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Comment by okhuman | Hacker News Reader

"ADHD" needs a rebranding... move away from clinical diagnosis from medical professionals which can be "heartbreaking" or "liberating" to coaches/advisors running community groups which build frameworks for these like minded, like personality individuals (and their associated family/friends) to operate in (like a 'club') and to help educate others (advocacy).

People with "ADHD" are already covered by the Big Five Personality Traits https://en.wikipedia.org/wiki/Big_Five_personality_traits like every other person is.

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As a coaching psychologist and a senior member of Shimmer team, I am ever so pleased to see you referring to the most validated bio-psychological model of personality traits. You are absolutely right that ADHD folk have a recognisable “signature” on a Big Five model, within the traditional and the modern interpretations of this theoretical perspective.

However, the Big Five model only talks about the most notable personality traits in statistical terms, whereas the lived experience of a person with ADHD is illuminated by the richness, variety and the amplitude of the rest of the personality traits which may be less statistically profound but critically important to a particular person and the way in which they relate to their ADHD.

While I can’t talk about the ADHD coaching overall, the “Shimmer model” is acutely attuned to the lived experience and phenomenology of each member we work with. And we always welcome critical and well-informed enquiries about what informs our approach. Thank you!

I propose we either call it "Focus Control Disorder" or where the context would be appropriate, "dopamine dysfunction". If someone is unable to function and it turns out they had a vitamin D or potassium deficiency, we don't call it "sunlight rejection disorder" or "bananaphobia", ya know? The very name of ADHD is ableist, it defines neurodivergent life in neurotypical terms (in this context, "neurotypical" merely means one has a brain that typically generates the proper amount of dopamine to function in modern society).

This is totally a problem with the manufactured society we have created as humans. I'm absolutely certain that when we lived off this earth more naturally, the traits that have become disadvantages were originally communal strengths. My personal hypothesis is that ADHD is a series of traits that evolved to make wonderful hunters. The ability for the slightest noise/motion to grab our attention, the hyperfocus on things that do grab our attention, the ability to make connections extremely fast in a fractal manner, all of these traits would be a huge advantage when hunting prey to feed your social group or to protect your group from predators.

The prefrontal cortex mediates executive function and working memory. It sends signals into the center of the brain which in turn reciprocated through dopamine neurons. Methylphenidate blocks the reuptake and breakdown of dopamine by MAO. Amphetamine stimulates the receptors on the other brain cells dendritic surface that dopamine stimulates. The middle of the brain then tells the front which tasks to focus on, what items to keep in working memory, and which emotions and behaviors to suppress. Working memory. Executive function. Emotional regulation. Because of a faulty d2 receptor, adhd brains do not respond to dopamine stimulation like neurotypical ones. They in turn fail to sufficiently signal the front of the brain which controls this higher brain function. It is unfortunate that the disease is called attention deficit hyperactivity disorder because it takes focus away from task salience--keeping on track and holding the steps to accomplish complex behavior i.e. The front of the brain. It also results in time blindness or the inability to evoke future potentials against closer consequences resulting in playing vidya instead of doing homework because the consequences are improperly measured by the front of your brain. Stimulants increase dopamine and acetylcholine. Coaching helps maintain task salience. Cognitive behavioral therapy teaches ways to externalize your executive functions and life skills and requires medical therapy in order to be successful. It is best to regard this as executive function disorder and stay away from attention as attention is often misinterpreted or lacks proper context.

Seems snap-25 also causes issues alongside d2. It helps pop out dopamine bubbles, in layman's terms. Dopamine is made in the nerve cell, then it is released outside the cell by a bubble called a synaptic vessel that basically goes inside out. It crosses the gap between cells and attaches to one of 4 dopamine receptors, the most important of which is d2 for adhd and amphetamine. It is then vacuumed up from that gap between cells by a set of proteins that can be blocked by ritalin, just like zoloft blocks the vacuum for serotonin. It then gets broken down by monoamine oxidase, another potential target for lots of therapies. This stuff is real folks and backed by knockout studies and fMRI scans.

Agree on the rebranding. Thank you for your positivity & inclusivity!!

Apologize if the "heartbreaking" and "liberating" language felt a bit dramatic (I am a bit dramatic...), but it really did feel that way for me after living my whole life feeling like I was constantly doing everything wrong.

Ever since slowly going deeper and deeper into the ADHD community, the positive spark of the community is undeniably special and since reframing a lot of my views on ADHD & myself, I've been able to lean more heavily on some of my "superpowers" as well.

We actually love the Big 5 personality traits out of all those similar quizzes, backed by good science and I think it's actually the fan fave of our Head ADHD Coaching Psychologist, Xenia!

There's an organization understood.org that is starting/forwarding the movement (neurodiversity as a whole, not just ADHD) exactly as you say! We're excited about some upcoming partnerships with them :)

Thanks for the nice reply and congrats on the launch!

So, please tell me, where does executive disfunction fall in the "Big Five"? How about time blindness? Emotional disregulation? Persistent short term memory issues?

It is a disorder which has a material impact on a person's ability to live in our society. In more severe cases, the afflicted benefit greatly from medication. No amount of rebranding or projection will change this.

Do you think this article describing a better name for ADHD as Variable Attention Stimulus Trait or VAST [1] addresses the concerns you bring up?

[1] https://www.additudemag.com/attention-deficit-disorder-vast/

"Executive function deficit" is another popular one.

Watch Barkley. They can't rebrand it as ADHD is already linked to law like PL 1973 and the Americans with disabilities act, and to get there was hard enough. We need to make people think executive function disorder when they hear the acronym ADHD.

Simplify much, are we?

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