How journaling can be a powerful tool in managing AD/HD

I’ve had quite severe AD/HD my whole life, but I wasn’t diagnosed until I was 30, at a time when the stresses, pressures, and responsibilities in my life had built to a point that I could no longer manage them and I sought help, out of fear of what the alternative could have been.

I had just changed jobs, I was writing my dad’s biography (which turned out to be a seven-year project), my wife and I were expecting our first child – my life felt intense, and so too did my reactions.

I was racked with anxiety, suffering depression, prone to outbursts, extremely agitated and irritable, I couldn’t sit still but I didn’t know what to do when moving, I had insomnia.

I began withdrawing, and every challenge became a catastrophe – I couldn’t see past a single moment, let alone picture a future of promise, and within those moments, I felt besieged by new problems with every passing second.

That was almost a decade ago. My diagnosis was a major crossroad in my life. God knows where I would be if it hadn’t happened.

Living with AD/HD requires ongoing management, because, as Dr Maté explains, it’s a lifelong condition comprised of equal parts genetics and environmental causes, meaning medication might help sometimes, and other times it won’t, and when the medication is removed, the AD/HD remains.

That is why managing it requires an approach that brings several strategies together, yes, including medication if appropriate, but also incorporating physical self-care, exercise, a nutritious diet, adequate sleep, and mindfulness (despite its challenge for people with AD/HD).

Journaling and goalsetting has been a critical strategy for me in managing my AD/HD and, while everyone is unique and I am the first to declare it’s not a silver bullet, I wanted to share some background on this disorder that is plaguing an increased number of people in the western world, and how and why a ritual of daily writing can help.

I know first-hand how challenging it can be on a bad day, and if any of this can help you, it’s worth sharing.

It’s probably worth starting with what AD/HD is, particularly given a seemingly-increasing perception that it’s a ‘nothing’ disorder, and simply a convenient tool for parents and teachers to create easier students and children.

I’m not going to go into an extensive descriptions here for the sake of brevity, so I encourage you to explore the research to which I refer to expand on it.

Without intending to be reductionistic, AD/HD can be summarised as a disorder resulting from the underdevelopment of the brain. Specifically, the underdevelopment of the prefrontal cortex (source).

This is the part of the brain responsible for “planning complex cognitive behaviour, personality expression, decision making, and moderating social behaviour” (source).

There is, of course, a genetic link for AD/HD, but it’s a predisposition, not a predetermination. That is: hereditary factors might make a person more susceptible to AD/HD, but it’s not guaranteed to develop and present.

The trigger for that presentation is the environment, often “early childhood stresses during the first years of crucial brain and personality development” (source), and the demands and experiences of life from then-on will dial up and down the severity of AD/HD traits.

What is the result of this underdevelopment of the brain?

I felt Dr Maté’s explanation was very relatable: “it’s called a ‘disorder’ for a reason… it dis-orders things in one’s life, creates a lack of order or workability.”

We need to address the rising cases of AD/HD, but to do that, we need to consider what can bring it about.

As mentioned, Dr Maté makes the case that the disorder arises in part due to genetic predisposition, and in part due to environmental factors, or experiences.

However, also as mentioned, we know AD/HD is caused by an underdeveloped prefrontal cortex. As a side note, this is supported by the fact that patients who suffer damage to the frontal lobe display the same symptoms/characteristics as those with AD/HD (source).

That means, we need to look to the years that play a significant role in brain development to ask the question of what leads to the underdevelopment of a mammalian brain – specifically, the prefrontal lobe.

And, just a warning, this can be quite confronting for parents, and I say that as someone with AD/HD who has parents, and as a parent with at least one child who I’m confident has AD/HD, despite not yet being diagnosed.

So, there’s plenty of parental guilt on my own side that I have to work through in order to best support my children.

However, regardless of our self-criticising guilt, Dr Maté and the supporting evidence is quite clear on the environmental triggers: infant interactions with primary caregivers and childhood upbringing.

The erosion of quality interactions between infants and children and their parents is further explained in the next section but, for now, it’s enough to state that AD/HD can be triggered by what Dr Maté labels ‘attunement’ – or, more precisely, a insufficient attunement – which refers to the connection between, initially, the mother and infant in the first nine months out of the womb, and then between the primary caregivers.

This insufficient attunement can be considered as a lack of genuine, loving and uninterrupted connection (that is: not spending the entire time on your mobile/cell phone when with a child/infant and, instead, sharing eye contact and non-verbal connections), which the infant is far more attuned to than we might realise.

The AD/HD can then be reinforced by the anxieties, unaddressed issues, and past traumas of both parents.

The way this plays out is through a reduced production of endorphins and dopamine, which results in an underdeveloped prefrontal lobe during the critical stages of brain development and, from then, the damage is done.

The following excerpt is taken from Dr Maté’s book to help explain this impact:

“From animal studies, we know social stimulation is necessary for the growth of nerve endings that release dopamine, and for the growth of receptors that dopamine needs to bind to, in order to do its work.

“In four-month-old monkeys, major alterations of dopamine and other neurotransmitter systems were found after only six days of separation from their mothers.

“In these experiments, writes Steven Dubovsky, Professor of Psychiatry and Medicine at the University of Colorado, quote, ‘Loss of an important attachment appears to lead to less of an important neurotransmitter in the brain. Once these circuits stop functioning normally, it becomes more and more difficult to activate the mind’.

“A neuroscientific study published in 1998 showed that adult rats, whose mothers had given them more licking, grooming, and other physical emotional contact during infancy, had more efficient brain circuitry for reducing anxiety, as well as more receptors on more nerve cells for the brain’s own natural tranquilizing chemicals.

“In other words, early interactions with the mother shaped the adult rats’ neural physiological capacity to respond to stress.

“In another study, newborn animals reared in isolation had reduced dopamine activity in their prefrontal cortex, but not in other areas of the brain.

“That is, emotional stress particularly affects the chemistry of the prefrontal cortex, the centre for selective attention, motivation, and self-regulation.

“Given the relative complexity of human emotional interactions, the influence of the infant-parent relationship on human neurochemistry is bound to be even stronger.

“In the human infant, the growth of dopamine rich nerve terminals and the growth of dopamine receptors is stimulated by chemicals released in the brain during experiences of joy – the ecstatic joy that comes from the perfectly attuned mother-child, mutual-gaze interaction.

“Happy interactions between mother and infant generate motivation and arousal by activating cells in the mid-brain that release endorphins, thereby inducing in the infant a joyful, exhilarated state.

“They also produce dopamine; both endorphins and dopamine promote the development of new connections in the prefrontal cortex. Dopamine released from the mid-brain also triggers the growth of nerve cells and blood vessels in the right prefrontal cortex and promotes the growth of dopamine receptors.

“A relative scarcity of such receptors and blood supply is thought to be one of the major physiological dimensions of ADD.

“The letters ADD may equally well stand for Attunement Deficit Disorder.”

It can all be summed up by this: the way in which you interact with your infant/child, particularly in the first couple of years, is the single biggest contributing factor to the awakening of AD/HD, particularly in those predisposed to the disorder through genetic inheritance.

Look, being a parent is a bloody tough job – it’s by far the hardest job I’ve ever had in my life – and we only ever do our best with what we have available and in any given situation.

And, in a lot of ways, much of this is out of our control, which is why it’s so important to have multi-approach strategy to managing AD/HD, because unless we change our entire way of life, it’s hard to see this disorder abating any time soon.

Allow me to explain, by addressing why AD/HD is on the rise (source).

There is a couple of categories we should just shift aside quickly, the first being quite obvious, in that an increased awareness of anything will make that thing appear more prevalent. So, that is to say, AD/HD hasn’t necessarily increased; our awareness of AD/HD has (source).

The second is the critical commentary of overdiagnosis, which would be silly to dismiss entirely, but which also can’t account for the consistent rise in, and entirety of, the numbers.

So, why are cases rising?

Well, having just been through what causes AD/HD, you might already have your own inclinations as to why the numbers are on the rise, especially when considering the world in which we live.

Again, I lean on the words of the more qualified Dr Maté to explain this.

“The greater prevalence of ADD in North America is routed in … the gradual destruction of the family by economic and social pressures in the past several decades.

“We have seen that the individual’s brain circuits are decisively influenced by the emotional states of the parents in the context of the multigenerational family history.

“Families also live in a social and economic context determined by forces beyond their control. If what happens in families affects society, to a far greater extent, society shapes the nature of families – its smallest functioning units.

“The human brain is a product of society and environment, just as it is a product of nature.

“The erosion of community, the breakdown of the extended family, the pressures on marriage relationships, and the growing sense of insecurity even in the midst of relative wealth, have all combined to create an emotional milieu in which calm, attuned parenting is becoming alarmingly difficult.

“The result in successive generations of children is seen in alienation, drug use, and violence; what Robert Bly has astutely described as ‘the rage of the unparented’.

“Bly notes in The Sibling Society, quote, ‘In 1935, the average working man had 40 hours a week free, including Saturday; by 1990, it was down to 17 hours. The 23 lost hours of free time a week since 1935 are the very hours in which the father could be a nurturing father and find some centre in himself, and the very hours in which the mother could feel she actually has a husband’.

“These patterns characterise, not only the early years of parenting, but entire childhoods.”

We know that AD/HD is awakened by a lack of – or insufficient – connection between the infant, in particular, and then the child, and their primary caregiver, as well as the unspoken anxieties and insecurities transferred between them.

The problem is, the ever-increasing demands and pressures of life as we know it make meeting the needs of infants and children increasingly difficult.

I want to be really clear about something here, because I think it’s an important point to make, given the incredible pressures already on parents and the amount of judgement they can feel.

This is not about you.

This is not about how hard you’re already trying. It’s not a commentary on how exhausted you feel, and how little you feel you have left to give. It’s not about you having to do more.

I’m in exactly the same boat – from both a child, and a parent perspective.

I know my parents loved me. I know they gave me everything they could. And I’m grateful for that, and I take nothing away from it, because I doubt I could do better.

In fact, it’s clear from my own family’s experiences that I’m producing similar results.

However, my underdevelopment and the emergence of AD/HD in me makes a simple, objective statement: I did not receive the connection and support I, as an individual, needed for the proper development of my brain.

Regardless of whether anyone thinks I did receive it, or whether they think I should be grateful for what I received, or whether my parents were even capable of giving more – none of that is being questioned, because the outcome is the evidence.

And, looking back objectively, I’m very aware of this. I’ve spoken at length to my psychologist about it, as we’ve begun addressing the issues it caused.

Both my parents were incredible high-achievers – my mum still is, I should add – and their professional pursuits gave me and my brother a privileged upbringing in many ways, for which I’m grateful.

But everything in life is a balance, and that privilege, high-achievement and wealth of material riches and experiences, came at the cost of the most fundamental physiological needs of love, care, support, and – most importantly – presence of my primary caregivers.

And I developed what my psychiatrist diagnosed when I was 30 as an extreme presentation of AD/HD.

Now, as a parent, in a world where the cost of living is higher and, yes, the wages are higher, but the per centage of wage taken up by living expenses is considerably higher, both my wife and I work – me, fulltime, she near fulltime – in order to pursue our career goals, and provide the life we want for our kids.

We both play sport to keep healthy, we try to see friends when we can (ha!), I obviously have my passion and dream of this very website and business you’re engaging with now, and I’m also the Chair of my dad’s Foundation.

We do all that to either provide for our family, or attempt to find a balance in life between meeting our responsibilities and actually living.

But it comes at a cost, and the cost is the available time and resources (as in, energy reserves) we provide to our children. And one of, if not both of, those children likely has AD/HD – they’re certainly presenting like they do.

I wanted to make this point, because life – let alone life as a parent – is bloody tough and, as Dr Maté explains, the way the western world is setup makes it clear that these challenges are only going to grow, not recede.

Children are often referred to as ‘sponges’ for their ability to absorb what’s going on and being said around them.

I think, more than anything, this research is a reminder to us that the absorption powers of our children are perhaps far greater than we realise, and our impact on them far more profound.

They pick up on anxieties, insecurities, job pressures, relationship pressures – all those things we try to hide, and think we’re succeeding at doing so.

I’ve heard psychology professor Dr Jordan B Peterson comment that it can take up to four generations for the impact of family trauma to dissipate, or for the cycle to be broken.

I’m unsure of his sources for that comment (as the comments are often made in a lecture/talk setting), but it seems to align fairly well with Dr Maté’s observations, as well as my own.

I’ve described my child’s situation, mine, and my father’s, but it’s worth also pointing out that my grandfather – my dad’s dad – experienced the sort of upbringing that would send Dr Maté into overdrive.

He was an orphan. Not only that, but he was separated from his brothers upon adoption. He was sent to live with a strict religious family. Then he fought in WWII, and was shot down over Papua New Guinea, earning him the Caterpillar Badge. Three years after WWII ended, my dad was born.

Four generations.

With any luck, the work, research, tools, and strategies I’m passionate about in your Story of My Life Journal can help my children ensure they break the cycle and, perhaps, do a better – or, more balanced – job of life than me.

Ok, so, here we are.

I hope you found that background, research, and explanation helpful.

I want to stress, as I do throughout this website, blog, and the Story of My Life Journal, that I’m not a health practitioner or professional, and I speak only from my own experiences and self-directed research into topics I’m passionate about.

So, please, I encourage you to speak to a professional – especially if you’re struggling with life – and consider this information as complementary to your strategies, if appropriate for you.