233, and proved the slow and fast neutron fissionability of uranium-233, which made possible atomic bombs.

After receiving his PhD in nuclear physics, he went to work for the US Government to help develop the atomic bomb, and invented, along with Robert Oppenheimer and Robert Connick, the currently used process for extracting plutonium from irradiated uranyl nitrate.

The bomb project finished, Gofman went back to college, this time to get his MD in 1946. In 1947, he transformed the world of heart disease prevention and treatment by developing a new flotation ultracentrifugal technique that discovered low-density lipoproteins (LDL) and high-density lipoproteins (HDL), and then he conducted the first prospective study demonstrating that high LDLs (also known as “bad cholesterol”) presented a risk for heart disease and high LDLs (also now known as “good cholesterol”) demonstrated a resilience against heart disease. He literally wrote the book on heart disease that’s still today used in medical schools, “Coronary Heart Disease,” published in first edition in 1959.

Recognizing that Gofman understood both nuclear physics and human medicine, in the early 1960s the Kennedy administration asked him if he’d start a Biomedical Research Division at the Lawrence Livermore National Laboratory, and supervise research into survivors of the Japanese atomic-bomb attack, Americans who’d been exposed to atomic and X-ray radiation, and look into the suspected relationship between radiation, DNA/chromosomes, and cancer.

Dr. Gofman ran the research division at Lawrence Livermore from 1963 to 1965, and the things he learned in his research began to trouble him. Other researchers were pursuing similar paths, with the publication in 1965, by Dr. Ian MacKenzie, of a report titled “Breast Cancer Following Multiple Fluoroscopies” (British J. Of Cancer 19:1-8), and in 1963, Wanebo and co-workers report “Breast Cancer after Exposure to the Atomic Bombings of Hiroshima and Nagasaki” (New England J. Of Med. 279: 667-671).

In a groundbreaking analysis of the studies extant at the time, Gofman and his colleague Dr. Arthur Tamplin concluded that even very low levels of radiation could cause human cancers, and published their research in the highly respected medical journal Lancet (1970, Lancet 1:297). Gofman’s work led to a worldwide reevaluation of both medical radiation (and the elimination of those shoe-store machines) and of the way nuclear power plants were constructed and operated. Today, although he’s passed away, he is still considered one of the leading experts on the effect of radiation on the human body.

Here’s what Dr. Gofman says to anybody who claims that nuclear medicine procedures (such as SPECT scans) are “safe”:

“In the mainstream medical literature are quite a number of epidemiological studies showing that even minimal doses of ionizing radiation induce extra cases of cancer.”

In a 1995 paper on low-dose radiation, Dr. Gofman pointed out that it only takes a single electron/photon-bullet (to use my analogy above), hitting the wrong part of a single cell, to cause cancer. Here’s how he summarized that paper on low-dose radiation, with five well-documented points that reflect the current state of knowledge:

“Point One: The radiation dose from x-rays, gamma rays, and beta particles is delivered by high-speed electrons, traveling through human cells and creating primary ionization tracks. Whenever there is any radiation dose, it means some cells and cell-nuclei are being traversed by electron-tracks. There are about 600 million typical cells in 1 cubic centimeter.

“Point Two: Every track --- without any help from another track --- has a chance of inflicting a genetic injury if the track traverses a cell-nucleus.

“Point Three: There are no fractional electrons. This means that the lowest ‘dose’ of radiation that a cell-nucleus can experience is one electron-track.

“Point Four: There is solid evidence that extra human cancer does occur from radiation doses which deliver just one or a few tracks per cell-nucleus, on the average.

“Point Five: Thus we know that there is no dose or dose-rate low enough to guarantee perfect repair of every carcinogenic injury induced by radiation. Some carcinogenic injuries are just unrepaired, or misrepaired…

“Conclusion: It is factually wrong to believe or to claim that no harm has ever been proven from very low-dose radiation. On the contrary. Existing human evidence shows cancer-induction by radiation at and near the lowest possible dose and dose-rate with respect to cell nuclei. By any reasonable standard of scientific proof, such evidence demonstrates that there is no safe dose or dose-rate below which dangers disappear. No threshold-dose. Serious, lethal effects from minimal radiation doses are not ‘hypothetical,’ ‘just theoretical,’ or ‘imaginary.’ They are real.”

Agreeing with the dangers of radiation to children, who are far more sensitive to damage by radiation than adults, the National Academy of Neuropsychology published an article in 1991 suggesting nuclear medicine (like SPECT scans) should be limited exclusively to pure research (which is not done in a doctor's office), with appropriate informed consent about the dangers, safeguards and follow-up, no cost to the client, committee overview, etc. (Heaton,T.B. & Bigler, E.D. 1991. Neuroimaging techniques in neuropsychological research. Bulletin of the National Academy of Neuropsychology, 9, 14.)

When I broke my back skydiving in 1971, I had a series of x-rays. Each one was a very quick burst of radiation, and each one increased my lifetime risk of developing cancer. Those x-rays were considered “safe” from a medical point of view, even though every medical expert acknowledges they can cause cancer, but they were “safe enough” because the risk of not knowing how badly my spine was injured was outweighed by the small probability the x-rays would cause cancer. This is referred to as the “risk-benefit ratio” and is how the government determines what they will call a “safe” level of exposure to radiation or other toxins.

The shoe-store machine, however, because it delivered a more prolonged dose of radiation to me (instead of a “picture” that flashed me with X-rays for a thousandth of a second, it was a continuous “movie” flow of X-rays), was dramatically more destructive to my DNA, so much so that after Dr. Gofman’s research was published in the 1960s nobody could justify keeping the machines in shoe stores any longer.

Neither of those radiation exposures, however, fired “bullets” of radiation at the most radiation-sensitive and cancer-reactive parts of my body: my brain, testicles, and much of my endocrine system (thyroid, etc.).

But with a SPECT scan, a child is injected with a radioactive material directly into his bloodstream. Its radiation-emitting particles are carried to every nook and cranny of his body. They flow into and irridadiate his developing testicles or her young ovaries and the eggs in them that will someday become children.

The radiation flows with the blood into the thyroid, the uterus, pre-developing breast tissue, the adrenals, the pituitary, and even the bone marrow.

Although most SPECT scannerss are only positioned to look for the “single photons” that are evoked by the detector when particles flash out of deep brain tissue, through the dura mater, through the bone of the skull, and the skin of the scalp to hit the SPECT detector, the entire body is filled with radiation.

If the SPECT scanner were put on the stomach, it would find radiation there; on the genitals, radiation there; on the feet, radiation there. “Bullets” are going off throughout the entire body — including in the child’s most radiosensitive organs such as developing breast, ovarian, testicular, uterine, and thyroid tissues.

And the “hit” isn’t only for a fraction of a second, like it would be with an X-ray: the radioactive agent injected with a SPECT scan decays slowly, and is still detectable in the bloodstream for days after injection. (And each time one of the unstable radioactive atoms of the SPECT agent decays to something that’s no longer radioactive, it emits “bullet” particles in the process, those hitting and tracking through the nearby tissues of the body at the time of breakdown.)

Lately there has been a lot of talk about the use of SPECT scans to diagnose ADHD. Of particular concern is that some physicians are using this procedure, whose risk-benefit ratio is considered acceptable for things like brain injury after a car accident or stroke (the main use for SPECT scans), on children. Children are far more susceptible to radiation-induced cancer than are adults, in part because radiation damage accumulates over time and cancers from radiation usually pop up decades after the initial exposure, and in part because their tissues are still developing and growing.

In 1997, at an ADHD conference in Israel, I had coffee with the National Institute of Health’s Dr. Alan Zametkin, who had done PET scan studies (which use lower-doses of radiation) on the brains of adults with ADHD to look for differences, and whose work had recently appeared on the cover of the Journal of the American Medical Association’s magazine. I asked Dr. Zametkin about the use of SPECT scans on children, and he told me flatly that he considered it both wrong and dangerous for the children.

While his PET scan studies had injected radioactive isotopes into the veins of their research subjects, they’d used a multi-million-dollar ultra-sensitive PET scanner to look for the action of the isotopes, meaning far less radiation was needed to be injected than with the SPECT scan machines, which are affordable for an emergency room or doctor’s office but less sensitive. (A PET scanner fills a room and is normally only found in a hospital or research facility: portable SPECT scan machines are available for emergency clinic and field use at much lower prices.)

And Zametkin’s studies had been done on consenting adults (not children) who were fully informed of the risks they were taking in receiving a full-body dose of decaying radiation, and who had not paid Dr. Zametkin to be in the study but were instead monitored for ill-effects from the radiation and offered other compensations.

Dr. Zametkin’s perspective represents the mainstream scientific view of using nuclear medicine, particularly with children, for anything other than pure research or life-threatening illness or injury. This is probably why when Daniel Amen told Dr. Zametkin that he intended to use SPECT scans on children, Dr. Zametkin reacted negatively. To quote Dr. Amen, “He gave me an angry look and said that the imaging work was just for research: It wasn’t ready for clinical use, and we shouldn’t use it until much more was known about it.” (Healing ADD, Amen, 2001)

Of course, much is known about the effects of SPECT and PET scans. They require injecting the entire body with a continual “spray of bullets” that decay over time. Their radiation exposure doesn’t last a thousandth of a second, like an x-ray, or even a few seconds like a fluoroscope: it lasts for hours, days, and traces remain for weeks. Everywhere in the body. With every single particle emitting radiation as it decays, and that radiation penetrating millions of cells on its way out of the body.

While it is possible to say that “no studies have shown that SPECT scans or the radiation levels used in them cause cancer,” it is a bit disingenuous: the only reason one could say that is because no such studies have ever been done. Actually, they’re not necessary: there is no such thing as “purely safe” radiation, just “risk-acceptable safe” radiation in the context of the need for the procedure. And doing such non-epidemological direct research on individual human subjects would be incredibly unethical.

There are techniques for imaging the brain that do not require injecting people with radioactive isotopes. The best-known and most widely used is the QEEG, which measures electrical activity at over a hundred different points on the scalp and then uses a computer to create a mapped image of brain activity. These have become quite sophisticated, and involve no danger whatsoever because they’re totally passive, “reading” the brain’s own electrical activity instead of injecting something into the body which is then measured as it shoots back out of the body.

So the next time somebody suggests a SPECT scan for you or your child, imagine yourself standing in that hotel window, looking down at a shooter on the lawn. You’re a cell in your body, and the shooter is just one of the millions of particles of radioactive substance about to be injected into your or your child’s vein prior to the SPECT scan.

And don’t forget to duck.

Bibliography:

AEC 1970. Atomic Energy Commission. Reports dated March 27 and May 4, 1970, from John R. Totter, Director of AEC's Biology and Medicine Division, to U.S. Senator Mike Gravel of Alaska. Totter was reporting on a pilot study of Alaskan natives by J.G. Brewen.

Barcinski 1975. M.A. Barcinski et al, "Cytogenetic Investigation in a Brazilian Population Living in an Area of High Natural Radioactivity," Amer. J. of Human Genetics 27: 802-806. 1975.

Baverstock 1981. Keith F. Baverstock et al, "Risk of Radiation at Low Dose Rates," Lancet 1: 430-433. Feb. 21, 1981.

Baverstock 1983. Keith F. Baverstock + J. Vennart, "A Note on Radium Body Content and Breast Cancers in U.K. Radium Luminisers," Health Physics 44, Suppl.No.1: 575-577. 1983.

Baverstock 1987. Keith F. Baverstock + D.G. Papworth, "The U.K. Radium Luminizer Survey," British J. of Radiology, Supplemental BIR Report 21: 71-76. (BIR = Brit. Inst. of Radiology.) 1987.

Boice 1977. John D. Boice, Jr. + R.R. Monson, "Breast Cancer in Women after Repeated Fluoroscopic Examinations of the Chest," J. of the Natl. Cancer Inst. 59: 823-832. 1977.

Boice 1978. John D. Boice, Jr. et al, "Estimation of Breast Doses and Breast Cancer Risk Associated with Repeated Fluoroscopic Chest Examinations..." Radiation Research 73: 373-390. 1978.

Chase 1995. Marilyn Chase, quoting radiologist Stephen Feig, in "Health Journal," Wall Street Journal, p.B-1, July 17, 1995.

Evans 1979. H.J. Evans et al, "Radiation-Induced Chromosome Aberrations in Nuclear Dockyard Workers," Nature 277: 531-534. Feb. 15, 1979.

Gofman 1971. John W. Gofman + Arthur R. Tamplin, "Epidemiologic Studies of Carcinogenesis by Ionizing Radiation," pp.235-277 in Proceedings of the Sixth Berkeley Symposium on Mathematical Statistics and Probability, July 20, 1971. University of California Press, Berkeley.

Gofman 1981. John W. Gofman. Radiation and Human Health. 908 pages. ISBN 0-87156-275-8. LCCN 80-26484. Sierra Club Books, San Francisco. 1981.

Gofman 1986. John W. Gofman, "Assessing Chernobyl's Cancer Consequences: Application of Four `Laws' of Radiation Carcinogenesis." Paper presented at the 192nd national meeting of the American Chemical Society, symposium on Low-Level Radiation. Sept. 9, 1986.

Gofman 1990. John W. Gofman. Radiation-Induced Cancer from Low-Dose Exposure: An Independent Analysis. 480 pages. ISBN 0-932682-89-8. LCCN 89-62431. Committee for Nuclear Responsibility, San Francisco. 1990.

Goldberg 1995. Henry Goldberg. Introduction to Clinical Imaging: A Syllabus. From the Steven E. Ross Learning Center, Department of Radiology, Univ. of California S.F. Medical School. 1995.

Harvey 1985. Elizabeth B. Harvey et al, "Prenatal X-Ray Exposure and Childhood Cancer in Twins," New England J. of Medicine 312, No.9: 541-545. Feb. 28, 1985.

Hoffman 1989. Daniel A. Hoffman et al, "Breast Cancer in Women with Scoliosis Exposed to Multiple Diagnostic X-Rays," J. of the Natl. Cancer Inst. 81, No.17: 1307-1312. Sept. 6, 1989.

Howe 1984. Geoffrey R. Howe, "Epidemiology of Radiogenic Breast Cancer," pp.119-129 in (book) Radiation Carcinogenesis: Epidemiology and Biological Significance, edited by John D. Boice, Jr., and Joseph F. Fraumeni. Raven Press, New York City. 1984.

Hulka 1995. Barbara S. Hulka + Azadeh T. Stark, "Breast Cancer: Cause and Prevention," Lancet 346: 883-887. Sept. 30, 1995.

Kodama 1993. Yoshiaki Kodama et al, "Biotechnology Contributes to Biological Dosimetry...Decades after Exposure," in Radiation Effects Research Foundation's RERF Update 4, No.4: 6-7. Winter 1992-1993.

Lloyd 1988. D.C. Lloyd et al, "Frequencies of Chromosomal Aberrations Induced in Human Blood Lymphocytes by Low Doses of X-Rays," Internatl. J. of Radiation Biology 53, No.1: 49-55. 1988.

MacMahon 1962. Brian MacMahon, "Prenatal X-Ray Exposure and Childhood Cancer," J. of the Natl. Cancer Inst. 28: 1173-1191. 1962.

Maruyama 1976. K. Maruyama et al, "Down's Syndrome and Related Abnormalities in an Area of High Background Radiation in Coastal Kerala [India]," Nature 262: 60-61. 1976.

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Modan 1989. Baruch Modan et al, "Increased Risk of Breast Cancer after Low-Dose Irradiation," Lancet 1: 629-631. March 25, 1989.

Myrden 1969. J.A Myrden + J.E. Hiltz, "Breast Cancer Following Multiple Fluoroscopies during Artificial Pneumothorax Treatment of Pulmonary Tuberculosis," Canadian Medical Assn. Journal 100: 1032-1034. 1969.

Skolnick 1995. Andrew A. Skolnick, quoting radiologist Stephen Feig and citing “many radiation physicists,” in "Medical News and Perspectives," J. Amer. Medical Assn. 274, No.5: 367-368. Aug. 2, 1995.

Stewart 1956. Alice M. Stewart et al, "Preliminary Communication: Malignant Disease in Childhood and Diagnostic Irradiation In-Utero," Lancet 2: 447. 1956.

Stewart 1958. Alice M. Stewart et al, "A Survey of Childhood Malignancies," British Medical Journal 2: 1495-1508. 1958.

Stewart 1970. Alice M. Stewart + George W. Kneale, "Radiation Dose Effects in Relation to Obstetric X-Rays and Childhood Cancers," Lancet 1: 1185-1188. 1970.

UNSCEAR 1993. United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and Effects of Ionizing Radiation: UNSCEAR 1993 Report to the General Assembly, with Scientific Annexes. 922 pages. No index. ISBN 92-1-142200-0. 1993. Committee for Nuclear Responsibility, Inc. Post Office Box 421993, San Francisco, CA 94142, USA.

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Why do so many children and adults with ADD/ADHD seem to lack the normal social graces or ability to make and keep friends, and what can be done about it?

Sandra’s parents looked across the table at me with a deep sadness in their eyes.

“We can handle her struggles with academics,” said Bonnie. “She’s in a private school and has a tutor, and is learning how to learn. But at twelve years old she should know how to make friends.”

“It’s even worse than that,” interjected Joe. “Whenever it looks like she might be making a new friend, she invariably ruins the friendship. She doesn’t attend to the other kids’ needs. She almost frantic about other kids, wanting them to like her, but she has to be the center of attention, she’s always bouncing around, and the result is that she sabotages any possibility for a friendship to develop.”

Bonnie and Joe were not incompetent parents, and ADHD wasn’t a new idea for them. Joe had been diagnosed almost a decade earlier, in his thirties, and Bonnie — a clinical psychologist who runs a shelter for battered women — had both academic and clinical exposure to it.

Bonnie added, “It really makes you think that maybe those who say ADHD is a mental illness are right. I mean, why else would Sandra have failed to learn social skills?”

And here we came to the core of the issue. Why, indeed, are so many ADHD children and adults relatively incompetent at social interactions?

Conventional wisdom is so firmly entrenched in the pathology view of ADHD that other options are generally not even considered. When the MTA study was done of the relative efficacy of therapy versus medication for schoolchildren, the type, quality, and style of the children’s instruction in school wasn’t even considered. (In fact the teachers were both paid a stipend and assured explicitly that their performance and the school’s teaching styles would not be evaluated in any way.)

The result, of course, is predictable. If you’re only looking for one thing — in this case, evidence that supports a theory of a mental disorder — then there is little doubt you can easily design studies to find it, even if it’s not there.

“Bonnie,” I asked, “what was your worst day in the past year, the one that really hit your self-esteem the hardest?”

She thought for a moment, then, frowning, said in a soft voice, “It was when our agency brought in an outside consultant to do evaluations, and he concluded that I wasn’t doing my job right. He did what he called a 360 degree evaluation, and solicited feedback from both the people funding our program, the people using it, and our staff. Everybody got to criticize me, although they called it a critique. And then he shared with me the things people said, and some of them weren’t all that flattering. I know he was trying to be constructive, but I was devastated. I was depressed for a week.” She looked at her hands, which were fists on the table, and relaxed them with an effort. “I guess I’m still upset about it.”

“How would you perform if that happened to you every single day?” I said.

Her eyes widened. “I’d be a mess. I’d quit my job.”

“What if you couldn’t quit your job? What if you were told the police would come and get you if you tried to?”

“You’re kidding, right?”

“No, I’m not kidding,” I said. “And you have all the mental and emotional resources of a grown-up adult, and training in these things as well. What if you were six years old?”

“Ahhhh,” she said, leaning forward on the table. “Now I get it. But what does that have to do with Sandra not knowing how to make friends?”

“I know,” Joe said. “I remember how terrible school was. To this day, I still feel like a fraud whenever I’m successful, because they so managed to convince me I was no good.” He turned to me. “Our daughter was so wounded by school during the early years when she should have been learning social skills that she wasn’t ‘available’ or paying attention enough to learn them. Her self-esteem was so low she couldn’t even imagine herself interacting with the other kids on an equal basis. Is that what you’re saying?”

“It’s exactly what I’m saying,” I said. “The style of instruction our schools use — including most of our private schools — is so dissonant with the style of learning these Hunter children have that they can’t succeed. It’s a set-up. And when they don’t succeed — even in the first grade — the teachers don’t question their own style of teaching. After all, it works with other kids: it must be the child’s fault. So the child is blamed for her own failure. We try to sugarcoat it by calling it a diagnosis, but she knows she’s being blamed. It’s her fault. And every single day in school is, for her, like Bonnie’s worst day in the office. Every day. Over and over and over. Year after year after year. When you think about it that way, it’s amazing she learns anything and that she even developed the most rudimentary of social skills. She’s the victim of severe, ongoing, institutional child abuse. And she’s responding in the way that many abused children respond: she’s shutting down in some times and situations, and becoming reactive at other times.”

“So what’s the solution?” Joe said.

“It’s twofold. First, stop the pain. Get her out of a school situation where there’s only one, limited style of teaching that doesn’t match her style of learning. Get her, instead, into a different teachers’ class, an alternative school, or home-school her. Anything is better than the wounds that are being inflicted on her right this moment.

“And, second, start systematically teaching her the social skills she missed learning as a child because she was in so much pain and so ostracized that she wasn’t available to learn them when the other kids did.”

“How do we do that?” Joe asked.

“There are lots of books and trainings on social skills,” I said, “but I’ve always thought the best was written by Dale Carnegie three-quarters of a century ago. It’s a book titled ‘How to Win Friends and Influence People.’ It contains thirty specific techniques that embody the best of interpersonal skills. Every week, read her one of the chapters, and give her the assignment of trying out that technique on somebody at school. When she reports back on the result, she gets a reward. By the time you’ve finished the book, I guarantee she will be more socially competent.”

“It’s that simple?” Joe said.

“It could be,” Bonnie jumped in. “Social skills are learned, not born. Every culture has different versions of them. And interactions with groups of non-related peers are learned mostly in school, in the primary grades. If she was in that much pain during those years — and when I think back to how many times she begged me not to send her to school, I realize she clearly was — she probably just missed that developmental stage because of all that pain.”

“And it’s never too late to learn,” I added. “The success of the Dale Carnegie Course for adults — where very week you have to try out two of the techniques and report back to the class the following week — proves it.”

Resources:
Montessori schools information

Homeschooling information:
Oak Meadow school (this is the homeschool program our youngest child attended)

Dale Carnegie information:
Summary of Carnegie's teachings
The Dale Carnegie organization
Dale Carnegie's book on social skills

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Meditation is an extraordinarily powerful way to strengthen ones’ mind and mental processes, find inner peace, and reboot the body and brain for optimal performance.

And sitting still and paying attention long enough to meditate can be damn hard for Hunters with ADHD.

Which is why I love my two meditation machines and highly recommend you check one or the other out. (I have no affiliation with either company.)

Back in the 1980s when I first started writing and speaking extensively about ADHD, my late friend Michael Hutchison (author: Mega Brain Power: Transform Your Life With Mind Machines And Brain Nutrients) and Rob Kall (who ran an annual conference on brain function and peak functioning) introduced me to “mind machines,” most also known as EEG neurofeedback devices.

EEG, or Electroencephalography, is a measure of brainwave activity, covering the types and intensity of a variety of different frequency patterns as well as their location in the brain itself.

There are specific brainwave patterns associated with the optimal states achieved by meditation, and what I’m calling my meditation machines first measure your brainwaves then feed them back to you in a way that lets you optimize the desirable frequencies and patterns associated with calmness or insight while minimizing the undesirable ones associated with being fidgety or distractible.

Because these devices are providing you with real-time feedback (mostly auditory) that rewards you when you hit the right state, they’re incredibly engaging. There are dozens of soundscapes you can choose for your feedback (I’m partial to rain and ocean waves) that are overlaid by “reward” sounds like birds chirping or waves becoming louder.

The first device, which I’ve used for years now, is from Muse, whose website is ChooseMuse.com. It wraps around your head, picking up brainwaves from your forehead against the “ground” point of your ears. It also has heart rate sensors and motion sensors and costs around $500; an older model is still generally available for around $250.

The second device, which just became available to the public in the past month, is from Sens.ai (which is also their website) and has sensors that directly contact the top and back of your skull as well as the forehead region, giving a somewhat more comprehensive brainwave analysis. It costs around $1,500.

Both are a heck of a lot cheaper than the equipment I bought back in the 1980s for my own brain-training: the first device I purchased included two IBM PC computers and a fancy brainwave-detection contraption and cost me over $20,000.

That early machine, though, taught me the usefulness of this sort of brain training. After a few weeks of regular 15-minutes-a-day practice, I found I was sleeping easier and less likely to get thrown off balance emotionally by the events of the day.

Both the Muse and the Sens.ai devices work with an app on your smartphone. With the Muse headband you use your own earbuds; the Sens.ai device is built around a pair of over-the-ear headphones.

You choose the program you want to run, depending on the goal of your meditation. Are you trying to build focus? Reduce distractability? Quiet the racing mind? Sleep better? Have better emotional regulation? Just have fun?

Both devices have programs for all these and more.

First you sit in a comfortable position and put the device on your head: you may have to moisten the sensors (the Sens.ai has a little water brush for this purpose) to give them an optimal electrical connection to your skin.  

Then you select the program you want to run from their app on your smartphone, close your eyes, and listen to the instructions, the guided meditation, or the background with the reward sounds. You can choose sessions from a few minutes to much longer (start short and work your way up).

MD Magazine recently ran an article about using the Muse device to train the brains of people with ADHD: it’s title was Neurofeedback Therapy Improves Behavior Outcomes in Patients With ADHD. The author, Erica Slaughter, noted:

“Patients with ADHD show a greater ratio between the resting theta waves and the faster beta waves compared with their age- and sex-equivalent peers without ADHD, with less ability to stay focused on a task. These quantitative data are an objective indicator of cortical dysregulations that can be improved through training patients to create better pathways through physician-guided operant conditioning.”

Given that Hunters are wired to be more easily distracted, it’s entirely possible that this “objective indicator of cortical dysregulations” are as much a function of growing up soaked in the high-stim rapid-motion culture driven by TV, smartphones, and the internet. If Hunters are more vulnerable to distraction by and addiction to these modern-day forms of entertainment, they may also be more wounded by them.

In the era before TV and computers, most people read, invited people over, or attended theater for entertainment; all three required training your own brain to a certain level of stillness and self-control. But when these electronic marvels hit the scene, the need for self-regulation largely vanished: the most ADHD kids will sit still for are highly-engaging content on TV or a computer screen.

After all, hyperfocus is one of the superpowers of Hunters: it just takes something fascinating (like a mind machine program on a smartphone) to kick that hyperfocus into gear.

Thus, modern children and adults with ADHD have a steeper hill to climb when it comes to developing the skills of paying attention and staying quiet while listening to boring content. These are skill sets already built into their Farmer friends and relatives; they must be learned almost from scratch by ADHD people.

As Dr. Robert Reiner of Behavioral Associates in New York told MD Magazine:

“The overall benefit of neurofeedback amounts to increased self-regulation, whether that is better regulation of anxiety, emotional states, attentional issues, or behavioral issues. If you can identify which parts of the grid are not operating optimally, then you can begin to train those parts of the brain to come online more effectively, and it basically strengthens the entire grid.”

Of course, it’s not just people with ADHD who use and benefit from neurofeedback. Various neurofeedback systems are currently employed by 78% of Fortune 500 companies, NASA’s astronaut training center, London’s Royal College of Music, the United States Olympic Training Center, Formula 1 teams, US Special Forces and Navy Seals training centers, and others.

There are over 700 studies showing a positive outcome from EEG neurofeedback, many relating to ADHD. This is a proven technology and it really works (I can testify!).

There are also EEG Neurofeedback professionals in virtually every city in America, most of whom are trained in using EEG to moderate the symptoms of ADHD. The devices work just fine for teenagers or even slightly younger kids, as well as adults of every age.

If buying these new gee-whiz EEG devices (or going to a therapist who uses them) is beyond your budget, don’t despair. Mindfulness meditation is also a powerful way of ameliorating ADHD symptoms and doesn’t require any hardware at all.

One study published in the journal Cognitive Behavioral Practice, “Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions,” lays it clearly:

“Overall, current empirical studies support the rationale for application of mindfulness to ADHD, show that mindfulness is a feasible and well-accepted intervention in ADHD samples, and provide promising preliminary support for its efficacy.”

There are hundreds of websites that teach mindfulness meditation, although here’s a simple way to get started.

Sit in a comfortable position anywhere. You can be in a quiet meditation room or a busy airport terminal: one of the really cool things about mindfulness is that you can practice it anywhere.

Start by becoming one with your body and your place. Notice how you’re positioned, how you’re breathing, any sensations you have in your body. Then cycle through your senses three times: notice what you’re seeing, what you’re hearing, what you’re feeling, and any tastes or smells. Spend five seconds or so with each sense, then move on to the next.

Now simply attend to your own attention: notice what you’re noticing. Some people find it useful to imagine they’re sitting at a control console — like the bridge of the Starship Enterprise — just above and behind the back of their head and they’re watching their body and mind in front of them.

Notice what comes up. Thoughts will bubble up, one after the other, and some will hook onto other thoughts until you’ll discover you’ve spent a few minutes going down one long thought train and gotten lost, forgetting to pay attention to your attention.

Don’t get upset: that’s normal and happens to everybody when they start meditation practice. Just notice it. Some people use the word “thinking” and imagine they’re mentally reaching out to their thought-bubble to touch it, causing it to pop and vanish. Then another thought will bubble up, and you repeat the process.

The key to mindfulness meditation is the mindful part: attending to how you’re attending to things. Being mindful of your mind.

I’ve practiced mindfulness meditation since I was a teenager (along with a few other forms: Kriya Yoga and Transcendental Meditation) and it’s been one of the biggest gifts of my life. (My first introduction came via Ouspensky and Gurjieff: I recommend The Fourth Way, In Search of the Miraculous, and Tertium Organum.

That said, even with over 50 years of practice behind me, I still find that using the Sens.ai or Muse devices help with my distractability and racing mind, and use them regularly.