I was professionally tested and diagnosed at the age of ten as ADHD/Gifted. I struggled all of my life because my gifts often threatened others, and I lacked the social skills that should have told me to mask it better.
In my case the evolutionary advantage involved tool making. I feel this is one of the key elements of the development of human civilization. I excelled in a career that involved those skills. In fact the trade was called Tool and Die Making.
Evolution does not lead to perfection. Darwin says as much (I actually read On the Origin of Species later in life.) I was often sabotaged in the workplace by people whose intellect focussed inward (narcissism) and were envious and insecure about my problem solving traits.
This is me- late diagnosed at 67, (female, figures). I did well with multiple choice tests partly because I moved on quickly from questions I wasn’t sure of. I solve problems fairly quickly and sometimes unusually, etc, etc. But the social aspect of those gifts was isolating and it’s a huge relief to know now the “why” of me. Life is SO much less anxiety-inducing than before my diagnosis. There’s still the grief of missed opportunities, but there’s almost always something to regret in life so no point in dwelling on it. Thanks for this article.
Hi Thom: I will keep this short, so the message won't get buried. You could have written this back in 2013 if you had read my 2013 book on ADHD (see my substack ADHDExplainer). It was called "Adult ADD Factbook -- The Truth About Adult Attention Deficit Disorder Updated June 2013."
More than half of the book is dedicated to a detailed discussion of the science that demonstrates proof by "a preponderance of evidence" that ADHD is clearly
(1) not a disorder
(2) how the dopamine system confers an advantage to those with low baseline dopamine which is related to threat responsiveness (survival)
(3) how that same low baseline dopamine creates poor working memory at baseline (academic impacts, etc.)
(4) how threat changes baseline dopamine and in the ADHD type, that increase in dopamine means better working memory, faster reaction times, etc.
(5) nonADHDer types have optimal dopamine processes at baseline (great for academics) but when dealing with a threat situation, that brain type over-amps (goes to above optimal dopamine for working memory) and creates problems: slower reaction times, worse cognitive function, decreased working memory, increased blood pressure and heart rate, etc.
That should be a teaser for you to read my book which goes much further into the advantages and upsides of the ADHD brain type than what you or most scientists have yet to write about.
My conclusions are based on 911 sources (citations). My audience -- those who live the experience every day -- has overwhelmingly endorsed my "take" on the upsides and downsides of the ADHD brain type. The book is still ahead of its time.
It has withstood 12 years of examination, critiques, and a two-year aggressive peer review by the Washington State Medical Commission who endorsed it from cover to cover in early 2017 and stated "Dr. Sterling is at least three years ahead of the rest of us." Turns out, I am still ahead of my peers 8 years later than that endorsement.
I am working on an update and fact check of the 2013 Book, which will be entitled "The ADHD Dopamine Dilemma and I -- 20 Years of Learning That You Should Know About."
I would say, without a doubt, and with confidence built from lived-experience feedback, this is the best book on ADHD that you have never read.
I am new to substack and still catching up. I was so thrilled to find this post. Thank you. Ron
I am not sure if you are referring to what I have said about the downside of the nonADHD brain in threat situations, or possibly something else. So, this might not be perfectly on-point.
Low baseline tonic dopamine, in my world, is measured by its proxy, working memory. There is no perfect way to measure baseline tonic dopamine, per se. It cannot be measured without being very invasive (so, not possible yet for humans without significant collateral damage).
However, after a huge deep dive (which is still going on) into what might be a credible method for estimating tonic dopamine presence, I found that the PRL clearly shows that baseline working memory levels (low, medium, optimal and above optimal) correlate to tonic dopamine activity measurements and synaptic surges needed to move available up towards optimal or to above optimal.
Above optimal surges of dopamine that take place in brains that already are optimal at baseline (nonADHD) makes things worse as it is moves to above optimal quite easily (nonADHD brain response to threat or any dopamine enhancing activity or chemical). There is a graph on page 130 of my book.
The literature clearly shows that impulsivity (not thinking twice) is highly associated with low baseline working memory in the ADHD scenario AND above optimal dopamine in the nonADHD scenario (too much dopamine "enhancement" or another way to put it is "over-amped"). I am sure you have seen or experienced the over-amped state of threat response. It is manifested by "falling apart," losing train of thought, slower reaction times, poor focus, forgetful, slower data retrieval (even of long term memory items), shakiness, increased body temperature, heart rate, blood pressure, and sensations related to pre-nausea, nausea, and vomiting.
Above optimal dopamine in the nonADHD will produce degraded working memory and, thus, more impulsivity in just about any dopamine enhancing scenario. Whereas, in the baseline low working memory situation (ADHD) as the dopamine enhancer increases available extracellular dopamine, that improves working memory up to optimal, most of the time, and rarely, in the ADHD scenario, to above-optimal.
So, if I am understanding your question correctly, yes, it is unlikely that the two scenarios, impulsivity (ADHD baseline) and good working memory (less impulsivity) would coexist.
And, it would be unlikely that the two nonADHD scenarios of impulsivity and good working memory would coexist. However, the nonADHD outcome due to almost any dopamine enhancement would be worse working memory and more impulsivity.
When dopamine enhancement takes place through any mechanism, the nonADHD brain will usually over-amp, and produce worse cognitive function. In other words, it can be said that threat and any other dopamine enhancement scenario "treats" the main variable of ADHD, poor working memory.
Thus, also, counter-intuitively: (1) I recommend that those who are utililzing medication to improve working memory (treat ADHD) might think about not using it on days they go sky-diving. Threats, as such, will not be handled as well on meds, and (2) Unfortunately, there are no reliable, useful medications for lowering dopamine response for nonADHDers so that they can have a similar brainset to the ADHDer for such dopamine enhancing activities. Another way of saying this is: If you don't fit the criteria for what we currently call ADHD, it may not be advisable to get in the cage with someone who does.
Non-ADHDers can approach that brainset through a lot of work on "calming," but, in my world, will always have more challenges for success in threat related activities.
Two disclaimers:
(1) All the above is NOT accurate for those who have significant sensory sensitivities. It is a different experience that requires a different understanding. Too long for here.
(2) It is possible to fit the criteria for the diagnosis of ADHD but not have poor working memory (low baseline dopamine). In that scenario, you will not have the same upside to your ADHD as someone else. The problem with the current diagnosing of ADHD is that almost never do evaluations include a legitimate, properly conducted and evaluated working memory testing. Without that, in addition to the symptom checklist, it is possible to meet the criteria for ADHD due to other factors, not related to working memory (low baseline dopamine). Thus, any dopamine enhancement attempts or experiences will be quite different for those who fit the criteria for ADHD but do not have significantly low working memory.
Recently figured it out at 82. No regrets over the past. Going like crazy into the future. Back to school for skills to open a new business.
Defining the world as neuro typical and neuro-minority - n typical because there are more of them and n minority because there are fewer of us. But don’t write that down - I am sure that, with more navel gazing, I will come up with something pithier. I just know it’s not a Delay, Deficiency, or Disorder.
I spent a lifetime trying to “human” like everyone else did so casually. And decades in therapy because of family issues which didn’t stop even after I emptied my vault of memories. Along the way I wandered down a variety of paths that were the wrong ones but from which I learned at least a little to grow my understanding of life in general. (ps - if you are even the least bit judgmental , stay away from some of the expressive dancing - as a nation, we are terrible dancers. 😂) I read one famous life coach’s books and learned a bit from each of his tomes. I finally found some truth in the one that told me he was out of ideas and I should just get my s**t together and go clean my room - I finally learned I had paid too much in order to make a man-splainer rich. I have since studiously run in the opposite direction from ads on the internet that will help me “cure” ADD or organize my life.
Two psychiatrists have said they suspected I have ADD, but had no understanding of what it is, much less how to treat it. I got some nice organizing hacks, though. 😆 I particularly enjoyed being told the skill set on how to write a paper. I was teaching English at the nearby high school at the time. 😖
The few things I have kept are mostly body awareness training from the East as well as the West.
My special skills are being optimistic but dissatisfied with incomplete answers, and high levels of optimism and patience, which kept me on the search that brought me here. I have read only a few pages so far because I am focused on absorbing all I can about my role as a hunter gatherer, which I instantly understood as being my
Hi, Thom. Totally agree with you. Wonder if ADHD traits are starting to reemerge in the gene pool due to the shift over the past 50 years to a society that has recently prioritized knowledge workers. The ability to spot patterns, trends, etc. can be of great benefit in careers such as law, finance, etc.
Regardless, it also seems to me that our one-size-fits-all education system may be based on agrarian expectations, and thus ADHD students stand out and suffer.
As a professor of professional graduate students, and almost surely an AuDHD prof as well (awaiting formal diagnosis), I see many of my students suffering in the classroom due to their neurotype. Typical accommodations are limited to extra time, which doesn't really help with those who have difficulty focusing regardless of time allotted.
What recommendations might you have for our education system to either change to better reach such students, or to find ways to adapt to the neurotypes of individual students?
HELL YES on public education. Every public school should prioritize PE--and hands on projects--get our kids OFF cell phones and into project based learning with pen/paper again..... your work is invaluable
How great these truths are finally getting recognition! I'm a retired third grade teacher, still teaching in other ways, and still trying to get the word out. After raising family, I returned to teaching just as they started pasting ADD/ADHD deficit labels on the identities of these and the other spectrum individuals, ADD, ADHD, dyslexia, Asperger's Syndrome and autism. They are all giftedly different in their way of dealing with life. ADD is not Attention Deficit Disorder, but is instead Attention Differently Directed, this applying to all those just listed.
Many of these individuals have been seen as reclusive, that because they are not based in traditional ways of linear left brain thinking. They are right brain open which is the realm of connection to intuition, inspiration, out-of-the box thinking, passions, insights, hands-on activities, and wanting to help others and the world, among many other impressive qualities, we often over-whelmed by the world for we are very open, due to no linear filter to sequence linear info coming in. We have insights and then use the linear left thinking brain to shape those insights into word and contribution.
And yes, after Bacon and Descartes turned the world toward just the linear thinking of the left brain, for convenience, and leaving out the deeper connective perceptions of the right brain and heart, soon followed the Industrial Revolution, which when amped up turned attention to manufacturing and industry with little concern for nature or people, so also education took on its linear thinking obsession, industrialized education, over-focusing all on only letters, numbers, facts and concepts, this focus beginning now in TK, pre kindergarten in schools.
This has been amplified by tech, we all trapped by the username and password world of not simplified lives, but more and more separate and unequal societies, for linear thinking without connection, creates more and more separation.
We all have also a right brain and deep heart, the heart now known as having neurons also, and deep perceptions for the ways to live successfully. Both brain hemispheres and the heart were all meant to work together.
My website: HeartCenteredMinds. Com has both my long papers on the facts of all this, plus short ones that carry these truths and how it affects students and we all. Also, my You Tube talk from 2011: Spectrum Learning Differences, Not Disorders (1:10), ends with the direction of saying, discovery/project-based learning is best for neuro atypical and typical learners and for balanced living.
I was professionally tested and diagnosed at the age of ten as ADHD/Gifted. I struggled all of my life because my gifts often threatened others, and I lacked the social skills that should have told me to mask it better.
In my case the evolutionary advantage involved tool making. I feel this is one of the key elements of the development of human civilization. I excelled in a career that involved those skills. In fact the trade was called Tool and Die Making.
Evolution does not lead to perfection. Darwin says as much (I actually read On the Origin of Species later in life.) I was often sabotaged in the workplace by people whose intellect focussed inward (narcissism) and were envious and insecure about my problem solving traits.
Thank you to those who liked this comment. Please check out my sub stack.
This is me- late diagnosed at 67, (female, figures). I did well with multiple choice tests partly because I moved on quickly from questions I wasn’t sure of. I solve problems fairly quickly and sometimes unusually, etc, etc. But the social aspect of those gifts was isolating and it’s a huge relief to know now the “why” of me. Life is SO much less anxiety-inducing than before my diagnosis. There’s still the grief of missed opportunities, but there’s almost always something to regret in life so no point in dwelling on it. Thanks for this article.
Hi Thom: I will keep this short, so the message won't get buried. You could have written this back in 2013 if you had read my 2013 book on ADHD (see my substack ADHDExplainer). It was called "Adult ADD Factbook -- The Truth About Adult Attention Deficit Disorder Updated June 2013."
More than half of the book is dedicated to a detailed discussion of the science that demonstrates proof by "a preponderance of evidence" that ADHD is clearly
(1) not a disorder
(2) how the dopamine system confers an advantage to those with low baseline dopamine which is related to threat responsiveness (survival)
(3) how that same low baseline dopamine creates poor working memory at baseline (academic impacts, etc.)
(4) how threat changes baseline dopamine and in the ADHD type, that increase in dopamine means better working memory, faster reaction times, etc.
(5) nonADHDer types have optimal dopamine processes at baseline (great for academics) but when dealing with a threat situation, that brain type over-amps (goes to above optimal dopamine for working memory) and creates problems: slower reaction times, worse cognitive function, decreased working memory, increased blood pressure and heart rate, etc.
That should be a teaser for you to read my book which goes much further into the advantages and upsides of the ADHD brain type than what you or most scientists have yet to write about.
My conclusions are based on 911 sources (citations). My audience -- those who live the experience every day -- has overwhelmingly endorsed my "take" on the upsides and downsides of the ADHD brain type. The book is still ahead of its time.
It has withstood 12 years of examination, critiques, and a two-year aggressive peer review by the Washington State Medical Commission who endorsed it from cover to cover in early 2017 and stated "Dr. Sterling is at least three years ahead of the rest of us." Turns out, I am still ahead of my peers 8 years later than that endorsement.
I am working on an update and fact check of the 2013 Book, which will be entitled "The ADHD Dopamine Dilemma and I -- 20 Years of Learning That You Should Know About."
I would say, without a doubt, and with confidence built from lived-experience feedback, this is the best book on ADHD that you have never read.
I am new to substack and still catching up. I was so thrilled to find this post. Thank you. Ron
"worse cognitive function"
i'm hung op on the relation between "increased impulsivity" and "[improved] cognitive function" they seem mutually exclusive
Hi. Thanks for the comment and question!
I am not sure if you are referring to what I have said about the downside of the nonADHD brain in threat situations, or possibly something else. So, this might not be perfectly on-point.
Low baseline tonic dopamine, in my world, is measured by its proxy, working memory. There is no perfect way to measure baseline tonic dopamine, per se. It cannot be measured without being very invasive (so, not possible yet for humans without significant collateral damage).
However, after a huge deep dive (which is still going on) into what might be a credible method for estimating tonic dopamine presence, I found that the PRL clearly shows that baseline working memory levels (low, medium, optimal and above optimal) correlate to tonic dopamine activity measurements and synaptic surges needed to move available up towards optimal or to above optimal.
Above optimal surges of dopamine that take place in brains that already are optimal at baseline (nonADHD) makes things worse as it is moves to above optimal quite easily (nonADHD brain response to threat or any dopamine enhancing activity or chemical). There is a graph on page 130 of my book.
The literature clearly shows that impulsivity (not thinking twice) is highly associated with low baseline working memory in the ADHD scenario AND above optimal dopamine in the nonADHD scenario (too much dopamine "enhancement" or another way to put it is "over-amped"). I am sure you have seen or experienced the over-amped state of threat response. It is manifested by "falling apart," losing train of thought, slower reaction times, poor focus, forgetful, slower data retrieval (even of long term memory items), shakiness, increased body temperature, heart rate, blood pressure, and sensations related to pre-nausea, nausea, and vomiting.
Above optimal dopamine in the nonADHD will produce degraded working memory and, thus, more impulsivity in just about any dopamine enhancing scenario. Whereas, in the baseline low working memory situation (ADHD) as the dopamine enhancer increases available extracellular dopamine, that improves working memory up to optimal, most of the time, and rarely, in the ADHD scenario, to above-optimal.
So, if I am understanding your question correctly, yes, it is unlikely that the two scenarios, impulsivity (ADHD baseline) and good working memory (less impulsivity) would coexist.
And, it would be unlikely that the two nonADHD scenarios of impulsivity and good working memory would coexist. However, the nonADHD outcome due to almost any dopamine enhancement would be worse working memory and more impulsivity.
When dopamine enhancement takes place through any mechanism, the nonADHD brain will usually over-amp, and produce worse cognitive function. In other words, it can be said that threat and any other dopamine enhancement scenario "treats" the main variable of ADHD, poor working memory.
Thus, also, counter-intuitively: (1) I recommend that those who are utililzing medication to improve working memory (treat ADHD) might think about not using it on days they go sky-diving. Threats, as such, will not be handled as well on meds, and (2) Unfortunately, there are no reliable, useful medications for lowering dopamine response for nonADHDers so that they can have a similar brainset to the ADHDer for such dopamine enhancing activities. Another way of saying this is: If you don't fit the criteria for what we currently call ADHD, it may not be advisable to get in the cage with someone who does.
Non-ADHDers can approach that brainset through a lot of work on "calming," but, in my world, will always have more challenges for success in threat related activities.
Two disclaimers:
(1) All the above is NOT accurate for those who have significant sensory sensitivities. It is a different experience that requires a different understanding. Too long for here.
(2) It is possible to fit the criteria for the diagnosis of ADHD but not have poor working memory (low baseline dopamine). In that scenario, you will not have the same upside to your ADHD as someone else. The problem with the current diagnosing of ADHD is that almost never do evaluations include a legitimate, properly conducted and evaluated working memory testing. Without that, in addition to the symptom checklist, it is possible to meet the criteria for ADHD due to other factors, not related to working memory (low baseline dopamine). Thus, any dopamine enhancement attempts or experiences will be quite different for those who fit the criteria for ADHD but do not have significantly low working memory.
Hope that makes sense. Take care, Ron
Recently figured it out at 82. No regrets over the past. Going like crazy into the future. Back to school for skills to open a new business.
Defining the world as neuro typical and neuro-minority - n typical because there are more of them and n minority because there are fewer of us. But don’t write that down - I am sure that, with more navel gazing, I will come up with something pithier. I just know it’s not a Delay, Deficiency, or Disorder.
I spent a lifetime trying to “human” like everyone else did so casually. And decades in therapy because of family issues which didn’t stop even after I emptied my vault of memories. Along the way I wandered down a variety of paths that were the wrong ones but from which I learned at least a little to grow my understanding of life in general. (ps - if you are even the least bit judgmental , stay away from some of the expressive dancing - as a nation, we are terrible dancers. 😂) I read one famous life coach’s books and learned a bit from each of his tomes. I finally found some truth in the one that told me he was out of ideas and I should just get my s**t together and go clean my room - I finally learned I had paid too much in order to make a man-splainer rich. I have since studiously run in the opposite direction from ads on the internet that will help me “cure” ADD or organize my life.
Two psychiatrists have said they suspected I have ADD, but had no understanding of what it is, much less how to treat it. I got some nice organizing hacks, though. 😆 I particularly enjoyed being told the skill set on how to write a paper. I was teaching English at the nearby high school at the time. 😖
The few things I have kept are mostly body awareness training from the East as well as the West.
My special skills are being optimistic but dissatisfied with incomplete answers, and high levels of optimism and patience, which kept me on the search that brought me here. I have read only a few pages so far because I am focused on absorbing all I can about my role as a hunter gatherer, which I instantly understood as being my
truth. Finally.
Hi, Thom. Totally agree with you. Wonder if ADHD traits are starting to reemerge in the gene pool due to the shift over the past 50 years to a society that has recently prioritized knowledge workers. The ability to spot patterns, trends, etc. can be of great benefit in careers such as law, finance, etc.
Regardless, it also seems to me that our one-size-fits-all education system may be based on agrarian expectations, and thus ADHD students stand out and suffer.
As a professor of professional graduate students, and almost surely an AuDHD prof as well (awaiting formal diagnosis), I see many of my students suffering in the classroom due to their neurotype. Typical accommodations are limited to extra time, which doesn't really help with those who have difficulty focusing regardless of time allotted.
What recommendations might you have for our education system to either change to better reach such students, or to find ways to adapt to the neurotypes of individual students?
HELL YES on public education. Every public school should prioritize PE--and hands on projects--get our kids OFF cell phones and into project based learning with pen/paper again..... your work is invaluable
"Impulsivity and quick decision-making enabled rapid responses to fleeting opportunities or sudden dangers."
granted, we have an amygdala for threat-detection, oft implicated in hyperarousal, but to say that "impulsivity" = surival-conffering seems... wrong?
How great these truths are finally getting recognition! I'm a retired third grade teacher, still teaching in other ways, and still trying to get the word out. After raising family, I returned to teaching just as they started pasting ADD/ADHD deficit labels on the identities of these and the other spectrum individuals, ADD, ADHD, dyslexia, Asperger's Syndrome and autism. They are all giftedly different in their way of dealing with life. ADD is not Attention Deficit Disorder, but is instead Attention Differently Directed, this applying to all those just listed.
Many of these individuals have been seen as reclusive, that because they are not based in traditional ways of linear left brain thinking. They are right brain open which is the realm of connection to intuition, inspiration, out-of-the box thinking, passions, insights, hands-on activities, and wanting to help others and the world, among many other impressive qualities, we often over-whelmed by the world for we are very open, due to no linear filter to sequence linear info coming in. We have insights and then use the linear left thinking brain to shape those insights into word and contribution.
And yes, after Bacon and Descartes turned the world toward just the linear thinking of the left brain, for convenience, and leaving out the deeper connective perceptions of the right brain and heart, soon followed the Industrial Revolution, which when amped up turned attention to manufacturing and industry with little concern for nature or people, so also education took on its linear thinking obsession, industrialized education, over-focusing all on only letters, numbers, facts and concepts, this focus beginning now in TK, pre kindergarten in schools.
This has been amplified by tech, we all trapped by the username and password world of not simplified lives, but more and more separate and unequal societies, for linear thinking without connection, creates more and more separation.
We all have also a right brain and deep heart, the heart now known as having neurons also, and deep perceptions for the ways to live successfully. Both brain hemispheres and the heart were all meant to work together.
My website: HeartCenteredMinds. Com has both my long papers on the facts of all this, plus short ones that carry these truths and how it affects students and we all. Also, my You Tube talk from 2011: Spectrum Learning Differences, Not Disorders (1:10), ends with the direction of saying, discovery/project-based learning is best for neuro atypical and typical learners and for balanced living.