Dopamine signals when a fear can be forgotten

Indeed, I was surprised both at the fact that it literally makes me feel better because the drug makes you feel good but also that it calmed my brain down and let me access some inner peace. But also the focus modification is big and I learned so many good habits that now I need much less of it to get stuff done. I wake up and start doing my chores before I even have my first dose!

When you see headlines (or hear podcasters) talk about dopamine and other neurotransmitters, remember that neurotransmitters are merely signaling molecules.

The correct way to interpret this study is that dopamine is part of the signaling chain involved in fear extinction. The specific details of where, how, and when that dopamine moves through the brain are important.

The wrong way to interpret these studies is to think of dopamine as a "level" within the brain that goes up and down. Resist the urge to assume that taking a dopamine-modulating drug will result in this specific outcome.

Dopamine response within the brain is very complicated and region dependent. When encoding aversive stimuli (things you learn to avoid) there is evidence that dopamine signaling decreases in some brain areas while it increases in others: https://www.sciencedirect.com/science/article/pii/S235215462... That's just the tip of the iceberg. Don't fall for the trap of thinking that dopamine does just one or two things in the brain.

The best place to help you cope with continuing an addiction, but not the best place to get rid of an addiction.

If you want to get rid of an addiction, stay away from addicts and everything they produce. Stay away from their artistic creations, stay away from their complicated explanations of the world, and stay away from their gossip. Also, please don't study to become any kind of "drug counselor," get regular person jobs and normal hobbies. You're dying of romance, and you need to figure out how to love the world as it is.

> The problem with amphetamine is you pay for every benefit: focus now, lethargy later; energy now, anhedonia later.

> But taking a small, consistent dose. Does that work? Do you feel you net benefits in life from taking the drug, discounting for withdrawal and/or tolerance?

There's a reason these medications are supposed to be taken regularly at the same dose in clinical practice. Patients should not be going through cycles of taking stimulants and then withdrawing all of the time.

There's a disconnect between the way some people try to use stimulants ad-hoc versus the therapeutic modality. The initial burst of confidence, energy, and positive mood that comes from intermittent use is a side effect, but people confuse it with a primary effect. They can get into cycles of chasing it with dose escalations or taking it on random days while they exist below baseline on others. This isn't a winnable battle over time because the brain will adapt, not to mention all of those off-days start to add up and people around them notice the extremely inconsistent mood and performance.

Unfortunately, misinformation about ADHD is all over the internet. I recommend ignoring basically anything that comes out of Reddit, Twitter, or TikTok because it's really that bad. Take medications as directed and set yourself up for some stability. Resist the urge to play with doses, take excess doses on some days, or try to play tolerance games. These never work in the long term.

There's a simple heuristic: When you reach stability, you shouldn't really feel the medication. It should be background noise. There's a reason why young people who have been properly titrated on stimulant medications don't understand what the big deal is with their peers taking large doses (without tolerance) and then speeding around for a while. It's where the myth about ADHD people reacting differently to stimulants comes from. Proper treatment will settle to equilibrium and shouldn't produce overt feelings of being drugged or hyperfocused.

Like saying a loud noise can cause an avalanche