Parke is a Licensed Professional Counselor based in Richmond, Virginia. He runs Therapy for Men RVA, a small private practice of male therapists working with men dealing with anxiety, stress, pressure, and feeling stuck. The practice offers walk-and-talk therapy along the James River and virtual sessions throughout Virginia. Learn more at www.therapyformenrva.com.
Dude Breathe: one idea. A few minutes to read. Once a week.
By Scott Keel, MD, MPH
This week’s piece is a guest post from Dr. Scott Keel, a local physician who specializes in ADHD. His practice, Even Keel Health, takes a whole-health approach to ADHD that looks beyond medication alone.
As a physician who specializes in ADHD, I spend my days helping people make sense of their neurobiology. But long before I ever wrote a prescription or explained executive dysfunction to a patient, I was just a guy trying to figure out why basic life felt like running a marathon in ski boots.
I live with ADHD. I’ve navigated the diagnostic roller coaster from the inside out, the years of wondering why I could hyperfocus through high-stakes medical crises, yet lose an entire afternoon to total paralysis over a stack of administrative paperwork.
Growing up, my parents did the absolute best they could with the tools they had. But like so many families, they were operating without a map. There was no real framework for understanding a child whose brain didn’t fit the standard mold.
In my practice today at Even Keel Health, I often realize that I am striving to be the physician my own parents never had access to: a clinician who sees the whole person, understands the neurobiology from the inside, and refuses to view ADHD through a lens of character flaws or simple deficit.
Renowned ADHD expert Dr. William Dodson often speaks about how neurotypical society hands us all a generic owner’s manual at birth. We are told to read the instructions, follow the standard steps, and make it work.
For a while, maybe we manage. We scrape by using sheer effort, masking, or relying on high anxiety as a pseudo-stimulant to force focus. But no matter how hard we try to follow those standard instructions, there is constant, exhausting friction. The gears grind. The engine overheats.
And when the generic manual inevitably fails us, we internalize it as a personal failure: I’m lazy. I’m inconsistent. I’m just not trying hard enough.
ADHD is not a disorder of knowledge. It is a disorder of consistency, specifically, in consistently doing what we already know. It is the gap between intention and execution.
Even as an expert in ADHD who spends every single day immersed in the science, research, and clinical strategy of neurodiversity, I still have an ADHD brain. I still face days where consistency is a steep, exhausting climb. Knowing the neuroscience inside and out doesn’t magically erase executive dysfunction.
The difference today isn’t that I have it all perfected; it’s that I threw away the generic instructions and built my own customized owner’s manual.
Having that personal manual is what allows me to catch myself, adjust, and keep thriving consistently, rather than drowning in old shame when things go off track.
This is why a whole-health approach to ADHD and mental health is so vital. Managing ADHD isn’t just about popping a pill to fix focus; it’s about addressing the entire human ecosystem.
True healing means integrating tailored medical management with somatic awareness, nervous system regulation, sleep hygiene, mindfulness, and processing the emotional residue of years spent feeling “out of sync.”
It’s about building a daily framework that respects how your nervous system actually processes stress, time, and emotion.
When you align your care, habits, and environment with your actual brain wiring, you stop spending all your energy just treading water or surviving the week. You open up the space to consistently thrive.
An ADHD brain isn’t broken; it is simply unique. Living well with it isn’t about forcing yourself into a neurotypical mold. It’s about writing your own rules, honoring your whole health, and leaning on a personalized manual that keeps you grounded, self-compassionate, and moving forward.
Try This
Think of one part of your life where you keep telling yourself, I should be better at this by now.
Maybe it’s paperwork, getting out the door on time, remembering appointments, finishing what you start, or keeping up with the little things.
Instead of asking, What’s wrong with me? ask:
What would I change if I stopped assuming the standard way was supposed to work for me?