Adults with ADHD show decreased function in brain dopamine reward pathway (2010)
ncbi.nlm.nih.gov
ncbi.nlm.nih.gov
That's how fast I lost focus. But on the other hand sometimes I can be extra-focused, with a prerequisite it's something I enjoyed -- where I truly focus on one single task nonstop, like I finally got the ebb and flow in a tranced out state. This resulted me in one case coding straight for 7 hours. It's not until my body started to crave for food or I don't know how long will this loose cannon shoot.
ADD is both a blessing and a curse to me. This is how I accquired coding and various IT skills since 13, all self-taught. But this also fucked me over exams, and my so life experience is greatly impacted. I also tried to play rhythm games to control focus, only to see it ultimately failed. The only thing I had to deal with it slightly is my Ritalin...only so slightly I can "normally" focus for an hour. I just hope things go right in the rest of my life.
Talk to your doctor, there have been many advances in ADHD meds and they all work differently on different people. Some people respond well to Ritalin, Some respond well to the generic. Some respond well the Adderal, or Vyvanse. For some people only the name brand formulation works. Some people any formulation works. Also, make sure you are at the right dosage. You can and do build up a tolerance over time. I try to take weekends off when I don't have anything in particular I need to do, and at least one or two weeks a year (normally when I go on vacation).
respectfully, I disagree with this. The last new therapy was atomoxetine, which is almost 20 years old now and not seen as terribly efficacious.
Everything else new has been some variation on mixed dextroamphetamine/amphetamine salts or methylphenidate. Vyvanse is just a pro-drug for dextroamphetamine.
The only novel thing in the pipeline is SPN-812, which may work similar to atomoxetine.
It’s definitely a relatively new development and a much more humanely effective drug than previous options.
— It is dextroamphetamine, which I’m inclined to believe is the more useful handedness. Levoamphetamine has more “body” effects. To the dextroamphetamine is bound a lysine molecule, and this together is an inactive powder. Enzymes in red blood cells are needed to cleave the lysine off and activate the dextroamphetamine. I’m quite certain that the dopamine rate-of-change detection mechanisms in the central nervous system cause very different behavioral and cognitive pattern cascades when it’s an almost imperceptively slow change, compared to an unhindered uptake of free amphetamine. Compare the difference in addiction potentials between faster and slower routes of administration of, say, nicotine - smoking fast, patches slow.
I'm not sure how much truth there is to this claim. As you mentioned, Lisdexamfetamine is just Dextroamphetamine bound to the amino acid, l-Lysine.
Once your stomach cleaves the l-Lysine, it yields free-floating D-Amp.
This mechanism of action isn't any different than most formulations of extended-release Dextroamphetamine, like Dexedrine ER spansules.
Additionally, Adderall and other standard mixed-isomer amphetamine salt formulations are a 75/25 mix of D-Amp/L-Amp, and the peripheral nervous system stimulation that L-Amp produces at that kind of dose (5mg for a 20mg pill) I would think to most wouldn't feel very noticeable at all.
Having gone through Adderall IR, Adderall ER, Vyvanse, and Dexedrine IR over the years, to me they all felt more or less the same (besides IR vs ER).
If for whatever reason Vyvanse happens to work better for some people, that's fantastic and more power to you, but the hype behind this is all marketing IMO. And, it's absurdly expensive without insurance.
It was the difference between $250/mo and $20/mo using Good Rx between generic Adderall/Dexedrine and Vyvanse.
This is incorrect. – With all due respect!
The action is enzymatic, and the enzyme is in red blood cells. It is slow. This is not the same as other “mechanical” time-release mechanisms. https://en.m.wikipedia.org/wiki/Lisdexamfetamine
Smoking, shooting, or squirting it up your ass won't do the trick. But injecting it would put it in direct contact with red blood cells, and so would rectal administration via absorption through rectal mucosa.
Lisdexamfetamine needs to pass through the GI tract where there's proper enzymatic activity.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805701/
"The environment in the rectum is considered relatively constant and stable and has low enzymatic activity in comparison to other sections of the gastrointestinal tract. In addition, drugs can partially bypass the liver following systemic absorption, which reduces the hepatic first-pass effect."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898170/
"Oral absorption of LDX was assessed in rat portal and jugular blood, and perfusion of LDX into isolated intestinal segments of anesthetized rats was used to assess regional absorption. .... LDX and d-amphetamine were detected in blood following perfusion of the rat small intestine but not the colon"
"The intact prodrug, LDX, was readily absorbed from the GI tract after oral administration, with relatively high levels of LDX detected in the portal blood of rats. When LDX was perfused into isolated segments of rat duodenum, jejunum, and ileum, it was absorbed into the systemic circulation; however, LDX was not absorbed during perfusion into colonic segments. These findings indicate that absorption of LDX occurs via carrier-mediated transport in the small intestines and are consistent with the physicochemical properties of LDX (ie, high aqueous solubility of greater than 0.85 g/mL within the physiologically relevant pH range of 1 to 812 and low lipophilicity [logP–1.75, unpublished data]), which would predict poor passive diffusion across biologic membranes"
But hey, here I am arguing on my weekend about why exactly putting a certain amphetamine prodrug up your ass won't work. What are we doing with our lives?
LDX was not metabolized in vitro by SGF, SIF, or trypsin, [so] any conversion of LDX to d-amphetamine in the GI tract in vivo is likely to be minimal. [...,] consistent with a model of absorption of predominantly intact LDX with subsequent enzymatic conversion to active d-amphetamine and l-lysine.
LDX was metabolized to d-amphetamine in rat and human whole blood but not in plasma. [Red blood cells] are responsible for the presystemic conversion of LDX to d-amphetamine.
LDX was metabolized to d-amphetamine by human RBCs but not by other blood fractions, such as white blood cells or platelets. Moreover, RBCs had a very high capacity for the metabolism of LDX. The rate of metabolism was not substantially reduced until concentrations of RBCs were reduced to 10% of normal hematocrit. Lysis of the RBCs also had little impact on the rate of metabolism of LDX, and nor did EDTA (a calcium chelator that inhibits the activity of calcium-dependent enzymes).
In conclusion, LDX is absorbed as the intact prodrug and converted to inactive l-lysine and active d-amphetamine primarily in the blood by RBCs.
It's fascinating isn't it? :)
I find the effect to be very very different.
Here's a graph of plasma concentration of free dextroamphetamine, time release capsules, and molecular-braked lisdexamfetamine: https://farm1.staticflickr.com/727/23028958560_2ae3ddc5bd_o....
For a 2019 review of novel molecules, see [1].
[0]: https://www.nature.com/articles/s41467-017-02244-2 [1]: https://doi.org/10.1080/14737175.2019.1628640
I think it's more that it doesn't work for as many people as does stimulant medication. But while it works on fewer people, for those that it does work on (myself and my partner included), it's very effective.
I take stimulants for idiopathic hypersomnia and I know things are a bit different for ADD folks, though.
Most ADHD people are also susceptible to RSD (Rejection Sensitive Dysphoria(?)) that can make us feel like the entire planet is crumbling when we experience even minor rejections. As in, suicidal ideation level pain that at some point we have to learn how to move through or just avoid relationships altogether.
Must be personal neurochemistry/predisposition. The breaking point hit when my partner showed me a video she took where she called my name 8 times standing right next to me trying to get my attention, and I had no clue. I was so zoned into the screen.
After seeing that I was like damn.
It's not just seeming like you don't care, but also putting the burden on others when they pick up your slack and frequently letting them down by things you do and/or don't do.
I encourage you to embrace the chemical imbalance as the reason. The medications do work and withdrawing from them isn't bad either (if you decide to take a pill holiday or extended non-use).
Finally, it's not about 'normal' focus. It's about you. If you're content with your productivity and behavior, then nothing is needed to change in your life. If you want to maximize your potential, then please consider medication. It doesn't go away (CBT never worked for me). Embrace your choice. Whatever you decide, is normal, it's your normal. That's perfectly acceptable.
Perhaps for you, but for others its a nightmare.
I can only assume one of two reasons:
1. They were on XR.
2. Abuse.
If it's another reason, maybe the formulation isn't the best for them because it's highly unlikely to have a 'nightmare' problem with getting off.
True but...on a probability basis, the two situations I gave are more than the majority of people's reason.
That's all I meant by what goes up must come down :)
I'm not trying to minimize your experience. I'm just trying to provide a more accurate framework on what's more statistically likely to occur within a population. That's all. Since others tend to be ignorant of the scientific facts on how this issue distributes among a population.
Interesting contrast though: for me leetcode, certain exams, and interviews often trigger hyperfocus. Studying and assignments, as well as day-to-day work, rarely do. I take a fair bit of medication so I can do my job. I'm trying to pivot towards something which more naturally engages my interest, maybe SRE or security work.
Interesting how we're all affected differently. I recommend skimming "delivered from distraction" if you haven't already, there are some good tips in there on how ADHD folks can deliberately create the right conditions for flow.
It’s just difficult for us to fit in to the system. Not only school, but a traditional 9-5 for me is difficult. Especially while not on medication.
Turn on, tune in, drop out
It is in the context of this society as we're fairly maladapted to it and struggle with a lot basic things that cause big problems in our lives.
I'm glad that ADD/ADHD is more accepted now because I remember when the idea some people have problems focusing was immediately dismissed as laziness or a fault in character. I didn't even consider getting tested until far into adulthood because of the stigma.
I'm convinced this disorder is named after attention and hyperactivity because the children don't adapt well to school. At least not the traditional mass education model where kids sit in a class listening to lectures all day. There's probably a lot more we don't know about it. Some doctors I've seen think it's a made up illness created to sell amphetamines.
> This resulted me in one case coding straight for 7 hours.
This happened to me this weekend. It's truly scary in retrospect. I got a business idea thursday, and coded nonstop until Sunday. It's a rentable AI service for dating apps. I launched it and it's super neat imo, but I lost almost 8 lbs in that time because I didn't eat, drink water, and slept only when my thoughts started to blank out.
I am now focusing on rehabilitating by eating a lot and going to the gym. I got so skinny. I wasn't on any medication either.
Now I take medication in the morning before I get to work and it basically lasts me through the work/school day. When I was younger I was perscribed ritalin, and it just made me sleepy so I stopped taking it. Now I take a more modern medication and it works wonders. The negative stigma against medication really harmed me in school, and I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.
That aside, I _so_ agree with grandparent post about the negative stigma associated with medication for adhd. I’m so angry at society, parents, everyone for having done this to me in my early years — if only I had started earlier instead of in my mid-20s.
But with the information and experience I have, I think if you get tested by a professional psychologist and he okays it, I’d be comfortable with kids as young as 5 getting medicated.
5mg of dexedrine at 8am gets me til 5-6pm and no crash afterwards.
I can focus on my work all day with no medication if I'm doing something that I find personally interesting. However, when I have a week's worth of online coursework and boring bookkeeping to do it's impossible to get more than 5 minutes done without staring out the window, putting something on in the background, and twiddling my thumbs. I can still buckle down and get work done without it, but it's so much more mentally draining to do a week of work without any medication than if I were just to take what the doctor recommends. YMMV obviously, I just wanted to suggest something for people like me who have been 'proudly' living with ADHD un-medicated.
How do you know that other people have it harder? My suspicion is that we all suffer in quiet desperation.
In case you're still confused, there's this thing called the DSM that people use to diagnose/classify mental disorders. It's a pretty big deal.
I've had panic attacks this year, I had depression years ago, went to therapy a lot better on that front. Enter: Xoloft followed by Trintellix (1 week in). I dealt w/ them pretty well, I'd go lay down, breathe and maybe take a cat nap, wake up in 30 minutes go back to work feeling like a million dollars. Now, not so much.
So, I started xoloft a month ago, it screwed up me libido and made me continually 'want it' but not able to 'deliver' (or it'd take way too long). Switched to Trintellix, still have panic attacks, sex is better, but anxiety doesn't seem affected. Now, I feel I'm actually more depressed though, and just not wanting to get out of bed. Motivation is rough.
I'm also taking Vyvanse for ADHD. It doesn't seem to be as effective as it was before adding anxiety meds.
Should I just scrap the anxiety meds altogether and just deal with adhd? Anyone else w/ similar experience want to chime in? It's really messing me up, and I've recently lost my main client so I really need to focus and get some income (web dev/laravel), or I'm gonna be homeless (40 w/ wife and 2 kids - so not an option).
Honestly my best advice is that, if you aren't having a good experience with your psychologist/psychiatrist you should find a better one. I've been lucky enough to be with a therapist who worked well for me as a teenager that I recently started seeing again for my anxiety. He recommends me to a local outpatient psychiatry department for my ADHD meds so I don't have to switch, but I don't know how much use the meds would be if I wasn't able to talk to him regularly.
Biology is complex, the drugs mess with that system in direct and indirect ways. Coupled with lag and resistance, it makes accounting for outcomes hard.
ADHD is interesting in that to me, our interaction and methods of coping with it need to be participatory. The drugs don't work on their own, we need to still make lists, walk around, exercise, crack jokes. Just realizing you have it pushes it off the mainline to a branch.
I'd say slow down, do some science and take great notes.
First, I will echo what the other poster said - work with your doctor. Everyone is different and reacts differently to medication.
I can only speak from personal experience, but be very careful with Vyvanse. In the beginning, the effects were wonderful. Increased motivation, focus, etc. however, after about a year the effects began to wear off and my dosage was titrated really high (120 mg per day). Even at that dosage, I could barely get out of bed sometimes. I also began having panic attacks and severe paranoia. As another poster described, when it wore off, I had some of the most sad periods to where I’d sit there and cry for no reason. It was like staring up a deep dark well with little to no light.
I had life stuff going on, so reactions weren't completely unwarranted, but they were unnecessarily amplified. I’m not a doctor, but I felt like covers up depression and kicks the can down the road. Sometimes it gives people the motivation to change their circumstances, thus improving their depression. But, in many cases, it drives people to chase the high in order to keep staving off the lows. I don’t mean the euphoric high, I mean the motivation/focus high.
Listening to your post, and please don’t take this the wrong way, but it sounds like you are chasing the high without addressing the low. If you are taking a benzodiazepine for anxiety, it may be worth trying a different medication since those can make anyone groggy (with or without stimulants).
For me, it didn’t end well and I had to stop taking Vyvanse cold turkey (whew that sucked). It took a couple of years, but life turned out so much better for me once I addressed the anxiety and depression (or in my case, bipolar depression). I also take stimulants again, without any issues.
I was taking Dextroamphetamine for ~4 years, great for ADHD symptoms, focus and energy is amazing, but terrible for libido and really raised my anxiety. I tried switching from Dex to Methylphenidate, but after one day I quit because of how it made me feel (paranoia++).
Fluctuated on-and-off the Dex for a while (i.e. taking it a few days a week), but the whip-saws in dopamine levels really hit me hard, anxiety++.
Recently switched over to Atomoxetine (brand name Strattera) which has an off-script application to treating ADHD. It has a much more subtle effect than Dex, and has to be taken daily it to be effective. After about ~30 days of Atomoxetine I feel MUCH better, anxiety and stress is only at background levels.
Atomoxetine is nowhere near Dex in terms of focus and energy, but it does certainly address many ADHD symptoms + doesn't create the residual anxiety (at least for me). Libido isn't 100% of unmedicated, but nowhere near as bad as amphetamines.
Then I by happenstance quit caffeine. And panic attacks went away. Sleep problems went away.
The meds were potentiating the caffeine!
Try quitting caffeine!
I am also using concerta because it is the only form of ritalin legal in my country. I don't really notice a difference compared to taking ritalin the other way.
I'm now on 2x 10mg methylphenidate (ritalin). It has definitely helped, but after a few weeks I now feel habituated (is that the right word?). Unless something is on fire or past deadline I'm back to getting no work done. I do notice positive effects when combined with (too much) caffeine, but ideally I want to quit soft drinks (and I don't like coffee).
I think I will ask my gp to switch to extended release. I hope he's willing to help me find something that works best for me.
As a sidenote, I do with people could be clearer when describing their medication. Just say the active ingredient, dosage, and frequency. Brand names can differ in different countries.
For reference:
- Ritalin, Concerta = Methylphenidate
- Adderall = Amphetamine
- Dexedrine = Dextroamphetamine
- Vyvanse = Lisdexamfetamine
Adderall is a mixture of several amphetamine salts including (25%?) dextroamphetamine and the formulas are subtly (and sometimes not so subtly) different between manufacturers. The key difference between Adderall and Dexedrine is the addition of those complementary amphetamines that balance out dextro's rough edges (Tracers!)
ADHD diagnosis is much more strongly correlated with affluence than many other mental illnesses.
Eliminating the 504 accommodation would be beneficial in my view.
What you're saying doesn't seem at odds with what I'm saying.
I would, however, be interested in seeing a study where they give kids with ADHD adderall and give kids without ADHD adderall and see if the test-score residual is statistically significantly higher for the ADHD group.
I have not seen any convincing experimental evidence that amphetamines are uniquely performance enhancing for those diagnosed with ADHD.
> it can be difficult to find a psychiatrist willing to prescribe medication
Absolutely - my SO is diagnosed and I've been with her in the pharmacy where she was blatantly accused of trying to get it so she could sell it (nope, just a normal college student diagnosed with ADHD). That was wild.
Source?
My understanding is it is the opposite way around. The lower down the socioeconomic totem pole you go the higher the rates of prevalence of ADHD.
Which would make sense given a) it runs in families and b) executive function disorders are correlated with negative life outcomes.
I can't imagine it makes you _more_ successful in life and thus more likely to be from an affluent family.
All the a-holes that abuse the drugs and the DX for any reason need to find another planet to live on IMO. It's so not cool.
> lower down the socioeconomic totem pole you go the higher the rates of prevalence of ADHD.
The key word in my original statement was "diagnosis". The rate absolutely seems to increase with lower SES, but diagnosis rate does not reflect that.
Your reasoning for why it is more common among poorer people seems to neglect the significant early environmental factors that might contribute to low SES high adhd prevalence in favor of a rich, genetically superior master-class.
Completely life changing. My focus and energy level were on par with a normal persons.
Unfortunately it was far too hard on the body. Started stroking out on it. Plus it interacted with almost every Medicane I’ve been prescribed.
Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from that. Gave it up after a few weeks.
Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.
Kids have it strong. Wife wants them on meds, but weird reactions run in family so I’m highly reluctant.
Anyway, good luck!
Depression is usually easier to diagnose accurately. Schizophrenia can be hit or miss, depending on severity. In my case (I'm bipolar), psychosis was so much a part of my normal life that I was completely blind to it and my external symptoms weren't severe enough to be recognizable.
For just ADHD, There are also other classes of medication that can help. Atomoxetine, bupropion, guanfacine, and clonidine are alternative medications that work differently than first line stimulants.
In people I know who have experienced it, it was very debilitating, so I hadn't even considered the possibility of having it for a long time and still being able to function.
Edit... this ended up being an entire blog post, my blog and email are in my profile.
For example I have ADHD without autism and grew up thinking I was “smart but lazy” because I was > 99% as far as raw intelligence but had little motivation for the drudgery associated with school (or indeed life itself), yet I could play video games for hours straight without seeming to be at a disadvantage compared to neurotypical peers.
This is because ADHD, among other things, is a disorder of attention regulation as opposed to being completely unable to pay attention to anything.
It's cool af if you're young and single and you can just go and go and go on what it is that you're totally wrapped up in. It's shite when you grow up a little and other people have expectations of you and you constantly fail to meet them.
It seems like this is not uncommon, quoting Matthew Walker’s “Why We Sleep”:
> Based on recent surveys and clinical evaluations, we estimate that more than 50 percent of all children with an ADHD diagnosis actually have a sleep disorder, yet a small fraction know of their sleep condition and its ramifications.
I have an auto immune condition(Sjogrens) as well As a clotting disorder. Plus way to much sugar in 20s.
Took many many years to figure the above out. Proper treatment diet has been helping, but a lot of damage has accumulated.
For real though CPAP is life changing if you need it and you get on it.
Out of 120 students, I was the only one who didn't graduate that year. Sometimes I feel like I have the world's worst case of impostor syndrome because of how high school went for me. I was constantly testing top of the class but most everyone looked at me like an abject failure. I went into college with practically zero note-taking or studying skills and the first couple of years were a nightmare, even with medication.
All this is to say that medication can help when you need to feel normal, but it can't replace the skills you should have been developing. Some people can develop those skills and get shit done without medication and I applaud them, but I tried that route and ended up _years_ behind my peers.
Exactly. These articles about ADHD and dopamine are often misinterpreted by people who assume that ADHD is a purely chemical imbalance with only chemical solutions.
It's similar to the situation with depression, where decades of misleading ads and pop-neuroscience articles led people to believe that depression == serotonin. Most people are coming around to the idea that the "chemical imbalance" narrative has done more harm than good in the realm of depression treatment, but the idea that ADHD == dopamine and that ADHD is a pure chemical imbalance is still common online.
These studies should be interpreted as a snapshot of the brain's function in the disordered state, but they shouldn't be interpreted as an inherent property of the person's brain. For example, patients suffering from depression will show certain patterns of serotonin activity during depressive episodes that will change following remission, even if the patient doesn't take medication. The brain isn't a unchanging machine that only operates in a single, fixed way.
You said it best: Medication can't replace the skills that one should be developing. Many people take medication as a gateway to develop those skills and go on to do quite well in life. Unfortunately, some people assume the medication lets them off the hook for learning those important skills. They tend to struggle years down the road when they've built a tolerance to the motivating and stimulating effects of the medications (the attention-enhancing effects tend to be more robust against tolerance, but the euphoric/motivating/stimulating effects will dwindle over time).
This is important. When I went on anti-depressants (for pure-o OCD), my intent was to get some breathing room and learn to manage my symptoms better.
I've definitely been able to do that, but it's lead to a few cases of thinking 'hey, I should be able to stop taking these now', which have all gone poorly for me. I think I'm better able to cope now if I don't have access to medication, but I won't be stopping again any time soon, it's too risky for me.
I've never heard this particular phrase before and I can only guess it's meaning vaguely from the context.
What does it mean?
The levo-amphetamine in adderall causes what is known as peripheral side effects. Higher heart rate. And so on. It doesn’t actually help the brain. Apparently it helps the dextro part last longer.
But its also potentially dangerous.
My blood is sticky(factor 5 Leiden), and cranial pressure runs high.
I tried going off blood thinners 2 months ago, for about a week. Dumb move.
My right side has regained most of its strength and sensation.
Neurologist chewed me out royal. I have to be very careful with meds.
Fewer stimulants I take the better. Vascular constrictors are dangerous for me.
Green Tea seems to not bother me. So I try and drink that or water.
The only major side effect that's a problem for me is the utter loss of appetite. Frustratingly, it's not that I'm not hungry, I just don't want food. So my stomach will start hurting and I force myself to eat, but it's a challenge. Plus earlier this year I had to give up sugar to account for prediabetes, every day is a struggle to make myself get enough calories. Still, the ability to stay focused on a task for 15 minutes, or even just process my students' sentences, is worth it.
ADD was REALLY hard on me when I was a kid. I had a difficulty making friends. I got really bad grades in school. Got in fights. Made me depressed and I thought something was broken with me.
You can start with 5mg and then ramp up from there. I'm on 15mg. I can't really feel 5m and 20mg is far too much.
At lower doses they won't really have any side effects and then you can keep them on for 90-120 days to see how they tolerate it.
One kid gets really bad headaches from less then 2mg pill. It’s a hard decision. Constantly monitoring them to see if they can manage without it. I think one is going to be okay with out.
Other one is probably going to have to go on. Still very young though
Was prescribed amatriptine for nerve damage. I had to get the lowest possible dosage, break pills into quarters. Even then it was still way too strong. ~1mg by my guess.
Doctors & pills straight up hate me.
If they aspire to aviator,stay away. If you really, really worry about locking them into somewhere with access to a Schedule II, then consider not doing it, but I can't overstate how effective and life changing the right treatment regimen is. For me it was like life going from black and white to full color. It can be a bit depressing 20-39 years down the line, and I'm considering getting something started with a Congress person to dial back some of the draconian controls if at all possible, because, not going to lie, it is disruptive as all hell to the lengths things have been allowed to achieve
I've seen other parents with kids who clearly have it do nothing, and the Kids are the ones who really suffer because they don't have a clue what is "wrong".
I kick the wall I'm physiologically disincluded from aviating, but I wouldn't trade all the life experiences I've been able to navigate because of the medication for that, and there's nothing that says the world has to remain so unfriendly to Adderall/ADHD med takers as well.
The Hypertension can be a problem, but a small maintenance dose of a blood pressure meds (or Hawthorne!) Tends to do the trick for me, but work with your doctor.
With the aforementioned supplement stack I’ve been able to go off doses as high as 60 mg of adderall per day without any significant withdrawal symptoms. It’s been a complete game changer in terms of making this medication a sustainable option for me. I will say as a caveat that things which reduce drug tolerance formation also typically attenuate some of the effects. In my case, ALCAR + ALA basically erase the potential for euphoria but don’t seem to diminish the mental benefits.
I used to experiment heavily with all kinds of supplement routines and other nootropics when I had my Adderall Rx.
ALCAR works but like you mentioned, it does blunt things a bit.
https://clinicaltrials.gov/ct2/show/NCT03729128
https://link.springer.com/article/10.1007/s11373-006-9096-4
Dextromethorphan works for tolerance on things other than Amphetamine as well, but that's outside the scope of the conversation.
FWIW, the best I ever felt was on Adderall + 200mg l-Theanine + 10mg Noopept + 15mg Dextromethorphan.
Ordering the rest now.
My chief issue is nerve damage. Anything that helps them is a big win.
Biab
Omg, I actually experience this very thing for myself. I thought I was unique in experiencing the "deepest most profound sadness imaginable" from Vyvanse. It's good to know it wasn't just me.
I did eventually connect the dots with Vyvanse, after taking it a bunch of times. I did several "test runs" where I took it some days, and not other days, and the deep sadness always and consistently occurred about 3-4 hours after taking Vyvanse.
Thankfully, Adderall doesn't have this horrible side effect.
> Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.
I've read that exercise can go a long way in mitigating ADHD. I'm trying to now motivate myself to exercise -- which if I'm able to do would essentially solve the problem ADHD (at least partially), and create a positive feedback loop that could improve my life for the better in the long run.
I’m at my best when hiking hills 3-6 miles a day.
That's not entirely true, though. There is a lot of value in learning good habits to cope with ADHD and developing systems and mental models to improve your ADHD situation. ADHD isn't a purely dopaminergic "chemical imbalance" in the brain that can only be improved with chemical solutions, similar to how depression isn't entirely a chemical imbalance of serotonin.
One of the downsides of aggressive ADHD medication treatment is that it can handicap learning of good habits and coping strategies. Some, thought not all, patients quickly learn to rely on the stimulant effect of their medication to get anything done, assuming that medication is the only way to improve. This becomes a problem as the motivating effects of stimulant medication wear off after months or years, leaving only the concentration-enhancing side effects. Internet forums are full of 20-something ADHD patients who think the only way to address their ADHD is ever increasing doses of stimulants, but eventually they hit prescribing limits and increasing side effects. The solution is to approach ADHD as a combined treatment with minimal medication and heavy emphasis on self-discipline and healthy habits.
Regarding this study: Don't forget that ADHD medications aren't simply dopamine dispensers. All of the stimulant ADHD medications have significant norepinephrine activity, as well. There are many reasons why pure dopamine agonists aren't effective for ADHD.
> I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.
In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.
Many people take stimulant treatment for years or decades, but the unfortunate reality is that the long-term effectiveness of stimulants isn't exactly a sure thing. Clinical trials and studies rarely run for more than a few months. The studies on long-term patients are mixed, but not encourage for long-term effectiveness of stimulants ( https://pubmed.ncbi.nlm.nih.gov/11322742/ ). If you only recently started taking stimulants, you might be in somewhat of a "honeymoon phase" where the core effects are still strong. Note that after years of use, people will tend to overestimate the effects of the drug due to the severity of withdrawal symptoms on days off.
In short, I'd encourage you to continue addressing your ADHD symptoms with ever-improving self discipline, personal habits, and healthy lifestyle choices. The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.
No, no, no, no. As someone who suffered remarkable mental turmoil over my inability to focus, despite reading books about it, asking everyone for help with my problems, just no, I hate this kind of puritanical thinking, it's exactly this kind of thinking which adds to the stigma of ADHD medication. The very first _day_ I took the medication I knew I'd stumbled upon something monumental. And then I realized that all those years of struggle in school and college, they were all for naught.
The only right answer is: see a psychologist if you think you have a problem, and get medicated if you and your psychologist feels you do have a problem.
> In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.
Nope. It just shit on my self-esteem and resulted in depression because I thought I was just not cut out for the things I wanted to be able to do.
> No, no, no, no.
I'm sorry you struggled, but I think you misinterpreted my post. I never suggested that people must go medication-free, or that therapy is the only option.
The point is that optimal medication treatment still requires effort to learn healthy habits, facilitate self-discipline, and improve one's ability to focus.
If you need medication to begin that process, so be it, but taking medication shouldn't mean that you neglect the self-improvement aspect of this. The medication can be a springboard, but it's a mistake to give up on self-improvement and hope that medication can do all of the heavy lifting.
I mean, my entire post was actually saying the opposite. One of the biggest downsides of having ADHD is the way it handicaps learning of good habits and life skills. I tried doing exactly what you describe in high school and the result was constantly failing to do extracurricular work and being branded as lazy by my peers and educators. There are a lot of comments in this thread on both sides of the argument that seem to take personal anecdote too far. My honest advice continues to be that medication is a great tool for those who need it, and therapy is something pretty much everyone should experience.
It really HAS changed my life. What I've found is that over the long term you're able to perform much much better.
By the time I was in my 30s I had developed coping skills which worked for the most part but I would find myself getting demotivated and defocused sometimes on long term priorities and sometimes unable to recommit to them.
Adderall totally changed that. I'm able to focus on tasks long term AND even if something bad happens in my life I'm able to keep right on track.
It's also helped me stay more positive knowing that projects get completed and there's nothing preventing me from accomplishing what I want to accomplish.
There are some downsides though:
- Adderall is illegal in most countries so you're not even allowed to travel with it in some places. I didn't really know this at first and I wish they would tell you. Most countries will overlook it but if you're China they could totally use it as an excuse to harass you if they wanted.
- It's very addictive. If I forget my meds it's basically impossible to function.
- It's VERY hard to get since it's a controlled substance. I'm only able to get it 72 hours ahead of time and if they're out of stock sometimes I have to wait. DO NOT wait until the last minute. Get it as early as possible.
- Some people have problems with off brands of XR (extended release) that has a different formulation. There's no standardization on the XR process and I think it's vendor specific.
When I think about that, it's kind of mind blowing.
For that matter, it is also crazy that we don't start giving children coffee at younger ages to help focus — since there are no known negative effects. It's just a cultural trope that it stunts growth, etc. It took ages before people recognized that there weren't really health downsides to coffee. We are so trained to expect that "every up has a down" — but what if that's just a relic of Calvinism and we are inhibiting our full potential because of misplaced fears?
This is a null hypothesis that hasn't been refuted due to lack of evidence, and not an alternative hypothesis that has been proven by evidence, right?
I ask because I've been looking into this before, and from what I remember there was virtually no evidence on long term use in reasonable amounts.
(There is evidence on short term use in reasonable amounts, and long term use in unreasonable amounts, though.)
But if we accept a "nutrition science" level of evidence, then I'd say there is strong evidence showing the naturalistic longterm use of adhd meds is not dangerous. Especially considering our baysian prior: a person off the street would estimate far stronger negative effects of taking speed every single day.
In fact, adhd meds are correlated with healthier outcomes (of course, huge selection effects. Yes, eating kale will be associated with increased health, but it isn't causal)
Here is the best recent review that I know of: https://www.sciencedirect.com/science/article/pii/S0924977X1...
I'd love to know your take.
Yeah, I'd say p much impossible to untangle there without experimental evidence.
I'll argue with the assumption that there is zero long term psychobiological consequences to exogenous psychostimulants (I personally don't buy this, but let's assume it was true). Increasing focus and task salience is only one of the many factors constitutive of human potential. They never give the answer for what to focus on, or whether a task is worth it or not, and rob the person of the opportunity for developing frustration tolerance. They turn people into indiscriminate doing machines, with little wisdom to guide it. Makes one think if prescription amphetamines being as widespread among plumbers as software engineers is truly a coincidence.
I will argue this is because our bioeconomics, our not wanting to do things is also part of our wisdom machinery. Having used for half a decade myself, I can spot some collogues who are on amphetamines; unnecessarily assertive, obsessed with orderliness of code, constantly in need of refactoring, huge bias for action with diminished wisdom to temper it (Well, also pees a lot.). There is a reason they are not being used by fighter pilots anymore because they can get too cocky and make decisions that kill their own.
No wonder everything looks like a good idea when your brain is swimming in dopamine and norepinephrine, but when everything looks like a good idea, how do you find what is the right thing to do in the medium/long term? Is that really the human potential? I would argue far from it. I think it is just enhancing the potential for a particular job description that requires you to sit on your bum all day and plumb boring stuff someone else tells you to.
Amps turn you into a drone. Any perceived benefit is met with equal or greater detriment.
I tick all the ADHD boxes but I managed to make it through college without meds so never should have started.
Psychiatry is broken and handing out prescription amphetamines to everyone who can’t focus is as bad as an idea as it initially sounds.
Also you don't have to actually take the medications at all to get an ADHD testing battery. Then you'll know if you actually have ADHD or if you actually didn't. If you don't then your comments are a bit insensitive. Self-diagnoses of various medical conditions by the untrained is notoriously inaccurate.
Someone in the same situation might feel much the opposite, but they also shouldn't use their experience to convince people that their attempt at treating a condition they have is inherently a bad choice.
If I got treatment for ADHD, maybe then I would be able to finally churn through all of my tasks and be a top performer in terms of closing stories. If I didn't pursue treatment, then maybe I continue to be unable to focus and completely burn out, resulting in the loss of my job. Maybe after that I pivot my career to where I'm doing something that I find to be more fulfilling. What's the better outcome?
It does help with "boring" tasks a little bit, in a sense, but they're still boring an uninteresting. It's not like I get a dopamine hit every time I do a piece of paperwork.
I usually describe it like this: for me ADHD sometimes makes things that are necessary for human life _really_ hard. Things like taking a shower in the morning or having breakfast, getting up to get water while working etc.
All these things take a toll on my day, I still do them but I feel like I'm doing something that I _absolutely_ don't want to do and at the end of the day I don't have any patient left for stuff that actually require my effort (e.g. listening to my wife when she's frustrated with me).
With medication I feel better about doing these necessary things so I can get to the end of the day without hating myself. That doesn't mean I'm gonna eat all the bullshit that gets thrown to me at work!
It's also not all roses, Ritalin is hard to manage, at least for me. I need to make a conscious effort to not devote too much of my attention to uninteresting details, etc. But it's not like it takes away your free will!
Without them, I actually have no problem focusing on certain things, but it's usually some unimportant problem or project that I become distracted by.
With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life. I become more attentive to my family, less irritated by distractions. And more a able to get important things done, like my taxes, that before would plague me.
I know some people seem to react to the meds by turning into a worker drone, But it doesn't do that to me. It does make me more excited to make progress and get things done right.
> With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life.
Executive function boost is non-negligible for sure, but it is still bound to operate in the short term.
Think your bioeconomics as a ledger, your energy levels as income and what you want to do as payments. Stimulants alter this ledger and as long as you can use them you will think you have a lot more income and you can sign up for more things to do. But do you really do have more income in the long term? Are you borrowing from your future income? Your future dopaminergic system? Your future neuroticism levels? I know the research is either missing or contested, but everything from evening crashes to need for increasing the dosage to long term dependence risk suggests that we are borrowing something from somewhere.
> I become more attentive to my family, less irritated by distractions.
Let me play the devil's advocate for a second: How do you know being more attentive to your family is the right thing? Maybe they are real assholes taking you for granted and getting irritated with them would make them get their act together and have a better chance in long term sustainable relationship. How do you know the distractions are not irritation worthy? Maybe they are things you need to get to the root of instead of enduring continuously.
I am exaggerating to make a point, and I'm sure you're mostly fine, but the danger is that thinking you have more "income" than you do will affect all your decisions in a way that accumulates and might not be long term sustainable. It can make you more conforming, and this will be praised by your family, boss, for the case with kids, their parents, but can we say with certainty that being more conforming all the time is really in one's best interest? Anger, irritation, anxiety, depression and even boredom, they are not there just as human failings but also as normal processes that can counter-balance over-exertion, over-exposure, weakly defended personal boundaries, meaninglessness, resentment.
Only way to know how continuous stimulant use is affecting you is to take a long break after multi-year use and evaluate where your life is, which for some people can be too late.
Now, if your goal is to swing for the fences and try to hit a home run, get to the top of your field, make a grand discovery, then ya, most of those kind of people are very non-coforming. But many are/were also very unhappy personally. In fact, many of the greatest outliers in our history suffered from manic depression or ADD or other mental issues.
Personally, I'm not swinging for the fences. I'm going to bunt if it means I have a much better chance of getting on base. Steve Jobs was very non-conforming. He was always very irritated and unpleasant with everyone around him. And sure, it seems to have had results. But I have no interest in becoming the next Steve Jobs if it means having what appears to have been an unhappy life with an early death.
Focus and discipline is very useful when solutions to problems are known.
But put someone extremely methodical in charge of R&D and they will take a zillion years to explore a large search space. Meanwhile a neurotic will run around randomly and stumble upon all kinds of things on the map. The down side with the neurotic mind, is after a prospective gold mine is found and a lot of methodical, disciplined work is required to exploit it they flake out.
Now if you pair them up interesting things unfold.
We are quiet good at identifying people's strengths and weakness. But we spend a lot of time exploiting weakness and squandering strengths of people.
If only the opposite happened more.
With better and growing understanding of how different minds work, I think we will see people compensating for each others weaknesses more.
Agreed! Not that this is going to make me stop taking it as needed because this is the society we live in (and I'm currently in college), but yeah. I was just talking to a parent of a 5th grader the other day and they were telling me all about how often their kid got in trouble at school (like I did in elementary school), and how she read up on the neuroscience and decided medicating was appropriate. They had me thus far, until they went on about how they didn't tell anyone at the school (it's beneficial t share this with teachers...) until the staff sent emails regarding the kid's improved behavior. One person even reached out and said "your kid hasn't been himself all week." SO I THOUGHT THE PARent was going to say that's what made them change the dose, BUT THEY DIDN'T!!! They took "your child hasn't been himself" as a COMPLIMENT. Something is very wrong here and it's not the parent's fault, it's our priorities in America regarding an outdated school system and long work week. Obedience is valued more than creativity. How are we supposed to improve with that mindset?
Might as well, we already load them up with sugar, which does have known side-effects.
Sarcasm aside, maybe not a direct negative side effect, but if you suffer from poor sleep, drinking too much coffee or drinking coffee too late in the day has correlation and lack of sleep certainly has negative side-effect.
Personally, I'll keep my kids off coffee and other drugs until they're old enough to buy it themselves.
Wow, that is truly amazing. I'm glad to learn about that.
I notice a slight depression if I stop taking my ADHD meds for a few days (perhaps up to a week), but after that I'm back to my old (ADHD-driven) self. So in a sense, it's not addictive at all. The depression can tempt one to get back on it, but that's about it.
One side effect of Adderall though is ED, and it's pretty bad. I guess it depends on the person, but for me, the ED was quite bad. The ED does go away after getting off of it.
You definitely have a withdrawal from adderall. A few days (up to a week) is typical of most drug withdrawals.
The drugs for that are very easy to get these days - you can get a prescription online by taking a survey and the pills will be mailed to you without ever talking to a human.
It's probably a lot better in the long-run to use exercise as a cure for ADHD.
(Instead of slamming your system with drugs upon drugs. With one drug taken to mitigate another's side effects, etc.)
Ok
[1] Nespresso is 63mg (5g of coffee), "average" espresso is 77mg (7g of coffee) https://www.caffeineinformer.com/caffeine-content/espresso
[2] https://www.coca-cola.co.uk/ingredients/caffeine/the-caffein...
That said, most coffee shop serve double espressos as standard, so if you factor that in, it seems on average your cup of cappuccino might have four time the caffeine than a can of coke.
There's also a couple Nespresso (maybe Keurig and others, too) capsules with double the caffeine content: Kazaar and Napoli.
So my impression (yeah I have to admit it’s a study of size 1) is rather that caffeine is more dangerous than I thought.
a) There are downsides to coffee. I know of a clinical neurologist (Steve Novella) who, when working with a patient with chronic headaches, will always ask "how much coffee do you drink." Always remember, if a "medicine" is doing good, it will have side effects. Period. Note that homeopaths simply love going on about how homeopathy doesn't have any side effects - spoiler, that's because it's not actually doing anything at a physical level.
b) Yes, daily use of stimulants in people with ADHD has been show to be pretty much ok. In fact, there are studies showing that kids who are not medicated are more likely to end up as substance abusers, largely because they're self medicating (remember, drug abuse is a symptom++). However, the kids who were treated with stimulants? No more risk than their neuro-typical peers.
c) The above says NOTHING WHATSOEVER about neuro-typicals taking it daily.
++ Source: my partner, currently doing her neuro-psych masters on addiction.
After that 10, I tried amphetamine which blew holes in my persistent brain fog. I went on Adderall and (as we've often heard) it changed my life.
I'm not advocating you change a regimen that is obviously working for you. I'm just adding another possible plotline to that same story.
“Aderall” is a mixture of dextroamphetamine and levoamphetamine, in a 3:1 ratio. Unlike some other drugs, both enantiomers have a therapeutic effect, but slightly different effects on the brain.
If one takes pure dextroamphetamine (“Dexedrine”) instead, that is also available as an inactive prodrug lisdexamfetamine (“Vyvanse”). This is different from an XR formulation, in that the drug is absorbed immediately, but lisdexamfetamine itself has no effect on the brain. However, enzymes in your red blood cells gradually convert the lisdexamfetamine to dexamphetamine. The advantage of this, is unlike an XR formulation, there should be no difference between different manufacturers.
Because it’s basically dextroamphetamine with a lysine molecule taped on, the psychoactive effects are really similar, but I’d describe it as cleaner if that makes sense. The “killer feature” of the enzymatic release is it’s basically a fixed timing, whereas with XR formulations of Adderall you have a 50/50 blend of immediate and delayed release 3:1 amphetamines. I believe you are correct, it’s not standardized. This, combined with the acids / bases both hurting overall blood levels (think grapefruit juice) means you just have a wildly inconsistent time over long term use of the medicine. For example, I’ve had pharmacies change generics on me without saying anything, I’ve had an inability to get my preferred generics, and I’ve had days where it’s felt like I took nothing at all. The worst are Nuvo and Mallinckrodt in my experience (IR 10mg 2x/day).
I’ve only been using Vyvanse for a week or so, but I can say it’s a marked improvement for me and the lack of a generic is a huge boon with regards to consistency.
Here in Australia, one month supply (30 tablets) costs 30 USD. The Australian government subsidises prescriptions for all Australian citizens and permanent residents. I believe the actual cost, prior to the subsidy, is around 85 USD. The government negotiates prices with the pharmaceutical manufacturers, and the prices it negotiates are generally less than those that US insurers pay. Manufacturers generally accept less revenue for the Australian market, since if they can't get it subsidised by the Australian government it becomes quite difficult to sell it here.
https://bnf.nice.org.uk/medicinal-forms/lisdexamfetamine-mes...
28 * 20mg = £54.62
28 * 30mg = £58.24
28 * 40mg = £62.82
28 * 50mg = £68.60
I've been on Ritalin for a few weeks now, and the difference is remarkable. If this is how normal people feel most of the time, I don't know... I am both relieved to have a name for what was causing me problems, and also feel the need to grieve lost opportunities in life. It's a complex mix of emotions.
Also, every time a post on here comes up about elaborate methods of achieving focus the comments are full of people typical-minding what really might actually be ADHD (the whole "everyone is like this right?" thing) and I'm just sitting there like.. maybe you should look into this it probably shouldn't be that hard.
Of course if you post that you get a bunch of replies from people who insist that, "no, actually, it's cell phones' fault" or that it's totally normal to absolutely loathe doing any mundane task.
That's why we invented shell scripts and cron!
On a serious note, what type of tasks would you consider mundane that you attribute to your ADHD to cause you to not want to do them that any non-ADHD person would also not have procrastination problems? Are these specific to work like filling out time sheets or other TPS reports? Home tasks like laundry/dishes/trash? All of the above? As a non-ADHD person, I hate all of the above tasks and only do them because it's part of adulting. Can't get paid without time sheets (this is my biggest hate). I'd rather do laundry (folding/ironing) than fill out time sheets. I have no rational explanation as it is a rather simple thing.
The difference is that buckling down and focusing... Don't always work for me. That's the fundamental difference that normal people don't get. That rather simple thing is basically the problem.
I'm pretty good at "adulting" and otherwise coping with my life but I hit roadblocks that other people sail by. I can do very complicated, difficult and tedious tasks but sometimes get stuck doing simple things like paying a parking ticket. I know how to do it. I know when it's due. I know I'll pay a penalty if I pay it late. I think about it all the time. But doing it is like lifting an incredibly heavy weight. Normal people don't feel the weight and think I'm lazy.
Mundane is probably not exactly the right word tbh, but it's hard to find the right word. I think it would be more accurate to describe it as things with a lot of upfront planning involved. If I can basically react my way through something to completion I can get into hyperfocus and just blaze through it.
A lot of the time the way I've gotten around this is to force it to be an emergency so I can't think about it too much. Either by leaving it to the last second or just convincing myself.
And that's a really common pattern you see in people before they get ADHD diagnoses.
The difference being my wife breaks down in tears every 3 months because she woke up to dishes in the sink _again_ and wasn't able to use her coffee cup because, though I meant to do them and said I would, I wound up not doing them.
That was the first 5 years of my marriage. Repeat for laundry. Repeat for trash.
For work I was on a list of 5 people out of 1000 person company who's names had gone all the way to the CEO for not filling out timesheets correctly.
I hope that makes the problem a little clearer for those who think "but everyone has trouble with that stuff"
I didn't mean to reply and talk about myself, I actually wanted to ask (if you wanted to share), about what led you to the diagnosis at that age - what kinds of things were not working for you? What were you developing coping skills for?
More that I gained “longer” focus.
It was a lot of shit, all at once, and it would be easy to shrug and say it would have been hard for anyone. But it was enough of a shock to my abilities that I was able to finally see that I just wasn't firing on all cylinders, even though I am otherwise intelligent and capable.
I have not lost my ability to focus. In fact, it's easier than ever. I've always been very distractible (another common symptom), and suddenly the kids making noise while playing next door, dogs barking, phones ringing no longer wreck the house of cards I'm holding in my mind while working on a problem. It's remarkable.
I still got a degree in computer science but with that path I was put on... I’m now a photographer and still live in the same area I grew up in.
I realize you have more years “wasted” but I’ve had quite a bit of time to come to terms with all of that. I think it’s important to keep in mind we all have advantages and disadvantages in life, and chances are if you’re on here you’ve still had a pretty charmed life. You’re intelligent, in a developed country, etc. Most people don’t have that.
Interesting you mention that. I had a Bicycle->Car accident when I was 8 and I've always been told that's when a number of my behaviors started to change (and I became the black sheep of the family I am now.) I didn't get diagonsed with ADD until I was almost 30, but oddly enough my current care doctor also specializes in head trauma.
I’m guessing that’d be different now, though I don’t know what extra care they could give. At the very least I think my parents would have thought to tie my sudden energy and worse grades to what happened.
do you have some examples? i suspect the majority of mine are the former
That sounds amazing. I can't even imagine that. I've just been diagnosed at 32 this year. Been on Ritalin for a few months but it doesn't seem to make a difference. Maybe 3% better. Things going bad still derails me significantly.
They're fairly conservative with meds in my neck of the woods, but I'm going to persist with my doctor to try them all to find what works.
The struggle to push through actually going through all the phone calls, emails and appointments necessary to get to that point is very un-ADHD friendly. So many times I considered just to give up and forget about it.
He’s 33 and has been in college since graduating high school and still doesn’t have a degree, and he’s actually quite intelligent.
Ritalin causes side effects for me as soon as I start to hit the therapeutic dose when titrating.
Adderall is terrible for me.
My youngest daughter is undoubtedly ADHD, and the insurance company requires you to try the first two before they will approve a third...
Modafinil was The Answer for me after trying everything else. I don't know why psychiatrists always insist on a battery of other drugs first, which can cause everything from aggression to obvious personality shifts to mania to damage to the dopaminergic axons of the brain.
2. Insurance companies require extra paperwork for anything other than the 2 or 3 most common drugs. I ended up on Dexmethylphenidate after trying a few others; I rate it as "okay" but still so much better than unmedicated that I paid a few hundred dollars out-of-pocket for it while I was convincing the insurance company to approve it. I ended up on ER, which doesn't work as well because they wouldn't approve 2x 10mg of non ER but would approve 1x 20mg of the ER. sigh
Fun fact: Methamphetamine naturally takes 3-3.5 hours to hit peak so Vyvanse has a more “meth-like” concentration curve as opposed to raw d-amp (or adderal which is 75% d-amp 25% l-amp) which hits way sooner. As an aside, Meth is very misunderstood and is in many ways a more ideal ADHD drug than normal amphetamine; and indeed it can be prescribed under the brand name Desoxyn. Methamphetamine when taken in low-moderate oral doses is completey safe and less jittery than amphetamine, but if abused (say, smoking 100mg d-meth) it becomes far more neurotoxic.
Understanding enantiomers (left-handed vs right-handed molecules in this case) is really important. For amp / methamp, the d enantiomer is 3-4x more powerful by weight yet is more cerebral as opposed to causing peripheral (body) stimulation. So d is almost always superior, although with adderall it has been found that the 75/25 d/l formula synergizes and has a bit longer half life
After college I finally got diagnosed again after being off medication for 8 or so years. Grew up first doing Ritalin->adderall->concerta->no meds. I realized how needlessly difficult I made college for myself.
We've been working through the book, "Finally Focused", to help our son. Magnesium supplementation is recommendation #1, Iron supplementation (if deficient as demonstrated by the test) and then the over-the-counter, lithium orotate. We haven't gotten further than chapter 3, yet.
The lab doesn’t sell directly so you have to order it through a wellness center.
I don't have ADHD, but I'm curious what the modern one is.
Back in middle school, around 2001, I did a report on ADD and ADHD, and 3 of the medications that existed for it: Ritalin, Cylert, and I'm not certain of the third but from the other comments Adderall sounds like it could be it (though I think it started with a "D", is there one that does?). The only thing I remember from it is the conclusion that if I got diagnosed and needed medication, I'd refuse Ritalin, and that Cylert seemed like the best of the three.
Moda doesn't touch my affect and it's wonderful.
Modafinil makes me feel like myself but a more productive version. The big issue with me has always been starting a task and modafinil makes a scary task a lot more approachable. My thoughts are more ordered, I can see the bigger architecture of a thing, verbal fluency is improved. I cycle off it Saturdays and Sundays and that works just fine for me.
I was working from home and the second it kicked in I started getting literal chills down my spine.
I ended up messaging a bunch of people on Facebook I haven’t talked to in years but felt a sudden affinity and empathy for.
I got distracted by a part of my apartment that I hadn’t cleaned in a while and missed a meeting because I ended up cleaning the whole place, including weird things like dusting the sides of books.
When I finally got to coding, it was like I was in the matrix. Hyper focused (and fwiw getting a lot done) but in a weird euphoric high feeling way.
I guess what I’m asking is is that how everyone feels the first time they take it?
And how long does it take to just feel normal on it, but like able to focus?
I want to try it again, because I need help focusing and know I can do better, but I’m genuinely afraid of the person I was on that stuff.
I use it occasionally still but with no euphoric, overwhelming empathy or boundless energy to mow the metaphorical fields. It helps me push through brain fog when things just need to be done.
I haven’t managed to get past the tooth grinding. I barely feel that I’m on it now, but every single time... I grind my teeth. Even if I feel perfectly relaxed otherwise.
I eventually learned to redirect myself - which Adderall enabled me to do. The first step was qualifying my own good and bad behaviors.
It took time to deepen the reward association with beneficial behaviors. That helped me redirect away from counterproductive behaviors - not just revived behaviors but also the persistent ones. Making progress on those was huge.
During this process, the messy, euphoric edges smoothed themselves out. I never had to address it directly.
About 6 months in I came to the conclusion that I really would have benefited from a therapeutic guide, someone who was familiar with this specific experience. I'm not sure there is anyone like that out there.
I'm an adult with ADHD and that paragraph describes me to a T, though it definitely was worse as a child
I got my first D grade in a subject in fifth grade, and the next seven years were basically my parents trying every tool at their disposal to motivate me to get better grades.
I was on academic probation four more terms than I wasn't in college, and graduated with a low C average after 5.5 years, plus two summer terms.
I got hired at the only company that forgot to ask for my GPA.
I think if I were just sightly less intelligent, I would have been in a world of hurt and possibly dead by now.
Even though I'm successful now in tech with a huge salary, this experience of being treated like I had a made-up disorder (can't easily perceive it with no physical impairment/more obvious mental issues), and was invisible to the system full of cold-hearted academic administrators quick to academically disqualify me still makes me seethe and feel wronged to this very day.
Can anyone relate?
ADHD treatment is not ADHD friendly. Society is not ADHD friendly. Neurotypicals literally have the same scale of mental privilege as whites do in a racial context.
I found it weird that people can get banned for talking about their anecdotal experiences with psychedelics on the ADHD subreddit too. Seems like some people are more comfortable being with the ADHD community and sticking with the status quo regimens, than actually doing something completely new.
Very interesting to hear of your experiences in this thread though. Maybe we need an r/ADHND for all us ADHDers on HN :P
Wow this is profound to say the least, thanks for making this connection I've intuitively felt but could not articulate the impact of my ADHD and potential to succeed in life starting from an early age.
I more and more realise that my brain and personality is not the kind that is made for desk work. I find it boring and difficult.
I have done other types of works that suits me better i beleive my life would be so much better if i just accepted that i was never to be sitting at a desk solving problems.
School has always been difficult for me, simply because it hard to learn the things you need to learn in shcool, for more intelligent individuals school is not the same big deal as it is for me. But thats just the way things is. The same way i was not born 2meter tall and an musculuar body.
I beleive that we will see more and more ADD/ADHD diagnosies in the future, simply because automation puts more demands on the individual and the jobs will be more mentally demanding.
I see a future where meds like adderal will be availble in the supermarkets.
Instead of giving people ADD/ADHD diagnosises we should just teach people to accept that not everyone are made for mentally demanding tasks and that not everyone goes thru school without it being a huge difficult task. Parents also needs to learn that their kids might not will be able to compete in the job markets in the future and the solution is not to medicate it away.
It's not even really related to intelligence. ADHDers run the gamut from really stupid, to average, to really smart.
I'm reasonably intelligent, but boy do I struggle with the basics on a day to day basis. Understanding complex stuff is fairly fun and engaging for me, so I spend a bunch of time doing it. That's usually at the expense of being a good husband, father, friend or brother.
It doesn't seem to be what you think it is.
This hypothetical sends chills down by spine knowing I might be making a deal with the devil to get a temporary fix on ADHD symptoms now for increased risk of dopamine downregulation or neurodegeneration later.
Can anyone relate and/or give me some peace of mind? ~60mg/day for 12 years and not letting up anytime soon as long as I need my executive functions under my command to do computer work. If I drop the stimulants I can maybe get a low wage job doing basic IT service desk stuff or live a simple life doing a 'muscle memory' line of work e.g. Amazon factory worker, go to trade school for something hands on, etc. that doesn't require asynchronous access to my prefrontal cortex + memories + instantaneous storage/retrieval with my working memory for hours on end.
God I envy neurotypical people, I feel handicapped mentally in comparison to their baseline.
Why not just say the country?
I would think that would also imply that access in other ways might be a bit "easier" as well...
I was diagnosed when I was younger, made the mistake of letting my prescription lapse (because I give myself breaks and therefore end up accumulating excess), and now can’t get the medication I need to function.
Fun fact, when you’re ADHD-PI, trying SSRIs isn’t just a harmless fun little exercise, it could have potentially life ruining consequences, which the psychiatrist will not tell you about.
If any psychiatrists are reading this, please know that the ‘harms’ of giving your patients the medication that is proven to work absolutely do not outweigh the harms of all the alternative coping mechanisms needed to avoid losing employment: black market pills, smoking/nicotine, caffeine by the gram, etc.
Wtf? I have done the same thing, gone off-and-on my RX I think 3 times now.
Whenever I wanted to get back on, I just found a random psychiatrist or clinic and said "Can you please renew my ADHD Rx? It's starting to really negatively impact my work performance." and then they'd say okay, sure.
This was in Colorado though, Boulder/Denver area. Half the university students and tech workers had prescriptions so it might be a biased area. Not sure what it might be like other places in the US.
Sorry you're going through that nonsense, if you want to shell out the money you can google "ADHD specialist" and pick a psychiatrist from the list that pops up. Will cost you ~$300-500 (IME) out of pocket for consultation and re-diagnosis.
I don't remember the wording of the preface, but I recall it arguing that the sheer size of the book could be regarded both as a cultural experience as well as a mental exercise.
The author of the preface argued that when (or perhaps if) you finished the book you would feel like you've just run a marathon. You would be highly fit, reading wise. Nothing would phase you.
This was probably compounded in my teenage head by the fact that the only quote I've heard from the author beforehand was:
"I consume libraries. I wear out spines and ROM-drives. I do things like get in a taxi and say, 'The library, and step on it.'"
It sounded like a complete opposite of myself at the time, but I did want to learn that ability. And I liked that preface a lot. It kept me going at it month after month on busy train rides, with the promise of some transcendent reward at the end.
There are famous footnotes in that book spanning several pages in tiny print. The amount of mental effort it took to read the thing was extraordinary for someone like me at the time. I often had to backtrack several pages to perform the context switch from a mini-novel footnote back to the main storyline.
This was many years ago now, and I have slipped far behind on my reading fitness. But I still carry with me the realization that I can't expect to be fit if I don't train hard.
Now, ADD is a whole nother beast. Sicknesses often require medical attention and this should not be smoothed over. Still, I think there's an interesting discussion to be had regarding reading fitness in the era of information. Maybe this is a widely discussed thing and I'm just not hearing it, but it seems obvious that we slip further toward obesity without training. Surely something similar happens with our ability to focus without training?
With depression, we might take medication to grant us a seat at the table of recovery via a therapist. The hope is to get off of that medication eventually. Perhaps the same holds true with ADD/ADHD? I am not a psychiatrist.
I've been wondering about this attention deficit and reading comprehension issue for awhile now. I would love to know how many of us adults actually read books anymore for longer than a thirty minute period? Any kind of book reading.
I like to think that I'm a somewhat experienced meditator by now. Having observed the mindfulness hype over the years I wonder if what people are really missing is just some silent focused time in general. If all you want is quieter mind, maybe you don't need a ten day silent retreat but just an hourlong reading session?
I know the topic has been beaten to death but it is an important one. This constant context switching between systems and devices who have been engineered to sap your impulse control and short-circuit your core reward system need to be investigated on a personal level. So it isn't just that you aren't doing those hourlong reading sessions in silence but that you're actively practicing a different kind of negative behavior.
This is just one uneducated person's opinion. If we're talking about a dysfunctional reward pathway would it not stand to reason that someone's gravitation toward systems who provide thousands of small immediate rewards only reinforce this dysfunction? Think video games, porn, and instagram. Juxtapose this with reading a novel, painting a picture, or finally understanding recursion. I feel kind of gross typing that out because it feels like some sort of appeal to nature but I can't shake it.
This makes perfect sense to me.
But in the longest term, what actually /is/ the point? What is the reward that people are supposed to be pursuing /instead/ of video games, porn, and Instagram? We cannot pursue long-term goals if we don't have any. Where do they come from, those goals, that purpose?
> I feel kind of gross typing that out because it feels like some sort of appeal to nature but I can't shake it.
I wonder what you mean by this.
The apparent grossness of appeals to nature must stem from the fact that they have been used to justify injustice. But every form of argument is used to justify injustice -- so I don't think we should pre-emptively cut away our mind's ability to think naturalistic thoughts, just to avoid error. Maybe we have ignored Mother Nature for too long.
This brings me back to the original question, about purpose. Maybe it comes from Nature. Maybe a failure to enthusiastically perform for society means that the menu of options offered by that society contains nothing compatible with what Nature actually wants for us.
Porn is the best example. Why is it bad? What real thing is it simulating? What should you be doing instead?
Video games are similar: What real thing is being simulated?
You mention the development of competencies as an alternative. I agree that this is better. But what purpose of Nature's is served by the development of skills?
The feeling I can't shake is that addiction is the substitution of the simulated for the real, that increasingly everything is simulated, that the thing we are being distracted from is our own biological reality, and that we are, again artificially, trying to hack our own reward systems to be satisfied with goals that our not in our own Natures.
That’s not really true. Medication can absolutely help for severe cases, but falling into the trap of thinking that ADHD is a purely chemical problem that can only be addressed with chemical solutions can lead people to neglect the important lifestyle and self-discipline changes that will really help their situation in the long term.
Don’t get caught up in ideas that ADHD is “just dopamine”, because that’s a path to ignoring the fact that personal changes and therapy can improve ADHD immensely.
These "chemical imbalance" narratives tend to do more harm than good by giving patients an idea that their symptoms are purely external to their own choices, and therefore completely out of their own control. Unfortunately, it's very difficult to convince suffering patients that they have some control over their situation without also implying personal blame for their problems, which doesn't go over well. The idea that the problem is faultless ("It's not you, it's just your brain!") and that the solutions are effortless ("This pill will fix your chemical imbalance") is just too tempting. The alternatives ("Read this book on study habits, leave your phone in another room while studying, use timeboxing...") are an unappealing alternative.
Don't get me wrong: Medications can and absolutely do help people, but this idea that the problem can only be treated via medication is demonstrably false. The most successful patients use a combination of medications, therapy, and healthy habit-forming. The least successful patients tend to give up on everything except the medication, reaching for ever-increasing doses or trying to play games of on-days/off-days or saving up extra medication. That's a losing battle.
There's definitely a healthy balance of smart lifestyle choices, coupled with medication for those who truly struggle and need to just get from zero to 1.
> Unfortunately, it's very difficult to convince suffering patients that they have some control over their situation without also implying personal blame for their problems
I also see it as a big part of the problem, that it's difficult to convince people that they do have control over their lives. In many psychotherapy books, when therapists describe various cases, this is a corner stone of a therapy success: a patient understanding that they do have control over their situation. That it's not the outer world that is so demanding that it leaves them no choice, but them choosing to cope in a particular way, and that there are other ways to react and cope.
For the reference, where I live we don't have ads for prescription medication. On the other hand everything tends to be diagnosed as depression and treated with antidepressants, no matter what symptoms are.
ADHD becomes a gift when you can focus and the brain just naturally learns, and memorizes very well. I went from being incapable of anything to being really great at anything I wanted to be (just late to the party). [1] http://addcentre.com/
May I ask how long have you been participating in the training?
Is it some kind of device on the head that you then learn to use with an on-screen app where you can get feedback on your "state" like meditation but with an interface?
I remember reading about this years ago and wondering when the tech would be available for use in-home.
Do you need to go to a professional clinic?
There are many different programs all with different goals, some try to optimize the relax range, some focus and some try to minimize cross talk. Imagine looking at a screen and it shows your POV from inside a roller coaster car. On the sides you can see a bar chart going up and down and a threshold level you want to attain. Eventually you learn to control it so you bring that bar to the threshold and hold it (Holding it is key). If your really motivated you can tell the technicians to bring the threshold down so far that you are able to focus greater than the average person.
It begins by controlling muscles in your eyes effectively, once movements of the eyes have stabilized(this is the hyperactivity part that negatively effects focus) light can effectively move into the visual cortex. Then tying the other senses(sound and touch) together probably switches on the focus networks in the brain. This leads to experiencing reality at much higher "resolution".
I would advise having professionals around(like I did) they can spot problems/anomalies and can aid in training. It can be dangerous to mess with your brain without professionals around.
I think i will try to find a place similar to yours in Scandinavia but want the quality to be right.
Alternatively i am thinking if consumer EEG electrodes are good enough at this time to create a personal setup.
You can read her various papers[1]. I've read many things about ADHD and functioning mechanics of the brain. This is by far the most substantive and practical resource of info that I managed to put to go use when I trained my brain.
Whereas people typically experience micro-rewards during the learning process, for people with ADHD, the reward response is too insufficient to reinforce learning. Without a proper reward system, a healthy learning system can't develop properly.
Some people firehose Will at the problem which may overcome an occasional challenge. That bandaid isn't sustainable, however.
not affiliated
https://www.amazon.com/Healing-ADD-Revised-Breakthrough-Prog...
A 80 minute video about ADD by the author: https://www.youtube.com/watch?v=UWnJ4wjVu9k
"Amen has built a profitable business around the use of SPECT (single photon emission computed tomography) imaging for purported diagnostic purposes.[6] His marketing of SPECT scans and much of what he says about the brain and health in his books, media appearances, and marketing of his clinics has been condemned by scientists and doctors as lacking scientific validity and as being unethical, especially since the way SPECT is used in his clinics exposes people to harmful radiation with no clear benefit."
I wonder what the parents of one of his youngest patients (below ten IIRC) would say to those scientists and doctors about "no clear benefits". Their son showed abnormal behaviour, drawing notebooks full of pictures of him killing his classmates. The brainscan revealed a huge brain tumor. Amen had to call several brain surgeons, till he found one who was willing to operate the child. After the removal of the tumor his behaviour normalised.
fMRI is getting closer as time passes and the techniques improve but still agreed to not be good enough yet.
The scientific criticism is valid, there's no direct link between his scans and the outcomes. He uses the science as a correlation for everyday self help stuff and catholic salvation.
It's not coincedence he talks about believing in miracles and jokes about wanting to become a catholic priest as a child. He grew up seriously into the church.
People are essentially paying for salvation and at a steep price, this is exactly why the protestant churches got started. Look closer!
But this study clarifies so much of my behaviour and self-image from when I was a kid to now. I bully myself fiercely, and never understood why I should be praised for high grades, when it was something expected of me. That definitely extends to now, where I can finish/deliver a product, but feel _nothing_ about it. No sense of accomplishment, no relief that something's shipped. Nothing. It stops me from taking on hobbies or really doing anything with the material that I learn. Leads to regular burnout and cycles of depression.
The article references methylphenidate as a good drug for ADHD, specifically for motivation. This makes me sad, because I'm on it, and not feeling very motivated.
It’s very annoying when I want to take the weekend off and have to suffer through massive withdrawal.
Honestly has changed my life for the better overall, but if anyone has any suggestions for trying to get rid of palpitations, it would be very much appreciated.
I’ve switched to Vyvanse and have been loving it. The on and off ramps are much longer so everything feels a bit more smooth than Adderall ever did.
This inability to form habits is extreme. If something's not right in front of me I forget that it exists. I've tried to start smoking, but as soon as the pack is gone I forget to buy another. I don't shower until it starts to effect me. I don't sleep until I can't keep my eyes open. I forget to eat until my stomach hurts. I truly don't believe I can become addicted to anything. I've been tempted to try crack because I've heard that everybody gets addicted to it and I might be able to use it to create artificial motivation in myself. I tried chewing nicotine gum every time I took a shower, but I just couldn't remember to do it, and it wasn't helping enough with forming habits.
I also have memory problems and basically have to re-invent everything from scratch all the time. I'm really good at solving problems so I've been able to cover up most of my failings. One story that highlights this happened when I was taking the ACT. There was one question at the end that I had to invent calculus to solve. I had a feeling that I hadn't solved a problem like it before, but I went ahead and solved it anyway and got every question on the math section correct. My verbal skills on the other hand were just barely acceptable.
Another anecdote about lack of schedule and routine also comes from my highschool time. Between classes I'd routinely forget that I had another class to go to. I'd see someone in the hall and start talking until the bell rang. In my highschool being late 3 times was equivalent to an absence, and 7 absences was an automatic fail. Needless to say I had probably the worst GPA in history. I also did very well on tests, but could never ever remember to read my book or do my homework.
Basically, a consistent theme is I'm totally worthless until I stumble into a magical sprint where I get 2 months worth of work done overnight.
I just spent from 1:30am to about 5:00am in my car with my laptop and was able to make 6 much needed git commits as well as taking care of a bunch of other issues with my main project. The last commits were the end of August with 14 commits over just a few days.
Wow, that was a ramble, but I've been up for about 30 hours now so that's not surprising.
For a long time my response to this tendency was to try to control, direct, pin down my motivation so that I could stick with something until it was done. Doing this caused me to actually have a real deficit of motivation, instead of just an always-changing motivation. Once I stopped trying to control it and embraced jumping-around, following my interest wherever it led me, I actually had much more success seeing tasks through to completion (and even circling back to ones I'd left behind, because I wasn't feeling guilty about having left them behind). It's like my attention is highly fragmented, but I still have the same amount.
An ADD person's motivation is like a wild animal that you just have to give room to so it can do its thing. Hitch a ride to it, instead of trying to tame it, and you'll eventually get where you want to go.
Having no external source of motivation is the death of us.
Not remotely true in my experience. Quite the opposite: I really struggle to be interested in motivators that are external, rather than internal.
http://russellbarkley.org/factsheets.html
The above link is a collection of PDFs summarizing key points on ADHD by Russel Barkley, generally considered by many in the ADHD community to be the 'god' of ADHD research.
I can focus easily on tasks - even hyper focus for hours. Problems arise when there's an important but boring task vs a nonessential but interesting task. I will struggle to just think about starting the boring task. It can be really crippling when working with other people or in a startup.
I tried to write about my own experiences with ADHD, in particular regarding distractions. https://www.kabdebon.com/founder/2020/08/25/creative-mayhem-...
Before I started training myself to meditate, I noticed that drinking a lot of coffee seemed to help me focus better. Though it was only really until I started meditating that I realized it was possible to direct my focus/attention in such a calculated manner. I had always resigned myself to "my attention" controlling the actions I took rather than the other way around with me actively choosing how I apply it.
After I stopped, I was more hyperactive and less focused... Yet the hyperactivity compensated for the "less focused" part, and I finished a week's work in a day.
That's my experience with meds so far. They completely eliminate my anxiety and make me feel in control of my emotions. Yet they make me less productive than when I'm in a hyperactive rush (even if my focus is reduced).
So for now I'm just going to embrace my inconsistency (in terms of emotions, energy, and focus) because I think I'm way worse without it. Establishing a routine helps me cope much better - I feel waking up early and having a good morning dictates how productive my day will be.
On meds, I finally felt in control of my life and energy. But it also felt bland, boring. I didn't feel anything. I had no anxiety to push me to go the extra mile. My personality & cheeriness were nonexistent. And I was, overall, simply less productive.
Not doing that again.
These medications are serious and side effects can include thoughts of suicide so I'm always shocked when doctors try to wing it and just prescribe whatever and see how it goes. I'm hoping it's because they don't know about the genetic tests yet but some are likely willfully ignorant.
I don't have experience with atomoxetine, but other meds, and this sounds a like an symptom of over dosage. The typical "ritalin robot" is usually causes by taking to much.
Maybe you can check out other meds. I experienced the "blend robot" situation a few times with Medikinet and learned that Methylphenidate is very sensitive to food intake and PH in the stomach, which can make the effect less predictable. I switched to Lisdexamfetamin - it's less dependent on food and works better for me.
Fasoracetam in particular looks promising but seems to be stuck in approval limbo:
They injected humans with cocaine for this study, am I reading that right?
For most other people it seems like they can hardly sleep while on bupropion.
I was told via forums that I might have ADD/ADHD because of this reaction.
What does HN think of this reaction?
I can literally sleep all day for days on end and fear and done irreversible brain damage.
It just sucks that I get addicted to weed because I'm super productive.
I just need a way to prevent myself from having marijuana before anything social or public.
The role of dopamine as an answer to all things reward or motivation is greatly exaggerate in the pop-neuroscience articles online. Doing nearly anything goal-oriented or even remotely rewarding is associated with dopaminergic activity.
People also tend to overlook the fact that the stimulants used in ADHD treatment also have significant norepinephrine activity which contributes to their pharmacological effects. Purely dopaminergic drugs often aren’t as energizing as you’d expect. In fact, selective dopamine agonist medications can induce narcolepsy-like symptoms where patients struggle to stay awake due to the complex nature of dopamine activity in the brain.
In your case, it’s possible that you’re naturally motivated but THC is causing disinhibition to override whatever is preventing you from being productive (anxiety). THC is also known for making boring tasks feel interesting, but it’s also known for decreasing motivation and making people feel like they’re accomplishing a lot more than they really are. In other words, it’s not a solution to anything. You’d be well served to spend some time exploring this with a psychiatrist or two.
Funny enough, I'm also very prone to anxiety on THC. So there might be a correlation there somewhere.
If you don't stop to reward yourself for what you do, you will loose interest no matter what.
You cannot trick your own brain.
There are even non-stimulant ADHD medications that have no dopaminergic activity at all (Intuniv).
Complex human thought processes can't be reduced to single neurotransmitters. Everything you do is a complex interaction of many pathways that use many different neurotransmitters.
ADHD also isn't purely a chemical disorder. Plenty of ADHD people learn to focus and be productive through therapy and constant self-directed change. Plenty of ADHD people treated with stimulants just use their chemically-induced focus to mess around on the internet and continue to waste time.
Effectively treating ADHD requires approaching it as a mix of medication and lifestyle changes. Reducing it to just dopamine is a trap.
Yeah. Took me a while to see the "2010"...
It's the point of almost all ADHD memes - thought it's common sense now.
Terrible analogy.
If you can design your life to be benefited by ADHD, that’s awesome.
If you’re stuck working a 9-5 like a large portion of the population ADHD sucks.