ADHD meds

[scottindenver]

Also thanks for sharing the diet info at this link: https://nutrientoptimiser.com/nutrients/adhd-diet/
I am not endorsing the link of course but I am trying to sort through what is most relevant. There is some evidence that magnesium and Vitamin D supplements may help with ADHD in general. Here is link to clinical study:
https://bmcpediatr.biomedcentral.com/ar ... 21-02631-1

Lots of research out there, I just haven't had time to do deep dive yet.

[scottindenver]

Also just posting this video from Russell Barkley. He has the most extensive research and writing on ADHD but it can be overwhelming to absorb a ton of information so this short 12 minute video encompasses the most relevant information. And he delivers it fast and clear so someone with ADHD will likely watch the whole thing. Please share if you can!

https://m.youtube.com/watch?v=_tpB-B8BX ... cmtsZXk%3D

[jacob]

Ignoring nuance - if you want support from society, exercising the pathological model is necessary. It controls access to accommodations.

Nuance is crucial though. The pathological model is but one way to accommodations, there are others. If the pathological model is based on traits, using it as a hammer is also risky because having some of the traits doesn't necessarily mean having the condition. In particular, different conditions may have an overlap of traits making it important to look for counterindicators. (Of course a person might have two or more conditions.)

Consider the following Venn diagram

from https://tendingpaths.wordpress.com/2022 ... n-diagram/

(It would make my point clearer if the "neurotypical" grey zone also included symptoms such as "present-oriented focus", "need for emotional bonding", "concern for fitting in", "thinking in rules", "typical social interactions", "narrow range of interests", "tendency to ignore consequences", "low planning horizon", "learning by rote memorization",... Again, not everybody has all traits.)

Some problems might just be environmental in nature. For example, lets take a gifted person who struggle with boredom in a (neuro)typical routine-based educational or work environment. We see that this [gifted] person displays at least some symptoms of ADHD being intensely curious about a shifting number of interests and focusing more on those than paying attention to the teacher or finishing their homework. So lets misdiagnose them with ADHD and give them some Adderall. The drug boosts the brain's reward circuit as well as the fight/flight response making it possible, enjoyable even, to engage what would otherwise be tedious boredom. However, it also reduces their interest in connecting different areas in complex ways---something that is counterproductive to most jobs and the compartmentalized schedule of the school system but also greatly rewarded in certain areas of life. Whoops! A better solution would have been to send them to the library instead of making them sit down to practice the 7x table with the neurotypical rote-learners for the umpteenth time.

My concern is that the pathological approach is too sensitive (hands out a diagnosis a little too freely) and not sufficiently specific (not good at rejecting people who don't actually have the condition).

Metaphorically speaking, the pathological approach is about using a hammer to "accommodate" round pegs into square holes. A better approach might be to find some round holes. I think the world is coming around to this.

Of course there are conditions that are truly debilitating and not just an environmentally incompatible temperamental difference. I'm not insisting that there should be a natural/behavioral solution for everything. I'm also not above using drugs in the performance-enhancing way from time to time. For example, alcohol tends to reduce inhibition and the ability to think. So if you have a condition (ha!) where you tend to think too much before you speak, alcohol is the drug of choice. It is therefore great for small-talk at loud parties, where nobody cares what anyone says anyway. However, a better solution might be to find another environment so that "shouting into the music to people who aren't paying attention anyway" is not the only social setting one has available.

In many ways, ERE is the alternative [environment] solution to the gifted person's problem of otherwise abiding a mundane society designed neurotypicals. Methinks this was more obvious before the FIRE-aspect became the dominant theme. Back then freedom-to was never an issue because the main problem was that "regular work" held people back from all the things they wanted to do.

[Scott 2]

@Jacob - That's a good chart. It reflects my current conversation with the doctor. The overlap is confusing.

It's worth noting our usual gap presents here. I'm primarily concerned with self-help. As an adult - what might improve my life? Behavioral changes get first priority.

I feel equipped to trial strategies, judge trade offs, assume risks, etc. I am consulting multiple specialists and my internal medicine physician. After collaborating with them, I am also self educating. Only then, have I tried any drug. During, I have my wife independently watching my response. I am also monitoring sleep, heart rate, mood, etc. My prescribing doctor is in regular contact. I have space for things to go wrong.


Your argument tends towards a systemic view. Approaching the problem at a population level. From that angle - I share similar concerns. Brain drugs are powerful. They can work miracles. But they can also ruin lives. The same with labels. It's a difficult needle to thread. Especially when the average person is less well equipped. Erasing variation isn't the solution. I am not claiming to have those answers.

I will say - I wish I had support at 10, instead of 40. My deficits are relatively mild. In many other ways, I was privileged. Yet, I suffered. Life didn't have to be that way. I have empathy for those going through it, especially with greater impairment. I can understand desperation for an answer.

[Ego]

My concern is that the pathological approach is too sensitive (hands out a diagnosis a little too freely) and not sufficiently specific (not good at rejecting people who don't actually have the condition).

Metaphorically speaking, the pathological approach is about using a hammer to "accommodate" round pegs into square holes. A better approach might be to find some round holes. I think the world is coming around to this.

The peg metaphor implies a fixed peg interacting with a fixed hole.

Reshaping a peg with drugs is one end of the spectrum. Seeking out a perfectly shaped hole is the other end.

Reality is a flowing confluence of biology, physiology, neurological wiring, gene expression, environment, preferences, skills .... all of which are fluid. Be water, my friend.

[7Wannabe5]

Interesting chart. Pretty clear where I belong on it (purple.) OTOH, I attempted to get myself diagnosed with ADHD in my late 30s, and the seemingly quite competent psychiatrist I met with informed me that since my mother has bi-polar disease, and I learned to read at a very early age, it is more likely that I suffer from mild cyclothymia. Also, self-medicating with two pots of coffee per day and integrating practices from half a dozen different organizational books seems to work well enough to allow me to tolerate some level of routine for maybe up to a year or so. OTOH, working full-time at the same dull corporate job for 10 years in a row in order to become FI? Yeah, that was never going to happen.

Also, super-interesting that ADHD provides the super-power of responding well in an emergency situation, because I have often found myself very calm and focused in crisis situations, while others who are usually more day-to-day take-charge types flounder.

[daylen]

I have wondered about where I might fit onto a chart like this. Never been diagnosed with any mental health conditions or put into any gifted programs. When I was in grade school, I failed a hearing test indicating a minor hearing loss which was later confirmed through genetic testing. Though I have always wondered if my hearing loss was a problem with inattention or brain wiring to my ears. It may be a little of both since it seems like I have gotten better at listening in situations that would have been difficult as a kid (e.g. crowds, high-pitched voices, talk across a room). I probably would have been more of a nerd as kid if I could hear what my teachers were saying and wasn't so susceptible to peer-pressure. As an adult I have leaned more towards the traits of ADHD and giftedness. I probably also have just a tad bit of autism, but I maintain that I am fairly normal. As a subjective judgement I'd say I am 40% normal 60% abnormal; then the abnormal splits into about 60% gifted 30% ADHD 10% autistic. I love my life as a semi-EREer but my life satisfaction predictable drops if I try to work full-time for extended periods of time. I self-medicate with coffee, booze, and weed.

[jacob]

I have wondered about where I might fit onto a chart like this.

(With the caveat, that the diagram would be even more helpful if it included normative traits as a fourth condition (extroverted, sensing, "emoting"))

One way to simplify it, at least when it comes to the problematic effects, is to look at executive functioning(*). Also mentioned by the OP. Since we all live in a reasonably complicated society (compared to goldfish in a bowl which is relatively simpler), humans need some level of EF. Without it, we're SOL. EF might easily be more important than intelligence in terms of whether one is able to navigate modern life.

People with autism and ADHD struggle because they have less EF than a [neuro]typical environment is designed for. According to the interwebs, this happens in 80% of the cases for either condition, so there's a specific counterindicator for you. Hence, a common coping strategy is to simplify the environment or more crudely stop paying attention to certain things, perhaps by introducing deliberate distractions (stimming).

(*) I like to use the computer-model of the brain. Here EF is loosely defined as the brain's task manager. A meta-program that decides what to focus on and what to prioritize in order to get things done.

Conversely, a gifted person or an INTJ(+) usually has EF in spades---more so than the (neuro)typical person. They'll tend to predict consequences and be able to choose the right actions to the point that "normal living challenges" become boring. A typical person will often have their present emotions override their EF and proceed to do something they'll regret or something that won't really fix whatever problem they're having. They will metaphorically not remove the nail from their head but rather seek comfort by emotionally bonding over the pain. IOW, there's a tendency to self-generate slow train-wreck situations. In contrast, a person with a high EF will be very good at tuning out irrelevant "inputs" once it's been decided what they are. It is thus not unusual to "grind through a task because it's 'only 5 years' and it's all part of the master plan".

(+) There's a strong correlation between IN**s and being gifted. Also see https://www.sengifted.org/post/sak-synthesis

A high EF would automagically determine that getting the nail out is more important than sharing how bad it feels. At level 1(*) it remains somewhat inconceivable that others don't see it that way. At level 2---once it is realized that not everybody is gifted with a good meta-planner/task-master---the problem of relating to other people becomes one of trying to guess what kind of obvious [to you] consequences they're missing/not aware of.

From the neurotypical perspective on appropriate EF, all three types (in the diagram) look like an horseshoe (a rolled up dimension, if you will). However, it's actually more like Wheaton levels in that anything too far away is either "too extreme" (inhuman) or "not trying hard enough" but in any case equally weird (and therefore a pathology). Without level 2 thinking, it's impossible to see that difference though.

(*) Level 1 is the typical mode of human thinking, that is, thinking about [concrete] stuff. Level 2 is thinking about thinking or "abstract thinking". Level 2 is required for any theory of mind beyond presuming that "everybody is fundamentally the same as myself". MHC has more to say about that (many more levels). You can probably draw some diagrams with nodes and connectors. The different minds would have different amounts of "nodes under consideration", different amounts of "connections between nodes", and different "prioritization of connections and nodes". I'm not sure if this is useful other than to visually illustrate the difference.

[Scott 2]

Here are autism surveys given to me, as a starting point, by the autism friendly therapist. My understanding is they seek your Type I thinking response to the question, not what happens when your Type II brain has time to override the impulse. My EQ score was scary low, but IRL I know the rules and fix that with my Type II responses.

Here are the links we talked about for neurodiversity screening. As I mentioned, the questions/answers and results aren't retained or saved. If you're interested in keeping any part of the screenings including results I recommend that you screenshot the pages as you go.

These are not tools meant for a diagnosis, just a starting point to see if neurodivergence is something to be considered. The empathy assessment while not specific to neurodivergence per se can be a helpful data point in the context of social relationships.

https://psychology-tools.com/test/raads-14

https://psychology-tools.com/test/autis ... m-quotient

https://psychology-tools.com/test/empathy-quotient

Teasing apart where you fit is complicated. The formal neuropscyh testing includes an IQ test, because "twice exceptional" is common. As someone is more gifted, or has had time to develop better strategies, it gets even harder to figure out. There are layers of masking to dig through.


I don't have any similarly vetted sources for ADHD. This is one I've tried:

https://www.idrlabs.com/adhd-spectrum/test.php

It seems a little dated. But, it could be a starting point.

[jacob]

Here are autism surveys given to me, as a starting point, by the autism friendly therapist. My understanding is they seek your Type I thinking response to the question, not what happens when your Type II brain has time to override the impulse. My EQ score was scary low, but IRL I know the rules and fix that with my Type II responses.

Here's mine for comparison. I got 6/42 on RAADS, 20/50 on the AQ, and 31/80 on the EQ. If the world ever needs anyone to control the nuclear self-destruct for the lab handling the Andromeda Strain, I'm your man

The EQ is interesting (I'm an insensitive brute), because it's strictly asking about the Fe-part (social and behavioral) of emotional intelligence, while ignoring the Fi-part (internal and subjective). I've previously played around with other emotional intelligence tests that differentiate between the two. IIRC, my results were something like EQ=80 on the social part and EQ=120 on the internal part. (Average = 100. Dunno what the standard deviation was, probably the usual 15-25ish)

This corresponds well with the INTJ temperamental stack, which is Ni-Te-Fi-Si/Ne-Ti-Fe-Se. This puts the Fi part in the third position and the Fe part in the seventh position. Ni-Te is essentially the basis for the executive functioning described above. Feelings are almost all internally oriented. In other words, it is important that the executive functioning is acting morally(*). Seeing moral courage brings a tear to my eye. Dead puppies, not so much. Whatever emotions that anyone is currently experiencing are generally considered irrelevant to the problem to be solved by the EF (because it's strategic and long-run and those emotions are likely gone tomorrow) Insofar it sounds weird, it is at least self-consistent. It's also highly effective in terms of doing "the right thing". IOW, the imbalance is explained by temperament. Basically, strongly typed INTJs make for doctors with terrible bedside manners ... and the reason is that bedside manner (placebo aside) is not very relevant to curing the patient(!) It's effectively impossible by construction to have both. I'm aware that postmodern doctoring makes allowances for the patient's perspective as well, but that requires some sacrifice of their own perspective in case the two conflict. Kinda goes back to the "if you're so smart, why are you not rich" or "if you're so smart, why are you not popular"? It's meant to be rhetorical, but the real answer is that the smart person prefers to be smart over being popular or rich and all three takes sustained focus on the preference which in turn takes away focus from the non-preferred.

That's another way of saying that if you want to be more empathic, the cost will likely be to sacrifice some of your moral focus. You will probably be required to lie to make others feel better. Likewise, you will probably be required to avoid giving your best to be liked by others. You will have to become inauthentic to yourself in order to appear more authentic to others. Everybody sets their own balance of preferences here. Doing both is not always possible.

(*) Going back to the Venn diagram, we see "preference for logic and fairness" and "highly developed morals" as part of the overlap between gifted and autism. Contrast this with a more neurotypical preference for "relational morals" (my tribe, right or wrong) and "situational morals" (I didn't really care until it happened to me).

I've tried to avoid dragging temperament into this, but I posit that a lot of this [controversy?] is actually temperamental differences. I think this goes back to the idea that small variations can be explained by different temperaments but that variations that are too large become a problem and consequently declared a condition. Much like excessive strength can become a weakness. In that regard, it's good to quantify things a bit to avoid the very common tendency to pathologize behaviors that fall outside the normative mainstream.

However! Going back to the whole square peg/round hole issue, the tension from a bad fit often contributes a lot to the personal struggle with a given situation. The most common temperaments (ES**) won't even notice this because the majority the people around them will be very similar in how they think and what they're interested in. Basically, ES** hold the normative upper hand in terms of "correct social behavior" in most places. They basically made the social game easy for themselves. It's thus easy to declare the less common temperaments (minus those who make the effort to fit in) to be weird because they're not playing by the rules as declared by the majority. However, I've definitely had privilege of seeing how even otherwise "normal" people become like fish out of water when thrust into an different environment where THEY feel the tension from a bad fit. Hint: The reaction is pretty much the same. Mirror-world.

[Slevin]

Should we have a different thread for talking about the autism bits? Or are we just chilling with this thread as the place to talk about neurodivergence?

As someone else who suspects ASD, but doesn't want to pay 3k-5k for someone to give me a sheet of paper... I scored 33/42 on RAADS, 38/50 on AQ, and 22/80 on EQ. I score INTP as always, which would run the TiNe cognitive stack. My EF is very good at abstract things, godawful with time management. When I make a schedule that has one important thing at 4:30 PM, that whole day is shot because I'm waiting for the 4:30 PM task. really a PITA. Hyperfocusing on one subject and seeing through it to the end, fantastic and easy. I can work on a project literally for fifteen hours if its interesting and we are working on something thats fun. Working on 3-4 projects at the same time and switching between them... definitely no... I have to work on one at a time until I see them through.

[Scott 2]

@Jacob - to contrast, my scores were 34/42 on RAADS, 40/50 on the AQ and 11/80 on the EQ.

While the surveys are not diagnostic, it was implied confirming the obvious might be wasted effort.

In hindsight, I'd have run detailed testing back then. I under appreciated the value of further breakdown.


I'm not skilled with the framework you are using, but I'd agree the EQ test has faults.

It is very sensitive to one's affective empathy. For me - emotional signaling does not work well. Stacking on that - I struggle with theory of mind. So I assume impaired signaling from everyone else as well. That combination causes me to score very low.

However, my cognitive and compassionate empathy are quite active. I have a strong desire for equality and justice. I hold no respect for hierarchy and minimal need for power. So once I get the signal, I likely care and think it's my duty to help. Even though I can't feel any gratitude from helping, lol.

It's a good example of how learning where the deficits are, can lead one to a better life. Once I bypass the broken signaling, I am relatively kind.


@Slevin - ASD and ADHD can be co-occurring. I see people calling it AuDHD. Due to the overlap pictured above, I think it's hard to separate the conversation.

Worth noting - ADHD does not mean one is deficient in focus. It means they have trouble regulating focus. So hyper focus remains possible, similar to in ASD. There's also an issue of time blindness (agnosia), which leads to the waiting pattern you described. One fears losing themselves and missing the appointment entirely, so they can do nothing until it happens.

I found constraining myself to resources for either condition was limiting. I'm drawing from both at this point. Outside of medication, I think the overall strategies are very similar. One has to figure out where their personal deficits are, then mine for potential solutions. The goal is not to "heal" the deficit, but to avoid letting it introduce impairments.

From what I can tell, medication (stimulants) is first line treatment for ADHD. With ASD, it's more of a last resort. That seems to be the key strategic difference.

[scottindenver]

Wow this thread got busy!

Semi-related but there may be some evidence for condition or temperament or whatever label we want to use called Cognitive Disengagement Syndrome. Here is Rusell Barkley discussing it, not an endorsement just trying to learn about myself and trying to understand.
https://m.youtube.com/watch?v=tQDuF-MKBDI

[scottindenver]

Also, super-interesting that ADHD provides the super-power of responding well in an emergency situation, because I have often found myself very calm and focused in crisis situations, while others who are usually more day-to-day take-charge types flounder.

Wow I have noticed this too! My wife panicked when a popcorn maker caught fire but I calmly got the fire extinguisher and put out the fire and my heart rate was only slightly elevated.

[jacob]

I'm not skilled with the framework you are using, but I'd agree the EQ test has faults.

It is very sensitive to one's affective empathy. For me - emotional signaling does not work well. Stacking on that - I struggle with theory of mind. So I assume impaired signaling from everyone else as well. That combination causes me to score very low.

However, my cognitive and compassionate empathy are quite active. I have a strong desire for equality and justice. I hold no respect for hierarchy and minimal need for power. So once I get the signal, I likely care and think it's my duty to help. Even though I can't feel any gratitude from helping, lol.

I wouldn't say it has faults. It just only tests the Fe-part while ignoring the Fi-part. Fe and Fi (along with the other Ne, Ni, Te, Ti, Se, Si) are human cognitive functions. We all have them in different degrees of preference and these differences determine our temperament. The i or e marks whether the function is directed inwards towards the self or directed outwards towards the environment and other humans.

Affective empathy is Fe. Compassionate empathy falls closer to Fi.

(Cognitive empathy is more of a theory of mind thing. Since I'm a rare type, I can't rely on projecting my own experience with my own mind onto other most people's minds (I was a fish out of water throughout all my literature classes when trying to understand what motivated "normal" characters'), but I eventually discovered MBTI, Kegan, and Spiral to figure other people out. This works well (better than average) but it slow because it takes time to understand people. It's much better than running blind though.)

Basically, being short on Fe and therefore not showing emotion and not reacting to other people's emotions does not mean that one does not have feelings. They are just more in tune with the self than with others. In contrast people who score low on Fi (and typically high on Fe) often confuse group feelings with their own; they don't know what their own feelings are. If they are with a smiling person, they're happy. If they're with a frowning person, they're sad. The EQ test above did not test for that.

I don't know for sure what goes on emotionally in an autistic brain, but I'm surprised that the EQ test above focused exclusively on Fe. Perhaps it's because even those who prefer to use Fi learn to fake some degree of Fe behavior as they get socialized to group interaction growing up. Basically, they learn the right things to say for a given situation. (E.g. when someone just had a baby, you're supposed to say "congratulations" to affirm the (usually) happy new parents; you should definitely avoid talking about the Fi-pain you're feeling on the newborn's behalf as they're been sold down the river in an overpopulated world. This might be where the executive functioning comes in(!). If you can't bring yourself to fake it, it's better to say nothing.) Whereas someone on the spectrum would tend to remain oblivious to the social cues and effective feedback for social situations, because it's too much information? (I have a somewhat simplistic theory of mind for autism and ADHD, so I'm speculating here.) This means that both asocial Fi-users as well as autists would fail that EQ test but for different reasons.

I suggest reading this link. Focus on (3 and 4) for the distinction between Fi and Fe and (5) for the difference in terms of different kinds of empathy. Once you know the difference, your cognitive empathy already exceeds the average person

PS: As always, when it comes to temperament, we're talking preferences between cognitive functions. When it comes to personality, absolute skill with a cognitive function also matters.

[DutchGirl]

Perhaps move this last part of the discussion to a fresh discussion, as it's more about how to test for character traits / neurodiversity than about how to pay for your ADHD meds and/or reduce the cost of ADHD meds?

[7Wannabe5]

Conversely, a gifted person or an INTJ(+) usually has EF in spades---more so than the (neuro)typical person. They'll tend to predict consequences and be able to choose the right actions to the point that "normal living challenges" become boring. A typical person will often have their present emotions override their EF and proceed to do something they'll regret or something that won't really fix whatever problem they're having. They will metaphorically not remove the nail from their head but rather seek comfort by emotionally bonding over the pain. IOW, there's a tendency to self-generate slow train-wreck situations. In contrast, a person with a high EF will be very good at tuning out irrelevant "inputs" once it's been decided what they are. It is thus not unusual to "grind through a task because it's 'only 5 years' and it's all part of the master plan".

I believe you may be somewhat confounding "intellectual style" and "organizational style." If we're using IQ as proxy for giftedness, I've known ENTPs with genius level IQs and INTJs with IQs lower than mine, but the organizational differences that would put ENTP more towards easily mistaken for ADHD and INTJ more towards easily mistaken for autism spectrum seem to hold across the IQ spectrum. For example, in "Game of Thrones" Tyrion Lannister (ENTP)is much more deferring and carefree and Littlefinger (INTJ) is much more efficient and systematic, but they likely have similar IQs. Walter White and Saul Goodman in "Breaking Bad" would be another example, although I would rate White's general IQ as a bit higher than Saul's. Being "spontaneous" and "carefree" in organizational style isn't any more about succumbing to "emotional override" than being "efficient and systematic." It's just a different way of being rational. Maybe playing chess vs. playing overlapping hands of poker.

[DutchGirl]

Did we already add that sometimes you can get medication cheaper in a different country than in the US? This could also be worthwhile to consider, although it might be difficult for THIS specific medication as it could be hard or illegal to move large amounts of it across borders.

Points of attention:
1. You do of course want medication that is of excellent quality as your health depends on that - so make sure you trust that country's healthcare system to check medications, and how they are stored, well. Good quality of a medication includes no pollutants, but also that it consistently DOES contain the right quantity (!) of the medication.
2. You want to make sure that the medication can be transported to where you live, safely, under the right conditions (moisture, temperature, pressure/movement) and without trouble with customs.
3. Check beforehand whether your doctor needs to give you a prescription to obtain this medication in the other country, and if so, what the prescription needs to look like (what language, etc).
4. I'm not sure whether your insurance company would pay for it, so find out about that and if they will pay for imported medication, know exactly what you need to claim the costs. (It can still be worthwhile if the insurance doesn't pay for it - but of course make your calculations).

[jacob]

If we're using IQ as proxy for giftedness, ...

I don't think we are anymore?! IQ is easy to test, but having the multiple symptoms in the Venn diagram above requires more than just having a high g-factor. If we stick to intellectual giftedness (cf. being athletically gifted or being gifted in the looks department), which I believe is what the diagram covers, then high intelligence is not a sufficient condition. I'm not even sure it's required but it definitely serves as a good base. (Just like being a tall mesomorph helps in the athletic department and facial symmetry helps in the beauty department. Without training or application, these remain talents though.)

Intellectual giftedness also requires creativity, motivation, and commitment in order to a) want to mentally explore a wide array of topics; and b) get there.

The interest and resulting focus on mental development is why intellectual giftnedness is 5-10x more common in IN-types than ES-types. I would think that ADHD would be a detriment to committing long enough to a particular exploration to actually get there despite a possible high intelligence. This is why ADHD and giftedness do not fully overlap. It may be that a highly intelligent person on the autism spectrum may lack the creative component of the gifted. This depends on whether you define creative as divergent(*) thinking (autism strongly tends towards convergent thinking) or simply "non-typical thinking" (ignoring norms due to not being aware of them in the first place) (autism definitely has that). As such, there's some controversy over whether ASD is creative or not. Methinks, for giftedness, the requirement would "constructive creative capability". It's hard for me to see how lacking that would lead to the symptoms expressed in the gifted.

(*) Divergent thinking = connecting typical thinking non-typical ways, aka lateral. Non-typical thinking lacks the connecting part.

In short, I do think that giftedness is a kind of "intellectual style". Perhaps more accurately the result of high intelligence + a certain intellectual style.

[daylen]

Okay, this is all fitting together in my mind a bit better. I don't think I would meet the diagnosis of ADHD and definitely not autism. I do think my EF is high and it seems like this helps with mind-state exploration as I can in some sense trust my mind to spring back to default mode. This lends itself to drug and empathy exploration which can often be powerful enough to scramble my own identity. My Fe is often aware of the external signs of ADHD and autism but my Fi is far behind in understanding the inner experience although crude simulations do occur.
 

Also if could share any strategies and tactics for better executive function that would be great as we could all benefit.

As Ego mentioned, the placebo effect can be quite powerful. Perhaps top-down belief imposition is akin to EF exercise.. but how to spark that fire in any context and keep it lit is a very individualized process it would appear. I may just be getting circular with no substance to give.

It seems that executive functioning correlates with being potentially(*) susceptible to placebo effects? If you can convince yourself of something temporarily then perhaps you can change your mind in the long run? Is the suspension of dis-belief enough? How fluid is EF over the lifetime? So many questions! This may be going off thread tracks.

(*) assuming some spark of top-down belief auto-magically occurs?