> People always describe the disorder as "lack of focus" but that's a really poor description for what I have.

The diagnosis, for me, became obvious when I reframed it from "lack of focus" to "poor control over what I focus on".

> I reframed it from "lack of focus" to "poor control over what I focus on".

That's exactly it, and why I prefer it be called an executive function disorder rather than any kind of focus disorder.

I can focus just fine. Too well, actually, to the detriment of all else, including physical needs like eating and sleeping. But I can't control it. I don't get to choose when I'm productive or when I'm not, let alone what I actually focus or work on. I could go weeks at a time where absolutely nothing is interesting enough, everything is painfully boring, and I'm so task paralyzed I just can't do anything. Likewise, I might give into a project for 48 hours straight non stop.

It's amazing I have a job at all, to be honest. I am also autistic, and it is a special kind of hell at times.

I'm audhd also and the truly disabling part of my neurotype is the fact that I can do things and focus, I just can't choose when and where and what my focus is on.

From decades of experience and lots of reading it's exactly this, and this is the important detail that most neurotypicals including many doctors are missing that would allow them to understand instead of being dismissive.

I find monotropism an apt way of understanding it. A normal person's attention is like a flashlight they control that illuminates much of a room at once. Autistic brains are a tight beam flashlight, almost a laser for some, with its aim difficult to change. ADHD brains are more like a tight beam flashlight on a motorized mount that swivels in all directions, but you're not always in control of where it swivels to...it's like an AI constantly overrides your direction inputs and points the light at what it deems most exciting or urgent at the moment.

> but you're not always in control of where it swivels to.

If we're going with that metaphor, I'd phrase it more in terms of that mount being prone to jamming. My attention doesn't go to completely random places, it only goes to places I want it to, but then gets stuck on things that wouldn't hold the attention of a neurotypical person.

> If we're going with that metaphor, I'd phrase it more in terms of that mount being prone to jamming

> but then gets stuck on things that wouldn't hold the attention of a neurotypical person.

Indeed, attention is frequently held for many hours or even days on the current subject of hyperfocus. I too have great difficulty deliberately directing my attention toward a subject I don't find exciting, but find it easy to get locked in on my natural interests. Hyperfocusing on one of my passions is delightful, even if it detracts from other important things.

> it only goes to places I want it to

That's true for me in a sense, but I've had so much trouble from hyperfocus states that I don't think about it quite that positively. I hyperfocus on a new hobby every week and buy tons of stuff for it that I abandon for the next week's hyperfocus. I get locked into politics and flame wars that make me stressed and sad the whole time, but waste hours on them. I would like to get locked into one of my passions that I always enjoy and that also enrich me in some way, but I end up spending hours hyperfocused on researching some esoteric topic of the day instead. Or worst case I hyperfocus on potential sources of doom and how to prevent them, but maybe that's not due to ADHD alone. All of those are things I "want" to focus on in some sense, but in many senses I very much don't want to.

That's why lack of control of the focus' subject seems one of the most important aspects to me. In my metaphor I guess I'd say something like the focus of the AI that's overriding my direction inputs is what's getting stuck on a subject.

> that I don't think about it quite that positively.

I don't think about that in a positive light, it's just factual information that helps me understand the shape of the problem. It's about recognizing that the places my focus goes to aren't random and arbitrary — I've never gotten stuck on, say, the intricacies of tap dancing, because I have little to no interest in tap dancing, and no reason to care. I did get stuck on knitting for a short while because I bought some pattern books as a gift for my mother, and had a peek inside — I _wanted_ to have a peek inside, what I didn't want was to lose a few hours to it.

Is it possible that autism is like a mode that gets switched on by the environment and in modern day it doesn’t switch off?

In many parts of the world during tribal times, feeling like you didn’t have control and feeling like the world is unpredictable is probably going to lead to death. Hyperfocus on getting things under control (in specific areas) would be useful, for example hyperfocus on shelter before winter if you feel like that is not under control, or hyperfocus on the food supply if that is not under control.

In the modern world it’s plausible to me that the conditions are just so out of control of the individual that the mode never turns off, and you get random seeming intense focus and irritability around lack of control and lack of focus on social fluidity (which in the tribal environment was basically N/A since everyone was basically the same as each other and you didn’t need these flexible protocols for socialization) etc etc.

I’m not diagnosed with autism but I feel like I have a lot of the classic traits and when I pay attention to my environment a lot of things bother me and I feel better when I fix them. But so many things bother me that it’s basically impossible to fix them all and then I disassociate from them. The things that bother me are like “this design is bad, fix it” but I can’t change all the objects around me like one could in a tribal setting where everything was made in house. Same with routine that is impossibly complex compared to tribal life.

This was also my experience. I found it bizarre that my son was being diagnosed with ADHD when I knew perfectly well how much he focused on his projects. When my sister (who learned about it when HER son was diagnosed) explained why hyperfocus was a diagnostic characteristic, it suddenly made sense.

It is also worth noting that I have encountered an effective therapy for ADHD, which also works miracles for many with autism. It is available at https://thecraigschool.org/. Unfortunately their therapy only works in prepubescent children. That's because it requires the child to make a strong 2 year emotional commitment, but nobody is ready emotionally to predict how they will change after puberty hits.

Still the fundamental principle of the therapy is generally applicable and interesting. It is to condition to child to the idea that, "Every should must come reinforced by a want." This emotional reinforcement results in getting the most possible out of their executive control. With the result that the child becomes able to task switch away from, then back to, hyperfocus.

It is worth anecdotally noting that I've known a couple of people without ADHD who conditioned themselves to the same idea. They reported that they have both the ability to engage with hyperfocus, and to task switch in and out of that state. If we as a society focused on instilling "shoulds" with mostly positive reinforcement, this would be more common. So what brings people with ADHD and autism up to normal executive control, could bring normal people up to superior executive control.

If I was starting over as a parent (not that I want to, I'm done with that part of life!), I would definitely use this idea to inform my parenting.

  > "Every should must come reinforced by a want." 

Interesting! Can you expand a bit on that? I am interested in the theory and practical applications. I guess affected grown-ups would love to learn about how it works as well.

  > Unfortunately their therapy only works in prepubescent children. (...) but nobody is ready emotionally to predict how they will change after puberty hits.

I don't understand why it wouldn't work with people when they are older though. If, during education, young people change in such a way they wouldn't need it anymore, then at worst they might gain superior executive control, no?

The theory is simple. When the thought of should comes reinforced by want, desire reinforces executive control, and makes you more likely to do that thing. This causes executive control, which actually issues those shoulds, to become more effective.

Here is my understanding of the issue with the therapy based on my experience with it.

They have created a therapeutic environment with so many rules and demands that the child encounters a constant stream of shoulds. They also implement a carefully thought out set of rewards that gives constant positive feedback for those who are succeeding.

But that positive feedback loop only gets started after the child is succeeding. And therefore it is essential that children enter the program with an overwhelming desire to succeed, and in a state where every one of those shoulds will connect to that overwhelming desire. They have a carefully optimized intake process that creates this initial state. That results in a child who is absolutely emotionally committed to a two year very difficult program.

The problem that I see with people who are older is that once we enter puberty, we become more resistant to receiving constant demands from adults. This undermines that initial commitment. It also undermines the positive feedback loop that is essential to maintaining the commitment into the second year.

Even if I am wrong about why it happens, the program told me that they have an age cutoff because the therapy program doesn't work after kids hit puberty. It isn't just an abstract theory. They tried it, and concluded that it doesn't work.

Thanks! That sounds like the intake process is quite critical.

  > The problem that I see with people who are older is that once we enter puberty, we become more resistant to receiving constant demands from adults.

I see, I can imagine that the success rate for teenagers would be less that way. Still gives me food for thought. If it depends on the overwhelming desire to succeed, than I can see how an innate "want" arises when people grow older.

It was only years later that I went back and tried to understand the intake process. I was blown away by what I realized.

The key to it is this. These kids absolutely HATE the experience of lacking executive control, in a classroom. Teachers have no idea how often they launch verbal attacks, but it is sheer misery for the kids.

Then they encounter this program. The program sits them down. Explains how it works. Lets them poke around. Talk to the kids in the program. Verify that it really works. And lets them know every rule, and every reward.

Then the program tells them, "You can't come unless you have completely internalized it. Every time you fail, you must remember how badly you wanted to succeed. We can't give you a second chance. If you have any doubt, prepare yourself longer."

Separately we parents are told, "This has to be your child's choice. You cannot try to convince them in any way. If you try, we will know and your child will fail. If your child asks questions, answer them honestly. If your child says that they are ready, ask them if they are SURE. If they say yes, then they can come. Not until."

And now the kids are caught. They absolutely know the tiger that they want to escape. It is their daily life. They absolutely know that there is an escape. They know how it works. They know that it works. And they know that it won't work if they have any doubt. Every last rule. Every time they hear it. They must WANT it. For 2 years.

It took my son about a month and half to declare himself ready. The first few months were misery for him. But I'd never seen anyone so determined to succeed. And succeed he did.

Wow, thanks for following up! Great to hear your kid did succeed. Hopefully he will be the master of his own executive control for the rest of his life.

Pretty impressive that they can get these kids to this level of awareness, making it feel like it is their own choice. When I look back at my childhood, I can't remember I had any agency like that, nor awareness that you could have one.

Honestly, he's struggled with it at times. But he does a lot better when he goes back to creating positive self-reinforcement for why he wants to accomplish the goals that he has set for himself. He's now doing fairly well in college. He wants to experience more of the world, and to that end will be a transfer student to Beijing next semester

Wish him luck!

For ADD/ADHD it is easy to go off the rails. But if the stereotype of asian discipline and expectations of overachievement holds, than that surrounding might offset the possible distracting experience of an uncommon environment I guess.

> the idea that, "Every should must come reinforced by a want."

I haven't heard that before...I need time to ponder and process that, but on the surface it sounds like gold!

The parents and town I grew up with were extremely religious and authoritarian. I grew up hearing how our personal desires should be ignored and suppressed, and only the will of God and authority figures matters. I think neurotypical people may be more able to function with such a mindset, but it's a losing battle for ADHD brains to try to force themselves too far from their natural wants/interests. Especially since lack of emotional regulation is a significant(but less discussed) difference for ADHD, focusing first on emotions and reorienting wants before focusing on getting the task at hand done might make a lot of sense for us.

> I would say I have "hyper focus", to the point where if I'm working on something interesting, I will lose track of time and am unable to redirect my attention to anything else.

I feel like knowing this tendency has made me extremely protective and avoidant of taking on tasks. I appear “lazy” to the outside observer. It’s something I’m still trying to solve.

Same here. People sometimes say my stuff is over engineered. What they're seeing is that I have additional requirements relate to keeping the project in a shape where I stay interested in it long enough to make progress.

Its not exactly a recipe for reliable technology but neither is what the managers are suggesting (or rather, suggesting differently today than they did yesterday) so I manage to make it work out OK most of the time.

Well, it's well known that ADD/ADHD aren't about lack of focus, but about an inability to direct one's focus to where it's needed.

Normal people can think "I need X, let's work on X" but ADHD people are at the mercy of what's "chosen for them" by their brain.

This was probably fine 4000 years ago, when the world was looser, and people could find their place in life regardless of their particular quirks, but not so much nowadays.

This difficulty or inability to direct focus can be "trained away" with enough effort, but it isn't easy at all.

I think it's the opposite. 4000 years ago we would fail to prepare and not survive the winter.

Nowadays we get by by occasionally solving a problem that nobody asked to have solved but golly the solution is kinda neat.

Recent research suggests the opposite: ADHD made for better hunters which was a valuable asset to the rest of the group.

And even later on, community life, with fewer distractions, less sedentary boredom (like in a modern office job) and fewer demands for precise timing and continuous focus, also made it easier. Even school either didn't exist or was a much loser affair than the institution we know for the past 2 centuries.

I'd prepare for winter 10x more easily than focus on some boring ass corporate task in a world filled with bullshit distractions and endless structured and strict time demands. And I'd have an extended family plus community to help with things.

Consider how people think it's rude if you're somewhat late on a rendezvous or meeting etc. Then consider how clocks and precise timekeeping weren't a thing for most of history, nor was reliable transit, cars, roads, and stuff. You got there, when you got there - even today in more rural countries.

I think that's offset by our ability to operate effectively "under fire". My lack of ability to direct attention is mostly a factor of modern convenience and work structure I think. Being assigned a presentation to deliver on architecture changes in two weeks doesn't really have the same stakes as being a hunter gatherer. I know most of what I have to do to earn money is bullshit at some level and that certainly adds to my inability to focus on it. But when things are crashing, the server is on fire and everyone is panicking, I'm at my most comfortable. There is a real and direct need and I can handle those situations better than most people based on my 20+ years doing this sort of work. It's when everything is humming along smoothly that I'm least productive.

I also believe it to have been easier with ADHD in the distant past. My reasoning is that in a small, but tighter group there will be others who can compensate for the ADHD person's executive function deficiencies. But the ADHD person might bring enough of a benefit by occasionally going down rabbit holes or discovering stuff that's off the beaten track that the group will still tolerate them.

This a where I lean also.

I forget where (and I really ought find it again) but I recall some linking of ADHD as simply the kind of traits that are necessary for survival -esque scenarios.

I know that I don't feel as awkward and weird when I'm in nature or building huts or what have you. Seeing the abundance of what nature has to offer and the possibilities actually feels far better than being in a concrete building and being forced to walk ONLY in designated walking areas.

My ADHD always feels the worse when I realize that I have to abide by _insert_arbitrary_deadline_here.

> My ADHD always feels the worse when I realize that I have to abide by _insert_arbitrary_deadline_here.

Similar here. For me, if I'm given some arbitrary deadline in the future, it almost guarantees I'm not going to do the thing until the day before, or depending on the task, hours before it's due.

"Hey webguy, we need this report by the end of next week" means I'm not doing it until Friday afternoon, and I have no control over it. Doesn't matter if I try to work on it earlier, just won't happen.

It's having an interest based nervous system. We crave novelty, urgency, interest, and challenge to do anything.

While I don't dispute the biological aspects of life with ADHD, I also cannot escape the reality of bullshit timelines.

My essence knows, without a shadow of a doubt, that time is cyclical. And just because some person or org says, randomly today, that something NEEDS TO BE COMPLETED by next Thursday or the world ends, doesn't actually change the nature of time.

There have been countless things in life where, as a civilization, we simply allow for trivial shit like this to have actual, life altering consequences. I think we're dumb.

If we died off we wouldn't be here.

Gene expression is more complicated than that.

> This was probably fine 4000 years ago, when the world was looser, and people could find their place in life regardless of their particular quirks, but not so much nowadays.

Is this likely? My overgeneralizing gut feel would be that more people who would have traits which might be perceived as unusual and impede survivability 4000 years ago would be more likely to receive a chance to live a regular lifespan in most today‘s societies.

Increased thrill seeking activity includes sex. The evolutional advantage could simply be more chance of passing on genes; from that point on it doesn’t matter if you fail at life, get outcast from society and/or die young.

Today we're much much more about conformity, rigid structrures, time management, and so on, than 4000 years ago, or even 50 and 100 years ago.

And today we're much less about having extended families and communities that take care of their members and lend a hand.

At best we have some half-arsed provisions by an indifferent state, and we're left on our own. A slip and you're broke, or homeless, or depressed on your own.

Your first sentence is gold.

It's only in the past few hundred years where focus actually matters: knowledge workers, and some factory work where lack of attention resulted in injury.

To be fair, that's what people mean when they say "lack of focus" too.

They don't mean "this person can't focus on anything", but "they can't focus on their school projects, their work" etc. They don't care if "but hey, I can hyperfocus for months on the history of late Roman battles or throat singing techniques".

This used to upset me, but as time goes on I'm more excited about it. Sometimes I run into someone else that only does that one or two things. They are happy they finished them, etc., but they seem envious of being able to do lots of things even if they don't end up mattering.

Ya sometimes it feels like a missed opportunity, but I think it's mostly just ego and not anything of real value. On the flip side, I feel like I've gained an incredible amount of diverse experience.

This right here.

The shear breadth of experience is sometimes staggering.

The difficulty for me is translating that into sustainable income. Job and experience hopping is great when your young, but then you get older and your resume portrays you as a total flake. (And admittedly, of the project is slow and boring, I might just dip. Life is short, I have things to do. And sitting still in an office for 8+hrs a day isn't one of them)

I was diagnosed ADD as well. This is my exact experience. Usually my focus being too strong on things I like, and an inability to direct it elsewhere towards uninteresting tasks. (picking up, making bed, dishes)

Same here. For me the worst are tasks that are uninteresting, yet require some amount of effort and thinking - things like organizing my wardrobe, or boring bureaucratic tasks at work.

I feel like that’s a different type of ADD or something. My wife has that type, so if she’s on her phone or focused on something I almost have to shake her to get her attention, whereas I’m very much the opposite (hard to focus on anything). Makes it hard to watch a series together bc she always wants to binge the whole thing in one sitting and I can never watch more than two episodes at a time.

I think this perfectly describes huge percentage of ADHD people. I always laugh when I am told: "But you don't sound so bad". Yeah, not sound so bad when I can be so deeply focused into something trivial like reading a blog, that I can miss a flight. And I KNOW I am that close of missing a flight, and still engage with something interesting right now, not something hugely critical to my life.

I read this comment and it matched my experience so closely I had to double check it wasn't a copy of one of my own posts.

We really do need an update to the diagnostic criteria and descriptions for ADHD, Autism and their combinations (DSM6?). I think monotropism is a good overarching description that aligns better with what we with these diagnosis experience.

If an alarm goes off to tell me to switch tasks, I tell it "fuck you" unless I know another person is counting on me to be timely in meeting them. I no longer respect people who suggest "keep a calendar" as a solution to my problems.

I’ve also found Dr Amen’s “types” of ADHD the most helpful way of understanding how ADHD affects people differently.

When I had my brain scanned, it was explained to me that ADHD isn’t a matter of lack of willpower or distraction - when you intentionally try to concentrate or focus (rather than when focus just “appears” naturally like it does for some tasks you’re interested in), blood actually flows away from your prefrontal cortex so you really do become worse at regulating decision making and have worse performance at whatever task you’re trying to accomplish. Whereas for people who don’t have this problem, intentionally concentrating forces blood into the prefrontal cortex, improving your performance.

It was also explained that even though we usually think of ADHD as a “hardware” issue with our brains, that’s rare. It’s normally a conditioned response related to how we learned to process stress and anxiety. The idea is that if you can improve your ability to handle your underlying stress and anxiety (through trauma therapy, healthier lifestyle and habits), your mind becomes much better at handling choice and focus. Although I haven’t been able to therapy my way out of it yet.

Yes. Rather a lack of control of the subject and intensity of focus. Which piss everyone off because they can't steer it from the outside, hence the "lack of focus" perspective.

It’s disregulation.

Not being able to focus on the things you need to focus on (or doing the boring routine stuff).

I’m audhd which adds a bit of extra fun - diagnosed adhd in August. Meds have been amazing

Same for me. I think this experience is pretty common amongst people diagnosed with AD[H]D.

Obsessive compulsive disorder. Only directed towards work and projects. I have it too.

Maybe co-occurence?

OCD seems to be characterized as having anxiety of fear about the obsession, which isn't something I experienced at all. I don't know much about the disorder though so would be worth doing some more research and introspection

There’s definitely a root anxiety at play, talk to your therapist.

For me personally, I feels more like an addiction to the dopamine I get from solving problems / deep thinking / being in a flow state.

And so your anxiety is NOT having that rush so you compulsively fixate on gaining it. Do you see? Still, talk to your therapist.

Did ADD turn into ADHD? I thought there was ADHD and ADD

Yes, ADD is no longer its own diagnostic, it's all ADHD, with three types (Hyperactive, Inattentive, and Combined).

Same here