I wasn't sexually abused, I wasn't neglected, I wasn't wanting of love. I was however often scolded to a point where I felt horrible about myself. Scolded to a point where I didn't even feel like I could exist without disrupting the world. At times yes, physically scolded but nothing so extreme as to leave a mark.

To be fair to my parents I was a very high energy and "difficult" child. Big emotions. I was always the problem.

Obviously compared to some upbringings this was a walk in the park. But it really did have an impact on me and who I grew up to be. In some ways it was likely a good impact. I learned that my energy had no place in the world. I learned that my emotions would likely cause more problems than they would solve. I learned to shut up, and sit down, and follow the rules, even when every ounce of my inner being wanted to do the opposite.

I've had a myriad of mental health issues throughout my adult life, ranging from low severity to medium, and on some rare occasions high. Genetics? Upbringing? Modern life? All of the above?

those most affected by executive dysfunction require therapy to be more directive, specific and accountable; that is, processing of past trauma and relational approaches are not sufficient. What often does not seem like trauma therapy at all can lead to great strides forward if it allows individuals to obtain a greater sense of structure and mastery in day-to-day life tasks

I've spent so much time in therapy doing the whole "let's go through your childhood and your past" and it was just not effective in tackling what I really needed. It's remarkable how many licensed therapists just didn't know how to deal with this. I'm sure it's really helpful for some people, but outside of increasing some basic awareness about how my family of origin resulted in present-day behaviors, I definitely reached diminishing returns on that route.

As skeptical as I am of AI as an interventional tool for "reaching our most effective selves", I can't help but feel that if it can be wired up to do the appropriate "micro-interventions" that reflect OP's insight ("directive, specific and accountable ... to obtain a grater sense of structure"), we might see 'ADHD' become a thing of the past (at least for the people that share my phenotype of it). It's my hope at least...

Couple that with just plain generational trauma - physical punishment that ND people are more sensitive to, the high prevalence of CSA, and a world that doesn’t even try to make any accommodations and you find it more rare to find neurodivergent people who are untraumatized.

One result mentioned here but worth highlighting is the capacity to dissociate and the existence of dissociative disorders. Many people in this cohort also find they have the ability to structurally dissociate as a coping mechanism of last resort - an outsized percentage of people diagnosed with OSDD, DID, and DDNOS are neurodivergent, and among social groups of neurodivergent people often dissociative people will tend to attract - it’s nearly to the point that “capacity to dissociate” could itself be a neurotype. Anyway it’s a fascinating line of study, and if I didn’t have folks w dissociative disorders in my life I might doubt their existence.

A diagnosis of ADHD or autism in adulthood often leads to incredible relief and grief in processing all the moments of being blamed and shamed for what was assumed to be a lack of effort, laziness and/or defiance.

This is definitely a factor for me when I tried to get diagnosed (which failed lol), because my parents whom caused my trauma would obviously refuse to blame themselves for my emotionally stunted development

Most people are diagnosed with autism or ADHD because they have problems due to trauma, or they have problems which gave them trauma, or them having these problems made them more sensitive, which in turn traumatised them when it wouldn't have done the same to others. Many of the diagnostic criteria are trauma responses or otherwise external signals which have very little to do with the internal experience of actually having autism or ADHD.

What does a well-developed, untraumatised person with autism or ADHD even look like? We can make some broad statements based on assumptions, but many of those people won't even be diagnosed, since they've never had reason to. What made life work out for them isn't an active area of study, since finding that group of people is close to impossible.

Especially when the trauma involes a caretaker. Parents are like a child's image of god, and for one to turn against the child is devastating.

Any apparent disorder in a person or persons has to be decomposed into the innate parts that existed prior to birth and the environmental experiences that happened afterwards as a prerequisite for any kind of theorising to give useful results instead of noise. They call this the diathesis-stress model and it's easily overlooked.

There's been a definite push with this stuff to attempt to reframe adhd as something that doesn't need medical intervention - however research shows that the best treatment are the recommended drugs, such as ritalin, dexamphetamine, atomoxetine, and guanfacine.

Definite pattern around minimising adhd and autism, not sure what the end game is.

There is no way anyone can tell me there is not a large genetic risk factor in developing ADHD and autism. Because I see it in the genetics of people who have ADHD and autism. The most frequent polymorphisms I found in ADHD belong in a gene called DDC or dopamine decarboxylase.

Does trauma play a role? Probably. But genetics amplifies the risk that trauma will initiate these disorders..

I have schizoaffective disorder, bipolar type and OCD and I see those in my genetics as well. And my childhood was traumatic as all get out. But that’s also because my disorder is genetic, and my mother and brothers were also mentally ill.

It’s not nature or nurture, it is always nature and nurture.

Any mental issue, symptom or disease lie on a spectrum, in terms of quality and severity. Psychiatric diagnoses are overlapping in more than 50% often making a single diagnosis incomplete.

My kid has some form of behavioral disorder but it doesn't really check all the boxes of any known condition. He doesn't have attention problems. He's very active, but not unmanageable. I don't think he's autistic, though he's socially awkward. He's very defiant with adults, so OCD does match (though that doesn't help much). Definitely very low self-esteem and all that. Mostly he's aggressive, low patience, disobedient AF, requires a ton of attention.

A particularly telling thing is that when we take long drives we often listen to children stories. He can listen for them for hours no problem. But when a story stops and until another one starts, he gets really nervous, makes a bunch of noise, annoys his brother, like he can't be canalised if he's not focused.

But what strikes me is that he seems to have a bunch of other conditions that doctors dismiss as benign. He has low teeth mineralization, often small skin bumps around his joints. He has a geographic tongue. He had digestive track pain when he was smaller. He had discoloration on his cheeks. He is quite skinny while he eats normally.

ChatGPT told us he could have coeliac, but we blood tested for coeliac and it came back negative. We tried a gluten free diet for a bit anyway, and that didn't seem to change anything at all.

We're like very puzzled. It's pretty clear that a psy test will find something behavioral, but no one is going to look at any kind of mineral deficiency, or anyhting like that.

Posting this here, Idk why, I'm kind of clueless about what to do at this stage.

UK, EU, America has different societal values. I never had an issue with ADHD growing up in Asia. Nobody friggin cares. It's only western people making a huge deal outta nothing.

I consider my ADHD as a weapon because I can take it down a notch with medicine when I need to focus, but for other things like gaming, I can use my aDHD for better perf.

Shit's nothing.

Assuming ADHD is to some extent a chemical thing (I.e. brain didn’t properly develop impulse control or attention span or whatever), we now live in a world that enables those exact things.

If you lived in a world where the principal media were written articles/books and long-form TV shows/movies, your brain was still trained to focus.

Most media is now basically an ADHD simulator, with constant context switching, intense stimuli etc. which only reinforces whatever ADHD traits one may have.

I would guess it’s somewhat similar to the interaction between smoking and asthma.

Although diagnosis relies on observations made while patients are awake, the prevalence of sleep disturbances in individuals with ADHD is reported to be in the range 25–55 % (Corkum et al. 1998; Hodgkins et al. 2013; Owens 2005; Sung et al. 2008). In a recent Australian study, 62 % of children with ADHD had moderate or severe sleep problems and 22 % took sleep medications during the 1-week observation period (Efron et al. 2014). Indeed, high nocturnal activity and disordered sleep were defining characteristics of ‘hyperkinetic reaction in childhood’ or ‘attention deficit disorder’ in earlier versions of the DSM (American Psychiatric Association 1980; Barkley 1990; Sadeh et al. 2006; Spruyt and Gozal 2011).

My hot take is that *a ton* of ADHD cases is primarily lack of restorative sleep due to sleep disordered breathing, that is suffocating in sleep. Brain does not enjoy suffocating so people tend to wake up. Every couple minutes. Whole night. Without actually being aware that they do. They feel tired and brain fogged, lose concentration easily, have poor impulse control and so on. Even "mildly" disordered breathing in sleep causes frequent microarousals that fragment sleep and basically obliterate its restorative quality.

But I've found this particular new-ish lens extremely illuminating, and it hasn't yet entered common parlance, so I post here in the hopes its helpful for others. After many years of hearing "tropes" from all 3 categories and having them only ~kinda feel like they fit, this was the one that made my jaw hit the ground and go holy shit, this is me, this is the thing that, if you understood it about it me, makes all the convoluted fuckery in my life click elegantly into place:

*Pathological Demand Avoidance*, or the more modern "friendlier" backronym, *Persistent Drive for Autonomy*.

Both are accurate, I find the former more accurate, if notably "harsher". But that's just my flavor of inner voice (how apt, for this topic).

Here are some random links I only skimmed, you can find sources that resonate with you in particular.

https://childmind.org/article/pathological-demand-avoidance-...

https://pmc.ncbi.nlm.nih.gov/articles/PMC4820467/

One example of a way this manifests in me personally, and how it relates to the intersection of the 3 things in the title:

I was massively stressed by a partner's attempts to get me to do things like clean out the garage, etc. I'd catastrophisize about the amount of time it would take, and spend the entire time in a sour mood, squirming for ways to get out of it. What ended up helping a great deal was explicitly setting time boxes at the outset, such as we will spend exactly three hours on this and stop at the three hour mark no matter what. Being able to "see the exit" in advance (and trust that it would be honored) pretty much completely resolved the issues.

* It has hints of helplessness/trappedness/persecution avoidance that feel like they could relate to growing up trapped in a house with a violently abusive father.

* It has high seeking for routine, predictability, and certainty that feel like they could be autism-coded.

* The "this genuinely feels in my body like the task will be forever" has time blindness, task-abandonment and followthrough issues that present like ADHD.

What is the actual balance of those 3 things in contributing? IDK, and it's probably different in various situations.

But for me, the PDA angle fits like a glove, and was the first mental model that succinctly encapsulated what it actually felt like in my head.

This rise in interest and, at times, conviction, is challenging clinicians and resources.

There you go. Seems like the academics are either pressured to gaslight people managing ADHD and autism or jump on bandwagon hoping a department notices and perhaps provide funding or other jolly.

They should get fucked with this harmful "research".

A diagnosis of ADHD or autism in adulthood often leads to incredible relief and grief in processing all the moments of being blamed and shamed for what was assumed to be a lack of effort, laziness and/or defiance.

I never understood this sentiment. It's just who I am and always have been. And I learned to deal with the circumstances. I don't understand why it makes people feel better to have a diagnosis they can blame.

Perhaps it's a generational thing? I know as a manager it's pretty common for reports to cite them having ADHD as why they can't do this or that. Meanwhile I mentally roll my eyes thinking, "no shit, me too, but I manage to get this done"

The increased awareness genuinely helps to many others. I suspect there's widespread denial do be untangled, too.