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Comment by kmarc | Hacker News Reader

Living in Europe, my perception (AKA: anecdotal / unscientific / non-measured) is that most of the ADHD-diagnosed people I know live in the US, while I only know one European person in my network who received similar diagnosis from a professional psychiatrist. Counterintuitively, I know way more European people than Americans, which makes my perception feel even more skewed.

I very well know that my sample(ing method) could be wrong, it can be a coincidence, etc etc.

So my questions are:

* anyone else have similar experience in their friend circles?

* is there a higher number of ADHD diagnosis in tech / wealthy population? (considering that most of my American friends/colleagues are from tech, this would somewhat explain)

* do I miss something obvious? (e.g. maybe Europeans would never discuss their diagnosis with friends, etc.)

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One hypothesis is that, in the country where you live, there is more stigma around ADHD in adults and it is more frequently ignored or dismissed.

It is an easy condition to ignore —- adults with ADHD are frequently not very “hyperactive” because even if they were as children, they’ve learned to modulate that behavior through experience.

The traits of inattentive-only ADHD are often written off as laziness when in reality that person is experiencing executive dysfunction that makes prioritization of tasks difficult. A common feature of ADHD is to be frequently paralyzed by indecision.

It’s not uncommon for those first diagnosed as adults to be completely blindsided by the disorder.

Which raises another question:

- How bad can it be, if it stays undiagnosed?

It's kind of like needing to wear glasses; all you know is that everything looks blurry, and as far as you know that's how everyone sees. And if you struggle to see clearly, well, that's your problem.

My guess is that it stays undiagnosed because doctors aren't trained to make the connection between untreated ADHD (as an adult) and the disparate consequences it has on one's life.

My wife was diagnosed with ADD (ADHD-I) at 20 (no points for H at all, literally none).

When all stimuli hit you at the same level it's really tiring. Someone clicking their pen, bird chirping outside, someone coughing in the hallway or the classroom next to you, someone picking his nose in the corner of your eyes etc. She isn't able to filter them at all.

I've come home to the place being flooded because she ran a bath but remembered she needed to do something in the kitchen, and that prompted something else, etc. We've fought because of little things, but those little things combined with having to process every single stimuli the world throws at you is difficult. If you're focusing on work, or just sitting around do you even register the things going on outside? She does. At the same 'volume' as the thing she's trying to focus on.

In high school she missed more classes than she went to. She was deemed lazy, dumb, and uncaring. We have three levels in the Netherlands and she barely completed the lowest one. Mainly because she was home sleeping, or just wandering off with her mind, migraines - you name it.

When she had to write school reports for a specific class the teacher would be baffled by the report. It went from the actual subject to a few pages of an English report, then a chapter of economics. I always imagined it as her having to go to the bathroom, coming back and remembering 'Shit I needed to write that book report for English class'. Because, obviously, this was only started just before or even after the deadline.

You'd think the schoolsystem would raise an alarm right? Nah, she wasn't exactly 'trouble' as in being busy / shouting / name any typical bad behaviour. She was just chaotic and 'dumb'. Real easy conclusion, especially when you have kids getting in fights and smoking joints - at least she was trying to do her homework.

So she missed a lot of opportunities, felt really bad about herself to put it lightly, and the migraines are a bitch too. I don't know if that's how bad it can be when undiagnosed but yeah. When the psychiatrist did the sessions / tried medications they also took an IQ test which indicated that when the world is not throwing stimuli at her (well it still is, but with the help of the meds she can filter it) she's actually really fucking intelligent (remember the lowest level she barely passed, could've easily done the highest level and moved on to university). After years of hard work catching up she did complete a BA and I couldn't be prouder. It's not easy believing in yourself after so many years of people saying you're dumb and lazy.

Thanks for the elaborate answer.

> If you're focusing on work, or just sitting around do you even register the things going on outside?

I actually do, and took me a while to realize that not everyone experiences surroundings as I do. Definitely can relate to this, and some of the other patterns you and others described here.

She sounds lucky to have someone that would take the time to understand her experience. Good job man.

How bad can cancer be, if it stays undiagnosed?

There are lots of serious conditions that, if left undiagnosed, are quite damaging or fatal.

Plus, it's often especially difficult to see how psychological/psychiatric problems affect oneself. It's easy to misattribute causes or misunderstand conditions. There are posts in this very discussion that tell how damaging undiagnosed ADHD has been.

Its the difference between being capable of joining Google and being unable to get anything better than McDonalds or similar. Sure you can go through life working minimum wage jobs and never see a doctor about it, but I certainly feel my life is better on medication. Basically it is the "I could do it if I just wanted/tried', and adhd was what prevented the person from wanting/trying.

American here. Lived the first 30 years of my life in the States, the next 20 in France/UK and have worked (temporarily at least) in most major European cities.

I think you are on to something with you last point. One long-standing joke about Americans is that within 5 minutes of meeting them you'll know more about their bank account, hopes/fears/dreams, and their lower colon than you'll ever know about your best European friend in a lifetime.

I'm not judging. We (Americans) are simply open about lots of personal details to everyone. We're a bit like the golden labs of humankind. If someone will listen, we're happy to talk about anything.

Europeans on the other hand (this is another BIG generalisation) are definitely much more private especially when it comes to health. I've been in the UK for quite a while now and I struggle to even learn the names of my neighbours two doors down. Good luck borrowing a cup of sugar around here. In the states I actually let someone use my shower! I knew him from passing in the hallway and he had a job interview in an hour but lost his keys.

Anyhow...I digress. #4 is my choice. Access to good healthcare is NOT a cause. But I don't want to go there and start a discussion on the pros/cons of socialised medicine. It always ends in shouting. :D

> Access to good healthcare is NOT a cause.

It is one of the causes, Europe is more than France/UK.

Fellow European here - at least in Poland it is virtually impossible to get diagnosed as an adult, and there is very little knowledge of ADHD among mental health prpfessionals.

ADHD affects around 5% population, as various studies have shown. In Poland we have virtually 0% adults diagnosed an on treatmnt, and I don’t know a single therapist that wI could confidently recommend to a person seeking diagnosis/treatment. (And I looked and asked around a lot).

By comparison, in SF there is a dedicated clinic for adult ADHD, not to mention therapists aware of such thing.

I’ve been diagnosed in France at 29. I had the chance to find a therapist that was aware of ADHD and transferred me to a specialist at the local hospital.

But it looks like I had been really lucky because France health authorities does not currently acknowledge the existence of adult ADHD.

That would explain why no one in Europe talks about it. I would add that since symptoms are really vague when explained, there is some sort of taboo when you talk about it because ADHD is just a sum of symptoms that, individually, are very common amongst the population.

I live in a smaller EU country and I tried to have a professional check me out, as I have a lot of problems with procrastination, productivity, paying bills on time etc.

I tried asking around (including asking some organization that deal with ADHD in children) for a recommendation for a psychiatrists that deals with ADHD in adults and couldn't get any.

After months of deliberation I finally hyped myself up to get an appointment with any psychiatrist in the local hospital, just to see if they will be of any help and could maybe refer me to someone else. They didn't even seem to know what I was talking about, said that I was obviously fine as I managed to graduate from a university and recommended that I have children to give me a sense of direction in life. So, yeah, good luck to anyone who has adult ADHD here.

The obvious answer is that in America drugs are advertised on TV, and if you see a lot of ads for ADHD medication you might be more aware of the possibility that you have ADHD, and it could be normalised. After all the stereotype of American zombie kids on Ritalin was being bandied about 10-20 years ago? Whereas ADHD is still relatively not well known in most European countries.

The UK was the same for autism about 10-15 years ago, it was barely talked about, now every class has 10-20% children diagnosed with autism and we have autism-friendly hours in cinemas/shops etc, nobody blinks an eye if you go out wearing big headphones etc. The same may happen for adult ADHD too.

I’m American in the tech industry. A majority of my close friends and I are diagnosed with ADD (I count 4 off the top of my head). Some people on my work team are open about their diagnoses as well.

It was difficult for me to admit to my family, friends and colleagues that I was being medicated for ADD. It took me four months before anyone besides my wife knew. The reason I came out with it is because some of the struggles reared their heads again. I realized that the people around me who have struggled with similar problems might also need a sympathetic ear, as I do.

Ultimately, my hesitance to discuss my diagnosis is due to fear of judgement (will people think I’m lazy or a druggy?) or fear that people may begin attributing my successes to the drugs.

tech / wealthy people have more access to healthcare in the USA

That might explain why in america more people in tech are diagnosed with ADHD, but would provide evidence against fewer people in europe being diagnosed with ADHD than in america (which is what the poster is asking about) since they have more access to healthcare, and it's not income dependent.

To answer the OP's question, I seem to recall that people with ADHD are more prone to be entrepreneurial (I believe a higher appetite for risk is the general explanation). Here is an article [0].

This would explain things if the people you know in tech happen to work for tech startups.

[0] https://www.forbes.com/sites/dalearcher/2014/05/14/adhd-the-...

Same in Canada. I haven't even bothered pursuing the diagnosis as it's a massive pain to get doctors to take things like this seriously in a socialised system.

In Europe, drugs cost the government money. In America, drugs cost you (and your employer) money.

There's a genetic component - as there is for Openness, which is higher on the West than the East Coast of the US.

So, maybe ADHD types were the first to leave Europe for the Americas?

I have similar observations, and your suggested explanations seem reasonable but I have nothing but anecdata either way. I have known a lot of people in tech in the US from whom I've gotten the distinct impression they are formally diagnosed with ADHD and perhaps on medication.

I have also known a lot of people who tend to self-diagnose problems that I suspect they don't really have and then talk about them a lot (such as ADHD). They're usually the people who are fixated on vaccines and 5G as the cause of many health problems, but they typically won't have much interaction with "establishment" doctors on these issues. It's my impression that this is more common in the US than Europe, but it's a distinct issue. Not sure if some of that is mixed in to your observations?

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