Actually ADHD | Medication Strategies & Clinical Wisdom

The ADHD Matrix. Jonathan Murphy, PMHNP-BC, names the false reality of ADHD as it exists on the internet and breaks down how smartphone technology is specifically designed to exploit the ADHD brain.
This episode covers:
  • The ADHD Matrix as the false reality constructed by online ADHD discourse
  • Why the ADHD brain's reliance on external stimulation makes the smartphone a unique problem
  • The slot machine mechanic at the core of smartphone design: variable reward schedules, multi-modal stimulation, anticipation as dopamine driver
  • Why reaching for the phone first thing in the morning makes everything else in the day harder
  • The 2019 flip phone decision and what cutting out the smartphone actually produced
  • Habit stacking, stupid small steps, and behavioral modification through positive reinforcement
  • Friction removal as a tool for behavioral change without device dependency
  • Algorithmic pricing as the next layer of dystopia: prices changing based on individual impulsivity rather than demographics
  • Why data surveillance matters even when you have nothing to hide
  • The "technology weaponizing ADHD brains" observation
  • Creativity as the deepest stimulation source and what differentiates it from instant gratification
  • Why the Reddit r/ADHD community has silenced ADDitude despite ADDitude being the credentialed industry standard
  • The two ADHDs: the individual clinical diagnosis that responds to medication and behavioral skills, versus the online tribal identity that focuses on societal change
  • Why the individuals who have actually improved their ADHD symptoms aren't online setting the narrative
  • The return to individual change: medication, behavioral tools, and the personal assessment of whether your fails are becoming wins
This is the seventh episode of Actually ADHD. Earlier episodes covered the optimization blueprint, the medication walkthrough, the Goldilocks Zone framework, the seven reasons medication fails, the broader cultural context of ADHD and identity, and now the technological architecture exploiting the ADHD brain. The book The Process: An Adult's Guide to ADHD Medication is available on Amazon: https://www.amazon.com/dp/B0H2Z6PM4T

Find the YouTube channel Focus Path | PMHNP-BC for the full clinical education catalog.

For educational purposes only. Not medical advice. Consult your own provider for clinical decisions.

What is Actually ADHD | Medication Strategies & Clinical Wisdom?

Adult ADHD from the board-certified PMHNP behind the YouTube channel Focus Path and the book The Process. Clinical perspective on medication, frameworks, and the conversations the internet hasn't been having.

This is Actually ADHD, sponsored
by the Focus Path YouTube channel.

I am your host, Jonathan Murphy,
psychiatric nurse practitioner.

Today, I'm going to wake
you up from the ADHD matrix.

What is the ADHD matrix?

It is a false reality that exists
on the internet Anything that

you've ever heard about the
internet regarding ADHD is false.

There's a whiff of reality
encased in A tribal identity.

I talked about this last time,
but I'm gonna go deeper because if

you're one of the adults with ADHD
that learned about their diagnosis

It could have been from the internet which
is a good thing But the problem is using

a smartphone when you have ADHD Because
the internet, smart technology, and

social media is designed specifically to
exploit the ADHD brain Let me tell you how

There are a lot of theories
when it comes to ADHD

But the one universal concept is true

ADHD brains have difficulty

with stimulation.

Stimulation

is elicited in the form of dopamine, and
we can think about the dopamine pathways

that are activated as novel stimulation

Because this firing of stimulus is
not consistent in an ADHD brain,

this individual is gonna become
more reliant on external sources

of stimulation to be engaged.

Low stimulation environment,
can't focus, falling asleep.

High stimulation environment,
paying attention, but maybe

flying by the seat of your pants

There are multiple ways to access
stimulation, even if it's not

in the environment And there's a
spectrum from healthy to unhealthy

and all the way in between

But here's the thing, the ADHD brain
needs stimulation, but the problem is

our brain is gonna get that stimulation
as soon as you reach for a smartphone.

Why?

The same reason why Las Vegas
is such a profitable enterprise

with the slot machine mechanic.

Dopamine cannot be activated
consistently by the same thing.

If you hit a jackpot every single time you
put a coin in the slot machine and brought

the lever down you would just leave.

It would cease to be
exciting pretty quickly.

However

Because you don't know when it's coming.

It's the anticipation that keeps people
pumping in the coins alongside the

flashing lights, visual stimuli, the
ringing bells, auditory stimulation, the

pulling of the lever, tactile stimulation

The phone works the exact same way

So when you wake up at the beginning of
the day, if you have ADHD and you reach

for your phone, which you're likely to
do ' cause you're gonna try to access

that stimulation, you get a little reward
for doing the least amount of effort,

which means everything you do for the
rest of the day is going to be that much

harder because it's the anticipation
of a reward that gives dopamine.

If you give yourself instant
gratification, everything

else is gonna seem harder

So that's just for starters

Before I got rid of my smartphone in 2019,
I was working on behavioral strategies

for ADHD, and right away, getting my
habit formation on track, slaying these

dragons, things I wanted to do, things
I always thought I wasn't good enough.

I said, "Okay, let's try
this a different way."

Everything I tried didn't work,
so let me try it a different way.

Break things down stupid small, have
a little checklist, prioritize things.

First it was the guitar, because
I had to prove to myself it

was possible, and it was.

Then you coordinate wake
time, then exercise.

Exercise is a big one because it gives
you a huge return on your investment.

Energy suffice to say, one after
another, kept stacking those habits.

But pretty early on, I would come up
with a plan, be motivated, and next

thing you know, I was distracted.

So when you're working on behavioral
modification, you wanna be positively

reinforcing the good things, and along the
way, you'll notice those distractions In

other words, you don't want to have a goal
that's, "I don't want to do something."

You want to focus on things you're
going to do, actionable goals.

You want to focus on actionable
goals But the difference between me

with a flip phone and a smartphone,
flip phone, wake up, get out of

bed, stretch, work out, read a book,
get started with work, feel good.

Wake up with a smartphone, get up, get out
of bed, go to the bathroom, and the next

thing you know it's knock, knock, knock.

"Honey, are you still in there?"

Really, that easily

But there's more

It seems that things are just gonna keep
increasingly become More dystopian by the

day because we have algorithmic pricing

Because all your data is tracked.

I don't care if I'm being surveilled.

I'm not doing anything wrong.

Yeah, well, the reason to surveil
you isn't necessarily because

you're doing something wrong.

Think about it.

The world runs on money, so your data…

It's not all about the
government gonna get you.

Why do you need your privacy?

Because you need your peace,
peace from the grift, and those

grifters are coming in hard.

They're analyzing your data.

They're tracking your location, and
then they're gonna sell you something

at every turn, and the prices change
based off what historical purchasing

data, these microanalytics, how often
you look at something before you buy it.

What makes an algorithm
choose a price point?

It's not how much money you have.

It's not what race you are.

It's n- none of those things.

It's how impulsive you are.

In other words Technology
is weaponizing ADHD brains.

And the scariest thing of all is
creativity, the thing that provides

the ADHD brain with the most reward.

It goes beyond immediate pleasure
and into a personal satisfaction

that is greater than the moment.

It is humbling, but it's, it is satisfying
on a level instant gratification will

never be, the act of creating something.

Stimulation is another
way of saying inspiration.

So we're gonna want it all now, but
we have to learn consistency is key.

And you don't need to cut out
the smartphone, but the most

important thing to do is to work
incrementally toward a goal so

In the spirit of that, delay
initiation of the device.

However, I love my flip phone.

It is the best thing that
I've probably ever done.

And

I have a phone and I
use it when I need to.

Nothing is lost.

I've only gained.

I'm talking to you now.

I have a YouTube channel.

I'm creatively and
professionally satisfied.

And all I did was cut out friction.

I already had gotten rid of the
smartphone, but the friction

was writing notes, writing them,
typing them, clicking them.

You really wanna think about those
friction points, and you wanna

remove the risk of impulsivity

So the irony is a place like
Reddit, they're gonna talk about

ADHD, but why are you there?

To learn about ADHD.

Is it for validation?

You gotta do that yourself because here's
the thing about ADHD, it's an individual

psychiatric diagnosis for one person.

But you go online and you go to Reddit,
they don't care about your life.

They care about what they say is ADHD.

Millions of people on Reddit talking
about ADHD, sharing anecdotal

information about medication

And they've silenced a publication
called Attitude that has

the greatest reputation behind it.

It's not perfect, but it's
the industry standard online.

They've been online for quite a while.

A publication with some

prestige and power.

I mean, they're working with YouTube.

Or was it Chad?

But ADDitude is the one that
publishes articles, and I have to

admit, there's a lot of schlock.

But at least it's licensed
professionals putting out the schlock.

Unfortunately, there's two
different types of ADHD.

There's the ADHD that's an individual
diagnosis where you can learn to hack

your behavior, you can get the medication
that's gonna help you, and you can apply

the behavioral skills to change your life.

But it's gonna be really hard to do
that with a slot machine in your pocket.

But on the internet What's the thing
that's bringing everyone together?

ADHD.

So what's gonna happen when you go
to r/ADHD and celebrate your wins?

What are you doing there?

The reality is, all these people
in life that have improved their

symptoms, have met their goals,
have lined up expectations and

reality, they're not online.

Because online and these social media
platforms are inherently distracting,

you're only gonna get people that are
setting the narrative are the ones

that cannot resist the distraction.

So where does the focus go?

Instead of on personal change,
individual change, it's societal

change, neurodiversity, changing
things in human resource departments.

It's not fair that people didn't
notice, so on and so forth.

And it's not to say that
that doesn't have its place.

It certainly does within corporate
environments, public health.

There's a variety of professionals and
perspectives and so on and so forth.

But if you have ADHD and you're trying
to improve your life, you have to

cut out everybody and everything, and
just look at one thing, your life.

When you apply the medication and the
behavioral tools, are you getting better?

Are the previous fails
slowly becoming wins?

If the answer is yes, then
you're on the right path.

But if you've lost your way in
the noise, that is okay, because I

just released a book that contains
everything I know about ADHD that

I've learned in a decade specializing
in, uh, ADHD treatment for adults.

It's called The Process: An Adult's
Guide to ADHD Medication, and it

is on Amazon available right now.

You can check the show notes for that.

But in the meantime,

That's gonna do it for Actually ADHD.

Join me on next episode where
you will receive more practical

strategies from a nurse practitioner
that won't sell you short