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submitted 8 hours ago* (last edited 56 minutes ago) by QualifiedKitten@lemmy.world to c/adhd@lemmy.world

Curious to hear what others think, as this definitely aligns with my own experiences.

The original study is behind a paywall, but I'm trying to see if I can get a hold of the full text somehow. For now, here's the abstract.

Abstract

Objectives: Recent studies report a fluctuating course of attention-deficit/ hyperactivity disorder (ADHD) across development characterized by intermittent periods of remission and recurrence. In the Multimodal Treatment of ADHD (MTA) study, we investigated fluctuating ADHD including clinical expression over time, childhood predictors, and between- and within-person associations with factors hypothesized as relevant to remission and recurrence.

Methods: Children with DSM-5 ADHD, combined type (N = 483), participating in the MTA adult follow-up were assessed 9 times from baseline (mean age = 8.46) to 16-year follow-up (mean age = 25.12). The fluctuating subgroup (63.8% of sample) was compared to other MTA subgroups on variables of interest over time.

Results: The fluctuating subgroup experienced multiple fluctuations over 16 years (mean = 3.58, SD = 1.36) with a 6- to 7-symptom within-person difference between peaks and troughs. Remission periods typically first occurred in adolescence and were associated with higher environmental demands (both between- and within-person), particularly at younger ages. Compared to other groups, the fluctuating subgroup demonstrated moderate clinical severity. In contrast, the stable persistent group (10.8%) was specifically associated with early and lasting risk for mood disorders, substance use problems in adolescence/ young adulthood, low medication utilization, and poorer response to childhood treatment. Protective factors were detected in the recovery group (9.1%; very low parental psychopathology) and the partial remission group (15.6%; higher rates of comorbid anxiety).

Conclusions: In the absence of specific risk or protective factors, individuals with ADHD demonstrated meaningful within-individual fluctuations across development. Clinicians should communicate this expectation and monitor fluctuations to trigger as-needed return to care. During remission periods, individuals with ADHD successfully manage increased demands and responsibilities.

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[-] atrielienz@lemmy.world 4 points 2 hours ago

Anyone who knows how good we function in a crisis is able to extrapolate from there that this would be a thing.

As others have said it's the burnout and the subsequent time it takes to recover that makes this basically unsustainable. Even when finding a balance there will still be burnout.

[-] MrPoopyButthole@lemmy.world 0 points 1 hour ago* (last edited 1 hour ago)

Hi. You have broken the community rules by posting paywalled content. Since there was a lot of engagement I am giving you the opportunity to edit your post and copy the text here that is available and then remove the link.

[-] QualifiedKitten@lemmy.world 1 points 1 hour ago

Is the psypost.org link paywalled for others? Or just the link to the original study?

[-] MrPoopyButthole@lemmy.world 2 points 1 hour ago

The problem is with the original study. We don't allow advertising or other ways that a person could extract money from our community. Some people are desperate for answers and it takes advantage of them. Sorry to be a pain!

[-] QualifiedKitten@lemmy.world 2 points 59 minutes ago

Ahh. My thinking was that articles like the one from psypost.org have a tendency to twist things for the sake of clicks, but they can be a nice primer for those of us who arent experts in the field, so I usually try to read the original study also, and was hoping to hear from others based on both sources. I'll delete the link to the original study while I see if I can get a hold of the full text somehow.

[-] tdawg@lemmy.world 10 points 4 hours ago

It's not really surprising when one of the core things that motivies people with executive disfunction is urgency

[-] rand_alpha19@moist.catsweat.com 17 points 5 hours ago

When I'm in the zone (hyperfocusing), I can stay awake for 20+ hours doing something. But just because I'm not experiencing symptoms doesn't mean I'm totally fine, lol. It's incredibly stressful to keep up with the demands I make of myself even when I'm able to do it.

[-] RedSeries@lemmy.world 4 points 3 hours ago

100% this. Coming out of an extended hyper focus is not only exhausting, it's untenable. The burnout feels awful.

[-] AnarchoSnowPlow@midwest.social 3 points 3 hours ago

Disregarding your physical needs in pursuit of dopamine for 20+ hours is a symptom.

[-] themeatbridge@lemmy.world 46 points 8 hours ago

It makes sense on the surface. ADHD is a deficiency of self -regulation. External pressures remove the "self" part of the equation. The scary part is the recurrence/remission cycle that makes it seem, to you and to everyone else, like you finally have your shit together.

[-] 474D@lemmy.world 4 points 4 hours ago

You fucking people are really making me feel like I have this.

[-] Septimaeus@infosec.pub 4 points 3 hours ago

Although most ADHD symptoms are things that neurotypical folks experience sometimes, if it seems like a lot of these are familiar, or describe a lot of your experience, you might consider asking your doctor about it.

The more we understand about ADHD, the more we realize how many undiagnosed people have been struggling with it their entire lives without support.

[-] MyTurtleSwimsUpsideDown@fedia.io 20 points 7 hours ago

I was just thinking that when I read:

“This might mean that people with ADHD perform their best in more demanding environments (perhaps environments that have stronger immediate consequences, like needing to put food on the table for a family or pay rent monthly). It also might mean that people with ADHD take more on their plate when their symptoms are relatively at bay.”

You mean the condition associated with dopamine regulation is affected by periods with a high density of short term goals with well defined, tangible outcomes?

[-] themeatbridge@lemmy.world 7 points 7 hours ago

Also, is it possible that environmental factors like high-pressure, work or death situations foster ADHD in adults? Like, high-pressure education, testing, and job markets increase the incidence of pathological emotional disregulation.

[-] TherapyGary@lemmy.blahaj.zone 9 points 6 hours ago

surprising

As a therapist with ADHD and lots of clients with ADHD, this is not a surprise to me at all, and I can't imagine it's a surprise to anyone else in the field (that would be surprising)

[-] QualifiedKitten@lemmy.world 4 points 5 hours ago

Any suggestions on ways someone might use this theory to better manage their symptoms? How can I make myself feel more busy when life isn't keeping me busy enough?

I've tried asking my manager for more work, but they've instead shifted some of my work to other people. I've been considering looking for a second job, but I'm afraid that will swing things too far to the other side.

[-] captainlezbian@lemmy.world 3 points 4 hours ago

Oh lots of us try utilizing it, you’re gonna love the burnout

[-] resonate6279@lemmy.world 2 points 4 hours ago

Get an EMT license and moonlight on the ambulance... it's kind of amazing

[-] QualifiedKitten@lemmy.world 1 points 53 minutes ago

LMAO, definitely not for me, but maybe a great idea for others here.

[-] Gerudo@lemm.ee 19 points 7 hours ago

I'm moving and had a hard date of about 2 weeks to have the house ready for real estate pictures/showings etc. I was so worried I'd drown in the list of things to do, but just poured every ounce of myself into getting it ready. I didn't have time to panic or freak out, just head first. When I was done, I was so fried I broke down and just cried.

I have had a few days to recover and I found myself cleaning, doing dishes immediately after cooking, picking up after myself, you know, normal things for a lot of people. I don't know how long it will last, but for now, my symptoms are better than they have been for a long time. I hate deadline stress, but it forces me to get shit done.

[-] QualifiedKitten@lemmy.world 5 points 5 hours ago

I hope you're doing alright now. I know moving can be extremely stressful, and hopefully your recovery time is enjoyable.

I remember once in college that I had a big paper to write, and I decided that I was going to get started on it "early" so that I could finish it early and avoid the deadline stress. I legitimately started it early, but somehow still managed to finish it at the very last minute. I spent my entire weekend in the library, and I don't think the final product was significantly better than if I had procrastinated on starting. I just spent a lot more time on the research part of it, and didn't really start putting anything together until the deadline stress kicked in.

Since that experience, I find it even more difficult to convince myself to start things early, since I'm afraid it will just mean spending more time on stressful tasks.

[-] PixelProf@lemmy.ca 24 points 7 hours ago

For me, it tracks, but the caveat is a high increase in burnout accumulation. No self regulation needed? No problem. Except when you can't self regulate healthy work amounts / dealing with demands.

[-] Wxfisch@lemmy.world 1 points 3 hours ago

This 100%

There is a limit to how much I can excel under high pressure environments until everything falls apart and I spiral into what seems like incompetence.

It’s actually that fall that caused me to finally get diagnosed. It took a couple years, a pandemic, and multiple people at my job retiring in short order, but I finally couldn’t balance all the spinning plates any more.

[-] Gormadt@lemmy.blahaj.zone 10 points 7 hours ago

So much this

70+ hour 5-7 day work weeks in a super high demanding job where people are basically hollering things for me to do that needed done in 2-5 minutes no-stop? I did that shit for 2 years. But man would I crash and burn out when I'd crash and burn.

Panic attacks, drinking like a fish, smoking pot like I was afraid of a non-smoke filled breath.

0/10 would not recommend.

[-] QualifiedKitten@lemmy.world 1 points 5 hours ago

Yeah, I think there's definitely an ideal balance, and I don't think consistent 70+ hour weeks is the right balance for anyone. If my work schedule is busy, but near 40 hours/week, burnout is probably not a major worry. Occasional weeks that demand more than 40 hours are manageable as long as they're balanced out by easy weeks or vacation time.

I've been really struggling with my current job because my actual workload is closer to 15-20 hours/week most weeks. I end up having a ton of trouble getting started, and am always late on things. I've tried on multiple occasions to tell my manager that I actually need more work, but they instead keep suggesting that I learn to delegate things more.

[-] spankmonkey@lemmy.world 8 points 7 hours ago

Greater life demands for a limited time frame, sure.

Long term life demands become overwhelming when they are comstant and for long periods of time.

[-] QualifiedKitten@lemmy.world 2 points 5 hours ago

Yeah, my experience is that if I have too much free time, I somehow don't get anything done. I'm much more productive and happy if I have a busy, but manageable to do list. Short periods of "too much" to do are also okay, especially when they have a clear end in sight, but they must be balanced out by a break of some sort.

[-] Rhynoplaz@lemmy.world 6 points 6 hours ago

Makes total sense to me. On a busy day, I get everything done with time to spare, on a slow day, I somehow don't have time to do anything.

[-] QualifiedKitten@lemmy.world 2 points 5 hours ago

Same here! I've repeatedly tried to explain this to my manager, and their response is that I should learn to delegate more. I feel so lucky to have a job that demands so little of me, but it sucks because I end up underperforming and unhappy. Since it's clear at this point that my manager won't give me more work, I guess I need to find other ways to make myself feel busy.

[-] Stanley_Pain@lemmy.dbzer0.com 9 points 8 hours ago

Definitely not the case for me. I just stress out until I pop.

[-] watson387@sopuli.xyz 3 points 6 hours ago

Yeah I'm great when I can hyperfocus. The problem is that it burns me the fuck out.

[-] kingblaaak@lemmy.world 4 points 7 hours ago

I just do a lot of little things per day, to accumulate at the end of week, to have a sense of completion. It's just a loop of maintenance, until I crash and need to recover. Somewhere i need to fit in social time, to create balance to deal with the real world.

[-] BearOfaTime@lemm.ee 6 points 8 hours ago
[-] MrPoopyButthole@lemmy.world 1 points 1 hour ago

This is still locked behind subscribing

this post was submitted on 18 Nov 2024
78 points (97.6% liked)

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