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Comment by whalesalad | Hacker News Reader

Do we all have ADHD or are stimulants just good? Seriously. Pretty soon all of us will be on legal meth and we sit back and go "hey this is fun I get this from my doctor it's good" and yet as a society we judge meth, crack and cocaine addicts.

Nearly anyone will respond well to a stimulant.

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Not a doctor.

As I understand it, caring for someone diagnosed with ADHD, the response to stimulants is quite different in people with ADHD.

When a neurotypical person with control of their executive function takes stimulants it will increase their energy levels but it will also interfere with their executive function. They will lose impulse control, have intrusive thoughts, difficulty focusing.

An ADHD person has difficulty regulating their executive function to begin with. All the different parts of the brain that have to work together in concert to perform a task have a leader that is easily distracted and they have a hard time controlling the leader. They start with confused thoughts and it can be struggle to maintain their focus on long-term plans/tasks. When they take stimulants it appears to help them regain control over their executive function. It increases their energy levels a bit but they way they react is quite different -- it can seem almost like it calms them down.

So no, we don't all have ADHD. And not everyone will respond the same way to stimulants. They're one tool that can help people who have trouble regulating their executive function.

This is patently false and also misleading as comparing adderall to meth is like comparing dynamite to a nuclear bomb

Edit: parent replied snidely to me, then deleted the comment. ¯\_(ツ)_/¯

Read this and see whether you think the same: https://astralcodexten.substack.com/p/know-your-amphetamines

Sorry, but substack is _not_ what I would qualify as a reliable source.

I get jumpy around Scott but he is a working psychiatrist and good about citing his sources.

Just as an aside, the comment is flagged and dead, not deleted.

Gotcha, thanks, I thought flagged comments usually showed up as “flagged,” TIL they disappear

The difference is a person with ADHD will be calmed by a stimulant rather than amped up by it. The ADHD brain can't focus because it doesn't produce enough dopamine to reward the neural circuits for maintaining focus. So there's this paradoxical effect where something that in typical brains would lead to hyperactivity leads to calmness and clarity in an ADHD brain. It's qualitatively different.

this is the classical DSM-V answer you hear thrown around but honestly times are changing, our understanding of this disorder is changing, and I do not think that is unequivocally true.

I don't think the way you've phrased it can possibly be true. I would assume whether you have ADHD or not an amphetamine is going to raise your heart rate.

Not at ADHD clinical doses.

And not all ADHD meds are stimulants.

Ever heard of Executive Dysfunction? It's when your brain says "turn off that lightswitch", and the part of your brain responsible for implementing the commands can't find the lightswitch.

It's very real, and it's a royal pain in the ass. It's also an exceptionally common issue for those with ADHD. And yes, meds help with it.

I was diagnosed with ADHD as a teen and recall being perplexed by the mixed messages of "don't do drugs!" and "here take this stimulant so you can do better in school!"

If I'm going to take drugs, it's going to be to feel good not to work hard. I'm not taking drugs so that I can fit into an insane world's view of what a productive member of society looks like.

HN doesn't seem to like to be told to stop taking heavy drugs.

I agree with you. These things seem to be handed out like candy to whoever says the right things to a shrink. I think every single one of my neighbors has an addy script from willy wonka internet docs.

When I was a kid, my parents were told to put me on meds as I didn't want to participate in school activities that I didn't find interesting. They smartly ignored that advice.

I played with pharmaceutical stimulants in college and they are absolutely amazing, which is why I don't touch them any more. It's not a thing I would ever want to become reliant on.

And I still have problems doing things I don't find interesting, which is also known as a normal state of existence.

Give virtually any human being on this earth an adderall prescription and they will spend the next few months espousing how wonderful it is and how much better their life is.

No shit buddy! It's amphetamine! Put it in the water supply to strengthen our GDP.

What's your take on caffeine?

Unless you're dosing your morning coffee with amphetamines, why make the comparison?

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