The Complexity of ADHD, with Dr. J. Russell Ramsay
Jul 25, 2022
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In this insightful conversation, Dr. J. Russell Ramsay, co-founder of the University of Pennsylvania's adult ADHD treatment program, delves into the multifaceted nature of ADHD. He unpacks the self-regulation model, linking it to time and financial management challenges faced by those with ADHD. Dr. Ramsay highlights emotional influences on financial decisions, offering practical strategies to manage impulses and anxiety around money. The discussion encourages embracing inconsistencies in habits and reframing the ADHD narrative for better outcomes.
The complexity of ADHD extends beyond basic diagnostic criteria, significantly impacting self-regulation, emotional management, and daily decision-making, especially in financial contexts.
Implementing specific, measurable financial goals and recognizing emotional triggers can improve financial management and overall well-being for individuals with ADHD.
Deep dives
Understanding ADHD Beyond Diagnosis
ADHD is often misunderstood, being reduced to official diagnostic criteria that focus solely on inattention, hyperactivity, and impulsivity. However, a deeper understanding reveals that ADHD encompasses challenges with self-regulation and executive functions, which play crucial roles in managing daily tasks, including financial responsibilities. Individuals with ADHD frequently experience difficulties with emotional regulation, time management, and organization, which can lead to complicated relationships with money. This nuanced view of ADHD highlights that it's not merely a deficit, but rather a distinct way of processing intentions and behaviors that intersect with various life domains, including finances.
The Impact of Inhibitory Fatigue on Financial Decisions
Inhibitory fatigue significantly affects decision-making processes in individuals with ADHD, particularly concerning financial habits. The concept illustrates how individuals can exert self-control throughout the day, only to later succumb to impulsive spending, especially when faced with immediate temptations. This behavior mirrors the well-known marshmallow test, where delayed gratification is challenging but crucial for effective money management. By recognizing the patterns of impulsivity tied to emotional and cognitive exhaustion, individuals can better strategize their financial decisions, such as setting up automatic deductions to manage savings without the risk of immediate temptation.
Building Positive Financial Habits Through Specificity
Developing financial habits involves setting specific, measurable goals rather than vague aspirations. For instance, instead of simply aiming to save money, individuals might focus on brewing coffee at home instead of purchasing it from cafes, which highlights the need for specific behavioral shifts. Emphasizing keystone habits can lead to cumulative benefits, creating a ripple effect that can improve overall financial and personal well-being. Furthermore, identifying potential emotional triggers and rationalizing financial decisions allows individuals to navigate their spending habits more effectively, turning perceived failures into manageable setbacks in their journey towards financial stability.
ADHD is more complex than just a summarized diagnosis in a diagnostic manual. There are many accumulated small behaviors physicians don't always identify that remain untreated.
In the first of this three-part series, we speak with Dr. J. Russell Ramsay, co-founder and co-director of the University of Pennsylvania's adult ADHD treatment and research program and associate professor of clinical psychology in the department of psychiatry at the Perelman School of Medicine.
The diagnostic assessment criteria for identifying ADHD include developmentally inappropriate inattention, hyperactivity, and impulsivity levels. The self-regulation view of ADHD is how efficiently one follows through on what they want to do.
Time management organization also translates to financial management motivation, behavioral initiation, and emotional regulation, which is not anywhere in the official diagnostic criteria. Money is a highly charged matter; telescoping out, it also ties in with the workplace, job loss, and some other risks for ADHD.
The Self-Regulation Model of ADHD
The self-regulation model resides within our executive functions. It's the equivalent of willpower, much like spending all day not eating ten chocolate chip cookies, but at 10:59 PM, you cave and eat them all. That's what's known as inhibitory fatigue. Using the analogy of eating as it relates to spending when you log onto Amazon.com. You spend all day not buying the item, even taking it out of your cart. Still, in the end, you click the one-click shopping and buy the item.
It's part of what the executive functions allow us to do by working toward delayed rewards. Any investment for which we have to buy in, we know we'll be better off. We want it, but it's hard because there's often some short-term cost. We would rather spend the hundred dollars today on something that we can have now than put it into the retirement fund for later.
Having a Plan
So what is your plan? What are you trying to do or not do? Be specific and make sure it's reasonable. Don't try to change everything, like training for a triathlon or deciding to go vegan.
Keystone habits are the routines and practices by which someone operates. They mark the base level of what you do without any need for willpower or persuasion. Whether positive or negative, each of these habits has a ripple effect across everything you do in life and business.
Sticking to the Plan
For people with ADHD, sticking to a plan is a challenge. They may follow it for a day or two and then start anticipating flaws. For example, you plan for your evening walk, and while putting the dishes in the sink, you start thinking, "You know what? It's a little chilly tonight. I'll start tomorrow."
Task interfering or escape behavior like that can also tie back to your financial planning by anticipating what could be some of the risk factors with a financial plan. Make informed decisions, predict and catch when we invariably start slipping up whatever the expense might be and if there’s a possibility of undoing it.
You will still slip up. We all do. What matters is catching it early and containing it, so it’s just a slip and not a total relapse.