Divergent Tabletop Wiki

Adhd 2.0 New Science And Essential Strategies For Thriving With Distraction From Childhood Through Adulthood

18 min readEdit

Adhd 2.0 - New Science and Essential Strategies for Thriving with Distraction

Understanding Adhd: Neurodevelopmental Spectrum, Not Deficit

Reframing Adhd: Ferrari Engine with Bicycle Brakes

ADHD represents a fundamental reframe from “deficit” to “Neurodevelopmental difference.” The central metaphor transforms understanding: people with ADHD possess a Ferrari engine (exceptional cognitive power, creativity, and capability) paired with bicycle brakes (insufficient Executive function and self-regulation). This isn’t about weakness—it’s about mismatch. The solution becomes clear: strengthen the brakes, don’t limit the engine.

ADHD affects approximately 5-10% of the population (likely higher due to underdiagnosis), persisting throughout life rather than being outgrown. Adults either develop compensatory strategies or experience adult-onset ADHD when life demands exceed coping capacity. The DSM-5 recognizes this distinction, validating adult experiences of suddenly decompensating under unprecedented stress (new parenthood, medical school, career advancement).

The Neuroscience Behind Adhd: a Glitchy Toggle Switch

Modern neuroscience reveals that ADHD stems from dysfunctional connectivity between two critical brain networks that should toggle cleanly:

In Neurotypical brains, these networks transition smoothly—one activates, the other deactivates. In ADHD brains, the toggle becomes “glitchy”—both networks fire simultaneously. This creates the paradoxical presentation: exceptional cognitive power paired with insufficient control. Within the DMN itself, the back portion (accessing autobiographic memory) and front portion (projecting into the future) work out-of-sync, further disrupting coherent thinking.

Critically, ADHD doesn’t involve an attention deficit but rather an overabundance of attention that cannot be controlled. People with ADHD can hyperfocus intensely on compelling tasks, then struggle to focus on necessary but boring activities. The word “deficit” is fundamentally misleading.

The Three Faces of Adhd: Lunatic, Lover, and Poet

ADHD manifests through three interconnected sets of traits, creating both vulnerability and extraordinary potential:

The Lunatic

The Lover

  • Unbridled optimism about possibilities
  • Seeing unlimited potential in situations
  • Inability to hold back enthusiasm and ideas
  • Warm, charismatic engagement with others

The Poet

  • Exceptional creativity and imagination
  • Dreamy, contemplative states
  • Constant urge to create and express
  • Deep emotional sensitivity and insight

These traits aren’t defects—they’re Neurodevelopmental features that create both challenges and gifts when properly understood and managed.

The Demon: Understanding Rumination and Rejection Sensitivity

Default Mode Network Overactivity: the Root of Suffering

When stuck in DMN overactivity, people with ADHD experience devastating psychological patterns:

The principle “neurons that fire together, wire together” explains why rumination strengthens negative neural pathways—but this same mechanism offers the solution through deliberate rewiring via external engagement.

Rejection-sensitive Dysphoria: a Specific Neurological Feature

RSD causes exquisite pain from perceived (or actual) criticism or rejection, often disproportionate to the triggering event. About 1 in 3 people with severe RSD find relief with clonidine/guanfacine combination targeting Emotional regulation. The inverse also exists: Recognition-Sensitive Euphoria (RSE), where even small encouragement produces outsized positive impact.

Understanding RSD as a Neurological feature transforms self-perception from character weakness (“you’re too sensitive”) to treatable neurology (“your brain processes rejection signals differently”).

Solution: Activating the Task-Positive Network

Counterintuitive Strategy for Breaking Rumination

The solution to rumination and catastrophic thinking is counterintuitive but powerful: activate the Task-Positive Network through deliberate external engagement. When rumination begins, immediately engage in activities requiring sustained external focus:

The mechanism is Neurological: external engagement activates the TPN, which automatically suppresses DMN activity. For children, replace “time-out” (sitting quietly) with “time-in” (physical activity like stationary bikes, mini trampolines, or dancing).

The Cerebellum: a New Frontier in Adhd Treatment

Understanding Cerebellar Function

The cerebellum (two kumquat-shaped lobes at the brain’s base containing 75% of brain neurons) was traditionally understood as controlling balance and coordination. Dr. Jeremy Schmahmann’s groundbreaking research revealed it also regulates “the speed, capacity, consistency, and appropriateness of cognition and emotional processes”—essentially serving as an “oscillation dampener” for thinking, emotion, and behavior.

Cerebellar damage produces Cerebellar Cognitive Affective Syndrome (CCAS) with symptoms nearly identical to ADHD: Executive function problems, Emotional dysregulation, and cognitive inconsistency. MRI studies show the cerebellar vermis (central midline strip) is slightly smaller in ADHD brains, suggesting cerebellar dysfunction contributes significantly to ADHD presentation.

Critically, the cerebellum is the brain’s most plastic (changeable) region. Evidence suggests stimulating and challenging it measurably improves ADHD symptoms through neuroplastic change.

Evidence-Based Cerebellar Stimulation Programs

Zing Performance represents the most researched cerebellar intervention. Ten minutes twice daily of progressively challenging balance and coordination exercises produces significant improvements:

Programs typically run 3-6 months with progressive difficulty increases. Zing Performance reports 80% significant success rates among 50,000 participants and offers money-back guarantees (rarely claimed).

Brain Balance Achievement Centers offer intensive balance protocols addressing brain hemisphere connectivity through franchised centers. Requiring 3x weekly hour-long sessions, these serve more severe ADHD/Autism cases with higher commitment but reported value.

Motion sickness medications represent an unconventional approach. Dr. Harold Levinson has prescribed meclizine, Dramamine, and Benadryl for ADHD/dyslexia for 20+ years, reporting excellent patient results. While not yet mainstream, Schmahmann’s research may eventually validate this approach by explaining the cerebellar-vestibular connection.

Connection: the Most Powerful Medicine

The Research: Connection Transforms Health Trajectories

Research from Dr. Vincent Felitti’s Adverse Childhood Experiences (ACEs) study demonstrates that childhood trauma, abuse, and neglect predict severe adult health problems. An ACE score of 4+ correlates with 390% increase in chronic pulmonary disease, 240% increase in liver disease, 460% increase in depression, and 1,220% increase in suicide attempts.

However, the antidote is equally powerful: connection and love. The Harvard Grant Study—80-year longitudinal research—found the single most important predictor of health, longevity, career success, income, leadership, and happiness is “love.” Critically, George Vaillant emphasized that love must be received and metabolized—the loved person must be capable of taking love in rather than pushing it away.

For people with ADHD, psychosocial integration—the sense of being connected and understood—is foundational. Without it, individuals experience “dislocation,” a state of psychological toxicity manifesting as disruptive behavior, anxiety, withdrawal, depression, eating disorders, poor academic/work performance, and suicidal ideation.

Practical Connection Strategies

Vitamin Connect takes many forms, most completely free:

  • Family meals: Proven to improve outcomes including SAT scores
  • Pets: Dogs, cats, guinea pigs provide unconditional love
  • Community rituals: Regular visits to favorite places with friendly interactions
  • Friendships: Maintain at least two close friendships with regular contact
  • Special time: Reserve at least 30 minutes weekly of uninterrupted one-on-one time with children
  • Group memberships: Join book clubs, lecture series, or interest groups
  • Forgiveness: Actively release anger and resentment regularly
  • Gratitude practice: Daily inventory of what you’re grateful for
  • Nature time: Solo or with friends (ideally with a dog); never worry alone
  • Spiritual practice: Engage with “Big Questions, Ideas, Uncertainties, Possibilities, and Hopes”

Vast: Culturally-Induced Adhd-Like Symptoms

Beyond genetically-inherited ADHD, a new phenomenon exists: VAST (Variable Attention Stimulus Trait). Modern life’s exponential data bombardment, constant connectivity, and ubiquitous electronic stimulation have conditioned brains for rapid-fire processing, constant stimulation-seeking, and shortened attention spans.

Many displaying “ADHD symptoms” actually have VAST, a response to modern conditions rather than Neurodevelopmental disorder. Unlike ADHD, VAST doesn’t require impairment criteria and includes significant strengths alongside challenges. Understanding this distinction prevents unnecessary pathologizing while recognizing real suffering.

Finding Your “right Difficult”: Strengths and Engagement

The Power of Appropriate Challenge

Most people with ADHD are naturally creative with a persistent drive to build, develop, or create something. If this creative “itch” goes unscratched, they feel listless, depressed, and unmotivated. If they pursue something beneath their abilities, they lose interest—boredom is kryptonite.

The key is finding the “right difficult”—a Goldilocks-level challenge matching their strengths and engaging their creativity. When found, people with ADHD “light up like a Christmas tree.”

Strengths Assessment: Ten Transformative Questions

Start by assessing your strengths through these ten questions (ideally with another person, written):

  1. What three or four things are you best at doing?
  2. What three or four things do you like doing most?
  3. What three or four activities/achievements have brought you the most praise?
  4. What are your three or four most cherished goals?
  5. What three or four things would you most like to get better at?
  6. What do others praise you for but you take for granted?
  7. What is easy for you but hard for others?
  8. What do you spend a lot of time doing that you’re really bad at?
  9. What could your teacher/supervisor do to make your time more productive?
  10. If you weren’t afraid of trouble, what would you tell your teacher/supervisor they don’t understand about you?

This information should be shared with schools or employers to advocate for better environments and strength-matching opportunities.

The Kolbe Index: Understanding Your Conative Style

The Kolbe Index reveals your conative style—your inborn way of exerting effort or taking action. It identifies four action tendencies:

  • Fact Finder: How you gather/share information (people with ADHD often score low—cut to the chase)
  • Follow Thru: How you handle organization/processes (often low-to-moderate—resistant to planning)
  • Quick Start: How you approach risk/uncertainty (often high—jump in without testing—“fire, ready, aim”)
  • Implementor: How you manage hands-on work/space (varies widely)

Understanding your natural MO helps you find work matching your strengths rather than fighting against your wiring.

Exercise: Miracle-Gro for the Brain

The Neuroscience of Exercise and Adhd

Exercise is one of the most powerful non-medical tools for ADHD, improving focus, mood, motivation, reducing anxiety, regulating emotions, and preparing the brain to expand, learn, and change better than any other activity.

The neuroscience: Exercise releases brain-derived neurotrophic factor (BDNF)—“Miracle-Gro for the brain”—creating fertile environment for new neurons and positive pathways. Exercise uses more nerve cells than any other activity; firing nerve cells release more dopamine and norepinephrine—key regulators of attention.

Stimulant medications work by increasing dopamine/norepinephrine; exercise does this naturally. Exercise smooths connectomes in the default mode network, allowing easier transitions to the task-positive network and prefrontal cortex activation.

Proven Results and Implementation

A 2018 Spanish meta-analysis of 700+ individuals found just 20-30 minutes of moderate exercise produced:

  • Increased reaction speed and response precision
  • Improved “gear-shifting” focus ability
  • 65% improved planning/organization skills from a single episode

School success example: Allison Cameron, an eighth-grade teacher in Saskatoon, brought in donated treadmills and stationary bikes with heart rate monitors. Students exercised 20 minutes of each 45-minute class to elevate heart rates to 65-75% max, then did classwork. Results: suspensions dropped to zero, test scores skyrocketed, reading levels grew 4 full grade levels in 4 months, students quit smoking, lost weight, and many reduced/eliminated medication.

At least 20 minutes daily, varying activities to stimulate different brain parts and combat boredom:

Accountability with someone else adds bonding and motivation. Best long-term motivator is remembering how good exercise makes you feel—stress reduction and well-being—not external goals like weight loss.

Creating Stellar Environments

Daily Structure and Routines

Structure provides “walls of the bobsled run”; without it, you careen off into disaster:

  • Start with schedules and to-do lists (writing things down neurologically reinforces importance)
  • Set up backup reminders and systems (partner nudges, alarms) for key commitments
  • Begin small with one or two regularly scheduled commitments, then build on success
  • For children, parents serve as “bumpers on a pinball machine,” keeping energies in check
  • Build in unstructured, uninhibited play time (essential venting/creating time)
  • Use rewards more than consequences for ADHD minds

Home Environment Essentials

Home must-haves for ADHD brains:

Nutrition for Adhd Brains

Nutrition powerfully affects ADHD symptoms:

Recommended supplements:

Sleep: the Foundation of Function

Sleep requirement is the amount needed to wake without an alarm clock. Insufficient sleep associates with increased obesity, depression, high blood pressure, depressed immune function (cancer risk), and anxiety.

Sleep apnea can mimic ADHD; if waking tired, overweight, or prone to irritability, consider sleep lab evaluation.

Fisher Wallace Stimulator (FDA-approved, non-habit-forming, no significant side effects) uses mild alternating current to stimulate neurotransmitters (serotonin, dopamine, beta-endorphin) and lower cortisol; helpful for insomnia, depression, anxiety, and some ADHD cases.

Sleep hygiene:

  • Turn off electronics at least 1 hour before bed
  • Charge devices outside bedroom overnight
  • Make bedroom as dark as possible
  • Keep bedroom cool

School and Work Environments

School environments should provide:

Work environments should offer:

  • Low-fear/high-trust from top down
  • Structured but not regimented
  • Workspace encouraging connection
  • Permission to be honest
  • Policy against gossip
  • Clear authority and communication lines
  • Clearly stated policies
  • Low HR involvement (work things out privately)
  • Permission to be yourself with strengths and weaknesses acknowledged
  • Capacity for initiative and credit
  • Management matching talents to tasks
  • Clearly stated expectations

Medication: Evidence-Based Tool When Appropriate

Understanding Medication Efficacy

Medication provides significant short-term benefits—symptom relief within hours for some. Empirical evidence shows 70-80% efficacy across 133 randomized studies (Dr. Samuele Cortese, 2018 meta-analysis).

According to psychologist Russell Barkley, ADHD costs nearly 13 years of life expectancy on average, making it worse than the top 5 U.S. Killers combined in life-expectancy impact. Yet it’s simultaneously “the most treatable disorder in psychiatry, bar none” with medications showing larger effect sizes, greater response rates, and more delivery systems than any other psychiatric condition.

When to Consider Medication

Assess risk vs. Benefit:

  1. Have I learned from reputable sources about ADHD?
  2. Am I doing everything non-medical (connection, structure, exercise, sleep, nutrition, meditation)?
  3. How much is this negatively impacting life?

A key principle: medication works better if you want to take it (placebo effect is real). Wait until you or your child genuinely wants it before starting.

Stimulant Medications (70-80% Efficacy)

Methylphenidate type (Concerta, Ritalin, Focalin, Metadate, Quillivant, OROS-MPH):

Amphetamine type (Adderall, Dexedrine, Evekeo, Vyvanse, Mydayis):

  • Raises norepinephrine more than dopamine
  • Slightly more effective for adults

How they work: Counterintuitively, stimulants “stimulate the brain’s brakes,” giving more control. Dopamine passes nerve cell information more cleanly, reduces noise, and tunes brain to the right channel. Dopamine increases motivation (2020 Brown study showed methylphenidate increased dopamine in motivation region—caudate nucleus). Norepinephrine increases arousal/wakefulness and improves environmental information intake.

Long-acting advantage: Traditional stimulants work ~4 hours; long-acting versions work up to 12 hours. A 2006 study: 40-50% satisfied with short-acting vs. 70% with long-acting.

Vyvanse (approved 2008):

  • Cannot be abused (no snorting/injecting)
  • Activated by red blood cell enzymes
  • Lasts 12-16 hours (effectively ~10 concentrated hours)
  • Completely soluble (easy to administer in beverages)

Mydayis (launched 2017) has 16-hour cycle in 3 steps (morning, noon, evening).

Non-Stimulant Options

Stimulant-like drugs (less effective than stimulants for most, but good alternatives):

  • Wellbutrin, Strattera, Norpramin: Originally antidepressants, longer-acting, no abuse potential, slower-acting (weeks to peak efficacy)
  • Modafinil (Provigil): Stimulates histamine network and dopamine; originally for narcolepsy; smooth 8-12 hour effect
  • Amantadine: Originally 1966 antiviral agent; acts weakly like dopamine surrogate; smooth up-to-24-hour effect

Outlier medications: Clonidine and guanfacine (Intuniv)—old blood pressure medicines that calm agitation, aggression, emotional hypersensitivity, and assist with focus. Useful alone or combined with stimulants; particularly helpful for rejection-sensitive dysphoria.

Critical Finding on Addiction

Taking stimulant medication early in life prevents addiction, not promotes it. Since 80% of addictions begin between ages 13-23, and people with ADHD are far more prone to addiction, starting stimulant medication before age 13 significantly reduces addiction risk.

Long-term studies show those with ADHD successfully treated with stimulants become addicted to substances far less frequently than the general population and dramatically less than untreated people with ADHD (who are 5-10 times more likely to develop substance addictions).

Most inappropriate use occurs among Neurotypical individuals without ADHD diagnoses who use stimulants to stay awake or intensify recreational drug highs. People actually diagnosed with ADHD rarely purposely take excessive amounts.

Common Side Effects and Management

Stimulants and some non-stimulants increase heart rate by 3-10 beats/minute and systolic blood pressure by 3-8 mmHg on average, with minimal long-term cardiac impact according to recent studies. Close doctor monitoring remains essential.

Withdrawal symptoms: When discontinuing stimulant medication, mild withdrawal symptoms occur nightly and can range from barely noticeable to causing increasing tiredness, anxiety, or aggression.

Genetic Testing for Optimization

Genetic testing shows promise but isn’t yet reliable for predicting which specific drug will work best. However, these tests provide extremely valuable information about how rapidly you metabolize certain medications, which helps tremendously with dosing.

Tempus, a Chicago-based company, uses “whole exome sequencing” rather than more common “small panel sequencing.” Whole exome testing examines all coding sites in DNA, important because biomarkers can appear in seemingly irrelevant data. The majority of applicants qualify for a maximum out-of-pocket cost of no more than $100.

Building Connection: Practical Implementation

Connection takes many forms and is largely free. Beyond the strategies mentioned earlier, consider:

The Gift-Curse Paradox: Adhd Strengths and Challenges

Despite serious risks, ADHD carries profound strengths when properly managed:

Among ADHD populations:

  • 50% of entrepreneur Support clients have ADHD (per Strategic Coach founder Dan Sullivan)
  • Many successful CEOs, inventors, artists, performers, scientists, and trial attorneys have ADHD
  • Several Academy, Grammy, Emmy, Tony, Pulitzer, and Nobel Prize winners have ADHD

The mathematician Alan Turing captured it: “Sometimes it is the people no one can imagine anything of who do the things no one can imagine.”

Key Takeaways for Thriving with Adhd

  1. ADHD is Neurological, not moral: Understanding the Ferrari engine/bicycle brakes metaphor transforms self-perception from shame to actionable understanding.

  2. The DMN-TPN toggle switch is the key leverage point: External engagement (exercise, creative work, physical movement) rewires neural pathways away from rumination.

  3. Connection is medicine; isolation is toxicity: Human connection is the most powerful health intervention available, literally adding years to life.

  4. The “right difficult” transforms engagement: Finding work/projects matching strengths and engaging creativity is transformative.

  5. Cerebellar stimulation offers concrete, non-medication pathway: Balance and coordination exercises can measurably improve ADHD symptoms.

  6. Environment powerfully determines ADHD symptom severity: Creating stellar environments demonstrates remarkable impact.

  7. Exercise is “Miracle-Gro for the brain”: A single 20-30 minute moderate exercise episode produces measurable improvements.

  8. Medication is highly effective and prevents addiction: Starting stimulant treatment before age 13 significantly reduces lifetime addiction risk.

  9. Rejection-Sensitive Dysphoria is treatable: Understanding RSD as Neurological feature enables targeted treatment rather than shame.

  10. ADHD exists on a spectrum and extends into adulthood: Recognition of adult ADHD is transformative for understanding lifelong patterns.

  11. The cerebellum represents a new frontier: Evidence suggests stimulating the cerebellum measurably improves ADHD symptoms.

  12. ADHD is a gift-curse requiring deliberate management: The same neurology producing devastating rumination also produces creativity and innovation.

Final Thoughts: Hope and Potential

The ultimate message of ADHD 2.0 is one of profound hope and possibility. By understanding the neuroscience behind ADHD, creating supportive environments, leveraging strengths, building genuine connections, and utilizing evidence-based strategies (including medication when appropriate), people with ADHD can move from struggling to thriving.

The reframe from deficit to difference, from broken to brilliant, from character flaw to Neurodevelopmental variation opens the door to genuine transformation. With the right Support, understanding, and strategies, the Ferrari engine can be safely and effectively unleashed, allowing people with ADHD to share their unique gifts with the world while managing the vulnerabilities that come with them.

The goal isn’t to make people with ADHD “normal”—it’s to help them become the best version of their brilliant, creative, dynamic selves.