[Llamamoe]

Sure, in light cases it might help, but mostly you see news/social media amplifying ableistic "look at <other people with>, they're managing, why aren't you? it's obviously your lifestyle choices"

But talk to any people who actually have ADHD and you'll realize that this doesn't help anyone: ADHD doesn't mean "easily distracted", it means "inability to maintain control over focus", and taking distractions away doesn't make this even marginally less impactful. You might be more likely to come back to a task instead of getting lost in distractions, but it's never gonna be enough for anyone but the lightest cases and misdiagnoses.

Just stop trying to decide how people should treat their disabling medical conditions. You've got millions saying "stimulants are the only thing that helped", and yet every time the topic of ADHD comes up, someone goes "hmm but maybe we shouldn't give people stims, and force them to use self-control they don't have to stop having ADHD ??"

[StefanBatory]

If someone had a broken arm you wouldn't tell them to exercise that arm more and that it's fine. Or that back in time people didnt had casts and they were fine.

I don't understand why so many people act otherwise when it does come to issues you can't see.

I don't have ADHD but I have friends who do. And no it's not a question of willpower they need meds to function. So I'm very sensitive when it comes to people saying it's on them like poster before you somewhat implies.

:(

[Swordfish12345]

> they need meds to function

Once you start taking meds you develop dependence and so your definitely need them.

But if there was a simpler environmental cause/solution, now that is out of reach entirely. It would take years for their mind to re-balance.

If you tried everything and nothing worked, then go for the meds, and take on the risks and side-effects.

But no one does this. They get diagnosed and then straight on meds for the rest of their life.

[eqvinox]

> Once you start taking meds you develop dependence and so your definitely need them.

In this generality, this statement is plain false folk tale. It certainly applies for some conditions and treatments, but without a study to back it up you should not be making this statement in regards to ADHD and its medications.

> If you tried everything and nothing worked, then go for the meds, and take on the risks and side-effects. But no one does this. They get diagnosed and then straight on meds for the rest of their life.

This is equally untrue. I can't make statements about other places and health care systems, but where I live they throw the kitchen sink at you for about a year or two before they progressively walk you up to the more "extreme" medication if nothing else helped.

[eqvinox]

> If you tried everything and nothing worked, then go for the meds, and take on the risks and side-effects.

By the way — you say this with some nonchalance. Those two years of "tried everything and nothing worked" cost me my university degree.

[Swordfish12345]

May I ask: when you say you "tried everything and nothing worked"...was this before you knew about the existence of ADHD?

The tragedy I find is that people first discover ADHD and then go straight on meds. They don't use this new realization and understanding of their condition to try to solve it without medication. And once you begin medication, your brain starts to change, and you really can't isolate whether a behavioral change is actually working independent of your medicated state. So begins a long journey of decreasing efficacy of the meds to the point that you will end up worse than where you started.

Also curious what you did try? What was the longest time you disconnected from the internet and social media? How much did you exercise?

[eqvinox]

> May I ask: when you say you "tried everything and nothing worked"...was this before you knew about the existence of ADHD?

No, this was after I knew about the existence of ADHD, and from the structure of the comments this should have been obvious to you. I was referencing my previous comment: "they throw the kitchen sink at you for about a year or two before they progressively walk you up to the more "extreme" medication if nothing else helped." It is quite clear that this refers to the early treatment phase after diagnosis.

> Also curious what you did try? What was the longest time you disconnected from the internet and social media? How much did you exercise?

To answer all 3 questions: enough, enough, and enough.

[StefanBatory]

Someone without ADHD will never understand this, I think.

[Swordfish12345]

> dependence

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2011.1...

Your brain adapts. It's pretty obvious.

If you give a mouse access to a button that triggers dopamine release, they keep pressing the button until they starve to death.

The brain has evolved a system to maintain homeostasis to prevent this happening.

[eqvinox]

> https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2011.1...

This paper does not say what you think it does. Please refer to my other comment discussing your sources.

[throwaway11460]

No, you don't develop any dependence like that. You just go back to the absolutely disfunctional state you were in before when you stop taking them.

If it was anything like drug addiction then it'd go back to normal after some time - but the normal of people with ADHD is different.

[Swordfish12345]

> You just go back to the absolutely disfunctional state you were in before when you stop taking them.

Your brain adapts by creating more dopamine transporters...meaning you need more dopamine for same effect. This happens in an effort to maintain homeostasis. There is no free dopamine unfortunately...what goes up must come down. The brain's homeostasis system is hard-wired.

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2011.1...

> but the normal of people with ADHD is different.

This is probably the biggest misunderstanding people have.

They are told that their brain doesn't produce as much dopamine as a normal brain, which is why they can take the meds and normal people cannot.

But this is not the case. Each brain produces the right amount for itself, and if you dope it with more, then it will counteract this, and you will build tolerance.

There is no evidence about the dopamine theory of ADHD. It's total conjecture with a couple of papers here and there. There are no biomarkers or imaging for diagnosing ADHD.

The end result is you are going to end up morphing people's brains to the point that they need to take the meds to attain their original state.

But whatever, no one seems to care, too much money to be made.

[throwaway11460]

I spent 25 years of my life without medication, it crippled my life and I couldn't get anything done unless absolutely, totally hyper focused on it. I don't even have high school. I failed at every job I had even though I won national programming competitions and everyone described me as the best programmer they ever met (and said that my technical knowledge is excellent but I'm just not doing the job so they have to let me go). I was homeless for some short time.

Up until I got diagnosed and medicated. First I had therapies, nothing. Then I had non-stimulant medication - worked but I had terrible side effects. Now I'm on methylphenidate and everything works like clockwork now.

Frankly I don't care about the theory behind it. It turned my life around and that's all I need to know.

[Swordfish12345]

I'm in a similar boat. But I am resisting meds. I always think I can pull it together with the right system and discipline.

I wouldn't trade the creativity and hyperfocus for anything. I feel I am on a journey and the one trick is to figure out how to beat this thing. But I am desperately struggling to get things done versus endless ideation/dreaming.

So I am very curious as to what you tried and why it didn't work. And of course, I hope there is something you didn't try that will work for me.

I have such a delicate balance at the moment and I cannot afford to disrupt it with meds, and could not afford to have med tolerance build after a few years leading me worse than when I started. EVERYONE tells me I should just take meds. The pressure is high. But I never will.

[Swordfish12345]

> mostly you see news/social media amplifying ableistic...

It's actually the opposite.

It is now practically forbidden to criticize anything related with ADHD.

After reading all the literature I concluded there were huge problems with almost every aspect of it. Then you go try to tell people and you are tarred and feathered.

Then look at incentives: on one side is: "a citizen concerned that maybe taking stimulant meds is going to cause greater problems" vs "drug companies and psych industry making huge money from increasing lifetime prescriptions of stimulants".

The people on the "hang on a minute" side of things are concerned about health and safety of society. They stand to make ZERO money from raising the alarm. On the other side its billions of dollars.

> trying to decide how people should treat their disabling medical conditions.

Trying to raise awareness of risks. I think people don't understand the risks. They see a smart pill with no side-effects.

Do what you like.

[eqvinox]

> After reading all the literature I concluded there were huge problems with almost every aspect of it. Then you go try to tell people and you are tarred and feathered.

You should probably cite some of that literature.

[Swordfish12345]

https://www.frontiersin.org/articles/10.3389/fsoc.2022.81476...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626918/

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2011.1...

https://pubmed.ncbi.nlm.nih.gov/25066615/

[eqvinox]

Now that I've commented on these papers in the sibling post, I can complain that you do not seem to understand what a citation is. What you provided are sources. Citations are references to sources. You're not referencing anything, just throwing them around implying they prove your point. To make them proper citations, you'll need to be clear on what you're actually pointing at.

[eqvinox]

> https://www.frontiersin.org/articles/10.3389/fsoc.2022.81476...

Written by an elementary education specialist and an unknown lecturer. No medical value.

> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626918/

A very nice summarization paper on ADHD. You do not seem to have read the summary at the end, as it does not support your points of argument. It primarily suggests a wider approach using additional medication, as well as DNA based diagnosis and treatment. The latter does not seem to be available yet.

> https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2011.1...

This suggests the brain adapts to long-term medication with methylphenidate, but does not go as far as establishing a causal relationship, or show that the dopamine transporter alterations are to the detriment of the patient.

In fact, this meta-study seems to be a contribution to the field of establishing the origins of ADHD; its argument is that these dopamine transporter changes may not be useful in understanding ADHD as they are caused by the treatment. However, there's this:

"It is, however, also possible that lower dopamine transporter density and lower dopamine release in medication-naive ADHD patients reflect prefrontal pathology, well demonstrated in neuroimaging results for ADHD (5), since frontostriatal glutamatergic circuits regulate striatal dopamine release."

It's hinting at a possibility that, in reverse, the unmedicated state without the long-term effects may be a key contributor to ADHD itself.

> https://pubmed.ncbi.nlm.nih.gov/25066615/

This discusses distinctions between ADHD diagnostic criteria in DSM-IV vs. DSM-5. The ones in DSM-5 cast a wider net than DSM-IV. The study comes to the conclusion that the net is still not wide enough, particularly in adults. I don't know why you believe this paper supports any of your points.

[Swordfish12345]

I suggest you read the paper (https://www.frontiersin.org/articles/10.3389/fsoc.2022.81476) which you dismissed. I have found that it summarizes most of the realizations I had from my own research. Otherwise it takes too long for me to explain.

Assistant professor, lecturer, reviewed by post doc. It's an article that summarizes stuff nicely referencing papers.

> but does not go as far as establishing a causal relationship

I love how the attitude is: here is a drug that you would think would cause side-effects and tolerance...which is does...and then the onus is on everyone to conclusively prove that it's bad. Smoke until we realize it causes cancer. Take opiates until we realize they are extremely addictive in certain packaging.

It's very much carefree experimentation on the world, rather than being risk-averse and acknowledging what we don't know.

It is common sense that the body will seek homeostasis to deal with this artificially increased dopamine levels. Which this study seems to indicate.

But it comes down to risk-appetite.

> DSM-IV vs. DSM-5.

We changed the diagnosis criteria and got: surprise, 27% increase in expected prevalence. How convenient.

The diagnosis criteria are just made up. The cause is not proven at all. There is no biomarker or imagery that can diagnose the condition successfully.

So patients present with an impairment...then you look at who has the impairment and craft the criteria such that it explains the impairment. Its a circular definition and extremely broad.

[eqvinox]

My dismissing that first paper was to your benefit. It is directly contradicted by the second source you link, which quite clearly points at genetic distinctions and markers in ADHD patients. Meanwhile that first paper argues ADHD may be "unreal" because current diagnostic criteria are ambiguous, redundant and arbitrary; and how we socially build it up.

I have no idea how you reconcile that in your head, but apparently you do. Everyone is entitled to their beliefs and opinions.

> There is no biomarker or imagery that can diagnose the condition successfully.

This, equally, is contradicted by the 2nd paper you link. It seems it's just too expensive (for the time being) to use DNA analysis in ADHD diagnostics.

Anyway, this discussion is no longer productive. These arguments are made, researched, exchanged, and resolved between medical experts. You are at odds with the current consensus of the medical community. It is your right and privilege to have your own well-researched opinion on this topic. However, when you then take this and argue for changes affecting a whole bunch of people across all of society, it becomes my right to call you out for the conflict of your opinion vs. medical consensus. I can see quite clearly why you believe "It is now practically forbidden to criticize anything related with ADHD." You expect people to agree with you, and you argue these things even in the face of people negatively affected by it.

You have two choices here. Study medicine (or pharmacology, or biochemistry), go into this field, and move the consensus. Or consider your belief exactly that: a belief, researched as it may be, that is still likely to be wrong because consensus is against you.

Sure, consensus is sometimes wrong. The way you're going about it is not how you change it, it's how you make an ass of yourself.

[throwaway11460]

Just don't take them if you're concerned.

[Swordfish12345]

You could have taken this advice for the opioid epidemic, and then it still would have affected you via family/friends. We've already been through this once.

[throwaway11460]

Not nearly the same thing. You're not going to get addicted to ADHD prescription stimulants unless you take much, much, much more (several orders of magnitude at least) than the prescribed dose. Not the case with opioids.