Orthogonal. Having ADHD doesn't imply a desire to be outside playing. It's a disorder of motivation, not a disorder of focus—an inability to practice, and sometimes to concentrate; but not an inability to think, or to enjoy thinking.
Personally, in my childhood, I liked math and science. I had (and still have) ADHD, which made that hard, but I struggled through, because that was my passion. Medication (which I didn't get until I was 22) makes it much less hard.
Telling me my aptitude was in running around outdoors would have been the last thing I ever wanted to hear. I liked exploring, sure (people with ADHD are almost always Bartle Explorer-types[1]), but building up physical endurance was just one of the many things I couldn't motivate myself to do, and would have heavily resisted someone attempting to push that on me.
I would further polish your desription - and call it a disorder of mismatched motivation.
People with ADHD can motivate just fine on things that stimulate them - and have even reported 'hyperfocus', a trance-like state of emersion in something. The problem is things that are not stimulating become very challanging or even impossible. This is why bills, appointment, rules, and chores can be so difficult for ADHD people to commit to. 'Normal Type' people may find misery in these sorts of tasks, but they are able to motivate themselves to complete them - and the tasks generally don't take that long for them.
A good way I've heard ADHD described is that people with the condition have no percetiption of time. If stimulated, its easy for them to loose track of how much time has passed - even forgetting to eat or sleep. If unstimulated, the misery seems to be never-ending, even if it would only take a short time to complete if the person applied themselves.
As an example: Michael Phelps (who has the condition) has been very able to motivate himself to practice swimming. Swimming at his level is a very tedious sport, requiring five or more hours a day in a pool staring at the black line on the bottom.
I've personally found sport (swimming and extreme) to be helpful in managing ADHD, both while doing the activity and maybe for a day or two afterwards. Also as a motivator before hand to get through tasks I find miserable to give some time for the activity.
Maybe I was using "motivation" in a jargon sense. Motivation (some people call it "willpower", but that ascribes it a "choosability" it doesn't really have) is the resource you have that allows you to do things you don't want to do.
To put it another way: some things in life are a hassle (or a "schlep", in pg's phrasing[1]). The more motivation you have, the less this matters. The less motivation you have, the more of a problem a thing being a "hassle" will be. When you have chronically-low motivation, you avoid "hassles" as a rule, to the point that you stop even being able to lead your mind down potential avenues of thought that involve "hassles."
If you want a fictional example of what having ADHD really tends to look like, it's not Calvin of C&H, it's Shikamaru from Naruto[2].
This model, by the way, has all sorts of consequences outside of just ADHD. When people are "too hungry to decide what to eat"—that's because hunger depletes motivation, and decisions are fundamentally hassles. The hungrier you get, the less motivation you can tap to "just" decide. (You can force yourself to decide, or trick yourself into deciding, but you can't "just" decide.)
[2] Yui from K-On is also a striking example. That show's entire theme, actually, is essentially "how to succeed in life despite having ADHD", which is a real surprise for something so fluffy.
I have ADD (I can't stand the H in ADHD - I'm not hyperactive) and I can spend hours and hours in front of a computer programming. I can also spend a hell of a lot of time doing laps of the pool for some reason.
I always find it ironic that it is my intense concentration that undoes me, the attention is ripping my mind away from the task I'm doing. Everything else seems to be a distraction, and that is intensely irritating.
Oh man, speaking to the choir. When I'm coding something interesting, my motivation and ability to focus is second to none. When it comes to things that don't massively interest me my brain is completely unable to focus. I've got better.
It's like our brains are like a magnetic pole. Some stuff is a opposite pole (so our brains magnetise towards it), and some are like the same pole and your mind is repelled from the task.
Once I was walking into the kitchen to pick something up off of the counter, and then as I reached for it, I got distracted and reached for the the fridge, and ended up literally falling over because I was trying to go in two different directions.
I look at people who are intrinsically motivated, seemingly all the time, with amazement. How are they able to consistently and constantly remain motivated? Is it because they have positive momentum in their results and I don't?
I am motivated by novel stimuli and challenges but once I figure it out and they become routine it almost becomes painful to keep working on it.
Not to discount your experiences, but that's not at all how I've felt as a sufferer of ADHD (nor my parents or my son). I would describe the feeling of ADHD not as lack of motivation but severe, almost physical, discomfort at attempts to concentrate. If you've ever suffered from nerve pain, you may know what I'm talking about. It's not quite analogous, since the ADHD discomfort is more of a strong, distracting 'itch', but it's similar in its phantom nature.
If one lives with that feeling since birth, it is really hard to understand that others just don't feel that way. We may try to push ourselves forward, through constant force of will, or because others tell us to 'tough-it-out', but it's exhausting. Whereas we see others reading a book a week or month even, we struggle to even read a paragraph - constantly starting over, re-reading, so distracted that we can barely even take in the information.
It's not until we gets treatment that we suddenly and clearly feel the difference, and then we understand the suffering that we've been going through all that time. Feeling 'normal' is amazing! It's like being able to read several pages at a time or sit through an entire lecture without feeling like you're constantly wiping away some sticky, opaque film between you and the information.
Your and my descriptions feel so qualitatively different that I've got to wonder if fundamentally different things are going on between the two.
A previous HN thread had a lot of people comparing ADHD to the effect of chronic sleep debt, with the suggestion that ADHD could be an effect of the inability to enter deep sleep. "Like never having slept enough" isn't an analogy I would make for my symptoms, but it would seem to fit yours much more closely.
As a probing guess, are your symptoms helped more by NRI-class drugs? From what I know about norepinephrine, it governs whether moment-to-moment attention will tend to fixate or drift. The symptoms of both that, and the disorder of motivation, seem to get conflated as "ADHD" for some reason.
In the book "ADHD Does not Exist" Richard Saul describes Neurochemical Diststractibility/Impulsivity(what we call adhd) of two types : low serotoning group and high level epinephrine/norepinephrine group.
"The two types described show subtly different symptom patterns.The low-serotonin group tends to look like what people think of when they think of the disorder called ADHD. The high epinephrine/norepinephrine group is "consistent in its inconsistency". Sometimes these patiens can concentrate well, and sometimes they can't."
Maybe this is related to what you say, I see it myself, somedays my brain just works better, I never understood why.
I don't know, maybe. The members of my family have the hyperactivity part of it, too. But, the hyperactivity is like constantly staying moving (while learning) to avoid that discomfort. And, I totally understand the distraction part and the need to feel overstimulated. Now that I'm thinking about it more - it's like I have to work extremely hard to remove my attention from the rest of the environment. Almost like I'm taking in too much information, and it's hard to shut out the other stuff. Does that make sense?
But, that's an interesting perspective, because all of the members of my family have some sort of bipolar, as well. And, bipolar has co-morbidity with ADHD. So, maybe that type of ADHD is different?
As far as NRIs, yeah I once had a panic attack (also co-morbid with bipolar and ADHD) and had to go to the ER. The neurologist gave me an NRI, and it made me so absolutely sick - it was a feeling like someone twisting my brain inside out.
Also, I've had sleep studies done, and I've had no underlying sleep issues.
You nailed it, this is me. When I have new stimuli I'm fully engaged to the point my head hurts at the end of the day from focusing so much. But then, the stimuli wear away and I'm back searching for new stimuli rather than powering through my work.
Rather than a desire to be active, I think it's a need. I can manage without medication but only if I'm active physically. That's why we shake our legs or arms while learning or digesting information. We need the activity.
But will the positive experience kids get with this kind of activity have a long-lasting impact in their life? Will they grow up to be adults without ADHD or lesser symptoms?
I was in the scouts when I was a kid and teen, ultimately reaching the rank of Eagle scout. I did plenty of outdoor activities and sports, not necessarily extreme, however we did go portaging deep into the Boundary Waters quite a few times. Yet, my ADHD persisted throughout my teens and 20s and I still suffer from this disorder as an adult in my mid-30s. Of course this is anecdotal.
I guess it's a positive thing that being active outdoors will help a child while he grows up. Hopefully it helps in the long-term. In my case, I only wish it had.
Short rant: it's pretty common these days to talk about the over-medication and over-diagnosing of children with ADHD. We must remember that some of these cases are truly warranted. I wasn't diagnosed until I was 30. Since I've been on meds my quality of life has improved dramatically.
Quick edit for a warning: ADHD medications are very powerful and must be treated with respect. Do your research before and after starting them. Don't hesitate to visit even abuser forums or reddit so you can read about the negative effects of consuming too much, too often. You can easily jeopardize your mental future by taking the medications the wrong way.
Similar situation here. I was diagnosed in my late 20s. I was having marital problems before Ritalin. Inattentiveness can be fatal to a relationship, and my executive function was poor, which put a lot of strain on my wife.
In school, with plenty of free time and few responsibilities, I did fine. A two hour homework assignment might take 6 hours, but I did OK. It was adult life that became unmanageable.
Like the author mentioned in the article, I don't think of it as a disease necessarily, it's a personality type. But it's a personality type that can make it difficult to live in the modern world without help.
Something to keep in mind is that adrenaline is something used in medication to treat ADHD in some cases. The desire for some to go out and do things like this (ie: Base Jumping) could be sourced to them craving that adrenaline that helps them focus. Maybe they are taking the wrong type of medication or maybe they aren't taking any at all.
Additionally I found this part very frustrating
>>Panksepp points out that while common stimulant medications for ADHD like Ritalin and Adderall may improve attention skills and academic performance in many kids, they do so at the cost of reducing the playfulness urge—at least temporarily. “We know these are anti-play drugs in animals,” he says. “That is clear and unambiguous.”
This is strongly anecdotal but as someone who takes Adderall, I can't say this could be any further from the truth. The only thing that I can come up with that could lead to this thinking is that younger kids who have trouble with their hyperactivity might not be as hyper anymore after taking medication (which was the whole point in the first place for some). All this is doing is encouraging more adrenaline junkies to treat themselves outside of conventional means.
I can actually attest to being less playful on medication. I'm a very upbeat, humorous, and witty person. Too much of a stimulant however makes me very bland, an intense listener, and I have trouble coming up with replies to people. I tend to think of it as generally I have a firehose of ideas and thoughts spewing, and medication pinches the hose and directs its flow. It's a balancing act though
From what I have witnessed it even varies with type of the same stimulant from person to person, even within a family. (In a case I know all too well the recipient get tongue swelling as well as clenched jaws[0] on R XR at 40mg/day but has absolutely no issues with doses from 40 - 80 mg/day of the standard one. Oh, and the other person in this study, the brother of the first, went into spiraling weight loss at 60mg/day but prefer XR.)
Also playfulness seems to be preserved in these two cases. The best explanation I can come up with is: lowers the "interesting" threshold so that driving according to the speed limits is less intensely boring etc.
[0]: of course this can be reactions to additives of XR but they are commonly referred to as side effects of R itself.
I found this with Ritalin as a kid, and amphetamines/various analogues as an adult. It makes me so focussed I get colossal social anxiety and my brain loops over everything. It's horrendous, and kinda stunted my social development.
This article is ignoring that fact that there is a variety of different types of ADHD[1]. For example I have ADHD-PI which is just ADHD without the hyperactivity. I can't say I ever had a strong desire to play outside when I was younger and if anything I resented it.
ADHD is a very complicated neurological disorder which can be difficult to diagnose due to its similarities with other disorders like depression or social anxiety. In my case, the social anxiety was noticed long before my ADHD was when in reality ADHD was the root cause. For others this can actually be the opposite, their symptoms appeared to be ADHD but in reality they have a sleeping disorder.
Articles like this seem to be pushing an agenda ( Website Title: Outsiders Online ) and are trying to find an easy generalized solution to a complicated problem. That being said, exercise mixed in with education is something that should be important anyway, for all kids. Exercise keeps you healthy and motivated, regardless of any mental disability they may have.
Isn't it normal to have difficulty focusing on things that are really boring?
ADHD diagnosis rates are several times higher in the US than in other developed countries, and orders of scale higher than in low-diagnosis countries (such as France). The biggest risk factors for an ADHD diagnoses include things like "being male" and "being in the youngest quartile of your kindergarten class". That's an amazing thing to pathologize. In the US, the drive to perform well on standardized tests has gotten to such an extreme that kindergarteners are expected to have literacy performance that was expected of 1st-graders a generation ago, and children are expected to come to kindergarten with the alphabet knowledge that they would have learned in kindergarten a generation ago. Meanwhile, the amount of time young children have spent at recess has declined hugely in the last 30 years, with very many schools having no recess at all.
Isn't there a margin where this is a disorder because of the interaction between an individual and their environment, where the environment is the problem?
Some amount of ADHD-spectrum behavior might should be considered within the range of normal child development, which is being pathologized by a system that doesn't give young children (especially slightly younger boys) enough exercise. The main treatment for ADHD is lifelong amphetamine use, and nobody can say whether this treatment prevents children from developing coping mechanisms that they would otherwise normally develop before adulthood.
If something as simple as more exercise can marginally reduce ADHD diagnosis or medication rates, that would be a huge advance.
This speaks to a common commment about ADHD. Where is the border between a 'personality trait' and a disorder?
The condition is usually defined by having an impairment in at least two environments (ie school, home, work, sports teams). 'Impairment' is obviously subjective, but implies something more than simply being bored. Playing a game in a boring meeting probably isn't ADHD. Being unable to focus for more than a few minutes in _any_ meeting is a stronger sign, and could really make it harder.
On diagnosis rates - in most countries its 2-5% (>10% of children in the USA..). That is about 2 standard deviations from an 'average' person, which can actually be quite a difference. For comparison, a 'genius' is someone who scores in the top 2% of an IQ test. Economic elite are '1%-ers'. I'd agree that there is a continiuous spectrum, and also that it is mis/over-diagnosed in a considerable number of cases. I think it is this over-treatment that you are questioning, but lets be cautious to not add to the stigma around legitmate cases of the condition.
I'd agree often the challange is between individual and their environment - although often 'enviroment' includes people around them. Often the environment is hard to change - do the 95% change to accomodate 5%? There is advice for careers that people with ADHD tend to be better at - sales, entrepreneurship, and medicine for their fast-pace and energy, or jobs like the military where there is a lot of structure.
I think its more complex than saying exercise would reduce diagnosis or medication rates. In particular, if exercise alone 'cures' ADHD, it is likely a mild or mis-diagnosed case. In my own experiance, exercise (as well as sleep and diet) do affect symptoms, but don't eliminate them.
Yea, my concerns are threefold: overdiagnosis, the diagnosis of young children, and the impact of treatment on developing children. I don't doubt that ADHD is a real disorder, but if the true rate of occurrence is 2-5% while the US diagnosis rate is 10%, that means that a huge proportion of American kids are overdiagnosed. And the leading treatment for ADHD is quite intense: lifelong use of very powerful drugs, with no real understanding of how that impacts normal child development.
I would be surprised if exercise alone works for people who struggle with a very disabling condition, but I suspect interventions less extreme than a full ADHD diagnosis and medication regimen would do a lot of good for kids who might otherwise be overdiagnosed as ADHD.
And as far as the concern as to whether the 95% should change to accommodate the 5%, what we're talking about here is "getting more exercise"—and when huge numbers of schools don't require recess—it's something that the 95% would benefit from.
ADHD has severe consequences on children: less happiness, less self control, more aggressiveness, higher risk of substance abuse and in general much lower grades.
Unless a new treatment can demonstrate that it can reduce these consequences as well as medication does in the majority of cases, let's stick with the treatment that works, shall we?
In addition, I would like to see more articles about the dangers of misdiagnosis of adhd. There are a lot a conditions that can be mistaken for adhd( sleep disorders to overactive thyroid).
The articles that try to glorify it really annoy me, I can't come up with a single benefit of adhd in my life.
I'd say hyperthyroidism is difficult to overlook. At least I hope nobody is started on long term stimulant treatment without routinely checking simple blood parameters.
I have ADHD. Rather than focus on what it is and whether it's real, I'd like to focus on what helps. Cardio and adrenaline help more than anything else for immediate relief. So much of dealing with ADHD is realizing your tendencies and building your life in a way that is conducive to your work flows. I know I need frequent breaks, privacy and hydration. If I'm about to have a panic attack because I can't concentrate and work is due, I go for a short bike ride and set the work aside momentarily. If I tried to work on at that moment, not only would I not make progress but I'll probably have an anxiety attack. Once I give my brain room to breath programming issues seem so much easier.
I think this is an excellent way to help some kids cope with adhd, but I definitely don't think it'd work universally. Reading this made me think back on my own struggle with adhd.
A few years ago I was diagnosed with adhd at the age of 23, and god damn do I wish it happened a decade sooner, but my parents were the type that didn't believe in that kind of stuff, so I was just lazy. It's stuck with me to this day even, it took me a while to come to terms with it and I at times I still think I'm lying to myself and I'm just lazy, and would never make this post on my main account.
I first started seriously considering that it might be something other than just laziness in college when I was studying for finals with some friends and we decided to enhance that studying with some adderall. Everyone got super focused, churning out work and wide awake for hours, except me. I felt pretty much nothing different at first, and was kinda pissed it didn't work, but got to studying anyways. The next day I was complaining to my friend about my apparent immunity to amphetamines, and thinking back I realized it might've had an effect after all. Instead of jumping around and doing 50 things at once in no logical order I actually stayed more or less on one thing at a time. I didn't get the apparent super human focus and metal boost, and it didn't keep me awake for shit, but I got to pick what I focused on. My friend mentioned that having that kind of reaction to stimulants might be a possible symptom of add, but I didn't take that seriously, since everything is apparently a symptom of add.
Later on I finally got a job with my own health insurance, and went to a therapist for an unrelated reason. Through multiple sessions I unloaded the story of my life, how I could never pay attention to just one thing when I was younger, but I saw it as an advantage because I could context switch between 10 things got damn good at it. How I loved driving so much because thinking about every other car on the road with me and predicting their actions all at once put my mind at ease. But as I got older, the 10 things I tried to focus on each needed a lot more focus than my rapid context switching could provide. It had gotten to the point that holding a conversation was a troubling task because I'd also be thinking about 10 other things and losing bits and pieces of it.
The first time my therapist told me that I may have adhd, I was actually insulted. I didn't want to consider the possibility that something was actually wrong with me, I was just lazy and needed to get my shit together. I never outwardly acted out as a kid, I wasn't hyperactive, there was no way I could have adhd. I later realized that a lot of my outlet went into computers instead, where for me the adhd was actually helpful.
I continued my sessions, and eventually she convinced me to see a psychiatrist. Over a few visits he also diagnosed me with adhd. I refused to take the prescription and ended up going to two other doctors that gave me the same diagnoses. I finally relented and worked with my therapist and the psychiatrist to set a plan of action. I was prescribed adderall, which I took daily for 3 months. At the same time I also started working on behaviors and methods to cope with it without medication. It was a night and day difference. I remember 2 weeks in sitting in my room almost in tears thinking "is this how normal people think all the time? They can choose? Why the fuck couldn't I have that".
After the first 3 months I started skipping my meds for one week out of every month to gauge how well I could deal without. It took about 7 months until I was confident enough to go off of it, but it feels like I never did. As much as I hate pharmaceuticals, there's no way I could've gotten to where I am today without. I genuinely feel that I've managed to change something in my brain to a less chaotic process. I didn't even know there was another way to think, I thought that was normal. Sure, it's still a struggle, and I still have my moments, but I can actually manage my life. I can decide to clean my apartment and not end up starting 5 other projects after 20 minutes of cleaning. The amount of shit I could have accomplished had I been able to handle my mind a decade earlier.
Sorry for the long winded rant, but damn it feels good to actually put that into words. I'm still ashamed in a way of it, it makes me feel "broken" I guess, so no one but my doctors and I know and writing that was a bit of a relief. I'm honestly not sure what my point of writing this was, other that to say that while giving kids heavy amphetamines is probably not a great idea, doing something to help from a young age could be massively life changing, and if nothing else is helping, waiting too long for medication probably isn't a great idea either.
> but my parents were the type that didn't believe in that kind of stuff, so I was just lazy.
You're not the only one: I failed many high school courses because I couldn't focus on getting the homework done. Official Parental diagnosis: Lazy $*#@. And my mother was even trained to identify mental problems like this, but developed a blindness to my symptoms.
I barely skated through highschool pretty much on test scores alone. If I couldn't do the homework in class the day it was due, it basically didn't get done. My sat scores managed to get me into college, which I dropped out of due to the homework. Went to two more community colleges after that for a year each, then another college I got a scholarship at but only made it 2 years there before I got a good job (thank god for my interest in computers from age 6) and decided it wasn't worth it. I'm considering going back now that I've gotten my head straight though.
Interesting nearly simul-post. Same here, I scored 1250 on the SAT, 31 on the ACT, and in the top 99th percentile on the CPT.
Literature/Comprehension has always been my weakness "Read the passage below, then select what you think best describes the point the author is trying to make" -- they all look like right answers.
Took 18 credit-hours per semester of courses on scholarship, right out of high school, failed all of them miserably, dropped out, goofed off for 5 years doing whatever would make money. Got a good job that pushed me back to school, once again got a scholarship, went for another year or two, was forced to quit due to personal circumstances. I have two years left on my BS in Computer Engineering, I may finish one day, but it's not very important to my current line of work.
I almost didn't post my original comment as it seemed off topic, but responses like this make me glad I did. It's good to realize I'm not alone in it.
2170/1400 on the sat, 35 on the act, not sure what the cpt is, and anything anything writing/literature related killed me. I passed my senior english class with a 59.5, literally as low as possible without failing. I have a total of ~2 years of credits on my ECE BS, but work as a sysadmin/devops and love it, if I finish my degree it'll just be something to hang on the wall.
I had the exact same grade in English IV - barely scraping by with a D. If I had failed that I would have been another year in school.
CPT "College Placement Test" was required by the local community college even though I had taken the SAT and ACT.
It was not a timed test at the time, it was multiple choice, and I was allowed to use a simple calculator. Might not have known all the right answers, but I knew how to figure out which one was the wrong one. I think I spent 6 hours on it. I by far scored the best on it out of all of them.
I used to be in network security for a financial institution, but I wear a few hats now. I'm a certified tower climber and senior network engineer(That makes the article even more relevant, half of the time I'm designing networks, the other half of the time I'm getting sunburnt, hanging off a 500ft tall piece of steel with a fiber cable dangling under me and a laptop on my back.) I have a good Cisco background, MCITP(the new, now old MCSE) and can take apart and fix nearly anything.
Thanks for your story. It would probably give away your main handle to disclose, but I'm curious why you wouldn't want to post it under that one.
Sadly, I had a few teachers who had a "must complete all homework to take the test" rule which pretty much screwed me over.
It was entertaining, however, to fail the Calculus high school class, and get a perfect score on the AP exam. Of course, that did nothing but reenforce the "Lazy *&#@" label to my parent's eyes.
Tests are the only way I passed highschool. If I got a teacher that required homework as a significant portion of the grade, I would fail that class. Leave me alone, let me sleep through class, then give me the test and let me go. Thankfully homework was usually only 20-30% of the grade, so the little I did along with my test scores passed me in most classes with a C. I managed to fail 7 classes in 4 years and still graduated with a 3.08, thanks to summer school and the extra points from honors/AP classes.
> waiting too long for medication probably isn't a great idea either
I think this is critical. I have a 7 year old daughter who was diagnosed about a year ago. For context pre-meds she was getting frustrated at her inability to put together her own LEGO creations. She would work on 5+ at a time. She was frustrated and was just being able to express her own frustration. Post-meds (dexmethylphenidate) she can actually build with LEGO (her greatest love I think).
The key idea however for us is that the meds give her time to learn. Not school learning stuff, but to learn about actions and consequences. About how her executive functioning can be improved and how her brain works.
Man that hits close to home. I remember always begging my parents for more lego sets, never finishing them and my parents giving me shit for that.
I usually refrain from commenting on anything relating to parenting at risk of being (rightfully) shouted down as I have no experience with it. But in this case, as someone that was in your daughters place once, 20 years later I think the best thing you can do for your daughter now is to reinforce sticking with something and finishing it. Basically developing the mindset she has on meds into a habit that she'll eventually be able to keep without them.
I think, as you mentioned, that learning about actions and consequences, especially in the long term instead of immediate ones, will help her a lot down the road. Your daughter is lucky to have you as a parent who is willing to guide her and help navigate through the bullshit that adhd can bring.
Sounds kinda familiar. No medication for me, but I'm a software engineer, focused driver, commercial multi-engine pilot. Not sure ADHD is a disability, just some traits that evolved that helped ensure survival.
I relate to many of your experiances. It is unfortunate there is such as stigma around the condition and medication that inhibits people from getting help.
I'm probably in the same boat. I see myself as a firefighter, things don't get my attention until their burning down, then I perform miracles to save them. Every few months my utility bills don't get paid until they turn it off.
Personal relationships degrade until the point they are about to fall apart, then a blast of attention brings them back to normal. I'm a disorganized mess but when the right moment hits, I can do in a day what would take someone else a month to do.
Unfortunately I have nearly zero trust in the psychiatric community, and little trust in the medical community. There's too much overmedication/overdiagnosis in a attempt to CYA, limit liability, and in some cases, profit. I'm always suspicious of anyone who could be motivated to prescribe medication or treatment by a factor other than solely my well being(I reworded that sentence several times trying to decrease ambiguity...hopefully it makes sense). Full courses of antibiotics are prescribed for a runny nose, hearing tests ordered for mild congestion. I've seen kids diagnosed with ADHD and medicated into submission when all they needed was good parenting and a structured environment. A family member adopted 3 children from 3 different families. Wouldn't you know all 3 of them 'had' ADHD. If they started making noise or acting like kids, she would say 'oh, it must be time for their medication'. I've mentioned this to a couple of MD acquaintances. One of their responses were "She's convinced something is wrong. If I don't prescribe something, she will just go down the list of doctors until she finds one that will. Then I'll be the bad doctor for not doing something. The buck might as well stop here."
In any case of my condition being real, I have a fear of dependency. I'm scared that if I finally do submit and take medication, I will become dependent on it. I know my propensity to addiction and have vigorously avoided all drugs, including alcohol, except OTC painkillers and occasionally some cold symptom medication my entire life. I'm not concerned with becoming addicted to adderall/ritalin/etc... -- I'm concerned that it will eliminate what little control I've managed to exert over the issue and I don't want to take it for the rest of my life.
Your story about being able to wean yourself from it with little negatives while still maintaining the benefits may have given me the confidence to take the next step and try to get help.
The common thing I see on /r/adhd is that medication can be useful as a crutch while you develop good habits. Going off of medication does bring you back to the old norm, but you've got some good coping methods built up by that point.
I've been browsing your comments in this thread some more and just have to reply to this point:
> In any case of my condition being real, I have a fear of dependency. I'm scared that if I finally do submit and take medication, I will become dependent on it.
One of the hallmarks of unmedicated ADHD is poor impulse control and addiction. Getting proper medication makes a world of difference, be wary of inadvertently making your life worse due to internal bias.
thank you for the sound advice. I'm checkout out bulletjournal and will likely at least try the medication route, assuming a doctor agrees and officially diagnoses me.
I was on Ritalin for a short time when I was around 14, I was as anti-medication then as I am now, didn't notice a difference and started refusing to take it after a month or so. I remember depression being mentioned at the time, although I don't know what the official diagnosis was.
The one medication that did seem to have great effect scared me so bad that I stopped taking it and refused to take any more -- percocet. I was prescribed some after oral surgery and threw it out after taking it for a couple of days. During that time, the house was cleaned spotless, laundry done and folded, even ironed my shirts and hung them (as opposed to my typical pattern of snatching them from the dryer and ironing them immediately before I wear them), and many other things were done that I would have normally procrastinated and waited until the very last minute. From talking to others, this doesn't appear to be a normal reaction to opioids.
My main one is a notebook that never leaves my side. If I have a thought, impulse or idea that isn't what I'm currently doing, I quickly write it down, usually with a flowchart kinda sketch and then go back to what I was doing. I give myself a maximum of about 15 seconds for this. Once I finish what I was originally doing I look in the notebook and pick the next thing to do.
The other big one is 3 goals a day. Every morning when I wake up, I give myself 3 goals that I must accomplish before going to bed. Generally they're trivial things, take out the trash, wipe down the kitchen counter, that kind of thing. I find that no matter how simple, it gives me the feeling of accomplishing something I set out to do and helps me reinforce non-impulsive thinking/decision making and remind myself that I can in fact finish a task that I thought of more than 30 seconds ago.
I can expand on how I cope tonight when I have more time if you'd like.
I've shunned mechanisms like this for fear I would become dependent on them, and then really in trouble if I were to lose the notebook, which, unless it was permanently attached to my body, would be quite likely.
Having 'the cloud' has started to help me. It's something I know I can't lose, so I'm slowly allowing myself to become dependent on it (things like calendar, short notes, and keeping track of receipts). And by the cloud, I mean google drive, emails to self, etc..
Hmm, doesn't writing something down increase your ability to remember about it later?
In my case writing seems to work as "hey brain, this stuff is important, don't forget". If I write something, it turns out I didn't need to. If I don't, it turns out I'd have better done.
Probably not for the same reason, because they are easy to replace. A notebook full of thoughts is not.
Interestingly though, I have shunned glasses for fear of becoming dependent on them. I can see well enough without them, and noticed, after wearing them for a while, my uncorrected vision was worse than before I started wearing them. Whatever mechanisms my eyes had developed to see better became less effective after wearing glasses for a while. I lost the last pair about 4 years ago and haven't replaced it.
I've used a notebook at well and I think you'd be able to work with the same strategy. The notebook is just ephemeral thoughts that you have the impulse to take action on, so you write them down instead of acting on them. At some point you move the worthwhile content to a better resting place. It shouldn't end up being an irreplaceable object :)
Correctly applied [0] it seems to trigger competition-mode[1] and a sense of urgency. This helps the brain cross the "interesting" threshold and stay focused instead of coming up with other ideas or dozing off.
0:-)
1: "I really should be able to get this done in the next 25 minutes."
Is ADHD associated with heredity? How does one go about getting oneself tested - if I am (and I fit a lot of symptoms) I would want to ensure my kids get the right sort of help early.
Yes, it appears to be hereditary, however no single gene has been implicated. There is also no subjective test, but if you see a psychiatrist they can usually diagnose you be asking questions about your symptoms. This can be problematic because some insururers won't pay for amphetamines to treat a condition that can be "faked".
It's unfortunate that this type of therapy is out of reach for the majority of kids. Not many parents have $50,000/yr of disposable income to send their child.
I know of a child right now that something positive like this may be the deciding factor between a productive life or a life behind bars, but the cost is at least 50% of his parents combined income, so he will not have that option.
Slightly off-topic, but I have seem some great responses here I would like to add a somehow controversial comment.
I have a 10 year old kid diagnosed with severe ADHD-Inattentive type. He is on meds and behavioral therapy, and I must agree with most of the posts that meds is a must for these kids.
My very personal an unscientific explanation is that ADHD is not a disease in the traditional sense; instead, it is just a brain that does not fit in our current lifestyle. Would my kid have any problem living in a simpler society (hunter-gatherer group) ? Definitively not.
From time to time I tell my wife - and she gets very angry - that our kid has a MS-DOS brain, while we are all running Windows 10. The analogy is no exact, but it is just to emphasize that my kid belongs to another time. I only wish he can find his place in this world.
There's a lot of research about ADHD, more than many other mental diseases...
There are a couple of things to remember:
- ADHD is a deficit in executive function, and one of the main symptoms is impulsive behaviour (unable to control urges). This is what causes hyperactivity, but also causes things like angry outburts, and other improper social behaviour that follows into adulthood
- The concensus among the research community is that ADHD is all negative. Measurably negative among all axes, especially when comparing people when on treatment and when not on it (drugs).
I know some people like to do the whole "silver lining" thing (like with autism), but ADHD is a disease, an impairment. You should think of it like you would think of having the flu your entire life. Sure, you get good at vomiting your guts out cleanly, but not much great about it.
- And a super important part is that this basically never goes away. There's this great analogy with a paraplegic. If you had a prosthetic leg, no matter how long you walked with it, you could never "train yourself" out of needing a prosthetic leg. Same thing with ADHD. The impulsive feelings don't leave, it's just that adults tend to be better at dealing with it than kids. But treatment is still very useful even later.
(That last part is important: emotional outbursts at work can be a bit hard to manage...)
> - The concensus among the research community is that ADHD is all negative. Measurably negative among all axes, especially when comparing people when on treatment and when not on it (drugs).
I disagree. I love my brain, it makes certain parts of life hard, but my hyperfocus and way of thinking about things that interest me are just so wonderful.
My life is at constant risk of screwing up but I'm really happy as a person.
I think for me a better analogy might be everyone else is on Win10, while I'm here running Plan9 or something.
I really don't see my condition as a disability, but I'm also not at the severe end of the spectrum. I do perfectly fine with activities I find stimulating, particularly when I get to work with my hands or it requires a lot of physical coordination. I can focus amazingly well on anything if it becomes crunch time and I absolutely need to. I forget to pay bills, schedule appointments, can't maintain a todo list, etc. These are all modern constructs though
There's also been research in the past few years showing individuals with ADHD are more likely to have received some sort of creative award (science fair, musical accomplishment) and can generate more ideas than typical individuals (divergent thinking).
Maybe it's just a difference in thinking that requires a different sort of structure, and only manifests as a disability as were not well suited for the modern ways of living that have arose.
I used to freelance and motivating myself for that was HARD.
I'm now working for a company full time, I get paid silly money and have quite a lot of freedom because if they keep giving me interesting problems, I solve them quickly and well. I think I'm in a really good role because as lead for the "innovation" team we're constantly moving onto new weird and wonderful projects.
Conversely, I cannot do a role which is about code maintenance. I get bored and demotivated very quickly.
There is pretty solid evidence that ADHD is grounded in differences in structure and wiring of the brain - its more of a hardware problem than software.
I'm not sure ADHD would have a better time for lifestyles. People with ADHD would always be a minority, and probably perceived as odd by others. Organisation and focus have always been useful traits - but also creativity and adventurousness have led to rewards as well (but also risk).
A better analogy I've heard is ADHD is like a Ferrari engine in a golf cart. There's loads of power and energy, but the steering and brakes struggle to keep up.
Would my kid have any problem living in a simpler society (hunter-gatherer group) ? Definitively not.
I know some children like that. Children who cannot keep quiet while hunting would not fare well in a hunter-gatherer society. Indeed, young members of a hunting party who move around too much and make too much noise are in danger of being eaten themselves by larger predator animals. I'm not sure that there has ever been a selection advantage to having difficulty maintaining attention focus.
The thing with ADHD is that the difficulty to maintain attention is often highly situational. As someone diagnosed I personally have a lot of trouble focusing on a lot, but when it comes to something like juggling or playing counter-strike it's pretty remarkable how well I suddenly tune everything out and get extremely engaged. Probably more so than a "neurotypical" person and their preferred activities. I'm also generally hyperactive, but not impulsive. I move around constantly at home, but in other social settings I'm able to sit still if it's socially unacceptable for me to be walking around or fidgeting.
Agreed. I've been a big fan of billiards for 20 years and I think a part of the reason is that playing well basically requires very short bursts of absolute focus, something that I'm good at. Pool is hands down the only game I can play for 14 hours straight and not get bored/tired of playing at all.
Yep. Get me in front of KSP(or World of Warcraft in the past) and 14 hours will have passed without me even looking up.
My older sister hates fidgeting. She punches me(somewhat playfully, on the arm/leg/etc...) every time I start 'bouncing'. I generally wind up with a few bruises when we have lunch. My leg will unconsciously bounce, or I'll start tapping, she'll give me a warning, I'll stop. Then in 30 seconds unconsciously start again. WHAP!. I might remember for a minute this time. Rinse repeat.
I'm inclined to doubt that these traits could have been a serious handicap in earlier times if we didn't really notice this as a template of behavior until recently.
People have talked about other kinds of mental disorders, not necessarily using modern names, for a long time. I don't know of any anachronistic terms that mean the same thing as what we mean by ADHD today, or older sources that made much recognition of ADHD symptoms at all.
The thing about ADHD is that you really don't get to pick what you hyperfocus on. Some days you may be focused on getting that beast, other days you may find an interesting termite mound that grabs your attention while on the hunt.
If I imagine myself hunting, I can't. I see myself too focused on creating the perfect spear (and never achieving it because I "squirrel" off onto another spear building tangent) to actually bother myself with the act of hunting.
Not to mention, one of the common symptoms of ADHD is bumping into objects when walking around. I can't imagine that going well on a hunting trip.
But once you got to the point of near starvation, assuming you were still physically capable, I bet you would become an excellent hunter. Until your appetite is satiated. Then it's off to lizard chasing in the middle of building your shelter.
I feel like the best tech analogy would be ADHD is like a GPU, great with lots of independent parallel tasks, but not as good as a CPU for tasks that have many interdependent steps.
Personally, in my childhood, I liked math and science. I had (and still have) ADHD, which made that hard, but I struggled through, because that was my passion. Medication (which I didn't get until I was 22) makes it much less hard.
Telling me my aptitude was in running around outdoors would have been the last thing I ever wanted to hear. I liked exploring, sure (people with ADHD are almost always Bartle Explorer-types[1]), but building up physical endurance was just one of the many things I couldn't motivate myself to do, and would have heavily resisted someone attempting to push that on me.
[1] https://en.wikipedia.org/wiki/Bartle_Test