Ask HN: Should I medicate my ADHD?

> SOME of them are.

Yes, it's true that not all of them are. But the first line treatment is pretty much always a stimulant, and non-stimulant pharmacotherapies for ADHD tend to not be as successful.

The main class of drugs considered to be non-stimulant treatments for ADHD, NSRIs, will actually have a somewhat stimulant effect owing to their primary usage being that of an antidepressant.

In rare cases you may even prescribe a depressor, but that's something you very rarely want to do-- every case is different and these drugs may work for some patients, but generally speaking it's a niche treatment approach with a very unfavourable risk-benefit ratio.

I'd recommend talking to a GOOD physician (a neurologist or a psychiatrist) - as a neurodiverse individual - I'm autistic, have ADHD, and have a few IQ points of being considered gifted - my doctor and therapist both told me that it was probably due to attention deficit) who has accomplished much without medication or awareness of these disorders (and giftedness). The tricky thing about being neurodiverse is that it is something ingrained into your brain - you don't know how it is to live without it - maybe you unconsciously masked some of the things.

A few things that are usually comorbidities of ADHD are mental health problems (such as anxiety or depression) and eating disorders (binge eating, anorexia, bulimia) - that you may have, and meds can help you with that (or not). A good doctor can give you the pros and cons. ADHDs also have more propensity for addiction (alcohol, drugs, gambling, pornography, etc) - so being aware of that can decrease the risk. Also, ADHDers can have low self-esteem (which is something that psychotherapy can help you overcome).

Despite being expensive (a few thousand dollars), one thing that could be a good idea is a neuropsychological evaluation that can give you more awareness (and data!) about your brain.

Medications should be part (and they can help a lot!) and not the whole of your therapeutic process: a psychotherapist specializing in cognitive-behavioral therapy (usually called CBT) can help you immensely. I also invested in occupational therapy (I'm a bit clumsy, and my handwriting could be better) and speech therapy to help transform and present my ideas into words - speaking with a doctor could be a good idea to help.

You certainly have a different history: my advice is to discuss it with your doctor and find the best tools (therapy, medications, adaptations to your work environment, etc) to overcome these challenges. Some medications can also have side effects - and a doctor must evaluate if - my doctor asked me for an electrocardiogram before recommending a medication)

A sound effect that medication had on me was that it helped me to overcome binge eating, and I felt less tired at the end of a workday (probably my brain was using a lot of energy to make me focus more on meetings).

Personally my favourite is a thread here:

https://x.com/uberstuber/status/1736489420466110843?s=46

It probably deserves a HN post of its own!

Simple decision tree on neurodivergence and medication. If your life is miserable and you are barely functioning, then medicate. If you are thriving then approach it carefully and make smaller adjustments.

To follow up, one of the convenient things about ADHD medication (stimulants) is that taking them is akin to flipping a light switch. On or off, there isn't an interim period where you're waiting for the medication to build up in your system in order to see an effect, nor do you need to taper off of it like you do some other types of medications. So if you try something and find you don't like the effects or it doesn't do what you want it to do for you, you can simply stop right there and go back to the way you were doing things before.