Edward Finkler • LonghornPHP • Nov. 2023, Austin TX Stronger Than Fear Mental Health in the Developer Community

Three things to know Not a “warning” per se ‣ I am going to swear a lot. ‣ I am going to cry. Any crying in public is a lot. ‣ I am going to need you to help me through it.

Thank you for getting up early to hear me cry.

This is about me.

None of this constitutes medical advice.

Ready?

Our Agenda Today My experiences with ADHD and mental illness ‣ ADHD Is A Superpower, Right? ‣ Impedance Mismatch and Monkeypatching ‣ Anxiety: “This Is For Your Own Good 👊” ‣ When Life Pours Lemon Juice In Your Eye ‣ It Is Not My Fault, But It Is My Responsibility

ADHD Is A Superpower, Right?

ADHD IS A SUPERPOWER, RIGHT? What is this alchemy? ‣ A developmental impairment of the brain’s self-management system, involving several different parts of the Central Nervous System (CNS) ‣ The Executive Functions of the brain: focus, planning, memory, task management, etc. ‣ These function as expected in certain situations: strong personal interest, perceived near-term danger. ‣ If not, extreme difficulty in developing and sustaining motivation. ‣ Dr. Russell Barkley calls it Motivation Deficit Disorder 
 https: // www.youtube.com/watch?v=bR3RJU6838c

ADHD IS A SUPERPOWER, RIGHT? What is this alchemy? ‣ Stuff I notice about me: ‣ Either highly aware or oblivious. ‣ Context Switching + Memory decay. ‣ Perception of time modulates dramatically. ‣ Extreme difficulty in initiating actions. ‣ Without a compelling reason to be interested, it’s very difficult for me to initiate an activity. ‣ Frequent confusion/juxtaposition of labels & values.

ADHD IS A SUPERPOWER, RIGHT? What is this alchemy? ‣ Deficient Emotional Self-Regulation (DESR) ‣ For me, this is the #1 debilitating problem with having my brain. ‣ Not even mentioned in current diagnosis criteria (DSM-V) ‣ “Emotion dysregulation is prevalent in ADHD throughout the lifespan and is a major contributor to impairment.” 
 “Emotion Dysregulation in Attention Deficit Hyperactivity Disorder” - https: / / ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2013.13070966 ‣ There is a lot of crossover between executive function “circuitry” of the brain and emotional circuitry.

ADHD IS A SUPERPOWER, RIGHT? What is this alchemy? ‣ How we feel deeply affects how we think and act. ‣ What does DESR do to people with ADHD? ‣ Social Interactions: Difficulty in social situations due to “inappropriate” emotional responses. ‣ Rejection-Sensitive Dysphoria: dysphoric reactions to perceived rejection by authority/ respected figures ‣ Stress: Increased susceptibility to stress due to poor emotional regulation. ‣ Comorbidities: Higher incidence of mood disorders and anxiety.

ADHD IS A SUPERPOWER, RIGHT? Comorbidity is fun to say ‣ Anxiety, Depression, and Mood Disorders ‣ About 50% of those with ADHD have an Anxiety Disorder. 
 https: // www.sciencedirect.com/science/article/abs/pii/S0165178122000373 ‣ Up to 70% of ADHD adults will be treated for Depression. 
 https: // chadd.org/about-adhd/depression/ ‣ Other mood disorders: about 35%; Bipolar 20%. ‣ Narcolepsy & Sleep Disorders: very prevalent; RLS about 50%. ‣ Autism: About 60% of those with ADHD have symptoms of Autism. ‣ Sensory Processing Disorder: about 50% of ADHD or SPD show symptoms of other disorder.

ADHD IS A SUPERPOWER, RIGHT? ‣ Growing up with ADHD ‣ I learned to control my behavior though self-shaming. ‣ Most people with ADHD feel like shit about themselves. ‣ Self-esteem rises over time for neurotypicals, peaking at age 60. ‣ Adults with ADHD’s self-esteem tends to decline as they age. 
 https: // www.additudemag.com/how-to-regain-self-confidence-adults-adhd/ What is this alchemy?

Impedance Mismatch + Monkeypatching

IMPEDENCE MISMATCH + MONKEYPATCHING Shit, they gave me an Itanium CPU. ‣ There isn’t a “problem” with the ADHD brain. It just works differently. ‣ However, society was not optimized for us, but for neurotypical individuals. ‣ We have to try to map society to the way our brain works — like an ORM or ETL system. ‣ ORMs introduce a lot of OVERHEAD!

IMPEDENCE MISMATCH + MONKEYPATCHING ‣ Also, there are some things we can’t do, that society relies on. ‣ We have to hack our environment to compensate. Luckily, we are pretty creative. (1) Medication (2) Behavior Training and Coaching (3) Sensory and Environmental Filtering (4) External Assist Systems Shit, they gave me an Itanium CPU.

IMPEDENCE MISMATCH + MONKEYPATCHING Can I even run a web browser on BeOS? ‣ Medication ‣ Stimulants and SNRIs ‣ Increase levels of Norepinephrine. ‣ Inhibits activity of Default Mode Network regions of brain 
 https: // pubmed.ncbi.nlm.nih.gov/31070233/; https: // pubmed.ncbi.nlm.nih.gov/21073458/ ‣ Clonidine and Guanfacine: Alpha Agonists. ‣ Lowers activity of adrenal nerve - > decreases in hyperactivity, drive, impulsivity, insomnia, and emotional over-reaction

IMPEDENCE MISMATCH + MONKEYPATCHING Can I even run a web browser on BeOS? ‣ Behavior ‣ People with ADHD need outside help. ‣ Therapy ‣ Coaching ‣ Supportive social groups

IMPEDENCE MISMATCH + MONKEYPATCHING Can I even run a web browser on BeOS? ‣ Sensory and Environmental Modification ‣ Filtering or Altering Sensory Input ‣ Modifying or moving to a different environment

IMPEDENCE MISMATCH + MONKEYPATCHING Can I even run a web browser on BeOS? ‣ Assist Systems ‣ Reminder systems ‣ Calendars ‣ Task Tracking ‣ THE QUEST LOG PROBLEM ‣ Possibilities of LLMs

Anxiety: 
 “This Is For Your Own Good” 👊

ANXIETY IS A JERK Sort of a one-trick pony ‣ Holy shit this is the worst part of having ADHD. ‣ Add in some special elements: ‣ Generalized Anxiety Disorder ‣ 4x more prevalent in folks with ADHD 
 “Generalized anxiety disorder among adults with attention deficit hyperactivity disorder” - https: / / pubmed.ncbi.nlm.nih.gov/34799150/ ‣ Sensory Processing Disorder ‣ More than half of ADHD folks also have symptoms of SPD

ANXIETY IS A JERK Sort of a one-trick pony ‣ The “Fear Circuit” of the CNS. ‣ The Fear Circuit perceives danger and induces pain and discomfort to get us to alter our behavior. ‣ Pain is the message format.

ANXIETY IS A JERK Sort of a one-trick pony ‣ Anxiety is most people’s primary motivator. ‣ For me, it manifests as comparison and diminishing my self-worth. Shame. ‣ I learned to doubt my ability in everything, and anticipate failure. ‣ I thought I had to prepare, constantly, for every possibility.

My self worth was measured by my perceived acceptance from others.

When Life Pours Lemon Juice In Your Eye

LESS THAN OPTIMAL Let’s not dwell on this too much. ‣ Stuff was great at the beginning of 2017. ‣ Stuff was really really bad by the end of 2017. ‣ Drifting, not doing so hot for a while. ‣ 2020 happens and I really nose dive. ‣ 2021 my body breaks down.

Let’s not dwell on this too much. ‣ WTF now? ‣ I had to start figuring out what to do. ‣ To change my trajectory, I had to stop hating myself. ‣ But it was the only thing I knew. ‣ I could not do this on my own. LESS THAN OPTIMAL

It Is Not My Fault, But It Is My Responsibility

IT’S NOT MY FAULT ‣ Forced to listen to my body. ‣ I started to prioritize my health; investing time in researching how to help myself. ‣ I realized that no one would care about it like I do. ‣ My perspective changed from “I am an anxious person” to “I am a person with an ADHD brain.” ‣ I learned that I have a disability. I didn’t ask for this. I wasn’t lazy.

BUT IT IS MY RESPONSIBILITY ‣ I also had to accept that I was the only one who could help me. ‣ Focusing on ADHD changed my treatment patterns a lot. ‣ Key was finding providers who understood ADHD and Anxiety/Trauma. ‣ Many common approaches to breaking down thought and behavior patterns are ineffective for those with ADHD. ‣ A lot of medical professionals have a simplistic understanding of ADHD.

ADHD AIN’T NO JOKE ‣ I have a disability that won’t get better. ‣ I am an anxious person. I have been since my first memories. That hasn’t changed in 50 years, and it won’t stop now. ‣ There are more years behind me than in front of me. ‣ I need people to help me. We are social creatures. -T.T.

The most important thing that you can do is love yourself, without condition or qualification. Love yourself, as you are, right now.

Thank you for listening. Edward Finkler funkatron.com osmihelp.org