Just as a counterpoint...I was successful throughout school and college but crashed and burned as soon as I moved to a new city for a software job at Amazon. Later, after quitting due to mental health issues I got a diagnosis for ADHD. I took vyvanse for about five or six months, but it didn't really help with my ADD symptoms and it gave me heart palpitations and made my anxiety worse.

After a lot of introspection, I realized that I was actually choosing to be disorganized, bad at managing my time, etc, because I didn't see these things as a priority. I've been working on my executive function, treating it as a skill that is possible to learn, and so far it's going well.

I got some really good advice from my therapist, who told me to stop saying I "should" do things and instead be honest with myself about whether something is actually a priority to me. She pointed out that whenever I tell myself I "should" do something and don't do it, I'm training my brain to ignore my own decisions. Before, I think my mindset was that I have default behaviors, and doing something productive takes effort - now I remind myself that I'm making a choice even when I default to my old habits.

I'm not sure this is much of a "counterpoint". Medication isn't the only solution to ADHD. In fact, it's often recommended that ADHD be treated with medication AND therapy, which often involves working on things like executive function. Also, there are different types of medication for ADHD. If you only tried Vyvanse, it's possible that a different type of medication would help without the negative side effects. You wouldn't say you're allergic to all antibiotics if you had a reaction to a single antibiotic.

After spending 4 years around people high on prescription amphetamines in an engineering school, here’s my impression as someone who was mostly sober: (during the day anyway)

They look (to me) like they just make that effect where some people get hung up on certain classes of ideas way stronger, if it happens to be video games you won’t get anything done but if it happens to be math then you’ll probably get very good grades.

The problem with using them as an adult is that success as an adult has more to do with effective socializing and less to do with ability. People high on these things are the worst to be around. There was one guy I thought I hated the whole time I was in college and he got off this stuff and it turned out he was an awesome person sober! Most of the other people I know who were on the drugs are similar.

I’m not saying amphetamines are bad but there not magic either. Personally I think the psychoactive effects of chocolate and coffee are plenty for most people and it’s all about managing it.

This comment is a non-sequitor to the parent. You appear to be referring to neurotypical people abusing amphetemines ("people high on .."). GP is referring to using a prescription to manage an actual disorder.

They're not the same thing, at all. Please do not commit the offense of saying that there's no such thing as ADHD, "everyone has trouble doing ..", etc.

The offense is when we drug kids for not wanting to sit at a desk, or not wanting to concentrate on something they're not interested in, or not performing under a certain teaching/learning model.

We put kids (and then adults) in the wrong environment and "fix" them with drugs so they conform to it.

Maybe we should change the environment or model instead. Different people thrive in different environments. A good thing, not something to be suppressed. It's a failure of our current time that we try to force "neuroatypical" into typical, instead of embracing this neurodiversity.

The actual offense is making handwavy statements like 'we're drugging kids for not wanting to concentrate on things they're not interested in'. ADHD is not as simple as that. And for people affected by it, even interesting things are often physically impossible to concentrate on - it's incredibly frustrating and a debilitating condition to live with without medication (depending on severity, of course). A different environment wouldn't solve the problem.

Aside from all that, I agree that forcing everyone to conform to the narrow range of 'normal' in general is less than ideal, but since this is the way current society is structured down to its very basis, the idealistic idea of turning that on its head is probably not very helpful to those presently impacted by it.

I don't know much (anything, really) about this so please don't construe my comment as one of any judgement. I'm really just curious to learn more.

A quick search shows that 9.4% of kids are diagnosed with ADHD.[1] (It's also the exact same percentage of total population with diabetes, which society seems to treat as an epidemic [2]) Of those kids, over 60% were on medication. Maybe I'm naive, but that seems like a lot. Do you think there are really that many kids who have "a debilitating condition"? The source lists a "behavior or conduct problem" as the number one reason to be diagnosed. That...seems a little suspect to me at first blush, but again, this isn't something I have much knowledge about.

[1] https://www.cdc.gov/ncbddd/adhd/data.html

[2] https://www.diabetes.org/resources/statistics/statistics-abo...

I absolutely think there is a such thing as ADHD and these people were prescribed the medication to manage it. There was one person who I think managed to get a prescription despite being “normal” and I didn’t notice much about him that changed but we also didn’t hang out much after that.

> I absolutely think there is a such thing as ADHD and these people were prescribed the medication to manage it

Then why do you claim they were "high"? No, they're more toward "normal" than they would otherwise be.

Claiming ADHD people are high, while you are "sober" is a pejorative which diminishes the fact that ADHD exists and needs treatment, and is usually intended to embarrass and denigrate those that have it.

Because amphetamines make you high, whether or not they are treating a disorder.

I have ADHD. I have taken quite a few medications for it over my lifetime, as have many of my friends. Clinically indicated amphetamine treatment does not mean the patient will not become high, or that the patient will remain sober.

It is an issue with which anyone taking these sorts of medications will be well acquainted. It's why many folks suffering from ADHD will sometimes not take their medication.

I think swiley is being a bit cheeky by applying the term "high" to those who are officially, medically stimulated. But you may be erring on the other side, giving too much weight to the official narrative that blesses "medical" speed and condemns "street" speed.

The real difference between medical and rec speed is dosage and route of administration. Big doses, taken nasally or intravenously, are abuse; small doses, taken orally, are medication.

But to concur with swiley, speed doesn't magically stop being speed when an ADHD diagnosis and a Trademarked Drug (TM) enter the picture.

I'm not sure what you consider to be "high" on amphetamines. I take 20mg Adderall XR and don't feel high. It is amphetamine, so of course you could take more, or take IR, to get more of a rush. As someone in their late 30's, that personally has little appeal to me and I'm past the stage of my life where I'd desire to use amphetamines for that purpose.

I think it was just an expression he used for effect.

Can you provide a little elaboration on "the worst to be around"? What makes it like that for you?

I don’t know, they’re less self aware and extremely assertive? They’re usually way louder.

I've recently started treatment with lisdexamphetamine and I feel like sometimes there's certainly a sense of being less restricted than when I'm not using it. And sometimes I feel a sense of (maybe unsubstantiated) confidence that I don't have without it.

Sometimes that's for the better, and sometimes it might be for the worse. I also feel very interested in doing good work, and learning more. Which means I'm not the most social person on our team, although I think I'm well enough liked, I'm not after-work friends with that many of them.

The social aspect is probably the most important aspect of success at work (moving up, political support, getting that money etc), but for now I'm really enjoying being able to focus my energy on a task and not get distracted by every little sound,thought or movement happening around me.

Your comments echo my experience in every detail. I, too, did not meet a shadow of my potential until I received an ADD diagnosis as an adult.

After taking Adderall for the first time, I immediately began keeping a systematic journal of notes (and creating other structures for myself). I remember walking to a store to get the notebook the very day I took the first pill — it was like a revelation.

Over the years since that day, I have transitioned to different ADD medications, but have found that I am not able to adhere to my structures when I am off medication. This is a non-trivial insight, as much well-meaning ADD advice is at the level of “create and follow structures” —- it is precisely this that medication allows me to do.

I've taken ADHD medication once in high school, and I hate how _good_ it was. It makes it so much easier for me to be the person I want to be, to accomplish the things I want to do. But I'm also adequately capable sober; I don't want to become medicated and then feel like I can't be productive unmedicated.

If you had a nutritional deficiency, would you avoid taking a supplement? Cause that's what the ADHD medication is doing; regulating dopamine and norepinephrine, which are usually deficient in ADHD brains.

> You often hear this advice but for someone who has a difficult time starting things, the idea of "building systems" is overwhelming.

Interesting. Elaborate please.

> ADHD (particularly the attention side, as an adult)

I take it that means hyperactivity wasn't one of your symptoms? I have the suspicion that I suffer from ADD (you basically described the same life I've had), but the hyperactivity part makes me unsure of myself.

460-375BCE - Greece - Hippocrates on people who couldn't focus but were good at reacting to events - attributed to an "overbalance of fire over water"

1693 - Scotland - John Locke - in "Some Thoughts Concerning Education" - discussed a class of students who "could not keep their mind from straying"

1798 - Scotland - Sir Alexander Crichton - "The Disease of Attention"

1800s - Various - Medical Textbooks of the time - referred variously to conditions “nervous child”, “hypermetamorphosis”, “mental instability”, “unstable nervous system” and “simple hyperexcitability”

1902 - England - Sir George Frederick - describing the same systems named the condition an “abnormal defect of moral control”

1937 - USA - Charles Bradley - first began experimenting with prescribing benzedrine (an amphetamine) to Children initially for headache and noted that it greatly improved focus in those who previously had not demonstrated that ability, but could not explain why stimulant drugs could induce a calming effect.

1944 - Switzerland - Ritalin developed (Methylphenidate, Rita from his wife) as a safer replacement to benzedrine

1968 - USA - DSM-II lists these by now well recognised and medicated symptoms as "hyperkinetic reaction of childhood"

1980 - USA - DSM-III - changed the name to "Attention Defecit Disorder"

1987 - USA - DSM-III (3rd edition) - changed the name to "Attention Defecit Hyperactivity Disorder"

1994 - USA - DSM-IV - refined the disorder into it's currently diagnosed form with 3 different types of ADHD, namely: Inattentive Type, Hyperactive/Impulsive Type and combined type.

2013 - USA - DSM-5 - refined to acknowledge that the 3 different types are not in fact types, rather presentations that can change over the course of an individual's life.

or...

maybe it's a newly invented fake phenomenon

ps - not a response to the comment preceding :)

The DSM-V describes three kinds of ADHD: 1. Predominantly inattentive 2. Predominantly hyperactive/impulsive 3. Combined

So yes, you can be diagnosed with ADHD without symptoms of hyperactivity

If you have a suspicion that you have ADD, I'd highly recommend you to talk to someone who specializes in adult ADHD and get their opinion.

I got diagnosed with ADHD 10 years ago at age 26. It's nice to get a confirmation, like "yep, the reason you threw a book at a kid in kindergarten and couldn't explain why (sorry Narek) was cause of poor impulse control related to ADHD," but it's not a satisfying conclusion. I mean, I still threw a book at a kid for no reason...

You can have ADHD and not have all of the symptoms - I can focus on a sigle task for a long time just fine, but I have a hard time sitting still in a chair (even when I'm gaming, I'm constantly shifting around in my chair, sitting on my legs, moving my legs, tapping, etc.)

It's good to put your feelings and emotions into context, but at the end of the day, you're still on the hook for your behavior and your success, and a lot of people use a mental condition as an excuse to never improve or never make hard decisions or take hard looks at their behavior. Don't fall into that trap - ADHD shouldn't define who you are or your behavior, it's just one aspect of the inputs into your decision making process.

I will say that being aware that I have impulse control issues has definitely helped me slow down - I used to have a crazy automatic mouth - I'd just say whatever popped into my brain from my subconscious. A lot of times it's hilarious, many times it's just plain freaking mean. Knowing this was an issue has helped me sort of hijack the wiring from my brain to my communication centers and has given me enough time to not say obviously stupid things. At first, it was me starting to say something, cutting myself off, then giggling and saying "don't worry about it," to teammates when they looked at me like I was a nutjob. As I've practiced more, I can let many thoughts pass without expressing them and just get a little bit of amusement to myself without offending anyone.

Another thing I've kind of owned is the hyperactivity - sometimes I just have to get up from my seat and walk around. I'm up and pacing before I even know what's going on. Getting a remote job has been pure heaven in this regard - I can dance around, or pace and think without bothering anyone. But when I worked in an office and needed to get up and stretch, say during a meeting, I'd jut do it. A lot of times, people would follow suit and realize they were kind of cramped, maybe fading a little bit, and a little bit of activity is just the pick me up you need in an afternoon meeting. The point is - take something that might be a detriment (needing to dance around all day) and turn it into a positive - "let's have a stretch break in the meeting!"

For further reflection I highly recommend "Scattered Minds" by Gabor Maté. Exceptional book by an exceptional physician.

NB for anyone considering this: Maté's hobby horse is that mental illness comes primarily from emotional trauma. If that's what you need to hear, great, but nowhere near being an explanation of the scientific consensus.

As someone with acute ADHD and prolonged childhood trauma, Gabor Maté is a godsend and I'd recommend this book as well.

Hyperactivity affects only 50% of people with ADD. Check out this video where Daniel Amen shows 7 types of ADD, maybe you will recognize your patterns. https://www.youtube.com/watch?v=UWnJ4wjVu9k

What do you mean when you say hyperactivity makes you unsure of yourself?

If hyperactivity is one end, I'm on the complete other end. And I always associated ADHD with being hyperactive.

Oh, I misunderstood.