by John Testore
Victimization and Criticism stop us from Achieving.
Self-awareness and Acceptance are the antonyms of Victimization and Criticism.
The latter are the main obstacles in ADHD, although common in Autism to a lesser extent.
Autism and ASD are two distinct disorders sharing some traits.
Autism normally requires institutionalization.
ASD was formerly known as Asperger Syndrome and is highly co-morbid with NPD = Narcissistic Personality Disorder.
To date, I score predominantly on ADHD, and I am grateful for my strong empathy.
Helping others is my biggest motivation and reward.
I don’t get along well with pathological ‘know it all’ ASDers.
Their concept of friendship is Convenience: if they need your help, they become best buddies, once achieved their goals they discard you on the spot without resentment.
They generally excel financially, henceforth better off with addressing their obsessions to expensive life-coaches on a “see you later”, non-committal fashion.
No offence intended, I just speak from personal experience.
Commitment is very along the lines with self-awareness and acceptance.
One doesn’t become aware in the blink of an eye. Difficult task in ADHD.
Professionals have coined the expression “Staying on Task”.
Why are awareness and acceptance fundamental to staying on task?
The ADHD brain is constantly wandering around, stimulant medication is a key element to achieve awareness. Awareness enhances Acceptance, Motivation and Self-esteem in succession.
Motivation is the driving force behind Reward.
People who are eager to start a new workday are a rarity.
The solution is seeing the reward at the end of the day, Motivation.
If you can’t see the light, seek reward in volunteering, but don’t enter the mindless pursuit, Addiction.
Acceptance is of big help for patience, reward doesn’t come straight.
As far as you try, you are never a failure.
The more you try, the more you’ll develop Self-esteem.
Many ASDers and ADHDers function better in an Adrenaline induced Crisis.
Crises are always accompanied by excess Adrenaline.
The concept is analogous in reverse: excess Adrenaline accompanies Crises.
This explains why many neurodivergents are more productive under stress.
Adrenaline is a powerful stimulant neurotransmitter.
It is also detrimental in excess as for the long-run, either physically or mentally, implying cardiovascular pathologies and psychoses.
Sadly, successful neurodivergent are willing ‘to pay the price’ by deliberately driving themselves in a critical direction.
It is no secret that world-billionaires ‘claim’ to be on the Autistic spectrum.
Could money have medicinal properties???
Walt Disney first advanced this theory in his Donald Duck’ s fumets: what’s better than an invigorating Dollar-shower?!
I bet he would have claimed to be on the Spectrum, these days…
Only Apple’Steve Jobbs was authentically in bad shape, yet he had the money…
Who wants to understand, they will…
I’m a First Responder diagnosed with ADHD/ASD, I don’t need to push myself in Critical scenarios, I respond to.
Less privileged ADHDers and ASDers purposely tackle deadlines at the very last moment pumped up of adrenaline, eventually succeeding by putting their lives at stake.
Processing thoughts can be Analysis-paralyzing in ADHD. Giving Priority is the hardest antidote to learn for squeezing activities in a 24 hours timeframe. ADHDers hate to Renounce.
One of the stereotypes of ADHD is Multitasking, a big misconception of Hyperactivity.
Although some people are particularly gifted at it, the neurotypical brain is not programmed for multitasking.
The results of multitasking are never accurate and oftentimes revised by an expert, so-called Fact Checkers, a new figure in today s workforce.
Fact-checkers are highly sought-after by companies which in so doing can implement multiple projects simultaneously.
ADHDERS excel at emergency’s decision-making, often mistaken for multitasking.
Despite the inaccuracy, multitasking requires lots of coordination, the weak side of ADHDERS.
This is the reason most ADHDERS work as First Responders: I can testify it in my capacity as EMT where decisions are minute-dependent.
I d be a failure as a clinician, where Analysis is the primary skill.
Worry-Paralysis, Analysis-Paralysis, all summarize into Procrastination, meaning ‘buying time’.
ADHDERS have a different concept of Time, at least in terms of hours.
First Responders are active 24/7. My average working day/night is 12 hours. Some times I feel exhausted, others I can put 48 hours in a row pumped up by adrenaline, a real blessing for my Supervisor especially during weekends, busiest times for EMTs and Police, nevertheless.
I’m dead serious, do disclose your ADHD status in Interviews for 911 jobs, whilst NEVER say to be a 9 to 5 chap!
All this to say that desktop jobs are a fat No to ADHD.
There are Office workers with ADHD however, accounting for Procrastinators ultimately looking for a new career involving more bodywork and less thinking.
Now, you ll notice that I m being overly sarcastic. My sense of British humour helps me with Dopamine release. I’m not saying ADHDERS are stupid by “less thinking”, I’m explaining in a non-academic context how the ADHD brain works.
Stimulant drugs increase dopamine and adrenaline release at pre-synaptic level.
It is thought that the ‘shooting release’ is the most powerful reaction in dopamine and adrenaline s depleted ADHD brain.
That would explain the rapid decision-making required in life-threatening scenarios.
The downside is that ADHDERS are highly dependent on medication.
I couldn’t work as EMT med-free.
I’m resolute to go med-free at the seaside in retirement, I can do it, I never take meds on holidays.
This consolidates my belief that Environment is crucial in Autism and ADHD, while Time is my worst nightmare.
Time-management is the main obstacle in ADHD.
Practically, there is no Time for ADHDERS.
Pressure is the definition of Time in ADHD.
Sufferers take actions under pressure, a contributing factor to hyperactivity and quick response.
While this is an advantage in emergency situations, it doesn’t work in organizational strategies.
Organizing requires Calmness and Thinking, which are time-dependent in nature.
Without medication, ADHDERS hardly stay calm.
‘To-do lists’ don’t work for me, the stereotypical therapeutic model for ADHD.
I remember my schedules.
Motivation and Reward are my driving tools in addition to stimulant medication.
Journaling is my daily Reward and Relaxation.
I look forward to Journaling, my Sympathetic Nervous System reminds me, no need for lists.
I ‘appoint’ on my agenda dreaded deadlines only.
As the name implies, Deadlines are always a burden to all, yet inevitable and often forgettable.
To say, everybody suffers from ADHD to a certain degree.
That said, my way of coping with Deadlines is dissecting them into Lines, dedicating a small portion of time every day to them in a monthly format, in so doing, removing the “deadly” component.
Decision-making is the benchmark of ADHD, although no trait is necessarily pathological exclusive.
These days, we got into the habit of Labeling each behavior.
I can understand the convenience from a diagnostic criteria, not indispensable in everyday’ situations. A Label refers to Chronic conditions, despite behavioral dysfunctions can occur occasionally in any individual.
We all take decisions on a daily basis. Indecisiveness alone is not a Illness but a Dimension, therefore not permanent and self-treatable.
These dimensions are named Consolation and Desolation in theology, Indecision and Spontaneity in psychology, respectively.
To say, there is both a Spiritual and Intellectual side to these mindsets. Theology is the spiritual branch of Psychology, despite academically independent. A bureaucratic system only, since theologians are mostly religious Leaders and Theology is dominion of religious Institutions.
I do look forward to the unification of Theology and Psychology in a single study course.
As of today, Theology defines Indecisiveness as a state of Desolation, whilst Decision-making as a state of Consolation.
The common denominator is Discernment, the final stage in taking a Decision.
This Interconnectivity is the natural antidote to Indecisiveness.
Desolation enhances Consolation by giving us time for Decision-analysis.
In other words, Desolation equals Discernment. Consolation equals Reward.
Psychology defines Desolation as Indecision.
Consolation as Spontaneity, synonymous to Self-esteem and Reward.
Different terminology for the same hopeful attitude.
Is Resilience fueled by Pride or a Virtue?
I talked about Desolation and Consolation in the context of Recovery.
Resilience is in fact a recovery process.
Most people attribute Desolation to Depression, two independent variables.
In lay terms, we can describe Desolation as Resilience, Depression as Hopelessness.
See the discrepancy?
The main feature of Desolation is Discernment.
Discerning is not a illness. It is put in the context of desolation since Discerning involves lots of Thinking and Reasoning, which in turn, summarize in Responsibility.
Decision-making is a responsibility.
Responsibilities are normally rewarding in the long-term, although a certain degree of pressure is inevitable in the first stage however, Consolation as in Reward is to follow.
In Depression, there is no Consolation, despite the struggle being real.
On that basis, can we define Resilience as a Virtue or a chemical Reaction?
Resilience is defined as a Virtue in ADHD.
However, Dopamine and Adrenaline fuel Resilience in ADHD.
These two neurotransmitters are naturally deficient in ADHD.
This prompts the question: “Can Resilience be Pride in the Neurodivergent?”
Narcissism is a common component of manic behavior.
Excessive Dopamine and Adrenaline can trigger Mania, an inflated form of ego.
Speaking as ADHDer and practicing Christian, I am confident in that I am not a Prideful person.
On the other hand, I am not sure whether Resilience is a natural trait or the outcome of stimulant medication.
I have been on stimulants for 20 years and I know I can’t function without, I tried to no avail.
Is Spontaneity a more correct word for Resilience?
I support Spontaneity.
Your thoughts welcome.
Major Depressive Disorder-MDD- is the most misleading diagnostic symptom.
Depression is the most common form of Mental Illness.
It is also the most misused term.
The correct medical terminology for depression is ‘Clinical Depression’, shortened to MDD, Major Depressive Disorder.
The definition is time-sensitive only, in reality: the DSM considers Depression a permanent state of Sadness over two weeks, regardless of major, minor, mild, etc.
What’s the purpose of Major then…?
Depression, or sadness, hits hard from the first day. ‘Major’ is a pure bureaucratic term for ‘Real’. A good psychiatrist doesn’t need two weeks to identify Clinical Depression, but must observe the DSM protocol for diagnosing.
The problem is, many co-morbid disorders can develop in two weeks.
It doesn’t necessarily have to be MDD, although practitioners make up their minds from the first visit and don’t look for options.
ADHD turns out to be the most versatile disorder in mental health following MDD.
To say that the two conditions are often misdiagnosed for one another.
In turn, ADHD is highly co-morbid with Autism however, it could be MDD.
This can be disastrous for treatment.
I believe mental health professionals would be better off without DSM.
MDD is typically treated with antidepressants targeting Serotonin, SSRI s.
ADHD is typically treated with amphetamines targeting Dopamine.
What are the effects on Autism?
MDD is experienced by autistics too.
There is no specific pharmacological treatment for Autism.
We mess up a lot with medications.
Off-label treatment is often the most effective for this very reason.
Conformity is the most reliable diagnostic tool for ADHD.
ADHDers can’t conform. Conformity is Boredom in ADHD and dreaded to death.
From this, the co-morbidity with Autism and MDD.
Since single diagnoses are virtually impossible, I believe in a Co-morbid approach in Mental Health, at least in the initial stages.
The results will highlight the most appropriate intervention.
It is not yet understood whether Executive Dysfunction is a Signal or Neurotransmission s disruption.
The brain’s main 3 regions are the Cerebrum, Cerebellum, Brainstem.
Although interconnected, some researchers entertain the notion of 3 separate brains within the cranial cortex: the Cerebrum is the largest anterior portion associated with Action. The Cerebellum is the smaller posterior portion where Neuronal Signals originate. The Brainstem is the lowest posterior portion connected to the Spinal Cord, processing tactile and motion nerve signals.
The Cerebellum is mostly associated with Spectrum Disorders.
Speculation wants that the Cerebellum and Cerebrum are disconnected in ADHD.
This would explain Procrastination, the failure to take action in the long-term.
The logic would be that stimulant-induced Dopamine and Adrenaline as in Neurotransmission, enhance Signals from the Cerebellum to the Cerebrum through electric synaptic impulses.
Dysfunctional brain electrical-activity is responsible for several disorders, Epilepsy the most common…
A Signal can be a thought, a decision, a memory, a skill, an intention…
When Signals don’t travel to the anterior Cerebrum, the first visible manifestations are Time Blindness, Lack of Motivation, Crisis, Burnout, all linked to Executive Dysfunction.
You will remember that healthy Executive Functioning revolves around Learning.
The same is for Dysfunction.
Time Blindness is the first symptom of failing Signaling.
When Signals don’t reach the Cerebrum, we can’t execute them, therefore we lose the sense of urgency, referred to as ‘Time Blindness’, literally: the sufferer cannot distinguish between day and night, the Circadian Rhythm acts on Fatigue only in order to put us to sleep, regardless of light or darkness.
A potentially fatal condition in the long-run.
With no sense of urgency, we automatically lose Motivation by tackling deadlines on the last day, reminded by the calendar or notebook. This ‘induced’ Sense of Urgency turns into a Sense of Crisis, or a State of Panic and Mania combined: Sparking adrenaline puts us in a 24 hours nonstop Work-mode.
Eventually, we do the job, not without paying the inevitable ultimate Price: Burnout.
For the record, Burnout is former Nervous Breakdown, far more explicitly dramatic defined and universally comprehensible.
Burnout is laughed off by youngsters who think it’s a harmless joke recovering in a good overnight sleep… far from truth.
Burnout can be irreversible or trigger multiple mental and physical illnesses.
Neurodivergence is NOT awesome, let’s stop pretending and advocate for Awareness and Acceptance instead!
This is real Empowerment, not praising our miseries.
Rant said, what’s the cure?
There is no cure.
Literature is plentiful. The answers always equal and partial.
As for ADHD, Reward enhancing dopaminergic compounds are the only solution.
Neuroscience is a fast-paced field. Like all medical disciplines to date, it is still primarily symptomatic oriented. Stimulants are being increasingly studied in Brain-signaling, rather than the initial precursors of all Signals, the Amino acids.
Amino acids are organic molecules virtually omnipresent in every living organism, the building blocks of life.
In the human body, they tend to bind in short chains named Peptides.
When Peptides contain at least 20 amino acids, they form Proteins.
Proteins are longer chains of amino acids also called Polypeptides.
A protein can have a structure of up to two Polypeptides.
In Mental Health, Proteins are outdated subjects of study.
Modafinil is the primary compound associated to protein synthesis to date, not yet understood after 30 years.
Coincidentally, this medication is somewhat ghosted, despite its effectiveness at cellular level.
Every biological process starts at cellular level.
Proteins play a crucial role in cellular development and Signal Processing, although pharmacology looks at the more remunerative symptomatic mechanisms of action.
Current stimulants target the manufacturing of dopamine and norepinephrine in ADHD and Narcolepsy.
They don’t target failing Brain-Signaling, the root-cause of Executive Dysfunction.
Although the mechanism of action is ‘supposedly’ not understood 30 years later, Modafinil showed promising results with boosting Neural Transportation Pathways responsible for carrying signals from the Cerebellum to the Cerebrum by Proteinic synthesis.
For non-known reasons, research was archived and the compound is available as a non-specific source of evidence, therefore deemed unsafe and not promoted openly by professionals.
It is known that Tryptophan and Tyrosine are the precursors of Serotonin and Dopamine, respectively, the two main humoral neurotransmitters.
There is no medication targeting these proteins, other than over the counter’ supplements.
Research is bound towards Neurotransmission at Synaptic level only.
Signaling deficiency is not taken into consideration by pharmaceuticals.
What we supposedly don’t know is whether dysfunctional Neurotransmission is a Signal-disorder or a Re-uptake dysfunction.
ADHD is highly co-morbid with Autism. It is a Spectrum Disorder. Like OCD, it is characterized by Paralysis-Worry.
Contrary to the logic, rewarding neurotransmitters are deficient at pre-synaptic level, while stationary at receptor-level.
The Hyperactivity associated to ADHD is a Craving for Dopamine and Adrenaline, NOT an Excess, as popularly endorsed by ignorant, sadistic, old Millennial teachers which my generation had the disgust of seeing.
I apologize to young educated teachers, I strive hard to come to terms with, although 20 years of abuse and humiliation leave the mark.
ADHD was the curse of all teachers, back in the day.
The timeframe was the 80/90 s, ndr.
Teachers didn’t have any basic Mental Health skills, ADHDers were seen as diabolically possessed, literally: we were called “Children of Satan” and treated accordingly, at least in England.
My predisposition to humanities is what saved me.
My Maths professor would have made for a Master Exorcist!
I do have issues with PTSD as well, you ll understand. It always gets in the way, out of control.
It is hard to stay on topic with ADHD, but I give free will to my mind, prior to typing guidelines. I’m not pretending, just being me.
So, back to the top.
Neurotransmission takes place between releasing cells, synapses and receiving cells, so-called Receptors.
The process must be interchangeable and continuous, henceforth regulated by the Autonomous Nervous System.
Once again, we cure the symptoms, not the disease.
In ADHD, dopamine and adrenaline are not re-uptaken in the releasing cells, they remain trapped in the receptors and ineffective.
That explains why Stimulants have a calming impact in ADHD by increasing dopamine and adrenaline at pre-synaptic level.
Speculation is that Humoral Neurotransmitters are active at releasing cells-level only.
Receptors would be the recharge-pools of dormant neurotransmitters.
Stimulants target Adrenal glands in order to manufacture extra dopamine and adrenaline.
Put it bluntly, we function on Stimuli.
By law of physics, Energy can only be released by ignition and absorbed.
Absorption gradually decreases energy, unless Re-uptaken and fired again.
This is the functional neurotransmission pattern.
However, it is not the end of the story: Idiosyncratic reactions are common in the brain.
‘Idiosyncratic’ refers to ‘Opposite, Atypical’ in Medical.
GABA is popularly known as the calming neurotransmitter by regulating nerve impulses. It has the potential of blocking the release of dopamine and adrenaline.
If taken into consideration the ‘Release Effect’, it would be an enemy in ADHD.
If taken into consideration the ‘Pre-synaptic Effect’, it would be a blessing.
These two mechanisms of action are not yet clear.
Personally, I m in favour of the Release Effect.
Paralysis-Worry is the medical term for Procrastination, or Overthinking.
ADHDers are good at taking cold decisions, whilst faulty at decision-making as result of low self-esteem. This is literally paralysing. Worry is the subconscious precursor. At this stage, it is easy to imagine the efficacy of stimulants.
Stimming is a visible feature of Paralysis-Worry, a repetitive, unproductive nervous tic like tapping hands or feet.
Could Stimming be a symptom of OCD?
They are indeed repetitive compulsions, with the exception that OCD ultimately releases anxiety, whereas Stimming can be permanent.
One of the most entertained hypotheses on the origins of Anxiety are the dopaminergic pathways involved in reward.
OCD, an omnipresent Compulsion in Anxiety, would appear to deplete dopamine by repetitive rewarding behavior.
Repetition is always tiring, even when producing positive results.
I don’t believe in repetition, a mere automation to me excluding any thought process, commonly known as “learning by heart” between lazy students on the quest for grades.
However, OCD is not only related to learning.
It affects hygiene, rituals…
Showering twice a day is draining, washing hands for anything we touch is daunting, etc.
A rewarding exercise becomes exhausting when long repeated.
Washing hands when dirty is rewarding. Washing hands half hour when not needed, depletes dopamine hence increasing anxiety.
Based on this model, lack of Reward would be the cause of anxiety.
Too simple to be true.
The dilemma remains whether the neurotypical indulge in Repetition for Reward.
Speculation is that anxious people don’t know how to “consume reward”, therefore repeating the same ritual over and over again.
They have highlighted addictive tendencies.
Attachments are the precursors of all addictions.
Since I m talking about addictions, I refer to unhealthy attachments.
The term ‘Addiction’ implies several behavioral changes.
Habits per se are not addictions, provided they don’t cause harm to ourselves and those around us.
.
An habit turns malignant when compulsory.
Repetition quickly destroys self-awareness, an alternative definition for Addiction.
When we are addicted, we can’t refrain from repeating the same destructive behaviors.
Examples are the most eloquent: reciting the Rosary is a beneficial repetitive Prayer. Drinking a bottle of whiskey per day is a destructive Addiction.
The neurodivergent brain is biologically oriented to destructive behavior.
Recreational drugs release massive amounts of dulling chemicals.
Like in ADHD, these substances, most commonly heroin, cocaine, methamphetamines, alcohol, are not reuptaken and require a new dose to kill emotional and physical pain.
Recreational drugs are sold on the street by gangs at prohibitive prices. Most users can’t afford them, therefore indulge in criminal activities.
Illegal substances become Pride for users: “I feel good, I can make it!” is the ultimate goal for normalcy.
Unlike the wealthy neurotypical who do drugs for entertainment, the purpose has totally different connotations.
I’m not afraid of being an anti-Prohibitionist.
Recreational drugs will always be available, Governments know where the plantations are, yet bombarder-planes don’t fly over.
Opium and Coca are the driving economies of Asia and Latin America.
Arresting dealers brings nothing, they are immediately replaced.
By selling recreational drugs in the pharmacies upon prescription, cartels will be forced out of business, while users will be medically supervised.
Meanwhile, bags of cocaine are found inside the White House…
Last but not least, the ‘Forget-Effect’ secures all addictions in the long-run through Self-denial and Euphoria.
Long-time addicts cannot recall the painful Withdrawal Syndrome, but the induced Euphoria only, as far as under the influence. They ll deny any Suffering, henceforth Repeating the pattern.
Loved ones become the worst enemies, never dare to say “I told you!” to an addicted family member.
They will only listen to fellow addicts, a new form of rehabilitation: making subjects on withdrawal meet with those on euphoria, a evidence-given therapy.
Addicts have strong camaraderie as in favour, make good use of it.
A lengthy process, though promising．
You cannot make it alone with addictions.
My advice as a medical first responder, is to always keep in mind that Addiction is a Illness, not a Crime.
That’s a start.
My name is John Testore and I m a British-Italian man married to a Japanese lady in Japan. I m a former Medical student. I was diagnosed with Autism and ADHD in Med-school causing me to drop after my third year and join the Ambulance Service as paramedic.
