Adderall Risks: Much More Than You Wanted to Know
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I've used it to get ahead in software for the past ~8 years. I recently gave it up, but it was hard to realize that it was time. It might be time for you, too.
The thing holding me back was fear. Fear I wasn't enough, that I couldn't be efficient. That I would get fired from my high position. Or even if I could make it work, that I still wouldn't get enough done on my startup (which has its own list of fears itself).
What finally pushed me to quit was realizing I wasn't as compassionate anymore; it was impacting my relationships. I had three separate people tell me in my coworking space that I look too busy and unapproachable so they never came to chat. I had a SO tell me that I'm emotionally unavailable too often. All within the time span of a month. I'm naturally an optimistic, compassionate person. This wasn't me, and being a robot (as mentioned in the article!) wasn't who I wanted to be, at any cost.
Indeed, three days after I quit I felt like a new person. I felt silly, fun, again. I had a week of "brain fog" where I wasn't productive. Afterward my efficiency went back up. Nowhere near the Adderall levels, but to a very acceptable level.
So in summary, you might not need it anymore if it's causing you grief. Sorry for the lame motivational things I'm about to say (Taken from the book, Daring Greatly):
You are enough.
You are worthy.
To reorient myself in a way that I can concentrate on work without Adderall, I sold my TV, my VR, and my $700 graphics card. I unsubscribed from Netflix, deleted Facebook, and got rid of Twitter. I don’t listen to music as background noise, or in the car. I’ve gone on a ketogenic diet with no MSG (so no cheap meats like sausages). I try to sit without looking at my phone when I’m waiting for five or ten minutes somewhere. The whole idea was to “reset” my brain to a lower level of overall stimuli, and largely it has worked. I feel better and can work harder than I did on Adderall, because I can work in the evenings without having a total breakdown, because taking Adderall after 5pm was always a disaster, I wouldn’t be able to sleep and I’d have really weird thoughts as I went to sleep.
I’m really glad I did all this as it made me realize what’s really important in my life, family and to a smaller extent friends, and the time with them is much more meaningful now. I can actually concentrate on what someone is saying to me. Maybe moreso, I actually care.
I can believe that the drugs can help some people get over some psychological hurdles that are keeping them from delivering a piece of work, but I'm really not sure why the work itself would end up any better than if it was done while sober. Given that a big effect of apmhetamines is to make you stay up all night, for weeks on end, in other words causing sleep deprivation, I find it very likely that the end result is in fact much worse than the baseline.
Personally, the only magic drug that I've found really helps me do better and more is getting enough sleep and doing so regularly, for many weeks. Even if it means having fewer waking hours for work during the day, it doesn't matter, because I can pull twice the work (and twice the quality of it) when I'm well-rested than I do when I'm tired and haven't been sleeping well.
So, taking a drug that completely screws your sleep patterns and just makes you forget how tired you are, sounds like a recipe for destroying the quality of your work, to me. And I think those studies the article quotes, the ones that haven't found any cognitive enhancement from Aderall (to healthy individuals and ADHD sufferers alike) are basically justifying my hunch.
A few years ago I quite adderall/dexedrine at a startup, it lowered my productivity as I rushed with caffeine and other things to fill the void, and within a month I was fired as I had become useless.
Adderall changed my personality well before I discovered coding. I discovered coding because it suited my adderall addiction, not the other way around. In fact, almost as a maladaptive trait, I changed my whole career path towards coding away from politics precisely because I realized how well suited this new line of work would be for my addiction: Only in coding could I continue with my dysfunctional adderall-addicted personality, get paid well for it, and paradoxically be seen as a functioning member of society.
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But now I'm stuck. I want to quit adderall but I know I can't do it without at least a month of not working.
Every vacation comes around, and I promise myself I'll make another attempt at quitting but back out, but fear prevents me from doing it.
The longest I ever quit successfully was for a few months while traveling around the world. I experienced the best romance I've ever had in my life, because without my personality being blunted by the effects of adderall, I could be my charming emotional self again.
That all faded when the trip ended, when I needed to become productive again and faced the disaster of not being able to perform.
And that, my friends, is what makes Adderall addiction so uniquely fucked up.
Unlike heroin, alcohol, or benzodiazepines, our economy currently rewards and even encourages us to continue our addiction to this drug.
I've been off the stuff for about 4 years, and I don't miss it at all. I'm actually a much better programmer without it - I don't get sucked into unimportant details, I have a more realistic sense of what I can and can't accomplish, and I'm more creative. More to the point, I have a life outside of a little bottle of pills now.
I got off of it after talking to some people who'd also gotten off - this helped alleviate my fears that I would have to give up my sweet programming career, and re-framed the problem as a matter of underused and atrophied motivation and willpower. It wasn't easy, but with a lot of love and support I managed to quit for good.
Hit me up if you want to talk - jonathan dot j dot mason, gmail.
I've also run into the same problem you described, of running out of adderall due to more and more tolerance. In desperation it even led me once to get some darknet speed pills off the internet, containing what I later found out to be meth... all due to a lack of available prescription alternatives. (I quickly learned methamphetamine is a completely different animal -- far more addictive, dangerously euphoric, and seriously neurotoxic. I learned to never do that again.).
I'm now experiencing my first health wake up call, which I'm convinced is linked to adderall use: just in the last few months, while using my iPhone I started to notice a very slight shaking in my fingers. Turns out: I have a family history of essential tremors and Parkinsons (caused by accumulated damage to dopamine receptors)... with ALS as a possible risk factor. That's right: A L fucking S.
And I'm only in my late 20's.
Terrifying. The illusion of my own invincibility has been shattered. For the first time in my life, it's abundantly clear that my problem with adderall is no longer just psychological: it's physical. That if I don't make changes soon... things could start going downhill for me -- fast.
I may take you up on that offer when I can muster up the courage. Thank you.
Please do - it's always a pleasure to help someone out of a bad situation that I've been in. And remember, fear is a prison without walls - you just have to make a decision to walk through that fear, and you're free.
Have you considered taking a personal leave to kick your habit? I mean, don’t take a vacation, but take a leave from your job and then quit the drug while instead working on personal projects and trying to remain productive. You will slump at first, but if you like what you are working on, you’ll probably pick up again after a few weeks.
I know not everyone can afford to do that, but it’s the best solution I could think of. Good luck!
I'm in Germany and I've been diagnosed with ADHD-PI lately (I am in my 30s) after seeing a private specialist about this topic. In addition to that DSM test and 3 other questionnaires, they ran a computer test measuring my ability to concentrate which was repeated after a couple of weeks on medication. The test results were very conclusive and I think that is the strongest diagnosis criteria that I have as it's actually measurable.
It was actually really hard for me to find a doctor to actually diagnose me. I called several doctors and it was either "we're not taking any more patients because diagnosis takes too long" or "we can't tell you if we can diagnose it, you can't make an appointment here, so come in but you might have to wait half a day". Not to mention that by the time you get to your doctor, un-medicated, you will forget to tell about half of your symptoms.
This is actually a major problem. I was diagnosed with ADD as a child but gave up the medication in my late teens because it had side-effects I didn't enjoy.
Late last year, I thought it might be worth trying it again, maybe with a milder dose. I booked an appointment with a doctor, who referred me to a psychiatrist. The psychiatrist told me there was a two week waiting period and that they'd call me back in a few weeks, and never did. It was two months before I remembered to follow it up.
I don't bore you with the rest of the details, but the short version is every medical professional I spoke to (and I spoke to about 5 during this saga) told me to wait and that they would organize something for me, and then didn't. Turns out if you lie to someone with ADD and leave the organization ball in their court like that, they'll never get treatment, because they struggle with the very thing you're asking them to do. It's pretty much the worst thing you can do for them.
Anyway, I've just realized I was planning to talk to the doctor about it again 4 months ago to try to get the ball rolling again. It's Christmas now, they won't be back at work until mid January. I'd better send myself an email, wish me luck.
Thanks for the advice, but surprisingly I have actually tried just not having ADD. This simple advice doesn't work very well for me, which is why I'm attempting to pursue medication again. The calendar entry goes off, I try to contact the doctor, maybe they're not in today, it's half way through the work day, I go to set another, I spot an email while I'm doing it and start following up on that, and then 4 months later it never happened.
I'm not suggesting that "try not having ADD", just suggesting you use mechanisms to remind you to do stuff that are persistent and thus work.
No offense, but from what you're saying, it's pretty clear you don't understand how ADHD works. ADHD is a disorder that affects executive function; the whole problem is that the system you're describing will fail for someone with even moderate but untreated ADHD, let alone more severe cases.
Maybe you don't mean it this way, but it's actually rather insulting to say that these mechanisms "are persistent and thus work", or that OP try a to-do list because "it's constantly staring at you until you actually complete it". ADHD means that you can't assume that those systems work, and it means that "constantly starting at you until you complete it" isn't actually a viable solution.
Hence, that's why OP read your post as "try not having ADD", because you're literally suggesting solutions that presume that they not have ADHD in the first place.
To be fair, the article does make the point pretty strongly that it is very hard to separate ADHD from natural variations of attention, concentration etc:
But “ability to concentrate” is a normally distributed trait, like IQ. We draw a
line at some point on the far left of the bell curve and tell the people on the far
side that they’ve “got” “the disease” of “ADHD”. This isn’t just me saying this.
It’s the neurostructural literature, the the genetics literature, a bunch of other
studies, and the the Consensus Conference On ADHD. This doesn’t mean ADHD is “just
laziness” or “isn’t biological” – of course it’s biological! Height is biological!
But that doesn’t mean the world is divided into two natural categories of “healthy
people” and “people who have Height Deficiency Syndrome“. Attention is the same
way. Some people really do have poor concentration, they suffer a lot from it, and
it’s not their fault. They just don’t form a discrete population.
In fact, if you think about it, such interventions are designed exactly to help people with poor executive function, as you say. Assuming that this is basically a description of what ADHD is, I don't see why behavioural interventions can't make a dent in it.
https://www.youtube.com/watch?v=lbMv0UkAswI&feature=youtu.be...
For people with ADHD, its a distraction that's willfully ignored while you're trying to complete one of the other hundred things on your to-do list that are also screaming for attention, most of them in more-urgent-but-less-important ways that this attempt to schedule an appointment with yet another provider who's likely going to make you prove once again that your life is falling apart by jumping through your life story and maybe trying some alternative that makes you ill, cranky, and introduces some sexual dysfunction that gives you one more thing to worry about alongside the thoughts of whatdoigetdonethisweekpleasejustletmecrossoffonethingtoday that you wake up to each morning.
> severe procrastination or complete lack of willpower
This sounds an awful lot like the attribution of a moral failing to people that suffer from an issue with executive function as it pertains to attention. This might be why people keep telling you that you are clearly articulating an inability to empathize. Imagine a mindset in which your fundamental assumptions, which seem self-evident to you, do not apply. If it seems difficult to understand why anybody would want to live that way, congratulations, you've got something in common! Nobody else wants to live that way either—the difference is that we don't have much of a choice, which is why we all have such strong opinions about this topic.
Rational? Far from it. Functional? Nope.
That's why it's a disease but we have medication to treat it.
It's like trying to tell someone that walking is easy, just put one foot in front of the other - to someone with no legs. Unfortunately it's harder to see missing legs for mental diseases.
In any case they certainly won't have anything like the kind of improvements people with ADHD has, improving from spectacularly bad to (usually) only slightly below normal.
It's a common mistake made by both professionals and laypeople that ADHD is a condition with only slight deficiencies in focus, when in reality they are often staggering.
Anecdotally, everyone with ADHD I've met understand the concept of things being so boring it becomes physically painful to do them. Everyone else think they heard me wrong.
For me the computerised test was almost impossible at the end, because my bored brain refused to even see the images on the screen. All I saw unless I blinked and tilted my head was a white, blank screen, only that it wasn't blank.
With methyl phenidate it was hard to understand it could have ever been hard, and that even though I still have significantly below average concentration even with medication.
Your anecdote has helped solidify this belief. 8/10 Adderall users I know are able to concentrate and complete complex, intricate tasks without the pills. The pills just put them in jet-speed mode.
It sounds like you truly have ADHD and are benefitting from proper medication. I wish nothing but the best for you.
However, I also wish the doctors would remove their heads from their ass and attempt to find a better method of diagnosis.
During my friend’s 3rd year of study at University, he realized many of his classmates were taking Adderall. Not only that, but those students had less trouble completing the crushing work load on time. So, he visited the local pill dispensing psychiatrist and walked out with his very own prescription.
Now we’re here, several years later, and he’s convinced that he really does have ADHD because the doctor keeps renewing his prescription. He chooses to forget that he initially got the prescription by regurgitating bullet points out of the DSM.
This is just one example. I’ve seen it countless times.
Is it really just me that thinks having oodles of young adults taking amphetamines daily is OK? I just can’t seem to wrap my head around it.
People below the 5th percentile in ability to concentrate, as measured by this test.
My health insurance made me take a CPT test and it indicated that I don't have ADHD. This means that they refuse to diagnose me despite that I have ALL of the inattentive symptoms. I did a lot of research on ADHD after that. Those tests have a 40-50% false negative rate. Luckily I am changing insurance next year. I already made an appointment with another doctor who is an expert in adult ADHD.
I don't know false positive rates off-hand, but they are properly much higher. Pretty much any mental or psychical illness causes inattention. There is no reliable test for ADHD. ADHD is not primarily about inability to concentrate, but executive function.
Instead, we use the DSM, which advises us to diagnose people with ADHD if they say they have at least five symptoms from a list.
This not true.
1. You need to have them "often" (approx. 5th percentile in the population)
2. You need to have them since childhood.
3. They may not be better explained by other disorders.
4. Need to have significant impairment in work, school or personal life.
Those criteria are based on decades of scientific research. They are the best way to diagnose ADHD. There has been promising research in computer tests, genetic tests and brain imaging, but none of those are reliable. A good doctor should spend significant time talking to the patient. Ideally they should also talk to other people who know them and review documents such as grade cards from school.
2. This is no longer considered true; see any of the recent research on adult ADHD.
The last two are obviously good ideas, but they don't really winnow down the pool very much.
1. There are normed rating scales. I assume OP was also tested on one when s/he filled out those additional forms. If I recall correctly they use the 5th percentile.
2. DSM-5 still requires symptom onset before the age of 12. As far as I know some researchers advocate raising the age limit further into adolescence, but don't want to get rid of it.
So they fake the symptoms, and get those advantages. That's what's refreshing about this posted article; it points out how ridiculous continuing this whole charade is.
Adderall is just becoming the new coffee.
Had a conversation with my doctor about my symptoms and how I feel and concluded that yes, I pretty obviously have ADHD and that it might be the cause of my depression. Went to a second doc for a second opinion as well and he also concluded ADHD. So yeah, I was a little shocked but as someone else said "I suddenly felt like my life story made sense". A lot of the problems that I attributed to my personality felt explained. I talked to older classmates as well and even they said that yes, looking back it was pretty obvious that I have ADHD.
He directly prescribed me a test batch of Atomoxetine (strattera) for trying. At this point I still didn't think I actually had it but went with it anyway.
The side effects were nuts for a couple days but I pulled through. Because of the slow onset it's very hard to actually 'see' a difference but oh man, it feels like life became a lot more manageable: Less arguing in my head, less impulsive behavior, I can keep habits like going to the gym up without getting bored, less of a fight to start a task and so on.
Atomoxetine allows me to be myself, minus a few of the ADHD quirks. I still have attention issues, or am jumpy and hyper, but it is less than before and more manageable by me.
I am worried that once I go to a different country I will have exactly what you described: That I will be in a long queue waiting for my turn, or that clinics are just full and reject me. My current advantage is that I speak Japanese and that ADHD here is still a kind-of new field. Not many Japanese adults go to get diagnosed, so the Japanese docs are free while the English clinics are booked out months in advance.
For example I have a stellar reading ability but my written work and spelling is awful.
The two things that really stick out for me are the existential implications of taking a pill that rewires your brain, and the inevitable intersection of that with one's career choices.
I think the compelling question is why people feel so compelled to take a pill to sell their souls to a rat race? Seems like an almost Huxleyan Prisoner's Dilemma to me.
Things like not being able to watch a movie, or even play some video games without missing huge parts of the story, or sitting through a conversation with a group of friends trying to constantly "catch up" to a topic that I missed a few minutes ago, or trying to be self aware enough to not change the subject on people too quickly because my mind has already changed topics twice during their conversation.
I love reading, and it's almost 100% out of the question when I'm not taking my medication. Somewhere around the 5th time of re-reading a paragraph trying to remember where I trailed off only to realize that I just did it again makes it really not a great experience.
Even the worst case scenario of the medication severely increasing my chance of heart attack, stroke, or Parkinson's wouldn't make me stop taking it, because it's given me a life. And I would rather live a shorter happier more fulfilling life than a potentially longer one.
I still remember the first day I took the medication, it was like somebody finally turned off a white noise machine in my brain and I could finally do all the things I've wanted to do.
I texted my wife after my first dose that I heard someone having a conversation near me and that I could hear them, but I didn't know what they were saying and I didn't care.
This was a revelation for me.
I recently chatted with a shrink who said that ADD patients typically _can_ focus on the things they want to do but struggle with the things they don't want to do. I strongly suspect he's mistaken - I don't know a soul who finds it easy to focus on filing their taxes (except sadistic accountant-type friends).
Nothing is more frustrating than having all the "motivation" and desire and curiosity for a task but none of the "ability" to make it happen.
I think people just want to be their best selves. They want to accomplish their goals and they use tools to accomplish those goals. I mean everyone carries a cell phone and I feel like those modify your life and thinking patterns a lot more than taking adderall does.
Cell phones: Possibility to carry a calendar - with alarm.
Stimulants: Lowers the threshold for "interesting" so you don't fall asleep/have to do "something"/etc. (Yep, multiple alternatives exist here.)
This seems pejorative. The reason why many take "a pill" isn't to sell their soul, it's to do the work they want to do but are otherwise incapable of doing. You may consider this work that they want to do to be "rat race" work, but that's just your judgment of their desires.
There seems to be an implicit assumption in your question that refers to adults. What about the growing number of people, diagnosed and treated as children or young adults before they really have an agency in the matter?
Some U.S. based statistics on diagnoses for different <18 year old groups: https://www.cdc.gov/ncbddd/adhd/data.html http://www.wnd.com/2013/04/radical-increase-in-kids-prescrib... https://www.cdc.gov/nchs/slaits/nsch.htm
When I’m not on medication, I have a lot of short term memory loss and sudden changes in train of thought. The impact of this was that I would sometimes “wake up” and have no recollection of how I got to where I currently was, I continuously lost everything, and had trouble with math word problems that were described over long paragraphs.
My parents actually originally went to the doctor because of the stress caused by always losing things.
Maybe the sadness effect would have gotten less with continuing the medicine, but overall, I didn't feel like taking drugs since they cause a lot of other side effects like insomnia.
Now I've been able to control my ADHD successfully. Atleast upto the point that it has stopped affecting my life and career so much.
a) 0 sugar in diet. Not even fruits. b) Try to sleep for atleast 8-9 hours a day. c) Drink lots of water throughout the day d) Exercise and no junk food. e) Have got an accountable job. Leading a software team so I know that procrastination will hurt me in the long run, so forced to do stuff on time.
However, even in low doses Adderall and Ritalin can cause psychosis in a small fraction of people. Is that what happened to you?
Ritalin made me angry, scared, and flat out unwilling to do work (although perhaps it would have helped the concentration had I decided I actually wanted to anything).
I hope adverse reactions to one of many possibly-effective medications don't deter patients from getting the help they need.
Even for milk, I drink raw milk and not processed milk.
> I drink raw milk
You'd have to drink milk in tiny quantities; I'd be astonished if raw vs processed makes a difference if so.
Lactose in milk is a type of sugar.
edit: I see you replied below this. No added sugar but still no fruit.
But still I'd say you're missing out on the benefits of fiber in fruit. The sugar in fruit wouldn't concern me it's offset by the vitamins, minerals and fiber.
Also, what are the supposed benefits exactly? Can you link to scientific studies validating them?
Of course, fruits are more tasty.
The two main side effects I had from Adderall were appetite suppression (which has the bonus side effect of intermitent fasting) and hyper focus. With hyper focus I could work like a machine for 14-16 hours, and would have to remind myself to stop and eat, but I couldn’t turn it off. When it came time to socialize I was still chewing away at my work. I was not present. To break myself from the work loop I would usually have to watch TV or go drinking with friends. The problem with the later is that you start to wake up with the dreads quite frequently, increasing your anxiety level. It also tires you out. I rarely (1-2/month) take Adderall now and when I do I take 5mg (down from 3x 20mg what I was originally prescribed for). Ritalin was a different story. Where Adderall was smooth and almost unnoticeable Ritalin would give you a rush, with effects lasting about four hours. I could take Adderall for my most boating early morning class and sitting in the front row I was excited as seeing a talk by novel prize winners. The problem with Ritalin was the anxiety and crash at the end of the day.
Prescribing stimulants to people with ADHD seems artificial. In most cases the risks are low and unless there’s abuse or the potential for abuse I think people should have the right to decide for themeselves what they want to take and how they want to live.
You mention getting prescribed in college, as a adult. How would you feel if you had been prescribed as a kid?
To me, growing up regularly taking amphetamines seems like it could twist your head pretty badly. Seems very irresponsible to be giving drugs to kids.
(I get the pressure to do it if the kid can't behave or focus and you think that's fucking up their life, but honestly, having gone through school, the fault is much more likely to lie with the school & what we expect of kids than the kids themselves...)
I live in Europe so you can forget about amphetamines/adderall basically, only thing you'll get here is Ritalin and even that not as easy as you might think. Modafinil is easy to get on the internet though. If I lived in the US, I would likely be on Adderall I'd guess.
It helped me so much that I wouldn't have completed studies and got my current job if I wasn't on it. I know, because I still remember the struggles I've had before (and over time learned that I am not alone, that many, many people suffer from ADHD-PI or ADHD-like symptoms and all think it's just them...).
Also, fuck everyone trying to tell people that "eat better, sleep more and do sports" will fix ADHD-PI. You should totally do all of these if you aren't already, but it's not fixing shit. Medication works.
I'm glad you are able to be happy on modafinil, but think about what you just commented: (1) alternatives are hard to get, (2) you have to get your substitution from the Internet without a prescription, (3) once you are on the gear you are able to notice the same deficiency in others, (4) you attribute your success to it and (5) "fuck everyone" trying to speak people into drug-free alternatives.
I haven't been to med school, but I can imagine this being a slide they would put into an example profile to stray people from prescribing Adderall et al.
It's actually really annoying being told that you don't need drugs to fix your condition when, based on your own experience, you really do
I often it found it quite stimulating in an amphetamine-like way even though it's a wakefulness agent.
This is completely wrong. It treats the symptoms of those of us with severe ADHD, and let's us do everyday things like sit in a theater or an airplane, or enjoy playing quietly with our little children.
It's not just about being an office drone spending 12 hours a day in Excel or some cynical bullshit like that, it's about every day life.
Further down you say:
> the tone of the paragraph is that it's not really medication, but something like caffeine which you can give to everyone and it'll have the same effect. It doesn't work like that.
It does work like that. You can give it to everyone, and (assuming the recipient has a good response, no side effects, etc.) it'll have the same effect. That effect might be "worth" more to people who are already at the low end of the bell curve, but it's the same effect.
> It's not just about being an office drone spending 12 hours a day in Excel or some cynical bullshit like that, it's about every day life.
Spending many hours in a row at a desk working on tasks that require extreme focus is my every day life, and the life of most of the people on this site I'd wager.
Where are you going with this? You're replying to an article that said "it helps everyone", and you're trying to say that some people aren't as worthy of help? Is that really where you want to go with this?
> Adderall doesn’t “cure” the “disease” of ADHD, at least not in the same way penicillin cures syphilis. Adderall will give everyone better concentration, and we’ve judged that it’s okay for people with terrible concentration to use it to overcome their handicap, but not okay for people with already-fine concentration to use it to become superhuman.
Apparently, that is actually true (not the same magnitude of effect but the same kind of effect - better concentration). And it's not in any way contradictory to it also being a medication.
> The dose I take would make a non-ADHD person into an obsessive hyper-focused teeth-grinding mess, but it basically just makes me normal.
That is almost exactly what the quote above said.
> Adderall is real medicine which cures a real problem.
I honestly don't understand how you got the impression that the original article claimed otherwise.
I believe you, but couldn't you equally say "The dose of human growth hormone I take would turn a non-Chronic-Shortness-Syndrome person into a freakish giant, but it basically just makes me normal"?
Adderall has a lot of utility for regular people, it works exactly like caffeine. Eventually all that dopamine from the amphetamines is going to ruin all your receptors, hth.
Being condescending, especially towards people with a disorder, doesn't serve anything.
Worse, people with disorders have to deal with this stuff all the time from other people. <To someone they know has depression, in front of the circle of friends> "Hey Peter, haven't seen you in a few weeks. Were you being sad again? ;D"
It makes me cringe a bit to see that behavior here.
The symptoms are definitely the sort of thing everyone can identify with to some extent. But I think the key detail in the definition of ADHD is that it’s a “disorder”. In other words, these symptoms are normally distributed but if the combination of them occurs often and causes distress to the patient and/or other people, then it’s real. Two people with exactly the same symptoms but different life situations or jobs such that one experiences distress and the other none should be diagnosed differently. Not everything can or should be reduced to objective ratings.
I’d also like to echo the observation that the restrictions and hurdles involved in getting an ADHD diagnosis and in acquiring stimulant medication for ADHD are seemingly designed to vex the ADHD sufferer far more than a neurotypical individual. I used to have to, once a month, call my doctors office to ask for a new prescription, then physically go there to pick it up, physically deliver it to the pharmacy, and then physically pick up the medication when it was available. Which isn’t always right away since Adderall is so commonly prescribed (and because my health insurance has an insane restriction that only covers the brand name—but that’s a different story). That’s three or four steps not required for the vast majority of medication that are each easy for an ADHD sufferer to forget, put off, or otherwise screw up. Laws have changed where I live recently so that I only have to deal with the doctors office once every three months but the physical delivery is still a requirement. Thankfully I live near the doctors office and have a flexible job. Most people aren’t so lucky.
So ironically it’s far easier for folks without ADHD to deal with getting Adderall than it is for those of us with the disorder. C’est la vie!
Edit: I also wanted to mention that I’ve found that I’m actually much more agreeable and less irritable when I’m on Adderall than not. My family has witnessed the difference and told me as much, and I feel it too. Whether that’s a direct effect of the stimulant or a secondary effect of the behavioral changes it engenders I don’t know but it’s worth noting that the potential personality changes aren’t all negative.
Adderall and the like are not magic pills that make the most important work/tasks get done first and effectively.
I went to a particularly expensive Silicon Valley psychiatrist who did of course immediately put me on Adderall, but also put me on NAC supplements to "avoid tolerance". It's been okay, they're cheap, never bothered not taking them to experiment. I can confirm feeling better after eating foods with magnesium, mostly because they're good for you.
BTW, if you're on amphetamine+guanfacine you need to avoid all of caffeine, sugar, and alcohol. What a bummer.
Your talking about things I’ve never heard of before, this does sound advanced. Any other things on your stack?
> Any other things on your stack?
Like nootropics? Popular internet topic but a little goes a long way. Here's what I know:
- Vitamin D 1k-5k IU, fish oil, theanine: These all work great and everyone should try them.
- Magnesium: Too many different supplement formulations to trust one, and I read they give you copper deficiency - just eat spinach and you're good. Actually zinc is better to supplement, especially for men.
- Nootropic stacks like Qualia: Tried some, but pretty sure they're expensive caffeine pills.
- Every other nootropic: Bacopa helps long-term but makes ADHD worse short-term(!). No effect from anything else.
> Your talking about things I’ve never heard of before, this does sound advanced. Any other things on your stack?
The original article mentioned how society has determined it is "not okay for people with already-fine concentration to use it to become superhuman".
The way you talk about this, though. Being impressed about someone's "advanced stack" of drugs to maximize their potential. I get the impression you're using it to become superhuman.
I'm not sure if I am the only one with this reaction, but I feel like your attitude is kinda offensive and disgusting. How much money have you made by abusing drugs in our rat race?
Yeah, I am kinda disgusted myself, but I am right on the cusp, and I am grasping at it. That last sprint. I’ve locked in 99.5%-tile wealth, but the next month to six will determine if I can get into 99.9%-tile, where the true game change is.
And I’m under no illusion, if I don’t bag this deal here for the 99.9%-tile (private aviation, super yacht and models) I’ll forever be stuck at 99.5%-tile (first class commercial, upper middle class lifestyle forever without having to work).
Just a little more... broke my way many times... just need this last bit...
Given the papers clearly state that some of these risks/issues are only appreciable for the amphetamine variants (and some only appreciable for the non-amphetamine drugs), this is, imho, a disservice.
There is a single anecdote about atomoxetine. The quote has nothing to do with the drug's action. The point of the anecdote is the researchers' attitude toward the behaviour of young children, in the context of debating their approach to judging side-effects. That is certainly relevant context: the paper in question is also looking at side-effects for amphetamine variants. Strange approaches to behaviour classification likely apply across all the trials involved.
Your original comment was that this is confusing. I think it's very clear. I am not left with the impression that results for atomoxetine are being conflated with results for amphetamine variants.
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https://www.reddit.com/r/Nootropics/comments/7n2qjz/adderall...
He cited the infamous squirrel monkey study without noting that (a) there were no signs of neural death or neurite retraction anywhere, and (b) reduced baseline dopamine levels are exactly what you would expect as part of the mechanism of tolerance.
That study did not establish the existence of neurotoxicity. It merely established the existence of tolerance.
I was diagnosed with ADHD when I was about 12. I never had an issue focusing in school. I never had any challenges completing my school work and would always complete it before everyone else. I would then get bored and fidget. It got to the point where it was a distraction to others and was brought to my parents' attention. I was then diagnosed with ADHD. I was never given any formal treatment, instead placed in a Gifted program with more intensive work.
I have been running my own businesses and consulting pretty much since I graduated high school. I am now 25. Things were going pretty good, except for one thing, deadlines. I struggled actually focusing and completing work. It got to the point where I could be working in my office for 12 hours straight and not actually get anything done.
The other major part of it is how it affects my relationships, especially with my SO. We can be holding a conversation and I can completely zone out for minutes at a time and not have any clue what she said because I was in my own head thinking. It is stressful because it gives the impression that I don't care what she is saying, but in reality I have limited to no control over it. This is common from others I speak with who have ADHD.
I have tried every management system in the book. None of it helped. I eventually tried Modafinil (I see a few people mentioned it here). I ultimately stopped taking it because I didn't like how it made me feel (restlessness and appetite loss) and I didn't get immense boosts to concentration.
I eventually decided that I may want to try Adderall. My doctor was suggesting that I may want to try something for over a year, but I resisted. In my mind Adderall was prescription meth and would "rot my brain". I would be come addicted and it would ruin my life.
But things just kept getting worse. My business keeps growing, and so are my responsibilities and deadlines, but I was really struggling to keep up. Finally, I decided to open my mind to taking something like Adderall.
After discussing it with my Doctor he alleviated most of my concerns. Ritalin and subsequently Adderall have been prescribed for almost 70 years and he has been prescribing them for decades without seeing "brain rot", withdraw, or anything like that long-term. After more research and discussing it with colleagues I decided to take it. Here are my thoughts and observations 2 months in.
* It's not addictive. I take it 1-2x a day when working, and not on weekends. I skipped 5 days of doses over Christmas without feeling the need to take it.
* Tolerance. You will get a euphoric effect the first 1-2x you take it, then you don't anymore. You still get the concentration benefits and that doesn't wear off over time - according to my doctor. I don't feel the need to increase dosages.
* It has a propensity for abuse. Basically people taking it to stay up for days at a time to study for exams... I can see where people would have the urge to do so, though I do not.
* It helps me concentrate. While it's not a magic solution to all of my problems, it makes it easier for me to be able to work and continue working for a long period of time. My productivity the past to months have been more than I ever have in the past 5 years.
* It lowers your appetite. I feel like I perpetually ate 30 minutes ago. I need to consciously decide to eat, which I do. * It gives me dry mouth. This is annoying, no matter how much I drink.
* It can affect sleep. To counteract this I take mine when I first wake up, then at 12pm I take either a full dose, half dose, or nothing depending on my day.
TLDR: It has helped me improve the quality of my life with no real negative effects. If Adderall continues to do so, I will continue to take it.
I'd love to have some effective nootropics for improved focus, cognition. Mostly to mitigate aging, grogginess from the chemo, and so forth.
I don't find the sports analogy very compelling. We watch sports for the competition and the idea that the results are a combination of genetics+work. Hence taking PEDs is cheating in a sports context.
But if there's a medication that helps you live your life better (i.e. in a way that's more fulfilling to you) and if taking the medication doesn't impact anyone else negatively, why would you not want it taken as widely as possible?
The important thing is to let would-be medication-takers know with full honesty what the side-effects are - this is what the article focuses on most.
> The human brain wasn’t built for accounting or software engineering. A few lucky people can do these things ten hours a day, every day, with a smile. The rest of us start fidgeting and checking our cell phone somewhere around the thirty minute mark. I work near the financial district of a big city, so every day a new Senior Regional Manipulator Of Tiny Numbers comes in and tells me that his brain must be broken because he can’t sit still and manipulate tiny numbers as much as he wants. How come this is so hard for him, when all of his colleagues can work so diligently?
> (it’s because his colleagues are all on Adderall already – but telling him that will just make things worse)
> He goes on to give me his story about how he’s at risk of getting fired from his Senior Regional Manipulator Of Tiny Numbers position, and at this rate he’s never going to get the promotion to Vice President Of Staring At Giant Spreadsheets, so do I think I can give him some Adderall to help him through?
I don't see the problem with the analogy.
You may have have a bad work environment where you feel like the only goal of your work is to one-up your co-workers. But your boss is not paying you and your co-workers to compete for sport. The reason you are getting a paycheck is because you are giving someone something they value. That person would be happier if they could get it for less money by putting you out of the job. But if that happens, that doesn't mean you should be unemployed - it means you could be helping society in a different way. In a well-functioning labor market, every worker will be more prosperous if they all produce more.
I found using some strains help the ability to switch to a new task and focus for a longer period of time. The problem is the next hour after the body needs additional rest.
Ritalin (and Vyvanse) makes me feel angry and crazy. I've not heard of Focalin, but I may look into it. I've been on varying doses of Adderall for 10+ years and I find it immensely helpful.
Other nutritional remedies can be found in "Prescription for Nutritional Healing" by Balch.
The adderall certainly helped me to focus, but the side effects were awful and I stopped taking it regularly. I’ve since been diagnosed with depression and started on sertraline (an SSRI), and very soon after noticed an improvement to my attention, ambition, and ability to complete tasks.
It’s not surprising, I guess, but near-constant thoughts of worthlessness/desire to die can make it quite difficult to focus on tasks and generally function.
Vyvanse is a prodrug. That means it metabolizes into the d-enantiomer of amphetamine, whereas Adderall contains a 75-25 mixture of the d- and l-enantiomers. (Enantiomers are like left- and right-handed gloves: they have the same chemical structure, but one is the mirror image of the other. Usually two enantiomers will have similar but slightly different effects; occasionally, they can have incredibly different effects - see thalidomide for an example).
So, without further study, it's hard to know, but it's likely that Vyvanse has a similar long-term profile to Adderall, because the active ingredient (lisdexamfetamine) metabolizes into the active ingredient that makes up about 75% of Adderall.
But, it's possible that the effects described are caused by the l-enantiomer, in which case they won't apply to Vyvanse. It's also possible that lisdexamfetamine itself has its own set of effects which may either cancel out or exacerbate the effects reported by Adderall.
To give you an idea of how prodrugs can have different effects from the drug that they metabolize into: Vyvanse does have a rather nasty feedback loop for some people, because amphetamines suppress the appetite, but lisdexamfetamine is metabolized into the active ingredient using the digestive cycle[0]. For some people, this can cause a really wonky extended release cycle, where they have no appetite mid-day (due to the drug) and can't eat enough to metabolize enough dextroamphetamine to get them through the afternoon, resulting in an afternoon crash. After this wears off and they develop an appetite again (around dinnertime), they'll eat, and then the dosage that was supposed to kick in after lunch finally kicks in after dinner, causing issues sleeping.
[0] This is intentional, and it's why Vyvanse is marketed as an "abuse-resistant" alternative to Adderall, because it's theoretically harder to extract an acute dosage from it.
Vyvanse is intended to be equivalent to Adderall XR, not IR, so the effects are intended to be spread out in both. If you're comparing to IR, you're no longer really comparing apples to apples anyway.
Been doing to off and on for a decade. Never had any addiction issues, no withdrawal sypmptoms when I skip taking them, and still seems as an effective as usual when i do.
I avoid the whole psychiatrist scam and get them from a real doctor.
>I don’t think there are good data here, but my intuitions and personal experience is that “addiction” of the sort you get with heroin or tobacco is very rare, at least when responsible people without a personal or family history of addictive behavior take stimulants as prescribed. Most people agree the risk is lower for extended-release stimulants (eg Adderall XR), and very low for Vyvanse.
I think that statement is bonkers.
Of course they are going to be addicted to the substance if they use it everyday of their lives.
My definition of addiction is not being able to stop taking the drug for whatever reason, and feeling some sort of withdrawal. I think for most people that take something daily, it would be extremely hard for them to stop.
This is where things get messed up: being chemically addicted to something where the cost of the drug can be astronomical .Yes, I am talking about Shire's Vyvanse.
>Shire Plc is a Jersey-registered, Irish-headquartered global specialty biopharmaceutical company... its brands and products include Vyvanse, Lialda, and Adderall XR.
The best is that they offer a program the temporarily reduces the price of the drug for a period of time aka you get addicted to it over that time period and then are forced to pay it becuase their is nothing like it until 2023.
Yes, I am aware that each state has different insurance options, but starting a company called "Shire Cares" just to spread the belief that they care but really do not is silly.
From their website: "Pay no more than $30 for up to 12 prescriptions up to a maximum savings of $60 per prescription.† (https://www.shireregistration.com/vyvanse%20savings%20link)"
What they do not tell you is after that period ends, the price goes up drastically. With insurance, 30 pills costs "around $286.42 (https://www.goodrx.com/vyvanse)
The last thing I will say is: Where is the data on a drug that annually generates billions of dollars each year? They have 10 million users. You are telling me they could not monitor the habits of 1-2k people over a couple years? Sounds fishy to me.
For others who want to learn more about the crazy growth of add/adhd medication sales that very few want to talk about. (http://www.nytimes.com/2013/12/15/health/the-selling-of-atte...)
If you don't have insurance, then contact Shire's affordance help or use one of those prescription assistance companies that handles it for you. I don't have insurance and I pay $35/mo to a company that got Shire to give me a free voucher for my 3-month prescription.
Just wanted to point that out to others.
Also, it's ridiculous that things like GoodRX and 3rd party assistance programs are viable business models.
That said, when I meet other people taking these meds, their doctor frequently has started them out on heroic doses. Like 80mg XR + 2x IR tablets a day to bump. Absolutely insane. And I reckon those people have a harder time quitting, especially psychological. The difference between an unmedicated and medicated day is just so extreme.
I've certainly met many people in uni who just can't control themselves with stimulants and quickly find themselves spiraling down the toilet bowl, and those are people I always worry about. Like the person who can't just take one, instead eating them over a 3-day spurt of zero sleep.
With insurance, my prescription is $50 / 30. I typically don't take it on weekends in order to limit tolerance, which further reduces the ongoing costs.
ADHD is one of the most well researched mental conditions. It is real and will cause significant impairment if untreated. Stimulants are the most effective medication in many but not all cases. Comments like that are harmful.
However, I agree with you that an ADHD diagnosis should not be given lightly.
How could such a condition be so frequent yet only present in just one country?
...it's often a sign you've missed some basic facts and need to rethink your priors. And so it is here.