[engx]

I've had ten friends take Adderall and all of them exhibited the same characteristics as a person on meth. They are not fun to be around. Sometimes they would be highly productive, other times they just bounce around the house, doing nothing. My current roommate takes Vyvanse and it's incredibly difficult to deal with.

To me, it's okay to say it's a performance enhancing drug and that some people need more energy (e.g. coffee) to get going. But I find it incredibly dangerous to suggest a person needs to take an amphetamine every single day to be normal.

I am open to change my opinion, especially if things like EEGs can conclusively establish ADHD. But all the troubles you describe, are universally human. If Adderall helps you overcome them, I'm all for your ability to take it. I'm just cautious about labeling everything a disorder or disease.

[komali2]

I can't speak for your roomates, friends, or the psychiatrists prescribing them drugs.

I can say that ADHD is a real disease, is documented, and Adderall is a recommended treatment (among others). Take a look at the other comments - as I said, mental disorders are not "on/off," and symptoms of mental disorders can be things that everyone in the world "just exhibit" - i.e. occasional depression, inability to focus, even delusions, panic attacks, or hallucinations. If you didn't get enough sleep one night and had mild hallucinations, that doesn't mean you have Schizophrenia. Now imagine you dealt with that, all the time, no matter what you did. That's why medication exists for mental illness.

In any case, regardless of your personal opinion, it's not really up to you. ADHD is real, according to doctors, and unless you are a doctor, you don't have anything more than a layman's opinion. Apologies for being harsh, but this is what I deal with. See:

https://www.nimh.nih.gov/health/topics/attention-deficit-hyp...

Under DSM-5, it is listed at F90.0, .1, and .2.

If you believe your friends or roomates are addicted to adderall or inappropriately prescribed, I recommend reaching out to their family, who can contact their pscyhologist.

[anigbrowl]

That's because adderall is basically meth. I know it's very hard to grasp the idea of ADHD as a condition but there are lots and lots of mental conditions whose existence cannot be conclusively demonstrated or dismissed by EEGs and the like; we just don't understand the brain as well as we'd like right now.

speaking as someone who has struggled with ADHD since being a small child, having to assert the existence of a sometimes-crippling condition to people who demonstrably don't understand it very well is really, really insulting and I am sick of it. You don't have to believe in my mental illness but unless you have a superior psychiatric model to offer, then please stop stigmatizing it by questioning the reality of something you don't understand.

Do you tell people who are color-blind that they can totally see red (or whatever) color, insisting they're just not looking hard enough? Probably not, because you likely know we can explain color blindness by unusual differences in the retina. But we only gained that knowledge relatively recently in history. You would not have been helping anyone who was colorblind by telling them to 'look harder' before that discovery was made, would you? Then please accept that you're not helping anyone with ADHD by telling them they just need to focus harder/ learn better habits/ etc..

...if for no other reason than that when I'm trying to explain ADHD, having to listen to someone's poorly-informed opinion on a complex medical topic is really distracting. It's very tiring for me in a face-to-face setting to have to stand there waiting for someone to catch up with my substantive arguments. I don't say that to be rude, I just don't know how else to explain what it feels like; to me most people are slow and talking them is about as much fun as driving in a traffic jam.

[kem]

One of the problems is that our models for "physical" nonbehavioral illness don't translate well into neurobehavioral problems.

Something like ADHD is heterogeneous (the AD problems are different from the H problems), but not totally so. Also, attention and behavioral control problems are normally distributed, like the good ol' bell shaped curve. They're fuzzy.

So those who claim it is not a real disease are correct in a sense: it's not like color blindness, or having a missing limb, or Huntington's disease or something like that. They're also right that it's normal to have attention problems at various points in life for various reasons. However, those who claim it is a real illness are also correct: there are people who have very unusual levels or patterns of attention problems, and even though they're not qualitatively different, they're quantitatively different, and they have serious problems as a result, and are not just screwing around or lazy.

Behavior problems are often much more akin to something like blood pressure or weight. So, it's true that you wouldn't say "high blood pressure is a disease." However, it is a state of illness, might reflect a disease, and can lead to death and other problems. Same with excessive weight. Some pudginess is normal, but at some level it becomes medically threatening. The boundary is vague, and arguments about whether or not weight problems are biological or environmental or social or behavioral are misleading: they're all of the above.

The problem is that when people say "I see my neighbor with ADHD, and think they just need to realize that's a normal part of life," part of what happens is that they're assuming that their own experiences with attention problems are the same as theirs, or that their neighbor who might be exaggerating is the same as everyone else with an ADHD diagnosis, or that their neighbor who has mild but clinically problematic attention problems is the same as the person with severe problems.

[derefr]

My favourite analogy, that I can't believe doesn't come up more often in these discussions:

Having a degree of ADHD is like having a degree of nearsightedness. Yes, almost everybody has some. And you know what that translates to? Almost everybody wearing glasses. It's "normal" to be nearsighted... and it's just as "normal" to wear glasses to correct it.

Imagine if people with a small amount of nearsightedness were expected to just struggle through their life without glasses. Wouldn't that be weird?

[anigbrowl]

Thanks for taking the time to write that - I'm going to recycle several of your points in future conversations. This is a frustrating topic for me as I've been through not acknowledging to myself that I had a problem, getting therapy, trying many different medications, investing time and effort to change diet and exercise habits and so on. Many things have led to incremental improvements but it's still An Issue, and explaining things to people from scratch really gets old.

[derefr]

If a person in a house with a working thermostat is comfortable in a room that is at 21 degrees, then they should, obviously, keep their thermostat at 21 degrees. They don't need to touch the dial; the default is sensible for them, and most humans.

If a person in a house with a broken thermostat is comfortable in a room that is at 21 degrees, however, they might have to set their thermostat to 25 degrees to make the room 21 degrees—because when their thermostat is set to 21, the room ends up 17 degrees.

That is the point of stimulants, and most other such neuro-active drugs: they move the dial on your (complex, multi-dimensional) neurochemical thermostat.

If you don't have a chemical imbalance—if you're neurotypical—you shouldn't "move the dial"; you'd just be moving it out of the comfortable human reference range.

If you have a chemical imbalance, then your "thermostat" is mis-calibrated, and so its default dial position is out of the comfortable human reference range. You definitely do want to "move the dial"—to move it into that range.

The point of stimulants is like the point of glasses: to shift everything by precisely the right amount so that they cancel out the problem, leaving you "normal." A person who has ADHD and is on the right dose of the right drug, shouldn't be able to be differentiated from a neurotypical person. If they can be, then, by definition, they're not on the right dose of the right drug—just like someone who still can't read the letters in the optometrist's office obviously has not yet found the correct diopter rating for their eyes.

[DannyBee]

(As others pointed out, Adderall is basically meth) First, there are non-stimulants. For example, Straterra is one, and it works great for me. So if your complaint is amphetamine, problem solved! The truth is we are pretty much still in the "using leechs to let blood" phase of being able to target drugs to brain chemistry. We know there is stuff firing wrong/activating wrong. We have theories why that is the case. But thoes theories are pretty basic, and we lack the capability to build drugs that affect the changes we want.

So, instead, we find existing drugs that help cope with symptoms.

As for the EEG part: you,in fact, can start to do that (using EEGs and qEEGs). See NEBA, etc.

"Conclusively" is hard, of course. You often can't conclusively establish someone has a brain tumor from an EEG, and those often have huge impact on the brain.