Scattered Minds summary

Let’s start at the beginning. What exactly is ADD? 

Well, the disorder has three major traits: poor attention skills, deficient impulse control, and hyperactivity. We’ll go through each of these traits in turn, starting with poor attention skills. 

What we mean here is an automatic “tuning out.” The mind is absent when its attention is required to complete tasks or process instructions. Inattentiveness takes many forms. A person with ADD might ask someone a question and zone out as they begin answering it. They might look up from a book and suddenly realize they can’t recall a single word they’ve read. Or they might enter a room and discover that they have no idea what they wanted to do in it. 

Whatever its form, inattentiveness causes considerable practical hardships. Kids who can’t focus fall behind in school; adults with the same issue make silly mistakes at work and miss out on promotions. Young or old, people with ADD are constantly being chastised for failing to do things they forgot about the moment they agreed to do them. 

Inattentiveness also interferes with people’s enjoyment of life. One patient told the author she had never understood music – it was a confusing, impenetrable wall of white sound. Another patient talked about how his ADD had isolated him socially. He said he felt like a human giraffe: his body lived in the same world as other people but it was as though his head were stuck in the clouds far above. 

Inattentiveness is rarely total, though. In fact, doctors sometimes miss ADD diagnoses because their patients are capable of hyperattentive focus. For example, a child who is inattentive at school may happily spend hours poring over maps in the evening. The thing is, the ADD mind can muster enough focus and motivation to complete tasks if those tasks are intrinsically interesting. A child with ADD who finds geography fascinating will have no problems focusing on studying maps. But that focus doesn’t carry over to other tasks that don’t interest her – science class, say, or tidying her room. Also, hyper-attentiveness often involves shutting out the rest of the world to engage in a single absorbing activity. That, too, is a feature of poor attention regulation.

The second characteristic of ADD is impulsiveness. Poor impulse control also takes different forms. A child with ADD may speak before thinking, blurting out thoughts that others find rude or inappropriate. Or they may find it impossible to stop themselves from interrupting others. Adults with ADD are often impulse buyers. One man who the author diagnosed with ADD said he would impulse buy the entire world if he had the money. More generally, impulsiveness is often the cause of excessive risk-taking. Kids with ADD may jump off roofs on a whim; teens might binge drink alcohol they find in the kitchen cabinets for the same reason. An adult with ADD may drive recklessly fast for no other reason than she felt like it. As one of the author’s patients put it, the only thing that ever slowed her down was the siren of a police car. 

The third and final trait of ADD is hyperactivity. Unlike the previous two traits, hyperactivity isn’t ubiquitous. Yes, many people with ADD can’t sit still – they fidget, drum their fingers, chew their nails, tap their feet, or can’t stop talking. But often, it’s entirely absent. Many girls with ADD, for instance, frequently go undiagnosed because their behavior isn’t a source of disturbance in classrooms: they sit still and appear to be listening to what their teachers are saying. The problem only comes to light much later when baffled parents start wondering why their well-behaved daughters are doing so poorly in school. 

Some people with ADD display all three traits. In that case, they may be diagnosed with ADHD – attention deficit hyperactivity disorder. But the presence of any two of these three traits is sufficient for a physician or psychologist to diagnose ADD. 

Now that we’ve defined the disorder, we can turn to its origins. What, in other words, “causes” ADD?