What is ADD?

by adrusi • 11 years ago

108 119 11 years ago

Good article. I was diagnosed as an adult, and now have coping strategies (including some stimulants for days when I really need to get shit done). Had I been diagnosed 30 years ago, oh the things I could have done.

The worst? My mother was a teacher. You'd think she would have caught it.

Task switching is really my biggest issue. Once I get in hyperfocus mode on something, a) I really hate getting interrupted, probably because b) getting back focused again is all but impossible.

robwormald2• 11 years ago

"Had I been diagnosed 30 years ago, oh the things I could have done" - truer words have never been spoken. I was diagnosed at 28 and it was like when I got glasses in middle school for the first time. "OHHHH, this is what the world is supposed to look like"

jschwartzi2• 11 years ago

I first got glasses at 26, so I think I understand what you mean. It was maddening to realize that my issues with math in high school may have been due to my inability to read the textbook quickly enough to succeed.

bpyne4• 11 years ago

Do the stimulants cause any jitters or mood alteration like caffeine can cause?

Cshelton2• 11 years ago

I took addrral as a kid and hated it. It changed my personality, it made me never hungry, I would stare into space, even though I'm super focused on a thought, friends would question what I was doing.

I've been taking Vyvanse now and I don't get any jitters or change in personality. The worst side effect is dry mouth...the best side effect...well, having a body high that last for hours, it's a nice bonus I guess? Is it healthy? I have no idea.

JohnBooty7• 11 years ago

Caffeine user for decades, Adderall user (10mg, twice daily) for close to a decade.

Neither gives me jitters, although I only take small doses of Adderall at a time. Adderall doesn't give me a crash when it wears off like caffeine does.

Adderall can make me more high-strung at times. A little more intense, a little more irritable.

It's a trade-off, of course... because failing to get necessary shit done can also make a person quite stressed out, you know? So Adderall, by helping me get stuff done, also indirectly improves my mood. It's not a magic cure, but it has been worth it for me.

adrusi3• 11 years ago

Yes. I don't take them frequently, and my dosage is still at the level it was when I was 15 and taking the regularly, and my tolerance is obviously lower than it was then, so the effects are more intense than for people who take it every day.

I can experiece occaisional jitters, and perceived body temperature fluctuations. I can be more a little withdrawn from the world around me. This is the case for any amphetamine drug at least. Ritalin can be a little different, but for the most part it's about the same for me. The most notable difference is that sometimes I feel irritable on ritalin.

kendallpark3• 11 years ago

Depends on the medication, dose, and your personal physiology. I was on a low dose dextroamphetamine as needed for a while. Then life got stressful and I found myself getting mild anxiety from it. I switched to Vyvanse which dextro packaged for extended release (lasts for 14 hours). Vyvanse did not induce any jitters but would keep me up late if I didn't take it first thing in the morning. I switched to a different extended release dextro that lasts for about half the time as Vyvanse. That's worked out well because I can take it in the afternoon without jeopardizing my sleep.

As a rule of thumb though I don't take stimulants on a regular basis, just as needed. Don't want to become dependent.

aidenn0• 11 years ago

They definitely can cause mood alteration, but tend to not cause jitters in the doses prescribed for ADHD.

BillyParadise2• 11 years ago

My experience is that when you're on the right dosage, no. I do hit a low around 10 hours after taking the pill (I have Vyvanse), when its effects start to wear off. Other than that, the only other side effect I have is that I end up biting the inside of my lower lip, I must be sucking all the time or something. Hurts the next day.

Oh, and if you take a pill, then forget and take another, well, it leads to a VERY jittery day.

melindajb5• 11 years ago

The stimulants can, especially in the early days, affect your mood. A good MD will work carefully to start very slowly and ramp up, with the idea to give you the lowest possible effective dose.

For example: my MD started me on the lowest dose of ritalin once a day for a week

then twice a day for a week

then once that was ok I was given a longer acting version called Concerta that I took once a day.

it took six months to ramp me up to my current dose. there were times he felt it was time to go up and I wasn't ready. there were times when I felt it was time and he wanted me to wait. I had some side effects that went away if I went down a dose level, and then as I adapted, I'd move back up again. My dr. was very experienced and warned me about what to expect--a period of feeling invincible for a few months that would fade (true), and a feeling in the evenings of "rebound" as medicine faded (true). He was my rock when I started on this and still is It brings tears to my eyes how he helped me change my life. Now I only see him every three months for 30 mins and I'm given an unusual amount of latitude: I'm given various doses and allowed to manage it myself--choosing lower doses when I want to drink real coffee (my full dose does NOT work with caffeine) or when I can't get a full night's sleep. I'm told this is highly unusual given the meds are a controlled substance and a sign of the faith my MD has that I'm not a drug seeker. (he's right. I saw "requiem for a dream" and let's say he'll never have to worry...)

I was lucky. I can afford the best doctors. the right medicine worked, the first time. This is not true of everyone.

I cannot emphasize enough how important it is that anyone who thinks they have ADHD to go to an MD who specializes in this stuff. Family doctors do NOT count. your basic Ph.D therapist doesn't count.

start with science, go slow and built outwards. FWIW my therapist says he will only work with 4 MD's in SF because his take is that they're all pill pushers. My MD is one of the only MDs in SF allowed to provide telephone prescriptions for Concerta. The pharmacy he sends me to never has shortages. This is also not consistently true, even in SF.

It's no joke. Amphetamines can screw you up. Take this stuff seriously, please and find a good doctor for a proper evaluation.

edit to add: you know I have ADHD: I didn't answer your question. haha!

the short answer is that yes, in the beginning your mood may be "up" and you may feel down on the rebound while you are adjusting. But as you stay with it, things even out and become VERY predictable. If you have ADHD you will recognize the terror I used to have about making sure my brain was ON a the right time--all sorts of weird rituals to wake it up for an important meeting, etc. On the meds, I have confidence my brain will be at its level best so my anxiety and its attendant grouchiness just went away. PS: coaching and therapy (two different things) helped this a lot and if you're late diagnosed as I was, you will need them. I recommend reading "driven to distraction" before you start meds, because that "invincible" feeling the first few months is the best time to start changing habits. you will dip in motivation after that, but never as bad as without and having those systems in place to fall back on will save you.

Cshelton2• 11 years ago

I was diagnosed at age 6. I hated taking addrral back then and stopped. The next time I took it was junior year in college. Wow, I knew I was already smarter than most of my peers, and I was finally able to show it in the grades. I wish I took it in HS, it's a game changer. I do agree with the OP, and I do not understand how programming is something I can focus on and do for hours. The brain is very interesting. (Just in writing this reply I set my phone down half way through...) ADD is a blessing and a curse. I love being able to think different though.

kendallpark3• 11 years ago

I was diagnosed with ADHD AFTER college. I had always performed well in school so there was no cause for alarm growing up. But I was always a spacey kid--my mind would race all over the place and I had trouble focusing on one single thing. Except when I hyperfocus. Then I have a hard time hearing other people around me.

The worst? My mother was a psychiatrist. You'd think should would've caught it.

During college, I coped by making my life as busy and stressful as possible. That helped me get stuff done. I also play(ed) sports. Now I am in med school and I take medications as-needed. Med school is sufficiently challenging so I find it easier to focus now compared to my previous 9-5 programming job.

lmitchell• 11 years ago

Thank you for sharing this - my girlfriend has ADD and this is the best explanation of what it really feels like and how it affects you that I think I've ever heard. I honestly feel like I understand her better now, which makes me really happy.

philliphaydon2• 11 years ago

I was diagnosed with ADD and spent years on ritilin. IMO its not about not focusing or having a short attention span. It's about not being stimulated. Too easily do we throw drugs at a problem rather than solving the cause.

thelambentonion• 11 years ago

I strongly suspect that I have ADD/ADHD (and I'm looking for a good psychiatrist in my area to discuss this with now), and I fully agree with you. However, in life and at work, there are many instances where I need to do things that I don't find particularly stimulating or interesting.

In these areas, my inability to force myself into the mindset of that work has seriously impacted my quality of life. I've spoken to a few people who I know have similar problems and are now on medication, and it seems like it's been INCREDIBLY constructive for them.

This is all anecdotal, of course, but I figured I'd throw in my two cents. I'd still like to find a solution that doesn't involve medication, just as a matter of personal convenience, but it's been a struggle so far.

philliphaydon2• 11 years ago

Ive found things over the years that help. When I was in school the only classes I could do and focus and pass was techical drawing, and physisics and chemistry. Any other class I likely landed in the deans office for various reasons. I spent most of my schooling on a daily report where I had to get teachers to grade my behaviour in class. That helped me more than ritilin.

After I dropped out of school I ended up doing programming which for me is super easy to focus with. I love solving problems.

So my job is easy for me. Except meetings. I fidgit during meetings. End up scratching or biting my nails.

Outside of work I travel and do photography. I like building stuff but that's hard in Singapore. So I miss building stuff with dad back in NZ. And watch movies. Anything else I can't focus long enough to do. For me. I have to be moving or solving a problem. Things like reading and writing are impossible. Even writing emails at work I keep short cos I end up never completing them.

JohnBooty7• 11 years ago

     However, in life and at work, there are many instances
     where I need to do things that I don't find 
     particularly stimulating or interesting.

Yes! There is a school of thought that says ADD is more of a "personality type" than a "disability."

Generally I view it that way as well. But it sure is a disability when you actually have to do boring things - and who doesn't have to do boring things? I mean really... who doesn't spend a significant portion of their lives doing things that aren't particularly interesting?

And I'm generally in not in favor of treating myself as if I'm "disabled" in any way whatsoever - I don't expect less of myself because I have ADD. Hell, I also participate in sports even though I'm asthmatic and blind in one eye and my depth perception sucks.

JohnBooty7• 11 years ago

Sorry to double-reply, but...!

    I strongly suspect that I have ADD/ADHD (and I'm looking
    for a good psychiatrist in my area to discuss this with
    now)

    ...I'd still like to find a solution that doesn't involve 
    medication, just as a matter of personal convenience, but 
    it's been a struggle so far.

The good news and bad news is that medication is only a part of the answer and it is far from a silver bullet.

Generally, the rest of the answer comes in the form of coping (ie, focus-enabling) strategies that literally apply to anybody in the world whether they have ADD or not.

In my experience, proper sleep is the biggest factor, followed closely by sufficient exercise (which of course helps you sleep as well). Proper environment. Proper task management system. Support and understanding from your partner. The exact formula is different for everybody, I'm sure.

    a good psychiatrist

Psychiatrists generally just prescribe medications and help to ensure they're working as designed. I have not heard of them being particularly helpful for ADD therapy and coaching; generally there are therapists who specialize in that sort of thing.

I highly support your idea of seeing a psychiatrist - I just wanted to give a heads up on what a psychiatrist will and won't do. Their worldview is generally limited to the medication itself, which can be incredibly myopic when it comes to ADD success.

Good luck!

jsolson2• 11 years ago

As an adult who was diagnosed with ADHD as a child and had teachers, professors, family, and friends suggest I seek treatment for it over the course of about 20 years, I respectfully disagree. I started into treatment in adulthood (this year), and it has radically improved my reliability when it comes to completing tasks I take on. Previously, even work I found interesting and exciting would only hold my interest until the next conversation I had with someone (which, since I sit in the middle of a sea of desks, usually took less than 10 minutes). I am more willing and able to say "that's interesting; can we talk about it tomorrow" rather than simply diving into it only to be distracted again later that day.

throwawadd2• 11 years ago

What is your treatment, if I might ask?

rsuelzer• 11 years ago

3 promotions in 3 years. Treatment changed my life.

bpyne4• 11 years ago

This talk really explained it for me in layman's terms. He has strong opinions about medications.

https://youtu.be/uU6o2_UFSEY

eruditely4• 11 years ago

This author is not serious or reputable, we already have the data over the years about what happens to you in life. Look at "ADHD in adults what the science says" or any lectures by Russell Barkley.

Give me a break, your finances, chances at failing in education, getting fired at work, are much higher with ADHD. Enough of the anti-medication nonsense.

eruditely4• 11 years ago

Unfortunately, we know that drugs are the best line of response, and that if you are familiar with the evidence people with adhd have orders of magnitude of issues with school/work than normal kids.

See : ADHD in adults, what the science says by Russell Barkley graphs and data are in there

hyperion2010• 11 years ago

Modern civilization is incredibly stimulus impoverished, especially the educational settings we provide for children. One interpretation of ADD is that certain brains are tuned to have higher thresholds for driving bottom up attention. The result of this is that in a 'normal' educational environment all stimuli fall well below the threshold for engagement so attention jumps all over the place because there is no signal strong enough to hold it. Now, take that same brain out into the woods and let it wander around and look at things and explore and where the 'normal' brain is overwhelmed by the sound of the wind in the leaves and the patterns of light on the forest floor the ADD mind sees the footprints of the deer and the outline of a grouse.

robwormald2• 11 years ago

A great book on this topic is "Driven to Distraction" - I recommend it to anyone curious about ADHD. The first chapter put me in tears - it was like reading a history of my life.

sirtaj• 11 years ago

Same. Suddenly my entire childhood made sense. It's also a little frustrating because I can't help thinking of all the lost time.

coldcode• 11 years ago

ADD and Autism are two instances of brain chemistry being "different" which strangely seem to work with programming and is fairly common among programmers. Sometimes I wish I had become a brain researcher, as the brain is a fascinating thing to study as we still know very little about how it works, and often times even less when it doesn't. We can't even adequately define what "normal" is if it even exists.

We can't even understand how drugs affect both of these; much of what we know to prescribe them is more guesswork and anecdotal than based on solid understanding.

JohnBooty7• 11 years ago

Very close to my own experiences.

ADD is like a television with excellent reception - only problem is, you don't get to choose which channel it's tuned into. :)

     "Had I been diagnosed 30 years ago..."

The goddamn name itself is painfully misleading. It's probably why I or my parents and teachers never even considered it until I was diagnosed in my 30s. "Attention deficit disorder" sounds like a disorder where you can't pay attention, not a disorder where you pay attention very well, just not to things of your choosing.

The misleading name is also probably part of the reason why some people question ADD's existence: they don't even understand what it is. They see kids with ADD focusing on video games or whatever and say: "See, they can pay attention!"

I have one problem with the article: not everybody experiences ADD exactly the same way. There are recognized subtypes such as predominately inattentive ADD, etc.

jwdunne2• 11 years ago

This is exactly my feelings 100%. Teachers made me out to be dumb or mentally defective to my mother but my mother saw something different at home, where my attention was free. My mum recounted a story of me at 3 years watching my father and grandfather empty out a flooded garage trench (not sure of the name). Supposedly, I gave a suggestion that blew everyone away because it made the job 100x easier.

A bit different to the teacher making fun of me to the whole class by sitting in a chair, pretending to be catatonic several years later because I didn't have the answer for her rapid fire 9 times table (I was daydreaming and as is common my mouth was slightly ajar).

Not to say there wasn't problems; my mum used to send me up to get her a brush or some small thing and I'd forget once I'd get upstairs. After more than a few bollockings, I learned to ask where it was in the hopes it'd jog my memory. I was accused of not listening and I couldn't explain that it wasn't my fault!

I could however spend hours on Sonic 2 without taking a break. I was also infatuated with science and spent hours coming up with inventions that, to my dismay, already existed. I remember reinventing the fire sprinkler. It was more like a fire water balloon but the principle was similar.

These little memories, which form just a tiny grain of the daily struggle for the past 23 years, are almost funny. A joke, however, isn't so funny everyday, many multiple times a day.

When you discuss one small nugget, people say "ohhhh everyone was like that" and, due to lack of focus, you are unable to defend against their dismissal.

After 23 years, all day everyday, and the pain, hospitalisation and searching, dismissal by the ignorant is almost insulting.

JohnBooty7• 11 years ago

It sucks. I'm sorry you had to deal with all of that.

Also, adding insult to injury, your use of the word "mum" suggests that you may have been forced to play the 50hz PAL version of Sonic 2 instead of the 60hz NTSC version.

dwarman3• 11 years ago

I have 2e ADHD, diagnosed only a few years ago at 63. A revelation. Lots of study ensued. This might be be a good article, the intro seems ok, but I cannot tell.

I cannot read this article. It reflows differently every time I scroll the page and the text I was reading goes .... somewhere. It is painful. iOS 8.4 Safari on iPad Air. - may be OK on desktop browsers. But I only go there for work these days.

So in that sense it is a self-referential demonstration of the problem with ADHD focus. Also a downvote on reflow logic these days. HTML5 has got too clever. Reflow on scrolling? wtf!

(edit). OK. I got around it. Last paragraph says it all for me. That hits what NT's cannot grasp: it's not a character defect, its not a "simple" matter of will power. FWIW, I have hit upon a way around some of the will power issues, the important ones like giving up smoking and losing weight to get out of pre-diabetic region: a form of mental Judo based on visualization and meditation. It's slow - can take a year - but it works. This after 20 years of trying using conventional will power based methods. I have a stack of Smoke-Ender certificates to attest to that.

DOORKNOB!

adrusi3• 11 years ago

Hmmm not sure why that would be happening. I test in on Firefox on Android (Nexus 5), where it works perfectly. I don't think I do any weird things with the CSS, although I just modified an existing theme, so maybe it's something I haven't looked at much.

Not everengineering websites is important for me, It's important to me that they work with javascript disabled and even in text-based browsers, so I'll look into this tomorrow.

dwarman3• 11 years ago

It seems that Safari iOS's latest "helpful" behavior, sliding the tabs and favorites bar out of sight, is changig the window size and so invoking reflow. Which moved what I was reading off the bottom of the screen. Scrolling down to find it again re-opened the tabs and favorites, changed the window size back, invoked reflow, and moved my reading point out of view above the window. Scrolling back up again - well, I'm sure you get the picture. Part of the magnitude of the issue was moving the page header (big green panel) from the top to the side and back again, also when the header was on the side the text font was larger.

chrismcb• 11 years ago

On my ipad the left pane keeps resizing, sometimes narrower sometimes not. I was using my left thumb to scroll. It really does make the site unusable.

jkmcf• 11 years ago

FWIW, I don't see any weird reflows on Chrome for Mac.

freshyill• 11 years ago

Sounds like some thing weird is happening. Just use the Safari Reader mode or whatever it's called.

muriithi• 11 years ago

Lots of reflows on Opera Mini.

unimpressive2• 11 years ago

I linked this on HN earlier today, Russel Barkley giving an overview talk on ADHD. Highly recommended:

https://www.youtube.com/watch?v=LyDliT0GZpE

EDIT: This thread is disappointing me. Part of why I linked this talk is that it paints a very different picture than most people would probably already have of what 'ADHD' looks like.

helpfulanon5• 11 years ago

Posted a comment about this as well - I also highly recommend watching this, Dr. Barkley's lecture altered how I view my myself

EGreg• 11 years ago

I honestly don't see the reactions described here as really abnormal.

Doesn't want to play 300 hour RPGs

Forcing oneself to study boring subjects is effective for two weeks then willpower gets worn down

Hmm, sounds like often ADD is a measure of how far you are from one of those studious people who are able to sit still and intensely focus... I don't think that's as useful as acknowledging there are different types of people. Personally, ADD seems to me to be the "Hysteria" of the 21st century. If anything, short attention span is manifest a lot more in today's generation because of the fast turnaround time of electronic queries (googling from your phone vs perusing the library), and vastly increased personal reachability (cellphone vs pre-beeper), leading to a faster pace of life.

Thom Hartmann wrote a book describing this phenomenon regarding ancestors who were adapted as hunters vs farmers:

https://en.m.wikipedia.org/wiki/Hunter_vs._farmer_hypothesis

triangleman• 11 years ago

The next day I had an anxiety attack because I had squandered a whole day

The root of the problem. ADD is an anxiety disorder.

smt889• 11 years ago

I highly recommend reading about the opinion of this doctor that ADD doesn't exist as a separate condition. It is, instead, a symptom of many other possible conditions.

http://time.com/25370/doctor-adhd-does-not-exist/

This is consistent with my own experience with people who believe they have ADD. Many of them turned out to have untreated anxiety and depression.

It's also interesting to note that there's a lot of research supporting the idea that mindfulness can decrease the effects of ADD. That seems to support the idea that ADD isn't a physiological fact, but a curable behavioral issue.

gizmo686• 11 years ago

That seems to support the idea that ADD isn't a physiological fact, but a curable behavioral issue.

Are those contradictory positions? For example, consider lactose intolerance. It is true that a change in diet can "cure" lactose intolerance (in the sense of you never experience any symptoms), but lactose intolerance is still physiological.

Similarly, is there any research that mindfulness actually cures ADD, rather than acts as a coping mechanism to reduce the symptoms of ADD.

smt889• 11 years ago

I didn't say that mindfulness would cure ADD. I just said mindfulness has been shown to decrease the effects. It's a not-very-well-defined condition to begin with, so I wouldn't believe a study claiming that something could cure it.

At the moment, there's no way to measure whether someone is cured. It may even be that "curing" ADD has some unintended/negative consequences -- perhaps some people have good qualities that are linked to their ADD. I really don't know.

Others4• 11 years ago

I read your article, and I agree with some of the points. I don't think stimulants are much of a solution either, if I could wake up one day and be "cured" of my ADD that would be fantastic. For me, distraction is a compulsion, one that I wish to be rid of.

However I really resent the suggestion that I could somehow cure myself with "mindfullness" or if I "just tried harder." It is really easy for a person who has never suffered from ADD to think this way, but neither are legitimate solutions. Sure I try hard, sure I meditate at least once a day. I do it because it helps me. That doesn't mean that one day, somehow, I'll be able to function on that alone. It is only with medication, and help from a psychologist, I can lead a normal life.

Honestly, when people suggest that I somehow could cure myself I feel terrible. I feel like flawed person, like I'm failing at the basic life skills everyone else has mastered. But worse than that, I dread that someone else will be exposed to that, before being diagnosed. I was blessed to be diagnosed at a young age, and I can't imagine going through school, and into the workplace without help.

smt889• 11 years ago

There are many illnesses that are considered very treatable or curable, but that doesn't mean every case can be improved. I definitely wasn't implying that people with ADD aren't trying hard enough!

A great example of the above is OCD. People with the illness have to work extremely hard to experience improvement, and not every case improves. But it's still considered to be something that people can recover from nearly completely.

throwaway901355• 11 years ago

I think it's clear at this point that ADHD is vastly over-diagnosed, particularly among people who self-diagnose after using the internet to confirm their beliefs.

However, ADHD and other executive disorders are very real and very debilitating for a small portion of the general population. I've unfortunately experienced this first-hand after a serious traumatic brain injury took me from normally-functioning adult to ADHD adult overnight. (Part of the reason I'm using a throwaway is that I prefer not to make this fact well-known).

This is consistent with my own experience with people who believe they have ADD. Many of them turned out to have untreated anxiety and depression.

This mirrors my experience somewhat, although I believe many people simply confuse normal human behaviors as ADHD symptoms. It's perfectly normal to prefer to focus on subjects you enjoy while experiencing difficulty when forced to focus on uninteresting topics, but somehow this has been construed as a symptom of ADHD on the internet. (As I've commented elsewhere, hyperfocus is not actually a symptom of official ADHD definitions but it's very popular on internet forums).

It's also interesting to note that there's a lot of research supporting the idea that mindfulness can decrease the effects of ADD. That seems to support the idea that ADD isn't a physiological fact, but a curable behavioral issue.

I have to disagree on several of your definitions here: There is plenty of research in to potential biological contributing factors to ADHD-type behaviors. However, the brain is remarkably plastic and capable of learning good or bad behaviors. Unfortunately, modern life tends to train us toward ADHD-like behaviors, with constant bombardments of stimuli and companies working overtime to develop products that distract us and are carefully designed to capture our attention.

Others4• 11 years ago

As someone with ADD, self-diagnoses is incredibly frustrating. It drives a really unhealthy perception of the disease.

CardenB• 11 years ago

I like how you say that ADD is over diagnosed but fail to see that you arrive at that conclusion in the same way that other wrongly self diagnose themselves.

I'm not agreeing with your or disagreeing with you, but you don't have any evidence to back up your claims.

melindajb5• 11 years ago

What in your background makes you qualified to make this assertion vs decades of peer reviewed science?

It's fine to have opinions, it's not fine to spread mis-information.

No one can tell by looking at or talking to someone whether they are self diagnosed or not. The fact is that ADHD is very challenging to treat as not all cases respond the same way to the medication and therapy. Executive function is quite complex and deeply related to environment as well as genetics. For example, if your parents blame you for being "lazy" vs helping you find coping strategies, that's bound to impact confidence and thus performance.

When lay people such as yourself pass judgement it makes it harder for those of us with the condition to get the accommodations we are legally entitled to.

I will remind you that ADHD is more heritable than height. Many adults over a certain age were actually under diagnosed.

Please also note that ADHD has one of the highest co-morbidity rates of any mental condition, that is, it is most likely to be accompanied by anxiety and depression for the precise reason that others like to judge people for character on things like forgetting small details. If you treat for anxiety and depression and NOT ADHD you can have very serious, long lasting problems.

ADHD is a lack of control of attention, and hyperfocus is an example of that. IT's usually a reason people go undiagnosed. the parents say, "oh johnny can focus when he wants to, he's just lazy."

I encourage anyone who thinks they have this condition to first read "driven to distraction" and then use its advice to seek out a qualified psychiatrist for a proper evaluation. Do NOT rely on family doctors or your average therapist. Get a specialist. It's worth it.

Now while I'm at it, to your point on "modern life." We all get depressed some times, but there's a wide gulf between that and clinical depression, which I'm sure you would agree with me on.

To that end, here's a post by one of the top ADHD writers, Gina Pera, based in silicon valley, on this very topic:

http://adhdrollercoaster.org/myth-busting/myth-4-modern-life...

I quote:

"Does that mean, however, our fast-paced life causes ADHD? No, Quinn says. Too much stress can impair anyone’s brain function, but it doesn’t cause ADHD. She offers this bottom line: “When you remove stressors, people with ADHD still have ADHD. In other words, it’s not purely stress that inhibits their functioning. It’s the lack of skills required to meet challenges.”

Moreover, our fast-paced world can make someone with ADHD function worse than they might have in earlier times. In fact, some experts say, that is another reason ADHD is being more widely diagnosed: because modern life is demanding more of us than ever before."

edited to add this additional quote:

"Moreover, ADHD’s recorded history might span at least 2,500 years. That’s when the Greek physician-scientist Hippocrates apparently observed a condition sounding suspiciously like ADHD. He described patients who had “quickened responses to sensory experience, but also less tenaciousness because the soul moves on quickly to the next impression.” No mention of cell phones and video games as causative factors."

helpfulanon5• 11 years ago

I had a similar situation - I didn't discover that I had ADHD until after an accident and possible brain injury brought it to my attention. Though my Drs were very skeptical that the accident caused ADHD, more that the shock threw it into overdrive.

After being diagnosed and doing some more thorough research I realized that ADHD had been present my entire life and may also run in my family, it just got much much worse after my accident.

What lazy drs, popular self-help and cheap internet content writing really botch when discussing ADHD is having us focus on the distraction portion and not the underlying reason for why - the portion of the brain responsible for executive function is diminished. This is a neurological problem. Part of the ADHD brain is malfunctioning.

Successfully coping with ADHD is more about learning mechanisms for how to react to stimuli without having the fully developed executive function abilities that others have. But people want to believe they don't have a problem, that they're not disabled. And the disorder doesn't manifest itself very visibly, so it's easy to deny, dismiss or ignore. So they write it off as an environmental problem, something that can be corrected with "proper thinking". This is false. It's a disability, and the solution is coping with the problem.

JohnBooty7• 11 years ago

     That seems to support the idea that ADD isn't a physiological
     fact, but a curable behavioral issue.

That's a false dichotomy; those aren't mutually exclusive things. Why suggest that something isn't a "physiological fact" because it can be successfully treated with mindfulness, CBT, or anything else?

Physiological issues affect behavior and vice-versa. That's why treatments like mindfulness and CBT are so effective.

     Many of them turned out to have untreated anxiety and 
     depression.

Sure. Absolutely. There is zero doubt in anybody's mind that ADD is comorbid with anxiety and depression, nor that those things can contribute to ADD.

     This is consistent with my own experience

My own experience is this: I can assure you that ADD has been a constant thing in my life for 39 years and that depression and anxiety have not been.

smt889• 11 years ago

It seems we agree on everything except semantics, but I'll respond anyway.

When I said "physiological fact", I meant to suggest a category including things like Down's Syndrome. I did not mean things like depression or other mental illnesses that may be observable using brain imaging and/or caused by physiological circumstances.

I won't get into the problems with trying to draw generalizations from brain imaging (easy enough to Google it), but I also have a problem with the idea that observable, physiological problems can't be fixed through behavioral means. We definitely agree on that.

I can assure you that ADD has been a constant thing in my life for 39 years and that depression and anxiety have not been.

I should have been clear that I don't think ADD is only a symptom of depression and anxiety. I was just sharing the theory that ADD is a common symptom of many conditions, rather than a true condition in itself. In my experience, the cause has been depression and anxiety, but that's obviously not an exhaustive or scientific sample.

adrusi3• 11 years ago

I've a few such pieces, including this one. It might very well be true that people who believe they have ADD, actually have one or more other psychiatric problems. Many people who believe they have ADD don't, and many diagnoses are invalid.

Unfortunately it's hard to prove to someone who can't experience it that ADD exists. Its symptoms are too easy to explained away with quite a few different theories. Unfortunately ADD is not just another overmedicalized normal condition. Even though far too many well intentioned people who can't understand assert that it is.

I do have problems with anxiety and depression, and they are not untreated. They are related to but distinct from ADD.

And mindfulness can help, like it can almost anything, because it's a tool for controlling your thoughts. This can be directed as willpower. While not without side-effects, willpower can overcome most of the problems associated with ADD in high enough doses.

smt889• 11 years ago

I personally don't have as much of an issue with the diagnosis of ADD as I do with the definition. I think the weak, unscientific definition drives the misdiagnosis.

I believe that in the future, the medical community will have a better understanding of the many things that can cause ADD, and the diagnosis of "primary ADD" will mostly be replaced by other diagnoses.

I have no idea if most of these will be depression/anxiety diagnoses or not. I was just talking about my own, very limited experience.

Unfortunately ADD is not just another overmedicalized normal condition.

I actually do think it might be overmedicalized in children. I grew up with many children who would be diagnosed with it today, but weren't at the time. Whether they had it or not, they grew into functioning adults without ADD.

melindajb5• 11 years ago

Here is information about current Israeli medical research that indicates a physical marker is close to being identified--by involuntary eye movements.

http://www.jpost.com/Israel-News/New-Tech/Involuntary-eye-mo...

Given that the condition was described over 2500 years ago by Hippocrates himself, I think you're parroting something that is akin to anti-vaccination theory. No credible science supports you.

I will also add, as I said below:

1) ADHD is more heritable than height. If it were "made up" that couldn't be true. Many parents are getting diagnosed when their kids come in, because those of us in the 70s and 80s were very under diagnosed.

2) ADHD has one of the highest co-morbidities of any mental condition, for the precise reason that we don't look "sick" --like depression or schizophrenia--so people assume things like talking too much, bouncing our legs,forgetting details, messy desks and so on, are signs of a character flaw. From the time we were small children our parents and teachers may have constantly berated us, calling us lazy, or stupid. That can give you a raging case of anxiety and/or depression and the science does show that if you treat for ADHD, the depression and anxiety often lift.

smt889• 11 years ago

I never suggested ADD is made up. I simply posted an interesting opinion that it's defined in a problematic way. Nothing I said (or linked to) suggests that there are no physiological markers for ADD, or that it doesn't exist.

ryhanson3• 11 years ago

Having been recently diagnosed with ADHD (inattentive type), I never thought I had ADHD, because I COULD focus on things. I didn't realize that this hyper-focused state I would go into was a major sign of ADHD, especially since I couldn't stop focusing.

I, too, was one of the fortunate ones that hyper focused on computers and programming. This focus started at a very young age, and has since turned itself into a very rewarding career.

You are not alone! I believe there is a pretty strong correlation between software developers and ADHD. I feel like programming works well with the chemistry of an ADHD brain. Some of the best engineers I've met have been diagnosed with ADHD. There are a few that I believe have it, but I'm not sure if they've been diagnosed or not.

ADHD truly is a very interesting brain type!

zkhalique• 11 years ago

How is being able to focus on, say, a coding problem, a sign of ADHD? This DSM 5 trait sounds a bit arbitrary.

ryhanson3• 11 years ago

It's not the ability to focus on a coding problem, that is a sign of ADHD. It's the inability to focus on anything BUT the coding problem.

It doesn't matter whether it is a coding problem, video game, book, website, or any other task. There are times when there is something much more important to be focusing on, but it requires such an insane amount of effort to focus on that thing, that you simply don't. Or maybe you do focus on the important task, but chances are it doesn't get your full attention or you end up distracted very quickly.

throwaway901355• 11 years ago

It's important to note that hyperfocus is not a DSM-V criteria for ADHD. In fact, hyperfocus doesn't appear anywhere in any official diagnostic criteria for ADHD that I'm aware of (If I'm wrong, I'd love to know).

The official DSM-V criteria, along with helpful explanations, are available here: http://www.cdc.gov/ncbddd/adhd/diagnosis.html

I'm still not sure how hyperfocus came to be such a popular idea on internet ADD forums and self-diagnosis websites. If someone can point me toward the etymology of the idea, I'd really like to see it.

toddkazakov2• 11 years ago

Before I read this article I never heard of ADD. Now that I am more familiar with the symptoms this sounds a whole lot like me.

When I start programming I can do this for 16 hours without eating, peeing, etc. I am constantly worried, always miss appointments, my girlfriend is always annoyed with me that I only do stuff that interests me and usually out of nowhere I stop listening to her in the middle of the conversation.

Finding an interesting job was priority number one for me. I just couldn't bear working 9-5 for a large corporation. In the middle of the day after I'd just stop paying attention to anything or anybody and just start playing chess.

I am quite surprised I experience about 80 percent of the symptoms listed on various websites, but it never occurred to me that this can be a real condition.

throwaway901355• 11 years ago

Now that I am more familiar with the symptoms this sounds a whole lot like me.
I am quite surprised I experience about 80 percent of the symptoms listed on various websites, but it never occurred to me that this can be a real condition.

If you suspect you have ADHD and you find that it is negatively impacting your life, I would suggest seeking a good psychiatrist for a professional evaluation. Be warned that some psychiatrists are all too eager to write a prescription and send you on your way, when successful treatment hinges on a deeper understanding of the condition and the development of successful coping strategies once you've identified the negative behaviors.

Moreover, it's worth noting that the author's definition of ADHD and hyperfocus doesn't actually match the medical definition of ADHD. Also, many of the ADHD websites list overly-broad ADHD criteria, such than almost any warm-blooded human could feasibly self-diagnose as having ADHD given the vagueness of the symptoms.

ADHD is, first and foremost, a deficit of attention abilities. It isn't quite as selective as the author makes it out to be, in that someone with the traditional medical definition of ADHD would not be able to focus on anything for 16 hours straight as you are able to. In fact, being able to focus for such a long period of time is a truly enviable ability, and I doubt you'd find any competent medical professional who would suggest that you have ADHD if you are able to focus on your work for twice as long as the 8-hour workday that most people struggle through.

It's important to note that we all miss appointments, we all prefer to do activities that interest us, we all occasionally stop listening to people mid-way through a conversation, and we all struggle to pay attention to boring jobs. These aren't signs of a disorder, these are just facts of life.

toddkazakov2• 11 years ago

All I am saying is this might explain many things in my behavior my friends/partners never understood (sometimes even I did not).

I lose interest too quickly in various things like readings books, playing games, following conversations. Even when writing, after a sense or two, I get bored in what I want to say. The only thing (so far) that interests me is my job.

I share your concerns that nowadays doctors tend just to prescribe drugs, that only treat the symptoms. All seek for a medical advice - i.e. get diagnosed. From there on I think the best I can do is be aware of the problem and try to except more control/will over the things that make sense.

JohnBooty7• 11 years ago

    It's important to note that we all miss appointments, we
    all prefer to do activities that interest us, we all
    occasionally stop listening to people mid-way through a
    conversation, and we all struggle to pay attention to
    boring jobs. These aren't signs of a disorder, these are
    just facts of life.

Absolutely. Those are important words, and are very very true. Let me add something very important:

While it is normal to "zone out" and struggle with boring tasks at times, if a person struggles with attention-related tasks on a long-term basis to the point where it negatively impacts their life, that points to some kind of behavioral issue.

falcolas• 11 years ago

A psychologist for meds, and a counselor for behavioral changes has worked the best for me. The meds make a tremendous difference, but they don't obliterate all of the issues, so there has to be more.

Plus, a counselor is cheaper by quite a bit than the psychologist, and can't prescribe meds, so they default to behavioral therapy.

deaddodo3• 11 years ago

It isn't quite as selective as the author makes it out to be, in that someone with the traditional medical definition of ADHD would not be able to focus on anything for 16 hours straight as you are able to.

"Hyperfocus" (perseveration, really) is a very real aspect of ADD, however it's not the blessing some make it out to be. In fact, Russell Barkley addresses it directly in one of his seminars [https://www.youtube.com/watch?v=e1IEv9CA2vA]. Other things the author said also made me think he had been wrongly diagnosed or has a minor form of ADD, but definitely the "choice of focus" point he makes and how amphetamines affect him.

kendallpark3• 11 years ago

Finding an interesting job was priority number one for me. I just couldn't bear working 9-5 for a large corporation. In the middle of the day after I'd just stop paying attention...

And that is one of the big reasons I quit 9-5 programming and started med school. I still do a lot of programming now, but it's stuff that I'm interested in, which makes a world of difference in terms of focus.

wmt• 11 years ago

Don't self-diagnose yourself too quickly, as none the features are not unique to ADD. Reading through the list of symptoms at http://www.helpguide.org/articles/add-adhd/adult-adhd-attent... I can more or less find myself from almost every symptom listed. I hyperfocus on programming and games, I easily forget conversations and deadlines, I constantly misplace and lose my things, my desk is cluttered, I can zone out during a conversation, I can blurt out things without thinking too much, I procrastinate very easily (I'm browsing HN right now instead working!), etc.

However, I don't have ADD. Despite the fact I share many features with people suffering from ADD, it doesn't take that much effort for me to focus in things I'm not exited about. I can do tasks I find boring for a long time if I really want to, and I can even consciously hyperfocus on almost any task that needs focus.

throwaway901355• 11 years ago

ADHD can be quite debilitating at the extremes. Understanding what it is and how to cope with it is extremely helpful for those who are afflicted.

That said, it's important to point out that the author of this post is defining ADD differently than the medical definition of ADD. The idea of hyperfocus is very popular among the self-diagnosed and on internet forums dedicated to ADD, but the term "hyperfocus" doesn't actually appear in any of the medical literature I can find, with the exception of a few books that seem to suggest that "hyperfocus" is more likely related to the idea of perseveration, which is a deficit in set shifting ability. However, perseveration isn't as selective as the concept of "hyperfocus," which seems selective for enjoyable tasks.

The idea of hyperfocus as a component of ADD is part of a bigger problem: The modern pop-psychology definition of ADD has been watered down and expanded so much that it is beginning to feel more like a horoscope than a medical diagnosis. Even official medical diagnostic criteria can't seem to agree on how strict the definition of ADHD is. For example, ICD-10 ADHD diagnostic criteria will yield a rate of roughly 1-2% ADHD in the general population of children. Using the DSM-IV criteria, that number rises to roughly 6-7% of children.

However, if you have the average person read an internet definition of ADHD or follow one of the first results for "ADHD test" in Google, you'd be hard pressed to find an average college student or tech worker who wouldn't identify as at least mildly ADHD per the pop-psychology definitions. Take a look at one of first results in Google for "adhd test": http://psychcentral.com/quizzes/addquiz.htm

Questions such as "How often are you easily distracted by external stimuli, like something in your environment" are so vague as to be applicable to everyone who has ever been distracted by a notification on their phone. I don't think I've known anyone who wouldn't agree with questions like "How often do you have difficulty sustaining your attention while doing something for work, school, a hobby, or fun activity" when we're expected to sit through 8+ hour desk jobs doing things that frequently aren't tasks we would have chosen to willingly pursue.

The growing misconception seems to be that for a non-ADHD person, it should be easy or somehow enjoyable to focus on the things that we don't necessarily enjoy doing. That's obviously not the case, but these casual redefinitions of ADHD as a disorder that is accompanied by an increased ability to focus on enjoyable tasks are really stretching the definition of what it means to have AD[H]D.

throwawadd2• 11 years ago

I have also been diagnosed with ADD and have serious problems focussing on studying - up to the point where I might drop out. I can pass many courses on an a+ level, but most courses that require a lot of studying are extremely hard to pass. I have already done some internships as a programmer - all of them very successful. I love computer programming and am certainly not bad at it.

But I have to wonder, what are my chances of getting a decent programming job in Europe without a degree? Getting internships has been very easy, but I can't imagine getting a job as a programmer can be as easy without a degree.

Are there people who know more about this, or people who I can talk to about this? Thanks

Wingman4l7• 11 years ago

I can't speak for Europe, but it seems like there are plenty of well-regarded dev houses in Seattle who are more interested in what you've done on Github or published in a mobile app store than what college degree you've got. There are also several multi-month programming bootcamps that claim a 90%+ placement rate in $70-100k+ USD jobs in development or data science.

unimpressive2• 11 years ago

but it seems like there are plenty of well-regarded dev houses in Seattle

Can you give any pointers to these or examples?

abalashov• 11 years ago

For whatever it's worth, you can read my article on dropping out of university two years in. However, this played out in the US, so it doesn't capture what I suspect to be a higher prevalence of official credentialism in Europe. Still, it might give you some pointers.

http://likewise.am/2015/07/26/too-cool-for-school-a-retrospe...

whoisthemachine• 11 years ago

Unfortunately, the hyperfocus comes with a huge side effect: once someone with ADD reaches near-completion of whatever they are focused on, they tend to lose the focus they have. This was and still can be the biggest hurdle for me to overcome.

lettergram• 11 years ago

It's interesting that people consider hyperfocus and lack-of-focus different. Essentially, they are two sides of the same coin.

ADHD is simply the lack of ability to control attention. There are drugs that work short-term, however long-term only methods of coping are really effective.

After reading everyone posts below, I figured I would direct you to my startup:

http://synaptitude.me

The startup (just applied to YC) that my team and I are working on actually addresses this issue using something called neurofeedback therapy:

http://synaptitude.me/blog/neurofeedback-in-200-words/

Effectively, your mind is like a programmable computer. Once you learn to recognize when you start losing focus, it's possible to program it (over time) to do something different. The idea being, neurofeedback therapy lets people better understand themselves and in-turn cope better.

After the brain has been reprogrammed it stays that way long-term (unless something else reprograms it).

If you are interested in reading more about neurofeedback, here's a literature overview:

http://synaptitude.me/blog/literature-overview-of-using-neur...

rtpg• 11 years ago

As someone dealing with ADD but (for legal reasons) can no longer get any Adderall (which is what I had as a kid to help out), does anyone have recommendations on alternative solutions that they've found to help?

reitanqild4• 11 years ago

"Gamification". And get me right here: not dumbifying.

I used to depend on the pomodoro technique and a other hacks like "autofocus" etc.

Basically techniques that allow you to set targets that you can easily and provably reach even if that target is just work-on-this-and-nothing-else-for-x-minutes-and-make-a-check.

Edit: and deadlines. Maybe another reason why the pomodoro technique works so well.

helpfulanon5• 11 years ago

The amino acid L-Tyrosine is a dopamine precursor and has a mildly beneficial effect. It's available over the counter though I've had to order on Amazon since it's not often found in stores. When I'm off meds I'll take that, some multi vitamins and a few cups of coffee (which is essentially a homemade 5-hour energy)

I mentioned this in other comments on this thread but there is a video series that is really great by Russel Barkley - he talks about education and coping strategies for kids and adults that aren't totally reliant on on meds. Relying on lists and reminders are important for adults

helpfulanon5• 11 years ago

If you have ADHD or are close to someone with it, do yourself a favor, sit down and watch this lecture series by Dr Russell Barkely: https://www.youtube.com/playlist?list=PLzBixSjmbc8eFl6UX5_wW...

It's geared a little more towards childhood ADHD, and it's quite long (I needed to be medicated in order to watch the whole thing, of course..) but this Dr is a fantastic expert on the topic and doesn't hold back on explaining the disorder in clear medical terms. He also does not sugar coat anything or tell you what you want to hear. It's a very pragmatic and thorough explanation of what ADHD means, and really opened up my eyes in many ways.

One of the important takeaways from that lecture is that ADHD is not simply attention problems, there are a myriad of related issues with executive function that are just not as apparent. Learning that ADHD is more than attention can fundamentally change your coping strategies. Well worth investing time into deeper education

QandAandQ2• 11 years ago

I was diagnosed with ADD when I was young. I read tons of people on here urging others to "get help". But what does that mean? Essentially there is only one thing a therapist can do. That is, prescribe you speed/amphetamines. These will make anyone more focused, its a complete fallacy that they are proper medication for having ADD. When you take these drugs (which are neurotoxic at higher/extended doses, a fact which is actively hidden by drug companies), you are seriously messing with your reward system. This makes them very hard to get off after taking them a while, as it can take months for your brain to go back to normal. Thats why people think they have such terrible ADD. Look! I cant focus without the meds! Well no wonder, they manipulated your brain chemistry at a huge level!

helpfulanon5• 11 years ago

The problem is that Drs see medication as an easy win. They prescribe meds and the patient sees results. So that's all they do, prescribe the meds and tell you to take them all the time and you'll be fine.

But in reality the meds should only be used as augmentation in situations when it's hard to stick to a coping framework. But nobody tells you that, because it's complicated and doesn't always work. So they prescribe meds and ask you to depend on them instead

theorose2• 11 years ago

Have you found a successful alternative to handling your condition?

I used to think ADD was made up to medicate difficult kids and that amphetamines are too dangerous to use as medicine. Then I changed careers and stopped working late nights in load chaotic social environments. It was awful. I was never really able to finish projects before, now I could hardly start them.

My father and his brothers had all been diagnosed with ADD, I did a little lit review, opened my mind and saw a doc. I was prescribed 5mg Dextroamphetamine daily and began finishing projects.

Before my diagnosis I meditated regularly, I did yoga and got exercise, I was into all kinds of "self-programming" and "mind-hacks." Only after I began taking a small daily amphetamine prescription did I start finishing projects.

It's been nearly a decade and my dosage has only increased once, to 10 mgs time-release. Every few years my doc screens my heart and liver. I am exposed to many, many chemicals that are neurotoxic at high levels. The solution to my meds is simple - don't take too much and keep them out of reach of children.

And yes, I'm messing with my reward system. That's because my reward system wasn't really working for me in the first place.

QandAandQ2• 11 years ago

Well luckily I am good enough at math/programming that I get huge amounts of leeway at my job. Meaning I miss tons of meetings, am always late, miss emails, and all that stuff. Basically as long as I keep coding like I do, my boss could care less about everything else. If this career didnt exist I would be in huge trouble. But regardless, I took medication for a long time. It worked for a while, but 5 years in I saw it lose effectiveness. Upping the dosage with little restraints led to addiction/abuse. Never taking too much is absolutely crucial, once your neural path ways have been exposed to high doses, it is very difficult to restrain yourself to small ones. Are you aware of behavioral/personality changes with it? Or have you generally stayed the same? My biggest issue was taking a drug every day that altered my personality in noticeable ways. After years on end its easy to forget who you were before, which I think is absolutely terrible.

Its difficult to find information about it online (thanks drug companies), but if you do real research into medical journals, Moderate doses can lead to long term/structural changes in the brain. Abuse can be neurotoxic. Ritalin is considerably safer than adderall/dex. This makes it hard to separate out what was caused by the drug and what is a symptom of ADD, thus causing a bad feedback cycle.

I recently saw a therapist (for unrelated issues) who said it was a common pattern for bright individuals who were bored with regular schooling to be diagnosed as ADD.

Meditation, exercise, proper sleep, and healthy food all have a huge effect. Biggest thing is being interested in what I am working on at work. I drink huge amounts of caffeine and sugar (soda helps the most), which help a ton. I take frequent breaks, go for walks, and work obscure hours. I end up getting about 4 peoples work done myself, mainly because I can leverage my programming ability to find shortcuts in the work that other people cannot.

studentrob• 11 years ago

Exercise, eat healthily, set goals and give yourself something creative and challenging to work on. Try this before taking medication.

dwarman3• 11 years ago

Coincidetally, this article showed up in my feed. Apart from the advice to carry a notebook to record what got one into the Hyperfcus Zone (I tried, I did, but I cannot remember to remember to make the note), it is a professional take much like our anecdotal ones here.

http://www.additudemag.com/adhd/article/10117.html

What is ADD?

Related Stories