Curious to hear what others think, as this definitely aligns with my own experiences.
The original study is behind a paywall, but I’m trying to see if I can get a hold of the full text somehow. For now, here’s the abstract.
Abstract
Objectives: Recent studies report a fluctuating course of attention-deficit/ hyperactivity disorder (ADHD) across development characterized by intermittent periods of remission and recurrence. In the Multimodal Treatment of ADHD (MTA) study, we investigated fluctuating ADHD including clinical expression over time, childhood predictors, and between- and within-person associations with factors hypothesized as relevant to remission and recurrence.
Methods: Children with DSM-5 ADHD, combined type (N = 483), participating in the MTA adult follow-up were assessed 9 times from baseline (mean age = 8.46) to 16-year follow-up (mean age = 25.12). The fluctuating subgroup (63.8% of sample) was compared to other MTA subgroups on variables of interest over time.
Results: The fluctuating subgroup experienced multiple fluctuations over 16 years (mean = 3.58, SD = 1.36) with a 6- to 7-symptom within-person difference between peaks and troughs. Remission periods typically first occurred in adolescence and were associated with higher environmental demands (both between- and within-person), particularly at younger ages. Compared to other groups, the fluctuating subgroup demonstrated moderate clinical severity. In contrast, the stable persistent group (10.8%) was specifically associated with early and lasting risk for mood disorders, substance use problems in adolescence/ young adulthood, low medication utilization, and poorer response to childhood treatment. Protective factors were detected in the recovery group (9.1%; very low parental psychopathology) and the partial remission group (15.6%; higher rates of comorbid anxiety).
Conclusions: In the absence of specific risk or protective factors, individuals with ADHD demonstrated meaningful within-individual fluctuations across development. Clinicians should communicate this expectation and monitor fluctuations to trigger as-needed return to care. During remission periods, individuals with ADHD successfully manage increased demands and responsibilities.
It makes sense on the surface. ADHD is a deficiency of self -regulation. External pressures remove the “self” part of the equation. The scary part is the recurrence/remission cycle that makes it seem, to you and to everyone else, like you finally have your shit together.
Anyone who knows how good we function in a crisis is able to extrapolate from there that this would be a thing.
As others have said it’s the burnout and the subsequent time it takes to recover that makes this basically unsustainable. Even when finding a balance there will still be burnout.
Welp, looks like I’m the only one with a really short attention span… I sense this article may be relevant to my condition, but I just glanced before jumping to comments so I have no idea…
For me, it tracks, but the caveat is a high increase in burnout accumulation. No self regulation needed? No problem. Except when you can’t self regulate healthy work amounts / dealing with demands.
So much this
70+ hour 5-7 day work weeks in a super high demanding job where people are basically hollering things for me to do that needed done in 2-5 minutes no-stop? I did that shit for 2 years. But man would I crash and burn out when I’d crash and burn.
Panic attacks, drinking like a fish, smoking pot like I was afraid of a non-smoke filled breath.
0/10 would not recommend.
I’m moving and had a hard date of about 2 weeks to have the house ready for real estate pictures/showings etc. I was so worried I’d drown in the list of things to do, but just poured every ounce of myself into getting it ready. I didn’t have time to panic or freak out, just head first. When I was done, I was so fried I broke down and just cried.
I have had a few days to recover and I found myself cleaning, doing dishes immediately after cooking, picking up after myself, you know, normal things for a lot of people. I don’t know how long it will last, but for now, my symptoms are better than they have been for a long time. I hate deadline stress, but it forces me to get shit done.
I hope you’re doing alright now. I know moving can be extremely stressful, and hopefully your recovery time is enjoyable.
I remember once in college that I had a big paper to write, and I decided that I was going to get started on it “early” so that I could finish it early and avoid the deadline stress. I legitimately started it early, but somehow still managed to finish it at the very last minute. I spent my entire weekend in the library, and I don’t think the final product was significantly better than if I had procrastinated on starting. I just spent a lot more time on the research part of it, and didn’t really start putting anything together until the deadline stress kicked in.
Since that experience, I find it even more difficult to convince myself to start things early, since I’m afraid it will just mean spending more time on stressful tasks.
This experience but in my case, I got a significantly lower grade despite the fact that I worked on the paper longer. It was a great shock to me, I never got that low of a grade when I did those papers at the absolutely last minute.
Hi. You have broken the community rules by posting paywalled content. Since there was a lot of engagement I am giving you the opportunity to edit your post and copy the text here that is available and then remove the link.
Is the psypost.org link paywalled for others? Or just the link to the original study?
The problem is with the original study. We don’t allow advertising or other ways that a person could extract money from our community. Some people are desperate for answers and it takes advantage of them. Sorry to be a pain!
Courtesy of Archive.ph
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