ADHD isn't really an attention deficit: regulation, interest and hyperfocus
Psychiatrist John Kruse says ADHD is not truly an attention deficit and describes an interest-driven brain, Sasha Hamdani calls it at its base a regulation problem that touches emotion, energy, sleep and appetite, and Andrew Huberman's ADHD episode highlights hyperfocus, time perception and working memory. This explains why someone who can focus for hours on a game can still be struggling with ADHD, and why emotional symptoms are so often missed.
How does John Kruse redefine ADHD? Show answer
As a deficit of control over attention, not a deficit of attention. People with ADHD have less voluntary control over directing, sustaining and shifting their attention.
Why can someone with ADHD play a video game for hours? Show answer
Because ADHD attention is driven by interest. The attention is real, but the person cannot reliably aim it where life demands or end it when they should.
What does Sasha Hamdani say ADHD is at its base? Show answer
A regulation issue. It involves difficulty regulating attention, motivation, energy, emotion, sleep and appetite.
Which two problems does Kruse say are missing from the official 18-symptom checklist? Show answer
Time management and emotional regulation. He says roughly 60% of people with ADHD report emotions that come up bigger and are harder to regulate.
What conditions does Kruse say trigger hyperfocus? Show answer
The task needs the right amount of challenge, not too easy and not too hard, and must be important and interesting to the person. Pleasure alone is not enough.
Why does Hamdani reject calling hyperfocus a superpower? Show answer
She says she has very little agency over it, like being able to fly without choosing when or where, and that the trope diminishes the struggle.
Why are emotional symptoms of ADHD so often misdiagnosed? Show answer
The criteria were built on observable, disruptive behaviour in hyperactive young boys, and emotional regulation cannot be observed from outside. People are then treated for anxiety or depression instead.
What ages of diagnosis does Hamdani cite for males and females? Show answer
An average of 6 to 8 for males and 35 for females. She points to the criteria, hormones and girls learning to mask.
How do Huberman and Hamdani differ on dopamine in ADHD? Show answer
Huberman leans on a low dopamine hypothesis. Hamdani says the problem is that the dopamine present is not in the right place at the right time.
What did Kruse say lab tests show about time estimation in ADHD? Show answer
People with ADHD are consistently inconsistent. They do not always underestimate or overestimate, but they estimate incorrectly far more often.
What are Hamdani's three moves for an emotional spike? Show answer
Recognise what is happening, move your body for a couple of minutes to bring the frontal lobe back online, and delay your response with a 10 to 15 minute alarm.
Who should diagnose ADHD? Show answer
A psychiatrist, physician or well-trained clinical psychologist. Medication decisions belong with a professional, and the article warns against self-diagnosis.