Winchester, Va. -- less than two hours from D.C.-- is the home of country music superstar Patsy Cline. It's also the setting of "Homeplace: A Southern Town, a Country Legend, and the Last Days of a Mountaintop Honky-Tonk."
Attention Deficit Hyperactive Disorder, known more commonly as ADHD, affects more than one in 10 children in the United States. And while the number of students who struggle with the disorder is increasing, we’ve come a long way from the early 20th century when they were thought to be ‘morally defected.’ Author Tim Denevi joins Kojo to discuss his personal history with ADHD.
- Tim Denevi Author, "Hyper: A Personal History of ADHD" (Simon & Schuster 2014)
MR. KOJO NNAMDIFrom WAMU 88.5 at American University in Washington welcome to "The Kojo Nnamdi Show," connecting your neighborhood with the world. Children with symptoms of attention deficit hyperactive disorder, ADHD, used to be called morally defective in the early 1900s. Their defect was blamed on poor parenting and the bad genes that come with low socioeconomic status.
MR. KOJO NNAMDIToday, the picture of ADHD is much different. A whole generation of adults have grown up with classmates, brothers and sisters or themselves have struggled with strict classroom rules, sit still, work quietly, control yourself. New treatments like therapy, accommodations at school and of course drugs like Ritalin and Adderall have helped people with ADHD to be successful in life, though some still worry about over diagnosis.
MR. KOJO NNAMDIThe struggle and medical history of ADHD is personal for writer Tim Denevi, author of the new memoir "Hyper: A Personal History of ADHD." Tim joins us now in the studio to discuss his new book. Tim Denevi, thank you so much for joining us.
MR. TIM DENEVIThank you so much for having me.
NNAMDIIf you have questions or comments for Tim Denevi, give us a call at 800-433-8850. Have you or your family ever been diagnosed with ADHD? How has it affected your life? What do you think our schools should be doing to handle children with ADHD? What can we do differently to help students with this disorder? You can also send email to email@example.com. Send us a tweet @kojoshow or go to our website kojoshow.org and make a comment or ask a question there.
NNAMDIIf you'd like to hear more from Tim about his new book, he'll be doing a reading at the Writer Center in Bethesda on Sunday, September 7 from 2:00 to 4:00 pm or you can catch him September 19 at the Hill Center with writer Judith Warner there. But right now you can call him, 800-433-8850 because he's sitting in the studio with me.
NNAMDITim, your book explores your personal history with ADHD. Most people know it as some ADD, some ADHD. What does it actually feel like to have ADHD?
DENEVIThat's a very good question. I think that was one of the goals of the book when I started to write it was to articulate a perspective -- a challenging perspective that even now is different than I feel. And in trying to articulate that, I often found myself not just writing about how other people saw me acting at that age, but how it felt to not be paying attention, to be feeling overactive and to suddenly almost wake up in your own body and see that you've disturbed everybody around you.
DENEVIAnd so it's interesting that we often think of ADHD as a lack of attention but one of the ways I try to write about it is, it can feel like this deep tunnel that you enter into until suddenly the world surges across you and you're walking across the classroom and haven't realized you left your seat. Or you're yelling out an answer to a rhetorical question that somebody asked, and disturbing everybody else.
DENEVIAnd I just remember so many of those moment s of horror and embarrassment where I had reentered into the world that everybody seemed to navigate to a certain degree more effectively. And I was shocked. And so the feeling of ADHD was, again, like being sometimes down these deep tunnels and then coming back in. And that tied a lot into the over activity. I would try to be aware of my over activity the older and older that I got. And it was almost as if the awareness, which I was really focusing on to be self aware can never quite catch up to the actual moment of action.
DENEVIAnd it was this pause or this delay that was like having towards infinity that I could never quite reach. And that was very hard to see the limits of what I thought self awareness, which is a goal to develop and a goal to make effective in functioning within this world.
NNAMDIOne of the things I find fascinating is when you talk about being in class in school and being so deep in your own thoughts that you would get out of your seat and walk without realizing that you had gotten out of your seat. At what point do you realize that, wait, I am doing something that nobody else is doing in this class? How young were you when you began to realize that?
DENEVII mean, from the beginning of memory, you know. It's right on the cusp. I started writing this book because there are all these experiences from the cusp and beginning of memory that I didn't quite understand. And so the act of trying to articulate them within narrative and using the tools that are available to you as a writer, narrative, image, setting, characterization, was very helpful to me to try to understand how I felt back then.
DENEVII don't feel that way anymore as often. It's different in adulthood. It's something like restlessness. You have much more control over your environment and your surroundings than you once did. But as a child there was that sensation of, from the beginning of memory, noticing reactions to other people but not -- reactions in the faces of other people but not understanding why they were reacting. So the first, you know, instance of response can be react back badly to them. And eventually you begin to know you...
NNAMDIThat's what I was about to talk about next. The stories you tell about your time in class and on the playground seem to center around conflict with teachers, other students or parents. Most of the time you seem surprised to find yourself in yet another conflict. Why do you think you spend -- that so much of your time in school was spent clashing with others?
DENEVIWhatever ADHD is, inattentiveness, over-activity, impulsivity, in a subset of the population if you have, you know, 3 to 7 to 10 percent of students or children who are struggling with that, it's not just that you're walking around the classroom. It's that within the specific environmental situation of that classroom that's not allowed. And that causes conflict. And that's fair enough because there's 25 other kids at the Catholic school that I was at. You know, there's other children that are trying to learn.
DENEVIAnd I wanted to not be doing that, if that makes sense. Nevertheless, I would suddenly be surrounded by conflict and I would learn then how to become a good fighter against other people. And instead of learning, you know, how to do my division or my social studies I would learn the ways in which I could use conflict to my advantage. And that's very detrimental because that messes with development and it also takes you away from the information you're supposed to be accessing both socially and academically.
NNAMDII keep thinking of a friend of mine that I went to both elementary and high school with who is now a medical doctor, but who I can tell now had ADHD when we were growing up. And one of the aspects of his life in class was getting into a lot of conflicts to the point where he began to understand conflict so well that there were times when he would instigate conflict because he knew it. Is that an experience you also had?
DENEVIIt's definitely an experience. And that's the danger of it. You ask why I pay so much attention to this, why I try to help children with it, why I try to identify it and treat it. And again, it's not just the over activity or inattention, which themselves can be detrimental, it's not that they lead to conflict, it's not that you get good at conflict. And in the end you're not good at doing other things. And when you've gotten to adulthood, that's the thing you practice the most is conflict. It's like the 10,000-hour thing which you spend your 10,000 hours fighting with other people. And that's very hard to undo once you become an adult.
NNAMDIIt's funny because we had a small gang and he's the only person I can think of who got into a fight with every other member of the gang at some point or another. Do you look back at any of your childhood memories and knowing what you know now about ADHD think, wow, that makes a lot more sense now?
DENEVII think it does, especially -- I grew up in a family of athletes. My uncle was a professional tennis player. My father was a professional baseball player. My grandfather was a professional baseball player. And on the baseball field, which is a place where you have an opportunity to deal with and express your over activity, still even within a structure that says move around, do these drills, run to first base, even when I had a chance to be active, those struggles to do what was expected of me within sports really highlights now just how tough things were.
DENEVII mean, now I think exercising is one of the very best things I can do. The over activity is different. That's why ADHD is very interesting because as you get older over activity decreases. And a lot of the studies have shown that. And what you have is more of an internal feeling of restlessness. And exercising now is fantastic, but I choose sports that don't lead to a ton of conflict. Team sports are hard, you know. They're good for children to play and to build different relationships and skills. But as an adult you can choose what you want to do.
DENEVIAnd so I can choose to go running and play tennis. I don't have to play basketball and get in a fight with somebody or do that. But as a child all of that conflict, even within environments where I had a physical outlet, really highlighted, like, that was ADHD. That really comes through.
NNAMDIOur guest is Tim Denevi. He is author of the book "Hyper: A Personal History of ADHD." He joins us in studio. We're inviting you to join the conversation. Have you or a family member been diagnosed with ADHD? How has it affected your life? Give us a call, 800-433-8850. We'll start with Matthew in Winchester, Va. Matthew, you're on the air. Go ahead, please.
MATTHEWThank you, Kojo and Tim, for taking my call. I was originally -- I'm 23 years old. I just finished actually my undergraduate degree and working on my Masters.
MATTHEWThank you. And so just kind of going through the educational system, I went to school in Fairfax, and in elementary school was diagnosed with ADHD and was put on Ritalin back when I was quite very young. And it wasn't until about middle school that another doctor said, you know what? I really don't think you need to be taking this medicine. And they took me off and what they ended up finding was that through having the discussions with me about what it means to possibly have ADHD and learn healthy and constructive mechanisms to how to kind of get a hold of it was what really made the difference, and not necessarily the medication.
MATTHEWI have a good number of friends that, you know, take Adderall and stuff like that even now in college. And so I always ask them, you know, did you ever have the conversation with that health professional, what does it mean to have ADHD and more about the educational process to the one who's being diagnosed, not just the, okay, socially constructed, you know, you are labeled as having ADHD. Okay, take these medicines. But how do you go that extra mile to really understand what it means? So that's something that I found extremely helpful and interesting.
DENEVIThank you for your question. I think that ADHD has a lot to do, whenever we talk about it, with privilege. And so if you happen to have a privilege enough situation where you can go to a school with a 15-person class where it's okay to wander around, you can make environmental adjustments, you can talk to the school psychologist about self awareness, how you're acting, how you're behaving, how you can respond to other people responding to you in a better way, then that can be, in some cases, just as effective as other avenues of treatment.
DENEVIAnd the first thing you would want to adjust from my own personal experience that I've seen and also from the literature is the environment, if you can. The problem is most people and many people can't just simply adjust their environment as easily. And so that's when we begin to get into questions about medication and other evidence-based therapies.
NNAMDIAnd we will get into medication a little more later in the discussion. But Matthew, thank you very much for your call because I'm glad you talked about environment, Tim, because your school experience changed dramatically from year to year. How well you did and how much you enjoyed being at school had a lot to do with your teachers. Some of them were very understanding. Others didn't seem to get it. What do good teachers do differently with students who have ADHD?
DENEVIThat's an excellent question. In my experience and from the reading that I've done, I often see that a good approach will have to do -- and this is very difficult to do -- with separating behavioral development from intellectual development. And often we think those are the same thing, you know, willpower. If your willpower -- study harder, willpower sit still. And when it comes to ADHD, the disorder itself highlights the difference between those two spaces.
DENEVIAnd when I had a teacher that could give me marks for behavior, which they have in school, and give me marks for academics on separate courses, I did very well, you know, because they were patient enough to understand that whatever my developmental process was, and I was lucky enough to have them, that they both go at different rates. And when you have a teacher that conflates both of those, willpower and intelligence, then you often run into conflict that will spread out from the one issue it's about, like sitting in class to academics to getting along with other students.
NNAMDIWhereas if, on the other hand, a teacher treated you individually as opposed to simply being a member of a class who was supposed or expected to do everything the same way, and allowed you to work in a way that allowed your ADHD to kick in but not take you away from what you were doing, you did better.
DENEVIYes. And that gets into the general broader conversation of ADHD in our society is both sides, whether it's a medical side or it's a more experiential side, they try to fit every single case into their larger argument. And individualization both educationally and also just when we talk about it I think is a really important point that gets lost in the way we discuss it.
NNAMDIYou tell a story about a fixation you had with earthquakes that turned into, well, an impressive science fair project. What happened there?
DENEVIThat's a good story. My mother sent a picture of the plaque that she still kept for the last 20 years to me recently. I had had a very bad third grade year at a Catholic school and eventually had to leave the school and had been in a lot of conflict with the teacher. And I went and had a new teacher at a new school. And she was very understanding and was able to separate those two aspects of academic and more personal development behaviorally.
DENEVIAnd so she, after we experienced the 1989 earthquake in Loma Prieta which was right near my hometown, was able to perceive that this was a motivating factor in expressing myself academically in class. And was able to do very small things which I could understand are difficult but sitting during recess and talking with me, you know, promoting that I do it in this way. Just being able to think on the fly and take how I was upset maybe about the earthquake in class and channel that towards an academic outcry.
NNAMDIYeah, because you were upset because you couldn't stop asking questions about the earthquake in class.
DENEVIYeah, I couldn't keep my mouth shut.
NNAMDIAnd when she gave you the project, another aspect of ADHD kicked in and that was a kind of highly focused tunnel vision working on that project. What eventually ended up happening with that earthquake project?
DENEVIYeah, when the -- it was the only thing I ever won. I went home -- because I didn't understand it. I wrote like I felt like -- it felt like -- it felt sad almost because I had never won anything in my life. And I had no context to be able to explain it. And I just think thinking on the fly and being able to individualize a student within the educational framework, it's so hard to be a teacher anyways. You have 30 kids in your classroom. You have so many demands. It's such a difficult and demanding job. But in my experience, teachers that can individualize your experience, especially in this sense and not apply it to a broader ideological framework...
NNAMDITeachers who were rigid you would get -- have your desk put outside the class? I mean, that obviously had to make you feel that there was something terribly wrong with you.
DENEVIYeah, it was very difficult because in this instance in third grade, whenever there was any conflict, the teacher would just drag my desk into the hallway and I'd spend hours out there at the school that I went to. I wasn't -- everything began to break down and that might've made it easier for her to navigate that classroom because, again, these are difficult traits to deal with. You know, it's hard for a teacher to deal with an over active child when they're trying to deal with 30 other children.
DENEVIBut if we're looking at ways to keep a child's development continuing forward so they make it to adulthood, that's one of the most detrimental things you can do is to pull them out and segregate them from the experience of being in a classroom altogether.
NNAMDIGot to take a short break. When we come back we'll continue our conversation with Tim Denevi. He is author of the book "Hyper: A Personal History of ADHD." If you have questions or comments you can call us at 800-433-8850. If the lines are filled, send us an email to firstname.lastname@example.org or shoot us a tweet @kojoshow. to what extent should doctors prescribe drugs to manage ADHD? Should -- or what other strategy should they, in your view, be trying, 800-433-8850? I'm Kojo Nnamdi.
NNAMDIWelcome back. Our guest is Tim Denevi. He is the author of the book "Hyper: A Personal History of ADHD." He joins us in studio. There are a lot of people on the phone who would like to join the conversation. If you're trying to ask a question or make a comment now, you may want to sent us an email to email@example.com or send us a tweet @kojoshow. I'll be getting to the phones very shortly but I'd like to discuss the issue of medications first.
NNAMDIThere are a number of treatments for ADHD. Best known is probably the use of amphetamines like prescription drugs like Ritalin, Adderall or Vyvanse. What do these drugs do and what does it feel like when you're on them?
DENEVIThat's an excellent question. One way I try to articulate a stimulant is it makes whatever the object in front of your gaze is closer and it empties the interference between you and that object, the subject of your gaze. And the difficulty with these drugs is that they work for everybody. Originally they thought they could help diagnose ADHD because suddenly kids who were very distracted would be more on the ball. But it makes everybody more on the ball. It happens to be that those kids have further to go so you notice it suddenly in the classroom or in a group.
DENEVIAnd whatever ADHD is, again, in terms of its primary symptoms, when you flood the brain with dopamine, which is often what time-release or instant-release stimulants will do, you tend to decrease that interference between the task at hand, like for now be a giant box for my Kia and it's instructions that need to be put together and there'd be no parts left over or, you know, reading a very difficult medical article from the early 1900s about the precursors of ADHD.
DENEVII could do research now -- I take a small dose of amphetamine -- I could do research without stimulants and it might take nine hours. But if I take the Adderall to do the research it will maybe take three to four hours. And what I've learned from that experience -- and you can say what you want about it -- is that for the first time I'll actually do research because it was so not worth it in the past.
DENEVIYeah, that I would just, you know, write narrative or I would do other things. But I really didn't begin to do research until I was an adult. I began to take Adderall and I could actually see its benefits in these specific areas. So I try to use it as an environmental target. If I know I'm going to be in a situation where there's a lot of that kind of interference for me then I'll take that a head of time. But that's very hard because how do you always know, you know? And how can you always -- it's very difficult.
DENEVII just find -- those drugs do work and they can work in the short term and they can be very helpful but they're very difficult. In the same way ADHD is very difficult to get your head around. Because as soon as you think you're starting to get a sense of exactly what it is, you realize it's kind of reflecting back on you and what you think of the world. And it becomes, you know, kind of a -- you know, a mirror that just reflects back.
NNAMDIA lot of debates surrounding these prescription drugs. Some people feel they've turned kids into automated beings who can only do homework and listen to their parents but are totally devoid of personality. How useful do you think they are in helping people with attention deficit disorder?
DENEVII think the goal is to start from the perspective of individuality and individualizing. And I think in some situations they can be very useful and very helpful, especially in the short term. It keeps somebody from getting expelled from school, to allow you then to work on the environmental factors around the situation and improve those.
DENEVIThey don't just work, I don't think -- I don't think any (unintelligible) therapy will just work when it comes to ADHD as a single silver bullet because it's too complex. We're talking about something at the border of biology and identity and personality and experience. And so when you're in a place like that, you can't just take away one thing or prescribe one thing and expect everything to get better.
DENEVIAnd that also has to do with the causality of ADHD. Everybody thinks there's -- if you can just find this one cause and isolate it, if you can turn this one key and open this one door, boy, there'd be food additives or the education system or something else then suddenly all that over activity will go away. And for the last, you know, 100 years since it's been studied, it's always resisted this kind of chorus of single causality. You know, it's always never been able to be treated with just a single thing.
DENEVIBut there's always somebody who tends to think, especially for the last 100 years, that if you just do this one thing then everything will be fine and your problems and the primary symptoms will go away.
NNAMDIHas to be individual. On now to the phones. We will start with Shawn in Baltimore, Md. Shawn, you're on the air. Go ahead, please.
SHAWNHi. I just wanted to make a quick comment about the, you know, over prescription or over...
SHAWN...over diagnosis, thank you, of ADHD. My brother and I both were diagnosed or diagnosed by our teachers when we were in grade school. I'm 30 now and he's 23. And when we were both in elementary school at the same school, both of us had a meeting with our parents and there was our teacher, our principal and the guidance counselor. And, you know, they suggested that we had ADHD and, you know, they were suggesting medications and things like that for both of us.
SHAWNAnd at the time my dad was pretty not into thinking that we had any issues like that. And, you know, he brought up the point that neither of the people at the meeting were doctors or any kind of medical professionals and that they shouldn't be, you know, saying that we have ADHD or trying to prescribe meds. They weren't prescribing medications but suggesting it.
SHAWNAnd I'm pretty glad now that he, you know, didn't agree with the teachers and didn't provide us with the medication because I know a lot of people that I know that are currently -- that currently take Adderall, whether it's to help them with studying or things like that or just take it recreationally. And it's just such a crazy thing to think back on that when I was in grade school my teacher and my principal could get together and suggest, you know, that I was -- that I had ADHD and that I should be on these medications. I'm just wondering how many other students there are that are out there that would have been prescribed the same thing or suggest that they are on that based from their teachers.
NNAMDITim Denevi, the person or persons who are most appropriately qualified to diagnose should not necessarily be teachers.
DENEVII think that what we're dealing with is the most studied childhood condition basically in the world. And there's actually a lot of good information out there that the psychiatric, medical and general academic community has taken 100 years to develop and, you know, get better at articulating. The problem is that a lot of times you run into these other levels of suggestion and even in some cases medication diagnosis of ADHD.
DENEVIOne of the really hard ones is the pediatrician. You know, you come in and you have 15 minutes. I mean, the way our American health system is now, it's very hard to, in 15 minutes, make a judgment like that. But then it's also an aspect of privilege if you can go to a specialist, a psychiatrist that you have to pay extra for so you can get a multi-model assessment, you know, among different lines.
DENEVIAnd again, there's no single cause for why ADHD is arguably over diagnosed and overmedicated, which I think is an often fair argument. But there are a lot of factors, you know, from our current medical system to the way that it's discussed and talked in our society. And just in the way that it's a condition that is often hard to understand, it's right at the borderline of normal functioning. There's a very good doctor who once said, people with ADHD can do anything. They just don't do it as well. They just have to do it over and over again many times.
DENEVII think that's a really good point in terms of where this substantive population falls in comparison to people that are functioning very well within our society, people that suffer from much more severe forms of societal disadvantage and handicap.
NNAMDIOur guest is Tim Denevi. He is author of the book "Hyper: A Personal History of ADHD." We move on now to Jonathan in Gaithersburg, Md. Jonathan, you're on the air. Go ahead, please.
JONATHANThank you. Good to be here with you. I have a question whether you might be familiar with the work of Dr. Gabor Mate in Canada. He makes an interesting argument. I haven't read his books but I've heard him on radio shows like this, Kojo. Not yours, I don't think, but others. And I've heard him say that he believes ADHD -- and he has ADHD, he's diagnosed with ADHD as well -- he believes ADHD is brought on by stress initially. Not that it's a reaction to stress in each situation where it becomes a problem, but that the onset of ADHD in children is related to stress in the household or to a stressful event that happened to the child.
NNAMDIHave you heard that hypothesis, Tim?
DENEVIThere's been a good amount of hypotheses over the last 100 years. And after the pharmaceutical revolution of the 1950s and '60s where suddenly you could treat schizophrenia and see results with a drug, people advocated that something like ADHD was like a bacterium. And if you found the right drug for it you could get it. There was a major response to that in the 1960s, the Anti-psychiatry movement. In the anti-psychiatry movement the argument is that something like ADHD is completely environmental caused, experientially caused. And also that people suffering from mental illness are in fact more sensitive to the harms of society and are articulating them better through their mental illness.
DENEVII think that's a very dangerous argument. And eventually psychiatry responded to that. And one of the discussions in terms of is ADHD biological, is ADHD environmental had to do with the idea of the primary symptom. Is it inattention that then caused you to not sit still? Is it not sitting still that then causes you to not pay attention? And so this hypothesis, I think, has a lot to do with arguing that stress is the primary symptom or cause. And then that leads to the other symptoms.
DENEVII think that, from the literature that I've read and the people that've spent most of their lives, you know, as academics and doctors studying this condition, they would say that the behavior exists. Environment makes it much worse. And so I think there is a valid point to stress making -- can make over activity and inattention worse. But to argue that stress itself causes over activity and inattention I think is a less valid argument.
NNAMDIMaybe stretching the point a little bit. Let's talk about treatments, because some of the other treatments for ADHD include behavioral therapy and making changes to one's environment. How, as far as you know, do those treatments work?
DENEVIIn my personal experience, I was very lucky to be growing up in the 1980s and 1990s in northern California where there were a lot of options available. And I saw a psychologist who had studied at Stanford with Dr. Bendura (sp?) . And her name is Lori and she applied -- we worked with cognitive behavior therapy, which was basically how to deal with the way other people were responding to me.
DENEVISo instead of targeting the primary symptoms of over activity and restlessness and inattention and impulsivity, which a drug might do, she said, let's look at how you react when people react to the way that you're acting. And how can you calm down? How can you disengage? How can you make better environmental decisions? And that's really hard for a kid because you're still gonna not calm down and...
NNAMDIYou're still a kid.
DENEVIYeah, but I found that to be very helpful because it did help to place my reality within a larger context too. You know, I understood that I was part of something bigger going on. And again, this gets down to individual skill. You can have the right approach or the right therapy but for a certain child, if you run into somebody that can't communicate that well with that child or if the child's situation doesn't line up with that that well, then it's not necessarily going to make things better. But she -- I really do think that she's a very intelligent, patient and caring woman -- was able to help me navigate through this world at a very difficult time and in an effective manner.
DENEVIAnd, you know, I was very lucky that my parents -- my outcome was as important as their outcomes in life. You know, they placed me equally to them and were willing to do not whatever it took to make it go away, but to just help me keep going forward through an expression of love, which has been a good example for me as a parent.
NNAMDIOn now to Jason in Washington, D.C. Jason, your turn.
JASONHey, can you hear me?
NNAMDIYes, we can.
JASONOkay. Two points. Number one, I'm definitely ADHD myself. With that said, it actually is beneficial. I have a PhD in biochemistry. I become obsessed with very small things in life. That's what I focus on. The issue that we have is that we treat kids and we treat this like a disease. It's not a disease. It's a personality. And we treat these kids who have hyperactive focus and what do we do?
JASONWe give them methamphetamines. If you take a look, you know, I mean, I'm sure your guest knows that, you know, things like (word?) and things like that, these are methamphetamines, hyperactive, hyper psychotic drugs. You're not helping the situation. This is a personality. The kids are fine. I'm not sure why we're treating this with drugs.
NNAMDIWhat do you see as the alternative?
JASONWhy can't we just say that, hey, some people are hyperactive and want to focus on very small things. Like I say, I'm PhD biochemist. You know, I grew up in the seventies. I guarantee you I am ADHD.
JASONBut I never had drugs. I just focus. That was my personality.
NNAMDIHow difficult was going to school for you as a child?
JASONNo, I mean, it was difficult in the sense that what I got obsessed on, I wanted to follow. But, like I say, I'm Ph.D. now. It's -- let kids be kids. And you definitely do not want to start treating hyperactive focus utilizing methamphetamine type drugs. Because what you're doing is you're treating the symptom with the product.
NNAMDILet me have Tim Denevi respond.
DENEVII'll respond in two ways. One would be that a lot of time with our personal narratives, if we make it into adulthood and then we're successful, we tend to think that we were going to end up there no matter what. And we had these traits or streaks that were bringing us there. But from my experience, for everybody that's had over activity or difficulty in the classroom make them stronger or better to get to the place they were going, there's other examples, like my friends that I grew up with and almost like me that almost drove off a cliff or ended up dead on the side of the road or flunked out of school or gave up or learned to fight with everybody all the time.
DENEVISo when we create our personal narratives, it's very hard to go back and realize that the outcome wasn't already determined. We weren't already going to make it to the place that we are now. And when we see the discussion on ADHD, a lot of times we see articulations like the caller just had, where I've made it to the spot, I've made it to this point. Then why do we need to do these other things in the past, because these were actually strengths.
NNAMDIDoes that represent the tendency of human beings to universalize our personal narratives and in the process of that, losing the individual narratives of others whose outcomes and whose process may be completely different?
DENEVII agree 100 percent. And I think that's why, again, ADHD is like this touchstone within our society. I find it kind of unsettling when I hear parents of students at a very elite prep school angry that some kids might be getting ADHD drugs to function better. If your child's already a successful student at an elite prep school, you're more advantaged not to just the 99 percent of all children alive now, but all children that have ever lived in the history of humanity. And focusing on these other children who are having a tough time and getting what you might think an advantage, is a way of turning away from your own privilege I think.
DENEVINot that you have to feel guilty about it or anything like that, I'm arguing. But it's a way of not looking at difference, which is I think is what you were highlighting. And that's how we make our personal narratives sometimes. We have to push beyond that.
NNAMDITaking another short break. When we come back, we'll continue our conversation with Tim Denevi about his book, "Hyper: A Personal History of ADHD." We're still inviting you to call us at 800-433-8850. Do you think ADHD has more to do with biology or with life experiences? How does that affect the way we treat it or should treat it? 800-433-8850. You can send email to firstname.lastname@example.org. Or shoot us a tweet @kojoshow. I'm Kojo Nnamdi.
NNAMDIWelcome back. We're talking with Tim Denevi about his book, "Hyper: A Personal History of ADHD." Tim, your writing style in this book seems to simulate the experience of a child with ADHD. The pace is quick. The narrative often bounces around from topic to topic. To what extent does your writing style show people, maybe intentionally, what it's like to have Attention Deficit. Or is it -- is this book also meant for readers with ADHD?
DENEVIWell, a lot of what I was trying to do was to replicate, again, a point of view that's gone. And that's replicating a logic in the way that you see the world. And so in the narrative sense, through the perspective -- the first-person perspective -- me, in the present, now, writing about how I saw the world as me, in the past, I was really trying hard to articulate how me, in the past, was seeing things differently perhaps than not to tell me, in the present sees it, but that how people who might not have ADHD would see it. And so I did try to avoid offering too much reflection and analysis from the present of what was going on, but really inhabit the perspective of my previous and earlier self, as to let the reader do a certain amount of work to understand what this means.
DENEVII didn't want this to be a polemic, where I said this is this, this is that. I wanted to give them an experience like good fiction will do, and let them respond to it. One of my favorite memoirs is Michael Ondaatje's "Running in the Family." And there's a chapter in it about his grandmother, called "The Passions of Lalla." It's beautiful. And whenever my students read it, half enjoy her and think she's fantastic. And half are like, "She's selfish. She gets to do whatever she wants." And I think that's the goal, in a sense, of the writing I was trying to do, is to articulate a perspective. And then let your reader and audience respond to it by doing work to understand how you are seeing the world and how that's different from what I experience.
NNAMDIWe got some email testimonies and some emails who seek guidance and information. First the testimonies. David in Bethesda writes, "Tim's anecdotes about the way his teachers treated him really stirred some memories. My fourth-grade teacher gave me two desks so I could kneel on a chair, put my body over one desk and work on the second. Her understanding that I did not need to sit still in order to learn led to some of the best educational experiences I had as a child." That's what you were talking about.
NNAMDIIndividual, innovative. And we got this email from Matt. "I have had ADHD my whole life. And I was struggling through high school until I moved to a school called Loudoun Schools for the Gifted. A this small, private school, I was given room to be able to move around and get the education that fitted me. I was finally able to enjoy learning. My family was lucky enough to be able to afford private school. But it was a game changer for my education, at the privilege of being able to access that."
NNAMDINow, guidance and direction. Michelle writes, "My two kids have been diagnosed with ADHD and receive all the support they need -- medicine, psychiatric support and school accommodations. They have now both graduated from college. What will be the transition to the real working world, where presumably accommodations will not be available? Are we doing a disservice to kids by protecting them into sheltered environments?"
DENEVIThat's a good question. A lot of the research show, over the past 50 years, that punishing students very severely with ADHD doesn't make them more in control of what's going on and doesn't prepare them for whatever difficulties they're going to face in the future. And so I would argue that you're going to always face difficulties, no matter who you are and no matter what your personality is like and no matter what's going on in your life. And the argument that we should give children more hardship earlier, so that when they meet the hardship of the regular world, they'll be prepared for it, I think is a really difficult argument to make.
DENEVIAnd I understand her fear. And I think that that's valid and that transition is tough. Another thing to say about ADHD is, again, out of all the cultural disadvantages that exist in our society, this is something that diminishes for up to 40 percent of the population that suffers it, as you age and get older. And I think that that's really important too. I noticed when I was about 22 that I just wasn't as exaggerated as I'd been. You know, I wasn't the loudest possible person at all times. I remember being in a class in college and limiting myself to three questions that I could ask for class, and writing them down and spacing out my time to ask them. That was a huge development for me.
DENEVIAnd for whatever reason, as you get older, the brain or experience or whatever, it is a more navigable situation.
NNAMDIThat may be helpful for Mary Ellen in Arlington, because she writes, "I have a son with ADHD who is now in college. He was diagnosed with ADHD when he was a junior in high school. At college, he struggles with meeting deadlines and test anxiety. He receives accommodations, but he is at risk of flunking out of college. He takes Adderall each day. My husband and my suggestions are met with angry outbursts and declarations that he does not need help. Tim, did you experience such college -- such challenges in college? And how did you deal with them?
DENEVIThat's a very good question. I was very lucky because once I got to college I had only seen myself through other people's eye, I think, growing up, and I kind of left where I was from. And I was so happy to be in this new space. And things were already getting better. That I had a very good experience. And I could, like, study Latin and Russian literature, which I was for some reason interested in instead of math or other subjects that I really felt uncomfortable all the time doing, but I had done. But to answer that, when I was in high school and it came to medication, I really felt that that medication was a judgment on me.
DENEVIAnd then I was taking an antidepressant. I wasn't taking a stimulant because I had had a bad reaction to it when I was younger. And I was always so upset. And it felt like the one power my parents still had over me was to have me take that. In looking back, now I know that that didn't make things worse, having to take it. I had enough issues already. The low dose of nortriptyline, which was a tricyclic antidepressant, didn't, you know, make everything more terrible. But I can understand that perspective that the parents are articulating of their child, that the parents are trying to help and the child is saying, "This isn't just help. This is a form of control and a form of power."
DENEVIAnd that can be very frustrating and difficult on both ends of the situation. And a lot of my fights with my mother -- that's -- the book's climax tends to more toward me being able to make the decision at 18 to not be on a drug anymore. And at the time, I thought it was a larger sense of freedom. But in reality, I really don't think that low dose of antidepressant ever did more damage than what it was trying to help improve. And nor did, you know, most of the therapies that I experienced later.
NNAMDIOn to Dee, in Washington, D.C. Dee, your turn.
DEEOh, thank you. This is such an important topic. I was diagnosed with ADHD in 2002 -- no, 2000, excuse me. And I was in graduate school. And I was, you know, I -- this was my second degree and so I was much older than you normally get a degree. And I was struggling. And so I went to the doctor and was diagnosed with ADHD and also a brain injury I had sustained evidently years before. And one of the things that -- there's been so much going on, I'm really glad I could hear the conversation as I was waiting -- there's so much about this condition that is mindboggling to me. I do believe the symptoms and the types of ADHD vary.
DEEThe subject of medication came up. I personally think that medication obviously didn't cure me. It wasn't introduced until very late in my life. But it actually did change my life in terms of making things easier. You know, suddenly, if I had to write a paper on Clausewitz and if I happened to find Clausewitz boring, I -- with the medication, I could do that.
NNAMDIYou could focus.
DEEAnd I think that was mentioned. You can -- exactly. And at my age, ADHD seems to be much more characteristic of the hyperfocus, which is why...
NNAMDII'm glad you mentioned that. I'm so glad you mentioned that because, Kathy we're running out of time and that was my next question for Tim. So were you through?
DEENo. I have one very important question that has not been addressed at all. And just from the demographics I'm hearing about with ADHD, I think it's a very important one. The difference between boys and girls with ADHD. I never acted out. I wasn't always a good student. I flunked the fourth grade because I -- when I was introduced to a subject that I didn't get right away...
NNAMDIIs it your belief that there is a difference between how...
NNAMDIOkay. Well, allow me to have Tim Denevi address that.
DENEVIThat's a good question. In the 1990's, Russell Barkley, who's a doctor that writes a lot about ADHD, I thought did a nice job trying to really articulate what it was. And he got into the idea of it having to do with crossing known borders around you. So that border might be to be somewhere on time. It might be to not yell out at somebody else. But that when it comes to the perception of these borders, children with ADHD -- boys and girls -- had problems with them. But they would manifest often across gender lines in different ways. And so he tried to find the kind of one apex between the genders that could articulate what it was in a larger sense.
DENEVIThat being said, I think it's very clear that we have over activity for a boy of five years old, that's a different level of over activity, often, for a girl of five years old. And that's something to keep in mind. One of the most important things about ADHD is it's age related. And so a five year old always looks hyperactive to a ten year old, or usually will. And the same thing can be said across gender lines. And a lot more women now are trying to figure out why they might have been having conflict or difficulty within their life. And it may fall along attentional lines.
DENEVIAnd they're now getting diagnosed and treated with (unintelligible) therapies by professionals in a way that they haven't in the past. So I do think it manifests differently. But I think that one of the good things going forward, is a lot more attention is being paid to the way it manifests differently across the gender spectrum, which wasn't always the case.
NNAMDICathy, thank you very much for your call. ADHD is often thought of as a lack of focus. But as Cathy brought up, you talk in the book also about the concept of hyperfocus, the ability to focus extremely deeply. Can you explain a little more?
DENEVIYeah. I think one of the issues is, you're just not on -- I think that one of the issues is, you can very easily be startled from one moment to the next. And that can seem like you're bouncing around at a very increasingly accelerated rate. I think it's dangerous to always argue that this hyperfocus is a great thing. But if you can find something that you're very passionate about -- parents will often say that my son can play video games for, you know, 10 hours straight and really get into them and do well. But then, when we have to do something else, it's difficult. Or when I was a kid, I could read my -- I could read "The Hobbit," all the way through.
DENEVIAnd my father, (unintelligible), he said, "What are you doing up late, reading that book right now? Why don't you go to bed?" Like, it didn't quite make sense to him, because our interests in that sense were different. But whatever that hyperfocus was, it did manifest in that way. It's hard to think that that's always an advantage. Because it, you know, personality is different, I think, than these traits of over activity, restlessness and impulsivity, than intelligence. You know, these all fall in different lines. I have a cousin who's very much like me. And when somebody says, "Sit still. Be quiet." He doesn't get that mad. He's like, "That person's ridiculous. I don't have to get upset."
DENEVIWhen someone says that to me, I'm like, "What did you say to me?" You know, like, I'll tend to even now and always have responded more.
NNAMDIAnd I'm afraid that's all the time we have. Tim Denevi is the author of "Hyper: A Personal History of ADHD." Thank you so much for joining us.
DENEVIThank you so much for having me on.
NNAMDIAnd thank you all for listening. I'm Kojo Nnamdi.
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