Normal Boyhood Is ADHD
world.hey.com
world.hey.com
From my experience the main disruption in the life of boys with adhd is primarily social. I have seen, privately when I was trusted, teen boys in tears of grief, regret, deep in despair of self loathing because of yet another in a long line of exploded relationships because of their impulsive words or actions that they feel powerless to stop. I've seen the incredibly strong feelings of rejection & isolation they suffer at feeling excluded or singled out because of behavior that they do not wish to have but do not know how to stop.
Succeeding in school, even learning itself is, to me, far secondary to this concern. Someone who has never read a book or learned algebra can still have a life they find fulfilling and meaningful on their own terms. I don't know that someone who cannot create and maintain relationships with their peers can.
There is some newer research, and shifting opinions among professionals, that adhd (or maybe just some variants of it) can be understood and addressed primarily as emotional regulation disorders. This fits with my observations of teenagers, yes especially boys, and also my own experience having adhd.
The hyperactivity and learning disruptions have been historically central because that is the parent or educator's experience of a child's adhd. But I think there's a lot to be practically gained by focusing on the child's experiences & goals, and how adhd disrupts them. This post isn't quite that.
The ADHD self-diagnosis trend amongst adults also needs to stop. People are now ascribing any minor challenge in life to ADHD. Everyone procrastinates. Everyone forgets people’s names. Everyone has trouble focusing sometimes. It’s not ADHD, that’s called life.
My worry is that by giving it a label, it lets people give in to negative behavior because “that’s just the way I am,” or “I’m neurodivergent.” But even people with severe emotional and behavioral challenges can navigate life. It’s not an excuse to be inconsiderate.
I meet adults today who self diagnose with ADHD so they can get Ritalin or something I suppose. They want to take stimulants to be more efficient at work or have more energy at home, but I can't imagine wanting to feel that way all the time. I HATED being on Ritalin, made me feel like a zombie.
Those people most likely don't feel like zombies and just feel normal (or better). ADHD medication is extremely personal, some people feel normal, others feel better, and some feel terrible on any given medication.
Decades of research by Russell Barkley and others have given us a fairly deep insight into ADHD and the tests and questionnaires that have been developed over those decades is what an adult should undertake. Procrastinating, forgetting names, dates and not being able to focus (a lot of the time, not just sometimes) are the milder symptoms that will more often than not push someone with ADHD into a downward spiral of depressions and alcohol abuse.
What do you mean by that, what specifically needs to stop? It's a "trend" that results from increased awareness about ADHD. This is massively helpful for people who have undiagnosed ADHD, but many people have sadly co-opted the term "ADHD" to describe any minor struggle, just like they did with OCD. This is a problem that sociologists might be able to tackle some day, but in most cases self-diagnosis is the first step to getting an actual diagnosis as an adult.
> Everyone procrastinates. Everyone forgets people’s names. Everyone has trouble focusing sometimes. It’s not ADHD, that’s called life.
Of course everyone does those things to some degree. It's ADHD when these and other challenges significantly affect multiple areas of your life, starting in childhood, and often including your private life.
> My worry is that by giving it a label, it lets people give in to negative behavior because “that’s just the way I am,” or “I’m neurodivergent.” But even people with severe emotional and behavioral challenges can navigate life. It’s not an excuse to be inconsiderate.
There a lot to unpack here. People with ADHD, autism, and many other disorders process information differently. It's a lot like interacting with someone from a very different cultural background, they might say something that you find rude, and you'll probably say something that they find rude.
Both of you are likely to be reasonably good people with good intentions but you'll probably end up offending each other sometimes, whether it's cultural or neurotype related.
The vast majority of people with ADHD and autism already try to fit into society that doesn't cater to them, e.g. by trying to strictly adhere to norms and expectations that are extremely difficult to adhere to due to cognitive differences inherent to these disorders (e.g. impulsivity with ADHD), because they disagree with these norms (think about petty laws you disagree with and break all the time), or perhaps just don't fully understand them.
This is called masking and it's often mentally and emotionally exhausting, frequently leading to severe burnout and depression which I think is quite a natural reaction when the rest of society constantly deems you to be "inconsiderate" or otherwise unacceptable even when you've been trying your best and don't have any bad intentions.
I think it's quite hypocritical and extremely inconsiderate to label people with ADHD or autism as "inconsiderate" without living a decade with their disorder.
Of course there are some people who will try to use their disorder (real or fake) to excuse their crappy behavior but that's in no way unique to ADHD. Worrying about whether people are using ADHD as an excuse for bad behavior makes as much sense as worrying about whether people in wheelchairs are faking it.
> Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study
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> ADHD was associated with significantly increased mortality rates. People diagnosed with ADHD in adulthood had a higher MRR than did those diagnosed in childhood and adolescence. Comorbid oppositional defiant disorder, conduct disorder, and substance use disorder increased the MRR even further. However, when adjusted for these comorbidities, ADHD remained associated with excess mortality, with higher MRRs in girls and women with ADHD than in boys and men with ADHD. The excess mortality in ADHD was mainly driven by deaths from unnatural causes, especially accidents.
I mean I know what he means and I think there is merit in the argument, but on the other hand sitting down, paying attention, understanding stuff, and doing stuff you don't want to are in fact essential skills to get through middle-class adult life.
I mean if I shouted and punched every boss or colleague I disagreed with, well in some sense maybe I'd have more fun and be living a more "manly" existence, but it certainly wouldn't be good for my bank account.
It's quite specific (17-yr-old boys) but I couldn't find a source for the ~25%. The CDC[1] writes it's 15% for boys (3-17 yrs old). Across all ADHD kids, 30% didn't receive medication or behaviour treatment anyways (a percentage that's risen since 2016): Where's the over-medication?
When I got started with my own diagnosis, a good friend of mine was very skeptical, like "everyone's getting their label and mental illness". Intelligent guy, philosopher with no pressure to do any work at all. It took him some time, research and self-reflection to face the diagnosis (he went to the same specialist and the tests are very thorough) and well... I guess it's true: As someone with ADHD I do have a lot of friends with the same condition, almost shocking but also understandable once you think about the effects on social interactions that ADHD bring.
I received an ADHD diagnosis a few years ago, into my late 30's, after struggling through and relishing the superpowers of my own behavior. I was suspected of having AD(H)D as a kid, and was assessed but ultimately didn't get a diagnosis. It also turns out that, being a life long technologist, you put me in front of a computer to do an assessment and I will hyperfixate on it because I was given yet another opportunity to be between chair and keyboard. Wild.
I do find that medication helps me. So does structure, and external pressures that help conform me to a healthy routine. Most importantly though, I'm incredibly interest-driven. If I am uninterested in actually solving the problem, it requires moving mountains to convince me that I actually should. Medication is a tool that helps me to do things that suck with less mental effort.
It's not about wanting to eat stimulants for fun. Hell, aside from caffeine, I'd never had a stimulant before starting my meds. And yeah, when I first started taking it, I was high as a kite. But once I leveled off, the new normal was good. It's not a silver bullet - healthy habits, and setting myself up for success are essential, and no amount of meds compensate for when I fall out of a healthy groove. But it has helped.
I'm not a psychiatrist, let alone medically trained at all, so unlike DHH I don't feel like I'm capable of commenting as to whether ADHD diagnoses in kids and providing them access to medications is the right call. What I can say though is that had I had better support as a kid to learn self-reflection, I think I would have been more aware of what I needed to be successful and could have muscled through my younger years with a little less stress and confusion.
Those things aren’t going to change how much you learn or how much you retain, but they will absolutely tank your grades, get you into conflicts with your teachers and cause massive amounts of stress, anxiety and depression for you.
I wasn’t given medication as a child, and my experiences with it as an adult do nothing to suggest to me it would have made me better at learning. What it might have done though was eliminate the need to pull all nighters and late night mad dashes to complete assignments. It might have made it so I didn’t dread having to start each year and get a new set of teachers used to the idea that I really am paying attention (for the most part) even if it doesn’t look like it. My adult experiences back up the idea that the effects of the medication do wane with time, and I have been weighing the trade offs of taking vs not taking these medications (a trade off which would have been more difficult to weigh as a kid for sure, but not impossible with appropriate support). I am concerned at the tone of these recent articles that seem to be toeing very close to the “ADHD isn’t real” line again and that medication isn’t appropriate just because we don’t know the mechanism of action or because you build up a tolerance over time. We don’t know the mechanism of action for a lot of medications, and you build up tolerances to a lot of medications. It’s never been about no trade offs. It’s always with any medication a question of whether the trade offs are worth it?
Do I worry that the system itself is built and geared to chose medicating kids instead of maybe adjusting the system to accommodate, sure I do. But the answer to that issue is to advocate that the system change such that medicating to fit into the system better isn’t needed, not to just argue the medications don’t really do anything. And I feel like this and the NYT article mostly have made the argument not that the system needs to change (except to the extent that it needs to stop using medication), but that the system is fine actually and we just need to make the kids conform better. This may be sensitivity on my part to fighting the battles that ADHD has brought into my life, but if it is, then this is a plea for writers to be more explicit about what they’re advocating for, and to maybe tone down the “pill poppers” rhetoric.
There's so much more that the individual can do, but they need a group around them for support and, to be blunt, monitoring. The system needs to improve (I refuse to use "change") and with how this whole manosphere shit is influencing our boys and teens, it needs some fixing fast. Am I the only one missing stoicism and clemency as I currently watch Adolescence?