7 ms·

I’m not sure about the whole neurological dysfunction story. It sounds a lot like the now debunked chemical imbalance story for depression. So far as I know the

by User23 4y ago

I’m not sure about the whole neurological dysfunction story. It sounds a lot like the now debunked chemical imbalance story for depression. So far as I know there’s no ADHD blood or other objective test. I am however sure about stimulant drugs being a shockingly effective productivity booster when properly dosed though. As the comment I’m replying to notes, it’s trivially easy to walk into a psychiatrist’s office and get an ADHD diagnosis and that’s the safest and most legal way to get them. Whether or not long term use is prudent is an entirely different matter of course. Edit: The above can be read as dismissive and that's not what I intended. Please see my reply further down for more context.

kayodelycaon 4y ago
ADHD is quite well studied. If you're up for it, there is a 2.5h video that goes into some detail about what it is and how it affects children. I found it quite fascinating and it helped me understand some of my symptoms. (Mine is comorbid with bipolar. Yay.) https://www.youtube.com/watch?v=YSfCdBBqNXY https://www.youtube.com/watch?v=YSfCdBBqNXY
- Mezzie 4y ago
  Quick questions, apologies if they're too sensitive: - Regarding your co-morbidity, how did you know/decide to seek ADHD treatment and diagnosis? Was it before or after your bipolar diagnosis? - Was there any concern about med interactions? I live with my sister, who's bipolar and we think she MAY have ADHD, hence my curiosity.
  - kayodelycaon 4y ago
    Always happy to talk, but I’m not sure how helpful I can be. I was diagnosed ADD as a child (~6 years old) but I wasn’t correctly diagnosed with bipolar until I was 33 after voluntarily seeking treatment on the recommendation of my primary care doctor. As far as treating the ADHD, my psychiatrist didn’t bother with a formal diagnosis. She just decided to treat the executive function issues I reported. Medication is trickier. I can’t use the traditional stimulants (or caffeine) without risking mania and panic attacks. So I’m taking Wellbrutin (an NDRI) which is both an antidepressant and a stimulant. It helps with ADHD, Anxiety, Depression, and sexual side effects from antipsychotics. I don’t have any major side effects to report than increase in sexual function and keeping me awake for the next 10~12 hours. (So no afternoon naps to recharge.)
    - Mezzie 4y ago
      Thanks for the reply! This was helpful. I'm glad that you were able to get the diagnosis and treatment you needed. And yes, very concerned about giving her any stimulants/mania inducing things. I'm glad to hear that Wellbutrin/NDRIs don't seem to have the same impact on bipolar people as SSRIs do, we'll look into that a bit. (Ironically, I had a terrible Wellbutrin experience. Bodies are weird.)
thenaturalist 4y ago
> I’m not sure about the whole neurological dysfunction story. Are you a medical professional or do you have a scientific source backing up your suspicion? The point why there is no objective blood test is mainly rooted in the fact that getting a true measurement of a neurotransmitter is prohibitively costly (measurement across intra- and inter-daily blood samples to establish a true baseline). Yet, scientists are doing this and there are genetic and neurotransmitter markers which are abnormal in people classified with ADHD. For further reading with a variety of medical sources I recommend [0]. It's a disorder, and presents with a large variety of expressions or comorbidities, but the symptoms (restlessness, jumping between hobbies) are shared and the consequences both in private as well professional lives are severe. The inability to focus on single things lead to worse career outcomes and worse relationship outcomes. It is a serious suffering for those affected. Ritalin has a 60 year pharmacological history and has proven to help people. Modern stimulants are even better. I am hugely grateful for the fact safe access exists and as someone affected badly, [I don't think it's appropriate to make fun of someone seeking access to this medication.] STRIKE that out, GP explained his intended meaning further below. [0]: https://www.medicalnewstoday.com/articles/325499 https://www.medicalnewstoday.com/articles/325499
- blamarvt 4y ago
  > I don't think it's appropriate to make fun of someone seeking access to this medication. As someone who takes daily medication, I didn't read the GP's comment as making fun. It seemed to just be a statement of belief.
  - thenaturalist 4y ago
    > I am however sure about stimulant drugs being a shockingly effective productivity booster when properly dosed though. As the comment I’m replying to notes, it’s trivially easy to walk into a psychiatrist’s office and get an ADHD diagnosis and that’s the safest and most legal way to get them. I might well be over sensitive to this topic, so my bad if I overstepped. Getting the diagnosis and getting medication has been such a huge relief, it's been quite emotional. The way I read GP's comment is that he's implying that if you have a productivity problem and cannot cut it otherwise, take the easy route, get an ADHD diagnosis (which he believes is not really a chemical imbalance) and cure your bad productivity with stimulants instead of effort. Labelling someone not trying hard enough or not cutting it 'cause you're not smart enough, or being a loser cause you need to take meds etc. etc. is exactly the kind of stigmatization people with ADHD might face. Again, my interpretation. I hope I am wrong.
modo_mario 4y ago
>So far as I know there’s no ADHD blood or other objective test. There's a few genes that have been found to be responsible/correlate strongly i believe but I assume genotyping goes a bit far for common diagnosis. I'm sure it's not the same for everyone that's diagnosed tho and there's a good amount of misdiagnosis too.
- hirvi74 4y ago
  > there's a good amount of misdiagnosis too. Until there is a more objective way to diagnose ADHD, how can one argue who really has the condition or not? It's not like we humans even remotely understand the brain in its entirety.
RHSman2 4y ago
Queue hackernews-ists jumping down your throat
triggercut 4y ago
> It sounds a lot like the now debunked chemical imbalance story for depression. If you are referring to the recent Joanna Moncrieff cherry picked literature review that had a press moment, then do some checking to see what her peers said in response. Moncrieff has a well established bias against pharmaceuticals and this is confirmation-bias writ large and has damaged the layman's understanding of what's happening. There are objective tests for ADHD. You can look at how the brain responds under MRI or ECG to show the depressed activity in the prefrontal cortex. It's not required for diagnosis but anyone who tries neurofeedback or checking/confirming dyspraxia maybe as it relates to other nervous system issues. What most people don't realise is the way stimulants work in the ADHD brain compared to the non ADHD brain are different. Superlatives like "shockingly" really mischaracterize what's happening and perpetuate a dangerous myth. Mostly based on anecdotes of the short-term effects of high-doses on young neurotypical individuals under stress. It's not the same.

by User23 4y ago

kayodelycaon 4y ago

ADHD is quite well studied. If you're up for it, there is a 2.5h video that goes into some detail about what it is and how it affects children. I found it quite fascinating and it helped me understand some of my symptoms. (Mine is comorbid with bipolar. Yay.) https://www.youtube.com/watch?v=YSfCdBBqNXY https://www.youtube.com/watch?v=YSfCdBBqNXY

Mezzie 4y ago
Quick questions, apologies if they're too sensitive: - Regarding your co-morbidity, how did you know/decide to seek ADHD treatment and diagnosis? Was it before or after your bipolar diagnosis? - Was there any concern about med interactions? I live with my sister, who's bipolar and we think she MAY have ADHD, hence my curiosity.
- kayodelycaon 4y ago
  Always happy to talk, but I’m not sure how helpful I can be. I was diagnosed ADD as a child (~6 years old) but I wasn’t correctly diagnosed with bipolar until I was 33 after voluntarily seeking treatment on the recommendation of my primary care doctor. As far as treating the ADHD, my psychiatrist didn’t bother with a formal diagnosis. She just decided to treat the executive function issues I reported. Medication is trickier. I can’t use the traditional stimulants (or caffeine) without risking mania and panic attacks. So I’m taking Wellbrutin (an NDRI) which is both an antidepressant and a stimulant. It helps with ADHD, Anxiety, Depression, and sexual side effects from antipsychotics. I don’t have any major side effects to report than increase in sexual function and keeping me awake for the next 10~12 hours. (So no afternoon naps to recharge.)
  - Mezzie 4y ago
    Thanks for the reply! This was helpful. I'm glad that you were able to get the diagnosis and treatment you needed. And yes, very concerned about giving her any stimulants/mania inducing things. I'm glad to hear that Wellbutrin/NDRIs don't seem to have the same impact on bipolar people as SSRIs do, we'll look into that a bit. (Ironically, I had a terrible Wellbutrin experience. Bodies are weird.)

thenaturalist 4y ago

> I’m not sure about the whole neurological dysfunction story. Are you a medical professional or do you have a scientific source backing up your suspicion? The point why there is no objective blood test is mainly rooted in the fact that getting a true measurement of a neurotransmitter is prohibitively costly (measurement across intra- and inter-daily blood samples to establish a true baseline). Yet, scientists are doing this and there are genetic and neurotransmitter markers which are abnormal in people classified with ADHD. For further reading with a variety of medical sources I recommend [0]. It's a disorder, and presents with a large variety of expressions or comorbidities, but the symptoms (restlessness, jumping between hobbies) are shared and the consequences both in private as well professional lives are severe. The inability to focus on single things lead to worse career outcomes and worse relationship outcomes. It is a serious suffering for those affected. Ritalin has a 60 year pharmacological history and has proven to help people. Modern stimulants are even better. I am hugely grateful for the fact safe access exists and as someone affected badly, [I don't think it's appropriate to make fun of someone seeking access to this medication.] STRIKE that out, GP explained his intended meaning further below. [0]: https://www.medicalnewstoday.com/articles/325499 https://www.medicalnewstoday.com/articles/325499

blamarvt 4y ago
> I don't think it's appropriate to make fun of someone seeking access to this medication. As someone who takes daily medication, I didn't read the GP's comment as making fun. It seemed to just be a statement of belief.
- thenaturalist 4y ago
  > I am however sure about stimulant drugs being a shockingly effective productivity booster when properly dosed though. As the comment I’m replying to notes, it’s trivially easy to walk into a psychiatrist’s office and get an ADHD diagnosis and that’s the safest and most legal way to get them. I might well be over sensitive to this topic, so my bad if I overstepped. Getting the diagnosis and getting medication has been such a huge relief, it's been quite emotional. The way I read GP's comment is that he's implying that if you have a productivity problem and cannot cut it otherwise, take the easy route, get an ADHD diagnosis (which he believes is not really a chemical imbalance) and cure your bad productivity with stimulants instead of effort. Labelling someone not trying hard enough or not cutting it 'cause you're not smart enough, or being a loser cause you need to take meds etc. etc. is exactly the kind of stigmatization people with ADHD might face. Again, my interpretation. I hope I am wrong.

modo_mario 4y ago

>So far as I know there’s no ADHD blood or other objective test. There's a few genes that have been found to be responsible/correlate strongly i believe but I assume genotyping goes a bit far for common diagnosis. I'm sure it's not the same for everyone that's diagnosed tho and there's a good amount of misdiagnosis too.

hirvi74 4y ago
> there's a good amount of misdiagnosis too. Until there is a more objective way to diagnose ADHD, how can one argue who really has the condition or not? It's not like we humans even remotely understand the brain in its entirety.

RHSman2 4y ago

Queue hackernews-ists jumping down your throat

triggercut 4y ago

> It sounds a lot like the now debunked chemical imbalance story for depression. If you are referring to the recent Joanna Moncrieff cherry picked literature review that had a press moment, then do some checking to see what her peers said in response. Moncrieff has a well established bias against pharmaceuticals and this is confirmation-bias writ large and has damaged the layman's understanding of what's happening. There are objective tests for ADHD. You can look at how the brain responds under MRI or ECG to show the depressed activity in the prefrontal cortex. It's not required for diagnosis but anyone who tries neurofeedback or checking/confirming dyspraxia maybe as it relates to other nervous system issues. What most people don't realise is the way stimulants work in the ADHD brain compared to the non ADHD brain are different. Superlatives like "shockingly" really mischaracterize what's happening and perpetuate a dangerous myth. Mostly based on anecdotes of the short-term effects of high-doses on young neurotypical individuals under stress. It's not the same.