As a kid in elementary school, I was diagnosed with ADHD. I think the diagnostic process is dumb and unreliable, and so the fact that I was diagnosed seems like it should only count as weak evidence. But knowing what I know about myself and having read a few books about ADHD, my best guess is that I have (and had) a moderate case of it.

I've never taken medication for it though. Why? Well, from my perspective, there has never been anything wrong with me. There's something wrong with The System. Fight the power!

For example, I'd be in school and the teacher would want me to pay attention to X. But instead of X, I'd want to think about Y. It's hard for me to focus on X when I am driven to think about Y.^[1]

Is this a bad thing? Well, it depends on the values of X and Y. Sometimes X and Y take values that make it good, other times they take values that make it bad.

• For example, when I'm behind the wheel of a car and X = "the stoplight in front of me" and Y = "that new Indian restaurant", it is bad.^[2]
• But when X = "Bobby's question about last night's algebra homework" and Y = "the flip book I'm working on", I'd argue that my "attention deficit" is good.
• Overall, I have always thought that my "attention deficit" does significantly more good than harm.

For this reason, I never wanted to take medication for ADHD. I thought that I was generally prone to paying attention to the "right" things, that the adults generally wanted me to pay attention to the "wrong" things, and that this was a problem with the world they were trying to get me to live in, not with my nature.

But the doctors and my parents had a totally different perspective. They thought my tendencies and behavior were in fact problematic. However:

1. Academically, I did pretty well in school.
2. Behaviorally, I was mischievous, but always in a harmless type of way.^[3]
3. I had this involuntary facial tick^[4] and apparently there is a risk that the medication would cause me to develop (much?) worse ticks.

For these reasons, they thought it was fine for me to avoid medication.

As a kid it was the doctors and my parents who were ultimately in charge of whether or not I took medication. Maybe if I argued that I wanted medication they would be receptive, but probably not. However, as an adult, it becomes my decision. So once I went away to college, I could have just gone to a neurologist or whatever and re-explored this decision to avoid medication.

I never did that though. Why? Cached thoughts.

I like who I am. My so called "attention deficit" is actually a good thing overall because it allows me to hyperfocus on the things that interest me, which is really valuable. Yes, sometimes this ends up biting me, but the bites aren't too frequent, nor are they too harsh.

When the topic of my ADHD came up, the above thought is what I would immediately gravitate towards. It's not as black-and-white as "it's the only thought I would ever think", but I gravitated towards it pretty strongly.

But over the past few weeks I've been starting to question how accurate that cached thought is.

I have pretty high levels of anxiety^[5] in general for various reasons, and I've been looking for ways to mitigate it. One cause of this anxiety is that I always have a million things I want to do. Things that are interesting and deserving of my attention. But I don't have time to do them all, of course.

And a related problem is that if I'm focused on something and need to stop, it feels like pulling teeth. For example, I started writing this post at a coffee shop, but at 3pm when they closed I had to stop what I was doing, close my laptop, and spend 20 minutes walking home. That was very uncomfortable.

But this sort of thing happens all the time. When I'm working and it's time to eat. When I'm coding and I have to go walk my dog. When I'm reading and it's time for me to go to racquetball. When I'm thinking and it's time for me to go to sleep.

Right now, I lean towards thinking that my ADHD does more harm than good and that I should take medication. But this line of thinking is also problematic. Why? Because there's an implicit and false dichotomy. It fails to seek out a Third Alternative. From the post:

“Believing in Santa Claus gives children a sense of wonder and encourages them to behave well in hope of receiving presents. If Santa-belief is destroyed by truth, the children will lose their sense of wonder and stop behaving nicely. Therefore, even though Santa-belief is false-to-fact, it is a Noble Lie whose net benefit should be preserved for utilitarian reasons.”

Classically, this is known as a false dilemma, the fallacy of the excluded middle, or the package-deal fallacy. Even if we accept the underlying factual and moral premises of the above argument, it does not carry through. Even supposing that the Santa policy (encourage children to believe in Santa Claus) is better than the null policy (do nothing), it does not follow that Santa-ism is the best of all possible alternatives. Other policies could also supply children with a sense of wonder, such as taking them to watch a Space Shuttle launch or supplying them with science fiction novels. Likewise, offering children bribes for good behavior encourages the children to behave well only when adults are watching, while praise without bribes leads to unconditional good behavior.

Noble Lies are generally package-deal fallacies; and the response to a package-deal fallacy is that if we really need the supposed gain, we can construct a Third Alternative for getting it.

What Third Alternative do I have? Well, how about just taking the medication as an experiment?

I realize that I (as well as my parents and the doctors^[6]) have been approaching the question as if I am either going to 1) be a person who doesn't take medication or 2) be a person who does take medication. But option #3 is much better: take medication for six weeks and see what happens.

It reminds me of the thing^[7] where thousands of years ago, philosophers thought that it was noble to sit inside and use your mind to figure things out, and that going out to look at the world to see what happens... well... that's ignoble. A job to be done by a man of much lower social status.

For my ADHD stuff, I've been acting like one of those old philosophers. Instead of just trying the damn thing, I've been straining to predict whether or not the thing will do more harm than good.

But that sort of "straining to predict" is dumb. I mean, again, why not just try the damn thing? Why predict when you can test?^[8]

• Well, sometimes the test is costly. Like, an MRI, perhaps. But ADHD medication is not expensive.
• Other times the test will have long-term, or even permanent effects. With the ADHD, I think there's always been a deep part of my mind that was afraid of this. I don't want the medication to "change me". In doing some research, this seems quite unlikely though. There's still some emotional part of me that is a little afraid of it "changing me", but it's not too loud.
• Sometimes the test is painful. Like one of those biopsies where they stab you with a big needle. That's not the case here though.
• Sometimes you're confident enough in the outcome that you don't need to bother testing. But again, that's not the case here.

I'm sure one can have a long discussion about the abstract question of when it makes sense to test and when it makes sense to avoid testing things. I'm not interested in doing that though. I think that for the purposes of this post, it's enough to say that when tests are cheap, painless, and don't have long-term effects, the bar is low and they're generally a pretty appealing Third Alternative.^[9]

1. ^{^}

   Note that this is not a deficit of attention. It is a difficulty controlling where attention is allocated.

   I've always really liked the spotlight metaphor for attention. With this metaphor, the spotlight is not dimmed. It's just more focused and harder to move.

2. ^{^}

   Which is one of the reasons why I don't drive.

3. ^{^}

   For example, I had this teacher for a class called "Research" or something. I thought the things he taught us were incredibly dumb. One thing I remember is how he spent a lot of time emphasizing how you have to underline some things in one color and other things in another color. As opposed to, y'know, the actually important principles of scientific research, a la Richard Feynman.

   So I played a bunch of pranks. One time I put a piece of scotch tape under the computer mouse to interfere with the laser motion detector thing. Another time I broke off a piece of my lead pencil's tip in the door's lock so that it couldn't be opened.

4. ^{^}

   I would lightly bite the inside of my left cheek in a way that caused my face to scrunch up a bit. It always seemed incredibly minor to me, but moderate to my parents and the doctors. I don't really remember the kids in school ever teasing me about it, or even pointing it out.

5. ^{^}

   That's not really the best word, but I'm not sure what a better word would be. 

6. ^{^}

   faithInTheMedicalSystem--

7. ^{^}

   Actually, I'm not sure how true this is. I remember hearing something along these lines, but I may be misremembering and/or straw-manning. I think what I'm remembering is something related to the philosophy of rationalism and how it stands in contrast to the philosophy of empiricism.

8. ^{^}

   I really like how chapter 1 of HPMoR explores this. Maybe Eliezer decided to discuss empiricism in the first chapter because empiricism is so foundational to rationality.

9. ^{^}

   Luck Based Medicine is probably relevant. Even if various treatments are non-standard and uncommon, who knows, maybe they'll work for you. If it's cheap to try, why not give it a shot?