[1] https://psychology-tools.com/test/adult-adhd-self-report-sca...
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.
For the full assessment with a psychiatrist, they do look at one's entire life history.
Yes. If you're getting diagnosed as an adult the general guidelines are that symptoms should be clearly traceable to teenage years and the earlier it is, the stronger the evidence is.
People experience ADHD-like symptoms later in life for any number of reasons, like anxiety and stress at work, home, or school. That's one of my peeves with how short the diagnostic process seems to be in certain countries (US and UK specifically), they don't seem to be particularly thorough when it comes to those things.
Can you provide some research on this?
> E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).
Or equivalent from ICD-11:
> Symptoms are not better accounted for by another mental disorder (e.g., an Anxiety or Fear-Related Disorder, a Neurocognitive Disorder such as Delirium).
As well as the long differential diagnosis sections in the DSM-5 and ICD-11 [1], for example:
> Boundary with Mood Disorders and Anxiety or Fear-Related Disorders: Attention Deficit Hyperactivity Disorder can co-occur with Mood Disorders and Anxiety or Fear-Related Disorders, but inattention, hyperactivity, and impulsivity can also be features of these disorders in individuals without Attention Deficit Hyperactivity Disorder. For example, symptoms such as restlessness, pacing, and impaired concentration can be features of a Depressive Episode, and should not be considered as part of the diagnosis of Attention Deficit Hyperactivity Disorder unless they have been present since childhood and persist after the resolution of the Depressive Episode. Inattention, impulsivity, and hyperactivity are typical features of Manic and Hypomanic Episodes. At the same time, mood lability and irritability may be associated features of Attention Deficit Hyperactivity Disorder. Late adolescent or adult onset, episodicity, and intensity of mood elevation characteristic of Bipolar Disorders are features that assist in differentiation from Attention Deficit Hyperactivity Disorder. Fidgeting, restlessness, and tension in the context of Anxiety or Fear-Related Disorders may resemble hyperactivity. Furthermore, anxious preoccupations or reaction to anxiety-provoking stimuli in individuals with Anxiety or Fear-Related Disorders can be associated with difficulties concentrating. To qualify for an Attention Deficit Hyperactivity Disorder diagnosis in the presence of a Mood Disorder or Anxiety or Fear-Related Disorder, inattention and/or hyperactivity should not be exclusively associated with Mood Episodes, be solely attributable to anxious preoccupations, or occur specifically in response to anxiety-provoking situations.
> Boundary with attentional symptoms due to other medical conditions: A variety of other medical conditions may influence attentional processes (e.g., hypoglycemia, hyperthyroidism or hypothyroidism, exposure to toxins, Sleep-Wake Disorders), resulting in temporary or persistent symptoms that resemble or interact with those of Attention Deficit Hyperactivity Disorder. As a basis for appropriate management, it is important to evaluate in such cases whether the symptoms are secondary to the medical condition or are more indicative of comorbid Attention Deficit Hyperactivity Disorder.
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.
It’s just that in other countries they call you stupid and fail you out of education destroying the lives and futures of millions of lives because those places have too many people in power, who like you, believe that if you don’t personally experience something then it mustn’t exist.
Those attitudes are merely annoyances in a professional setting. It just means we have to undo the damage they cause. The amount of people helped by medications and therapy is substantial and cannot be ignored.
Christ. These discussions remind me of one of my professors. He used to claim ADHD was a made up disease too. He also used to say vitamin D deficiency was a drug company scam. Then I was diagnosed with ADHD and hyperparathyroidism secondary to vitamin D deficiency. It's as if god himself wanted me to be living proof that he was full of shit.
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.
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.
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)
In my experience it often creates an unbearable internal conflict where you're acutely aware that you really need (or want) to do something else, but you find it impossible to set your current task aside.
I would end up in situations where I'm not enjoying the hyperfocus activity because I'm simultaneously feeling guilty over not doing the more important thing, and there's would be nothing I can do about it. I could try to switch tasks but my mind would wander back, I would make more mistakes, if I had to talk to someone then I wouldn't be present and alert in the conversation, and would suffer even more negative consequences because of that.
Nobody sees that side of it though.
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.
[1] https://www.sciencedaily.com/releases/2017/02/170216105919.h...
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.
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.
This is already the case. Maladaptation is a fundamental diagnostic criteria of essentially every neuropsychiatric condition. There is no reason to treat something if it's not causing you harm.
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.
You can "know thyself" perfectly well without having labels.
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.
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.
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.
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.
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.
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 radiates 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).
But I've heard from people doing some tests with certain medications that indeed they were able to focus and plan like never before. But also loose some passion and creativity. I've heard from yet others that they should have started way earlier, before essentially wrecking their life.
I think for me at times medication would help me. But it feels like a big step and I'm not "ill", I'm not wrecking my life, my life is ok. I also feel like "this is me, I'm learning about the good and the bad." Idk, maybe I'm overly sentimental about it. I'm also to lazy to go to the doctor.
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 might have been fine because you just have something like 140 mm Hg, whereas others with 180-190 might not be so lucky....
Yes. And it if it doesn’t, then just stop refilling your meds.
but
Until I started doing stims, I was regularly forgetting about food/water until I could barely move, and at one occasion I procrastinated from replying to an email with the offer of my life until the deadline was over. There's a lot that you can explain with "not motivated enough", but these just don't make any sense, right?
You do need some sort of a label to prescribe controlled substances. Even if you forget about the meds, just knowing that it's a pretty common thing and you're not alone is pretty helpful.
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.
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.
According to DSM‑5‑TR and ICD-11, ADHD is subdivided into three presentations: predominantly inattentive, predominantly hyperactive-impulsive, and combined.
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.
I spent decades hoping for the ability to invoke those bursts. Days of unexplainable block until a deadline was really close, so the anxiety spike could trigger a few hours of focus. I then did the work of a week in an evening/night, and back to square one.
It REALLY wasn't fun continuously worrying that people will think I'm slacking off while an invisible barrier kept me from working.
E.g. doing a rough structure and hen it feeds my brain in the background, helps when the burst comes :)
It's not that much the deadlines for me though, really just need to have good days where I suddenly lock in.
Also helpful: boring "entertainment". Stops me from browsing twitter, boring enough to peel myself away from very easily again. E.g. twitch streams or sitting outside.
>I'm alread doing the work, just more often in a deadline panic mode.
Yup, that's the right mindset. Figuring out proper time management as an adult is non-ideal, but it is a _much_ better problem to have than working always in a panicky rush or not at all.
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.
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.
> Your son could do anything he wants if he’d just sit down and shut up.
https://psychology-tools.com/test/adult-adhd-self-report-sca...
cristea•2mo ago
"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).
desert_rue•2mo ago
0xAFFFF•2mo ago
And then if you're getting medicated, another whole world of fun begins (restricted prescriptions, shortages, etc)
jampekka•2mo ago
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.
orwin•2mo ago
bestouff•2mo ago
__alexs•2mo ago
naruhodo•2mo ago
eatitraw•2mo ago
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.
viraptor•2mo ago
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.
exitb•2mo ago
otikik•2mo ago
At that age the brain has already developed and meds are less helpful than when you are young. Even taking meds out of the picture, a diagnosis would have helped me a lot and not being diagnosed had very negative consequences.
I was told to "brighten up" my whole life while growing up. My parents well not abusive - it's just that I had good grades at school, so they didn't understand why I struggled with tasks that were "simpler than school". I also struggled with social interactions. I ended up with very low self-esteem, thinking I was just "slower" or "more stupid" than others. Most teenagers try to find and define the final shape of their mind. I though the "real me" was an embarrassment that needed to be hidden. So during my teenage years I built a "mask" instead. ("Masking" is a psychological phenomenon, I have now learned)
I am very good at "faking" not having ADHD now. Most of my friends and coworkers don't know. I can't mask all of my symptoms, though, nor all of the time. I can't "fake" not forgetting my car keys, or doing my taxes. I still wear my mask most of the time.
Sometimes I don't know whether my wife got in love with me, or with the image I project of myself. I don't know if there's a "myself" any more.
Also, ADHD has a genetic component. Having a diagnose for myself would have been useful before I had my son, who turned to have hyperactive ADHD. I love him to bits and I would not change him, but he's a handful. When he's off-meds he's almost intolerable. I would have had him nevertheless, but I would have had the right expectations.
squigz•2mo ago
This seems like an underappreciated side-effect of awareness of these things. I can't imagine what some parents must feel - about themselves, and their kid - when raising a child with ADHD and not knowing much or anything about it.
bestouff•2mo ago
I'm lucky enough to live somewhere where healthcare is a given and she's currently in the diagnostics phase (for the second time), but I'm still scared for her future. Even with help and meds and whatnot, life won't be easy I guess.
squigz•2mo ago
> life won't be easy I guess.
Probably not, but at least she won't have to struggle with not understanding why her life is so much harder than others. And having a parent who understands that struggle and the problems she faces will help a lot.
otikik•2mo ago
On that note, when your kid becomes a teenager, he’ll be more likely to get hooked into addictive substances like drugs, tobacco, or alcohol than others, I’m afraid to say. I will be paying attention to this matter very closely and will make sure that my son has all the information about them when that period comes.
Good luck on raising your kids! It’s the biggest adventure in life.
otikik•2mo ago
- What this child needs is more discipline, you have to punish them more when they misbehave.
squigz•2mo ago
theothertimcook•2mo ago
My primary school had a run club at the beginning of the day we'd hit laps of the school between roll call and 1st session, iirc we had 10 minutes you had to do at least one lap, you had to have good pace for two to be allowed a third, I don't recall many doing 4.
When I moved to highschool I didn't immediately notice why I was suddenly struggling to keep my shit together in class, the absence of moderate intensity cardio at the start of the day.
There's a few books and papers that back this up also
otikik•2mo ago
sceptic123•2mo ago
I wonder if finding it hard to answer these kind of questions could be an indicator for some other kind of neurodiversity.
karmakaze•2mo ago
> So if you score 4 out of 6, the chance you actually have ADHD is:
Judging by the questions and responses though I find that hard to believe.Questions: 2 and 3 almost seem like a 'gimme' to answer 'Sometimes', and 4 to answer 'Often' isn't a stretch.
I also find question 1 to be frequently 'Sometimes' or more unless a type-A personality.
Only questions 5 & 6 seem to be directly associated (IANAD).
As another comment mentions, I wonder how that percentage changes if the person is already on the autstic spectrum.
sceptic123•2mo ago
> you have a strong reason to seek a full assessment