Recognizing ADHD in Adults: Heather Brannon (Transcript)

Here is the full transcript of Heather Brannon’s talk titled “Recognizing ADHD in Adults” at TEDxHeritageGreen conference.

In her insightful talk “Recognizing ADHD in Adults,” Heather Brannon explores the nuanced experiences of adults living with ADHD, illustrating the condition’s profound impact on their daily lives and mental health. Through the compelling stories of individuals like Sally and Tom, she vividly portrays the internal struggles, such as the relentless self-talk and challenges with mundane tasks, that characterize adult ADHD.

Brannon highlights how ADHD is not just about the inability to focus but also involves complex issues of self-esteem, anxiety, and the constant battle against societal misunderstandings and expectations. She explains the scientific basis of ADHD, emphasizing the critical role of neurotransmitters like dopamine and norepinephrine in managing attention and executive functions. The talk also addresses the broader implications of untreated ADHD, including the strain on relationships and professional life, and the paradox of perfectionism driven by a deep-seated fear of failure.

Brannon advocates for the importance of recognizing and properly treating ADHD in adults, presenting medication as an effective means to mitigate symptoms and improve overall functioning. Her message is one of hope and empowerment, urging a shift in perception towards ADHD in adults and highlighting the potential for significant improvement with the right support and interventions.

Listen to the audio version here:

TRANSCRIPT:

Understanding ADHD

Most of the time, when you think of somebody with ADHD, this is what you think of. But now I’d like for you to meet Sally. Sally is an incredibly creative person. She has a master’s in fine arts from Boston University. She’s the person that people at work come to if they need fresh ideas. Sally has ADHD.

So, Sally is driving down the road and there’s this constant conversation going on inside her head. She’s thinking, “Why did I have to look at that last email? I thought it was going to take me two minutes to write a response, and 20 minutes later, the stupid thing still isn’t written. And I’m late.” And I would say I’m going to do better next time. But I say that every single day and nothing changes. So what’s the deal?

And then friends and family, people who love Sally, say things like, “You forgot. How could you forget? I told you 10 times. Are you listening to me? Do we need to get your ears checked? Are you just not paying attention?” Or, “How could you go to the grocery store? All we needed was bread and milk, and you come back with a hundred and fifty dollars worth of groceries and no bread or milk. How does that happen?”

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The Impact of ADHD

So, you can see this would be a hard place to have confidence because Sally has her voice on the inside of her head telling her she’s not doing well and she has voices on the outside of her head confirming it. So this makes Sally anxious. As you can imagine, a lot of adults who have ADHD feel anxious, actually, 75 percent of adults who have anxiety actually have ADHD as the cause of their anxiety.

Whether they’re anxious or not, they know something is not right and they’ll make monumental efforts to make it right. But it’s still not right. And they’re usually waiting for the other shoe to drop, for everybody else to figure out they’re not as competent as they appear. But here’s the thing. Sally is actually competent. So what’s going on? What’s going on with ADHD?

At its core, ADHD is a deficiency of neurotransmitters, mainly dopamine and norepinephrine. You need dopamine to be interested in things like what your husband is telling you to get at the grocery store; and need norepinephrine for executive functions like concept of time and prioritizing. Because you need to know how much time has passed, so you know whether you need to stop answering that email so you can get to your appointment. And you need to know that it’s more important to get to the appointment on time than it is to finish that email today. And there are many, many other examples I can give.

Tom’s Story

Now I’d like for you to meet Tom. Tom is a people person. He is a great friend. He can connect with just about anybody. Tom checks his mail about once a week, usually when the door of the mailbox won’t close all the way because there’s so much mail in there. Tom has to force himself to go get the mail and he brings it in and he sets it down on the table because the mail is not interesting.

Unfortunately, he sets the mail down on last week’s mail, and that’s sitting on top of mail from the week before that. So the mail started out being interesting but then it ended up being overwhelming. And at some point, Tom just swept all the mail into a box and stuck the box in a closet. And it doesn’t matter that there were bills that needed to be paid because they’re not interesting until the situation becomes overwhelming and now the water gets turned off because Tom didn’t pay his water bill. Now he’s interested.

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And this doesn’t just happen at home. It happens at work, too. At home, if Tom is overwhelmed, he can just move right past it. But he doesn’t have that luxury at work. So if you see Tom sitting in a meeting, he is just seething internally because he has so much that he has to do, and these people are just wasting his time in another boring meeting.

And the problem, it’s not just the mail. It’s the mundane details of human existence that we all have to deal with, like going to the doctor, going to the dentist. And people with ADHD know they need to do them, but they’re either mundane or they’re overwhelming. And you can see that neither one of those situations will get the job done.

Until the situation becomes so big that they have to address it. So these are people who are living their life in crisis all the time. And just think about the health implications of that, the risk of heart attack, the high blood pressure, the weight gain.

ADHD’s Broader Impacts

And this doesn’t just affect the person with ADHD. It affects everybody around them because they don’t understand what’s going on. But then neither does the person with ADHD. Nobody understands what’s going on. So this is the corporate executive who has great ideas, but she’s late getting your individual reviews done. This is the stay at home mom who is frantically running around all day long. But when her husband comes home, the house is a mess and she hasn’t even started dinner yet.

This is a college professor who’s a great teacher, but it takes him forever to grade his tests. And this is the husband who has to stay late at work because he can’t get any work done until everybody leaves, because that’s when he can focus.

Now, here’s where this gets interesting, because most people with ADHD, including Tom and Sally, are perfectionists. What’s up with that? It’s all about the shame. Because they know what they need to do, they’re clear thinking adults, but they can’t get it done. And they have a world of people who see that they’re not getting things done. They don’t understand. They’re not aspiring to be that person. They’re trying really hard not to be that person. And it’s not working.

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In their minds, the only way to counter the shame of not getting something done and then hearing about it is to do it perfectly. So what’s the solution? That’s the best part of this conversation, because there is a solution. Medication helps tremendously because this is a chemical deficiency. Sally gets her ADHD treated and now she can have creative thoughts without having that big swirl of ideas running around in her head. And she can look at an email and see if she has time to answer it or she needs to save it for later.

Now, Sally can be on time for her appointment, and that frees up the perfectionist who was trying so hard to be on time before and was failing every time.

A Brighter Future

Tom gets his ADHD treated. Now he can open up the bills and pay them and he can sit down and read a book and remember what he read. At work, Tom can sit quietly, as any adult would in a meeting, even though it’s a really boring meeting because he doesn’t have to stimulate himself to be interested in it.

Now the corporate executive gets her reviews done and she has more time for great ideas. The stay-at-home mom can spend time with her kids really being present with her kids because she’s not frantically running around all the time. The college professor can help the students who are struggling because he knows what their grades are. And the husband can come home on time and spend time with his family because he got his work done during work hours.

So, does everybody have this? I mean, don’t we all feel stressed at times? Yes, of course we all feel stressed, but for some people, this is life-altering. They can’t move forward and they live a life of hidden shame. In the 28 years I’ve been seeing patients, in my professional opinion, I think we’re looking at two to three out of ten people, and that’s a lot of people who could be feeling a whole lot better. Thank you for your time.