Tag: mental health

Ants and grasshoppers and mental health

There is the old fable of the ant and the grasshopper – the ant saves and saves and saves and at the end has plenty. The grasshopper splurges and splurges and enjoys and at the end has nothing. In some versions, the grasshopper dies. In others, he borrows from the ant. Most tellings of the fable don’t end well for the grasshopper.

“Be like the ant”, goes the moral of the story.

I’m not so sure if that is the right strategy for “real life”. Talking about myself, I have spent large parts of my life living like an ant, and a lot of it has not been fun. I’m not talking about money here – credit cards apart, I’m entirely debt-free, and my wife and I paid off our home loan (the only big loan I’ve taken) in a fifth of the term. That has allowed us to take risks in terms of careers, and do more interesting things, so that part of “living like an ant” I don’t regret at all.

It is more on the non-monetary fronts. I might have written about this in the past, likening it to the movie Ganesha Subramanya. The plot there is a classic ant plot – that you “need to achieve something in life” before you can find a girlfriend or get married. And various people making fun of the protagonists for this philosophy.

Quoting from my old blogpost on this:

In the two years prior to going to IIT, it had been drilled into my head that it was wrong to relax or have fun until I had “achieved my goals”, which at that point in time was basically about getting into IIT. I did have some fun in that period, but it usually came with a heavy dose of guilt – that I was straying from my goal.

In any case, I got into IIT and the attitude continued. I felt that I couldn’t relax until I had “finished my work”. And since IIT was this constant treadmill of tests and exams and assignments and grades, this meant that this kind of “achievement” of finishing work didn’t come easily. And so I went about my life without chilling. And was unhappy.

Sometimes I think this problem went away in my twenties, but now that I think deeper about it, whether I think like an ant or a grasshopper is related to my state of mind, and it is self-fulfilling. When I am feeling contented and fine (what I like to think is my “normal state”) I’m a grasshopper. I sometimes bite off too much. I want to do everything. I want to enjoy also. And sometimes that means putting off work (or “borrowing from my future time”).

However, when I’m going through a rough patch or not in the best of mental health, I suddenly go off into ant mode. I don’t want to risk going lower, so I become extra cautious. Extra caution means fulfilling my responsibilities as and when they come, and putting off the fun for later (rather than the other way round). In other words you don’t want to borrow – from your future time!

If you think of utility theory, your “happiness” (or “welfare”) as a function of your “wealth” (need not always be monetary – can be physical or mental health as well) is concave. The more wellness you have, the less the marginal utility of getting more wellness (among other things, this explains why insurance, on average, can get away with offering a lower rate of return).

Among other things, what this means is that the loss of wellness from the loss of a rupee far exceeds the gain of wellness from the gain of a rupee (and this is consistent at all wealth levels – again I’m using rupees only for convenience here). And so when you are in a bad mental state, if you are optimising for not slipping further, you will necessarily follow a low-risk policy. And you become more “anty” (and antsy, of course).

Somewhere you need to break off that cycle. Even when you are otherwise not feeling well, you need to somehow give yourself that stimulus, and that means being a grasshopper. It is a conscious effort that you need to make – that yes, your life is shit and you are not doing well, but being an ant is most likely NOT going to help you get out of it.

And slowly you transition your way out. You will realise that occasionally you CAN borrow from your future time – that maximises your overall happiness over time (while at the same time not shirking). And you start being more of a grasshopper. And so forth until you are in “ground state”.

In some way a lot of fables have their morals the wrong way around – favouring the ant over the grasshopper; favouring the hedgehog over the fox. I guess a lot of them simply haven’t aged well enough to our current context and lifestyles!

Blackjack and ADHD

My mornings feel like I’m playing blackjack. A few months back, I had a bit of a health scare (elevated blood sugar levels), and since finding good low-carb food in/around office is a challenge, after that I’ve been taking my own lunch box.

It’s a fairly elaborate lunch, which one colleague calls as “looking rather European”. It started with grilled paneer and grilled vegetables, but has now grown to a massive glass Ikea box with grilled paneer, boiled eggs, grilled vegetables (some pre-blanched / steamed before grilling), roasted and crushed nuts and (of late) kimchi.

And despite my cook occasionally helping me out with some mise-en-place, there are a lot of things to do every morning. Some of the processes involved are:

  • keeping water for boiling, for eggs
  • putting eggs carefully into the boiling water (without breaking), and setting a timer for 7 minutes. If I’m not wearing my Apple Watch, I need to also run around to find my phone
  • Putting water in the steamer for steaming vegetables
  • Putting the hard veggies (carrot, beans, broccoli) into the steamer and closing the pot.
  • Taking out the veggies from the steamer before they are too soggy
  • Slicing paneer
  • Grilling paneer on the frying pan with salt and pepper and olive oil
  • Grilling veggies on the frying pan with salt and pepper and olive oil (including the steamed veggies)
  • Pre-heating the air fryer
  • Adding almonds into the air fryer; shaking the fryer once in the middle, transferring almonds to the pestle and mortar
  • Putting cashews into the air fryer
  • Taking out cashews when they have just browned and putting into the pestle and mortar
  • Putting eggs in cold water after seven minutes are up
  • Peeling and slicing eggs, and seasoning with salt and pepper
  • Crushing cashews and almonds and adding them to grilled vegetables

I don’t think I’ve ever timed myself. However, pretty much every morning I get into a frenzy trying to finish all of this, and then take my daughter to school on time. Maybe some days I take twenty minutes. Maybe I take thirty. I don’t even know. Life is such a blur.

As you can imagine, the above process can be heavily parallelised. And while my menu is standardised, the process is not. Which means I’m trying to both experiment and measure at the same time. While cooking four different processes at exactly the same time.

Sometimes, life feels like playing blackjack. You would have flipped the paneer over in the frying pan maybe for one last time. And then you think “I can peel this egg before the paneer is done”. Before you know it the paneer is black. You are not wearing your watch, so you go in search of the phone – to put the timer for the egg. In that time the veggies are burnt.

I don’t even know why I sometimes put myself through this. Maybe this is yet another tradeoff between physical and mental health. For now, physical seems to be winning.

Maybe a sustainable long term strategy is to forego lunch as well (nowadays I don’t eat breakfast unless I’ve gone to the gym in the morning), and transition to an “OMAD” (one meal a day) lifestyle.  Or maybe I should find myself some nice lunch I can take to office which doesn’t involve so many parallel steps.

Until I figure something out, I’ll continue running in the mornings.

In appreciation of Tom Vadakkan

The former Congress spokesperson had said on national TV that ‘a tweet is a very lonely man who needs counselling’. While he might have been misinformed on that count, I do think that social media nowadays overindexes on spreading mental illness. 

Let me get the most controversial statement out of the way right upfront – most activism relies on creating anxiety. Yes, I just said it. I must mention that creating anxiety may not be the express intention of the activism. However, it is an inevitable effect.

I had written about this a long time ago, specifically in the context of environmental activism. Basically, things like carbon taxes (and other Pigouian taxes) and other price-based measures of environment regulation mean that things have been priced in by the time an ordinary person comes across it.

“Should I take the plastic cup from the coffee shop?”. Has already been priced in in the price of plastic.

“Can I take shower for another 15 minutes extra today?”. If I’m paying fair price for the water this ceases to be a moral question.

“Is it okay to drive across the city each day by my own car? Wouldn’t it result in extra emissions?”. If the price of the extra emissions has been included in the price of fuel, again don’t need to worry.

On the contrary, you might see that a lot of activism (and left-wing activists are generally against the price mechanism) is about creating guilt. It’s about making you think at every point in time because the price mechanism doesn’t account for it. And it is not just about environmental activism.

Take political correctness for example. A lot of jokes from my childhood (and even from a few years ago) are not kosher any more because they hurt the sentiments of some minority or another. So, while we’ve been conditioned to make these jokes as if they are normal, now there is an extra layer of thought, leading to anxiety.

And activists won’t let you be in peace either. For example, one rational response to things being shit all around us (like it is right now, as covid cases are raging, and bodies have to wait for days together to get cremated) is to just ignore it all, get into our little bubbles and move on. Activists don’t let you do that. It’s not uncommon to see tweets of the nature of “how can you sleep soundly when <some unknown person you wouldn’t normally care about> is dying on the street?”. It’s about creating guilt.

A few days back, I put this tweet (of late, all my blogposts seem to be expansions of random thoughts I would’ve thrown around on twitter):

I guess this deserves an explanation. I keep quitting social media, and while I’m on it, I keep unfollowing (and muting, and blocking) people who post too much negative or “outrage-y” stuff. The reason I go on social media is to have some nice discussions, see some ideas and so on. For news, I have my morning bundle of The Times of India, The Business Standard and The Economic Times.

“Why do people outrage so much on social media”, I was wondering aloud to my wife the other day. I wasn’t talking about people giving their opinions on what is wrong or how it should be done (that at least adds SOME value). I was talking about tautologies of the like of “oh, Kumbh Mela is being allowed to go on”. Or “migrants are dying due to the sudden lockdown”. No opinion. No value addition. Just selective amplification of news that people will get from the next morning’s papers anyways.

My wife and I had a long discussion. One of the points that came out of the discussion is that people seek some solidarity on social media. People are anxious, have nobody around them to share their anxieties with, and if they can find like-minded people on social media who share their anxieties and empathise with them, it is rational to rant on social media. The downside, of course, is that you might lose the people who don’t share your anxieties.

One of my links above refers to Jordan Peterson’s 12 Rules For Life (another source of anxiety that activism creates – “what will people think of me given that I’m quoting someone they’ve ‘cancelled’?”. It results in self-censorship. And by not expressing your thoughts your mental health becomes worse). I think that was his Rule 11. I want to now bring up his Rule 1 (later on I might bring up his Rule 12. Most of the rest are not worth quoting).

In the first chapter of his book, he talks about anxiety and depression, taking the case of lobsters. The thing about anxiety (I’ve just about gotten off another round of medication for it) is that you get into a situation of heightened defences.

This is a natural reaction. If you are walking in the jungle and hear a lion roar, you better have heightened defences. The problem with chronic anxiety is that you are always in a state of heightened defences. You are always worried that something might go wrong. This means you have less mental and physical energy for more productive stuff. And so it hampers your life.

Being in a state of anxiety means you want to get early information of anything that might go wrong. This makes you an ideal candidate for “24×7 news” – since that sets you up and prepares you well in time for anything that might go wrong. Depending on your persuasion, you either get your news from television, or from social media. Thus, on the margin, mentally ill people are MORE LIKELY to be on social media all the time, and be on it for the sake of news.

Let’s put things together.

  • Anxious people are more likely to be on social media for news
  • They are more likely to get triggered by news, and become anxious about it.
  • They want some release from the anxiety, and that can come by way of empathy from people with similar anxieties. This means they tweet (or post) their anxieties. Sometimes it could just be tweeting tautologies.
  • At other times it is retweeting activism from people they empathise with. And activism fundamentally causes more anxiety (as explained above)
  • Thus, anxious people end up spreading their anxieties through social media. And when someone says they don’t care about these anxieties, the privilege card gets brought out.
  • And so, on the margin, spending more time on social media can make you anxious, by increasing your exposure to tweets that create anxiety.

Unfortunately I’m unable to find the video (it seems to have been removed from YouTube). So I’ll just link to this blogpost by Vadakkan’s then co-panelist Amit Varma.

And how do I plan to deal with all the shit happening around? By following Jordan Peterson’s 12th rule. I spend half an hour in the morning reading newspapers. Given what’s happening around, I feel depressed and worried. And then by the time I have moved to the business newspapers I am feeling better. And then I get on with life. And work. And keeping my family and myself safe. And I only use twitter one day a week.

PS: I learnt while researching this post that Tom Vadakkan is with the BJP now.

covid-19 and mental health

I don’t know about you but the covid-19 pandemic and the associated lockdown have had a massive (negative) impact on my mental health. And from the small number of people I’ve spoken to about this, I don’t think I’m alone in this.

Before I continue I must mention that in the past I’ve been diagnosed with ADHD, anxiety and depression, though I haven’t been under medication for any of them for a long time now.

For starters, there’s the anxiety related to the disease itself. Every three or four days I suffer from what I’ve now come to dub “psychological corona”. Most of the times this is triggered by an allergy I get (I’m allergic to pollen from the tree in front of my house, a fact I conveniently forgot until I had bought this house). I start sneezing and coughing, and start imagining the worst.

One time, though, this “psychological corona” was legit thanks to my own stupidity. I had accepted a sample that a nearby baker had offered me, taking off my mask to eat it, and then remembered that he had been coughing before I entered the shop. And then panicked. I had thought later that I should write a blogpost on “the importance of keeping a consistent risk level” but then forgot.

The next level of anxiety is work-related. I’m lucky enough that I had a medium-term ongoing project at the time the lockdown started. This anxiety is regarding whether these clients will continue to pay, and if so, for how long. I don’t think I want to comment much on this issue (beyond bringing this up).

What I have mentioned so far is possibly what everyone has been going through. And then there is the “next layer”.

I have a 3 3/4 year old at home, and her school has been shut for over three months now. We don’t employ any help to take care of her (in other words, we use her school as our “child care”), and in normal times, we had worked out a method where we could get work done while still hanging out with her adequately.

Now, with the lockdown, this is doubly hard. We have settled on a method where the wife and I work in alternating 90 minute bands, with the person who “isn’t working” in that time band hanging out outside the study with the child. One of the responsibilities of the “person outside” is to ensure that the child doesn’t knock on the door.

This worked fine for me as long as I mostly had “fighter work” to do, as I could switch on and off at will as I entered and exited the room (though sometimes I found it harder to switch off when exiting). For the last month or so, my work has been more stud than fighter, and this band-based system has been a disaster. Most times, by the time I get into the zone, my slot is over.

And not getting work done in my slot is the least of my problems. The thing is that I’m “always working”, either trying to work on my work, or parenting (school meant that the total hours of work were far fewer). And it can be tiring. And from the point of view of my ADHD (I can easily get distracted and lose my train of thought), getting constant outside stimulus (even if it’s from close family) can be extremely draining.

What makes the problem really bad is that most outlets that help me normally deal with life are now absent. All sport has been shut, though nowadays football has been trickling back to life (yes, next Sunday I’m staying up late to watch Everton-Liverpool).

Getting regular exercise has been a part of my usual protocol of managing my mental health and it doesn’t help that gyms are closed (my gym wants to open, the state government wnats to open gyms, but the union government isn’t giving permission).

Children under 10 aren’t allowed to go out here “except for essential purposes” (I don’t understand the reason behind this, since the pandemic hasn’t really been affecting children). This means we can’t go out as a family. My wife and I can’t go to a shop together. I can’t take my daughter to a park (which is a big way in which I’ve bonded with her over the years).

The list is not complete but I’ll stop here since this is turning into a long rant. I’m pretty sure you have your own list of how the pandemic has hurt your mental health. And the lockdown isn’t helping one big on this.

Oh, and if there are therapists you recommend, please recommend.

Yet another social media sabbatical

Those of you who know me well know that I keep taking these social media sabbaticals. Once in a while I decide that I’m spending too much time on these platforms, wasting both time and mental energy, and log off. Time has come for yet another such break.

I had a bumper day on twitter yesterday. I wrote this one tweet storm that went viral. Some 2000 plus retweets and all that. Basically I used some 15 tweets to explain Bayes’s Theorem, a concept that most people find really hard to understand.

For the last 24 hours, my twitter mentions have been a mess. I’ve tried various things – applying filters, switching from the native app to tweetdeck, etc. but I find that I keep checking my mentions for that dopamine rush that comes out of new followers (I have some 1500 new followers after the tweetstorm, including Chris Arnade of Dignity fame), new retweets and new likes.

And the dopamine rush is frequently killed by hate, as a tweetstorm like this will inevitably generate. I did another tweetstorm this morning detailing this hate – it has to do with the “two Overton Windows” post I’d written a couple of weeks ago.

People are so deranged that even a maths tweetstorm (like the one at the beginning of this post) can be made political, and you see people go on and on.

In fact, there is this other piece I had written (for Mint, back in 2015) that again uses Bayes’s Theorem to explain online flamewars. Five years down, everything I wrote is true.

It is futile to engage with most people on Twitter, especially when they take their political selves too seriously. It can be exhausting, and 27 hours after I wrote that tweetstorm I’m completely exhausted.

So yeah this is not a social media sabbatical like my previous ones where I logged off all media. As things stand I’m only off Twitter (I’ve taken mitigating steps on other platforms to protect my blood pressure and serotonin).

Then again, those of you who know me well know that when I’m off twitter I’ll be writing more here. You can continue to expect that. I hope to be more productive here, and in my work (I’m swamped with work this lockdown) as well.

I continue to be available on WhatsApp, and Telegram, and email. Those of you who have my email or number can reach me in one of those places. For everything else, there’s the “contact” tab on this blog.

See you more regularly here in the coming days!

Using ADHD to combat anxiety, anger and everything else

Sometimes I find that documenting thoughts can really help for later on in life when you’ve forgotten certain workflows. As you are well aware, I document pretty much everything here. However, some things sometimes get left out, and the problem with not documenting those things is that you end up forgetting what you had made.

In some way, it’s like the Guy Pearce character in Memento – who has extreme memory loss to the extent that he needs to take polaroid photos and make tattoos on his body as notes for himself. It’s not that bad for me, but I find that when I don’t document stuff adequately, I tend to forget thoughts. And even when I forget thoughts and ideas (that happens all the time), having documented them somewhere means that I stumble upon it sometime (yes, I randomly read my old blog posts from time to time), and that surely helps.

For example, I know that when I go through a prolonged period of depression (most recently happened last December), reading the first chapter of Jordan Peterson’s 12 Rules For Life helps.

Anyway, this is one thing I’ve followed from time to time since 2013, but have never really documented it. As long-time readers of my blog might know, I was under medication for both anxiety-depression and ADHD for the large part of 2012. I discontinued most of it in early 2013, but have occasionally gone back to taking ADHD medication (it’s a pain to get that medication – being highly controlled, you need doctor’s prescription in triplicate, etc. to get it. In the UK, the entire process through the NHS took a year and a quarter!).

Part of the reason why I’d been able to discontinue the medication was the realisation that it was in some way my ADHD that had contributed to anxiety and depression (making lots of small mistakes -> some of these mistakes proving costly -> fretting endlessly about these -> random pattern recognition based on small samples).

The other reason I was able to step down on all the medications was that I could actually “use my ADHD” to combat anxiety. The thing with ADHD is that while you can sometimes be incredibly distracted and unable to focus, you are also able to go into “hyperfocus” when you are doing something you are interested in. This thing you are hyperfocussed on could be work, or watching certain kinds of TV, or even getting lost in old cricket scorecards (or reading my own old blogposts!).

So the method I developed to combat times when I was anxious about something was to find something quickly that I could get hyperfocussed about (there are plenty of those) and use that to fully distract myself from whatever my thought process was at the time. Having ADHD also means you  can let go of whatever thoughts you have in your head rather easily. And so once you’re done with your hypefocussed task, you don’t usually return to the earlier state of high anxiety, and you can get on to normal life.

It’s a simple enough process, but ADHD also means that you very often forget simple solutions you’ve found to problems earlier, and keep reinventing the wheel. And hence the need for this documentation.

Recently I discovered that this method works for other forms of mental instability as well. For example, the common advice given to deal with anger is to “walk away from the scene” or “take a break”. This has largely worked really badly for me. I get angry. I walk away. Obsess over what just happened. Come back angrier.

But I have a secret weapon to deal with this – ADHD! Just walking away doesn’t help. I just end up hyperfocussing on what just happened. Instead the trick is to find something I can get absorbed in. A rabbit hole I can get into and get out of without remembering what had happened just before I got in. And there’s no way the anger can survive this kind of an experience.

The only problem is that when you’re angry with something, and that’s resulted in a “live fight”, walking away to do something totally unrelated can get the counterparty even angrier. I didn’t say I have solutions for all the problems in the world, did I?

Carbon taxes and mental health

The beautiful thing about mid-term elections in the USA is that apart from the “main elections” for senators, congresspersons and governors, there were also votes on “auxiliary issues” – referenda, basically, on issues such as legalisation of marijuana.

One such issue that went to the polls was in Washington State, where there was a proposal for imposition of carbon taxes, which sought to tax carbon dioxide emissions at $15 a tonne. The voters rejected the proposal, with the proposal getting only 44% of the polled votes in favour.

The defeat meant that another attempt at pricing in environmental costs, which could have offered significant benefits to ordinary people in terms of superior mental health, went down the drain.

Chapter 11 of Jordan Peterson’s 12 Rules for Life is both the best and the worst chapter of the book. It is the best for the reasons I’ve mentioned in this blog post earlier – about its discussions of risk, and about relationships and marriage in the United States. It is the worst because Peterson unnecessarily lengthens the chapter by using it to put forward his own views on several controversial issues – such as political correctness and masculinity – issues which only have a tenuous relationship with the meat of the chapter, and which only give an opportunity for Peterson’s zillion critics to downplay the book.

Among all these unnecessary digressions in Chapter Eleven, one stood out, possibly because of the strength of the argument and my own relationship with it – Peterson bullshits climate change and environmentalism, claiming that it only seeks to worsen the mental health of ordinary people. As a clinical psychologist, he can be trusted to tell us what affects people’s mental health. However, dismissing something just because it affects people negatively is wrong.

The reason environmentalism and climate change play a negative impact on people’s mental health, in my opinion, is that there is no market based pricing in these aspects. From childhood, we are told that we should “not waste water” or “not cut trees”, because activities like this will have an adverse effect on the environment.

Such arguments are always moral, about telling people to think of their descendants and the impact it will have. The reason these arguments are hard to make is because they need to persuade people to act contrary to their self-interest. For example, one may ask me to forego my self-interest of the enjoyment in bursting fireworks in favour of better air quality (which I may not necessarily care about). Someone else might ask me to forego my self-interest of a long shower, because of “water shortages”.

And this imposition of moral arguments that make us undertake activities that violate our self-interset is what imposes a mental cost. We are fundamentally selfish creatures, only indulging in activities that benefit us (either immediately or much later). And when people force us to think outside this self-interest, it comes with the cost of increased mental strain, which is reason enough for Jordan Peterson to bullshit environmentalism itself.

If you think about this, the reason we need to use moral arguments and make people act against their self-interest for environmental causes is because the market system fails in these cases. If we were able to put a price on environmental costs of activities, and make entities that indulge in such activities pay these costs, then the moral argument could be replaced by a price argument, and our natural self-interest maximising selves would get aligned with what is good for the world.

And while narrowly concerned with the issue of climate change and global warming, carbon taxes are one way to internalise the externality of environmental damage of our activities. And by putting a price on it, it means that we don’t need to think in terms of our everyday activities and thus saves us a “mental cost”. And this can lead to superior overall mental health.

In that sense, the rejection of the carbon tax proposal in Washington State is a regressive move.

Mental health triggers

My ADHD seems to have become much worse over the last couple of days. Like this morning I had this episode where I couldn’t decide whether to go back home to get an umbrella, and thus turned around twice while I was in the middle of crossing a road.

In part, I blame this on having just read a book on ADHD – the second such book I’ve read in the last week (I found this book from the bibliography of previous one). While this book told me the impact of ADHD on relationships, and helped me understand what someone married to someone with ADHD goes through, in the course of doing so it reminded me of all the problems that one faces when you have ADHD.

So in some way, as I read through and “revised” the list of problems that one has with ADHD, all these problems have started surfacing (more likely I have noticed these issues every time they’ve come up). And this has led to a positive feedback loop, and thus much shorter attention spans and massive distractions and even mild addiction (to online chess).

This is not an isolated incident. In the past as well, when I’ve read material related to mental health problems that have affected me as well, the precise problem gets triggered. So when I read some stuff about depression, I’m likely to have a depressive episode after that. Similar with anxiety.

Interestingly, there is no impact when I read something related to a problem that I myself have never faced – like I once started reading Siddhartha Mukherjee’s essay on bipolar disorder and it had no effect whatsoever on me.

It wasn’t always this way. Long back, before I got diagnosed, reading stuff about mental health issues which I later got diagnosed with would make me feel hopeful – hopeful perhaps that there was in fact a diagnosis for what I was going through and it wasn’t simply “laziness” or “ineptitude” on my part that was causing me all that I was going through. But once I got the diagnosis, and figured out lifestyle changes to deal with my issues, reading more has only triggered the respective issue.

I guess the solution for this is simple – unless absolutely necessary (say there is a specific issue for which I seek help on) I shouldn’t read stuff about mental health issues that I might be facing.

I won’t spare you, though – here is an essay about ADHD that I had written three years ago (which I dug up after a conversation on ADHD with a friend yesterday).

 

Discrete and continuous diseases

Some three years or so back I got diagnosed with ADHD, and put on a course of Methylphenidate. The drug worked, made me feel significantly better and more productive, and I was happy that a problem that should have been diagnosed at least a decade earlier had finally been diagnosed.

Yet, there were people telling me that there was nothing particularly wrong with me, and how everyone goes through what are the common symptoms of ADHD. It is a fact that if you go through the ADHD questionnaire (not linking to it here), there is a high probability of error of commission. If you believer you have it, you can will yourself into answering such that the test indicates that you have it.

Combine this with the claim that there is heavy error of commission in terms of diagnosis and drugging (claims are that some 10% of American kids are on Methylphenidate) and it can spook you, and question if your diagnosis is correct. It doesn’t help matters that there is no objective diagnostic test to detect ADHD.

And then your read articles such as this one, which talks about ADHD in kids in Mumbai. And this spooks you out from the other direction. Looking at some of the cases mentioned here, you realise yours is nowhere as bad, and you start wondering if you suffer from the same condition as some of the people mentioned in the piece.

The thing with a condition such as ADHD is that it is a “continuous” disease, in that it occurs in different people to varying degrees. So if you ask a question like “does this person have ADHD” it is very hard to give a straightforward binary answer, because by some definitions, “everyone has ADHD” and by some others, where you compare people to the likes of the girl mentioned in the Mid-day piece (linked above), practically no one has ADHD.

Treatment also differs accordingly. Back when I was taking the medication, I used to take about 10mg of Methylphenidate per day. A friend, who is also on Methylphenidate and of a comparable dosage, informs me that there are people who are on the same drug at a dosage that is several orders of magnitude higher. In that sense, the medical profession has figured out the continuous nature of the problem and learnt to treat it accordingly (a “bug”, however, is that it is hard to determine optimal dosage first up, and it is done through a trial and error process).

The problem is that we are used to binary classification of conditions – you either have a cold or you don’t. You have a fever or you don’t (though arguably once you have a fever, you can have a fever to different degrees). You have typhoid or you don’t. And so forth.

So coming from this binary prior of classifying diseases, continuous diseases such as ADHD are hard to fathom for some people. And that leads to claims of both over and under medication, and it makes clinical research also pretty hard.

Do I have ADHD? Again it’s hard to give a binary answer to that. It depends on where you want to draw the line.