What is ADHD? Dr. Ryan Sultan Explains

Host: All right, well, a lot of people may think attention deficit hyperactivity disorder or ADHD only affects kids, but this is a huge misconception. It really is.

More than 11% of children have been diagnosed with ADHD compared to nearly 4% of adults. October, by the way, is ADHD Awareness Month.

So joining us right now to talk about it is Dr. Ryan Sultan. He's a medical director of integrative psych. Thank you for being here.

Host: In simple terms, what is going on in ADHD brain?

Dr. Sultan: So what we want to start is we want to think about ADHD and childhood. And I think you guys did a really nice job framing this around the idea that ADHD doesn't exist in adulthood, that that was an idea that we had up until about the 1990s.

And part of that came from that the fact that ADHD symptoms, they really start to show up in childhood.

And what we see are that youth with ADHD tend to have brains that are a little bit different than everyone else's, right?

So these are your eyes in front here, your prefrontal cortex. When we scan this part of a brain with a person with ADHD, we're going to notice there's less activity of dopamine, which is a neurotransmitter.

You might notice there's less blood flow here. And you might notice it's not as developed.

And this part of your brain, it's like the brake on a car. So it allows you to sort of slow down control impulsivity.

So maybe you wouldn't call out in class as a little kid. Or that you might be have better judgment before doing something rash.

So as you get older, usually we think this would go away and you'd have no symptoms. But we actually found that two-thirds of people with ADHD still have symptoms into adulthood.

And that's where this idea of adult ADHD started to develop.

Host: So what are some of the signs and symptoms in children and adults? Are they different, similar?

Dr. Sultan: Yeah, so you want to think of the underlying idea and then you kind of could project it out onto maybe school versus work environments and in both cases interpersonal relationships.

So for kids, we notice a lot of careless mistakes will have parents coming in saying, you know, I tell them something and it goes in one year and out the other.

And, you know, they might be hyperactive. So impulsive, inattention, and hyperactivity.

As you talk more about adults, careless mistakes come from what? Anything related to executive function, which is I have to do multiple things that are kind of complex tasks.

So anything with planning or organization, these people would struggle with, say, planning a trip because there's so many decisions that you have to make along the way.

And they tend to also find that they're not going to be able to sit and have a duration of attention spend that's as long as some without ADHD.

Host: And is there so pretty much a stigma towards us?

Dr. Sultan: Yeah, I think it's decreased significantly, but historically, yeah, there's absolutely been that.

And an idea that these people are not as smart, which has never been found to be true, as well as the idea that it doesn't exist.

And that's not true that we made up this idea recently because we actually know that people were talking about what we think about as ADHD now back in the 1700s.

Host: Interesting. Are there some strengths associated with people who have ADHD that actually allow them to still perform, normally? What's considered normally?

Dr. Sultan: Yeah, so I mean, I actually like to even step away from a normal idea. I think people with ADHD, there's sort of an idea of thinking them as not neurotypical, meaning their brains are a little different, but that there are some advantages to that for them, right?

So the advantage for some reason to this change in their brain, which we know probably has been around a long time, like hundreds of thousands years ago, like when we were hunter-gatherers, is that they have, they're more creative, that they think out of the box, and they come up with different, more interesting solutions, they tend to be more adventurous, they take higher risks, which can have disadvantages for them, but also is an opportunity for payoff.

Host: I've probably had ADHD as a child, but my mom would just say, I'm hardheaded. Got it? Listen, go in.

Host: Well, you still stubborn. Yeah, yeah. I'm going to lose.

Host: Dr. Sultan, thank you so much for joining us today. He's like, why am I here? While y'all are fighting, I appreciate it for a complete guide, by the way, to ADHD, or to make an appointment. Please visit the websites on your screen.

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Columbia University Faculty | 411+ Citations | NIH-Funded Researcher