Eric Piehl comments on attention dysregulation ADD and ADHD

ADD is real , treating ADD works ; supporting information :

ADD is real

ADD is diagnosed by criteria that are very complex. ^[1]

You might not like or believe the criteria.

But if you actually use the criteria, you get a 👤︎ group of adults who, compared to the 👥︎ general population, have or are:

image from TotallyADD video ADHD Awareness Month in 1 Minute, select to view video

2× as many divorces, ^{[citation needed]}
3× the rate of alcohol and drug abuse, ^[2] ^{[citation needed]}
4× as many 💥︎ car crashes, ^[3] ^[4]
4½× as many accidental traumatic brain injuries (as children and young adults), ^[5] ^[6] ^[7] ^[8]
5× as many deaths 🔫︎ by suicide, ^[2] ^{[citation needed]} ?
3-4× as many sexually-transmitted infections/diseases STIs/STDs (young adults), ^[9] ^[10]
6-9× as many 🚼︎ crisis/unplanned pregnancies, ^[9] ^[11]
7× as likely to not complete high school as an adolescent, ^[12]
4-9× as likely to commit crimes and 🛂︎ go to jail. ^[13] ^[14]

In addition, they:

Have held 2× as many jobs. ^{[citation needed]}
Earn less: by US$2 or €2/hour (young adults), ^[15] or $10 000 or €9 000/year (all adults), or $20 000 or €18 000 (adults with advanced degree). ^{[citation needed]}
Have a shorter expected life expectancy, by 12.7 years. ^[16]

In children, the outcomes are:

poor grades,
poor standardized test scores in reading and math,
increased use of school-based services,
higher rates of detention, grade retention and expulsion,
lower rates of ⟰ graduation from high school and college, ^[17] and
shorter expected life expectancy, by 8.4 years (children with ADHD-Combined type) (by adulthood). ^[16]

With the criteria having such predictive power, and the outcomes being so terrible, ADD seems pretty real to me.

23 Signs You Do Not Have ADHD

If you think ADD is just an excuse for people who are lazy, please:

Take another look at the outcomes above.
Answer "Why you think anyone would want to join this club?"

cartoon with … My ADHD diagnosis … 'upgraded' my life story … everything became clear. For more info, see https://totallyadd.com

But there is hope—in education and treatment …

Treating ADD works

When you treat adults with ADD, it:

reduces by 50% their rate of alcohol or drug abuse, ^[18] ^[19]
reduces by 40% their rate of 💥︎ car crashes, ^[20] ^[21]
reduces by 40% their rate of sexually-transmitted infections/diseases STIs/STDs (male young adults), ^[10]
reduces by 32%-41% their rate of committing crimes, ^[22]
reduces their odds of 🛂︎ being in jail, ^{[citation needed]}
reduces their odds of being dismissed from their jobs, ^[18] and
increases by 10× their odds of ⟰ finishing college. ^{[citation needed]}

When you treat children with ADD, it:

reduces core symptoms of ADHD, and
increases academic productivity. ^[17]

With such powerful outcomes, and low cost-to-treat, ^{[citation needed]} treating ADD seems to be a pretty good deal to me.

Where I have seen numbers, treatment seems to bring most outcomes close to the range in the general population.

In 👥︎ people whose untreated-ADD resulted in significant impairment to their 🏫︎ school, 🏢︎ work or 🏠︎ home-life, once treated, they can begin work catching up on any skills they previously found unattainable, such as ⟰ education, organizational skills, and 👥︎ interpersonal skills/relationships. ^{[citation needed]}

Treatment

cartoon with … Learning new habits to manage my ADHD requires patience, consistency, focus, repetition, and routine. And ADHD is a problem with patience, consistency, focus, repetition, and routine. So that's fun. For more info, see https://totallyadd.com.

Sorry, it looks like if you decide to treat, you are going to need regular exercise and 💊︎ medication. ^[23] ^[24] And mindfulness, yoga, organization techniques, and more.

But given the outcomes above, who would choose to not treat?

Don't want to think of yourself as 💊︎ pro-medication?
Rebrand your thinking as anti-suffering.

For a more nuanced view …

When you are offered a test or intervention,
BRAN reminds you to ask about and consider the
Benefits,
Risks, and
Alternatives and to also consider the effects of doing
Nothing in this situation.

— Sarah J Buckley, MD, Gentle Birth, Gentle Mothering: A Doctor's Guide to Natural Childbirth and Gentle Early Parenting Choices

Results of this thinking include:

If a particular treatment has negative side-effects larger than the positive intended-effects, modify or abandon this treatment in favor of a different treatment. ^[25]
But keep in mind the Risks of not treating.

What about abuse? Aren't some treatments—the stimulants—listed in the 🇺🇸 USA as Schedule II drugs?
Yes. ^[26] But:

These stimulants don't meet any of the three criteria for inclusion on that list. ^[26]
ADDers who sell their medication to others should be using it for themselves.
Those who buy it from ADDers don't get any of their desired effects. ^[27]

When Medication Costs Too Much: Prescription Assistance.

If the treatment method you worked out with your ⚕︎ doctor includes extended-release methylphenidate (Ritalin) (Concerta), ensure that your product actually works—is made by a manufacturer that uses OROS technology (or maybe DELEXIS®; don't know yet): Effectiveness of 💊︎ Concerta (extended-release methylphenidate) and its imitators.

Pick any ADHD symptom and consider how it might undermine one's career.
Or one's marriage.
Or how it would sabotage goals, friendships, and consistent parenting.
And impact health, finances, and eventually one's self-esteem.
It's a Holistic disorder.
So it demands a Holistic approach.^[34]

Supporting information

More sources and numbers will make this chart more compelling. If you have such sources or numbers, please let me know via the button at the bottom of this page.

Outcomes	ADD vs non-ADD	Treated-ADD vs non-treated-ADD (vs non-ADD )


Divorces	2× ^{[citation needed]}	— ^{[citation needed]}
sexually-transmitted infections/diseases STIs/STDs	3-4× (young adults) ^[10] 4× (hyperactive young adults) ^[9]	reduced by 40% (male young adults) ^[10] (closer to the range in the general population)
🚼︎ crisis/unplanned pregnancies	6.2× (and those pregnancies had more risk factors, including smoking, alcohol abuse and substance abuse) ^[11] 9.5× (hyperactive young adults) ^[9]	— ^{[citation needed]}


posttraumatic stress disorder PTSD	3× ^[28]	— ^{[citation needed]}
alcohol or drug abuse or addiction	3× ^[2] ^{[citation needed]}	½× ^[18] ^[19] (bringing it close to the range in the general population)
💥︎ car crashes (Motor Vehicle Collisions MVCs)	4× ^[3] 3 280 deaths and 200 000 injuries per year in the 🇺🇸 USA ^[4]	reduced by 42% ^[20] ^[21] (closer to the range in the general population) Additionally, ADHD-diagnosed male teens had much better Impaired Driving Scores IDS if their stimulant was sustained-release. ^[29]
accidental traumatic brain injuries (as children and young adults)	4½× ^[5] ^[6] ^[7] ^[8]	protective ^[7]
deaths 🔫︎ by suicide ?	higher ^[30] 5× ^[2] ^{[citation needed]}	— ^{[citation needed]}
⚰ death	expected to be early by: ◦ 8-11-13-25 years ^[30] ^[31] ◦ 8.4 years (children with ADHD-Combined type) (by adulthood) ^[16] ◦ 12.7 years (adults) ^[16]	better ^[30] ^[31]


Crimes	4-9× ^[13] ^[14]	reduced by 32%-41% ^[22] (somewhat closer to the range in the general population)
🛂︎ in jail	4-9× ^[13] ^[14]	reduced by 21%-45% ^[13] (somewhat closer to the range in the general population)


Income	US$2 or €2/hour less (young adults) ^[15] US$10 000 or €9 000/year less (all adults) ($20 000 or €18 000 (adults with advanced degree) ^{[citation needed]} 35 absences from work per year ^[32]	— ^{[citation needed]} — ^{[citation needed]} — ^{[citation needed]}
job changes:	2× ^[32]	— ^{[citation needed]}
quit due to dislike	1½× (young adults) ^[15]	— ^{[citation needed]}
fired or dismissed	1½× (fired, young adults) ^[15] 2× (dismissed) ^[32]	— ^{[citation needed]}
laid off/made redundant	2½× ^[26]	— ^{[citation needed]}
unemployment	longer ^{[citation needed]}	— ^{[citation needed]}
unemployed and not in school	11× (young adults) ^[15]	— ^{[citation needed]}
working memory problems (predictor of academic success)	4× ^[33]	— ^{[citation needed]}
grades in 🏫︎ school (children)	poor ^[17]	— ^{[citation needed]}
standardized test scores in reading and math (children)	poor ^[17]	— ^{[citation needed]}
use of school-based services (children)	increased ^[17]	— ^{[citation needed]}
rates of detention, grade retention and expulsion (children)	higher ^[17]	— ^{[citation needed]}
did not complete high school as an adolescent	7× ^[12] worse ^[17]	— ^{[citation needed]}
⟰ finish college—holds a 4-year college degree	⅓× (young adults) ^[15] lower ^[17] lower educational achievement ^[32]	10× ^{[citation needed]}


Outcomes	ADD vs non-ADD	Treated-ADD vs non-treated-ADD (vs non-ADD )

References

^[1] To see the ADHD full criteria exactly, go to your public library Reference Desk, and ask to see the "DSM-5", the "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" by the American Psychiatric Association (APA). Sorry, the full text is not currently on the web. But for good extracts, please see "Symptoms and Diagnosis of ADHD." USA CDC. August 26, 2019. or "DSM-5 Diagnostic Criteria" with screener questionnaires. Takeda Pharma. 2017. Accessed 2019-09-17.