If anyone here reading this needs the motivation or gentle reminder: you might not need Adderall anymore.
I've used it to get ahead in software for the past ~8 years. I recently gave it up, but it was hard to realize that it was time. It might be time for you, too.
The thing holding me back was fear. Fear I wasn't enough, that I couldn't be efficient. That I would get fired from my high position. Or even if I could make it work, that I still wouldn't get enough done on my startup (which has its own list of fears itself).
What finally pushed me to quit was realizing I wasn't as compassionate anymore; it was impacting my relationships. I had three separate people tell me in my coworking space that I look too busy and unapproachable so they never came to chat. I had a SO tell me that I'm emotionally unavailable too often. All within the time span of a month. I'm naturally an optimistic, compassionate person. This wasn't me, and being a robot (as mentioned in the article!) wasn't who I wanted to be, at any cost.
Indeed, three days after I quit I felt like a new person. I felt silly, fun, again. I had a week of "brain fog" where I wasn't productive. Afterward my efficiency went back up. Nowhere near the Adderall levels, but to a very acceptable level.
So in summary, you might not need it anymore if it's causing you grief. Sorry for the lame motivational things I'm about to say (Taken from the book, Daring Greatly):
I really relate with this. It took extraordinary measures for me to get where I can work efficiently without Adderall. Adderall turned me into such a different person that my wife started to be scared of me. Just interrupting me from work was a landmine, I was so mean. The doctor just said “be nicer” when I asked him about Adderall and anger issues. I’m a fun and easygoing person and it was like that part of me would get snuffed out and I’d become a robot on Adderall. I feel like it let me become a programmer. I locked myself in a home office for three months 10 hours a day learning to program, working on a demo project, and got my first professional position. The Adderall definitely enabled this singlemindedness.
To reorient myself in a way that I can concentrate on work without Adderall, I sold my TV, my VR, and my $700 graphics card. I unsubscribed from Netflix, deleted Facebook, and got rid of Twitter. I don’t listen to music as background noise, or in the car. I’ve gone on a ketogenic diet with no MSG (so no cheap meats like sausages). I try to sit without looking at my phone when I’m waiting for five or ten minutes somewhere. The whole idea was to “reset” my brain to a lower level of overall stimuli, and largely it has worked. I feel better and can work harder than I did on Adderall, because I can work in the evenings without having a total breakdown, because taking Adderall after 5pm was always a disaster, I wouldn’t be able to sleep and I’d have really weird thoughts as I went to sleep.
I’m really glad I did all this as it made me realize what’s really important in my life, family and to a smaller extent friends, and the time with them is much more meaningful now. I can actually concentrate on what someone is saying to me. Maybe moreso, I actually care.
I started taking Adderall recently and so far, I've had the inverse experience socially. It's made it much easier for me to meaningfully engage with people. By gaining control over my focus, I can now overlook "the little things", and I'm no longer compelled to "chase dopamine".
I'll be honest, but I find it very hard to believe that amphetamines can
really enhance your cognitive skills. I'm talking from second-hand experience
only, but it's pretty clear to me that they can have the effect of making you
feel like you're smarter, faster, leaner, better- but this feeling is just a
side effect of taking the drug, and does not reflect a real improvement.
I can believe that the drugs can help some people get over some psychological
hurdles that are keeping them from delivering a piece of work, but I'm really
not sure why the work itself would end up any better than if it was done while
sober. Given that a big effect of apmhetamines is to make you stay up all
night, for weeks on end, in other words causing sleep deprivation, I find it
very likely that the end result is in fact much worse than the baseline.
Personally, the only magic drug that I've found really helps me do better and
more is getting enough sleep and doing so regularly, for many weeks. Even if
it means having fewer waking hours for work during the day, it doesn't matter,
because I can pull twice the work (and twice the quality of it) when I'm
well-rested than I do when I'm tired and haven't been sleeping well.
So, taking a drug that completely screws your sleep patterns and just makes
you forget how tired you are, sounds like a recipe for destroying the quality
of your work, to me. And I think those studies the article quotes, the ones
that haven't found any cognitive enhancement from Aderall (to healthy
individuals and ADHD sufferers alike) are basically justifying my hunch.
They definitely increase energy levels. A person can stay up for days on them. They are an unwise and partial substitute for sleep but a substitute nonetheless. Like you mention, a large part of what they do is change intrinsic motivation, not intelligence. When you feel "charged" with energy, it is hard to oppose doing intellectual work. Amphetamines are pure energy. And intellect loves pure energy...so does physical work. But its not for free. Amphetamines decrease circulation..they caused Peyronies Disease for me..and I used to take them all the time in college with no issues. Age always brings the true nature of bad habits to bear.
I really hope people don’t read these posts and think oh man I gotta get aderall because everybody is on it. (For people that don’t actually have some serious issue studying.) if you managed to get into a good college without using aderall something tells me you already have the ability to focus very well. I also think this type of post will bring out a large fraction of the small amount of people doing it and make it look substantial.. I for one agree that substantial regular sleep and finding a job that you like, and holding yourself accountable to achieving the goals you set for yourself are far more powerful than temporarily pounding out 1000 lines of code. I have met tons of people over the years who would finish homework before others and half of the time they would be bored and not sure what to do with themselves and end up sort of always confused about what they want to do with themselves and not very passionate vs. the people studying away in the lab frustrated that they don’t “get it” end up finding a love for the material fairly often when they suddenly start “getting it”.. it’s not to say that one day there won’t be a “make you smarter” drug, but I doubt strongly that a stimulant like aderall is it.. more likely it’s equivalent to drinking a small amount of coffee every 15 mins over the period of a long work day. In my case I don’t take anything like aderall and have achieved plenty and been able to work very long and intense hours through a variety of techniques I use. For example, don’t drink all of your coffee right away in the morning, drink it more slowly. When you are on a roll don’t go to lunch or grab coffee with your work mate, just keep trucking. Visualize the feeling you will have when you finish the thing you are trying to get done at the end of the day and stay focused on that when you start to get distracted. Get up and walk around for 60 seconds to get some blood pumping. Kneel down on your knees instead of sitting for say 5 mins. When you get interrupted by a co worker come up with a nice way of saying that you are in the middle of something. Change locations if you are losing interest and focus in what you are working on. Listen to some music without words to help get you into a zone. Come up with a story to tell yourself about why your thing you are working on is important. Think about what food or reward you will give yourself when you get something done that you think is a good checkpoint. Basically my point is that if you come up a set of methods that help you become successful rather than relying upon a drug then you can essentially persuade your brain to keep investing time and energy into your goal and is more resilient long term. It requires you to build up these skills to train yourself to be able to do these techniques, — no silver bullet.
I've spent years trying to get off adderall, swinging between having serious addictions with it (even pouring bottles down toilets), quitting it for months, and then eventually coming back to it as work/stress accumulates.
A few years ago I quite adderall/dexedrine at a startup, it lowered my productivity as I rushed with caffeine and other things to fill the void, and within a month I was fired as I had become useless.
Adderall changed my personality well before I discovered coding. I discovered coding because it suited my adderall addiction, not the other way around. In fact, almost as a maladaptive trait, I changed my whole career path towards coding away from politics precisely because I realized how well suited this new line of work would be for my addiction: Only in coding could I continue with my dysfunctional adderall-addicted personality, get paid well for it, and paradoxically be seen as a functioning member of society.
-------
But now I'm stuck. I want to quit adderall but I know I can't do it without at least a month of not working.
Every vacation comes around, and I promise myself I'll make another attempt at quitting but back out, but fear prevents me from doing it.
The longest I ever quit successfully was for a few months while traveling around the world. I experienced the best romance I've ever had in my life, because without my personality being blunted by the effects of adderall, I could be my charming emotional self again.
That all faded when the trip ended, when I needed to become productive again and faced the disaster of not being able to perform.
And that, my friends, is what makes Adderall addiction so uniquely fucked up.
Unlike heroin, alcohol, or benzodiazepines, our economy currently rewards and even encourages us to continue our addiction to this drug.
I felt the same way about cigarettes (and then sugar) for awhile. They helped me focus and think about hard problems (or so I thought). Anyways, not as good example as Adderall, whose effects are probably more effective than what I imagined.
Have you considered taking a personal leave to kick your habit? I mean, don’t take a vacation, but take a leave from your job and then quit the drug while instead working on personal projects and trying to remain productive. You will slump at first, but if you like what you are working on, you’ll probably pick up again after a few weeks.
I know not everyone can afford to do that, but it’s the best solution I could think of. Good luck!
You sure you're not me? I got into coding seriously in college after I started to take adderall to help study, and ended up making a career of it. I was absolutely terrified of quitting, because I felt like I couldn't do the one thing I was good at without it. I tried quitting and lost jobs over it, several times. It got to a point where I couldn't function as a human without it - I'd just sit in bed and feel sorry for myself. My addiction progressed to needing more than I could convince any doctor to prescribe, so I started getting more in various illegal ways.
I've been off the stuff for about 4 years, and I don't miss it at all. I'm actually a much better programmer without it - I don't get sucked into unimportant details, I have a more realistic sense of what I can and can't accomplish, and I'm more creative. More to the point, I have a life outside of a little bottle of pills now.
I got off of it after talking to some people who'd also gotten off - this helped alleviate my fears that I would have to give up my sweet programming career, and re-framed the problem as a matter of underused and atrophied motivation and willpower. It wasn't easy, but with a lot of love and support I managed to quit for good.
Hit me up if you want to talk - jonathan dot j dot mason, gmail.
Very good points. I do notice while on it, that it's extremely easy to get sucked down into rabbit holes, losing sense of time and of what's important.
I've also run into the same problem you described, of running out of adderall due to more and more tolerance. In desperation it even led me once to get some darknet speed pills off the internet, containing what I later found out to be meth... all due to a lack of available prescription alternatives. (I quickly learned methamphetamine is a completely different animal -- far more addictive, dangerously euphoric, and seriously neurotoxic. I learned to never do that again.).
I'm now experiencing my first health wake up call, which I'm convinced is linked to adderall use: just in the last few months, while using my iPhone I started to notice a very slight shaking in my fingers. Turns out: I have a family history of essential tremors and Parkinsons (caused by accumulated damage to dopamine receptors)... with ALS as a possible risk factor. That's right: A L fucking S.
And I'm only in my late 20's.
Terrifying. The illusion of my own invincibility has been shattered. For the first time in my life, it's abundantly clear that my problem with adderall is no longer just psychological: it's physical. That if I don't make changes soon... things could start going downhill for me -- fast.
I may take you up on that offer when I can muster up the courage. Thank you.
> I may take you up on that offer when I can muster up the courage. Thank you.
Please do - it's always a pleasure to help someone out of a bad situation that I've been in. And remember, fear is a prison without walls - you just have to make a decision to walk through that fear, and you're free.
"We could still have a principled definition of ADHD. It would be something like “People below the 5th percentile in ability to concentrate, as measured by this test.” Instead, we use the DSM, which advises us to diagnose people with ADHD if they say they have at least five symptoms from a list. "
I'm in Germany and I've been diagnosed with ADHD-PI lately (I am in my 30s) after seeing a private specialist about this topic. In addition to that DSM test and 3 other questionnaires, they ran a computer test measuring my ability to concentrate which was repeated after a couple of weeks on medication. The test results were very conclusive and I think that is the strongest diagnosis criteria that I have as it's actually measurable.
It was actually really hard for me to find a doctor to actually diagnose me. I called several doctors and it was either "we're not taking any more patients because diagnosis takes too long" or "we can't tell you if we can diagnose it, you can't make an appointment here, so come in but you might have to wait half a day". Not to mention that by the time you get to your doctor, un-medicated, you will forget to tell about half of your symptoms.
And even that would give them a measure of the benefits. If it’s the same benefit that actual ADHD receives then it’s still a useful metric. If it’s less than the benefit when used for actual cases then, in aggregate, the benefits would be a low bar. Arguably that’s a better bias as it would make the benefits/costs decision more conservative. They’re taking the difference in measurements for each individual.
Maybe everyone will score better, although I don't believe so because the tests are trivial for people without ADHD.
In any case they certainly won't have anything like the kind of improvements people with ADHD has, improving from spectacularly bad to (usually) only slightly below normal.
It's a common mistake made by both professionals and laypeople that ADHD is a condition with only slight deficiencies in focus, when in reality they are often staggering.
Anecdotally, everyone with ADHD I've met understand the concept of things being so boring it becomes physically painful to do them. Everyone else think they heard me wrong.
For me the computerised test was almost impossible at the end, because my bored brain refused to even see the images on the screen. All I saw unless I blinked and tilted my head was a white, blank screen, only that it wasn't blank.
With methyl phenidate it was hard to understand it could have ever been hard, and that even though I still have significantly below average concentration even with medication.
I’ve long held the belief that ADHD is wildly over diagnosed (in the US, at least).
Your anecdote has helped solidify this belief. 8/10 Adderall users I know are able to concentrate and complete complex, intricate tasks without the pills. The pills just put them in jet-speed mode.
It sounds like you truly have ADHD and are benefitting from proper medication. I wish nothing but the best for you.
However, I also wish the doctors would remove their heads from their ass and attempt to find a better method of diagnosis.
During my friend’s 3rd year of study at University, he realized many of his classmates were taking Adderall. Not only that, but those students had less trouble completing the crushing work load on time. So, he visited the local pill dispensing psychiatrist and walked out with his very own prescription.
Now we’re here, several years later, and he’s convinced that he really does have ADHD because the doctor keeps renewing his prescription. He chooses to forget that he initially got the prescription by regurgitating bullet points out of the DSM.
This is just one example. I’ve seen it countless times.
Is it really just me that thinks having oodles of young adults taking amphetamines daily is OK? I just can’t seem to wrap my head around it.
Competition, till nothing is left of us.
Makes me grateful every day, that brain implants are not yet here. Every day before that is a present, else we would have our heads chopped up on the altar of progress to become twitching, spasming prosthetic gods for the common good, until there was nothing left to ask why we did this to ourselves in the first place.
It depends on where you set the bar. If you make it easy for 80% of the population to ace it, then the only people who will fail are the ones with serious deficiencies.
They compared the error rates of working+short time memory to values that non-adhd people score.
My score was significantly lower than average at my first test and on my second test above average on medication.
I've often wondered if Dyslexia and attention deficit disorders are connected and/or occur together. I was diagnosed with Dyslexia when I was quite young but it was before the greater awareness of AD-disorders. I've not tried Adderall but have tried Modafinil which worked as advertised.
>Not to mention that by the time you get to your doctor, un-medicated, you will forget to tell about half of your symptoms.
This is actually a major problem. I was diagnosed with ADD as a child but gave up the medication in my late teens because it had side-effects I didn't enjoy.
Late last year, I thought it might be worth trying it again, maybe with a milder dose. I booked an appointment with a doctor, who referred me to a psychiatrist. The psychiatrist told me there was a two week waiting period and that they'd call me back in a few weeks, and never did. It was two months before I remembered to follow it up.
I don't bore you with the rest of the details, but the short version is every medical professional I spoke to (and I spoke to about 5 during this saga) told me to wait and that they would organize something for me, and then didn't. Turns out if you lie to someone with ADD and leave the organization ball in their court like that, they'll never get treatment, because they struggle with the very thing you're asking them to do. It's pretty much the worst thing you can do for them.
Anyway, I've just realized I was planning to talk to the doctor about it again 4 months ago to try to get the ball rolling again. It's Christmas now, they won't be back at work until mid January. I'd better send myself an email, wish me luck.
A better system of tracking tasks is useful for everyone, not just ADHD. Try setting a calendar entry for a date on which you'll follow up if you haven't heard anything back, and use something like Google Keep (key point is it has a mobile app and webpage) to organize to-do lists.
>Try setting a calendar entry for a date on which you'll follow up if you haven't heard anything back
Thanks for the advice, but surprisingly I have actually tried just not having ADD. This simple advice doesn't work very well for me, which is why I'm attempting to pursue medication again. The calendar entry goes off, I try to contact the doctor, maybe they're not in today, it's half way through the work day, I go to set another, I spot an email while I'm doing it and start following up on that, and then 4 months later it never happened.
The point of a to-do list (or reminder in Google Calendar) is that it's constantly staring at you until you actually complete it. It sounds like you're using one-off calendar entries.
I'm not suggesting that "try not having ADD", just suggesting you use mechanisms to remind you to do stuff that are persistent and thus work.
> The point of a to-do list (or reminder in Google Calendar) is that it's constantly staring at you until you actually complete it. It sounds like you're using one-off calendar entries. I'm not suggesting that "try not having ADD", just suggesting you use mechanisms to remind you to do stuff that are persistent and thus work.
No offense, but from what you're saying, it's pretty clear you don't understand how ADHD works. ADHD is a disorder that affects executive function; the whole problem is that the system you're describing will fail for someone with even moderate but untreated ADHD, let alone more severe cases.
Maybe you don't mean it this way, but it's actually rather insulting to say that these mechanisms "are persistent and thus work", or that OP try a to-do list because "it's constantly staring at you until you actually complete it". ADHD means that you can't assume that those systems work, and it means that "constantly starting at you until you complete it" isn't actually a viable solution.
Hence, that's why OP read your post as "try not having ADD", because you're literally suggesting solutions that presume that they not have ADHD in the first place.
How does a persistent in-your-face reminder that does not go away until completed fail? I suppose severe procrastination or complete lack of willpower would do it, but are these not different from ADHD?
CydeWeys - thanks for your persistent posts... they are a wonderful example of how someone without the condition cannot fathom what is going on "inside" and thinks they can be fixed with a system or willpower. These things help to a point but there is an underlying problem that can't be fixed this way.
Easy, just close the browser tab and never use calendar or keep ever again.
Rational? Far from it. Functional? Nope.
That's why it's a disease but we have medication to treat it.
It's like trying to tell someone that walking is easy, just put one foot in front of the other - to someone with no legs. Unfortunately it's harder to see missing legs for mental diseases.
For people with ADHD, its a distraction that's willfully ignored while you're trying to complete one of the other hundred things on your to-do list that are also screaming for attention, most of them in more-urgent-but-less-important ways that this attempt to schedule an appointment with yet another provider who's likely going to make you prove once again that your life is falling apart by jumping through your life story and maybe trying some alternative that makes you ill, cranky, and introduces some sexual dysfunction that gives you one more thing to worry about alongside the thoughts of whatdoigetdonethisweekpleasejustletmecrossoffonethingtoday that you wake up to each morning.
> severe procrastination or complete lack of willpower
This sounds an awful lot like the attribution of a moral failing to people that suffer from an issue with executive function as it pertains to attention. This might be why people keep telling you that you are clearly articulating an inability to empathize. Imagine a mindset in which your fundamental assumptions, which seem self-evident to you, do not apply. If it seems difficult to understand why anybody would want to live that way, congratulations, you've got something in common! Nobody else wants to live that way either—the difference is that we don't have much of a choice, which is why we all have such strong opinions about this topic.
>> Hence, that's why OP read your post as "try not having ADD", because you're literally suggesting solutions that presume that they not have ADHD in the first place.
To be fair, the article does make the point pretty strongly that it is very hard to separate ADHD from natural variations of attention, concentration etc:
But “ability to concentrate” is a normally distributed trait, like IQ. We draw a
line at some point on the far left of the bell curve and tell the people on the far
side that they’ve “got” “the disease” of “ADHD”. This isn’t just me saying this.
It’s the neurostructural literature, the the genetics literature, a bunch of other
studies, and the the Consensus Conference On ADHD. This doesn’t mean ADHD is “just
laziness” or “isn’t biological” – of course it’s biological! Height is biological!
But that doesn’t mean the world is divided into two natural categories of “healthy
people” and “people who have Height Deficiency Syndrome“. Attention is the same
way. Some people really do have poor concentration, they suffer a lot from it, and
it’s not their fault. They just don’t form a discrete population.
Also, if attention etc is a "normally distributed trait", any behavioural intervention that can help someone near the middle of the distribution has a pretty good chance of helping someone near the extremes, also. To take the example of height again, just because someone is short doesn't mean they won't look taller with high heels.
In fact, if you think about it, such interventions are designed exactly to help people with poor executive function, as you say. Assuming that this is basically a description of what ADHD is, I don't see why behavioural interventions can't make a dent in it.
I am also from Germany, but moved to the US for work. I am 29. Recently someone suggested to me I might have ADHD. After learning more about it, I had a feeling that many adults with ADHD have: I suddenly felt like my life story made sense.
People below the 5th percentile in ability to concentrate, as measured by this test.
My health insurance made me take a CPT test and it indicated that I don't have ADHD. This means that they refuse to diagnose me despite that I have ALL of the inattentive symptoms. I did a lot of research on ADHD after that. Those tests have a 40-50% false negative rate. Luckily I am changing insurance next year. I already made an appointment with another doctor who is an expert in adult ADHD.
I don't know false positive rates off-hand, but they are properly much higher. Pretty much any mental or psychical illness causes inattention. There is no reliable test for ADHD. ADHD is not primarily about inability to concentrate, but executive function.
Instead, we use the DSM, which advises us to diagnose people with ADHD if they say they have at least five symptoms from a list.
This not true.
1. You need to have them "often" (approx. 5th percentile in the population)
2. You need to have them since childhood.
3. They may not be better explained by other disorders.
4. Need to have significant impairment in work, school or personal life.
Those criteria are based on decades of scientific research. They are the best way to diagnose ADHD. There has been promising research in computer tests, genetic tests and brain imaging, but none of those are reliable. A good doctor should spend significant time talking to the patient. Ideally they should also talk to other people who know them and review documents such as grade cards from school.
I am not an expert, I just did some research on my own. If you know more than I do please share.
1. There are normed rating scales. I assume OP was also tested on one when s/he filled out those additional forms. If I recall correctly they use the 5th percentile.
2. DSM-5 still requires symptom onset before the age of 12. As far as I know some researchers advocate raising the age limit further into adolescence, but don't want to get rid of it.
This is all a bullshit facade. 60% of ADHD adderall prescriptions are from people who realize they can work better by using it.
So they fake the symptoms, and get those advantages. That's what's refreshing about this posted article; it points out how ridiculous continuing this whole charade is.
Also from Germany but moved to Japan for work. I never suspected ADHD until someone here on hackernews hinted at it, and even then the idea just seemed absurd. Went to a doc and they suggested doing a "NIRS scan" while I perform a basic task (in my case playing rock paper scissors). I only later read that NIRS scans are only being trialed for ADHD so it seemed more like a quick money grab, but in either way my result graph looked a lot different than what an average graph should look like, hinting at depression and ADHD.
Had a conversation with my doctor about my symptoms and how I feel and concluded that yes, I pretty obviously have ADHD and that it might be the cause of my depression. Went to a second doc for a second opinion as well and he also concluded ADHD. So yeah, I was a little shocked but as someone else said "I suddenly felt like my life story made sense". A lot of the problems that I attributed to my personality felt explained. I talked to older classmates as well and even they said that yes, looking back it was pretty obvious that I have ADHD.
He directly prescribed me a test batch of Atomoxetine (strattera) for trying. At this point I still didn't think I actually had it but went with it anyway.
The side effects were nuts for a couple days but I pulled through. Because of the slow onset it's very hard to actually 'see' a difference but oh man, it feels like life became a lot more manageable: Less arguing in my head, less impulsive behavior, I can keep habits like going to the gym up without getting bored, less of a fight to start a task and so on.
Atomoxetine allows me to be myself, minus a few of the ADHD quirks. I still have attention issues, or am jumpy and hyper, but it is less than before and more manageable by me.
I am worried that once I go to a different country I will have exactly what you described: That I will be in a long queue waiting for my turn, or that clinics are just full and reject me. My current advantage is that I speak Japanese and that ADHD here is still a kind-of new field. Not many Japanese adults go to get diagnosed, so the Japanese docs are free while the English clinics are booked out months in advance.
I really, really wish there was more discussion of this. This is something that is very present in my life and the lives of people I have worked with, but nobody talks about it.
The two things that really stick out for me are the existential implications of taking a pill that rewires your brain, and the inevitable intersection of that with one's career choices.
I don't take adderall, but I'm not too convinced by the concerns listed here. The drug seems far less risky than alcohol on all counts, and I'm pretty sure all amphetamine users are aware that their playing with some sort of fire.
I think the compelling question is why people feel so compelled to take a pill to sell their souls to a rat race? Seems like an almost Huxleyan Prisoner's Dilemma to me.
If you're "ADHD" it affects having fun just as much as working - imagine you can't finish a book and you can't hold down a conversation with a stranger long enough to start dating them. There are pretty universal subconscious skills medication improves here.
This is what I have to explain to people, my ADHD doesn't only apply to things I don't want to do.
Things like not being able to watch a movie, or even play some video games without missing huge parts of the story, or sitting through a conversation with a group of friends trying to constantly "catch up" to a topic that I missed a few minutes ago, or trying to be self aware enough to not change the subject on people too quickly because my mind has already changed topics twice during their conversation.
I love reading, and it's almost 100% out of the question when I'm not taking my medication. Somewhere around the 5th time of re-reading a paragraph trying to remember where I trailed off only to realize that I just did it again makes it really not a great experience.
Even the worst case scenario of the medication severely increasing my chance of heart attack, stroke, or Parkinson's wouldn't make me stop taking it, because it's given me a life. And I would rather live a shorter happier more fulfilling life than a potentially longer one.
I had held off getting tested for ADHD because I was convinced I was just lazy and didn't like schoolwork but once I noticed I couldn't play a single videogame for more than 15 minutes at a time and had to do something else, I got myself tested and ultimately diagnosed.
I still remember the first day I took the medication, it was like somebody finally turned off a white noise machine in my brain and I could finally do all the things I've wanted to do.
I texted my wife after my first dose that I heard someone having a conversation near me and that I could hear them, but I didn't know what they were saying and I didn't care.
Same - for me the leading indicator of having "true" ADD is the inability to concentrate on the things I _want_ to do.
I recently chatted with a shrink who said that ADD patients typically _can_ focus on the things they want to do but struggle with the things they don't want to do. I strongly suspect he's mistaken - I don't know a soul who finds it easy to focus on filing their taxes (except sadistic accountant-type friends).
Nothing is more frustrating than having all the "motivation" and desire and curiosity for a task but none of the "ability" to make it happen.
>I think the compelling question is why people feel so compelled to take a pill to sell their souls to a rat race? Seems like an almost Huxleyan Prisoner's Dilemma to me.
I think people just want to be their best selves. They want to accomplish their goals and they use tools to accomplish those goals. I mean everyone carries a cell phone and I feel like those modify your life and thinking patterns a lot more than taking adderall does.
"I think the compelling question is why people feel so compelled to take a pill to sell their souls to a rat race?"
There seems to be an implicit assumption in your question that refers to adults. What about the growing number of people, diagnosed and treated as children or young adults before they really have an agency in the matter?
I know we like to think of them as not having agency, but we can still give teens and preteens choices. I know some kids who the medication helped, some who grew out of needing it when they grew older, and some who had strong side effects and stopped taking it after a few weeks. But they most certainly did have that choice.
> I think the compelling question is why people feel so compelled to take a pill to sell their souls to a rat race?
This seems pejorative. The reason why many take "a pill" isn't to sell their soul, it's to do the work they want to do but are otherwise incapable of doing. You may consider this work that they want to do to be "rat race" work, but that's just your judgment of their desires.
For what it’s worth, for me, the main impact of adderall is on a second to second level, not whether I can concentrate for 12 hours straight.
When I’m not on medication, I have a lot of short term memory loss and sudden changes in train of thought. The impact of this was that I would sometimes “wake up” and have no recollection of how I got to where I currently was, I continuously lost everything, and had trouble with math word problems that were described over long paragraphs.
My parents actually originally went to the doctor because of the stress caused by always losing things.
I felt extremely sad on taking Adderall and other similar stimulant medications like Ritalin.
Maybe the sadness effect would have gotten less with continuing the medicine, but overall, I didn't feel like taking drugs since they cause a lot of other side effects like insomnia.
Now I've been able to control my ADHD successfully. Atleast upto the point that it has stopped affecting my life and career so much.
a) 0 sugar in diet. Not even fruits.
b) Try to sleep for atleast 8-9 hours a day.
c) Drink lots of water throughout the day
d) Exercise and no junk food.
e) Have got an accountable job. Leading a software team so I know that procrastination will hurt me in the long run, so forced to do stuff on time.
I take fruits which have no/negligible sugar like Amla, Lemos, Avocados. Once in a while, I do take supplements. But on the whole, I try to live a more natural life, with as less drugs/medicines as possible.
Even for milk, I drink raw milk and not processed milk.
Pasteurization was invented for a reason though, and literally saved millions of lives. I can't fathom how the supposed benefits of raw milk could outweigh its risks.
Also, what are the supposed benefits exactly? Can you link to scientific studies validating them?
edit: I see you replied below this. No added sugar but still no fruit.
But still I'd say you're missing out on the benefits of fiber in fruit. The sugar in fruit wouldn't concern me it's offset by the vitamins, minerals and fiber.
I was on ADD meds (including ritalin for a few years) and I agree with everything you said. My behavioral therapist who put me on the ADD meds did mention all of those 5 factors but I wish better action plans were put in place rather than just saying "these could help".
Another thing that can help is doing a yoga class once a week. I found the 3h0 Kundalini yoga to be the most helpful. But eliminating sugar is a big one too there are many ways in which we unintentionally expose our self to everyday food items that can induce ADD states.
Interesting, Adderall always had the opposite effect on me. I have a tendency towards mild depression, which was a problem on Ritalin but which Adderall treated very well. It functions as a mild anti-depressant in many people (it was why my doctor suggested switching).
However, even in low doses Adderall and Ritalin can cause psychosis in a small fraction of people. Is that what happened to you?
Same. Adderall (plus welbutrin more recently) have been enormously effective at helping with the mild depression that have plagued me my entire life. (Adderall isn't indicated to treat depression but it doesn't hurt and is particularly effective for me when combined with welbutrin.)
Ritalin made me angry, scared, and flat out unwilling to do work (although perhaps it would have helped the concentration had I decided I actually wanted to anything).
I hope adverse reactions to one of many possibly-effective medications don't deter patients from getting the help they need.
I was high school dropout turned Yale PhD. I was prescribed for either Adderall or Ritalin for about 20 years starting in my second year of University.
The two main side effects I had from Adderall were appetite suppression (which has the bonus side effect of intermitent fasting) and hyper focus. With hyper focus I could work like a machine for 14-16 hours, and would have to remind myself to stop and eat, but I couldn’t turn it off. When it came time to socialize I was still chewing away at my work. I was not present. To break myself from the work loop I would usually have to watch TV or go drinking with friends. The problem with the later is that you start to wake up with the dreads quite frequently, increasing your anxiety level. It also tires you out. I rarely (1-2/month) take Adderall now and when I do I take 5mg (down from 3x 20mg what I was originally prescribed for).
Ritalin was a different story. Where Adderall was smooth and almost unnoticeable Ritalin would give you a rush, with effects lasting about four hours. I could take Adderall for my most boating early morning class and sitting in the front row I was excited as seeing a talk by novel prize winners. The problem with Ritalin was the anxiety and crash at the end of the day.
Prescribing stimulants to people with ADHD seems artificial. In most cases the risks are low and unless there’s abuse or the potential for abuse I think people should have the right to decide for themeselves what they want to take and how they want to live.
That's how I feel about drugs in general, but I think society has this weird split of two extremes: any unprescribed, street drug is super dangerous and evil, and any prescribed drug is just just medicine correcting an "imbalance", and is totally benign and fine and good. Madness both ways.
You mention getting prescribed in college, as a adult. How would you feel if you had been prescribed as a kid?
To me, growing up regularly taking amphetamines seems like it could twist your head pretty badly. Seems very irresponsible to be giving drugs to kids.
(I get the pressure to do it if the kid can't behave or focus and you think that's fucking up their life, but honestly, having gone through school, the fault is much more likely to lie with the school & what we expect of kids than the kids themselves...)
I’d avoid perscription drugs for my kids if possible. For me, ADD was a kind of personality trait that affected how I looked at and reacted to the world. It had pros and cons. Adderall helped me deal with the cons when the time was right. I wouldnt try to take that away from my children. Also knowing what I know I could probably be a better parent to children with ADD.
I started taking Modafinil about 4-5 years ago and my only regret is that I didn't start earlier.
I live in Europe so you can forget about amphetamines/adderall basically, only thing you'll get here is Ritalin and even that not as easy as you might think. Modafinil is easy to get on the internet though. If I lived in the US, I would likely be on Adderall I'd guess.
It helped me so much that I wouldn't have completed studies and got my current job if I wasn't on it. I know, because I still remember the struggles I've had before (and over time learned that I am not alone, that many, many people suffer from ADHD-PI or ADHD-like symptoms and all think it's just them...).
Also, fuck everyone trying to tell people that "eat better, sleep more and do sports" will fix ADHD-PI. You should totally do all of these if you aren't already, but it's not fixing shit. Medication works.
I feel like comments like yours are one reason doctors don't like prescribing it.
I'm glad you are able to be happy on modafinil, but think about what you just commented: (1) alternatives are hard to get, (2) you have to get your substitution from the Internet without a prescription, (3) once you are on the gear you are able to notice the same deficiency in others, (4) you attribute your success to it and (5) "fuck everyone" trying to speak people into drug-free alternatives.
I haven't been to med school, but I can imagine this being a slide they would put into an example profile to stray people from prescribing Adderall et al.
The reason doctors don't like prescribing it is because it's not FDA-approved for ADHD. It's not FDA-approved for ADHD because of bureaucratic/economic reasons, AFAIK.
This is completely wrong. It treats the symptoms of those of us with severe ADHD, and let's us do everyday things like sit in a theater or an airplane, or enjoy playing quietly with our little children.
It's not just about being an office drone spending 12 hours a day in Excel or some cynical bullshit like that, it's about every day life.
I mean, I get that we are discussing ADHD here, but you could have at least read the next sentence:
> Adderall doesn’t “cure” the “disease” of ADHD, at least not in the same way penicillin cures syphilis. Adderall will give everyone better concentration, and we’ve judged that it’s okay for people with terrible concentration to use it to overcome their handicap, but not okay for people with already-fine concentration to use it to become superhuman.
I read it - the tone of the paragraph is that it's not really medication, but something like caffeine which you can give to everyone and it'll have the same effect. It doesn't work like that. The dose I take would make a non-ADHD person into an obsessive hyper-focused teeth-grinding mess, but it basically just makes me normal. Adderall is real medicine which cures a real problem.
> but something like caffeine which you can give to everyone and it'll have the same effect
Apparently, that is actually true (not the same magnitude of effect but the same kind of effect - better concentration). And it's not in any way contradictory to it also being a medication.
> The dose I take would make a non-ADHD person into an obsessive hyper-focused teeth-grinding mess, but it basically just makes me normal.
That is almost exactly what the quote above said.
> Adderall is real medicine which cures a real problem.
I honestly don't understand how you got the impression that the original article claimed otherwise.
But it does work like that, and drug tolerance is why you can eat a 30mg XR and be normal and I would be flying off anything more than 5-10mg IR.
Adderall has a lot of utility for regular people, it works exactly like caffeine. Eventually all that dopamine from the amphetamines is going to ruin all your receptors, hth.
"The dose I take would make a non-ADHD person into an obsessive hyper-focused teeth-grinding mess, but it basically just makes me normal. Adderall is real medicine which cures a real problem."
I believe you, but couldn't you equally say "The dose of human growth hormone I take would turn a non-Chronic-Shortness-Syndrome person into a freakish giant, but it basically just makes me normal"?
What he's saying is that Adderall boosts anyone's ability to concentrate. The dose you take boosts your concentration levels from "really low" to "normal." It would boost a non-ADHD person's concentration levels from "normal" to "way overfocused."
>I mean, I get that we are discussing ADHD here, but you could have at least read the next sentence
Being condescending, especially towards people with a disorder, doesn't serve anything.
Worse, people with disorders have to deal with this stuff all the time from other people. <To someone they know has depression, in front of the circle of friends> "Hey Peter, haven't seen you in a few weeks. Were you being sad again? ;D"
It makes me cringe a bit to see that behavior here.
I don't think you understand the argument being made.
Further down you say:
> the tone of the paragraph is that it's not really medication, but something like caffeine which you can give to everyone and it'll have the same effect. It doesn't work like that.
It does work like that. You can give it to everyone, and (assuming the recipient has a good response, no side effects, etc.) it'll have the same effect. That effect might be "worth" more to people who are already at the low end of the bell curve, but it's the same effect.
> It's not just about being an office drone spending 12 hours a day in Excel or some cynical bullshit like that, it's about every day life.
Spending many hours in a row at a desk working on tasks that require extreme focus is my every day life, and the life of most of the people on this site I'd wager.
Where are you going with this? You're replying to an article that said "it helps everyone", and you're trying to say that some people aren't as worthy of help? Is that really where you want to go with this?
Interesting stuff. I was diagnosed with ADHD 12 years ago (after undergoing testing because I suspected I might). I tried various medications and after several years found that Adderall XR worked best. Tolerance is real, though, and I’ve had to increase my dose over the years, but I take half doses some days and skip when I can, which subjectively seems to help.
The symptoms are definitely the sort of thing everyone can identify with to some extent. But I think the key detail in the definition of ADHD is that it’s a “disorder”. In other words, these symptoms are normally distributed but if the combination of them occurs often and causes distress to the patient and/or other people, then it’s real. Two people with exactly the same symptoms but different life situations or jobs such that one experiences distress and the other none should be diagnosed differently. Not everything can or should be reduced to objective ratings.
I’d also like to echo the observation that the restrictions and hurdles involved in getting an ADHD diagnosis and in acquiring stimulant medication for ADHD are seemingly designed to vex the ADHD sufferer far more than a neurotypical individual. I used to have to, once a month, call my doctors office to ask for a new prescription, then physically go there to pick it up, physically deliver it to the pharmacy, and then physically pick up the medication when it was available. Which isn’t always right away since Adderall is so commonly prescribed (and because my health insurance has an insane restriction that only covers the brand name—but that’s a different story). That’s three or four steps not required for the vast majority of medication that are each easy for an ADHD sufferer to forget, put off, or otherwise screw up. Laws have changed where I live recently so that I only have to deal with the doctors office once every three months but the physical delivery is still a requirement. Thankfully I live near the doctors office and have a flexible job. Most people aren’t so lucky.
So ironically it’s far easier for folks without ADHD to deal with getting Adderall than it is for those of us with the disorder. C’est la vie!
Edit: I also wanted to mention that I’ve found that I’m actually much more agreeable and less irritable when I’m on Adderall than not. My family has witnessed the difference and told me as much, and I feel it too. Whether that’s a direct effect of the stimulant or a secondary effect of the behavioral changes it engenders I don’t know but it’s worth noting that the potential personality changes aren’t all negative.
This is not necessarily related to the medication. ADD often represents as hyperfocus, to the detriment of the things you should be focusing on. https://en.m.wikipedia.org/wiki/Hyperfocus
I noticed this in college. My adderall-using friends and roommates would take a pill to study for a test, and sometimes that's exactly what they'd do. But sometimes they'd obsessively clean their room or get into a Wikipedia editing war or corner someone and talk their ear off about a pet topic.
Yes absolutely. Not a manager but I noticed this. I think there is also a state of mania involved. While not on these drugs you have a better sense of what is worth effort rather than this euphoric feeling of doing anything for the sake of it.
Adderall and the like are not magic pills that make the most important work/tasks get done first and effectively.
> There are occasional claims that magnesium or some other substance can help reverse Adderall tolerance.
I went to a particularly expensive Silicon Valley psychiatrist who did of course immediately put me on Adderall, but also put me on NAC supplements to "avoid tolerance". It's been okay, they're cheap, never bothered not taking them to experiment.
I can confirm feeling better after eating foods with magnesium, mostly because they're good for you.
BTW, if you're on amphetamine+guanfacine you need to avoid all of caffeine, sugar, and alcohol. What a bummer.
AFAIK the best evidence is for NMDA antagonists reversing tolerance. In fact magnesium is a a NMDA antagonist, but it a very weak one. I have read about people using memantine or something more potent to reverse tolerance, but I would be very wary about using potent NMDA antagonists regularly given what we know about them.
> Hmmm, never heard of adding NAC. And do you supplement magnesium too?
> Your talking about things I’ve never heard of before, this does sound advanced. Any other things on your stack?
The original article mentioned how society has determined it is "not okay for people with already-fine concentration to use it to become superhuman".
The way you talk about this, though. Being impressed about someone's "advanced stack" of drugs to maximize their potential. I get the impression you're using it to become superhuman.
I'm not sure if I am the only one with this reaction, but I feel like your attitude is kinda offensive and disgusting. How much money have you made by abusing drugs in our rat race?
> I feel like your attitude is kinda offensive and disgusting. How much money have you made by abusing drugs in our rat race?
Yeah, I am kinda disgusted myself, but I am right on the cusp, and I am grasping at it. That last sprint. I’ve locked in 99.5%-tile wealth, but the next month to six will determine if I can get into 99.9%-tile, where the true game change is.
And I’m under no illusion, if I don’t bag this deal here for the 99.9%-tile (private aviation, super yacht and models) I’ll forever be stuck at 99.5%-tile (first class commercial, upper middle class lifestyle forever without having to work).
Just a little more... broke my way many times... just need this last bit...
Guanfacine (Tenex/Intinuv) is just a prescription you can get for ADHD hyperactivity. It complements stimulants really well but is hard to live with - you feel sedated, have no alcohol tolerance, and ramping off it takes a week or two.
> Any other things on your stack?
Like nootropics? Popular internet topic but a little goes a long way. Here's what I know:
- Vitamin D 1k-5k IU, fish oil, theanine: These all work great and everyone should try them.
- Magnesium: Too many different supplement formulations to trust one, and I read they give you copper deficiency - just eat spinach and you're good. Actually zinc is better to supplement, especially for men.
- Nootropic stacks like Qualia: Tried some, but pretty sure they're expensive caffeine pills.
- Every other nootropic: Bacopa helps long-term but makes ADHD worse short-term(!). No effect from anything else.
I think in many cases the reason people can't maintain focus on programming is motivation, not incapacity. Sounds like bullshit when they say most lose focus after 30 minutes and check their phone. If you're really interested in something you focus on it. Yeah I struggle to focus writing CRUD apps for unsexy products. But I wrote a puzzler game in twenty nonstop hours. I know this is anecdotal but I've seen the same with friends A exercising, B playing videogames, C reading, D playing music.
This article confusingly talks about atomoxetine in several places, but atomoxetine is very different than Adderall, in particular, because it's not a stimulant.
The article itself doesn't, some of the quotes from relevant papers do. It seems likely that studies are often done comparing treatments, and at least one of the quotes has context supporting that idea.
No, it very clearly mixes anecdotes from the papers about atomoxetine with those of amphetamine variants. It also lumps in "adhd drug" risk studies (which include plenty of non-stimulants) into a discussion about adderall and it's variants.
Given the papers clearly state that some of these risks/issues are only appreciable for the amphetamine variants (and some only appreciable for the non-amphetamine drugs), this is, imho, a disservice.
What do you mean "no"? The article literally never mentions atomoxetine outside of quoted text. It mentions it twice in the contextual part of quotes from papers also dealing with amphetamine variants.
There is a single anecdote about atomoxetine. The quote has nothing to do with the drug's action. The point of the anecdote is the researchers' attitude toward the behaviour of young children, in the context of debating their approach to judging side-effects. That is certainly relevant context: the paper in question is also looking at side-effects for amphetamine variants. Strange approaches to behaviour classification likely apply across all the trials involved.
Your original comment was that this is confusing. I think it's very clear. I am not left with the impression that results for atomoxetine are being conflated with results for amphetamine variants.
He cited the infamous squirrel monkey study without noting that (a) there were no signs of neural death or neurite retraction anywhere, and (b) reduced baseline dopamine levels are exactly what you would expect as part of the mechanism of tolerance.
That study did not establish the existence of neurotoxicity. It merely established the existence of tolerance.
I wanted to share my experience with Adderall. I've been taking it for about 2 months now. Some backstory.
I was diagnosed with ADHD when I was about 12. I never had an issue focusing in school. I never had any challenges completing my school work and would always complete it before everyone else. I would then get bored and fidget. It got to the point where it was a distraction to others and was brought to my parents' attention. I was then diagnosed with ADHD. I was never given any formal treatment, instead placed in a Gifted program with more intensive work.
I have been running my own businesses and consulting pretty much since I graduated high school. I am now 25. Things were going pretty good, except for one thing, deadlines. I struggled actually focusing and completing work. It got to the point where I could be working in my office for 12 hours straight and not actually get anything done.
The other major part of it is how it affects my relationships, especially with my SO. We can be holding a conversation and I can completely zone out for minutes at a time and not have any clue what she said because I was in my own head thinking. It is stressful because it gives the impression that I don't care what she is saying, but in reality I have limited to no control over it. This is common from others I speak with who have ADHD.
I have tried every management system in the book. None of it helped. I eventually tried Modafinil (I see a few people mentioned it here). I ultimately stopped taking it because I didn't like how it made me feel (restlessness and appetite loss) and I didn't get immense boosts to concentration.
I eventually decided that I may want to try Adderall. My doctor was suggesting that I may want to try something for over a year, but I resisted. In my mind Adderall was prescription meth and would "rot my brain". I would be come addicted and it would ruin my life.
But things just kept getting worse. My business keeps growing, and so are my responsibilities and deadlines, but I was really struggling to keep up. Finally, I decided to open my mind to taking something like Adderall.
After discussing it with my Doctor he alleviated most of my concerns. Ritalin and subsequently Adderall have been prescribed for almost 70 years and he has been prescribing them for decades without seeing "brain rot", withdraw, or anything like that long-term. After more research and discussing it with colleagues I decided to take it. Here are my thoughts and observations 2 months in.
* It's not addictive. I take it 1-2x a day when working, and not on weekends. I skipped 5 days of doses over Christmas without feeling the need to take it.
* Tolerance. You will get a euphoric effect the first 1-2x you take it, then you don't anymore. You still get the concentration benefits and that doesn't wear off over time - according to my doctor. I don't feel the need to increase dosages.
* It has a propensity for abuse. Basically people taking it to stay up for days at a time to study for exams... I can see where people would have the urge to do so, though I do not.
* It helps me concentrate. While it's not a magic solution to all of my problems, it makes it easier for me to be able to work and continue working for a long period of time. My productivity the past to months have been more than I ever have in the past 5 years.
* It lowers your appetite. I feel like I perpetually ate 30 minutes ago. I need to consciously decide to eat, which I do.
* It gives me dry mouth. This is annoying, no matter how much I drink.
* It can affect sleep. To counteract this I take mine when I first wake up, then at 12pm I take either a full dose, half dose, or nothing depending on my day.
TLDR: It has helped me improve the quality of my life with no real negative effects. If Adderall continues to do so, I will continue to take it.
I used Ritalin as a crutch after radiation. It helped. Sometimes quite a bit. Recovery time span was 6 months. Now the Ritalin helps less, meaning I barely feel it's effects; so now I'm taking one or two pills weekly.
I'd love to have some effective nootropics for improved focus, cognition. Mostly to mitigate aging, grogginess from the chemo, and so forth.
It seems to me like the biggest problem, if I'm to accept that Adderall is as frequently abused as described here, is the same one you have in sports with PEDs: if a bunch of people are on Adderall and establish the "baseline" level of attention you're supposed to have, then "just" being diligent gets you left in the dust.
The article doesn't really describe it being "abused," just perhaps too "easy" of an option for some who really could "just try harder". (By "easy" I mean prescribed or requested with the "sure why not" attitude without reviewing the side-effects which the author lays out pretty plainly.)
I don't find the sports analogy very compelling. We watch sports for the competition and the idea that the results are a combination of genetics+work. Hence taking PEDs is cheating in a sports context.
But if there's a medication that helps you live your life better (i.e. in a way that's more fulfilling to you) and if taking the medication doesn't impact anyone else negatively, why would you not want it taken as widely as possible?
The important thing is to let would-be medication-takers know with full honesty what the side-effects are - this is what the article focuses on most.
The article talks about people's careers being stymied, or people losing promotions to, colleagues whose attention span is longer because they're abusing Adderall. That's the intro.
> The human brain wasn’t built for accounting or software engineering. A few lucky people can do these things ten hours a day, every day, with a smile. The rest of us start fidgeting and checking our cell phone somewhere around the thirty minute mark. I work near the financial district of a big city, so every day a new Senior Regional Manipulator Of Tiny Numbers comes in and tells me that his brain must be broken because he can’t sit still and manipulate tiny numbers as much as he wants. How come this is so hard for him, when all of his colleagues can work so diligently?
> (it’s because his colleagues are all on Adderall already – but telling him that will just make things worse)
> He goes on to give me his story about how he’s at risk of getting fired from his Senior Regional Manipulator Of Tiny Numbers position, and at this rate he’s never going to get the promotion to Vice President Of Staring At Giant Spreadsheets, so do I think I can give him some Adderall to help him through?
Sports is a zero-sum game. Productive labor is not. The mathematician Paul Erdos used amphetamines to make many major breakthroughs. This was a great benefit for society, regardless of whether he perhaps took a professorship that some less productive mathematician would otherwise have obtained.
While many industries have an element of zero-sum competition, that's not the default. Whether you're designing a car, doing a surgery, giving a haircut, cooking a hamburger, etc. you are giving something of value to your customers.
You’re describing retail jobs, where that might be true. But most white-collar workers never interact directly with customers. They have to demonstrate value to their boss, which does make it a zero-sum situation.
I don't think any of the jobs I listed are retail. I went out of my way to include a variety of industries, including knowledge work. "Demonstrating value to your boss" could include zero-sum bullshit or actual production. As a programmer, I've done both kinds of work.
Even assuming (optimistically) that an exceptionally good hair stylist could somehow... uh, I don't know, be so good that they can hire more stylists? Assuming there's space?... it's pretty rare to have, say, multiple heads of the same department.
You could cut more people's hair by getting it done faster, or do a better job cutting each person's hair. The point is that jobs where productivity improvement is possible are very common. Economically, productivity and technology are equivalent, and are the basis for prosperity. Productivity is not, in general, zero-sum.
The post uses accounting, which, well, maybe it's a different story if we're talking about complicated tax schemes that can save a lot of money, but in general I think we can say that if the workers are more productive fewer rather than more are needed.
It seems to me like this claim contradicts your previous assertion that there's "no zero-sum game." The zero-sum game is, they only need so many workers, and if all your coworkers are achieving levels of productivity only possible with chemical enhancement, then you get left behind.
This is no different than saying that the street sweepers were left behind by street sweeping machines. Or that accountants got left behind by the invention of accounting software. This is what technology is all about. It's not zero-sum, because there's other work in the world waiting to be done to make people's lives better.
You may have have a bad work environment where you feel like the only goal of your work is to one-up your co-workers. But your boss is not paying you and your co-workers to compete for sport. The reason you are getting a paycheck is because you are giving someone something they value. That person would be happier if they could get it for less money by putting you out of the job. But if that happens, that doesn't mean you should be unemployed - it means you could be helping society in a different way. In a well-functioning labor market, every worker will be more prosperous if they all produce more.
Maybe ideally on some macro level that's how it works out. In the meantime, on the micro level, many people are in competition with their coworkers and it seems kind of blind to the realities of the workplace to pretend otherwise. Everybody here has heard of stack ranking, right?
Promotions, and the salary/opportunity increases that come with them, absolutely are a zero-sum game. I’m a little baffled that anyone could think otherwise, actually.
Curious if anyone is using weed flowers or extracts to treat these any related issues? Some strains are known to help focus the mind.
I found using some strains help the ability to switch to a new task and focus for a longer period of time. The problem is the next hour after the body needs additional rest.
I'm fairly severely ADHD, and Adderall does not work for me. As in I was getting psychedelic effects before reaching a therapeutic dose. Ritalin is better, and Focalin better still (same effect as ritalin, lower side effects).
It's surprising how the different medications can affect people with seemingly similar symptoms.
Ritalin (and Vyvanse) makes me feel angry and crazy. I've not heard of Focalin, but I may look into it. I've been on varying doses of Adderall for 10+ years and I find it immensely helpful.
I was treated both as a child and as an adult. After I quit my adult medication I was a wreck, and ended up going to therapy. It wasn't specifically to address ADHD, but just me in general. I took a break from work, began eating well, sleeping well, and exercising, and I feel like I've gotten a lot better at focusing. My diet became more or less low-carb, and I did strength training. Could those be it? I don't know, but I feel a lot better and am more professionally accomplished than I ever was. There's my anecdote.
I was diagnosed with moderate ADHD, inattentive type, as a teenager and prescribed adderall. I was also quite depressed, but I hid that from my psychiatrist.
The adderall certainly helped me to focus, but the side effects were awful and I stopped taking it regularly. I’ve since been diagnosed with depression and started on sertraline (an SSRI), and very soon after noticed an improvement to my attention, ambition, and ability to complete tasks.
It’s not surprising, I guess, but near-constant thoughts of worthlessness/desire to die can make it quite difficult to focus on tasks and generally function.
QBC (quercitin/bromelain/vitamin c) seems to have a very good effect on my attention span, ability to concentrate, anxiety levels, etc. However it does not go well with coffee, I get a "speedy" feeling I don't like. So unfortunately I don't take this supplement as much as I would like, because I love coffee so much.
Other nutritional remedies can be found in "Prescription for Nutritional Healing" by Balch.
(Disclaimer: I've studied pharmacokinetics, though I'm not a pharmacologist)
Vyvanse is a prodrug. That means it metabolizes into the d-enantiomer of amphetamine, whereas Adderall contains a 75-25 mixture of the d- and l-enantiomers. (Enantiomers are like left- and right-handed gloves: they have the same chemical structure, but one is the mirror image of the other. Usually two enantiomers will have similar but slightly different effects; occasionally, they can have incredibly different effects - see thalidomide for an example).
So, without further study, it's hard to know, but it's likely that Vyvanse has a similar long-term profile to Adderall, because the active ingredient (lisdexamfetamine) metabolizes into the active ingredient that makes up about 75% of Adderall.
But, it's possible that the effects described are caused by the l-enantiomer, in which case they won't apply to Vyvanse. It's also possible that lisdexamfetamine itself has its own set of effects which may either cancel out or exacerbate the effects reported by Adderall.
To give you an idea of how prodrugs can have different effects from the drug that they metabolize into: Vyvanse does have a rather nasty feedback loop for some people, because amphetamines suppress the appetite, but lisdexamfetamine is metabolized into the active ingredient using the digestive cycle[0]. For some people, this can cause a really wonky extended release cycle, where they have no appetite mid-day (due to the drug) and can't eat enough to metabolize enough dextroamphetamine to get them through the afternoon, resulting in an afternoon crash. After this wears off and they develop an appetite again (around dinnertime), they'll eat, and then the dosage that was supposed to kick in after lunch finally kicks in after dinner, causing issues sleeping.
[0] This is intentional, and it's why Vyvanse is marketed as an "abuse-resistant" alternative to Adderall, because it's theoretically harder to extract an acute dosage from it.
I think another important consideration might be that peak plasma concentrations on Vyvanse would be lower than on Adderall (because it's more spread out over time). Some effects only happen at certain plasma concentrations.
> I think another important consideration might be that peak plasma concentrations on Vyvanse would be lower than on Adderall (because it's more spread out over time).
Vyvanse is intended to be equivalent to Adderall XR, not IR, so the effects are intended to be spread out in both. If you're comparing to IR, you're no longer really comparing apples to apples anyway.
I take straight amphetamines, much easier to manage dosing than with Adderal.
Been doing to off and on for a decade. Never had any addiction issues, no withdrawal sypmptoms when I skip taking them, and still seems as an effective as usual when i do.
I avoid the whole psychiatrist scam and get them from a real doctor.
Author does a decent job of going through some things, but this statement did not sit well with me.
>I don’t think there are good data here, but my intuitions and personal experience is that “addiction” of the sort you get with heroin or tobacco is very rare, at least when responsible people without a personal or family history of addictive behavior take stimulants as prescribed. Most people agree the risk is lower for extended-release stimulants (eg Adderall XR), and very low for Vyvanse.
I think that statement is bonkers.
Of course they are going to be addicted to the substance if they use it everyday of their lives.
My definition of addiction is not being able to stop taking the drug for whatever reason, and feeling some sort of withdrawal. I think for most people that take something daily, it would be extremely hard for them to stop.
This is where things get messed up: being chemically addicted to something where the cost of the drug can be astronomical .Yes, I am talking about Shire's Vyvanse.
>Shire Plc is a Jersey-registered, Irish-headquartered global specialty biopharmaceutical company... its brands and products include Vyvanse, Lialda, and Adderall XR.
The best is that they offer a program the temporarily reduces the price of the drug for a period of time aka you get addicted to it over that time period and then are forced to pay it becuase their is nothing like it until 2023.
Yes, I am aware that each state has different insurance options, but starting a company called "Shire Cares" just to spread the belief that they care but really do not is silly.
What they do not tell you is after that period ends, the price goes up drastically. With insurance, 30 pills costs "around $286.42 (https://www.goodrx.com/vyvanse)
The last thing I will say is: Where is the data on a drug that annually generates billions of dollars each year? They have 10 million users. You are telling me they could not monitor the habits of 1-2k people over a couple years? Sounds fishy to me.
I have taken Adderalls twice in my life for longer periods of time, and both times it was no problem to stop. I stop taking it cold turkey, I feel a bit shitty for a week, and then its fine. If anything, it feels less addictive then caffine, which has worse physiological symptoms.
I've taken 20mg Adderall XR or 50mg Vyvanse for over a decade and have no issues quitting it which I regularly have to do when I run out while living abroad. Agreed - much easier to skip than caffeine.
That said, when I meet other people taking these meds, their doctor frequently has started them out on heroic doses. Like 80mg XR + 2x IR tablets a day to bump. Absolutely insane. And I reckon those people have a harder time quitting, especially psychological. The difference between an unmedicated and medicated day is just so extreme.
I've certainly met many people in uni who just can't control themselves with stimulants and quickly find themselves spiraling down the toilet bowl, and those are people I always worry about. Like the person who can't just take one, instead eating them over a 3-day spurt of zero sleep.
If you have good insurance (so most people here that work full-time jobs in tech), then you should be paying almost nothing for Vyvanse.
If you don't have insurance, then contact Shire's affordance help or use one of those prescription assistance companies that handles it for you. I don't have insurance and I pay $35/mo to a company that got Shire to give me a free voucher for my 3-month prescription.
Just wanted to point that out to others.
Also, it's ridiculous that things like GoodRX and 3rd party assistance programs are viable business models.
I'll offer an alternate voice here - I take Vyvanse, and went without insurance for a few months two years ago. I tried Adderall and Ritalin, and neither had comparable impact. I ended up spend ~$300 / 30 on Vyvanse and honestly thankful that it was available at that price each time.
With insurance, my prescription is $50 / 30. I typically don't take it on weekends in order to limit tolerance, which further reduces the ongoing costs.
Adderall is amphetamine salts. It's f*king SPEED. Laboratory-grade SPEED. (yea, yea methamphetmine is delivered in higher concentrations when being abused, but I don't care Adderall is still goddamn SPEED -- and people give this shit to their kids!) It's not that far off from "meth minus the battery acid." Why on Earth anyone would want to give that shit to their own kids is beyond me, especially since it's often offered as a remedy to one of the MOST over- and mis-diagnosed conditions there is.
In addition to lower doses like you said, effects of stimulates like amphetamines are completely different if taken orally than if they are sniffed or injected.
ADHD is one of the most well researched mental conditions. It is real and will cause significant impairment if untreated. Stimulants are the most effective medication in many but not all cases. Comments like that are harmful.
However, I agree with you that an ADHD diagnosis should not be given lightly.
I wasn't implying ADHD wasn't real. It very much is real, but unfortunately it seems to have become a sort of "catch-all" diagnosis. It's now more of a common label than it is a medical diagnosis. Isn't it equally as dangerous to not treat the underlying issues or root causes? And when the common 'treatment' for a hyper-active disorder diagnosis is a prescription for Adderall/Vivanse (again, this is speed with a fancy brand name. call it what it is) it's incredibly dangerous -- these are KIDS we're talking about, there's no way we've had enough time to tell what giving this shit to a brain that's still under development actually does in the long term. Then there's the very real potential for abuse -- we're already in an opioid epidemic in the USA do we really need a bunch of tweaked out kids running around?
Don't know about other countries but in S. Africa it also exists. We don't have Adderall as far as I'm aware but I know of people who use Ritalin and say it has improved their daily lives.
If anyone here reading this needs the motivation or gentle reminder: you might not need Adderall anymore.
I've used it to get ahead in software for the past ~8 years. I recently gave it up, but it was hard to realize that it was time. It might be time for you, too.
The thing holding me back was fear. Fear I wasn't enough, that I couldn't be efficient. That I would get fired from my high position. Or even if I could make it work, that I still wouldn't get enough done on my startup (which has its own list of fears itself).
What finally pushed me to quit was realizing I wasn't as compassionate anymore; it was impacting my relationships. I had three separate people tell me in my coworking space that I look too busy and unapproachable so they never came to chat. I had a SO tell me that I'm emotionally unavailable too often. All within the time span of a month. I'm naturally an optimistic, compassionate person. This wasn't me, and being a robot (as mentioned in the article!) wasn't who I wanted to be, at any cost.
Indeed, three days after I quit I felt like a new person. I felt silly, fun, again. I had a week of "brain fog" where I wasn't productive. Afterward my efficiency went back up. Nowhere near the Adderall levels, but to a very acceptable level.
So in summary, you might not need it anymore if it's causing you grief. Sorry for the lame motivational things I'm about to say (Taken from the book, Daring Greatly):
You are enough.
You are worthy.
I really relate with this. It took extraordinary measures for me to get where I can work efficiently without Adderall. Adderall turned me into such a different person that my wife started to be scared of me. Just interrupting me from work was a landmine, I was so mean. The doctor just said “be nicer” when I asked him about Adderall and anger issues. I’m a fun and easygoing person and it was like that part of me would get snuffed out and I’d become a robot on Adderall. I feel like it let me become a programmer. I locked myself in a home office for three months 10 hours a day learning to program, working on a demo project, and got my first professional position. The Adderall definitely enabled this singlemindedness.
To reorient myself in a way that I can concentrate on work without Adderall, I sold my TV, my VR, and my $700 graphics card. I unsubscribed from Netflix, deleted Facebook, and got rid of Twitter. I don’t listen to music as background noise, or in the car. I’ve gone on a ketogenic diet with no MSG (so no cheap meats like sausages). I try to sit without looking at my phone when I’m waiting for five or ten minutes somewhere. The whole idea was to “reset” my brain to a lower level of overall stimuli, and largely it has worked. I feel better and can work harder than I did on Adderall, because I can work in the evenings without having a total breakdown, because taking Adderall after 5pm was always a disaster, I wouldn’t be able to sleep and I’d have really weird thoughts as I went to sleep.
I’m really glad I did all this as it made me realize what’s really important in my life, family and to a smaller extent friends, and the time with them is much more meaningful now. I can actually concentrate on what someone is saying to me. Maybe moreso, I actually care.
That's great (the lower stimuli regimen.) I envy your ability to discipline yourself for greater accomplishments in your future. Good luck friend!
Have you considered other medication such as Atomoxetine?
I started taking Adderall recently and so far, I've had the inverse experience socially. It's made it much easier for me to meaningfully engage with people. By gaining control over my focus, I can now overlook "the little things", and I'm no longer compelled to "chase dopamine".
I'll be honest, but I find it very hard to believe that amphetamines can really enhance your cognitive skills. I'm talking from second-hand experience only, but it's pretty clear to me that they can have the effect of making you feel like you're smarter, faster, leaner, better- but this feeling is just a side effect of taking the drug, and does not reflect a real improvement.
I can believe that the drugs can help some people get over some psychological hurdles that are keeping them from delivering a piece of work, but I'm really not sure why the work itself would end up any better than if it was done while sober. Given that a big effect of apmhetamines is to make you stay up all night, for weeks on end, in other words causing sleep deprivation, I find it very likely that the end result is in fact much worse than the baseline.
Personally, the only magic drug that I've found really helps me do better and more is getting enough sleep and doing so regularly, for many weeks. Even if it means having fewer waking hours for work during the day, it doesn't matter, because I can pull twice the work (and twice the quality of it) when I'm well-rested than I do when I'm tired and haven't been sleeping well.
So, taking a drug that completely screws your sleep patterns and just makes you forget how tired you are, sounds like a recipe for destroying the quality of your work, to me. And I think those studies the article quotes, the ones that haven't found any cognitive enhancement from Aderall (to healthy individuals and ADHD sufferers alike) are basically justifying my hunch.
They definitely increase energy levels. A person can stay up for days on them. They are an unwise and partial substitute for sleep but a substitute nonetheless. Like you mention, a large part of what they do is change intrinsic motivation, not intelligence. When you feel "charged" with energy, it is hard to oppose doing intellectual work. Amphetamines are pure energy. And intellect loves pure energy...so does physical work. But its not for free. Amphetamines decrease circulation..they caused Peyronies Disease for me..and I used to take them all the time in college with no issues. Age always brings the true nature of bad habits to bear.
I agree with you. If anything I believe the amount of people these drugs assist is actually a tiny fraction.
I really hope people don’t read these posts and think oh man I gotta get aderall because everybody is on it. (For people that don’t actually have some serious issue studying.) if you managed to get into a good college without using aderall something tells me you already have the ability to focus very well. I also think this type of post will bring out a large fraction of the small amount of people doing it and make it look substantial.. I for one agree that substantial regular sleep and finding a job that you like, and holding yourself accountable to achieving the goals you set for yourself are far more powerful than temporarily pounding out 1000 lines of code. I have met tons of people over the years who would finish homework before others and half of the time they would be bored and not sure what to do with themselves and end up sort of always confused about what they want to do with themselves and not very passionate vs. the people studying away in the lab frustrated that they don’t “get it” end up finding a love for the material fairly often when they suddenly start “getting it”.. it’s not to say that one day there won’t be a “make you smarter” drug, but I doubt strongly that a stimulant like aderall is it.. more likely it’s equivalent to drinking a small amount of coffee every 15 mins over the period of a long work day. In my case I don’t take anything like aderall and have achieved plenty and been able to work very long and intense hours through a variety of techniques I use. For example, don’t drink all of your coffee right away in the morning, drink it more slowly. When you are on a roll don’t go to lunch or grab coffee with your work mate, just keep trucking. Visualize the feeling you will have when you finish the thing you are trying to get done at the end of the day and stay focused on that when you start to get distracted. Get up and walk around for 60 seconds to get some blood pumping. Kneel down on your knees instead of sitting for say 5 mins. When you get interrupted by a co worker come up with a nice way of saying that you are in the middle of something. Change locations if you are losing interest and focus in what you are working on. Listen to some music without words to help get you into a zone. Come up with a story to tell yourself about why your thing you are working on is important. Think about what food or reward you will give yourself when you get something done that you think is a good checkpoint. Basically my point is that if you come up a set of methods that help you become successful rather than relying upon a drug then you can essentially persuade your brain to keep investing time and energy into your goal and is more resilient long term. It requires you to build up these skills to train yourself to be able to do these techniques, — no silver bullet.
I've spent years trying to get off adderall, swinging between having serious addictions with it (even pouring bottles down toilets), quitting it for months, and then eventually coming back to it as work/stress accumulates.
A few years ago I quite adderall/dexedrine at a startup, it lowered my productivity as I rushed with caffeine and other things to fill the void, and within a month I was fired as I had become useless.
Adderall changed my personality well before I discovered coding. I discovered coding because it suited my adderall addiction, not the other way around. In fact, almost as a maladaptive trait, I changed my whole career path towards coding away from politics precisely because I realized how well suited this new line of work would be for my addiction: Only in coding could I continue with my dysfunctional adderall-addicted personality, get paid well for it, and paradoxically be seen as a functioning member of society.
-------
But now I'm stuck. I want to quit adderall but I know I can't do it without at least a month of not working.
Every vacation comes around, and I promise myself I'll make another attempt at quitting but back out, but fear prevents me from doing it.
The longest I ever quit successfully was for a few months while traveling around the world. I experienced the best romance I've ever had in my life, because without my personality being blunted by the effects of adderall, I could be my charming emotional self again.
That all faded when the trip ended, when I needed to become productive again and faced the disaster of not being able to perform.
And that, my friends, is what makes Adderall addiction so uniquely fucked up.
Unlike heroin, alcohol, or benzodiazepines, our economy currently rewards and even encourages us to continue our addiction to this drug.
I felt the same way about cigarettes (and then sugar) for awhile. They helped me focus and think about hard problems (or so I thought). Anyways, not as good example as Adderall, whose effects are probably more effective than what I imagined.
Have you considered taking a personal leave to kick your habit? I mean, don’t take a vacation, but take a leave from your job and then quit the drug while instead working on personal projects and trying to remain productive. You will slump at first, but if you like what you are working on, you’ll probably pick up again after a few weeks.
I know not everyone can afford to do that, but it’s the best solution I could think of. Good luck!
You sure you're not me? I got into coding seriously in college after I started to take adderall to help study, and ended up making a career of it. I was absolutely terrified of quitting, because I felt like I couldn't do the one thing I was good at without it. I tried quitting and lost jobs over it, several times. It got to a point where I couldn't function as a human without it - I'd just sit in bed and feel sorry for myself. My addiction progressed to needing more than I could convince any doctor to prescribe, so I started getting more in various illegal ways.
I've been off the stuff for about 4 years, and I don't miss it at all. I'm actually a much better programmer without it - I don't get sucked into unimportant details, I have a more realistic sense of what I can and can't accomplish, and I'm more creative. More to the point, I have a life outside of a little bottle of pills now.
I got off of it after talking to some people who'd also gotten off - this helped alleviate my fears that I would have to give up my sweet programming career, and re-framed the problem as a matter of underused and atrophied motivation and willpower. It wasn't easy, but with a lot of love and support I managed to quit for good.
Hit me up if you want to talk - jonathan dot j dot mason, gmail.
Very good points. I do notice while on it, that it's extremely easy to get sucked down into rabbit holes, losing sense of time and of what's important.
I've also run into the same problem you described, of running out of adderall due to more and more tolerance. In desperation it even led me once to get some darknet speed pills off the internet, containing what I later found out to be meth... all due to a lack of available prescription alternatives. (I quickly learned methamphetamine is a completely different animal -- far more addictive, dangerously euphoric, and seriously neurotoxic. I learned to never do that again.).
I'm now experiencing my first health wake up call, which I'm convinced is linked to adderall use: just in the last few months, while using my iPhone I started to notice a very slight shaking in my fingers. Turns out: I have a family history of essential tremors and Parkinsons (caused by accumulated damage to dopamine receptors)... with ALS as a possible risk factor. That's right: A L fucking S.
And I'm only in my late 20's.
Terrifying. The illusion of my own invincibility has been shattered. For the first time in my life, it's abundantly clear that my problem with adderall is no longer just psychological: it's physical. That if I don't make changes soon... things could start going downhill for me -- fast.
I may take you up on that offer when I can muster up the courage. Thank you.
> I may take you up on that offer when I can muster up the courage. Thank you.
Please do - it's always a pleasure to help someone out of a bad situation that I've been in. And remember, fear is a prison without walls - you just have to make a decision to walk through that fear, and you're free.
"We could still have a principled definition of ADHD. It would be something like “People below the 5th percentile in ability to concentrate, as measured by this test.” Instead, we use the DSM, which advises us to diagnose people with ADHD if they say they have at least five symptoms from a list. "
I'm in Germany and I've been diagnosed with ADHD-PI lately (I am in my 30s) after seeing a private specialist about this topic. In addition to that DSM test and 3 other questionnaires, they ran a computer test measuring my ability to concentrate which was repeated after a couple of weeks on medication. The test results were very conclusive and I think that is the strongest diagnosis criteria that I have as it's actually measurable.
It was actually really hard for me to find a doctor to actually diagnose me. I called several doctors and it was either "we're not taking any more patients because diagnosis takes too long" or "we can't tell you if we can diagnose it, you can't make an appointment here, so come in but you might have to wait half a day". Not to mention that by the time you get to your doctor, un-medicated, you will forget to tell about half of your symptoms.
That seems like an odd test. Of course everybody will score better on a concentration test while on medication for concentration.
They want to measure the benefits of medication.
That’s missing the point. ADHD meds make everybody concentrate better, regardless of whether the person actually has ADHD.
And even that would give them a measure of the benefits. If it’s the same benefit that actual ADHD receives then it’s still a useful metric. If it’s less than the benefit when used for actual cases then, in aggregate, the benefits would be a low bar. Arguably that’s a better bias as it would make the benefits/costs decision more conservative. They’re taking the difference in measurements for each individual.
I think his point was that the test saturates at a normal person's level of concentration. So medicating normal people does not improve their score.
For ceteris paribus you need data on all variables for all observations. The more variety the better, too.
Maybe everyone will score better, although I don't believe so because the tests are trivial for people without ADHD.
In any case they certainly won't have anything like the kind of improvements people with ADHD has, improving from spectacularly bad to (usually) only slightly below normal.
It's a common mistake made by both professionals and laypeople that ADHD is a condition with only slight deficiencies in focus, when in reality they are often staggering.
Anecdotally, everyone with ADHD I've met understand the concept of things being so boring it becomes physically painful to do them. Everyone else think they heard me wrong.
For me the computerised test was almost impossible at the end, because my bored brain refused to even see the images on the screen. All I saw unless I blinked and tilted my head was a white, blank screen, only that it wasn't blank.
With methyl phenidate it was hard to understand it could have ever been hard, and that even though I still have significantly below average concentration even with medication.
I’ve long held the belief that ADHD is wildly over diagnosed (in the US, at least).
Your anecdote has helped solidify this belief. 8/10 Adderall users I know are able to concentrate and complete complex, intricate tasks without the pills. The pills just put them in jet-speed mode.
It sounds like you truly have ADHD and are benefitting from proper medication. I wish nothing but the best for you.
However, I also wish the doctors would remove their heads from their ass and attempt to find a better method of diagnosis.
During my friend’s 3rd year of study at University, he realized many of his classmates were taking Adderall. Not only that, but those students had less trouble completing the crushing work load on time. So, he visited the local pill dispensing psychiatrist and walked out with his very own prescription.
Now we’re here, several years later, and he’s convinced that he really does have ADHD because the doctor keeps renewing his prescription. He chooses to forget that he initially got the prescription by regurgitating bullet points out of the DSM.
This is just one example. I’ve seen it countless times.
Is it really just me that thinks having oodles of young adults taking amphetamines daily is OK? I just can’t seem to wrap my head around it.
Competition, till nothing is left of us. Makes me grateful every day, that brain implants are not yet here. Every day before that is a present, else we would have our heads chopped up on the altar of progress to become twitching, spasming prosthetic gods for the common good, until there was nothing left to ask why we did this to ourselves in the first place.
It depends on where you set the bar. If you make it easy for 80% of the population to ace it, then the only people who will fail are the ones with serious deficiencies.
They compared the error rates of working+short time memory to values that non-adhd people score. My score was significantly lower than average at my first test and on my second test above average on medication.
As I understand it ADHA is one of those spectrum conditions like Dyslexia so a single diagnostic test may not be enough.
For example I have a stellar reading ability but my written work and spelling is awful.
I've often wondered if Dyslexia and attention deficit disorders are connected and/or occur together. I was diagnosed with Dyslexia when I was quite young but it was before the greater awareness of AD-disorders. I've not tried Adderall but have tried Modafinil which worked as advertised.
Someone I know was diagnosed with both as well. You might be on to something there.
Me too as I am not the best at short term memory etc I once ended up on a train to Wembley when I was supposed to be in Wimbeldon :-)
>Not to mention that by the time you get to your doctor, un-medicated, you will forget to tell about half of your symptoms.
This is actually a major problem. I was diagnosed with ADD as a child but gave up the medication in my late teens because it had side-effects I didn't enjoy.
Late last year, I thought it might be worth trying it again, maybe with a milder dose. I booked an appointment with a doctor, who referred me to a psychiatrist. The psychiatrist told me there was a two week waiting period and that they'd call me back in a few weeks, and never did. It was two months before I remembered to follow it up.
I don't bore you with the rest of the details, but the short version is every medical professional I spoke to (and I spoke to about 5 during this saga) told me to wait and that they would organize something for me, and then didn't. Turns out if you lie to someone with ADD and leave the organization ball in their court like that, they'll never get treatment, because they struggle with the very thing you're asking them to do. It's pretty much the worst thing you can do for them.
Anyway, I've just realized I was planning to talk to the doctor about it again 4 months ago to try to get the ball rolling again. It's Christmas now, they won't be back at work until mid January. I'd better send myself an email, wish me luck.
A better system of tracking tasks is useful for everyone, not just ADHD. Try setting a calendar entry for a date on which you'll follow up if you haven't heard anything back, and use something like Google Keep (key point is it has a mobile app and webpage) to organize to-do lists.
>Try setting a calendar entry for a date on which you'll follow up if you haven't heard anything back
Thanks for the advice, but surprisingly I have actually tried just not having ADD. This simple advice doesn't work very well for me, which is why I'm attempting to pursue medication again. The calendar entry goes off, I try to contact the doctor, maybe they're not in today, it's half way through the work day, I go to set another, I spot an email while I'm doing it and start following up on that, and then 4 months later it never happened.
The point of a to-do list (or reminder in Google Calendar) is that it's constantly staring at you until you actually complete it. It sounds like you're using one-off calendar entries.
I'm not suggesting that "try not having ADD", just suggesting you use mechanisms to remind you to do stuff that are persistent and thus work.
> The point of a to-do list (or reminder in Google Calendar) is that it's constantly staring at you until you actually complete it. It sounds like you're using one-off calendar entries. I'm not suggesting that "try not having ADD", just suggesting you use mechanisms to remind you to do stuff that are persistent and thus work.
No offense, but from what you're saying, it's pretty clear you don't understand how ADHD works. ADHD is a disorder that affects executive function; the whole problem is that the system you're describing will fail for someone with even moderate but untreated ADHD, let alone more severe cases.
Maybe you don't mean it this way, but it's actually rather insulting to say that these mechanisms "are persistent and thus work", or that OP try a to-do list because "it's constantly staring at you until you actually complete it". ADHD means that you can't assume that those systems work, and it means that "constantly starting at you until you complete it" isn't actually a viable solution.
Hence, that's why OP read your post as "try not having ADD", because you're literally suggesting solutions that presume that they not have ADHD in the first place.
How does a persistent in-your-face reminder that does not go away until completed fail? I suppose severe procrastination or complete lack of willpower would do it, but are these not different from ADHD?
No, those are often core problems in ADHD. This is (much of) what it means to have poor executive function.
CydeWeys - thanks for your persistent posts... they are a wonderful example of how someone without the condition cannot fathom what is going on "inside" and thinks they can be fixed with a system or willpower. These things help to a point but there is an underlying problem that can't be fixed this way.
Easy, just close the browser tab and never use calendar or keep ever again.
Rational? Far from it. Functional? Nope.
That's why it's a disease but we have medication to treat it.
It's like trying to tell someone that walking is easy, just put one foot in front of the other - to someone with no legs. Unfortunately it's harder to see missing legs for mental diseases.
Its in your face.
For people with ADHD, its a distraction that's willfully ignored while you're trying to complete one of the other hundred things on your to-do list that are also screaming for attention, most of them in more-urgent-but-less-important ways that this attempt to schedule an appointment with yet another provider who's likely going to make you prove once again that your life is falling apart by jumping through your life story and maybe trying some alternative that makes you ill, cranky, and introduces some sexual dysfunction that gives you one more thing to worry about alongside the thoughts of whatdoigetdonethisweekpleasejustletmecrossoffonethingtoday that you wake up to each morning.
> severe procrastination or complete lack of willpower
This sounds an awful lot like the attribution of a moral failing to people that suffer from an issue with executive function as it pertains to attention. This might be why people keep telling you that you are clearly articulating an inability to empathize. Imagine a mindset in which your fundamental assumptions, which seem self-evident to you, do not apply. If it seems difficult to understand why anybody would want to live that way, congratulations, you've got something in common! Nobody else wants to live that way either—the difference is that we don't have much of a choice, which is why we all have such strong opinions about this topic.
>> Hence, that's why OP read your post as "try not having ADD", because you're literally suggesting solutions that presume that they not have ADHD in the first place.
To be fair, the article does make the point pretty strongly that it is very hard to separate ADHD from natural variations of attention, concentration etc:
Also, if attention etc is a "normally distributed trait", any behavioural intervention that can help someone near the middle of the distribution has a pretty good chance of helping someone near the extremes, also. To take the example of height again, just because someone is short doesn't mean they won't look taller with high heels.
In fact, if you think about it, such interventions are designed exactly to help people with poor executive function, as you say. Assuming that this is basically a description of what ADHD is, I don't see why behavioural interventions can't make a dent in it.
>To take the example of height again, just because someone is short doesn't mean they won't look taller with high heels.
https://www.youtube.com/watch?v=lbMv0UkAswI&feature=youtu.be...
That's a funny video, but what am I expected to get from it?
I am also from Germany, but moved to the US for work. I am 29. Recently someone suggested to me I might have ADHD. After learning more about it, I had a feeling that many adults with ADHD have: I suddenly felt like my life story made sense.
People below the 5th percentile in ability to concentrate, as measured by this test.
My health insurance made me take a CPT test and it indicated that I don't have ADHD. This means that they refuse to diagnose me despite that I have ALL of the inattentive symptoms. I did a lot of research on ADHD after that. Those tests have a 40-50% false negative rate. Luckily I am changing insurance next year. I already made an appointment with another doctor who is an expert in adult ADHD.
I don't know false positive rates off-hand, but they are properly much higher. Pretty much any mental or psychical illness causes inattention. There is no reliable test for ADHD. ADHD is not primarily about inability to concentrate, but executive function.
Instead, we use the DSM, which advises us to diagnose people with ADHD if they say they have at least five symptoms from a list.
This not true.
1. You need to have them "often" (approx. 5th percentile in the population)
2. You need to have them since childhood.
3. They may not be better explained by other disorders.
4. Need to have significant impairment in work, school or personal life.
Those criteria are based on decades of scientific research. They are the best way to diagnose ADHD. There has been promising research in computer tests, genetic tests and brain imaging, but none of those are reliable. A good doctor should spend significant time talking to the patient. Ideally they should also talk to other people who know them and review documents such as grade cards from school.
1. Are you finding "approximately 5th percentile in the population" somewhere in the DSM, or did you make it up?
2. This is no longer considered true; see any of the recent research on adult ADHD.
The last two are obviously good ideas, but they don't really winnow down the pool very much.
I am not an expert, I just did some research on my own. If you know more than I do please share.
1. There are normed rating scales. I assume OP was also tested on one when s/he filled out those additional forms. If I recall correctly they use the 5th percentile.
2. DSM-5 still requires symptom onset before the age of 12. As far as I know some researchers advocate raising the age limit further into adolescence, but don't want to get rid of it.
https://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.20...
This is all a bullshit facade. 60% of ADHD adderall prescriptions are from people who realize they can work better by using it.
So they fake the symptoms, and get those advantages. That's what's refreshing about this posted article; it points out how ridiculous continuing this whole charade is.
Adderall is just becoming the new coffee.
Also from Germany but moved to Japan for work. I never suspected ADHD until someone here on hackernews hinted at it, and even then the idea just seemed absurd. Went to a doc and they suggested doing a "NIRS scan" while I perform a basic task (in my case playing rock paper scissors). I only later read that NIRS scans are only being trialed for ADHD so it seemed more like a quick money grab, but in either way my result graph looked a lot different than what an average graph should look like, hinting at depression and ADHD.
Had a conversation with my doctor about my symptoms and how I feel and concluded that yes, I pretty obviously have ADHD and that it might be the cause of my depression. Went to a second doc for a second opinion as well and he also concluded ADHD. So yeah, I was a little shocked but as someone else said "I suddenly felt like my life story made sense". A lot of the problems that I attributed to my personality felt explained. I talked to older classmates as well and even they said that yes, looking back it was pretty obvious that I have ADHD.
He directly prescribed me a test batch of Atomoxetine (strattera) for trying. At this point I still didn't think I actually had it but went with it anyway.
The side effects were nuts for a couple days but I pulled through. Because of the slow onset it's very hard to actually 'see' a difference but oh man, it feels like life became a lot more manageable: Less arguing in my head, less impulsive behavior, I can keep habits like going to the gym up without getting bored, less of a fight to start a task and so on.
Atomoxetine allows me to be myself, minus a few of the ADHD quirks. I still have attention issues, or am jumpy and hyper, but it is less than before and more manageable by me.
I am worried that once I go to a different country I will have exactly what you described: That I will be in a long queue waiting for my turn, or that clinics are just full and reject me. My current advantage is that I speak Japanese and that ADHD here is still a kind-of new field. Not many Japanese adults go to get diagnosed, so the Japanese docs are free while the English clinics are booked out months in advance.
I really, really wish there was more discussion of this. This is something that is very present in my life and the lives of people I have worked with, but nobody talks about it.
The two things that really stick out for me are the existential implications of taking a pill that rewires your brain, and the inevitable intersection of that with one's career choices.
I don't take adderall, but I'm not too convinced by the concerns listed here. The drug seems far less risky than alcohol on all counts, and I'm pretty sure all amphetamine users are aware that their playing with some sort of fire.
I think the compelling question is why people feel so compelled to take a pill to sell their souls to a rat race? Seems like an almost Huxleyan Prisoner's Dilemma to me.
If you're "ADHD" it affects having fun just as much as working - imagine you can't finish a book and you can't hold down a conversation with a stranger long enough to start dating them. There are pretty universal subconscious skills medication improves here.
This is what I have to explain to people, my ADHD doesn't only apply to things I don't want to do.
Things like not being able to watch a movie, or even play some video games without missing huge parts of the story, or sitting through a conversation with a group of friends trying to constantly "catch up" to a topic that I missed a few minutes ago, or trying to be self aware enough to not change the subject on people too quickly because my mind has already changed topics twice during their conversation.
I love reading, and it's almost 100% out of the question when I'm not taking my medication. Somewhere around the 5th time of re-reading a paragraph trying to remember where I trailed off only to realize that I just did it again makes it really not a great experience.
Even the worst case scenario of the medication severely increasing my chance of heart attack, stroke, or Parkinson's wouldn't make me stop taking it, because it's given me a life. And I would rather live a shorter happier more fulfilling life than a potentially longer one.
I had held off getting tested for ADHD because I was convinced I was just lazy and didn't like schoolwork but once I noticed I couldn't play a single videogame for more than 15 minutes at a time and had to do something else, I got myself tested and ultimately diagnosed.
I still remember the first day I took the medication, it was like somebody finally turned off a white noise machine in my brain and I could finally do all the things I've wanted to do.
This. This was exactly my experience.
I texted my wife after my first dose that I heard someone having a conversation near me and that I could hear them, but I didn't know what they were saying and I didn't care.
This was a revelation for me.
Same - for me the leading indicator of having "true" ADD is the inability to concentrate on the things I _want_ to do.
I recently chatted with a shrink who said that ADD patients typically _can_ focus on the things they want to do but struggle with the things they don't want to do. I strongly suspect he's mistaken - I don't know a soul who finds it easy to focus on filing their taxes (except sadistic accountant-type friends).
Nothing is more frustrating than having all the "motivation" and desire and curiosity for a task but none of the "ability" to make it happen.
I should have clarified: I'm talking about "abusers" here, not those who genuinely need the drug.
>I think the compelling question is why people feel so compelled to take a pill to sell their souls to a rat race? Seems like an almost Huxleyan Prisoner's Dilemma to me.
I think people just want to be their best selves. They want to accomplish their goals and they use tools to accomplish those goals. I mean everyone carries a cell phone and I feel like those modify your life and thinking patterns a lot more than taking adderall does.
Both stimulants and cell phones can be extremely useful for ADHD users.
Cell phones: Possibility to carry a calendar - with alarm.
Stimulants: Lowers the threshold for "interesting" so you don't fall asleep/have to do "something"/etc. (Yep, multiple alternatives exist here.)
"I think the compelling question is why people feel so compelled to take a pill to sell their souls to a rat race?"
There seems to be an implicit assumption in your question that refers to adults. What about the growing number of people, diagnosed and treated as children or young adults before they really have an agency in the matter?
Some U.S. based statistics on diagnoses for different <18 year old groups: https://www.cdc.gov/ncbddd/adhd/data.html http://www.wnd.com/2013/04/radical-increase-in-kids-prescrib... https://www.cdc.gov/nchs/slaits/nsch.htm
I know we like to think of them as not having agency, but we can still give teens and preteens choices. I know some kids who the medication helped, some who grew out of needing it when they grew older, and some who had strong side effects and stopped taking it after a few weeks. But they most certainly did have that choice.
> I think the compelling question is why people feel so compelled to take a pill to sell their souls to a rat race?
This seems pejorative. The reason why many take "a pill" isn't to sell their soul, it's to do the work they want to do but are otherwise incapable of doing. You may consider this work that they want to do to be "rat race" work, but that's just your judgment of their desires.
For what it’s worth, for me, the main impact of adderall is on a second to second level, not whether I can concentrate for 12 hours straight.
When I’m not on medication, I have a lot of short term memory loss and sudden changes in train of thought. The impact of this was that I would sometimes “wake up” and have no recollection of how I got to where I currently was, I continuously lost everything, and had trouble with math word problems that were described over long paragraphs.
My parents actually originally went to the doctor because of the stress caused by always losing things.
I felt extremely sad on taking Adderall and other similar stimulant medications like Ritalin.
Maybe the sadness effect would have gotten less with continuing the medicine, but overall, I didn't feel like taking drugs since they cause a lot of other side effects like insomnia.
Now I've been able to control my ADHD successfully. Atleast upto the point that it has stopped affecting my life and career so much.
a) 0 sugar in diet. Not even fruits. b) Try to sleep for atleast 8-9 hours a day. c) Drink lots of water throughout the day d) Exercise and no junk food. e) Have got an accountable job. Leading a software team so I know that procrastination will hurt me in the long run, so forced to do stuff on time.
How do you get enough vitamins without any fruits? Are you just using supplements?
I take fruits which have no/negligible sugar like Amla, Lemos, Avocados. Once in a while, I do take supplements. But on the whole, I try to live a more natural life, with as less drugs/medicines as possible.
Even for milk, I drink raw milk and not processed milk.
> 0 sugar
> I drink raw milk
You'd have to drink milk in tiny quantities; I'd be astonished if raw vs processed makes a difference if so.
I mentioned raw milk not in reference for "0 sugar". Just mentioned normally that I try and keep away from processed food, drugs, medications etc.
Still seems weird that in avoiding sugar, you're going as far as not eating fruit, but you still have milk.
Pasteurization was invented for a reason though, and literally saved millions of lives. I can't fathom how the supposed benefits of raw milk could outweigh its risks.
Also, what are the supposed benefits exactly? Can you link to scientific studies validating them?
> a) 0 sugar in diet. Not even fruits.
Lactose in milk is a type of sugar.
edit: I see you replied below this. No added sugar but still no fruit.
But still I'd say you're missing out on the benefits of fiber in fruit. The sugar in fruit wouldn't concern me it's offset by the vitamins, minerals and fiber.
Fruits are just dessert vegetables. You don’t need them for anything.
You can avoid fruits and still get your nutrition from vegetables, which are more nutrient dense in general (especially leafy greens).
Of course, fruits are more tasty.
I was on ADD meds (including ritalin for a few years) and I agree with everything you said. My behavioral therapist who put me on the ADD meds did mention all of those 5 factors but I wish better action plans were put in place rather than just saying "these could help".
Another thing that can help is doing a yoga class once a week. I found the 3h0 Kundalini yoga to be the most helpful. But eliminating sugar is a big one too there are many ways in which we unintentionally expose our self to everyday food items that can induce ADD states.
Interesting, Adderall always had the opposite effect on me. I have a tendency towards mild depression, which was a problem on Ritalin but which Adderall treated very well. It functions as a mild anti-depressant in many people (it was why my doctor suggested switching).
However, even in low doses Adderall and Ritalin can cause psychosis in a small fraction of people. Is that what happened to you?
Same. Adderall (plus welbutrin more recently) have been enormously effective at helping with the mild depression that have plagued me my entire life. (Adderall isn't indicated to treat depression but it doesn't hurt and is particularly effective for me when combined with welbutrin.)
Ritalin made me angry, scared, and flat out unwilling to do work (although perhaps it would have helped the concentration had I decided I actually wanted to anything).
I hope adverse reactions to one of many possibly-effective medications don't deter patients from getting the help they need.
I was high school dropout turned Yale PhD. I was prescribed for either Adderall or Ritalin for about 20 years starting in my second year of University.
The two main side effects I had from Adderall were appetite suppression (which has the bonus side effect of intermitent fasting) and hyper focus. With hyper focus I could work like a machine for 14-16 hours, and would have to remind myself to stop and eat, but I couldn’t turn it off. When it came time to socialize I was still chewing away at my work. I was not present. To break myself from the work loop I would usually have to watch TV or go drinking with friends. The problem with the later is that you start to wake up with the dreads quite frequently, increasing your anxiety level. It also tires you out. I rarely (1-2/month) take Adderall now and when I do I take 5mg (down from 3x 20mg what I was originally prescribed for). Ritalin was a different story. Where Adderall was smooth and almost unnoticeable Ritalin would give you a rush, with effects lasting about four hours. I could take Adderall for my most boating early morning class and sitting in the front row I was excited as seeing a talk by novel prize winners. The problem with Ritalin was the anxiety and crash at the end of the day.
Prescribing stimulants to people with ADHD seems artificial. In most cases the risks are low and unless there’s abuse or the potential for abuse I think people should have the right to decide for themeselves what they want to take and how they want to live.
That's how I feel about drugs in general, but I think society has this weird split of two extremes: any unprescribed, street drug is super dangerous and evil, and any prescribed drug is just just medicine correcting an "imbalance", and is totally benign and fine and good. Madness both ways.
You mention getting prescribed in college, as a adult. How would you feel if you had been prescribed as a kid?
To me, growing up regularly taking amphetamines seems like it could twist your head pretty badly. Seems very irresponsible to be giving drugs to kids.
(I get the pressure to do it if the kid can't behave or focus and you think that's fucking up their life, but honestly, having gone through school, the fault is much more likely to lie with the school & what we expect of kids than the kids themselves...)
I’d avoid perscription drugs for my kids if possible. For me, ADD was a kind of personality trait that affected how I looked at and reacted to the world. It had pros and cons. Adderall helped me deal with the cons when the time was right. I wouldnt try to take that away from my children. Also knowing what I know I could probably be a better parent to children with ADD.
I started taking Modafinil about 4-5 years ago and my only regret is that I didn't start earlier.
I live in Europe so you can forget about amphetamines/adderall basically, only thing you'll get here is Ritalin and even that not as easy as you might think. Modafinil is easy to get on the internet though. If I lived in the US, I would likely be on Adderall I'd guess.
It helped me so much that I wouldn't have completed studies and got my current job if I wasn't on it. I know, because I still remember the struggles I've had before (and over time learned that I am not alone, that many, many people suffer from ADHD-PI or ADHD-like symptoms and all think it's just them...).
Also, fuck everyone trying to tell people that "eat better, sleep more and do sports" will fix ADHD-PI. You should totally do all of these if you aren't already, but it's not fixing shit. Medication works.
I feel like comments like yours are one reason doctors don't like prescribing it.
I'm glad you are able to be happy on modafinil, but think about what you just commented: (1) alternatives are hard to get, (2) you have to get your substitution from the Internet without a prescription, (3) once you are on the gear you are able to notice the same deficiency in others, (4) you attribute your success to it and (5) "fuck everyone" trying to speak people into drug-free alternatives.
I haven't been to med school, but I can imagine this being a slide they would put into an example profile to stray people from prescribing Adderall et al.
The reason doctors don't like prescribing it is because it's not FDA-approved for ADHD. It's not FDA-approved for ADHD because of bureaucratic/economic reasons, AFAIK.
>"fuck everyone" trying to speak people into drug-free alternatives.
It's actually really annoying being told that you don't need drugs to fix your condition when, based on your own experience, you really do
You need to be careful about movement disorders if you're going hard on the Modafinil.
I often it found it quite stimulating in an amphetamine-like way even though it's a wakefulness agent.
'Adderall doesn’t “cure” the “disease” of ADHD'
This is completely wrong. It treats the symptoms of those of us with severe ADHD, and let's us do everyday things like sit in a theater or an airplane, or enjoy playing quietly with our little children.
It's not just about being an office drone spending 12 hours a day in Excel or some cynical bullshit like that, it's about every day life.
I mean, I get that we are discussing ADHD here, but you could have at least read the next sentence:
> Adderall doesn’t “cure” the “disease” of ADHD, at least not in the same way penicillin cures syphilis. Adderall will give everyone better concentration, and we’ve judged that it’s okay for people with terrible concentration to use it to overcome their handicap, but not okay for people with already-fine concentration to use it to become superhuman.
I read it - the tone of the paragraph is that it's not really medication, but something like caffeine which you can give to everyone and it'll have the same effect. It doesn't work like that. The dose I take would make a non-ADHD person into an obsessive hyper-focused teeth-grinding mess, but it basically just makes me normal. Adderall is real medicine which cures a real problem.
> but something like caffeine which you can give to everyone and it'll have the same effect
Apparently, that is actually true (not the same magnitude of effect but the same kind of effect - better concentration). And it's not in any way contradictory to it also being a medication.
> The dose I take would make a non-ADHD person into an obsessive hyper-focused teeth-grinding mess, but it basically just makes me normal.
That is almost exactly what the quote above said.
> Adderall is real medicine which cures a real problem.
I honestly don't understand how you got the impression that the original article claimed otherwise.
No, that's a myth. Dosage varies from person to person, but "more ADHD" (as in more severe AHDH-related problems) does not equal higher tolerance.
But it does work like that, and drug tolerance is why you can eat a 30mg XR and be normal and I would be flying off anything more than 5-10mg IR.
Adderall has a lot of utility for regular people, it works exactly like caffeine. Eventually all that dopamine from the amphetamines is going to ruin all your receptors, hth.
"The dose I take would make a non-ADHD person into an obsessive hyper-focused teeth-grinding mess, but it basically just makes me normal. Adderall is real medicine which cures a real problem."
I believe you, but couldn't you equally say "The dose of human growth hormone I take would turn a non-Chronic-Shortness-Syndrome person into a freakish giant, but it basically just makes me normal"?
What he's saying is that Adderall boosts anyone's ability to concentrate. The dose you take boosts your concentration levels from "really low" to "normal." It would boost a non-ADHD person's concentration levels from "normal" to "way overfocused."
>I mean, I get that we are discussing ADHD here, but you could have at least read the next sentence
Being condescending, especially towards people with a disorder, doesn't serve anything.
Worse, people with disorders have to deal with this stuff all the time from other people. <To someone they know has depression, in front of the circle of friends> "Hey Peter, haven't seen you in a few weeks. Were you being sad again? ;D"
It makes me cringe a bit to see that behavior here.
I don't think you understand the argument being made.
Further down you say:
> the tone of the paragraph is that it's not really medication, but something like caffeine which you can give to everyone and it'll have the same effect. It doesn't work like that.
It does work like that. You can give it to everyone, and (assuming the recipient has a good response, no side effects, etc.) it'll have the same effect. That effect might be "worth" more to people who are already at the low end of the bell curve, but it's the same effect.
> It's not just about being an office drone spending 12 hours a day in Excel or some cynical bullshit like that, it's about every day life.
Spending many hours in a row at a desk working on tasks that require extreme focus is my every day life, and the life of most of the people on this site I'd wager.
Where are you going with this? You're replying to an article that said "it helps everyone", and you're trying to say that some people aren't as worthy of help? Is that really where you want to go with this?
Interesting stuff. I was diagnosed with ADHD 12 years ago (after undergoing testing because I suspected I might). I tried various medications and after several years found that Adderall XR worked best. Tolerance is real, though, and I’ve had to increase my dose over the years, but I take half doses some days and skip when I can, which subjectively seems to help.
The symptoms are definitely the sort of thing everyone can identify with to some extent. But I think the key detail in the definition of ADHD is that it’s a “disorder”. In other words, these symptoms are normally distributed but if the combination of them occurs often and causes distress to the patient and/or other people, then it’s real. Two people with exactly the same symptoms but different life situations or jobs such that one experiences distress and the other none should be diagnosed differently. Not everything can or should be reduced to objective ratings.
I’d also like to echo the observation that the restrictions and hurdles involved in getting an ADHD diagnosis and in acquiring stimulant medication for ADHD are seemingly designed to vex the ADHD sufferer far more than a neurotypical individual. I used to have to, once a month, call my doctors office to ask for a new prescription, then physically go there to pick it up, physically deliver it to the pharmacy, and then physically pick up the medication when it was available. Which isn’t always right away since Adderall is so commonly prescribed (and because my health insurance has an insane restriction that only covers the brand name—but that’s a different story). That’s three or four steps not required for the vast majority of medication that are each easy for an ADHD sufferer to forget, put off, or otherwise screw up. Laws have changed where I live recently so that I only have to deal with the doctors office once every three months but the physical delivery is still a requirement. Thankfully I live near the doctors office and have a flexible job. Most people aren’t so lucky.
So ironically it’s far easier for folks without ADHD to deal with getting Adderall than it is for those of us with the disorder. C’est la vie!
Edit: I also wanted to mention that I’ve found that I’m actually much more agreeable and less irritable when I’m on Adderall than not. My family has witnessed the difference and told me as much, and I feel it too. Whether that’s a direct effect of the stimulant or a secondary effect of the behavioral changes it engenders I don’t know but it’s worth noting that the potential personality changes aren’t all negative.
Any other managers notice that workers on Adderall will spend enormous amounts of time on totally non-productive or completely unrelated tasks?
This is not necessarily related to the medication. ADD often represents as hyperfocus, to the detriment of the things you should be focusing on. https://en.m.wikipedia.org/wiki/Hyperfocus
I do this all the time. I have been diagnosed with ADHD, but I'm not on any medication for it. I think you're confusing the treatment and the disease.
I noticed this in college. My adderall-using friends and roommates would take a pill to study for a test, and sometimes that's exactly what they'd do. But sometimes they'd obsessively clean their room or get into a Wikipedia editing war or corner someone and talk their ear off about a pet topic.
Yes absolutely. Not a manager but I noticed this. I think there is also a state of mania involved. While not on these drugs you have a better sense of what is worth effort rather than this euphoric feeling of doing anything for the sake of it.
Adderall and the like are not magic pills that make the most important work/tasks get done first and effectively.
> There are occasional claims that magnesium or some other substance can help reverse Adderall tolerance.
I went to a particularly expensive Silicon Valley psychiatrist who did of course immediately put me on Adderall, but also put me on NAC supplements to "avoid tolerance". It's been okay, they're cheap, never bothered not taking them to experiment. I can confirm feeling better after eating foods with magnesium, mostly because they're good for you.
BTW, if you're on amphetamine+guanfacine you need to avoid all of caffeine, sugar, and alcohol. What a bummer.
AFAIK the best evidence is for NMDA antagonists reversing tolerance. In fact magnesium is a a NMDA antagonist, but it a very weak one. I have read about people using memantine or something more potent to reverse tolerance, but I would be very wary about using potent NMDA antagonists regularly given what we know about them.
Hmmm, never heard of adding NAC. And do you supplement magnesium too?
Your talking about things I’ve never heard of before, this does sound advanced. Any other things on your stack?
> Hmmm, never heard of adding NAC. And do you supplement magnesium too?
> Your talking about things I’ve never heard of before, this does sound advanced. Any other things on your stack?
The original article mentioned how society has determined it is "not okay for people with already-fine concentration to use it to become superhuman".
The way you talk about this, though. Being impressed about someone's "advanced stack" of drugs to maximize their potential. I get the impression you're using it to become superhuman.
I'm not sure if I am the only one with this reaction, but I feel like your attitude is kinda offensive and disgusting. How much money have you made by abusing drugs in our rat race?
> I feel like your attitude is kinda offensive and disgusting. How much money have you made by abusing drugs in our rat race?
Yeah, I am kinda disgusted myself, but I am right on the cusp, and I am grasping at it. That last sprint. I’ve locked in 99.5%-tile wealth, but the next month to six will determine if I can get into 99.9%-tile, where the true game change is.
And I’m under no illusion, if I don’t bag this deal here for the 99.9%-tile (private aviation, super yacht and models) I’ll forever be stuck at 99.5%-tile (first class commercial, upper middle class lifestyle forever without having to work).
Just a little more... broke my way many times... just need this last bit...
Fair enough
Guanfacine (Tenex/Intinuv) is just a prescription you can get for ADHD hyperactivity. It complements stimulants really well but is hard to live with - you feel sedated, have no alcohol tolerance, and ramping off it takes a week or two.
> Any other things on your stack?
Like nootropics? Popular internet topic but a little goes a long way. Here's what I know:
- Vitamin D 1k-5k IU, fish oil, theanine: These all work great and everyone should try them.
- Magnesium: Too many different supplement formulations to trust one, and I read they give you copper deficiency - just eat spinach and you're good. Actually zinc is better to supplement, especially for men.
- Nootropic stacks like Qualia: Tried some, but pretty sure they're expensive caffeine pills.
- Every other nootropic: Bacopa helps long-term but makes ADHD worse short-term(!). No effect from anything else.
I think in many cases the reason people can't maintain focus on programming is motivation, not incapacity. Sounds like bullshit when they say most lose focus after 30 minutes and check their phone. If you're really interested in something you focus on it. Yeah I struggle to focus writing CRUD apps for unsexy products. But I wrote a puzzler game in twenty nonstop hours. I know this is anecdotal but I've seen the same with friends A exercising, B playing videogames, C reading, D playing music.
This article confusingly talks about atomoxetine in several places, but atomoxetine is very different than Adderall, in particular, because it's not a stimulant.
The article itself doesn't, some of the quotes from relevant papers do. It seems likely that studies are often done comparing treatments, and at least one of the quotes has context supporting that idea.
No, it very clearly mixes anecdotes from the papers about atomoxetine with those of amphetamine variants. It also lumps in "adhd drug" risk studies (which include plenty of non-stimulants) into a discussion about adderall and it's variants.
Given the papers clearly state that some of these risks/issues are only appreciable for the amphetamine variants (and some only appreciable for the non-amphetamine drugs), this is, imho, a disservice.
What do you mean "no"? The article literally never mentions atomoxetine outside of quoted text. It mentions it twice in the contextual part of quotes from papers also dealing with amphetamine variants.
There is a single anecdote about atomoxetine. The quote has nothing to do with the drug's action. The point of the anecdote is the researchers' attitude toward the behaviour of young children, in the context of debating their approach to judging side-effects. That is certainly relevant context: the paper in question is also looking at side-effects for amphetamine variants. Strange approaches to behaviour classification likely apply across all the trials involved.
Your original comment was that this is confusing. I think it's very clear. I am not left with the impression that results for atomoxetine are being conflated with results for amphetamine variants.
I'd love to see Scott write one of these for modafinil (Provigil).
Somebody asked him in the comments and he said Gwern wrote a good article on modafinil. https://www.gwern.net/Modafinil
Copying in a post from Reddit:
https://www.reddit.com/r/Nootropics/comments/7n2qjz/adderall...
He cited the infamous squirrel monkey study without noting that (a) there were no signs of neural death or neurite retraction anywhere, and (b) reduced baseline dopamine levels are exactly what you would expect as part of the mechanism of tolerance.
That study did not establish the existence of neurotoxicity. It merely established the existence of tolerance.
I wanted to share my experience with Adderall. I've been taking it for about 2 months now. Some backstory.
I was diagnosed with ADHD when I was about 12. I never had an issue focusing in school. I never had any challenges completing my school work and would always complete it before everyone else. I would then get bored and fidget. It got to the point where it was a distraction to others and was brought to my parents' attention. I was then diagnosed with ADHD. I was never given any formal treatment, instead placed in a Gifted program with more intensive work.
I have been running my own businesses and consulting pretty much since I graduated high school. I am now 25. Things were going pretty good, except for one thing, deadlines. I struggled actually focusing and completing work. It got to the point where I could be working in my office for 12 hours straight and not actually get anything done.
The other major part of it is how it affects my relationships, especially with my SO. We can be holding a conversation and I can completely zone out for minutes at a time and not have any clue what she said because I was in my own head thinking. It is stressful because it gives the impression that I don't care what she is saying, but in reality I have limited to no control over it. This is common from others I speak with who have ADHD.
I have tried every management system in the book. None of it helped. I eventually tried Modafinil (I see a few people mentioned it here). I ultimately stopped taking it because I didn't like how it made me feel (restlessness and appetite loss) and I didn't get immense boosts to concentration.
I eventually decided that I may want to try Adderall. My doctor was suggesting that I may want to try something for over a year, but I resisted. In my mind Adderall was prescription meth and would "rot my brain". I would be come addicted and it would ruin my life.
But things just kept getting worse. My business keeps growing, and so are my responsibilities and deadlines, but I was really struggling to keep up. Finally, I decided to open my mind to taking something like Adderall.
After discussing it with my Doctor he alleviated most of my concerns. Ritalin and subsequently Adderall have been prescribed for almost 70 years and he has been prescribing them for decades without seeing "brain rot", withdraw, or anything like that long-term. After more research and discussing it with colleagues I decided to take it. Here are my thoughts and observations 2 months in.
* It's not addictive. I take it 1-2x a day when working, and not on weekends. I skipped 5 days of doses over Christmas without feeling the need to take it.
* Tolerance. You will get a euphoric effect the first 1-2x you take it, then you don't anymore. You still get the concentration benefits and that doesn't wear off over time - according to my doctor. I don't feel the need to increase dosages.
* It has a propensity for abuse. Basically people taking it to stay up for days at a time to study for exams... I can see where people would have the urge to do so, though I do not.
* It helps me concentrate. While it's not a magic solution to all of my problems, it makes it easier for me to be able to work and continue working for a long period of time. My productivity the past to months have been more than I ever have in the past 5 years.
* It lowers your appetite. I feel like I perpetually ate 30 minutes ago. I need to consciously decide to eat, which I do. * It gives me dry mouth. This is annoying, no matter how much I drink.
* It can affect sleep. To counteract this I take mine when I first wake up, then at 12pm I take either a full dose, half dose, or nothing depending on my day.
TLDR: It has helped me improve the quality of my life with no real negative effects. If Adderall continues to do so, I will continue to take it.
I used Ritalin as a crutch after radiation. It helped. Sometimes quite a bit. Recovery time span was 6 months. Now the Ritalin helps less, meaning I barely feel it's effects; so now I'm taking one or two pills weekly.
I'd love to have some effective nootropics for improved focus, cognition. Mostly to mitigate aging, grogginess from the chemo, and so forth.
It seems to me like the biggest problem, if I'm to accept that Adderall is as frequently abused as described here, is the same one you have in sports with PEDs: if a bunch of people are on Adderall and establish the "baseline" level of attention you're supposed to have, then "just" being diligent gets you left in the dust.
The article doesn't really describe it being "abused," just perhaps too "easy" of an option for some who really could "just try harder". (By "easy" I mean prescribed or requested with the "sure why not" attitude without reviewing the side-effects which the author lays out pretty plainly.)
I don't find the sports analogy very compelling. We watch sports for the competition and the idea that the results are a combination of genetics+work. Hence taking PEDs is cheating in a sports context.
But if there's a medication that helps you live your life better (i.e. in a way that's more fulfilling to you) and if taking the medication doesn't impact anyone else negatively, why would you not want it taken as widely as possible?
The important thing is to let would-be medication-takers know with full honesty what the side-effects are - this is what the article focuses on most.
The article talks about people's careers being stymied, or people losing promotions to, colleagues whose attention span is longer because they're abusing Adderall. That's the intro.
> The human brain wasn’t built for accounting or software engineering. A few lucky people can do these things ten hours a day, every day, with a smile. The rest of us start fidgeting and checking our cell phone somewhere around the thirty minute mark. I work near the financial district of a big city, so every day a new Senior Regional Manipulator Of Tiny Numbers comes in and tells me that his brain must be broken because he can’t sit still and manipulate tiny numbers as much as he wants. How come this is so hard for him, when all of his colleagues can work so diligently?
> (it’s because his colleagues are all on Adderall already – but telling him that will just make things worse)
> He goes on to give me his story about how he’s at risk of getting fired from his Senior Regional Manipulator Of Tiny Numbers position, and at this rate he’s never going to get the promotion to Vice President Of Staring At Giant Spreadsheets, so do I think I can give him some Adderall to help him through?
I don't see the problem with the analogy.
Sports is a zero-sum game. Productive labor is not. The mathematician Paul Erdos used amphetamines to make many major breakthroughs. This was a great benefit for society, regardless of whether he perhaps took a professorship that some less productive mathematician would otherwise have obtained.
There is a pretty limited set of fields of endeavor where you could make this argument without it being ridiculous on its face.
While many industries have an element of zero-sum competition, that's not the default. Whether you're designing a car, doing a surgery, giving a haircut, cooking a hamburger, etc. you are giving something of value to your customers.
You’re describing retail jobs, where that might be true. But most white-collar workers never interact directly with customers. They have to demonstrate value to their boss, which does make it a zero-sum situation.
I don't think any of the jobs I listed are retail. I went out of my way to include a variety of industries, including knowledge work. "Demonstrating value to your boss" could include zero-sum bullshit or actual production. As a programmer, I've done both kinds of work.
Even assuming (optimistically) that an exceptionally good hair stylist could somehow... uh, I don't know, be so good that they can hire more stylists? Assuming there's space?... it's pretty rare to have, say, multiple heads of the same department.
You could cut more people's hair by getting it done faster, or do a better job cutting each person's hair. The point is that jobs where productivity improvement is possible are very common. Economically, productivity and technology are equivalent, and are the basis for prosperity. Productivity is not, in general, zero-sum.
The post uses accounting, which, well, maybe it's a different story if we're talking about complicated tax schemes that can save a lot of money, but in general I think we can say that if the workers are more productive fewer rather than more are needed.
More productivity allows the work to get done with fewer workers, which is generally a good thing in normal economic conditions.
It seems to me like this claim contradicts your previous assertion that there's "no zero-sum game." The zero-sum game is, they only need so many workers, and if all your coworkers are achieving levels of productivity only possible with chemical enhancement, then you get left behind.
This is no different than saying that the street sweepers were left behind by street sweeping machines. Or that accountants got left behind by the invention of accounting software. This is what technology is all about. It's not zero-sum, because there's other work in the world waiting to be done to make people's lives better.
You may have have a bad work environment where you feel like the only goal of your work is to one-up your co-workers. But your boss is not paying you and your co-workers to compete for sport. The reason you are getting a paycheck is because you are giving someone something they value. That person would be happier if they could get it for less money by putting you out of the job. But if that happens, that doesn't mean you should be unemployed - it means you could be helping society in a different way. In a well-functioning labor market, every worker will be more prosperous if they all produce more.
Maybe ideally on some macro level that's how it works out. In the meantime, on the micro level, many people are in competition with their coworkers and it seems kind of blind to the realities of the workplace to pretend otherwise. Everybody here has heard of stack ranking, right?
Promotions, and the salary/opportunity increases that come with them, absolutely are a zero-sum game. I’m a little baffled that anyone could think otherwise, actually.
Assuming the company is doing well, financially, it's not zero-sum if there's enough money for everyone to get a salary increase.
How does that work out for cost centers?
Curious if anyone is using weed flowers or extracts to treat these any related issues? Some strains are known to help focus the mind.
I found using some strains help the ability to switch to a new task and focus for a longer period of time. The problem is the next hour after the body needs additional rest.
I'm fairly severely ADHD, and Adderall does not work for me. As in I was getting psychedelic effects before reaching a therapeutic dose. Ritalin is better, and Focalin better still (same effect as ritalin, lower side effects).
It's surprising how the different medications can affect people with seemingly similar symptoms.
Ritalin (and Vyvanse) makes me feel angry and crazy. I've not heard of Focalin, but I may look into it. I've been on varying doses of Adderall for 10+ years and I find it immensely helpful.
Anyone here had luck with some kind of alternative treatment?
I was treated both as a child and as an adult. After I quit my adult medication I was a wreck, and ended up going to therapy. It wasn't specifically to address ADHD, but just me in general. I took a break from work, began eating well, sleeping well, and exercising, and I feel like I've gotten a lot better at focusing. My diet became more or less low-carb, and I did strength training. Could those be it? I don't know, but I feel a lot better and am more professionally accomplished than I ever was. There's my anecdote.
I was diagnosed with moderate ADHD, inattentive type, as a teenager and prescribed adderall. I was also quite depressed, but I hid that from my psychiatrist.
The adderall certainly helped me to focus, but the side effects were awful and I stopped taking it regularly. I’ve since been diagnosed with depression and started on sertraline (an SSRI), and very soon after noticed an improvement to my attention, ambition, and ability to complete tasks.
It’s not surprising, I guess, but near-constant thoughts of worthlessness/desire to die can make it quite difficult to focus on tasks and generally function.
QBC (quercitin/bromelain/vitamin c) seems to have a very good effect on my attention span, ability to concentrate, anxiety levels, etc. However it does not go well with coffee, I get a "speedy" feeling I don't like. So unfortunately I don't take this supplement as much as I would like, because I love coffee so much.
Other nutritional remedies can be found in "Prescription for Nutritional Healing" by Balch.
A friend of mine who has ADHD takes Vyvanse instead. Does it have similar risks?
Sure, it's just [a prodrug to] dextroamphetamine.
(Disclaimer: I've studied pharmacokinetics, though I'm not a pharmacologist)
Vyvanse is a prodrug. That means it metabolizes into the d-enantiomer of amphetamine, whereas Adderall contains a 75-25 mixture of the d- and l-enantiomers. (Enantiomers are like left- and right-handed gloves: they have the same chemical structure, but one is the mirror image of the other. Usually two enantiomers will have similar but slightly different effects; occasionally, they can have incredibly different effects - see thalidomide for an example).
So, without further study, it's hard to know, but it's likely that Vyvanse has a similar long-term profile to Adderall, because the active ingredient (lisdexamfetamine) metabolizes into the active ingredient that makes up about 75% of Adderall.
But, it's possible that the effects described are caused by the l-enantiomer, in which case they won't apply to Vyvanse. It's also possible that lisdexamfetamine itself has its own set of effects which may either cancel out or exacerbate the effects reported by Adderall.
To give you an idea of how prodrugs can have different effects from the drug that they metabolize into: Vyvanse does have a rather nasty feedback loop for some people, because amphetamines suppress the appetite, but lisdexamfetamine is metabolized into the active ingredient using the digestive cycle[0]. For some people, this can cause a really wonky extended release cycle, where they have no appetite mid-day (due to the drug) and can't eat enough to metabolize enough dextroamphetamine to get them through the afternoon, resulting in an afternoon crash. After this wears off and they develop an appetite again (around dinnertime), they'll eat, and then the dosage that was supposed to kick in after lunch finally kicks in after dinner, causing issues sleeping.
[0] This is intentional, and it's why Vyvanse is marketed as an "abuse-resistant" alternative to Adderall, because it's theoretically harder to extract an acute dosage from it.
I think another important consideration might be that peak plasma concentrations on Vyvanse would be lower than on Adderall (because it's more spread out over time). Some effects only happen at certain plasma concentrations.
> I think another important consideration might be that peak plasma concentrations on Vyvanse would be lower than on Adderall (because it's more spread out over time).
Vyvanse is intended to be equivalent to Adderall XR, not IR, so the effects are intended to be spread out in both. If you're comparing to IR, you're no longer really comparing apples to apples anyway.
I take straight amphetamines, much easier to manage dosing than with Adderal.
Been doing to off and on for a decade. Never had any addiction issues, no withdrawal sypmptoms when I skip taking them, and still seems as an effective as usual when i do.
I avoid the whole psychiatrist scam and get them from a real doctor.
Author does a decent job of going through some things, but this statement did not sit well with me.
>I don’t think there are good data here, but my intuitions and personal experience is that “addiction” of the sort you get with heroin or tobacco is very rare, at least when responsible people without a personal or family history of addictive behavior take stimulants as prescribed. Most people agree the risk is lower for extended-release stimulants (eg Adderall XR), and very low for Vyvanse.
I think that statement is bonkers.
Of course they are going to be addicted to the substance if they use it everyday of their lives.
My definition of addiction is not being able to stop taking the drug for whatever reason, and feeling some sort of withdrawal. I think for most people that take something daily, it would be extremely hard for them to stop.
This is where things get messed up: being chemically addicted to something where the cost of the drug can be astronomical .Yes, I am talking about Shire's Vyvanse.
>Shire Plc is a Jersey-registered, Irish-headquartered global specialty biopharmaceutical company... its brands and products include Vyvanse, Lialda, and Adderall XR.
The best is that they offer a program the temporarily reduces the price of the drug for a period of time aka you get addicted to it over that time period and then are forced to pay it becuase their is nothing like it until 2023.
Yes, I am aware that each state has different insurance options, but starting a company called "Shire Cares" just to spread the belief that they care but really do not is silly.
From their website: "Pay no more than $30 for up to 12 prescriptions up to a maximum savings of $60 per prescription.† (https://www.shireregistration.com/vyvanse%20savings%20link)"
What they do not tell you is after that period ends, the price goes up drastically. With insurance, 30 pills costs "around $286.42 (https://www.goodrx.com/vyvanse)
The last thing I will say is: Where is the data on a drug that annually generates billions of dollars each year? They have 10 million users. You are telling me they could not monitor the habits of 1-2k people over a couple years? Sounds fishy to me.
For others who want to learn more about the crazy growth of add/adhd medication sales that very few want to talk about. (http://www.nytimes.com/2013/12/15/health/the-selling-of-atte...)
I have taken Adderalls twice in my life for longer periods of time, and both times it was no problem to stop. I stop taking it cold turkey, I feel a bit shitty for a week, and then its fine. If anything, it feels less addictive then caffine, which has worse physiological symptoms.
I've taken 20mg Adderall XR or 50mg Vyvanse for over a decade and have no issues quitting it which I regularly have to do when I run out while living abroad. Agreed - much easier to skip than caffeine.
That said, when I meet other people taking these meds, their doctor frequently has started them out on heroic doses. Like 80mg XR + 2x IR tablets a day to bump. Absolutely insane. And I reckon those people have a harder time quitting, especially psychological. The difference between an unmedicated and medicated day is just so extreme.
I've certainly met many people in uni who just can't control themselves with stimulants and quickly find themselves spiraling down the toilet bowl, and those are people I always worry about. Like the person who can't just take one, instead eating them over a 3-day spurt of zero sleep.
If you have good insurance (so most people here that work full-time jobs in tech), then you should be paying almost nothing for Vyvanse.
If you don't have insurance, then contact Shire's affordance help or use one of those prescription assistance companies that handles it for you. I don't have insurance and I pay $35/mo to a company that got Shire to give me a free voucher for my 3-month prescription.
Just wanted to point that out to others.
Also, it's ridiculous that things like GoodRX and 3rd party assistance programs are viable business models.
I'll offer an alternate voice here - I take Vyvanse, and went without insurance for a few months two years ago. I tried Adderall and Ritalin, and neither had comparable impact. I ended up spend ~$300 / 30 on Vyvanse and honestly thankful that it was available at that price each time.
With insurance, my prescription is $50 / 30. I typically don't take it on weekends in order to limit tolerance, which further reduces the ongoing costs.
If you take the prescribed amount, addiction is not likely. --nothing bonkers about that.
Adderall is amphetamine salts. It's f*king SPEED. Laboratory-grade SPEED. (yea, yea methamphetmine is delivered in higher concentrations when being abused, but I don't care Adderall is still goddamn SPEED -- and people give this shit to their kids!) It's not that far off from "meth minus the battery acid." Why on Earth anyone would want to give that shit to their own kids is beyond me, especially since it's often offered as a remedy to one of the MOST over- and mis-diagnosed conditions there is.
In addition to lower doses like you said, effects of stimulates like amphetamines are completely different if taken orally than if they are sniffed or injected.
ADHD is one of the most well researched mental conditions. It is real and will cause significant impairment if untreated. Stimulants are the most effective medication in many but not all cases. Comments like that are harmful.
However, I agree with you that an ADHD diagnosis should not be given lightly.
I wasn't implying ADHD wasn't real. It very much is real, but unfortunately it seems to have become a sort of "catch-all" diagnosis. It's now more of a common label than it is a medical diagnosis. Isn't it equally as dangerous to not treat the underlying issues or root causes? And when the common 'treatment' for a hyper-active disorder diagnosis is a prescription for Adderall/Vivanse (again, this is speed with a fancy brand name. call it what it is) it's incredibly dangerous -- these are KIDS we're talking about, there's no way we've had enough time to tell what giving this shit to a brain that's still under development actually does in the long term. Then there's the very real potential for abuse -- we're already in an opioid epidemic in the USA do we really need a bunch of tweaked out kids running around?
If there is another root cause then it isn't ADHD. As I already said I agree with you that one should be careful in diagnosing ADHD.
Just out of curiosity: do you ever stop and think/ask why ADD or ADHD exist only in the US?
How could such a condition be so frequent yet only present in just one country?
Huh. Citation needed. I know many people in the UK with a diagnosis.
Don't know about other countries but in S. Africa it also exists. We don't have Adderall as far as I'm aware but I know of people who use Ritalin and say it has improved their daily lives.
The Ritalin prescription train is alive and well in industrial Asia. You seem to be basing an argument on false priors.
When you stumble across such a fascinating question nobody seems to be thinking about...
...it's often a sign you've missed some basic facts and need to rethink your priors. And so it is here.
Adderall is very much present in Europe as well. So is Ritalin.