I "muddled through life" until I got diagnosed at 42 with inattentive ADHD.

At that age the brain has already developed and meds are less helpful than when you are young. Even taking meds out of the picture, a diagnosis would have helped me a lot and not being diagnosed had very negative consequences.

I was told to "brighten up" my whole life while growing up. My parents well not abusive - it's just that I had good grades at school, so they didn't understand why I struggled with tasks that were "simpler than school". I also struggled with social interactions. I ended up with very low self-esteem, thinking I was just "slower" or "more stupid" than others. Most teenagers try to find and define the final shape of their mind. I though the "real me" was an embarrassment that needed to be hidden. So during my teenage years I built a "mask" instead. ("Masking" is a psychological phenomenon, I have now learned)

I am very good at "faking" not having ADHD now. Most of my friends and coworkers don't know. I can't mask all of my symptoms, though, nor all of the time. I can't "fake" not forgetting my car keys, or doing my taxes. I still wear my mask most of the time.

Sometimes I don't know whether my wife got in love with me, or with the image I project of myself. I don't know if there's a "myself" any more.

Also, ADHD has a genetic component. Having a diagnose for myself would have been useful before I had my son, who turned to have hyperactive ADHD. I love him to bits and I would not change him, but he's a handful. When he's off-meds he's almost intolerable. I would have had him nevertheless, but I would have had the right expectations.

> it has been shown time and time again that this might emphasize the symptoms and make a person "sicker".

While that's true, for ADHD self description it's common to under estimate the impact. That's why you typically get asked for someone who knows you to join the diagnosis visit - because they're likely to say you're actually doing worse than you think.

This is a screener questionnaire, not a diagnosis tool. If you answer "very often" to enough of them then it's the author's suggestion that you should look into it, not that you have ADHD.

I wonder if finding it hard to answer these kind of questions could be an indicator for some other kind of neurodiversity.

Yes, it's even worse when you're diagnosing a child, as you will have to answer these questions for them, which puts your parental expectations into the mix. In the end however, people get diagnosed, get medication and start to feel a little better, so maybe it's all worth it.

> With answers as "very often" means very different things to different people.

Agree, I think it's certainly a problem and I too wish it was more defined, but alas. Related, Literal Banana on surveys: https://carcinisation.com/2020/12/11/survey-chicken/

> In addition these general questions that a lot of people can relate to will cause a lot of people to get unneeded screening

Yes, a lot of people have ADHD. I link to the study that shows high specificity in the general population. Empirically, the tool works. You gotta start getting concerned about your symptoms from somewhere.

Did you know that ADHD is more common among people on the autism spectrum?

It’s different in the US- it is worse.

My pet theory is that one of the reasons for an increase in the diagnosis of ADHD is that fewer people smoke today. Nicotine as a stimulant likely treated a lot of undiagnosed cases of ADHD.

I think there is value in knowing a term for the symptoms one might experience because it provides the ability to connect with like-minded people and potentially look into useful strategies to mitigate those symptoms, if they become problematic.

However, I do strongly agree with you that setting a boundary to "normal" and therefore implying these states to be abnormal and something that needs to be fixed is not helpful. We should be able to label a wide spectrum of neurological wiring quirks without nudging people towards changing them, unless it actually negatively impacts their ability to live a fulfilling life.

Sounds familiar. I've been quite successful professionally, I have accomplished many nice things. But always in the final days/hours and under extreme pressure (ie 2 nights of no sleep to finish PhD thesis in time for print for defense, etc, very difficult for people around me also. I'm currently working on our old house. Also not nice for me, and people around me. The results are pretty nice and technically fully correct though.)

I've had the same comment about being chaotic, and not being able to see the bigger picture during performance reviews my whole life. But I've always felt unable to see the bigger picture if not understanding the details. Although recently I've gotten better at letting go, trusting my mental models etc, but also at finding great, structured project leads (or assistants if I'm in the lead). Such people are invaluable to me, although I must say that I also start to find it easier and easier to just copy their behaviour (ie things like "Start project with timeline, not important if it's 100% accurate, its more about the order of things" - etc... At least you will appear very structured which radiates confidence!).

I've also had a manager at one point in my career that said: We really just want you to start many things, you are in research not in development. It's great that you start with so much enthusiasm, let de development people determine the fit for product later... (But perhaps a bit more "eye on the market" would be nice!)

That was somewhat of an eye opener, at 35 (42 now).

On the other hand for me, these discussions help me to frame my challenges in a productive way that gives me a chance to make useful changes to my life to accomodate them, instead of blaming myself when I struggle to do something that seems like it should be easy. So I guess the answer is, YMMV.

The article doesn't do a good job of highlighting that there is help beyond medication, and that the personal "size" of the problem should be taken inro account. I mean, "answering 6 questions -> yay, stimulants" is a bit of a shortcut, isn't it.

Recognizing that one's problems with being organized (and other executive functions) have a reason, and are not just a result of "being lazy" or "not trying enough" can be powerful and liberating. It allows acceptance and a systematic approach at addressing them. Of course, medication can help a lot while learning how to make things easier for oneself in other ways, but this should be decided with a professional who has experience with diagnosing and treating ADHD in adults, ideally one that does not simply want to push pills.

In any case, it's good to seek out more information or consult a professional IF you think you're being held back. If not, then that's great! For others, articles like this might provide the initial nudge for a noticeable improvement in their lives.

My mother is very similar to what you have described and mimicks some reponses of her to her ADHD situation pre-diagnosis/post-diagnosis.

She is also ~60 and accomplished in her professional,social and family life.

Pre-diagnosis she would reject suggestsions going into the direction of an ADHD diagnosis, due to her accomplishments being above average --> not possible to have a disability/neuro-divergence.

The achievements are her achievements, but the expense in the context of her capabilities was very high and quite taxing on her.

A diagnosis or even treatment is not making the person normal, but it can help provide that person with options to alleviate the expense of operating differently to the baseline.

I am very happy that you managed to have this success in your life so far and you made that happen.

But under your assumption that you have ADHD you might have made that happen against odds that would have been in part optional if you had access to treatment options.

It's interesting to read this from someone who more at a more advanced stage of life, but I also wonder if there is a built-in assumption around diagnoses and treatments being potentially negative.

I think people seek out these diagnoses because they are struggling to cope with modern life in one way or another. I don't think its only a matter of attitudes ("everything must be treated"), but also the fact that the world is different. In other words, there could be two solutions: Medication/treatment to make life easier for the individual, or fix the world such that it can accommodate the arguably natural variance among individuals.

We're choosing the former, because the latter is just so, so difficult. But I think a world exists where the needs of currently medicated people with mild degrees of ADHD could thrive without any medication, and it sounds like a softer, more colorful world.

Would you say the same if it were as physical disability? If you were born without hands and had slowly learnt how to do everything required in everyday life via an adaptation, would you reject a prosthetic if it were available?

We know people with ADHD are able to manage. The real test is always, after they try medication, is their life easier or not. A lot of people who were adamant they were managing just fine before the meds report afterwards they didn't realize how much effort they were putting in on a day to day basis just to manage themselves.

And this is not some general trend towards overmedicalization. As the article pointed out, there are precisely two psychiatric drugs that have this statistically significant an effect.

>I worry about all of this labelling that we apply to various ends of the "normal" spectrum. Where does it lead us? Is it actually helping?

People develop taxonomy to help understand the world and themselves. Knowing what you have helps you seek treatment.

> I have muddled through all my life.

Part of the journey for a lot of ADHD sufferers is getting experience what non muddled life is like.

> I think that's OK. I'm not looking to be "treated" because I'm a bit different.

Cool, I am glad that worked for you. But keep in mind that lots of people, myself included, experience extremely negative aspects of ADHD.

>meditation

Much less effective than the treatments the article mentions.

If you suspected you had hypertension, would you be as confident to say we don't need to label and track those because you got old, worked and lived just fine thus far with no major episodes?

You might have been fine because you just have something like 140 mm Hg, whereas others with 180-190 might not be so lucky....

Getting treatment or not is a decision. It is linked to pressure of suffering. You write that you did well and managed your life well. Awesome. Other people feel extensive pressure of suffering and are not able to manage their lifes like you did. For those, professional treatment can be life saving.

No, it is not just “being treated”, although learning some techniques to control anxiety has helped me a lot (meditation, in my case). Just “know thyself”, and realizing that your struggles have a root different from “laziness” helps with self-esteem.

Isn't it a bit of a non sequitur? The fact that you choose not to be treated (with a history of unhealthy self-medication) doesn't imply that someone else would not benefit from changing some healthy(-ier) medication specifically targeted at ADHD.

So to answer your questions: 1. it leads us to people getting treated (or at least having the choice) for stuff that makes their life harder 2. Yes, it is helping.

Where it leads us, is to people with ADHD suffering less. Which, I don't know about you, but making fewer people suffer and for people to suffer less are basically the two driving motivations for life, so I'm in favor of it.

You're older, so you grew up in a different time, and you found your place in the world. The treatment means finishing projects, not needing to wait until the last minute to do something in order to do it. It means less stress and unecessary anxiety. It's helping people reach their potential, and not fall into the cracks.

> Is it actually helping?

Yes. And it if it doesn’t, then just stop refilling your meds.

Thanks for the catch! I updated the text in the first paragraph below.

You say that like it’s a joke, but the huge wall of text did that for me. Unless I was being forced to take the test, I’d just have given up on doing it.

> shouldn't these symptoms have been there all your life, not just 6 months prior

Yes. If you're getting diagnosed as an adult the general guidelines are that symptoms should be clearly traceable to teenage years and the earlier it is, the stronger the evidence is.

People experience ADHD-like symptoms later in life for any number of reasons, like anxiety and stress at work, home, or school. That's one of my peeves with how short the diagnostic process seems to be in certain countries (US and UK specifically), they don't seem to be particularly thorough when it comes to those things.

6 months is a reasonable cutoff for a screening tool because it allows for changes in the environment. E.g. you might cope well in high school, but you move to university and suddenly your old strategies don't work anymore and your life is falling apart.

For the full assessment with a psychiatrist, they do look at one's entire life history.

It could very well be ADHD. Depression is certainly another possibility, but if your symptoms are more or less consistent throughout life, then it makes ADHD much more likely.

It's definitely a bit tricky. Depression can cause problems with attention. But also: ADHD people have depression at much higher rate.

> When I was young I used to look at the watch compulsively to check what time it is and I never went late to an appointment.

Lots of ADHDers come up with all sorts of coping mechanisms. It's one of the reasons the test misses a significant chunk of ADHD population.

I scored 6 out of 6 although I highly doubt I have ADHD. Those are pretty normal things. You learn to deal with it and try again. Technology, alarms, calendar events come to your aid. Or I unplug something to force myself to deal with a thing. One thing I'm bad with those is locking things, I leave the key in the ignition, leave doors open...

>and I wasn't diagnosed with ADHD because I lack hyper motion activity.

That sounds a bit weird, ADHD is known to have hyperactive and inattentive variants; and the lack of a single symptom does not lead to a negative diagnosis.

I’m younger at mid thirties, but I was recently diagnosed with a career and personal life already “in check” so my experience might be useful.

I’d 100% recommend you go for a check. For me, the main outcome has been getting rid of the nagging feeling that my potential is wasted in making up for shortcomings.

Now it’s no longer “I am bright and curious, and this compensates my {lack of consistency, periods of “writers block”, reduced attention to detail}”. It’s hard to explain without direct experience how cleanly those problems you’ve been trying to white knuckle all your life just… stop. It’s not a personality change, it’s much closer to allergy meds letting you breathe, the bad symptom goes away.

The only con is that once you get the meds there’s work to be done. The productivity tips and books you’ve likely heard all your life and were unusable now can actually be put to practice… but you haven’t done it yet.

So it’s like you stop being bedridden but if you want to be fit you still have to go the gym. It’s just that now going to the gym is a task you can realistically approach, and that in itself is a game changer.

ADHD was not "invented". It is a neurodevelopmental disorder. The stimulant medications are effective at treating the symptoms when compared to placebo.

Stopped reading at "treatable with glasses."

I'm old enough to remember when vision impairment was invented. To sell glasses.

Granted some people have difficulty seeing. I'm one of them. But I've only heard of people in the US getting glasses for something which is basically a lack of looking hard enough.

----

Your response was ablest, dismissive and quite offensive.

1. ADHD was first described in 1798 by Sir Alexander Crichton

2. It is a neuro-developmental disorder where there is dysregulation of dopamine and norepinephrine receptors in the brain

3. It is identifiable via MRI scans where size differences were noted in specific areas of the brain (Caudate nucleus, Putamen, Nucleus accumbens, Amygdala, Hippocampus) [1]

4. It is about 80% heritable [2]. So genetics for inheriting ADHD from your parents is about equivalent to genetics from height which is also around 80%.

The "meds" increase the intensity of dopamine signals to a level that allows the brain to react to them, rather than being too low for them to be detected.

[1] https://www.sciencedaily.com/releases/2017/02/170216105919.h...

[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC7046577/

This mentality is the biggest part of the problem. "Lack of discipline", hah!

With ADHD, with autism spectrum, whenever you label something that's caused by a different brain wiring, something that's caused by something pyhsical in the brain, you are doing unspeakable level of harm to those people suffering. I know, I'm one of them, I suffered from this mentality for 30 years.

If you can "fix" your difficulty with contentrating with "discipline", all the more power to you. Don't assume it's the same with everyone else.

Medicating vs not medicating is a worthy topic to talk about. Labeling the hardness people face as a lack of discipline is just cruelty, whether it stems from ignorance or lack of knowledge.