Loading practices
Loading practices
Areas › Focus, starting, and ADHD › Getting assessed and diagnosed
The reflex is to escalate: three alarms, a different app, an entire new system built on Sunday night. What is needed is a change of kind, something that makes doing it easier or not doing it cost something in the moment itself. Notice that reflex when it shows up in you, because clients catch it from us.
'Do not follow blindly what you do not know to be true' (Quran 17:36). Escalating a system that has already failed means following a hunch about why it failed.
الإسراء
وَلَا تَقۡفُ مَا لَيۡسَ لَكَ بِهِۦ عِلۡمٌۚ إِنَّ ٱلسَّمۡعَ وَٱلۡبَصَرَ وَٱلۡفُؤَادَ كُلُّ أُوْلَٰٓئِكَ كَانَ عَنۡهُ مَسۡـُٔولࣰ ا
Do not follow blindly what you do not know to be true: ears, eyes, and heart, you will be questioned about all these
Qur’an 17:36read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
More of the same is not reliably better. In a large multicentre randomised trial of adults with ADHD, methylphenidate outperformed placebo while structured group psychotherapy was not clearly superior to individual clinical management. That trial compared treatments rather than reminder systems, and the lesson travels: intensifying an input is not the same as changing what kind of input it is.
Philipsen A, Jans T, Graf E, Matthies S, Borel P, Colla M, Gentschow L, Langner D, Jacob C, Groß-Lesch S, Sobanski E, Alm B, Schumacher-Stien M, Roesler M, Retz W, Retz-Junginger P, Kis B, Abdel-Hamid M, Heinrich V, Huss M, Kornmann C, Bürger A, Perlov E, Ihorst G, Schlander M, Berger M, Tebartz van Elst L, Comparison of Methylphenidate and Psychotherapy in Adult ADHD Study (COMPAS) Consortium. (2015). Effects of Group Psychotherapy, Individual Counseling, Methylphenidate, and Placebo in the Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial.. JAMA psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Turning up the volume on the wrong axis moves nothing except how much the person now hates the alarm.
Most autistic people also meet the criteria for ADHD. The other direction is much thinner: only a small minority of people with ADHD meet the criteria for autism.
When someone says they feel restless inside, ask what the restlessness wants. Restless to move, or restless to do one particular thing until it feels right?
Disruptive mood dysregulation disorder was built partly to keep the bipolar label off children whose future nobody can yet see. Worth remembering when that word lands on a family's paperwork: it describes now, and it does not settle later.