ADHD and monotropism (2023)

> People always describe the disorder as "lack of focus" but that's a really poor description for what I have.

The diagnosis, for me, became obvious when I reframed it from "lack of focus" to "poor control over what I focus on".

> I would say I have "hyper focus", to the point where if I'm working on something interesting, I will lose track of time and am unable to redirect my attention to anything else.

I feel like knowing this tendency has made me extremely protective and avoidant of taking on tasks. I appear “lazy” to the outside observer. It’s something I’m still trying to solve.

>often a new idea will strike me like an epiphany that immediately takes the top spot of my attention.

So, lack of focus, then? Lack of focus after all is not the same as inability to focus in general.

It's more the inability to focus on what matters, without getting distracted and focusing on another thing.

Same here. People sometimes say my stuff is over engineered. What they're seeing is that I have additional requirements relate to keeping the project in a shape where I stay interested in it long enough to make progress.

Its not exactly a recipe for reliable technology but neither is what the managers are suggesting (or rather, suggesting differently today than they did yesterday) so I manage to make it work out OK most of the time.

This used to upset me, but as time goes on I'm more excited about it. Sometimes I run into someone else that only does that one or two things. They are happy they finished them, etc., but they seem envious of being able to do lots of things even if they don't end up mattering.

There are different types and combinations of ADD/ADHD/Autism/Parkinson’s/etc.

The closest to reality anyone tried to describe are Dr. Amen’s ADHD “types” and regions of the brain related to attention-deficit symptoms. But it’s much more complex. E.g. when you don’t process Folic Acid due to MTHFR mutations, chemicals can be generated that cause other genetic mutations in the brain over time, causing psychosis. And some stimulants with likely undiagnosed predisposition of paranoia can cause schizophrenic-like symptoms for years. If you just take what a psychiatrist or even the supplements that Dr. Amen would suggest, it may be a miracle for some people, but for others that miracle may turn into a nightmare. I didn’t recognize that I was having hallucinations and paranoia until years later.

I’ve found a set of things that I eat and natural supplements that work for me, and it took years of struggle. I miss the meds, but they didn’t make me better, they almost ruined my life.

Well, it's well known that ADD/ADHD aren't about lack of focus, but about an inability to direct one's focus to where it's needed.

Normal people can think "I need X, let's work on X" but ADHD people are at the mercy of what's "chosen for them" by their brain.

This was probably fine 4000 years ago, when the world was looser, and people could find their place in life regardless of their particular quirks, but not so much nowadays.

This difficulty or inability to direct focus can be "trained away" with enough effort, but it isn't easy at all.

I feel like that’s a different type of ADD or something. My wife has that type, so if she’s on her phone or focused on something I almost have to shake her to get her attention, whereas I’m very much the opposite (hard to focus on anything). Makes it hard to watch a series together bc she always wants to binge the whole thing in one sitting and I can never watch more than two episodes at a time.

What kind of work accomodations have you seen that work/help for people with autism or ADHD?

how often do you encounter screen addiction nowadays? (phone or pc overuse)

I think this is partly right, partly misguided.

Misguided: there's now a focus on causality and precise identification based on symptoms and negative impact caused that wasn't present in the days of exorcisms and shamanism. Those eras were primarily characterized by people in positions of (often corrupt or unqualified) authority declaring diagnoses for others, largely without the consent of the diagnosed. Now, the default mode of mental health treatment is now focused on identifying symptoms according to specific rubrics, and diagnosing (or not) based on the presence of those rather than the agenda, religious feelings, or whims of people in positions of authority.

Partly right: what I described above is the default or desired diagnostic approach. We have a long way to go before it's actually performed for everyone. Coercive diagnoses are not uncommon even under modern medical/diagnostic practices: parents seek out spectrum or ADHD diagnoses for kids who aren't suffering, just not meeting parental expectations; psychotic people are handled by modern mental health systems with extremely low autonomy, etc.

Conversations here are also often confused: diagnoses for many mental health conditions are qualitative and measured not only by symptoms but by harms. The DSM and friends aren't like the diagnostic instruments for cancer or heart disease: physiological indicators are much rarer in mental health, so mental health diagnoses combine enumerations of behavioral symptoms and negative impacts caused to one's life. That implies a subtlety that's hard to come by among non-medical-professionals: you don't "have" ADHD (or OCD, Autism, etc.) in the same way you "have" an ulcer; you have those conditions if you present with a certain subset of the symptoms for the diagnosis, many of which are behavioral. Whether a particular treatment is merited has to do with both symptoms and the harms posed by those symptoms to your quality of life. So saying "I have ADHD" is a less meaningful statement than "I have some symptoms of ADHD and they seriously damage my quality of life, therefore I seek treatment".

Add to that our limited (but growing, and better than it was in past decades) understanding of pharmaceutical treatments for mental health disorders--many of the drugs we use to treat, say, depression or ADHD behave with all the subtlety of driving a bulldozer through a convenience store because you wanted to get a gallon of milk--and you have a complex area discussed using outdated binary pathological terminology. That's a recipe for suspicion and confusion.

In short, it is, as you say, hyperbolic to characterize modern mental health treatment as shamanism. But lingering corrupt medical practice and the complexity of the field for laypeople make it hard to see how, specifically, things are improving in this area.

I read the whole article and I agree that the first sentence was a very poor choice as an introduction to the rest of the content.

However, it is an interesting article if you ignore that bit of bluster. The amount of overlap and traits commonly associated with ADHD and autism.

Eh, newtons theory of universal gravitation is still a theory, even if he had no access to particle physics, and even if later the Theory of General Relativity (among others) largely supplanted it. It’s also still useful (and used!) in most real life engineering situations. It’s rare where time dilation applies in say civil engineering.

That folks with Autism and ADHD may have large portions of their symptoms occur because they focus too much on some specific things, to the detriment of others - like emotional well being/regulation - can still be falsifiable (better than most psychiatric theories for sure!) and useful clinically.

Personally, it lines up with what I’ve seen and experienced.

That there is another (perhaps chemical, or brain structure) theory too doesn’t necessarily change that!

Not quite, but I think there's a lot of overlap between ADHD and autism, and that the labels are becoming increasingly blurry.

The final paragraph touched on it:

> It is, I think, too early to say with any confidence that autism and ADHD (or KCS) share a common root in monotropism, but the overlapping traits of the people receiving each label clearly demand some kind of explanation, and preliminary results do suggest that each is strongly correlated with monotropism – especially in combination.

Also, a definition of monotropism from their homepage (not my writing):

> I believe that the best way to understand autistic minds is in terms of a thinking style which tends to concentrate resources in a few interests and concerns at any time, rather than distributing them widely. This style of processing, monotropism, explains many features of autistic experience that may initially seem puzzling, and shows how they are connected.