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 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.
Please, do yourself a favor. Don't suffer. Take drugs.
Been there, glad I did. They're not a cure-all, but they certainly help.
And, yes, under a doctor's supervision. Try to find a doctor who will work with you, and give you the leeway to try different things until you find what's best for you.
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.
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.
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.
Here's some quantification of the number of students who take calculus before the "usual" age in this era:
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).
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.
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.
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.
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. :)
Even doctors don't understand.
"They tended to procrastinate and be forgetful and had difficulty in harnessing their talent to complete many daily tasks"
Crap, I guess I really might have ADHD. Would effective and safe is the prescription medication?
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?
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.
Rather than downmod I'll ask a follow-up question and request research citations to back up that statement mentioning two distinct triggers for ADHD behavior.
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.
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.]
There's some interesting discussion of statistical tests applied to the data.
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.
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.
This is just from a quick Google search. I'm sure there are more.
No, I'm not related to him at all. Are you related to someone who has an opinion on research on human cognitive psychology?
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 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.
Yes. That sort of story is quite common even among people who don't have ADHD.
If you are in 8th grade, and you are capable of learning all the material without doing any homework, then it is just not rational to do homework.
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 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.
One issue for me: I find that caffeine makes me physically jittery and muscularly tense. I wonder what smaller doses of ritalin might have done for you (or might do for me)?
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.