This is my favorite essay yet. It made me laugh out loud thinking about someone calling out my uncontrolled behavior at work. I think you are a little hard on parents and kids that use ADHD to get accommodations. Without accommodations some kids couldn’t graduate high school. Smart But Scattered is the best book on the topic that I know. Academically coaching a scattered and gifted kid has been the most difficult project I’ve ever managed. Knowing greatness is possible I’ve set my need for a hug aside and been the bad cop. I’m sad and alone but for my daughter I would do it all over again.
It's one of those things that people ain't understand unless they are the bright but scattered few. Some don't need medication and can cope or compensate really well. For me, it was very apparent I needed some help
I should have been diagnosed in my early teens or pre-teen years. In high school, over 30 years ago, a special superlative in our senior yearbook was given to me: "biggest procrastinator". It was kind of hurtful, but also true. While my grades were exceptional, I often turned work in on the day of assignment, having written it minutes before class started. I have struggled with that, and other traits of ADHD my whole life, until a coworker noticed and asked if I ever had been evaluated. So in my mid-40s, I got evaluated and CLEARLY met the criteria and then some. A whole new world opened for me and it's been amazing ever since I started on focalin. This diagnosis came after my two boys were recommended for diagnosis and treatment by several teachers. They both also CLEARLY have ADHD and function much better with medication and environmental structure. Grades are much better and focus on what's important is much better. They do not take medication over the summer, except for when they might have an athletic or academic "camp", they need to attend. During the summer, their personalities are much the same as when on ADHD meds, but everything about them is messier and less focused. They will go out to play with friends and not come home until well after dark, way past their time to come home. Their rooms are unacceptably messy, rules are not followed, etc All hallmarks of ADHD. We don't medicate these issues in the "off-season", but do discipline them. It can be frustrating but it's necessary to give them breaks. As for me, my work research has picked up, I have published more than ever, and my intraoperative skills are insanely better. Anesthesiologists are multitaskers, and when I'm medicated my focus is laser sharp on what it needs to be. Now, do I see others diagnosed and taking meds that are misdiagnosed? absolutely. But that is between them and their PCP or psychiatrist. My job is to safely get the through surgery. But I notice it.
Great insights. Yours sounds a bit like the context element. Your job and the education system require that focus. But if you were not in that environment, would those tendencies be bad? That's a really weird question to wrangle with. We almost take these careers like we are all the same and interchangeable, but I'm beginning to think we are all wired quite differently.
Thank you so much for this article. I've noticed a trend lately, especially among teenagers, fueled by TikTok culture, of so-called "self-diagnosis." I'm not in any way bashing people who are actually correctly diagnosed with this condition, like my little brother, for example. But the point is that people need to differentiate between a constant behavior and a temporary one.
Right. And it's so far beyond just ADHD. Most other mental health diagnoses have become either a status symbol or an excuse! It's crazy and I hope healthy brains start winning out again.
I've had so many people tell me that I have ADHD and could easily get medication to treat it. I might... I don't care. To your point on hunting... I'm easily the best when it comes to bird hunting and deer hunting when I'm not forced to sit in a blind for hours without moving. I'm awesome at fishing, but can't stand ice fishing. I can't just sit there, like a bump on a log, for hours. Then again, the people I know who do that? I find them boring.
Years ago I saw a documentary about obesity. A medical anthropologist said something that struck me: "Everyone is obese." He explained that the nature long ago selected out humans who could not easily store summer abundance as fat. Therefore we have in our very genes the potential to be obese. It is the world that has changed, not us. Certainly this principle must also apply to ADHD and possibly even to autism.
A hunter-gatherer community needed generalists and specialists, obnoxious warriors need hyper-focused nerds who love making straight arrow shafts, perfect obsidian spear points and knives. It needed quiet girls who made the best leather shoes, woven tunics and tanned hides. It needed nosey aunts and gabby grandmothers for match making and keeping the peace through shame or confrontation. Modernity despises what was once essential in human communities.
It isn't that we don't fit the world, the world doesn't fit US!
ADHD seems to be a huge, raging catchall these days. I blame poorly used technology, people would rather lean on what the “confuser” (my term for computer) tells them over critical thinking.
One huge issue you missed here was the idea that giftedness is often mislabeled as ADHD. The list of “characteristics” of gifted kids and symptoms of ADHD can be similar sometimes. In a nutshell (a very short explanation) the difference between ADHD kids and gifted kids is that the ADHD kid will exhibit symptoms all of the time, the gifted kid, only when he’s bored with what’s going on in the classroom.
There were so many threads I left uncovered. It's become such a nested problem. And yes, gifted kids who are bored certainly look ADHD and so we drug them.... It's such an issue.
Also, do not forget, it was traditionally males diagnosed with ADHD historically. Females often present differently. The diagnosis wasn't very prevalent in my small town, and when it popped up it was absolutely boys who were identified.
"Our schools and corporate structures, modeled after factory workflows, have created a bias against normal, healthy behaviors that have a long evolutionary advantage, pathologizing them into a disorder."
Exactly! Now people have started doing it to themselves too... it helps them excuse their poor self-control rather than having to be responsible for it.
These diagnoses, medications, and hacks, willpower has become the baby that got thrown out of the bathwater. The people I really feel bad for are the ones really suffering from it, because:
(a.) They struggle to get the necessary and correct treatment since research slows down
(b.) Others start trivializing their conditions because of the fake majority.
I was a medical student in my mid-late 30s. There was no illusion that I might have been projecting a diagnosis. I didn't even realize it at the time. It wasn't until I was settled into my career, post-residency that I realized I was still having struggles that could not be explained by boredom, sleep deprivation, rigor of the job, etc.I had a whole other life and career prior to medicine, and it involved working at the therapy level with kids having ADHD. ADHD does exist. It's very over diagnosed, but it does exist.
Of course it exists. However, our current culture not only over diagnoses it but also exacerbates those who have it by levying artificial expectations that we didn’t evolve with.
To be fair, we live in a time where most of what we do and use was developed much faster than evolution would take. Kids are learning things about basic science in medical school that were merely whispers of potential when I was a med student.
However, I am firmly rooted to the belief that science is never settled. What we know about something one day can instantly change with new information. And we should never stop questioning. Kind of like what we were told about Covid "vaccines" vs what they turned out to be - yet TPTB refuse to look at the hard data.
Phenomenal. An absolutely phenomenal piece. To hold the complexities of it all is to sit on the edge of deep discomfort and friction and contextualize and KEEP MOVING. Fellow author John Rosemond like Hannah S does a solid job on this topic too. Thanks so much for writing this, Michael.
This is my favorite essay yet. It made me laugh out loud thinking about someone calling out my uncontrolled behavior at work. I think you are a little hard on parents and kids that use ADHD to get accommodations. Without accommodations some kids couldn’t graduate high school. Smart But Scattered is the best book on the topic that I know. Academically coaching a scattered and gifted kid has been the most difficult project I’ve ever managed. Knowing greatness is possible I’ve set my need for a hug aside and been the bad cop. I’m sad and alone but for my daughter I would do it all over again.
It's one of those things that people ain't understand unless they are the bright but scattered few. Some don't need medication and can cope or compensate really well. For me, it was very apparent I needed some help
I too am balancing gifted and scattered. So many times I just livot the expectations and environment and they suddenly aren't a pain anymore.
I should have been diagnosed in my early teens or pre-teen years. In high school, over 30 years ago, a special superlative in our senior yearbook was given to me: "biggest procrastinator". It was kind of hurtful, but also true. While my grades were exceptional, I often turned work in on the day of assignment, having written it minutes before class started. I have struggled with that, and other traits of ADHD my whole life, until a coworker noticed and asked if I ever had been evaluated. So in my mid-40s, I got evaluated and CLEARLY met the criteria and then some. A whole new world opened for me and it's been amazing ever since I started on focalin. This diagnosis came after my two boys were recommended for diagnosis and treatment by several teachers. They both also CLEARLY have ADHD and function much better with medication and environmental structure. Grades are much better and focus on what's important is much better. They do not take medication over the summer, except for when they might have an athletic or academic "camp", they need to attend. During the summer, their personalities are much the same as when on ADHD meds, but everything about them is messier and less focused. They will go out to play with friends and not come home until well after dark, way past their time to come home. Their rooms are unacceptably messy, rules are not followed, etc All hallmarks of ADHD. We don't medicate these issues in the "off-season", but do discipline them. It can be frustrating but it's necessary to give them breaks. As for me, my work research has picked up, I have published more than ever, and my intraoperative skills are insanely better. Anesthesiologists are multitaskers, and when I'm medicated my focus is laser sharp on what it needs to be. Now, do I see others diagnosed and taking meds that are misdiagnosed? absolutely. But that is between them and their PCP or psychiatrist. My job is to safely get the through surgery. But I notice it.
Your story is my own. I do not take medication for it, but grunt through the anastomosing dead ends and soldier on, breaching the minefield.
Great insights. Yours sounds a bit like the context element. Your job and the education system require that focus. But if you were not in that environment, would those tendencies be bad? That's a really weird question to wrangle with. We almost take these careers like we are all the same and interchangeable, but I'm beginning to think we are all wired quite differently.
Yes, it would. Medicine is my 2nd career.
Thank you so much for this article. I've noticed a trend lately, especially among teenagers, fueled by TikTok culture, of so-called "self-diagnosis." I'm not in any way bashing people who are actually correctly diagnosed with this condition, like my little brother, for example. But the point is that people need to differentiate between a constant behavior and a temporary one.
Right. And it's so far beyond just ADHD. Most other mental health diagnoses have become either a status symbol or an excuse! It's crazy and I hope healthy brains start winning out again.
I've had so many people tell me that I have ADHD and could easily get medication to treat it. I might... I don't care. To your point on hunting... I'm easily the best when it comes to bird hunting and deer hunting when I'm not forced to sit in a blind for hours without moving. I'm awesome at fishing, but can't stand ice fishing. I can't just sit there, like a bump on a log, for hours. Then again, the people I know who do that? I find them boring.
I keep hearing that same story over and over. I’m looking forward to when we can break that paradigm.
I remain scattered, except when I am focused.
Years ago I saw a documentary about obesity. A medical anthropologist said something that struck me: "Everyone is obese." He explained that the nature long ago selected out humans who could not easily store summer abundance as fat. Therefore we have in our very genes the potential to be obese. It is the world that has changed, not us. Certainly this principle must also apply to ADHD and possibly even to autism.
A hunter-gatherer community needed generalists and specialists, obnoxious warriors need hyper-focused nerds who love making straight arrow shafts, perfect obsidian spear points and knives. It needed quiet girls who made the best leather shoes, woven tunics and tanned hides. It needed nosey aunts and gabby grandmothers for match making and keeping the peace through shame or confrontation. Modernity despises what was once essential in human communities.
It isn't that we don't fit the world, the world doesn't fit US!
You nailed it on all levels!
ADHD seems to be a huge, raging catchall these days. I blame poorly used technology, people would rather lean on what the “confuser” (my term for computer) tells them over critical thinking.
One huge issue you missed here was the idea that giftedness is often mislabeled as ADHD. The list of “characteristics” of gifted kids and symptoms of ADHD can be similar sometimes. In a nutshell (a very short explanation) the difference between ADHD kids and gifted kids is that the ADHD kid will exhibit symptoms all of the time, the gifted kid, only when he’s bored with what’s going on in the classroom.
I wrote about the willingness of “professionals” to label my gifted child as ADHD in the 90’s here: https://collettegreystone.substack.com/p/six-homeschooling-is-my-child-gifted
There were so many threads I left uncovered. It's become such a nested problem. And yes, gifted kids who are bored certainly look ADHD and so we drug them.... It's such an issue.
Also, do not forget, it was traditionally males diagnosed with ADHD historically. Females often present differently. The diagnosis wasn't very prevalent in my small town, and when it popped up it was absolutely boys who were identified.
"Our schools and corporate structures, modeled after factory workflows, have created a bias against normal, healthy behaviors that have a long evolutionary advantage, pathologizing them into a disorder."
Exactly! Now people have started doing it to themselves too... it helps them excuse their poor self-control rather than having to be responsible for it.
These diagnoses, medications, and hacks, willpower has become the baby that got thrown out of the bathwater. The people I really feel bad for are the ones really suffering from it, because:
(a.) They struggle to get the necessary and correct treatment since research slows down
(b.) Others start trivializing their conditions because of the fake majority.
I wrote about this too: https://modernsattvik.substack.com/p/do-you-suffer-from-add
Great point. I wish I had read yours earlier because I would have stolen the Medical Student Syndrome concept. That's perfect. Thanks for sharing.
You're welcome Michael... Looking forward to more of your articles too 🙂
I was a medical student in my mid-late 30s. There was no illusion that I might have been projecting a diagnosis. I didn't even realize it at the time. It wasn't until I was settled into my career, post-residency that I realized I was still having struggles that could not be explained by boredom, sleep deprivation, rigor of the job, etc.I had a whole other life and career prior to medicine, and it involved working at the therapy level with kids having ADHD. ADHD does exist. It's very over diagnosed, but it does exist.
Of course it exists. However, our current culture not only over diagnoses it but also exacerbates those who have it by levying artificial expectations that we didn’t evolve with.
To be fair, we live in a time where most of what we do and use was developed much faster than evolution would take. Kids are learning things about basic science in medical school that were merely whispers of potential when I was a med student.
However, I am firmly rooted to the belief that science is never settled. What we know about something one day can instantly change with new information. And we should never stop questioning. Kind of like what we were told about Covid "vaccines" vs what they turned out to be - yet TPTB refuse to look at the hard data.
https://youtu.be/Rys7KDFue5k?si=GXHIE4zqfvLUs05V
Lol. Exactly.
Phenomenal. An absolutely phenomenal piece. To hold the complexities of it all is to sit on the edge of deep discomfort and friction and contextualize and KEEP MOVING. Fellow author John Rosemond like Hannah S does a solid job on this topic too. Thanks so much for writing this, Michael.
Thanks, and fantastic to hear. I’ve been following your work as well and there’s similar ‘scope creep’ in what you write about.