3 ms·

I am diagnosed ADHD. I have used dexamphetamine as prescribed which worked pretty well, in moderate dosages because I am sensitive, but I came to dislike the ef

by sph 1y ago

I am diagnosed ADHD. I have used dexamphetamine as prescribed which worked pretty well, in moderate dosages because I am sensitive, but I came to dislike the effect it had on me: I felt like I was attached to a horse that kept pulling me around even when I just wanted to stop and take a break. And the fact that I would crash 5 hours later. In 2020, before even knowing I had ADHD, let alone being medicated, I managed to quit my (vaped) nicotine habit after using progressively smaller patches; meanwhile my executive dysfunction grew so much, during the most stressful time of my entire life, that I literally had a major nervous breakdown. It took years of therapy, diagnosis with ADHD, medication, to connect the two factors: I had been self-medicating with nicotine by entire life, and as I reduced the amount of it in my bloodstream, the more scattered I became [1] Then I tested my theory: I bought some nicotine patches, cut at very low dosage. And lo! it was as effective as dexamphetamine was, with much fewer of the side-effects, no pulling effect [2] and cheaper. It's been now a year and a half and honestly it's been working great. I slap on a small patch in the morning, it lasts MUCH longer than a pill, and it even allowed me to move and still lead a productive life in a country where ADHD is not even recognised. I asked my psychiatrist and they confirmed that nicotine is known to work as a third-line medication but usually amphetamines are preferred. This is not medical advice, yadda yadda, but worked for me, and I've always wanted to write a post about it. Regarding addiction: pretty much none, patches take too long to take effect to create addiction (i.e. caused by a predicable spike in dopamine). My dosage (~7.5mg patch cut out from a larger one) has been the same for the past 18 months, and trying larger doses just makes me sleepy (nicotine has a U-shaped effectiveness curve). Nicotine is much maligned, but if you do the research, avoid the smoking and inhalation devices but only use patches, maybe you'll find it helps you as well. --- 1: I read that cigarette smoke during the formative years is associated with lifelong ADHD, and my pet (silly) theory is that the increasing stigma surrounding smoking of the past ~30 years might be one of the many factors we see ADHD on the rise. We might have 2 or 3 generations of smoking parents that were themselves self-medicating because of growing up in times where smoking was commonplace. 2: if I need to feel like a productive machine for a couple hours, coffee and a tyrosine pill can recreate the amphetamine feeling pretty well

actionfromafar 1y ago
That pet theory might have legs. I like it.
- sph 1y ago
  I also blame screens. My other pet theory is that in 30 years we'll discover there is really no such thing as ADHD, just pre-frontal dopaminergic dysfunction from a lot of different causes, such as addiction (there is a great presentation by Dr. Todd Love about how ADHD and drug addiction present exactly the same), superstimuli frying our reward systems and natural differences in drive between people. What we're doing now is just treating the symptoms.
  - actionfromafar 1y ago
    I think screens can provoke AHDL-like symptoms or perhaps even trigger ADHD, but it existed before screens. Also a lot of illnesses are managed, even when we actually know the cause, we can't always undo the damage, just manage it.
  - cleansingfire 1y ago
    Except that ADHD is older than screens, and exists without drugs or addiction.
    - sph 1y ago
      Yes, but incidence rates are increasing. You can blame that on better diagnoses, or, more likely in my opinion, some other factors which didn't exist before.
      - piva00 1y ago
        It can be both though, there's ADHD as it is currently understood as a genetic/neurological issue where the dopaminergic system is impacted, and creates all the effects experienced by ADHD sufferers. There might also be environmental issues, like you mention, that could be creating similar issues but not from the point of a genetic neurological divergence. That is an important distinction since the treatment for one cause is very different to another. The incidence rates increasing are very correlated to better diagnoses, 30 years ago most people with ADHD wouldn't be diagnosed unless they fit into the extreme cases of it. That was my experience, as a kid I was very bright but considered "lazy" since I couldn't focus as my peers did out of school, was always interested during classes, and excelled in school even though I could never do my homework or other assignments, constantly forgot important deadlines, it was always stressful but I found ways to manage it. Thirty years later and I fit in the criteria, no idea how my life would've turned out if I knew about it before, my coping/management mechanisms ended up being to lean into the stress and harness it, it made me achieve things but also created a whole other host of issues with anxiety later in life.

by sph 1y ago

actionfromafar 1y ago

That pet theory might have legs. I like it.

sph 1y ago
I also blame screens. My other pet theory is that in 30 years we'll discover there is really no such thing as ADHD, just pre-frontal dopaminergic dysfunction from a lot of different causes, such as addiction (there is a great presentation by Dr. Todd Love about how ADHD and drug addiction present exactly the same), superstimuli frying our reward systems and natural differences in drive between people. What we're doing now is just treating the symptoms.
- actionfromafar 1y ago
  I think screens can provoke AHDL-like symptoms or perhaps even trigger ADHD, but it existed before screens. Also a lot of illnesses are managed, even when we actually know the cause, we can't always undo the damage, just manage it.
- cleansingfire 1y ago
  Except that ADHD is older than screens, and exists without drugs or addiction.
  - sph 1y ago
    Yes, but incidence rates are increasing. You can blame that on better diagnoses, or, more likely in my opinion, some other factors which didn't exist before.
    - piva00 1y ago
      It can be both though, there's ADHD as it is currently understood as a genetic/neurological issue where the dopaminergic system is impacted, and creates all the effects experienced by ADHD sufferers. There might also be environmental issues, like you mention, that could be creating similar issues but not from the point of a genetic neurological divergence. That is an important distinction since the treatment for one cause is very different to another. The incidence rates increasing are very correlated to better diagnoses, 30 years ago most people with ADHD wouldn't be diagnosed unless they fit into the extreme cases of it. That was my experience, as a kid I was very bright but considered "lazy" since I couldn't focus as my peers did out of school, was always interested during classes, and excelled in school even though I could never do my homework or other assignments, constantly forgot important deadlines, it was always stressful but I found ways to manage it. Thirty years later and I fit in the criteria, no idea how my life would've turned out if I knew about it before, my coping/management mechanisms ended up being to lean into the stress and harness it, it made me achieve things but also created a whole other host of issues with anxiety later in life.