The Neuroanatomy of ADHD and thus how to treat ADHD - CADDAC - Dr Russel Barkley part 3ALL

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[flawlix]

My ADHD was far less impairing when I was a kid. I’ve never really had issues with things like reading comprehension or verbal skills. But the time blindness, the lack of time management skills, inability to organize… they’re crippling me in my career. I’m an attorney. Not being able to manage my time is a huge problem in a job based almost entirely on time management. I work slower to try to keep track of everything. And I work longer hours to make up for being slow or losing time down a rabbit hole.

[eddymison]

"Well, I'm working on it.. " every person with ADHD can relate.

[Brohoyoslo]

This man has explained the entirety of my life and its conflicts in 30 mins. My mind is completely blown.

[AmolPoudyal]

This man literally lost his twin brother to ADHD. People that say he's being too negative are the same people who have hard time distinguishing what is actually true and what they believe is true. This man has done more than his critics to help people with ADHD. I have pretty bad ADHD and I'm glad I got on medications.

[kevindeoliveira]

me: can´t focus
also me: watches 40 min videos about neuroanatomy

[annarold]

"ADHD is not a problem of knowledge, it never was. It is about how to use that knowledge". Please!! every doctor must watch this video. The German doctors I have visited say I had very good grades my whole life, so I do not have ADHD. Even though all the synthoms are there and that the “good grades” were achieved under a continued suffering :(

[soulreaperichig]

Here are important ideas from this lecture for fellow ADHDers who might not be able to focus.

0:33: Three concepts to build the model
First concept - Inhibition: You have to stop and build a pause in your behaviour. Basically, stop and think before you act.
1:17: Three kinds of inhibitions that's impaired in ADHDers
1:20 a) Can't inhibit the urge to respond on the moment to an event. (impulsiveness)
1:29 b) Inability to interrupt an ongoing behaviour when it's time to do something else. (especially if the ongoing behaviour is rewarding)
1:50 c) Inability to protect working memory from distractions.
2:20 ADHDers don't perceive distractions any more than others. The difference is that they respond to them and go off task.
2:28 Once off task, they can't retain the goal and won't return to the task.
2:37 So it's a series of responding to irrelevant events in life which is why it is so hard to accomplish your goals.
2:40 To sum up ADHDers have an inhibition problem.
2:47
Second concept: Self regulation
3:45 We self-regulate to change a distant consequence. We try to alter the future, not the now.
4:34 All deferred gratification requires self regulation.
4:40
Third concept: Executive function
5:31: Definition of executive function: The action to the self designed to change you so as to change your future .
5:51: We have five executive abilities.
6:53: The executive abilities are path dependent, meaning they require the previous on to develop. Think of it like a pyramid.
7:06 Boring technical terms, name dropping and some boasting.
8:07 Executive functions can be describes as actions to the self.
8:30 Role of non verbal working memory:
8:41 Humans have the best system for holding images in the minds.
9:49 You recall past events through images.
10:32 1st executive function: Stopping
10:32 2nd executive function: Reimage the relevant past.
10:37 3rd executive function: Speech to the self.
10:48 4th executive function: Emote to yourself.
10:51 5th and highest executive function: Planning, problem-solving, and simulating multiple possible responses.
11:27 Manual play leads to mental play.
11:54 Children begin to speak to others then themselves loudly then speak in their mind.
15:03 Athletes can improve their performance just by visualizing. They use the same brain as they'd if they actually performed.
15:14 When you speak to yourself you activate the speech part of the brain. And since it's the same system, you can't speak to yourself as well as others.
15:37 So rather than calling it internalization, you should call it privatization.
17:03 Chart of development of inhibitions.
17:29 Most people develop all executive functions by 30. ADHDers lag by 30-40%
18:02 So you learn self management and by extension you think about the future instead of the now.
18:36 Most 30 year olds anticipate 8-12 weeks into the future.
19:03 Summary
20:14 The frontal lobe's role was to keep track of favours. It's now used for vicarious learning.
21:13 ADHD kids can't use behaviour of others to modify their own behaviour.
21:39 ADHD kid lack hindsight, foresight, and anticipation of future events.
21:52 Adult ADHD is the consummate disorder of time management.
22:24 Until adulthood, language and instructions have little role in controlling the behaviour of an ADHDer. Because language cannot control motor function.
22:55 Adult ADHDers have a deficit in comprehending what they read, see, and hear.
23:10 Delay in morally governing behaviour.
23:22 We modify emotions which is the basis of self-discipline, persistence and motivation due to the emote to yourself executive function.
23:34 the ability to internalize are playing gives rise to the ability to generate multiple options when we are faced with the problem and if this system isn't working very well people tend to fall back on over learned outdated ineffective behavior.
23:43 the system also involves putting behavior together, to solve the problem stringing a sequence of actions together, so we should see that people with ADHD have a lot of trouble with problem solving in their mind with generating multiple possibilities for getting things done and then with following the one that most effective in doing so but we should also see that they have trouble stringing behavior together in a proper sequence and we will see this no better than in their speech.
24:25 Example of how ADHDers speak.
25:22 Adult ADHDers speech pattern include circumlocution and verbal wandering.
25:36 ADHD is not an attention disorder; it's time blindness. You're nearsighted in time.
25:50 Adults and kids with ADHD wait till the future is imminent.
27:12 ADD is actually IDD aka intention deficit disorder.
27:32 The back part of the brain acquires knowledge, the front part puts it together. ADHD separates these two as a meat cleaver. So no matter what you know, you can't utilize it like others. ADHD is a performance disorder. You can't perform the things you know how to do.
28:37 All treatment must be rooted at the point of performance aka the real world.
28:49 You have to restructure the environment to show what they know.
28:57 Teaching skills is useless because they won't be used.
30:00 Medication is required for most ADHDers (disagree with this one). The effects of medication is temporary.
30:59 Meds can be rephrased as neurogenetic intervention.

Solutions
31:25 We need to tighten up accountability. Bring those consequences closer in time.
33:15 Externalize key pieces of information.
33:38 You can't hold things in your mind so write them down. Use an external resource to compensate for an internal problem.
35:21 Use external temporal guidance devices. (I personally recommend JIRA) Break the future into pieces and do a piece a day.
36:14 Social consequences can be motivating.
36:55 Use manual problem solving.

EDIT 25 April 2022: After a lot of hesitance, I finally went to a psychiatrist 4 months ago and started taking medication. I was prescribed the generic version of Strattera and it's made a huge, huge, huge improvement to my life. So if you're like what I was and averse to the idea of medication, please give it a shot, it might change your life.And if it doesn't you can always stop taking it. I believe I was reluctant to take medication because of all the societal stigma. I'm glad I overcame it and took help. Best of luck to all my fellow ADHDers.

[WifeMamaArtist]

I nearly cried when I watched this.... it’s me completely and in every way (as someone who has struggled for over 40 years)

[Chellirsl]

I’ve watched all this crying. I’ve never felt more understood. I had my diagnosis last week, I’m 36, almost 37 yo.Today it’s my first day under medication and I’m feeling great for the first time in a long time. I was so tired to be called promising but irresponsible, intelligent but not good putting things to practice, great but always late, unreliable, unfocused, lazy, slow, distracted… geez… I seriously don’t want to keep crying thinking of all the time and opportunities I’ve lost. But at this very moment I can’t stop feeling angry about everybody who kept saying I should just do more, double down, just focus, just this, just that as if it was just that easy and I was just lazy. I’m angry but also happy. Finally I know why and it’s a relief. I feel so much weight taken off of my shoulders… so much. Sry for the rant, but it was a big emotional day for me today.

[MsMyrevolution]

Anyone else watch this and just cry? Cry because you recall all of the hurt these symptoms have caused you. Cry because you feel slighted by your own brain. Cry because for the first time in your life you finally heard a solid explanation and solution - like someone actually gives a shit about what you’re experiencing. I’ve been beaten down for these characteristics by my parents, teachers, peers, and colleagues. All of the people who should have been guiding me and helping me. It breaks my heart. But I can’t wait to show them! 💪🏻

[quanmack]

This is my first time watching a video where I actually got a solution. This man taught me more about myself than I knew in all my years of experience of being in this body. So many points he made were so important but I won't be writing them because this entire video deserves to be watched again and again.

[monkiram]

This is why smart phones saved my life, my to-do list, notes app and calendar are crucial extensions of my working memory

[binathere]

I've never been diagnosed. I'm 68 now. I've only realised in the past year I have this as well Autism. I've learned to sit quietly and not interject or say things that seem insulting to others. I've learned to not babble on about my keen interests that no one cares about. . I'm still trying to learn to keep on track when I do interact. I can still tend to raise my voice when I get passionate about a subject.
Some smarty pants people say if you can't talk about a subject and successfully relay it to others, then you don't understand the subject. Wrong. I have a rich inner life, but am unable to express myself fully. It's so annoying.

[MandiSamara]

I wish I had seen this sooner. This video needs to be shared in schools, in doctor's offices, and ALL therapists should be made to watch this. My friend's therapist recently told him to stop saying he has ADHD, drink more water, drink less coffee, go for walks, read mantras, and get another job on top of his full time job that he already has. 🙄 Like yeah... so helpful.

[FayCreative]

Dr. Barkley is great. His brother was an ADHDer, whom one day never got a repeat lot of his meds. He then went driving a car and had a fatal crash because he didn’t take his meds. Dr. Barkley was devastated that his brother died like this and hadn’t taken his med to be able to pay attention to drive.

[LadyCounsel]

This guy is absolutely brilliant when it comes to the ADHD brain. I have learned so much from watching his videos. My son suffers from ADHD and because of Dr. Barkley's lectures I have been able to make sense of his behaviors. I think everyone who struggles with this, or knows someone who does, should watch his videos. You will have a lot more empathy for yourself and others by doing so! Amazing! I've learned a long time ago that I have to be my son's frontal lobe and that his environment has to be manipulated to get him to accomplish anything.

[keanu]

I know the crowd doesn't mean harm but someone who has struggled with ADHD and is now 30, the giggles and laughs rub me the wrong way because they think it's funny basic stuff but this disorder has caused me so much pain and hearing it finally being explained in a way I can relate to hurts me so much to hear others laugh at what has brought me so much pain over my life.

[Zachary-Daiquiri]

I've gained more perspective in the first 20 minutes than I did seeing therapists and self treating for 20 years. I can only imagine how many people this is helping.

[reebertJunkman]

Validation. That’s what I got from this. I’m 50+ years old, my whole life I have fought, partly failed or failed, fought harder, partly failed, and fought harder to win again.

This guy pegged my issues and makes me realize I’m not nuts.

I have come up with many of his recommendations on my own. That feels good to.

But to me it’s about validation.
Wish I could get my wife to understand this about me.

[kevingr]

I was showing symptoms all through my childhood, but it didnt really affect my life in a negative way big enough to illicit a reaponse. I was a gifted student who got mostly A and B on everything and didnt really have problems reading (as long as it was interesting). Also the amount of reading you are expected to do in middle and high school was still manageable. College was different though. You cant really wing a 30 page paper the night before. Impulsivity and time-blindness started to impact my life a lot more. I switched jobs every 3 months, sometimes from being fired but usually from loosing interest. I didnt get diagnosed until i was 30 and it has helped a lot. Medication is one thing. It helps with some things, sometimes. The biggest change though has come through the lessening of guilt through understanding myself. Really people, please please please: If you suspect you might have ADHD go get checked. You dont have to do the medication if you dont want to, but knowing what you are up against really does wonders for your own mental health.