6 ms·

My $0.02 as a response to several comments I read in this thread: I was diagnosed with ADHD in my 40s and got Concerta. My belief is that ADHD is not a disease,

My $0.02 as a response to several comments I read in this thread: I was diagnosed with ADHD in my 40s and got Concerta. My belief is that ADHD is not a disease, nor a disability (even though it acts like one very frequently) and in fact there is evidence that ADHD is an important part of our evolution as a species. The problem(s) mostly relies with the modern way of life and what is expected from the society at large. In that context I try to feel ok when I daydream while I have countless of boring things to take care of as I totally feel ok when I hyperfocus in a creative endeavor. The meds are just a tool that I use no more than two times per week in order to take better care of myself and others. It is not a therapy and it's not me. I believe that Sensitive Rejection Dysphoria is very real for people like us, but the worst version of it is when you reject yourself because you are different and you try hard to be someone else.

jasonfarnon 1y ago
"The problem(s) mostly relies with the modern way of life and what is expected from the society at large." I assumed not just ADHD but a number of other psychological conditions are more about reconciling some individuals to this particular society. It seems baked into a lot of their diagnostic criteria, like how well one "functions" at school or work. Surely ADHD would not be cognizable where people don't have to spend 8hrs/day through their youth sitting in one place.
- nxobject 1y ago
  > Surely ADHD would not be cognizable where people don't have to spend 8hrs/day through their youth sitting in one place. Or, for that matter, in a society where people regulated their days by cues like the sky and the body, rather than the carefully organized "rain or shine" clocked time needed by the Industrial Revolution. (This thesis isn't mine: the historian EP Thompson wrote a classic article on how the transition from a rural to an industrial working class in Britain was accompanied with timetabling and "clock discipline".) https://academic.oup.com/past/article-abstract/38/1/56/1454624?redirectedFrom=fulltext https://academic.oup.com/past/article-abstract/38/1/56/14546... https://academic.oup.com/past/pages/special_issue_3 https://academic.oup.com/past/pages/special_issue_3
- rcxdude 1y ago
  The line is indeed, fuzzy. The basic definition of a disorder is very much dependent on context, because in general it requires that the behavior or thought pattern is causing distress or danger to the patient or those around them. There are many facets of the human mind which have a substantial variation among the population, where some range is adaptive to certain situations and some part becomes a problem, and where exactly that flips will depend on the individual and the context they are in. But I think it's unhelpful to claim that because this line is contextual, it means there isn't really a problem. It's a problem because that individual is in that context (and often it's preferable to address the behaviour or thought patterns than the context), and there are individuals where it would be a problem in basically any context.
matheusmoreira 1y ago
Completely agree. People with ADHD are simply incompatible with many facets of mormal life. Take school for example. If someone doesn't fit into the mass education model, they say they have attention deficit. That same person might then go home and hyperfocus on computer programming for 12 hours straight like a machine. It makes no sense. The mass education model where hundreds of people sit on a chair listening to lectures for hours on end just isn't right for people with ADHD. Medications are just there to help cope with an imperfect reality which refuses to change for our sake.
- onoesworkacct 1y ago
  ADHD isn't a personality quirk and also, it is fundamentally a disorder of regulation not attention. The education system (for all its drawbacks and inflexibility) works for most because they're able to regulate the urge to get up and climb random shit when they can't figure out how to start writing the answer to Q1 on the worksheet.. I also think its cope to take a disorder where a specific part of the brain tasked with very specific functions is physically less dense and performs than other people and go "ADHD isnt real he's just quirky!1"
  - nathan_compton 1y ago
    I guess its tempting to take like MRI/ECG style studies and draw fundamental conclusions from them about the distinction between "personality" and "disorder" but I think its good to bear in mind at least three things: 1. a lot of these studies suck. Brain imaging is very hard, the interpretation and analysis of the results involves lots of degrees of freedom, the study sizes are typically not as big as you'd like, and most of the results are only really visible in aggregate. I do not give much credence to them, as a scientist. One way to think of this is that if someone separates two groups of people into "ADHD" and "NOT ADHD" and you average their MRIs you might detect a difference in the two groups. But one person's MRI would be almost useless to assign them to one of the two groups. You could certainly try it, but it would not be very effective. 2. Literally every difference in behavior between two people or between a person and themselves at a different time is necessarily reflected in a difference in brain behavior, at least if you buy the materialist paradigm that brain -> mind or at least brain == mind. Thus, you would expect differences in personality to show up in MRI scans as well as differences which rise to the level of "disorder." 3. The brain isn't made up of "specific parts with specific functions." While its certainly true that we can roughly map different areas to different functions, its really not separable in any way that (for example) a human designed machine might be. We cannot remove and replace your "attention center" and it doesn't really mean anything to talk about it without all the rest of your brain. The part/whole relation is bullshit in all contexts (in my opinion as a mereological nihilist) but especially in neuroscience. I guess its sort of a useful rhetorical frame to point to physical differences between brains as some kind of determination of the distinction between "mere" personality differences and "disorders" but I just don't think it makes sense in a fundamental way. I'm a person with ADHD and Autism diagnoses and I think they are handy things to use from time to time, I think of them as entirely relational descriptions pertaining to my position with respect to the world, not fundamental ontological categories. On the other hand, I think of essentially everything as relational and I don't really believe in fundamental ontological categories so maybe I'm the fucked up one.
Ericson2314 1y ago
I think this is a nice attitude. I would say I do think it's possible to hyperfocus too much, I feel like I might have done that.
rollulus 1y ago
You might enjoy reading “The ADHD advantage” by Anders Hansen. He describes the evolutionary explanation as well.
- fragmede 1y ago
  I enjoyed reading Jurassic Park, for all it had to do with science.
Llamamoe 1y ago
This is a common belief people have, especially those with mild ADHD or those who wish to be dismissive of the disorder. Unfortunately, in reality while there are some very limited advantages, as a whole ADHD is a whole-brain dysfunction where your neurons are literally incapable of maintaining their level of operation as long as in a healthy person, with ALL of your executive functions - all self-regulation, planning, delaying gratification, emotion management, etc - being impaired across the board, not just tuned differently. Hyperfocus is commonly brought up, but neurotypical people experience it as well. Less often, but also without the compulsive loss of control, while being able to maintain a higher level of effort and work without it at all times. People also like to claim we'd be better as lookouts or sentries but this isn't true. People with ADHD don't pay more attention to a broader range of things, they're just incapable of focusing it when necessary, not to mention they drift off and get distracted instead of staying watchful far, far more. That's before getting into the fact that ADHD correlates negatively with pretty much every single life outcome, not just those depending on society - things like neurodegenerative disease, cardiovascular and metabolic problems, sleep disturbance, etc. I understand the desire to frame things you're experiencing in a positive manner, but... in this case, it doesn't really work, and I somewhat resent it personally, as it makes people less likely to take ADHD as seriously as it needs to be.
- deleted 1y ago
  [deleted]
- scns 1y ago
  > People also like to claim we'd be better as lookouts or sentries but this isn't true. People with ADHD don't pay more attention to a broader range of things Have to disagree. Noticing every small noise a neurotypical Brain filters out makes you a good canary.
  - kqr 1y ago
    ...assuming the person is able to focus on the 30 minutes of nothing that comes before the noise. The person in my life with ADHD would start scribbling equations in the dirt or braid the loose threads on their clothing after five minutes, and easily fail to notice the noise twenty-ive minutes after that.
kruffalon 1y ago
Isn't one of the criteria for something to be a disability that it makes it harder to function in the world you are in? So it has to do with the mismatch between yourself (including the accommodations in place for you), the world and whatever is considered a reasonable life for a person in that world.
- nathan_compton 1y ago
  I think can be a disability but not a disease, I think is the idea.
QuadmasterXLII 1y ago
ADHD is obviously a spectrum, (possibly on top of a binary), and more and more cases on the light end are getting diagnosed, which is, I have no reason to doubt, very helpful. I don’t know if the light end is a disability or a disease. The heavy end of the spectrum, the lying on the floor suffering crippling bladder pain but unable to muster the willpower to walk to the bathroom and piss even though that would immediately fix the problem end of the spectrum, is a disease and a disability. I cannot picture an ancestral environment where this is adaptive.
veunes 1y ago
Too often the conversation swings between "meds are bad" and "meds fix everything," when the truth is way more nuanced
thomastjeffery 1y ago
If it's not a disability, then why can't I work on projects that I am excited to work on? Sure, my ADHD experience is probably the impetus for most of those projects in the first place, but that doesn't help me get anything done, whether I want to or not. It sounds like what really happened is that you found an appropriate amount/cadence of medication for your body. That's much more difficult than many realize, which is why each stimulant is sold with 5 different delivery methods: immediate release, capsule with drug dust coated in timed digestion substance, capsule with hole to pump via capillary action, skin patch, and the bonus prodrug lisdexamphetamine that metabolizes into amphetamine at the rate of digestion.
NegativeK 1y ago
Respectfully, my experience is very different than yours -- and I'm somewhere in between you and people who have it really bad. ADHD can absolutely be a handicap. It might be that it's exacerbated by modern life's demands, but I frankly can't be bothered to care -- I live with these symptoms that I wish would go away, and I can't switch to some world that would work well with them. And it's not rejecting myself or trying to be someone I'm not. I spent quite a while before diagnosis doing that. Getting treatment for and acknowledging the issues of ADHD is being more aware of who I am and what I need than pretending that things will work out. They don't, and they didn't. And I know my experience isn't unique.

jasonfarnon 1y ago

"The problem(s) mostly relies with the modern way of life and what is expected from the society at large." I assumed not just ADHD but a number of other psychological conditions are more about reconciling some individuals to this particular society. It seems baked into a lot of their diagnostic criteria, like how well one "functions" at school or work. Surely ADHD would not be cognizable where people don't have to spend 8hrs/day through their youth sitting in one place.

nxobject 1y ago
> Surely ADHD would not be cognizable where people don't have to spend 8hrs/day through their youth sitting in one place. Or, for that matter, in a society where people regulated their days by cues like the sky and the body, rather than the carefully organized "rain or shine" clocked time needed by the Industrial Revolution. (This thesis isn't mine: the historian EP Thompson wrote a classic article on how the transition from a rural to an industrial working class in Britain was accompanied with timetabling and "clock discipline".) https://academic.oup.com/past/article-abstract/38/1/56/1454624?redirectedFrom=fulltext https://academic.oup.com/past/article-abstract/38/1/56/14546... https://academic.oup.com/past/pages/special_issue_3 https://academic.oup.com/past/pages/special_issue_3
rcxdude 1y ago
The line is indeed, fuzzy. The basic definition of a disorder is very much dependent on context, because in general it requires that the behavior or thought pattern is causing distress or danger to the patient or those around them. There are many facets of the human mind which have a substantial variation among the population, where some range is adaptive to certain situations and some part becomes a problem, and where exactly that flips will depend on the individual and the context they are in. But I think it's unhelpful to claim that because this line is contextual, it means there isn't really a problem. It's a problem because that individual is in that context (and often it's preferable to address the behaviour or thought patterns than the context), and there are individuals where it would be a problem in basically any context.

matheusmoreira 1y ago

Completely agree. People with ADHD are simply incompatible with many facets of mormal life. Take school for example. If someone doesn't fit into the mass education model, they say they have attention deficit. That same person might then go home and hyperfocus on computer programming for 12 hours straight like a machine. It makes no sense. The mass education model where hundreds of people sit on a chair listening to lectures for hours on end just isn't right for people with ADHD. Medications are just there to help cope with an imperfect reality which refuses to change for our sake.

onoesworkacct 1y ago
ADHD isn't a personality quirk and also, it is fundamentally a disorder of regulation not attention. The education system (for all its drawbacks and inflexibility) works for most because they're able to regulate the urge to get up and climb random shit when they can't figure out how to start writing the answer to Q1 on the worksheet.. I also think its cope to take a disorder where a specific part of the brain tasked with very specific functions is physically less dense and performs than other people and go "ADHD isnt real he's just quirky!1"
- nathan_compton 1y ago
  I guess its tempting to take like MRI/ECG style studies and draw fundamental conclusions from them about the distinction between "personality" and "disorder" but I think its good to bear in mind at least three things: 1. a lot of these studies suck. Brain imaging is very hard, the interpretation and analysis of the results involves lots of degrees of freedom, the study sizes are typically not as big as you'd like, and most of the results are only really visible in aggregate. I do not give much credence to them, as a scientist. One way to think of this is that if someone separates two groups of people into "ADHD" and "NOT ADHD" and you average their MRIs you might detect a difference in the two groups. But one person's MRI would be almost useless to assign them to one of the two groups. You could certainly try it, but it would not be very effective. 2. Literally every difference in behavior between two people or between a person and themselves at a different time is necessarily reflected in a difference in brain behavior, at least if you buy the materialist paradigm that brain -> mind or at least brain == mind. Thus, you would expect differences in personality to show up in MRI scans as well as differences which rise to the level of "disorder." 3. The brain isn't made up of "specific parts with specific functions." While its certainly true that we can roughly map different areas to different functions, its really not separable in any way that (for example) a human designed machine might be. We cannot remove and replace your "attention center" and it doesn't really mean anything to talk about it without all the rest of your brain. The part/whole relation is bullshit in all contexts (in my opinion as a mereological nihilist) but especially in neuroscience. I guess its sort of a useful rhetorical frame to point to physical differences between brains as some kind of determination of the distinction between "mere" personality differences and "disorders" but I just don't think it makes sense in a fundamental way. I'm a person with ADHD and Autism diagnoses and I think they are handy things to use from time to time, I think of them as entirely relational descriptions pertaining to my position with respect to the world, not fundamental ontological categories. On the other hand, I think of essentially everything as relational and I don't really believe in fundamental ontological categories so maybe I'm the fucked up one.

Ericson2314 1y ago

I think this is a nice attitude. I would say I do think it's possible to hyperfocus too much, I feel like I might have done that.

rollulus 1y ago

You might enjoy reading “The ADHD advantage” by Anders Hansen. He describes the evolutionary explanation as well.

fragmede 1y ago
I enjoyed reading Jurassic Park, for all it had to do with science.

Llamamoe 1y ago

This is a common belief people have, especially those with mild ADHD or those who wish to be dismissive of the disorder. Unfortunately, in reality while there are some very limited advantages, as a whole ADHD is a whole-brain dysfunction where your neurons are literally incapable of maintaining their level of operation as long as in a healthy person, with ALL of your executive functions - all self-regulation, planning, delaying gratification, emotion management, etc - being impaired across the board, not just tuned differently. Hyperfocus is commonly brought up, but neurotypical people experience it as well. Less often, but also without the compulsive loss of control, while being able to maintain a higher level of effort and work without it at all times. People also like to claim we'd be better as lookouts or sentries but this isn't true. People with ADHD don't pay more attention to a broader range of things, they're just incapable of focusing it when necessary, not to mention they drift off and get distracted instead of staying watchful far, far more. That's before getting into the fact that ADHD correlates negatively with pretty much every single life outcome, not just those depending on society - things like neurodegenerative disease, cardiovascular and metabolic problems, sleep disturbance, etc. I understand the desire to frame things you're experiencing in a positive manner, but... in this case, it doesn't really work, and I somewhat resent it personally, as it makes people less likely to take ADHD as seriously as it needs to be.

deleted 1y ago
[deleted]
scns 1y ago
> People also like to claim we'd be better as lookouts or sentries but this isn't true. People with ADHD don't pay more attention to a broader range of things Have to disagree. Noticing every small noise a neurotypical Brain filters out makes you a good canary.
- kqr 1y ago
  ...assuming the person is able to focus on the 30 minutes of nothing that comes before the noise. The person in my life with ADHD would start scribbling equations in the dirt or braid the loose threads on their clothing after five minutes, and easily fail to notice the noise twenty-ive minutes after that.

kruffalon 1y ago

Isn't one of the criteria for something to be a disability that it makes it harder to function in the world you are in? So it has to do with the mismatch between yourself (including the accommodations in place for you), the world and whatever is considered a reasonable life for a person in that world.

nathan_compton 1y ago
I think can be a disability but not a disease, I think is the idea.

QuadmasterXLII 1y ago

ADHD is obviously a spectrum, (possibly on top of a binary), and more and more cases on the light end are getting diagnosed, which is, I have no reason to doubt, very helpful. I don’t know if the light end is a disability or a disease. The heavy end of the spectrum, the lying on the floor suffering crippling bladder pain but unable to muster the willpower to walk to the bathroom and piss even though that would immediately fix the problem end of the spectrum, is a disease and a disability. I cannot picture an ancestral environment where this is adaptive.

veunes 1y ago

Too often the conversation swings between "meds are bad" and "meds fix everything," when the truth is way more nuanced

thomastjeffery 1y ago

If it's not a disability, then why can't I work on projects that I am excited to work on? Sure, my ADHD experience is probably the impetus for most of those projects in the first place, but that doesn't help me get anything done, whether I want to or not. It sounds like what really happened is that you found an appropriate amount/cadence of medication for your body. That's much more difficult than many realize, which is why each stimulant is sold with 5 different delivery methods: immediate release, capsule with drug dust coated in timed digestion substance, capsule with hole to pump via capillary action, skin patch, and the bonus prodrug lisdexamphetamine that metabolizes into amphetamine at the rate of digestion.

NegativeK 1y ago

Respectfully, my experience is very different than yours -- and I'm somewhere in between you and people who have it really bad. ADHD can absolutely be a handicap. It might be that it's exacerbated by modern life's demands, but I frankly can't be bothered to care -- I live with these symptoms that I wish would go away, and I can't switch to some world that would work well with them. And it's not rejecting myself or trying to be someone I'm not. I spent quite a while before diagnosis doing that. Getting treatment for and acknowledging the issues of ADHD is being more aware of who I am and what I need than pretending that things will work out. They don't, and they didn't. And I know my experience isn't unique.