Most of us with ADHD spend years, decades, and sometimes our entire lives searching for a way to change how we feel inside. Some experts speculate that, because of genetics, people with ADHD experience pleasure less often than those who do not have the ADHD genes. We must resort to extraordinary means to experience ordinary joy. Because we feel less engaged and at peace than others do, we are always seeking ways — instinctively or deliberately — to feel fully alive.
What makes matters worse is that the inner feelings we don't like are entwined with feelings we do like, creating a hodgepodge that escapes easy definition. Often, mental health professionals will diagnose the bad feeling as depression, anxiety, even psychosis. They are usually wrong.
Are You Itchy?
The true source of the bad feeling is what I call an "internal itch," which is difficult to scratch. At the heart of ADHD is a restive, irritating pain that flares and subsides, but never goes away. In my 63 years of living with my own ADHD, and in my 32 years of treating people who have it, I've learned that one of the most important topics to address is how to scratch the itch.
First, realize that you can't make the itch go away. You could sedate yourself and go to sleep, but you will wake up still trying to change how you feel inside.
We should find constructive ways of scratching the itch, but, usually, it is the destructive ways of doing so that we try first. That's because they are quicker and easier. The most common are substance abuse, compulsive activities (like gambling), online addictions, various sexual behaviors, shopping, misuse of food, and excessive exercise or sleep.
ADHDers develop quirky habits to scratch the itch. One patient of mine became addicted to DVR-ing "Let's Make a Deal" and "The Price Is Right" every day, then watching them in the evening. Only by watching the shows could he relieve the bad feeling the itch caused. Another patient said she found relief by sitting in a bathtub filled with cold water and ice cubes for as long as she could stand. As she sat in the tub, the bad feeling abated.
More dangerous habits, like reckless risk-taking, impulsive experimentation, or foolhardy business dealings, can derive from not recognizing the need to scratch the itch. The best approach is to recognize the ADHD itch and to find productive ways to scratch it. Through the years, I've found that these three methods top the list:
> FIND A CREATIVE OUTLET. People with ADHD need a creative outlet in order to be productive. In my own case, if I am not working on a book, I get depressed. I don't have to be at the keyboard all day, but knowing that I have a book in progress scratches my itch. Almost invariably, people with ADHD thrive when they have some kind of creative outlet in their lives, and they wither when they don't.
Your creative outlet can be just about anything. A garden can be a perfect outlet for one person, while starting a business works for another. Training a dog, working on a committee, researching a stock, or taking up cooking can scratch the itch. Don't make the mistake of saying, "I'm not creative." If you have ADHD, you are creative. You need to find out at what.
> EXERCISE THE ITCH AWAY. My friend and colleague, John J. Ratey, M.D., showed that physical exercise and movement sharpen brain function and help manage ADHD symptoms, in his superb book, Spark. No matter what your age, if you have ADHD, get moving and stay moving.
> MAKE THE HUMAN CONNECTION. I call this "the other vitamin C," vitamin Connect. It is essential for life, and it works wonders in scratching the itch. Make time for a friend or a group, and try to connect deeply with people. Don't settle for the superficial blather that passes for connection these days. Go deep. Get real. You will find your itch fading into pleasure.
Be creative in finding your own ways of scratching the ADHD itch. By paying attention to the itch within yourself, and by finding the ways of scratching it that work best, you can turn a curse into a source of achievement and joy.
NED HALLOWELL, M.D., is a practicing psychiatrist and founder of the Hallowell Center for Cognitive and Emotional Health, outside Boston, and in New York City. He is the author of 19 books, including Shine: Using Brain Science to Get the Best from Your People.