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Why see a psychiatrist? Are those really things to 'fix' on the whole - given the upsides?

I'm incredibly energetic. I can't sit down for long - so I just stand in meetings. TV is a waste of time, so is social small talk, I do what I care about (and it rewarded me well). I've just felt like the speed, risk tolerance, freedom it provides me, and intuition make a powerful combination.

I'd say the ADHD (if it is) makes you unique. All the world needs is more conformists... [I may be conflating ADHD with my incredibly independent personality]



> I may be conflating ADHD with my incredibly independent personality

I think you are, to a degree. Serious ADHD is AWFUL to live with and there's barely any upside.

> I can't sit down for long - so I just stand in meetings.

It's nice that you can mitigate not being able to sit down for long by just standing, but for many people with ADHD, not being able to sit for long is more than just stance. It's because they can't focus on the task they need to do in front of them so they feel the urge to physically leave and seek out more interesting things.

Before I began medication, meetings were a nightmare to me. I was constantly zoning out every few seconds and absorbing absolutely nothing. Even if I did pay attention for a few seconds, I would forget everything a few minutes later. So I tried writing notes, but it became completely impossible to listen to people when I was actively writing. It was extremely humiliating to walk out of a 2 hour meeting knowing I wasted the entire thing.

> TV is a waste of time

Again, I think this is separate from ADHD. If anything, people with ADHD are more likely to seek out distractions. This does depend on the individual, though.

> I've just felt like the speed, risk tolerance, freedom it provides me, and intuition make a powerful combination.

Speed? It took me 3 days to find the motivation to fill out a simple 1-page form.

Risk tolerance? I think you may be referring to impulsiveness. The main difference is that being risk tolerant at least acknowledges the risk, while being impulsive means using an exciting new mental stimuli as an excuse to make rash decisions (often with poor consequences).

Freedom? ADHD is incredibly suffocating. It's wanting to start doing something but feeling overpowered and locked-up. It's wanting to achieve long-term goals but feeling like you're constantly self-sabotaging yourself. It's making a plan in the morning, being unable to accomplish anything during the day, and furiously kicking yourself at night in an endless cycle of self-hatred. For me, ADHD is the complete opposite of freedom. It's a prison.

I apologize if I'm disregarding your experience by citing my own experience. But please don't suggest people to not see a psychiatrist, or that ADHD isn't something to fix. For most people, ADHD is a constant and serious detriment to school, work, relationships, and just everyday life.


> Freedom? ADHD is incredibly suffocating. It's wanting to start doing something but feeling overpowered and locked-up. It's wanting to achieve long-term goals but feeling like you're constantly self-sabotaging yourself. It's making a plan in the morning, being unable to accomplish anything during the day, and furiously kicking yourself at night in an endless cycle of self-hatred. For me, ADHD is the complete opposite of freedom. It's a prison.

This describes my life with haunting accuracy.


Can't tell if you have a diagnosis or not. If it would be useful to chat my email address is in my profile and a few people have already reached out. I'm not a doctor and can't diagnose you but I'm happy to hear about your experience and share where it chimes with mine.


The minor upside has been I just don't do what I don't find interesting. So, my life has always been interesting. Often that's not been in a good way, like boss phones "why aren't you at work?" and I reply... "I could probably make it there by like...11". This was at about 9am when I was supposed to be in at 8:30am. It was some factory job I fucking hated. The wall of awful struck and I couldn't seem to attempt to get myself there any earlier than 11. That's what my mind was telling me. He didn't know what to say, so he hung up the phone. He called back 5 mins later and told me not to bother coming back to work. I was relieved and terrified all at the same time. Relived cos I just couldn't do it anymore anyway. Terrified because I had spent the last 2 years freeloading off my girlfriends mother who i later learned took out loans to support me and I'd only just got that job 6 weeks earlier after not working all that time.

Life was fucking hell in my early 20s. In my early 30s I'm a successful software engineer (thank fuck) and it tends to manifest in me bitching about how the software should be, daydreaming of it being that way, then endlessly pursuing side quests at work to make it so. Turns out that is actually a valuable way to be as a software engineer as I tend to make the software better at a much faster rate as compared to my peers.


wy35 - well answered response. I don't know that I am ADHD, so your experience trumps mine!


Hashtag nailed_it


ADHD has a wide spectrum, people with real ADHD cannot function without medication ( speaking as a parent with a child who has it). Yes, without medication he would either be not focussed or hyper focussed. But, the biggest issue is lack of executive function, which is debilitating. And, no matter what, real life needs you to be able to follow instructions, and do things in order. If a 7 year old with a simple life cannot function, think what it can do to an adult? The medication helps, but it's a process, and you have to find the right one and the correct dosage. Added to that, you need a competent psychiatrist, we lucked out after a few tries. Basically what the medication is doing is strengthening the neural connections, so that executive function becomes a habit, to the point where you don't need it. If you do it right 50% of people with ADHD won't need it. And, you can be a genius but if you lack executive function, you can't do basic everyday things, let alone complex tasks. Somehow the media has started painting ADHD as some kind of superpower, when it's a serious debilitating condition.


Thanks for sharing your experience. Really valuable to me and many others on here. A question and a quibble if that's OK:

> what the medication is doing is strengthening the neural connections, so that executive function becomes a habit, to the point where you don't need it. If you do it right 50% of people with ADHD won't need it.

I had understood that this only applied to children who are young enough to have developmental neuroplasticity. Is your understanding different? Appreciate your steer as it sounds like something you have understood in more detail than me.

Quibble:

> people with real ADHD

I don't think you mean to, but this is a little clumsy. As you say in the previous sentence, ADHD is a wide spectrum. You can have ADHD but function, there is no "real" ADHD, only various degrees of severity.


From what I understand, the brain never loses its neuroplasticity, but early intervention is always better. You hear stories of people who got diagnosed as adults, got the right medication and therapy and their lives improved tremendously. Again I want to stress that it is a combination of medication and behavioral changes. For a child, it means a lot of repetitive suggestions, patience and accommodations at home and school. For adults, I've heard Cognitive Behavioral Therapy and meditation working well.

When I said "real ADHD" I was responding to the earlier comment, where the person was trying to say how ADHD is some kind of superpower, and there are a lot of folks I hear say they have ADHD when they clearly do not. It is a large spectrum, but even folks at the lower end of the spectrum find it really hard to function. To give you an example, my son would be at the lower end of the spectrum, but we saw him struggling as he started elementary school. We were less worried about academics, but we started noticing that he was losing confidence because his peers would get what the teacher said while he did not. And, all that was leading to a loss in confidence.We read a ton of books, tried behavioral changes and recommended suggestions before we tried medication. And it simply did not work. We tried 3-4 different medications before one worked with no effects. It was a painful and heartbreaking journey. And our psychiatrist told us we were right to intervene early, because once the kids get to 3rd grade, the academic pressure increases and they are already behind their peers. I recommend Russell Barkley's you tube videos, they are excellent, and really helped me understand what ADHD is.


To expand - why not use it to your advantage? Consultants for larger, competitive companies do well w/ ADHD. Leaders do well. Founders do well (if they can stay focused on the opportunity).

I have a CompSci degree, and loved doing algorithms, etc - but can't be bothered to sit behind an IDE for hours. So what - enough of people can do that well. I've found leadership to be the best use of skillsets where these 'symptoms' appear.


I think this is a really interesting, nuanced point. It's one I talked to my doctor about because it was a concern I felt (and feel). Thanks for sharing it here! HN is usually a good space for contrarian opinions, but even so this sort of thing might get shot down a good percentage of the time.

The way I would express it is: ADHD medication curbs the downside of ADHD, but many people report and experience significant upsides to their condition too. The traditional view of ADHD medication is also that it turns children into "zombies". Do I run the risk of losing my 'edge' as a person?

I'm not a scientist, and I'm not a doctor. With that said, here are my notes from my doctor when we discussed this:

  1. I feel that oftentimes negative and positive personality traits in people go hand in hand, outside of ADHD. For example, the calm, methodical, detail-oriented people who make excellent assimilators and "deliverers" in startups are often a necessity to building something incredible, but can also be the very *worst* people to have around you when you're trying to "yes and" about fragile ideas, because they live relentlessly in the real world. Do the traits I exhibit in my ADHD also make me a more effective leader? Do I simply not understand the upsides because they exhibit as personality traits?

  2. Dr. X: There is little in the way of conclusive evidence, but he believes that it's possible that ADHD medication can curb traits that are either perceived as positive or genuinely positive in ADHD patients. This is why a key assessment is the extent to which negative traits manifest themselves. If you have ADHD but do not suffer from life-deranging consequences in some material sense (executive function impaired to the point where your career, relationships, or emotional wellbeing are suffering), then it's often not necessary to take medication at all.

  3. Dr. X: the common impression of ADHD medication -- and in particular Ritalin -- seems to be magnified by the fact that parents are in general deeply worried about their children and the sense that their personalities are altered in some way. In adults, the available treatments do not appear to have serious long term consequences for personality and cognitive function. So it's completely permissible to take XR/IR medication for ADHD on days when you especially need to focus, for example, and not worry about "missing" a day. Equally, if -- in consultation with your doctor during titration and your family and friends -- you feel that there is an untenable negative consequence of medicating, then you can of course stop.

  4. Dr. X: Anecdotally, ADHD sufferers frequently both underestimate and ignore the consequences of the disorder in their lives. Sometimes it's necessary to have them tell stories about areas of their relationships and personal lives which they find are surprising or hard which are unrelated to their ADHD, and very often doing so reveals that their ADHD manifests itself in ways which are wholly unsurprising but not visible to the patient.

  5. Taking the time to find the right medication and dosage is vital. Diagnosis is step one, and after that it is very often months of tweaking, talking, and collaboration with the doctor to establish the right dosage level (strength), formulation (XR/IR, and within that e.g. prodrug is an XR which is a sort of "prequel" to the chemicals you need -- so it stimulates the body creating them rather than dumping the chemicals themselves into your system), and brand (e.g. Ritalin, Concerta, and Medikinet are all methylphenidate, but Concerta is commonly a 25/75 release, Ritalin is available in IR or XR although XR is less popular than Concerta XR, and Medikinet is a 50/50 timed release). Finding something which works for you takes time, and is not an easy feat.
It's fantastic that you're not experiencing significant downsides to ADHD! I'm glad you were as clear as you were in your articulation of your concern, I worry that when some people express things like this they cause unnecessary worry in those who are experiencing meaningful downsides which put them off seeking medication. The tradeoffs are different for everyone.


Thank you for sharing that.


Because it is extremely difficult to control ADHD to your advantage. It is your entire experience of reality.


i have a history of failing to meet deadlines because of my procrastination. this disqualifies me for most leadership positions because i am labeled as unreliable.

i am happy for you that you have been fortunate with your path.


No idea if I am ADHD, I could just have a lot of energy - because I focus well.




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