ADHD impacts my life very much, but I was diagnosed as an adult. I honestly have no idea how I operated pre-diagnosis (and pre-medication). I think about some of the struggles I went through (e.g. my entire educational experience or my entire experience as a founder) and I really suffered in those times.

However, I absolutely agree with you.

Daily stimulants are a frustrating balancing act. Anti-depressants have frustrating side-effects. If I operated well without either or both, I would drop them in a hot second.

I DO benefit from medication to a degree that it has vastly improved my quality of life. I also benefit from therapy and the development of coping tools — in fact, I think anyone who benefits from medication should also seek therapy because it’s SO helpful.

This isn’t really a counterpoint to your experience, but more of a companion-point. Your post doesn’t make me think that you are an irrationally anti-pill person or anything like that. I’m just reinforcing what you’ve implied: treatment isn’t one-size-fits-all (although, at least in America, the medical system sure tries to make it that way). It’s incredibly important for anyone with ADHD to find the right tools for them.

I think sometimes it’s hard to tell whether something is interfering or not. If you’ve been squeaking by your whole life you might think this is “normal” simply because you’ve never experienced actual normal.

I go back and forth with ADHD meds. I’d say every 18 months or so I decide to take a week or two off. Sometimes that break goes on for a while because I think everything is fine and dandy. I think the longest I was off medication since starting (as an adult) was about 18 months. I can sometimes get by okay without meds, and sometimes that’s my preferred course of action, but invariably when I start taking them again I “remember” what it’s like not to have a crippling inability to do exceedingly simple tasks. And honestly, it’s kind of nice. Much less mentally exhausting.

As someone who has found ADHD medication to be hugely beneficial, I completely agree with you. Treatment has its tradeoffs. In general, stimulants greatly improve my quality of life. But at the same time, they can wreck my appetite and make me prone to anxiety and irritability. And dealing with the bureaucracy of scheduled medications is a serious headache. If someone is happy with their life and their symptoms aren't negatively impacting them, then what's the point?

> If you believe you have ADHD, and your therapist believes you have ADHD, BUT your life isn't negatively impacted by it, why start treatment now?

If your life isn't negatively impacted by it then you might be hyperactive or have trouble paying attention, but you don't have ADHD, by definition. It only becomes a disorder when it's causing a significant ongoing negative impact on your life.

I don't think you are correct. Just because the name has disorder in it does not mean you have to have a significant negative impact on your life.

It is a mental disorder. My brain functions differently than a normal functioning brain without ADHD. I have built my life in a way so that does not negatively impact my life significantly.

That's the crux of it right there. I've had a wonderful, wonderful life, a rewarding career, a 30 year marriage and raised intelligent, well-grounded kids. Not just by _my_ definition, but by those around me whom I respect.

On the one hand, it doesn't sound like any possible ADHD tendencies you might have are causing you much grief. Also remember that ADHD is hugely situational - I've had a pretty great career and up until a year or two ago I wouldn't have ever suspected I fit the bill. It was only during a perfect storm of overlapping stressors that I really felt like I was struggling.

On the other hand, just because you can survive doesn't mean life has to be this hard. And looking back I now realise that much of my life I was doing just that. I was surviving, when I could have been doing so much better.

It’s literally only a disorder if it interferes with your life. Otherwise, it’s not a disorder. Like, it’s in the definition.

https://www.cdc.gov/ncbddd/adhd/diagnosis.html

This is true of almost all of these disorders: no interference with life means not a disorder.

Saying “if you have no negative effects from ADHD” is the same as saying “if you’re alive when you’re dead”.

My personal experience with ADHD is that you are told it is a problem that needs medication, regardless of whether or not it impacts your life in a serious way.

Often, psychologists/psychiatrists/medical doctors will fail to include the literal definition of disorder. ADHD is one of those things that is a popular target for medications as a knee-jerk reaction.

That was sort of my point, I guess.

On the other side of this, I wasn't sure if my life was negatively impacted or not. I decided to try out medication to see, and my wife and I instantly started noticing improvements in our lives. I was getting more done with less mental strain, and there were tons of tiny little things that she wasn't having to remember for me or worry about because I wasn't losing track of them.

YMMV.

I concur, and I think OP has the answer already. I went to a psychiatrist (diagnosed at age 34) because of significant problems that were getting in the way of life, but if that's not the case for you then there is no justification for the time and expense of treatment.

That's the healthiest take. Severity of any disorder is a function of its effect on the person and the person's social and life function. If these are minimal and minimal, IMO pursuing medication is really not warranted.

> Source: ADHD treatments that left me a zombie when all I really needed was therapy and help to figure out realistic, functional coping mechanisms.

A good psychiatrist will have you do all of the above.

I don't think treatment is always a necessary outcome, but awareness probably is. Medication helps with doing things, but if all you did was take medication, your family would still have no idea why you constantly lose your housekey or why you chronically show up late. Simply being able to establish that "these are things I'm not going to be good at" or something along those lines is an improvement.

One of the DSM criteria is literally "There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning." So if there isn't something being affected, you don't meet the diagnosis criteria.

Thanks for your more nuanced take.