Telling Time with ADHD: Now and Not Now
By: Julia Daley
What even is ADHD?
We had a whole issue on the topic, so I won’t rehash everything here. ADHD, or Attention Deficit/Hyperactivity Disorder, is a neurodevelopmental condition, meaning that people are born with ADHD and experience its impacts throughout their lives. ADHD usually presents in one of three types: hyperactive, inattentive, or combined (which is a mix of both hyperactive and inattentive types). ADHD brains are different from neurotypical brains, and they especially struggle with regulating their dopamine levels in addition to reduced working memory capacities.
Lacking in dopamine, ADHDers often experience executive dysfunction, or their ability to plan, execute, monitor, and adjust their actions in daily life. This executive dysfunction is considered the “core” of the problems that ADHDers endure. Unable to control where their attention goes, they may hyperfocus on a special interest instead of doing their homework. They often battle themselves internally to maintain focus on something uninteresting—a lecture or a meeting—as their dopamine-deprived brains desperately search for anything more stimulating for it to pay attention to. Their working memories are easily overwhelmed, so they often lose their trains of thoughts or forget things they should do.
Whether due to that forgetfulness, or perhaps their poor executive functioning, ADHDers can be inconsistent with anything involving deadlines—being somewhere at a certain time, or doing something by a certain time. Many ADHDers describe their difficulties with timing as “time blindness” and consider it the symptom that most impacts their day-to-day lives. It’s almost as if time, as neurotypical people understand it, doesn’t exist in the same way in ADHD brains. They feel the passing of time differently, if they feel it at all. For example, while in hyperfocus, ADHD people often don’t notice that hours have passed them by. It’s hard to make plans when your understanding of time is fundamentally different from everyone else.
All of the above, of course, is just the tip of the iceberg when it comes to the trials and tribulations of living with an ADHD brain. Researchers don’t fully understand the whole scale of the iceberg, either. We know a lot about what ADHD looks like in young (mainly white) boys, but when it comes to girls, or women, or men, or … everyone else, well, that research is just (barely) getting started. One recent area scientists are beginning to explore in ADHD is time: maybe that self-reported “time blindness” is what really lies at the heart of the ADHD iceberg.
Neurological Time
Physical time—the ticking of a clock, the countdown of a timer—is something we can measure. How we feel and experience time within our brains is a much trickier thing to understand. Why can time feel both fast and slow? How can we distinguish between a long and short time? Is my sense of time the same as your sense of time? These questions imply that we have some sort of internal clock, one that can keep track of the time around us, and this inner clock may vary between individuals.
There are a whole bunch of theories of how our internal clocks might work …but I have little time to go over them all here, alas. No one particular theory stands out at the moment. In a brief nutshell, most theories of neurological time tend to focus on the following concepts to try to explain how the brain does time:
- The brain has some way of consistently recognizing the passing of time (For example: the ticking hands of a clock)
- The brain has some way of remembering how much time things usually take (For example: it usually takes fifty ticks for the coffee machine to make coffee)
- The brain has some way of comparing the present time with a past reference time (For example: the coffee machine seems to be slower than usual)
- There is an important reason for our brains to perceive the passage of time (For example: humans use their understanding of time to determine the optimal method of making coffee)
At the moment, we can’t point to a particular region in the brain and clearly identify it as our neurological clock. Based on what we know so far, there are a few areas in our brains and bodies that seem particularly important for our theorized internal clocks, which the different theories try to account for. Let’s start with our eyes, which contain photoreceptors, or cones and rods that react to the changing intensities and hues of the sun’s rays throughout the day. These form the foundation of our “circadian clock,” which helps our bodies follow a pretty consistent rhythm through daily life: waking us up, signaling when we should start getting hungry, helping us feel sleepy, etc. As elegant as this light-based clock is, though, it does not fully account for all of the ways we humans can perceive time, especially for shorter intervals like seconds or minutes, which would involve a much-too-subtle change in light intensity for us to really be conscious of.
Dopamine seems to be another big player in maintaining our internal clocks, though we’re still not quite sure exactly what role it fulfills (Fung et al., 2021). Varying dopamine levels seem to change the “tempo” or speed of our internal clock (how fast the clock hands move). When dopamine levels are elevated, it seems to increase the speed of our internal clocks, which would make us feel as if time is slowing down as we perceive “more ticks” between actions (i.e. things seem to take more time). When dopamine levels are reduced, our internal clocks seem to slow down, which makes us feel as if time is moving faster as there are fewer “ticks” between actions (so things seem to be happening sooner than expected).
Dopamine, of course, is also a big component of our motivational system, and so far researchers haven’t fully been able to disentangle these two facets of dopamine: timing and motivation. Perhaps the broader neurological theory of Predictive Processing, then, plays a role here. When we are surprised—because something happened faster/slower than we expected it to—dopamine levels rise. This surprise tells our predictive brain to adjust its internal models. It may be that dopamine helps us adjust the speed of our internal clocks in response to prediction errors (Fung et al, 2021). If it does indeed have a role in time perception, then perhaps that explains why people with ADHD—and their dysregulated dopamine levels—seem to struggle so much with time blindness.
Time Blindness (aka ADHD Time)
Trevor Noah, the famous comedian, has been open about his late-ADHD diagnosis (meaning he was an adult at diagnosis). In a podcast episode with psychiatrist Dr. Kristin Carothers, he talks about his experience with ADHD time, of “now” and “not now.” For Noah, everything in his life seems to be split into what’s happening in the present (now) and things that are happening later (not now). He feels like his ADHD keeps him stuck in the now, which makes planning for future things (the not-now stuff) an eternal challenge.
Noah isn’t alone in feeling like time (especially the battle between now and not-now) is a central part of ADHD. More and more researchers are starting to look more closely at all the problems of executive dysfunction in ADHD and wondering if maybe wonky internal clocks—and dopamine’s relationship with those inner clocks—is actually the main element making up the massive ADHD iceberg (see Ptacek et al., 2019 and Weissenberger et al., 2021 for two recent reviews of the literature).
Let’s look at some areas where ADHD internal clocks just don’t seem to work quite as they should:
Slower Processing Speed
One of the more basic measures of our internal clocks is how quickly our brains can process and then react to stimuli, and this measurement is known as our “processing speed.” Processing speed can vary between people, with some of us able to react more quickly than others. It can be difficult to separate processing speed from working memory—maybe slower reactions are due to smaller working memories—so it’s not a perfect measurement by any means. Still, preliminary research seems to be showing that both children and adults with ADHD tend to have slower processing speeds than other people (Ptacek et al., 2019; Weissenberger et al., 2021). In addition, this difference seems to be occurring mainly at the milliseconds-range of processing (Anobile et al., 2022); this time-range is mostly subconscious, so it could be that the deficit in ADHD brains is indeed at the processing speed level and not at the working memory level (which would be more likely to show up in a longer time range, like seconds or minutes). Having a slower processing speed means that tasks often take more time for ADHDers to complete.
Faster Internal Clocks
As mentioned earlier, we suspect that dopamine plays a role in regulating the speed of our internal clocks. ADHD brains and dopamine have a complicated relationship—ADHD brains either don’t make enough dopamine, or else their dopamine receptors are not as good at receiving dopamine (a kind of chicken or the egg conundrum). Based on the research we have so far on time perception, the internal clocks of ADHDers seem to run faster than other people’s (Zheng et al., 2022b). Faster internal clocks mean that time feels slower for ADHD brains. That pause in a conversation that seems brief to a neurotypical brain might seem an eternity for an ADHD brain, and this may be why people with ADHD are so much more prone to interrupting conversations at inappropriate times (because they felt as if they’d waited a long enough time). This faster internal clock could be the foundation for ADHD impatience—everything seems to take forever.
Time Estimation
People with ADHD are pretty terrible at estimating how much time has passed, or how much time a task will take to complete (Barkley et al., 2001; Ptacek et al., 2019; Weissenberger et al., 2021; Zheng et al., 2022a; Zheng et al., 2022b). Their brains operate at ADHD speed, after all! ADHDers are just as likely to underestimate time as they are to overestimate it—so they’ll swing wildly between thinking a task will be short and easy, or believing a task is difficult and will take a lot of time. Rarely are ADHD brains accurate, even on tasks they’ve completed many times before. This means when people with ADHD try to make a plan, they’re more prone to failure. They may avoid doing something they think will take too much time, or else not give themselves enough time to fully complete something.
Temporal Discounting
I’m sure you’ve heard of the marshmallow test—where children are sat at a table with a marshmallow and told to avoid eating it; the length of time they can avoid temptation is known as temporal discounting. As you might expect from impulsive ADHD brains, they are just not very good at temporal discounting (Barkley et al., 2001). Of course this applies to more situations than just resisting tasty marshmallows! People with ADHD really struggle with waiting for nebulous future rewards—say a comfortable retirement or a university degree—and tend to succumb to the ever-present temptations of the “now.” It’s much more immediately satisfying to use your hard-earned money on a shopping spree, after all, than it is to put it in an investment account for a payoff that is decades down the line. That’s such a far away “not now” time that it might as well not exist for an ADHD brain!
Thoughts for Teachers
So, what can teachers do about all this? Well, there’s not much in the way of research to suggest anything concrete at the moment. Certainly, just tossing a planner or a calendar at a student with ADHD won’t magically fix their internal clocks. As a chronic sufferer of time blindness myself, I have a few ideas that seem to work with my wonky internal clock, and maybe they’ll be helpful for you or your students (or both).
Clocks and timers are my constant companions. I always wear a wristwatch, and I also have my smartphone on hand, and between those two devices I usually know what time it is. While teaching, I display a timer counting down how much time remains until an activity should be finished. This helps me and my students know when to move on, or maybe to start working more quickly; of course, I’m monitoring the class as well, and I adjust the timer as needed. I time everything—my walk to work, the time spent grading student writing, how long it takes to prepare a smoothie—so I now have a pretty good, concrete measurement of how long it takes me to do things. This (usually) means I can make more accurate plans, and things (usually) go as I anticipated. Usually.
Remembering that far-off rewards might seem unreal to students also helps. If a student can’t imagine their life a week from now, let alone a whole semester from now, pressuring them with the loss of their final “A” grade as a reminder to do their homework just isn’t going to work. I’ve tried instead to make grades in my courses more concrete, with clear point values for everything; these points are then manually tracked inside students’ namecards. The first thing my students do when they arrive at their desks is flip open their namecards and check their points. Any surprise—like a 0 they didn’t expect—gets an immediate reaction, perhaps because the cards are tangibly “in the now.” I also build in grade-check opportunities, usually at the end of each unit, where students calculate how many points they’ve earned so far, and how many more they need to earn to get the final grade they’re aiming for.
I also “gamify” my classes where I can. I have a decorated tin full of cut-out stickers (which are super easy to distribute), and my adult students will do just about anything to get a coveted sticker to decorate their namecards with (or their laptops or their phones…). The stickers seem to be another tangible motivation for students. I’ve “gamified” participation with the help of the ClassDojo app. When students actively participate, like answering a question or using English to talk with their classmates, I can give them a participation point via the app. Positive points are announced by a cheerful “DING!” that the students find satisfying. If they earn enough points in a class period, they can get a sticker. Their decorated namecards become something of a status symbol (and a conversation starter!), and I regularly hear students bragging about the quantity of stickers on their namecards with each other. The amount of time needed to earn a sticker–a single class period–seems to overcome any difficulties students might have with temporal discounting; all that active class participation tends to help their final grades in the distant not-now future, so as far as I’m concerned, it’s a win-win for easy classroom management!
Some Caveats
I really need to emphasize how research into ADHDers’ sense(s) of time is still very much in its early stages. The foundational basis for much of it is a bit dated, meaning the researchers relied on the DSM-IV’s definitions of ADHD instead of the DSM-5’s. The older diagnostics for ADHD were even more boy-biased than the current ones, and were more skewed towards identifying the hyperactive presentation of ADHD. This doesn’t mean the findings are flawed, per se, but it does mean that we can’t fully rely on the conclusions in these older studies to apply to the full spectrum of the ADHD experience (especially those with the inattentive presentation).
In addition, even today, the majority of ADHD research is still heavily boy-focused in its participants. I now jump to a study’s methods section to check their participant gender-ratios before deciding if I want to take the time to read through it fully. Only a single study I referenced in this piece (Zheng et al, 2022a) had a balanced participant ratio of girls and boys; the rest were either skewed (70% to 80% male) or lacked female participants entirely.
Time blindness and timing differences may not be issues for solely ADHD brains, either. Irregular internal clocks seem to occur in schizophrenia and Parkinson’s Disease as well (Fung et al, 2021). Many people with ADHD often have an additional diagnosis of… something else, like autism, depression, or Oppositional Defiance Disorder (ODD). Do these “hybrid” brains have similar issues with the perception of time as an ADHD-only brain? (Do ADHD-only brains even exist?) Who knows if we’ll ever know, as most studies exclude patients with dual-diagnoses (unless it’s ODD, for some reason, perhaps again due to the boy-heavy skew).
There are early signs that ADHD stimulant medication (medications like Ritalin or Concerta), and its role in dopamine production in ADHD brains, may also impact time perception. In studies that include three groups—ADHD, medicated-ADHD, and comparable controls—the medicated-ADHD participants tend to perform somewhere between the other two groups (Campez et al., 2021). We still don’t know if ADHDers’ internal clocks might improve further with long-term medication usage, especially for children who start receiving treatment from early ages. Longitudinal research of this sort is hard to do, and takes a long time (it’s in the name!), so with any luck some of these questions will be resolved… eventually. Not now, at any rate.
References
Anobile, G., Bartoli, M., Pfanner, C., Masi, G., Cioni, G., & Tinelli, F. (2022). Auditory time thresholds in the range of milliseconds but not seconds are impaired in ADHD. Scientific Reports, 12, 1352.
Barkley, R. A., Edwards, G., Laneri, M., Fletcher, K., & Metevia, L. (2001). Executive functioning, temporal discounting, and sense of time in adolescents with ttention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD). Journal of Abnormal Child Psychology, 29(6), 541-556.
Campez, M., Raiker, J. S., Little, K., Altszuler, A. R., Merrill, B. M., Macphee, F. L., Gnagy, E. M., Greiner, A. R., Musser, E. D., Coles, E. K., & Pelham, W. E. (2021). An evaluation of the effect of methylphenidate on working memory, time perception, and choice impulsivity in children with ADHD. Experimental and Clinical Psychopharmacology, 30(2), 209-219.
Fung, B. J., Sutlief, E., & Hussain Shuler, M. G. (2021). Dopamine and the interdependence of time perception and reward. Neuroscience Biobehaviour Review, 125, 380-391.
Ptacek, R., Weissenberger, S., Braaten, E., Klicperova-Baker, M., Goetz, M., Raboch, J., Vnukova, M., & Stefano, G. B. (2019). Clinical implications of the perception of time in Attention Deficit Hyperactivity Disorder (ADHD): A review. Medical Science Monitor, 25, 3918-3924.
Weissenberger, S., Schonova, K., Büttiker, P., Fazio, R., Vnukova, M., Stefano, G. B., & Ptacek, R. (2021). Time perception is a focal symptom of Attention-Deficit/Hyperactivity Disorder in adults. Medical Science Monitor, 27, e933766.
Zheng, Q., Cheng, Y. Y., Sonuga-Barke, E., & Kar-man Shum, K. (2022a). Do executive dysfunction, delay aversion, and time perception deficit predict ADHD symptoms and early academic performance in preschoolers. Research on Child and Adolescent Psychopathology, 50, 1381-1397.
Zheng, Q., Wang, X., Chiu, K. Y., & Kar-man Shum, K. (2022b). Time perception deficits in children and adolescents with ADHD: A meta-analysis. Journal of Attention Disorders, 26(2), 267-281.
Julia Daley is a senior lecturer and Assessment Coordinator at Hiroshima Bunkyo University, and she received her Masters in TESOL from Northern Arizona University. She has taught English writing and conversation in many classrooms in the US and Japan. Julia enjoys collecting vintage watches as a fashionable way to compensate for her dysfunctional internal clock.