Curious to hear what others think, as this definitely aligns with my own experiences.
The original study is behind a paywall, but I'm trying to see if I can get a hold of the full text somehow. For now, here's the abstract.
Abstract
Objectives: Recent studies report a fluctuating course of attention-deficit/ hyperactivity disorder (ADHD) across development characterized by intermittent periods of remission and recurrence. In the Multimodal Treatment of ADHD (MTA) study, we investigated fluctuating ADHD including clinical expression over time, childhood predictors, and between- and within-person associations with factors hypothesized as relevant to remission and recurrence.
Methods: Children with DSM-5 ADHD, combined type (N = 483), participating in the MTA adult follow-up were assessed 9 times from baseline (mean age = 8.46) to 16-year follow-up (mean age = 25.12). The fluctuating subgroup (63.8% of sample) was compared to other MTA subgroups on variables of interest over time.
Results: The fluctuating subgroup experienced multiple fluctuations over 16 years (mean = 3.58, SD = 1.36) with a 6- to 7-symptom within-person difference between peaks and troughs. Remission periods typically first occurred in adolescence and were associated with higher environmental demands (both between- and within-person), particularly at younger ages. Compared to other groups, the fluctuating subgroup demonstrated moderate clinical severity. In contrast, the stable persistent group (10.8%) was specifically associated with early and lasting risk for mood disorders, substance use problems in adolescence/ young adulthood, low medication utilization, and poorer response to childhood treatment. Protective factors were detected in the recovery group (9.1%; very low parental psychopathology) and the partial remission group (15.6%; higher rates of comorbid anxiety).
Conclusions: In the absence of specific risk or protective factors, individuals with ADHD demonstrated meaningful within-individual fluctuations across development. Clinicians should communicate this expectation and monitor fluctuations to trigger as-needed return to care. During remission periods, individuals with ADHD successfully manage increased demands and responsibilities.
It makes sense on the surface. ADHD is a deficiency of self -regulation. External pressures remove the "self" part of the equation. The scary part is the recurrence/remission cycle that makes it seem, to you and to everyone else, like you finally have your shit together.
I was just thinking that when I read:
You mean the condition associated with dopamine regulation is affected by periods with a high density of short term goals with well defined, tangible outcomes?
Also, is it possible that environmental factors like high-pressure, work or death situations foster ADHD in adults? Like, high-pressure education, testing, and job markets increase the incidence of pathological emotional disregulation.
You fucking people are really making me feel like I have this.
Although most ADHD symptoms are things that neurotypical folks experience sometimes, if it seems like a lot of these are familiar, or describe a lot of your experience, you might consider asking your doctor about it.
The more we understand about ADHD, the more we realize how many undiagnosed people have been struggling with it their entire lives without support.
Hospitality is this for me, and has been for the last 18~ years.
Really you have a good hour of power where the bulk of customers will want to eat, drink and have a good time - all at once because fuck the kitchen and the bar.
Having to relay information from the kitchen, make sure the bar hasn't lost a docket, dealing with spills, intoxicated patrons, wait people missing a meal / adding the wrong meal to an order plus the general meeting and greeting of walk-ins / bookings.
It's also managing wages - when to knock people off, who to send home early, who costs more, who is unwell or le' tired. Who can't work together, who is bad at pack down or requires micromanagement once the busy period is over.
It's a never ending list of monitoring, putting out fires, managing expectations of patrons and staff - all the while being legitimately nice and keeping your cool.
Oh, and if something gets missed you've just put the next days crew in a bad spot. Didn't prep that aquafaba? Forgot to swap a postmix bag, change a gas bottle, polish cutlery, clear tables or even check the fucking toilets for passed-out patrons?
Rinse and repeat 5+ days a week. And this isn't including how to manage personal relationships, hobbies and general self-care when everyone else is working a 9-5.
At least I'm not bald or grey yet.