Pharyngula had a post about ADD that led inevitably to commentors decrying ADD as an imaginary condition, overdiagnosed, unnecessarily medicated, etc. Of course, it got me riled, as someone who has it, and had trouble getting diagnosis and medication, and can now see a significant positive difference. My comment was long, people might not read it there because of that, so I’m quoting myself here:

I find that arguments about AD(H)D tend to sound a lot like arguments by fundamental religionists against atheism or homosexuality. You know, pronouncements of absolutes by people who have no personal experience. Yeah, just like that.

Think a Mile in My Brain, guys and gals.

My brother and I both have ADD. So did my uncle and maternal grandmother. I’m a bit skeptical of “acquired ADD” because almost every other ADDer I know or have spoken with belongs to a family with ADD and/or other related problems. If you’ve gone through life with this wild and crazy brain, you know that one way or another, you need to adapt to Neurotypical environments and situations all the time. School is the first one, and your success or failure in this is a major determinant of your success or failure in life. Not only is the structure a bad fit with your thinking pattern, but you have endless opportunities to be rejected socially and have no idea why, to try and try and try and be called a failure, to spend hours more than everyone else doing the same things and be told you’re not working hard enough. Unless they start making ADD schools, it’s the ADD student who has to adapt. Someone whose ADD is milder might be able to manage his or her behavior enough to cope, but for some it simply isn’t possible. Or wasn’t, until now, with medications.

If you do manage to get through the school environment, you’re faced with another challenge, the work environment. Some jobs are better suited to an ADD mind than others, but an ADDer who’s been mentally all over the place except for the directed learning situation in school might have a terrible time finding or keeping even these, since it involves committing to a single thing – making one kind of product, focusing on a single skill, repeating a particular action – even if the environment itself changes enough to be stimulating. Plus, it involves a completely different skill set than what you may have found effective during school, and there are no teachers or psychologists giving you suggestions on the best way to get organized and stay focused. Some of us could make a lifelong career out of finding the best way to organize a file cabinet or supply closet, and that’s nowhere near as funny as it sounds.

People who don’t have ADD, or are not living with someone with ADD, don’t have an inkling. Do you walk into a room and forget what you were there for? Do you lose your keys? Do you sometimes find yourself unable to concentrate because something else is on your mind? Sure you do. But I bet you can’t imagine what it’s like for this to be the way every single thing is in your life, every hour of every day. Stand in a room. Put a movie on the TV, turn on the radio, open up a book, get out the vacuum cleaner, and make some phone calls. Try to pay attention to all of them at once. It’s only a tiny taste.

I spent over 40 years like this, edging gradually towards a depression that was almost suicidal, coping on antidepressants, but only just, mental chaos and clutter echoed constantly by my physical surroundings. Yeah, I could probably have managed to cope for the rest of my life, and deal with never feeling like I was ever good enough, smart enough, creative enough, or deserving enough. However, I finally started medications, and I can tell you first hand that regardless of side effects or potential failings, or any other negative thing you can say about them, you don’t know how good they are. You have no idea.

I can see why kids would be less likely to abuse other “drugs”, because when your brain is your enemy like this, you self-medicate. The stimulants help you calm down and focus. More of them, please. Alcohol makes you more energetic and gregarious, and when you drink enough you can blame your failings on the alcohol rather than yourself – plus, you fall asleep, which is a rare and wonderful thing. You try to find something that will either help you focus, or help you forget, because you are, after all, a sub-prime human being who’s never tried hard enough or worked up to potential, which is why you’re a failure! The stimulants for ADD, though, make it so you can think of one thing at a time. They make it so you can remember what you’re supposed to remember. They make it so you can prioritize, and finish what you start before starting something new. They make it so that the opportunities for negative criticism from others and by yourself are minimized, and success breeds success. The need to self-medicate to overcome the thought obstacles and the negative self-image becomes less and less.

My understanding of AD(H)D is longstanding and personal. I’ve exhibited almost all the symptoms, have several of the comorbid conditions, and have gone through a whole lot of therapeutic approaches (and self-medicating approaches) before reaching the point now where I wish I had been this person I am for all those previous years. A child who genuinely has ADD might not be able to articulate as well the problems he has without medications, or the specific benefits he gains with them, but they’re there. If the medications help him or her to avoid the frustration and misery that’s almost inevitable during an unmedicated childhood and adolescence (and adulthood) then nobody should be denying him its benefits. Especially someone who has no clue what it’s like to live with ADD.

The blog article cited in the post is here, which links to the studies from which the information came, and is followed by comments just like Pharyngula’s.