Exactly. So so so many people do not understand this element of psychological disorders

The D in ADHD is “disorder”, which normally means you can’t function socially, at work, and/or take care of yourself. Normally I don’t consider scatterbrained knowledge workers in the top 5% of the income distribution to be in that category. It is kind of fun so do work on speed though!

There are lots of ways "can't function socially, at work, and/or take care of yourself" can manifest even if you're in the top 5% of the income distribution. For example, that person's house might be an absolute disaster zone, with overgrown lawns, tasks piling up and a million tiny piles of bills and papers to be done "later". They might need 4 separate alarm clocks in 3 different physical places in order to wake up on time every day. They might be constantly forgetting to follow up with family and friends all the time and isolated and alone when they're not in the office. They might be the co-worker that when everyone is talking about what they did over the holiday weekend responds with "not much" because they're otherwise too embarrassed to admit they spent the whole 3 days in a state of paralysis over what to even do. They might be putting all their energy into appearing normal and functional at work because the alternative is being homeless or starving and you might never know because you don't see them outside the office.

All that to basically say income and job descriptions do not inherently say anything about what disorders a person may or may not be suffering from.

In other words, being able to live with a condition is not the same as the condition being debilitating.

A lot of mental illnesses go unnoticed by others because they're often very easy to hide (and you're encouraged to hide them). Thinking that you can't be in the top 5% of earners and are just doing "speed for fun" is like thinking you can't be suicidally depressed just because you are a comedian. Hell, most people were surprised by Anthony Bourdain despite him being open about his depression. What you see is not reality, so don't be quick to judge. You'd be surprised how many peoples mental states are a house of cards but look like they're living in the finest of mansions.

Seriously, comments like the GPs are not only bad takes, but actively harmful. It perpetuates the belief that people should hide rather than seek help. The big issue with mental illnesses is that they are typically extreme versions of normal behavior and we often paint them as unrealistically extreme and constant. They're highly variable and the most common thing to happen is people only seek help when they're in the spiraling states, where they are incapable of getting that help, but will not seek it out when they've normalized.

Plus, you don't know if they're in that top 5% post medication and would not have been prior. You don't have the counterfactual power to make such judgements.

> They might need 4 separate alarm clocks in 3 different physical places in order to wake up on time every day

I don't know if I have ADHD, but I've always been terrible at getting out of bed.

It bugged me so much I ended up building an app[0] to force me to get up. If I didn't get up and scan my toothpaste barcode within a few mins of my alarm, I'd have to pay $10.

It also has cheat detection so I can't just turn off the phone to avoid getting up. Alarms are stored in the cloud and lock 1 hour before going off so they can't be changed.

Many of my users tell me they have ADHD so it seems likely I fall somewhere on the spectrum.

[0] Nuj Alarm Clock - https://nuj.app

It's a good thing no one defines disorders the way you do going through life miserable but have set up your life in such a way and with a set of coping mechanisms that help you stay afloat is apparently fine and your life needs to be in shambles. Do you feel the same way about chronic pain? Is dragging yourself to work despite it prove you don't need help. Clearly you can handle the suffering. It's the exact same.

Surviving only because you've structured your life to revolve around the limitations of your disorder isn't a sign that everything is fine.

Adderall and its contemporaries aren't speed and I promise you it isn't fun. Stimulant medications are miserable to be on, it's just that not being on them is worse. That one time you took high-dose adderall in college is not at all reflective of what the experience is like.

What if you can function socially, at work, can mostly take care of yourself and generally look the part, but on the inside you are a miserable husk of a person exhausted from the neverending struggle to appear functional and normal?

Is that person just having fun on speed in your view?

Others have responded to you as if you weren’t being disingenuous, so I will respond as one should to people like you: go fuck yourself.

Anyone that dismisses this as being a scatterbrained person that likes to do speed is clearly not trying to help anyone and are only here to tear them down and make them hate themselves more than they already do. The world would be a better place if trash like you was collected and disposed of. Grow up, asshole.

> Self-diagnosis is not a diagnosis.

Nit: Self-diagnosis is the first step towards a formal diagnosis. You don't go to the doctor to get antibiotics before self-diagnosing that you're sick.

That said, as useful as a formal diagnosis is (getting proper help, and even meds), don't skip it if you can afford to do it.

Yes. Thank you for stating it so well. Self diagnosis is like a conjecture based on observation. It needs to be proved out formally to be a working theory. But that’s part of the process and there absolutely is value in self diagnosis. It’s up to professionals to sort the wear from the chaff, webmd be damned.

Similarly anecdotal evidence is just not strong evidence, but it is still evidence. Anecdotal evidence from a lot of people is a dataset and from a wide variety of people is a good dataset. It's all about confidence levels. Consider likelihoods (different from probabilities) and just update your priors but never forget the confidence intervals. They're the most important part!

I still thought "X is a spectrum" is essentially the same as saying that everyone have it, which I don't think is a useful assertion. There should still be a threshold somewhere, something that of course psychology won't try to draw.

It could be, but that's why I think that the "self-diagnosis != diagnosis" statement is important

The threshold for any disorder is usually “is it causing a significant and negative impact on your ability to live a normal life”. And while there are a lot of squishy terms in that statement, it’s about the best we have. We know even less about the workings of the brain than we do about the workings of your body and anyone with a chronic and rare health issue can tell you just how little we know about the workings of the body. So these sorts of “standard normal life” and “significant impact” fuzzy phrases are our best tool.

Everyone is late sometimes, are you so chronically late that you’re losing or at risk of losing your job despite doing things that normal people would do (e.g. getting up earlier, setting alarms etc), that could be (along with other symptoms) an indication of ADHD.

Everyone is sad sometimes, even deeply so. Are you so down that the very act of getting up and making yourself food seems too much? Are you so hopeless that even doing something you love makes you feel nothing? That (along with other symptoms) might indicate you have depression.

Everyone has things that they want to have “just right”, whether it’s a well organized tool box, a clean car or a spotless mirror. Do you find yourself needing to ensure that every dish in your cabinets are sorted properly by size and weight, every day, even if it means missing that important meeting with a friend you haven’t seen in years and even though you already did this yesterday and only used two plates since then? That might (along with other symptoms) indicate that you have OCD.