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.
For me, it tracks, but the caveat is a high increase in burnout accumulation. No self regulation needed? No problem. Except when you can’t self regulate healthy work amounts / dealing with demands.
So much this
70+ hour 5-7 day work weeks in a super high demanding job where people are basically hollering things for me to do that needed done in 2-5 minutes no-stop? I did that shit for 2 years. But man would I crash and burn out when I’d crash and burn.
Panic attacks, drinking like a fish, smoking pot like I was afraid of a non-smoke filled breath.
0/10 would not recommend.
Yeah, I think there’s definitely an ideal balance, and I don’t think consistent 70+ hour weeks is the right balance for anyone. If my work schedule is busy, but near 40 hours/week, burnout is probably not a major worry. Occasional weeks that demand more than 40 hours are manageable as long as they’re balanced out by easy weeks or vacation time.
I’ve been really struggling with my current job because my actual workload is closer to 15-20 hours/week most weeks. I end up having a ton of trouble getting started, and am always late on things. I’ve tried on multiple occasions to tell my manager that I actually need more work, but they instead keep suggesting that I learn to delegate things more.
This 100%
There is a limit to how much I can excel under high pressure environments until everything falls apart and I spiral into what seems like incompetence.
It’s actually that fall that caused me to finally get diagnosed. It took a couple years, a pandemic, and multiple people at my job retiring in short order, but I finally couldn’t balance all the spinning plates any more.