Comment by nikkwong | Hacker News Reader

Comment by nikkwong | Hacker News Reader

Stimulants are still first line therapy for treating ADHD but I think mindfulness meditation is wholly underrated. People with ADHD have too much activity and overly-robust neural nets in the default-mode network in comparison to healthy controls. There is a network above this network, the salience network [0] that is responsible for the switching between the default-mode and executive control networks.

ADHD may present with many brain-network anomalies, but I believe the classic case is one where there is more default-mode activity, less executive control activity, and ineffective switching occurring from the salience network. Mindfulness meditation is honed at training the salience and attention networks towards playing closer attention, which offsets the deficits observed in ADHD.

That's my lay interpretation; but actually, I believe that people who suffer from ADHD probably have even more to gain, relatively, than those who don't from taking up the habit of mindfulness meditation. It's not an easy fix--I've read that it takes about twice as long for those with ADHD to benefit from the practice. But it seems like it's worth it; after all, your mind is really the only tool that you have.

Those interested in this topic should read about ADHD and it's relation to the salience and executive networks; and how mindfulness sharpens the function in these areas.

[0]: https://en.wikipedia.org/wiki/Salience_network

I’m not clear. Are you someone who has ADHD or is this recommendation based on experiences with someone with ADHD?

I have ADHD and meditation, for me, is very difficult. Painful even.

Meditation practitioners have been writing for thousands of years about the problem of "quieting the monkey mind" which reads just like your typical description of ADHD, only in the specific setting of a meditation retreat (which is typically an intentionally challenging, spartan, uncomfortable environment - hence one where pretty much everyone is enticed to get fidgety and hyper). It's difficult for everyone at first!

Next time Please state that upfront: you don’t know anyone with ADHD that this has been effective for and you dont have ADHD yourself.

“Have you tried” comments from people without firsthand experience is basically asking others to be your guinea pig. I didn’t say “hard” I said “pain” as in a physical reaction. If you don’t have the same pathology I don’t think you can truly empathize or understand what you’re asking me to do (even if you think you do).

I’m glad you found meditation and that it’s helpful for you. I’m asking that you modify your evangelism in the future to give people maximum context on where your suggestions are coming from (and associated limitations).

There is a lot of data that meditation is beneficial for people with ADHD and potentially even more so since they “need it more”. Yes it is extremely challenging which is why in my parent I stated that according to what I have read, it takes someone with ADHD potentially twice as long to see the benefits of practice in comparison to healthy controls. I have ADHD and have learned to meditate; my mind was out of control, and I feel as though I have control of it now, without stimulant medication. I encourage you to look into the data if this is something you find interesting.

Thanks! Have you found any types of meditation work better or are easier? Suggestion where to start if it hasn’t stuck in the past?

I've only tried mindfulness meditation, but as others have chimed in in the thread, other types may be easier depending on your circumstance. As I started, even being able to focus for 5-10s uninterrupted by thought was a huge win. It may be slow, but eventually you will be able to extend these periods and get to a point where it's actually 'working'.

Also, I don't think using stimulants or other adhd meds (like atomoxetine), if they're part of your routine is necessarily cheating. I like to think of them as 'training wheels', which will help you focus internally and less on your thoughts. It will still be difficult (like it is even for those who don't have ADHD), but it may help your brain start shaping those neural important pathways a bit sooner and more easily than it'd otherwise come unmedicated.

There’s a nut bar on Reddit who talks about the dangers of “quietism” and I have to grudgingly agree with some of his points. I did quiet my monkey mind, but then discovered that without my constant, rapid fire internal monologue, I had difficulty engaging in other self improvement activities. I would later discover I was working predominantly from Fast thinking (Thinking Fast and Slow) which has trouble moralizing on your actions.

Mindfulness is not the same thing, but I’m not sure it’s a solution for us either.

I have unmedicated ADHD (Psychiatrist diagnosed) and I really struggled with mindfulness meditation (Even tried a Vipassana retreat). However Transcendental Meditation (TM) worked really well. I find my mind is more organized after a year of practising.

I had a bad back before trying meditation so it was doubly bad.

I have a trick for you but quieting your mind won’t necessarily make your life better. I would instead encourage you to look at “walking meditation”. Forest bathing, cycling, walking. Tai chi is remarkably good. A lot of people with emotional issues are detached from their bodies, and part of healing is accepting that “you” is both your mind and your body.

Alright, caveat served: count your breaths. Count to ten, then start over. This gives your brain something to do, connecting the math and verbal centers but without triggering deeper thoughts. You will catch your mind has wandered when you realize you just counted 13. Just stop and start over, don’t get into judging yourself. It happens to everyone. Just go back to 1. You can analyze the sitting afterward, not in the middle.

But seriously, tai chi is fucking amazing.

Strong agree

Breathe in: ONE. Breathe out: TWO. Next: THREE... reset at 10.

If you find yourself breathing in on an even number, or out on an odd number, you've gotten lost. No problem, just reset to 1. Got to ten? You win! Also, reset to 1.

Very useful and simple technique for calm and focus.

I also think ADHD is a combo of many different, more specific problems that we blob into ADHD since we are not precise enough to diagnose it beyond the 3 types we have now, and these sets of problems are responsive to stimulants.

For some people with ADHD, this will work very well, others will not. Some with ADHD are already naturals at mindfulness because they have really bad time blindness. They are always, a bit too in the moment and low anxiety.

> ...naturals at mindfulness because they have really bad time blindness...

FWIW, this is not what "mindfulness" means. Mindfulness is a combination of concentration (i.e. intentionally focused attention) and insight (i.e. a deep intuitive knowledge and familiarity with the three characteristics, viz. anicca, dukkha, anatta). People who have reached the deepest stage of enlightenment (known as arahants) are believed to be able to switch their default mode network on or off pretty much arbitrarily (there is interest in verifying this claim experimentally, and it doesn't seem to have been outright refuted so far); they seem to have reached a deeply ingrained understanding of what it does and doesn't do for them, and the control ultimately flows from that.

Read closer, "naturals" means they have talent at the skill, unlike the contrasted people who have a harder time about it in parent comments. If you are a natural, it doesn't mean you go pursue that skill either. You also get hyperfocus with ADHD.

I'm sort of inclined to agree with your premise that ADHD may describe how a patient presents without describing the underlying faulty physiology; but, at the same time—it's all about attention.

It doesn't matter how you get there—mechanisms that can improve executive control and control over the mind's salience network will greatly end up benefiting those who suffer with ADHD. Those who practice mindfulness meditation—ADHD sufferers or not—show strengthened neural circuitry in both executive control and salience networks. Head trauma, environmental factors, genetics or what have you; working to strengthen these networks is a good thing.

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