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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Article
Assisted dying
Care
Comment
Politics
5 min read

Suicide prevention groups are abdicating their responsibility on assisted dying

Not speaking out is a dereliction of duty to vulnerable people

Jamie Gillies is a commentator on politics and culture.

Three posters with suicide prevention messages.
Samaritans adverts.

On Friday, Kim Leadbeater’s assisted suicide bill will return to the Commons for a second day of report stage proceedings – when MPs consider amendments. Third reading, when the House votes on the bill itself, is expected to take place the following Friday. Opponents of this controversial bill will be hoping that enough MPs feel uneasy about it to say ‘this far and no further’. They will need around 30 MPs to have changed their minds since a vote last year in order for a defeat of the legislation to be assured. 

As politicians have weighed this issue, there’s been a conspicuous silence from one constituency you’d expect to have been outspoken: suicide prevention organisations. People might be surprised to know that Samaritans, perhaps the best-known suicide prevention charity in the UK, a cornerstone of prevention efforts since the 1950s, did not submit evidence on the bill before Westminster or a separate bill at Holyrood. Other groups like Suicide Prevention UK (SPUK) and Papyrus have also been silent. One has to wonder why, given the bearing a law change would have on their work. 

Suicide prevention charities and their volunteer counsellors do incredible work. Over the years, millions of people in desperate circumstances have received life-changing support. Today, every person contacting a suicide prevention helpline is told that their life has value, and that there is hope in the bleakest of circumstances. Every caller without exception is also told not to harm themselves. But this couldn’t continue under an assisted dying law. A two-track approach would have to be devised, depending on a caller’s circumstances. A scenario helps to illustrate this point: 

Caller: “I am thinking about ending my life”. 

Adviser: “Please know that there is hope. I’m here to listen and I can offer support, so you don’t have to make that choice.” 

Caller: “Well, I have terminal cancer you see…” 

Adviser: “Oh, sorry, I need to put you through to a colleague. Your situation is a bit more, err, complex. You need to know your legal rights”. 

Some proponents of assisted dying are quick to dismiss concerns about suicide prevention, arguing that assisted dying and suicide are wholly separate categories. However, this argument doesn’t hold water. Whilst campaigners use euphemistic terminology and employ Orwellian rhetoric about ‘exercising choice at the end of life’, and people ‘shortening their deaths’, it is clear that the bills they promote would permit suicide with the enablement of the state. 

An assisted dying law would see doctors prescribing lethal drugs to certain patients which they can take to end their own lives. The dictionary definition of suicide — “the act of killing yourself intentionally” — has not changed. Neither has legislation giving expression to this idea. Logically and legally then, assisted dying involves suicide. 

Samaritans is clear on this. A ‘policy brief’ on assisted dying published in November — the most recent statement on the issue by the organisation — begins by saying that it usually applies to terminally ill people and involves “assisting the person who is terminally ill to hasten their own death”, adding: “The act that kills them is performed by the person themselves”. Their death is a suicide, in other words. 

You might assume an organisation that says, “every suicide is one too many”, whose stated aim is to see “fewer people die by suicide”, would be opposed to assisted dying - or at the very least concerned about it. However, Samaritans goes on to say that it does not “take a position on whether assisted dying is right or wrong, or on what the law should be on this matter”. Why? Because it “would involve making a range of judgements” that could compromise people’s “perception of our ability to provide non-judgemental emotional support”. 

Samaritans and other suicide prevention organisations should be intensely interested in what the law says. The introduction of assisted dying in any part of the UK would mean suicides being condoned and enabled in healthcare settings for the first time — a radical departure from the existing approach. Professionals always counsel against suicide, no matter a person’s motivation for wanting to end their life. Every citizen is precious, and every life worth saving. 

Prevention organisations must also realise that a change of this gravity will have a wider impact on culture. Research shows a rise in non-assisted suicides in countries that have introduced the practice. Sending a message that some suicides are permissible might make their prevention work harder. Organisations saying nothing in the face of all this is astonishing. 

As noted above, assisted dying poses practical questions as well as philosophical ones. If the law changes, organisations will no longer be able to adopt a universal approach to suicide prevention. A call to a suicide prevention helpline from a terminally ill person will have to be handled differently to a call from a person who is not terminally ill. For some, suicide would be a healthcare ‘right’. How will organisations navigate this? Doesn’t it concern them? 

There has been some advocacy from individuals engaged in suicide prevention, if not from organisations. In February 2024 psychiatrists wrote to The Times to warn that the Westminster assisted dying Bill would “undermine daily efforts to prevent suicide”, particularly among the elderly. Louis Appleby, the UK Government’s suicide prevention adviser has also spoken against a change in the law, arguing that it would harm efforts to drive down suicides. 

Appleby explained, “once the principle behind suicide prevention has been set aside, once any part of the ground has been ceded — not only to allow suicide but to assist it — we have lost something we may not get back. There are countless causes of irremediable hardship, many reasons people may want to make despairing choices. Could they become exceptions to suicide prevention too?” This principled position is exactly what you’d expect from someone whose job is protecting hurting people, no matter their personal situations. 

I’m loath to criticise suicide prevention groups as I deeply appreciate their work. However, by not contributing to the debate on assisted dying, they are abdicating their responsibility to shape a policy that would impact their mission, and the people they serve. A policy that would lead to state-sanctioned suicides and impact culture in profound ways. It’s terribly sad to see groups that fight to end suicides failing to stand against a policy that would harm their work. Failure to speak today may be viewed as a dereliction of duty in years to come. 

With a final vote on Kim Leadbeater’s Bill days away, and the decisive vote on Scottish plans not due for months, there is still time for suicide prevention groups to enter the fray. I pray that they will.

Support Seen & Unseen

Since Spring 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 enjoy 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.

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