Phones, notifications and broken attention: one of the world’s leading experts explains whether it’s ADHD or just the world moving too fast
Professor of psychiatry at Harvard Medical School, John Ratey he is the man who co-wrote it with Edward Hallowell in 1994 Driven to Distractionthe book that introduced ADHD to the general public. Before then, it was thought to be a childhood disorder. That volume sold over a million copies and opened the eyes of millions of adults who finally understood why they struggled to maintain attention.
Today, thirty years later, Ratey returns to the bookstore with ADHD 2.0just released in Italy by Vallardi. The book addresses a question that concerns many of us: More and more adults are convinced they have ADHD. But is it really like that? Or simply our brain can no longer keep up with the pace of the hyper-connected worldwith phones that vibrate constantly, notifications that never stop, stimuli that come in waves? In this one exclusive interview Ratey explains how to distinguish a real disorder from a mental overload.
By the way, Ratey is the same one who wrote in 2008 Sparkthe best seller that showed how exercise acts on the brain exactly like stimulant drugs. Same neurotransmitters, same benefits on attention and mood. Since then his recipe has not changed: the brain must be trained like a muscle. Every day, without exceptions.
Professor Ratey, today many people recognize themselves in the symptoms of ADHD and believe they have it. But how can you tell if it’s really ADHD and not anxiety, depression, chronic stress or other conditions that mimic its symptoms? In your clinical experience, how many people who think they have ADHD actually have a different disorder?
“In our book ADHD 2.0 we described the concept of being constantly stimulated by an excessive amount of information. Bang, bang, bang. It’s a continuous bombardment, “too much” and all the time. As a result, people have less and less attention span. The crucial point is precisely the difficulty in sustaining attention: they cannot stay on track, they want to move on to the next thing immediately. It’s a phenomenon that starts early, with our phones and kids literally being programmed to quickly jump from one stimulus to the next. So yes, there are a lot of people who think they have ADHD but don’t. We speak of a true diagnosis when these symptoms become such that they impact the person’s functioning, ruining school, work, friendships or family life. If there is this concrete impact on life, then we try to treat it, first with understanding, then perhaps with drugs, but also by implementing strategies to help attention.”
In the book you introduce the concept of VAST (Variable Attention Stimulus Trait), a form of attention variability caused not by genetics, but by our hyperconnected environment. How many suffer from VAST without knowing it?
“Probably around 40 percent of people suffer from it. If we look at our children on their phones, the cell phone temporarily solves the VAST because it offers the immediate attraction of what they are watching, be it TikTok, a game, chatting or something else. For many this solves the problem: they are no longer distracted, but captivated. So we have a huge number of people with an attention problem, but there it becomes a question of differential diagnosis: it depends, as I was saying, on how much this concretely affects their existence.”
She also talks about “the right level of difficulty”: a mental challenge can help deactivate the ADHD brain without overwhelming it. But how can an adult who suffers from it find this balance, especially if he works in an office where he cannot choose his own tasks?
“It’s about learning to set your own internal goals. You have to tell yourself: Ok, I want to finish this project or I want to do it in the best way possibleworking hard to achieve excellence and maintain that level of performance. In a standard office job it’s more complicated, but you can make any task difficult (and therefore challenging) by holding yourself to a higher standard. And that helps.”
With Dr. Hallowell you state that ADHD can be seen as an asset, even a superpower, if managed well. It’s an encouraging message, but doesn’t it risk minimizing the real difficulties faced by those who suffer from it?
“Real suffering must absolutely be taken into consideration. We need to see how much the disorder is ruining relationships, schooling or business. Then we can say: Yes, I have this superpower, I can change direction quickly, I can get excited and be so captivated that I spend hours exploring things in a way that others don’t. Especially today, with artificial intelligence we can explore everything and become experts quite quickly. And people with ADHD love all this: being able to satisfy the need to perfectly understand whatever ‘turns them on’ in that moment.”
There’s a striking statistic in the book: ADHD reduces average life expectancy by 13 years, more than smoking or diabetes. What happens in the bodies and lives of these people to reduce longevity so drastically?
“Yes, it affects more than diabetes and smoking. What happens to many unfortunate people with ADHD is that they become depressed, overloaded with stress or fall into addictions. Addiction, by the way, is a huge problem for those with ADHD, as they desperately search for a place to feel “okay.”. They start with drugs, alcohol, or activities that give them peace or that tap into their need for intense stimulation. This plays a fundamental role in undermining their physical well-being. That’s why they live less. It is crucial for public health to say: “Hey, we have to do something“. It is not a myth, it is a fact that we must treat where possible.”
The case of Professor David he talks about in the book is enlightening: as long as he was running he was fine, but as soon as he got injured the ADHD symptoms exploded. How often does exercise mask invisible ADHD?
“I think it happens all the time. We see it in professional athletes: they train three or four hours a day and their attention is impeccable. Then, when they retire or get injured, it becomes a problem: they fall into addictions, they have anger and violence problems. They stop making their brain work well, because the brain works much better when it is excited by the “training mode”. The professor’s case opened my eyes: he was a man who didn’t know he had ADHD. He ran at least seven miles (11 km) every day. and this masked every symptom he got injured, bingo: first he got depressed and then he showed these ADHD symptoms that seemed to come out of nowhere, but were actually kept at bay by his daily habit.”
She suggests that daily exercise helps with ADHD. Is there a recipe you can give readers? How many minutes, how many times a week to see improvements?
“How many times a week? Every day. If you have ADHD you have to manage your attention on a daily basis. It can be as simple as a walk, but also do something that requires your brain to really work. I, for example, am a big fan of jumping rope. I believe it is the easiest and at the same time the most complicated exercise you can do anywhere. By skipping rope you raise your heart rate, activate your muscles and have your brain “on fire” to maintain rhythm and balance. It trains the cerebellum and all parts of the brain involved in attention”.
At Spark, you showed that exercise increases the same neurotransmitters as stimulants. Why then do most doctors continue to prescribe the pill first and then the movement, instead of the other way around?
“It’s all a question of myths, of what you believe. A great American philosopher said: I wouldn’t have seen it if I didn’t believe it. Belief follows what you see around you and is something that we as doctors are also subject to. It is difficult for doctors to believe that exercise has such therapeutic power. But you have to look at the evidence, which I presented in Spark: Exercise has a profound effect on treating anxiety, stress, depression and especially attention.”
By the way, almost twenty years after the release of Spark, would you add anything to the book today?
“I would put much more emphasis on balance and rhythm, as well as strength training. We already knew that being stronger and having more muscle helps longevity, but it also impacts the brain. The interesting thing that has emerged recently is a difference in the effect of strength training on mood. While aerobic exercise and weights are similar in improving cognition, lately it has been found that the areas of the brain that manage our mood are specifically and powerfully affected by strength training. It is very important to add the weighs on any activity you do.”
Coming back to ADHD, many use supplements like Omega-3, Magnesium, Vitamin D to help the brain manage it. Are they really useful?
“There’s no question that Omega-3 fatty acids are helpful for ADHD, as well as mood and anxiety. Most people don’t eat enough salmon or deep-water fish, so it’s a supplement I highly recommend. Magnesium is another supplement that we don’t use much but can powerfully influence our attention. These two, among many others, have been shown to be helpful. And let me say one last thing…”
“I think it’s a crime that our children don’t get exercise in schools. It’s vital that parents recognize this. It’s not just about playing sports, it’s about moving, playing outside. Especially with the reality of cell phone addiction, which hooks little ones so quickly, very early. I’ll never forget when we were trying to teach my granddaughter to crawl forward: we used her favorite toys, food, nothing worked. But as soon as we put a cell phone there, she immediately climbed onto it. It’s an addiction early, they see their parents on the phone all the time, it risks being a losing battle if we aren’t aware of it and don’t address it.”
© ALL RIGHTS RESERVED