Is ADHD a real disorder?

OTM, I have an uncle who's like this. It led to his divorce.

Also: yes ADD is real, it has to do with certain neural pathways not being connected or something. I know that Ritalin does have a calming effect on me so that I concentrate more, although I don't have the "hyperactive" variant thank God. And I don't eat much sugar/junk food.

also makes me want to make posts saying "see i'm not just lazy and undisciplined, it's SCIENCE". (i was serious about that stuff though. repeatable studies scientific consensus yadda yadda.)

x-post

I used to run 5 miles a day. I biked a 100k once. I was working two jobs, keeping the second mostly because it was fun. And because it was at a brewery, so I got free beer. I was very active. I was about to get a big promotion at my computer job. ...And then I got a virus, and it (or its hormonal/neurological/immunological aftermath) pretty much derailed my life.

So I'd just like to second Trayce's "fuck you", and heartily.

There's lots of health conditions that aren't well understood. Lots of people tend to be judgemental assholes about them. Before the docs had medical evidence for Multiple Sclerosis, they called it "hysterical paralysis". Because naturally if they can't understand an illness, it's all in your head or you're just lazy. That was probably 50 years ago or more, but people's tendency to be closed minded bastards is still going strong.

that's why i never used the term, "therapist", as i considered it too loaded.

instead, i used "talky pshrink" and "drug-pushing pshrink."

also, using street drug-terms to refer to your meds makes them easier to handle.

That's science for you.

I was once fairly energetic, as per the poster above, but I got glandular fever many years ago, since which time, I am a lot less energetic, and tend to tire quickly and easily.

guilty as charged
http://img.photobucket.com/albums/v323/kenjuggle/vogue.jpg

Tell me more about *adult* ADHD.

I just did a checklist thingy and the checklist says I might have it, but I always doubt the results of these things (if you unconsciously want to prove to yourself that you do have a disorder, you'll tick the numbers up a bit higher and vice versa).

I am a habitually messy, disorganized person, and I am easily distracted. I have trouble finishing projects, I procrastinate heavily, make tasks take way longer than they need to, and often feel "overwhelmed by the basic tasks of daily life" and all that.

uh oh... that also sounds like me. but can't these things be attributed just to one's basic personality type, rather than a 'disorder'?

A 'disorder' is not an illness - it's not a construct that can either 'exist' or not. So while I'm sure no-one's doubting the myriad symptoms of what is known as ADD/ADHD are real, the contention is whether it's beneficial, to anyone, to treat it as a mental illness (DSM-IV).

ADD/ADHD cannot exist clinically without empirical biological / neurological evidence to support its existence (see: schizophrenia etc), which is why the DSM is quick to present it as a disorder (see: passive agressive syndrome (DSM-III), female sexual dysfunction etc.)

Problem-focussed checklists (DSM, internet) are never, ever a good way to help somebody.

Frankly, the dark hand of big pharma has always hovered over diagnosis of this kind. And at the end of day, is actually it useful? Label kids, drug'em up etc. God I sound like Tom Cruise.

I sort of agree, but hardly a kid at 27.

yeah, it worries me that so many parents seem so quick to drug their kids up, rather than dealing with their behaviour from a psychological angle. i'm certainly not opposed to chemical intervention, i just think that huey's right about the financial motivations behind some of the over-prescribing that seems to be going on. drugs should be a last resort, not a quick fix.

hurting, are you considering seeing a doctor/psychologist about this stuff?

Drug me drug me drug me drug me
Drug me with natural vitamin c
Drug me with pharmaceutical speed
Drug me with your sleeping pills
Drug me with your crossword puzzles
Drug me with your magazines
Drug me with your fuck machines
With a fountain of fads
More rock and roll ads
Drug me drug me drug me me me

ADHD, which is characterized by hyperactivity, disorganization, impulsivity, emotionality, unstable personality, fidgetiness, and inability to relax (2,3), has been reported to be present in 17 percent to 40 percent of various cocaine-dependent populations (1,2,4,5). Less well known is the fact that cocaine modifies these symptoms, thus making it more difficult to correctly diagnose such patients. We have reported that one reliable indicator of the presence of ADHD among adult cocaine-dependent subjects is the history of a "paradoxical" reaction to cocaine use (1). A carefully obtained clinical history confirms that despite eventual deterioration as cocaine dependence develops, patients with ADHD initially derive symptomatic improvement from the use of cocaine and may resort to this readily available stimulant for self-medication (1,6).

Instead of the excitation (4) and exacerbation of psychiatric symptoms (7) observed in cocaine-using populations without ADHD, cocaine induces a constellation of beneficial effects in the ADHD population; they include relaxation, anxiolysis, mood stabilization, improved focus and ability to think, and increased capacity to engage in productive activity, all in the relative absence of a euphoric response (1,4). Whether some individuals with ADHD could continue to use cocaine for symptomatic relief without actually abusing it has not been investigated, although it appears unlikely.

^^^^

V V TRUE

ahhhh... i always thought it was weird that ritalin had a calming effect on ADHD/ADD ppl, but a complete speed effect on me and my friends when we tried it years ago (damn, that was an awesome night).

XPOST: Big kids = bigger market </cynicism>

I am a habitually messy, disorganized person, and I am easily distracted. I have trouble finishing projects, I procrastinate heavily, make tasks take way longer than they need to, and often feel "overwhelmed by the basic tasks of daily life" and all that.

This is precisely what I mean - we're taught to focus on 'negative' aspects of our personality as though they're somehow bad. We've been sold the idea that there's a 'norm' we must all subscribe to - that's the very essence of psychiatry, for example.

Why is procrastination bad? Or being mildly disorganised? If you're overwhelmed, why isn't that a problem with your situation / environment, rather than a problem with you? What about looking for solution-focussed (i.e. positive) elements to those areas that you're struggling with?

Others may disagree, but please don't go down the psychiatric route. You'll only end up making that diagnosis / label part of your personality, as it were - and therefore another negative aspect. It's also a very vicious cycle to get out of (see: people disagnosed with depression, borderline personality disorder etc).

A decent psychologist (i.e. non-medical model, no conflicts of interest etc) should be able to help you gain some perspective on those aspects you're feeling uncomfortable with.

xpost...so what you're saying is that hurting 2 should do some coke so he can self-diagnose? ;)

This is precisely what I mean - we're taught to focus on 'negative' aspects of our personality as though they're somehow bad. We've been sold the idea that there's a 'norm' we must all subscribe to - that's the very essence of psychiatry, for example. Why is procrastination bad? Or being mildly disorganised? If you're overwhelmed, why isn't that a problem with your situation / environment, rather than a problem with you? What about looking for solution-focussed (i.e. positive) elements to those areas that you're struggling with?

Sorry, but this is bullshit. First of all, I am seeing a very good psychoanalyst who generally disfavors medication. He is helping me with a lot of things, but not with these particular problems. These problems have held me back in every area of my life, including wreaking havoc on my college transcript. And in fact I've seen therapists for much of the last 10 years, and in spite of great progress in my self-confidence and romantic life, I've made only marginal progress in this.

Procrastination and disorganization are real problems. They can lead to career and marriage failure, depression, feelings of wasted potential and missed opportunities. Fuck, if I wanted to of course I could "change my environment" instead - I could go live on some commune or something. But that isn't what I want.

I have the Adult ADD. It sucks.

Do you take meds?

if I wanted to of course I could "change my environment" instead. I could go live on some commune or something

You have utterly missed my point, but congratulations on calling bullshit.

And in fact I've seen therapists for much of the last 10 years

What I actually recommended was a decent psychologist - i.e. not a cash-cow 'therapist' who charges money for you talk shit about yourself.

They were "decent psychologists," dude. Which is exactly why I call bullshit - you don't know me at all, you're just pushing your agenda

I MEAN DO YOU HONESTLY FUCKING THINK I'VE NEVER THOUGHT OF THIS STUFF BEFORE LIKE DO YOU THINK IT'S NEVER OCCURRED TO ANYONE BUT YOU THAT BEHAVIORAL DISORDERS ARE "CONSTRUCTS" YOU BULLSHIT COLLEGE FUCK? FUCK OFF!

Mate, if you look at the tone of what I originally wrote you'll see I was just giving explaining, in friendly terms, my standpoint based my own hellish experiences. It certainly wasn't aimed at you, although I obviously made a mistake quoting something you wrote. Apologies.

Uh, yeah, I apologize for that as well. It's just that I've been struggling with these problems for much of my life. I've tried medication-free approaches and I've tried avoiding the labeling of any disorder. In fact I've never gone on any medication or deliberately gone for any kind of disorder evaluation. I'm aware of all of the philosophical and epistemological problems of psychiatric diagnosis.

But I also know that there are certain people who clearly have a serious problem they cannot entirely control. In extreme cases this sometimes leads to suicide. I knew a guy whose parents ignored his psychiatrist's severe bipolar diagnosis and he wound up firing a gun into traffic from his car and driving into a bus. I'm not expecting to drive into any buses, but I do think *disorders* can be quite real at the same time as being constructs.

hurting 2, i don't think huey was pushing any agenda except trying to offer some kind of concerned advice - which is kinda what you were asking for, right?

when i offered up the suggestion that these things are just aspects of 'personality types' i didn't mean to marginalise how shitty it must be for you to be going through all this. obviously, you explained your situation in more detail in later posts, so now i can see that you really feel these symptoms (or whatever the word for it is) have the potential to fuck up your life if you don't sort them out.

Yeah, exactly, I'm obviously not saying that the 'disorders' and their associated symptoms - paranoia, voices, depression, tiredness, intrusive thoughts etc - are not real in any way. All I'm saying is that it's often unhelpful to diagnose, label and prescribe using the current medical model, and I believe it's important that people - not you H2 - are aware of this when going to the GP, having a few symptoms ticked in a box, and being given a 'scrip for some ineffectual drug. I have no idea how the system works in the US - I'm talking from a UK / Australia perspective.

95% of the people being treated for clinical depression in the UK would benefit from some sort of concurrent psychotherapy, which they don't get. It's the pathologising of emotional peaks and troughs by drug companies. (disclaimer before more shoutiness: in my opinion).

I agree with all of that in general.

I really should learn not to air my dirty laundry on message boards in the first place :-/

I used to.

king, would you mind shooting me an e-mail?

i'm a bunch of different nerve endings/reactions/states that i don't even bother labeling, it's a waste of my time =) i just deal with what i can and talk to ppl when i can't.

That's great stuff, I'm really happy for you, deems. And that you can identify that it's your shoulder at the door, as well as oiling the hinges.

I think it was someone on this thread that said you can get private healthcare to do an assessment by approaching it as a mental health crisis rather than directly, so I have given that a go.

I think that was probably me - and yeah, though it was less "you can" than "you have to", based on the plan that I get through work. I'm glad that it's working out, even before you get any further with the referral. Are the projected times still "about a year"?

I've been back through that avenue again - my sleep has been terrible since I got a settled dosage. Well, it's been terrible before that, but it used to be "I don't get to bed before 2am half of the time", and over the last 8 months it's gone to "I don't get to bed before 2am pretty muich ever". I'd have settled on the right dosage (60 mg Elvanse) a few months earlier except I wanted to see if I could get my sleep back under control before sealing the deal, and yeah that didn't happen. He did offer that a lot of the symptoms of ADHD and the symptoms of sleep deprivation - well, it's not the same circle, but there's a lot in both.

(I'm not really doubting my diagnosis - the meds definitely do something, and I do still have the levels of focus that can be useful)

It's largely gotten worse since. I use a sleep tracker app to record it, and the weekly average to-bed time has crept up, in January it wasn't before 3am, with one week where the average was 3:34am, and the time asleep under 5 hours.

There's a counter-example too, right at the start of December there's 2:01 as the average to-bed time, and a whole 6 hours 12 average time in bed. And that's me travelling over to Dublin with Jen, for my sister's wedding. We got in the day before, checked in and asked if there was anything we could do (nope), so we had a meal and turned in early. It wasn't even great sleep, but I got up the next morning, checked if my sister needed anything, went over and sorted out what needed sorting out, checked us in for the flight back, got lunch for Jen on the way back, just had a very capable morning, then realised and started swearing "Fuck! Sleep actually works! Fuck!"

It's not even "I get to bed and toss and turn", it's just I'm up and I'm doing something (probably video games) and I'll intend to get to bed, and then just not. There's been a fair few other things happening this year in the house, not many of them mine to tell, and of course The Wider Context, so it might not be an ADHD thing at all. Anyway, a month ago I had my six-months talk with the doc, and he suggested 5mg (non-liz)dexamfetamine in the evening to see if I need a burst of focus to get "all the things done that I want to get done" before going to bed. I tried it, and the first night I was up until 4:30am and it got better but not significantly. Also it just doesn't match what I feel - it's that not I need to get my to-do list done (I mean, I do need to get it done, though the bits relating to the orderly running of the household are getting done, with the occasional asterisk) it's just pouring time into a vessel, with occasional "a bar has filled!" dopamine hits.

And I saw him at the start of this week, and he sent out a dosage of a sleeping pill: Quviviq (Daridorexant) - he said it's like taking your foot off the accelarator rather than slamming on the brakes, and crucially it won't leave me drooling in the morning. I'd been hoping that it's would be more of a knockout pill, almost "take standing next to bed" - the problem is that if it gets to 10pm and I want to start getting to bed, I already have action I can take - I can start getting to bed. I've got an alarm that goes off every night, and generally gets ignored. After a few nights, it looks like it just comes down heavy after a few hours (or I could just be exhausted) so I'm going to start taking it at 9 this evening with the hope that I'll be out by 11.

Update: it took all of today to get this written, though I wouldn't really consider that an ADHD thing as much as an 'feeling awkward about posting it, including posting it when my last post was "everything fine here, boss!"' thing, but I did take it at 11:00 and I am pretty woozy now, so that's good?

The lack of sleep is usually offset by getting up and taking the Elvanse and mostly I'm fine (first flush of "the drugs work!" from upthread fine) for most of the day, though sometimes it hits harder and I'm a zombie in the evening. Some time around when I managed to destroy a plastic utensil during cooking by just leaving it in the gas flame, I said to Jen "okay I should see a counsellor or something about this", and that took a while (I realise now that my current state is roughly "fixed in work, back to the previous outside of work") and in fact I hadn't done so by my six-month check-up, and I said oh so it looks like there'll be some path forward there, and Jen said "I'm really happy to hear that, but still I'd like you to see a counsellor",

Which brings me back to: I went back to Bupa and pressed the buttons, and they said oh no we don't cover sleep stuff, and so I (six weeks later) went back and said "No but it is a mental health thing" and they said "yeah but we still won't", so I need to go find myself a private counsellor.

(I am at, this stage, just blogging, I'm aware)

It's not directly related, RAG, but I'm definitely of the sort where I'm happiest when I can say that there's one things holding me back, and as soon as I get that sorted, I'll be fine.

Okay, screen starting to swim, love to you all, see you tomorrow :)

Came back from a week's holiday and it's totally messed up my habits. Anyone else have a problem with this?

And the feeling of having a breakthrough of new interests/ approaches to life that will make things better, then it turns out to be a mirage/trap and the confusion never quite goes away?

― Robert Adam Gilmour, Tuesday, June 3, 2025 5:41 PM (one week ago) bookmarkflaglink

Yeah, routine changes are a classic habit breaker. You can reestablish them though.

Also, there are always peaks and valleys, and the best you can hope for is an upward overall trend.

i haven't been able to finish writing a piece in _months_, ugh

i even switched to vyvanse again

Another way I've been thinking about it is that the scattered, confused attention and constant accumulation of new interests unwittingly creates this prison maze. I've been dismantling the prison maze for years now and I keep seeing new wings to it that I wasn't previously aware of.

The inability to organize my interests properly has stunted me terribly. Maybe this all sounds too vague but it's the best I can describe it right now.

There's a lot of things I'm on the edge of losing interest in but I'm not ready to let go of them just yet. I think the conventional logic would be to throw away too much and see what happens but I think that would create a vacuum and excitement that would confuse me further. So I'm going to slowly and steadily let go of things.

I've been on the same dose of my meds (15mg 2x a day) for over a decade despite needing an increased dosage because I have this irrational but very acute fear that if I bring up medication management to my (inattentive, elusive, shitty) doctor, I will be flagged as pill-seeking. And so I take my meds as usual despite both their efficacy and duration being barely worth the copay. Last week I took a pill at noon and promptly fell asleep on the couch.

When I take my regular dose plus half, it's effective, but when I do that, the end of the month pill deficit is too excruciating to handle, so I try to be judicious

Having returned to my job, I am very disappointed to find that the intense anxiety and restlessness I feel when I have to do a stack of marking, which was the thing that made me think OK maybe I do have this disorder, is completely unaffected by the medication. May even be worse.

Maybe you need anxiety meds instead

I guess so.

yes this worked for me. still utterly disorganised but I no longer worry about it.

Hm I have a query about ADHD but it's gonna go on another thread