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ADHD drug treatment and risk of negative events and outcomes

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Re: ADHD drug treatment and risk of negative events and outcomes

#301

Post by alexrp »

thelaxiankey wrote: post #187
alexrp wrote: post #156

Earlier quoted context omitted.

> The question I pose to the “it’s a disease, medicate it” crowd is; is the person maladapted or is the culture maladaptive? Overwhelmingly the former in my case. I'll have projects that I desperately want to work on for weeks or months, but just can't bring myself to actually get started on without the extra push from Vyvanse. It would be nice if society could be just a bit more accommodating for people with ADHD, b…

the thing about being human is you internalize cultural values as your own. if you lived in a society that valued, i dunno, tracking and hunting down giraffes in small groups, would you have the same struggles? what if just participating in society required ~20 hours of athletic activity a week? i'm not entirely convinced you would have this problem, based on the anthropology i've read. the signal of a maladaptive cu…

My desire to work on said projects is intrinsic; no one around me expects me to do so. In fact, quite a few of my projects add no value to broader society and exist only because I found doing them interesting. I don't imagine the surrounding culture valuing the hunting of giraffes would particularly affect this one way or the other. (Except if said culture doesn't have computers, I guess.)

> personally, this has been a very helpful reframing. If I simply can't bring myself to do something, that means not that I am bad and my willpower is bad, it just means that something is materially wrong and I should consider addressing it by doing things that my body will let me do.

To be clear, I don't think I'm "bad" or that I have a moral failing just because I can't bring myself to do some things. (If anything, that sounds like an internalization of some unfortunate cultural norms...) In my case, it's a contradiction: I want to do a thing for intrinsic reasons, but I can't bring myself to do the thing due to insufficient motivation/focus (for lack of a better term). It can be maddening at times.

But if we take a more typical example that many ADHD people struggle with like, say, doing the dishes or cleaning the house... I guess I don't really understand what might be "materially wrong" here, or how doing something else addresses whatever that is or, more to the point, actually gets those chores done...? This sounds a bit hand-wavy to me.

Re: ADHD drug treatment and risk of negative events and outcomes

#302

Post by onoesworkacct »

matheusmoreira wrote: post #223
Nikolas0 wrote: post #168

My $0.02 as a response to several comments I read in this thread: I was diagnosed with ADHD in my 40s and got Concerta. My belief is that ADHD is not a disease, nor a disability (even though it acts like one very frequently) and in fact there is evidence that ADHD is an important part of our evolution as a species. The problem(s) mostly relies with the modern way of life and what is expected from the society at large…

Completely agree. People with ADHD are simply incompatible with many facets of mormal life. Take school for example. If someone doesn't fit into the mass education model, they say they have attention deficit. That same person might then go home and hyperfocus on computer programming for 12 hours straight like a machine. It makes no sense. The mass education model where hundreds of people sit on a chair listening to l…

ADHD isn't a personality quirk and also, it is fundamentally a disorder of regulation not attention. The education system (for all its drawbacks and inflexibility) works for most because they're able to regulate the urge to get up and climb random shit when they can't figure out how to start writing the answer to Q1 on the worksheet..

I also think its cope to take a disorder where a specific part of the brain tasked with very specific functions is physically less dense and performs than other people and go "ADHD isnt real he's just quirky!1"

Re: ADHD drug treatment and risk of negative events and outcomes

#303

Post by timcambrant »

cruffle_duffle wrote: post #221
TrackerFF wrote: post #99

I'm on Ritalin - which works for me. Where I'm from (Norway), getting a diagnosis is no walk in the park. Very extensive process, if you're adult. At least the doctors I've seen, have all been very precautious in prescribing anything other than the basics. If Ritalin doesn't work for you, they'll obviously try something other...but my doctor told be straight up that it is a red flag when some patients will ask specif…

Urg, short acting Ritalin is the absolute worst. There are so much better stimulant meds out there.

Would you care to give any examples?

Re: ADHD drug treatment and risk of negative events and outcomes

#304

Post by Llamamoe »

Nikolas0 wrote: post #168

My $0.02 as a response to several comments I read in this thread: I was diagnosed with ADHD in my 40s and got Concerta. My belief is that ADHD is not a disease, nor a disability (even though it acts like one very frequently) and in fact there is evidence that ADHD is an important part of our evolution as a species. The problem(s) mostly relies with the modern way of life and what is expected from the society at large…

This is a common belief people have, especially those with mild ADHD or those who wish to be dismissive of the disorder.

Unfortunately, in reality while there are some very limited advantages, as a whole ADHD is a whole-brain dysfunction where your neurons are literally incapable of maintaining their level of operation as long as in a healthy person, with ALL of your executive functions - all self-regulation, planning, delaying gratification, emotion management, etc - being impaired across the board, not just tuned differently.

Hyperfocus is commonly brought up, but neurotypical people experience it as well. Less often, but also without the compulsive loss of control, while being able to maintain a higher level of effort and work without it at all times.

People also like to claim we'd be better as lookouts or sentries but this isn't true. People with ADHD don't pay more attention to a broader range of things, they're just incapable of focusing it when necessary, not to mention they drift off and get distracted instead of staying watchful far, far more.

That's before getting into the fact that ADHD correlates negatively with pretty much every single life outcome, not just those depending on society - things like neurodegenerative disease, cardiovascular and metabolic problems, sleep disturbance, etc.

I understand the desire to frame things you're experiencing in a positive manner, but... in this case, it doesn't really work, and I somewhat resent it personally, as it makes people less likely to take ADHD as seriously as it needs to be.

Re: ADHD drug treatment and risk of negative events and outcomes

#305

Post by Llamamoe »

homefree wrote: post #133

My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) and ADHD is kind of a weakly differentiated diagnosis that could apply to most people. Probably something like this was lost when people stopped smoking, obviously beneficial for health - but a huge amount of the public was taking stimulants regularly via nicotine until relatively recently.

> and ADHD is kind of a weakly differentiated diagnosis that could apply to most people.

It's not, the problem is that it sounds like it because ~everyone faces some (way) lesser version of the struggles ADHD people face literally every day, many of whom probably do have some subclinical degree of executive dysfunction.

My personal thumb rule is that somebody is capable of finishing school, autonomously managing their living conditions, finding and keeping a job, and having at least a modicum of social life at the same time, they're high-functioning enough that they almost definitely don't have ADHD, or only some ultra-light version of it.

Re: ADHD drug treatment and risk of negative events and outcomes

#306

Post by Llamamoe »

TrackerFF wrote: post #99

I'm on Ritalin - which works for me. Where I'm from (Norway), getting a diagnosis is no walk in the park. Very extensive process, if you're adult. At least the doctors I've seen, have all been very precautious in prescribing anything other than the basics. If Ritalin doesn't work for you, they'll obviously try something other...but my doctor told be straight up that it is a red flag when some patients will ask specif…

> is a red flag when some patients will ask specifically for Adderall, as the potential for misuse is much higher. And for him, it was a last resort.

This is so stupid. It's so much better of a medication, the potential for addiction and abuse at therapeutic doses is minimal to none, and yet healthcare systems around the globe are continuing to avoid prescribing it. Ugh.

Re: ADHD drug treatment and risk of negative events and outcomes

#307

Post by 99_00 »

mandevil wrote: post #185
mithametacs wrote: post #101

Earlier quoted context omitted.

I literally did the thing you’re not supposed to do. my psych kept giving me everything by Adderall. So I went to one of those online doctors and got Adderall through her. Then I just told my psychiatrist that I have Adderall prescription and she took it over. For the record, she’s actually really reasonable and I like her but very conservative about the stimulants. Which when I finally got them were a revelation. Me…

The DEA put Adderall on its list of the most abused medication, and limits production of it and investigates doctors who prescribe too much of it. This is a response to the problems with the abuse of legal opiates a decade ago- the DEA now takes potential abuse of legal drugs much more seriously and adderall (an amphetamine- it's a cousin of meth) is at a high risk of abuse. Your psychiatrist is trying to deal with t…

All abuse is bad. Some abuses are worse than others.

What abuse are they seeing with adderall? What I hear in casual conversations is that people are abusing it to learn things. Is that what the DEA was seeing too?

Re: ADHD drug treatment and risk of negative events and outcomes

#308

Post by LtdJorge »

DrewADesign wrote: post #204
gms7777 wrote: post #88

Earlier quoted context omitted.

I think especially as adults (esp. people that managed to get to adulthood without being diagnosed), a lot of people think they don't have certain symptoms, when really they just have developed elaborate systems for managing those symptoms. I never related to "time blindness" because I was always consistently early for things, but really I was just deeply anxious about being on time for things. I would set like 10 al…

Yeah time blindness is my arch nemesis… but it has led to some pretty serious grit and persistence for difficult things under pressure. You need me to start on an arduous, long, difficult task right this second? No problem. You need me to do something on February 23rd 2027 at 4:30am in Anchorage Alaska? Should be fine as long as I’m still using the same calendaring system then. You need me to chip away at a backgroun…

Fck, you just described me.

Re: ADHD drug treatment and risk of negative events and outcomes

#309

Post by claudex »

bawolff wrote: post #300
unmole wrote: post #285

Earlier quoted context omitted.

- Supply chains - Skilled workforce - Risk capital - Regulatory overhead

Other drugs are made outside the USA, what is so special about adderal (besides us regulations which other countries dont have to listen to)

Maybe it's just that the cost to set up the production elsewhere is too much for the expected market. The shortage of the drugs doesn't mean there will be enough buyer to cover the cost (and make enough profit).

Re: ADHD drug treatment and risk of negative events and outcomes

#310

Post by flir »

klipklop wrote: post #77

The irony about getting treatment for ADHD is that medical providers make it very hard to get the proper medication and treatment. People with ADHD are horrible at following through and handle rejection poorly. So the worse the ADHD is, the less likely somebody will be able to actually get treatment for it. A lot of people suffer because doctors fear losing their license like so many did during the pain pill debacle.…

> People with ADHD are horrible at following through and handle rejection poorly

The form my GP gave me (after telling me I probably wasn't) sat in my car for six months, untouched. Went private. No regrets.

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