One of the best things we can do for people with ADHD is to adjust our expectations of people in general (adults and children).
ADHD wasn't identified as a disorder until recently because it wasn't a disorder until recently. For most of human history, the traits associated with ADHD would have been at worst a wash and in many cases advantageous to have in small numbers within a community. The adults that I know with ADHD are disproportionately likely to be the movers and shakers in their worlds—they work well under pressure and make things happen. You don't want everyone to be that way, but having a portion of the population that can't sit still has huge advantages.
That only changed when we moved into the 20th century and started expecting 100% of the population to be okay with sitting quietly in a chair for 6 hours a day for 12 years of their lives and then, if they had any kind of ambition, to do more sitting in chairs working a white collar job until retirement.
The people with ADHD aren't a problem, the unnatural world we've created is the problem, and we risk losing an important part of the larger organism that is civilization if we force these people to conform.
As someone with family members with ADHD and as a manager who has had employees with ADHD, the challenge is differentiate and find those cases where it can be "advantageous". Is not easy at all. Also, there are different types and levels of ADHD. It's not a super power to forget things you wanted to remember and being late all the time, there's no benefit on that for anyone. Sometimes the extra creativity or hyper-focus on things that are not a goal for an organization is not an advantage. It's very complicated. I wish I had a solution.
> The people with ADHD aren't a problem, the unnatural world we've created is the problem, and we risk losing an important part of the larger organism that is civilization if we force these people to conform.
This is pretty much what the social model of disability pushes: if society changed with a thought for all some of us wouldn't be as disabled - in my specific case reducing bright lighting, reducing noise pollution, and reducing specific smells would help me a stupendous amount.
I had undiagnosed ADHD for 35 years and I suffered a lot. When my future girlfriend came to visit my place for the first time, I feard that we would not have electricity because I did not pay the bills. Not a money issue, but between all the daunting daily tasks I just was not able to accomplish that task for MONTHs.
I was working on my PhD in CS and didn't get anything done at all. I was in constant fear of getting a task related to Excel, because all these little cells have always made me nervous and furious. I would invest 2-3 hours working around a repetitive task of maybe 20 minutes, because doing it was unbearable. I had always been socially anxious, because for being socially active you need that type of attention that is just hard to maintain. I love being in nature, but going for a walk through the woods? Not possible, because it's "not exciting" enough.
Then a friend gave me some of his pills. I took them for a few days and for the first day of my life I understood how everybody else was feeling, how everybody else could be so confident, behaving confident, just being and feeling normal. I knew that feeling from rare occasions, the absence of all that struggle you are constantly feeling in your body. I had my first normal workday ever. Just going to work, doing work, having a break, later going home. I had never experienced that ever before. And still I didn't believe I had ADHD, never slipped my mind, lol. But then COVID hit and we went into lockdown and homeoffice and I could not work at all and I suffered immensly. I knew that feeling of "I want to do it SO hard, but I just CAN'T" very well, but this time it hit me very hard, for weeks. She convinced me to get diagnosed and here I am, it feels like a distant past already. It was like an instant switch, even though it's a journey to retrain my brain after for decades it had to come up with mechanics to deal with the disorder.
I know there many out there that are/were like me and I know there are many out there that had a quite different experience with their ADHD. Please don't walk around saying society is the problem. Society is not the problem when it comes to depression and it's not the problem when it comes to ADHD. A lot of people would benefit from a different society for sure, but for me and many others it's nothing more than a disorder. It was a miracle I could start a PhD to begin with (and of course getting my Master's was a constant struggle, just as my whole life had been miserable and a struggle). Many others end up drug addicted, dropping out ot school, having a clinical depression, and other nasty stuff. As all mental disorders, we do not know too much about it, but as a matter of fact the medication helps greatly and I am so glad I got finally diagnosed. Some that have ADHD do not suffer that much as I did, but a lot of do. I only wish that my disorder does not get misrepresented as "wouldn't be a big deal in a more open society".
I swear, every ADHD post on hacker news, someone comes in here with this uninformed nonsense.
For those of you afflicted with this curse, lookup Dr Russell Barkley’s videos on YouTube. He’s retired now, but was a great ADHD researcher. Really helped me understand what was going on.
As a Brit with a childhood diagnosis of ADHD and a second confirming diagnosis in adulthood, it amuses me to look at the country where recreational and medical use of cannabis is legal and widely accepted, but there's a lot of pearl-clutching about what a credentialed psychiatrist is saying someone needs and a patient also feels they need.
The way ADHD medication is treated is wild to me. Doctors expect that people will be taking these medications for the rest of their life, and yet society treats these people almost like they're criminals. You can't get too much supply of the medicine. You can't easily travel with it. A pharmacy might just refuse to sell it to you. A future doctor might just decide that ADHD isn't real. And apparently the medicine can also just... run out.
Maybe the medication is just scrutinized too much?
as an adult with ADHD (and a child who was diagnosed at 11) i dont understand the fascination by laypeople with confidential mental health treatment.
if kids can have ADHD surely adults can too. i feel that these types of critical pieces often embolden critics of mental health and i dont quite understand why these people feel so aggrieved by allowing people to participate fully in the modern world
The real item here is that ADHD threatens a nonADHDer's sense of identity and brings into question the existence of free will, effort, self discipline and self determination.
ADHD is a real condition. People who have it suffer immensely from it. They don't have a sense of time. They don't have a sense of priority. They procrastinate tremendously. They are extremely forgetful and tend to get stuck in an unproductive rut. The moment they swallow a pill.. i.e Adderall, they stop being late. They turn in their assignments completely finished. They can remember better. They won't lose their jobs. They stop procrastinating that much. Basically, they get to be a functional human being.
But, someone who doesn't have ADHD only has their own frame of reference to judge ADHD. People without ADHD also have a tendency to procrastinate. They also tend to be late if they are don't care about being on time. They don't feel the motivation to show up for work etc. And yet, despite not having the motivation they FORCE themselves to show up for work. Despite having a tendency to procrastinate they FORCE themselves to not procrastinate because they know the payoff. They won't be late because they CARE and they know it is DISRESPECTFUL to make the other person wait. Why can't you use a reminder on your iPhone, Google Calendar etc? is their retort. If you are forgetful why don't you write stuff down?
Discipline is a muscle. The more you force yourself to use it the easier it gets the next time. ADHD isn't special. Even I feel like not doing things BUT I FORCE MYSELF TO DO IT.
Why can't you? Instead, you are choosing to take the easier route by swallowing a pill. This is the equivalent of someone choosing to take steroids to build muscle instead of putting in the hard work at the gym.
This is how a nonADHD person thinks. They are proud of working hard and they are proud of their accomplishments. Of doing hard things. Overcoming obstacles etc. But, when they see someone with ADHD struggle they just chalk it down to them being lazy. They don't understand that the ADHD brain is wired differently.
Again, this is not their fault. Human beings cannot relate to anything that is outside of their direct experience.
Your personal ADHD diagnosis is confidential information. Population-level increases in ADHD diagnosis and stimulant prescriptions is not confidential information. It is useful public health information.
I don't think it's fully settled what percent of this increase is due to more ADHD in the population versus a change in standards (the second is not inherently bad).
Was there something in the article that struck you as critical of mental health or aggrieved in some way? It seemed like a pretty reasonable take to me.
> “If I give stimulants to the average person, they’ll say their mood, their thinking, and their energy are better,” Goodman said.
Why shouldn't healthy people have access to long-acting stimulants under the supervision of their doctor? Why limit healthcare to interventions that restore health to a minimal baseline? If as Dr. Goodman says, a pill can make the average adult happier, sharper, and more productive, why shouldn't everyone have access to it?
Those pills have different effects on people with adhd and people without it. A pretty bad explanation trying to keep it simple: The adhd brain basically destroys neurotransmitters in the brain before they can be absorbed by the body. The stimulant will cause a lot more neurotransmitters to be created so that more of them can be absorbed by the body (both the natural NTs and the ones caused by the stimulant). For someone without adhd there wasn't anything stopping the natural NTs before so all the stimulant will do is flood the body with one kind of stuff.
Felt rather unfortunately information light to me — lots of evidence that standards for adult ADHD are lacking, but not a lot of investigation into what those standards should look like.
Agreed. I'm definitely the "target" of this article, as I've just recently been diagnosed in my late 30s with adult ADHD. I feel like I've shown the signs during my childhood - poor grades due to poor attention span, constant fidgeting, and emotional irregularity due to hyperactivity and my impatience of others. Only recently have I thought to actually see anyone about it, as I've started seeing similar signs in my daughter.
Reading through the article, it definitely highlighted concerns I had about my process: lack of available providers (to the point that many wouldn't even accept a call from a new patient), essentially forced to use online services, relatively short discussions before treatment, and ultimately being prescribed stimulants.
Overall, I'm glad I started this process. I definitely feel better on the medication, to the point where I'm able to effectively track my daily tasking, keep cohesive notes, drastically reduce my unintended verbal interruptions of others, and churn work out without context switching so often. I obviously can work without the medication, but it's absolutely a night and day difference to me. Ultimately, I just hope that the progression of the adult ADHD diagnosis and discovery continues to mature, and online services aren't completely cut off from the space.
Perhaps we should not look to The Atlantic to make medical treatment and standards recommendations. The article is a good summary of the situation, makes a good case for complicating factors (comorbidities in adult adhd, rogue prescribers in telehealth), and is largely fact focused.
That said, the answer to "what is the solution" is that it takes time to figure out what the best treatment plans are and feedback success and failure into diagnostics. It is a process of never-ending improvement. For example depression was known to Hippocrates and despite that multiple thousands of years of history we still don't have a 100% success rate diagnostics and treatment for it. Adult ADHD is only about 10 years old. Odds are by the time it grows up the current symptoms will lessen. But in the meantime, people seeking treatment for it should be aware that they are part of an ongoing experiment, i.e. they are in the Wild West.
It also skirted over the medication shortage. This is a big deal: some medications have been unavailable for months, all are in short supply, pharmacists are pissed, and patients are suffering. Despite this I’ve yet to find an in-depth explanation of how we got here.
[+] [-] lolinder|2 years ago|reply
ADHD wasn't identified as a disorder until recently because it wasn't a disorder until recently. For most of human history, the traits associated with ADHD would have been at worst a wash and in many cases advantageous to have in small numbers within a community. The adults that I know with ADHD are disproportionately likely to be the movers and shakers in their worlds—they work well under pressure and make things happen. You don't want everyone to be that way, but having a portion of the population that can't sit still has huge advantages.
That only changed when we moved into the 20th century and started expecting 100% of the population to be okay with sitting quietly in a chair for 6 hours a day for 12 years of their lives and then, if they had any kind of ambition, to do more sitting in chairs working a white collar job until retirement.
The people with ADHD aren't a problem, the unnatural world we've created is the problem, and we risk losing an important part of the larger organism that is civilization if we force these people to conform.
[+] [-] mhss|2 years ago|reply
[+] [-] ddmf|2 years ago|reply
This is pretty much what the social model of disability pushes: if society changed with a thought for all some of us wouldn't be as disabled - in my specific case reducing bright lighting, reducing noise pollution, and reducing specific smells would help me a stupendous amount.
[+] [-] unknown|2 years ago|reply
[deleted]
[+] [-] TheBen1|2 years ago|reply
Then a friend gave me some of his pills. I took them for a few days and for the first day of my life I understood how everybody else was feeling, how everybody else could be so confident, behaving confident, just being and feeling normal. I knew that feeling from rare occasions, the absence of all that struggle you are constantly feeling in your body. I had my first normal workday ever. Just going to work, doing work, having a break, later going home. I had never experienced that ever before. And still I didn't believe I had ADHD, never slipped my mind, lol. But then COVID hit and we went into lockdown and homeoffice and I could not work at all and I suffered immensly. I knew that feeling of "I want to do it SO hard, but I just CAN'T" very well, but this time it hit me very hard, for weeks. She convinced me to get diagnosed and here I am, it feels like a distant past already. It was like an instant switch, even though it's a journey to retrain my brain after for decades it had to come up with mechanics to deal with the disorder.
I know there many out there that are/were like me and I know there are many out there that had a quite different experience with their ADHD. Please don't walk around saying society is the problem. Society is not the problem when it comes to depression and it's not the problem when it comes to ADHD. A lot of people would benefit from a different society for sure, but for me and many others it's nothing more than a disorder. It was a miracle I could start a PhD to begin with (and of course getting my Master's was a constant struggle, just as my whole life had been miserable and a struggle). Many others end up drug addicted, dropping out ot school, having a clinical depression, and other nasty stuff. As all mental disorders, we do not know too much about it, but as a matter of fact the medication helps greatly and I am so glad I got finally diagnosed. Some that have ADHD do not suffer that much as I did, but a lot of do. I only wish that my disorder does not get misrepresented as "wouldn't be a big deal in a more open society".
[+] [-] atlas_hugged|2 years ago|reply
For those of you afflicted with this curse, lookup Dr Russell Barkley’s videos on YouTube. He’s retired now, but was a great ADHD researcher. Really helped me understand what was going on.
[+] [-] halayli|2 years ago|reply
[+] [-] hammyhavoc|2 years ago|reply
[+] [-] Aerroon|2 years ago|reply
Maybe the medication is just scrutinized too much?
[+] [-] unknown|2 years ago|reply
[deleted]
[+] [-] kanbara|2 years ago|reply
if kids can have ADHD surely adults can too. i feel that these types of critical pieces often embolden critics of mental health and i dont quite understand why these people feel so aggrieved by allowing people to participate fully in the modern world
[+] [-] romeros|2 years ago|reply
ADHD is a real condition. People who have it suffer immensely from it. They don't have a sense of time. They don't have a sense of priority. They procrastinate tremendously. They are extremely forgetful and tend to get stuck in an unproductive rut. The moment they swallow a pill.. i.e Adderall, they stop being late. They turn in their assignments completely finished. They can remember better. They won't lose their jobs. They stop procrastinating that much. Basically, they get to be a functional human being.
But, someone who doesn't have ADHD only has their own frame of reference to judge ADHD. People without ADHD also have a tendency to procrastinate. They also tend to be late if they are don't care about being on time. They don't feel the motivation to show up for work etc. And yet, despite not having the motivation they FORCE themselves to show up for work. Despite having a tendency to procrastinate they FORCE themselves to not procrastinate because they know the payoff. They won't be late because they CARE and they know it is DISRESPECTFUL to make the other person wait. Why can't you use a reminder on your iPhone, Google Calendar etc? is their retort. If you are forgetful why don't you write stuff down?
Discipline is a muscle. The more you force yourself to use it the easier it gets the next time. ADHD isn't special. Even I feel like not doing things BUT I FORCE MYSELF TO DO IT.
Why can't you? Instead, you are choosing to take the easier route by swallowing a pill. This is the equivalent of someone choosing to take steroids to build muscle instead of putting in the hard work at the gym.
This is how a nonADHD person thinks. They are proud of working hard and they are proud of their accomplishments. Of doing hard things. Overcoming obstacles etc. But, when they see someone with ADHD struggle they just chalk it down to them being lazy. They don't understand that the ADHD brain is wired differently.
Again, this is not their fault. Human beings cannot relate to anything that is outside of their direct experience.
[+] [-] fasthands9|2 years ago|reply
I don't think it's fully settled what percent of this increase is due to more ADHD in the population versus a change in standards (the second is not inherently bad).
[+] [-] lolinder|2 years ago|reply
[+] [-] istjohn|2 years ago|reply
Why shouldn't healthy people have access to long-acting stimulants under the supervision of their doctor? Why limit healthcare to interventions that restore health to a minimal baseline? If as Dr. Goodman says, a pill can make the average adult happier, sharper, and more productive, why shouldn't everyone have access to it?
[+] [-] hudell|2 years ago|reply
[+] [-] tcmb|2 years ago|reply
You can replace 'stimulants' with 'alcohol' in the quote above and it will still be true.
[+] [-] jolux|2 years ago|reply
[+] [-] slipperlobster|2 years ago|reply
Reading through the article, it definitely highlighted concerns I had about my process: lack of available providers (to the point that many wouldn't even accept a call from a new patient), essentially forced to use online services, relatively short discussions before treatment, and ultimately being prescribed stimulants.
Overall, I'm glad I started this process. I definitely feel better on the medication, to the point where I'm able to effectively track my daily tasking, keep cohesive notes, drastically reduce my unintended verbal interruptions of others, and churn work out without context switching so often. I obviously can work without the medication, but it's absolutely a night and day difference to me. Ultimately, I just hope that the progression of the adult ADHD diagnosis and discovery continues to mature, and online services aren't completely cut off from the space.
[+] [-] ororroro|2 years ago|reply
That said, the answer to "what is the solution" is that it takes time to figure out what the best treatment plans are and feedback success and failure into diagnostics. It is a process of never-ending improvement. For example depression was known to Hippocrates and despite that multiple thousands of years of history we still don't have a 100% success rate diagnostics and treatment for it. Adult ADHD is only about 10 years old. Odds are by the time it grows up the current symptoms will lessen. But in the meantime, people seeking treatment for it should be aware that they are part of an ongoing experiment, i.e. they are in the Wild West.
[+] [-] Keegs|2 years ago|reply
[+] [-] lolinder|2 years ago|reply
[+] [-] duckhelmet|2 years ago|reply
[deleted]
[+] [-] piloto_ciego|2 years ago|reply
[deleted]