Today I’d like to indulge in a little thought experiment.
As the title suggests, the thought experiment is: if we had a completely reliable treatment that could totally “cure” ADHD, what would happen?
For various reasons, that premise is an oversimplification and something that is not likely to ever happen. We can’t even really say what it would mean to entirely cure ADHD, or to make people with ADHD “the same” as neurotypical people.
The first question to ask is, what would that really accomplish? Maybe not as much as we’d expect, actually.
I’d suggest that entirely eliminating everyone’s ADHD symptoms would not suddenly allow people with ADHD to start living like people without ADHD.
That’s because ADHDers have build up a lifetime of consequences from living with ADHD symptoms. Eliminating the symptoms would not eliminate that accumulated baggage. The baggage takes a couple different forms:
- Not developing skills: People with ADHD struggle with things like organization, emotional regulation and time management because our ADHD symptoms interfere in those areas. However, a secondary effect is that people who are better at those skills to begin with are able to further develop them over time, which is more difficult for us. If our symptoms were eliminated overnight, we would not suddenly develop neurotypical-level skills in these areas, but we would be in a better position to develop these skills through therapy, coaching, self-reflection, etc. Even if we suddenly had “normal” executive functions, we would have to learn how to use them.
- Emotional effects of living with ADHD: Living with ADHD means not being able to do things other people take for granted, and not necessarily even knowing why you can’t do them. Over time, that changes the way you see yourself. It damages your self-esteem and leads to counterproductive coping mechanisms. Getting rid of ADHD symptoms doesn’t undo those emotional effects – instead, that’s something that happens with intentional work over time, preferably with the help of therapy!
The point here is that there’s a lot more to coping with ADHD than just treating the symptoms. Even if we could treat the symptoms perfectly, there would be a lot more to do.
In our thought experiment of a 100 percent effective ADHD treatment, there’s another question to consider: what would the side effects be?
I’m going to suggest that there would have to necessarily be some side effects.
One of those side effects might be that you enjoy certain activities more or less than you used to. For example, if treating ADHD reduced some of my novelty-seeking tendencies, would I still get an intense high from traveling to new places? If ADHD made me tolerate boredom more easily, would I enjoy music as deeply as I do?
Just because there are side effects, possibly even including changes to personality, doesn’t mean our hypothetical treatment would be a bad thing of course. To get rid of ADHD symptoms in one fell swoop, it might well be worth it. Rather, the point is that we couldn’t necessarily expect to eliminate our symptoms without some broader consequences in our lives.
More generally, what this thought experiment highlights to me is that ADHD, despite being defined by a set of symptoms, is about much more than those symptoms in our lives. It’s about accumulated emotional consequences and lack of opportunities to develop certain self-regulation skills. It’s even about what activities we enjoy and how we like to spend our time.
We’re certainly much more than our ADHD symptoms, but those symptoms are still intertwined with many aspects of who we are, which is what makes treating and coping with ADHD an art as well as a science!