Mental illness, attention deficit disorder, and suffering
blog.plover.com
blog.plover.com
Despite these factors only 20% of ADHD individuals receive treatment which can make a big difference. Medications can be helpful but are not by any means a "cure". Rather specific behavioral therapies are a necessary part of an effective treatment program.
As a physician specializing in behavioral health, I've treated a great number of ADHD adults. It's impressive how much improvement patients could make over a period of months to years as a result of their determined effort. I came to appreciate patients' innate talents that many were eventually able to exploit. It was gratifying to see some become top-tier innovators in their fields including technologies.
Of course people will "identify" unique traits as part of their sense of "self". ADHD individuals may come to regard aspects of their quirky cognitive styles as part of an "identity" but that's not necessarily the same as having ADHD as the biggest component.
Last thing I'll say is that ADHD is considered a developmental disorder. IOW there's no sharp line between having/not having it. The extent it's a problem depends on the context, which is a huge discussion topic in its own right.
Growing up, ADHD was my biggest enemy in life and I didn't even realize it.
Once I began treatment, the change was almost overnight. I know I'm just one data point in a sea of data points, but I really just want to add that I'm on the other end of the parent comment and getting diagnosed, other than my marriage and the birth of my son, was the best thing that's ever happened to me.
That corresponds to what many ADHD adults have experienced. Based on what I've observed among ADHD patients, early response to treatment is a reason for optimism. Chances are ongoing treatment will support continued improvement for months if not years. And not just the patient but also the person's family and beyond. Differences in outcomes are decidedly non-trivial.
Basically, meds set you on a healthy path that might lessen the effects of the disorder.
The short answer is that I was diagnosed independently by 2 professionals, I have a family history of ADHD, and I exhibit all of the symptoms of ADHD.
Anecdotally, I know what stimulant abuse looks like. I have seen friends abuse adderall and other stimulants. I react totally different to it than they do.
Since starting: I'm less angry. I'm less annoyed. I have the ability to listen to my spouse talk to me. I'm not jittery or jumpy any more. I am not always singing, tapping, humming, talking over people, talking at yelling volume in normal conversations. I know when to stop talking. I can actually take naps now and go to sleep before my body almost literally shuts down like I used to not be able to.
I'd be happy to give you or anyone else a more in depth walk through how I got here and how I'm sure of what I have, but I understand that's not what you asked for.
THIS! Absolutely this.
Bit crazy that these are also the symptoms of someone on withdrawal from amphetamines and other stimulants†, huh?
But wait a sec... we had these before going anywhere near medication?
Could it possibly be we've been living a life of dopamine withdrawal?
† I was going to say "amphetamine addiction" but stopped myself... a significant number of these poor folk are self-medicating to escape the constant agony of their inner turmoil. They just couldn't get what they needed under the supervision of modern medicine, and micro-dose their intake so it delivers the beneficial effects and minimises the side-effect.
edit: formatting
I'm not very keen on the "everyone needs a dopamine break" hypothesis because I'm not sure those are actually the symptoms of amphetamine withdrawal. I mean, for me when it crashes it just makes me unable to get off the couch or go home from work because I forget to do it.
Thank you. I may not have adhd but at least it gives hope.
If you need someone to talk though it with or if you have questions, my email is in my profile.
Unfortunately medical science is not at the point yet where it can, in an individual case, objectively verified with e.g. a brain scan or a blood test.
You should be aware that comments like yours, while surely not your intention, do real damage to the large category of people (more than half; ibid) who have the disorder and are not receiving treatment because they are being gaslit by a society that already minimizes the disorder at every turn.
[1] http://www.russellbarkley.org/factsheets/Consensus2002.pdf
I used to be this kind of person, I ignored the fact that I had many ADHD signs, and it's taken me decades to finally figure out what was wrong with me all along was something I thought was bullshit. Getting diagnosed has completely changed my life.
As someone who also fights an internal battle with my diagnosis 24/7, comments like this are not helpful and can even be hurtful.
Would you ask someone with a hearing aid how they could be sure they were deaf? Or someone wheelchair bound how they could be sure they can't just walk if they try hard enough?
The world of work that we have made for ourselves as a society can be as inaccessible as the built environment can be to those who need accommodations to move around it safely.
Comments like these are hurtful. I ask myself the question the commenter asked me every single day. I just try to approach them with care and the assumption they are coming from a good place. I know that isn't always the case, but it's the best I can do.
Also, it's wild that I already have a strategy and thoughts about dealing with comments like these. It's only been a few weeks, but it's already happened a handful of times.
Musk and Andreessen's recent comments on the matter angered me. And though I don't think Andreessenn's were necessarily out of the same place of hate's as Elon's were, they were still framed in a damaging way.
I try to as well, I had to rewrite that comment several times to be bit more generous but had to leave it where it was. It's hard - Ironically it comes from a place of wishing the world would be more generous to you. Beyond regular therapy I don't talk openly about this, both for this reason, and as I had been struggling with, and treated, for depression for over 20 years (which it now turns out is exacerbated or even caused by the untreated ADHD).
I've spent an incredible amount of effort and energy actively hiding this fact and any consequences from employers, teachers and loved ones out of fear of what it would mean for my already difficult to maintain status quo. I've seen what the stigma of mental health can do to ones career and future opportunities (unless of course you are an active and visual advocate, campaigner as well as your normal role).
It's deeply unfortunate that it's so asymmetrical. u/symlinkk has asked a question that in isolation is merely a category error, a lazy intellectual argument regarding burden of proof, subjectivity inherent in the DSM, clinical standards regarding impairment, etc., that can be dispatched in short order. However the emotional effect of a question that implicitly denies the existence of the illness remains long after the intellectual error is corrected.
It's structurally similar to LGBT erasure. We have already gone through life for years believing that there was something wrong with us that we could fix, and therefore was a moral failing and source of shame ("just use a planner" [1]). If in fact it is an immutable characteristic akin to sexuality, then it cannot be a source of shame. One would not ask nowadays whether one was really sure about their sexual orientation. Then again, very few people recreationally take testosterone.
I can only wish you the best regards, and be grateful that we live in the modern day where science (but not the general public yet) has developed an understanding of these things.
[1] https://old.reddit.com/r/ADHD/comments/pelip6/how_i_cured_my...
At the very least, it’s possible that the benefits to healthy individuals are highly subjective.
What benefits of Adderall are you referring to?
Drugs like Adderall can have distinct adverse effects, like cardiac arrythmias, increased blood pressure, jitteriness, insomnia, anxiety. And drug misuse/dependence is a major problem with stimulant-class agents.
So for sure it's not true that everyone benefits from Adderall. Widely abused on college campuses, among non-ADHD students it has a small positive effect on academic performance and at higher doses is a distinct negative. OTOH for people with ADHD the right treatment (Adderall or alternative) can be greatly beneficial. (That is, ADHD treatment allows recipients to perform closer to their non-ADHD peers.)
Finding out if a person has ADHD requires evaluation by a qualified behavioral health clinician. Often it's not an easy diagnosis to make for even the best clinicians. Anyway I'd concur that diagnosis and treatment should not be attempted as a DIY project. Collaborating with a trustworthy practitioner is by far the best option.
No I wasn't. Though I'm aware of the effects you mention in this comment. Adderall or any amphetamine, including methamphetamine acts similarly. But I do think "euphoria" and "focus" are kind of antithetical, so likely not happening at the same time.
However people with ADHD don't experience these things, not euphoria or energy anyway. "Focus" is more like decreased distraction or clarity of thought. With medications ADHD people typically are calmer, more "centered" and more appropriately motivated to get done what they need to.
Ironically the "stimulant" medications aren't stimulating to those with ADHD. IOW they don't feel anything in particular from the medications, it simply allows them to function more fluently. Of course if the dose is way too much, even ADHD folks will have side effects (usually jittery sensations, anxiety, interference with sleep, and other effects).
Naturally I can't recommend using prescription and DEA-controlled drugs without a good medical reason, but of course I'm sure you knew I'd say that. :)
Because Adderall is (IMHO) suboptimal. Most of the physical effects come from the 25% levoamphetamine, a primarily physical stimulant.
Other ADHD drugs [1] are 100% dextroamphetamine, which exerts most of its effect in the brain, with minimal physical side effects. D-AMP doesn't increase my blood pressure, doesn't increase my RHR, doesn't cause insomnia nor jitters. It feels smoother than a cup of coffee.
1: then there's methylphenidate, which I've never tried and haven't studied as much.
For normal people it just gets you euphoric and agitated, we get CALMER cause we live in a state of constant agitation.
This is even with 10+ years of diagnosis.
Do you have any insight into why it is this way? Have physicians always feared the DEA and threat of losing their license in pursuit of helping their patients try different controlled medications? Did the pill mills ruin it for the entire medical industry?
85 years later these two drugs are still the mainstay of ADHD treatment. Sure delivery systems have proliferated and drug variants have been available. Stimulant-class medications remain first-line treatments. Amazingly even after nearly a century nothing better has ever been developed, and it certainly hasn't been for lack of trying.
Prior to 1970 there were relatively few restrictions, but widespread abuse lead to legislation establishing the DEA and tightened regulations. Drugs of abuse were sifted into a schedule of classes 1 to 5, where class 2 drugs were legal to prescribe but subject to limits intended to reduce diversion and misuse.
BTW one of the legal schedule 2 drugs is methamphetamine, approved for ADHD. We know it can be misused, leads to severe dependency problems, but used properly is an effective and quite tolerable treatment for ADHD. Indeed I have prescribed it for a number of patients in the past.
With the huge opioid crisis that's emerged in recent years scrutiny by state licensing boards has increased regarding prescribing patterns. This is making many prescribers nervous to the max. While the thrust of regulators has been in regard to opioid drugs other scheduled drugs such as stimulants, benzodiazepines are caught up in it as well.
Primary care docs are affected by the zealous "witchhunt" in regard to prescribing practices. Hospitals, clinic administrators, etc., are equally touchy about docs prescribing scheduled drugs. So prescribers anticipate getting static if they prescribe stimulants however reasonable it may be. Especially true for PCPs who lack specific training in managing ADHD--harder to defend their actions if challenged by admins.
Among psychiatrists (who should know about ADHD) other factors are operating. Some don't like dealing with ADHD patients, notorious for poor follow through, don't show up for appointments, lose prescriptions, don't pay their bills, etc. Also ADHD cases are frequently more complicated than average due to comorbidities, social issues (marriage/family problems, difficulty at job, etc.), potential for substance use disorder.
Patients without ADHD are more likely to be comparatively more straightforward to deal with, so ADHD sufferers aren't accepted as patients.
Yes indeed, "pill mills" have made everyone's life more difficult. But it doesn't mean every doc who prescribes scheduled drugs operates a pill mill. The tendency to throw out babies with their bathwater is fearsome to many doctors.
Here's my advice to colleagues: every patient deserves a thorough diagnostic evaluation. If ADHD is one diagnosis, it should be treated vigorously within appropriate clinical guidelines. If stimulant treatment is indicated start with a low dose, titrate gradually until reaching an effective and tolerable level. Do not neglect behavioral treatments, these are essential. (Book-length description in progress.)
The SECRET to successful treatment and keeping regulators at bay: excellent clinical documentation. I never was "in trouble" over prescribing, I had the records showing rationale for every prescription, so nothing to be afraid of.\
Your story isn't unusual, there's a shortage of qualified, and willing, providers in this domain. Combined with a cultural bias against and misunderstanding of people with ADHD the treatment situation is troublesome. Educating providers and the public is badly needed. If that's done, over time availability of high-quality care for people with ADHD will improve.
My experience with GPs is that they do not understand those issues and do not know how to direct to someone who does. It's not like a physical ailment where they know with a fair degree of certainty what the next avenue is.
Organizations like CHADD, local or state psychiatric associations have referral lists that can be useful. Likewise some insurers publish lists of clinical specialists. Other folks with ADHD who are in treatment might have a practitioner with room to see a new patient.
Pays to keep trying to find a provider you can work with, it will happen sooner or later and will be well worth all the trouble you went to.
However, it's also one of my greatest strengths. When my brain decides to attack a problem, I'm astonishingly productive. Over the last couple of weeks, I've been hyperfocused on implementing a motion control system for a side project. As a result, I've designed a CoreXY platform, designed a control board for it, learned how to use ngspice to tune the power-up circuit, learned how to use Sympy, used it to derive closed-form solutions for jerk-controlled motion, and found a way to implement that solution in which the motion control interrupt takes a grand total of 70 cycles on Cortex M0. And this is just my spare time outside of work, where I had a completely different set of hyperfocii, and similar productivity.
So, I completely agree with the author that if somebody were to offer me a megadollar in exchange for getting rid of my ADD, I'd have to think very hard about that indeed.
[...] 15 The clinical presentation of ADHD can be described as primarily inattentive, primarily hyperactive-impulsive, or combined,
depending on the nature of their symptoms (American Psychiat-ric Association, 2013). [...]
I personally believe everybody should be allowed to take these stimulants if they want to, because many people would benefit from it. The propaganda around stimulants working radically differently on those with ADHD vs those without is just that (I can go on about why I think that in much more detail). Ask anybody you’re close with how taking their friend’s adderall to study worked out. Look into people like Paul Erdos.
Anyway, I think you can definitely argue that there is a lot more nuance to psychiatry than you see in clinical settings (probably many disorders should be broken up into multiple others, others are just symptoms rather than a problem itself, others are not even disorders but just a different way of being). But really all that matters is that psychiatrists can match symptoms to treatments that work. Matching poor/misdirected executive function to medication that “boosts” dopamine and norepinephrine works pretty well, so why worry about the name of the condition?
This is the complete opposite of my experience. A lot of my life has been dominated by a hyper-focus that feels like it isn't under my control. I would stay awake reading until I can't think anymore with relentless pursuit of something that was entirely non-relevant to critical priorities in my life.
I very recently (past couple of months) started taking stimulants, and one of the biggest differences for me was the feeling of desperation to pursue was greatly relaxed. Not gone, but definitely not as intense.
I think a lot of the problem here is the definition of focus is overloaded. For me, there are (at least) two distinct levels of focus on different time scales. I define short-term focus as stability on task level executive function. Can you tolerate a brief interruption and go back to what you were doing? Or plan ahead for the next task? This ability is absolutely compromised relative to the population norm for me. I have essentially 0 local stability. On a longer time scale, I think a similar stability notion applies. I frequently get completely engrossed for periods of a few weeks on a topic - beyond healthy levels of interest. But one day, it's just gone - vapid.
Time for some serious hand waving: my mental model of what stimulants do to me decrease the activation threshold for picking something in an executive space. By lowering this plane, it's easier for me to remain more stable as the surface is a lot more clear.
I'm curious to know if what I'm saying sounds like 100% bullshit though - I haven't really talked through this mental model with anybody.
I experienced them before I was aware of my issues, before had ever tried any medication.
Without medication, at least for me and I suspect almost all other people, hyperfocus is something that comes and goes at random and is rarely centered on what it should be (even if I do find it interesting, like real analysis coursework). But even regular people hyperfocus when they take adderall.
Yes, the author got that A that one time, but what could he have achieved if he had managed to work on it for more than one night? Or put another way: if you are lucky enough to succeed and level-up through the academia/career/whatever ladder enough despite these problems, you’ll eventually get to a point where cramming doesn’t cut it. You’ll be surrounded by people who are just as smart but who can actually focus at the right times on the right things, and then you’ll struggle (speaking from experience).
a) I can't choose what to focus on. So if I need to do something but it's not the latest thing I'm obsessed about, tough luck
b) Deadlines help but if it's not something I'm obsessed about and there's no deadlines, not going to happen
My experience maps the author, I did well in university because becoming super interested in a subject and reading everything about it for a couple of weeks to the detriment of everything else worked well. Well it worked well in France where we had 2 exams a year and all exams were open book, it didn't work that well in the US where tests were more regular and memorising random uninteresting fact was expected (I lost point in a computer graphics class for not being able to give the name of companies that were members of the Opengl architectural board or when the first version was released... Who cares??)
After graduating, I'd say the fact that I get very interested in things and completely focus on them actually helped me in my career. On the other hand, my inability to do paperwork, send invoices on time (been a consultant most of my life), do my taxes etc lost me around 150k so far. So, it's a double edged sword for sure.
Hyperfocus is a symptom of ADHD proper. Stimulants can also make you feel hyperfocused. However, the general reported effects of stimulants are a feeling of "normalcy", not hyperfocus as a result of stimulants. Many people taking stimulants are still symptomatic, albeit managed, meditation long term is generally an excruciatingly (if excruciating) adjunct to stimulants.
Second, Adderall often gives the feeling of superfocus and speed to neurotypical individuals but has been statistically shown to give little gain in practice in terms of certain raw metrics. A very strong dopaminergic placebo, as it were. I'd suspect the reason for it being considered effective is that it keeps you glued on tasks for significantly longer than otherwise . It's not propaganda, it's science, you can look at the studies yourself, it's pretty drastic. However there may be another layer on top of that that that could be propagandizing what is otherwise a valid scientific distinction.
Much agreed in the last half, I've seen a lot of subclinical dissociative like disorders fall into ADHD, or DPDR, when really there is probably a core condition and several other families lumped in. Such is always the curse of dimensionality reduction. A more root-cause preserving descriptive language set that doesn't rely on the anchor of billing codes would open up the scientific fields a lot. Language determines nomenclature, which determines assumed avenues of exploration. A dimension reduced model of mental health along symptomatic axes will almost always destroy symptom and condition "root cause" linkage. Additionally like you noted anxiety and depression are more symptoms of traumatic disorders and less actual disorders in and of themselves. My pet theory is that's one reason why "depression" is so hard to cure, imagine trying to generically cure "fever" instead of making vaccines, etc.
Ramble over! I think (especially later on) we think pretty similarly!
Yeah, hyperfocus is a symptom of ADHD proper. But if you're unmedicated, for most people it's not something you can control - if you could, it wouldn't really be a disorder at all. I was responding specifically to the following paragraph:
"Until I got to college I didn't understand how people could spend hours a day “studying”. When I got there I found out. When my first-year hallmates were “studying” they were looking out the window, playing with their pencils, talking to their roommates, all sorts of stuff that wasn't studying. When I needed to study I would hide somewhere and study. I think the ability to focus on just one thing for a few hours at a time is a great gift that ADD has given me."
That's pretty much exactly what it feels like to take adderall. For me taking stimulants like adderall allows me to force focus even on stuff I don't care much about/even when I don't normally feel like it. And yes, this is exactly the way people without ADHD feel too (as you mention - even if you don't have ADHD, you can still focus on-task for a long time and feel smart as fuck).
What you mention about dopaminergic stimulants only actually benefitting people with ADHD is likely an oversimplification. To meet the DSM criteria (and thus, in most clinical settings, to get diagnosed with ADHD-I) you just need persistent problems focusing. Hence my overall point that anybody that thinks they have trouble focusing should be able to just take adderall. ADHD is a spectrum and not a binary condition anyway. You can meet 4 DSM criteria and remain untreated, or meet 5 DSM criteria and take 60mg of amphetamine every day.
The "propaganda" is that ADHD is this cut-and-dry binary condition where people with ADHD who take dopaminergic stimulants totally don't get high (go on /r/ADHD and read any post about someone taking medicine for the first time), hyperfocus/tunnel-vision (ie "bad hyperfocus"), chatty, irritiable, or have trouble sleeping. And conversely that people without ADHD who take dopaminergic stimulants will only masturbate, stay up late, dance at a club, or take apart their neighbor's lawnmower. When in reality this is mostly set, setting, conditioning, dose, habits, tolerance, dose metering, and expectations.
And as a consequence of this propaganda, mostly because some people benefit a lot from taking dopaminergic stimulants but they also get you high and our society moralizes against that, plenty of people who don't meet the formal requirements for ADHD under the DSM, are subclinical or at the threshold of being clinical, can't afford a $100 copay every 2-4 weeks, or don't have the executive function to seek treatment remain untreated.
It is hard to control, but it can help you do one thing as long as you're willing to abandon all other parts of your life, like eating/sleeping.
I've noticed that in the ADHD community, there are some very vocal people that will wear the diagnosis with pride. I mean, good for them - but it is not really anything I can relate to. I treat it pretty much like I treat my gout...take my medication, adjust my lifestyle, and go on with my day.
ADHD is a curse, and I will never be able to see it as anything but that. Am I grateful to know why I am the way that I am? Certainly. But I will never be able to get onboard with the “ADHD as superpower” line that some fellow ADHD folks have adopted. Glad they can see it that way, but if someone offered me a way to 100% cure it tomorrow, I’d take it and never look back. Getting medicated has made a difference in my life, to be sure, but I can’t imagine ever seeing this condition as a positive aspect of my identity.
It's a curse.
I wonder how many people are jumping on the bandwagon of being ND and have actually been credibly diagnosed with ADHD?!
I'm super smart, but ADHD destroyed my schooling and I've never met my potential.
I'd start well, be ahead of the other kids by miles, and then would go totally off the rails.
It's was the same for School as it was for Work.
Relationships were also hard due to impulsiveness.
ADHD is a curse, not a super power.
> The coping mechanisms that had served me reasonably well during my young adulthood suddenly stopped working during the pandemic. So, I became unable to motivate myself to a deadline, which had generally been a powerful force to motivate my attention and efforts.
I have experienced the exact same situation (but with work)... always been motivated by well-planned deadlines, but it just... doesn't work anymore?
I'm trying to figure out why. Suspect a combination of WfH, unrelated family issues, dealing with diagnosis and past trauma, a general surge in anxiety across the board resulting in a total burnout of any motivation... just ceasing to care about anything much at all.
High five back to you. No shame in that game. I’m mostly just glad to have learned that my issues weren’t just because I was “lazy” but because my brain just doesn’t work that way. I learned something about myself, even if it cost me a few years to learn it!
And I wish you all the best. When those coping mechanisms run out, they run out hard. My wife is an attorney, and one of her best friends at work clearly has undiagnosed ADHD. We both keep pushing her to talk to someone about it because I know the day is coming when she’s going to hit that wall, and I seriously don’t wish it on anyone. It’s bad. When it happened to me, I had no idea what was going on. I’d always been able to just get things done (albeit in absolute panic mode), and then suddenly I just wasn’t able to. Keep fighting, my friend.
Oh, don't I know it.
Have switched career paths a few times because of it. About 4-5 years to ride the wave up before the crash.
Thankful for MY partner... because she's an absolute harbour in the storm. All the executive function I lack, and then more to spare. Otherwise I'd probably be homeless, imprisoned or dead.
Think I am finally dealing with it properly.
After a stint back in corporate management land, I had a full on nervous breakdown that almost destroyed me and my marriage.
I had one of the most enviable jobs in my field. It was a dream in my city.
I'm still not fully recovered, what ever that means, and never will be the same again really!
I guard my mental health like the Crown Jewels these days!
Which in itself isn't easy!
You can take medication to adhere to these artificial expectations on how an individual should function within society. Or you can live in a way that matches your natural behavior and capabilities.
Granted, we sometimes cannot avoid having to function in the expected way so medication is helpful. But seeing it as an illness that one needs to constantly surpress just doesn't sound right to me.
It's part of my personality. I'm not proud of it. But I also certainly don't see it as something that needs to be constantly treated.
Most milder mental disorders are probably like this; it doesn't make any sense from the evolutionary point of view that a significant proportion of the population would have largely genetic trait that is only harmful in all situations. It's just that traits like ADHD and high levels of anxiety probably were helpful - or at least not harmful - in our evolutionary context, but are not anymore.
This. In tribal times it was an asset. A few individuals that sleep till noon and stay up all night? Who cares. When the tribe got attacked by others or wild animals they could save 100-150 peoples lives.
some people with physical deficiencies have no issue navigating the world, and some do. same with queer folk. same with people with ADHD. sure there's a societal aspect, but there's also relationship aspects and everything else. we don't live in a vacuum. you can't look at it from the perspective of "if we were hunter-gatherers we would be fine" because that's not the reality of the world.
and fwiw there are plenty of things one can do that are not working 8 hours a day, that are not working during 9-5, that are not focus related. you just choose not to do them, or do not find the proper opportunity.
and that's why medication exists. so people _can_ do normal things and live a normal life. the system isn't great, to be fair, and i wish it were reformed, but until the glorious proletariat uprising, i'd prefer people get the mental health they need to focus on their lives and not some fictitious idea of what may be
What if the behaviour causes pain to you? What if it's the cause of your anxiety, depression, loneliness, addiction? Because at a certain point, you need to admit that it's not that you need a life that matches your capabilities, but some help.
Would you think the same if someone were short-sighted? Should they live in a way that everything is at arms reach?
I think the idea of wearing it as a badge of pride is because that reflex is easier than being more honest and introspective. At the same time it might help soften the pain. If you have a disability, you are a strain on those around you. You shouldn’t be ashamed of it, but you shouldn’t be prideful either. You should be proud when you succeed against the odds and you know it took hard work, but that’s not adhd happening.
For a brief time I entertained that I should be more adhd positive. Ultimately I realized that bias is not helpful at all if it clouds my perception of how it impacts my life or those around me. For some people though, perhaps it helps lessen the burden of the common self-loathing that tends to manifest as sufferers age.
I've managed to fix a lot of the organizational problems with a multi pronged sleep / exercise / med regimen, too. All in all, I'd call it net positive.
I think the big distinction, and what TFA is getting at, is ADHD actually is more like a true neurodiverty than a disorder. The dysfunction largely manifests due to the constraints in the modern world. I love making things but I hate "adulting" - bills, paperwork, keeping 9 million small things in order. Were I living in a hunter-gatherer or early agrarian society, things would be different.
I'm able to offset bad prioritization skills by being really good at breadth-first search and having a huge knowledge base from curiosity driven rabbit holes when I should be doing my "real" work. It feels much more balanced than depression, which just sucks the life out of me and reduces all aspects of quality of life across the board.
I also think it's irrelevant that in some perfect (historical) society ADD would be perfectly suited, because I don't live in that society. I live in the modern one and I want to be a productive part of it.
How did you know you hit the mark when you found it?
I have been trying for the greater part of a decade, and I think there are only two possible explanations at this point:
1. I am one of the x% of people that medications do not work /as well/ for.
2. I have too high of expectations of the effects of the medications.
Doctors have been no help, and I do not mean that in an arrogant way. But when I ask, "how do I know if the medication and dosage is optimal?" They act like I am asking if P = NP.
I still haven't repaired a few things in my life that still cause me significant stress (happy to go in-depth if you email, see bio), but I really had no idea what the medication would do until I tried it.
For me; it quietened my (extremely vocal) inner critic and therefore lowered my anxiety, and it slowed down the rapid bounce-around of my thoughts, particularly in situations where I wasn't deeply stimulated (eg I outlasted my kid playing ball for the first time ever because I stayed interested and wasn't just counting down the minutes until I could say 'okay that's enough'). And that's it.
But that means I can actually start to do the hard work of building the right habits to put some important bits of my life back on track, particularly when they'd been built wrong and have to be torn down.
> I feel like it helps me to get to Everest base camp, but I still have to climb the damn mountain.
I feel like I can climb the mountain most days, but I can't get to the base camp to get started. I've actually considered if there is something else lurking in the shadows like Sleep Apnea or something else? I just know I have an odd issue where no matter when I take the meds, they do not work until around 1:00/2:00 in the afternoon. I have no idea why -- maybe I need to build a base level for them to start working? Doctors think it's highly unusual, but seem to offer little to no advice past that point.
> I’ve found that medication will get you to a baseline ability to function
I will say, it does wonders for my physical hyperactive symptoms, but it does tend to make me talk faster (I've always talked fast to begin with) and I tend to want to talk more/longer. It's nice to not have to pace and bounce around all the time.
Still, I have noticed I tend to feel a bit more impatient in someways -- like I doubt I could sit down and just read a book. I'd still get bored or distracted and feel compelled to do something more stimulating as my mind tends to feel a bit overclocked.
> If you aren’t already familiar with the work of Russell Barkley
I am familiar with him. I do respect the work he has done, but I also have some qualms with him. I feel like he tends to overemphasis the effects of medication, and it feels kind of odd coming from him since according to his Wiki, "He has been a paid consultant, for pharmaceutical companies including Eli Lilly, McNeil, Janssen-Orth, Janssen-Cilag, Novartis, Shire, Takeda pharmaceuticals, and Theravance."
I do appreciate his research and opinions, and I think he means well, but just because he is the leading researcher in the field does not mean he cannot be incorrect about some things.
I still do this even while medicated. Except, it can actually worse because I can focus on distractions longer than I normally would have pre-medication.
It's not really a brag, but I'd rather be medicated and keep a routine than lose the things that make me different as a knowledge worker. I'm a more lateral thinker than my peers, and that comes in super handy, for example.
The biggest part I don't like is the inability to ever really be 'here in the now' e.g. enjoying the moment. All these important life events just fly by me without even reacting to them it seems, and only in hindsight do I start tearing up thinking about what I missed.
I’m saying this to a level where I personally know bloodlines where men suicide is just a thing that “will happen”. Guess what is the last year’s diagnosis on that?
I live in a society where official stats says that 0.0-0.1% of population is affected and such treatment is not needed. From multiple available treatment options (where single one has around 30% efficiency) there are only 2 available. I recently heard a joke that probably full European country has at most 2 ADHD therapists. Sure maybe you’re lucky enough to get diagnosis but then you might not even be able to treat it meds unless you emigrate. That’s why pride is important - it creates advocates. Advocates creates awareness and awareness provides solutions.
As you mentioned your diagnosis there is a chance you’re sensitive to the critique (it’s often coexisting). Keep in mind that your critique is targeting exact same people like you who struggled with it and came out with pride. Don’t take that away from people.
On a lot of ADHD communities it’s just a constant struggle session about how every problem in people’s life is because of ADHD. It’s exhausting and seems maladaptive.
Comparing yourself, when you have mild characteristics in common with a diagnosis and then saying it’s not so bad is perhaps not so helpful to those who do struggle with it.
When I was diagnosed with ADHD, the disorder did cause me significant problems. Over the years I have managed to do a lot better, where I can now relate to the state the author is in (just the ADHD part, I do not suffer from depression).
I would now say it’s not so bad too.
If they did, then they felt it was an issue at the time. Clearly they don't anymore, so it has stopped being a disorder.
> Over the years I have managed to do a lot better
Great! So you've fixed it. Now you don't have a disorder anymore, just a quirk of the mind.
If you're diagnosed ADD/ADHD you can have a wide variety of direct and secondary side effects for which treatments can improve your success and quality of life, and it's not very kind to dismiss their experiences regardless of what other people are going through.
Gatekeeping a diagnosed disorder is mega cringe.
Over the years I had come up with ways to deal with myself, but they're barely sufficient.
I’m very sure I sit somewhere on the spectrum and have depressive disorder markers as well. But the last thing I want to do is to promote these traits. I am not proud of them nor hiding them. They do make me unique. But that’s my business, not the world’s.
What worries me is how easy it is to get diagnosed. TikTok for example will also show you ads for a simple single click ADHD diagnosis and medication plan. Almost as if it’s being handed out like candy.
I found tranquility by looking inward for answers, not outward. I go on my “mental health” walks/runs. I even have taught myself to be mindful enough to notice when platforms like TikTok are emotionally manipulating you and I’ll be half crying while coming to a realization that this keeps me addicted. As I separate myself more from tech and to more nature in the world, these “character traits” don’t seem to be so defining anymore. It’s just a personal observation I’ve made as screen time declines.
I blame the medical profession for not better promoting the concept of normal human variability in these traits, too, and educational leadership for not differentiating career oriented education around people's strengths and weaknesses there in secondary school at least.
Outside of them, yes it is a nightmare that looks exactly how you would design a process someone with ADHD cannot go through.
I see no ill will behind it. It is just bureaucracy combined with moral panic.
This means you have to get your prescription filled within a small window at the end of your previous supply if you want to avoid running out. You also can't have a recurring prescription, but a rare doctor might renew a prescription over the phone. And even then, you have to deal with pharmacies running out last minute, travel impacting your refill schedule, and health insurance coverage for the otherwise ludicrously expensive medication.
A nightmare process that someone with ADHD cannot go through indeed.
I've met one doctor before who believed it. But after switching to a few other ones (not due to that, but due to circumstances like me moving states or, later on, my doctor doing the same), I dont think that's true.
Every single doctor I had since then was able to write prescriptions for 3 months supply (because they are required to evaluate the patient every 90 days before writing a refill prescription).
So you're allowed to have 90 days worth of prescription, but pharmacies aren't supposed to fill more than 30 days at a time. Ultimately this means 12 trips to the pharmacy a year, if you're lucky.
The only ability to say "no" that you have is to not use the platform, and given how much useful content coalesces into just a few platforms, you're basically saying "no" to getting content in this fashion
And who would benefit from that change in classification or public opinion? Health care providers, because why would e.g. the NHS or health insurance pay for therapy or medication or anything else that would help you for something that is "just" a character trait?
My girlfriend got diagnosed with ADHD in her 30's, but only because there was a very short-lived and quickly shut down (due to cost) program at the NHS for adult ADHD diagnosis. If she hadn't had that, she would never have been able to get a diagnosis or the relevant medication.
Here in the UK, ADHD drugs are controlled substances. They can only be prescribed as by registered psychiatrists as part of ongoing treatment with patient monitoring. There are not enough doctors qualified to do this, and as a result people who need the treatment are facing year-long queues.
Don't get medical advice from TikTok, and don't form an opinion of a mental disorder and its treatment from TikTok either. The "have you tried mental health walk?" thing is as infuriating as cancer patients getting "have you tried essential oils and yoga?"
They're controlled susbtances in the US too, but there appear to be a whole slew of sites in the US where you can fill out a form and they'll send you a perfectly legit scrip
> There are not enough doctors qualified to do this, and as a result people who need the treatment are facing year-long queues.
For anyone reading this who thinks they might need treatment and is putting it off, note that there are (expensive! ~£1k) private alternatives where you can get assessed and prescribed by a UK psychiatrist over Zoom with appointments as soon as today.
I used them after struggling for a long time trying to get diagnosed via the NHS (“you’re a successful young man! You can’t have ADHD!”) and have recommended them to several people.
- They could
- Sometimes it does
- "It" doesn't work a single way, which is why there are so many different opinions of how to look at it :)
Neurodivergence (view that mental disorders are a form of human variation that should be celebrated), medicalization (view that they are diseases, much like physical diseases), and personal responsibility (view that they are caused by personal choices) are all lenses which need to coexist in order to explain mental illness.
ADHD is probably the cleanest example because all three lenses truly apply. For many people with ADHD, it’s who they are, and there are aspects of it that they wouldn’t want to change. It’s also a condition which often needs medication to be managed properly. Plus, (in my experience with loved ones) it’s impossible for people with ADHD to function unless they are trying to take responsibility for their actions.
For most disorders, you need at least two lenses. You can’t fully understand alcoholism unless you acknowledge that both personal responsibility and a medical condition (“substance use disorder”) play a roll. Ditto anxiety and depression.
I have interpreted and see personal responsibility as the affected person being responsible for managing the issues. Not as the issues being caused by themselves. E.g., it is not your fault you have it, you did not caused it, but you are responsible for learning strategies or taking drugs to manage issue to the possible extend.
I cannot do things in time. Not even things that should be rewarding and fun. I cannot start tasks until it's too late, or in the rare event I start I cannot focus long enough on them to make a difference. I cannot really explain why. I know I should just do them, but there's some mental block that I cannot overcome. It has always been this way. None of the strategies I've tried ever made a difference. I always have a to-do list of a hundred small and big things I should have done two weeks ago that stresses me out. I also always lose things.
It's not unusual that I end up crying alone due to stress over all the things I should have done and feeling stupid for putting myself in the same spot again.
I manage to get good grades simply due to the expected workload being much less than my capability and being a good test-taker. At the final weeks before an exam the urgency of the situation allows me to absorb whole courses in a single week and get an A on the exam. But had I just worked 2 hours a day during the whole semester instead I could have saved myself all the stress and the depression and been a lot happier. And even though I know this, I will invariably do the same thing next semester.
I've tried getting help and a diagnosis, but the doctors will dismiss me after a single look at my grades. All they see is a student with great grades (and therefore not in need of help) looking to scam them out of some study drugs.
I get by, and manage to never get in any huge trouble despite my shortcomings. The big problem, except my mental health, is how it negatively impacts my relationships. I have a heard time prioritizing my girlfriend when I'm always stressed and always have a hundred things I should do, which is a reoccurring problem in our relationship. And making time for my friends is even harder.
I have cut out most nonessential responsibilities from by life just to reduce the stress a little. But I have no idea how I will manage big responsibilities like having children in the future without burning out.
I have given up any hope of getting a diagnosis. But I'm worried about the future, and I don't know what to do.
There's probably no help to get here, of course. I just wanted to get if off my chest.
Until recently, my life has been a slow descent into an abyss of despair. Then I got diagnosed and since I've started medication, for the first time in my life I am actually proud of myself. Proud of all my talents and place in the world. There actually is hope and excitement for the future.
Here's my suggestion: do everything possible to talk with a psychiatrist. Get diagnosed. It might be something else, but if it's ADHD you'll be happy to learn that treatment is _very_ effective and often life changing. This is not hyperbole.
i graduated with a decent grade point, like a B+ or A-, and i got straight As in my masters degree. i got jobs all over the world and am pretty smart to not have huge issues with work or anything like that. i still have issues socially, doing work, doing work i'm good at, and all that. even if i manage to mostly get good grades.
and i went to a psych and explained my issues, and i got meds for it. just because you get good grades doesn't mean you don't have ADHD, you just found ways to cope. life isn't just getting good grades and you're fine and don't have ADHD, if that were so then a lot of people wouldn't have any issue.
keep trying, and find a good psych.
If they don't dismiss you the diagnosis process usually involves things like asking your parents about your childhood and things outside classwork.
It's really interesting how attention disorders show and hide themselves. Like the author, I had a consistently inconsistent way of losing or forgetting things. I don't tend to be late or forget appointments, but I have a hard time scheduling them in the first place. I have rejection sensitivity dysphoria, which explains why relationships, family included, have ended poorly and needed a long time from which to recover. I did not complete college and had no idea what I was doing the entire time despite breezing through high school. I have many abandoned and unfinished projects around the house. I have been fortunate to receive accommodations at work such as choosing slightly different hours as needed, but now I understand why that was something I needed.
It hits you like a ton of bricks when you realize "I've had ADHD my whole life" because it explains every negative experience you've ever had. Having authoritarian type parents was the cherry on top.
> (W)hen the world has been willing to let me what I can do in the way that I can do it, the results have been pretty good. When the world has insisted that I do things the way everyone else does them, it hasn't always gone so well.
This is such a succinct description of the main issue with attention disorders. I think the author makes a very good argument that it's the stigma, not the disorder, that is causing more problems than anything. I know stigma against disorders like this is why it never came up.
I intend to obtain an official diagnosis and potentially try medications. The thing is, it's incredibly overwhelming to choose because half of you knows you're doing pretty well right now, why change? The other part is wondering what your true potential looks like, and fighting against how much work and experimentation you think that will take.
since adhd is treated with amphetamine which is essentially a performance enhancing drug that boosts your focus/awareness/intensity. it's probably dangerous to think of your medicated self's potential as being truer than your natural self's. seems like a trap.
people can _choose_ if they want medication, how they feel on it, and what it helps them with. and it helps millions of people have normal productive lives without fear of inadequacy or ruin because of dysfunction or cognitive issues.
it's great if you or others don't believe in medication, but humanity has coped with drugs that affect performance for millennia.
the tendency to treat disorders with (often life-long) amphetamines and ssris is a relatively recent development. obviously it's your choice to ween or risk it (unless you're restrained in a facility) and it's not bullshit to advise caution generally but especially to anyone seeking "true potential" vs "normal life without suffering"
As a constant sufferer who's been dealing with a debilitating case for over a year now, I love the way the author framed depression. It perfectly describes my fear that if I ever get "better", it's only a local maxima, and I will never be freed of this curse. It's laughable to even think, given how I can suffer from day to day, but I'm honestly afraid of finding something that improves my condition, because of the unknown of how depression might still be lurking in the shadows. I still try (often not very hard), but that fear is there nonetheless.
I'm suspicious of how often ADHD is diagnosed, and the subjectivity and lack of detailed mechanistic explanations. More study is required. I have little experience with where the current youth/teen culture is at, regarding diagnoses, and mental illness.
Behaviours that I attribute to ADHD have caused me a lot of suffering, and contributed to me being less reliable than I would like w.r.t deadlines, and personal commitments. On the other hand, I'm funny, and very creative. Like painfully creative. Like it's a goddamn joy/pain to be exploding with ideas and interests all the time. Going down rabbit holes, etc.
My current medication is quite helpful, although I experienced very bad side-effects to the first medications I took 20 years ago. This led me to avoid medication for about a decade and a half, to my detriment. Medication has not been a cure-all, and has come with some physical side-effects that I choose to tolerate. With age, I've developed coping strategies, but it's still a daily (weekly?) struggle. This is where accepting yourself -- flaws and all comes in. That tension between personal-improvement, and personal kindness / acceptance.
I'm reliable enough to get by, but I think perhaps I would have been a super-star. Still trying, I guess?
All that said, I don't know if I would get rid of it. The easy creativity, just-do-it default, and humour are part of who I am and want to be. That said, the detriments have absolutely been real and contributed to my own suffering. Although, with age, I feel as though I've been through the crucible and am basically unstoppable. I just don't know exactly where I'm going. I am so much tougher, mentally, than I was. Suffering is not all bad, as long as it's not catastrophic, or inescapable.
So .. uh .. yeah. YMMV.
There's a lot of modern discourse around "identity". My view is that the only healthy conception of your identity is the things you share with no one else. So ADD is not your identity, nor is your skin color, ethnicity, religion and so on. Rather, your identity is the result of experiences unique to your life and how those experiences shaped you.
Another big issue here is locus of control. I'm reminded of this quote: "I was dissatisfied with my own conduct, and laid the blame for my excesses on irresistible inner forces, as well as a combination of inscrutable external factors, invisibly staged to provoke and upset me."
But going undiagnosed, it did force me to cope in creative ways.
I'd zone out in class and forget about tests. Only to inhale all the info in the dopamine-induced panic of the night before.
Long, wordy explanations bored me to tears. Which gave me deep sensitivity when explaining things to others.
And to keep myself sane during endless school days, I'd bend over backwards to try and "real-time edit" topics to be more interesting.
Finally, in my senior year of high-school, I read a blog post summarizing the classic ADHD memoir "Driven to Distraction". For the first time ever, I asked my parents to take me to a doctor. I was diagnosed basically on the spot.
The change was immediate. I went from serial coaster to rampant bookworm. Within a month, I tracked up in all my classes. I finished out high school with a bang (though it didn't matter much to college admissions).
There's always been a slight pang wondering what might have been had I read that blog post sooner. I certainly had the scholastic chops to excel, and could've landed at a much "better" school (and maybe even a "better" career).
But then I remember the blessing in disguise my alma mater, Queens College actually was. Few students cared to take advantage of the (surprisingly) excellent faculty, so I had their undivided attention. Also, the relatively lax workload gave me the space to split my time between class and internships.
And then I think about the weird, rewarding professional path those internships led me down. Where I inhale large amounts of information quickly. Find the shortest, sweetest way to explain it. And "real-time edit" the subject to make it as interesting as possible.
These aren't super-powers. These were talents I was forced to discover and lean on to cope with those that I lacked.
Aurora Holtzman coined "intensity" for this context, it works pretty well.
https://eggshelltherapy.com/podcast-blog/2020/02/13/aurora-h...
Not sure if this is true.
Evolutionary psychologists have explored the improved tunnel vision that accompanies depression as a means for finding one’s way out of harmful situations.
Society-wide it seems many people are living in harmful situations/ways and are able to medicate their way out of the tunnel vision before recognizing the sources of pain.
> Not sure if this is true.
The remarkable film "Melancholia" (Lars von Trier, 2011) was inspired by the director's depression, and one particular upside: that when things get bad, like really bad, the depressive can function better than normal folks because the outside now matches their inside. Kirsten Dunst plays a young woman with utterly crippling depression, I've never seen anything like it in real life or on film, like unable to move or eat. But when the Earth is about to be destroyed, she's sanguine, unlike everyone else.
Not sure if this is true to life, but it makes some sort of sense.
It’s the classic “what doesn’t kill you makes you stronger” adage at work. The sad thing is that it does kill many, and for some, never leaves in order to make room for growth.
As for the tunnel vision, that’s an interesting one because it does let you focus in on a problem exceptionally well and that could be useful. The trouble I’ve found in myself is that I haven’t always had the tools or resources to do something with that attention.
You end up intently focused on a problem, and it just becomes a painful echo chamber instead of an opportunity to address something. I suspect this is largely due to a lack of understanding and teaching. Perhaps too, like you mentioned, we expect medication to function as a solution eventually, relieving ourselves of any duty to investigate internal solutions. Had I known how normal depression is though, how it can present, how it can be managed, I suspect my own experiences could have been a lot better. It’s impossible to be certain.
I definitely disagree about the ups and downs in any case. Struggle defines us and helps us grow. Getting better doesn’t have to be a fun or enjoyable experience.
https://www.hopkinsmedicine.org/health/treatment-tests-and-t...
While I can believe the condition does exist (schizophrenia may be similarly difficult to accurately diagnose, but it surely exists), it really seems to be overdiagnosed in children, and in adults, I imagine amphetamine addiction plays a big role in continued diagnoses. It's rather odd to read articles about it that make no mention of this factor.
> I find it so very irritating that there is no term for my so-called ⸢attention deficit disorder⸣ that does not have the word “disorder” baked into it. I know what a disorder is, and this isn't one.
But the author then argues against a strawman:
> Why does any deviation from the standard have to be a disorder? Why do we medicalize human variation?
It doesn't, and in fact, the diagnostic criteria for ADHD and many other disorders require that the deviation amount to a disorder rather than not interfering with someone's life.
What the author really seems to be criticizing is that he learned and began identifying with the medical term for a disorder ("the ADD really is a part of my identity") and now he'd like a different way to describe his experience.
Fair! But get the cause-and-effect the right way around: we don't need to "stop labeling every difference as a disorder," we need to not adopt diagnostic terms and apply them to ourselves inappropriately. That's a part of what DeBoer is criticizing—that people self-diagnose and then "perform their various personalities."
To be clear, I agree with the author that it would help to have terminology for people who don't feel negatively impacted by their brains being different in a way that we can label, not just for those who do. Maybe the author could get started with that by dropping the "disorder" bit and just identifying himself as someone with an attention deficit.
A good analogy would be height: a person who is several standard deviations from the mean will face challenges in life that require various forms of intervention, but we don't generally think of them as having a _disorder_ unless there's an identifiable biological cause that usually has other effects.
Another good point of comparison is vision. We can accurately measure vision and create medical devices to correct unwanted variation. As someone with myopia, I find it to be only slightly medicalized -- going to get an eye exam doesn't feel much like visiting a doctor, and people don't tend to talk about it as one does a medical condition. I imagine that if we were able to make a similar kind of standardized assessment of whatever neurological basis there is for ADHD, we would consider medication for it more akin to a stepladder or a pair of glasses (or even an antihistamine) than a treatment for a mental illness.
More to the point, I don't think I'd consider it very offensive if someone called my height a disorder, because it's not core to my identity in the same way thinking is. Calling ADHD (or autism, etc.) a disorder feels like telling someone they're personally deficient, because the person is inextricable from the condition. Growing really tall in your teens is something that happens to you; having ADHD your whole life is something that you are. Note that this is true even if their thinking does meet the criteria to be a disorder.
While I basically entirely agree with your comment, my partner (who is an optometrist here in Australia) would often point out to me that myopia is a big risk factor for retinal degeneration and detachment, open angle glaucoma, and cataracts at a young age. So while we definitely shouldn't treat mild myopia (like I, and likely you have) as some horrific medical condition, she also gets a bit frustrated by general practitioners and retail optoms who don't treat a lot of the eye diseases she handles with the gravity some of them actually should bear.
Anyway this is a massive tangent, just was something interesting I wanted to share!
My (somewhat loosely informed) intuition suggests to me that in the same way that not spending enough time exposing the eye to light outdoors increases the severity of myopia, it would likely be causative in those other degenerations. Use it or lose it!
Not that I know anyone who spent all of their childhood with nose in a book then graduated to a computer, cough... I say this having quite mild myopia, although I wear glasses still, can't stand a blurry world.
Significant differences in brain neurophysiology are well-documented in ADHD (vs. non-ADHD people), and show genesis of the condition is multi-factorial. Calling ADHD a "disorder" implies the condition has physiological origins but is not attributable to a narrow/distinct range of factors like a condition termed a "disease" (such as viral illness, etc.).
The issue of diagnosis conceptually reflects a state where "malfunction" and "maladjustment" or "maladaptation" coincide. IOW malfunction is relevant when it's maladaptive, that is lacks fitness to a problem-space. In a computer application a bug (malfunction) can lurk undetected as long as the code containing the error is not invoked. But when some refactoring exposes the bad code to invocation, that code is maladaptive and the result is dysfunction of the application.
An example is an ADHD individual with trouble prioritizing who takes longer than peers to complete tasks. Not a problem when deadlines are minimal. But thrust into a role where timely performance is required risks failure, loss of a job, etc. The individual's malfunction is then maladaptive, which could prompt the person to seek help to mitigate malfunction and improve adaptability to realities of employment.
Consequently there's no across the board right or wrong answer to the "correct" way to regard ADHD characteristics. Also I agree with you that "mental illness" is a misleading term that could profitably be expunged from our vocabulary. However were that to happen the conditions that are labeled as such are still very real and will in many cases continue to need treatment regardless of the labels we apply.
> <X> is part of the natural variation in how human brains work, and ... it's a category error to think of it as a malfunction to be repaired
No! No one is saying that everyone at one end of the spectrum has a disorder. It is specifically not a category error because the term "disorder" is not applied based on the variability, but rather based on whether the variation meaningfully disrupts the individual's life.
That's why the only change the author needs to make here is to say he has an attention deficit rather than saying he has a disorder.
If you are not disrupted, you do not have a disorder. Psychiatric medicine is about you and how you feel about it. If you feel like you can make a life change and have it not impact you, great! Do that.
> A hunter gatherer might actually [...]
That's nice, but it's not what you are and not how your life currently looks. So why do you think it's relevant? I don't understand this reference.
> Its like saying someone who is very tall has a disorder because it makes them a poor horse jockey
It is not, because this is about mental quirks that impact your life to such an extent that you feel you cannot adequately live it.
No. Again: the diagnostic criteria are not this simple, and it's a strawman to argue against something that isn't happening. Diagnosis requires disruption across multiple areas of one's life—not just an inability to be successful at the highest competitive levels in a specific skill.
I would just add that I like to refer to it as "attention dysregulation" rather than 'deficit'... my experience I can focus on one singular task to the exclusion of all other needs and demands (even base biological ones), to point of being in pain and exhaustion and causing myself harm.
Staying up for 40 hours programming... running trails for hours and hours... I have more than enough attention.
If someone is psychotic and disconnected with reality are we just applying our neurotypical filter? Should we just accommodate people who hear voices?
We should do a better job than we do now.
To the same degree disorder may be an acceptable label by a clinician, but we need a different word for regular everyday use - because if I come into work and tell everyone I have a disorder, they're going to make assumptions. And then back into the closet that information goes.
I'd say a lot of people don't share information about their neurodiversity for this very reason. The fact the top comment here argues about the linguistics rather than the content or spirit of the article, tells me we're not ready for that yet. Which is surprising given the readership of this website likely caters to more neuro atypicals than average.
In particular, I think it's important to recognize that most people do share information about their neurodiversity, and really this is the key point of neurodiversity as a term. When there's no "disorder" framework lurking in the background, people are happy to talk about how they're cranky in the morning or terrible at public speaking or spent the last 30 minutes anxiously editing their 5 line email. It's only when people worry about falling under some particular label that letting others know becomes an issue.
Not applied to intelligence in the USA[2]. Personally I think retard is a fine word, so long as it is not applied to anyone with a low IQ, which most people wouldn’t do. Idiot, imbecile, and moron[1] are also fabulous words, which have lost their technical meaning from last century, because they were repurposed for “vernacular” use. Then again, I like using “special” or “speshul” too, so perhaps I am just bigoted.
[1] https://journals.sagepub.com/doi/pdf/10.1177/070674376300800... (1963)
[2] https://web.archive.org/web/20150627145120/http://www.wsj.co... (2010)
The concern, by some, is that eventually new terms will become a new pejorative. " 'Intellectual disabilities' carries less baggage with it at this moment," said Douglas Biklen, dean of the School of Special Education at Syracuse University. "Twenty years from now, it can become the new epithet."Or used against you. Happened several times in my life, no thank you. The iron thing is. Most of them are working in care.
I wish I could say the same. Were you diagnosed as child or an adult? I was diagnosed as an adult, and the school system I grew up in was rather... unwilling... to accommodate my "personality" differences.
- the behaviour they've been exhibiting, or
- the actual label/diagnosis of ADHD
I feel like hirvi is talking about the former, in childhood years, whereas michael perhaps is about adult life and the latter?
Most of the time, ADD works in my favor. But sometimes, (and NOT always due to "societal expectations") I need my brain to work differently than it does, and for those occasions the meds do wonders. But I truly hate the after-effects, thus I rarely take them.
1. When high levels of energy or reaction are required e.g. sports and games where reaction speed and/or impulsivity is advantageous. I have been told on multiple occasions when I have been in emergency situations with others, that I do not tend to "Freeze up" like many others do.
2. High stress environments -- When it gets down to "Fire and Brimstone" time, I can develop a "hyperfocus" in which I can focus for an exceptionally and unhealthy long amount of time. However, too much of this without recharging, and I burnout. In fact, I think there is a joke that ADHD medical school students all become ER doctors.
3. Environments where divergent and abstract thinking is beneficial over convergent thinking. I often think I can come up with good ideas, but I personally find my mind falling short of being able implement them.
4. Social situations. I know this somewhat ironic, since we tend to have trouble listening and pay attention to conversations, but I seriously have done extremely well in any role dealing with customer service, talking to unfamiliar people, etc.. I imagine a part of this is possible due to my personality, but I have heard anecdotes from other people with ADHD having similar experiences.
1. Yes, but I also have to know that I am the one in charge... otherwise I will not take charge, but I will be ready to be told exactly what to do, and THAT I will do very quickly. [see A below]
2. Also yes, and true for software development too, but it makes the long burn so difficult. Give me a fire to put out! I casually know an ER doctor who is highly regarded, but his personal life is a mess and he's into extreme sports. (And saw my son when he came in with a suspected neck fracture.)
3. Again, yes. Once a solution has been found, I'm done! Implementing it? Naaah... that's the boring stuff.
4. Sort of... I think due to personality and temperament yes, but also upbringing.
Two more points building on those.
Autism and adhd have a high co-morbidity. If someone has social skills to the point where others comment on how good they are; highly unlikely that's you. If the idea that you "intellectualise social interaction" rings a bell, it might be the case.
Sensitivity issues. This is a reason behind my addition to point 1 above. The most mild of corrections comes across as an accusation that one is am totally worthless and useless. A constant running inner critic devaluing every thought and action. My experience is that this is silenced or at least turned down by medicating with stimulants... and it is totally liberating.
1. I can sympathize.
2. I am software engineer that has and currently played various extreme sports, so there is probably a strong correlation lol.
3. I don't have enough bandwidth to implement thing sometimes when the RAM is maxed out and I do not have any Swap Space.
4. Makes sense. My family was predominantly in the medical field and they constantly would have to talk with lonely and/or bored patients all the time. So, you are probably on to something.
> "intellectualise social interaction" rings a bell
I tried to search for what this meant, but I found a few differing ideas that I didn't know which one to attribute to what you meant. Do you mind elaborating?
I do tend to talk fast and talk a lot. It used to get me in a lot of trouble in school growing up because I would basically talk non-stop (wasn't diagnosed or treated during those times). I still talk a lot, but I have grown out of a lot of it.
I have sound sensitivity issues like misphonia and I hate going to concerts despite being a musician at one time due to how painful I find the volume. If I go, I have to wear earplugs or I find it physically painful to be a setting that loud. Same thing with small engine devices like chainsaws and other machinery.
I do not think I have co-morbid Autism, but if I do not, then I probably missed a good chance -- then again, there is probably symptom overlaps between the two.
> disorders require that the deviation amount to a disorder
That is medicalizing diversity. Creating "disorders" where no one is bothered by them.
This is not uncommon in psychology. In the 1970s, homosexuality was also a "disorder."
He seems committed to using the term "disorder" about himself, even though he says he doesn't have one. But it's a problem of his own making: he could stop saying he has ADD and start saying he has an attention deficit.
> interfering with someone's life
The specific phrase used in the DSM-V is: "symptoms interfere with or reduce the quality of social, academic, or occupational functioning".
Schooling started to become compulsory in the USA in the mid-to-late 19th century, and really only became universal in the early 20th century.
By the late 20th century we had decided that children whose normal behavior "interfered with or reduced [...] academic [...] functioning" had a disorder.
We created a system that does not accommodate everyone, then turned around and said that those who are not accommodated are definitionally disordered. The logic is clearly backwards.
Similar story with labor.
Try imagining a literal five-year old in a grown-up body. That's what this person is like when it comes to anything that does not have immediate (< 5 minutes) consequences.
I say this with love, to be clear. They are the most wonderful person. But I could not live with them without support.
Any system that accommodate this type of problem needs an external support structure to offload the burden on many other people. In our society, we call it mental healthcare, and we use diagnoses to help triage.
Or consider a game where different character classes exist e.g., Necromancer (can raise an army with no resource, quickly) and Wizard (requires lots of resources, slow to develop though some units are exceptionally strong). Would it make sense to consider being a Wizard to be a disorder in such a game?
Does someone with congenital heart failure have a disorder?
I'm not suggesting that ADHD is on par with congenital heart failure, but neither are skin color or one's propensity towards wizardry on par with ADHD.
If a game map is small (there is not much time for development before you are destroyed) and/or resource-poor then being Wizard is certainly a disadvantage compared to Necromancer (it is a "disorder", wizards are "demented" from the Necromancer's point of you).
Perhaps a concept like CPU/GPU binning would be a bit more helpful to consider, but even then, it reduces one’s entire experience into manufacturing terms.
The worst CPUs are thrown in the trash. So are the broken hammers, and eventually the screwdriver misused as a hammer.
The author frankly does not know what he’s talking about. And, clinically, he does not have ADHD.
I have a mood disorder (NPSLE). I am on permanent disability and I have been hospitalized several times.
Even though I know my disorder comes with a gift, and rather unappreciated gift because I do consider myself neurodivergent, I also know at times I want to die at my own hands. And I also know it makes me unable to work.
I think the threshold for where we think some Neurotype is affecting our life has been lowered dramatically.
https://news.ycombinator.com/newsguidelines.html
Edit: we've had to ask you before about breaking the HN guidelines (https://news.ycombinator.com/item?id=30570715). If you wouldn't mind reviewing them and sticking to the intended spirit of the site, we'd appreciate it.
The criteria specifies that "There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning."
I don't see this as being the same thing as ADHD being a NEGATIVE. It's like saying that being short is a disorder because it interferes with picking fruit from tall trees, and being tall is a disorder because it interferes with your ability to be a jockey. While both of these are true, it's ultimately condescending to frame either of these as a "disorder" simply because both aspects negatively interfere with one lives in certain contexts.
The diagnostic criteria does not rule out that one can be an exceptional A+ student which still has their symptoms interfere with school functioning if they're for instance repeatedly sent to the principals office for disrupting classes. Simply the very fact they have an issue that other children typically do not typically have, wipes away all consideration of their positive merits, and justifies a rather insulting label. To me, this is reflective of the typical feeling superior to those who are atypical.
>I think the threshold for where we think some Neurotype is affecting our life has been lowered dramatically.
Undoubtedly, but this doesn't in itself justify not lowering the threshold.
"There's too many kids being diagnosed with ADHD."
Um, just maybe those kids would really like to not be made to feel absolutely worthless in life because they have struggles with their attention that was previously written off as them being naughty or not trying hard enough?
Don't get me started on what a horrendous environment a school can be to someone who might just operate a little bit differently.
That criteria sentence from the CDC website is overly broad. If you watch more technical talks [1] on ADHD they go into much more detail about what ADHD is exactly and why it affects almost everything very severely (it has a specific impact on executive function, which cuts across a lot of behavior). It's not just a wishy washy way of describing a category of dysfunction.
[1] one example: Dr Russell A Barkley ADHD - The 30 Essential Ideas everyone needs to know https://www.youtube.com/playlist?list=PLzBixSjmbc8eFl6UX5_wW...
Currently 9.4% of children are diagnosed with ADHD[1], but we don't diagnose 9.4% of the population as having a disorder on merit of being very tall or very short. In fact, with ADHD, we're also not also counting the opposite of ADHD as a disability, so we're counting a HUGE swathe of the lower end of the spectrum as being disabled. I don't disagree the reason ADHD is considered so serious is cultural, but I find the culture to be incredibly condescending.
For context, Russell A Barkley has been a paid consultant for a large number of pharmaceutical companies. He takes the position that ADHD is akin to a physical handicap and Ritalin is akin to a wheelchair, espousing how incredibly treatable of a disorder ADHD is. I don't agree with him very much because I've found the wheelchair to have a surprising amount of side effects while not being entirely effective. It feels more like a wheelchair I sit in to please others which ruins my own health. I have watched all of Russell Barkley's videos, and took him seriously enough to try everything he advised (Which is a LOT and I had to fight with psychs to try some of it), and it didn't work. Overall, I've mostly found myself to be pretty successful without using any sort of pharmacological treatment, and thus I'm not very attached to the "ADHD as a disorder" narrative and honestly feel like it's mostly done me a disservice.
I also don't really feel it's something I have to accept due to it being scientific fact, as the sheer instability of ADHD diagnostic rates makes me sceptical scientists really have that firm of a grasp on the disorder, the differences in how people react to medication is pretty much completely unexplained by the current scientific theories, and the current scientific theories don't really explain that well why people without ADHD seem to have performance enhancing benefits from the drugs [2]. Which makes me wonder if we're "treating" ADHD, or if we're just letting people with ADHD dope while not allowing others to. To me, I suspect ADHD is an oversimplification of a more complex underlying reality, similar to IBS. I am much more keen on the "ADHD as as social construct" theory than I am on the "ADHD as a medical condition" theory.
[1] https://www.cdc.gov/ncbddd/adhd/data.html [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489818/
Not every disorder has a double-sided spectrum of behavior. What's the opposite of Bipolar?
I don't doubt that diagnosis is hard and error-prone, and I don't think any honest scientist claims they have firm explanations for every aspect of ADHD and its treatments. It's an ongoing field of research.
But 70 - 80% of children quickly show improvements in response to stimulant therapy very quickly. That's worth a try for such a debilitating condition that sees a third of its patients drop out of high school and 5 - 10% graduate college at all. ADHD's heritability is insanely high at ~80%. None of your tenuous data-free assertions really changes the good science that has been established. We're not talking about controversial stuff here like SSRIs that barely beats placebo. You're going to have to do more than poke at some gaps to twist ADHD into the wholly different "social construct" theory you have even less actual evidence for.
[1] https://www.sciencedaily.com/releases/2008/08/080811195643.h...
In my experience, I noticed most the negative impacts caused by the disorder were actually due to how I was treated by others for the negative impact my disorder caused in their lives (real or perceived).
According to other people.
What if I think my behavior or emotions are appropriate or justified? The people that are not like me get to tell me how I should be? Seems kind of sick to me. What about the opposite? Are the people that lack disturbances in behavior, emotion, and cognition really that much better off? Regardless, they are definitely accepted easier (assuming they have no other divergent issues causing them to not fit the mold).
To me, it seems like ADHD is basically a diagnosis in which one lacks the proper neurological components of being a good little worker-drone in a capitalistic machine.
Can't focus? Can't sit still for 8 hours straight? Take longer to complete tasks? That's no good. Take these pills, shut up, sit still, and produce! Who cares about the longterm effects of taking amphetamines everyday. It's not /their/ problem, it's /my problem/. I mean, that is all us dairy cows are good for right? And what good is a dairy cow that produces no milk?
I’m not sure this is correct. If someone is managing their ADHD it doesn’t mean they don’t have it.
Yes, many individuals with ADHD can cope without medication and may go on to live good-enough lives that might be the envy of others. However, there may be a lot of potential being left on the table staying untreated.
So to say that someone clearly doesn’t have ADHD because they don’t have a rep of reckless driving tickets because of impulsivity lapses is a bit of a slap in the face for many who still do, but developed compensation strategies to some extent.
It sure is not handled like one. If that is the case, then I find it odd that most people get treated by psychiatrist and not neurologist. Also, why are fMRI and other neurological scans not used to diagnosis the illness? It seems to be merely symptom based diagnostics coupled with psychological evaluations.
(I am not saying there are not structural neurological differences.)
Six.
I had an MRI for hearing problems and they found flares around my occipital horns. They still did nothing.
Mental illnesses are the most medically stigmatized disorders.
FWIW, the author definitely has ADD/ADHD based on their descriptions.
By the way, don’t tell someone who is disabled and was hospitalized several times with a mood disorder that they’re gatekeeping a disorder. I can assure you, I know more than you do about mental illness, It’s genetics, and its environmental factors.
Why not?
I'm not saying it's what you're doing here, but it's quite common for sufferers of a particular condition to gatekeep their labels and online communities.
I do it myself!
Typical example: "Everyone is a little bit ADHD." Um, sure... but I can 99% guarantee it is being said in bad faith to discredit actual suffering. GTFO!
I find keeping a super simple excel sheet with a monthly list of work and personal tasks works well with next actions for litterally everything except daily habits/ routines. The act of physically moving complete items from one location to another seems to keep me using it (I use Desktop version with autosave enabled) its not so mobile friendly but it works better for me. Every task system I've tried which is a huge number of them I've got bored with or forgotten to use or micro managed to much, I dislike daily task systems for a number of reasons. This improved my productivity and focus literally about 1000%. I find leaving stuff off the lists causes more persistent interruptions to focus, I beleive due to the zeigarnik effect.
I've found diet works best when Low GI as glucose spikes and crashes really screw things up, will power correlates with glucose levels massively. I don't use any supplements but have done tons in the past they aren't really needed. Diet ratio 50% veggies, 25% protein, 25% carb per plate is a good ratio. Tea, Coffee can be a negative so its good to experiment times without it.
I think this is true. We're working and learning in institutions that are incredibly restrictive for people who operate a little bit differently, and it's telling how common ADD is as a colloquialism and not just as a diagnosis.
Foucault used to compare schools to prisons, and joke that the former is the only institution in democratic societies where someone still tells you when you can use the toilet. It's not always so easy to tell with ADD like behavior if the person is pathological or the environment, because you can actually make a pretty decent case for the latter, unlike for some other mental illnesses.
Without playing down the need to help people who do suffer from mental illness, not prematurely pathologizing people and framing them as aberrant is important. In particular with the inflation of ADD diagnoses of young children going hand in hand with a change in culture that seems to have largely robbed children of any opportunity to actually live like kids.
If life were different but the ADHD brain wasn't, I think there might be a world where it's not considered a disorder.
I've lived with ADHD-C all my life, and it was something that got me labelled as "lazy" and "unfocused" and even sometimes I was told that I didn't give a shit. People who saw me work 16hr days or work for weeks on end without a day off, these same people called me those things because of how I came across in social situations or in everyday life situations.
I think my tribe of ADHDers sorta see it as part of the formula in how we evaluate our own merit. I'm capable of incredible creativity and ruthless hyperfocus on task when I get spooled up the right way, and so I feel GOOD about myself because I know my true potential. I don't think of myself as some leper weirdo who can't talk right, asks too many questions, turns on a dime. Other people don't really think about that, it's not natural to take that sort of probabilistic view of people, of what they MIGHT be capable of. Stakes are high, and the cost of error correction is high enough usually to motivate a rigid adherence to cautiousness.
I'm not sure how exactly I feel about this article, but I'll say this in conclusion: I've never, ever, ever, even once wanted a different brain than the one I have.
I've wanted to be treated better, and considered more fairly.
I have also suffered a couple periods of major depression, which I agree is horrible in a far less ambiguous way. I can actually identify some very positive outcomes of those episodes. Ways in which struggling my ass off to try to be okay pushed me to achieve. But I'd absolutely throw out the good with the bad, if I could. I wouldn't wish depression on my worst enemy.
It can be simultaneously true that ADHD has no positive consequences for some people, whereas it brings benefits (or is correlated to beneficial traits) in other people.
This man, there is nothing wrong with. It is the world around him that's wrong. And apparently it's a clock speed thing, that's an actual scientific conclusion I'm arriving to, and talking with doctors about how to measure with high precision. It's literally, literally, literally the beat of a different drummer, fewer Hertz, and if he did go somewhere with more people like him it would not only be much better, he would both be much more liked and like those around him more (which is reinforcing), people would return him his lost belongings, his defeats would be many fewer, and...I divine his depression would vanish.
Mental and behavioral issues are tough because there are many shades of grey. If whatever you are experiencing is causing you pain and you cannot stop it, than it’s a problem.
I think modern society is tough because we tend to have fewer social connections and institutions. It’s easier to get stuck in bad situations or to be isolated than in the past, and I think that makes latent problems more problematic. The good news is that we have professionals who can help, but that bad news is we also have others (schools, etc) who help themselves.
What he is describing is everyone. The last sentence should read "Everyone has these problems just like me."
We are conditioned from a very early age to compare our insides to everyone elses outsides - the personas that they represent - or more accurately that we represent for them. Whether we imagine ourselves better than that persona or inferior in some way - it is all illusion.
Nothing is good or bad but thinking makes it so (where have you heard that before?)
Reading the comments below I feel there is a lot of beating oneself up. I know... I do this all the time. When I recognize that I am doing this I redirect it to accept and love my natural self (very liberating). This is our human nature. We all share in this. We should feel perfectly natural and ok about our nature.
The difficulty is in adapting to the structure of society. We are challenged to find ways to adapt and manage our nature in order to find some measure of accomplishment in that structure. Some adapt readily. Others have to work at it. We all face the same challenge and we all acheive different measures of success. Just make sure that it is your measure of success that you are striving to achieve.
The labels and their definitions are all a product of a feckless mental health industry that needs to create something to justify their existence. The definitions describe observable human nature and the labels categorize them. The negative connotation is a judgement - this is what causes so much stress.
This body of work is dynamic and changing. The American Psychaitric Association Diagnostic Criteria at one time included homosexuality as a mental disease. Can't suffer from Aspergers because technically it is no longer a diagnosis. So consider these examples to help keep it all in perspective.
Your "don't beat yourself up" is just as unhelpful as telling depressed people to "cheer up".
ADHD is a neurological disorder physically affecting the brain. It causes executive dysfunction that people can't think themselves out of.
How come that we try to create AI with NNs and billions of funding, but we don't pay the same amount of attention towards understanding the foundations of our own thinking?
I'm pretty open that I think ADHD is a disability, and anyone calling it a "superpower" is smoking crack.
I have ADHD, there's nothing cute or great about it, it really sucks to have this disability, I have lost countless opportunities and had to work 10x as hard to achieve the same as everyone else because of it.
I'm not less valuable as a person because of it of course, but I would gladly return my "gift" if that was possible.
If you're interested to know what science says about ADHD, start here: https://pubmed.ncbi.nlm.nih.gov/33549739/
Having a high IQ, being economically privileged, very good looking,is going to change the impact ADHD has on someone.
Also, its widely agreed that ADHD is over diagnosed.
Keep those points in mind when reading accounts like these.
In my case it meant staying out of jail, managing to graduate college and getting a career I could thrive in. Still... serious downsides along the way and always a struggle to hold it all together.
posted without source
If so how?
Years ago in college I was prescribed Adderall but it didn't make me focus more. It made me compulsively clean my apartment, masturbate, tweak out, and occasionally be extremely paranoid of being attacked while on public transit. I was ready to rip someone's head off. I discourage using this medication.
If you haven't reduced carb intake to a bare minimum I suggest maintaining it first for a month before looking for more help.
I have severe ADHD and Adderall has played a huge role in allowing me to do things (like building a successful career as a software engineer) that never would have been possible without it.
I am less angry, less impulsive, more deliberate, more attentive, more kind, and more patient.
Your reaction sounds like the reaction of someone without ADHD. I'm not claiming that's the case. I know everyone has different reactions to medications and you should do what's best for you. That said, starting adderall literally changed my life.
I would consult a physician though instead of eating less bread if you really do feel that you might suffer from a mental disability. Bread might help, but professional insight will certainly help more.
Did that get better for you?
You mean you only consumed water and salt for 20 hours of the day, or avoided these? Just trying to get clarity.
Also, did you find that type of carb food had much impact, or just overall amount?
I found myself reaching for more sweets both natural and artificial when confronted with stressful or difficult tasks as a coping or escape mechanism. This was very distracting. It was the hardest of all to reduce the intake of artificial sweeteners. I used to compulsively chew gum. Gum with aspartame did help me lose 70 pounds when I first started fasting, but I have since sworn it off entirely, as I find the sweets cravings to be a source of distraction themselves. The cravings and irrational dreams of injecting sweets do end after a while. I was very addicted to sweets and was unable to feel full. I think nowadays this is called leptin resistance.
Otherwise, I'm the same me. Just functioning and less pissed off or annoyed all the time.
I'm a regular brusher and flosser, for what it's worth.
The "test" is an honest answer to the question "if they made a pill to make it go away, would you take it?"
This is how I feel way too often.
Also “preserving genetic traits that are potentially useful in the future” is way to close to eugenics for my comfort.
How typical.
> When my first-year hallmates were “studying” they were looking out the window, playing with their pencils, talking to their roommates, all sorts of stuff that wasn't studying. When I needed to study I would hide somewhere and study. I think the ability to focus on just one thing for a few hours at a time is a great gift that ADD has given me.
That's the opposite of executive disfunction. (To be fair, the author does describe other hallmarks of executive disfunction elsewhere.)
Fucking lol
There's a perspective in some ADHD circles (and likely other mental health circles) that the concept of neurodiversity/neurodivergent are not the correct framing for living with ADHD. It follows this idea that when people highlight (or unmask) the parts of ADHD that make them quirky or entertaining to society, they are not revealing the _very negative_ symptoms of ADHD that are extremely debilitating. The proliferation of sound bite videos that portray ADHD in a very positive light on TikTok, ADHD memes, etc. gloss over the dark realities of ADHD. My personal belief is that while it's good to help people understand some of the more lighthearted ADHD symptoms, it's important that we share even the negative aspects. Of course, negative things don't get engagement (as the author states when he gets to mentioning a battle with depression).
TikTok isn't covering things like ADHDers' propensity to lose their jobs due to poor performance, the financial ruin from overspending and money mismanagement, poor physical health and wellbeing, likelihood to have comorbid depression and anxiety, missing out academic/professional opportunities, fewer if any meaningful relationships because of social disorder symptoms attributed to ADHD. You rarely, if ever, see social media ADHDers talk about how ADHD affects something like dental health because of the "out of sight, out of mind" effects and the inability to form healthy hygiene habits because there are no immediate consequences (the "now or not now" mental modes). How getting a restful night's sleep is a rare delight because of ADHD's ability to delay sleep. You'll never hear them talk about how ADHD people have a significantly shorter life expectancy than the general population--some studies calculating it by as much as 20 years.
These are all very negative, debilitating pieces of ADHD that get glossed over by modern social media movements of the quirky/neurodivergent ADHD crowd. Even this author doesn't really dive into the dirty pieces.
This is a long one, but all of that said: I have ADHD. I was diagnosed at 8 years old. Finally, got on stimulants for the first time as an adult and my life's trajectory turned around in a just few months. I still struggle with all the negative things that come with ADHD. But I believe that ADHD is both a blessing and a curse; that I can personally celebrate the parts that make me quirky and bring me joy and also be aware of the negative effects it has on me and on my ability to function in modern society. I do see it as a disability, but not as a hindrance. The more I learn to accommodate it for myself the better off I'm going to be long-term.