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Comment by addthrowaway75 | Hacker News Reader

My friend it is you who should consider being ashamed. Suggesting stimulants as the first line of treatment rather than cardiovascular exercise, good sleep, and a healthier relationship with food is at best dismissive of the body of modern research and at worst introduction of a dangerous 'just pop a pill' crutch. Stimulants are not at all the only way out of the ouroboros of adhd symptoms making today hard and tomorrow too.

I don't disagree that things like this can be exploitative and if it happens even once then I agree with the 'you should be ashamed' thesis statement. You're treating the solution as a very black and white thing in this comment of yours though and the vitriol with which you wrote it left me with the impression that pushback is warranted.

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> Suggesting stimulants as the first line of treatment rather than cardiovascular exercise, good sleep, and a healthier relationship with food is at best dismissive of the body of modern research and at worst introduction of a dangerous 'just pop a pill' crutch.

Literally none of this is true. The research overwhelmingly shows that stimulant medication is the most effective treatment for ADHD, and second place isn't even close. Show me a single paper that shows that "good sleep" is a more effective treatment for ADHD than medication and I'll eat my shoe.

ADHD and stimulants are codefined. That doesn't prove anything, it's a circular definition.

The people who got exercise, slept well and kept meaning in their life avoided falling down the hole. They aren't in the study in the first place.

> The people who got exercise, slept well and kept meaning in their life avoided falling down the hole. They aren't in the study in the first place.

The people who kept up with a well planned exercise routine, slept well instead of trying to catch up with work at 2am in a mad rush, and had meaning in their life because they didn't push their friends away with uncontrolled emotional outbursts? Perhaps they aren't in the study because they don't have ADHD?

They almost assuredly do not have adhd. Please folks, stop pushing this crap. Exercise and diet all require expenditure of executive function you don't have. Barkley explains it best. Yes, physical activity and diet improve your executive function like properly inflating your tires improve your gas mileage. At the end of the day you have a physiological disorder that needs a coordinated treatment of both stimulants and cognitive behavioral therapy along with compassionate people surrounding you. Start with your GP and if you hear the "muh, you don't need drugs" "just get more discipline" bullshit, find another gp and make sure they help you get a referral to an adhd expert who knows what executive function disorder means.

Perhaps those also absent from the study are those with ADHD, but whose family accepted and nurtured it instead of projecting onto them and never listening. Those people don't usually need to mask and don't end up mentally underdeveloped because the people entrusted with their care actually cared about them, rather than trying to "mold" them into something they're not.

Seriously, why does ADHD and other neurodivergent "treatment" always fail to listen to the afflicted? It's ableist and othering, and it's fucking disgusting.

My family loves and accepts me and my sons. They still push the same bullshit here. You can't jog your way out of adhd and "you just lack discipline" is literally "telling a woman they deserve it for looking like a slut" level of being totally off the mark and clueless. I even have a significant amount of multi-discipline training and actual professional research under my belt and they ignore me and the experts I seek for help.

> The people who got exercise, slept well and kept meaning in their life avoided falling down the hole. They aren't in the study in the first place.

Horseshit.

I have a sleep tracker and an exercise tracker that tell me I get enough of both and I’ve plenty of meaning in my life. None of those things helped nearly as much as adderall.

My problem with this comment is that the other argument is well demonstrated with a litany of scientific literature - whereas this argument is at best interpretation unprovable.

*If you are talking about the exercise and diet fixes adhd research...A litany of scientific literature with studies that closely follow and ensure compliance with protocol? Or perhaps incorrectly select cohorts because those with adhd are not going to be compliant without being cornered and forced?

*HN is hard to follow. Do you mean "research supports stimulant first" or "research on people who self identify with adhd and are fitness nuts shows"

This is somewhat offensive.

ADHD meds are suggested as a first line treatment above all of those other things because they are more effective than all those things, like several times as effective, and are well tolerated and inexpensive.

It is that fact which plays into why this treatment is exploitative. You should only ever be trying something like this after exhausting a number of more effective options. This program is marketing itself as for people who AREN'T EVEN DIAGNOSED with ADHD and pretending this is somehow an "evidence-based" approach.

Definitely agree ADHD medication has been proven to be most effective. Thank you for this comment!

Most of members use coaching as a tool in conjunction with medication or other forms of treatment. Our service is not marketed as treatment, but simply another tool (for guidance, support, accountability, skill discovery) you use like to do lists, education blogs, body doubling, etc.

Our methods, on the other hand, stand on the shoulders of giants and are based on evidence-based approaches and methods. We put a lot of effort & care to conferring with the medical/clinical, coaching, and other helping professions to ensure what we're building is based on evidence-based approaches. Happy to share more over if helpful! hi@shimmer.care

I agree their phrasing could have been better. However in my country it typically takes 1-2 years to get a diagnosis and start treatment. It's even a few months to a year if you go private.

I can see this sort of thing being at least a stop-gap, and something that might help while someone's waiting to get access to the better treatment.

Listen, if you are people reading this with adhd, don't listen to me, don't listen to this guy, don't listen to OP. Find an expert in adhd. Make sure they understand what executive function disorder means. Listen to them. Please don't suffer with this. It's not your fault.

Thanks for this, you're being very evenhanded. Lifestyle changed sustained over time is the way to go, any remaining bad feelings can be taken as signals or just part of life. Pills aren't magic.

Spoken as someone who never had to deal with decades of prolonged abuse for the crime of not having enough dopamine

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