The flip side of this is that people who legitimately have ADHD are surely more likely to have it diagnosed if they're having to deal with the added academic difficulty of going through school almost a year earlier than their September born peers.
That is, even in a world with no overdiagnosis of ADHD, we would 100% expect an effect of the sort this article raises.
I think I had the opposite effect whereby ADHD symptoms were created because i was so far ahead of my peers (September birthday) that some cognitive skills never developed properly for lack of challenge. (I have test results that point to very selective cognitive skill gaps which might be attributable to that)
I had a full 4 hour neuropsych test done as the result of a concussion. The test I was bad at was where they read you a list of random words and test your ability to retain immediately and after spaced repetitions. The first time I heard it I retained very little but on subsequent repetitions what I did learn I retained. So like a very specific sort of being bad at something. The rest of the tests were all in decently high percentiles.
>where they read you a list of random words and test your ability to retain immediately
Person, woman, man, camera, TV type words? Sounds like other neuro tests.
I've screwed up these tests as I focus on repeating each word in the gap between the next word being said then repeat with the new word being added to the point I've missed the next word.
I've never "liked" this test, as I don't think it's always indicative of what they are trying to make it. This sounds more like interviewing a potential server that isn't allowed to write down the order.
Sounds like the WAIS-III intelligence test. The state tested me using this as an admission criteria for a summer camp full of gifted children. They accepted two kids from our school which was generally pretty rare, especially considering our school’s socioeconomic level.
If I recall correctly you’re talking about the working memory index. I scored 50th percentile on that portion of the test but top 0.4% overall, which I’ve always felt like reveals something about my “ADHD brain”. It’s definitely not the norm. The administering psychologist seemed super interested in my testing and I asked a lot of questions about the process. She brought me back in for a second day of tests as some of the tests I exceeded the space available. I recall they had a band writing symbol recognition and copying test, and I filled up a page front and back, so she had to come back the next day with more pages to accurately measure me since you aren’t supposed to “ace” a part of an intelligence test.
I often think about it because I often think “well, being 1 in 250 is pretty good, but that also means there’s literally millions of people smarter than me”. Hard work and building good habits like going to bed on time has been key to actually making use of the “raw power” of my brain, and Adderall as an adult has helped a ton with this despite side effects that I try to keep under control (irritability and seeming more ‘robotic’. Every time I try to stop using it I feel like my career slips and I become depressed. The me on Adderall is capable of being a competent software engineering team lead juggling multiple balls in the air. The me without Adderall struggles as a senior software engineer writing code for one project.
I’m excited to take a 2 week break from the meds on vacation later this year though. I constantly feel like I’m “grinding my gears” too hard, so to speak, like the Adderall is adding jet fuel to my engine of a brain and it’s gonna burn me out. It hasn’t happened yet but I really want to avoid tolerance.
I think colechristensen had a test for episodic memory. Such a test is not included in the Wechsler intelligence scales (currently WAIS-IV for adults, WISC-V for older children), but tests for working memory are. Simplified, working memory are that limited number of items you can keep in mind, until you are disturbed or thinks about something else. Episodic memory is what you still remember after your thoughts are disturbed, and what you may remember for 10 minutes or 50 years. Surprisingly, episodic memory is not closely related to IQ and is, thus, not included in intelligence tests. What colechristensen seems to describe is that his learning was hampered by an attention deficit, but he was able to retain the information in his episodic memory when he eventually registered it.
The converse is also true. We may be missing diagnosis for people born in September, who may struggle but not quite meet the definitions which often include academic performance.
Even "academic performance" isn't a clear enough predictor. It isn't even a single axis!
I was a perfect student all through grade school; except I had terrible grades in almost every class. Why? Because I almost never did homework. I usually aced tests without even trying, though. And I could always provide meaningful input into class discussions. But that isn't enough for the strict traditional structure of academia.
Teachers would make me stay after school to try to catch up on homework, and I would just wait patiently until it was late enough in the evening that they would give up and let me go home. This was a recurring pattern from 4rth grade all through 12th. I only graduated high school because I finished hundreds of pages of make-up work over the last couple weeks.
The reality is I couldn't do homework. I could focus and sit still, which must have meant I don't have any attention or hyperactivity disorder...
...but that's not what ADHD is. It's an executive functioning disorder.
ADHD is being diagnosed more today because it has been incredibly under-diagnosed in the past. It's still significantly underdiagnosed in adults today.
This largely mirrors my experience. You know how people talk about addiction, and how they are "drawn" to their poison, like by some force? The polar opposite of that is what I felt with homework. Like trying to push two identical magnetic poles together.
I knew I could, I knew I should, but I could never do. I could only watch myself, never participate.
It's really validating to have words like "executive dysfunction" to describe this pattern, as opposed to "lazy", "tired", and "unmotivated" - which are all I had growing up.
Good point, and also I wonder how many of these diagnoses are deliberately sought by parents aware of the "relative age within school year" phenomenon. Holding kids back a year because of this has become so common that it has a name: redshirting. Having them diagnosed as ADHD and either medicating or holding back seems like a natural extension.
I don't mean to suggest that anyone's faking it BTW. As the authors point out, the real problem here might be underdiagnosis of September children. But parents of August kids might be more than a little predisposed to schedule that doctor visit, listen to that diagnosis, etc. in a way that parents of September kids would not be.
Submitted a few times in the past but never discussed.
---
An unexplored link here is No Child Left Behind and its successors; in 2001, K-12 became standardized test prep schools as grades earned funding. Bubbling certainly drove me a little batty.
As a June baby in a state with a July cut off, I was always nearly a year younger than the majority of the class. It caused me no end of difficulty in school, to the point I loathed school, barely graduated high school with a 2.0 GPA and more than the legal limit of skipped days, diagnosed with ADD, and went straight to career in the valley. It was only when I was close to 30 that I sort of realized I actually was smart and could do well in school, and quit my lucrative career to get highest honors at UIUC CS- a very difficult program where graduating with C’s was an achievement - but I pulled off a 4.0 (A+ at UIUC adds nothing to the GPA). When I had my daughter, born in late May, I held her back a year in preschool and put her in a private school that mixes multiple years in the same differentiated class. She is so happy in school, and I just hope that she doesn’t have to experience the years of misery and failure I experienced that led to an adult life filled with anxiety that I’ve only recently conquered. Public school in the US is not structured in a way that is adaptable to the various states of human maturation you see in kids that all mature in different ways at different rates. It’s factory education, and if you’re not a widget of the right shape it cuts you up.
Do you think there's something about the precise age (to within a few months) that a child begins school that drives this bias in diagnosis? Or would we have the same problem with a hard cutoff date, even if all kids started school an entire year later? Or is it largely a matter of how much development a child undergoes even in 1 month at such an age (eg, a combination of factors)?
I guess I ask because there will always have to be a cutoff, even if it's a soft cutoff.
As a non-parent, the best solution I can see is to give the parents the knowledge and freedom to make the choice, and to add this data to perhaps mitigate over-diagnosis (and any attached stigma).
Of course, as I write this out, it occurs to me how much of a burden on parents an extra year without school could be
the problem seems to be the difference between the oldest and the youngest kid in a class. OP had problems through his school life as they were always the youngest. so starting the same process a year later doesn't seem to help.
what would help is an adaption of the montessori model where an age range of three years is in a class, and the expectation of all kids behaving the same naturally disappears.
doing that at least in kindergarten will at least avoid a mistaken diagnosis for ADHD. but my hope is that montessori kids will also fare better in a regular school because they learned to be more independent.
>I guess I ask because there will always have to be a cutoff, even if it's a soft cutoff.
We could ditch the "academic year" idea entirely and just have kids join the classes when they are ready for them and not force a cohort to all have to learn and progress at exactly the same rate (one which, statistically, is either too slow or too fast for essentially every student).
I don't think it's as easy as that. Planning and managing different lessons for the same time slot is way harder than planning and managing one lesson for the same time slot. The more kids in the room, the harder it gets.
I have a November birthday and started school at four during the last year the "at-least five by September cut-off" was implemented. I generally felt like everyone was way ahead of me for most of my school years. I was never diagnosed with ADD, but I never tried to find out either - I certainly wouldn't be surprised. I did alright in school, but I think that was because I studied extra hard because I always felt so far behind. I can't imagine that will work for everyone.
I appreciate your post. With a little one who is about to turn three, I've been thinking about school and the affects of going too early a lot lately. I worry about holding him back in case he'd end up bored and unchallenged. I've seen quite a few really smart people make some bad turns due to boredom. But, of course, I wouldn't want my kid to spend their life chasing all the "smarter" people either. That life has not done well for my self-esteem. Regardless, mixing multiple years in the same class sounds like an excellent way forward.
I have the feeling that for me it's the exact opposite. Born end of June, cutoff is the June the 30th, but my parents insisted to to let me start a year later. This lead to me being up to a year older than anyone else. School stuff was always too easy for me (I might be also a bit smarter than the mean, but who knows?), so I never needed to really work for school and when the topics came where rote memorization and repetition helps I always fell a bit back. To this day I never really memorized the multiplication tables for example. Ask me what 7*8 is and I have to do math in my head. And this is only the most basic example.
Because I never really pushed training the
binomial formulas I later run out of time when I had to solve more complex formulas where having those ingrained helps "finding the shortcuts" instead of "brute force".
We have a saying, that I "never learned how to learn".
But it may also be that I suffer from undiagnosed ADHD (on top of that).
I think I got lucky. Late July with a school that (at the time) had a Sept 1 cutoff. There was only one person younger than me until middle school.
My kindergarten teacher, who was also a family friend, requested I do it again because I wasn't mature enough. And she was right, honestly; I'd fight against nap time, and remember no end to problems in first grade with sitting still.
However, while maturity played a roll, the problem was I was bored. I went in to kindergarten being able to add, subtract and read, and had already started doing multiplication with my mom (herself a high school teacher). Another year in kindergarten would've been torture for me. Thankfully I had an amazing first grade teacher who recognised the problem. Instead of insisting on ADHD, she gave me more challenging stuff and let me work on my own. She never called on me to read aloud, because she gave me other books to read behind the class's book. This lasted until my 4th grade year, where one of my teachers didn't like it. Thankfully by then I was mature enough to recognise what I needed to do, etc.
So really, I wonder how much of this is a mixture between multiple things and how many times kids get given ADHD diagnoses when what they really need is differentiated education. Granted, this is difficult; I was a math/science secondary school teacher (and I think it's even harder for elementary school teachers, for various reasons ranging from standards to their own competency in the subjects they teach), and it was almost impossible at times.
That said, maybe I do have ADHD. I went on an amphetamine for weight loss at one point, and there were times I noticed I could focus longer and easier. But I've always had a tendency to get bored of something easily, and I'm sure the Internet hasn't made it any better. So I avoid getting tested as it doesn't impact work or study or anything for me (anymore than the Internet itself does)
Very, very similar to my experience. I'm now approaching my mid-30s and under investigation with my therapist for ADHD.
School was always a breeze, I would get hyperfocused during classes paying attention to instructors and content but could never, ever do homework. Any kind of school work outside of school hours was a struggle. Still managed to be always on top of my classes.
I never actually learned how to learn, studied statistics in university and was hit by a brick wall on how to actually learn things which depended on more than just passively absorbing content...
To this day I don't believe I have a decent strategy for learning, it's a very scattered approach where I dunk into the subject from multiple angles and slowly build a mental model based on the patterns I see repeating from multiple sources. I'll start with an introductory book to gather an overview of the subject and then will jump in between other books and more advanced sections to see earlier concepts already applied and then backtrack to the gaps I see missing in my knowledge.
Somehow this way of learning is much more motivating to me than simply parsing through a linear approach of theory building. Whenever I try to go front-to-back with a textbook I get terribly unfocused.
You don’t really sound like someone with ADHD to me. You sound like someone who is smart and gets bored with easy tasks. I’ve worked with kids with clinical ADHD and it is very obvious to everyone involved.
HN (and probably the Bay Area which usually is reflected here) has become a weird echo chamber of nerds all claiming they think they have ADHD. When really, it’s that smart people get bored very easily. And most of what we do in our jobs are boring. Of course, stimulants help with this - why do you think we all drink so much coffee. Prescription stims are even better and are well tolerated. The right western doc will happily diagnose and prescribe for ADHD regardless of the severity.
I know ADHD is a spectrum, but I believe that diagnosis is only really warranted for those truly clinical - people who literally cannot hold any job at all and would be homeless otherwise. I guess there is the argument we should all just be allowed to take whatever drug we want and there is certainly merit to that.
Even the most productive coders, writers, musicians etc talk about their struggles to stay focused. It takes grit and intense self discipline to sit for 8 hrs doing work that isn’t immediately satisfying. Most people can’t do this, it’s not abnormal. People goof off at work all the time in most jobs, because they can’t hold their attention for so long.
I don't live in the Bay Area, I'm not American, I'm not going through this investigation to get medicated, I'm actively avoiding pursuing this path due to the impact that getting medicated with Aderall/Ritalin/etc. had on close friends.
I have not yet been diagnosed with it but my therapist felt it was important after almost 3 years of therapy to check it. I believe my therapist has a bit more of insight into my mental health (and mental health in general) than a random HN comment.
I appreciate your point of view but feel it can come off wrong, I have multiple signs that warranted from my therapist a deeper investigation and I will trust them.
Again, I'm not looking into getting medicated to focus, I don't want to be constantly on speed to function.
I feel like your kind of comment is exactly what made me not ever think about this. I can hold a job, I could do well in school (but not in university, at all), it's not because others might have it much worse than I do that I'm not worth to be checked on. You have no idea about the state of my mental health and struggles to be able to judge if I'm just smart and bored or if there is something else underlying it all.
I just bring this up because I feel your comment comes from a good place of caring but it's ultimately unhelpful and, depending to who else you could have directed this comment, could be actively harmful.
Thankfully, I don't feel like I am "on speed" at the dose I take. The goal was to increase the levels of neurotransmitters I'm not good at producing/not sensitive enough to while stopping short of noticeable stimulation. I honestly don't want to feel high or like I'm "tweaking out" because that's just as distracting.
But the inability to maintain focus held me back for many, many years as my parents did not believe ADHD was a "thing". I didn't get medicated until I was in my 30s and it has made a world of difference. It's not a panacea and I still have my own tendencies, strengths, and weaknesses. But it's more like wearing glasses instead of having to squint for my entire life. Sure, I'd survive without it, but it's a tool to somewhat make up for a biological shortcoming versus the accepted norm.
I wish you luck in your pursuit of self improvement and I hope you discover effective ways to get closer to where you want to be. It's a good thing to explore and learn about for sure.
I find that hearing people talk about their experiences with ADHD really damaged my initial outlook on the disorder. I have it too, and to be honest, I kind of expected a panacea by how people -- even professionals -- talk about treatment.
According to various sources, ADHD is the single most treatable psychiatric condition. But I guess what I expected from treatment, and what technically constitutes as treatment were misaligned.
Thankfully there are also other drugs being researched for people who cannot tolerate some drugs well - I believe they are looking at Fascoracetam in Japan for children.
I also do really believe we should be meditating more or something similar - when I try to read a novel these days (even one I am interested in) I find it is significantly more difficult to do it than it was when I was much younger and had generally lower reading comprehension.
Okay, sorry, I made some assumptions that were wrong. I think if your therapist is recommending it, it is definitely worth looking into it further and I hope you can find some treatment that works.
Me personally, being on HN, I started to believe I too had ADHD reading peoples' stories on here. After a lot of therapy, and even going for an ADHD evaluation myself (a huge pain in the NHS), I realized it was more a result of burn out and depression. Thankfully, with a lot of therapy (almost a year now), I am slowly regaining my focus, and even improving my ability to deal with boring tasks (which I had convinced myself, based on stories on the internet about adult ADHD, that I could never do).
If I had been in the US, I would have self referred to a psychiatrist, gotten an ADHD diagnosis, and been on meds by now. Problem solved? I don't think so, I never would have treated the fundamental psychological issues that actually were causing the problem. But I would have gotten ADHD diagnosed and think there was something wrong with my brain forever. I feel this must happen a lot in the US. Adult ADHD is actually very rare - it is very hard to go unnoticed as a child with ADHD.
I would strongly suggest anyone reading HN stories about adult ADHD first to see a psychologist and do talk therapy first. Also, make sure to get a second opinion on a diagnosis like adult ADHD.
> I don't want to be constantly on speed to function.
As someone with ADHD that was professionally diagnosed on multiple occasions, I would say to keep this up if you can.
If you can find something that works, then keep at it. I chose the medication route many years ago, and it's been rather... bittersweet to say the least. But that is just my experience, and I believe I am somewhat of an outlier -- at least with the information I currently have.
> a weird echo chamber of nerds all claiming they think they have ADHD
autistics tend to do that? :)
I was given ritalin as an adult to see if I had ADHD. The test was simple, take it, do you feel you concentrate/focus better? if not, you don't have it.
There are also many types of ADHD and also severity - a spectrum like you say. Probably everyone with it do not need major medication. But it is still probably valuable to diagnose everyone who is so they can properly develop habits to aid it.
The biggest thing I ask people about is the executive function aspect. Are you simply getting distracted because you are bored or do you also find you have tasks you legitimately WANT to do but for some reason your executive function does not allow you do it. That seems to be (as a lay person) the biggest tell for someone who actually has ADHD.
I’m nearly fifty and got diagnosed with ADHD about five years ago.
I got expelled from school at 15 for just never showing up. Despite being one of the smartest kids in school, I would do so well I a new class and then it would tank badly.
I’ve never held a job for more than 18 months.
I’ve had the benefit of being a well spoken good looking white man that interviews like a god and is very good at writing a resume, plus I had good people in my corner giving me excellent references. In a booming job market, getting work was easy enough.
But my life was going off the rails. Depression. Risk taking behaviour. Anti social issues and so on.
Saw a GP for serious cyclical depression issues. I was self medicating with caffeine and flu meds.
She said have you considered you might have ADHD?
I hadn’t considered it all.
Got referred to a specialist. He said it’s very hard to get diagnosed with ADHD later in life.
90 minutes later after my life history we started a trial on Ritalin!
Overall - ADHD is a curse. It’s not a super power. And Ritalin, Adderall etc… are not miracles.
Interestingly my experience is a mix of your and the parent comment.
I'm born towards the end of the year, and where I'm from (Afroeurasia) there isn't a strict year based cutoff. So I had Jan-born peers almost 2 years older, and folks a year younger.
Fortunately I was always fairly bright despite probably spending a solid 30% of my time daydreaming. I could catch up quickly... until it started getting harder in high school. Uni and grad school hit me, and I finally got dx'ed some time back (still in grad school).
I think I have been lucky that in school, most teachers were fairly nice intelligent people, and I was always the good, quiet kid who'd ask good questions (because I'm interested in everything). Having a good structure at home also majorly helped.
But in retrospect? Anybody spending hours every day daydreaming... yeah, screen them for ADHD, that was kinda obvious.
That’s why I choose a school for my daughter that differentiates in the class. That means they adapt material per student by their abilities across subjects. My daughter is extraordinarily advanced in reading and math, but she is in a class of kids around her age but the material is adapted to her ability individually. The age component for me is about maturity in a social context.
> It’s factory education, and if you’re not a widget of the right shape it cuts you up.
That's a fitting description that matches a factoid I read about mandatory education early days: the goal was to have workers who could read and count to operate industrial machinery.
it was also meant, like the army and later tv, to create a uniform national culture and erode local communities in favor of the newborn unnatural countries.
How does this article's findings correlate in countries with other cut offs?
Like in Norway, everyone born the same year go to school together, even though the school starts in September. (Which confused me a lot when reading Harry Potter as a kid, as some dates there didn't "add up"). We segregate sports teams that way as well, making it often better to be a jan/feb kid, as you're always the biggest/strongest, and thus get the extra attention, training opportunities etc, so a bias towards those birthdays in our sports.
There is also a strange statistics with baby borns in early January and late December. There is a high spike of births in early days of January and a strange hole in births in the last days of December.
My daughter is usually the youngest kid in class (born middle December - here we put babys born in the same year in the same class) and usually has trouble because she is not as developed as kids born 11 months earlier - this difference will be less noticeable later in life, but know when she is 6 years old it is a bit sad.
I wonder if there is delayed reporting by some people/hospitals to get a better “year”.
I knew someone who came to the US as part of the Vietnamese boat people and his parents chopped a year or two off his age so he could start in kindergarten (and he didn’t know his actual birth year 30+ years later).
I was “diagnosed” with ADD and was put on ritalin which had 0 affect on me. Wasn’t until later in life I realised I didn’t have ADD I just wasn’t enjoying parts of school.
Put me in physics class, technical drawing, cooking, math, I focused and did really well. Every other class was boring and non stimulating and so I acted up.
The last line is logically ambiguous. In Europe, I believe in 2019, they found two effects: a significant _underdiagnosis_, offset by a tiny over diagnosis; now you could argue phones and screens artificially raise the genetic baseline, or that America is inherently different. But I will tell you ADHD meds calm me down, or when measured with a heart strap monitor over a full day fairly meaningfully lower my heart rate.
It’s perhaps a meme now that adhd is over diagnosed, but I’d guess the majority is pill seeking individuals looking to compete at school or at work and less false positive diagnoses such as yours.
Net net you seem to have solved it fairly quickly so at least that’s good: even when you get the diagnosis wrong if you can backtrack without significant cost then maybe it’s not absolutely horrible.
In my experience it was the opposite - there were almost no kids labeled ADHD. Where did you live that everyone was labelled ADHD?
Most people blamed the behaviour of difficult children on their difficult parents.
That being said there are a lot of people who are purposely seeking ADHD meds who know they are not ADHD just to get drugs. Those people are kind of ruining it for everyone else. They are usually pretty easy to spot though
> Put me in physics class, technical drawing, cooking, math, I focused and did really well. Every other class was boring and non stimulating and so I acted up.
Being able to focus (sometimes to self-destructive levels) on things we enjoy are as much a part of ADD as being chronically unable to focus on things we find boring.
> Put me in physics class, technical drawing, cooking, math, I focused and did really well. Every other class was boring and non stimulating and so I acted up.
I’m curious what you think ADD is, since what you describe here is practically textbook symptoms.
Diagnosing every child who is bored and not paying attention with ADD and putting them on drugs is trying to shift blame from teachers and the education system to kids.
I didn’t say ADD/ADHD don’t exist. I said it’s over diagnosed. We just like to label kids and tell them they are broken and needs drugs when in reality most kids are bored of the sterile environment of learning with the dumbed down education system that teachers are forced to adhere to because acknowledging that not all kids learn the same way as other kids is too hard.
> Diagnosing every child who is bored and not paying attention with ADD and putting them on drugs is trying to shift blame from teachers and the education system to kids.
No, it's trying to see if they have a condition which is readily and effectively treated through medication. I have ADHD, and my daughter has ADHD, so I've been through this a few times with the docs. The _gold standard_ for determining if a patient has ADHD is treatment with stimulants. There are assessment surveys they have you fill out and such, but there's tons of other underlying issues which can cause similar symptoms and lead to false positives. The best, easiest, most reliable way to tell if someone really has ADHD is to give them Adderall and see what happens.
My psychiatrist says that he has done this even with patients who end up getting diagnosed with other issues like bipolar. Why? Because despite being a scheduled drug, stimulants are incredibly safe at pharmaceutical doses, without any serious side effects. It's harmless to try, and if it doesn't work you move on to try something else.
Btw what studies have been done have shown that if anything ADHD is under diagnosed, and severely so in the case of girls. A lot of people who have had other underlying issues have initially been misdiagnosed as ADHD, but this is not the same thing as general over diagnosing, and generally is because ADHD must be first considered and ruled out before moving on to conditions which require the use of more serious drugs.
Caffeine is a stimulant drug used all over the world. First-line stimulants used for ADHD are in a similar class. They work quickly and the side effects are quickly apparent. Stopping them isn't a risk to your health. Overdosing to the point of severe injury is difficult.
Over-the-counter pain medications are more far more dangerous in all categories: allergies, overdose, effects of long-term use, etc.
Funny you make broad sweeping conclusions based on your single experience.
Could also just be you have a mild form of ADHD and you do not need medication at all and Physics and similar is the thing you like to hyper focus on. For some people the ADHD is a huge gift if the thing their brain happens to want to latch onto is also something they enjoy and/or can make a career out of.
Also do we really want to be shifting blame onto teachers at this point? They are overworked and already taking enough shit from parents as it is. And the ones I know and have talked to are constantly finding new and creative ways to get kids interested in their teaching
> Funny you make broad sweeping conclusions based on your single experience.
Funny you make a broad and sweeping conclusion based on one single message posted on a forum.
> Also do we really want to be shifting blame onto teachers at this point?
Not just teachers. The education system as a whole. You know with math, there's often multiple ways to achieve the same answer. I failed math one year because even tho I showed the work to get to the solution and it was a completely valid method with a correct solution, I got 0 because I did not do it the textbook way. Teachers are not allowed to teach math any other way than what the department of education dictates. Math can be quite fun and engaging, but you know, better to keep kids dumb and medicated than helping them.
Oh and before you jump to conclusions and claim this is one single experience. It's not a single experience.
What makes you believe that? I hear people spout this all the time, but it's an irrational belief to me. The condition is still diagnosed via interviews, pseudoscientific psychometrics, and other arbitrary and vague heuristic. There are still no biological markers than can be used to diagnose the condition. At least, not with a high level availability nor a price point that would justify the mainstream usage of such methods.
Thus, if we have no clear and definitive way to know if someone has the condition, then, if you will forgive my poor analogy, it's all just Schrodinger's ADHD -- both over diagnosed and under diagnosed at the same time.
What is quite clear is that a subgroup of the population suffers greater in some areas than others, and we kind of found something that helps those people. I find that much more important than gatekeeping people who would benefit from treatment.
What were your difficulties? As the youngest in both elementary school and high school (almost a whole year of difference to the oldest), I had no struggles specific to my age. In elementary school and early highschool I overperformed and in later high school I performed averagely.
OTOH, I was born several months after you so I must have been the youngest in my grade, my birthday was usually after the first day of school. My parents might have even fabricated by age for all I know. My best friend in highschool was almost an entire year older than me. It didn't bother me in the least. I didn't even noticed it until I was in highschool. This caused me ZERO difficulties.
My cousin was born about a month after me and he was in a younger grade than me. We grew up together and I always felt bad for him that he couldn't get highschool over with a year sooner like me. He was jealous of me. He also got into a ton of criminal behavior and has been in and out of jail for the past 20+ years, so I could easily say that was caused by the trauma of him being a year back from me in school. Who knows.
This (or backing up a year any year) might have helped you too.
> and put her in a private school that mixes multiple years in the same differentiated class.
This might backfire, for the same reason that you had trouble -- differentiation is difficult to do in practice.
And your childhoold school might have been less differentiable than a modern public school, which has the benefit of computerized material and automated adaptive tests.
Of course, if the private school solves it by having a far lower student:teacher ratio, then of course that's better than a public school, all else equal.
Another thing parents can do is, instead of switching to private school, put that money toward hiring PTA-sponsored assistant-teachers in the classrooms.
Psychiatry & neuroscience today are some of the closest equivalents to physicians applying leeches in the 16th century.
Through no fault of their own.
We, simply, have legitimately very little knowledge of those fields of science. Our understanding of the human brain is just not there.
So much of Psychiatry is throwing pills at symptoms after talking about your life.
That's often the state of the art in the field.
Genetic sequencing, and the ability to use genetic markers to diagnose illness, hopefully will change things. A cheap and effective diagnostic tool that isn't based on guesswork and "tell me your life story."
Cupping is probably a better analogy. Also, there was a long stretch of time there where we didn't use leeches, at least in part due to the stigma associated with the older practice.
ADHD is actually one of the things that’s actually rigorously and quickly testable (assuming you’re willing to take self-reported effects / observations, you can’t read a number off a lab test) but it’s never done because it involves giving someone without any medical diagnosis a schedule 2 drug and we moralize that for some reason.
You just give the person a stimulant and see what happens. If they get really awake, hyperactive, excited, anxious, shaky, hyperfocused, etc. then nope, if they get calm, content, or sleepy then yes. And it’s not like this is crazy in general, we do “just treat it and see if they get better” as the test for plenty of things.
Nobody bats an eye when we do the same thing for depression, it’s super common for people who exhibit the symptoms to be asked to try a few antidepressants and see if they work.
I get that some people abuse stimulants but they suuuuuuck. Life changing because they allow you to function but you will also curse them for it. The side effects are awful. So much so that I tried a bunch of non-stimulant medications until I found one that worked. Nobody who doesn’t have ADHD is gonna wanna regularly take adderall or vyvanse just because it would be miserable and that’s before the fact that they aren’t cheap.
Edit: /rant Mental health is wild because smart and well meaning people designed a system that actively prevents people from being honest and getting help. Want to talk to your therapist about your suicidal thoughts, bulimia, or self-harm, nope. Not unless you want to take a mandatory grippy sock vacation away from your support network and get set back in school or lose your job all things famous for improving mental health. Wanna tell your psychologist that you think you might have ADHD because you were at a party, tried something and it made you felt way different than everyone else, haha drug seeker.
They work great for me (adderall and friends). I don’t use them because of the side effects. When I can arrange my work life to be one or two things I like I can focus and work 10 hours productively and it feels easy. Make me manage a lot of trivia and distractions happen and I fall apart. So, I pick hard things and do them and just ignore the rest. It has worked out okay.
This was always known to be false, but was a popular opinion in pop-psychology for a time.
It is untrue.
Stimulant medications DO NOT have this claimed opposite effect on people with ADHD. This is not a view that is supported by science and is not a valid diagnosis method.
If true you should let me, someone who can be put to sleep by adderall and caffeine, the degenerates I know (and love but cannot understand) who take adderall specifically for those opposite effects, and my therapist and psychologist who both ranted to me about their frustrations diagnosing their ADHD patients because they can’t use this test.
I’m not even saying you’re wrong, but it doesn’t match my personal experience at all (in both directions), and the belief is apparently widespread enough that real professional mental health providers believe it.
It would be genuinely surprising to me if someone who works all day with people who take these medications and talk about their effects wouldn’t be armed with a million counterexamples if at minimum the observations didn’t line up. Like they’ve got to be seeing some real effect even if the explanation is wrong.
Such a drastic change in effect—a drug inducing powerful stimulant effects in one group, and sedating effects in another—should be easily measurable by study, no? Is there any scientific literature documenting this?
So I’m not saying that I agree that it’s AS difinitive as this guy makes it out to be; but as someone with diagnosed ADHD, I can 100% validate the experience of stimulants having the opposite effect on me vs my neurotypical close-contacts.
I can comfortably take a nap after popping 10mg of dexamphetamine, whereas most people would be atleast moderately buzzed. And this has been the case since day 1 (I was diagnosed at 26), so it’s not just a factor of tolerance.
Another great example is the fact that the single biggest benefit to ADHD meds for me has been a complete reversal of my life-long anxiety.
I’m now zen as f..k, whereas before being proscribed meds I was a very anxious, hyper-self critical person.
> a drug inducing powerful stimulant effects in one group, and sedating effects in another
I firmly believe this has more to do with dosages than anything else. Sure, give a random person a 10mg Adderall and one might be more sedated or hyperactive. Give them 100mg (almost double therapeutic max), and I guarantee they won't be calm sedated.
Sure, everyone has a different threshold that needs to be hit for whatever underlying reasons just like alcohol. One beer might make some feel buzzed, one beer might not do anything. But for an average person (not a chronic alcoholic), I guarantee they'll be fucked-up after 6+ beers.
ADHD is a diagnosis based on symptoms. It has a number of causes. Your mental health professionals would prefer different diagnostic criteria. Those other criteria would result in a different set of people being diagnosed with ADHD. The current diagnostic criteria are symptoms that cause problems for the sufferer. Thus successful treatment of ADHD as currently diagnosed improves lives. Why is the diagnostic criteria you describe better?
Nobody has ever suggested I have ADHD and I've never tried Adderall, but a nice cup of coffee is an ideal bedtime drink for me and a couple of Red Bulls before a lecture in college would have me fall asleep in the class.
I used to drink an energy drink before bed and people thought I was super weird for it! I didn’t find out it was an ADHD thing until my therapist asked, I guess knowingly, how caffeine affected me and I went on this whole rant about it.
That is also because you regularly consumed caffeine, no?
If you took a 6 month long tolerance break, I would be interested to see if you still had that effect. Insomnia is not that uncommon of a symptom of stimulant withdrawal.
> my therapist and psychologist who both ranted to me about their frustrations diagnosing their ADHD patients because they can’t use this test.
Why? I thought there was a clear and insurmountable amount of evidence behind all their little psychometric tests? /s
> real professional mental health providers believe it.
Plenty of doctors and professionals believe incorrect information all the time. Just because one went to a fancy medical school does not make them infallible no matter how much their ego may try to convince you otherwise.
I've heard this before but similarly to the other replies this doesn't match my lived experience at all. Are you just talking about the function in the brain, e.g. it does the same thing to the neurotransmitters, or are you talking about the effects it has on the person taking it?
As a kid, when sugar came around and other kids would get hyper, it always had this effect on me and I was really confused.
But some of that may have been environmental because I had experience with hyper friends breaking my stuff and so learned to be cautious, so I might have developed increased caution in response to stimulation for non-physiological reasons.
One related I've noticed is that people respond to certain drugs way differently to me. For example, cannabis acts like a stimulant for me (especially the first 1-2 hours) whereas it practically puts some to sleep.
>Want to talk to your therapist about your suicidal thoughts, bulimia, or self-harm, nope. Not unless you want to take a mandatory grippy sock vacation away from your support network and get set back in school or lose your job all things famous for improving mental health.
It takes a hell of a lot more than this to be involuntarily taken into a psychiatric hospital.
The stuff you are saying is flat out wrong. It's also extremely harmful. I say this as someone who volunteers on a suicide hotline and takes calls like this every night I'm on shift.
No one is going to involuntarily take you to hospital unless you are in really, really imminent danger (as in, you have a loaded gun and insist you will use it in twenty minutes level of danger). Just having suicidal thoughts or even self-harming will not result in your autonomy being taken away.
Please, if you are having harmful thoughts, the best thing you can do is talk to someone. Don't let the nonsense above scare you away - you CAN talk to your therapist about this stuff. It's why they exist.
> Don't let the nonsense above scare you away - you CAN talk to your therapist about this stuff. It's why they exist.
I’ve had every therapist I’ve ever seen give me a rehearsed speech about what things they’re required by law to take action (i.e 5150 although technically a different number here) for and it’s always self-harm and suicidal-thoughts, but not ideation. Maybe it varies by state?
The speech always came with a wink wink just don’t tell me explicitly and we can talk about it here so I think they agree with you.
“Action” is different from involuntary commitment.
All I can say is that out of the many thousands of calls yearly to the Seattle-area hotlines, the number of direct involuntary interventions was on the order of a few dozen a year at most.
Yes, if you are in imminent danger, people will come to you and try and talk you out of it, and there are lots of voluntary hospitalizations, but it’s honestly rare for someone to be taken against their will and usually only happens in cases of heavy psychosis.
The thing with a therapist is that many are not set up to be crisis counsellors and so they will want you to talk to someone who can help in a crisis rather than once a week for an hour. But that’s all.
Putting aside other factors for a moment, a rigorous test surely depends on the dose.
Stimulants like lisdexamfetamine can be titrated over a period of several weeks to determine effectiveness and tolerance of the dose, which are unknown until tested - that doesn't seem quick to me and indicates that clinicians can't expect a binary response from a one-off dose.
Nothing about solar cycles, or sun position, and other seasonal factors relating to fetal development. An old topic, covered in better detail in a plethora of past research articles. Might be more revealing to read about seasonal differences between children born in south vs north hemispheres.
I'm not sure if what you're talking about has anything to do with the article. It sounds like you're just making a flippant comment based on the title of the article (please correct me if I'm wrong). From the article:
> Most states have arbitrary cutoffs for kindergarten entry, with children who do not reach a given age by a certain date required to wait a year. In 18 states, children who will turn 5 before Sept. 1 can enter kindergarten in the year that they turn 5; children who will turn 5 after Sept. 1 must wait until the next year. So in states with Sept. 1 cutoffs, in any given class, August-born children will usually be the youngest and September-born children the oldest.
These arbitrary cutoffs have important implications for the diagnosis of A.D.H.D.
There are also other reasons birth month could be related to psychiatric disease that sound more pseudoscience-y at first. There's good reason to believe that infection at the wrong time of pregnancy can increase risk of Schizophrenia for example, meaning that the alignment of cold and flu season could affect disease rates by birth month.
I agree the comment was probably just being sarcastic, but I think it's worth noting that there could be a more biological component to an effect like this, doesn't need to be a societal environment/diagnosis rate thing to be plausible.
It's interesting reading about a lot of pseudoscience as you go through scientific training, because obviously you have an immediate negative reaction to it. But I've started to notice that more often than not there is some underlying grain of truth that is taken to an extreme and/or given a ridiculous explanation. This in turn dampens real research on the potentially interesting line of questioning.
Classic Gemini excuse-making. Clearly these kids' problems are caused by $CELESTIAL_BODY being at $PLACE during $TIME; idk why they keep whining like this!
But also: focus isn't distributed bimodally; ADHD is in some respects a matter of degree, not kind. Accordingly, many ADHD treatments also improve the abilities of people without ADHD—to ends both benign (the "secular literature" of productivity porn, which overlaps with behavioral ADHD management) and less-so (widespread stimulant abuse on college campuses). That leaves us with evaluating impairment to a student's quality of life. Is doing that by comparison to their classmates subjective? No—you can still make objective statements about comparative ability—but the ethical question of "do Gemini deserve a 12-month cognitive disadvantage compared to their grade-level peers?" is harder to answer than the medical "would this kid still be diagnosed if they were relatively older?". The article's argument is weaker for eliding it.
What's the difference between stimulant use with a prescription and stimulant use without? A priori why demonize one as abuse and accept the other as legitimate.
Honestly, I took it as an axiom so as to steel-man the article's argument; if there were no difference between prescribed and unprescribed use, any dismissal of concerns about overprescription would be trivial.
But if I had to argue for it:
I'd wager that unprescribed usage on college campuses is more likely to fall outside of medical guidelines (e.g. at late hours to pull all nighters, or in higher doses for recreational and euphoriant purposes). Whether or not one demonizes this as unethical, it should be uncontroversial to describe the concomitant increases in e.g. seizure risk, addiction, and other side effects as not-benign.
It also advantages 1) lawbreakers who 2) can afford secondhand stimulants. Yes, this is also evidence towards "ok so don't legally require an rx to purchase these"—but such are the rules of the game students are playing, and the argument from personal freedom is strained when made in a competitive context.
What’s the difference between giving people with poor impulse control unfettered access to stimulants and giving them a set of rules that provide structure?
The dosage probably. Prescription tries to get the lowest dose that effectively treats whereas you would probably buy based on value for money off your pal Gregg who knows the dark web. The dose will also go unchecked and unmonitored for effectiveness.
Stimulation prescriptions come with requirements like blood pressure checks to make sure your heart isn't going to explode too.
If you stopped at the first sentence, it would be a great comment. Not really sure what other points are trying to be made, but you got a chuckle right off the bat.
I would recommend taking this book or similar ones with a grain of salt. Just going off the summary it claims to "prove" that ADHD isn't inheritable, which goes against lots of well established research showing strong inheritability of ADHD.
Any books that claim to undercover the "root cause" of something as varied and complex likely haven't. Now it might have great insights, but presenting the book this way gives a bit of undertone as "cure ADHD with this one simple trick!".
Guessing about the content of the book, it likely seems to discuss healing emotional regulation by some means. If so I'd agree it's a valuable aspect of treating ADHD, as most ADHD'ers also suffer significant emotional damage. That damage and accompanying maladaptive coping often is far impactful than ADHD itself.
Maté says the inheritable trait is a kind of nervous sensitivity that develops into ADHD in certain early childhood environments especially when the caretakers are stressed, depressed, or otherwise unable to provide the infant with the stable, responsive gaze that they need. I don’t know how true that is, but that’s the idea in “Scattered Minds.”
He literally starts the book by saying that he didn't know much about ADHD until four or five years before writing and then he and his three(?) sons were all diagnosed with it and then (or so I gather because I stopped reading then) he comes up with some novel theories contradicting the experts in the field.
There's so much evidence-based material to read from people who have spent decades studying ADHD that it's a shame instead to waste time on Mate. He may be an expert in some things, just not this
Agree with other responses. Maté's book, as his other works, resonates intuively - a humanistic shout in this cold and sick world.
Things are however more complex. He gets a lot of publicity, eg with recent Joe Rogan interview clips on the topic being spammed to me by YouTube's rec engines. Mental health issues are something that many people take intellectually lazy stances, to one direction or another, and this is somewhat worrying.
This book is 20 years old. I'd imagine the scientific & clinical understanding of ADHD has progressed since. Opposing views are of course important for progression, but I'd like to understand his thinking in wider context of psychiatry. Would be interesting to see a dissection of his ADHD points, carried out in a rigorous way.
Sometimes I wish HN had a rule against posting things about mental health (perhaps with the exception of Ask HN threads).
At the very least, I'm curious what the statistics on references are compared to technical topics. There's always so much misinformation in ADHD threads. It's really exhausting.
> Sometimes I wish HN had a rule against posting things about mental health
Don't stop at mental health; basically any discussion outside of programming is a disaster AFAICT. It doesn't get cleaned up because the participants don't realize how bad it is. I avoid anything close to economics. I only checked the comments here to see if there was a non-paywalled version.
Perhaps, but is it really detrimental to discuss it? HN is decently moderately enough to avoid flame wars, and sure there's a lot of anecdotal talk going about by folks who aren't doctors, but that doesn't mean that patients/the public shouldn't discuss health.
Perhaps a sticky/banner for health topics may be a good idea? Like "This is a health topic, please don't make unverifiable claims and mark your opinions as your own"?
As a counter-anecdote, I have an early September birthday, but the 1st Sept cut-off was advisory rather than strictly enforced. So I was a “year ahead” of where I should have been for my exact age up until I was 13. At which point I repeated a year, going from the youngest of my classmates to the oldest.
Exactly the sort of child the article implies would at risk of being over-diagnosed with ADHD as a pre-teen. Except I wasn’t diagnosed until almost 25 years later.
Of course I’m just one data-point, but I’d be curious whether the developmental age differences might potentially _cause_ ADHD development among younger classmates rather than just indicate misdiagnosis.
I’m wondering if the opposite might be true as well - underdiagnosing people from different months. I was born in March and in Poland where I grew up school was assigned by birth year. So the oldest kids in a given class were from January, the youngest from December. I have had little problems in primary school and gymnasium without putting much work into it. Then in high school it got harder, but I still passed, again, without almost any work, skipping classes, being late all the time. I started really struggling at an university and later in life and I eventually got diagnosed.
Granted, ADHD disgnosis was rather uncommon in Poland in the 90s, but I can see how a kid doing good early in school could have been not diagnosed.
> All this raises the question of whether the disease is being overdiagnosed.
No chance of it not actually being a disease?
Maybe different brain types are as common as blood types. We'll never know while we label anything that doesn't play nicely with commercialism as diseased haha
This idea has been proposed multiple times before but, from what I remember (and I’m paraphrasing here) we’re identifying it as a disorder not because it’s a disease per se but because it affects the lives of those people and in general has been deteriorating ever since humans changed their lifestyles from hunters to farmers.
Not a disease? That's down to semantics and personal opinion. What isn't opinion is the fact that the symptoms of ADHD have been objectively identified on a global scale, in people from very different cultures and social classes.
I agree that it isn't beneficial to label a very livable condition with the same word that we use for much harsher illnesses, and it doesn't help that it's not a visible condition. But as somebody with ADHD, it really hurts me to keep seeing this argument repeated ad nausea.
Maybe the issue isn't that it is being overdiagnosed, but rather the fact that the only treatment we consider worthwhile is prescribing amphetamines to children.
> Maybe different brain types are as common as blood types.
What this research shows is that at least a significant part of ADHD diagnosis rates results from bureaucratic reasons, and unrelated to either disease or brain types.
The royal "we", as it were, definitely doesn't know everything. Most of us are not on the same page. Our society's collective consciousness is getting better, though.
I am endlessly fascinated by the effect your birth month may have on you. It begins with trivial things: if you are born in summer, then by the time you are 6 months old and have developed a vague awareness of your world, "going out" means adding uncomfortably many layers of clothing and being tossed into a cold and harsh environment. Whereas if you are born in winter, your first real playtime outside is a warm and wonderful experience, with flowers and butterflies and soft grass.
But the effect on your personality may go beyond this [0]:
> The season in which babies are born can have a dramatic effect on their future risk relating to the development of conditions such as neurological disorders, including seasonal affective disorder, bipolar depression, schizophrenia and type I diabetes. Research has shown that the season a baby is born in can have a major effect on whether or not they will become a heavy smoker.
> The risk of suicide increases by 17% for people born in the spring–early summer compared with those born in the autumn–early winter
Our daughter sleeps better and longer in winter, because it gets dark early - so her birth month correlates with the amount of sleep she got in certain stages of development during the last years.
In past ages, the birth month also directly influenced how much (and what kind of) food was available in certain stages of development.
This may sound esoteric, but I really think there is some deep truth in attributing personality traits to astrological signs.
>There are plenty of counter examples of other people who are born in the same month than me who are totally different.
That's irrelevant though. He didn't say it is a law of nature that forces development in the same exact way. Just that it's a factor.
What is the concern is how a statistically significant part of those born at X months are affected, compared to those being born at Y months.
Not whether there are exceptions. Of course there will be. People being the same in both groups might even be the majority. But one group (say "born in spring-summer ) having 17% more of something compared to the other is a big thing, and that's whats considered here - even if the rest 83% are the same on that aspect.
Now ponder the effects of all unhealthy food you will stuff in her and which modern society will make her effectively addicted to! Whatever effect the weather has pales in comparison.
It's like when people talk about "lunacy" i.e. the moon influencing human behavior. The moon causes the tides and we're 60% water; how could it not have some effect?
The tides work because water flows across the surface of the rigid Earth. You have a body that holds your water in, and a far more massive, much closer object than the moon, exerting far, far more gravitational pull on you than the moon.
Also, the moon is approximately the same every day (but higher or lower in the sky). It looks different on different days due to shadows, not gravity.
I honestly think that the best way to fix everything wrong in the world is to reduce class sizes in schools, and age categorisation seems like a good place to start.
If there is such a difference between the academic results of a kid born in July and another one born in August, wouldn't it make sense to double the amount of classes and group the children in age groups of 6 months of length rather than a year of length?
The Montessori approach actually does the opposite re: age categorization.
Small classes, yes, very.
But classes with multiple age groups together. 3 year age spans is my recollection. Basically "junior elementary" and "senior elementary" and "adolescent" is how I've seen it grouped.
Many ideas going on here, but partially it's younger kids learning from older kids or being able to access "older" material if they can handle it, encouraging mentoring relationships, not living under the illusion that just because two kids are the same age that they are measurable against each other on some skill sets, encouraging individualized learning paths, etc.
ADHD is actually underdiagnosed in most countries...
A proper diagnosis is highly correlated both with the probability of certain consequences (violence, drug addiction, low academic performance...) and the likelihood of treatment lessening those consequences.
The problem here is not ADHD being over diagnosed. The problem is using academic performance in place of actual diagnosis in the first place. It's a good predictor, but we are entirely capable of more. ADHD is the best studied disorder there is.
ADHD has been very significantly plaugued by misinformation and stygma. Misinformation is still baked into the name itself!
But things are getting better. People are learning that ADHD is actually an executive functioning disorder, that you aren't likely to grow out of it as an adult, and that stimulant medication isn't the Boogeyman that the war on drugs has made it out to be.
So it's no wonder that we are seeing increased diagnosis rates! We're seeing an increase of LGBTQ+ identification rates, too. It's pretty obvious why.
This whole article is just fear mongering backed by circular reasoning. Do better, NYT.
177 comments
[ 3.4 ms ] story [ 218 ms ] threadThat is, even in a world with no overdiagnosis of ADHD, we would 100% expect an effect of the sort this article raises.
Person, woman, man, camera, TV type words? Sounds like other neuro tests.
I've screwed up these tests as I focus on repeating each word in the gap between the next word being said then repeat with the new word being added to the point I've missed the next word.
I've never "liked" this test, as I don't think it's always indicative of what they are trying to make it. This sounds more like interviewing a potential server that isn't allowed to write down the order.
If I recall correctly you’re talking about the working memory index. I scored 50th percentile on that portion of the test but top 0.4% overall, which I’ve always felt like reveals something about my “ADHD brain”. It’s definitely not the norm. The administering psychologist seemed super interested in my testing and I asked a lot of questions about the process. She brought me back in for a second day of tests as some of the tests I exceeded the space available. I recall they had a band writing symbol recognition and copying test, and I filled up a page front and back, so she had to come back the next day with more pages to accurately measure me since you aren’t supposed to “ace” a part of an intelligence test.
I often think about it because I often think “well, being 1 in 250 is pretty good, but that also means there’s literally millions of people smarter than me”. Hard work and building good habits like going to bed on time has been key to actually making use of the “raw power” of my brain, and Adderall as an adult has helped a ton with this despite side effects that I try to keep under control (irritability and seeming more ‘robotic’. Every time I try to stop using it I feel like my career slips and I become depressed. The me on Adderall is capable of being a competent software engineering team lead juggling multiple balls in the air. The me without Adderall struggles as a senior software engineer writing code for one project.
I’m excited to take a 2 week break from the meds on vacation later this year though. I constantly feel like I’m “grinding my gears” too hard, so to speak, like the Adderall is adding jet fuel to my engine of a brain and it’s gonna burn me out. It hasn’t happened yet but I really want to avoid tolerance.
I was a perfect student all through grade school; except I had terrible grades in almost every class. Why? Because I almost never did homework. I usually aced tests without even trying, though. And I could always provide meaningful input into class discussions. But that isn't enough for the strict traditional structure of academia.
Teachers would make me stay after school to try to catch up on homework, and I would just wait patiently until it was late enough in the evening that they would give up and let me go home. This was a recurring pattern from 4rth grade all through 12th. I only graduated high school because I finished hundreds of pages of make-up work over the last couple weeks.
The reality is I couldn't do homework. I could focus and sit still, which must have meant I don't have any attention or hyperactivity disorder...
...but that's not what ADHD is. It's an executive functioning disorder.
ADHD is being diagnosed more today because it has been incredibly under-diagnosed in the past. It's still significantly underdiagnosed in adults today.
...with atrophied hands.
I knew I could, I knew I should, but I could never do. I could only watch myself, never participate.
It's really validating to have words like "executive dysfunction" to describe this pattern, as opposed to "lazy", "tired", and "unmotivated" - which are all I had growing up.
I'm sure repeating brings with it all kids of other problems.
I don't mean to suggest that anyone's faking it BTW. As the authors point out, the real problem here might be underdiagnosis of September children. But parents of August kids might be more than a little predisposed to schedule that doctor visit, listen to that diagnosis, etc. in a way that parents of September kids would not be.
---
An unexplored link here is No Child Left Behind and its successors; in 2001, K-12 became standardized test prep schools as grades earned funding. Bubbling certainly drove me a little batty.
I guess I ask because there will always have to be a cutoff, even if it's a soft cutoff.
As a non-parent, the best solution I can see is to give the parents the knowledge and freedom to make the choice, and to add this data to perhaps mitigate over-diagnosis (and any attached stigma).
Of course, as I write this out, it occurs to me how much of a burden on parents an extra year without school could be
what would help is an adaption of the montessori model where an age range of three years is in a class, and the expectation of all kids behaving the same naturally disappears.
doing that at least in kindergarten will at least avoid a mistaken diagnosis for ADHD. but my hope is that montessori kids will also fare better in a regular school because they learned to be more independent.
We could ditch the "academic year" idea entirely and just have kids join the classes when they are ready for them and not force a cohort to all have to learn and progress at exactly the same rate (one which, statistically, is either too slow or too fast for essentially every student).
I appreciate your post. With a little one who is about to turn three, I've been thinking about school and the affects of going too early a lot lately. I worry about holding him back in case he'd end up bored and unchallenged. I've seen quite a few really smart people make some bad turns due to boredom. But, of course, I wouldn't want my kid to spend their life chasing all the "smarter" people either. That life has not done well for my self-esteem. Regardless, mixing multiple years in the same class sounds like an excellent way forward.
Because I never really pushed training the binomial formulas I later run out of time when I had to solve more complex formulas where having those ingrained helps "finding the shortcuts" instead of "brute force".
We have a saying, that I "never learned how to learn". But it may also be that I suffer from undiagnosed ADHD (on top of that).
My kindergarten teacher, who was also a family friend, requested I do it again because I wasn't mature enough. And she was right, honestly; I'd fight against nap time, and remember no end to problems in first grade with sitting still.
However, while maturity played a roll, the problem was I was bored. I went in to kindergarten being able to add, subtract and read, and had already started doing multiplication with my mom (herself a high school teacher). Another year in kindergarten would've been torture for me. Thankfully I had an amazing first grade teacher who recognised the problem. Instead of insisting on ADHD, she gave me more challenging stuff and let me work on my own. She never called on me to read aloud, because she gave me other books to read behind the class's book. This lasted until my 4th grade year, where one of my teachers didn't like it. Thankfully by then I was mature enough to recognise what I needed to do, etc.
So really, I wonder how much of this is a mixture between multiple things and how many times kids get given ADHD diagnoses when what they really need is differentiated education. Granted, this is difficult; I was a math/science secondary school teacher (and I think it's even harder for elementary school teachers, for various reasons ranging from standards to their own competency in the subjects they teach), and it was almost impossible at times.
That said, maybe I do have ADHD. I went on an amphetamine for weight loss at one point, and there were times I noticed I could focus longer and easier. But I've always had a tendency to get bored of something easily, and I'm sure the Internet hasn't made it any better. So I avoid getting tested as it doesn't impact work or study or anything for me (anymore than the Internet itself does)
School was always a breeze, I would get hyperfocused during classes paying attention to instructors and content but could never, ever do homework. Any kind of school work outside of school hours was a struggle. Still managed to be always on top of my classes.
I never actually learned how to learn, studied statistics in university and was hit by a brick wall on how to actually learn things which depended on more than just passively absorbing content...
To this day I don't believe I have a decent strategy for learning, it's a very scattered approach where I dunk into the subject from multiple angles and slowly build a mental model based on the patterns I see repeating from multiple sources. I'll start with an introductory book to gather an overview of the subject and then will jump in between other books and more advanced sections to see earlier concepts already applied and then backtrack to the gaps I see missing in my knowledge.
Somehow this way of learning is much more motivating to me than simply parsing through a linear approach of theory building. Whenever I try to go front-to-back with a textbook I get terribly unfocused.
HN (and probably the Bay Area which usually is reflected here) has become a weird echo chamber of nerds all claiming they think they have ADHD. When really, it’s that smart people get bored very easily. And most of what we do in our jobs are boring. Of course, stimulants help with this - why do you think we all drink so much coffee. Prescription stims are even better and are well tolerated. The right western doc will happily diagnose and prescribe for ADHD regardless of the severity.
I know ADHD is a spectrum, but I believe that diagnosis is only really warranted for those truly clinical - people who literally cannot hold any job at all and would be homeless otherwise. I guess there is the argument we should all just be allowed to take whatever drug we want and there is certainly merit to that.
Even the most productive coders, writers, musicians etc talk about their struggles to stay focused. It takes grit and intense self discipline to sit for 8 hrs doing work that isn’t immediately satisfying. Most people can’t do this, it’s not abnormal. People goof off at work all the time in most jobs, because they can’t hold their attention for so long.
I have not yet been diagnosed with it but my therapist felt it was important after almost 3 years of therapy to check it. I believe my therapist has a bit more of insight into my mental health (and mental health in general) than a random HN comment.
I appreciate your point of view but feel it can come off wrong, I have multiple signs that warranted from my therapist a deeper investigation and I will trust them.
Again, I'm not looking into getting medicated to focus, I don't want to be constantly on speed to function.
I feel like your kind of comment is exactly what made me not ever think about this. I can hold a job, I could do well in school (but not in university, at all), it's not because others might have it much worse than I do that I'm not worth to be checked on. You have no idea about the state of my mental health and struggles to be able to judge if I'm just smart and bored or if there is something else underlying it all.
I just bring this up because I feel your comment comes from a good place of caring but it's ultimately unhelpful and, depending to who else you could have directed this comment, could be actively harmful.
But the inability to maintain focus held me back for many, many years as my parents did not believe ADHD was a "thing". I didn't get medicated until I was in my 30s and it has made a world of difference. It's not a panacea and I still have my own tendencies, strengths, and weaknesses. But it's more like wearing glasses instead of having to squint for my entire life. Sure, I'd survive without it, but it's a tool to somewhat make up for a biological shortcoming versus the accepted norm.
I wish you luck in your pursuit of self improvement and I hope you discover effective ways to get closer to where you want to be. It's a good thing to explore and learn about for sure.
According to various sources, ADHD is the single most treatable psychiatric condition. But I guess what I expected from treatment, and what technically constitutes as treatment were misaligned.
I also do really believe we should be meditating more or something similar - when I try to read a novel these days (even one I am interested in) I find it is significantly more difficult to do it than it was when I was much younger and had generally lower reading comprehension.
Me personally, being on HN, I started to believe I too had ADHD reading peoples' stories on here. After a lot of therapy, and even going for an ADHD evaluation myself (a huge pain in the NHS), I realized it was more a result of burn out and depression. Thankfully, with a lot of therapy (almost a year now), I am slowly regaining my focus, and even improving my ability to deal with boring tasks (which I had convinced myself, based on stories on the internet about adult ADHD, that I could never do).
If I had been in the US, I would have self referred to a psychiatrist, gotten an ADHD diagnosis, and been on meds by now. Problem solved? I don't think so, I never would have treated the fundamental psychological issues that actually were causing the problem. But I would have gotten ADHD diagnosed and think there was something wrong with my brain forever. I feel this must happen a lot in the US. Adult ADHD is actually very rare - it is very hard to go unnoticed as a child with ADHD.
I would strongly suggest anyone reading HN stories about adult ADHD first to see a psychologist and do talk therapy first. Also, make sure to get a second opinion on a diagnosis like adult ADHD.
As someone with ADHD that was professionally diagnosed on multiple occasions, I would say to keep this up if you can.
If you can find something that works, then keep at it. I chose the medication route many years ago, and it's been rather... bittersweet to say the least. But that is just my experience, and I believe I am somewhat of an outlier -- at least with the information I currently have.
autistics tend to do that? :)
I was given ritalin as an adult to see if I had ADHD. The test was simple, take it, do you feel you concentrate/focus better? if not, you don't have it.
The biggest thing I ask people about is the executive function aspect. Are you simply getting distracted because you are bored or do you also find you have tasks you legitimately WANT to do but for some reason your executive function does not allow you do it. That seems to be (as a lay person) the biggest tell for someone who actually has ADHD.
I’m nearly fifty and got diagnosed with ADHD about five years ago.
I got expelled from school at 15 for just never showing up. Despite being one of the smartest kids in school, I would do so well I a new class and then it would tank badly.
I’ve never held a job for more than 18 months.
I’ve had the benefit of being a well spoken good looking white man that interviews like a god and is very good at writing a resume, plus I had good people in my corner giving me excellent references. In a booming job market, getting work was easy enough.
But my life was going off the rails. Depression. Risk taking behaviour. Anti social issues and so on.
Saw a GP for serious cyclical depression issues. I was self medicating with caffeine and flu meds.
She said have you considered you might have ADHD?
I hadn’t considered it all.
Got referred to a specialist. He said it’s very hard to get diagnosed with ADHD later in life.
90 minutes later after my life history we started a trial on Ritalin!
Overall - ADHD is a curse. It’s not a super power. And Ritalin, Adderall etc… are not miracles.
I could write a book on my experiences….
I'm born towards the end of the year, and where I'm from (Afroeurasia) there isn't a strict year based cutoff. So I had Jan-born peers almost 2 years older, and folks a year younger.
Fortunately I was always fairly bright despite probably spending a solid 30% of my time daydreaming. I could catch up quickly... until it started getting harder in high school. Uni and grad school hit me, and I finally got dx'ed some time back (still in grad school).
I think I have been lucky that in school, most teachers were fairly nice intelligent people, and I was always the good, quiet kid who'd ask good questions (because I'm interested in everything). Having a good structure at home also majorly helped.
But in retrospect? Anybody spending hours every day daydreaming... yeah, screen them for ADHD, that was kinda obvious.
That's a fitting description that matches a factoid I read about mandatory education early days: the goal was to have workers who could read and count to operate industrial machinery.
Like in Norway, everyone born the same year go to school together, even though the school starts in September. (Which confused me a lot when reading Harry Potter as a kid, as some dates there didn't "add up"). We segregate sports teams that way as well, making it often better to be a jan/feb kid, as you're always the biggest/strongest, and thus get the extra attention, training opportunities etc, so a bias towards those birthdays in our sports.
There is also a strange statistics with baby borns in early January and late December. There is a high spike of births in early days of January and a strange hole in births in the last days of December.
My daughter is usually the youngest kid in class (born middle December - here we put babys born in the same year in the same class) and usually has trouble because she is not as developed as kids born 11 months earlier - this difference will be less noticeable later in life, but know when she is 6 years old it is a bit sad.
I knew someone who came to the US as part of the Vietnamese boat people and his parents chopped a year or two off his age so he could start in kindergarten (and he didn’t know his actual birth year 30+ years later).
The result appears to be consistent across countries with different cutoff dates.
For example, British Columbia with a December 31 cutoff date.
https://www.cmaj.ca/content/184/7/755
Put me in physics class, technical drawing, cooking, math, I focused and did really well. Every other class was boring and non stimulating and so I acted up.
ADD is over diagnosed.
It’s perhaps a meme now that adhd is over diagnosed, but I’d guess the majority is pill seeking individuals looking to compete at school or at work and less false positive diagnoses such as yours.
Net net you seem to have solved it fairly quickly so at least that’s good: even when you get the diagnosis wrong if you can backtrack without significant cost then maybe it’s not absolutely horrible.
But sometimes I think difficult children are automatically labeled ADHD and the solution is drugs without trying to find the cause.
I reminded of this Ted talk https://www.ted.com/talks/sir_ken_robinson_do_schools_kill_c...
Most people blamed the behaviour of difficult children on their difficult parents.
That being said there are a lot of people who are purposely seeking ADHD meds who know they are not ADHD just to get drugs. Those people are kind of ruining it for everyone else. They are usually pretty easy to spot though
Being able to focus (sometimes to self-destructive levels) on things we enjoy are as much a part of ADD as being chronically unable to focus on things we find boring.
I’m curious what you think ADD is, since what you describe here is practically textbook symptoms.
I didn’t say ADD/ADHD don’t exist. I said it’s over diagnosed. We just like to label kids and tell them they are broken and needs drugs when in reality most kids are bored of the sterile environment of learning with the dumbed down education system that teachers are forced to adhere to because acknowledging that not all kids learn the same way as other kids is too hard.
No, it's trying to see if they have a condition which is readily and effectively treated through medication. I have ADHD, and my daughter has ADHD, so I've been through this a few times with the docs. The _gold standard_ for determining if a patient has ADHD is treatment with stimulants. There are assessment surveys they have you fill out and such, but there's tons of other underlying issues which can cause similar symptoms and lead to false positives. The best, easiest, most reliable way to tell if someone really has ADHD is to give them Adderall and see what happens.
My psychiatrist says that he has done this even with patients who end up getting diagnosed with other issues like bipolar. Why? Because despite being a scheduled drug, stimulants are incredibly safe at pharmaceutical doses, without any serious side effects. It's harmless to try, and if it doesn't work you move on to try something else.
Btw what studies have been done have shown that if anything ADHD is under diagnosed, and severely so in the case of girls. A lot of people who have had other underlying issues have initially been misdiagnosed as ADHD, but this is not the same thing as general over diagnosing, and generally is because ADHD must be first considered and ruled out before moving on to conditions which require the use of more serious drugs.
Wow no wonder america has such a drug problem…
Over-the-counter pain medications are more far more dangerous in all categories: allergies, overdose, effects of long-term use, etc.
Stimulants are one of the safest medications used. There is plenty of data to support this.
Could also just be you have a mild form of ADHD and you do not need medication at all and Physics and similar is the thing you like to hyper focus on. For some people the ADHD is a huge gift if the thing their brain happens to want to latch onto is also something they enjoy and/or can make a career out of.
Also do we really want to be shifting blame onto teachers at this point? They are overworked and already taking enough shit from parents as it is. And the ones I know and have talked to are constantly finding new and creative ways to get kids interested in their teaching
Funny you make a broad and sweeping conclusion based on one single message posted on a forum.
> Also do we really want to be shifting blame onto teachers at this point?
Not just teachers. The education system as a whole. You know with math, there's often multiple ways to achieve the same answer. I failed math one year because even tho I showed the work to get to the solution and it was a completely valid method with a correct solution, I got 0 because I did not do it the textbook way. Teachers are not allowed to teach math any other way than what the department of education dictates. Math can be quite fun and engaging, but you know, better to keep kids dumb and medicated than helping them.
Oh and before you jump to conclusions and claim this is one single experience. It's not a single experience.
What makes you believe that? I hear people spout this all the time, but it's an irrational belief to me. The condition is still diagnosed via interviews, pseudoscientific psychometrics, and other arbitrary and vague heuristic. There are still no biological markers than can be used to diagnose the condition. At least, not with a high level availability nor a price point that would justify the mainstream usage of such methods.
Thus, if we have no clear and definitive way to know if someone has the condition, then, if you will forgive my poor analogy, it's all just Schrodinger's ADHD -- both over diagnosed and under diagnosed at the same time.
What is quite clear is that a subgroup of the population suffers greater in some areas than others, and we kind of found something that helps those people. I find that much more important than gatekeeping people who would benefit from treatment.
You concluded this just based on your single experience?
It could be wrongly diagnosed for many people and still be under diagnosed overall.
My cousin was born about a month after me and he was in a younger grade than me. We grew up together and I always felt bad for him that he couldn't get highschool over with a year sooner like me. He was jealous of me. He also got into a ton of criminal behavior and has been in and out of jail for the past 20+ years, so I could easily say that was caused by the trauma of him being a year back from me in school. Who knows.
This (or backing up a year any year) might have helped you too.
> and put her in a private school that mixes multiple years in the same differentiated class.
This might backfire, for the same reason that you had trouble -- differentiation is difficult to do in practice. And your childhoold school might have been less differentiable than a modern public school, which has the benefit of computerized material and automated adaptive tests.
Of course, if the private school solves it by having a far lower student:teacher ratio, then of course that's better than a public school, all else equal.
Another thing parents can do is, instead of switching to private school, put that money toward hiring PTA-sponsored assistant-teachers in the classrooms.
Through no fault of their own.
We, simply, have legitimately very little knowledge of those fields of science. Our understanding of the human brain is just not there.
So much of Psychiatry is throwing pills at symptoms after talking about your life.
That's often the state of the art in the field.
Genetic sequencing, and the ability to use genetic markers to diagnose illness, hopefully will change things. A cheap and effective diagnostic tool that isn't based on guesswork and "tell me your life story."
Psychology is in great part pseudoscience. Lots of studies that are neither falsifiable or reproducible.
Psychiatrists are the modern equivalent of barber surgeons, or trying to make fine jewelry with a chisel and a hammer.
You just give the person a stimulant and see what happens. If they get really awake, hyperactive, excited, anxious, shaky, hyperfocused, etc. then nope, if they get calm, content, or sleepy then yes. And it’s not like this is crazy in general, we do “just treat it and see if they get better” as the test for plenty of things.
Nobody bats an eye when we do the same thing for depression, it’s super common for people who exhibit the symptoms to be asked to try a few antidepressants and see if they work.
I get that some people abuse stimulants but they suuuuuuck. Life changing because they allow you to function but you will also curse them for it. The side effects are awful. So much so that I tried a bunch of non-stimulant medications until I found one that worked. Nobody who doesn’t have ADHD is gonna wanna regularly take adderall or vyvanse just because it would be miserable and that’s before the fact that they aren’t cheap.
Edit: /rant Mental health is wild because smart and well meaning people designed a system that actively prevents people from being honest and getting help. Want to talk to your therapist about your suicidal thoughts, bulimia, or self-harm, nope. Not unless you want to take a mandatory grippy sock vacation away from your support network and get set back in school or lose your job all things famous for improving mental health. Wanna tell your psychologist that you think you might have ADHD because you were at a party, tried something and it made you felt way different than everyone else, haha drug seeker.
The above post is utterly false.
This was always known to be false, but was a popular opinion in pop-psychology for a time.
It is untrue.
Stimulant medications DO NOT have this claimed opposite effect on people with ADHD. This is not a view that is supported by science and is not a valid diagnosis method.
I’m not even saying you’re wrong, but it doesn’t match my personal experience at all (in both directions), and the belief is apparently widespread enough that real professional mental health providers believe it.
It would be genuinely surprising to me if someone who works all day with people who take these medications and talk about their effects wouldn’t be armed with a million counterexamples if at minimum the observations didn’t line up. Like they’ve got to be seeing some real effect even if the explanation is wrong.
I can comfortably take a nap after popping 10mg of dexamphetamine, whereas most people would be atleast moderately buzzed. And this has been the case since day 1 (I was diagnosed at 26), so it’s not just a factor of tolerance.
Another great example is the fact that the single biggest benefit to ADHD meds for me has been a complete reversal of my life-long anxiety.
I’m now zen as f..k, whereas before being proscribed meds I was a very anxious, hyper-self critical person.
I firmly believe this has more to do with dosages than anything else. Sure, give a random person a 10mg Adderall and one might be more sedated or hyperactive. Give them 100mg (almost double therapeutic max), and I guarantee they won't be calm sedated.
Sure, everyone has a different threshold that needs to be hit for whatever underlying reasons just like alcohol. One beer might make some feel buzzed, one beer might not do anything. But for an average person (not a chronic alcoholic), I guarantee they'll be fucked-up after 6+ beers.
There’s a REALLY obvious difference.
It’s visible as an effect in studies too. In various forms. At random, one paper of many which captures one aspect: https://doi.org/10.1111%2Fj.1469-7610.2010.02333.x
ADHD is a diagnosis based on symptoms. It has a number of causes. Your mental health professionals would prefer different diagnostic criteria. Those other criteria would result in a different set of people being diagnosed with ADHD. The current diagnostic criteria are symptoms that cause problems for the sufferer. Thus successful treatment of ADHD as currently diagnosed improves lives. Why is the diagnostic criteria you describe better?
If you took a 6 month long tolerance break, I would be interested to see if you still had that effect. Insomnia is not that uncommon of a symptom of stimulant withdrawal.
Why? I thought there was a clear and insurmountable amount of evidence behind all their little psychometric tests? /s
> real professional mental health providers believe it.
Plenty of doctors and professionals believe incorrect information all the time. Just because one went to a fancy medical school does not make them infallible no matter how much their ego may try to convince you otherwise.
Do they, as far as you're aware, have this opposite effect one some people - but it's not considered to be correlated to whether they have ADHD?
But some of that may have been environmental because I had experience with hyper friends breaking my stuff and so learned to be cautious, so I might have developed increased caution in response to stimulation for non-physiological reasons.
That might not actually be real: https://www.science.org.au/curious/people-medicine/does-suga...
It takes a hell of a lot more than this to be involuntarily taken into a psychiatric hospital.
The stuff you are saying is flat out wrong. It's also extremely harmful. I say this as someone who volunteers on a suicide hotline and takes calls like this every night I'm on shift.
No one is going to involuntarily take you to hospital unless you are in really, really imminent danger (as in, you have a loaded gun and insist you will use it in twenty minutes level of danger). Just having suicidal thoughts or even self-harming will not result in your autonomy being taken away.
Please, if you are having harmful thoughts, the best thing you can do is talk to someone. Don't let the nonsense above scare you away - you CAN talk to your therapist about this stuff. It's why they exist.
I’ve had every therapist I’ve ever seen give me a rehearsed speech about what things they’re required by law to take action (i.e 5150 although technically a different number here) for and it’s always self-harm and suicidal-thoughts, but not ideation. Maybe it varies by state?
The speech always came with a wink wink just don’t tell me explicitly and we can talk about it here so I think they agree with you.
All I can say is that out of the many thousands of calls yearly to the Seattle-area hotlines, the number of direct involuntary interventions was on the order of a few dozen a year at most.
Yes, if you are in imminent danger, people will come to you and try and talk you out of it, and there are lots of voluntary hospitalizations, but it’s honestly rare for someone to be taken against their will and usually only happens in cases of heavy psychosis.
The thing with a therapist is that many are not set up to be crisis counsellors and so they will want you to talk to someone who can help in a crisis rather than once a week for an hour. But that’s all.
I’m not sure that’s true. These are not mine, but supposedly true to life:
https://reallifecomics.com/comic.php?comic=july-31-2020
https://reallifecomics.com/comic.php?comic=august-3-2020
https://reallifecomics.com/comic.php?comic=august-4-2020
https://reallifecomics.com/comic.php?comic=august-5-2020
Stimulants like lisdexamfetamine can be titrated over a period of several weeks to determine effectiveness and tolerance of the dose, which are unknown until tested - that doesn't seem quick to me and indicates that clinicians can't expect a binary response from a one-off dose.
> Most states have arbitrary cutoffs for kindergarten entry, with children who do not reach a given age by a certain date required to wait a year. In 18 states, children who will turn 5 before Sept. 1 can enter kindergarten in the year that they turn 5; children who will turn 5 after Sept. 1 must wait until the next year. So in states with Sept. 1 cutoffs, in any given class, August-born children will usually be the youngest and September-born children the oldest. These arbitrary cutoffs have important implications for the diagnosis of A.D.H.D.
I agree the comment was probably just being sarcastic, but I think it's worth noting that there could be a more biological component to an effect like this, doesn't need to be a societal environment/diagnosis rate thing to be plausible.
It's interesting reading about a lot of pseudoscience as you go through scientific training, because obviously you have an immediate negative reaction to it. But I've started to notice that more often than not there is some underlying grain of truth that is taken to an extreme and/or given a ridiculous explanation. This in turn dampens real research on the potentially interesting line of questioning.
But also: focus isn't distributed bimodally; ADHD is in some respects a matter of degree, not kind. Accordingly, many ADHD treatments also improve the abilities of people without ADHD—to ends both benign (the "secular literature" of productivity porn, which overlaps with behavioral ADHD management) and less-so (widespread stimulant abuse on college campuses). That leaves us with evaluating impairment to a student's quality of life. Is doing that by comparison to their classmates subjective? No—you can still make objective statements about comparative ability—but the ethical question of "do Gemini deserve a 12-month cognitive disadvantage compared to their grade-level peers?" is harder to answer than the medical "would this kid still be diagnosed if they were relatively older?". The article's argument is weaker for eliding it.
But if I had to argue for it:
I'd wager that unprescribed usage on college campuses is more likely to fall outside of medical guidelines (e.g. at late hours to pull all nighters, or in higher doses for recreational and euphoriant purposes). Whether or not one demonizes this as unethical, it should be uncontroversial to describe the concomitant increases in e.g. seizure risk, addiction, and other side effects as not-benign.
It also advantages 1) lawbreakers who 2) can afford secondhand stimulants. Yes, this is also evidence towards "ok so don't legally require an rx to purchase these"—but such are the rules of the game students are playing, and the argument from personal freedom is strained when made in a competitive context.
Stimulation prescriptions come with requirements like blood pressure checks to make sure your heart isn't going to explode too.
you’re proud of yourself for that aren’t you?
you part of New Nazi Nation or someshit?[1]
~ genx jesus
It provides a compelling argument as to the root cause of ADHD.
[1] https://drgabormate.com/book/scattered-minds/
Any books that claim to undercover the "root cause" of something as varied and complex likely haven't. Now it might have great insights, but presenting the book this way gives a bit of undertone as "cure ADHD with this one simple trick!".
Guessing about the content of the book, it likely seems to discuss healing emotional regulation by some means. If so I'd agree it's a valuable aspect of treating ADHD, as most ADHD'ers also suffer significant emotional damage. That damage and accompanying maladaptive coping often is far impactful than ADHD itself.
There's so much evidence-based material to read from people who have spent decades studying ADHD that it's a shame instead to waste time on Mate. He may be an expert in some things, just not this
Things are however more complex. He gets a lot of publicity, eg with recent Joe Rogan interview clips on the topic being spammed to me by YouTube's rec engines. Mental health issues are something that many people take intellectually lazy stances, to one direction or another, and this is somewhat worrying.
This book is 20 years old. I'd imagine the scientific & clinical understanding of ADHD has progressed since. Opposing views are of course important for progression, but I'd like to understand his thinking in wider context of psychiatry. Would be interesting to see a dissection of his ADHD points, carried out in a rigorous way.
At the very least, I'm curious what the statistics on references are compared to technical topics. There's always so much misinformation in ADHD threads. It's really exhausting.
Don't stop at mental health; basically any discussion outside of programming is a disaster AFAICT. It doesn't get cleaned up because the participants don't realize how bad it is. I avoid anything close to economics. I only checked the comments here to see if there was a non-paywalled version.
Perhaps a sticky/banner for health topics may be a good idea? Like "This is a health topic, please don't make unverifiable claims and mark your opinions as your own"?
OPINION: I think....
ANECDOTE: When I experienced this...
Exactly the sort of child the article implies would at risk of being over-diagnosed with ADHD as a pre-teen. Except I wasn’t diagnosed until almost 25 years later.
Of course I’m just one data-point, but I’d be curious whether the developmental age differences might potentially _cause_ ADHD development among younger classmates rather than just indicate misdiagnosis.
Granted, ADHD disgnosis was rather uncommon in Poland in the 90s, but I can see how a kid doing good early in school could have been not diagnosed.
No chance of it not actually being a disease?
Maybe different brain types are as common as blood types. We'll never know while we label anything that doesn't play nicely with commercialism as diseased haha
I think this video talked about this concept in more depth https://youtu.be/QUjYy4Ksy1E
I agree that it isn't beneficial to label a very livable condition with the same word that we use for much harsher illnesses, and it doesn't help that it's not a visible condition. But as somebody with ADHD, it really hurts me to keep seeing this argument repeated ad nausea.
Maybe the issue isn't that it is being overdiagnosed, but rather the fact that the only treatment we consider worthwhile is prescribing amphetamines to children.
I've not seen or made this argument before, where does it usually go and/or what is the end result?
I too have ADHD, I'm sorry if my curiosity and thoughts have caused you harm. I'm new to it and want to know what's what.
Do you have any wikis or articles or twitter threads that can get me up to speed on the basics without traumatising people?
What this research shows is that at least a significant part of ADHD diagnosis rates results from bureaucratic reasons, and unrelated to either disease or brain types.
We know a lot about ADHD and what causes it. We know its effects and how beneficial it is to treat it, especially with medication.
I've also been diagnosed with ADHD myself, but it was relatively recently so I'm not a part of that we that knows everything just yet :)
Different blood types don't impact people's life differently. Disorders like ADHD do affect the lives of people who have it.
It was an example of something biologically common anyway, I didn't compare it to ADHD the way you've read it.
But the effect on your personality may go beyond this [0]:
> The season in which babies are born can have a dramatic effect on their future risk relating to the development of conditions such as neurological disorders, including seasonal affective disorder, bipolar depression, schizophrenia and type I diabetes. Research has shown that the season a baby is born in can have a major effect on whether or not they will become a heavy smoker.
> The risk of suicide increases by 17% for people born in the spring–early summer compared with those born in the autumn–early winter
Our daughter sleeps better and longer in winter, because it gets dark early - so her birth month correlates with the amount of sleep she got in certain stages of development during the last years.
In past ages, the birth month also directly influenced how much (and what kind of) food was available in certain stages of development.
This may sound esoteric, but I really think there is some deep truth in attributing personality traits to astrological signs.
[0] https://en.wikipedia.org/wiki/Influence_of_seasonal_birth_in...
There are plenty of counter examples of other people who are born in the same month than me who are totally different.
There is also a huge difference how people handle sickness like the ones mentioned in the wik article.
The origin of those signs are also totally different and are pure fiction
What's the problem?
That's irrelevant though. He didn't say it is a law of nature that forces development in the same exact way. Just that it's a factor.
What is the concern is how a statistically significant part of those born at X months are affected, compared to those being born at Y months.
Not whether there are exceptions. Of course there will be. People being the same in both groups might even be the majority. But one group (say "born in spring-summer ) having 17% more of something compared to the other is a big thing, and that's whats considered here - even if the rest 83% are the same on that aspect.
Then it ought to be provable, no need to guess.
It's like when people talk about "lunacy" i.e. the moon influencing human behavior. The moon causes the tides and we're 60% water; how could it not have some effect?
Is that seriously the etymology of that word? If so, that is absolutely fascinating.
Also, the moon is approximately the same every day (but higher or lower in the sky). It looks different on different days due to shadows, not gravity.
If there is such a difference between the academic results of a kid born in July and another one born in August, wouldn't it make sense to double the amount of classes and group the children in age groups of 6 months of length rather than a year of length?
Small classes, yes, very.
But classes with multiple age groups together. 3 year age spans is my recollection. Basically "junior elementary" and "senior elementary" and "adolescent" is how I've seen it grouped.
Many ideas going on here, but partially it's younger kids learning from older kids or being able to access "older" material if they can handle it, encouraging mentoring relationships, not living under the illusion that just because two kids are the same age that they are measurable against each other on some skill sets, encouraging individualized learning paths, etc.
https://www.theatlantic.com/magazine/archive/2022/10/boys-de...
A proper diagnosis is highly correlated both with the probability of certain consequences (violence, drug addiction, low academic performance...) and the likelihood of treatment lessening those consequences.
ADHD has been very significantly plaugued by misinformation and stygma. Misinformation is still baked into the name itself!
But things are getting better. People are learning that ADHD is actually an executive functioning disorder, that you aren't likely to grow out of it as an adult, and that stimulant medication isn't the Boogeyman that the war on drugs has made it out to be.
So it's no wonder that we are seeing increased diagnosis rates! We're seeing an increase of LGBTQ+ identification rates, too. It's pretty obvious why.
This whole article is just fear mongering backed by circular reasoning. Do better, NYT.