Our Internal Dialogue’s Impact on ADHD, Anxiety, Depression, and Autism

Internal dialog and impact on ADHD

Do you talk to yourself?

A young man named Ryan Langdon, from his post at InsideMyMind https://insidemymind.me/2020/02/05/how-my-internal-monologue-affects-my-attention-deficit-disorder/ wrote of his internal dialogue, as a person with ADHD, that he referred to as being hyper-neuro-vocal in that he tends to have hyper self-talk that interferes with his concentration. In his own investigation, he found that others with ADHD tend to get carried away in their hyper self-talk, while those without ADHD sometimes report not even being aware of any self-talk or internal dialogue (what he refers to as being hypo-neuro-vocal). In fact, Ryan speaks of the primary challenge, for him and his experience of ADHD, as being his internal dialogue that interferes with his concentration.

How is your internal dialogue?

Do you think in words, in an internal dialogue, in pictures, or are you not aware of any internal thoughts (must be rather quiet)? I’ve had the opportunity to interview literally tens of thousands of individuals ADHD, anxiety problems, depression, and autism. The bulk have described active self-talk that seems to interfere with daily functioning. I don’t know anyone with no internal dialogue. Maybe there are some who are not aware of their own self-talk, which does not mean it’s not present. In fact, such thoughts are often referred to as automatic thoughts, which are simply thoughts that are so automatic that we don’t even realize we’re having them. However, everyone is different and we’ve all heard of individuals (maybe this is your experience) who tend to think and process information predominately in pictures (visual learners…). I would imagine that most of us think in both words and pictures (we talk to ourselves, and visualize people and experiences). The primary issue, in terms of a ‘disorder’, is the extent to which our thoughts interfere with our daily functioning.

How our thoughts get in the way

I’ve never talked with a person struggling with anxiety who did not have anxiety-provoking self-talk or a depressed person without depressing self-talk. Individuals struggling with ADHD tend to have thoughts they can’t shut-off that manifest in non-stop talking (that is rather distracting for them and those around them), and individuals with autism tend to have a strong internal focus and/or obsessive thoughts about any random item or interest. Frankly, there is barely anyone on this planet who doesn’t have trouble, at one time or another, getting a handle on their thoughts. One of the primary aspects of therapy is helping to control what’s going on in our heads.

So, what do we do?

We learn to control our thoughts, that’s what we do. We use internal forces to think about something else, which is the basis for the best-research therapeutic approach used today; cognitive-behavioral therapy. We also use external cues to remind us to stay focused; either way, we learn to redirect our thoughts to more healthy topics and perspectives, and back-to-task. Medication can be very helpful and tends to quiet the background chatter and sharpen our focus. Auditory and visual cues can also be a plus in terms of, for example, wearing ear-buds that play a recording, every minute, of a friendly voice reminding us to stay on-task, or a visual cue on our desk to remind us to focus, or highlighting every noun or verb in a paragraph so we must stay active and focused in our reading, and on-and-on it goes. There are countless strategies.

I appreciate Ryan bringing this to light

Ryan’s post, which got about a million views, has been appreciated by so many who can relate to his challenge of controlling his internal dialogue. In fact, like so many who can relate, Ryan perceives his challenge with ADHD as not being distracted by external stimuli (such as a tapping pencil) but, rather, his own thoughts. That is a fascinating and integral aspect of ADHD, not to mention anxiety, autism, and every other disorder with which we struggle; if we can control our thoughts, we can control the disorder rather than it controlling us. I’m looking forward to hearing more from Ryan, and from those who learn productive ways to overcome their daily challenges. God bless.

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Dr. John Carosso

Dr. Carosso has more than 30 years of experience as a licensed Child Clinical Psychologist and Certified School Psychologist working in private, inpatient, outpatient, residential, school, and home settings. He is Clinical Director of Community Psychiatric Centers (cpcwecare.com), a licensed Behavioral Health Outpatient Clinic, and operates both the Autism Center of Pittsburgh (autismcenterofpittsburgh.com) and the Dyslexia Diagnostic and Treatment Center (dyslexiatreaters.com).