Confusing creativity with ADHD
Focus vs. Creativity
Creativity competes with focus. When the brain wanders, attention drops. When the mind is focused, its creative powers serve a single purpose. Human progress is based on rampant creativity. However, school primarily demands focus and attention.
At the end of this chapter I provide a prescription. On the way, I try to show how schooling nullifies my prescription and leads to side effects such as the ADHD "epidemic".
Rage to master as ADHD
The rage to master is a characteristic that could easily drive one to a false ADHD diagnosis. A true rage to master is monothematic and mono-focal. The kid might dig into building models of planes and show no interest in anything else for hours, weeks, or even months. The same kid forced to listen or focus on any other topic would quickly stop paying attention and start fidgeting (see Fidgeting and creativity). Creative kids have very little tolerance for boredom. All things other than their interests can be painfully unstimulating. Gifted kids show little patience for accepting structured activity imposed by others. That leads to classic symptoms of ADHD. It is not that the modern world reveals a psychiatric disorder called ADHD, as stipulated by Gladwell (see below). It is not that we value rationality and that fidgeting kids lack in it. For those gifted kids, the coercive pressures of schooling is the thing that makes them contribute to the "ADHD epidemic". Schooling does not reveal ADHD. It reveals traits that can be a problem or a blessing or both.
Scientists can prove that ADHD kids show worse performance in memory tasks and even in video games. The problem is that there are methodological snags in differentiating between "boring memory tasks" and "interesting video games". The true diagnosis can only come by letting the kid choose the task in question. This can be difficult, esp. in a lab setting. So the division should be between "boring memory tasks and boring video games" vs. "individual kid's favorite video games and fascinating tasks involving memory". If the kid got a singular interest that can consume its attention, there is no pathology. Only if it can be proven that the kid can't focus on anything under any circumstances, we can call it a problem. Even then exercise might work better than Ritalin for therapy.
Scientists need to look for the match between the environment, brain inputs, mental status, and the memory status. In short, if a seemingly disruptive kid finds his favorite activity that satisfies his learn drive or novelty seeking needs, he may start performing well. Giving a kid a video game does not ensure the match. The game may be boring too. Equally well, the game may be interesting only for a while. The game may not form that perfect match. In an ideal case, researcher should give a kid a dozen of options, or better yet ask "What would you most like or love to do right now?" and then satisfy that wish. He might then be surprised with the degree of attention the kid can pay. This should nullify the diagnosis of a pathology. The testing I propose here is hard to do in a doctor's office. It is the parent who has the best access to this type of information. A kid with quirky high focus abilities cannot be classified as ADHD. His departure from the norm is not maladaptive and may actually be beneficial.
Malcom Gladwell proves bogus ADHD diagnosis
I am a great admirer of Malcolm Gladwell. I love his bold generalizations. All generalizations, by definition, are wrong to a degree, but his are inspirational. That makes them precious. When he says "10,000 hours of intense practice turns you into an expert", he sparks millions to go for the noble 10,000 hours target. He makes thousands feel good about their own 10,000 hours. We do not really need to barter about it possibly being 9,999 hours. Herbert Simon made similar generalizations before and they help us all understand expertise and the value of hard work.
Despite my admiration, I must say that, two decades ago, Gladwell has delivered a piece of text that is a standing self-contradiction. Given Gladwell's power and influence on a large sway of the population, his text may even be dangerous. Gladwell wrote about ADHD and Ritalin. He tried to prove that ADHD is real and Ritalin may do a good job. Nobody should take drug recommendations easy. All drugs are backed by powerful financial interests. It is super-hard to find unbiased information. However, paradoxically, Gladwell convinced me that an ADHD diagnosis may be a blessing. Years ago, I checked DSM IV just to rank myself on the ADHD spectrum. I had always joked that I am a classical case, however, I wanted to give it a serious evaluation. In my self-diagnosis, I instantly hit many hyperactivity checkmarks. All of those come from traits I consider highly valuable in creative work. I love and cherish my hyperactivity. I use it in my work.
When it comes to attention deficit, however, I failed to meet the criteria. After all, in my line of work, lapses of attention are costly. Actually, when I focus well, I would say that my focus is pretty remarkable. I can focus on things of interest to the exclusion of the entire world.
It was Gladwell's article that convinced me that I meet ADHD criteria of DSM IV almost perfectly. Gladwell's article was wrong on so many levels, with wrong examples, misinterpretations, and reality distortions, that I truly lost my ability to read his article! If Gladwell was right, I should be taking Ritalin. I will explain why this would be a disaster. I can easily manage my "disorder" and even use it to increase my productivity. I do not have problems with "intellectual consideration and rationality" as Gladwell's article might imply.
I always read texts incrementally. This type of reading leaves me with a lot of room for creative wandering and, paradoxically, for minimum reading error. However, in Gladwell's case, even reading incrementally was not possible. His text sparked a zillion of creative threads that stole all my attention. Needless to say, creativity is a great thing if it can be controlled. Incremental reading makes it easy. During a creative explosion, I have to take a break from reading, write down the ideas for future use, and move on to something else. Exercise works best for an effective break. I returned to Gladwell's article on the next day, and then two days later. I then returned a few more times to continue reading. I managed to finish reading. Gladwell proved I suffer from pathological attention deficits at times of high creativity. I suffer from those deficits on a daily basis. Even more, if a have a day without pathological lapses in attention, I start worrying. A day without lapses of attention could come from bad sleep, working too hard, stress, or other ill health factors. By arguing that a rise in ADHD is real, Gladwell convinced me that I am ADHD positive, and I love it!
Is ADHD problem real?
If you have been diagnosed with ADHD and still read this article, you should probably cherish the diagnosis. Otherwise it is simple: Attention deficit problem is real. Hyperactivity problem is real. They can cause real problems (see: Consensus 2002). You can crank up all traits to pathological levels as much as you can get poisoned with most innocent food components. These traits will superimpose on other personality traits which can make diagnosis difficult. If there is a clear drop in IQ, the traits may be classified as maladaptive. Traits associated with ADHD can be assessed incorrectly in a doctor's office or in classroom conditions. They will often be based on unreliable parental testimony, or even a heavily biased teacher's testimony. A kid marked as inattentive may turn out to have focus capacity superior to average. Traits underlying ADHD have genetic components. They may be more visible in the modern world. Most of all, we inherit those traits because they can be a blessing too. They are associated with creative personalities and as such should be investigated thoroughly and capitalized upon rather than suppressed. Ritalin may improve performance. In a right dose, so does alcohol or even cocaine. All drugs must be taken with utmost caution. If your kid gets a Ritalin prescription, if you are not sure, ask for a second opinion. Ritalin is a short-term measure similar to the use of anti-depressants (see: Ritalin will backfire). Before you go in that direction, read Dr B. Cramond: The Coincidence of Attention Deficit Hyperactivity Disorder and Creativity.
Using DSM-5, I should classify myself as classic hyperactive, highly impulsive, and often extremely inattentive. At the same time, I love and cherish all those aspects of my personality. What is inappropriate for many people, and might be disruptive for others, can be indispensable in creative work. Fidgeting is healthy. I keep moving all the time. My impulsivity is all about the brevity of life and having little patience for all forms of time wasting. As for inattention, paradoxically, it is all about focus. During a jogging, I may think about some research ideas so hard, that I forget the whole world and get to the destination only because of reflex automaticity. This is great! This provides more processor power for the job at hand (and less for lesser things). Call me absent-minded professor and I take it as a compliment. Give me a memory task or a stop signal task in a lab and I will probably perform poorly. Unless I consider the experiment interesting, e.g. in my own work, my mind could easily go elsewhere. I would fail to pay attention and flunk. I would do awfully with video games. My brain would keep whispering "you are wasting your time". I might even easily fail at a math test. I love math when it leads to solving a specific problem. Otherwise I might think the job would take too much time to be worth it. In some settings, an observer researcher might think "this guy just cannot focus on the job. He is bad a math". There is nothing about "mental discipline" here. When there is a job to do, I am proud of my discipline. I solved a thousand math problems at work, but none of that work was "slogging out through with mental discipline". I was always drawn by the light in the tunnel, which made math fun and easy. Whatever is not easy today requires some more learning, not slogging through. In a math task in a lab, I might not even trigger the self-discipline gun. "Slogging out through" is rarely a good idea. Good problem solvers show less brain activity. Productive mental tasks are usually easy and the need to slog comes from getting stuck in a blind alley. This is what makes some SuperMemo users not too effective. They have a rational capacity to slog through. They often bring it as a habit from school. They slog, while the right action would be to ask why the job is getting harder. In case of SuperMemo, slowing down should lead to eliminating leeches (i.e. pieces of information that refuse to stick to memory).
How does the modern environment reveal and magnify my ADHD? With incremental learning, I can learn at light speed. This has ruined my patience for reading long linear books. I read many books as a kid, i.e. before SuperMemo. Now I may seem impulsive or impatient. One of my close colleagues even joked "SuperMemo has damaged your brain". I am proud of that diagnosis. These days, there are smarter ways of reading. Old-style book reading is dead for me.Many educators and psychologists consider all ADHD brouhaha pretty dangerous. A legitimate research may be hijacked to turn kids into robots for perfect submission, conformity, and obeyance of commands! You bet I would be prescribed Ritalin as a kid! Many teachers considered me extremely disruptive. This would hasten the diagnosis. Malcolm Gladwell would say "it is no longer considered appropriate to cast aside those who because of some neurological quirk have difficulty coping".
Is rampant creativity a problem? It can be if it is not harnessed in a rational manner. Otherwise, rampant creativity is the most precious thing that helps change the world. It is the basis of problem solving, research, invention, and more.
This is how creativity can be harnessed without detriment to attention and problem solving capacity (for more see: Good sleep, good learning, good life):
- morning: let creativity go wild, keep learning, keep thinking, keep veering off the topic, go mad if need be. If you like to play your dopamine card, a cup of coffee before that slot might be an acceptable form of doping
- after 2-3 hours, the brain will naturally slow down due to a neural overload defense mechanisms. This helps organize all effects of creative output and add some more focused learning or problem solving
- exercise: peak circadian time for exercise is also good for "focused creativity", i.e. the time when exercise induced alertness can put various creative threads together into new quality. Metaphorically speaking, the brain is slowing down creatively because of neural fatigue, but can still put creative pieces together in adrenaline-driven setting
- siesta: napping is vital for clearing the mind. It can also possibly play a role in organizing knowledge, similar to what happens during night sleep (see below). At little cost, napping multiplies a person's creative lifespan by two. It provides two creative days in one calendar day
- evening: let creativity go wild again, keep learning, keep thinking, keep searching
- late night shower: this is a problem solving time. Rampant creativity is now dead. With eyes closed, with no distractions, "focused creativity" can kick in again. This might be the best time to push for the hint of the ultimate solution
- sleep: invention time! Sleep is a natural neural organizer. REM sleep reshuffles pieces of information stored in the brain during the day. Deep sleep congeals new structures. It is not always obvious, but most of answers to problems solved by humanity are put together in sleep and revealed in the morning. Sleep is a free ticket to invention. It is the time when you literally solve problems without lifting a finger. This is why alarm clocks should be banished (at least in creative professions and in youth)
Figure: Optimizing the timing of brainwork with respect to the circadian cycle. This exemplary graph was generated with the help of SleepChart on the basis of 3-year-long daily measurements of a free-running sleep rhythm. The horizontal axis expresses the number of hours from awakening (note that the free running rhythm period is often longer than 24 hours). are actual sleep episode measurements with timing on the horizontal, and the length on the left vertical axis. Homeostatic sleepiness can roughly be expressed as the ability to initiate sleep. Percent of the initiated sleep episodes is painted as a thick blue line (right-side calibrations of the vertical axis). Adenosine-related homeostatic sleep propensity increases in proportion to mental effort and can be partially cleared by caffeine, stress, etc. Circadian sleepiness can roughly be expressed as the ability to maintain sleep. Average length of initiated sleep episodes is painted as a thick red line (left-side calibrations of the vertical axis). Mid-day slump in alertness is also circadian, but is biologically different and results in short sleep that does not register as red sleep maintenance peak. Sleep maintenance circadian component correlates (1) negatively with temperature, ACTH, cortisol, catecholamines, and (2) positively with: melatonin and REM sleep propensity. Optimum timing of brainwork requires both low homeostatic and circadian sleepiness. There are two quality alertness blocks during the day: first after the awakening and second after the siesta. Both are marked yellow in the graph. For best learning and best creative results use these yellow blocks. Caffeine can only be used to enhance alertness early in this optimum window (brown). Later use will affect sleep (caffeine half-life is about six hours). Optimum timing of exercise is not marked as it may vary depending on the optimum timing of zeitgebers (e.g. early morning for DSPS people and evening for ASPS people). For more details see: Biphasic nature of human sleep.
My perfect formula worked for many great minds in the past. I cannot be sure that it would work for you, but it sure stands in violent opposition to a typical day at school. This is how schooling would destroy the creative day prescription:
- morning would be ruined by early waking for most kids
- the creativity step would be skipped. Some kids would be too sleepy to engage in creativity. Others would be silenced by school rigor. Brainstorming with peers would be ok as long as it was permitted
- without the creativity step, the period for focused work would be more lethargic and dispassionate, perhaps clouded by sleep deprivation
- exercise might be wrongly timed at school. Instead of helping the process, it might interfere with it. In a circadian cycle, all pieces must come together at the right time
- naps are not possible at school and school lasts too long to make post-school naps effective and/or healthy. Some kids sleep in two long blocks with naps taking up to 5 hours. This is a rare formula with hard-to-evaluate consequences. It is certainly unnecessary
- without a siesta, evening creativity is greatly diminished. This is the time when tired kids are forced to "slug through" their homework. Only teens who take longer naps can truly benefit from self-directed learning in the evening
- sleep cannot be a good memory organizer if its last REM-rich phase is cut off with the alarm clock
Only a fraction of kids truly enjoy school. Those are the kids who have the best natural defenses against school routine or whose personality and circadian cycle provide a good match that makes it possible to draw some benefit. Paradoxically, it is mostly the gifted ones who like school. These are the kids who need school the least! They would thrive in a homeschooling or unschooling settings!
Circadian aspect of ADHD
The whole host of sleep problems in ADHD can be easily explained by disruptions of the circadian cycle caused by the suppression of creativity, post-school napping, evening homework, and sleep phase disorders (esp. DSPS). All sleep problems in this context seem to fit a similar pattern: circadian misalignment. This usually has the form of going to sleep in a wrong phase, insomnia, premature waking, problems with waking up, stimulants to remedy ADHD, and a vicious cycle of hyperactivity and troubled sleep.
If your kid gets an ADHD diagnosis, before you agree to drug him, try this simple formula for a few weeks:
- let him sleep as long as he wants,
- let him move and run as much as he wants, and
- let him learn at the time when he wants.
To make sure that it all does not collapse, keep notes and try to fit the kid into some circadian frame (e.g. clear lights out time, clear computer time allocations, limits on evening games, limits on comfort foods, etc.). The free routine requires a bit of experience to make it work. Try it out for 3-4 weeks. If it does not work, at least you can say you tried for drug-free existence.
Remember, pharmaceutical giants push hard in the direction of drug use. This is why all potential users must counter-push hard to provide the balance of forces. Natural remedies in the shape of sleep, diet, and exercise can do miracles in many cases.
No good diagnosis can be made on a kid in conditions of circadian disruption. For an ideal ADHD evaluation, kids should be in their best natural state. For many, the period of school nullifies such a possibility. A good evaluation can only take place during a longer vacation when kids free run their exercise, learning, feeding, and sleep. The sad truth is that kids are their real selves only during the vacation.
All aspects of ADHD are manageable to a degree. Following the child's interests is one of the best remedies. It affects hyperactivity, impulsivity, and inattention in one swoop. An engrossed kid can lose all its symptoms.
Some teachers will insist that teens are impulsive and therefore need to be directed. This is the opposite of what needs to be done. Gentle pointers are ok. Otherwise, impulsivity can be harnessed and help engage kids in intellectual obsessions. Even if obsessions keep changing, they are likely to bring multiple fruits. For quick reassurance, if your kid is daydreaming, ask a simple question "What are you thinking about?". This is a simple recommendation from Dr B. Cramond that an analytical parent will easily use to see information processing value in all cases of inattention. Kid's brain is a perfect goal-oriented novelty seeking missile (see: Learn drive). Even if it is hard to attribute much value to a particular daydream, for neural/biological reasons, it is almost a guaranteed productive effort. Pathologies are possible, but a healthy well-growing kid should be allowed to dream to his heart's content.
Circadian cycle can be an ally too. SleepChart can demonstrate that capacity to learn follows a circadian curve. In a well-rested adult, best learning occurs in the morning and after a siesta. Worst learning occurs late in the night and at lunch time. Some evening type readers might protest this finding due to the fact that many teens do their learning in conditions of a phase shift, i.e. when they wake up before their optimum waking hour and when they work well into the night due to the shift in their circadian peak. This is particularly true for those who take monster naps after school. Those naps actually substitute for night sleep, which is shrinking in conditions of high pressure from school.
ADHD is considered a learning disability. Paradoxically, in a well-rested kid, symptoms will coincide with best learning windows. This is an indicator of the correlation between giftedness and ADHD. The paradox comes from the fact that SuperMemo measures synaptic and network capacity, while ADHD occurs at higher, behavioral level. In short, the kid's brain may be ready for high-quality learning at the neural level, however, he won't learn a thing because of running around wild.
In that sense, the circadian cycle can be used to look for periods of extended push zone. Those periods will coincide with lesser learning performance in an adult. When the kid's neural capacity to learn drops, the same kid's capacity to oppose the tutor drops. In simplest terms, the kid in a more lethargic state can actually learn more. All aspects of ADHD will wane as long as the child is not affected by other interfering factors such as sleep deprivation, emotional distress, sickness, etc.
Additional homeostatic aspect of ADHD can be tackled with exercise. Each time hyperactivity becomes an issue, a short energy burning session can help. This is done best in a free running system in which the kid self-regulates its mobility. It will wax and wane in the circadian cycle, but the oscillation itself is homeostatic. This is why it cannot be done by a fixed system of schooling: 45 min learning and 15 min. of running around, esp. that ADHD kids do not take breaks from interesting activities well. Once they focus and pay attention, all disruption can put a spanner in the works. Breaks come naturally through fatigue. They may be needed in 10 minutes, or after two hours.
The circadian cycle depends on the waking phase. Homeostatic control of mental activity is a complex process that cannot be modelled easily. Most of all, it depends on the type of brainwork involved. Engrossing activities will often require less mental energy as they provide a good match between kids cognitive skills and task difficulty. Needless to say, all those permutations of factors will differ for different kids and may even be hard to predict for the same kid on different days.
In other words, it is almost impossible to make a kid fit a universal frame. This defeats the purpose of school schedules. That defeat is most painful for gifted kids or ADHD kids. Child's schedule needs to be computed individually on the basis of demand. Child's brain is the best computer for the purpose.
Learning, exercise, sleep, feeding and other activities would best be free run, and only general circadian framework may be captured for predicting the optimum time for nighttime sleep, siesta, and perhaps the main exercise block (equivalent of PE).
- creativity and focus stand in opposition. Both are desirable and vital
- my formula for best creativity is described here
- rigors of schooling may reveal creative personalities as most disruptive
- ADHD as defined in DSM-5 can easily lead to marking creative individuals with a mental disorder
- ADHD diagnosis in conditions of sleep disruption, or under a pressure of schooling, cannot be considered reliable
- before kids are drugged, they should always be given a chance of free running schedule that can mitigate symptoms
- using drugs for managing learning problems that come with compulsory schooling is like managing side effects of a bad medicine with an even worse medicine
- psychiatric drugs target receptors and neurotransmitters, not specific brain structures. As such they are bound to have side effects
- circadian approach can greatly mitigate attention and hyperactivity problems
- rampant creativity that underlies innovation can destroy focus and can be harnessed with circadian tools
- schedule designed around the circadian cycle provides for best learning and for the best creative potential
- schedule designed around the circadian cycle may mitigate all negative aspects of ADHD
- school schedule design stands in mortal conflict with lifestyle conducive for learning and creativity
- geographic differences in ADHD diagnosis show the magnitude of potential costs of misdiagnosis