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An editorial project about ADHD, design,

and thirty years of misunderstanding.

Before you start reading.

1

I was thirty when a psychiatrist told me I had ADHD. By then, I had spent more than ten years working as a designer and had come up with dozens of explanations for why so many things seemed harder for me than they did for other people. I thought I wasn’t disciplined enough, organized enough, focused enough. I was too anxious, too lazy, too distracted. Sometimes all of those things at once. The diagnosis didn’t solve any of these problems. But for the first time, it gave them a clear explanation.

I’m not a doctor or a researcher. I’m a designer who has spent thirty years living with his brain and only recently started to understand how it works. This text is an attempt to bring together personal experience, current research, and questions I spent years trying to answer.

2

3

If you’re a designer and much of this feels familiar, I hope it helps you understand yourself a little faster. If you work with designers, I hope it helps you better understand the people around you. And if neither applies to you, then this is simply a story about spending years looking for the problem in yourself, only to discover that you were looking in the wrong place all along.

Chapter 1.

Chaos.

ByFriday,mybrainusuallyfeelslikearoomwherethemusichasbeenplayingfortoolong.
Mostpeoplehavesomeversionofthisfeelingattheendofahardweek.Butforroughlyoneinthirtyadultsworldwide,itisnottheendoftheweekthatcausesit.Itisthedefaultsetting.
ADHDisoneofthemoststudiedneurodevelopmentalconditionswehaveandoneofthemostmisread.Thenameitselfispartoftheproblem."Attentiondeficit"impliesashortage,somethingthatcouldbetoppedup.Butthereisnoshortage.Theattentionisallthere,sometimesuncomfortablyso.Whatismissingistheabilitytodirectit:tochoosewhatitcatches,howlongitholds,andwhenitletsgo.RussellBarkley,whohasspentdecadesbuildingtheresearchfoundationforhowweunderstandthecondition,hasarguedsincethelate1990sthatthecoreproblemisnotattentionatallitisinhibitorycontrol,themechanismthatletsthebrainpausebeforeresponding,filterwhatisrelevant,andstayontaskwithoutbeinghijackedbywhateverhappenstobemoreinterestinginthemoment.Thedeficit,ifthatwordstillapplies,isinself-regulation.
Inpractice,thismeanstheminddoesnotworkthroughaqueue.Itworksmorelikearoomfullofcompetingsignals,eachmakingacaseforwhyitmattersrightnow.Forme,thatlookslikemorethantwentyopenbrowsertabsthatsomehowallfeelnecessary.Forsomeoneelse,itlooksdifferent,buttheunderlyingstructuretendstobethesame:attentionthatlatchesontoeverythingatonceandwillnotletgooncommand.
Thispatternshowsupreliablyacrosscultures,languages,andgeographies.Globalmeta-analysesestimatethatsomewherebetween2.5%and6.8%ofadultslivewithADHD,translatingtoover130millionpeopleworldwide.Thevariationinthosenumbersreflectsgenuinedisagreementabouthowtocountwhethertorequireaconfirmedchildhoodonsetorsimplymeasurecurrentsymptomsbutthescaleisconsistent.Thisisnotararecondition,anditisnotprimarilyachildhoodone.IntheUnitedStatesalone,approximatelyhalfofthe15.5millionadultscurrentlydiagnosedreceivedthatdiagnosisatage18orolder.Millionsmorehaveneverbeendiagnosedatall.Theyhavespentdecadesconstructingexplanationsforthemselves:notdisciplinedenough,tooscattered,toointheirownheads.Probablyjustacharactertrait.
Whatmakestheconditiongenuinelyhardtodescribefromtheinsideisthatitdoesnotfeellikeadisorder.Itfeelslikeathinkingstyle.
Theconstantcirclingbacktounfinishedtasks,theideasthatsurfaceatthewrongmoment,theinabilitytocloseatrainofthoughtuntilitgoessomewherethesethingsdonotannouncethemselvesassymptoms.Theyannouncethemselvesas*you*.TheboundarybetweentheconditionandthepersonisoneofthestrangeraspectsofADHD:thedisruptionistracedtoalterationsinthesynapticcircuitsoftheprefrontalcortexthepartofthebrainresponsibleforregulationandcognitivecontrolbutfromtheinside,whatyoufeelissimplythetextureofyourownthinking.
WhenIfirstcameacrossBarkley'sframingthatthisisnotaboutattentionrunninglow,butabouttheregulatorysystemthatgovernsattentionnotdoingitsjobwhatstruckmewasnottheaccuracy,thoughitwasaccurate.Whatstruckmewasthatitcouldbedescribedatall.Foralongtime,theroomwiththemusicstillplayinghadfeltlikeaprivateexperience:somethingthatexistedonlyinsidemyhead,withnonameandnoswitch.

Chapter 2.

Attention.

Attentiondeficitisahistoricalmisnomer,andresearchershaveacknowledgedasmuchfordecades.AttentioninADHDisn'tinshortsupply.What'simpairedisitsregulation:theabilitytoaimattentionwhereit'sneeded,holditthere,andreleaseitwhenit'stimetoswitch.Sincethelate1990s,RussellBarkleyhasbuiltamodelinwhichthecoreoftheconditionisn'tattentionbutinhibitorycontroland,morebroadly,executivefunctionthemanagerialprocessesthatletapersonactonagoalratherthanonwhateverhasseizedtheminthemoment.ItisoneofthemoststronglyevidencedframeworkswehaveforunderstandingADHD.
Thisbreakdownleavesavisibletraceinthebrain.Atypicalbrainrunstwonetworkslikeaseesaw:thedefaultmodenetworkhandlestheinwardstreamself-talk,mind-wandering,thoughtsaboutoneselfandgoesquietwhenataskswitchesontheoutward-facingnetwork.InADHD,thatswitchworkslesscleanly:thedefaultnetworkdoesn'tfullydeactivateandinsteadintrudesontheworkjustasthebrainistryingtoconcentrate.Thisistheneuralversionoftheroomwherethemusicneverquiteturnsoff.
ThesameunevenregulationproducesoneofthemostreliablyreproducedmarkersofADHD:response-timevariability.Theissueisn'tthatapersonissteadilyslowerthaneveryoneelse.It'sthattheirownperformancefluctuatesfromoneminutetothenextmorethanusualstretchesofnormalengagementbrokenupbybrieflapsesofattention.Thisisalsowherethesubjectiveyouneverknowwhatkindofdayit'llbecomesfrom:thesamepersonwhoworkedatfullcapacityyesterdaycan'tgatherthemselvestoday,anditisn'tlazinessormoodbutameasurablepropertyofthesystem(Kellyetal.).
Deeperdown,atthelevelofneurochemistry,liesdopaminesignaling.Dopamineregulatessensitivitytoreward,theallocationofeffort,andthecapacitytosustainactionunderload,andinADHDthissystemworksdifferently(Volkowetal.,2009).Thepracticalconsequenceisthatattentionswitchesonnotbecauseataskisimportant,butbecausesomethingaboutitgrabshold.ThepsychiatristWilliamDodson,oneofthefirstspecialistsinadultADHD,describesthisasanervoussystemthatrunsoninterestratherthanimportance:theneurotypicalbrainmobilizesaroundatask'ssignificance,theADHDbrainaroundnovelty,urgency,interest,orchallenge.It'sworthnamingthestatusofthatformulationplainly:it'saclinicalgeneralizationbuiltondecadesofpractice,notanexperimentallyprovenmechanism.Itsvalueisn'tinrigorbutindescriptiveaccuracyandinhowwellitlinesupwiththedopaminemodelattheleveloflivedexperience.
Thesamelogicexplainstherelationshipwithdeadlinesthatlooks,fromtheoutside,likeirresponsibility.Theapproachofadeadlinechangesatask'sstatus:important-but-distantbecomesurgent-and-immediate,andlandsinthecategorythesystemactuallyrespondsto.Subjectively,itfeelsasthoughtherightbuttonwon'tpressuntilthelastwindowandthen,insideit,pressesitself.Someonewhostartsatthelastmoment,againandagain,isn'tchoosingthatscript.They'rewaitingforthetasktobecomeurgentenoughforthebraintoseeit.
Inthepartwhereattentionregulationfailsintheotherdirection,thephenomenonhasanamehyperfocus:astateofcompleteabsorptioninatask,withthelossofanysenseoftimeorsurroundings.Heresomecautionisneeded,becausehyperfocuscomeswrappedinmanyclaimsandlittledata.Foralongtimetherewasn'tevenanagreeddefinition;theresearchisthin,andtheevidencethatit'sspecifictoADHDremainsmixed.ThestudybyHupfeldandcolleagues(2019)wasamongthefirsttoformallyshowthatpeoplewithstrongersymptomsreportitmoreoften.It'scommonlycalledasuperpower,andthat'sthefirstthingtodropnotbecausethestateisn'treal,butbecausethewordliesaboutitsnature.Hyperfocushasabuilt-inflaw:youcan'taimit.Thesamemechanismthatholdsyouindifficultworkforhourswill,withequalease,holdyouinsometrivialdetailwhilethethingthatmatterssitsuntouchedbesideit.Youcanloseawholedayperfectingsomethingnoonewillnotice.Thesystemdoesn'ttellthenecessaryfromtheunnecessary;ittellstheinterestingfromthedullandthatisitsstrengthanditscostatonce.
Onelastthingmattersaboutalloftheabove:noneofitbelongstoADHDalone.Executive-functionlapses,unevenattentionregulation,motivationthatdependsoninteresttheseshowupinotherconditionstoo,andinpeoplewithnodiagnosisatallduringstretchesoffatigueorstress.ADHDisn'tasinglesymptombutastablecluster,andit'sdiagnosedclinically,throughhistoryandinterview,notfromanyonesign.Abrainscanwon'tshowit:group-leveldifferencesinneuroimagingarereal,butyoucan'treadthediagnosisoffoneindividual'sscan.That'sworthholdingontoeverytimeaninternalbutthisallfitsmestartspushingtowardaconclusionaboutyourselforsomeoneelse.