1. There is absolutely no sympathy:
The problem with ADHD is that it is a disorder of degree not kind. If I had epilepsy or cancer or had some of my limbs missing then people around me would be supportive and understanding. But not ADHD. Everybody's mind wanders. Everyone would like to only do interesting things. Everyone forgets things from time to time. But, the problem is the degree to which these afflict people with ADHD.
We don't expect someone without legs to walk normally or properly. Yet, when it comes to the mind we have little patience. Somehow, we expect people to get their act together. We label them lazy, unmotivated and indisciplined. A product of poor parenting. We get frustrated that they are not reaching their full potential. In a way, having ADHD in 2014 is like being Gay or having an interracial marriage in the 60s or 70s. Ignorant cynical judgmental people assume that you can will your way out of ADHD through discipline and will power.
2. ADHD does give you super powers:
Insane creativity. The ability to think outside the box. The ability to make off the wall zany connections. Always looking for small advantages and using creativity to your advantage. I use mnemonics to remember things. I hired people overseas who follow up on everything I do. I built products that are on track to doing well. When I do succeed, people write it off as being lucky.
I wish I could write more. But I am actually supposed to be doing something else right now.
Recently diagnosed myself, I spent years and years trying to control it via willpower. The real turning point when I realized I needed to see someone was a few months ago. I found that hobbies I loved (gaming, programming, etc) would no longer hold my attention and I was compulsively getting up and wandering to the kitchen/bathroom just because my brain felt like it was frying. This is extremely hard to explain, because I'm not slacking to get off of work and do something fun like everyone else, I was compulsively slacking because very little would grab me.
In the example you list, it'd be like telling the first person, "Everyone feels bloated after eating a big meal - that doesn't mean you need to stay in bed all day when you think you have 'food poisoning'".
I agree that it's frustrating to read articles like this that trivialize mental disorders and downplay the struggles that they can actually cause for people.
Sure. So, I pay like $60 - $70 per month per person. I found highly detail oriented, responsible and non judgmental individuals via elance.com, guru.com, taskrabbit (before it changed its model.) I hired two people.
All they have to do it ping me on Skype/Gmail and ping me every hour for a few hours from Mon - Sat. Once in the morning and 3 to 4 times in the evening. It just takes them a few seconds. That's it. They will just check in on your progress and hold you accountable. They will notice patterns and give advice. Like for ex: If I am not very productive, they will tell me to go to Starbucks so I can focus. Basically I am outsourcing my executive functioning.
I am constantly on the lookout for tips and tricks that worked for other ADHD people who became successful. So, this one I picked from Trudie Styler (Sting's wife). Also it pays to read the comment section of ADHD related articles because that is a goldmine of useful anecdotal information. There was this case where the mom complained that the reason her son did well in school was because he failed a grade and was doing school with along his sister. His sister kept him on track and followed up with everything he was supposed to do. Now that he is about to go to college alone, the mom mentioned her fears about his future. So a combination of these pushed me to build a team around me that keeps me on track.
Ditto on advice: I'm in the same boat and I have a virtual assistant check with me daily to make sure I'm on target as well. I noticed I'm fairly socially accountable to others (but have a severe disrespect for personal timelines) so the way to make it work for me is to basically somehow involve another person checkling in on all the priorities I make.
I created a profile in the above mentioned sites and posted the job requirements. I mentioned that I was very disorganized and needed help to keep me on track. All I needed was someone who would check in on me every hour on Skype/SMS for a few hours every day. Basically, they would enquire about my progress and how far I have come in the last 1 hour on a particular task.
As soon as you post the job, you get responses within 30 mins. Now, most applicants won't even care to modify their prebuilt response templates or even read the requirements properly. These are easy to weed out. Now, the single most important characteristic of the person you hire is that they should care about your success. You don't want someone who just goes through the motions. You want someone who is assertive and will be your help mate.
After that I made a list of 4 to 5 most important things I wanted to achieve in my life. (Source: Think and Grow Rich) Then made a list of things I wanted to achieve in the next 10 years. 5 years. 1 year and 6 months. I emailed these lists. Then, I made daily, weekly, monthly actionable plans to propel me towards my goals.
This will give them ( and you ) a rough picture of what it is that you are trying to do. The thing is that you can ignore a software reminder but it is difficult to ignore a reminder from another person.
At the end of the day, I get an email report listing all the tasks that I did and those I skipped.
It's sad that the article didn't even mention exercise as a potential treatment for ADHD. The OP implies that kids will simply "grow out" of ADHD, drugs, or changing the environment may be enough.
While these are valid solutions, exercise may be equally or even more effective.
John J. Ratey, one of the pioneers of ADHD [1], recently wrote the excellent Spark: The Revolutionary New Science of Exercise and the Brain[2]. In it, he explains in colorful details what happens in the brain, and why exercise may be the best treatment for a bunch of neurochemical imbalances - including ADHD.
IMO the terminology of neurochemical imbalance should be avoided. It's the sort of framing that is much preferred by the pharmacological industry, because it suggests that the nature of the problem is well understood and can be directly addressed with their products. In reality there is only a very vague idea of mental illness and related neurotransmitters. To make a computer analogy, it's like calling a problem an "electron imbalance", without even knowing whether hardware or software is to blame.
I'd never noticed this before, but you're right - "neurochemical imbalance" sounds convincing but holds no explanatory power by itself, and sounds very much like an updated version of "imbalance of the humours".
In fairness, software runs on hardware and a faulty instruction would send electrons to the wrong place and cause an imbalance... /melvin
That said, this has been proven many times over to be rooted in an atypical response to normal levels of neurotransmitters which then results in the appearance of an imbalance or, depending on your perspective, a real imbalance as that specific set of neurons requires higher baseline levels for normal functioning.
This isn't Big Pharma vs The People for most of us. Just soccer moms in LA. The rest of us are helped by low doses of magic pills and are happy that solution is out there and infuriated at cases of abuse and overprescription.
No, nothing has been "proven" about ADHD or other sorts of mental illness. We only have clusterings of symptoms, but know nothing about root causes. Certain chemicals seem to interact well with the symptoms, but again there is no known mechanism that fully explains the mechanism of action. There have been hypotheses that e.g. schizophrenia is explained by dopamine and depression by serotonin, but these have all proven to be too simplistic, because in many patients the levels of these neurotransmitters do change after taking medication, but the symptoms stay.
I should say I'm not at all anti-pharma. I just think that the marketing should be honest. It should be "this addresses some of the symptoms", and not "this corrects your imbalances" because the scientific hypotheses about those imbalances have long been disproven. My hunch is that the structure of neural connections also has to play a big role. This would explain why simply changing levels of chemicals does not immediately fix things.
Exercise is the miracle cure for everything, it would seem.
Though it'd be a moderate help if we could agree on what "counts as exercise" - a 15 minute walk? Resistance training (how many sets/reps)? HIIT? The fads can be tough on the average person who just wants health.
The book (Spark, link above) analyzes a handful of studies comparing the correlation between the type and duration of exercise, and its effects.
In short: you won't see any long lasting benefits from a single 15min. The best results were achieved at 75-85% of your aerobic capacity, at least a couple of hours per week (total).
You can also benefit from mixing simple aerobic exercises with others that require more coordination and fine movement of your body - martial arts, for example.
Swimming is a pretty good exercise for those who are bored by most other exercises. It may take six months or longer to see results from exercise, though, so it's hard to suggest exercise as a be-all-end-all fix.
Thanks for linking to this book. I'm realizing how much better I can think after I've gotten exercise (I have ADD) and I'm interested to read 30% of this book ;)
At the very least, if exercise does indeed work as well as medication, then the medication can provide the catalyst to get on a regular exercise schedule!
as someone who was diagnosed adhd but am probably not any longer, i think basketball is a perfect solution. the game requires constant improvisation, which is a like crack to most novelty seekers. and then you get the second benefit (the intense physical work out) as a bonus, which maybe helps you grow out of adhd.
I was diagnosed with ADHD when I was 12. Classic, "textbook" example of one. I felt like it was a curse until I was about 20. I was put on Focalin, Ritalin, Adderall, Vyvanse over those years.. they all made me calm and focused. Without my meds, I used to live in my head all day, theorizing how the universe and neurons work.. playing with ideas, twisting shapes in my mind. I was also prone to depression, anxiety, and I hated dealing with emotions.
Then one day, when I was about 23, I did LSD and cannabis together. My whole world came crashing down, and I realized that ADHD was a label that limited my true potential, and made me judgmental of "neurotypicals". After my trip, I realized that I lost about 75% of my visual-spatial ability (I felt out of it for a year or so as I missed having that ability), but I also felt more at peace, open-minded, and in the present moment. I also became a "doer", rather than a "thinker". I do not use any meds at all now; I meditate in the morning for at least 20 minutes, and try to run at least once a week.
With that said, I still like variety, and am a jack of all trades. Last time I did freelance, I loved doing marketing research, design, coding, programming and social media.
I took a small dose of shrooms few months ago; it made me closer to nature, and it got rid of my porn/fapping addiction. I really think that psychedelics have the potential to "round" people out.
It's weird and frustrating that people label many abnormalities as "diseases".
When I read a list of ADHD symptoms I keep asking myself - how is that a bad thing? Being bored doing unenjoyable tasks, hating homework, "Not seem to listen when spoken to",Struggle to follow instructions,Dash around, touching or playing with anything and everything in sight, Have trouble sitting still during school and homework, Be constantly in motion, Have difficulty doing quiet tasks or activities....
I knew a kid that had ADHD. Unfortunately it was just a label - way for a kid to get everything. The kid didn't had ADHD imo, he was just spoiled and his parents were failing to do any parenting. The kid would eat whole mountain of sweets, drink cola all day, play games and scream and cry whenever he was prohibited something. In school he wasnt interested in learning and he basically would do nothing or play portable games all day. He would also not care for others and his needs would be always #1 before anything else.
Parents were really protective of him so they would fight with teachers whenever they would try to do something about it. The kid seemed to be pretty smart and he got all this figured out and used it a lot. But whenever he would be with people he didnt knew in a room, or with no-bullshit people, he would be actually quiet and behaving very good.
SOME ADHD cases sounds like just putting label on failed parenting to shut parents and avoid being sued by them for not doing any proper parenting.
Somebody was reading a list of ADHD warning signs to me from some self help book, which all perfectly described a mutual friend of ours: things like "interrupts other people while they're talking", "doesn't return phone calls", "no respect for authority", "always wants to be the center of attention", etc. I asked, "Maybe they're just an asshole? Isn't it possible to be an asshole without having ADHD?"
Oh, all right, I'll admit: it was really all about me. ;)
You cherry-picked "kiddy" symptoms thereby creating a strawman. I am not a medical doctor, so I'm not going to tell you what it is or isn't -- but one of the symptoms you omitted, depression -- is NO FUCKING JOKE.
Some of the symptoms you name sound like they're picked up from a list of symptoms for diagnosing children with ADHD:
Dash around, touching or playing with anything and everything in sight, Have trouble sitting still during school and homework.
As a 20-something, relatively successful (founded and sold a company, work as an engineering consult for various companies, back in school getting my prereqs for medicine) male, I certainly am not playing with anything and everything in sight, nor do I dash around.
However, I do have a tendency to carry around something for my hands to play with -- a pen, squishy ball, my own fingers -- because they get restless. I also sometimes feel like I have a huge amount of excited energy balled up inside of me which I need to get out. I normally remedy this by exercising or running up and down a set of stairs a few times. One might say that my symptoms are adult versions of the childhood symptoms you point out.
As other people have mentioned, depression something that is often comorbid with ADHD. I personally have been severely depressed -- so much so that it caused "distress" (real-life problems) for an extended period of time. I became so tense, bored, disheartened, stressed-out by doing something I really loved. Depression followed. I won't say much else; if you'd like to understand this a bit more, let me know, and I'll spend some more time with a reply.
I need to second this. It isn't just being bored, it is being totally unable to function. There are things that I am interested in and REALLY want to learn/do/practice/build/enjoy but sometimes I am just totally incapable. I know what I want and I know what I need but I can't do it. Dr. Russell Barkley refers to ADHD as a performance disorder that was misnamed as an attention disorder and I tend to agree.
So how do you do this in software? Consulting? Startup? I'm a couple years into my first software development job out of school and barely get through the moderate amount of work that's assigned to me right now. I'm afraid of switching to another development job where more would be expected of me (consulting! startups!). Without having these problems under control I may not be reliable despite my talent.
Over the last month or so I've been reading up on product management and it sounds like a good fit. Interact with people, track markets, discover problems, craft creative solutions, have other people figure out the exact implementation... Lately I've been trying to discover broad problems and their solutions in my current position, and it seems to be helping (helps me feel like I'm actually contributing, at least). I don't know any product managers to talk to about their day-to-day stuff though. Has anyone with ADHD found that to be a good career path?
Hah. Sounds very familiar. Get yourself in a customer facing role ASAP. This was the advice given to me by a director of product management, who went on to be the GM of our division, and now CEO of a well regarded UK startup.
I switched to delivery consulting after almost 4 years of product dev, and wished I'd done it sooner. There are so many more things to concern yourself with than straight dev work, that your AD(H)D can be a massive advantage.
On the other hand, you will need to teach yourself how to "cut corners" that is antithetical to a software engineering/product maintaining programmer. It's not actually cutting corners, but making calls about when the deliverable should be in the customer's hands with some known design flaws, vs. stuck in beta whilst you wrestle with the extendability.
Now, after a number of years in customer facing roles, technically leading $1M+ programs, I'm thinking about the move to product management. Looking back, I'd have been a crappy junior PM if I'd jumped straight across.
I've seen people with ADD thrive in the "technical marketing", "demo developer", "internal system's engineer" roles, as they are constantly solving different problems, often with little to no requirement to get it right, document it, or look after their hacks. It does require strong (technical) communication skills, though.
Thank you for your advice. Those are the roles I feel drawn to so it's nice to hear some validation of those tendencies :) I'll keep an eye out for them.
I tried consulting. I couldn't self-motivate to self-imposed deadlines. Barely averted disaster. Never again.
Tried a startup. Same problem. Worse result.
Now I startup surf as a developer, but only to interesting projects. If I work on a boring project, I'm going to wind up behind schedule. One I learned that about myself, I adjusted my job searches to fit (as much as possible).
Project management? I suppose if I weren't the one actually doing it that would work. But if you switch early on, you're stuck with it. I'd get a few more years of software on your resume before bailing. That gives you experience with various kinds of scheduling and PMs and a better idea of the PM you'll want to be.
Got hired by one. They didn't have enough people so I added about a dozen acronyms to the resume. After it cratered I picked up a job based on those acronyms. Rinse and repeat.
This article's premise is built on an incorrect understanding of "treating" or "fixing" or "losing" (symptoms).
If: baseline x is underwhelming to the point of painful boredom
Else: baseline y is higher and therefore satisfyingly stimulating
Then the fundamental problem of a lacking reward system for "normal" (x) baseline activity remains unresolved.
I have ADHD and decided to try medication for the first time only a few years ago (in my 20's). Sure, keeping things "interesting" and "new" can trick one's mind into paying additional attention towards the daily grind, but not for one second does that mean that ADHD would be resolved.
To make a more clear point, let's apply this thinking to another context: Murderers would be cured if there weren't anyone to murder, right? No. You're supposed to solve problems, not symptoms.
That's the thing, I think. Treatment (both cognitive behavioral therapy and chemical) has enabled me to get on with my life in so many ways.
It's not about getting rid of the symptoms - they're still there. It's about knowing when your symptoms are getting the better of you -- and taking agency over them. If my brain is a wall of TV's all tuned to different channels with the volume turned to 11, adderal finally gave me a clicker to be able to turn all but one off. Or, at least, mute.
And in many ways, I'm glad I'm not asymptomatic on medication: many of the downsides of ADHD can actually be huge, huge upsides. I thought it would kill my creative problem solving, going on meds: if anything, it's put it into overdrive. Instead of stashing something in my subconscious and hoping a solution percolates up a few minutes, hours, days, or weeks later ... I can pick up the puzzle, look at it, really concentrate and think about it. It's a life changing thing to realize what it's like to actually ruminate on a problem. On the other hand, I still make the zany off the wall connections between two problems that let me come up with a solution to both of them.
Instead of hoping for the luck of the draw, though, I can stack the deck.
I 100% agree. People think ADD/ADHD is "resolved" on meds, but it's not the case. They started me on 27mg of Concerta, then 54mg, then I was (thankfully) moved to Vyvanse and titrated my way up to 60mg. The story hasn't changed - it's still valuable to leverage the downsides into strength. An ADD/ADHD brain is certainly a chaotic one, but going on meds has enabled me to do better planning/execution and to actually complete tasks. Your wall of TVs analogy is great - I often describe my head as the similar murmur you hear from a crowd. Thoughts are like white noise where it's nearly impossible to pick the right one out, let alone stay with it for a while when it's so easy to hear everything else on top of it.
Not to sound skitzo, but I think the meds do a great job of quieting that noise. While medicated, I have the ability to plan a task or project, execute each step, and actually stick with it to the end. It's still possible to get off task, and perhaps worse if you do (since then you're REALLY focused on being off task), but the meds still help me think. But that is where it stops. They don't resolve problems - they provide most of the tools needed to change the way you think so you can work on resolving them yourself.
Now, to the popular point of diet and exercise; I'm sure it's a mix of improved medication delivery, the natural stress relief, and the endorphin benefit that comes with it - but eating well and regularly exercising seems to amplify the medication's benefit by 15-20%. Those two things are marginally helpful without meds, along with several other "natural remedies" that I have tried, but I think a combination of all of the above is key.
My original point was just that the article makes it sound like symptoms should be treated via introducing new parts to the equation which ultimate distract people from boring situations. Yet, ADD/ADHD in its TRUE FORM works 100% independent of one's desire to pay attention. The argument of "BUT VIDEO GAMES ARE FINE SO IT'S CLEARLY CHOICE" is 100% falsified by Dr. Thomas E Brown's research. He provides such excellent insight - I am so fortunate to have met him.
I'll close this novel of a post with an analogy made by Dr. Brown when we met:
"Picture a massive old wooden sailboat with dozens of crew frantically fighting to pull the sails, keep up with the demands of their job, etc. Non-ADD/ADHD folk can get a benefit from medication, but it just speeds up both the captain and crew.
ADD/ADHD folk, on the other hand, are instead sailing through a terrible storm at a much faster pace than normal and can hardly see - but the crew still keep up with their jobs. The captain is the problem. In this case, the captain is the only one sped up by the meds, and suddenly, no matter how chaotic and messy that voyage is, it's all under control."
I'd say one of the causes for over-medication is the lack of willingness of both parents and children to work on ways to succeed without use of medication.
I have (fairly bad) ADHD and my doctor did give me medicine, but only half the light dosage of Strattera, which isn't a stimulant.
Long story short, I ended up hating feeling comatose from the medicine so much I began to work through my ADHD by structuring my life and finding things I was actually interested in.
But it would've been so easy to give me some Adderall and let me just do my thing, which I believe a lot of parents and doctors do. It's the quick and easy route, but arguably worse in the long run when the children grow up to be adults dependent on managing their ADHD with a crutch instead of on their own.
I'm not sure I agree with calling drugs a "crutch".
Nobody in their right mind would tell me that Singulair or Dulera is a crutch for my asthma. Nobody would call albuterol inhalers overprescribed or asthma overdiagnosed either. My allergist always has to tell me not to work my life around my triggers past a certain point too. Yet I hear it all the time about the Adderall and Vyvanse I used to take, and about ADHD. All. the. time.
I have pretty bad ADHD too. My parents didn't want to put me on any meds, so I learned all the coping mechanisms the hard and expensive way _and_ feel that I lost out on a lot of opportunities when I was younger as a result. It's the only childhood issue I still hold a grudge over. When I could finally do whatever I wanted, I felt like a huge burden was lifted with meds because I never stopped struggling with said coping mechanisms anyway. Including stuff like "take a shower" and "eat lunch" on my daily-todo HabitRPG checklist.
Unfortunately I'm trying to get pregnant and had to get off almost everything, so now I'm back to digging myself into a hole, getting frustrated with even my non-standard and fun life. If it wasn't for the fact that I have a partner to rely on, I probably would be telling my obgyn to go fuck herself about her judgment call regarding non-stimulant ADHD meds known to be safe. ADHD is a huge negative impact on my life, and I'd even qualify it as being worse than something potentially life-threatening like asthma >:P
Obviously not everyone is the same, and abuse is definitely a problem. That doesn't equate to a crutch IMO. Not to mention there's a million other problems in the way, one in the US being a lack of accessible and affordable quality health care so people with ADHD can easily get help with non-medication options...
I watched a talk by Dr. Barkley a while back and he had a wonderful way of phrasing it (paraphrased): "Suppose you had a person in a wheelchair who needed in your building. Would you build a ramp and then after 30 days take it down, saying 'Well, by now they should have figured out how to get into the building.' NO! It's a remedy for a handicap. Neither should you deny medication to someone with another kind of handicap when they need it."
After I let that sink in I suddenly didn't give a crap about the anti-pharma crowd. I have what I need and it helps me, so fuck 'em.
And yes, without it the daily routine isn't one. Completely there.
> After I let that sink in I suddenly didn't give a crap about the anti-pharma crowd. I have what I need and it helps me, so fuck 'em.
Unfortunately the anti-pharma crowd is actively making it more difficult for you to access your medication, by placing increasingly strict controls on access to Adderall and other Schedule II drugs, placing quotas on production (which cause medication shortages[0]), and other measures to 'combat overuse'.
Of course, the only people this actually hurts are people who need the medication on a daily basis and only use legal means to access it, whereas people who abuse/'overuse' it simply stock up ahead of time, or turn to the black market.
I suppose a "crutch" in that if you are ever forced to leave them, you can't function the same.
If you can control your ADHD off meds, then the meds would be considered a cruch (imo).
Not to slight you at all -- I wish I had meds even right now, because managing without them sucks. A lot.
But personally, I can't say I'd never want to be in a place where, as an adult, I have to learn to manage my life because I _can't_ take my medicine. I suppose I'm the opposite of you and am glad my parents had me learn to cope without medicine :-)
Good luck getting pregnant though. Why are ADHD meds considered unsafe when you're pregnant?
In that sense, yes. It seems to be used (and I initially read your comment in this way) in a negative/shaming manner too often, in the "you can theoretically walk so why are you using crutches" sense. There's always degrees of control, right? Everyone with ADHD can live without it, but for more serious cases the quality of life would suffer so much that it's a question if it's worth living without it. That's my grudge - mine is so bad and sucks up so much of me that I can't imagine getting to a point without meds. Then again I know that's a barrier in itself - it's hard to imagine having no end date for taking meds and coming to grips with the idea that some part of you is deficient.
It's also kind of funny to me to think of "why need an unnecessary crutch" for everything else because society loves doing it so much for psychiatric disorders but not much else. I got the same reaction from some people over taking antidepressants (my parents gave in then, because yay suicidal ideation). I think it's harder to understand and empathize with something that's often invisible or an extension of something that affects everyone. My rambly HN comments and commit messages with the 5 minute timer for hyperfocus that you don't see looks totally different from me looking pale and coughing a lot.
re: pregnancy: stimulants are considered iffy, hence why you also can't drink much caffeine - premature births, withdrawal (!), birth defects, and the like. My obgyn, my psychiatrist, and my PCP also like to err on the side of taking as little as possible - I'm also off TCAs for nerve pain, and had to switch nasal sprays and to lower potency topical steroids for dermatitis - so nobody will write me a prescription. So I can't even take Intuniv (non-stimulant, taken at night due to drowsiness, maybe an option for you? meant for children but my adult ADHD-specializing psychiatrist really likes it for adults), not just the Vyvanse I used with it. Meanwhile, the possibility of a fetus exposed to insufficient oxygen for even a moment is so terrifying to them that they're willing to put me on _more_ meds if I'm one of those women that get worse during pregnancy. After I just stepped down due to better control too, dammit. I'm also expressly forbidden from skirting around exercise, one of my biggest avoidable triggers. Risk management is funny.
Thanks though :D and best of luck to you too with your life in general. I planned months in advance to set up maximal coping mechanisms and read a gazillion ADHD help books in preparation for this. If you can cope okay even if not by choice I am super jealous. I'm having a mini breakdown every day. And of course I went over my timer for this comment. I feel like I can scroll the comments on this story and tell who has ADHD depending on how long their comment is. :P
I'm glad that worked for you. I was diagnosed with ADHD not long ago. Before my diagnosis, I was about to quit a job that I actually liked for the second time. I like my job. I liked my last job. I like programming, I liked my coworkers. Given a challenge, I was always able to rise to the challenge. Given something more mundane, I lost all motivation and capability.
For years, I had blamed myself. I thought I was lazy and a shitty person. I was prone to binge eating and drinking. I was depressed as hell.
Most people can't restructure their lives to work around their symptoms. I don't feel like I should have to. I certainly don't want to.
Are you managing with medication now? I wonder if those who are able to restructure are lower on a spectrum. Your situation sounds similar to mine and attempts to restructure have been difficult. I haven't used medication for years because I bought into the idea that it would limit me and I could overcome if I just work hard enough but finally I've realized it just feels like every single thing is harder than it needs to be. I feel like I've wasted a lot of time beating my head against the wall.
Strattera usually isn't the first drug chosen, because it doesn't work for everyone. It primarily works on norepinephrine as a reuptake inhibitor. It's basically in the same class as bupropion (which is sometimes also prescribed off label for ADHD, though it's usually used as an antidepressant for those with cyclothymia or to aid in smoking cessation).
Ritalin works by inhibiting the re-uptake of dopamine and norepinephrine.
Amphetamine (adderal) works on dopamine, norepinephrine and seratonin. Not only is it a re-uptake inhibitor, but it actually "reverses the polarity" on neuron vesicles, causing them to dump their loads.
For some with ADHD, strattera works just fine. For others, strattera will make them feel like a zombie (or do nothing at all), while as little as 5mg of amphetamine salts a day will be sufficient.
A lot of folks with ADHD do just fine without medication. And others struggle with the thought of taking "the easy way out" for decades, and end up with a shitload of additional problems - primarily in the self confidence zone. Some only need the medication to get things back on track, establish routines and so forth ... but others really do need it.
Chronically untreated ADHD is painful, debilitating, embarrassing, and so unnecessary.
For the past few years I've taken both Adderall and Vyvanse, with the past 2 years being Vyvanse. I thought I would be taking these drugs for the rest of my life if I wanted to be successful, because when I didn't take them, I could not focus on work tasks at all. However, the "cost" of these drugs for me was that I couldn't turn off. I was driven from the time I woke up to the time I went to bed. My social life definitely suffered.
So, as I started a new job this year in January, I decided to make a clean break. I quit Vyvanse cold turkey and started a new job. I've been doing exceptionally. I never thought this could happen. Thinking back on the issue just yesterday I was telling a colleague that I thought this was likely because I must have been bored with the tasks at my previous job, and I've found all the new tasks to be interesting enough to bring out what I consider great performance from myself, though not the insane amount of performance I was doing on Vyvanse.
Anecdotal at best, but I independently came to the same conclusions as this article, for whatever it's worth.
"In short, people with A.D.H.D. may not have a disease, so much as a set of behavioral traits that don’t match the expectations of our contemporary culture."
On a positive note, there are A.D.(H.)D. symptoms that do have upsides and can be worked around very cleverly.
Still, there are some that squarely fall into the problematic kind, for example the problem to go back to a task when disturbed (instead of Task A -> disturbed with Task B -> Task A, you go Task A -> Task B -> Task C) or the tendency to avoid mentally taxing task.
> Nor am I saying we that should not use stimulant medications like Adderall and Ritalin, which are safe and effective and very helpful to many kids with A.D.H.D.
are they really safe and effective? I've taken these after being diagnosed with ADHD as an adult, and although I believe they are quite effective, I am really surprised they give these drugs to young children. I would not.
I'm an adult woman with adhd and it's definitely been an advantage as an entrepreneur. When I hyper focus on our company, brilliant things happen because I can think out of the box and my passion and obsession for our product has my undivided attention. Needing to constantly shift work environments, go for walks, and multitask has worked well for me in my startup life. However, in my former corporate life, it was at times crippling and embarrassing. I really appreciated this article because it elevates the need for those with adhd to choose the work environment best fit for their behavioral needs and hopefully sheds light to a wider audience that adhd is in fact 'a real thing'. In a previous corporate role, when i spoke to HR about my daily struggle working in an office environment with tv's on and lots of cubes with loud people talking, they didn't take me seriously and just thought it was a 'millennial' problem. I had to work saturday nights and sundays just to complete my work because during the work week it was so difficult to focus with all the surrounding noise. I lied to my manager about all my weekend work because she down played the very realness my adhd had on my ability to focus like I was making it up. I hope this article brings to light that many people do suffer from adhd and to take their work environment requests seriously. I hope it also encourages those with adhd to be more vocal about it.
I worked at an office park in the SF peninsula for a year and see now why I was the guy always going out exploring. I'd ride my bike around, found out we could get on the roof, checked out all the wetlands surroundings, and asked a whole lot of questions on Quora. Haha, I was the wacky energetic guy. Some of the stuff I had to do just about bored me to tears.
I was diagnosed with ADHD at a very young age, and have been doing battle with my attention span for most of my life. I had only read a half dozen books all the way through when I graduated from High School, despite reading at a college reading level before I was out of elementary school and having started hundreds of them. The few books that I had read included Les Miserables and War and Peace, both of which I binge-read over a period of a few days, barely allowing myself to eat and rarely allowing myself to shower while I read them. The other ones were Frindle, Tangerine, The Curious Incident of the Dog in the Night Time, and Catcher in the Rye. They were completely consuming. My addiction to video games was so intense and so severe that they were outright banned at my house. I was terrible at school, skipping more than half of my classes, but tested in the 99th percentile for standardized testing, learning a lot of what I should have learned in school by deduction as I was taking the test. That allowed me to get into college, which I later dropped out of, electing instead to buy a one-way ticket to China unsure if I would ever come back. Basically I was either 0% engaged in something or 110%, and if I wasn't engaged it felt like no matter how hard I fought I couldn't force myself to care.
The turning point came when I was living in eastern Ukraine serving a Mormon mission. As per the mission rules, the only books we read were scriptural, we only used a computer for 30 minutes a week to email home, and in my particular mission I spent 90% of my time, every minute from 11 AM to 9 PM (except for a one-hour dinner) walking around, talking to people in the streets.
I don't know if it was age or that I was finally rid of the many stimulants I used to have, but my mind just slowed down. I concentrated on everything, and, perhaps especially because I was speaking Russian, I could literally recall every word of every conversation I had. I sat down in the mornings and studied the intricacies of the Russian language for an hour straight without blinking an eye. I read the Old Testament cover to cover; something that would have made me literally pull my hair out just a year earlier.
Then I went home. I got an iPhone, I got on the Internet, and it all came back. I try to limit the stimulants, (I've become very minimalistic), and I usually spend a lot of the morning with a calmer mind, but... I work online. I love the Internet. And I haven't yet been able to calm my mind like it was for those two years.
It may be a matter of self-control - it probably is, but learning to program is incredibly painful. 10 minutes at a time sometimes with an incredible number of stops and starts.
I don't know what the answer is, nor do I pretend that I can project my experience onto some greater understanding of what ADHD is, how to defeat it, or if it needs defeating, but the experience of feeling like I could finally do all the things I wanted to do because I didn't have anything else to stimulate me was fascinating, and it may be valuable to someone else.
Similar story here: early age, 0 or 100, high tests and little completion. The difference is I've been programming for most of my life (I'm not exaggerating; I started at 7y). It's likely because I started so young that I find that's my hyper focus outlet, though I still find that every time I try to learn Java it feels so painful I break something and run away (though I know C, C++, Obj-C, Swift, Python, PHP, Perl, shell, and even some Forth). Don't get me wrong, I know exactly two people that like Java and everyone else says it's painful, but they can do it anyway. I simply cannot. My mind shuts off and boycotts the information until the topic changes. It's infuriating.
Having anything at all near me that supplies instant gratification (electronics, mainly) puts me in what I call "hunted mode". That is, I'm itching for something to switch my attention to and very easily distracted. When I remove such things and engage with the world (and turn off or DND my devices -- important) then I seem to enter "hunter mode" where I can put my focus where it needs to be and hold it.
So, of course I become a professional software developer, right?
Adderall lets me work. Turning shit off when I get home lets me live. Paper books let me read (ebooks for reference, though; I'm not a Luddite).
Which is to say: I'm with ya, and you're right about environmental sensory stimulants. But you're kind of wrong about it being a matter of self control. It is, but the problem is that you (we) lack the control of self-control. That's the nasty thing the article doesn't go into. This is an Executive Function disorder, a "cousin" disorder to things on the Autism scale (ever read a list of those symptoms and check off an uncomfortable few?). That's why we wind up medicated. We do need that dopamine to hang around to push through the daily administrivia.
Yet, the article was right that outside of city life this would be great. But I'm a city guy, so ... yeah.
My uncle is a psychiatrist, and he has a theory that the definition is more of a matrix than a spectrum. He says that what is often called attention deficit would better be described as intention surplus - you have more intention than your attention can handle. A lot of A.D.D. cases are confused by the fact that they can spend several hours hyperfocused on something, so it's not a lack of attention that's the problem, it's that there is a limited supply of attention which cannot keep up with one's attention.
Putting it this way opened my eyes to my own diagnosis (diagnosed A.D.D as a child).
Sp3000 made a relevant comment in response to this but he may be hellbanned as it came up dead.
The article cites research into dopamine receptor issues in those with ADHD and I believe adderall works to inhibit reuptake so you have more dopamine in circulation than you would normally.
I can't speak for everyone but personally it is never a matter of "this feels rewarding and this doesn't". It's more being able to function vs. not being able to function. Without medication "I know I need to do these things, man I should really do these things, look at this list I made of things I need to do" which can spiral into what may be depression when the things don't get done, people get let down, etc... Whereas with medication you are just able to do what you need/want to do.
With unmanaged ADHD I have many ideas and desires that would be rewarding to complete but I am frequently just unable to perform.
The article seems to be making a case that people with ADHD should find things to do with their life that don't conflict with their condition.
I think "we have the technology" to give people the ability to alter their brain chemistry to let them do things they wouldn't be able to otherwise, and having that choice available or those who want to take advantage of it is better than not having it.
I was late diagnosed with ADHD. I used to be on Adderall for years. I'm now on a non-stimulant medication, as well as an anti-anxiety anti-depressant.
Adderall helped me in college. It helped me get every homework done, even if the homework was pointless.
I spent some time trying to switch medications, as I personally did not like feeling glued to whatever activity I was doing. I like having the choice to focus, or not focus.
I switched environments, where I could experiment with this new way of approaching learning and working. I don't mind iterative, mundane tasks, because at the end of the day and before I begin them, I try to think about why it's interesting, novel, and different, for me to perform this iteration of task. I try to think that the fact that I have gotten my mind to this state without dramatic intervention is as well novel, unique, and worthy of self praise.
In a world where I already felt distracted and slow, Adderall offers a quick fix. But I would have never built those parts of myself, of my mind, that can find novelty in what superficially appears to be 'boring'. I just try to change everything else in my control, to help myself see 'boring' in a different perspective. If I work in java at work on jsp pages, at home and during my 'web surfing time' at work, I teach myself about unikernals, clojure, the curry howard isomorphism - with serious intent, over long periods of time. And then I begin to see connections in the ordinary that are extraordinary.
As for nootropics, I'm trying to look for research in anything that uses language such as 'relaxing / calming' and 'focus'. I think there is a serious slant in literature that truly believes, and primes it's audience to believe stimulant -> better concentration. Stimulant -> temporary concentration. I am firmly confident that stimulants either prevent or override the creation of neural connections that are less explicit.
Regarding nootropics, gwern has an excellent writeup on different ones, and how he tested them http://www.gwern.net/Nootropics. You might already have seen it, in case it might be helpful to others.
Before I was medicated for inattentive ADD, sitting down to study was essentially impossible. I would sit down to read, and within a minute my mind would start to wander and it took an enormous amount of effort and mental energy to get my mind back to focusing. But once again I would lose my train of thought unintentionally and start day dreaming. I used to lock myself away from any distractions, but my mind was just not equipped to learn the way my high school and college required me to. I needed to learn and I wanted to learn but I didn't have the ability to.
After taking Adderall, my mind doesn't wander aimlessly and it doesn't take an enormous amount of effort sit still and study. I still need to take mental breaks every hour and use will power to get myself to sit down and learn, but the effort was just much less, making it a much easier process. I am naturally motivated and curious. But this is hindered by the fact that I can't naturally sit and learn. On Adderall all of a sudden I can focus, and my motivation and curiosity can let me successfully get things done.
As far as tasks that would feel good even without medication, video games for example, I had even more focus and could play for longer periods of time if I wanted to. But now all of a sudden playing video games didn't seem as attractive to me anymore, because there were other things I needed to get done (like study) which I always wanted to do but were too hard. When the threshold of effort required to do work successfully is lowered, it becomes much easier to stop myself from playing video games and actually get motivated and excited about learning and getting work done.
I take dexedrine (and not adderall) and was just recently diagnosed at 33. BUT..
I don't have to fight to learn. For the first time in my life i have a thought ( " I need to finish my homework. ") i walk over get my homework out and finish it in a single session. Before i would think about doing homework, put it off for hours, finally get frustrated enough with myself that i can force myself to do it, make tea and check my phone, have tea and sit down about an hour later then i had planned do ten minutes of work, lose interest, fight myself, get frustrated, and have to walk away with really only having done 10 minutes of work.
This last example applied to hobbies, work, watching TV, relaxing, to everything. i highly regret waiting but am now quite a bit happier.
It does not improve motivation past the first few weeks (the honeymoon phase). Once your body is used to it you have to still talk yourself into doing whatever it is you need to start. Or even better have a routine to get you started on things so you can do it on autopilot.
The only rewarding feeling that has manifested itself for me is having more pride in the code I write. Completing goals otherwise feels the same as before I medicated.
Without medication the best feeling was post exercise, but this feeling is and was short lived.
The feeling of the medication is totally transparent now. I do not feel any side effects, or feel anything that would suggest they are kicking in.
I know it's not the same as pure Java, but I found that trying to build an Android App was a practical way of learning Java. I had an app I wanted to make, and having that as the goal kept me going through all the boring parts of learning a new language.
That's somewhat of a heartbreaking story. I wonder if your mind was calmed during those two years because you had found your calling and were happy with your situation, for the first and only time in your life?
I'm not suggesting you change your life now, btw. Maybe you are, for whatever reason, unable to engage in things which you are not fully committed to.
I'm not against citations but obviously it would be nice if we were amply schooled in the biological functions of dietary nutrients so that the knowledge was just more tacit.
On some level it feels like you're asking me to link to a proof that a<sup>2</sup> + b<sup>2</sup> = c<sup>2</sup> solves for the hypotenuse of a triangle.
Here's a start: <i>CONCLUSION: The ratio of membrane omega-3 to omega-6 PUFAs can be modulated by dietary intake. This ratio influences neurotransmission and prostaglandin formation, processes that are vital in the maintenance of normal brain function.</i> <b>Source:</b> http://europepmc.org/abstract/med/12728744
Some medical observations about EFA deficiency symptoms include: <i>Symptoms of omega-3 fatty acid deficiency include fatigue, poor memory, dry skin, heart problems, mood swings or depression, and poor circulation. It is important to have the proper ratio of omega-3 and omega-6 (another essential fatty acid) in the diet.</i> <b>Source:</b> http://umm.edu/health/medical/altmed/supplement/omega3-fatty...
http://www.ncbi.nlm.nih.gov/pubmed/23574158 (this study doesn't include the term ADHD at all but it does speak of the need for EFA's in hippocampal neurogenesis, the common clinical finding of hippocampal atrophy in depressed patients, and the finding that EFA administration gives a statistically significant improvement in depressed patients in clinical trials. The reason this matters for our purposes is because the hippocampus
<b>Hippocampus and amygdala morphology in attention-deficit/hyperactivity disorder.</b>
<i>The enlarged hippocampus in children and adolescents with ADHD may represent a compensatory response to the presence of disturbances in the perception of time, temporal processing (eg, delay aversion), and stimulus seeking associated with ADHD. Disrupted connections between the amygdala and orbitofrontal cortex may contribute to behavioral disinhibition. Our findings suggest involvement of the limbic system in the pathophysiology of ADHD.
</i> <b>Source:</b> http://www.ncbi.nlm.nih.gov/pubmed/16818869
OK, admittedly, I didn't know or expect to find that people with ADHD often have an !ENLARGED Hippocampus. This doesn't mean that EFA's aren't part of the problem/solution equation though.
Just knowing that the amygdala is involved should also cause us to form hypotheses about traumatic memories and anxiety type issues being co-involved with ADHD (struggle with learning, self-control of behavior)
Dietary studies are indicated to determine if essential fatty acid supplementation can influence central nervous system serotonin and dopamine metabolism and modify impulsive behaviors related to these neurotransmitters. Source: http://www.ncbi.nlm.nih.gov/pubmed/9715354
The brain is sufficiently complex and interconnected that when you see problems like ADHD (which generally seem to be very treatable/preventable/reversible with certain dietary choices rather than inherent structural problems from birth/genetics) strongly expressed in a person then you can be pretty sure that a large portion of nutrients which relate to brain development and health are either deficient or otherwise not being metabolized normally.
One of the first things IMO that should happen when trying to provide treatment for patients with any disease should be to question them about their diet and emphatically educate them on the critical and irreplaceable role of the different nutrients and how a lack of them may be effecting them. (commonly green vegetables, seafood, healthy fats, Magnesium...etc.)
The diet of most Americans in the last few decades may have increased in calories but I think it's become less diverse and inclusive in essential nutrition. This is arguably the cause of the rise in behavioral and mood disorders among our youth.
Interesting that the article goes down the route of providing more stimulus to help treat ADHD.. wonder if there's also a case for reducing our need for more stimuli (e.g. with mindfulness or meditation) or whether that's just too against the grain of how we are moving as a society (in to a more digital, multi-tasked world)
> wonder if there's also a case for reducing our need for more stimuli (e.g. with mindfulness or meditation)
A study was done in Australia ten years ago on a type of meditation that encourages you to be more mindful to see what effect it can have on ADHD. Children were able to reduce or even cut out their medication completely after completing the meditation program.
That's a whole different topic, even though to an outsider they may seem related by the stimuli concept. ADHD is an impulse control disorder. Increasing the stimulus levels of positive things around such a person induces a natural focus to those things. Reducing stimuli would alternately induce sleep or painful boredom that will express itself in highly random and chaotic ways after a short time.
Sometimes I think it would be a good idea to turn everything off and read a book. When I wake up after trying that I realize how many times I've tried it before and it's at least a few days before I get the idea again...
I have only experienced ADHD second hand, my partner has been diagnosed with it years ago, and a good friend of mine as well. I recognise the "coping mechanisms" with alcohol, and the frustration of getting mundane things done.
The article suggests that the intense concentration or "hyperfocus" they have when they find something interesting can be used to their advantage. Both my partner and friend have gotten into occupations where they can do this. But there will always be mundane things that have to get done as well. Everyone has to pay taxes, and has to watch their spending. Few people like to do this, but almost everyone has to. Having a thrilling job does not alleviate you from these things.
So yes, it can probably help somewhat, but it can't "fix" ADHD completely.
No amount of structure can remove the fact that they are inherently extremely unrewarding, and even staring out the window offers more rewards. The stick just doesn't seem to work for my ADD inclined mind - never has.
This unscientific narrative is dangerous. ADHD can go away over the years, without medication. But you can't predict it, and there is no evidence for particular causes of "remission".
More stimulation is hardly the answer to the social problems arising from ADHD, to drug addictions or a myriad of other problems patients have. It certainly doesn't work against depression, and good luck curing 5-10% of children just by "stimulating" them more.
Coping with ADHD means improving Attention and Focus. The single most effective way is medication. Additionally mindfulness/awareness meditation has been shown to work. Other activities like martial arts or dancing may have similar effects, but less reliably so.
Another patient of mine, a 28-year-old man, was having a lot of trouble at his desk job in an advertising firm. Having to sit at a desk for long hours and focus his attention on one task was nearly impossible. He would multitask, listening to music and texting, while “working” to prevent activities from becoming routine.
Eventually he quit his job and threw himself into a start-up company, which has him on the road in constantly changing environments. He is much happier and — little surprise — has lost his symptoms of A.D.H.D.
Having worked at an ad agency and startups, if you can find an interesting startup you're going to be in a much easier place when it comes to motivation. It may not solve everything, but it'll make things easier.
I'm glad the article spoke to specific regional recruitment issues in the brain and evolutionary advantages. As someone who was diagnosed at a young age and retain the condition through adulthood, it wasn't until I understood the evolutionary advantages to not being able to quiet regions of the brain not involved in the specific activity - that I learned how to self-learn.
Long story short, it's not just the testing conditions in which it's beneficial to not be in a class-room setting, but the learning phase too. Essentially, I'm completely worthless trying to absorb new information in a room full of people. It's nearly impossible to not be conscious of those around me. However, at home - where I can control environmental factors - everything changes. I am not forced to be reactive and can happily concentrate - even with other portions of the brain remaining active (listening, wondering, whatever).
I've never been diagnosed but I'm bored all of the time. I'm almost 30. I've been fairly successful in jobs where I'm learning new stuff all the time. Is it possible I'm ADD?
Do you find routines to be near impossible to establish / follow (eating breakfast, waking up within the same two hour period, taking a shower, etc.)? Are you unable to remember anything without a constantly visible list / alerting system? Do certain irrelavant noises cause you to instantly lose all concentration? Do you have a tendency to forget to pay bills for months while racking up several hundred or thousand dollars in fees? Do your relationships suffer as you often go months without remembering to talk to close friends? Are you usually 5 - 10 minutes late for all meetings and social functions due to an inability to accurately predict durations and intervals of time?
I think I'm having the exact reverse problem. My focus at work is very good, but I feel anxiety levels going up during the day. Drinking coffee sends my anxiety through the roof. Also I'm often so concentrated on things happening inside my head, that I forget to pay attention to the outside world. This is especially problematic when talking to other people (that talk slowly), or in traffic.
Probably these symptoms are not so bad when compared to ADHD, but at times I just wish there was a (preferably natural) medicine to deal with this.
It isn't unusual to have generalized anxiety or a specific anxiety disorder in addition to ADHD.
Definitely see a psychiatrist to get an official diagnosis--it will help you feel better just knowing what you have. Also, I'd recommend seeing a doctor and getting a physical done too. You may have something physical that is causing the anxiety.
I have both ADHD and anxiety. I went to a psychiatrist and got an ADHD diagnosis. In addition, blood tests plus followup tests done by my doctor showed Graves' disease--a thyroid autoimmune disorder that causes anxiety.
Having both of these diagnosed and seeking treatment has provided me with a lot of relief. I strongly recommend you do the same.
The article wonders at the huge increase in diagnoses that mysteriously disappear in adulthood, but if the author had spent some time at college recently he'd know that Adderall is seen as THE way to ace tests and study more.
It isn't difficult to walk into a doctors office and act and say the right way and things to get your prescription after you get tired of buying it off friends, either.
Well huh. I'd never thought I had ADHD, just a complete inability to motivate myself to do things. However, the descriptions in this article describe me perfectly! Everything seems dull, I'm constantly seeking new experiences, the idea of a daily routine terrifies me (even though my father keeps encouraging me to develop one), but I can play piano for an entire day.
Nailed it. But do yourself a favor and don't self-label. Go talk to a professional for a while and see what their take is. By which I mean an LCW or psychologist, not a GP. :)
I've spent at least two decades depressed at my inability to get things done.
Earlier this summer, I tried to talk to my psychiatrist about my inability to reign my focus, and how that was severely impacting my life and my ability to accomplish my goals. Her responses both times were dismissive, that "No one likes doing boring things." Obviously... but the things I'd mentioned weren't boring to me. I had no idea how to help her understand.
Do you have any suggestions for talking to a psychiatrist?
i come from a generation where adhd is vocalised using a cash register chime, so i aggressively avoid acknowledging the diagnosis stead the syndromes
> My patient “treated” his [distraction'boredom'frustration'creative depletion] simply by changing the conditions of his work environment from one that was highly routine to one that was varied and unpredictable. All of a sudden, his greatest liabilities — his impatience, short attention span and restlessness — became assets.
i developed a similar work environment.. i called it distracting my distractions
i often have multiple projects i want to work on with varied goals and requirements and if i start to lull while working i just shift to another project
i used to do this when i was a younger when reading
i would have many books open and scattered on my floor, all open to different pages
my friends might start reading a book at the same time as me and finish the book in one week what took me a four weeks to finish, but after that four weeks was over i would have finished reading three other books as well,
each finishing at the end of that four weeks
books are really easy to build productive workflows around: you can immediately determine speed and pace based on time it takes to read the second page and how long the book is; with projects it is more difficult,
i may get stuck on one function for hours and another will come out of me effortlessly,
it is a now a matter of correctly recognising when i've begun to sludge signalling i should move to another project
most recently i have been taking breaks from work every thirty minutes or so, unless i am whistling through something, and get up and stretch,
while giving my back and butt the rest i try to analyse my progress since the last stretch and determine if a project shift would do me good
This is pretty much the same approach I took to largely overcome ADHD-like symptoms. I happen to believe that, if you've fallen into a routine, it's time to re-evaluate, anyway - so the tactic of engineering a more stimulating environment seems like a great idea regardless.
Second, it's very important in discussions like this to qualify the target audience. A LOT of people have SOME of the symptoms, even to levels that impair their lives. NOT a lot of those people have full-blown ADHD.
If you have SOME symptoms and things like that help you, that's fantastic. In my direct and social experiences, however, those with clinical ADHD diagnoses are assisted with such suggestions, but very rarely do they improve things to the point that there is no longer a significant impairment to that person's life. THAT is when medication is a good fit: clinical diagnosis, life and environment changes haven't significantly helped, and there is still a negative impairment on one's life.
I realise there are others that likely have much more severe manifestations of the symptoms than me, but I don't think it's quite as black and white as you're making out. Surely the line you describe as "full-blown clinical ADHD" is somewhat arbitrary, when the symptoms exist on a spectrum?
I didn't attempt to get myself diagnosed, but yes, it was a significant impairment towards my life, and yes, there still is quite a negative impairment. If I wanted to get routine tasks done with any kind of consistency, I may well have to look into medication.
But instead, I structured my life around a very diverse range of stimulating past-times, and set myself up with very few obligations (e.g. no employer). This leaves a lifestyle of jumping between stimulating and challenging activities, which allows me to be a lot more productive, and achieve much more, than I ever did when I was in formal education or working a repetitive office job.
> In my direct and social experiences, however, those with clinical ADHD diagnoses are assisted with such suggestions, but very rarely do they improve things to the point that there is no longer a significant impairment to that person's life.
How far did they take the suggestions? Did they quit their job and start their own startup? While I agree that medication is probably the best solution for certain types of lifestyle, I do think adjusting one's environment is an underrated and underexplored solution, that could do with more research.
> Did they quit their job and start their own startup?
They forget to shave and flush the toilet, so no. When I mean full-blown clinical ADHD I don't mean interrupting people and being unable to finish a coding project on time. I mean "gets fired from Mickey D's for randomly staring at the walls". Inattentiveness on a scale that's not being discussed in this article or this thread.
Perhaps I feel so strongly about all of this because I've attended group sessions with non-tech people that are truly suffering because of this thing and I don't have any way of bridging the understanding gap with mere comments on a website. This is a difficult malady for those in tech. Outside of tech? It's sink or doggy paddle, and when you sink there's a whole ocean under you, not a swimming pool.
Watts doesn't deny the differences between those affected by ADHD and those who are not. He argues that these differences are best understood as personality traits and not products of an affliction.
This isn't a matter of ignorance, but interpretation of and reaction to scientific discoveries.
There is no success because of ADHD. There is success despite having ADHD.
It's not a personality trait that I cannot physically do something I want to do and need to do without medication and, frankly, I'm sick of people who don't experience it offering new theories on it as if they have some grand insight into it.
Get a head injury that breaks your executive functions. Join us. Then try to offer it up as a personality trait.
Love a lot of your posts here you're very vocal and well explain. I'm an ADHDer, software developer, avid researcher, fascinated with neuroscience and cognitive science and studied modules of it in university. But I sense you've been reading a lot from Barkley? And Barkley unfortunately can be closed minded(his brother had ADHD and died in a car crash so it's understandable he's negative towards it).
We've seen in neuroscience that certain characteristics in ADHD, i.e lack of inhibition can lead to positives. The brain compensates.
Honestly, I feel in the next decade ADHD will be looked upon as a subset of personality/neurological traits, more in line with how as Aspergers is been seen nowadays.
If ADHD isn't real but the drugs do something with utility what should be societies stance? If somebody wants to, or needs to do work that requires more concentration, how do we justify denying them the opportunity to better themselves?
Much like giving welfare under the guise of disability, this discussion reflects yesterday s ethics on today's questions.
I'm not a fan of the perspective from which this article is written. Where the author writes "X is affected by ADHD", I'm inclined toward "X has a short attention span", or "X is hyperactive".
The same perspective is taken by "victims" of ADHD, parents, and members of the media alike. I think we'd all be better off if we stopped speaking of these conditions as external forces acting upon the self, and instead, as mutable characteristics of the self.
I don't have a short attention span and I'm not hyperactive. I spend a lot of time thinking about things. I deduce things noticeably faster than my peers as long as it's not socially related. I have intense focus as long as something remains stimulating. When things lose my interest or are pointless they become tedious and it's not about attention span. I cannot stop worrying about assigned tasks to the point of anxiety. There is a mental barrier and I cannot work on the task despite intentions and efforts to do so. Medications don't really help me. They do at first, then they become less effective. An interesting side note about meds: The first time on meds I finally could see social cues and body language. It was a whole new world. I still see them off the meds now that I know about them but I may have trouble understanding what they mean due to lack of experience in receiving those signals. Getting proper sleep, nutrition, and having regular, serious exercise help more than meds. The affliction is very real. Just because you can't see it or refuse to believe in it doesn't change the fact that it impacts the lives of others.
Something to think about: it's possible you have more than one named disorder (though they could be related in chemistry). When I first started ADHD meds I had a similar reaction as you, though I wound up in actual panic attacks from the anxiety. When I treated the anxiety with an ultra-low dose then everything came out perfect.
I've since stopped the anxiety med and feel I've trained myself a little more on how to handle it. I have my moments but have the skills I need now to recognize those moments and bring myself down. Luckily one can do that with mild anxiety, unlike ADHD...
The biggest non-medicinal benefits are absolutely sleep, nutrition, and exercise -- you're right. Without a good foundation, nothing can be built.
> "I don't have a short attention span and I'm not hyperactive"
I thought these were the defining characteristics of ADHD? I'm sorry, please forgive my lack of familiarity.
> "When things lose my interest or are pointless they become tedious"...
I don't understand how this is considered a symptom of anything. To me, this is entirely normal. Things that you aren't interested in should be tedious. The mental barrier you speak of is internal honesty - you don't find importance or interest in X, and consequently, motivation doesn't emerge.
You speak with the world view of a neurotypical human. I'm happy for you.
For the perspective of the broken toys in the box, let me explain. :)
When an NT is asked to do a boring, repetitive task, he'll do it for eight hours and then get drunk afterwards to recover. Good job.
When an ADHD-afflicted individual is asked to do a boring, repetitive task, he'll do it for about five minutes and then spend eight hours trying to find a way to not do it again. Or stare at the wall. Or berate himself for not working. Or rack up a disabling level of anxiety because he's not working.
You present this as something everyone does, and you're right to. The disorder comes in when someone cannot do it. Not that the person will not muster some internal whatever to push on, but that the person's brain is physically incapable of doing it. The same kind of incapable as a major depressive being incapable of talking himself out of an anxiety-induced depression.
When it's a disorder, it's a disorder. The problem is that so many people see the high numbers of people being diagnosed and write it off as a fad. It's not. Maybe the numbers are high and some are being misdiagnosed, or maybe we're learning about all the edge cases. I don't know. I do know it exists and it's an impairment and it goes well beyond basic motivation.
I've had "do it or you're fired" moments where THAT wasn't enough to motivate me, and I had a very real fear of being unemployed.
First of all, thank you for this in-depth response. It beats the hell out of anonymous and explanation-less downvotes.
I had never come across the word neurotypical before your comment and now, after reading the corresponding wikipedia page, I am aware that it does characterize me (i.e. "anyone who does not have autism, dyslexia, developmental coordination disorder, bipolar disorder, ADD/ADHD, or other similar conditions").
For the majority of elementary, middle, and secondary school, I fit your anecdote pretty well, minus the getting drunk part (I was young, sheltered, and without access to or interest in alcohol).
However, after sophomore year or so, I realized how much time I had wasted pushing through boring, repetitive tasks, and I grew incapable of completing assignments. This turning point left me in the position of ADHD-afflicted individuals for the final two years of high school. Call it burnout, early senioritous, or whatever - the symptoms were the same. With fear of college app rejections as my motivation (like your fear of unemployment), I couldn't bring myself to do mandatory, largely weighted assignments. They were just too boring, meaningless. Somehow I remained motivated up until then. I really don't know how, to be honest.
Out of curiosity, how would you say my realization [and subsequent drop-off in academic performance] relate to ADHD and NT?
On another note, are A
DHD-afflicted individuals literally incapable of mustering the "internal whatever" you speak of? Is the ability to conjure motivation entirely absent? It's really hard to compare similarly subjective abilities, like pain thresholds and the like.
Even if this incapability is just that: a true incapability, I'm not certain that portrayal of ADHD as an affliction is a net-benefit. It seems better for people to believe in their own capabilities, even when many are literally incapable, as you say. Similarly, the belief in free will is good for people and society - even if free will is obviously nonexistent. Determinism yields higher rates of depression and discourages self-responsibility.
The Diagnosis of ADD (Attention Deficit Disorder) has been folded into ADHD as a subtype Attention Deficit HyperActivity Disorder- Primarily Inattentive.
It is a symptom when normal people even if they are disinterested in a task can still summon the level of focus needed to effectively complete a task. That is a much harder proposition for someone with an attention deficit syndrome condition.
I'm not saying it doesn't exist. I'm suggesting that it be considered a characteristic, and not an external force. This way, we don't grow dualistic, differentiating between oneself and one's brain.
I guess it's the dualism here that I'm criticizing, not ADHD itself. See the fourth paragraph:
"if you have the 'illness,' the real problem is that, to your brain, the world that you live in essentially feels not very interesting."
This distinction between "you" and "your brain" is what bothers me.
I think the way it has to be explained is that, sometimes I'll read a book but my phone will be there. Just near me so I'll tap the on button, no notifications, back to reading. Tap the on button. Read. I didn't check the time. What time is it? Tap the on button. Ignore the time. Read. Turn the on button. I can never just read. Its fun but not exciting.
1. There is absolutely no sympathy: The problem with ADHD is that it is a disorder of degree not kind. If I had epilepsy or cancer or had some of my limbs missing then people around me would be supportive and understanding. But not ADHD. Everybody's mind wanders. Everyone would like to only do interesting things. Everyone forgets things from time to time. But, the problem is the degree to which these afflict people with ADHD.
We don't expect someone without legs to walk normally or properly. Yet, when it comes to the mind we have little patience. Somehow, we expect people to get their act together. We label them lazy, unmotivated and indisciplined. A product of poor parenting. We get frustrated that they are not reaching their full potential. In a way, having ADHD in 2014 is like being Gay or having an interracial marriage in the 60s or 70s. Ignorant cynical judgmental people assume that you can will your way out of ADHD through discipline and will power.
2. ADHD does give you super powers: Insane creativity. The ability to think outside the box. The ability to make off the wall zany connections. Always looking for small advantages and using creativity to your advantage. I use mnemonics to remember things. I hired people overseas who follow up on everything I do. I built products that are on track to doing well. When I do succeed, people write it off as being lucky.
I wish I could write more. But I am actually supposed to be doing something else right now.