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To add a counterpoint to all the apologetics, ADHD as a cause rather than as a symptom is a point of view dominant in the US and not shared by most of the rest of the world. If you're inclined to take drugs to try to fix it then so be it, but you might want to try behaviour change first.

[FWIW this reply and "advice" is not directed at the parent, kobeya, but is a general point of information.]

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> "Not shared by the rest of the world"

And that is their loss. ADHD is very much a cause whose impact goes far beyond just procrastrination. It causes people to be terrible spouses who are never there when they are needed. It causes lost friendships through blinkered social conduct. It causes persistent self hatred and anxiety and depression.

"you might want to try behaviour change first"

This is such a, forgive the harshness, ignorant way of thinking about ADHD that it makes my blood boil. Behaviour change works when the person in question has the capabilities of making that change stick. This is the equivalent of telling a handicapped person to try b-mod to climb the stairs.

It. Just. Won't. Work. A shortage of persistence cannot be solved through more vigorous exhortations towards greater persistence. Here's how I think of the drugs. The drugs lay the platform so that I can implement the behaviour change. They don't let me study better. They let me start studying in the first place, at which point, all the best practices and behaviour modifications can come into play.

Thank you. It's such a toxic sentiment which seems to only originate from people with limited exposure to the condition. It makes my blood boil as well to hear/read things like "you might want to try behaviour change first". I want to be like, "what do you think I've been trying to do since the age of 8?"

Meds have been absolutely indispensable for at least starting to implement good habits, extended focus, etc. And it's still a huge struggle.

As disinclined as I am to enter a discussion about this I'd like to suggest interpreting my hasty terminology "behaviour change" as encompassing a wide variety of behaviours, and not just of the affected individual. "Environment" might have been a better word. For example, under "behaviour" or "environment" as opposed to "medication", I include the poor conditions in public schools, the poor quality of food, the addicting quality of television, internet and computer games and the poor quality of many interpersonal relationships.

Thank you for saying the things I wanted to say. Environment is certainly the better word. Really, how much can an 8-year-old change? Not much.

*edit - of course, there is a level of individual responsibility as well.

Eight year olds can't change the environment much. But if we are making a lot of eight year olds struggle when we put them in an artificial environment, I hope we're considering whether we've make mistakes designing that environment.

agreed. I assume you are talking about the school environment?

I would add home environment (parents and siblings especially), culture, entertainment, friends, religion, sleeping habits, socioeconomic status... etc.

As someone diagnosed with ADHD in their mid 30's, I've had plenty of environment changes over the years (including with a Psychiatrist who understood my then-reluctant view on meds); honestly none helped me nearly as much as meds.

> ADHD is very much a cause whose impact goes far beyond just procrastrination. It causes people to

Just because ADHD causes other problems doesn't mean that ADHD itself comes out of nowhere. The previous post has a valid point that ADHD itself is a symptom of something else and that drugs aren't necessarily the best way to reduce/eliminate ADHD at the source.

The currently understood source of ADHD is a mis-wiring of the brain. Currently we don't know of a better way than meds to alleviate such a condition. CBT helps to a degree, CBT + meds works much better for more severe cases.

> The currently understood source of ADHD is a mis-wiring of the brain.

Is that actually understood, though? We had the heavily promoted social consensus for a long while that depression is caused by a chemical imbalance, which is now seen as a somewhat disproven theory that never had much evidence.

Very little about the brain is really well understood. That said, this is about the best we have so far.

From a video I linked elsewhere in this discussion:

Gallo, E. F., & Posner, J. (2016). Moving towards causality in attention-deficit hyperactivity disorder: overview of neural and genetic mechanisms. Lancet Psychiatry, 3(1), 555-567. Konrad, K., & Eickhoff, S. B. (2010).

Is the ADHD brain wired differenctly? A review on structural and functional connectivity in attention deficit hyperactivity disorder. Human Brain Mapping, 31(1), 904-916.

https://www.youtube.com/watch?v=V5tLi1bYilA

How is it ignorant to suggest behavior change as a first option? If the person can't make it stick then sure try the drugs, but if they don't need the drugs they're likely better off without them. Add in the fact that ADHD is commonly over-diagnosed and yeah, I'd try behavior modification first. People can display the "signs" of ADHD for a whole host of non-ADHD reasons.

You are right of course. The frustration comes because people with adult ADHD have likely had a lifetime of this suggestion, and a lifetime of failing to stick to such modifications, often to the point of developing comorbid issues like low self esteem. When medications finally open the door they have fruitlessly banging their head against, it's frustrating to hear people espousing that, actually, behavior modification is all you really need, even if it is not intended as such (though often it is).

This is very accurate. Thanks.

Learned inattention is different from ADHD. The whole world has learned innattentive behavior at this point. This can be solved without medication fairly simply. ADHD or as Dr Russell Barkley calls it, Executive Function Disorder, is neurological in origin. By all means try behavior changes first, like you said, but if that works, it was never ADHD to begin with. Finding a youtube video of Dr Russell Barkley was a godsend for me.

> but if that works, it was never ADHD to begin with

You're putting yourself in an irrefutable position then.

No, it's just saying that under scrutiny, it's not all that hard to differentiate "learned inattention " and bad habits from genuine ADHD.

Yes, because the argument is that the US over-diagnoses ADHD. As in kids being kids and not being laser-focused are suddenly diagnosed with ADHD. In this case, someone procrastinating because they have something difficult to do would be ADHD. It may not be the case.

What is most of the rest of the world? Most countries in Europe recognize it. International medical associations also recognize it. Are there countries where a psychiatrist would never diagnose ADHD?

I think this is about adult ADHD.

Some quick video material about the belief that ADHD doesn't exist, and is not a treatable condition: https://www.youtube.com/watch?v=V5tLi1bYilA - informative and entertaining.

But don't just take their word for it, have a look at the reference material in the video description.

Another interesting, and emotional, view of the effect of not being on meds from the same artist: https://www.youtube.com/watch?v=rD9qK8-sMGQ

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