ADHD: Breaking the Red-to-Blue Loop(twitter.com)
twitter.com
ADHD: Breaking the Red-to-Blue Loop
https://twitter.com/uberstuber/status/1736489420466110843
21 comments
Everyone on Twitter doesn't think they have ADHD. The algorithm probably put you in a bubble since you seem to engage with that kind of content.
I'm being a little hyperbolic. As far as the algorithm, I rarely see anything from anybody I don't follow, or that isn't retweet by them. I'll maybe make my statement more explicitly subjective: in my experience, heavily following people from Tech Twitter, there is a much greater representation of ADHD than is visible to me elsewhere in the world.
Nitter link for convenience: https://nitter.net/uberstuber/status/1736494429702390264
I also have ADHD and found this thread interesting and useful.
I also have ADHD and found this thread interesting and useful.
Was this meant to stop at 57?
I'm writing it as I go. There's an annual challenge called threadapalooza where you write 100 tweets on a subject in December
Excellent thread! Thanks for doing it and congrats on your journey so far.
I also have ADHD which was fortunately diagnosed when I was in third grade. Meds helped greatly but I still struggled academically. Unfortunately, I stupidly noped out of taking meds starting my senior year of high school, then flamed out of college and went through a "lost decade" in terms of life, career and even relationship progress until I kinda hit bottom and got back on meds. Since then, with a combo of meds and accepting I need to consistently apply basic tools (lists, systems, processes), I've had pretty constant upward progress on all dimensions and have overall been doing really well.
One small suggestion regarding your posts... in a few places you mention "(Tool XYZ) works just as well as meds." I think it's great that they've worked well for you! Based on my understanding of the literature, I think it's the case that those things can work as well as, or even better than, meds for some people. Personally, I've tried exercise, meditation, talk therapy and pretty much everything else which has shown a modicum of real potential in the literature. Despite multiple serious attempts in multiple ways over significant periods, for me, they all turned out "helped a little, but not enough." I think the reality is that the effectiveness of treatments can vary widely across ADHD individuals (and also across life phrases within individuals, especially adolescence to adulthood).
I think the literature mostly supports the idea that meds are still the most likely treatment to be "sufficiently effective" to enable a meaningful difference in life outcomes. However, as you mention, meds won't "do it for you", don't work for everyone and it's certainly the case that med effectiveness requires finding the right med or combo of meds, the right dosing and an effective, sustainable usage pattern. Which, for many, can require patience, perseverance and a lot of difficult-to-sustain experimentation while tracking changes that can be hard to self-assess.
The reason I'm careful to mention this whenever I discuss treatments is that there's still a pretty common bias in the general populace against meds. Some people who don't have ADHD just think "smart pills" are a crutch for slackers or dummies. Some people who have ADHD hate thinking of themselves as someone who "needs" meds to "fix themselves" or even to be "normal." This is definitely why and how I ended up with that lost decade, which I still deeply regret. This is all made harder by the fact that, ADHD IS somewhat over-diagnosed and mis-diagnosed, especially self-diagnosis, and some people do abuse the same meds. Yet, despite all this, some ADHDers still remain undiagnosed or are struggling without effective treatment.
I also have ADHD which was fortunately diagnosed when I was in third grade. Meds helped greatly but I still struggled academically. Unfortunately, I stupidly noped out of taking meds starting my senior year of high school, then flamed out of college and went through a "lost decade" in terms of life, career and even relationship progress until I kinda hit bottom and got back on meds. Since then, with a combo of meds and accepting I need to consistently apply basic tools (lists, systems, processes), I've had pretty constant upward progress on all dimensions and have overall been doing really well.
One small suggestion regarding your posts... in a few places you mention "(Tool XYZ) works just as well as meds." I think it's great that they've worked well for you! Based on my understanding of the literature, I think it's the case that those things can work as well as, or even better than, meds for some people. Personally, I've tried exercise, meditation, talk therapy and pretty much everything else which has shown a modicum of real potential in the literature. Despite multiple serious attempts in multiple ways over significant periods, for me, they all turned out "helped a little, but not enough." I think the reality is that the effectiveness of treatments can vary widely across ADHD individuals (and also across life phrases within individuals, especially adolescence to adulthood).
I think the literature mostly supports the idea that meds are still the most likely treatment to be "sufficiently effective" to enable a meaningful difference in life outcomes. However, as you mention, meds won't "do it for you", don't work for everyone and it's certainly the case that med effectiveness requires finding the right med or combo of meds, the right dosing and an effective, sustainable usage pattern. Which, for many, can require patience, perseverance and a lot of difficult-to-sustain experimentation while tracking changes that can be hard to self-assess.
The reason I'm careful to mention this whenever I discuss treatments is that there's still a pretty common bias in the general populace against meds. Some people who don't have ADHD just think "smart pills" are a crutch for slackers or dummies. Some people who have ADHD hate thinking of themselves as someone who "needs" meds to "fix themselves" or even to be "normal." This is definitely why and how I ended up with that lost decade, which I still deeply regret. This is all made harder by the fact that, ADHD IS somewhat over-diagnosed and mis-diagnosed, especially self-diagnosis, and some people do abuse the same meds. Yet, despite all this, some ADHDers still remain undiagnosed or are struggling without effective treatment.
very thoughtful and eloquent response. i echo this sentiment, as i stopped taking meds in high school, and i struggled more then and at uni, and just in general. i recently got back on meds and they’ve been an invaluable tool to organise my life.
i was successful unmedicated despite myself, but definitely would have been better equipped personally and professionally, had i continued care.
i was successful unmedicated despite myself, but definitely would have been better equipped personally and professionally, had i continued care.
Thanks for the thoughtful response.
There's so much nuance and individuality and cultural baggage around ADHD treatments, it's difficult to convey, and you've done so very well here. I'll see if I can incorporate some of that as I finish up the 100 posts.
There's so much nuance and individuality and cultural baggage around ADHD treatments, it's difficult to convey, and you've done so very well here. I'll see if I can incorporate some of that as I finish up the 100 posts.
Cool! I found it very interesting and look forward to reading the other 43 :).
I read all of them (lol hyperfocus) and got to 57 asking myself the same thing.
I believe the thread is still being updated. There’s a time difference of 6 hours between the initial and last tweet.
I believe the thread is still being updated. There’s a time difference of 6 hours between the initial and last tweet.
One nitpick: I have been subjected to a pitch about some form of that prioritization quadrant a million times over. I actually find people pitching me on some graphic to prioritize all my life viscerally annoying. It feels like I’m being talked down to by an obscenely long Twitter thread, part of a long lineage of parents, teachers, professors, and bosses doing the same. I’m glad it worked for the author but that feels like it would not work for most people like me.
Fair, there's a ton of bs out there.
I hope you find something that works for you
I hope you find something that works for you
ADHD as a self diagnosis is a plague. As a medical diagnosis it is consistently overdiagnosed, and dangerously underdefined.
It's largely the verbalisation of personality trait arrangement: If on the BIG FIVE you are: - Low in Conscientiousness - Low in Agreeableness - High in Neuroticism - Posses an above average IQ, but a below average working memory due to poor prefrontal cortical development (not entirely causal but partially causal for above personality elements)
You will suffer from the "symptoms" of ADHD. Typically, unstable or volatile childhood environments are seen as a key driver of this.
It's largely the verbalisation of personality trait arrangement: If on the BIG FIVE you are: - Low in Conscientiousness - Low in Agreeableness - High in Neuroticism - Posses an above average IQ, but a below average working memory due to poor prefrontal cortical development (not entirely causal but partially causal for above personality elements)
You will suffer from the "symptoms" of ADHD. Typically, unstable or volatile childhood environments are seen as a key driver of this.
> As a medical diagnosis it is consistently overdiagnosed
Not in adults https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195639/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9884156/ https://pubmed.ncbi.nlm.nih.gov/27553219/ https://pubmed.ncbi.nlm.nih.gov/25317367/
Not in adults https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195639/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9884156/ https://pubmed.ncbi.nlm.nih.gov/27553219/ https://pubmed.ncbi.nlm.nih.gov/25317367/
Okay when the parent poster is clearly stating a disagreement with the broad medical community, citing journals is a useless retort.
Its possible for thr broad medical community to not be in line with the latest research (diagnostic criteria are somewhat trailing), and evidence of that would be the strongest possible support for a claim that the broad community was wrong (because it had not incorporated the latest relevant research.)
Now, sure, its useless for convincing the speaker (though not others who may be witnessing the debate) to bring out research evidence if the argument is “the medical community is wrong, and my source for that is my own unsupported belief bolstered by a conspiracy theory that the truth is actively suppressed from publication.”
Now, sure, its useless for convincing the speaker (though not others who may be witnessing the debate) to bring out research evidence if the argument is “the medical community is wrong, and my source for that is my own unsupported belief bolstered by a conspiracy theory that the truth is actively suppressed from publication.”
Yep :) my comment was for the people reading the thread, not the person I replied to.
> It's largely the verbalisation of personality trait arrangement: If on the BIG FIVE you are: - Low in Conscientiousness - Low in Agreeableness - High in Neuroticism - Posses an above average IQ, but a below average working memory due to poor prefrontal cortical development (not entirely causal but partially causal for above personality elements).
> You will suffer from the "symptoms" of ADHD.
If one accepts, for the sake of argument, your description is true and supported by evidence, you still haven't supported your claim of overdiagnosis, or even explained the symptoms, just defined an equivalence.
Now, if you could also justifiably claim that a substantial and definable in advance, on other basis than treatment response, subset of those people will not respond to ADHD treatment, you’d have a decent cases that ADHD was overly broadly defined and that its diagnostic criteria swept in at least two distinct subpopulations that can and should be distinguished diagnostically, and one of which should be considered to have something different than ADHD.
> You will suffer from the "symptoms" of ADHD.
If one accepts, for the sake of argument, your description is true and supported by evidence, you still haven't supported your claim of overdiagnosis, or even explained the symptoms, just defined an equivalence.
Now, if you could also justifiably claim that a substantial and definable in advance, on other basis than treatment response, subset of those people will not respond to ADHD treatment, you’d have a decent cases that ADHD was overly broadly defined and that its diagnostic criteria swept in at least two distinct subpopulations that can and should be distinguished diagnostically, and one of which should be considered to have something different than ADHD.
Because your comments lack citations, my rebuttal will too…
> As a medical diagnosis it is consistently overdiagnosed, and dangerously underdefined.
Maybe in your population, but it is under-diagnosed in the following populations: adults, women/girls, prison population, gifted/talented students, populations with an exceptional stigma towards mental disorders.
I don’t understand what you mean by ADHD being under-defined.
> You will suffer from the "symptoms" of ADHD.
Suffering the symptoms and having those symptoms significantly interfere with your life is what it means to have ADHD.
> Typically, unstable or volatile childhood environments are seen as a key driver of this.
This is false. Child rearing has little to no effect on having the disorder. However, genetic variation contributes to (i.e. has an effects size of) at least 70% of the disorder.
> Posses an above average IQ
IQ is negatively correlated with ADHD… are you discussing a specific type of person with ADHD with the second paragraph?
> As a medical diagnosis it is consistently overdiagnosed, and dangerously underdefined.
Maybe in your population, but it is under-diagnosed in the following populations: adults, women/girls, prison population, gifted/talented students, populations with an exceptional stigma towards mental disorders.
I don’t understand what you mean by ADHD being under-defined.
> You will suffer from the "symptoms" of ADHD.
Suffering the symptoms and having those symptoms significantly interfere with your life is what it means to have ADHD.
> Typically, unstable or volatile childhood environments are seen as a key driver of this.
This is false. Child rearing has little to no effect on having the disorder. However, genetic variation contributes to (i.e. has an effects size of) at least 70% of the disorder.
> Posses an above average IQ
IQ is negatively correlated with ADHD… are you discussing a specific type of person with ADHD with the second paragraph?
It seems you have simply redefined it within a different framework of understanding you are more agreeable to, but I do not see how it is useful. This is in fact one of the rare diagnoses which respond unreasonably well to medication alone, at least (as the author noted) while you are under its effects. Its not clear what treatment your understanding might offer that differs significantly from that of mainstream psychiatry. I have only heard of "the Big Five" mentioned in association with Jordan Peterson and personality tests, neither of which do much to recommend this.
Learning about ADHD and other forms of neurodivergence as an adult has been absolutely revelatory. So much of my life makes more sense, in retrospect.
Incidentally, it's funny to see a thread like that on Twitter. I think Twitter is impeccably tuned for ADHD. A constant stream of bite-sized novelty. It sometimes seems like everyone on Twitter thinks they have ADHD. Maybe that's not a coincidence.