ADHD Symptoms or Moral Defects?

Ah, ADHD. The, "defect of moral control without general impairment of intellect and without physical disease." While, this 1902 observation by a professor of pediatrics often cited as an early description of ADHD probably lumps ADHD in with conduct disorders, the inappropriate sentiment that ADHD symptoms signal moral deficiencies seems to linger today.

It's understandable to some extent; people with ADHD have issues with impulsivity, attention, and hyperactivity. This can lead to some mischievous, disruptive, or obnoxious behaviors, especially in the classroom, but misinterpreting misbehaviors that stem from ADHD as moral defects is unhelpful and damaging.

ADHD Symptoms Are Not a Choice

When people misinterpret ADHD symptoms as moral failings, a person with ADHD may incorrectly feel as if he or she is rotten, lazy, selfish, slovenly, uncaring, etc. This misconception can have a devastating effect on self-esteem, especially if the ADHD goes undiagnosed for a long period of time.

Regarding ADHD symptoms as character flaws implies one can improve his or her symptoms through increased intention, care, effort, or practice. When intention, effort, care, and practice fail to correct unwanted behaviors, as they most certainly will, the person with ADHD can feel demoralized, perplexed, ashamed, and downright stupid.

The person with ADHD is often left asking, "Why can't I just get it together? Why can't I just be normal? What is so hard about getting stuff done? Why can't I remember anything important? What is wrong with me?"

The answer is NOTHING! Nothing is wrong with a person who has ADHD. ADHD brains are zebras in a world built for horses. You can't saddle up a zebra and expect a trail ride, but well-designed alternative strategies and appropriate support can help zebras live healthy, stripe-proud lives in a horse's world.

People With ADHD Care -- A Lot

Tying ADHD symptoms into moral parameters complicates treatment. It misidentifies the underlying cause of undesirable behaviors as willful rebellion, which implies the individual can and must use willpower to overcome the behaviors. In reality, people with ADHD use a profound amount of willpower in an attempt to control daily ADHD symptoms. Willpower is not the problem nor the solution to managing ADHD symptoms.

Successful ADHD treatment consists of creating the right set of circumstances to support the ADHD brain. This necessary support can be achieved through stimulant medications and/or intentional workarounds. These workarounds take time and creativity to implement and some may only work short-term as novelty wears off, but, not to worry, there is a large, supportive community of ADHD individuals who are eager to offer ideas and myriad resources from which to glean wisdom. There are also ADHD coaches, therapists, support groups, and even Brain Balance centers that can help.

Unfortunately, even when ADHD has been diagnosed, it can be easy to fall into the trap of mislabeling symptoms of the disorder as moral failings. Let's look at the symptoms and discuss how they can be misconstrued as moral weakness by the person with ADHD and those he/she interacts with:

Impulsivity:

Has difficulty with delayed gratification

Acts before considering the results or consequences

Overreacts

Pursues interests/ideas with short-sighted urgency

Moves from task to task without finishing

Speaks without thinking

Interrupts

Acts with unusual determination

How it Appears to Others:

Uncaring

Stubborn

Inconsiderate

Selfish

Irresponsible

Idiotic

Obnoxious

Self-serving

Impatient

What Impulsivity Feels Like:

The same professor who described the moral defectiveness above also observed in ADHD "an abnormal degree of passionateness”. This is actually a great way to describe how impulsivity feels. Impulsivity can make every task seem urgent or no task seem urgent. Signals to complete important tasks can come through in the brain as fleeting whispers while less important or totally unnecessary tasks can feel like urgent commands.

Trying to control impulsivity, which most people with ADHD do to an exhausting degree on a daily basis, feels like carrying on emptying the dishwasher when you've just spotted Bigfoot out your kitchen window. Impulsivity feels like an urgent energy or pull that fills your stomach and seeps into your throat. Sometimes it expresses itself in quick bursts of behaviors or words that bypass the logical brain leaving the person befuddled by his/her own thoughtless actions. Other times impulsivity pushes a person into the car in her pajamas to buy a chicken coop and a dozen chicks before Home Depot closes. In either scenario, impulsivity feels like an overwhelming push, a rush of urgency, or a spilling over of hardly conscious words or behaviors-- surges of unreasonable passion.

Why it Happens:

The brain uses dopamine to set the "weight" or "volume" of brain signals. This helps a neurotypical individual determine what is most important in the moment. Because the ADHD brain is wired differently and often has a deficiency of important neurotransmitters like dopamine, the "volume" of brain signals becomes dysregulated. Tasks that neurotypical brains would easily label as priorities with strong signals can come as whispers to the ADHD brain, especially if they are dopamine-depleting tasks. Starved of dopamine, their brains' strongest signals center around acquiring it. And shopping, taking risks, learning something interesting, social media, sugar, novelty, food, arguments, and gossip are all quick ways to get it. Attending to a task? Not so much.

Ever wonder why people with ADHD procrastinate? Putting off important tasks leads to an adrenaline surge, which floods the brain with epinephrine and, like magic, the ADHD brain can finally attend to the task the person has wanted to get done all along. Talk about a recipe for developing anxiety disorders!

Effect of Impulsivity on Self-Esteem:

Often people experiencing impulsivity with ADHD feel badly for the impulsive actions they take and feel desperate to prevent them from occurring again. They cannot understand why they continually choose to blow off responsibilities in favor of more interesting activities or why they say or do things they instantly regret. They may develop anxiety disorders including social anxiety or obsessive-compulsive disorder because they fear they do not have control over themselves and may suffer the shame, stress, hopelessness, and lack of self-confidence that comes from chronic procrastination and task avoidance.

Hyperactivity:

Has difficulty sitting still

Climbs about/on the move

Fidgets

Feels restless or easily agitated physically or mentally

Constantly searches for physical or mental stimulus

Talks too much, too loudly, or too quickly

Moves or pursues tasks as if driven by a motor

Experiences racing or overlapping thoughts

How it Appears to Others:

Inconsiderate

Neurotic

Obnoxious

Willful

Defiant

Undisciplined

Impatient

Uncaring

Wild

Strange

Workaholic

What Hyperactivity Feels Like:

Hyperactivity in ADHD feels like a surge of energy in the chest or "ants in your pants". It can feel like you are being chased by an invisible bee and, because nobody can see the bee, you just look like a crazy person swatting at and running from nothing. It could also feel like, as the symptom checklist describes, you are "being driven by a motor", meaning you are moving from task to task almost as if driven by an outside force.

Because of social pressure to sit still that begins in elementary school, many people with ADHD turn their hyperactivity inwards in an attempt to hide it. Many adults with hyperactivity settle down physically over time, which gives the impression that they have outgrown their ADHD when, in reality, they have just hidden the hyperactivity within themselves. They go about their day with a brain full of hummingbirds, flitting from task to task. Relaxation is not something attainable or appealing to a person experiencing hyperactivity and they may feel impatient with anything or anyone that derails them from their tasks.

Why it Happens:

The ADHD brain needs more stimulation from the environment than the average brain to make up for its deficit of neurotransmitters like dopamine and norepinephrine. It can get this stimulation in several ways including: novelty-seeking, misbehaviors, arguments, movement, sugar, risk-taking, talking, and fidgeting. Boredom or "relaxation" in the ADHD brain can feel highly intolerable as it signals the urgent need to boost languishing dopamine levels.

Effect of Hyperactivity on Self-Esteem:

Hyperactivity can have undesirable social effects as neurotypical classmates understandably wish to separate themselves from "troublemakers" who step on their boundaries and break rules. For adults, many hyperactive symptoms turn inward and become racing thoughts or overly chatty behaviors, which can complicate social interaction. Adults may also attend to tasks with hyper-focused energy, unable to attend to other people's needs for attention or nurturing. These social consequences can leave adults and children feeling lonely, ashamed, unworthy, and unwanted.

Inattention:

Behaves absent-mindedly

Forgets items, responsibilities, commitments, events, and conversations

Appears to not listen when spoken to directly

Daydreams

Makes careless mistakes

Has difficulty following conversations

How it Appears to Others:

Spacey

Unreliable

Irresponsible

Thoughtless

Self-absorbed

Lazy

Weird

Stupid

Careless

Inconsiderate

What it Feels Like:

Inattention feels like having a brain full of butterflies. You know you are supposed to catch them in your net, but you cannot catch them all at once. You are not sure which one to go after, so you chase the prettiest ones. You have no jar to keep the captured ones in so they sometimes escape the net. It's a symptom that one usually realizes after it has happened and is left scrambling to catch up with the moment.

Why Inattention Happens:

Dopamine is involved in memory and attention processes, so not having enough obviously affects those abilities. Additionally, the ADHD nervous system plays by different rules than the neurotypical nervous system. Most nervous systems respond to the world by learning to seek reward and avoid punishment. They do this by creating reward and avoidance pathways in the brain. When these pathways are activated, the nervous system signals how it needs to attend to the situation and determines an appropriate response to prioritize survival, reward, and avoidance of punishment.

While people with ADHD cognitively recognize the benefit of seeking rewards and avoiding punishments, their nervous systems don't seem to wire up in the same way as most people, which leaves them largely unmoved by rewards/punishments that motivate most. They find themselves putting forth enormous efforts to get motivated by the same things others get motivated by. It's not that they don't care, it's that their nervous system motivates them to action using different parameters.

Rather than rewards/punishment the ADHD nervous system is wired to attend to information related to personal interests. Not, self-interest, but personal interests, as in, information that provides insight, excitement, intrigue, or curiosity. Because of this "alternate wiring", the nervous system of people with ADHD seems to prioritize personal interests over rewards and punishment avoidance.

This type of nervous system has advantages in that it allows people with ADHD to take risks, explore, create, question, and dig deep into the world around them. It's a nervous system built for ingenuity and entrepreneurialism and even high-stress, emergency situations, but it can cause real challenges in a world where attending to repetitive, and often dull daily tasks are necessary to maintaining physical, emotional, and social health.

One can see how this type of nervous system might appear self-serving to others, which can be frustrating for the person with ADHD who is subject to the ADHD nervous system's interest-based filters. See this fantastic article for more details and tips on dealing with the ADHD interest-based nervous system.

This type of nervous system contributes to inattentive symptoms as the "brain task manager" prioritizes interesting input over input that may be important but less interesting. This can pull people with ADHD out of the present moment and into their internal worlds.

Effect of Inattention on Self-Esteem:

People with inattentive symptoms are often accused of not listening or caring about others. They forget important commitments, are "time blind", and ask questions they should already know the answers to. This leads to a great deal of shame as they struggle to express the care and concern they have for loved ones in the ways they are expected to. In reality, they put a lot of daily effort into sustaining attention to details their brains would rather ignore and refuse to "glue in place".

Task Paralysis:

Unable to complete simple tasks

Procrastinates

Avoids undesirable yet necessary tasks

Busies him/herself with meaningless tasks in effort to avoid

How it Appears to Others:

Lazy

Unreliable

Selfish

Stupid

Uncaring

What it Feels Like:

Wrangling an uncooperative brain by, for instance, electing to create a meal plan for the week instead of pressing "Next Episode" or heading to the pool, can sometimes feel like forcing oneself to lift a boulder from one's chest, slog through mud, or squint one's way through foggy, unfamiliar territory. It can feel like a short circuit, or "systems" going offline. It takes a heavy, wearing effort every day to fight with an uncooperative brain-- a nervous system that has priorities mismatched to the necessary daily tasks. A person experiencing task paralysis knows what he or she needs to do and wants to do it on a cognitive and moral level, but just cannot manage to get his/her body to cooperate. This can cause deep shame and frustration.

Why it Happens:

Motivation and rewards for completing tasks are brain processes that depend upon neurotransmitters and nervous system pathways. One can see how a brain starving for vital neurotransmitters would be reluctant to perform tasks that would not produce any or enough to be worthwhile. When the brain refuses to cooperate in this way, the individual is left to either assert exhausting, Herculean willpower to complete tasks or avoid tasks until they gather enough urgency to provide a spark of adrenaline, thus making the task worthwhile chemically to the brain.

Task Paralysis' Effect on Self-Esteem:

Task paralysis can cause self-loathing, frustration, and distress. It can devastate one's self-esteem as one compares him or herself to others who seem to have no problem attending to tasks. It can make a person feel as if he or she is lazy or worthless. He or she may despair over constantly disappointing others and him/herself. For mothers with ADHD, this can be especially devastating as traditional social values communicate highly task-oriented expectations (cleaning, cooking, scheduling, budgeting) for successfully managing a "happy" home.

Researchers Studied Relationship Between ADHD and Moral Maturity

ADHD symptoms do not indicate moral weakness. Even science says so. Check out this preliminary study that tried and failed to indicate a relationship between ADHD and poor moral reasoning. In this study, researchers hypothesized that because a significant number of inmates also suffer from ADHD, a diagnosis of ADHD would most likely mirror deficiencies in moral reasoning. Instead, their research showed, "a diagnosis of ADHD does not appear to hinder the development of mature moral reasoning." They actually found that IQ was a better predictor of mature moral reasoning than an ADHD diagnosis (higher IQ = more mature moral reasoning) and concluded that moral reasoning was a complex mechanism that required more research.

While ADHD symptoms can result in undesirable behaviors, the behaviors are not willful but are manifestations of depleted neurotransmitters and an alternate wiring of the nervous system. Stimulant medications, behavioral therapy, and appropriate support can go a long way to help a person with ADHD limit undesirable symptoms. Most people with ADHD assert a heroic amount of willpower and self-discipline as they try their hardest to get through each day in a world built for brains unlike their own. They are criticized and shamed often for the very qualities that make them passionate problem-solvers, determined dream-achievers, and innovative go-getters. By leveraging and encouraging these natural, astounding skills and providing treatment, support, and workarounds for life skills that do not come easily, people with ADHD can flourish.