Understanding ADHD in Adults Podcast Episode

Some people say ADHD is my superpower, right? That provides a lot of creativity. That creates a lot of opportunities for people to look at things in ways that “neurotypical” people would not look at. And so, some people say, hey, my ADHD, my thoughts that come in and someone’s talking about this, and I jumped to this thought and then I jumped to that thought.

And the next thing I know, I’m coming up with all sorts of very interesting solutions to it that can be helpful for people. Greetings and welcome everyone to Breaking Bread, the podcast brought to you by Apostolic Christian Counseling and Family Services. Excellent, as always, to have you along.

Today we’re going to be talking about ADHD, a topic that’s really a household term. And to have this conversation, I’m really excited to have Ted Witzig Jr. with us, a psychologist, and Aaron Platner, a psychiatrist, and I think these two brothers will offer a great deal of insight as we consider ADHD.

Welcome, both of you. Thanks, Matt. Good to be talking again. You know, I mentioned there in the intro that ADHD is a household term, and really, we have, I would say a really good grasp of it at the younger ages, most of my career has been in education, knowing who has ADHD and how we acquiesce that in the classroom. And so, we have context for what this looks like in the maturing individual and how do we serve this maturing individual who experienced ADHD.

But I’d like to pivot the conversation because we said in the maturing years. And so how then do we support the mature ADHD individual? I think this is a very welcome conversation. And I know both of you deal with and have the opportunity to serve and to support individuals with all manner of disabilities and trials and difficulties and ADHD is one of them.

So, does that intention hit to the both of you? Thanks for having us today. Most people, when they think of ADHD, think about it in children and teens, and that’s where it shows up. But for many years, there was a thought that it was something that people just grew out of and that it was a childhood disorder and that it didn’t go into adulthood.

But today we know that many adults continue to have ADHD symptoms, and sometimes they’re never diagnosed or not diagnosed as children, and so they’re being first diagnosed with it as an adult. Other times, people had been diagnosed as children and adolescents, but now as they come into their adult years have to adapt as well.

I think that’s really helpful, to hear that historical perspective. And again, we’ve started saying everybody does know ADHD. Aaron, what does ADHD stand for? And perhaps provide some of the medical background to undergird our understanding of ADHD. Sure. So, when we think about ADHD, that is an acronym for Attention Deficit and Hyperactivity Disorder.

We know a lot of us are more aware of the hyperactivity part, right? That’s the young kid who can’t sit still, maybe very fidgety or just very impulsive. This is the person who might blurt out an answer or when you’re supposed to be at a store, they’re maybe climbing on things or just all over the place.

Now, when we think about that as a youth, this comes back to that frontal lobe, the front part of our brain here. God has given us a frontal lobe that is larger than the other creations he has made. And one thing about humans, created in God’s image, we are really unique in the fact that we exist in community with other people who are not directly related to us.

I mean, termites live in community, but they’re basically just clones of themselves, right? Sure. We are not. They all have the same brother. Yes. And I’m sure you have examples of beehives and how they work together, but they don’t have these huge differences that we as individuals have. And so how do we navigate the differences between each other?

Well, that’s where that frontal lobe plays a role. It is essentially the brakes that we all need in our lives. So, when James says to be slow to speak and quick to listen in a way, I mean, that’s the frontal lobe saying, hey, just slow down. Right. Let the person finish. And so, if you see someone such as a football player who’s been hit multiple times in that frontal lobe, they will have more periods of aggression, more periods of agitation, more periods of impulsivity.

That frontal lobe has been damaged, but someone with more of an ADHD, we can see that the frontal lobe is not as well developed, both on scans, which comes back to more of a dopamine issue, right? And I know we’ve talked about dopamine on other podcasts is the neural transmitter, which makes the brain communicate.

That is that kind of pleasure seeking, right? And we also have norepinephrine, which is another neurotransmitter that also has to do with that frontal lobe that kind of helps put the brakes on. So, when we think about people with ADHD, as I talk about them doing all these hyperactive things, in a way, they’re stimulating themselves.

They’re bringing that level of dopamine up to a level that allows them to function, but by doing that, they’re able to raise that level of dopamine. So, they’re better able to function and interact with each other, which means that in some ways they’re putting the brakes on, so they’re not as impulsive as far as interrupting, they’re able to sit still for longer time periods.

Or they’re able to wait in line longer for the drinking fountain, these sorts of things that help us engage or interact with other people. This is really a matter of importance because we’re relational. We don’t expect, for example, five-year-olds to have the same level of impulse control as we do somebody who is 10 or 15 or 20 or 25.

And we know that brain development continues throughout that time. What happens is that over time with kids who have ADHD versus those who don’t is that earlier on, they’ll tend to be sometimes more similar to their peers because their peers don’t have as good of brakes either. Right? But over time, some of that gap will widen and then they get in trouble, more things of this nature.

One other thing I want to say here is sometimes people will use the term. ADHD. They do it a lot with other categories like OCD as well. And so, if somebody forgets something, or they do one thing out of order, oh, that’s my ADHD. Or if somebody likes their pencils put on their desk, right?

Well, I’m so OCD, we have to distinguish the way that the words get thrown around from an actual diagnosis. And that’s something that Aaron and I will take very seriously with people because we want to treat people for the right things. So, I’ve got just a yes, no question, but feel free to elaborate.

There are evaluations and you can have a diagnosis. A 60-year-old man comes in and says, I wonder if I have ADHD. There is a path forward to having a clinical diagnosis. We’ve got the test for that. Is that yes, or no? Well, so there is a way that we could go about assessing that. What would you say to that, Aaron?

I would say yes, but a 60-year-old, it’s going to be quite a journey. So, Matt, often people will come and say, you know, I think I have ADHD and that will be their chief complaint or chief concern coming there. I can do what is a clinical diagnosis, which is asking questions and determining, is this more of an ADHD-like condition caused by other conditions or is this an ADHD diagnosis?

So, for example, if someone has generalized anxiety disorder, one of the diagnostic criteria is poor concentration, but that’s also a diagnostic criterion for someone with depression. So, you can see with psychiatry, there are a lot of symptoms that overlap with each other. The other option is that ADHD can exist alongside or with another condition. That is separate. But those two conditions together can make each other worse, such as someone with a learning disability. They might have dyslexia. And so, as they’re trying to focus, things are getting flipped. That makes it even harder to pay attention. And it’s more difficult for them to work through their dyslexia.

So, you have to address both of those at the same time, but understand they influence each other. So, that’d be the one in the clinical way, but often there’s also a more of what we’d say is a neuropsychiatric or neuropsychological testing, where you can actually go to a testing center or someone who’s a specialist and they will give people actual tests.

Some of the tests are self-scale where the person circles, yes or no, or rates himself on a scale, you know, zero, not much, 10, significant, and they’ll rate themselves on how they self-report on their symptoms. And they can also give that scale to others. I’m sure as you were a teacher, you might’ve gotten some of those scales to report on kids in class or their parents and families.

How important is it, I mean, you mentioned Ted, we throw around that term a lot. And we, as kind of the end of a joke, oh, this is the way I am ADHD. But I hear what you’re saying is that there is a sacred use of the term, and it should be honored as such. How important is it for somebody with suspicion to really know?

So, of course, this is the field that I’m in, psychology. We specialize in giving some of those tests and that’s one of the things that we do. So, my bent is going to be toward doing some of those inventories and doing some of the tests to see, for example, if we can pull apart which pieces are working correctly, and which aren’t.

So, for example, it’s very possible for somebody to have average intelligence or even strong intelligence, and yet, because they have ADHD, they get a lot of slippages. And so, they might think they’re dumb, for example, and to be able to know where somebody’s abilities are, where they’re currently functioning. And then we can actually try to target interventions towards them, both in the school, medically and in terms of counseling. If somebody, for example, when we do these tests has anxiety that shows up, we want to treat that and we want to treat that whole person. As was said, oftentimes the diagnosis is symptoms.

Okay. With a kind of a cluster of information gathering, the person’s self-report, other people who observe them closely, and then also their history, because with ADHD, the symptoms have had to start in childhood. ADHD by its nature, and by the way the diagnosis is written, is a neurodevelopmental disorder that starts in childhood and then shows its way along.

Yeah, and that’s helpful, Ted, and I can see your opinion that if a person is wanting help, that’s really square one. If a person wants help with a certain matter, then knowing what is playing out and what is behind the scenes and what is going on is of utmost importance to you.

And so perhaps looking into ADHD and whether it’s present or not is a part of good care. Sure. It’s just important that we, I’ll call it a rule out approach as opposed to a rule in approach. If you say, oh, you know what? I forget my keys sometimes; I must have ADHD. Well, that’s a rule in. That’s like saying I did this so I have this versus being able to say, okay, that may be one thing. Is it part of a cluster of things? And is that due to anxiety? Was that due to a stressful work week? Or is this something that shows up over time?

So, I’ve got a question, and it has to do with this idea that for quite a while now, we’ve had ADHD on our radar, as it concerns kids. And I think, Aaron, you really laid out why that’s the case. They live in a very structured environment in school. It manifests itself when you’ve got straight rows and times where you need to be quiet, and this is when you listen. I mean, it’s going to just explode, and the teacher is dealing with disruption.

And so all of a sudden, we’ve got a problem to solve and hey, ADHD is a part of this issue. And so, we have provided a great deal of support for that individual with ADHD in their younger years. My question now is, what does it look like in the life of an adult? What now are the matters of crisis that say, you know what, we need to find some answers here and then what does it look like to provide support?

It seems to me this is a landscape untended, whereas the young classroom has been attended now for a long time so say more about this adult space. I do think like you mentioned classically we see it in kids, and parents are going to take different approaches. Some include medications, some include different environments. The beauty of getting older is that you aren’t restricted to this narrow classroom, you can do all sorts of different jobs. And so, some people say ADHD is my superpower.

They don’t see it as non-attention but see it as so many different things coming at the same time. It’s hard to know which one you’re going to stick with, but that provides a lot of creativity and that creates a lot of opportunity for people to look at things in ways that neurotypical people would not look at.

And so, some people say, hey, my ADHD thoughts that come in. And, you know, someone’s talking about this, and I jumped to this thought, and then I jumped to that thought. And the next thing I know, I’m coming up with all sorts of very interesting solutions to it that can be helpful for people. And so, some people would say it’s not attention deficit, it’s attention different, or it’s an inability to weed through all these different options, because if that dopamine is more stimulated, one can be over simplistic and can specify on the one thing to move ahead. So, if someone picks a career that creates a lot of stimuli, they’re always being stimulated. It’s going to be helpful for them to focus on what they need to do or not do. So, you can see people with ADHD who tend to kind of gravitate more for athletics.

You know, you’ve got a quarterback, there’s a lot of sensation coming in. They’ve got to put a lot of input and make a decision and go quickly. That stimulation can be helpful. Or, you know, someone who maybe is just at a job where it’s a lot of movement, like an electrician who is like, you’re looking at the house and moving around.

That can be much more helpful than someone who’s at a stereotypical desk with a cubicle. That may not be a great fit for someone who struggles with that tension. So as an adult you can see people find different careers that are better for their difficulties. However, as people get older, we do see that hyperactivity slowing down as far as the physicalness, but we don’t see the hyperactivity of the brain necessarily slowing down.

So, it’s one thing to forget your lunch at school and mom needs to bring the lunch and you have to get a hot lunch, right? If you’re moving ahead and you’ve got all these things going on and you forget a very important business thing. There’s a lot more weight to that. And if you haven’t found the structure of people with more of attention deficit, they lose things. It’s not that they do it on purpose, but they’re coming home from work, and they’ve got many things they want to do, and it’s going through their mind, and they just try to put their keys there.

And when someone asks, where are your keys, their thoughts are already way beyond that. And so, they lose their keys, or they lose their checkbook, right? That’s a little bit bigger deal as an adult to lose your checkbook than a kid losing their homework. So, what I see, and this is like, when do you treat or not treat? There is the whole psychiatric and the DSM, right? That it has to be causing significant difficulties in your life. Right? And so, if you think about someone in a relationship, and it tends to be more men than women as we think about ADHD. So that’s why I’m picking on the husband. If you think about the husband versus the wife who are raising kids and have a lot of bills to pay and all these things going on, there needs to be a certain teamwork of handing the baton back and forth, right?

But if the person can’t maintain the baton and do what he’s been asked to do or remember it or forget it, that can cause a lot of stress in the relationship, which causes the wife to say, you’re not listening to me. They’re probably listening, but their mind’s going to different places. And so, it may not appear that they’re listening to their wives. So, the communication part might be, might not be there. There might be forgetfulness. And then, you know, the wife needs to cover for him, where the person’s able to “sit still.” But they’re not able to have that engagement and communication filling their roles either at work or with the family.

And that can create a lot of stress in which sometimes it’s actually the spouse saying you need to help my husband because he’s putting a lot of stress on our relationship, and I need help. Thanks, Aaron. I love the fact that Aaron brought up that it’s important that we see and find ways that we can see people’s strengths.

We’re oftentimes treating disorders, but the flip side to that is we want to help people to live their best, whatever that is. And so, creativity and spontaneity can be really fun also, and a really good thing. But when that turns into things that lead to relational problems or job problems or forgetfulness that goes beyond what an employer can deal with, those kinds of things, then we get into trouble.

A big part of this is understanding that people with ADHD have a will that they can exert and make choices. That’s important to understand. The flip side is that this is not all about will, okay? And family will sometimes look at it and say, if you would try harder, okay? And in one sense, yeah, trying is a part of this.

So don’t hear me that it’s not true. But the other part of this is it’s not just about trying harder, and I think that is probably one of the reasons that the diagnosis and getting it is so important because otherwise we’ll just treat it as a matter of will or selfishness or whatever.

Now, again, somebody with ADHD can be selfish and somebody with ADHD might not try as hard as they need to sometimes. But the flip side is that’s true of all of us. And we don’t want to say that this is just about trying harder. I appreciate that, Ted, and I’d like to ask you again to give us some ideas of exercises, perhaps things that you would do in the room as you work with people with this.

Certainly, Aaron, there is a medical approach to this. I mean, you’ve mentioned dopamine and other neurotransmitters, and you’ve explained medically what’s going on here, and so I think it’s easy for us to make the connection that says that. Thanks. I’m guessing there’s some medication here that could be helpful to this end, but Ted, you spend your time on the therapy end of things.

Is there one thing to say, if you have ADHD, try this, or this would be something that we would look at in terms of practice. Yep. So, as we look at the package of skills, okay, that we’re going to use and I’ll let Aaron talk more to the medications end of things, but I’m going to look at it through three main lenses that I’m going to try to help the person with.

Okay. One is, in a therapy context, I’m going to try to help them understand good coping skills that can be social skills, that can be skills to help them to get their self-esteem in a correct place if they feel less than. It’s going to also try to help them keep anxiety and depression lower, those kinds of things.

I’m also going to teach them things like relaxation skills and being able to quiet themselves at times. Those things don’t naturally occur. We’re going to do it in a way that works for them. So, coping skills are a big part of it. Number two, some of the lifestyle management skills, getting good exercise, sleep, those kinds of things. We know that with extra energy and things like that, but also just moving and keeping that brain healthy is really important to brain health as a part of this, getting sleep and sleep problems go hand in hand a lot of times with ADHD. Eating well. Again, the concept here is if they’re just dysregulated and they’re just going super high on caffeine or just eating trash, whatever, we’re creating other swings in the system.

We want to create a good health base for that. The third thing that we’re going to focus on is relationships. So, it’s coping skills, lifestyle management, and then relationships. And with that, it’s about social skills. It’s about having people in their life to help them to have cues and to coach and to develop in their own home or businesses, the ways that we work together to make things work.

Make sure there’s good relationships, communication, but also too, sometimes it’s helpful to have somebody who is actually a coach. And what I mean by a coach is sometimes it’s somebody at the workplace or whatever, but there are people who are ADHD coaches or organizational helpers. And again, this isn’t about a one-time fix.

But it is about some of those lifestyle management things to help with social coping. I really appreciate that, Ted. And what I hear is that you really take the approach that says, okay, so this is the way your brain processes the world. You can live with this, but it’s going to take some things to learn these skills.

Aaron, medically, what should we know? There are definitely things we can do and I do hear the question of oh, isn’t it just these iPhones and screens and you know, we’re just raising this generation in this culture that’s exacerbating all of this attentional deficit.

And there’s no doubt that the screens are changing our brains. And we do know that ADHD does have a genetic component. It does seem to be in the history, a very clear indication of people who have ADHD and their family, and that is passed down. So, we know that genetic components are there.

So, coaching, when I come in the house, here’s a place I put my keys, very specific structured, those sorts of things. Those can be very helpful for people with ADHD to do the things they need to. The gold standard is still medications. So, you really split it up into stimulant medications and non-stimulant medications.

So, the non-stimulant medications would be like a medicine called Wellbutrin or Bupropion or Strattera or Atomoxetine and some others that can work with the norepinephrine, which once again, breaks in that frontal lobe to say, slow down, think it through. That’s where the norepinephrine can kind of help put that brake on, but then you have the stimulants and you’re right, you have Ritalin and Adderall, which are the two classes of medications that actually work on that frontal lobe and increase the level of dopamine.

It’s just important to remember that two people can have ADHD and could look very different. But what we want to do is if somebody is concerned about this, we would encourage them to get an assessment and that looks at all these different factors we talked about. And then to get treatment that looks at these different factors too.

How does their brain work? How are their relationships working? Their coping skills, their lifestyle, all those different pieces. And then as they grow and develop as they go through life to try to figure out the best kind of settings to be able to work in and to thrive in. I think that’s really helpful.

And, you know, I’m really super intrigued by the environment that really elevates the presence of ADHD. You mentioned the classroom for the young child. You mentioned the cubicle for the worker. Let’s go to the church space. Let’s go to the spiritual space. I hear even as you walked through the coping skills, Ted, lifestyle, relationships, calming, relaxing, quieting sure sounds a lot like prayer, sounds like reading read your Bible. Come to a church service and sit and be quiet. This is a setting and I’m wondering what we see in this spiritual space because I can imagine it’s got to be very discouraging for a person who wants sincerely to live out their faith and have their attention going in a thousand ways.

And we kind of have this sense, and I’m not even sure how accurate it is, but that the spiritual person can focus on the Lord. So anyway, what can you share for those who struggle. Yep, I think this is true for ADHD. It’s true for other situations as well when people have learning issues or whatever, is that we have to figure out how to do this, how to make it work well for us. And so, for example, when we come in and sit down in church and for many people, their minds can move faster than the minister is speaking. Okay. That’s not true of every minister, but for many ministers, it’s true. So, one of the things we normally do is just pace ourselves, remind ourselves to focus and things of that nature, but somebody with ADHD, you might find, for example.

It’s good for them to also have a note card or a little something that they could take notes in, so that they’re, that they’re listening and writing and listening and writing and going back and forth. Again, church service is about an hour, so we’re not talking about that they have to maintain it forever.

But I think the other side to this is sometimes spirituality is for those who are the most studious, those who are the most book smart are the most spiritual. And we just need to remember that people can live that out in a lot of different ways. Yes, we want to get the Word into us, but maybe this person finds an audio Bible really helpful.

Maybe they find doing something that’s more of a devotional reading that has a plan that they can follow or doing that with another person. Maybe they find that sitting and reading is going to be hard, but serving the Lord by being able to bless others in certain ways is going to be really a way that they can live out their faith.

So, we’re just trying to help them to be able to see that they are an important part of the body of Christ and to live into that and not to be discouraged by that. Aaron, thoughts? Yeah, I would agree. I mean, I think the beautiful thing about the Gospels is how Jesus meets people where they are. Yeah. He has this ability to say these things that just meets him right there, but as he approaches different people, his approaches seem to be across the board.

And so, I think we have this kind of this mind, I remember as a kid, my grandparent had this picture of this old man praying with his Bible and there’s a piece of bread. This is our daily bread. And so, you’ve got this Instagram devotion time with a cup of coffee and their Bible.

It’s just solitary sitting there, but at the same time, I have a neighbor who walks and prays. I know this because I’ve talked to her and she sits there and as she’s praying, the next thing she knows, she’s going over her grocery list and what she needs to do and balancing her checkbook.

So, for her, going for a walk helps her stay focused and concentrate. And she needs that stimulus. And we have so many different ways that we can consume spiritual things such as audio Bible where you walk or something like that. So, I do think that we need to understand that God has given many different gifts and availabilities to meet him in his presence and so someone with ADHD might find that it’s more helpful for them to be engaged in these kinds of activities.

I do think the sitting and receiving the Word as we do traditionally on Sundays at an Apostolic Christian Church is a very wonderful way to receive but I know for others they enjoy small group conversations of Bible studies where there’s more talking and engaging and they’re more actively learning and they find that is something that is able to help them supplement the more traditional service where they’re sitting still.

And so, I think we can find where people are at and try to meet them there, that they can bring attention to an appropriate level and be able to better receive or understand what their thoughts being present with the Word of the Lord. Thanks, Ted. Thanks, Aaron. I really appreciate it as we brought this matter of ADHD that is well understood perhaps in youth but present in adults also. And I really loved how we touched on not only the medical or biological matter but also how the relationships and social life impact our emotions.

And then now, lastly, and maybe most importantly, spiritually, and that God has made a way for us to worship him in all of our uniqueness, I think is really exciting.

Thanks, both of you, for being on. Bless you, each one who’s listening, wherever you’re at. And we pray and trust that this has been helpful for you. God bless you, each one. Thanks.