[otikik]

I'm not a mental health professional, and I don't know the author. Please be assured that I don't mean any disrespect whatsoever: consider getting tested for ADHD by a mental health professional.

I was diagnosed very late, since my ADHD was of the "inattentive" kind. I would not be troublesome at home or at school, like an hyperactive child would. A lot of people like this go undiagnosed.

One of the traits of ADHD is that our brains crave novelty, and that is definitely one of my struggles. Having professional help makes a difference.

> When I’m building something, that information is the thing coming to life in front of my eyes, every new button etc is awesome.

The neurotypical version of this is called "being in the zone", which just means "enjoying what you are doing, so holding concentration for long periods of time takes very little effort". The ADHD version of this is more intense, it's called hyperfocus. The activity absorbs all of your attention. You barely feel hunger or sleepiness, you can literally go a it for days, you keep thinking about it while you are not doing it. It's useful if you happen to hyperfocus on something that is helpful to you.

[Aurornis]

> One of the traits of ADHD is that our brains crave novelty

I know you meant well by your post, but this type of reductionism doesn't really do justice to ADHD and can lead a lot of people astray.

It's actually very normal to crave novelty. It's also normal to become bored with repetitive, boring work. It's not a unique feature of ADHD, nor is craving novelty a diagnostic indicator for ADHD. These are normal features of being human and not, by themselves, suggestive of ADHD.

I feel like this is important to highlight because the pop-culture definition of ADHD has changed dramatically in recent years. The definition has shifted so much that any description of feeling bored or seeking novelty is mistaken for ADHD, which is definitely not the case for the actual diagnostic criteria.

I don't mean to discourage people from seeking help from mental health professionals, but I do want to discourage people from self-diagnosing and getting tunnel vision on a specific diagnosis (generally ADHD) to the exclusion of other explanations.

[csallen]

It's actually very normal to crave novelty. It's also normal to become bored with repetitive, boring work. It's not a unique feature of ADHD, nor is craving novelty a diagnostic indicator for ADHD. These are normal features of being human and not, by themselves, suggestive of ADHD.

Thanks for mentioning this. I see so many comments with people self-diagnosing themselves with pathologies because, "I forget things often," "I get distracted a lot," "I get bored," "I sometimes doubt myself when there's a challenge ahead of me."

These are normal things!

I think a lot of people just don't have a good baseline for what's normal.

[Aurornis]

> I think a lot of people just don't have a good baseline for what's normal.

I saw a lot of this when I mentored college grads for a while.

I also saw another problem where people were resistant to the idea that they were normal. This happened a lot with tech students who grew up being the smartest kid in their local elementary school and the computer wizard in the family. They grew up being told they were smart and destined for success. When they didn't get selected for a FAANG job or their startup wasn't successful, they'd often go searching for alternate explanations. ADHD was a common one. I can't count how many times I listened to people explain to me that they were "going to get a FAANG job" or "going to do a startup" but then they "discovered they had ADHD". Like it wasn't okay to just get a normal job, they had to have a specific and public reason why they weren't in a 99th percentile position.

[robocat]

How can we help our friends that buy into this self-victimisation?

Our culture accepts and normalises the behaviour of using self-deceptive excuses. Our culture provides prepackaged excuses which are socially unacceptable to confront. It is a self-reinforcing system including professionals and woowoo practitioners.

The word trauma gets trivialised to be used as an outcome for the normal vicissitudes of life: blame your parents for everything and accept you can never "recover" and you must never repress. Woowoo past-life trauma and regression therapies and discussions - arrrgh.

My responses so far are limited to (a) dropping people I like from my life because their behaviour was unacceptable, (b) playing along with the beliefs of other friends regardless of the damage of those beliefs, (c) slowly trying to influence those I care about the most (d) blithely ignoring everything - training myself to not care.

We can all clearly see faults in others. Our other problem is to recognise within ourselves when we are making self-deceptive excuses or blaming others for things under our own control. Should I buy into the self-help industry? Counselling, coaching, or woowoo?

[8n4vidtmkvmk]

Have you tried telling them straight up that their behaviour is unacceptable? That they need to stop feeling sorry for themselves and complaining or no one will want to be around them?

I found out this lesson the hard way. I was a miserable kid. I don't know how it figured it out, but feeling sorry for yourself accomplishes nothing. Maybe life is shit. Maybe you're over-exaggerating. Doesn't matter, you're not going to get out of that situation by 'woowoo'ing.

Sometimes folks just need to reflect. One core memory I have was when I was really young. I was crying over something. My older brother's friend said to me "Why are you crying? You just want attention!" and that shut me right up. I thought about it, realized he was right, and realized I didn't need to cry.

[robocat]

> Have you tried telling them straight up that their behaviour is unacceptable?

Yea, but it isn't effective on anybody that is fooling themselves or that isn't interested in listening to me. I lack the skill of influence. My usual outcome in this situation is that I drop anyone that is unwilling to listen because it isn't healthy for me. I do give people the benefit of the doubt. Both parties need to respect each other - one-sided submission is unpleasant.

The majority of people learn for themselves as they mature and they are easy to communicate with. Your examples fit this.

The problem is the people that never learn or don't care to. I don't know what to do with them.

[riehwvfbk]

Well, what's the alternative? What's not "woowoo"? Something along the lines of "you are bad, tainted by original sin and deserve to suffer?" Or is it "you need to hustle harder?" Well, guess what - self-harm is no more productive than self-delusion.

[8n4vidtmkvmk]

I guess I had the opposite problem. I'm still not quite sure. I was maybe in the top 5 or so of my highschool but never thought of myself as a genius but more like "not dumb". Got into uni, did OK (3.4 GPA) but didn't try super hard either. Graduated, and then no one really wanted to hire me. Finally, some small PHP shop "took a chance" on me and I quickly became their top developer. Worked there 8 years, started getting interviews at a few different FAANG positions but kept failing, I guess because I thought I was so good at my day job I shouldn't have study for an interview. Eventually wised up, studied my butt off for 3 weeks and got in.

Where was I going with this story... it's hard to get into FAANG but it's really a matter of studying/practicing the right things. Doesn't matter how good you are at writing code, really.

Maybe some of these kids are qualified but don't interview well like me. Or maybe their resumes aren't interesting enough to pique a headhunter or whatever AI has taken their jobs.

This is probably not PC for me to say, but people need to stop using mental health issues as an excuse. Maybe they have some, maybe they don't. What are you going to do? Give up on life, or figure out how to work with them?

[balfirevic]

> I think a lot of people just don't have a good baseline for what's normal.

True, but that works both ways. "Surely everyone else gets distracted this much".

[richarme]

Disagree. I think adults with ADHD are well aware that they are not "normal" with respect to many of the symptoms, even if they don't know it's due to ADHD. At least that's my personal experience.

Few examples off the top of my head:

- being unable to pay bills/fines on time even with plenty of money in the bank.

- being physically unable to keep sitting in a chair after a while in meetings.

It's easy to see that most people around you don't exhibit such traits.

[TeMPOraL]

Yes, but adults who have ADHD, but neither know it nor suspect they may have it, will look for alternative explanations to make sense of their consistent failures at things other people seem to handle fine. A common one they arrive at is character flaws. They'll see themselves as lazy or childish, and as they try and fail to correct it, they'll internalize guilt and shame.

"Surely everyone else gets distracted this much" is exactly the kind of belief that creates and reinforces feelings of guilt.

[8n4vidtmkvmk]

People need systems. Oh, I forgot to pay that bill on time. Oh I forgot again. And again. And again. Maybe I have ADHD? Whoops, forgot to pay the bill.

Maybe they do have ADHD, maybe they don't. Maybe they should get diagnosed so they can learn more about it and find strategies for dealing with it instead of blaming it.

But regardless, just find something that works for you and stop making excuses. I used to forget my wallet, keys, and/or employee badge. Now I keep a wooden bowl near my front door, and keep those items in there and only those items in there. When I leave, I put those items in my pockets and go. When I come home, I puts them back in the bowl. Simple routine. Prevents forgetting.

Bills go on autopay. If you can't autopay for some reason, put it in your calendar. Forget to check your calendar? Set an alarm that you have to dismiss.

[dns_snek]

> Maybe they do have ADHD, maybe they don't. Maybe they should get diagnosed so they can learn more about it and find strategies for dealing with it instead of blaming it.

Cool, I wish it was that simple but I don't think you realize how screwed up the system is. The waiting lists are YEARS long in many places, and many people with ADHD (I would dare to speculate the majority) get misdiagnosed with just anxiety and depression at some point, for women it's even harder and they're often misdiagnosed with bipolar.

The fight to even get your struggles appropriately recognized is long and exhausting, often requiring energy that people with ADHD just don't have.

> But regardless, just find something that works for you and stop making excuses.

This sort of advice is perhaps the most common form of gaslighting that individuals with ADHD experience from childhood up to present day and I don't think you understand how damaging it is.

People with ADHD should still make an effort, but these aren't just "excuses" and the fact is that the majority will never be able to consistently perform at the same level as non-ADHD people of similar intelligence. If I can't find something that works, and people who should know better say I'm "healthy", then this means I'm suffering from a character flaw like laziness.

This is the highway to guilt, self-loathing and internalized shame, which eventually leads to suicidal ideation (1 in 4 people with ADHD) and approximately half of those will attempt to take their own life at some point.

Obviously certain systems can and do work for certain people, but they're not a solution and chances are that the people you're lecturing have already tried various systems and still struggle.

How are you accommodating people who you think are using ADHD as an excuse?

> put it in your calendar. Forget to check your calendar? Set an alarm that you have to dismiss.

Autopay is a valid tactic, but other suggestions just don't work consistently. Even if there's an alarm that has to be dismissed, there's a chance that you'll dismiss the alarm, go to pay the bill and then get sidetracked by a random chore and completely forget about it again.

That's why ADHD is a disorder and a disability, not just a personality quirk. I hope that you mean well, but you're spreading very unhelpful and potentially damaging commentary on the topic.

[csallen]

I have plenty of money in the bank. I work for myself and set my own schedule. Yet my bills, fines, and letters pile up and accrue late fees constantly. I've filed my taxes late like 7 out of the last 10 years.

Maybe I'm naive, but the thought has never occurred to me, "Maybe it's because I have ADHD."

[hnuser123456]

Mostly people who grew up in too pristine of a world, who think that everything should be easy following established procedures, that anything being difficult is a sign of a medical issue rather than just... a difficult task.

We all have our own interests. We are easily bored by things that are very far away from our interests. You cannot force any given person to care about any given topic as much as you want them to or think they should. Or you can, but then you no longer know who that person really is, and your concept of them becomes inaccurate, setting you up for surprise when that person isn't what you wanted them to be.

[otikik]

Agree on everything. I must point out that I specifically mentioned “by a mental health professional” and I led with the fact that I am not one. I should have stressed it more perhaps.

[fn-mote]

> this type of reductionism doesn't really do justice to ADHD

Sure, but the poster lives that life (has adhd) so you should give some credence to that as well. They want others to have an easier road.

[codazoda]

I am very similar to op.

What type of mental health professional should we seek out?

I talked to a PA about ADD a couple times, but dropped it because they seemed doubtful and I felt a bit ashamed (because you treat ADD and ADHD with a controlled substance).

I went on phentermine for a few weeks, for weight loss, and my mind felt absolutely amazing on that medicine. It’s apparently dangerous for long term use though.

I’ve written my own story; how to lose money with 25 years of failed businesses.

https://joeldare.com/how-to-lose-money-with-25-years-of-fail...

[robocat]

> 25 years of failed businesses.

Your written story comes across to me mostly as regrets of counterfactual timelines; the result of your perception because of societal pushes. If you wrote "25 years of successes", I wonder how it would read?

> What type of mental health professional should we seek out?

What a strange question... the implication is that you think your life problems (perhaps completely normal) are due to a medical condition. Perhaps ask the people who know you best what mental health conditions you have. It's a slippery slope once you submit into the mental health vampire system (and abrogating your agency has other psychological costs).

What's the medical term for a hypercondriac that believes there's something wrong with their mental health so badly that there is something wrong? I'm pulling your leg: it is normal to worry and do seek help if you actually need it. Usually family and friends have a good idea if you need professional help: mental health problems are almost defined as problems that cause you and your loved ones severe downsides and outcomes are often visible (less commonly well hidden).

In theory, coaches are the people to help us learn to attain goals. Is get councelling getting coaching?

The article itself is frustrating because it a narrative based on self-diagnosis using psych terms (conditioning, dopamine). Any comments here are framed within that context. I wonder how their friends would explain the problem they have identified?

[codazoda]

> regrets of counterfactual timelines

I think I agree. These are my memories and our memory is not great. I've even learned that when I am most confident, I am more likely to be incorrect. It's not lost on me that I am relying on my own imperfect memory.

> What a strange question...

My question was specific to the comment I replied to, which suggested a mental health professional, which I was contrasting to a family physician.

[magnetowasright]

I'd avoid physician assistants and nurse practitioners.

If you want a formal diagnosis, a clinical psychologist should have the authority to assess and diagnose ADHD. A psychiatrist can, too. The best way to approach getting a diagnosis (and the finer detail of what kinds of psychologists can do a formal diagnosis, what referrals you might need, etc.) is highly dependent on location. Once you have a diagnosis, you should be able to try medications if you want.

If you aren't interested in medications, you might still want to pursue some (enough for you to learn about yourself) or all of a formal diagnosis if you want. The benefits and downsides of a formal diagnosis are also highly location dependent.

Talking to a psychologist might be helpful regardless of diagnosis.

Please don't use an ADHD 'coach', they're a predatory scam

[otikik]

Psychologist first. Psychiatrist if the former recommends one.

[ajb]

Not entirely sure that's the right way round, but it may depend on your jurisdiction.

In the UK, if a psychiatrist recommends some kind of therapy, they will refer you to someone else. But if a psychologist* does, they will do it themselves. Which kind of leaves them marking their own homework.

* Clinical psychologists are the ones qualified to deal with mental health problems. There are several other categories.

[TeMPOraL]

With ADHD, I'd recommend the reverse. ADHD is one of the few things in psychiatry that in many cases can be diagnosed or ruled out very quickly, in big part because the effective medication - stimulants - are one of the very few psychiatric drugs that work instantly, and have obvious effect. People with ADHD have a different way of responding to those than people without, and therapeutic change is drastic enough to give useful information to a doctor over couple days worth of therapy.

For that reason, I recommend not just talking with any psychiatrist, but specifically one who specializes in adult ADHD. This is because the "failure mode" of a person with ADHD going to someone who dismisses the possibility and "wants to rule out other things first" can be disastrous. It's highly likely that such a person will be treated for depression first.

In contrast to ADHD, it can take years to rule out depression. The process usually involves a combination of drugs and therapy. Therapy is basically dating - for it to work, you need to find a therapist that's a good match for you personally; determining patient-therapist fit usually requires at least couple sessions, so it may take you a year or more of switching therapists every other month before you find the one that can help you - and that's if someone even tells you that you're allowed and supposed to switch therapists if it's not working out with your current one, instead of trying to power through (or blaming yourself). And, to make it worse, the deal is similar with the drugs.

First-line pharmaceutical treatment for depression involves drugs that universally take at least a month to fully kick in and start showing any positive effect. There's couple families of drugs, couple variants in each, and you're supposed to rotate through them (and dosages) until you find one that has noticeable positive effects, and side effects you can deal with. Worst case scenario here is, again, years of wasted time (and money, and your will).

Maybe you'll get lucky and get the right drug the first time around. I sure did with the SSRIs I got prescribed back almost 20 years ago. But, if you (also) have ADHD, you're screwed anyway. Those drugs don't just take a month to kick in - they take a month to wear off. Things get better, you stop paying attention, get too distracted or anxious to renew your prescription, stop taking the medicine, and by the time you realize your mistake, you're back where you started except now also ashamed and reluctant to call your doctor.

I'm not saying to assume you have ADHD or dismiss other possibilities - just don't set yourself up for failure by going to the "default" doctor that is likely to follow the "default" procedure and treat you for the "default" condition that happens to be one of the hardest ones to diagnose and treat.

[Aurornis]

> I talked to a PA about ADD a couple times, but dropped it because they seemed doubtful

Let me add some context to this that isn't obvious from the outside: There has been a massive surge in ADHD self-diagnosis in recent years, fueled largely by TikTok and other social media. During COVID it got so bad that there were even pill mills offering ADHD diagnoses via TikTok ads, and anyone who paid their fee was basically guaranteed a diagnosis after a short 5-minute video call.

This causes problems for many reasons, but one of the biggest is that people are arriving to doctors with a self-diagnosis to the exclusion of other conditions. It's the job of doctors to look at the whole picture and explore other explanations, which can feel insulting when someone has already arrived at a conclusion.

There's a growing problem where people who are actually suffering from depression, anxiety, or even physical conditions like sleep apnea are self-diagnosing as ADHD and then requesting stimulants from their doctors, which temporarily masks their underlying condition and makes everything worse.

I understand why you felt shame, but if there's one thing I can tell you it's this: You actually want a doctor who questions the diagnosis, doesn't rush to prescribe habit forming medications, and explores the big picture. Having someone concerned about your health as a whole is very valuable.

> (because you treat ADD and ADHD with a controlled substance).

There are actually several non-stimulant ADHD medications. They can work quite well, but they come with one caveat: They can take a long time to show their full effects. There are studies showing that the positive effects of Straterra (Atomoxetine) continue increasing even past the first 12 months.

Controlled substance stimulant medications have the opposite time course. People take them and feel them working immediately. Within hours. However, tolerance also starts accruing immediately and people will often feel like the medications aren't "working" after a while, when in reality they've just reached steady state.

> I went on phentermine for a few weeks, for weight loss, and my mind felt absolutely amazing on that medicine.

I have to warn you: All stimulant medications will produce false feelings of euphoria, motivation, and excitement when you first start taking them. These effects do not last. The brain will adjust to the medication over time and that "amazing" feeling will disappear.

Your experience is extremely common, though: People take a stimulant, either from their doctor or from a friend, and feel great. They think that if they can secure a constant supply, they will feel that way forever. Unfortunately, it can actually distract from the true goals of ADHD treatment when people start chasing that short-lived feeling while neglecting the treatment of their attention.

The truth is that after someone has taken a stimulant for years, it no longer makes them "feel amazing" like that, even though it can help the ADHD. The brain reaches a new homeostasis in the reward centers. This introduces a secondary problem, wherein any missed doses or attempts to lower the dose produces a rebound effect where mood, motivation, and focus are temporarily lowered due to deviation from that new homeostasis.

In short: Don't read too much into how you felt while taking powerful stimulants for a short while. It's not analogous to the therapeutic effects of ADHD treatment, though it's easy to mistake one for the other.

[user68858788]

As someone with ADHD that definitely gets dopamine from novelty, is there actually anything that can be done? Adderral and vyvanse work for a couple days and then I build a tolerance. The only indefinite solution is to completely remove all distractions from my area (internet, games, food) but that’s never been sustainable for me. Moderation, rewards on completion, and other mental tricks don’t work for me. Crisis is a good motivator, such as overwhelming student loans, but I’m back to being unfocused now that those are under control.

At this point I’ve mostly accepted my success is severely limited by ADHD.

[magnetowasright]

> Adderral and vyvanse work for a couple days and then I build a tolerance

Have you been able to go through titration and dose adjustment with a (competent) psychiatrist? When starting or restarting meds it's expected for the first few days (or more) to have a more obvious impact. After your body has adjusted to being on the meds, if the meds aren't helping (or are outright making things worse, like making you sleepy), you could just need a higher dose. The adjustment period is a bit different than the issue of proper long term tolerance.

There's a fair few options as far as stimulant meds go, and the combinations of drugs, release profiles, and dosages can take a bit of iteration to find what works.

There’s also nonstimulant medications used for ADHD but they're generally less effective than stimulant meds, but we're all different and maybe they'll help?

[user68858788]

I haven’t been to a psychiatrist in five years. It wouldn’t hurt to go back and see what they say. Thanks for giving me some hope!

[magnetowasright]

Please do! It took my mate like a year and a half with an amazing psychiatrist to settle on a regimen.

I'd recommend having a look through some ADHD groups; they're full of knowledge and tips and tricks that can help you self advocate.

A psychiatrist should have explained to you upon prescribing these meds that the first few days may feel like rocket fuel and that thereafter they may feel great (or can make it worse), and they should have advised you to keep a diary about your meds so at your next appointment you can review the impact the meds had and any related struggles like remembering to take your afternoon meds (if you had them, for example).

Whatever happened with your last psychiatrist that left you with no helpful meds, no guidance on determining whether the meds are working for you or not, and no follow up to boot is so unacceptable.

A little bit of self advocacy can go a VERY long way, though. Things like asking to book the next appointment at the end of your current appointment, and asking if there's any particular side effects you need to watch out for until your next appointment can mean the difference between what happened to you last time and you finding meds that actually work. You shouldn't have to remind them to do any of that but it can really help.

Sorry, I ranted a bit! I just really hope you find a psychiatrist who will actually just do their job and work with you to figure it out! Finding meds that actually help is quite achievable.

[user68858788]

I appreciate a good rant, thank you! You’ve moved me and I’ll definitely be scheduling something soon. I was unprepared to self advocate the first time I worked with a psychiatrist, but now I have a bit more experience and some clear goals, thanks to you.

Thanks again for taking the time to help out a stranger!

[magnetowasright]

I really hope it all works out for you! I'm sure it will; you've got this! :)

[atlintots]

how has a diagnosis helped you?

[otikik]

I did get depressed for a while, which is a common comorbidity. Drugs helped somewhat. Ultimately sleep, diet, family, friends and sport helped more.

I am less hard on myself. My therapist helped me realize that some of the things I was blaming myself for were actually not my fault. I have some techniques to help me with some of my everyday struggles. I sometimes are able to aim my hyperfocus instead of just letting it point to whatever random thing crosses my mind - the trick there is realizing that almost anything worth knowing has some interesting nuggets, you just have to dig for them sometimes.

My son was diagnosed at an appropriate age (he has hyperactivity so it has been visible for a while).

[pithanyChan]

Druhgs. Dropped his dealer and got the Gustav.

I'm kidding. Once you know what, you can check your patterns against the standard and the deviations. Then you can approach the circuits that are fucked and identify triggers.

Best to get to the roots of the reinforcement in childhood, though. Behaviors and preferences surpressed, people you didn't beat up for reasons and so on, behavioral triggers, when you held back and why. What distracted you when you did a specific thing or the other. And, of course, the standard stuff, what were you rewarded for and did you really care about that thing yourself?

Might take a while but it'll be worth it.

[jbs789]

Fascinating bc I have seen this behaviour as an observer of others - I read the first couple paragraphs and landed in the same spot.