Association between ADHD medication and depression: A 10-year follow-up
ncbi.nlm.nih.gov
ncbi.nlm.nih.gov
I got diagnosed with ADHD 5 months ago, started medication 2 months ago, and last week I told my therapist I'm pretty sure my life-long depression is in remission. There's a definite feeling that my life is now in a slight upwards trajectory, even on the worst of days.
Life tends to become pretty sad when you have no control over your executive function and action.
> Well, a dose doesn’t last forever. It wouldn’t be surprising if it was a net negative.
My near-sightedness returns as soon as I put down my prescription glasses. I've had to wear them every single day to be able to function decently. Imagine that.
Your doctors are probably doing more harm than good by not treating an underlying metabolic disorder. It’s quite possible you have an underlying B6 deficiency.
Why don’t you go get your B6 levels tested and ping me when you get them back OK?
Most psychiatric problems are not due to a nutritional deficiency. My B6 levels aren’t causing my adhd.
Is that why I’ve been able to get off all of my medications? Because I’m a kook and I don’t know anything about neurobiology? Or anything about immunology? Or genetics?
You say your B6 levels are not causing your ADHD, but have you ever had them tested?
Yeah it’s so "kooky" that they keep finding B6 defieicny over and over in children with ADHD.
https://hrcak.srce.hr/file/303406
And heck, you might try to take it with your meds, it might help: http://sjh.umsha.ac.ir/download.php?mod=a_atch&atch_id=253&a...
And I suppose it is nothing that polymorphisms in a gene that makes dopamine (DDC) is implicated in ADHD and also needs B6 as a cofactor.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946061/
But I am the kook I guess. No, it’s not crazy at all to take an amphetamine. It’s not crazy to never wonder why they don’t try to find out why you’re not producing enough amphetamines on your own. It's not crazy we give these drugs endlessly yet ADHD keeps rising.
My Schizoaffective Bipolar Disorder is caused by nutrition. Ask me how!
> My Schizoaffective Bipolar Disorder is caused by nutrition.
I suppose anything is possible, but from what I know -- I'm not a psychiatric professional but I've lived with one for 20 years -- it sounds unlikely to be true for most people with similar diagnoses. Believe me, psychiatric hospitals would love to make more beds available by "curing" mental illness with diet.
I'm not saying you shouldn't be on drugs or that you'll find the drugs stop working. I'm just saying the effects on the brain are pretty complex and shouldn't be compared to wearing glasses.
I also started having very annoying anxiety in the morning after taking meds. And all that with a reduced effectiveness of the drug - clear slowdown in the afternoon after lunch which I didn't have in the beginning of treatment (the dosage was more or less constant from the start after initial titration).
Ritalin clearly affects my sleep patterns. On it I never feel rested and wake up with a feeling I haven't slept at all. There was no change, the effect was present from the start. It takes at least three days without meds for it to be gone.
Finally, Ritalin is definitely bad for my creativity. For instance, I have a habit to play piano or guitar as a way to relax since I was a kid. Composing or improvising at least 50% of the time. This invariably stops when I am on meds - it feels like the activity becomes dull and stops being pleasurable.
All in all, I think it is great that the meds exist and work for a large number of people. That being said I can't stand when someone praises stimulants alluding the consequences of taking them are invariably positive and the side-effects are trivial (if they are acknowledged).
Sadly, most internet discussions on ADHD meds (among people who don't deny it) are infected with overly simplistic toxic positivity: "get diagnosed and treated and your life will be fixed while you'll be happy". The first part I agree with but there is no need to trivialize - the life is more nuanced than that.
I'm not sure how many people with addictions are regularly forgetting to take their drugs without a phone reminder.
The point of the delay release is that you don't have the same kind of ramp up to extreme effects and then come-down. Instead the goal is to get a (roughly) consistent dose that helps with executive dysfunction, and doesn't do much else. As always, that's something you work out with the help of a psychiatrist, not everyone reacts to methylphenidate the same way.
My point is, of course AMPH helps depression from ADHD, because ADHD is a debilitating disorder. But AMPH probably doesn't help in other types of depression not caused by executive function disorders.
Somewhat before that – US context late 1970s – there was political pushback against the largely unrestrained (but legal) amphetamine production by the pharma industry, which supplied more than enough to saturate all the recreational and abuse cases.
DEA brought amphetamines into the Scheduled drugs, manufacturing became quota limited. Incidently, the medical community found that psychostimulants does not have any medical value in treating depression.
Some studies have found them beneficial, some not. The pharma industry has since transitioned into opioids but stimulants have been making a comeback for 20 years with record numbers in ADHD,ADD diagnoses.
Apologies for the late reply, HN doesn't really notify me
Apologies for the late reply, HN doesn't really notify me
Methylphenidate affects me in fairly subtle ways and I'm constantly wondering whether it's actually working or if it's a placebo effect. However, my general experience when I look at the tracking data I collect in my own life mirrors this sentiment.
Methylphenidate doesn't get rid of my distractability or make it easy for me to focus whenever I want, but it does help with my executive dysfunction just enough that I can now set timers more reliably, I can now use calendars more effectively. It's not that the medication made the problem go away, but it seems to have helped enough that it "unlocked" a bunch of additional coping strategies that I had never been able to access in the past no matter how much I tried.
Definitely not for everyone, but also that's what a psychiatrist is for -- to help you experiment with different medications to see if there is one that will help, and to monitor you to see what the side effects are and what the long-term effects are, and to figure out and advise you on what your risk factors are. For some people it can be life-changing.
I think a lot of people see this as a question of medication vs therapy, but for a lot of people with ADHD the two parts work together -- the medication makes the therapy more effective and more productive.
I actually tried TWICE to drop my meds. Each time my life fell apart, as you described.
The second time, however, I did not interpret my life falling apart the way you did: instead of interpreting it as validation of the medication's effectiveness, I interpreted it as a withdrawal period. So the second time I quit, I expected going into it that the process of adapting to life without medication would probably last at least 2-3 years.
I can't say what would've happened had I taken your path and not mine. But fifteen years in, I have no regrets. I still don't do what I'm told, but I'm productive and happy and useful. I've found my own way, and it's been a good way.
I have been diagnosed in my 30s and when I stop medication, my life returns to the same exact shit it's been for 30 years. It feels like falling apart, because that's how it was for three decades for me.
That said, I'm happy you found a path without needing the medication. One of the positive aspects of ADHD medication is that you actually learn to function without them, because it gives you the mental energy and fortitude to build healthy habits that can help keeping you ticking along even without the boost of increased dopamine.
ADHD is defined as a disorder of executive function: that is, an individual with ADHD is unable to do what they wish to do. This was an accurate description of me; to this day, finding and working toward my goals is something I'm constantly working on.
But if I look back on my childhood, I see that there was never a time when I had space to figure out how to understand and execute my own wishes in the world. Indeed, within my own family it was not recognized that I had a will of my own at all.
Medication helped cope with this state of affairs, but it never helped repair it. So e.g. if I found I didn’t much like being a student, I could take a stimulant and improve my ability to perform as a student. But taking that medication did nothing to help me solve that key equation: to do something I want to do, that other people also want me to do for them.
So my answer to the problem posed by an ADHD diagnosis is growth: I had to start as an autodidact, but as I’ve grown into my adulthood I’ve found friends, mentors, and peers along the way who help me find my way. The world is making it harder and harder to get, but it’s out there.
It probably started with reading _Delivered From Distraction_ years ago. I tried a bunch of stuff in that book. Nothing was a silver bullet (because there is no silver bullet), but I have to give credit to that book for inspiring me.
Nowadays if I'm writing, journalling, praying, and getting honest feedback from friends regularly I'm probably on the straight and narrow. But I try not to be too hard on myself: life isn't a contest, after all.
Cheers and kudos!
I’ve only just finally started actually fulfilling my potential and reading your comment fills me with the regret that things were not different for me…
Epigenetic mechanisms are what turn pigs into boars when released into the wild. In humans, if someone undergoes drastic starvation in their childhood, their children will often be fat. Their bodies hold onto fat more readily because it essentially expects to undergo a similar level of starvation. Evolutionarily, people who's epigenetics could benefit their children in this way were selected for via easier survival.
There are no studies, due to a lack of understanding in the past, of the effects of lifetime use on future generations. It could, potentially, be a positive effect - or none at all.
But that's optimistic for biological mechanisms imo, I'm remaining a pessimist and preferring the route of non-lifetime medication. If someone else wants to test this on their life and family, I would be happy to read about it.
Now, for the last 8 years I am med free and showing signs of recovery.
You do not need meds. You need to find out why you need them biologically. We know that ADHD is primarily caused by low dopamine. So why are you not making enough dopamine?
I also feel like:
> We know that ADHD is primarily caused by low dopamine
is a bit of an oversimplification. ADHD is not always caused by low dopamine/norepinephrine/etc production, it's often in part caused by faster than normal reuptake of those chemicals. But when arguing that ADHD is entirely caused by environmental deficiencies, "you're not producing enough dopamine" sounds better than "your brain is absorbing dopamine too quickly so it's not signaling as effectively as it should even when it's released in the same amounts as other people."
And again, this is complicated and different people's brains work differently, medication isn't right for everyone. That's why doctors should be involved. But what's going on is a lot more complicated than "something in the environment is making you depressed so you don't release dopamine" or "you don't have enough of X vitamin so your body can't produce the chemicals it needs"; it's more accurate to say that ADHD is often caused by differences in how actual neurons and synapses interact.
If reabsorption is happening prematurely, it's not necessarily that less dopamine/norepinephrine is being produced, it's that the chemicals being produced aren't as able to be used to do the things they're supposed to do.
And that more complicated explanation ends up being a lot more useful to describe some of the less well-known symptoms of ADHD that sometimes pop up for some people; symptoms like hyperfocusing, poor interoception. It paints a more complicated, multi-faceted picture of how the body can find itself unable to stop focusing on things when neurotransmitters do manage to finally bond, or why certain bodily signals just don't seem to reach the brain reliably. I am not a doctor, but I think it's a lot easier to understand what ADHD does when you look at through the lens of a physical difference in the brain that has knock-on effects on how the brain continues to develop as it learns to rely on other signals and coping mechanisms and strengthen those pathways.
TLDR I kind of disagree with the explanation of people with ADHD as if they're dopamine-deficient, I think where modern research is leaning is that they (often, everyone is unique) have brains that aren't able to make use of the dopamine (and other chemicals, not everything in the world is dopamine) that is produced.
It's clear you're an evangelist for this approach, but your complete dismissal of people who have issues with drugging children doesn't add anything to the discussion.
I don't think it's reasonable for OP to advocate for policy that would materially make their life worse. I'm not sure what you expect their response to be, but it's not going to be, "medication doesn't work for everyone? Great, I'll just go back to being miserable then so no one accidentally takes it unnecessarily."
Prescription medication is something you should work out with a doctor/psychiatrist who monitors your behavior and figures out whether the approach is right for you. But even if methylphenidate only worked for even just 10% of the people who have ADHD -- those people should have access to it. And the rest of the people don't need to take it, that's something their psychiatrist/doctor can work out with them.
> complete dismissal of people who have issues with drugging children
It bothers me that people read "hey, medication worked for me and didn't give me depression" as "literally everybody and their dog should be on this." I don't think that OP is the person here who's dismissing or generalizing.
Children are supposed to be outside moving 8-12 hours a day, have you seen puppies? They need something similar. Instead many parents give their children tablets, plop them in front of the TV and do something else. Kick them into the back yard or go throw a ball with them.
Every child I know diagnosed with ADHD had parents who didn't want to deal with them. Bringing them to the gym, to the park, playing in the backyard; it's a lot of work. Kids who have trouble focusing are likely tired and overstimulated. Reduce the number of toys, remove TV / tablets, and send them outside. It'll probably solve itself.
As an experiment, look at the people you know on medication (or ask), look at the troubled children, etc. I guarantee you'll see the same trend: single parent home, started medication at an early age, regular therapist appointments, etc. They're unhappy and need depressants, ADHD medication, etc.
It's not always the case, but it's a trend. People who are diagnosed with ADHD at a younger age likely have parents who just don't want / know how to deal with issues. Mental health "experts" treat the symptoms via medication, but the underlying issue(s) just continue to fester.
What we really need is a strong emphasis on family development, courses built around it and support groups. Parents naturally do this, but I think it's been severely broken down the past 50-60 years and is getting exponentially worse. As such we see more: single parent homes, abundance of medication, reduction in religion and adult social clubs, etc.
I take daily medication and it has been literally life saving as I was able to turn things around and keep my marriage from falling apart, not to mention my happiness from being able to accomplish much, much more. I'm holding off medication for my daughter only because it lessens appetite and she is very skinny already. Once she's grown to her full height we'll get her meds she can use too.
I agree with your point but as I’m wrapping up raising my own children I’m coming to the conclusion that I made it a lot harder in myself. Driving them to a million activities, even driving them to playgrounds several times per week, Home Depot kids workshops and so much more.
Sometimes I think a better thing would’ve been to simply say, “Go play outside.”
Once you have a child with ADHD, or if you are someone with ADHD, you will understand just how wrong you are. Until then, enjoy your bliss.
https://link.springer.com/article/10.1186/1471-2431-12-50
> Approximately 10% of the sample was classified as having ADHD. We found depression, anxiety, healthcare coverage, and male sex of child to have increased odds of being diagnosed with ADHD. One of the salient features of this study was observing a significant association between ADHD and variables such as TV usage, participation in sports, two-parent family structure, and family members’ smoking status. Obesity was not found to be significantly associated with ADHD, contrary to some previous studies.
https://www.sciencedirect.com/science/article/pii/S221133551...
> Youth with ADD/ADHD engaged in screen time with an average of 149.1 min/weekday and 59% had a TV in their bedroom. Adjusting for child and family characteristics, having a TV in the bedroom was associated with 25 minute higher daily screen time (95% CI: 12.8–37.4 min/day). A bedroom TV was associated with 32% higher odds of engaging in screen time for over 2 h/day (OR = 1.3; 95% CI: 1.0–1.7).
https://journals.lww.com/jrnldbp/Abstract/2018/04000/Sleepin...
> A shorter sleep duration and less time spent in cognitively stimulating activities were associated with an increased risk of developing ADHD symptoms and behavior problems.
There's plenty more, but the gist is pretty clear. Get your kids outside, give them a supportive and safe environment, teach them how to behave like adults, give them plenty of sleep, and provide them plenty of opportunities to learn. All those reduce risk of depression and ADHD (hence the correlation above).
This does not imply causation. Someone with ADHD is more likely to give in to distraction and dopamine. This study was done with a sample of people who already have ADHD. Nothing in it indicates that television time is going to cause ADHD.
Someone who has a better relationship with exercise, screens, or whatever, doesn't mean they don't have ADHD anymore. Medicated or not. They just have better support and lifestyle habits that minimize how much it might impact them.
If a disease can be resolved through changes in lifestyle is it a disease needing medication?
I think that is kind of the point, is it not? We can give the kids anti-depressants for being depressed or we can help them change their lifestyles. We can give the kids ADHD drugs or we can change their lifestyles. We can let the kids get diabetes, put them on drugs, or help them lose weight.
This is a ridiculous discussion. Yes, drugs can help and we may need to use them in extreme cases to aid in lifestyle changes, but shouldn’t the goal be improved life style
I don't really have much to do with the prescribing part of it (besides my personal medication decisions, and doing my part to not ignore the problem), so I'll leave that to my friends in the medical industry. Though especially having held some uninformed opinions on people who need medication earlier in life, I think it's important to not make people question whether they should take life-changing medication because of stigma or social pressure.
I will say my personal experiences have exposed me to people who need medication but have trouble accepting it a lot more than the latter, so I don't want to pretend my experience is universal.
ADHD has strong correlations with motor control and sleep issues, and is notoriously under-diagnosed amongst girls as they tend to present and be perceived differently.
ADHD is also understood to be hereditary and therefore given that the divorce rate for adults with ADHD is much higher than normal you should expect a higher incidence of children with ADHD growing up in a single family household. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4071160/
Your second source is ridiculous, if you actually read the study they looked only at kids diagnosed with ADHD and then found that kids with tvs in their rooms watched more tv. It should seem obvious that this would be the case and im fairly certain you would get the same results if you looked at non-diagnosed kids (which again, they didn't)
I have a child with ADHD (age 9) and a child without (age 6). They are both highly intelligent, but compared to each other:
* My ADHD child is significantly more attracted to screens, video games, and quick stimulation in general. If he doesn't have a screen, he's much more likely to engage in simple, lower-focus activities like simply spinning and running in circles or just hitting things against each other. When given the choice, he will always choose screen stimulation.
* My non-ADHD child is more likely to play with clay and building materials, read, write, and draw. He likes TV and video games, but will very often decide to do other, lower-stimulation activities without being prompted. When outside, he explores and examines things, and will play more structured, imaginative games with rules.
* My ADHD child sleeps much less than the non-ADHD child. He has trouble falling asleep, and wakes up very early every morning on his own. It is impossible to "give them plenty of sleep" when they literally can not sleep.
* My ADHD child exercises much more than the non-ADHD child. He is more interested in going outside in general.
* My ADHD child does not like studying and can not focus on learning things. He learns less, he learns slower, he is disruptive in class. He acts more immaturely even when we take much time teaching him to behave like an adult. He is often depressed because he feels like there's something wrong with him because he has a significantly harder time just having fun doing things that other kids his age do. He feels depressed because he wants to learn things that he simply can not make himself sit long enough to focus on. He feels depressed because he knows he is being immature and disruptive and feels like he literally can not control it.
Given the same opportunities and treatment, my ADHD child has more screen time, more time exercising, less time sleeping, learns less, is less mature, and is more depressed. He is on medication now, but I felt the way you do for years, and it set him back severely in school and life, including his friendships and relationships with family. On medication, he is doing much better in every single respect, but he still struggles, and the medications become less effective over time (we're still trying to find something that works better long-term).
I'm going to be frank here. You are taking studies that show correlation, ignorantly assuming causation, and making judgements and giving advice about an area that you clearly do not have any personal connection to. ADHD may be overdiagnosed, it may have been underdiagnosed in the past (note that ADHD is strongly correlated with self-medication and addiction, which has always existed), but it's not something that you can really easily cause or prevent, and dealing with ADHD in a child is stressful and challenging for both the parent and the child. Assuming neglect among parents of children with ADHD is absolutely uncalled for, and contrary to my experience, where parents of children with ADHD are absolutely run ragged from years of trying to fight to keep their kids healthy, sane, and educated.
I never once suggested the parents were being neglectful in the sense they weren't giving it their all or trying their hardest. To your point, they're ragged, the ADHD children clearly need more work, etc. Further, I'm sure the "mental health professionals" recommended it to them.
I'm not going to share my personal experiences, but I truly do understand all of this and the struggle. I agree we have no proof about what causes ADHD, and those were all correlations. That said, I can say that in the past 100+ years our entire environment as a species has changed. We have some pretty unreasonable expectations on children and not all of them will want to build, some will want / need to lasso cattle, ride horses, hunt, etc (as we did for tens of thousands of years). They may not learn the way we structure our society, they may not respond well to the chemicals, the change in diet, what have you. It could simply be genetics.
The point I was trying to make was it's clear why depression is often correlated (there was no causation in this paper btw) with ADHD and ADHD drugs. Societal and family support is weaker than it was 80 years ago, there's lack of community, less dual-parent households, constantly being told "the world will end", etc That's kind of my point.
ADHD and depression are a disease, meaning they are a variety of symptoms that when presented together are diagnosed as impeding normal function. Those symptoms can have various causes and unless careful observation is made, it's possible to conflate or miss the cause, there may also be a multitude of causes. Treating the cause will "cure" the disease, much like you can cure (or at least dramatically reduce the risk of) type 2 diabetes with diet and exercise (the issue being your bodies ability to process glucose -- often due weight); but not Type 1 diabetes.
What I want to clarify is that I think this is a societal issue, but expressed it through personal observations. Having one parent clearly has an impact (less energy and capability to give to an ADHD child), having structured education, having screens, etc.
Give the example you stated around screen time; would your son be better off trying to learn to focus or playing outside? I honestly don't know for sure, but what is clear is that you care. I'm 100% sure you're doing your best to make that judgement call. My point, was that many times the parents don't care, they just want their kids out of their hair.
My general point was never to assign blame, it was to point out that diseases such as ADHD, Autism, depression, anxiety, etc to be diagnosed together. Further, that those diseases often correlate with some of the issues I highlighted. That doesn't mean it's all cases, but to ignore reality isn't going to help either. If we don't examine the causes and we just medicate -- it wont work well for the children. Medicate as needed, but if we can, we should try to cure the disease.
To be told "you're just a bad parent who lets their kid watch an iPad too much" is infuriating. (I'm trying to keep things civil per the site rules, but my honest reaction begins with 'F' and ends with 'U', guy.)
EDIT: But yes, they’re also saying that many parents are doing it wrong, and they’re assigning much of the blame to parenting. My point was that when a huge percentage of parents are “doing it wrong”, maybe there’s some wider systemic thing at play. Like economic forces that make people work harder than they should if they have kids, dissolution of support networks that would’ve normally cared for the kids in addition to the parents, etc. I’m not saying that this is a cause of ADHD, because I know little about it, but if you take their opinion as correct, then much of the blame could be laid at the societal structures we’ve created rather than the individual.
* "Every child I know diagnosed with ADHD had parents who didn't want to deal with them."
* "look at the people you know on medication (or ask), look at the troubled children, etc. I guarantee you'll see the same trend"
* "likely have parents who just don't want / know how to deal with issues"
There's only a single phrase "not always the case, but it's a trend" that frames it as a societal issue on average, but that doesn't counter the incredibly general conclusions made by the poster.
Sorry for being snarky. Not sorry for calling out destructive, unscientific bullshit.
Like I said in my comment, they pointed out some real problems, but made sweeping generalizations, mostly negative, about the people in question.
ADHD is not well understood by a lot of people, and someone with or without ADHD who is well-versed in the topic pointing out that their comment is not helpful to discussion about how to treat the disorder, shouldn't be dismissed as them "Taking it personally".
Parents are clearly doing their best and looking for support. The "experts" are paid (in many cases) through recurring attendance and kick-backs from pharma... why would we assume they'd want to resolve the issue any other way? Even the research is often funded by pharma... Note the NIH even receives revenue (and individual scientists) from creating patents associated with drugs.
Here's something I posted in another comment, but ADHD / Depression is a "disease" is a bucket of symptoms that impair an organisms normal function.
1. I would argue that what you describe isn't impairing normal function. It's that we are attempting to make children do abnormal things (sit in a room all day and be lectured at. At the end you have an exam). Society is failing to raise children properly and expecting things that are abnormal for the human animal.
2. A disease is basically diagnosed from a bucket of symptoms. Those symptoms will have different causes. Without taking a measured approach at identifying the causes, you are likely going to see a plethora of factors. These can and do include things like hyperactivity from siting and watching TV (now they have energy and want to move). Things of that nature.
Now to compound the issue, look at how all the parents are responding. There is no way they'd consider alternatives.
One way I try to explain it to people: "We give people insulin because they have diabetes. Diabetes is the disease, but you can cure it through diet and exercise for Type 2 (it's environmental), Type 1 you cannot (it's genetic). Insulin treats the disease, but doesn't cure it".
Why are we giving all the kids medication instead of trying to have them diet and exercise (or what ever equivalent)?
Parents in this thread are taking it very personally, but in reality I'm trying to discuss ways to treat the underlying issue(s). And yes, I am saying that there are societal, family, etc expectations and management that can be employed to remove symptoms of the disease (which in effect would "cure" the disease).
ADHD is hereditary, genetic, and has to do with how the brain tends to be wired in that individual. ADHD can be helped through environment and habit changes, and impacts can be reduced, but you cannot cure it.
It seems that you think ADHD is not a real disease, given your quotes around the words "disease", "cure", etc. If some people are mis-diagnosed, it doesn't invalidate all the others.
https://pubmed.ncbi.nlm.nih.gov/31810593/
And ADHD is not a disease, it is a disorder. There is no biological markers yet for a diagnosis either.
Anyway, I don’t think the poster was saying it doesn’t exist. They appear to be saying there are correlations and often a diagnosis at a young age is a reflection more on a willingness to accept a hyper child vs not. That is to say, a child can have ADHD, but that doesn’t mean you have to medicate them. Medicating them (again at a young age) for ADHD, indicates a willingness and potentially eagerness to medicate, as opposed to attempting to correct issues. Ie just give the drugs, don’t try to figure out why they’re depressed.
1) The study is right and every doctor and medical institution I've talked to is wrong.
2) The study's results are being generalized too far or misinterpreted. E.g. I've been told (and it's true in my experience) ADHD people tend to be attracted to screens for the dopamine hit and characteristically lack self-control, rather than the screens causing ADHD.
3) The study is cherry-picked and wrong. Either it is an abnormal result that doesn't replicate, or the study was badly constructed.
Given the fact that my doctors gave me multiple studies to look at which showed the exact opposite conclusion, my prior leads me to believe (2) or (3) over the first possibility. I'll skim the study he posted later though when I have time.
My anicdata doesn't constitute medical science, so it's entirely possible that this study is right and I am wrong, and I'm big enough to admit that. I wouldn't bet on that outcome though, in this case.
EDIT: Also one point you may or may not be aware of is that non-medicative interventions for ADHD are at best a coping mechanism and never satisfactorily address the underlying issues. In the words of my doc: if you are diagnosed with ADHD and you can solve your problems completely with therapy and just going outside or whatever, you didn't have ADHD in the first place and the diagnosis was wrong. Actual ADHD is when your brain is wired up a different way, and general lifestyle interventions can't address the problems that causes.
ADHD people have spent their entire lives feeling frustrated and powerless as the well-meaning people around them tell to simply "stop being so distracted!". Believe me, if we could turn it off we would. It's not so simple. The poster above is making essentially the same critique: that it's not the kid's neural chemistry or wiring that is causing them issues; it's the parent's fault. Stop being a bad parent!
That's worse than unhelpful.
This is speculating on the motivations of a wide class of people without data, and is complete nonsense.
I have no idea where you take this opinion from or if you can back it up. From my anecdotal evidence exactly the opposite is true: kids from families who do realize there is such a thing as mental health and who care deeply about their kids - those get diagnosed. Kids from other families just get mostly slapped around and screamed at to get their shit together.
https://www.sciencedirect.com/science/article/pii/S014976342...
I have a child clinically diagnosed with ADHD. It’s absolutely nothing to do with time spent with him. We have stable family home, active life style. etc
He just has a brain that works differently. Not worse. Different. He might struggle to pay attention at school but he’s written two novels!
PS. Religion is horse shit so if that’s the only other thing you have left for me to help him, I’ll take my chances, thanks
Looking back, I clearly had ADHD, but since it's a condition that's unique and specific symptoms vary per person, I just happened to have mechanisms that worked and got lucky with how my brain patterns fit into school from Elementary - High School.
I had plenty of outdoor activity, and plenty of video games / computer use. Not that you mentioned it, but I also read fantasy/sci-fi books like they were daily papers, finished all of my incomplete homework in the morning while waiting for class to start, and was constantly multi-tasking in class (reading, doing homework for an upcoming class, or occasionally fidgeting).
My sample size is 1, but I have 4-5 diagnosed (either as kids or adults) close friends with similar stories.
Your comment takes some generally-well-known positive advice (exercise more, social interaction & supportive relationships are good, parenting kids is a big task that takes time & effort), and identifies some real problems we face today (social isolation, a lack of non-religious adult organizations, sedentary lifestyles) and uses it to disparage people with real, diagnosable conditions, and vilifying those who turn to medication for it.
I'm fine with how my life worked out, but I can't imagine being the kind of kid whose ADHD manifested in a different way that made school exponentially harder than it was for me, and being told that life-changing medicine, that let me participate in school or work just like everyone else does, is something I was given by mistake, or that I just had shit parents or should have played outside more.
Do you have adhd, or do the drugs help you focus and you want that?
Calling it a disease implies something is wrong, but having trouble focusing isn’t “wrong”. It’s a skill one can acquire and may have a variety of factors impacting it (from genetics to environment to mental management).
That’s the issue I personally take with these kind of discussions. Medication may help you focus (coffee does that), but do people who need coffee in the morning to focus well have a disease? Hardly.
On medication now, he still has a hard time, but he is actually capable of controlling himself, he is capable of forcing himself to focus, and he's much happier. Now it is just a skill for him to work on, but in the past, it was an actual impossibility. It is a true disorder, not just "trouble focusing", and ADHD medication is a fundamental need for some people to function at all, and not comparable to a morning coffee.
In the past, these people were often assumed to be possessed, or insane, and were institutionalized, killed, or imprisoned. It's not like ADHD is a new epidemic or something.
As an ADHDer, I never understood what it was like for others until I got treatment with stimulants. It's like I can just take this magic pill and for 8 hours I'm "normal."
I wish there was an opposite pill, one which made people inattentive and impulsive. Then everyone else could try it for a day or two and see how debilitating it is. Regular, everyday life is like being falling-down drunk in terms of mental incapacitation, and the pills for the first time let us experience life sober.
Edit: how old is your son now? One thing I worry about as a parent of an ADHDer as well is her eating. I've so far avoided treatment for her because I'm worried she'll eat less and her growth will be stunted. We're cautiously waiting on medication until post-puberty.
We do a couple off days now and then, but not a lot because he feels like it's a wasted day because he can't focus on anything he really wants to. I suggested that he could take weekends off the stimulant, but he says he'd rather be able to operate mostly every day than to have a more focused week and completely wasted weekend, and I feel like he's capable of making that decision for himself.
I suggest you have someone sleep 4 hours a night for a week. You'll often see the same symptoms as someone with ADHD.
I don’t think it gets as bad as ADHD but I definitely get a taste of it.
Why is it not the same for ADHD or depression? Type 1 is genetic and Type 2 is environmental.
The argument I was attempting to make is different from what everyone here is saying I think. What is a disease?
> Disease - a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms
Two points:
1. I would argue that what you describe isn't impairing normal function. It's that we are attempting to make you do abnormal things (sit in a room all day and be lectured at. At the end you have an exam). Society is failing to raise children properly and expecting things that are abnormal for the human animal.
2. A disease is basically diagnosed from a bucket of symptoms. Those symptoms will have different causes. Without taking a measured approach at identifying the causes, you are likely going to see a plethora of factors. These can and do include things like hyperactivity from siting and watching TV (now they have energy and want to move). Things of that nature.
Given the above, we're effectively medicating children for personal / societal reasons, not because the human animal is actually suffering or impaired in any way.
“ In this paper, we discuss candidate triggers of islet autoimmunity and factors thought to promote progression from autoimmunity to overt type 1 diabetes (figure 1). These factors seem to have their effect mainly in the genetically predisposed individuals.” [my emphasis]
I'm talking about tasks I want to do but would struggle with without medication (mainly coding for pleasure).
Yeah - I could find different things to do with my life, but I love coding and I am delighted to find there's a simple pill I can take that helps me do more of it.
Granted, I am happy for you and I think drug laws are ridiculous.
If cocaine had positive effects that outweighed the negatives then it absolutely should be prescribed. But it doesn't. Unlike methylphenidate - which for most people has fairly mild downsides at the doses it is usually prescribed in. It is also largely non-addictive with little evidence of long-term health damage.
Also unlike cocaine.
All in all, I'm not sure how this comparison helps.
https://en.wikipedia.org/wiki/Methylphenidate
Though I'll grant you we don't have data for long-term effects.
https://www.sciencedirect.com/science/article/pii/S014976341...
Further, as you pointed out does have benefits (which is I assume why it's prescribed). Cocaine and meth have similar effects btw (pros and cons), abuse is what causes the issue(s). People can survive on both for decades though.
In my case, my grades plummeted and I was unable to get into the colleges I wanted, or to graduate from an engineering program like I had wanted. I ended up graduating with a degree after 7 years and bouncing between 4 different colleges, and I've had a decently good career in Silicon Valley where being a generalist is a solid plus. But my dreams of being a (literal) astronaut were flushed down the toilet in the process.
Kids shouldn't have to sacrifice their dreams or their self-esteem because parents are unwilling or unable to seek proper treatment.
I did my best and most days I was too tired to give my child the attention and guidance they needed and he suffered needlessly. I resisted prescription medication for as long as possible until it became absolutely necessary. It works and there are side-effects, including symptoms that overlap with depression.
I am spending more time with my son (especially physical activities) and I hope someday he doesn't need methylphenidate.
I am likely still shadow-banned and nobody will see this message. I hope this message gets out and more single parents get the help they need.
You must not know many parents then.
Parents I know that have children with ADHD recognize their children are struggling beyond simple hyperactivity. These are children that are markedly behind their peers in childhood milestones regardless of their family upbringing, education, and socio-economic status. These are children that have a deficiency in the executive function of their brains where hyperactivity is one of many symptoms, and is not even necessarily the most worrying.
These are children that struggle with simple tasks that other children do not.
Parents of these children are no less loving, caring, or capable than parents without ADHD children. Parents should not be shamed for using effective medications (like MDH) so their children can have positive outcomes in their development and adult-life.
> What we really need is a strong emphasis on family development, courses built around it and support groups
ADHD is generally a disorder that you are born with. No amount of family development can prevent the disease.
Educate yourself by watching this: https://www.youtube.com/watch?v=NUQu-OPrzUc&t=137s
I’m sorry, it doesn’t seem like you’re really challenging the argument.
That's probably because it's an argument uninformed by even the slightest bit of research into how a brain with ADHD works.
Also you're sealioning, so :reported:
huh hadn't heard that before -- good to know
I see this with someone close to me.
Diagnosed with ADHD as a child, medicated, later diagnosed with depression.
The real issue, however, was probably more related to brain development/executive function because their mother smoked a pack of cigarettes a day through pregnancy.
You've struck a nerve with some commenters, but personally I think you're on to something.
I question the same thing everyday for my family.
One way I try to explain it to people: "We give people insulin because they have diabetes. Diabetes is the disease, but you can cure it through diet and exercise for Type 2 (it's environmental), Type 1 you cannot (it's genetic). Giving insulin treats the disease, but doesnt' sure it"
This is the same thing for ADHD or depression. Some people probably have Type 1, others (I think the vast majority) have Type 2.
Sure you can mask the issue, somewhat. But you can't cure it through the medications today.
I grew up in a two-parent household. I had a doting, stay-home mom who spent lots of time with us. I lived in a safe neighborhood where I rode bikes with other kids for miles around during the summer. My family took long road trips to places like Yellowstone National Park for weeks and day trips to the zoo, the botanical gardens, the science museum, etc. I did not have a TV in my room and screen time was limited. I was involved in sports at school, summer swim team, and karate which my dad did with us.
I have ADHD which resulted in crippling depression when I was in college. As soon as I got diagnosed and medicated, I was able to be like the normal people that I always wanted to be, and align my actions with my goals.
I was diagnosed as an adult. My parents kept me consistently active and engaged. Plenty of play outdoors, fishing, camping, riding bikes. They were involved in my education until, as a teen, I wanted more independence. I’m not saying I had an ideal upbringing, but I have very loving involved parents (dad and stepmom; relevant below).
I don’t know if that’s why my diagnosis came later, but I seriously doubt it. My mom, unlike my dad and stepmom, was deeply skeptical (a) that ADHD even exists and (b) that ADHD medication is safe, effective, or necessary.
That kind of bias is powerful, and easy for kids to pick up on. I was mortified of these meds before my diagnosis. Now I can’t imagine how I lived without them (and I very well may not be alive today had I not sought treatment).
I’m sure there’s often some truth to some of what you’re saying, to be clear. One of the most difficult parts of getting my diagnosis was that the diagnostic criteria are entirely external to the patient being diagnosed: they’re framed around how parents and other adults perceive a child’s behavior. It took a patient and understanding doctor to help me map those criteria to my internal experiences and my adult life.
But I don’t think I benefitted at all from waiting decades for a diagnosis.
That sounds like me. My parents are stilled married and about to have their 45th anniversary. The extended family are all on their first marriage and in retirement age or raising families.
I started medication after 30, mental health is not a valid thing in my traditional family. According to them, my struggles were because I hadn't learned my proper place yet. Shame and ridicule from adults, and allowing others in the family to participate, was their idea of proper treatment that would 'fix' me into being a proper young lady. This after their first attempts to keep me in line failed. After that, exclusion within family events, that I was forced to attend, was the treatment of choice. At least less parental attention meant they couldn't keep reminding me how defective I was.
Unsurprisingly, I was very unhappy and depressed. Then I decided to love myself and see the absolute dysfunction this nuclear religious anti-mental health family idea is. Now, I am the most well-traveled, curious, adventurous and financially successful person in the family. That didn't happen until I was able to get the help I needed.
By help, I mean medication to do the core things only I'm responsible for in a world that doesn't fit into the way I function. Provide myself with food and shelter as an adult. I am on the higher end of hyperactive ADHD, also dyslexic - which I learned after getting medication for ADHD. I noticed similarities in my niece, I was told I didn't know what I was talking about and that I couldn't be dyslexic or ADHD since I could read and played video games for hours on end.
I don't like medication and it took me a long time to admit it to others, but the world isn't going to change to fit how I function. So, I use medication to fit myself into it for my basic survival needs.
>> As such we see more: single parent homes, abundance of medication, reduction in religion and adult social clubs, etc.
Reduction in religion is not a negitive, I personally experienced it as mental and shaming child abuse within a roman catholic/protestant home. Even now I experience it as other people overstepping themselves by trying to insert and force their righteous will onto my personhood and that of my nieces/nephews. I have a difficult time understanding how this is still allowed and even valued. Of course my family also doesn't see or remember any of this the way I do.
Unless you have solid studies that establish _causation_, not correlation, to back up your assertions, your facile dismissal of all existing medical research in favor of your own personal social prescriptions deserves zero consideration.
Part of the problem is that it's very difficult to get the right dosage for any given day because diet, metabolism, and hormones seem to have a big impact on how effective it is. We've found it's better to go with a lower-dose extended release, and then let her self-medicate with 5mg regular tablets as needed. This works great now because she's a fairly responsible teenager (when medicated), but it was really hard when she was younger.
Unfortunately extended release Methylphenidate of any kind/brand is only partially covered by Dutch health insurance[1], and I'm certain the cost is prohibitive for people who might be less well off.
1: In essence, the government has determined that all Methylphenidate variants are equal, and so you can just take the cheapest instant release variant or else pay the difference out of your own pocket.
What I do instead is two lower-dose XR pills per day. The four hits over about 8 hours seems to work pretty well for me.
The bipolar-level manic highs and depression/lows are very real.
The feelings of suicide and hopelessness creep up; I have enough personal awareness and grit to ignore it but it feels awful.
To avoid that creep-up, the best thing I found is to have “break” days at least once or twice a week. That is, no pills.
I doubt your daughter or others with ADHD have that luxury though.
I've had to be very careful about NOT using those terms when talking to doctors and psychiatrists. As a layperson that description seems to fit, but it causes huge red flags for medical professionals and they freak out, resulting unnecessary tests and evaluations for my kid.
The key term for the "manic" phase after the meds wear off is "Rebound Effect". Also when the dose is too high the generally accepted term is "zombie mode" or "zombie-like". Calling it an "overdose" will really cause people to freak the fuck out.
I’m not saying it’s not possible to have those side effects, I just haven’t experienced them.
Surely any zombie is too much zombie.
Getting horribly fall down drunk as a teenager caused me to shit my pants once. But I didn’t so much as fart when I got tipsy on vacation recently.
Put it another way if makes you feel better -- a little bit of D3 via direct sunlight and D3 rich foods will improve your mood and health outcomes in a variety of ways. An excessive amount of D3 will give you kidney stones and harm your bones.
It's one thing to be worried about subtle effects from medication, but I already know what the long term health and brain effects are from constant insomnia and regularly forgetting to eat. Neither of those are good for brain function.
So yeah, seems like a pretty reasonable risk to take, particularly given the fact that I have a psychiatrist, therapist, and multiple friends and family monitoring me.
Let me flip the question back to you. Would you notice if D3 or iron or protein intake was subtly harming you over the course of multiple years? Is that something that terrifies you?
But you tell me it feels good. And you are more productive etc. And all the experts agree. So who am I to argue?
But yes, I do think the benefits for my mental health very clearly outweigh the theoretical risks you posit. So even if I agreed with what you're saying (which I don't), a subtle hammer tap to the soul is still very clearly and obviously better than the sledgehammer to the soul that is sleep deprivation (something that I concretely know would impact my brain function as I age and that I concretely know makes me less of myself). If that causes you to raise your eyebrows, then I'm not sure what to say other than that you're bad at risk analysis.
Wikipedia has quite a lot of information on it: https://en.wikipedia.org/wiki/Methylphenidate
Turned out I just didn't like living in Florida.
Though, being fair, those are thoughts other people will direct at those with ADHD as well.
Is it the condition which causes this, or the diagnosis of the condition? I think diagnoses can easily inspire feelings of futility. It's no longer something you can change about yourself by wanting to change, it becomes a medical condition you've been stuck with.
> it becomes a medical condition you've been stuck with
90-ish% of people with ADHD respond well to stimulants, and have complete remission of symptoms. And for those who don't respond well to stimulants, we have bupropion, etc.
It's the one class of mental disorders where medication is very effective. For almost all with ADHD, it's not something you're "stuck" with.
No, it is not.
https://www.aafp.org/dam/AAFP/documents/patient_care/adhd_to...
If you have to keep taking amphetamines you are stuck with it. It is clear that something dopamergenic is going on with these kids, but no one is trying to find out why they do not have enough dopamine. You know we have biological pathways that produce dopamine which are controlled by things in our environment.
https://www.researchgate.net/figure/he-biosynthetic-pathway-...
Yeah, I said it, you can control ADHD by changing the environment. Zinc, B6, air pollution, protein intake, etc...
Yet all we get is a pill? And you are all happy with that?
And by doing things it can even be "basic" stuff like laundry etc.
"Oh all that stuff I've been struggling with wasn't actually my fault? With this magic pill I can get stuff done too and not feel like an imposter all the time? Heck yea!"
I can imagine what you saying applying to some childhood diagnoses. I cannot speak to anyone I know who was diagnosed in childhood thinking that way though.
Executive Dysfunction means you're screaming in your head to stand up and get work done, but your brain just keeps browsing hacker news. And not just monthly or weekly, but hourly. Sometimes even every few minutes.
Diagnosed or undiagnosed.
So, there's definitely a chance. Two thoughts:
- Everyone will occasionally exhibit some ADHD symptoms, the question is how often. Monthly? Probably not a problem. Hourly, or every few minutes? Probably is a problem.
- See a professional. Self diagnosis can't get you the help you need.
I should probably get it checked. Thing is I'm afraid of "faking it", if it makes any sense?
I'm definitely not, as you put it, the stereotypical "hyperactive", but on learning more, I realized how many little tics I have that I do but in very masked ways so as to not draw attention. But that aside, there is 3 different diagnosis for ADHD - primary hyperactive, primary-inattentive or combination (both to some level). Despite what I said about tics, my diagnosis was for the inattentive side of things. "Head in the clouds", "daydreamer", etc.
It's all relatively new for me, it wasn't something I really seriously considered until a year or two ago (and I'm in my 40s now), despite having a brother who was medicated fairly young and a father who displays many of the same traits (never diagnosed though). It's definitely helped me to know this, puts some puzzle pieces in place, so to speak, and gives me a path forward toward managing something I didn't really realize I needed to manage, but was having a significant impact on my life regardless.
BTW, when you talk about tics, do you mean physical tics, like fidgeting, walking around, moving your feet, etc? Because it's quite often noticed by others that I'm doing too much of that
As I kid I didn't have any inkling of what aspects of my personality and/or abilities were related to ADHD, and most people I've met who were diagnosed young have been in the same bucket.
If anything being diagnosed should help stave off depression since ADHD tends to mimic a mentality most people just refer to as "lazy". You don't have "executive function disorder", you just fixate on things you like and ignore stuff you don't. You don't have ADHD, you're just messy and disorganized.
Futility comes with a lack of understanding when it comes to this disease.
When I was a kid, I constantly described myself as "lazy" and "tired". Now I understand I was really experiencing "executive disfunction" and "understimulation".
Adding those words to my vocabulary didn't cure my ADHD, but it did relieve some internalized shame and anxiety that were caused by living undiagnosed (and therefore untreated).
All that's missing is how there's no consequence underlying that hesitation; how you can't justify why you can't do the task.
I think you're getting downvoted because it sounds like you're encouraging people not to get professional help.
I'd go as far as to argue that a diagnosis opens the door to solutions even non medical ones.
> it becomes a medical condition you've been stuck with.
It can feel like this. However, for me, it was much more of a "finally, an explanation!". It showed me my limits are a bit lower than I hoped for, but it gave me immense clarity about those limits. Plus finding your limits, realising there are things you'll never achieve... I think that's anyone's fate sooner or later. It's okay.
The meds are not without their side effects. Every now and then I take a break for a week or so just to reset my biology. As my problems with executive functioning return, so does the depression.
I think the moral of the story is that interaction with your doctor should be ongoing. You should not just get a prescription for Adderal or Ritalin and check back with them in 2 years.
* Being told you're lazy
* Being told you're stupid
* Being told you don't care
* Being told you aren't trying (when you're trying incredibly hard)
* Being told you must have 'something' wrong with you
* Being told that your parents have given up on you
A friend on ADHD meds told me that it feels like trading unbridled creativity for stability. He found it to be an essential drug for functioning, but I got a sense that it involved losing something really central to your sense of self. Almost like being made sedated/compliant by force.
I have long dealt with the double edged sword of ADHD (diagnosed at 27, obvious symptoms since early age). I have had my best ideas / 1st author papers during moments of hyperfocus. At the same time, I struggle to do mundane busy-work with any level of reliability and have had bouts of depression tied to ADHD derived perfectionism/procrastination (if you know, you know).
I have yet to make the leap to medication as I have managed to 'hang on' through the different things I have tried in life. I often joke that I will start medication if I get fired. I am grappling with the decision of making the leap over to medication, and if the cons are worth it in any situation that isn't incredibly desperate.
Some perspective here would really help.
edit: Thanks a lot for sharing your personal experiences. It really helps in at least convincing me to give meds a try. I'll set up an appointment .... tomorrow, soon, surely
However, I felt I lost a subtle intuition edge.
When I stopped I was a mess, until I found Chen Style Tai Chi, which somehow mitigated my worst symptoms without any (negative) side effects.
From there, I’ve been able through (simply aging) and deliberate practice of various techniques to make it so ADD is rarely an issue for me anymore.
Currently I take L Tyrosine, CDP Choline, coffee, lionsmane and kava. My focus and ease of attention are amazing, and I've been very productive.
Even if I get diagnosed and get a prescription, I would still take these supplements as they support the core problem: low dopamine, low acetylcholine. Eat well, exercise too.
I had the same concerns, but I found them to be unwarranted; there was no 'trade'. For me, it's more like being given access to a dial to control the speed of all the scattered thoughts flying around in my head. I can space out and get distracted just as effectively as I do without meds, but when I need to focus, I can nudge that dial. Focus is an active process, and it's one that I maintain control over.
I was only given 1/3 the recommended starting dose though, so it'll likely get increased when I see my doctor again.
Side effects are light to moderately sever headache if I don’t drink enough water, IBM, high blood pressure and a pinch of insomnia.
It’s all worth it.
This is a good way to put it. Prior to starting medication (vyvanse specifically, although I tried concerta) initiating a task or trying to learn something was, most of the time, "too hard" so I spun my wheels doing random stuff and occasionally doing just enough work to keep myself employed. Now, nothing is "too hard" because it's possible for me to get over the activation barrier and start doing the thing.
As someone who has been diagnosed as an adult and been on meds for a few years I could not agree more.
I recommend trying treatment though, I can't see any downsides if it is an option for you. Highly likely there will be clear physiological side effects, but nothing to be scared about.
Until earlier this year, when a variety of factors pushed me to finally try them.
All of a sudden, I could focus on things without having to have all of the stars aligned. I never realized the extent and complication of my self-medication until I tried meds. I don't think I've lost my "sparkle." Instead meds help it come out because my follow-through is so much better.
It took me a few months to find the right med - finally on the right one + dose now, but it took some time, so be prepared to experiment with your doc if you choose to try meds.
It's not the right choice for everyone, but it's definitely been the right choice for me, and it's one I wish I had made a lot sooner.
Also worth noting for those less familiar with medication names, methylphenidate is sold under the brand names Ritalin and Concerta.
Still early days. I'm about 2 months in. I can feel the effects when I am on it. I can feel when it starts to wear off. No feeling of addiction at all. No dependence. No taking it every day like I've heard about for depression medication. Take breaks on weekends / on light work days without looming deadlines.
I actually like a big part of my ADHD brain more than the drugged version. Probably because I am used to it. But also I kind of like being multi-threaded by nature. It feels great to be able to do a lot of things simultaneously. The downside to this is it's very hard to be "present" in anything. This is where the ADHD meds come in.
I've been taking a lot of notes on feelings and side-effects since starting, and on the emotional side I feel a stronger sense of everything - from pleasure to joy to sorrow. Maybe it's the "present" part of it.
I have always been very good at "listening," well, hearing what people are saying and internalizing it/remembering it. But I've never been good at listening - in terms of applying critical thought to what people are actually saying to me. More like a note+file vs. analysis.
Some parts of me that have been dormant, especially the creative as in creating (not creative as in thinking) side of me has really sprung to life. And I'm enjoying that aspect the most.
Anyway, depression seems to be very far away from the side effects for me. It would suck and I empathize with anyone who has complications/side effects like that.
Trying to conform to a neurotypical world is hard.
(Both sources were quickly googled, I'm sure there are better papers.
1 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701286/ 2 - https://link.springer.com/chapter/10.1007/978-1-59259-006-3_...
It's one of the main reasons doctors prescribe different stimulants. I've personally heard every mutation of "This one worked for me but the other one gave me bad side effects and little effect".
I of course know that this is how it's meant to be used.
But having gone through ADHD and trans healthcare I know everything that looks like ammo will be used as ammo. Even the things that explicitly state they are not ammo. By healthcare professionals and those that want to enact change on a higher level.
Or maybe we do and I've never been privy to this knowledge nor provided such a test.
It would be like trying to tracks cars by only observing traffic lights.
They are treated with stimulants that have no effect on bipolar disorder.
I'd rather be on a small methamphetamine dose than Lithium if I got to choose my misdiagnosis.
Especially as someone who wasn't bi-polar - it was creepy af... kind of like disassociation. It wasn't me.
Bipolar is often comorbid with ADHD. Stimulants can help, but can they also cause mania if used alone.
Given that stimulants work nearly 100% of the time for ADHD cases, and don't pose a great risk to patients for whom ADHD is not the root cause, this is a sensible approach to take. As long as the psychiatrist follows up and makes sure the medication is working, and investigates if it is not.
https://www.cdc.gov/nchs/products/databriefs/db76.htm
It seems like most people do stop using them with time.
Now, 2+ years on SSRIs and I can honestly say I've never felt more like myself. With the meds, I feel like I've unlocked my full potential. Before, I had bouts of heightened success, but they were always weighed down by this underlying instability. I don't consider myself a "drugged" person, but rather the version of myself that I want to be.
I didn’t take ADHD meds as a kid, so I can’t speak to their effect on me. But when diagnosed as an adult, I had suffered nearly my whole life with chronic depression and anxiety.
Both reached a crisis level a few years back, which was a major factor in seeking diagnosis. This diagnosis, and treatment, saved my life. I won’t share my medical charts or anything, but I will say that since my meds and dosage have been consistent, depression is still there but barely noticeable. Anxiety much more manageable.
These meds helped me put my life back together. I’m not dismissing the study, or that other people have different experiences. But I share my perspective when things like this come up, in case it benefits others who might have similar struggles and wonder if ADHD might be a factor.
I don’t think that’s true, I thought it was a correlation, not causation.
All of these problems then feed into depression and anxiety. Is that so hard to believe? Less friends, less success, more abuse of substances, it's a potentially rough life.
If so, look at these articles, which review the hard evidence and find there's very strong links between ADHD and depression, and anxiety: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990565/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6493806/
- ('if You Have ADHD, You Are Likely To Be depressed'): https://www.youtube.com/watch?v=xkXpcs_an80
- ('why does your adhd make things so hard'): https://www.youtube.com/watch?v=svD71EJWOBU
I'm a "closet'ed" adhd person and these books have helped:
- Anxiety and Panic: How to Reshape Your Anxious Mind and Brain by Harry Barry
- ADHD 2.0 by Edward M. Hallowell M.D. & John J. Ratey M.D.
Sounds like they just did a meta-analysis and saw a link between ADHD and depression and blamed the med.
So, I took a flouroquinolone and had a text book reaction. 50+ physicians later at mayo and other top US hospitals and I was gaslighted more than helped in any way. I am now in a group for sufferers and meet new people daily, who took the drug and the doctor completely dismissed their neurological issues as anxiety.
After sending documents to my primary he agreed that I suffered an ADR and stopped prescribing it completely unless no other options exist.
"Health care providers/professionals (HCPs) play a critical role in ADR surveillance. Only 6% of all ADRs are reported and under-reporting acts as great impedance in exchange of drug information." https://www.ijbcp.com/index.php/ijbcp/article/view/1652
https://en.wikipedia.org/wiki/Quinolone_antibiotic#Adverse_e...
Edit: I think the reactions are rare but not as rare as we think. The onset of symptoms is anywhere from few hours after a single dose up to 12 months(this is now on the label). If I did not have an instant reaction I don't think I would have believed that a medication I took 6 months ago caused it. I have talked to many individual suffering from SFN, CFS, Fibro, chronic tendonitis issues who had an infection prior and took the drug. The physician never asked and they never made the connection.
Few individuals recovered, only to take the drug again few years later and end up in a worse state.
A few times I was able to get my hands on really pure dextroamphetamine (>90% validated by a lab test), and even with a tolerance, there is no way you're consuming more than 100mg over the course of a day. 10-15mg was my sweetspot to get enough focus without getting locked into tasks and feeling wired. Although speed like that is pretty hard to find and quite pricey (~60-70€/g).
I've also realized that most of the unpleasant physical side effects of speed (palpitations, jittering, elevated cardiac rythm, anxiety, etc) are actually due to the massive amount of caffeine in it and not the amphetamine themselves (tho I'm sure there is a synergy between them). Even while feeling pretty high on pure amphetamine, my bpm only rose by about 4-5 bpms (compared to 15+ on street speed). For anyone in the same case, L-theanine works wonders to calm down the caffeine side effects, highly recommend you keep some around just in case.
On the comedown of a multi-day binge, I don't feel depressed per se. I'm constantly tired while awake, which I can only keep at bay if I'm physically active. Also, my ability to focus and get motivated dips below baseline, inversely proportional to how high over baseline I was. (And I would speculate that it is mostly due to a depletion of dopamine & its precursors rather than a withdrawl, as it can be alleviated through a decent diet).
From what I've read as well, most of the long term side effects of amphetamine abuse stem from chronic lack of sleep, food & water rather than damage from the molecule itself. Although repeated overstimulation of your reward/dopaminergic system definitely can't be good for you, be it through adaptation or damage of the dopaminergic neurons (I remember reading somewhere that long term meth users are more prone to Parkinson's).
> After MPH treatment discontinuation... returned to baseline levels by 31 to 60 days
In the case of ADHD, amphetamine helps the dopamine dysfunction which in turns alleviates the depressive symptoms.
With adderall and Dexedrine, there is high likelihood of habit forming psychological addiction if not physical addiction. There’s the ever increasing tolerance, etc.
But sometimes dopamine and norepinephrine levels are so low you need a firehouse.
Look, my mother has ADHD (or something like it), and she had no problem teaching the (mostly boys) in her class with ADHD. A few even went off their meds in her class. Unfortunately, the next year, they were put right back on with a new teacher.
Happy for the kids, but when they're adults, they'll find out that they have many other executive functions impaired, not just attention management, and the cool teacher won't fix these.
Unless you are in great pain, or can't walk, stay completely away from doctors and hospitals.
My nephew was diagnosed with ADHD and was given Ritalin. He hung himself a week later.
Unfortunately, In Sweden, an official diagnosis means higher insurance (fine), higher mortgages (not fine) and the inability to hold certain licenses.
Of course those markers of ADHD are pretty severely affecting my life, which is why I was seeing the Psychologist in the first place...
Would anyone recommend seeking a diagnosis in those conditions? Has anyone done this in Sweden and then gotten a mortgage? Is there anything else I can do?
I live on the border with Denmark, I’m not sure if it’s ok for me to access healthcare in Denmark without a “CPR Number” https://international.kk.dk/cpr-number
The idea that ADHD affects mortgage rates! How terribly absurd. I'm sorry to hear that.
Salary data is also publicly available, but as a nominal fee and you buy a “book” which is an area of the country.
When it comes to mortgages, banks ask for extended rights to look into your data on your behalf, you have to sign this with your digital ID (BankID).
This information is centralised and you give permission because they are ostensibly looking for outstanding debts and bankruptcies.
Unfortunately I only learned about the health discrimination when I was applying for an official diagnosis, I received a letter from a company “Modigo” warning me against getting a diagnosis because it can negatively impact my life in this way.
I heeded the warning of course.
I elaborated more about it but I got downvotes after that, so…
> Although only 8.6% of American males are on antidepressants at any given time, they seem much better represented as a percentage of mass shooters. Here are 39 mass shooters who were either on antidepressants at the time of their rampage, had abruptly quit taking their medication when they went on their spree, or had been prescribed antidepressants at some point in the past.
https://thoughtcatalog.com/jeremy-london/2019/09/37-mass-sho...
Michael Moore came to the same conclusion when researching for his movie, Bowling for Columbine: https://www.youtube.com/watch?v=04UqzYOdGNs
These drugs can have serious side effects in x/1,000,000 people. What happens when you give them to tens of millions? You'll start to see those edge cases. Why didn't we have many of these mass shootings prior to 1990? When did we start mass dosing our kids? I think we have a lot more research to do, if anyone is actually willing, but you'd be going up against the big guys.
If you are a parent and considering Ritalin for your child, first ask yourself if you'd consider legal cocaine to be a reasonable solution for your child. If that sounds insane to you, then you should consider the fact that Ritalin is probably not so different.
What do you consider a “small” dose?
With respect, you are being a bit too condescending relative to the amount of knowledge of the issue you posses.
If you're one of the few for whom it didn't work out, cool. But with equal respect, your anecdotal experience is not sufficient to call it "legal cocaine". Neither is it sufficient to make generilizations about how medical care of ADHD should be approached.
2. Five minutes of research online shows that my experience is not uncommon. Hell, reading the warning label from the pharmaceutical manufacturer is sufficient to make my point.
3. I am very pro-medication when it comes to treating ADHD, but I also believe many people are not sufficiently educated on the potential consequences of these medications in children.
Part of the process of treating ADHD is finding the right medication, and Ritalin works for most, and if it's working as intended, does not produce the "high" feeling that you got. If you're getting high off of it, it's not the drug for you, or you're on the wrong dose.
Doesn't make it okay to call it "legal cocaine".
> Five minutes of research online shows that my experience is not uncommon. Hell, reading the warning label from the pharmaceutical manufacturer is sufficient to make my point.
Obviously it's documented, but it doesn't make your point. As I already said, it's a thing that happens in the process when finding the correct dosage for an individual.
Though for neurotypical people who don't have the disorder, there's no correct dosage and they'll experience what you did.
It's still a very useful therapeutic, and I strongly believe it should not be stigmatized. But parents absolutely do need to be educated about the sort of prescription drug this is.
I liken this somewhat to the use of opioids for pain control after surgery: they are a fantastic tool that I would certainly not want to forego. But I am grateful that we've become more intentional about educating people on some of the specific dangers around their use so that patients can be more aware. I'd like to see the same thing happen around the use of strong stimulants in children.
Extended release is usually preferred by doctors in part because you avoid the highs and lows.
Regardless of what “normal” practice is, if you are getting high from methylphenidate, the dose is wrong, and if you can’t get therapeutic effects at a dose low enough to avoid a “brutal” comedown, you should be looking for alternatives.
Agreed, this is why I no longer use it to treat my condition. The point I am making is that parents need to be aware of these potential side effects, because a child isn't necessarily in a position to articulate the fact that they are experiencing adverse effects like this. The medication is a CNS stimulant first and foremost. These effects aren't exactly rare.
Hello. That's me. I can sleep on that dose. Is that not normal?
In particular because cocaine is addictive whereas methylphenidate is not. Cocaine is euphoric while methylphenidate is much less, cocaine is arrogant while methylphenidate is just in-the-zone, just makes you want to work. Makes drudgery feel like a video game.
There is also such a thing as an affine cocaine user, like Maradona, Iceberg Slim, and Sherlock Holmes (whose cocaine use was based on a real guy--a fucking freakish detective whose privacy Arthur Conan Doyle protected). These guys actually have an essentially healthy relationship with the drug, and yeah it's rare but it exists and they should be allowed to have it. Or narcoleptics, they're not going to get heart problems, let them.
Or what? If Sherlock Holmes was on your child's abduction case, would you tell him no cocaine injections for the deduction trances? Nah man, you'd tell him go for it. That's legal cocaine. And the best detective of all time! In that case, would you still argue legal cocaine is bad for your child?
Honestly I'm like, methylphenidate can be taken like in high school, for athletic competitions, tests, and writing essays...that's when I would have taken that or similar. Later on parties, that's medically acceptable, and is a medically-accepted partly-recreational use for a part of the supply, which is mostly intended for work.
So one thing, daily methylphenidate reduces adult height about as much as artistic gymnastics, like two inches. Apart from that, like something milder is better...like coffee with whey protein, that's worth 5 milligrams of methylphenidate. There's vyvanse, that's a good one for kids. There's adderall, too strong I'd say, but typically there's adderall deficits and ritalin deficits, never heard of someone being helped by both.
I would say I would have wanted the choice for myself as a kid.
"Warnings Ritalin may be habit-forming. Tell your doctor if you have a history of drug or alcohol addiction. Keep the medication where others cannot get to it.
Misuse of Ritalin can cause addiction, overdose, or death. Tell your doctor if you have had problems with drug or alcohol abuse."
It used to say roughly: don't crush it and snort it or you will surely get addicted.
Meaning, sticking to the doctor's instructions would be fine.
That warning is recent.
A well-trained psychiatrist can diagnose me in <10 minutes and ADHD meds are not that strong. I don't know what "intervention" means, but outgrowing ADHD is a common myth [1]. What you describe is not ADHD. I would try elsewhere. Sorry.
[1] https://chadd.org/about-adhd/myths-and-misunderstandings/
I'm trying, probably somewhat poorly, to make the point that there are a lot of potentially useful things to try in terms of managing ADHD beyond Ritalin (though that can be a very useful tool for some).