The Persistence of ADHD to Adulthood - Important New Findings

[@chillenld]

Higher work demands mean I don't have to regulate as much when you look at the big picture - prioritize work over everything else. Don't talk to friends, ignore health concerns, skip appointments, mess up your sleep, get generally impulsive outside of work. I shift toward detail mistakes instead of bigger picture things at work. It's much less noticeable to anyone but my partner and I, and even then, success at difficult work looks to both of us like doing well a lot of the time. Then inevitable burnout or health issues, forces a reduction in demand, means a forced one-dimensional reprioritization toward health, if you're fortunate enough to be able to take a stress leave or be supported during this period. Then you go to work, take on more than you should, get praise or benefits for overloading, and the cycle repeats. Crashing really hard on one of these cycles led to my diagnosis late in life, but you could even see it in childhood. My anecdotal theory is partly linked to time blindness. I'm extremely uncomfortable and exhausted when I have to consider future events, plan out how long tasks will take, be generally mindful of the time, but if I'm essentially handed a "time blindness is good" card I'll happily lose myself in that demanding task, no matter the ancillary cost. Edit: Oh, and not to end on a negative, note this can improve with recognition. Recognizing the cycle helped to identify the different areas of dysregulation, to notice when they creep in, and to actively shift priorities over time to necessitate regulation in more areas. Giving forgiveness for the problems that comes up from this, and taking steps to adjust before it spirals out of control.

[@melodyyoung9640]

Thanks for the relatable comment

[@MarlaCouture]

Thanks for verbalising what I have been trying to articulate for so long.

[@sensitiveself]

Well this sounds familiar!

[@Valgween]

I've also described a lot in my life

[@bethanykittok3903]

Whoa, this is clarifying. Work demands high=less trouble with prioratization! 😮 it's me

[@velvetvvitch]

For me and many of my fellow patients in burnout rehab, especially late diagnosed women, it's the opposite. I do believe the childhood diagnosis plays a big role here, in my experience being untreated poses a huge problem until we can figure out how to change our lives to live more in tune with the adjustments needed to reduce stress. Yes, we can perform very well under pressure but if you live with substantial stress over long periods of time it turns out parts of your body start dying.

[@jessd956]

Yes!

[@deepestbluesea_6351]

Why 'especiallly women'? I only ask because, as a very late diagnosed male with severe ADD of the predominantly inattentive type, it gets a bit wearing hearing descriptions of ADHD in women and girls that precisely matches my own experience, and it bothers me greatly that the assumption that boys don't suffer from adhd of this type means that those boys who do (as I have done my whole life) will be dismissed as not having adhd 'because only women and girls have adhd like that'. And please don't take offence at this comment: my own daughter has ADHD just like mine and, just like me, she's quiet, introspective, a daydreamer, who does well at school because she works twice as hard as she'd otherwise have to. It's not about disrespecting the experience of girls and women, it's about not leaving the 'inattentive', non-hyperactive, internalised-ADHD children of either sex behind.

[@zachhanks4399]

@@deepestbluesea_6351I don’t think this is a problem that exists outside your own head. Am male, am late diagnosed ADHD without hyperactivity, father of ADHD son with hyperactivity. There’s no underdiagnosis problem for boys or men who have ADHD without hyperactivity. There’s is, however, an underdiagnosis problem for girls and women that’s existed for decades and still in the process of being rectified. I think you’re conflating what’s *possible* with what’s *probable,* or with what’s actually true. Furthermore, there have never been ADHD subtypes. There were ADD subtypes in the DSM-III until 1987, when with the release of the revision (the DSM-III-R) the name was changed from “ADD” to “ADHD,” and “subtypes” were removed altogether as a classification, because patient symptoms were observed to change significantly with time, maturity, and differing contexts - especially hyperactivity, which almost all ADHDers outgrow by adulthood. If you have ADHD, you just have ADHD, and your symptoms not only will differ from mine, but they may differ from your own symptoms at an earlier or later time in your life.

[@nekoneko-tw9oj]

Same

[@goaway6339]

@@deepestbluesea_6351 A significantly under-researched arena is how female hormone cycles and life stages affect symptoms and life course for women. It's commonly talked about now how stimulant medications don't work as well (if at all) for a good week every month, and then constantly post-menopause. The social demands placed on women can be quite different too. So, not invalidating your concerns, but there's an extra layer of complexity here and it's been historically unacknowledged or ignored.

[@NSBT19]

When I'm given a task and a due date I'm unstoppable. When I have to manage others I have difficulty trusting delegation. When I have to do something for my own sake, it is difficult, but when something is done for somebody else I will stay focused.

[@mattjbirtell]

I struggle getting out of bed for anything I want to do for myself. If it’s for work, my dog, family or someone else. I will get out of bed and be there… Idk if it’s depression or poor self worth or both but I struggle with doing anything good for myself.

[@bikergirl420.]

Very relatable. High demand jobs that are physically demanding & dangerous to some, but not to us keep me in a good zone, but only if the job is enjoyable. Hormones changing in later life, even with hrt is horrendous for adhd symptoms. Worse than being a teenager.

[@melodyyoung9640]

I'm sitting here nodding my head,

[@mrsrichards99]

Yep. Menopause nearly killed me, and I mean that literally. HRT is helping things to improve, but I doubt I will ever again find a stimulant med effective, and that feels pretty devastating.

[@bikergirl420.]

@@melodyyoung9640 the enthusiastic adhd nod 😂🤜🏻🤛🏻

[@bikergirl420.]

@@mrsrichards99 Feel your pain & understand. Just wish in the U.K. there was more support/awareness on this 🤜🏻🤛🏻

[@paulbolton2322]

@@bikergirl420. Correct zero in NHS, irony...... Lol. Thank god for peer groups.

[@nickwright9064]

It must depend so much on your adult life. I used to be a musician. ADHD (diagnosed as an adult) was there but far less of a problem. Now I am a lawyer, billing 2,000+ hours per year and juggling a lot of cases. It's a huge problem in that life. It must be very difficult to get comparable data. I can comment on the busy/stressful periods point, albeit probably on a shorter timeframe. My experience is that when I am very busy at work, I am stressed, but my anxiety level drops. I think ADHD can leave us with feeling of inadequacy, of not doing or being enough. But billing 10-12 hours in a day when very busy, those feelings fall away. I can't work more. I've done enough. When work is quieter, and the adrenalin is lower, my ADHD is much more of a problem for me. This is when the burnout hits.

[@Minepj]

Define symptoms. My EF were exceptional when I was caring for my mother after she got diagnosed with cancer up to her death from the illness. That is, my EF were exceptional in that specific context, outside of it my working memory for example was completely shot and took years to recover, my ability to focus on anything else was nonexistent. So yes, you can isolate periods of our lives and superficially conclude our symptoms are reduced but it's really an illusion. Unfortunately it's not how ADHD works.

[@Somebodywhoexists]

I wonder for you if there was a bit of hyperfocus happening while caring for your mother, and I also would be curious about how your nervous system was responding to the stress. Hyperarousal can give us that energy boost that can support functioning in the short term, but can lead to illness or burnout if we are consistently relying on it to function.

[@Minepj]

@Somebodywhoexists The thing is none of these has any bearing in real life. It's not like you can just get into a clinician's office and have these things assessed. I feel like sometimes the discourse on social media gives the wrong impression that this is what ADHD diagnosis and treatment is. The outcome of my assessment is that I have ADHD with particularly pronounced working memory and EF issues.The psychologist ended giving up on trying to figure out what my presentation/severity was because she couldn't confirm the findings of the clinical interview (high on inatention symptoms) with CPT and ended up questioning how reliable my answers were. What the psychiatrist concluded is that there's nothing warranting treatment in the psychologist's assessment, my issues are, because of course, a "refuses to try hard enough cuz personality" thing. Oh and I have a high iq (working memory and processing speed non withstanding) which isn't really helping when faced with such bs.

[@lambs5258]

“Bounty paper towel commercial flannel” gave me a laugh LOL

[@gyahwhat9648]

me too! although i think it's brawny

[@hardrocklobsterroll395]

I feel like my periods of reduced symptoms are often followed by a period of low energy burnout or inability to maintain habits.

[@Endomatx]

I find this fascinating! I've long noticed in myself what I've described to others as a sense of "momentum" that would build during periods of heavy obligations. During some of the most demanding of these, I basically felt no symptoms of ADHD at all but never really connected the dots for some reason. It is also a common experience for me (primarily inattentive adhd) to struggle most with the initial start of a task but often once I've begun it isn't nearly as difficult to continue. I'm curious if there is some sort of shared underlying interplay between this small scale sense of "resistance/relief" for individual tasks and the larger scale sense of compounding "momentum" when life is particularly busy. Always appreciate your videos, Dr. Barkley!

[@mattjbirtell]

The anxiety and time constraint drives you forward to begin and finish because there is no time to procrastinate. The continuous accomplishment of tasks means you’re earning dopamine the reward chemical. So you feel more focused and driven to finish due to the anxiety and consistent dopamine drip. 💧 I’ve noticed with my ADHD and with most people with ADHD the busier I am the less depressed I feel and the more work I get done and can do. Dr. K or Healthy Gamer for a 1.8 his first semester of college so he quit playing video games the next semester to try and focus more on school. He ended the next semester with a 1.2 or something. Proving that being less busy and having more free time usually exacerbates ADHD symptoms and executive functioning issues. 😅

[@rogermcgrath7946]

Oh just hearing high demands periods, yes! Deadlines like school exams helped me focus. They gave me structure.

[@rogermcgrath7946]

But then Id burnout hard 😂😂😂😂

[@miriam4235]

I find that periodes of high demand, also come with more external daily structure systems. It also more people holding me accountable. Both things that reduce symptoms.

[@vans4lyf2013]

Exactly! That’s been my experience too

[@ThePatchworkQuill]

This resonates with me too - oftentimes these periods not only have the inbuilt urgency and accountability that I struggle with day to day, there's often less decision making and strategic/long term thinking and planning required. If I have clarity on what needs done and how it needs done, and it needs done now, that's pretty much everything my brain needs to function well. And when that sweet spot is achieved, it feels like my brain chemistry is closer to what is considered typical, and that can bleed over positively into other areas of my life, like timekeeping and general working memory. That said, the exact opposite occurs in high demand times, if the demands on me involve planning, strategic thinking, or there is ambiguity on what desired outcomes are or what exactly is required from me. High demand situations where the demands involve things which are unfamiliar or for which I have no frame of reference or template to work from, or at least to start from - that can render me virtually non-functional, with zero ability to articulate that I'm struggling or identify the support I need.

[@ntufar]

I think the recurrence of symptoms depends on family, work, social life environments. From my experience, when I have a relatively calm periods with good environment at work, loving family environment, good social life, the symptoms are less pronounced. But when there is a stressful event at work, family life, social environment, the symptoms come back and require treatment.

[@aprilwichman98]

For me, and I am a 58 year old woman, the key to this is better metabolic health and improving the gut microbiome. As someone who grew up during the 70’s and 80’s my parents followed the low far craze and we were raised on processed foods, inflammatory seed oils, and margarine. As a child I could not pay attention or sit still in class. I couldn’t go anywhere in a car without extreme motion sickness, etc. My story is too long to post, but today I am my best self and greatly improved on a low carb diet, simple whole foods, regular exercise consisting of 8 hours of pickleball and heavy weight training, and supplements including vitamin D3, K2-mk7, Quercetin, Zinc, & Magnesium. I fall asleep with one minute of laying down most night. No pharmaceuticals, ever.

[@KatHot567]

I would be one of the recovered persons throughout my 20s and 30s - until menopause hit and all the symptoms were back after decades. Also the high demand argument fits me also; throughout these ‘symptom free’ decades I was engaged in high demand activities and I believe today that the obligations resulting from the high demand kept me performing well. Looks like there’s a price to pay for it as I’m now falling apart!

[@nananoname3089]

I took a break after school, worked, travelled and idled around for 2 years. I felt incredible!! I started university in a difficult subject and... i got soo overwhelmed. When life stuff crumbled around me it was just too much. ...so the -having less symptoms and therefore taking on higher demands- makes a lot of sense to me. With now some years of therapy I know I need to find/create a balance in my life to sustainably live a good life (..depression and burnout free and whatever)

[@Tekay37]

The fluctuating explains so much about my life! I always had phases where I could just easily get my work done and then there are phases where I can't make any progress, no matter how hard I try. I have to reflect what caused each phase, because I am pretty sure both phases were a reaction to things that happened in my life.

[@gyahwhat9648]

one more possibility that might explain this... times of high demand/stress can raise your body's production of cortisone. cortisone is anti-inflammatory, at least in the short term. many anti-inflammatory medications seem to reduce adhd symptoms. so high demand lifestyle could be a way to auto-medicate

[@argonaught1291]

What is being measured? Could the ADHD in remission under stress also be masked? I have a job where I have to very carefully but quickly absorb information that appears then is gone - and then I have to improvise a response on the spot. Highly demanding and for pretty much the only time in my life I actually pay attention - because I have to. I'm truly thankful. But I am mangled afterwards. Similarly, working to a deadline works - I get things done - but my ADHD doesn't magically vanish. Sure, I experience a strong impulse to get things done that would otherwise be absent. But in most ways I fight my ADHD every step, am slower than I 'should' be and am a mess at the end of it. But I met the deadline and the work I produced was probably good.

[@Jotto999]

What I seem to experience is that higher demands make me more attentive *temporarily*. But I accumulate burnout, and after months or years I'm a hollow shell of a person, just fried. Eventually I come crawling back into a low-stress lifestyle, where my symptoms seem exaggerated *temporarily*. Then my burnout symptoms slowly improve over months/years. Been through this cycle many times. Right now I have 2 saving graces: 1) my girlfriend is a very good-natured person, and 2) I'm surprisingly good at handling money, to the point where I'll probably retire by age 40. Severe inattentive-type, diagnosed at 30. Stay strong everyone, focus on the long-game.

[@bethanykittok3903]

Sell us your money self-help book? 😂

[@chriscohlmeyer4735]

A missing part of the diagnosis in my opinion is : do you or have you learned to mask or compensare for the various criteria. Late adolescents and young adults likely don't need significant masking to generally fit in with the NTs. In later adulthood the masking and compensating take their toll leading to more being diagnosed or re-diagnosed. A friends son was diagnosed at age 20, during that process the mother was told "you also have ADHD but are currently managing without treatment, if that changes you can talk to your doctor about medication",

[@rm06c]

This really is a remarkable study and not one I would have expected. Considering that ADHD is highly heritable, do we know if the fluctuating symptoms are also heritable, I.e., do people with ADHD that goes through full remission also have children with ADHD that goes through full remission? On a separate question; I always understood ADHD to be a disorder of the brain and it's structures and/or connections. If the majority of people with ADHD have fluctuating symptoms, is the brain changing itself in order to fix or compensate for the issue? What's going on in the brain of an individual with fluctuating symptoms? Are there significant or noticeable changes in the brain when comparing symptomatic to non-symptomatic periods? Excellent video and thank you for everything you do on this channel.

[@ChristianEwald]

It's unlikely that the brain structures themselves change that drastically. Performance in ADHD is variable and inconsistent often depending on factors like interest or external pressure. Keep in mind that Dr. Barkley often stresses that one pillar of ADHD management is accountability. A high demand environment automatically means a lot of accountability. I'd be curious if the researchers will follow this study up once people reach their mid-thirties. Bonus points if they track rates of anxiety and depression for particpants.

[@tristanreimann4103]

I really struggled with this study as it was really the opposite of my experiance. The symptoms might be lesser during periods of high work but it's extremely unsustainable. I work as an engineering professional, when in work crunch periods of extremely focused work I find my body switches into hyperfocus mode, but rather than obsession into an idea it's into supporting "the execution of work". I can work for 1-2 weeks up to a month at levels of extreme focus, demonstrating almost zero symptoms. But when that task/work is done I rebound and am at some of the worst symptoms I get for a time usually atleast as long, usually longer. The hardest part for myself and professional friends is that this demonstrates a standard you can work at, but you can't live up to for significant periods of your career/life

[@bethanykittok3903]

Love this as it highlights that the brain can change over time.

[@EddieSlabb]

Wonderful information for those who need it. I can relate to the findings for as an adult, I was "test wise" enough to know what responses fit with normative behavior. I did not want to have the stigma of having a disorder, even though I surely have since benefited from treatment and support.

[@russellbarkleyphd2023]

thank you for your note and for your support.

[@melodyyoung9640]

My busiest parts of working life were chaotic, and creatively focused. So while I may describe them as good, in retrospect I tailored my life to allow for "unimportant" details to drop away. Recently that I've been more objective about the hard parts. I wonder if ADHD people accept tradeoffs. I thought instability and disorder was the cost for engaging in an interesting and creative life. The story I've told myself was that I was working too hard to accommodate and maintain the "normal" stuff.

[@tbs_Incorporated]

I was rewarded for suppressing and obfuscating my symptoms. Still had them, just didn't talk about them out loud and became agitated when they were pointed out to me. As for demand, having demands placed on me helped focus and hyperfocus, unless or until I couldn't effectively perform the task. Then its despair and depression.

[@bethanykittok3903]

^this^ so much this

[@boossersgarage3239]

cool to hear about your side hustle doing Voiceovers.

[@russellbarkleyphd2023]

Thanks! just keeping it light.

[@ADHDES]

Also the life demands increases over ages form childhood, Adulthood until elderly forward.

[@deepestbluesea_6351]

Thank you for this video. It's a very interesting study and a very good summary and explanation by you. It also helps me to make a bit more sense of my own experience.

[@SteelmanArgument]

Really interesting. I (29M) was undiagnosed during my mid 20s for different reasons. And I can totally anecdotally relate to this. I got out of college and started at an IT department at age 23. I quickly earned reputation and became a team leader by 24. I excelled at it. But then I fantastically CRASHED on the brink of burnout within roughly a year. And I always got feedback that I was bad with deadlines, organisation, planning etc. I switched a position “down” recently to get rid of the stress and it’s one of the best things I’ve done for myself.

[@gyahwhat9648]

this clears up a lot of the confusion I've had regarding periods of my life when I was relatively successful. often without any significant amount of scaffolding

[@gyahwhat9648]

then again, many of those times coincided with glucocorticoid medications

[@JustMyAutisticalities]

This is such an interesting report and study. Thank you so much for sharing and explaining the most important points. As an Adult with AuDHD I can relate to the findings on a personal level. I look forward to your next review. Thank you again!

[@rogermcgrath7946]

Would love to know the correlation of the people and the exercise they did at the time of lessened symptoms - I did so much sport and exercise in school it helped me thru study etc

[@zergbong]

the more difficult the job and the friendlier the team, the better I feel. We need a bio marker, these studies even I don't believe them.

[@ADHDES]

Higher work and life demands increase stress level which act as booster for tasks achievement and doing well, this stress rise the level of cortisone and norepinephrine as a part of fight or flight responses of the sympathetic nervous system, which leads to activition of presynaptic A2 resptor in prefrontal cortex in which cause increases in signal amplitude and ignoring in reliant signals, but in long term stress exposure lead to the opposite and cause dysfunction at all.

[@Dirty_Hamble]

"Bounty commercial!" 😂 Love it!! 👍

[@piotrgraniszewski8544]

Wow this is groundbreaking work ❤

[@julietteelisabeth1734]

I think even those of us who remain in the diagnostically significant category, if tested with a less blunt instrument than the DSM would see fluctuations. Especially in women if tested at different times of the month and tested in puberty, pregnancy, postpartum, and perimenopause. Hormones play a significant role in fluctuation in ADHD in women due to the role of oestrogen and how it affects dopamine production and it is seriously under represented in research.

[@rhiannonkingston9659]

It would be interesting to see a follow up study that divides people by gender/biological sex as they age. The high demand times also seem to be when people’s sex hormones have stabilized for periods of time. Yes? No? Is it not a bit premature to say that people have recovered/outgrown ADHD in their mid 20’s? We typically live much longer than that and could continue to fluctuate.

[@OriginalOogway]

Hello dear doctor Would you please make a video from your Respective on study techniques for medical students Would like to hear your suggestions 🌸🙏

[@mrmarksmeets]

I don’t recall him saying what the definition of “recovery” was.

[@melodyyoung9640]

My mind went there too

[@mrmarksmeets]

@@melodyyoung9640 the best definition I could find of "recovery" was this part "The participants were grouped into four longitudinal patterns: stable persistence (symptoms consistently met diagnostic thresholds), stable partial remission, recovery (sustained full remission), and fluctuating ADHD (alternating periods of remission and recurrence)." So in other words, the definition really is about the "elimination" (or full reduction or these things just 'go away') of all the ADHD traits, your working memory is fine, can organize yourself, no wandering thoughts, life magically falls into place (ok, I'm being cheeky on that one) The other question I would have is for the % that this did happen too, were they really ADHD brains?

[@melodyyoung9640]

@mrmarksmeets maybe "remission" would be a better word? I wonder if the participants were living lives or doing jobs that required tedious or annoying aspects. I've had phases where a cooperative atmosphere played to our strengths, so my "symptoms" were not draining. It seems a very hard thing to measure.

[@mrmarksmeets]

@ yeah there could be a whole bunch of factors too, could be masking/suppression, could be lack of knowledge and not being aware that a particular trait was a result of adhd, like he said in the video it also depends who you ask Remission, not sure…would reduction be better?

[@melodyyoung9640]

@@mrmarksmeets I threw a random word out there because I have trouble imagining how the data could be reliably measured.

[@HerneyReyesGutierrez-oq8ef]

I waa about to go to sleep until i saw this up

[@jonathandelapaz-se6vz]

Good morning

[@Cerbera66]

It was different for me, as a child and teenager I had clear ADHD symptoms (retrospectively, the diagnosis itself didn't exist then), then it got better until I passed the age of 50. From then on, it was as if a dam had collapsed and the symptoms have actually been worse since then than before. 😒🙄

[@NewLeafEFT]

I look forward to this study stretching beyond age 25 to 30 and beyond the time when the brain, by neurotypical standards, really finishes developing. The age when young men cease to be daredevils and start to weigh consequences. Then I look forward to it stretching to menopause. Then I look forward to it being subcategorised by wealth and employment, and the levels of boundaries, challenges, autonomy and new experience in that particular life. Finally I look forward to the neurological difference being measurable to the point that subjective personal experience of the differences is no longer the main diagnostic tool. It would be rather nice if brief amphetamine therapy were an acceptable test because a) measurable physical differences contrary to expected of NTs and b) nobody can really get a handle on how out of step things really are without first getting a tiny insight into the other experience. We are asked to measure difference with no benchmark and it delays adult requests for diagnosis until a crisis point. When are we going to stop saying to people with these functional differences that they can hobble round the track, so there is no service until they fall over?

[@shaneward_adhdreimagined]

Is remission a useful word though? If ADHD is considered highly heritable, the distinction is a diagnosis predicated on its level of impairment in life circumstances. The starting point for a diagnosis is a value judgment on the level of impairment in a particular domain, which would then suggest that a remission is the same - you only "have" ADHD when you're struggling to manage your EF and emotions? Yet there is sufficient evidence to suggest that some of these dopaminergic pathways have a significant genetic basis?

[@kennethnicholson3750]

This is like the ADHD version of the sorting hat picking your house in hogwarts

[@sv863530]

A tip for everyone interested in the original paper: Visit your local library. They may have a way to get you a copy of the article for a small fee.

[@Blackcomanche]

Alternatively, go to your nearest university library!

[@jonathandelapaz-se6vz]

Scihub

[@russellbarkleyphd2023]

or view the abstract using my reference in the description and find her contact information there then write to Dr. Sibley directly for a free reprint.

[@creativesource3514]

Go to pubmed

[@ograda3120]

I always figured that the premise of the hunter-gatherer book addressed in one of the videos here is in the fact there's NOTHING more 'interesting' (demanding), in nature, than a growling stomach. Not your boss, not your friend, but your stomach. It's easy to see how this sort of urgency (although at the time normalcy) could benefit. All of this of course if the first explanation is true. Never read it though so I don't know

[@OrafuDa]

2:58 Btw, the legend on the graph in the paper appears to have the letters on the data points partially wrong. “S” data points appear to be self reports, “T” teacher reports and “P” parent reports, but the legend has a “T” on two different kinds of reports at the top and a “P” on two different kinds of reports at the bottom. And the bottom legend also puts an “S” on the combined report nodes. This should probably get corrected on such an important graph.

[@russellbarkleyphd2023]

As the title of the graph says, these are just individual examples of each group. And, yes, where the lines converge from the different sources of reporting it’s very difficult to read the letter indicating that source of reporting. This doesn’t change their overall findings reported later in the paper. Thanks for the heads up though and for watching. Russ

[@SharonSoupcoolers]

Hi Dr Barkley, I have a question concerning my just turned 13 year old daughter. She has been medically on paper diagnosed ADHD, ODD, CD and LD.. She’s on Concerta 27 mg one daily. My question is, she was born with Sagittal Craniosynostosis.. She had the major CVR head surgery a day after turning 5 months old. She had a lot of frontal bossing. Did this condition play its part in her ADHD..

[@russellbarkleyphd2023]

I really can’t say for sure but any process adversely affecting the frontal lobes can produce an ADHD like condition. I wish you all the best for your family.

[@helion6884]

Can you please give definitions of what is meant by remission and recovery? I believe that these terms are being used specifically to describe the reduction in the presence and severity of the outwardly observable, quantifiable, disruptive symptoms established for diagnosis in the DSM. I don't believe you mean that the underlying neurological functions and traits associated with ADHD some how change in cycles. My understanding (and my own internal experience of my own cycles of waxing and waning symptoms as an adult) is that the core neurological traits don't change. My experience is better described as a cycle of alignment and misalignment between my traits, the availability and effectiveness of my acquired coping strategies and accommodations, the demands and stresses placed on me by my environment, and the demands I place through the goals I set for myself within my environment. When those factors are in sync I don't express the symptoms, challenges, and disruptions of ADHD the same way as when they are out of sync, but my brain is functioning the same in both cases. An analogy would be someone who experiences damage to their ulnar nerve that impairs hand strength and dexterity. Initially they will experience and express significant distributions in the tasks of daily life. But, after enough years of adjustment, practice, and with the right supports and accommodations they may get to a point where they can function in life just as well as someone without that nerve damage. As a lay person I don't believe the words remission or recovery would be accurate descriptions for that change and I wonder if the use of them here, for ADHD, is enforcing a particular framework of understanding that may be misleading and may lead some to come to unhelpful and incorrect understanding of the nature of ADHD in adulthood.

[@PKWeaver74]

There are two types of children with ADHD, those whose ADHD persists into Adulthood and those who were misdiagnosed.

[@dratatianacostella7985]

I have very impaired ADHD kids , being on stimulants since very young age makes a complete remission more possible?

[@ZombieHobo]

There’s no time to daydream when you have too much to do.