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Q&A with Thomas Brown and Russell Barkley on Medication and Creativity

Thomas E. Brown, PhD, and Russell J. Barkley, PhD, are two of the leading researchers and authors on adult ADHD. They joined the National Resource Center’s Ask the Expert series to discuss adult ADHD and answer listener questions. Ask the Expert shared their discussion with the readers of CHADD’s Attention magazine.
Question: What is the relative importance of medication versus therapy when helping individuals with emotional regulation?

Dr. Brown: The underlying factor is brain chemistry dynamics. That doesn’t mean medicine works for everybody, but we have pretty good evidence that it works for a lot of people with ADHD if it’s individually tailored for their body’s chemistry and needs. For some people, if you can get the medication right, they pretty much know what they need to do [to accomplish their goals]. For them, the medicine alone might be quite helpful in the same way as when you put a pair of glasses on someone who can’t see very well and it improves their vision.

We need to acknowledge that medicine doesn’t work for everybody. Stimulants work for about eight out of ten people. For some people, it’s huge how much it helps them; others it helps substantially, but not hugely; and still others it helps a little but not that much. Medication is often but not always effective.

Question: How can someone affected by ADHD tell the difference between the impulsivity associated with ADHD and intuition?

Dr. Barkley: I don’t think there’s any researcher making that distinction; it’s a rather interesting question. 

Usually, when we think of intuition we think of creativity, and here we have seen some research on this issue. We do know that being a little disinhibited or impulsive does help to contribute to the ability to come up with a wide range of possible solutions to various difficulties. But that doesn’t mean that having a lot of impulsiveness is likely to make one even more creative.

But as the impulsiveness begins to increase, particularly as it approaches the level of impulsiveness we see in ADHD, which is quite serious, we begin the see it goes the opposite way. It actually can begin to interfere with creativity, because the individual becomes so distractible and so impulsive that he or she can’t stay the course. The person can’t continue to focus on a particular problem to overcome obstacles and reach goals.

So, it’s a mixed blessing—a little bit can help in expressing creativity, but a lot of impulsivity can interfere with creativity, problem-solving, and task accomplishment.

Looking for more from Dr. Brown and Dr. Barkley?

Or watch the Ask the Expert webinars:

About the experts:

Dr. Brown is an assistant clinical professor of psychiatry at Yale University School of Medicine, associate director of the Yale Clinic for Attention and Related Disorders. His books include Attention Deficit Disorder: The Unfocused Mind in Children and Adults.

Dr. Barkley is a clinical professor of psychiatry at the Medical University of South Carolina and research professor of psychiatry at the State University of New York Upstate Medical University. His books include Taking Charge of Adult ADHD.

This article appeared in ADHD Weekly on September 28, 2017.

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