11 ms·

About getting treatment: it's extremely irritating that some people judge using Ritalin is somehow morally wrong. Yes, I get that "lifestyle changes" could help

• munk-a 7y ago
  There's another weird factor. Ritalin is an upper and it's stigmatized to take an upper - either your performance, judged by coworkers, will be equivalent or below theirs and the stimulant is seen as the only thing keeping you in your job (which can get super depressing internally) - or, if you're doing well in your position, it can breed internal and external doubt as to whether your performance would just be normal and is being boosted by the drug. It's kinda hilarious that, when going off Ritalin, things don't slow down (or become "less upped by the upper") they stop - this article touches on it but ADHD can feel the most torturous when it impedes even your leisure - especially when coupled with depression. Ever spent a day off staring at a wall dreading the possibility that you might waste a day until you realize the sun has gone down? Yup, so much fun.
  • rhombocombus 7y ago
    I keep it very closely that I am on any sort of medication because of the stigma. At this point in my life I refuse to allow someone else to have an opinion of what my doctor and I decide I need to be healthy.
    • colechristensen 7y ago
      I take a suite of medications for symptoms like this and never felt the need to advertise or hide it, and never experienced stigma although I have the mindset that leads me to not even notice negative cues (a mixed blessing).
    • Teelo 7y ago
      More people need to do this. So many people are way too open about their private life and then end up frustrated when they get negative reactions about their disorder.
  • Mirioron 7y ago
    What I don't understand is - why is it a problem that somebody performs better on medication? Life isn't sports or a game. It's not a competition. Shouldn't people be happy that someone else can keep their life together? That's less of a burden on society. >Ever spent a day off staring at a wall dreading the possibility that you might waste a day until you realize the sun has gone down? That sounds silly and boring. I was daydreaming instead of looking at the wall.
    • RankingMember 7y ago
      > It's not a competition I surmise that the people who have a problem with the idea of someone taking medication feel otherwise.
    • viklove 7y ago
      > It's not a competition. Are you kidding? Life in a capitalistic economy is _absolutely_ a competition.
      • noodle_face_ 7y ago
        Life itself is competition...
      • insertnickname 7y ago
        In a capitalist economy, others doing well generally benefits you. It's not zero-sum.
        • viklove 7y ago
          Sometimes you benefit from others doing well. Sometimes you are hurt by it. It's not as simple as you make it out to be. Globalization, for example, is zero-sum for many people. Since we're now buying <wheat/metal/electronics> from <x country>, people who did that here lost their jobs. It's absolutely a competition. In capitalism you have to fight for your right to feed yourself, and if you are in the bottom x% of society, you quite literally have to live on the streets.
  • penagwin 7y ago
    > Ever spent a day off staring at a wall dreading the possibility that you might waste a day until you realize the sun has gone down? Yup, so much fun. This is literally every Saturday for me. I'm thinking about keeping my Ritalin by my bed. I don't understand why it's so difficult and it makes me really frustrated - I just can't get out of bed. I try to wake up and my mind goes "naw". I sit up to get out of bed, sit there for 40 minutes, and still can't get myself to get out of bed. Stare at my Pillow, some reddit posts, another 45 minutes are gone. Now it's 2pm, I've wasted half the day. My depression tells me it's because I'm a lazy piece of shizzle. Source: Diagnosed with ADD/Aspergers/Depression/Anxiety... Horaay :(
    • sibeliuss 7y ago
      Being diagnosed with all of those things -- doesn't it seem like a pharmaceutical spiral brought on by a sick process? Ever since my sister was misdiagnosed with a handful of labels and put on a handful of drugs which subsequently ruined her life for a very long time I've been interested in looking at alternatives to the pharma status quo. I read Lost Connections by Johann Hari recently and it was remarkable. The chapter on how people with similar diagnoses radically improved by joining a gardening club (reconnecting with others) makes the book worth reading, but it goes into much much more. It's worth looking up.
      • deleted 7y ago
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      • ddorian43 7y ago
        None of these "alternatives" ever fixes bipolar,schizophrenia, borderline, adhd, etc. When you have those stuff, you need to take meds AND join the gardening club. You can't go manic at the gardening club.
        • sibeliuss 7y ago
          Right. Those are very extreme diagnoses. Medication is often required. What this book speaks to is the problem with overprescription as applied to the average person, and offers many solutions.
  • deleted 7y ago
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  • IIAOPSW 7y ago
    Replace "upper" with "caffeine" and the absurdity becomes apparent. "either your performance, judged by coworkers, will be equivalent or below theirs and the stimulant is seen as the only thing keeping you in your job (which can get super depressing internally) - or, if you're doing well in your position, it can breed internal and external doubt as to whether your performance would just be normal and is being boosted by the caffeine." the difference between them lies only in the degree of effectiveness. I dream that within my lifetime uppers will be as de stigmatized as weed.
  • hotfrost 7y ago
    > the stimulant is seen as the only thing keeping you in your job (which can get super depressing internally) Literally experiencing this right now while getting a degree in software engineering. Got diagnosed during my first year with AD(H)D and I'm currently in my fourth, final year. Looking back at things I have no clue how I even managed to pass the harder subjects/courses. All I remember is I took my meds and studied about 12 hours a day 3 weeks straight during the hardest parts. Before I had never studied more than 2 hours a day and I would start only about 5 - 8 days before a test. I often wonder if I could work at a software company without my medicine because of this and it actually worries me.
• Mirioron 7y ago
  >Imagine if there was a pill to reduce risk of cardiac arrest, with some increased risk of something relatively minor. (Some?) Antihypertensive drugs can contribute to harm to the liver. They're unlikely to cause anything on their own, but if your liver is already not the healthiest it can make things worse. >Yes, I get that "lifestyle changes" could help, but I don't want to change my lifestyle. As far as I've read about ADHD, nothing comes close to the effect that medication has in treating the issue.
  • dx87 7y ago
    I can't speak for everyone, but regularly exercising and eating healthier foods reduced my need to take my ritalin as often. When I first started taking it, I had to take a dose every 2 hours to stay on track. Once I started eating healthier and doing ~1 minute of exercise every hour, I can comfortably go 3-4 hours between doses. I still function much better when I take my medication, but as long as I eat healthy and exercise, I don't feel useless without it.
    • Mirioron 7y ago
      Yes, exercise absolutely helps, but a person with ADHD is much more likely to exercise if they have been prescribed medication. Without medication they will likely just stop exercising at some point, because they "don't feel like it today" and then forget that they were supposed to exercise every day. Then 3 months later they remember for a moment, commit to exercising again, but that only lasts for another 3 weeks.
  • steve_adams_86 7y ago
    You're probably right when it comes to those of us who medication works well for, but there are some people who medication doesn't help much. In those cases I think diet and exercise tend to be the best line of defence against symptoms.
• bnjms 7y ago
  > Yes, I get that "lifestyle changes" could help No. Just don't entertain this idea. You can go 20 years since the first time someone told you you may be ADHD or depressed with subsequent diagnoses. Then tell yourself it's all in behavior no one needs drugs. But twenty years on you'll still find yourself in the same cyclical patterns of periodic depression or chronic inability to select your attention to a task. "Lifestyle changes" could help with the right crutch. But if you need Ritalin or another drug to learn those lifestyle changes so be it. In your (not quite perfect) comparison. It's as if the pill will reduce cardiac arrest and improve peoples aptitude to learn to run for 30 minutes daily.
  • colechristensen 7y ago
    Very true. There are about a dozen factors with a positive correlation with each other, but they are not links in a causal chain. One does not simply "fix" them, they all have feedback on one another. The knowledge of how they are related helps, but does not fix.
  • ninjakeyboard 7y ago
    Yeah I'm 36 getting a diagnosis/script now and it took an incredible amount of distress to finally get me to the doctor.
    • filoleg 7y ago
      There is definitely a lot of internalized shame/pressure when it comes to ADHD diagnosis and seeing a specialist. I have been diagnosed and prescribed since many years ago, but I still feel the distress and get anxious every time I am forced to switch a provider due to life events (nothing dramatic; usually just either to me moving states or my provider moving states, which is exactly what happened with my most recent one).
    • steve_adams_86 7y ago
      You're not alone. I was 33 on a high powered rocket to the bottom. I think ADHD can erode your sense of self, your self esteem, and as a result, every part of you. The distress gets real. And yet once you finally realize you _need_ help, you have such a low appreciation for yourself that you don't believe you _deserve_ help. If I didn't have kids I probably wouldn't have gotten help. I did it for them. I'm glad I did now – everyone deserves help.
• timw4mail 7y ago
  The medication is just as personal as other options in how effective they are. As a diagnosed sufferer of ADHD, my experience is that Adderall works better than Ritalin, but the extended release stuff shortens my temper. If I'm still having a bad day, an energy drink can help. On boredom: I can be bored, but lack the drive to do anything to make me less bored. When I'm having fun, it is difficult to switch to the next thing I need to do.
• devwastaken 7y ago
  Ritalin based drugs are all that works for me. It's not even a choice, it's that I don't function how I need to without it.
• ditonal 7y ago
  Well, I admit I'm biased because I started taking ADHD meds and then had a manic/psychotic episode, that involved me getting involuntarily committed to a psych ward and burning all my career bridges, and also got diagnosed with heart failure, and I attribute a huge chunk of the blame to the ADHD meds. Both my psychiatrists and cardiologists insisted I needed even more meds or things would get worse, but instead I just said, I'm going to disregard medical advice, I'm going back to a no meds baseline, and focus hard on lifestyle changes, and everything improved. I've been emotionally stable and my echocardiogram and cardiac MRI showed my heart is back to normal. So that's my bias. I am just a bit of a psych meds skeptic these days - I don't think the comparison to drugs like insulin carry as much weight as their advocates would like them to. For one thing, there's no brain scans or blood tests for any of these diagnoses. The diagnosis criteria is basically a "personality test", called the DSM-5, a manual heavily influenced by the pharmaceutical companies. Stimulants at least do in fact have research supporting they actually outperform placebo (unlike the massively prescribed antidepressants), but they come with a host of negative side effects. If you're predisposed to mania, you shouldn't take stimulants. If you're predisposed to heart problems, you shouldn't take stimulants. My question is, how was I supposed to know that I was predisposed to these things short of finding out the hard way by taking the stimulants and having those negative side effects almost ruin my life/kill me? Previously, on HN people have accused me of "doing it wrong" in some sense with the ADHD meds, but the truth is I got the diagnosis from the doctor and took the meds as prescribed. The whole idea that we can neatly categorize this person as ADHD, this person as MDD, this person as Bipolar-2, this other person as bipolar-1, this other person as BPD, after doing a ton of investigating into mental health, I just no longer buy it. I do think the answer is in lifestyle changes, the person who is at risk of cardiac arrest, yes they should exercise for 30 min a day and reduce sodium intake before relying on a pill if that pill carries with it a ton of other dangerous side effects. I also agree with that other commentor, that our society, and my past self, is a bit obsessed with "success" metrics, usually judged by things like career success. The idea that, maybe if you just accept that your career won't be what it could be but that's better than drugging yourself up to achieve those goals, seem foreign to some people. Becoming "somebody" important becomes more important than just being stable and healthy. Well, if you find yourself in my position, where you get diagnosed with heart failure and learn that ~50% of people in your position die within 5 years of diagnosis, all the sudden that big N promotion doesn't seem as important anymore. And the drugs that help you get there don't seem as worth it. So nowadays my mind still wanders constantly, my wife gets frustrated by how often I start day-dreaming mid-conversation with her, and I know that intellectually I'm capable of more career success but I'm held back primarily by my lack of focus and discipline. But I've come to just accept all that, being on stimulants to fix it, is not worth the downsides.
• smorephism 7y ago
  For what it's worth, I took up running, changed my diet, and found that both of those in combination did effectively nothing to address my ADHD symptoms. I'm a lot healthier now than I was before I discovered I loved running, but to this day I use medication because it's the only thing I've tried that makes a meaningful difference.
  • steve_adams_86 7y ago
    Running and diet improvements did great things for my ADHD, but it's not consistent. I'd fall into slumps due to ADHD-fuelled depression, I think. The stimulants do a great job warding that off and keeping me consistent with exercise. Consistent exercise tends to keep me consistent with diet. If anyone argued that stimulants are bad for my health, I could only point out that without them, my health suffers acutely through sheer neglect and it's a downward spiral.
• viklove 7y ago
  A pill that decreases the risk of cardiac arrest is very different than a pill that is psychoactive. Many people just can't relate to taking a drug that quite literally changes your behavior on a day-to-day basis, even if it has positive effects on your life. This is something I myself have struggled with. I suffer from anxiety but I can't bring myself to take medication because I like the person I am and I don't want to change my behavior or personality. No one should be stopping you from taking Ritalin, but each of us is entitled to our own opinion, so the only thing that is irritating is when someone calls out an opinion another holds even if that opinion has no tangible effect on anyone's life.
  • kitsune_ 7y ago
    " Lanham, Md. (Jan. 8, 2019)— The message is clear. Treatment for attention-deficit/hyperactivity disorder (ADHD), along with the related health risks it poses, has the possibility of adding an average of nine to 13 years to the lifespan of children and adults diagnosed with ADHD. This is the implication of a cutting-edge research study conducted by Russell A. Barkley, Ph.D., who evaluated the connection between ADHD and 14 critical health factors including nutrition, exercise, and tobacco and alcohol use." https://chadd.org/advocacy-blog/new-research-suggests-untreated-adhd-reduces-life-expectancy/ https://chadd.org/advocacy-blog/new-research-suggests-untrea... ADHD is an extremely harmful condition. You are more likely to end up in jail, crash a car, suffer from diabetes, smoke etc. than neurotypical people. 9 to 13 years in life expectancy, I mean, wowzah. And opinions held in society or groups obviously have an effect on individuals. That's how social systems work.
    • viklove 7y ago
      I feel like you're now arguing in bad faith. Medicine for heart health does not change your behavior significantly. ADHD medication does. That's the distinction I'm trying to make.
      • 0xcde4c3db 7y ago
        > Medicine for heart health does not change your behavior significantly. This part of your argument is decidedly false. It's been an open secret for decades among public performers of several stripes (actors, public speakers, musicians, etc.) that beta blockers can prevent stage fright [1]. More recently, there have been multiple studies suggesting a link between statin use and increased irritability and aggression [2] [3]. Basically, the distinction between "psychoactive" and "non-psychoactive" drugs is more about the reasons people take them than it is about the drugs themselves. To a first approximation, there's no such thing as an objectively "non-psychoactive" drug. [1] https://www.nytimes.com/2004/10/21/arts/mixed-reviews-for-a-stagefright-remedy.html https://www.nytimes.com/2004/10/21/arts/mixed-reviews-for-a-... [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5005588/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5005588/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488854/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488854/
• fouc 7y ago
  Can someone share how Ritalin helps with the issue of attention switching? How does it reduce distractibility?
  • munk-a 7y ago
    My best personal description of it would be something like... my brain is constantly thrashing and offloading caches - with Ritalin the context switches still happen but the prior task doesn't get booted out of memory... so it's sort of like imaging running across a marshland, where every time you hit water you lose... the Ritalin might be like logs across streams, it isn't that suddenly you're always running across solid ground, you aren't constantly in single focus[1] but you can cross more of the marsh and reach the far side without getting wet. There, that's my terrible analogy. 1. There's a flip side, staying with the marsh analogy, there are also some dykes someone built randomly in the marsh and it's really easy to run along those, and they're really comfortable... but they might not go to the far side of the marsh - but hey it's right over there and it'd be easy to get over there instead of trying to trudge through the marsh. Running on those dykes feels really good since you're definitely running, but you don't get to chose where the dyke goes and it might not be helpful for yourself to run along it.
    • fouc 7y ago
      The initial computer-based analogy seems useful. I definitely do notice a sort of forgetfulness around the context of a project, particularly the reasons/motivation for doing it. Thinking about this, I wonder if ADHD people struggle with being project managers? Especially when it's important to mentally keep track of the big picture and the contexts around various tasks. -- I guess this is sort of different from working memory though, or it's more subtle (because I definitely don't have any actual forgetfulness, it's easy for me to remember things etc)
  • firecall 7y ago
    Short Answer: Ritalin functions as a DRI (Dopamine reuptake inhibitor). One of the theories is that ADHD could be a lack of Dopamine.
• bananamerica 7y ago
  I said that before about antidepressants: I wish psychiatric medications were as magical as many neurotypicals think.