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Comment by derefr | Hacker News Reader

I don't know if I really have ADD. There's no real physiological test for it, just self-assessments and the rejection of the null hypothesis upon the introduction of various drugs.

What I do know: until I started treatment for ADD, the entire concept of "willpower" or "motivation" just didn't make sense to me. It was something other people had, maybe; or perhaps they were lying. But with treatment, "motivating myself" into doing things for merely their effects on my long-term goals is a perfectly obvious thing to do. It's very similar to what it felt like to go through puberty and gain a sex drive—but what I've gained is a drive to succeed in life.

Watching my own behaviour, introspectively, is fascinating. I keep expecting to hear a little voice that says "eh, that's too much effort; it makes me tired just to think of doing that." That voice was a persistent companion for most of my life. Now, that voice is just not there.

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It would be great if we could experiment upon you. Every three months we'd start you on a new regime of pills. You wouldn't know if they were meds or placebo. The people giving them to you wouldn't know either. The people writing the report wouldn't know, until after they'd written the report.

Obviously we can't do this. But I dearly love to know what the results would be.

For what it's worth: I suspect you would tell the difference between placebo and med. I'm not so sure about everyone taking those meds.

It is a lovely idea. I would go even further; I wish for a world where everyone is given a "neuropharmapseutical chemistry kit" for their 13th birthdays (along with RISUG for boys, and a few other things) and told to play with their own brains (using a paired mobile app that gives them things like daily dual n-back tests) until they find a happy optimum.

Fill the kit with agonists, reuptake inhibitors, and antagonists for every major neurotransmitter—serotonin, dopamine, norepinephrine, GABA, acetylcholine, glutamine, histamine, etc.—in liver-keyed prodrug form. Provided as well would be something like an Epipen, full of a chemical that would preferentially react with (and thus neutralize) any prodrugs left in your bloodstream, in case of emergencies. (Not that your liver will let you process the prodrugs into amines quickly-enough to harm you physically, but there's always the chance of, say, sudden suicidal ideation.)

But ignoring futurism, we've always got gwern: http://www.gwern.net/Nootropics

Interesting, but above all else it would require enough testing technology to be able to say you have stabilized back to your regular levels (or stabilized at all) before trying out the next new thing. Otherwise you are simply wildly screwing around with your chemistry and hormones to an extent that you may not be able to accurately measure the effects of any one specific drug on its own, because the effects are fluctuating and your body is constantly trying to adapt.

While I applaud applications of the Scientific Method, you write as though you have some doubt that the effects are real.

I took Vyvanse for a couple of months to try to help my concentration... holy cow. When it took effect 40 minutes after taking it, I felt like a jackhammer. It was no slight effect that you could dismiss as placebo, my blood pressure went up and I was on task for ten hours of the day, no problem. All the cobwebs that happen after that big pasta lunch? Gone. My mind was sharp, focused, and my friends all noticed that I was noticeably more aggressive in conversation.

The down side was that sleeping became very difficult. I'd wake up over and over during the night with way-too-vivid dreams. Worse, my heart started feeling like it was fluttering and my blood pressure machine, which told me that it was a bit higher, also indicated that I had an irregular heartbeat.

> you write as though you have some doubt that the effects are real.

I'm sure that for some people there is ADD, and that the meds are an important part of being able to function.

Huh? There are most certainly proper tests for ADD, of all of types and varieties. It is unfortunate that self reporting is the most frequently used diagnostic technique, but it is by no means the only one. Heck there are structural brain differences in people with ADHD that can be detected!

> Heck there are structural brain differences in people with ADHD that can be detected!

Though not on an individual level, as far as I know. But studies on larger groups have shown differences from non-AD(H)D scans (source: I once saw a Youtube video with a semi-bald psychiatrist (?) with ADD.)

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