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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Review
Culture
Film & TV
Trauma
5 min read

This bad TV version of The Last of Us ruins much more than storytelling

Following up the acclaimed video game doesn't deliver prestige viewing.
A pensive looking woman glances to the side.
Ellie, played by Bella Ramsey.
HBO.

What’s the point of the TV adaptation of The Last of Us

Throughout its second series, I’ve been trying to wrap my head around this question. I’m still short of an answer. 

Turning the two The Last of Us video games into prestige TV was always going to be problematic, because those video games already were prestige TV. You just had to press buttons on a controller now and then.  

The first The Last of Us video game is regularly included in lists of the best video games ever, and it’s not because of any ground-breaking gameplay or because of any technological advancements it made. It’s because of its story.  

It is richly character-focussed, gritty, realistic, and utterly human. The Last of Us Part I (as it’s now known) carries the kind of gravitas and emotional complexity you might expect from the likes of The Sopranos, Breaking Bad, Chernobyl, or The West Wing. It’s already prestige TV.  

So, is the TV adaptation simply an attempt to make this same story accessible to people who don’t play video games? Maybe. That would make sense, were it not for its deeply frustrating second series, the finale of which has just aired. 

The Last of Us Part II was massively controversial when it released in 2020. (WARNING: absolutely colossal spoilers ahead, for both the games and the TV show). Joel – the main protagonist of the first game – is abruptly and brutally murdered in its opening act. This leads Ellie – his pseudo-surrogate-daughter – to hunt down those responsible in attempt to enact a reckoning.  

In the video game, most of the story is told over the course of three days. First, from Ellie’s perspective, then from the perspective of Abby, Joel’s killer. In the TV show, the second series covers Ellie’s side of the story before very abruptly shifting to Abby’s side in the final seconds, leaving the viewers with a cliffhanger. Even as someone who’s played the game and knows what’s going to happen, it felt like a bit of a slap in the face. 

But for someone who hasn’t played the games it must be bordering on nonsensical. Even spread over two series, the story is so truncated, and so much is left unsaid. I can’t imagine making sense of this series without having played the video game first. But the TV show is basically just a live action remake of the game. Which again begs the question: what’s the point of the TV adaptation of The Last of Us

I’ve found this series, and the video game it’s based off, hugely frustrating. Because it’s trying to convey an important message. But both the game and the show contrive to undermine their important central ideas through poor storytelling techniques and structures.  

But in making clear what was left unsaid in the game, the power of the moment is undercut. Much is spoken; little is said. 

Let’s take one example. Half-way through the game (or towards the end of series 2), Ellie has tracked down and tortured one of Abby’s friends for information on her whereabouts. Afterwards, she talks to her lover Dina about what happened.  

In the game, it’s harrowing. Ellie is visibly shaken by what she’s just witnessed herself do. “I made her talk.” She says. And then to Dina: “I don’t want to lose you.” “Good,” comes Dina’s reply. And that’s it. Cut to black. Little is spoken; much is said.  

But where the scenes last about 30 seconds in the game, in the TV show it’s over five minutes long. “I made her talk. I thought it would be harder to do, but it wasn’t. It was easy. I just kept hurting her.” So says Ellie, halfway through the conversation. The writers are clearly trying to make explicit Ellie’s fear that she’s losing herself, and Dina by extension, in her thirst for revenge. But in making clear what was left unsaid in the game, the power of the moment is undercut. Much is spoken; little is said. 

“I know writers who use subtext and they’re all cowards,” Garth Marenghi once said. I can only assume he writes for HBO now. 

It’s a shame the scene gets fluffed as badly as it does, because really it’s the centrepiece of the narrative. Faced with unthinkable violence, Ellie chooses to repay the act in kind. But, in hunting down and torturing those responsible, ultimately Ellie finds herself becoming less and less human with each act of revenge. Here, in this conversation with Dina, Ellie begins to glimpse the reality of this. That acts of violence towards others are ultimately also acts of violence towards her own nature.  

This is, as it turns out, a deeply Christian notion. Where other Ancient Near Eastern creation myths depict their gods as creating the world through violent and bloody struggle, in Genesis God merely speaks life into being. Where Jesus’ disciples would violently overthrow their Roman oppressors, he instead says “those who live by the sword, die by the sword.”  

Moreover, Jesus’ death by crucifixion was unspeakably cruel and violent, encompassing protracted public humiliation, sexual abuse, and mutilation. It is here that Christ draws the suffering of the world to himself, that we might be given the opportunity to live free from the ongoing cycle of violence that surrounds us. Not that we might avoid having violence done to us, but that we might find the strength not to be violent in turn.  

And this is the ultimate paradox at the centre of Christianity: that the greatest show of strength the world has ever seen is found in Christ’s being nailed to a tree.  

Violence begets violence begets violence begets violence. That’s the message of The Last of Us Part II; albeit one conveyed in a rather ham-fisted way. While I’m not optimistic, I hope the next series of the TV show manages to fix the game’s wobbly narrative structure to convey this in a way that is nuanced and compelling. Because it’s a message we desperately need to hear. 

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Since Spring 2023, our readers have enjoyed over 1,000 articles. All for free. 
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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.

Graham Tomlin
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