How is it before and after meds? I have been diagnosed recently and the doctor is suggesting meds but I am afraid to loose my hyper focus if I take them.

How did you mask it?

What meds you got?

Starting titration this week… bit apprehensive

It makes sense to me also. The compensation (and masking, etc) someone with unmedicated ADHD has to do is relentless and constant.

After awhile, with much difficulty, it does become subconscious and automatic, much like a part of your personality — or the ADHD itself.

So I’m not at all surprised to hear that it manifests in changes to the brain.

No, being able to cope is definitely a good thing. Didn’t mean to seem like I was against it!

I have heard of remission for bipolar disorder, which is usually when someone has gone an extended period of time without having a manic episode. But that type of remission is only achieved through the use of medication, 99% of the time. I would assume the same for ADHD honestly, but the difference to me is that bipolar isn’t a neurodevelopmental disorder present at birth. And, most people don’t get full relief of ADHD symptoms even with meds. I guess I’m just stuck on the use of the word remission here because what I’ve read up til this point is that the concept of people growing out of ADHD is outdated and incorrect, and that people learn to compensate and work around their symptoms, but they don’t actually go away.

Apparently I'm a super high functioning adhd, only medicated recently after like 20 years. Although I coped extremely well (did well as engineer), it was so much extra effort. Now that I'm on meds I see how hard my life was before. I would never call high function adhd remission myself..

For example, I was always exhausted and scared of context switching because I knew distractions would ruin my process. Now that I'm medicated there's no fear and in fact I'm very good at multi tasking. At the end of the day I'm not exhaused and defeated like I was before when i was supposedly in "remission".

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“Remission” doesn’t mean “gone”, though.

Yeah, and I don't think it's impossible for people to remap their mind to some extent. We all know that therapy can prove fruitful for people with depressive disorders, producing documented change in gene expression. I don't see why targeted treatments couldn't work similarly for people with ADHD.

If you read the article, that doesn't appear to be the case. The new neutral activity was in the left motor cortex, whose function is to control the muscles and limbs on the right side of your body.

It's related to how when part of your brain is damaged, sometimes another part will assume the functions the damaged part was supposed to do.

Remission is a reduction or disappearance of symptoms, so yes.

I feel that my ADD (I don’t have ADHD) is in remission. I no longer miss deadlines/work to the last moment, or procrastinate. Maintaining my organizational tools doesn’t feel difficult and if I start to slip I recognize it as a sign to lessen my work load and refocus. I don’t have nearly as much trouble finding things or organizing myself, and I don’t forget or loose things as I used to. I feel, generally, in control of my attention and time management.

Repetitive behaviours, positive reinforcement strategies, therapy, excercise, and ayahuasca have been the enabling factors.

This is Reddit, I stated clearly that I’m not an expert and this is just my opinion. I am allowed to have opinions, thank you.

>5 nights out of 7

Anyone who's been on reddit a while will know that 5/7 is a perfect score. So, can't complain.

Right? But which clubs? There’s so many!

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I chose a combination.

Yeah, the phrasing in this OC rubs me the wrong way. People can't learn away fundamental workings of their brains... This is like saying you can learn away...your eyesight?

Noted. Good clarification!

If I understand correctly, while those traits are common in people with ADHD, not everyone with those traits has ADHD, correct?

If that's the case, then the implication is that you essentially become like someone with those traits who doesn't have ADHD.

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I'm not a neurologist but I am good friends with some. As I understand, the difference is that coping mechanisms are superficial whereas neuroplasticity is ingrained.

That is to say it's outwardly the same thing, but employing coping strategies over time results in rewiring neural pathways to the point they're not "coping" strategies so much as your brain perceiving it as the normal, correct response to that stimulus. The same mechanism as practice driving muscle memory.

There’s a link to the full study in the article which addresses medication usage. But no, I can’t see drawing that conclusion from study.

I don't know, but I've been medicated for ADHD for 23 years, and it helps me manage my symptoms, but as soon as I don't take it, my ADHD symptoms seem to be worse than before I ever started medication. I don't think it should be considered remission if symptoms only improve while medicated, and then get even worse than they were in the first place when the medication is stopped.

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From what I understand it's not a lack of dopamine receptors so much as one's dopamine reuptake system being "too efficient" -- effectively cleaning up the dopamine before it's had the opportunity to actually finish doing its neurological job.

But yeah, ADHD in particular is a very multifaceted, complex, and nuanced topic. Being a neurological disorder already makes it such, but the way it intersects and interacts with social contexts makes for such a large variety of manifestations, many seemingly contradictory.

I did mostly fine as a kid because structure was imposed on me by school and parents...and because I had intense rejection sensitivity (and validation euphoria) which shaped my coping mechanisms. Yeah I hated and procrastinated on homework until the very last minute, but I'd ultimately do it because the prospective shame of teachers and parents being disappointed in me was overwhelming. Yeah I'd fidget, but to save myself from attention and embarrassment I'd keep them subtle and unnoticeable by others, like little tiny finger movements (imagining I'm playing an instrument -- in my case initially the recording and then the violin). Yeah I'd daydream and lose focus in class, but if there was a chance the teacher would call on me to answer something I'd be laser focused -- don't wanna disappoint.

Because of this no one knew I had ADHD, including myself. Always just figured I was just a "creative daydreamer" and "sensitive hopeless romantic". Never even considered the possibility as all I knew was the stereotype of hyperactive disruptive children with poor grades who couldn't focus where I was the opposite: a quiet and reserved kid with good grades who would hyperfocus on a good book or video games for hours (gee who would've thought that hyperfocus on things you're very interested in is itself a symptom of something called "attention-deficit" disorder.)

In middle school my family and I suspected social anxiety and got some SSRIs to medicate which ended up being terrible (made me feel incredibly apathetic to everything.)

And so for the longest time I figured I was just doomed to be an introverted socially anxious person.

Then adulthood came and I lost the externally imposed life structures of childhood and just fell apart. Still took me a decade to figure out I had ADHD, but in retrospect it all made so much sense...and my so-called social anxiety was primarily me subconsciously leaning into my rejection sensitivity as a coping mechanism to fight against other ADHD symptoms.

You can’t get ADHD remission and the original guy is talking out if his ass.

That tracks as my I have been put on estrogen pills now bc I dont produce enough

As much as I love the idea of saying that the brain is not "damaged", it is unfortunately untrue that the ADHD brain is developed the way it is "supposed to".

ADHD is in fact a neurodevelopmental disorder, which means that during key stages of development both before and after birth brain growth and connectivity was impaired and that leads to lifelong developmental and practical issues with the brain and central nervous system.

Even though we can't point to a single cause for the major known neurodevelopmental disorders, we can compare neurodevelopmentally disordered brains to brains that developed without major (or minor) disruptions to development.

For example, with ADHD, brains show less matter overall, especially in the prefrontal cortex (controlling executive function), amygdala, (emotional regulation), hippocampus, (memory and emotional regulation), basal ganglia (emotion, movement, intention and action) as well as poorer connectivity through multiple different structures of the brain. This isn't an exhaustive list of the regions that are affected, since there are multiple factors that affect development, some genetic, some epigenetic, some environmental, and on and on.

In addition, the chemical differences with dopamine and norepinephrine are less efficient, which adds to the executive function challenges and adds to the learning time needed.

Our brains weren't supposed to develop this way - many of us can trace very well what the likely factors were when we look at our family history. For example, my mother and grandmother both were heavy smokers while pregnant, and both experienced some fairly severe trauma when they were younger.

The result, for me personally, was that my mother's smoking resulted in me being born premature and underweight with trauma at birth, and poorly developed brain and lungs. I have ADHD with many of the resulting comorbidities from poor brain development that I can actually pinpoint. I have poor gross motor control, emotional regulation challenges, a learning disability, and the regular basket of ADHD symptoms.

My brain is developmentally abnormal. You can compare it to a brain that developed without the interference of smoking and trauma and genetic causes in the same way that you can compare my hands, which are developmentally normal, to hands that developed abnormally, say, with webbing or an extra finger. You can make the same comparison between a heart that developed normally to a heart that developed abnormally with a hole in it.

When it comes to "repairing" what we're talking about is building new connections in the brain to compensate for the deficits of abnormal development, which is where educators and therapists (emotional, speech, occupational, etc.) come in.

For example, the parts of my brain that control gross motor function, vision, numbers, spatial awareness - they suck. This translates, for me, into having a hard time judging speed, distance, counting, maths skills, and movement. However, through targeted, informed learning understanding my brain differences, I have been able to learn maths, play sports, learn to drive, and play piano. However, for me to learn these things, I needed a higher number of repetitions than the average learner, needed multisensory approaches, needed to engage different parts of my brain, and had to build different connections to "repair" the faulty connectivity that I came with.

In maths, for example, I really struggle with number concepts. For me to understand division conceptually I had to learn it with visual and verbal processing rather than just numbers alone; I didn't understand that 30/2=15. I had to first see it with a group of 30 split into two physical groups using manipulatives, then understand that when we say "thirty divided 'by' two", the "by" actually means "into two equal groups" and/or "if thirty is divided into groups with two each in them, you will have 15 of those groups". I had to literally write out those sentences to understand that 30/2=15.

And I have to do that for every maths concept, from division to fractions to algebra to factors - if not, the information will not stay in my long-term memory. I have uneven cognitive development, whereby my verbal processing and intelligence is much higher, so I built pathways to conceptual understanding through those areas of my brain to compensate for the damaged developmentmal areas that could not function normally. So in a sense, I have "repaired" my brain's number sense to that of a neurodevelopmentally normal brain at this point. Now I just know 30/2=15.

People with major neurodevelopmental disorders need to do this is many areas for many different skills and functions, and do all the time.

I was wondering the same thing. I can’t find anything that suggests the relationship between left corticospinal tract and executive function and attention.

Yeah, the majority of what's expected, like 9 - 5, show up on time, keep track of tens of different things at once etc. is definitely difficult for ADHD brains without good coping strategies.

I would argue some jobs (data, engineering, dev work, especially agency work) play into the strengths of someone with ADHD, but the structures we build around them are limiting, since output + time management is often top priority, and middle management doesn't want to spend additional resources looking after someone or introducing flexibility.