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.
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.
You fucking people are really making me feel like I have this.
Hospitality is this for me, and has been for the last 18~ years.
Really you have a good hour of power where the bulk of customers will want to eat, drink and have a good time - all at once because fuck the kitchen and the bar.
Having to relay information from the kitchen, make sure the bar hasn’t lost a docket, dealing with spills, intoxicated patrons, wait people missing a meal / adding the wrong meal to an order plus the general meeting and greeting of walk-ins / bookings.
It’s also managing wages - when to knock people off, who to send home early, who costs more, who is unwell or le’ tired. Who can’t work together, who is bad at pack down or requires micromanagement once the busy period is over.
It’s a never ending list of monitoring, putting out fires, managing expectations of patrons and staff - all the while being legitimately nice and keeping your cool.
Oh, and if something gets missed you’ve just put the next days crew in a bad spot. Didn’t prep that aquafaba? Forgot to swap a postmix bag, change a gas bottle, polish cutlery, clear tables or even check the fucking toilets for passed-out patrons?
Rinse and repeat 5+ days a week. And this isn’t including how to manage personal relationships, hobbies and general self-care when everyone else is working a 9-5.
At least I’m not bald or grey yet.
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.
If everything’s a crisis, then nothing is.
It’s not really surprising when one of the core things that motivates people with executive disfunction is urgency
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.
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.
This absolutely tracks with my experience after having a kid. Suddenly I have little to no time to waste and so every hour I have to myself I feel that urgency and pressure to get as much done as possible. I’ve never had less free time or been so consistently productive as this last year. I think the demands are not so intense that I’m going to crash, but I do chafe against the limitations. I’m frustrated that I’m unable to excuse the time for my favorite leisure activities, and I miss video games. However I have gotten so many projects done, some things that have been sitting around for years, that I have to give myself a bit of credit for once.
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.
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.
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.
Could also be that in times of remission, we take on more challenges: Start dating again, get pregnant, challenging new job to pay for it all. Or challenging career change, get a degree, get training.
And that would not be newsworthy at all.
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.
Is the psypost.org link paywalled for others? Or just the link to the original study?
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!
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.
