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OP absolutely should not wait to get a diagnosis just because you are so afraid of stimulant medication. Even if they share your fears, a diagnosis doesn't mea

OP absolutely should not wait to get a diagnosis just because you are so afraid of stimulant medication. Even if they share your fears, a diagnosis doesn't mean a doctor will just shove pills down their throat. It means that a doctor will work with them to help! Stimulant medication can be very addictive when abused. On the other hand, when used as directed to treat ADHD, stimulants have been shown to significantly decrease the incidence of new and existing substance abuse disorders. It's incredibly difficult for someone with untreated ADHD to follow the rest of your advice. Why? Because they have executive dysfunction! Getting help with that is foundational to doing the rest, not the other way around like you implied. You won't "probably have a heart attack when you're 30" because you take stimulants. Will you have a higher risk? Yes, but not over 50%! Not even close! If you actually keep reasonably good track of your blood pressure and heart rate, you will probably have a lower risk of cardiac arrest. The same if you start exercising & sleeping more, eating healthier, etc. because you finally have the executive functioning you needed to start doing those things. Stimulant medication is the first line of treatment for ADHD because it has been extensively studied. Numerous peer reviewed trials have shown its safety and usefulness. The risks are well known and obsessively managed.

tastysandwich 4y ago
Yes, executive dysfunction makes it more difficult. But it's really not out of the realm of possibility that a person with ADHD can eat a side of salad and go for a jog. Or would you disagree with that? There are extreme cases but we're clearly not dealing with that here. Furthermore, at least we I live (and I hear even more so in the US), it's well known that psychiatrists readily hand out stimulant medication with zero therapy. They give you a questionnaire (which is easy to bluff), and if you answer yes to enough they'll hand you a prescription. They don't ask about your diet, sleep, exercise, etc. I'm not doubting the effectiveness of stimulant medication. As I said, I take them! But let's not pretend there are zero side-effects, and that it's not a big decision to make. Particularly when oftentimes it's lifestyle choices that are the main driver of OP's symptoms. It seems pretty reasonable to me to suggest taking a look at those first, before rushing to stimulants. Is that wrong? I'd also like to reiterate my advice to seek therapy, as if you are struggling they can give excellent, tailored advice for dealing with many of these issues. And once again - I'm not against stimulants. I'm just suggesting a reasonable amount of caution before seeking them out. I'd say that's pretty sensible?
- thomastjeffery 4y ago
  > But it's really not out of the realm of possibility that a person with ADHD can eat a side of salad and go for a jog. Depending on the person, it can be really really hard. I for one could never get the hang of it, and I really tried. This is the case for most people that get diagnosed with ADHD; after all, executive dysfunction is the primary symptom. You may not be asking for the impossible, but what you are asking is unreasonable. Most people with untreated ADHD have a very difficult time building healthy habits, but as soon as they start treating their ADHD, healthy habits become quite manageable. > Furthermore, at least we I live (and I hear even more so in the US), it's well known that psychiatrists readily hand out stimulant medication with zero therapy. Yes, it's so well known that most psychiatrists who do prescribe medication for ADHD have to deal with very serious threats of malpractice even based on unsubstantiated claims of misdiagnosis. Even if a claim of stimulant abuse is legitimate, that isn't necessarily the prescribing physician's fault. The reality is that ADHD can't be 100% proven or disproven to exist in a patient. Stimulants can only be prescribed for three consecutive months at a time between doctor/patient visits, and patients are expected to lock their medication away, or be held criminally liable as victims of theft. If a patient loses their medication, they cannot have it refilled. Dextroamphetamine and methylphenidate are Schedule II drugs: the most strict federal control for drugs that can be legally prescribed. Other Schedule II drugs include fentanyl, PCP, and cocaine. On top of that, many insurance providers refuse to cover stimulant medication outright, all because of the very fears and stigma you are sharing. This is incredibly problematic, because stimulant medication is the most effective treatment for most ADHD patients, and has been thoroughly studied and peer reviewed. We have a very serious problem in the US, and elsewhere, of putting fear above science. A sensible risk analysis that incorporates peer-reviewed data is not being used - or even considered - when creating public policy. ADHD is the most well-studied mental disorder there is. To pretend there is some unknown danger lurking in a dark corner where we haven't bothered to look yet is entirely disingenuous; yet this is the approach that many take with stimulant medication. It's easy to understand why fear is so much more effective at influencing policy than science: selection bias. We all hear about the worst case scenario, but almost never hear about the best or median cases. As humans, we are wired to predict cases we hear about as more likely than those that we don't hear about. > Particularly when oftentimes it's lifestyle choices that are the main driver of OP's symptoms. That's the point. If OP has ADHD, then it's not their lifestyle choices that are the main driver of their symptoms: it's their ADHD symptoms that are the main driver of their lifestyle choices! And if that is the case, then they will need to start treating their ADHD in order to effectively manage their lifestyle choices. What you have recommended is that OP, "think hard about that route" before seeing a psychiatrist. You have recommended that OP make, "many lifestyle changes [they] can and should make before [they] leap immediately to a ADHD diagnosis." There's a serious problem with that recommendation: If they don't have ADHD, then avoiding a diagnosis just keeps them from knowing so with reasonable certainty. If they do have ADHD, they will almost definitely struggle to make the lifestyle changes you recommend, and never be able to get to step #2 (see a psychiatrist about ADHD diagnosis). You are very seriously asking OP to put the cart before the horse, for fear that the horse might shit in their face. People have been putting carts behind horses for over three thousand years; and despite the position of the horse's ass in front of the driver's face, it's still considered the best positioning method available. Practically everything we do has a risk attached. Stimulant medication has plenty of risk. Leaving ADHD untreated has far greater risks: an assertion backed by peer reviewed study. The most effective and safe way to deal with potential ADHD is to make that treatment readily available.

tastysandwich 4y ago

Yes, executive dysfunction makes it more difficult. But it's really not out of the realm of possibility that a person with ADHD can eat a side of salad and go for a jog. Or would you disagree with that? There are extreme cases but we're clearly not dealing with that here. Furthermore, at least we I live (and I hear even more so in the US), it's well known that psychiatrists readily hand out stimulant medication with zero therapy. They give you a questionnaire (which is easy to bluff), and if you answer yes to enough they'll hand you a prescription. They don't ask about your diet, sleep, exercise, etc. I'm not doubting the effectiveness of stimulant medication. As I said, I take them! But let's not pretend there are zero side-effects, and that it's not a big decision to make. Particularly when oftentimes it's lifestyle choices that are the main driver of OP's symptoms. It seems pretty reasonable to me to suggest taking a look at those first, before rushing to stimulants. Is that wrong? I'd also like to reiterate my advice to seek therapy, as if you are struggling they can give excellent, tailored advice for dealing with many of these issues. And once again - I'm not against stimulants. I'm just suggesting a reasonable amount of caution before seeking them out. I'd say that's pretty sensible?

thomastjeffery 4y ago
> But it's really not out of the realm of possibility that a person with ADHD can eat a side of salad and go for a jog. Depending on the person, it can be really really hard. I for one could never get the hang of it, and I really tried. This is the case for most people that get diagnosed with ADHD; after all, executive dysfunction is the primary symptom. You may not be asking for the impossible, but what you are asking is unreasonable. Most people with untreated ADHD have a very difficult time building healthy habits, but as soon as they start treating their ADHD, healthy habits become quite manageable. > Furthermore, at least we I live (and I hear even more so in the US), it's well known that psychiatrists readily hand out stimulant medication with zero therapy. Yes, it's so well known that most psychiatrists who do prescribe medication for ADHD have to deal with very serious threats of malpractice even based on unsubstantiated claims of misdiagnosis. Even if a claim of stimulant abuse is legitimate, that isn't necessarily the prescribing physician's fault. The reality is that ADHD can't be 100% proven or disproven to exist in a patient. Stimulants can only be prescribed for three consecutive months at a time between doctor/patient visits, and patients are expected to lock their medication away, or be held criminally liable as victims of theft. If a patient loses their medication, they cannot have it refilled. Dextroamphetamine and methylphenidate are Schedule II drugs: the most strict federal control for drugs that can be legally prescribed. Other Schedule II drugs include fentanyl, PCP, and cocaine. On top of that, many insurance providers refuse to cover stimulant medication outright, all because of the very fears and stigma you are sharing. This is incredibly problematic, because stimulant medication is the most effective treatment for most ADHD patients, and has been thoroughly studied and peer reviewed. We have a very serious problem in the US, and elsewhere, of putting fear above science. A sensible risk analysis that incorporates peer-reviewed data is not being used - or even considered - when creating public policy. ADHD is the most well-studied mental disorder there is. To pretend there is some unknown danger lurking in a dark corner where we haven't bothered to look yet is entirely disingenuous; yet this is the approach that many take with stimulant medication. It's easy to understand why fear is so much more effective at influencing policy than science: selection bias. We all hear about the worst case scenario, but almost never hear about the best or median cases. As humans, we are wired to predict cases we hear about as more likely than those that we don't hear about. > Particularly when oftentimes it's lifestyle choices that are the main driver of OP's symptoms. That's the point. If OP has ADHD, then it's not their lifestyle choices that are the main driver of their symptoms: it's their ADHD symptoms that are the main driver of their lifestyle choices! And if that is the case, then they will need to start treating their ADHD in order to effectively manage their lifestyle choices. What you have recommended is that OP, "think hard about that route" before seeing a psychiatrist. You have recommended that OP make, "many lifestyle changes [they] can and should make before [they] leap immediately to a ADHD diagnosis." There's a serious problem with that recommendation: If they don't have ADHD, then avoiding a diagnosis just keeps them from knowing so with reasonable certainty. If they do have ADHD, they will almost definitely struggle to make the lifestyle changes you recommend, and never be able to get to step #2 (see a psychiatrist about ADHD diagnosis). You are very seriously asking OP to put the cart before the horse, for fear that the horse might shit in their face. People have been putting carts behind horses for over three thousand years; and despite the position of the horse's ass in front of the driver's face, it's still considered the best positioning method available. Practically everything we do has a risk attached. Stimulant medication has plenty of risk. Leaving ADHD untreated has far greater risks: an assertion backed by peer reviewed study. The most effective and safe way to deal with potential ADHD is to make that treatment readily available.