Ferrari Engine with Bicycle Brakes: A Review ADHD 2.0
My love for Dr’s Hallowell and Ratey began with their first book, Driven to Distraction, I had never read something so validating and encouraging. I read it and not only did I have a better understanding of ADHD in general but it felt empowering. If you haven’t read that book, I highly encourage you to do so. Since their update in 2011, there have been a lot of advancements in the field of psychobiology and more specifically ADHD. We’re starting to see more and more people being vocal and sharing their experiences with ADHD that doesn’t necessarily follow the “guidelines” according to the DSM. If you’re interested in reading my blog about my feelings in regards to the DSM criteria you can do so by clicking here.
More importantly, we are starting to see more understanding of inattentive types in general but more specifically women. Inattentive's tend to go undiagnosed until adulthood when the pressure to be “productive” increases. However, there is a large misunderstanding by the professionals responsible for screening and diagnosing. One of the DSM criteria is that the symptoms have to be present before the age of 12. The problem is the symptoms in inattentives often go unnoticed by others and even combined types. We don't realize until we’re adults and the pressure is on that there may be something wrong.
My journey is similar. Symptoms were noticed in childhood but brushed off as just faults in my character. This is why I am so happy to see yet another wonderful source of information from what I consider the ‘rockstars’ of the ADHD world, their latest book released in mid-January 2021, ADHD 2.0: New Sciences and Essential Strategies for Thriving with Distraction-from Childhood Through Adulthood.
Hallowell and Ratey estimate in their book that at least 5% of the population have ADHD and they believe that number could be even higher because people are managing with their ‘workarounds.’ They go on to argue that ignorance about this condition costs lives and I have to agree. Oftentimes individuals with ADHD have very low self-esteem and a toxic sense of self due to chronic setbacks, negative messages, and shame. ‘This can lead to suicide, addictions of all kinds, felonious acts (the prisons are full of people with undiagnosed ADHD), dangerously violent behavior, and a shorter life,” write Hallowell and Ratey. It is believed that having ADHD can take at least 13 years off your life expectancy; more than smoking, obesity, diabetes, and high cholesterol combined. According to another ADHD expert, Dr. Barkley, “About two-thirds of people with ADHD have a life expectancy reduced by up to 21 years. But the good news is according to Hallowell and Ratey, better understanding and treatment can minimize that.
ADHD 2.0 starts by going over the idea that ADHD is a spectrum, that everyone looks different and not everyone presents with the symptoms outlined by the DSM. Yet, diagnosis and treatment are often reliant on the official DSM diagnosis to qualify for insurance reimbursement and sometimes medication administration. They go on to put their two cents into what they feel is more appropriate criteria for ADHD with explanations of what it REALLY looks like. I appreciate that they focus more on a strengths-based way to look at the “deficits” of ADHD. Turning “problematic” behaviors into “useful” strengths. It's all about mindset.
VAST is an acronym thrown out pretty earlier in the book and referenced through the end. VAST stands for Variable Attention Stimulus Trait. VAST is an acronym first proposed by a woman who is a health editor at the KQED in San Francisco, Carrie Feibel, Hallowell and Ratey liked it so much they asked for permission to adopt the term. They argue that VAST is an environmentally induced cousin of ADHD, meaning that our current environment has cultivated the need for variable attention, aka multi-tasking and instant gratification. However, I would like to note that this is a learned behavior versus a brain-based condition like ADHD. Therefore medication is not something that will help improve the symptoms, which is why it is important to get a clear diagnosis.
Something that stood out for me was the discussion about the cerebellum, the part of your brain that is responsible for the coordination and strengthening of various physical skills. It helps us with balance and movement. It works ‘in concert with the vestibular systems of the inner ear, it operates like a little gyroscope to coordinate our balance and physical movements,’ writes Hallowell and Ratey. This would explain why there is a correlation between chronic ear infections and motion sickness in those with ADHD. The cerebellum is a very important part of our brain, despite only making up 10% of our brain, ‘it contains a full 75% of the neurons of the brain.” Which explains why so many ADHD individuals tend to be athletic and why exercise is so important in the treatment plan.
If you’re a parent of a child/teen with ADHD, or even an adult still figuring yourself out, I encourage you to read chapter five. “Find Your Right Difficult” is an important chapter to help us learn to see our strengths. Instead of trying to fit that peg in a square hole, it's about realizing that you’re ok being a peg, you don't have to be square. It's all about tapping into your superpower and building on your strengths. Questions on page 68 can help you get an idea of what are your strengths, or those of your child and how to advocate for them. This can be helpful in the 504 plan accommodation section or helping you as an adult look for a job or reevaluate your current one.
Not surprising, there is a chapter on the benefits of exercise which was most likely written by Dr. Ratey, author of Spark: The Revolutionary New Science of Exercise and the Brain, another must-read! This chapter on the power or exercise has some new advances and studies that aren’t included in Spark so make sure to not skip over this one. It has some additional tips and resources as well, specific to ADHD.
Hallowell and Ratey argue that medication gives you the most bang for your buck. ADHD medications often are misunderstood and given a bad rap. Parents are hesitant to administer them to their children and as adults, we are often made to feel like drug addicts when we go to the pharmacy to pick up our “schedule II” medications. However, they argue that these medications when taking properly actually are some of the safest, most effective, and with the least side effects of most psychiatric medications. Adderall was first used in the 1930s for ADHD and approved for the treatment of children with ADHD in 1960. Ritalin was first used in 1957. 70-90% of cases saw significant improvement with stimulants and 50-60% experienced elimination of symptoms.
The authors also don't shy away from addressing the popular myth that these medications increase the risk of abuse and/or addiction. The opposite is true, taking medication for ADHD has been shown to lower the rates of addictions as most addiction problems begin with individuals self-medicating and finding that illicit substances such as cocaine, help with concentration and productivity. However, the effects that those with ADHD get from these substances are substantially different than those without ADHD. Individuals with ADHD typically become calmer and more focused versus the high that most get from these stances. Important to note: stimulants are indeed listed among the top drugs abused by high school and college ages students without ADHD. Most of the abuse that takes place is by ‘neurotypicals’ trying to pull an all-nighter to study for an exam or get that paper done. On the flip side, ‘Long-term studies found that those with ADHD who are successfully treated with stimulants become addicted to substances far less than the general population, and certainly less than the population who have ADHD and do not take stimulant medication,” notes Hallowell and Ratey.
So there you have it, an overview of the pivotal follow-up to Driven to Distraction. ADHD 2.0 is a quick and easy read full of up-to-date information from the ADHD word. It has relevant research, guides, and tips to help you manage ADHD. It is a strengths-based and empowering read from the duo making waves in the ADHD world, Dr. Hallowell and Ratey.
If you have any questions or would like to suggest a topic for a future blog, you can reach out to me by email at Colleen@ScatteredPotential.com, subscribe to my blog, or my newsletter by filling out the form below. Follow me on Facebook, Twitter, and Instagram.