00:00:17.720
So, for as long as I can remember, my memory has been bad. I was hoping you weren't going to laugh at that, but I'll take it. I can't remember conversations that I've just had, and sometimes I don't know where I've left my phone. If I don't write an idea down, it's often gone—sometimes forever. I can remember some things; phone numbers are generally okay. I am pretty sure I remember my parents' birthdays and their anniversary. I can recognize people's faces, but I probably am not going to remember your name. The worst part of this is in conversations. I'll be talking to someone, having a serious business conversation, and parts of it just disappear. I know this; it happens in every conversation I have. Sometimes, when I'm in the middle of a sentence, I'll forget where I'm going with that sentence, and I'll have to stop.
00:01:42.040
A few years ago, I developed the skill of just admitting that I have no idea where I'm going, and I need to stop talking right now. This situation makes me feel like there's something wrong with my brain. When I was in school, I didn't do homework at all. I'm fairly intelligent, and my parents and teachers knew that; they just thought I was lazy. They would say things like, 'Well, you know, just sit down and do it. It's not that hard. Just sit down and do your work.' It's not that they were wrong; they just didn't understand how difficult it was for me to begin. That part—just sitting down and starting my work—was the hard part. I barely graduated from high school, and in fact, the only reason I did was that my principal recognized my challenges and waived some requirements for me. I graduated with a 1.4 GPA, third from last in my class of 218. However, I did manage a good SAT score, which allowed me to go to college.
00:02:54.680
I went to Oregon State University, where I dropped out after five years. I accumulated more than enough credits to graduate, but they were in topics that interested me, not in what the university required for a degree. So, I gave up. Then I started my career, and things improved for a while. It turns out that getting paid is a pretty good motivator to do work, and the fear of potentially losing your job is an even better motivator. However, as my career progressed, new challenges emerged, and I started losing track of what I was supposed to be doing. I would abruptly lose interest in a project. One day, I might be very excited about it, and the next day, I wouldn't care at all. When I got bored, I would just quit working, and sooner or later, I'd start to feel bad. I'd get in a little trouble and get talked to by someone, prompting me to force myself back into work. But forcing myself to work on something I didn't want to do led to burnout, again and again.
00:03:57.480
I left university in 2004, and in the last ten years, I've held more than ten jobs—only two of them for more than a year. I'm really hoping I can make it another month; if I do, I will have been at GitHub for a year. About two and a half years ago, I was working at LivingSocial, and it was a really challenging job. There were many people relying on my group for deliverables, and others in the company whom I admired—individuals I had known since I started in the Ruby community. Their respect was important to me, but I felt like I was letting them down. I wasn't doing a good job at work; I was losing track of my responsibilities and not finishing projects. It was really hard and disheartening.
00:05:01.240
For a long time, I figured this was just a memory problem, a different manifestation of the same issues I've faced all my life. I went to my therapist to discuss it, but memory isn't usually something a therapist deals with—they focus on feelings. So, she referred me to some psychiatrists, giving me four phone numbers. I took those and sat on them for months. Every day, I'd look at the business cards, planning to call, thinking to myself, 'Today's the day; I need to make an appointment and talk to someone to figure this out.' Yet, every night, I'd go to bed without having called any of them. This has been a recurring pattern for me; I often find something I need to do, focus on that need, and then not follow through.
00:06:06.459
Just to illustrate, I've been submitting proposals to conferences for over a year, and until recently, I haven't been able to get around to actually doing it. It often takes a lot of pressure to motivate me. Around the same time I was seeking help from my therapist about my memory issues, I was talking to peers and mentors in the Ruby community about staying motivated and preventing burnout. One of those conversations led me to a book titled "Delivered from Distraction." I purchased it on my Kindle while on my way to the airport for a flight, read it on the plane, and continued over the next couple of weeks. It sounds dramatic, but it genuinely changed my life.
00:07:02.720
The book is written by two doctors, Ned Hallowell and John Ratey, who are both psychiatrists and have ADHD. They grew up in a time when ADHD did not exist as a diagnosis. The book is a guide that helps illustrate what ADHD feels like and includes a lot of information about symptoms, contributing factors, diagnosis, and treatment. There are also personal stories from the authors' experiences and their patients—both children and adults. Every page resonated with me. I found something I could relate to, something that felt familiar. Prior to reading this, I thought my experiences were unique to my brain, a blend of my personality and upbringing contributing to my challenges.
00:08:16.560
Reading "Delivered from Distraction" helped me realize that other people felt the same way I did. Knowing other people shared similar struggles motivated me to seek help. When I got home from that trip, a week after my conversation about finding help, I found the motivation to finally call those psychiatrists. I spoke with one whom I found in Seattle, who understood ADHD because her husband was diagnosed as an adult. I started seeing her two years ago, and it has really helped me.
00:09:04.480
Now, let's talk about what ADHD actually is. The most commonly accepted definition in the United States comes from the Diagnostic and Statistical Manual of Mental Disorders, or the DSM—the definitive guide for psychiatrists. The DSM was revised in 2013, and the current version is DSM-5. An interesting aspect of that revision was how the criteria for ADHD relaxed in diagnosing adults. Previously, getting an adult diagnosis was quite challenging.
00:09:32.760
The DSM lists two categories of nine criteria. To qualify for a diagnosis, you must have six symptoms from each category, but in adults, the DSM-5 has lowered that number to five. The revision also subtly changed some wording which makes it easier for practitioners unfamiliar with ADHD to diagnose adults accurately. For the diagnosis to apply, symptoms must have been present before age 12, impact your life negatively, and be present in multiple contexts—such as at home, work, or in social situations. Let me show you the list of inattention symptoms.
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Most of these symptoms are internal; they are mental processes that people can't necessarily observe. You might have difficulty focusing on details at work or miss minor things. You may struggle to complete tasks or find it hard to pay attention during conversations, where you might seem disengaged. Sometimes, you might forget recent dialogue, start multiple tasks but lose focus, and jump from one unfinished task to another. You could become sidetracked easily, have trouble managing sequential tasks such as recipes or forms, and you might find it hard to keep your space organized. Time management is often a struggle, where you miss deadlines or have difficulty even starting tasks.
00:12:24.520
For example, you might frequently lose your wallet, keys, or phone. You may get easily distracted by external stimuli—such as noises that others might ignore. Adults may also experience a situation where their brains shift focus unexpectedly to unrelated thoughts, leaving important tasks behind. Additionally, you might miss appointments, forget to eat, or struggle with returning phone calls or emails. Out of those nine symptoms, I personally relate to eight of them.
00:13:17.560
My ADHD is predominantly inattentive. There are also hyperactivity symptoms, which are more observable. People tend to see these symptoms in children, but adults can exhibit them too. You may find yourself fidgeting or moving around unnecessarily during meetings. You might leave your seat at inappropriate times or feel physically restless, struggling to remain still. Others might notice that you need to move around or speak a lot, possibly even interrupting conversations.
00:14:00.679
For instance, I often fidget by bouncing my leg or pacing. I feel the urge to move almost constantly. These visible hyperactivity symptoms can become embarrassing, especially as an adult, because you know certain behaviors are not socially acceptable. You realize that interrupting someone is wrong, yet it happens anyway; your brain doesn't always acknowledge the social contract at that moment. Frustratingly, it can feel like an involuntary response.
00:15:27.600
So, what's it really like? Have you ever found yourself reading a book and realizing you've flipped five pages without comprehending a word? Or been engaged in a conversation, yet not grasped what the other person said? There are moments when you're working on programming, looking back at lines of code without remembering writing them at all. I often experience losing parts of conversations, as if they simply vanished.
00:16:14.640
This reminds me of a year ago when I was writing this talk. I had a great joke idea while on a plane. Since I couldn't get to my phone, I panicked about not remembering it. I repeated the joke in my head over and over, which never works. I continued to get distracted and ended up thinking about how I should carry a notebook. Eventually, I focused on the joke again, but then I got distracted imagining this story as part of my talk instead of its original intention.
00:17:04.720
When I got out my phone, I realized that writing down this experience might help illustrate what ADHD is really about. It’s important to share these insights, as they resonate with many people. It's not all bad, though; ADHD can be a gift for some. Many people experience hyperfocus, where they excel at a single task, deeply immersing themselves. Individuals with ADHD often possess unique nonlinear thinking abilities that can lead to creative problem-solving. When they find something engaging, they can become passionately focused.
00:18:49.320
The authors of "Delivered from Distraction" argue that ADHD is not necessarily a disorder; instead, they view it as a collection of traits that describe a specific way of thinking. This perspective can help people feel less broken. As for managing ADHD, it varies for everyone. Research shows that exercise can be beneficial. On days when I go for a bike ride in the morning, I tend to have a more productive day. Morning exercise can enhance focus and productivity.
00:19:53.640
It's also essential to understand the conditions under which you can work effectively. For me, I work better late at night, after exhausting the more distracted aspects of my attention during the day. I can focus better at night, regardless of distractions, perhaps because the nighttime allows me to consolidate my focus.
00:20:49.800
Therapy can help in understanding ADHD. Supports, like support groups, provide valuable context. Regarding medication, ADHD medications have sometimes gained a bad reputation for being quick fixes, especially after their notable rise in use in children over the years. It's essential to work closely with your doctor to ensure you choose the proper treatment, as ADHD and depression are often linked.
00:21:49.600
Some antidepressants can be effective for ADHD. I take Wellbutrin, which has helped my depression though it didn't positively affect my ADHD. Stimulants like Ritalin and Adderall do work for many, and they work well for me. Nevertheless, any treatment needs supervision, and it's not a one-size-fits-all solution.
00:22:59.600
Often, undiagnosed ADHD can contribute to feelings of depression because individuals are aware of the challenges they face in organizing their lives. On the other hand, treating ADHD may sometimes heighten awareness of personal struggles, potentially exacerbating depression. Understanding these dynamics is crucial to managing ADHD effectively. When diagnosed, it's common to reflect on past experiences. I found myself pondering how, if I had known about my ADHD in my teenage years, my life could have been significantly different. This realization can be quite challenging; it underscores feelings of regret, but sharing these experiences is important.
00:24:33.040
Nevertheless, I wouldn’t trade my experiences with ADHD. While I could wish for a bit less memory clutter, the coping mechanisms I've developed have become valuable strengths. The skills I take pride in—like creative problem solving and intuitive understanding of systems—are largely due to my ADHD. They have helped me develop a unique perspective that I truly appreciate.
00:25:40.720
ADHD can provide some interesting advantages as well; for example, I often observe all sorts of conversations in public, using this ability to generate spontaneous thoughts for my social media. My capacity to tune in to overlapping dialogues allows me to share the amusing and ridiculous things I overhear without losing my current conversation. I view this as a superpower.
00:26:43.040
I hope to have shared my journey in a way that resonates with any of you who might see aspects of your own experiences reflected in what I’ve said. There's often a painful process to understanding ADHD—my hope is that by sharing my story, at least one person here can avoid that same level of pain. If my insights resonate with you, I encourage you to read "Delivered from Distraction," highlight the parts that reflect your reality, and take it to a therapist. Speak to your doctor about your concerns regarding ADHD, and consider seeking a psychiatric referral.
00:27:35.679
Here in Washington State, there are also psychiatric nurse practitioners who specialize in ADHD treatment. The important thing is to take proactive steps to understand and address your situation.
00:28:54.280
Thank you.
