Caveat emptor

Without going into personal details — I have a stake in ADHD. I'm raising awareness and try to help those who have it — knowingly or not. Due to that I'm always on the lookout of new knowledge, ideas, techniques and tools.

My knowledge is based on personal experience, accounts of those diagnosed and pre-diagnosed, conversations with therapists but also taken from the books and internet sources such as published research, info-sites or (rarely) popular publications.

I'm not a professional researcher nor a doctor. I don't cross-reference information so it's not unlikely that I am wrong. Please keep that in mind and if you find false information don't hesitate to contact me.

Basics

ADHD is a complex neurocondition that's difficult to either describe or categorize. In a nutshell it's a dopamine and norepinephrine dysfunction that might cover both their production and "consumption". Those hormones/neurotransmitters impact deeply on everyone's life. When they don't work as they should, they bring full spectrum of various issues.

Depending on case by case basis, it can be norepinephrine, dopamine or both that is driving person's ADHD. Dopamine seekers might engage in novelty, searching for something that gives them rush, being always on the run. Norephinephrine overproducers might be anxious and unwilling to change, making adventures only through the books. Mixed — well — it depends on a moment.

Because of the above, symptoms differ greatly from person to person and can take form of an ever-energetic charismatic parent as well as a heavily depressed teenager. Notably, ADHD is co-morbid with ASD — Autism Spectrum Disorder, which is also known as Autistic Disorder or Asperger Syndrome. Half of the individuals with ASD are having ADHD symptoms. Quarter of individuals with ADHD are having signs of ASD symptoms.

Autistic traits in ADHD add another layer of complexity, as they might introduce many co-morbid issues like rigidness of view, denying change, over-sensitivity, heightened body awareness and so on.

Impact

It's important to note that while negative impact on person's life can be managed, it cannot be completely eliminated. ADHD guides highlight necessity of partaking in sports, meditation, keeping healthy diet, supplementing, going outside often, avoiding stressful situation, stimuli-rich environments, and — of course — taking medications. Managing ADHD requires work but even when guidelines are meticulously followed they aren't flawless — allowing negative influence to occasionally break through.

When that happens, events and stimuli imperceivably small or seemingly unimportant could have profound and negative impact on ADHD person's day. They might lead, one step after another, to chain of events with undesirable, sometimes dramatic, outcomes.

For example for a person with misophonia (condition in which fight-or-flight response is triggered by everyday sounds) — a colleague chewing at office's cafeteria might trigger a serious conflict; 15 minutes spent in queue between new, bright and colorful advert screens might induce anxiety or make them aggravated for the rest of the day. Late day call with a manager without agenda can put someone in "waiting paralysis" — do nothing in wake of preparing for event, many hours away. Critical review can, amplified through RSD (rejection sensitive dysphoria), completely drain energy and make one unproductive through procrastination spiral. Blinking, buzzing or motion within environment might constantly annoy, priming for nervous response and lashing out on close ones.

Feel?

It's difficult to relay a feeling. I have a simple method that received tiny in volume, but positive reviews. It goes like that:

I ask inquirer to pick a number between 2 and 10. In this scale "1" is baseline person, no ADHD at all. "10" is a person with a borderline strong ADHD. Most pick "10" — they want to feel the contrast. Then I ask them to describe their yesterday including a lot of details. I take some pieces, multiply negative elements using factor and ask how they'd feel.

So someone tells me they were waiting 5 minutes for an appointment — I make them imagine it was 50 minutes. They describe how annoyed and tired they were after filling 3 very long and boring forms — I ask them to imagine that there were 30. They were startled by someone honking — I twist it into situation where someone tried to push them off road. They say that their partner called them "silly", and I replace it "f*****g brainless moron".

As we continue we eventually get to the point where my conversation partner is horrified. They point out surrealism of scenarios but also tell me they are completely unbelievable.

I agree. It's unlikely that someone is living an "Always 10" life (and I hope for it, too). I relate to a RPG character sheet. Roll a dice for every trait of hundreds. Imagine they roll 3 for sound sensitivity, 5 for visual sensitivity, 10 for boredom amplification, etc.. No max point bound, though.

We sometimes move to the other end of the scale, discuss the effects of spending 16 hours per day at work or school — merely factor of 2. Or needing twice as many hours to rest but having same day to work on.

Parents of ADHD children notice that they often get hyperactive when they get tired only to almost pass-out from exhaustion into the sleep. How come is that if the child should be N-times more tired and thus getting sleepy faster?

I introduce the concept of life levers: on-off switch for triggering specific behavior. In this particular case, "go to sleep" lever is pulled strong, but it doesn't budge. Body wants to rest, mind thinks otherwise. As rest is impossible (mind is, pun intended, pulling the string) there's only one way — increase available energy. Running, jumping or dancing is a great way to make heart pump harder. Just as getting excited and talky or anxious and scared. More oxygen — more energy, body can go on.

Pull gets stronger and stronger. When the critical mass is achieved it moves at crashing speed, almost cutting child's conscious off. They fall asleep where they are. Adults with ADHD told me anecdotes about them getting into "stasis": being too tired to get into the bed. They "rest" motionless, watching TV, browsing the web or listening to music until long into night, to be able to ready themselves for sleep.

There are many levers and they're usually linked to the body needs: sleep, eat, drink, use toilet. But there are also psychological needs like socializing or being loved which takes contrasting form, from expressing need for complete solitude to expressing need for a great closeness. This friction in lever is aforementioned factor.

Visibility

Doubt in conversation sets sooner or later. It definitely can't be that bad nor can it be common, can it?

ADHD is developed very early in life. It's either inherited (up to 82% of cases, depending on study) or caused by some external factors (e.g. head injuries, pollution) during childhood. People with ADHD don't feel different from others because there's no difference they could've feel. Frequently their subjective experiences and feelings are dampened and/or suppressed by people close to them. Most often by unknowing ADHD-bearing parents who pass wealth of family-proven strategies and words of wisdom.

Forms of suppression are innocent and sound completely harmless from outside. They reassure that that sound isn't that loud, soup isn't that hot, teacher's critique isn't that harsh, school isn't that boring, colleagues aren't that mean, pain isn't that strong, emotional response is too great etc.

Theme is consistent: "tune it down". Makes sense — everyone are experiencing the same and they don't complain, so why person with ADHD should? One of the very first things after getting formal diagnosis is re-learning how to feel and respond as well as embracing that those strong experiences and feelings are real. Not a subject of imagination or over-reaction.

Many diagnosed discover that they were right all along only in their very late adulthood. I know people who were diagnosed only in their 70s. Imagine being told for 70 years that you're feeling "wrong" or "too strong".

And there's ODD: Oppositional defiant disorder. Some reject "foreign" truths and rebel. Some get over it when they reach adulthood, some fight against the system in one way or another — sometimes even in a very noble ways, like becoming a doctor. Not for a career, but for a mission. Or maybe they become one of "those" specialists that always love to argue.

Depending on the study it's estimated that 5-15% general population have ADHD worldwide. For comparison — according to statcounter, 2022 data — MacOS has 14.6% desktop operating system share and Linux has 2.8% desktop share.

Recent (but not very recent) research confirmed that no one grows out of ADHD — as previously thought. Where are those people?

Kids quickly figure out that being overly sensitive makes them stand out, so they hold back tears. Rebelling youth notices that gains aren't what they'd want, so they look elsewhere. Naturally aggressive people are either in prison or resourceful enough to hang out at therapies. Some calm themselves with alcohol and drugs. There are countless ways to cover the symptoms.

They learned to not stand out.

Strategies

Generic "strategy" when dealing with ADHD is recognizing pressure points and avoid or minimize them. Even minor annoyances can build up very quickly.

Strategies can take one of two forms:

• Passive avoidance (e.g. use ANC headset to cut out external noise)
• Active avoidance (e.g. automate form filling)

It's not important which form strategy takes. Mostly it's matter of personal preference but can help when deciding on a solution. Amplified through ADHD (and increased body-sensitivity) back pain can be resolved by buying expensive chair (passive avoidance) but also by exercising (active avoidance). In terms of software passive avoidance would be to select application that "just works" while active would mean hacking it out until it works.

Interestingly, people — especially adults — have many "natural" strategies pre-diagnosis. Many are self-made, but some are carried as legacy throughout generations.

Usually they take, again, innocent advice-like forms e.g.: "Don't talk to uncle Bob before his morning coffee" or "Don't worry about little Joe, boys in our family were always little rascals". But sometimes they are in form of efficient coping strategies e.g. "nothing calms nerves better than a good steak" — years before high-protein diet was confirmed to be efficient in treating ADHD symptoms.

There are also physical trinkets and toys, but rarely they're passed along unless it's a music instrument, but there's something to consider. Greece, not only homeland to the oldest known text describing ADHD (see: The Obtuse Man of Theophrastus), is also homeland to a komboloi — ancient fidget toy known today as "worry beads". There's no known link, but one can wonder.

Diagnosis

You could be reading above and thinking — I feel very similar, but I'm not diagnosed — is it possible that I have ADHD?

ADHD is much more common that one could think. As noted previously — depending on study — prevalence in general population is estimated to be between 5-15 percent. In some contexts those numbers are probably higher. According to doctors' anecdotes: in artistic environments or IT industry it "feels like at least double".

Sharing (some or all) feelings is not enough. Everyone can procrastinate, get over- stimulated or stressed and seek dopamine hit after a rough day. As with many psychological conditions it's frequency and magnitude of disruption they cause. For example — getting food poison after eating at a café and refusing to go there — completely healthy behavior. Diet narrowing to only 10 different meals is a problem — not only dietary one, but also social and psychological one. What happens when 10th meal can no longer be obtained?

When someone would suspect they have cancer, they'd get tested. ADHD impacts on life expectancy (reducing it by 10-15 years, depending on study), so why not get tested? ADHD diagnosis and treatment has a positive impact not only on the diagnosed but also for on a whole family (from whom ADHD might be inherited).

If you suspect and can spare resources to get checked — consult the specialist.

Final

ADHD is a very deep, wide and sometimes even self-contradicting condition. It's very well, and continuously, researched and every single month we are learning something new.

Public perception is mixed bag. Some believe that ADHD is simply bad behavior, or see it as a fad. Some see it as an entryway for easy-obtainable drugs. Some see it as an excuse for lazy.

I don't know many things about it, even though I spent a lot of time and energy researching it by myself. There's two things I'm certain about: It's very real and it's not a good thing.

If you suspect you have it — get formal diagnosis, start treatment. It helps. Suspect someone might have it? If not for themselves convince them to get checked for the sake of their family — it spreads.

P.S. A Joke

It happens that in conversations ADHD is a "cool thing" as many very interesting and successful people admit openly to have it.

I tell them to consider this (quite awful, frankly) joke:

Open water swimming champion and his trainer enter a public pool, only to find young boy swimming in their reserved lane.

Trainer, neither wanting to escalate nor give up the lane, comes up with a ruse:

As agreed, world's champion and young boy prepare for a race. Trainer signals the start and… It's incredible! Boy launches like a rocket. He finishes the race while the champion is merely half-way through.

Trainer is mind-blown: