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Comment by void-pointer | Hacker News Reader

I feel like I’m going mad.

Is ADHD a debilitating condition that can be consistently and independently diagnosed, with verifiable symptoms and clear criteria as to who _has_ ADHD and, more importantly, who _hasn’t_?

or is it a loosely defined group of behaviours that all people experience at different severities at some point in their lives, which have all been grouped into a nebulous so-called disorder (although many neurodivergent people now don’t like it being called that) so that doctors can quickly and efficiently work through the ever-growing mountain of patients who struggle with concentration in a world that is constantly and systematically trying to distract them?

I don’t want to insult people and I don’t want to be rude. But the more I read about ADHD, the more it feels like a meaningless diagnosis to absolve people of the responsibility to work on their concentration, and absolve them of blame if they can’t.

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ADHD is ultimately a disability of reduced executive function, and all of the seemingly disconnected symptoms are connected by that common fact. Everyone has challenges with executive function in life - especially if chronically sleep deprived, but the degree of severity varies substantially to the point where people with ADHD are radically different from people without on a lot of axes.

It's quite the opposite of "absolve[ing] people of the responsibility to work on their concentration." Instead the diagnosis shows that this is indeed the reason why people with ADHD have been struggling to meet expectation their whole life, and there are specific actionable things they can do to fix it, that aren't the same thing that work for people without ADHD.

I had a huge amount of guilt and shame that comes from having tried every productivity, organization, and concentration technique to no avail. I felt like I was pushing against an invisible brick wall that nobody else had. I could deeply care about something, focus all of my energy on it, and yet fail to do it for reasons that remained a mystery to me- when peers with less innate ability and less motivation/drive still did it easily. The diagnosis made sense of this, and pointed me to solutions that actually work.

As a parent of a young child with ADHD that was kicked out of 5 schools before getting a diagnosis that led to him thriving... the idea that it is just an excuse to avoid personal responsibility seems absurd. I could (and have) guilted myself into thinking this way about myself, but can't really apply that to an innocent young kid trying their hardest to fit in, and constantly being rejected and abused by adults and peers due to their brain just working so differently.

But how does “there are specific, actionable things they can do to fix it” mesh with the declaration that people with ADHD are part of a community of neurodivergent people who seem to actively push against the idea that they need fixing?

I don't think that's a fair way to characterize the ADHD community's stance. I follow some of the 'leaders' of the ADHD community including William Curb (Hacking your ADHD) and Jessica McCabe (How to ADHD) and they are extremely focused on specific strategies and techniques that enable ADHD people to live more effectively in a neurotypical world.

These strategies don't "fix" or "cure" ADHD, but allow us to do what we want in our life, and are generally very different from productivity and life strategies that work best for non-ADHD people.

One could imagine a world where ADHD was the norm, and things would work out just fine, with a lot less stress for those with ADHD. However, that simply isn't the case, and the ADHD community is quite realistic about that.

Thanks for the insight, I’ll take a look at those people.

It doesn't.

I always seem to upset a lot of people when I bring up my take/experience on this because they seem to find it (psychologically) threatening. Labels such as ADHD seem to have value for those who use them and want not further examine themselves or their situation.

I was diagnosed with ADHD as an adult and after a few years of psychotherapy (and trying medication) it's becoming clear to me that a lot of what people call adhd, people with adhd, ... is an external observation of an internal experience of emotional management issues with regards to anxiety and anger: impulsively responding to these emotions in a way that was learned during an earlier developmental stage, that now no longer leads to desirable outcomes (often hiding, running away, not getting externally angry when it is appropriate or desired). A lot of self-deceit and unworkable mental models seem to be involved. I hope I'm not projecting myself too much :).

This is a good point, and why so many ADHD people feel guilty or unsure about their diagnosis. Doesn't everyone feel like this?

Adrian Chiles' "inner chimp" and other columns [1] helped me understand it. Also, when I laughed off my psychologists' questions ("oh, everyone would answer these questions the same way, this is silly"). Oh no they don't, she said.

There will be a grey area for sure. But for people who have it, it is real, and it is different to how other people experience the world.

https://www.theguardian.com/society/2020/sep/30/my-treatment...

It’s just that ADHD was not recognized until recently. We as a society is not well informed about this. But it’s important for us to feel the need to address this problem.

I think the best analogy is myopia. Until glasses were invented, people with poor eyesight were very limited in what they can do. People with glasses were stigmatized (remember “four-eyes”?). We didn’t know what caused it. Then things became normalized and lens making techniques became so advanced and ubiquitous that it no longer became such a big deal to see people with glasses. Then things like contact lenses and surgical procedures that came along which can correct it, making the person with myopia indistinguishable from one without. We are now starting to reach a stage where people can prevent the condition from developing because we have a better understanding of the disorder (although there are a lot of snake oils out there).

ADHD is like myopia, which limits the range of things that people are capable of. We have imperfect tools like adderall which has a lot of unwanted side effects. My hope is that technologies like AI personal assistants geared toward helping people with ADHD will act as a way to augment these deficiencies, much in the way glasses have. We as a civilization simply did not reach that stage.

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