Thoughts on ADHD

by romeostevensit2 min read7th Oct 202015 comments

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A few different things that have occurred while investigating. It seems weird to me there are lots of posts about akrasia and productivity but not adhd.

1. High Rejection Sensitivity makes my attention in general more flinchy. Rather than just explicit rejection, you can think of this as a high sensitivity to negative feelings in general with rejection just being of extra highlight. This becomes a bit of a closed loop if I'm avoid noticing how flinchy my attention is because that would also imply unpleasant things.

2. Imbalanced novelty seeking dovetails really nicely with 1 because it gives me more buckets to run to. Find something I don't like in one tab? There is another tab a muscle memory shortcut away. It also encourages multitasking in the sense of listening to music or eating at the same time as I do other things. Novelty feels somewhat additive, so that 3 minor novelties can combine to make me feel 'stimulated enough.' In the same way that insulin insensitivity is a problem this feels a bit like a sort of dopamine insensitivity (probably not literally literally since dopamine doesn't work the way the folk version of it does). When I'm not stimulated enough I'm more likely to notice unwanted stimuli. Novelty, or surprise, is 'spiky' (activating, pulling of attention) enough to keep attention away from the unpleasant.

3. Higher than average branch factor + completionism = bad combo. By branch factor I mean the average number of thoughts activated by each thought. When this is less than 1 I tend towards idle relaxation, between 1 and 2 and I have a coherent chain + the ability to analyze a few possible alternatives. 3+ and I'm a bit all over the place. This isn't so bad if/when my pruning heuristic scales with the branching, but if it doesn't I'm in for a bad time. Thoughts tend to just expand without healthy cycles of contraction until they become unwieldy for working memory, at which point novelty seeking becomes a nice relief, at which point I lose most of my cache and am back to square one the next time I go to load the problem. But the next time I go to load the problem I run into exactly the same issue but now even worse because reloading the cache doesn't have any novelty to make it fun. So now the task feels really big and boring. And I don't have a strong sense of why I failed last time, so attention remains diffuse etc. This also results in avoidance of needing to keep cache, which makes it harder to break tasks into chunks with reasonable save points, which means both that activation cost is higher and that I'm likely to avoid starting them unless I can dedicate a big chunk of time.

4. The tendency to go up the ladder of abstraction rather than down. This post being a good example....Extracting universal principles feels more productive than doing the local optimization. But this becomes incorrect under marginal analysis even if it is true in general. Going up the ladder of abstraction is a way of dealing with too many branches on the object level, but often throws out getting the actual task done.

5. Mimesis. Spending too much time with others with adhd.

6. Lack of a directly responsible self. If you repeatedly had meetings at work where a particular chunk of work was brought up and the manager just said, yeah this needs to get done followed by moving on to another topic and the work never got done, you'd have a pretty good idea why this wasn't a workable strategy. Yet when this happens internally we don't bat an eyelash. Which self will actually do the work? Because it won't be the planning and virtue signaling PR self.

7. lack of a felt sense of progress and not knowing how to generate that for oneself. Having been spoon fed too many 'felt sense of progress' superstimuli in the form of video games and escapist fiction and completionism on link aggregators that I can pretend are educational. These compete with the nebulous and self defined and enforced felt sense of progress from my own tasks.

8. Excess sensitivity to wait times. Ignoring/glossing over things with only marginally longer wait times to start, even if they are significantly better once started.

9. excessive ambiguity aversion, especially in the face of decisions with negative tradeoffs. Might imply that positive reframes are more important for adhd than for others.

10. In practice it feels like conscientiousness is the ability to generate a sub-system and then have other parts agree to subordinate their goals to it in some space-time-ritual bound way. It feels like time related cognition is the mechanism by which this coordination happens. Therefore, linked to the time dysregulation that is commonly associated with other adhd symptoms.

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Hi,

As a newcomer to this site, I'm still feeling my way around. But, for a bit of information, my background is in Psychology and Social Research (postgraduate level), as well as having worked in mental health services. My interests centre around a fascination concerning human development, neurodiversity, construction of identity, as well as race, gender, and suchlike.

Found this post on ADHD, read it, and my interest was piqued. Just adding some thoughts/observations (whether they will be helpful, or not, I cannot say)...

With respect to things like ADHD, I find it hard to understand why they are societally so problematized, if we are to accept that humans are a neuro-diverse species. In reality, no two human brains will function exactly alike, because being products of nature-nurture, our neural pathways develop as a reflection of both our innate traits, and of our external environment. What our innate traits are, it is hard to say, because from the very moment of birth, an infant is interactive (i.e. its nature immediately starts to interact with its nurture). Given that diverse humans have very diverse life experiences, it may be expected that neurologically, they will develop in different ways - be that subtly, or highly overtly. 

Now, I don't know whether any of you have read theories about so-called "Dandelion Children And Orchid Children", or theories concerning what are considered to be "Highly Sensitive People". It would appear that those with ADHD have some of the traits of both "Orchid Children", and of HSPs (highly sensitive people). Dandelion versus orchid is a theory that proposes that some children are of a nature that is placid, requires little stimulus, is not highly-excitable, is not energetic, is not very questioning or challenging, and ends to thrive in situations where there is minimal input from parents and caregivers, whilst thriving no better in situations where a lot of input and stimulus is given (Dandelions). Such children are often easy-going, but are rarely gifted and talented, or high achievers. Bu contrast Orchids can be hugely temperamental, very sensitive to all stimuli and thus requiring careful management of them, are excitable, passionate, energetic, question and challenge a lot, have a thirst for knowledge, and only tend to thrive in those situations where they get optimal parental/caregiver input. Where this occurs, they may be very gifted individuals, with a propensity for high achievement - BUT, the circumstances have to be ideal for them to flourish. If they are in less than ideal circumstances, they really struggle because of their sensitivity, passion, energetic and questioning natures, and their need for carefully-regulated stimulus. All of these, individually and in combination, are likely to lead the Orchid into trouble, should they not be recognized for what they are, and understood by others around them (especially adult caregivers and role-models). For instance, the questioning and challenging nature can be interpreted by some adults as rude or confrontational. The energetic, passionate nature can be misunderstood as restless and demanding. The need for carefully-regulated stimuli, ditto. But, in the right environment, these same traits become gifts, where a child can be encouraged to channel them towards a high level of learning and achievement.

HSPs, too, have traits that in the wrong circumstances, can create havoc for them. They are much akin to Orchid people, in that they are very sensitive to stimuli of all kinds (perhaps overly so) and thus need stimuli to be carefully regulated. HSPs can be easily distracted in the presence of multiple stimuli - for example, if they have to focus on doing something like reading a book in a noisy, crowded atmosphere, they may find the noise and/or crowds distracting and find it hard to concentrate on the book. But if left peacefully to read, they are the sort of people who will gain a more in-depth understanding of the literature they are reading because their interest level in it is greater than for most people, and also they interrogate the subject-matter more rigorously. HSPs are sensitive to human emotions, also. They are very attuned to what others are thinking and feeling, and can easily suffer from "emotional contagion" (being overwhelmed by other people's emotions), or worry a lot about what others are thinking/feeling.

Might it be that ADHD is something akin to the traits of an HSP or an Orchid, but viewed within the wrong environmental or circumstantial context? So, the person with ADHD, as noted, has an interest in novel experiences, has a high sensitivity to stimuli, can be very energetic... but, because those who are around them view such traits in a negative context, the person with ADHD is slowly conditioned to view them as negative too? Look at it this way...

For example, imagine that a kid in high school is very energetic, has a thirst for novel knowledge, likes to ask lots of questions (both because this is a factor of how they learn, and also because it reflects the high level of stimulus they require either because of their deep interest in a topic, or, conversely, because it helps keep them interested in a topic), and sometimes asks what adults (including parents and teachers) might consider to be difficult or challenging questions. It is likely that some (perhaps many) people might view this child as somewhat annoying, challenging, maybe even disruptive in a classroom situation because the child places a lot of demand on the adults' attention, requires considerable one-on-one time, and also asks things that the adult may find it difficult to answer and explain. But, in the optimal setting, with an intelligent adult who has time to give to the child one-on-one, and who is happy to answer lots of questions (even ones that others may dismiss as silly or challenging), the same child might be less disruptive and annoying - might even thrive and be highly capable.

It is hard when somewhat perjorative labels (including, perhaps, ADHD) come to be attached to individuals because our human society cannot actually cope with what it means to truly accept and embrace neurodiversity. I have no idea if I am ADHD myself, as I have never been tested, though I definitely have some traits that are similar (as well as very similar to Orchids and to HSPs). I have definitely had negative experiences in life when people do not understand my sensitivity to stimuli, my sensitivity to other people's feelings and emotions, my need to ask questions, my desire to immerse myself to what some people consider an extreme degree in academic and other topics that fascinate me, and my ability to multi-task and also to think about multiple topics simultaneously. I tend to find that I am treated by many as somewhat of an outsider, an oddity or curio. Yet I also found that my traits lead to academic success, and to a considerable deal more learning as an autodidact. Result being, I am currently in the process of completing my first novel, and am also writing a factual book on hegemonic masculinity! 

I think, maybe, that a part of anyone's being human is the necessity to learn to understand oneself in a very frank and honest way. To evaluate oneself, strengths and weaknesses. To comprehend what ones traits are. And, then, to find some direction in life that affords these optimal expression. That affords optimal meaning in terms of who we see ourselves to be. To find a purpose that gives our strengths and traits meaning, and which allows us to use them to best effect. This is not easy, and nor can it be done immediately. I would argue it is a lifelong process. Sometimes, the best we can hope for is an approximation of it that allows us to feel partly fulfilled whilst simultaneously giving us the impetus we need to improve upon matters yet again.

"To know thyself" - perhaps that is the important starting position?

The split there might be related to the valence-arousal correlation. Around 30% of the population has a positive correlation between valence and arousal (high energy situations such as loud music and crowds are seen as positive), 30% have a negative correlation (calm relaxing situations are seen as positive) and 40% are ambi, can go either way.

I recognize myself very much in the dandelion child description; makes me feel slightly better about not being gifted or a high achiever :)

I've never been evaluated for ADHD (or seriously considered it) but some of these -- especially 2, 3, 6, 7, 9 -- feel very familiar to me.

My list is a bit different, but yeah, noticed a lot of overlap in a few things that feel familiar to me either now or from my past, but no one has ever suspected me of having ADHD, presumably because I get lots of stuff done. Does make me suspect ADHD is made up of a cluster of behaviors that are common and we only consider it ADHD when a bunch of them are present, rather than something with a single causal mechanism. Maybe this is already what people think about ADHD; I've not learned about it much as it hasn't seemed personally relevant to me.

There is a known physiological cause, though. A 30% smaller brain volume/developmen than appropriate for your age in five distinct brain regions.
There's also consideration of splitting apart SCT and ADHD. And of course, there's common comorbidities.
And personally I believe, ADHD genes are just executing a high-variance strategy. [as being mildly brain-damaged leads to interesting neurological adaptations and tradeoffs]

source:
https://www.youtube.com/watch?v=G2u8E5UqEHU&list=PLLZlFL4q6WTGKUsTMdHQ4l4Gu01lqEy8g&index=23 

By your description, that sounds exactly like multiple causes coming together to produce a disorder where less than all of nearly all of those causes would not be a disorder, even if they causes some difficulties.

[epsitemic status: mainly paraphrasing what Dr. Barkley is saying in those videos (worth watching!), maybe look deeper into the research for the claims he makes for a better/more precise understanding of the science, but that's above my paygrade/interests]

No, from my understanding, ADHD is a single trait, that specifically affects those five affected brain regions, predictably leading to specific deficits in executive function. 
those are:
Right Frontal Lobe (Orbital Prefrontal Cortex) 
Basal Ganglia (Mainly Striatum and Globus Pallidum) 
Cerebellum (central vermis area, more on right side) 
Anterior Cingulate 
Cortex Corpus Callosum (Primary Anterior Splenium)

And ADHD is also shown to be hereditary.
So ADHD is best understood as an alternative neurological phenotype, given the prevalence, not an uncommon one.
[Barkley doesn't put it like that, but that part is just semantics]

You can't spot the difference in an individual, because there's too much variance in how brains usually look like/different areas are sized, but this "five affected brain regions"-pattern becomes apparent, when they looked at scans of a lot of people having the ADHD diagnosis and people who don't have it.

You can focus on the "disorder"-part of the word, but whether it gets in your way enough to be diagnosed and called a disorder, strongly depends on your coping skills, your environment and also your goals.
For example, if your life is about being an idle rich person, who surfs on the beach and lazes around all day, there's no need to get you on Ritallin.

But put someone in a school setting or work place where they must pay attention, they'll have difficulty meeting expectations in a very predictable manner.

And also there's presumably a second disorder called SCT, which is posited as being a second "Execuitve Disorder"-disfunciton, where people are slow and very dreamy.
And that can appear with, but also independent of ADHD (and ADHD doesn't have to include SCT).
But also also, people don't like SCT, because try diagnosing someone's kid with "Sluggish Cognitive Tempo"-disorder without calling them stupid. 
[ADHD doesn't have a correlation to IQ, SCT I'm not sure..... also those labels are somewhat controversial and not everyone will use the same methodology, cause psychiatry is a sprawl]

And having ADHD increases risk of having other mental disorders, but this can partly be blamed on failing so hard, because you have ADHD. 
[a life of constant failure isn't great for the psyche and all that, but maybe it's the different neurology too]

 

EDIT:
Also apparently 1/3 of ADHD cases happen because of a neuro strep-infection causing an autoimmune reaction that destroys those parts, during pregnancy. If that's the case, there's a high likelihood of seizures, too. Those acquired cases seem to also be lumped together. Won't claim I fully understand, if/why that makes sense.

Okay, yes, as explained then that does seem to point in the direction of a single causal mechanism rather than a collection of symptoms that across some threshold add up to ADHD.

wonderful resource! thanks for the link, it gives me some additional rabbit holes to investigate.

Agreed, there is no "decision theory/rationality under ADHD coherence constraints". There should be, though. 
In a sense, you learn to make it up for yourself, as you go along.

11.
You can mentally construct chains of necessary actions quickly and get a feeling of pleasurable productivity from doing so. It's not much trouble to folow the association chains, circle back to the problem and even have a very thorough plan!

However, then executing that plan is boring, so it won't get done.

12.
Extreme variance in motivation during the day; motivation is dependent on stimulant use and hidden, difficult to manage variables like "dopamine availability".
When you don't have it, you're also not motivated to deal with it.

13. [your 1, I think]
Dazed, low consciousness states where nothing gets done and you mindlessly follow the dopamine gradient. The so called "hyperfocus". [watching YouTube/playing video games/online chat/commenting on LessWrong...... damnit!]
Pretty sure, you could actually see less areas lighting up when neuroimaging.
Rejection-sensitivity? Not sure what it has to do with rejection. It's just that what I find important when I'm properly "with it" will not occur to me. Even if it does, it won't seem "plausible/meaningful" and be crowded out by stronger associations.

It's not so much that the utility function changes, but more like your utility function not being loaded, leaving you in a default, feral state. 
There might be vague awareness of this not being right at times, but there's no surefire way of fully waking up. Taking more stimulants might help, but can also fuel a more fun, extended "hyperfocus"-episode.

 

14.
Trouble is, you often can make plans just fine, but you might as well not bother, since you won't be able to know if/when you're going to be properly "awake" to execute them.

15.

Computer use is absolutelly necessary, but also extremely risky.

16.

Load times of a couple seconds or less are often enough to lead you to do another more engaging thing to do on the computer. Software and webpages satisfice hard for "acceptable speed", that can easily break your flow and disrupt concentration.

--

Not that those things are insurmountable. They are just very difficult, because you have to guard and manage your consciousness state from constant memetic threats trying to grab your extension. Internal (earworms, intrusive memories from TV shows, daydreaming, thinking thru random problems) and external (the internet, recommendations).
The digital world is actively hostile to an ADHDers coherence and there's no best practices for guarding against it yet.
I'm working on it, though.

High Rejection Sensitivity makes my attention in general more flinchy. Rather than just explicit rejection, you can think of this as a high sensitivity to negative feelings in general


Good point. Do you or does anyone else have any insight into why these tendencies might be more prevalent with ADHD? 

Some ideas:

? More getting into trouble and more failure and underperforming leads to more negative experiences involving condemnation and judgement.

? Reduced inability to self-sooth and in general to manage emotions leads to equivalent incidents being felt more keenly.

Both of those seem true. There's also the thing where the time dysregulation means now often feels like forever.

Have you seen this SSC posts which posits that rejection sensitivity is a result of being diagnosed with anything, and not a symptom of ADHD?

https://slatestarcodex.com/2018/08/14/ssc-survey-results-adhd-and-rejection-sensitivity/

ah, missed that one. Thanks!

A nice one from the comments:

"Those who are permanently ill, long term, — if they don’t want to succumb to neuroticism — are forced to discover and embrace their lives outside the mainstream narratives." -JKPaw