ADHD is a common condition in adults, estimated to be around 3-5% of the population. It's very frequently comorbid with other behavioral disorders like depression, bipolar disorder, obsessive-compulsive disorder, etc. But even "pure" ADHD can be quite disadvantageous. People with ADHD are much less likely to finish school, have trouble staying employed, more likely to be divorced, have greater health care utilization among other adverse outcomes.
Despite these factors only 20% of ADHD individuals receive treatment which can make a big difference. Medications can be helpful but are not by any means a "cure". Rather specific behavioral therapies are a necessary part of an effective treatment program.
As a physician specializing in behavioral health, I've treated a great number of ADHD adults. It's impressive how much improvement patients could make over a period of months to years as a result of their determined effort. I came to appreciate patients' innate talents that many were eventually able to exploit. It was gratifying to see some become top-tier innovators in their fields including technologies.
Of course people will "identify" unique traits as part of their sense of "self". ADHD individuals may come to regard aspects of their quirky cognitive styles as part of an "identity" but that's not necessarily the same as having ADHD as the biggest component.
Last thing I'll say is that ADHD is considered a developmental disorder. IOW there's no sharp line between having/not having it. The extent it's a problem depends on the context, which is a huge discussion topic in its own right.
I am 30. I got diagnosed with ADHD a few months ago and I started treatment (adderall and lifestyle changes).
Growing up, ADHD was my biggest enemy in life and I didn't even realize it.
Once I began treatment, the change was almost overnight. I know I'm just one data point in a sea of data points, but I really just want to add that I'm on the other end of the parent comment and getting diagnosed, other than my marriage and the birth of my son, was the best thing that's ever happened to me.
Thank you for having this perspective to help treat your adhd patients, wish there were more like you. I’ve encountered quite a few doctors who admitted they are scared of the DEA and losing their license and make us jump through flaming hoops to adjust dosages of stimulants or force us to navigate a byzantine maze of psychiatry to get to a psychiatrist that will take the liability away for prescribing/adjusting scheduled medications.
This is even with 10+ years of diagnosis.
Do you have any insight into why it is this way? Have physicians always feared the DEA and threat of losing their license in pursuit of helping their patients try different controlled medications? Did the pill mills ruin it for the entire medical industry?
Do you know how a patient would get funneled to someone like you with expertise on this matter?
My experience with GPs is that they do not understand those issues and do not know how to direct to someone who does. It's not like a physical ailment where they know with a fair degree of certainty what the next avenue is.
What improvement would an adult with ADD (without H) have without being diagnosed and without having access to a treatment ? I may or may not have ADD but diagnosing adults in my country is extremely uncommon, and anyway the symptoms I have can be indicative of many other mental troubles, so I'm interested in not-medical ways to cope
I have ADD. Not ADHD; I'm almost never hyperactive. I do, however, hyperfocus on anything and everything, to the point that it's caused severe problems to my career, relationships, and personal life. I'm nearly always hyperfocused on something, and I rarely have control over what that is. I'll forget to eat, sleep, talk to people, or really do anything else for several days at a time when it gets bad. Fortunately, over the years I've learned techniques to solve some of the problems, like having somebody to hold me accountable. Even so, it remains my biggest challenge.
However, it's also one of my greatest strengths. When my brain decides to attack a problem, I'm astonishingly productive. Over the last couple of weeks, I've been hyperfocused on implementing a motion control system for a side project. As a result, I've designed a CoreXY platform, designed a control board for it, learned how to use ngspice to tune the power-up circuit, learned how to use Sympy, used it to derive closed-form solutions for jerk-controlled motion, and found a way to implement that solution in which the motion control interrupt takes a grand total of 70 cycles on Cortex M0. And this is just my spare time outside of work, where I had a completely different set of hyperfocii, and similar productivity.
So, I completely agree with the author that if somebody were to offer me a megadollar in exchange for getting rid of my ADD, I'd have to think very hard about that indeed.
ADD is just old terminology. You have ADHD, and you should read up on some updated science cause you got some very weird, very wrong ideas about your own condition.
As someone diagnosed with ADHD later in life, a lot of these ADHD superpowers are just the result of taking dopaminergic stimulants. Especially the hyper focus and feeling superior to people staring out the window or failing to heads-down work for several hours straight. Yes you can hyperfocus even without stimulants, but the real superpower is having access to them so you can channel that consistently.
I personally believe everybody should be allowed to take these stimulants if they want to, because many people would benefit from it. The propaganda around stimulants working radically differently on those with ADHD vs those without is just that (I can go on about why I think that in much more detail). Ask anybody you’re close with how taking their friend’s adderall to study worked out. Look into people like Paul Erdos.
Anyway, I think you can definitely argue that there is a lot more nuance to psychiatry than you see in clinical settings (probably many disorders should be broken up into multiple others, others are just symptoms rather than a problem itself, others are not even disorders but just a different way of being). But really all that matters is that psychiatrists can match symptoms to treatments that work. Matching poor/misdirected executive function to medication that “boosts” dopamine and norepinephrine works pretty well, so why worry about the name of the condition?
> As someone diagnosed with ADHD later in life, a lot of these ADHD superpowers are just the result of taking dopaminergic stimulants. Especially the hyper focus and feeling superior to people staring out the window or failing to heads-down work for several hours straight.
This is the complete opposite of my experience. A lot of my life has been dominated by a hyper-focus that feels like it isn't under my control. I would stay awake reading until I can't think anymore with relentless pursuit of something that was entirely non-relevant to critical priorities in my life.
I very recently (past couple of months) started taking stimulants, and one of the biggest differences for me was the feeling of desperation to pursue was greatly relaxed. Not gone, but definitely not as intense.
I think a lot of the problem here is the definition of focus is overloaded. For me, there are (at least) two distinct levels of focus on different time scales. I define short-term focus as stability on task level executive function. Can you tolerate a brief interruption and go back to what you were doing? Or plan ahead for the next task? This ability is absolutely compromised relative to the population norm for me. I have essentially 0 local stability.
On a longer time scale, I think a similar stability notion applies. I frequently get completely engrossed for periods of a few weeks on a topic - beyond healthy levels of interest. But one day, it's just gone - vapid.
Time for some serious hand waving: my mental model of what stimulants do to me decrease the activation threshold for picking something in an executive space. By lowering this plane, it's easier for me to remain more stable as the surface is a lot more clear.
I'm curious to know if what I'm saying sounds like 100% bullshit though - I haven't really talked through this mental model with anybody.
Thanks for sharing, I really appreciated the last half. Good thoughts generally One downside I think after reading here is that there is some wacko in the first half of the post that I feel compelled to comment on a few things.
Hyperfocus is a symptom of ADHD proper. Stimulants can also make you feel hyperfocused. However, the general reported effects of stimulants are a feeling of "normalcy", not hyperfocus as a result of stimulants. Many people taking stimulants are still symptomatic, albeit managed, meditation long term is generally an excruciatingly (if excruciating) adjunct to stimulants.
Second, Adderall often gives the feeling of superfocus and speed to neurotypical individuals but has been statistically shown to give little gain in practice in terms of certain raw metrics. A very strong dopaminergic placebo, as it were. I'd suspect the reason for it being considered effective is that it keeps you glued on tasks for significantly longer than otherwise . It's not propaganda, it's science, you can look at the studies yourself, it's pretty drastic. However there may be another layer on top of that that that could be propagandizing what is otherwise a valid scientific distinction.
Much agreed in the last half, I've seen a lot of subclinical dissociative like disorders fall into ADHD, or DPDR, when really there is probably a core condition and several other families lumped in. Such is always the curse of dimensionality reduction. A more root-cause preserving descriptive language set that doesn't rely on the anchor of billing codes would open up the scientific fields a lot. Language determines nomenclature, which determines assumed avenues of exploration. A dimension reduced model of mental health along symptomatic axes will almost always destroy symptom and condition "root cause" linkage. Additionally like you noted anxiety and depression are more symptoms of traumatic disorders and less actual disorders in and of themselves. My pet theory is that's one reason why "depression" is so hard to cure, imagine trying to generically cure "fever" instead of making vaccines, etc.
Ramble over! I think (especially later on) we think pretty similarly!
I think he's definitely talking about natural hyperfocus - for one thing the author is in his 50s and I don't think you could get ADHD drugs as easily in 1985.
It is hard to control, but it can help you do one thing as long as you're willing to abandon all other parts of your life, like eating/sleeping.
I have ADHD (ADD), and was diagnosed after 30 - though I've greatly suffered from it since my teenage years. Sure, it is a big part of me, always has been, but I don't really make it part of my identity. I can't control it like a superpower, and there are serious consequences if you're not careful.
I've noticed that in the ADHD community, there are some very vocal people that will wear the diagnosis with pride. I mean, good for them - but it is not really anything I can relate to. I treat it pretty much like I treat my gout...take my medication, adjust my lifestyle, and go on with my day.
Exactly. I can point to specific ways in which my (at the time, undiagnosed) ADHD has negatively impacted my life: I never finished my PhD because I couldn’t execute a dissertation. The coping mechanisms that had served me reasonably well during my young adulthood suddenly stopped working during the pandemic. So, I became unable to motivate myself to a deadline, which had generally been a powerful force to motivate my attention and efforts. Based on my raw intellect alone, I should have been able to contribute more substantively than I have (or, frankly, than I will ever be able to do). I feel that loss.
ADHD is a curse, and I will never be able to see it as anything but that. Am I grateful to know why I am the way that I am? Certainly. But I will never be able to get onboard with the “ADHD as superpower” line that some fellow ADHD folks have adopted. Glad they can see it that way, but if someone offered me a way to 100% cure it tomorrow, I’d take it and never look back. Getting medicated has made a difference in my life, to be sure, but I can’t imagine ever seeing this condition as a positive aspect of my identity.
Personally I don't like seeing it as a regular illness. Yes it's a complication to how society wants people to function. Work 8 hours a day 5 days a week. Go to school 6 hours a day 5 days a week. Be productive in that time frame. Keep focus on given tasks.
You can take medication to adhere to these artificial expectations on how an individual should function within society. Or you can live in a way that matches your natural behavior and capabilities.
Granted, we sometimes cannot avoid having to function in the expected way so medication is helpful. But seeing it as an illness that one needs to constantly surpress just doesn't sound right to me.
It's part of my personality. I'm not proud of it. But I also certainly don't see it as something that needs to be constantly treated.
I agree. My adhd has never made me more able than anyone, but has certainly been a detriment to myself and those around me. The best I can do is not hate myself for what I evidently can’t control, and continue working to lessen the damage it does. I mean, I was diagnosed because it’s a problem. Not because I have super powers.
I think the idea of wearing it as a badge of pride is because that reflex is easier than being more honest and introspective. At the same time it might help soften the pain. If you have a disability, you are a strain on those around you. You shouldn’t be ashamed of it, but you shouldn’t be prideful either. You should be proud when you succeed against the odds and you know it took hard work, but that’s not adhd happening.
For a brief time I entertained that I should be more adhd positive. Ultimately I realized that bias is not helpful at all if it clouds my perception of how it impacts my life or those around me. For some people though, perhaps it helps lessen the burden of the common self-loathing that tends to manifest as sufferers age.
Similar. I don’t understand wearing it with pride. There is no pride in it. It’s not an accomplishment. When people do this, it looks like a pre-emotive cop-out. “I’m saying to everyone I have ADHD so that if something goes wrong, I have something to blame and can also blame you if you are the authority for not giving me a pass”.
Same, it's been nothing but a liability and to be perfectly frank it makes my daily life way more stressful than it should be.
The biggest part I don't like is the inability to ever really be 'here in the now' e.g. enjoying the moment. All these important life events just fly by me without even reacting to them it seems, and only in hindsight do I start tearing up thinking about what I missed.
ADHD like many different things are a spectrum. You can have a slight disorder or you can have a really really strong one.
I’m saying this to a level where I personally know bloodlines where men suicide is just a thing that “will happen”. Guess what is the last year’s diagnosis on that?
I live in a society where official stats says that 0.0-0.1% of population is affected and such treatment is not needed. From multiple available treatment options (where single one has around 30% efficiency) there are only 2 available. I recently heard a joke that probably full European country has at most 2 ADHD therapists. Sure maybe you’re lucky enough to get diagnosis but then you might not even be able to treat it meds unless you emigrate. That’s why pride is important - it creates advocates. Advocates creates awareness and awareness provides solutions.
As you mentioned your diagnosis there is a chance you’re sensitive to the critique (it’s often coexisting). Keep in mind that your critique is targeting exact same people like you who struggled with it and came out with pride. Don’t take that away from people.
Completely agree. I think it is just part of the general trend for people to try to attach themselves to labels in search of an identity or community - of course some labels are very readily apparent so you are kind of forced by society to identify with the label, but for a mostly invisible condition like ADHD I really don’t get it.
On a lot of ADHD communities it’s just a constant struggle session about how every problem in people’s life is because of ADHD. It’s exhausting and seems maladaptive.
That is why I think my diagnosis was a double-edged sword. It helped give me a lot of answers and closure to past traumas, but with that knowledge I think it has somewhat held me back from things I have wanted to accomplish. I have used it as a reason as to why I couldn't do something, when the reality is that ADHD wasn't what held me back, but damn was it an easy scapegoat.
It is quite possible that some of those who "wear the diagnosis with pride" have more pronounced symptoms that are not as well addressed by the medication. In which case, they have no alternative but to wear it. Speaking from personal experience at least.
There are many who believe certain abilities they have are because of adhd rather than skills they have developed despite the disorder or plainly individual traits.
The diagnostic criteria for mental illness is, to simplify, that an aspect of your mind causes significant problems. If it doesn’t, as the author’s attention seems not to, then you probably shouldn’t be diagnosed with the disorder.
Comparing yourself, when you have mild characteristics in common with a diagnosis and then saying it’s not so bad is perhaps not so helpful to those who do struggle with it.
Are you implying that the author did not get a professional diagnosis and is merely comparing himself to people who have ADHD?
When I was diagnosed with ADHD, the disorder did cause me significant problems. Over the years I have managed to do a lot better, where I can now relate to the state the author is in (just the ADHD part, I do not suffer from depression).
ADD and ADHD have 5 sub-symptoms of varying impairment, with varying degrees of severity.
If you're diagnosed ADD/ADHD you can have a wide variety of direct and secondary side effects for which treatments can improve your success and quality of life, and it's not very kind to dismiss their experiences regardless of what other people are going through.
Since the topic has come up again, I'd like to take the opportunity to thank the people on HN who have commented at length about ADHD in the past. Without it I might not have realized that the thing that's made my life laborious, if not miserable, since I was a teenager wasn't me being « lazy » or my « temper ». I simply happened to have ADHD and never realized it. Without it I might just have lived the rest of my life thinking that I'm just that way and I'll never be able to fullfil my goals because my brain won't let me. That's a sort of despair I don't know many people can emphasize with, at least none whom I'm familiar in my everyday life.
Over the years I had come up with ways to deal with myself, but they're barely sufficient.
The part I hate most today is that if you relate to a video on ADHD/DID/Depression/Schizophrenia/etc, you will be fed the content until you convince yourself you have a “character trait”. That’s a serious problem with long term effects on society.
I’m very sure I sit somewhere on the spectrum and have depressive disorder markers as well. But the last thing I want to do is to promote these traits. I am not proud of them nor hiding them. They do make me unique. But that’s my business, not the world’s.
What worries me is how easy it is to get diagnosed. TikTok for example will also show you ads for a simple single click ADHD diagnosis and medication plan. Almost as if it’s being handed out like candy.
I found tranquility by looking inward for answers, not outward. I go on my “mental health” walks/runs. I even have taught myself to be mindful enough to notice when platforms like TikTok are emotionally manipulating you and I’ll be half crying while coming to a realization that this keeps me addicted. As I separate myself more from tech and to more nature in the world, these “character traits” don’t seem to be so defining anymore. It’s just a personal observation I’ve made as screen time declines.
I blame the medical profession for not better promoting the concept of normal human variability in these traits, too, and educational leadership for not differentiating career oriented education around people's strengths and weaknesses there in secondary school at least.
Contrary to the depiction above it remains as far as I know exceptionally difficult to acquire adhd treating medication; they’re almost all controlled substances, heavily regulated and consumption tightly monitored.
To me its pretty unconscionable that you can't opt out of parts of suggestion algorithms.
The only ability to say "no" that you have is to not use the platform, and given how much useful content coalesces into just a few platforms, you're basically saying "no" to getting content in this fashion
> you will be fed the content until you convince yourself you have a “character trait”.
And who would benefit from that change in classification or public opinion? Health care providers, because why would e.g. the NHS or health insurance pay for therapy or medication or anything else that would help you for something that is "just" a character trait?
My girlfriend got diagnosed with ADHD in her 30's, but only because there was a very short-lived and quickly shut down (due to cost) program at the NHS for adult ADHD diagnosis. If she hadn't had that, she would never have been able to get a diagnosis or the relevant medication.
This seems oddly ignorant of the effect ADD/ADHD has on a person's ability to function in modern life at a similar level to other people. It's not something you can introspect away. If I'm not on ritalin, I can introspect all I want, nothing useful is getting done.
Here in the UK, ADHD drugs are controlled substances. They can only be prescribed as by registered psychiatrists as part of ongoing treatment with patient monitoring. There are not enough doctors qualified to do this, and as a result people who need the treatment are facing year-long queues.
Don't get medical advice from TikTok, and don't form an opinion of a mental disorder and its treatment from TikTok either. The "have you tried mental health walk?" thing is as infuriating as cancer patients getting "have you tried essential oils and yoga?"
Here’s a perspective (more a response to the DeBoer article than this one) which I find helpful and which I think not enough people acknowledge:
Neurodivergence (view that mental disorders are a form of human variation that should be celebrated), medicalization (view that they are diseases, much like physical diseases), and personal responsibility (view that they are caused by personal choices) are all lenses which need to coexist in order to explain mental illness.
ADHD is probably the cleanest example because all three lenses truly apply. For many people with ADHD, it’s who they are, and there are aspects of it that they wouldn’t want to change. It’s also a condition which often needs medication to be managed properly. Plus, (in my experience with loved ones) it’s impossible for people with ADHD to function unless they are trying to take responsibility for their actions.
For most disorders, you need at least two lenses. You can’t fully understand alcoholism unless you acknowledge that both personal responsibility and a medical condition (“substance use disorder”) play a roll. Ditto anxiety and depression.
> personal responsibility (view that they are caused by personal choices)
I have interpreted and see personal responsibility as the affected person being responsible for managing the issues. Not as the issues being caused by themselves. E.g., it is not your fault you have it, you did not caused it, but you are responsible for learning strategies or taking drugs to manage issue to the possible extend.
I think I might have ADD, but since I'm a straight A student, socially well adjusted and not hyperactive I can not get any healthcare professional to take my problems seriously.
I cannot do things in time. Not even things that should be rewarding and fun. I cannot start tasks until it's too late, or in the rare event I start I cannot focus long enough on them to make a difference. I cannot really explain why. I know I should just do them, but there's some mental block that I cannot overcome. It has always been this way. None of the strategies I've tried ever made a difference. I always have a to-do list of a hundred small and big things I should have done two weeks ago that stresses me out. I also always lose things.
It's not unusual that I end up crying alone due to stress over all the things I should have done and feeling stupid for putting myself in the same spot again.
I manage to get good grades simply due to the expected workload being much less than my capability and being a good test-taker. At the final weeks before an exam the urgency of the situation allows me to absorb whole courses in a single week and get an A on the exam. But had I just worked 2 hours a day during the whole semester instead I could have saved myself all the stress and the depression and been a lot happier. And even though I know this, I will invariably do the same thing next semester.
I've tried getting help and a diagnosis, but the doctors will dismiss me after a single look at my grades. All they see is a student with great grades (and therefore not in need of help) looking to scam them out of some study drugs.
I get by, and manage to never get in any huge trouble despite my shortcomings. The big problem, except my mental health, is how it negatively impacts my relationships. I have a heard time prioritizing my girlfriend when I'm always stressed and always have a hundred things I should do, which is a reoccurring problem in our relationship. And making time for my friends is even harder.
I have cut out most nonessential responsibilities from by life just to reduce the stress a little. But I have no idea how I will manage big responsibilities like having children in the future without burning out.
I have given up any hope of getting a diagnosis. But I'm worried about the future, and I don't know what to do.
There's probably no help to get here, of course. I just wanted to get if off my chest.
Suggest best is to talk to a psychiatrist. If you think it is adhd then see if you can find a specialist and try make a booking. It costs but you'll get help quicker than trying to talk to a GP.
Don't trust a stranger on the internet, but that was me until a few months ago.
Until recently, my life has been a slow descent into an abyss of despair. Then I got diagnosed and since I've started medication, for the first time in my life I am actually proud of myself. Proud of all my talents and place in the world. There actually is hope and excitement for the future.
Here's my suggestion: do everything possible to talk with a psychiatrist. Get diagnosed. It might be something else, but if it's ADHD you'll be happy to learn that treatment is _very_ effective and often life changing. This is not hyperbole.
i was diagnosed when i was 8 or 9, took meds til i was 15 and then not again until recently. i got mostly As and Bs in school, medicated or not. when i wasn't medicated i did get some Cs and no credit at uni when i struggled with courses i didn't put time into.
i graduated with a decent grade point, like a B+ or A-, and i got straight As in my masters degree. i got jobs all over the world and am pretty smart to not have huge issues with work or anything like that. i still have issues socially, doing work, doing work i'm good at, and all that. even if i manage to mostly get good grades.
and i went to a psych and explained my issues, and i got meds for it. just because you get good grades doesn't mean you don't have ADHD, you just found ways to cope. life isn't just getting good grades and you're fine and don't have ADHD, if that were so then a lot of people wouldn't have any issue.
Wow, really nice article that gives practical examples of what ADD/HD looks like. I am not officially diagnosed, but I am 99% sure ADD/HD is something I have coped with my entire life. This has come up only recently with the pandemic forcing my schedule to change, and I started to realize how much the "9-5 routine" was keeping my train on its tracks and hiding any semblance of an attention disorder.
It's really interesting how attention disorders show and hide themselves. Like the author, I had a consistently inconsistent way of losing or forgetting things. I don't tend to be late or forget appointments, but I have a hard time scheduling them in the first place. I have rejection sensitivity dysphoria, which explains why relationships, family included, have ended poorly and needed a long time from which to recover. I did not complete college and had no idea what I was doing the entire time despite breezing through high school. I have many abandoned and unfinished projects around the house. I have been fortunate to receive accommodations at work such as choosing slightly different hours as needed, but now I understand why that was something I needed.
It hits you like a ton of bricks when you realize "I've had ADHD my whole life" because it explains every negative experience you've ever had. Having authoritarian type parents was the cherry on top.
> (W)hen the world has been willing to let me what I can do in the way that I can do it, the results have been pretty good. When the world has insisted that I do things the way everyone else does them, it hasn't always gone so well.
This is such a succinct description of the main issue with attention disorders. I think the author makes a very good argument that it's the stigma, not the disorder, that is causing more problems than anything. I know stigma against disorders like this is why it never came up.
I intend to obtain an official diagnosis and potentially try medications. The thing is, it's incredibly overwhelming to choose because half of you knows you're doing pretty well right now, why change? The other part is wondering what your true potential looks like, and fighting against how much work and experimentation you think that will take.
since adhd is treated with amphetamine which is essentially a performance enhancing drug that boosts your focus/awareness/intensity. it's probably dangerous to think of your medicated self's potential as being truer than your natural self's. seems like a trap.
I recently went through the exact same process you're going through. I'd be happy to chat if you have questions or anything. Email in profile if you want.
> But what if the Devil came and offered to cure my depression, and the price was my right arm? That question is easy. I would say “sounds great, but what's the catch?” Depression is not something with upsides and downsides. It is a terrible illness, the blight of my life, the worst thing that has ever happened to me. It is neither an adorable character trait nor an annoyance to be managed with medical treatment. It is a severe chronic illness, one that is often fatal. In a good year it is kept in check by medical treatment but it is always lurking in the background and might reappear any morning. It is the Joker: perhaps today he is locked away in Arkham, but I am not safe, I am never safe, I am always wondering if this is the day he will escape and show up at my door to maim or kill me.
As a constant sufferer who's been dealing with a debilitating case for over a year now, I love the way the author framed depression. It perfectly describes my fear that if I ever get "better", it's only a local maxima, and I will never be freed of this curse. It's laughable to even think, given how I can suffer from day to day, but I'm honestly afraid of finding something that improves my condition, because of the unknown of how depression might still be lurking in the shadows. I still try (often not very hard), but that fear is there nonetheless.
I have ADHD - mostly inattentive. I'm 46. I was diagnosed in my early twenties. I had never heard of ADHD, but a friend who had been diagnosed with it sounded like he had a lot of overlapping issues. I skipped three grades (middle school), but then failed out of university in my final year.
I'm suspicious of how often ADHD is diagnosed, and the subjectivity and lack of detailed mechanistic explanations. More study is required. I have little experience with where the current youth/teen culture is at, regarding diagnoses, and mental illness.
Behaviours that I attribute to ADHD have caused me a lot of suffering, and contributed to me being less reliable than I would like w.r.t deadlines, and personal commitments. On the other hand, I'm funny, and very creative. Like painfully creative. Like it's a goddamn joy/pain to be exploding with ideas and interests all the time. Going down rabbit holes, etc.
My current medication is quite helpful, although I experienced very bad side-effects to the first medications I took 20 years ago. This led me to avoid medication for about a decade and a half, to my detriment. Medication has not been a cure-all, and has come with some physical side-effects that I choose to tolerate. With age, I've developed coping strategies, but it's still a daily (weekly?) struggle. This is where accepting yourself -- flaws and all comes in. That tension between personal-improvement, and personal kindness / acceptance.
I'm reliable enough to get by, but I think perhaps I would have been a super-star. Still trying, I guess?
All that said, I don't know if I would get rid of it. The easy creativity, just-do-it default, and humour are part of who I am and want to be. That said, the detriments have absolutely been real and contributed to my own suffering. Although, with age, I feel as though I've been through the crucible and am basically unstoppable. I just don't know exactly where I'm going. I am so much tougher, mentally, than I was. Suffering is not all bad, as long as it's not catastrophic, or inescapable.
> For me the ADD really is a part of my identity — not my persona, which is what I present to the world, but my innermost self, the way I am actually am. I would be a different person without it. I might be a better person, or a happier or more successful one (I don't know) but I'd definitely be someone different.
There's a lot of modern discourse around "identity". My view is that the only healthy conception of your identity is the things you share with no one else. So ADD is not your identity, nor is your skin color, ethnicity, religion and so on. Rather, your identity is the result of experiences unique to your life and how those experiences shaped you.
Another big issue here is locus of control. I'm reminded of this quote: "I was dissatisfied with my own conduct, and laid the blame for my excesses on irresistible inner forces, as well as a combination of inscrutable external factors, invisibly staged to provoke and upset me."
DeBoer does the classic thing of "Inventing a guy to get mad at." Are there people who think their ADHD has no downsides and give them superpowers? Sure. There's a lot of people on earth and a distribution of opinions. Why not let people commiserate over their suffering and celebrate the quirks they've leveraged into strengths?
But going undiagnosed, it did force me to cope in creative ways.
I'd zone out in class and forget about tests. Only to inhale all the info in the dopamine-induced panic of the night before.
Long, wordy explanations bored me to tears. Which gave me deep sensitivity when explaining things to others.
And to keep myself sane during endless school days, I'd bend over backwards to try and "real-time edit" topics to be more interesting.
Finally, in my senior year of high-school, I read a blog post summarizing the classic ADHD memoir "Driven to Distraction". For the first time ever, I asked my parents to take me to a doctor. I was diagnosed basically on the spot.
The change was immediate. I went from serial coaster to rampant bookworm. Within a month, I tracked up in all my classes. I finished out high school with a bang (though it didn't matter much to college admissions).
There's always been a slight pang wondering what might have been had I read that blog post sooner. I certainly had the scholastic chops to excel, and could've landed at a much "better" school (and maybe even a "better" career).
But then I remember the blessing in disguise my alma mater, Queens College actually was. Few students cared to take advantage of the (surprisingly) excellent faculty, so I had their undivided attention. Also, the relatively lax workload gave me the space to split my time between class and internships.
And then I think about the weird, rewarding professional path those internships led me down. Where I inhale large amounts of information quickly. Find the shortest, sweetest way to explain it. And "real-time edit" the subject to make it as interesting as possible.
These aren't super-powers. These were talents I was forced to discover and lean on to cope with those that I lacked.
I can relate to certain parts of the author's post, but not all of it. I do like that I can focus very intensely and work for hours on end on a single subject, BUT (and it is a big but) it is very hard for me to get there and I have to be vastly interested in the subject. Sometimes I can go weeks, or even months, on a very exciting project (80 hour weeks voluntarily) only to get to some very mundane or boring parts and then go weeks struggling to work at all (and spend weeks trying to shift into a more exciting part to get me revved up again). If it is a subject I hate and don't find interesting at all it is very difficult to get the work done. Overall, I consider ADD in my case way more of a negative than a positive. I'd give it up for free in a heartbeat.
Thanks for sharing! This is incredibly relatable. One of my hallmarks has always been intensity. I rarely half-ass anything, and when I do, it's almost astonishingly mediocre. But normally it rockets between obsession and extreme apathy. Emotional reactions to anything are always 200%.
“ Depression is not something with upsides and downsides.”
Not sure if this is true.
Evolutionary psychologists have explored the improved tunnel vision that accompanies depression as a means for finding one’s way out of harmful situations.
Society-wide it seems many people are living in harmful situations/ways and are able to medicate their way out of the tunnel vision before recognizing the sources of pain.
>> Depression is not something with upsides and downsides.
> Not sure if this is true.
The remarkable film "Melancholia" (Lars von Trier, 2011) was inspired by the director's depression, and one particular upside: that when things get bad, like really bad, the depressive can function better than normal folks because the outside now matches their inside. Kirsten Dunst plays a young woman with utterly crippling depression, I've never seen anything like it in real life or on film, like unable to move or eat. But when the Earth is about to be destroyed, she's sanguine, unlike everyone else.
Not sure if this is true to life, but it makes some sort of sense.
Depression also seems to teach people valuable lessons when they survive it. For example, it leaves some people far more resilient in certain circumstances.
It’s the classic “what doesn’t kill you makes you stronger” adage at work. The sad thing is that it does kill many, and for some, never leaves in order to make room for growth.
As for the tunnel vision, that’s an interesting one because it does let you focus in on a problem exceptionally well and that could be useful. The trouble I’ve found in myself is that I haven’t always had the tools or resources to do something with that attention.
You end up intently focused on a problem, and it just becomes a painful echo chamber instead of an opportunity to address something. I suspect this is largely due to a lack of understanding and teaching. Perhaps too, like you mentioned, we expect medication to function as a solution eventually, relieving ourselves of any duty to investigate internal solutions. Had I known how normal depression is though, how it can present, how it can be managed, I suspect my own experiences could have been a lot better. It’s impossible to be certain.
I definitely disagree about the ups and downs in any case. Struggle defines us and helps us grow. Getting better doesn’t have to be a fun or enjoyable experience.
Im sure there is some truth to depression being adapative, but I wouldn’t trust anything that evo psych has to say. There is just no way to properly validate their arguments. We can barely explain bird beaks let alone the most complex organ we know of.
I don't really trust mental health diagnoses, but I'll admit to being heavily biased by a background in molecular biology, microbiology and biochemistry. Some diseases are clearly and unambiguously diagnosable - say you have drug-resistant TB, we can do a PCR test and detect the exact strain of TB you are suffering from. Even in some other diseases where there is no blood test and the diagnosis is clinical, like Parkinson's, the criteria seem so much clearer than anything I've heard about ADHD / ADD etc. For example:
While I can believe the condition does exist (schizophrenia may be similarly difficult to accurately diagnose, but it surely exists), it really seems to be overdiagnosed in children, and in adults, I imagine amphetamine addiction plays a big role in continued diagnoses. It's rather odd to read articles about it that make no mention of this factor.
The author really does not do a great job, here, at least in saying something sensible as a response to DeBoer's piece. The core premise seems to be that:
> I find it so very irritating that there is no term for my so-called ⸢attention deficit disorder⸣ that does not have the word “disorder” baked into it. I know what a disorder is, and this isn't one.
But the author then argues against a strawman:
> Why does any deviation from the standard have to be a disorder? Why do we medicalize human variation?
It doesn't, and in fact, the diagnostic criteria for ADHD and many other disorders require that the deviation amount to a disorder rather than not interfering with someone's life.
What the author really seems to be criticizing is that he learned and began identifying with the medical term for a disorder ("the ADD really is a part of my identity") and now he'd like a different way to describe his experience.
Fair! But get the cause-and-effect the right way around: we don't need to "stop labeling every difference as a disorder," we need to not adopt diagnostic terms and apply them to ourselves inappropriately. That's a part of what DeBoer is criticizing—that people self-diagnose and then "perform their various personalities."
To be clear, I agree with the author that it would help to have terminology for people who don't feel negatively impacted by their brains being different in a way that we can label, not just for those who do. Maybe the author could get started with that by dropping the "disorder" bit and just identifying himself as someone with an attention deficit.
The "neurodiversity" viewpoint here is that what we call "ADHD" is part of the natural variation in how human brains work, and that it's a category error to think of it as a malfunction to be repaired, but rather as a difference to be accommodated. That accommodation may or may not be via medication and therapy, but that shouldn't necessarily mean that the underlying neurological state is a diseased one.
A good analogy would be height: a person who is several standard deviations from the mean will face challenges in life that require various forms of intervention, but we don't generally think of them as having a _disorder_ unless there's an identifiable biological cause that usually has other effects.
Another good point of comparison is vision. We can accurately measure vision and create medical devices to correct unwanted variation. As someone with myopia, I find it to be only slightly medicalized -- going to get an eye exam doesn't feel much like visiting a doctor, and people don't tend to talk about it as one does a medical condition. I imagine that if we were able to make a similar kind of standardized assessment of whatever neurological basis there is for ADHD, we would consider medication for it more akin to a stepladder or a pair of glasses (or even an antihistamine) than a treatment for a mental illness.
I think the main gripe sits with how we label it and the way we associate with the label. Yes, in a medical context we can use words like retard, but it's not acceptable to use this word in front of a patient because often the medical definition isn't known.
To the same degree disorder may be an acceptable label by a clinician, but we need a different word for regular everyday use - because if I come into work and tell everyone I have a disorder, they're going to make assumptions. And then back into the closet that information goes.
I'd say a lot of people don't share information about their neurodiversity for this very reason. The fact the top comment here argues about the linguistics rather than the content or spirit of the article, tells me we're not ready for that yet. Which is surprising given the readership of this website likely caters to more neuro atypicals than average.
My main grip with having ADHD is why it's so damn hard to do simple things like open the mail or make a phone call, it's almost like needing a secretary to survive. Second gripe is how hard it is to get an appointment to get medication sorted. I've never felt judged or victimized for it, though I have felt personally lacking due to my struggles to get things done.
I find ADHD to be an "occasional" disorder. I feel very much like the author much of the time, but honestly I want it to continue to be researched as a disorder, because I want strategies and medications that are better than post-it notes and Adderall (and yes, I've tried lots and no, none of them are better for me than the occasional 5mg of Adderall).
Most of the time, ADD works in my favor. But sometimes, (and NOT always due to "societal expectations") I need my brain to work differently than it does, and for those occasions the meds do wonders. But I truly hate the after-effects, thus I rarely take them.
> the diagnostic criteria for ADHD and many other disorders require that the deviation amount to a disorder rather than not interfering with someone's life.
> interfering with someone's life
The specific phrase used in the DSM-V is: "symptoms interfere with or reduce the quality of social, academic, or occupational functioning".
Schooling started to become compulsory in the USA in the mid-to-late 19th century, and really only became universal in the early 20th century.
By the late 20th century we had decided that children whose normal behavior "interfered with or reduced [...] academic [...] functioning" had a disorder.
We created a system that does not accommodate everyone, then turned around and said that those who are not accommodated are definitionally disordered. The logic is clearly backwards.
I’ve often thought that I could be diagnosed with ADHD if I wanted, but I don’t feel the need to label myself with a “disorder” and its possible stigma for something that I feel helps me more than it hurts (now that I’ve learned strategies to work with it). Then again, it might have been easier/faster to find my coping strategies if I was diagnosed early. For these reasons, I think it would be helpful to drop the “disorder” bit culturally.
Imagine your skin has a different from your neighbors color. Would it be sensible to consider it a disorder? Even if it may happen that it negatively affects your every day life, and it may be maladaptation in the region where you live but it may be a considerable advantage if you had lived on different latitude.
Or consider a game where different character classes exist e.g., Necromancer (can raise an army with no resource, quickly) and Wizard (requires lots of resources, slow to develop though some units are exceptionally strong). Would it make sense to consider being a Wizard to be a disorder in such a game?
If the authors life is not being impacted by his ADHD then he does not have ADHD. The clinical diagnosis for a mental illness is that it impacts your life in a negative way. His attention deficit does not impact his life in a negative way, therefore it’s not a disorder.
The author frankly does not know what he’s talking about. And, clinically, he does not have ADHD.
I have a mood disorder (NPSLE). I am on permanent disability and I have been hospitalized several times.
Even though I know my disorder comes with a gift, and rather unappreciated gift because I do consider myself neurodivergent, I also know at times I want to die at my own hands. And I also know it makes me unable to work.
I think the threshold for where we think some Neurotype is affecting our life has been lowered dramatically.
To add a small snippet of what I've found works against these type symptoms currently I use L-Tyrosine 500mg per day cycled on off every so often. At times I will take breaks every 3 months for a few weeks or so then maybe use Schisandra Berry extract for a week.
I find keeping a super simple excel sheet with a monthly list of work and personal tasks works well with next actions for litterally everything except daily habits/ routines. The act of physically moving complete items from one location to another seems to keep me using it (I use Desktop version with autosave enabled) its not so mobile friendly but it works better for me. Every task system I've tried which is a huge number of them I've got bored with or forgotten to use or micro managed to much, I dislike daily task systems for a number of reasons. This improved my productivity and focus literally about 1000%. I find leaving stuff off the lists causes more persistent interruptions to focus, I beleive due to the zeigarnik effect.
I've found diet works best when Low GI as glucose spikes and crashes really screw things up, will power correlates with glucose levels massively. I don't use any supplements but have done tons in the past they aren't really needed. Diet ratio 50% veggies, 25% protein, 25% carb per plate is a good ratio. Tea, Coffee can be a negative so its good to experiment times without it.
"Many of the downsides of ADD would be less troublesome for everyone, if our world was a little more accepting of difference, a little more willing to accommodate people who were stamped in a slightly different shape that the other cogs in the machine"
I think this is true. We're working and learning in institutions that are incredibly restrictive for people who operate a little bit differently, and it's telling how common ADD is as a colloquialism and not just as a diagnosis.
Foucault used to compare schools to prisons, and joke that the former is the only institution in democratic societies where someone still tells you when you can use the toilet. It's not always so easy to tell with ADD like behavior if the person is pathological or the environment, because you can actually make a pretty decent case for the latter, unlike for some other mental illnesses.
Without playing down the need to help people who do suffer from mental illness, not prematurely pathologizing people and framing them as aberrant is important. In particular with the inflation of ADD diagnoses of young children going hand in hand with a change in culture that seems to have largely robbed children of any opportunity to actually live like kids.
It IS odd that ADD/ADHD is approached this way. There's a sort of weird relativism wherein ADHD can be considered a deviated cognition and not a disorder, but it depends on the environment. Because of the ways of the world, and how modern life goes, it's considered a disorder largely because of the effect it has on integrating with that norm.
If life were different but the ADHD brain wasn't, I think there might be a world where it's not considered a disorder.
I've lived with ADHD-C all my life, and it was something that got me labelled as "lazy" and "unfocused" and even sometimes I was told that I didn't give a shit. People who saw me work 16hr days or work for weeks on end without a day off, these same people called me those things because of how I came across in social situations or in everyday life situations.
I think my tribe of ADHDers sorta see it as part of the formula in how we evaluate our own merit. I'm capable of incredible creativity and ruthless hyperfocus on task when I get spooled up the right way, and so I feel GOOD about myself because I know my true potential. I don't think of myself as some leper weirdo who can't talk right, asks too many questions, turns on a dime. Other people don't really think about that, it's not natural to take that sort of probabilistic view of people, of what they MIGHT be capable of. Stakes are high, and the cost of error correction is high enough usually to motivate a rigid adherence to cautiousness.
I'm not sure how exactly I feel about this article, but I'll say this in conclusion: I've never, ever, ever, even once wanted a different brain than the one I have.
I've wanted to be treated better, and considered more fairly.
I don't know if I have ADHD, but learning more about it, and other forms of neurodiversity, has recontextualized the first 2/3 of my life. I've usually managed to get by pretty well through life's expectations, but I have had struggles along the way that were really confusing. Places where other people seemed to have no trouble meeting expectations, but I would constantly come up short. I also relate to some of the positive aspects or adaptations that folks describe. I haven't prioritized seeking diagnosis or treatment because I've largely figured out how to get by, to my own satisfaction. Although, I know that I could be more dependable to other people if I did.
I have also suffered a couple periods of major depression, which I agree is horrible in a far less ambiguous way. I can actually identify some very positive outcomes of those episodes. Ways in which struggling my ass off to try to be okay pushed me to achieve. But I'd absolutely throw out the good with the bad, if I could. I wouldn't wish depression on my worst enemy.
It can be simultaneously true that ADHD is over-diagnosed (in some cultures), and also that people can benefit from treating what we currently understand as/call ADHD.
It can be simultaneously true that ADHD has no positive consequences for some people, whereas it brings benefits (or is correlated to beneficial traits) in other people.
I am open about my diagnosis of ADD, as are some doctors with ADD who see a doctor for their ADD.
This man, there is nothing wrong with. It is the world around him that's wrong. And apparently it's a clock speed thing, that's an actual scientific conclusion I'm arriving to, and talking with doctors about how to measure with high precision. It's literally, literally, literally the beat of a different drummer, fewer Hertz, and if he did go somewhere with more people like him it would not only be much better, he would both be much more liked and like those around him more (which is reinforcing), people would return him his lost belongings, his defeats would be many fewer, and...I divine his depression would vanish.
I’m pretty sure that I could get an ADD diagnosis. But it’s not something that bothers me.
Mental and behavioral issues are tough because there are many shades of grey. If whatever you are experiencing is causing you pain and you cannot stop it, than it’s a problem.
I think modern society is tough because we tend to have fewer social connections and institutions. It’s easier to get stuck in bad situations or to be isolated than in the past, and I think that makes latent problems more problematic. The good news is that we have professionals who can help, but that bad news is we also have others (schools, etc) who help themselves.
"...There are bigger downsides to ADD, like the weeks when I can't focus on work, or when I get distracted by some awesome new thing and don't do the things I should be doing, or how I lost interest in projects and don't always finish them, blah blah blah. I am not going to complain about any of that, it is just part of being me and I like who I am pretty well. Everyone has problems and mine are less severe than many. ..."
What he is describing is everyone. The last sentence should read "Everyone has these problems just like me."
We are conditioned from a very early age to compare our insides to everyone elses outsides - the personas that they represent - or more accurately that we represent for them. Whether we imagine ourselves better than that persona or inferior in some way - it is all illusion.
Nothing is good or bad but thinking makes it so (where have you heard that before?)
Reading the comments below I feel there is a lot of beating oneself up. I know... I do this all the time. When I recognize that I am doing this I redirect it to accept and love my natural self (very liberating). This is our human nature. We all share in this. We should feel perfectly natural and ok about our nature.
The difficulty is in adapting to the structure of society. We are challenged to find ways to adapt and manage our nature in order to find some measure of accomplishment in that structure. Some adapt readily. Others have to work at it. We all face the same challenge and we all acheive different measures of success. Just make sure that it is your measure of success that you are striving to achieve.
The labels and their definitions are all a product of a feckless mental health industry that needs to create something to justify their existence. The definitions describe observable human nature and the labels categorize them. The negative connotation is a judgement - this is what causes so much stress.
This body of work is dynamic and changing. The American Psychaitric Association Diagnostic Criteria at one time included homosexuality as a mental disease. Can't suffer from Aspergers because technically it is no longer a diagnosis. So consider these examples to help keep it all in perspective.
I also have ADHD and suffered my entire school and university years due to it. I have used every medication there is for it. I recommend everyone to take up meditation. Even 5 minutes a day is good. Im not saying quit your normal medication etc, just meditate for 5 minutes a day, every day. It will make a difference like day and night.
I dare to say that all three examples - depression, adhd and homosexual orientation - have in common, that they lead to questions about identity.
How come that we try to create AI with NNs and billions of funding, but we don't pay the same amount of attention towards understanding the foundations of our own thinking?
this trend of trying to make ADHD into some kind of "superpower" is hogwash and a direct consequence of some deep internalized able-ism of the people that propose that view.
I have ADHD, there's nothing cute or great about it, it really sucks to have this disability, I have lost countless opportunities and had to work 10x as hard to achieve the same as everyone else because of it.
I'm not less valuable as a person because of it of course, but I would gladly return my "gift" if that was possible.
>Having a high IQ, being economically privileged, very good looking,is going to change the impact ADHD has on someone.
In my case it meant staying out of jail, managing to graduate college and getting a career I could thrive in. Still... serious downsides along the way and always a struggle to hold it all together.
Daily 20 hour water (& salt) fasting reduced my desire to jump between tasks. Less scatter-brained too. My thoughts stay on rails longer. Didn't change my diet much; I don't eat many refined foods or carbs other than occasional bread.
Years ago in college I was prescribed Adderall but it didn't make me focus more. It made me compulsively clean my apartment, masturbate, tweak out, and occasionally be extremely paranoid of being attacked while on public transit. I was ready to rip someone's head off. I discourage using this medication.
If you haven't reduced carb intake to a bare minimum I suggest maintaining it first for a month before looking for more help.
I started adderall a few weeks ago after a vary recent diagnoses at 30 years old. It affected my personality in the sense that my wife claims that I now seem interested in what she has to say, I no longer get angry at the smallest things, I have patience with my son, and I don't get so overwhelmed that I regularly want to curl up in a ball and cry.
Otherwise, I'm the same me. Just functioning and less pissed off or annoyed all the time.
I was diagnosed at 8 years old. Was on Adderall for 10 years. Went off of it as I entered my 20s. Started it again at 31 after doing a rediagnosis, and I've been on it for a year. I now regret not starting it up again in my 20s. I don't think it affects (or would have affected) my personality, but it would have positively influenced my life. In the last year, I've been able to overcome a lot of stuff to get my life "back on track," and I'm finally in a place where I feel happy and productive again.
A lot of the benefits of neuro-diversity are seen at the population level. The bearers of these traits are “taking one for the team” so to speak because they are preserving a genetic trait potentially useful for the future but may be painful in the present. There’s going to be a wide range of suffering though, from manageable ADHD to crippling depression. Society should simply support these people and mitigate near term suffering as much as possible, but calling these things a disorder isn’t wholly inaccurate because they can be reasonably described as problematic for current day life, even if potentially advantageous in future scenarios.
>The bearers of these traits are “taking one for the team” so to speak because they are preserving a genetic trait potentially useful for the future but may be painful in the present
I would rather not “take one for the team” especially if “the team” has to be dragged kicking and screaming into providing any support/“compensation” for the “service” I am providing.
Also “preserving genetic traits that are potentially useful in the future” is way to close to eugenics for my comfort.
> When I was around seventeen I took a Real Analysis class at Columbia University.
How typical.
> When my first-year hallmates were “studying” they were looking out the window, playing with their pencils, talking to their roommates, all sorts of stuff that wasn't studying. When I needed to study I would hide somewhere and study. I think the ability to focus on just one thing for a few hours at a time is a great gift that ADD has given me.
That's the opposite of executive disfunction. (To be fair, the author does describe other hallmarks of executive disfunction elsewhere.)
A lot of people using "ADD," should know that it doesn't exist anymore. Now it's all diagnosed as ADHD with three sub types: combined (the most common), hyperactive, and inactive. "ADD" aligns with the inactive type. Anyway...
There's a perspective in some ADHD circles (and likely other mental health circles) that the concept of neurodiversity/neurodivergent are not the correct framing for living with ADHD. It follows this idea that when people highlight (or unmask) the parts of ADHD that make them quirky or entertaining to society, they are not revealing the _very negative_ symptoms of ADHD that are extremely debilitating. The proliferation of sound bite videos that portray ADHD in a very positive light on TikTok, ADHD memes, etc. gloss over the dark realities of ADHD. My personal belief is that while it's good to help people understand some of the more lighthearted ADHD symptoms, it's important that we share even the negative aspects. Of course, negative things don't get engagement (as the author states when he gets to mentioning a battle with depression).
TikTok isn't covering things like ADHDers' propensity to lose their jobs due to poor performance, the financial ruin from overspending and money mismanagement, poor physical health and wellbeing, likelihood to have comorbid depression and anxiety, missing out academic/professional opportunities, fewer if any meaningful relationships because of social disorder symptoms attributed to ADHD. You rarely, if ever, see social media ADHDers talk about how ADHD affects something like dental health because of the "out of sight, out of mind" effects and the inability to form healthy hygiene habits because there are no immediate consequences (the "now or not now" mental modes). How getting a restful night's sleep is a rare delight because of ADHD's ability to delay sleep. You'll never hear them talk about how ADHD people have a significantly shorter life expectancy than the general population--some studies calculating it by as much as 20 years.
These are all very negative, debilitating pieces of ADHD that get glossed over by modern social media movements of the quirky/neurodivergent ADHD crowd. Even this author doesn't really dive into the dirty pieces.
This is a long one, but all of that said: I have ADHD. I was diagnosed at 8 years old. Finally, got on stimulants for the first time as an adult and my life's trajectory turned around in a just few months. I still struggle with all the negative things that come with ADHD. But I believe that ADHD is both a blessing and a curse; that I can personally celebrate the parts that make me quirky and bring me joy and also be aware of the negative effects it has on me and on my ability to function in modern society. I do see it as a disability, but not as a hindrance. The more I learn to accommodate it for myself the better off I'm going to be long-term.
Some comments were deferred for faster rendering.
jrapdx3|3 years ago
Despite these factors only 20% of ADHD individuals receive treatment which can make a big difference. Medications can be helpful but are not by any means a "cure". Rather specific behavioral therapies are a necessary part of an effective treatment program.
As a physician specializing in behavioral health, I've treated a great number of ADHD adults. It's impressive how much improvement patients could make over a period of months to years as a result of their determined effort. I came to appreciate patients' innate talents that many were eventually able to exploit. It was gratifying to see some become top-tier innovators in their fields including technologies.
Of course people will "identify" unique traits as part of their sense of "self". ADHD individuals may come to regard aspects of their quirky cognitive styles as part of an "identity" but that's not necessarily the same as having ADHD as the biggest component.
Last thing I'll say is that ADHD is considered a developmental disorder. IOW there's no sharp line between having/not having it. The extent it's a problem depends on the context, which is a huge discussion topic in its own right.
lghh|3 years ago
Growing up, ADHD was my biggest enemy in life and I didn't even realize it.
Once I began treatment, the change was almost overnight. I know I'm just one data point in a sea of data points, but I really just want to add that I'm on the other end of the parent comment and getting diagnosed, other than my marriage and the birth of my son, was the best thing that's ever happened to me.
sizzle|3 years ago
This is even with 10+ years of diagnosis.
Do you have any insight into why it is this way? Have physicians always feared the DEA and threat of losing their license in pursuit of helping their patients try different controlled medications? Did the pill mills ruin it for the entire medical industry?
gibquaaludes|3 years ago
My experience with GPs is that they do not understand those issues and do not know how to direct to someone who does. It's not like a physical ailment where they know with a fair degree of certainty what the next avenue is.
poulpy123|3 years ago
thequux|3 years ago
However, it's also one of my greatest strengths. When my brain decides to attack a problem, I'm astonishingly productive. Over the last couple of weeks, I've been hyperfocused on implementing a motion control system for a side project. As a result, I've designed a CoreXY platform, designed a control board for it, learned how to use ngspice to tune the power-up circuit, learned how to use Sympy, used it to derive closed-form solutions for jerk-controlled motion, and found a way to implement that solution in which the motion control interrupt takes a grand total of 70 cycles on Cortex M0. And this is just my spare time outside of work, where I had a completely different set of hyperfocii, and similar productivity.
So, I completely agree with the author that if somebody were to offer me a megadollar in exchange for getting rid of my ADD, I'd have to think very hard about that indeed.
luckydata|3 years ago
https://pubmed.ncbi.nlm.nih.gov/33549739/
throwaway6532|3 years ago
unknown|3 years ago
[deleted]
opportune|3 years ago
I personally believe everybody should be allowed to take these stimulants if they want to, because many people would benefit from it. The propaganda around stimulants working radically differently on those with ADHD vs those without is just that (I can go on about why I think that in much more detail). Ask anybody you’re close with how taking their friend’s adderall to study worked out. Look into people like Paul Erdos.
Anyway, I think you can definitely argue that there is a lot more nuance to psychiatry than you see in clinical settings (probably many disorders should be broken up into multiple others, others are just symptoms rather than a problem itself, others are not even disorders but just a different way of being). But really all that matters is that psychiatrists can match symptoms to treatments that work. Matching poor/misdirected executive function to medication that “boosts” dopamine and norepinephrine works pretty well, so why worry about the name of the condition?
klysm|3 years ago
This is the complete opposite of my experience. A lot of my life has been dominated by a hyper-focus that feels like it isn't under my control. I would stay awake reading until I can't think anymore with relentless pursuit of something that was entirely non-relevant to critical priorities in my life.
I very recently (past couple of months) started taking stimulants, and one of the biggest differences for me was the feeling of desperation to pursue was greatly relaxed. Not gone, but definitely not as intense.
I think a lot of the problem here is the definition of focus is overloaded. For me, there are (at least) two distinct levels of focus on different time scales. I define short-term focus as stability on task level executive function. Can you tolerate a brief interruption and go back to what you were doing? Or plan ahead for the next task? This ability is absolutely compromised relative to the population norm for me. I have essentially 0 local stability. On a longer time scale, I think a similar stability notion applies. I frequently get completely engrossed for periods of a few weeks on a topic - beyond healthy levels of interest. But one day, it's just gone - vapid.
Time for some serious hand waving: my mental model of what stimulants do to me decrease the activation threshold for picking something in an executive space. By lowering this plane, it's easier for me to remain more stable as the surface is a lot more clear.
I'm curious to know if what I'm saying sounds like 100% bullshit though - I haven't really talked through this mental model with anybody.
WalterSear|3 years ago
I experienced them before I was aware of my issues, before had ever tried any medication.
tbalsam|3 years ago
Hyperfocus is a symptom of ADHD proper. Stimulants can also make you feel hyperfocused. However, the general reported effects of stimulants are a feeling of "normalcy", not hyperfocus as a result of stimulants. Many people taking stimulants are still symptomatic, albeit managed, meditation long term is generally an excruciatingly (if excruciating) adjunct to stimulants.
Second, Adderall often gives the feeling of superfocus and speed to neurotypical individuals but has been statistically shown to give little gain in practice in terms of certain raw metrics. A very strong dopaminergic placebo, as it were. I'd suspect the reason for it being considered effective is that it keeps you glued on tasks for significantly longer than otherwise . It's not propaganda, it's science, you can look at the studies yourself, it's pretty drastic. However there may be another layer on top of that that that could be propagandizing what is otherwise a valid scientific distinction.
Much agreed in the last half, I've seen a lot of subclinical dissociative like disorders fall into ADHD, or DPDR, when really there is probably a core condition and several other families lumped in. Such is always the curse of dimensionality reduction. A more root-cause preserving descriptive language set that doesn't rely on the anchor of billing codes would open up the scientific fields a lot. Language determines nomenclature, which determines assumed avenues of exploration. A dimension reduced model of mental health along symptomatic axes will almost always destroy symptom and condition "root cause" linkage. Additionally like you noted anxiety and depression are more symptoms of traumatic disorders and less actual disorders in and of themselves. My pet theory is that's one reason why "depression" is so hard to cure, imagine trying to generically cure "fever" instead of making vaccines, etc.
Ramble over! I think (especially later on) we think pretty similarly!
astrange|3 years ago
It is hard to control, but it can help you do one thing as long as you're willing to abandon all other parts of your life, like eating/sleeping.
TrackerFF|3 years ago
I've noticed that in the ADHD community, there are some very vocal people that will wear the diagnosis with pride. I mean, good for them - but it is not really anything I can relate to. I treat it pretty much like I treat my gout...take my medication, adjust my lifestyle, and go on with my day.
cbfrench|3 years ago
ADHD is a curse, and I will never be able to see it as anything but that. Am I grateful to know why I am the way that I am? Certainly. But I will never be able to get onboard with the “ADHD as superpower” line that some fellow ADHD folks have adopted. Glad they can see it that way, but if someone offered me a way to 100% cure it tomorrow, I’d take it and never look back. Getting medicated has made a difference in my life, to be sure, but I can’t imagine ever seeing this condition as a positive aspect of my identity.
ascar|3 years ago
You can take medication to adhere to these artificial expectations on how an individual should function within society. Or you can live in a way that matches your natural behavior and capabilities.
Granted, we sometimes cannot avoid having to function in the expected way so medication is helpful. But seeing it as an illness that one needs to constantly surpress just doesn't sound right to me.
It's part of my personality. I'm not proud of it. But I also certainly don't see it as something that needs to be constantly treated.
steve_adams_86|3 years ago
I think the idea of wearing it as a badge of pride is because that reflex is easier than being more honest and introspective. At the same time it might help soften the pain. If you have a disability, you are a strain on those around you. You shouldn’t be ashamed of it, but you shouldn’t be prideful either. You should be proud when you succeed against the odds and you know it took hard work, but that’s not adhd happening.
For a brief time I entertained that I should be more adhd positive. Ultimately I realized that bias is not helpful at all if it clouds my perception of how it impacts my life or those around me. For some people though, perhaps it helps lessen the burden of the common self-loathing that tends to manifest as sufferers age.
david38|3 years ago
psyclobe|3 years ago
The biggest part I don't like is the inability to ever really be 'here in the now' e.g. enjoying the moment. All these important life events just fly by me without even reacting to them it seems, and only in hindsight do I start tearing up thinking about what I missed.
xlii|3 years ago
I’m saying this to a level where I personally know bloodlines where men suicide is just a thing that “will happen”. Guess what is the last year’s diagnosis on that?
I live in a society where official stats says that 0.0-0.1% of population is affected and such treatment is not needed. From multiple available treatment options (where single one has around 30% efficiency) there are only 2 available. I recently heard a joke that probably full European country has at most 2 ADHD therapists. Sure maybe you’re lucky enough to get diagnosis but then you might not even be able to treat it meds unless you emigrate. That’s why pride is important - it creates advocates. Advocates creates awareness and awareness provides solutions.
As you mentioned your diagnosis there is a chance you’re sensitive to the critique (it’s often coexisting). Keep in mind that your critique is targeting exact same people like you who struggled with it and came out with pride. Don’t take that away from people.
cjbgkagh|3 years ago
opportune|3 years ago
On a lot of ADHD communities it’s just a constant struggle session about how every problem in people’s life is because of ADHD. It’s exhausting and seems maladaptive.
hirvi74|3 years ago
bananamerica|3 years ago
thevagrant|3 years ago
colechristensen|3 years ago
Comparing yourself, when you have mild characteristics in common with a diagnosis and then saying it’s not so bad is perhaps not so helpful to those who do struggle with it.
jimvdv|3 years ago
When I was diagnosed with ADHD, the disorder did cause me significant problems. Over the years I have managed to do a lot better, where I can now relate to the state the author is in (just the ADHD part, I do not suffer from depression).
I would now say it’s not so bad too.
BizarroLand|3 years ago
If you're diagnosed ADD/ADHD you can have a wide variety of direct and secondary side effects for which treatments can improve your success and quality of life, and it's not very kind to dismiss their experiences regardless of what other people are going through.
Gatekeeping a diagnosed disorder is mega cringe.
Bayart|3 years ago
Over the years I had come up with ways to deal with myself, but they're barely sufficient.
thenerdhead|3 years ago
I’m very sure I sit somewhere on the spectrum and have depressive disorder markers as well. But the last thing I want to do is to promote these traits. I am not proud of them nor hiding them. They do make me unique. But that’s my business, not the world’s.
What worries me is how easy it is to get diagnosed. TikTok for example will also show you ads for a simple single click ADHD diagnosis and medication plan. Almost as if it’s being handed out like candy.
I found tranquility by looking inward for answers, not outward. I go on my “mental health” walks/runs. I even have taught myself to be mindful enough to notice when platforms like TikTok are emotionally manipulating you and I’ll be half crying while coming to a realization that this keeps me addicted. As I separate myself more from tech and to more nature in the world, these “character traits” don’t seem to be so defining anymore. It’s just a personal observation I’ve made as screen time declines.
lr4444lr|3 years ago
I blame the medical profession for not better promoting the concept of normal human variability in these traits, too, and educational leadership for not differentiating career oriented education around people's strengths and weaknesses there in secondary school at least.
SamoyedFurFluff|3 years ago
taurath|3 years ago
The only ability to say "no" that you have is to not use the platform, and given how much useful content coalesces into just a few platforms, you're basically saying "no" to getting content in this fashion
Cthulhu_|3 years ago
And who would benefit from that change in classification or public opinion? Health care providers, because why would e.g. the NHS or health insurance pay for therapy or medication or anything else that would help you for something that is "just" a character trait?
My girlfriend got diagnosed with ADHD in her 30's, but only because there was a very short-lived and quickly shut down (due to cost) program at the NHS for adult ADHD diagnosis. If she hadn't had that, she would never have been able to get a diagnosis or the relevant medication.
Sakos|3 years ago
pornel|3 years ago
Here in the UK, ADHD drugs are controlled substances. They can only be prescribed as by registered psychiatrists as part of ongoing treatment with patient monitoring. There are not enough doctors qualified to do this, and as a result people who need the treatment are facing year-long queues.
Don't get medical advice from TikTok, and don't form an opinion of a mental disorder and its treatment from TikTok either. The "have you tried mental health walk?" thing is as infuriating as cancer patients getting "have you tried essential oils and yoga?"
elil17|3 years ago
Neurodivergence (view that mental disorders are a form of human variation that should be celebrated), medicalization (view that they are diseases, much like physical diseases), and personal responsibility (view that they are caused by personal choices) are all lenses which need to coexist in order to explain mental illness.
ADHD is probably the cleanest example because all three lenses truly apply. For many people with ADHD, it’s who they are, and there are aspects of it that they wouldn’t want to change. It’s also a condition which often needs medication to be managed properly. Plus, (in my experience with loved ones) it’s impossible for people with ADHD to function unless they are trying to take responsibility for their actions.
For most disorders, you need at least two lenses. You can’t fully understand alcoholism unless you acknowledge that both personal responsibility and a medical condition (“substance use disorder”) play a roll. Ditto anxiety and depression.
watwut|3 years ago
I have interpreted and see personal responsibility as the affected person being responsible for managing the issues. Not as the issues being caused by themselves. E.g., it is not your fault you have it, you did not caused it, but you are responsible for learning strategies or taking drugs to manage issue to the possible extend.
throw314_|3 years ago
I cannot do things in time. Not even things that should be rewarding and fun. I cannot start tasks until it's too late, or in the rare event I start I cannot focus long enough on them to make a difference. I cannot really explain why. I know I should just do them, but there's some mental block that I cannot overcome. It has always been this way. None of the strategies I've tried ever made a difference. I always have a to-do list of a hundred small and big things I should have done two weeks ago that stresses me out. I also always lose things.
It's not unusual that I end up crying alone due to stress over all the things I should have done and feeling stupid for putting myself in the same spot again.
I manage to get good grades simply due to the expected workload being much less than my capability and being a good test-taker. At the final weeks before an exam the urgency of the situation allows me to absorb whole courses in a single week and get an A on the exam. But had I just worked 2 hours a day during the whole semester instead I could have saved myself all the stress and the depression and been a lot happier. And even though I know this, I will invariably do the same thing next semester.
I've tried getting help and a diagnosis, but the doctors will dismiss me after a single look at my grades. All they see is a student with great grades (and therefore not in need of help) looking to scam them out of some study drugs.
I get by, and manage to never get in any huge trouble despite my shortcomings. The big problem, except my mental health, is how it negatively impacts my relationships. I have a heard time prioritizing my girlfriend when I'm always stressed and always have a hundred things I should do, which is a reoccurring problem in our relationship. And making time for my friends is even harder.
I have cut out most nonessential responsibilities from by life just to reduce the stress a little. But I have no idea how I will manage big responsibilities like having children in the future without burning out.
I have given up any hope of getting a diagnosis. But I'm worried about the future, and I don't know what to do.
There's probably no help to get here, of course. I just wanted to get if off my chest.
thevagrant|3 years ago
sph|3 years ago
Until recently, my life has been a slow descent into an abyss of despair. Then I got diagnosed and since I've started medication, for the first time in my life I am actually proud of myself. Proud of all my talents and place in the world. There actually is hope and excitement for the future.
Here's my suggestion: do everything possible to talk with a psychiatrist. Get diagnosed. It might be something else, but if it's ADHD you'll be happy to learn that treatment is _very_ effective and often life changing. This is not hyperbole.
kanbara|3 years ago
i graduated with a decent grade point, like a B+ or A-, and i got straight As in my masters degree. i got jobs all over the world and am pretty smart to not have huge issues with work or anything like that. i still have issues socially, doing work, doing work i'm good at, and all that. even if i manage to mostly get good grades.
and i went to a psych and explained my issues, and i got meds for it. just because you get good grades doesn't mean you don't have ADHD, you just found ways to cope. life isn't just getting good grades and you're fine and don't have ADHD, if that were so then a lot of people wouldn't have any issue.
keep trying, and find a good psych.
astrange|3 years ago
If they don't dismiss you the diagnosis process usually involves things like asking your parents about your childhood and things outside classwork.
hatware|3 years ago
It's really interesting how attention disorders show and hide themselves. Like the author, I had a consistently inconsistent way of losing or forgetting things. I don't tend to be late or forget appointments, but I have a hard time scheduling them in the first place. I have rejection sensitivity dysphoria, which explains why relationships, family included, have ended poorly and needed a long time from which to recover. I did not complete college and had no idea what I was doing the entire time despite breezing through high school. I have many abandoned and unfinished projects around the house. I have been fortunate to receive accommodations at work such as choosing slightly different hours as needed, but now I understand why that was something I needed.
It hits you like a ton of bricks when you realize "I've had ADHD my whole life" because it explains every negative experience you've ever had. Having authoritarian type parents was the cherry on top.
> (W)hen the world has been willing to let me what I can do in the way that I can do it, the results have been pretty good. When the world has insisted that I do things the way everyone else does them, it hasn't always gone so well.
This is such a succinct description of the main issue with attention disorders. I think the author makes a very good argument that it's the stigma, not the disorder, that is causing more problems than anything. I know stigma against disorders like this is why it never came up.
I intend to obtain an official diagnosis and potentially try medications. The thing is, it's incredibly overwhelming to choose because half of you knows you're doing pretty well right now, why change? The other part is wondering what your true potential looks like, and fighting against how much work and experimentation you think that will take.
gfody|3 years ago
since adhd is treated with amphetamine which is essentially a performance enhancing drug that boosts your focus/awareness/intensity. it's probably dangerous to think of your medicated self's potential as being truer than your natural self's. seems like a trap.
lghh|3 years ago
adepressedthrow|3 years ago
As a constant sufferer who's been dealing with a debilitating case for over a year now, I love the way the author framed depression. It perfectly describes my fear that if I ever get "better", it's only a local maxima, and I will never be freed of this curse. It's laughable to even think, given how I can suffer from day to day, but I'm honestly afraid of finding something that improves my condition, because of the unknown of how depression might still be lurking in the shadows. I still try (often not very hard), but that fear is there nonetheless.
JabavuAdams|3 years ago
I'm suspicious of how often ADHD is diagnosed, and the subjectivity and lack of detailed mechanistic explanations. More study is required. I have little experience with where the current youth/teen culture is at, regarding diagnoses, and mental illness.
Behaviours that I attribute to ADHD have caused me a lot of suffering, and contributed to me being less reliable than I would like w.r.t deadlines, and personal commitments. On the other hand, I'm funny, and very creative. Like painfully creative. Like it's a goddamn joy/pain to be exploding with ideas and interests all the time. Going down rabbit holes, etc.
My current medication is quite helpful, although I experienced very bad side-effects to the first medications I took 20 years ago. This led me to avoid medication for about a decade and a half, to my detriment. Medication has not been a cure-all, and has come with some physical side-effects that I choose to tolerate. With age, I've developed coping strategies, but it's still a daily (weekly?) struggle. This is where accepting yourself -- flaws and all comes in. That tension between personal-improvement, and personal kindness / acceptance.
I'm reliable enough to get by, but I think perhaps I would have been a super-star. Still trying, I guess?
All that said, I don't know if I would get rid of it. The easy creativity, just-do-it default, and humour are part of who I am and want to be. That said, the detriments have absolutely been real and contributed to my own suffering. Although, with age, I feel as though I've been through the crucible and am basically unstoppable. I just don't know exactly where I'm going. I am so much tougher, mentally, than I was. Suffering is not all bad, as long as it's not catastrophic, or inescapable.
So .. uh .. yeah. YMMV.
slibhb|3 years ago
There's a lot of modern discourse around "identity". My view is that the only healthy conception of your identity is the things you share with no one else. So ADD is not your identity, nor is your skin color, ethnicity, religion and so on. Rather, your identity is the result of experiences unique to your life and how those experiences shaped you.
Another big issue here is locus of control. I'm reminded of this quote: "I was dissatisfied with my own conduct, and laid the blame for my excesses on irresistible inner forces, as well as a combination of inscrutable external factors, invisibly staged to provoke and upset me."
unknown|3 years ago
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weirdsounds|3 years ago
gaze|3 years ago
s-lambert|3 years ago
jglmn|3 years ago
But going undiagnosed, it did force me to cope in creative ways.
I'd zone out in class and forget about tests. Only to inhale all the info in the dopamine-induced panic of the night before.
Long, wordy explanations bored me to tears. Which gave me deep sensitivity when explaining things to others.
And to keep myself sane during endless school days, I'd bend over backwards to try and "real-time edit" topics to be more interesting.
Finally, in my senior year of high-school, I read a blog post summarizing the classic ADHD memoir "Driven to Distraction". For the first time ever, I asked my parents to take me to a doctor. I was diagnosed basically on the spot.
The change was immediate. I went from serial coaster to rampant bookworm. Within a month, I tracked up in all my classes. I finished out high school with a bang (though it didn't matter much to college admissions).
There's always been a slight pang wondering what might have been had I read that blog post sooner. I certainly had the scholastic chops to excel, and could've landed at a much "better" school (and maybe even a "better" career).
But then I remember the blessing in disguise my alma mater, Queens College actually was. Few students cared to take advantage of the (surprisingly) excellent faculty, so I had their undivided attention. Also, the relatively lax workload gave me the space to split my time between class and internships.
And then I think about the weird, rewarding professional path those internships led me down. Where I inhale large amounts of information quickly. Find the shortest, sweetest way to explain it. And "real-time edit" the subject to make it as interesting as possible.
These aren't super-powers. These were talents I was forced to discover and lean on to cope with those that I lacked.
nu11ptr|3 years ago
intellix|3 years ago
gfody|3 years ago
Aurora Holtzman coined "intensity" for this context, it works pretty well.
https://eggshelltherapy.com/podcast-blog/2020/02/13/aurora-h...
kortex|3 years ago
mensetmanusman|3 years ago
Not sure if this is true.
Evolutionary psychologists have explored the improved tunnel vision that accompanies depression as a means for finding one’s way out of harmful situations.
Society-wide it seems many people are living in harmful situations/ways and are able to medicate their way out of the tunnel vision before recognizing the sources of pain.
javajosh|3 years ago
> Not sure if this is true.
The remarkable film "Melancholia" (Lars von Trier, 2011) was inspired by the director's depression, and one particular upside: that when things get bad, like really bad, the depressive can function better than normal folks because the outside now matches their inside. Kirsten Dunst plays a young woman with utterly crippling depression, I've never seen anything like it in real life or on film, like unable to move or eat. But when the Earth is about to be destroyed, she's sanguine, unlike everyone else.
Not sure if this is true to life, but it makes some sort of sense.
steve_adams_86|3 years ago
It’s the classic “what doesn’t kill you makes you stronger” adage at work. The sad thing is that it does kill many, and for some, never leaves in order to make room for growth.
As for the tunnel vision, that’s an interesting one because it does let you focus in on a problem exceptionally well and that could be useful. The trouble I’ve found in myself is that I haven’t always had the tools or resources to do something with that attention.
You end up intently focused on a problem, and it just becomes a painful echo chamber instead of an opportunity to address something. I suspect this is largely due to a lack of understanding and teaching. Perhaps too, like you mentioned, we expect medication to function as a solution eventually, relieving ourselves of any duty to investigate internal solutions. Had I known how normal depression is though, how it can present, how it can be managed, I suspect my own experiences could have been a lot better. It’s impossible to be certain.
I definitely disagree about the ups and downs in any case. Struggle defines us and helps us grow. Getting better doesn’t have to be a fun or enjoyable experience.
episode0x01|3 years ago
FollowingTheDao|3 years ago
ImaCake|3 years ago
photochemsyn|3 years ago
https://www.hopkinsmedicine.org/health/treatment-tests-and-t...
While I can believe the condition does exist (schizophrenia may be similarly difficult to accurately diagnose, but it surely exists), it really seems to be overdiagnosed in children, and in adults, I imagine amphetamine addiction plays a big role in continued diagnoses. It's rather odd to read articles about it that make no mention of this factor.
https://www.verywellmind.com/amphetamine-high-21916
GavinMcG|3 years ago
> I find it so very irritating that there is no term for my so-called ⸢attention deficit disorder⸣ that does not have the word “disorder” baked into it. I know what a disorder is, and this isn't one.
But the author then argues against a strawman:
> Why does any deviation from the standard have to be a disorder? Why do we medicalize human variation?
It doesn't, and in fact, the diagnostic criteria for ADHD and many other disorders require that the deviation amount to a disorder rather than not interfering with someone's life.
What the author really seems to be criticizing is that he learned and began identifying with the medical term for a disorder ("the ADD really is a part of my identity") and now he'd like a different way to describe his experience.
Fair! But get the cause-and-effect the right way around: we don't need to "stop labeling every difference as a disorder," we need to not adopt diagnostic terms and apply them to ourselves inappropriately. That's a part of what DeBoer is criticizing—that people self-diagnose and then "perform their various personalities."
To be clear, I agree with the author that it would help to have terminology for people who don't feel negatively impacted by their brains being different in a way that we can label, not just for those who do. Maybe the author could get started with that by dropping the "disorder" bit and just identifying himself as someone with an attention deficit.
djur|3 years ago
A good analogy would be height: a person who is several standard deviations from the mean will face challenges in life that require various forms of intervention, but we don't generally think of them as having a _disorder_ unless there's an identifiable biological cause that usually has other effects.
Another good point of comparison is vision. We can accurately measure vision and create medical devices to correct unwanted variation. As someone with myopia, I find it to be only slightly medicalized -- going to get an eye exam doesn't feel much like visiting a doctor, and people don't tend to talk about it as one does a medical condition. I imagine that if we were able to make a similar kind of standardized assessment of whatever neurological basis there is for ADHD, we would consider medication for it more akin to a stepladder or a pair of glasses (or even an antihistamine) than a treatment for a mental illness.
Mandatum|3 years ago
To the same degree disorder may be an acceptable label by a clinician, but we need a different word for regular everyday use - because if I come into work and tell everyone I have a disorder, they're going to make assumptions. And then back into the closet that information goes.
I'd say a lot of people don't share information about their neurodiversity for this very reason. The fact the top comment here argues about the linguistics rather than the content or spirit of the article, tells me we're not ready for that yet. Which is surprising given the readership of this website likely caters to more neuro atypicals than average.
michaelbrave|3 years ago
jeffheard|3 years ago
Most of the time, ADD works in my favor. But sometimes, (and NOT always due to "societal expectations") I need my brain to work differently than it does, and for those occasions the meds do wonders. But I truly hate the after-effects, thus I rarely take them.
drewcoo|3 years ago
> disorders require that the deviation amount to a disorder
That is medicalizing diversity. Creating "disorders" where no one is bothered by them.
This is not uncommon in psychology. In the 1970s, homosexuality was also a "disorder."
aahortwwy|3 years ago
> interfering with someone's life
The specific phrase used in the DSM-V is: "symptoms interfere with or reduce the quality of social, academic, or occupational functioning".
Schooling started to become compulsory in the USA in the mid-to-late 19th century, and really only became universal in the early 20th century.
By the late 20th century we had decided that children whose normal behavior "interfered with or reduced [...] academic [...] functioning" had a disorder.
We created a system that does not accommodate everyone, then turned around and said that those who are not accommodated are definitionally disordered. The logic is clearly backwards.
Similar story with labor.
escapedmoose|3 years ago
d0mine|3 years ago
Or consider a game where different character classes exist e.g., Necromancer (can raise an army with no resource, quickly) and Wizard (requires lots of resources, slow to develop though some units are exceptionally strong). Would it make sense to consider being a Wizard to be a disorder in such a game?
thevagrant|3 years ago
FollowingTheDao|3 years ago
The author frankly does not know what he’s talking about. And, clinically, he does not have ADHD.
I have a mood disorder (NPSLE). I am on permanent disability and I have been hospitalized several times.
Even though I know my disorder comes with a gift, and rather unappreciated gift because I do consider myself neurodivergent, I also know at times I want to die at my own hands. And I also know it makes me unable to work.
I think the threshold for where we think some Neurotype is affecting our life has been lowered dramatically.
orbit7|3 years ago
I find keeping a super simple excel sheet with a monthly list of work and personal tasks works well with next actions for litterally everything except daily habits/ routines. The act of physically moving complete items from one location to another seems to keep me using it (I use Desktop version with autosave enabled) its not so mobile friendly but it works better for me. Every task system I've tried which is a huge number of them I've got bored with or forgotten to use or micro managed to much, I dislike daily task systems for a number of reasons. This improved my productivity and focus literally about 1000%. I find leaving stuff off the lists causes more persistent interruptions to focus, I beleive due to the zeigarnik effect.
I've found diet works best when Low GI as glucose spikes and crashes really screw things up, will power correlates with glucose levels massively. I don't use any supplements but have done tons in the past they aren't really needed. Diet ratio 50% veggies, 25% protein, 25% carb per plate is a good ratio. Tea, Coffee can be a negative so its good to experiment times without it.
Barrin92|3 years ago
I think this is true. We're working and learning in institutions that are incredibly restrictive for people who operate a little bit differently, and it's telling how common ADD is as a colloquialism and not just as a diagnosis.
Foucault used to compare schools to prisons, and joke that the former is the only institution in democratic societies where someone still tells you when you can use the toilet. It's not always so easy to tell with ADD like behavior if the person is pathological or the environment, because you can actually make a pretty decent case for the latter, unlike for some other mental illnesses.
Without playing down the need to help people who do suffer from mental illness, not prematurely pathologizing people and framing them as aberrant is important. In particular with the inflation of ADD diagnoses of young children going hand in hand with a change in culture that seems to have largely robbed children of any opportunity to actually live like kids.
adenozine|3 years ago
If life were different but the ADHD brain wasn't, I think there might be a world where it's not considered a disorder.
I've lived with ADHD-C all my life, and it was something that got me labelled as "lazy" and "unfocused" and even sometimes I was told that I didn't give a shit. People who saw me work 16hr days or work for weeks on end without a day off, these same people called me those things because of how I came across in social situations or in everyday life situations.
I think my tribe of ADHDers sorta see it as part of the formula in how we evaluate our own merit. I'm capable of incredible creativity and ruthless hyperfocus on task when I get spooled up the right way, and so I feel GOOD about myself because I know my true potential. I don't think of myself as some leper weirdo who can't talk right, asks too many questions, turns on a dime. Other people don't really think about that, it's not natural to take that sort of probabilistic view of people, of what they MIGHT be capable of. Stakes are high, and the cost of error correction is high enough usually to motivate a rigid adherence to cautiousness.
I'm not sure how exactly I feel about this article, but I'll say this in conclusion: I've never, ever, ever, even once wanted a different brain than the one I have.
I've wanted to be treated better, and considered more fairly.
acjohnson55|3 years ago
I have also suffered a couple periods of major depression, which I agree is horrible in a far less ambiguous way. I can actually identify some very positive outcomes of those episodes. Ways in which struggling my ass off to try to be okay pushed me to achieve. But I'd absolutely throw out the good with the bad, if I could. I wouldn't wish depression on my worst enemy.
JabavuAdams|3 years ago
It can be simultaneously true that ADHD has no positive consequences for some people, whereas it brings benefits (or is correlated to beneficial traits) in other people.
daniel-cussen|3 years ago
This man, there is nothing wrong with. It is the world around him that's wrong. And apparently it's a clock speed thing, that's an actual scientific conclusion I'm arriving to, and talking with doctors about how to measure with high precision. It's literally, literally, literally the beat of a different drummer, fewer Hertz, and if he did go somewhere with more people like him it would not only be much better, he would both be much more liked and like those around him more (which is reinforcing), people would return him his lost belongings, his defeats would be many fewer, and...I divine his depression would vanish.
Spooky23|3 years ago
Mental and behavioral issues are tough because there are many shades of grey. If whatever you are experiencing is causing you pain and you cannot stop it, than it’s a problem.
I think modern society is tough because we tend to have fewer social connections and institutions. It’s easier to get stuck in bad situations or to be isolated than in the past, and I think that makes latent problems more problematic. The good news is that we have professionals who can help, but that bad news is we also have others (schools, etc) who help themselves.
thread_id|3 years ago
What he is describing is everyone. The last sentence should read "Everyone has these problems just like me."
We are conditioned from a very early age to compare our insides to everyone elses outsides - the personas that they represent - or more accurately that we represent for them. Whether we imagine ourselves better than that persona or inferior in some way - it is all illusion.
Nothing is good or bad but thinking makes it so (where have you heard that before?)
Reading the comments below I feel there is a lot of beating oneself up. I know... I do this all the time. When I recognize that I am doing this I redirect it to accept and love my natural self (very liberating). This is our human nature. We all share in this. We should feel perfectly natural and ok about our nature.
The difficulty is in adapting to the structure of society. We are challenged to find ways to adapt and manage our nature in order to find some measure of accomplishment in that structure. Some adapt readily. Others have to work at it. We all face the same challenge and we all acheive different measures of success. Just make sure that it is your measure of success that you are striving to achieve.
The labels and their definitions are all a product of a feckless mental health industry that needs to create something to justify their existence. The definitions describe observable human nature and the labels categorize them. The negative connotation is a judgement - this is what causes so much stress.
This body of work is dynamic and changing. The American Psychaitric Association Diagnostic Criteria at one time included homosexuality as a mental disease. Can't suffer from Aspergers because technically it is no longer a diagnosis. So consider these examples to help keep it all in perspective.
pornel|3 years ago
Your "don't beat yourself up" is just as unhelpful as telling depressed people to "cheer up".
ADHD is a neurological disorder physically affecting the brain. It causes executive dysfunction that people can't think themselves out of.
unknown|3 years ago
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asimovfan|3 years ago
closedloop129|3 years ago
How come that we try to create AI with NNs and billions of funding, but we don't pay the same amount of attention towards understanding the foundations of our own thinking?
EdwardDiego|3 years ago
I'm pretty open that I think ADHD is a disability, and anyone calling it a "superpower" is smoking crack.
luckydata|3 years ago
I have ADHD, there's nothing cute or great about it, it really sucks to have this disability, I have lost countless opportunities and had to work 10x as hard to achieve the same as everyone else because of it.
I'm not less valuable as a person because of it of course, but I would gladly return my "gift" if that was possible.
If you're interested to know what science says about ADHD, start here: https://pubmed.ncbi.nlm.nih.gov/33549739/
99_00|3 years ago
Having a high IQ, being economically privileged, very good looking,is going to change the impact ADHD has on someone.
Also, its widely agreed that ADHD is over diagnosed.
Keep those points in mind when reading accounts like these.
throwaway6532|3 years ago
In my case it meant staying out of jail, managing to graduate college and getting a career I could thrive in. Still... serious downsides along the way and always a struggle to hold it all together.
lghh|3 years ago
posted without source
freemint|3 years ago
If so how?
orangepurple|3 years ago
Years ago in college I was prescribed Adderall but it didn't make me focus more. It made me compulsively clean my apartment, masturbate, tweak out, and occasionally be extremely paranoid of being attacked while on public transit. I was ready to rip someone's head off. I discourage using this medication.
If you haven't reduced carb intake to a bare minimum I suggest maintaining it first for a month before looking for more help.
lghh|3 years ago
Otherwise, I'm the same me. Just functioning and less pissed off or annoyed all the time.
codyogden|3 years ago
elchief|3 years ago
ck2|3 years ago
The "test" is an honest answer to the question "if they made a pill to make it go away, would you take it?"
chrischen|3 years ago
throwaway6532|3 years ago
This is how I feel way too often.
Pulcinella|3 years ago
Also “preserving genetic traits that are potentially useful in the future” is way to close to eugenics for my comfort.
adhd1110101|3 years ago
How typical.
> When my first-year hallmates were “studying” they were looking out the window, playing with their pencils, talking to their roommates, all sorts of stuff that wasn't studying. When I needed to study I would hide somewhere and study. I think the ability to focus on just one thing for a few hours at a time is a great gift that ADD has given me.
That's the opposite of executive disfunction. (To be fair, the author does describe other hallmarks of executive disfunction elsewhere.)
Bolkan|3 years ago
Fucking lol
jasfi|3 years ago
codyogden|3 years ago
There's a perspective in some ADHD circles (and likely other mental health circles) that the concept of neurodiversity/neurodivergent are not the correct framing for living with ADHD. It follows this idea that when people highlight (or unmask) the parts of ADHD that make them quirky or entertaining to society, they are not revealing the _very negative_ symptoms of ADHD that are extremely debilitating. The proliferation of sound bite videos that portray ADHD in a very positive light on TikTok, ADHD memes, etc. gloss over the dark realities of ADHD. My personal belief is that while it's good to help people understand some of the more lighthearted ADHD symptoms, it's important that we share even the negative aspects. Of course, negative things don't get engagement (as the author states when he gets to mentioning a battle with depression).
TikTok isn't covering things like ADHDers' propensity to lose their jobs due to poor performance, the financial ruin from overspending and money mismanagement, poor physical health and wellbeing, likelihood to have comorbid depression and anxiety, missing out academic/professional opportunities, fewer if any meaningful relationships because of social disorder symptoms attributed to ADHD. You rarely, if ever, see social media ADHDers talk about how ADHD affects something like dental health because of the "out of sight, out of mind" effects and the inability to form healthy hygiene habits because there are no immediate consequences (the "now or not now" mental modes). How getting a restful night's sleep is a rare delight because of ADHD's ability to delay sleep. You'll never hear them talk about how ADHD people have a significantly shorter life expectancy than the general population--some studies calculating it by as much as 20 years.
These are all very negative, debilitating pieces of ADHD that get glossed over by modern social media movements of the quirky/neurodivergent ADHD crowd. Even this author doesn't really dive into the dirty pieces.
This is a long one, but all of that said: I have ADHD. I was diagnosed at 8 years old. Finally, got on stimulants for the first time as an adult and my life's trajectory turned around in a just few months. I still struggle with all the negative things that come with ADHD. But I believe that ADHD is both a blessing and a curse; that I can personally celebrate the parts that make me quirky and bring me joy and also be aware of the negative effects it has on me and on my ability to function in modern society. I do see it as a disability, but not as a hindrance. The more I learn to accommodate it for myself the better off I'm going to be long-term.
Guthur|3 years ago
lghh|3 years ago
aaron695|3 years ago
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3qz|3 years ago
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klyrs|3 years ago