Years ago, when I was a phd student, I had been to the psychologist at the university health center because I was unable to concentrate on anything. I had filled the ADHD diagnosis survey they gave me beforehand, and I was convinced I had ADHD. The psychologist discarded the survey and focused on a personal problem I had that time (my dad has been in a very bad accident). She told me there is nothing wrong with me, except that I was having a bad time. Her evidence was that I had a brilliant academic record (best student researcher, my GPA was not that good though). After all, when I am really interested in something I could concentrate very intensely for a couple of hours on that thing. She asked me if I would like to have some help with time management and organization techniques. I told her that I had read so many books on that, that I could give a seminar on it myself.
I was actually very relieved with her diagnosis, because, well, it sounded good, and I dislike the idea of medicating myself. But my problems came back frequently to haunt me. There have been numerous days when I couldn't get myself to do a simple task such as paying bills (just the physical act of writing checks and mailing). It sounds weird, but when I have many things to do, my brain shuts off and reacts by refusing to do anything at all. I know about getting things done and every conceivable productivity technique, but I never can get myself to put these in practice. I am very disorganized, and this costs me a lot. I am doing considerably good in my academic career, but doing awful in taking care of trivia.
I always took pride in doing OK without having to take any medication, but I guess I could do much better with medication. It hurts sometimes to endure these symptoms, but I have been able to carry on so far, so good. I don't know, after reading this article, I think maybe I should be seeing a psyciatrist this time, and get a second opinion.
I think the "paying the bills" thing is pretty normal, at least within a certain class of folks. And it's something you can learn to work with.
I have all of my bills auto-paid. I've learned from experience -- having the power cut off, the phone cut off, the internet cut off -- that it just works better that way. I've never had a shortage of cash, but sometimes even opening the envelope with the bill inside seems oddly intimidating.
But again, you can work with that. Now everything is auto-paid; I don't even bother to open the bills. Nothing gets cut off anymore. I still get the odd annoying thing to deal with, and I've tried to get in the habbit of when there's something that I catch myself ignoring to open it immediately. I've also become a huge user of to-do tracking and set deadlines for myself -- having my daily checklist with past due things staring back at me in red works wonders. Everything goes in there. Mails to family, mails I need to respond to for business stuff (I have a hot key that creates a to-do list with a 24 hour deadline to answering a mail), stuff that needs to get done for a next release. It helps immensely.
These patterns are far too normal, especially among gifted folk for me to be willing to call them an illness and my feeling is that medicating people for these things represses some of the responsibility to build coping mechanisms that people have traditionally used to deal with this sort of thing since time immemorial. They also change your personality. If I weren't so restless when doing stuff I find boring, maybe I wouldn't have done as many interesting things? Maybe I'd still be working in a standard 9-to-5?
Surely there were smart people that had to overcome difficulty focusing before the intervention of amphetamines.
Yes, I have to second this. Almost 50% of adults diagnosed with ADD have a substance abuse problem by the time they get help for it, and something like 30% have major depressive disorder.
If you don't get actual medical help, there's a very good chance you will slip into either self-medication or major depression or both in the long run. Been there, done that, lost years of my life in the process. Learn from my life, please.
A friend of mine got perfect math SATs at 12 and started taking college math at 13. He never got past freshman year to graduate, just jumped from school to school repeating freshman year, dropping in and out of college. I think he had trouble with anything that required long-term logical reasoning that could not be done in 1 shot.
He constantly rocked back and forth and could never sit still, even into his 20s. His eyes always darted back and forth when talking with people. I don't know what he's doing now -- he seemed to be overclocked with very little cache and ram. Wonder what became of him.
For high level abstract, symbolic reasoning, low cache and ram is a critical impairment. At that level SAT math really means nothing. In fact, college math at 13 doesn't even seem that impressive -- I believe after Kumon level J you get into calculus and plenty of grade-school kids take this.
It could have been a genuine problem for him, but even with the best drugs, I wouldn't expect some kind of "unlocking your potential" moment.
I remember reading a study that found the biggest difference between high-performers and their peers precisely that of attention control. It involved looking at lights moving in a particular pattern. When the pattern was detected, normal people showed increased brain activity. High-performing individuals showed decreasing brain activity, presumably because they optimized the pattern recognition process, and focused all the resources there.
I suppose those are USA stats. I come from a place where Kumon is a household name. I never went to one, although when I learned about it from my friends in 5th grade, I was actually jealous that my parents didn't send me there.
My feelings are mixed on such. I was on Ritalin as a teenager and I felt like it stripped me of my creativity and started refusing to take it. I had trouble focusing a lot of the time (though I also have the ability to hyper-focus). I've taken a few times illicitly since just to have a reference point, and I still find that the mental gymnastics that I've had to develop as an adult (I'm 28) to try to get myself to hyper-focus on the whole are a better coping mechanism than taking amphetamines on a regular basis.
I feel like scatter-brained-ness is a dual-edged sword. On the one hand, it contributes to difficulty in staying "on-topic" on a regular basis; on the other hand, I feel like it's been the mechanism that's allowed me to broaden my interests and to absorb a lot of information in usually disconnected areas and sometimes connect pieces that might be less natural for others without this "affliction".
This is of course an anecdote, and I believe as others have pointed out concentration is spectrum and there are extreme poles where medication may be the only option, but I'm leery of it becoming a catch all solution as it has become in the US (but not in other developed countries).
Not predictably. Right now often jumping into a debugging session I'll have a glass of wine or so, but historically if I look back over the most productive phases of my life they've varied between times where I didn't drink at all to where I drank too much.
The most effective coping mechanisms have been combinations of removing distractions and sometimes short meditation. More recently I find if I'm distracted that going running for 15 minutes will help clear my head. If I find myself procrastinating too much I often run Freedom.app for an hour or two at a stretch to help drop me into the zone. When I'm working in an office I tend to start extremely early or extremely late so that I'm alone at the office for long stretches. When I'm working from home (I live with my co-founder) I tend to shut the door for long stretches and occasionally notice that I shift my sleeping schedule so that a large block of the time where we're awake is mutually exclusive.
It's mostly the stuff I mentioned in the comment below (or above, depending on how the voting goes).
For those not familiar with hyper-focusing, it's a trait that's been observed in a significant minority of ADD cases where the person has the ability to focus extremely closely on a task for an extended period of time (for me often 12-16 hours). I get most of my code written in those blocks, which happen on average 3-ish times a week.
The ground rules for me are that it has to be something that I can really get into. Today I'm writing docs, so that's a no-go (hence the proliferation of news.yc comments). Code will do, hard debugging will do, reading research, writing essays will do. Catching up on email, writing docs -- really a good half of startup-y tasks -- won't.
Sometimes it comes naturally and I can start as soon as I wake up, especially if I just slept because I was too exhausted to continue and am still in the middle of a problem. Every once in a while, this will last for periods even up to two weeks.
The trick is building up momentum. It's easy to get distracted at the beginning, almost impossible once I'm "in".
So I open up my to-do list. Pick a problem. Turn off the internet. Close my door. Usually it takes about half an hour. If it doesn't work in the first half hour, I can try a couple of things to jump-start the process: 10-15 minutes of meditation or running will work probably half of the time.
From there I'm usually good until a problem is solved. There are some activities that won't snap me out of it -- cooking, playing bass a bit (often I do that when thinking through a problem), but I can't, for instance, talk to people. Sometimes the problem lasts an hour; sometimes it's a week. Since there's momentum already built up, I usually have a quick break of doing administrativa and maybe 30-50% of the time can jump right into the next problem.
Naturally most people that know me never see me in those blocks, so I often come off as scatter-brained or generally laid-back, but that's because my largest bursts of productivity are partitioned off into those blocks.
I've always been puzzled. Is ADD an actual disorder? Or is it the normal state of most humans? I have never been diagnosed with ADD. Nor have I ever thought of trying to get diagnosed. But I identify with your comment. In fact, your work habits actually seem pretty normal. I think a lot of people get most of their work done when they are "in the zone" and then spend the other rest of the time procrastinating and wasting time.
I don't think it's the normal state for most humans, but it is descriptive of one end of the spectrum of normality, when testing for a limited set of properties.
That's why I'm opposed to people medicating for it generally.
Basically it's "people who have trouble motivating themselves to do things they don't really want to" (though may think they should). It can be inconvenient if your view of society is that smart people should be interchangeable. My personal belief is that this is just friction between relatively recently evolved (post-industrialization) social norms and the way that people actually work, and those two pieces not fitting together all the way down has been labeled ADD (among other things).
To put a very fine point on things: what some people call ADD is why I am a founder. I could probably medicate myself into being a contented employee of a "good" company and stay there forever. But honestly, fuck that. I don't feel like getting shifty when things start boring me -- usually every 3 to 4 years -- and needing to do something else is a disorder.
My best friend on the other hand lives in the US and takes amphetamines for her ADD. I hear her describe what she struggles with and can relate to it, but what I hear is, "Wow, she really hates her job," rather than, "Wow, she has a hard time focusing." American psychiatrists apparently disagree.
The reason I am asking is, I am having problems with ADHD but I haven't tried any medication yet. What you said sounds very promising.
I cannot ever imagine myself planning for the next day and being able to follow that plan. I sometimes am just like as you described, cannot even take the trash out, because I have so many things in my mind, confused.
The first time I took Adderall I was angry and upset that I'd missed years of my life because I couldn't piece fragmented moments together into a cohesive whole identity. It was like waking up from a long sleep. I was 18.
I have recently begun experimenting with Adderall (under dr. supervision of course). My symptoms don't seem to be as bad as others' but I do have problems with planning and problems with executing a plan without getting distracted once I've made it. The distractibility makes programming difficult because I tend to want to take a short break before tackling a difficult design or debugging problem but then end up surfing the internet for 30 minutes before I can get back "in the mood" to move forward again. Adderall seems to take care of these problems and keep me focused on the work even when it gets difficult. At this point I look on it as a performance enhancing drug.
I've been using Ritalin, not Adderall. Here's my experience:
I started on Ritalin 15 years ago or so. At first, I found myself oddly calm and rational, even at what struck me as really inappropriate times (such as during an emotional conversation with my wife). Like I became Mr. Spock.
Then I noticed that my personal soundtrack disappeared. There was always music running though my head. Assorted, pop-ish, catchy melodies. And they were gone. Sadness.
I think I stopped taken it then, but shortly later went back on it. The effects were not as striking. (The soundtrack returned, hooray! and has not left again since then.)
Nowadays, I find hard to say how well it works. I more or less take it when I feel like it, and I think it helps, but it seems I've acclimated. (Side note: I'm pretty sure the Ritalin, plus Wellbutrin, were key to my quitting smoking. Take note, all you stimulant-chasing dopamine-deprived chain smokers.)
On the other hand, years ago I felt as though there was a TV in my head and someone was changing the channel every second. That's gotten much better. But on-demand focus, still not so good.
Now I wonder if I should try Adderall. I did a stint with Strattera, but it didn't seem to do much.
Meanwhile, I'm writing possibly commercial apps to help me stay organized, so maybe there's an upside. :)
Do you work late into the day, up to the moment when you go to sleep?
After taking Adderall my brain would sometimes be too wired to come down, at first I attributed this to the medicine but later realized it's simply exhaustion.
Another myth, even among doctors, is that this is a condition of children who run up walls and across ceilings. Not so. It afflicts adults who are not hyperactive. It is characterized by periods of intense concentration and other periods of complete inability to focus. It is pretty easily treatable with amphetamine type prescription drugs, which help them to calm down and concentrate, exactly the opposite effect from most of us. Unfortunately it is harder to diagnose in high IQ adults, because they are better at disguising the symptoms.
I had to explain to my neurologist yesterday, that it was the old model for ADD where it just 'went away' and that the new model for ADHD is that it often persists until adulthood, and that even though I'm almost 30 I most definitely need to take amphetamine salts daily to accomplish meaningful work with computers.
"It is characterized by periods of intense concentration and other periods of complete inability to focus."
"They tended to procrastinate and be forgetful and had difficulty in harnessing their talent to complete many daily tasks"
What's scary for parents is that a lot of that sounds like "teenage boy," and I'm not sure how well I understand differential diagnosis of ADD as contrasted with adolescent brain restructuring. I know young people whose parents have told me that the young people have ADD, and some of those young people are BRILLIANT. Some other young people I know seem every bit as disorganized, but who am I to diagnose someone, even my own child, without a lot of clinical experience?
I'm sure I'll get downmodded for even mentioning this, but in the natural health community we don't believe that ADHD is really a brain disorder, certainly not to the extent the APA maintains. I find it absurd that close to 1/4th of school age children in some schools supposedly need to be on brain altering pharmaceuticals. Why don't we see this in other countries?
Some dietary triggers for the ADHD like behavior commonly mentioned are artificial colors, sugar, MSG, and processed grains (and a lack of sufficient nutrition in general.)
For instance, there was a segment in the movie SuperSize Me describing a school for behaviorally problematic children. The staff found they could improve things by changing only the school lunch selection.
That was at the top of Google and describes a 2007 study in The Lancet. There's plenty more if you go looking.
The trouble with dispersal of natural health information is that the pharmaceutical and food industries are two of the biggest advertisers in mainstream media, have enormous influence, and they both profit tremendously from an ignorant public who's willing to buy low cost low quality foods and then take drugs to treat the resulting symptoms.
The trouble with dispersal of natural health information is that the pharmaceutical and food industries are two of the biggest advertisers in mainstream media
That should have nothing to do with publication in peer-reviewed scientific journals, which is what I was really asking about. [After edit: I see the Time magazine link you posted refers to an interesting study in the journal The Lancet, which is very well regarded. Now I'll have to look that up and follow up further citations. Thanks.] Scientific journals can have their problems too, article by article,
but that's where I'd like for carefully verified information about what triggers ADHD.
I'll read the Time article in light of the link I've just posted here, which I recommend highly and often to readers of HN. [After edit: I see the Time article ended with a suggestion, from an expert, that it might be a good idea to eat more "organic" foods. Interestingly, there is also a lot of research on phytotoxins suggesting that many "natural" sustances found in plants, which after all evolved defenses of various kinds against being eaten by animals, may sometimes be many more times risky for human health than some "artificial" substances commonly found in lower doses in typical foods. But again thanks for posting the link, which gives me something to follow up on.]
I'm generally a "natural health freak" (rest of my family says), but I have also seen (and teachers in my family testify, too) the impact on productivity for kids when on/off their meds (ritalin,etc).
I'd also say it's not inconceivable that there could be a huge chunk of today's children who have ADHD - way larger than a generation or two ago. For a similar (though not as prevalent) phenomenon, look at how autism has been ramping up in recent decades.
The profile is usually pretty clear: the kid is unable to behave himself or perform any action for which there is not an instant reward. Its not something that shows up with hormones, it is the central characteristic of the child's life from day one.
Thanks to you and to the other participants for your replies. I see a real opportunity here to further advance the psychology of human mental abilities by further investigating the distinction Keith Stanovich
draw between "intelligence" (I would say "IQ," but his terminology is standard) and "rationality." There are various forms of human cognition, and IQ tests miss many of them. Stanovich reports that there are mental tests that would reliably show, among adults with high IQ, who has executive function problems and who does not.
I think it's an important clarification of the conceptualization of human cognitive abilities, and I can't count on everyone to do the Google search that you have done, especially on a site with new participants every day.
No, I'm not related to him at all. Are you related to someone who has an opinion on research on human cognitive psychology?
I've got quite a lot of distractibility, but my office mate really does. He got connected with the work of Edward Hallowell, specifically "Driven to Distraction" ( http://www.amazon.com/isbn/dp/0684801280 ) and has since had his doc get him on ritalin. It's just been a few weeks, but he seems a lot more focused to me.
It's making me wonder if I need to talk to a doc about trying me on one of those meds. Doesn't seem like it's much of a risk, does it?
[I've struggled mightily to force myself to focus - to no avail - and know that I could be way more productive if the mind would obey better :/ ]
I come from a bit of a different perspective here in that I started out taking Ritalin as a kid - I was probably 8 or 9 instead of in my teens. It was awesome. Ritalin showed me what it was like to be "normal". I took it for about a year and, for me, once I had seen "normal", I was able to just settle down. I still hyperfocused and was fidgety but I was able to recognize those times whereas, before Ritalin, I had not known that what I was doing was odd/different/good/bad.
My 'IQ' hid my ADHD, because until highschool I got by without studying or paying attention or doing homework. I'd ace the tests, and it was enough to pass. In highschool, I needed to study or at least pay attention and didn't. Teachers said I was smart, but lazy.
I think its a pretty common situation. Nevermind that some people are independent learners, and the public education system is ill suited to this style of learning.
What may be new here is the changing view of what happens to the high-IQ, ADHD child upon growing up. I think there was a time when the high IQ score would have been taken as a prediction of all the usual socioeconomic success correlated with high IQ, but now the more nuanced view is that adult workers need other forms of cognition (broadly characterized as "executive functioning") to thrive in the workplace.
I was diagnosed very with mild ADD and have had my IQ tested and it's pretty darn high.
I went to the doctor and asked for Ritalin once during college and I found that I used it just like caffeine -- I'd be extra focused for a while on getting things done and then I'd realize I was staying awake way later than I planned. But I'd be tired the next day, and so the Ritalin seemed like it was more of a stimulant than a treatment, with one pill equal to about 10 shots of espresso.
I never refilled the Ritalin prescription -- it was no fun being medicated and staying up late and then being tired the next day. I noticed that I was far better at doing mundane tasks that required focus, but FAR less curious and less prone to switching tasks if I was bored.
Notably, I read tons of linux man files at the time and learned how to use a lot of command line utilities that I'd never had the patience to learn before.
But I'd also find that I'd read articles that were actually quite boring and upon finishing them I'd regret wasting the time.
There are a lot of occupations where my Ritalinized state would be an advantage. But one thing I love about my current approach to life is that I am able to leverage my own strengths. Sometimes being a bit scattered is a huge benefit. I also get the "hyper focus" common to people with ADD and there are days when 4 hour chunks go by as if they were 10 minutes and I realize I've accomplished incredible feats of productivity (and yet I remain energized).
Once in a while (maybe once every 2 weeks) I have a very scattered day. I have come to appreciate those days as good opportunities to restore balance. I use them to do extra exercise, eat extra healthy food, pick up the guitar, take an afternoon nap, etc. They are my brain's way of telling me that it wants a change of scenery.
I also find that regular, vigorous exercise and a bit of caffeine in the morning is far more effective than Ritalin was at giving me the ability to avoid being too scattered.
The best insight (which I actually learned from a comment here on HN last year) is that when I do find myself procrastinating it's my brain's way of telling me that I'm not happy with some decision I've made -- maybe an approach to some code, etc. So I use it as a cue to revisit what I've done and most of the time sure enough there is something lurking that was bugging me, and once I address it my productivity is back to normal.
Bottom line: I view mild ADD as a huge asset. I am extremely productive and while I have not yet managed to achieve my desired level of financial success I think I have plenty of ability to get done what I want to get done and tremendously enjoy the creative process and focused work involved.
Yeah good question. My suggestion would be to talk to the doctor about side effects and request the option of trying each of the pharmaceutical treatments (perhaps for a month each) before making a decision about which you ought to be on.
I do recommend trying them, at least to satisfy your curiosity... and some people really find them helpful.
One thing I should also mention is that I've found that other aspects of diet seem to correlate with ADD symptoms. Getting plenty of exercise, taking an omega 3 supplement, drastically reducing sugar, and eating a fair bit of leafy green veggies are all things that I attribute to helping me focus more quickly. There are probably some websites/books dedicated to this topic, and it might be worth exploring.
I know someone like that (high IQ/ADD, diagnosed by a psychologist) who refuses treatment. I think this person would benefit a lot from treatment but I have been unsuccessful in getting my point across. Any suggestions?