ADHD 2.0
ADHD 2.0:
New Science and Essential Strategies for Thriving with Distraction from Childhood Through Adulthood
Edward M. Hallowell, M.D., and John Ratey, M.D.
In the book ADHD 2.0 psychiatrists Dr. Edward Hallowell and Dr. John Ratey explain ADHD (Attention-Deficit/Hyperactivity Disorder), and provide strategies to live a full life while managing this diagnosis. In this blog post I will be giving a brief (and deeply simplified) summary on the workings of ADHD, and will distill the main self-management strategies that doctors Hallowell and Ratey recommend to readers.
No brain is the same.
No brain is the best.
Each brain finds its own special way.
-Edward Hallowell
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What is ADHD?
Attention Deficit/Hyperactivity Disorder is a developmental disorder with no known cause. ADHD shows up differently for each individual with it, however, the most common traits of ADHD are distractability, impulsivity, and hyperactivity. Diagnosis for ADHD is most often done in childhood during elementary school years, however, just because someone was not diagnosed in childhood does not mean that they can’t be diagnosed in adulthood. Adults being diagnosed with ADHD is thought to occur as symptoms may be manageable until life stressors become too intense, and our original coping mechanisms no longer suffice.
If you think you may have ADHD and are seeking either a diagnosis or more information, you can connect with your family doctor, or you can seek out additional diagnostic screening questionnaires and support through CADDRA (Canadian ADHD Resource Alliance).
How can I work with my ADHD?
Whether you have a diagnosis for ADHD or identify with the symptom criteria (symptom criteria can be found here), this section will summarize Dr. Hallowell and Dr. Ratey’s strategies for working with an ADHD brain.
Stay Connected: Hallowell speaks to vitamin connect “the other vitamin C” being a major antidote for stress, and negative self concept. Connection is also a great way to stay accountable through check-ins, body doubling, and simply the regular reminder that we are witnessed and loved.
How to Stay Connected:
Have meals with friends or family, intentionally stay off of screens and let conversation flow.
Adopt a pet (this is my favourite piece of advice!) if you can afford it and your life can allow it. Pets are one of the most reliable ways to get enough Vitamin Connect without needing to rely on frequent human connection.
Check in with a couple of friends regularly. Hopefully these check-ins can be in person, but a phone call, or even a few texts can go a long way.
Use the human check-out at the grocery store, even having a brief conversation with a stranger can nudge us back into connection with the world and out of feeling anonymous and alone.
Join a class, club, or group, and show up to the meetings. If you aren’t sure where to find these meetups, I encourage you to go to your local community centre or library and start there to see what is on offer.
Engage in a gratitude practice, there is a reason why this is suggested so often - the research is undeniable in how helpful a gratitude practice can be with shifting toward a compassionate growth mindset. A gratitude practice is more than just saying “I am grateful for my cat”, rather it is also answering the '“why” behind the statement. For example, “I am grateful for my cat because she makes me smile and laugh every day”.
Get outside and into nature - when we are in nature our perspective starts to shift from me to we. That “we” perspective keeps us feeling part of something greater than ourselves and enlivens our relationships to people, plants, animals, the ocean, and beyond!
When worry starts to take over, reach out! When we worry alongside folks with a growth mindset, that worry can transform into a solution focussed conversation instead. Hallowell and Ratey encourage readers to worry alongside folks that lift us up rather than meeting us in a doom and gloom mindset.
Tap Into Your Strengths: Particularly for folks managing ADHD, boredom is a guaranteed way to exacerbate symptoms and amplify stressors. When we engage in a challenge that is suited to our strengths, ADHD and non-ADHD alike, we build confidence and sense of purpose.
Answer these questions (pg. 68) below to assess for your strengths:
What 3 or 4 things are you best at doing?
What 3 or 4 things do you like doing the most?
What 3 or 4 activities or achievements have brought you the most praise in your life?
What are your 3 or 4 most cherished goals?
What 3 or 4 things would you most like to get better at?
What do others praise you for but you take for granted?
What, if anything, is easy for you but hard for others?
What do you spend a lot of time doing that you are really bad at?
What could your teacher or supervisor do so that your time could be spend more productively?
If you weren’t afraid of getting in trouble, what would you tell your teacher or supervisor that they don’t understand about you?
Using your answers to these questions, you can start to get a sense of what may be the most fulfilling use of your time. Hallowell and Ratey encourage readers to find common ground where one’s interests and skills overlap in a venn diagram of “the circle of all things you really like to do, the circle of all the things you are really good at doing, and the circle of things someone will pay you to do” (pg. 69).
Set Up Your Environment: Our environments matter a great deal. What we expose ourselves to and how we choose to spend our time will reflect back onto our thoughts, relationships, and activities.
How to Set Up an Environment?
Daily Structure: This is essential to most humans, and particularly for those managing ADHD. Structure for ADHD folks can be particularly difficult, and generally the simplest way to start is through maintaining a schedule and having to-do lists.
Nutrition: You can likely guess where this is going… prioritize whole veggies, whole fruits, and drink lots of water. Avoid processed foods, and sugar. Whole veggies, fruits, grains, and water are the best fuel we can give our hard working brains, when we regularly consume processed foods, it is like putting diesel in a sedan.
Sleep: Here is another obvious one, however, it is consistently a challenge with the access to streaming services, social media, and general light pollution. Some of the tips that Hallowell and Ratey recommend are to charge your devices outside of your bedroom, turn off all electronics an hour before bed, make your bedroom as dark as possible, and turn down the heat or open a window to keep the temperature low.
Mindset: Calling back to the encouragement to develop a gratitude practice, this is an essential part of maintaining a growth mindset. Another tip is to start noticing how you feel after spending time with people, this will help guide where your time will be best spent, and maybe will give some inspiration for directing gratitude toward some of those people that lift you up!
Accept Help: Life can get hard, like really hard sometimes. To help us through challenging periods, it is important to have our support systems set up - this can come in the form of friendships, counsellors, or support groups. Find people that you feel supported by and keep them around!
Exercise is Essential: When we get our heart rate up, our brains release a protein (brain derived neurotropic factor) that aids in the growth of new neurons and neural pathways. This regeneration in our brains will aid in expanding our capacity for focus and emotional regulation.
Movement Breaks: Raising our heart rate has been correlated to better focus and stress reduction. Try out 5 - 10 minutes of jumping jacks, high knees, mountain climbers, or squats before you need to sit and settle into a task. And when you notice yourself slipping back into the internal battle of re-directing your focus, get up and get moving again.
Develop Balance: There is interesting research coming out around the relationship between balance and attention. Working on our balance can improve focus, mood, and executive function. An easy place to start to to brush your teeth while standing on one leg.
Movement and Motivation: Studies have shown that the most effective way to stick with regular exercise is to recall how good you feel when the exercise is over. Remembering these good feelings and reduced levels of stress can tap us into our internal motivation, we continue to move because moving makes us feel good and less stressed! And when we feel good and our stress levels are managed, we can stay patiently engaged with tasks and more regulated in our emotions.
Medication as a Tool: Doctors Hallowell and Ratey speak candidly about the benefits of ADHD medication. The psychiatrists engage readers in recognizing some of the stigma and fears around taking medications, and help to reframe these drugs for what they truly are, tools. As I am no expert in medication, I have simply pulled some questions from ADHD 2.0 to self-assess for whether it may be time to have another conversation with your family doctor about pursuing pharmaceutical interventions. If you would like to know more about the different types of ADHD medications you can find a helpful chart here.
How will I know when the time is right to pursue ADHD medication? (pg. 111)
In addition to consulting my healthcare provider, have I learned as much as I can about this disorder from reputable sources?
Am I doing everything I can in terms of non-medical treatments (e.g. connecting, building structure into my day, getting exercise and quality sleep, eating well, meditating, and other beneficial habits?)
How much is this disorder negatively impacting my life or the life of a loved one?
This book is a mere 132 pages long and is incredibly helpful in explaining the working of ADHD. I recommend the book to anyone with ADHD to read deeper into some of the strategies provided, and for anyone who has regular contact with someone with ADHD to help build empathy and understanding.
***this blog post was written by me and my fallible human brain, without any AI
