Fast Minds

The full title is Fast Minds: How to Thrive If You Have ADHD (Or Think You Might). It came out in 2013 from Berkley Books, under the Harvard Health Publications label. The foreword is by Howie Mandel. The library record lists 332 pages, sellers say 352; the difference probably comes from the bibliography and the index.

I could not find a verified Turkish edition; I am writing it under its original title.

I wrote this piece based on the book's table of contents, the publisher's and the authors' website descriptions, an article adapted from the book and published, the opening page of chapter eight, and published reviews. I describe the chapter contents as far as I could see them, and where I could not see something, I say so.

Who wrote it

Craig Surman is a neuropsychiatrist. He is an assistant professor of psychiatry at Harvard Medical School and scientific coordinator of the Adult ADHD Research Program at Massachusetts General Hospital. His name also appears among the authors of the Safren study published in JAMA in 2010, which I mention in the article on cognitive behavioral therapy on this site.

Tim Bilkey is a psychiatrist working in the Canadian province of Ontario. He is reported to have done more than three thousand four hundred assessments of adult ADHD. In 2009 he founded a training program called FAST MINDS so that physicians could recognize and treat adult ADHD, and the College of Family Physicians of Canada accredited the program that same year. The book's name comes from this program.

The third name is Karen Weintraub, a science journalist. She writes for the Boston Globe and USA Today, and she previously published The Autism Revolution. On the cover her name follows the word "with."

The idea the acronym carries

FAST MINDS is an acronym: Forgetful, Achieving below potential, Stuck in a rut, Time challenged, Motivationally challenged, Impulsive, Novelty seeking, Distractible, Scattered. Forgetful, falling short of your potential, stuck in the same place, always in trouble with time, struggling with motivation, acting without thinking, seeking novelty, easily distracted, disorganized.

The starting idea of the book, as far as I can read it from the article adapted from it, is this: when clinicians look for ADHD, they look at outcomes visible from the outside, like being fired or bad grades. But the real burden is the invisible effort to compensate. Working late to make up for the scatter of the day, finishing on the last night the work that does not get done without deadline pressure, checking everything twice. According to the authors, these people live reactively: not like someone who is prepared, but like someone always trying to catch up with something. If you ask me, this is one of the most honest descriptions of life with adult ADHD.

The "or think you might" part of the subtitle opens the door to people without a diagnosis too: everyone who sees some of the symptoms in themselves is invited. According to a published review, the book estimates the worldwide prevalence in adults at around four percent and defines the core problem as "consistent engagement."

Inside the book

The table of contents has twelve chapters. The book is divided into three main parts: Understanding FAST MINDS, A FAST MINDS Operating Manual and Building the Life You Want. At the back there is a summary and workbook, a thought record form and the Adult ADHD Self-Report Scale (ASRS). The bibliography runs to about thirteen pages. I worked out which chapters fall into which part from seller and review records: the first three chapters seem to be devoted to understanding, the six in the middle to the operating manual, and the last three to working with a physician and sustaining progress.

Understanding. Chapter one, "What are fast minds?", introduces the acronym and the nine traits. Chapter two is "Tune in to your fast mind," that is, listening to your own mind. Chapter three is called "Fast minds made me do it." I could not see the text of this chapter; judging by the title, I guess it is a chapter that links behaviors to these traits, but that is a guess.

Operating manual. Chapter four is "Use the prefrontal checklist," a checklist for the front part of the brain. Judging by the title, I think it is a chapter that goes through the executive functions one by one, but I could not see its content. Chapter five is "Be your own chief executive," chapter six "Don't just do it, think about it!". The seventh is "Find where and how you thrive." The eighth is "Feel well, function well," the ninth "Help other people get it." I know the content of these six chapters mostly from the titles and the publisher's description. The description promises the following: personalized strategies for time, tasks and relationships, organizing habits that work, reducing decisions made without thinking and negative thought patterns, and building environments that support you where you struggle.

I was able to read the beginning of one chapter. Chapter eight opens with Rachel's day: failing to get to work by nine despite three coffees, sleeping through the second alarm as well, forgetting her lunch at home, dinner not happening until nine, moving from the television to the computer and going to bed late. Right after this short scene comes the generalization of the opening: people with these traits often keep one area, usually work or school, standing, and have no strength left for their own needs. It looks at the same place as the article I wrote on this site on why self-care is hard.

In the article adapted from the book there is a section called "know how you work best." The authors ask the reader to note at least three moments of success: while running, while solving a hard problem, while working with their hands, while teaching someone what they know. Then they ask you to look at the context of those moments: interest, strength, other people. This seems to ask the same question as the title of chapter seven, but I could not verify which chapter it was taken from. The same article also lists five principles underlying the book. Negative thinking and a distracting environment can be reduced. The brain works best on tasks that are interesting, meaningful and have clear steps. Difficult functions can be handed off to "peripheral brains": an alarm, a phone, a planner, other people. The right habit at the right moment keeps you from getting derailed. Trying out new strategies needs the right setting and accountability.

Working with a physician, and what comes next. Chapter ten is "Make the most out of medication," making the best use of medication. Chapter eleven, "What else works?", covers coaching, cognitive behavioral therapy, mindfulness, support groups and lifestyle change, according to the publisher's description. Chapter twelve, "Thriving on the journey," is about the road ahead.

Its strongest points

First, the language. Edward Hallowell, one of the authors of Driven to Distraction, found the book easy to read yet deep in his cover blurb. Paul Efthim, writing for New England Psychologist, said he is not a fan of self-help books and still counted this as one of the good adult ADHD books he has come across. A cover blurb is advertising, but the conclusion of a clinician who says up front that he keeps his distance from the genre says more.

Second, it does not exaggerate when it comes to strengths. It asks when environment, interest and skill fit work, and it does not say "ADHD is a superpower." A quote from a person in the book, given in one review, sums this up well: "A disorder? Sure. A defect? No."

Third, the structure itself: first understanding, a six-chapter working section in the middle, and working with a physician and sustaining things at the end. The workbook and thought record form at the back do not leave the reader only reading.

Weaknesses and criticism

First, a distinction. A book being a good book and it being a treatment are not the same thing. Yet when you close the cover, you can be left with the feeling that you have a treatment in your hands. Books often give that feeling; this one can too.

FAST MINDS is not a diagnostic criterion but an acronym that helps you remember. An ADHD diagnosis rests on clinical criteria and a detailed assessment. Anyone could say yes to most of the nine adjectives on some day: forgetfulness, being late, boredom. The book keeps the door wide. For some readers this generosity is reassuring; for others it is a door that opens onto hastily fitting yourself into this picture. I think that while reading the book you also need to look at how a diagnosis is made, because you do not arrive at a diagnosis through an acronym. The ASRS at the back is also a screening scale, not a diagnosis.

On the evidence side: Surman's name appears in research, but I have not seen a study testing the book itself, that is, what a reader gains from reading it on their own. The strategies it recommends are related to cognitive behavioral programs. Those programs have been shown to be effective when run with a therapist. I could not find data showing that people who read the same strategies on their own from this book got the same result.

Let me add one caution. The book was written in North America, within the health system and medication rules there. When reading the medication chapter, you need to adapt the questions of prescriptions, medical reports and access to the conditions in your own country. That is why the article what to expect from medication treatment in Turkey can sit next to it. And the medication decision is made by the physician, not the book. An audiobook listener whose diagnosis is more than ten years old wrote that the book speaks more to the newly diagnosed or to those still researching themselves; I do not think this impression is unfounded. Finally, the book came out in 2013; its app and technology examples may be dated.

Who it is for, and who it is not for

For those who have just been diagnosed or are about to be, are ready to build systems and like short chapters. Also for someone who says, "I know what to do, I don't know how to get to know myself." The workbook section is suited to working on your own.

Not for someone who is already diagnosed, has been trying various methods for ten years and is looking for even more methods; a more application-heavy book like the Tool Kit will suit them better. Not for someone looking for a standard protocol either. And someone whose grief or doubt is still fresh should not get carried away by the acronym and shut down with "I have all of these."

Where it sits on the shelf

On the beginner side, close to introductory books like Driven to Distraction. Those explain what you are facing; this book tries to produce a usable operating manual. On the practical side, the Tool Kit leans on tools and a cognitive behavioral framework from start to finish. Fast Minds, on the other hand, opens with getting to know yourself and only then moves on to tools.

If you want a structured protocol, Mastering Your Adult ADHD sits somewhere else: with weekly modules and a tested program. Fast Minds does not replace that program, but it can be a step that explains to the reader what tires them so much and why. The book's ninth chapter, "Help other people get it," can be read together with the article on this site about disclosing your diagnosis, on explaining your ADHD to others.

My take

I would take this book off the shelf not as a guide but as an entry door. The acronym sticks, the language is easy, the scope is wide. But in my own life I would keep not the acronym but the parts that ask at which point in a day like Rachel's in chapter eight things fall apart. Rather than reading the book from cover to cover, I think it is better to go to the area where you get most tired and work with that chapter.