January 31, 2023
ADHD is utterly fascinating. ADHD people can have a wonderful life, or a hair-raising race over really dangerous banana peels. Most often they have both, sometimes as periods of their lives and sometimes at the same time.
Now that everyone knows about ADHD and the stigma has gone down, it is easy to forget (if you knew it in the first place) that the statistics is terrifying. Barkley and collaborators paint the picture with multiple longitudinal studies, like this one:
Untreated ADHD people are significantly more likely to have a car accident, and twice as likely to smoke than non-ADHD (probably because they self-medicate with nicotine).
At the same time, the days are long gone since it was called "minimal brain dysfunction". There are loads of super successful people with ADHD, most of them are open about being ADHD, and often credit it for their success.
The discussion has already shifted to how it is misunderstood and full of myths. It is clear that the problem lies in the mismatch between the ADHD person and the environment, with its multiple layers of what is the "right" and the "wrong" way to be.
Even so, you don't escape such a fundamental mismatch in life unscathed. The vast majority of ADHD people who are as happy and successful as anyone else have to deal with comorbidities, the official term for add-on issues like anxiety and depression. It is the price for relying on coping mechanisms, the unavoidable strategy when there are long-standing confusions in place.
The short answer is no. There must be a problem, the statistics makes this clear. But what is the problem? There are several paths to take.
The confusion starts with the name. Attention seems to be the last thing ADHD people have a deficit in, if anything, hyperfocus is a key characteristic.
Moreover, it is not clear that research on attention sheds much light. It is a huge research area that quickly breaks down to many subfields, partly because there is no agreement on what a general definition of attention is. It can be defined in narrow specific contexts but none are directly relevant for real life.
More promising than attention would seem to be executive functions, the processes that allow us to control and direct our behavior. Maybe the issue is not exactly attention but where and when we deploy it?
That turns out to be a can of worms too. Professor R. Barkley, one of the main experts in this area, calls it a "vaguely defined and poorly crafted psychological concept" in his book Executive Functions and goes on to say
Why is sorting cards into categories based on your own sorting rule not an EF, while sorting them so as to discover an examiner’s undisclosed sorting rule is considered an EF? Such distinctions cry out for an operational definition of the term “EF,” yet none that is currently available can manage even these distinctions.
As he puts it, “theories of cognitive control are likely to be seriously incomplete unless they incorporate relevant social/emotional factors”, and "the view of EF offered by cognitive psychology or those wedded to EF test batteries is not worth having. Their contents are devoid of social relevance and context."
He runs into the same problem we will repeatedly see in these upside downs, with the obvious question
Other than convenience or tradition, why are tests given in clinical or lab settings the widespread basis for measuring EF, and not direct observations of human action in natural settings or rating scales completed by patients and others?
that has the predictable answer: "The neglect of emotion may stem from the inherently greater difficulty in measuring emotional and motivational states."
Problems real, explanations suck.
Link to EF post. Same with attention
Wiggly ADHD
Past names for ADHD.
Still getting support through disabilities. Necessary but creates problems because education is sorely lacking.
The "disease of moral failure still there " and the undertones still very much there and probably driving much of the comorbidities and difficulties.
Lots of unnecessary stuff, makes everything hard to navigate. Because it is so upside down.
The deeper reasons why this is so are in WEIRD, [Normal], [other links].
But you can implement a practical viewpoint right now: listen to the ADHD people and combine with what we know on the science front to lay out the situation and possible adaptations so individuals can tailor it to themselves.
My take: Scientist hat: this does not make sense. ET hat: the situation is very bad and very real. Personal: I am very lucky, I get it, it is my kin, and my own family.
Goal vs Transitional
Why transitional: refer back to main part of UD: this will take time. In the meantime, carve out own space and beyond
We have loads of info - give numbers about reddit etc, links to articles
Are you ADHD, ask other ADHD people?
The current diagnostic tool has been developed for kids, it is the Vanderbilt Assessment Scale. [explain]
It has 47 Symptoms Questions, all about behavior, that look like this
[performance part] - scored as learning disabilities.
ADHD people have a dim view of this questionnaire.
[meme]
The eyes of the teen in my family that was recently diagnosed opened wide with dismay when he saw the actual form and realized that his parent and his teacher had been asked a very long list of questions about his behavior but there was no such form for him to fill in.
2-fold: external issues, own issues
Adderalling