Attention Deficit Disorder, The Anticapitalist Condition

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Yves here. Perhaps readers will insist that I am insufficiently discerning, but I have difficulty in accepting the premise of this piece that attention deficit disorder is a creation of modern society, the result (primarily if not entirely) of time demands in combination with tech overstimulation.

First, it’s not as if the 21st century invented time regimentation. William Blake published Jerusalem, with its mention of “dark satanic mills,” in 1804. Recall that children as young as 8 and 9 worked in these mills. Attention deficit disorder typically shows up in young-ish school age children. I studied the history and literature of the Industrial Revolution through the 1960s. I recall not a single reference either in studies or in novels of individuals with an ADD type affliction. Or to put it another way, the dreamy artistic sort was never depicted as having difficulty with, say, getting to parties more or less on time.

Many pre-industrial era subsistence farming tasks require attentiveness to time. If you have dairy cows, you need to feed them and milk them on a strict schedule. If you were doing day fishing, you needed to be mindful of when to head back to shore.

Second, the rise in the diagnosis of attention deficit disorder predates kids growing up attached to smartphones. It was pretty much unheard of in my youth, but was becoming common in the generation behind, to the degree that many children and teens grew up taking medication to combat it. That makes me suspect the trigger was environmental….but not the home environment so much as chemicals. Even to the extend that regulators require companies to analyze safety, they do so on a substance by substance basis. It’s far too complex to study the impact of multiple synthetics, even before getting to the problem of exposure levels (as substance interactions may well considerably lower the “safe” threshold).

And I don’t mean to seem to second guess someone as well respected as Gabor Maté, but I know people personally who suffered from profound emotional neglect in infancy and toddlerhood and yet are well organized and decisive, so I have difficulty in seeing poor parental attachment as strongly causal as he does. Recall that the nobility did not raise their children; they farmed them out to nannies. So some might have been lucky enough to have formed a bond with one they had the entire time they were grown up (Winston Churchill was willing to endure ridicule from his schoolmates by insisting his nanny come to important events). But that was exceptional.

By Laura Basu, openDemocracy’s economics editor. She is the author of Media Amnesia: Rewriting the Economic Crisis and co-editor of The Media & Austerity. Originally published at openDemocracy

My husband has attention deficit disorder. Well, he hasn’t actually been diagnosed. He’s way too ADD for that. Trying to get Erik a diagnosis in the Netherlands, where we live, involved multiple phone calls to get referred to the right place; form-filling and questionnaires; a long wait to get an appointment; having to go over the forms and questionnaires with an assistant psychologist; digging out old school reports; and arranging interviews with Erik’s dad (who has suspected ADD) and brother (who has diagnosed ADHD) to find out what he was like as a child.

Needless to say, Erik did not complete the process. It’s a miracle that anyone with the neurological condition does.ADDitude mag, a publication for people with ADD and ADHD, lists the signs of ADD as: “poor working memory, inattention, distractibility, and poor executive function”. Executive functions are skills that help you get things done like plan, manage time and multitask. Erik doesn’t have the ‘H’ in ADHD – he isn’t that hyperactive. But people with ADD don’t get on with bureaucracy.

Erik doesn’t appreciate being told that the way his brain works is “poor”. He spent the first 40 years of his life not knowing that he might have ADD. Instead, since childhood, he was told that he was weird, stupid or broken. He then spent five years wrestling with the idea of having it: first rejecting the label, then accepting it in private but still feeling afraid to talk about it to others.

“My whole life people have thought I’m a clown. I don’t want to give them confirmation,” is what he said when I asked why he never mentioned it to friends.

The reason people think he’s a clown is that he’s the most creative thinker I have ever met. Erik is a visionary. He has big ideas, big dreams, big plans. He’s not always so hot at carrying them out. Unfinished projects include our first flat that we lived in half-built for eight years; a new internet protocol; and a new intellectual property regime for pharmaceuticals.

Now, at the age of 45, Erik is adopting what he calls the ‘LA mindset’: owning his divergence. It’s a journey we’ve been on together, him with his ADD and me with both a chronic autoimmune disease I was diagnosed with in 2017 and facing up to the fact that the binge drinking and chain smoking of my youth may have been about something deeper than me doing my British patriotic duty.

The books of the Hungarian-Canadian medical doctor and writerGabor Matéhave guided us on our journeys. Maté has written about ADD (he has it), chronic illness, and addiction and compulsive behavior (he exhibits it).

Maté dissents from the mainstream consensus on what causes ADD, which is that it’s mostly genetic. He says that while there is a genetic element, what determines whether or not you develop it is the extent to which you receive the right nurturing in infancy. Five-sixths of human brain circuitry is wired after birth. Those with ADD have different wiring in the prefrontal cortex, which controls self-regulation and attention. For optimal brain development to occur, infants need food, shelter, and secure attachment with their primary caregivers.

You can’t blame the parents, though. Not receiving the right nurturing doesn’t necessarily mean abuse or neglect, though it can. Parents being stressed out and not being able to attune to their infant can do the job. Maté was born to Jewish parents in Budapest two months before the Nazis occupied the city. But it doesn’t have to be that extreme. Show me one parent who isn’t stressed to the eyeballs struggling with work, finances and trying to raise kids without enough help and on no sleep.

These are individual neurophysiological features but they arise within social contexts. Our capitalist societies create stressed-out families, carceral schools and toxic workplaces. No wonder our brains are going haywire on anunprecedented scale. ADD is a capitalist condition.

ADD Is the New Schizophrenia

I’m not the first person to say this. In his 2011 book‘Capitalist Realism’, the late Mark Fisher wrote that ADHD was “a pathology of late capitalism – a consequence of being wired into the entertainment control circuits of hypermediated consumer culture”.

Gabor Maté is clear that ADD is not a pathology; it is a developmental divergence. It isn’t fundamentally caused by our era’s hypermediated culture, he argues – however, culture can and does feed and reinforce it.

Fisher was riffing on critical theorist Fredrick Jameson’s metaphor of ‘the schizophrenic’ as typical of 1980s postmodern culture. Jameson described a culture in which we are constantly being bombarded by random images, a ‘series of pure and unrelated presents in time’. He wrote that people with schizophrenia embodied the fragmentation of identity that this experience of time creates: the failure to craft a coherent sense of self that connects the past, present and future.

Other thinkers of the late 20th century had their own unorthodox theories of schizophrenia, notably philosopher Gilles Deleuze and psychoanalyst Felix Guattari in their 1972 book ‘Anti Oedipus’.

Fisher, a further-education teacher cum philosopher, pointed out that the culture industry had moved on since Jameson was writing in the 1980s. Fisher wrote: “What we in the classroom are now facing is a generation born into that ahistorical, antimnemonic blip culture – a generation, that is to say, for whom time has always come ready-cut into digital micro-slices.”

For Fisher, the person with ADD, with their distracted focus and ‘poor working memory’, was the updated symbol of our age. And that was 2011, well before TikTok and Instagram Reels.

What Fisher didn’t mention was that for Deleuze and Guattari, if not for Jameson, schizophrenia was not just the condition of late capitalism, it was also its exterminating angel. By giving rise to postmodern schizophrenia, they argued, late capitalist culture was sowing the seeds of its own demise. Late capitalism (AKA neoliberal capitalism) is disorderly, chaotic, unruly. It’s the economic Wild West, where money is king, finance is fictitious, and all barriers to its flows are bulldozed. This creates cultures and subjectivities that are also disorderly, chaotic and unruly.

But at the end of the day, capitalism needs order, stability and rules. It needs the state. It needs the state’s militaries, its laws and its bureaucracies. And it needs good, stable, reliable citizens to do its bidding. The chaos and disorder of schizophrenia threatens to disrupt the whole system.

To be honest, I’m not sure if using a serious mental illness as a metaphor for our modern malaise is OK. For theorists like Deleuze, though, it was important to see mental illnesses as political rather than natural and private categories. They are experienced by individuals but they are produced in and by societies. The personal is political.

The same can be said for neurological differences like ADD. And, like schizophrenia, ADD can similarly be understood not only as our era’s totemic condition but also as its Trojan Horse.

ADD Against the Clock

“ADHD is at its heart a blindness to time,” says pre-eminent ADD expertRussell Barkley. Erik disagrees. It’s not a blindness to time, he argues, but an oblivion to a particular social construction of time: regimented clock time.

Capitalism instituted an economy based on wage labour and with it, the commodification of time. Time became money. Or more precisely, workers’ labour time became capitalists’ profit.

In ‘Hours against the clock: on the politics of laziness’, Lola Olufemi explains how capitalism captures time, turning it into a finite resource that we are forever losing to our work. Productivity growth, the mantra of capitalism, means speeding up production so that we are always producing more in the same amount of time.

We see the tyranny of capitalist time most starkly inAmazon warehouseswhere workers’ every movement is monitored by algorithms and the least productive regularly fired. We see it in poultry farms where workers are forced intowearing diapersbecause they don’t have time for bathroom breaks.

Due to differences in wiring and chemistry in the brain’s frontal lobe, the person with ADD does not experience this kind of linear time. Gabor Maté says that, for ADDers, there are two states of time: the here-and-now and the ever after. I am constantly reminding Erik that time passes. If I tell him it’s 2pm, he will continue to believe that it’s 2pm until I tell him that two hours have passed and it’s now 4pm. Similarly, he has no concept of not being on time for a meeting until the appointed time has already passed and he hasn’t left the house yet.

You can see why this kind of human is inimical to an economic system grounded in the regimentation of time. Good luck trying to get a person with ADD to get to school or work on time, do set tasks for certain durations and then go home and do whatever they need to do to be able to do the exact same thing tomorrow.

Because we are always on the clock, even when we’re free. In the evenings we are preparing for work tomorrow. On the weekends we’re trying to forget about work while making sure our sleep routine doesn’t get so messed up that we can’t get up on time on Monday. On holidays if we’re lucky we get to unwind for a few moments before having to start back again.

Not to be flippant, but I’ve always thought of the alarm clock as a violation of human rights. For people with ADD, it literally is. They are notoriously poor sleepers. But like many things about them, their sleep is only ‘poor’ because of the time pressures exerted upon them by school or work. Erik’s intrinsic sleep pattern seems to be biphasic. He has one phase of sleep at night and then another in the morning or after lunch. This would be completely fine if his current job didn’t require him to be in from 9 to 5. In fact, the latestsleep researchsuggests that human sleep is naturally biphasic. It’s capitalism that demands – and then makes sure you fail to get – the solid eight hours.

Erik is high functioning. When we met he was a risk analyst at a major bank. But he can only take the tyranny of time for so long. Eventually, usually after a year or two, he will quit and need to reclaim his time, and his sleep. We are privileged to be able to afford to live like this, though it isn’t always easy. Millions of ADDers, along with billions of non-ADDers, never escape the grind. But who knows, if we collectively adopted the ADD non-compliance with capitalist time, maybe we could.

Capitalist Bureaucracy

You may associate bureaucracy with a bloated state, but the term ‘Kafkaesque’ is more apt under today’s hyper-capitalism than it has ever been. Have you ever tried reaching Airbnb customer service? The lateDavid Graeberargued that the notion of bureaucracy as just a problem of a large state is propaganda. For him, governments and companies are barely distinguishable from each other in their bureaucratic hellishness.

State and private sector bureaucracies are in fact often intertwined. In the Netherlands, if you are behind on some tax or other, government departments hire private debt collectors to come after you. Once in their grip, it’s almost impossible to extricate yourself from ever-mounting fines and fees. The trauma that Erik has suffered from harassment by these bailiffs is no joke. (One of his projects is to set up a ‘national union of non-payers’, but he hasn’t quite gotten around to it yet.)

If there’s one thing the ADD brain can’t handle, it’s bureaucracy. Due partly to reduced dopamine levels, those with ADD find it virtually impossible to devote any amount of time to activities for which they have no internal motivation. If you want to get an ADD kid to do their maths homework, you need to structure itlike a video game that delivers a hit of dopamine every time they score a point.

Let’s face it, along with straight-up bureaucracy – which takes up an inordinate amount of our time and for which are paid nothing – much of the paid work we do can also pretty much be classified as bureaucracy. It has no intrinsic meaning, it adds no value to society and we do it purely to get money to stay alive. Again, those with ADD are unable to motivate themselves to do things that have no intrinsic meaning. We can ask ourselves why any of us can – when you think about it, who is it really that has the disorder?

ADD Is an Anarchist

This is not to say that people with ADD are lazy. Far from it. Erik is pretty much a workaholic. Like many people with ADD, he has hyper-focus for certain things. For him, it’s making movies and 3D graphics, sewing, learning about cryptocurrency, playing the guitar and gardening. Just not for things that other people tell him to do.

If anything, Erik embodies Karl Marx’s ideal communist human. Marx wrote that, under capitalism’s regime of labour time, “each man [sic] has a particular, exclusive sphere of activity, which is forced upon him and from which he cannot escape. He is a hunter, a fisherman, a herdsman, or a critic, and must remain so if he does not want to lose his means of livelihood”.

But under communism, with democratic control over production, we would be free to develop our talents at will. It would be possible “for me to do one thing today and another tomorrow, to hunt in the morning, fish in the afternoon, rear cattle in the evening, criticise after dinner, just as I have a mind, without ever becoming hunter, fisherman, herdsman or critic”.

The ADD brain is not made for pointless drudgery. It’s made for creative, free-form thinking, where connections fire off in all directions. The same wiring that generates internal chaos and distractibility also means thatADDers are betterat ‘divergent thinking’, ‘conceptual expansion’ and ‘overcoming knowledge constraints’.

True, capitalism often ends up befitting from the ADD non-engagement with bureaucracy, as those bailiffs will attest. The individual with ADD will most often be the one getting harmed. Or, let’s be honest, the ADD person’s long-suffering partner will end up doing their bureaucracy for them, especially if that partner happens to be of the female persuasion.

But still, the ADD brain’s point-blank refusal of capitalism’s hijacking of time through both wage labour and bureaucracy, and its insistence on creativity, pleasure and self-expression, should be seen as a source of raw, joyous, anarchic rebellion.

Love Is a Doing Word

For Gabor Maté, while medication may be helpful in many cases, it should never be the first or only port of call for treating ADD. ADD is not a disease. It’s a neurodevelopmental difference, caused by families that are too stressed-out by the pressures of life to give their kids the attention they need.

People with ADD have been brutalised by society. The same goes for addicts and for people with chronic diseases. The good news is that people can heal at all stages in life. What they need to be able to do so are spaces where they are accepted and given room to pursue their passions, connect to their feelings and nurture their self esteem. In other words, what they need is what everyone needs.

I’ve always said that love is not just a feeling, but a verb, an action. Apparently I’m not the only one to think this. The American psychiatrist Scott Peck defines love as action, as the “willingness to extend oneself in order to nurture another person’s spiritual and psychological growth, or one’s own”. Maté ends his book with the words: “If we can actively love, there will be no attention deficit and no disorder.”

We owe it to each other to create those spaces of active love and healing. Along the way, we can all learn from the ADD brain’s refusal of labour time and capitalist bureaucracy. We can all adopt its defiantly creative, lateral thinking. We can all embrace the disorder that will set us free.

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  1. PlutoniumKun

    Its always interesting, but a little futile I think to try to apply modern psychiatry to earlier times. So often the symptoms of underlying problems are culturally mediated, so you can only tell so much from novels or history of the past. Years ago there was a big budget BBC/HBO series on ancient Rome called…. Rome which was quite interesting in that the characters were clearly written with some personality problems that are likely to arise in a brutally hierarchical, slave based culture. One of the key characters was an ex soldier who would probably now be identified as having ADHD of some type along with impulse control problems that are familiar to anyone who has dealt with kids from abusive or neglectful backgrounds.

    But I don’t think there is any doubt but that the internet has severely affected peoples attention span (of course, TV used to be blamed for that). I’ve always been a ‘grazer’ of information rather than a deep reader – even as a student I’d spend hours in the library flitting across many books and periodicals rather than focusing on just reading on book at a time, but I’m much worse now than I used to be. I spend a lot of time just following writers or sources I like, while the mound of half read books by my bed grows higher and higher. Maybe its age, but it seems to me that our culture just doesn’t value sitting and reading a book anymore. Even with visual culture, instead now of watching an hour science TV show everyone (including me) flips from 10 minute YT clip to another one (in fairness, there are some brilliant science, culture and history YTers).

    1. The Historian

      To me, most modern psychology seems to be a concerted effort to put us into boxes for control.

      I am also a grazer and a half reader and I am glad to know I am not alone! I tend to drop books when they attempt to steer me to a particular point of view – something I absolutely hate. I’ve gotten to putting books on my e-reader so that I can scan through them. If the book turns out to have truly valuable or interesting information that I want to refer to later, then I buy the hard copy.

      Like you, I love Youtube. Sure, there is a lot of trash on it but there are also wonderful sites, like the Bard College Hannah Arendt site, the Yale and MIT classes, and especially lately – many many sites where people are documenting their attempts at alternative living – something I can’t find elsewhere!

  2. Social Chemistry

    In addition to chemistry, biology and physics, illness is also defined in parts from what we tolerate socially.

    To the the ADD/ADHD I would add increasing discipline and obedience imposed on people as well as decreasing general tolerance for each other as part of the increased number of people with these diagnoses.

    Discipline and obedience: as demanded by the crypo-fascist surveillance state that the Western world is descending to. Example would be the total obedience and deferrence the US police demands in order to not shoot you. The behaviour must be learnt over time.

    Decreasing tolerance: as an example I could mention the old originals in our village where I grew up. There were quite a few old men that were odd but still tolerated and accepted by the village as a part of the community. Today there is nobody that has an “odd” approach to life and many deviances are not particularly accepted.

      1. digi_owl

        UK was (is?) also overtly structured around class. I suspect that it was tolerated more in the upper classes, because they had the economic leeway to do so.

        And it is those classes we hear about in books and plays, not the toiling masses in the fields and factories.

      2. c_heale

        I think the UK does still tolerate it. Although I haven’t lived there for many years, my family still does.

      3. The Rev Kev

        Or as “Yes Minister” put it-

        James Hacker: ‘Eccentricity can be a virtue.’

        Sir Humphrey: ‘If you call it individualism.’

        Bernard Woolley: ‘That’s one of those irregular verbs, isn’t it. I have an independent mind, you are an eccentric, he is round the twist.’

      4. .human

        Yes, Yves. I see the diagnoses and drug treatment as a form of coercion in order to force non-comformists.

        Free thinkers and visionaries are not to be allowed as they could upset the apple cart. The media is complicit in this as demonstrated by any number of examples of omission, outright distraction, disinformation, and assasination. See Julian Assange for an extreme prosecution of one with enlightened ideals.

        1. Questa Nota

          Supply creates its own demand.

          Supply of what, you may ask? Ritalin, Concerta, various similar meds that were doled out like candy to bullied parents for their, er, active kids. Schools, other parents, teachers and too many other helpers played a role. Then some kids saw that those same meds were helpful around test time in high school and college, so they went to their classmates local dealers.

          Ask around to see how the now-grown kids felt about their experiences.

          1. Cat Burglar

            An old friend, a molecular biologist and endurance athlete as an adult, was schooled as an active boy in brutal pre-Vatican II Catholic schools in a rough northeast town. Once he was punished by having to sit under the teacher’s desk during class and being periodically kicked by the teacher. The next day, during the middle of class, the classroom door was flung open, and his mother stepped into the room. Pointing at the teacher, she said, “If you touch my son again, I’ll kill you!” This was in a town where threats like that meant something; he was never touched again.

            The younger son had the same problem, and she took him out of school rather than allowing him to be drugged. There were some rough years to follow. But he has been reelected more than once to his seat as a state senator.

            1. HotFlash

              Umph. Agree, mostly, but still. When my husband was a boy in Catholic school, he was what would now be diagnosed as hyperactive, or ADD, or whatever. Sr. Beatus had a diagnosis, too. “That boy is bored, we shall give him music lessons,” she decreed. So, he took music lessons and by the age of 12 was church organist and choir director for his small rural parish. He is now (mostly) retired, but music has always been in his life and he is a respected builder of exceptional musical instruments. Thank you, Sr. Beatus, we thank you often.

              His nephew, similar temperament, was diagnosed as ADHD and medicated (Ritalin). A supply of his Ritalin was sent to his gradeschool, and he got his daily dose from there as a condition of attendance. That one of the schoolboard trustees was a Dr who prescribed Ritalin at the drop of a hat was coincidental, I am quite sure.

              1. Cat Burglar

                Drawing up a balance sheet on the Catholic education experience means recognizing both the good and bad. I know plenty of other people that were helped by it.

      5. Ignacio

        I feel that I have lately become somehow eccentric partly to ‘blame’ to NC, hahaha! May be eccentric is not the word. Rara avis could do better. The other day I had a meeting with some long standing friends and was ‘accused’ of some eccentricity regarding themes like Ukraine, economy, climate change, vaccines…

        It has possibly to do with semantic difficulties and don’t know how to differentiate precisely between eccentric, non-conventional, rare, weird…

  3. digi_owl

    My personal take is that the rise in AD(H)D and aspergers (autism is, IMO, an older and more severe disability that overlap) comes not from “inattention” as such, but from the nature of “work”.

    For one thing we have moved from physical work to mental work in the “post-industrial” western world. Thus people now are required to sit still and read for hour and hours on end. Some cope, other do not. Those that do not, get medicated until they do.

    Another element is that much of the works day is spent in meetings, talking and “interacting”. Again some cope, others do not. And those jobs that didn’t need as much human to human interaction has been largely automated away. I sometimes wonder if that stereotype of the eccentric and cranky librarian or archivist comes down to someone with aspergers having found a hideaway job.

    1. hazelbrew

      Just a quick note on language – its changed and evolved over time.

      The DSM is the reference for american psychologists, and used widely globally (e.g. in the UK).
      What is the DSM?

      “The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders”

      It is versioned. so DSM-4 was 93 or 94. , DSM V came out in 2014. There are further tweaks over time to each major version.

      Aspergers was added in 94. it came out of the manual in the 2014 version. What used to be referred to as Asperger’s syndrome or sometimes “high functioning autism” has been placed alongside other conditions as simply “Autistic spectrum disorder” (ASD).

      There are links and evidence of collaboration from Hans Asperger with the Nazis. So people want to distance themselves from the name.

      ASD also gets referred to now as Autistic Spectrum Condition – its the same thing as ASD. but calling it a Condition is less stigmatizing than a disorder.

  4. rob

    while I don’t envy any parent who feels these ADD/ADHD behaviors are discernible in their children, and fear this will result in their child being disadvantaged in the world we live in… of the corporate master; I do disagree with the basic assumptions of the value of “fitting in” to this society.
    As someone who probably escaped that diagnosis… I always hate the groupthink mantra that this is a problem, and how it bleeds into the consciousness of the masses.

    I for one, think that time is one of the most valuable things people get to experience between the point of being born and dying. And for whatever reason, some of us are more comfortable getting lost in the matrix, and surfing through it.
    I will not be shamed by creatures who are currently destroying the planet, and assaulting every life form on it. Heading everyone on the planet into a spiral downward, destroying everything as we go. This world is run by maniacs., where the competitive advantage of being able to lie, cheat, and steal
    with no sense of guilt, universally wins out over people WITH a conscience.
    And now, this value system of these clearly inferior beings is being reinforced with the “norms” of society labels.
    I don’t have any problem with people needing whatever strategies they need to get by;( i.e. their individual diagnosis) , but I do have a problem with the dominant society labeling itself as better.

  5. GramSci

    It is peculiar, how uppers like Adderall, can settle down a “hyperactive child”. I’ve always been partial to the theory that a goodly proportion of such children are simply “underaroused”. I.e., bored. The alienation of labor in the modern factory-school is textbook Marx. Uppers (hell, even a jolt of java, why not a line of blowsnow?) will make kids engaged, even if their accomplishments upon graduation will be nothing but stanzas of gibberish.

    1. digi_owl

      Speaking of java, there is the claim that the introduction of coffee to England was what gave rise to the enlightenment. Because now rather than getting lethargically drunk on beer, people would stay up all night debating anything between heaven and hell.

      There may even be passages from some lady’s diary where she decries the foul brew because of how her man stays up all night at the nearby coffeehouse rather than come home to her.

    2. CanCyn

      I have a friend whose brother-in-law became addicted to crack cocaine and was in a bad way for many years (in his twenties). He got help, got clean and has been well for many years. A few years ago he was in a terrible motorcycle crash and was given pain killers – opioids. I asked my friend if they were worried about him becoming addicted. She said no because he has an unusual physiology – crack actually calmed him down and opioids act like uppers and he hates the feeling! According to his doctors, this is not unusual – one person’s upper is another person’s downer. Perhaps explains why some people can drink coffee all day and still sleep at night?

    3. Joe Well

      The theory of underarousal does not mean boredom in the traditional sense, but that the brain for whatever reason is not activating the areas dedicated to executive function. The fact is that ADHD can be most obvious at parties where a person can’t follow a conversation with many participants.

    4. Stick'em

      As we recently talked about at here at NC with autism spectrum disorders, what people with attention deficit disorders have is not one thing. There’s more than one thing going on here with more than one cause, much of which isn’t crystal clear.

      Call ADHDs a spectrum if you’d like, just we do with ASDs. Genetics folks call this kind of state a multifactorial condition with variable expression.

      For example, we were just looking at some old family pics on Mother’s Day. My wife noted in all the 25+ childhood pics of my brother posing with the family, every single time someone is holding him by the shoulders. Basically this is the incontrovertible visual evidence of what we all remember him being like as a child. He’ll run off if you don’t restrain him.

      In all seriousness, I remember one day when my brother ran up and down the hall in our house for something like 2-3 hours straight. I remember interrupting him once long enough to ask him why he was doing this, and he replied, “I don’t know. I just feel like running.”

      Whatever ^that is, it certainly isn’t the same thing as a kid being a couch potato, staring and social media, anime cartoons, and the blinking lights of video games, then not being able to pay attention to what’s going on in the real world afterwards.

      There was no so-called “trigger event” for my brother that changed his life. No prolong exposure to computer graphics. There was no chance to get used to some schedule at school or on a farm before he became symptomatic. He was always like this as far as anyone can remember. As in toddlerhood. Why? I have no idea and don’t need to invent a myth to fill the place of not knowing. It is what it is.

      BTW, now my brother is a successful patent attorney and Ritalin got him through law school. So while being mindful not to tell anyone else what to do or believe, there is a population of people for whom the hyperactivity piece of ADD is really strong and the only way these folks can sit down long enough to read a law book is medication. There’s no doubt in my mind.

      1. Deely

        This spectrum is actually recognized in the diagnosis of ADHD. An official medical diagnosis is labeled mild, moderate or severe. And the presentation is noted as well, hyperactive presentation, inattentive presentation, or mixed presentation. So an actual medical diagnosis (rather than self-diagnosis via internet) will be: mild ADHD, inattentive presentation. That tells you a lot about what the persons experience of ADHD is like.

      2. Stick'em

        The heritablility of ADHD is estimated to be about 0.75 as reviewed here:

        which is huge.

        Of course in psychiatry there is this trend in which the diagnosis/medication process can go backwards. Meaning a kid has trouble paying attention in school, somebody prescribes him/her Adderall, and if it works in reducing the problem behaviors, then the kid is retroactively confirmed to have a diagnosis of “ADD.”

        This ^ kind of thing muddies the water on what constitutes “real” ADHD vs. what is something else, such as the environmentally-induced short attention span theater related to screen addiction so often reported in schools.

        So we call ADD a multifactorial condition and the heritable factors “susceptibility genes.” The variable expression is in part dependent on factors such as how the diagnosis is made and the lack of definitive biological markers present for psychiatric conditions in general.

        1. hazelbrew

          It is a bit like the spectrum when it comes to ASD diagnosis as well isn’t it?
          There is a range of category isnt’ there when going through an ASD assessment, if you only have problems in one category then you might end up with a diagnosis of, say, social and communication disorder, or dyspraxia. Have problems across enough of them and you receive an ASD diagnosis.

          similarly for ADHD diagnosis
          e.g. from our NHS: NHS diagnosis guidelines
          if you have in 6 or more symptoms of inattentiveness or hyperactivity for children. it changes for adolescent and adult is… mmm. confused picture.

          I get confused between the ASD / ADHD language and research at times, there seems to be so much overlap the two the more you read about it. and very high comorbidity rates.

  6. mistah charley, ph.d.

    Journalist Aaron Maté, sometimes mentioned at this site, is the “proud son” of Dr. Maté.

    About a decade ago I got an ADD diagnosis and took medication for about a year. I was already in my 60s and retired, the medication didn’t make much difference in my life, and I stopped.

    In the last few years what HAS improved my quality of life is using a CPAP machine for sleep apnea.

      1. Petter

        Or funding for why prevalence rates by states vary so much. Kentucky has the highest at 14.8%, Nevada the lowest at 4.2% (easy to Google).

        1. Rolf

          Under IDEA (the Individuals with Disabilities Education Act), if ADHD adversely affects a student’s education then it can qualify as a health impairment (not a specific learning disability per se) and entitle them to specialized services and instruction (K-12 up through age 21). IDEA funding is federal, but identification (Child Find) and delivery is up to the state, and therein lies the problem, as there is very significant variation in the percentage of students served by IDEA on a state-by-state basis (far beyond what one would expect statistically), with 3-fold to 10-fold variation (e.g., Table 1 [1]).

          [1] Koretz D & Barton K, Educational Assessment 9:29-60 (2004)

  7. Joe Well

    >>caused by families that are too stressed-out by the pressures of life to give their kids the attention they need.

    Victim blaming, or victims’ parents blaming.

    And ahistorical. Imagine thinking that pre-industrial parents with 9 kids were giving their children more attention.

    1. mistah charley, ph.d.

      Just an observation about family size – and I speak from knowing the family of my father – who had 1 brother, 6 sisters – and my wife – who has 6 sisters. In families like this, the older siblings are an important source of attention, companionship, and instruction to the younger ones, so while “parental” attention is diluted in large cohorts, familial interaction is not.

      1. anon y'mouse

        what you say rings true from my grandparents’ tales of their own upbringings (both with 6 older siblings). both were essentially raised by their oldest sisters.

        of course, the inverse happens as well—siblings can damage and abuse as significantly as parents do, even if they aren’t performing the parental duties.

  8. Watt4Bob

    In my experience, those with ADD and ADHD come in all sorts of flavors, but the thing they have in common is a lack of patience.

    I work for a sales organization and have often, not entirely in jest, suggested that it was a requirement for sales positions to have ADD.

    I have a cousin who was diagnosed with ADD. Among the questions that stood out to him was something like this;

    “Do you quickly size-up people you meet as being less intelligent, and thus uninteresting, and not worth your time?”

    This cousin has been very successful in business, and life-long friends with my brother, who is highly intelligent, creative, and decidedly unsuccessful.

    When this cousin left the consultation that diagnosed him with ADD, he immediately jumped on a plane and flew to meet my brother, and declare that he now knew what was wrong with them both.

    Now they both seem satisfied that their ADD is a by-product of superior intelligence. One, a rich capitalist who owns a successful business, and one living hand-to-mouth doing odd jobs, both believe they’re the smartest person in the room, and both with zero patience.

    People with ADD do not pay attention, and many of them will tell you why, if you ask.

    The answer is many times something like this;

    “It’s stupid.”

    “It’s not important.”

    “I haven’t got time.”

    BTW, these sorts are the kind who drive me crazy by clicking on anything that pops-up in their emails, leading to the spread of malware, virus’s and wide-spread spamming, which necessitates extreme measures to counter.

    Very smart, impatient, and inattentive, and many, think it’s a super-power.

    1. GramSci

      .. and, to my earlier question, after they get their Adderall-assisted graduate degree, isn’t it still stanzas of gibberish? Not to say an impatient kid in an inner-city school can’t be “helped” by an ADHD diagnosis. Just asking, helped to what end?

  9. Lexx

    We have a dog with Cushing’s. He dictates our “schedule”, when our day begins, because 4 a.m. is his limit for dealing with the symptoms; there is no cure, only management. He’ll come and tell me (with remarkable accuracy according to the clock) if I’m late for any of his every-eight-hour feedings. His meds must be taken with food. If I told this to a farmer, he/she would totally get it…

    … because likewise the farmer, his “schedule” is dictated to him by his livestock. He doesn’t need to look at a timepiece. The nature and behavior of his animals determine the rhythms of his day – sunrise and sunset – and the seasons. He can ignore one bawling cow with full udders for a few more minutes of shuteye but the bawling tends to set off a chain reaction. In farming communities, a dairy farmer whose cows can be heard across the valley because he’s let them go unmilked past their pain tolerance will hear about it from the other farmers. If you see a farmer who looks like his ears have been chewed to nubs, the snack wasn’t necessarily enjoyed by his good wife. It probably happened every time he went to the feed store until his animal husbandry improved.* The “independent farmer” has many bosses; they determine his schedule. He can yes or no, but if no, there will be consequences to him and that can make a man pay attention to what’s important.

    I liked Pluto’s choice of the words ‘culturally mediated’. Indeed.

    *Or up close and personal right after they finished milking their own cows. He could see a rooster tail of dust coming up the road to his barn.

    Martin Blaser refers to autism and it’s cousins on the spectrum as a ‘modern plague’. His book, ‘Missing Microbes’ talks about what his community of scientists see as the consequences to us for our unwise use of wide spectrum antibiotics since the 40’s. There were powerful motivations for pushing the science, not least was the child mortality rate. His argument seems credible. A full third of the book is footnotes alone. The chapter titled ‘Mother and Child’ was hair-raising and he’s one of those writers who makes no extra effort to frighten the reader – the facts are sufficient on their own. The last time I can remember closing the cover on a book and feeling something crawl up my spine like that, I’d just finished reading ‘The Sixth Extinction’ by Elizabeth Colbert. I thought ‘we’re effed’ and much of what I’ve read since echoed that sentiment. Same shit, different book. ‘Missing Microbes’ was something new and just as horrifying. Like most of these stories, the evidence of the consequences for our choices have been with us for decades.

    1. hunkerdown

      It’s a cute rhetorical trick to treat material needs of life as equivalent to the ideal imperatives of plan, but management has enough of an attitude problem without being naturalized like that.

      I, on the other hand, see autism as armor against emotional manipulation by the cajoling classes, and hope it becomes even more prevalent than whatever this PMC complex is.

    2. HotFlash

      Again, umph. There is a reason that so many milch cows are named “Bossy”. Me, I just got cats, but same drill.

  10. MT_Wild

    Here’s an article on the genetic component to ADHD. Genes do take cues from the environment, so certainly not downplaying the role that might play.

    ADHD runs in my and my wife’s family. My brother and I were both to young to be diagnosed in school (it wasn’t a thing), but we both were instead IQ tested and put in the gifted program so we’d bother fewer people.

    My brother’s son was diagnosed, and my son’s teacher has approached us about testing. Both our daughters handle school fine. Curious if it’s at least a partially sex linked trait or just displays differently between boys and girls so they get diagnosed at different rates.,search%20for%20ADHD%20susceptibility%20genes.

    1. lance ringquist

      same with my family, and my wifes. wild mood swings and bi-polar blackouts are not unusual. i kinda stay away for my sanity.

    2. hazelbrew

      the plural of anecdote is not data, but I can add my own story to this and the genetic component and ADHD

      We have three children – one diagnosed a few years ago with ASD and ADHD (boy) , the second diagnosed last summer with ADHD (girl)

      That has led to a few years of reading and learning what I can about it, including reading about the genetic prevalency… and the increased likelihood that if one child has it the siblings are much more likely to.

      When we did the Connors assessment the second time the joke was “remember we are doing it for X not for you”… which has led me down the path of an assessment for myself. If I look back at my history it fits the profile for ADD, but I need a proper assessment to understand it fully. e.g. I had (still have!) classic symptoms like being able to focus for hours at a time on something that motivates me (the hyper focus state)? yes totally. Losing interest and day dreaming on something boring? yes that to. Poor impulse control? yes. A blindness to whether something happened last week or year? yes that to. Lockdown made that particularly difficult, with little variation in the day to day. Start new tasks before finishing old ones? yup

      I have started trying to understand my 80+ year old fathers own perspective on it, and we share similar traits, and his stories very much resonate with what I read on ADD now. He’s 82 and still needs to have loads of projects on the go :D. and we realize we both constantly fidget.

      I think it likely that our histories would meet the diagnostic criteria.

      Curious if it’s at least a partially sex linked trait
      – the research and diagnosis for ASD is biased towards male presentation of symptoms. The same is true for ADHD, there is a gender bias in the research.
      ADHD: a women’s issue

      – girls are more adept at masking, and don’t present with the same disruptive social behaviours that boys can.

      – I have found it even harder to read and understand the situation around adult ADHD . I see a lot of what I describe as “if you managed to make it this far it can’t be a problem”. but ADHD’ers are far more likely to be diagnosed with other disorders, like substance abuse, to have failed relationships, impulsivity problems, issues with managing cash/life, anxiety and depression.

      I speak to a good number of people like myself among colleagues that are on an adult diagnosis path, triggered by a diagnosis of one of their children.

  11. John Merryman.

    It’s occurred to me the binary dynamics are synchronization, which is centripedial and harmonization, which is effected by centrifugal dynamics. So reality is nodes and networks, organisms and ecosystems, particles and fields.
    Since our Western culture is largely object oriented, the emphasis tends to be on the synchronization. Which is ok, as long as there is sufficient energy being fed into the system, otherwise it implodes, like a star going supernova and collapsing into a black hole.
    Given the history of the US has been several centuries of growth, capped off by several decades of debt, we are in a Wiley Coyote situation. Just a thought.

    1. John Merryman.

      The point being that attention is about being focused on the point at the center and stepping back and seeing the context.

  12. Alyosha

    I got diagnosed in the early 90’s, at about 18. They told me I was gifted and had a learning disability at the same time; I told them that school was just boring because it was too easy. I declined medication based on the fact that they wanted to give me open access to the class of drugs I was most likely to become addicted to (and I was no stranger to recreational drug use, already knowing that stimulants affected me differently than they did my friends).

    I got rediagnosed about a year ago because things I had come to associate with clinical depression can also be ADD. They made me take the whole battery of tests again, which I quite enjoyed. I’m iffy on the meds, though no fear of overuse and addiction since the last thing I want to do anymore is stay up all night ripping rails. But I also think we ADDers get a bad rap. I can concentrate deeply in my wood shop, my gardens, in books, etc. This piece does a great job of pointing out that what we’re bad at is the bullshit of modern, corporate life. I’m pretty lucky to have a weird job that often (but not always) allows ADD and its bursts of deep concentration to be an asset. It’s also not corporate so I have some flexibility that limits the ADD downsides.

    Sometimes I think that just being smart is a risk factor for ADD as diagnosed and understood by society. I actually credit my high functioning ADD to incredible luck with early teachers. My second grade teacher recognized my boredom and instead of forcing me into compliance sent me to the library with a bin to collect books on a subject, then gave me a corner of the class room for the last month of the school year where I wrote my first “research” paper on baseball.

    1. Lexx

      I was raised by a couple of special education teachers; I was in college the first time I became aware of the existence of gifted programs. The schools levees failed repeatedly through high school. Special education programs were mandated by the state so that budget was always safe. Gifted programs had no such protection. They were few and far between; they have never kept up with demand and probably never will.

      I was outside this morning planting another row of Danvers carrots and thinking about calories. That as long as calories remained the yardstick for ‘getting enough to eat’, we’d never get the nutrition we needed. Meeting the real needs of children would always be far down the priority list. Yes, it’s better than death, but only just.

      Lines of cocaine then, not railroad ties in the woodshop? ;->

  13. David in Santa Cruz

    The “problem” is the medicalization of eccentricity, as far as I’m concerned. It’s down to a socioeconomic system that is intolerant of neuro-diversity and that over-compensates conformists.

    As for medication, I recently read the autobiography of Jorma Kaukonen, late of the Jefferson Airplane and Hot Tuna. The “genius” and all-night jam sessions of the ‘60’s and early ‘70’s were fueled by “diet pills” that were eventually outlawed and re-marketed as Adderall. It just needed a diagnosis.

    As a chubby 3rd- and 4th-grader I was prescribed Dexadrine as a “diet pill” circa 1967 — I kid you not! It focused my mind wonderfully and I hated how heavy the basketball got when they took me off it…

  14. JEHR

    This article brings to mind another article about the brain and how one side of the brain is being emphasized over the other side.

    ‘We behave like people who have right hemisphere damage,’ says Iain McGilchrist.

    Dr. Iain McGilchrist argues that many of the problems our society faces stem from the fact that the left hemisphere of our brains has come to dominate our minds and lives.”

  15. Raymond Sim

    Many pre-industrial era subsistence farming tasks require attentiveness to time. If you have dairy cows, you need to feed them and milk them on a strict schedule. If you were doing day fishing, you needed to be mindful of when to head back to shore.

    Those ways of life also typically demand, of men in particular, a great deal of strenuous physical activity, often including frequent bursts of maximum effort, and also rather more individual initiative and attention to detail than city folks typically realize, or are even equipped to perceive. There’s a big neurological component to the efficient application of muscular strength, and in my experience, getting good at manual farm labor changes the inside of your head.

    Concerning sticking to a schedule, where dairying is concerned even well into the last century the sun was still the clock that mattered for most purposes. I personally find living by the sun experientially different from living by an artificial clock. And cows who need to be milked will bawl, loudly, if you don’t keep to their accustomed schedule, which not only makes it hard to ignore your duties, but also tells everyone within a kilometer or so that you’re slacking off.

    1. Lexx

      Any discussion of the gut-brain axis? Didn’t see it in the table of contents in ‘The Emissary’.

  16. Darius

    I have been on ADD medication for about 10 years. Before that, I was incapable of making decisions and was easily influenced even when I knew it was wrong. I couldn’t muster arguments fast enough to stick up for myself. I also could never muster the energy to get something done.

    Like my maternal grandmother’s family, I still have a thousand balls in the air at once, but I now can sit down for an hour and concentrate on a task.

    ADD is also a rich person’s condition. It is almost impossible to find a therapist who works with it under insurance.

  17. Susan the other

    Much better than the title. Really inspiring. “Who is it really that has the disorder?” Well, I can certainly see an entire system that is disordered-to-perfection so that any order, no matter how peculiar, might appear to be disorder. Perhaps it’s the genesis of denial, since it is so comforting to have everything explained, no matter how absurdly. And so on. Makes me wonder how we might “diagnose” ADD in squirrels. No doubt they have their own existential contradictions. Elephants seem pretty solid – but they are documented as going on group rampages. Fight or flight? This is such a deep rich vein of thought, no?

  18. Cat Burglar

    Hyperactivity was what teachers called the problem in the early 1960s, and that is what they called me. The significance of long division was poorly explained to us — it clearly could not hold a candle to the vibrancy of feeding the horses, or the croaking of a toad in a creekside burrow, or surviving a night in the bushes before the rescuers found us that time the YMCA day-hike got lost. The disciplined ability to focus on abstract relations of logical necessity has its right place, but so do other orientations — my assumption has been they are just part of the normal human range of adaptive responses.

    A society with an economic base dealing in abstract quantitative returns during clock-measured time units has been around for only a short while, and its ultimate value is not clear. I have climbed rocks and mountains with mathemeticians, skilled manual workers, retail clerks, scientists, and mud bath attendants, as they delivered expert performances in skill and safety in a dynamic and hazardous natural surrounding. Some had barely any competence managing themselves in conventional work or social time environments, but they could do things that most people think are impossible. The problem is the requirements of the economy, not the minds of the people in it.

  19. anon y'mouse

    seems like ADD/ADHD would make you lose a limb as a child in a Satanic Mill.

    even kids who have regulation problems are like to snap to attention if they are terrified into it, and even more under the guidance of an oppressive overseer. half of my family, raised by a violent alcoholic and incapable since of doing much with their lives, can easily attest to getting to places on time and carrying out discrete and even somewhat complicated tasks with precision, and are definitely not mental defectives (teaching themselves many subjects, art, music etc enough to not be a total novice). but organize their lives, a career, juggle both of those plus child raising? not a chance.

  20. Antagonist Muscles

    the alarm clock as a violation of human right

    This bit really resonated with me. I have been unemployed for several years, and during the same period I did not use an alarm clock. The positive effect on my mental clarity has been incredible, though it is difficult to separate this effect from that of not having the dread and anxiety of day in the office looming over me.

    That whole idea of wealthy people enforcing discipline and preventing laziness by coercing labor is absurd. I voluntarily wake up at 6am without an alarm clock and proceed to exercise . (I read NC around 8am and my rare comment is in the evening.) This schedule would have been unthinkable for me when I was employed, irrespective of my bedtime the night before.

  21. Adam Eran

    Thom Hartmann (founder of a school for ADD kids, in addition to his political work) characterizes ADD as “hunter/gatherer brain.” Continually scanning for something new, impulsively deciding to pursue a deer rather than a rabbit, when hunting, etc. are assets in certain circumstances. Modernity embraces “farmer brain,” but that doesn’t mean it has eliminated the need for ADD types. Sales is one field where the ADDs thrive. I’ve actually met a software architect who was great, then got Adderall and said it made him even more productive. So…fitting the mentality to the task appears to be the problem here. The article…TLDR. (Chalk that up to my ADD!)

  22. podcastkid

    I’m only as far as here…

    You may associate bureaucracy with a bloated state, but the term ‘Kafkaesque’ is more apt under today’s hyper-capitalism than it has ever been. Have you ever tried reaching Airbnb customer service? The late David Graeber argued that the notion of bureaucracy as just a problem of a large state is propaganda. For him, governments and companies are barely distinguishable from each other in their bureaucratic hellishness.

    Which is heavy.

    So far, I have two ideas. First, if TPTB wanted to learn-us-helplessness [or force us into Kafka world], they couldn’t do better than turn electronics from a means to an end.

    Second, there may be a disjunctiveness in our era…just like in William Blake’s era. It’s like one of those coal mining kids trying to make sense out of church? There used to be causes, but at this moment we are between causes and capitalist bureaucracy? Mentally [in the lebenswelt out there] the ambivalence may be worse; but since the water warmed slowly we can’t recognize the situation?

    1. podcastkid

      But I think new chemicals/jabs probably are better explanations, at least for more than half of contributing factors. If I had to guess.

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