Diagnosed with ADHD as an adult, and on stimulants (went through 3 kinds before we found one that seemed to help).
What "high"? Our brain chemistry literally works differently than neurotypical people and the stimulants don't get us high. In fact they often have a calming effect. I had to fight not to fall asleep at my desk two days this week (Not entirely the medication's fault, lotta family stress wrecking my sleep).
Does tolerance eventually cause the dosage to increase or the medication to cycle? Yes. But as others have mentioned taking the weekend off (or hell, just forgetting periodically in my case) mitigates that to a large extent. And, since there is such a hard time acquiring the medication even with a prescription skipping weekends or vacations has the benefit of seeing people through the inevitable shortage their pharmacy will have.
> What "high"? Our brain chemistry literally works differently than neurotypical people and the stimulants don't get us high. In fact they often have a calming effect.
Is this actually true? I see this repeated a lot. The one time I increased dosage of Adderall too quickly, I felt very calm and almost "normal" again, but I attributed this to a mild euphoria because euphoria is technically the effect one gets when high on these drugs. When I see people repeat what you said, I begin to question if that was just the drug working as intended. Sadly I ended up having to get off the drug shortly after this because A) I got too spooked about how nice it was and didn't want to chase this feeling and B) I noticed the "crash" phase resulted in deep suicidal ideation.
My statement was perhaps too broad. It is possible for ADHD people to get high off their medications, yes. But that is a signal the dosage is too large. Normal dosage and usage won't get a person "high" in the traditional sense, much in the same way injecting insulin into a healthy person is bad but a diabetic person requires it for standard function, however too high of a dose would still be bad for a diabetic person too.
Suicidal ideation as a side effect is bad. I'm sorry you had that experience.
Okay, having executive function and the ability to function normally is not euphoria.
Also opioids are an entirely different class of drugs from amphetamines. Their effects are very different. You can’t just classify everything under the umbrella of “euphoria”, that’s anti-science. Amphetamines are stimulants, opioids are not.
For people who have ADHD, they have dopamine dis-regulation. Stimulants return their brain to the correct amount of dopamine, which is why they can have proper executive function on stimulants.
Meaning, and hold on to your seat here, the amount of dopamine they have on stimulants is equivalent to the amount you have all the time. They’re not addicted, they’re meeting you where you are. If they’re addicted, then necessarily you must be even more addicted, because you have the effects 24/7.
> For people who have ADHD, they have dopamine dis-regulation
I hear this vague idea all the time. It's not true.
> Okay, having executive function and the ability to function normally is not euphoria.
Never said it was. And why always so vague.... "Ability to function normally", what were your disabilities? What was restored to you when taking the meds?
It is known that ADHD is caused by dopamine disregulation in the brain. If you can’t acknowledge basic science on the matter, then this conversation is useless. It would be like arguing with you over if the sky is blue or green.
It is also known that typical symptoms of ADHD include poor performance in school, poor performance in work, poor performance in common life tasks like cleaning. These are real and affect people’s quality of life, income, and even their lifespan as a second order effect.
Sure, we can say, to an extent, that we should instead design our systems better to better accommodate the ADHD brain. But ultimately, if people with severe ADHD cannot exist successfully in the society that exists today, then they should be medicated. And that includes children. It’s really not worth letting children flunk out of high school or develop life-long addictions to undermine the “danger” of stimulants.
Like everything in life, it’s a cost-benefit analysis. Risk analysis. Yes stimulants have a risk, but so does not being on stimulants. So, we have to weigh it.
If a child is currently failing school in elementary school and has ADHD, it’s unlikely they’ll spontaneously get better. Do we really want to risk their entire life, forever, because stimulants are scary? No. That’s a bad decision.
I’ve known many people who threw their entire life away to avoid medication, out of fear. I’ve known people to refuse anti-psychotics and then subsequently be institutionalized. I’ve known people to reject stimulants and then never hold down a job and become homeless. And I’ve known people to reject chemotherapy, and then die remarkably quickly and painfully.
Everything is risk analysis. There is no black and white answer. Its case per case, medication per medication.
people whose life is amazing don't go through the process of getting stimulants (or even SSRIs) prescribed to them. psychiatrists know about this. the plan is usually to cycle the meds. is this great and works every time? no. is this better than the alternative? yes.
ADHD is not great. and in many cases it's so bad people die from "not paying attention", and Ritalin (methylphenidate) is visibly helping people avoid those early deaths.
> One should question the rate of which it is diagnosed, and who is getting diagnosed.
The medical consensus after multiple enquiries in the UK has come to:
1. The rate of diagnosis is far too low (the evidence of this being we're catching people as adults who should've been caught as children).
2. Our diagnostic criteria aren't inclusive enough (we have historically missed inattentive presenting ADHD, we have historically missed ADHD presenting in women)
These results are politically unpalatable so the enquiry is I think currently being run for the third time, but signs point to ADHD overdiagnosis being a hoax/fake news/whatever you call it.
The issue is that ADHD is not real in the organic sense. Well, at least the evidence is scant. It's more of a description than a disorder. It's not something one "has."
I like to compare ADHD to racial categorization of people. Race is not real in a biological sense, but it's definitely real in a social sense.
I am probably butchering what I am trying to say so, just read this if you want to understand someone(s) that can communicate eloquently.
The set of symptoms is roughly recognizable and treatment protocols are established. There's some data and bad theories, and informed consent based on all this. (Imagine how informed the patient can be downstream of this!)
So yes, just as with depression, where we have only very crude understanding of how SSRIs work. We have the RCTs, cohort studies, and we know that it's better than placebo.
Some people fight with depression through their whole life. Just as with ADHD.
As with Alzheimer's we are painfully in the dark with regards to etiology, prevention and treatment, but that doesn't mean it's not real.
There's multiple Alzheimer's (there's the early onset familial version, and it has something to do with APOE4 / amyloid, but there's the rest which is a big question mark), it's also not real yet, because the biomarkers we have are almost useless. Still we try what makes sense, and try to help people who are suffering from it. Same as with ADHD.
And just as the heritability of any complex behavior (intelligence and susceptibility to depression) is not a simple thing it doesn't mean it's not real.
> Some people fight with depression through their whole life. Just as with ADHD.
See I just don't think they're even similar. How is being sometimes (and sometimes is the operative word in ADHD) unable to follow instructions, forgetting things, having social anxiety, putting things off etc anything like the depression from being abused as a child?
I think a lot of the symptoms of ADHD are just underperforming "neurotypicals". Struggling is not an illness. Finding things hard doesn't mean you have an innate inability to do them, in sorry to tell you
> See I just don't think they're even similar. How is being sometimes (and sometimes is the operative word in ADHD) unable to follow instructions, forgetting things, having social anxiety, putting things off etc anything like the depression from being abused as a child?
Untreated ADHD is associated with a literal doubling in your suicide risk compared to your peers.
> and sometimes is the operative word in ADHD
No it isn't? I think you need to go and research what ADHD actually is, you appear to have formed an opinion without good foundations.
> These results are politically unpalatable so the enquiry is I think currently being run for the third time, but signs point to ADHD overdiagnosis being a hoax/fake news/whatever you call it.
And here's one for you: hundreds of thousands of scroungers and workshy young adults are saying they have ADHD to get pip and other perks... Because this is even less of a charade than back pain used to be, you can legit go on holiday with ADHD, they even give people mobility passes in the UK for ADHD, screwing over people in actual wheelchairs who really do suffer in society
One should ask if the benefits outweigh the costs regardless of arbitrary thresholds for diagnosis.
ADHD medications are generally safe, and many objections to their use appear to stem more from normative objections to medicating attention and behaviour than from evidence-based concerns about patient welfare.
My anecdata as a college aged kid on ADHD meds with friends who want a stimulant prescription:
Psychs will put you on an SSRI first, and then atomoxetine (non-stim ADHD med) before prescribing the good stuff.
The kids who want to party and/or study harder don’t take the stuff that doesn’t get you high. The kids that are struggling with basic stuff bear with it, and usually follow up to me with surprise that the non-stimulant is actually helping them.
Of course, we usually do graduate to the good stuff. So I understand the sentiment, and often question my own reliance on the drugs.
One characteristic of ADHD is that many people don't build up tolerance, or only minor tolerance, to therapeutic doses of some stimulants including amphetamines.
It's really not the same as what's being discussed here.
That is not a characteristic of ADHD. Th most damaging thing to ADHD is the myth that the medications affect people with ADHD differently. It is the most pseudoscientific piece of information that is commonly repeated.
As for tolerance, it absolutely happens. Most people do not stay on the medications for a long enough time to really feel the tolerance to begin with. Sure, in a clinical trial of four to six weeks, it might not be noticed. I've been on them for well over a decade, and it's a night and day difference.
I think this is a very different problem. I'm prescribed those "happy pills" as you call them. I forget to take them regularly, in fact I think you may have just reminded me to take mine as long as I remember by the end of this comment.
There isn't a high, in fact if I don't modulate how I eat and hydrate, I don't feel it. But if I get the timing just right, with the correct breakfast and everything, I can just barely manage to do the boring tasks that normally my brain will do nearly anything to distract me from.
Eventually tolerance does build, I manage that by taking weekends off and every 6 months or so, I'll take 1-2 weeks off cold turkey.
I need this shit to remotely participate in the bullshit gauntlet we call an economy. Without it, I'm essentially disenfranchised. I can get a job by channeling some hyper-focus long enough to show I'm not incompetent, but once the daily grind sets in, the rent payments don't stop.
These medicines are a by-product of the society we produced. We refuse to refine the society so we medicate the incompatibility.
I'm sure everyone's different but for me, weekdays on and weekends off seems to handle avoiding the tolerance. I don't need to be nearly as focused when I'm off work.
You’re upset that they banned the illegal drugs but not the legal ones? They probably just need more education to reach your level of logical thinking.
I'm so sick of this moralistic attitude toward psychiatric drugs. "Happy pills"? Come on. There are ways to work around tolerance. Even if there aren't, what's so terrible about a temporary improvement?
I'd wager most of us use some sort of vision correction. This does nothing to fix the underlying problem or even halt the progression, and most of the treatments leave us with a lifelong dependency on them. And yet nobody goes around derisively referring to "happy lenses" and talking about how stupid optometrists are.
There are legitimate doubts about the effectiveness of some psychiatric drugs. I don't believe ADHD drugs are among them. Regardless, that should be framed as a need for better education and dissemination of the information, better studies to determine effectiveness and better treatment regimens, and new drugs that do a better job. It should not be framed as "happy pills" with this derisive attitude just because the condition I take medication for is a brain condition rather than something like a heart condition.
> Even if there aren't, what's so terrible about a temporary improvement?
Is it temp though? ADHD is a list of symptoms with no verdict on the cause. What exactly is the plan beyond the amphetamines? A lot of people I see simultaneously want diagnosing but not curing. It's like the double think required to say not having a symptom can actually be having one. As in, "Despite what I can achieve, I still struggle, and that counts as not being able to do it at all". Why do people never mask a language delay for instance? If masking is something all AuDHD people do, why is it always faculties largely intact but they find stuff hard (harder than whatever you feel, despite not having such a great theory of mind they seem to be aware of how other minds work just fine)
