6 ms·

My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) and ADHD is kind of a weakly differentiated

My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) and ADHD is kind of a weakly differentiated diagnosis that could apply to most people. Probably something like this was lost when people stopped smoking, obviously beneficial for health - but a huge amount of the public was taking stimulants regularly via nicotine until relatively recently.

0xCMP 1y ago
I've also heard something similar. That maybe the reason so many are diagnosed today[0] is they were self-medicating via smoking. [0]: Which requires it to be affecting your life -- NOT that you actually do or don't have it and are dealing with it okay. Diagnostic criteria is that it must be hindering you in a job/school/relationships/etc.
brikym 1y ago
It's a performance enhancing drug for a lot of people. So many of my colleagues are on it.
Spooky23 1y ago
That’s a good point on the nicotine. I found out that i have ADHD through a process of dealing with a hearing issue - I have something called auditory processing disorder (APD), which means while I have excellent hearing, my brain has difficulty processing speech in high noise environments, especially with multiple people or frequencies that correlate to women. ADHD and autism spectrum disorders are highly correlated with it. A friend who is an audiologist was out with me at an event and basically spotted the adaptations that I had adopted subconsciously over my life (I’m in my 40s). I then got tested and confirmed. It’s likely a result of many consecutive ear infections I had as a kid. When reading up on APD, the literature describes stories of various people… and it was like looking back on a story of my life. The ADHD correlation is thought to be related because of the way the brain develops (or doesn’t) in the presence or absence of stimuli. I say this because it would be easy to dismiss my scenario. By most measurements I’m successful and doing great. But had I known or maybe been treated in the past, certain difficult aspects of my life would have likely been managed better or avoided. Brains are complex, and it’s important not to dismiss that problems that people have.
- mrexroad 1y ago
  Clinically ADHD and suspected APD here. I also have excellent hearing in both ears (20k+ hz), but I’m shit at understanding conversations in noisy environments… especially if my wife is speaking. Her voice is markedly harder for me to process than other people’s when there’s background noise. She used to assume I was being ADHD and not paying attention, etc, and get frustrated, but after years of me visibly focusing on her with unreasonable intensity while listening, she started accepting it. It’s always ironic that my hearing is usually noticeably better than any friends or family (both in frequency range and noticing sounds), but I’m often the only one who can’t fully follow conversations at a restaurant/bar/conference/etc.
  - Spooky23 1y ago
    Yeah that’s remarkably similar to my experience. The only surprise is that my hearing was excellent — all of those punk shows in the 90s didn’t damage my hearing! If it bugs you, a good audiologist or instrumentation specialist can measure the frequencies impacted and mitigate it with hearing aids. I tried it, and i would best describe it like transitioning from 1080p to 4k. The gotcha is the hearing aids are expensive and it is difficult to get a diagnosis that insurance will cover as it’s technically not a hearing loss.
  - kayodelycaon 1y ago
    Same. Excellent hearing but I can’t follow conversations in noisy places. I only catch every other word. It’s like my brain isn’t filtering out the noise in real time so it just stops hearing. Annoyingly, this can also affect video calls when people don’t speak clearly.
- spangry 1y ago
  Pretty sure that's what I have too (and am diagnosed ADHD). I used to complain to my Mum that I couldn't hear what people were saying on the bus back home from school. She took me to get a hearing test and it turns out I have bat-like hearing. I'm just not able to seperate out speech from background noise - noisy restaurants and bars are a nightmare.
enneff 1y ago
The science doesn’t support your hypothesis btw.
- jasonfarnon 1y ago
  Meaning what? All those college kids who took a friend's ritalin prescription to complete a term paper could have done just as well without it? I'm skeptical. Some of us wouldn't have even done the term paper without it, or would have mailed it in. I tend to think of it as little different than steroids. Maybe there's a bigger boost for some individuals than others, but the boost is probably across the board.
  - yosame 1y ago
    There was a study where they tested the effects of ADHD meds on test performance and perceived performance. It found that stimulants increased perceived performance for everyone, but actual test scores were only improved for people with ADHD. This is a good overview of the literature: https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2013.00198/full https://www.frontiersin.org/journals/neuroscience/articles/1...
  - deleted 1y ago
    [deleted]
- homefree 1y ago
  I’m willing to update, but a lot of “science” is bullshit.
rrrrrrrrrrrryan 1y ago
> a huge amount of the public was taking stimulants regularly Anecdotally, 100mg of caffeine combined with 200mg of L-theanine makes me maybe 25% as productive as I am on 5mg of Adderall, which is actually enough for me to function most days.
deleted 1y ago
[deleted]
thirdacc 1y ago
>My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) Of course they do. They're stimulants, that's what they do. Some people just need them to be closer to normal, or whatever's considered normal in post-Industrial society. Modafinil promotes wakefulness in everyone, not just narcolpetics. Anxiolytics calm down everyone, not just the anxious, and psilocybin makes everyone feel euphoric, not just the depressed. It would be weird if stimulants only had an effect of ADHD patients. > and ADHD is kind of a weakly differentiated diagnosis that could apply to most people. I don't think we really understand it yet, but it's not something most people have. As the article mentions, people ADHD have a higher rate of transportation accidents, lower life expectancy, higher crime rates, higher addiction rates, etc. The differences show up in brain scans, performance tests, genetic biomarkers, heritability/twin studies, etc. Whether you think of it as a disability, or brain type, or whatever - ADHD is something real. > Probably something like this was lost when people stopped smoking, obviously beneficial for health - but a huge amount of the public was taking stimulants regularly via nicotine until relatively recently. Yes, and this is possibly why 35-55% of adults with ADHD smoke today, compared to 19% of the population. Studies have shown that nicotine is helpful for everyone but particularly helpful for those with ADHD. Nicotine-derived formulations are still being explored.
- ttul 1y ago
  ADHD is a well-established, highly heritable neurodevelopmental disorder. Large-scale twin, genetic, neuroimaging, and longitudinal studies consistently show distinct brain, behavioral, and outcome differences compared to the general population. While we don’t yet understand every mechanism or subtype, the condition is robustly characterized and recognized by all major medical bodies. The World Federation of ADHD International Consensus Statement concludes: “ADHD is a genuine neurodevelopmental disorder with a well-documented genetic and neurobiological basis” and emphasizes that claims to the contrary are “contrary to scientific evidence and risk causing harm” [1]. Medical and psychological professionals are VERY confident that ADHD is a real condition—on par with the confidence they have in diagnoses like major depressive disorder or generalized anxiety disorder. Across psychiatry, ADHD, depression, and anxiety are all among the best-documented psychiatric conditions. There is more skepticism about disorders with fuzzier boundaries (e.g., “personality disorders” or “internet addiction”), but ADHD is NOT in that category. I believe ADHD is stigmatized in our culture because our modern world makes us all feel distracted at times; therefore, it seems like people with the diagnosis are perhaps getting a “free ride” by blaming their poor behavior on a “condition”. But ADHD is so much more than just having a hard time focusing because of social media and phones. It manifests as a spectrum of extreme challenges that lead over time to sufferers having a significantly harder time navigating life than people without ADHD. Merely having a hard time concentrating does not make you an ADHD candidate. You must experience a range of symptoms that interfere materially in multiple areas of life. ⸻ Reference [1] Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., Rohde, L. A., Yang, L., Cortese, S., Almagor, D., Stein, M. A., Albatti, T. H., Aljoudi, H. F., Alqahtani, M. M. J., Asherson, P., … Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience and Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022 https://doi.org/10.1016/j.neubiorev.2021.01.022
jakkos 1y ago
> ADHD is kind of a weakly differentiated diagnosis that could apply to most people I don't think this hypothesis would survive a look through the literature on google scholar. ADHD is associated with huge increases in risks of suicide, substance abuse, homelessness, accidents, crime, autoimmune disease, etc etc etc. It's not just "damn I find it hard to focus sometimes".
- mrlongroots 1y ago
  I have diagnosed ADHD and I agree largely with the person you are responding to. The claim is not that ADHD is not a set of people with real psychiatric disorders, but it is a loose umbrella for what are actually disparate problems. I recently learned that my symptoms, to a large extent, can be explained more accurately as POTS or something adjacent, and the meds I guided my psychiatrist towards were far more helpful than the stimulants I was being prescribed. This was a combination of me, reddit, and later LLMs arriving at me-specific diagnoses that go beyond clinical guideline regimes.
  - jakkos 1y ago
    > a loose umbrella for what are actually disparate problems For me, the DSM-V & DIVA criteria are eerily accurate. I was diagnosed as an adult and it felt like a cruel cosmic joke reading through the psychiatrist report and realizing that most of my past and present issues were repeatedly-documented commonalities of a single condition. It was as if my life had just been playing out from a predetermined script. I fully agree that that many distinct conditions are incorrectly swept under the "ADHD umbrella", but ADHD is not in any way a "loose" description of me. > more helpful than the stimulants My currently prescribed stimulants have been the only thing to ever make me feel consistently "okay", after having previously given up on medications ever helping. I'm sure they also enable me to write a few more lines of code per day, but I'd still be taking them even if they made me significantly worse at doing so.
    - homefree 1y ago
      My criticism is not that the criteria don’t apply or that people don’t think they do - but that most people reading it seem to describe what you’re saying. It seems more like a horoscope to me - everyone can find themselves in the criteria. It’s an observable thing, I’m just not sure I buy its special distinction. People also used to make the claim that the stimulant drugs had special effects (or even opposite effects) on those with ADHD vs. the non ADHD population which always seemed like bullshit to me, but I don’t see that claim being made here anymore. Edit: after writing this comments others in the thread started making this claim
matheusmoreira 1y ago
Stimulants will stimulate anyone with a nervous system. It's just that ADHD patients will respond disproportionately well to the treatment, thereby justifying the risks.
- astrange 1y ago
  Although "stimulate" is a bit misleading. They can calm you down if they stimulate the part of the brain responsible for calming you down more than the other parts.
ttul 1y ago
Your hypothesis is contracted by mountains of high quality scientific evidence. ADHD is a well-defined condition and there is an accepted way of diagnosing someone with it that effectively divides those with the condition from those without it. Stimulant medications may help many people to feel and be more productive, but that does not imply that people who meet the criteria for ADHD do not represent an identifiable group. I highly encourage you to browse the Consensus Statement on ADHD, referenced below. It’s a compilation of 202 facts about ADHD, accepted by a global consensus of experts on ADHD. Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., Rohde, L. A., Yang, L., Cortese, S., Almagor, D., Stein, M. A., Albatti, T. H., Aljoudi, H. F., Alqahtani, M. M. J., Asherson, P., … Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence‑based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022 https://doi.org/10.1016/j.neubiorev.2021.01.022
- thisislife2 1y ago
  > "high quality scientific evidence" Mostly, unfortunately, funded by Pharmaceutical companies - ADHD Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic ( https://www.amazon.com/ADHD-Nation-Children-American-Epidemic/dp/1501105914 https://www.amazon.com/ADHD-Nation-Children-American-Epidemi... ): > More than 1 in 7 American children get diagnosed with ADHD—three times what experts have said is appropriate—meaning that millions of kids are misdiagnosed and taking medications such as Adderall or Concerta for a psychiatric condition they probably do not have. The numbers rise every year. And still, many experts and drug companies deny any cause for concern. In fact, they say that adults and the rest of the world should embrace ADHD and that its medications will transform their lives.
  - astrange 1y ago
    Properly designed preregistered studies are credible even if they're funded by people you don't like. All medication in the US is approved by studies funded by the company that applies to be able to sell it. Who else would be motivated to study them?
pygy_ 1y ago
I don't know if the evidence is more than anecdotal, but I've read that ADHD smokers who are taking adderal have to increase the dose of their treatment to remain functional when they quit smoking. I've been taking nicotine patches for half a year now, with great success (and it is available OTC unlike other stimulants). Nicotine in itself isn't toxic at these doses (7, 14, 21mg), it's a cool life hack :-).
- homefree 1y ago
  I enjoy cigars and notice the positive effect, my fear with the patches or Lucy/zyn is that it not being self limiting seems to lead to people having one in their lip literally every waking minute when they’re not eating.
  - pygy_ 1y ago
    Patches are changed once per day, and their pharmacokinetics isn't addictive (the nicotine blood levels rise too slowly to give you a dopamine boost). I sometimes realize in the afternoon that I forgot to change my patch in the morning because I'm a bit drowsy (a feeling not unlike being uncaffeinated when you're used to drinking coffee). AFAIK the withdrawal symptoms fade out in at most a week.
Llamamoe 1y ago
> and ADHD is kind of a weakly differentiated diagnosis that could apply to most people. It's not, the problem is that it sounds like it because ~everyone faces some (way) lesser version of the struggles ADHD people face literally every day, many of whom probably do have some subclinical degree of executive dysfunction. My personal thumb rule is that somebody is capable of finishing school, autonomously managing their living conditions, finding and keeping a job, and having at least a modicum of social life at the same time, they're high-functioning enough that they almost definitely don't have ADHD, or only some ultra-light version of it.
- kayodelycaon 1y ago
  High-functioning doesn’t mean you’re not suffering horribly every single day. It can mean you’re a strong willed and good at masking. I was “functional” through a four month long psychotic break in which I was constantly one mistake from people finding out I wasn’t human and killing me. (I’m fine now. No lasting trauma fortunately.) How someone looks from the outside isn’t a good measure of their mental health. How many people have been depressed and killed themselves without any obvious warnings?
- rwyinuse 1y ago
  The problem with your rule of thumb is that there can be lots of external factors at play. Like, what if the person happens to be deeply gifted and/or interested in some school subjects, allowing hyperfocus on them? What if there is major external pressure pushing them to take care of their home, do well at school etc? I think ADHD is a spectrum, which includes those with "ultra-light" symptoms as well. Whether those in the lower-end of the spectrum need stimulant medication is a different matter.
NegativeK 1y ago
I grew up with this belief (not your belief; it's a common one) and it hindered me from realizing I needed help. I regularly have people doubt my diagnosis to this day. If we talk about it more, a lot of them _continue_ to doubt me even after I explain masking. Again, it's not just your belief -- I grew up hearing radio jockeys calling ADHD "bad parenting disease" -- but this belief is harmful. It ostracizes people and discourages help for a disability that causes measurable harm.
pas 1y ago
> that could apply to most people what does that mean? most people have more than 99% identical genes yet we are not clones. most people don't have a perfect BMI of 23.5 (or whatever is the middle), yet there are clear pathologies on the BMI spectrum, no? most people could better manage their lives and emotions but most people don't have that severe problems. the usual diagnostic criteria simply does not apply for most people. the cutoff is pretty high. (problems in multiple spheres of life present before the age of ~14 -- though there's brain damage induced ADHD too) but of course most people would benefit from some of the ADHD management strategies (which is better time management, planning, organizing things and consistently putting them into their assigned place, cognitive reframing of pervasive bad thoughts, getting a coach, etc.), but at the same time most people would not benefit from being on the usual ADHD meds (maybe they would benefit from some much smaller doses)

0xCMP 1y ago

I've also heard something similar. That maybe the reason so many are diagnosed today[0] is they were self-medicating via smoking. [0]: Which requires it to be affecting your life -- NOT that you actually do or don't have it and are dealing with it okay. Diagnostic criteria is that it must be hindering you in a job/school/relationships/etc.

brikym 1y ago

It's a performance enhancing drug for a lot of people. So many of my colleagues are on it.

Spooky23 1y ago

That’s a good point on the nicotine. I found out that i have ADHD through a process of dealing with a hearing issue - I have something called auditory processing disorder (APD), which means while I have excellent hearing, my brain has difficulty processing speech in high noise environments, especially with multiple people or frequencies that correlate to women. ADHD and autism spectrum disorders are highly correlated with it. A friend who is an audiologist was out with me at an event and basically spotted the adaptations that I had adopted subconsciously over my life (I’m in my 40s). I then got tested and confirmed. It’s likely a result of many consecutive ear infections I had as a kid. When reading up on APD, the literature describes stories of various people… and it was like looking back on a story of my life. The ADHD correlation is thought to be related because of the way the brain develops (or doesn’t) in the presence or absence of stimuli. I say this because it would be easy to dismiss my scenario. By most measurements I’m successful and doing great. But had I known or maybe been treated in the past, certain difficult aspects of my life would have likely been managed better or avoided. Brains are complex, and it’s important not to dismiss that problems that people have.

mrexroad 1y ago
Clinically ADHD and suspected APD here. I also have excellent hearing in both ears (20k+ hz), but I’m shit at understanding conversations in noisy environments… especially if my wife is speaking. Her voice is markedly harder for me to process than other people’s when there’s background noise. She used to assume I was being ADHD and not paying attention, etc, and get frustrated, but after years of me visibly focusing on her with unreasonable intensity while listening, she started accepting it. It’s always ironic that my hearing is usually noticeably better than any friends or family (both in frequency range and noticing sounds), but I’m often the only one who can’t fully follow conversations at a restaurant/bar/conference/etc.
- Spooky23 1y ago
  Yeah that’s remarkably similar to my experience. The only surprise is that my hearing was excellent — all of those punk shows in the 90s didn’t damage my hearing! If it bugs you, a good audiologist or instrumentation specialist can measure the frequencies impacted and mitigate it with hearing aids. I tried it, and i would best describe it like transitioning from 1080p to 4k. The gotcha is the hearing aids are expensive and it is difficult to get a diagnosis that insurance will cover as it’s technically not a hearing loss.
- kayodelycaon 1y ago
  Same. Excellent hearing but I can’t follow conversations in noisy places. I only catch every other word. It’s like my brain isn’t filtering out the noise in real time so it just stops hearing. Annoyingly, this can also affect video calls when people don’t speak clearly.
spangry 1y ago
Pretty sure that's what I have too (and am diagnosed ADHD). I used to complain to my Mum that I couldn't hear what people were saying on the bus back home from school. She took me to get a hearing test and it turns out I have bat-like hearing. I'm just not able to seperate out speech from background noise - noisy restaurants and bars are a nightmare.

enneff 1y ago

The science doesn’t support your hypothesis btw.

jasonfarnon 1y ago
Meaning what? All those college kids who took a friend's ritalin prescription to complete a term paper could have done just as well without it? I'm skeptical. Some of us wouldn't have even done the term paper without it, or would have mailed it in. I tend to think of it as little different than steroids. Maybe there's a bigger boost for some individuals than others, but the boost is probably across the board.
- yosame 1y ago
  There was a study where they tested the effects of ADHD meds on test performance and perceived performance. It found that stimulants increased perceived performance for everyone, but actual test scores were only improved for people with ADHD. This is a good overview of the literature: https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2013.00198/full https://www.frontiersin.org/journals/neuroscience/articles/1...
- deleted 1y ago
  [deleted]
homefree 1y ago
I’m willing to update, but a lot of “science” is bullshit.

rrrrrrrrrrrryan 1y ago

> a huge amount of the public was taking stimulants regularly Anecdotally, 100mg of caffeine combined with 200mg of L-theanine makes me maybe 25% as productive as I am on 5mg of Adderall, which is actually enough for me to function most days.

deleted 1y ago

[deleted]

thirdacc 1y ago

>My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) Of course they do. They're stimulants, that's what they do. Some people just need them to be closer to normal, or whatever's considered normal in post-Industrial society. Modafinil promotes wakefulness in everyone, not just narcolpetics. Anxiolytics calm down everyone, not just the anxious, and psilocybin makes everyone feel euphoric, not just the depressed. It would be weird if stimulants only had an effect of ADHD patients. > and ADHD is kind of a weakly differentiated diagnosis that could apply to most people. I don't think we really understand it yet, but it's not something most people have. As the article mentions, people ADHD have a higher rate of transportation accidents, lower life expectancy, higher crime rates, higher addiction rates, etc. The differences show up in brain scans, performance tests, genetic biomarkers, heritability/twin studies, etc. Whether you think of it as a disability, or brain type, or whatever - ADHD is something real. > Probably something like this was lost when people stopped smoking, obviously beneficial for health - but a huge amount of the public was taking stimulants regularly via nicotine until relatively recently. Yes, and this is possibly why 35-55% of adults with ADHD smoke today, compared to 19% of the population. Studies have shown that nicotine is helpful for everyone but particularly helpful for those with ADHD. Nicotine-derived formulations are still being explored.

ttul 1y ago
ADHD is a well-established, highly heritable neurodevelopmental disorder. Large-scale twin, genetic, neuroimaging, and longitudinal studies consistently show distinct brain, behavioral, and outcome differences compared to the general population. While we don’t yet understand every mechanism or subtype, the condition is robustly characterized and recognized by all major medical bodies. The World Federation of ADHD International Consensus Statement concludes: “ADHD is a genuine neurodevelopmental disorder with a well-documented genetic and neurobiological basis” and emphasizes that claims to the contrary are “contrary to scientific evidence and risk causing harm” [1]. Medical and psychological professionals are VERY confident that ADHD is a real condition—on par with the confidence they have in diagnoses like major depressive disorder or generalized anxiety disorder. Across psychiatry, ADHD, depression, and anxiety are all among the best-documented psychiatric conditions. There is more skepticism about disorders with fuzzier boundaries (e.g., “personality disorders” or “internet addiction”), but ADHD is NOT in that category. I believe ADHD is stigmatized in our culture because our modern world makes us all feel distracted at times; therefore, it seems like people with the diagnosis are perhaps getting a “free ride” by blaming their poor behavior on a “condition”. But ADHD is so much more than just having a hard time focusing because of social media and phones. It manifests as a spectrum of extreme challenges that lead over time to sufferers having a significantly harder time navigating life than people without ADHD. Merely having a hard time concentrating does not make you an ADHD candidate. You must experience a range of symptoms that interfere materially in multiple areas of life. ⸻ Reference [1] Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., Rohde, L. A., Yang, L., Cortese, S., Almagor, D., Stein, M. A., Albatti, T. H., Aljoudi, H. F., Alqahtani, M. M. J., Asherson, P., … Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience and Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022 https://doi.org/10.1016/j.neubiorev.2021.01.022

jakkos 1y ago

> ADHD is kind of a weakly differentiated diagnosis that could apply to most people I don't think this hypothesis would survive a look through the literature on google scholar. ADHD is associated with huge increases in risks of suicide, substance abuse, homelessness, accidents, crime, autoimmune disease, etc etc etc. It's not just "damn I find it hard to focus sometimes".

mrlongroots 1y ago
I have diagnosed ADHD and I agree largely with the person you are responding to. The claim is not that ADHD is not a set of people with real psychiatric disorders, but it is a loose umbrella for what are actually disparate problems. I recently learned that my symptoms, to a large extent, can be explained more accurately as POTS or something adjacent, and the meds I guided my psychiatrist towards were far more helpful than the stimulants I was being prescribed. This was a combination of me, reddit, and later LLMs arriving at me-specific diagnoses that go beyond clinical guideline regimes.
- jakkos 1y ago
  > a loose umbrella for what are actually disparate problems For me, the DSM-V & DIVA criteria are eerily accurate. I was diagnosed as an adult and it felt like a cruel cosmic joke reading through the psychiatrist report and realizing that most of my past and present issues were repeatedly-documented commonalities of a single condition. It was as if my life had just been playing out from a predetermined script. I fully agree that that many distinct conditions are incorrectly swept under the "ADHD umbrella", but ADHD is not in any way a "loose" description of me. > more helpful than the stimulants My currently prescribed stimulants have been the only thing to ever make me feel consistently "okay", after having previously given up on medications ever helping. I'm sure they also enable me to write a few more lines of code per day, but I'd still be taking them even if they made me significantly worse at doing so.
  - homefree 1y ago
    My criticism is not that the criteria don’t apply or that people don’t think they do - but that most people reading it seem to describe what you’re saying. It seems more like a horoscope to me - everyone can find themselves in the criteria. It’s an observable thing, I’m just not sure I buy its special distinction. People also used to make the claim that the stimulant drugs had special effects (or even opposite effects) on those with ADHD vs. the non ADHD population which always seemed like bullshit to me, but I don’t see that claim being made here anymore. Edit: after writing this comments others in the thread started making this claim

matheusmoreira 1y ago

Stimulants will stimulate anyone with a nervous system. It's just that ADHD patients will respond disproportionately well to the treatment, thereby justifying the risks.

astrange 1y ago
Although "stimulate" is a bit misleading. They can calm you down if they stimulate the part of the brain responsible for calming you down more than the other parts.

ttul 1y ago

Your hypothesis is contracted by mountains of high quality scientific evidence. ADHD is a well-defined condition and there is an accepted way of diagnosing someone with it that effectively divides those with the condition from those without it. Stimulant medications may help many people to feel and be more productive, but that does not imply that people who meet the criteria for ADHD do not represent an identifiable group. I highly encourage you to browse the Consensus Statement on ADHD, referenced below. It’s a compilation of 202 facts about ADHD, accepted by a global consensus of experts on ADHD. Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., Rohde, L. A., Yang, L., Cortese, S., Almagor, D., Stein, M. A., Albatti, T. H., Aljoudi, H. F., Alqahtani, M. M. J., Asherson, P., … Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence‑based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022 https://doi.org/10.1016/j.neubiorev.2021.01.022

thisislife2 1y ago
> "high quality scientific evidence" Mostly, unfortunately, funded by Pharmaceutical companies - ADHD Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic ( https://www.amazon.com/ADHD-Nation-Children-American-Epidemic/dp/1501105914 https://www.amazon.com/ADHD-Nation-Children-American-Epidemi... ): > More than 1 in 7 American children get diagnosed with ADHD—three times what experts have said is appropriate—meaning that millions of kids are misdiagnosed and taking medications such as Adderall or Concerta for a psychiatric condition they probably do not have. The numbers rise every year. And still, many experts and drug companies deny any cause for concern. In fact, they say that adults and the rest of the world should embrace ADHD and that its medications will transform their lives.
- astrange 1y ago
  Properly designed preregistered studies are credible even if they're funded by people you don't like. All medication in the US is approved by studies funded by the company that applies to be able to sell it. Who else would be motivated to study them?

pygy_ 1y ago

I don't know if the evidence is more than anecdotal, but I've read that ADHD smokers who are taking adderal have to increase the dose of their treatment to remain functional when they quit smoking. I've been taking nicotine patches for half a year now, with great success (and it is available OTC unlike other stimulants). Nicotine in itself isn't toxic at these doses (7, 14, 21mg), it's a cool life hack :-).

homefree 1y ago
I enjoy cigars and notice the positive effect, my fear with the patches or Lucy/zyn is that it not being self limiting seems to lead to people having one in their lip literally every waking minute when they’re not eating.
- pygy_ 1y ago
  Patches are changed once per day, and their pharmacokinetics isn't addictive (the nicotine blood levels rise too slowly to give you a dopamine boost). I sometimes realize in the afternoon that I forgot to change my patch in the morning because I'm a bit drowsy (a feeling not unlike being uncaffeinated when you're used to drinking coffee). AFAIK the withdrawal symptoms fade out in at most a week.

Llamamoe 1y ago

> and ADHD is kind of a weakly differentiated diagnosis that could apply to most people. It's not, the problem is that it sounds like it because ~everyone faces some (way) lesser version of the struggles ADHD people face literally every day, many of whom probably do have some subclinical degree of executive dysfunction. My personal thumb rule is that somebody is capable of finishing school, autonomously managing their living conditions, finding and keeping a job, and having at least a modicum of social life at the same time, they're high-functioning enough that they almost definitely don't have ADHD, or only some ultra-light version of it.

kayodelycaon 1y ago
High-functioning doesn’t mean you’re not suffering horribly every single day. It can mean you’re a strong willed and good at masking. I was “functional” through a four month long psychotic break in which I was constantly one mistake from people finding out I wasn’t human and killing me. (I’m fine now. No lasting trauma fortunately.) How someone looks from the outside isn’t a good measure of their mental health. How many people have been depressed and killed themselves without any obvious warnings?
rwyinuse 1y ago
The problem with your rule of thumb is that there can be lots of external factors at play. Like, what if the person happens to be deeply gifted and/or interested in some school subjects, allowing hyperfocus on them? What if there is major external pressure pushing them to take care of their home, do well at school etc? I think ADHD is a spectrum, which includes those with "ultra-light" symptoms as well. Whether those in the lower-end of the spectrum need stimulant medication is a different matter.

NegativeK 1y ago

I grew up with this belief (not your belief; it's a common one) and it hindered me from realizing I needed help. I regularly have people doubt my diagnosis to this day. If we talk about it more, a lot of them _continue_ to doubt me even after I explain masking. Again, it's not just your belief -- I grew up hearing radio jockeys calling ADHD "bad parenting disease" -- but this belief is harmful. It ostracizes people and discourages help for a disability that causes measurable harm.

pas 1y ago

> that could apply to most people what does that mean? most people have more than 99% identical genes yet we are not clones. most people don't have a perfect BMI of 23.5 (or whatever is the middle), yet there are clear pathologies on the BMI spectrum, no? most people could better manage their lives and emotions but most people don't have that severe problems. the usual diagnostic criteria simply does not apply for most people. the cutoff is pretty high. (problems in multiple spheres of life present before the age of ~14 -- though there's brain damage induced ADHD too) but of course most people would benefit from some of the ADHD management strategies (which is better time management, planning, organizing things and consistently putting them into their assigned place, cognitive reframing of pervasive bad thoughts, getting a coach, etc.), but at the same time most people would not benefit from being on the usual ADHD meds (maybe they would benefit from some much smaller doses)