My gripe with some of these simple questions is that they do not provide a framework to answer the questions within.
"How often do you feel X?" With answers as "very often" means very different things to different people. For one person once a month could be very often since they expect this to never happen, while for another person a few times a day might be expected.
The problem here is that if people think that they might have a condition or be sick, it has been shown time and time again that this might emphasize the symptoms and make a person "sicker".
In addition these general questions that a lot of people can relate to will cause a lot of people to get unneeded screening, thereby straining an overloaded health service (it might be different in the US, I'm in Europe).
> it has been shown time and time again that this might emphasize the symptoms and make a person "sicker".
While that's true, for ADHD self description it's common to under estimate the impact. That's why you typically get asked for someone who knows you to join the diagnosis visit - because they're likely to say you're actually doing worse than you think.
Yes, it's even worse when you're diagnosing a child, as you will have to answer these questions for them, which puts your parental expectations into the mix. In the end however, people get diagnosed, get medication and start to feel a little better, so maybe it's all worth it.
> In addition these general questions that a lot of people can relate to will cause a lot of people to get unneeded screening
Yes, a lot of people have ADHD. I link to the study that shows high specificity in the general population. Empirically, the tool works. You gotta start getting concerned about your symptoms from somewhere.
This might depend on the country for EU. In France especially if you're an adult, getting an appointment for a diagnosis is either extremely long (public health sector delays regularly exceed one year), very expensive (over a 100€ out-of-pocket) or downright impossible (if you're in a big city you're fine, some places don't have anyone available at all). Sometimes it's a combination of those (yay).
And then if you're getting medicated, another whole world of fun begins (restricted prescriptions, shortages, etc)
My understanding is that you typically pay something like this in the US for a specialist visit even if you have insurance, especially if you haven't already paid the year's deductibles.
I worry about all of this labelling that we apply to various ends of the "normal" spectrum. Where does it lead us? Is it actually helping?
I easily score as ADHD, but I'm in my 60s now and have never been diagnosed or treated. I have muddled through all my life. Yes, I often self-medicated unhealthily (cigarettes, various over-the-counter uppers), but also relatively healthily (I've been practicing meditation for decades). I managed to have two, long, fruitful careers (20 years of journalism, coming up to 20 years of software engineering) that (I'm betting) was at least partly attributable to me being on the outer edges of normal.
I think that's OK. I'm not looking to be "treated" because I'm a bit different.
Sounds familiar. I've been quite successful professionally, I have accomplished many nice things. But always in the final days/hours and under extreme pressure (ie 2 nights of no sleep to finish PhD thesis in time for print for defense, etc, very difficult for people around me also. I'm currently working on our old house. Also not nice for me, and people around me. The results are pretty nice and technically fully correct though.)
I've had the same comment about being chaotic, and not being able to see the bigger picture during performance reviews my whole life. But I've always felt unable to see the bigger picture if not understanding the details. Although recently I've gotten better at letting go, trusting my mental models etc, but also at finding great, structured project leads (or assistants if I'm in the lead). Such people are invaluable to me, although I must say that I also start to find it easier and easier to just copy their behaviour (ie things like "Start project with timeline, not important if it's 100% accurate, its more about the order of things" - etc... At least you will appear very structured which rediates confidence!).
I've also had a manager at one point in my career that said: We really just want you to start many things, you are in research not in development. It's great that you start with so much enthusiasm, let de development people determine the fit for product later... (But perhaps a bit more "eye on the market" would be nice!)
That was somewhat of an eye opener, at 35 (42 now).
My pet theory is that one of the reasons for an increase in the diagnosis of ADHD is that fewer people smoke today. Nicotine as a stimulant likely treated a lot of undiagnosed cases of ADHD.
I think there is value in knowing a term for the symptoms one might experience because it provides the ability to connect with like-minded people and potentially look into useful strategies to mitigate those symptoms, if they become problematic.
However, I do strongly agree with you that setting a boundary to "normal" and therefore implying these states to be abnormal and something that needs to be fixed is not helpful. We should be able to label a wide spectrum of neurological wiring quirks without nudging people towards changing them, unless it actually negatively impacts their ability to live a fulfilling life.
> However, I do strongly agree with you that setting a boundary to "normal" and therefore implying these states to be abnormal and something that needs to be fixed is not helpful. We should be able to label a wide spectrum of neurological wiring quirks without nudging people towards changing them, unless it actually negatively impacts their ability to live a fulfilling life.
Except I don't buy this framing that the two are in conflict. The more general awareness there is in the general population around neurodiversity, simultaneously the less shame there is about medicating and also, the greater willingness there is to accommodate each person's individual diversity.
Accomodations initially rolled out for diagnosed neurodiverse people: Like being able to control the lighting in your workspace, or being issued noise cancelling headphones no questions asked, also benefit neurotypical people who are also on the further end of the bell curve for things like that.
On the other hand for me, these discussions help me to frame my challenges in a productive way that gives me a chance to make useful changes to my life to accomodate them, instead of blaming myself when I struggle to do something that seems like it should be easy. So I guess the answer is, YMMV.
The article doesn't do a good job of highlighting that there is help beyond medication, and that the personal "size" of the problem should be taken inro account. I mean, "answering 6 questions -> yay, stimulants" is a bit of a shortcut, isn't it.
Recognizing that one's problems with being organized (and other executive functions) have a reason, and are not just a result of "being lazy" or "not trying enough" can be powerful and liberating. It allows acceptance and a systematic approach at addressing them. Of course, medication can help a lot while learning how to make things easier for oneself in other ways, but this should be decided with a professional who has experience with diagnosing and treating ADHD in adults, ideally one that does not simply want to push pills.
In any case, it's good to seek out more information or consult a professional IF you think you're being held back. If not, then that's great! For others, articles like this might provide the initial nudge for a noticeable improvement in their lives.
My mother is very similar to what you have described and mimicks some reponses of her to her ADHD situation pre-diagnosis/post-diagnosis.
She is also ~60 and accomplished in her professional,social and family life.
Pre-diagnosis she would reject suggestsions going into the direction of an ADHD diagnosis, due to her accomplishments being above average --> not possible to have a disability/neuro-divergence.
The achievements are her achievements, but the expense in the context of her capabilities was very high and quite taxing on her.
A diagnosis or even treatment is not making the person normal, but it can help provide that person with options to alleviate the expense of operating differently to the baseline.
I am very happy that you managed to have this success in your life so far and you made that happen.
But under your assumption that you have ADHD you might have made that happen against odds that would have been in part optional if you had access to treatment options.
It's interesting to read this from someone who more at a more advanced stage of life, but I also wonder if there is a built-in assumption around diagnoses and treatments being potentially negative.
I think people seek out these diagnoses because they are struggling to cope with modern life in one way or another. I don't think its only a matter of attitudes ("everything must be treated"), but also the fact that the world is different. In other words, there could be two solutions: Medication/treatment to make life easier for the individual, or fix the world such that it can accommodate the arguably natural variance among individuals.
We're choosing the former, because the latter is just so, so difficult. But I think a world exists where the needs of currently medicated people with mild degrees of ADHD could thrive without any medication, and it sounds like a softer, more colorful world.
Would you say the same if it were as physical disability? If you were born without hands and had slowly learnt how to do everything required in everyday life via an adaptation, would you reject a prosthetic if it were available?
We know people with ADHD are able to manage. The real test is always, after they try medication, is their life easier or not. A lot of people who were adamant they were managing just fine before the meds report afterwards they didn't realize how much effort they were putting in on a day to day basis just to manage themselves.
And this is not some general trend towards overmedicalization. As the article pointed out, there are precisely two psychiatric drugs that have this statistically significant an effect.
Getting treatment or not is a decision. It is linked to pressure of suffering. You write that you did well and managed your life well. Awesome.
Other people feel extensive pressure of suffering and are not able to manage their lifes like you did. For those, professional treatment can be life saving.
Isn't it a bit of a non sequitur? The fact that you choose not to be treated (with a history of unhealthy self-medication) doesn't imply that someone else would not benefit from changing some healthy(-ier) medication specifically targeted at ADHD.
So to answer your questions: 1. it leads us to people getting treated (or at least having the choice) for stuff that makes their life harder 2. Yes, it is helping.
No, it is not just “being treated”, although learning some techniques to control anxiety has helped me a lot (meditation, in my case). Just “know thyself”, and realizing that your struggles have a root different from “laziness” helps with self-esteem.
Where it leads us, is to people with ADHD suffering less. Which, I don't know about you, but making fewer people suffer and for people to suffer less are basically the two driving motivations for life, so I'm in favor of it.
You're older, so you grew up in a different time, and you found your place in the world. The treatment means finishing projects, not needing to wait until the last minute to do something in order to do it. It means less stress and unecessary anxiety. It's helping people reach their potential, and not fall into the cracks.
Am I missing something, or do they not actually say how to score the test? From playing with another version [1], any answer in a grey box counts for 1 point.
You say that like it’s a joke, but the huge wall of text did that for me. Unless I was being forced to take the test, I’d just have given up on doing it.
Tangentially, I am so glad they talked about the Sensitivity and Specificity of the test, and how those values combined to actually affect the result of the test. These are such basic and yet important metrics for statistics.
unless I misunderstood what little I know of ADHD, shouldn't these symptoms have been there all your life, not just 6 months prior? I score 4/6 on the scale without question, but I wasn't functioning like this before (maybe 2/6), only these last few years, with no change in environment or routine
6 months is a reasonable cutoff for a screening tool because it allows for changes in the environment. E.g. you might cope well in high school, but you move to university and suddenly your old strategies don't work anymore and your life is falling apart.
For the full assessment with a psychiatrist, they do look at one's entire life history.
That - or a very similar one that is used where I live - was the very first screener I took. It's basically just part of the initial assessment with your GP, before you see a specialist. The interview you have with your GP should also be taken into consideration.
I scored 7... Sorry, joking but yes - I can relate to all the questions there. Some of those (like appointments) I learned to cope with. I just schedule everything in my phone and have 20 alarms throughout the day, which I enable to remind be about certain events. I wonder however, how many people would pass this test in this world of distractions.
When I was young I used to look at the watch compulsively to check what time it is and I never went late to an appointment. Is this ADHD too? Or maybe just depression that I procrastinate everything nowadays? Or maybe effect of extensive usage of technology?
I scored 6 out of 6 although I highly doubt I have ADHD. Those are pretty normal things. You learn to deal with it and try again. Technology, alarms, calendar events come to your aid. Or I unplug something to force myself to deal with a thing. One thing I'm bad with those is locking things, I leave the key in the ignition, leave doors open...
It could very well be ADHD. Depression is certainly another possibility, but if your symptoms are more or less consistent throughout life, then it makes ADHD much more likely.
It's definitely a bit tricky. Depression can cause problems with attention. But also: ADHD people have depression at much higher rate.
> When I was young I used to look at the watch compulsively to check what time it is and I never went late to an appointment.
Lots of ADHDers come up with all sorts of coping mechanisms. It's one of the reasons the test misses a significant chunk of ADHD population.
I passed the test at 100%. Still, I had gone through a professional assessment not that long ago, and I wasn't diagnosed with ADHD because I lack hyper motion activity. I compensate it with ultra-hyper brain activity, but that doesn't qualify for ADHD. However, they've found some trails of ASD in turn.
>and I wasn't diagnosed with ADHD because I lack hyper motion activity.
That sounds a bit weird, ADHD is known to have hyperactive and inattentive variants; and the lack of a single symptom does not lead to a negative diagnosis.
I've scored pretty high on the "inattentive scale", but got only a few points on the "hyperactive" one. I was told that both scales must be high to be diagnosed with ADHD.
>I was told that both scales must be high to be diagnosed with ADHD.
My understanding is that this is not the case, that ADD (without the hyperactive part) used to be considered a separate diagnosis but this is no longer the case, and one of the scales qualifies.
I am not a proffessional though, so take it with a grain of salt, but it might be worth double checking just in case.
I sometimes wonder if I have ADHD or something, but I’d only score myself 1 / 6 on this test. “Trouble wrapping up the final details of a project” describes me perfectly, but I wouldn’t say I’m in the grey for any of the others.
Maybe that’s because I’ve developed coping mechanisms though. I don’t miss appointments because I scrupulously write everything down, and I don’t fidget with things sitting down because I don’t put myself in positions where I can’t get up and walk around.
Anyone tried to get diagnosed after 50? I'm 50+, I believe I have the symptoms. I have coped basically all my life but the cost was (and still is) pretty high. Lots of stress and probably a lot of missed opportunities too.
Getting diagnosed is somewhere on my "maybe to do" list but I'm not sure it's even worth to try.
I’m younger at mid thirties, but I was recently diagnosed with a career and personal life already “in check” so my experience might be useful.
I’d 100% recommend you go for a check. For me, the main outcome has been getting rid of the nagging feeling that my potential is wasted in making up for shortcomings.
Now it’s no longer “I am bright and curious, and this compensates my {lack of consistency, periods of “writers block”, reduced attention to detail}”. It’s hard to explain without direct experience how cleanly those problems you’ve been trying to white knuckle all your life just… stop. It’s not a personality change, it’s much closer to allergy meds letting you breathe, the bad symptom goes away.
The only con is that once you get the meds there’s work to be done. The productivity tips and books you’ve likely heard all your life and were unusable now can actually be put to practice… but you haven’t done it yet.
So it’s like you stop being bedridden but if you want to be fit you still have to go the gym. It’s just that now going to the gym is a task you can realistically approach, and that in itself is a game changer.
Meanwhile, I have a wife and two kids, live in a nice house. I did well at school. I have no problem landing jobs that pay really well. I have lots of friends. I have many hobbies I like. I can play music decently well. I like 3d modelling. I am writing screenplays. I did the startup thing.
I am not depressed, I am not anxious, I feel fine, I feel smart, I feel able.
I have no particular "strategy" to "cope" with my "disorder". I am just disordered, and I don't care. Does it get me in trouble? Not really. The worst I got is my brother telling me he can't count on me cause I am mostly MIA. I can live with that. Sometimes I think that if I was more ordered, I would have a better career. But the reality is that I don't even want to have a better career. Which is probably the main reason why I don't have a better career.
I am not sick. I don't have ADHD. Not the way people who have ADHD describe it.
People with ADHD forget a lot of stuff all the time. They can't function properly at all. It's nothing to do with "finishing projects". It's about finding ways not to lose your car keys every day.
In the US, ADHD is way over-diagnosed. It's over diagnosed because US society makes you believe that "success" is a question of "willpower", and that if you can't gather enough "willpower", it's because you're somehow broken. It's over diagnosed, because the health system is incentivized to over-diagnosed. It's over diagnosed because they create 1 minute tests that are made to make people feel like they have it. It's over diagnosed because it's one of the only mental conditions that can be treated with pills, which means it's monetizable. It's overdiagnosed, because it's not a condition people feel ashamed of (unlike depression).
I know a lot of people on HN are diagnosed and treated for it. But you guys need to really ask yourself whether the way you felt before being diagnosed was so bad that you need to take brain-altering drugs to "fix" it.
I'm old enough to remember when ADHD was invented. To sell meds.
Granted some people have difficulty concentrating, I'm one of them. But I've only heard of people in the US getting medications for something which is basically a lack of discipline.
ADHD was not "invented". It is a neurodevelopmental disorder. The stimulant medications are effective at treating the symptoms when compared to placebo.
There's no need to explain when you're factually wrong. I'm brazilian and I have been diagnosed with ADHD by a neurologist. My existence falsifies your entire comment.
This mentality is the biggest part of the problem. "Lack of discipline", hah!
With ADHD, with autism spectrum, whenever you label something that's caused by a different brain wiring, something that's caused by something pyhsical in the brain, you are doing unspeakable level of harm to those people suffering. I know, I'm one of them, I suffered from this mentality for 30 years.
If you can "fix" your difficulty with contentrating with "discipline", all the more power to you. Don't assume it's the same with everyone else.
Medicating vs not medicating is a worthy topic to talk about. Labeling the hardness people face as a lack of discipline is just cruelty, whether it stems from ignorance or lack of knowledge.
> The ADHD epidemic is less about the discovery of a disease and more about the construction of one. Over the past two decades, we have witnessed the normalization of drugging children into classroom compliance — an act made possible only through the coordinated actions of pharmaceutical companies, medical professionals, school systems, and parents, all embedded in a culture that equates emotional and behavioral difficulty with biomedical defect.[1]
While I think lack of discipline is over simplistic, I also think that labelling and diagnosing children is a simple and effective way for parents to absolve themselves of responsibility for their own failures. Parenting is hard, but admitting that is harder.
I'm definitely not saying ADHD and Autism don't exist, I'm just saying that it's possible that ADHD diagnoses are higher than they should be. It's easier to externalise and medicate a problem than it is to look at your own behaviour as a parent.
There is a certain truth to this. The history of psychiatry isn't pretty.
It's called a "disorder" because it is maladaptive: it causes the individual to fail to adapt to the environment. Children and even adults with "attention deficit" often fail to adapt to school, leading to diagnosis. Plenty of teachers get fed up with impulsive children that are incapable of paying attention or even sitting still in class, and they send them to doctors in order to "fix" the kid so they can do their jobs.
It's somewhat self-contradictory though. When you look closer at these patients with "attention deficit", you find that a high number of them are capable of hyperfocus. There's almost always something that deeply engages them. For some it's computers, for others it's car engines, there's always something. You find that all these people with "attention deficit" can suddenly display the ability to pay attention to specific things for ten hours straight.
I make it a point to identify instances where the person is capable of deeply concentrating. I always try to disprove their notions that they are "dumb lazy kids". For me it's a matter of basic human dignity. Once that's out of the way, I may offer them drugs to help them cope with the environment they find themselves in. Not before.
Maybe the problem is just that these people are not compatible with the mass education system where you listen to lectures for hours on end. Maybe that's just the most efficient method for the school, not the best teaching method for these kids. Perhaps there is an environment where they are well adapted, where the disorder does not manifest. Until such an environment is found, drugs and therapy are available.
> It's somewhat self-contradictory though. When you look closer at these patients with "attention deficit", you find that a high number of them are capable of hyperfocus. There's almost always something that deeply engages them. For some it's computers, for others it's car engines, there's always something. You find that all these people with "attention deficit" can suddenly display the ability to pay attention to specific things for ten hours straight.
The problem is that even that hyperfocusing is not always helpful. Focusing on something for 10 hours straight while ignoring everything else - obligations, one's body's needs, etc - is not very much healthier than not being able to stay focused.
(Not that I disagree with much of what you're saying; just feel it's necessary to point out, as many people do think the hyperfixating on things is strictly an advantage)
I agree with this also. I'm not living in the USA, but from afar it looks like overmedication is a very valid concern that should be explored more.
I draw the line at overly dismissal point of views, telling those who suffer to just put themselves into it and show some discipline. I'm 38 years old and been gaslit by well intentioned people for 30 of those. It needs to stop.
I'm old enough to remember when vision impairment was invented. To sell glasses.
Granted some people have difficulty seeing. I'm one of them. But I've only heard of people in the US getting glasses for something which is basically a lack of looking hard enough.
----
Your response was ablest, dismissive and quite offensive.
1. ADHD was first described in 1798 by Sir Alexander Crichton
2. It is a neuro-developmental disorder where there is dysregulation of dopamine and norepinephrine receptors in the brain
3. It is identifiable via MRI scans where size differences were noted in specific areas of the brain (Caudate nucleus, Putamen, Nucleus accumbens, Amygdala,
Hippocampus) [1]
4. It is about 80% heritable [2]. So genetics for inheriting ADHD from your parents is about equivalent to genetics from height which is also around 80%.
The "meds" increase the intensity of dopamine signals to a level that allows the brain to react to them, rather than being too low for them to be detected.
"How often do you feel X?" With answers as "very often" means very different things to different people. For one person once a month could be very often since they expect this to never happen, while for another person a few times a day might be expected.
The problem here is that if people think that they might have a condition or be sick, it has been shown time and time again that this might emphasize the symptoms and make a person "sicker".
In addition these general questions that a lot of people can relate to will cause a lot of people to get unneeded screening, thereby straining an overloaded health service (it might be different in the US, I'm in Europe).
While that's true, for ADHD self description it's common to under estimate the impact. That's why you typically get asked for someone who knows you to join the diagnosis visit - because they're likely to say you're actually doing worse than you think.
Agree, I think it's certainly a problem and I too wish it was more defined, but alas. Related, Literal Banana on surveys: https://carcinisation.com/2020/12/11/survey-chicken/
> In addition these general questions that a lot of people can relate to will cause a lot of people to get unneeded screening
Yes, a lot of people have ADHD. I link to the study that shows high specificity in the general population. Empirically, the tool works. You gotta start getting concerned about your symptoms from somewhere.
And then if you're getting medicated, another whole world of fun begins (restricted prescriptions, shortages, etc)
My understanding is that you typically pay something like this in the US for a specialist visit even if you have insurance, especially if you haven't already paid the year's deductibles.
I easily score as ADHD, but I'm in my 60s now and have never been diagnosed or treated. I have muddled through all my life. Yes, I often self-medicated unhealthily (cigarettes, various over-the-counter uppers), but also relatively healthily (I've been practicing meditation for decades). I managed to have two, long, fruitful careers (20 years of journalism, coming up to 20 years of software engineering) that (I'm betting) was at least partly attributable to me being on the outer edges of normal.
I think that's OK. I'm not looking to be "treated" because I'm a bit different.
I've had the same comment about being chaotic, and not being able to see the bigger picture during performance reviews my whole life. But I've always felt unable to see the bigger picture if not understanding the details. Although recently I've gotten better at letting go, trusting my mental models etc, but also at finding great, structured project leads (or assistants if I'm in the lead). Such people are invaluable to me, although I must say that I also start to find it easier and easier to just copy their behaviour (ie things like "Start project with timeline, not important if it's 100% accurate, its more about the order of things" - etc... At least you will appear very structured which rediates confidence!).
I've also had a manager at one point in my career that said: We really just want you to start many things, you are in research not in development. It's great that you start with so much enthusiasm, let de development people determine the fit for product later... (But perhaps a bit more "eye on the market" would be nice!)
That was somewhat of an eye opener, at 35 (42 now).
However, I do strongly agree with you that setting a boundary to "normal" and therefore implying these states to be abnormal and something that needs to be fixed is not helpful. We should be able to label a wide spectrum of neurological wiring quirks without nudging people towards changing them, unless it actually negatively impacts their ability to live a fulfilling life.
Except I don't buy this framing that the two are in conflict. The more general awareness there is in the general population around neurodiversity, simultaneously the less shame there is about medicating and also, the greater willingness there is to accommodate each person's individual diversity.
Accomodations initially rolled out for diagnosed neurodiverse people: Like being able to control the lighting in your workspace, or being issued noise cancelling headphones no questions asked, also benefit neurotypical people who are also on the further end of the bell curve for things like that.
Recognizing that one's problems with being organized (and other executive functions) have a reason, and are not just a result of "being lazy" or "not trying enough" can be powerful and liberating. It allows acceptance and a systematic approach at addressing them. Of course, medication can help a lot while learning how to make things easier for oneself in other ways, but this should be decided with a professional who has experience with diagnosing and treating ADHD in adults, ideally one that does not simply want to push pills.
In any case, it's good to seek out more information or consult a professional IF you think you're being held back. If not, then that's great! For others, articles like this might provide the initial nudge for a noticeable improvement in their lives.
She is also ~60 and accomplished in her professional,social and family life.
Pre-diagnosis she would reject suggestsions going into the direction of an ADHD diagnosis, due to her accomplishments being above average --> not possible to have a disability/neuro-divergence.
The achievements are her achievements, but the expense in the context of her capabilities was very high and quite taxing on her.
A diagnosis or even treatment is not making the person normal, but it can help provide that person with options to alleviate the expense of operating differently to the baseline.
I am very happy that you managed to have this success in your life so far and you made that happen.
But under your assumption that you have ADHD you might have made that happen against odds that would have been in part optional if you had access to treatment options.
I think people seek out these diagnoses because they are struggling to cope with modern life in one way or another. I don't think its only a matter of attitudes ("everything must be treated"), but also the fact that the world is different. In other words, there could be two solutions: Medication/treatment to make life easier for the individual, or fix the world such that it can accommodate the arguably natural variance among individuals.
We're choosing the former, because the latter is just so, so difficult. But I think a world exists where the needs of currently medicated people with mild degrees of ADHD could thrive without any medication, and it sounds like a softer, more colorful world.
People develop taxonomy to help understand the world and themselves. Knowing what you have helps you seek treatment.
> I have muddled through all my life.
Part of the journey for a lot of ADHD sufferers is getting experience what non muddled life is like.
> I think that's OK. I'm not looking to be "treated" because I'm a bit different.
Cool, I am glad that worked for you. But keep in mind that lots of people, myself included, experience extremely negative aspects of ADHD.
>meditation
Much less effective than the treatments the article mentions.
We know people with ADHD are able to manage. The real test is always, after they try medication, is their life easier or not. A lot of people who were adamant they were managing just fine before the meds report afterwards they didn't realize how much effort they were putting in on a day to day basis just to manage themselves.
And this is not some general trend towards overmedicalization. As the article pointed out, there are precisely two psychiatric drugs that have this statistically significant an effect.
So to answer your questions: 1. it leads us to people getting treated (or at least having the choice) for stuff that makes their life harder 2. Yes, it is helping.
You can "know thyself" perfectly well without having labels.
You're older, so you grew up in a different time, and you found your place in the world. The treatment means finishing projects, not needing to wait until the last minute to do something in order to do it. It means less stress and unecessary anxiety. It's helping people reach their potential, and not fall into the cracks.
[1] https://psychology-tools.com/test/adult-adhd-self-report-sca...
For the full assessment with a psychiatrist, they do look at one's entire life history.
When I was young I used to look at the watch compulsively to check what time it is and I never went late to an appointment. Is this ADHD too? Or maybe just depression that I procrastinate everything nowadays? Or maybe effect of extensive usage of technology?
It's definitely a bit tricky. Depression can cause problems with attention. But also: ADHD people have depression at much higher rate.
> When I was young I used to look at the watch compulsively to check what time it is and I never went late to an appointment.
Lots of ADHDers come up with all sorts of coping mechanisms. It's one of the reasons the test misses a significant chunk of ADHD population.
That sounds a bit weird, ADHD is known to have hyperactive and inattentive variants; and the lack of a single symptom does not lead to a negative diagnosis.
My understanding is that this is not the case, that ADD (without the hyperactive part) used to be considered a separate diagnosis but this is no longer the case, and one of the scales qualifies.
I am not a proffessional though, so take it with a grain of salt, but it might be worth double checking just in case.
And some questions feel true for everyone *looking around*.
I don't think I have ADHD, but could go either way on half the questions based on whether I include my helpers or not.
Maybe that’s because I’ve developed coping mechanisms though. I don’t miss appointments because I scrupulously write everything down, and I don’t fidget with things sitting down because I don’t put myself in positions where I can’t get up and walk around.
Getting diagnosed is somewhere on my "maybe to do" list but I'm not sure it's even worth to try.
I’d 100% recommend you go for a check. For me, the main outcome has been getting rid of the nagging feeling that my potential is wasted in making up for shortcomings.
Now it’s no longer “I am bright and curious, and this compensates my {lack of consistency, periods of “writers block”, reduced attention to detail}”. It’s hard to explain without direct experience how cleanly those problems you’ve been trying to white knuckle all your life just… stop. It’s not a personality change, it’s much closer to allergy meds letting you breathe, the bad symptom goes away.
The only con is that once you get the meds there’s work to be done. The productivity tips and books you’ve likely heard all your life and were unusable now can actually be put to practice… but you haven’t done it yet.
So it’s like you stop being bedridden but if you want to be fit you still have to go the gym. It’s just that now going to the gym is a task you can realistically approach, and that in itself is a game changer.
Meanwhile, I have a wife and two kids, live in a nice house. I did well at school. I have no problem landing jobs that pay really well. I have lots of friends. I have many hobbies I like. I can play music decently well. I like 3d modelling. I am writing screenplays. I did the startup thing.
I am not depressed, I am not anxious, I feel fine, I feel smart, I feel able.
I have no particular "strategy" to "cope" with my "disorder". I am just disordered, and I don't care. Does it get me in trouble? Not really. The worst I got is my brother telling me he can't count on me cause I am mostly MIA. I can live with that. Sometimes I think that if I was more ordered, I would have a better career. But the reality is that I don't even want to have a better career. Which is probably the main reason why I don't have a better career.
I am not sick. I don't have ADHD. Not the way people who have ADHD describe it.
People with ADHD forget a lot of stuff all the time. They can't function properly at all. It's nothing to do with "finishing projects". It's about finding ways not to lose your car keys every day.
In the US, ADHD is way over-diagnosed. It's over diagnosed because US society makes you believe that "success" is a question of "willpower", and that if you can't gather enough "willpower", it's because you're somehow broken. It's over diagnosed, because the health system is incentivized to over-diagnosed. It's over diagnosed because they create 1 minute tests that are made to make people feel like they have it. It's over diagnosed because it's one of the only mental conditions that can be treated with pills, which means it's monetizable. It's overdiagnosed, because it's not a condition people feel ashamed of (unlike depression).
I know a lot of people on HN are diagnosed and treated for it. But you guys need to really ask yourself whether the way you felt before being diagnosed was so bad that you need to take brain-altering drugs to "fix" it.
I'm old enough to remember when ADHD was invented. To sell meds.
Granted some people have difficulty concentrating, I'm one of them. But I've only heard of people in the US getting medications for something which is basically a lack of discipline.
https://ebm.bmj.com/content/30/Suppl_1/A52.2
With ADHD, with autism spectrum, whenever you label something that's caused by a different brain wiring, something that's caused by something pyhsical in the brain, you are doing unspeakable level of harm to those people suffering. I know, I'm one of them, I suffered from this mentality for 30 years.
If you can "fix" your difficulty with contentrating with "discipline", all the more power to you. Don't assume it's the same with everyone else.
Medicating vs not medicating is a worthy topic to talk about. Labeling the hardness people face as a lack of discipline is just cruelty, whether it stems from ignorance or lack of knowledge.
While I think lack of discipline is over simplistic, I also think that labelling and diagnosing children is a simple and effective way for parents to absolve themselves of responsibility for their own failures. Parenting is hard, but admitting that is harder.
I'm definitely not saying ADHD and Autism don't exist, I'm just saying that it's possible that ADHD diagnoses are higher than they should be. It's easier to externalise and medicate a problem than it is to look at your own behaviour as a parent.
[1]<https://ebm.bmj.com/content/30/Suppl_1/A52.2>
It's called a "disorder" because it is maladaptive: it causes the individual to fail to adapt to the environment. Children and even adults with "attention deficit" often fail to adapt to school, leading to diagnosis. Plenty of teachers get fed up with impulsive children that are incapable of paying attention or even sitting still in class, and they send them to doctors in order to "fix" the kid so they can do their jobs.
It's somewhat self-contradictory though. When you look closer at these patients with "attention deficit", you find that a high number of them are capable of hyperfocus. There's almost always something that deeply engages them. For some it's computers, for others it's car engines, there's always something. You find that all these people with "attention deficit" can suddenly display the ability to pay attention to specific things for ten hours straight.
I make it a point to identify instances where the person is capable of deeply concentrating. I always try to disprove their notions that they are "dumb lazy kids". For me it's a matter of basic human dignity. Once that's out of the way, I may offer them drugs to help them cope with the environment they find themselves in. Not before.
Maybe the problem is just that these people are not compatible with the mass education system where you listen to lectures for hours on end. Maybe that's just the most efficient method for the school, not the best teaching method for these kids. Perhaps there is an environment where they are well adapted, where the disorder does not manifest. Until such an environment is found, drugs and therapy are available.
The problem is that even that hyperfocusing is not always helpful. Focusing on something for 10 hours straight while ignoring everything else - obligations, one's body's needs, etc - is not very much healthier than not being able to stay focused.
(Not that I disagree with much of what you're saying; just feel it's necessary to point out, as many people do think the hyperfixating on things is strictly an advantage)
I draw the line at overly dismissal point of views, telling those who suffer to just put themselves into it and show some discipline. I'm 38 years old and been gaslit by well intentioned people for 30 of those. It needs to stop.
I'm old enough to remember when vision impairment was invented. To sell glasses.
Granted some people have difficulty seeing. I'm one of them. But I've only heard of people in the US getting glasses for something which is basically a lack of looking hard enough.
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Your response was ablest, dismissive and quite offensive.
1. ADHD was first described in 1798 by Sir Alexander Crichton
2. It is a neuro-developmental disorder where there is dysregulation of dopamine and norepinephrine receptors in the brain
3. It is identifiable via MRI scans where size differences were noted in specific areas of the brain (Caudate nucleus, Putamen, Nucleus accumbens, Amygdala, Hippocampus) [1]
4. It is about 80% heritable [2]. So genetics for inheriting ADHD from your parents is about equivalent to genetics from height which is also around 80%.
The "meds" increase the intensity of dopamine signals to a level that allows the brain to react to them, rather than being too low for them to be detected.
[1] https://www.sciencedaily.com/releases/2017/02/170216105919.h...
[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC7046577/