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Thriving with FAST MINDS

Categories: 2013, February

by Craig Surman, MD, and Tim Bilkey, MD, with Karen Weintraub

OFTEN WHEN CLINICIANS DIAGNOSE ADHD, they look for obvious signs of impairment such as being dismissed from jobs or poor grades at school. But this focus on external consequences misses what it’s like to live with these characteristics every day. It fails to capture the most common burden of what we call FAST MINDS traits: the extra time and effort it takes to compensate—such as late hours at work making up for the constant distractions during the day, or last-minute cramming on projects that won’t get done without deadline pressure.

People with FAST MINDS may be living with the constant stress of being reactive rather than proactive—handling demands at the last minute, under stress, rather than being prepared and feeling confident. They may spend their time constantly double-checking themselves to make sure they haven’t made a mistake. This extra effort may get them by at work or school but leaves little time and energy for themselves or a social life. They may suffer demoralization, anxiety, or other distress because of the impact of FAST MINDS traits on their lives. Yet often, only those closest to them know how hard they work to succeed.

FAST MINDS explained

FAST MINDS is an acronym for the challenges of living with ADHD.

When reading the following traits, see if they reflect your experience (or those of someone you care about).

  • FORGETFUL: Do you forget what people have told you? Do you forget where you put things? Do you need reminders for every day things? Do you miss appointments?
  • ACHIEVING BELOW POTENTIAL: Do you feel you underachieve? Do you feel you should be getting better grades than you do at school, or should have made it further than you have in your career?
  • STUCK IN A RUT: Are you having a hard time moving ahead in your life? Do you feel like you’re trapped trying to keep your head above water, playing catch-up instead of living how you want to? Are you stuck in important areas of your life, such as at work or in school?
  • TIME CHALLENGED: Are you often late? Do you often underestimate the amount of time that things take? Does time drift away? Do you have trouble ?guring out how long a task is “supposed” to take?
  • MOTIVATIONALLY CHALLENGED: Are you a procrastinator? Do you do things at the last minute or need the pressure of a deadline to get things done? Do you have a hard time getting started on tasks? Do you get partway done with many tasks but have trouble completing them?
  • IMPULSIVE: Do you do things without anticipating consequences (making decisions, shopping, driving, sex, drugs)? Do you blurt things out in conversation? Do you engage in risky sexual behavior? Do you make purchases without considering the cost or your budget?
  • NOVELTY SEEKING: Are you often bored? Do you seek out new, stimulating experiences to avert boredom? Do you say yes to new obligations when you are already too busy?
  • DISTRACTIBLE: Do sights, sounds, thoughts, or lower-priority activities distract you from what you should be doing? Do you ?nd yourself daydreaming on a daily basis?
  • SCATTERED: Are things messy in your personal space? Is there chaos on your desk, in your house, or in your car? Is it hard to stay on top of what you need to do, and when you need to do it?

Know how you function best

We like to ask people to tell us about moments of success, when their interests and actions are aligned and they feel like they’re ?ring on all cylinders. These are periods we think of as full engagement, or what some psychologists call ?ow. For one individual, it was giving speeches in front of giant crowds; for another, it was chatting up clients.

Think about how you felt the last time you were doing something you truly love: You were in the moment, not criticizing yourself or worrying that you might be doing something wrong. You just did it. Hold that thought. We want you to brie?y note at least three of these moments: Maybe they happen when you’re running, or solving a tricky problem, or working with your hands, or teaching someone else what you know.

Then, dig into those experiences a bit to better understand what helped them work, what context got you ?ring on all cylinders. Consider, for example, how the event or situation was different from ones that were less successful. Did the context play to your strengths? Your interests? Did it minimize challenges? Were other people involved?

How did you make it happen? Do this with a few experiences, and look for patterns. What do you notice about how your interests, strengths, or challenges in?uence where you are successful?

Principles for thriving with FAST MINDS

It helps to know the factors that help you engage—the more of your life that has the characteristics you identified above, the better. Medication for ADHD can also help eliminate challenges. But it also takes personalized strategies to thrive with FAST MINDS. Here are some common principles that underlie those strategies:

  • Emotional, negative thoughts and distracting environments can be minimized.
  • Our brains engage best in interesting, meaningful tasks, with clear steps that can be held in mind.
  • Many challenging functions can be outsourced to “peripheral brains” (alarm reminders, smartphones, planners, other people).
  • The right habits at the right moment can keep one from falling off track with daily demands, impulsivity, and relationships.
  • It takes the right environment—and accountability—to practice new strategies.

We have been honored to learn these principles from thousands of people that explored their own strengths and challenges with us—and thrived as they implement the strategies that are highest yield for them.


Craig Surman, MD, is a neuropsychiatrist at Massachusetts General Hospital and an assistant professor of psychiatry at Harvard Medical School. He is a member of CHADD’s professional advisory board. Tim Bilkey, MD, is a psychiatrist in Ontario, Canada, who developed the original FAST MINDS program to help other physicians recognize, diagnose, and treat adult ADHD. The College of Family Physicians of Canada accredited this program in 2009. Karen Weintraub is a science journalist who has written extensively about neuroscience and conditions such as autism, Alzheimer’s, obsessive-compulsive disorder, and ADHD." 
Adapted from Fast Minds: How to Thrive If You Have ADHD (Or Think You Might) by Craig Surman, MD, and Tim Bilkey, MD, with Karen Weintraub, by arrangement with Berkley, a member of Penguin Group (USA) Inc. Copyright © 2013 by Harvard University. 
This article originally appeared in the February 2013 issue of Attention magazine. Copyright © 2013 by Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). All rights reserved. No portion of this article may be reproduced without written permission from CHADD.

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