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How I Run a Company with ADHD (andrewaskins.com)
784 points by askins4trouble 13 days ago | hide | past | web | favorite | 494 comments

It’s interesting to see how hard if is to separate ADD from ADHD by a description of traits or behaviors.

I have ADD and pretty much recognize myself in a lot of this.

It’s almost impossible to focus on anything that is not interesting “right now” and what is “interesting” changes in cycles spanning a few weeks.

During a cycle I become completely absorbed, you know, not eat, not sleep and not being communicative, absorbed.

For a long time this worked out both personally (depending on who you ask) and with my employers/employees that so far have had no issues with my rather irregular rhythm (thank you tech!).

Oh, the storytelling and talking... I feel sorry for my brain and, in retrospect, people that had to listen (I’m sorry! And I didn’t mean to be rude and offensive, it was just my thoughts at that very second!).

As life have changed mainly through becoming a dad it has also become a lot more difficult —- not everything about kids is “interesting”, and staying up to 4 to tinker with something “interesting” is just such a bad idea when someone jumps on your face at 6.

Everyone needs food? And it’s my responsibility? Today again?! Phew... etc.

Spending energy on “non-interesting” things really is draining and seem to lead to kind of mini depressions.

I’m happy that I’ve come to a point where I at least can see some of this behavior which allows me to work on some changes.

Hard work though!

Perhaps I should write about how I run(?) a family with ADD? It would make for a lot of laughs and a some sad stuff.

ADD is now under the umbrella of ADHD. ADHD just has 3 types:[0]

1. ADHD Predominantly Inattentive (ADHD-PI)

2. ADHD Predominantly Hyperactive (ADHD-PH?)

3. ADHD Combined (ADHD-C)

ADD falls under the first one. It makes sense that you'd recognize yourself in that. They're now considered to be the same disorder, but just presenting in a different way.

One of the things that's usually not discussed, but what you should watch out for is emotional control. Apparently it's easier for people with ADHD to have their emotions flip. Russell Barkley has an amazing series of lectures about it. You can find various bits on YouTube. You could see if maybe you'll discover even more about yourself.

[0] https://www.cdc.gov/ncbddd/adhd/diagnosis.html

Yeah, this is called emotional disregulation. I have it to some extent, but am an adult with lots of experience noticing and regulating it. One of my kids is super kind but often responds to minor annoyances with an extremely irritated tone, or will collapse into an incoherent puddle at minor obstacles.

ADHD can be a huuuuge problem in relationships. Especially if you're going out with someone who would score very high on conscientiousness. They won't understand that things that are easy for them are hard for you, and will assume that you're just trying to piss them off, or are incorrigibly lazy. This is exacerbated because it's not like you can't do those things, it's just that you will inconsistently do them, and average towards not doing them.

At the time I was going out with the mother of my to be first child, my father (a psychiatrist) gave me a preliminary test just to see where the land was, so to speak.

On my partners request I should add.

For fun my then partner took the test as well.

My score 80% or whatever: “severe autistic traits”. WTF?! Ouch...

Hers? A clean 0. Zero?! You’re kidding. Sure she’s probably the most compassionate human being I’ve ever met, but come on!

Eventually we got a daughter and split up a year later.

Best thing that could have happened for anyone of us, daughter included, and we have a great relationship where we hang out all the time.

I believe in part this is because she doesn’t expect “normal” from me when we’re no longer together.

It also gave me a wake-up call telling me I had shit to properly sort out.

I too highly recommend Russel Barkley's videos about ADHD. They taught me so much. The most striking thing was learning how it's a primarily emotional disorder, and how this has harmed my relationships.

Here's a fantastic lecture (split into ~5 minute segments -- this guy gets it :) by Dr. Barkley:

ADHD - The 30 Essential Ideas Everyone Needs to Know


Can't edit anymore: found the whole talk in one video https://www.youtube.com/watch?v=SCAGc-rkIfo&app=desktop

Have to second the emotional and relationship aspect of it.

The general physician I went to initially to kick of the quest for diagnosis obviously had an interest and gave me a book called “the answer” (edit).

If you are Swedish: “hemligheten”

In english the tag line (translated by me): “from moments to lasting relationships”

Found the English version :)

The Answer: How to start a relationship and make it last


Could not find any reviews on this book, can you go into any detail around how it helped you?

It kind of made me think and question why I had such attachment issues.

Why the same pattern I saw in how I had to be ”interested” to give something or someone my attention repeated over and over.

I’ve had many relationships over the years with a specific pattern: I lose interest in about a year.

One total burn-out after another. Extreme interest followed by absolutely nothing.

There’s a follow up book I can’t find in English called (my translation): ”The dark secret”, that treats what they call ”deorganized attachement”

This one’s actually more relevant for me personally as my youth and upbringing was... “interesting” and in several ways traumatic.

On the topic of books:

“Healing ADD” was really useful for my partner:


Perhaps more to the point than the diagnostic criteria, is Dr. Barkley's observation that ADHD is a general impairment of executive function. Inability to direct attention is over emphasized being just one of the symptoms of that impairment.

I'll never understand how we name things. It's weird to have "Hyperactive" in the umbrella term when only two of the three categories have it as a trait.

I always have that same feeling with the mostly non-fatal term 'comorbidity'

Yes to everything, especially about having kids!

Many responsibilities in family life are uninteresting. Often I have to be patient for weeks in order to work on something I find interesting. Months ago I found a great programming project to work on. However, I'm caught in a period in which my wife is working a lot of extra hours, leaving me to deal with cooking, house repair, running my daughter to activities, finances, etc. I also work full-time as a developer. On top of it, I'm the president for my daughter's basketball league, which requires a lot of attention to administrative tasks. I'm perpetually at odds with my desire to work on the interesting project and getting done what needs to be done.

I'm coming out of a mini-depression now. As an example of what it's like, several weeks ago I was sent a link to post to our league's FB page. The link pertains to an event next weekend. Posting would have taken under 5 minutes, but I shied away from it until yesterday. The thought of one more trivial task in my day completely paralyzed me for weeks, but I felt increasing anxiety and the depression worsened.

In my younger days, I would have ignored needs to focus on what made me feel happy at the time. Nowadays I feel too anxious when I do so.

> The thought of one more trivial task in my day completely paralyzed me for weeks, but I felt increasing anxiety and the depression worsened.

Same. It's subsided to a large extent, but I spent years in that state. I'm not even angry at my brain, but just a little sad about how much time and opportunities this wasted for me.

> In my younger days, I would have ignored needs to focus on what made me feel happy at the time. Nowadays I feel too anxious when I do so.

Same. Except I do wish I got back to that "younger days" state. Literally nothing ended up badly from doing that; hell, I owe my whole programming career to it. Between doing what you want instead of what you have to vs. the other way around, the worst is really the third option: being paralyzed by an internal conflict and doing neither.

> The thought of one more trivial task in my day completely paralyzed me for weeks, but I felt increasing anxiety and the depression worsened.

Wow, this describes a few recent events for me. Thanks for sharing!

Sounds like potentially interesting content. Just a thought, I'm glad that I'm the one who gets to decide which embarrassing stories about my childhood go on the internet as my parents have never used social media for anything other than connecting with old friends. It looks like your username might be your real name, and if it is you might consider posting this proposed content under a pseudonym instead. A while back I read an article by a writer who actively refuses to honor her daughter's request to not be written about, and it caused me to consider this issue a bit (I don't agree with her at all): https://www.washingtonpost.com/lifestyle/2019/01/03/my-daugh...

> I don’t agree with her at all

Who is “her” in this case — the writer or the daughter?

Judging by his general recommendations, the writer.

lilbobbytables was spot on, sorry for the ambiguity!

I agree with you. I'm with the daughter on this one and am super glad that I didn't grow up in a time when my parents could have posted things about me online (photos or text).

I remember hearing something about how ADD is now not considered qualitatively different from ADHD in terms of what it does to you, and that it's just "ADHD with a bit less hyperactivity".

Would definitely be interested in hearing your wins running a family and managing this

Just had to cut out a long digression in true ADD fashion. I'll save it for my future blog!

So in short list format, just sharing some methods I employ, sans digressions:

0. Awareness. Took way too long for me to reach it.

1. What is mentioned in the article: prioritisation! That needs to lead to routine. Hard work this, but most important, as I have to be able to engage auto-pilot for "non-interesting" tasks.

2. Sleep. Just do it. I have found out that lack of sleep takes me down hyper-focus lane. Great when you are alone and is tinkering along for a weekend. Not at all in basically all other scenarios. Hit bed before 11.

3. Eat and drink. Healthy and just enough. The effects are similar to #2 if I don't.

4. Physical activities. Go for a 20 min run. It is boring, but reach the point of proper sweating and keep going for another 10-20 min. The effects on me are amazing and in many ways resemble #5, only even better.

5. Breathe. Honestly, I have started practicing mindfulness and it just works for me. It takes me down into myself and allows me to spread focus.

On the bus right now, and this is what I can think of at the moment. Always a work in progress. I'll see about that blog...

>> 4. Physical activities. Go for a 20 min run. It is boring, but reach the point of proper sweating and keep going for another 10-20 min.

Long time skateboarder, hung up in a 9-5, knees are starting to shit the bed at 30, and don't skate much any more as a result. Realized, fairly recently, that over the years my mental state was declining/flatlining largely in part to not exercising. Skating is just fun, provides a sense of freedom, used to be a huge part of my social life, and the physical activity kept my body and mind in shape, and it's totally left a negative impact not having that involved in 50%+ of my daily activities.

Going on a tangent, but I recently purchased a recumbent bike as a means of remaining stimulated/keeping boredom at bay while exercising, and it's hands down one of the best purchases I've ever made. It's a matter of going to YouTube and popping on a walkthrough on a framework/library/etc, the news, documentary, or anything of interest, and just peddling away for the next hour... Only problem is, it's hard to stop going once you start :/

Anyways, read through this thread and your mentions, as someone else has mentioned, are the most articulate descriptions of the struggles that one faces with ADD. Personally, I'm in an environment where many don't consider it "real" and look down upon those who have sought medical help as "meth addicts", and my only wish is for them to understand and also to be able to distinguish the medications from one another and not group them with illicit/highly toxic drugs.

Glad to have come across yours and many other's comments on the topic. Made my morning :)

I was in your spot 8 years ago. Long time surfer, skater, wakeboarder whose body started crapping out. This book changed my life: https://www.amazon.com/Starting-Strength-Basic-Barbell-Train....

Strength training with barbells fixed all those aches and pains in my knees and joints that braces and doctors and physical therapy couldn't. When I started squatting, I suddenly stopped being afraid to walk down stairs. My posture improved. I noticed I had way more endurance when riding, and it made ever part of that, from carving to pumping, easier and better and more powerful.

For me personally, resistance training with weights is better than almost any other exercise for managing ADHD. I don't know what it is, but something about lifting keeps me focused and calm for a few days after a workout. Cardio never really did that for me.

I’ve been following this program for six months. Love it for its simplicity. Great official app. I am sure the book is great, but the app makes getting to the gym and just getting started and staying on track so easy.

The SL 5x5 website and random videos for form are plenty, the book is not really necessary.

I used to play handball at elite level, and exactly as you say, years after quiting I noticed these effects of not managing life properly.

It’s two sides to it as I see, as going all in with athletics obviously gives you the physical bit “for free”. Well not for free, really, but you know what I mean.

The other part is the strict routine you have to keep.

It’s not ever a problem as life revolves around an interest!

Rather, I used to get annoyed if something disrupted my routine regarding food, rest and practice.

To get better and stonger (interest) I have to eat, sleep and turn up ready for practice two times, every day.

Ah... good times! But also severely limiting. But also great... But... :)

Awesome that I could help make your day! Inspiring even.

> engage auto-pilot for "non-interesting" tasks.

Routine is useful. My life is full of mini routines, although not necessarily making as cohesive as a picture as they could, there are certainly plenty of gaps.

I have a bad problem where things go to shit if a normal "auto-pilot" task of mine has to changed.

Simple example, I always have my keys in my pocket, I feel for them as I walk out the door. They're there, I continue. Same thing with my truck (it has manual locks) - I feel for the big plastic on the key, then close the locked door.

However, when leaving the house without pockets (in dirtbike gear), there is room for things to go wrong for me.

I can't just check that pocket. So I either have to replay putting the keys in my bag or not be lazy and check the bag.

I've had to learn to not be lazy and require physical proof... because last time it turns out they were indeed in the bag, _but the bag was in the house_.

Much recognition.

I actually use a pocket of a specific jacket whether I use it or not.

This is where I put them on entry, and this is where the check is on exit.

Without routines like these anything can and will happen, just ask my (soon to be) wife! :)

Ok, so basically forcing yourself to live like a normal, healthy person.

It gets easier with routines and practice and will eventually start a positive spiral if you stick to it for a few weeks.

If you “lose” it (you will) and end up out of the spiral or going backwards, remind yourself of how good your brain felt after that 30 min run or 15 minute of focused breathing.

You probably have a hyper-sensitive brain of sorts, and you will know what I mean. It sensitive in a way that it behaves like a sponge. Feed it good stuff and it will behave better.

Drain it with no good sleep, bad food, sugar and intense focus without rest? Setting of a bad spiral. Learn to feel when this kicks in.

The work never stops, so force it! Just do it.

> 0. Awareness. Took way too long for me to reach it.

My 11 year old son was diagnosed with ADHD-PI over a year ago, and we've had great success with with all of the above areas for him. 0, 1, 2, and 4 especially. We've gotten things running pretty well at home by recognizing he needs a break from homework to "run around in circles (as he calls it)" for a bit, setting up physical activities like shooting hoops that are easy to start/stop, having a strong routine in the morning before school, and making sure we don't slip at bed times. Another key to his success is his teacher. She's been simply amazing at letting him sit, stand, take 5 to go run up/down stairs, etc. when he needs it. Most importantly, he recognizes that she genuinely cares and it makes him want to do well, unlike a past teacher or two that simply treated him like a nuisance.

The morning routine is probably the biggest win, though. We went from barely able to get out the door in time for school to our son often getting up early and getting fully ready (dressed, bed made, breakfast eaten, lunch packed, showered, etc) before mom or I even get out of bed. He's always so proud of himself when that happens, too.

How do I find/subscribe to this blog? Definitely interested. Email's in profile.

Yes, kids are difficult -- not to mention kids with ADHD! I often used to regret having kids, and still get anxious about taking care of them. And then all of a sudden I see pictures of their sweet faces, or imagine their laughter, and all is good in the world. My place is a shitty mess, because I've been doing physics/biology/machine learning/tennis instead of chores? It's okay. Let it go and just love them.

I'm separated and co-parenting and realized that I would freak out every Thursday because clearly my place is too shitty for the kids to arrive, and obviously I'm a terrible father. Once I could name the "Thursday freakout", it became a lot easier to manage and to reduce the intensity from wanting to bail on everyone to just laughing it off.

It gets easier (before it gets harder?, don't know yet.) A former colleague put it best -- the highs are higher, and the lows are lower. It's just no one really tells you how low the lows can be.

> Perhaps I should write about how I run(?) a family with ADD? It would make for a lot of laughs and a some sad stuff.

Given how poignantly you expressed my own experience of living with ADHD Primarily Inattentive (what you called ADD above), and as someone on the cusp of becoming a father, I would appreciate this more than I can express.

As a random suggestion from someone who did manage to not get his children killed despite ADD... look into bullet journaling as an organizational system for parenting duties. Ignore the endless art-project nonsense on the internet, read the book, and focus on using it for task management and scheduling.

As an adult with ADD, it was a miraculous new perspective on tracking all the things I used to fail to do. I so, so wish I'd had it when I was dealing with small children.

I strongly second the use of a bullet journal.

I can't count the number of times while talking to my psychologist, in the middle of a breakdown thinking "If only there were a system that I could offload all of the dumb things I can't remember to do..."

...and then laughing my way out of the room because my wife told me weeks earlier that she wishes I were using my journal. She notices that I'm happier when I use it, she is much happier because she doesn't have to ask me to do something 4 times...

Thank you very much.

Using OrgMode for keeping my work-life in order has been a life-changer. But perhaps a bullet journal is more suited for keeping personal, and family life. I've never looked into them properly, but will definitely do so today.

I hear my partner is not the only one that worries? :)

I’m constantly playing the “no ones died yet on my watch” card.

It somehow doesn’t make her feel any better.

Amanda Palmer covered this well, in her song A Mother's Confession (which should make any parent cringe). It starts with her baby, whom she thought couldn't roll yet, rolling off a changing-table shelf and landing on the floor. "At least the baby didn't die" becomes her mantra, as the song details terrible parenting mistake after terrible parenting mistake.

As a ~15 days shy of being a father, I strongly second this request.

Wow. I have never heard someone articulate so clearly my own experience with ADD. Would love to read more about how you've managed your shifting responsibility/lifestyle!

One thing that actually was important in kicking things off was reading/hearing this quote somewhere, probably the interweb.

This was while sorting out the effects of neglecting loved and dear ones at a point in time.

It goes something like this:


You met an a-hole one day. Yeah, it’s just another a-hole.

You meet a-holes everyday?

Well, maybe you’re the a-hole.


Worth thinking about if you find yourself in bad spots all the time.

> Perhaps I should write about how I run(?) a family with ADD? It would make for a lot of laughs and a some sad stuff.

I would really like to read that - and I hope this doesn't come out as cynical or heartless, I can understand that having ADD comes with challenges. I am simply intellectually curious to hear how someone lives with such a condition.

I also feel/think - but I might be 100% wrong - that many of us have "some" light form of ADD, perhaps driven by our use of mobile devices. Curious to hear if you have any thought about it.

> many of us

Well, it’s a spectrum, isn’t it!

I’ve said it a couple of times already in this thread, all is well as long as daily suffering is at a minimal, for anyone that happens to be involved.

Mobile device (constant access to information specifically) is a big problem for me, that is for sure.

I remember playing computer games competitively impacted me in a really negative way when I was younger as well, much in the same way.

The “feeling” in my brain and mind is pretty similar (phone vs gaming) and it seems to create a really bad disconnect emotionally.

This “disconnect” leads to a kind of apathy and when in that state pretty much nothing of value can happen.

I’m currently making a routine of handing my phone to my partner when at home, as I’m unable to handle it.

There’s just so much interesting stuff all over and “interesting” trumps pretty much everything else, often at the expense of relationships.

For a concrete example I described a typical grocery store situation in another post.

> I have ADD and pretty much recognize myself in a lot of this.

I do not have ADD (afaik), and I also recognize myself in a lot of this. I think many of these behaviors are very common in general.

Yes of course.

The question is always: does it impede a “normal” life and is anyone constantly suffering?

I thought my so called issues were perfectly manageable until I got my second child.

I described it in a different post as being stuck in development.

Remaining a child in many ways, and constantly fighting overwhelming emotions or, almost worse, non at all.

I decided I couldn’t keep doing what I was doing, and it’s been a struggle ever since.

Mostly I make it work, but my partner might have a word or two about these things:

Going to the grocery store with a long list of items, only to be overwhelmed by the astounding number of types of coffee.

Spending 45 minutes looking online for anything regarding beans and grounds. Fascinating stuff! Animals eating from the trees and pooing the beans out?! Wow.

Leaving after one hour with a bag of potatoes — cause’ couldn't handle it.

You can probably see that if this is a repeating pattern someone’s bound to suffer.

Anxiety is just around the corner with depression right behind it, stemming from these issues.

As someone who has ADD and is going to have to run a family on ADD I'd totally read that.

As soon as I get the left border color of this button just right.

I was thinking, "as soon as I find the _perfect_ domain name". It could take a while. =)

Don't forget find the perfect static site generator, realize you might as well use Wordpress with a nice theme, try out a plugin that does <x> badly, write <x> manually, decide to make it a plugin, learn how Wordpress does plugins (it's not great!), get annoyed by theme so build one yourself, find out what this 'css grid' thing is all about, sprinkle in some JS for something cool, use the fancy new features despite not needing them so choose a build tool that is simpler than Webpack, learn that tool and run into a weird issue so go for Webpack anyways, find out Webpack has changed completely, get everything working and decide that maybe you should just use that static site generator after all. Or maybe that new LiveView thing, but you'd have to learn a new language and framework for that. Would look good on your CV maybe? Then your RPi arrives and you start tinkering with that.

Oh, the CMS race. Done it a few times already. Many nights spent building custom WP plugins and trying out static site generators.

Not a single blog-post but a lot of potential knowledge.

I’ve landed in static. Either GH pages or through netlify CMS. For now.

Needs re-evaluation, I can tell. But when?! I have a family to run.

I've been out of web dev for a while and am supposed to be doing a site today, check my comment history for how well that's going. My design process has resembled your comment quite closely.

While I do still run into this exact problem, I do think I've learned something along the way.

Basically, it boils down to: commit to either doing most of it yourself, with carefully considered bits of outsourced help, or go for an outsourced solution and deal with the bits you need to change.

The former usually is more fun, and probably works best for stuff you need to work on (as in, alter) over time.

The latter is less fun, but if you can handle working within the boundaries presented and if the thing you're doing is throwaway or relatively unchanging, it's probably the best way to go.

When it comes to CRUD web stuff, for example, I find that Wordpress is often the best way to go, even though I hate most of it with a passion. But the fact is that with just a few plugins (Advanced Custom Fields primarily!), it's often one of the best solutions available for a typical website, especially if it has news/blog type stuff and if it's not mission-critical to yourself or the client.

The same applies to smaller 'units' of code. Every time you add code that isn't your own, you add limitations and risks, but in practice it's often worth it. The skill I'm trying to improve is to know when to make what choice in this regard.

(to be clear, when I choose Wordpress, I'm basically accepting that almost the whole thing is a dumpster fire. Most of my work then involves isolating myself from the resulting mess, whether by avoiding WP's templating/querying system, or making sure a site runs on its own server. And yet it's still worth it at times)

> and am supposed to be doing a site today, check my comment history for how well that's going

I burst into laughter when I read this, holy shit if I'm not doing the exact same thing right now. You could probably graph my mood by HN comments frequency.

This is basically how I made Qards (https://qards.io). I kid you not. Good to see I'm not alone :)

How about some pun around "add" being adding a family and ADD. "justaddfamily"?

Hey, my mind is racing here!

What is it now — cache invalidation and naming things? :)

and off-by-one errors, never forget!

>> just such a bad idea when someone jumps on your face at 6.

I second this!

I can relate on the family stuff.

My (adult) daughter inherited ADD from me. Which means she and I understand each other in a way that her mother and her twin brother do not understand us. At least they've learned to just let us do the grocery shopping and not try to help.

Huh that sounds a little bit like me, though I don't think it's as strong. I definitely have those cycles of things that are interesting to me and anything else is just so hard to focus on.

Just wondering, what sort of things are you trying to combat that?

Made a short-list in a comment below!

Are there techniques to trick your mind into thinking that something is interesting?

No, you can't trick your mind into things. It's too smart for that.

The best thing I've found is to just accept you have the ADHD and work around it. If I know I'm going to do a tedious task that is going to be boring and require concentration, I usually give myself a 2-3 minute break every 20 minutes just to get up and walk around. It's very important to have discipline to make sure the break doesn't turn into a huge 45 minute sidetrack.

Actually I've found that for my mind at least this works. Do the sort of motivational tricks that your mom/dad/teacher used on you 20 years ago. At this point we go get icecream. At this point we stop for a game. At this point we go for a bike ride. If you get here you get a small lego toy. If you get at X we go to that restaurant ...

I am fully aware of the trick and I could just choose right now to violate the thing entirely. It still works.

I don't suppose that counts as tricking your mind into thinking something is interesting. Still works.

For me personally, no.

But having had an intake of decent energy during the day, and a 30 min run in the evening allows my brain to brush the teeth and put three beasts to bed at night without collapsing into apathy.

I have to constantly interrupt what I’m doing during the day and “check the sensors” so to speak.

Hands up if you’ve been so consumed you missed lunch more than one instance this last month!

Keep doing that, and the deterioration is in progress.

If not of oneself perhaps relationships? And what is “self”?

Hands up to that! It totally aggravates my wife that I can just forget about lunchtime or dinner or whatever meal is coming next because I've become so involved in something.

Right now is the worst. I made a list of work I need to do today, but none of it was very stimulating. So I opened up Hacker News, saw this article, and have been on this for close to an hour now. In that time, I've read it and a lot of comments (Jordan's comments being my favorite so far). I've decided to try Todoist as suggested by the author, so I've set that up. I already know that I'm going to fall away from it like I do every other organizational method (Evernote, Keep, Kanban varieties, physical notebooks), so a little mini bit of negativity has set in. And now all I want to do is get up from my desk, and run around to see how my employees are doing. I have 60 of them, so that could take awhile. And before I know it, I've done nothing but read about ADHD and talk about the weekend all day.

I really bash myself for these periods of the day. I feel like I'm wearing a sign on my forehead that says "Brian hasn't done anything for 4 hours!" And that sign would be true. On the flip-side when a problem comes along, I'm all over it. I'll work night and day to get it done. I'll do so to the short term detriment of relationships, but I'll solve it. If I have constant interesting problems flowing in, I look like a working machine. If I just have boring redundant work like dealing with employee "time cards" or invoices, it takes all day to get to it, and I look like I'm day-dreaming or lazy.

It's now an hour and 15 into this sidetrack. So I think I'll go get some water, walk around, and maybe sit back down and get some work done before 9am. I'll have to or else I won't get anything done. I have to attend 3 meetings in a row where I'm listening and not speaking. If you are ADHD, you know how that's going to go.

> I have to attend 3 meetings in a row where I'm listening and not speaking. If you are ADHD, you know how that's going to go.

So about 30 minutes of active listening and 150 minutes of some of the deepest problem solving time where you can miraculously focus on all the problems you couldn't before? (The hard part is if somebody talks directly to you during the latter and not the former. You'll never know, though, unless somebody tells you about it later.)

Haha! Very true. Lost in your thoughts. Better take a notebook though or all of those solutions will melt away.

Rewarding yourself after a boring activity is kind of cliche?, but it works. Eating a piece of candy after going to the gym for example.

I see a lot of myself and my own behavior in this comment and I'd love to hear about your experiences on running your family!

Could you please write about this! Sounds very interesting!

My reaction to this article has been... complex.


Bah! Another article about ADHD. ADHD's over diagnosed and not not as big a problem as people make it out to be. But, I'm curious all of a sudden, so I might as well read it.

> For the first 19 years of my life I knew I was lazy.

Yeah, I'm pretty lazy too. That's just who I am, though. I don't have ADHD...

> So what, you can't stop bouncing your leg at the restaurant?

I thought I was the only one that did that. It drives my aunt crazy.

> I'll be halfway through a team meeting and realize I haven't heard anything that was said. That's ADHD.

THAT'S ADHD? I do that all the time. I can't listen to podcasts either. But I just have difficulty processing the spoken word. I'm much more of a book learner anyway.

> I was happiest with my nose in the book

I'm seeing a disturbing pattern take shape.

> I'll take a break to read an article and hours will go by before I realize what's happened. Not minutes, hours. That's ADHD.


> I'm horrible at completing simple, repetitive tasks. I'm terrible at time management, and conceptualizing time in general.

Uh oh.

Other comments here have mentioned that stimulants help ADHD sufferers focus. I recently cut back to 2 20oz cans of red bull a day, but I was up to 4 a few years ago. I just thought caffeine was my drug of choice. Everyone's addicted to something, right?

I currently have 52 open tabs on my laptop and another 37 open on my desktop.

I'm not quite sure what to do with all of this. I just thought I was lazy.

"I divide my officers into four groups. There are clever, diligent, stupid, and lazy officers. Usually two characteristics are combined.

Some are clever and diligent -- their place is the General Staff.

The next lot are stupid and lazy -- they make up 90 percent of every army and are suited to routine duties.

Anyone who is both clever and lazy is qualified for the highest leadership duties, because he possesses the intellectual clarity and the composure necessary for difficult decisions.

One must beware of anyone who is stupid and diligent -- he must not be entrusted with any responsibility because he will always cause only mischief."

-Kurt von Hammerstein-Equord

> must beware of anyone who is stupid and diligent -- he must not be entrusted with any responsibility because he will always cause only mischief

Well, hard-working but not clever people will do useless work and create extra work overloading everyone else. BUT, this happens when they don't have good management and leadership above them, to prioritize and handle them bite-sized pieces, and to set their frame of mind to focus on "results in the bigger picture".

Probably putting "clever and lazy" and leadership roles is the cause for bad management and leadership which makes his "stupid and diligent" underperform in ways that drag everyone down.

Sayin' this as a "clever and lazy" person myself - I know that if I don't have someone I am responsible to (doesn't matter if it's a managers, partner, peer etc.) that is truly hard working and diligent is a recipe for total disaster. I'd rather be accountable to people way less creative, and even lower both IQ and EQ, as long as they come with a solid work ethic and focus to detail and they manage to drag me in this direction to! If the world would have only of people like myself in all leadership positions, nothing would ever get done, and the "diligent / hard-working" people will probably go crazy and either kill themselves or start wars.

> Well, hard-working but not clever people will do useless work and create extra work overloading everyone else. BUT, this happens when they don't have good management and leadership above them, to prioritize and handle them bite-sized pieces, and to set their frame of mind to focus on "results in the bigger picture".

I've always thought of "stupid" as different from "not smart". I can't fault people for not having the experience or knowledge that I or others have. I tend to think more of an "active stupid" as a lack of common sense, and making actually poor choices as opposed not making good ones.

To me, it's more the difference of "My laptop is overheating and I can't figure out why" versus "My laptop is overheating so I poured water on it to cool it off."

Stupid is consistently making poor choices and not listening to advice from others when those poor choices run amok.

Not smart is not intuitively knowing what to do in a given situation - this can be learned away - it won't give you the intuitive answer, but at least you'll know not to do something in a given circumstance.

I have this tab open from a procrastination session some days ago:


I like the definition of stupid vs. intelligent from there - intelligent person consistently makes win-win decisions. Stupid person consistently makes lose-lose decisions, inflicting loss on other people for no gain for themselves.

This comments talks about officers. I.e., they're all in leadership roles.

Great quote. How is laziness defined in this? I am wondering if I am lazy or not. Sometimes I think I am, sometimes I am sure I am not. What's a good quick test for this?

I believe laziness in this situation should be defined as having adequate alone time to process your thoughts, rather than always being busy doing something all the time.

People whose work involves mainly analytical thinking tasks are often mistakenly perceived by public society as lazy while in fact they have always been working all this time, probably harder than most. It's only because the nature of their work is not physically visible to the naked eyes.

Quality decision can only be made after it has been given sufficient time to carefully analyze all the information and its available options. This can only be achieved successfully when people have plenty of quiet moments alone to really think about the specific problem. Those who are always busy doing something all the time rarely have this opportunity, they are always in a rush and don't have the habit to utilize the process or pattern required for analytical thinking. Just like how everything in life is a trade off, if you don't dedicate adequate time for thinking tasks, you cannot expect to formulate quality decisions.

I image that a simple test for "clever and lazy" is if you'd rather come up wit6h valid and constructive ways of or reasons for not having to do something rather than actually doing it.

Logistics. Finding the simplest and least resource-intensive way of accomplishing something. The laziest (and cheapest) and most clever person will come up with a solution that satisfies both requirements.

Additionally, a lazy person will take any chance at delegating even important tasks to subordinates. This is a good thing, because without delegation, the leader is the bottleneck. If someone else can do it, delegate. "Clever and diligent" people will try to complete the most important tasks themselves to ensure they get done right, thus creating a bottleneck.

I guess I constantly flip between diligent and lazy. That is, I consider myself lazy and love finding tricks to get the job done much faster or automate it away, but I have extreme problems with delegation. For some reason I'm pretty much incapable of asking other people to do something for me. I think it may have come from a mix of empathy and being extremely overprotective of my tinkering/thinking time as a kid. Whenever I consider asking someone for help, I feel like asking them to take the extra workload is infringing on their personal time, which is sacred.

>"Clever and diligent" people will try to complete the most important tasks themselves to ensure they get done right, thus creating a bottleneck.

This is the difference between me and my mom. She'll put off something for ages because she could theoretically do it herself, but I'll just hire someone else to do it after calculating the value of my time/opportunity cost vs hiring someone.

Recently, I got 3 tasks. I quickly redefined one task to be esentially equal to an other and one task beeing low priority. Got everything approved and found a library which could do the one remaining task. I wrote zero lines of code :P

I have ADHD. There are other serious neurological issues connected to ADHD. It's a very misunderstood disorder with a broad spectrum of identifiable symptoms that could indicate ADHD.

If you are heavily medicating with caffeine, then that can be a signal. I was using Pseudoephedrine and caffeine to self medicate and stabilise my moods and behaviours. That was before I got prescribed Ritalin.

But as the article says, I find Ritalin dulls my creative thinking and pattern matching that is required for insightful realisations.

Rejection Sensitive Dysphoria is big problem for me. I over think things, the slightest misread comment can ruin my day.

I also have a problem with cyclical depression and euphoric highs that are a bit like bi-polar but not as severe.

So yeah - It's hell. I hate having ADHD. I never looked for a diagnosis, but when I got one it was a light-bulb moment. Life still sucks. It's not a super-power and I'm not blessed.

> Rejection Sensitive Dysphoria is big problem for me. I over think things, the slightest misread comment can ruin my day.

I am a recent adult ADHD diagnosis recipient, and I never knew that there was words to describe this but it describes me perfectly as well, so thank you for the knowledge kind stranger.

I ditched my Ritalin for similar reasons, although I do have a hunch Adderall would help me better since the one time I took it recreationally in college, rather than "get me high" like it was the other college kids, it sort of just made me well..normal. I got my homework done that day according to schedule!

Why not get a proper prescription with an open minded psych helping guide you?

I read his comment exactly as you meant, i.e.: "I may seek a proper prescription for Adderall since it helped me that one time I got a dosage from someone".

Maybe it's not legally prescribed as medication in his country? I might be wrong though.

"I got my homework done that day according to schedule!" :)

I have adhd too and got my diagnosis when I was 25 because someone here in hackernews pointed out what I was fighting with isn’t normal or just laziness. It was eye opening for me too because all of a sudden a lot of things made sense.

Adhd is absolutely widely misunderstood. It fucks up and affects so many parts of my life, from inhibition, impulsiveness to emotions and motivation. I overthink everything, my mind gets trapped focusing on completely wrong thoughts and don’t even get me started with RSD (Intuniv / guanfacine treats RSD by the way but it’s not available for adults where I live. Look into it!) . The more I myself learn about it, the more I realize how completely mislabeled the name “adhd” for it is.

I agree with you, adhd is hell. I would pay a lot to get rid of it it if I could. Stimulants somewhat help with the focus part but that’s about it. I’m even self experimenting a lot with other medication like MAOIs and antidepressants that have some studies related to adhd done on them them in the hope to find something that works better than my Ritalin.

TSM is another thing that has a 50% success rate in “treating adhd” but it’s not enough evidence for me to shell out this much money.

> I have adhd too and got my diagnosis when I was 25 because someone here in hackernews pointed out what I was fighting with isn’t normal or just laziness.

Same here, about a year ago I came across a thread here on hackernews pointing out symptoms. Then I remembered that there was some testing done in my childhood (but didnt remember what for). Got properly diagnosed some time later.

I wish I remembered that thread and who pointed out the symptoms, they very much deserve a beer on me.

How, as an adult, did you get a doctor to diagnose ADHD? Every time I've brought it up with a healthcare provider, I lay out my difficulties and coping mechanisms, and the conversation ends with them saying "Well, it sounds like it's not much trouble for you. Anything else?"

I just don't know how to make them get it. I feel like I have so much potential for success, but I can't harness it.

I was just diagnosed about a year ago, at age 38. I'd suspected for years, but was mired too deep in depression to do anything about it. Finally I had my depression under control, and with the help of my wife (I'm terrible at making appointments!), made an appointment to see a psychologist who specialized in ADHD.

He interviewed me about my symptom history for an hour. Pro tip! Make yourself a list of all the things you want to mention to the psych. I wish I had brought a list, because after I left I thought of so many more examples I had wanted to bring up.

Despite my not bringing a list, he said near the end of the hour that if he had to make an immediate diagnosis, then yes, he would say I had ADHD. I took home a test (it was around 350 true/false questions) that he wanted me to take to rule out any other diagnoses that might be an issue.

I took the test and returned to him in a week. We went over the test results (nothing unexpected) and he diagnosed me with moderate ADHD-PI (primarily inattentive). He wrote me a letter to take back to my GP to try medication, and my GP handles my Adderall prescription now.

ADHD is a lifetime condition, and having symptoms since childhood is part of the diagnostic criteria, so when you're making your list, make sure you're including your childhood. I was very smart, and coasted through grade school with excellent grades, but there were still signs even then. Like when in 5th grade I just stopped doing any work for an entire semester. They threatened to hold me back from 6th grade, and I made up all the work in a single afternoon, sitting in the teacher's office while the rest of my class was on a field trip. Or all the times I would get in trouble for "not listening to the teacher" because I was hyperfocused on reading a book and literally was not even aware that I was being spoken to.

> with the help of my wife (I'm terrible at making appointments!)

It's so, so helpful to have a partner who can help with actually getting an appointment set up. I found it to be one of the hardest parts of the process of getting diagnosed, and probably wouldn't have gotten through it without help from my wife.

It really is! There's so much I couldn't do without her. We both have our own mental and physical health struggles (Me: depression, ADHD, fibromylgia, and T2 diabetes, Her: Sensory Processing Disorder, anxiety, and bipolar 2), and we like to joke that between the two of us, we make up one whole neurotypical person.

When one of us is struggling, the other helps pick up the pieces. When both of us are struggling, we work together to prioritize what actually has to be done (ex: we have to acquire something for dinner tonight, but we can do the dishes tomorrow), and do the necessary things together.

I'm in Australia...

I first saw a GP for my cyclical depression issues. She suggested I might have ADHD. I then got referred to a neurologist.

An Adult ADHD diagnosis can be hard as many Dr's work on the basis that ADHD is something that 'goes away' in adult hood. Which isnt really the case, and wasnt the case for me.

I was able to demonstrate childhood patterns that matched the disorder diagnosis; despite having a high IQ (for want of a better way to describe it), I have zero qualifications, failed at school, never went to uni and bounce from job to job. Always starting well, but then going off the rails. Where as my siblings are all exceptional performers in their careers. I was also the eldest, and suffered a high degree of stress in the womb and early childhood (for reasons I wont go into), which are contributing factors.

Glad the ADHD was recognised with depression symptoms; my girlfriend had the same diagnosis and was fobbed off with antidepressants, which made it even worse.

When it comes to getting an assessment for any sort of mental health issue the best advice I've heard is to answer all the questions from the perspective of your worst day because that's the situation you're trying to avoid. Coping mechanisms are great but they don't work all the time, and at least in my experience once they fail I end up in a downward spiral that can be really hard to get back out of.

Best of luck to you - I made an appointment to go and actually finish the assessment process off the back of reading this article this morning. I wonder if having started it and got distracted twice previously will count as a point in my favour?

Schedule an appointment with a clinical psychologist who specializes in ADHD and ask to be evaluated. It may take some looking to find someone who is accepting adult patients.

If you can’t find and ADHD specialist someone who does IQ exams can also help. My personal route included going to a clinical psychologist who specialized in IQ testing. Thought I might have mild dyslexia or similar. Turns out IQ exams (properly administered ones) show significant patterns related to working memory issues in ADHD.

I feel you. When I was first trying to get diagnosed (in small-town Virginia) it was really hard finding someone who could help.

You'll probably want to figure out if it makes sense to convince one of your existing doctors to consider it, or if it makes sense to find a new doctor who can help you. Odds are good that you'll need to do the latter anyway, as your primary care doctor is going to refer you to a psychiatrist for an actual diagnosis. So one thing to think about is just asking for a referral.

One way to shortcut the actual finding-of-a-doctor would be to do a search for "adult ADHD" on Yelp for your area. Hopefully, someone's reviewed a doctor and used that phrase, and you can figure out if the review is for a doctor who'd be good to connect with.

I had to go to a psychiatrists who specialised in ADHD to get a diagnosis.

GPs would tell me to stop being lazy when I would asked for a referral to one, so I paid top price and went direct.

I found this doctor _did_ get it, it was worth it, so now navigating treatment. It was a huge relief as it's like someone has finally listened to what I have been saying for over a decade.

"Well, it sounds like it's not much trouble for you. Anything else?"

Best advice I've heard here is that you need to talk less about how you're coping, and more about how it's still impairing you despite that.

After all, so the doctor reasons, if you've built coping skills that handle it without medication, then why not just stick with those? What you have to do is give them an answer to that unspoken question.

That sounds like my GP. I struggle with anxiety, depression and obesity among other things. Every time I go to an appointment with them I hear "Well, it's all in the head you know."

I hate this and it's the case with most GPs, at least in my country. I genuinely just wish my therapist was also my GP.

> Well, it's all in the head you know.

Yes I know, thats exactly where the issue is.

In general that means they think it's imaginary. Find another doctor.

It's particularly malicious as it's using a phrase that is literally true and accurate description of the problem to dismiss the existence of the problem!

Can you opt for a second opinion? Like, is that legally possible to be enforced? If yes, I'd go for that. If you have trouble functioning in society, a diagnosis plus therapy or medication can really direct you in the right way. You still have to put in effort, of course, but basically less because these aid you.

Have you ever seen a clinical psychologist? That's how I was diagnosed.

The GPs mentioned in this thread are so incompetent that it makes me angry.

My girlfriend was diagnosed with ADHD as well a few years ago, after her son was. She's on Concerta in a special delivery mechanism that gives her a 'boost' after a few hours; it's not an all day thing but it gets her through most of it. Same with her son. Ritalin is described over here as a short-working medication; you should look into other medication as well. My girlfriend mentions that her medication is subtle, but effective - it helps with mood swings and all that.

However, I can imagine that some aspects of ADHD - notably the hyperfocus - can be considered a positive trait, something that is hard to let go of. And that's fine, if you want to have it you can skip the medication just fine.

However, you also mentioned RSD; my girlfriend described that the medication she's on helps a lot with daily mood swings. She seems a lot more patient and resilient about small things in the day now that she's on the medication. Do consider it if you find yourself struggling in e.g. the workplace.

Interestingly, I find that medication does not affect my hyperfocus in a negative way. If anything, it's even easier for me to achieve hyperfocus on a task when my Adderall is "on". I find that what medication helps me most with is the initial hurdle of starting a task. Once I actually get going, I'll usually hyperfocus on it (if it's the type of task I hyperfocus on, which includes programming, but sadly does not include housework). I procrastinate at work far far less when I'm medicated. Without medication, I struggle hard with starting new tasks.

Interesting symptoms. The coffee consumption, mood swings and cyclical depression and also symptoms other commenters described like needing lists for everything or overthinking things are a perfect match for someone close to me. The only thing missing is some-kind of uneasiness within crowds.

But that person was actually diagnosed with "Sensory Processing Disorder".

I'm glad that people are more aware of ADHD and because of that receive proper medication. On the other hand the symptoms of ADHD can be very similar to other disorders. Many neurological problems overlap and someone having a dysfunction in one area could also have a dysfunction in others.

So to all commenters in here, be aware that a label of ADHD may only be a part of the full picture.

After my diagnosis with ADHD, we wondered if my wife might also have it, albeit milder than mine, as she struggled with a lot of the same things I do. She went for the full neuropsych eval, and was actually diagnosed with Sensory Processing Disorder, not ADHD. So I'm not surprised to see some overlap there.

Ask your psych to try dexedrine/amphetamines. Ritalin was absolutely toxic and dulled my personality and gave me huge mood swings.

> If you are heavily medicating with caffeine, then that can be a signal. I was using Pseudoephedrine and caffeine to self medicate and stabilise my moods and behaviours. That was before I got prescribed Ritalin.

Does tea count? I dislike coffee; I only drink some when I absolutely need to stay awake (caffeine in energy drinks is another thing, this I like). But ever since I was a kid, I've been drinking ridiculous amounts of black teas every day, on the order of 10-15 cups. I ask because I keep hearing that the stuff in tea is pretty much the same thing as caffeine...

It is the exact same thing. The first cup of black tea brewed from given leaves has about half as much caffeine as a cup of coffee.

RSD is a nightmare for me. Something I always have to work on

My "coping" mechanism, annoying for some, I am sure, but I just bluntly immediately ask for feedback and try to get to the bottom of it as soon as possible. I am fortunate enough to have a manager that understands my condition and he offers me plenty of "spot" feedback which I cannot appreciate more.

I totally relate to that! I do it as well - I often cant leave something alone. It drives my wife insane as I'll just keep on about it when she wants to move on and let it go. I do it at work sometimes too, and it can come across as a bit intimidating, especially with people who dont like up front confrontation.

Have you found any support groups or any that were affective? I have taken a cursory glance at some support groups available to me in the past, plus some internet circles, but found them not personal enough to be effective or I felt too detached from the people involved from their day to day problems. But I feel like I, as well as other ADHD folk would benefit from some sort of HN "accountability" partner or group that understands the condition but also the type of work we do.

I had no idea it was a thing. I thought I had ADHD-PI with a side of anxiety, but I’m blown away to find that RSD has a super strong link to ADHD.

I think it’s treatable. Anecdote: I knocked doors for the Hillary campaign in Denver in 2016 at the request of a friend. While this initially terrified me, something changed over the week I was there.

I found that when I went home, my social anxiety was damn near nonexistent. I’d inadvertently done exposure therapy for rejection, and goddamn it felt great. It wore off eventually, but I’m still trying to get back there, now that I know where “there” is.

The "bit like bipolar part" might be a thing called emotional hyperarousal thats common with adhd, if you ever need its name to google

Thanks! I'll look that up and ask my Dr :-)

Edit: Yikes! I took their little quiz, I ticked the 'often' choice to all those questions...

I don't know if I have ADHD but I really identify with the things you're saying.

It's not that you realize halfway through a meeting you haven't heard anything -- everybody does that from time to time -- it's when you CONSTANTLY struggle to follow what others are saying in a meeting, even when it's an important meeting; most of your peers have no trouble doing that; sure, some will also phase out, but they normally don't.

It's on the level of the pot head in your team telling you "Dude, you're my hero, I've never seen someone not give a fuck like you" because he noticed you were not paying attention during a meeting.

Everybody is losing focus in school, sure, everybody is losing their school items, sure, but not everybody sits on a test and then goes home with the test in his backpack, instead of submitting it, right?

How many times have you boarded the wrong train or buss?

How many times have you booked and airplane ticket with the wrong dates?

Does everybody mess up their invoices on a regular basis, until it stresses you out enough that you triple check it every time?

Do you only perform while anxious?

Have you ever tried stimulants? I have and it was a HUGE "AA-HAAA, so I guess the chatter in my head is gone, I can sit at my desk for 2 hours straight, my pulse has gone from 90bpm to 60bpm, I'm completely calm, I guess this is how normal people feel everyday? "

> it's when you CONSTANTLY struggle to follow what others are saying in a meeting, even when it's an important meeting

Sort of. I have no problem paying attention in a meeting in which I might be called on because of the terror of getting called on and not knowing what was asked (that happens to me a lot).

I find it very difficult to listen to podcasts. My mind drifts off and I realize I haven't heard the last 20 minutes, so I rewind. On good days, I can make it about an hour before I start drifting off. On bad days, I'm lucky to make it through 10 minutes.

> How many times have you booked and airplane ticket with the wrong dates?

Never. I'm hypervigilant when traveling by air. I only board the wrong bus if I'm really distracted, like I'm in a conversation either in person or online and I'm focusing on that instead of where I'm going. I'm the kind of person that really has to focus on where he's going. Even when I'm driving, I'll miss turns if my passenger is talking to me.

> It's on the level of the pot head in your team telling you "Dude, you're my hero, I've never seen someone not give a fuck like you" because he noticed you were not paying attention during a meeting.

I've had people tell me that after meetings before.

> Have you ever tried stimulants?

I've never tried stimulants stronger than red bull. I have noticed that large doses of caffeine calms me down. It's a fairly common occurrence for me to drink an espresso or red bull before bed and having no problems sleeping.

Btw, I'm not implying that stimulants calming one down is a must or that just/all people with ADHD get that effect; in fact, after the effects wear off, I wouldn't be able to sleep for hours.

This like a checklist of things that I do. I've been known to sit there looking like I've been listening to a conversation, and then when someone asks me a question have no idea what anybody was talking about, and that will be the first point at which I notice I wasn't listening to anything going on around me. Thankfully I've got colleagues who are understanding about it, but damn is it embarrassing having to answer with "I'm sorry, I wasn't listening at all".

I wonder how to judge answers to these questions if you take into account coping mechanisms.

I've boarded a wrong tram a few times. I never did book an airplane ticket wrong because it's a high-stakes thing that I check 20 times (and then few more times next day) just to be sure I didn't screw up. Whenever I feel there's a chance to make a mistake that would be inconvenient, I'm fixating on it and doing it really extra careful - therefore not making the mistake. Same with invoices; I wrote myself software to calculate and I still check everything with a calculator before sending the PDF off.

Isn't the chatter associated with other disorders such as depersonalization / anxiety / racing thoughts ? Asking because I experienced it under some stress & anxiety lately.

When I'm anxious, for sure the racing-thought/chatter is more pronounced; I've also been diagnosed with BPD and that psychiatrist actually asked me to do and ADD/ADHD test because these go hand-in-hand (I've scored 6/9 for ADD, which was apparently sub-threshold for ADD in adults).

Depersonalization/feelings of emptiness -- I do experience those occasionally because those are part of BPD, but they've gone down significantly over the years and I have a pretty stable life right now.

The bad thing for me is if I'm well rested/not anxious I'm usually not interested in doing anything at all; it's just my hypothesis that anxiety is my high-functioning mechanism for my ADD.

While on certain stimulants (they're not all the same) things just click and I am very calm, zero chatter in my head, I feel a bit dumber than usual, but I also can just focus and do meaningful things. Other stimulants make me euphoric and while I can focus I can easily end up focusing on the wrong things; on other stimulants I'm more anxious than usual, more driven and still better able to focus; unfortunately I live in a country where adults cannot receive stimulants period, let alone find a psychiatrist who's willing to play with stimulants/non-stimulants, dosages and so on.

I think the best description of ADHD I heard was that it has more to do with an "attention-switching" deficit. People with ADHD are capable of intense focus on highly stimulating things like a good book. The intensity of focus drowns out everything else, making it hard to deal with other important tasks until the book is finished.

It's also much more difficult to maintain their attention on things that are no longer stimulating.

So ADHD folks are great at starting interesting projects, but once the space of possibilities has been narrowed down and all that's left is hammering it out, it becomes intensely difficult to maintain attention on that due to lack of stimulation.

I also like the idea that it would be better labeled, “intention deficit disorder”.

Dr. Barkley’s talk completely altered my understanding of the disorder. I always knew I had it. My life roughly paralleled the author’s. After failing out of school, I found workarounds that got me through the second time (thanks to extremely supportive parents).

This video, combined with my wife’s urging, caused me to find a legitimate doctor who specialized in it (he’s ADHD too), and get treatment. I was already doing well with my coping mechanisms, but my life took off like a rocket with treatment.

If anything in the article or the comments resonates, I would watch this ASAP: https://m.youtube.com/watch?v=SCAGc-rkIfo

Any insight on how you went about finding a competent doctor for this?

After watching this video, and almost being moved to tears with how accurately everything in it described my life, and seeing your comment about being better off with treatment, I am convinced I should finally try something.

I too have been able to cope, but I would love to live beyond just coping and I am realizing it is only shame and pride stopping me from getting help, and fear that meds could make me worse or I couldn't find a good doctor.

I literally just googled ADHD doctor, tried to find reviewed, and then scheduled some appointments. You can tell a lot from how they handle the appointment and evaluate you.

If they’re cavalier about just throwing meds at you, I’d probably keep looking. My doctor always counsels that the ideal is to work myself into a position in life where I no longer need to take medication. He encouraged me to bail on it during vacations, if that’s my preference. He interviews and is constantly looking for signs that I should adjust my dosage. If you’re in SF, shoot me another reply and I’ll send you his info.

I'm in SF and interested in who you used - would you mind posting your doctor's name, or else posting a way to DM you (maybe twitter handle?). Thanks!

Thanks for the input. I'm on a different coast, but I appreciate it!

This sounds familiar to me. I've been trying to launch a blog for years. It goes in cycles. I start building a site, learning a web framework or static site generator, writing CSS and JavaScript, coming up with topic ideas, etc. Then, when the interesting learning part is over, I get bored and it just sits there for a few months until I start again with a different idea for the design or typography. It's a pattern I observe in several areas of my life.

(It's not that I'm not suited or capable of doing the writing part of blogging; I make a living ghost writing other people's blog articles and ebooks.)

Maybe you’re actually interested in design and typography?

Maybe, but only being able to focus on things that happen to grab your attention/interest is one of the major pain points of having ADHD.

It's not a matter of preferring to work on more interesting things. It's more along the lines of not realizing uninteresting things need to be dealt with (or even exist at all, sometimes) until they bite you in the ass.

Keeping up the theme of starting a blog... you'll have a rational understanding that a blog needs content. But you'll get wrapped up in solving the more interesting design/engineering problems. Once those parts of the project have been sorted out well enough that you are no longer actively solving a problem (note, I didn't say they were completed), something unrelated, but more interesting, will cross your mind and steal your attention away.

The attention switching idea seems consistent with my own experiences. I dated a girl with pretty severe ADHD; whenever she watched Arrested Development (a very fast paced sitcom with a lot happening) she would turn into a zombie and be almost entirely oblivious to any outside stimuli.

I have ADHD and have literally trained myself to use Arrested Development to put myself to sleep. Always the same episode. Even with the most crowded mind, I lay down with one earbud in, and I can’t make it 3 minutes without passing out.

The rapid dialogue means there’s no opportunity for intrusive thoughts to enter, but I know it all by heart, so there’s zero intrigue in any of it.

I have a similar situation, but it's a daydream. If I lie down and think about it and let my mind wander I usually find myself waking up many hours later.

> So ADHD folks are great at starting interesting projects, but once the space of possibilities has been narrowed down and all that's left is hammering it out, it becomes intensely difficult to maintain attention on that due to lack of stimulation.

This is not something that most people have problems with?

Not to the degree people with ADHD seem to have this problem. A recent study looked at whether people with ADHD were more likely to repeat a grade. Here's what they found:

>28% of individuals with ADHD repeated a grade compared with 7% of controls (p< .001).


You can find many such studies about ADHD that find that people with ADHD just do worse in situations that require sustained attention and persistence.

I have a couple hundred tabs open across a few machines... It's a horrible cycle and every now and then Firefox feels sorry for me and corrupts my session so that I lose it all.

Yes, all of those things are classic ADHD... But they barely even scratch the surface. That's just the "haha" relatable stuff. Time management issues are real.

ADHD is, in essence, making a list of all the things you need to get done, placing the list in all areas you frequent as visible as possible, and then wondering how 16 hours went by and you're still on item #1 but now you know a whole lot about lizards that you didn't before.

ADHD is also the reason you can get work done for 16 hours straight without distractions.

The overdiagnosing of ADHD is only making things worse because it prevents some people from understanding when they need to make real lifestyle adjustments... both people who hide behind the diagnosis and people who refuse to take it seriously.

In today's world of hyper-distraction this is becoming all the more pertinent. ADHD can affect people of all walks of life and level of intellect, and it can be paralyzing as an adult with the amount of sensory information present in today's society. And we still aren't even sure what environmental factors if any can cause ADHD... for all we know modern society is contributing.

From an article I saw here the other day

> ...even short­-term engagement with an extensively hyperlinked online environment (i.e., online shopping for 15 minutes) reduces attentional scope for a sustained duration after coming offline, whereas reading a magazine does not produce these deficits


Overdiagnosis is real -- being a developmental disorder, ADHD people present age-inappropriate behavior -- "you're too old for this." A lot of people simply grow out of it (although, the ADHD brain typically reaches maturity around the age of 35, so, it can take a while). But many people never grow out of it, so underdiagnosis of ADULT ADHD is real.

In most countries, however, underdiagnosis is the real issue in most countries. I'm in the Netherlands and I went to a school for special children and talked to half a dozen therapists over ten years, and not one of them even considered it, while it's one of the most common disabilities, and considered one of the easiest to treat. I went to my GP and she had no idea about it, I basically had to explain the diagnostic criteria to her myself. It's possible I've just been really unlucky with the last 10 professionals I went to, but I think it's representative of the attitude in Europe -- especially the farther you go south and east.

These items pretty accurately described me before I started taking meds for ADHD, about 15 years ago. Over that time, I've taken a moderate dose of either Concerta (Ritalin extended release) or Adderall XR most days I work. I very rarely take the meds on weekends or holidays, and occasionally don't take them on work days. I've been doing tech work since the early 1990s, so a big chunk of my career was while I was untreated.

For me, the meds have a simple to describe effect: the amount of mental energy I use to concentrate goes down greatly when the meds are in my system.

I did some of my most innovative, creative work early in my career, before the meds. This was due to a number of factors, and I've done some pretty innovative stuff since, but not on that same level. (A big part was being in the right place at the right time.)

But there was cost: even though I was in my 20s, coming home after concentrating for 8 or 9 hours, even after a full night's sleep, I would need to take a nap before finishing my evening. Many hours of concentration just drained me, because it took so much energy.

The meds have changed little, for me, except allowing that focus to cost less.

Yeah. I don't want to be somebody who jumps on the bandwagon and self-diagnoses themselves with ADHD, but I also fall into all of these categories, have developed a bunch of his coping mechanisms on my own (the lists part really hit home, I cannot get shit done without making multiple lists and sub-lists throughout the day so that I have an anchor to fall back on when I'm getting distracted), and consume gratuitous amounts of caffeine to keep focused. I've gone through a gallon and a half of Monster in a single day on many occasions, though my normal daily consumption peaked at about 3/4 of a gallon. I've had other people suggest that I might have ADHD as well, but I have no desire to get a diagnosis even if the doc would agree. I'm doing alright with myself and making improvements over time. I do appreciate articles like this because whether or not I have "ADHD" I do have a bunch of overlapping symptoms/patterns-of-behavior, and reading about how other people cope with similar experiences seems useful.

As someone who was diagnosed just about a month ago after a lifetime of coping I’m curious, what’s the argument against diagnosis?

I'm certainly not arguing that anybody else should avoid diagnosis. I don't expect this to be a popular opinion, but I tend to stay away from medical practitioners in general. The last time I broke a bone I did some googling and treated it at home; I generally feel like the time and money needed to access professional medical advice isn't worth the knowledge which is already available at my fingertips faster and cheaper. If I were to get diagnosed at some point, it would be because society won't let me buy kiddie-meth (Ritalin/Vivance) over the counter. I've tried kiddie-meth four times illicitly, and it did wonders for me, but I'm not yet ready to incorporate it into my regular drug stack. I worry about potential effects from prolonged use (the "dulling" some people describe), and it makes me prone to giving <i>all</i> of my effort to the task at hand even when that isn't actually clever. I'm not ready to burn that filament yet. If I were throwing everything I had into a startup, I could totally see getting on the stuff. I'm about a decade from that point in life by my best approximations. As a side note, I accidentally smoked a little bit of actual-meth once (the guy who packed the bowl didn't tell me there was meth in it -- long story), and the effects were very similar. I didn't realise why I had been in such a great flow-state until it was revealed to me about a week later.

it sound like your argument is essentially that medical professionals cost too much money and have too low availability to make it worth your effort, is that correct? if so, may I ask where in the world you live?

Midwest US. If I felt like they were good at what they're for, I would probably use them more. My experiences have been bad. We're veering quite a bit off-topic here, but the last time I went to a doctor it was because I was shitting blood. I figured it was probably hemorrhoids based on googling, but was worried of an off-chance of cancer and decided to get it checked out. They had me collect a stool sample and come back two weeks later. I did, and the first thing they did was throw the sample away without examining it -- they said they shouldn't have even asked for me to collect a stool sample to begin with and apologized. Cool doc, thanks for having me scoop my shit into a cup for no reason. Then they charged me ~$300, had me get naked, and the doctor asked why I wasn't circumcised without me bringing it up and encouraged me to get circumcised multiple times (in my 20s) while I repeatedly said I wasn't interested and that it's supposed to harm sensitivity, and then he finally proceeded to stick a camera up my ass. The results were ultimately inconclusive, he said it was probably hemorrhoids but that he couldn't see them with the camera and verify that. So I'm out ~$300, my collecting-my-own-shit-in-a-little-cup virginity, my arguing-with-a-doctor-about-circumcision virginity, and my having-a-camera-shoved-up-my-ass virginity, and I don't know anything more than my free google searches told me two weeks earlier. 0/10, would not visit again. YMMV.

No, it's not lost on me that I admitted to previously consuming 3/4 of a gallon of Monster a day two comments ago and now I'm posting about shitting blood, but I think there were other contributing factors (notably bad lifting technique).

Edit: More on topic, if I don't care about the yes/no checkbox of whether they think I have "ADHD," and I don't want to get on the medication (which I've tried, informally researched, and made a fairly informed decision about), what can professional advice provide me that internet research about symptoms and ways of coping with them can't?

Yeah, I have about the same opinion of the medical profession. Except for fixing mechanical problems (e.g., fractures) they seem pretty much worthless. Prescriptions that do fck all to fix anything and inconclusive diagnoses after you waited WAY past your appointment time leave a pretty sour taste. If a remodeling contractor operated the way most doctors do, they’d be skewered on the 6 o’clock news.

> it's not lost on me that I admitted to previously consuming 3/4 of a gallon of Monster a day two comments ago and now I'm posting about shitting blood

May be pure coincidence, but in my case the former was causing the latter. Through trial and error I discovered that zero caffeine intake completely eliminates my symptoms.

I think caffeine was a contributing factor, but not the sole cause. I imagine the niacin wasn't helping either. I'm totally off energy drinks now, but still strung out on caffeine pills. I intend to introduce some of the other ingredients of energy drinks back into my drug stack eventually, but I'm out of the niacin game (mostly due to worries about liver damage). FWIW, with better lifting habits and some other dietary changes I haven't shat blood in years despite only cutting the energy drinks out fairly recently.

> what’s the argument against diagnosis?

I know you didn't ask me, but as somebody who just realized he could have a mental illness, the thing that terrifies me most is being branded. Technically, on the books, ADHD is an incurable mental illness. That means, once diagnosed, you're forever mentally unstable in the eyes of both the law and potential business partners.

I doubt I'll bother to get officially diagnosed. The risk is too great and the upside too small. I've been coping this long with it and now that I know what I'm dealing with I can find ways to cope with it even better.

I feel like I fit in all these descriptions. Unfortunately coffe does nothing for me, so I have no drug of choice.

FWIW, I was the same, until I ran into some issues at work.

Talking to a medical professional was eye opening. It's worth having he conversation, at the very least. I was very skeptical after being diagnosed.

Then I forgot to renew my prescription the other week and it was utter chaos. I can't believe how much focus and discipline I used to lack.

How did the professional help?

I was referred to a psychiatrist who had me fill out a questionnaire, and we spent about an hour iterating through my life beginning from childhood. The questions they asked, individually, felt meaningless, but trends emerged fast.

I get that these questions can be gamed if you're just seeking a prescription, but in my case I'm generally quite hesitant to take these sorts of drugs. I have close friends who had many very messed up years due to struggles with ADHD medication.

Now I feel like I'm living life with my eyes open. Far from perfect, but I am able to have ownership of my issues.

Meds aside (which do help, and not all will trigger personality or physical changes), there are some coping mechanisms which you can pick up. Even with meds, you’re really only given a bit more control over your attention, so having coping mechanisms are still useful.

> I knew I was lazy

And absent minded. And flighty. Thats why the homework never got done. Can binge on a video game for hours and hours, with a singular, obsessive focus. Therefore, no attention problem, right? (WRONG!)

Talk to a doctor. Do be wary of the temptation to explain away all these failings that you presume are choices... thats always a very attractive scenario... but get a professional opinion.

> Can binge on a video game for hours and hours, with a singular, obsessive focus. Therefore, no attention problem, right? (WRONG!)

Can you elaborate on that? Why is it wrong?

I've thought about this topic a lot in the past. I remember back in the day I had massive gaming sessions (like 10 hours a day for weeks). Games that are competitive and "skillful" too, not just lounging around playing them 1 handed. It required tremendous focus.

But when playing a game, you often have only 1 task happening which is "play the game", there's nothing distracting you and it requires your brain to actively be engaged.

However if you replace gaming with writing a 5,000 word blog post or creating some web app suddenly that focus isn't there. If you can focus during the game, why can't you focus outside of it?

Video games tend to be highly stimulating activities - many people with ADHD can keep their attention fixated on a singular activity, so long as that activity is stimulating enough. Video games, sports, or whatever.

Hyper-focus like that doesn't mean you have ADHD - but people often use it to rule out ADHD as a possibility, and never get tested, when maybe they should.

I'm considering it after reading this. I have considered it in the past, but you know... I find it hard to start and finish tasks once something else catches my fancy.

I don't know if it's me or modern culture but my brain needs instant feedback. Video games are nearly unparalleled for that. Programming is similar, exams and homework (unlike a lot of people posting here) do it for me too, because I get that feedback in a solid, concrete number.

One of the ways that stimulants treat ADHD is by raising dopamine and norepinephrine levels. Also, one of the big problems with ADHD is time-blindness. Basically, to the ADHD person, there are only two times: Now and Not Now.

Video games are highly stimulating and full of immediate feedback when you do well or poorly. This gives you the dopamine hit that your brain is searching for. And the immediate feedback means that the results of your doing well or poorly are felt right away, instead of in a nebulous future.

So you can focus during the game because you're getting a constant stream of dopamine and you always know how well you're doing. Get to the blog post though and... where'd the dopamine go? If you don't write this blog post right now when will you feel the pain? If it's not for a while, then it's too far away for the ADHD brain to put it into perspective because of the time-blindness. It's one of the reasons ADHDers are famous for procrastinating til the last moment, then suddenly cranking out that paper the night before. Once you finally get that sense of urgency of the impending deadline, you can focus.

> I remember back in the day I had massive gaming sessions (like 10 hours a day for weeks). Games that are competitive and "skillful" too, not just lounging around playing them 1 handed. It required tremendous focus.

It's deceptive; from the outside games seem like a single task that you can just focus on, unlike those other single tasks. But games are usually made up of a lot of things to keep track of, remember, etc. and it oddly works well for ADD/ADHD since you repeatedly switch focus between them all, something we're actually great at doing.

Take a competitive game like Overwatch: there's the general things to focus that any FPS has, but you also have to keep other things in mind like: map layout, your own positioning, ability cooldowns, enemy positioning (where you remember them and where they're likely to be next), the objective, whatever strategy you or your team have, etc. Instead of being distracted off the single task of "playing Overwatch", you're actively switching between the different phases that make up "what am I going to do next", even if you don't notice it.

Conversely, if a game is going slowly, you might get distracted and wander off looking for something more intense to do -- like killing an enemy -- and get yourself caught out of position.

Or in a PvE-multiplayer/single-player sense, consider raids (10-20man group vs. 1 boss) in MMOs: you have your own character's attack rotation to do, but also the flow of the current boss to think about: incoming spells, curses/debuffs to watch for, positioning, next objective (if the boss is more phase-based rather than just repetitive attacking), etc. If you're a melee character positioning and moving might be a constant thing to focus on, too. Even if you're already used to it and it's automatic to you, it's still something your mind actively thinks about and switches focus between.

Even in a game that has much less mechanics going on, your ADD/ADHD might just switch focus between the game's visuals, just as you physically get distracted by things around you (except this time they're the in-game environment and not distractions, but things the devs intended for you to interact with).

TL;DR: A video game isn't a single, coherent task that goes from A-Z, it's a giant collection of many tiny repeating (but not necessarily repetitive) tasks that you constantly switch between, like a processor context-switching between processes. And that plays into ADD/ADHD's pros rather than cons.

Those are all totally valid points (and I 100% agree) but don't you do the same thing when coding a project?

You have writing docs, writing tests, working on the user auth work flow / any app features, researching features / inspiration, designing a page, writing a bit of CSS, tinkering with the ops side of things (deployment / infra code), thinking about how you're going to generate traffic to it, writing blog posts or making videos surrounding your project idea and the list goes on.

You could bounce around all of that and could think "ok, what's next?" after completing any one of those things but for some reason it's not the same.

Although I guess another difference is games tend to have a lot of immediate rewards, or even more strongly, "potential" rewards. Like in your PvE MMO example. There's always a chance something might drop that will make your character better. Especially useful in games like path of exile (action RPG where your items / loot play a big factor) and even if the items you want don't drop, you're still gaining experience to level up your character which gives you ancillary rewards, and since it's a multiplayer game you could trade them with other people for things you want in return.

Where as with the coding project, there's really no rewards until it's done and even then there's no guarantee. You have to be content with just patting yourself on the back with a "hey good job, you finished writing tests for the user sign up work flow, now move onto X".

The same thing applies to writing to a lesser extent. There's research, coming up with a good example, writing sections / paragraphs, creating associated images, etc.. None of that really has immediate effects until it's fully done and you publish it, and even then, the publishing aspect might not even be the thing that motivates you to write it. Like, I've written 230ish blog posts but I write them with 0 expectations. I write them because they help me materialize what I'm learning or have learned, but sometimes it's difficult to write even if I think to myself that I want to.

Those are all "small" tasks for programming but monumental tasks compared to competitive gaming "tasks". For example, thinking about enemy positioning is likened to a mathematical function having the input of "enemy character" + "enemy team composition", sometimes accounting for the current map or where they were before. (Or their strategy if you've deduced it by now) It's a sub-second calculation likened to predicting where a ball thrown at you will land, and running there. On the other hand, writing a user auth flow is a minimum total of minutes with many things to remember at the same time. You can get distracted (even for a brief period of time) pretty easily in a time span of minutes.

The idea of loot and reward is a good theory but I meant it only in the sense of gameplay, and I can prove it by "loot lockout": in World of Warcraft you can only get loot from a raid boss in a specific difficulty once a week. The next successes give you no reward (and you can't trade loot with someone who did get loot when you couldn't). However, I've still cleared the same bosses several times a week because they were also fun. It was guaranteed that I wouldn't get immediate -- or any -- rewards for my success but it was still fun and focusable.

Maybe it just boils down to people are really different haha.

Your experience is interesting because I played Diablo 3 when it first came out and shortly afterwards got bored because the loot wasn't interesting. Once I finished all of the difficulties in hardcore mode (before everything got nerfed beyond its initial release) I uninstalled. But, I somehow managed to put thousands of hours into Diablo 2 and Path of Exile, both of which have much more interesting items (at least to me). Maybe the reward aspect is more important to me in those types of games.

I get what you mean by the gaming tasks though. I used to play moba style games. Every second had something to think about, and really it's almost like you have to turn off your brain and just let your brain take over if that makes any sense. If you tried to explain the exact work flow of what you had to think about in 5 seconds it almost seems impossible, but somehow with enough practice it's effortless. Maybe when your brain is in that state, it's not possible to get distracted.

At first glance, it would seem like ADHD might help with multitasking - and maybe it can to a certain extent, but generally only by coincidence. They aren't jumping from task to task in a structured way. Instead, they are failing to keep their attention on activities with low levels of stimulation, and constantly bouncing to activities with higher levels of stimulation.

Most people can relate to that experience, of course. Its just a much bigger struggle for ADHD folks (hence, the self-image of laziness, lacking discipline, etc), and often takes medication to manage.

In a fast paced action game, everything tends to stimulating. In software development... its mixed bag for most of us!

> In a fast paced action game, everything tends to stimulating. In software development... its mixed bag for most of us!

Yes, this was indeed my point (alongside the micro-tasks point in my other reply): games are made to be flashy, stimulating and exciting. They're made to pull your attention, which makes them easier to focus on for someone with ADHD.

A lot of Twice Exceptional* people get labeled lazy. It may not be ADHD. It may be some other hidden issue. In the vast majority of cases, people who get identified as an adult seem to be tremendously relieved and empowered by having a better label than lazy.

* https://en.m.wikipedia.org/wiki/Twice_exceptional

That's a label I've never heard of before. My younger self checks every single one of the boxes in the strength/weaknesses table. I graduated college with a 2.2GPA entirely on my ability to score really well on all the exams I managed to show up to.

I failed freshman composition 3 times in a row since it was the only class where tests were not part of the grade.

As an adult, I find that laziness had become a learned behavior. I was smart and generally easy-going meant that none of my K-12 teachers were willing to flunk me, but getting an A seemed out-of-reach. This meant that I could "get by" with minimal effort, while intense efforts didn't result in obviously visibly better outcomes.

I eventually found a good therapist (though Sturgeons law[1] definitely holds for therapists) and have been sorting things out since.

Holy crap, that sounds almost exactly like my college experience except I dropped out after my major/department was cut from the university.

As far as "getting by" and laziness as a learned behavior, I always worked hardest on my hobbies throughout K-12, so as an adult I've gotten to the point where my hobbies have become my careers. I started building PCs and running Linux on my own in High School, along with playing music, so now I'm a software engineer/musician. Software is one of the few careers where you can go on an insane research binge on a whim and actually be praised for it, and performing music is one of the only things that I've ever done that fully quiets my mind. Something about the adrenaline of being on a stage really helps with my ADHD-Inattentive type; guess it's just like a stimulant.

"Do what you love and you'll never work a day in your life", etc

Well, particularly with ADHD, if it’s harder to power through life tasks or remain focused on topics that are not mentally stimulating, it typically means you can hyper focus when you do stumble into something that is mentally stimulating. I think people with ADHD have a high propensity to large successes, or tragic failure because if you don’t find your true interest or calling, it’s harder to carry through something that you find is just ok.

My handicap is medical. If I can't focus, it's usually because I'm miserably sick or feverish.

Having the correct label helps some people get their uncooperative body to be productive enough to make life suck less. Just calling it "laziness" generally suggests zero real remedies and often leads to the beatings shall continue until morale improves.

I went the other direction. I had no problem with being called lazy or calling myself lazy. It was a familiar and comforting crutch, like slipping into an old pair of sneakers. I only got B+ on the test? No worries. I could have gotten an A had I actually tried and wasn't so lazy. But, I couldn't be bothered, because I'm lazy.

The fact I may have an incurable mental illness (and that I could be branded as such) terrifies me.

Don't consider it an incurable mental illness. It's not a sickness, it's just a genetic variation in how the brain is wired. Having a certain percentage of the population with ADHD was probably an advantage in our evolutionary past. There are a lot of good things that come alongside it, like hyperfocus, greater creative thinking, and an increased ability to multitask. It's only really a big problem in our modern society, that values people's abilities to be super-productive cogs in a machine and values consistent output over anything else (like creative solutions), that ADHD becomes a huge problem.

I appreciate what you're trying to do, but it's not about what I think. It's about what the rest of society thinks, especially the legal system and people hiring programmers for jobs. I don't imagine judges look kindly on someone who is officially diagnosed with a mental illness deciding not to take any medication for said mental illness.

Well, true. I have not disclosed to my job that I was diagnosed with ADHD, and I don't particularly plan to (I wouldn't deny it if it came up, but I'm not going to volunteer the information either). There are more downsides than upsides to disclosure. It's generally recommended to not disclose, especially during the hiring process, unless you truly cannot cope in your job without some sort of ADA accommodation, in which case you must disclose for the ADA to kick in.

Plenty of people with ADHD choose not to take medication though, and I'm having trouble coming up with a situation in which a judge would order you to take it. As long as you're not blaming your ADHD as a reason you broke the law (which you shouldn't, ADHDers may have poor impulse control and bad executive function, but we still need to hold ourselves accountable for our actions), I don't see where it's the law's business if you have it or don't, or medicate it or don't. There are plenty of non-medication coping strategies, including therapy and coaching.


Exceptional doesn't mean better.

Unusual strengths and unusual deficits are both exceptions to the norm.

One of the two "exceptions" is mental illness so

There are other axes by which to assess humans than "acheivement". There are even other axes for value! Someone can be "exceptional" along any of them.

Goal oriented self-directed behavior is what distinguishes us from apes.

Underachieving is just inability to deploy your efforts effectively, or even inability to muster an effort in the worst cases. That translates to every domain and aspect of human life from scholastic to social to friendships etc etc etc.

Value is not entirely subjective.

Life isn't deterministic.

I know literally no one who isn't quite lazy. My friends have no ADHD and they suck at time management, hate finishing projects and have a hard time focusing on boring shit.

Welcome. We call it, life.

Whenever I have more than 10 tabs open, I add all of them except the one I'm actually reading right now into a 'to read' bookmark. I have hundreds of such bookmarks and sometimes when I'm in the mood (ie. bored and distracted) I'll rummage through it.

> I just thought caffeine was my drug of choice. Everyone's addicted to something, right?

That's probably sugar, not caffeine. Sugar is a much stronger drug than caffeine. Try coffee, not red bull.

My parents followed the “ADHD is overdiagnosed these other kids just need discipline” script.

My brother as an adult was able to self diagnose and just try adderall(or was it ritalin) since even non-ADHD people get benefits concentrating with it, and yeah that worked out well for him, he doesnt continue using it and can approach professional work more holistically. I would attribute a lot of his academia challenges and underperformance to undiagnosed ADD/ADHD. Works great for the coked out party scene though. Got to swim in the right environment.

I dont have the above experience, but I did take an in person class at a college recently. Havent otherwise done formal education in almost a decade. The first couple of sessions I was fidgeting and couldnt stand sitting still, which was shocking to me but I got acclimated after that. I cant imagine what children are going through, I think our environment isnt helping

I'm long-diagnosed (and medicated) ADHD, but this article still went straight to the wife as a great way for her to see a little more into my head.

Quick question, and this is really for everyone else out there and although directed at you, it isn’t really about you.

How do you KNOW that adhd is “overdiagnosed?” Are you a clinical psychiatrist? Or a clinical researcher?

Probably not. You just saw some article written by a person who doesn’t specialize in the area. Who doesn’t have access to the full data, nor have any exposure to what’s REALLY going on out there.

You don’t know. You just think you know because you saw some Netflix documentary about teenagers selling adderall pills.

Remember selection bias: the narrative comes first and then we filter data to fit our idea of how the world “is.”

Nominally what this means is people avoid getting treatment that could make a real difference to their life.

ADHD is both overdiagnosed and underdiagnosed.


Sorry I don’t accept this as a legitimate reference.

Why not?

Because they're (neuro)typically annoying. :P

Practically speaking any disorder that impairs executive functioning and uses Schedule II drugs in treatment is going to be over diagnosed because of malingering by people who want the drugs and under diagnosed in the population of individuals with the disorder because of impaired executive functioning and self awareness.

Honestly I had/have many similar symptoms (of course there is more than can be written in a short comment) and was diagnosed and started medication over a year ago. It has been very positive for me. YMMV.

First thing to do... close those tabs. They are the enemy.

The human mind can only concentrate on a few things at a time even when "multitasking", and it cannot concentrate on anything else when working on a complex, concentration-oriented problem. Respect how your brain works, even if it goes against your ADD instincts. (Example, from a book on how thought works... you can concentrate on multiple things while driving, but you can't concentrate on multiple things while computing 57 x 432.61 in your head. There are two modes to thinking; one allows multitasking but limits complexity of individual tasks. The other allows deep complexity, but at the exclusion of thinking of anything else.

So those 52 tabs? If you try to think about all of them, you can't think about any of them in a meaningful way. Pushing things off your plate is the most fundamental defense mechanism the ADD mind can have. Have one tab open. Or two or three. Finish what you're doing before trying to do something else. Don't let the squirrel do the thinking for you. You can outthink the squirrel.

> > I was happiest with my nose in the book

> I'm seeing a disturbing pattern take shape.

I fall into alot of the list but I will say I do not suffer from ADHD.

When I was at school I was told I had ADHD and put on Ritalin. But I couldn't tell the difference between taking ritalin and not taking it, I didn't focus any better, didn't get in trouble any less.

I always figured I wasn't challenged enough in school, or wasn't doing something I enjoyed.

If I was doing technical drawing I always got top of the class and helped the other kids with their work. In History class we learned about NZ history which is like 150 years of nothing, so I couldn't focus, yet you give me a book about Egypt and I'm fascinated and sit for hours reading.

Fast forward many years and I watched: https://www.ted.com/talks/ken_robinson_says_schools_kill_cre...

ADHD is a real thing, but I recon majority of people 'diagnosed' with ADHD, don't actually suffer from it. And I don't believe the Author suffers from it.

My partner went to a Waldorf school grade 1 through 12, and whenever we discuss what school was like it blows my mind that she has no idea about just how horribly "regular" schools are at fostering creativity and interest. She has been diagnosed with ADHD as an adult because she has a REALLY hard time with handling everyday life, but for her school was never a problem because of the "fluid" philosophy of Waldorf.

While I like Sir Robinson's talk, for me The Seven-Lesson Schoolteacher is what really struck a cord: http://www.swaraj.org/multiversity/gatto_7lesson.htm. I always felt like the school system (in Sweden at least) mainly wanted to students to fit into it, rather than the other way around. So as someone who is gifted according to WISC and WAIS, but who lacks the executive functioning and skill to do anything except whatever happens to be the most interesting at the moment, it was just hell. Even now at age 36 my body goes stiff whenever someone mentions homework O_O

> And I don't believe the Author suffers from it.

The author was diagnosed after multiple sessions with a medical professional.

> The author was diagnosed after multiple sessions with a medical professional.

Yes, and we also know that medical professionals can also misdiagnose ADHD...

I don't think that you can or should try to armchair-diagnose or armchair-undiagnose someone with from a single blog post. You can't know what the author has struggled with in their life.

Haha! I have I think 800+ tabs open (not loaded) in firefox on my personal laptop, and who knows how many on my phone. This is with 27mg of Concerta and 40mg of Strattera every day. Caffeine's next to useless for me. I get a 15-45 minute energy burst on it in followed by a few hours of extreme drowsiness, which is usually not worth it.

I think maybe the best way to tell if you fall in this category is the subjective experiences. And like many things it can be a spectrum so you can have it to some degree.

I know for me, I went to my dream college and studied exactly what I wanted to study, yet I couldn’t keep up. I went from getting mostly As in high school to eventually failing out (later to return). I was under immense psychological stress and couldn’t get myself to do basic things. I was always overwhelmed. I couldn’t and still can’t be in social situations when loud music is nearby. I’ve essentially had to reshape my life to work around this. It made me nearly non-functional.

And years later, now that I’ve built my life in a way where it works with my ADD, I can be incredibly productive and imaginative and innovative.

>I currently have 52 open tabs on my laptop and another 37 open on my desktop.

What about the second desktop?

Hahaha. Just the two computers for me, plus maybe 1 tab open on my phone. Luckily, my phone isn't as addictive to me as it is for other people. I type at 120wpm and having to slow all the way down to 30wpm on a phone stabs me to my very soul.

My evernote and bookmarks are overflowing, though.

>I type at 120wpm and having to slow all the way down to 30wpm on a phone stabs me to my very soul.

I feel your pain. I hate typing on phones; feels so inefficient. It is definitely good to not have the 50 tabs problem mobile too.

> ...

wait, aren't we all like that?

Perhaps ADHD is a frequent misdiagnosis. They are not uncommon in medicine, which is really guesswork in white coats.

However, actual ADHD, and other similar attentional or executive function impairments are very likely to be under diagnosed BIG TIME.

Perhaps for some people ADHD is transitional, chronic - related to serious anxiety / pressure. I don't think everything is always 0 or 1

I was officially diagnosed at age 32. This wasn’t some pill mill diagnosis either. I worked with my psych for 3 months before we tried any meds, it would’ve been longer but I had accidentally discovered most of the practical methods for dealing with it on my own.

Two great reliefs came from the diagnosis:

1. I’m not a lazy, unmotivated person

2. Meds, at the right dose, are amazing. When my Vyvanse kicks in, it’s like walking away from an outdoor block party in my brain and getting into a sound proof booth where I can hear only the noise I want (or have) to.

Things I lived with my whole life that were both positive and negative depending on the circumstances:

- I can’t even stand the thought of a task, class, or activity I’m not interested in, but if I’m even slightly interested I can go deep fast and keep going with no loss of zeal until I’m satisfied. Basically, I can get super obsessed with stuff for short or long periods of time. My hobby background is ridiculously all over the place.

- I think and iterate my thoughts faster than most people can keep up, and I iterate my thoughts externally, if I’m on a roll good luck getting a word in between breaths. My psych “classified” me as a second order thinker and I run lots of what-if permutations and shave and shape creative solutions very fast. It also means I must be extremely cognizant of letting other be heard, especially those that like to ruminate on an idea and bring it to light more fully formed.

- My leg never stopped bouncing, helpful when I played music to keep time, annoying to anyone near me.

- I’m quick to temper and just as fast back to moving on.

- Little to no patience for bullshit or things I just am not interested in. Don’t tell me a detailed story of how to get there, just give me the highlights. I do t care about how you feel about some objective thing, just give me the facts and let’s keep moving.

Lots of other stuff, but basically I coped, unknowingly by creating rituals that allowed me to not forget or have to waste time finding things:

- Get home, keys and wallet go in the exact same place every time

- Todo list for next week created at the end of every Friday, revised at the end of every week day, and reviewed every morning

- The thing I want to do least is the thing I force myself to do first, and nothing else until it’s done

- Organize my schedule in a calendar, if it’s not in there it doesn’t exist and I won’t remember

- Just remembered to put that thing in the car for tomorrow and I’m laying in bed? Get up RIGHT NOW and go do it.

- Can’t forget your coat if your car keys are always in them

- My working area is spotless. No bobble heads on the desk or stacks of papers. Desk is completely clear, cables neatly organized, zip tied, and hidden.

Here’s the thing, maybe you do have ADHD. Maybe you don’t. The rituals you focus on and make so habitual you don’t even have to think about them will still work for you.

I have suspected for years that I may have ADHD, and the thread is slowly confirming my suspicions. (ofc, it can only truly be confirmed by an authorized professional)

1. Lazy - CHECK

2. can’t even stand the thought of a task, class, or activity I’m not interested - CHECK

3. My hobby background is ridiculously all over the place - CHECK

4. My leg never stopped bouncing, helpful when I played music to keep time - CHECK. Literally air double-bass drumming to some really high tempo progmetal as I type this.

5. I’m quick to temper and just as fast back to moving on. - 1st NEGATIVE

6. Don’t tell me a detailed story of how to get there, just give me the highlights - 2nd NEGATIVE

7. I'll take a break to read an article and hours will go by before I realize what's happened - CHECK

8. I'm horrible at completing simple, repetitive tasks. I'm terrible at time management - CHECK

9. Lost hours / while day at a time when I was doing something interesting - CHECK

10. creating rituals - Literally follow 90% of the rituals you already mentioned.

At this point if I was diagnosed with ADHD, I don't know if I'd be annoyed or relieved at the revelation.

> can’t even stand the thought of a task, class, or activity I’m not interested

But who is?

This is one of the problems in modern society, the concept that if you're not interested in something then you can skip it and find a medical excuse.

No-one ( generalising ) likes doing tax returns or washing dishes, but you need to look beyond the immediate discomfort to the longer-term benefits. That is self-discipline, not some magical superpower.

> but you need to look beyond the immediate discomfort to the longer-term benefits. That is self-discipline, not some magical superpower.

And that is _exactly_ what someone with ADHD struggles with. Long term consequences be damned, I want something that excites me and gives me a benefit _now_.

A real hard problem here is distinguishing between a lack of discipline and ADHD. Maybe that's kind of unknowable.

Exactly. Thus, the discussion about the stigma around it.

Nope it really was a problem.

My brain wanders off to the point of literally not being able to pay attention. To the point, that I would routinely get barely passing grades in a boring course but ace interesting courses. Very few other students had that level of variance in their grades.

I also just can't do anything that has to do with data entry. I start, and in 2 minutes I realize the number are all wrong. I get double vision on the screen and am either yawning/daydreaming/thinking of the interesting things within that small time.

Ive been on vyvanse for 9 years and im warning you that it will eventually stop working and the side effects will get worse than the cure

Vyvanse specifically or all the various forms of amphetamine that are used to treat ADHD (e.g., Ritalin, Adderall, Concerta, ...)?

I believe it has to do with vyvanse and the enzymes required to break it down. I suspect its taxing on the liver and eventually it cant make the required amount of enzymes to activate it

So, work with your psychiatrist or GP and try something else. Vyvanse is not the only option. Even stimulants are not your only options.

At some point, you just can't fix it with more amphetamine because the side effects become stronger than the desired effect. See the post below for more info.

Define “eventually”. What’s your dosage history, etc? Do you take magnesium, zinc, or anything else to combat tolerance?

The main issue is that tolerance to all the effects of the drug doesn't increase uniformly. Originally I was on 70mg for about 5 years but started to notice that it wouldn't last the whole day anymore. My doctor gave me a booster which worked well for about a year but slowly I started to realize that the side effects were becoming worse than the desired effects.

My main issue was that originally it gave me a calm and relaxing feeling but over time I began to feel more an more anxiety. I'm not normally an anxious person, and the first time I an anxiety attack I thought I was having a heart attack and went to the ER. Magnesium, L-tyrosine, and good sleep can help but eventually, it would just make me feel jittery and unfocused. The anxiety also caused me to subconsciously swallow air and combined with the increased water I would drink it started to cause me stomach issues. I suspect the excess water diluted my stomach acid causing my stomach to make more. The swallowed air put pressure on my esophagus and eventually, I developed a hiatal hernia. This allowed my stomach acid to start damaging my esophagus and would result in constant burping / GERD.

The worst part is that the GERD was anxiety induced and things like Tums or even Zantac or Nexium did nothing. The only thing that worked was Xanax. However, Xanax is an incredibly powerful drug that can cause bizarre behavior because sometimes you speak without a normal filter. I didn't like the concept of having to take another powerful drug to counter the side effects of the first powerful drug, nor was I comfortable with medication effecting my personality. Furthermore, because of the stomach issues, I began to feel like I needed to make a change because it wasn't sustainable. I began a regiment to taper off by reducing the dosage and stopped taking it daily.

It wasn't as bad as I thought because what I realized is that the original effect that helped me just didn't work anymore and I really hadn't felt it in a long time. In many ways, that slow reduction of effect over time trained me to be able to do work without it. By the end, I was more productive without it because I wouldn't have the stomach/anxiety issues. Furthermore, my sleep has never been better.

Would a holiday have helped? If you went somewhere else you didn't need the help, and stopped taking it for two weeks would the tolerance have dropped to the point where it didn't cause issues?

> The thing I want to do least is the thing I force myself to do first, and nothing else until it’s done

That can end really badly; I'm glad it's worked out for you.

It was the same for me... except my tab counter is at 1399 and rising.

I should probably see a psychologist someday.

I thought I was up there with 430. Clearly, I still have some way to go.

I reached 5000 a few times... I also have 10000 links in Pocket.

My browser tends to crash at around 1000.

I just thought "tick!" an uncomfortable number of times in a row while reading that. Gonna go get a coffee.

> ADHD's over diagnosed


No source. It's stream of thought. That's literally what was going through my mind when I read the title. I have no idea if it's true or if I just read a clickbait headline once and it stuck in my head.

...yeah, that happened.

I were in ADHD tests but I was told I may just have "small_brain_clipboard", never heard anything back..


An ADHD diagnosis is based roughly on a 5-percentile standard[0]. In other words, if you are a hardworking, industrious person, but the rest of society is harder-working and more industrious, then you automatically become ADHD-diagnosed by virtue of being on the left side of the bell curve.

It's also worth noting that in France, ADHD is seen as a problem with a child's environment instead of a medical issue[1].

[0] https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...

[1] https://www.psychologytoday.com/us/blog/suffer-the-children/...

France also generally views autism this way and fails to diagnose and properly treat autistic children. It’s a huge problem and probably ruins many families and children’s lives. I would not be surprised if in a couple decades we are talking about the “shame” of France’s approach to ADHD as well.




Almost all "normal" levels on your bloodwork and all other tests are essentially 2 standard deviation cut offs.

Context and history is just as important.

Okay, I start with a disclaimer, I suspect this opinion to be unpopular on HN. Anyway, I can't help thinking that ADHD is one of those mental disorders that merely reflects some increased demands of society rather than a genuine mental disorder and that people with ADHD are just part of the natural variation of different personality types.

There also seems to be a huge divide between the US and Europe, where such disorders seem to be diagnosed way less often. It has always appeared to me that many people in the US are more easily considered mentally ill when they do not fully conform to society's expectations, and at the same time the people who suffer from severe mentally illness are less cared for in the US than in Europe. Or maybe that's just how the media portray it.

As someone who struggled for 32 years before I was diagnosed - you don't know what you're talking about.

I have been to multiple (European) therapists who had just your approach and had no idea about ADHD. For years.

In the end, I knew all the techniques for getting things in order, just couldn't follow up on them, and wasted tremendous amounts of my life trying to do things. (Not to mention gaining ~30kg, because I instinctively ate a ton of sugar - which has a similar dopamine-inducing effects to Ritalin, just with calories and not as long-lasting)

After taking one pill I was able to finally get myself together.

And to give a seeming counterexample that only reinforces your point: I was also diagnosed with adult ADD in recent years. At first the meds seemed to help slightly. Then not so much, and the side-effects (lack of sleep, for example) actually made it worse at times.

Now after a lot of trial and error it appears that I might have been (partially) misdiagnosed. The cause of my issues may stem more from Complex PTSD, which has a lot of overlapping symptoms. Processing the source of that has given me a lot more relief from the ADHD symptoms than the medication ever did.

But even so, the only reason my mental health issues have seen any kind of progress at all was because I started taking them seriously, found people who supported me in that, and with therapists started trying things out and re-evaluating as we went along. What definitely did not help was telling myself "nah, I don't have ADHD. I don't want to be one of those people who hides behind that excuse and is medicated for the rest of his life" for years.

I'm happy that the Ritalin works for you, and I'm happy that I'm making my own progress. In both cases the solutions were only found due to not being dismissive about mental health issues being real illnesses.

Can confirm the above. I'm greatful for my diagnosis and the medicines that exist. Also, there is close to zero stigma surrounding AD(H)D and related medication in my personal and professional circles. I was diagnosed at age 21, and I would have benefited immensely from a more timely diagnosis. Medication (Concerta) allowed me to take charge of my life. Instead of being swamped by endless impulses and their echoes, I had a say in the matter of what I wanted to do. Imagine continuously sinking into yourself with no predictable way to resurface. Buoyancy is a nice thing to have, and taken for granted by those who don't know better.

> swamped by endless impulses and their echoes

Thank you.

Same age, same situation, same location, still they are not able to diagnose me. Trying to solve with moda

Diagnosed at 6 with ADHD in the US by a proper battery of psychiatrists, therapists, etc. Medicated until 17. Still going to therapy regularly in the EU to deal with a myriad of ongoing issues as ADHD has changed how it impacts my life into adulthood. I am a "textbook" case.

So basically the reality of my life is not subject to your opinions. Stop projecting your value system onto other people's lives.

> Stop projecting your value system onto other people's lives.

There really is no need for snarky replies like that, as I haven't even remotely talked about value systems in any conceivable way. Whether someone has a mental disorder or not does not depend on any "value system" -- or, at least, it should not, provided that there is real science behind the diagnosis. I made the remark because my father used to work as a professor of psychology and I had many discussions about such topics in the past, including the complexity of diagnosis in the field and the difficulty of classifying mental disorders, and how these classifications have changed over time and vary from country to country (for example "koro"). So I'm generally interested in the topic and know that many theories in psychology are highly problematic; some of them, such as C.G. Jung's archetypes, are even decidedly unscientific. The aim was certainly not to look down on other people or impose a value system.

Even if I have, in your opinion, indirectly insinuated that you might not have a mental disorder (which wasn't my intention), I really can't see why anyone would be offended by that.

I'm sorry to hear that but just because someone diagnosed you at 6 doesn't mean I believe it's right to medicate a child that early.

If you could do it all over again, would you have waited until you were grown before you took medication?

You don't know how hard it is, as a parent, to make the call to medicate your six year old child.

Here are some of the things that went through my own mind:

- Maybe he'll outgrow it (he's fairly severe ADHD, but we went through a long process of hoping that it was just a maturity-level thing)

- Paper after article after paper sent by well-meaning family members about how ADHD is over-diagnosed. Doubt.

- Side-effects (obviously, first thing every parent thinks about)? How severe will they be in my child?

- Ritalin + suicide [0].

- If we medicate him at six, _will he ever learn the tools to manage ADHD without meds_? He'll potentially spend his entire childhood on meds.

- If we don't medicate him, and he's consistently labelled a 'problem child' in his class, how will that affect his self-esteem as he grows up? How will it affect his feelings about school and work?

- If we don't medicate him, and he struggles and falls behind his classmates in his schoolwork (which, even in Grade 1, he was - significantly), are we holding him back? He's a super smart kid, he just can't focus.

- If we medicate him, and it doesn't work (we have to try multiple meds), how will it affect his self-esteem to be constantly visiting psychiatrists, pediatricians, etc. A thing I've noticed: doctors have zero problems talking overly-candidly in front of my kid about his failings, as though he's not there.

- We were literally told by a doctor that once you get on the medication train, 99% of parents don't get off until at least mid-high school. Am I comfortable with that?

After that long thought process (and so much more), we put him on medication. We're going very slowly in ramping up the dosage, but he's already caught up to his classmates in school, and he seems happier. I don't know if we've done the right thing, but I do know: it's not as clear-cut right/wrong as you make it out to be.

[0]: http://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc...

I would have preferred to be medicated with 6 rather than 14, which is when I started medication for ADHD.

I wouldn’t have flunked half as many classes, nor taken 15 years to get into my career of choice, had I been diagnosed and treated at 6, and not 36.

>So basically the reality of my life is not subject to your opinions. Stop projecting your value system onto other people's lives.

how ironic


Unnecessarily hostile? No. People who have to constantly deal with a difficulty other people don't have, while those people completely unoriginally reflect the same doubt that's been repeated over and over again, can make frustrated comments in a thread on the topic without being characterized as hostile.

It is a calmly stated ignorant opinion.

Imagine living with a diabetes, or some other invisible issue that affects your life, and having to hear such calm opinions all the time from people around you. Telling you that your issue is not real (so - de facto - you're imagining it).

To give perhaps a slightly more nuanced take on this comment, and without the pointlessly provocative "suspect this opinion to be unpopular": when a mental "disorder" is diagnosed one of the key criteria is usually that it is causing distress. What I think this commenter is trying to get at is that the current structure of society could be causing this distress to a personality type that previously wouldn't have done so.

I have many of the traits in the article, and find some of them weigh very heavily. I think one of the reasons for that is that I'm easily distracted, and computers are terrible for people like me because I'm just a couple of clicks away from watching an effectively infinite collection of sports highlights, reading newspapers, looking at photos, cat videos on YouTube etc. etc. A concrete example is writing this comment when I really should have my head down in a project that I'm working on.

I think I would be much happier in a job where smartphones and computers aren't involved, like working on a nature reserve. I can't make that change quickly - I run a small business with a couple of colleagues and support a family - but I'm starting to turn the tanker towards a life like that because the effort involved in managing the bureaucracy of contemporary life takes a lot out of me. And I've actually got it pretty easy in terms of flexibility and pay, like many of us on HN.

It's rather like a milder version of RD Laing's idea that it's not people who are mentally ill, but society that's ill. I think that's taking it way too far, and there are obviously people who have extreme versions of personality types who would be distressed no matter what the circumstances - but the point stands that our psychology hasn't evolved to withstand the pummelling that it gets from the attention economy.

This measured response to the GP is better than other "You're wrong" comments below.

I've never been diagnosed with ADHD (I'm in Europe), but I'm absolutely certain I have it from all of the reading I've done on it in the past (and I recognise everything from the blog). I totally get what the GP is trying to say, and you captured it with:

> the current structure of society could be causing this distress to a personality type that previously wouldn't have done so

I have often felt like the standard world of work didn't work for me, or things that others do, like make a plan of things to-do just doesn't work for me. There are other issues that come from this also, which is working late into the evening to avoid distractions, which leads to poor time management in general, that again doesn't fit into the modern world.

I'm now a CTO of a successful software company - and interestingly what that's given me is the chance to create a way of working that works for me. I work sporadically, but when I do I blitz it (hyperfocus) and can get months of work done in days. I have surrounded myself with a collection of super smart people, but also a range of organised and disorganised. To allow the organisation to deliver, but also to allow for the benefits of the hyperfocus, which for us have lead to the big and major pieces of tech which sets us apart from our competitors.

This is obviously anecdotal, but it adds some credence to the GPs point.

I'm still sat in my house most evenings promising myself I'll do some cleaning at some point (amongst other things), and never do. I'm going to take the advice from the blog and try Todoist to see if that can motivate me to get stuff done.

I see comments here about how ADHD is related to Autism. Perhaps it is, but I wonder if it's more similar to bipolar light. It seems the hyperfocus is like mania and the endless distractions and the lack of motivation for menial tasks is like a sort of depression. I may be way off - and may be putting my foot in my mouth and offending sufferers of bipolar (which if so, I apologise), but that's how it sometimes feels to me.

What you've written feels very familiar. It became clear early on to me that I wouldn't be able to fit into standard models of what "work" is, and running my own company was the way I found to make a living without feeling utterly miserable.

In terms of organisation I have a system that's like a low-tech version of Todoist. I have these text files on my desktop set up to sync through Dropbox so I can access them on my phone too:

today.txt - Tasks specifically for today so I don't get distracted by other, later tasks.

week.txt - A list of the next seven days with specified tasks in each. If there's something that comes in which I don't need to do today, but will need to at some point relatively soon, I put it somewhere this file. At the beginning of each day I move tasks for that day into today.txt and move the day header to the bottom of this file.

later.txt - Non-urgent tasks that I look at once in a while, and move things into week.txt if I have time.

current.txt - A simple list of projects that I'm currently working on.

I have various others, and use a calendar app for meetings etc, but I've found that structure to work well. I actually find apps like Todoist more distracting than they're worth sometimes, because I get caught up in configuring and reconfiguring them, adding tags to tasks etc. Plain text fulfills my need for simplicity and clarity.

That's interesting, thanks for sharing. If Todoist doesn't work out, I'll try something like that.

>> Perhaps it is, but I wonder if it's more similar to bipolar light. ... I may be way off - and may be putting my foot in my mouth and offending sufferers of bipolar (which if so, I apologise), but that's how it sometimes feels to me.

As someone with bipolar, this isn't offensive at all. It is a condition that can present very differently, as personally my manic symptoms are more severe than depressive, but much of what people describe is very similar to the milder bipolar symptoms. Ive actually been reading this thread closely looking for additional coping strategies, and will likely check out some of the to do-list apps recommended.

There are some things that are wildly different, and severe mania is very different, almost presenting more like anxiety than adhd, but the milder manic symptoms are definitely similar.

Even if ADHD were part of the natural variation of different personality types, or if it were only manifested as a disorder in modern society, that would not be mutually exclusive with it being a genuine neurodevelopmental (not mental) disorder.

Whether the behaviours and feelings that we define as ADHD are natural or not has no bearing on the fact that people who present them can be very adversely affected as individuals. Good health is best defined in terms of adaptation to one's environment; if modern society has been built by and for the 90-95% of humans with no ADHD symptoms and that has a detrimental effect on the 5-10% of those who we define as having ADHD, then it is a legitimate and genuine disorder.

We can theorise all we want about the evolutionary origins of ADHD or whether a different society might ameliorate or eliminate the symptoms of the disorder, but people with ADHD who are born today into this society deserve the chance to live a healthy and productive life like anyone else. The fact that certain medications and therapeutic interventions are so demonstrably effective at improving the quality of life for people with ADHD means that refusing to recognise it as a genuine disorder is actively damaging to them.

> The fact that certain medications and therapeutic interventions are so demonstrably effective at improving the quality of life for people with ADHD means that refusing to recognise it as a genuine disorder is actively damaging to them.

Or perhaps those drugs and treatments might also provide benefits to "normal" people. The true damage being that normal people are unable take advantage of them.

I echo this, but also that point that it's "demonstrably effective" doesn't invalidate the original poster's point, which is that perhaps it's a normal personality trait that doesn't fit with the modern world. The medication might put you 'back in your box' so you can interact with the modern world more effectively, but it doesn't mean the trait is in itself abnormal.

Many people not ”suffering” is of this opinion.

The quotes around “suffering” imply that you yourself might not even know everyone around you suffers, i.e. you’re suffering by proxy, but you’re the one causing it.

Everyone can relate to specific “symptoms” of ADD/ADHD, the question is: can you control the impulses and is it affecting your ability to lead a “normal” life.

Normal here means looking after yourself and potentially other members of your family.

Honestly, in a way it’s like being in a state of arrested development. Staying a child and having your brain work against you in progressing.

Things that for many is effortless takes a huge amount of energy and leave you drained for the rest of the day.

In a way I’d like to say it’s about growing the hell up, only it doesn’t happen by itself like it should. One might need to retort to assistance, be it medical or mental excercises.

In a way I agree with what you’re saying, there are nuances to it though.

I agree and feel the same about many mental illnesses or traits (intelligence in that regard seems close to attention span).

In the end, some with higher impulses and inner trouble still manage to have more control and lead a successful life when others with little disabilities are overwhelmed.

What awes me the most is how one can be willing to mess with his brain chemistry with drugs rather than arrange one's life around his traits. There are so many tools now that I can't accept "forgetting appointments" is a disability necessiting drugs.

I am not certain as to why you feel the need to ponder about the reasoning someone else might choose to take medication to alleviate issues in their life. In what way is it harmful to your life that others choose to use medication that you don't?

Psychology/Psychiatry is derided on HN frequently and any time a submission comes up about ADHD or any other mental illness, inevitably people will chime in about how they feel about medicating children or that people just need to make lifestyle changes.

Why is it awe inspiring that someone might use drugs to help alleviate what they see in themselves as a deficiency? Are painkillers taboo as well? Anesthesia for surgery? Coffee or Tea? These all affect the brain chemistry but perhaps they're on your approved list of ways in which drugs are allowed to interact with people's brains?

ADHD can not be fully encompassed with the idea that it's simply unorganized people that forget appointments. You are correct that there are strategies that people can employ to tackle that particular issue. You are incorrect in separating drugs away from other tools.

You are not required to take medication for your ailments or explore recreational drugs. You can choose to eschew all these things in your life. You don't need to denigrate people that choose a different path from you, though.

Constant modification of your behavior seems like a bad idea to me. Coffee probably can be used like that I guess, I don't drink any.

I've tried a handful of recreational drugs and that created that opinion actually. I messed with my brain enough to prefer my own identity I guess. Also enabled me to understand why my schizophrenic friend ended up chosing suicide over heavy medication under which you are barely yourself anymore. Guess I'm amazed that one would prefer his artificial self, especially over petty details that can be strategized for.

It's easy to think this, as is thinking people with depression just need to pick themselves up. If you've lived with someone that actually has ADHD you'll have another opinion.

There is obvious over-diagnosis with ADHD (and related) conditions. Every parent knows that. I don't think it's an "opinion" at this point. I can factually get all my kids diagnosed with ADHD if I choose to. The first victims of the situation are kids with "actual ADHD", whose problems are trivialized.

> Every parent knows that.

"Every X knows" is usually sign of agreeing on a conclusion based on gut feelings and without verifying if the arguments leading up to them hold water.

Is it so in this case? What it "usually" means seems irrelevant. Have you been through a diagnosis with your kids?

I think you fail to realize that the burden of proof is not on me here.

The burden of proof falls on the one making the non trivial claim. I don’t need to prove the null hypothesis.

Wait, what, I'm not the GP, but:

Which claim are you referring to here?

1. Your unsubstantiated claim of ADHD being overdiagnosed

2. GP's unsubstantiated claim of "Every X knows Y"

The null hypothesis must be "ADHD diagnostic criteria has high specificity", because without that it's not diagnosis. What evidence do you have to demonstrate low specificity?


It is estimated by psychologists who specialize in ADHD that 5% of the population has ADHD. 4% of children are diagnosed with ADHD. 2% of adults are diagnosed with ADHD.

That smells a lot more like under-diagnosis.

FWIW, I think most American's know that it's easy to get a doctor to give you just about any drug without much proof of needing it. if you go to the right doctors, you are pretty much just paying them to write a prescription, not for the visit.

There is also an issue of under-diagnosis in adults and young girls.

This in part (girls and women) begs the question whether this is a case of the old healthcare gender bias.

I personally think definitely there’s something to it.

What is now called ADHD or ADD, has been observed and commented on in medical literature since the 1800s. It is well researched and understood by those who study it, but it is commonly misunderstood even by practitioners who don't understand it.

The main problem is in the name. People fixate on the attention deficit aspect of the impairment because it's right there in the name, however an attention deficit is simply one of a number of symptoms that are caused by ADHD.

ADHD is a developmental disorder that results in a generalized impairment of ALL executive functions. This includes the ability to purposefully direct attention, to modulate emotions, and to perceive the passage of time. It also impairs ones ability to hold an inner monologue, or 'voice'.

There are also other psychological illnesses that may present as "co-morbidity" with ADHD because of the detrimental effects of ADHD on ones quality of life, such as depression.

It is know that the disorder has an unusually high correlation to heredity, and no environmental causes (save one virus which may causes a similar executive function impairment). It is absolutely clear that it is an inherited disorder. It is not caused by modern society and constant interruption.

I would get behind that. I was diagnosed just over two months ago and the things that have been hard for me is remembering appointments, getting around to doing chores (such as paying bills and cleaning), and managing university studies (too much other stuff to learn everywhere =/ ).

I got suggested to get tested after failing out for the second time and the testing showed very much lower than average sustained attention. I never myself thought about getting tested since I did really well at a lot of tasks and just couldn't figure out how to micromanage all the weird administrative tasks of every day life. If I didn't have to do those everything would be going amazing, but instead it's sunk me into (small) debt and a period of homelessness a few years back.

I think a lot of people in the EU (where I am) would have gotten diagnosed if tested, but we seldom test school age children who don't have a very hard time in school. If you do somewhat ok or manage it seems odds are you can go undiagnosed forever.

The criteria in the EU are also much more strict (and "outdated") because we generally use ICD-10 still, whereas the US used the DSM.

Thats true. Also there must be documented start in childhood.

Depends. I was diagnosed independently in EU (Poland) and in US (California) at the age of 32. They didn't need a paper documentation, just asked about my childhood.

Ok. In Sweden I had a lot of trouble since my parents refused to cooperate (friends of scientologists, don't 'believe in diagnoses'), but I eventually got my living grandparent to help as much as he could after about a year.

I think you hit the hammer on the nail. If you look at how obsessed HN/Silicon Valley is with improving performance, nootropics, etc, this falls right in line, and hits that niche.

Half this thread is people saying, omg I just thought I was lazy, I guess I should start taking doctor prescribed amphetamines now.

There is a theory that what we consider ADHD might have naturally evolved, because it would give an evolutionary advantage for hunter-gatherers.[0] Life in the modern era is different from hunter-gatherer lifestyle and thus people with ADHD find it difficult to fit in.

I don't know how true this theory is. There is some evidence for it, because ADHD is very prevalent, but at the end of the day it doesn't matter why people struggle. What matters is that they do and we have the tools to help with that.

A big reason for the divide between Europe and the US in ADHD is that Europe usually uses the ICD, while the US uses the DSM. The DSM seems to be less strict about the criteria. It's probably also the case that many Europeans, particularly in former Soviet states were never tested.

[0] https://en.wikipedia.org/wiki/Hunter_vs._farmer_hypothesis

I feel that the general attitude in the US to people slightly outside the norm is "you have a disorder, go take pills". In Europe it's "you are less intelligent, go to an easier school and then do manual labor".

Both are terrible solutions in their own ways.

That is NOT the approach in Europe at all... Maybe in one or two countries, but not in Europe as a whole.

When I was a child (80s in the Netherlands) it was definitely the case.

It is the approach in Spain at least, where I live.

Can't say I saw that, growing up in a European country.

Its unpopular because it is wrong.

The brains of someone with ADHD (assuming correct diagnosis) are different from NTs, akin to people with autism.

AFAIK the latest scientific research points at that ADHD is just one of the many variants on the autism gene. But I don't have a source at hand right now, so grain + salt.

Yeah, I’ve always felt it resembles a form of autism.

With ADD I score awfully high on the spectrum...

10 years before I finally got my ASD diagnosis I did not get an official AD(H)D diagnosis, but I did get Ritalin prescribed off the record. And it helped (though the coming down and instability between the high's was awful).

In case you remember any of these sources, I'd love to read more...

My sources are people (at least 2) whom I know IRL, who work with people with autism one way or another (which is group I'm part of).

FWIW, here are some sources I found with a quick DDGing:

1) https://www.hearingsol.com/articles/adhd-and-autism/

2) https://www.spectrumnews.org/news/large-set-brain-scans-reve...

ADHD is not part of normal variation and it's not based in personality. It's a condition chiefly caused by distinct biological differences in dopamine transporter function. ADHD's effects are in executive function: memory, attention, inhibition. Granted there are some personality traits associated with it, but those are secondary. That said, personality and presence of other conditions likely has some effect on who is diagnosed / misdiagnosed.

As for whether ADHD is disordered, there is evidence that it was a positive adaption in more primordial settings. Greater distractability may have equated to faster response to predators or more success in hunting. However, to be a disorder, a condition simply needs to be presently maladaptive. In modern society, ADHD typically is.

ADHD is the realest mental disorder out there. It has well defined medical symptoms, diagnosis criteria, and clinical treatment is more effective than with depression.

Saying “oh mayyyybe ADHD isn’t real” makes no sense unless you believe all mental disorders are fake.

Source? Claiming it's the realest mental disorder is a bold claim.

According to Stanford's sleep clinic something like 25% of people diagnosed with ADD/ADHD actually have narcolepsy. A real disease has an objective test of some kind while an ADD/ADHD diagnosis is entirely subjective.

(Initially wrote a much angrier reply cuz I was so pissed off)

Even with physical diseases there are often misdiagnoses and genera oversights.

There’s definitely a social aspect to certain kinds of misdiagnoses, but medicine is not obvious in some contexts. The human body is pretty complex!

It's not just about performace. Dealing with emotional stress will become very had if you keep overthinking it and can cause serious issues. ADHD medication can really help in those situations.

As someone who has ADD, I agree. I’ve been reading the biography of Leonardo DaVinci and the author mentioned if he was alive today, he would most likely have been medicated for ADHD and mood swings.

I think things like diet, food additives, busy society, and work demands make it impossible for people like us to function well.

I know for me at least, I live a pretty unconventional life so I can thrive in my own way. I’m often up very late. I’ll obsessively work on something and neglect others. I’ll be late to things. I can’t do big social environments and I definitely can not handle stuff like night clubs. I need a lot of alone time to sift through all of the data that has bombarded me. It’s taken me years to figure out. But as I craft my life to work with my oddities, I become happier, healthier, and more productive.

I think for me, a better description than mental illness is “neurodivergent.” Because if I build my life in my own unconventional way, I might be able to thrive. And then when I get put in situations that don’t work for me, I become textbook mental illness.

My mom was diagnosed with adhd when she was an adult. She grew up in a strict southern household, and grew up before smartphones or the internet. She has always struggled with attention problems and distractions. Environment may make someone more likely to develop adhd, but there are people who have adhd just because of genetics.

No. I think that it’s a condition that isn’t yet treated effectively and perhaps shouldn’t treated as much as it is in adolescence in the US, but it’s a very real condition with very real effects on work, relationships - everything that you do.

>I can't help thinking that ADHD is one of those mental disorders that merely reflects some increased demands of society rather than a genuine mental disorder

There's physiological differences in the brain though


Of course there are. You can’t chain a brain without doing so physically. The comment you’re replying to is positing the cause of said changes.

You are correct, after re-reading the comment I can see that I misinterpreted the comment as meaning something along the lines of "ADHD people are really just lazy and want special accommodations", which was hasty and cynical on my part.

In your view, what defines a genuine mental disorder?

Probably something like schizophrenia and dementia, something that's more visible and immediate and evokes an oh-this-guy-is-crazy! reaction.

Seems like the OP thinks ADHD and ADD is more akin to personality disorders, which is much fuzzier and is hard to tell if it's a disorder or a 'disorder'.

What is the difference between a disorder and a 'disorder' in that case? When is a disorder really a 'disorder'?

I tend to see classification and diagnosis as a pragmatic means to an end. The important part of defining a personality disorder or a mental disorder in general is to nail down a set of characteristics to effectively diagnose people that suffer from similar conditions and give them access to treatment and advice that may help them relieve the impairment and distress it's causing.

Classification on this level should be largely unconcerned with whether the disorder represents some sort of fundamental deficiency of the brain or some rare personality trait that only becomes a problem due to a failure of society and social expectations. Not because social change to accommodate atypical personalities isn't desirable, but because it doesn't immediately help the diagnosed cope with the conditions they have to deal with in the present.

Because of this, the disorder-'disorder' dichotomy seems wholly useless to me, at least without a clear definitional basis.

I have zero doubts about autism, depression, borderline syndroms, and severe cases of schizophrenia.

Definition by example would have to be exhaustive to answer my question.

No. ADHD is a lack of bandwidth on the mesocortical pathway. It's like a backbone link between the ventral tegmental area and the prefrontal cortex.

In the US it's extremely popular to give your kids speed if you're a bad parent so it's overdiagnosed. I will agree that it's more of a natural variation than a dysfunction. I don't really understand the details but I've heard smart sounding people comment that something or another about it's genetics implies that there is probably a net benefit to society or it would have been bred out by now.

Private vs socialised healthcare could have a big effect on diagnoses. When patients can just keep going to doctors until they get the diagnosis they want, doctors that more readily make a diagnosis will make more money.

With socialised healthcare the doctors have enough traffic to not need more clients usually. I don't think I've met a doctor in Poland (even paying out of pocket) who wanted me to come more often than absolutely necessary.

Sorry, should have made this clearer. I mean private healthcare leads to more diagnoses. In socialised healthcare the doctors have no financial incentive. Hence the original comment saying that diagnoses are less common in Europe.

Your correcct. Not the fault of the author, so I still like the article. But I think you are correct.

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