ADHD traits more reliably predict mental health issues than autistic traits
nature.com
nature.com
“Attention-deficit hyperactivity disorder traits are a more important predictor of internalising problems than autistic traits”.
@dang, could we enlist your help in title-smithing for accuracy? Something along the lines of "ADHD traits a more reliable indicator of depression/anxiety vs ASD" or the like.
"internalizing problems" seems like it's notably different than "mental health issues"
I wonder why impulsivity doesn't get as much attention, no pun intended.
Impulse control can be an aspect of the disorders, but that isn’t the topic at hand; nor does it make sense to directly compare to “criminal behavior” and other negative traits randomly.
Someone with ADD lacks some control over the direction of their thoughts, but not necessarily actions. The two are similar, of course.
Jumping from a vehicle or throwing a punch is a failure of impulse control, because the person usually regrets doing it at all, almost immediately. ADD doesn't usually lead to regretted actions, but regretted balance of how time spent, how long is spent on an activity.
Totally anecdotal, but what might help with ASD is some sense that you’re different from other people, and other people sensing that you’re different. On one hand that is innately difficult, but it’s somewhat more concrete and tangible than with ADHD. You at least get a sense of what you’re working with. On the other hand, ADHD can trick you into thinking you’re neurotypical.
You end up living decades feeling like a complete fraud. You have to internalise debilitating shame and anxiety for failing to be normal. You’re 25 and still can’t remember to pay your bills on time, or 35 and still drive your car until it runs out of fuel, 45 and can’t hold a job, 55 and can’t remember your family’s birthdays (you know the dates, but it comes and goes), etc. You constantly fail on basic tasks and disappoint everyone around you. People don’t think you’re forgetful or distractible; they think you’re cold or aloof, irresponsible or careless, and so on.
Everyone assumes you’re just a regular person who opts to perform poorly. You begin to think it must be true.
I’m not saying ASD is easier. I think ADHD simply has an insidious nature that causes one to try to hide themselves even more so, sabotaging themselves in ways that make the condition even worse.
My experience with ASD is that you can be a target, people are unfair and unkind to you, but unless you’re exceptional at masking or you’re closer to the neurotypical side of the spectrum, people seem to stop expecting you to be “normal”. They won’t necessarily penalize you for being atypical. People recognize that you need assistance. They might not like it, but you’re less likely to be scolded for going off script. With ADHD, your life is spent doing that dance, and everyone expects you to stay on script. If they stop expecting you to, then you’ve really fucked up — at least if you were on the spectrum you’d have an excuse, though.
Again, not saying ASD is easy. My sister is fairly debilitated by it and I’m not so much, and while my ADHD has caused significant struggles it has still allowed me a more comfortable life and career than she has. It just seems that you’re more likely to be overtly discriminated for having ADHD, I guess.
Feel free to tell me how wrong I am, how this doesn’t reflect your experience, and so on! I don’t think I’m right, I think I’ve just had this impression over time. I’m curious what others think and what this study brings to mind.
I hope you’re making progress and unloading some of the externalized stuff. It’s really hard work!
But personally?
Caring but not doing is the path to deep depression and constant guilt.
There is absolutely nothing worse for me than the feeling of "I need/want to do this thing today" and then I just can't get myself to do it. I wind up losing hours of time being completely unable to do anything. Literally sitting in a chair and staring at a wall feeling frustrated with myself. Not replacing what I need to do with anything else either. Not even watching a show or playing a game or something. Just sitting. Or laying down. Unable to make myself do it.
It's miserable. Medication has fixed basically all of this for me.
(a) "socially", as the name implies, is not just about the end result (X thing was done or not done) that's important, but the social perception around it. Someone not caring and not doing is seen and treated as a jerk. Someone caring but with a legitimate issue for not doing, is seen sympathetically, or can be provided accomondations, etc. The same way you'd excuse a blind or person who can't walk for needing special accomondations. This has very real effects, even if the fact that X wasn't done doesn't change.
(b) It also matters hugely for the person, to know themselves that it isn't just that they don't care or are just lazy, but that they have an underlying issue.
Man isn't that the truth. I can't begin to count the amount of times I've been accused of being lazy, or the times I've been told I could amount to more if I just applied myself.
Getting a diagnosis is amazing, not because it gives me access to drugs -- I don't use any -- but because it allows me to stop blaming myself for the ADHD symptoms.
Absolutely. One thing I’ve found though is that it takes a long time to realize how many things there are that you’ve internalized due to ADHD.
I’ll find myself kind of falling into a rut of self loathing and think, wait, how’d I get here? What’s the root of this?
After a bit of digging over minutes, hours, or days, I come to realize such bizarre ideas have been embedded over the years that really don’t make sense. Unfortunately their effect is totally real.
Finding and dealing with these things is kind of like weeding a garden. Identifying the weeds can be difficult, and they’re all hiding in and around the cover of normal plants. Their seeds and roots keep growing back if you aren’t careful.
No one in my childhood and teenage years had the idea that I was 'different'. However, I was constantly gaslighted that I was, for example, too rude to look people straight in the eye, shake hands, kiss all people on a family birthday (yuck) or that I was lazy because I really needed an hour of rest after school or work instead of doing household chores immediately.
I never fully met all the social norms, my siblings did, and was therefore a bit of the black sheep in the family. According to my (loving) parents everything was my own choice, and of course in a sense it is, so in the end I fully believed that too. It took some time to rebuild my self-image.
I strongly suspect the more divergent you appear while still being high functioning, the better off you might be (in regards to internalizing, at least). Of course that’s only based on my personal relationships and experiences; I could be way off the mark.
ADHD has become such a fad that people tend to be dismissive of new diagnosis, especially in adults. But adults are exactly where you'd expect to see a lot of new diagnosis, since many of us had negligent health care when we were younger (for example: I also have significant hearing loss that wasn't diagnosed until I was 14, but I had been failing hearing tests since I was 7, no one told my parents). And in middle age the compensating behavioral systems we developed can just stop working, especially when assaulted by pandemic-related chaos.
Well, ADHD/ADD you don't suddenly catch. You have it or you don't.
>ADHD has become such a fad that people tend to be dismissive of new diagnosis, especially in adults.
I'm not so sure it's a fad. People say it's a fad, but could be because they dismiss people who genuinely have it, and also because it was not something diagnoses back in the past (say, pre 90s), so every boomer or even Gen-Xer can view it as just an excuse (as in: "we didn't have that excuse back in my days..").
It's also because like any mental issue, it's invisible. Same way people ask people with depression to just "snap out of it" or "be more positive".
As for the work thing and being lazy - I strongly believe lazy isn’t a core trait so much as a symptom of core traits and your environment. I imagine if you’re interested in something, your “laziness” suddenly evaporates, though I accept that I could be wrong.
I used to think I was lazy and resented it about myself so much. I’ve come to realize that I’m actually extremely dysfunctional when confronted with uninteresting work. It’s not like I think I shouldn’t have to do it. I believe work is inherently good for us, assuming it’s pro social and beneficial to the worker and community. It’s part of how we support the people around us. I have no problem with that and I like the idea. Nonetheless, my brain goes haywire when I need to do an excruciatingly boring thing for the 200th time.
Part of what made me realize this is discovering the extent I will go to engineer ways out of doing work I don’t like. That’s not lazy at all.
As for holding a job, the notion of a “full cup” (or an empty one) in psychology is a useful analogy to use: doing things which energizes us fills the cup (exercise, play, sex, good nourishment, rest), while other things like unsatisfying work, dysfunctional relationships, not enough rest, bad nourishment, etc. will drain the cup. If you’re running on empty, holding or getting a job is a monolithic challenge. Don’t doubt how hard it is. Everything is on hard mode. It’s already hard enough for many of us, but ADHD makes this kind of thing seem insurmountable at times. A common response is to do nothing because it’s hard to imagine where to even begin.
I can’t speak for you, but you might be underestimating what you’re up against. This is easy to do because you’re surrounded by people who minimize what you’re dealing with (often without realizing it at all).
As for attention disorders, I'm definitely in the territory of "everything is hard", and I've been doing nothing for some time now (even before pandemic). But I'm hoping this year I can finally make some forward progress.
I hope this year is better for you. I find I have to have an explicit plan, otherwise I rarely act on things in a meaningful way. Maybe that would help you too. I set very basic goals and try to arrange my living space and even digital spaces around the goal. If it isn’t in front of me all the time, I’ll quickly forget it. I underestimated how much I need to shape my life around goals and plans for a very long time. It drives my family crazy, they think I’m obsessive. In reality it’s like the world vanishes from existence if it isn’t pushed into my face constantly; if I try to hide anything from them, I’m hiding it from myself too.
I grew up thinking/convincing myself I was """normal""", living in a family where my father wasn't diagnosed with Aspergers/ASD and ADHD until my early teens - my sister has severe/low-functioning ASD with severe mental disability. In hindsight, my parents should have probably had me diagnosed but I'm sure there was guilt and fear that their youngest would be "affected" as well.
I ended up coping with long-term self-social isolation/videogaming until my early 20's, when I finally got referred to a psychiatrist by my doctor and diagnosed with ADHD.
Masking my ADHD day in day out is extremely tiring and by the time I get home from work I just want to do nothing but sit in my office and play video games to make up for all the dopamine that I crave but don't get during the day - while dishes, paperwork, clothes pile up and the shame of not doing them is a constant reminder.
I still find it hard to have conversations with people and don't think I'll ever be in any kind of relationship - I feel like I've somehow told myself that I won't find any meaningful bond with anybody though I'm sure that's the depression and anxiety creeping in.
It's hard not to compare yourself to others and ask "why am I not like them?" when the answer is simply always "because you are you and that's okay" without feeling guilty or ashamed. It's a constant shadow over me (and maybe others too?) and even with regular visits to my psychiatrist and medication it's hard.
I know I’m just another human being with weird thoughts. There isn’t anything that odd or special about me in the scheme of things. But the sense of that, the experience of feeling like an “other” or an imposter, is excruciatingly isolating.
I find it hard to simply order coffee at times because in my mind, I feel as though I’m operating the marionette that people see as “me” and watching from behind its shoulders.
My interpretation is largely around failure cases. People with ASD who can't mask it tend to fail in "abnormal" ways; i.e. ways that neurotypical people don't. Those "abnormal" failures are something neurotypical people can't "put themselves in the shoes" of. That unfamiliarity leads to either discrimination or empathy, depending on the person/situation/etc.
ADHD tends to fail in "normal" ways; i.e. ways that neurotypical people do fail. Most problems associated with ADHD are something that neurotypical people might also do, but far less frequently than someone with ADHD. E.g. forgetting an appointment is "normal", forgetting 5 in a row is not. That familiarity allows people to feel like they can "put themselves in the shoes" of someone with ADHD. They sometimes think those problems can be solved the same way a neurotypical person might, and think the person with ADHD is simply refusing those solutions. That leads to more discrimination or ill will; because the problems are "normal", the person with ADHD is judged by "normal" standards.
I don't think it's isolated to ADHD, either. Any mental health disorder that has "normal" failure cases is prone to that effect. People with depression that can't get themselves out of bed are often judged by "normal" standards, because neurotypical people sometimes don't want to get out of bed. People with social anxiety get judged by "normal" standards because not wanting to socialize sometimes is a fairly "normal" problem.
That’s actually a very important aspect of all of this. As hard as it is to have ADHD and have to do the whole square peg in a round hole thing, it’s understandably hard for the people around us as well. It’s totally forgivable to expect what works for them to work for us.
And of course, many people have the jackpot of having both of those, as one is a common commorbidity of the other.
It might just be that the DSM-V is wrong and that those people have both ASD and ADHD
That's wrong.
>if you have ASD you can't have ADHD
Not only you can, but it's a very common diagnosis.