My sister was properly diagnosed with ADHD several years ago, and she encouraged me to get tested. My tester, a PhD psychologist who specialized in neuropsych testing, said the evidence was borderline, but ultimately refused to give a diagnosis because I did well in high school and that's unheard of in "true" ADHD. I promise I'm not exaggerating--I have the report to prove it. He completely ignored that I never had to pay attention in school because it was so easy for me, and I only started to run into problems in college when the material got more difficult.

Thankfully my psychiatrist disagreed with that and started me on medication anyway, and since then I've actually been able to understand why I am the way I am and work through my issues. (I found out a year later that my parents actually had me tested in first grade and I was diagnosed then, but they intentionally kept it from me my whole life.)

I know this is just one anecdote, but it's a common discussion point online that mental healthcare like this isn't always the most accessible. I think well-intentioned research and self-diagnosis can certainly have their place, depending on one's circumstances, and as long as care is taken to avoid unscientific information.

The reason I ask is that your response leans very heavily into the importance of expertise and a specific form of knowledge, without showing the kind of subjective empathy for the experience of the people dealing with these challenges that I’m confident you have in spades given your profession.

And given your personal draw to scientific expertise (given your profession), and investment in building that expertise in yourself, and continued personal material and ego investment in that expertise being valued (and the school of thought that legitimises and makes that expertise worthy), as well as your clear intelligence and exploration and insights in this space, it seems an interesting question to ask whether in your deepest reflection there is any sense of conflict or tendency to bias, and how you consider if that shapes your views.

But at the same time as someone diagnosed in my 30's that meds really helped. i'd feel like i'm pulling up the ladder on others.

The neurodiversity at work trend does irk me a little, especially when people start talking about so called "superpowers" and their benefits to the company.

I am biased too but I have endured a lot of anguish putting my faith in psych professionals. The vast majority of progress I've made over the years has come via discussions with other folks like me. But you claim it's unsafe? It's been more effective (and safer) to find my own way.

Also, is there are evidence based instruments to aid in diagnosis, then why do those same instruments tend to magically be removed from care during the treatment phase?

For the sake of analogy, if a patient were to be diagnosed with hypertension and an anti-hypertensive medication regiment is started. I imagine upon returning for a follow up visit, the patient's blood pressure will be remeasured in order to verify the efficacy of the treatment.

For ADHD, I had to go through quite a significant diagnostic process before being given the green light for treatment. Upon returning for a follow up, the only methodology used to gauge treatment efficacy is being asked, "How is <insert medication> work for you?"

I always try to answer the question honestly, but after almost 12 years of treatment, I still am not sure what to expect in terms of treatment. Are such questions truly the only evaluation of treatment? How can one tell if medication is working better than they realize or not at all? Perhaps my expectations are too high? Also, wouldn't some metric help determine if tolerance is occurring?

Every single self diagnostic tool I have looked at in that period would have screwed me over. I would have misdiagnosed myself.

I second everything in this comment. If you think you have ADHD, explore the topic with professionals. Your own biases can trap you with internet apps.

see e.g. https://www.nature.com/articles/d41586-020-00922-8 , https://www.healthline.com/health/adhd/adhd-linked-to-trauma

You mentioned evidence about what works and what doesn't. As someone who struggled with ADHD, I am curious about your thoughts on the app intentions or goals.

Never occurred to me that something focused on symptoms instead of treatment could be harmful, but I suppose it's worth considering.

The issue I have with "ADHD" in general is that there are so many other well-recognized and researched causes that more satisfactorily explain many of these behavioural issues - like depression and / or anxiety - than "ADHD". There are even personality disorders that can cause such long-term behavioural issues - for e.g., Avoidant Personality Disorder or even Obsessive Compulsive Personality Disorder (both stemming from anxiety issues), and they can be more correctly and confidently diagnosed than the cluster** that is "ADHD" (whose diagnostic criteria has been already revised multiple times in the Diagnostic and Statistical Manual).

Alan Schwarz, the author of the book ADHD Nation has investigated the ties between pharmaceutical companies and doctors:

> "The six-question screening instrument that was endorsed by the World Health Organization was devised by doctors with a very long history in ADHD research," he says. "These are, generally, men who have been enriched by the pharmaceutical industry in order to churn out research and churn out things like this that merely expand the ADHD market. "What we've seen over the past 10 [to] 20 years is a constant enthusiasm on the part of the ADHD lobby to get more and more adults to consider the possibility that they, too, have ADHD," Schwarz says.

(Source: Adult ADHD Can't Be Diagnosed With A Simple Screening Test, Doctors Warn - https://www.npr.org/sections/health-shots/2017/05/29/5276546... ).

I am not against self-help or personal research. But please note that it is very easy to be mislead by such things and very easy to misdiagnose your symptoms. Even the professionals have a tough time with this!

The overall design is unfocused and cluttered, just the exact thing I don't need as someone with ADHD.

I don't think I'd use this.

Idk wtf is wrong with these people whining about AI generated images.

I use that on mobile so the referenced website, HN, and 99.9% of the web is in dark mode by default.

First of all, it's not really well done: there are no control questions, no inverted questions, no consistency checks (like re-phrased duplicate questions) or anything a well-designed self-test must have. All answers are obviously ranked, introducing perception biases. Questions like "how often do you interrupt someone" or "how often you were told" or "did parents notice" are highly culturally-dependent. The childhood questions do not discern between younger and older ages (where behavioral differences are drastic), and likely to introduce a skew based on one's age and long-term memory function (which, AFAIK, ADHD does not directly affect). To me it looks like nothing of value would be lost if the whole test would be replaced with a short description what ADHD is and then a single yes/no question "do you think you may have some of the described symptoms?"

I would understand something like ANT, which (as I understand it) tests way closer to actual brain behavior, than those distant derivatives smeared over social prisms, self-perception lenses, and dice rolls of life's [pseudo-]randomness.

I'm happy for people to try to make a business of this if the tools are helpful.

I've had a successful career, so I obviously had to develop my own strategies for managing it. But I'd be very happy if my kids didn't have to spend 20 years figuring it out for themselves. Monetize away.

Sure, there might be people out there selling snakeoil, but that's the case for every domain. Does that mean we nobody should try to make apps to solve domain problems at all? Of course not.

So you're asking everyone to stop monetizing ADHD. So the two alternatives are make the apps for free or don't make them at all. The former is not realistic or sustainable and later gives up potential upside.

I mean, do you think all ADHD apps will just be bad and are just people trying rip off ADHDers?

I think a more reasonable premise is yes, just in every domain, there will be snake oil sellers unfortunately and it's up to the consumer to watch out for those. But there will also be genuine people who are trying to solve this problem and that will potentially give people a lot of value for the money they pay for it.