Sorry, Dave, ADHD is real, and (not acknowledging it) can hurt you. Hi. I’m Richard. I’m a Ruby Core Contributor. I also code in Rust, and enjoy giving talks and writing books about How to (Contribute to) Open Source. I was diagnosed with ADHD in my late 30’s. What does it mean that I was “diagnosed” with ADHD? Am I simply a speed junkie? What even is ADHD, and why is there so much misinformation and misunderstanding about it? Keep reading to find out.

For context, this is inspired by DHH, the creator of Ruby on Rails, musing out loud that maybe ADHD isn’t really a thing and that people who claim to have it are really just speed junkies in his post ‘Cold reading an ADHD affliction’. Though it’s turned into a bit of a personal essay on my ADHD journey and thoughts on what it means to be a leader in the age of social media.

Why do I think I have ADHD?

First off. What was my diagnosis story? As a child, I was told I had a “great memory” and was a solid A- to B+ student. School wasn’t interesting, so I didn’t really try. My biggest behavioral issue was that I snuck books into class and read them under my desk. If your mental picture of someone with ADHD is an out-of-control “little monster,” then this seems like the opposite. I got through college with a degree, taught myself Ruby on Rails (thanks for the framework, Dave!), got a job, and, at some point, started giving conference talks around the world. So far, so good. No ADHD is on the horizon for me!

I started seeing a therapist because I’m a knowledge worker, and I wanted to make sure my brain was in top shape. A high-performing athlete sees physical therapists and trainers even when performing well. I heard others talk about their ADHD on social media. I was surprised at some symptoms like “hyperfocus,” the blessing/curse that is an inability to stop a task you’re engaged with. I heard about time blindness and other traits that resonated with me. As Jessica McCabe from “How to ADHD” (YouTube channel and book) would say, “But every [programmer] has those problems, right?” You might think this is where my therapist stood up and loudly declared, “NO, YOU HAVE ADHD.” But they didn’t; I’ve found there’s a bit of a stigma about ADHD, even within the mental health community. My therapist’s approach was to not validate my “hey, this is resonating with me” but instead take the approach of Asking, “What are the impacts of that being true? How can that information be helpful?” for lack of a better term they “leaned out” of the self-diagnosis but didn’t dismiss it (thankfully). They encouraged me to seek more materials and bring them back to discuss with them.

Oof, I skipped a part. Why was I bringing that self-diagnosis part up to my therapist? ADHD doesn’t just affect your professional life. In fact, my ADHD is amazing for my professional life (usually) as it helps me debug a problem for hours as the day slips away. It also affects relationships. Life for me growing up was tough. I always felt like something was wrong. I felt like life was harder for me than everyone else, but I did well enough, so it mostly sounded like I was a big complainer to adults. I was able to develop coping mechanisms that worked, such as bringing books to school when I was young. I had more agency to adapt to the world when I got older. This is one reason I’m so drawn to open source: it lets me fix problems that are trivial to others but deeply painful and personal.

While I could terraform my professional and adult life to work with my brain quirks and preferences, terraforming my wife and children wasn’t an option. Children are quite inflexible in their needs, and it was difficult for me to adapt. I’m generally meh at doing mundane and basic things but then will over-compensate by knocking a handful of really difficult (and interesting) things out of the park. You can’t do that with kids. All their needs are primal yet basic, and it doesn’t matter how well you can change a diaper - there’s no way to do it so well that your infant says, “Wow, that was great.”

One day, I was having an argument with my wife. It was about how I never planned dates. It got heated. She had to go to a meeting, and I planned to return to the conversation “Hey, how about we grab lunch after your meeting to talk it over.” I realized that I needed to meet the basic expectations of planning events and trying to compensate for them by taking action then and there. The suggestion might seem trite or pandering, but she thought it was good and agreed.

An hour later, she walked into my office (garage), and I literally couldn’t remember why she was there. Or rather, I was in the middle of another task, and when she walked in, I had to rack my brain to quickly retrieve the info that would provide context to her: “I’m here.” It took a split second too long, and she noticed. Turns out that I don’t “have a good memory.” What I have is the ability to recall extremely detailed information about a situation, given that I’m primed with the context.

This gives the false impression of me having a good memory but makes things like “forgetting” you were fighting with your wife and agreeing to go have lunch with her really confusing to other people. It makes it seem like you care about other things but not them. In fact, I deeply care about the people around me, especially my wife. She got pissed, I had a bit of a breakdown. We did go to lunch, and while there, I realized that I had lost track of time and missed my remote call with my therapist. Oops.

That was a bit of a boiling-over moment, and I was convinced something was wrong in a way that “try harder (at relationships)” was not the fix. I pushed my therapist harder. They suggested an awful info session class on relationships for couples with ADHD that left my wife in tears. Eventually, we found the book “ADHD and Us” by Anita Robertson, and I could really see myself and my relationship in the words of that book.

Even with the book in hand and anecdotes resonating with both my wife and me, I still deeply questioned my self-diagnosis. My therapist at the time still didn’t want to “label” me. I oscillated between “everyone has these problems” and “this matches my lived experience too well to be a coincidence.” It turns out that self-doubt and doubting whether or not you’ve got ADHD is really common. So when I see posts by people who want to be leaders in the community musing out loud that maybe ADHD isn’t really a thing and that it’s all in our heads, it’s pretty hurtful. Not because he’s wrong to have those thoughts or question norms but because everyone who has ADHD already HAS THOSE THOUGHTS. It’s a deeply unhelpful take, and there’s an already misunderstood world of ADHD, even within the medical community.

At this point, I was not on meds, but I started bringing up the things from the book more and more. I didn’t actually know how to get meds to try them, but I was medication-curious. I found an online ADHD provider, and I felt a mixture of relief and doubt when they said, “Yes, sounds like you have ADHD,” and gave me a prescription. Was I telling them what they wanted to hear because I had hyperfocused on the topic and knew all the symptoms inside and out? Or did I actually have ADHD? For the longest time, that was my biggest battle. Answering the question, “Do I actually have ADHD? Or is this all in my head?” I eventually found an available in-person psychiatrist. They are REALLY hard to find. I blankly asked them, “Is this real, or did I make it up,” and through many sessions, they affirmed that I had ADHD. But I still didn’t believe it.

I sought out more of an empirical approach. I eventually found some quite expensive but thorough testing. I signed up for hours of testing at a specialty clinic where they administered mind games like “say the color of a word when the word is the spelling of a different color.”

For one test, I sat for 15 extremely boring minutes in front of a computer, and every time I heard a beep or saw a dot on the screen, I clicked a mouse button. I then took my meds and, about an hour later, took the exact same test. At the end of the day, I was convinced I was making everything up; the tests seemed easy. I could see how someone could game the attention one, but I was doing this for me; I wanted to know. I focused and tried as hard as possible. I was convinced the before and after scores would be the same.

Spoiler alert, they were not. From the report:

Integrated Visual and Auditory Continuous Performance Test – 2nd Edition (IVA-CPT-2) This is a computer-based test specifically designed to assess for symptoms of ADHD. Richard’s performance is considered a valid estimate of his functioning. Overall, he earned Impaired scores when he was tested without stimulant medication, whereas his performance was in the Normal range when he was tested with stimulant medication.

Apparently I was “impaired” on the first test without my medication. On the second test, with my medication I’m “normal.” So maybe I didn’t do so great and the medication does have a measurable positive impact, even if I can’t always tell a difference when I take it.

Later, I would move my prescription to my general practitioner (which I also found out is probably the normal way that most people are prescribed ADHD medication). That doctor also asserted that I had ADHD. And finally, I moved to see Anita Robertson as a therapist. You might remember that name as the author of the book “ADHD and Us”, which I loved so much. Turns out she lives in Austin, Texas. She also affirmed my suspicions.

Does DHH know more about my ADHD then me?

So, do I have ADHD, Dave? I don’t know. I still question everything about my brain regularly. Your post didn’t help that but didn’t cause it, so I don’t blame you for that question. Yes, I take “speed” regularly. Still, it’s not like people with ADHD are the only people in the world stimming themselves to keep up with society. It’s also a weird drug. I can tell a difference if I haven’t taken it, but it’s very subtle to me. I have my medication in a timer cap because I genuinely cannot tell whether I’ve taken it or not. Sometimes I forget.

Before meds, I was self-medicating with caffeine, a lot so of it. I started drinking coffee when I was a child, lots of milk and sugar, but out of the same pot as my parents. I loved how it felt, and the world seemed less bad, if just a bit so. I still enjoy coffee, but more for the taste, and I have far less of it than I did before getting on medication.

Medication helps quite a bit in many areas of my life. Personally and profesisonal. But it’s not a magic fix. One common community line is “Therapy and Meds, or Therapy. But not just Meds.” To that extent, I don’t think anyone can or should decide what’s right for me and my body.

What even is ADHD?

One thing I HATE about ADHD is it’s basically a meaningless term. Telling someone “I have ADHD” is usually as helpful as telling someone “I like ants.” It might be true, but most people need help figuring out what to do with the information. For the record, I hate ants; I’m mildly allergic to them. Why say that I have ADHD if it’s not helpful?

It’s helpful to me to find others who have similar struggles so we can learn from one another and see one another. I’m a member of ADHD programmers subreddit, where I try to help fight the tide of negativity and self-doubt from time to time. People regularly ask there if they should tell their managers co,-co-workers, or even friends if they have ADHD. Usually, the answer is “no” or “it depends.” Again, only some people react to that information positively or helpfully.

So what is positive or helpful? I told my last manager I had ADHD, and while I didn’t quite regret it, I got mentally lumped in with another co-worker who also has ADHD. I didn’t like that, as I felt negatively judged for someone else’s behavior. I sought to work with them to understand what accommodations could look like. I also did this with the help of my therapist. Some accomadations were helpful, some were not. If you’re looking for ways to help someone with ADHD this video talking about things that help and things that don’t was useful. Plenty of resources are also out there, but it’s a bit of a minefield. Some clinicians and personalities come in with doom and gloom: “ADHD is a chronic and debilitating…yada-yada,” and some come in with genuinely helpful and useful advice.

One challenge here is that not all ADHD is alike. It is like an RPG game where you can assign certain character attributes at the beginning of the game. Everyone in the world has all of the attributes. An “average” or “median” player might assign all skills equally or go for a common min/max like a brawler that maxes strength or a rogue that maxes stealth. Someone with ADHD has just as many points to apply, but they end up in uncommon areas. One thing I’m quite good at is metacognition. I.e., thinking about thinking. Basically, I’ve never had a quiet moment in my brain while I was awake. Nearly every action I take, I think about it before and sometimes think about why I’m thinking about it while doing it. This translates to me being very good at writing tutorials, as I’m composing a mini-tutorial in my brain every time I do any task. It also translates to usability work because not only do I mess up a lot of processes accidentally, but I can remember exactly WHY I made the assumptions I made. I know what to change about the process or environment to steer me down a better path. I make it sound like a superpower, but it’s got a downside as well…I overthink some of the simplest tasks, and standardized test-taking is super hard for me. I’m constantly questioning whether the problem is really “that easy” or if the author hid some tricky language I’m not catching.

Not all ADHD folks are good at metacognition. Going back to the RPG analogy. All wizards might have more intellect than strength; that’s one attribute that helps to classify them as in the wizard group, but some might have higher charisma than others. ADHD is kind of like that, but it’s harder to pin down. One common category is self-agency. That’s the ability to say to yourself, “I want to X”, and then actually be able to follow through with it. Like “I want to do the dishes” or “I want to send a patch to the Puma webserver.”

Kids have a still-developing pre-frontal cortex and, therefore, have problems with agency. Last night, my 6-year-old kept telling me he wanted to apologize for his mistake, but he just couldn’t. He had the right idea; his car was pointed in the right direction, but there wasn’t any charge on the battery to get anywhere. That’s a common negative. One frequently cited positive is “good in an emergency.” One example that comes up at home is when my wife took me to a wedding with a bonfire. I didn’t know anyone, but I was generally social when another guest walked by and fell INTO the bonfire. Everyone else froze. I eyed a piece of wood that hadn’t caught fire yet, braced there with my hand, and pulled him out with my other hand. He was dusting himself off, and no one else had moved. Everyone said things like “Wow” and “That was amazing, what you just did”, but I literally didn’t even think about it. I don’t know why everyone didn’t jump up and do the same thing. On the flip side, I did not notice that I opened 10 drawers to find a thing and didn’t close any of them.

In an RPG context, what distinguishes us is that our skill points are distributed in a not-normal way. You may have heard of neuro-divergent, neuro-diverse, or neuro-spicy folks. That’s what I think of when I hear those terms. I imagine a bell curve, and in the middle is most people, at either end: both high and low is a much smaller group, and that’s where you’ll find us. We generally have challenges that are hard to comprehend or relate to, but we excel in equally surprising ways. We’re not better or worse, we just are.

One scene that comes to mind is from the classic “Butch Cassidy and the Sundance Kid.” Butch and Sundance are on the run from the law and need a job to feed themselves. They know how to rob, so they figure they’re qualified for a job protecting goods from robbers (more or less). In the job interview, the hiring manager hands Sundance a firearm and asks him to shoot a brick. It’s the gunslinger equivalent of a whiteboarding interview. Sundance moves to holster his weapon and then draw it when the guy stops him. He tells him, “I just want to know if you can shoot,” meaning drawing is above and beyond; he’s looking for basic proficiency. He couldn’t even do the minimum. Sundance misses the easier shot and says, “I’m better when I move.” The guy is confused, so Sundance holsters the weapon, then draws and fires 3 times in rapid succession, hitting the brick in an impressive display. On the surface, he can’t do the basics, but when tasked to go above and beyond in a field he cares about… he can deliver.

What does it all mean?

That’s a lot of rambling, so let’s wrap this up. The same cognition test shows I have a higher-than-average IQ. On several tests for things like visual perception, I rank as “superior.” In some ways, this discrepancy helped me hide my symptoms and is what led me to not get a diagnosis sooner. Now that I’ve got my diagnosis, am I happier? Am I more productive? Is my family life better? In general, I’m more attentive to mundane things than before. I might not notice much difference, but my wife reports a noticeable change for the better. I can do boring things like standardized compliance training more easily at work. But meds and therapy aren’t “fixes,” as there’s no problem to be fixed. They’re about fitting my square brain and needs into the round holes of society.

This isn’t a “society is bad and should accommodate me” conclusion. Society did not wrong me. Society didn’t make me. I’m not the Joker. If I could change one thing, it would be that we all try to have more empathy for one another. That doesn’t mean you must agree with everyone’s actions or perceptions. It means that when someone tells you a lived experience you don’t understand, come to it with curiosity before condemnation.

I wrote this in response to a post by a “leader” in the community who idly wondered some thoughts aloud. If I ask for empathy, he deserves some as a person, the same as anyone else. If we want more empathy from one another, we need it from our leaders. We need their curiosity.

Dave has actively fought to be a leader in the Ruby community. The post right before this ADHD screed is about him joining the board of directors of a billion-dollar corporation. He is definitively a person of power. The titles before that are:

  • Obsessive problem solving followed by aimless wandering
  • House rules in Fortnite
  • Too much therapy at work

I appreciate his openness. I don’t feel he’s “hiding” anything from you or me. But there was a time when “Daring Greatly” by Brene Brown was on everyone’s bookshelf, daring people to be vulnerable. Many didn’t read it and missed that oversharing is its own form of deflection. Dave’s rambling stream-of-consciousness makes for interesting controversy, but what does it achieve?

As a leader, what is Dave leading us towards? I don’t think he knows, at least not here. I wish he would distinguish his musings to differentiate between “I understand the consequences of these words and the outsized impact they may have and endorse them as a leader of a company, a board, and a community.” Versus “I woke up and had a thought and didn’t have anyone else to say it to, so I wrote it here.” I also wish to have more conversations with him, personally and with the community. I wish he was more curious about some of these statements. They’re certainly strong opinions, but are they weakly held? It’s unknowable.

What exactly does he want out of that ADHD post? He claims it’s for me to say, “I do speed.” Weird flex, but okay. I take Lisdexamfetamine. I’ve not hidden that from anyone; I bring it up in casual conference conversations. He would know, but I don’t believe I’ve ever seen him at a RubyConf, and usually, he leaves the day after his talk at RailsConf as long as I’ve been going to them since ~2012. I’ve only chatted with Dave when I organized a fancy dinner. I’m guessing he’ll be around for Railsworld, so maybe I can catch him there next year.

Maybe I can ask him, “What led to that ADHD observation and thought that produced the article? How does that make you feel? What do you need that leads you to want to write about this? What specific request might you have for your reader?” Maybe if you see him, you can ask.