ADHD as a Performance Disorder

Here I discuss the important notion that ADHD is not a disorder of knowledge and knowing what to do, but one of performance and doing what you know, when and where it would be effective to do so. That when and where I call the “point of performance.” This video reviews why this problem arises in ADHD, what it means for understanding ADHD, and its implications for trying to manage the performance problems posed by ADHD. More information about this concept can be found in my lectures on executive functioning and ADHD as well as in my latest books below:
Taking Charge of ADHD: The Complete Authoritative Guide for Parents (4th ed.) published in June 2020)
12 Principles for Raising a Child with ADHD (published in October 2020)
Taking Charge of Adult ADHD (4th ed.) (Published October 2021)
Treating ADHD in Children and Adolescents: What Every Clinician Needs to Know. (Published May 2022)

[@killzoltar]

I'm literally so thankful for this man and his ambition to get the public to understand this disorder.

[@russellbarkleyphd2023]

Thanks!

[@frenchw1nter]

Oh my god, same here. Dr Barkley's lectures have been absolutely invaluable to me.

[@medicinemom3620]

Same! I just found him yesterday and understand my daughter more now than I ever have!! I am so glad I can gain the knowledge to be a better parent, helping her be successful at whatever she does.

[@sarahlminordesignllc8458]

yes!! I am just now discovering him. Having the diagnosis myself, I'm trying to understand it more, and this was SUPER HELPFUL!

[@patriknsvensson4042]

Yes he have explaind my hole life. Unfortunally i new Everything to late

[@3dchick]

One thing that's helped me is accepting that if I can't see it, it doesn't exist. Food in the back of the refrigerator, office supplies, you name it. I've started simplifying my organization so I can see what I have. Not thrilled with how it makes my house look, but it is helping me not lose things ir spend money pointlessly replacing things I already have.

[@nicktefft6225]

A quantum shift in perspective on managing the disorder. Compensatory, not corrective. Time in the therapist's office should be for building systems, routines, reminders, consequences, rewards, and scaffolding, not just analysis. Another great video, please keep it up.

[@annadachowska24]

It's catharsis for me, from when my therapist who claimed that works with ADHD told me she is frustrated with me that I know about the things that will help me with ADHD but not use it. She still doesn't know why I left her after only two sessions

[@AliDawn]

Face and Palm spring to mind!

[@mslvc2011]

This is literally the central feature of the disorder. This therapist doesn't understand ADHD at all!

[@Najahfreeman]

I remember seeing a short video of you explaining that ADHD was kind of "misnamed". It sticked with me. Explaining it's a performance disorder helps a lot. Just to stop receiving the annoying "Work harder !" and all its variant where they talk to you like a kid, expecting you lived 3 decades without knowing basic productivity tricks.

[@nnylasoR]

✨First!✨ 42yo late-diagnosed AuDHD woman here 🙋🏻‍♀️ I’m so honored to be viewing this - and have more material to share with my [exasperated] husband. 😅

[@russellbarkleyphd2023]

Great!

[@andymellor9056]

Thanks again for this. I am an engineer, and I pay conscious attention to systems and procedures, so I really get the idea of designing accommodating and supportive environments.. For me, things have to be visual. I need to structure my environment so that it guides me to do the things I should be doing and removes distractions. This means eliminating clutter, having a place for things (preferably labelled), using apps that lock out other apps and websites on my phone and laptop, using a bullet journal, so I need to refer to my phone less, making timers visual. Carving out focus time in my schedule so I won't be interrupted, etc.

[@HibiscusHigh]

Thanks for sharing your experience. I am visual as well and would like to increase my visuals. Q: Did u ever have an issue with clutter and piles of stuff sitting and not getting organized and put away? I have many piles in my bedroom - have since a child. How would you suggest launch a beak through to tackle this core issue?

[@andymellor9056]

@HibiscusHigh good question. All. My. Flipping. LIfe. I am making progress on it, however. For me (and we are all different, so I'd say to anyone reading, make your own way through), I am adopting a fourfold approach. 1. No Zero Days. I have promised myself I will do some decluttering, some guitar practice, and some exercise every day. Even if this is only throwing away one bit of unneeded paper, doing one scale exercise, or walking the dog. I have that commitment printed out and blu-tacked to my bedroom wall. The benefit of this is that these things stay in my mind. Some days, I do more. I work from home a fair bit, so I can do 10-15 minutes of one or the other when I'm having a screen break. In terms of decluttering, it's constantly chipping away at the mess, and that sustained effort is paying off. I think we tend to have an 'all or nothing' mindset, and it doesn't help. Decluttering is boring, so small amounts frequently works for me. 2. Triage. Jessica on HowtoADHD has a good video on this. Take a pile. Sort your pile into 3 categories. Act, Store. Dispose. Only when you have gone through the pile do you address the actions / put the things away / dump the trash. As we have been decluttering the house, we have designated places to put stuff that's too good to throw away but that we don't want. We either ebay it or gift it to a charity store or the local free to a good home facebook site. 3. Containment. I recently bought a load of clear plastic stackable crates and am using them to store all my ½ finished projects. Now, instead of being in piles, they are in labelled boxes in one big stack. I can actually see carpet.... A side benefit of this is that it reduces friction in terms of restarting a project because everything is in the box. For paperwork, you can sort stuff into box files and then later sort them into proper oder for filing. 4. Prevention. Stop new piles from forming. I think this is the hardest part, but I always try and e.g. open and triage today's mail before it is tomorrow's pile. Cancel subscriptions to magazines you don't want, try and sleep on impulse buys etc. Hope this helps.

[@kissa3168]

​@@andymellor9056 "I can actually see carpet" 😂

[@kissa3168]

Visuals are huge. I'm doing some remodeling at home and trying to hack my ADHD at the same time, because this project had extended way beyond its initial deadline. So, I figured out, for instance, that if I put the tape measure, pen, and cutter *on top* of the linoleum roll, I'm highly likely to actually measure and cut it the next day instead of get overwhelmed and watch tv instead.

[@vans4lyf2013]

I love your lectures, it's like you observe me personally and base your lectures on my activities lol. I really struggle with chronic procrastination and work avoidance, the only times I'm productive is when I'm in a role where procrastination isn't really possible e.g. customer service or I have daily deadlines and checkins with a boss - it provides so much accountability and helps me immensely. Unfortunately that just isn't sustainable. I'm now in research, the open-ended and often nebulous complex tasks, isolation and lack of deadlines is literally hell for me. I don't want to give up my research career, but feel I may have to if I can't find a way to resolve my task avoidance without relying on other people. I already take medication, which helps a lot with focus, but doesn't do much for task initiation/avoidance. How can people with ADHD resolve chronic procrastination without relying on being accountable to other people? It's just not practical to expect a boss to do daily checkins with me and adds unnecessary work to their plate. They would much prefer an independent person, and there's no shortage of people who thrive on this work style in research.

[@sfstucco]

Wow. Big Wow. Your comment/autobiography/problems could have been written by me. Seriously, everything. I also work in research. Procrastination/task avoidance. All the same. I didn't used to be like that, as my neurotic fear of being "found out" (for being "defective") drove me to overwork constantly. But life did a number on me, and now the procrastination that I had trouble with in my "personal life" moved into my job life. Additionally, I have trouble relaxing in "off time." I didn't have that with jobs that had set times and tasks. Like shift work (the next shift takes over your work).

[@roxanekalmus1483]

I recognize myself in some respects too. I'm a Masters student in film studies and I've been feeling more and more unable to write anything for uni because it is, to put it simply, not stimulating enough. They ask big papers of me (my dissertation especially) that require a lot of research and nitpicking and I procrastinate until the absolute last moment, then get lost in the nitpicking and in the end I do nothing and wait again. I'm interested in the subjects, but I am not passionate and pushed by an imminent deadline here. Other students that feel the same about research are able to power through because "it's just a few papers". I am NOT. The only place I could ever do my work well was film sets (the ever-changing but heavily structured aspect of it fits me). I'm trying to get into film school/a practical film studies program because it's taking a toll on my self-esteem ("am I fucking stupid ?", etc.) Especially when Ritalin apparently doesn't work for me and is the only thing legal in my country.

[@russellbarkleyphd2023]

Thank you. While I try to share the research findings, I have multiple family member s with ADHD and growing up with them gave me even more insight into the struggles with it.

[@publius9350]

@@russellbarkleyphd2023 that's part of why we love you, professor. Your review of the research is what is front and center, but the stories of your family show how you have seen the repercussions and how you are trying to make a better world for people who suffer these issues and the family they affect. I wonder, have you and Professor Thomas Joiner ever had a chance to interact on the issue of suicide and ADHD? He also has focused his research on addressing a matter that is very personal. I wish the healthcare industry (Kaiser, I'm looking at you) took it as seriously.

[@vans4lyf2013]

​@@sfstucco I'm glad to know there are others with this issue. And I completely agree about being able to relax in your off time with a shift job because you know you can't take your work home with you. Whereas when you have a research job that you procrastinate constantly you never feel off and you constantly have a huge cognitive burden of low level stress and guilt due to lack of progress.

[@Finkeldinken]

I really appreciate the term "prosthetic environment" Thank you for this one, it is a really good one for me.

[@russellbarkleyphd2023]

My pleasure. Thanks for viewing it.

[@DarrenGerbrandt]

I knew I had ADHD years ago but was never really diagnosed and recently at age 51 I came across a bunch of information that I did not have before for issues I was/am experiencing not knowing they were because of ADHD and finding they are indeed part of it, to listen to this video and finally feel understood... I just cannot describe the feeling. Thank You.

[@jakeku2662]

These short chunks are very useful in sharing and teaching about the reality of living with ADHD. Thanks.

[@Ace11121147]

Hello Dr.Barkley, a video idea for you might be simply listing the most important research papers/meta analysis of ADHD. A lot of us undiagnosed have to fight for a diagnosis and only way to that is through knowledge.

[@russellbarkleyphd2023]

I will consider it. There are so many.

[@FriendofWigner]

A few years back, before I got my diagnosis, I was constantly having beers with a good friend, trying to work out why I seemed to tank my life every 5-10 years. At some point, he said that he was getting a bit tired of constantly giving me road maps I never wanted to follow. I remember thinking, "I have a million maps in my head, I know how to make them. What I need to know is how, as the navigator, I get the driver to follow my instructions instead of f***ing off to the river to throw rocks at birds." This video is probably the best summary of that feeling I have heard. The disconnect between intention and action is palpable to me, and it isn't always easy to describe that to people.

[@RexyLearnStuff]

Yes to this ! I get so bothered at people giving me "advice" when I mention X struggle. I KNOW!!! For god dake it's so obvious! let me reference all the books I red and videos I watched trying to figure out my issues 😂 I KNOW it all. I just can't do it. Soo frustrating

[@LissetteAzar1]

Thank you Dr. Russell Berkeley. I’m a 3rd grade teacher of an inclusion classroom with many students with ADHD and ADHD + Learning Disability who need to pass their state tests for promotion to 4th grade. Your videos and knowledge have been insightful in discovering ways to be an engineer and support them in their executive function at the point of performance. Simply amazing information!

[@brisafey]

And, BT is working for me. I have a visible list of activities to be performed each morning. I have made notations on the tiles behind my kitchen sink to remind me of several things. I still struggle to add things to my calendar or make a list of one-off things to be done, like an appointment for my car. If those things accumulate I am like a deer in headlights and it can take days to sort out and prioritize... (or, in the case of the car appointment, almost a month). This lecture mentioned "social accountability". A new term for me. But it explains why, if I have made a commitment to others it DOES get done. often late, last minute.. Thank you, Dr. Barkley. I discovered your lectures about two years ago and the information has improved my life.

[@PoppiJuly11]

My paramount daily struggle could not be described better than that. Thank you, doctor Barkley for such a celestial lecture 🌸

[@joelwilliams3115]

This was the concept that made me really understand what ADHD is when i watched your 2009 lecture on youtube a few months ago. My whole life of 29 years, i've wondered why i can know something; why i can know the exact process to do something, and do it well, and yet still never get myself to do it. ADHD is the reason. It's why everything i learned in therapy never gets put into practice, its why the only thing that would ever get me to move toward a goal is stress placed by the environment such as school or work... and even sometimes that was not enough to get me to move. Sometimes i would just let everything collapse, leading to depression. It's why my music career never took off, why it will be hard to ever do anything like start my own business and be self employed. I hope stimulant medication can change this for me when i start it shortly. It's a shame we can't have dopamine re-uptake inhibitors that work for 24 hours, similar to atomoxetine or SSRI's. Anyway, thanks for your expertise Dr Barkley.

[@BongShlong]

Bupropion (wellbutrin) is a dopamine reuptake inhibitor (check me on that) but basically it works 24h. I don't find it very strong but it hast helped me a lot with starting tasks. Like an catalyst in chemistry, it reduces the felt barrier to entry if that makes sense. This has been an incredibly helpful thing, even though the effect is not very strong it does reduce my depression. I usually got depressed due to lack of performance and the resulting consequences like accumulating tasks, shame and bad feedback. It also doesn't me me as anxious and wired as stimulants do. Overall, the side effects seem manageable and I have even stopped smoking, another application for which it is used

[@chillitotes]

I have ADHD. I am mentally exhausted from all the mental labour I have to engage in. There are very few (if any) tasks that I engage in where I am unconciously competent. In other words I am always thinking about what I am doing. I am also a perfectionist and I wonder if this has arisen from being concious when undertaking any task. I have become aware of a thought I have a lot "how can I make this better?". I especially like to make processes more efficient and to a high standard. Could it be that by always concious that I have become a perfectionist. When I started to use Elvanse at 70mg I couldn't bring a thought to mind, it was epic. Unfortunately 70mg was too high (I am on 60mg) and I am finding that it helps with my focus less and less. I like to ponder, don't know if there is an answer.

[@hannahriss1349]

Thank you doesn’t even come close to express just how grateful I and so many people are for your videos, your work, everything!❤

[@vidyapaul8231]

This is incredibly helpful. As I was explaining to my therapist, I was incredibly anxious over an event because I was worried about my performance. 😅 I was told it was ego. (Yes) But there’s a dysfunction/break in the synapse. I can literally feel that. That’s where the frustration and avoidance comes from. I recently started medication for my adhd. GAME CHANGER. Everything you explained that’s happening in our neuro pathways with and without medication support is expressed in my performance. The before and after. 🙏🏽 I’m so thankful for the research and your accumulative explanations. You are appreciated. 🤗

[@sfstucco]

I'm 62, and I figured this sort of "split" between knowledge & performance for myself years ago. But I am glad others have this information now. It would have helped me greatly when I was younger. I always felt mortified/horrified when "caught" unprepared & asked a question in a work meeting, for example, and couldn't access my knowledge, process the thoughts I generated, or verbalize anything. I always came off looking like a dummy. I later (somewhat) learned to say that the question required a thoughtful answer, and that I would like get back to them later with a response/assessment. The split had a lot to do with a life of "failed potential" (along with cptsd).

[@russellbarkleyphd2023]

That’s a fine strategy you used.

[@jimikrakorn6132]

Thank you Dr. Barkley. Your theory makes a lot of sense of my world.

[@russellbarkleyphd2023]

Thanks. I am glad it provides some insight.

[@raymondjurie9047]

Thank you Dr. Barkley for your research in this area, having been recently diagnosed I've found your work through youtube and have found it very helpful in understanding the condition. Not only does your passion shine through but your manner and communication skills help late adult diagnosed people like myself make sense of this all. Your friendly and sympathetic approach backed by your rigorous research and and analytical ability have been literally a lifesaver for me, you have made a difference to so many people so cheers to you and keep up the good work.

[@Chizuru94]

Thank you so, so much for this additional short video covering this! Never has a sentence resonated more with me than when I heard that sentence in your lecture back then (paraphrasing); "People with ADHD know what to do, they just can't do what they know". And that still holds so true for me. Also, learning smth and applying it after knowing how to do it, actually doing, muscle memory and more. I'm almost 30 now and consider myself still unable to live or do or work on my own. Medication is also hard to get in Germany or rather the right one and even treatment or a psychiatrist. My brother is even 36 and my other one also, both likely also untreated ADHD. It sucks on so many ends :( So again, thank you so much for all these videos, they are much appreciated for people who just want to inform themselves and those with ADHD alike!

[@russellbarkleyphd2023]

My pleasure. Thanks!

[@Kruglord]

This is such a fantastic perspective. I've been saying for a years now, "I'm good at my job, I'm just bad at doing it," and that is really backed up by this explanation.

[@Chizuru94]

5:55 So so true. Also expains why years of therapy and CBT never helped me (I'm sadly still unmediacted). I KNOW what to do, but can't do what I know. Same goes for social anxiety etc. I know I don't have to be afraid and will be fine, but my body rings all alarm bells still and nothing helps for a long duration. For my brother, no anxiety med or antidepressant ever worked as well. Also since it's likely dopamine related for us D:

[@danamckerrow9902]

Thank you for another excellent resource article, Dr Barkley. I use one specific soundtrack as scaffoding to prompt and guide my morning routine, (akin to a Pavlovian response), and being a set length helps with time-blindness, too 👍

[@russellbarkleyphd2023]

Thanks. I have a video on time blindness coming on Thursday.

[@AliDawn]

This is a great idea. I love music and use it all the time to help me with mood, energy and to get over that initial inertia/ procastination. I've never thought about using it to help with Time Blindness too. I'll give it a go.

[@danamckerrow9902]

@@AliDawn Good-o, AliDawn, consider coming back to let me know yr soundtrack. I use Songs about Discipline by Akira the Don ☆☆☆☆☆

[@AliDawn]

@@danamckerrow9902 sounds interesting. I'll give them a listen!

[@WonkyGrub]

One thing that I find could be hard to overcome in adult adhd is that the artificial rewards and consequences would be self imposed, and thus might carry less weight as motivators as they are known to be somewhat arbitrary potentially. What are your thoughts on that, and perhaps ways to address that?

[@yarntoast]

Artificial rewards don’t work for me at all. With my impulsivity I generally just get myself the reward if I’m able and that’s that.

[@lyndafjellman3315]

You hit it on the nailhead for me. I have tons of knowledge, but just can't get anything done.

[@Chizuru94]

Same and also with applying stuff, even skills that are "learned". Best to you as well, though and it getting better bit by bit and easier!

[@Pazaluz]

I've been researching ADHD since i was 16 and suspected i might have it after reading about it. I got diagnosed at 27 with inattentive type. Now i'm 31 and taking medication. I'm very great full for the videos you make and the information you share with us. It has been far out the most helpful in understanding myself. I've been an intake patient for other mental health issues, and when i mention adhd they'll note it down but it mostly stops there, unless you bring it up yourself again. It feels like it's not always taken very seriously. A lot of psychiatrist are also not very keen on prescribing stimulants. I also noticed that A LOT of psychiatric patients have adhd and/or autism. On top of other mental health disorders like borderline, psychosis, schizophrenia, addiction etc. But the doctors focus mostly on these as they're more urgent or serious, and adhd goes to the background and isn't discussed as much.

[@eecneihappy]

❤ Thank you so much Dr. Barkley this was wonderful. We appreciate you so much and this was a great way to think of the brain.

[@russellbarkleyphd2023]

You are too kind. Thanks for watching.

[@naturally_rob]

So, regarding those who were diagnosed with ADHD in adulthood? I was diagnosed over a year ago, but I'm struggling all the same. I have seen 4 different therapists and 2 psychologists since my diagnosis, all of whom have pushed to me that I need to understand first. I've spent the past 3 or so years trying so hard to understand as many aspects of ADHD as possible. I've spent late nights reading research papers over and over again. I've talked extensively about it with my girlfriend and a college. Yet, it's pushed to me that the problem is that I do not know enough or that I am not trying hard enough. I'm told to do better, sometimes told how, but rarely am I given the support to do so. I have sticky-notes scattered all over my room and my laptop. I have 10 or so "open-faced" notebooks. Four of which are devoted solely to my diagnosis, my treatment, and my reading of research. I routinely ask for clarification and a moment to write down something the words the professionals I've seen spew at me. I know big fancy words regarding ADHD that touches on the neurological, psychological, and social aspects of this disorder. What do I do? What support is there for adults with ADHD who are past getting support from schooling and parenting? Is it a matter of me continuing to try different therapists and psychologists? Or am I missing something?

[@kissa3168]

I relate to your struggle. As adults, we don't get the same systems that push and reward us as when we were kids. I would suggest creating your own. For instance, you want to go out to see a movie, so you make a deal with yourself (better yet, tell someone, such as a friend) that you can only do that upon completing a task that you have to do. This might sound ridiculous, but it does actually work, depending on the importance of both the task and the reward. I'd also recommend joining an accountability group or finding an accountability buddy.

[@RexyLearnStuff]

​@@kissa3168 I don't understand the making rules for yourself. Maybe it's defiance disorder or my adhd is just way out there in impulse control,but My brain is like "oh rewards! Exciting!why wait until after I finish! , I'll just give myself the rewards and do the work after... "😂

[@kissa3168]

​@RexyLearnStuff That's absolutely true, too! This is not a 100% foolproof solution, because it only works under certain circumstances. In my case, it becomes like a game. But I'm not in the mood for games at *all* times, so then I have to use other tools to get shit done. Not that it always gets done, mind you.

[@Alex-js5lg]

If we consider ADHD as a performance disorder (which I think makes sense), I think we have to also consider the impact of performance on *storage* of knowledge. A deficiency in attention limits the amount of information that can be absorbed for two reasons: 1) You can't absorb what you don't hear/see/process; 2) Irrelevant distractions can overload working memory - at least as I understand it - which can inhibit the brain's ability to store each of the individual "chunks" of data held within the working memory at a given time. I consider working memory to be analogous to RAM in a computer. Your computer only has so much capacity to process information that it's actively working with. Anything over that capacity gets relegated to slower, larger storage systems or is overwritten (and therefore lost or corrupted).

[@RexyLearnStuff]

I always joke at my husband that I have very little RAM in my brain that's why I need a lot for the millions tabs open in my computer 😂

[@desktopkanbans]

I believe that individuals with ADHD could benefit from effective visual structures, similar to those provided by digital Desktop Kanbans.

[@PRASAD_PAWAR_MB]

I am diagnosed with ADHD for Attention level and the great part is that my therapist said its treatable. but this knowledge, its really sparked my interest in understanding about my ADHD. Its really helpful and insightful for person like me

[@miklassic]

Thank you for sharing your knowledge here too, Dr. Barkley. I have your book, but It's so much easier to listen than to read most of the time ;) I hope I finally get to it though!

[@russellbarkleyphd2023]

Many adults prefer the videos for learning. Thanks!

[@weaviejeebies]

This is probably why I feel fed up with people who either take the "oh c'mon grow up" track or (worse imo) a condescending, "sigh...don't you know how? Awww, you should've asked...here, let me tell you..." In my experience, they use a tone that's appropriate for a toddler or a particularly smart pet. Like, really? Gee, I never thought to actually learn how to do stuff, that's certainly the root cause of all my ills, wwwwoowwww. Thanks, SuperNT! My life is now forever changed all because of your insight. Not. These days I've learned to put my hands up and say, "I haven't started because I'm struggling with my disorder. There's a piece missing from my scaffolding, and as soon as I figure out what, things will commence. If I need any help at all, I'll ask. Right now, what I need from you is understanding and refraining from the urge to micromanage." If they can't honor that, that's generally when 🤬 tends to give me the space and time I need.

[@tanvipunjabi104]

...can't find sufficient words to Thank You Dr.Barkley. You help in 'knowing self' so to speak....you help in removing guilt, shame and most of all - multitudes of confusions....its like two people living in one brain mostly opposing each other. Listening to what you are saying so very specifically so clearly lays a patch of peace between those two, which in turn seems to have started helping these two opposing entities to coordinate n cooperate. Get to see the actual n factual problem and focus on correct manner of solving them. What could better in life than receiving the light n guidance towards correct road to thinking. Gratitude Sir. Salute! Dr. Barkley. God bless you. Love you😊

[@Alex-kj9rc]

Another excellent video!

[@russellbarkleyphd2023]

Awesome!

[@soberich1]

54 years old, only been diagnosed for 4 months. 21 days on vyvanse 40 Literally life has changed Bit a proper shit show for 50+ years All the usual chaos , This guy has taught me more in a few weeks of valuable information that makes complete sense Thanks so much Russell much love 🇬🇧 I’ve subscribed and am like a sponge at the moment

[@soberich1]

Been a proper

[@whitway]

53 and diagnosed about 3 months ago myself.

[@fabiengarcia3011]

Thank you for this video ! I dont't understand very well the power of urgency, motivational stress, deadlines, social motivation... on adhd (just fuel tank boost ?). CDS also as a Performance Disorder ? Thanks again :)

[@99koto]

Ok, so I've watched a lot of your videos, but the ramp example you provided, hits the nail on the wall. I have a mental performance disorder. How the person with the wheelchair needs a ramp, i need my environments to aid my mental performance.

[@antkcuck]

The way you explain this is fantastic, thank you so much

[@russellbarkleyphd2023]

My pleasure. Thank you too

[@ivana61681]

No one understands this disorder and no one can explain it better than Russell Barkley. I’ve listened to other experts (Brown, Ramsey…), but Barkley’s presentation skills are second to none, which is why it is such a joy to listen to him.

[@AurielleAurora]

This is SUCH valuable information! I needed this today

[@lucas.severo]

Dr. Russel é minha grande referência pra conseguir compreender cada vez mais o TDAH. Obrigado por ser essa luz

[@chrisriis]

Thanks doc for your commitment to sharing your insight!

[@jakeku2662]

Any suggestions for treat an adut who is chronically anhedonic and isn't motivated by rewards?

[@mguitarte]

Thank you, Dr.

[@russellbarkleyphd2023]

Thanks for watching it.

[@hmelt004]

Thank you so much for this information! I am learning so much about my brain from your work.

[@999dream000]

it's this lifelong attempt to "figure out how to do things". "i am bad at doing things", i search. "how to get things done". i know so much but i still can't *do* the things that would *help me to do things*. it's circular and hard to get out of... i wish there were better supports. i went to an adhd doctor and they said i have some heart condition that means i can't have adhd meds - i wasn't able to ask them about non-stimulants at the time and they removed me from the service. they didn't hear me out right - i told them the thing i struggle with most is getting things done, but they said they couldn't see it or something

[@russellbarkleyphd2023]

I am sorry to hear of these travails with your health service. The quality and availability of services varies markedly around the world and within each country. Try the European Network for Adult ADHD website.

[@999dream000]

@@russellbarkleyphd2023 what exactly am i looking for on that website?

[@sarahlminordesignllc8458]

Thank you, Dr. Barkley, for providing such an insightful video! It has been incredibly informative, and I intend to share it with those who may not have a full grasp of what ADHD entails. I greatly appreciate the efforts of dedicated doctors like yourself who work tirelessly to dispel misconceptions and raise awareness about ADHD.

[@awol526]

Thank you so much for sharing your lectures, Dr. Barkley!

[@thehighpriestess8431]

A special request. People with ADHD and Bipolar can be treated for both?

[@Self-Care-Embodiment-Coach]

Thank you.

[@nananoname3089]

I've seen videos of yours reposted somewhere several times.. but today I looked for a yt channel and I'm so happy I found it *-* .. had a total breakdown day over exactly that problem today .. I've been in therapy for over 1.5 years now and it has helped a lot already but these key points are still generally unchanged for me .. I have no regular outside structure as a uni student redoing courses and it's soo hard to find people that are relyable and willing to provide structure for me. I'm so happy someone from a therapy group agreed to meet up weekly to work on whatever.. these mondays have carried me through the whole summer semester and I'm so thankful for that. ...still, the other 6 days I struggle so hard and I'm so frustrated and I just want to get better at life (again?)

[@nananoname3089]

Bit of a rant.. oops

[@jeanjones2281]

This is why i dont believe in moving kids to the next grade ONLY by testing scores. many adhd kids do much better in later years of high school because they have been taught the tools to use. I am adhd. All 4 of my kids are adhd. And my grand child is adhd. I taught my kids how to make lists, use stickems and visible calendars, use timers and alarm clocks. Also over and over I partnered in any organization skills such as cleaning their rooms, organizing their desks and lockers etc. Using the tools and consistency over and over has made it much easier for them as adults.

[@angelleburrus]

Thanks so much this makes so much sense, now I am confident that I'm on the right track to finding a solution that sticks and works!

[@maryannprice3429]

Meds are helpful but as a professional singer,I have an out of body ear, which listens as I sing simultaneously giving me feedback,but I still sing vocal exercises to relax me to the point of being relaxed enough to allow myself to open the door for the ‘ear’.

[@maryannprice3429]

Access! I may have add but relaxed singing draws from a deep pool of creative force over my right shoulder. I guess the reward of good singing allows focus for me. But before a show I still need to warm my voice. Otherwise, I’m warming up in public on songs 1 and 2!

[@jhmstagg9104]

I'm going to have to listen to this a couple of times. It's still necessary to figure out how the meds are going to help you or what you're going to do when you are taking the meds. Or how to know if the meds are working. When you're an older adult your strategies are a little bit different in figuring out what you are and what you aren't doing that is working or not

[@annaharris2870]

Thanks Dr Barkley, I really appreciate your videos. As an adult with ADHD, most of my 'performance' challenges are in the workplace. I have checklists and visual prompts, lots of accessible reference information etc. Do you have any advice for people with ADHD to find ways to speed up our performance? I have spent a lifetime compensating for ADHD by doing a perfect job every single time which, of course, makes me very slow. If I didn't work in a disability-related sector, I don't think I would have a job at all. Thank you, Anna.

[@AliDawn]

@annaharris2870 yeah, exactly my problem too. I know what to do and have all sorts of lists to help but I still struggle with procastination and flitting from one task to another because they all seem so important. I have started to many things but haven't finished very much.

[@AliDawn]

Oh, and compensating for my adhd through perfectionism has totally been my strategy to cope with work and home life. I don't have time for this in my new job as I am too busy and have to demonstrate output rather quickly. They would just rather things got done and then refine them later. Plus, I am expected to make decisions on the spot. My usual approach of doing lots of research and perfecting my documents isn't going to work in my new job but my Imposter Syndrome is stopping me from just relying on my knowledge and gut instincts. I keep flitting from task to task too because there is so many important things to do but it means I have started lots of things but not finished much so I have very little to show for my time working here so far. I also keep getting distracted by urgent issues when they arise instead of focusing on getting the foundations properly in place which will hopefully mean less of the urgent things will come up.

[@annaharris2870]

@@AliDawn Hi AliDawn, I completely understand and appreciate your struggles because they are mine too. I have invested in ADHD coaching which has been helpful to a point. There are battles of the mind that I may need to work through with a psychologist. The reality is, I'll probably always be slow unless I snare a job that fits with my natural talents / areas where I am already confident & quick. What are your strong areas?

[@AliDawn]

@annaharris2870 yeah, I am tempted to get adhd coaching. I have a fantastic therapist that I've been seeing for 10+ years but maybe more specific coaching whilst I have this new job is a good idea. My job suits the perfectionist/hyperfocus part of me but have always wondered if I would be better in a more creative role, ideally in music. But I don't have the self-motivation/ control to follow my music so a job where I have to go into the office is what I need atm.

[@cammerations]

I really want more detail about what those systems would look like. I just don't know where to start

[@AmandaJuneHagarty]

What's the old saying? Give a man a fish and you feed him for a day, teach a man to fish and you feed him for a lifetime...if he has ADHD make a sticky note.

[@stmcm]

I have a question in regards to CBT-interventions. A Token System - could it look like this: - On each Sunday set the Tasks and fun stuff for the upcoming week, for each day. Say, 2 private- and 5 work related tasks of the day. - Each task that is done gets you 1 Token. - Tokens can be redemmed to do the fun stuff but only for the specific day. - No done task = no tokens = no fun stuff. Some tasks done = some tokens = some fun stuff. And so on. Would that approach make sense? And is there a book or paper that addresses concepts like this?

[@russellbarkleyphd2023]

It makes sense. If it’s for a child, I describe setting up such a program in my books, 12 Principles for Faising a child with ADHD or Your Defiant Child. I don’t know of a book that describes it for adults but check the books by Ari Tuckman to see if he describes it.

[@KairosDBT]

Thank you again.

[@Finkeldinken]

Question for you, Dr. Barkley: I've been wondering if pathological demand avoidance is seen in ADHD, or is that an ASD thing exclusively?

[@russellbarkleyphd2023]

It’s SSD and also oppositional defiant disorder, I think.

[@Finkeldinken]

@@russellbarkleyphd2023 thank you for the response, I only got the notification now, but I do really appreciate it!

[@leonardosturzbecher2875]

Dr Russell, thanks for your great content! I'm from Brazil and I follow all your videos. Could you please help me with a big question? I am very afraid of taking Ritalin or venvanse in the long term, because I am afraid of desensitizing my neurons or having some very strong side effect in the long term. I am 28 years old and I have been taking the drug for 1 year. I have moderate/severe ADHD and would need to be on medication for life. God bless you and thank you for sharing your content with us.

[@cjsun7871]

Thanks!

[@EdwardThomasLee]

We are aweful at first impressions. But a lot of life is first impressions. Like dating, job interviews, and meeting people.

[@ribok4o]

Dr. Barkley... reading previous comments I find that all has been already told, therefor as a diversform of my gratitude I present to you - The Beatles

[@teresaharris-travelbybooks5564]

How do you apply these treatments for adults? You can't believe that ADHD adults are going to find prosthetic environments in the real world? How many workplaces are even going to be able to provide noise free, stress free, trigger free environments? And not everyone can work from home. I'd like to hear more about the 'social accountability ' behavioral therapy.

[@braincuriosities]

Hi Dr Barkley! Isn't knowledge stored in the temporal lobe and the dlPFC though? decorative memories get stored in the hippocampus then via thalamic connections end up in the prefrontal according to most literature on memory. In that case how is the Parietal Lobe the one considered the knowledge part of the brain but not the PFC or Temporal Lobe? Isn't also the Decision making network within mesial-temporal areas including the striatum and the precuneus? Thanks in advance, and thank you for informing people.

[@braincuriosities]

Also to what extent state dependent memory could be the reason training interventions do not work?

[@russellbarkleyphd2023]

Yes, that is true for the most part but my video on this does not single out the parietal lobe as the storehouse for memories but the entire posterior part of the brain, including subcortical structures like the hippocampus. As I say, the view is a gross oversimplification but it is used to make the point that ADHD, being chiefly a frontal and prefrontal region disorder, is a performance, not a knowledge disorder.

[@braincuriosities]

@@russellbarkleyphd2023 that makes a lot of sense, thank you for your answer!

[@db1777]

If I could only figure out how to make boring tasks interesting I could finally catch up on paper work I've been putting off for weeks sitting on my desk.

[@acalavidyaraja]

thank you, Dr Barkley. I am on the way to my psychiatrist right now. He will prescribe me Strattera.

[@_ktbelle_draws_3223]

Thank Dr Barkley!! What recommendations do you have for 1 learning about the “scaffolding” and implementing it for oneself as an adult struggling with adhd, and 2 for a spouse who wants to help but doesn’t desire to be a “parent” in the marriage?

[@sussiq8812]

What to do if adhd and autism coexist?

[@JohnSWren]

Need examples. Not learning, performance. Same problem with sports, reading about tennis doesn't improve performance. Yes, I understand that. Practice, practice, practice. I find it impossible to understand how to use that insight with ADHD. Practice what?

[@lakritzeslena]

Just sent this to my former therapist 😏

[@adrianopper9472]

ADHD can affect the short term to long term memory, though

[@shadowmystery5613]

Also modern world: Jusz cram enough knowledge into people brains and they automatically succeed - if not it's entirely their their fault and they're stupid and lazy XD We also need compensatory strategies beyond slapping people into 8 hour work days so they have enough down time for things that interest them and where they can let their mind run free. Because what's the purpose of work if you just burn out like a jet engine and need expensive treatment in psychiatric wards in irregular intervals or a new employer every few months 😂 Not to mention the enormous loss of income vs. normal people - totally "fun" to get shafted from economic and financial stability, earning only half of what you could or in my case, being told I'm not even worth being paid minimum wage 😆

[@bejornv]

Soo basically we're screwed

[@nezarmohammedtourabi5026]

ADHD is not a disorder!!! Just a different brain wiring!

[@AliDawn]

It's a personal choice to decide if people want to call their ADHD a disorder, disability, condition, difference, neurodivergence, or something else. I like the term neurodivergent because it helps me understand that my brain works differently to other people's but still makes me feel valid as a person. However, I still say it is a disorder because my life is very disordered and a struggle because of my adhd.

[@yarntoast]

Yes, it is a disorder because to be diagnosed requires impairment. To say otherwise is ableist and dismissive to those of us who struggle.

[@fascistscansuckit]

Until I was diagnosed and medicated I never knew I had a constant level of background stress/anxiety about performance: Will I be able to do alll the things? Remember? Organize? Prioritize? All my daily activities and responsibilities? Stimulants have removed it! If I forget meds, my lower rib cage will start to feel tight, bc my abdomen begins to tense up..so stimulants have been the best anti-anxiety treatment, specifically performance anxiety. All the mh "professionals" I'd consulted with through the first few decades of my adult life just pushed the button for depression! Anxiety! And gave me medications for them, which never worked. I just wish more mental health practitioners knew how to differentially diagnose adults for ADHD, who had never been previously diagnosed. Particularly women.

[@AliDawn]

@russellbarkleyphd2023 , so much for this. It is a similar concept that I've been using for a while to describe my adhd, a term that I borrowed from ASD and other processing conditions where the difficulties are expressed as whether the person has difficulties with the "input" of information or with the "output" of information. My difficulties are mainly with the "output" of information which is akin to your "performance" terminology. I like both terminologies and will definitely think about adhd being a "performance" issue. However, I still like thinking of it as an "output" disorder too. All of the information, aka things that have been inputted into my brain, aka "knowledge " is there locked in my brain. I just struggle to piece the bits of information together into a sequence that makes sense to other people, especially when it comes to speech. If someone asks me a question my brain will respond by giving me every word / concept, that I could say back to them all at once and mix it it in with some emotions and visuals too and then I have to consciously sort through that mass of information to pick the words and string them together in a way that is coherent for the other person. Unfortunately that second stage of the process is done by my working memory / executive function and it is pot luck as to whether I will pick the right words in time before I forget everything that was given to me in that bag of data. This also takes time so I look like I'm really stupid and don't know the answer to the question when I do know the answer, in fact I could give a thousand different really detailed answers if I could do a direct mind link, but I know I have to pick the one the other person will understand rather than the disordered bag of answers that are currently in my head. Then cue the anxiety which makes the processing even harder. Then, because I've taken so long to respond, the other person thinks they have to repeat their question in a slightly different way which just means my brain dumps more information into the cache that I am trying to sort through. Thankfully, my meds have made my speech a lot easier if it is something I am really knowledgeable and motivated about and if I can stay calm. Still really annoying though when my brain suddenly forgets random words, even though they are quite simple words. Then the anxiety comes back in.

[@800wooden]

Thanks!