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.

  • themeatbridge@lemmy.world
    link
    fedilink
    English
    arrow-up
    46
    ·
    10 hours ago

    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.

      • Septimaeus@infosec.pub
        link
        fedilink
        English
        arrow-up
        4
        ·
        6 hours ago

        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.

    • MyTurtleSwimsUpsideDown@fedia.io
      link
      fedilink
      arrow-up
      20
      ·
      9 hours ago

      I was just thinking that when I read:

      “This might mean that people with ADHD perform their best in more demanding environments (perhaps environments that have stronger immediate consequences, like needing to put food on the table for a family or pay rent monthly). It also might mean that people with ADHD take more on their plate when their symptoms are relatively at bay.”

      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?

      • themeatbridge@lemmy.world
        link
        fedilink
        English
        arrow-up
        7
        ·
        9 hours ago

        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.