How I Run a Company with ADHD
andrewaskins.com
andrewaskins.com
I have ADD and pretty much recognize myself in a lot of this.
It’s almost impossible to focus on anything that is not interesting “right now” and what is “interesting” changes in cycles spanning a few weeks.
During a cycle I become completely absorbed, you know, not eat, not sleep and not being communicative, absorbed.
For a long time this worked out both personally (depending on who you ask) and with my employers/employees that so far have had no issues with my rather irregular rhythm (thank you tech!).
Oh, the storytelling and talking... I feel sorry for my brain and, in retrospect, people that had to listen (I’m sorry! And I didn’t mean to be rude and offensive, it was just my thoughts at that very second!).
As life have changed mainly through becoming a dad it has also become a lot more difficult —- not everything about kids is “interesting”, and staying up to 4 to tinker with something “interesting” is just such a bad idea when someone jumps on your face at 6.
Everyone needs food? And it’s my responsibility? Today again?! Phew... etc.
Spending energy on “non-interesting” things really is draining and seem to lead to kind of mini depressions.
I’m happy that I’ve come to a point where I at least can see some of this behavior which allows me to work on some changes.
Hard work though!
Perhaps I should write about how I run(?) a family with ADD? It would make for a lot of laughs and a some sad stuff.
1. ADHD Predominantly Inattentive (ADHD-PI)
2. ADHD Predominantly Hyperactive (ADHD-PH?)
3. ADHD Combined (ADHD-C)
ADD falls under the first one. It makes sense that you'd recognize yourself in that. They're now considered to be the same disorder, but just presenting in a different way.
One of the things that's usually not discussed, but what you should watch out for is emotional control. Apparently it's easier for people with ADHD to have their emotions flip. Russell Barkley has an amazing series of lectures about it. You can find various bits on YouTube. You could see if maybe you'll discover even more about yourself.
ADHD can be a huuuuge problem in relationships. Especially if you're going out with someone who would score very high on conscientiousness. They won't understand that things that are easy for them are hard for you, and will assume that you're just trying to piss them off, or are incorrigibly lazy. This is exacerbated because it's not like you can't do those things, it's just that you will inconsistently do them, and average towards not doing them.
On my partners request I should add.
For fun my then partner took the test as well.
My score 80% or whatever: “severe autistic traits”. WTF?! Ouch...
Hers? A clean 0. Zero?! You’re kidding. Sure she’s probably the most compassionate human being I’ve ever met, but come on!
Eventually we got a daughter and split up a year later.
Best thing that could have happened for anyone of us, daughter included, and we have a great relationship where we hang out all the time.
I believe in part this is because she doesn’t expect “normal” from me when we’re no longer together.
It also gave me a wake-up call telling me I had shit to properly sort out.
Here's a fantastic lecture (split into ~5 minute segments -- this guy gets it :) by Dr. Barkley:
ADHD - The 30 Essential Ideas Everyone Needs to Know
https://www.youtube.com/watch?v=BzhbAK1pdPM&list=PLzBixSjmbc...
The general physician I went to initially to kick of the quest for diagnosis obviously had an interest and gave me a book called “the answer” (edit).
If you are Swedish: “hemligheten”
In english the tag line (translated by me): “from moments to lasting relationships”
Many responsibilities in family life are uninteresting. Often I have to be patient for weeks in order to work on something I find interesting. Months ago I found a great programming project to work on. However, I'm caught in a period in which my wife is working a lot of extra hours, leaving me to deal with cooking, house repair, running my daughter to activities, finances, etc. I also work full-time as a developer. On top of it, I'm the president for my daughter's basketball league, which requires a lot of attention to administrative tasks. I'm perpetually at odds with my desire to work on the interesting project and getting done what needs to be done.
I'm coming out of a mini-depression now. As an example of what it's like, several weeks ago I was sent a link to post to our league's FB page. The link pertains to an event next weekend. Posting would have taken under 5 minutes, but I shied away from it until yesterday. The thought of one more trivial task in my day completely paralyzed me for weeks, but I felt increasing anxiety and the depression worsened.
In my younger days, I would have ignored needs to focus on what made me feel happy at the time. Nowadays I feel too anxious when I do so.
Same. It's subsided to a large extent, but I spent years in that state. I'm not even angry at my brain, but just a little sad about how much time and opportunities this wasted for me.
> In my younger days, I would have ignored needs to focus on what made me feel happy at the time. Nowadays I feel too anxious when I do so.
Same. Except I do wish I got back to that "younger days" state. Literally nothing ended up badly from doing that; hell, I owe my whole programming career to it. Between doing what you want instead of what you have to vs. the other way around, the worst is really the third option: being paralyzed by an internal conflict and doing neither.
Wow, this describes a few recent events for me. Thanks for sharing!
Who is “her” in this case — the writer or the daughter?
Would definitely be interested in hearing your wins running a family and managing this
So in short list format, just sharing some methods I employ, sans digressions:
0. Awareness. Took way too long for me to reach it.
1. What is mentioned in the article: prioritisation! That needs to lead to routine. Hard work this, but most important, as I have to be able to engage auto-pilot for "non-interesting" tasks.
2. Sleep. Just do it. I have found out that lack of sleep takes me down hyper-focus lane. Great when you are alone and is tinkering along for a weekend. Not at all in basically all other scenarios. Hit bed before 11.
3. Eat and drink. Healthy and just enough. The effects are similar to #2 if I don't.
4. Physical activities. Go for a 20 min run. It is boring, but reach the point of proper sweating and keep going for another 10-20 min. The effects on me are amazing and in many ways resemble #5, only even better.
5. Breathe. Honestly, I have started practicing mindfulness and it just works for me. It takes me down into myself and allows me to spread focus.
On the bus right now, and this is what I can think of at the moment. Always a work in progress. I'll see about that blog...
Long time skateboarder, hung up in a 9-5, knees are starting to shit the bed at 30, and don't skate much any more as a result. Realized, fairly recently, that over the years my mental state was declining/flatlining largely in part to not exercising. Skating is just fun, provides a sense of freedom, used to be a huge part of my social life, and the physical activity kept my body and mind in shape, and it's totally left a negative impact not having that involved in 50%+ of my daily activities.
Going on a tangent, but I recently purchased a recumbent bike as a means of remaining stimulated/keeping boredom at bay while exercising, and it's hands down one of the best purchases I've ever made. It's a matter of going to YouTube and popping on a walkthrough on a framework/library/etc, the news, documentary, or anything of interest, and just peddling away for the next hour... Only problem is, it's hard to stop going once you start :/
Anyways, read through this thread and your mentions, as someone else has mentioned, are the most articulate descriptions of the struggles that one faces with ADD. Personally, I'm in an environment where many don't consider it "real" and look down upon those who have sought medical help as "meth addicts", and my only wish is for them to understand and also to be able to distinguish the medications from one another and not group them with illicit/highly toxic drugs.
Glad to have come across yours and many other's comments on the topic. Made my morning :)
Routine is useful. My life is full of mini routines, although not necessarily making as cohesive as a picture as they could, there are certainly plenty of gaps.
I have a bad problem where things go to shit if a normal "auto-pilot" task of mine has to changed.
Simple example, I always have my keys in my pocket, I feel for them as I walk out the door. They're there, I continue. Same thing with my truck (it has manual locks) - I feel for the big plastic on the key, then close the locked door.
However, when leaving the house without pockets (in dirtbike gear), there is room for things to go wrong for me.
I can't just check that pocket. So I either have to replay putting the keys in my bag or not be lazy and check the bag.
I've had to learn to not be lazy and require physical proof... because last time it turns out they were indeed in the bag, _but the bag was in the house_.
It gets easier with routines and practice and will eventually start a positive spiral if you stick to it for a few weeks.
If you “lose” it (you will) and end up out of the spiral or going backwards, remind yourself of how good your brain felt after that 30 min run or 15 minute of focused breathing.
You probably have a hyper-sensitive brain of sorts, and you will know what I mean. It sensitive in a way that it behaves like a sponge. Feed it good stuff and it will behave better.
Drain it with no good sleep, bad food, sugar and intense focus without rest? Setting of a bad spiral. Learn to feel when this kicks in.
The work never stops, so force it! Just do it.
My 11 year old son was diagnosed with ADHD-PI over a year ago, and we've had great success with with all of the above areas for him. 0, 1, 2, and 4 especially. We've gotten things running pretty well at home by recognizing he needs a break from homework to "run around in circles (as he calls it)" for a bit, setting up physical activities like shooting hoops that are easy to start/stop, having a strong routine in the morning before school, and making sure we don't slip at bed times. Another key to his success is his teacher. She's been simply amazing at letting him sit, stand, take 5 to go run up/down stairs, etc. when he needs it. Most importantly, he recognizes that she genuinely cares and it makes him want to do well, unlike a past teacher or two that simply treated him like a nuisance.
The morning routine is probably the biggest win, though. We went from barely able to get out the door in time for school to our son often getting up early and getting fully ready (dressed, bed made, breakfast eaten, lunch packed, showered, etc) before mom or I even get out of bed. He's always so proud of himself when that happens, too.
I'm separated and co-parenting and realized that I would freak out every Thursday because clearly my place is too shitty for the kids to arrive, and obviously I'm a terrible father. Once I could name the "Thursday freakout", it became a lot easier to manage and to reduce the intensity from wanting to bail on everyone to just laughing it off.
It gets easier (before it gets harder?, don't know yet.) A former colleague put it best -- the highs are higher, and the lows are lower. It's just no one really tells you how low the lows can be.
I would really like to read that - and I hope this doesn't come out as cynical or heartless, I can understand that having ADD comes with challenges. I am simply intellectually curious to hear how someone lives with such a condition.
I also feel/think - but I might be 100% wrong - that many of us have "some" light form of ADD, perhaps driven by our use of mobile devices. Curious to hear if you have any thought about it.
Well, it’s a spectrum, isn’t it!
I’ve said it a couple of times already in this thread, all is well as long as daily suffering is at a minimal, for anyone that happens to be involved.
Mobile device (constant access to information specifically) is a big problem for me, that is for sure.
I remember playing computer games competitively impacted me in a really negative way when I was younger as well, much in the same way.
The “feeling” in my brain and mind is pretty similar (phone vs gaming) and it seems to create a really bad disconnect emotionally.
This “disconnect” leads to a kind of apathy and when in that state pretty much nothing of value can happen.
I’m currently making a routine of handing my phone to my partner when at home, as I’m unable to handle it.
There’s just so much interesting stuff all over and “interesting” trumps pretty much everything else, often at the expense of relationships.
For a concrete example I described a typical grocery store situation in another post.
Given how poignantly you expressed my own experience of living with ADHD Primarily Inattentive (what you called ADD above), and as someone on the cusp of becoming a father, I would appreciate this more than I can express.
As an adult with ADD, it was a miraculous new perspective on tracking all the things I used to fail to do. I so, so wish I'd had it when I was dealing with small children.
I can't count the number of times while talking to my psychologist, in the middle of a breakdown thinking "If only there were a system that I could offload all of the dumb things I can't remember to do..."
...and then laughing my way out of the room because my wife told me weeks earlier that she wishes I were using my journal. She notices that I'm happier when I use it, she is much happier because she doesn't have to ask me to do something 4 times...
Using OrgMode for keeping my work-life in order has been a life-changer. But perhaps a bullet journal is more suited for keeping personal, and family life. I've never looked into them properly, but will definitely do so today.
I’m constantly playing the “no ones died yet on my watch” card.
It somehow doesn’t make her feel any better.
This was while sorting out the effects of neglecting loved and dear ones at a point in time.
It goes something like this:
—-
You met an a-hole one day. Yeah, it’s just another a-hole.
You meet a-holes everyday?
Well, maybe you’re the a-hole.
—-
Worth thinking about if you find yourself in bad spots all the time.
I do not have ADD (afaik), and I also recognize myself in a lot of this. I think many of these behaviors are very common in general.
The question is always: does it impede a “normal” life and is anyone constantly suffering?
I thought my so called issues were perfectly manageable until I got my second child.
I described it in a different post as being stuck in development.
Remaining a child in many ways, and constantly fighting overwhelming emotions or, almost worse, non at all.
I decided I couldn’t keep doing what I was doing, and it’s been a struggle ever since.
Mostly I make it work, but my partner might have a word or two about these things:
Going to the grocery store with a long list of items, only to be overwhelmed by the astounding number of types of coffee.
Spending 45 minutes looking online for anything regarding beans and grounds. Fascinating stuff! Animals eating from the trees and pooing the beans out?! Wow.
Leaving after one hour with a bag of potatoes — cause’ couldn't handle it.
You can probably see that if this is a repeating pattern someone’s bound to suffer.
Anxiety is just around the corner with depression right behind it, stemming from these issues.
I second this!
My (adult) daughter inherited ADD from me. Which means she and I understand each other in a way that her mother and her twin brother do not understand us. At least they've learned to just let us do the grocery shopping and not try to help.
Just wondering, what sort of things are you trying to combat that?
The best thing I've found is to just accept you have the ADHD and work around it. If I know I'm going to do a tedious task that is going to be boring and require concentration, I usually give myself a 2-3 minute break every 20 minutes just to get up and walk around. It's very important to have discipline to make sure the break doesn't turn into a huge 45 minute sidetrack.
I am fully aware of the trick and I could just choose right now to violate the thing entirely. It still works.
I don't suppose that counts as tricking your mind into thinking something is interesting. Still works.
But having had an intake of decent energy during the day, and a 30 min run in the evening allows my brain to brush the teeth and put three beasts to bed at night without collapsing into apathy.
I have to constantly interrupt what I’m doing during the day and “check the sensors” so to speak.
Hands up if you’ve been so consumed you missed lunch more than one instance this last month!
Keep doing that, and the deterioration is in progress.
If not of oneself perhaps relationships? And what is “self”?
Right now is the worst. I made a list of work I need to do today, but none of it was very stimulating. So I opened up Hacker News, saw this article, and have been on this for close to an hour now. In that time, I've read it and a lot of comments (Jordan's comments being my favorite so far). I've decided to try Todoist as suggested by the author, so I've set that up. I already know that I'm going to fall away from it like I do every other organizational method (Evernote, Keep, Kanban varieties, physical notebooks), so a little mini bit of negativity has set in. And now all I want to do is get up from my desk, and run around to see how my employees are doing. I have 60 of them, so that could take awhile. And before I know it, I've done nothing but read about ADHD and talk about the weekend all day.
I really bash myself for these periods of the day. I feel like I'm wearing a sign on my forehead that says "Brian hasn't done anything for 4 hours!" And that sign would be true. On the flip-side when a problem comes along, I'm all over it. I'll work night and day to get it done. I'll do so to the short term detriment of relationships, but I'll solve it. If I have constant interesting problems flowing in, I look like a working machine. If I just have boring redundant work like dealing with employee "time cards" or invoices, it takes all day to get to it, and I look like I'm day-dreaming or lazy.
It's now an hour and 15 into this sidetrack. So I think I'll go get some water, walk around, and maybe sit back down and get some work done before 9am. I'll have to or else I won't get anything done. I have to attend 3 meetings in a row where I'm listening and not speaking. If you are ADHD, you know how that's going to go.
-----
Bah! Another article about ADHD. ADHD's over diagnosed and not not as big a problem as people make it out to be. But, I'm curious all of a sudden, so I might as well read it.
> For the first 19 years of my life I knew I was lazy.
Yeah, I'm pretty lazy too. That's just who I am, though. I don't have ADHD...
> So what, you can't stop bouncing your leg at the restaurant?
I thought I was the only one that did that. It drives my aunt crazy.
> I'll be halfway through a team meeting and realize I haven't heard anything that was said. That's ADHD.
THAT'S ADHD? I do that all the time. I can't listen to podcasts either. But I just have difficulty processing the spoken word. I'm much more of a book learner anyway.
> I was happiest with my nose in the book
I'm seeing a disturbing pattern take shape.
> I'll take a break to read an article and hours will go by before I realize what's happened. Not minutes, hours. That's ADHD.
Wat.
> I'm horrible at completing simple, repetitive tasks. I'm terrible at time management, and conceptualizing time in general.
Uh oh.
Other comments here have mentioned that stimulants help ADHD sufferers focus. I recently cut back to 2 20oz cans of red bull a day, but I was up to 4 a few years ago. I just thought caffeine was my drug of choice. Everyone's addicted to something, right?
I currently have 52 open tabs on my laptop and another 37 open on my desktop.
I'm not quite sure what to do with all of this. I just thought I was lazy.
Some are clever and diligent -- their place is the General Staff.
The next lot are stupid and lazy -- they make up 90 percent of every army and are suited to routine duties.
Anyone who is both clever and lazy is qualified for the highest leadership duties, because he possesses the intellectual clarity and the composure necessary for difficult decisions.
One must beware of anyone who is stupid and diligent -- he must not be entrusted with any responsibility because he will always cause only mischief."
-Kurt von Hammerstein-Equord
Well, hard-working but not clever people will do useless work and create extra work overloading everyone else. BUT, this happens when they don't have good management and leadership above them, to prioritize and handle them bite-sized pieces, and to set their frame of mind to focus on "results in the bigger picture".
Probably putting "clever and lazy" and leadership roles is the cause for bad management and leadership which makes his "stupid and diligent" underperform in ways that drag everyone down.
Sayin' this as a "clever and lazy" person myself - I know that if I don't have someone I am responsible to (doesn't matter if it's a managers, partner, peer etc.) that is truly hard working and diligent is a recipe for total disaster. I'd rather be accountable to people way less creative, and even lower both IQ and EQ, as long as they come with a solid work ethic and focus to detail and they manage to drag me in this direction to! If the world would have only of people like myself in all leadership positions, nothing would ever get done, and the "diligent / hard-working" people will probably go crazy and either kill themselves or start wars.
I've always thought of "stupid" as different from "not smart". I can't fault people for not having the experience or knowledge that I or others have. I tend to think more of an "active stupid" as a lack of common sense, and making actually poor choices as opposed not making good ones.
To me, it's more the difference of "My laptop is overheating and I can't figure out why" versus "My laptop is overheating so I poured water on it to cool it off."
People whose work involves mainly analytical thinking tasks are often mistakenly perceived by public society as lazy while in fact they have always been working all this time, probably harder than most. It's only because the nature of their work is not physically visible to the naked eyes.
Quality decision can only be made after it has been given sufficient time to carefully analyze all the information and its available options. This can only be achieved successfully when people have plenty of quiet moments alone to really think about the specific problem. Those who are always busy doing something all the time rarely have this opportunity, they are always in a rush and don't have the habit to utilize the process or pattern required for analytical thinking. Just like how everything in life is a trade off, if you don't dedicate adequate time for thinking tasks, you cannot expect to formulate quality decisions.
If you are heavily medicating with caffeine, then that can be a signal. I was using Pseudoephedrine and caffeine to self medicate and stabilise my moods and behaviours. That was before I got prescribed Ritalin.
But as the article says, I find Ritalin dulls my creative thinking and pattern matching that is required for insightful realisations.
Rejection Sensitive Dysphoria is big problem for me. I over think things, the slightest misread comment can ruin my day.
I also have a problem with cyclical depression and euphoric highs that are a bit like bi-polar but not as severe.
So yeah - It's hell. I hate having ADHD. I never looked for a diagnosis, but when I got one it was a light-bulb moment. Life still sucks. It's not a super-power and I'm not blessed.
I am a recent adult ADHD diagnosis recipient, and I never knew that there was words to describe this but it describes me perfectly as well, so thank you for the knowledge kind stranger.
I ditched my Ritalin for similar reasons, although I do have a hunch Adderall would help me better since the one time I took it recreationally in college, rather than "get me high" like it was the other college kids, it sort of just made me well..normal. I got my homework done that day according to schedule!
Adhd is absolutely widely misunderstood. It fucks up and affects so many parts of my life, from inhibition, impulsiveness to emotions and motivation. I overthink everything, my mind gets trapped focusing on completely wrong thoughts and don’t even get me started with RSD (Intuniv / guanfacine treats RSD by the way but it’s not available for adults where I live. Look into it!) . The more I myself learn about it, the more I realize how completely mislabeled the name “adhd” for it is.
I agree with you, adhd is hell. I would pay a lot to get rid of it it if I could. Stimulants somewhat help with the focus part but that’s about it. I’m even self experimenting a lot with other medication like MAOIs and antidepressants that have some studies related to adhd done on them them in the hope to find something that works better than my Ritalin.
TSM is another thing that has a 50% success rate in “treating adhd” but it’s not enough evidence for me to shell out this much money.
I just don't know how to make them get it. I feel like I have so much potential for success, but I can't harness it.
However, I can imagine that some aspects of ADHD - notably the hyperfocus - can be considered a positive trait, something that is hard to let go of. And that's fine, if you want to have it you can skip the medication just fine.
However, you also mentioned RSD; my girlfriend described that the medication she's on helps a lot with daily mood swings. She seems a lot more patient and resilient about small things in the day now that she's on the medication. Do consider it if you find yourself struggling in e.g. the workplace.
But that person was actually diagnosed with "Sensory Processing Disorder".
I'm glad that people are more aware of ADHD and because of that receive proper medication. On the other hand the symptoms of ADHD can be very similar to other disorders. Many neurological problems overlap and someone having a dysfunction in one area could also have a dysfunction in others.
So to all commenters in here, be aware that a label of ADHD may only be a part of the full picture.
Does tea count? I dislike coffee; I only drink some when I absolutely need to stay awake (caffeine in energy drinks is another thing, this I like). But ever since I was a kid, I've been drinking ridiculous amounts of black teas every day, on the order of 10-15 cups. I ask because I keep hearing that the stuff in tea is pretty much the same thing as caffeine...
It's on the level of the pot head in your team telling you "Dude, you're my hero, I've never seen someone not give a fuck like you" because he noticed you were not paying attention during a meeting.
Everybody is losing focus in school, sure, everybody is losing their school items, sure, but not everybody sits on a test and then goes home with the test in his backpack, instead of submitting it, right?
How many times have you boarded the wrong train or buss?
How many times have you booked and airplane ticket with the wrong dates?
Does everybody mess up their invoices on a regular basis, until it stresses you out enough that you triple check it every time?
Do you only perform while anxious?
Have you ever tried stimulants? I have and it was a HUGE "AA-HAAA, so I guess the chatter in my head is gone, I can sit at my desk for 2 hours straight, my pulse has gone from 90bpm to 60bpm, I'm completely calm, I guess this is how normal people feel everyday? "
Sort of. I have no problem paying attention in a meeting in which I might be called on because of the terror of getting called on and not knowing what was asked (that happens to me a lot).
I find it very difficult to listen to podcasts. My mind drifts off and I realize I haven't heard the last 20 minutes, so I rewind. On good days, I can make it about an hour before I start drifting off. On bad days, I'm lucky to make it through 10 minutes.
> How many times have you booked and airplane ticket with the wrong dates?
Never. I'm hypervigilant when traveling by air. I only board the wrong bus if I'm really distracted, like I'm in a conversation either in person or online and I'm focusing on that instead of where I'm going. I'm the kind of person that really has to focus on where he's going. Even when I'm driving, I'll miss turns if my passenger is talking to me.
> It's on the level of the pot head in your team telling you "Dude, you're my hero, I've never seen someone not give a fuck like you" because he noticed you were not paying attention during a meeting.
I've had people tell me that after meetings before.
> Have you ever tried stimulants?
I've never tried stimulants stronger than red bull. I have noticed that large doses of caffeine calms me down. It's a fairly common occurrence for me to drink an espresso or red bull before bed and having no problems sleeping.
I've boarded a wrong tram a few times. I never did book an airplane ticket wrong because it's a high-stakes thing that I check 20 times (and then few more times next day) just to be sure I didn't screw up. Whenever I feel there's a chance to make a mistake that would be inconvenient, I'm fixating on it and doing it really extra careful - therefore not making the mistake. Same with invoices; I wrote myself software to calculate and I still check everything with a calculator before sending the PDF off.
Depersonalization/feelings of emptiness -- I do experience those occasionally because those are part of BPD, but they've gone down significantly over the years and I have a pretty stable life right now.
The bad thing for me is if I'm well rested/not anxious I'm usually not interested in doing anything at all; it's just my hypothesis that anxiety is my high-functioning mechanism for my ADD.
While on certain stimulants (they're not all the same) things just click and I am very calm, zero chatter in my head, I feel a bit dumber than usual, but I also can just focus and do meaningful things. Other stimulants make me euphoric and while I can focus I can easily end up focusing on the wrong things; on other stimulants I'm more anxious than usual, more driven and still better able to focus; unfortunately I live in a country where adults cannot receive stimulants period, let alone find a psychiatrist who's willing to play with stimulants/non-stimulants, dosages and so on.
It's also much more difficult to maintain their attention on things that are no longer stimulating.
So ADHD folks are great at starting interesting projects, but once the space of possibilities has been narrowed down and all that's left is hammering it out, it becomes intensely difficult to maintain attention on that due to lack of stimulation.
Dr. Barkley’s talk completely altered my understanding of the disorder. I always knew I had it. My life roughly paralleled the author’s. After failing out of school, I found workarounds that got me through the second time (thanks to extremely supportive parents).
This video, combined with my wife’s urging, caused me to find a legitimate doctor who specialized in it (he’s ADHD too), and get treatment. I was already doing well with my coping mechanisms, but my life took off like a rocket with treatment.
If anything in the article or the comments resonates, I would watch this ASAP: https://m.youtube.com/watch?v=SCAGc-rkIfo
After watching this video, and almost being moved to tears with how accurately everything in it described my life, and seeing your comment about being better off with treatment, I am convinced I should finally try something.
I too have been able to cope, but I would love to live beyond just coping and I am realizing it is only shame and pride stopping me from getting help, and fear that meds could make me worse or I couldn't find a good doctor.
(It's not that I'm not suited or capable of doing the writing part of blogging; I make a living ghost writing other people's blog articles and ebooks.)
The rapid dialogue means there’s no opportunity for intrusive thoughts to enter, but I know it all by heart, so there’s zero intrigue in any of it.
This is not something that most people have problems with?
>28% of individuals with ADHD repeated a grade compared with 7% of controls (p< .001).
https://www.ncbi.nlm.nih.gov/m/pubmed/23382575/
You can find many such studies about ADHD that find that people with ADHD just do worse in situations that require sustained attention and persistence.
Yes, all of those things are classic ADHD... But they barely even scratch the surface. That's just the "haha" relatable stuff. Time management issues are real.
ADHD is, in essence, making a list of all the things you need to get done, placing the list in all areas you frequent as visible as possible, and then wondering how 16 hours went by and you're still on item #1 but now you know a whole lot about lizards that you didn't before.
ADHD is also the reason you can get work done for 16 hours straight without distractions.
The overdiagnosing of ADHD is only making things worse because it prevents some people from understanding when they need to make real lifestyle adjustments... both people who hide behind the diagnosis and people who refuse to take it seriously.
In today's world of hyper-distraction this is becoming all the more pertinent. ADHD can affect people of all walks of life and level of intellect, and it can be paralyzing as an adult with the amount of sensory information present in today's society. And we still aren't even sure what environmental factors if any can cause ADHD... for all we know modern society is contributing.
> ...even short-term engagement with an extensively hyperlinked online environment (i.e., online shopping for 15 minutes) reduces attentional scope for a sustained duration after coming offline, whereas reading a magazine does not produce these deficits
https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20617
Overdiagnosis is real -- being a developmental disorder, ADHD people present age-inappropriate behavior -- "you're too old for this." A lot of people simply grow out of it (although, the ADHD brain typically reaches maturity around the age of 35, so, it can take a while). But many people never grow out of it, so underdiagnosis of ADULT ADHD is real.
In most countries, however, underdiagnosis is the real issue in most countries. I'm in the Netherlands and I went to a school for special children and talked to half a dozen therapists over ten years, and not one of them even considered it, while it's one of the most common disabilities, and considered one of the easiest to treat. I went to my GP and she had no idea about it, I basically had to explain the diagnostic criteria to her myself. It's possible I've just been really unlucky with the last 10 professionals I went to, but I think it's representative of the attitude in Europe -- especially the farther you go south and east.
For me, the meds have a simple to describe effect: the amount of mental energy I use to concentrate goes down greatly when the meds are in my system.
I did some of my most innovative, creative work early in my career, before the meds. This was due to a number of factors, and I've done some pretty innovative stuff since, but not on that same level. (A big part was being in the right place at the right time.)
But there was cost: even though I was in my 20s, coming home after concentrating for 8 or 9 hours, even after a full night's sleep, I would need to take a nap before finishing my evening. Many hours of concentration just drained me, because it took so much energy.
The meds have changed little, for me, except allowing that focus to cost less.
I know you didn't ask me, but as somebody who just realized he could have a mental illness, the thing that terrifies me most is being branded. Technically, on the books, ADHD is an incurable mental illness. That means, once diagnosed, you're forever mentally unstable in the eyes of both the law and potential business partners.
I doubt I'll bother to get officially diagnosed. The risk is too great and the upside too small. I've been coping this long with it and now that I know what I'm dealing with I can find ways to cope with it even better.
Talking to a medical professional was eye opening. It's worth having he conversation, at the very least. I was very skeptical after being diagnosed.
Then I forgot to renew my prescription the other week and it was utter chaos. I can't believe how much focus and discipline I used to lack.
I get that these questions can be gamed if you're just seeking a prescription, but in my case I'm generally quite hesitant to take these sorts of drugs. I have close friends who had many very messed up years due to struggles with ADHD medication.
Now I feel like I'm living life with my eyes open. Far from perfect, but I am able to have ownership of my issues.
And absent minded. And flighty. Thats why the homework never got done. Can binge on a video game for hours and hours, with a singular, obsessive focus. Therefore, no attention problem, right? (WRONG!)
Talk to a doctor. Do be wary of the temptation to explain away all these failings that you presume are choices... thats always a very attractive scenario... but get a professional opinion.
Can you elaborate on that? Why is it wrong?
I've thought about this topic a lot in the past. I remember back in the day I had massive gaming sessions (like 10 hours a day for weeks). Games that are competitive and "skillful" too, not just lounging around playing them 1 handed. It required tremendous focus.
But when playing a game, you often have only 1 task happening which is "play the game", there's nothing distracting you and it requires your brain to actively be engaged.
However if you replace gaming with writing a 5,000 word blog post or creating some web app suddenly that focus isn't there. If you can focus during the game, why can't you focus outside of it?
Hyper-focus like that doesn't mean you have ADHD - but people often use it to rule out ADHD as a possibility, and never get tested, when maybe they should.
Video games are highly stimulating and full of immediate feedback when you do well or poorly. This gives you the dopamine hit that your brain is searching for. And the immediate feedback means that the results of your doing well or poorly are felt right away, instead of in a nebulous future.
So you can focus during the game because you're getting a constant stream of dopamine and you always know how well you're doing. Get to the blog post though and... where'd the dopamine go? If you don't write this blog post right now when will you feel the pain? If it's not for a while, then it's too far away for the ADHD brain to put it into perspective because of the time-blindness. It's one of the reasons ADHDers are famous for procrastinating til the last moment, then suddenly cranking out that paper the night before. Once you finally get that sense of urgency of the impending deadline, you can focus.
It's deceptive; from the outside games seem like a single task that you can just focus on, unlike those other single tasks. But games are usually made up of a lot of things to keep track of, remember, etc. and it oddly works well for ADD/ADHD since you repeatedly switch focus between them all, something we're actually great at doing.
Take a competitive game like Overwatch: there's the general things to focus that any FPS has, but you also have to keep other things in mind like: map layout, your own positioning, ability cooldowns, enemy positioning (where you remember them and where they're likely to be next), the objective, whatever strategy you or your team have, etc. Instead of being distracted off the single task of "playing Overwatch", you're actively switching between the different phases that make up "what am I going to do next", even if you don't notice it.
Conversely, if a game is going slowly, you might get distracted and wander off looking for something more intense to do -- like killing an enemy -- and get yourself caught out of position.
Or in a PvE-multiplayer/single-player sense, consider raids (10-20man group vs. 1 boss) in MMOs: you have your own character's attack rotation to do, but also the flow of the current boss to think about: incoming spells, curses/debuffs to watch for, positioning, next objective (if the boss is more phase-based rather than just repetitive attacking), etc. If you're a melee character positioning and moving might be a constant thing to focus on, too. Even if you're already used to it and it's automatic to you, it's still something your mind actively thinks about and switches focus between.
Even in a game that has much less mechanics going on, your ADD/ADHD might just switch focus between the game's visuals, just as you physically get distracted by things around you (except this time they're the in-game environment and not distractions, but things the devs intended for you to interact with).
TL;DR: A video game isn't a single, coherent task that goes from A-Z, it's a giant collection of many tiny repeating (but not necessarily repetitive) tasks that you constantly switch between, like a processor context-switching between processes. And that plays into ADD/ADHD's pros rather than cons.
I failed freshman composition 3 times in a row since it was the only class where tests were not part of the grade.
As an adult, I find that laziness had become a learned behavior. I was smart and generally easy-going meant that none of my K-12 teachers were willing to flunk me, but getting an A seemed out-of-reach. This meant that I could "get by" with minimal effort, while intense efforts didn't result in obviously visibly better outcomes.
I eventually found a good therapist (though Sturgeons law[1] definitely holds for therapists) and have been sorting things out since.
As far as "getting by" and laziness as a learned behavior, I always worked hardest on my hobbies throughout K-12, so as an adult I've gotten to the point where my hobbies have become my careers. I started building PCs and running Linux on my own in High School, along with playing music, so now I'm a software engineer/musician. Software is one of the few careers where you can go on an insane research binge on a whim and actually be praised for it, and performing music is one of the only things that I've ever done that fully quiets my mind. Something about the adrenaline of being on a stage really helps with my ADHD-Inattentive type; guess it's just like a stimulant.
"Do what you love and you'll never work a day in your life", etc
Having the correct label helps some people get their uncooperative body to be productive enough to make life suck less. Just calling it "laziness" generally suggests zero real remedies and often leads to the beatings shall continue until morale improves.
The fact I may have an incurable mental illness (and that I could be branded as such) terrifies me.
That's probably sugar, not caffeine. Sugar is a much stronger drug than caffeine. Try coffee, not red bull.
How do you KNOW that adhd is “overdiagnosed?” Are you a clinical psychiatrist? Or a clinical researcher?
Probably not. You just saw some article written by a person who doesn’t specialize in the area. Who doesn’t have access to the full data, nor have any exposure to what’s REALLY going on out there.
You don’t know. You just think you know because you saw some Netflix documentary about teenagers selling adderall pills.
Remember selection bias: the narrative comes first and then we filter data to fit our idea of how the world “is.”
Nominally what this means is people avoid getting treatment that could make a real difference to their life.
https://slatestarcodex.com/2014/09/17/joint-over-and-underdi...
The human mind can only concentrate on a few things at a time even when "multitasking", and it cannot concentrate on anything else when working on a complex, concentration-oriented problem. Respect how your brain works, even if it goes against your ADD instincts. (Example, from a book on how thought works... you can concentrate on multiple things while driving, but you can't concentrate on multiple things while computing 57 x 432.61 in your head. There are two modes to thinking; one allows multitasking but limits complexity of individual tasks. The other allows deep complexity, but at the exclusion of thinking of anything else.
So those 52 tabs? If you try to think about all of them, you can't think about any of them in a meaningful way. Pushing things off your plate is the most fundamental defense mechanism the ADD mind can have. Have one tab open. Or two or three. Finish what you're doing before trying to do something else. Don't let the squirrel do the thinking for you. You can outthink the squirrel.
> I'm seeing a disturbing pattern take shape.
I fall into alot of the list but I will say I do not suffer from ADHD.
When I was at school I was told I had ADHD and put on Ritalin. But I couldn't tell the difference between taking ritalin and not taking it, I didn't focus any better, didn't get in trouble any less.
I always figured I wasn't challenged enough in school, or wasn't doing something I enjoyed.
If I was doing technical drawing I always got top of the class and helped the other kids with their work. In History class we learned about NZ history which is like 150 years of nothing, so I couldn't focus, yet you give me a book about Egypt and I'm fascinated and sit for hours reading.
Fast forward many years and I watched: https://www.ted.com/talks/ken_robinson_says_schools_kill_cre...
ADHD is a real thing, but I recon majority of people 'diagnosed' with ADHD, don't actually suffer from it. And I don't believe the Author suffers from it.
While I like Sir Robinson's talk, for me The Seven-Lesson Schoolteacher is what really struck a cord: http://www.swaraj.org/multiversity/gatto_7lesson.htm. I always felt like the school system (in Sweden at least) mainly wanted to students to fit into it, rather than the other way around. So as someone who is gifted according to WISC and WAIS, but who lacks the executive functioning and skill to do anything except whatever happens to be the most interesting at the moment, it was just hell. Even now at age 36 my body goes stiff whenever someone mentions homework O_O
The author was diagnosed after multiple sessions with a medical professional.
Yes, and we also know that medical professionals can also misdiagnose ADHD...
I know for me, I went to my dream college and studied exactly what I wanted to study, yet I couldn’t keep up. I went from getting mostly As in high school to eventually failing out (later to return). I was under immense psychological stress and couldn’t get myself to do basic things. I was always overwhelmed. I couldn’t and still can’t be in social situations when loud music is nearby. I’ve essentially had to reshape my life to work around this. It made me nearly non-functional.
And years later, now that I’ve built my life in a way where it works with my ADD, I can be incredibly productive and imaginative and innovative.
What about the second desktop?
My evernote and bookmarks are overflowing, though.
I feel your pain. I hate typing on phones; feels so inefficient. It is definitely good to not have the 50 tabs problem mobile too.
wait, aren't we all like that?
However, actual ADHD, and other similar attentional or executive function impairments are very likely to be under diagnosed BIG TIME.
Two great reliefs came from the diagnosis:
1. I’m not a lazy, unmotivated person
2. Meds, at the right dose, are amazing. When my Vyvanse kicks in, it’s like walking away from an outdoor block party in my brain and getting into a sound proof booth where I can hear only the noise I want (or have) to.
Things I lived with my whole life that were both positive and negative depending on the circumstances:
- I can’t even stand the thought of a task, class, or activity I’m not interested in, but if I’m even slightly interested I can go deep fast and keep going with no loss of zeal until I’m satisfied. Basically, I can get super obsessed with stuff for short or long periods of time. My hobby background is ridiculously all over the place.
- I think and iterate my thoughts faster than most people can keep up, and I iterate my thoughts externally, if I’m on a roll good luck getting a word in between breaths. My psych “classified” me as a second order thinker and I run lots of what-if permutations and shave and shape creative solutions very fast. It also means I must be extremely cognizant of letting other be heard, especially those that like to ruminate on an idea and bring it to light more fully formed.
- My leg never stopped bouncing, helpful when I played music to keep time, annoying to anyone near me.
- I’m quick to temper and just as fast back to moving on.
- Little to no patience for bullshit or things I just am not interested in. Don’t tell me a detailed story of how to get there, just give me the highlights. I do t care about how you feel about some objective thing, just give me the facts and let’s keep moving.
Lots of other stuff, but basically I coped, unknowingly by creating rituals that allowed me to not forget or have to waste time finding things:
- Get home, keys and wallet go in the exact same place every time
- Todo list for next week created at the end of every Friday, revised at the end of every week day, and reviewed every morning
- The thing I want to do least is the thing I force myself to do first, and nothing else until it’s done
- Organize my schedule in a calendar, if it’s not in there it doesn’t exist and I won’t remember
- Just remembered to put that thing in the car for tomorrow and I’m laying in bed? Get up RIGHT NOW and go do it.
- Can’t forget your coat if your car keys are always in them
- My working area is spotless. No bobble heads on the desk or stacks of papers. Desk is completely clear, cables neatly organized, zip tied, and hidden.
Here’s the thing, maybe you do have ADHD. Maybe you don’t. The rituals you focus on and make so habitual you don’t even have to think about them will still work for you.
1. Lazy - CHECK
2. can’t even stand the thought of a task, class, or activity I’m not interested - CHECK
3. My hobby background is ridiculously all over the place - CHECK
4. My leg never stopped bouncing, helpful when I played music to keep time - CHECK. Literally air double-bass drumming to some really high tempo progmetal as I type this.
5. I’m quick to temper and just as fast back to moving on. - 1st NEGATIVE
6. Don’t tell me a detailed story of how to get there, just give me the highlights - 2nd NEGATIVE
7. I'll take a break to read an article and hours will go by before I realize what's happened - CHECK
8. I'm horrible at completing simple, repetitive tasks. I'm terrible at time management - CHECK
9. Lost hours / while day at a time when I was doing something interesting - CHECK
10. creating rituals - Literally follow 90% of the rituals you already mentioned.
At this point if I was diagnosed with ADHD, I don't know if I'd be annoyed or relieved at the revelation.
But who is?
This is one of the problems in modern society, the concept that if you're not interested in something then you can skip it and find a medical excuse.
No-one ( generalising ) likes doing tax returns or washing dishes, but you need to look beyond the immediate discomfort to the longer-term benefits. That is self-discipline, not some magical superpower.
That can end really badly; I'm glad it's worked out for you.
I should probably see a psychologist someday.
Source?
My brother as an adult was able to self diagnose and just try adderall(or was it ritalin) since even non-ADHD people get benefits concentrating with it, and yeah that worked out well for him, he doesnt continue using it and can approach professional work more holistically. I would attribute a lot of his academia challenges and underperformance to undiagnosed ADD/ADHD. Works great for the coked out party scene though. Got to swim in the right environment.
I dont have the above experience, but I did take an in person class at a college recently. Havent otherwise done formal education in almost a decade. The first couple of sessions I was fidgeting and couldnt stand sitting still, which was shocking to me but I got acclimated after that. I cant imagine what children are going through, I think our environment isnt helping
I were in ADHD tests but I was told I may just have "small_brain_clipboard", never heard anything back..
...........
It's also worth noting that in France, ADHD is seen as a problem with a child's environment instead of a medical issue[1].
[0] https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...
[1] https://www.psychologytoday.com/us/blog/suffer-the-children/...
https://www.bbc.com/news/magazine-17583123
https://www.theguardian.com/world/2018/feb/08/france-is-50-y...
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
Context and history is just as important.
There also seems to be a huge divide between the US and Europe, where such disorders seem to be diagnosed way less often. It has always appeared to me that many people in the US are more easily considered mentally ill when they do not fully conform to society's expectations, and at the same time the people who suffer from severe mentally illness are less cared for in the US than in Europe. Or maybe that's just how the media portray it.
I have been to multiple (European) therapists who had just your approach and had no idea about ADHD. For years.
In the end, I knew all the techniques for getting things in order, just couldn't follow up on them, and wasted tremendous amounts of my life trying to do things. (Not to mention gaining ~30kg, because I instinctively ate a ton of sugar - which has a similar dopamine-inducing effects to Ritalin, just with calories and not as long-lasting)
After taking one pill I was able to finally get myself together.
So basically the reality of my life is not subject to your opinions. Stop projecting your value system onto other people's lives.
I have many of the traits in the article, and find some of them weigh very heavily. I think one of the reasons for that is that I'm easily distracted, and computers are terrible for people like me because I'm just a couple of clicks away from watching an effectively infinite collection of sports highlights, reading newspapers, looking at photos, cat videos on YouTube etc. etc. A concrete example is writing this comment when I really should have my head down in a project that I'm working on.
I think I would be much happier in a job where smartphones and computers aren't involved, like working on a nature reserve. I can't make that change quickly - I run a small business with a couple of colleagues and support a family - but I'm starting to turn the tanker towards a life like that because the effort involved in managing the bureaucracy of contemporary life takes a lot out of me. And I've actually got it pretty easy in terms of flexibility and pay, like many of us on HN.
It's rather like a milder version of RD Laing's idea that it's not people who are mentally ill, but society that's ill. I think that's taking it way too far, and there are obviously people who have extreme versions of personality types who would be distressed no matter what the circumstances - but the point stands that our psychology hasn't evolved to withstand the pummelling that it gets from the attention economy.
Whether the behaviours and feelings that we define as ADHD are natural or not has no bearing on the fact that people who present them can be very adversely affected as individuals. Good health is best defined in terms of adaptation to one's environment; if modern society has been built by and for the 90-95% of humans with no ADHD symptoms and that has a detrimental effect on the 5-10% of those who we define as having ADHD, then it is a legitimate and genuine disorder.
We can theorise all we want about the evolutionary origins of ADHD or whether a different society might ameliorate or eliminate the symptoms of the disorder, but people with ADHD who are born today into this society deserve the chance to live a healthy and productive life like anyone else. The fact that certain medications and therapeutic interventions are so demonstrably effective at improving the quality of life for people with ADHD means that refusing to recognise it as a genuine disorder is actively damaging to them.
The main problem is in the name. People fixate on the attention deficit aspect of the impairment because it's right there in the name, however an attention deficit is simply one of a number of symptoms that are caused by ADHD.
ADHD is a developmental disorder that results in a generalized impairment of ALL executive functions. This includes the ability to purposefully direct attention, to modulate emotions, and to perceive the passage of time. It also impairs ones ability to hold an inner monologue, or 'voice'.
There are also other psychological illnesses that may present as "co-morbidity" with ADHD because of the detrimental effects of ADHD on ones quality of life, such as depression.
It is know that the disorder has an unusually high correlation to heredity, and no environmental causes (save one virus which may causes a similar executive function impairment). It is absolutely clear that it is an inherited disorder. It is not caused by modern society and constant interruption.
The quotes around “suffering” imply that you yourself might not even know everyone around you suffers, i.e. you’re suffering by proxy, but you’re the one causing it.
Everyone can relate to specific “symptoms” of ADD/ADHD, the question is: can you control the impulses and is it affecting your ability to lead a “normal” life.
Normal here means looking after yourself and potentially other members of your family.
Honestly, in a way it’s like being in a state of arrested development. Staying a child and having your brain work against you in progressing.
Things that for many is effortless takes a huge amount of energy and leave you drained for the rest of the day.
In a way I’d like to say it’s about growing the hell up, only it doesn’t happen by itself like it should. One might need to retort to assistance, be it medical or mental excercises.
In a way I agree with what you’re saying, there are nuances to it though.
I got suggested to get tested after failing out for the second time and the testing showed very much lower than average sustained attention. I never myself thought about getting tested since I did really well at a lot of tasks and just couldn't figure out how to micromanage all the weird administrative tasks of every day life. If I didn't have to do those everything would be going amazing, but instead it's sunk me into (small) debt and a period of homelessness a few years back.
I think a lot of people in the EU (where I am) would have gotten diagnosed if tested, but we seldom test school age children who don't have a very hard time in school. If you do somewhat ok or manage it seems odds are you can go undiagnosed forever.
Half this thread is people saying, omg I just thought I was lazy, I guess I should start taking doctor prescribed amphetamines now.
Both are terrible solutions in their own ways.
The brains of someone with ADHD (assuming correct diagnosis) are different from NTs, akin to people with autism.
AFAIK the latest scientific research points at that ADHD is just one of the many variants on the autism gene. But I don't have a source at hand right now, so grain + salt.
I don't know how true this theory is. There is some evidence for it, because ADHD is very prevalent, but at the end of the day it doesn't matter why people struggle. What matters is that they do and we have the tools to help with that.
A big reason for the divide between Europe and the US in ADHD is that Europe usually uses the ICD, while the US uses the DSM. The DSM seems to be less strict about the criteria. It's probably also the case that many Europeans, particularly in former Soviet states were never tested.
[0] https://en.wikipedia.org/wiki/Hunter_vs._farmer_hypothesis
As for whether ADHD is disordered, there is evidence that it was a positive adaption in more primordial settings. Greater distractability may have equated to faster response to predators or more success in hunting. However, to be a disorder, a condition simply needs to be presently maladaptive. In modern society, ADHD typically is.
Saying “oh mayyyybe ADHD isn’t real” makes no sense unless you believe all mental disorders are fake.
I think things like diet, food additives, busy society, and work demands make it impossible for people like us to function well.
I know for me at least, I live a pretty unconventional life so I can thrive in my own way. I’m often up very late. I’ll obsessively work on something and neglect others. I’ll be late to things. I can’t do big social environments and I definitely can not handle stuff like night clubs. I need a lot of alone time to sift through all of the data that has bombarded me. It’s taken me years to figure out. But as I craft my life to work with my oddities, I become happier, healthier, and more productive.
I think for me, a better description than mental illness is “neurodivergent.” Because if I build my life in my own unconventional way, I might be able to thrive. And then when I get put in situations that don’t work for me, I become textbook mental illness.
There's physiological differences in the brain though
https://en.wikipedia.org/wiki/Attention_deficit_hyperactivit...
In the US it's extremely popular to give your kids speed if you're a bad parent so it's overdiagnosed. I will agree that it's more of a natural variation than a dysfunction. I don't really understand the details but I've heard smart sounding people comment that something or another about it's genetics implies that there is probably a net benefit to society or it would have been bred out by now.
Because of this, it's not unusual for other conditions to cause people to experience similar symptoms to those with AD(H)D. The main difference, is that for people with AD(H)D, the symptoms are chronic and disruptive.
Many symptoms caused by the executive function component can also be experienced by those who have theirs inhibited. This can be because they are: tired, stressed, drunk etc.
When reading this or other articles on AD(H)D, if you resonate with the symptoms I urge you to read up and potentially get diagnosed.
Just please don't assume that "everyone has some kind of ADHD" or that "ADHD is't real" because some symptoms are shared by other conditions, and can often seem like regular parts of the human condition.
Things that aren't "can't focus" that are symptoms of ADHD:
- bad temper - speaking before thinking (followed by immediate regret) - often making spur of the moment decisions without thinking of long-term consequences
The overarching thing being that lots of people with ADHD do things _despite knowing on a rational level that it's not a good idea_, because that thought usually isn't loud enough to actually stop your actions (at least not fast enough anyways).
There's always a bit of "yeah everyone has that" when you talk about laziness and lack of focus, making it feel a bit like an unfalsifiable diagnosis. But there's a lot of people who most definitely don't have bad temper issues or go binge drinking all the time (Though this isn't everyone with ADHD either of course).
The symptoms you describe are impacted by the two elements I described (executive function issues and dopamine regulation).
People with AD(H)D have issues with regulation and executive function, which can lead to issues in how one controls themselves. This can lead to the issues of controlling oneself that you describe.
On top of that, dopamine (which is more accurately a "motivation hormone", which creates the desire to do things) is different in AD(H)D brains. Basically, people with AD(H)D will get a dopamine kick from certain types of behaviours, and not from others. This can result in the relative importance of tasks being very different from neuro-typical ordering. As a result, addictive behaviours can be more common (especially for things like video-games), or also the prevalence of hyper-focus that people with AD(H)D experience.
I agree with your last paragraph fully. The lack of understanding around the condition can lead many to make uninformed actions and opinions that can be harmful to those with AD(H)D, diagnosed or not. This can have negative impacts on patient mental health, and is the reason why people should be more aware of this oft misunderstood condition.
I have my own personal hypothesis that some types of ADHD are caused by persistent stress due to sensitive sensory reactions. Also, another hypothesis of mine is that some may just develop similar symptoms with enormous stress factors (e.g. no proper caregiving at early age, or PTSD). Is there any literature that corroborates or disproves such hypothesis?
What do you mean by symptom-based diagnosis? Most ailments are diagnosed by their symptoms. If you mean diagnosis by measurement of specific chemicals/etc in the brain, I've heard of some studies that show that you can diagnose ADHD through brain scans[1]. Just because there's symptom overlap doesn't make the diagnosis moot. Both allergies and the common cold can result in similar symptoms, yet we still diagnose them separately because they are not the same thing. Yes, depression and ADHD might have some similar symptoms caused by their own unique effects on dopamine in the brain, but they are both much more complex than that.
> I have my own personal hypothesis that some types of ADHD are caused by persistent stress due to sensitive sensory reactions
Given that ADHD has a very heavy genetic component, I am inclined to disagree. However, I did find a paper[2] that indicated a link between socio-economic factors and ADHD. The causation/correlation is not particularly clear in the paper, but it could be interesting to look at.
[1] https://www.medicalnewstoday.com/articles/315884.php [2] http://www.academicpedsjnl.net/pb/assets/raw/Health%20Advanc...
This. When I am highly stressed I look like I have AD(H)D. Or ASD. When I'm not, I don't.
We don't quite know how to pursue ἀρετή, virtue, eudemonia, excellence, whatever you want to call it in life because modern life was built for another kind of person and the animal life we left behind is far gone. Advice about "fixing" ourselves is mostly about finding effective ways to fit square pegs into round holes (like Adderall)
The ugly thing I've found, which accords with what you have said here, is that the best treatment for me is as many hours of sunshine as possible and several hours of vigorous exercise a day. (Thanks for teaching that, Marine Corps.)
But of course there are very few jobs with security, brain exercise, and mobility that give me this, and essentially no jobs that are compatible with it (that it is, where I could take this time off per day and still retain a job).
So of course I use medication and stick with jobs that drive me nuts, jobs that are terrible for me but pay well. I feel for the ADHD people who weren't gifted as decent a brain as mine, as if it weren't for that I doubt my employers would have been as indulgent of my other flaws from ADHD.
PTSD. Constant stress. Having trouble just keeping promises to friends. Failing to even keep up a hobby. The inability to control your own concentration.
ADHD most definitely sucks.
Adderall isn't going to do anything unless you are actually functioning suboptimally. It will, however, most certainly decrease your attentional/executive performance if you are at an optimal state. Look up the U-shaped response curve.
No matter how you live with ADHD there will always be distractions pulling you away from what you need to do. There will always be things you should remember but don't, things you should have done at a specific time but were distracted and forgot.
It doesn't matter what society you live in or what the cultural norms are, those of us with ADHD are lacking some basic functions that makes life harder. And it sucks.
I’m so torn on it. On one hand, it makes me so productive, but on the other, it makes me so unemotional and cold and abrasive.
It also makes me sweat, increases my heart rate, and has a terrible comedown when taken often.
I was diagnosed at 16 and was on it for years, eventually moving up to 4x the dosage as my body grew resistance.
I’ve stopped it for the past couple years, and now am back to the lowest dosage on rare occasions I take it, but still unsure how to feel about it.
IF you are working from home with minimal contact, it works. Never EVER answer a phone call when you are on it (this is to whoever planning to use it in the future). God knows, how many times I argued with a client just because of Adderall.
It forces anyone using it to keep the communication to a minimum. And when a client calls (usually oblivious, but demanding), you will end up arguing at some point.
Adderall = never do anything social including phone calls. I am serious.
For me and I assume for others, it is not a fully adequate treatment. Some symptoms it fixes, some it helps with, some it does nothing for, some it actually makes worse. (In particular, impulsivity and inability to task switch accurately.)
Then there are the side effects, and the comedowns after tolerance builds.
Nevertheless you must still learn coping skills, still pursue other treatment (exercise, decent diet, sleep, CBT if needed), still struggle as the square peg.
I have used medication for roughly 5 years ish of 30 some years of life, intermittently. I'd say taking it is better treatment than not, but honestly, like you, I feel a deep ambivalence towards it. (Even resentment, sometimes.)
Adderall is not the only option; it didn’t work for me. It took a bit, and I ended up with Dextroamphetemine. The physical side effects dulled down to the occasional restless leg, and the mental effects work well.
Look up titration. The right doctor will help you dial this in and interview you to make the right call.
Honest question, I don't know much about ADHD. What's ADHD actually is?
But seriously, I agree with the square peg / round hole comments. I don't believe ADHD to be an illness because there are plenty of environments where I could thrive, the trick was it had to involve doing something I loved. Fortunately for me, I loved computer programming.
I can relate to this, and I think there's a potentially large underbelly of society, that many (most?) of us are walking around with undiagnosed personality "disorders" (let's say, traits) like ADHD, the autistic spectrum, agoraphobia, narcissism, sociopathy, and so on - maybe even ones we haven't discovered or classified yet.
The infamous DSMMD (Diagnostic and Statistical Manual of Mental Disorders) is a massive tome, where pretty much every member of human society can find a matching category..
Some of the bumps I’ve experienced in life probably would have gone smoother if this was made apparent to me years ago and I had the tools I have now to work with it.
What is exciting is that the wandering-in-the-dark of psychology is being usurped by neurology actually understanding how the brain works on gradually higher and higher levels.
Without my medicine I have trouble watching a tv show or movie I really like, I can't play some videogames because they can't keep my attention even though I'm having a great time. I'll normally listen to an hour long podcast over a few days because every 5 minutes I need to pause it to "focus" on something else (like I just did to write this comment), and often I don't come back to it (like I probably won't tonight!)
I wasn't diagnosed until I was 19 or 20 because my perfectionism (which was/is directly tied to the anxiety/major depression I was diagnosed with at 14, but self-diagnosed at 9) sort of overrode the traditional symptoms. I did well in school (because I couldn’t NOT have perfect grades). I excelled at work. For many years, I was compulsively neat. (I’m not really sure what happened to the neatness).
When I was 17, I was put on ADHD meds as a way to treat side-effects of an antidepressant, but I found it had a ridiculously positive impact on my life. In college, I was formally diagnosed, and my psychiatrist posits that the fact that I appeared to be “fine” is what kept me under the radar. According to my doctor, it’s not uncommon for that to happen, especially if the individual is of above-average intelligence (I was given the “gifted” label before entering kindergarten).
I always “joke” (except, it’s not a joke an I’m 100% serious), that I’m a high-functioning ADHD person. And it’s true; over the last 15 years or so, I’ve learned to augment my behavior and recognize when the disease is impeding on my life. For clarification: being able to recognize something != always being able to change what is happening. I’ve also been fortunate to find work in fields where my ability to do multiple things at once is useful.
But I tell people I’m in meetings with frequently about the stuff I do to help quell my worst tendencies (I play puzzle games on my phone, for instance, so that I can pay attention to what people are saying. It looks rude, but the alternative is me literally not being able to focus on what is being said. And when I explain it, I’ve never found someone to be unsupportive), and I try to plan and make adjustments for my own time clock.
Like you, if it’s something I’m interested in, I can be hyper focused for hours. But the second something is born for even just not that compelling, it’s a struggle.
Jesus, I did this a lot in my previous job, and couldn't explain it to my colleagues. Always felt so judged.
Keeping a task list is definitely key. I have a plain text file called "tasks.txt" open at all times and in the morning I'll list the stuff. I live by the "if it takes under 5 minutes do it right away" mantra.
Sometimes I'll end up working on a task, that while it does need to get done, is not necessarily the first task on my list (or on the list at all). So after a "distraction break", I check my task list again so I don't forget.
I am extremely good at figuring out issues. I'm a technical architect (programmer) and I often find myself going around and fixing others' issues quickly, but time management and attention to detail are definitely issues - issues that have been thankfully solved by technology and forethought.
It's the only thing I've found that keeps me reigned in to a single task and grinding down the work instead of wasting away hours.
Give the book a try. It changed my life (and I don't say that lightly). If I'm right, it might change yours.
Have you ever come across this article in the Economist, summarizing research providing evidence that ADHD is a legacy of our nomadic past when ADHD traits conferred an evolutionary advantage?
https://www.google.com/amp/s/amp.economist.com/science-and-t...
My takeaway is that entrepreneurship is one of the few areas of modern life where ADHD might actually be a help rather than a hindrance.
He explains it as not as much of an attention disorder as much as it is a time management disorder: we're nearsighted to time and all its constraints.
When I tried to look up whether ADHD could actually be a sleep disorder, I only found a lot of the reverse: Articles saying that people with ADHD often also get a bad sleep. But I certainly wondered whether the causation might be the other way around.
From what you're saying, sounds like there's evidence that it can be, at least partially?
I have a friend who knows a dentist. The dentist said that when he sees signs of sleep issues (apnea, but he might have seem more) in his patient's mouth, he recommends they get treated. And very often, if the patient had ADHD symptoms, the symptoms went away after getting the sleep apnea treated.
And lastly, yeah. I Also get a lot of ADHD symtpoms depending on my sleep quality/quantity.
I also can relate to the entire ADHD <> entrepreneurship affinity because I come up with so many "niche", interesting business ideas but I struggle to exceute. Some of these ideas could make me a lot of money too with minimal investment.
Right after college I co-founded a startup. I was looking for a way to avoid joining "the real world" of working people. I stopped taking the meds and was basically just hyperfocusing all the time. That first year there was only 8 total days I didn't go into the office to work (including weekends and holidays). I was able to use the hyperfocusing because I didn't have a family and didn't feel like I needed a life. That company was bought and a few years later I started another and went through the hyperfocusing stage again. I didn't even sleep in a regular cycle, I would stay up for 20-24 hours and then sleep 4-8. I was a mess, but it didn't matter.
Years later I now have a family and those habits won't fly. I have always remembered the advice my doctor gave me now 24 years ago, but it was only the past 6-8 years or so that I actually started applying it. It works very well in my case, but I know my case is not extreme.
I need to avoid carbs during the day. I need to get a good night's sleep. If I eat a salad at lunch I do not have attention issues. I now do low carb almost all the time and it has changed my life.
Do I actually have ADHD? Yes, I think so. But it's not an extreme case, and I find it to be pretty well managed with good diet and sleep habits. Exercise helps a lot too. Always try this route before drugs. It's not a silver bullet, but I believe it can help a lot of people that might otherwise look to medication to solve their ADHD problems in themselves or their children.
My curiosities when reading this article :
Did the psychologist actually fix the slipping grades in any meaningful way? If so, was it through pharmacological methods, or some other technique? If it was dealt with through prescriptions, and the grades improved at the sake of anxiety, is that (graduating college with better grades) worth it? If it's worth it, should that behavior be drug into life as a founder -- presumably due to some sort of advantage that those pharmaceuticals may provide, and the anxiety just dealt with somehow else?
These are all honest questions, if anyone cares to share their take on the situation with me. I've been in similar situations.
In the past I jokingly said I need the stress and I think it holds true. In high pressure/thight deadline situations I can work with a high focus for hours but struggle working on projects which are going smooth.
But you (and I) need to keep a few things in mind.
- Even if you tick all the boxes it doesn't mean you have ADHD
- If you're more or less leading a functional life already it doesn't matter if you have ADHD
On the other hand, whether or not you have ADHD, if you tick all the boxes, you might be able to learn helpful coping strategies regardless of your level of 'functional'.
At 33 I knew something was wrong with me. But I didn't know what. I always felt different than other people and I couldn't contain my thoughts and restlessness leading to mostly complete inattentiveness and a chaotic approach to life. At worst it felt like having my head filled with fleeting thoughts, like 3-5 radios next to my ears with music, different positive thoughts and ideas all at once.
I went to a private practicioner and got diagnosed with ADHD. The ritalin and later Concerta tablets have improved my life 10X. I have been able to streamline my career, streamline my life and I can truthfully say that in a way, it saved me completely. I am now employed in a Fortune500 company, making a small ton of money (relatively) and can sustain myself very well. I will be buying my first real estate this fall. But without it, I don't know what I would have done. Become a homeless, drug-addicted hippie in a third world country maybe?
There are trade-offs to taking it. (1) Emotional and energy depletion at the end of the day is one. I don't take it in the weekends, because I don't like the soul-less me that I become.
I am able to have laser focus and almost have an unfair advantage to others when I am working on something that requires intense attention to detail or having to speak on some complex subject.
Moral of the story: If you suspect it, get diagnosed and get medicines to help focus on the toughest of days at work and in your life. It is certainly a life changer if you are undiagnosed. Don't let ADHD waste your life away.
Do this self test to consider whether you should see a specialist (Psychiatrist & MD) to get the diagnosis: https://psychcentral.com/quizzes/adhd-quiz/
I don't know any details about ADD/ADHD, but I can relate to a lot of these symptoms. I never once thought I had ADHD, but it would make sense that something like this is a spectrum rather than a binary property.
For me, this was a really great article. Thanks for sharing.
I actually created an app to help my workflow specifically around the way my brain likes to jump between topics:
Part of the challenge I have with reading is that I'll be interested in something for a few hours and then my brain will be triggered with something I'm reading and my brain will switch contexts.
Then I'll want to read about some other topic.
With Polar I can jump around easier and take notes directly in the source material.
It supports incremental reading such that you can mark the portions of a document you've read and jump right back to them when you open the document a second time.
It's really a lifesaver for me honestly. I've definitely been able to get a lot more reading done.
Behind each of these success stories is a lot of people in the background, giving reminders, dealing with the person who has tuned out for half the meeting, excusing lapses, etc. I say this as someone with the disorder myself. (The author’s description of the “time travel” effect is on point!) I take those people in my life for granted to often. But reading stuff like this and seeing it from the 3rd person perspective is a good reminder.
Also worth noting that success stories on HN are subject to the survivor bias. (Not exclusive to the “entrepreneur with adhd” trope, of course, but definitely applicable.)
For me, seeing that infographic of how a person with ADHD tells a story was revealing. I had too many of those boxes in line.
> I'm horrible at completing simple, repetitive tasks. I'm terrible at time management, and conceptualizing time in general.
I loathe doing anything repetitive to the point where I simply won't do it even when necessary or "spend hours building an overly complex script to help me copy-paste 10 excel lines".
The threads that have stemmed from this quote has also made me realize there is a good chance I am ADHD and could only benefit by speaking with someone.
> spend hours building an overly complex script to help me copy-paste 10 excel lines
How is this not describing 90% of HN? The 2nd one is even the topic of one of the most linked jokes on XKCD (https://xkcd.com/1205/)
PS: I "medicate" myself with Weed. This helps me ordering thoughts a lot. Also it doesn't slow me down - quite the opposite.
Supplements that can help: - Good multi - CLO - Arginine AAKG - Creatine - Alpha GPC - Vinpocetine - Ashwahganda - Bacopa - Huperzine - Rhodiola - Uridine - Lyons Mane Mushroom
Lots of room for weirdos to do great things in this world.
1) Amphetamine 2) Minimalism 3) Start with small wins and scale up in tasks 4) Have a plan in place so you don't waste #1.
ftfy
I have yet to find an entire company with ADHD although, given the accretion of VC firms in the SF area, I hold the possibility open.
Couldn't make it work. Would get into loops of crunching all weekend to finish the work I'd committed to doing in the week. Became a shitty and irritable Dad due to work stress. Spent hours in loops like "This would be totally doable if I just started now ... but it hurts too much to stop thinking about what I'm interested right this minute ... but it's going to hurt later ... let's analyze all of the ways this is a repeat of my previous fuckups to see if I can figure my way out of this one ... and down the HOOOOOoooooooole"
Confounding factors: (1) trying to do school at the same time. (2) getting served with divorce papers when I thought I had come to terms with things. (3) Sleep apnea treated with CPAP. Impulsivity / exhaustion / obstacles at bedtime results in not using CPAP which results in greater distraction and higher impulsivity -> downward spiral for the week.
I learned a very valuable lesson, though.
You CANNOT fight procrastination by analysis. You MUST start the thing. There is no other solution. Any other choice is procrastination. Mantra: "You need to stop. What's your next action? What's your next action? ... " This seems obvious, but in the throes of an analysis / procrastination spiral it seems like maybe, just maybe you might be able to think your way out of this. NO.
I also started a new medication at the beginning of 2017 - generic Strattera. It didn't prevent these problems, but it has actually been a great help. There are side-effects, but I'm willing to accept them. I call it my "anti fuck-it" medication. It damps down impulsivity without reducing my creativity (impulsivity is the source of creativity). This is suprisingly multi-faceted. I am less likely to overeat (less likely to say I don't need more pie but fuck it!). I can do deeper search in strategy games or planning (less likely to look a few moves ahead, get befuddled, and say fuck it, I'll just do this random action). It also feels like I have another register of short-term memory, although this could be due to sleep, etc.
So ... don't rule out meds, but they're not a silver bullet. Also, the wrong meds can damage or kill you. I still have some interesting minor mental issues from Dexedrine a decade and a half ago. On it, I got paranoid and that almost killed me.
EDIT> One other tip: limit any online discussion to 1 reply. You get one reply, and that's it. Don't keep responding to a thread. It really doesn't matter, and is a huuuuuge time sink.
In a time of crisis, such as a last minute deliverable or an outage, I am probably the most productive engineer in my company. I churn out code like a machine, ruthlessly prioritize, scour our graphs and analytics tables for insight into what's causing the issues, and generally absolutely crush everything put in front of me. Diving into the analytical side has produced significant business wins in terms of identifying problems and implementing solutions that solved complex and hitherto undiscovered business problems to the tune of tens of millions of dollars.
But as soon as the crisis is over, a switch flips, and I can no longer sustain productivity. I have a bit of code I'm working on to improve a certain large download feature. I know all of what I need to write. I know every file by heart, how everything fits together, all relevant third-party and internal APIs, and how I would implement this optimally, including some fancy lazy evaluation and ringbuffer tricks that will make the whole flow more efficient.
But I find it very hard to keep contributing to it. It's just uninteresting once solved. On top of that, I work in an open-plan office and thus have the silence punctured by load conversation, video meetings that some folks have at their desks, and the visual distraction of people walking around. Unfortunately I have a mini-cafe and a restroom nearby, meaning my eyes have many people to track.
On top of this, office politics are difficult for me. Before I started taking medication, I really couldn't pay attention in meetings or interviews. Same for many conversations. This tends to be interpreted as indifference or disinterest. I often want to pay attention but just can't. I hate the protocol where I have to add a bunch of "thank yous" and "pleases" and a bunch of flowery language around emails and other communication rather than getting straight to the point. HR is not a fan of direct language.
This leads into the emotional aspects of ADHD. I feel as though emotions can be stronger for me than for the average person, especially negative emotions such as anger. Pretty much my entire life, from childhood until now, I've been told to calm down, think things through a bit more, and not act so rashly.
As a result, despite having a good track record due to some aforementioned business wins (better than everyone in my org), I tend to alienate leadership and am considered somewhat "unmanageable." I was put up for staff and rejected because, sure, you found some cool things, but can you lead a team for 6 months?
Vyvanse has helped. I no longer get up from my desk an infinite number of times, and my tendency to start a bunch of 20% projects that each need 100% of my time has drastically reduced. I feel as though maybe 30 is closer to my mental age.
There is apparently a correlation between ADHD and other issues. I've taken non-diagnostic tests for some form of high functioning autism and tested fairly highly. Some of my family members clearly have issues, e.g. my younger brother runs away and hides during social circumstances sometimes to recharge and has trouble making eye contact, as does an uncle of mine. Finding the truth of the autism issue at it applies to me is the next phase of my journey.
All in all, it's an interesting situation to be in. You're smart enough to recognize that you're broken in various ways and will forever know that, despite your best efforts, you have significant challenges that will make it difficult to fulfill your potential. But no one can see these issues.
I lived and grew up in Brooklyn during the 1970s, and it was interesting to note that my friends who remained in the city after having children had their kids on some type of medication (lithium, prozac, amphetamines) compared with my kids and a few others who left for the countryside, or another country. It's not urban vs. rural, but more an American thing. After having lived overseas for 8 years, and some other odd years in other countries, I returned to the US, and when I turned on a TV for the first time in a long time, all I saw were big pharma adds for everything from spastic colon to mental disorders. Fortunately, I killed cable and only watch films, or read, or watch self-curated internet snippets of videos, news and articles. When I stay in a hotel, I see the same adds pushing cures, solutions in the guise of attractive people in bucolic settings. It's no wonder there's a rush to medicate everything.
I truly feel compassionate for anyone who feels bad, or different enough to suffer mentally or physically. I know, since I have had my own battles for sure. I only hope we aren't somatizing the population of kids, and implanting the idea that something is wrong with otherwise "normal" children.
[1] https://www.psychologytoday.com/us/blog/the-theater-the-brai...
[2] https://www.webmd.com/add-adhd/childhood-adhd/features/adhd-...
[3] https://www.bmj.com/rapid-response/2011/11/02/adhd-neither-d...
The author didn't really delve into whether he uses meds to cope with ADHD.
How do other people who have ADHD cope with it as startup founders? Do meds like Adderall, Ritalin or Concerta work? What about Nootropics?
Asking cos this situation seems to be very common in our profession i.e. starting some side project, getting overwhelmed with perfectionism, distractions and never shipping. Is that ADHD or just plain procrastination?
This note is toward the end of the article:
A note on medication: When I take medication I feel these skills being dulled. I can't think as quickly, I'm not as outgoing. ADHD medication also contributes to an increase in anxiety, and so for me it's not worth it. If you're struggling you should absolutely try it. For some people, medication is a must. Don't ever feel bad about taking it if it helps you.
Incidentally, I've had really good experiences with modafinil (aka Provigil). It's not approved for ADHD treatment in the US, but studies suggest it is effective, and it's widely prescribed off label.
For example I heard emergency room doctors are really good careers for those with ADHD.