Smart But Stuck
By Thomas E Brown
- [ ] The first of many books about ADHD that I will read this year
- [ ] ADHD and emotions, the impacts of emotion on ADHD and executive functions
- [ ] What emotions impact my EF
- [ ] High IQ and ADHD, are severely impacted by emotions. They obsess over and can be derailed by emotions. They often can not follow their own emotions, they can properly manage their emotions, they feel emotions intensely
- [ ] Barkley believes that struggle with emotional regulation should be a diagnostic criteria, particularly in combined type
- [ ] New working definition of ADHD: a complex syndrome of developmental impairments of executive functions, the self management system of the brain, a system of mostly unconscious operations. These impairments are situational specific, chronic and significant impair the functioning of a persons daily life
- [ ] Emotions are situational. The emotional push to complete an essay with the deadline looming, activates the task initiation EF, even in the subject that does not interest the student. A breakup can derail the engaged subject because the obsession of emotions from the break up. Our actions and EF thus can be dictated by the emotions
- [ ] The feelings of pride, remorse, shame, regret, excitement, etc from the triggering and thoughts of specific memories. Memories play a significant role in our emotions and thus our EF
- [ ] Working memory is impacted and our emotions affected
- [ ] It’s not about will power but when will power is presented as a cure it exacerbates feelings of shame, guilt, frustration, etc. It appears to be will power when a person can write a great essay the night before or become immersed in a subject but then show up late to work or lose their keys. They are responding to emotion
- [ ] The delayed development of the brain, emotional and maturity
The book is divided into profiles and stories of people that have been impacted
- [ ] Context of events matters
- [ ] Many people in their early 20’s need the social context and support to manage their delayed development. It matters who you hang out with
- [ ] People with ADHD suffer higher rates of social anxiety, as many as a third
- [ ] Wow this kid sounds like me: gets too involved in a relationship. Struggles falling to sleep, can’t wake up in the morning. Is afraid to go to class because of the shame of missed assignments. Intelligent but reading and writing is difficult. Uses substances to cope. Does better when there is structure and immediate accountability
- [ ] He had the same sleep issues that I did
- [ ] The not showing up to class, being ashamed of uncompleted assignments, struggling in school, that spiral - wow that was me and I completely related. I did not know that other people shared that experience
- [ ] I don’t even know what the rest of the chapter was about but I identified
- [ ] With therapy, stimulates, and structure - this student was able to succeed
Karin
- [ ] Social anxiety, depression
- [ ] Drops classes, shows up to the building on time but too anxious to actually step inside
- [ ] Our brains can’t regulate and distinguish the big threat anxiety from the small ones. What should be small becomes big. We don’t have the space to deal with our frustrations, worries, shame, in a sensible manner. We have low emotional regulation. Our brains can’t modulate
- [ ] Our brains are flooded with intense emotions that push out other facts, events, and rationality
- [ ] Avoidance, lying, etc
- [ ] Wow this is me. Stopped going to class because they missed one and then too embarrassed to go back and unable to make the rational choice and solve the problem
- [ ] This is a powerful book, even if I miss all the details, these stories are stories about me
- [ ] Perfectionism and poor planning
- [ ] Quitting unexpectedly, avoiding difficult conversations, burning bridges because it’s easier than the conversation, poor social skills that impact others and the person, out of sight out of mind
- [ ] Being rejected at a young age impacts the future social growth of the adult. Being alone and not developing friendships, we don’t learn how to behave and have proper social skills
- [ ] Hibernation
- [ ] Immobilizing emotions
- [ ] Troubles with reading comprehension and short term memory. Rereading the same paragraph many times and not remembering it
- [ ] Low levels of estrogen can cause impairments to EF, particularly working memory, executive functioning, and processing speed. Some women develop ADHD symptoms when they experience menopause
- [ ] Mid life onset cognitive impairment
- [ ] Many people that take medication unprescribed, take it not to get high but to study and feel the actual effects
- [ ] There is little correlation between IQ and EF
- [ ] Effective dose does not have to do with age, weight, or severity of symptoms. Effective dose has to do with how sensitive the person’s body is to the medication
- [ ] Lazy looser with great potential that never got it together- wow that sounds like me
- [ ] Possible selfs - we have good and bad images and versions of ourselves. Lonely, bullied, successful, athletic, etc
- [ ] An individuals many possible selfs can be viewed as a cognitive manifestation of a person’s enduring goals, aspirations, motivations, fears, and threats. They provide the self relevant form, meaning, organization, and direction to these dynamics. They provide the essential link between the self concept and motivation.
- [ ] Gosh even writing that was evidence of what they are discussing in the book. I can have comprehension but poor short term memory and understanding, having to reread to listen to something multiple times to remember it - working memory and processing speed problems
- [ ] Illusion of transparency: the idea that people can see through you and you will be found out. Is a tendency for people to overestimate the degree to which their personal mental state is known by others
- [ ] That was 100% me at blue ridge
- [ ] I don’t want to be any of the losers in this book but I identify so hard with them, this book is telling my story
- [ ] I feel like my strong emotions are not real, they are just a silly symptom of ADHD. Everything is exaggerated and I am just a loser with fake feelings
- [ ] Lack of social awareness
- [ ] Inappropriate behavior, lack of awareness, rejection, struggle to develop friendships. They say things to be funny without realizing how others will take it or think that others will take it positive when actually it is taken negative. Their behavior can be outrageous and inappropriate, exaggerated, and out of bounds
- [ ] The person in this chapter carried Homer and Marge Simpson toys and would behave like they do. The person spent so much time alone away from peers and instead watched TV and movies that they learned behavior from entertainment, instead of peers.
- [ ] Wow, that is me. I spend all my time alone that I learn my behavior from TV and movies. I have said and behaved in ways because that is what I saw on the screen
- [ ] Autism spectrum
- [ ] Kids are rejected more frequently and quicker
- [ ] They even specifically mention summer camp, being rejected on the first day of summer camp
- [ ] Just being smart is not enough, consistent, significant effort and output is required
- [ ] Problems with work and marriage
- [ ] People with ADHD have higher levels of unemployment, financial troubles, problems at work, showing up on time, attention to detail, and struggle finding the correct work environment
- [ ] They can seem to lack empathy but that is not entirely true, they miss having the emotional flexibility to think about how their actions impact others. They can often do this is in reflection but not in the moment
- [ ] The author brings up autism and Aspergers often. He claims that there can be over lapping symptoms and can show those tendencies
- [ ] They struggle in marriage and relationships. Their partners have described them as; lacking empathy, inattentive, disorganized, bad with money, lacking emotion, emotionally unregulated
- [ ] a slew of others things that were tough to hear but have been said to me
- [ ] Again this chapter is speaking to me. I have struggled with jobs and I have struggled in relationships in many of the same ways as this person. Although in my defense I have put significant effort into being a good partner, I do chores, I am good with money, I am medicated, and I try my best to limit the impact I have on my partner
- [ ] A study of adults with ADHD in their 30’s found that less than 40% had lived with a partner. Many were delayed in this category and were only starting to be ready to date or being in relationships, in their 30’s
- [ ] I am not afraid that I will not be loved, I am afraid that I can’t love others
- [ ] I need to reread this chapter and this book
- [ ] I find that this book in similar to other ADHD books, where extreme examples are used and it causes me anxiety. I have severe ADHD but these stories can be overwhelming. I will relate to the first half and then will find out the person is a hoarder or doesn’t pay their taxes or something else. Reminder that I can’t read ADHD/addiction books back to back and to focus on the solution
- [ ] Obsessive thinking - the chapter on PTSD
- [ ] ’No particular form of adversity worsens ADHD, but the cumulative subjective weight of multiple stressors is likely to cause significant exacerbation of ADHD impairments in adults’
- [ ] ‘Severity of ADHD inattention and/or hyperactivity independent of cooccurring disorders was associated with negative life events; breakup/divorce, getting fired, major change in financial status or living conditions.’
- [ ] ‘Have especially hard time coping with loose and stress because they have greater difficulty in modulating and coping with intense emotions. As a result their painful life events tend to become more intense and more disruptive, than many others in similar circumstances’
- [ ] ‘Those with ADHD tend to get stuck in single minded worry and pain’ - impairments of working memory, make it hard to modulate and keep in mind positive thoughts
- [ ] ‘These events are intensified and prolonged by the difficulty of modulating emotional reactions, tending to get totally immersed in the emotion currently effecting them and by a weak capacity to keep in mind other facts and feelings that might help to attenuate their current emotional state. Many suffer from attentional biases, a tendency to tilt and recall their memories to similar times when they felt and experienced, similar feelings of sadness, frustration and rejection’
- [ ] Geez, this chapter hits me how I responded to everything the past year and half. I don’t have PTSD, I have ADHD. I obsessed, got derailed, threw out everything that I was and let a break up and subsequent lose of job define my entire life and destroy me
- [ ] I need to get my ADHD treated
- [ ] Problems with written expression are very common in people with ADHD
- [ ] Written expression learning disorder
- [ ] Impacts of impaired written expression on executive function
- [ ] Realistic hope: it is not BS, fluffy flowers, you can do anything you put your mind to. It is realistic about the challenges and pit falls. Some people will need medication, adjust the career they are pursuing, get accommodations, or other assistance. But hope is an essential part of recovery and treatment. It recognizes the strengths and obstacles while working to making it better
- [ ] Recognizes and sustains awareness of potential constrains and obstacles, while working to help the person develop ways to cope with their life situation as it really is and work to make it better
- [ ] Three steps:
- [ ] Evaluation and thorough explanation by a expert clinician. Need to include substance use, IQ test, strengths/weaknesses, feedback from friends/family/teachers/coworkers, and range of impact and behaviors in all areas of life. Should be followed by science based education
- [ ] Consider options for treatment and/or accommodations
- [ ] Psychotherapy and support
- [ ] Treatment is not an escalator always going up. There are stumbles and valleys. It gets better and then it hurts. The person and team have to be ready for this, develop the ability to see past the mistakes and stumbles, see the larger road and the improvements
- [ ] I don’t see this, all I see are the stumbles
- [ ] More intense and longer treatments helped many of his patients
- [ ] Ends with a series of questions about each chapter
- [ ] ADHD is not about will power, it is about the brain. I need to remind myself of that. It will not be overcome with substantial and appropriate support and treatment
- [ ] This was a powerful book that hit me deeply. It did not make me feel like there was a solution or that I learned significantly new things. I felt like I am not alone and that there are people like me
- [ ] I want to be one of the success stories and not a looser that collapses under the weight of ADHD. There is hope and I can get better, I am ready to do the work
- [ ] I am glad that I read this book at the one year of being fired. This book made me feel heard and gave me hope of recovery