Thanks friends.
I thought I was bad at lots of things other people were good at, because I was more disciplined and saw the bigger picture. So I only worked on important things. Things that could matter to millions of people, or still be relevant in 100 years.
And all the side quests and rabbit holes were obviously for recharging, expanding my biological-being-on-an-odd-planet situational awareness, or benefited me as self-improvement challenges. All in service of the important things.
How would tracking the day of the week, doing homework on something I could learn later if/when I ever needed it, or mowing the lawn, help me accomplish anything important?
Wasting brain space on those kinds of things would be dysfunction. I actively culled such dreck!
Now I know my self-narrative was Stockholm Syndrome coping.
But I still don't mow lawns, and if the blinds are drawn when I finish a big task, I couldn't guess if it was am or pm better than a coin toss. My day metric is when Amazon Prime's "Your Orders" list, tells me I am a day closer to getting a crafting item I ordered for a project I may never get to.
As someone with peer reviewed ADHD but not official diagnosis, what are friends gonna do about it? They can tell you, you're always late and it's annoying but that's about it. At some point it becomes just who you are as a person, part of your character sheet. If you're not planning to change and it's mostly under control (have job, life, etc), does it even matter to put a label on the thing?
I feel like a diagnosis in my 20's would've been useful. Now it's like I got me my coping strategies and they work pretty well. If I do or don't have ADHD doesn't really change anything.
And for anyone else reading, the leading symptom of adult-diagnosed adhd is saying and thinking things like "I don't get it, ADD can't be real, that's just how everyone is"
I feel like it is very disrespectful, especially when the conversation is about something completely different. Also, I'm not a medical professional, and it is possible that their ADHD-like symptoms are caused by something else.
That being said, if they ask if I think they have ADHD, or any other form of neurodivergence, I will say yes.
The proctor noted my restless legs, frequent posture shifts, and "tendancy to tap the table when not responding to the stimuli" (this was a strategy I had come up with to create something to do in response to "doing nothing", as it made a sort of rhythm that gave me something to do). I then realized that the test meant very little, but the proctor was watching and diagnosing me durng the test.
The one I did (QbCheck) was a similar setup but you were presented with shapes on the screen, either a square or a circle, and either blue or red. All you had to do was press the spacebar when the shape on the screen was the same shape and colour as the previous one. No sound distracitons (or maybe I just had the volume muted.)
You also had to do the test on a laptop with a forward facing camera so the software could track eye movement.
I remember starting the test and thinking "This is exactly what my brain is wired for, I'm going to be awesome at this test!"
Within a minute my mind had already moved on to "I wonder how they score this test? I guess they're looking at accuracy, reaction times, how those trend over time, whether the accuracy/reactions goes up/down if they show the same shape/colour more than twice in a row?" etc...
It didn't take long for me to then get jolted into a "wait, did I just zone out a bit there and miss one?"
Then I became overly conscious of my eyes wandering around and not looking at the screen.
Then my mind moved on to "what if I'm too good at this and it means I won't get a diagnosis?"
Soon it was "When will this ever end? This must have been going on for ages!" only to find it had only been about 3 minutes.
The test took 20 minutes or so and I was mentally exhausted by the end of it.
My actual ADHD diagnosis was backed up by an 80 minute interview, basically doing the DSM-5 questions but linking it all back to childhood experiences too. I've no idea how much weight the QbCheck test had.
Glad I got the diagnosis, I've been masking both for years (diagnosed in my late 40s) but just got burnt out doing so. Medication helps but isn't perfect and since I'm probably AuDHD I find the ADHD medication amplifies some of the Autism traits and makes me into a bit of an emotional zombie, but that seems to be better than having zero motivation (aside from stress/deadlines and serious consequences).
I am having a really difficult time finding a reputable psychiatrist to assess adult ADHD. I called 15 places and only heard back from one. I scheduled an appointment. They had 1/5 stars, gave me a 30 year old 1 page questionnaire, and asked to see my childhood report card. I did not see them again.
Yesterday I got a callback from an office offering this online test but nothing else? It all smells fishy.
Did anyone have to cross state lines to find a reputable psychiatrist?
There might be some hope in deep learning, particularly in observing eye movement components to deliver reliable biomarkers in the future, but I’m not so confident any time soon.
It’s dreadful and fascinating at the same time that defining and testing for ADS has been so elusive for so long…
https://www.youtube.com/watch?v=BzhbAK1pdPM&list=PLzBixSjmbc...
There are some cool studies done where people with a without ADHD are tasked to forage berries. The people with ADHD do better and adhere to foraging patterns which existing theories suggest would be more optimal.
A lot of the studies like that indicate the individual with the condition might benefit more from ADHD than the group they’re in, but I’m not sure that studies have explored group benefits very much.
There’s an often cited paper in which nomadic men who carry a certain ADHD-related allele (DRD4-7R, a dopamine reception variant with ADHD traits and novelty seeking) tend to have better nutritional status. I can’t recall much about it or how high quality it is.
With your foraging example, it does make me think ADHD is a small group/individual optimisation. Prioritising high vigilance and individual productivity over social cohesion.
I speak with no authority. I don’t even know how such a theory could be tested.
What do you think nutritional stunting means?
It would make sense to me that evolutionary there would be different mental development paths depending on the requirements of their situation.
This is coming from my understanding that ADHD is more prevalent in stressful upbringings.
So there is still room for complete failure in life, and maybe its a lot of luck/environment that some ADHD people succeed naturally.
Like being physically weak is not an advantage in white collar jobs.
2. Assuming it really is: Why would this make it unlikely to be encoded on a single gene? As a layman, the only condition I'm aware of with this "downside but also upside" quality is sickle cell anaemia (downside is anaemia, upside is increased resistance to malaria), which is decided by a single nucleotide change on chromosome 11.
Though, with ADHD, I think it's definitely more than that. It doesn't just make it hard to focus, it makes it hard to focus on what you need to, until the moment that it is obviously now or never. Focus, though - there's tons of that, flitting about, and sometimes grabbing you up and running away with you - sometimes for months. I would imagine that there are a lot of novel discoveries attributable to it.
Also, having different sleeping patterns can mean that the people with ADHD are likely better equipped to keep a fire burning overnight and possibly be alert for predators.
Per the DSM-5, one of the core symptoms of ADHD:
"often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
Essentially all traits that you might think of as "traits" and not "features of the species" have downsides and also upsides. Where there's any significant imbalance, the genes for that trait will be purged from the gene pool (if the trait is basically all negatives) or sweep to become universal (if all positives).
- Clinical Interview
- Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV)
- Wechsler Memory Scale – Fourth Edition (WMS-IV)
- Conners Continuous Performance Test – Third Edition (CPT-3)
- Delis-Kaplan Executive Functioning System, selected subtests
- Wisconsin Card Sorting Test (WCST)
Are you familiar with any of those? I did some research after receiving my report and apparently the combination of tests listed above are well-respected, about as good as it gets. I’m curious what your take is.
The subjective part of the assessment was actually the clinician making sense of the data. My cognitive assessment (IQ and its subtypes) scored fairly high, I averaged something like 115 (84th percentile). But my memory assessment scores (audio/visual memory/working memory, immediate/delayed memory) tanked tremendously, I averaged around 90 (30th percentile).
My positive diagnosis was based on the variability of scores and the clear cognition-memory gap. The results made sense, aligned with my experience in life (I fell asleep in almost every lecture in college, sustaining attention while taking notes was a heavy audio-visual working memory exercise for me).
I personally haven’t adopted any of this as my identity but it opened a door to do some metacognition and reflect on how I interface with the world. Also the stimulant medication didn’t magically fix everything, sometimes the hyper focus is worse, but there was one HUGE benefit that I didn’t realize I was missing - emotional regulation. I’m a heavy ruminator and pretty much suffered in silence most of my life, my inner dialog is much more organized and calm, and I can comb through my thoughts easier now.
P.S. I cannot recommend enough - check out “HealthyGamerGG” on YouTube. He does some deep dives on ADHD and other diagnoses. Classically trained psychiatrist with something like 5 years of training as a Buddhist monk. Very insightful guy who’s both data-driven and spiritual, helping a lot of people.
I'm not OP but that seems like a very respectable diagnostic track. No test is 100% reliable, so you'd want multiple tests. Even then the results can realistically only be interpreted by a psychologist that is familiar with your situation (hence the clinical interview). So this seems perfectly proper.
> Also the stimulant medication didn’t magically fix everything
Sadly there is no medication that fixes adhd. The only thing these medication does is make it easier to deal with by alleviating (some of) the symptoms. Personally I've noticed from my medication (methylphenidate) that it make it easier to stay focused on whatever task I'm doing, but if that happens to be scrolling reddit, I can still waste hours, perhaps even more since I would have otherwise distracted myself from reddit long before. So it's not perfect, but it does enable me to concentrate 8h+ at work, and that's ultimately the main benefit it brings me.
The more common view is that because prevalence of attentional deficit in autism is so high, it's rare to find someone with autism who isn't also able to fit an ADHD diagnosis. This might mean a shared common ancestor as it were, or perhaps autism has attentional deficit as an intrinsic part of the disorder rather than people with autism also often having ADHD.
The other direction is the amount of people who have ADHD who also have autism. In this case, while the overlap is higher than the general population, it is easy to find people with ADHD who do not meet the diagnostic criteria for autism.
Put more simply, people with ADHD aren't necessarily autistic, but people with autism are usually ADHD.
Uh, what? How exactly could treatment be more distinct than ADHD people being indicated for a highly-regulated drug like amphetamines, which are extremely effective to the point of being life-changing treatment? Meanwhile nobody would consider prescribing Adderall to treat autism. What a bizarre conflation of two completely different disorders.
We don't really know what mental disorders are and so we don't have objective diagnostic tests for them. [1]
We just have treatments that sometimes work for some people (and with the replication crisis[2] that sometimes is probably a lower value than expected).
https://m.youtube.com/watch?v=W99n083E0IA&pp=ygUeZnJlYWtzIGd...
Good test, though—very effective.
Given the overlap between ADHD and video games, I'm not convinced of the accuracy. It felt like a lame rhythm minigame to me.
I don't think the research is solid, my guess is these tests are convenient for insurance and liability paperwork since stimulants are controlled substances.
Good to know that neurotypical people mostly likely test differently than I did.
My one surprise from this article is that "play a web game for 18 minutes" in an uncontrolled environment was considered enough testing for a diagnosis!
For our autism assessment a couple months ago, our therapist (whom we've been seeing for about a year at that point?) had us take one or two relatively short multiple choice assessments or the like and that was enough to diagnose us as on the spectrum. Did you know: Not all autistics struggle with eye contact? Some of us (ourselves included) are actually pretty good at it. One reason it's called a spectrum!
The previous time with our mental health professionals factored into their diagnoses, though, not just the tests. The takeaway: Book a therapist and psychiatrist both if you don't already and get those balls rolling.
But then I worried if my system worked, I would be misdiagnosed.
It didn’t work. I was 98th percentile.
Thanks for sharing this!
Also, congratulations, once you figure it out your life is going to change for the better in a way you can't currently understand (literally, lacking the brain regions and/or development for it, take it from me), but the process can kinda suck a lot, so stick with it, it's worth it in the end, wherever you end up.
He says while commenting on HN as CI runs...
Yeah man I can go ahead and let you know early if you want.
It turns out, there are other conditions out there that can appear to be be ADHD. If a trained therapist can confuse them, outside observers certainly can too, so it is possible that "very ADHD-acting" person you know might not have it.
(Or, especially for females, the reverse can be true, as not everyone with ADHD manifests with the same trademark hyperactivity.)
So the first rule of getting attention for your paper is to re-define common terms...
Executive dysfunction, especially that which was not impairing as a child, has a lot of potential causes. Anxiety, depression (yes, ADHD can cause these, but these can also cause executive dysfunction in people without ADHD), OCD, Bipolar (manic people in particular often attribute worsening of hyperactivity and distractability to ADHD instead of mania), Schizophrenia pretty much universally is related to cognitive symptoms and lowered motivation even when not psychotic, and borderline personality disorder can cause changes in interests and identity.
For many of these conditions, stimulants can act as a band aid on something else. It can superficially make people feel better (of course, it's speed), but it can distract from other symptoms that are impairing functioning, and prevent people from seeking long term solutions.
I recognize that non-medical options should always be front line approaches but there can be a chicken and egg effect as to making that happen.
In my youth I adhered to a "better living through chemistry (wink wink)", I do now too (rip Mitch Hedburg) but the wink wink part is very rare and disciplined and now it's all about pharma and supplements to wring what I can out of what I've got left.
That's not to say I'm not on the medication train (despite moaning about medications a lot). I do personally avoid taking any controlled substances. This is easy because I hate how stimulants make me feel, but in general I worry about the effects of having a direct reward signal from taking a pill.
This sometimes solves the problem by itself, or it reduces the levels of stimulants needed.
So, uh, ... a whole textbook. And I probably forgot some.
Well I only know that because I skipped to the end. Then, while scrolling up I realised I missed the whole side-quest about promising to not cheat the test again, taking the test again, but then "accidentally" finding an exploit the system, and then cheating the test again, but this time cheating even more to see the results.
Then, scrolling up more I see that this whole thing started with seeing stars and then buying a telescope on amazon (probably at 3am).
And here I am commenting on HN instead of replying to an email...
The other thing is, ADHD in my mind is really a syndrome that starts with a symptom - inattention - that can be caused by so, so many things.
I have both, because of course I do, I had a medical problem that exacerbated my ADHD to a significant, significant degree (it's amazing I was able to be a software engineer for so long without treatment). So don't just tunnel vision in... as we tend to be prone to do. Get the whole workup with an experienced clinician, it's so lifechanging it's hard to describe.
You wrote "the test is quick, easy, and painless" but I also want to note that it's not always. Depending on your country, parents, specific doctor, etc it can be very difficult to get a proper diagnosis and help. In some places a big criteria is diagnosis during childhood so if you're 30 or 40 you might have no chance. Or a chance but it depends on your parents retroactively answering a questionnaire, or finding an old report card with the right words.
As you said it's life changing to get the right help and I encourage everyone to pursue this.
It’s funny, I went to therapy a lot of times before I found someone I could stick with, and if I were to give my past self a list of what I’ve gotten from therapy, I think I would’ve been unimpressed. Nevertheless, I’ve noticed that I’m more confident and calmer, and it has definitely improved my relationships.
There’s a kind of virtuous cycle that happens where you replace a grumpy mindset where you’re always mad at yourself for not meeting other peoples’ expectations and always mad at other people for making your life hard, with a confident mindset where you understand yourself, are therefore comfortable relating to other people about your abilities and needs, and can focus on putting yourself in situations where you’ll be successful.
It was sort of fun, we talked about how Arthur Schawlow (who co-invented the laser and won the Nobel prize) was banned from driving on Stanford campus and had to be chauffeured. And I finally understood what he was talking about; you can access this perspective for anybody by constructing such a narrative. What if everybody’s a misunderstood genius at something? Why not? How would you live in such a world? One insight among many.
The quick answer:
Understanding neurobiology and the meta-cognition about the why of certain behavioural patterns and experiences is extremely helpful to just calm down and "forgive" myself, and not judge myself so harshly. It's as if I can optimise my life by leaning on my strengths and importantly recognising and dealing with my weaknesses. Just the awareness lets me catch myself getting into patterns, and act on them sometimes, and just let myself be the other times without any guilt. This insight brings peace more than you think. I can now organise my inner dialog and enjoy the diverse thoughts while also being aware of my impact on people in my life.
I was skeptical of the meds myself. I spoke with about 20 people through AHD support groups and group sessions. The drugs are mostly a trial and error affair with side-effects and altered behaviour. My subtle lifestyle changes - keeping one true todo list, always logging down my thoughts and taking comfort in the fact that they are jotted down so that I dont have to keep going down that thought and actually get up and go catch the train etc already gave me the biggest benefits. Then I wanted to see for myself what the drugs could actually do. At the end of it I may choose to take them or not. After 8 months of slow analytical trial and error with a very helpful psychiatrist who understood where I am coming from, I now take a very small dose of Elvanse(Vyvanse) + Guanfacine on some days of the week where I feel like I could use the help. They are not life-changing. They nudge me into being more capable of being me. My wife can notice the regulation the drugs let me have - A win for me. My kid has a better relationship with me than before - A win for me. Could I do without? Sure. But, I choose to have that little support to manage myself to get to who I want to be around my family without losing who I am. To each their own.
Longer background:
Despite reading about and knowing the symptoms of ADHD, and being told by a professional 10 years ago that I should consider getting formally diagnosed, I thought to myself - "Hey, I am smart. I feel happy and satisfied. I dont have any problem. I'm good as I am. I dont need to do anything about it." and promptly kept sweeping any thoughts about it under the proverbial rug.
Until, I started seeing my son develop in front of me. Seeing all those symptoms - impulsivity, hyper-focus on few things and inattentive to most others, emotional regulation issues, extreme reasoning abilities in some areas while being "immature" in other areas. This was me growing up. Being smart and intelligent, but longing to fit in, struggling to deal with the mundane. So, I decided to get diagnosed properly. Basically, I could hide behind my smartness and the ability to manage my symptoms until it just myself in my life, and then my wife, and then my son, but when the second one came along, I couldn't manage anymore and the overwhelm started to show the real patterns.
It takes courage to be honest and vulnerable.
The medication unlocks your ability to learn the skills you need to cope with the problems you have, and therapy gives you the outside feedback you need to escape your own brain trying its hardest to mess things up and hide the mess.
Imagine if every 10 seconds this guy was in your body taking over your hands for a second or two: https://www.youtube.com/watch?v=GguQu5Iderg
Btw no criticism implied on my end, I'm just now constitutionally incapable of not telling people they should get screened. Hmmm I wonder why I have difficulty resisting that urge...
The chance to be diagnosed with an appropriate gate varies greatly based on where you live and which doctor you can see and more. It can be anything from a 5 minute conversation, to 6 months of inconvenience, to no chance of even existing in your lifetime, to suck it up and don't ask because your career will end.
Huh? You don't have to be tested as-a-child, you don't have to call up your fourth grade teacher. You can self report your subjective experience.
"Did you have these problems as a child? Have you always had trouble doing your homework? Did stressing out about homework enable you to do the homework?"
They ask the question a few different ways typically.
I get it, perhaps it is different in your area, but I get the impression that an adult ADHD diagnosis is far from impossible.
If you search (eg reddit) for ADHD adult diagnosis, it is filled with horror stories. There's even lots of posts of people diagnosed and medicated for 20+ years that move to another country and can't get a prescription. Or you get a prescription, but the pharmacy won't dispense it or insurance won't pay for it. A typical post on these topics also has one or more people responding "I'm in the same place and it was easy" but also has one or more people responding "I'm in the same place and I tried for 3 years before giving up". By the way, it's also common for women to have more trouble getting a diagnosis compared to male siblings and friends with the same symptoms.
In the US, at least, it ranges from difficult to straightforward, but that's not true everywhere
Can't speak for the whole of the continent but UK here and I got my ADHD diagnosis a few years shy of 50 years old. Wasn't tricky at all, just a long-ish (8 month) wait for a non-private diagnosis (not full NHS but via an outsourced provider via Right-To-Choose).
When going through the DSM-5 questions (during an ~80 minute interview) I was asked to give examples from both current life experience and from childhood, and that was enough.
If you try to do it through the public system it's very difficult to even get an appointment because there's months long waiting lists. Basically if you have a job and function somewhat OK in normal life you won't be diagnosed in the public system. If you do get through it can be a long process where they want to interview your parents etc to determine if you had symptoms as a child. But you can also get a diagnosis through private practitioners and some of them function almost like diagnosis mills. A couple of video interviews and tests and you are done.
But for your specific brain it does make enough and it will fight to maintain that via homeostasis (usually by creating more dopamine vacuums/re-uptakes that stick around a long time...there is good science on this).
So you become dependent on the medication and tolerance can occur making your situation worse than it was in the end.
ADHD-as-a-diagnosis is just a clever way to make the government okay with prescribing stimulant medication to "people who it can help" and having someone safely monitor its usage, and to assure the government that we won't end up with too large of percentage of the population taking it.
Those are some possible outcomes, yes, but it is not a black/white thing, and that is actually WHY it's important to work with a qualified doctor to monitor medication, effects, dosage and so on, and make adjustments as necessary.
Different medications work very differently as it relates to dopamine, uptake, production, etc. And there are also non-stimulant medications that may be effective for some folks.
This is just my story but before ADHD diagnosis and medication I was unemployed, on food stamps, in an abusive relationship, and struggling with alcoholism. After taking medication for a couple years I'm in a healthy relationship, making good money in a stable job, and on the wagon. The medication prescribed helped so much with my impulse control issues that it literally changed my life.
I hope I am addicted to it so I don't forget
I wish I could find it again and run it across some cohorts, because it was quite fascinating to feel my brain suffer more on the horizontal arrows.
In general, if you are in the industry, save yourself (and your kids) some trouble and get diagnosed before it becomes a problem.
Add: I wonder why they don't just give people some ritalin and ask if they feel calmed down? Except the obvious reason of course
And in the most interesting cases, you can find a lot of value in both - stimulants keeps you going, guanfacine gives you perspective and the ability to unclench.
Edit: And this is me trying to restrain myself so I don't look like someone starting a cult...
I have been screened a few times for ADHD and each time was found to obviously have it.
Ritalin does not make me feel calmer. I have been told by those close to me that there are externally visible improvements in my behavior. At doses to reach that effect, it also impacts my sleep quality enough that I don't take it.
Adderall causes mild symptoms of psychosis and mania before it has any theraputic effect.
Dexmethylphenidate (aka Focalin) has identical theraputic effects to ritalin, but slightly reduced side-effects.
Methylphenidates can be quite numbing (zombifying) in my group of ADHD friends but dex seems to have a more consistenly helpful effect. The unfortunate caveat for me is that I personally seem predisposed to pelvic floor/urinary issues, which you'll find anecdotal evidence of being exacerbated by amphetamines (research seems yet to catch up), but aside from that the theraputic effects, particularly in emotional regulation seem so far unmatched.
It's unfortunate we have such a tentative model of how our body and, particularly, our minds work so drug treatments often require a trial and error process.
I found methylphenidate-based drugs to be useless after a few days.
Have you tried pure lis or dexamphetamine? I know dex can be prescribed without the mixture, maybe lis can too. I keep meaning to ask my doctor about it.
The other issue I find is tolerance, though even with this I'm still far more focused than when I'm not taking adderall. It really is amazing how much better it makes me feel. I find no problem with addiction whatsoever -- if I forget to take it, then I just have full blown ADHD, but I'm no worse off. I also find it's more effective if I minimize coffee, but I haven't yet cut coffee entirely. (I find caffeine is vastly more addictive than amphetamines.)
Strattera was subtle, but I had clearly improved feedback at work, a cleaner apartment, and no side effects.
Qelbree caused a lot of nausea.
Intuniv caused lightheadedness and got me an unnecessary cardiac workup.
Wellbutrin doesn't have as much ADHD efficacy as Strattera (my doc won't let me take both at the same time), but it improved my seasonal depression and motivation significantly. I had some irritability for the first few days after a dose increase, but otherwise the only side effect is reduced hunger and I also stopped asking people for cigarettes or zyns when I'm drunk.
I was diagnosed with Shiftwork Disorder at one point in time and was prescribed Modafinil and it was incredible for the most part and had zero side-effects, but my doctor wont prescribe it for ADHD. One down-side to Modafinil is that I could get stuck on an unproductive task and would realize in hindsight that I had just been hyper-attentative to this unimportant task for hours.
I think many prescribers give ADHD adults a high dose too soon causing side-effects. In my experience, it's best to start with a low dose and slowly increase as necessary. The myth is ADHD responds quickly, but observing hundreds of patients it takes months, not days, for benefit of treatment to develop. There's wisdom in the phrase, "start low and go slow".
I have had bad reactions to every stimulant I tried since I developed bipolar 1 in my late teens (had taken them as a child for ADHD).
I had a good response to strattera, but there's a variety of them out there.
Yeah, it's basically why I don't bother with it. I know it works, but trading one set of problems that I know how deal with for a different set of problems that needs more meds isn't appealing at all.
I was able to laser focus and jam through things but the side effects were not worth it and I backed off. I've yet to find a magic pill that does that without the side effects.
So they can't test by response, because everyone would be like "yeah I can focus better", you have to test with the drug on, and the drug off, to see whether the "horsepower increase" is worth the fuel price. Increasingly strained metaphors are my strength.
In ADHD (and most conditions) diagnosis by medication response is not acceptable. Response to drugs is highly variable and fails criteria for acceptable tests. Also drugs can produce side-effects. According to professional standards, it's unethical to expose people to nontrivial risks without good cause.
But also seems very much like a software dev, so does seem to reinforce the stereo type.
I have some really interesting, but lengthy text that's really important for me to read for class. No cell phone, cleaned my room, put on specialized focus music, jot down all my random thoughts on a notepad, got myself a cup of coffee and made sure I eliminated all distractions.
I then proceed to read the first two or three sentences before I realized I have been mindlessly scanning the text with my eyes like I'm reading, but instead I am doing the equivalent of watching a movie. I'm 100% zoned out and in la la land.
I realize this, so I stop, refocus, repeat. I realize I did it again, stop, refocus and try reading out loud. I'm annoyed because I'm saying the words out loud but not comprehending it.
I meditate for 30 seconds to calm my mind, try to refocus and repeat. I finally get through it after about 30 minutes.
Here's how my personal experience looks with medication:
I pick up the damn paper, read it and summarize it with notes in 5 minutes.
Understandably people want to help when they see someone struggling with the same things they did, and I'm not suggesting that you don't seek out professionals if you think you might have a disorder, but we need to stop labeling completely normal behaviour as problematic.
Just like people without various disorders can't relate well to those with e.g. ADHD, people with the these disorders also understand neurotypical behaviour way less than they think they do. A large number seems to struggle with separating "normal" quirks of the brains and their diagnoses.
I am not sure that is objectively true in the sense that people think. If so, the condition would have a much more objective diagnostic process. I have been professionally described as ADHD, had an fMRI (unrelated reason), and my results came back perfectly normal.
I know n=1, but the data doesn't necessarily suggest that ADHD is some kind of organic, neurological disease.
To that point, I'm going push back on this language just a bit:
> you end up addicted and pretty much permanently require drugs to function well
That is negatively framing medication, which if taken properly as prescribed is no different than any other medication someone might take to help with a chronic health condition. It slightly encourages and leans into the idea that ADHD is "fixable" without medication and so taking medication is a problem (or due to a weakness, etc).
I'm not discounting the value of other forms of non-medical treatment, but in many case medication IS appropriate as part of the overall treatment that a person requires to manage their ADHD. We should not use language that stigmatizes treatment that should be between a person and their doctor.
in reality, if the side effects are minimal and you function better on it, it's a sip of water and a pill a day and that's largely it for health outcomes. most drug interventions are generally extremely well-studied with very large sample sizes. there's a reason why clinical research is considered gold-standard - the regulatory requirements to even get a drug to market is monumental and some of the most rigorously audited and vetted processes in the world
the ironic thing is that most of the big pharma detractors are also ingesting dozens of supplements, the vast majority of which have little to no good empirical evidence backing them (and very small effect sizes to boot) along with even less regulatory oversight for issues like contamination, formulation, or if it even contains the active ingredient. which isn't to say that 'big pharma' doesn't often pursue avenues for profitability reasons instead of the public good but that's not the typical critique that an anti-empiricist brings most times
The difference the medication makes is similarly revelatory to putting on eyeglasses. Of course you never want to take them off.
There's no withdrawal symptoms, per se, for most people, the addiction is purely psychological from "trying to drive with only 3 tires sucks"
The actual meaning is more complex, involving inability to stop, negative effects on your life, etc. - none of which apply to wearing your glasses or breathing.
If you can be behaviorally addicted to gambling, or even more aptly eating, you can be behaviorally addicted to medication that doesn't give you any physiological dependency.
> The DSM-5 has re-classified the condition [ed: gambling addiction] as an addictive disorder, with those affected exhibiting many similarities to those with substance use disorder. They both activate a reward mechanism in the brain, causing dopamine release to reinforce repetitive behavior. Both often lead to loss of control.
Edit: to engage more substantively, imagine if your glasses gave you, say, mild skin irritation that progressively got worse with wear, but you chose to mitigate that and wear them anyway. I would rate it at that level.
The reasons you cite are why it is a controlled substance, and why it should be taken under supervision of a doctor. But they aren't arguments against the drug itself or that it is in a different "category" of drug. It is a treatment, and like any treatment, the pros/cons should be discussed with medical professionals and appropriate decisions made for each individual.
And yes, sadly our society fails people who are different and our medical system fails people with regards to their medication all the time - that can happen with any medication though. And yes, consequences vary greatly depending on the medication.
People with ADHD are often amused by referring to amphetamines as a "hard drug" since it has practically none of the typical hard drug effects on them.
I'm on stimulants and I agree that the post you responded to needed reframing. But I think we do ourselves and anyone else who isn't "normal" in body or mind a huge disservice just focusing on acceptance of treatment when there are larger societal changes that could be made.
That said, I think we agree that accepting the treatment folks need to function in society as it exists is a step in the right direction.
On its own, its not "a serious dysfunction". Within the context of operating within the current societal setup for a paycheck that provides basic survival needs, yeah.
It allows me to sit down and do 'something' without being taken completely off task for the rest of the day because someone kept knocking on the door or reading a hostile/complaint email. What that 'something' is is not always 'productive' but now I can do it without everyday things or upcoming events throwing me in a completely different direction.
Meds helps with the alignment issue. If you are taking meds and its making you "productive all the time" and you find yourself addicted to it, I suggest talking to your doctor about that. I had to work with CBT just to form a habit of remembering to take the medication, and it took a few years before I finally started to remember regularly. I still forget on days that dont fit into that routine
The author of the article is contributing to this by using their medical diagnosis to "outsmart" the system for writing material. Presenting a proper ADHD assessment as merely an online test just adds fuel to the fire (and if this is the only interaction they had I am skeptical of the assessment procedure).
> and while treated ADHD can make you productive "all the time", you end up addicted and pretty much permanently require drugs to function well
That's an unfair and sweeping characterization of the immediate therapeutic benefits and long-term health outcomes of individuals.
I don’t think I was trying to “outsmart” anything, I’m just a naturally curious person
No? First, even when I was taking it almost every day for three years, I kept forgetting to take it. Today, my last refill was in February this year.
I recommend against raw-dogging reality with ADHD without meds. At least so you have baseline "this is what normal feels like"
Consider the subreddit r/stopspeeding, a recovery community for people addicted to stimulants. Many, many users share similar stories of being prescribed a stimulant medication for ADHD, then beginning to abuse it. Many of these people really do have ADHD, but find that their lives are better without stimulant medication.