Hyperfocus and ADHD

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Q: I recently read an article that said "hyperfocus," or concentrating intently on a task, is a symptom of ADHD. Is this true? I thought that ADHD symptoms dealt with lack of attention.

A: Some of those affected with a form of Attention Deficit Disorder (ADHD) may "hyperfocus" on activities (like staring out the window or playing a video game) that help them escape from the world. However, that trait alone is not used in the symptom diagnosis of this disorder. Intense focus is something that people—both those with and without ADHD—utilize in a positive manner to engage in life and complete tasks at hand. The key is whether or not that ability is used to help them function in everyday life.

To zone-in or zone-out: That is the question

Hyperfocus is a term used to describe a deep and intense form of concentration. In fact, it's not unusual for a person to be so attached to an activity (playing ping-pong, surfing the Internet, watching television, reading, etc.) that he or she completely loses track of time for seconds, minutes or even hours. And, many zone out and don't even notice or acknowledge another person's presence or conversation unless they are physically separated from their focused activity.

Needless to say, this is an extreme form of focus with the potential to yield either positive or negative consequences. In other words, if the ability to hyperfocus can be channeled to tasks that need to be completed, such as homework or paying attention at school or work, it's a gift. However, if someone is only able to focus on activities of personal interest but not on assignments, conversations or instructions, or if they focus so intently that it causes them to miss appointments, meals, social time or sleep, it can be a detriment.

Hyperfocus and ADHD

It is a misunderstanding that those with ADHD cannot concentrate and focus, because they often can. The difference is that they can intensely focus on what is of interest to them at the time (like swimming or video games) but have difficulty with subjects or tasks not of their choosing (like homework assignments on topics they don't like or group activities). They may feel overwhelmed when trying to organize and complete other assignments or responsibilities, leading to increased stress. In essence, they space out because of this overload.

This is in contrast to those without ADHD, as they are still able to focus and follow through with an uninteresting task without being distracted. They can organize, remember conversations, plan, socialize and balance, even when stressed by multiple assignments or life needs.

It's a daily challenge

While every person with ADHD has different behaviors and challenges, what they have in common are difficulties that began before age seven that have continued for six months or more. In children, the behaviors must be different in that they are more severe and frequent than that of their peers. In adults, these behaviors must affect their ability to carry out normal activities in at least two areas of their lives: work, school, relationships, social settings and home.

More specifically, while some people with ADHD may be impulsive (such as blurting out during conversations, making decisions without thinking them through) and/or hyperactive (fidgeting, feeling restless), others may have problems with attention (losing track of time, experiencing trouble remembering and organizing, having trouble focusing on one task at a time). Some even fluctuate between combinations of all three.

Going for the gold medal of focus

If a person with ADHD has the ability to hyperfocus, it can be used as a confidence builder for other activities. For instance, if they like the constant movement from one topic to the next while multi-tasking and working on several applications at the same time, a job in the computer industry may be of interest. Or, if they enjoy a solo activity such as playing an instrument, swimming or running, they have the potential to excel in such an area. Olympian Michael Phelps, who was diagnosed with ADHD as a boy, is a prime example.

The key is to find a constructive activity that takes advantage of these episodes of hyperfocus, and then use that strength to keep them "on-target" with the demands of their daily lives. Suggestions include but aren't limited to the following:

Helping them find an interest that engages them in the world, such as music, reading or actively working on an activity, versus passive involvement.
Using their "interest" as a motivating factor to accomplish other tasks. For example, if they like to swim, schedule a time for that activity with the understanding that they need to take on other scheduled tasks one at a time beforehand. This is not easy for those with ADHD, and they may require help to stay on target (including behavioral therapy with/without medications, and strong support from family and/or a significant other, coach or teachers).
Getting rid of external distractions (such as noise, interruptions from calls and e-mail and video games) while trying to accomplish a task or keep to a schedule.
Ridding the workspace of clutter, leaving only one project to be completed at a time. This way, the focus must be aimed on the task at hand.
Prioritizing tasks into what is important and urgent. Ask them to accomplish these first, then complete others in a timely manner.
If they get lost in hyperfocus and seem to escape from reality when on the computer, playing video games or watching television, limit the time by setting an alarm to "wake" them away from that activity and re-focus them on what they ought to be doing.

Lastly, if a form of ADHD is affecting you or a loved one, speak with your personal physician and ask for an evaluation. With the proper help, these focusing issues can be addressed.

For further information, check out Children and Adults with Attention Deficit/Hyperactivity Disorder as well as Additude Magazine.

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)