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Comment by engx | Hacker News Reader

Why do people on meth enjoy cleaning? There is little difference between meth and Adderall. Taking any type of stimulant even coffee helps people do menial tasks and be more optimistic while doing them.

Maybe millions of people are effected by some problem of distraction and lack of focus. But to suggest there's some biochemical reason for this that's cured by amphetamines seems like pseudoscience to me.

Drugs do work. If you want to take amphetamines to improve your work performance, go for it. But to suggest that it's a disease seems disingenuous.

There's something like 16 million Americans who take Adderall, which has drastically increased in used (300%+ from 2008-2012). Another poll said 35% of college students had said they'd tried Adderall.

The science of ADHD is ambiguous. The science of moderate uses of amphetamine or methamphetamines for improving work performance is easier to understand.

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Imagine this: you're an adult professional, sitting at your desk looking at a freelance work assignment that needs to be done by tomorrow, weeping with frustration because you've been staring at it for eight solid hours, trying and trying to begin, and you can't because focusing on anything important is like trying to grip a handful of water.

Because you ran out of your meds.

This is what my life is like. If that doesn't sound like a medical condition to you, then I don't know what you're thinking. If you think I haven't tried everything else imaginable to deal with it, you're mistaken. The only thing that works is amphetamines. There's definitely downsides, and if someone showed me a better solution I'd love to try it. But, so far, there isn't one.

Maybe some people take the meds who don't really need them. That's a shame. You don't get to sacrifice my career just to keep some people from getting high.

three things:

1. You do not enjoy your work, and thus have no motivation.

2. Maybe you should not do the work and suffer the consequences.

3. You have built a mental dependency that you must take amphetamines to "focus", and this hinders your real ability to focus.

All of those things ^^^ I have experienced at one point or another in my life. You can focus, you have to make yourself. There is no other way. You do not need medication... But maybe you do, I highly doubt it though.

> Maybe you should not do the work and suffer the consequences.

I've done that. A lot. It sucks. That's why I take medication.

> You can focus, you have to make yourself. There is no other way. You do not need medication...

I don't understand why people can't quite believe that mental illness is real. You would never tell a diabetic or an asthmatic that they shouldn't have to take medicine every day. But if someone's clinically depressed, or has ADD, or any of a hundred other mental conditions, people just assume you're imagining things or being lazy.

It is hereditary too. I've seen how in past generations, children with these kind of conditions were just labeled as trouble makers and got no help and eventually failed out the system.

Just simple understanding and acceptance that this is a condition, medication or not, makes a huge difference. And yet here we are still arguing it.

I have struggled with ADHD for my entire life. I don't think you realize how it can affect you.

I started to take medication after nearly failing out of college. It was physically impossible for me to study for more than 40 minutes; I would fall asleep no matter where I was. It was not a matter of motivation or dedication. I was hitting a physical barrier that I could get around any other way.

I agree that there is over-diagnosis is a problem, but especially as a person who came around to medication as a last resort, it is very offensive to say that I don't need it. I avoided it for years, but within a few months I was able to use all of the strategies I had learned, coupled with the meds, to seriously turn my life around. I went from academic probation (GPA in the 2.2 range) to top of my classes with about 15 mg of adderall a day. I've tried placebos, I've tried therapy, but I would not be able to do the work I do today without drugs.

Have you ever thought about your body and mind were not designed to do things that need constant focus?

Look, I understand you may not understand what it is like having ADHD, but your post came off incredibly dismissive. Telling a person with ADHD to "just focus" can be like telling a person in a wheelchair to "go for a run": it is incredibly frustrating to hear and can be nearly impossible. This may be a hard concept for you to get your head around, but this is a real problem for some people and medication is a real(and often necessary) solution to a real problem.

I agree that there are people who will benefit from the use of prescription medications to treat different life issues. I too suffer from hours of staring at work, unable to start or finish. I don't think I have a learning disability or a disease that needs treatment. But I think there are many alternatives to help people who cannot start and finish work tasks.

I can usually find a quiet and productive work environment free from distractions. I can usually adjust my caffeine intake levels. I can usually adjust the amount of personally stress in my life. I can usually adjust the amount of sleep. I can usually break up my work into small enough chunks to get started. I can block certain computer activities which are distracting.

Yes everybody is different. No, we should not throw out the baby with the bathwater. Yes, we should be exploring alternative treatments besides powerful amphetamines which can cause addiction and health issues. I don't believe having a problem justifies all the cost that go along with treatment. Sometimes the solution is worse than the problem.

I don't want to have to do drugs at work to keep my career from those who want to take a pill and work for 12 hours a day.

"Sometimes the solution is worse than the problem."

For someone without the condition, perhaps.

My entire life I've tried to work with managing techniques, such as those you suggest, and a hundred others, none of which made a blind bit of difference. Caffiene does not seem to affect me in the same way as it does most people btw. So I've spent a good part of my career trying to find roles and bosses more suited to my scatty ways - often far from easy - once I realised I was a little unusually wired.

The biggest problem ADD has is that everyone gets distracted, struggles to focus sometimes, so the majority of people exatrapolate that out and presume there's nothing wrong. Then go on to suggest 5 things that help them with their occasional distractions. That's like telling a wheelchair user to just walk. "Well have you tried walking differently?" "Tried a stick?" I spent 50 years trying to just walk and I still can't. My first week on meds however, when I was told I'd probably wouldn't yet notice a difference, was indescribable. Truly I don't have the words. I almost dropped into depression realising I could have been like this my whole life. "Is this what other people have all the time?". I could have achieved so much!

That I achieved some measure of success with the condition, compared to how my mind could have worked surprises and disappoints in equal measure - what might I have achieved?

For many actually with the condition it's highly debilitating. They can't not be distracted. Ever. Often they're being distracted from being distracted from... IT IS NOT "oh look, shiny" on facebook. For some powerful amphetamines will be the best solution of those yet available (in very low doses compared to dietary or recreational uses). You don't get any of the same effects as you would taking amphetamines at a party. It's a neurological imbalance, so a neurological treatment will often be fitting.

Course I probably shouldn't think of it as a learning disability and just adjust the amoutn of tea I drink and look at some ideas for people who cannot start and finish work tasks.

I don't want over diagnosis, or easy diagnosis of very young children, and ideally want some more tools in the box I can choose from.

Why do you assume that I'm not already using all of the techniques you described, in conjunction with the meds? Why do you assume that you know what's going on inside my head better than I do?

I'm not being rhetorical, I honestly would like to know. It's a huge problem that so many people refuse to believe that mental illness exists, not just for me and not just for ADD. You wouldn't say to someone with chronic fatigue syndrome "Yes, nobody likes to get up for work, but you just have to suck it up and deal with it." You wouldn't tell a diabetic that they shouldn't have to take shots just to get through the day. What makes you feel qualified to do that to me?

> Yes, we should be exploring alternative treatments besides powerful amphetamines which can cause addiction and health issues.

Absolutely we should! I would love to find a non-stimulant treatment that works for me. I regularly do research and ask my doctor to see if there are any new treatments available. Until they come up with one that works, I'm going to keep doing what I need to do to get by.

Also, I'd love to see a source on "addiction and health issues," because Ritalin and the other common ADD meds are not addictive, and have no long-term side effects for the large majority of patients, at clinical doses.

> I don't want to have to do drugs at work to keep my career from those who want to take a pill and work for 12 hours a day.

This is a strawman. That has never happened to you; your career is not under threat from drug abusers. My career will absolutely crash out immediately if I stop taking my meds, I've tried it before. What you're doing is no different than medical marijuana prohibition: you'd sooner let patients suffer than run the risk that someone might get high.

Imagine this: you're an adult professional, writhing in pain and occasionally vomiting, weeping in frustration while laying in bed not able to get out.

Because you ran out of heroin.

That is what my life was like. If that doesn't sound like a medical condition to you, then I don't know what you're thinking.

This medical condition is called withdrawal.

You are right in that discontinuing ADHD medication can lead to withdrawal symptoms.

But you are dead wrong in that ADHD does not disappear after withdrawal. As it would if it were a drug addiction.

ADHD was there before taking medication, and it will persist long after stopping medication. (If we assume the diagnosis was correct.)

It can indeed cause withdrawal symptoms but not so bad since psychiatrists suggest "treatment holidays", where you are free to choose not to take them for a few weeks.

Other psychiatric medications are often withdrawn slowly. For example, a patient on weekend leave in hospital would be called straight back to the ward if they lose their prescribed benzodiazepines e.g smashing a bottle of solution, due to withdrawal. Especially the case if used during alcoholism detox, where the seizures could kill otherwise.

Many of the symptoms also do not go away with medication. It's not a magic bullet. It just raises the floor a little bit so things are easier to manage. Some days the medication doesn't help all that much if other things off set it.

I just realized that my post was extremely easy to misread :/ I hope it's fixed now.

I think mine was too since I was agreeing with you, ADHD is most definitely not a symptom of stimulant withdrawal.

Were you writhing, vomiting and weeping before you ever took a hit of heroin? Did you continue writhing, vomiting, and weeping for months after quitting with no reduction?

No?

Sounds more like detox.

I'm regular drug addict and know the feeling.

In this case its called rebound effects.

When you have a medical condition that you treat with medication, a shocking consequence of discontinuing treatment is a return of that medical conditions symptoms.

On the bright side, people don't call you a slacker anymore. Now your just a drug addict.

You're correct.

I have had experienced something similar with Xanax. The symptoms returned but worse than ever and I was certain that taking loads of it is absolutely necessary. Once you are able to go off, the symptoms go back to normal. Anxiety doesn't appear, but Xanax only makes it worse. It is same story with stimulants.

"Detox" doesn't start before you ever take the drug, and continue long after you stop. Might as well say that diabetes is just insulin detox.

16 million Americans seems to correlate fairly well with the medical consensus that around 5% of adults have some degree of ADHD. Perhaps it's not as widely over-diagnosed as sometimes claimed?

" But to suggest there's some biochemical reason for this that's cured by amphetamines seems like pseudoscience to me."

A pseudo science that very strongly runs in families.

A pseudo science that's strongly linked with dopamine transmission.

A pseudo science that has some medical evidence pointing to it being an under development of the frontal lobes.

I suggest you google the field a little.

okay well lets delve into the science here:

http://www.ncbi.nlm.nih.gov/pubmed/27489770 "Quantifying patterns of brain activity: Distinguishing unaffected siblings from participants with ADHD and healthy individuals."

http://www.ncbi.nlm.nih.gov/pubmed/27471442 "Neural Biomarkers for Dyslexia, ADHD, and ADD in the Auditory Cortex of Children."

http://www.ncbi.nlm.nih.gov/pubmed/27422412 "Network Structure among Brain Systems in Adult ADHD is Uniquely Modified by Stimulant Administration."

as you can see there is no ambiguity that ADHD is a biochemical and neural network-grounded disorder backed by a galaxy of studies. the sad fact is that stimulants don't work for up to 20% of people with ADHD, dooming them to dysfunction.

and yes, the pharmas are greedy, and promote overdiagnosis. and yes, modern life promotes ADHD-like symptoms-- but the whole point of ADHD is that it's a priori relative to life experience.

> There is little difference between meth and Adderall.

I posit that you don't yet know enough about neuropharmacology to have beneficial opinions on this topic.

There is little difference between water and hydrogen peroxide.

I think you are being a bit dismissive of what is a widely accepted mental disability[1][2][3][4][5]. If you want to spout some nonsense about how you feel about the field, that's fine, but note that you are falling into the same category of people that don't believe in climate change because winter was "pretty cold". It just so turns out that the world is not all about you, and while it may be difficult to understand that this may be a real issue for some people, you shouldn't say that this is a substance abuse problem. To say that is at the very least ignorant.

[1]: http://psycnet.apa.org/journals/bul/121/1/65/ [2]: http://www.sciencedirect.com/science/article/pii/S0890856709... [3]: http://www.mednet.org.uy/~spu/wp/WPA_2_2003.pdf#page=42 [4]: http://psycnet.apa.org/psycinfo/2000-00431-006 [5]: http://www.sciencedirect.com/science/article/pii/S0387760406...

> But to suggest that it's a disease seems disingenuous.

That allows (at least) two things: pressuring insurance companies to pay for treatment, and pressuring students to undergo treatment.

This is FUD.

ADHD is well researched, and well understood by those who study it. The problem is that people think ADHD is just an issue of self discipline or attentiveness. It is not. It is a serious disorder with serious effects that are unambiguous. No doubt there are stimulant seeking people who claim to have ADHD to get stimulants, and people without ADHD representing that they have ADHD may lead to the impression that the disorder is ambiguous when it isn't. Also if someone has ADHD for long periods of time they may have co-mobidity with other disorders such as depression, etc. and this also may muddy perceptions.

ADHD is not strictly an attention issue. It's named for attention because that is an early and obvious symptom but it is much worse then that. Calling the disorder an attention deficit disorder has turned out to be very bad as it leads people to the wrong mental model of the disorder. Thinking that it's just laziness on the part of the patent or the patents parents, in the case of children. This is a tragically misguided perception, based in ignorance and the poor choice of names.

In actuality ADHD is a developmental disorder that is a more general impairment of executive function that includes regulation of emotion, working memory and the internal perception of time and other effects in addition to inattentiveness. This impairment is due to abnormal dopamine transport that can be clearly observed in MRI studies.

These studies have been repeated many times in many contexts, with various controls, and been thoroughly confirmed.

Also, you are wrong about Adderall. There is a significant difference between meth and Adderall. Stimulants are by for the best understood, most tested, longest used, and lowest risk medications in psychotherapy. Only a few stimulants show clinical improvement in the function of people with ADHD, and the improvement can be profound. Caffeine for example does not show these clinical improvements.

So basically you know jack shit about this topic, and therefore should keep quite, just like any other medical condition you know nothing about. It actually causes harm by interfering with the dissemination of reliable information in the study and treatment of a very serious disorder.

For better (read: actual) information start here:

Here: https://youtu.be/GR1IZJXc6d8

Or for a more complete talk:

Here: https://youtu.be/SCAGc-rkIfo

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