Full title: ADHD drug treatment and risk of suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality: emulation of target trials
Makes sense that methylphenidate helps with most of the things associated with classical ADHD symptoms but not with clumsiness that can lead to accidental injuries; or, in my case, just bruises on my shins all the time.
I was diagnosed with ADHD in my early 30s and prescribed Concerta to help manage it
For a few years being medicated for ADHD was a godsend. I was finally able to be more productive and focus on work, my career took off in a huge way, I've literally tripled my income since I started medication
Now I'm incredibly burned out, I've been having pretty severe memory problems, I'm on medical leave from my job to try and course correct a bit here. I don't think this is purely caused by the medication, I think it is stress related as well, but my doctor's only course of action right now is to reduce and re-evaluate my meds
On one hand, being medicated was incredible for me. It felt like it finally let me overcome my demons and be the person I wanted to be and always knew I was capable of being
On the other hand, if it led to my current situation it's probably one of the worst choices I could have ever made. I hate having massive holes in my memory like this, and being burned out this way is extremely difficult to bear
So... If you can balance things better than I could, it's still probably worth being medicated. I don't regret it I just wish it hadn't burned me out like this
Had a similar experience with adderall. Worst decusion I ever made. Totally changed my personality. Made we eccentric, obsessive, hyper sexualized. Fucked my sleep schedule, gave me a weird kind of speech impediment occasionally, etc, etc, etc.
Also found out after I quit that it also probably contributed to an anuersym in my heart.
Highly recommend anyone to stay the hell away from amphetamines if at all possible.
Conclusion for those who read the title and read it as an implied negative effect on use.
> Drug treatment for ADHD was associated with beneficial effects in reducing the risks of suicidal behaviours, substance misuse, transport accidents, and criminality but not accidental injuries when considering first event rate. The risk reductions were more pronounced for recurrent events, with reduced rates for all five outcomes. This target trial emulation study using national register data provides evidence that is representative of patients in routine clinical settings.
Curious if anyone has gone through the process of an adult adhd diagnosis at Kaiser SF.
Through my attempts, I've been told they don't really do adult adhd diagnoses without documentation of issues as a kid. I was recommended Wellbutrin to deal with symptoms in 2017. Got onto adderall when I moved health insurance in 2021. Back to Kaiser in 2024, I was routed to the same psychiatrist who once again wouldn't budge on adderall and once again recommended Welbutrin.
I used an online clinic to get my assessment (which I understand isn't taken seriously) which is what she cited. I asked what aspect of the assessment documentation did she think left me unqualified and she cited marijuana use in 2016. I asked her how she squares the fact that I'm an adult professional that makes comparable money to her, I have experience using both wellbutrin and adderall and see the former doing nothing and the latter helping,
there's hundreds of times more evidence for adderall efficacy vs the flakey data on wellbutrin... She responded with something like: "I believe in my heart of hearts that what I am doing is right".
I thought the entire situation was kind of insane. Further research into the person makes me think they're a bit of a loon.
Not surprised. ADHD medications save lives, including the lives of others when it comes to things like preventing car accidents. I could even see it being required for driving the way corrective lenses can be.
The World Anti-Doping Agency, who defines what a performance enhancing drug is and if it's banned in sports, grants Therapeutic Use Exemptions for methylphenidate and its siblings. This is despite some countries using other medicines as first-line treatment for ADHD that aren't banned by WADA.
The justification is that treatment for people with ADHD markedly reduces accidents and suicidality, and that banning the drug outright would do more harm than would come from liars getting the drug and harming sports.
And yet it was easier for me to get a driving license being unmedicated than it would be medicated. In either case I'd need to pay a bullshit fee for a psychologist to glance at me and rubber stamp a form, and take an extra exam which is completely trivial to pass. In the case of being medicated I'd need to additionally get my GP to sign off on it as ADHD meds have the infamous "yellow sticker" telling you to not operate heavy machinery. If I ever did get in an accident on medication the insurance companies would make a meal out of it anyway, despite it being signed off.
The whole process is a complete and total scam that's not making anything or anyone any safer.
The youtube channel of ADHD science researcher Russell Barkley gave me the push to get diagnosis in my last year of undergrad and It was like lightning to see all my symptoms laid out since childhood in context of the underlying brain science. He does a lot of debunking of bad research too. Great channel.
He has excellent lectures on the science and history (hundreds of years which was surprising to me that it had been studied formally for so long yet is still a weird and new “American disease” in Australia—-even considering how backwards and slow we are down here).
Just looking now at his channel now. I’m happy to see a critique of Gabor Mate’s ADHD theory in his playlists.
I’ll watch that for sure as I’ve always felt very uneasy, and a little indignant, listening to Mate talk about ADHD; but I’ve never been able to put my finger on why exactly!
The irony about getting treatment for ADHD is that medical providers make it very hard to get the proper medication and treatment. People with ADHD are horrible at following through and handle rejection poorly. So the worse the ADHD is, the less likely somebody will be able to actually get treatment for it. A lot of people suffer because doctors fear losing their license like so many did during the pain pill debacle. It's a risk for them to prescribe a stimulant, but zero risk to tell you to eff off.
As many have said in this thread, most doctors will tell you to go away or give you Welbutrin (which works poorly, if at all). I feel for your struggle.
There are non-stimulant ADHD meds as well. Most of us don't get a chance to try all of them.
In fact, I was surprised to learn that Adderall is highly illegal in many countries, including Japan and South Korea(), both of which have a higher standard of healthcare, and a much longer life expectancy, than the US does. In other words, they're not anti-health.
() In theory, you can bring Adderall into South Korea with your American prescription. In practice, not really.
This is actually less of an issue for technically inclined folks, since we can get our initial fix from the darknet using cryptocurrency, and then getting more consistent at planning and sticking to routine becomes cognitively easier. This also has the advantage of the fact that researching darknet is actually quite fun and stimulating, sort of like a difficult video game with lots of little tricks and secrets.
I agree, except I've been much happier with Wellbutrin. After getting through the initial insomnia a few years ago and switching to normal release, not extended, I have good focus and don't have tremors or back pain like I did with stimulants.
And most people who claim to have ADHD don’t have ADHD. But apparently thinking you have ADHD makes you feel better about doing things you don’t enjoy.
I'm on Ritalin - which works for me. Where I'm from (Norway), getting a diagnosis is no walk in the park. Very extensive process, if you're adult.
At least the doctors I've seen, have all been very precautious in prescribing anything other than the basics. If Ritalin doesn't work for you, they'll obviously try something other...but my doctor told be straight up that it is a red flag when some patients will ask specifically for Adderall, as the potential for misuse is much higher. And for him, it was a last resort.
> is a red flag when some patients will ask specifically for Adderall, as the potential for misuse is much higher. And for him, it was a last resort.
This is so stupid. It's so much better of a medication, the potential for addiction and abuse at therapeutic doses is minimal to none, and yet healthcare systems around the globe are continuing to avoid prescribing it. Ugh.
I was diagnosed as a kid, I never really took the meds consistently. My perspective now is that adhd people are a minority tribe, very chill people living in an unchill world. I feel blessed that I have the ability to function and find my place in this world without taking the meds, not everyone with the “disease” is so lucky. Having adhd you feel alot like an alien most of the time, which can of course be alienating but also very liberating.
The question I pose to the “it’s a disease, medicate it” crowd is; is the person maladapted or is the culture maladaptive?
My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) and ADHD is kind of a weakly differentiated diagnosis that could apply to most people.
Probably something like this was lost when people stopped smoking, obviously beneficial for health - but a huge amount of the public was taking stimulants regularly via nicotine until relatively recently.
> and ADHD is kind of a weakly differentiated diagnosis that could apply to most people.
It's not, the problem is that it sounds like it because ~everyone faces some (way) lesser version of the struggles ADHD people face literally every day, many of whom probably do have some subclinical degree of executive dysfunction.
My personal thumb rule is that somebody is capable of finishing school, autonomously managing their living conditions, finding and keeping a job, and having at least a modicum of social life at the same time, they're high-functioning enough that they almost definitely don't have ADHD, or only some ultra-light version of it.
I grew up with this belief (not your belief; it's a common one) and it hindered me from realizing I needed help.
I regularly have people doubt my diagnosis to this day. If we talk about it more, a lot of them _continue_ to doubt me even after I explain masking.
Again, it's not just your belief -- I grew up hearing radio jockeys calling ADHD "bad parenting disease" -- but this belief is harmful. It ostracizes people and discourages help for a disability that causes measurable harm.
what does that mean? most people have more than 99% identical genes yet we are not clones.
most people don't have a perfect BMI of 23.5 (or whatever is the middle), yet there are clear pathologies on the BMI spectrum, no?
most people could better manage their lives and emotions but most people don't have that severe problems.
the usual diagnostic criteria simply does not apply for most people. the cutoff is pretty high. (problems in multiple spheres of life present before the age of ~14 -- though there's brain damage induced ADHD too)
but of course most people would benefit from some of the ADHD management strategies (which is better time management, planning, organizing things and consistently putting them into their assigned place, cognitive reframing of pervasive bad thoughts, getting a coach, etc.), but at the same time most people would not benefit from being on the usual ADHD meds (maybe they would benefit from some much smaller doses)
I've seen so much strongly relatable ADHD content over my life, and had so many close friends get diagnosed, that I've often wondered if I'm in the population, or if it's pathologizing the regular experience of modern humans.
I haven't had mental healthcare, so I don't have much personal insight, but I found this interview with Trevor Noah very interesting. It's the first time I've heard someone who identified with ADHD share his experience, and not have it resonate with mine:
I listened to that episode when it first came out, and was quite surprised that first of all it wasn't just another "how adhd is actually a superpower" nonsense click farm thing, which seem to be pervasive, but secondly how clear it was that if Trevor didn't find the success he did, he'd very clearly match the normal criteria for needing stimulants because he'd probably be hampered in every day life due to having it.
Additionally, I had the opposite impression that you did, and as an early 30s man it nearly made me tear up thinking about how much the real struggles described by both of them resonated with me.
ADHD diagnosis is one of the few non-socialized parts of our medical system. Because of the abuse potential they charge a fairly steep fee (cad $3k+, with a $2k+ autism assessment addon) to even attempt diagnosis (after screening by your GP — referral required).
The intake paperwork alone was perhaps 100 pages of online questionnaires that lead to interviews where they schedule counselling and evaluation sessions with you.
It took me almost a year to complete because 100 pages of “often always sometimes never” multiple choice questions (with attention checking red herrings) proved to be an almost insurmountable barrier for me.
I ended up completely surrendering to their scheduling requests: “just book it and tell me when it is. I will adjust my schedule around you. Agreeing on mutually free times with six providers is a functional impossibility. Just book it. Now. Go. Lock it in.”
It took a year to get through the maze and now they’ve booked me ASAP: three months out.
If I have an opportunity to give feedback it will be that they badly need people on their team with lived experience. It makes sense that a system designed by people who were able to complete multiple years of medical education and training is effectively blind to conscientiousness and executive function deficits.
Then again, perhaps the maze is another preventative measure: if you are able to speedrun it, perhaps you shouldn’t get medical meth.
My $0.02 as a response to several comments I read in this thread:
I was diagnosed with ADHD in my 40s and got Concerta. My belief is that ADHD is not a disease, nor a disability (even though it acts like one very frequently) and in fact there is evidence that ADHD is an important part of our evolution as a species.
The problem(s) mostly relies with the modern way of life and what is expected from the society at large. In that context I try to feel ok when I daydream while I have countless of boring things to take care of as I totally feel ok when I hyperfocus in a creative endeavor.
The meds are just a tool that I use no more than two times per week in order to take better care of myself and others. It is not a therapy and it's not me. I believe that Sensitive Rejection Dysphoria is very real for people like us, but the worst version of it is when you reject yourself because you are different and you try hard to be someone else.
This is a common belief people have, especially those with mild ADHD or those who wish to be dismissive of the disorder.
Unfortunately, in reality while there are some very limited advantages, as a whole ADHD is a whole-brain dysfunction where your neurons are literally incapable of maintaining their level of operation as long as in a healthy person, with ALL of your executive functions - all self-regulation, planning, delaying gratification, emotion management, etc - being impaired across the board, not just tuned differently.
Hyperfocus is commonly brought up, but neurotypical people experience it as well. Less often, but also without the compulsive loss of control, while being able to maintain a higher level of effort and work without it at all times.
People also like to claim we'd be better as lookouts or sentries but this isn't true. People with ADHD don't pay more attention to a broader range of things, they're just incapable of focusing it when necessary, not to mention they drift off and get distracted instead of staying watchful far, far more.
That's before getting into the fact that ADHD correlates negatively with pretty much every single life outcome, not just those depending on society - things like neurodegenerative disease, cardiovascular and metabolic problems, sleep disturbance, etc.
I understand the desire to frame things you're experiencing in a positive manner, but... in this case, it doesn't really work, and I somewhat resent it personally, as it makes people less likely to take ADHD as seriously as it needs to be.
Isn't one of the criteria for something to be a disability that it makes it harder to function in the world you are in?
So it has to do with the mismatch between yourself (including the accommodations in place for you), the world and whatever is considered a reasonable life for a person in that world.
ADHD is obviously a spectrum, (possibly on top of a binary), and more and more cases on the light end are getting diagnosed, which is, I have no reason to doubt, very helpful. I don’t know if the light end is a disability or a disease.
The heavy end of the spectrum, the lying on the floor suffering crippling bladder pain but unable to muster the willpower to walk to the bathroom and piss even though that would immediately fix the problem end of the spectrum, is a disease and a disability. I cannot picture an ancestral environment where this is adaptive.
If it's not a disability, then why can't I work on projects that I am excited to work on?
Sure, my ADHD experience is probably the impetus for most of those projects in the first place, but that doesn't help me get anything done, whether I want to or not.
It sounds like what really happened is that you found an appropriate amount/cadence of medication for your body. That's much more difficult than many realize, which is why each stimulant is sold with 5 different delivery methods: immediate release, capsule with drug dust coated in timed digestion substance, capsule with hole to pump via capillary action, skin patch, and the bonus prodrug lisdexamphetamine that metabolizes into amphetamine at the rate of digestion.
Respectfully, my experience is very different than yours -- and I'm somewhere in between you and people who have it really bad.
ADHD can absolutely be a handicap. It might be that it's exacerbated by modern life's demands, but I frankly can't be bothered to care -- I live with these symptoms that I wish would go away, and I can't switch to some world that would work well with them.
And it's not rejecting myself or trying to be someone I'm not. I spent quite a while before diagnosis doing that. Getting treatment for and acknowledging the issues of ADHD is being more aware of who I am and what I need than pretending that things will work out. They don't, and they didn't.
This was an observational study, not a randomized control trial.
Access to care is one plausible confounder. Individuals who receive treatment may differ systematically in socioeconomic status, healthcare access, parental advocacy, comorbidities—from those who do not, affecting outcomes.
Haven't read the study yet, though I've been associated with research at the same department. Usually the study design is using matched controls which negates the effect of the parameters you mention. Sweden basically has free healthcare so there is not much difference in access to care, and controlling for the potential residual factors makes studies results quite stable.
It took 3 months just to get get an initial appointment with my Psychologist and then two months later to get formally tested. Another month wait afterwards to meet with her and get treatment started (Adderall, Xanax etc.). I moved to Kentucky for college and the college doctors as well as many local psychiatrists wouldn't refill my Adderall and Xanax. It took me 3 months of fighting with the college health center to get them to find me a place that would refill and take over my mental health care. My Psychologist couldn't refill them out of state. It's annoying long to get care and to have to fight with doctors.
As someone from Nigeria who's self-diagnosed with ADHD (my brain switches gears on the spectrum, and I've learned to cope without formal help), reading this thread hits different.
Here, access to stimulants like Adderall or alternatives are expensive to be viable to the average household (if there is fore-knowledge, which is undocumented), doctors rarely diagnose ADHD in adults (that kind of access is on the premium side, so many have zero idea).
I self-medicate with coffee and green tea to get that dopamine hit, and mix in novelty tricks (gamifying tasks) to keep my monkey brain engaged. But the cultural stigma? Folks just call it laziness or blame "village people" (supernatural enemies).
It's exhausting, but I've leaned into the positives—like my ability to hyperfocusing on creative work for hours.
US folks, your bureaucracy sounds brutal, but at least diagnosis is an option. Anyone else from outside the West dealing with this?
> But the cultural stigma? Folks just call it laziness or blame "village people" (supernatural enemies).
Funny, my daughter just stops my explanations after circa one minute, abruptly, saying that her brain just does not listen anymore and there is no reason for me to continue. Which is blunt, but kind. I understand and stop talking, that's that. We can do that since we know our limits, I would assume that Africa in general is more attuned to accepting people as they are? For my daughter it makes a world of difference that she can communicate her ADHD symptoms. The medication are there to make ADHD people behave like "normal" people, but acceptance in the other direction could quite helpful as well.
With some luck and effort you can have some effect with diet. It would be nice to see a graph between the rise of white flour and the amount of ADHD in the world. I would love to step off medication, but it's not doable without switching to sufficient combination training and good diet, I have neither now :) As they point out in the article it can be great to find out your vitamin levels to address shortage.
> These types of complex carbohydrates are less likely to spike your blood sugar levels and help keep you feeling fuller for longer, which may help improve your focus and attention.
> By avoiding simple carbohydrates, like sugar and white flour, you may reduce specific ADHD symptoms. [0]
I just finished fixing my bike (Suntour Perfect) and have started taking it on smaller trips, hopefully that will be _my_ way to a more stable day to day. [1]
The funny thing about this is sex actually does a good job at treating ADHD symptoms. Sad to see most doctors prescribing medication instead of helping kids get laid.
Almost argue most adults are doing the opposite which makes me concerned for the population.
What the heck is with this title? The actual title is "ADHD drug treatment and risk of suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality: emulation of target trials"
It's quite sad that ADHD is as stigmatized as it is: even though it is a very well-characterized condition in psychiatric literature, the most common 'pop-science' take one hears about it is that ADHD is completely overdiagnosed and may not even exist as a condition. Also, I know multiple people, even though well-managed ADHD would not negatively affect their careers, are barred from certain professions (like high-security military careers and being pilots) simply due to having ADHD and being medicated for it.
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[ 4.4 ms ] story [ 90.1 ms ] threadFor a few years being medicated for ADHD was a godsend. I was finally able to be more productive and focus on work, my career took off in a huge way, I've literally tripled my income since I started medication
Now I'm incredibly burned out, I've been having pretty severe memory problems, I'm on medical leave from my job to try and course correct a bit here. I don't think this is purely caused by the medication, I think it is stress related as well, but my doctor's only course of action right now is to reduce and re-evaluate my meds
On one hand, being medicated was incredible for me. It felt like it finally let me overcome my demons and be the person I wanted to be and always knew I was capable of being
On the other hand, if it led to my current situation it's probably one of the worst choices I could have ever made. I hate having massive holes in my memory like this, and being burned out this way is extremely difficult to bear
So... If you can balance things better than I could, it's still probably worth being medicated. I don't regret it I just wish it hadn't burned me out like this
Also found out after I quit that it also probably contributed to an anuersym in my heart.
Highly recommend anyone to stay the hell away from amphetamines if at all possible.
> Drug treatment for ADHD was associated with beneficial effects in reducing the risks of suicidal behaviours, substance misuse, transport accidents, and criminality but not accidental injuries when considering first event rate. The risk reductions were more pronounced for recurrent events, with reduced rates for all five outcomes. This target trial emulation study using national register data provides evidence that is representative of patients in routine clinical settings.
Through my attempts, I've been told they don't really do adult adhd diagnoses without documentation of issues as a kid. I was recommended Wellbutrin to deal with symptoms in 2017. Got onto adderall when I moved health insurance in 2021. Back to Kaiser in 2024, I was routed to the same psychiatrist who once again wouldn't budge on adderall and once again recommended Welbutrin.
I used an online clinic to get my assessment (which I understand isn't taken seriously) which is what she cited. I asked what aspect of the assessment documentation did she think left me unqualified and she cited marijuana use in 2016. I asked her how she squares the fact that I'm an adult professional that makes comparable money to her, I have experience using both wellbutrin and adderall and see the former doing nothing and the latter helping, there's hundreds of times more evidence for adderall efficacy vs the flakey data on wellbutrin... She responded with something like: "I believe in my heart of hearts that what I am doing is right".
I thought the entire situation was kind of insane. Further research into the person makes me think they're a bit of a loon.
The justification is that treatment for people with ADHD markedly reduces accidents and suicidality, and that banning the drug outright would do more harm than would come from liars getting the drug and harming sports.
The whole process is a complete and total scam that's not making anything or anyone any safer.
I’ll watch that for sure as I’ve always felt very uneasy, and a little indignant, listening to Mate talk about ADHD; but I’ve never been able to put my finger on why exactly!
As many have said in this thread, most doctors will tell you to go away or give you Welbutrin (which works poorly, if at all). I feel for your struggle.
In fact, I was surprised to learn that Adderall is highly illegal in many countries, including Japan and South Korea(), both of which have a higher standard of healthcare, and a much longer life expectancy, than the US does. In other words, they're not anti-health.
() In theory, you can bring Adderall into South Korea with your American prescription. In practice, not really.
The form my GP gave me (after telling me I probably wasn't) sat in my car for six months, untouched. Went private. No regrets.
That's how I started my treatment, at least.
This depends on the person. ADHD medication by itself doesn't work nearly as well for me as ADHD medication+Wellbutrin.
I advise you to take a look at the role of GABA in ADHD. It’s probably more important than the Norepinephrine and dopamine.
https://www.sciencedirect.com/science/article/pii/S002839082...
At least the doctors I've seen, have all been very precautious in prescribing anything other than the basics. If Ritalin doesn't work for you, they'll obviously try something other...but my doctor told be straight up that it is a red flag when some patients will ask specifically for Adderall, as the potential for misuse is much higher. And for him, it was a last resort.
This is so stupid. It's so much better of a medication, the potential for addiction and abuse at therapeutic doses is minimal to none, and yet healthcare systems around the globe are continuing to avoid prescribing it. Ugh.
The question I pose to the “it’s a disease, medicate it” crowd is; is the person maladapted or is the culture maladaptive?
Probably something like this was lost when people stopped smoking, obviously beneficial for health - but a huge amount of the public was taking stimulants regularly via nicotine until relatively recently.
It's not, the problem is that it sounds like it because ~everyone faces some (way) lesser version of the struggles ADHD people face literally every day, many of whom probably do have some subclinical degree of executive dysfunction.
My personal thumb rule is that somebody is capable of finishing school, autonomously managing their living conditions, finding and keeping a job, and having at least a modicum of social life at the same time, they're high-functioning enough that they almost definitely don't have ADHD, or only some ultra-light version of it.
I regularly have people doubt my diagnosis to this day. If we talk about it more, a lot of them _continue_ to doubt me even after I explain masking.
Again, it's not just your belief -- I grew up hearing radio jockeys calling ADHD "bad parenting disease" -- but this belief is harmful. It ostracizes people and discourages help for a disability that causes measurable harm.
what does that mean? most people have more than 99% identical genes yet we are not clones.
most people don't have a perfect BMI of 23.5 (or whatever is the middle), yet there are clear pathologies on the BMI spectrum, no?
most people could better manage their lives and emotions but most people don't have that severe problems.
the usual diagnostic criteria simply does not apply for most people. the cutoff is pretty high. (problems in multiple spheres of life present before the age of ~14 -- though there's brain damage induced ADHD too)
but of course most people would benefit from some of the ADHD management strategies (which is better time management, planning, organizing things and consistently putting them into their assigned place, cognitive reframing of pervasive bad thoughts, getting a coach, etc.), but at the same time most people would not benefit from being on the usual ADHD meds (maybe they would benefit from some much smaller doses)
I haven't had mental healthcare, so I don't have much personal insight, but I found this interview with Trevor Noah very interesting. It's the first time I've heard someone who identified with ADHD share his experience, and not have it resonate with mine:
https://youtu.be/SkDvqvpxKBY?si=oszaQx7OOh5G3NXb
Additionally, I had the opposite impression that you did, and as an early 30s man it nearly made me tear up thinking about how much the real struggles described by both of them resonated with me.
ADHD diagnosis is one of the few non-socialized parts of our medical system. Because of the abuse potential they charge a fairly steep fee (cad $3k+, with a $2k+ autism assessment addon) to even attempt diagnosis (after screening by your GP — referral required).
The intake paperwork alone was perhaps 100 pages of online questionnaires that lead to interviews where they schedule counselling and evaluation sessions with you.
It took me almost a year to complete because 100 pages of “often always sometimes never” multiple choice questions (with attention checking red herrings) proved to be an almost insurmountable barrier for me.
I ended up completely surrendering to their scheduling requests: “just book it and tell me when it is. I will adjust my schedule around you. Agreeing on mutually free times with six providers is a functional impossibility. Just book it. Now. Go. Lock it in.”
It took a year to get through the maze and now they’ve booked me ASAP: three months out.
If I have an opportunity to give feedback it will be that they badly need people on their team with lived experience. It makes sense that a system designed by people who were able to complete multiple years of medical education and training is effectively blind to conscientiousness and executive function deficits.
Then again, perhaps the maze is another preventative measure: if you are able to speedrun it, perhaps you shouldn’t get medical meth.
The problem(s) mostly relies with the modern way of life and what is expected from the society at large. In that context I try to feel ok when I daydream while I have countless of boring things to take care of as I totally feel ok when I hyperfocus in a creative endeavor.
The meds are just a tool that I use no more than two times per week in order to take better care of myself and others. It is not a therapy and it's not me. I believe that Sensitive Rejection Dysphoria is very real for people like us, but the worst version of it is when you reject yourself because you are different and you try hard to be someone else.
Unfortunately, in reality while there are some very limited advantages, as a whole ADHD is a whole-brain dysfunction where your neurons are literally incapable of maintaining their level of operation as long as in a healthy person, with ALL of your executive functions - all self-regulation, planning, delaying gratification, emotion management, etc - being impaired across the board, not just tuned differently.
Hyperfocus is commonly brought up, but neurotypical people experience it as well. Less often, but also without the compulsive loss of control, while being able to maintain a higher level of effort and work without it at all times.
People also like to claim we'd be better as lookouts or sentries but this isn't true. People with ADHD don't pay more attention to a broader range of things, they're just incapable of focusing it when necessary, not to mention they drift off and get distracted instead of staying watchful far, far more.
That's before getting into the fact that ADHD correlates negatively with pretty much every single life outcome, not just those depending on society - things like neurodegenerative disease, cardiovascular and metabolic problems, sleep disturbance, etc.
I understand the desire to frame things you're experiencing in a positive manner, but... in this case, it doesn't really work, and I somewhat resent it personally, as it makes people less likely to take ADHD as seriously as it needs to be.
So it has to do with the mismatch between yourself (including the accommodations in place for you), the world and whatever is considered a reasonable life for a person in that world.
The heavy end of the spectrum, the lying on the floor suffering crippling bladder pain but unable to muster the willpower to walk to the bathroom and piss even though that would immediately fix the problem end of the spectrum, is a disease and a disability. I cannot picture an ancestral environment where this is adaptive.
Sure, my ADHD experience is probably the impetus for most of those projects in the first place, but that doesn't help me get anything done, whether I want to or not.
It sounds like what really happened is that you found an appropriate amount/cadence of medication for your body. That's much more difficult than many realize, which is why each stimulant is sold with 5 different delivery methods: immediate release, capsule with drug dust coated in timed digestion substance, capsule with hole to pump via capillary action, skin patch, and the bonus prodrug lisdexamphetamine that metabolizes into amphetamine at the rate of digestion.
ADHD can absolutely be a handicap. It might be that it's exacerbated by modern life's demands, but I frankly can't be bothered to care -- I live with these symptoms that I wish would go away, and I can't switch to some world that would work well with them.
And it's not rejecting myself or trying to be someone I'm not. I spent quite a while before diagnosis doing that. Getting treatment for and acknowledging the issues of ADHD is being more aware of who I am and what I need than pretending that things will work out. They don't, and they didn't.
And I know my experience isn't unique.
Here, access to stimulants like Adderall or alternatives are expensive to be viable to the average household (if there is fore-knowledge, which is undocumented), doctors rarely diagnose ADHD in adults (that kind of access is on the premium side, so many have zero idea).
I self-medicate with coffee and green tea to get that dopamine hit, and mix in novelty tricks (gamifying tasks) to keep my monkey brain engaged. But the cultural stigma? Folks just call it laziness or blame "village people" (supernatural enemies).
It's exhausting, but I've leaned into the positives—like my ability to hyperfocusing on creative work for hours.
US folks, your bureaucracy sounds brutal, but at least diagnosis is an option. Anyone else from outside the West dealing with this?
> But the cultural stigma? Folks just call it laziness or blame "village people" (supernatural enemies).
Funny, my daughter just stops my explanations after circa one minute, abruptly, saying that her brain just does not listen anymore and there is no reason for me to continue. Which is blunt, but kind. I understand and stop talking, that's that. We can do that since we know our limits, I would assume that Africa in general is more attuned to accepting people as they are? For my daughter it makes a world of difference that she can communicate her ADHD symptoms. The medication are there to make ADHD people behave like "normal" people, but acceptance in the other direction could quite helpful as well.
With some luck and effort you can have some effect with diet. It would be nice to see a graph between the rise of white flour and the amount of ADHD in the world. I would love to step off medication, but it's not doable without switching to sufficient combination training and good diet, I have neither now :) As they point out in the article it can be great to find out your vitamin levels to address shortage.
> These types of complex carbohydrates are less likely to spike your blood sugar levels and help keep you feeling fuller for longer, which may help improve your focus and attention.
> By avoiding simple carbohydrates, like sugar and white flour, you may reduce specific ADHD symptoms. [0]
I just finished fixing my bike (Suntour Perfect) and have started taking it on smaller trips, hopefully that will be _my_ way to a more stable day to day. [1]
[0] https://add.org/adhd-diet/
[1] https://i.ebayimg.com/images/g/NxQAAeSwpg1odZbS/s-l1600.jpg (about the same bike)
Almost argue most adults are doing the opposite which makes me concerned for the population.