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Comment by colechristensen | Hacker News Reader

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That's not what ADHD is, that's what someone who knows very little about ADHD and has never experienced it themselves thinks it is.

Your comment's parent might know very little about ADHD, but your critique shows an antiquated view as well. It's not only the ADHD person that needs to change by any means available so that they fit the expectation of the system. The system, too, is in need of change, so that we accommodate more diverse people. Improving the environment that you operate in goes a very long way and might enable exactly the kind of change that makes children and adults with ADHD thrive. Medication is just one option. CBT and more flexible environments are as important, probably even more so.

It's not an either/or thing. At least for my kid, it's been a combination of the 3 that have helped, but if you dropped a component (including the medication), she wouldn't be doing nearly as well.

>Your comment's parent might know very little about ADHD

I know plenty about myself and that label.

I agree with the label being a huge problem. It's basically compressing a multitude of individual characters with huge differences on multiple dimensions of behavior into a binary label, which people confronted with someone bearing that label then decompress based on their personal view on the topic, which is like an algorithm trained on caricatures of what society portraits as ADHD. Your comment sounds like you're doing the same mistake: you take your favorite solution for a complex problem, which (I agree here!) might actually be sufficient for some, a relief for many, any at least good or not harmful for everyone else, but you try to market it as the only necessary solution while invalidating everyone's needs that go beyond this solution. It creates the reactions that you can see in already a handful comments that basically call for the individual to accommodate to the system at all cost...

There are many people who have the diagnosis and don’t agree with the mainstream perspective on medication etc. Don’t claim to speak everyone.

Hmm, I do this this is a point worth considering, but it needs nuance. ADHD is overdiagnosed in young boys, by about 3% iirc. But the thing is overdiagnosis doesn't mean that it doesn't exist at all. It's certainly underdiagnosed in middle-aged women for example, and tends to be underdiagnosed in women in general. There's also a point to be made that some ADHD meds are not without side effects, and kids aren't always listened to when they complain about them (I have a friend who was on Concerta as a kid and had a lot of side effects that really bothered her). But also, ADHD meds are a complete lifeline when they work, and they do work in most cases.

> It's certainly underdiagnosed in middle-aged women for example, and tends to be underdiagnosed in women in general.

What I'd like to see studied more is whether that root cause is underdiagnosis of inattentive type ADHD. My daughter was diagnosed because my wife is aware of this and had her evaluated, which led to me getting evaluated and eventually on medication. The common thread I've observed is that if you're reasonably intelligent such that it's not causing you to fail classes/get fired, people will just call you lazy and not entertain the idea that there's actually something else wrong. Couple that with girls/women having inattentive type w/o hyperactivity, and I think you do end up with a pretty solid bias.

> But also, ADHD meds are a complete lifeline when they work, and they do work in most cases.

For some there's a lot of trial and error, too. I wonder how many give up or insurance stops paying before they get to the right medication.

Ok, but what about when those children grow into adults that can’t sit still for 8 hours either? I am in my mid-thirties and I am still waiting for the hyperactivity to die down.

Getting the best out of yourself and your environment isn't a matter of waiting to fit in to the sit-down-and-focus shaped life. You have to learn about yourself and learn about how to shape your environment to live your best life, and a major step is not thinking about having that temperament as a disease to be overcome.

Ironically, I know myself very well. I had no choice early on life. I was not officially diagnosed until I was a young adult, FWIW.

Most of my difficulties in life are due to the intersections of my 'temperament' with others. If there was a way I could make life work for me, I would have done so by now. I did not choose to have this 'temperament', and I do not want to have this 'temperament.'

If you have been able to make your life fit for you, consider me jealous. But you need to understand that because you or others are capable of doing so does not mean everyone else is capable of the same.

I understand, very personally, the struggle and frustration.

Do you think most people are made to sit still for 8 hours? Do you think someone who can't do that is defective?

> Do you think most people are made to sit still for 8 hours?

No, I was just reiterating the value in the GP comment. I do think the ability to set still has some sort of distribution like all other human attributes. I think it's more important to focus on how little someone sits still compared to how long someone sits still. I'd be lucky to make it a few minutes.

> Do you think someone who can't do that is defective?

No, I do not think of myself nor others that way. I would identify as misaligned. Honestly, ADHD does not cause me as much harm as it does for everyone else in my life. And brother, let me tell you, after all the punishment you receive for being misaligned, you really start to believe you are defective.

>Ok, but what about when those children grow into adults that can’t sit still for 8 hours either?

Frankly, my ability to do exactly that when I do something I'm interested in is part of the problem.

I'd snap out of my hyperfocus at 11pm, realizing I haven't eaten or drank anything since lunchtime.

Yeah, the attention deficits can absolutely cut both ways.

It’s amazing to see a disproven and frankly ancient viewpoint espoused with a straight face here. When I was a kid in the eighties your way of thinking was already defunct.

This isn't defunct in any way. To the contrary. I've been diagnosed with ADHD myself and creating an environment that is accommodating to my individual needs has absolutely been in line with what experts recommended to be, and it's been a corner stone of my success.

CBT teaches you to evaluate how to shape the environments your living in so that you can benefit the most from your resources and weaknesses and suffer the least from your weaknesses. For some people, this can include taking stimulants, and this is where I do not condone your parent comment's undertone. Nevertheless, it's been proven over and over again that the rigid system that we call schools does not welcome neuro-atypical students and that we could do a lot more to help those who do not react well to stimulants, who do not want to use them (for whatever individual reason), or simply haven't been diagnosed yet! Allowing for movement instead of forcing to suppress it is a very good example for what could be done. One shouldn't make the mistake to think that this alone would be enough for every single child with ADHD, though. But for some, it could be enough.

And that viewpoint doesnt even account for adult ADHD/executive dysfunction.

Exactly. It also ignores recent genetic testing that's showing how different mental illnesses and developmental disorders cluster around the same dysfunctional gene cohorts. To very little surprise ADHD and Autism appear to be closely related for example.

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