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A new article in the Science section of last week’s New York Times was the first in a series called “Therapeutic Window,” by psychiatrist Dr. Awais Aftab. He starts off saying many of his patients complain that they can’t stay on task, can’t get chores done, forget things, and run late.
Most of them say that they have an attention problem. Dr. Aftab thinks the label is leading us astray.
In a lab, “attention” means filtering—picking out what information matters and ignoring the rest. What Aftab’s patients describe is something entirely different: the inability to stay with a task once they’ve started. Staying on task depends less on filtering and more on whether your brain treats the task as worthy of doing at all.
A research study backs this up. When kids in the study took stimulants, the brain circuits that changed were the ones handling reward and motivation. The attention circuits didn’t budge. So the medication works by making dull things feel more worth doing (creates a reward), not by sharpening your focus.
Two practical tips came out of the article:
First, don’t wait to feel focused. Build rewards into your work. Give yourself shorter deadlines, a timer you can see, and tasks that are small enough to finish so you feel like you’ve accomplished something.
Second, don't rely on a test. People with ADHD sometimes score fine, and people without it sometimes score badly. What decides the diagnosis is your history: how far back your attention issue goes, whether it shows up in more than one part of your life, and what it’s costing you. Mostly that’s a conversation, not a score.
Dr. Aftab ended the piece with a question that I keep coming back to: Which labels do you accept without question, and which do you reflexively reject?
It’s easier to swallow a label whole or dismiss it entirely than it is to sit and really contemplate the details in your life.
One in four think they have ADHD. In reality, many people are just exhausted
Words of Wisdom
ADHD is not about knowing what to do, but about doing what one knows
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