6 ms·

Well the problem with ADHD is the same problem of pretty much all psychological disorders - diagnosis is only ever really fuzzily falsifiable. You get diagnose

Well the problem with ADHD is the same problem of pretty much all psychological disorders - diagnosis is only ever really fuzzily falsifiable. You get diagnosed with it if you tick enough of the boxes of behaviours/dysfunctions associated with it - you can fall short of a diagnosis by one behaviour and still be in a very similar condition to a diagnosed person, or tick enough boxes but fall short based on the diagnosing physicians judgement of severity. The interesting thing is that despite the condition being composed of a wide gamut of seemingly unrelated behaviour, ~90% of people with ADHD respond extremely well to the same treatment - stimulant medication. We also observed notable neurological similarities in aggregate among people with the condition, but not enough to have much utility as a diagnostic tool.

giraffe_lady 4y ago
I can credibly claim stimulant treatment for adhd saved my life so I'm not at all skeptical of its value in this context. But doesn't everyone respond extremely well to stimulants? They're some of the most common recreational drugs and neurotypical people seek them out for performance enhancement on cognitive tasks.
- LocalPCGuy 4y ago
  > doesn't everyone respond extremely well to stimulants? Not really - despite their popularity (as you say, heavily sought after), studies have shown that there really isn't a significant cognitive boost for neurotypical folks that take these stimulants[1]. While they have a significant effect for those with ADHD because their brain is not providing the chemicals properly, and these drugs enable that. They aren't boosting cognitive abilities for those with ADHD, they are fixing a problem so that folks with ADHD can think and focus properly. Didn't spend a ton of time looking up the sources I've read this in, but here is one: [1] - https://www.mdpi.com/2226-4787/6/3/58 https://www.mdpi.com/2226-4787/6/3/58 > Studies support that stimulants enhance attention, memory, self-regulation and executive function in individuals with ADHD. Recent research, however, has found that many college students without ADHD report misusing prescription stimulants, primarily to enhance their cognitive abilities. > ... > Overall, the present findings indicate dissociation between the effects of Adderall on activation and neurocognition, and more importantly, contrary to common belief, Adderall had little impact on neurocognitive performance in healthy college students.
  - giraffe_lady 4y ago
    Interesting, their use for that is so common I assumed it was a real effect. People who use them that way definitely think it helps. Prescription stimulants are also pretty powerful mood boosters though so I imagine it's very easy to assume you're smarter while on them just because they make you feel great. Anyway thanks for the info, definitely upends an assumption I'd had for years.
    - LocalPCGuy 4y ago
      I had the same assumption for a long time, that's why I share the info. Plus, as someone recently diagnosed with ADHD as an adult (and yes, things all clicked, plus family history, and for the doubters - it was a 6 hour long testing process), I feel like it's important to have correct information about medication out there.
    - nonameiguess 4y ago
      I was a biology major several decades ago now, which is a major dominated by extremely competitive pre-med students trying to get into Harvard Medical School. Taking speed during finals week was extremely common. I only tried it once personally, and I can't say it helped me concentrate better, because I could already concentrate perfectly fine to begin with. But I could not concentrate for 16-20 hours a day, every day for an entire week. With speed, you can do that.
      - LocalPCGuy 4y ago
        I think this is a good caveat and not something I've seen called out in the studies I've seen.
      - DoughnutHole 4y ago
        Yea stimulants probably don't really offer much of a performance boost to an already healthy brain - but if your brain is already defective from fatigue they can keep you going beyond what's humanly possible. The Germans didn't ply their soldiers with speed in WWII because it improved their reflexes or their tactics - they did it so a soldier could fight when his brain would otherwise be mush from not sleeping in days. Anyone can benefit from just having more usable hours in a day.
- Auracle 4y ago
  I’m on stimulants for idiopathic hypersomnia. While they give me energy and motivation, my mind is significantly more scattered when I’m on them. I take Vyvanse daily but have Adderall as a booster and the latter in particular does that to me. I certainly didn’t have the “oh, this is how my brain is supposed to work” moment that I’ve read a lot of people with ADHD having when first taking them. I’ve also heard that some people with ADHD sleep better on stimulants, which definitely isn’t the case for everyone else.
- corobo 4y ago
  > But doesn't everyone respond extremely well to stimulants? I wish lmao. I'm on meds and while I can see a difference between non-meds and now I could easily go back to bed after they kick in and sleep the entire day away. Still doing the dosage dance with the doc. Someone who didn't need them would likely be a little hyper if not bouncing off the walls depending on the dosage.
  - giraffe_lady 4y ago
    That sounds like maybe an adhd thing? Not trying to diagnose you but from the comment it's not clear whether that's what they're prescribed for. I definitely get a noticeable feeling of calm/steadiness/"settling" as my stimulants kick in, and yes it would be very easy to go back to bed at that point. My understand is that this is not a typical part of the stimulants experience for people without adhd. But by "responds well" I meant that they improve focus, energy, motivation, and mood even in non-adhd people, not that they have the same effects. Other comments have addressed that this is at least somewhat a misconception on my part though.
    - corobo 4y ago
      Sorry to be more clear yeah I've got an ADHD diagnosis and the meds are for that Apologies for the misread too
- chiefgeek 4y ago
  I do not. I had a psychiatrist years ago who insisted I was ADHD. I was also on heavy dose of Zoloft. He prescribed Adderall XR. Took it for months. Did nothing. Years later, I've done a ton of transformative work on myself. I realized it (the supposed condition) was mostly about me not wanting to do what was in front of me. I've tried taking both standard Adderall and XR in the recent past and it does absolutely zero. Possibly related - my PCP gave me a genetic test and it showed that I have some gene configuration that essentially makes me immune to the effects of caffeine. Which makes sense, because I have to drink a boatload to feel anything from it.
solumunus 4y ago
> The interesting thing is that despite the condition being composed of a wide gamut of seemingly unrelated behaviour, ~90% of people with ADHD respond extremely well to the same treatment - stimulant medication. This is constantly presented as some sort of ultimate validation of these disorders and every time I read it I'm absolutely baffled. Stimulants used in ADHD medication improve focus and productivity for almost everyone, the fact that they also do it for people with chronic focus/attention issues should be surprising to no one... They're literally performance enhancing drugs.
- fsociety 4y ago
  This is not true at all. LocalPCGuy made a great comment refuting this. Brain scans also show the unique difference between someone with and without ADHD and what medication does to both brains.
- DoughnutHole 4y ago
  There's a wide spectrum of symptoms that are very effectively treated by stimulants in people with ADHD apart from focus/productivity, including anxiety, insomnia, working memory, and emotional regulation. Outside of treating ADHD stimulants will more typically make all of these things worse, not better. The most unusual aspect of stimulant treatment for ADHD is for the hyperactive and combined types - stimulants reduce hyperactivity and impulsive behaviour, and people with ADHD on low dose stimulants are less likely to engage in reckless behaviour or develop problems with substance abuse - not things you'd ever say about stimulants and the average person. You certainly don't get too many neurotypical people finding they can finally nap once they're on low-dose amphetamines.
- corobo 4y ago
  Meds didn't do anything useful for me until I'd had the dosage bumped a few times. Kept sending me back to sleep if anything, first day I was on them I had a 16 hour nap.
- Doxin 4y ago
  There's clearly something weird going on re: ADHD+stimulants though. Most people don't calm down if you give them stimulants.

giraffe_lady 4y ago

I can credibly claim stimulant treatment for adhd saved my life so I'm not at all skeptical of its value in this context. But doesn't everyone respond extremely well to stimulants? They're some of the most common recreational drugs and neurotypical people seek them out for performance enhancement on cognitive tasks.

LocalPCGuy 4y ago
> doesn't everyone respond extremely well to stimulants? Not really - despite their popularity (as you say, heavily sought after), studies have shown that there really isn't a significant cognitive boost for neurotypical folks that take these stimulants[1]. While they have a significant effect for those with ADHD because their brain is not providing the chemicals properly, and these drugs enable that. They aren't boosting cognitive abilities for those with ADHD, they are fixing a problem so that folks with ADHD can think and focus properly. Didn't spend a ton of time looking up the sources I've read this in, but here is one: [1] - https://www.mdpi.com/2226-4787/6/3/58 https://www.mdpi.com/2226-4787/6/3/58 > Studies support that stimulants enhance attention, memory, self-regulation and executive function in individuals with ADHD. Recent research, however, has found that many college students without ADHD report misusing prescription stimulants, primarily to enhance their cognitive abilities. > ... > Overall, the present findings indicate dissociation between the effects of Adderall on activation and neurocognition, and more importantly, contrary to common belief, Adderall had little impact on neurocognitive performance in healthy college students.
- giraffe_lady 4y ago
  Interesting, their use for that is so common I assumed it was a real effect. People who use them that way definitely think it helps. Prescription stimulants are also pretty powerful mood boosters though so I imagine it's very easy to assume you're smarter while on them just because they make you feel great. Anyway thanks for the info, definitely upends an assumption I'd had for years.
  - LocalPCGuy 4y ago
    I had the same assumption for a long time, that's why I share the info. Plus, as someone recently diagnosed with ADHD as an adult (and yes, things all clicked, plus family history, and for the doubters - it was a 6 hour long testing process), I feel like it's important to have correct information about medication out there.
  - nonameiguess 4y ago
    I was a biology major several decades ago now, which is a major dominated by extremely competitive pre-med students trying to get into Harvard Medical School. Taking speed during finals week was extremely common. I only tried it once personally, and I can't say it helped me concentrate better, because I could already concentrate perfectly fine to begin with. But I could not concentrate for 16-20 hours a day, every day for an entire week. With speed, you can do that.
    - LocalPCGuy 4y ago
      I think this is a good caveat and not something I've seen called out in the studies I've seen.
    - DoughnutHole 4y ago
      Yea stimulants probably don't really offer much of a performance boost to an already healthy brain - but if your brain is already defective from fatigue they can keep you going beyond what's humanly possible. The Germans didn't ply their soldiers with speed in WWII because it improved their reflexes or their tactics - they did it so a soldier could fight when his brain would otherwise be mush from not sleeping in days. Anyone can benefit from just having more usable hours in a day.
Auracle 4y ago
I’m on stimulants for idiopathic hypersomnia. While they give me energy and motivation, my mind is significantly more scattered when I’m on them. I take Vyvanse daily but have Adderall as a booster and the latter in particular does that to me. I certainly didn’t have the “oh, this is how my brain is supposed to work” moment that I’ve read a lot of people with ADHD having when first taking them. I’ve also heard that some people with ADHD sleep better on stimulants, which definitely isn’t the case for everyone else.
corobo 4y ago
> But doesn't everyone respond extremely well to stimulants? I wish lmao. I'm on meds and while I can see a difference between non-meds and now I could easily go back to bed after they kick in and sleep the entire day away. Still doing the dosage dance with the doc. Someone who didn't need them would likely be a little hyper if not bouncing off the walls depending on the dosage.
- giraffe_lady 4y ago
  That sounds like maybe an adhd thing? Not trying to diagnose you but from the comment it's not clear whether that's what they're prescribed for. I definitely get a noticeable feeling of calm/steadiness/"settling" as my stimulants kick in, and yes it would be very easy to go back to bed at that point. My understand is that this is not a typical part of the stimulants experience for people without adhd. But by "responds well" I meant that they improve focus, energy, motivation, and mood even in non-adhd people, not that they have the same effects. Other comments have addressed that this is at least somewhat a misconception on my part though.
  - corobo 4y ago
    Sorry to be more clear yeah I've got an ADHD diagnosis and the meds are for that Apologies for the misread too
chiefgeek 4y ago
I do not. I had a psychiatrist years ago who insisted I was ADHD. I was also on heavy dose of Zoloft. He prescribed Adderall XR. Took it for months. Did nothing. Years later, I've done a ton of transformative work on myself. I realized it (the supposed condition) was mostly about me not wanting to do what was in front of me. I've tried taking both standard Adderall and XR in the recent past and it does absolutely zero. Possibly related - my PCP gave me a genetic test and it showed that I have some gene configuration that essentially makes me immune to the effects of caffeine. Which makes sense, because I have to drink a boatload to feel anything from it.

solumunus 4y ago

> The interesting thing is that despite the condition being composed of a wide gamut of seemingly unrelated behaviour, ~90% of people with ADHD respond extremely well to the same treatment - stimulant medication. This is constantly presented as some sort of ultimate validation of these disorders and every time I read it I'm absolutely baffled. Stimulants used in ADHD medication improve focus and productivity for almost everyone, the fact that they also do it for people with chronic focus/attention issues should be surprising to no one... They're literally performance enhancing drugs.

fsociety 4y ago
This is not true at all. LocalPCGuy made a great comment refuting this. Brain scans also show the unique difference between someone with and without ADHD and what medication does to both brains.
DoughnutHole 4y ago
There's a wide spectrum of symptoms that are very effectively treated by stimulants in people with ADHD apart from focus/productivity, including anxiety, insomnia, working memory, and emotional regulation. Outside of treating ADHD stimulants will more typically make all of these things worse, not better. The most unusual aspect of stimulant treatment for ADHD is for the hyperactive and combined types - stimulants reduce hyperactivity and impulsive behaviour, and people with ADHD on low dose stimulants are less likely to engage in reckless behaviour or develop problems with substance abuse - not things you'd ever say about stimulants and the average person. You certainly don't get too many neurotypical people finding they can finally nap once they're on low-dose amphetamines.
corobo 4y ago
Meds didn't do anything useful for me until I'd had the dosage bumped a few times. Kept sending me back to sleep if anything, first day I was on them I had a 16 hour nap.
Doxin 4y ago
There's clearly something weird going on re: ADHD+stimulants though. Most people don't calm down if you give them stimulants.