ADHD as a circadian rhythm disorder: evidence and implications for chronotherapy (2025)
frontiersin.org
frontiersin.org
The associations with ADHD really are there, but that may just also be because a huge number of brain processes have a circadian regulation, and those get disrupted by whatever is causing ADHD.
The causality is also bidirectional, because whatever ADHD does could cause light exposure behavioral changes, which could leave a circadian phenotype.
In general, a huge number of diseases have circadian phenotypes. To be a circadian disorder, you’d have to have clock mutations, and ADHD really doesn’t have those. So calling it a circadian disorder feels off.
But from personal experience, the linkage is strong enough to warrant deeper research, and beyond that, there’s some steps we can take ourselves. Regular walks in nature, going out to get sun… all generally useful things to do that do seem to help ADHD as well.
This seems the most likely given my own experience with ADHD and sleep issues. Good sleep alleviates some of the worse aspects of ADHD. Conversely bad sleep exacerbates ADHD symptoms which can also worsen sleep, etc.
My 23andme profile says I have genes associated with delayed sleep. ADHD (and autism) really seem like they're driven by a cluster of multiple genes with many overlapping between people with the condition(s), but not all.
One rationale for that is how surprisingly prevalent ADHD is across many societies, which only makes sense to me if there's multiple genes which combine and which together confer various advantages to societies as a whole (if not to the individuals). One of the gene sets seem to be sleep issues. It makes sense in a pop-psychology level evolutionary biology where the "creative" types also tend to stay up later which might give them more focus time, or perhaps for story tellers / poets recounting tribal history, etc.
I hope this area gets more research. These things are highly inheritable among families.
I know because I am on the spectrum and suffer from overload. At night is my "flow time" when the creativity happens.
The clock just has that spread. And I’d argue it makes evolutionary sense. You want people who are alert later, in a group. But this holds for most animals too.
But the clock itself has a population wide variation in its actual period. It varies between 23.8 hours and 24.6 hours, and everyone far from the 24 hour ideal pays a tax. The clock either has to phase advance or phase delay to synchronize, and over time that has all kinds of impacts, including on sleep, but also memory and learning, stress, attention…
The whole system is clocked. Every cell in our body runs a 24 hour cycle, driven by the transcription, translation, inhibition and breakdown of the core clock proteins. They’re in a negative feedback loop, with a time delay, and all kinds of mutations can shift the overall period of the clock. If it’s of a core clock protein, the effect will be strong, but other genes cycle or have their functions in a cycle due to the clock, and feed back into the clock, so small mutations can accumulate to cause circadian period variation.
It’s also why you see circadian phenotypes in all kinds of diseases. Definitely needs more research, but the research is also hard. You need to observe the body in high resolution over many time points to start making sense of all this, and that’s expensive and exhausting. We’ll get there, though.
As a person with ADHD and who noticed that whenever I have a few weeks off (so no schedule restrictions, so to speak) my sleep schedule seems to advance by almost an hour a day, this sounds like it might explain a few things.
Can't speak for you but at least myself I find there's a delay of 24 to 48 hours before either sufficient or lack of sleep really catches up with me. It takes 2 to 3 nights of good sleep (unfortunately somewhat difficult to pull off) before I feel fully functional.
I got ADHD and Autism diagnosed as teen, the diagnostic was rather solid. Got methylphenidate for some months. I ran away from home with 17, i moved together with my girlfriend (at 26) into an emotionally stable environment and... the symptoms disappeared. No jactation, no special interests, no masking. Everything just disappeared. A bit of stimming remains. And a horribly fucked up sleep cycles.
Had undiagnosed RAD and CPTSD for longer than i'm self-aware. Severe emotional neglect for my first 17 years. Parental rejection plays a big part in here.
I'd be like, maybe i'm just a special case, and nothing of this applies to other people. But i see other ADHD-havers being too similar to me, and that includes hypervigilance and silent walking, which are apt adaptions to certain kind of childhood environments.
Maybe too much gets diagnosed as ADHD that is not genetic at all...
Stress changes the layout of your brain along with your body's chemical responses. With ADHD, genetics seem to play a larger role where you can lack the stressors and still end up with the same end result. I wouldn't be surprised that treatments would work across both CPTSD and ADHD.
This seems unexpectedly one-sided to me. It could equally be that ADHD is CPTSD from something that current knowledge does not consider traumatic (yet).
Edit: I think in practice this looks like normalisation of neglect and violence within a family.
It's very typical for there to be overlap between inevitability and environmental circumstances
I also have polymorphism in my melatonin, receptor genetics that are linked to this disorder. But I have several other genetics that make this a definite polygenic disease. So I highly doubt chronology efforts are going to work in a holistic way.
My heritage is from the Sami people of Finland. And my disorder is most likely related to that heritage and my sensitivity to light changes. But also changes in my diet. Specifically higher omega-3 fatty acids, and I mean really high.
How much & for what? I remember seeing a paper many years ago which claimed better depression at about 2g+ EPA/day.
> But also changes in my diet.
You should seriously try "metabolic psychiatry" for at least 6months with daily blood tests on GKI 1-2 (what children with epilepsy do). Most popular is for bipolar.
What about for someone who wants to better understand how sleep and their biological & cognitive functions are related?
https://youtu.be/KZJAmcpc9SE?is=5XZvvDQwLMC_rIdv
A book recommendation:
Internal Time — Till Roenneberg
Papers: 1. https://physoc.onlinelibrary.wiley.com/doi/epdf/10.1113/expp...
Somewhat old, but still a good systems level review. We know some of this stuff to higher resolution now.
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC7202392/
This one is a very approachable one on sleep and rhythms, and especially talks about why mental health disorders and sleep disruption tend to co-occur.
Royal Institution
Ty for the links and your other posts
A few years I was playing around with analyzing my own genome and found a needle in the haystack: an unstudied clock gene mutation (in CRY2), which, after correspondence and tests from scientists in the field, is effectively confirmed to delay the clock. Sort of unbelievable story, will write it all up some day.
As far as ADHD is concerned, I’ve never been officially diagnosed but certainly have some traits (and notably missing others); it makes me suspect that ADHD is probably a cluster of different etiologies, some caused by circadian issues, some not.
I’ve often wondered if having this variant would be useful at all for chronobiologists in the field to study / observe. Feel free to shoot me an email (in bio).
Back then, I got my genome sequenced via nebula genomics (no longer around). I found a lab that screens ~150 genes that potentially contribute to circadian disturbances. I punched all of those genes into this software called gene.iobio that came with the nebula report, which reports any potentially interesting variants and links out to Clinvar. There were a ton of results, everyone carries loads of these harmless variants, but the one that jumped out was in a gene I knew played a critical role in clock timing, and amazingly, that was it.
Cry2, or Cryptochrome2, is from a fascinating family of genes. I’m a chronobiologist by training and pursuing independent research in it, so I’m always fascinated to hear more about how it feels like from the inside.
Happy to share more if you ever want to connect. Tl;dr: feel from the inside is bad, would not recommend!
They'll return a BAM file to you which contains your genome, consider this the raw data. You can take this data to screening services that specialize in analyzing your genome for specific purposes. E.g. here's a service that specifically analysis for the sake of genealogy: https://www.yfull.com/
I've only dipped my toes into the topic but that's my base understanding so far, it's pretty intimidating at times but quite interesting.
If I sleep for 8 hours or more I get hypnic headaches, and massive all-day migraine-like headaches.
I have to sleep a max of 7 hours a night. Always feel slightly tired, but the alternative is headaches.
I average about 6 and it gets as low as 3.5-4.5 during the week, with a catch up 8 every so often. I get wicked and debilitating migraines which relate to missing the catch up 8 hours or missing my daily bike rides (30-40km).
I’d love a migraine cure.
idiot doctors what do they know
I don't know if it's because I'm in my 40s, have ADHD, or got on the meds. But it's becoming more noticeable the last couple of years.
I'm very sensitive to light in the morning and can't get back to sleep when the sun peeks in. And at night if my wife left her phone face up, I know when she gets a notification. I see the screen light up through my shut eyelids.
Eg see https://retractionwatch.com/2025/07/29/frontiers-retract-122...
problem solved I guess
I don't know about Frontiers in Psych specifically, but, see also: https://www.reddit.com/r/AskAcademia/comments/1oi5dhy/whats_...
> see this title
> oh man that would explain a lot
Ok after reading a chunk of this the correlation is pretty wild. Having the data it’s quite striking. Sleep intervention as a form of ADHD treatment has always seemed reasonable to me but this gives a lot more clarity to the approach and mechanisms.
For me, the seasonal aspect of it aligns with their blue light findings (both driving symptoms and aligning with improvement under the intervention of having a grow-LED garden setup on my desk), and in a second maybe related matter we’ve found using blue light blocking glasses an hour before bed to be the most impactful single intervention around sleep quality and onset (the ones that are like orange laser safety glasses, not the mildly reflective desk-work glasses)
> see this title
> think authors are reversing causation hard
-- signed, a deep Night Owl
The following (informally described) symptoms are well-known consequences of ADHD:
- Delayed Sleep Phase [1]
- Staying Up Late [2]
- Revenge Bedtime Procrastination [3]
Newsflash, getting a full night's sleep helps alleviate ADHD symptoms, while being perpetually sleep-deprived wrecks us.
But there are reasons why we stay up late. Simply forcing us to sleep doesn't address those reasons.
Which is why I wrote about it so much, and keep spamming these links even though it feels so darn obvious. Not to the authors of the study, it appears.
[1] https://romankogan.net/adhd/#Delayed%20Sleep%20Phase
staying up late rocks. its the funnest. why would i give that up? just to pay attention better at work? no thanks.
You may eventually find yourself in a situation where the tradeoff is worth it.
E.g., you have a family to feed, and your ability hold a well-paying job hinges on your performance.
sigh
ADHD PEOPLE ARE NOT MOTIVATED BY REWARD[1]
We literally can't do the things we want and need to do [2].
We know full well the trade-off is worth it. It's just that we can't have it.
Sincerely,
--an AuDHDer
I'm not sure that's an entirely fair way to frame that. ADHD people can be highly motivated by reward, but being motivated isn't enough to consistently navigate the path from wanting something to getting something. Reward can make you want something more, and even try harder for it, but ADHD means that sometimes no matter how much you want something and how hard you try it just doesn't happen.
N=1 here, but for me, anything that's more than an hour or two in the future rapidly loses any motivating power; any reward that happens after more than a day may as well happen at infinity.
We consciously want the thing, but that isn't enough for executive function to kick in, so "I need to get off the sofa so I can make tasty dinner" results in not having moved two hours later.
I can do all of these things anyway. Of course, this does present the potential reality that were I able to sleep like people, I could be even more successful, but after a near death experience, then disability, I've learned to be happy with where I am.
I am in this situation, forcing me to adapt and get up early like most normies.
My job performance did not improve. And going to sleep early only makes me more miserable, because now I have exactly zero personal, interrupt-risk-free time.
It's not that there aren't tradeoffs, it's that we don't get to choose these tradeoffs (as in: the cost of choosing is huge and nonzero).
Some people are just night owls. A large percentage of night owls have ADHD. I think they can linked without it meaning that people with ADHD have to learn to get up at 5AM.
Keep staying up late if that's what feels natural for you, but it's probably worth making sure that you're still getting enough sleep and that you don't have other issues (like sleep apnea) keeping you from getting the quality of sleep you need. There's a lot of other health issues associated with sleep disorders and sleep problems will tank people's ability to focus even when they have non-ADHD brains.
but there's a strong cultural bias to judge people that wake up at 11am as lazy. and people that stay up to 4am are reckless.
but somebody that slept the same seven hours from 11pm-6am is pragmatic and responsible.
Everyone may experience some of those things some of the time, particularly if they are overwhelmed, overworked, overstressed, etc.
ADHD is experiencing most of these most of the time - as in all the time - for your entire life.
As an analogy: everyone may experience toe pain sometimes if and when they stub their toe on kitchen table leg.
But if it hurts like that all the time, for your entire life - you'd get it checked out, right? There are solid chances something is different about your body.
Now multiply that by 100.
To reword this: say, each relatable entry on that page is a 2% likelihood of ADHD.
If you relate to 100 of them, the chances you're not ADHD drop to 13%.
I've got enough people through an official diagnosis this way that this page, in itself, is a decent enough diagnostic tool.
Not all highly correlated symptoms will turn out to have a common mechanistically-explainable cause, but all symptoms of a mechanistically-explainable cause obviously are highly correlated.
being perpetually sleep-deprived wrecks everyone. If you've got ADHD getting the sleep you need won't cure it, but it will make it easier to manage. If you don't have ADHD, but a lot of the symptoms fit for you, getting sleep might those all go away.
And the cruel tragedy is that it becomes this self-reinforcing cycle.
Sleep bad > "Bad" ADHD day > Harder to fall asleep. Rinse. Repeat.
https://stephaniesarkis.com/blog/study-finds-that-stimulant-...
The best that helps sleep in my experience is doing sports. Lots of it.
You should re-evaluate what is happening to you as it is not an ideal situation: it may be possible you have something else instead of ADHD (or together with ADHD) or you maybe taking it too late in the day.
https://aasm.org/journal-sleep-methylphenidate-can-have-slee...
At a new home, I remodeled four rooms to have three bands wide of LED lighting surrounding the ceilings, hidden from below by cove molding. It is an actual sunny day, with an “an actual” sunny sky inside. Winter, midnight, eclipse? Not a concern.
Having all that intense light reflecting off entire ceilings creates soft diffuse lighting, no shadows, even though it is extremely bright.
Helped a lot with waking up and avoiding depression, all year round.
On the sleep treatment, anything that can help sleep is good, my body has always operated well on a 30 hour day, which means terribly almost all the time, by default. But I do a lot of things that help, so my sleep is pretty good most of the time.
I would see sleep aids as a pretty narrow interventions relative to my ADHD.
Correlation would be nowhere near equivalence.
It’s been five years, so I expect the best components are different, more efficient and cheaper.
In winter, the lights can be considered part of my heating system. In summer, windows get opened. If I did it again, I would have some little fans up there expelling air from the cove directly outside.
But that is fine tuning. I am really happy. (When the lights are on. /h)
I also work best in long bursts of up to 12 hours, with days of full rest in between bursts. I don't do well with a five days a week 9-5 work schedule.
And timeline urgency / time pressure tends to do well at putting me into deep flow state, whereas it can be hard for me to get into flow state for work otherwise.
> And timeline urgency / time pressure tends to do well at putting me into deep flow state, whereas it can be hard for me to get into flow state for work otherwise.
As long as there's a tangible reason the deadline is urgent, then I feel the same way. If it's just an arbitrary demand then I don't respond like they'd hope. My brain knows when something is truly urgent and when it's not.
I did this for several years. It works great
6x 28 hour days pack cleanly into a 7-day week, so all Mondays you wake at the same time, then all Tuesdays you wake 4 hours later and so on. It was one of the most productive times of my life but ultimately left my partner feeling unhappy and lonely.
Fuck it we do our best with 24 hour days…
That's enough synchronization that I am going to give some thought to what the crossovers times with "normals" will be, and may try it.
Synchronizing across M-F, then adjusting between Friday evening and Monday morning, to repeat.
Impossible to express just how deeply frustrating it is to have the “sleep when I want you to, not when you want to” kind of fight. Over and over. For decades after being a grown ass adult.
It’s weird that it has to be explained to 24h normies but pressuring someone to alter a part of their biology like this is wrong. Gosh honey, plastic surgery might be uncomfortable in an ongoing way for you, but I’m willing to take that risk. Gee babe, I see you need a vegan/carnivore lifestyle but please change this just doesn’t work for me.
People can always make these things their red line and force the issue I guess, find out where the other person’s red line is. The weird part is that the sleep thing is generally accepted as reasonable and polite society kinda regards the other behaviors as very unacceptable
>get on the floor
>walk the dinosaur
I wouldn't say I "have ADHD" but I do have a what I call an "attention prioritization and low energy disorder" that nothing i've ever tried has helped. I hear stimulants might help, but never tried em, can't get em.
That doesn't mean distractions weren't there, and those distractions are still around if I live with other people. Growing up, a lot of distractions were parents and siblings. Exciting things on television with lots of noise that I'd notice. Libraries were brutal - quiet places where I would notice people shuffling papers, turning pages, and going about their activities in "silence". I was always better off when folks would just leave me alone to do stuff with lots of background noise so I wouldn't notice stuff - or just being alone. Staying up late gave me that.
It doesn't take modern life or a boring place to be free from distractions.
I'm not saying that these can't be factors, but the original question was asked in a way that suggests it might be a general explanation, and it clearly cannot explain everything.
- My time in the field of psychology has made me think that the use of imprecise language for describing psychology has a large and problematic societal impact
ADHD is correlated with but is NOT a "circadian rhythm disorder". This is definitionally true.
There are many causes of ADHD. One of them is likely sleep issues.
https://www.bmj.com/content/350/bmj.h68.abstract
https://www.sciencedirect.com/science/article/abs/pii/S13899...
I'd be curious to see if there's been any larger scale follow up on this since.
Associations between sleep problems in children with ADHD and parental insomnia and ADHD symptoms
Light coming in from a window is generally filtered. Light being bright can be very deceptive. Even if the temperature is correct. Your eyes crave that deep infrared energy that LEDs and energy efficient windows actively reject.
Before this I used to sleep very late, even when I was a kid, and morning schedules were too hard. This way, there's no oversleep risk.
1. a large majority of ADHD sufferers are phase-delayed and struggle with insomnia
2. you can induce ADHD-like symptoms in normal people by restricting sleep
3. Some of the interventions that improve sleep timing and quality affect ADHD (but it isn't a total cure)
I would think this wouldn't be such a problem if society would acknowledge night owls exist and allow work to adjust accordingly. Forcing a night owl to live the life of a morning lark is likely not the best way to get their best work. The person suffers who has to try and live in a world not designed for when they sleep, and the employer suffers by getting less out of those people.
I have ADHD and left to my own devices I would go to sleep somewhere between 2-4am. At work, I don't function so well before about 2pm some days... and by that point that day is almost over.
It is better for me to align with a pattern where I get some level of restful sleep, as opposed to one where I do not ultimately.
In an ideal world, you are obviously correct, but in the world between a severely disturbed sleep where I get a handful of hours of actually restorative sleep, vs once where I actually sleep for 7 hours? One wins over the other.
And yes, given I have an entire medical team (for other reasons, I have a SCI) I have done about everything you can to resolve sleep. Between ADHD however, symptoms related to the SCI etc, we really do just have to go with whatever we can reasonably get.
Indeed. I've struggled with it since childhood, not only me. The same "symptoms" for lack of a better word are seen with my mother, my aunt and my grandmother. All are night owls, all sleep poorly etc.
For whatever reason, regardless of how much sleep i've had, my brain begins to kick into high gear with a clarity of thought and capacity to dedicate myself to things starting at about 9PM. This remains true REGARDLESS of sleep, how well rested I am, general health, etc. I could have had NO sleep for 24 hours, still be away at 9PM the next night, and it's like a switch.
The ONLY time this ever differs, for reasons still unknown, and where I fit into "normal society" is for whatever reason, when I visit Russia (which I have not done for some time for obvious reasons.)
When I am in Russia, with no effort at all, I sleep normal hours without issue, and wake up during the day time actually well rested. This ceases once I return to my timezone. This same pattern is not seen when say, I visit the US instead.
If only I could harness this magic...
1) Melatonine 300mcg 5-6 hours befor desired sleep time 2) 10k lux light for 30m when waking up 3) Nobeltin (nootropic) it enhances clock amplitude, so I do get less sleepy during teh day and more sleepy at night ..
things taht kind of helped but find hard to keep: Keto (I feel less sleepy on Keto, and easier to fall a sleep but it's been a while since ive been on keto)
However, it's almost like I'm so conditioned to being groggy in the mornings that I still find it hard to get up even if I feel fairly refreshed.
I am very much in the same boat. Mornings have never been my friend. Even the few restful nights and refreshed mornings I get are spoiled by learned grogginess and overstaying in bed.
I hope there is more awareness in the future about the importance of sleep for neurodivergent people. This could help with the social jet lag most of us feel with having to follow a schedule that simply does not work for us.
go bed earlier then ffs
So yeah, no. ADHD is pretty serious, let’s take it seriously. Morning jog won’t fix you. ADHD-specific therapy is the most important in the beginning, then you need to find drugs that work. Check out Buprion.
My sleep issues are at least manageable.
Also, without doing anything my triglycerides, LDL cholesterol and blood sugar which had gone way out of whack, went back to normal.
I started using my oral appliance on a Monday. That Friday I was so energetic I ran 12 miles in one go. I hardly ever run or even practice that much, but I was just so wired that I couldn't help it. It was an amazing feeling. I highly suggest sleep apnea treatment even if you don't think it sounds like you.
I would highly encourage anyone who can get a sleep study done to do it. Most insurance companies will at least cover the sleep study and sleep sleep apnea can lead to a lot of considerably-more-expensive issues later down the line. It's not very invasive anymore, all they had to do was have me sleep with a pulse oximeter for a few nights and apparently that was enough.
Treating my sleep problems as delayed melatonin, by boosting melatonin with tiny supplements combined with a few other lifestyle changes (that I started well before the supplements), has led to me feeling sleepy and a calmer mind at night and simultaneously clear-headed and not groggy in the morning. And the clearer-headedness persists all day. That was never my pattern in the previous 30 years, no matter all the things I tried.
When it first starts, it's more of a warm glow than a light. The max brightness can also be set.
You can make your artificial sunrise take as long as you want, and connect them to a sleep tracker so they're timed to wake you up during a comfortable phase.
I've been doing this for 12 years, and I don't think I have ever been upset to hear my alarm since, as long as I'm home and the lights have prepared me. Lately I've even been waking up before my alarm about half the time, even though I work on a schedule one time zone east of where I am.
It's shocking to me that it's not more popular for everybody. I guess the benefit is hard to explain.
Tried it with gusto over about 3, among a ton of other things. Didn't work for me at all.
> we propose a pragmatic, behavioral-first clinical pathway
Read: cheap
> Read: cheap
I mean, if it works great, if it doesn't there's a lot of other options.
Individually nothing works, but the combination crossed a tipping point for me with radical change.
I squatted, stood up, and the blood pressure monitor saw a drop and my pulse doubled 5 seconds later. It was trying to make up for lost time like my body had no idea I stood up.
Do you have any pointers to get more details? Since he didn't seem to know what it was exactly, we discussed POTS but that's a bit broad rather than a specific thing to treat it seems.
One thing that made a night-and-day difference, if you will, was diet. I often blamed my bipolar or my pills on my unruly sleep schedule. But when I stopped eating bad food from restaurants, and I was mostly making stuff in my own kitchen, with fresh ingredients and fruits and vegetables, I could spontaneously wake up with the sunrise, no alarm, every day. It was not fun, because I was also losing weight and my stomach always demanded immediate attention, no matter how many dirty dishes in the kitchen sink. But as far as circadian rhythm, that puppy fell right into line for as long as I stuck carefully to such a diet.
That discipline ultimately falls apart every time, sadly. I am relatively powerless to deal with my lousy diet. But coming around to the diabetes diagnosis, I will also issue warning bells to the younger ADHD and night owls. Watch your blood sugar.
My blood glucose and insulin levels appear closely related to my drowsy/waking moods, and also to my troublesome bouts of anger and rage. Two types of [synthetic modern] insulin proved to be an amazing miracle in terms of calming down, having good sleep, and banishing nightmares and terrors.
My erstwhile psychiatrist was a forensic one, and she would fret about "blue light at night" but I doubled down on that danger to propose that having Internet disputes and arguments turning into rage and screaming? Perhaps that was detrimental to my sleeping and dreaming?
Therefore, I propose this to anyone who struggles with circadian rhythm: rather than letting physicians tweek you (or your young children) out of your minds, consider your diet, blood glucose, and all the other "sleep hygiene" factors. Really do an inventory of the fundamentals before you resort to drugs. It could save your life.
is there a test for this? how do you know?
www.frontiersin.org##.InfoDrawerHowever, my issue at the time was that I could never find a light with high enough lux values that I felt like I could trust. Plus, another issue with light therapy is that one can basically never stop for any moderate amount of time, and well, my ADHD makes that near impossible.
I honestly think I would have better success with sleep issues if I could just control my own schedule or have a flexible schedule, but that is not really a luxury most jobs can provide.
The whole sleep hygiene things been sort of discredited and doctors just follow a script with like 5 things they will prescribe you for sleep problems and after those 5 things it’s like oh well we tried
I once showed them a study I found online in a reputable journal (at least the study was conducted by someone from a well regarded university in a journal that wasn’t obviously bad)
The doctor didn’t even look at the study, he just saw where it came from and said “yeah we don’t use that journal”
I would have much more appreciated an answer if I don’t have time to read your bullshit vs what he gave me
(Adhd joke hehe/no hehe)
My son has severe ADHD. The sleep deprivation is why he can only use medication for special events like tests. He can't sustain it for any long-term period.
But the majority will not. Treating ADHD through stimulants usually has fantastic outcomes for patients.
Sleepy therapy (CBT-I) may be the best supported treatment for insomnia, but it's still quite shit. ~50% of people will see little to no improvement after going through therapy.
"ADHD" symptoms can manifest for a variety of reasons, and that's why good ADHD testing involves multiple exams alongside the traditional ADHD ones to help figure out what actual issues are present.
Also, comorbidities make this all the more complicated. Your assertion that people need "more sun" and "regular sleep" could very well be true, yet someone can still have ADHD.
Protocols however are always changing depending on new findings. Not saying this is the case, but not considering something unknown at the time doesn't make a doctor not worth a damn.
> Your assertion that people need "more sun" and "regular sleep" could very well be true, yet someone can still have ADHD.
if that was the case the treatment wouldn't be unecessary, like I specifically wrote in the comment you are replying to.
Sun and proper sleep is certainly helpful for people with ADHD but the likelihood of them getting that is vastly increased if they’re medicated correctly.
Plenty of people with ADHD manage just fine (or better: sleep) without stimulants. Now if the ADHD is of the ‘late diagnosed’ kind, no one knows what reliably works or if the construct has been bent beyond its breaking point.
And people should drop the cynicism that just because there are doctors around everyone is well cared for. Just look at the opioid crisis in the US, fuelled by respectable doctors chasing financial incentives.
This is the kind of absurd thing that people say when they know drugs from 2000s teen comedies, I fear. Just cause you've vaguely heard about people doing adderal at parties doesn't mean it's anything like meth, which is the common layperson misunderstanding. It's not a difference in degree, but a difference in kind.
oh man, just reading these three words spikes my blood pressure
That seems pedantic but it's really important, here: ADHD (& MDD & ASD & all of em) are not singular physical diseases with a shared cause, but rather a bucket of symptoms that is used as a heuristic for picking treatments (which almost always means some sort of physical intervention, though therapy alone obviously helps in some cases). This isn't cause psychiatry is bad, but rather because we live in a pre-Gallilean era of cognitive science, and lack the theoretical tools to even begin describing these sorts of systematic, structural disorders in strictly neurological terms.
This is why psychiatrists prescribe off-label so often, and don't treat "diagnosis" like the big ceremony we expect as laypeople; you never truly "have" ADHD on an ontological level, you just have a psychiatrist who thinks that assignment is the best rough bucket to put you in to pick treatments. If you go to a different psychiatrist for more than a makeup/temp arrangement you'll have to get rediagnosed, technically speaking.
Some relevant tidbits to try to avoid a wall of text:
- Many, many providers still hold ~DSM4 ideas about ADHD being extremely rare in adults, and only valid as a diagnosis if you have solid proof of hyperactivity as a child. (ADHD has three "presentations": hyperactivity, impulsivity, and inattention, where the final one is dominant in adults by far). This is especially frustrating in light of the aforementioned methodological facts.
- As that hints at, ADHD treatment is marred by the absurdly harmful sentiment that there's some huge class of lazy jerks who just want to cheat out there, and that we have to carefully separate those lazy people from the people who have executive dysfunction through no fault of your own. Hopefully it's obvious that that's absurd, even if you're not as Sapolosky-pilled as I; if that's a coherent worry in the first place, it's like shutting down SNAP in reaction to a 1% fraud rate.
- ADHD diagnoses have been skyrocketing, which makes some clinicians assume it's overdiagnosed. See also: v***s + tylenol => ASD. Again, hopefully that doesn't need refutation here.
- In practice, getting an accurate sense of whether ADHD drugs help you is a huge rigamarole that is far harder than basically any other disorder (with the possible exception of BPD?); if you don't get educated upfront and choose providers carefully (which feels scummy and plays into the shame that prevents people from seeking treatment already), you can easily just spend hundreds of dollars and get a clinician who will never seriously consider ADHD treatment. They'll shower you in serious drugs of all kinds with aplomb for disorders that arguably fit some of the symptoms (usually MDD, GAD, and/or BD), but they've decided far before they ever met you that adult ADHD is a myth/conspiracy/mass hysteria.
- Finally, 'get more and better sleep' is just a goofy alternative to treatments that we know work, especially when it's heavily relying on the little 'melatonin only as your doctor recommends' disclaimer, which is hiding the fact that melatonin is not meant to be taken long term. It's like "use a planner" or "have you tried writing stuff down?" -- that stuff surely helps, but people go to psychiatrists because they've been trying their hardest for years and still feel like they're drowning.
Is it our (let's be real lol) fault that we are incapable of doing what we want to do to the extent that it causes persistent, serious distress? IDK. But I can personally report that I stumbled into an ADHD diagnosis and actual treatment (dextroamphetamine + bupropion) changed my life; without it I would be a constantly-stressed coaster terrified of getting fired and spending much of my workday staring at my hands, rather than feeling like the most capable engineer I've ever been by far.
And I only got there because I went to a psychiatrist for suspected GAD and she recommended it. Only later (through loved ones and close friends) did I learn how uniquely awful it is to try to find out if it helps you in the first place, which goes against the underlying ethos of our entire psychiatric system.
TL;DR: As a debugging principle for programs, yes, but for psychiatry in general and ADHD in particular, no.