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Comment by Spivak | Hacker News Reader

If true you should let me, someone who can be put to sleep by adderall and caffeine, the degenerates I know (and love but cannot understand) who take adderall specifically for those opposite effects, and my therapist and psychologist who both ranted to me about their frustrations diagnosing their ADHD patients because they can’t use this test.

I’m not even saying you’re wrong, but it doesn’t match my personal experience at all (in both directions), and the belief is apparently widespread enough that real professional mental health providers believe it.

It would be genuinely surprising to me if someone who works all day with people who take these medications and talk about their effects wouldn’t be armed with a million counterexamples if at minimum the observations didn’t line up. Like they’ve got to be seeing some real effect even if the explanation is wrong.

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Seconded.

There’s a REALLY obvious difference.

It’s visible as an effect in studies too. In various forms. At random, one paper of many which captures one aspect: https://doi.org/10.1111%2Fj.1469-7610.2010.02333.x

Nobody has ever suggested I have ADHD and I've never tried Adderall, but a nice cup of coffee is an ideal bedtime drink for me and a couple of Red Bulls before a lecture in college would have me fall asleep in the class.

I used to drink an energy drink before bed and people thought I was super weird for it! I didn’t find out it was an ADHD thing until my therapist asked, I guess knowingly, how caffeine affected me and I went on this whole rant about it.

That is also because you regularly consumed caffeine, no?

If you took a 6 month long tolerance break, I would be interested to see if you still had that effect. Insomnia is not that uncommon of a symptom of stimulant withdrawal.

Such a drastic change in effect—a drug inducing powerful stimulant effects in one group, and sedating effects in another—should be easily measurable by study, no? Is there any scientific literature documenting this?

So I’m not saying that I agree that it’s AS difinitive as this guy makes it out to be; but as someone with diagnosed ADHD, I can 100% validate the experience of stimulants having the opposite effect on me vs my neurotypical close-contacts.

I can comfortably take a nap after popping 10mg of dexamphetamine, whereas most people would be atleast moderately buzzed. And this has been the case since day 1 (I was diagnosed at 26), so it’s not just a factor of tolerance.

Another great example is the fact that the single biggest benefit to ADHD meds for me has been a complete reversal of my life-long anxiety.

I’m now zen as f..k, whereas before being proscribed meds I was a very anxious, hyper-self critical person.

> a drug inducing powerful stimulant effects in one group, and sedating effects in another

I firmly believe this has more to do with dosages than anything else. Sure, give a random person a 10mg Adderall and one might be more sedated or hyperactive. Give them 100mg (almost double therapeutic max), and I guarantee they won't be calm sedated.

Sure, everyone has a different threshold that needs to be hit for whatever underlying reasons just like alcohol. One beer might make some feel buzzed, one beer might not do anything. But for an average person (not a chronic alcoholic), I guarantee they'll be fucked-up after 6+ beers.

> my therapist and psychologist who both ranted to me about their frustrations diagnosing their ADHD patients because they can’t use this test.

Why? I thought there was a clear and insurmountable amount of evidence behind all their little psychometric tests? /s

> real professional mental health providers believe it.

Plenty of doctors and professionals believe incorrect information all the time. Just because one went to a fancy medical school does not make them infallible no matter how much their ego may try to convince you otherwise.

Any sources?

ADHD is a diagnosis based on symptoms. It has a number of causes. Your mental health professionals would prefer different diagnostic criteria. Those other criteria would result in a different set of people being diagnosed with ADHD. The current diagnostic criteria are symptoms that cause problems for the sufferer. Thus successful treatment of ADHD as currently diagnosed improves lives. Why is the diagnostic criteria you describe better?

Are you claiming that the test identifies a subset, or ALL people with ADHD?

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