[suggestion]

Why do you presume I'm neurotypical and undiagnosed with any psychiatric disorder? I'm formally diagnosed with severe OCD, depression, and ADHD. I was on SSRI, then SNRI and additionally methylphenidate for years. Eventually I got tired for feeling like a shell of a human being, and weaned off of the SNRI. It took a lot of effort to induce neuroplasticity and ease my OCD and depression, but I did it. Eventually, I weaned off the methylphenidate because I believed I could do it if I tried. Later in life, I also gained and eventually lost weight, which was a similar acceptance that "bad" things, like hunger, are ok and a symptom of something good, my body consuming fat. Then the same for sore muscles at the gym. Over time, I accepted discomfort and the fight or flight my brain was constantly trying to force onto me was a lie, and eventually my brain and nervous system caught up. My physical and mental health improved, my social life, my professional life, etc.

I bet if you knew your house would burn down if you didn't do "normal" things you would have done them no problem.

Stimulants make otherwise unenjoyable things enjoyable? Who would have thought? Do you think people that do "normal" things enjoy them? Is it necessary to enjoy everything all the time?

[KPGv2]

> Why do you presume I'm neurotypical and undiagnosed with any psychiatric disorder?

Because you talk like one, with no apparent empathy for the neurodiverse, except perhaps people with profound issues. "We shouldn't treat any problems except the catastrophically bad." Gross.

> I bet if you knew your house would burn down if you didn't do "normal" things you would have done them no problem.

This is not arguing in favor of your stance, but rather in favor of mine. You're essentially saying "ADHDers can't get shit done without being in dangerous situations, and THAT IS ACCEPTABLE." And yet you think this supports your idea that non-catastrophic disorders shouldn't be treated.

[bgilroy26]

>I bet if you knew your house would burn down if you didn't do "normal" things you would have done them no problem

Getting yourself to do things in a boring situation that you might only do in an exciting situation is a big challenge in ADHD management

If everything was a "house on fire" level emergency, many ADHDers would get more done but would eventually collapse from running around on adrenaline for days

These problems are not easily solved

[suggestion]

The point is it's obviously a problem of perspective. Things are not important because they aren't considered important. If the stakes are higher they are elevated in importance and more demanding of attention.

To pretend that humans are hedonic beasts incapable of cognitive adaption is ridiculous. We do not operate purely on impulse save for pharmaceutical intervention. We can force ourselves to give things more or less importance regardless of the actual stakes.

[autoexec]

Exciting and even emergency situations don't cure ADHD or allow people with ADHD to magically function "normally" (or even effectively enough to avoid serious harm to themselves/others). The amount of importance a person with ADHD attributes to a task doesn't tell you if they'll be able to complete it as well as they would if they were being treated with medication or even if they will be able to complete it at all.

People with ADHD cannot all just "force themselves" to function. Novelty, excitement and interest can help, some of the time, but the rest of the time it's disaster. Depending on severity, the result of not getting the treatment they need can often include things like an inability to keep a job, homelessness, prison sentences, and accidents/injury. Those kinds of outcomes are pretty damn important to avoid, extremely stressful (exciting) to experience or be in imminent danger of, and certainly more than enough to motivate people to do the best that they can, but some percentage of people will never be able to avoid those outcomes by trying to will themselves into "cognitive adaption".

Others may be able to stave off the absolute worst outcomes without medication, but only through exhaustive efforts that prevent them from accomplishing the things they want in life. Why should someone constantly and needlessly push themselves to their absolute limit just to accomplish what comes easily for most people? For what? Bragging rights about how they reshaped their brains by sheer force of will? If medication for a mental condition can make people's lives better they should be free to take it.

To whatever extent you've been able to function without medication, that's great. Don't assume that what worked for you is applicable to everyone else, or even to most other people.

[rini17]

You are forgetting what people did before psych meds were available. Almost everyone treated themselves with alcohol and tobacco. Coffee is up there, too. There is cognitive adaptation, not denying it, but only up to a point.

[suggestion]

Tobacco didn't exist for most of the world until the 17th century and you're discounting the fact that life was objectively much worse by virtually every metric.

People were constantly bombarded with death, disease, things like starvation were near term risks, violence was everywhere, etc.

You're also overestimating the prevalence of alcoholism. Alcohol consumption was largely driven by safety and necessity, not abuse. Alcoholism was arguably more of a social stigma historically than it was today, certainly with harsher criminal penalties in many societies.

[elcritch]

And living, or rather surviving, on adrenaline fueled high stakes brinkmanship sucks. Especially if that's just to enable doing simple chores.

[bgilroy26]

The situation you're describing is circular. Perspective taking and prioritization are executive functioning skills and executive functioning skills are precisely what are lacking in a person who has ADHD

[suggestion]

This is a gross over exaggeration of ADHD and under exaggeration of the effectiveness of non pharmacological treatments

[interstice]

If I knew my house would burn down if I forgot where my keys where it wouldn't do much more than turn me into a paranoid barely functional mess. Higher stakes do not automatically help. Although ironically part of being ADHD is functioning well in high stakes situations, it's not healthy to create high stakes situations in order to function (although some people do this).

[BenjiWiebe]

This is one of the most personally compelling reasons why I agree with my ADHD diagnosis - I've known for a long time that I work better in a state of chaos than not. I actually often enjoy it. And others have commented on that about me as well.

Edit: by chaos I mean things breaking down, going wrong, catching fire, etc. I accomplish things easily once I've taken so long to get to them, that they're seriously urgent.

[maximilianburke]

Just because something works for you to lead a normal life doesn’t mean it works for everyone.

[suggestion]

What the DSM defines as normal is far too narrow and we're too eager for quick fixes without discomfort or discipline.

[autoexec]

A person's treatment doesn't depend on what's "normal" it depends on the level of impairment/improvement. Why do you even care if somebody takes medication for a condition they have and it makes their lives easier? Why should anyone avoid a "quick fix" to a major problem because you think they should suffer more discomfort?

[suggestion]

East Asians are "impaired" the least, and the presumption among Western scientists, particularly American scientists regarding Asian Americans, is that they are simply undiagnosed despite their out performance in nearly every metric of success.

Why do you think that is?

[autoexec]

I'm sure it must have nothing at all to do with cultural stigma. If that were true we'd see signs of mental struggles in their home countries. In the US I'm sure all the model minority bullshit people project on them doesn't cause them any extra pressure or anxiety right?

Asian Americans are so successful that they certainly must not have disproportionately higher rates of suicide right? That might be a sign of some "impairment" going unaddressed! Or maybe you see the rate at which they're killing themselves as yet another metric of success? Those scrappy East Asians are just so good at doing stuff!

[suggestion]

Asian Americans and East Asians have lower suicide rates than Americans (over 60% lower), and especially American white males, you've fallen for a false trope, which is exactly what I expected when I posed the question. I knew that you would immediately appeal to this false trope because you're looking for an excuse.

They outperform by the metrics that matter for a clinical diagnosis and the West is so quick to jump to the conclusion that they're "under diagnosed", it's a uniquely Western and especially American conclusion.

[antonvs]

So your answer to mental health issues is “git gud”?

[ohthehugemanate]

That's a hell of a journey! Congratulations on the accomplishment and thank you for sharing.

Like many other biological systems, neurological wiring is multidimensional and not a natural fit into our arbitrary culturally defined abstractions, or even language. And the dimensions themselves are multifaceted expressions of multiple genes and environmental factors. I am happy to hear stories like yours, of people who can ultimately achieve "normal" functional parity without medication.

Have you considered if that would have been possible without the journey? Had you, on day 1, cancelled that first therapist appointment and decided to grit your teeth and "try" instead, could you have "accepted discomfort" on your own? Or is it possible that the methylphenidate created supportive conditions that improved your chances?

I ask because there is a body of well reproduced research demonstrating not only that ADHD patients have specific genetic and neurobiological differences from neurotypicals in areas associated with executive function, but that long term ADHD medication use can permanently bring the neurological differences into line with neurotypical controls. Something like 20% of medicated childhood ADHD patients can ultimately stop medication without losing points in functional testing or the associated brain structures. It's a lower percentage in adults and less well studied, but still exists. It's a big difference from the results of every non-chemical intervention we've studied, which have single digit efficacy percentages if they beat P at all.

I'm interested in your feelings about this because ADHD is by far the most-studied psychological disorder in the world, and ADHD medications as a group are not only equally well studied, but also the most successful and least harmful of any psychiatric drug. There are more safety and efficacy studies for ADHD medication than for ibuprofen.

So... if you feel your recovery was not helped by the neurogenetic compensations provided by methylphenidate, you should know that you are flying so far in the face of some of the best-validated medical science, that you imply invalidity of pharmaceutical or medical science as a whole.

... which is fine of course - it's your body and brain! But I bet it would help readers to know how you think this aligns with the science, or maybe what you think of medical science altogether. Questions like "Do you take ibuprofen?" And "Do you vaccinate?" Become relevant.

[suggestion]

Yes I have and it was just as difficult post medication as it was pre. Ironically, while on the SNRI my ADHD was "worse" due to the sheer apathy I felt about literally everything, so I was prescribed to help me "focus" and be "motivated".

You're leaving out the part about being "well studied" paired with your conclusions is almost exclusively in American and Western European populations, things are significantly less clear in other populations and cultures.

[UpsideDownRide]

You are overselling ADHD meds by quite a bit. There is plenty of data in literature that quite a bit of people will not respond positively to meds. So if they work for you that's great. But lightly shaming someone by implying they might be anti medicine is super uncool and as an ADHD person you really should know better. Lets not invalidate each other just because experiences are not exactly the same.