Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010326/

by rbanffy • 6 years ago

324 330 6 years ago

ncbi.nlm.nih.gov

cbluth• 6 years ago

i have severe ADD, and i dont have the patience with myself to read enough of this article to benefit my understanding of it.

arkitaip• 6 years ago

I feel you dude, I have the same problem with content about dealing with procrastination.

pastrami_panda• 6 years ago

Many years ago I read the preface to the behemoth of a book that is Infinite Jest by DFW.

I don't remember the wording of the preface, but I recall it arguing that the sheer size of the book could be regarded both as a cultural experience as well as a mental exercise.

The author of the preface argued that when (or perhaps if) you finished the book you would feel like you've just run a marathon. You would be highly fit, reading wise. Nothing would phase you.

This was probably compounded in my teenage head by the fact that the only quote I've heard from the author beforehand was:

"I consume libraries. I wear out spines and ROM-drives. I do things like get in a taxi and say, 'The library, and step on it.'"

It sounded like a complete opposite of myself at the time, but I did want to learn that ability. And I liked that preface a lot. It kept me going at it month after month on busy train rides, with the promise of some transcendent reward at the end.

There are famous footnotes in that book spanning several pages in tiny print. The amount of mental effort it took to read the thing was extraordinary for someone like me at the time. I often had to backtrack several pages to perform the context switch from a mini-novel footnote back to the main storyline.

This was many years ago now, and I have slipped far behind on my reading fitness. But I still carry with me the realization that I can't expect to be fit if I don't train hard.

Now, ADD is a whole nother beast. Sicknesses often require medical attention and this should not be smoothed over. Still, I think there's an interesting discussion to be had regarding reading fitness in the era of information. Maybe this is a widely discussed thing and I'm just not hearing it, but it seems obvious that we slip further toward obesity without training. Surely something similar happens with our ability to focus without training?

relativeadv• 6 years ago

This is really insightful, thanks. Makes me want to take another swing at Infinite Jest.

With depression, we might take medication to grant us a seat at the table of recovery via a therapist. The hope is to get off of that medication eventually. Perhaps the same holds true with ADD/ADHD? I am not a psychiatrist.

I've been wondering about this attention deficit and reading comprehension issue for awhile now. I would love to know how many of us adults actually read books anymore for longer than a thirty minute period? Any kind of book reading.

I like to think that I'm a somewhat experienced meditator by now. Having observed the mindfulness hype over the years I wonder if what people are really missing is just some silent focused time in general. If all you want is quieter mind, maybe you don't need a ten day silent retreat but just an hourlong reading session?

I know the topic has been beaten to death but it is an important one. This constant context switching between systems and devices who have been engineered to sap your impulse control and short-circuit your core reward system need to be investigated on a personal level. So it isn't just that you aren't doing those hourlong reading sessions in silence but that you're actively practicing a different kind of negative behavior.

This is just one uneducated person's opinion. If we're talking about a dysfunctional reward pathway would it not stand to reason that someone's gravitation toward systems who provide thousands of small immediate rewards only reinforce this dysfunction? Think video games, porn, and instagram. Juxtapose this with reading a novel, painting a picture, or finally understanding recursion. I feel kind of gross typing that out because it feels like some sort of appeal to nature but I can't shake it.

acruns• 6 years ago

I have ADHD, and I don't have the patience with myself to read enough of your reply to benefit my understanding of it.

dkersten• 6 years ago

Sure, I vaguely remember seeing a bunch of studies about how instant access to information, social media, "mindless" entertainment and constant stimulation is badly hurting our ability to focus. I've personally stopped listening to music or reading social media/news on my phone when I commute or go for walks, as I find the quiet time really helps my focus and attention longer term.

PragmaticPulp7• 6 years ago

The good news is that you don’t need to. In fact, these articles tend to give people a false feeling of understanding, and an impression that ADHD is purely a chemical situation in the brain that can only be treated with drugs.

That’s not really true. Medication can absolutely help for severe cases, but falling into the trap of thinking that ADHD is a purely chemical problem that can only be addressed with chemical solutions can lead people to neglect the important lifestyle and self-discipline changes that will really help their situation in the long term.

Don’t get caught up in ideas that ADHD is “just dopamine”, because that’s a path to ignoring the fact that personal changes and therapy can improve ADHD immensely.

oriolid2• 6 years ago

Would you share some of your assumedly true understanding?

TheLegace5• 6 years ago

Take a look at this new treatment(neurofeedback)[1]. It changed my life. Instead of changing brain chemically you can change the structure of your brain. It's not ADHD that's the problem, its the focus networks in the brain not being trained properly.

ADHD becomes a gift when you can focus and the brain just naturally learns, and memorizes very well. I went from being incapable of anything to being really great at anything I wanted to be (just late to the party). [1] http://addcentre.com/

saeranv• 6 years ago

This is really fascinating. I just sent them an email to see if I could participate (diagnosed with ADHD 6 months ago at age 33, feeling pretty depressed that all the years of struggling/setbacks were to some degree unnecessary).

May I ask how long have you been participating in the training?

theironlily• 6 years ago

I’m just starting neurofeedback, curious what your experience was like. May I email you at the address you have on profile ?

kossTKR2• 6 years ago

I am very interested in this but am currently located in Scandinavia. What does the training practically entail?

Is it some kind of device on the head that you then learn to use with an on-screen app where you can get feedback on your "state" like meditation but with an interface?

I remember reading about this years ago and wondering when the tech would be available for use in-home.

Do you need to go to a professional clinic?

quercusa• 6 years ago

I don't know anything about those folks but my son (inattentive type) got a lot of value from neurofeedback about 10 years ago under a psychologist using the full EEG skull cap. He went once a week for 18 months then less often for another year or two. Wish I'd done it...

Tarq0n• 6 years ago

The evidence currently suggest that Neurofeedback does not outperform a placebo. There's a nice round up of the research at the bottom of this article: https://www.psychologytoday.com/us/blog/brain-myths/201302/r....

s9w• 6 years ago

I'm confused - it's all about dopamine. That's why it's treated with dopaminergic drugs.

TheAdamAndChe• 6 years ago

A deeper understanding of the mechanisms can lead to all sorts of benefits, from more accurate testing to better targeted pharmaceuticals to better studies of genetics.

PragmaticPulp7• 6 years ago

Dopamine isn't a simple 1-dimensional value that goes up or down with drugs. It's not even accurate to describe ADHD medications as dopaminergic drugs, as stimulants have significant norepinephrine activity as well.

There are even non-stimulant ADHD medications that have no dopaminergic activity at all (Intuniv).

Complex human thought processes can't be reduced to single neurotransmitters. Everything you do is a complex interaction of many pathways that use many different neurotransmitters.

ADHD also isn't purely a chemical disorder. Plenty of ADHD people learn to focus and be productive through therapy and constant self-directed change. Plenty of ADHD people treated with stimulants just use their chemically-induced focus to mess around on the internet and continue to waste time.

Effectively treating ADHD requires approaching it as a mix of medication and lifestyle changes. Reducing it to just dopamine is a trap.

marvion2• 6 years ago

I'm confused

Yeah. Took me a while to see the "2010"...

It's the point of almost all ADHD memes - thought it's common sense now.

_dibly9• 6 years ago

This was an interesting read but, as an adult with ADHD, all I get out of this is that medication is even more of a benefit to those with real difficulties coping with their ADHD. I've always been one to 'just deal with it' but after a few years of working through school and seeing my younger brothers go through the same thing with medication, I realized that I was essentially just handicapping myself.

Now I take medication in the morning before I get to work and it basically lasts me through the work/school day. When I was younger I was perscribed ritalin, and it just made me sleepy so I stopped taking it. Now I take a more modern medication and it works wonders. The negative stigma against medication really harmed me in school, and I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.

zarkov993• 6 years ago

What medication do you take now? Did you take anything while growing up?

pen2l3• 6 years ago

I take concerta, 18mg, and it works wonders. The only small negative is the its life is a little too long... even if I take it at 7am, I find I have difficulty getting to sleep sometimes up till 3am... and then my whole sleep schedule gets shifted and it’s damn difficult to get it back to a proper rhythm.

That aside, I _so_ agree with grandparent post about the negative stigma associated with medication for adhd. I’m so angry at society, parents, everyone for having done this to me in my early years — if only I had started earlier instead of in my mid-20s.

_dibly9• 6 years ago

Growing up I was perscribed ritalin, however I stopped taking it within a few months because my middle-school brain was not enjoying the side-effects (mostly drowsiness). Now I'm perscribed Adderall and it works great. It can be annoying because every college student under the sun is taking adderall to cram last minute but it's a different drug when you actually need it to function. For most people Adderall just keeps them awake and hyper-focused so they can do whatever they need to get done, regardless of the hours it takes them. For someone who has ADHD, it really just brings us to what that baseline is for most people.

I can focus on my work all day with no medication if I'm doing something that I find personally interesting. However, when I have a week's worth of online coursework and boring bookkeeping to do it's impossible to get more than 5 minutes done without staring out the window, putting something on in the background, and twiddling my thumbs. I can still buckle down and get work done without it, but it's so much more mentally draining to do a week of work without any medication than if I were just to take what the doctor recommends. YMMV obviously, I just wanted to suggest something for people like me who have been 'proudly' living with ADHD un-medicated.

disiplus3• 6 years ago

what do you take now. im also an adult with adhd, i did take ritalin before but concerta is the only thing available to me right now. i dont think its especially effective to me, but i take only 36mg per day. and its better then not taking anything.

_dibly9• 6 years ago

I take 30-MG Adderall XRs, my brothers both take IR before classes since they have more downtime, but I work from home so most days I wake up and work until 4-5PM at my desk. Also worth mentioning that we all take the doctor recommended dosages, I worked my way up from 10MG doses and I absolutely do not recommend self-medicating in any way.

anonymoushn• 6 years ago

That's just ritalin. If you think it would be more effective to take a straight dose of 10mg than to use the time release mechanism, I think you could achieve this by getting the drug out of the pills you already have.

I am also using concerta because it is the only form of ritalin legal in my country. I don't really notice a difference compared to taking ritalin the other way.

dx873• 6 years ago

Yeah, the stigma against the medication, and the people who casually say "omg, I'm like, so ADD" really hurt the people who have actually been diagnosed with it. Depending on where you live, it can be difficult to find a psychiatrist willing to see you for a diagnoses and subsequent prescription because they think that you're a college kid wanting to abuse it or sell it. I had to call 4-5 different offices until I found a psychiatrist that would see me, and you can check the /r/ADHD and see a bunch of stories about people who moved to a different state for work, but nobody will prescribe them their medication in their new state, and now they're struggling at their new job.

whimsicalism7• 6 years ago

From my perspective, the thing that has hurt the credibility around ADHD diagnoses is the pretty blatant use by affluent parents to get diagnoses so they can get test-time extensions for their kids.

ADHD diagnosis is much more strongly correlated with affluence than many other mental illnesses.

Eliminating the 504 accommodation would be beneficial in my view.

treeman7912• 6 years ago

Took adderal for year.

Completely life changing. My focus and energy level were on par with a normal persons.

Unfortunately it was far too hard on the body. Started stroking out on it. Plus it interacted with almost every Medicane I’ve been prescribed.

Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from that. Gave it up after a few weeks.

Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.

Kids have it strong. Wife wants them on meds, but weird reactions run in family so I’m highly reluctant.

cpuguy83• 6 years ago

Having gone through this with my fam, given that you seem to have reactions to every med, have you considered it may be autism or aspurgers? ADHD and autism are often seen together, and reactions to other meds also seems to be fairly common. I just wanted to throw that out there because this realization that it's not just ADHD, not just anxiety, etc has changed our life dramatically... and there are meds that can help with this (on top of some dietary changes).

Anyway, good luck!

_dibly9• 6 years ago

I'm not a parent, so I don't really have any grounds to argue how someone should raise their children. The only anecdote I'll add is that I would be reluctant to hold someone back from an opportunity to have the normalcy that I couldn't have in school. When I got to high school it was like my ADHD kicked into full gear, I started performing significantly worse and outright failing classes. My classmates, friends, and even teachers treated me like a lazy burnout.

Out of 120 students, I was the only one who didn't graduate that year. Sometimes I feel like I have the world's worst case of impostor syndrome because of how high school went for me. I was constantly testing top of the class but most everyone looked at me like an abject failure. I went into college with practically zero note-taking or studying skills and the first couple of years were a nightmare, even with medication.

All this is to say that medication can help when you need to feel normal, but it can't replace the skills you should have been developing. Some people can develop those skills and get shit done without medication and I applaud them, but I tried that route and ended up _years_ behind my peers.

andybak• 6 years ago

Started stroking out on it

I've never heard this particular phrase before and I can only guess it's meaning vaguely from the context.

What does it mean?

acbart• 6 years ago

It sounds like you've had too many bad reactions to want to keep trying, but did you try Concerta/Ritalin? That's what I was on when I was younger, and it seemed effective. I'm on Vyvanse now.

The only major side effect that's a problem for me is the utter loss of appetite. Frustratingly, it's not that I'm not hungry, I just don't want food. So my stomach will start hurting and I force myself to eat, but it's a challenge. Plus earlier this year I had to give up sugar to account for prediabetes, every day is a struggle to make myself get enough calories. Still, the ability to stay focused on a task for 15 minutes, or even just process my students' sentences, is worth it.

burtonator2• 6 years ago

They're your kids so it's your decision but might I suggest trying a low dose of Adderall or other medication and ramp up over time?

ADD was REALLY hard on me when I was a kid. I had a difficulty making friends. I got really bad grades in school. Got in fights. Made me depressed and I thought something was broken with me.

You can start with 5mg and then ramp up from there. I'm on 15mg. I can't really feel 5m and 20mg is far too much.

At lower doses they won't really have any side effects and then you can keep them on for 90-120 days to see how they tolerate it.

salawat• 6 years ago

So, heres a lifer's perspective, if it helps.

If they aspire to aviator,stay away. If you really, really worry about locking them into somewhere with access to a Schedule II, then consider not doing it, but I can't overstate how effective and life changing the right treatment regimen is. For me it was like life going from black and white to full color. It can be a bit depressing 20-39 years down the line, and I'm considering getting something started with a Congress person to dial back some of the draconian controls if at all possible, because, not going to lie, it is disruptive as all hell to the lengths things have been allowed to achieve

I've seen other parents with kids who clearly have it do nothing, and the Kids are the ones who really suffer because they don't have a clue what is "wrong".

I kick the wall I'm physiologically disincluded from aviating, but I wouldn't trade all the life experiences I've been able to navigate because of the medication for that, and there's nothing that says the world has to remain so unfriendly to Adderall/ADHD med takers as well.

The Hypertension can be a problem, but a small maintenance dose of a blood pressure meds (or Hawthorne!) Tends to do the trick for me, but work with your doctor.

cik2e2• 6 years ago

There are supplements, backed by research, that practically remove all of the negative side effects of adderall. To start with, the sadness you felt on vyvanse sounds like dopamine depletion. You want to be taking l-tyrosine to make sure there’s plenty of fuel for the amphetamine to work with. ALCAR + ALA counteract the psychomotor agitation and tolerance formation. Magnesium + zinc help with muscle cramping. Selenium is neuroprotective. And of course you want to make sure you’re getting enough electrolytes (sodium + potassium) and balancing your intake, as a general rule for life, but especially if you take stimulants.

With the aforementioned supplement stack I’ve been able to go off doses as high as 60 mg of adderall per day without any significant withdrawal symptoms. It’s been a complete game changer in terms of making this medication a sustainable option for me. I will say as a caveat that things which reduce drug tolerance formation also typically attenuate some of the effects. In my case, ALCAR + ALA basically erase the potential for euphoria but don’t seem to diminish the mental benefits.

Zenbit_UX3• 6 years ago

You can get a genetic test to see which adhd medication works best with your DNA and is least likely to give undesirable side effects.

winter_blue3• 6 years ago

Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from that. Gave it up after a few weeks.

Omg, I actually experience this very thing for myself. I thought I was unique in experiencing the "deepest most profound sadness imaginable" from Vyvanse. It's good to know it wasn't just me.

I did eventually connect the dots with Vyvanse, after taking it a bunch of times. I did several "test runs" where I took it some days, and not other days, and the deep sadness always and consistently occurred about 3-4 hours after taking Vyvanse.

Thankfully, Adderall doesn't have this horrible side effect.

Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.

I've read that exercise can go a long way in mitigating ADHD. I'm trying to now motivate myself to exercise -- which if I'm able to do would essentially solve the problem ADHD (at least partially), and create a positive feedback loop that could improve my life for the better in the long run.

PragmaticPulp7• 6 years ago

I've always been one to 'just deal with it' but after a few years of working through school and seeing my younger brothers go through the same thing with medication, I realized that I was essentially just handicapping myself.

That's not entirely true, though. There is a lot of value in learning good habits to cope with ADHD and developing systems and mental models to improve your ADHD situation. ADHD isn't a purely dopaminergic "chemical imbalance" in the brain that can only be improved with chemical solutions, similar to how depression isn't entirely a chemical imbalance of serotonin.

One of the downsides of aggressive ADHD medication treatment is that it can handicap learning of good habits and coping strategies. Some, thought not all, patients quickly learn to rely on the stimulant effect of their medication to get anything done, assuming that medication is the only way to improve. This becomes a problem as the motivating effects of stimulant medication wear off after months or years, leaving only the concentration-enhancing side effects. Internet forums are full of 20-something ADHD patients who think the only way to address their ADHD is ever increasing doses of stimulants, but eventually they hit prescribing limits and increasing side effects. The solution is to approach ADHD as a combined treatment with minimal medication and heavy emphasis on self-discipline and healthy habits.

Regarding this study: Don't forget that ADHD medications aren't simply dopamine dispensers. All of the stimulant ADHD medications have significant norepinephrine activity, as well. There are many reasons why pure dopamine agonists aren't effective for ADHD.

I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.

In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.

Many people take stimulant treatment for years or decades, but the unfortunate reality is that the long-term effectiveness of stimulants isn't exactly a sure thing. Clinical trials and studies rarely run for more than a few months. The studies on long-term patients are mixed, but not encourage for long-term effectiveness of stimulants ( https://pubmed.ncbi.nlm.nih.gov/11322742/ ). If you only recently started taking stimulants, you might be in somewhat of a "honeymoon phase" where the core effects are still strong. Note that after years of use, people will tend to overestimate the effects of the drug due to the severity of withdrawal symptoms on days off.

In short, I'd encourage you to continue addressing your ADHD symptoms with ever-improving self discipline, personal habits, and healthy lifestyle choices. The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.

pen2l3• 6 years ago

In short, I'd encourage you to continue addressing your ADHD symptoms with ever-improving self discipline, personal habits, and healthy lifestyle choices. The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.

No, no, no, no. As someone who suffered remarkable mental turmoil over my inability to focus, despite reading books about it, asking everyone for help with my problems, just no, I hate this kind of puritanical thinking, it's exactly this kind of thinking which adds to the stigma of ADHD medication. The very first _day_ I took the medication I knew I'd stumbled upon something monumental. And then I realized that all those years of struggle in school and college, they were all for naught.

The only right answer is: see a psychologist if you think you have a problem, and get medicated if you and your psychologist feels you do have a problem.

In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.

Nope. It just shit on my self-esteem and resulted in depression because I thought I was just not cut out for the things I wanted to be able to do.

_dibly9• 6 years ago

One of the downsides of aggressive ADHD medication treatment is that it can handicap learning of good habits and coping strategies

I mean, my entire post was actually saying the opposite. One of the biggest downsides of having ADHD is the way it handicaps learning of good habits and life skills. I tried doing exactly what you describe in high school and the result was constantly failing to do extracurricular work and being branded as lazy by my peers and educators. There are a lot of comments in this thread on both sides of the argument that seem to take personal anecdote too far. My honest advice continues to be that medication is a great tool for those who need it, and therapy is something pretty much everyone should experience.

burtonator2• 6 years ago

I've been on Adderall for 5 years ... I'm 43 right now.

It really HAS changed my life. What I've found is that over the long term you're able to perform much much better.

By the time I was in my 30s I had developed coping skills which worked for the most part but I would find myself getting demotivated and defocused sometimes on long term priorities and sometimes unable to recommit to them.

Adderall totally changed that. I'm able to focus on tasks long term AND even if something bad happens in my life I'm able to keep right on track.

It's also helped me stay more positive knowing that projects get completed and there's nothing preventing me from accomplishing what I want to accomplish.

There are some downsides though:

- Adderall is illegal in most countries so you're not even allowed to travel with it in some places. I didn't really know this at first and I wish they would tell you. Most countries will overlook it but if you're China they could totally use it as an excuse to harass you if they wanted.

- It's very addictive. If I forget my meds it's basically impossible to function.

- It's VERY hard to get since it's a controlled substance. I'm only able to get it 72 hours ahead of time and if they're out of stock sometimes I have to wait. DO NOT wait until the last minute. Get it as early as possible.

- Some people have problems with off brands of XR (extended release) that has a different formulation. There's no standardization on the XR process and I think it's vendor specific.

dr_dshiv2• 6 years ago

You know what's totally nuts? Taking Amphetamine daily for years in reasonable doses essentially has no long term negative effects. In that way, similar to coffee.

When I think about that, it's kind of mind blowing.

For that matter, it is also crazy that we don't start giving children coffee at younger ages to help focus — since there are no known negative effects. It's just a cultural trope that it stunts growth, etc. It took ages before people recognized that there weren't really health downsides to coffee. We are so trained to expect that "every up has a down" — but what if that's just a relic of Calvinism and we are inhibiting our full potential because of misplaced fears?

bg4• 6 years ago

I started taking it in my late 30s for ADD and it was life changing. Over time though it was making me super angry so I stopped taking it. I now focus on sleep and exercise but my career really accelerated while I was taking it.

n4gN1• 6 years ago

Do you take the XR version or do you take regular adderall? I've taken regular adderall on and off for the last 10 years. It helped me so much in the past but I started to feel very fatigued by it. These days I have an extremely difficult time focusing and have been contemplating going back on it.

skissane2• 6 years ago

Some people have problems with off brands of XR (extended release) that has a different formulation. There's no standardization on the XR process and I think it's vendor specific.

“Aderall” is a mixture of dextroamphetamine and levoamphetamine, in a 3:1 ratio. Unlike some other drugs, both enantiomers have a therapeutic effect, but slightly different effects on the brain.

If one takes pure dextroamphetamine (“Dexedrine”) instead, that is also available as an inactive prodrug lisdexamfetamine (“Vyvanse”). This is different from an XR formulation, in that the drug is absorbed immediately, but lisdexamfetamine itself has no effect on the brain. However, enzymes in your red blood cells gradually convert the lisdexamfetamine to dexamphetamine. The advantage of this, is unlike an XR formulation, there should be no difference between different manufacturers.

Baeocystin8• 6 years ago

I literally just got diagnosed with adult ADD a month ago. I'm 46! It... explains a lot of things, both for better and for worse. I never even realized I was developing coping skills vs. just developing normal skills, if that makes sense. I definitely have had the same types of problems as you describe.

I've been on Ritalin for a few weeks now, and the difference is remarkable. If this is how normal people feel most of the time, I don't know... I am both relieved to have a name for what was causing me problems, and also feel the need to grieve lost opportunities in life. It's a complex mix of emotions.

nullsense12• 6 years ago

Adderall totally changed that. I'm able to focus on tasks long term AND even if something bad happens in my life I'm able to keep right on track

That sounds amazing. I can't even imagine that. I've just been diagnosed at 32 this year. Been on Ritalin for a few months but it doesn't seem to make a difference. Maybe 3% better. Things going bad still derails me significantly.

They're fairly conservative with meds in my neck of the woods, but I'm going to persist with my doctor to try them all to find what works.

The struggle to push through actually going through all the phone calls, emails and appointments necessary to get to that point is very un-ADHD friendly. So many times I considered just to give up and forget about it.

aidenn04• 6 years ago

Which "more modern" medication are you on, out of curiosity?

Ritalin causes side effects for me as soon as I start to hit the therapeutic dose when titrating.

Adderall is terrible for me.

My youngest daughter is undoubtedly ADHD, and the insurance company requires you to try the first two before they will approve a third...

topicseed• 6 years ago

Not OP, but I believe some people with ADHD seem to be helped with Modafinil (Provigil). It is normally used for severe lethargy and narcolepsy but has been working for ADHD, too.

WhiteNoiz3• 6 years ago

We are trying out various ADHD meds for my son and every one is like a deal with the devil - it helps with some things, but leaves him twice as wired when it wears off, or makes him sleepy or keeps him awake at night. I hope in the future we can get more targetted treatments without so many side effects.

haneefmubarak• 6 years ago

What's a more modern medicine in this context?

__blockcipher__2• 6 years ago

I would guess Vyvanse, it’s dextroamphetamine bound to a lysine molecule. Your liver must cleave the lysine before the d-amp is released giving a smooth release, taking ~3.5 hours till you hit max blood concentration.

Fun fact: Methamphetamine naturally takes 3-3.5 hours to hit peak so Vyvanse has a more “meth-like” concentration curve as opposed to raw d-amp (or adderal which is 75% d-amp 25% l-amp) which hits way sooner. As an aside, Meth is very misunderstood and is in many ways a more ideal ADHD drug than normal amphetamine; and indeed it can be prescribed under the brand name Desoxyn. Methamphetamine when taken in low-moderate oral doses is completey safe and less jittery than amphetamine, but if abused (say, smoking 100mg d-meth) it becomes far more neurotoxic.

Understanding enantiomers (left-handed vs right-handed molecules in this case) is really important. For amp / methamp, the d enantiomer is 3-4x more powerful by weight yet is more cerebral as opposed to causing peripheral (body) stimulation. So d is almost always superior, although with adderall it has been found that the 75/25 d/l formula synergizes and has a bit longer half life

Forgeties79• 6 years ago

Man are you me?

After college I finally got diagnosed again after being off medication for 8 or so years. Grew up first doing Ritalin->adderall->concerta->no meds. I realized how needlessly difficult I made college for myself.

jFriedensreich• 6 years ago

Could you let us know what more modern medication you are using? I have serious problems with Ritalin side effects but am not aware of any alternatives besides adderall, vyvanse or riatlin like products.

aantix2• 6 years ago

Curious if you've ever done a hair follicle mineral test to check for mineral deficiencies?

We've been working through the book, "Finally Focused", to help our son. Magnesium supplementation is recommendation #1, Iron supplementation (if deficient as demonstrated by the test) and then the over-the-counter, lithium orotate. We haven't gotten further than chapter 3, yet.

costcopizza• 6 years ago

I like this idea. Do you have a source for a company that will do this? Or does it require a doctors office visit?

Izkata• 6 years ago

When I was younger I was perscribed ritalin, and it just made me sleepy so I stopped taking it. Now I take a more modern medication and it works wonders.

I don't have ADHD, but I'm curious what the modern one is.

Back in middle school, around 2001, I did a report on ADD and ADHD, and 3 of the medications that existed for it: Ritalin, Cylert, and I'm not certain of the third but from the other comments Adderall sounds like it could be it (though I think it started with a "D", is there one that does?). The only thing I remember from it is the conclusion that if I got diagnosed and needed medication, I'd refuse Ritalin, and that Cylert seemed like the best of the three.

emptysongglass4• 6 years ago

The more modern medication for me was modafinil but I had to beg for it. My psychiatrist made me go through the stringer of usual suspects before she allowed me moda: first adderall, then ritalin, then straterra (this one actually gave me acute psychopathy and constantly leak semen). All three caused profound personality shifts.

Moda doesn't touch my affect and it's wonderful.

stallmanite• 6 years ago

The substance starting with a D was probably Dextroamphetamine. It’s the old standard and has been around forever. It’s basically Adderall with just the R isomer rather than a mixture of Levo & Dextro isomers.

anonybadger• 6 years ago

Curious - what’s the more modern medication that you take! Thanks.

cgb223• 6 years ago

As someone with ADHD I was once prescribed the lowest dose of adderall (5 mg?) and I found it was so much like being high it genuinely scared me

I was working from home and the second it kicked in I started getting literal chills down my spine.

I ended up messaging a bunch of people on Facebook I haven’t talked to in years but felt a sudden affinity and empathy for.

I got distracted by a part of my apartment that I hadn’t cleaned in a while and missed a meeting because I ended up cleaning the whole place, including weird things like dusting the sides of books.

When I finally got to coding, it was like I was in the matrix. Hyper focused (and fwiw getting a lot done) but in a weird euphoric high feeling way.

I guess what I’m asking is is that how everyone feels the first time they take it?

And how long does it take to just feel normal on it, but like able to focus?

I want to try it again, because I need help focusing and know I can do better, but I’m genuinely afraid of the person I was on that stuff.

steve_adams_862• 6 years ago

Very similar experience with Dexedrine here, but that wore off after a week or so. I would indiscriminately DO things, like a ride in lawn mower ghost riding into an overgrown field with a full tank of gas. Was I productive? In a sense. Was I effective? Not as much.

I use it occasionally still but with no euphoric, overwhelming empathy or boundless energy to mow the metaphorical fields. It helps me push through brain fog when things just need to be done.

I haven’t managed to get past the tooth grinding. I barely feel that I’m on it now, but every single time... I grind my teeth. Even if I feel perfectly relaxed otherwise.

WarOnPrivacy3• 6 years ago

I had some initial freakout when some bad patterns started reemerging. It took time to learn how to accept & adapt to the changed mindset.

I eventually learned to redirect myself - which Adderall enabled me to do. The first step was qualifying my own good and bad behaviors.

It took time to deepen the reward association with beneficial behaviors. That helped me redirect away from counterproductive behaviors - not just revived behaviors but also the persistent ones. Making progress on those was huge.

During this process, the messy, euphoric edges smoothed themselves out. I never had to address it directly.

About 6 months in I came to the conclusion that I really would have benefited from a therapeutic guide, someone who was familiar with this specific experience. I'm not sure there is anyone like that out there.

kickbutt22• 6 years ago

I used Adderall everyday for a year, and I would generally recommend people stay away from it if they can unless you have extreme ADD/ADHD. I know that a lot of people are saying that it changed their lives and in fact, it helped me to understand how far I could push my mind and body to its productivity limits, which helps me be productive today. However, as mentioned in some of the other comments, it makes you angry and I have lost many friends and closed many doors socially. I also would not say that I was actually more purposeful in my daily activities. Meaning, I may have been able to produce more mental and physical output but like you mention, I would fixate on lots of unnecessary things that ultimately put me behind in what I wanted to accomplish over the course of a year or even who I wanted to be as a person.

seattledev3• 6 years ago

This is very normal for first time usage. It's described as euphoria. I believe it goes away with sustained use for most people. It did for me, and I was sort of sad that it did - it was the happiest months of my life. Even now after not having used adderall for years I still don't get that initial euphoria feeling when I randomly take one again.

paufernandez• 6 years ago

What do you take now? My kid is still doing mostly fine 'just dealing with it' (10yo) but I want to be ready.

logicOnly• 6 years ago

Wondering if this is why marijuana makes me insanely productive. Both impact dopamine.

It just sucks that I get addicted to weed because I'm super productive.

I just need a way to prevent myself from having marijuana before anything social or public.

PragmaticPulp7• 6 years ago

Dopamine isn’t a simple 1-dimensional axis that moves up or down with drug use. There are many different pathways that use dopamine as their signaling molecule. Some dopamine receptors are involved in recording positive events, while other dopamine pathways record negative events.

The role of dopamine as an answer to all things reward or motivation is greatly exaggerate in the pop-neuroscience articles online. Doing nearly anything goal-oriented or even remotely rewarding is associated with dopaminergic activity.

People also tend to overlook the fact that the stimulants used in ADHD treatment also have significant norepinephrine activity which contributes to their pharmacological effects. Purely dopaminergic drugs often aren’t as energizing as you’d expect. In fact, selective dopamine agonist medications can induce narcolepsy-like symptoms where patients struggle to stay awake due to the complex nature of dopamine activity in the brain.

In your case, it’s possible that you’re naturally motivated but THC is causing disinhibition to override whatever is preventing you from being productive (anxiety). THC is also known for making boring tasks feel interesting, but it’s also known for decreasing motivation and making people feel like they’re accomplishing a lot more than they really are. In other words, it’s not a solution to anything. You’d be well served to spend some time exploring this with a psychiatrist or two.

iamdbtoo• 6 years ago

As someone who has ADHD and is also a heavy marijuana user, I've found the marijuana mostly helps me with the frustration of the ADHD experience. It makes it difficult for the frustration to reach a boiling point and that's what actually makes me productive. Adderall has been WAY more effective at this, though.

narwally• 6 years ago

Similar experience for me. Marijuana definitely makes me feel stupider, but it slows my brain down enough that I can actually focus on one thing at a time so I actually end up more productive overall. Kind of a worse is better situation. I've found the best combination for me to be XR Adderall with a very low dose of THC. Unfortunately my addictive personality makes not abusing marijuana difficult, so I just don't use it these days.

kick_in_the_dor2• 6 years ago

I'm also wondering the same thing - I take 2.5mg of a sativa-dominant edible and I'm able to focus insanely well. I typically do this after I'm done with my real job for the day so I can study AI, for example to read an AI paper. I typically have much more trouble doing this without THC.

Funny enough, I'm also very prone to anxiety on THC. So there might be a correlation there somewhere.

montyminds12• 6 years ago

Thank you for the interesting read...

leroy_masochist• 6 years ago

Dynamic scans were started immediately after injection of 4-10 mCi of [11C]raclopride (specific activity 0.5-1.5 Ci/μM at end of bombardment) and after injection of 4-8 mCi of [11C]cocaine (specific activity > 0. 53 Ci/μmol at end of bombardment) and were obtained for a total of 60 minutes as described (12)

They injected humans with cocaine for this study, am I reading that right?

slaymaker1907• 6 years ago

Cocaine and meth are actually schedule 2 drugs unlike marijuana. It is surprising that they used Cocaine instead of a more common stimulant like Adderall or something.

boxfire• 6 years ago

Does anyone else think the NIH online reader is a disastrous UI for mobile? I mean yes there is a PDF link at the top, please don't point out the obvious. I just mean who the heck checked the box to accept this work, or worse yet demanded this horrible pagination interface? I'm sure that they've been promoted to the highest levels in this fail-up world...

sjy• 6 years ago

Yes, and the same applies to virtually all other research databases. I’d forgotten this until you mentioned it because I’ve become so habituated to going direct to PDF.

aidenn04• 6 years ago

children with ADHD require stronger incentives to modify their behavior than those without ADHD5; they also show a failure to delay gratification, have impaired responses to partial schedules of reinforcement, and preference for small immediate rewards over larger delayed rewards6,7.

I'm an adult with ADHD and that paragraph describes me to a T, though it definitely was worse as a child

I got my first D grade in a subject in fifth grade, and the next seven years were basically my parents trying every tool at their disposal to motivate me to get better grades.

I was on academic probation four more terms than I wasn't in college, and graduated with a low C average after 5.5 years, plus two summer terms.

I got hired at the only company that forgot to ask for my GPA.

I think if I were just sightly less intelligent, I would have been in a world of hurt and possibly dead by now.

steve_adams_862• 6 years ago

Likewise, there is a fine line between my personality and the kind that tends to end up in poverty or dead where I live. I feel like I’m constantly barely clinging to whatever i remains about me that allows me to thrive at all. I don’t act to my best judgement most of the time.

baybal2• 6 years ago

And this is how you burn out from work.

If you don't stop to reward yourself for what you do, you will loose interest no matter what.

You cannot trick your own brain.

sergiomattei2• 6 years ago

I recently started atomoxetine for my ADHD and had to completely stop it. Side effects were killing me.

After I stopped, I was more hyperactive and less focused... Yet the hyperactivity compensated for the "less focused" part, and I finished a week's work in a day.

That's my experience with meds so far. They completely eliminate my anxiety and make me feel in control of my emotions. Yet they make me less productive than when I'm in a hyperactive rush (even if my focus is reduced).

So for now I'm just going to embrace my inconsistency (in terms of emotions, energy, and focus) because I think I'm way worse without it. Establishing a routine helps me cope much better - I feel waking up early and having a good morning dictates how productive my day will be.

On meds, I finally felt in control of my life and energy. But it also felt bland, boring. I didn't feel anything. I had no anxiety to push me to go the extra mile. My personality & cheeriness were nonexistent. And I was, overall, simply less productive.

Not doing that again.

Zenbit_UX3• 6 years ago

I said this somewhere else in the thread already but it sound like it could help you, get a genetic compatibility test for adhd meds, my doctor gave me a referral for one and it gave clear recommendations on which medications would likely be fine and which would have chances of negative side effects. Even without the referral I'm sure you can get a test like this privately for reasonable price.

These medications are serious and side effects can include thoughts of suicide so I'm always shocked when doctors try to wing it and just prescribe whatever and see how it goes. I'm hoping it's because they don't know about the genetic tests yet but some are likely willfully ignorant.

sergiomattei2• 6 years ago

I'll definitely take a look. I had no idea those compatibility tests are a thing.

emptysongglass4• 6 years ago

I mentioned this elsewhere but strattera (atomoxetine) straight up gave me acute psychosis and semen leakage. It was a monstrous drug for me.

marvion2• 6 years ago

But it also felt bland, boring. I didn't feel anything

I don't have experience with atomoxetine, but other meds, and this sounds a like an symptom of over dosage. The typical "ritalin robot" is usually causes by taking to much.

Maybe you can check out other meds. I experienced the "blend robot" situation a few times with Medikinet and learned that Methylphenidate is very sensitive to food intake and PH in the stomach, which can make the effect less predictable. I switched to Lisdexamfetamin - it's less dependent on food and works better for me.

fajarsiddiqfs• 6 years ago

I hope you get better in time. Side effects is really bad

scns5• 6 years ago

I recommend this book to anyone suffering from ADD. The author did over 80.000 brainscans.

not affiliated

https://www.amazon.com/Healing-ADD-Revised-Breakthrough-Prog...

A 80 minute video about ADD by the author: https://www.youtube.com/watch?v=UWnJ4wjVu9k

Techbrunch• 6 years ago

FYI before you watch an 80 minute video (which I did):

"Amen has built a profitable business around the use of SPECT (single photon emission computed tomography) imaging for purported diagnostic purposes.[6] His marketing of SPECT scans and much of what he says about the brain and health in his books, media appearances, and marketing of his clinics has been condemned by scientists and doctors as lacking scientific validity and as being unethical, especially since the way SPECT is used in his clinics exposes people to harmful radiation with no clear benefit."

Source: https://en.wikipedia.org/wiki/Daniel_Amen

Hamlet42• 6 years ago

Thanks for saving my time.

scns5• 6 years ago

As a european, it is sad to see, that the health system in the US is geared towards profit.

I wonder what the parents of one of his youngest patients (below ten IIRC) would say to those scientists and doctors about "no clear benefits". Their son showed abnormal behaviour, drawing notebooks full of pictures of him killing his classmates. The brainscan revealed a huge brain tumor. Amen had to call several brain surgeons, till he found one who was willing to operate the child. After the removal of the tumor his behaviour normalised.

friendlybus2• 6 years ago

Too much of this is religion dressed up. People paying for miraculous salvation. Martin Luther would have something to say here.

scns5• 6 years ago

There is nothing miraculous about scanning the brain, and looking whats going wrong, it's a science based process.

smw• 6 years ago

Might be worth reading his Wikipedia page[1] for some criticism before taking his work too seriously.

[1] https://en.wikipedia.org/wiki/Daniel_Amen

scns5• 6 years ago

to make it DRY

https://news.ycombinator.com/item?id=24676962

Hewlberno2• 6 years ago

I have adhd myself, and I built a NLP tool around working out how well medication is working for me. I'm launching the mvp of it in the next few days if anyone is keen! https://moodmap.app

ravedave5• 6 years ago

I tried to get emailed for when it opens and it sent me to a sign up page. The sign up page didn't do anything. No console errors.

Hewlberno2• 6 years ago

Thanks will check it out!

LocalH• 6 years ago

I’ve had more help with my ADHD symptoms from a series of DMT experiences, than I ever did from the mainstream treatment process. One single DMT experience (containing about an objective hour of intensely being dragged through time) greatly minimized my ADHD symptoms for at least six months. There is untapped potential in psychedelics for treatment of things like this. It’s a crime against humanity that we allowed neurotypicals to decide for everyone how these neurochemistries are managed.

ADHD treatment is not ADHD friendly. Society is not ADHD friendly. Neurotypicals literally have the same scale of mental privilege as whites do in a racial context.

kinakomochidayo• 6 years ago

I agree with this. I also had significant success by permanently alleviating the major symptoms of ADHD (like bumping into walls, not cleaning room, not being able to pay bills on time) with 1 trip of LSD about 8 years ago. I don't even drink coffee, and I'm getting by with the occasional bouts of anxiety which I can deal with separately. I also occasionally do Ayahuasca for trauma/childhood healing work - which I suspect many people with ADHD have.

I found it weird that people can get banned for talking about their anecdotal experiences with psychedelics on the ADHD subreddit too. Seems like some people are more comfortable being with the ADHD community and sticking with the status quo regimens, than actually doing something completely new.

nullsense12• 6 years ago

I think it's cos that community is a very wide range of people, some of which are very young. It's not like HN where we are all older and generally a crowd who really likes to tackle problems from an intellectual angle and try things out to get the data on them. That subreddit kinda has to stick to the lowest common denominator which is just following the standard advice.

Very interesting to hear of your experiences in this thread though. Maybe we need an r/ADHND for all us ADHDers on HN :P

sizzle8• 6 years ago

"Neurotypicals literally have the same scale of mental privilege as whites do in a racial context."

Wow this is profound to say the least, thanks for making this connection I've intuitively felt but could not articulate the impact of my ADHD and potential to succeed in life starting from an early age.

M0T0K02• 6 years ago

I'm eternally annoyed that nobody on this page mentions the Racetams (Aniracetam, Piracatam, etc.) as potential alternatives to dosing speed everyday. I myself began to have heart issues from even just Ritalin (mild perhaps compared to Addy or Vyvanse).

Fasoracetam in particular looks promising but seems to be stuck in approval limbo:

https://nootro.info/fasoracetam-adhd-treatment/

jdc• 6 years ago

Cf. phenylpiracetam - developed for the Soviet cosmonauts in '83

https://en.wikipedia.org/wiki/Phenylpiracetam

M0T0K02• 6 years ago

Indeed thank you, but no follow-ups or recent developments in other 'Racetams it seems. Modafinil is the only one that comes to mind that is atypical but has made strides in being a prescribed alternative.

ergwwrt• 6 years ago

Michael Phelps. ADHD. 28 Olympic Medals. That is all you have to know about ADHA..

emit_time3• 6 years ago

Bill Gates. Random condition. $100 billion dollars. That’s all you need to know about random condition.

Terrible analogy.

If you can design your life to be benefited by ADHD, that’s awesome.

If you’re stuck working a 9-5 like a large portion of the population ADHD sucks.

stevefan1999• 6 years ago

I'm an ADD adult and this especially hits me when I'm participating competitions, be it leetcode coding competition or examination. I just hate to do it and every other bits of attention source will got me seeked on, like a notification from my phone, or someone dropped a pen to the ground.

That's how fast I lost focus. But on the other hand sometimes I can be extra-focused, with a prerequisite it's something I enjoyed -- where I truly focus on one single task nonstop, like I finally got the ebb and flow in a tranced out state. This resulted me in one case coding straight for 7 hours. It's not until my body started to crave for food or I don't know how long will this loose cannon shoot.

ADD is both a blessing and a curse to me. This is how I accquired coding and various IT skills since 13, all self-taught. But this also fucked me over exams, and my so life experience is greatly impacted. I also tried to play rhythm games to control focus, only to see it ultimately failed. The only thing I had to deal with it slightly is my Ritalin...only so slightly I can "normally" focus for an hour. I just hope things go right in the rest of my life.

GABeech• 6 years ago

The only thing I had to deal with it slightly is my Ritalin...only so slightly I can "normally" focus for an hour. I just hope things go right in the rest of my life.

Talk to your doctor, there have been many advances in ADHD meds and they all work differently on different people. Some people respond well to Ritalin, Some respond well to the generic. Some respond well the Adderal, or Vyvanse. For some people only the name brand formulation works. Some people any formulation works. Also, make sure you are at the right dosage. You can and do build up a tolerance over time. I try to take weekends off when I don't have anything in particular I need to do, and at least one or two weeks a year (normally when I go on vacation).

fnord77• 6 years ago

there have been many advances in ADHD meds

respectfully, I disagree with this. The last new therapy was atomoxetine, which is almost 20 years old now and not seen as terribly efficacious.

Everything else new has been some variation on mixed dextroamphetamine/amphetamine salts or methylphenidate. Vyvanse is just a pro-drug for dextroamphetamine.

The only novel thing in the pipeline is SPN-812, which may work similar to atomoxetine.

AuryGlenz5• 6 years ago

Speaking of tolerance, I really wish there was an “antidote” that could be taken at night. It would encourage better sleep and I would think would help fight tolerance a ton.

I take stimulants for idiopathic hypersomnia and I know things are a bit different for ADD folks, though.

jv22222• 6 years ago

Has ADD had any kind of effect on your relationships? If so, in what way? I was wondering if ADD might make it seem like one doesn’t care about people because it’s hard to maintain focus on them.

thrav• 6 years ago

It absolutely does and is extremely challenging for a particular type of partner. There are many books on the subject.

Most ADHD people are also susceptible to RSD (Rejection Sensitive Dysphoria(?)) that can make us feel like the entire planet is crumbling when we experience even minor rejections. As in, suicidal ideation level pain that at some point we have to learn how to move through or just avoid relationships altogether.

gavinray6• 6 years ago

Yes, this is why I stopped filling my prescription two years ago. I excelled at work but it was damaging my relationship due to being so "zoned in" and at times robotic.

nullsense12• 6 years ago

Its very hard on relationships.

It's not just seeming like you don't care, but also putting the burden on others when they pick up your slack and frequently letting them down by things you do and/or don't do.

heimatau6• 6 years ago

I'm in the same boat as you. As I've aged, I've realized it's necessary for me to have medication for me to be productive for an extended period of time.

I encourage you to embrace the chemical imbalance as the reason. The medications do work and withdrawing from them isn't bad either (if you decide to take a pill holiday or extended non-use).

Finally, it's not about 'normal' focus. It's about you. If you're content with your productivity and behavior, then nothing is needed to change in your life. If you want to maximize your potential, then please consider medication. It doesn't go away (CBT never worked for me). Embrace your choice. Whatever you decide, is normal, it's your normal. That's perfectly acceptable.

sibeliuss• 6 years ago

withdrawing from them isn't bad either

Perhaps for you, but for others its a nightmare.

titanomachy• 6 years ago

I agree with the "blessing and curse" characterization. I owe my career to thousands of hours spent hyperfocused on learning programming languages for fun while I was supposed to be doing homework. On the other hand, I've come close to losing my job because of difficulty carrying out assigned tasks that don't matter to me.

Interesting contrast though: for me leetcode, certain exams, and interviews often trigger hyperfocus. Studying and assignments, as well as day-to-day work, rarely do. I take a fair bit of medication so I can do my job. I'm trying to pivot towards something which more naturally engages my interest, maybe SRE or security work.

Interesting how we're all affected differently. I recommend skimming "delivered from distraction" if you haven't already, there are some good tips in there on how ADHD folks can deliberately create the right conditions for flow.

christopher22• 6 years ago

I’m ADD and I don’t think it’s a disorder, but a trait that was selected for. I think it’s an explorers gene.

It’s just difficult for us to fit in to the system. Not only school, but a traditional 9-5 for me is difficult. Especially while not on medication.

dragonsngoblins• 6 years ago

I worry that for me the regularity of the 9 to 5 is the problem, rather than what it is I'm doing from 9 to 5. I'm not sure if that is definitely the case, but I feel like I'd be so much better off if I could be in a situation where I worked 3 or 4 days a week, and not necessarily all in a row

bobloblaw45• 6 years ago

I also have ADD. I'm untreated since it's kinda expensive and my job is easy enough to not need to be.

I'm glad that ADD/ADHD is more accepted now because I remember when the idea some people have problems focusing was immediately dismissed as laziness or a fault in character. I didn't even consider getting tested until far into adulthood because of the stigma.

matheusmoreira• 6 years ago

Similar experience here. As a kid I couldn't manage to read a couple paragraphs on a boring subject but I could study and practice programming for 12 hours straight. Developed plenty of coping mechanisms and was only diagnosed in adulthood halfway into medical school. Every ADHD patient I've seen has a similar story of hyperattention...

I'm convinced this disorder is named after attention and hyperactivity because the children don't adapt well to school. At least not the traditional mass education model where kids sit in a class listening to lectures all day. There's probably a lot more we don't know about it. Some doctors I've seen think it's a made up illness created to sell amphetamines.

nullsense12• 6 years ago

It's named after how we annoyed our parents and teachers as kids. Such a terrible name for it.

summitsummit4• 6 years ago

This resulted me in one case coding straight for 7 hours.

This happened to me this weekend. It's truly scary in retrospect. I got a business idea thursday, and coded nonstop until Sunday. It's a rentable AI service for dating apps. I launched it and it's super neat imo, but I lost almost 8 lbs in that time because I didn't eat, drink water, and slept only when my thoughts started to blank out.

I am now focusing on rehabilitating by eating a lot and going to the gym. I got so skinny. I wasn't on any medication either.

WarOnPrivacy3• 6 years ago

My working theory is that abuse damages (and neglect stunts) the reward system and we interpret that as ADHD (as good a moniker as any).

Whereas people typically experience micro-rewards during the learning process, for people with ADHD, the reward response is too insufficient to reinforce learning. Without a proper reward system, a healthy learning system can't develop properly.

Some people firehose Will at the problem which may overcome an occasional challenge. That bandaid isn't sustainable, however.

emit_time3• 6 years ago

Biggest issue for me is palpitations on adderall. Withdrawal gives me annoying palpitations and I get them sometimes while taking it.

It’s very annoying when I want to take the weekend off and have to suffer through massive withdrawal.

Honestly has changed my life for the better overall, but if anyone has any suggestions for trying to get rid of palpitations, it would be very much appreciated.

Texasian• 6 years ago

I had the same issue.

I’ve switched to Vyvanse and have been loving it. The on and off ramps are much longer so everything feels a bit more smooth than Adderall ever did.

emit_time3• 6 years ago

I’ve tried vyvanse and Ritalin, but neither seem to work nearly as well for me :(

st1x7• 6 years ago

I'm in my late twenties and this whole discussion makes me reconsider the past 10 years of my life and think about how different my academic and early professional experience could have been if I had seen a doctor at the right time.

lawrenceyan• 6 years ago

Meditating every day has done amazing things for me in terms of bringing clarity/focus to my life. I understand, however, that my ADHD if any is likely less pronounced than others and can see the benefit that taking medication can provide.

Before I started training myself to meditate, I noticed that drinking a lot of coffee seemed to help me focus better. Though it was only really until I started meditating that I realized it was possible to direct my focus/attention in such a calculated manner. I had always resigned myself to "my attention" controlling the actions I took rather than the other way around with me actively choosing how I apply it.

smnplk2• 6 years ago

In my country you can't get diagnosed and treated for adult ADHD if you weren't diagnosed as a child. Which is a complete bullshit. One can only buy meds on a black market and hope for the best...

jkaplowitz• 6 years ago

That is bullshit, absolutely. My understanding is that the correct clinical criteria do require that the symptoms showed up by age 7, but that it's not at all necessary for the diagnosis to have occurred during childhood.

fnord123• 6 years ago

In my country

Why not just say the country?

robswc• 6 years ago

I'm curious too.

I would think that would also imply that access in other ways might be a bit "easier" as well...

smnplk2• 6 years ago

Slovenia

quake• 6 years ago

This makes a ton of sense to me. When I was a kid, just about everyone (including my parents) knew I had ADD/ADHD, but never did anything about it. Including myself. It wasn't until I lost a job because I was so easily distractable that I realized how much of a hold it had on my life. Medication helps, but really only on making it easier to pry myself from distractions.

But this study clarifies so much of my behaviour and self-image from when I was a kid to now. I bully myself fiercely, and never understood why I should be praised for high grades, when it was something expected of me. That definitely extends to now, where I can finish/deliver a product, but feel _nothing_ about it. No sense of accomplishment, no relief that something's shipped. Nothing. It stops me from taking on hobbies or really doing anything with the material that I learn. Leads to regular burnout and cycles of depression.

The article references methylphenidate as a good drug for ADHD, specifically for motivation. This makes me sad, because I'm on it, and not feeling very motivated.

Flow• 6 years ago

I was prescribed bupropion to stave off lack of energy and possibly heighten my mood. To my surprise it made me so sleepy I had to take it before bed.

For most other people it seems like they can hardly sleep while on bupropion.

I was told via forums that I might have ADD/ADHD because of this reaction.

What does HN think of this reaction?

victorkab• 6 years ago

Very interesting. Most people I've talked to with ADHD share this experience of sudden loss of motivation...

I can focus easily on tasks - even hyper focus for hours. Problems arise when there's an important but boring task vs a nonessential but interesting task. I will struggle to just think about starting the boring task. It can be really crippling when working with other people or in a startup.

I tried to write about my own experiences with ADHD, in particular regarding distractions. https://www.kabdebon.com/founder/2020/08/25/creative-mayhem-...

blackflame7000• 6 years ago

Who knew there were this many people on amphetamine. Back in the day they called that speed. Surprised all these people are admitting their Vyvanse and Adderall usage publicly.

LordFred3• 6 years ago

Hi all, just want to provide some more information on ADHD in general if people are interested.

http://russellbarkley.org/factsheets.html

The above link is a collection of PDFs summarizing key points on ADHD by Russel Barkley, generally considered by many in the ADHD community to be the 'god' of ADHD research.

brundolf2• 6 years ago

My experience as someone who (probably) has ADD and who knows lots of people who do, is that ADD people tend to be highly passionate and motivated. It's just that our motivations jump around all over the place.

For a long time my response to this tendency was to try to control, direct, pin down my motivation so that I could stick with something until it was done. Doing this caused me to actually have a real deficit of motivation, instead of just an always-changing motivation. Once I stopped trying to control it and embraced jumping-around, following my interest wherever it led me, I actually had much more success seeing tasks through to completion (and even circling back to ones I'd left behind, because I wasn't feeling guilty about having left them behind). It's like my attention is highly fragmented, but I still have the same amount.

An ADD person's motivation is like a wild animal that you just have to give room to so it can do its thing. Hitch a ride to it, instead of trying to tame it, and you'll eventually get where you want to go.

zrkrlc• 6 years ago

The assumption here is that you have a structured enough environment that you get tasks delivered on your doorstep regularly.

Having no external source of motivation is the death of us.

brundolf2• 6 years ago

Having no external source of motivation is the death of us

Not remotely true in my experience. Quite the opposite: I really struggle to be interested in motivators that are external, rather than internal.

sizzle8• 6 years ago

What I really want to know is if taking all this adderall to beat my axon terminals into submission and pump out dopamine + block re-uptake is going to cause an early onset of an Alzheimer-esque neurodegeneration when I'm approaching my senior years.

This hypothetical sends chills down by spine knowing I might be making a deal with the devil to get a temporary fix on ADHD symptoms now for increased risk of dopamine downregulation or neurodegeneration later.

Can anyone relate and/or give me some peace of mind? ~60mg/day for 12 years and not letting up anytime soon as long as I need my executive functions under my command to do computer work. If I drop the stimulants I can maybe get a low wage job doing basic IT service desk stuff or live a simple life doing a 'muscle memory' line of work e.g. Amazon factory worker, go to trade school for something hands on, etc. that doesn't require asynchronous access to my prefrontal cortex + memories + instantaneous storage/retrieval with my working memory for hours on end.

God I envy neurotypical people, I feel handicapped mentally in comparison to their baseline.

sizzle8• 6 years ago

A big middle finger to my ~top 20 public university who wouldn't give me any accommodations of extra time because they required some ridiculous hoops to jump through proving I had trouble concentrating and finishing an exam in the allotted time, they wanted substantial documentation with brain scans showing I had a deficit all because ADHD isn't considered a bonafide disability by the government. I almost flunked out cause of some calculus and organic/biochemistry classes that required tons of rote memorization (pre-med before switching to computer major).

Even though I'm successful now in tech with a huge salary, this experience of being treated like I had a made-up disorder (can't easily perceive it with no physical impairment/more obvious mental issues), and was invisible to the system full of cold-hearted academic administrators quick to academically disqualify me still makes me seethe and feel wronged to this very day.

Can anyone relate?

_dibly9• 6 years ago

I'm in community college, but my experience in high school was basically identical to yours. High school and the beginning of college were a nightmare for me for essentially the same reasons you describe. I still feel like I'm shaking off some kind of imposter syndrome when I'm interviewing for a new client. Students used to seethe when my test scores were read because, despite testing top of the class I never did any extracurricular work or engaged in class very much. Eventually even the teachers started to treat me like a burnout. I'd start a new semester and the teacher would already know who I was from chatting in the teachers' lounge. At least in community college the student/faculty pool is wide enough that I can avoid those types of interactions, plus the switch to computer science and some decent ADHD meds have made all the difference.

pontifier2• 6 years ago

I have ADHD and have noticed that I have extreme difficulty maintaining a schedule or forming habits. Almost everything I do is the result of by moment to moment decisions. I flit from project to project as needed, and have hundreds of things going on all the time.

This inability to form habits is extreme. If something's not right in front of me I forget that it exists. I've tried to start smoking, but as soon as the pack is gone I forget to buy another. I don't shower until it starts to effect me. I don't sleep until I can't keep my eyes open. I forget to eat until my stomach hurts. I truly don't believe I can become addicted to anything. I've been tempted to try crack because I've heard that everybody gets addicted to it and I might be able to use it to create artificial motivation in myself. I tried chewing nicotine gum every time I took a shower, but I just couldn't remember to do it, and it wasn't helping enough with forming habits.

I also have memory problems and basically have to re-invent everything from scratch all the time. I'm really good at solving problems so I've been able to cover up most of my failings. One story that highlights this happened when I was taking the ACT. There was one question at the end that I had to invent calculus to solve. I had a feeling that I hadn't solved a problem like it before, but I went ahead and solved it anyway and got every question on the math section correct. My verbal skills on the other hand were just barely acceptable.

Another anecdote about lack of schedule and routine also comes from my highschool time. Between classes I'd routinely forget that I had another class to go to. I'd see someone in the hall and start talking until the bell rang. In my highschool being late 3 times was equivalent to an absence, and 7 absences was an automatic fail. Needless to say I had probably the worst GPA in history. I also did very well on tests, but could never ever remember to read my book or do my homework.

Basically, a consistent theme is I'm totally worthless until I stumble into a magical sprint where I get 2 months worth of work done overnight.

I just spent from 1:30am to about 5:00am in my car with my laptop and was able to make 6 much needed git commits as well as taking care of a bunch of other issues with my main project. The last commits were the end of August with 14 commits over just a few days.

Wow, that was a ramble, but I've been up for about 30 hours now so that's not surprising.

ddorian43• 6 years ago

Tried going to a doctor ? How many hours do you sleep ?

pontifier2• 6 years ago

Oh, I take adderall and it helps. Interestingly, sometimes I'll drink caffeine and an adderall and then take a relaxing nap. I also forget to take my adderall quite often.

blodkorv• 6 years ago

As an adult with ADD i cast doubts about the diagnosis. I have started to more and more think my diagosis is just a result of not being a high productive high intelligence individual.

I more and more realise that my brain and personality is not the kind that is made for desk work. I find it boring and difficult.

I have done other types of works that suits me better i beleive my life would be so much better if i just accepted that i was never to be sitting at a desk solving problems.

School has always been difficult for me, simply because it hard to learn the things you need to learn in shcool, for more intelligent individuals school is not the same big deal as it is for me. But thats just the way things is. The same way i was not born 2meter tall and an musculuar body.

I beleive that we will see more and more ADD/ADHD diagnosies in the future, simply because automation puts more demands on the individual and the jobs will be more mentally demanding.

I see a future where meds like adderal will be availble in the supermarkets.

Instead of giving people ADD/ADHD diagnosises we should just teach people to accept that not everyone are made for mentally demanding tasks and that not everyone goes thru school without it being a huge difficult task. Parents also needs to learn that their kids might not will be able to compete in the job markets in the future and the solution is not to medicate it away.

nullsense12• 6 years ago

ADHD brains are actually different due to pervasive developmental delays.

It's not even really related to intelligence. ADHDers run the gamut from really stupid, to average, to really smart.

I'm reasonably intelligent, but boy do I struggle with the basics on a day to day basis. Understanding complex stuff is fairly fun and engaging for me, so I spend a bunch of time doing it. That's usually at the expense of being a good husband, father, friend or brother.

It doesn't seem to be what you think it is.

sizzle8• 6 years ago

Anyone else scared of dopamine downregulation from decades of amphetamines?

I can literally sleep all day for days on end and fear and done irreversible brain damage.

ovlomob• 6 years ago

Found this, opinions?

https://time.com/25370/doctor-adhd-does-not-exist/

https://www.snopes.com/fact-check/work-of-fiction/

Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

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