I'm not a medical expert or anything but I guess there is a good chunk of population who just procrastinates or can struggle with focus without having ADHD? Or is there always a 1:1 relationship?
A lot of people (myself included) procrastinate on something because it's emotionally uncomfortable, without necessarily having ADHD. For example, when I was much younger, I'd procrastinate on math homework specifically, not because I struggled with focus, but because it was difficult to admit to myself that I didn't know how to do it and would need to practice. Subjects that came more naturally to me (English, science) didn't give me a "fear of failure" response in the same way.
Growing up, my parents didn't have encouragement or patience in their emotional toolkit. You were expected to do everything perfectly - homework, writing a letter, any kind of planning, even sweeping the floor or washing dishes - and if you struggled in any way you were berated at length.
Many decades later even mundane things can be a battle - ringing a doctor to ask for an appointment, or a provider to query a bill, filling in forms and so on. Most of my procrastination stems from my experiences back them. It is easier in my mind to defer action than to risk the imagined verbal abuse. I'd imagine a fair share of non-ADHD related organisational issues can be traced to similar experiences.
Just like you can't out-train a bad diet, you can't out-live a shitty childhood.
Really sorry you went through this. Your experience reminds me of mine, which left me to contend with a lifetime of challenges.
> Just like you can't out-train a bad diet, you can't out-live a shitty childhood.
I think I’d challenge this slightly. Out training a bad diet probably doesn’t work, but is better than a bad diet with no training. And when you fix your diet, the training can start working wonders.
My childhood left deep and unhealthy imprints, but I’m no longer in that environment. I think you can out-live a shitty childhood, by changing your diet so to speak. This is grueling work, painful, slow, and often frustrating. But replacing old patterns can really transform living in the same way changing a bad diet can transform the process of training.
Over time I’ve come to believe strongly that the only thing harder than dealing with the past is not dealing with it. And over time, this gradually transforms the present. I very much prefer the late 30s version of me to all of the preceding iterations.
Best of luck on your own journey. Send me an email if you ever want to chat. (Not selling anything, just someone who cares about this topic a lot).
That sums up a lot of workplace disfunction. Proactively pushing new ideas and then getting blamed for failure, not applauded for them attempt. It’s why corporates can’t innovate internally.
The book "Learned Optimism" was a life changing read for me coming from this kind of background. It includes exercises that start to rewire your brain. Highly recommended.
But with the upside that it is technically unknown whether or not you actually could have pulled it off if you tried, and if every once in a while you manage to perform the impossible, that covers for 100 failures.
People who don't care about their children don't care about this, of course. You have failed them simply by being a child.
"Why didn't you just have better parents you stupid little brat, didn't anybody teach you anything you absolute dumbass lazy #%!£ moron?"
It did mess up with my ego heavily. Because once in a while I would actually manage to push through anxiety and do something, and I'd succeed.
Unfortunately it made me quite narcistic, as I ended up with belief that I could always succeed, if only I gave in some effort - but as I never tried to do that in practice, I ended up at the top of Dunning-Kruger curve. High ego, no skills.
Excelling at school & career at an early age, while being absolutely trashed at home/family time, gave me the anxt from sticking my head out of the room. But, at the same time, while out and about, already working on something, subconcious power trip in most interactions.
Like, when I am already on a roll, I have this vivid vision of the tasks to take & tools to use. I am quick to decide and to come up with solutions and at the same time very loud about it.
But every time I wake up, I feel worthless, scared that I am not enough, that one step into the world, means step between thousands of angry faces that want to hold my face against a gutter.
How do you overcome this? I've avoided things due to emotional discomfort my whole life and I don't think I can ever do better at this point. I find that it requires conscious effort to learn to do things that are required as standard for most adults.
With math specifically I had a good teacher in high school who made us practice in class together. He'd get everyone to sit around a table and he'd give handheld whiteboards to every fourth or fifth person (depending on the number of basic steps in the problem), and then the person with the whiteboard would do the first step and pass it to the person on their right. That experience stuck with me because just forcing me to get started (with help available) was enough to quickly clear up anything I was avoiding getting started on at home.
I still avoid doing things because they're emotionally uncomfortable occasionally, so I haven't really found a general solution. But it's gotten better over time and it's less of an issue when I'm more invested in something.
I have found the advice in this Andrew Huberman video to be helpful. Long version: [1] Useful clip from that longer video: [2]
TL;DR: motivation is a muscle that can be developed as long as your efforts to do so are voluntary. In other words, do the hardest thing that you can actually do, even if it is just pick up one piece of trash and put it in the garbage. Or wash one dish. The list of possibilities is endless. The idea is to face your discomfort, and as you do so repeatedly, your ability to do so increases.
Makes perfect sense. Kind of interesting the opposite can bite too: Math came naturally to me, but after seeing some high standardized test scores adults paraded them around and made a big deal of it, so it became stressful to do without perfect outcomes. For my own kids I just refused to allow a lot of that stuff like IQ testing, etc.
Yep, that's my experience as well. Or because it's just something I don't like to do that much or that doesn't give me some good hormone to my brain in exchange after doing it.
Extreme forms of procrastination do not mean that someone has ADHD by definition. It can be rooted in anxiety, stress, depression, other mental health conditions. It can be lack of motivation, or simply the habits and behaviors one has developed over time.
I’d really like to know in addition to personal anecdotes of successfully overcoming it, what on average turns out to be most effective?
My ADHD meant I couldn't hold down a job or relationship. You lose your job enough times and the depression that follows is inevitable.
That said, I can imagine a Dustin where I had stumbled into a different career, a different family situation. Then my ADHD might not have caused enough problems to be a disorder.
I sometimes wonder if it’s just a sign of being in the wrong career.
A lot of people chase the money in an area of general interest. But the actual tasks they are being paid for might simply not be what they are suited for.
If always think to myself if only brainstorming, ideation and online shopping were a career haha.
ADHD is definitely a major cause, but another big one which is much more complex to talk about is “avoidant” type behaviors that are a result of trauma/neglect/abuse early in life.
There is correlation that occurs among diagnoses of ADHD, Autism, CPTSD, and other “mental issues”, such that by the time one becomes noticeable as having pathological effect, then it’s likely to be able to identify at least a few more issues acting in a comorbid manner.
Avoidant behaviors can also just be a result of getting older. Everyday is the youngest you will ever be and gradually doors close off to you which can induce panic and anxiety.
Starting a task towards a longer term goal brings to the forefront of how little time you have left.
People love to label things, and parents overlabelling ADHD has been a common warning among anyone working with kids now.
In broader context I think we are now finally starting to pay attention to the fact every single human is subtly or not so subtly different, and we haven't even scratched the surface of mapping all those particularities and so we put people into categories we know, not necessarily where the actually belong.
It's great were slowly letting go of 'normalising' ourselves, but we're going to have to learn entirely news vocabularies to says describe who we then are. Also, by thinking about yourself you define yourself, so if you think differently you define differently. I.e. we are fluid, to a certain extent.
I was diagnosed with anxiety and ADHD about 8 years ago, and since then, I have mainly worked on my anxiety. My anxiety has diminished drastically, and I have found that my ADHD symptoms are now manageable without medication (although I still struggle some days). For me, ADHD led to failing in my daily duties as a kid, which led to higher and higher levels of anxiety, which really exacerbated my ADHD symptoms. Now that I have learned how to control my anxiety, and with the resulting calming of my nervous system, the ADHD isn't nearly as problematic.
TL;DR: anxiety and ADHD are often intertwined and they spiral each other out of control, so what looks like ADHD is sometimes much worse because of anxiety.
If you read the diagnostic criteria that is used, it’s so broad it could easily apply to most of the world’s population…as long as they declare they have trouble focusing.
I disagree. I think that 6 months or more of 5/9 symptoms of inattentiveness or 5/9 symptoms of hyperactivity, persistently, does not represent most of the world. (And excluding: "The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions." 6/9 symptoms are required to diagnose children) [0]
Indeed, surveys show that it's probably under 10% [1]. Mind you, these are surveys of symptoms, not surveys of diagnoses.
If you look into how the criteria is chosen its very arbitrary. And this descriptive diagnosis where you pick from list A and B is extremely bizarre from a common sense standpoint. And there is no brain imaging or genetic markers available.
> The number of criteria required for a diagnosis of ADHD has been set arbitrarily in DSM-5. No scientific justification has been presented nor method used for deciding how many criteria should be required
> For the case of ADHD specifically, this is translated to: “if an individual has attention deficit hyperactivity disorder it is because he is inattentive, disorganized and hyperactive-impulsive, and if an individual is inattentive, disorganized and hyperactive-impulsive it is because he has ADHD.
The set of symptoms are not arbitrary, but are connected logically, by each being the result of a deficit in some type of executive function. ADHD is broadly a disability of executive function.
Executive function is historically entirely a psychological concept, although there is starting to be some biological understanding which came later (e.g. which brain regions are involved, etc.).
> The number of criteria required for a diagnosis of ADHD has been set arbitrarily in DSM-5. No scientific justification has been presented nor method used for deciding how many criteria should be required.
Erm.. welcome to psychiatry ?
There is nothing bizarre (or unique to ADHD) about picking from a list of precise, agreed-upon criteria to form a mental health diagnosis. It's how the entire field works, and it's actually a huge step forward from the times when each therapist made up their own definitions.
In the absence of definite imaging or genetic markers for most illnesses, building consensus on criteria and thresholds in a reference manual (the DSM) is the next best possible way to end up with objective, useful and standardized definitions.
Not having a blood test for an illness doesn't mean it isn't real.
> It's important to be aware that each percentage point is hundreds of millions of dollars.
You don't need to resort to conspiracy theories once you understand the above.
Many people probably do have the same brain wiring, or maybe it's a low level of background dopamine, or whatever it turns out to be once science figures it out.
The reason most of the worlds population isn't diagnosed[0] is that second D: Disorder.
No disorder, no problem, no diagnosis.
[0] outside of lack of access to mental health resources, not knowing what they're looking for so never getting referred to a place to diagnose it, not believing in treating mental health issues, self-medicating, avoiding stigma, etc
This is true about most diagnostic criteria, which is why medical students think they have all the illnesses before they get experience with people who actually have them. Its just very difficult to use words with sufficient precision to capture the bits that are, somehow, more obvious once experienced.
The brain does adapt to adhd meds and there are studies showing this.
The thing I don’t like about adhd is that the premise is the brain doesn’t produce enough dopamine so we return it to normal levels…but the brain always seeks homeostasis so it will adapt by producing more dopamine reuptake cells. There are no conclusive imaging studies or genetic markers for it.
The meds certainly do work but if you ask someone to explain their condition to you they have all have the same simplified and erroneous explanation as to why they can handle addictive meds and the general population cannot.
I think it’s pretty much a general smart drug but with high risk of addiction.
Deep breath in... Many people who suffer from ADHD actually have undiagnosed allergies.
My father was told he had ADHD late in life... he had allergies. I had problems with focus and being scatterbrained... on days the tree pollen was up. Kiddo was starting to get easily distracted and unable to focus on schoolwork... It was an allergy to the hard wheat used in U.S. bread making and preservatives.
You [edit: most people] don't just "have ADHD." That's like diagnosing someone with a headache disorder. There's an underlying cause that requires more work to dig out.
No that's not true. ADHD is a real thing that exists. You shominimize that.
Now are there other disorders/illnesses/allergies that affect concentration definition.
A lot of people have deviated septum or allergies that make nasal bresthing incredibly hard without effort. Of course this has a major effect on concentration.
Other examples surely exist. But please don't minimize real debilitating ADHD.
I don't think they are in any way minimizing ADHD. ADHD is diagnosed by symptoms, and has a large number of different possible underlying causes, most of which are not well understood. When ADHD is caused or worsened by an allergy, that in no way makes it not real ADHD, but can make it easier to treat, if the allergy is identified!
It's known that ADHD is highly heritable and has some specific genetic mutations weakly associated with it, but it can also be caused by traumatic brain injury, toxin exposure, some food dyes and preservatives, and allergies. It's very likely that many of the heritable genetic factors themselves have interactions with external environmental factors, and can therefore be treated with environmental manipulation, if we can understand it better.
If you ever get diagnosed as having ADHD though, then every doctor will forever pretend that they know for a 100% fact that your ADHD is caused by mutated dopamine receptors, while having done no testing of course; why would they when you have already been diagnosed
That is pretty silly, and a misunderstanding of the research. All of the mutations in dopamine transport associated with ADHD are pretty weakly associated, and still very common in the non-ADHD population.
You are actually making the case that ADHD doesn't exist or is pretty meaningless.
There is no scientific basis for it, it was a bunch of criteria that were arbitrarily chosen to create a term called "ADHD" so that they can prescribe meds.
You just have to ask the question as to why we can't give meds to everyone when 25% of college students report using them. Why can't we give meds to someone addicted to social media as a fix?
Everything is premised on it being a neurodevelopmental brain defect from birth...so that meds can be effective. But there is no basis for this.
You might as well just give anyone who doesn't get good marks at school or doesn't perform at work meds. In fact people want to do this.
I'm not talking about difficulty breathing. I'm talking about a systemic inflammatory response from allergies that includes neurological symptoms like an inability to focus, problems with reading comprehension, and uncontrolled daydreaming or "tuning out." Every time I got my allergy shots, my concentration was shot for the day, and it had zero to do with my nasal passages.
I'm not minimizing the problems of those who suffer from ADHD. I'm hoping that they work with their doctors to see if there's more going on.
ADHD is a spectrum, so it can have different severities. Some people simply find it more difficult to function well whereas some people find it absolutely and utterly impossible.
What spectrum means in this context is that it's a multi-dimensional problem- different levels of severity across a large number of different dimensions. Executive function is typically broken up into a large number of different functions, and people have different levels of each, so a person that functions well in one context might do poorly in another, and vice versa.
> What spectrum means in this context is that it's a multi-dimensional problem
I used "spectrum" to mean that ADHD is not always severe enough to cause outright disability, but the underlying problems can still be present to a lower degree.
The parent mentioned "procrastinates or can struggle with focus without having ADHD" (emphasis mine) and I wanted to point out that some of those people may also have some very mild form of ADHD.
I don't disagree with your point, but you are misusing the term and misunderstanding what it means when it is applied to neurodevelopmental disorders like autism and ADHD.
ADHD the diagnosis is a set of symptoms. These individual symptoms may be present to varying degrees in different people. The fact that it varies means that ADHD is a spectrum. That's not misuse or misunderstanding, and it agrees with your original comment. I'm simply clarifying what I meant because it's not just "everyone has different specialties". It's that specific problems that can contribute to ADHD can be present in people even if they don't have the entirety of ADHD. There is no genetic boolean that decides if one will have ADHD or not.
While, sure, everyone does have different specialties, they could also have some traces of ADHD that aren't severe enough to give them all the symptoms but still manage to hurt their performance in certain areas.
Also, I said nothing of autism. Please don't extrapolate
ADHD is the set of symptoms. The only reason people care about the term is because you can access drugs.
> “The child often has difficulty sustaining attention in tasks or play activities because she has ADHD and she has ADHD because she does not sustain her attention in tasks or play activities.” As Pérez-Álvarez (2017, p. 2) notes “the symptoms are the guarantee of the diagnostic category, which in turn is invoked to explain the symptoms in an endless loop.”
Aren't you guys talking about an academic and somewhat theoretical definition of the term "spectrum"?
In reality, it means
"But doctor, how can you attach this very serious and stigmatizing diagnosis to my child while skipping half the tests in the official criteria and fudging the numbers to reach some threshold number?"
"Oh don't worry, it's a spectrum, you see"
...
"But doctor, what you just entered into my medical records is not what I told you at all, how can you be sure you're making the correct diagnosis if you're not really listening to what I'm saying, and when you're completely misrepresenting my situation?"
I'm using "spectrum" to mean that mild and severe cases of ADHD exist, as well as everything in between.
For example, ADHD controls my life and I was never diagnosed with it until I figured out the symptoms myself, because nobody could ever see me struggling with it - there is no fighting it for me. However for some others, their ADHD is trivially controllable via medicine or habit-forming.
When analyzing people what is not a spectrum? Every human attribute can be placed on a spectrum. Even other diseases, disorders, etc.. A broken bone can be a hairline crack or shattered into pieces.