In Praise of ADHD
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Imagine a scheduler that has many tasks to schedule, and more incoming work than it can schedule in a timely fashion. The scheduler is designed to consider all tasks, but will give a higher priority to tasks that provide immediate feedback.
A consequence of this design is that tasks which require a lot of time to complete, but provide little to no feedback until after the task is completed, are typically starved for resources. Often, they will never complete, or even start running.
Well, that's basically how my brain worked before I started exerting control over it. I would flip from thought to thought, lingering on things that provided immediate feedback, like playing musical instruments or video games.
Planning is a difficult task when your brain works that way. I had to consciously focus attention away from things that I was seemingly wired to fixate on. Even determined concentration was hampered by constant context switching, which I felt I had little control over.
ADD is a chronic condition, and I still have to deal with this on a daily basis. But it has gotten easier. Luckily, I've been able to develop enough coping techniques to at least take care of myself.
Most people who know me assume that I am very high functioning. As a software developer, I am pretty successful, and people equate that with intense concentration and process-oriented thinking. My own, inner world is far more chaotic than others could imagine!
It truly fascinates me how much phones in particular have changed our day to day behavior. I don't know if this is true, but I recall reading that many people check their phone, on average, every five minutes. While I hesitate to call that unhealthy, it's bound to have some kind of noticeable effect.
* Have a calendar at hand everywhere -- on your computer, on your phone, everywhere. Enter stuff into it immediately. Live and die by the calendar, because you will never remember things on your own.
* Know what you're aiming to do on a day. Maybe you can cope with a to-do list, but speaking for myself they feel oppressive, like I am judging myself for all the things I've failed to do. But you can keep one thing in mind.
* Email yourself! I bat tasks back and forth between my home and work emails, based on where I can act on them.
* Exercise. It helps with a lot of things and research suggests it helps with ADHD as well.
* It's the morning. You've made coffee. You should be preparing to do some exercise. Don't open the laptop or phone. I know you're going to "just check". Don't. Don't start, you won't stop.
* When you learn about something that distracts you easily, either give up the addiction or accept the cost. I've pissed away thousands of hours of my life on websites like this one. I have mixed feelings about what I gained and lost. Right now I am noticing that Slack is becoming a problem for me.
* Read books. Physical books lack the ability to open tabs or follow links.
* Have times of day when you ignore things. At work I generally ignore messages on my phone. At home I ignore emails from work. In particular, there is no way for my work to reach me on my phone. No email, no slack, nothing.
* Work in pairs! This has been phenomenal for me.
* Do you take shorter-acting medication, like I do? Set an alarm for the doses you need later in the day. Left to my own devices I can easily sail past 2pm and then at 4pm wonder why the hellSQUIRREL I can't conCLANGcentrate on my wWIKIPEDIAork.
* You will struggle with impulse buys. Rehearse in your mind what it will be like when you get the thing. Think about the regret of having given into the impulse. Even a few seconds of delay can break it.
There are probably other coping mechanisms I don't realise are coping mechanisms.
These are not enough by themselves. Not even close. Almost every one of these is only possible because I am taking ritalin, and every one of them is necessary because ritalin can't do everything by itself.
* Routine! Having a reliable routine means I am never lost for what I should be doing or where I should be. I don't organise because I am prone to perfectly planning everything -- I organise because I'm dysfunctional without it. For example: every Friday is laundry day. Anything that misses the Friday slot has to wait for next Friday.
* Don't stock your favourite foods. Everyone lives with temptations, but ADHD makes it that much harder to resist. I have a number of foods which I love and which I simply do not have in my home. No chocolate, no peanut butter, no bread, no pasta. I have these occasionally and as a treat. But if they are around they will get eaten. So I just don't keep them.
* Don't know your passwords. Use a program like keepass. If you know the passwords for sites and apps, you will log into them from more places.
* Go to an office to work, whatever "office" means to you. Make the hours regular. Try to create a distinct physical separation. The difference makes it easier to enforce rules about what you can do when.
* You see a topic on reddit, hackernews etc that you deeply care about. Don't open it. Don't read the comments. You'll struggle to stay out and -- as you can see from my comments elsewhere under this post -- struggle to control your emotions. Just stay away. That's what I should've done with this one.
* Don't take breaks if you're making forward progress. People say to take breaks, but in my experience it pretty much ensures you will derail the rest of your time. Right now, for example, I'm in about the 4th hour of a 5 minute break.
* Do your best on sleep hygiene. Being tired weakens your ability to resist impulse still further. You will say and do more things you'll wish you hadn't.
* Get a filing cabinet. Add folders. Get stuff off your desk as fast as you can. Empty your email inbox as completely as you can.
* Subject to your finances, pay your bills ASAP. You will forget them. Or worse: forget them, remember them, feel stressed about forgetting them, then forget them, over and over until they're paid.
Between ADHD, anxiety and depression, just being alive is exhausting. But I have gotten better at playing through the basic levels over time.
Combined with how well anti-spam has been working for e-mail I am amazed at how useful e-mail has become again. There was a time when I would have received 30-50 "extra" e-mails a week that I would have to spend micro-calories ignoring until I decided to clean the inbox. If you can keep them out of the inbox to begin with, do it.
If I buy a block of chocolate or a jar of peanut butter, I won't be eating them regularly. I'll be eating them that day. I will feel shitty afterwards, I will berate my lack of willpower, blah blah blah, none of which changes that it did happen.
The easiest way to win is not to play.
- I try to get myself to do recurring things at a specific time. It's too hard to wake up at say 7:00 a.m. The reason it's hard it because I forget to set an alarm clark. Instead I'd cope by just making sure I get a job where I don't have to be there before a certain time, and that time is after I'd naturally wake up.
- When I need to do something I on a recurring basis, I try to make the task visible. Like living a toothbrush lying by the sink, putting vitamins in a 7-day pill thing for the week, etc.
- I have have 11 bank accounts, each with a single purpose, and I have automatic transfers set up between all of them (it's not perfect, but it's pretty good). I prevent overdrawing a checking account by using a pre-paid debit card that won't let me take the balance below zero. When I have to buy something that requires a tip, where the tip will be subtracted from the bill later, I pay with a credit card and then immediately send a payment from the debit card to the credit card. I pay all my bills on the day I get paid, so I don't have to remember to do it later.
- I embrace trying new things, because if I'm wired to be attracted to shiny objects, I might as well find a way to enjoy them!
- lately I've been exercising a lot, and that seems to help
- medication, which may or may not help, but it doesn't seem to be hurting
- I plan as few things as possible, so I have less to remember
- I archive or delete my email as fast as I can
That's only true if waking up at 7am is the exception rather than the rule. I've found that morning is by FAR my most productive hours, so I need to wake up early.
I bought a cheap, battery powered alarm clock[1]. Opened it up and cut the part of plastic pieces of the snooze buttons (on top) so they can't push the actual button underneath. Set alarm for 7am while it's open (the minute and hour buttons double as snooze, so we need to disable them, too).
This provides the three essentials of a functional alarm clock:
1. It's hard to change the time.
It's hard to enforce an early bedtime if you know you can always push back your alarm a bit. And it's hard to resist doing that when you know how tired you'll be in the morning.
Enforcing a wake-up time puts the right incentives in place. When I don't get enough sleep, my thought becomes "Why did I stay up so late, again?" instead of "Why didn't I let myself sleep in?". Making it a pain to change the time of the alarm provides enough time delay to ask yourself whether this is really what you want to be doing.
2. It can't be snoozed
Snoozing is terrible. It makes your body temperature drop back to sleeping levels, which makes it even harder to get out of bed next time. It also lets you waste away the morning with the assurance that you won't fall asleep and miss the time sensitive thing in a few hours. No snooze forces you to start your day immediately.
3. It's not on your phone[2]
Charge your phone away from your bed to avoid mindless browsing when you wake up. Better to start your day thinking about what you will actually do. A proactive start sets you up for fewer reactive distractions.
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[1] It's a generic model that can be purchased through many brands. I did a quick Amazon search to find the model; this was the first result I found: https://www.amazon.com/gp/aw/d/B015MDVZI0/
[2] If you insist on a phone alarm, Talalarmo for android is the next best thing: https://f-droid.org/app/trikita.talalarmo
All good points. In my case, I left out the part about how I don't want a regular bedtime. When I have tried to sell myself on the idea of a bed time, I found it too hard to commit to the idea. Instead I usually just go to bed when I start feeling sleepy, which in typically in the 9p to 12a range.
- Having some constant amount of structure in my life. Always having some activity schedule for 945 am and attending it without exception has forced discipline on my day as early as possible. In college, I chose one class to attend per quarter and always showed up. If I can fixate on one thing to center a schedule around, I find keeping plans much easier.
- Exercising for 30 minutes or more everyday, as early in the day as possible. This is key to calming me down and also gives me measurable goals that I can pursue and achieve
- Medication. As much as I hate admitting to myself that I need to be medicated, I think staying on my prescription has served me well
- Automating as many important things as possible. Credit card payments are the biggest thing here for me, I don't trust myself to remember recurring events on a horizon longer than a week so being able to automate utility bill pay (could backfire, but better than slipping up) and credit card balance pay off has been a relief
- If you're a developer, pair program as much as possible. The pressure of needing to show someone else that you're competent gets to you. You have someone else to call you out when you're going on a tangent that you'd walk back a few hours later.
Try to get exercise every day. Try to get intense exercise 2-3 times a week. Work your body to exhaustion, and your quality of sleep will improve as well.
Eat lots of protein and fat, and treat sugar like a toxin.
Other people report meditation helps, I suspect it probably would.
When ADD is acting up, I am not able to meditate.
Going to second the exercise advice. If I can get it started (just get out the door) I am always greatly rewarded.
Disclaimer: don’t self diagnose based on things you read on the Internet. Ask a real doctor.
It's not perfect but it works better for me than any medication / job combination I tried so far.
Imagine that the threads present themselves to the scheduler. They arise continuously and spontaneously. Most of them are not valuable and should be rejected wholesale.
Now take away the scheduler. The threads come and go as they please. They wrestle away the execution time from each other. They spontaneously explode or implode. Nothing corrals them, nothing gives a policy for deciding which one to devote time and effort to.
No matter how hard you lecture the CPUs for being lazy, it never changes the behaviour of unscheduled and unschedulable threads. But it sure can make you feel bad.
You say you've been lugging around the diagnosis since being a teenager. I was diagnosed at 32. Medication has been liberating. I am able to just be and do with exhaustion, failure, misery and self-loathing.
I have a very dear friend who has grappled with ADHD his entire life. A few years ago, we were talking on the phone when I asked him what the most troubling aspect of ADHD is for him, and his response was far different than what I was anticipating. For him, the one aspect that has been most debilitating is the constant self-doubt, self-loathing, and feelings of worthlessness that accompany.
In a world where ADHD is viewed as a novelty disorder, stimulant abuse remains largely unchecked, and societal stigmas only serve to marginalize those afflicted, it's easy to understand why someone might feel this way.
To get a little technical, here's an article from Neuropsychopharmacology:
"For years, it was assumed that stimulants had paradoxical calming effects in ADHD patients, whereas stimulating 'normal' individuals and producing locomotor activation in rats. It is now known that low doses of stimulants focus attention and improve executive function in both normal and ADHD subjects. Furthermore, the seminal work of Kuczenski and Segal showed that low, oral doses of methylphenidate reduce locomotor activity in rats as well."
Often you hear that if stimulants like Ritalin, Vyvanse, or Adderall help people stay calm, that means that they must have ADHD. This isn't true. These drugs will help anyone focus and pay attention. Giving stimulants to a kid with ADHD is more like giving a child with a learning disability more time on a test -- and advantage that might help anybody, but helps that child more -- than fixing his brain.
In general though, yes dextroamphetamine is a powerful stimulant that enhances physical and mental performance in healthy individuals as well as those with ADHD.
That tiredness makes me anxious, and I get even more badly distracted.
Somehow, I do make it through most days.
I have been diagnosed with ADD a year ago (with inattentiveness being the strongest aspect of it) and this is exactly what is on my mind the most as well, even before the diagnosis. I am constantly fighting the feeling that people only put up with me for as long as their patience lasts, and that I will inevitably screw up in a way that makes them roll their eyes one last time and be done with me. Which also causes a lot of avoidance-behaviour.
I fear seeing people close to me upset that I lost (for example) a gift they gave to me, or my colleagues annoyed at me for not be on time for meetings, those kinds of things. It hurts to be judged as someone not caring about how they have to put up with my quirks, and the fact that it genuinely is a struggle for me made me feel like an incompetent failure for years.
The diagnosis giving a grip on where these issues come from and how to handle them better (and also realising that my self-perception does not match that of the people around me). Even without medication, this awareness is already helping a lot in making me more productive. It also helps the people around me cope I guess, since I can explain to them that yes, I do care and I do try, and I want to come up with solutions to these frustrations together.
Apparently this is a very common, and easily overlooked anxiety among people with ADHD/ADD.
[0] https://www.reddit.com/r/ADHD/comments/6eq724/a_post_that_ta...
I haven't unfortunately. Oh I've tried, in spurts and bursts, but I can never seem to make it stick. I always go back to that immediate reward cycle. It's really frustrating but I often feel simply incapable. I think it's co-morbid with an internet/computer/gaming addiction, which sucks because this is my job and hobby as well, but it's hard to pull myself away and do "maintenance tasks" as I call them.
And yes, I also was diagnosed with ADD and given stimulants as a child (and more recently, as an adult).
This is the first time I've seen the "hidden benefits" notion asserted in the ADHD context. Based on my conversations with people with ADHD (I work for an assistive tech startup [2], so run into lots of them), there is not much of a perception that ADHD provides them a net benefit.
1: https://www.amazon.com/Dyslexic-Advantage-Unlocking-Hidden-P...
But the notion that it has benefits is hardly new. In the classic book "Driven to Distraction," the author a psychiatrist who also has ADHD, wrote about discovering ADHD: "I knew I was a slow reader [...] but I never had understood why I came up with different ways of solving problems, why I had an intuitive approach to so much, why I tended to think outside the box, why I could be so impatient so often, why I was so quick to draw conclusions, why I had an oddball sense of humor, and so on."
He writes a longer article on the benefits of ADHD here, and makes clear that the negative traits are also often the positive traits: http://www.hallowellnyc.com/HallowellNYC/LivingwithADD/Benef...
I'm sure many with split personality disorder are capable of deluding themselves into thinking its a good thing too.
Edit: I was diagnosed with ADHD by neurologist and psychiatrist.
Medication made it possible to turn it into a reliable career with promotion paths.
That said, "incapable" was a poor word choice. Not entirely inaccurate, however. I know of many people who end up shifting jobs a lot - smart but lazy is how the upper management sees them.
I am glad to see medication is helpful for you! I have tried it, but I didn't feel like the benefits outweighed the risks (the irony).
I'm not on the "ADHD is a good thing" side of this, but the argument you're implying has some serious problems. First of all, who says that people with ADHD are incapable of working in a modern corporation? Secondly, you're examining only one side of what is asserted to be a tradeoff. There are certainly other ways to be successful in life than working at a corporation, and if ADHD provides an advantage on those other paths, then it could clearly be considered a good thing.
ADHD is a disorder whose primary feature is the inability to control concentration. It's a disorder because the feature is strong enough that a person has trouble interacting with society without help. So, someone who is diagnosed with ADHD has trouble interacting with society without help.
There is no modern institution which supports an inability to control concentration as a money provider. Paintings need to be completed. Novels need to be completed. Abstract thoughts need to be written down.
Any advantage experienced by those with ADHD is also experienced by those who have trouble directing their concentration, but not to a severe enough degree to require assistance interacting with society. I can bet a lot of folks with ADHD would rather live at that point on the spectrum.
This was (somewhat controversially) softened to "clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning" in DSM-V (2013).
For example, imagine a musician with ADHD. They might struggle a good deal in school, which requires doing a lot of to-them-boring stuff. But once they're out of school, they might be perfectly good at earning a living, because the environment they create is suited to their approach to the world.
I was talking just recently with a software developer with ADHD. They preferred a pair programming environment because that was much more engaging to them than solo coding.
One could certainly exhibit ADHD-like _symptoms_ while still being capable of coping on their own (= low 'impairment'), but an ADHD diagnosis would be incorrect in this case [1]. By definition (DSM-IV Criterion D 'clinically significant impairment'), an ADHD diagnosis is appropriate only when the symptoms cause severe enough impairment that require assistance (e.g., 'clinical intervention') to function.
[1] See e.g., "Symptoms Versus Impairment: The Case for Respecting DSM-IV’s Criterion D", http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.893...
> One could certainly exhibit ADHD-like _symptoms_ while still being capable of coping on their own (= low 'impairment'), but an ADHD diagnosis would be incorrect in this case [1].
I don't see how your source backs this statement up. Yes, it's possible to have many symptoms but low impairment, but your premise that "capable of coping on one's own" is the same as "low impairment" is simply false.
Are you sure about that?
Further, as I mention elsewhere, it's true that we're not a hunter-gatherer society anymore. But neither are we a farming society. As we automate more and more of the boring stuff, I think we are, cognitively, moving in a direction where hunter-gather cognition fits in much better: https://news.ycombinator.com/item?id=16607911
I can point you to a zillion people with ADHD who hold high positions in modern corporations, and a zillion more who do excellent work. ADHD is just a different way the brain works, there are many highly effective coping mechanisms to deal with it. And ADHD does have some real benefits as well, such as hyperfocus and creativity.
Also, I should note that there are a ton of people who don't even know they have ADHD simply because they don't understand what it looks like, and they naturally developed coping mechanisms that allowed them to be highly productive. ADHD doesn't look like the cartoon pop-culture version its portrayed as. It's not like some uncontrollable child bouncing off the walls and unable to concentrate on anything.
For myself, I didn't realize I had ADHD until I was 40. Why would I suspect? I graduated college at 20 (with a degree in Mathematics), I learned about turing machines in high school on my own time, I read textbooks for fun, I love science and math, I can get lost in good books or studying quite easily. But those are, actually, signs of ADHD, which is a horribly mis-named condition, it's not about a deficit of attention it's about interest-based attention. If I'm interested in something then I can immerse myself in it quite easily, dedicate hours to study, churn through dense written material, iterate through "boring" repetitive tasks, etc. But if I'm not interested in something then forcing myself to do it can be like pulling teeth.
The sons of Hermes love to play
And only do their best when they
Are told they oughtn't;
Apollo's children never shrink
From boring jobs but have to think
Their work important.
jobs don't need creativity in the quantities that adhd people muster by default. they need, let's say, 5 units of creativity, not 50000 -- that many leads to being outside of the room when the job only requires you to be near the edge of a box in the room.
thinking "outside the box" is a hindrance. most people can't get on your level, and you can't bring yourself to where your thoughts really make sense to them. the point is that with adhd, it isn't a choice to make. they can't control whether to be inside the box, outside the box, or even in the same building as the (conceptual) box.
if it were a choice to make, it'd just be an advantage.
I'd be especially curious as to the data behind your sweeping statement that "they can't control whether to be inside the box, outside the box, or even in the same building as the (conceptual) box". That's not my experience, now how the people with ADHD I know behave, and it's not what the ADHD literature I'm familiar with says. I'm sure it's true about somebody, but I strongly doubt it's close to everybody.
ADHD is an extreme deficit of executive functions.
These things do not benefit me, or empower me. I feel a part of what I could have been is just out of reach, and that’s ADHD in a nutshell for me. If I’m being perfectly honest only two real positives exist as a result of ADHD for me:
First, I’ve always been able to utterly lose myself in a book, fiction or non-fiction. I’d be lying if I said that was always a good thing, but it can be useful. I tore my way through Gray’ Anatomy in a few days, while people I know took a month to do the same.
Second, I was lucky in having patient, yet firm parents who helped me learn what was socially acceptable at a young age. I don’t compulsively interrupt people, I can sit through a whole opera without blinking, and I have a strong verbal filter. The downside was that all of this was very hard-won, and at times painful for everyone involved.
All in all, I’d drop ADHD in a heartbeat if I could.
They administered a battery of tests, among them a few controls to screen for malingerers. Each was narrow enough of a task to believably evaluate a specific aspect of cognitive ability.
The results were evaluated against the broader population of people with similar levels of intelligence
So, for example, in one test, the task is to sum a continuing stream of spoken digits. Apparently, the test includes a distribution of other' performance,and that distribution defines 'normal.' performing worse than the mean (or whatever measure) is therefore abnormal and, potentially, indicative of some disorder or another.
Tl;Dr they use ostensibly reliable statistical methods to define 'normal'
I was on ADHD medication for many years, and on balance, I'd probably still choose to use it if it didn't make my anxiety so unmanageable. These days I manage it with nicotine, which is an imperfect but working solution.
I find that hyperfocus has become predictable enough for me that I can benefit from it while reliably avoiding the behaviors that cause it (edit: confusing phrasing; I mean can avoid it when I don't want it). In that sense, ADHD may be a benefit to me, but I don't know if it's worth the drawbacks. But if I could open up my source code and do some tweaking, I'd fix the anxiety long before I worried about the ADHD.
I would have put a "side-by-side" comparison of the same text on pages like this to make it more prominent--one with the beeline effect and one without.
The strengths include (paradoxically) the ability to hyperfocus to a greater degree than non-ADDers and the ability to achieve peak performance in short-term crisis situations instead of freaking out.
Point one: This is not a hunter gatherer society. A highly successful hunter gatherer will do very poorly in today's office-bound society. If you want someone who can only be a hunter gatherer to be successful in today's society, you can't just tell them to "calm down" or "concentrate harder", you have to make accommodations.
Point two: All the creativity in the world won't help when you get bored of a painting, a story, a novel halfway through and can't finish it. Note - I didn't say "don't want to finish it", I said "can't finish it". Just like someone with clinical depression can't just snap out of it and be happy, someone with moderate to severe ADHD can't force themselves to concentrate.
Point three: ADHD does not just affect concentration. Another big impact that ADHD has is on the ability to connect an action and its consequences if those two are separated by more than a few minutes. Funny image -> immediate dopamine response -> fantastic feedback loop. Doing your homework -> discomfort and frustration -> very negative feedback loop.
Now imagine trying to live in a world where doing work and getting paid have no correlation in your brain. You have to intellectualize that doing work leads to getting paid, except you can't concentrate on it long enough to care.
It's true we aren't a hunter-gatherer society. But neither are we a farming society anymore. Circa 1% of the population works in agriculture. Yes, you can look at the Industrial Revolution as applying farming culture to machines; instead of tilling rows, we do piecework. And 1950s-era white-collar organization is basically applying the industrial model to paperwork.
But automation is ending that era. With the rise of the computer, we are getting machines to do all the boring stuff. We are passing out of the farming/industrial era. It's my belief that we're entering an era where the ability to do repetitive, boring work is becoming obsolete. If we technologists do our job well, the only work left is exploratory, creative, social.
So yes, having ADHD in a farmer's world isn't easy. But as the author says, the world's changing away from that.
What's happening is what I read awhile back - calling ADHD an advantage in society is presenting a weak man argument. Sure, it seems reasonable since they're adding the caveats... but the point that's coming across is that ADHD is not a real disorder since it's an advantage to have, and people who are on meds who have no real reason to be on them.
Just see how many people in these threads come to say that it's not a real problem, that behavioral therapy is sufficient, that we're overmedicating children, that everybody is "a little ADHD".
Whatever era we may be hypothetically entering; it's not the era we're in now. Being unable to direct your concentration is hinderance, not a help. And I don't think it will help in this hypothetical era, either. Not when finishing works of creativity requires a certain amount of "grit" - concentration on a task that provides no immediately positive feedback.
If you personally need medication, great, you should use it. But I don't think that justifies dumping on the people who don't. Or the people who do, but also see benefits in their different cognitive style. My ADHD has been a pain in the ass for me, but I'd never trade it away, as I like the benefits.
Point two: you made it a point to use the wrong word - A person with ADD sure as shooting can finish a book. Might they skim some boring sections, find later that it seems like they jumped around and missed something, use bookmarks often when bored, or reread sections to 'catch up' and remember what they've forgotten? Sure - but that doesn't preclude finishing a book if it's good.
Point three: from a brief skim I probably agree, plus I'm bored now ;)
Re point two: In my experience, the vast majority of people don’t read the things they’re assigned or supposed to read, they just skim them. So the issue isn’t reading a book, it’s writing one.
But I think 85% of the issue with my ADHD is the social stigma and people who will never understand nor accept it.
I don’t think the right response is some kind of eye-rolling “ADHD-positivity”; people need help, treatment, and acceptance.
ADHD is what you might consider one of the more “telegenic” disabilities, which is all the more reason to advocate for an inclusive, understanding approach to disabilities in general. Otherwise, people won’t get the help they need, and dumbasses will continue to revert to their tropes of “laziness”, “lack of willpower”, “bad parenting”, and “just need to put in more effort”.
There’s a lot of confusion about what ADHD is and whether it exists at all. Here’s what, you don’t really need irrefutable evidence about someone’s predicament to care about other people who are different from you. Regardless of what you think is the case wrt ADHD, there’s an opportunity for you to grapple with the fact that there are people dealing with struggles invisible to you every waking day of their lives, and that you need to take that into account when judging them as children, students, co-workers and human beings, and where they got or didn’t get to in life.
You... sound like you participate in a lot of online discussion groups where the general public talks about ADHD.
I don't think this is healthy, for all the reasons you list. I mean, support groups are useful for some people, and you can have online support groups, but just like in person support groups, you need to filter so that the people who just want to insult you are not participating.
I think this is something that needs to be taught in high school; once you are out of high school? you get to pick your peers. If your peers make you feel bad about who you are, pick new peers.
That's nice in theory, but it is a little like telling black people to only befriend nice white people or women to ignore all the sexist pigs. If essentially the entire world is the problem and there is a relatively small number of people that really get your issues (are really on the same page as you), acting like they just need to be choosier about their friends amounts to victim blaming.
In that case, I totally agree that you have a larger problem.
But my experience of adhd is not like that. My experience is that the only context in which other people give me a hard time about this sort of thing is if I talk about it in certain online communities. If you talk with a therapists or psychiatrist or if you read books by people educated in the field, you generally get useful help from a compassionate person. Heck, I've had good experiences talking with my bosses about this sort of thing. Mostly it's just the faceless internet trolls I've experienced espousing the views we are talking about, and I thing it's very easy (and very unhealthy) to get into a situation where it feels like faceless internet trolls represent how most people think.
My point is that talking about this sort of thing online is quite often super counterproductive.
(as to the larger issue... I can see what you mean about victim blaming... but I also point out that you could replace 'avoid' with 'ostracize' in my original post without really changing the denotation of my words, if you wanted more of a 'fight back' connotation.)
I'm sure you mean well and I hope it benefits the person you are addressing. But my experience is that this is not a good way to help someone.
I was sexually abused as a child. That was hard to recover from. Advice like "Just talk to nice men" was not actionable. If all you have known is abuse, you don't know how to identify nice people. You also don't know how to talk to them in a way that helps.
The above person is complaining about their situation and your response most likely makes them feel blamed for the situation and most likely doesn't help them find a path forward. And this is likely partly because of how they framed it and you are responding to how they framed it. Other people will respond that way as well and it usually just compounds the problem.
This second comment by you contains much better information that may be more helpful to them, such as listing the types of persons that you have found helpful to talk to. That still doesn't straight up solve it, but it is much more potentially useful.
I'm not trying to fight with you or whatever. There are ways to make the points you have made that are helpful and supportive. I don't think your first comment is that sort of thing.
Best.
Re-reading my own comments, I think you are right that my comment wasn't helpful.
It probably would be worth the time for me to figure out how to say this in a more constructive way, because I do see a lot of people, especially my more right-leaning friends who feel deep feelings of persecution from, you know, things people have said on the internet, that would never be said in real life anywhere I or they have been or would go.
Best.
I agree but ADHD is one of the better of psychiatric disorders to have regarding both job prospects and IMO social stigma. You can can join the military and operate a lot of jobs with ADHD medication or a past of ADHD. Bipolar/Schizo/Depression have even a bigger social stigma not to mention they are often automatic disqualifiers.
This hit me pretty hard. This has been me for the past 4 years. Diagnosed in college and convinced myself ADHD wasn't real, or if it was, I didn't have it. I was just inherently lazy and unfocused and needed to just "man up" and figure it out.
Still haven't gone back to attempt to get diagnosed again. I guess I'm a little scared. Even though I've struggled with inattention (not hyperactivity, though) my whole life there's an entire half of my being that is just screaming saying "it's not a real problem, other people have real problems, this is just something you need to get past already."
> [snip]
> there's an entire half of my being that is just screaming saying "it's not a real problem, other people have real problems, this is just something you need to get past already."
You're gonna laugh if you read one of the early case studies (about someone who thought similarly) in the book "Driven to Distraction" and come to the realization how typical that feeling & response is for people with ADHD (particularly the "Primarily Inattentive" variant). When I read the case study, my thought was: "Dammit, even my (stereotypical) objections suggest it's an accurate diagnosis!".
I'd really recommend the book--it's not perfect but it covers a lot of helpful ground.
My current explanation-by-way-of-analogy:
Having ADHD-PI is like running a marathon while wearing a pantomime horse suit, yes, running a marathon like that is hard for everyone but what you don't realize is that other people aren't running it while also having a broken leg. (And neither you nor they can tell there's a difference between the two of you because of the pantomime suit--hey, I didn't say this was a good analogy. :D )
It took months just to feel normal again. For those who were wondering, I took a mix of short and long releasing stimulants. Although, I mainly blame the short releasing ones for most of my troubles.
We are a VERY significant minority of the population, and our institutions are not working for us. We should organize and do something about it instead instead of letting people try to medicate away our differences.
I have been working for three years on a ADHD friendly Taskmanager as an obsessive side-project to solve exactly that daily life problem. In 6 weeks I will open it up for internal trial testing - volunteers welcome - just send me an email if you wanna join the trial (first version is Android only).
To do lists, books, apps work for a while, until the novelty wears off and the dopamine return is diminished.
Good luck with the app. Focus on dopamine.
I used to think this meant there was no point in trying out a new productivity system because I knew it'd only be effective for a month or so...
But then I had my "To Do List Epiphany":
It doesn't matter if a to do list or other productivity system only works for a month--because you still got a month's productivity! A system doesn't have to be the be-all and end-all system for-all-time.
Because, let's face it, people aren't going to stop coming up with new productivity systems, so, when one stops working, just move onto another one. It's okay.
(With this in mind I've toyed with the idea of a productivity system generator that randomly combines elements of other approaches to keep it novel, e.g.:
* Ah, so, this new productivity system called "Get It Parked" only allows you to enter half of a to-do item in an app and then the other half in a shared community physical notebook located in a park which gets burned at 9pm each day in a community ceremony. :) )
I ultimately homeschooled and I spent a lot of time on various parenting lists. Nutritional supplements actually have a good track record of calming down wild kids, but that isn't a standard recommendation and gets dismissed as woo if you talk about it.
If you are interested in that angle, there's interesting research and discussion related to nutrition and prison populations here:
https://news.ycombinator.com/item?id=16140867
Over the years, I have seen other articles that suggest that ADHD makes one a better soldier or whatever. I'm not really surprised by the research cited here concerning ADHD genes and things like migration and occupational outcomes.
Once upon a time, we talked about personality differences, saying some people were shy and others gregarious. Now, we diagnose shy people with conditions like selective mutism and we say gregarious people have no filter and diagnose them with conditions like ADHD. I realize some people really suffer. But I think it makes vastly more sense to take a nutritional approach and also consider what people are well suited for and help them find their niche instead of medicalizing and medicating everything under the sun.
Because if you blur these together, you can hurt people who genuinely need help.
If people with ADHD need, for example, better nutrition and are being given drugs instead, they may currently be getting harmed.
Given how much the three psychiatrists I've worked with have tested my health, inquired about my diet, given instructions about alcohol consumption, sent me for extensive blood tests, tracked my weight and blood pressure, I feel perhaps this isn't the case at all.
Maybe the experts have expertise. And maybe your anecdotal experience and my very different anecdotal experience are not medical proof of anything.
I was a mom trying to do right by my kids. That's it. I think I did right by my kids.
I spent a lot of time on parent support groups talking to mostly other moms who often disagreed with the well paid experts writing their kids off and making a pretty penny in the process.
Our entire medical system makes its money off of ongoing treatment, not off of actually fixing anything. And you might pause and wonder for a minute about that inherent conflict of interest before fanboying your experts any further.
But it is not true to say that every single case is the same.
Making universal statements about the nature of ADHD and universal statements about available treatments can deter people from seeking and receiving help that would work for them.
Experts are more likely to diagnose correctly than layfolk. No single error changes that fact. Insofar as people are deterred from seeking expert attention, the net effect is harmful.
Attributing the differences in our experiences to a uniform medical conspiracy against the public doesn't bear on whether treatments work or not for different cases.
My parents cared too. Nobody told them about ADHD, because it just wasn't a commonly-known thing in that time and place. I was smart enough to stumble forward through school, with their love and heartbreak and the dedication of many frustrated teachers. But I would've done a lot better with just a little treatment. And I find it hard not to take personally the idea that others should be discouraged from seeking help from a professional.
Attributing the differences in our experiences to a uniform medical conspiracy against the public doesn't bear on whether treatments work or not for different cases.
Accusing me of wildly overreacting is not a good way to help in such a situation. It just puts out the fire with gasoline.
Criticising an industry as having inherent conflict of interest is not remotely a conspiracy theory.
I think I am done here. This is a really tiresome pattern on HN of late where two or more people gang up on me and use bad faith tactics and then I get downvoted etc. It's a no win situation for me and seems entirely unrelated to whatever point I have tried to make.
But I'm as prototypical of a case as it comes. I went straight from college dropout to an A-grade distinguished student with medication.
1) If medication doesn't work, don't berate me with conspiracy theories.
2) Several companies offer free medication programs for ADHD. Did you try that? Or are you just projecting your anti-medication decision onto others?
3) Or your kid doesn't have ADHD, see #1
It isn't a conspiracy theory and I am not anti medication. I was being attacked by someone taking my remarks very personally and twisting them out of shape, which appears to also be what you are doing.
My point is that some kids benefit more from a nutritional approach than from medication. That doesn't mean medication does nothing. But it does mean that it is possible that some people would benefit more from other approaches and may not get the opportunity to learn that if the first thing done is medication.
It isn't saying drugs do nothing. It isn't saying you should never take drugs or you are bad or wrong for taking drugs. It is saying that if a nutritional deficiency is a factor, drugs won't fix that. Nutrition will. In fact, many drugs are known to deplete nutrients and thereby can make things worse over the long run.
I have been on meds for the past 2 years and started at 26. I don't think this is "fixing" as I'm on probably the lowest dosage. Since day 1 I felt the same way I did after coffee. Vyvanse to me is extended release caffeine which kicks in as my morning coffee wears off and carries me through the day.
Do note that I had been working for 4 years before I started Vyvanse.
I have a distinct feeling that my ADHD brain doesn't have the ability to remember details with the same fidelity as my peers. I am constantly forgetting all but the most critical details, but I have a ability to intuit solutions from the details I have forgotten.
I am very successful in my career, but I failed my way through school and struggled with addiction when I was younger. It's not easy to live with ADHD. I have a lot of anger, people frustrate me so much. They are too slow and don't take enough risks.
My current and most effective solution to date is an Android Wear 2.0 watchface that does the following things.
1. Has a list of granular routines I can select. "Work - Start", "Work - Priority", "Home - End", "Let's get started" are all examples of such.
2. I can "load" a list such that I can iterate through tasks one by one _linearly_ and I don't tap my wrist to denote "done" until the task is done.
3. While a list is loaded, my wrist vibrates every thirty seconds to keep me on task.
4. I can "Clear" a list at any time to stop my wrist from buzzing and to return to a "select a routine / priority list" mode, it also stops when I complete a list.
This keeps me on task, reminds me that I've decided to work towards a singular goal, and keeps my current "cursor" at a glance. A part of me wishes I didn't have to live this way, but it's a coping mechanism that keeps me more effective than I've ever been and I will likely use it and improve upon it for the rest of my days.
So, ama if you're curious about any other details. I am interested to know if a system like this would work for others. Right now it's literally an APK I load onto my watch that hits an API running on kubernetes. Simple, but effective.
[1] https://en.wikipedia.org/wiki/Hunter_vs._farmer_hypothesis
Saying that "ADHD is good because it makes you restless which makes you more adaptable to change" is therefore questionable. You could be restless and adaptable to change without having enough issues that it would warrant an ADHD diagnosis.
A correct argument would have to include the properties separating people with ADHD with those with similar traits, but aren't hampered in their daily function because of it: It could for example go like: "Having ADHD is good, because if you are too unfocused to keep a job, you get a lot of free time".
ADHD is a neurogenetic disorder of executive function, it's not contagious, not acquired, not caused by video games, screens or the age at which schooling starts.
They are: interest based attention, emotional hyperarousal, and rejection sensitivity. It's amazing how many other symptoms of ADD these features cover, and how important they are in describing how ADD affects daily life.
But there is no blanket treatment for everyone.
Just diagnosed as an adult partially due to parents not "believing in it," refused testing then and I was blind to it until now. Currently friendless, jobless, broke, homeless and a bazillion unfinished projects not exactly the picture of praiseworthy. ADHD is a misnomer, it's an executive function disorder, but the name will never change because it's embedded in disability laws. Medicating for emotional regulation, continuity of thought, completing tasks and not coming-off as weird are lifesaving... don't avoid medication out of some antivaxx nonsense.
Worth watching:
- ADHD Child vs. Non-ADHD Child Interview https://youtu.be/-IO6zqIm88s
- How To Know If You Have ADHD https://youtu.be/5GBMS7WPFSs
- This is how you treat ADHD based off science, Dr Russell Barkley part of 2012 Burnett Lecture https://youtu.be/_tpB-B8BXk0
- Dr Russell Barkley on ADHD Meds and how they all work differently from each other https://youtu.be/LnS0PfNyj4U
- The Neuroanatomy of ADHD and thus how to treat ADHD - CADDAC - Dr Russel Barkley part 1c https://youtu.be/wccW-KB2OsI
Do you care to elaborate?
the no filter thing is the most noticeable part. it can lead to extremely unprofessional management at worst (along with problems organizing). the upside is that it creates people who naturally come off as relateable and funny; because any conversation with them immediately feels casual and fun, they happen to be great at hosting podcasts and doing standup comedy (i believe most successful comedians have adhd, and many admit it). in a business setting they can be very convincing without you noticing it.
it's more like a personality type than a disorder, and really it's considered a disorder because it's a personality that hates sitting still in class and listening to a teacher for the first 22 years of life. most successful people i know with adhd had some weird career path where they didn't do great in school, switched focus many times and then careers during their 20s.
Rabbit holing (which is how ADHD brains tend to act with a lot of available stimulation/information) is pretty much the exact opposite of coping and being productive.
It's not "real" in the sense that there's a single mechanism underlying ADHD. It's not real in the sense that "people with ADHD are affected differently by amphetamines, so it's okay for them to take them."
The way I think about it is that attention is a bell curve, and that at some point on the left of that curve, symptoms interfere with happy, economically productive lives. Psychiatrists try to help those people with stimulant drugs, whose efficacy have been proven in the short term, but are basically unproven in the long term. There are companies making bank on this arrangement.
In summary, I guess it's complicated. You're right, but maybe your therapist is, too. Por que no los dos?
ADHD is, ultimately, as real as climate change. The experts say it's real; have been saying it's real for many years. The people who disagree don't trust those experts.
As for the psychiatrist, they don't make any extra money from prescribing. They could make more money if they kept you coming in each month or week for behavioural therapy (which doesn't have great results for adhd anyway, but it's something).
Basically, you are right, psychiatrists could make more money doing therapy, but therapy is more for psychologists and not psychiatrists. Most psychiatrists make money off of volume of patients. So it is in their best interest to prescribe more and consult less. The more patients that come through their office and they prescribe meds to the more money they make. He used the example of the psychiatry department at the public hospital next door to his office. On average, one doctor in that office can see upwards of 30 patients a day. With my friend, he can see at most 6 patients a day. For my friend though, as a psychologist doing one-on-one therapy he can charge more and see less patients.
In regards to medicating versus therapy, like many other things, people react differently to different things. Some individuals may do better with therapy over meds and vice-versa. The downside of meds is that typically becomes a lifetime treatment. Therapy on the other hand, when it works, is easier to reduce over time (although most people will continue, even at a significantly reduced interval).
Who the fuck would medicate a 5 or 10 year old child for being "too active"? This is like the 50s shock therapy for unruly teenagers, but done with chemistry instead. Less blood and morbidity, more mental castration. Many people who take up Ritalin and Adderal, especially from a young age, have issues with mental development and end up addicts for life. If/when they finally take off their meds, they find themselves 10x worse because of the long-term withdrawal.
This thread is filled with reddit-tier pseudoscience about ADHD being some kind of evolutionary trait relating to hunter gatherer communities. What a load of bullshit, I don't know if I should be laughing or not. It's worrisome that even serious people and many psychologists believe that shit.
This is an archaic idea, you sound like an older individual. Am I right on that?
> reddit-tier pseudoscience... downvoted to hell
We can test for ADHD just like we do breast cancer.
> medication is often a crime... ADHD [is an] evolutionary trait... What a load of bullshit
Impulsivity is a sin, right? I'm not some puppet for your chuch, pal.