Explainer
Attention
Care
Culture
Psychology
5 min read

How to help someone with ADHD to live well

Overstimulation, inner critics, and the quiet power that restores balance
An emoji-style brain divided in two with active emojis one side and calm ones the other.
Nick Jones/Midjourney.ai.

This week’s headlines about ADHD in the UK paint a troubling picture. NHS England commissioned an ADHD Taskforce which has warned that waiting lists for assessment and support are “unacceptably long”, with services buckling under the pressure of rising demand. In some areas, including Coventry and Warwickshire, NHS boards have even paused new adult referrals to prioritise children. Charities are already preparing legal challenges. 

Among the Taskforce’s key recommendations is a call for general practitioners to take on a bigger role. Rather than referring every suspected case to specialist services, GPs are to receive training to recognise and manage ADHD within primary care – a shift intended to relieve the enormous strain on the system. But this raises a human question as well as a policy one: while people wait (often for months or even years) what can families and friends do to help? And might some of these strategies reduce the need for crisis-level specialist support in the first place? 

Around  five per cent of the population is thought to have ADHD, though the true figure may be higher. Rising diagnosis rates have prompted some scepticism: are we simply getting better at recognising the condition, or is something new happening in our overstimulated modern world? 

Psychiatrists Edward Hallowell and John Ratey suggest that many of us now live in an attention environment that mimics ADHD. They call this phenomenon VAST: Variable Attention Stimulus Trait. VAST is not a disorder, and it is not “ADHD lite”; rather, it’s a product of neuroplasticity, i.e., the brain’s capacity to adapt to its environment. ADHD, by contrast, is neurodevelopmental – it is part of how a person’s brain is wired from the start. ADHD can’t be “undone” – nor would many want it to be. ADHD is a way of being that entails many strengths as well as struggles, as I have written about before. But where there are struggles, both ADHD and VAST respond to similar strategies for living well. 

Hallowell and Ratey describe the brain as operating through a set of overlapping neural networks. Two of these, the Task Positive Network and the Default Mode Network, play a key role in attention and focus. The Task Positive Network switches on when we’re engaged in a clear, structured activity: writing an email, cooking dinner, solving a problem. When it’s active, we’re absorbed and unselfconscious. The Default Mode Network, by contrast, takes over when we’re not focused on a specific task. It’s the realm of daydreaming, reflection, and big-picture thinking – reviewing what we’ve done, imagining what comes next. 

For most people, the brain glides between these two states smoothly. But in today’s hyperconnected, screen-saturated culture, many of us – especially those with VAST – flicker between them too quickly, never giving our Default Mode Network enough time to process what has just happened. The result is stress, restlessness, and mental exhaustion. 

In ADHD, though, the problem is different and deeper. Brain scans suggest that both networks may be running simultaneously, and the Default Mode Network in particular has a knack for interrupting. Imagine trying to finish a task while a running commentary in your head constantly questions its worth, urgency, or achievability. That’s the ADHD experience: the Default Mode’s chatter makes tasks hard both to start and to finish. 

But the Default Mode Network isn’t all bad. It can be a source of creativity, moral reflection, and meaning. It’s the voice that tells you a task matters, that something is worth your effort. Hallowell and Ratey liken it to the classic “angel and devil” on your shoulders – but the devil often shouts louder. That’s partly because the human brain is wired to prioritise threat. We remember criticism more vividly than praise, and replay social embarrassments more easily than successes. For people with ADHD, this negativity bias can be overwhelming. As Hallowell and Ratey put it: 

“People who have ADHD or VAST are particularly prone to head towards gloom and doom in their minds because they have stored up in their memory banks a lifetime of failure, disappointment, shame, and frustration. Life has taught them to expect the worst.” 

This relentless inner critic drives many ADHDers to self-soothe – ideally through human connection, but too often through less healthy means: food, alcohol, drugs, or risky behaviours. Statistically, people with ADHD are ten times more likely to develop an addiction, and their average lifespan is at least 13 years shorter than that of the general population. 

So how can friends and family help? Is there a way to interrupt the drive to self-medicate in self-destructive ways? The answer, remarkably, is so ancient and simple as to almost seem facile: it is love. 

When the Default Mode Network first hits upon a negative self-judgement, its instinct is to reach outward – to seek comfort and belonging. If connection is unavailable, the “devil voice” finds substitutes in addictive or numbing behaviours. But when real, safe relationships are present, they act as a protective buffer. Studies show that people with ADHD who experience strong, consistent love from partners, friends and family have lower addiction rates, better health, and longer lives. 

Of course, loving someone with ADHD can sometimes demand extra patience. Your ADHD friend or family member is likely to be the most creative, empathetic, and generous person you know, yet also the one who forgets your birthday, arrives late, or leaves your message unanswered. None of this is intentional neglect; it is the Default Mode’s interference – the whisper that says, “They probably don’t like me that much anyway.” Understanding this dynamic transforms frustration into compassion. It helps us see that behind the missed text is someone fighting an invisible cognitive tug-of-war – a loved one who needs reassurance, not reprimand. 

Even for those without ADHD, our era of constant notifications and information overload is training our brains toward VAST-like patterns. We’re pulled between self-judgment and self-justification, between doing and ruminating, with little space for rest. Learning to quiet the inner critic and nurture connection is good for all of us. 

When we tune into the gentler side of our Default Mode Network – the voice that says “You are valuable to the people around you” – mistakes lose their sting, and perfection ceases to be the price of self-worth. 

The NHS may take years to fully resolve its ADHD backlog. But in the meantime, there is meaningful work that families, friends, and communities can do. We can offer the connection that helps quiet the inner storm by being the person who reaches out, forgives the lateness, and replies with warmth even when the other couldn’t. 

This may not shorten the waiting list, but it could lengthen lives. For the millions with ADHD, and the millions more living with VAST, love is not a sentimental afterthought – it is the neurological antidote to despair. 

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Essay
Culture
Doubt
Music
Psychology
9 min read

What happens when perfect plans are outsmarted by the world?

There may be delight hiding in the doom.
Two people sit and stand next to a grand piano on a stage.
Striking the wrong note.
Polyfilm.

If I’ve learned anything at all from decades working with businesses, it’s that they love an acronym. For a while the acronym we loved was VUCA. Not a nuclear jet nor a foot wart, VUCA emerged from the leadership theories of Warren Bennis and Burt Nanus to reflect the Volatility, Uncertainty, Complexity and Ambiguity of contemporary leadership. Nothing gets a roomful of executives nodding sagely than the observation that we live in a VUCA world. For a while it felt almost sacrilegious not to evoke VUCA at some point when training leaders. It was comforting to tell people who were supposed to be shaping the world that everything was, well… a bit nuts. 

But in the last few years VUCA has lost its shine. Things have started to get too crazy, a bit too VUCA for anyone’s liking. The wars, the plagues, the natural disasters, the political upheaval, the shaking of old certainties- it’s all gone a bit super-VUCA. The acronym that once reassured us that the world tends to resist our perfect plans has been outsmarted by the world it once captured. What are we to call this permacrisis, this omnishambles, this SNAFU, when super-mega-hyper-VUCA just sounds stupid? A new acronym was needed. Enter stage left- BANI, the invention of futurologist Jamias Cascio to designate the way things are now: Brittle, Anxious, Non-Linear, Incomprehensible. We’ve had a romantic breakup with the world- you’re not like it used to be, you used to be fun, you’ve changed!  

In March, Seen & Unseen celebrates its second anniversary. We are two years old. Old enough to appreciate a birthday cake, too young not to burn our fingers on the candles. I’ve been writing for the site since the beginning and to this day feel surprised that this quirky mishmash of a brainfart I keep writing is still accepted for publication each month. Either the folks at Seen& Unseen are pathologically kind to their own detriment, or my monthly missive of misery is not quite as off the wall as I fear it might be.  

When I look at the world, I feel like we’re in a football match with no referee. I keep shouting foul and looking for someone to blow the whistle. It feels like the Tower of Babel. Even the technologies we thought would unify us have made us incomprehensible to one another. Like the scene in That Hideous Strength (the third book in C.S. Lewis’ Cosmic Trilogy) where a roomful of people is magically befuddled. They can no longer understand each other, and anyone who rises to take charge of the situation speaks gibberish that only adds volume to the babble. We don’t need any more opinions. We certainly don’t need any more people with misplaced certainty they have the answer. 

To be honest, I’ve just run out of ideas. I’m confused, baffled, clueless. But what embarrasses me most is not my helplessness, it’s my hope. For some reason, in jarring contrast to the circumstances, I can’t shake off the sense that ultimately all this will make sense, that breakdowns lead to breakthroughs. We’re in the unbearable part of the story where everything goes wrong, but if we put the book down now, we’ll think that was the end of it, when it was really just the set up. Pretty much everything I’ve written for Seen & Unseen over the last two years equates to: grief, this looks bad, but maybe there is more to it than it appears. 

There is another anniversary being celebrated this year. This January marked the fiftieth year of a musical event so remarkable that a new dramatization of it premiered at the Berlin Film Festival to mark the occasion – the recording of The Köln Concert. (Watch the trailer of Köln 75.) If we are looking for a story of how beauty emerges from disaster, this one is worth telling. The event was organised by eighteen-year-old Vera Brandes, at that time the youngest concert promoter in Germany. She booked the Cologne Opera House, but given that it was a jazz concert, it was scheduled to begin at 11:30pm following an opera performance earlier that evening.  

The performer, jazz pianist, Keith Garrett travelled to the concert from Zurich. But rather than flying, he sold his ticket for cash and opted to make the 350-mile trip north with his producer Manfred Eicher in a Renault 4. He had not slept well for several nights and arrived late afternoon in pain, wearing a back brace, only to discover that the opera house had messed up. The Bösendorfer 290 Imperial concert grand piano he had requested had been replaced by a much smaller Bösendorfer baby grand the staff had found backstage. The piano was intended for rehearsals only, in poor condition, out of tune, with broken keys and pedals. It was unplayable. Jarrett tried it briefly and refused to perform. But Vera Brandes had sold 1,400 tickets for the evening. So, while he headed out to eat, she promised to get him the piano he required. 

But it was not to be. The piano tuner who arrived to fix the baby grand tells her a replacement is impossible. It was January in Northern Germany, the weather was wet and cold, and any grand piano transported in those conditions without specialist equipment would be damaged irreparably. They had to stick with the piano they had. Keith Jarrett’s meal didn’t go well either. There was a mix up at the restaurant and their food arrived late. They barely had chance to eat anything before returning to the venue. And when Garratt saw the tiny defective Bösendorfer still on the stage, he again refused to play, only changing his mind because Eicher’s sound-engineers were set up to record.  

So the concert begins. A reluctant pianist – tired, hungry and in pain – sits at a ruined piano, and records the bestselling piano solo album and bestselling jazz album. Ever. He improvises for over an hour. Starting tentatively, exploring the contours, befriending the limitations of his damaged instrument – learning its capabilities as he plays. But soon Jarrett is whooping, yelling and humming with delight as he extracts beauty from the brokenness. The limited register forces him to play differently. The disconnected pedals become percussion. By the time he reaches the encore, the joy of his playing is irrepressible – it sends shivers down the spine. And when he finishes, the applause goes on. Forever.  

Jarrett pulled off an impossible feat and sealed his reputation as one of the greatest pianists of his generation. And I take heart from the event, because when I face the world, I sometimes imagine I feel like he did facing that piano. Tired and pained and doubtful any good will come of playing. Can I order a new world, please? One more to my liking. One less likely to hurt. Yet I can’t quite shake off the intuition that there may be delight hiding in the doom, a treasure only unearthed by those willing to play. 

I am drawn to Job. He is a hero to all those who are sick of the answers of others but have no answers themselves. 

This year I celebrate my own anniversary. I was born seven months after that fateful night in Cologne, in the equally salubrious town of Birkenhead. This is my fiftieth year too. The 3:15pm of life: too early to clock off, too late to start anything new. If living is a race between maturity and senility – gaining the wisdom to live before losing our marbles – then I’m odds-on for a photo finish. The evidence accumulates daily that I am likely to live longer than most of my vocabulary.  

Jung held a positive view of old age. He viewed it as the time for religion to ripen. And I can’t help agreeing with him. The older I get the closer God seems. As muscle mass thins the spirit deepens. Outwardly I’m fading away, inwardly I am being renewed day by day. This undoubtedly underlies my hope of beauty arising from our brokenness. In some small and barely noticeable way it is already happening in me. And I know I’m not alone in that.  

Jung also wrote about Job- the Hebrew epic of suffering and restoration. Job’s life is like one of those old blues songs. He loses his wife, his kids, his home, his health. He’s left broken, infested with sores and sitting in the dust. If you’ve been in a situation like that, you’ll know that even the most well-meaning friends can respond with surprising incompetence. Job’s friends are no different. They are true believers in Just-World Theory, the universal human tendency to assume that if bad things happen to us we must deserve them, we must have been bad. They live in a world ultimately governed by the kind of instant karma that causes car crashes on YouTube, and they’re keen to teach Job the way the world really is.  

But Job resists them at every turn. He may have a proverbial reputation for patience, but he is anything but patient. I used to think this was a story about a man defending his innocence, but it’s much more than that. It’s the story of a man who goes through a breakup with God. He once lived a life of goodness, abundance, and gratitude in which he knew God as attentive and lovingly present. His friends are not just arguing that he’s being punished for some undisclosed sin, but that he’d always been wrong about God. He’d never known God- not really. The God they knew was volatile, capricious, arbitrary, vicious - like a rescue dog, you never quite knew when he would turn. And Job’s suffering was the proof of it. 

The problem for Job is that he has no clue why he is suffering, but he will not let his friends obliterate the history he has shared with heaven. He knows God to be utterly faithful, constantly present, sublimely attuned, hugging the contours of his life as the sea hugs the shore. He wants nothing to do with a fickle god who falls asleep on the job or flounces off the first time we let him down. He rejects the here-again gone-again god of his friends. Sometimes, to know God, we need to reject those who claim to speak for God.  

The weird thing in Job’s story is that eventually God shows up. Over the course of the narrative, he has asked God 122 questions, and God responds with 61 of his own. The questions are rhetorical- they point to all the places God is present that Job isn’t, all the things that God knows that Job doesn’t, all the things God has done that Job hasn’t. And by the end, Job is satisfied, his friends are dismissed, and his life is restored. God is as Job expected, intimately present but ultimately mysterious. He was right to reject the obtuse certainties of his friends and face the pain of the world with a cultivated sense of unknowing. 

When I ponder how best to bring beauty out of a BANI world, how best to play its brokenness like Jarret played his Bösendorfer, I am drawn to Job. He is a hero to all those who are sick of the answers of others but have no answers themselves. He is also a hero to those who, despite all evidence to the contrary, cannot smother their hope. Those who discern the leavening yeast sown in the hearts of humans across the planet; too inconspicuous to make the news, but destined to rise when the time is right.

Celebrate our 2nd birthday!

Since March 2023, our readers have enjoyed over 1,000 articles. All for free. This is made possible through the generosity of our amazing community of supporters.

If you’re enjoying Seen & Unseen, would you consider making a gift towards our work?

Do so by joining Behind The Seen. Alongside other benefits, you’ll receive an extra fortnightly email from me sharing my reading and reflections on the ideas that are shaping our times.

Graham Tomlin

Editor-in-Chief

Watch the Köln 75 trailer