[simplemts]

You nailed it on the end for me as an Adult with ADHD diagnosed in my 30s.

Motivation has been my biggest A-Ha with ADHD and trying my absolute best to align what I do with what I want to do otherwise I am setting myself up for failure and others for disappointment with me.

[acchow]

Learning to create motivation is the ultimate hack for insufficient executive function.

People tend to think of motivation as some innate property of your person. But it's actually an emotional response to inputs.

[krono]

ADHD is a neurodevelopmental disorder. The symptoms of this disorder are caused by physical differences in the brain, right there in the prefrontal cortex where those responses to inputs are generated.

It sometimes happens that I just physically can't bring myself to complete some simple but important chore. That's not because I'm mentally weak, but because my ADHD brain does not provide the right amount of dopamine which everyone else with a more typical brain would get.

[gmadsen]

ADHD is diagnosed by the occurance of defined symptoms. like most things in the DSM. Many things can manifest psychologically to give the collection of symptoms. Its not purely or even needs to be structural differences in the prefrontal cortex

[krono]

The specific set of symptoms and the diagnosis they would lead to according to the DSM, are in fact rooted in a set of interconnected structural neurological differences in the prefrontal cortex.

The ability to recognise when someone might be thirsty, doesn't mean dehydration no longer exists. They go together.

[flir]

> in a set of interconnected structural neurological differences in the prefrontal cortex.

Can you prove that? Because my understanding is that ADHD isn't diagnosable by imaging the brain. If there was a structural difference, presumably it would show up on scans? Or at least post-mortems?

[throwaway60707]

My brain exhibits significant differences on EEG that the neuro-doctor said are suggestive of ADHD or ASD.

AFAIK it is visible on fMRI, but doing so is incredibly expensive and taxing on the person - you'd need to keep them in the fMRI for very long time, repeatedly, and watch them doing different tasks.

But I've seen papers about this where they did that with some people. The brain simply doesn't fire up like a normal brain does. The structural difference itself might be too small (on cellular or even molecular level) to see with current resolution, but the effect is clearly visible - as well as that medication makes the brain behave more like normal brains, as opposed to normal brains on stimulants (which puts them into overdrive).

Quick search:

- https://www.medicalnewstoday.com/articles/315884

- https://bmcmedimaging.biomedcentral.com/articles/10.1186/s12...

[acchow]

ADHD brains operate differently, which is clearly visible on imaging. However, this is not sufficient for a diagnosis because you still need impairment in your life.

[throwaway60707]

The diagnosis is a continual process. My psychiatrist first did many questionnaires with me to determine whether it might be ADHD or something else, and then prescribed ADHD medication (first Strattera but that gave me significant side effects, now I'm on Concerta).

But this doesn't end with the prescription - I visit the doctor every 2 weeks and he continually questions me about the effects the medication has on my life, and tries to see whether it matches the expected outcome for a person with ADHD. If it did not, they would change the diagnosis.

In my case, everything fits - the stimulants make me slow down or even sleep, I'm less angry and overall more emotionally stable, less impulsive, and finally able to work on a task that I choose for an extended period of time. If this was not the case, I'm sure the doctor would be looking for a different diagnosis.

[btilly]

I prefer the procedure from 20 years ago. Where ADHD was defined by having the systems, and then testing every other thing that it could be.

It took my son 2 months to be officially diagnosed. A real pain? Sure. But a heck of a lot better than the situation today where kids with chronic sleep deprivation are given an ADHD diagnosis, then sent home with a medication that masks the sleep deprivation while giving them insomnia.

[throwaway60707]

My ADHD medication (yes, stimulants - and a pretty high dosage in my case) causes me to slow down and sleep. Then I wake up about an hour or so after taking it and am a normal person. I was diagnosed as an adult, but this was always the case for me - as a teen I drank 3 redbulls in the evening and went to sleep, because I finally could as my brain stopped keeping me awake with millions of thoughts.

[sgarland]

I would drink about a pot of coffee per day as a teenager, throughout the day. Never had any impact on my sleep either, which I always assumed was just tolerance.

Turns out once medicated, if I have caffeine after about 15:00 I’m in for a bad night. Brains are extremely weird.

[scns]

> ADHD is a neurodevelopmental disorder.

At first i wanted to disagree, then i realized why. Disorder means wrongly ordered or sickness. ADHD is classified as such, and if you want treatment, you need to get yourself diagnosed.

I really dislike the pathologizing of every neurotype that deviates from the imaginary normal person. I'm pretty sure, if you look closely you'll find something "broken" in everybody.

Other perspectives are possible. ADHD can be an advantage. A survey in a network of CEOs found over 60% have it: https://www.youtube.com/watch?v=XdT4DIiX7Nk

Some become a Rockstar: https://www.youtube.com/shorts/ElaL9Zo_Oes

[throwaway60707]

ADHD can also be totally debilitating and I - a person with strong ADHD - don't think this talk of "it's an advantage" is helping anyone. Yeah in very few cases there are some positives, but usually not.

In my case, I was hyper-focused on computers since I was a child, and that got me my career/business and that probably saved my life -- because I was totally unable to do anything in school and wasn't able to finish first year of high school and dropped out of it. I wouldn't call it an advantage even though it's probably the reason why I'm so good with computers.

In many cases like the CEOs you speak of, you see the surface - their success - but you ignore the problems they have in day-to-day life, the ruined childhood and the ruined relationships in adulthood. Many would trade all their success for normal life.

It's definitely a disorder. A weird one that might give you above average abilities in some very specific cases and areas of life, but still a disorder. You wouldn't say autism isn't a disorder just because there are few autistic savants.

Also consider - ADHD is much more often present in highly intelligent people. What you see might be a person that was able to overcome their disorder through their intelligence, but their life would be much better and they'd be way more successful had they not have the disorder. And now imagine how a person of average intelligence with ADHD must struggle with their life.

[skjoldr]

ADHD really doesn't correlate with IQ, I think what you meant is that adults with ADHD who can get their life together enough to get diagnosed are more likely to also be intelligent, which is true, and those with ADHD and cognitive deficits on top are far more likely to be forgotten and to end up in a prison, which is also sadly true.

I have an IQ of 136, which is considered to be very gifted, but my performance and life success thus far are decidedly average. It's a debilitating condition if it's not detected in time and not managed.

[throwaway60707]

Same here. I'm sure I'd be able to do much better if it was not for my ADHD. I don't even care about business - but I'm really sad about my childhood, and about the adult relationships I ruined before I knew what's up with me.

[krono]

It is indeed a sad state of affairs and a continuously deteriorating one at that. Ironically unhelpful are all the extra hoops society makes us "neurodivergents" jump through again and again before they'll give us the the things we need that will let us become more like them.

With regards to the second half of your post: I understand how you meant for it to come across and that you posted it with the best of intentions, but it still hurts a little bit to read. To save you the sob story, let's just say it's a bit similar to telling paraplegic to be happy with his cool motorised wheelchair that he gets to ride around in all day, and that some of the greatest achievements in history were made by people who often sat in chairs also :)

[ip26]

Being fundamentally incapable of feeling content, relaxed, and at ease for more than about three seconds is certainly not the most debilitating thing that could happen to you, and it can make you dogged and tireless, but it’s also not the normal human condition.

It’s a cruel paradox. A constant background of quiet anxiety, permanent absence of satisfaction, risk taking behavior combined with gripping fear of failure, and a perpetual quest for more can be a great adaptation in an unstable and insecure environment. However, it’s not exactly a blessing.

[ip26]

It’s more insidious. The condition mucks with your priorities & how you think you should approach problems, so even if you know how to hack yourself to be motivated, will it be for the right things?

As far as I can tell, focus and motivation are just a symptom of the deeper discomfort and anxiety caused by lower neurotransmitter levels. In turn, that shapes your relationship with the world.

[anoojb]

Seems like you're describing motivation as a psychological skill that can be cultivated beyond some innate baseline. How does this work?

[btilly]

It is. I've been trying to offer tips on how it works in my comments in this discussion.

If you want some personal books for yourself, try Meditations (by Marcus Aurelius), The Gentle Art of Not Giving a F_ck, and Atomic Habits. If you want some management books to help with your team, try Peopleware (a classic), First, Break All The Rules (much better than the title suggests), and Tribal Leadership.

[copperx]

I'd like to subscribe to your newsletter, if what you say is true. Can you expound on that idea?

[ChrisRR]

Motivation has always been my biggest issue, even for relatively small tasks like picking up a wrapper after I've snacked. It's not just the big things like trying to concentrate at work, it even stops you doing relatively short, low effort tasks until everything builds up or it becomes too late