Why Can't I Focus: Understanding ADHD - Minority#
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For students, being easily distracted and unable to focus in class is a serious issue. In the blink of an eye, the knowledge the teacher is imparting can shift from 1+1 equals 2 to "the trajectory design of a rocket launch." It may take a long time at home to figure things out, and sometimes even tutoring is needed to relearn the material. But will there be distractions in after-school classes? That's another story.
The reasons for this issue may stem from two aspects: one is psychological factors, such as high life stress, recent significant life events, or certain mental illnesses; the other could be the presence of Attention Deficit Hyperactivity Disorder, abbreviated as ADHD, commonly known as "hyperactivity disorder."
From a traditional perspective, being easily distracted seems to be a "personality flaw," representing a person as arrogant, conceited, and disrespectful. But is that really the case? Of course not!
If the issue is psychological, it needs to be addressed through psychological counseling. If it is ADHD, then professional psychiatric involvement is necessary. In this chapter, we will discuss specific solutions for these two types of problems.
After being tormented by attention issues for twenty-nine years, my pain finally overcame procrastination, and I gathered information on all the clinics in Beijing that could treat adult attention deficits. After battling the appointment system for a whole month, I finally secured a precious opportunity to discuss this issue with a doctor.
The concept of "attention deficit" is often stigmatized. Let's recall the child in school who could never sit still and was always causing trouble—what kind of treatment did they receive?
For children, those baseless accusations seem justified: "He broke the rules, so he should be punished."
But if we think further, considering the unusual structure of this child's brain or the family factors behind them, we ultimately find that such treatment is unfair, cruel, and lacking empathy.
Indeed, simple "punishment" can quickly and effectively eliminate the behavior, but it does not address the core of the problem. On the contrary, such public attacks and humiliation harm the child's self-esteem and the social cognitive abilities of all their classmates.
I held similar concerns while waiting for my appointment, but when I stepped into the doctor's office, they did not make excessive judgments. They briefly asked me some questions: "Is your room messy?" "Do you have trouble concentrating in class?" "Do you often forget things?"
Next, they asked some questions related to mental health, such as anxiety, depression, and sleep. The conclusion was: "There was indeed an attention issue in childhood, but most cases resolve their symptoms in adulthood. Your current attention problems could be either unresolved ADHD or concentration issues due to anxiety; we need to conduct differential diagnosis to determine the exact problem."
In fact, the relationship between attention issues and anxiety or depression is very complex. On one hand, anxiety and depression can lead to difficulties in concentration. On the other hand, ADHD patients often experience certain social functional impairments, such as being unable to complete schoolwork or tasks, losing control of emotions leading to conflicts with colleagues or even being fired, and struggling to maintain good interpersonal relationships. These symptoms can trigger anxiety and depression. Therefore, the causal relationship between the two needs careful analysis by a doctor.
So I was sent for tests and to fill out forms. In today's world, who isn't anxious or depressed? Fortunately, the results showed only mild depression and mild anxiety. Armed with these results, I met the doctor for the second time, and the final conclusion was: "Unfortunately, I still have not self-healed from attention deficit into adulthood. If you want medication, we need to conduct a more comprehensive ADHD interview. If the conclusion is positive, then medication can be prescribed. Of course, for adults, the demands of the work environment on attention are not as high as in school, so if you feel your situation is not severe enough, you can choose not to take medication, as all medications have side effects."
A week later, I returned to the hospital for the ADHD interview, which was more targeted than the previous series of tests. A set of M.I.N.I questionnaires was used to screen common clinical issues, including anxiety, depression, obsession, sleep, and questions related to addiction and alcoholism. Then came the DIVA-5 interview specifically designed for ADHD, where the doctor asked question after question, such as: "When someone speaks directly to you, do you often feel like you're not listening?" "Do you often feel restless?" I needed to recall both childhood and current situations and respond accordingly. After answering a series of questions, I received the conclusion: "Mixed presentation characteristics of attention deficit and hyperactivity disorder, exhibiting both attention deficit and hyperactivity symptoms." The doctor also advised me to pay more attention to issues of "anxiety, depression, and obsession," and if I needed medication, I could come back next time to get it prescribed by specialists or doctors.
What Is It?#
ADHD, or Attention Deficit Hyperactivity Disorder. From the name, we can see that the typical symptoms of this disorder are divided into two parts: one part is attention deficit, which includes frequently zoning out, being forgetful, and being unable to focus on tasks. The other part is hyperactivity and impulsivity; individuals with these symptoms act like a machine that runs 24 hours a day, buzzing and never stopping. They tend to act recklessly and impulsively, often not considering the consequences. Finally, there is a mixed type of patients who exhibit both symptoms.
This disorder is commonly referred to as "hyperactivity disorder," but this is a rather poor term because it not only overlooks the "attention deficit" aspect but also carries a certain mocking or derisive connotation.
If we describe it more emotionally, a student's feeling might be "all the information is floating in the air, but I can't grasp anything," "all the conditions and formulas are constantly flashing, making it impossible to focus on specific reasoning steps," or "any external information can interrupt what I'm currently doing." This feeling of "losing control" and "life being out of control" is likely the sensation of being unable to maintain attention.
If "attention ability" malfunctions, it can lead to a high degree of fatigue when doing assignments, and sometimes it may even be impossible to complete tests and homework. If forced to do assignments, it can easily lead to resistance and a lack of motivation, or even complete abandonment of the task, resulting in copying classmates' answers the next day just to get by.
This deficiency in attention can have a ripple effect, causing problems in many subjects. For example, reading classical Chinese texts in language studies, writing long sentences, balancing chemical equations, memorizing vocabulary and texts in biology, and even the simplest numerical calculations can all be affected.
Let's take the common "classical Chinese reading" question in language exams as an example to experience the cognitive processing of information. Now, please try to patiently read the following practice question:
Meng Changjun of Zhao said to the King of Zhao: "I wish to borrow troops to save Wei." The King of Zhao said: "I cannot." Meng Changjun said: "Those who dare to borrow troops do so out of loyalty to the king." The king said: "Can I hear more?" Meng Changjun said: "The troops of Zhao are not stronger than those of Wei, and the troops of Wei are not weaker than those of Zhao. However, the land of Zhao is not in danger every year, and the people do not die every year; while the land of Wei is in danger every year, and the people die every year. Why is that? Because the west is a barrier to Zhao."
Let's carefully experience the process of understanding the text. Suppose we are doing a small question related to one or two sentences, we need to understand the meaning of these sentences and form a conclusion. But while reading, the information we've already read gets "discarded," and we completely lose track of the relationship between the previous information and what we are currently reading. As we read and discard, we end up not understanding a single sentence, and all the information is scattered in the air, making it impossible to answer the question.
Not only classical Chinese reading, but students with severe attention deficits may also encounter problems when processing modern texts, which is often clinically referred to as "reading disorder." This is a very popular research area, and interested friends can read related literature.
Many people might think this condition is "a very bad thing," just like another term that suffers from societal stereotypes, "mental illness," which seems "dirty," and whether one has this condition is seen as a result of "personal choice." However, this is not the case. I often explain this issue to others like this: if your friend's arm is broken and they can't lift heavy objects, we wouldn't say, "You can't lift it because you're not trying hard enough!" That would be absurd. People with ADHD face the same issue; a part of their brain function is "broken," making it impossible for them to "focus" or "self-regulate."
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (also known as DSM-5), published by the American Psychiatric Association, clearly defines this disorder, listing nine typical symptoms of attention deficit and hyperactivity.
The nine typical symptoms of attention deficit include: "often fails to pay attention to details," "often makes careless mistakes," "often finds it difficult to concentrate," "often does not seem to listen when spoken to directly," "often does not follow through on instructions, such as failing to finish chores or duties," "has difficulty organizing tasks and activities," "often avoids tasks that require sustained mental effort," "often loses things necessary for tasks," "is easily distracted by extraneous stimuli," and "often forgets daily activities."
The nine typical symptoms of hyperactivity and impulsivity include: "often fidgets or taps hands or feet," "often leaves seat in situations where remaining seated is expected," "often runs about or climbs in inappropriate situations," "often unable to play or engage in activities quietly," "often talks excessively," "often blurts out answers before questions have been completed," "often has difficulty waiting for their turn," and "often interrupts or intrudes on others."
Please note that to facilitate readers' quick understanding of each standard's meaning, I have only "paraphrased" the content rather than copying the entire diagnostic criteria. Its descriptions are indeed very obscure, and the general public finds it difficult to understand at a glance. Therefore, you should not simply diagnose yourself based on these few sentences; everything should be based on professional medical advice from a doctor.
At first glance, you might think this is a set of "rainbow tricks," applying this framework to everyone, and there will be some aspects that resonate, but that does not mean everyone has ADHD.
For childhood, at least six of the nine typical symptoms must be met, and the duration must exceed six months; for patients who meet the childhood criteria, adulthood must meet at least five criteria, and the duration must exceed six months to be considered as adult ADHD. Whether each condition is met requires more detailed judgment, usually involving the participation of family members and the patient in recalling experiences.
The DIVA Foundation in the Netherlands has published a set of "Diagnostic Interview for Adult Attention Deficit Hyperactivity Disorder" (also known as DIVA-5), which lists various specific scenarios. This is a very detailed and powerful diagnostic tool, but unfortunately, it has not yet completed reliability and validity analysis in the country, so it cannot be used as a formal clinical diagnostic tool.
In addition to DSM-5, the World Health Organization's "International Classification of Diseases, Tenth Revision" (ICD-10) also has an independent set of diagnostic criteria, which are stricter, requiring symptoms to appear before the age of 7, and both attention deficit and hyperactivity must be met simultaneously.
Globally, the prevalence of ADHD is not a low number. Reports from the United States indicate about 11%; in Greater China, Taiwan's figure is 7.5%, Hong Kong is 5% to 7%, and mainland China is also 5% to 7%.
If we break down this number, if a class has 50 children, then 2 to 4 children may exhibit similar issues, and this group of children does not perform well academically. Let's re-examine traditional stereotypes; children with "hyperactivity and impulsivity" symptoms may be described as restless underachievers, while children with "attention deficits" might be typically described by a teacher as "daydreaming in class, not paying attention, not trying hard." The descriptions are accurate, but they do not touch on the essence of the matter.
ADHD has a genetic contribution as high as 75%, so when visiting a doctor, they will ask, "Does anyone in your family have this symptom?" If so, it adds supporting evidence. The remaining 25% is attributed to environmental factors, including exposure to toxic chemicals such as heavy metals, alcohol, or cigarettes during pregnancy and childhood. Low birth weight is also a risk factor.
Speaking of genetic factors, the corresponding "physical entity" is naturally genes. In fact, scientists have discovered some genetic loci associated with ADHD.
For example, the FOXP2 gene on chromosome 7, which is involved in brain function expression, particularly in the development of embryonic language functions. Additionally, the IP6K1 gene on chromosome 3 has also been found to be related to ADHD.
Many online genetic testing services can help us check if we possess these genetic traits. Of course, a person's external performance is the result of the interaction between genes and the environment; having the genes does not mean we will definitely express ADHD, so do not view it as a clinical diagnosis.
Finally, I would like to share my genetic testing results with readers; you can read it as a form of entertainment.
A table lists several genetic loci related to ADHD, with five showing high-risk status and four showing low-risk status.
How Does It Happen?#
A large number of existing studies suggest that this disorder is related to dopamine secretion. It governs many cognitive processes, such as motor control; Parkinson's disease is caused by insufficient dopamine secretion. Additionally, functions such as attention, motivation, and impulse control can lead to ADHD when they malfunction.
A research report published by the National Institutes of Health in the United States states that ADHD patients have significantly fewer dopamine receptors than the general population. Other studies have also found that they utilize dopamine less efficiently. Dopamine is strongly associated with our emotional experiences, specifically a sense of "reward." For example, when in love, people may feel intense passion and happiness when together, with dopamine playing a crucial role in this feeling.
The difficulty in generating a "reward feeling" can lead to troublesome consequences in learning scenarios. Taking high school life as an example, the entire high school experience revolves around the ultimate goal of the college entrance examination, which is both elusive and distant, making it hard to receive stable, timely, and strong feedback to motivate us to focus and study hard. For ADHD patients, when it is difficult to obtain "rewards," they may easily indulge in "instant gratification," or be described as "short-sighted" or "narrow-minded." This also explains why ADHD patients are more prone to issues like "addiction to TV, games, and the internet."
Teachers and parents often make such accusations: "What ADHD! Look how focused he is when playing games; why does he zone out when studying? He just doesn't want to learn!"
This way of thinking overlooks the operational mechanisms of modern entertainment, which are characterized by providing players with short-term stimulation. For ADHD patients, this is an easily obtainable reward, so they prefer tasks that are novel, challenging, and create a sense of urgency.
In contrast, tasks that require sustained effort to achieve rewards are harder to maintain. Almost no child "doesn't want to achieve good grades"; influenced by their environment, most students still have a deep desire for good results. When they don't achieve good grades, they feel pain, which is not a deliberate mistake. Conversely, some children may have a stronger desire to "study well" than others, but their lack of control functions makes them easily distracted by external information, leading to a seemingly "carefree" demeanor. The inverted causal explanation of "he just doesn't want to learn" does not help us solve the problem; rather, it harms both parties.
On the other hand, we should not conclude that someone does not have ADHD simply because "look how focused he is when doing other things." The root of ADHD is not "lack of attention," but rather the inability to control attention through personal will. Therefore, sometimes patients may exhibit attention deficits, while at other times they may struggle to disengage from a highly focused state, showing a compulsion to continue completing a task. This describes the "H" in ADHD, which corresponds to the English term Hyperactive, meaning overly active or overly engaged.
Regarding whether ADHD is a real disorder, scientists in the field of brain science have provided very intuitive answers. Some studies have found that the cortical thickness of the frontal lobe in ADHD patients is thinner than that of the general population. What does this mean? We need to start discussing the anatomical structure of the brain.
If we were to slice the brain open, we would find that it is not a uniformly textured "big pudding." From the outside in, it can be roughly divided into gray matter and white matter. The former consists of cell bodies, while the latter consists of fibers connecting the cells. These "cell bodies" make up the "cerebral cortex," and "thinner cortical thickness than the general population" means they have fewer gray matter cells. In later chapters, we will mention that the frontal lobe governs social life and emotional management. But besides these, it also participates in attention and memory processes. This explains why ADHD patients may experience "forgetfulness," "easily distracted," and "poor emotional control."
Symptoms appearing in childhood are a necessary condition for ADHD. Besides anxiety and depression, there are other conditions that can lead to symptoms similar to ADHD, but their underlying mechanisms differ. The most well-known of these are contemporary internet products.
These internet products stimulate users' dopamine secretion using various psychological knowledge and product design techniques to create a sense of "accomplishment." This is particularly evident in highly interactive mobile applications, with short video platforms being the most typical. The excessive dopamine secretion brought by these products can cause our brains to become insensitive to the stimuli from daily life, resulting in an external manifestation of "insufficient dopamine secretion." However, this is not a symptom caused by congenital factors, so we should view it separately from ADHD.
In fact, short video platforms are more dangerous than we imagine. If we feel tired from studying, the first thought that might come to mind is "let's watch a few short videos to take a break," but this content does not help the brain recover.
The brain is like a fuel engine; as long as it is engaged in thinking, it consumes energy and produces metabolic waste. Not only is studying and working a form of high-intensity thinking, but browsing short videos also involves high-intensity information processing. Therefore, it does not serve as a "rest" but rather increases cognitive load.
The reason we feel that short videos provide a "resting effect" is due to the inherent nature of this media expression form. Their core idea is to quickly evoke a strong positive emotion within a minute, satisfying the user.
Let's recall the characteristics of short videos: the editing pace is extremely fast, with no delays whatsoever, and every second is filled with strong emotional tension. This is similar to the "climax" of a movie, but a movie takes dozens of minutes to build up to this "climax," while short videos are always at "climax."
When we encounter a lack of "sense of achievement" during lengthy, complex tasks, we naturally begin to seek this easily accessible emotional energy. Short videos do not solve the problem of "mental fatigue," but rather the problem of "emotional low."
However, despite their various issues, this does not mean that short videos themselves are bad. Just like a knife can be dangerous, we can still use it to cook delicious dishes. The most important thing is to maintain a vigilant awareness while browsing this content, clarifying our purpose for viewing it—whether it is to address emotions or relieve fatigue—and what we truly need at that moment.
If we seek to let our minds "rest," then daydreaming while staring at the ceiling, taking a walk outside, or napping for a few minutes are all good methods. Based on this reasoning, I personally do not recommend students to scroll on their phones during breaks, nor do I suggest rushing to finish homework in a few minutes, as it significantly impacts the learning effectiveness of the next class.
As long as we remain aware of these concepts, I believe the negative effects of these "modern technologies" will not harm our brains.
Take Action: Addressing the Issues of Distraction#
This is a controversial question: is ADHD a personality trait or a disorder?
Can we understand that the formation of traits like "naturally careless" or "lively and active" is due to lower dopamine secretion? How do we define this as a personality trait or a disorder? Should we intervene with treatment?
A very important criterion here is the subjective thoughts of the individual: do they feel distressed due to these symptoms? If so, they need assistance and treatment; if not, then they do not. Throughout this process, respecting subjective will is crucial. Whether teachers or parents, they should avoid interfering with the patient's requests based on assumptions or subjective desires.
If you have decided to seek medical assistance, these brief suggestions may help you.
Introduction to Medical Treatment and Medication#
If you want to determine whether you have ADHD, you need to consult a professional psychiatrist for diagnosis. For students or children, almost every city can provide diagnosis, but in China, adult ADHD is only diagnosed in psychiatric hospitals in first-tier cities like Beijing and Shanghai. Even if you are an adult, you can only register for the children's attention deficit hyperactivity clinic. Some doctors in smaller places may even directly assert, "Adults cannot have ADHD."
On the other hand, some hospitals are very hasty in diagnosing ADHD. When I was in school, a teacher mentioned that some children were diagnosed within fifteen minutes. These diagnostic methods are very rash and arbitrary, affecting not only the future life trajectory of the patient but also the public perception of ADHD. Therefore, I sincerely recommend that readers seek assistance from more qualified hospitals if needed.
During the medical visit, doctors typically assess family history, diagnose basic psychological conditions, differentiate other psychological issues, and evaluate ADHD-related symptoms and their potential harm. Some hospitals may provide objective data through EEG, while others base their diagnosis on the subjective feelings and recollections of the visitor.
Current diagnostic methods have significant limitations. I once conducted a survey in a community, collecting 1,387 responses, among which 153 people reported being diagnosed with ADHD (11%), 514 suspected they had ADHD (37%), and 720 stated they were not ADHD patients (52%). Considering the norm of 5% to 7%, and taking into account that many ADHD patients may self-heal in adulthood, this number seems high. This is also reflected in the diagnostic experiences of some clinical doctors, who indeed report that some patients have been misdiagnosed with ADHD, and after taking medication, they found no effect, suffering from many side effects unnecessarily.
However, if you are truly suffering from this issue and hope to find some "quick fixes," you might consider appropriate medication. Currently, there are two types of medications available in the country: one is called "Zhuanzhuda," and the other is "Zesida." The former is a more expensive "red label" medication that requires a specialist doctor to prescribe. As a central nervous system stimulant, it can quickly produce noticeable effects, and most users report it as "effective," but the effect comes quickly and fades just as fast. The latter is a cheaper medication that works by preventing the reabsorption of neurotransmitters, thereby promoting neural activity. General doctors can prescribe it, but based on "friends' statistics," feedback from those who have taken it is not very good, with significant side effects and average efficacy.
These medications can only improve symptoms; when you need attention, taking the medication in advance can help you focus, but not taking it means you won't have that ability. If you develop tolerance from regular use over a long time, the dosage must also increase (in some Western countries, there are many types of medications for treating ADHD, and switching medications can alleviate this issue, but currently, there are no alternative medications in China). In other words, we must take medication for life; there is no such thing as "curing ADHD."
Possible Alternatives to Medication#
Everyone has some degree of aversion to psychiatric medications, and I completely understand this sentiment. On one hand, 80% of ADHD patients can improve their symptoms through medication, but on the other hand, the potential side effects of insomnia, nausea, and vomiting can indeed be tough to endure. Moreover, once the medication is stopped, the symptoms will return, which seems unprofitable. Each person's balance of costs and benefits is different, so choosing not to take medication is also an understandable choice.
In addition to medication, ADHD patients can also alleviate this issue through psychological counseling. Compared to simply taking medication, it is a gentler choice. However, it requires more energy and time, meaning it is a long-term battle.
Clinical counseling for ADHD encompasses many aspects. In addition to addressing anxiety and depression stemming from ADHD itself, it usually involves behavioral management, which means establishing a set of behaviors and strategies that can harmoniously coexist with ADHD symptoms. For example, before starting a task, clearly prioritizing tasks and tackling them one by one; or establishing a more suitable organization strategy for oneself, rather than merely pursuing tidiness.
In addition to behavioral therapy, psychologists can address broader issues through "family psychological counseling": how should parents communicate with children who have ADHD? And how should children express their thoughts and feelings to their parents? Without external knowledge assistance, ordinary parents often suffer and cannot understand why their child is "different" from others. Through the psychologist's expertise, parents can be greatly helped to emerge from this gloom.
If you are a parent, I recommend reading the book "Life Without Being Stuck by ADHD," which records the stories of a psychologist dealing with various clinical cases and the author's methods for handling different situations. The cases introduced in this book can provide references for parents, and the author can serve as a good role model, encouraging parents to calmly face their children's various issues. If you are already an adult, I recommend reading "When ADHD Patients Enter the Workplace," where the author humorously introduces a series of behavioral strategies to help readers better cope with the chaos of life.
Of course, in addition to various treatments, accepting this "disorder" is another option. Let's rethink the question mentioned in this article: is ADHD itself a personality trait or a disorder? Do we really need to intervene?
For contemporary society, especially for students, the lack of attention and the various lifestyles it brings can indeed cause significant pain. This is because the learning environment in schools places high demands on attention.
But outside of this context, is ADHD still a major issue? Everyone may have different answers to this question; some choose professions or fields that do not require high attention, such as designers, gardeners, chefs, and drivers. Because ADHD has the characteristic of being difficult to escape once immersed, if a child can immerse themselves in such tasks, they might achieve surprising accomplishments. Others choose to accept the trait of being "careless and easily lost in their own world" and coexist harmoniously with it.
After receiving my diagnosis, my feeling was not one of burden or collapse, but rather a release of a weight. When I was a student, teachers did not understand the issues I faced and often described me as an impatient student because I "stopped listening halfway through class," giving me many unfair evaluations, as if I were a bad person. But after receiving this diagnosis, I felt I could finally address those past questions.
As for my current self, although I still feel tormented when writing and preparing for exams (you can guess how many times I got distracted while writing this book), there are always ways to solve pressing issues. For example, I might start a live stream before a deadline, with the camera facing my desk; if I start to get distracted, my friends will mock me, which is a decent solution.
Besides these high-focus scenarios, ADHD brings many additional benefits. For instance, due to this highly distracted nature, fresh ideas and thoughts easily pop into my head, which can become material for my writing and development. Moreover, compared to the average person, various chaotic concepts in my brain collide more easily and form a conceptual network. Therefore, subjects that test summarization and organization, such as English and biology, I perform excellently in. This has made my university life relatively smooth, as psychology itself is a major that tests summarization and organization. Lastly, I never feel bored; whether waiting for a bus or during a long run, I can slip into "daydreaming mode" in just three seconds, so those seemingly tough times don't seem to affect me much.
Thus, reasonably planning and adopting another perspective on ADHD seems to address this issue. Although it may not suit everyone, I hope this will be a choice suitable for some readers.
Common Misconceptions and Pitfalls#
In the final sections of this chapter, I want to issue some warnings: do not pretend to be ill to deceive for medication if you are not sick, do not sell medication if you are ill, and do not take ADHD medications circulating underground indiscriminately.
ADHD medications are often referred to as "smart drugs" and are mistakenly believed to be "magical pills that help underperforming children achieve good grades." Based on this, a gray market for medication has formed in various countries. A study in April 2023 investigated the prescription drug abuse among American middle school students and found that some schools had as high as 25% of students involved in such issues, highlighting the severity of misuse of stimulant medications.
Is it safe for individuals without ADHD to take these medications? The answer is no. For those without the disorder, taking these stimulants or reuptake inhibitors can lead to various negative effects, some of which can even be life-threatening.
Everyone's dopamine secretion in the brain has a "just right" level. For patients with insufficient dopamine secretion, medication can help them replenish the lacking dopamine. However, for those who are already "normal," trying to push dopamine levels to abnormally high levels through medication can lead to significant problems.
Although there may be a short-term feeling of "being very energetic and having excellent attention," studies have found that this is merely superficial; in the long run, they do not lead to significant improvements in academic performance. On the other hand, these medications can damage attention function, create psychological dependence on the drugs, and even lead to severe health issues such as delusions and seizures. In other words, this "shortcut" approach can bring considerable trouble to future life.
There are two pathways for the circulation of these medications: one is "pretending to be ill" to deceive doctors for prescriptions, and the other is ADHD patients "stockpiling medications" and selling them. Currently, the underground price of Zhuanzhuda can reach two to three times its hospital price. Zhuanzhuda itself is expensive, and regular medication can cost nearly a thousand yuan a month. Selling these medications at high prices can yield considerable profits. However, this behavior is not only irresponsible to oneself but also causes great harm to hospitals, patients, and the general public.
Considering that many hospitals currently diagnose ADHD based on phenomenological aspects, this means that one can obtain an ADHD diagnosis by providing just the right answers in various tests, thus deceiving the hospital for "red label medication." Some do this for their children, while others do it to sell. Because of these issues, many doctors in hospitals are now very reluctant to prescribe such medications, leaving patients who genuinely need them without medication, which is quite unfortunate.
In light of these circumstances, I want to seriously urge everyone: if you are not an ADHD patient, please do not deceive hospitals for medication, as this creates distrust between doctors and patients, greatly increasing the difficulty for genuine patients to seek medical help. Whether the deceived medication is taken by oneself or sold to others, it can cause significant harm to the user and create erroneous stereotypes about ADHD in society.
If You Are Not an ADHD Patient#
We have discussed many aspects related to ADHD patients, but suppose you do not belong to this group and want to try to improve the stability of your attention; I would recommend some simple tips.
First, let's introduce a relatively "advanced" method: neurofeedback technology. This technology was initially used to treat anxiety disorders. To help patients learn the feeling of "relaxation," psychologists place several electrodes on the visitor's head, and then a computer reads our brainwave signals through the electrodes to determine whether the visitor is in a "relaxed state." If so, music is played. Through continuous practice and attempts, people can learn the skill of "relaxation." Based on the same principle, we can also learn the ability to "pay attention." When I was in graduate school, I found that some research groups were working on this, where a "spider-man" character climbs continuously on the screen; the more focused we are, the higher he climbs. This method is reportedly quite popular among children.
However, if we cannot find such professional institutions or simply feel that "going out is too troublesome," we can try simpler methods. For example, sitting at a desk and writing numbers in a spiral pattern.
A handwritten illustration shows a spiral shape made up of numbers expanding outward from a central point. The range of these numbers is from 1 to 97. There is a mark between 94 and 95, which is the "distraction mark."
During the exercise, we need to do our best to keep our attention on the paper, and if we find our attention "disconnecting," we quickly make a mark. After filling the entire page, we tally today's "score." By continuously experiencing the feeling of focusing attention, we can learn the ability to "control attention." This task is simple enough; unlike doing math problems, it does not require recalling various formulas or making various inferences, so it does not have a certain "difficulty." This is a very pure attention exercise, and as long as we persist in doing it every day, we can gradually learn to "focus."
In addition to writing numbers, intensive and extensive two-digit addition and subtraction calculations are also a feasible training method. This is particularly effective for elementary or middle school students. The underlying principle is to promote the development of working memory, thereby improving children's information processing abilities.
You might think this practice is too boring; is there something more fun? Of course! Board games are also an excellent attention exercise, with Go being a very good practice method. In addition, chess and Chinese chess are also suitable, as the process of playing requires our attention to be highly engaged, constantly processing the changes in the entire game. We can find software that suits our difficulty level for computer matches, or use online platforms to compete with other users.
If you feel unmotivated to play chess, watching "Chess Spirit King," studying AlphaGo, or watching "Harry Potter" might make chess seem cool, gradually sparking your interest.
Addendum: Neurodiversity#
In addition to ADHD, there are many terms used to describe people whose behavior patterns are "different from the norm": such as autism (ASD), anxiety disorders (AD), bipolar disorder (BD), dissociative identity disorder (DID), obsessive-compulsive disorder (OCD), calculation disorders, and reading disorders.
Let’s rethink the typical symptoms of ADHD, especially the "H" part. It includes talking excessively, interrupting others' work, and being unable to control interruptions while others are speaking. If we remove the "ADHD" label and look at it alone, this seems like a very "annoying person."
With a clear diagnosis, those so-called "patients" seem to gain a protective barrier that allows them to receive some understanding and support from society. For those without these symptoms, societal stereotypes usually demand that our behaviors align with societal averages, which can exclude many individuals with different personality traits.
This raises a very thought-provoking question: do we really need to combat the way our brains operate and force ourselves to conform to certain social norms?
Different people may hold different views, but some progressive companies and educational institutions have begun various attempts to ensure their environments are inclusive. For example, providing a quiet workspace for those sensitive to noise, allowing students or employees to freely choose their seating, and offering small toys to relieve their stress. Additionally, IELTS exams provide special versions of test papers and extended time for ADHD patients to ensure they can fully demonstrate their language abilities.
There is a specific term used to describe this advocacy, known as "neurodiversity." This concept emphasizes that differences in people's personalities are caused by different brain functioning, and there is no inherent superiority or inferiority. To embrace these diverse individuals, we need to create a more inclusive society, which includes expectations for how everyone treats each other and our expectations for a good learning and working environment. When we describe a person's behavior, we may only have two choices: "normal" and "abnormal," while neurodiversity provides a third option to view this matter: "people are diverse."
The concept of "neurodiversity" offers a new possibility for those suffering from ADHD. If this inclusive perspective can be widely accepted by society, and people begin to be willing to make efforts for it, then some students who struggle with attention can complete their academic work more comfortably without feeling pain for not being "integrated into the majority."
A junior who conducts research in criminal psychology once said, "People with specific genes are born on the path to becoming criminals." This is true; many antisocial personalities have corresponding genetic factors. These factors can affect the development of our brain's prefrontal cortex and limbic system, leading to various disordered behaviors, and some extreme outcomes may result in someone becoming a psychopathic killer.
However, individuals with these genes can also ultimately become excellent painters, authors, or scientists. The important influencing factor that determines these differences is the quality of their environment. A supportive and healing family and social environment can help these children grow up healthily. Conversely, an environment filled with abuse, discrimination, and prejudice can fully induce those innate genes, leading to one social tragedy after another. These examples highlight the importance of a positive social atmosphere.
The reason I write this chapter is also to help promote the development of the concept of "neurodiversity." Although not everyone has ADHD, if we do some simple math: gathering various mental illnesses, including ADHD, as well as those suffering from similar symptoms who do not meet clinical standards, the number will undoubtedly be large.
A fair society, a society that pursues humanitarianism, should ensure that every individual with these traits can find their suitable place and explore the world with confidence.
About This Article#
This article is excerpted from our published "Contemporary Student Survival Handbook," in which we explain nine issues faced by contemporary students from multiple perspectives of education, psychology, and brain science:
- Why don't I want to study?
- Why do I always start things but not finish them?
- Why can't I learn no matter what I do?
- Why can’t I focus at all?
- Why is my writing so hollow?
- Why do I feel lost when facing major decisions?
- Why can't I escape my emotions?
- Why can't I face myself?
- Why must I endure school and exams?
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Related Reading: Distraction Is Not Your Fault—Adult ADHD Consultation Guide
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