Cognitive Disengagement Syndrome (CDS) - Quick Summary of The Other Attention Disorder

00:00 Introduction to the Topic
01:21 Two-dimensional nature of symptoms of CDS
04:35 Best symptoms for identifying CDS
06:02 Various cognitive activities that might be occurring in CDS
09:56 Reviewing the various criteria for whether CDS should be viewed as a distinct mental disorder
17:26 Conclusion - CDS does seem to be a distinct mental condition from ADHD and other disorders.
Here I briefly discuss a second attention disorder previously called sluggish cognitive tempo but now known as cognitive disengagement syndrome (since 2022).
Reference
All of these findings are summarized in the Report of the Workgroup on Sluggish Cognitive Tempo in the Journal of the American Academy of Child and Adolescent Psychiatry to be found here. www.jaacap.org/article/S0890-...

[@j.d.aengus]

My gratitude to Dr. Barkley for continuing to spread awareness of CDS. I received an ADHD diagnosis in 2020 (very well into adulthood), but a previous video that he did about SCT (as he said, the previous name for CDS) sounds more like my experience than even Inattentive ADHD does. I am certain that I have both, but CDS still isn't in the diagnostic manual. I'm that previous video, he mentioned that research has found that CDS (SCT) is able to be treated with atomoxetine (aka Strattera), and so I asked my doctor about trying that medication, and it certainly does help me!

[@bas2452]

As a communications student, I just wanted to thank you for the work you put into creating these videos. It's hard to overstate the importance and value of your content. It certainly goes beyond the positive impact you have on the lives of people with ADHD (like me). At risk of being dramatic, I believe experts like yourself play one of the most critical parts in counterbalancing the everlasting, society eroding, stream of nonsense produced on social media. Your contribution to true understanding does not go noticed! Wish you all the best.

[@sokrates5421]

Can you also include research on CDS in your weekly research updates whenever new studies get published?

[@russellbarkleyphd2023]

Yes.

[@Drnonstop]

Anyway, very interesting video, the ”some parts of the brain sleep” bit hit me hard. Not sure if I have CDS, but after I have those blank stares I feel the same shame as when I wake up, excusing myself

[@bethanykittok3903]

My entire life.

[@MR-ym3hg]

Yes! I think my social anxiety draws from this as a repeated experience. Especially when making first/early impressions.

[@merfgamgee9485]

It's comforting to know that CDS is a subject of research. I've had the symptoms since childhood. They went into remission for a few months when I was a teenager and I've spent much of my adulthood trying to recapture that state. Work is definitely challenging. I've tried a few medications, including Vyvanse, but none have hit the spot, unfortunately.

[@joan.nao1246]

@merfgamgee have you looked into gut health info, esp the science behind GAPS diet for neuro diversity?

[@merfgamgee9485]

@@joan.nao1246 I tried an elimination diet similar to GAPS several years ago but didn't notice any changes. The gut health science is definitely worthwhile keeping an eye on.

[@snjspring]

Do you exercise? Are you overweight? Sleep study?

[@mhilyard1]

Yes it's awesome that this is actually being researched. Atomoxetine/Strattera (acts on norepinephrine) seemed to help me a lot but caused digestive issues and I switched to Bupropion which also acts on norepinephrine in addition to dopamine and it seems to work just as well with less side effects. Everyone is different but that's what works for me. I wonder if there will be any research on other medications that act on norepinephrine as far as CDS?

[@MR-ym3hg]

@@mhilyard1 I'm just starting atomoxetine after trying low dose Adderall for several months. If you don't mind sharing, do you have ADHD + CDS? If so, what is the benefit you felt from these? How long did your GI issue last before you switched? I'm trying to prepare myself for the GI issues and if I have them, see if I can power through long enough to know if this class might benefit me if I find the one/dosage with tolerable long term side effects.

[@ericm6415]

CDS sounds like a perfect description for my state of mind as a child (up to 10yo). I've been diagnosed with ASD-1. I'd be interested to see the cross-over on those

[@LesVraisFilous]

Thank you for these videos ! Are you planning to make a video explaining a bit more about how ADHD and CDS can coexist ? I'm trying to understand how hyper and hypo activity can be there at the same time, it's a bit confusing for me.

[@cordellboss]

I need to get tested for this my grandma and even co workers of mine have been making comments about my low motor and how I don't do any work. One of them said to a co worker I don't want to work with him on a cart because I would just be working by myself. Of course this isn't true because all I want to do is get my work done but others have commented that I spend too much time on certain stuff that should be done in quick succession like cutting up boxes. I have always gone at my own pace for fear of messing up and I do appear absent minded, confused, and non verbal at times.

[@karlidomingo]

My question - I haven’t heard the term “dissociation” involved at all in regards to this syndrome, and yet, the symptoms seem to define dissociation. How does CDS differ from dissociating? Obviously dissociating can be a response to other factors, such as trauma and PTSD, as well as a symptom of depression, anxiety, schizophrenia, and bipolar disorder. Can you do a video on this? Thank you Dr. Barkley!

[@russellbarkleyphd2023]

There are no studies comparing CDS to dissociative disorders. My hunch is that the latter also include depersonalization and even out of body experiences that are not part of CDS. But I bet there is overlap between them. Be well.

[@MeloniousThunk]

@@russellbarkleyphd2023 I love this conversation. Thanks for asking the question I was thinking, @carlidomingo and for engaging us on this platform, Dr. Barkley

[@Teo-door]

thanks for finally giving me a word to explain my situation, and to know i'm not just crazy. or alone with this. Thanks. it means a lot

[@megs4193]

It really sounds like a lot of what I do, being born in 1970 we obviously didn't have the help that children do today. For me personally I have been diagnosed with adhd, but also neurodivergent and cptsd. One thing I think affected me personally is, I was never told what to do, ever, I was lucky to have people around me doing good things that I picked up on, but basically...it was like being accidentally invisible, there was no malice or neglect just...I seemed to be fine, I believed I was fine therefore I wasn't really told yes or no except for basic, hygiene, eating, sleeping and getting up...unfortunately I'm 53, and I only have vivid memories from 9 on, and even that is just a guess. This really really got my attention though. Thank you so much. My psychologist here in Tasmania Australia recommended you to me, and I see why 👋😃 💞💞💞.

[@mrchips.9245]

do you have an issue with memory and procrastination ?

[@MrWinMrWin-qr2bn]

The overlap between all these mental health problems really makes me think how much misdiagnosis happens 😢. So many things can result in attention issues besides ADHD.

[@iliyanovslounge]

Thank you for taking the time to put out such informative content.

[@amphibien8264]

Thank you for all that you do for CDS and ADHD. I've found that I have significantly improved overall with the help of stimulants (even at low doses) but there have been areas where I still struggled. CDS seems to explain where I'm still struggling to see improvement. I'm exploring my treatment options now that I know about CDS.

[@ernestalab6592]

What meds are you on?

[@amphibien8264]

@@ernestalab6592 I tried generic Adderal, Adderall XR, and Vyvanse. CDS still remains too much of an issue, and I can't handle high doses nor do high doses come with any benefits over low dose. Overall, they help a little with the ADHD side of things, but CDS has barely improved.

[@ernestalab6592]

Dr Barkley I m obsessed with your information, it’s so helpful and interesting! Thank you so much ! These symptoms I have them all , but just been diagnosed with ADHD. I also experience learning difficulties, get hyper focused on stuff I m interested in, till I get over it. I been told I have combined type. I m not driven by motor all the time, I get fatigued a lot. but if I m into project I also can’t stop working/moving. Wondering if I really have adhd or this instead . This could be so easily mixed up and now my new diagnosis imposter syndrome kicked in and I think what if I don’t have ADHD.

[@SunshineGrove04]

dr. Barkley, I can stare off but I don't have a blank mind.. is that more maladaptive daydreaming.. I WISH my mind could go blank although I am sure many who do struggle with this, wish that it wasn't like that for them. I am AuDHD and C-PTSD.. my mind has ALWAYS been busy.. although I do find that being on Concerta it does help slow ALL the thoughts coming at once in a rapid-fire way.. yet still soo stuck in Frozen Overwhelm b/c so much is sinking in my life.

[@meeerdock]

Dr Barkley your channel has made a big difference in my attempt to filter and understand the vast information regarding ADHD on the internet. I wanna ask if you have in mind any credible scientist like yourself doing somethink similar for ASD.Thank you.

[@russellbarkleyphd2023]

Not that I know of. But check the autism center of excellence at Duke University operated by Geraldine Dawson to see what information they provide. And the MIND Institute at UC Davis is also a fine resource. Be well

[@adila2442]

Your lectures are very informative. Your book Take Charge of Adult ADHD was recommended by my support group.

[@bethanykittok3903]

Has anyone looked at CDS with a correlation to dopamine? I feel like this diagnosis may fit me. It may fit my mother. Both my mother and my maternal grandfather were diagnosed with Parkinsons.

[@themobbit9061]

I wonder if this is related in any way to childhood trauma including ongoing negative mirroring, verbal or emotional abuse. I have several clients in that category that space out or have an energy shut down - freeze responses -when the trauma is triggered in the present. What do you think?

[@russellbarkleyphd2023]

There is a greater relationship to child and family adversities than is seen in ADHD so it’s possible but would not account for most cases.

[@themobbit9061]

@@russellbarkleyphd2023 Thank you for your thoughts. And also for analyzing the current research for us!

[@edinbrodlic4564]

@@russellbarkleyphd2023thing is, how would one reliably quantify and measure positive/negative mirroring in early caregiving, to conclude that it is not a cause? Even severely traumatised people seem to claim their childhoods were “not that bad”, simply due to a lack of memory/awareness. All we have is anecdotal evidence based on hazy memories?

[@FocusFrameMD]

Thank you for your work, Doctor. It's so disappointing and scary to see how little is known about CDS. But it's heartwarming to see doctors doing this kind of research out there. You mentioned how ADHD is more disruptive than CDS. I can only speak for myself, but my CDS symptoms feel to be much greater disruptors than my ADHD ones. Adderall can help with focus when ADHD is the problem, but if CDS is the problem, it doesn't help even though it serves its purpose. The issue with CDS, as far as i understand it, is one of shifting gears from "the inside" to "the outside." The clutch isn't focus; it's energy. Stimulants and caffeine can't give me that, and when you're always lethargic and fatigued despite rest, disengagement is difficult to avoid and engagement with any new task is borderline impossible. Too much inertia, so you stay stuck; mentally asleep. The point about there being literal sleep-like brain activity during these disengagements was mindblowing. No wonder it feels so sleep-like Issues like these seem pointless to bring up to psychiatrists and therapists. Do you have suggestions on resources for participating in research and having these conversations there? My descriptions feel far more productive as research aid, than as complaints to my psych lol

[@hollybigelow5337]

I am someone who is convinced I have CDS. What I am really looking forward to is more understanding of how CDS relates to Rejection Sensitivity Dysphoria. I have heard it's estimated 99% of people with ADHD have RSD. If that is true, and if most of us who have CDS are currently receiving a diagnosis of ADHD because CDS isn't in the DSM right now, that would suggest that there is a huge correlation of RSD in CDS. I watched another video recently that perhaps people with ADHD are rejected by their peers because of impairments in controlling emotions like anger. That makes tons of sense to me. Is it the same with CDS? I can get very angry when I need people who are trying to control me to leave me alone, but personally I thought it took awhile for that to happen, so I thought most people who aren't close to me hadn't seen that side of me, but is that just me not realizing it? Or is there perhaps something else making it so people with CDS are getting rejected by their peers?

[@ernestalab6592]

I m like you only people I feel close to I can be very frustrated and show rage. I have RSD for sure and people pleasing is exhousting for me. I can’t at all take criticismfrom strangers so try to be perfect “outside”. But I also have ALL symptoms of CDS 😮and thinking could my adhd be misdiagnosed, or it just overlaps with CDS. As I have a lot more symptoms like hyperfixation, learning difficulties that either is separate in its own or caused by ADHD.

[@hollybigelow5337]

@@ernestalab6592 Oh, I definitely have hyper fixation and can be easily overwhelmed and show that overwhelm to the handful of people who are close enough to me to be unfortunate enough to experience that with me. I definitely do the people pleasing. Let’s put it this way, even though I am convinced they are two separate disorders, they currently are both officially diagnosed as ADHD, so they must have enough in common to be lumped into the same diagnosis for so many years. And it does sound like there are plenty of people who have both ADHD and CDS. I’m pretty sure once they are separated I will personally only qualify for CDS, but that doesn’t mean I won’t still have a lot of similar symptoms and also understanding for those who have ADHD.

[@kerryhitzke4490]

Thank you

[@hermanmusimbi4337]

Dr. Barkley, there is a drug being investigated for ADHD that's already indicated as a treatment for narcolepsy. Its called solriemfetol or sunosi. Sleepy ADHD kinda sounds like CDS in some respect. Could this be a promising treatment? Also when can we hope to see this on a DSM?

[@russellbarkleyphd2023]

That drug might be helpful but no one has studied it as yet. And it is our hope that the review paper will lead to it being in the next DSM, whenever that gets constructed.

[@hermanmusimbi4337]

@@russellbarkleyphd2023 I hope this becomes the case. I appreciate your work

[@An-mei]

Thank you Dr Barkley.🌹Very interesting! Does the person remember about what they were thinking about as compared to dissociation?

[@russellbarkleyphd2023]

Usually, yes, but not always if it is mind blanking as there is nothing to recall.

[@An-mei]

@@russellbarkleyphd2023 Thank you. I am so grateful to hear of you.

[@TeeganLee]

Is the presentation of CDS similar to sleep apnea? Would sleep apnea need to be ruled out for CDS to be considered? Are there studies looking at whether CDS could actually be caused by sleep issues?

[@bethanykittok3903]

Good question! I would love to know the answer to this as well!

[@KairosDBT]

Fabulous.

[@slartybobfoster2273]

I get this thing sometimes, especially if I'm tired, where I just stare straight ahead, my eyes can lose focus and I'm just empty. It's not scary, it's actually quite enjoyable. It's like I'm just taking a break and only lasts about 10 or 15 seconds. I've done it all my life and I've noticed others doing it. If someone talks to me during this experience it's like I'm not there. I might reply with "what" but it's almost a dream like "what" and I'm not alert. Is this what we're talking about here?

[@Catnapdogday8008]

Everytime I have tried to describe what my mind is doing when I “zone out” to professionals I have been told they sound stroke like. My mind is completely blank. I’m thinking of nothing, or often repeating one word over and over. My mental fatigue is and always has been in control of my life. I can sleep for 12 hours a day and want to sleep the days away. My mind is nowhere in my zone outs. I know where I am and what’s going on and I can hear my name or respond if being spoken to but at the moment it’s happening there is nothing going on inside my head. I just stare and I feel my eyes drying out and tell myself “blink now” and then back to nothing until I’m forced “back into the room”

[@mrchips.9245]

do you get stressed too quickly and have problem with procrastination? and everything seems boring

[@Rigoroushonesty]

Dr Barkley: what if the mind wandering consists of analyzing the environment or the behavior of the people in the vicinity? Or attempting to recognize patterns in people in their environment. I often disengage to this extent, it causes severe impairment in my employment. What's wrong with me. And I often see things that other people don't.

[@Desh681]

9k viewers in 16 hours? Alright, there's more of us than i thought lol.

[@MoEl2]

This channel by Dr Russell is just describing me for atleast a year or two. I have never been like this, I'm 26...

[@classuscle1605]

When my CDS symptoms get worse, I feel like I'm taking an antipsychotic or first-generation antihistamine. It reminds me of the sluggish, drowsy sedation caused by diphenhydramine, quetiapine and promethazine. Stimulants (amphetamine, methylphenidate, caffeine) become less effective, to the point where I can sometimes barely feel them at all at the prescribed dosages. I find it a lot easier to fall asleep as well. The tiredness is of a different nature to what it feels like when I don't get enough sleep - it's tightly coupled to apathy and fewer emotions. Could there be some sort of dysregulation of the brain's acetylcholine/histamine pathways involved?

[@zakm0n]

Any information of type 1 juvenile diabetes and CDS?

[@tracyerskine7573]

As a child I regularly got pulled up for staring blankly or for my mind wandering. Now as an adult I listen to books and even watch films and box sets and I find myself watching or listening but I'm not always focusd on what I'm watching. I know there is sound and visual occurrences but I don't get the detail it just flows by... I have always experienced mind wandering and staring, blankly and loosing track of what I'm saying or even missing what I'm seeing and hearing. If I read or watch something that I am familiar with I can fill out the blanks but otherwise I can't and needed to go back and listen or watch from the last but I remember. Is this ADD, SCT or CDS or all three?

[@legoguru3000]

If you know anyone doing research on this that need someone who might have it I'm here 😆✋

[@russellbarkleyphd2023]

Check out the list of authors in that review paper cited in the video description for who is studying CDS now. The lead author, Steve Becker, is especially prominent in this field.

[@Spectre2434]

❤❤❤ The ADD 😮😮😮

[@dmb357]

Dr. Barkley- why hasn’t CDS been included in the DSM yet? Do you think it will eventually?

[@russellbarkleyphd2023]

There was not enough evidence on the validity of CDS as a separate disorder back in the years 2008-2012 when the DSM was being revised. That has all changed since then so let’s hope it gets into the next one, DSM6 whenever that gets created.

[@yfdvjjjhvdd]

All I know is mine is not voluntary even tho I have a consciousness as I am mind blanking.

[@BBFCCO733]

So this definitely describes me. I’m taking vyvanese, do you think I should ask for a second opinion as treatment?

[@ernestalab6592]

I just been diagnosed with ADHD and starting same meds as you tomorrow. Does it help ? As I have all symptoms of CDS like you 😮

[@spookshow]

Are there transcripts to these videos?

[@russellbarkleyphd2023]

No, sorry, but an AI program might be able to do it.

[@Spectre2434]

Is this in the DSM

[@shinpad]

I’m not sure if you have the money but paying for an editor for your videos might be more effective in reaching a large amount of GenZ and get this the proper attention it deserves

[@jowke7289]

They can only handle 6 second videos 😩

[@niceguy2527]

How does on treat CDS?

[@g.m.9180]

"ADHD" is "ADD", they are not different conditions, just the same condition that can present with or without hyperactivity. In fact, ADD is now considered an outdated term. CDS is a different condition with different symptoms. It is not ADD. But it's possible to have adhd and cds together.

[@alexlaw1892]

It would make more sense to go back to calling it ADD. ADHD has never made sense to me.

[@Desh681]

Or EFDD (executive functioning dysfunctional disorder) or something similar. That was the one that clued me in on it’s severity

[@Drnonstop]

Could there be a ”third” too? Since ”treatment resistant” is a thing(? Is it?) and ADHD/ADD seemed to have the same treatment. But if ADHD is EF/SR-D and ADD is CDS, could there be something else like dark matter, hidden in plain sight? Or might trauma involved since the youth have a permanent spot in the working memory and therefore causing an underdevelopment alongside? Crazy theory: could the power of suggestion (helped some children w ADHD with fake MRI-scan) actually cause you to have an imagined disorder? (In adhd with or without cds, or with misdiagnosed or no adhd)?

[@russellbarkleyphd2023]

Maybe. We just don’t know a lot about this but we know enough to know it exists as a legitimate condition. Be well.

[@Drnonstop]

Thank you! Interesting, some people say they were too late to explore the world, too early to explore space - but they are now in the present where the mind needs exploration!

[@bethanykittok3903]

Love the dark matter reference. Sounds like a Star Trek Episode where dark matter gets trapped in Spok's brain!

[@PhoenixsWorldVideos]

Can't believe they named a real disorder 'SEE DEEZ'