Being a founder, not to mention a CEO, can be a very lonely place, carrying loads of stress and requiring to constantly be at peak performance. This often makes it hard to find a balance between one's professional and personal life. Maintaining strong relationships with the co-founders and investors is also not an easy task, where clarity and empathy are not always present. As one of my entrepreneurs says: “It’s not the technological challenge we deal with, it’s the mental one.”

“Throughout my +15 years as a professional, I've always been attracted to the intersection of business and psychology through entrepreneurship - What makes people tick? How do people think and act? And what motivates people in business? What drives me is being there for the amazing entrepreneurs, who are under constant pressure, so that they can make our world a better place. That’s what I’m here for, and this is my podcast – The Human Founder.”

Dr. Shirley Hershko, Specialist in Attention Deficit Hyperactivity Disorder BIG

Most important - awareness and diagnosis

5-10% of the population has ADHD due to an imbalance of dopamine in the brain. It doesn’t pass in childhood and continues into adulthood. Despite the way we’re used to thinking about ADHD, it applies not only to learning skills but also to relationships, family, and work.

We all experience attention difficulties from time to time. What differentiates normal attention difficulties from attention deficit disorder? With attention deficit hyperactivity disorder (ADHD) there are significant, everyday difficulties, like feelings of being stuck, and it’s not the result of a stressful life event or a particular mental state.

What does the diagnostic process look like?

In adults - there is a basis for examination through a conversation with an expert professional: explaining their childhood and where ADHD fell in it, how it manifests in other areas of their lives, how great the difficulties are, etc. In children - the diagnosis is with the parents and teachers, who will also testify from their point of view on how the difficulties are manifested.

When we were little, they were called "the disturbed/ lazy child" - today there is awareness, but it's mostly reserved for children. That leaves the adults living with ADHD unanswered.

Is there an “overdiagnosis” of ADHD today? Since we’re flooded with information, stimulation, and a fast-paced environment, could it be misrepresented?

Shirley explains that attention deficit disorder cannot develop due to our environment, like from screens/education methods/nutrition, because it’s something neurological - a lack of dopamine.

Therefore, drug treatment only helps those who have this problem, and will not be able to help those who don’t actually have it. Even alongside the huge number of stimuli that floods us daily, there is a big difference in how those with ADHD and those without it cope.

Therefore, it’s very important to go for an in-depth diagnosis - such a diagnosis will give an unequivocal answer to “why I'm so late”, “why it takes so much more effort to do things”, “why I'm not listening”, “why it may seem like I'm lazy”. The reason is ADHD and awareness is a powerful tool in helping those with it cope.

ADHD in startups

"ADHD is a Superpower for Startups and entrepreneurs":

Creative thinking, unique minds, cool ideas, lots of curiosity, originality, spontaneity, ambition- there are lots of things that go hand in hand with ADHD and the life of an entrepreneur. On the other hand, there are also difficulties like time organization.

With ADHD, it is difficult to function according to time frames accurately. Someone with ADHD has a core misconception of time, and one of the common tendencies, as a result, is procrastination.

The hormone dopamine is also called the "propulsion hormone" as it has an important role in the production of motivation. When there is a time deficiency due to attention deficit disorder, it’s very difficult to start something, persevere in it over time and finish it. Those who suffer from it feel a lot of stress.

Within the world of startups, there is a stressful work environment and significant deadlines. How can the difficulties be overcome?

Recognition is important, by telling the manager and colleagues. Explain - "You’re not lazy or irresponsible" - you have difficulties due to the ADHA but have corresponding solutions:

  • short deadlines
  • Reminders every day of what's happening and where I got to in my work
  • A quiet room to work from

As executives, it can be difficult for us to swallow these needs within the startup, which relies so heavily on initiative and independence. So, an example of another need can help us see the situation clearly - if a person with a wheelchair or glasses came into the company, it would be obvious to us that they need help with certain things, and not ask them to pull themself together and solve their difficulties on their own. The same is true with ADHD, which is "invisible" but exists just as much.

For entrepreneurs with ADHD, the entrepreneurial trait is obviously more prominent, which includes creativity and crazy ideas. On the other hand, they are in situations where order, organization, meticulousness, planning, and control - here they need outside help.

This contrasts with the expression of programmers for example, who often indicate that once they dive into the work it’s impossible to get them out of it. In this case, too, there are specific needs that are important to pay attention to - for programmers the environment is very significant, and they can easily fall between the cracks when the environment is not right for them.

Between co-founders, communication and awareness can lift or bring down any relationship. When people with and without ADHD work together, misunderstandings can arise, and it needs to be bridged and explained.

What does ADHD look like in men compared to women?

ADHD is manifested differently in men and women, which is why many women are misdiagnosed. Boys tend to be more hyper and disturbing in class, which is more noticeable, while girls are more likely to stare, dream, and space out. 85% of teachers admitted that they could not detect attention deficit disorders in girls.

Boys are diagnosed 4 times more often within the same family - in 70% of cases the sister will be diagnosed 5-9 years later after her brother is diagnosed with ADHD because she is more of a "space cadet". The result of not being aware is that in old age they reach a threshold of frustration that can develop into anxiety, depression, and emotional difficulties. From the outside it seems like everything is fine - they have a good job, they're successful, with degrees, but inside they are suffering.

Why is ADHD less prominent in women? Diagnosis for women is different - there are other criteria for diagnosis, they can’t be measured on the men's scale, just as other physical measures such as height and weight. Along with the fact that women want to please their environments more, the ‘hyper’ symptoms are less pronounced compared to the “spacey”, so ADHD in women often seems invisible. One should go to a professional in the field, who is updated on new studies and developments on the specific topic of attention deficit disorders in women for a diagnosis and help.

The symptoms according to the DSM

To answer the diagnosis of whether a person has ADHD, there should be at least 5 of the following symptoms:

1. Procrastination - under pressure, at the last minute

2. Short attention span of 5-15 minutes

3. Easily distracted from anything be it internal (thoughts) or external

4. Forgetfulness -i.e., the multiplication table, messages

5. Loss of belongings - sweatshirts, pencil case, phone

6. Tendency to avoid mental exertion that requires prolonged attention - for example, reading books. One must consider the intervening variable of high intelligence as an influence as well. On the other hand - hyper-focus when something is interesting - they go all in and dive deep

7. Lack of regulation

The effects of ADHD

Nutrition: ADHD causes unhealthy, impulsive eating patterns, there's a tendency to forget to eat all day and then come home at the end of a workday and binge, or for some snacking all day. People with ADHD are twice as likely to become obese, and 4 times more likely to develop an eating disorder associated with overeating. It’s not a matter of awareness that they don’t have, but a lack of attention to food, and it’s important to be aware of it. So, it will not help to repeat and lecture them on what is healthy, the key is the environment. Therefore, nowadays in bariatric surgery it is necessary to check for attention disorders because it may be a futile solution. What can help, for example, is simply put the unhealthy food in the back of the refrigerator, far from the eye, far from the heart - or better yet, don't buy it in the first place. Another thing that can help us to prepare all the meals in advance to avoid impulsive decisions during the day.

Sleep Disorders: 75% of people with ADHD suffer from sleep disorders. Neurologically melatonin is secreted later - this means it’s harder to fall asleep, and easier to concentrate at later hours because there are fewer distractions at night- so they can work better. This leads to less continuous sleep, which makes waking up harder, and worse fatigue.

Also, physiologically - they cannot fall asleep. Here flexibility can help a lot on the part of managers, for the company’s sake - to give employees the night and come to work later, for optimal functioning. No need to stay in the fixed frame. In addition, there is a drug treatment of melatonin if needed.

Also, sleep hygiene, which refers to the right conditions (specific nighttime rituals and environments can help)

Relationships: On the contrary to what we might assume when two spouses have attention deficit disorder - it’s easier for them to understand one another. In cases when only one is dealing with it, there tend to be a lot more arguments. There is 3 times the risk of divorce, infidelity, and less satisfaction from the marital relationship when one of the spouses has ADD. Couples' therapists can focus on ADHD; the awareness and treatment make the difference. ADHD is an umbrella disorder - it’s impossible not to look through this filter and its effect. All of these are also very relevant to the partnership between co-founders when one of them has ADHD.

Parenting: The whole issue of order and organization is very difficult in the matter of raising children. If it’s a child with ADHD, there is a difference in the coping of a parent who also has ADHD, and a parent who does not. A parent who also has ADHD can understand his child better but will also deal with more stress and anxiety knowing the difficulties that his child is going to go through. The parent who doesn’t have ADHD has more difficulty understanding his child and is more likely to be angry and frustrated.

Coping strategies

1) Medication - 80% success rate. The brain has a specific enzyme that pumps dopamine too quickly into the cells, and the drug treatment balances the rhythm. A specially trained neurologist/psychiatrist/doctor will tailor the exact treatment for you, there is no substitute for it. The issue of food/drug/cigarette/sex/internet addictions is greater in people with ADD, but luckily drug treatment is both non-addictive and reduces the risk of addiction. Lots of studies have found that there are no bad long-term consequences for drug treatment.

Beyond that, there is also “natural” treatment, but it’s still not a substitute for drug treatment. Just as we don’t tell someone with glasses to take them off and deal without them and ask them - why are you addicted to glasses; we should look at pharmacological treatment for ADD in the same way.

2) Exercise is found to be effective in the 2nd place - because it secretes a lot of dopamine, which also contributes to the feeling of happiness, and regulates impulsivity and anxiety.

3) For proper behaviour as parents of children with ADD it’s important to undergo parental guidance, where they can reinforce to the parents what to do and strengthen them because they are with the child most of the time and can feel lost.

4) Help - external help can cover the difficulties.

5) Organizing time adapted to those with ADHD improves the quality of life. For example:

a. Lists - don’t go around with a long list – you need to do work on it, decide what’s important/urgent, different areas, write how long it will take, etc. Don’t just write down goals, assign them to a time frame that suits you, even if it's 1 AM - otherwise it just will not happen.

b. Accountability from others - they can help you by keeping you in check.

c. Rule 80-20 - People with ADHD have a greater tendency to be perfectionists and have OCD, which can get them stuck on a task. This rule says that in 20% of your effort and time you manage to do 80% of the work, to make the last 20% perfect you would have to invest 80% more time. Is it worth it? If we try to be 100% in everything, we will not succeed at anything; we need to draw our boundaries and understand the price we are willing to pay.