Adults with ADHD show decreased function in brain dopamine reward pathway (2010)(ncbi.nlm.nih.gov)
ncbi.nlm.nih.gov
Adults with ADHD show decreased function in brain dopamine reward pathway (2010)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010326/
336 comments
I agree with the "blessing and curse" characterization. I owe my career to thousands of hours spent hyperfocused on learning programming languages for fun while I was supposed to be doing homework. On the other hand, I've come close to losing my job because of difficulty carrying out assigned tasks that don't matter to me.
Interesting contrast though: for me leetcode, certain exams, and interviews often trigger hyperfocus. Studying and assignments, as well as day-to-day work, rarely do. I take a fair bit of medication so I can do my job. I'm trying to pivot towards something which more naturally engages my interest, maybe SRE or security work.
Interesting how we're all affected differently. I recommend skimming "delivered from distraction" if you haven't already, there are some good tips in there on how ADHD folks can deliberately create the right conditions for flow.
Interesting contrast though: for me leetcode, certain exams, and interviews often trigger hyperfocus. Studying and assignments, as well as day-to-day work, rarely do. I take a fair bit of medication so I can do my job. I'm trying to pivot towards something which more naturally engages my interest, maybe SRE or security work.
Interesting how we're all affected differently. I recommend skimming "delivered from distraction" if you haven't already, there are some good tips in there on how ADHD folks can deliberately create the right conditions for flow.
I’m ADD and I don’t think it’s a disorder, but a trait that was selected for. I think it’s an explorers gene.
It’s just difficult for us to fit in to the system. Not only school, but a traditional 9-5 for me is difficult. Especially while not on medication.
It’s just difficult for us to fit in to the system. Not only school, but a traditional 9-5 for me is difficult. Especially while not on medication.
I definitely agree with this. I seriously suspect that I have ADD, and a burden has been lifted off my shoulders ever since I quit my 9-5 startup job and started travelling the North America a van + freelance coding.
Turn on, tune in, drop out
Turn on, tune in, drop out
that's riskier
>I’m ADD and I don’t think it’s a disorder
It is in the context of this society as we're fairly maladapted to it and struggle with a lot basic things that cause big problems in our lives.
It is in the context of this society as we're fairly maladapted to it and struggle with a lot basic things that cause big problems in our lives.
I worry that for me the regularity of the 9 to 5 is the problem, rather than what it is I'm doing from 9 to 5. I'm not sure if that is definitely the case, but I feel like I'd be so much better off if I could be in a situation where I worked 3 or 4 days a week, and not necessarily all in a row
Similar experience here. As a kid I couldn't manage to read a couple paragraphs on a boring subject but I could study and practice programming for 12 hours straight. Developed plenty of coping mechanisms and was only diagnosed in adulthood halfway into medical school. Every ADHD patient I've seen has a similar story of hyperattention...
I'm convinced this disorder is named after attention and hyperactivity because the children don't adapt well to school. At least not the traditional mass education model where kids sit in a class listening to lectures all day. There's probably a lot more we don't know about it. Some doctors I've seen think it's a made up illness created to sell amphetamines.
I'm convinced this disorder is named after attention and hyperactivity because the children don't adapt well to school. At least not the traditional mass education model where kids sit in a class listening to lectures all day. There's probably a lot more we don't know about it. Some doctors I've seen think it's a made up illness created to sell amphetamines.
It's named after how we annoyed our parents and teachers as kids. Such a terrible name for it.
wow that's a really interesting and seemingly insightful perspective and now i view the ADHD label as an insult.
I'm in the same boat as you. As I've aged, I've realized it's necessary for me to have medication for me to be productive for an extended period of time.
I encourage you to embrace the chemical imbalance as the reason. The medications do work and withdrawing from them isn't bad either (if you decide to take a pill holiday or extended non-use).
Finally, it's not about 'normal' focus. It's about you. If you're content with your productivity and behavior, then nothing is needed to change in your life. If you want to maximize your potential, then please consider medication. It doesn't go away (CBT never worked for me). Embrace your choice. Whatever you decide, is normal, it's your normal. That's perfectly acceptable.
I encourage you to embrace the chemical imbalance as the reason. The medications do work and withdrawing from them isn't bad either (if you decide to take a pill holiday or extended non-use).
Finally, it's not about 'normal' focus. It's about you. If you're content with your productivity and behavior, then nothing is needed to change in your life. If you want to maximize your potential, then please consider medication. It doesn't go away (CBT never worked for me). Embrace your choice. Whatever you decide, is normal, it's your normal. That's perfectly acceptable.
> withdrawing from them isn't bad either
Perhaps for you, but for others its a nightmare.
Perhaps for you, but for others its a nightmare.
> but for others its a nightmare.
I can only assume one of two reasons:
1. They were on XR.
2. Abuse.
If it's another reason, maybe the formulation isn't the best for them because it's highly unlikely to have a 'nightmare' problem with getting off.
I can only assume one of two reasons:
1. They were on XR.
2. Abuse.
If it's another reason, maybe the formulation isn't the best for them because it's highly unlikely to have a 'nightmare' problem with getting off.
+1 on the XR makes it worse, but -1 on the only other reason being abuse. These drugs are not one-size-fits-all.
Different people have different reactions.
> These drugs are not one-size-fits-all.
True but...on a probability basis, the two situations I gave are more than the majority of people's reason.
True but...on a probability basis, the two situations I gave are more than the majority of people's reason.
What goes up must come down in the equilibrium. The more amphetamine salts you take the harsher the crash and withdrawal.
If someone actually has ADHD, the person doesn't feel 'up'. Instead, after taking meds, they should feel more self control, less frigidity, and more calm. Withdraw should become the opposite. (I'm speaking generally, based on more research than my fingers and toes, not for individual cases).
Yeah totally, I meant dopamine released by synapses going up on x-y axis then it reaches a peak and comes down. More amphetamines will keep your dopamine levels above baseline but there is a point of diminishing returns (therapeutic dosage), then once your last dose runs its course your dopamine levels fall precipitously and crashes down below your baseline dopamine levels also known as 'withdrawal' period until you get back to your normal baseline. The more amps you take, the harder you crash down below baseline and your adhd symptoms return and feel much worse as you have less freely available dopamine.
That's all I meant by what goes up must come down :)
That's all I meant by what goes up must come down :)
I'm on a very low dose of lisdexamfetamine and i freaking haaaaate missing a dose. As I understand it, it is a precursor of dextroamphetamine and your body converts it into it slowly through a metabolic-like process-- so pretty similar to XR but less of a saw-tooth curve throughout the day and more of a single sine curve.
I wouldn't call it a nightmare, but it sometimes feels like one. It is really a miracle drug for me in terms of letting me let myself comply to external demands on my attention and order my life.
> i freaking haaaaate missing a dose
I'm not trying to minimize your experience. I'm just trying to provide a more accurate framework on what's more statistically likely to occur within a population. That's all. Since others tend to be ignorant of the scientific facts on how this issue distributes among a population.
I'm not trying to minimize your experience. I'm just trying to provide a more accurate framework on what's more statistically likely to occur within a population. That's all. Since others tend to be ignorant of the scientific facts on how this issue distributes among a population.
:(
> This resulted me in one case coding straight for 7 hours.
This happened to me this weekend. It's truly scary in retrospect. I got a business idea thursday, and coded nonstop until Sunday. It's a rentable AI service for dating apps. I launched it and it's super neat imo, but I lost almost 8 lbs in that time because I didn't eat, drink water, and slept only when my thoughts started to blank out.
I am now focusing on rehabilitating by eating a lot and going to the gym. I got so skinny. I wasn't on any medication either.
> This resulted me in one case coding straight for 7 hours.
This happened to me this weekend. It's truly scary in retrospect. I got a business idea thursday, and coded nonstop until Sunday. It's a rentable AI service for dating apps. I launched it and it's super neat imo, but I lost almost 8 lbs in that time because I didn't eat, drink water, and slept only when my thoughts started to blank out.
I am now focusing on rehabilitating by eating a lot and going to the gym. I got so skinny. I wasn't on any medication either.
> The only thing I had to deal with it slightly is my Ritalin...only so slightly I can "normally" focus for an hour. I just hope things go right in the rest of my life.
Talk to your doctor, there have been many advances in ADHD meds and they all work differently on different people. Some people respond well to Ritalin, Some respond well to the generic. Some respond well the Adderal, or Vyvanse. For some people only the name brand formulation works. Some people any formulation works. Also, make sure you are at the right dosage. You can and do build up a tolerance over time. I try to take weekends off when I don't have anything in particular I need to do, and at least one or two weeks a year (normally when I go on vacation).
Talk to your doctor, there have been many advances in ADHD meds and they all work differently on different people. Some people respond well to Ritalin, Some respond well to the generic. Some respond well the Adderal, or Vyvanse. For some people only the name brand formulation works. Some people any formulation works. Also, make sure you are at the right dosage. You can and do build up a tolerance over time. I try to take weekends off when I don't have anything in particular I need to do, and at least one or two weeks a year (normally when I go on vacation).
Speaking of tolerance, I really wish there was an “antidote” that could be taken at night. It would encourage better sleep and I would think would help fight tolerance a ton.
I take stimulants for idiopathic hypersomnia and I know things are a bit different for ADD folks, though.
I take stimulants for idiopathic hypersomnia and I know things are a bit different for ADD folks, though.
> there have been many advances in ADHD meds
respectfully, I disagree with this. The last new therapy was atomoxetine, which is almost 20 years old now and not seen as terribly efficacious.
Everything else new has been some variation on mixed dextroamphetamine/amphetamine salts or methylphenidate. Vyvanse is just a pro-drug for dextroamphetamine.
The only novel thing in the pipeline is SPN-812, which may work similar to atomoxetine.
respectfully, I disagree with this. The last new therapy was atomoxetine, which is almost 20 years old now and not seen as terribly efficacious.
Everything else new has been some variation on mixed dextroamphetamine/amphetamine salts or methylphenidate. Vyvanse is just a pro-drug for dextroamphetamine.
The only novel thing in the pipeline is SPN-812, which may work similar to atomoxetine.
Lisdexamfetamine is profoundly different than other variants of amphetamine in utility and experience. It’s not just a prodrug – it has a rather clever molecular time-release mechanism. It comes in very slowly over a period of two hours, with plasma concentration plateau of two more. This makes a big difference; I experience no cravings or drug-seeking for more of the drug at any point. It’s also less of a “jolt”; The slow, steady increase in effect is much more conductive to steady yet limber focus. It’s just incredibly functional medicine. Also, the description of a 14-hour effective duration is accurate in my experience.
It’s definitely a relatively new development and a much more humanely effective drug than previous options.
— It is dextroamphetamine, which I’m inclined to believe is the more useful handedness. Levoamphetamine has more “body” effects. To the dextroamphetamine is bound a lysine molecule, and this together is an inactive powder. Enzymes in red blood cells are needed to cleave the lysine off and activate the dextroamphetamine. I’m quite certain that the dopamine rate-of-change detection mechanisms in the central nervous system cause very different behavioral and cognitive pattern cascades when it’s an almost imperceptively slow change, compared to an unhindered uptake of free amphetamine. Compare the difference in addiction potentials between faster and slower routes of administration of, say, nicotine - smoking fast, patches slow.
It’s definitely a relatively new development and a much more humanely effective drug than previous options.
— It is dextroamphetamine, which I’m inclined to believe is the more useful handedness. Levoamphetamine has more “body” effects. To the dextroamphetamine is bound a lysine molecule, and this together is an inactive powder. Enzymes in red blood cells are needed to cleave the lysine off and activate the dextroamphetamine. I’m quite certain that the dopamine rate-of-change detection mechanisms in the central nervous system cause very different behavioral and cognitive pattern cascades when it’s an almost imperceptively slow change, compared to an unhindered uptake of free amphetamine. Compare the difference in addiction potentials between faster and slower routes of administration of, say, nicotine - smoking fast, patches slow.
> Lisdexamfetamine is profoundly different than other variants of amphetamine in utility and experience. It’s not just a prodrug – it has a rather clever molecular time-release mechanism
I'm not sure how much truth there is to this claim. As you mentioned, Lisdexamfetamine is just Dextroamphetamine bound to the amino acid, l-Lysine.
Once your stomach cleaves the l-Lysine, it yields free-floating D-Amp.
This mechanism of action isn't any different than most formulations of extended-release Dextroamphetamine, like Dexedrine ER spansules.
Additionally, Adderall and other standard mixed-isomer amphetamine salt formulations are a 75/25 mix of D-Amp/L-Amp, and the peripheral nervous system stimulation that L-Amp produces at that kind of dose (5mg for a 20mg pill) I would think to most wouldn't feel very noticeable at all.
Having gone through Adderall IR, Adderall ER, Vyvanse, and Dexedrine IR over the years, to me they all felt more or less the same (besides IR vs ER).
If for whatever reason Vyvanse happens to work better for some people, that's fantastic and more power to you, but the hype behind this is all marketing IMO. And, it's absurdly expensive without insurance.
It was the difference between $250/mo and $20/mo using Good Rx between generic Adderall/Dexedrine and Vyvanse.
I'm not sure how much truth there is to this claim. As you mentioned, Lisdexamfetamine is just Dextroamphetamine bound to the amino acid, l-Lysine.
Once your stomach cleaves the l-Lysine, it yields free-floating D-Amp.
This mechanism of action isn't any different than most formulations of extended-release Dextroamphetamine, like Dexedrine ER spansules.
Additionally, Adderall and other standard mixed-isomer amphetamine salt formulations are a 75/25 mix of D-Amp/L-Amp, and the peripheral nervous system stimulation that L-Amp produces at that kind of dose (5mg for a 20mg pill) I would think to most wouldn't feel very noticeable at all.
Having gone through Adderall IR, Adderall ER, Vyvanse, and Dexedrine IR over the years, to me they all felt more or less the same (besides IR vs ER).
If for whatever reason Vyvanse happens to work better for some people, that's fantastic and more power to you, but the hype behind this is all marketing IMO. And, it's absurdly expensive without insurance.
It was the difference between $250/mo and $20/mo using Good Rx between generic Adderall/Dexedrine and Vyvanse.
> Once your stomach cleaves the l-Lysine, it yields free-floating D-Amp.
This is incorrect. – With all due respect!
The action is enzymatic, and the enzyme is in red blood cells. It is slow. This is not the same as other “mechanical” time-release mechanisms. https://en.m.wikipedia.org/wiki/Lisdexamfetamine
This is incorrect. – With all due respect!
The action is enzymatic, and the enzyme is in red blood cells. It is slow. This is not the same as other “mechanical” time-release mechanisms. https://en.m.wikipedia.org/wiki/Lisdexamfetamine
Sure, technically, but read the FDA paper on it's pharmacokinetics.
Smoking, shooting, or squirting it up your ass won't do the trick. But injecting it would put it in direct contact with red blood cells, and so would rectal administration via absorption through rectal mucosa.
Lisdexamfetamine needs to pass through the GI tract where there's proper enzymatic activity.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805701/
"The environment in the rectum is considered relatively constant and stable and has low enzymatic activity in comparison to other sections of the gastrointestinal tract. In addition, drugs can partially bypass the liver following systemic absorption, which reduces the hepatic first-pass effect."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898170/
"Oral absorption of LDX was assessed in rat portal and jugular blood, and perfusion of LDX into isolated intestinal segments of anesthetized rats was used to assess regional absorption. .... LDX and d-amphetamine were detected in blood following perfusion of the rat small intestine but not the colon"
"The intact prodrug, LDX, was readily absorbed from the GI tract after oral administration, with relatively high levels of LDX detected in the portal blood of rats. When LDX was perfused into isolated segments of rat duodenum, jejunum, and ileum, it was absorbed into the systemic circulation; however, LDX was not absorbed during perfusion into colonic segments. These findings indicate that absorption of LDX occurs via carrier-mediated transport in the small intestines and are consistent with the physicochemical properties of LDX (ie, high aqueous solubility of greater than 0.85 g/mL within the physiologically relevant pH range of 1 to 812 and low lipophilicity [logP–1.75, unpublished data]), which would predict poor passive diffusion across biologic membranes"
But hey, here I am arguing on my weekend about why exactly putting a certain amphetamine prodrug up your ass won't work. What are we doing with our lives?
Smoking, shooting, or squirting it up your ass won't do the trick. But injecting it would put it in direct contact with red blood cells, and so would rectal administration via absorption through rectal mucosa.
Lisdexamfetamine needs to pass through the GI tract where there's proper enzymatic activity.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805701/
"The environment in the rectum is considered relatively constant and stable and has low enzymatic activity in comparison to other sections of the gastrointestinal tract. In addition, drugs can partially bypass the liver following systemic absorption, which reduces the hepatic first-pass effect."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898170/
"Oral absorption of LDX was assessed in rat portal and jugular blood, and perfusion of LDX into isolated intestinal segments of anesthetized rats was used to assess regional absorption. .... LDX and d-amphetamine were detected in blood following perfusion of the rat small intestine but not the colon"
"The intact prodrug, LDX, was readily absorbed from the GI tract after oral administration, with relatively high levels of LDX detected in the portal blood of rats. When LDX was perfused into isolated segments of rat duodenum, jejunum, and ileum, it was absorbed into the systemic circulation; however, LDX was not absorbed during perfusion into colonic segments. These findings indicate that absorption of LDX occurs via carrier-mediated transport in the small intestines and are consistent with the physicochemical properties of LDX (ie, high aqueous solubility of greater than 0.85 g/mL within the physiologically relevant pH range of 1 to 812 and low lipophilicity [logP–1.75, unpublished data]), which would predict poor passive diffusion across biologic membranes"
But hey, here I am arguing on my weekend about why exactly putting a certain amphetamine prodrug up your ass won't work. What are we doing with our lives?
Ah - I understand these passages such that they describe the passage of the intact LDX molecule into the bloodstream, and I don't see mention of the lysine-amphetamine cleavage action. This describes what part of the intestine is able to pull the whole LDX molecule into the blood. Note the distinction between absorption and metabolism. Later passages:
LDX was not metabolized in vitro by SGF, SIF, or trypsin, [so] any conversion of LDX to d-amphetamine in the GI tract in vivo is likely to be minimal. [...,] consistent with a model of absorption of predominantly intact LDX with subsequent enzymatic conversion to active d-amphetamine and l-lysine.
LDX was metabolized to d-amphetamine in rat and human whole blood but not in plasma. [Red blood cells] are responsible for the presystemic conversion of LDX to d-amphetamine.
LDX was metabolized to d-amphetamine by human RBCs but not by other blood fractions, such as white blood cells or platelets. Moreover, RBCs had a very high capacity for the metabolism of LDX. The rate of metabolism was not substantially reduced until concentrations of RBCs were reduced to 10% of normal hematocrit. Lysis of the RBCs also had little impact on the rate of metabolism of LDX, and nor did EDTA (a calcium chelator that inhibits the activity of calcium-dependent enzymes).
In conclusion, LDX is absorbed as the intact prodrug and converted to inactive l-lysine and active d-amphetamine primarily in the blood by RBCs.
It's fascinating isn't it? :)
I find the effect to be very very different.
Here's a graph of plasma concentration of free dextroamphetamine, time release capsules, and molecular-braked lisdexamfetamine: https://farm1.staticflickr.com/727/23028958560_2ae3ddc5bd_o....
LDX was not metabolized in vitro by SGF, SIF, or trypsin, [so] any conversion of LDX to d-amphetamine in the GI tract in vivo is likely to be minimal. [...,] consistent with a model of absorption of predominantly intact LDX with subsequent enzymatic conversion to active d-amphetamine and l-lysine.
LDX was metabolized to d-amphetamine in rat and human whole blood but not in plasma. [Red blood cells] are responsible for the presystemic conversion of LDX to d-amphetamine.
LDX was metabolized to d-amphetamine by human RBCs but not by other blood fractions, such as white blood cells or platelets. Moreover, RBCs had a very high capacity for the metabolism of LDX. The rate of metabolism was not substantially reduced until concentrations of RBCs were reduced to 10% of normal hematocrit. Lysis of the RBCs also had little impact on the rate of metabolism of LDX, and nor did EDTA (a calcium chelator that inhibits the activity of calcium-dependent enzymes).
In conclusion, LDX is absorbed as the intact prodrug and converted to inactive l-lysine and active d-amphetamine primarily in the blood by RBCs.
It's fascinating isn't it? :)
I find the effect to be very very different.
Here's a graph of plasma concentration of free dextroamphetamine, time release capsules, and molecular-braked lisdexamfetamine: https://farm1.staticflickr.com/727/23028958560_2ae3ddc5bd_o....
New formulations are advances. I'm on Vyvanse and it has way fewer side effects than other amphetamine formulations. I could see someone deciding meds are not for them based on side effects or short duration and the come-down lows, and then have those go away entirely by taking Vyvanse.
There was also some work on repurposing fasoracetam for individuals with glutamate receptor issues, though I think they started with teens instead of adults. [0]
For a 2019 review of novel molecules, see [1].
[0]: https://www.nature.com/articles/s41467-017-02244-2 [1]: https://doi.org/10.1080/14737175.2019.1628640
For a 2019 review of novel molecules, see [1].
[0]: https://www.nature.com/articles/s41467-017-02244-2 [1]: https://doi.org/10.1080/14737175.2019.1628640
> The last new therapy was atomoxetine, which is almost 20 years old now and not seen as terribly efficacious.
I think it's more that it doesn't work for as many people as does stimulant medication. But while it works on fewer people, for those that it does work on (myself and my partner included), it's very effective.
I think it's more that it doesn't work for as many people as does stimulant medication. But while it works on fewer people, for those that it does work on (myself and my partner included), it's very effective.
Has ADD had any kind of effect on your relationships? If so, in what way? I was wondering if ADD might make it seem like one doesn’t care about people because it’s hard to maintain focus on them.
It absolutely does and is extremely challenging for a particular type of partner. There are many books on the subject.
Most ADHD people are also susceptible to RSD (Rejection Sensitive Dysphoria(?)) that can make us feel like the entire planet is crumbling when we experience even minor rejections. As in, suicidal ideation level pain that at some point we have to learn how to move through or just avoid relationships altogether.
Most ADHD people are also susceptible to RSD (Rejection Sensitive Dysphoria(?)) that can make us feel like the entire planet is crumbling when we experience even minor rejections. As in, suicidal ideation level pain that at some point we have to learn how to move through or just avoid relationships altogether.
Yes, this is why I stopped filling my prescription two years ago. I excelled at work but it was damaging my relationship due to being so "zoned in" and at times robotic.
It affect people differently. It makes me much more attentive and able to listen to what my wife has to say. She has been very happy with the effects.
Yeah absolutely. It seems most people get only positive effects.
Must be personal neurochemistry/predisposition. The breaking point hit when my partner showed me a video she took where she called my name 8 times standing right next to me trying to get my attention, and I had no clue. I was so zoned into the screen.
After seeing that I was like damn.
Must be personal neurochemistry/predisposition. The breaking point hit when my partner showed me a video she took where she called my name 8 times standing right next to me trying to get my attention, and I had no clue. I was so zoned into the screen.
After seeing that I was like damn.
Its very hard on relationships.
It's not just seeming like you don't care, but also putting the burden on others when they pick up your slack and frequently letting them down by things you do and/or don't do.
It's not just seeming like you don't care, but also putting the burden on others when they pick up your slack and frequently letting them down by things you do and/or don't do.
I also have ADD. I'm untreated since it's kinda expensive and my job is easy enough to not need to be.
I'm glad that ADD/ADHD is more accepted now because I remember when the idea some people have problems focusing was immediately dismissed as laziness or a fault in character. I didn't even consider getting tested until far into adulthood because of the stigma.
I'm glad that ADD/ADHD is more accepted now because I remember when the idea some people have problems focusing was immediately dismissed as laziness or a fault in character. I didn't even consider getting tested until far into adulthood because of the stigma.
This was an interesting read but, as an adult with ADHD, all I get out of this is that medication is even more of a benefit to those with real difficulties coping with their ADHD. I've always been one to 'just deal with it' but after a few years of working through school and seeing my younger brothers go through the same thing with medication, I realized that I was essentially just handicapping myself.
Now I take medication in the morning before I get to work and it basically lasts me through the work/school day. When I was younger I was perscribed ritalin, and it just made me sleepy so I stopped taking it. Now I take a more modern medication and it works wonders. The negative stigma against medication really harmed me in school, and I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.
Now I take medication in the morning before I get to work and it basically lasts me through the work/school day. When I was younger I was perscribed ritalin, and it just made me sleepy so I stopped taking it. Now I take a more modern medication and it works wonders. The negative stigma against medication really harmed me in school, and I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.
I've been on Adderall for 5 years ... I'm 43 right now.
It really HAS changed my life. What I've found is that over the long term you're able to perform much much better.
By the time I was in my 30s I had developed coping skills which worked for the most part but I would find myself getting demotivated and defocused sometimes on long term priorities and sometimes unable to recommit to them.
Adderall totally changed that. I'm able to focus on tasks long term AND even if something bad happens in my life I'm able to keep right on track.
It's also helped me stay more positive knowing that projects get completed and there's nothing preventing me from accomplishing what I want to accomplish.
There are some downsides though:
- Adderall is illegal in most countries so you're not even allowed to travel with it in some places. I didn't really know this at first and I wish they would tell you. Most countries will overlook it but if you're China they could totally use it as an excuse to harass you if they wanted.
- It's very addictive. If I forget my meds it's basically impossible to function.
- It's VERY hard to get since it's a controlled substance. I'm only able to get it 72 hours ahead of time and if they're out of stock sometimes I have to wait. DO NOT wait until the last minute. Get it as early as possible.
- Some people have problems with off brands of XR (extended release) that has a different formulation. There's no standardization on the XR process and I think it's vendor specific.
It really HAS changed my life. What I've found is that over the long term you're able to perform much much better.
By the time I was in my 30s I had developed coping skills which worked for the most part but I would find myself getting demotivated and defocused sometimes on long term priorities and sometimes unable to recommit to them.
Adderall totally changed that. I'm able to focus on tasks long term AND even if something bad happens in my life I'm able to keep right on track.
It's also helped me stay more positive knowing that projects get completed and there's nothing preventing me from accomplishing what I want to accomplish.
There are some downsides though:
- Adderall is illegal in most countries so you're not even allowed to travel with it in some places. I didn't really know this at first and I wish they would tell you. Most countries will overlook it but if you're China they could totally use it as an excuse to harass you if they wanted.
- It's very addictive. If I forget my meds it's basically impossible to function.
- It's VERY hard to get since it's a controlled substance. I'm only able to get it 72 hours ahead of time and if they're out of stock sometimes I have to wait. DO NOT wait until the last minute. Get it as early as possible.
- Some people have problems with off brands of XR (extended release) that has a different formulation. There's no standardization on the XR process and I think it's vendor specific.
I literally just got diagnosed with adult ADD a month ago. I'm 46! It... explains a lot of things, both for better and for worse. I never even realized I was developing coping skills vs. just developing normal skills, if that makes sense. I definitely have had the same types of problems as you describe.
I've been on Ritalin for a few weeks now, and the difference is remarkable. If this is how normal people feel most of the time, I don't know... I am both relieved to have a name for what was causing me problems, and also feel the need to grieve lost opportunities in life. It's a complex mix of emotions.
I've been on Ritalin for a few weeks now, and the difference is remarkable. If this is how normal people feel most of the time, I don't know... I am both relieved to have a name for what was causing me problems, and also feel the need to grieve lost opportunities in life. It's a complex mix of emotions.
I am nearly 40 and I have wondered for a long time whether I have adult ADD but have been afraid to go down the diagnostic path, because I'm scared I will lose one of the few true talents I have, which is hyperfocus (or the complete opposite, depending) - that said I think this quality is ruining relationships, so while I can hyperfocus on work or projects, my personal life is a mess. But, I don't know if this is ADD, some kind of anxiety, borderline depression, whether it's something else or whether it's just me.
I didn't mean to reply and talk about myself, I actually wanted to ask (if you wanted to share), about what led you to the diagnosis at that age - what kinds of things were not working for you? What were you developing coping skills for?
I didn't mean to reply and talk about myself, I actually wanted to ask (if you wanted to share), about what led you to the diagnosis at that age - what kinds of things were not working for you? What were you developing coping skills for?
I don't want to get in to too much detail on a public board, but the short of it is that several major events in rapid succession (unexpected death of my father, lawsuits involving his estate, Covid just as I was re-growing my IT business, loss of several major clients/income security due to same, a sudden chronic health problem, etc, etc, etc, etc.) overwhelmed my ability to get things done in a timely manner. I sought help, and something in the way I was talking must have piqued my psychiatrist's attention, I got tested, and here we are.
It was a lot of shit, all at once, and it would be easy to shrug and say it would have been hard for anyone. But it was enough of a shock to my abilities that I was able to finally see that I just wasn't firing on all cylinders, even though I am otherwise intelligent and capable.
I have not lost my ability to focus. In fact, it's easier than ever. I've always been very distractible (another common symptom), and suddenly the kids making noise while playing next door, dogs barking, phones ringing no longer wreck the house of cards I'm holding in my mind while working on a problem. It's remarkable.
It was a lot of shit, all at once, and it would be easy to shrug and say it would have been hard for anyone. But it was enough of a shock to my abilities that I was able to finally see that I just wasn't firing on all cylinders, even though I am otherwise intelligent and capable.
I have not lost my ability to focus. In fact, it's easier than ever. I've always been very distractible (another common symptom), and suddenly the kids making noise while playing next door, dogs barking, phones ringing no longer wreck the house of cards I'm holding in my mind while working on a problem. It's remarkable.
Appreciate your answer, thank you - really sorry for the loss of your dad, losing mine really changed a lot of things for me.
Thank you for your kind words. I am sorry for your loss as well. And yeah, it was rough.
Hey! I'm 21 and was diagnosed at 11 or 12. I've learned a LOT about myself just in the past couple years by reading up on additional ADHD symptoms that aren't just school-related (since the diagnoses really just focuses on how my disability impacts others, like teachers and parents). I have a 10mg Ritalin prescription that I was supposed to take twice a day in grade school, one in the morning and another at lunch. I've found that it lasts for about 5 hours. Recently, I started cutting them in half and only taking 5mg whenever I need to do work. Not sure if that sounds bad, but I don't have a problem with any of my symptoms when I'm not doing work I'm not passionate about (most homework). The point is, you don't have to always be on meds once you get them, and you can get a low enough dose to have control over it instead of being on it all day every day. Also, just like the other comments on here, I don't lose my hyperfocus at all when I'm on meds. It just helps me stay "on a roll" instead of wandering off to do other stuff or getting super spaced out. 10/10 would recommend getting diagnosed. Anything you can do to deepen your self understanding is going to be beneficial in the long run. I know I'm only 21, but please trust me on that last part, if nothing else. Best of luck:)
Do you have any experience with the extended-release versions? My doctor has suggested I give them a try as well, (started with the dose/type you mentioned) to see which form works best. Of course, treatment management for this is all pretty new to me, regardless of my age, so I'm interested in hearing other's experiences.
I don't have any experience with extended release, and honestly since I'm in college my doctor grills me more and more every time I go in to renew the prescription. I keep thinking I'm gonna go off of it and then I still need it and objectively that might look sketchy, since I some students sell their meds. I'm scared that if I bring up any other type that might look worse? Anyway, this thread has taught me more about extended release and I'll likely look into that when I start working after graduation.
Thanks for the response, and good luck with your studies.
Didn’t lose hyper focus.
More that I gained “longer” focus.
More that I gained “longer” focus.
THIS!!! it just helps keep me "on a roll" instead of spacing out
I had a bad concussion when I was 12 that ended up tanking my testosterone levels (and god knows what else). I was extremely tired all the time. I didn’t get it properly diagnosed for nearly 15 years, and in that time I turned down going to Ivy League schools and a bunch of other opportunities. I have to admit going on HN can be a bit of a bummer as I always thought I was destined for the lives a lot of people have here (Silicon Valley, startups, etc).
I still got a degree in computer science but with that path I was put on... I’m now a photographer and still live in the same area I grew up in.
I realize you have more years “wasted” but I’ve had quite a bit of time to come to terms with all of that. I think it’s important to keep in mind we all have advantages and disadvantages in life, and chances are if you’re on here you’ve still had a pretty charmed life. You’re intelligent, in a developed country, etc. Most people don’t have that.
I still got a degree in computer science but with that path I was put on... I’m now a photographer and still live in the same area I grew up in.
I realize you have more years “wasted” but I’ve had quite a bit of time to come to terms with all of that. I think it’s important to keep in mind we all have advantages and disadvantages in life, and chances are if you’re on here you’ve still had a pretty charmed life. You’re intelligent, in a developed country, etc. Most people don’t have that.
> I had a bad concussion when I was 12 that ended up tanking my testosterone levels (and god knows what else).
Interesting you mention that. I had a Bicycle->Car accident when I was 8 and I've always been told that's when a number of my behaviors started to change (and I became the black sheep of the family I am now.) I didn't get diagonsed with ADD until I was almost 30, but oddly enough my current care doctor also specializes in head trauma.
Interesting you mention that. I had a Bicycle->Car accident when I was 8 and I've always been told that's when a number of my behaviors started to change (and I became the black sheep of the family I am now.) I didn't get diagonsed with ADD until I was almost 30, but oddly enough my current care doctor also specializes in head trauma.
Brain trauma is scary stuff. Back when it happened to me (the year 2000) the doctors weren’t at all concerned with the concussion. I broke my arm pretty severely and my back also hurt, and that’s all they cared about.
I’m guessing that’d be different now, though I don’t know what extra care they could give. At the very least I think my parents would have thought to tie my sudden energy and worse grades to what happened.
I’m guessing that’d be different now, though I don’t know what extra care they could give. At the very least I think my parents would have thought to tie my sudden energy and worse grades to what happened.
All good points, and worth keeping in mind. I didn't live in the 'states until I was a teen, so I know how lucky I am to be here, too. It's also OK to feel grief over loss at the same time. Like I said, it's a relatively new diagnosis for me, so it's going to take me a while to process things. Overall, I am grateful, though, and that is important to emphasize.
I'm a little bit younger, and pretty much the same on all of this (except vyvanse for me). I really wish I'd figured it out in my teens or twenties.
Also, every time a post on here comes up about elaborate methods of achieving focus the comments are full of people typical-minding what really might actually be ADHD (the whole "everyone is like this right?" thing) and I'm just sitting there like.. maybe you should look into this it probably shouldn't be that hard.
Of course if you post that you get a bunch of replies from people who insist that, "no, actually, it's cell phones' fault" or that it's totally normal to absolutely loathe doing any mundane task.
Also, every time a post on here comes up about elaborate methods of achieving focus the comments are full of people typical-minding what really might actually be ADHD (the whole "everyone is like this right?" thing) and I'm just sitting there like.. maybe you should look into this it probably shouldn't be that hard.
Of course if you post that you get a bunch of replies from people who insist that, "no, actually, it's cell phones' fault" or that it's totally normal to absolutely loathe doing any mundane task.
>mundane task
That's why we invented shell scripts and cron!
On a serious note, what type of tasks would you consider mundane that you attribute to your ADHD to cause you to not want to do them that any non-ADHD person would also not have procrastination problems? Are these specific to work like filling out time sheets or other TPS reports? Home tasks like laundry/dishes/trash? All of the above? As a non-ADHD person, I hate all of the above tasks and only do them because it's part of adulting. Can't get paid without time sheets (this is my biggest hate). I'd rather do laundry (folding/ironing) than fill out time sheets. I have no rational explanation as it is a rather simple thing.
That's why we invented shell scripts and cron!
On a serious note, what type of tasks would you consider mundane that you attribute to your ADHD to cause you to not want to do them that any non-ADHD person would also not have procrastination problems? Are these specific to work like filling out time sheets or other TPS reports? Home tasks like laundry/dishes/trash? All of the above? As a non-ADHD person, I hate all of the above tasks and only do them because it's part of adulting. Can't get paid without time sheets (this is my biggest hate). I'd rather do laundry (folding/ironing) than fill out time sheets. I have no rational explanation as it is a rather simple thing.
I'll try explaining this one and maybe why you're being downvoted.
The difference is that buckling down and focusing... Don't always work for me. That's the fundamental difference that normal people don't get. That rather simple thing is basically the problem.
I'm pretty good at "adulting" and otherwise coping with my life but I hit roadblocks that other people sail by. I can do very complicated, difficult and tedious tasks but sometimes get stuck doing simple things like paying a parking ticket. I know how to do it. I know when it's due. I know I'll pay a penalty if I pay it late. I think about it all the time. But doing it is like lifting an incredibly heavy weight. Normal people don't feel the weight and think I'm lazy.
The difference is that buckling down and focusing... Don't always work for me. That's the fundamental difference that normal people don't get. That rather simple thing is basically the problem.
I'm pretty good at "adulting" and otherwise coping with my life but I hit roadblocks that other people sail by. I can do very complicated, difficult and tedious tasks but sometimes get stuck doing simple things like paying a parking ticket. I know how to do it. I know when it's due. I know I'll pay a penalty if I pay it late. I think about it all the time. But doing it is like lifting an incredibly heavy weight. Normal people don't feel the weight and think I'm lazy.
Sibling's explanation is pretty good really. I would also have trouble doing timesheets (have thankfully never had a job that required them) but not because of adhd, just because they seem pointless and like they bring no value to my life at all. Standard adulting things are only an issue in so far as they are often out of sight out of mind, and that's a common struggle for people with ADHD (drawers are our enemy).
Mundane is probably not exactly the right word tbh, but it's hard to find the right word. I think it would be more accurate to describe it as things with a lot of upfront planning involved. If I can basically react my way through something to completion I can get into hyperfocus and just blaze through it.
A lot of the time the way I've gotten around this is to force it to be an emergency so I can't think about it too much. Either by leaving it to the last second or just convincing myself.
And that's a really common pattern you see in people before they get ADHD diagnoses.
Mundane is probably not exactly the right word tbh, but it's hard to find the right word. I think it would be more accurate to describe it as things with a lot of upfront planning involved. If I can basically react my way through something to completion I can get into hyperfocus and just blaze through it.
A lot of the time the way I've gotten around this is to force it to be an emergency so I can't think about it too much. Either by leaving it to the last second or just convincing myself.
And that's a really common pattern you see in people before they get ADHD diagnoses.
>As a non-ADHD person, I hate all of the above tasks and only do them because it's part of adulting.
The difference being my wife breaks down in tears every 3 months because she woke up to dishes in the sink _again_ and wasn't able to use her coffee cup because, though I meant to do them and said I would, I wound up not doing them.
That was the first 5 years of my marriage. Repeat for laundry. Repeat for trash.
For work I was on a list of 5 people out of 1000 person company who's names had gone all the way to the CEO for not filling out timesheets correctly.
I hope that makes the problem a little clearer for those who think "but everyone has trouble with that stuff"
The difference being my wife breaks down in tears every 3 months because she woke up to dishes in the sink _again_ and wasn't able to use her coffee cup because, though I meant to do them and said I would, I wound up not doing them.
That was the first 5 years of my marriage. Repeat for laundry. Repeat for trash.
For work I was on a list of 5 people out of 1000 person company who's names had gone all the way to the CEO for not filling out timesheets correctly.
I hope that makes the problem a little clearer for those who think "but everyone has trouble with that stuff"
^^^^yes. it's different than procrastination. it's MORE than procrastination. if part of my is scared of a certain task (because stress is biologically the same as fear), it's sometimes like my brain wont't "let" me do it. even if i try, I'll sit there thinking about it torturing myself instead of getting it over-with. it truly is crippling at times. I know it sounds dramatic to non_ADHD and neurotypical people, but if you are committed to making an equitable space, you have to trust and believe that the disabled person is telling you the truth.
> I never even realized I was developing coping skills vs. just developing normal skills
do you have some examples? i suspect the majority of mine are the former
do you have some examples? i suspect the majority of mine are the former
Sure. I'm happy to share individually, but I don't really want to post them on a public board. My email's in my profile if you want.
how do i see it in your profile?
It, uh, helps that I make sure it's visible to others first. Sorry about that. Please check my profile again.
You know what's totally nuts? Taking Amphetamine daily for years in reasonable doses essentially has no long term negative effects. In that way, similar to coffee.
When I think about that, it's kind of mind blowing.
For that matter, it is also crazy that we don't start giving children coffee at younger ages to help focus — since there are no known negative effects. It's just a cultural trope that it stunts growth, etc. It took ages before people recognized that there weren't really health downsides to coffee. We are so trained to expect that "every up has a down" — but what if that's just a relic of Calvinism and we are inhibiting our full potential because of misplaced fears?
When I think about that, it's kind of mind blowing.
For that matter, it is also crazy that we don't start giving children coffee at younger ages to help focus — since there are no known negative effects. It's just a cultural trope that it stunts growth, etc. It took ages before people recognized that there weren't really health downsides to coffee. We are so trained to expect that "every up has a down" — but what if that's just a relic of Calvinism and we are inhibiting our full potential because of misplaced fears?
> we don't start giving children coffee at younger ages to help focus
> we are inhibiting our full potential because of misplaced fears?
I'll argue with the assumption that there is zero long term psychobiological consequences to exogenous psychostimulants (I personally don't buy this, but let's assume it was true). Increasing focus and task salience is only one of the many factors constitutive of human potential. They never give the answer for what to focus on, or whether a task is worth it or not, and rob the person of the opportunity for developing frustration tolerance. They turn people into indiscriminate doing machines, with little wisdom to guide it. Makes one think if prescription amphetamines being as widespread among plumbers as software engineers is truly a coincidence.
I will argue this is because our bioeconomics, our not wanting to do things is also part of our wisdom machinery. Having used for half a decade myself, I can spot some collogues who are on amphetamines; unnecessarily assertive, obsessed with orderliness of code, constantly in need of refactoring, huge bias for action with diminished wisdom to temper it (Well, also pees a lot.). There is a reason they are not being used by fighter pilots anymore because they can get too cocky and make decisions that kill their own.
No wonder everything looks like a good idea when your brain is swimming in dopamine and norepinephrine, but when everything looks like a good idea, how do you find what is the right thing to do in the medium/long term? Is that really the human potential? I would argue far from it. I think it is just enhancing the potential for a particular job description that requires you to sit on your bum all day and plumb boring stuff someone else tells you to.
I'll argue with the assumption that there is zero long term psychobiological consequences to exogenous psychostimulants (I personally don't buy this, but let's assume it was true). Increasing focus and task salience is only one of the many factors constitutive of human potential. They never give the answer for what to focus on, or whether a task is worth it or not, and rob the person of the opportunity for developing frustration tolerance. They turn people into indiscriminate doing machines, with little wisdom to guide it. Makes one think if prescription amphetamines being as widespread among plumbers as software engineers is truly a coincidence.
I will argue this is because our bioeconomics, our not wanting to do things is also part of our wisdom machinery. Having used for half a decade myself, I can spot some collogues who are on amphetamines; unnecessarily assertive, obsessed with orderliness of code, constantly in need of refactoring, huge bias for action with diminished wisdom to temper it (Well, also pees a lot.). There is a reason they are not being used by fighter pilots anymore because they can get too cocky and make decisions that kill their own.
No wonder everything looks like a good idea when your brain is swimming in dopamine and norepinephrine, but when everything looks like a good idea, how do you find what is the right thing to do in the medium/long term? Is that really the human potential? I would argue far from it. I think it is just enhancing the potential for a particular job description that requires you to sit on your bum all day and plumb boring stuff someone else tells you to.
I’ve read a lot of comments around amphetamines. This is probably my favorite.
Amps turn you into a drone. Any perceived benefit is met with equal or greater detriment.
Amps turn you into a drone. Any perceived benefit is met with equal or greater detriment.
+1 thanks for this
Feels like every week someone here is touting the idea of ADHD meds being this solution, all these people are just undiagnosed, there’s an unfair stigma against, and I feel compelled to bring up that I bought into that thinking, got a legit diagnosis and took meds as prescribed, they triggered mania in me and nearly ruined my life.
I tick all the ADHD boxes but I managed to make it through college without meds so never should have started.
Psychiatry is broken and handing out prescription amphetamines to everyone who can’t focus is as bad as an idea as it initially sounds.
I tick all the ADHD boxes but I managed to make it through college without meds so never should have started.
Psychiatry is broken and handing out prescription amphetamines to everyone who can’t focus is as bad as an idea as it initially sounds.
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I mean comments like this are the reason there's such a stigma against medication. It's kind of ignorant to say that "psychiatry is broken", "my meds ruined my life", or "I made it through school without them so I never needed them" as if none of those things had anything to do with you.
Someone in the same situation might feel much the opposite, but they also shouldn't use their experience to convince people that their attempt at treating a condition they have is inherently a bad choice.
Someone in the same situation might feel much the opposite, but they also shouldn't use their experience to convince people that their attempt at treating a condition they have is inherently a bad choice.
You might just be smart / high IQ so you could still stumble through college. Imagine what more you could of accomplished if you didn't? Higher abilities need higher standards.
Also you don't have to actually take the medications at all to get an ADHD testing battery. Then you'll know if you actually have ADHD or if you actually didn't. If you don't then your comments are a bit insensitive. Self-diagnoses of various medical conditions by the untrained is notoriously inaccurate.
Also you don't have to actually take the medications at all to get an ADHD testing battery. Then you'll know if you actually have ADHD or if you actually didn't. If you don't then your comments are a bit insensitive. Self-diagnoses of various medical conditions by the untrained is notoriously inaccurate.
Thank you for writing this. As someone who has recently been weighing the pros/cons of seeking treatment for ADHD, this has been one of the best points I've read on the potential downsides to it. Currently, in my career (software dev) I've been feeling increasingly burnt out and like it's impossible to focus on anything. I have to sit back and ask myself, is the problem that I can't focus, or is the problem that I'm doing something that I feel is meaningless?
If I got treatment for ADHD, maybe then I would be able to finally churn through all of my tasks and be a top performer in terms of closing stories. If I didn't pursue treatment, then maybe I continue to be unable to focus and completely burn out, resulting in the loss of my job. Maybe after that I pivot my career to where I'm doing something that I find to be more fulfilling. What's the better outcome?
If I got treatment for ADHD, maybe then I would be able to finally churn through all of my tasks and be a top performer in terms of closing stories. If I didn't pursue treatment, then maybe I continue to be unable to focus and completely burn out, resulting in the loss of my job. Maybe after that I pivot my career to where I'm doing something that I find to be more fulfilling. What's the better outcome?
If anything ADHD medications (ritalin) make me _more_ prone to burning out, not less. Just FYI.
It does help with "boring" tasks a little bit, in a sense, but they're still boring an uninteresting. It's not like I get a dopamine hit every time I do a piece of paperwork.
I usually describe it like this: for me ADHD sometimes makes things that are necessary for human life _really_ hard. Things like taking a shower in the morning or having breakfast, getting up to get water while working etc.
All these things take a toll on my day, I still do them but I feel like I'm doing something that I _absolutely_ don't want to do and at the end of the day I don't have any patient left for stuff that actually require my effort (e.g. listening to my wife when she's frustrated with me).
With medication I feel better about doing these necessary things so I can get to the end of the day without hating myself. That doesn't mean I'm gonna eat all the bullshit that gets thrown to me at work!
It's also not all roses, Ritalin is hard to manage, at least for me. I need to make a conscious effort to not devote too much of my attention to uninteresting details, etc. But it's not like it takes away your free will!
It does help with "boring" tasks a little bit, in a sense, but they're still boring an uninteresting. It's not like I get a dopamine hit every time I do a piece of paperwork.
I usually describe it like this: for me ADHD sometimes makes things that are necessary for human life _really_ hard. Things like taking a shower in the morning or having breakfast, getting up to get water while working etc.
All these things take a toll on my day, I still do them but I feel like I'm doing something that I _absolutely_ don't want to do and at the end of the day I don't have any patient left for stuff that actually require my effort (e.g. listening to my wife when she's frustrated with me).
With medication I feel better about doing these necessary things so I can get to the end of the day without hating myself. That doesn't mean I'm gonna eat all the bullshit that gets thrown to me at work!
It's also not all roses, Ritalin is hard to manage, at least for me. I need to make a conscious effort to not devote too much of my attention to uninteresting details, etc. But it's not like it takes away your free will!
I'm not sure that the affects of stimulants for ADD are across the board, as you describe. That is, for lots of people, me included, add meds seem to boost my executive functions.
Without them, I actually have no problem focusing on certain things, but it's usually some unimportant problem or project that I become distracted by.
With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life. I become more attentive to my family, less irritated by distractions. And more a able to get important things done, like my taxes, that before would plague me.
I know some people seem to react to the meds by turning into a worker drone, But it doesn't do that to me. It does make me more excited to make progress and get things done right.
Without them, I actually have no problem focusing on certain things, but it's usually some unimportant problem or project that I become distracted by.
With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life. I become more attentive to my family, less irritated by distractions. And more a able to get important things done, like my taxes, that before would plague me.
I know some people seem to react to the meds by turning into a worker drone, But it doesn't do that to me. It does make me more excited to make progress and get things done right.
I might have over-emphasized the worker drone persona. But I think the potential for self-deception and long term foolishness is still there across the board.
> With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life.
Executive function boost is non-negligible for sure, but it is still bound to operate in the short term.
Think your bioeconomics as a ledger, your energy levels as income and what you want to do as payments. Stimulants alter this ledger and as long as you can use them you will think you have a lot more income and you can sign up for more things to do. But do you really do have more income in the long term? Are you borrowing from your future income? Your future dopaminergic system? Your future neuroticism levels? I know the research is either missing or contested, but everything from evening crashes to need for increasing the dosage to long term dependence risk suggests that we are borrowing something from somewhere.
> I become more attentive to my family, less irritated by distractions.
Let me play the devil's advocate for a second: How do you know being more attentive to your family is the right thing? Maybe they are real assholes taking you for granted and getting irritated with them would make them get their act together and have a better chance in long term sustainable relationship. How do you know the distractions are not irritation worthy? Maybe they are things you need to get to the root of instead of enduring continuously.
I am exaggerating to make a point, and I'm sure you're mostly fine, but the danger is that thinking you have more "income" than you do will affect all your decisions in a way that accumulates and might not be long term sustainable. It can make you more conforming, and this will be praised by your family, boss, for the case with kids, their parents, but can we say with certainty that being more conforming all the time is really in one's best interest? Anger, irritation, anxiety, depression and even boredom, they are not there just as human failings but also as normal processes that can counter-balance over-exertion, over-exposure, weakly defended personal boundaries, meaninglessness, resentment.
Only way to know how continuous stimulant use is affecting you is to take a long break after multi-year use and evaluate where your life is, which for some people can be too late.
> With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life.
Executive function boost is non-negligible for sure, but it is still bound to operate in the short term.
Think your bioeconomics as a ledger, your energy levels as income and what you want to do as payments. Stimulants alter this ledger and as long as you can use them you will think you have a lot more income and you can sign up for more things to do. But do you really do have more income in the long term? Are you borrowing from your future income? Your future dopaminergic system? Your future neuroticism levels? I know the research is either missing or contested, but everything from evening crashes to need for increasing the dosage to long term dependence risk suggests that we are borrowing something from somewhere.
> I become more attentive to my family, less irritated by distractions.
Let me play the devil's advocate for a second: How do you know being more attentive to your family is the right thing? Maybe they are real assholes taking you for granted and getting irritated with them would make them get their act together and have a better chance in long term sustainable relationship. How do you know the distractions are not irritation worthy? Maybe they are things you need to get to the root of instead of enduring continuously.
I am exaggerating to make a point, and I'm sure you're mostly fine, but the danger is that thinking you have more "income" than you do will affect all your decisions in a way that accumulates and might not be long term sustainable. It can make you more conforming, and this will be praised by your family, boss, for the case with kids, their parents, but can we say with certainty that being more conforming all the time is really in one's best interest? Anger, irritation, anxiety, depression and even boredom, they are not there just as human failings but also as normal processes that can counter-balance over-exertion, over-exposure, weakly defended personal boundaries, meaninglessness, resentment.
Only way to know how continuous stimulant use is affecting you is to take a long break after multi-year use and evaluate where your life is, which for some people can be too late.
I think you are probably right that "conforming" may not always be the best way to handle things. But most people that end up being diagnosed with ADD are already very non-conforming and they want to just be nudged closer to average.
Now, if your goal is to swing for the fences and try to hit a home run, get to the top of your field, make a grand discovery, then ya, most of those kind of people are very non-coforming. But many are/were also very unhappy personally. In fact, many of the greatest outliers in our history suffered from manic depression or ADD or other mental issues.
Personally, I'm not swinging for the fences. I'm going to bunt if it means I have a much better chance of getting on base. Steve Jobs was very non-conforming. He was always very irritated and unpleasant with everyone around him. And sure, it seems to have had results. But I have no interest in becoming the next Steve Jobs if it means having what appears to have been an unhappy life with an early death.
Now, if your goal is to swing for the fences and try to hit a home run, get to the top of your field, make a grand discovery, then ya, most of those kind of people are very non-coforming. But many are/were also very unhappy personally. In fact, many of the greatest outliers in our history suffered from manic depression or ADD or other mental issues.
Personally, I'm not swinging for the fences. I'm going to bunt if it means I have a much better chance of getting on base. Steve Jobs was very non-conforming. He was always very irritated and unpleasant with everyone around him. And sure, it seems to have had results. But I have no interest in becoming the next Steve Jobs if it means having what appears to have been an unhappy life with an early death.
Very well put. Focus is a double edged sword.
Focus and discipline is very useful when solutions to problems are known.
But put someone extremely methodical in charge of R&D and they will take a zillion years to explore a large search space. Meanwhile a neurotic will run around randomly and stumble upon all kinds of things on the map. The down side with the neurotic mind, is after a prospective gold mine is found and a lot of methodical, disciplined work is required to exploit it they flake out.
Now if you pair them up interesting things unfold.
We are quiet good at identifying people's strengths and weakness. But we spend a lot of time exploiting weakness and squandering strengths of people.
If only the opposite happened more.
With better and growing understanding of how different minds work, I think we will see people compensating for each others weaknesses more.
Focus and discipline is very useful when solutions to problems are known.
But put someone extremely methodical in charge of R&D and they will take a zillion years to explore a large search space. Meanwhile a neurotic will run around randomly and stumble upon all kinds of things on the map. The down side with the neurotic mind, is after a prospective gold mine is found and a lot of methodical, disciplined work is required to exploit it they flake out.
Now if you pair them up interesting things unfold.
We are quiet good at identifying people's strengths and weakness. But we spend a lot of time exploiting weakness and squandering strengths of people.
If only the opposite happened more.
With better and growing understanding of how different minds work, I think we will see people compensating for each others weaknesses more.
>> "I think it is just enhancing the potential for a particular job description that requires you to sit on your bum all day and plumb boring stuff someone else tells you to."
Agreed! Not that this is going to make me stop taking it as needed because this is the society we live in (and I'm currently in college), but yeah. I was just talking to a parent of a 5th grader the other day and they were telling me all about how often their kid got in trouble at school (like I did in elementary school), and how she read up on the neuroscience and decided medicating was appropriate. They had me thus far, until they went on about how they didn't tell anyone at the school (it's beneficial t share this with teachers...) until the staff sent emails regarding the kid's improved behavior. One person even reached out and said "your kid hasn't been himself all week." SO I THOUGHT THE PARent was going to say that's what made them change the dose, BUT THEY DIDN'T!!! They took "your child hasn't been himself" as a COMPLIMENT. Something is very wrong here and it's not the parent's fault, it's our priorities in America regarding an outdated school system and long work week. Obedience is valued more than creativity. How are we supposed to improve with that mindset?
Agreed! Not that this is going to make me stop taking it as needed because this is the society we live in (and I'm currently in college), but yeah. I was just talking to a parent of a 5th grader the other day and they were telling me all about how often their kid got in trouble at school (like I did in elementary school), and how she read up on the neuroscience and decided medicating was appropriate. They had me thus far, until they went on about how they didn't tell anyone at the school (it's beneficial t share this with teachers...) until the staff sent emails regarding the kid's improved behavior. One person even reached out and said "your kid hasn't been himself all week." SO I THOUGHT THE PARent was going to say that's what made them change the dose, BUT THEY DIDN'T!!! They took "your child hasn't been himself" as a COMPLIMENT. Something is very wrong here and it's not the parent's fault, it's our priorities in America regarding an outdated school system and long work week. Obedience is valued more than creativity. How are we supposed to improve with that mindset?
> You know what's totally nuts? Taking Amphetamine daily for years in reasonable doses essentially has no long term negative effects. In that way, similar to coffee.
This is a null hypothesis that hasn't been refuted due to lack of evidence, and not an alternative hypothesis that has been proven by evidence, right?
I ask because I've been looking into this before, and from what I remember there was virtually no evidence on long term use in reasonable amounts.
(There is evidence on short term use in reasonable amounts, and long term use in unreasonable amounts, though.)
This is a null hypothesis that hasn't been refuted due to lack of evidence, and not an alternative hypothesis that has been proven by evidence, right?
I ask because I've been looking into this before, and from what I remember there was virtually no evidence on long term use in reasonable amounts.
(There is evidence on short term use in reasonable amounts, and long term use in unreasonable amounts, though.)
Well, it's scientifically difficult to randomly assign people and assess effects for multiple decades. So the ideal evidence won't be available.
But if we accept a "nutrition science" level of evidence, then I'd say there is strong evidence showing the naturalistic longterm use of adhd meds is not dangerous. Especially considering our baysian prior: a person off the street would estimate far stronger negative effects of taking speed every single day.
In fact, adhd meds are correlated with healthier outcomes (of course, huge selection effects. Yes, eating kale will be associated with increased health, but it isn't causal)
Here is the best recent review that I know of: https://www.sciencedirect.com/science/article/pii/S0924977X1...
I'd love to know your take.
But if we accept a "nutrition science" level of evidence, then I'd say there is strong evidence showing the naturalistic longterm use of adhd meds is not dangerous. Especially considering our baysian prior: a person off the street would estimate far stronger negative effects of taking speed every single day.
In fact, adhd meds are correlated with healthier outcomes (of course, huge selection effects. Yes, eating kale will be associated with increased health, but it isn't causal)
Here is the best recent review that I know of: https://www.sciencedirect.com/science/article/pii/S0924977X1...
I'd love to know your take.
> In fact, adhd meds are correlated with healthier outcomes (of course, huge selection effects. Yes, eating kale will be associated with increased health, but it isn't causal)
Yeah, I'd say p much impossible to untangle there without experimental evidence.
Yeah, I'd say p much impossible to untangle there without experimental evidence.
In some cultures it's common to give kids coffee. My parents didn't give me coffee when I was a kid but my wife's parents started giving it to her at an early age. My kids both drink coffee. My older one started on black coffee when he was 2. It's just a routine part of his day. Coffee at breakfast and then at cafecito in the afternoon.
Coffee has been shown to reduce the length and quality of REM sleep, which is very important for early brain development. Read the relevant section in ‘Why We Sleep’ and you may change your mind.
I drank coffee for several years (around 4 cups a day, not later than 4pm) and suffered from insomnia and didn’t know the origin. Since I stopped caffeine intake, my insomnia is basically gone and I feel a lot more functional because of better sleep.
So my impression (yeah I have to admit it’s a study of size 1) is rather that caffeine is more dangerous than I thought.
So my impression (yeah I have to admit it’s a study of size 1) is rather that caffeine is more dangerous than I thought.
I wonder what it means if I can drink 4 espressos before bed and sleep like a baby... does anyone have research on caffeine metabolisms and ADHD / other diagnoses?
Not everyone is the same. I have heard of drug addicts who could only drop heroin by replacing it with massive amounts of highly-caffeinated energy drinks, in quantities that would be objectively bad for most regular folks.
I only managed to drop drinking a shit tonne of Red Bull once I started Ritalin.
Wow that explains a friend’s monster energy intake
Yeah I know several people who tell me the same like you... Again not proper science but it seems that caffeine tolerance and metabolism is quite different from person to person.
> For that matter, it is also crazy that we don't start giving children coffee at younger ages to help focus — since there are no known negative effects.
Might as well, we already load them up with sugar, which does have known side-effects.
Sarcasm aside, maybe not a direct negative side effect, but if you suffer from poor sleep, drinking too much coffee or drinking coffee too late in the day has correlation and lack of sleep certainly has negative side-effect.
Personally, I'll keep my kids off coffee and other drugs until they're old enough to buy it themselves.
Might as well, we already load them up with sugar, which does have known side-effects.
Sarcasm aside, maybe not a direct negative side effect, but if you suffer from poor sleep, drinking too much coffee or drinking coffee too late in the day has correlation and lack of sleep certainly has negative side-effect.
Personally, I'll keep my kids off coffee and other drugs until they're old enough to buy it themselves.
> You know what's totally nuts? Taking Amphetamine daily for years in reasonable doses essentially has no long term negative effects. In that way, similar to coffee.
Wow, that is truly amazing. I'm glad to learn about that.
I notice a slight depression if I stop taking my ADHD meds for a few days (perhaps up to a week), but after that I'm back to my old (ADHD-driven) self. So in a sense, it's not addictive at all. The depression can tempt one to get back on it, but that's about it.
One side effect of Adderall though is ED, and it's pretty bad. I guess it depends on the person, but for me, the ED was quite bad. The ED does go away after getting off of it.
Wow, that is truly amazing. I'm glad to learn about that.
I notice a slight depression if I stop taking my ADHD meds for a few days (perhaps up to a week), but after that I'm back to my old (ADHD-driven) self. So in a sense, it's not addictive at all. The depression can tempt one to get back on it, but that's about it.
One side effect of Adderall though is ED, and it's pretty bad. I guess it depends on the person, but for me, the ED was quite bad. The ED does go away after getting off of it.
> So in a sense, it's not addictive at all.
You definitely have a withdrawal from adderall. A few days (up to a week) is typical of most drug withdrawals.
You definitely have a withdrawal from adderall. A few days (up to a week) is typical of most drug withdrawals.
I had the same problem with Adderall. So I switched to Ritalin and my life has been much better. Adderall also made me constipated, sweaty, unable to sleep... my circulation got so bad my hands would freeze up at my desk, so I would layer on clothes and sit there sweating with frozen hands and feet. I don’t know how the seemingly most popular ADHD drug could give me so many side effects.
> One side effect of Adderall though is ED, and it's pretty bad. I guess it depends on the person, but for me, the ED was quite bad. The ED does go away after getting off of it.
The drugs for that are very easy to get these days - you can get a prescription online by taking a survey and the pills will be mailed to you without ever talking to a human.
The drugs for that are very easy to get these days - you can get a prescription online by taking a survey and the pills will be mailed to you without ever talking to a human.
Well, the drugs for ED (e.g. Sildenafil) are quite bad / not really good for your health.
It's probably a lot better in the long-run to use exercise as a cure for ADHD.
(Instead of slamming your system with drugs upon drugs. With one drug taken to mitigate another's side effects, etc.)
It's probably a lot better in the long-run to use exercise as a cure for ADHD.
(Instead of slamming your system with drugs upon drugs. With one drug taken to mitigate another's side effects, etc.)
They are also ridiculously expensive.
The big popular ones that advertise (Hims and Roman) are very overpriced. I found Blink Health sells a generic version for much cheaper ($2 a pill).
Some children are given coke, pepsi, mountain due or other soda drinks with high caffeine content.
None of those drinks have anywhere near the caffeine of coffee, though. An energy drink of some kind probably does though.
That’s not true. ~100mg in a cup of coffee, 40mg in an espresso shot, the same 40mg in a can of Coca-Cola (and ~60mg in Diet Coke).
Caffeine in an espresso shot (and conversely one cappuccino) is ~63-77mg[1], and one can of Coca-Cola & Diet is 32mg & 42mg[2].
[1] Nespresso is 63mg (5g of coffee), "average" espresso is 77mg (7g of coffee) https://www.caffeineinformer.com/caffeine-content/espresso
[2] https://www.coca-cola.co.uk/ingredients/caffeine/the-caffein...
[1] Nespresso is 63mg (5g of coffee), "average" espresso is 77mg (7g of coffee) https://www.caffeineinformer.com/caffeine-content/espresso
[2] https://www.coca-cola.co.uk/ingredients/caffeine/the-caffein...
It would seem some espresso do have the same caffeine as a can of coke, some even clock in less, but ya on average it seems to have about double the amount.
That said, most coffee shop serve double espressos as standard, so if you factor that in, it seems on average your cup of cappuccino might have four time the caffeine than a can of coke.
That said, most coffee shop serve double espressos as standard, so if you factor that in, it seems on average your cup of cappuccino might have four time the caffeine than a can of coke.
That's true, forgot about that part (and why I take them into account as "2 shots" in my max daily coffees).
There's also a couple Nespresso (maybe Keurig and others, too) capsules with double the caffeine content: Kazaar and Napoli.
There's also a couple Nespresso (maybe Keurig and others, too) capsules with double the caffeine content: Kazaar and Napoli.
Ok, I'll try to jump in here.
a) There are downsides to coffee. I know of a clinical neurologist (Steve Novella) who, when working with a patient with chronic headaches, will always ask "how much coffee do you drink." Always remember, if a "medicine" is doing good, it will have side effects. Period. Note that homeopaths simply love going on about how homeopathy doesn't have any side effects - spoiler, that's because it's not actually doing anything at a physical level.
b) Yes, daily use of stimulants in people with ADHD has been show to be pretty much ok. In fact, there are studies showing that kids who are not medicated are more likely to end up as substance abusers, largely because they're self medicating (remember, drug abuse is a symptom++). However, the kids who were treated with stimulants? No more risk than their neuro-typical peers.
c) The above says NOTHING WHATSOEVER about neuro-typicals taking it daily.
++ Source: my partner, currently doing her neuro-psych masters on addiction.
a) There are downsides to coffee. I know of a clinical neurologist (Steve Novella) who, when working with a patient with chronic headaches, will always ask "how much coffee do you drink." Always remember, if a "medicine" is doing good, it will have side effects. Period. Note that homeopaths simply love going on about how homeopathy doesn't have any side effects - spoiler, that's because it's not actually doing anything at a physical level.
b) Yes, daily use of stimulants in people with ADHD has been show to be pretty much ok. In fact, there are studies showing that kids who are not medicated are more likely to end up as substance abusers, largely because they're self medicating (remember, drug abuse is a symptom++). However, the kids who were treated with stimulants? No more risk than their neuro-typical peers.
c) The above says NOTHING WHATSOEVER about neuro-typicals taking it daily.
++ Source: my partner, currently doing her neuro-psych masters on addiction.
increased impulsiveness and sleep quality are know negative impacts
I started taking it in my late 30s for ADD and it was life changing. Over time though it was making me super angry so I stopped taking it. I now focus on sleep and exercise but my career really accelerated while I was taking it.
Same here. Super angry about some random guy wearing a blue sweater that I didn’t like for example. It made no sense to me why I was that angry, but it went away after quitting... I was seriously afraid to kill somebody if I would continue taking it.
I got like that on Ritalin & quit stims for 10 years.
After that 10, I tried amphetamine which blew holes in my persistent brain fog. I went on Adderall and (as we've often heard) it changed my life.
I'm not advocating you change a regimen that is obviously working for you. I'm just adding another possible plotline to that same story.
After that 10, I tried amphetamine which blew holes in my persistent brain fog. I went on Adderall and (as we've often heard) it changed my life.
I'm not advocating you change a regimen that is obviously working for you. I'm just adding another possible plotline to that same story.
I was on prozac with adderall and I have uncontrollable anger. I immediately got off of it. The problem might be with adderall or the mixture (if you're taking other meds).
> Some people have problems with off brands of XR (extended release) that has a different formulation. There's no standardization on the XR process and I think it's vendor specific.
“Aderall” is a mixture of dextroamphetamine and levoamphetamine, in a 3:1 ratio. Unlike some other drugs, both enantiomers have a therapeutic effect, but slightly different effects on the brain.
If one takes pure dextroamphetamine (“Dexedrine”) instead, that is also available as an inactive prodrug lisdexamfetamine (“Vyvanse”). This is different from an XR formulation, in that the drug is absorbed immediately, but lisdexamfetamine itself has no effect on the brain. However, enzymes in your red blood cells gradually convert the lisdexamfetamine to dexamphetamine. The advantage of this, is unlike an XR formulation, there should be no difference between different manufacturers.
“Aderall” is a mixture of dextroamphetamine and levoamphetamine, in a 3:1 ratio. Unlike some other drugs, both enantiomers have a therapeutic effect, but slightly different effects on the brain.
If one takes pure dextroamphetamine (“Dexedrine”) instead, that is also available as an inactive prodrug lisdexamfetamine (“Vyvanse”). This is different from an XR formulation, in that the drug is absorbed immediately, but lisdexamfetamine itself has no effect on the brain. However, enzymes in your red blood cells gradually convert the lisdexamfetamine to dexamphetamine. The advantage of this, is unlike an XR formulation, there should be no difference between different manufacturers.
I’m currently switching to Vyvanse after 10+ years using adderall. There is no generic formulation (at least in the us) because it came to market in 2007. I’ve had several issues with inconsistent adderall from various generic manufacturers and that issue simply isn’t possible right now with Vyvanse. The downside is, it’s $400 a month without insurance, and $100 a month with good insurance.
Because it’s basically dextroamphetamine with a lysine molecule taped on, the psychoactive effects are really similar, but I’d describe it as cleaner if that makes sense. The “killer feature” of the enzymatic release is it’s basically a fixed timing, whereas with XR formulations of Adderall you have a 50/50 blend of immediate and delayed release 3:1 amphetamines. I believe you are correct, it’s not standardized. This, combined with the acids / bases both hurting overall blood levels (think grapefruit juice) means you just have a wildly inconsistent time over long term use of the medicine. For example, I’ve had pharmacies change generics on me without saying anything, I’ve had an inability to get my preferred generics, and I’ve had days where it’s felt like I took nothing at all. The worst are Nuvo and Mallinckrodt in my experience (IR 10mg 2x/day).
I’ve only been using Vyvanse for a week or so, but I can say it’s a marked improvement for me and the lack of a generic is a huge boon with regards to consistency.
Because it’s basically dextroamphetamine with a lysine molecule taped on, the psychoactive effects are really similar, but I’d describe it as cleaner if that makes sense. The “killer feature” of the enzymatic release is it’s basically a fixed timing, whereas with XR formulations of Adderall you have a 50/50 blend of immediate and delayed release 3:1 amphetamines. I believe you are correct, it’s not standardized. This, combined with the acids / bases both hurting overall blood levels (think grapefruit juice) means you just have a wildly inconsistent time over long term use of the medicine. For example, I’ve had pharmacies change generics on me without saying anything, I’ve had an inability to get my preferred generics, and I’ve had days where it’s felt like I took nothing at all. The worst are Nuvo and Mallinckrodt in my experience (IR 10mg 2x/day).
I’ve only been using Vyvanse for a week or so, but I can say it’s a marked improvement for me and the lack of a generic is a huge boon with regards to consistency.
> Vyvanse. The downside is, it’s $400 a month without insurance, and $100 a month with good insurance.
Here in Australia, one month supply (30 tablets) costs 30 USD. The Australian government subsidises prescriptions for all Australian citizens and permanent residents. I believe the actual cost, prior to the subsidy, is around 85 USD. The government negotiates prices with the pharmaceutical manufacturers, and the prices it negotiates are generally less than those that US insurers pay. Manufacturers generally accept less revenue for the Australian market, since if they can't get it subsidised by the Australian government it becomes quite difficult to sell it here.
Here in Australia, one month supply (30 tablets) costs 30 USD. The Australian government subsidises prescriptions for all Australian citizens and permanent residents. I believe the actual cost, prior to the subsidy, is around 85 USD. The government negotiates prices with the pharmaceutical manufacturers, and the prices it negotiates are generally less than those that US insurers pay. Manufacturers generally accept less revenue for the Australian market, since if they can't get it subsidised by the Australian government it becomes quite difficult to sell it here.
Here are the prices the NHS has to pay.
https://bnf.nice.org.uk/medicinal-forms/lisdexamfetamine-mes...
28 * 20mg = £54.62
28 * 30mg = £58.24
28 * 40mg = £62.82
28 * 50mg = £68.60
https://bnf.nice.org.uk/medicinal-forms/lisdexamfetamine-mes...
28 * 20mg = £54.62
28 * 30mg = £58.24
28 * 40mg = £62.82
28 * 50mg = £68.60
They have a coupon, just so you know. I believe it’s just a form on their website. It brings to copay down considerably.
Do you take the XR version or do you take regular adderall?
I've taken regular adderall on and off for the last 10 years. It helped me so much in the past but I started to feel very fatigued by it. These days I have an extremely difficult time focusing and have been contemplating going back on it.
>Adderall totally changed that. I'm able to focus on tasks long term AND even if something bad happens in my life I'm able to keep right on track
That sounds amazing. I can't even imagine that. I've just been diagnosed at 32 this year. Been on Ritalin for a few months but it doesn't seem to make a difference. Maybe 3% better. Things going bad still derails me significantly.
They're fairly conservative with meds in my neck of the woods, but I'm going to persist with my doctor to try them all to find what works.
The struggle to push through actually going through all the phone calls, emails and appointments necessary to get to that point is very un-ADHD friendly. So many times I considered just to give up and forget about it.
That sounds amazing. I can't even imagine that. I've just been diagnosed at 32 this year. Been on Ritalin for a few months but it doesn't seem to make a difference. Maybe 3% better. Things going bad still derails me significantly.
They're fairly conservative with meds in my neck of the woods, but I'm going to persist with my doctor to try them all to find what works.
The struggle to push through actually going through all the phone calls, emails and appointments necessary to get to that point is very un-ADHD friendly. So many times I considered just to give up and forget about it.
I have a friend that I’m positive has ADD. He agrees with me it’s a possibility but it stops there. He was even given stimulants by someone but he hasn’t tried them. He’s not opposed to it, but he’s so bad he never gets around to popping that pill. Actually setting up a doctor appointment is never going to happen.
He’s 33 and has been in college since graduating high school and still doesn’t have a degree, and he’s actually quite intelligent.
He’s 33 and has been in college since graduating high school and still doesn’t have a degree, and he’s actually quite intelligent.
Took adderal for year.
Completely life changing. My focus and energy level were on par with a normal persons.
Unfortunately it was far too hard on the body. Started stroking out on it. Plus it interacted with almost every Medicane I’ve been prescribed.
Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from that. Gave it up after a few weeks.
Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.
Kids have it strong. Wife wants them on meds, but weird reactions run in family so I’m highly reluctant.
Completely life changing. My focus and energy level were on par with a normal persons.
Unfortunately it was far too hard on the body. Started stroking out on it. Plus it interacted with almost every Medicane I’ve been prescribed.
Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from that. Gave it up after a few weeks.
Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.
Kids have it strong. Wife wants them on meds, but weird reactions run in family so I’m highly reluctant.
I'm not a parent, so I don't really have any grounds to argue how someone should raise their children. The only anecdote I'll add is that I would be reluctant to hold someone back from an opportunity to have the normalcy that I couldn't have in school. When I got to high school it was like my ADHD kicked into full gear, I started performing significantly worse and outright failing classes. My classmates, friends, and even teachers treated me like a lazy burnout.
Out of 120 students, I was the only one who didn't graduate that year. Sometimes I feel like I have the world's worst case of impostor syndrome because of how high school went for me. I was constantly testing top of the class but most everyone looked at me like an abject failure. I went into college with practically zero note-taking or studying skills and the first couple of years were a nightmare, even with medication.
All this is to say that medication can help when you need to feel normal, but it can't replace the skills you should have been developing. Some people can develop those skills and get shit done without medication and I applaud them, but I tried that route and ended up _years_ behind my peers.
Out of 120 students, I was the only one who didn't graduate that year. Sometimes I feel like I have the world's worst case of impostor syndrome because of how high school went for me. I was constantly testing top of the class but most everyone looked at me like an abject failure. I went into college with practically zero note-taking or studying skills and the first couple of years were a nightmare, even with medication.
All this is to say that medication can help when you need to feel normal, but it can't replace the skills you should have been developing. Some people can develop those skills and get shit done without medication and I applaud them, but I tried that route and ended up _years_ behind my peers.
> All this is to say that medication can help when you need to feel normal, but it can't replace the skills you should have been developing.
Exactly. These articles about ADHD and dopamine are often misinterpreted by people who assume that ADHD is a purely chemical imbalance with only chemical solutions.
It's similar to the situation with depression, where decades of misleading ads and pop-neuroscience articles led people to believe that depression == serotonin. Most people are coming around to the idea that the "chemical imbalance" narrative has done more harm than good in the realm of depression treatment, but the idea that ADHD == dopamine and that ADHD is a pure chemical imbalance is still common online.
These studies should be interpreted as a snapshot of the brain's function in the disordered state, but they shouldn't be interpreted as an inherent property of the person's brain. For example, patients suffering from depression will show certain patterns of serotonin activity during depressive episodes that will change following remission, even if the patient doesn't take medication. The brain isn't a unchanging machine that only operates in a single, fixed way.
You said it best: Medication can't replace the skills that one should be developing. Many people take medication as a gateway to develop those skills and go on to do quite well in life. Unfortunately, some people assume the medication lets them off the hook for learning those important skills. They tend to struggle years down the road when they've built a tolerance to the motivating and stimulating effects of the medications (the attention-enhancing effects tend to be more robust against tolerance, but the euphoric/motivating/stimulating effects will dwindle over time).
Exactly. These articles about ADHD and dopamine are often misinterpreted by people who assume that ADHD is a purely chemical imbalance with only chemical solutions.
It's similar to the situation with depression, where decades of misleading ads and pop-neuroscience articles led people to believe that depression == serotonin. Most people are coming around to the idea that the "chemical imbalance" narrative has done more harm than good in the realm of depression treatment, but the idea that ADHD == dopamine and that ADHD is a pure chemical imbalance is still common online.
These studies should be interpreted as a snapshot of the brain's function in the disordered state, but they shouldn't be interpreted as an inherent property of the person's brain. For example, patients suffering from depression will show certain patterns of serotonin activity during depressive episodes that will change following remission, even if the patient doesn't take medication. The brain isn't a unchanging machine that only operates in a single, fixed way.
You said it best: Medication can't replace the skills that one should be developing. Many people take medication as a gateway to develop those skills and go on to do quite well in life. Unfortunately, some people assume the medication lets them off the hook for learning those important skills. They tend to struggle years down the road when they've built a tolerance to the motivating and stimulating effects of the medications (the attention-enhancing effects tend to be more robust against tolerance, but the euphoric/motivating/stimulating effects will dwindle over time).
>Many people take medication as a gateway to develop those skills and go on to do quite well in life.
This is important. When I went on anti-depressants (for pure-o OCD), my intent was to get some breathing room and learn to manage my symptoms better.
I've definitely been able to do that, but it's lead to a few cases of thinking 'hey, I should be able to stop taking these now', which have all gone poorly for me. I think I'm better able to cope now if I don't have access to medication, but I won't be stopping again any time soon, it's too risky for me.
This is important. When I went on anti-depressants (for pure-o OCD), my intent was to get some breathing room and learn to manage my symptoms better.
I've definitely been able to do that, but it's lead to a few cases of thinking 'hey, I should be able to stop taking these now', which have all gone poorly for me. I think I'm better able to cope now if I don't have access to medication, but I won't be stopping again any time soon, it's too risky for me.
There are supplements, backed by research, that practically remove all of the negative side effects of adderall. To start with, the sadness you felt on vyvanse sounds like dopamine depletion. You want to be taking l-tyrosine to make sure there’s plenty of fuel for the amphetamine to work with. ALCAR + ALA counteract the psychomotor agitation and tolerance formation. Magnesium + zinc help with muscle cramping. Selenium is neuroprotective. And of course you want to make sure you’re getting enough electrolytes (sodium + potassium) and balancing your intake, as a general rule for life, but especially if you take stimulants.
With the aforementioned supplement stack I’ve been able to go off doses as high as 60 mg of adderall per day without any significant withdrawal symptoms. It’s been a complete game changer in terms of making this medication a sustainable option for me. I will say as a caveat that things which reduce drug tolerance formation also typically attenuate some of the effects. In my case, ALCAR + ALA basically erase the potential for euphoria but don’t seem to diminish the mental benefits.
With the aforementioned supplement stack I’ve been able to go off doses as high as 60 mg of adderall per day without any significant withdrawal symptoms. It’s been a complete game changer in terms of making this medication a sustainable option for me. I will say as a caveat that things which reduce drug tolerance formation also typically attenuate some of the effects. In my case, ALCAR + ALA basically erase the potential for euphoria but don’t seem to diminish the mental benefits.
Dextromethorphan is the most potent anti-tolerance medication you can get your hands on, and it doesn't dampen any effects like ALCAR can.
I used to experiment heavily with all kinds of supplement routines and other nootropics when I had my Adderall Rx.
ALCAR works but like you mentioned, it does blunt things a bit.
https://clinicaltrials.gov/ct2/show/NCT03729128
https://link.springer.com/article/10.1007/s11373-006-9096-4
Dextromethorphan works for tolerance on things other than Amphetamine as well, but that's outside the scope of the conversation.
FWIW, the best I ever felt was on Adderall + 200mg l-Theanine + 10mg Noopept + 15mg Dextromethorphan.
I used to experiment heavily with all kinds of supplement routines and other nootropics when I had my Adderall Rx.
ALCAR works but like you mentioned, it does blunt things a bit.
https://clinicaltrials.gov/ct2/show/NCT03729128
https://link.springer.com/article/10.1007/s11373-006-9096-4
Dextromethorphan works for tolerance on things other than Amphetamine as well, but that's outside the scope of the conversation.
FWIW, the best I ever felt was on Adderall + 200mg l-Theanine + 10mg Noopept + 15mg Dextromethorphan.
Can you recommend any sources for the mentioned supplements and their interaction with amphetamines?
I’d try to retrace my path through the research for you but I’m on mobile for the rest of the day. I got the anecdotal recommendations from Reddit and then was able to confirm everything on google scholar. So just search for “amphetamine + supplement” on scholar and it should be easy to find the relevant papers. I will say that a lot of them were animal studies but I seem to recall at least a few human trials in the mix.
On magnesium. It’s been a huge help for migraines and muscle aches. Aside from zinc the others haven’t been on my radar.
Ordering the rest now.
My chief issue is nerve damage. Anything that helps them is a big win.
Ordering the rest now.
My chief issue is nerve damage. Anything that helps them is a big win.
It sounds like you've had too many bad reactions to want to keep trying, but did you try Concerta/Ritalin? That's what I was on when I was younger, and it seemed effective. I'm on Vyvanse now.
The only major side effect that's a problem for me is the utter loss of appetite. Frustratingly, it's not that I'm not hungry, I just don't want food. So my stomach will start hurting and I force myself to eat, but it's a challenge. Plus earlier this year I had to give up sugar to account for prediabetes, every day is a struggle to make myself get enough calories. Still, the ability to stay focused on a task for 15 minutes, or even just process my students' sentences, is worth it.
The only major side effect that's a problem for me is the utter loss of appetite. Frustratingly, it's not that I'm not hungry, I just don't want food. So my stomach will start hurting and I force myself to eat, but it's a challenge. Plus earlier this year I had to give up sugar to account for prediabetes, every day is a struggle to make myself get enough calories. Still, the ability to stay focused on a task for 15 minutes, or even just process my students' sentences, is worth it.
So, heres a lifer's perspective, if it helps.
If they aspire to aviator,stay away. If you really, really worry about locking them into somewhere with access to a Schedule II, then consider not doing it, but I can't overstate how effective and life changing the right treatment regimen is. For me it was like life going from black and white to full color. It can be a bit depressing 20-39 years down the line, and I'm considering getting something started with a Congress person to dial back some of the draconian controls if at all possible, because, not going to lie, it is disruptive as all hell to the lengths things have been allowed to achieve
I've seen other parents with kids who clearly have it do nothing, and the Kids are the ones who really suffer because they don't have a clue what is "wrong".
I kick the wall I'm physiologically disincluded from aviating, but I wouldn't trade all the life experiences I've been able to navigate because of the medication for that, and there's nothing that says the world has to remain so unfriendly to Adderall/ADHD med takers as well.
The Hypertension can be a problem, but a small maintenance dose of a blood pressure meds (or Hawthorne!) Tends to do the trick for me, but work with your doctor.
If they aspire to aviator,stay away. If you really, really worry about locking them into somewhere with access to a Schedule II, then consider not doing it, but I can't overstate how effective and life changing the right treatment regimen is. For me it was like life going from black and white to full color. It can be a bit depressing 20-39 years down the line, and I'm considering getting something started with a Congress person to dial back some of the draconian controls if at all possible, because, not going to lie, it is disruptive as all hell to the lengths things have been allowed to achieve
I've seen other parents with kids who clearly have it do nothing, and the Kids are the ones who really suffer because they don't have a clue what is "wrong".
I kick the wall I'm physiologically disincluded from aviating, but I wouldn't trade all the life experiences I've been able to navigate because of the medication for that, and there's nothing that says the world has to remain so unfriendly to Adderall/ADHD med takers as well.
The Hypertension can be a problem, but a small maintenance dose of a blood pressure meds (or Hawthorne!) Tends to do the trick for me, but work with your doctor.
They're your kids so it's your decision but might I suggest trying a low dose of Adderall or other medication and ramp up over time?
ADD was REALLY hard on me when I was a kid. I had a difficulty making friends. I got really bad grades in school. Got in fights. Made me depressed and I thought something was broken with me.
You can start with 5mg and then ramp up from there. I'm on 15mg. I can't really feel 5m and 20mg is far too much.
At lower doses they won't really have any side effects and then you can keep them on for 90-120 days to see how they tolerate it.
ADD was REALLY hard on me when I was a kid. I had a difficulty making friends. I got really bad grades in school. Got in fights. Made me depressed and I thought something was broken with me.
You can start with 5mg and then ramp up from there. I'm on 15mg. I can't really feel 5m and 20mg is far too much.
At lower doses they won't really have any side effects and then you can keep them on for 90-120 days to see how they tolerate it.
Proper dosage for me can be 10-100 times less then a normal person. Varies greatly.
One kid gets really bad headaches from less then 2mg pill. It’s a hard decision. Constantly monitoring them to see if they can manage without it. I think one is going to be okay with out.
Other one is probably going to have to go on. Still very young though
One kid gets really bad headaches from less then 2mg pill. It’s a hard decision. Constantly monitoring them to see if they can manage without it. I think one is going to be okay with out.
Other one is probably going to have to go on. Still very young though
Do they make them at such low doses or do you need to split it yourself?
Split myself. Quarter of a 10mg pill (2-3mg) will either give me energy $ focus all day, put me to sleep, or give me the worst imaginable headache/partial blindness that takes days to recover from.
Was prescribed amatriptine for nerve damage. I had to get the lowest possible dosage, break pills into quarters. Even then it was still way too strong. ~1mg by my guess.
Doctors & pills straight up hate me.
Was prescribed amatriptine for nerve damage. I had to get the lowest possible dosage, break pills into quarters. Even then it was still way too strong. ~1mg by my guess.
Doctors & pills straight up hate me.
Having gone through this with my fam, given that you seem to have reactions to every med, have you considered it may be autism or aspurgers? ADHD and autism are often seen together, and reactions to other meds also seems to be fairly common.
I just wanted to throw that out there because this realization that it's not just ADHD, not just anxiety, etc has changed our life dramatically... and there are meds that can help with this (on top of some dietary changes).
Anyway, good luck!
Anyway, good luck!
Bipolar, schizophrenia, and depression can also cause attention deficient. It is extremely common for children with Bipolar to be misdiagnosed as ADHD.
Depression is usually easier to diagnose accurately. Schizophrenia can be hit or miss, depending on severity. In my case (I'm bipolar), psychosis was so much a part of my normal life that I was completely blind to it and my external symptoms weren't severe enough to be recognizable.
For just ADHD, There are also other classes of medication that can help. Atomoxetine, bupropion, guanfacine, and clonidine are alternative medications that work differently than first line stimulants.
Depression is usually easier to diagnose accurately. Schizophrenia can be hit or miss, depending on severity. In my case (I'm bipolar), psychosis was so much a part of my normal life that I was completely blind to it and my external symptoms weren't severe enough to be recognizable.
For just ADHD, There are also other classes of medication that can help. Atomoxetine, bupropion, guanfacine, and clonidine are alternative medications that work differently than first line stimulants.
I'm curious if you're willing to share, how psychosis can be a part of a normal life, how you can have it for any length of time without it being recognizable? Did I understand correctly? Is it like, having a very unusual perception of reality, but not so unusual as to interfere with normal functioning?
In people I know who have experienced it, it was very debilitating, so I hadn't even considered the possibility of having it for a long time and still being able to function.
In people I know who have experienced it, it was very debilitating, so I hadn't even considered the possibility of having it for a long time and still being able to function.
I'll send you an email, as this is getting off topic. :)
Edit... this ended up being an entire blog post, my blog and email are in my profile.
Edit... this ended up being an entire blog post, my blog and email are in my profile.
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This is possible. When I was diagnosed, it was autism masking ADHD (apparently the other way around is more common though) because I have all the ADHD issues with everything except my special interest. I was told that ADHD more commonly masks autism though, so it's certainly worth exploring the possibility.
The “able to function normally for special interest” is a symptom of ADHD itself, there is no need to bring in autism as an additional explanatory variable. (Not saying your autism didn’t mask symptoms but what you described happens in ADHD without autism very frequently)
For example I have ADHD without autism and grew up thinking I was “smart but lazy” because I was > 99% as far as raw intelligence but had little motivation for the drudgery associated with school (or indeed life itself), yet I could play video games for hours straight without seeming to be at a disadvantage compared to neurotypical peers.
This is because ADHD, among other things, is a disorder of attention regulation as opposed to being completely unable to pay attention to anything.
For example I have ADHD without autism and grew up thinking I was “smart but lazy” because I was > 99% as far as raw intelligence but had little motivation for the drudgery associated with school (or indeed life itself), yet I could play video games for hours straight without seeming to be at a disadvantage compared to neurotypical peers.
This is because ADHD, among other things, is a disorder of attention regulation as opposed to being completely unable to pay attention to anything.
Hyper focus is a cool super power of adhd.
So cool that you routinely don't do the dishes, laundry, rubbish, childcare or gardening because you're way too in the zone.
It's cool af if you're young and single and you can just go and go and go on what it is that you're totally wrapped up in. It's shite when you grow up a little and other people have expectations of you and you constantly fail to meet them.
It's cool af if you're young and single and you can just go and go and go on what it is that you're totally wrapped up in. It's shite when you grow up a little and other people have expectations of you and you constantly fail to meet them.
Speaking about other possible conditions, anecdotally there are two people in my family who saw a psychiatrist for ADHD like symptoms, who years later were eventually diagnosed with sleep apnea (both with a normal BMI).
It seems like this is not uncommon, quoting Matthew Walker’s “Why We Sleep”:
> Based on recent surveys and clinical evaluations, we estimate that more than 50 percent of all children with an ADHD diagnosis actually have a sleep disorder, yet a small fraction know of their sleep condition and its ramifications.
It seems like this is not uncommon, quoting Matthew Walker’s “Why We Sleep”:
> Based on recent surveys and clinical evaluations, we estimate that more than 50 percent of all children with an ADHD diagnosis actually have a sleep disorder, yet a small fraction know of their sleep condition and its ramifications.
I have sleep apnea, and ADHD. Before getting on CPAP life was pretty tough. It definitely exacerbated my ADHD at least 2x. So, I can understand that if you're neurotypical and have sleep apnea it is going to be affecting your executive function such that you aren't at 100%. The flip side is ADHDers are significantly more likely to be morbidly obese and have other health complications like sleep apnea as a result. At that point it's a real downward spiral. Very glad I finally sought treatment for my apnea after kicking the can down the road for 4 whole years, which is very typical ADHD behavior in itself.
For real though CPAP is life changing if you need it and you get on it.
For real though CPAP is life changing if you need it and you get on it.
Good guesses. I do have apnea. I have a cpap and it’s well controlled.
I have an auto immune condition(Sjogrens) as well As a clotting disorder. Plus way to much sugar in 20s.
Took many many years to figure the above out. Proper treatment diet has been helping, but a lot of damage has accumulated.
I have an auto immune condition(Sjogrens) as well As a clotting disorder. Plus way to much sugar in 20s.
Took many many years to figure the above out. Proper treatment diet has been helping, but a lot of damage has accumulated.
> Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from that. Gave it up after a few weeks.
Omg, I actually experience this very thing for myself. I thought I was unique in experiencing the "deepest most profound sadness imaginable" from Vyvanse. It's good to know it wasn't just me.
I did eventually connect the dots with Vyvanse, after taking it a bunch of times. I did several "test runs" where I took it some days, and not other days, and the deep sadness always and consistently occurred about 3-4 hours after taking Vyvanse.
Thankfully, Adderall doesn't have this horrible side effect.
> Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.
I've read that exercise can go a long way in mitigating ADHD. I'm trying to now motivate myself to exercise -- which if I'm able to do would essentially solve the problem ADHD (at least partially), and create a positive feedback loop that could improve my life for the better in the long run.
Omg, I actually experience this very thing for myself. I thought I was unique in experiencing the "deepest most profound sadness imaginable" from Vyvanse. It's good to know it wasn't just me.
I did eventually connect the dots with Vyvanse, after taking it a bunch of times. I did several "test runs" where I took it some days, and not other days, and the deep sadness always and consistently occurred about 3-4 hours after taking Vyvanse.
Thankfully, Adderall doesn't have this horrible side effect.
> Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.
I've read that exercise can go a long way in mitigating ADHD. I'm trying to now motivate myself to exercise -- which if I'm able to do would essentially solve the problem ADHD (at least partially), and create a positive feedback loop that could improve my life for the better in the long run.
Exercise is a huge help.
I’m at my best when hiking hills 3-6 miles a day.
I’m at my best when hiking hills 3-6 miles a day.
> Started stroking out on it
I've never heard this particular phrase before and I can only guess it's meaning vaguely from the context.
What does it mean?
I've never heard this particular phrase before and I can only guess it's meaning vaguely from the context.
What does it mean?
Elevated BP & hypertension causing Serious Negative cardiovascular issues to the point of immobilization and even arrhythmia.
Adderall is so commonly prescribed but honestly for some people the better choice may be dextroamphetamine. I know it was for me.
The levo-amphetamine in adderall causes what is known as peripheral side effects. Higher heart rate. And so on. It doesn’t actually help the brain. Apparently it helps the dextro part last longer.
But its also potentially dangerous.
The levo-amphetamine in adderall causes what is known as peripheral side effects. Higher heart rate. And so on. It doesn’t actually help the brain. Apparently it helps the dextro part last longer.
But its also potentially dangerous.
It sounds like the OP was talking about stroke. The way it was written ("started") it's a little unclear whether the OP was in fear of experiencing a stroke because of other side effects (elevated BP or something), or actually experienced a stroke, which is an extremely rare side effect.
I get minor strokes a lot. TIAs. So far haven’t a full blown stroke.
My blood is sticky(factor 5 Leiden), and cranial pressure runs high.
I tried going off blood thinners 2 months ago, for about a week. Dumb move.
My right side has regained most of its strength and sensation.
Neurologist chewed me out royal. I have to be very careful with meds.
My blood is sticky(factor 5 Leiden), and cranial pressure runs high.
I tried going off blood thinners 2 months ago, for about a week. Dumb move.
My right side has regained most of its strength and sensation.
Neurologist chewed me out royal. I have to be very careful with meds.
Ah, good luck to you! I can see why you wouldn't want to add any risk factors at all. Sorry to be nosy but do you need to avoid caffeine?
Yes!
I don’t avoid it nearly enough because, well high demand job. But I try.
Fewer stimulants I take the better. Vascular constrictors are dangerous for me.
Green Tea seems to not bother me. So I try and drink that or water.
Fewer stimulants I take the better. Vascular constrictors are dangerous for me.
Green Tea seems to not bother me. So I try and drink that or water.
You can get a genetic test to see which adhd medication works best with your DNA and is least likely to give undesirable side effects.
Yeah, the stigma against the medication, and the people who casually say "omg, I'm like, so ADD" really hurt the people who have actually been diagnosed with it. Depending on where you live, it can be difficult to find a psychiatrist willing to see you for a diagnoses and subsequent prescription because they think that you're a college kid wanting to abuse it or sell it. I had to call 4-5 different offices until I found a psychiatrist that would see me, and you can check the /r/ADHD and see a bunch of stories about people who moved to a different state for work, but nobody will prescribe them their medication in their new state, and now they're struggling at their new job.
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From my perspective, the thing that has hurt the credibility around ADHD diagnoses is the pretty blatant use by affluent parents to get diagnoses so they can get test-time extensions for their kids.
ADHD diagnosis is much more strongly correlated with affluence than many other mental illnesses.
Eliminating the 504 accommodation would be beneficial in my view.
ADHD diagnosis is much more strongly correlated with affluence than many other mental illnesses.
Eliminating the 504 accommodation would be beneficial in my view.
Software engineering gave me the opportunity to go from being in the bottom economic class to the highest. And guess what, when I was a kid and college student I didn’t have the resources to obtain mental health treatment. Now that I’m a software engineer I can afford therapists, psychologists and psychiatrists that help me manage ADHD and bipolar. I’m still the same person. I just have more access now.
Sure - also the metrics measured in industry are not the same as the metrics measured in school.
What you're saying doesn't seem at odds with what I'm saying.
I would, however, be interested in seeing a study where they give kids with ADHD adderall and give kids without ADHD adderall and see if the test-score residual is statistically significantly higher for the ADHD group.
I have not seen any convincing experimental evidence that amphetamines are uniquely performance enhancing for those diagnosed with ADHD.
What you're saying doesn't seem at odds with what I'm saying.
I would, however, be interested in seeing a study where they give kids with ADHD adderall and give kids without ADHD adderall and see if the test-score residual is statistically significantly higher for the ADHD group.
I have not seen any convincing experimental evidence that amphetamines are uniquely performance enhancing for those diagnosed with ADHD.
Nobody ever claimed so. Amphetamines help (until they only "help", of course) everybody, that's well known.
>ADHD diagnosis is much more strongly correlated with affluence than many other mental illnesses.
Source?
My understanding is it is the opposite way around. The lower down the socioeconomic totem pole you go the higher the rates of prevalence of ADHD.
Which would make sense given a) it runs in families and b) executive function disorders are correlated with negative life outcomes.
I can't imagine it makes you _more_ successful in life and thus more likely to be from an affluent family.
All the a-holes that abuse the drugs and the DX for any reason need to find another planet to live on IMO. It's so not cool.
Source?
My understanding is it is the opposite way around. The lower down the socioeconomic totem pole you go the higher the rates of prevalence of ADHD.
Which would make sense given a) it runs in families and b) executive function disorders are correlated with negative life outcomes.
I can't imagine it makes you _more_ successful in life and thus more likely to be from an affluent family.
All the a-holes that abuse the drugs and the DX for any reason need to find another planet to live on IMO. It's so not cool.
I'm on my phone right now, so hard to pull up a source. That said:
> lower down the socioeconomic totem pole you go the higher the rates of prevalence of ADHD.
The key word in my original statement was "diagnosis". The rate absolutely seems to increase with lower SES, but diagnosis rate does not reflect that.
Your reasoning for why it is more common among poorer people seems to neglect the significant early environmental factors that might contribute to low SES high adhd prevalence in favor of a rich, genetically superior master-class.
> lower down the socioeconomic totem pole you go the higher the rates of prevalence of ADHD.
The key word in my original statement was "diagnosis". The rate absolutely seems to increase with lower SES, but diagnosis rate does not reflect that.
Your reasoning for why it is more common among poorer people seems to neglect the significant early environmental factors that might contribute to low SES high adhd prevalence in favor of a rich, genetically superior master-class.
I was talking with my wife just last week about my hypothesis that there is probably a strong correlation between prescriptions for various performance enhancing drugs (such as Adderall and Ritalin) and the number of extracurricular activities that high school students are signed up for.
That's completely irrelevenat to what I was talking about. As an adult, it can be difficult to find a psychiatrist willing to prescribe medication.
Sorry, I perceived it as relevant to the first sentence you said.
> it can be difficult to find a psychiatrist willing to prescribe medication
Absolutely - my SO is diagnosed and I've been with her in the pharmacy where she was blatantly accused of trying to get it so she could sell it (nope, just a normal college student diagnosed with ADHD). That was wild.
> it can be difficult to find a psychiatrist willing to prescribe medication
Absolutely - my SO is diagnosed and I've been with her in the pharmacy where she was blatantly accused of trying to get it so she could sell it (nope, just a normal college student diagnosed with ADHD). That was wild.
Why would they accuse her? High dose? I hope she complained to pharmacy board.
I think they thought she was taking me along because she was going to sell to me after? It was unclear, but they were definitely suspicious of my presence.
As someone with ADHD I was once prescribed the lowest dose of adderall (5 mg?) and I found it was so much like being high it genuinely scared me
I was working from home and the second it kicked in I started getting literal chills down my spine.
I ended up messaging a bunch of people on Facebook I haven’t talked to in years but felt a sudden affinity and empathy for.
I got distracted by a part of my apartment that I hadn’t cleaned in a while and missed a meeting because I ended up cleaning the whole place, including weird things like dusting the sides of books.
When I finally got to coding, it was like I was in the matrix. Hyper focused (and fwiw getting a lot done) but in a weird euphoric high feeling way.
I guess what I’m asking is is that how everyone feels the first time they take it?
And how long does it take to just feel normal on it, but like able to focus?
I want to try it again, because I need help focusing and know I can do better, but I’m genuinely afraid of the person I was on that stuff.
I was working from home and the second it kicked in I started getting literal chills down my spine.
I ended up messaging a bunch of people on Facebook I haven’t talked to in years but felt a sudden affinity and empathy for.
I got distracted by a part of my apartment that I hadn’t cleaned in a while and missed a meeting because I ended up cleaning the whole place, including weird things like dusting the sides of books.
When I finally got to coding, it was like I was in the matrix. Hyper focused (and fwiw getting a lot done) but in a weird euphoric high feeling way.
I guess what I’m asking is is that how everyone feels the first time they take it?
And how long does it take to just feel normal on it, but like able to focus?
I want to try it again, because I need help focusing and know I can do better, but I’m genuinely afraid of the person I was on that stuff.
I had some initial freakout when some bad patterns started reemerging. It took time to learn how to accept & adapt to the changed mindset.
I eventually learned to redirect myself - which Adderall enabled me to do. The first step was qualifying my own good and bad behaviors.
It took time to deepen the reward association with beneficial behaviors. That helped me redirect away from counterproductive behaviors - not just revived behaviors but also the persistent ones. Making progress on those was huge.
During this process, the messy, euphoric edges smoothed themselves out. I never had to address it directly.
About 6 months in I came to the conclusion that I really would have benefited from a therapeutic guide, someone who was familiar with this specific experience. I'm not sure there is anyone like that out there.
I eventually learned to redirect myself - which Adderall enabled me to do. The first step was qualifying my own good and bad behaviors.
It took time to deepen the reward association with beneficial behaviors. That helped me redirect away from counterproductive behaviors - not just revived behaviors but also the persistent ones. Making progress on those was huge.
During this process, the messy, euphoric edges smoothed themselves out. I never had to address it directly.
About 6 months in I came to the conclusion that I really would have benefited from a therapeutic guide, someone who was familiar with this specific experience. I'm not sure there is anyone like that out there.
Very similar experience with Dexedrine here, but that wore off after a week or so. I would indiscriminately DO things, like a ride in lawn mower ghost riding into an overgrown field with a full tank of gas. Was I productive? In a sense. Was I effective? Not as much.
I use it occasionally still but with no euphoric, overwhelming empathy or boundless energy to mow the metaphorical fields. It helps me push through brain fog when things just need to be done.
I haven’t managed to get past the tooth grinding. I barely feel that I’m on it now, but every single time... I grind my teeth. Even if I feel perfectly relaxed otherwise.
I use it occasionally still but with no euphoric, overwhelming empathy or boundless energy to mow the metaphorical fields. It helps me push through brain fog when things just need to be done.
I haven’t managed to get past the tooth grinding. I barely feel that I’m on it now, but every single time... I grind my teeth. Even if I feel perfectly relaxed otherwise.
This is very normal for first time usage. It's described as euphoria. I believe it goes away with sustained use for most people. It did for me, and I was sort of sad that it did - it was the happiest months of my life. Even now after not having used adderall for years I still don't get that initial euphoria feeling when I randomly take one again.
I used Adderall everyday for a year, and I would generally recommend people stay away from it if they can unless you have extreme ADD/ADHD. I know that a lot of people are saying that it changed their lives and in fact, it helped me to understand how far I could push my mind and body to its productivity limits, which helps me be productive today. However, as mentioned in some of the other comments, it makes you angry and I have lost many friends and closed many doors socially. I also would not say that I was actually more purposeful in my daily activities. Meaning, I may have been able to produce more mental and physical output but like you mention, I would fixate on lots of unnecessary things that ultimately put me behind in what I wanted to accomplish over the course of a year or even who I wanted to be as a person.
Which "more modern" medication are you on, out of curiosity?
Ritalin causes side effects for me as soon as I start to hit the therapeutic dose when titrating.
Adderall is terrible for me.
My youngest daughter is undoubtedly ADHD, and the insurance company requires you to try the first two before they will approve a third...
Ritalin causes side effects for me as soon as I start to hit the therapeutic dose when titrating.
Adderall is terrible for me.
My youngest daughter is undoubtedly ADHD, and the insurance company requires you to try the first two before they will approve a third...
Not OP, but I believe some people with ADHD seem to be helped with Modafinil (Provigil). It is normally used for severe lethargy and narcolepsy but has been working for ADHD, too.
My psychiatrist was disinclined to try that one with me seeing that both Methylphenidate (Ritalin) and Adderal caused sleep issues for me.
You just have to get over the curve of about a week of regular dosage then you can sleep at a normal hour. But it should be the first thing you do in the morning.
Modafinil was The Answer for me after trying everything else. I don't know why psychiatrists always insist on a battery of other drugs first, which can cause everything from aggression to obvious personality shifts to mania to damage to the dopaminergic axons of the brain.
Modafinil was The Answer for me after trying everything else. I don't know why psychiatrists always insist on a battery of other drugs first, which can cause everything from aggression to obvious personality shifts to mania to damage to the dopaminergic axons of the brain.
1. There is a strong slant against off-label uses of drugs in general
2. Insurance companies require extra paperwork for anything other than the 2 or 3 most common drugs. I ended up on Dexmethylphenidate after trying a few others; I rate it as "okay" but still so much better than unmedicated that I paid a few hundred dollars out-of-pocket for it while I was convincing the insurance company to approve it. I ended up on ER, which doesn't work as well because they wouldn't approve 2x 10mg of non ER but would approve 1x 20mg of the ER. sigh
2. Insurance companies require extra paperwork for anything other than the 2 or 3 most common drugs. I ended up on Dexmethylphenidate after trying a few others; I rate it as "okay" but still so much better than unmedicated that I paid a few hundred dollars out-of-pocket for it while I was convincing the insurance company to approve it. I ended up on ER, which doesn't work as well because they wouldn't approve 2x 10mg of non ER but would approve 1x 20mg of the ER. sigh
We are trying out various ADHD meds for my son and every one is like a deal with the devil - it helps with some things, but leaves him twice as wired when it wears off, or makes him sleepy or keeps him awake at night. I hope in the future we can get more targetted treatments without so many side effects.
Man are you me?
After college I finally got diagnosed again after being off medication for 8 or so years. Grew up first doing Ritalin->adderall->concerta->no meds. I realized how needlessly difficult I made college for myself.
After college I finally got diagnosed again after being off medication for 8 or so years. Grew up first doing Ritalin->adderall->concerta->no meds. I realized how needlessly difficult I made college for myself.
> When I was younger I was perscribed ritalin, and it just made me sleepy so I stopped taking it. Now I take a more modern medication and it works wonders.
I don't have ADHD, but I'm curious what the modern one is.
Back in middle school, around 2001, I did a report on ADD and ADHD, and 3 of the medications that existed for it: Ritalin, Cylert, and I'm not certain of the third but from the other comments Adderall sounds like it could be it (though I think it started with a "D", is there one that does?). The only thing I remember from it is the conclusion that if I got diagnosed and needed medication, I'd refuse Ritalin, and that Cylert seemed like the best of the three.
I don't have ADHD, but I'm curious what the modern one is.
Back in middle school, around 2001, I did a report on ADD and ADHD, and 3 of the medications that existed for it: Ritalin, Cylert, and I'm not certain of the third but from the other comments Adderall sounds like it could be it (though I think it started with a "D", is there one that does?). The only thing I remember from it is the conclusion that if I got diagnosed and needed medication, I'd refuse Ritalin, and that Cylert seemed like the best of the three.
The more modern medication for me was modafinil but I had to beg for it. My psychiatrist made me go through the stringer of usual suspects before she allowed me moda: first adderall, then ritalin, then straterra (this one actually gave me acute psychopathy and constantly leak semen). All three caused profound personality shifts.
Moda doesn't touch my affect and it's wonderful.
Moda doesn't touch my affect and it's wonderful.
How would you describe modanafil vs dexedrine?
Like being "baseline" vs being wired. Dexedrine was the first thing I was put on and I was on it for half a year. Cycling off it on the weekends was agonizing: exhaustion like I'd never felt before, depression, sleeping for 12 hours at a time.
Modafinil makes me feel like myself but a more productive version. The big issue with me has always been starting a task and modafinil makes a scary task a lot more approachable. My thoughts are more ordered, I can see the bigger architecture of a thing, verbal fluency is improved. I cycle off it Saturdays and Sundays and that works just fine for me.
Modafinil makes me feel like myself but a more productive version. The big issue with me has always been starting a task and modafinil makes a scary task a lot more approachable. My thoughts are more ordered, I can see the bigger architecture of a thing, verbal fluency is improved. I cycle off it Saturdays and Sundays and that works just fine for me.
The substance starting with a D was probably Dextroamphetamine. It’s the old standard and has been around forever. It’s basically Adderall with just the R isomer rather than a mixture of Levo & Dextro isomers.
what do you take now. im also an adult with adhd, i did take ritalin before but concerta is the only thing available to me right now. i dont think its especially effective to me, but i take only 36mg per day. and its better then not taking anything.
That's just ritalin. If you think it would be more effective to take a straight dose of 10mg than to use the time release mechanism, I think you could achieve this by getting the drug out of the pills you already have.
I am also using concerta because it is the only form of ritalin legal in my country. I don't really notice a difference compared to taking ritalin the other way.
I am also using concerta because it is the only form of ritalin legal in my country. I don't really notice a difference compared to taking ritalin the other way.
Extended work from home finally pushed me to get diagnosed (ASS + ADHD).
I'm now on 2x 10mg methylphenidate (ritalin). It has definitely helped, but after a few weeks I now feel habituated (is that the right word?). Unless something is on fire or past deadline I'm back to getting no work done. I do notice positive effects when combined with (too much) caffeine, but ideally I want to quit soft drinks (and I don't like coffee).
I think I will ask my gp to switch to extended release. I hope he's willing to help me find something that works best for me.
As a sidenote, I do with people could be clearer when describing their medication. Just say the active ingredient, dosage, and frequency. Brand names can differ in different countries.
For reference:
- Ritalin, Concerta = Methylphenidate
- Adderall = Amphetamine
- Dexedrine = Dextroamphetamine
- Vyvanse = Lisdexamfetamine
I'm now on 2x 10mg methylphenidate (ritalin). It has definitely helped, but after a few weeks I now feel habituated (is that the right word?). Unless something is on fire or past deadline I'm back to getting no work done. I do notice positive effects when combined with (too much) caffeine, but ideally I want to quit soft drinks (and I don't like coffee).
I think I will ask my gp to switch to extended release. I hope he's willing to help me find something that works best for me.
As a sidenote, I do with people could be clearer when describing their medication. Just say the active ingredient, dosage, and frequency. Brand names can differ in different countries.
For reference:
- Ritalin, Concerta = Methylphenidate
- Adderall = Amphetamine
- Dexedrine = Dextroamphetamine
- Vyvanse = Lisdexamfetamine
I'm on 6x10 mg of ritalin, and one thing that helped me with it losing its effectiveness is taking a reduced or no dose on weekends, and making a concerted effort to get plenty of sleep. I noticed that I'd be sleeping less when I took it, and eventually the ritalin was just counteracting how tired I was, but not providing any benefit beyond that.
Unfortunately this didn't work for me because it meant I would just sleep 20 hours a day of weekends and essentially didn't have a weekend
that's me right now. i dont take it weekends in hope i dont get dependent on it.
If this is the effect it had you on then you're dependent. But luckily in my case, and I think most cases, it's not really a psychological dependency. It took me maybe three months or more to kick the physical withdrawal effects
> - Adderall = Amphetamine
Adderall is a mixture of several amphetamine salts including (25%?) dextroamphetamine and the formulas are subtly (and sometimes not so subtly) different between manufacturers. The key difference between Adderall and Dexedrine is the addition of those complementary amphetamines that balance out dextro's rough edges (Tracers!)
Adderall is a mixture of several amphetamine salts including (25%?) dextroamphetamine and the formulas are subtly (and sometimes not so subtly) different between manufacturers. The key difference between Adderall and Dexedrine is the addition of those complementary amphetamines that balance out dextro's rough edges (Tracers!)
yeah i started doing that. it's not especially hard. i just wished i would have more options.
I take 30-MG Adderall XRs, my brothers both take IR before classes since they have more downtime, but I work from home so most days I wake up and work until 4-5PM at my desk. Also worth mentioning that we all take the doctor recommended dosages, I worked my way up from 10MG doses and I absolutely do not recommend self-medicating in any way.
you wouldn't know anything about adhd meds and depression/anxiety?
I've had panic attacks this year, I had depression years ago, went to therapy a lot better on that front. Enter: Xoloft followed by Trintellix (1 week in). I dealt w/ them pretty well, I'd go lay down, breathe and maybe take a cat nap, wake up in 30 minutes go back to work feeling like a million dollars. Now, not so much.
So, I started xoloft a month ago, it screwed up me libido and made me continually 'want it' but not able to 'deliver' (or it'd take way too long). Switched to Trintellix, still have panic attacks, sex is better, but anxiety doesn't seem affected. Now, I feel I'm actually more depressed though, and just not wanting to get out of bed. Motivation is rough.
I'm also taking Vyvanse for ADHD. It doesn't seem to be as effective as it was before adding anxiety meds.
Should I just scrap the anxiety meds altogether and just deal with adhd? Anyone else w/ similar experience want to chime in? It's really messing me up, and I've recently lost my main client so I really need to focus and get some income (web dev/laravel), or I'm gonna be homeless (40 w/ wife and 2 kids - so not an option).
I've had panic attacks this year, I had depression years ago, went to therapy a lot better on that front. Enter: Xoloft followed by Trintellix (1 week in). I dealt w/ them pretty well, I'd go lay down, breathe and maybe take a cat nap, wake up in 30 minutes go back to work feeling like a million dollars. Now, not so much.
So, I started xoloft a month ago, it screwed up me libido and made me continually 'want it' but not able to 'deliver' (or it'd take way too long). Switched to Trintellix, still have panic attacks, sex is better, but anxiety doesn't seem affected. Now, I feel I'm actually more depressed though, and just not wanting to get out of bed. Motivation is rough.
I'm also taking Vyvanse for ADHD. It doesn't seem to be as effective as it was before adding anxiety meds.
Should I just scrap the anxiety meds altogether and just deal with adhd? Anyone else w/ similar experience want to chime in? It's really messing me up, and I've recently lost my main client so I really need to focus and get some income (web dev/laravel), or I'm gonna be homeless (40 w/ wife and 2 kids - so not an option).
This is absolutely something you should be working with a psychiatrist to regulate and find the dosage that works best for you. I don't take any medication for anxiety/depression but I regularly smoke pot and that does wonders for my anxiety. Of course, for some people pot can have the opposite effect which is why using it to self-medicate is a risky proposition.
Honestly my best advice is that, if you aren't having a good experience with your psychologist/psychiatrist you should find a better one. I've been lucky enough to be with a therapist who worked well for me as a teenager that I recently started seeing again for my anxiety. He recommends me to a local outpatient psychiatry department for my ADHD meds so I don't have to switch, but I don't know how much use the meds would be if I wasn't able to talk to him regularly.
Honestly my best advice is that, if you aren't having a good experience with your psychologist/psychiatrist you should find a better one. I've been lucky enough to be with a therapist who worked well for me as a teenager that I recently started seeing again for my anxiety. He recommends me to a local outpatient psychiatry department for my ADHD meds so I don't have to switch, but I don't know how much use the meds would be if I wasn't able to talk to him regularly.
How is your sleep? Exercising enough?
Biology is complex, the drugs mess with that system in direct and indirect ways. Coupled with lag and resistance, it makes accounting for outcomes hard.
ADHD is interesting in that to me, our interaction and methods of coping with it need to be participatory. The drugs don't work on their own, we need to still make lists, walk around, exercise, crack jokes. Just realizing you have it pushes it off the mainline to a branch.
I'd say slow down, do some science and take great notes.
Biology is complex, the drugs mess with that system in direct and indirect ways. Coupled with lag and resistance, it makes accounting for outcomes hard.
ADHD is interesting in that to me, our interaction and methods of coping with it need to be participatory. The drugs don't work on their own, we need to still make lists, walk around, exercise, crack jokes. Just realizing you have it pushes it off the mainline to a branch.
I'd say slow down, do some science and take great notes.
Haven't taken any of the anxiety mediation, but do have some experience of anxiety + ADHD.
I was taking Dextroamphetamine for ~4 years, great for ADHD symptoms, focus and energy is amazing, but terrible for libido and really raised my anxiety. I tried switching from Dex to Methylphenidate, but after one day I quit because of how it made me feel (paranoia++).
Fluctuated on-and-off the Dex for a while (i.e. taking it a few days a week), but the whip-saws in dopamine levels really hit me hard, anxiety++.
Recently switched over to Atomoxetine (brand name Strattera) which has an off-script application to treating ADHD. It has a much more subtle effect than Dex, and has to be taken daily it to be effective. After about ~30 days of Atomoxetine I feel MUCH better, anxiety and stress is only at background levels.
Atomoxetine is nowhere near Dex in terms of focus and energy, but it does certainly address many ADHD symptoms + doesn't create the residual anxiety (at least for me). Libido isn't 100% of unmedicated, but nowhere near as bad as amphetamines.
I was taking Dextroamphetamine for ~4 years, great for ADHD symptoms, focus and energy is amazing, but terrible for libido and really raised my anxiety. I tried switching from Dex to Methylphenidate, but after one day I quit because of how it made me feel (paranoia++).
Fluctuated on-and-off the Dex for a while (i.e. taking it a few days a week), but the whip-saws in dopamine levels really hit me hard, anxiety++.
Recently switched over to Atomoxetine (brand name Strattera) which has an off-script application to treating ADHD. It has a much more subtle effect than Dex, and has to be taken daily it to be effective. After about ~30 days of Atomoxetine I feel MUCH better, anxiety and stress is only at background levels.
Atomoxetine is nowhere near Dex in terms of focus and energy, but it does certainly address many ADHD symptoms + doesn't create the residual anxiety (at least for me). Libido isn't 100% of unmedicated, but nowhere near as bad as amphetamines.
Sorry to hear you’re going through such a tough time right now. Was there myself back a couple of years ago, down to the two kids. I have also played the merry go round of trying different medications and even different diagnoses. Took 3 years of trial and error to find the right meds and the right diagnosis.
First, I will echo what the other poster said - work with your doctor. Everyone is different and reacts differently to medication.
I can only speak from personal experience, but be very careful with Vyvanse. In the beginning, the effects were wonderful. Increased motivation, focus, etc. however, after about a year the effects began to wear off and my dosage was titrated really high (120 mg per day). Even at that dosage, I could barely get out of bed sometimes. I also began having panic attacks and severe paranoia. As another poster described, when it wore off, I had some of the most sad periods to where I’d sit there and cry for no reason. It was like staring up a deep dark well with little to no light.
I had life stuff going on, so reactions weren't completely unwarranted, but they were unnecessarily amplified. I’m not a doctor, but I felt like covers up depression and kicks the can down the road. Sometimes it gives people the motivation to change their circumstances, thus improving their depression. But, in many cases, it drives people to chase the high in order to keep staving off the lows. I don’t mean the euphoric high, I mean the motivation/focus high.
Listening to your post, and please don’t take this the wrong way, but it sounds like you are chasing the high without addressing the low. If you are taking a benzodiazepine for anxiety, it may be worth trying a different medication since those can make anyone groggy (with or without stimulants).
For me, it didn’t end well and I had to stop taking Vyvanse cold turkey (whew that sucked). It took a couple of years, but life turned out so much better for me once I addressed the anxiety and depression (or in my case, bipolar depression). I also take stimulants again, without any issues.
First, I will echo what the other poster said - work with your doctor. Everyone is different and reacts differently to medication.
I can only speak from personal experience, but be very careful with Vyvanse. In the beginning, the effects were wonderful. Increased motivation, focus, etc. however, after about a year the effects began to wear off and my dosage was titrated really high (120 mg per day). Even at that dosage, I could barely get out of bed sometimes. I also began having panic attacks and severe paranoia. As another poster described, when it wore off, I had some of the most sad periods to where I’d sit there and cry for no reason. It was like staring up a deep dark well with little to no light.
I had life stuff going on, so reactions weren't completely unwarranted, but they were unnecessarily amplified. I’m not a doctor, but I felt like covers up depression and kicks the can down the road. Sometimes it gives people the motivation to change their circumstances, thus improving their depression. But, in many cases, it drives people to chase the high in order to keep staving off the lows. I don’t mean the euphoric high, I mean the motivation/focus high.
Listening to your post, and please don’t take this the wrong way, but it sounds like you are chasing the high without addressing the low. If you are taking a benzodiazepine for anxiety, it may be worth trying a different medication since those can make anyone groggy (with or without stimulants).
For me, it didn’t end well and I had to stop taking Vyvanse cold turkey (whew that sucked). It took a couple of years, but life turned out so much better for me once I addressed the anxiety and depression (or in my case, bipolar depression). I also take stimulants again, without any issues.
I do. I was having anxiety attacks on dextroamphetamine. 5 mg a day. I was resigned to dealing with them sometimes.
Then I by happenstance quit caffeine. And panic attacks went away. Sleep problems went away.
The meds were potentiating the caffeine!
Try quitting caffeine!
Then I by happenstance quit caffeine. And panic attacks went away. Sleep problems went away.
The meds were potentiating the caffeine!
Try quitting caffeine!
For me a 10mg dose will last 20-40 hours.
If I take at same time each day it “builds up”
Made proper dosing Very difficult
Could you let us know what more modern medication you are using? I have serious problems with Ritalin side effects but am not aware of any alternatives besides adderall, vyvanse or riatlin like products.
Curious if you've ever done a hair follicle mineral test to check for mineral deficiencies?
We've been working through the book, "Finally Focused", to help our son. Magnesium supplementation is recommendation #1, Iron supplementation (if deficient as demonstrated by the test) and then the over-the-counter, lithium orotate. We haven't gotten further than chapter 3, yet.
We've been working through the book, "Finally Focused", to help our son. Magnesium supplementation is recommendation #1, Iron supplementation (if deficient as demonstrated by the test) and then the over-the-counter, lithium orotate. We haven't gotten further than chapter 3, yet.
I like this idea. Do you have a source for a company that will do this? Or does it require a doctors office visit?
This is the one we ordered. We haven’t administered it yet.
https://arltma.com/hairanalysis/
The lab doesn’t sell directly so you have to order it through a wellness center.
The lab doesn’t sell directly so you have to order it through a wellness center.
What's a more modern medicine in this context?
I would guess Vyvanse, it’s dextroamphetamine bound to a lysine molecule. Your liver must cleave the lysine before the d-amp is released giving a smooth release, taking ~3.5 hours till you hit max blood concentration.
Fun fact: Methamphetamine naturally takes 3-3.5 hours to hit peak so Vyvanse has a more “meth-like” concentration curve as opposed to raw d-amp (or adderal which is 75% d-amp 25% l-amp) which hits way sooner. As an aside, Meth is very misunderstood and is in many ways a more ideal ADHD drug than normal amphetamine; and indeed it can be prescribed under the brand name Desoxyn. Methamphetamine when taken in low-moderate oral doses is completey safe and less jittery than amphetamine, but if abused (say, smoking 100mg d-meth) it becomes far more neurotoxic.
Understanding enantiomers (left-handed vs right-handed molecules in this case) is really important. For amp / methamp, the d enantiomer is 3-4x more powerful by weight yet is more cerebral as opposed to causing peripheral (body) stimulation. So d is almost always superior, although with adderall it has been found that the 75/25 d/l formula synergizes and has a bit longer half life
Fun fact: Methamphetamine naturally takes 3-3.5 hours to hit peak so Vyvanse has a more “meth-like” concentration curve as opposed to raw d-amp (or adderal which is 75% d-amp 25% l-amp) which hits way sooner. As an aside, Meth is very misunderstood and is in many ways a more ideal ADHD drug than normal amphetamine; and indeed it can be prescribed under the brand name Desoxyn. Methamphetamine when taken in low-moderate oral doses is completey safe and less jittery than amphetamine, but if abused (say, smoking 100mg d-meth) it becomes far more neurotoxic.
Understanding enantiomers (left-handed vs right-handed molecules in this case) is really important. For amp / methamp, the d enantiomer is 3-4x more powerful by weight yet is more cerebral as opposed to causing peripheral (body) stimulation. So d is almost always superior, although with adderall it has been found that the 75/25 d/l formula synergizes and has a bit longer half life
> I've always been one to 'just deal with it' but after a few years of working through school and seeing my younger brothers go through the same thing with medication, I realized that I was essentially just handicapping myself.
That's not entirely true, though. There is a lot of value in learning good habits to cope with ADHD and developing systems and mental models to improve your ADHD situation. ADHD isn't a purely dopaminergic "chemical imbalance" in the brain that can only be improved with chemical solutions, similar to how depression isn't entirely a chemical imbalance of serotonin.
One of the downsides of aggressive ADHD medication treatment is that it can handicap learning of good habits and coping strategies. Some, thought not all, patients quickly learn to rely on the stimulant effect of their medication to get anything done, assuming that medication is the only way to improve. This becomes a problem as the motivating effects of stimulant medication wear off after months or years, leaving only the concentration-enhancing side effects. Internet forums are full of 20-something ADHD patients who think the only way to address their ADHD is ever increasing doses of stimulants, but eventually they hit prescribing limits and increasing side effects. The solution is to approach ADHD as a combined treatment with minimal medication and heavy emphasis on self-discipline and healthy habits.
Regarding this study: Don't forget that ADHD medications aren't simply dopamine dispensers. All of the stimulant ADHD medications have significant norepinephrine activity, as well. There are many reasons why pure dopamine agonists aren't effective for ADHD.
> I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.
In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.
Many people take stimulant treatment for years or decades, but the unfortunate reality is that the long-term effectiveness of stimulants isn't exactly a sure thing. Clinical trials and studies rarely run for more than a few months. The studies on long-term patients are mixed, but not encourage for long-term effectiveness of stimulants ( https://pubmed.ncbi.nlm.nih.gov/11322742/ ). If you only recently started taking stimulants, you might be in somewhat of a "honeymoon phase" where the core effects are still strong. Note that after years of use, people will tend to overestimate the effects of the drug due to the severity of withdrawal symptoms on days off.
In short, I'd encourage you to continue addressing your ADHD symptoms with ever-improving self discipline, personal habits, and healthy lifestyle choices. The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.
That's not entirely true, though. There is a lot of value in learning good habits to cope with ADHD and developing systems and mental models to improve your ADHD situation. ADHD isn't a purely dopaminergic "chemical imbalance" in the brain that can only be improved with chemical solutions, similar to how depression isn't entirely a chemical imbalance of serotonin.
One of the downsides of aggressive ADHD medication treatment is that it can handicap learning of good habits and coping strategies. Some, thought not all, patients quickly learn to rely on the stimulant effect of their medication to get anything done, assuming that medication is the only way to improve. This becomes a problem as the motivating effects of stimulant medication wear off after months or years, leaving only the concentration-enhancing side effects. Internet forums are full of 20-something ADHD patients who think the only way to address their ADHD is ever increasing doses of stimulants, but eventually they hit prescribing limits and increasing side effects. The solution is to approach ADHD as a combined treatment with minimal medication and heavy emphasis on self-discipline and healthy habits.
Regarding this study: Don't forget that ADHD medications aren't simply dopamine dispensers. All of the stimulant ADHD medications have significant norepinephrine activity, as well. There are many reasons why pure dopamine agonists aren't effective for ADHD.
> I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.
In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.
Many people take stimulant treatment for years or decades, but the unfortunate reality is that the long-term effectiveness of stimulants isn't exactly a sure thing. Clinical trials and studies rarely run for more than a few months. The studies on long-term patients are mixed, but not encourage for long-term effectiveness of stimulants ( https://pubmed.ncbi.nlm.nih.gov/11322742/ ). If you only recently started taking stimulants, you might be in somewhat of a "honeymoon phase" where the core effects are still strong. Note that after years of use, people will tend to overestimate the effects of the drug due to the severity of withdrawal symptoms on days off.
In short, I'd encourage you to continue addressing your ADHD symptoms with ever-improving self discipline, personal habits, and healthy lifestyle choices. The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.
> In short, I'd encourage you to continue addressing your ADHD symptoms with ever-improving self discipline, personal habits, and healthy lifestyle choices. The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.
No, no, no, no. As someone who suffered remarkable mental turmoil over my inability to focus, despite reading books about it, asking everyone for help with my problems, just no, I hate this kind of puritanical thinking, it's exactly this kind of thinking which adds to the stigma of ADHD medication. The very first _day_ I took the medication I knew I'd stumbled upon something monumental. And then I realized that all those years of struggle in school and college, they were all for naught.
The only right answer is: see a psychologist if you think you have a problem, and get medicated if you and your psychologist feels you do have a problem.
> In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.
Nope. It just shit on my self-esteem and resulted in depression because I thought I was just not cut out for the things I wanted to be able to do.
No, no, no, no. As someone who suffered remarkable mental turmoil over my inability to focus, despite reading books about it, asking everyone for help with my problems, just no, I hate this kind of puritanical thinking, it's exactly this kind of thinking which adds to the stigma of ADHD medication. The very first _day_ I took the medication I knew I'd stumbled upon something monumental. And then I realized that all those years of struggle in school and college, they were all for naught.
The only right answer is: see a psychologist if you think you have a problem, and get medicated if you and your psychologist feels you do have a problem.
> In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.
Nope. It just shit on my self-esteem and resulted in depression because I thought I was just not cut out for the things I wanted to be able to do.
>> The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.
> No, no, no, no.
I'm sorry you struggled, but I think you misinterpreted my post. I never suggested that people must go medication-free, or that therapy is the only option.
The point is that optimal medication treatment still requires effort to learn healthy habits, facilitate self-discipline, and improve one's ability to focus.
If you need medication to begin that process, so be it, but taking medication shouldn't mean that you neglect the self-improvement aspect of this. The medication can be a springboard, but it's a mistake to give up on self-improvement and hope that medication can do all of the heavy lifting.
> No, no, no, no.
I'm sorry you struggled, but I think you misinterpreted my post. I never suggested that people must go medication-free, or that therapy is the only option.
The point is that optimal medication treatment still requires effort to learn healthy habits, facilitate self-discipline, and improve one's ability to focus.
If you need medication to begin that process, so be it, but taking medication shouldn't mean that you neglect the self-improvement aspect of this. The medication can be a springboard, but it's a mistake to give up on self-improvement and hope that medication can do all of the heavy lifting.
GP seems to be arguing that medication is absolutely appropriate as part of a solution. You seem to be vehemently arguing that medication was critically important for you. There’s probably less contradiction than it appears you’re arguing.
Perhaps school and college were the problems and not your ADHD?
>One of the downsides of aggressive ADHD medication treatment is that it can handicap learning of good habits and coping strategies
I mean, my entire post was actually saying the opposite. One of the biggest downsides of having ADHD is the way it handicaps learning of good habits and life skills. I tried doing exactly what you describe in high school and the result was constantly failing to do extracurricular work and being branded as lazy by my peers and educators. There are a lot of comments in this thread on both sides of the argument that seem to take personal anecdote too far. My honest advice continues to be that medication is a great tool for those who need it, and therapy is something pretty much everyone should experience.
I mean, my entire post was actually saying the opposite. One of the biggest downsides of having ADHD is the way it handicaps learning of good habits and life skills. I tried doing exactly what you describe in high school and the result was constantly failing to do extracurricular work and being branded as lazy by my peers and educators. There are a lot of comments in this thread on both sides of the argument that seem to take personal anecdote too far. My honest advice continues to be that medication is a great tool for those who need it, and therapy is something pretty much everyone should experience.
What medication do you take now? Did you take anything while growing up?
I take concerta, 18mg, and it works wonders. The only small negative is the its life is a little too long... even if I take it at 7am, I find I have difficulty getting to sleep sometimes up till 3am... and then my whole sleep schedule gets shifted and it’s damn difficult to get it back to a proper rhythm.
That aside, I _so_ agree with grandparent post about the negative stigma associated with medication for adhd. I’m so angry at society, parents, everyone for having done this to me in my early years — if only I had started earlier instead of in my mid-20s.
That aside, I _so_ agree with grandparent post about the negative stigma associated with medication for adhd. I’m so angry at society, parents, everyone for having done this to me in my early years — if only I had started earlier instead of in my mid-20s.
Try dexedrine imo, I had what you're describing with XR pills like vyvance and if I ever woke up late I knew I couldn't take the pill without having an all-nighter.
5mg of dexedrine at 8am gets me til 5-6pm and no crash afterwards.
5mg of dexedrine at 8am gets me til 5-6pm and no crash afterwards.
How early do you think you should have started? And how would one know its the right time?
That’s a tough one, that’s a really tough one, especially as I’m seeing my 5 year old niece and seeing myself in her... in her inability to remain focused and motivated. It’s tough because even I am sometimes biased against running to medication as sloppy fixes when root causes of ailments and a full safety profile of drugs isn’t 100% clear.
But with the information and experience I have, I think if you get tested by a professional psychologist and he okays it, I’d be comfortable with kids as young as 5 getting medicated.
But with the information and experience I have, I think if you get tested by a professional psychologist and he okays it, I’d be comfortable with kids as young as 5 getting medicated.
Thanks, I have a 11 year old with ADHD and as you say its a tough decision so I am always looking for advice. Take care.
Growing up I was perscribed ritalin, however I stopped taking it within a few months because my middle-school brain was not enjoying the side-effects (mostly drowsiness). Now I'm perscribed Adderall and it works great. It can be annoying because every college student under the sun is taking adderall to cram last minute but it's a different drug when you actually need it to function. For most people Adderall just keeps them awake and hyper-focused so they can do whatever they need to get done, regardless of the hours it takes them. For someone who has ADHD, it really just brings us to what that baseline is for most people.
I can focus on my work all day with no medication if I'm doing something that I find personally interesting. However, when I have a week's worth of online coursework and boring bookkeeping to do it's impossible to get more than 5 minutes done without staring out the window, putting something on in the background, and twiddling my thumbs. I can still buckle down and get work done without it, but it's so much more mentally draining to do a week of work without any medication than if I were just to take what the doctor recommends. YMMV obviously, I just wanted to suggest something for people like me who have been 'proudly' living with ADHD un-medicated.
I can focus on my work all day with no medication if I'm doing something that I find personally interesting. However, when I have a week's worth of online coursework and boring bookkeeping to do it's impossible to get more than 5 minutes done without staring out the window, putting something on in the background, and twiddling my thumbs. I can still buckle down and get work done without it, but it's so much more mentally draining to do a week of work without any medication than if I were just to take what the doctor recommends. YMMV obviously, I just wanted to suggest something for people like me who have been 'proudly' living with ADHD un-medicated.
> I can focus on my work all day with no medication if I'm doing something that I find personally interesting. However, when I have a week's worth of online coursework and boring bookkeeping to do it's impossible to get more than 5 minutes done without staring out the window, putting something on in the background, and twiddling my thumbs. I can still buckle down and get work done without it, but it's so much more mentally draining to do a week of work without any medication than if I were just to take what the doctor recommends.
How do you know that other people have it harder? My suspicion is that we all suffer in quiet desperation.
How do you know that other people have it harder? My suspicion is that we all suffer in quiet desperation.
I often wonder what kind of impulse drives someone to think, believe, and then confront others with their insanely regressive opinions. At least today I have a concrete answer.
In case you're still confused, there's this thing called the DSM that people use to diagnose/classify mental disorders. It's a pretty big deal.
In case you're still confused, there's this thing called the DSM that people use to diagnose/classify mental disorders. It's a pretty big deal.
What do you take now? My kid is still doing mostly fine 'just dealing with it' (10yo) but I want to be ready.
Curious - what’s the more modern medication that you take! Thanks.
> children with ADHD require stronger incentives to modify their behavior than those without ADHD5; they also show a failure to delay gratification, have impaired responses to partial schedules of reinforcement, and preference for small immediate rewards over larger delayed rewards6,7.
I'm an adult with ADHD and that paragraph describes me to a T, though it definitely was worse as a child
I got my first D grade in a subject in fifth grade, and the next seven years were basically my parents trying every tool at their disposal to motivate me to get better grades.
I was on academic probation four more terms than I wasn't in college, and graduated with a low C average after 5.5 years, plus two summer terms.
I got hired at the only company that forgot to ask for my GPA.
I think if I were just sightly less intelligent, I would have been in a world of hurt and possibly dead by now.
I'm an adult with ADHD and that paragraph describes me to a T, though it definitely was worse as a child
I got my first D grade in a subject in fifth grade, and the next seven years were basically my parents trying every tool at their disposal to motivate me to get better grades.
I was on academic probation four more terms than I wasn't in college, and graduated with a low C average after 5.5 years, plus two summer terms.
I got hired at the only company that forgot to ask for my GPA.
I think if I were just sightly less intelligent, I would have been in a world of hurt and possibly dead by now.
Likewise, there is a fine line between my personality and the kind that tends to end up in poverty or dead where I live. I feel like I’m constantly barely clinging to whatever i remains about me that allows me to thrive at all. I don’t act to my best judgement most of the time.
A big middle finger to my ~top 20 public university who wouldn't give me any accommodations of extra time because they required some ridiculous hoops to jump through proving I had trouble concentrating and finishing an exam in the allotted time, they wanted substantial documentation with brain scans showing I had a deficit all because ADHD isn't considered a bonafide disability by the government. I almost flunked out cause of some calculus and organic/biochemistry classes that required tons of rote memorization (pre-med before switching to computer major).
Even though I'm successful now in tech with a huge salary, this experience of being treated like I had a made-up disorder (can't easily perceive it with no physical impairment/more obvious mental issues), and was invisible to the system full of cold-hearted academic administrators quick to academically disqualify me still makes me seethe and feel wronged to this very day.
Can anyone relate?
Even though I'm successful now in tech with a huge salary, this experience of being treated like I had a made-up disorder (can't easily perceive it with no physical impairment/more obvious mental issues), and was invisible to the system full of cold-hearted academic administrators quick to academically disqualify me still makes me seethe and feel wronged to this very day.
Can anyone relate?
I'm in community college, but my experience in high school was basically identical to yours. High school and the beginning of college were a nightmare for me for essentially the same reasons you describe. I still feel like I'm shaking off some kind of imposter syndrome when I'm interviewing for a new client. Students used to seethe when my test scores were read because, despite testing top of the class I never did any extracurricular work or engaged in class very much. Eventually even the teachers started to treat me like a burnout. I'd start a new semester and the teacher would already know who I was from chatting in the teachers' lounge. At least in community college the student/faculty pool is wide enough that I can avoid those types of interactions, plus the switch to computer science and some decent ADHD meds have made all the difference.
I’ve had more help with my ADHD symptoms from a series of DMT experiences, than I ever did from the mainstream treatment process. One single DMT experience (containing about an objective hour of intensely being dragged through time) greatly minimized my ADHD symptoms for at least six months. There is untapped potential in psychedelics for treatment of things like this. It’s a crime against humanity that we allowed neurotypicals to decide for everyone how these neurochemistries are managed.
ADHD treatment is not ADHD friendly. Society is not ADHD friendly. Neurotypicals literally have the same scale of mental privilege as whites do in a racial context.
ADHD treatment is not ADHD friendly. Society is not ADHD friendly. Neurotypicals literally have the same scale of mental privilege as whites do in a racial context.
I agree with this. I also had significant success by permanently alleviating the major symptoms of ADHD (like bumping into walls, not cleaning room, not being able to pay bills on time) with 1 trip of LSD about 8 years ago. I don't even drink coffee, and I'm getting by with the occasional bouts of anxiety which I can deal with separately. I also occasionally do Ayahuasca for trauma/childhood healing work - which I suspect many people with ADHD have.
I found it weird that people can get banned for talking about their anecdotal experiences with psychedelics on the ADHD subreddit too. Seems like some people are more comfortable being with the ADHD community and sticking with the status quo regimens, than actually doing something completely new.
I found it weird that people can get banned for talking about their anecdotal experiences with psychedelics on the ADHD subreddit too. Seems like some people are more comfortable being with the ADHD community and sticking with the status quo regimens, than actually doing something completely new.
I think it's cos that community is a very wide range of people, some of which are very young. It's not like HN where we are all older and generally a crowd who really likes to tackle problems from an intellectual angle and try things out to get the data on them. That subreddit kinda has to stick to the lowest common denominator which is just following the standard advice.
Very interesting to hear of your experiences in this thread though. Maybe we need an r/ADHND for all us ADHDers on HN :P
Very interesting to hear of your experiences in this thread though. Maybe we need an r/ADHND for all us ADHDers on HN :P
"Neurotypicals literally have the same scale of mental privilege as whites do in a racial context."
Wow this is profound to say the least, thanks for making this connection I've intuitively felt but could not articulate the impact of my ADHD and potential to succeed in life starting from an early age.
Wow this is profound to say the least, thanks for making this connection I've intuitively felt but could not articulate the impact of my ADHD and potential to succeed in life starting from an early age.
As an adult with ADD i cast doubts about the diagnosis. I have started to more and more think my diagosis is just a result of not being a high productive high intelligence individual.
I more and more realise that my brain and personality is not the kind that is made for desk work. I find it boring and difficult.
I have done other types of works that suits me better i beleive my life would be so much better if i just accepted that i was never to be sitting at a desk solving problems.
School has always been difficult for me, simply because it hard to learn the things you need to learn in shcool, for more intelligent individuals school is not the same big deal as it is for me. But thats just the way things is. The same way i was not born 2meter tall and an musculuar body.
I beleive that we will see more and more ADD/ADHD diagnosies in the future, simply because automation puts more demands on the individual and the jobs will be more mentally demanding.
I see a future where meds like adderal will be availble in the supermarkets.
Instead of giving people ADD/ADHD diagnosises we should just teach people to accept that not everyone are made for mentally demanding tasks and that not everyone goes thru school without it being a huge difficult task. Parents also needs to learn that their kids might not will be able to compete in the job markets in the future and the solution is not to medicate it away.
I more and more realise that my brain and personality is not the kind that is made for desk work. I find it boring and difficult.
I have done other types of works that suits me better i beleive my life would be so much better if i just accepted that i was never to be sitting at a desk solving problems.
School has always been difficult for me, simply because it hard to learn the things you need to learn in shcool, for more intelligent individuals school is not the same big deal as it is for me. But thats just the way things is. The same way i was not born 2meter tall and an musculuar body.
I beleive that we will see more and more ADD/ADHD diagnosies in the future, simply because automation puts more demands on the individual and the jobs will be more mentally demanding.
I see a future where meds like adderal will be availble in the supermarkets.
Instead of giving people ADD/ADHD diagnosises we should just teach people to accept that not everyone are made for mentally demanding tasks and that not everyone goes thru school without it being a huge difficult task. Parents also needs to learn that their kids might not will be able to compete in the job markets in the future and the solution is not to medicate it away.
ADHD brains are actually different due to pervasive developmental delays.
It's not even really related to intelligence. ADHDers run the gamut from really stupid, to average, to really smart.
I'm reasonably intelligent, but boy do I struggle with the basics on a day to day basis. Understanding complex stuff is fairly fun and engaging for me, so I spend a bunch of time doing it. That's usually at the expense of being a good husband, father, friend or brother.
It doesn't seem to be what you think it is.
It's not even really related to intelligence. ADHDers run the gamut from really stupid, to average, to really smart.
I'm reasonably intelligent, but boy do I struggle with the basics on a day to day basis. Understanding complex stuff is fairly fun and engaging for me, so I spend a bunch of time doing it. That's usually at the expense of being a good husband, father, friend or brother.
It doesn't seem to be what you think it is.
What I really want to know is if taking all this adderall to beat my axon terminals into submission and pump out dopamine + block re-uptake is going to cause an early onset of an Alzheimer-esque neurodegeneration when I'm approaching my senior years.
This hypothetical sends chills down by spine knowing I might be making a deal with the devil to get a temporary fix on ADHD symptoms now for increased risk of dopamine downregulation or neurodegeneration later.
Can anyone relate and/or give me some peace of mind? ~60mg/day for 12 years and not letting up anytime soon as long as I need my executive functions under my command to do computer work. If I drop the stimulants I can maybe get a low wage job doing basic IT service desk stuff or live a simple life doing a 'muscle memory' line of work e.g. Amazon factory worker, go to trade school for something hands on, etc. that doesn't require asynchronous access to my prefrontal cortex + memories + instantaneous storage/retrieval with my working memory for hours on end.
God I envy neurotypical people, I feel handicapped mentally in comparison to their baseline.
This hypothetical sends chills down by spine knowing I might be making a deal with the devil to get a temporary fix on ADHD symptoms now for increased risk of dopamine downregulation or neurodegeneration later.
Can anyone relate and/or give me some peace of mind? ~60mg/day for 12 years and not letting up anytime soon as long as I need my executive functions under my command to do computer work. If I drop the stimulants I can maybe get a low wage job doing basic IT service desk stuff or live a simple life doing a 'muscle memory' line of work e.g. Amazon factory worker, go to trade school for something hands on, etc. that doesn't require asynchronous access to my prefrontal cortex + memories + instantaneous storage/retrieval with my working memory for hours on end.
God I envy neurotypical people, I feel handicapped mentally in comparison to their baseline.
In my country you can't get diagnosed and treated for adult ADHD if you weren't diagnosed as a child. Which is a complete bullshit. One can only buy meds on a black market and hope for the best...
That is bullshit, absolutely. My understanding is that the correct clinical criteria do require that the symptoms showed up by age 7, but that it's not at all necessary for the diagnosis to have occurred during childhood.
>In my country
Why not just say the country?
Why not just say the country?
Slovenia
I'm curious too.
I would think that would also imply that access in other ways might be a bit "easier" as well...
I would think that would also imply that access in other ways might be a bit "easier" as well...
Not OP but this is functionally true in the US.
I was diagnosed when I was younger, made the mistake of letting my prescription lapse (because I give myself breaks and therefore end up accumulating excess), and now can’t get the medication I need to function.
Fun fact, when you’re ADHD-PI, trying SSRIs isn’t just a harmless fun little exercise, it could have potentially life ruining consequences, which the psychiatrist will not tell you about.
If any psychiatrists are reading this, please know that the ‘harms’ of giving your patients the medication that is proven to work absolutely do not outweigh the harms of all the alternative coping mechanisms needed to avoid losing employment: black market pills, smoking/nicotine, caffeine by the gram, etc.
I was diagnosed when I was younger, made the mistake of letting my prescription lapse (because I give myself breaks and therefore end up accumulating excess), and now can’t get the medication I need to function.
Fun fact, when you’re ADHD-PI, trying SSRIs isn’t just a harmless fun little exercise, it could have potentially life ruining consequences, which the psychiatrist will not tell you about.
If any psychiatrists are reading this, please know that the ‘harms’ of giving your patients the medication that is proven to work absolutely do not outweigh the harms of all the alternative coping mechanisms needed to avoid losing employment: black market pills, smoking/nicotine, caffeine by the gram, etc.
> I was diagnosed when I was younger, made the mistake of letting my prescription lapse (because I give myself breaks and therefore end up accumulating excess), and now can’t get the medication I need to function.
Wtf? I have done the same thing, gone off-and-on my RX I think 3 times now.
Whenever I wanted to get back on, I just found a random psychiatrist or clinic and said "Can you please renew my ADHD Rx? It's starting to really negatively impact my work performance." and then they'd say okay, sure.
This was in Colorado though, Boulder/Denver area. Half the university students and tech workers had prescriptions so it might be a biased area. Not sure what it might be like other places in the US.
Sorry you're going through that nonsense, if you want to shell out the money you can google "ADHD specialist" and pick a psychiatrist from the list that pops up. Will cost you ~$300-500 (IME) out of pocket for consultation and re-diagnosis.
Wtf? I have done the same thing, gone off-and-on my RX I think 3 times now.
Whenever I wanted to get back on, I just found a random psychiatrist or clinic and said "Can you please renew my ADHD Rx? It's starting to really negatively impact my work performance." and then they'd say okay, sure.
This was in Colorado though, Boulder/Denver area. Half the university students and tech workers had prescriptions so it might be a biased area. Not sure what it might be like other places in the US.
Sorry you're going through that nonsense, if you want to shell out the money you can google "ADHD specialist" and pick a psychiatrist from the list that pops up. Will cost you ~$300-500 (IME) out of pocket for consultation and re-diagnosis.
i have severe ADD, and i dont have the patience with myself to read enough of this article to benefit my understanding of it.
The good news is that you don’t need to. In fact, these articles tend to give people a false feeling of understanding, and an impression that ADHD is purely a chemical situation in the brain that can only be treated with drugs.
That’s not really true. Medication can absolutely help for severe cases, but falling into the trap of thinking that ADHD is a purely chemical problem that can only be addressed with chemical solutions can lead people to neglect the important lifestyle and self-discipline changes that will really help their situation in the long term.
Don’t get caught up in ideas that ADHD is “just dopamine”, because that’s a path to ignoring the fact that personal changes and therapy can improve ADHD immensely.
That’s not really true. Medication can absolutely help for severe cases, but falling into the trap of thinking that ADHD is a purely chemical problem that can only be addressed with chemical solutions can lead people to neglect the important lifestyle and self-discipline changes that will really help their situation in the long term.
Don’t get caught up in ideas that ADHD is “just dopamine”, because that’s a path to ignoring the fact that personal changes and therapy can improve ADHD immensely.
[deleted]
Would you share some of your assumedly true understanding?
It's a massive topic to cover in the scope of HN comments. ADHD also tends to be a touchy subject on HN. For a less heated parallel, consider reading up on how the "chemical imbalance" narrative has been harmful for public perception of psychiatry: https://www.psychiatrictimes.com/view/debunking-two-chemical... . People consume a lot of medication ads (in the US) and bite-sized, reductionist narratives about neurotransmitters and walk away thinking that psychiatry is simply about manipulating neurotransmitters up or down. In reality, psychiatry has known for a long time that complex behavioral disorders like ADHD, depression, PTSD, and so on aren't as simple as neurotransmitter balance in the brain, nor do they purely arise from your genetic code.
These "chemical imbalance" narratives tend to do more harm than good by giving patients an idea that their symptoms are purely external to their own choices, and therefore completely out of their own control. Unfortunately, it's very difficult to convince suffering patients that they have some control over their situation without also implying personal blame for their problems, which doesn't go over well. The idea that the problem is faultless ("It's not you, it's just your brain!") and that the solutions are effortless ("This pill will fix your chemical imbalance") is just too tempting. The alternatives ("Read this book on study habits, leave your phone in another room while studying, use timeboxing...") are an unappealing alternative.
Don't get me wrong: Medications can and absolutely do help people, but this idea that the problem can only be treated via medication is demonstrably false. The most successful patients use a combination of medications, therapy, and healthy habit-forming. The least successful patients tend to give up on everything except the medication, reaching for ever-increasing doses or trying to play games of on-days/off-days or saving up extra medication. That's a losing battle.
These "chemical imbalance" narratives tend to do more harm than good by giving patients an idea that their symptoms are purely external to their own choices, and therefore completely out of their own control. Unfortunately, it's very difficult to convince suffering patients that they have some control over their situation without also implying personal blame for their problems, which doesn't go over well. The idea that the problem is faultless ("It's not you, it's just your brain!") and that the solutions are effortless ("This pill will fix your chemical imbalance") is just too tempting. The alternatives ("Read this book on study habits, leave your phone in another room while studying, use timeboxing...") are an unappealing alternative.
Don't get me wrong: Medications can and absolutely do help people, but this idea that the problem can only be treated via medication is demonstrably false. The most successful patients use a combination of medications, therapy, and healthy habit-forming. The least successful patients tend to give up on everything except the medication, reaching for ever-increasing doses or trying to play games of on-days/off-days or saving up extra medication. That's a losing battle.
Thanks for writing this out. My only comment is this: it's a touchy subject because while you are describing one end of the spectrum, the opposite end is almost always applied for those struggling with ADHD - "Just work harder! You'll get over it"
There's definitely a healthy balance of smart lifestyle choices, coupled with medication for those who truly struggle and need to just get from zero to 1.
There's definitely a healthy balance of smart lifestyle choices, coupled with medication for those who truly struggle and need to just get from zero to 1.
Thank you very much for writing this! It's very well formulated and expressed. I especially liked
> Unfortunately, it's very difficult to convince suffering patients that they have some control over their situation without also implying personal blame for their problems
I also see it as a big part of the problem, that it's difficult to convince people that they do have control over their lives. In many psychotherapy books, when therapists describe various cases, this is a corner stone of a therapy success: a patient understanding that they do have control over their situation. That it's not the outer world that is so demanding that it leaves them no choice, but them choosing to cope in a particular way, and that there are other ways to react and cope.
> Unfortunately, it's very difficult to convince suffering patients that they have some control over their situation without also implying personal blame for their problems
I also see it as a big part of the problem, that it's difficult to convince people that they do have control over their lives. In many psychotherapy books, when therapists describe various cases, this is a corner stone of a therapy success: a patient understanding that they do have control over their situation. That it's not the outer world that is so demanding that it leaves them no choice, but them choosing to cope in a particular way, and that there are other ways to react and cope.
The problem with "Read this book on study habits, leave your phone in another room while studying, use timeboxing..." isn't that it's unappealing (and a reasonably smart person should be able to figure out most of these without being told). It's that these approaches don't really work if you don't have some baseline ability to focus. And too often it comes out just as "you're stupid and lazy".
For the reference, where I live we don't have ads for prescription medication. On the other hand everything tends to be diagnosed as depression and treated with antidepressants, no matter what symptoms are.
For the reference, where I live we don't have ads for prescription medication. On the other hand everything tends to be diagnosed as depression and treated with antidepressants, no matter what symptoms are.
Take a look at this new treatment(neurofeedback)[1]. It changed my life. Instead of changing brain chemically you can change the structure of your brain. It's not ADHD that's the problem, its the focus networks in the brain not being trained properly.
ADHD becomes a gift when you can focus and the brain just naturally learns, and memorizes very well. I went from being incapable of anything to being really great at anything I wanted to be (just late to the party). [1] http://addcentre.com/
ADHD becomes a gift when you can focus and the brain just naturally learns, and memorizes very well. I went from being incapable of anything to being really great at anything I wanted to be (just late to the party). [1] http://addcentre.com/
The evidence currently suggest that Neurofeedback does not outperform a placebo. There's a nice round up of the research at the bottom of this article: https://www.psychologytoday.com/us/blog/brain-myths/201302/r....
I am very interested in this but am currently located in Scandinavia.
What does the training practically entail?
Is it some kind of device on the head that you then learn to use with an on-screen app where you can get feedback on your "state" like meditation but with an interface?
I remember reading about this years ago and wondering when the tech would be available for use in-home.
Do you need to go to a professional clinic?
Is it some kind of device on the head that you then learn to use with an on-screen app where you can get feedback on your "state" like meditation but with an interface?
I remember reading about this years ago and wondering when the tech would be available for use in-home.
Do you need to go to a professional clinic?
There can be a lot to understand depending on how much change your actually looking for (so much I could write a book). But its just putting EEG electrodes on the skull to record frequency ranges in the brain. These frequencies(Delta, Gamma and Alpha) relate to the "focus", "relaxation"(related to meditation) and "cross-talk" functions of the brain that primarily are controlled by the Sensory-Motor Cortex.
There are many different programs all with different goals, some try to optimize the relax range, some focus and some try to minimize cross talk. Imagine looking at a screen and it shows your POV from inside a roller coaster car. On the sides you can see a bar chart going up and down and a threshold level you want to attain. Eventually you learn to control it so you bring that bar to the threshold and hold it (Holding it is key). If your really motivated you can tell the technicians to bring the threshold down so far that you are able to focus greater than the average person.
It begins by controlling muscles in your eyes effectively, once movements of the eyes have stabilized(this is the hyperactivity part that negatively effects focus) light can effectively move into the visual cortex. Then tying the other senses(sound and touch) together probably switches on the focus networks in the brain. This leads to experiencing reality at much higher "resolution".
I would advise having professionals around(like I did) they can spot problems/anomalies and can aid in training. It can be dangerous to mess with your brain without professionals around.
There are many different programs all with different goals, some try to optimize the relax range, some focus and some try to minimize cross talk. Imagine looking at a screen and it shows your POV from inside a roller coaster car. On the sides you can see a bar chart going up and down and a threshold level you want to attain. Eventually you learn to control it so you bring that bar to the threshold and hold it (Holding it is key). If your really motivated you can tell the technicians to bring the threshold down so far that you are able to focus greater than the average person.
It begins by controlling muscles in your eyes effectively, once movements of the eyes have stabilized(this is the hyperactivity part that negatively effects focus) light can effectively move into the visual cortex. Then tying the other senses(sound and touch) together probably switches on the focus networks in the brain. This leads to experiencing reality at much higher "resolution".
I would advise having professionals around(like I did) they can spot problems/anomalies and can aid in training. It can be dangerous to mess with your brain without professionals around.
Thank you! Do you have any leads book wise, a certain methodology or a though leader in the field?
I think i will try to find a place similar to yours in Scandinavia but want the quality to be right.
Alternatively i am thinking if consumer EEG electrodes are good enough at this time to create a personal setup.
I think i will try to find a place similar to yours in Scandinavia but want the quality to be right.
Alternatively i am thinking if consumer EEG electrodes are good enough at this time to create a personal setup.
Yes the doctor who oversaw my treatment pioneered the treatment and is the thought leader in the field.
You can read her various papers[1]. I've read many things about ADHD and functioning mechanics of the brain. This is by far the most substantive and practical resource of info that I managed to put to go use when I trained my brain.
http://addcentre.com/page-29/page-31/
You can read her various papers[1]. I've read many things about ADHD and functioning mechanics of the brain. This is by far the most substantive and practical resource of info that I managed to put to go use when I trained my brain.
http://addcentre.com/page-29/page-31/
This is really fascinating. I just sent them an email to see if I could participate (diagnosed with ADHD 6 months ago at age 33, feeling pretty depressed that all the years of struggling/setbacks were to some degree unnecessary).
May I ask how long have you been participating in the training?
May I ask how long have you been participating in the training?
The training is about 1-2 hour sessions. You need about 20 sessions. They can completed once a week. But if your serious you would do 2-3 times the first 4-6 weeks to change things with greater momentum. After it is complete you never need to think about it again.
I don't know anything about those folks but my son (inattentive type) got a lot of value from neurofeedback about 10 years ago under a psychologist using the full EEG skull cap. He went once a week for 18 months then less often for another year or two. Wish I'd done it...
I’m just starting neurofeedback, curious what your experience was like. May I email you at the address you have on profile ?
Feel free to email me. You will probably get much more complete response through that medium. Good luck!
Many years ago I read the preface to the behemoth of a book that is Infinite Jest by DFW.
I don't remember the wording of the preface, but I recall it arguing that the sheer size of the book could be regarded both as a cultural experience as well as a mental exercise.
The author of the preface argued that when (or perhaps if) you finished the book you would feel like you've just run a marathon. You would be highly fit, reading wise. Nothing would phase you.
This was probably compounded in my teenage head by the fact that the only quote I've heard from the author beforehand was:
"I consume libraries. I wear out spines and ROM-drives. I do things like get in a taxi and say, 'The library, and step on it.'"
It sounded like a complete opposite of myself at the time, but I did want to learn that ability. And I liked that preface a lot. It kept me going at it month after month on busy train rides, with the promise of some transcendent reward at the end.
There are famous footnotes in that book spanning several pages in tiny print. The amount of mental effort it took to read the thing was extraordinary for someone like me at the time. I often had to backtrack several pages to perform the context switch from a mini-novel footnote back to the main storyline.
This was many years ago now, and I have slipped far behind on my reading fitness. But I still carry with me the realization that I can't expect to be fit if I don't train hard.
Now, ADD is a whole nother beast. Sicknesses often require medical attention and this should not be smoothed over. Still, I think there's an interesting discussion to be had regarding reading fitness in the era of information. Maybe this is a widely discussed thing and I'm just not hearing it, but it seems obvious that we slip further toward obesity without training. Surely something similar happens with our ability to focus without training?
I don't remember the wording of the preface, but I recall it arguing that the sheer size of the book could be regarded both as a cultural experience as well as a mental exercise.
The author of the preface argued that when (or perhaps if) you finished the book you would feel like you've just run a marathon. You would be highly fit, reading wise. Nothing would phase you.
This was probably compounded in my teenage head by the fact that the only quote I've heard from the author beforehand was:
"I consume libraries. I wear out spines and ROM-drives. I do things like get in a taxi and say, 'The library, and step on it.'"
It sounded like a complete opposite of myself at the time, but I did want to learn that ability. And I liked that preface a lot. It kept me going at it month after month on busy train rides, with the promise of some transcendent reward at the end.
There are famous footnotes in that book spanning several pages in tiny print. The amount of mental effort it took to read the thing was extraordinary for someone like me at the time. I often had to backtrack several pages to perform the context switch from a mini-novel footnote back to the main storyline.
This was many years ago now, and I have slipped far behind on my reading fitness. But I still carry with me the realization that I can't expect to be fit if I don't train hard.
Now, ADD is a whole nother beast. Sicknesses often require medical attention and this should not be smoothed over. Still, I think there's an interesting discussion to be had regarding reading fitness in the era of information. Maybe this is a widely discussed thing and I'm just not hearing it, but it seems obvious that we slip further toward obesity without training. Surely something similar happens with our ability to focus without training?
This is really insightful, thanks. Makes me want to take another swing at Infinite Jest.
With depression, we might take medication to grant us a seat at the table of recovery via a therapist. The hope is to get off of that medication eventually. Perhaps the same holds true with ADD/ADHD? I am not a psychiatrist.
I've been wondering about this attention deficit and reading comprehension issue for awhile now. I would love to know how many of us adults actually read books anymore for longer than a thirty minute period? Any kind of book reading.
I like to think that I'm a somewhat experienced meditator by now. Having observed the mindfulness hype over the years I wonder if what people are really missing is just some silent focused time in general. If all you want is quieter mind, maybe you don't need a ten day silent retreat but just an hourlong reading session?
I know the topic has been beaten to death but it is an important one. This constant context switching between systems and devices who have been engineered to sap your impulse control and short-circuit your core reward system need to be investigated on a personal level. So it isn't just that you aren't doing those hourlong reading sessions in silence but that you're actively practicing a different kind of negative behavior.
This is just one uneducated person's opinion. If we're talking about a dysfunctional reward pathway would it not stand to reason that someone's gravitation toward systems who provide thousands of small immediate rewards only reinforce this dysfunction? Think video games, porn, and instagram. Juxtapose this with reading a novel, painting a picture, or finally understanding recursion. I feel kind of gross typing that out because it feels like some sort of appeal to nature but I can't shake it.
With depression, we might take medication to grant us a seat at the table of recovery via a therapist. The hope is to get off of that medication eventually. Perhaps the same holds true with ADD/ADHD? I am not a psychiatrist.
I've been wondering about this attention deficit and reading comprehension issue for awhile now. I would love to know how many of us adults actually read books anymore for longer than a thirty minute period? Any kind of book reading.
I like to think that I'm a somewhat experienced meditator by now. Having observed the mindfulness hype over the years I wonder if what people are really missing is just some silent focused time in general. If all you want is quieter mind, maybe you don't need a ten day silent retreat but just an hourlong reading session?
I know the topic has been beaten to death but it is an important one. This constant context switching between systems and devices who have been engineered to sap your impulse control and short-circuit your core reward system need to be investigated on a personal level. So it isn't just that you aren't doing those hourlong reading sessions in silence but that you're actively practicing a different kind of negative behavior.
This is just one uneducated person's opinion. If we're talking about a dysfunctional reward pathway would it not stand to reason that someone's gravitation toward systems who provide thousands of small immediate rewards only reinforce this dysfunction? Think video games, porn, and instagram. Juxtapose this with reading a novel, painting a picture, or finally understanding recursion. I feel kind of gross typing that out because it feels like some sort of appeal to nature but I can't shake it.
> If we're talking about a dysfunctional reward pathway would it not stand to reason that someone's gravitation toward systems who provide thousands of small immediate rewards only reinforce this dysfunction?
This makes perfect sense to me.
But in the longest term, what actually /is/ the point? What is the reward that people are supposed to be pursuing /instead/ of video games, porn, and Instagram? We cannot pursue long-term goals if we don't have any. Where do they come from, those goals, that purpose?
> I feel kind of gross typing that out because it feels like some sort of appeal to nature but I can't shake it.
I wonder what you mean by this.
The apparent grossness of appeals to nature must stem from the fact that they have been used to justify injustice. But every form of argument is used to justify injustice -- so I don't think we should pre-emptively cut away our mind's ability to think naturalistic thoughts, just to avoid error. Maybe we have ignored Mother Nature for too long.
This brings me back to the original question, about purpose. Maybe it comes from Nature. Maybe a failure to enthusiastically perform for society means that the menu of options offered by that society contains nothing compatible with what Nature actually wants for us.
Porn is the best example. Why is it bad? What real thing is it simulating? What should you be doing instead?
Video games are similar: What real thing is being simulated?
You mention the development of competencies as an alternative. I agree that this is better. But what purpose of Nature's is served by the development of skills?
The feeling I can't shake is that addiction is the substitution of the simulated for the real, that increasingly everything is simulated, that the thing we are being distracted from is our own biological reality, and that we are, again artificially, trying to hack our own reward systems to be satisfied with goals that our not in our own Natures.
This makes perfect sense to me.
But in the longest term, what actually /is/ the point? What is the reward that people are supposed to be pursuing /instead/ of video games, porn, and Instagram? We cannot pursue long-term goals if we don't have any. Where do they come from, those goals, that purpose?
> I feel kind of gross typing that out because it feels like some sort of appeal to nature but I can't shake it.
I wonder what you mean by this.
The apparent grossness of appeals to nature must stem from the fact that they have been used to justify injustice. But every form of argument is used to justify injustice -- so I don't think we should pre-emptively cut away our mind's ability to think naturalistic thoughts, just to avoid error. Maybe we have ignored Mother Nature for too long.
This brings me back to the original question, about purpose. Maybe it comes from Nature. Maybe a failure to enthusiastically perform for society means that the menu of options offered by that society contains nothing compatible with what Nature actually wants for us.
Porn is the best example. Why is it bad? What real thing is it simulating? What should you be doing instead?
Video games are similar: What real thing is being simulated?
You mention the development of competencies as an alternative. I agree that this is better. But what purpose of Nature's is served by the development of skills?
The feeling I can't shake is that addiction is the substitution of the simulated for the real, that increasingly everything is simulated, that the thing we are being distracted from is our own biological reality, and that we are, again artificially, trying to hack our own reward systems to be satisfied with goals that our not in our own Natures.
Sure, I vaguely remember seeing a bunch of studies about how instant access to information, social media, "mindless" entertainment and constant stimulation is badly hurting our ability to focus. I've personally stopped listening to music or reading social media/news on my phone when I commute or go for walks, as I find the quiet time really helps my focus and attention longer term.
I have ADHD, and I don't have the patience with myself to read enough of your reply to benefit my understanding of it.
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I feel you dude, I have the same problem with content about dealing with procrastination.
My working theory is that abuse damages (and neglect stunts) the reward system and we interpret that as ADHD (as good a moniker as any).
Whereas people typically experience micro-rewards during the learning process, for people with ADHD, the reward response is too insufficient to reinforce learning. Without a proper reward system, a healthy learning system can't develop properly.
Some people firehose Will at the problem which may overcome an occasional challenge. That bandaid isn't sustainable, however.
Whereas people typically experience micro-rewards during the learning process, for people with ADHD, the reward response is too insufficient to reinforce learning. Without a proper reward system, a healthy learning system can't develop properly.
Some people firehose Will at the problem which may overcome an occasional challenge. That bandaid isn't sustainable, however.
I recommend this book to anyone suffering from ADD. The author did over 80.000 brainscans.
not affiliated
https://www.amazon.com/Healing-ADD-Revised-Breakthrough-Prog...
A 80 minute video about ADD by the author: https://www.youtube.com/watch?v=UWnJ4wjVu9k
not affiliated
https://www.amazon.com/Healing-ADD-Revised-Breakthrough-Prog...
A 80 minute video about ADD by the author: https://www.youtube.com/watch?v=UWnJ4wjVu9k
FYI before you watch an 80 minute video (which I did):
"Amen has built a profitable business around the use of SPECT (single photon emission computed tomography) imaging for purported diagnostic purposes.[6] His marketing of SPECT scans and much of what he says about the brain and health in his books, media appearances, and marketing of his clinics has been condemned by scientists and doctors as lacking scientific validity and as being unethical, especially since the way SPECT is used in his clinics exposes people to harmful radiation with no clear benefit."
Source: https://en.wikipedia.org/wiki/Daniel_Amen
"Amen has built a profitable business around the use of SPECT (single photon emission computed tomography) imaging for purported diagnostic purposes.[6] His marketing of SPECT scans and much of what he says about the brain and health in his books, media appearances, and marketing of his clinics has been condemned by scientists and doctors as lacking scientific validity and as being unethical, especially since the way SPECT is used in his clinics exposes people to harmful radiation with no clear benefit."
Source: https://en.wikipedia.org/wiki/Daniel_Amen
As a european, it is sad to see, that the health system in the US is geared towards profit.
I wonder what the parents of one of his youngest patients (below ten IIRC) would say to those scientists and doctors about "no clear benefits". Their son showed abnormal behaviour, drawing notebooks full of pictures of him killing his classmates. The brainscan revealed a huge brain tumor. Amen had to call several brain surgeons, till he found one who was willing to operate the child. After the removal of the tumor his behaviour normalised.
I wonder what the parents of one of his youngest patients (below ten IIRC) would say to those scientists and doctors about "no clear benefits". Their son showed abnormal behaviour, drawing notebooks full of pictures of him killing his classmates. The brainscan revealed a huge brain tumor. Amen had to call several brain surgeons, till he found one who was willing to operate the child. After the removal of the tumor his behaviour normalised.
Thanks for saving my time.
You don't save time by listening to only one side and forming an unbalanced opinion. One reason i like HN so much, is that you can read a debate and get both sides of the coin.
https://en.wikipedia.org/wiki/Dialectic
https://en.wikipedia.org/wiki/Dialectic
Might be worth reading his Wikipedia page[1] for some criticism before taking his work too seriously.
[1] https://en.wikipedia.org/wiki/Daniel_Amen
[1] https://en.wikipedia.org/wiki/Daniel_Amen
to make it DRY
https://news.ycombinator.com/item?id=24676962
https://news.ycombinator.com/item?id=24676962
Too much of this is religion dressed up. People paying for miraculous salvation. Martin Luther would have something to say here.
There is nothing miraculous about scanning the brain, and looking whats going wrong, it's a science based process.
I looked at it and did the questionnaire he supplies.
The scientific criticism is valid, there's no direct link between his scans and the outcomes. He uses the science as a correlation for everyday self help stuff and catholic salvation.
It's not coincedence he talks about believing in miracles and jokes about wanting to become a catholic priest as a child. He grew up seriously into the church.
People are essentially paying for salvation and at a steep price, this is exactly why the protestant churches got started. Look closer!
The scientific criticism is valid, there's no direct link between his scans and the outcomes. He uses the science as a correlation for everyday self help stuff and catholic salvation.
It's not coincedence he talks about believing in miracles and jokes about wanting to become a catholic priest as a child. He grew up seriously into the church.
People are essentially paying for salvation and at a steep price, this is exactly why the protestant churches got started. Look closer!
Except mainstream science rejects the validity of SPECT scans as a diagnostic tool for ADHD.
fMRI is getting closer as time passes and the techniques improve but still agreed to not be good enough yet.
fMRI is getting closer as time passes and the techniques improve but still agreed to not be good enough yet.
This makes a ton of sense to me. When I was a kid, just about everyone (including my parents) knew I had ADD/ADHD, but never did anything about it. Including myself. It wasn't until I lost a job because I was so easily distractable that I realized how much of a hold it had on my life. Medication helps, but really only on making it easier to pry myself from distractions.
But this study clarifies so much of my behaviour and self-image from when I was a kid to now. I bully myself fiercely, and never understood why I should be praised for high grades, when it was something expected of me. That definitely extends to now, where I can finish/deliver a product, but feel _nothing_ about it. No sense of accomplishment, no relief that something's shipped. Nothing. It stops me from taking on hobbies or really doing anything with the material that I learn. Leads to regular burnout and cycles of depression.
The article references methylphenidate as a good drug for ADHD, specifically for motivation. This makes me sad, because I'm on it, and not feeling very motivated.
But this study clarifies so much of my behaviour and self-image from when I was a kid to now. I bully myself fiercely, and never understood why I should be praised for high grades, when it was something expected of me. That definitely extends to now, where I can finish/deliver a product, but feel _nothing_ about it. No sense of accomplishment, no relief that something's shipped. Nothing. It stops me from taking on hobbies or really doing anything with the material that I learn. Leads to regular burnout and cycles of depression.
The article references methylphenidate as a good drug for ADHD, specifically for motivation. This makes me sad, because I'm on it, and not feeling very motivated.
Biggest issue for me is palpitations on adderall. Withdrawal gives me annoying palpitations and I get them sometimes while taking it.
It’s very annoying when I want to take the weekend off and have to suffer through massive withdrawal.
Honestly has changed my life for the better overall, but if anyone has any suggestions for trying to get rid of palpitations, it would be very much appreciated.
It’s very annoying when I want to take the weekend off and have to suffer through massive withdrawal.
Honestly has changed my life for the better overall, but if anyone has any suggestions for trying to get rid of palpitations, it would be very much appreciated.
I have ADHD and have noticed that I have extreme difficulty maintaining a schedule or forming habits. Almost everything I do is the result of by moment to moment decisions. I flit from project to project as needed, and have hundreds of things going on all the time.
This inability to form habits is extreme. If something's not right in front of me I forget that it exists. I've tried to start smoking, but as soon as the pack is gone I forget to buy another. I don't shower until it starts to effect me. I don't sleep until I can't keep my eyes open. I forget to eat until my stomach hurts. I truly don't believe I can become addicted to anything. I've been tempted to try crack because I've heard that everybody gets addicted to it and I might be able to use it to create artificial motivation in myself. I tried chewing nicotine gum every time I took a shower, but I just couldn't remember to do it, and it wasn't helping enough with forming habits.
I also have memory problems and basically have to re-invent everything from scratch all the time. I'm really good at solving problems so I've been able to cover up most of my failings. One story that highlights this happened when I was taking the ACT. There was one question at the end that I had to invent calculus to solve. I had a feeling that I hadn't solved a problem like it before, but I went ahead and solved it anyway and got every question on the math section correct. My verbal skills on the other hand were just barely acceptable.
Another anecdote about lack of schedule and routine also comes from my highschool time. Between classes I'd routinely forget that I had another class to go to. I'd see someone in the hall and start talking until the bell rang. In my highschool being late 3 times was equivalent to an absence, and 7 absences was an automatic fail. Needless to say I had probably the worst GPA in history. I also did very well on tests, but could never ever remember to read my book or do my homework.
Basically, a consistent theme is I'm totally worthless until I stumble into a magical sprint where I get 2 months worth of work done overnight.
I just spent from 1:30am to about 5:00am in my car with my laptop and was able to make 6 much needed git commits as well as taking care of a bunch of other issues with my main project. The last commits were the end of August with 14 commits over just a few days.
Wow, that was a ramble, but I've been up for about 30 hours now so that's not surprising.
This inability to form habits is extreme. If something's not right in front of me I forget that it exists. I've tried to start smoking, but as soon as the pack is gone I forget to buy another. I don't shower until it starts to effect me. I don't sleep until I can't keep my eyes open. I forget to eat until my stomach hurts. I truly don't believe I can become addicted to anything. I've been tempted to try crack because I've heard that everybody gets addicted to it and I might be able to use it to create artificial motivation in myself. I tried chewing nicotine gum every time I took a shower, but I just couldn't remember to do it, and it wasn't helping enough with forming habits.
I also have memory problems and basically have to re-invent everything from scratch all the time. I'm really good at solving problems so I've been able to cover up most of my failings. One story that highlights this happened when I was taking the ACT. There was one question at the end that I had to invent calculus to solve. I had a feeling that I hadn't solved a problem like it before, but I went ahead and solved it anyway and got every question on the math section correct. My verbal skills on the other hand were just barely acceptable.
Another anecdote about lack of schedule and routine also comes from my highschool time. Between classes I'd routinely forget that I had another class to go to. I'd see someone in the hall and start talking until the bell rang. In my highschool being late 3 times was equivalent to an absence, and 7 absences was an automatic fail. Needless to say I had probably the worst GPA in history. I also did very well on tests, but could never ever remember to read my book or do my homework.
Basically, a consistent theme is I'm totally worthless until I stumble into a magical sprint where I get 2 months worth of work done overnight.
I just spent from 1:30am to about 5:00am in my car with my laptop and was able to make 6 much needed git commits as well as taking care of a bunch of other issues with my main project. The last commits were the end of August with 14 commits over just a few days.
Wow, that was a ramble, but I've been up for about 30 hours now so that's not surprising.
My experience as someone who (probably) has ADD and who knows lots of people who do, is that ADD people tend to be highly passionate and motivated. It's just that our motivations jump around all over the place.
For a long time my response to this tendency was to try to control, direct, pin down my motivation so that I could stick with something until it was done. Doing this caused me to actually have a real deficit of motivation, instead of just an always-changing motivation. Once I stopped trying to control it and embraced jumping-around, following my interest wherever it led me, I actually had much more success seeing tasks through to completion (and even circling back to ones I'd left behind, because I wasn't feeling guilty about having left them behind). It's like my attention is highly fragmented, but I still have the same amount.
An ADD person's motivation is like a wild animal that you just have to give room to so it can do its thing. Hitch a ride to it, instead of trying to tame it, and you'll eventually get where you want to go.
For a long time my response to this tendency was to try to control, direct, pin down my motivation so that I could stick with something until it was done. Doing this caused me to actually have a real deficit of motivation, instead of just an always-changing motivation. Once I stopped trying to control it and embraced jumping-around, following my interest wherever it led me, I actually had much more success seeing tasks through to completion (and even circling back to ones I'd left behind, because I wasn't feeling guilty about having left them behind). It's like my attention is highly fragmented, but I still have the same amount.
An ADD person's motivation is like a wild animal that you just have to give room to so it can do its thing. Hitch a ride to it, instead of trying to tame it, and you'll eventually get where you want to go.
The assumption here is that you have a structured enough environment that you get tasks delivered on your doorstep regularly.
Having no external source of motivation is the death of us.
Having no external source of motivation is the death of us.
> Having no external source of motivation is the death of us
Not remotely true in my experience. Quite the opposite: I really struggle to be interested in motivators that are external, rather than internal.
Not remotely true in my experience. Quite the opposite: I really struggle to be interested in motivators that are external, rather than internal.
Hi all, just want to provide some more information on ADHD in general if people are interested.
http://russellbarkley.org/factsheets.html
The above link is a collection of PDFs summarizing key points on ADHD by Russel Barkley, generally considered by many in the ADHD community to be the 'god' of ADHD research.
http://russellbarkley.org/factsheets.html
The above link is a collection of PDFs summarizing key points on ADHD by Russel Barkley, generally considered by many in the ADHD community to be the 'god' of ADHD research.
Very interesting. Most people I've talked to with ADHD share this experience of sudden loss of motivation...
I can focus easily on tasks - even hyper focus for hours. Problems arise when there's an important but boring task vs a nonessential but interesting task. I will struggle to just think about starting the boring task. It can be really crippling when working with other people or in a startup.
I tried to write about my own experiences with ADHD, in particular regarding distractions. https://www.kabdebon.com/founder/2020/08/25/creative-mayhem-...
I can focus easily on tasks - even hyper focus for hours. Problems arise when there's an important but boring task vs a nonessential but interesting task. I will struggle to just think about starting the boring task. It can be really crippling when working with other people or in a startup.
I tried to write about my own experiences with ADHD, in particular regarding distractions. https://www.kabdebon.com/founder/2020/08/25/creative-mayhem-...
I have adhd myself, and I built a NLP tool around working out how well medication is working for me. I'm launching the mvp of it in the next few days if anyone is keen! https://moodmap.app
Meditating every day has done amazing things for me in terms of bringing clarity/focus to my life. I understand, however, that my ADHD if any is likely less pronounced than others and can see the benefit that taking medication can provide.
Before I started training myself to meditate, I noticed that drinking a lot of coffee seemed to help me focus better. Though it was only really until I started meditating that I realized it was possible to direct my focus/attention in such a calculated manner. I had always resigned myself to "my attention" controlling the actions I took rather than the other way around with me actively choosing how I apply it.
Before I started training myself to meditate, I noticed that drinking a lot of coffee seemed to help me focus better. Though it was only really until I started meditating that I realized it was possible to direct my focus/attention in such a calculated manner. I had always resigned myself to "my attention" controlling the actions I took rather than the other way around with me actively choosing how I apply it.
I recently started atomoxetine for my ADHD and had to completely stop it. Side effects were killing me.
After I stopped, I was more hyperactive and less focused... Yet the hyperactivity compensated for the "less focused" part, and I finished a week's work in a day.
That's my experience with meds so far. They completely eliminate my anxiety and make me feel in control of my emotions. Yet they make me less productive than when I'm in a hyperactive rush (even if my focus is reduced).
So for now I'm just going to embrace my inconsistency (in terms of emotions, energy, and focus) because I think I'm way worse without it. Establishing a routine helps me cope much better - I feel waking up early and having a good morning dictates how productive my day will be.
On meds, I finally felt in control of my life and energy. But it also felt bland, boring. I didn't feel anything. I had no anxiety to push me to go the extra mile. My personality & cheeriness were nonexistent. And I was, overall, simply less productive.
Not doing that again.
After I stopped, I was more hyperactive and less focused... Yet the hyperactivity compensated for the "less focused" part, and I finished a week's work in a day.
That's my experience with meds so far. They completely eliminate my anxiety and make me feel in control of my emotions. Yet they make me less productive than when I'm in a hyperactive rush (even if my focus is reduced).
So for now I'm just going to embrace my inconsistency (in terms of emotions, energy, and focus) because I think I'm way worse without it. Establishing a routine helps me cope much better - I feel waking up early and having a good morning dictates how productive my day will be.
On meds, I finally felt in control of my life and energy. But it also felt bland, boring. I didn't feel anything. I had no anxiety to push me to go the extra mile. My personality & cheeriness were nonexistent. And I was, overall, simply less productive.
Not doing that again.
I said this somewhere else in the thread already but it sound like it could help you, get a genetic compatibility test for adhd meds, my doctor gave me a referral for one and it gave clear recommendations on which medications would likely be fine and which would have chances of negative side effects. Even without the referral I'm sure you can get a test like this privately for reasonable price.
These medications are serious and side effects can include thoughts of suicide so I'm always shocked when doctors try to wing it and just prescribe whatever and see how it goes. I'm hoping it's because they don't know about the genetic tests yet but some are likely willfully ignorant.
These medications are serious and side effects can include thoughts of suicide so I'm always shocked when doctors try to wing it and just prescribe whatever and see how it goes. I'm hoping it's because they don't know about the genetic tests yet but some are likely willfully ignorant.
I'll definitely take a look. I had no idea those compatibility tests are a thing.
> But it also felt bland, boring. I didn't feel anything
I don't have experience with atomoxetine, but other meds, and this sounds a like an symptom of over dosage. The typical "ritalin robot" is usually causes by taking to much.
Maybe you can check out other meds. I experienced the "blend robot" situation a few times with Medikinet and learned that Methylphenidate is very sensitive to food intake and PH in the stomach, which can make the effect less predictable. I switched to Lisdexamfetamin - it's less dependent on food and works better for me.
I don't have experience with atomoxetine, but other meds, and this sounds a like an symptom of over dosage. The typical "ritalin robot" is usually causes by taking to much.
Maybe you can check out other meds. I experienced the "blend robot" situation a few times with Medikinet and learned that Methylphenidate is very sensitive to food intake and PH in the stomach, which can make the effect less predictable. I switched to Lisdexamfetamin - it's less dependent on food and works better for me.
I hope you get better in time. Side effects is really bad
I mentioned this elsewhere but strattera (atomoxetine) straight up gave me acute psychosis and semen leakage. It was a monstrous drug for me.
I'm eternally annoyed that nobody on this page mentions the Racetams (Aniracetam, Piracatam, etc.) as potential alternatives to dosing speed everyday. I myself began to have heart issues from even just Ritalin (mild perhaps compared to Addy or Vyvanse).
Fasoracetam in particular looks promising but seems to be stuck in approval limbo:
https://nootro.info/fasoracetam-adhd-treatment/
Fasoracetam in particular looks promising but seems to be stuck in approval limbo:
https://nootro.info/fasoracetam-adhd-treatment/
Cf. phenylpiracetam - developed for the Soviet cosmonauts in '83
https://en.wikipedia.org/wiki/Phenylpiracetam
https://en.wikipedia.org/wiki/Phenylpiracetam
Indeed thank you, but no follow-ups or recent developments in other 'Racetams it seems. Modafinil is the only one that comes to mind that is atypical but has made strides in being a prescribed alternative.
> Dynamic scans were started immediately after injection of 4-10 mCi of [11C]raclopride (specific activity 0.5-1.5 Ci/μM at end of bombardment) and after injection of 4-8 mCi of [11C]cocaine (specific activity > 0. 53 Ci/μmol at end of bombardment) and were obtained for a total of 60 minutes as described (12)
They injected humans with cocaine for this study, am I reading that right?
They injected humans with cocaine for this study, am I reading that right?
Cocaine and meth are actually schedule 2 drugs unlike marijuana. It is surprising that they used Cocaine instead of a more common stimulant like Adderall or something.
Does anyone else think the NIH online reader is a disastrous UI for mobile? I mean yes there is a PDF link at the top, please don't point out the obvious. I just mean who the heck checked the box to accept this work, or worse yet demanded this horrible pagination interface? I'm sure that they've been promoted to the highest levels in this fail-up world...
Yes, and the same applies to virtually all other research databases. I’d forgotten this until you mentioned it because I’ve become so habituated to going direct to PDF.
I was prescribed bupropion to stave off lack of energy and possibly heighten my mood. To my surprise it made me so sleepy I had to take it before bed.
For most other people it seems like they can hardly sleep while on bupropion.
I was told via forums that I might have ADD/ADHD because of this reaction.
What does HN think of this reaction?
For most other people it seems like they can hardly sleep while on bupropion.
I was told via forums that I might have ADD/ADHD because of this reaction.
What does HN think of this reaction?
I'm in my late twenties and this whole discussion makes me reconsider the past 10 years of my life and think about how different my academic and early professional experience could have been if I had seen a doctor at the right time.
Anyone else scared of dopamine downregulation from decades of amphetamines?
I can literally sleep all day for days on end and fear and done irreversible brain damage.
I can literally sleep all day for days on end and fear and done irreversible brain damage.
Who knew there were this many people on amphetamine. Back in the day they called that speed. Surprised all these people are admitting their Vyvanse and Adderall usage publicly.
Wondering if this is why marijuana makes me insanely productive. Both impact dopamine.
It just sucks that I get addicted to weed because I'm super productive.
I just need a way to prevent myself from having marijuana before anything social or public.
It just sucks that I get addicted to weed because I'm super productive.
I just need a way to prevent myself from having marijuana before anything social or public.
Dopamine isn’t a simple 1-dimensional axis that moves up or down with drug use. There are many different pathways that use dopamine as their signaling molecule. Some dopamine receptors are involved in recording positive events, while other dopamine pathways record negative events.
The role of dopamine as an answer to all things reward or motivation is greatly exaggerate in the pop-neuroscience articles online. Doing nearly anything goal-oriented or even remotely rewarding is associated with dopaminergic activity.
People also tend to overlook the fact that the stimulants used in ADHD treatment also have significant norepinephrine activity which contributes to their pharmacological effects. Purely dopaminergic drugs often aren’t as energizing as you’d expect. In fact, selective dopamine agonist medications can induce narcolepsy-like symptoms where patients struggle to stay awake due to the complex nature of dopamine activity in the brain.
In your case, it’s possible that you’re naturally motivated but THC is causing disinhibition to override whatever is preventing you from being productive (anxiety). THC is also known for making boring tasks feel interesting, but it’s also known for decreasing motivation and making people feel like they’re accomplishing a lot more than they really are. In other words, it’s not a solution to anything. You’d be well served to spend some time exploring this with a psychiatrist or two.
The role of dopamine as an answer to all things reward or motivation is greatly exaggerate in the pop-neuroscience articles online. Doing nearly anything goal-oriented or even remotely rewarding is associated with dopaminergic activity.
People also tend to overlook the fact that the stimulants used in ADHD treatment also have significant norepinephrine activity which contributes to their pharmacological effects. Purely dopaminergic drugs often aren’t as energizing as you’d expect. In fact, selective dopamine agonist medications can induce narcolepsy-like symptoms where patients struggle to stay awake due to the complex nature of dopamine activity in the brain.
In your case, it’s possible that you’re naturally motivated but THC is causing disinhibition to override whatever is preventing you from being productive (anxiety). THC is also known for making boring tasks feel interesting, but it’s also known for decreasing motivation and making people feel like they’re accomplishing a lot more than they really are. In other words, it’s not a solution to anything. You’d be well served to spend some time exploring this with a psychiatrist or two.
As someone who has ADHD and is also a heavy marijuana user, I've found the marijuana mostly helps me with the frustration of the ADHD experience. It makes it difficult for the frustration to reach a boiling point and that's what actually makes me productive. Adderall has been WAY more effective at this, though.
Similar experience for me. Marijuana definitely makes me feel stupider, but it slows my brain down enough that I can actually focus on one thing at a time so I actually end up more productive overall. Kind of a worse is better situation. I've found the best combination for me to be XR Adderall with a very low dose of THC. Unfortunately my addictive personality makes not abusing marijuana difficult, so I just don't use it these days.
This is why I choose to take an edible when dosing for studying. Harder to abuse with no instant gratification.
I'm also wondering the same thing - I take 2.5mg of a sativa-dominant edible and I'm able to focus insanely well. I typically do this after I'm done with my real job for the day so I can study AI, for example to read an AI paper. I typically have much more trouble doing this without THC.
Funny enough, I'm also very prone to anxiety on THC. So there might be a correlation there somewhere.
Funny enough, I'm also very prone to anxiety on THC. So there might be a correlation there somewhere.
And this is how you burn out from work.
If you don't stop to reward yourself for what you do, you will loose interest no matter what.
You cannot trick your own brain.
If you don't stop to reward yourself for what you do, you will loose interest no matter what.
You cannot trick your own brain.
I'm confused - it's all about dopamine. That's why it's treated with dopaminergic drugs.
Dopamine isn't a simple 1-dimensional value that goes up or down with drugs. It's not even accurate to describe ADHD medications as dopaminergic drugs, as stimulants have significant norepinephrine activity as well.
There are even non-stimulant ADHD medications that have no dopaminergic activity at all (Intuniv).
Complex human thought processes can't be reduced to single neurotransmitters. Everything you do is a complex interaction of many pathways that use many different neurotransmitters.
ADHD also isn't purely a chemical disorder. Plenty of ADHD people learn to focus and be productive through therapy and constant self-directed change. Plenty of ADHD people treated with stimulants just use their chemically-induced focus to mess around on the internet and continue to waste time.
Effectively treating ADHD requires approaching it as a mix of medication and lifestyle changes. Reducing it to just dopamine is a trap.
There are even non-stimulant ADHD medications that have no dopaminergic activity at all (Intuniv).
Complex human thought processes can't be reduced to single neurotransmitters. Everything you do is a complex interaction of many pathways that use many different neurotransmitters.
ADHD also isn't purely a chemical disorder. Plenty of ADHD people learn to focus and be productive through therapy and constant self-directed change. Plenty of ADHD people treated with stimulants just use their chemically-induced focus to mess around on the internet and continue to waste time.
Effectively treating ADHD requires approaching it as a mix of medication and lifestyle changes. Reducing it to just dopamine is a trap.
A deeper understanding of the mechanisms can lead to all sorts of benefits, from more accurate testing to better targeted pharmaceuticals to better studies of genetics.
> I'm confused
Yeah. Took me a while to see the "2010"...
It's the point of almost all ADHD memes - thought it's common sense now.
Yeah. Took me a while to see the "2010"...
It's the point of almost all ADHD memes - thought it's common sense now.
Thank you for the interesting read...
Michael Phelps. ADHD. 28 Olympic Medals. That is all you have to know about ADHA..
Bill Gates. Random condition. $100 billion dollars. That’s all you need to know about random condition.
Terrible analogy.
If you can design your life to be benefited by ADHD, that’s awesome.
If you’re stuck working a 9-5 like a large portion of the population ADHD sucks.
Terrible analogy.
If you can design your life to be benefited by ADHD, that’s awesome.
If you’re stuck working a 9-5 like a large portion of the population ADHD sucks.
That's how fast I lost focus. But on the other hand sometimes I can be extra-focused, with a prerequisite it's something I enjoyed -- where I truly focus on one single task nonstop, like I finally got the ebb and flow in a tranced out state. This resulted me in one case coding straight for 7 hours. It's not until my body started to crave for food or I don't know how long will this loose cannon shoot.
ADD is both a blessing and a curse to me. This is how I accquired coding and various IT skills since 13, all self-taught. But this also fucked me over exams, and my so life experience is greatly impacted. I also tried to play rhythm games to control focus, only to see it ultimately failed. The only thing I had to deal with it slightly is my Ritalin...only so slightly I can "normally" focus for an hour. I just hope things go right in the rest of my life.