[rastamutta]

The fact that everyone is diagnosed with adhd and then given amphetamines is going to be the medical scandal of this century. I have several friends who have become unbearable due to being constantly high, one of them quit their job and is now unemployed and alone, unable to function in crowds. Of course they all report that they feel great on the speed!

[rtikulit]

Everyone is different, and it's unfortunate that your friend's experience is not good, and that you don't know anyone with a healthy relationship with their medication.

The truth is that lots of people manage their stimulants just fine. Across everyone I know on stimulants, 8 friends and family, none are as you describe. These are people I physically see on a regular basis. No one is addicted, high, unable to function or experiencing material personality changes. Every single one of them is taking low to moderate doses, as needed, and says their stimulants changed their life for the better, allowing them to function "normally" at work or school.

[cranium]

Fast acting stimulants are prone to abuse, and people with ADHD are more likely to have addictions (because, you know, deficit of dopamine). A competent psychiatrist follows their patient throughout the treatment to evaluate if the cure is worse than the disease. If that's the case, adapt the treatment: switch to extended release medication, change medication, up/lower the dose, impose weekly sessions to keep the medication to control abuse,... The tool box is clearly not empty.

Did you ask your friends how they are doing or did you find them annoying once and decided the problem was their medication?

[dymk]

They sound like they’re not managing their ADHD well and could use adjusted medication and therapy.

Hopefully their friends are supportive of them and not secretly denying the existence of their disease.

Because wow, that’d be really abhorrent of those friends.

[rastamutta]

That's exactly it, they probably need to adjust their medication. It seems like you are unable to understand that this position comes from a place of trying to be supportive, but thanks for the implication.

[Eumenes]

Seriously. There are "doctors" offices in NYC that operate in 5 minute appointment intervals. The entire waiting room is full of white collar professionals or college students with this terrible disease, ADHD. Anyone who wants it can get it, you just gotta find a pill mill. You self diagnose by saying "I can't concentrate" or "I get distracted" and the shrink writes you a legal script for speed. Some places may have you answer a questionnaire, which is self fulfilling prophecy. Seriously, look at these questions, its laughable this qualifies you for legal meth - https://add.org/wp-content/uploads/2015/03/adhd-questionnair...

[rtikulit]

ADHD is real, it deeply damages people's lives and it is usually treatable with stimulants, with an unusual degree of effectiveness. My psychiatrist told me up front that his diagnostic process was not directed towards ADHD and that he might end up with some other diagnosis or none at all. In the end he diagnosed me with ADHD after a process of interviews, tests, evaluation of historical evidence, and submissions by my family regarding my life and behaviour. I have a fat file of the documentation involved.

You are talking about greedy irresponsible doctors and bad faith "patients".

These are not the same thing.

[Eumenes]

Stimulant's are effective at improving mood and productivity. There is no question there. I'm highly skeptical of a "disease" or "disorder". Having worked in investment banks where the majority of people were on adhd meds, college where most students were on adhd meds, and seeing all these mid-life diagnoses - is troubling, esp. when prescribing these drugs to children. Its becoming normalized, and even celebrated. Sitting in a classroom for hours everyday, glued to your seat, demanded to shut up and pay attention, is not an ideal environment for kids. If you deviate from that, you could be a candidate for adhd. Once you start these drugs, its difficult to stop and you develop a dependence. I took them for years in my youth and deeply regret it, because it was simply a bandage for addressing areas of self improvement that I ignored. I wish I had someone around back then to play devils advocate.

[rtikulit]

My revelation came when I observed my oldest child in kindergarten (which was nothing like being glued to a seat). My child was the large and obvious behavioural outlier. Then the unbelievable process in grade 3 of coaching their attention to and completion of simple homework, with much emotional distress and sobbing and feelings of inadequacy. Same with participation in sports. There is no such thing as “an ideal environment” where my kids would function in some kind of parity with their peers.

You have no clue because you have no pertinent experience.

[Eumenes]

You have to look out for your own kid and do what's best, not my place to speak, but I think we can agree on different approaches to these problems. Not all have to be involved with diagnosis or medicine.

I shared these articles in another comment, but this is what I fear is taking over the 'mental health' diagnosis situation atm:

https://unherd.com/2022/11/who-decides-if-youre-mentally-ill...

https://mentalhellth.xyz/p/the-buzzfeed-ification-of-mental

[rtikulit]

I will agree that you are conflating and grossly oversimplifying a number of related but different issues. As a result your conclusions are just not valid.

Does the educational system make age-inappropriate almost inhumane demands on children? Yes. Do many kids have attentional and behavioural issues that are not ADHD? Yes. That can be improved without medication? Yes. Should these be distinguished from true AHDH and treated differently? Yes. Should kids with ADHD try non-medical interventions first? Yes. Should kids who have clear diagnostic markers for ADHD and who respond well to stimulants be prescribed stimulants? Hell yes. Should psychiatrists try to weed out non-ADHD people looking for legal sources of speed? Hell yes. Are the fields of psychopathology and psychotherapy problematic? Somewhat. Are they "right"? Not exactly, no. Are they "wrong"? Not exactly, no. Do they relieve suffering? Sometimes, Do they create unintended consequences? Yes, more often than we'd like. Is the whole field conducted in bad faith? No! Is it a work in progress? Yes. Are there bad faith practitioners? Yes. Are there incompetent practitioners? Yes. Are there competent practitioners acting in good faith? Absolutely yes. Are there reliable signals to tell these apart? No, unfortunately, no. Is there an epidemic of performance-enhancing prescription drug abuse in the circles in which you run? Apparently so, and I've heard this elsewhere. Is there performance-enhancing prescription drug abuse in the circles in which I run? Not to my knowledge.

Life is complicated. You do no good by mashing all this stuff together and disposing of it with simplistic conclusions.

[dymk]

> I'm highly skeptical of a "disease" or "disorder".

Well, it’s you versus the entire medical community. Who do you think is more likely yo be right?

Your bad experience is unfortunate but does not reflect that of most people with ADHD. It’s the only disorder which responds incredibly well to treatment by stimulants, and you’ll find that fact proven out by medical science.

[Eumenes]

Psychology/psychiatry has a dark past and seems to change its mind on things very often (often because of political correctness). Borderline a pseudoscience.

Until there's a blood test or concrete psychological proof, its just simply not a disease. These articles were great reads on this phenomenon of self diagnosis:

https://unherd.com/2022/11/who-decides-if-youre-mentally-ill...

https://mentalhellth.xyz/p/the-buzzfeed-ification-of-mental

[dymk]

> Until there's a blood test or concrete psychological proof, its just simply not a disease

Again, you versus the entire medical community. I am saddened to see you making such strong claims from a position of such ignorance.

You're talking about self-diagnosis, and I'm talking about medical professional diagnosing the disease.

[ojkelly]

Yep and this ends up hurting everyone who legitimately suffers from it.

Both from people who do this, then decide the meds just get them high, so they must get everyone high—they don’t.

And from those who see this and use it as fuel attempt to discredit the condition itself.

> writes you a legal script for speed.

ADHD meds aren’t street drugs. There’s stimulant and non-stimulant options, that work for different people.

> its laughable this qualifies you for legal meth

Desoxyn is a rare treatment option, valuable to those who really need it.

Methamphetamine may be _very_ close to other amphetamines, but the methyl group unlocks access to other parts of the brain. It’s a different drug, with different effects.

I fully agree with you that this shouldn’t be happening, but the comparisons to street drugs only work in favour of operations like the one you describe in NYC.

[mial]

While I agree that stimulant are overprescribed they can however be at least temporarily helpful to help someone with ADHD get their life in order and make meaningful lifestyle changes in order to get the symptoms under control.

[ojkelly]

How would we measure if it’s being overprescribed?

It’s more likely still under-diagnosed.

The pandemic threw such a big spanner in the works that so many of us started to struggle enough to notice it wasn’t normal. This put the mental health system under significant strain. More people than ever have been diagnosed.

In the US, an ill-guided rule that limits the manufactured capacity of stimulants, not by demand, but by an arbitrary number, impact people recently.

They couldn’t refill their scripts. Supply effectively ran out.

> temporarily helpful to help someone with ADHD get their life in order and make meaningful lifestyle changes in order to get the symptoms under control.

A wheelchair is temporarily helpful, so are reading glasses. They could help someone to get their life in order, and make meaningful lifestyle changes to get their symptoms under control.

Somehow I think we’d both agree even after that you wouldn’t take someone’s wheelchair or reading glasses from them?

[herbst]

Ritalin comes with weird side effects. My partner changed quite a bit in a short time until she herself couldn't stand it anymore. Mostly because the libido died and left a thumb feeling.

So she switched to better amphetamines (Dextro) and side effects turned away. Leaving only the positive, expected, effects essentially.

I took a lot of amphetamines in my life. But Ritalin is the only one I can't stand myself on. It's like a neuroleptic is packaged in (I know it isn't) but it makes so thumb and cold. IMO