In the recent episode of the ICHAS Podcast, we chatted with Ian Cox about ADHD a condition he was diagnosed with.

ADHD is a condition around which there is a lot of confusion and during the chat, Ian dispelled some of the common myths associated with it. Some of the most famous people in history from Leonardo Da Vinci to Mozart to Picasso all had the condition and Ian also chatted about what it’s like to live with it and how people experience bursts of enormous concentration followed by the complete opposite, the big challenge is it’s out of the control of the person when these happen.

Ian also highlighted some of the key areas he wants people who don’t have the condition to understand and also shared some useful resources for people to learn more. You can hear the full episode below.

Thanks, Ian for joining me today. And I suppose just for anybody who may be listening in if you want to give me a quick intro just about your own background.

Sure, yeah, well, I’m a Senior Lecturer with ICHAS at the Irish College for Humanities and Applied Sciences in Griffith College in Dublin. I’m also a psychologist and a counsellor and psychotherapist.

So that’s, that’s my background a little bit more, I suppose. I was personally diagnosed with ADHD, adult ADHD about eight years ago. So as well as working within the field and the profession, we also have a little bit of knowledge, on both sides of the fence. So it’s yet a complex, complex issue for sure.

Could you tell us maybe a bit more about the condition itself, because I get the feeling it’s one of those that’s misunderstood by a lot of people?

Yeah, it’s certainly misunderstood, not helped by the name, which, which doesn’t, doesn’t really fit. It’s, you know, one thing that we know at this stage is it’s not a deficit of attention, it is an inability to regulate attention. So there’s a bit of a bit of a misnomer there. So fundamentally, what ADHD is, is it’s a neurodevelopmental disorder. So it’s not a mental illness but it can be considered a disorder or, you know, something like that, but certainly not a mental illness.

So what we know about it, is there’s a very strong genetic component behind ADHD and what it seems to do, from what we know, is an effect of what we call the executive function in the brain, which is a very higher-order function that humans have, which involves planning, working towards certain goals, regulating our behavior, that kind of thing. What this really sort of results in is three different types of ADHD. So there are three different what we call presentations of ADHD, the one we’re most used to, and which is interestingly enough, most associated with boys would be what we call the hyperactive type. So the symptoms of this would largely be obviously the inability to focus attention for long periods of time unless it is something that interests the individual, which is a little bit different and we’ll come to that later. I think, hyperactivity, and fidgety problems with emotional regulation as well. So the reason why this particular presentation of ADHD, the hyperactive presentation of ADHD is considered to be more present or it’s certainly more noticed, is because it does tend to disrupt other students and other teachers in the class.

The other presentation, which is much more common in girls, but not exclusive to girls will be what we call the inattentive type, the space cadet the daydreamer drifting off. Without any of those issues that might disrupt other people, they often get ignored, because they’re not bothering the rest of the class or the teacher or at home so it’s often overlooked. So we do know that in terms of adult ADHD, we’re picking up a lot more in girls, because it gets overlooked at an early level.

The last is what we call combined type where there’s a little bit of hyperactivity and a little bit of inattentive presentations would be probably the second most common. So that’s really in a nutshell what ADHD is.

So you can already see some of the challenges because it’s the two extreme ends of the spectrum where people are either really can’t like you often hear where, say, people when they get diagnosed with it in schools oh, this person is never going to be successful, because they could never sit still. Or they just could always daydream, it’s very broad and you have the likes of Michael Phelps and Will Smith getting diagnosed with it and most of them say the same thing about, that they always struggled with grades and the reason for it was because they hadn’t been diagnosed with it.

Interestingly enough with all of those professions that you mentioned, they’re an entrepreneur, you know, singers, actors, they tend to work in very specific ways. They tend to burst in bursts of energy of highly focused energy and this kind of brings us to another aspect of ADHD, which is overlooked, which is a times a negative effect, but more so it’s quite positive hyperfocus. So the ability to focus in ways that other people cannot focus for relatively short bursts of time but extremely intensely. So entrepreneurs are perfect for this. actors, writers, artists. Jack Kerouac is another great example of somebody who was never diagnosed with ADHD but unquestionably had it. Jack Kerouac used to sellotape his manuscripts together and write books in one or two sittings. So there’s a little bit of a little bit of exaggeration, I think behind that on his publisher’s part, but unbelievably, you know, I don’t think he wrote on the road in a day, I think it was more like two or three days. But it’s that ability to hyper-focus. Richard Branson interestingly enough, hired a personal assistant to take care of the more boring, mundane matters in his life, while he focused on those very passionate hyper focusing issues, you know, massive burst of attention very focused and then it just seemed to slip away.

This is the problem that people have with hyperfocus, there is no control over it, it will just switch itself off like that without warning. So you’ll find people with ADHD, like Richard Branson, may be fully immersed in a task, doing great work, suddenly, the light goes out and that’s it, and the whole thing falls apart. So it’s unpredictable, very useful, but very unpredictable.

So it sounds almost like they’re literally racing against the clock like it’s a dial, it’s going there and once the dial is empty that’s it.

That’s very much that’s how they describe it. Interesting enough. Yeah, it is. It’s very, it’s very unpredictable and so what you get then with this unpredictability is a lot of what we call impostor syndrome, which seems to creep in with a lot of people who have ADHD and who are quite successful. There’s a knowledge of this underlying frailty in terms of attention, not being able to regulate it not being able to focus when I need to focus it, it switches on when it wants to switch on and it switches off when it doesn’t.

You get depression, self-doubt, self-criticism, a lot of this stuff, which leads in later adulthood to a lot of what we call comorbidities. We think that between 60 to 80% of people with ADHD also have something else. In childhood, it tends to be conduct disorders, dyslexia, and learning difficulties in adulthood, it tends to develop into things like bipolar and borderline.

This is complicated by the fact that bipolar and borderline share a huge amount of symptoms with ADHD, inability to regulate emotion, irritability, predictability, and impulsive behavior. So we noticed as well, particularly with adults with ADHD, there may have been a lifetime of misdiagnosis, they may have been diagnosed with bipolar with borderline anger management issues, and all along, it could have been ADHD.

Are there any common myths about ADHD?

I think initially, one of the issues with ADHD was because of the impact it has on people’s ability to function and to focus for long periods of time what you would have is pretty poor results in school, pretty poor grades in school. So there are two myths here. One myth is that people with ADHD have lower IQs than other people. In fact, what we know now is it’s quite the opposite. That’s one issue and secondly, the notion that school measures intelligence. What school does seem to measure is the ability to work for extended periods of time, and reproduce information based on your memory, which is exactly what ADHD seems to affect.

So there was this misnomer that people with ADHD tend to be, tend to have lower IQs actually, the research now indicates the opposite, tends to be people with average to above average, IQs complicated by the fact that a huge amount of children, young people who score in around, you know, 130 on IQ tests with which we placed them in the gifted range, tend to have a disproportionate amount of ADHD. Now the problem there is gifted kids tend to get bored very easily, they tend to get frustrated very easily, they tend to find it difficult to regulate their emotions, all classic signs of ADHD, so you may have misdiagnosed, or more than likely you may have a child who has both.

When you mentioned the extreme bursts even historically, Pablo Picasso, and Leonardo da Vinci both had ADHD. Albert Einstein had it too, these prove exactly the complete opposite to that point of lower IQ because historically, they’re viewed as some of the standout thinkers in history.

Yeah, absolutely, and really, what it points towards is, is a problem with how we, how we measure intelligence and the ways in which we, I suppose, perceived the education system, you know, the education system does certain things. Well, one thing it does not do is measure intelligence and so that ability to, as I said perform over long periods of time, in a very set way is kind of anathema to people with ADHD.

There was actually a really, really good book written a few years ago by Thom Hartmann, probably one of the most revolutionary books about ADHD called Hunter in a Farmer’s World. And this is an evolutionary perspective on ADHD that Hartmann puts forward, which is very persuasive. His notion is that, you know, over the span of human history, people with HD were vital to the community, they were the hunters, they would sleep all day, get up at midnight, vanish, and come back with a deer over their shoulders. They were valued as central aspects of the community. They did what they wanted, when they wanted, when that light, that attentional spotlight switched on, they will be gone and they bring back whatever kill that they would have, would have had.

As the Industrial Age crept in and as we became more regimented, we get up in the morning, we go to work, we sit at a desk for eight hours, we come home, we have our dinner, we do it again, we do it again. All of a sudden, now what you have is these people with a hunter’s brain, living in a farmer’s world. Now, they look like they are, there’s something wrong with them, that they’re maladaptive that they don’t fit in what’s changed is society, and how we how we live and how we operate, and what we expect of people. So I would even question whether it’s a disorder at all. My personal position is that I think it’s a disorder of society, rather than a disorder of the individual. Because in different societies, these people fit in perfectly well and over time.

You mentioned at the start that you had been diagnosed with it. What’s your own experience been like?

Yeah, very difficult, and I also talked about comorbidity. So I also have what we call borderline personality disorder, which does tend to coexist in later life with ADHD. There’s a theory there that it’s the stresses and strains of living with ADHD that possibly contribute towards the development of things like depression, bipolar, and BPD over time, and it’s very challenging. The research shows that if you get a diagnosis early, the correct diagnosis for ADHD and the correct help, usually therapeutic help and I’m not a big supporter of pharmacological interventions, although in some cases, I think it is necessary but I think far lower in terms of percentage than the number of people who are medicated at present, but it is difficult in people who are diagnosed later in life with adult ADHD do tend to have their lives tend to be a little bit of a car crash, I hate to say it, but literally, at times, they’re 400% more likely to have a road traffic accident or other accidents.

So there is that they tend to have much more in the way of separations and divorces difficult relationships, work, history tends to be a little bit of a disaster lots of getting fired from jobs, lots of leaving jobs on impulse, and lots of what we call self-sabotage, which is quite interesting. What builds up apparently, or what seems to build up in a lot of people who haven’t been diagnosed and reached adulthood with ADHD is an awful lot of self-criticism, self-doubt, and being very negative towards themselves. All of these problems are not down to a disorder or a genetic problem, but down to my personality. You can imagine what it’s like living with that.

So you do have a lot of these other issues anxiety depression creeping in. The work life in particular self-sabotage, just going back to self-sabotage is an interesting one because it’s often quite a cunning way that people with ADHD get out of doing jobs that have become very mundane or boring. They will start turning up late incomplete tasks, not getting on with other members. Eventually, they’ll get fired but it will be entirely of their own making.

A lot of the time being fired is a huge relief. Because the enthusiasm that they started off the job in gives way to a sort of boredom and frustration over time as it becomes more mundane. So people with ADHD are fantastic when they start jobs, highly motivated, highly focused, and highly committed, and when the task becomes boring or the job becomes sort of mundane, all of the attention just seems to snap out of it. It becomes extremely difficult to turn up every day and do the job on it.

When it comes to the therapeutic side of things in treating ADHD what does that involve?

There tends to be sort of a two-pronged approach in terms of therapy. One is, if you’re dealing with adults, in particular, what you’re looking at is the long-term psychological and emotional effects of living with an underlying condition like ADHD.

So it’s a hell of a lot of baggage day. Yeah, it’s, it’s, you know, that can take that can take a long time. Therapy does tend to be quite involved. So on the one hand, you’re dealing with those issues. And then on the other hand, what you’re looking at, CBT, in particular, is very, very useful for working with the present-day issues of ADHD, how to manage your time making lists, which was a bit of a revelation for me. Not holding things in your head, executive function is one of the parts of our brain that’s most effective ADHD, which is goal-oriented behaviour, inhibiting certain behaviours planning for the future and that tends to go out the window. So along with that working memory tends to be affected.

So a lot of people with ADHD tend to have poor short-term memories, very good long-term memories. So things like lists are great. In terms of dealing with people, emotional regulation is deeply affected by ADHD as well. People with ADHD tend to be very passive, very aggressive, passive-aggressive, tend to be very irritable as well and a lot of that is just out of frustration, frustration that you don’t fit in, and you don’t do things the way other people do.

Having clients with ADHD as well over the years, one thing seems to crop up again and again and it’s this notion that they feel like an alien, whether they’re young people or adults, they feel like they were literally I’ve heard this many times, particularly with young people, they were put on this planet, and didn’t get the same manual that everybody else got. Because their brains don’t work the same way as everybody else, which is a great analogy, and it actually fits quite well.

So you’re taking that sort of two-pronged approach where you’re learning how to manage yourself, and in particular, how to learn with the limitations that this has placed on you, but also some of the benefits. Hyperfocus is loosely termed in the ADHD population as being a bit of a sort of inverted commas superpower because it elevates attention to the degree that other people cannot reach it for a very short amount of time.

But it does mean you don’t work the same as everybody else, you don’t think the same as everybody else. So a lot of the therapy is involved with looking at the past, looking at the history, looking at how to cope with everyday tasks in the present, and the third aspect, which should sort of encompass both of those is learning to accept that you are different, you do not do things the way other people do.

The solution to treating ADHD isn’t to make you like everybody else. Because that can’t happen. Your brain is not wired that way.

It illustrates the point that in a school system, where everybody’s wearing the same uniform and going to class at the same time teaching are being taught the same subjects ADHD seems to get magnified in that environment.

Oh absolutely and one thing I think you mentioned earlier on is this notion that, you know, we’ve become quite regimented in terms of our society and I would totally agree, I kind of described it a little bit differently in terms of bandwidth. You know, the bandwidth of what we consider normal now has become so tight and so narrow, and we live in such a regimented society. You even think about the things nowadays that are supposed to improve our lives like technology, going online, having your pin number or your password, putting it in knowing you have to do this at a certain time, or else I’m going to get cancelled or my account will be turned will be shut down. At the moment. adults with ADHD are struggling with all of this stuff for everybody else. This seems to work really well. I imagine people with ADHD are having their electricity turned off they’re having their phones cut off. They’re having all sorts of things switched off on them losing passwords, forgetting passwords, forgetting their PPS number. These things that seem relatively small are incredibly disruptive in today’s society.

So they struggle on a lot of a lot of big issues. But these little day-to-day things as well, these demands of deadlines, renewing things by a certain date, having pin numbers, having passwords, are posing a huge problem.

Just the access we have now to information through our phones means there are unlimited ways to get distracted.

Oh, absolutely there is that. So you bring up sleep there, which is an interesting, interesting concept and a lot of people with ADHD will have very, very interesting sleep routines, delta waves, white noise, you know, like the vacuum cleaner, or a hairdryer, you can get these eight-hour videos now on YouTube. A lot of people in ADHD will have the TV on, and they’ll also have some white noise on in the background, to anybody else I’m imagining, it’s very distracting and very off-putting to people with ADHD, this is the perfect recipe for sleep, it chews up your electricity bill but at least you’ll get some sleep.

So it is a little bit different and we don’t really know why I think the fact that the brain is so occupied, probably contributes to the sleep pattern. There was a very interesting study done a while ago using EEG and they looked at the brain patterns and the activity in certain parts of the brain, particularly the anterior cingulate cortex of people with ADHD when they were active, living their life normally and then when they were asked to do a task, and what we found was really interesting. When their minds are occupied with a task, the activity goes almost down to sleep levels. So in normal day-to-day functioning, very similar to when they’re asked to do a task that they weren’t engaged in or interested in, or motivated towards the brain almost went into sleep mode. So this is the idea as to why extra stimulation at night and very sort of passive information nothing that’s interesting seems to switch the brain off. Yeah.

That shows the hyper-focus they have they will zero in 100% on a certain thing but everything else just fades into the background.

It’s what we thought for a while was that it was a motivation-based system. We know that’s not the case and this is why I used to get teachers and parents saying, you know, you need to be motivated, you know, the cure to ADHD is motivating you to do well in school. That doesn’t work. It’s what we call an interest-based system if the person is interested, they can do that hyper-focus will switch on. This is something that happens in schools a lot, you get reports back about kids with ADHD. Little Johnny doesn’t do his work. He’s not paying attention in class unless it’s something he’s interested in. As this as if this is some sort of criticism. Well, yeah, if little Johnny has ADHD, his hyperfocus is only switching on when he’s interested in something, and again, this isn’t a conscious switching on, there’s nothing he can do about it, it lights up, and then at some point, the lights gonna go out.

For people who may be living without ADHD, what advice would you give to them to help them understand ADHD better?

I think number one, and this goes for almost every sort of condition, whether it’s a mental disorder, or you know, ASD, or whatever it might be and we do this a lot is, you know, don’t expect people who have these conditions to be normal, because they’re not.

So you know, why can’t you just do things like every other child, why can’t you just be normal? Baseline, they’re not, and they’re not going to be their brains are not wired the same. There are functional differences in the brain. But there are also structural differences in the brain. There tends to be less volume in the prefrontal cortex, which helps us inhibit behaviour. You may want to run down the street naked. your prefrontal cortex is that part of your brain that says hang on a second, this is not a great idea. So that part of the brain tends to be, there tends to be less matter less volume in that part of the brain.

Whereas the limbic system, which regulates our emotions, in particular, tends to be overactive, and in fact, structurally bigger than other people. So there are differences there that are not down to choice or motivation or anything like that but are purely genetic and biological.

Second is, realise that what you’ve got isn’t a person, it’s, again, going back to, you know, staring at the interview, the name is appalling, it is not a deficit in attention, because as we’ve just looked at, in some cases, it’s an excess of attention. It’s hyper-focus, it’s really an inability to regulate attention.

So the second point I’d say to people is, to be aware that on the surface, you have somebody who is struggling to fit in struggling to do things the way that everybody else does things and you can view it in those terms. On the other hand, you also have a secret weapon, you have somebody who can focus like nobody else can focus you have somebody who has, as I said, a lot of us ADHDers call it kind of a superpower. Use it, work on it, find out what interests them, encourage them help them along that path.

Another thing, just going back into the sort of education system we did away with apprenticeships, about 20 years ago, largely in secondary schools. I’m glad to see they’re coming back. I think it’s great. I think that did a lot of damage to people with ADHD because they make great carpenters, electricians, and mechanics, because they can hyperfocus, then switch off and hyperfocus and switch off. I think losing the program in schools really alienated people with ADHD even further.

So it’s on the one hand, understanding that someone with ADHD is different, not through choice to biology, and secondly, that what they have are extraordinary strengths, people with ADHD make fantastic police officers are fantastic detectives. In certain spheres of the military, they excel. They reckon, interestingly enough, in the US military, something between as high as 60 to 80% of snipers have ADHD so it’s a very small cohort.

When you think about the job they do, it’s perfect. They’re sent out usually on their own or in a team of two at most, with very little oversight, just as a little in brackets here. People with ADHD don’t do authority, generally speaking. So they’re set out on their own, they have a task, and then they’re asked to hyper-focus for long periods of time.

Added to that is the fact that their life is almost constantly at threat. This is a huge excitement for somebody with ADHD because it fires up all the circuits in the brain, and the dopamine is flowing. So dangerous jobs are disproportionately taken up by people with ADHD they reckon in the prison system up to 50% of inmates male inmates have ADHD of some type.

Again, high-risk endeavours. So anything that involves risk, danger, focus for Hybris to focus for short periods of time, you’ll find ADHD people with ADHD are attracted to jobs like moths to light

So in that case detective programs might have a lot to answer for because nearly every detective and every program seems to have some sort of condition.

So you’ve brought up a particular favourite point of my Sherlock Holmes. Sherlock Holmes, classic ADHD, all the way through, there have been books written about it, how Arthur Conan Doyle had it figured out so perfectly. Whether he had it or not, we don’t know. But it’s an almost perfect case study and somebody with ADHD.

Another thing that does crop up later on in life is the notion of self-medicating, that people with ADHD will often turn to illicit drugs, alcohol, that kind of thing, to control their brains to try and regulate it for themselves. Sherlock Holmes did this and the argument is, well, you know, if he was if he had ADHD, if he was so flighty and so hard to, to where to pin down and had this hyper focus, why would you have taken cocaine? Well, what we know now is stimulants actually work the opposite on people with ADHD. What stimulants tend to do is they stimulate the prefrontal cortex, which is that part of the brain that helps inhibit behaviour which is a little bit underactive in people with ADHD. So it actually helps them regulate their emotions better by taking stimulants and that’s what your goals did. So he is an almost perfect case study in ADHD.

Want to Learn More About ADHD?

You can learn more about the condition on the ADHD Ireland website the organisation is dedicated to providing up-to-date information, resources, and networking opportunities to individuals with ADHD, parents of children with ADHD, and the professionals who serve them.

Ian also recommended the book ADHD: A Hunter in a Farmer’s World. Written by Thom Hartmann it explains that people with ADHD are not disordered or dysfunctional, but simply “hunters in a farmer’s world”. They possess a unique mental skill set that would have allowed them to thrive in a hunter-gatherer society . His book also offers concrete non-drug methods and practices to help hunters embrace their differences, nurture creativity, and find success in school, at work, and at home. Thom also Reveals how some of the world’s most successful people can be labeled as ADHD hunters, including Benjamin Franklin, Thomas Edison, and Andrew Carnegie.

About Ian: Ian is a psychologist and counsellor based in Co. Wexford. Ian works primarily with young adults at his private practice and is also a board member of The National Association of Pastoral Counsellors and Psychotherapists (NAPCP). Ian was also diagnosed with ADHD.

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