Transcription
All right, so you know there's been a lot of interest in our community about ADHD recently. And, um, you know, we've been talking. We gave up, we did a lecture on why ADHD, people with ADHD, wind up with addiction so easily. We also talked about why people with ADHD wind up with depression so easily, and like, what are the correlations between those two things.
But one of the key things that I tend to talk to just about all of my ADHD patients about, which we haven't really talked about here, is, uh, why ADHD exists. So if you, if you guys check out Dr. K's Guide to Depression and Dr. K's Guide to Anxiety, there's sections in there about why depression and anxiety exist. Like, these are essentially illnesses that are hyper-activations of existing circuitry. So in the case of depression, we have this thing called the default mode network, which gives us the capacity to self-reflect. And it's when our self-reflection capacity gets overblown and turned on, stuck in the on position, that we wind up with depression. So people who are depressed, for example, always think about themselves, like, in a weird way, right? They're like, "Oh, the world would be better off without me." Where it's like, the world doesn't really, you know, it's like gonna be okay if you're there or not there, right? You start to think like, very, very, you get stuck thinking about how bad you are. Like, literally, the thoughts in your mind are stuck on you and your sadness.
In anxiety, for example, anxiety is nothing but the ability to predict danger in the future. Like, that's a very useful circuit to have in the brain, right? Like, we want the ability to predict problems. When that circuit gets stuck in the on position, we end up sort of like always seeing danger everywhere because any uncertainty becomes a source of danger. And so this is the kind of thing where, like, you know, as we understand depression, anxiety, and if you really want to overcome them, you have to understand, like, why these things exist in our brains and where they come from to truly, like, understand how they work and then ultimately master them.
So what I'd like to do today, we've talked a lot about ADHD and depression, ADHD and addiction, this and that, yadda yadda, procrastination, whatever. But we've never talked about why ADHD exists, or what is it truly? And so my hope today is to share with you all some information about my understanding of, like, why humans have ADHD, how ADHD is changing over time, and how it may not necessarily be a, may not necessarily be as maladaptive as people think.
So the first thing to understand, uh, before we kind of dive in, is that I'm going to be talking about ADHD in sort of a broad term. And I just want to acknowledge that, for example, like, if we look at the level of ADHD across the population, that it kind of varies, okay? And what I mean by that is that there's sort of like a bell curve of attention. So let's do this, okay? So if we want to understand ADHD, what we want to do, we just have to start by kind of acknowledging this. So if we look at, like, people's attention, so the capacity to attend to something, society looks like this. So there's like, you know, most people, like, can sort of control their attention. This is where, like, most people kind of exist, right? So one standard deviation includes 85 percent of the population, if my statistics is pretty good. But then there are some people over here who have very strong attention, and then some people down here who have attention that wanders a lot. So what we're going to talk about is why human beings have fluctuating, or like, a wide span of attention, right?
So if we look at human beings, if we look at something like, let's say, we just look at height, as a quality, or tendency to get anger, angry. So like, we look at anger or height, we see essentially the same thing. So most attributes within human populations are going to follow this kind of bell curve, where like, 85 percent of people are going to be here, and then some people get super angry, and then some people are doormats. And that's just how human beings work. So the question is sort of like, why? And it tends to be that, you know, human beings have variability in situations that, like, variability is beneficial for people. So if we look at something like anger, you know, we don't want everyone to be getting super pissed all the time. We want some people to be like, get angry easily, right? And maybe they're going to be our warriors. And then we want some people who are going to be like, a little bit more passive, and maybe they're going to be our farmers. And so we tend to see across human populations that we have, you know, a bell curve of cognitive ability. And attention is no different.
So then the question becomes, like, why wouldn't we want everyone having, like, a super focused attention? You know, why do we want people that have attention that wanders? And so the, the short answer is, like, there's a very interesting theory about hunters versus farmers. So some people did some personality research and essentially concluded that there are two types of people. The farmer is someone who, like, likes routine, doesn't get bored. So like, you know, wants stability. So the farmer will like, wake up at 5 AM every day, like, go out to the fields, do the same thing, like, day after day after day after day. And they derive a lot of pleasure or enjoyment from, like, things like routine and stability. They really like, they dislike being disrupted. So they don't want, like, random events to happen. They just want, they want to be able to predict things. And they derive a lot of, like, pleasure, enjoyment, and satisfaction out of routine.
And then we have hunters. So hunters are a little bit different. The idea of waking up and doing the same thing over and over and over again is like, very, very, like, annoying or frustrating to them. They get bored easily. So what they need to do is they need to be like, more dynamic. So they like, you know, walking through the jungle and paying attention to lots of different stimuli. So they're like, "Oh, like, look, there's like something happening over here. And then this looks like an animal footprint. And what is that that I smell? It seems like something's going on. I smell something strange. And then there's birds circling overhead. Oh, they're like vultures over there. So maybe there's like some kind of predator over there." So hunters are people that integrate a lot of information. And so what we kind of see is that in, like, old human society, we sort of needed both, right? We needed some people to go out and hunt, and we needed some people to like, kind of stay at home and farm. And that the more successful societies were the ones that had, like, both cognitive types, okay? So in a sense, like, what we see is that attention variation within populations is selected for, is a positive.
So what does that mean for us, okay? What that means for us is that our society has been shaped over the last year, primarily by farmers, right? So like, if you kind of look, ever since the industrial revolution, like, we've had, you know, this idea of like, fixed time jobs, right? Like, as, as things got more centralized, what we started to see is like, "Okay, you go to the same place every day, you have your job." Like, even the concept of a job, like a thing that you do, instead of lots of things that you do, is like a farmer-oriented society, right? Because the farmers basically took over and they're like, "Everyone's gonna have a job, and this is gonna be your job, and I'm gonna do my job, and we're all gonna do our jobs, and then like, society will work wonderfully." And then we've got our hunters who are like, "I'm bored of my job. I want to do something else." And the farmers were like, "No, you have to." If you want to be outside instead of being indoors, you can deliver mail, become a postal worker.
And so our society, since the industrial revolution, got heavily shaped by farmers. And so what ended up happening is our society became more and more methodical, more structured, where everyone is the cog in their, you know, in in the particular machine that they're a part of. And the farmers love that kind of thing. They're like, "Fantastic! Like, everyone is a cog. There's perfect order. There's stability. And the world is is going well." And then there's a group of people who are the hunters, who started to struggle in this society. So they actually started to like, move into potentially like, more, um, dynamic professions, right? As schooling got implemented, we started selecting for people who can sit in a chair from eight to three. So now we started selecting people for their ability to sit in a chair. And then we added college, which is like, "Okay, who is like farmer enough to not be forced into learning and kind of can kind of learn on their own?" So then we added something like a GPA, right? And what we did is we selected for people in college who are like, not dynamic. They're people who can force themselves to go to class, or they don't have to force themselves, they like going to class because they're structured. They go to their 8 AM class, they study on time, they do everything on time, they don't procrastinate. And we're going to reward these people.
So over time, what happened is society became pro-farmer. And then we did something interesting, okay? What we did is we took the hunter kids in school and we said, "Oh my god, these hunter kids are, they're not able to sit and do what they're supposed to, right?" And so then we started diagnosing them with ADHD. So there's a couple of interesting things here. The first is that studies have been done that the student-teacher ratio determines the likelihood of getting diagnosed with ADHD. If you have one teacher to 30 students versus one teacher to 15 students, ADHD will be like twice as likely to be diagnosed in this group than this group. And that's controlling for number of kids. So if I have two, uh, let's put it this way, you know, like, if I have two classrooms, one that has 30 kids and two teachers, and one that has 30 kids and one teacher, like, the number of ADHD diagnoses in this classroom is going to be way higher.
And so what we begin to see is something that's interesting about a disorder, which is that a disorder, especially mental illnesses, disorders aren't just disorders by themselves. A disorder evolves when there's a genetic vulnerability plus environmental circumstance. So what we see in ADHD is that if you literally look at the term disorder, there's a lack of order or function within a particular environment. So for people who have ADHD, what it is, is their mind is dynamic, right? So that may be the genetic vulnerability. They may be a hunter. And what we're doing is we're putting them in a classroom, right? We're sticking them on a farm. And so this is where the disorder, the disorder arises between, within this gap. And this is what ADHD is. Now, this is where we have to go back for a second to our bell curve and acknowledge that, like, for a lot of people that I work with with ADHD, it's about finding the right environment for them to to thrive in. And then their illness no longer becomes a disorder, it can actually become a disadvantage. I mean, an advantage. But there are, there are certainly people who have very disordered attention to where, like, they lit, like, really, it is like, feels like a very serious, like, illness to me. But I would say that the majority of people that I work with with ADHD, even though it is an illness or a disorder or, uh, makes their life hard, that I would say like two-thirds of them, about 70 percent of them, can function very well with their ADHD in the right circumstance. And in fact, it's even advantageous. So there are some professions that we'll talk about. So event planner is actually surprisingly one. Other examples are like Twitch streamer, esports athlete. So actually, a lot of professions, even working in the emergency room, um, can that, or being a paramedic, being a plumber. There are several professions that, bizarrely enough, seem to like work totally fine with people with ADHD. And there are some situations where ADHD, in having a dynamic mindset, because remember that the reason you're getting diagnosed is because you're unable to sit in a classroom for like seven hours a day, right? So like, there are even some professions which are actually geared towards ADHD. And if you actually, like, go back and watch all of the, uh, interviews we've done with streamers, what you'll find is that like, like a greater percentage of streamers compared to the normal population have ADHD, just based on their own self-report, right? Like, so many people like will say, "Oh yeah, I have ADHD." And it turns out that this kind of hunter mentality can actually be advantageous in some, some situations.
So, um, just to kind of recap, I think the key point here is that there are two kinds of people. There's like farmers and they're hunters. And when you stick a hunter in a farmer's society, there you'll create an environmental circumstance that allows their dynamic mind to start to become like a disorder or not function well. There's also sort of evidence to this where, like, when kids get individualized attention, they're able to perform better in school and don't get kind of evaluated or diagnosed for ADHD. So there's a lot of stuff about, like, you know, just the amount of structure that people can tolerate.
The other thing that tends to go on in a lot of schools is that people will medicate children for the purpose of obedience, right? So like, if I have, if I'm a, if I'm a teacher, and I've got like 30 rowdy kids, and I medicate the five rowdiest of them, then it's like easy for me to like teach my class, right? And what we tend to see is like, the most disruptive kids get diagnosed with ADHD because they can't restrain their attention.
Next thing that we're going to talk about is like, what is Attention Deficit Disorder, ADD, or ADHD? And we're going to talk a little bit about some myths around ADHD and some, like, tricky things about diagnosis. So the first thing to understand is that it is a disorder of attention, okay? So this is where a lot of people get tripped up. So disorders of attention, basically, the way that I think about it is an inability to control your attention. So this is, this, the lack of this understanding is why I think ADHD is the most over-diagnosed and the most under-diagnosed psychiatric diagnosis. And you may wonder, "How can something be over-diagnosed and under-diagnosed at the same time?" The reason that you can have that is because you get a lot of people who don't have the disorder that are getting a diagnosis, and you are missing a lot of the people that do have a diagnosis, but you don't catch it because of other things.
So here are a couple of common misnomers about ADHD that people don't get. The first is that people with ADHD can't focus. This is actually incorrect. So with ADHD, we see a disorder of attention. So what we see with ADHD is actually hyperfocus plus a lack of focus. So what is actually very common in people with ADHD is that they can sit and do one activity for four hours at a stretch, provided it is the right activity. So what you see is a disorder of attention where once an ADHD kid is doing something, it is very, very hard to get them to change gears. So once they almost have like an obsessive quality to their attention, okay? So this is one of the reasons that it gets misdiagnosed because, like, parents will be sitting there with their kids and they'll be like, "He never pays attention to school." But once he starts playing with Legos, like, you have to physically pull him away. Like, it is so hard to get his attention once they are doing something that they're super into. So this sort of disruption of focus, or this like inability to control your attention, can result in hyperfocus. And it's because parents or teachers or other people will see the hyperfocus. They'll even see it with a particular subject. It's like, "My kid can't pay attention in math, but like, as long as it's history, he can sit there and read books." Like, you can give him like a history book at the age of seven, and he'll like, read it for four hours at a time. So people with ADHD can absolutely hyperfocus on particular things. And in this situation, it can also be like maladaptive because you can't change your, your focus, you can't stop, uh, studying history and start studying mathematics. Plus a lack of focus. So when it comes to mathematics, you have, once again, like, an inability to focus. So when I think about disordered attention, what I really, when I think about ADHD, I think about disordered attention. When I think about disordered attention, it is both a combination of hyperfocus and lack of focus.
Okay, so the next thing to kind of think a little bit about is, um, let me just think for a second whether I want to say anything about this. Does this make sense to people? Okay. So the next thing to talk a little bit about, I'm going to go over just a couple of other, like, reasons why ADHD is misdiagnosed. So the first is that we just kind of talked about is that ADHD kids sometimes hyperfocus. Therefore, people think, "Oh, since they're capable of hyperfocus, they, uh, don't actually have ADHD." So other reasons are good grades. So oftentimes, what you'll have is kids with ADHD who have high IQs plus ADHD. And what this results in is good grades. And just because a kid is like, brute force IQ their way through things, or develops compensatory mechanisms for studying. So like, they're not actually able to sit and focus, but they may develop all kinds of compensatory mechanisms like group studying. Another example of self-medication with drugs. Another example is being a night owl. And you may wonder, "What does being a night owl have to do with ADHD?" Well, let me explain to you. So people with ADHD sometimes find that a certain amount of fatigue slows down their mind and allows them to study, right? And so you'll also see this, this kind of pattern. They'll do other things to slow their mind down, either drugs, or they'll even play video games. They'll do things that kind of make them like, half exhausted, so that their mind is able to like, sit properly. So we see a lot of misdiagnosis actually because kids have good grades, because kids are smart. So we miss the diagnosis.
Another reason that we've already talked about is things like class size. So this is another reason why kids are diagnosed with ADHD is because, like, you know, there's just too many kids in the class. And so normally, like, if you think about a six-year-old, like, a six-year-old is only supposed to be able to hold their attention for a certain amount of time. But depending on external pressures, class size, things like that, you can actually get, like, over-diagnosis of ADHD. There's also, remember, uh, another reason that it's misdiagnosed is, like, you know, uh, how can I say this? Like, developmental idiosyncrasies. Remember that the primary reason, the regions of the brain that are involved in ADHD are the frontal lobes, or executive function, which if you guys watch either of my other lectures on depression or addiction, you'll realize this statement is a huge oversimplification because we go over all the different regions of the brain that ADHD affects. So executive dysfunction is kind of what we're looking at, right? And so we also have to remember that, like, kids develop at different rates. So not all seven-year-olds are gonna behave the same, right? Just like height, or appetite, or puberty, or all manner of other, like, developmental milestones, our frontal lobes' ability and our executive dysfunction or function develops at its own idiosyncratic rate. And so some people are just like, you know, some people start puberty early, some people start puberty late. In the same way, some people's frontal lobes develop earlier, some people's frontal lobes develop later. Like, I see this even in my two kids because my older kid has like a super developed frontal lobe for her age, and my younger kid, like, by comparison, it doesn't have a frontal lobe that's quite as developed, or not anywhere near. And that's just like, individually the way they are. Like, the younger one will get there, and this is going to take her some amount of time. So there are developmental idiosyncrasies that will cause people to diagnose kids with ADHD. And you may get a label, and once you get a label, you're like, "Oh, I have ADHD," even though as your frontal lobe develops, you may grow out of ADHD. And if you guys kind of think, like, "How is it possible to grow out of ADHD?" Just think about the attention span of a two-year-old versus a four-year-old versus a fourteen-year-old versus a forty-year-old, right? The attention span naturally changes over time. So even if you get diagnosed at the age of 12 with ADHD, you may not have ADHD when you're 22. It doesn't necessarily have to be a lifelong diagnosis. So this is another reason that people get misdiagnosed with ADHD.
So class size or environment. So there's another thing that oftentimes, like, these are the ways in which ADHD gets missed. This is why it gets misdiagnosed. This is sort of how it gets misdiagnosed. So what I mean by that is that a lot of times, like, kids with ADHD will be labeled with behavioral problems, okay? So like, you'll get a kid and they'll, they'll be like, "Oh, they like, Oh, here's another one, actually. Doesn't listen or is defiant." Okay, this is really, really common. We remember that the problem with ADHD is like attentional control. So if an ADHD kid is playing with Legos, their parents will say that this person doesn't listen. And oftentimes, like, like, you know, let's say you have a kid with ADHD and you tell them, "Go wash your hands." And then the kid, like, on the way to the bathroom will get distracted by something because they'll see, like, a toy on the floor and they'll start picking it up, they'll start playing with the toy. And the parents will get mad at them, right? And once they get mad at them, they're like, "Like, you, you're not listening to me. You never listen. Bad child. Bad child. Bad child." And so this "not listening" thing gets sometimes perceived as defiance. And then the punishment that they get then leads to shame and self-esteem problems and a lack of agency. So we talked about this in the depression lecture as well, where a lot of times, like, you know, kids with ADHD will get, like, punished, or they'll have different kinds of experiences, either social experiences, behavioral experiences, like school experiences. They're perceived as not being obedient, right? That's kind of like the defiant thing. So we'll get all these kids who actually have ADHD who are labeled as bad kids. So they have behavioral problems, they don't listen, they're defiant, you know, they're argumentative. Um, there are all kinds of problems that these kids will kind of get labeled as. But that's not, they don't actually have those problems. They're not being defiant. It's not like the kid is like, "Walking to the bathroom and is like, 'Screw my parents, I'm gonna play something.'" What they end up doing is they just get distracted by something and then they, like, they just get distracted by it. And then they get punished for it. And then they feel bad because they don't even really realize what they did wrong, right? They sort of connect the dots afterward. But in the moment, their mind just like, switches gears and they forget.
There's another thing. They get perceived as forgetful, right? So, "Oh, like, this person is just forgetful. Like, their memory is terrible." I've even had this. So I, one time had, um, a dude come into my office and say, "Like, I think I may have dementia." And the dude was like, in his, like, late 20s. And I was like, "Why do you think you have dementia?" I was like, "That's bizarre. Like, I don't hear that every day." They're like, "Well, my memory is just terrible." And I was like, "Well, tell me about that." And he's like, "Well, my wife tells me I forget stuff all the time." So we started talking about it. And then, like, the more that I realized, like, "Oh, this guy doesn't have a memory problem. He has like an attention problem." So this is where, if we remember, so if we think about, like, memories stored in our brain, let's say this is where memories are stored. Remember, they have to get in, they have to get put in somewhere, and then they have to get recalled. And so if, if this is missing, or you can't recall it properly, we think, "Oh, like, it, you know, I wasn't able to recall it." But the truth is, it never got planted in, in the first place.
So a good example of this is if someone tells me, if I ask, like, this is a classic example, okay? The easy example of understanding attention versus recall. Who here meets a bunch of people at a party and forgets their names? Right? Like, it doesn't have to be a bunch of people, it can even be one person. You meet one person, you, you're like, "Hey, my name is Olok," and they say, "My name is whatever." Like, it doesn't, it never even sinks in. Like, and you're like, "Oh, I forgot that person's name, right?" And it's like, "How can you forget that person's name so quickly?" Like, within five seconds of introducing yourself, you forget their name. Within two seconds of introducing yourself, you're like, "What was that person's name again?" And then you just, or they just introduced themselves, you've already forgotten the name. So you don't, like, think that you're like, "Oh, well, it's stupid. I can't just ask them like, right away, like, 'What is your name?'" Right? So why does that happen? It's an intentional thing because when you introduce yourselves, your attention is on your introduction, so you're not listening to them. So the name never gets implanted in your brain in the first place, right? So it's never being entered in. And so this is why people with ADHD have, like, they they get perceived as forgetful. It's not because they have any problem with recall, they don't have dementia. It's just that their attention is wandering, so the stuff never gets put in in the first place, okay?
So this is, like, when we kind of look at the misdiagnosis of ADHD, or let's start from the top. So like, ADHD essentially is a disorder of attention. And that attentional disorder can result in hyperfocus, which leads to a lot of misdiagnosis because parents are like, "Oh, like, you know, he can, like, do Roblox all day long, no big deal." Also gaming, right? So we'll talk about, let's talk about gaming in a second. But, uh, it's both hyperfocus plus a lack of focus. It tends to get misdiagnosed or missed in a lot of people due to their ability to get good grades, which oftentimes has to do with, like, compensatory mechanisms that they'll set up. Um, can get misdiagnosed due to things like class size or environment because, remember, a psychiatric diagnosis tends to be a vulnerability plus an environmental factor combined. And then, um, another reason that it gets misdiagnosed is because people just develop at their own pace. So it's like, you can't expect all seven-year-olds to be able to sit in the classroom at the same level, right? Some kids are going to really love it, some kids, it's going to be hard. And then, like, people will sort of grow out of it. So oftentimes, kids with ADHD get misdiagnosed with things like behavioral problems, problems like, "Oh, they don't listen." They get punished for defiance or lack of obedience, um, for being forgetful. "Oh, my kid is like, they're just completely forgetful. Like, I can't rely on them for, you know, to remember anything." And it's not an issue of recall, it's an issue of attention.
So let's talk about gaming in ADHD. Why do kids with ADHD love gaming? It's because games demand your attention, okay? So like, this is the cool thing about a video game, right? Like, it doesn't ever kind of get boring. It just like, and, and people with ADHD will self-select for particular video games that, um, will demand their attention in the right way. So the game is constantly giving you stimuli, right? So it's like, "Oh, like, there's a random encounter here." If I'm playing, like, Fortnite or a battle royale, like, "Now there's someone over here." Or like, "I can queue up for a game of League, and there's always like some kind of thing that is like triggering and pulling in your attention." And so this is also where people will get misdiagnosed because parents will be like, "I don't understand why my kid can't study. He can sit there and literally play on, you know, on a computer for like 12 hours, like, without stopping for food." And that is once again because it is disordered attention, right? So they can hyperfocus. So video games are, are very, very addictive to people with ADHD because they allow your mind to be fully focused, and it's sort of like a never-ending, like, ability to get focused.
And this is where we can almost take a quick spiritual detour and we can acknowledge that if you look at, like, old texts on yoga and meditation, they say that focus equals bliss. That the happy mind is not an anxious mind or a distracted mind, but a focused mind. So if you do something like watch a sunset, why do sunsets look so cool? It's because they like allow you to focus your mind. If we look at the nature of, like, um, you know, unhappiness in the mind, it's usually like unfocused thoughts. So a good example of this is anxiety. When you're thinking about one thing, and you're thinking about another thing, and you're thinking about a third thing, you may think that it's all the same thought. But if you really pay attention to anxiety, it's actually rapidly moving thoughts. You may be anxious about a party, but you may think, "Oh, does that mean that I'm focused on the party?" No. If you actually pay attention to your thoughts, you're not focused on the party. When you have anxiety about going to a party, you're like, "Oh, what if I'm wearing the wrong thing? And then what if people think I'm stupid? And then people won't like me? And who am I gonna talk to? Am I gonna be standing in the corner with a drink, not talking to myself? And everyone's gonna think I'm a loser? And then like, I'm gonna walk up and try to join a conversation, and that's gonna seem super awkward because I'm just like walking up and not saying anything." So you kind of think about, like, all these 15 different things. It's not one thought. It's not like watching a sunset where you're not like thinking, "Oh, like, the sunset has this sunspot here, and then it's got this, and then it's got this, and then it's got this." You're just absorbed in the experience. So yogis sort of figured out that focus equals bliss. And if you can be absorbed in one thing, that will lead to a mental feeling of, like, calmness and enjoyment. And so this is what's so addictive about gaming is that gaming sort of gives us a sense of focus. And so even though the game is rage-inducing, we find ourselves drawn to it. Why? Because we can be absorbed within it, right? Like, a good example of this is, like, if you, if you play something like Dark Souls, like, while you're fighting the boss, you have like laser focus. And it's after you get one-shotted that you throw your controller down and smash everything, right? But it's, it's the sh, because when you get one shot at in Dark Souls, what happens? It shatters your beautiful focus. When you're playing, like, League of Legends or Valorant or whatever, you're like, hyper-focused. And it's when your teammate disconnects mid that it shatters your focus, and then you start raging. Why? Because this thing gets taken away from you.
Okay, so we see kind of that gaming and ADHD are like, really, really great because they take your disordered attention and allow you to hyperfocus on it so easily. And the mind just loves that. From a spiritual perspective, by spiritual perspective, I mean this is sort of like the way that the yogis looked at things. It's not really like scientific in the sense that they didn't do, like, you know, a randomized controlled trial on ten thousand humans. What they did is look at themselves with, like, ten thousand intensity. They took an N of one and explored it all the way down to the core.
Okay, now let's talk a little bit, since we're on the topic of gaming. So now let's talk a little bit about, like, being ADHD in the modern world, okay? And why is this important? It's because if we look at our world, our world is changing rapidly. So remember that the industrial revolution basically made us a society of farmers, right? Where everyone is a cog in the wheel, or cog in the machine, right? We have nine to five, all this other stuff. There's this idea of high school, college, career. Even the word career, you guys get this? The word career implies like one thing that you do for your entire life. It's a farmer-biased word, you guys get that? It's not like, and then the, there's like the opposite is odd jobs, right? Like, and so you guys see like the value judgment difference between these two things. So if you look at someone like Elon Musk, like he doesn't have a career, he's a dude with odd jobs. You all get that? Like, Bill Gates had a career. Elon Musk has odd jobs. He's like, "Uh, I'm gonna start a company that sends people into space. I'm gonna start an electric car company. I'ma start a company that drills into the ground and like high-speed rail transport, like on California, right?" So like, this is where if we look at the industrial revolution and the consequence of the industrial revolution, what we see is that, like, there's such a heavy bias about what is successful and what is good versus what is bad. And it's very, very farmer-focused. It's very anti-hunter, okay?
But now, like, the world is changing. So like, I'll just give you guys a couple of examples, okay? So like, what tends to happen is over time, our attention can transform. So we can, you know, make our attention more farmer-like, or we can go over here and make it more hunter-like. So studies that have been done which basically show that, like, short content makes people more ADHD. So there are studies that show that, like, so people will sometimes ask me, "Okay, is it okay if my kid, like, uses a screen?" And they're like, "What do you think about screen time, Dr. K?" And that's where, like, I know it sounds kind of weird, but not all screen time is the same. Like, there's no such thing, I mean, there is something is screen time, but how you use the screen makes a big difference. Oh my god, that's just completely illegible chat. Even that's too much for me. So for example, what I'll advise parents to do is long-form content on a on a screen is fine. So for example, a movie is okay, but YouTube compilations are bad. And let's just think about this. So like, if I spend my days watching movies, my brain is literally going to be entrained to pay attention to something over long periods of time. If I watch YouTube compilations, my attention is shifting like every 60 seconds. Ads are another thing that makes things like more hunter-like, increases the dynamic nature of our mind.
So now let's look at a couple of different things, okay? So like, let's look at a couple of categories. Let's talk about content, then let's talk about, uh, discussion, okay? And then let's talk about dating. So let's look at, like, how these things have progressed over time. So back in the day, if I wanted content, what I had to do was read a book, right? And this was like a 30-hour endeavor. And then what happened? Someone like invented television, where they're like, "Oh, look, there's a TV show." And now it's like a one-hour endeavor, right? And then someone came along and invented YouTube, and now it's like anywhere from five to 15 minutes, right? And then someone came along and was like, "Hey, let's do this live," and they invented Twitch. Now you can watch a stream for like eight hours at a stretch, but like, you know, there's there's an increase in the dynamic nature of Twitch, right? In which, which content platform is growing the most rapidly? There it is. Good job. TikTok, which is like less than 60 seconds, bro. So what's happening is like, we are actually selecting for shorter and shorter attention spans. So as kids start watching TikTok, and if we kind of look at the ADHD diagnosis, ADHD has been increasing all along, right? Over time. If we go down this way, we'll see an increase in ADHD diagnosis.
Next thing to kind of think about, let's think about, like, discussions, for lack of a better term. So it used to be like, people talking, like, let's, like, you know, the Roman Senate. And then like, people hanging out on porches, right? So these were like long things, like people would talk for hours. And then what's happening is like, the internet comes along, and then we have these things called discussion forums, which if you still go to places like RPG Codex, you'll see like discussion forums that are like years old, right? You'll have a thread that's like years old where people are still talking about it. And then over time, we even get things like Reddit, where it's like, there's some discussion, but the discussion, like, tends to happen, like, temporarily or shortly. And then we end up with things like Twitch and Twitter, which is like, if you blink, you'll miss chat, right? And so we see the same thing. Oh no, we're lagging. GG. We have to move. Um, we see things like Twitch and Twitter where, like, the the discussion rate is very, very rapid.
And let's even talk about dating, okay? So dating, there used to be courtship. This is like a long and drawn-out process of like balls and meetings and things like that. And then after the courtship process, like years later, centuries later, we started this thing called dating, right? So people will say, "Are you walking out with someone?" Or whatever terminology they used. And that, like, dating is like a little bit more dynamic. You meet a couple more people, you kind of do, you know, it takes a couple months, maybe a couple years. Like, courtship is like more structured. And then after dating, you know, more recently, I'd say in the last 20, 30 years, like, as the availability of birth control kind of increased, we sort of have like a hookup culture, right? Where like, it's no longer just about getting married. Like, you don't even need to get married, you can just like, date for the sake of dating, and you can like, hook up just to have a good time. Like, there's no, there's no value judgment attached to it. And now we have Tinder. And in the courtship, you're like, dealing with one person. And the dating thing, let's say you're dealing with like three to five people. In the hookup culture, maybe you're dealing with like five to 20, depending on, oh god, once again, terrible handwriting. And then, like, Tinder, it's like literally a numbers game. So it's like 99 plus, right? So we see that society is like moving in this direction. As we move in this direction, we're going to see an increase in ADHD-like symptoms. Oh my god, chat, Dr. K is on the struggle bus today. And as we see an increase in ADHD-like symptoms, like, we're gonna see, like, more people feeling like they have ADHD.
But something interesting is also happening, which is that society is moving away from the farmers. So if you guys read anything by, like, Charles Dickens, right? Like, there's like, back in the day of, like, book writing, or like Tolstoy, very, very, like, long attention span authors, and long attention span, like, consumers of content. And so what's happening over time is that we're getting, like, going down this way, where like, as society becomes ADHD, the more ADHD mindset becomes more advantageous. So this is where, like, it's been my experience, for example, with Twitch streamers, that the average Twitch streamer is more ADHD than the average, like, person. And what that actually does for them is actually gives them a competitive advantage. So even this kind of stuck out with me. We did an interview with the Daily Dose of the Internet dude. So if you, you like, think about the DDO I guy, like, what he basically does is like, uses his own attention span as like a judge for what the internet will like or not like, right? His attention span becomes a tool instead of a problem. Now, remember, he still exists in a primarily farmer society where there's like bank accounts and monthly payments and this and that and mortgages and credit scores and all this stuff. So we're not saying that, like, it's necessarily an advantage. But I have seen that, like, as we get more and more Twitter-oriented, our attention spans seem to be shorter.
So if you look at political discourse over the case, over time, right? So it started off with, like, let's say the Roman Senate, where people go and construct arguments and, like, will discuss for hours and hours at a time. And now we've got, like, Twitter trolls, right? Who will just make like, bizarre political statements that no one fact-checks, has no nuance, and just incites emotion. So it's almost like being ADHD means that you can't be a senator in ancient Rome. But having ADHD in today's society makes you a political pundit, like, it's easy, right? So this is like a good example of how our society is actually moving more towards ADHD. We're sort of cultivating a shorter attention span. But bizarrely, actually, this may serve as an advantage for those of you who feel like you've got ADHD.
And so there are a couple of other trends, for example, that, like, some companies have embraced. So I don't know if you guys know this, but like Google, for example, last time I checked, or based on the clients I've worked on, does not have a nine to five work culture. They're like, "We don't care when you come in. You can work at, like, two in the morning if you want to, just needs to get done on time. Like, we don't care, like, when you come in." And so Google also sort of figured out that, like, "Okay, we're just gonna give our engineers like a cafeteria and a place that's open 24 hours, and they can come and work wherever they want to." So they've sort of selected for the night owls. And they did something really cool here because remember, in the nine to five work culture, like, these people would not be able to get a job, or they wouldn't be able to keep a job, even though they're super talented and could be very good programmers. And so by Google sort of stepping away from the, the farmer culture and moving towards, like, a more free culture, they actually allow these people that may be a little bit more ADHD, maybe late risers, maybe circadian rhythm disorder folks, to actually be productive programmers.
Another example of this is actually work from home, right? So work from home, like, more and more people are moving towards work from home, which is like, you may wonder, "Okay, what does that have to do with ADHD?" But it's like a less structured environment, right? We're moving away from structure towards dynamic work environments. And the more that we move in those directions, I think the more that the ADHD crowd will be like, more able to, like, do a good job. So I'll give you guys just a very simple example of how work from home, like, supports ADHD. Remember, people with ADHD have hyperfocus or disordered focus or lack of focus, right? And the problem, if you've got ADHD, you guys may know this, is that, like, you know, your typical day is like, waiting to get inspired to work, panicking, procrastinating, and then every now and then you get a four-hour window. You get these four magical hours where you do 24 hours of work. You guys know what I mean? And so it's like, you just, like, wake up one day and you're like, "Let's go!" And then you just do all the work. And then, like, for the rest of the week, you're trying to figure out, "Why couldn't I do that on Monday? Like, when is that gonna happen again?" And so the work from home culture allows these people to succeed because if you're like an ADHD person, you have to
Work from nine to five. Like, what happens if your magical four hours doesn't happen in that window? You're screwed. You're never gonna get promoted. You're gonna get fired. It's like, GG.
So, as we work from home, it's sort of like you just kind of work from home. You can be in your pajamas. But if you've got a flash of inspiration, what used to happen is you get a flash of inspiration. Oh no, gotta change out of my pajamas, put on my suit, commute for an hour. And by the time you get to the office, it's like you're hungry, over-caffeinated, and like, it's shattered. Your muse is gone.
And now, in the work-from-home environment, it's like, if you get that flash of inspiration, it's like you don't even need to put on pants. You just sit down and like, bang out like you program like a madman for four hours. And then you can go and like, get some pizza afterward, right?
And so, like, our society is actually moving in an unstructured environment. Things are getting more ADHD. But on the flip side, if you have, if your attention span is more in this realm, you may actually find that you have some competitive advantages. Questions?
So, just to kind of summarize, okay? So let's like, do major points. First of all, ADHD exists for a reason, right? And this goes into why society needs farmers and hunters. Okay? Generally speaking, ADHD gets over and under-diagnosed. Okay? So it gets misinterpreted in a lot of ways. What is it? It's a disorder of attention, which means hyper-focus plus lack of focus. And this confuses a lot of people.
Point number three: Society is increasing ADHD. But on the flip side, if you have ADHD, you may actually have an advantage, as long as you're careful about making it an advantage. Okay? So this is why people are ADHD. If y'all, if this kind of resonates with you, like, now hopefully you have like a big, high-order sense of like, why things are this way. And also, like, just think a lot about this point, especially.
So when I work with with individuals, what I'll really do is work really hard to try to figure out, okay, like, what is your unique like advantage that you can bring to a dif- like, a particular work environment or your goals or whatever. And what I found time and time and time again is that we don't need to medicate them to turn them into like, essentially farmers. What it's really about, and sometimes they still need medication, but what it's really about is creating sort of a life or structure that allows your dynamic mind to be an advantage instead of a disadvantage. Okay? Questions?
Can you have low attention span without ADHD? Absolutely, right? So like, that's what I'm saying is that as a whole, society is shrinking our attention span. You all get that? Because you don't need an attention span the way that you used to. Like, entertainment used to involve reading a book. So like, think about this. Every time that, like, 200 years ago, every time someone read a book, what they're doing is training their attention span to be longer.
And now, if like, if I'm just like chain-watching stuff, like, and that too, you can, you know, you can tell they're different kinds of content consumers. There's the long-form podcast content consumer, there's the high-energy Twitch chat consumer, and there's like something in the middle, which is like the 25-minute video essay on YouTube. And so depending on where your attention span is, you may gravitate towards a particular kind of content. And depending on which kind of content you watch, you will be training your attention span a particular way. If all you watch is YouTube compilations of memes, a podcast is gonna feel super boring.
What if I watch both? Well, that's like, that's totally normal, right? So like, the mind doesn't always want the same kind of thing. So there's also a variation in like, how consistently you like your content. Like, some people only like to read books and can't stand movies. And some people are like, I like Game of Thrones books, I like Game of Thrones TV show, and Season 8 is the best TV is the best season of television that has ever been created in the history of humanity. There's variation within populations, right? It's truly a masterpiece, right?
So now we understand like the advantage. This, by the way, so I love lecturing like in person. So like, I love teaching. But like, I can't make a YouTube video for the life of me. Like, I just can't sit down. Like, I've tried it a thousand times where I'm just like talking to the camera. I just can't do it. I need some amount of like, actual energy to like, keep my mind going. Uh, so someone's saying, I thought drugs were a big part of treatment for ADHD. So oftentimes, medicine is used for ADHD.
So let's go over like, basic evidence around ADHD treatments. Okay? First thing to understand is that medication is as effective as therapy. So if you go to like, a cognitive behavioral therapist who teaches you how to focus your mind and like, map things out and all these other skills, you can learn skills that are just as effective as taking like Adderall or methylphenidate or whatever it is. Taking ADHD medication. This is something that is very, very poorly like understood in society is that you can get the benefit of medication without medication. Like, the effect sizes are the same.
Second thing to understand is that the reason that people do medication is because it's easy, right? So it's like, very easy, especially if you've got a 13-year-old. Like, taking your 13-year-old to therapy twice a week so they can entrain the right kind of skills is like, very expensive and cumbersome. It's like, you gotta get in the car, drive them to their appointment, they have an hour-long appointment. As a parent, you have to wait around, pick them up, and bring them home. So it's like a two-hour investment twice a week, which is like four hours. And it's just easier to medicate them. And it's like, the medication works right away, right? The kids love it too. You guys are just bashing on the parents. Like, the kids love it. They're like, I take a pill and suddenly my mind works like everyone else's. That's easy. I don't want to sit here and map out my week for an hour twice a week. It's torture. Does that make sense?
Other questions? Uh, is that why adults get meds since their brains are already developed? It's harder to train those skills? No. So sort of. So the reason that adults get meds is because their brain is naturally developed, maybe as much as it will. But even then, your frontal lobes develop until the age of about 30 or 32. And I suspect that we're even delaying the amount of time that it takes our frontal lobes to mature. So I think that if you do a study in 10 years about when the frontal lobes mature, it'll like, they'll mature by 35. So I think that's changing. So our frontal lobes are maturing slower than before, or there's more maturation to be had. The reason that adults get meds, sure, you're not, you just can't count on your frontal lobes developing more if you're like over 32. But they can train those skills in CBT just as well as kids can. Argue? Yeah. So most of the studies are done in adults, so that's not the issue. The issue is, once again, if you're an adult, it's just easier, right?
Uh, what's the link to, uh, is there any link between giftedness and ADHD? That's an excellent question, and one that we're actively researching right now. So we do a lot of different research here at HG, and we're actually looking into that question. So we've noticed that there's a lot of people in our community who are gifted kids, and there are a lot of people in our community who have ADHD. So is there an overlap? It's something we're actively investigating.
How do I confirm if I have ADHD or not? You go get a professional evaluation. So someone saying, Dr. Russell Barkley makes the point that medication for ADHD is like providing a wheelchair to someone with a mobility issue. I completely agree. And let's just look at that statement more closely. So providing a wheelchair to someone with a mobility issue is like more complicated than it seems. So depending on the mobility issue, is this person able to walk? Like, if they've been in a car accident and they need to go to rehab and learn to walk again, or are they missing their legs? Can they learn to use prostheses? So much like ADHD, is providing a wheelchair, sometimes you need a wheelchair, and sometimes that person will need the wheelchair for the rest of their life. But there are populations of people that we are sticking in wheelchairs and we're never teaching them how to walk again. And so that's a problem. Because I think much like mobility issues, there's a differential diagnosis for what's causing your mobility issue, and there are different treatment options to see that to address your mobility issue. It may be a prosthetic, it may be a wheelchair, it may be that you can walk without either, you just have to train it up the right way.
Why do people say ADHD is fake? So you'd, you'd probably have to ask them first of all. But I'd say it has to do with a lot of the misdiagnosis stuff that I talked about earlier. So ADHD is oftentimes perceived as a different kind of problem, like, oh, this person is defiant or isn't listening. The other reason that I think people say ADHD is fake is because they have a neurotypical brain. And so like, it's easy for them. They take it for granted that their mind is able to focus, and they cannot imagine a world in which their mind just like, gets unplugged at random times or switches the channel on you, right? So like, imagine that you're watching television and you control what channel you're watching. And then like, imagine a different scenario where like, your channel randomly changes. If you've had a remote control your entire life, it can be very hard for you to understand that like, other people's channels are just randomly changing and they have no control over that. It's such a given in their life that they have some degree of attentional control.
What are the downsides to meds? There are some downsides. It, it's very kind of individualistic. So like, remember that prescribing medication is about a balance of benefits versus hindrances. So I try to steer clear of medications in general. So about 30% of people in my practice have medication. I have no value judgment. Like, I'm not saying that you shouldn't be on medication. I prescribe this stuff, after all. But I think that oftentimes, like I was saying with the wheelchair analogy, that medication will sometimes be a substitute for some amount of like growth or change, which sometimes people just don't have the bandwidth for. Like, I have a patient, for example, who's got like, you know, two teenagers, and they just don't have the time to like, do yoga and like, a juice cleanse, right? So it's like, just take your SSRI. Like, don't worry about it. Like, you can take care of yourself like down the road. But right now, you have like, more important things to worry about. So, so medication is like useful because it is easy, right?
So with ADHD, for example, some of the things that I get concerned about are, is the brain development? But we don't really know exactly how that, how stimulants affect brain development over time. Um, it's not clear that it's really harmful at all. There are definitely concerns for a lot of stimulant medication with being underweight and appetite suppression. So remember, when you take a medication, it gets dissolved and distributed throughout your entire body. So medications will have effects in many places besides your brain. And so one example of like, stimulant medication is that it suppresses appetite. So if you have a 13-year-old who is going undergoing a growth spurt and normally they're consuming a high amount of calories, and you give them like ADHD medication, sometimes they won't feel as hungry. How will that affect their long-term growth? So it does appear that there are weight changes that happen with ADHD medication, which you have to be careful about. That's just one example.
So would you recommend a forcefully extended attention span? It depends on where you are on the spectrum. So I'd recommend that you should be in control of your attention span. And so if you tell your mind to do something, it should listen. So if I tell it, hey, it's time to stream, forget about Dota, it should listen. It can kick and scream a little bit, like mine did today, but then it sort of gets in gear. If you tell it, hey, it's time to study, it should sit and listen. That's what I'd recommend.
How do you deal with an inferiority complex caused by ADHD? So I don't know if you've seen the, the, um, ADHD and depression lecture. But I'd start by watching that. You can also check out Dr. K's Guide to Depression. So for those of y'all that are dealing with inferiority complexes, so the guide to depression has a lot of stuff about some scars and like the way that those complexes form, which maybe we can talk about today. But there's like more detail about how to digest those, dissolve those, etc., in the guide. We'll talk about that today though. Some scars are excellent. Someone's doing their homework. Okay, shall we move on? So bro, I'm dealing with every complex and it ain't pretty. Like, I get that. That's why in the guide, we talk about how to deal with all of the complexes.
So this is something that I like about Eastern psychology more so than Western psychology. So Western psychology is really good at like diagnosing the content of the mind. So I'll say like, oh, this person has an ethical edible complex, this person has narcissistic personality disorder, this person, you know, like has borderline personality disorder, this person is a sociopath or psychopath. So they'll, they're really good at like describing the content of the person's mind. But I think Eastern psychology has a better handle on the process of mind. So how fundamentally does a complex form? Where do complexes come from? And how do we get rid of them? And then the particulars of it are like, whatever you want. But that's why like, we kind of go into detail. We'll talk about this today. I'll teach something about it. But if you guys are interested in this, that's why we have five of the common some scars that lead to depression. So these are five complexes that people experience that cause them to be depressed. One example is like, I'm hopeless, therefore like, there's no point in doing anything. It's almost, almost this nihilism, doomer complex. Another example is falling behind. I've fallen behind, therefore, you know, like, it's too late. So there are a lot of different things that you can kind of examine. Um, so if you guys are interested in the nature of how complexes form, like definitely check out the depression guide. Okay, let's talk about, uh, uh, how do I deal with micromanaging parents and the consequences in my mid-20s? We'll talk about, we'll do a holiday stream about parents and micromanagement or something. Let me think about that.
So someone saying, structure and discipline are hard. Need tips. So this is why where I'd say, agreed, structure and discipline are hard. But remember that you don't necessarily have to rely on structure and discipline, right? You can rely on like inspiration and environment. So what I'd say is, if you guys have difficulties, here's like a quick nutshell. If you have difficulties with structure and discipline, and that's not what you're good at, just don't bother in a weird way. So all the discipline you need is like, set up a study group, for example. And then like, just make all the discipline you need is not to study for eight hours. Because if you're studying by yourself, right, like you are going to, yeah, if you, you're studying by yourself, every hour you have to make a check, like a willpower check. And if you fail your check, you start playing a video game. But if you're studying with a group of friends, like you just have to make one willpower check to get there, and then they will keep you involved. When I say inspire, that's where your company is very important. If you're around a bunch of people who are like, you know, entrepreneurs, like you will naturally have a more entrepreneurial bend. If you're around a bunch of people who are like game developers, and like there's a Discord server for game development, and you hang out on that Discord instead of like a League of Legends Discord, you're more likely to develop games in one than the other, right? Though all Discord is going to cause you to play games, the development Discord server is going to cause you to make games.
Uh, what effect does weed have on ADHD? Not a good one, in essence. All right. So like, like weed is like not a very good drug, especially if you have a developing brain. Like, if you want to get, if you want to become 35, you have your life established, and then you want to like, use weed, and it's legal and stuff, I'd say go for it. So I'd say that most. We'll do comparison. We'll answer questions for like, 10 more minutes, then we'll do comparison. Okay? Um, so like, cannabis is one of these. Why does cannabis feel like it helps? Because it does help certain things, and it screws you over in other ways. So like, the reason that cannabis feels like it helps is because it helps. It just also hurts, right? So like, here's the, it's almost just like the ADHD medication in the wheelchair analogy. Where let's say you use cannabis for your anxiety. Like, it can help with your anxiety. But then not only will you potentially get rebound anxiety, which is when, and so if you use substances to regularly treat anxiety, and you take the substance away, you will actually worsen your anxiety. So you get stuck in this cycle of being dependent on the substance, and that doesn't even help anymore. It's like caffeine, where your body develops a tolerance, and then there's no net positive. You become dependent on it to function, and then it's not actually helping your anxiety. It's just like, you've developed a tolerance. So weed is a problem because it is very, very effective at making your problems go away. The problem is that it only makes, it makes you feel like your problems go away. It doesn't actually make your problems go away. It makes your problems usually worse. So like, people who drown themselves in substances, well, like, oh, like once I'm drunk, like I can forget all, all of my cares. But they're your cares for a reason, right? So you can do that, and you can delay the clock by 24 hours, but all the problems are still going to be there. Um, and, and this is where, you know, a lot of people think that. So that's the basic problem with weed. It also tends to mess with your habit formation circuitry. So like, the ability to form good habits is more difficult while you're using marijuana. So there's a common misconception that weed like causes IQ problems. I don't think it causes IQ problems. What it does is far, far more insidious, which is that it causes motivational problems and habit formation problems, right? That's why there's sort of this idea of a pothead, which is like someone who sits around all day and does nothing. Now, chances are, there's a little bit of a reciprocal relationship there. That people who, who sit around and do nothing gravitate towards pot, and pot makes people want to sit around and do nothing. So it's not all the pot. The other general thing that you should be careful about is like, if you have a developing brain, and you add substances to it, how does that affect the development of your brain? The short answer is, we don't know. So I'd say like, steer clear that stuff, especially if you're like a teenager, or even your earlier, early 20s. Um, so one person saying, how do I deal with the imposter syndrome of whether I might actually have ADHD or I'm just normal and lazy, especially since the waiting list for formal assessment is so long here? So if you're stuck between trying to figure out, am I lazy or do I have ADHD? Really common problem. Excellent question. What do you do about it? And this is where it's kind of interesting, but the short answer is, it sort of doesn't matter, right? So like, I know it sounds kind of weird, but whether you have a diagnostic reason for being the way that you are, or you are lazy, you still have the same shared problem, which is that you're unable to do things. That problem needs to be fixed. Whether you have ADHD or you're lazy, like that's sort of, in a weird way, it's almost irrelevant. It does become relevant because ADHD may open up additional ways to fix it. So I'm not saying it's truly irrelevant, but what I'm saying is that the situation is what it is. The ADHD is just a label that you put upon it, right? It may give you some amount of tools, may give you some amount of options. But this is where I'd say that, you know, if there are tools to organize yourself with ADHD, they may help you even if you're lazy. So this is where, you know, your situation is what it is, irrespective of what label someone will give you. And so there are things that you can do irrespective of what label you have, right? So what is the nature and experience of your inability to work? Ask yourself that question. That question is the same whether you have ADHD or don't have ADHD. And then you ask yourself, okay, so like, what is like, what is it that makes it hard for me to work? Is it, is it I feel unmotivated? What does that mean? What does unmotivation mean? Like, what does that mean to feel unmotivated? Is it that your mind is distracted? Is it that you're afraid of the consequences? Is it that when you start to work, like you, you automatically compare yourself to other people and you think, there's no point in studying because this person is going to do a better job than I am? There are all kinds of things that can impact your motivation. And so you have to understand the nature of your experience. You're going to get more answers studying yourself than you will from like, getting a particular label and finding external answers. And that may sound weird. You're like, but wait, if I have ADHD, doesn't that mean that there are all these solutions out there? News flash, as someone who treats people with ADHD, they're all on the struggle bus anyway. It certainly can help and there can be transformative, uh, you know, interventions that you can do for ADHD. I'm not downplaying those. But I'd say like 70% of people that I diagnose with ADHD still have to go through the process of like self-discovering and figuring out what works for them. And that's because ADHD isn't homogeneous, it's heterogeneous, right? So not everyone's ADHD is the same way. It's at the end of the day, like that personal exploration of what is holding you back, I think is worth way more than getting a label that applies to a mass of people for whom different things may work, right? Because not all, it's not like there's one medication for ADHD, there's like half a dozen. And why is that? It's because different people need different things. So even the label does not fix your problems and magically make them go away.
So Dr. K, I limited my my caffeine use to one drink per day and now I'm having trouble with motivation and focus. I was self-medicating with it and I now realize it was helping me function. What else can I do? Cut out that last cup of caffeine, bro or girl. You're fatal, Dave. So I assume you're a dude, but you never know. So this is where like, just cut out the rest of it. Get completely off of it. That's the right move. Either go to two cups a day or no cups a day. So if you needed to. So here's, okay, so people are wondering why two or none. So caffeine has a half-life, which is the amount of time it takes to like metabolize the caffeine. Okay? So when you drink a cup of coffee, there's a period of time where like, you have a high level of caffeine in which it probably gives you like a work debuff. I mean, sorry, work buff. But then over time, it like, the buff declines. And then you may hit this point where it no longer buffs you, and then can actually, you can enter a period of caffeine withdrawal, which is a debuff. Which is why people sometimes need caffeine twice per day, right? So you like, get that first buff, and as your level wanes, you get that second afternoon cup of masala chai, and then like, that carries you like through the rest of the day. So you got these like two peaks. So for some people, one cup of coffee is enough to where like, they get a mild buff, and they kind of like, their half-life is such that it carries them through the day without a problem. But depending on your individual metabolism, if you're like me, and you're avata, one cup is never enough. So it's either two or bust. So that has to do with your individual metabolism.
Dr. K, do you think diagnosing ADHD during drug addiction is possible? Yes, I think it's possible, but it's hard. So what I would do to, so the people that I've diagnosed with ADHD who are on drugs are the ones that I usually make a historic diagnosis. So I won't send them for neuropsych testing. I'll ask them or their parents, like, what was this person like as a kid? And so you can sort of get enough from a history to see, oh, this person probably had a has ADHD, even though they're on substances now. And that becomes very, very important because oftentimes ADHD itself being underdiagnosed can keep someone from ever becoming sober. So there's a whole video on this. We did a lecture on ADHD and addiction where we kind of explored how ADHD is a vulnerability for for drug use, right? So if you are impulsive because you have ADHD, and your ability to like, restrain your impulses and act more emotionally, we go through a bunch of neuroscience and stuff like that. There are a lot of reasons why having untreated ADHD makes sobriety very difficult. And so interestingly enough, sometimes what I'll have to do is prescribe people stimulants, get the ADHD under control, even while they're like abusing marijuana or opiates, and then like, once the ADHD gets under control, then they can actually like get control of their substance use. So sometimes you have to do it like that. It's tricky.
Alcohol can be really bad too for ADHD? Absolutely. Like we said, some people with ADHD use alcohol as like a cognitive like depressant, right? So it slows your mind down so that you can like focus more easily.
Do I have ADHD myself? No, I don't think so. I probably would have gotten diagnosed if I was a kid in today's school system with ADHD. So I have a high level of Vata, which I think is quite ADHD. But I don't think that my function is impaired. That's partially because of the way that I've structured my environment. I am about that. So I think if I was like, if I was, if I was in school now, I would like, there's a 50% chance I would get diagnosed with ADHD based on like, I could never study. I could never like, if I was interested in something, I could pay attention to it. If not, and I was just like, kind of smart, so it wasn't that bad of a deal. That big of a deal.
Can ADHD patients become top students at competitive universities and scientific fields? Absolutely. Absolutely. I've had those students as my patients.
Do Indian schools diagnose ADHD a lot? I don't know. I don't think they, they definitely don't go by doshas. Um, it's interesting like in India, like the understanding of Ayurveda is so like divided. Like some people are into it, and some, most people are not. So they don't understand like, most Indian people don't even understand what dosha is, based on the people I've talked to.
Okay, let's move on. Someone's asking about oxcarbazepine or Trileptal causing ADHD or depression. That's definitely a question for your provider. That's the kind of thing where like, oxcarbazepine and Trileptal can definitely cause depressive kind of symptoms, right? But like, that's definitely something you should, concentration problems, sure. But that's the kind of discussion you should be having with your provider. That's the specificity of like, if you guys really want to do a lecture on pharmacology, we can. But you know, because Trileptal is a mood stabilizer, right? So it's going to like, slow down your action potentials and stuff, which can have a side effect of being depressed and can lead to concentration problems. But I would expect Trileptal to cause people to have like, slow concentration as opposed to like, like rapid stuff.
Is it normal for a psychologist to ask for blood work to be checked before they diagnose you with ADHD? I don't know if it's normal or not. Is it smart? Absolutely. What do you look for in blood work? So we did, we did a lecture on this, chat. There are like six lab tests that everyone in chat should get. You guys should get evaluated for six conditions because one out of two human beings will have one of these problems. 50% of chat will have one of these problems. Anemia, thyroid problems, sleep apnea, uh, what else? B12 deficiency, maybe vitamin D deficiency. What was the other one? Anemia, sleep apnea, thyroid, vitamin D, diabetes. Thanks, chat. Lab tests for gamers? Yes. Thank you, TechTeller. Yup. Vitamin D more than B for us chatters. You.