The exact same thing happened to obesity. What, presumably, started out as a good-faith effort to make people stop bullying other people for being fat, became "fat acceptance" and "health at every size" (HAES). Now people are denying basic medical truths and "calling out" their doctors over their declining health. I've even had a woke friend want to try both dieting and bulking up, but she expressed profound guilt about wanting to, like, traditionally improve her appearance, because, I'm a twisted sense, it's a form of body shaming. Everyone on Tumblr says you're a goddess no matter what, so of course if you attempt to change your body, you're rejecting that premise and implying that you aren't already "perfect". Personally, I think a lot of these people are just jealous and insecure. They want to change, too, but it's a lot easier to just pull everyone down and cultivate an insular culture of yes-people to make you feel good about yourself.
That all sounds like a good reason to treat ADHD as a medical problem, to manage it with treatment and medication and then to move on as one would when managing diabetes or dermatitis. None of it sounds like a reason to try and declare ADHD an identity category.
Also, your "secondly" in the last paragraph - does that not risk simply having self-diagnosis metastasize until the ADHD distinction is no longer a distinction at all?
I tend to agree with you here. I probably have undiagnosed adhd. Didn’t quite realize it until middle age and have lots of coping mechanisms and have been successful in life in some ways and other ways not. Medicating (in my case with coffee and anger and downtime) got me very functional, but I am still in a brain that has a much higher context switching cost than average together with a difficulty focusing on tasks I don’t care about. That doesn’t cause cognitive distortions so much as thoughts that are perceived as odd and a presentation that seems aloof yet randomly enthusiastic. In short, just a bit out of sync with the world. What would it be like to sync up, I can guess, but not know.
Diabetes and dermatitis don't impact your mind and behavior. People don't identify deeply with the subtle operations of their skin and pancreas, but they do with their minds and behaviors. This seems pretty straightforward to me am I missing something?
You've talked elsewhere in the thread about the self, in kind of unitary terms, standing alone and reckoning with the universe. I'm really curious to hear more exposition on what kind of thing that is to you and its relationship to the mind and brain.
In any case I'd say that both "ADHD is just like hypertension and has nothing whatsoever to do with who I am as a person" and "ADHD is the only interesting thing about me" are both unnaturally extreme and nonsensical positions. ADHD impacts domains of life that are central to how people think about what matters about who they are. Forget whether it's useful--I don't think it's possible for people to think about their mental conditions in just the way they think about hypertension or other medical problems that have nothing to do with how they think or act. Nor do I think it would be especially desirable or conducive to overall mental health to do so. It can actually be pretty destructive to externalize parts of your psyche in this way (but boy does our culture love externalizing parts of our psyches lately).
Didn't we kind of decide the opposite thing about depression, that reifying it as a very well-understood medical condition with a straightforward solution was both conceptually and practically problematic for people? In fairness I'd say the state of art re: ADHD is on marginally better theoretical footing, but still, the difference isn't radical.)
Do the people who have adopted the totalizing vision of ADHD seem particularly healthy, regarding their disorders? Are they healing better than someone who sees it as a challenge but not an aspect of their personality? Are they managing the disorder better?
At least when you're standing in the little room, you're limited to a very few options, and you can just do one to get it out of the way.
But really, even this is medicalizing a known human trait. When we walk through a door, our mind does a context change and we shed our previous purpose.
Every time this happens to me, I chuckle, because it seems so ridiculous, and yet it's so true. It's happened even when I'm actively trying to avoid it.
This was literally a George Carlin bit. I forget what era, maybe 90s but it could have been earlier.
It took me decades to get good at just standing there and relaxing enough to have time for the original purpose to resurface. Also I often ask my wife what I’m doing. She doesn’t usually know either, but she always had some other ideas of what I SHOULD be doing. Which is okay. Better than standing around.
It’s ok to embrace a stereotype if the stereotype is a cool, edgy one like neurodivergence. Stereotypes are convenient scaffolding for people who feel unmoored.
Agree. Of course someone will also throw out the caveat that stereotypes can sometimes be harmful and hurtful, which I won't dispute, but stereotypes are like lunch meat: they're bad for you in large amounts, you don't want to see them in the process of being made, and yet sometimes they're the only thing you can afford.
I have a kid (14) who is autistic and his autistic identity is whiplash for him. On one hand he really does get along with other ND people better - all of his friends are - and it helps him normalize his own situation as someone who is just fundamentally different in a core way than what other people and society as a whole expects. If that were the whole deal he would wear the flag publicly. On the other hand he’s quite aware of how people sink into self blame behind the label and how the whole label and diagnosis situation attracts a bunch of “helpers” who are really uncomfortable with him being himself even if it’s not bothering anyone, and who look at him in a condescending way almost as a project. In the end he just wants what most people want- he wants his normal to be accepted as normal.
As far as I can tell they generally know something's up. Autism and the various copes/trauma reactions/etc. that go with it are much more visible than we think from the inside.
I've been where your kid is. And I know it's really uncomfortable when other people bring up my diagnosis -- even though it becomes pretty obvious pretty quickly.
That said... and I can't speak for your kid, only myself, but this might be of some use to you. I don't think it's so much that I want to be treated as "normal", though it's something close to that. I want to be treated as "fundamentally competent". I want people to trust that, in most matters most of the time, I can handle things as well as any other person. (Which, yes, requires some effort on my part to ensure that is true!)
Thats at least partially true and he does want to feel competent. “Normal” was his word by the way.
The situation with kids is maybe different because people reach out to help in ways that he finds extremely condescending. (And I agree.) As a kid it’s hard to get away from some of these people (they can be your teachers for example).
That's a really interesting story and I think it highlights something underdiscussed - that if you're a "divergent" person you're prone to attract "typical" people who are into seeing you as a project. If you make your diagnosis a big part of your personality, you'll truly attract those type of people. In my opinion, from my experience having ADHD and anxiety that's almost like PTSD, the more I'm vocal about it being "part of me," the more I get a weird clinical "project" type adoration from people.
When we see people performing their diagnosis-identity, we're seeing someone in the honeymoon phase of discovering the levels of validation they can get. I think we're basically seeing snapshots of a million people before they start to see how little that validation will do for them in the long run.
Oh yeah. I see that. I think I've felt something like this - I can remember, when I was in my teens and twenties especially, this confusion over the fact that some people give me less attention but feel like my real friends, while other people give me a lot of attention, making me feel like "oh wow is this what friendship is supposed to be like," and then getting tired of me in a way that my other "less attentive" friends didn't.
Yeah, I think it is about that, and I also think that that practice of justifying why you think you're above criticism... I think that's part of it. I think it's one of the many aspects of this that feels good but then has severely diminishing returns after the honeymoon phase, resulting in a thing where people who get over it just stop posting about it and are in turn replaced by more people in the honeymoon phase who want to post about it.
I think there is a revolving door but there are a number of people who need the validation so much that they grasp it very tightly and it becomes their identity.
I'm 38 and was never formally diagnosed with ADHD or anything until a few years ago, when tiktok began serving me all the ADHD content, I was like "holy shit is this not normal?" - and it was a lot of stuff like what you describe: standing in the kitchen, mal-adaptive work patterns (procrastination, etc), inability to do X even though I need to do X, etc. I've often felt like these traits were annoying but pretty common, so I like never thought anything of it. I just thought I sucked at prioritization or something (which is true)
Went to a psych who had been suggesting for years I might have ADHD (in addition to depression) and got an Rx for Vyvanse. Totally changed the way I can focus during the work day and my ability to do tasks I don't want to do literally went up 100x. Especially true in my new "work from home all the time and also do 100% of the parenting" post-covid post-divorce life.
Since then I've had an off an on relationship with the drug. I feel like it's a cheat in life and there is some tradeoff I haven't learned yet, like I'm going to get Alzheimers at 55 or something. Selling my soul at the crossroads in order to make better spreadsheets...
I think if prescription stimulants help you to live a more productive life, by god, you should take them without guilt - who cares if it's a cheat in life? When we are sick, we take medicine to make it better. Your character doesn't enter into it.
I went through basically this exact same experience minus the divorce and the parenting. I did eventually discover the tradeoff: I started feeling awful, like completely miserable, as soon as the drugs wore off. Eventually I had the same horrible feeling when I first woke up in the morning before I'd taken them. I was angry at everyone, I wanted to burst into tears, and I had a throbbing hangover-style headache. I barely had enough motivation to brush my teeth and get dressed, let alone do anything else, until the meds had kicked in. In the end I stopped taking them and I felt much better after a couple weeks. At this point, two years later, I don't believe I've ever had ADHD. I did, however, have a very unhealthy lifestyle involving way too much alcohol, way too little sleep, a terrible diet, an addiction to social media, and an inability to cope with stress in a healthy way. When I finally accepted that those things weren't just a manifestation of undiagnosed ADHD - after over a year of taking adderall daily - I forced myself to make the more difficult incremental changes that have actually durably improved my life. I am in a much better place today.
I'm not saying that this is what will happen to you, but for me personally the adult ADHD diagnosis felt like a solution to all my problems and the way I felt on medication initially confirmed that belief. If I gained anything from the experience it was acceptance that there was no single disorder that explained my deeply unhealthy life and no single pill that could fix it in the long term.
I know a massive number of people who've been diagnosed with ADHD as adults in the past three years and I often wonder how many are headed down the same path I was. I hope they find a similarly positive resolution even if ADHD doesn't turn out to be the answer.
My gf often likes to say she has 27 tabs open, 3 are frozen, and there's music coming from an unknown tab that she can't turn off.
She'll joke about this being the natural product of a raging Gemini, or that it's in her maternal DNA. But she never says a word about ADHD, or being speshal. Rather, this is just the way she is. Perhaps, like myself, she has no social media presence and feels no inclination for the type of public self-aggrandizement that seems to be a requirement for basic web interaction these days.
That, or she's just a neurotic normy like the rest of us...nothing spesh about that.
Aug 8, 2022·edited Aug 8, 2022Liked by Freddie deBoer
As someone who by any definition "has ADHD," I'll say two things that I hope will be relevant -
1) Freddie, the brainfog you describe from your meds basically gave you ADHD, so you know what it's like... When you describe the brain fog, I 100% relate, as it's how I feel when I don't have Concerta in my system. As I believe that my condition doesn't make my feelings and perceptions totally different from everyone who doesn't have the condition, I read your description of the brain fog and conclude "Freddie's experience with meds makes him officially know what ADHD feels like."
2) Sometimes I think this stuff sadly is a sign of how generally immature (in terms of self-perception) most people online are. This is based on just how much more I used to obsess over self-perception and also be online... and as I told myself "just do your best in your job and your relationships and you won't have to worry about your identity so much" I stopped going online as much.
I honestly think that there's a self-selection bias going on here and that many of the people posting about their special ADHD are going through a phase... I was very into ADHD as an identity for a few months, but then that stopped giving me anything good, so I drifted away from framing things through my diagnosis.
I often suspect that, while, yeah, there are a lot of influencers who will be "ADHD influencers" and thus make the obsession their identity, a lot of the people who spend so much time online posting about ADHD... I suspect that we're often seeing a rotating cast of people who get into it, experience the diminishing returns, and then stop being into their diagnosis as an identity.
What's interesting about that is that online, a mass movement of peopel committed to a belief looks the same as immature people going through phases and then getting replaced by people who are also immature and going through phases every few years.
In my utopia every ADHD-based influencer would come with a warning to the effect of: These ideas will give you a confidence boost in the short term but don't think about your diagnosis like this forever.
“I suspect that we're often seeing a rotating cast of people who get into it, experience the diminishing returns, and then stop being into their diagnosis as an identity.”
This is an great observation and one I want to keep in mind!
As someone who has ADD, manages it fairly successfully the usual way (Adderall), and otherwise does not find it something to celebrate or base one’s sense of self around… what’s really annoying about the “neurodivergence” discourse is how it usually boils down to a big nothingburger. Guess what? Companies that supposedly celebrate neurodiversity are gonna be managed, organized, structured, and otherwise run in all the exact same ways as always. All the processes and tools are going to be whatever your boss is comfortable with, up to and including purposefully inflicting deliberately unstructured systems on you because they personally like the “flexibility.” Whether or not anything is substantively better or worse at a company for someone with ADHD basically just boils down to whether it’s well and humanely run, or is otherwise just a shitty place to work. Just like always.
I agree with most of your analysis here, Freddie. I am a clinical psychology professor, and I thought for years that we needed to de-stigmatize mental illness; but now we have ended up with the opposite problem due to the role of social media. It's not healthy for people to define the core of their identities by their disorders! So I largely agree with you. But I did want to mention one critique. You have offered some good examples of people with ADHD over-interpreting their experiences through a diagnostic lens. But it is also true that ADHD is associated with problems with emotion regulation, and those emotion regulation problems are often a bigger source of difficulty in daily life than are the symptoms of inattention and impulsivity. This piece by Russ Barkley does a nice job outlining what we know about this link between ADHD and difficulties with emotion regulation: https://www.additudemag.com/desr-adhd-emotional-regulation/
We should do all we can to reduce stigma while maintaining that stigma is not a refusal to enable a filter that you have constructed to cloister your own soul from the outside world.
Hmm, I am not sure I understand the context for your comment. I do think social media is leading to social contagions of all kinds right now, though I am not sure how Munchausen's would be implicated.
Try this: a wave of psychological hypochondria to gain attention or to excuse one’s insecurities. It cheapens the experience of those who really have the problem.
Ah, ok, I think I have a better sense of what you means. I do think it is possible that social media is leading to this sort of social contagion. The psychological processes involved are probably unconscious rather than deliberately manipulative.
I was diagnosed with both autism and ADHD as an adult after losing my job, and after I was given a clinical diagnosis there definitely is a mental switch that gets flipped that makes me see things through a lens that includes that diagnosis. For a lot of those things, I do not think I'm "over-interpreting [my] experiences through a diagnostic lens", I think I am correctly interpreting things in the context of my diagnosis. While DeBoer and the Gawker piece are reactions to over-interpretations and a sort of totalizing label, I would assume that the ADHD meme-makers also believe the majority of their content is in the "correct interpretation in the context of their diagnosis" zone and not the "totally normal human stuff _must_ be ADHD, because I do it and I have ADHD" zone. As the Gawker writer said: "As for me, I just need to find a middle ground between the stern refuseniks insisting I’m a drug-seeking inadequate and the TikTokers telling me that I’m a precious, delicate baby and probably a creative genius."
Previous to the diagnosis, I would occasionally attribute certain traits to "because I'm an engineer" or "because I played too many video games as a kid" and I'm sure I over-extended on those attributions as well.
... well, yes, because I'm a tin-foil hatter that thinks that nicotine patches/gums and a more consistent sleep schedule are more than sufficient for me, but that was just a quote from the Gawker piece you linked. Which, by the way, congrats on getting me to read and appreciate a neo-Gawker piece. The finest bait-and-switch citation: I think their cameo upstaged you.
Sorry if I somehow seemed to suggest that all claims by people with ADHD are over-interpretations through a diagnostic lens! My aim in my comment was to say that sometimes, when people with ADHD talk about their emotional experiences, they are completely on target about how those experiences are shaped by their ADHD. Problems with emotion regulation are a key feature of ADHD, so it seems likely that people with ADHD are quite right that their emotional experiences are sometimes distinctively different. In any event, I am sincerely sorry if my comment sounded insulting in a way that I did not intend!
It definitely was not insulting. I thought I was adding to your partial critique by saying "from their perspective, they usually think it makes sense". Not only because of the scientifically documented "emotion regulation" side, but also from the very regular "I cannot perfectly predict what 'normal' would be like, since I used to think I was 'normal' and have been informed that I am not".
In other words, before hitting "Post" on your meme about how you teleport 15 minutes into the future as soon as the shower hits or you sit down to poop there's no simple test to tell you "this is an ADHD thing consistent with the 'time blindless' thing my therapist told me about" or "this is a time-honored tradition among all humans, not just the humans that we didn't know to diagnose with ADHD". While I'm sure there's grifters and people over-extending into an identity, I would put money on the "view from the self" being "that sounds like what my therapist warned me about" rather than "time to get some likes and validation". And this view-from-the-self problem applied to Virgos and Geminis and Engineers and Gamers too, so it really is only a partial critique of DeBoer's post, since we're all humans going through it.
Ngl, I lose anywhere between 15min - 1hr on the toilet and in the shower not because I’m adhd, but because I’m just thinking or reading about random shit.
Sometimes I think diagnoses like adhd are less about “what’s normal or not”, and more about the understanding the distinct ways you process the things we all go through as humans (since to me, it roughly boils down to what chemical/biological factors are influencing your brain processing) :)
I'm sure I've heard a talk by Russel Barkley where he mentions that, in terms of emotion regulation, the part of the brain that is overdeveloped or over-reacts in bipolar is underdeveloped in ADHD (I only half-followed it and I'm not a neurologist), which is interesting because they get misdiagnosed as each other. It's probably one of the hardest parts of ADHD to manage and takes a lot of upfront prevention. It's also the hardest thing to explain to people, because they see you throwing a tantrum like a 4-year-old, plus it's never for like, what you would think of "emotional" reasons like sadness or anger or fear.
But what I've found across the board is that, with ADHD, when you describe the symptoms to someone (who's not your psychiatrist) they'll usually respond "well everyone feels that way, you're fine" whereas when they witness the behaviour they're like "holy fuck, do you have dementia?" "eeewwww that's disgusting". Actually, when we witness our own behaviour we're also thinking that and, well, it's unpleasant, but it's also the way you can hold onto sanity, to retain self-awareness and a sense of proportion. Which makes me agree with Freddie - it's not so much the emotions themselves that are specific, it's their magnitude. And in any case, a lot of the time it goes beyond emotions, which is the problem with an approach like the DSM of listing symptoms: suffering tends to look similar across the board.
It's frustrating because ADHD is portrayed by these influencers as this kind of quirky kind of chronic lazyitis, with these bubbly, wacky zany nerdy personalities, like and I'm not sure they're even doing it consciously, but it's nails on chalkboard. Constant infantilisation and humiliation due to how the symptoms look is probably one of the worst things about dealing with the condition. I'm an extremely serious person, I hold myself and other people to high standards, I don't like to half-ass things. The idea that we're all really Cubert Farnsworth trapped in an adult body running around looking for Cool Nerdy Stuff!!! which a lot of them conveniently sell, and that these people are liberating us from that, is such nails on chalkboard. I don't see how "ADHDers should read children's books because we're different" (which I've seen) is any different to "women should stay in the kitchen because we're different". It points to such a stunted vision of what people's lives are supposed to be like and what we can aspire to, with or without a neurological disability.
With that said, a lot of what these people describe is quite relatable - I mean, probably to anyone also - because they're not describing emotions, they're describing the mildest, most kawaii manifestations of executive dysfunction - the inability to start stuff, to act on intentions. Though the issue with any "neurodiversity" shit on the internet is that on the one hand, you go on tumblr and twitter and read the big influencers, you're reading the highest-possible functioning people and they're basically saying "well we don't need healthcare, just acceptance, meds are a personal choice, please buy my cute hot pink pill organiser" and then you go on reddit, where it's people who (a) have ADHD and (b) are addicted to the internet and (c) a large minority of whom are on methalphenidate or Adderall + weed, which means their short-term memory and attention span are probably totally cooked anyway.
Thanks for this analysis of why you are ambivalent about the pop culture presentation of ADHD! Even when the material presented is somewhat relatable, there is a kind of trivialization of the real suffering involved in having ADHD--that sense of never being able to meet your own high standards or the expectations other people might have of you. There is genuine suffering entailed in this condition, at least for those I love who have it.
I think a lot of it is down to the medium, as well. And it's not so much pop culture - it's the way people brand themselves on social media, especially the tik toks I've seen, like they even dress and act like a Cal Arts mad science kid (also I'm old AF so there's maybe that, but I feel like it's the lame shit from my generation or the one just after, rather than some new shit that's making me yell "get off my lawn").
I noticed the r/adhd subreddit is a lot less into the whole "neurodiversity" thing, even though there's some crap on there too. That's because on reddit, for all its flaws, having to self-brand isn't built into it. It's largely anonymous. No one can remember who was called Haunted_bacon or what they said. On twitter, tumblr, instagram, probably tik tok, if you get a diagnosis, there's virtually no way for you not to rebrand, especially if you go on there to connect with other people with the same diagnosis. You might call yourself something with your disability in it, or put it in your profile, so people know how to treat you. So, immediately, you're going to keep your brand a little bit more kawaii than what a neurological disability actually entails, because it's your identity now. Some as someone with Crohns doesn't want to smear bloody poop on their face and call it "contouring", it's going to be a lot of "TFW insert family-friendly fart joke here". And, as usually happens on social media, you start to adapt your language so as to appear in on the jokes, which are largely the repetition of the language and, ultimately, your thinking adapts too, out of fear of the kind of domino row of associations that drives social media.
Someone like ADHD Alien is a good example, because she clearly either has done the research, or has a team. Her comics are very accurate, and she goes into details that not many other influencers do in terms of the behaviour and emotional states that the condition entails. Then there's the whole "alien" part. I even get the posts with the lists of explained behaviours, because a lot of them come across as kind of intentional or even defiant or spiteful, if you don't know why it happens. Like, if you're an extremely serious person with ambitions and projects, but then you're always flaking out because your brain just won't cooperate, people who wanted to work with you will undoubtedly and correctly judge you to be unreliable. But when the behaviour contrasts with your personality and values as a whole, it's worse than that: it can come across as spiteful, or even deliberately insulting, like it's specifically them you decided you didn't want to work with. In fact a symptom of ADHD is also to blow people's reactions out of proportion and see them as rejection of you as you're crap. But it's the overlay of promoting neurodiversity to fight against stigma that's the problem, because it implies it's all just illusion based on misunderstanding, and if anything it implies that, on top of everything, you're incapable of judging your own behaviour as crap when it actually is, because of "internalized ableism", which also undermines your ability to accept when you've actually achieved something good. It has this kind of neutralising effect on your own capacity to judge what you've done, and how people are treating you, that parallels the effects of ADHD itself, and turns you into this kind of empty vessel blown about by the assumption of correct or incorrect social conditioning, and then everything is reduced to feelings, or "ADHD emotions", where what feels good or bad entirely depends on perspective. It's basically shooting yourself in the foot and then apologising for it, or "empowerment" as it's known.
It's no surprise that most of these influencers are women, because it can take us literally decades to notice something is ever so slightly inconvenient to us and not just to everyone else. Like, if you were doing a research project and you just couldn't do the reading, even though you stared at all the pages trying to toilet-plunge the words into your brain, and then even where you did get some ideas, you couldn't get them together in a coherent fashion, for sure that's annoying to everyone but, mostly, you're the one who didn't get to read the book, or do the work, or get anywhere. That is bad on its own merits, for a start. And then, that alone is fuel for all kinds of thought spirals, before you even add in letting people down: the knowledge that you have this potential, but it's worthless unless it's actually put to use - every newborn baby has potential - and you can't put it to use, so what are you hear for? Then someone says shit like "you are enough" or "people should accept you for you", which is totally beside the point. So for a start, if you want to make things worse for someone with just about any mental health condition, think up some snappy self-help slogans that rhyme and leave them around where they can see when they're distressed (I saw this advice actually offered to someone with bipolar once - horrifying). Saying "You are enough" to someone with ADHD basically confirms their worst, most self-destructive thoughts. It also implies that nothing we can be involved in is more important than some kind of hobby that makes you feel like your true self and is interchangeable with something else that will fulfill the same function, and what more does a good girl need? And, really, fuck that.
I'm also often around people, in my family or at work, who clearly would do well to get help, but that's something that's hard to face, and they don't realize how rampant their shit is because they're used to it (been there). With ADHD, I noticed that I can still do a lot of things, at the price of great effort, with the correct crutch. If people have, say, a blindness to whole aspects of human behavior, or things they can never learn, I can imagine that's a lot harder to face, and I know a few, who are too old and right-wing to be into the whole neurodiversity thing, but act in a very similar way. In order to cope, they start to see their deficits as signs of their genius. Anyone who complains about their behavior just can't deal with someone who thinks differently. Or they project the symptoms that are hardest to face for them onto other people, all the while branding them as normies who don't understand. Which is basically neurodiversity. They also tend to be raging randroids, because being utterly individualist makes it hard to face personal deficits, but also it helps you not have to face them. Plus the approach implies that the "neurodiverse" are a community who understand each other and it's soothing to be around each other or, if not, we have a duty to be more understanding to each other, otherwise that's internalised ableism. I know for a fact I'm not a soothing presence. And the less soothing behaviours of my executively dysfunctional peers are among the least soothing to me.
Getting back to the neurodiversity movement on the internet, its branding or flavour is left-wing. But it's absolutely randroid to its core: it's a market logic based on absolute raging individualism and self-delusion, encouraging you to go it alone and fuck the consequences, in place of actual healthcare, in a world where the latter is harder and harder to come by. It also boils down or flattens out neurology and human relationships into emotions and vibes conditioned by invisible social forces: liking the colour pink is the same process as constantly losing your keys, or having intrusive thoughts. The flipside is that whether someone gets treated as a beautiful neurodiverse unicorn who needs to be accepted, or a Karen poltergeist deserving of death threats, really depends on what boils down to aristocratism, or whether you're Someone, with a Vibe. Plus, the way social media works, people who post aren't the end users or customers, but more like the fuel and raw material, so social media "narcissism" is really a total effacement of everything about yourself, besides a set of adjectives and nouns that constitute "your identity" but are even less tangible than what's in your passport, as your mental health conditions, along with every other characteristic that human beings might have, are harnessed to generate profits for Google and Twitter. We should be pissed. But we're too busy being grateful to feel seen, plus it's kind of hard to coordinate all being pissed at the same thing at once in these conditions.
I've just given you an essay in which I lay out my case against it all, and none of it is what you're saying. Why don't you read the words that are already there on the page?
A neurotypical person always has 3-6 tabs (never more, never less) open at any time and will under no circumstances stray from this bound. This is definitely the behavior of a normal and well-balanced person.
I wonder how many people might actually benefit from a browser plugin that caps your tabs at a certain number, and closes the least/recently used one if you open a new one.
If anything, astrology offers less of an out here than self-diagnosed neurodivergence. At least with astrology, if the moon on Tuesday is really bad for you to send out job applications, you better make hay on Thursday when Jupiter is where it needs to be. With Tumblr psychology you're just a helpless victim of your own mental quirks all the time.
I’ve beaten this drum here before, I think, but I struggle with the prevalence of adult ADHD especially following the pandemic. It feels as though, at this point, I have more friends with a recent ADHD diagnosis than without one. In terms of actual numbers, that’s probably not true; but if I start counting, it’s upwards of 5 people around me in the past 2 years. Tons of them learned they had it because they saw relatable twitter or tiktok content about it.
I’m not a doctor or a psychiatrist. Maybe that many people around me all had the same neurological disorder all the time I knew them and I just had no clue. But I can’t help but wonder, when so many of them “learned” they’d “always been this way” six months after transitioning to fully remote work, tied to a desk in their own house 8-10 hours a day, feeling the anxiety of having to perform dull, meaningless work without the stimuli of coworkers’ conversation, errands to get up and run, the ordinary, pleasant changes of scenery in a normal day.
It just about broke me, and I work a job I generally like - during the pandemic it often felt like my brain was chasing me away from the computer. But I think the mind built to cheerfully perform the solitary screen-based drudgery much work now demands is rare, and I think adult ADHD discourse has fed a lot of people the lie that it’s their difficulty that is the anomaly, rather than drawing attention to the fact that staring and clicking all day in the same rooms where we eat and sleep is a shitty way to live and most people probably can’t do it.
This dovetails with one of the above threads, about my fear of the quick-and-easy version of neurological healthcare becoming a replacement for high-quality healthcare that is currently terribly inaccessible for people. I’m not against telehealth or even telehealth prescriptions on principle - friends of mine have had to jump through some truly stupid hoops to, say, get a longstanding prescription refilled while traveling, which is stupid - but I am against letting shoddy, profit-driven healthcare startups be considered good enough for the majority of people who can’t afford or access good healthcare.
Also, nothing makes me exhibit ADHD-like symptoms more than video calls. So there’s my personal bias.
I think (as someone who was diagnosed with ADHD in 2019) that there's also an in-the-middle possibility that a lot of people who would qualify as having ADHD pre-pandemic only got bad enough to the point of actually needing to seek a diagnosis when the pandemic ripped all their compensatory mechanisms away. Sort of like how low-level asthma is still asthma, but may not need medical attention until you layer a respiratory infection on top.
I think there's definitely some meat to what you say, but also that low-level ADHD may not reach the threshold of a serious enough disorder to require medical treatment - it might just be a different way of interfacing with the world that is perfectly livable and non-disruptive given the right routines and "lifehacks" - but still remains a particularly vulnerable personality type, driven by biology, to having those routines and lifehacks ripped away.
This is a great point, and I think you're right. There are other comments here that do better than my griping and point out that the societal solution has, unfortunately, been for people to seek personal psychiatric help in a fucked up healthcare system, rather than workplaces adjusting to better accommodate the effects on people's brains that the modern workplace seems to be having.
Though I do see an issue here related to Freddie's statements about making a neurological problem an identity - I'm all for people taking medication that helps them function in the world and suffer less, I'm not remotely anti-psychiatry. But I also know, because I've been very close to people with ADHD for most of my life, that interventions besides medication can make a huge difference to people with mild-to-moderate ADHD, and that prescription stimulants can have significant side effects. On the parts of the Internet deep in the kind of discourse Freddie describes, the prescription is as much a part of the identity as the condition (probably in no small part because in our current healthcare system, ADHD meds are often easy and cheap to get, compared to regular, dedicated, good-quality therapy). I think uncoupling the disorder from identity is necessary to free people to figure out what about their pandemic situation rendered their mild difficulties debilitating, and to learn supplemental methods of dealing with it.
I also think, for ADHD, accommodations and non-medical compensation are generally preferable if only because it's such a pain in the ass to keep up with an ADHD prescription. I've found it very difficult to get them because it's a controlled substance stimulant, and my psychiatrists have been unwilling to try a second brand on me when the first one had intolerable side effects because they worry I'm hoarding the medication for resale. My ADHD friend in the military can't take ADHD medication at all without discharge from her unit, and has suffered closed doors on her career even for having the diagnosis. And then, you know, even when you do have the ADHD meds, the nature of the disease makes it impossible to remember to actually take them consistently.
I agree with decoupling it from identity, though. I don't talk about having ADHD anywhere where it isn't specifically relevant, because I wouldn't want someone to associate me with an identity that's largely characterized by being unable to live up to the basic expectations of adulthood. I'm mortified now to be asking my workplace for a reasonable accommodation for technology - I'm worried about getting disciplined or labeled an unreliable worker, and would much rather just take a pill.
It’s not that I don’t believe you - I do! - but it’s hard for me to reconcile the real difficulties people have getting and maintaining a prescription with the fact that, until the FDA started cracking down, half my facebook ads were for Adderall pill-mill telehealth clinics promising me meds after one 30-minute appointment. I wish it were so easy for you to try out other prescriptions, or your friend in the military to take what she needs. This doesn’t make me think you’re lying, obviously, but it feels like a strange, ugly societal disconnect. Our healthcare institutions can’t get reliable prescriptions to people with a longstanding diagnosis, so a shady startup slides in to churn out both the prescriptions and the pills.
I have ugly dystopian visions of a world where we’re all supposed to cover for our bad days with medication that makes us better workers - and that feels closer to us now than a world where somebody can have a few unproductive days or get an accommodation without worrying they’ve put themselves on the chopping block.
I guess my question from there would be: do the telehealth pill mills actually work? Or do they take your money for an intake, maybe give you a 30-day scrip that the pharmacy may or may not fill, and then ghost you? A scam company ripping people off isn't the same as the healthcare institution defaulting to medication, nor is it the same as a larger cultural bent towards overmedication.
I think your ugly dystopia is, in fact, ugly - but I also think that it's a more illusory specter than the reality of it being really hard to get proper medication if you have ADHD. I may be oversensitive to anti-medication rhetoric, since I do need to take eight different prescriptions to keep myself sober and emotionally functional, and have run into anti-medication sentiment both on a personal axis and on a structural healthcare axis, but "take a pill to be a better worker" feels more like a Dead Kennedys song* than an accurate take on accessing medication as a mentally ill or neuroatypical person.
I think I didn’t express myself clearly! I’m truly not suggesting that it’s actually easy to get needed medication--I do think the realities you described are realities and common ones. And that the pill mill telehealth clinics are scams. I was more noticing that shady telehealth scams are sliding in to provide help that is difficult to get from actual healthcare institutions. It seems like for some, it might be easier right now to get a cheap 30-day scrip from a scam company than to get your insurance to cover stable therapy, medication, and monitoring of side effects from your actual doctor. That’s the ugly disconnect I see, that we can have cutesy tiktok memes about how quirky it is to have ADHD, and pill mills embedding those tiktoks to suggest I set up an appointment with them, and also people paralyzed with terror that even getting the formal diagnosis will render them unemployable. All of those things existing together suggests something broken somewhere!
And the dystopia I imagine progresses out from that - not a world where medication is prima facie bad and everybody is a Brave New World zombie, but a world where the easy, scammy, shitty version of psychiatric/neurological healthcare is the one most people can access, and employers and insurers remain unmotivated to provide actual care for people, tailored to their ability to function rather than to the employer’s greatest convenience.
"Adderall pill-mill telehealth clinics promising me meds after one 30-minute appointment"
I think because most average, sincere, law-abiding ADHDers (for lack of a better descriptor) are likely to steer clear of such outfits, because they want actual help. On the other hand, those who just want to abuse the meds steer toward such places. Thus, legitimate patients suffer from the onerous restrictions and whatnot, but abusers still have easy access. Just another drug war success story.
I have been ADD and had a diagnosis basically my entire life. The pandemic certainly exacerbated my issues; I struggled like I hadn't since I was an adolescent and just getting to know my symptoms and treatments.
It would not surprise me at all if folks who were in the nebulous gray area of having some symptoms but being able to function were pushed into full blown crisis/condition by the pandemic.
Yup, this is true. My twin brother was diagnosed in childhood - that doesn't make me an expert or anything, but I've been close to someone who exhibited, and continues to exhibit, all of these symptoms.
There's probably a lot more going on in my friends' minds than I'm privy to, especially during the two years we saw very little of each other. I know someone can seem to be thriving and be struggling under the surface. But these were, by and large, not people who visibly struggled with executive function, emotional regulation, or memory in any way in the previous years of our friendship.
Almost all of my friends who work desk jobs have loved WFH (especially if they are able to carve out a separate office space in their home) whereas I, who was diagnosed with ADHD in 2018, have felt like it makes my brain melt. Virtual school made my 6 y/o nephew's ADHD symptoms appreciably worse (and it sucked for his non-ADHD older brother too, but in a different way).
In terms of the anomoly of why so many of your friends have sought a diagnosis recently -- none of my IRL normie friends have been diagnosed with ADHD (other than my one friend suggesting to me recently that she might have it because she's very neat and minimalist), but many people I know through Twitter have been. Maybe it is a social contagion thing, but I think it's a lot more likely that the unfortunate condition of being Very Online is somewhat co-morbid with ADHD. There is also a growing awareness in the last 5ish years about how often presents differently in women (less of the stereotypical hyperactivity, more of the hot mess can't keep your shit together).
Also, a formal diagnosis of ADHD requires you to have presented symptoms prior to the age of 10, and since ADHD drugs are Schedule II, doctors tend to be pretty strict about it.
These are good points. I know that ADHD changes the mental relationship to reward – I have read in the past that with ADHD boys, it’s very common to be obsessed with/hyperfixate on video games, for example, because it’s a constant stream of spontaneous rewards that it’s otherwise difficult for their brains to manufacture. (More or less, I am, again, not a doctor!)
I tend to see some ADHD-like symptoms as being caused by our online ecosystem messing with all of our mental relationships to reward. But it may be that I’m seeing it backwards — maybe people whose mental relationships to reward were already affected by their ADHD are more likely to spend a lot of time in online places that are designed to manufacture those rewards.
I hate WFH. I can definitely say that I have never exhibited any ADHD symptoms in my life – and I was screened as a kid, because my twin had it – but those TikTok lists of “just ADHD things“ perfectly describe my life trying to work from home. 
I've had a similar experience to Sarah re: knowing a shocking number of people who were diagnosed with ADHD in the past two years. These are real life friends and the majority are not extremely online (at least not any more than your average person who scrolls Instagram and Tiktok daily). I was also one of those people so I have n=1 data on how easy it is to get a diagnosis - it's extremely easy. They basically asked me "Have you had trouble concentrating for a long time?" and took my "yes" as gospel without any further questions. It was truly so easy I thought it couldn't be real. I then moved to another state while medicated for ADHD and had an identical experience with a doctor in my new state. Doctors must vary widely in how they treat people who think they have ADHD, because for me it was basically as easy as asking for medication and immediately getting it. I stopped taking it after a year because it dawned on me that I don't actually have ADHD, but that's another story.
I really understand the "letting people down, over and over" part of your post - also actual ADHD person here and this feels like it has been the theme of my life when I am not medicated. It has cost me opportunities, clients, and friendships, etc and SUCKS.
This week I rear-ended someone on the highway because I was daydreaming. No one was injured, but my car is totaled and I'm waiting on the insurance adjuster to let me know how financially fucked I am over the other party's car. #justADHDthings
Two months ago, I was babysitting a friend's car and lost the key. I turned the house upside down, but ended up having to pay $750 for a locksmith to break it open and replace the key for me. I was so ashamed I didn't tell them what had happened until they asked why the new key looked different. #ADHDpride
My best friend, who was diagnosed in childhood, calls it her "lazy inconsiderate bitch disease." I was diagnosed in adulthood, but we have the same experience with it: ruined friendships, financial instability, struggles in the workplace, and most of all, a general feeling of just being a bad, lazy, selfish person who can't do what other people seem to do easily. I understand people who want it to be a cute personality quirk instead of a cluster of socially-stigmatized behaviors that actually hurt us and other people emotionally and financially. It's just that pretending it's a cute personality quirk doesn't make it so.
re: mass transit, I loved that aspect of living in northern Europe, taking the train everywhere instead of driving. Of course, doing that successfully requires packing all you need and not forgetting anything (being an hour into a 2 - 3 hour train trip and realizing you forgot your suit jacket at home is the worst), in addition to navigating the train timetable and making it there on time. Nothing easy about traveling when you're ADD!
Still, it was a lot safer, and as everyone else here says cost a lot less given the cost of auto accidents.
I realized I had lost my wallet fifteen minutes before my cab was leaving for a two week trip to LA. The only reason I was able to do much of anything there was that I had a separate drivers license from another time I thought I had lost my wallet. The wallet showed up months later in the pants pocket of a pair of shorts I was wearing when I packed.
I felt like a complete idiot, ashamed and embarrassed by this. My family wasn't going on the trip so at least there was that. Then I realized that - well - there were so many small things like this growing up. And the emotional overwhelm around that, really made me avoid people for a long time. Not so great.
I utterly respect your decision to delete (don't feel bad!), but having gotten here late and always appreciating your contributions, I can't help but feel, based on the responses, that I missed something worthwhile with this one.
Aww thanks. I always appreciate your comments too. I wrote about ADHD symptoms that aren't cute--in my case, being very messy and letting people down. I just didn't want the specifics on the internet forever.
Oof, I wrote you a longer response that got eaten. Nevertheless, I have the best of intentions to come back and recreate it later today. Will my brain cooperate? Guess we'll find out! ; )
So, yeah, unsurprisingly, my brain did not, in fact, cooperate. But better late than never, right? I can’t guarantee I won’t end up having the same change of heart you did, in terms of this hanging around on the internet forever, but it’ll exist long enough for you to read it, and that’s good enough. Anyway, it’s mainly just random commiseration…
I come by my ADHD from my dad’s side, and my mom’s side provided the delightful addition of OCD. For me, this manifests as a need for excessive (and idiosyncratically perfectionistic) order and structure in my environment in order to be able to function my best (or hell, even adequately), coupled with a severe deficiency in being able to create or maintain that state of order. It’s a truly spiffy combo.
One of the best things I ever did for myself (and it took a looooong time for me to come around to the idea) was to sign up for routine house cleaning and to work with a personal organizer occasionally. (Insert standard privilege disclaimers and whatnot here.) It utterly transformed my quality of life, and it freed up enough space for me, mentally, that I was able to focus on a lot of important things that had gotten deeply neglected while I was busy bashing myself endlessly against the brick wall of housekeeping. I knew it had been bad for me, but I didn’t realize until then exactly how high a mental load I’d been carrying from just that one area of my life. As accomodations go, it did more to improve my mental health than any medication I’ve ever been on.
That said, in the early days of the pandemic, when everything was still so uncertain, I made the grievous error of suspending the service. Between all the pandemic stresses and the fact that I’d become a new mom for the first time shortly before it all hit, things went downhill rather quickly. Fast-forward to now, and I’m stuck in a perpetual loop of not wanting to bring the cleaners back because I’m too ashamed of all the disorganized junk piles, but I’m also too ashamed of the other mess to bring in an organizer. I’m currently working my way toward doing one or both, but it’s agonizingly slow progress -- just keeping up with regular old entropy is hard enough.
Anyway, there’s not really a point to this, other than solidarity, I guess. Just saying that I get it, that I feel for you, and that it’s not just you. Routine household upkeep is my eternal white whale. FWIW, I’ve found a lot of solace and ideas in the book How to Keep House While Drowning by KC Davis, and also from her website and videos. She puts a lot of emphasis on “care tasks” being functional, not moral. Anyway, you might check it out if the idea resonates.
Whatever the specifics, I hope your struggle eases up soon. And even if it’s a bit rich for me to say so, I hope you know that you don’t deserve to feel shame for this stuff. We just do the best we can.
Thank you so much for your comment. I really appreciate it. I'm in a very similar situation, too ashamed of the mess to get help. I'm starting to get an idea for how I can attack it though, in part because of your comment. If you're comfortable, could you send me an email so I can follow up less publicly? No worries if not! carina.substack@gmail.com
Another issue here is the way that all this “specialness” actively undermines our sense of solidarity with those around us. Rather than working together to build a platform that supports our common, flawed, humanity and help us all to thrive, there is a generation that thinks the fight to demand a bigger share of (often artificially) scarce resources based on whatever “unique” ailments we can define ourselves by.
Right - the progressive turn away from the universal to the particular has its hands all over this. And it's a problem, for basic organizational issues if nothing else.
There seems to be an odd exception to this though: the universal banner of the 'oppressed'.
I feel like what you say about particular over universal is mostly true with this, especially on a smaller scale. But it seems like there is one large-tent idea that certain progressives all rally behind; which is basically that anyone not cis white male, or in traditional positions of power or authority (historically largely the same thing, but not currently of course), are the 'out-group' antagonists that they can all unify against.
And while overtly excluding a large demographic like white dudes is decidedly non-universal by definition, I think they are simply ignoring that pesky detail by covering it with their own 'universal' descriptor: the historically oppressed people of the world.
In other words, I think they see universal suffering a much more important ideal to rally behind than universal solidarity or truth.
I don't think the "turn away from the universal to the particular" is purely the domain of the progressive. I think it is s a uniquely dominant trait of Americans nurtured on decades of "rugged individualism". The anti-progressive version is group therapy via religious practice with community via in-grouping. The progressive "nons" seek the comfort of the particular as the community
Modernity has caused a fracturing of the common weal into particular common weals each operating as if others don't exist or shouldn't exist.
But I can't say that there's an easy fix to that considering this development has taken several decades to manifest.
That one, specifically, is so ubiquitous - "we're known for our crazy weather, like everywhere else!"
The exact same thing happened to obesity. What, presumably, started out as a good-faith effort to make people stop bullying other people for being fat, became "fat acceptance" and "health at every size" (HAES). Now people are denying basic medical truths and "calling out" their doctors over their declining health. I've even had a woke friend want to try both dieting and bulking up, but she expressed profound guilt about wanting to, like, traditionally improve her appearance, because, I'm a twisted sense, it's a form of body shaming. Everyone on Tumblr says you're a goddess no matter what, so of course if you attempt to change your body, you're rejecting that premise and implying that you aren't already "perfect". Personally, I think a lot of these people are just jealous and insecure. They want to change, too, but it's a lot easier to just pull everyone down and cultivate an insular culture of yes-people to make you feel good about yourself.
That all sounds like a good reason to treat ADHD as a medical problem, to manage it with treatment and medication and then to move on as one would when managing diabetes or dermatitis. None of it sounds like a reason to try and declare ADHD an identity category.
Also, your "secondly" in the last paragraph - does that not risk simply having self-diagnosis metastasize until the ADHD distinction is no longer a distinction at all?
I tend to agree with you here. I probably have undiagnosed adhd. Didn’t quite realize it until middle age and have lots of coping mechanisms and have been successful in life in some ways and other ways not. Medicating (in my case with coffee and anger and downtime) got me very functional, but I am still in a brain that has a much higher context switching cost than average together with a difficulty focusing on tasks I don’t care about. That doesn’t cause cognitive distortions so much as thoughts that are perceived as odd and a presentation that seems aloof yet randomly enthusiastic. In short, just a bit out of sync with the world. What would it be like to sync up, I can guess, but not know.
Diabetes and dermatitis don't impact your mind and behavior. People don't identify deeply with the subtle operations of their skin and pancreas, but they do with their minds and behaviors. This seems pretty straightforward to me am I missing something?
The question is not whether that distinction is real. The question is whether or not maintaining it is useful for healing and management.
You've talked elsewhere in the thread about the self, in kind of unitary terms, standing alone and reckoning with the universe. I'm really curious to hear more exposition on what kind of thing that is to you and its relationship to the mind and brain.
In any case I'd say that both "ADHD is just like hypertension and has nothing whatsoever to do with who I am as a person" and "ADHD is the only interesting thing about me" are both unnaturally extreme and nonsensical positions. ADHD impacts domains of life that are central to how people think about what matters about who they are. Forget whether it's useful--I don't think it's possible for people to think about their mental conditions in just the way they think about hypertension or other medical problems that have nothing to do with how they think or act. Nor do I think it would be especially desirable or conducive to overall mental health to do so. It can actually be pretty destructive to externalize parts of your psyche in this way (but boy does our culture love externalizing parts of our psyches lately).
Didn't we kind of decide the opposite thing about depression, that reifying it as a very well-understood medical condition with a straightforward solution was both conceptually and practically problematic for people? In fairness I'd say the state of art re: ADHD is on marginally better theoretical footing, but still, the difference isn't radical.)
Do the people who have adopted the totalizing vision of ADHD seem particularly healthy, regarding their disorders? Are they healing better than someone who sees it as a challenge but not an aspect of their personality? Are they managing the disorder better?
“Standing in the kitchen wondering why” ok I’m 60 and well, hey younger folk—guess what’s coming your way too! :) ‘Normal’ sounding stuff imho.
At least when you're standing in the little room, you're limited to a very few options, and you can just do one to get it out of the way.
But really, even this is medicalizing a known human trait. When we walk through a door, our mind does a context change and we shed our previous purpose.
Every time this happens to me, I chuckle, because it seems so ridiculous, and yet it's so true. It's happened even when I'm actively trying to avoid it.
Not before 40, though.
Eh. My husband has been absent-minded his whole life. Some folks are🤷♀️ (He is for lack of a better term ‘neurotypical’)
That makes me think of the Sparks track 'Probably Nothing':
https://www.youtube.com/watch?v=K6Q9SBt01so
This was literally a George Carlin bit. I forget what era, maybe 90s but it could have been earlier.
It took me decades to get good at just standing there and relaxing enough to have time for the original purpose to resurface. Also I often ask my wife what I’m doing. She doesn’t usually know either, but she always had some other ideas of what I SHOULD be doing. Which is okay. Better than standing around.
It’s ok to embrace a stereotype if the stereotype is a cool, edgy one like neurodivergence. Stereotypes are convenient scaffolding for people who feel unmoored.
Agree. Of course someone will also throw out the caveat that stereotypes can sometimes be harmful and hurtful, which I won't dispute, but stereotypes are like lunch meat: they're bad for you in large amounts, you don't want to see them in the process of being made, and yet sometimes they're the only thing you can afford.
Race essentialism is another example. Stereotypes are bad if they’re used against you, but good if they make you feel like you belong, supposedly.
Perhaps, but why couldn't they go for liberty spikes or black lipstick?
Because fewer people are exposed to Hot Topic thanks to the downfall of mall culture.
Kinda starting to miss traditional organized religion.
I have a kid (14) who is autistic and his autistic identity is whiplash for him. On one hand he really does get along with other ND people better - all of his friends are - and it helps him normalize his own situation as someone who is just fundamentally different in a core way than what other people and society as a whole expects. If that were the whole deal he would wear the flag publicly. On the other hand he’s quite aware of how people sink into self blame behind the label and how the whole label and diagnosis situation attracts a bunch of “helpers” who are really uncomfortable with him being himself even if it’s not bothering anyone, and who look at him in a condescending way almost as a project. In the end he just wants what most people want- he wants his normal to be accepted as normal.
As far as I can tell they generally know something's up. Autism and the various copes/trauma reactions/etc. that go with it are much more visible than we think from the inside.
I've been where your kid is. And I know it's really uncomfortable when other people bring up my diagnosis -- even though it becomes pretty obvious pretty quickly.
That said... and I can't speak for your kid, only myself, but this might be of some use to you. I don't think it's so much that I want to be treated as "normal", though it's something close to that. I want to be treated as "fundamentally competent". I want people to trust that, in most matters most of the time, I can handle things as well as any other person. (Which, yes, requires some effort on my part to ensure that is true!)
Thats at least partially true and he does want to feel competent. “Normal” was his word by the way.
The situation with kids is maybe different because people reach out to help in ways that he finds extremely condescending. (And I agree.) As a kid it’s hard to get away from some of these people (they can be your teachers for example).
That's a really interesting story and I think it highlights something underdiscussed - that if you're a "divergent" person you're prone to attract "typical" people who are into seeing you as a project. If you make your diagnosis a big part of your personality, you'll truly attract those type of people. In my opinion, from my experience having ADHD and anxiety that's almost like PTSD, the more I'm vocal about it being "part of me," the more I get a weird clinical "project" type adoration from people.
When we see people performing their diagnosis-identity, we're seeing someone in the honeymoon phase of discovering the levels of validation they can get. I think we're basically seeing snapshots of a million people before they start to see how little that validation will do for them in the long run.
Oh yeah. I see that. I think I've felt something like this - I can remember, when I was in my teens and twenties especially, this confusion over the fact that some people give me less attention but feel like my real friends, while other people give me a lot of attention, making me feel like "oh wow is this what friendship is supposed to be like," and then getting tired of me in a way that my other "less attentive" friends didn't.
Oh yeah. I'm pretty sure I've been a part of that dynamic plenty of times back in the day!
Hmm. I think you’re on to something.
At the very least it’s about clearing a lane so that you can be vocal and above personal criticism.
Yeah, I think it is about that, and I also think that that practice of justifying why you think you're above criticism... I think that's part of it. I think it's one of the many aspects of this that feels good but then has severely diminishing returns after the honeymoon phase, resulting in a thing where people who get over it just stop posting about it and are in turn replaced by more people in the honeymoon phase who want to post about it.
I think there is a revolving door but there are a number of people who need the validation so much that they grasp it very tightly and it becomes their identity.
I'm 38 and was never formally diagnosed with ADHD or anything until a few years ago, when tiktok began serving me all the ADHD content, I was like "holy shit is this not normal?" - and it was a lot of stuff like what you describe: standing in the kitchen, mal-adaptive work patterns (procrastination, etc), inability to do X even though I need to do X, etc. I've often felt like these traits were annoying but pretty common, so I like never thought anything of it. I just thought I sucked at prioritization or something (which is true)
Went to a psych who had been suggesting for years I might have ADHD (in addition to depression) and got an Rx for Vyvanse. Totally changed the way I can focus during the work day and my ability to do tasks I don't want to do literally went up 100x. Especially true in my new "work from home all the time and also do 100% of the parenting" post-covid post-divorce life.
Since then I've had an off an on relationship with the drug. I feel like it's a cheat in life and there is some tradeoff I haven't learned yet, like I'm going to get Alzheimers at 55 or something. Selling my soul at the crossroads in order to make better spreadsheets...
This is a great point
I think if prescription stimulants help you to live a more productive life, by god, you should take them without guilt - who cares if it's a cheat in life? When we are sick, we take medicine to make it better. Your character doesn't enter into it.
I went through basically this exact same experience minus the divorce and the parenting. I did eventually discover the tradeoff: I started feeling awful, like completely miserable, as soon as the drugs wore off. Eventually I had the same horrible feeling when I first woke up in the morning before I'd taken them. I was angry at everyone, I wanted to burst into tears, and I had a throbbing hangover-style headache. I barely had enough motivation to brush my teeth and get dressed, let alone do anything else, until the meds had kicked in. In the end I stopped taking them and I felt much better after a couple weeks. At this point, two years later, I don't believe I've ever had ADHD. I did, however, have a very unhealthy lifestyle involving way too much alcohol, way too little sleep, a terrible diet, an addiction to social media, and an inability to cope with stress in a healthy way. When I finally accepted that those things weren't just a manifestation of undiagnosed ADHD - after over a year of taking adderall daily - I forced myself to make the more difficult incremental changes that have actually durably improved my life. I am in a much better place today.
I'm not saying that this is what will happen to you, but for me personally the adult ADHD diagnosis felt like a solution to all my problems and the way I felt on medication initially confirmed that belief. If I gained anything from the experience it was acceptance that there was no single disorder that explained my deeply unhealthy life and no single pill that could fix it in the long term.
I know a massive number of people who've been diagnosed with ADHD as adults in the past three years and I often wonder how many are headed down the same path I was. I hope they find a similarly positive resolution even if ADHD doesn't turn out to be the answer.
My gf often likes to say she has 27 tabs open, 3 are frozen, and there's music coming from an unknown tab that she can't turn off.
She'll joke about this being the natural product of a raging Gemini, or that it's in her maternal DNA. But she never says a word about ADHD, or being speshal. Rather, this is just the way she is. Perhaps, like myself, she has no social media presence and feels no inclination for the type of public self-aggrandizement that seems to be a requirement for basic web interaction these days.
That, or she's just a neurotic normy like the rest of us...nothing spesh about that.
As someone who by any definition "has ADHD," I'll say two things that I hope will be relevant -
1) Freddie, the brainfog you describe from your meds basically gave you ADHD, so you know what it's like... When you describe the brain fog, I 100% relate, as it's how I feel when I don't have Concerta in my system. As I believe that my condition doesn't make my feelings and perceptions totally different from everyone who doesn't have the condition, I read your description of the brain fog and conclude "Freddie's experience with meds makes him officially know what ADHD feels like."
2) Sometimes I think this stuff sadly is a sign of how generally immature (in terms of self-perception) most people online are. This is based on just how much more I used to obsess over self-perception and also be online... and as I told myself "just do your best in your job and your relationships and you won't have to worry about your identity so much" I stopped going online as much.
I honestly think that there's a self-selection bias going on here and that many of the people posting about their special ADHD are going through a phase... I was very into ADHD as an identity for a few months, but then that stopped giving me anything good, so I drifted away from framing things through my diagnosis.
I often suspect that, while, yeah, there are a lot of influencers who will be "ADHD influencers" and thus make the obsession their identity, a lot of the people who spend so much time online posting about ADHD... I suspect that we're often seeing a rotating cast of people who get into it, experience the diminishing returns, and then stop being into their diagnosis as an identity.
What's interesting about that is that online, a mass movement of peopel committed to a belief looks the same as immature people going through phases and then getting replaced by people who are also immature and going through phases every few years.
In my utopia every ADHD-based influencer would come with a warning to the effect of: These ideas will give you a confidence boost in the short term but don't think about your diagnosis like this forever.
“I suspect that we're often seeing a rotating cast of people who get into it, experience the diminishing returns, and then stop being into their diagnosis as an identity.”
This is an great observation and one I want to keep in mind!
Cool, thanks!
As someone who has ADD, manages it fairly successfully the usual way (Adderall), and otherwise does not find it something to celebrate or base one’s sense of self around… what’s really annoying about the “neurodivergence” discourse is how it usually boils down to a big nothingburger. Guess what? Companies that supposedly celebrate neurodiversity are gonna be managed, organized, structured, and otherwise run in all the exact same ways as always. All the processes and tools are going to be whatever your boss is comfortable with, up to and including purposefully inflicting deliberately unstructured systems on you because they personally like the “flexibility.” Whether or not anything is substantively better or worse at a company for someone with ADHD basically just boils down to whether it’s well and humanely run, or is otherwise just a shitty place to work. Just like always.
I agree with most of your analysis here, Freddie. I am a clinical psychology professor, and I thought for years that we needed to de-stigmatize mental illness; but now we have ended up with the opposite problem due to the role of social media. It's not healthy for people to define the core of their identities by their disorders! So I largely agree with you. But I did want to mention one critique. You have offered some good examples of people with ADHD over-interpreting their experiences through a diagnostic lens. But it is also true that ADHD is associated with problems with emotion regulation, and those emotion regulation problems are often a bigger source of difficulty in daily life than are the symptoms of inattention and impulsivity. This piece by Russ Barkley does a nice job outlining what we know about this link between ADHD and difficulties with emotion regulation: https://www.additudemag.com/desr-adhd-emotional-regulation/
We should do all we can to reduce stigma while maintaining that stigma is not a refusal to enable a filter that you have constructed to cloister your own soul from the outside world.
The core dialectic of DBT is the key here; you have been doing the best you can AND you need to do better.
I wish there was a way we could link to comments. I love this.
Thank you so much for posting this article. My husband has acute ADHD and I think DESR is the puzzle piece I was missing.
Do you think that social media could also be contributing to a mass outbreak of Munchausen's syndrome?
Hmm, I am not sure I understand the context for your comment. I do think social media is leading to social contagions of all kinds right now, though I am not sure how Munchausen's would be implicated.
Try this: a wave of psychological hypochondria to gain attention or to excuse one’s insecurities. It cheapens the experience of those who really have the problem.
Ah, ok, I think I have a better sense of what you means. I do think it is possible that social media is leading to this sort of social contagion. The psychological processes involved are probably unconscious rather than deliberately manipulative.
Most aren't deliberate, but some definitely are, and social media is not the only culprit. But that's just my opinion.
Rebecca, I caught auto-correct mistake: I meant "psychological hypochondria", not "physiological".
I need to set the font bigger on my iPhone, I guess. *sigh*
I was diagnosed with both autism and ADHD as an adult after losing my job, and after I was given a clinical diagnosis there definitely is a mental switch that gets flipped that makes me see things through a lens that includes that diagnosis. For a lot of those things, I do not think I'm "over-interpreting [my] experiences through a diagnostic lens", I think I am correctly interpreting things in the context of my diagnosis. While DeBoer and the Gawker piece are reactions to over-interpretations and a sort of totalizing label, I would assume that the ADHD meme-makers also believe the majority of their content is in the "correct interpretation in the context of their diagnosis" zone and not the "totally normal human stuff _must_ be ADHD, because I do it and I have ADHD" zone. As the Gawker writer said: "As for me, I just need to find a middle ground between the stern refuseniks insisting I’m a drug-seeking inadequate and the TikTokers telling me that I’m a precious, delicate baby and probably a creative genius."
Previous to the diagnosis, I would occasionally attribute certain traits to "because I'm an engineer" or "because I played too many video games as a kid" and I'm sure I over-extended on those attributions as well.
you are not a drug-seeking inadequate
... well, yes, because I'm a tin-foil hatter that thinks that nicotine patches/gums and a more consistent sleep schedule are more than sufficient for me, but that was just a quote from the Gawker piece you linked. Which, by the way, congrats on getting me to read and appreciate a neo-Gawker piece. The finest bait-and-switch citation: I think their cameo upstaged you.
Either way, thnx bby, luv u 2.
Sorry if I somehow seemed to suggest that all claims by people with ADHD are over-interpretations through a diagnostic lens! My aim in my comment was to say that sometimes, when people with ADHD talk about their emotional experiences, they are completely on target about how those experiences are shaped by their ADHD. Problems with emotion regulation are a key feature of ADHD, so it seems likely that people with ADHD are quite right that their emotional experiences are sometimes distinctively different. In any event, I am sincerely sorry if my comment sounded insulting in a way that I did not intend!
It definitely was not insulting. I thought I was adding to your partial critique by saying "from their perspective, they usually think it makes sense". Not only because of the scientifically documented "emotion regulation" side, but also from the very regular "I cannot perfectly predict what 'normal' would be like, since I used to think I was 'normal' and have been informed that I am not".
In other words, before hitting "Post" on your meme about how you teleport 15 minutes into the future as soon as the shower hits or you sit down to poop there's no simple test to tell you "this is an ADHD thing consistent with the 'time blindless' thing my therapist told me about" or "this is a time-honored tradition among all humans, not just the humans that we didn't know to diagnose with ADHD". While I'm sure there's grifters and people over-extending into an identity, I would put money on the "view from the self" being "that sounds like what my therapist warned me about" rather than "time to get some likes and validation". And this view-from-the-self problem applied to Virgos and Geminis and Engineers and Gamers too, so it really is only a partial critique of DeBoer's post, since we're all humans going through it.
Ngl, I lose anywhere between 15min - 1hr on the toilet and in the shower not because I’m adhd, but because I’m just thinking or reading about random shit.
Sometimes I think diagnoses like adhd are less about “what’s normal or not”, and more about the understanding the distinct ways you process the things we all go through as humans (since to me, it roughly boils down to what chemical/biological factors are influencing your brain processing) :)
My wife would relate to this. She is amazed at the way time just spins away for me when I'm in the bath.
I'm sure I've heard a talk by Russel Barkley where he mentions that, in terms of emotion regulation, the part of the brain that is overdeveloped or over-reacts in bipolar is underdeveloped in ADHD (I only half-followed it and I'm not a neurologist), which is interesting because they get misdiagnosed as each other. It's probably one of the hardest parts of ADHD to manage and takes a lot of upfront prevention. It's also the hardest thing to explain to people, because they see you throwing a tantrum like a 4-year-old, plus it's never for like, what you would think of "emotional" reasons like sadness or anger or fear.
But what I've found across the board is that, with ADHD, when you describe the symptoms to someone (who's not your psychiatrist) they'll usually respond "well everyone feels that way, you're fine" whereas when they witness the behaviour they're like "holy fuck, do you have dementia?" "eeewwww that's disgusting". Actually, when we witness our own behaviour we're also thinking that and, well, it's unpleasant, but it's also the way you can hold onto sanity, to retain self-awareness and a sense of proportion. Which makes me agree with Freddie - it's not so much the emotions themselves that are specific, it's their magnitude. And in any case, a lot of the time it goes beyond emotions, which is the problem with an approach like the DSM of listing symptoms: suffering tends to look similar across the board.
It's frustrating because ADHD is portrayed by these influencers as this kind of quirky kind of chronic lazyitis, with these bubbly, wacky zany nerdy personalities, like and I'm not sure they're even doing it consciously, but it's nails on chalkboard. Constant infantilisation and humiliation due to how the symptoms look is probably one of the worst things about dealing with the condition. I'm an extremely serious person, I hold myself and other people to high standards, I don't like to half-ass things. The idea that we're all really Cubert Farnsworth trapped in an adult body running around looking for Cool Nerdy Stuff!!! which a lot of them conveniently sell, and that these people are liberating us from that, is such nails on chalkboard. I don't see how "ADHDers should read children's books because we're different" (which I've seen) is any different to "women should stay in the kitchen because we're different". It points to such a stunted vision of what people's lives are supposed to be like and what we can aspire to, with or without a neurological disability.
With that said, a lot of what these people describe is quite relatable - I mean, probably to anyone also - because they're not describing emotions, they're describing the mildest, most kawaii manifestations of executive dysfunction - the inability to start stuff, to act on intentions. Though the issue with any "neurodiversity" shit on the internet is that on the one hand, you go on tumblr and twitter and read the big influencers, you're reading the highest-possible functioning people and they're basically saying "well we don't need healthcare, just acceptance, meds are a personal choice, please buy my cute hot pink pill organiser" and then you go on reddit, where it's people who (a) have ADHD and (b) are addicted to the internet and (c) a large minority of whom are on methalphenidate or Adderall + weed, which means their short-term memory and attention span are probably totally cooked anyway.
Thanks for this analysis of why you are ambivalent about the pop culture presentation of ADHD! Even when the material presented is somewhat relatable, there is a kind of trivialization of the real suffering involved in having ADHD--that sense of never being able to meet your own high standards or the expectations other people might have of you. There is genuine suffering entailed in this condition, at least for those I love who have it.
I think a lot of it is down to the medium, as well. And it's not so much pop culture - it's the way people brand themselves on social media, especially the tik toks I've seen, like they even dress and act like a Cal Arts mad science kid (also I'm old AF so there's maybe that, but I feel like it's the lame shit from my generation or the one just after, rather than some new shit that's making me yell "get off my lawn").
I noticed the r/adhd subreddit is a lot less into the whole "neurodiversity" thing, even though there's some crap on there too. That's because on reddit, for all its flaws, having to self-brand isn't built into it. It's largely anonymous. No one can remember who was called Haunted_bacon or what they said. On twitter, tumblr, instagram, probably tik tok, if you get a diagnosis, there's virtually no way for you not to rebrand, especially if you go on there to connect with other people with the same diagnosis. You might call yourself something with your disability in it, or put it in your profile, so people know how to treat you. So, immediately, you're going to keep your brand a little bit more kawaii than what a neurological disability actually entails, because it's your identity now. Some as someone with Crohns doesn't want to smear bloody poop on their face and call it "contouring", it's going to be a lot of "TFW insert family-friendly fart joke here". And, as usually happens on social media, you start to adapt your language so as to appear in on the jokes, which are largely the repetition of the language and, ultimately, your thinking adapts too, out of fear of the kind of domino row of associations that drives social media.
Someone like ADHD Alien is a good example, because she clearly either has done the research, or has a team. Her comics are very accurate, and she goes into details that not many other influencers do in terms of the behaviour and emotional states that the condition entails. Then there's the whole "alien" part. I even get the posts with the lists of explained behaviours, because a lot of them come across as kind of intentional or even defiant or spiteful, if you don't know why it happens. Like, if you're an extremely serious person with ambitions and projects, but then you're always flaking out because your brain just won't cooperate, people who wanted to work with you will undoubtedly and correctly judge you to be unreliable. But when the behaviour contrasts with your personality and values as a whole, it's worse than that: it can come across as spiteful, or even deliberately insulting, like it's specifically them you decided you didn't want to work with. In fact a symptom of ADHD is also to blow people's reactions out of proportion and see them as rejection of you as you're crap. But it's the overlay of promoting neurodiversity to fight against stigma that's the problem, because it implies it's all just illusion based on misunderstanding, and if anything it implies that, on top of everything, you're incapable of judging your own behaviour as crap when it actually is, because of "internalized ableism", which also undermines your ability to accept when you've actually achieved something good. It has this kind of neutralising effect on your own capacity to judge what you've done, and how people are treating you, that parallels the effects of ADHD itself, and turns you into this kind of empty vessel blown about by the assumption of correct or incorrect social conditioning, and then everything is reduced to feelings, or "ADHD emotions", where what feels good or bad entirely depends on perspective. It's basically shooting yourself in the foot and then apologising for it, or "empowerment" as it's known.
It's no surprise that most of these influencers are women, because it can take us literally decades to notice something is ever so slightly inconvenient to us and not just to everyone else. Like, if you were doing a research project and you just couldn't do the reading, even though you stared at all the pages trying to toilet-plunge the words into your brain, and then even where you did get some ideas, you couldn't get them together in a coherent fashion, for sure that's annoying to everyone but, mostly, you're the one who didn't get to read the book, or do the work, or get anywhere. That is bad on its own merits, for a start. And then, that alone is fuel for all kinds of thought spirals, before you even add in letting people down: the knowledge that you have this potential, but it's worthless unless it's actually put to use - every newborn baby has potential - and you can't put it to use, so what are you hear for? Then someone says shit like "you are enough" or "people should accept you for you", which is totally beside the point. So for a start, if you want to make things worse for someone with just about any mental health condition, think up some snappy self-help slogans that rhyme and leave them around where they can see when they're distressed (I saw this advice actually offered to someone with bipolar once - horrifying). Saying "You are enough" to someone with ADHD basically confirms their worst, most self-destructive thoughts. It also implies that nothing we can be involved in is more important than some kind of hobby that makes you feel like your true self and is interchangeable with something else that will fulfill the same function, and what more does a good girl need? And, really, fuck that.
I'm also often around people, in my family or at work, who clearly would do well to get help, but that's something that's hard to face, and they don't realize how rampant their shit is because they're used to it (been there). With ADHD, I noticed that I can still do a lot of things, at the price of great effort, with the correct crutch. If people have, say, a blindness to whole aspects of human behavior, or things they can never learn, I can imagine that's a lot harder to face, and I know a few, who are too old and right-wing to be into the whole neurodiversity thing, but act in a very similar way. In order to cope, they start to see their deficits as signs of their genius. Anyone who complains about their behavior just can't deal with someone who thinks differently. Or they project the symptoms that are hardest to face for them onto other people, all the while branding them as normies who don't understand. Which is basically neurodiversity. They also tend to be raging randroids, because being utterly individualist makes it hard to face personal deficits, but also it helps you not have to face them. Plus the approach implies that the "neurodiverse" are a community who understand each other and it's soothing to be around each other or, if not, we have a duty to be more understanding to each other, otherwise that's internalised ableism. I know for a fact I'm not a soothing presence. And the less soothing behaviours of my executively dysfunctional peers are among the least soothing to me.
Getting back to the neurodiversity movement on the internet, its branding or flavour is left-wing. But it's absolutely randroid to its core: it's a market logic based on absolute raging individualism and self-delusion, encouraging you to go it alone and fuck the consequences, in place of actual healthcare, in a world where the latter is harder and harder to come by. It also boils down or flattens out neurology and human relationships into emotions and vibes conditioned by invisible social forces: liking the colour pink is the same process as constantly losing your keys, or having intrusive thoughts. The flipside is that whether someone gets treated as a beautiful neurodiverse unicorn who needs to be accepted, or a Karen poltergeist deserving of death threats, really depends on what boils down to aristocratism, or whether you're Someone, with a Vibe. Plus, the way social media works, people who post aren't the end users or customers, but more like the fuel and raw material, so social media "narcissism" is really a total effacement of everything about yourself, besides a set of adjectives and nouns that constitute "your identity" but are even less tangible than what's in your passport, as your mental health conditions, along with every other characteristic that human beings might have, are harnessed to generate profits for Google and Twitter. We should be pissed. But we're too busy being grateful to feel seen, plus it's kind of hard to coordinate all being pissed at the same thing at once in these conditions.
So should I close more tabs or open more tabs to be neurotypical?
Exactly! I couldn’t work out which was the “right” way 😆
All roads lead to neuroatypicality, I'm afraid, calling into question the meaning of the term "typical"
CHECKMATE
I've just given you an essay in which I lay out my case against it all, and none of it is what you're saying. Why don't you read the words that are already there on the page?
A neurotypical person always has 3-6 tabs (never more, never less) open at any time and will under no circumstances stray from this bound. This is definitely the behavior of a normal and well-balanced person.
One shall not open two tabs, except on the way to opening a third tab. Seven tabs is right out.
I wonder how many people might actually benefit from a browser plugin that caps your tabs at a certain number, and closes the least/recently used one if you open a new one.
Close every other tab, except skip prime number tabs.
If anything, astrology offers less of an out here than self-diagnosed neurodivergence. At least with astrology, if the moon on Tuesday is really bad for you to send out job applications, you better make hay on Thursday when Jupiter is where it needs to be. With Tumblr psychology you're just a helpless victim of your own mental quirks all the time.
I’ve beaten this drum here before, I think, but I struggle with the prevalence of adult ADHD especially following the pandemic. It feels as though, at this point, I have more friends with a recent ADHD diagnosis than without one. In terms of actual numbers, that’s probably not true; but if I start counting, it’s upwards of 5 people around me in the past 2 years. Tons of them learned they had it because they saw relatable twitter or tiktok content about it.
I’m not a doctor or a psychiatrist. Maybe that many people around me all had the same neurological disorder all the time I knew them and I just had no clue. But I can’t help but wonder, when so many of them “learned” they’d “always been this way” six months after transitioning to fully remote work, tied to a desk in their own house 8-10 hours a day, feeling the anxiety of having to perform dull, meaningless work without the stimuli of coworkers’ conversation, errands to get up and run, the ordinary, pleasant changes of scenery in a normal day.
It just about broke me, and I work a job I generally like - during the pandemic it often felt like my brain was chasing me away from the computer. But I think the mind built to cheerfully perform the solitary screen-based drudgery much work now demands is rare, and I think adult ADHD discourse has fed a lot of people the lie that it’s their difficulty that is the anomaly, rather than drawing attention to the fact that staring and clicking all day in the same rooms where we eat and sleep is a shitty way to live and most people probably can’t do it.
This dovetails with one of the above threads, about my fear of the quick-and-easy version of neurological healthcare becoming a replacement for high-quality healthcare that is currently terribly inaccessible for people. I’m not against telehealth or even telehealth prescriptions on principle - friends of mine have had to jump through some truly stupid hoops to, say, get a longstanding prescription refilled while traveling, which is stupid - but I am against letting shoddy, profit-driven healthcare startups be considered good enough for the majority of people who can’t afford or access good healthcare.
Also, nothing makes me exhibit ADHD-like symptoms more than video calls. So there’s my personal bias.
I think (as someone who was diagnosed with ADHD in 2019) that there's also an in-the-middle possibility that a lot of people who would qualify as having ADHD pre-pandemic only got bad enough to the point of actually needing to seek a diagnosis when the pandemic ripped all their compensatory mechanisms away. Sort of like how low-level asthma is still asthma, but may not need medical attention until you layer a respiratory infection on top.
I think there's definitely some meat to what you say, but also that low-level ADHD may not reach the threshold of a serious enough disorder to require medical treatment - it might just be a different way of interfacing with the world that is perfectly livable and non-disruptive given the right routines and "lifehacks" - but still remains a particularly vulnerable personality type, driven by biology, to having those routines and lifehacks ripped away.
This is a great point, and I think you're right. There are other comments here that do better than my griping and point out that the societal solution has, unfortunately, been for people to seek personal psychiatric help in a fucked up healthcare system, rather than workplaces adjusting to better accommodate the effects on people's brains that the modern workplace seems to be having.
Though I do see an issue here related to Freddie's statements about making a neurological problem an identity - I'm all for people taking medication that helps them function in the world and suffer less, I'm not remotely anti-psychiatry. But I also know, because I've been very close to people with ADHD for most of my life, that interventions besides medication can make a huge difference to people with mild-to-moderate ADHD, and that prescription stimulants can have significant side effects. On the parts of the Internet deep in the kind of discourse Freddie describes, the prescription is as much a part of the identity as the condition (probably in no small part because in our current healthcare system, ADHD meds are often easy and cheap to get, compared to regular, dedicated, good-quality therapy). I think uncoupling the disorder from identity is necessary to free people to figure out what about their pandemic situation rendered their mild difficulties debilitating, and to learn supplemental methods of dealing with it.
I also think, for ADHD, accommodations and non-medical compensation are generally preferable if only because it's such a pain in the ass to keep up with an ADHD prescription. I've found it very difficult to get them because it's a controlled substance stimulant, and my psychiatrists have been unwilling to try a second brand on me when the first one had intolerable side effects because they worry I'm hoarding the medication for resale. My ADHD friend in the military can't take ADHD medication at all without discharge from her unit, and has suffered closed doors on her career even for having the diagnosis. And then, you know, even when you do have the ADHD meds, the nature of the disease makes it impossible to remember to actually take them consistently.
I agree with decoupling it from identity, though. I don't talk about having ADHD anywhere where it isn't specifically relevant, because I wouldn't want someone to associate me with an identity that's largely characterized by being unable to live up to the basic expectations of adulthood. I'm mortified now to be asking my workplace for a reasonable accommodation for technology - I'm worried about getting disciplined or labeled an unreliable worker, and would much rather just take a pill.
It’s not that I don’t believe you - I do! - but it’s hard for me to reconcile the real difficulties people have getting and maintaining a prescription with the fact that, until the FDA started cracking down, half my facebook ads were for Adderall pill-mill telehealth clinics promising me meds after one 30-minute appointment. I wish it were so easy for you to try out other prescriptions, or your friend in the military to take what she needs. This doesn’t make me think you’re lying, obviously, but it feels like a strange, ugly societal disconnect. Our healthcare institutions can’t get reliable prescriptions to people with a longstanding diagnosis, so a shady startup slides in to churn out both the prescriptions and the pills.
I have ugly dystopian visions of a world where we’re all supposed to cover for our bad days with medication that makes us better workers - and that feels closer to us now than a world where somebody can have a few unproductive days or get an accommodation without worrying they’ve put themselves on the chopping block.
I guess my question from there would be: do the telehealth pill mills actually work? Or do they take your money for an intake, maybe give you a 30-day scrip that the pharmacy may or may not fill, and then ghost you? A scam company ripping people off isn't the same as the healthcare institution defaulting to medication, nor is it the same as a larger cultural bent towards overmedication.
I think your ugly dystopia is, in fact, ugly - but I also think that it's a more illusory specter than the reality of it being really hard to get proper medication if you have ADHD. I may be oversensitive to anti-medication rhetoric, since I do need to take eight different prescriptions to keep myself sober and emotionally functional, and have run into anti-medication sentiment both on a personal axis and on a structural healthcare axis, but "take a pill to be a better worker" feels more like a Dead Kennedys song* than an accurate take on accessing medication as a mentally ill or neuroatypical person.
*outro to "Moon Over Marin"
I think I didn’t express myself clearly! I’m truly not suggesting that it’s actually easy to get needed medication--I do think the realities you described are realities and common ones. And that the pill mill telehealth clinics are scams. I was more noticing that shady telehealth scams are sliding in to provide help that is difficult to get from actual healthcare institutions. It seems like for some, it might be easier right now to get a cheap 30-day scrip from a scam company than to get your insurance to cover stable therapy, medication, and monitoring of side effects from your actual doctor. That’s the ugly disconnect I see, that we can have cutesy tiktok memes about how quirky it is to have ADHD, and pill mills embedding those tiktoks to suggest I set up an appointment with them, and also people paralyzed with terror that even getting the formal diagnosis will render them unemployable. All of those things existing together suggests something broken somewhere!
And the dystopia I imagine progresses out from that - not a world where medication is prima facie bad and everybody is a Brave New World zombie, but a world where the easy, scammy, shitty version of psychiatric/neurological healthcare is the one most people can access, and employers and insurers remain unmotivated to provide actual care for people, tailored to their ability to function rather than to the employer’s greatest convenience.
"Adderall pill-mill telehealth clinics promising me meds after one 30-minute appointment"
I think because most average, sincere, law-abiding ADHDers (for lack of a better descriptor) are likely to steer clear of such outfits, because they want actual help. On the other hand, those who just want to abuse the meds steer toward such places. Thus, legitimate patients suffer from the onerous restrictions and whatnot, but abusers still have easy access. Just another drug war success story.
I have been ADD and had a diagnosis basically my entire life. The pandemic certainly exacerbated my issues; I struggled like I hadn't since I was an adolescent and just getting to know my symptoms and treatments.
It would not surprise me at all if folks who were in the nebulous gray area of having some symptoms but being able to function were pushed into full blown crisis/condition by the pandemic.
I can't judge your friends' psychiatric diagnoses, but actual ADHD is much more than lack of focus:
* Bad emotional control
* Bad short-term memory
* Difficulty in visualizing multiple possible outcomes of a course of action
* Difficulty in remembering relevant past experiences in the moment
* Difficulty in creating and executing plans
Yup, this is true. My twin brother was diagnosed in childhood - that doesn't make me an expert or anything, but I've been close to someone who exhibited, and continues to exhibit, all of these symptoms.
There's probably a lot more going on in my friends' minds than I'm privy to, especially during the two years we saw very little of each other. I know someone can seem to be thriving and be struggling under the surface. But these were, by and large, not people who visibly struggled with executive function, emotional regulation, or memory in any way in the previous years of our friendship.
You're a twin!?
Yes! He’s a much better person than I am.
Almost all of my friends who work desk jobs have loved WFH (especially if they are able to carve out a separate office space in their home) whereas I, who was diagnosed with ADHD in 2018, have felt like it makes my brain melt. Virtual school made my 6 y/o nephew's ADHD symptoms appreciably worse (and it sucked for his non-ADHD older brother too, but in a different way).
In terms of the anomoly of why so many of your friends have sought a diagnosis recently -- none of my IRL normie friends have been diagnosed with ADHD (other than my one friend suggesting to me recently that she might have it because she's very neat and minimalist), but many people I know through Twitter have been. Maybe it is a social contagion thing, but I think it's a lot more likely that the unfortunate condition of being Very Online is somewhat co-morbid with ADHD. There is also a growing awareness in the last 5ish years about how often presents differently in women (less of the stereotypical hyperactivity, more of the hot mess can't keep your shit together).
Also, a formal diagnosis of ADHD requires you to have presented symptoms prior to the age of 10, and since ADHD drugs are Schedule II, doctors tend to be pretty strict about it.
These are good points. I know that ADHD changes the mental relationship to reward – I have read in the past that with ADHD boys, it’s very common to be obsessed with/hyperfixate on video games, for example, because it’s a constant stream of spontaneous rewards that it’s otherwise difficult for their brains to manufacture. (More or less, I am, again, not a doctor!)
I tend to see some ADHD-like symptoms as being caused by our online ecosystem messing with all of our mental relationships to reward. But it may be that I’m seeing it backwards — maybe people whose mental relationships to reward were already affected by their ADHD are more likely to spend a lot of time in online places that are designed to manufacture those rewards.
I hate WFH. I can definitely say that I have never exhibited any ADHD symptoms in my life – and I was screened as a kid, because my twin had it – but those TikTok lists of “just ADHD things“ perfectly describe my life trying to work from home. 
I've had a similar experience to Sarah re: knowing a shocking number of people who were diagnosed with ADHD in the past two years. These are real life friends and the majority are not extremely online (at least not any more than your average person who scrolls Instagram and Tiktok daily). I was also one of those people so I have n=1 data on how easy it is to get a diagnosis - it's extremely easy. They basically asked me "Have you had trouble concentrating for a long time?" and took my "yes" as gospel without any further questions. It was truly so easy I thought it couldn't be real. I then moved to another state while medicated for ADHD and had an identical experience with a doctor in my new state. Doctors must vary widely in how they treat people who think they have ADHD, because for me it was basically as easy as asking for medication and immediately getting it. I stopped taking it after a year because it dawned on me that I don't actually have ADHD, but that's another story.
Deleting this. Thank you for the kind comments. ❤️
Yeah, it's a challenge sometimes. There isn't enough room in my brain to listen and speak, and its hard to switch between them.
😔
Oddly enough, I wrote a Facebook post last month making almost exactly the same point https://www.facebook.com/samcraft/posts/pfbid033EdB3DzXV35sBMk5bUQyJswMTQ8dnfzM6zYyCsvk7qUBqqgSAw1CXTd9nYCv4D4Tl
I really understand the "letting people down, over and over" part of your post - also actual ADHD person here and this feels like it has been the theme of my life when I am not medicated. It has cost me opportunities, clients, and friendships, etc and SUCKS.
This week I rear-ended someone on the highway because I was daydreaming. No one was injured, but my car is totaled and I'm waiting on the insurance adjuster to let me know how financially fucked I am over the other party's car. #justADHDthings
Two months ago, I was babysitting a friend's car and lost the key. I turned the house upside down, but ended up having to pay $750 for a locksmith to break it open and replace the key for me. I was so ashamed I didn't tell them what had happened until they asked why the new key looked different. #ADHDpride
My best friend, who was diagnosed in childhood, calls it her "lazy inconsiderate bitch disease." I was diagnosed in adulthood, but we have the same experience with it: ruined friendships, financial instability, struggles in the workplace, and most of all, a general feeling of just being a bad, lazy, selfish person who can't do what other people seem to do easily. I understand people who want it to be a cute personality quirk instead of a cluster of socially-stigmatized behaviors that actually hurt us and other people emotionally and financially. It's just that pretending it's a cute personality quirk doesn't make it so.
Solidarity, homie.
This doesn't surprise me slightly. Thanks for the info!
I hope my car insurer never finds out I have lazy inconsiderate bitch disease.
My mechanics are certainly aware of this.
re: mass transit, I loved that aspect of living in northern Europe, taking the train everywhere instead of driving. Of course, doing that successfully requires packing all you need and not forgetting anything (being an hour into a 2 - 3 hour train trip and realizing you forgot your suit jacket at home is the worst), in addition to navigating the train timetable and making it there on time. Nothing easy about traveling when you're ADD!
Still, it was a lot safer, and as everyone else here says cost a lot less given the cost of auto accidents.
I realized I had lost my wallet fifteen minutes before my cab was leaving for a two week trip to LA. The only reason I was able to do much of anything there was that I had a separate drivers license from another time I thought I had lost my wallet. The wallet showed up months later in the pants pocket of a pair of shorts I was wearing when I packed.
I felt like a complete idiot, ashamed and embarrassed by this. My family wasn't going on the trip so at least there was that. Then I realized that - well - there were so many small things like this growing up. And the emotional overwhelm around that, really made me avoid people for a long time. Not so great.
I utterly respect your decision to delete (don't feel bad!), but having gotten here late and always appreciating your contributions, I can't help but feel, based on the responses, that I missed something worthwhile with this one.
Whatever it was, you've got my best wishes.
Aww thanks. I always appreciate your comments too. I wrote about ADHD symptoms that aren't cute--in my case, being very messy and letting people down. I just didn't want the specifics on the internet forever.
Oof, I wrote you a longer response that got eaten. Nevertheless, I have the best of intentions to come back and recreate it later today. Will my brain cooperate? Guess we'll find out! ; )
So, yeah, unsurprisingly, my brain did not, in fact, cooperate. But better late than never, right? I can’t guarantee I won’t end up having the same change of heart you did, in terms of this hanging around on the internet forever, but it’ll exist long enough for you to read it, and that’s good enough. Anyway, it’s mainly just random commiseration…
I come by my ADHD from my dad’s side, and my mom’s side provided the delightful addition of OCD. For me, this manifests as a need for excessive (and idiosyncratically perfectionistic) order and structure in my environment in order to be able to function my best (or hell, even adequately), coupled with a severe deficiency in being able to create or maintain that state of order. It’s a truly spiffy combo.
One of the best things I ever did for myself (and it took a looooong time for me to come around to the idea) was to sign up for routine house cleaning and to work with a personal organizer occasionally. (Insert standard privilege disclaimers and whatnot here.) It utterly transformed my quality of life, and it freed up enough space for me, mentally, that I was able to focus on a lot of important things that had gotten deeply neglected while I was busy bashing myself endlessly against the brick wall of housekeeping. I knew it had been bad for me, but I didn’t realize until then exactly how high a mental load I’d been carrying from just that one area of my life. As accomodations go, it did more to improve my mental health than any medication I’ve ever been on.
That said, in the early days of the pandemic, when everything was still so uncertain, I made the grievous error of suspending the service. Between all the pandemic stresses and the fact that I’d become a new mom for the first time shortly before it all hit, things went downhill rather quickly. Fast-forward to now, and I’m stuck in a perpetual loop of not wanting to bring the cleaners back because I’m too ashamed of all the disorganized junk piles, but I’m also too ashamed of the other mess to bring in an organizer. I’m currently working my way toward doing one or both, but it’s agonizingly slow progress -- just keeping up with regular old entropy is hard enough.
Anyway, there’s not really a point to this, other than solidarity, I guess. Just saying that I get it, that I feel for you, and that it’s not just you. Routine household upkeep is my eternal white whale. FWIW, I’ve found a lot of solace and ideas in the book How to Keep House While Drowning by KC Davis, and also from her website and videos. She puts a lot of emphasis on “care tasks” being functional, not moral. Anyway, you might check it out if the idea resonates.
Whatever the specifics, I hope your struggle eases up soon. And even if it’s a bit rich for me to say so, I hope you know that you don’t deserve to feel shame for this stuff. We just do the best we can.
Thank you so much for your comment. I really appreciate it. I'm in a very similar situation, too ashamed of the mess to get help. I'm starting to get an idea for how I can attack it though, in part because of your comment. If you're comfortable, could you send me an email so I can follow up less publicly? No worries if not! carina.substack@gmail.com
Absolutely! Curious to hear your idea! : )
Another issue here is the way that all this “specialness” actively undermines our sense of solidarity with those around us. Rather than working together to build a platform that supports our common, flawed, humanity and help us all to thrive, there is a generation that thinks the fight to demand a bigger share of (often artificially) scarce resources based on whatever “unique” ailments we can define ourselves by.
Right - the progressive turn away from the universal to the particular has its hands all over this. And it's a problem, for basic organizational issues if nothing else.
There seems to be an odd exception to this though: the universal banner of the 'oppressed'.
I feel like what you say about particular over universal is mostly true with this, especially on a smaller scale. But it seems like there is one large-tent idea that certain progressives all rally behind; which is basically that anyone not cis white male, or in traditional positions of power or authority (historically largely the same thing, but not currently of course), are the 'out-group' antagonists that they can all unify against.
And while overtly excluding a large demographic like white dudes is decidedly non-universal by definition, I think they are simply ignoring that pesky detail by covering it with their own 'universal' descriptor: the historically oppressed people of the world.
In other words, I think they see universal suffering a much more important ideal to rally behind than universal solidarity or truth.
I don't think the "turn away from the universal to the particular" is purely the domain of the progressive. I think it is s a uniquely dominant trait of Americans nurtured on decades of "rugged individualism". The anti-progressive version is group therapy via religious practice with community via in-grouping. The progressive "nons" seek the comfort of the particular as the community
Modernity has caused a fracturing of the common weal into particular common weals each operating as if others don't exist or shouldn't exist.
But I can't say that there's an easy fix to that considering this development has taken several decades to manifest.