Show HN: Shimmer – ADHD coaching for adults, now on web | Hacker News Reader

Show HN: Shimmer – ADHD coaching for adults, now on web

shimmer.care

229 pointschristalwang265 comments

Hi, I’m Chris, one of the co-founders of Shimmer. Last October, following my ADHD diagnosis, I launched Shimmer (https://shimmer.care), one-to-one ADHD Coaching for adults. Our HN launch was here: https://news.ycombinator.com/item?id=33468611.

A quick recap before I dive into our new launch: Shimmer is an ADHD coaching service for adults. We took apart the traditionally expensive, inaccessible ADHD coaching offering ($300-600+/session) and redesigned it from first principles. You get matched with one of our expert ADHD coaches, meet weekly over video, and get supported throughout the week via text and with learning tools. This solution is special to me personally (and our community) because it doesn’t just give you “knowledge” or offer another “tool”—our coaches help you set realistic goals, take personalized steps towards it, and keep you accountable.

Today we’re excited to launch our most-request feature: Web.

Over the past 9 months, we learned (and iterated) a lot with our members and coaches. A few key challenges pointed to the need for a web version: (1) ADHD “object permanence” challenges (e.g. out of sight out of mind), we needed to be multi-platform so when you finish a task or goal or encounter a challenge, regardless of if you’re near your laptop or phone, you can check it off & ping your coach right away, (2) members used reflection modules (e.g. after each task, you’re prompted to reflect on what worked and didn’t work, and it informs your coach) more thoroughly than we originally anticipated, and web allows for deeper reflection and typing, (3) overarching coaching goals were often forgotten during the day-to-day, and the web makes it easier to use visual cues to keep goals top of mind for motivation, (4) many of our members struggle with phone addiction and driving members to the mobile app ended them up in Tiktok/IG, whereas the web app offers a focused environment to get in their “coaching zone”.

Our new web app was designed alongside over 1,200 members, 22 coaches, countless hours of testing and iterating. We’re excited (but nervous!) to unveil this new version. If you have ADHD (or think you do), we’d love for you to check out our platform and give us critical feedback (or positive reinforcement!). It’s a super streamlined and ADHD-friendly signup process and in honor of our web launch and back to school/work, the first month is 30% off.

Our pricing: $115/mo. for Essentials plan (15-min weekly sessions), $230/mo. for Standard plan (30-min weekly sessions), $345/mo. for Immersive plan (45-min weekly sessions); all plans additional 30% off first month, HSA/FSA-eligible.

We know these prices are expensive for many people with ADHD and we’re committed to bringing costs down over time. It’s more affordable than what many people are paying for coaches, but the fact that we’re relying on humans, and not going the “we can automate all this with AI” route, puts a floor on how low the costs can drop. That said, here are some actions we’re taking to drive down costs for those who need it: (1) we offer needs-based scholarships and aim to have 5% of members on them at any time, (2) we often run fully sponsored scholarships with our partners—over 40 full ride scholarships and 100 group coaching spots have been disbursed alongside Asian Mental Health Project, government of Canada, and more, and (3) we have aligned our coaching model alongside Health & Wellness Coaching, which is expected to be reimbursed in 2024. If you have ideas or expertise here, please reach out to me directly at chris@shimmer.care.

On behalf of our small but mighty & passionate Shimmer team, I’m excited for the Hacker News community to share your thoughts, feedback, and ideas. If you feel comfortable, I’d also love to hear your personal ADHD story and what has worked / hasn’t worked for you.

Co-founders Christal & Vikram

Open articleView on HN

"All of our Shimmer ADHD Coaches are licensed or certified mental health professionals or have extensive experience with ADHD & undergo our Shimmer Coach Training program developed alongside our clinical advisors Dr. Amin Azzam (MD, MA), Dr. Anil Chacko (PhD), and our Head ADHD Coaching Psychologist Xenia Angevin."

What is "undergo our Shimmer Coach Training program developed alongside our clinical advisors Dr. Amin Azzam (MD, MA), Dr. Anil Chacko (PhD), and our Head ADHD Coaching Psychologist Xenia Angevi"?

Are they doctors or not? Psychologists or not? AI or not? There is so much mumbo jumbo and scams and pseudo medicine in psychology related issues, that this sentence simply reads as "yeah trust us, some of us are doctors, people who are doing the work, are not".

Also amount of usage of word "coaching" is abusive. Are coaches respectable? Do they have credentials? Why coaches and not psychologist or psychotherapist?

Appreciate this question, it's one we've gotten a lot and quite frankly I agree we haven't nailed the best way to articulate it. To answer a few of your questions... - We don't use psychologists or psychotherapists as the front-line helper because there is a severe shortage of them and our main goal is accessibility. There is a provider shortage (psychologists, psychiatrists, therapists, etc.) in the US and most places in the world - Depending on someone's severity, helpers can include parents/teachers, peer support specialists, mentors, coaches, therapists, psychiatrists, the list goes on (I tried to broadly categorize from least to most intensive); our service does not aim to support the most severe. Anyone who screens with high degree of Mh impairment is not suggested to use Shimmer (and we have screening in the onboarding process) - Frankly, depending who you ask, you'll get a different answer for "are coaches respectable". Coaching is a modality that is "up and coming" because of (1) the need for more providers and subclinical support services, and (2) the credentialing / reimbursement models are evolving... see next point: - We align our model most closely to Health & Wellness Coaching, which is estimated to be reimbursed by next year: https://www.wellcoachesschool.com/post/medicare-moves-advanc...

Overall though, we use PhDs/psychiatrists/master-level coaches to supervise, create protocols, trainings, etc. and use coaches to deliver. (Not AI). Our coaches are either credentialed by ICF (International Coaching Federation) like BetterUp or Ginger or Lyra's coaches, NB-HWC (National Board - Health & Wellness Coaching), or have masters-level psych degree and go through our training.

Happy to expand on any of the above!

You say you haven't found a way to articulate it. You should articulate it exactly the way you do in this comment.

You are not providing licensed medical services. Just come out and say it, since it's true. Yes, saying that will cause people to distrust you, and well it should. You are right about there being a shortage, but there is no substitute for a real doctor.

That said, being upfront about it instead of trying to beat around the bush or make excuses doesn't help you. It only serves to make you even more untrustworthy. Your attempts to obscure the fact that you aren't providing real medical service only suggests that you know in your heart that what you are providing is not the same. If you believed your "coaches" were good enough, you wouldn't have to do anything at all to hide the fact that they were not real doctors. You could just come out and say it.

Shimmer is NOT clinical and we do NOT provide licensed medical services. We are most definitely not trying to substitute a real doctor. Full stop. We hope that is clear in all of our communications and website, and do NOT try to obscure that.

However, we do a lot of work to work with the right experts (which include clinicians, psychiatrists, etc.) to ensure what we do it safe, follows best practice, is science-backed, and is effective. And we definitely want to highlight this work that has been done and the importance of it.

We will update the language to better reflect this immediately.

> Shimmer is NOT clinical and we do NOT provide licensed medical services

In which case I personally find the phrase "All of our Shimmer ADHD Coaches are licensed or certified mental health professionals" to be quite deceptive.

Thank you for pinpointing this. I re-read many times, and I agree with you. I've just re-written the whole section with our Lead Coaching Psychologist, Xenia.

Your website has photos of the doctors for the "care team" and coaches buried under a link. Come on, just be uprfront with people.

please elaborate on which licenses and certifications they have. Can I confirm those credentials, how will I know if they are industry recognized and respected instead of your own in-house certification.

None of them are our own in-house certifications. We haven't designed that yet, however we are considering it. Not meant to replace incoming certifications in the short- or medium-term, but to reward coaches for their learning and work and for common language. Example credentials of our coaches are: ICF, NB-HWC, MSW, PhD, EMCC, PsyD, LCSW, LMFT. Not all coaches have all of those credentials—it'll differ by coach.

> Not all coaches have all of those credentials—it'll differ by coach.

What decides who gets what coach? Is it a triage based on symptom severity or first-come-first-serve?

Or highest paid best coach..

This was an excerpt of a longer message; we did not claim all our coaches are licensed or certified mental health professionals.

Original wording: All of our Shimmer ADHD Coaches are licensed or certified mental health professionals* or have extensive experience with ADHD & undergo our Shimmer Coach Training program

Even the full original wording doesn't align with what you later said:

> Overall though, we use PhDs/psychiatrists/master-level coaches to supervise, create protocols, trainings, etc. and use coaches to deliver. (Not AI). Our coaches are either credentialed by ICF (International Coaching Federation) like BetterUp or Ginger or Lyra's coaches, NB-HWC (National Board - Health & Wellness Coaching), or have masters-level psych degree and go through our training.

If the licensed or certified mental health professionals aren't actually hands-on with your clients, it's awfully misleading to say that all of your coaches are licensed or certified mental health professionals or blah blah blah. If you were being honest, you'd skip the nonsense about using mental health professionals as coaches and just say that your coaches go through your training program and are supported by mental health professionals--you know, the actual truth.

Just updated the language in our FAQ for this!

> quite frankly I agree we haven't nailed the best way to articulate it.

You've certainly nailed the best way to articulate "we haven't worked out how to best phrase our bullshit to fly under the radar" though.

We've just changed our language with the support of our care team and the folks in this thread! Super open to more suggestions if it can better represent what we're doing (ADHD Coaching)

Looks like the same bait and switch Dr. K (Healthy Gamer) did. Put a real MD on the poster, and once they sign up hook your customers with people with 3 weeks of "professional training".

But honestly, that can be a win. A good process (with a person you resonate with) can go further than a medical degree. Personal opinion, based on lots of experience.

Thanks for this comment—you've nailed it. The service we're providing in it's very nature is not medical and instead encompasses support functions like accountability, celebration of the member, helping the member feel "seen and heard", etc. Many of our members have not got that from their doctors, nor do they expect it given the doctors role. We advocate for layering the services you need together (e.g. I have a doctor, psychiatrist, coach, right now.) and our coaches work hard to communicate the role of a coach and the boundaries.

Providing "not a medical service" but advertising it using explicitly medical terminology appears to be the root of the problem, don't you think?

If a fitness trainer started throwing around things like "clients reported reduction of sciatica symptoms" you would of course assume they are licensed physical therapists and that you are treating sciatica. They could just as easily say "pain management through exercise" and not get caught in that kind of credential limbo.

We definitely are not trying to pass as a medical service. However, we do our due diligence to make sure we have medical staff on board to advise us on our protocols, services, train our staff, supervise our staff, and to stand in if there is any escalation needed. We hope it's clear Dr. Anil himself is not coaching and very happy to make things more clear by adding his title to the front of the card.

> We definitely are not trying to pass as a medical service.

> HSA/FSA-eligible.

Try harder?

healthcare and medicine aren't synonymous

psychologists, mental health therapists, physical therapists, occupational therapists, pharmacists, and so on, do not practice medicine - but the services they provide can be paid for with HSA and FSA money

https://en.wikipedia.org/wiki/Allied_health_professions

Technicalities don't matter, explicitly calling it out creates a false connection in readers brains. Like how some snake oil treatments say "FDA cleared" because they know consumers don't know what it means.

I disagree. This isn't about technicalities. I think it's about you assuming that others draw a "false connection" just because you saw one. Most people don't see HSA/FSA and automatically assume that a service is medical care. HSA/FSA funds are for healthcare-RELATED expenses and cover lots of things that aren't medical co-pays or medication: sunscreen, condoms, breast milk pumps, glasses or contacts, health-related home improvements (e.g., wheelchair ramps, hand rails), transportation for medical care, weight loss programs, menstrual care products, band-aids etc. All of those things are healthcare-related, but they're clearly not medical care.

There's nothing wrong with stating the objective reality that the cost of Shimmer is HSA/FSA-eligible. HSA/FSA-eligibility is directly relevant to one of Shimmer's key goals, making ADHD coaching accessible to people who can't afford traditional coaching. Using HSA/FSA funds brings down the overall cost significantly, so it's going to be a factor when budgeting. It isn't even close the same thing as snake oil treatments claiming to be "FDA cleared." Consumers may not realize that "FDA cleared" is an absolutely meaningless phrase, but I think we can agree that most adults know the difference between a condom and a licensed medical professional dispensing FDA-approved medication.

"HSA/FSA-eligible" is a legitimate, accurate phrase to describe the services Shimmer provides. Plus, anyone who has a HSA/FSA has most likely received education or literature about it through the company providing it for them (typically their employer). They're not reading this post thinking, "Since I can pay for this with the account that I use to buy sunscreen and band-aids, I will surely see a physician and get drugs." Personally, I thought, "Gee, I wish I had a HSA/FSA so I could use it to pay for this health-related service." All brains are different, especially ADHD brains. It's unhelpful to assume they'll all draw the same false conclusion as you did.

I don't think that's a particularly fair point - HSA/FSA eligibility is a billing related question. There are plenty of counseling services that aren't run by formally accredited folks that can achieve HSA/FSA eligibility. The billing arrangement isn't particularly relevant - I do agree that it'd be good to be more forward about the fact that you'll be talking to someone without formal accreditation.

Thank you for this comment, we've changed the language to reflect this last point on formal medical accreditation, and clarified that even if they do have medical credentials, in Shimmer's capacity they will be practicing ADHD coaching

It's absurd to claim that you're not trying to pass as a medical service when you're offering coaching for a neurological condition.

You can argue medical vs healthcare or whatever semantics you want but if it quacks like a duck it's a duck.

Is my golf coach a physical therapist or a physical movement coach? He's been helping me improve my swing around an injury I had dirt biking.

If your golf coach is helping you with your golf swing, I'd say that he's a golf coach.

My grandma once helped me with my math homework, was she a mathematician?

You might get lucky with your golf coach. There are people that went to medical school for that though. Your choice.

She was able to help you though. You don't need a PhD in mathematics to be able to answer some math questions.

Positive human interaction goes a long way.

A good school would provide this. Does that make them a medical service? Or is this actually educational?

It's a totally coherent position to hold that the name 'ADHD' gestures at a real thing, but also reject the medicalization of that thing (or, more weakly, that that thing can/should be addressed solely medically). The predominance of the 'medical lens' in addressing cognitive differences is reflected in the language available for naming and describing those things, whether you actually agree with it or not.

The notion that ADHD 'really is' a neurological disorder and 'really isn't' anything else misunderstands the purpose of psychiatric diagnostic categories like ADHD in the first place. Psychiatrists and psychologists aren't in the business of ontology, and clinicians especially aren't.

Take it from someone who has it: this is a stupidly narrow way to think about ADHD.

You honestly could have fooled me. The amount of preaching, unfalsifiable theories and casuistry that goes on in the ADHD space is beyond the pale.

Executive function theory, delayed rewards theory, everywhere you go, when the axioms of the presenter changes, so does the "root cause" of ADHD change.

Granted it's common for these problems to pop up every where in online media the past five years or so...

... but when Law and Order SVU episodes from the 90s have more empirical cause-and-effect rigor to their detective stories than half the opinions-masquerading-as-theories in the ADHD space, then I find his skepticism understandable and I empathize with it.

I wish it were not true. I deeply, deeply crave a scientist in a lab coat to point to a chain of chemicals that describe the problem in concrete unarguable terms. The smoking gun, if you will. Something Feynman and Einstein (so to speak) could analyze, criticize and come up sucessfully defeated in attempting to prove the theory wrong, admitting the shown evidence and resulting theory is true.

We see instead research universities pouring money and big minds into Diffusion Tensor Imaging, doing hundreds/thousands of high resolution scans on kids' brains who obviously have ADHD and not only being unable to find the root cause of the problem, but they cannot even show a difference in the data that relates to ADHD at all.

Wtf is going on...

It is probably deeply impolite for me to say this, because I'm directly challenging your livelihood and it's 'more good' if I just ignore your website and move on.

To be clear, I don't work at Shimmer or any place centered on treating ADHD or helping people with it. Idek if Shimmer's services are useful.

I just want to push back on the notion that 'this is a neurological disorder' is the only acceptable or useful way to think about ADHD.

To your point, I think it's clear that the world hasn't really figured out what ADHD is yet. That is, we haven't figured out the best way to think or talk about it, let alone treat it.

That's why I think it's important to hold onto that label with a light touch, and an understanding that our conception of the problem is likely to change a lot in the future. The 'real core' that we do know about ADHD is in the common struggles of people, situated as they are, who have ADHD-like symptoms and experiences. Those are worth addressing with anything that helps, and if you have those struggles yourself you know you can't wait for an ideal 'final answer' from scientific or other authorities to try to improve your life.

All that said it's way easier to be comfortable with non-commercial, community-oriented efforts of people sharing their experiences and trying to figure out what works for them in an ad-hoc way. Companies offering solutions to people, especially people who fear that their ADHD-ish struggles might cost them their livelihood or are destabilizing their lives, do have to prove themselves trustworthy and effective somehow and there's a lot of room for scammy bullshit with something like this. I don't disagree with the skepticism so much as the scientism and medicalism.

Just recently found about his youtube channel and have found his content to be quite beneficial. Did not know that he'd done this. Can I read about this anywhere? There seems to be a lot of folks who are critical about him.

I don't know about the details, but even simply from watching HealthyGamerGG videos (which are quite good), the way he pushes his group counseling service(?) using essentially volunteers(??) who are licensed through him does seem suspect. Guess enshittification applies even to internet individuals.

I mentioned this in the main comment but I believe if you try to sign up they make it clear it’s not professional mental health service.

That's fair. I'm not accusing him of pretending it's professional. More like it seems dubious of him trying to push his side hustle in his regular programming. It's like he's presenting a paid service as the natural progression from his free advice. And as if his trained coaches are a proxy for himself.

I think calling Dr. K a bait and switch is a bit unfair. They make it very explicit before signing up that it’s not medical care and that it’s just a coach and not a mental health professional.

Unless they changed the onboarding process, it’s made obvious to the user what it is.

You're absolutely right about the onboarding process. It's very clear that Shimmer does not provide medical care. I think some people just don't realize that doctors exist outside of medical practices. "MD" is a title earned by completing a medical degree, not a job title. There's no reason to assume someone with an MD is acting in the capacity of medication-dispensing doctor at all times. Medical expertise is clearly relevant for the position of "clinical advisor" for an ADHD-related service. Many, if not most, Shimmer users use coaching as an add-on to first line medical treatments and/or therapy. It makes perfect sense to have someone on board who's well-versed in the medical side of ADHD treatment. Operating an ADHD coaching program without someone knowledgeable in that area would be downright dangerous. I'm glad Shimmer has a MD on their team to cover all the bases.

What I've seen from most of these services is they essentially hire independent contractors with experience in a related field. They "train" them with a series of required videos then send them on their way.

Not saying that's what this is doing, but that's what this whole industry does. Unfortunately, there simply aren't enough health care providers.

I think people often forget how poor the quality of an average health care provider truly is.

I would argue that most therapist are incompetent, undertrained, and potentially more damaging than helpful. Of course, there are absolute diamonds in the roughs, but they are few and far between in my (and many others') experience.

I see a hundred of these companies that apparently "specialize in ADHD". I see them all in the same light unfortunately of profiteering in various ways around the incompetent medical system the US has.

Is this a better price than a licensed therapist? Yes

Is this a more practical solution than what you might get? Yes

But it just feels ethically wrong to promote your services to people who are "undiagnosed" or "think they have" ADHD. This is exactly what social media is doing today in the sense of trying to convince you have something because you happen to engage in said content.

I mean just look at the eligibility:

- Adults 18+

- No formal diagnosis required

- Smartphone with internet access

- No suicidal ideation with plan and/or intent

https://www.nytimes.com/2022/10/29/well/mind/tiktok-mental-i...

> Is this a better price than a licensed therapist? Yes

Good luck finding a licensed therapist who has bookings or availability. In Seattle I have had almost 0 luck over multiple years, and I have talked to many other people who have had the exact same amount of luck. The very few therapists around here who do specialize in ADHD either specialize in children, or they are so booked up they don't even bother with a wait list.

Mind you this is for cash payments, if you want insurance to cover care you are completely out of luck no matter how good your insurance is.

Thank you for this. Many of our members have the exact experience you're talking about here. Many therapists go as far as saying they specialize with ADHD when they in fact don't. For those who do specialize in ADHD, it's far and few between—with waitlists out the door. Additionally, therapy is addressing different but sometimes overlapping space we are—we are forward-looking, action-oriented coaching (e.g. reaching goals and how you set up your life for it) and we don't do therapy (more backwards looking, unpacking, talking, etc.)

Yup, it's a clear giant flashing sign that the market is fully broken that we (with our employers) are all paying ~$25,000+ per adult for health insurance, and cannot find mental health providers who are interested in taking said insurance.

• Big shortage of providers

• Providers see taking insurance is like pulling teeth because they never want to pay and why should they because they can get a full appointment book from cash patients alone, due to the shortage.

So things like therapy become completely out of reach unless you're very wealthy, or if you've gotten to the point that you are desperate to go into ruinous debt, trading one problem for another one.

> it's a clear giant flashing sign that the market is fully broken

If so many people need mental health treatment, then I think it's a more gigantic sign that our society is absolutely toxic and FUBAR.

A therapist friend recommended I use https://psychologytoday.com/us/ to search.

I had reasonable lucky but ymmv.

Not affiliated/etc.

I've had success with Psychology Today search in the Seattle area --- if a provider is full or has no openings, ask if they know anyone who is not. That has also helped me!

Yup, all we hear about constantly from politicians is that there’s a mental health crisis. Every time there’s a mass shooting, they blame mental health. Okay, fine, we all agree this is a problem, so why can’t I find a therapist? Why can’t my bipolar 1 ex wife find a psychiatrist? She’s batshit manic right now telling the cops I’m breaking into her apartment stealing antique doll dresses for crying out loud. How does she get help? She has to go to the ER and get hospitalized if she wants any attention, but those stays cost $30,000 typically in my experience. She’s had several.

Sorry about the rant…

So yeah, there’s a fucking mental health crisis and no one seems to want to do anything about it.

I'm super sorry to hear about your ex wife. I have someone close to me in the same situation and we've also been battling it for our whole lives. No need to apologize for the rant, I'm also here being mad for you (for us)!!

Well you’re doing something at least. I’m trying to get my adhd diagnosed after my mom refused when I was a kid, and I’ve been self medicating my whole life with caffeine and weed, unaware I even could have this disorder.

I thought it was just being a hyperactive kid — that wasn’t me. But then I learned about all the symptoms as an adult. Yup, I’ve got ‘em all, like friggen ash catchem. I feel like a lot of adults failed me here but I’m not blaming anyone, even my mom. She had the best intentions but didn’t trust the “medical industrial complex” as she called it.

Somehow I’ve managed all this time by placing myself in environments where my executive function isn’t impaired (I dunno if that’s even the correct terminology), but now I’m in a job where I can barely function leading people to get upset with me, and I don’t know what to do. I’ve been trying to get a diagnosis for over a year, and fiiiiiinally I have something on the books for November. It’ll be over $1000 out of pocket and I have excellent insurance. Top notch.

Anyway, this is just to say keep fighting the good fight. Don’t know if I’ll use your service but I’ll consider it after I get my diagnosis.

Sweet summer child. Insurance will pay for it. You just have to spend $5000 of your time nagging them.

> I’ve been self medicating my whole life with caffeine and weed

As someone that has been treated for over a decade, I swear this combo is perhaps better than the treatments. Not initially, for there is a "honeymoon" period of course, but definitely over the longer term.

I'd go back to the combo if it weren't for the legal and social issues that come with it.

Do not let me discourage you by any means. I am just some random person with an n=1 experience. I truly hope you get the help you need, and that you find something that works even better.

Thanks for validating that this is indeed a combo that works for people suffering from this. Weed was the only way I got through my doctorate, I would have never been able to write my dissertation sober.

I’ve quit weed more or less (became a daily thing, now just occasionally). Today what I’m doing is exercising (a lot) and this is really helping me. But I do go back to the weed pen every now and then, and there’s nothing that makes me feel more focused and capable than that first hit (is that how normal people feel all the time?).

But the problem I have with it is it plugs me up and I also am driven to eat like shit. So I’ve gotta figure out the right balance still.

Honestly this is one of those times when ranting is wholly appropriate.

All I could think while looking for a little mental health support this past year as a relatively wealthy and high functioning person was "god, what in the actual hell do people who are a lot sicker and a lot poorer than me do?". Of course the tragic answer is "things just go really badly for them".

Because the AMA want to protect doctor salaries, so they won't let doctors immigrate from other countries and practice here, as if there's anything worse about the training in Europe.

Yep. I did find a therapist that I really like, but I had to give up on the idea of using insurance.

Yeah, and if you do manage to jam your foot in the door at one of those places they just look at you sideways.

Thanks for your comment and perspective. Our services, as mentioned, are not medical services for ADHD. It is forward-looking, goal-oriented coaching with a specialty in ADHD and executive functioning. The entire modality is represented by organizations like ACO https://www.adhdcoaches.org/ and recommended by top ADHD experts and doctors alike - specifically as a non-clinical, non-medical addition to support people with ADHD. We welcome anyone who wants to come and be coached on ADHD-related skills & goals. For example, if you want to work on your executive functions but you don't have an ADHD diagnosis, you're completely welcome here! This is also because certain cultures (or an array of different circumstances could put someone in this position) prevent folks from getting a timely diagnosis and/or they don't want to tell their parents, etc. But in this case they can still get coaching with less of the stigma.

What's wrong with any of the eligibility?

You're making a lot of assumptions here. Let's tackle them one by one:

1. "I see them all in the same light unfortunately of profiteering in various ways around the incompetent medical system the US has."

You're right, it is unfortunate that you see them all as profiteering off of the failures of the American medical system. As you've noted, the issue here is your choice not to look for nuance or independently evaluate each service.

2. "Is this a better price than a licensed therapist?"

Shimmer has been very clear every step of the way that coaching is not the same thing as — or a substitute for — therapy. For some people, therapy isn't necessary. For others, like me, therapy isn't enough. Coaching fills in the gaps and covers areas that aren't necessarily a great use of time in therapy. In my case, I use therapy to dig into major mental health issues (MDD and PTSD, primarily). I use coaching to help me figure out how to overcome executive functioning barriers and prioritize day-to-day tasks. Both are incredibly helpful in different ways.

3. "It just feels ethically wrong to promote your services to people who are 'undiagnosed' or 'think they have' ADHD."

Have you ever tried to get an ADHD diagnosis in the US? Until recently, testing was virtually impossible for many Americans to access because of scarcity and cost. I was initially quoted $1,700 for an ADHD evaluation from an out-of-network provider, and that was after calling around to numerous places that took insurance, all of which were booked up indefinitely and required referrals (which not everyone's PCP will provide for ADHD testing). I got lucky and found a $500 option, which was then treated as "unofficial" by some prescribers. Finally, I got an "official" diagnosis from an online testing service (unrelated to Shimmer) for $150. I'm incredibly fortunate to have had access to the $650 it cost me to get a diagnosis, along with medical and therapy providers who supported me along the way. Others are less privileged. Do those people not deserve help simply because they can't access a formal diagnosis?

4. "This is exactly what social media is doing today in the sense of trying to convince you you have something because you happen to engage in said content."

Shimmer isn't in the business of telling people they have ADHD or handing out stimulants to any random undiagnosed person who asks. If you take a few moments to look up Shimmer's website and social media, you'll see that they're clearly not aiming to convince people they have ADHD. Each potential client meets with one of the founders (or, I assume, another qualified team member) to discuss their specific situation and needs. If they're a good fit for one of those coaches, they're allowed to sign up and begin coaching. On the off chance that someone did fall through the cracks and begin coaching despite not having ADHD, and their coach didn't notice it right away, then one of two things might happen. Either they'd leave because ADHD coaching isn't suitable for them, or they'd continue because a lot of what happens in ADHD coaching is helpful for all kinds of people with executive dysfunction and trouble focusing.

5. "I mean just look at the eligibility"

"Eligibility" requirements are a bare minimum. One can easily infer from the content Shimmer creates that its services aren't intended (or useful) for all adults with smartphones and internet access.

6. Your link to an article titled "Teens Turn to TikTok in Search of a Mental Health Diagnosis"

Take another look at the eligibility requirements you posted. Shimmer is for adults only. Yes, technically people ages 18 and 19 have ages in the "teens," but they are legally and developmentally considered adults capable of making informed, reasoned decisions about their health. An adult seeking out ADHD one-on-one ADHD coaching from a mental health professional is not the same thing as a teenager scrolling tiktok and diagnosing themselves based on their uninformed interpretation of a video.

If you look at their footer on their main page you will see that “teens” is the next upcoming service.

> But it just feels ethically wrong to promote your services to people who are "undiagnosed" or "think they have" ADHD.

You don't have to 'actually have' ADHD (whatever that means!) to benefit from advice, habits, or practices typically leveraged by ADHDers. You just have to have a similar enough struggle that works in a similar enough way that those techniques help you somewhat. Whether you have ADHD matters way less than whether those things help you.

That said, idk how to really evaluate for-profit companies orienting themselves around the ADHD label to provide services along those lines as opposed to freely associating online communities or whatever.

But the truth is that just like with an actual therapist (or medication) you actually have to evaluate the efficacy of the treatment for yourself. There actually isn't a formula for treating ADHD, and it's not something you can just hand off to someone else. In that respect, services like this are no different from their more authoritative counterparts in psychiatry or psychology.

> This is exactly what social media is doing today in the sense of trying to convince you have something because you happen to engage in said content.

Not quite, imo. The TikTok phenomenon is decidedly less practical (that is, less about doing anything) and more identitarian. It's about asserting membership in an informal group and differentiating yourself from others. It's 'finding yourself' like teens and young adults have always done laden so heavily with (sloppy use of) medicalizing language and a tendency to essentialize, run a bit amok. It's also innocent stuff, like in-jokes about the catharsis of finding a suitable label, of discovering that your struggles aren't totally idiosyncratic but 'a thing'.

But 'if you think you might have ADHD, check this thing out' isn't at all the same thing as 'if you laughed at this meme, you have ADHD'.

Good points, but when you say it is less practical, how do you figure? More people than ever are using social media and AI to self-diagnose. So much that the surgeon general issued an advisory on mental health and scholars like Jonathan Haidt have been sounding off the alarms in the last few years.

https://www.hhs.gov/about/news/2023/05/23/surgeon-general-is...

I feel like a lot of people in the thread don’t realize ADHD Coaching is an established thing that’s more like a specialization of life or organizational coaching than like therapy. It’s a certified practice, but not like being a doctor.

Pretty sure I was paying around $100/hr when I did it years ago, so those prices aren’t insane. The dude coaching was someone with obvious ADHD who (like a lot of us) probably had an easier time communicating what should be done than doing it himself. He definitely was no therapist.

But it added accountability and validation (or challenge, if needed), and he was trained in various organizational techniques. And since he was also ADHD he could speak from experience. My understanding from him was it was pretty common for the coaches to be ADHD people who’d gotten training and certification as a side gig.

I know nothing at all of Shimmer, but it sounds like a remote version of that than anything meant to be therapeutic per se. This is more like the training you should get after the meds start to work but you still don’t have good habits.

> The dude coaching was someone with obvious ADHD who (like a lot of us) probably had an easier time communicating what should be done than doing it himself. He definitely was no therapist.

I just wanna add to this: ADHD is fundamentally about subjectivity. The trouble with ADHD lives in what it's like to be someone who has it. And medical doctors, scientists, and even psychologists, who don't have ADHD often attend so much to the objective facts that are known about ADHD or particular treatments for it that they neglect, discount, and basically fail to grok virtually anything about what having ADHD is like, what taking stimulant medication is like, and so on.

As a result I've consistently gotten way better care from 'less qualified' clinicians who themselves have ADHD than from 'more qualified' ones who don't. I would (and you should, too) expect a psychiatric nurse or nurse practitioner who has ADHD to do a better job with ADHD patients than a PhD-MD who doesn't. And it's totally reasonable that some random coach who has ADHD but only minimal training could be genuinely helpful.

The on-boarding workflow felt sycophantic and pandering. When you ask me to express my vulnerabilities and respond with statements like:

> You're in the right place! 41% of Shimmer members rated 5 for the impact ADHD has on their lives, just like you. Shimmer is the newest way to work with your ADHD: You'll build skills and implement systems that are catered to YOUR life.

> Thank you for sharing. Shimmer members work on similar challenges and 86% have improved within 3 months.

it evokes an image in my mind of a guy holding open a trench coat saying "I got what you need."

At the same time, as someone who has spent a lot of time developing insight into the spectrum of disorders around emotional and internal regulation trying to understand my own life and mind, the workflow was helpful. It showed me that I'm not the target audience for your product. That's OK though, different strokes for different folks.

Best of luck and I hope you're able to support people and do good in the world. :+1:

> Our pricing: $115/mo. for Essentials plan (15-min weekly sessions), $230/mo. for Standard plan (30-min weekly sessions), $345/mo. for Immersive plan (45-min weekly sessions); all plans additional 30% off first month, HSA/FSA-eligible.

Please please put a link to this information on the main site. Anything I'm half interested in using I do a cmd+F "Pricing" and if there aren't results I usually bail.

Also when I hit "Find my coach" and am redirected to the quiz, I just get a blank screen.

This service looks great, and I intend on using it.

"Please please put a link to this information on the main site. Anything I'm half interested in using I do a cmd+F "Pricing" and if there aren't results I usually bail."

That's a pretty specific thing to measure folks on

Obvious and transparent pricing is a requirement for services I sign up for, and the fastest check for services that align with that requirement is cmd+F. As a consumer I'm obviously entitled to measure services however I'd like.

Updated! Now you can cmd+F and find it. Thanks for this suggestion.

I have the same opinion. Someone trying to sell has a full understanding that you need to know the price. It's The fundamental of the transaction. The only reason someone hides a price is that they have something to hide, or they want to do a hard sell. I'm not interested either of those intimately related things, especially the tribulations that would follow.

It's great to see they freely added the price. I suspect they're not guilted of anything above.

I'm the same - I don't want to get invested in a service, hand over my email address and other details, etc., only to later find that the price is too high for me, once the free trial has expired.

Oh, this is a good idea re: "pricing"; right now it's on the homepage under the section "Flexible plans built for every brain". Thank you for this—will be adding today.

Hm, I'm not able to replicate the blank screen. For now you can bypass this section by going to app.shimmer.care and creating an account directly, but let me check in with my co-founder on the blank screen issue.

And awesome, glad you resonated! Let me know if I can help with finding the right coach! chris@shimmer.care

> Oh, this is a good idea re: "pricing"; right now it's on the homepage under the section "Flexible plans built for every brain". Thank you for this—will be adding today.

I appreciate you accommodating my request. Normally the cmd+F route gets me to a "Pricing" link at the bottom near things like "Careers" and whatnot, which is totally fine.

> Hm, I'm not able to replicate the blank screen. For now you can bypass this section by going to app.shimmer.care and creating an account directly, but let me check in with my co-founder on the blank screen issue.

https://imgur.com/a/zvQ72hT

Happens every time.

Again I appreciate the update + response. Best of luck with your service.

The other co-founder and cto here, we just made the updates to the site so it should reference "pricing" in the subscription plans section! Really appreciate the suggestion here.

Also for the blank screen, I wasn't able to reproduce either but the quiz is an embedded Typeform. There may be a plugin/extension enabled on your browser that could be blocking it. What browser are you using and are you able to try viewing it on incognito?

I've observed some negativity in this discussion, and it appears that many comments might be based on assumptions about Shimmer. While some criticism centers on how the service is worded, I think looking at the bigger picture is essential.

How many of these commenters have founded a business that has faced the level of scrutiny they're applying here? Have they taken the time to speak with someone who has worked with a Shimmer coach about their experience? I ask these questions because I've actually done so, unlike many here.

Since my diagnosis last year, I've been with Shimmer, and my coach has been nothing short of amazing. While I can only speak for my experience, I urge others to think twice before criticizing a service that many active users, including myself, rely on and appreciate.

I've even written a blog post about my positive experience with Shimmer, which I'd happily share. Discovering Shimmer was a pivotal moment for me when I was tackling a significant challenge, and it helped me gain the momentum I needed to start my own business.

Was Shimmer the only factor? Certainly not! But would I have made such transformative changes in my life without it and my coach's guidance? That's unlikely.

I was at a loss for where to begin, and choosing Shimmer was the right decision for me. So, I urge everyone to be thoughtful and considerate before leaving critical comments. Give those who use the service a chance to share their perspectives. I've witnessed Shimmer's evolution over the past year and the hard work they've put in to make their service valuable.

Let's honour that effort by engaging in a respectful and balanced discussion.

Edit: forgot to include this -> https://satellitemtl.com/blog/adhd-coaching/

Agree. Shimmer is currently in the "assume good faith" category and it would help everyone if commenters gave feedback and asked questions from this perspective.

From what I've seen of Shimmer, the rapid-fire negativity in this discussion is not warranted. I have run a mental health startup. Criticism is constant and highly energised, and it really wears you down after a while. I expect they're also copping it from established practitioners, their industry bodies, and various regulators.

I currently use Shimmer, I have used BetterHelp and TalkSpace. These last two are... not in the "assume good faith" category. Perhaps they could show up to HN for some "robust discussion".

The thing I would like from Shimmer is a policy and mechanism where if you stop accessing the app and showing up to coaching, they stop billing you. Of course this would be startup poison, businesses are built on subscription revenue from non-users. But only billing for care you provide is the strongest show of ethics and consumer-centering I can imagine. Especially when your client base is ADHDers! Shimmer, if you currently do this, put it on the front page in bold.

In my opinion all of these mental wellness apps start out in the good faith category but will transition to borderline scam. Same as most VC startups. Mental health service providers are expensive, and trying to get equivalent services at rock-bottom AppStore prices isn’t going to work. They’ll build up some reputation using VC money, and then when the time is right they’ll sneakily reword their site and introduce some “AI” component. Mark my words.

We hope to stay in this good faith category, and unfortunately are not able to offer "rock bottom app store prices". We believe in the power of human connection (with others, with coach) so we will not be replacing humans with AI. However, I will say, we already have AI components (on the back end to help with coach efficiency—e.g. helping coaches summarize notes, helping them schedule sessions, prioritize their messages, etc.) so hopefully it's not a surprise when we say AI!

Erm, a lot of grifts don't charge low prices. That's why they're so lucrative!

So far it's not looking good with this line: "All of our Shimmer ADHD Coaches are licensed or certified mental health professionals *OR* have extensive experience with ADHD & undergo our Shimmer Coach Training program" (emphasis mine). That should be a PR disaster with a blog post correcting it already in the works.

There's typically no human connection between you and unskilled sharing economy labor. "Experience with ADHD"? Please! Most entry-level workers have experience with something but it's still entry-level. Higher paying jobs are based on supply and demand. See the difference between DoorDash and jobs requiring a Commercial Drivers License. It isn't the number of miles driven, it's licensing and certification, which that *OR* sneakily gets you out of. It's like The Santa Clause, it's a cartoonishly misleading sentence.

Thanks for having us in the "assume good faith" category—we are committed to staying there! And I appreciate your sentiment. We have already made changes to the website, communication, flows, and processes based on this megathread, so I'm very grateful (even if emotionally hard)!

And re: auto-cancel, we've also debated this internally at length. We believe that the worst "startup poison" is not adhering to your customers, so we definitely don't mind shutting off subscriptions and have done it numerous times.

Currently I will admit it's not automated fully yet but my co-founder & CTO tracks whether members have been inactive 40 days (since some users might be paused for a month) and then he goes through this every week or so and double check their meeting with their coach (and if needed, check if there's a pre-agreed situation with their coach) and then will unsubscribe them. We are already in the processes of solidifying the protocol here to make it fully automated. A bit of context on why we don't cancel right away: holding the member's spot with their coach and ensuring the coach has the time/capacity to serve them is important, and sometimes members just don't show up for 1-2 weeks and when they come back, their coaches work with them to either catch up or sort something else out. If we were to just take their spot away, it can be really jarring (especially in harder times for our members) to not have their spot with their coach anymore (e.g. recurring time in calendar held) or support with that coach all together (e.g. coach capacity). Thinking more about it, one of the options we threw around was to have members be able to set this up early on: e.g. "If I don't do X for 30 days, please pause my account, I acknowledge I may not be able to access the same coach after", something along those lines. Very open to ideas.

I've been using Shimmer for close to a year now and would highly recommend it. Have found it really useful and it's worth the money. I go over super specific issues with my coach each week in the 15 minute sessions: e.g. how do I prepare for a work trip without being late for my plane/forgetting half the stuff I need, how do I avoid being accidentally grumpy with my colleagues.

I've written a detailed review here: https://www.focusbear.io/blog-post/my-thoughts-on-shimmer-ca...

I never really trust these kinds of "reviews", where you talk about x and sell a product related to x, regardless if the review was positive or negative

I’ve been diagnosed since I was a kid and I will say this is interesting. I’m glad it’s not just another AI tool claiming it can “solve ADHD” (especially the chat bots I see popping up, which I’ve tried and they aren’t good). I’ve never considered coaching seriously in the past… but can you share more about what sort of folks coaching works for and what sorts it doesn’t? And what sort of outcomes or stories you’ve seen?

Coaching works best for those who are ready for forward movement: unlike most types of therapy, coaching is goal-oriented / solution-oriented and requires the member to be in a good enough space to want to look into the future & put in the work. Often members use therapy / medication in tandem with coaching.

Coaching works least effectively for those with severe comorbidities like depression/anxiety/bi-polar that are not concurrently being treated or at least do not significantly impair their day-to-day functions.

We have really extensive testimonials on our homepage (you can load more as well) but a few of my favorites are: (1) a 45-50 y/o man who got promoted after thinkng he would not ever get promoted again—now he is director level and manages dozens of reports and has a renewed sense of confidence in himself; (2) and 24-34 grad student who was able to find her dream job post-MBA after burning herself out at almost every other job she's had before and never feeling like she "fit"; her Shimmer coach helped her look at jobs that fit her unique ADHD, find ways to approach the job hunting process in a way that fit her brain, and then eventually secure that job.

"Coaching works best for those who are ready for forward movement"

Meaning "if our product doesn't work, it's really your fault"

Come on, that's unfair. It's one thing to be sceptical about this particular product, but the assertion that outside of a clinical, targetted environment, people need to want to receive the help they're getting to benefit is not controversial. If you obstinately refuse to read any courseware or attend any lectures, do you turn around and blame the school when you fail to learn anything from a class?

Thank you!

I read it as “you get out of it what you put into it”

Exactly. The coach cannot do the work for you, but will support you along the way.

The sentence could definitely be worded better. When I first read it, I had a similar thought, but upon further reading, I realized I was making a very large and unfair assumption. It's not exactly a secret that people who are already doing pretty well are the ones who have the energy and capacity to make further progress. Struggling with mental health issues, especially executive dysfunction, makes it harder to to do the work required to improve one's mental health. That reality is endlessly frustrating but undeniable. Someone who's not ready to move forward may not have the capacity to benefit from the structure and content of coaching. Coaching is all about taking active steps toward goals between sessions. It takes a lot of energy and effort. When I was just barely treading water, I didn't have the energy for that kind of work. I had to get to that point through therapy, support from friends, and a LOT of rest. Sure, I could have talked to my coach once a week, but I wouldn't have had the capacity to benefit as much as I do now. That doesn't mean it would have been "my fault" if I didn't benefit from coaching; it means I wouldn't have been a good fit, and Shimmer probably wouldn't have taken my money.

Thank you for sharing your thought process & feedback taken on the wording. I'll go back to this one. And I really do appreciate you sharing your personal story. Especially the last part where you acknowledge that we wouldn't have kept coaching if you weren't in the right space. This is true in that we have gently recommended pauses to several members when they weren't in the right headspace to continue with coaching and weren't in a space to benefit. This is true across most coaching modalities, in terms of the focus on forward movement and the need for the capacity to support this. I personally have both a founder coach and an ADHD coach, and can attest to the amount of work necessary outside of sessions to create sustainable results. Once again, thank you for sharing your story, and wholeheartedly agree that it's not about "fault", just about fit!

That applies to everything where you are being trained in something. My instructor can give me a practice exam, but can't take the real exam for me. A fitness trainer can go grocery shopping with me, but cannot force me to eat healthy.

“ Shimmer was born from my personal frustration when I was diagnosed last year & wasn’t able to find an affordable, quality ADHD coach. True hyperfocus mode,”

Having a diagnosis that you have a recognized mental health disorder and then being able to, in less than a year, have a full platform launched and ready to go should make anyone who struggles with ADHD pause and ask how and question everything.

I’ve had ADHD my whole life and was diagnosed 10ish years ago. I couldn’t, medicated or not, accomplish anything of this magnitude in that amount of time if my life depended on it.

Nor anyone I know who has ADHD.

I can’t even think how your first thought would be to find a “coach” and then the idea you have is a coach platform and decided to run with it and attempt to build a whole ass platform instead of adapting to your new diagnosis.

Also why look for a coach? Not a therapist? Coach’s are known to be a morally grey area.

Further more, hyperfocus doesn’t work like this and putting it in the cheeky “true hyperfocus mode” sounds disingenuous and unempathetic to your intended clients struggles.

Finishing stuff is HARD for ADHD people. How is this already done?

This reeks of trying to profit off the ADHD boom of the last couple years.

I hope I’m wrong about my suspicions and I hate that this is my first comment on this site, but seriously this is concerning.

I normally want to lift people up and commend them on their accomplishments yet I can’t for the life of me understand the thought process here. It’s the most neurotypical/grifty answer to a diagnosis I’ve ever heard.

> Having a diagnosis that you have a recognized mental health disorder and then being able to, in less than a year, have a full platform launched and ready to go should make anyone who struggles with ADHD pause and ask how and question everything

Agreed. This 'origin story' reads a bit too much like it's written for a VC pitch deck. Theranos of course famously build their 'product' on the basis of the CEO's fear of needle pricks.

To the founder if you're still here, do you guys have some sort of studies or patient records that show that your business helped people with ADHD? How do you guys convince the customers that you guys are worth paying for except PR commentaries?

Hi yes, I am still here. (1) We currently only have self reported symptom reduction (83% state symptom reduction within 6 weeks) that we've been using as a proxy so far, but we know we need more. (2) We are actually in the process of designing a more formal pilot with our Clinical Advisor Dr. Anil Chacko. We will launch this in the next 2 months, which we're very excited by. We're just tying up the loose ends in terms of setting up the logistical infrastructure for data collection, etc., and making sure the process is designed to not be overly burdensome for people with ADHD.

So you only have one claim (83% state symptom reduction within 6 weeks, whatever that means) at this point and that claim seems very weakly supported as it is not rigorous and no customer can verify. As a non-traditional medical startups I understand you guys want to get ahead fast and quick, but to me I am not sure if ADHD patients want to gamble a few hundred bucks to save money in the hopes that it MIGHT work for them.

Definitely, and we hear you. We're excited for our upcoming pilot with more rigorous study. Also, as mentioned in a different thread, we're definitely not a medical service nor replacement for medical service. If members are looking to "save money" from an alternative, the alternative this person would be comparing us to would be another ADHD coaching service (likely an individual or small group of coaches)—in this case, that service likely will not have pilot data at scale either.

Ok (1) is paper thin. Self-reported can be anything.

(2) makes me laugh because these things don’t take 2 fucking months. An initial protocol for a study, maybe. In reality such studies take years and years - I’ve done it with surgical skill development training program validation.

My advice would be to conform your thing to an existing body of knowledge and build your arguments on that - that’s what we did. Congrats on the language in your answers though. Why don’t you tell us a bit more about tying up those “loose ends” and “infrastructure for data collection etc.”

Agree that we want to bolster (1). Also we are not trying to prove we are medically improving symptoms, as that is not our service. We are helping members with ADHD reach future-oriented goals, and take ADHD-adapted approaches to coaching. So having them go through onerous testing etc., when we aren't a medical service, especially if it would suggest to others that we are, wouldn't make sense.

(2) I'm not saying that it takes 2 months. I'm saying we will begin enroling folks into the pilot in 2 months. We have been planning for a while now. Also, we are not trying to plan a randomized control trial nor prove medical outcomes, so our pilots are different.

Thank you for your advice! Would love to learn more about what you're building!

Re: "loose ends": we're currently conferring with adhd experts in academia and medicine to choose the right outcome metrics to study, make sure they have the right (recent) peer reviewed literature, incorporate them into our processes/tech such that the UI/UX is friendly for folks with ADHD, etc. The outcome metric(s) are the most challenging part right now because we want it to be aligned with existing body of knowledge (as you mentioned), yet reflect what we're working on (most aligned with Health & Wellness Coaching and Acceptance Commitment Training)—e.g. we're not looking for simply measuring symptoms, more so impairment and life quality. And for "data collection", we're also working with our clinical advisor on the minimum amount of data (and what variables) we'll need to ask from our members for the study. Happy to elaborate on any of the above and our process, where we're at, etc., offline! chris@shimmer.care

What do you mean by "these things" in the sentence "these things don't take 2 fucking months"? Getting their new pilot for effectiveness measurement from it's current state to launch? Where do you think it's at now, and why do you think two months isn't long enough to get to launch?

If a tobacco company tells you they've done internal research are you going to believe it? When anyone coming from a commercial background tries to do independent research with a reputable university or researchers it's going to take a lot more than 2 months to get them to do it. And if they're truly independent they're not going to be interested in just cooking the numbers to simply match your short-term product launch ambitions. The ultimate goal with such efforts is to pursue consensus - meaning multiple pieces of independent research with varying discussions and outcomes.

These are my experiences: With our product I found several experienced and reputable professors who assisted us. They did not take any money and they did not put their fingers on the scale. Their researchers were paid out of their budgets and we had to stay away from it as much as possible. The research took well over 2 years, and many of the results did not conclusively verify that our product really works. Instead they were broadly insightful on what could be modified our changed about it. Hence the "these things don't take 2 fucking months".

What I really mean is that I think they're full of shit. And they're laying it on pretty thick instead of being honest and humble about what they've got - which is an early stage monthly subscription coaching service/community. In response to questions they're laying it even thicker with even more happy-go-lucky obtuse language.

I find this repulsive because I have ADHD. This presentation can really take advantage of how the condition works. Feelings of community are something we have a tendency to be enamored by in the short-term. On the other hand I got my help in no small part thanks to participating in conversations in places like this one here, so there might be folks with this problem reading these comments. And this is very important - there are psychiatrists, experienced therapists and qualified IRL coaching that you should go to get proper help. It's worth the money. This help is not going to come from (young) people who say they have all the answers along with a business model just 3 months after they've gotten their own diagnosis.

I think we have radically different interpretations of "launching a pilot". I consider that to be the beginning of an experiment - not the announcement of completed results.

idk much about this, maybe it's really great, but i get a lot of instagram ads from a lot of no-name companies preying on people with ADHD, and their tendency to forget. they all follow a similar cringe tiktok formula "I have ADHD, after using XYZ, i've become so organized and productive!". their aim is to hit the user with a high subscription cost after a short trial.

one of the scummier ads i've been shown is for "happyo", after digging in, it's just a collection of some lame ass planner apps. it costs $3 for the first week, but then jumps up to $67.99 for the next 3 months. to me, what they're doing is predatory.

my 2 cents is just go through some telehealth platform and find a therapist who specializes in ADHD that is covered by your insurance. if your copay is $25 for an HOUR session.... then 1 visit a week is only $100/mo. and if you want to go "immersive", schedule 3 visits a week lol

I've seen the same ads, and we definitely don't advertise to "cure" ADHD in any way. We actually don't even do a free trial, as we want our members to be committing to the coaching process intentionally. We try to make our processes the opposite of predatory—e.g. if a member is inactive for 40+ days, we check with their coach and automatically cancel them. If they forget and tell us when the bill comes, we refund them.

Unfortunately ADHD-specialized therapists are few and far between, especially once you layer in insurance. We are working on creating recommendations & databases of other ADHD-specialized helping professions like therapists to informally connect our members to when they need that!

I'm curious to hear more about the privacy and security practices of a service where you divulge your deepest darkest secret: that you're living with a disorder. Something that unscrupulous potential employers or others with nefarious intentions (e.g. bullies on the internet) can abuse.

The privacy policy on the website doesn't exactly fill me with "this is HIPAA levels of privacy" feelings. It seems rather generic with the typical "marketing information we collect" type of language, and a dearth of information around data protection, but I'm no expert in this stuff: https://www.shimmer.care/privacy

If I'm using this service, talking about all my goals, plans, challenges, shortcomings, being vulnerable, all over video, how do I know that it's protected? What protections are in place to know any video calls are secure and not going to be leaked on e.g. TikTok?

I know how hard it is to run a startup and get all the compliance checkboxes checked. I'm rooting for services like these instead of drugs or other worse alternatives being pushed. I just think if you're in the health space, this is a rather important thing to get right!

If you're curious, might I suggest directing these questions toward the email address referenced multiple times in the link you posted? In case you've forgotten, it's privacy@shimmer.care. I'm sure they'll be able to answer your questions better than the comments section.

Keep in mind that not everyone considers their ADHD their "deepest darkest secret." Some of us are open and unashamed of being neurodivergent. Obviously, unscrupulous employers are a thing, but many of us would be "found out" from our social media presence long before employers managed to find out we're receiving coaching services from Shimmer. As for having your calls leaked on tiktok due to lack of security, I regret to inform you that there are lots of ways to record "secure" calls (like taking a video of the screen). Recording someone without their consent in some states, so it's always possible that you could be putting yourself at risk when you divulge anything sensitive to anyone via video or phone. Think about it, though. What would happen to Shimmer if they leaked a user's private call on tiktok? Their business would lose legitimacy and crumble. If you're truly concerned that Shimmer would risk destroying their entire business by leaking your "shortcomings" on tiktok, in-person coaching may be a better fit for you.

It still seems like useful feedback that this is something some people might find concerning.

We're getting complaints about your comments because some readers are interpreting them as suspiciously pro-OP. I assume you're just expressing your personal point of view but it would be good to pull back a bit because it's coming across the wrong way.

Thanks and agree on protecting our members and their private conversations. Right now, we use Google Meet videos for the video sessions with a coach and so they are encrypted end-to-end and not recorded. We also don’t store any information from the google meet session in our platform. We can definitely include this in our privacy policy and will look into how to make this more transparent with regards to our data policies. We will be building out video functionality in the near future and our privacy policies including opt-out etc will be included.

I absolutely adore this. Gonna message you Christal and Vikram, but what a lovely, thoughtful, difficult, energetic show HN.

Having spent years battling through medical services and alternatives, and doing self work, and being in community to handle this, it's such a breath of fresh air to see it being done well and in celebration of what ADHD can be.

Thank you, anonymous person! I appreciate the recognition a lot. I have personally gone through many routes as well, in support of my ADHD, and I hope to be able to continue creating & working on a piece of the solution that is beneficial to the community! My favorite part about work is hearing success stories or members working through challenges. It's an honor to be a part of their ADHD journey!

I think you got the wrong folks on the team to make this effective.

Also,

First we have: "For providers: Psychiatrists, Therapists, Doctors" (why so many capital letters?)

And then we have:

Eligibility - Adults 18+ - No formal diagnosis required - Smartphone with internet access - No suicidal ideation with plan and/or intent

If there is no diagnosis required then why signal about ADHD?

HIPAA compliance?

I'm sure some people will find it useful; but I get used car salesman vibes and I don't really trust MBAs or CTOs into AI for this kind of thing.

I feel like I may have it, but I am so down in a hole I just want others to do the boring shit like cooking and cleaning and billing for me and I can just work & play. I have tried for years alredy. Is there a solution for that?

It sounds like you're maybe looking for a virtual assistant of some sort? I recently heard of a company Athena (more geared towards founders) and "The Doers" (more geared towards women business owners, I always get their ads on IG) but I think you can find a VA in many places. Not an expert in this space though!

I don’t believe a virtual assistant can cook, nor clean, nor anything else physical.

Oh, duh. Yes. My bad. I guess an assistant of some sort? Or task swapping with someone else? My roommate cooks and I clean, so at least it's only 1 out of 2 things I don't like to do that's covered.

There is. (Assuming USA Tech Salary, and willingness to use money to fix problems.)

1. Clean up your place JUST enough to get some cleaning people in. (Yes, you can hire people to clean the apartment. Even if you are SITTING IN IT.)

2. Cooking: Find a meal service you like, and order. Honestly there's many good ones, we've been using Top Chef.

3. Get all your bills on auto-pay against your credit card. This will also make sure you are never late on your bills.

Money is merely potential energy. If you need to convert it into real energy... do it.

> Money is merely potential energy.

That's a neat way to put it!

Ideally, do just what you said and have another person to do those things. My wife has ADHD and I take care of all financial stuff and most of the cleaning (we also have a maid but she only comes weekly). We each cook for ourselves, but she largely does pre-made meals and takeout, whereas I actually cook all of my food from scratch.

That maybe sounds asymmetric and unfair, but though I'm healthy now, I've been in situations in the past where I couldn't even dress myself and she took care of me. It's a lifetime partnership. Workload doesn't need to be perfectly symmetric at all times. Besides, when I lived alone before getting married, I also paid all the bills and did all the cooking and cleaning myself, so it's not like this added work.

I think you shouldn't even try to self diagnose and get a professional assessment instead. To give my personal anecdote, to me it sounds more like depression. I have ADHD (diagnosed at a very young age) and the thing is I very very much want to do the boring stuff. However the procrastination and forgetfulness is almost unavoidable and much worse is how hard it is to focus. Couldn't read a page of a book if the window is open and I heard the slightest bird chirp. Need absolute silence and order to be able to focus on the task at hand.

I hear that depression is often comorbid with ADHD, since people who struggle with executive function to the point where they’re having trouble keeping their life in order are also likely to get depressed about their inability do do anything about it.

> I just want others to do the boring shit like cooking and cleaning and billing for me and I can just work & play.

Congratulations, you are just like every other human on the planet. We really need to stop passing off regular human traits as medical disorders.

You cherry-picked and missed this bit:

>...I am so down in a hole...

which as another commenter said, sounds like depression.

Besides, medical diagnosis advances with time and better understanding, and some "regular human traits" turn out to be symptoms of problems we didn't previously understand. Yes, not everything is a disorder, but an argument that amounts to "in my day we just got on with it" isn't very helpful either.

I don't really understand what this could do. If you have ADHD, you can know everything in your head and still fail to put it into practice. Are there productivity hacks that can overcome that?

I love this question! This is the exact problem (or one of them) that we're solving. All the info is out there, but it's about practice. With your coach, you'll be experimenting each week with different skills or habits and trying to arrive at the system that works best for you. Your coach will help you prioritize & keep you accountable, but also help you remove roadblocks and learn from reflections. There are also "hacks" as well that our coaches and members share with each other, for sure.

I also got diagnosed late last year. I had a great experience with Shimmer and recommend it to any friends/acquaintances that get diagnosed.

It's fairly normal practice to get an ADHD coach with or without also seeing a therapist. Main factors seem to be money, how severely ADHD is affecting that person's life, and whether they have a mix of anxiety/depression with it.

Having this type of service available is really important imo. You can try out multiple coaches if you need to, and there's a system built around the experience to hopefully encourage consistent positive outcomes. With all the baggage that "medicine" comes with in the US, it seems like a positive to have this type of coaching exist outside of the medical system.

My two cents as someone going through a late in life diagnosis at 39.

The landing page has way too much text. I don't see how the average person with ADHD would get through it to the service offered

Indeed, I have ADHD and it's evening now, so I got no meds in me.

With my hamster brain, I saw a wall of text at the top of this page, clicked the link, a wall of text on the landing page, even the title is too much information to digest. I literally have no idea what this thing does, and I won't allocate any effort in diving deeper. Focus is precious, I don't give that away easily.

I don't want to make assumptions, but this seems it has been done and designed by someone that has no idea how ADHD works.

Here's the ideal landing page for a product like this tailored for us: a clear tagline, 3 bullet points, pricing, and a FAQ section. That's it. Anything else is completely wasted on us.

People with ADHD like me don't read, they skim for anchor points. Even under the magical effect of amphetamines, unless I am deeply engaged, reading one sentence after the other is asking too much, especially since I learned to extract a ton of information from skimming and by the shape of things on a page. 80% of prose is filler after all.

In any case, good luck and I hope this help reaches those that need it and cannot afford focus in pill form.

What I read was that the founder and author of this thread got diagnosed a year ago and instantly got to building the service.

I also got diagnosed as an adult but though things started making sense when I went through the evaluations it has taken years of conscious thought to unravel my difficulties and even start to see what I should do and avoid doing because of it.

Personally I just can't find myself trusting a service like this unless it has strong connections to ongoing research or as part of treatment by professionals.

But I could really use a coach. I need someone to help me stick to and maintain my to-to list and/or help me write reminders but I'd really like them to really understand ADHD and be able to spot thoughts and behaviors and help me do well.

I've found some great paycholigists can do this, and I think it's very very rare among the rest of the population.

Thanks for weighing in—It is true that I was diagnosed last year, but that is most definitely not when my journey started. I grew up in an asian family as a "3rd culture kid", I'm also queer and came out in 2017, so things like getting diagnosed, etc., is not a simple process when you layer in cultural & family dynamics. We're working hard to get plugged in as part of the support system with professionals, and already are recommended by several psychiatrists and therapists. However, as discussed in earlier threads, we are not "treatment" and do not provide medical advice. If you ever change your mind and want a free consultation, don't hesitate to e-mail us! And agree on great psychologists being able to do that is rare!

I'm unsure if you know this, but everyone with ADHD responds differently to different stimuli.

I have ADHD and am, and always have been, a reader and writer. Once I get locked in on something, I have trouble refocusing my attention elsewhere.

I work with individuals with ADHD who regularly point out that I have provided too much text for them to process.

We each have our own unique challenges in this, and recognizing that helps strengthen the community as a whole IMO.

The most effective online service that truly does help is Focusmate. Quite cheap and has a very simple premise.

We love Focusmate!!

ADHD Management Guide

For individuals with ADHD, leading a balanced life can be a challenge, but with the right strategies, it can be achieved. Here are some essential tips to help manage ADHD effectively:

1. Diet:

Lower Carbs & Sugar: Reducing carbohydrate and sugar intake can positively impact focus and energy levels. 2. Physical Activity:

Regular Exercise: Engage in at least 1 hour of exercise daily to boost cognitive function and reduce hyperactivity. 3. Mental Wellbeing:

Meditation: Incorporate mindfulness and meditation practices to improve concentration. Pomodoro Technique: Use the Pomodoro method to break tasks into manageable intervals, aiding focus. 4. Support Systems:

Coaching & Support Groups: Joining such groups can provide guidance, understanding, and community. 5. Caffeine Intake:

Reduce Caffeine: Excessive caffeine can increase anxiety, especially in individuals with ADHD. 6. Planning & Organization:

Consistent Planning: Establish a routine and stick to it for better time management. Micro-Tasking: Break down tasks into smaller steps. This approach can make daunting tasks feel more achievable. 7. Medication (Consult a Professional):

Consider Adderall: If other strategies aren't enough, consult your doctor about the possibility of medication like Adderall. Remember, everyone's journey with ADHD is unique. It's essential to find what combination of strategies works best for you and to seek professional advice when needed

If you can successfully do all of the first 6 items on your list then you probably do not have ADHD, so no wonder they work so well.

Not saying they are not good habits to develop, but come on...

That's like telling someone in a wheelchair that they can climb stairs by putting one foot in front of the other.

Funny this is one of the most distracting blog posts I've read in a bit.

Emojis everywhere, boxes, Intercom, sign up to the newsletter, animations, confusing wordings, multiple colors for the text. I doubt the author has a grasping of ADHD.

Appreciate the feedback! I'm the author here (Christal)...unfortunately I definitely have ADHD!

Many of our members and team need the emojis for the visual relation but I definitely see your point. I will tone down the emojis and make the newsletter show up only at the end of the article. I'll also send this to a content editor for the confusing wordings, etc.! If there are any specific examples, don't hesitate to let me know.

I thought the emojis and animations and stuff were great. Good job.

My savior! Thank you!

As a person with ADHD myself I'm definitely on the same wavelength with finding emojis distracting but a friend of mine finds them extremely engaging. I suspect that the emoji appeal is more whether you were raised in a setting with them embedded into speech or appended at the end of speech. That's all to say that I don't think the OP was really accurate when they said emojis distracted people with ADHD - it distracts some of us - and engages other[1].

I would also personally appreciate a more neutral professional tone to writing but it's important to get a wider understanding of your audience before over tuning your presentation.

1. (And if you really want to engage me put hyphens everywhere - I do mean everywhere... but that's just me.)

Thanks for this perspective. I generally try to make it at least not distracting for most people, even though I know no 1 style will work for everyone.

Yes, I hear your point on neutral tone as well, I'm a bit dramatic at times.

I am the same with brackets. I use brackets so often-I type them then delete them (or at least reduce them to a "normal" amount) before hitting send, usually.

Maybe you should have a big switch at the top for "Stimulus mode" and "Distraction-free reader". And maybe another one that shoots fireworks.

I laughed out loud at the end. That's a good idea. https://www.understood.org/ actually has a good example of this (reduce-motion mode)

We'll look into this for sure—I'd love a confetti mode.

Not sure if you've already done it, but I find the current state of it just fine - I wouldn't say it's overboard. Not to put extra work on you, but I wonder if it's worth creating a both a highly visual and low-noise version of your blog posts, considering ADHD tends to be co-morbid with stuff like ASD. Just a thought.

I made a few small changes to current, but not everything. And yes, I like that example of low-/high-noise. We're going to look into this in the coming weeks as we revamp our website.

> I doubt the author has a grasping of ADHD

Do you? It can be hurtful to tell someone they "aren't ADHD enough".

First line of the article:

> I was diagnosed last year & wasn’t able to find an affordable, quality ADHD coach

ADHD people might like the animations, emojis, and colors, and might not read a long boring plaintext article linearly from start to finish. Everyone has different preferences though...

Personally I didn't find anything confusing or distracting about the article, and I felt like I could jump between random sections that look interesting (where the colors, emojis, and animations draw me in to different topics).

> It can be hurtful to tell someone they "aren't ADHD enough".

The author can have ADHD, but not have a grasping of how to solve this. One doesn't preclude the other.

Keep in mind they are the ones trying to sell a ADHD solution. Cutting off on visual and auditory distractions is very 101. It doesn't inspire lot of trust if they don't grasp that. Even if they all have ADHD for real.

Cutting off visual and audio distractions is very 101 for what goal though? We aren't doing homework or taxes. In one situation it may be "distraction", in another it may be "stimuli" and enjoyable. ADHD people like to stim. In this situation I think the visual stimuli were good.

Speak for yourself. I have ADHD and I don't appreciate it.

This is an incredibly rude way to give feedback.

This is sort of the thing. Everyone I meet with ADHD has some similarities, an a lot of nuanced differences and lots of their own little tricks and methods for dealing with it. Many of them have therapists they believe have had a positive effect on them. Many have medications that they believe have a positive effect. That may or may not be true depending. Whatever seems to be working is whatever they're evangelizing and while I'm glad that mental health is becoming more accepted and discussed, I wish treatments/rituals/coachings/medications were left up to the patient and whomever they chose for professional care

Therapy helped for me until it didn't and then medication did and still does. That's just me. My nephew struggles with medications. It's so easy just to get an initial reaction with mental health issues, and then want to evangelize whatever stimulated that reaction, but this stuff is nuanced. There's all kinds of variables commonly shared and some not so common.

Anyway, be cautious of telling people what they grasp with personal health issues, they likely just don't grasp your particular flavor. But with regard to this website, I'd be cautious in general.

It reeks of excited evangelizing done by someone who's way of interacting with the world is business and computers.

I know a pair of BFFs who both have ADD. Watching them try to have one conversation is quite eye opening. And a bit exhausting. I'm thinking back to every conversation I've ever had with a polymath or a person with ADD and asking myself, "man, is this what everyone else experienced listening to me?" No wonder the conversations always devolved to 1:1.

People with ADD understand why they shouldn't distract others, but theory and practice are poles apart, even by academic standards. Seeing tangents in text is a good indication they have an accurate diagnosis.

Ironically my friend married someone with ADHD, they visited us, and me and her took a walk, that ended up being 4 hours because it was so effortless for us to just jump topic to topic and talk about 10 different things in detail at the same time. We didn't have to re-focus or focus our energy to keep pace with normal people's way of speaking.

It was the wildest and easiest conversation I've ever had in my life.

Yes! This is what I’m talking about in my sibling post. I’ve never communicated on this level and it’s so easy. We started by texting giant walls of text (we called them stories), but those started getting too long, so we moved to leaving voice memos. It got to the point our memos were 30 minutes long back and forth. Now we talk on the phone for hours and it’s almost impossible to hang up, since we’ll just keep talking and taking.

And yeah, I definitely understand what you mean when you say it’s wild and easy. I don’t know if I can go back to talking with normal people lol.

I’ve been talking with a new friend who has ADHD, and I love the way we talk and interact. We say that we have “motor mouths” because we’ll just talk and talk and talk. We talk over eachother and interrupt eachother constantly, but somehow we are still able to communicate. Other people get upset with me but she really gets what it’s like, so we accept eachother and just go with the flow.

Does anyone know if there is a dating app for people with adhd? I’m curious if I have this kind of connection with other people as well or if it’s just her.

I'm curious, why are you so concerned about how ADHD affects people who don't have ADHD? What makes you think we "shouldn't distract others?" Have you considered that the problem might be failure to accommodate ADHD brains rather than people with ADHD not complying with arbitrary neurotypical standards?

Did you read the message I replied to? It was the experience of someone with ADHD reading the article.

I didn't look at the article until now. Gah that's terrible. I think we found a new low, folks!

Hi Christal and Vikram —

I'm working on something in the same space but for autism and social skills. I'd love to hear more about how you went through the process for HSA/FSA eligibility.

I assume this is basically their main "secret sauce". I wouldn't count on it being shared.

We have a community of ADHD, Autism, and generally mental health founders that we build alongside of. Starting a startup is hard, especially when you're mission-driven, so we love helping wherever we can and will take the help we can get to! It's a big, interrelated problem we're solving and we need to work together to get us closer (because we are VERY far off).

Yes, definitely! Would love to chat and hear more about what you're building, and share whatever we can to help. Email us directly at hi@shimmer.care, both Vikram & I get emails from there!

I always wonder how this can be offered to patients when it seems like it should be classed as a medical device / service and regulated. It's intended for use in a named medical disorder and the guidance is very clear [1] (UK guidelines).

It is presented as having an evidence base with trained clinicians, but then the T+Cs state: 'Coaches are not trained or licensed medical professionals and are not qualified to diagnose, treat or manage any healthcare conditions, including behavioural health conditions.'

It makes me really sad to see so many companies like this - the services are always hugely expensive and target vulnerable people.

[1] https://assets.publishing.service.gov.uk/government/uploads/...

That was my initial question as well. What are their qualifications for calling themselves ADHD coaches?

I'm bombarded with ads from ADHD apps since my diagnosis and I have tried many. None, none at all, have helped me. It's praying on the weak.

Exactly. Also, what is the intervention if the coaches cannot provide any advice or guidance[1] or manage the condition. I really think services like this should be regulated - I'm not sure why ADHD seems like a soft diagnosis and always slips through the net.

[1] (a) you acknowledge and understand that Coaches are not trained or licensed as medical professionals, and you agree to not request that Coaches provide you with any medical or healthcare advice or guidance, and (b) you agree to not rely upon any information provided to you by Coaches, content received through the Services or other Members when making important lifestyle, health, financial or relationship decisions.

“Cannot provide any advice or guidance” is an exaggeration; that quote excludes (a) medical advice and (b) important decisions. It does not, for example, exclude advice on making unimportant decisions, which is a skill that a lot of people with ADHD could use help improving!

The most common certifications for ADHD coaches are from ICF and NB-HWC, although those generic coaching certifications are not just for ADHD. There are targeted training schools / credentials from organizations like iACT as well that are focused on ADHD Coaching. Many of our coaches are trained at iACT but some also have PhDs/masters in ADHD-related fields in addition to generic coaching.

I'm sorry nothing has worked for you so far—I had similar experiences when I was diagnosed. If you're willing to, I'd love to do a free consultation with you to see if we (or any other program our coaches know of) can help! chris@shimmer.care

We also would like this to be covered through reimbursement, however we're not there yet (with ADHD Coaching) and right now it's primarily out of pocket. The team at Well Coaches and other organizations (including ICF, ACO) are working hard to progress the modality.

In terms of cost, we do try our best to keep costs as affordable as possible and have a needs-based financial aid program. We also do a lot of scholarship sponsorships whenever we can with our community partners. We hope to do more in the future (and some are coming in October!)

Not impressed after spending a few minutes on your website.

First off - What happens with my information after your quiz? "Please enter your e-mail. This question is required.* Question 5 of 5"

I suggest you to inform the user about data-policy before the User clicks "OK".

Another problem on your website is this; "Password must be at least 6 characters".

You should follow best practices when it comes to password policy requirements. I mean, you are working with sensitive information right?

For anyone who reads this comment and have ADHD, you should check out NICE | The National Institute for Health and Care Excellence before you consider giving money to random people on the internet claiming all kinds of psudoscience..

Link - https://www.nice.org.uk/guidance/ng87/chapter/Recommendation...

It seems like so much of the confusion and distrust just comes from using the term "ADHD". Why not just talk about "focus", "motivation", etc.? You can still SEO the shit out of your product with more terms like "ADHD", "dopamine", "discipline", etc. and not have to wade through all this vitriol associated with insinuating licensed treatment of a medical disorder as a hook / marketing ploy.

You’ll find that ADHD is a really hot topic at the moment. Everyone I know is getting diagnosed and the stigma is disappearing. It’s actually to the point that you will get cancelled if you question the “science”.

Good point and thought. I started this because of my ADHD built the product with a community of 50 ADHD-ers alongside us (not including the coaches and experts). We also do a lot of work in advocacy for adult ADHD, women x ADHD, BIPOC x ADHD, and more. Our mission is rooted in helping people with ADHD succeed, however if we happen to help others that's even better! I guess we're choosing the harder route.

I'm curious if you looked at neurofeedback/neurostimulation as an alternative to therapy based intervention when looking at your offering.

I don't have ADHD, but met the founders of https://neurode.com 2 days ago, and I'm in the neurotech space.

I'm surprised to see coaching based solutions continue to exist in a space where more direct interventions exist.

Can you give some of your thinking on this?

Thank you for sharing your experiences - neurofeedback/ neurostimulation is indeed a novel and promising pathway to, ultimately, improving quality of life for those who has ADHD. While we can't talk about all of coaching since it differs, our coaching offer which is informed by the 3rd wave cognitive and behavioural psychological approaches, is situated firmly within the practices that were demonstrated to be useful and helpful to those with ADHD. This is supported by the ongoing research in coaching and psychotherapy. In addition, our view is that it is a combination of different types of interventions which really makes a difference for those with ADHD. I am eagerly watching the progression of Neurode though, and the trials!

This comes across as a cynical cash-grab to cash on the current rise in public awareness around ADHD and other Neuroatypical and Neurodiverse individuals.

That’s a lot of text for a landing page targeting people with ADHD.

After a quick skim of it, I still don’t know why shimmer is any different than any other e-therapy service.

Edit: just noticed you mentioned the stream lining of your site in your also very-long-post. The sign up is a type form. Why? That’s actually another barrier to signing up, and it feels weird being “off site”.

Thank you—we have received this feedback a few times, and will definitely be decreasing the size and amount of text on our homepage. With 2 FTE (me and my co-founder & CTO Vikram), we haven't gotten around to it yet (but it's high on our list!). I think right now the website reflects a bit of my writing/speaking style, which is a bit of "oversharer" but working on changing that.

The biggest difference between Shimmer & e-therapy is that we offer Coaching. Coaching is a partnership for action—for goal-oriented action. You partner with your coach and make changes in your life to reach those goals: e.g. you may be perfecting your morning routine or working on your habits for work-from-home, whatever it may be. For e-therapy, or therapy, it's more about unpacking past to present, talking, processing, etc.

Lastly, for Typeform, we are also working on moving off of it, bad reason but also because we are a lean team and test each part of our flow first (with 3rd party services) and have slowly been migrating to build in house for parts most important. Right now many of our priority features are focused on member experience with coaching for building in-house.

Hi Chris,

When I started my research on my own ADHD condition and nootropics I found out that 27% of the USA jail population has ADHD.

Curious about other stats about ADHD in other populations, for example how much of the drug abuse population has ADHD for example.

Curious about what you might have found upon such areas of inquiry..

Definitely drug/alcohol. Among adults who have an alcohol use disorder, ADHD is 5-10 times more common (American Addiction Centers); Among children, children with ADHD are 2-3X more likely to abuse substances than kids in the general population. Other areas where folks with ADHD have pretty alarming stats: School (46% more expulsions), Healthcare (33% more ER visits, 3x more motor vehicle accidents), Home (3-5x more divorce). It's a really important problem that has far reaching impacts, where multiple solutions are necessary to make a sustained dent to improve the lives of people with ADHD!

The ADHD community, like many underserved populations, tends to be overrepresented in the prison population due to lack of accommodations and resources, along with stigma. There's a great deal of peer-reviewed research on the subject of ADHD and drug addiction. The overall gist is that people with ADHD are at higher risk for substance use disorders than their neurotypical counterparts due to several possible factors, including chronically low levels of dopamine and contextual factors like lack of resources and stigma.

Keep in mind that those numbers may be skewed based on how ADHD was diagnosed in the past. Only in the last few years have we started to see more traditionally "successful" people being diagnosed with ADHD, which is revealing that the percentage of the general population with ADHD is likely much higher than previously thought. ADHD was considered a "disease" that caused people to make trouble. That created a vicious cycle of stigma and punishment for those who had been diagnosed or expressed obvious symptoms. Meanwhile, lots of people with more subtle ADHD symptoms, stronger support systems, and greater privilege were never diagnosed at all. I'd take that 27% statistic with a big grain of salt, especially if it's coming from nootropics websites.

What is your team's take on the theory of ADHD as a "survival strategy" of childhood/parent trauma, and healing it by working through the trauma instead of merely managing its symptoms?

I'm not on that team, but: that doesn't meet my experience in the slightest. My parents are great, and I didn't have any significant childhood trauma. In retrospect, my symptoms went back to when I was a wee little lad, well before I had to deal with any of life's curveballs.

Well, that theory says that typically memories of traumatic events are repressed and show up only in form of symptoms like ADHD. Your "claim" that you had a non-traumatic childhood (and your parents did neither?) does not invalidate that theory.

It's interesting how I was downvoted. I am just curious, I am not saying one or the other is "true". I have no idea, I am not a professional. However, I do think it is a relevant question to ask and discussion to have.

I am just looking into this as someone who only in his 40s discovered that he had significant childhood trauma that he was not in any way aware of, and my mother too which is something we never talked about, and that my symptoms and my "suffering" has finally almost disappeared now that I'm doing proper trauma therapy. I would have claimed I had "great parents" and "no childhood trauma" in the same way as you, and rejected that theory, if you had asked me a few years ago.

The way the theory is phrased makes it unscientific and the HN community in general tends to be especially critical when that occurs.

I also want to add that the scientific-ness of it or not doesn't invalidate it as an explanatory device in your personal journey - they are on orthogonal axes.

I merely asked a question about the team's position on it.

To pick a random study of many: https://pubmed.ncbi.nlm.nih.gov/29086104/

"Children with ADHD were more likely than controls to have ever experienced a traumatic event (27 vs 16%; OR: 1.99; 95% CI 1.21, 3.27). This difference remained significant in the adjusted model (OR: 1.76, 95% CI 1.03, 3.01) accounting for child factors (age and gender) and family socio-demographic factors (parent age, parent high school completion and single parent status). Among those with ADHD, trauma-exposed children had higher parent-reported ADHD severity and more externalizing problems than non-exposed children, however, this effect attenuated in adjusted model. Children with ADHD were more likely to have experienced a traumatic event than controls. The high prevalence of trauma exposure in our sample suggests that clinicians should evaluate for trauma histories in children presenting with ADHD. "

Or another: https://pubmed.ncbi.nlm.nih.gov/27816036/

"Childhood Trauma Exposure is common in Substance Use Disorder patients and associated with adult ADHD but not with the persistence of childhood ADHD into adulthood. These findings suggest that the increased rate of adult ADHD in SUD patients with CTE is not the consequence of a negative effect of CTE on the persistence of childhood ADHD into adulthood, but a direct expression of the high rate of childhood ADHD in SUD patients with CTE."

Or this one: https://pubmed.ncbi.nlm.nih.gov/19337826/

"Controlling for demographic variables, comorbid disorders, and ADHD severity, we noted significant associations between lifetime depression and environmental adversities, including victimization trauma, parent-child conflict, and behaviorally-independent negative life events. "

I think this is a much better expression of your point as it makes clear that there is a correlation within a subset of people who have ADHD - rather than implying that all people with ADHD were exposed to trauma as children. Everything brain related is extremely complicated and there are quite a few comorbidities that have already been identified (the ASD-ADHD link for instance) and it's quite possible there is a link for some people between their developmental environment and neurological processing. That overlap isn't all-inclusive though - a fair number of people with ADHD grew up in wonderfully supportive environments.

Brain stuff - it just ain't simple.

This supports a theory that childhood trauma may be one reason of many ADHD might eventually manifest, not a theory that it's the reason ADHD ever manifests. Even here, it's saying 27% of the diagnosed peope had identifiable trauma in their past. That seems to hint there are many other possible causes and ways to treat.

Yes, thank you for the sources.

When I'm hearing now is "ADHD has a correlation with traumatic events." What I was hearing before was "If you don't think your ADHD is a result of trauma, you need to dig deeper."

It goes to show you that what's being written isn't always how folks interpret it.

If only 27% of ADHD sufferers have experienced childhood trauma then we can be certain that such trauma is not its cause.

"Correlation" is the key word here. I think it's really important to keep in mind that a lot of people with ADHD have childhood trauma because of how adults responded to their ADHD symptoms. In my case, I have plenty of trauma, almost all of which was the direct results of adults shaming and criticizing me for traits that turned out to be due to ADHD. If your ADHD makes it impossible for you to focus in school, and the adults in your life shame and yell at you every day because you can't focus in school, you're going to have both trauma and ADHD. There's also a solid chance you'll end up with some anxiety and depression. All we know is that a) there's a correlation, b) lots of people with ADHD don't have severe childhood trauma, and c) it's a huge stretch to assume that every person with ADHD is repressing severely traumatic childhood events and never finding out about it. I think it's potentially plausible that generational trauma might have an epigenetic impact, but we'd need a lot more data to know that.

I really hope this doesn't come across as an attack against you or your environment because I don't mean it that way: My fairly recent understanding is that "shaming and criticizing" is something that can hurt or even traumatize you only when your caregivers didn't show you how to maintain healthy boundaries and regulate your own emotions (mostly by living it) - a.k.a. "self worth". I have learned this the hard way, and it sounds like you too.

I think a larger factor is that there are plenty of us folks with ADHD that didn't have traumatic childhood experiences and have had therapy in the past (with no impact on our ADHD tendancies).

If the comment was intended to say that some people may have ADHD like symptoms due to childhood trauma and that might be resolved by working that out it was quite poorly worded - to me at least it read as coding all ADHD as treatable by therapy and environmentally caused and that is simply untrue for me. There may be a certain amount of defensiveness in our community in particular because for a long time ADHD was written off as behavioral issue causing laziness rather than being treated as a true neurologically divergent condition. I was diagnosed about twenty two years ago and I've seen a lot of FUD around my condition and the ineffectiveness of ritalin and other stimulants - they very well may have been mis-prescribed in the 90s but for a decent chunk of us it has been highly impactful.

The irony is that ADHD is extremely unscientific. If you go down the rabbit-hole, you will find out that the diagnosis criteria is entirely arbitrary, and the neurodevelopmental claim is unproven. No conclusive brain imaging and no gene studies either. Taking addictive meds which you develop a dependency for your entire life with health risks, premised on a theory of brain dysfunction that is not proven. Also, a medicine that 1/4 college students find benefit from. The symptoms are real, but the cause is still unknown, and the medicine works for everyone. No long-term safety studies either.

Maybe there's just overlap between CPTSD symptoms and ADHD, not that they're literally the same thing.

Both PTSD and ADHD (and any other mental "disorder") are _defined as_ a list of symptoms, and do not imply different root causes.

see e.g. "The hidden links between mental disorders" https://doi.org/10.1038/d41586-020-00922-8 available on sci-hub

"Since the 1950s, psychiatrists have used an exhaustive volume called the Diagnostic and Statistical Manual of Mental Disorders, currently in its fifth edition. It lists all the recognized disorders, from autism and obsessive–compulsive disorder to depression, anxiety and schizophrenia. Each is defined by symptoms. The inherent assumption is that each disorder is distinct, and arises for different reasons. However, even before the DSM-5 was published in 2013, many researchers argued that this approach was flawed. “Any clinician could have told you that patients had not read the DSM and didn’t conform to the DSM,” says Hyman, who helped to draft the manual’s fifth edition. Few patients fit into each neat set of criteria. Instead, people often have a mix of symptoms from different disorders. Even if someone has a fairly clear diagnosis of depression, they often have symptoms of another disorder such as anxiety. “If you have one disorder, you’re much more likely to have another,” says Ted Satterthwaite, a neuropsychiatrist at the University of Pennsylvania in Philadelphia.

This implies that the way clinicians have partitioned mental disorders is wrong. Psychiatrists have tried to solve this by splitting disorders into ever-finer subtypes. “If you look at the way the DSM has evolved over time, the book gets thicker and thicker,” says Satterthwaite. But the problem persists — the subtypes are still a poor reflection of the clusters of symptoms that many patients have. As a result, the world’s largest funder of mental-health science, the US National Institute of Mental Health, changed the way it funded research. [...]"

Yes, they do imply different root causes. PTSD requires a root cause of experiencing trauma. ADHD is not PTSD because it is not caused by trauma, and therefore therapy to deal with childhood trauma will not benefit people with ADHD.

It is, however, very true that they can look the same. I work with kids who have been through trauma and it is only on the order of years since people started recognizing that in these kids, many ADHD symptoms were caused by trauma and could be reduced or go away entirely with trauma-specific therapy.

Therapy to deal with childhood trauma can absolutely benefit people with ADHD. Having ADHD doesn't magically make you immune to PTSD or other impacts of childhood trauma. It just means you also have ADHD. I know this because I have both ADHD and C-PTSD, and the ADHD was very, very present by the time the trauma started. Trauma symptoms exacerbate ADHD symptoms, and often vice versa. Both need to be treated. If kids' ADHD symptoms improve with trauma treatment, that doesn't necessarily mean they never had ADHD. It just means their overlapping symptoms might be less difficult to handle or, just as likely, mask. Ignoring the reality of overlap between trauma and ADHD serves only to erase people who have both. It benefits no one.

I'd go further and claim anyone benefits from trauma therapy, which is basically about healthy boundaries between you and the world, how nobody but you yourself are responsible for your feelings, how to regulate and enjoy every emotion, how to accept and welcome death, nonviolent communication, trauma-sensitive awareness of your own thoughts and (re)actions, how to tune your own belief systems more towards your own enjoyment and the benefit of those around you, the power of stories you tell yourself about the world and the power of rituals, etc.

No, I definitely didn't mean to say a kid with ADHD can't also have C-PTSD.

What I meant was that a kid who doesn't have any background of trauma can still have ADHD, but does not have PTSD, and no amount of therapy for childhood trauma will help their ADHD symptoms. That's my point - that there is overlap in symptoms but they are still different problems, that require different treatment.

I didn't downvote you but I honestly just hate this kind of thing.

"You didn't have childhood trauma you say? Sounds just like something somebody who did have childhood trauma would say!"

Like what the hell are you supposed to say to something like this?

It's always interesting to do some introspection. Why do you take offense from something that is simply not true for you?

"There is a theory that claims everyone who has ADHD has pink hair." - "I don't have pink hair." - "Are you sure? Did you check?" - "Yes, I did."

Actually, this kind of thing is exactly what you learn in trauma therapy to watch out for, take note, and investigate. You call it "triggers".

Nowhere in this thread did I claim that the theory is proven. Just that it is out there, has a big following, and is also actively being investigated by the research community. I do think that it is worth discussing, which I tried to do in ways that should not offend anyone.

Also, very likely what we have here is a misunderstanding of what we agree to call "trauma", or "adverse childhood experiences" (and more importantly, what they have meant for a little child that went through them).

I know this discussion is from long ago, but I just saw it, so I may as well respond.

I didn't say I find this offensive, I said "I just hate this sort of thing". That implies annoyance and disdain, not offense.

> There is a theory that claims everyone who has ADHD has pink hair." - "I don't have pink hair." - "Are you sure? Did you check?" - "Yes, I did."

> Actually, this kind of thing is exactly what you learn in trauma therapy to watch out for, take note, and investigate. You call it "triggers".

I'm confused what point you're making with these two paragraphs. That example back and forth is a great example of what sort of thing I meant when I said "I just hate this sort of thing". I would suggest that if you don't find the first interlocutor in that dialogue to be really annoying, then you're the weird one, not the person who already knows they don't have pink hair and really did not need to check.

If asking someone with non-pink hair whether they've checked the color of their hair is indeed an important part of training for trauma therapy, then I'm skeptical of those training programs. (But I doubt this is actually the case, and think it's more likely that it's an incorrect representation.)

While I don’t doubt your experience at all, really, I have great parents and a nice childhood in a happy house.

Sometimes a cigar is just a cigar.

It really depends on the person. It's the case for some folks but definitely not all (not myself) and in that case, it's important to address the root cause. Our team actually advocates for mixed treatment when relevant (while acknowledging the provider shortage, differences in means/access to quality healthcare) - this usually includes working with psychiatric, clinical, counseling and psychotherapy practitioners (and/or coaches). These treatment protocols may include medication, therapy, and more. Doesn't need to be done all at once, but drawing on these tools as needed.

I have seen a lot of coaches and websites everywhere, leading to the question How does your ADHD Coaching differ from those who offer individually?

Yes! There are tons online, many great quality ones too. For us, we offer robust and reliable service with coaches who we have vetted, are supervised, and are accessing professional development opportunities on regular basis. In addition, our coaching philocosophy and practice has solid foundations in evidence-based practices. Individual providers of ADHD coaching may not have these checks and balances in place, unfortunately. We also have an app that supports growth and accountability throughout the week, which can be a challenge for individual coaches who use email/google docs, etc. And lastly, quite practically we can offer at a lower rate per face-minute because we handle all the "back-end" tasks for them (e.g. advertising, tech, customer service, billing, etc.). Especially for coaches who have ADHD themselves, us handling all the "other stuff" can be a gamechanger. Happy to jam offline on specific coaches or your specific situation! chris@shimmer.care

Must be a US thing. Over here you pay 23€/month for a 1 hour in person psychiatrist session.

> What are the biggest challenge areas you experience with your ADHD? Select up to 3.

why stop at 3?

We thought about this a lot and asked many potential members and members. The purpose of this question is to get a sense of the most pressing challenges (such that if they begin, the coach knows them) so we don't want folks to answer "all of the above". Also, in coaching often only a few can be tackled at the same time. It also forces some reflection of prioritization (which in itself can be super hard for people with ADHD, we acknowledge) which hopefully is helpful to folks. There's some tradeoffs here, we acknowledge. We try to balance the purpose (for us, Shimmer, and for the member) and the logistics of it, but are always open to suggestions!

Erf that pricing is cooked. Straight into the basket of unobtanium along with the 3000 bucks for adult diagnosis. Cheers but no thanks.

Man I'm glad I don't live in the US. Healthcare for a profit is gross. Go get some government funding and release your service for more accessible prices.

We're currently applying, thank you!

Healthcare providers in countries with universal healthcare are doing it for a profit; they get paid, after all.

Conversely, most US hospitals are nonprofits and US insurance companies' profits are capped by ACA. But that doesn't stop them from being expensive.

> We’re beyond thrilled to announce the public launch of our #1 requested feature: Web Access.

Umm, am I missing something? It reads like "web access" is your unique selling point? Weird...

> many of our members struggle with phone addiction

Perhaps the phone addiction is actually the root problem…instead of some totally unproven neurodevelopmental theory.

Will somebody please just report these guys for the unlicensed practice of medicine?

Love this!

Thank you so much!

It’s a dessert topping and a floor wax!

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