How Do You Deal With ADHD Among Entrepreneurs?

Dr. Shirley Hershko,
Specialist in Attention Deficit Hyperactivity Disorder

Most important - awareness and diagnosis

5-10% of the population have ADHD due to an imbalance of dopamine in the brain. It doesn’t pass in childhood and continues into adulthood. Despite the way we’re used to thinking about ADHD, it applies not only to learning skills but also to relationships, family and work.

We all experience attention difficulties from time to time. What differentiates normal everyday attention difficulties from Attention Deficit Disorder? In Attention Deficit Hyperactivity Disorder (ADHD) there are significant, everyday difficulties, feelings of being stuck, and it’s not the result of a stressful life event or a particular mental state.

What does the diagnostic process look like?

In adults - there is more basis for examination through a conversation with an expert professional: what was in their childhoods, where do they see it in all sorts of areas of their lives, how great the difficulties are, etc.

In children - the diagnosis will be together with the parents and teachers, who will also testify from their point of view how the difficulties are manifested.

When we were little they were called "the disturbed/ lazy child" - today there is awareness, but it's mostly for children. The adults are still left unanswered and unaware.

Is there an “over diagnosis” today? Faced with all the floods of information and stimulation in our lives and their fast pace?

Shirley explains that Attention Deficit Disorder can not result from screens / education / nutrition because it’s something neurological - a lack of dopamine.

Therefore, drug treatment only helps those who have this problem, and will not be able to help those who don’t have attention Deficit Disorder. Even alongside the huge amount of stimuli that floods us on a daily basis, there is a big difference in the coping of those with ADHD and those who don’t.

Therefore, it’s very important to go for an in-depth diagnosis - such a diagnosis will give an unequivocal answer; That's why it takes so much effort, I’m not listening, being late. I'm not lazy, I'm not screwed. Here's the reason. Awareness is powerful.

ADHD in startups

"ADHD is a Superpower for Startups and entrepreneurs":

Creative thinking, unique minds, cool ideas, lots of curiosity, originality, spontaneity, ambition, dynamism - there are lots of things that go hand in hand with the life of the entrepreneur.

On the other hand, there are also the difficulties:

- Time organization - It’s difficult to function according to time with accuracy. At the base of someone with ADHD is a misconception of time, and one of the common tendencies as a result is procrastination.

The hormone dopamine is also called "propulsion hormone", it has an important role in the production of motivation. When there is a deficiency due to Attention Deficit Disorder, it’s very difficult to start something, persevere in it over time and finish it. Those who suffer from it feel a lot of stress.

Within the world of startups there is a stressful work environment and significant deadlines. How can the difficulties be bridged?

Recognition is important, by telling the manager and colleagues. Explain - "You’re not lazy or irresponsible" - you come with difficulty and also with solutions:

1. Give me short deadlines

2. Reminders every day, what's happening, where did you get to in your work

3. Quiet room to work from

As executives, it can be difficult for us to swallow these needs within the startup, which relies so heavily on initiative and independence. So an example of another need can help us see the situation clearly - if a person with a wheelchair or glasses came into the company, it would be obvious to us that they need help with certain things, and not ask them to pull themself together and solve their difficulties on their own. The same is true with ADHD, which is "transparent" but exists just as much.

For entrepreneurs with ADHD, the entrepreneurial trait is obviously prominent, which includes creativity and crazy ideas. On the other hand, they "fall" in places of order, organization, meticulousness, planning, control - here they need outside help.

This is in contrast to the expression in programmers for example, who often indicate that once they dive into the work it’s impossible to get them out of there. In this case, too, there are specific needs that are important to pay attention to - for programmers the environment is very significant, and they can easily fall between the cracks when the environment is not right for them.

Between co-founders - communication and awareness can lift or bring down any relationship. When it comes to the work of people with ADHD who work with people who don’t have this disorder, misunderstandings can arise, and they need to be bridged and explained.

What does ADHD look like in men compared to women

ADHD is manifested differently in men and women, which is why many women are being missed out. Boys tend to be more hyper and disturbing in class which is more noticeable, while girls are more likely to stare, dream, and be swallowed up in the background.

85% of teachers admitted that they could not detect Attention Deficit Disorders in girls.

Boys are diagnosed 4 times more often within the same family - in 70% of cases the sister will be diagnosed 5-9 years later after her brother is diagnosed with ADHD because she is more of an "astronaut".

The result of not being aware is that in old age they reach a threshold of frustration that can develop into anxiety, depression and emotional difficulties. From the outside it seems like everything is fine - they have a good job, they're  successful, with degrees, but inside they are suffering.

Why is ADHD less prominent in women?

Diagnosis for women is different - there are other criteria for diagnosis, they can’t be measured on the men's scale, just as other physical measures such as height and weight. Along with the fact that women want to please the environment more, and the symptoms of the hyper are much more pronounced then being “floaty”, they remain "transparent". One should go to a professional in the field, who is updated on new studies and developments on the specific topic of Attention Deficit Disorders in women.

The symptoms according to the DSM

In order to answer the diagnosis of whether a person has ADHD, there should be at least 5 of the following symptoms:

1. Procrastination - under pressure, at the last minute

2. Short attention span of 5-15 minutes

3. A mind that is distracted from anything internal (thoughts) / external

4. Forgetting - the multiplication table, messages

5. Loss of belongings - sweatshirts, pencil case, phone

6. Tendency to avoid mental exertion that requires prolonged attention - for example, reading books. One has to consider the intervening variable of high intelligence as an influence as well. On the other hand - hyper-focus when something is interesting - they all go all in and dive deep

7. Lack of regulation

The effects of ADHD

- Nutrition: ADHD causes unhealthy, impulsive eating patterns, there's a tendency to forget to eat all day and then come home at the end of a work day and binge, or for some snacking all day. People with ADHD are twice as likely to become obese, and 4 times more likely to develop an eating disorder associated with overeating. It’s not a matter of awareness that they don’t have, but a conduct of inattention to food, and it’s important to be aware of it. Therefore - it will not help to repeat and lecture them on what is healthy, the key is the environment. This is why nowadays in bariatric surgery it is obligatory to check for Attention Disorders, because it may be a futile solution. What can help, for example, is simply put the unhealthy food in the back of the refrigerator, far from the eye, far from the heart - and it’s better not to buy it at all. Another thing that can help is to prepare all the meals in advance, to avoid impulsive decisions during the day.

- Sleep Disorders: 75% of people with ADHD suffer from sleep disorders, neurologically melatonin is secreted later - this means it’s harder to fall asleep, and easier to concentrate at later hours because in the night is there's fewer distractions, and they can work better. This leads to less continuous sleep, getting up is harder, and they're more tired in general.

Also physiologically - they can not fall asleep. Here flexibility can help a lot on the part of managers, for the company’s sake - to give employees the night and come to work later, for optimal functioning. No need to stay in the fixed frame. In addition, there is a drug treatment of melatonin if needed.

Second is sleep hygiene, which talks about behavioral and environmental rituals (neurologists) that help produce the right conditions. It’s not due to an emotional source.

- Relationships: on the contrary of what we might assume, when two spouses have Attention Deficit Disorder - it’s easier to understand each other. In cases when only one is dealing with it, there tends to be a lot more arguments. There is 3 times the risk of divorce in relation to the population (which also has a ratio of more than 1: 3), infidelity, exchanges of spouses, much less satisfaction from the marital relationship when one of the spouses has Attention Deficit Disorder. There are couples therapists who focus on ADHD, the awareness and treatment makes the difference. ADHD is an umbrella disorder - it’s impossible not to look through this filter and its effect. All of these are also very relevant to partnership between co-founders when one of them has ADHD.

- Parenting: The whole issue of order and organization is very difficult in the matter of raising children. If it’s a child with ADHD, there is a difference in the coping of a parent who also has ADHD, and a parent who does not. A parent who also has ADHD can understand his child better, but will also deal with more stress and anxiety knowing the difficulties that his child is going to go through. The parent who doesn’t have ADHD has more difficulty understanding his child and is more likely to be angry and demanding.

Coping strategies

1) Medication - 80% success. The brain has a specific enzyme that pumps dopamine too quickly into the cells, and the drug treatment balances the rhythm. A specially trained neurologist / psychiatrist / doctor will tailor the exact treatment for you, there is no substitute for it.

The issue of food / drug / cigarette / sex / internet addictions is greater in people with Attention Deficit Disorders, and in fact drug treatment is both non-addictive and reduces the risk of addiction, it only affects while taking it. Lots of studies have found that there are no bad long-term consequences for drug treatment.

Beyond that, there is also “natural” treatment, but it’s still not a substitute for drug treatment. Just as we don’t tell someone with glasses to take them off and deal without them, and ask them - why are you addicted to glasses, we should look at pharmacological treatment for Attention Deficit Disorders in the same way.

2) Sport is found to be effective in the 2nd place - because it secretes a lot of dopamine, which also contributes to the feeling of happiness, and regulates impulsivity and anxiety.

3) For proper behavior as parents of children with Attention Deficit Disorder, it’s important to undergo parental guidance, where they can reinforce to the parents what to do and strengthen them, because they are with the child most of the time and can feel lost.

4) Help with the environment - external help that will help cover for the difficulties.

5) Organizing time adapted to difficulties and Attention Disorders improves the quality of life:

a. Lists - don’t go around with just a list that goes on from day to day, you need to do work on it - decide what’s important / urgent,  different areas, write how long it will take - a task can not be more than an hour - two hours to suit people with ADHD. Don’t just write down goals, but put in a diary at a time that suits you, even if it's 1 AM at night - otherwise it just will not happen.

b. Commitment to external people - the ability to be helped.

c. Rule 80-20 - People with ADHD have a greater tendency to perfectionism, OCD, a desire to do a perfect job, and then the job gets stuck. This rule says that in 20% of your effort and time you manage to do 80% work, and then you have the last 20% left, that if you want to do them to make it perfect, you will have to invest another 80% of your time and effort, and have to think if it's worth it. If we try to be 100% in everything we will not succeed in anything, we need to draw our boundaries out of an understanding of the price we are willing to pay.

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