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.
