Absolutely, as someone diagnosed at 6, and 33 now. Being on medication allows me to actual live my life. Ive tried to be "normal" and not be medicated various times in my life, but it's just been bad every time. Our brains are wires differently, you can't just overcome it.
My family has a long history of alcohol and substance abuse, I'm the first to be diagnosed and medicated for ADHD. If you're not medicated and have ADHD the risk of substance abuse is much higher, and there is a strong link to alcoholics being undiagnosed with ADHD.
I'm always scared of the long term effects of the medication, but without it I can't work or hardly even function.. I'm not sure of these benefits another user mentioned, but whatever they are is not worth the trade off at all.
I really wish adhd meds had an effect on me. Both me and my brother have tried them and seen no benefits from them. I've tried multiple different medications but I forget exactly what they were. All I noticed was my heart feeling a bit weird. With the amount of people saying it's had such a positive effect on them, I really wish I could experience what it's like to be properly medicated :/
Research on kids show that as long as you do 5d/week 10m/y, the effects on height are not noticable. If kids are on drugs all the time, they will be on average about 1.5 cm (IIRC) shorter.
Based on that, and my experience with taking meds everyday (diagnosed at 35, weekend school), where they tend to "accumulate" tension and I eventually have to take few days off, I'd extrapolate that side effects of 5/7 10/12 dosing are minimal.
But there's a whole other dimension to thinking about side effects. Based on research (I believe on thousands of Scandinavians) on pregnant women with ADHD, giving them stimulants during pregnancy is better for their children than not. (Based on lectures by Jarosław Jóźwiak, Polish MD, psychiatrist, specializing in ADHD, which themselves are based on current research). There's so many side effects of having unmedicated untreated ADHD other than deaths and accidents, that, quoting Joe Rogan's common sense comment, "giving amphetamine to kids (end of quote)" is a no brainer. Obesity, drug abuse, poor diet, depression, anxiety, emotional disregulation in general, ppl at school hating and mobbing you for being overly emotional and "crazy", poor school and life results, avg. age of first sex at 13 vs 18 for women, not having sex at all for young guys, and the general feeling that something is wrong with you compared to others.
In light of all these and other ADHD symptoms and effects, treating it with a well adjusted dose of stimulants sounds like the much better alternative. Just talk to your doctor early, when you suspect sth wrong with meds. They change how they work through lifetime, sometimes requiring dose adjustments. You might have to consciously eat more food (due to less appetite and burning more calories), than feels needed.
When I hear the "giving amphetamine to kids" crowd, i.e. the people who oppose medicating children with hard drugs, I instantly think of an article from 1930's, where a bunch of farmers burned down a radio station, because it "interfered" with their crops.
Just knowing that drugs are bad, without understanding the underlying mechanism with mutated dopamine pathway system and how it benefits from miniscule (for that individual) doses of stimulants is such a bad Dunning Kruger example. And it will hurt people (unmedicated ADHD sufferers) until the general population level of awareness rises. Or until people stop distrusting science and doctors, but I think that ship has sailed.
I have ADHD, which to avoid boredom, “tells” me to do more risky things. Is it a surprise that life expectancy is lowered with higher risk? And that the ADHD medication lowers the risky bits therefore increasing life expectancy?
Question to my fellow ADHDers who take the meds, is fun still fun and happening? or has calmness become the new fun?
ADHD meds unlocked a new dimension of -social, normal people- fun previously inaccessible. Hanging out with people without annoying them, not being late to events, remembering to call friends.
But the -crazy- fun is still accessible. I'm more risk aware, but still get the unconventional ideas. And I can always drop meds for a day and have a "high" day with less productivity and more "crazy" ideas. And I don't mean crazy as a negative, more like an adjective that describes it well.
However, it's important to love yourself (and this can be practiced and trained) and all your aspects. Even your ADHD self without meds, even your depression and dark thoughts. https://www.youtube.com/watch?v=9s9PbBfwDfo
Also, I went through a lot of meds, and one I ended up with was because the first one made me a little too much "robot" like for my own liking. I'm too used to being "me" and didn't like how much the first one changed me. But I'd rather people try for themselves than have an opinion based on mine.
Stimulants don’t dampen the fun. More fun, if anything. Very few downsides.
But being a Category 2 controlled substance means health care providers are always pushing me towards off-label use of antidepressants that DO have very big and worrying side effects.
> antidepressants that DO have very big and worrying side effects.
I've read: sexual dysfunction, food cravings, changes to insulin response contributing to hard to lose and large weight gain (increasing diabetes risk), general tiredness making exercise difficult, loss of enjoyment
I've known quite a few many people go from slim to balloon in months and then unable to shift the weight years later. The doctors parrot the line that low mood was just suppressing appetite...
And if that's not bad enough, those side effects can be permanent. This is unlike stimulants, which have side effects some people really don't like, but they go away when you stop.
It's like being invited to play Russian roulette. Literally, as suicidal ideation ironically is a known side effect of the antidepressants...
The concerta I take will occasionally leave me to be less talkative and less curious to the point where if I want to be in a more social context, I want to either time it right or not take it, but it also depends on hydration and diet that day. Otherwise I find it pretty important. I did downsize from 36mg to 27mg.
I have the inattentive version but it's simply not bad enough to take meds.
What I don't like about this study is that they only take meds into consideration, but there are other treatment options. For example cognitive behaviour therapy.
Also, they included studies that included self-diagnosed ADHD. Self diagnoses are on the rise and very often wrong (I.e. trauma response might present with adhd like symptoms). Aside from some other flaws I think the significance of this study is limited...
> I'm not arguing that they don't help, but CBT also increases other metrics, e.g. self esteem, acceptance, self-efficacy, and so on.
I was recently diagnosed, and am on stimulants, which are definitely helpful.
That being said, I'd been going to therapy for about six years (currently winding that down), and I have to say that the therapy alone definitely helped with lots of the emotional/childhood stuff that I don't think would have been helped by medication alone.
I would be prone to believe that both therapy & medication are effective, and indeed my prescribing doctor called this out (although she focused on CBT, which is the easy one to test with controlled trials).
ADHD is a spectrum, not on/off thing. Someone with milder symptoms may do okay without stimulants, and find help from therapy. Those with worse symptoms typically need the stimulants.
I got diagnosed super late in life and I'm currently enjoying the fun cessation phase of said medication. Calmness is not the word I would use to describe it, but I'm glad it works for other people. Couldn't pay me a million dollars to take another pill, I'll just procrastinate and get bored often
For me, yes, I still have all the fun. I just have a much lower baseline stress level to compare the fun times to. Like, if now I’m going from 70% joyful on a normal day to 100% fun on a special occasion, it’s not as much of a swing as when going from 5% joyful to 95% happy.
You may have the Hyperactive-Impulsive presentation (or the Combined one), which is relatively rare among adults. I have the other one of the three (Inattentive), and I wouldn't say it raises my impulsivity, though I guess it's hard to know. The meds literally saved my life and career, but I also almost exclusively take them when working or in lowkey social situations so it's hard to say what they might do when, like, rock climbing or whitewater boating or something.
I suppose impulsivity in terms of working on what I should be working on instead of going into some rabbit hole is a type of impulsivity, and that's certainly decreased! I wouldn't call the former state "fun" though... more like "shameful", "irrational", and "distressing". Personally -- YMMV.
Anyway: yes that's plausible, as this review found pretty strong evidence of increased mortality from injury. Still, I'd personally say it's unlikely for two major reasons:
1. Presumably most injury deaths happen to adults, which are relatively quite unlikely to have the HI presentation.
2. There's just so many plausible causes of injuries, especially in a society with cars. The inclusion of "intentional injury" also introduces a factor that's no doubt strongly corellated with socioeconomic status (i.e. being murdered/manslaughtered), another very plausible cause.
I know that my rate of low speed car accidents has dropped dramatically off since I got on the meds.
Just an anecdote there, but I believe there's a study or two demonstrating a correlation between ADHD and car accidents - I imagine being inattentive in a car is likely to also increase your risk.
It's an ever present neurological condition but the presenting symptoms can change over time as the brain develops. It's not just learning to manage it because not all the symptoms can be self managed.
...ok. Well. Responding politely on the offchance that you mean well and were just in a bit of a rush:
1. You are not necessarily "born with" ADHD. That's certainly a very plausible explanation, but ADHD is a disorder defined solely for diagnostic reasons, using only collections of symptoms; unlike a typical physical disease, no internal mechanisms or underlying causes are posited, on purpose. So saying with confidence that you can never develop it during lifetime is just invalid, putting aside the more philosophical discussions of nature v. nurture and free will that would come up if that roadblock were ever cleared.
2. In the new DSM5-defined paradigm, the three "presentations" of ADHD are assumed to present at different times at different intensities through the typical sufferer's lifespan, with the prototypical progression being Hyperactive-Impulsive or Combined in childhood that leads into Inattentive in adulthood. This is far from absolute, or at least it's supposed to be -- sadly many US psychiatrists still insist on seeing evidence of hyperactivity in childhood before trying out an adult ADHD diagnosis, based mostly on outdated, partial advice from the DSM4.
3. As the flipside of #1, it can also go away without explanation or reason, i.e. go into "remission"; I don't care to gather data on common that is, but I can say with absolute certainty that it cannot be ruled out. That's just how DSM-defined mental health disorders work on a fundamental level.
4. Either way, none of that is relevant to the question of how prevelant it is overall, which is simply a matter of empirical measurement. Without looking it up, I feel confident that it's well below 50%, so objectively "rare" in some sense.
5. I feel like the "some people just get better at managing it" thing is some personal axe you're grinding about people who are virtuous enough to just grit their teeth through psychiatric disorders vs. those who use drugs to cheat. If not: sorry! If so: please don't do that.
Finally, the "edit" button is inline, it just disappears after some amount of time for some odd reason. HN UI never fails to confuse me, as well!
there is a lot more of me getting to choose what it is i end up doing each day. i find fun in doing those things now pretty regularly. cracking a tough problem can feel as good as jumping out of a plane did. that is to say, my brain is still not a great judge of how relatively cool something is, because even something like scuba diving or fast sports were wildly cool the first time and then the second time it was like "this again?".
i feel much safer though knowing that now when i sometimes get a little bit of the itch, i'll think about it for a few seconds and go "eh, maybe later," and return to trying to make a thing, or play some music, or why is that stupid thing still broken oh its because i broke it.
Usually when I hear about health insurance being unreasonable, it's the united States. However, denying health insurance for a pre existing condition is illegal in the United States under the affordable care act, and I'm not aware of any exception to this that would explain your situation.
This is marked on the page as an 'Original Investigation', but right below the title it says it's a 'Systematic Review and Meta-Analysis'.
I'm skeptical about meta analyses in general because, the times when I've dug into a meta analysis and traced the conclusions back to the original papers, I've always been disappointed, and ended up not being convinced of the conclusions of the meta analysis.
Anyway, I haven't done that exercise for this paper, but I will say:
- Although the authors say they did a "systematic review and meta-analysis of 19 studies", only 12 of the 19 papers are included in the meta analysis.
- Only one of the authors read all the studies they included ("Study quality was assessed by 1 reviewer.")
- That reviewer was Lucy Corrigan, BSc ("Full texts were screened (L.C.) against the same inclusion and exclusion criteria (165 articles)...")
Discrete-time hazard analysis indicates that the log odds of mortality were significantly lower among 18 and 19 year old adults ever diagnosed with ADHD and significantly higher among 46 to 64 year old adults ever diagnosed with ADHD, with a crossover occurring at age 33.
While you all argue about ... checks... whether ADHD should be treated with stimulants?
... let me drop the website about the ADHD-comorbid health issues that you're probably not getting proper attention for. here, just go straight to the clinican details:
My dad always asked whether these calmer people live longer or just slower.
Speaking of treatment, do you also find LLMs awesome at getting you over the hump? For example, if I need to gather information across emails, chats, and documents for some form... odds are it will get done at the very last moment or later. But now that the clanker will do all that for me and put the first draft for fixes, I do it at the earliest possible moment.
The medical system is stacked against people with executive dysfunction. If you can't make timely appointments and argue with insurance you'll actively deteriorate. Not even counting things like remembering your meds.
I have come to believe that medications are the primary method to bamboozle normal people, even with normal executive function, and tie them up in knots of nonsense about when/how/if to take the doses on a daily basis.
I've often heard of elderly people who've got so many prescribed drugs that they begin doing really badly, and some whiz physician intervenes, sweeps away all their prescriptions at once, and suddenly the patient is doing far, far better. I've also seen friends of my parents who were so utterly bogged down by all the requirements, and my Dad valiantly authored spreadsheets and managed the regular refills and all that stuff for them. And my Dad is not an HCP by any means.
It is obvious that clinics and prescribers can effectively put a "leash" on their patients by tying them to at least one specific medication that keeps them coming back for more, on a regular basis. If you cannot live without your prescription, then you will learn to be loyal and compliant with your prescriber and your pharmacy.
The taking of medications is analogous to the sacraments of the Catholic Church. There are specific rituals to be followed for each. There are specific substances to be taken. We don't really know what these substances are (the Hebrew word "manna" actually means "what is it?") But the priestly class decrees how they are to be administered and taken. And obviously, we cannot have life within us if we do not partake in the correct sacraments.
And that is why I strictly limit the amount of medications that I take, because it is a slippery slope to being bogged down in intricate daily rituals, fasting, abstinence, and appointments to go get more.
As a person with severe ADHD, who has never taken any medication, I find this study troubling. It uses statistical correlation to indicate causation.
People on ADHD medicine are also going through mental health treatments and get special care and privileges in society. At the same time, the effects of ADHD medication numb their responses and emotions to what seems outwardly stable and normal but deep inside it is an inhibitor of development.
So excuse me for saying so, but I don’t buy into the conclusions of this study at all.
It sounds like you are confusing ADHD meds, which are stimulants (basically speed) with benzos, which they give for depression/anxiety. First you have to understand what ADHD even IS, which is a lack of executive function. All that means is it is harder to know what to do out of the millions of things floating in front of your brain every second. Stimulants, which usually make people feel more wired, tend to make those with ADHD feel more calm. Because they aren't flitting between thoughts and the stimulant empowers them to have a more normal executive function to actively choose what to pay attention to.
Worth noting this feeling of calm comes solely as relief from spastic thoughts. Your body still responds in every other way as you would from taking a stimulant, and yet people feel calmer and more orderly because their baseline thoughts are so frenetic.
maybe what you're saying is true for some patients but I tried the stimulants when I was diagnosed and they just made me feel uncreative, suppressed my appetite until I was a dangerous weight, and overall felt horrible. also made my dick temporarily smaller while I was on the drug. but sure, explain to that person how their brain works. I'm sure you know better than them. And me too, I obviously made up those effects and chose to go back to being unmedicated because I'm wrong about the effects of the drugs.
and I have pretty severe ADHD, so I strongly believe the diagnosis was correct. drugs just affect people differently. GP is talking about stimulants. I experienced what they describe.
they even took away my sense of humor. I'd rather die.
not everyone experiences this. I know people who love these drugs and report none of this. but some do
The other problem with the study is that it does not take income into consideration. This is my largest pet peeve with so many studies, they're basically ignoring a major indicator of quality of life and then make weird conclusions.
But ADHD has been shown to significantly affect income. It’s hard to excel in a high paying career when it’s affecting you strongly. It’s probably pretty hard to normalize for income, then, because it’s a confounding factor.
But that too largely depends on your parents income and wealth as well, ADHD is less of a problem in higher paying job than lower paying job. In fact, for higher paying jobs where you can delegate, AHDH can be an advantage.
How would we know which way that runs? Lower income could expose you to stressors that make ADHD worse, maybe especially in childhood. But ADHD could also easily make it harder to earn money or hold a stable career down too.
it is a review of existing literature. maybe someone will attempt to explore those factors in the future.
from the paper:
"Future research should consider psychosocial and sociodemographic factors to understand how being female,
being of a minoritized race or ethnicity, and having experienced childhood maltreatment may contribute to the risk of mortality in people with ADHD. More diverse and representative samples are needed to improve generalizability and to identify inclusive pathways for intervention. Subgroups of people with ADHD who experience the highest mortality risk should be examined to support informing of initiatives to reduce premature mortality in people with ADHD. Clinically, these findings underscore the importance of long-term, comprehensive care for individuals with ADHD, with particular attention to identifying and addressing modifiable factors that may contribute to excess mortality risk. The association between medication use and lower mortality also highlights the importance of equitable access to evidence-based ADHD assessment and treatment."
Ooh, let me count the privileges I get, starting at zero.
Zero…
There, done. What treatment for ADHD has done for me in the real world is drastically cut my anxiety and stress. Turns out the most challenging parts of my life involved knowing I had to do a thing, or I’d get fired or evicted or sued or such, and being utterly incapable of getting myself to do it until it became a crisis. What a piece of crap I must be, right, for ignoring the things a responsible adult would be doing!
And then I started taking meds for it, and found out I could, just, decide to sit down and gather my tax paperwork, or write that report, or balance the checkbook, even though those things didn’t need to be done for several more weeks. At first, it was utterly liberating. And then it was kinda soul-crushing. I could’ve been living like this the whole time, minus all the stress and self esteem issues and anxiety? And then it was liberating again. Well, bummer life use to be like that, but it’s not anymore, so yay!
And it didn’t do a single thing to my emotions, other than removing about 90% of the anxiety from my life.
(I have to get this in before the inevitable jackass opines: no, life isn’t suddenly “easier because you’re taking meth”. I get no stimulant sensation whatsoever from my dose of Adderall. My morning coffee has a much stronger effect. It just allows me to decide what I should be working on at any given moment, even when no one’s angry at me. It is not an energy booster in any way.)
Well, you've made some incorrect assumptions. You seem to think yourself verysmart, so you should understand a snap judgement like this is worth very little. You don't need psychological treatment alongside it and the results are pretty obvious and immediate. Try it or don't, but I have trouble seeing the value in your narrow and uninformed opinion.
It is more efficacious to have therapy alongside the medication, according to various studies I've read, but I have trouble accessing the therapy because it's expensive, so the meds alone will do for now.
I still need a list or five, but at least now I can remember I have a list, where I left my list, and to use my list.
There’s also the chicken-and-egg problem here. Know what makes it super hard to get organized and motivated to start therapy for ADHD? ADHD! Dealing with insurance companies is the exact kind of demoralizing nightmare that makes it extremely hard for the people who need the treatment to actually get it.
Fuck this is so true. My first therapist I tried immediately told me she'd be annoyed if I missed appointments or was late. Half my goddamn problem was forgetting appointments and not being organized enough to use a calendar consistently. Decided fuck this, and took me a long time to try and find another one.
I put my list on the mirror in the bathroom, right in front of my face, to try to build a morning routine. I got sick of forgetting to brush my teeth, or put on deodorant, etc. That list sat on my mirror for 2 years, and every morning I would forget to use it. Fuck I hate it.
I had 3 therapists I went through. After the first few meetings where they tell you you have ADHD, they all eventually stopped being helpful. Mostly I needed them to tell me what I needed to do to to build good habits or what I can do to work around my ADHD... and all they wanted to do was listen to me talk and provide no helpful information. None of them told me about the side effects of the medication, how I should use it, or anything. Now I have no therapist, and I'm not really any worse off. The medication helped me way more. But that's just my experience.
I feel you on the "My list is right there!" and then it becomes invisible, or if you ever do perceive it, it's only a source of guilt, not organisation.
What a wild, unsubstantiated take. It's wild to suggest ADHD medications are dulling emotions and wild to suggest that this effect is less damaging than the developmental disorder which is unmedicated moderate to severe ADHD. I have watched this disorder destroy people to the point of homelessness. I've had my own struggles with it in the past. And your comment isn't even accounting for comorbidities such as severe anxiety or depression, or complications from broken executive function such as not taking care of your body, not exercising and not eating healthily. I don't think you know much about ADHD at all.
Well they dull emotions as you probably don't snap and hit some bystander/teacher/parent/friend, but also you probably feel as normal people feel as 'fine' which might be issue for some people eg if you are musician and you need strong emotions to perform. But good thing with stimulants is that effects are pretty short term and if you feel that they dull emotions too much for now you just can stop taking those for moment and then continue when you need it.
No offence, but how do you know what the effect of the medication is, if you've never taken it? Your description doesn't match my experience.
I'm unsure about the inhibitor of development bit also, do you mean physiological, intellectual, emotional... ...software?
Are you able to clarify what special care and privileges are you thinking of? I have seen a psychologist a few times, but I can't afford to do so nearly as much as I need to.
meanwhile, as a fire-breathing, unicycling, sensation-seeking, self-care-neglecting, bad-choice-making, person with severe adhd on medication, I dont buy what you dont buy. This shit's rough.
I mean, does it though...? The strongest claim they make is that "timely diagnosis and treatment" (via medication) "may reduce the risk", which seems like a pretty indisputable statement based on the observed corellations.
Anyway, as a side note:
People on ADHD medicine are also going through mental health treatments and get special care and privileges in society
I mean technically yeah, but the vast, vast majority of psychiatric medication management relationships don't involve therapy. Still more likely to pursue it though, I agree. Is that a bad thing, though? Absent of evidence pharmacological treatment doesn't help, this feels like a time we can just recommend and embrace both.
the effects of ADHD medication numb their responses and emotions to what seems outwardly stable and normal but deep inside it is an inhibitor of development
Your musings are not at all based in science, but instead personal anxieties. That's fine for you, but please don't casually muse about the secret nature of lifesaving clinical treatments, especially the treatment that is possibly the most stigmatized yet effective treatment in our society (after PrEP, I suppose).
> This review also showed a significant association between ADHD medication use and reduced rates of all-cause mortality in people with ADHD.
Can someone let the fine fellows at the DEA know this so they can knock it off with being stupidly strict with the manufacture of the stimulant medications?
My family has a long history of alcohol and substance abuse, I'm the first to be diagnosed and medicated for ADHD. If you're not medicated and have ADHD the risk of substance abuse is much higher, and there is a strong link to alcoholics being undiagnosed with ADHD.
I'm always scared of the long term effects of the medication, but without it I can't work or hardly even function.. I'm not sure of these benefits another user mentioned, but whatever they are is not worth the trade off at all.
Based on that, and my experience with taking meds everyday (diagnosed at 35, weekend school), where they tend to "accumulate" tension and I eventually have to take few days off, I'd extrapolate that side effects of 5/7 10/12 dosing are minimal.
But there's a whole other dimension to thinking about side effects. Based on research (I believe on thousands of Scandinavians) on pregnant women with ADHD, giving them stimulants during pregnancy is better for their children than not. (Based on lectures by Jarosław Jóźwiak, Polish MD, psychiatrist, specializing in ADHD, which themselves are based on current research). There's so many side effects of having unmedicated untreated ADHD other than deaths and accidents, that, quoting Joe Rogan's common sense comment, "giving amphetamine to kids (end of quote)" is a no brainer. Obesity, drug abuse, poor diet, depression, anxiety, emotional disregulation in general, ppl at school hating and mobbing you for being overly emotional and "crazy", poor school and life results, avg. age of first sex at 13 vs 18 for women, not having sex at all for young guys, and the general feeling that something is wrong with you compared to others.
In light of all these and other ADHD symptoms and effects, treating it with a well adjusted dose of stimulants sounds like the much better alternative. Just talk to your doctor early, when you suspect sth wrong with meds. They change how they work through lifetime, sometimes requiring dose adjustments. You might have to consciously eat more food (due to less appetite and burning more calories), than feels needed.
When I hear the "giving amphetamine to kids" crowd, i.e. the people who oppose medicating children with hard drugs, I instantly think of an article from 1930's, where a bunch of farmers burned down a radio station, because it "interfered" with their crops.
Just knowing that drugs are bad, without understanding the underlying mechanism with mutated dopamine pathway system and how it benefits from miniscule (for that individual) doses of stimulants is such a bad Dunning Kruger example. And it will hurt people (unmedicated ADHD sufferers) until the general population level of awareness rises. Or until people stop distrusting science and doctors, but I think that ship has sailed.
If yes, check for [1]
[1] https://en.wikipedia.org/wiki/Toxoplasmosis
Question to my fellow ADHDers who take the meds, is fun still fun and happening? or has calmness become the new fun?
But the -crazy- fun is still accessible. I'm more risk aware, but still get the unconventional ideas. And I can always drop meds for a day and have a "high" day with less productivity and more "crazy" ideas. And I don't mean crazy as a negative, more like an adjective that describes it well.
However, it's important to love yourself (and this can be practiced and trained) and all your aspects. Even your ADHD self without meds, even your depression and dark thoughts. https://www.youtube.com/watch?v=9s9PbBfwDfo
Also, I went through a lot of meds, and one I ended up with was because the first one made me a little too much "robot" like for my own liking. I'm too used to being "me" and didn't like how much the first one changed me. But I'd rather people try for themselves than have an opinion based on mine.
Edit: moved a coma, added yt link.
But being a Category 2 controlled substance means health care providers are always pushing me towards off-label use of antidepressants that DO have very big and worrying side effects.
I've read: sexual dysfunction, food cravings, changes to insulin response contributing to hard to lose and large weight gain (increasing diabetes risk), general tiredness making exercise difficult, loss of enjoyment
I've known quite a few many people go from slim to balloon in months and then unable to shift the weight years later. The doctors parrot the line that low mood was just suppressing appetite...
It's like being invited to play Russian roulette. Literally, as suicidal ideation ironically is a known side effect of the antidepressants...
What I don't like about this study is that they only take meds into consideration, but there are other treatment options. For example cognitive behaviour therapy. Also, they included studies that included self-diagnosed ADHD. Self diagnoses are on the rise and very often wrong (I.e. trauma response might present with adhd like symptoms). Aside from some other flaws I think the significance of this study is limited...
But it does exactly that. There have been enough studies about this. CBT and medication combined improved faster, but CBT alone catches up in a few months. E.g. https://journals.sagepub.com/doi/abs/10.1177/108705471667119... or this study here: https://pubmed.ncbi.nlm.nih.gov/31280035/
>Stimulants are the gold standard treatment.
I'm not arguing that they don't help, but CBT also increases other metrics, e.g. self esteem, acceptance, self-efficacy, and so on.
I was recently diagnosed, and am on stimulants, which are definitely helpful.
That being said, I'd been going to therapy for about six years (currently winding that down), and I have to say that the therapy alone definitely helped with lots of the emotional/childhood stuff that I don't think would have been helped by medication alone.
I would be prone to believe that both therapy & medication are effective, and indeed my prescribing doctor called this out (although she focused on CBT, which is the easy one to test with controlled trials).
I suppose impulsivity in terms of working on what I should be working on instead of going into some rabbit hole is a type of impulsivity, and that's certainly decreased! I wouldn't call the former state "fun" though... more like "shameful", "irrational", and "distressing". Personally -- YMMV.
Anyway: yes that's plausible, as this review found pretty strong evidence of increased mortality from injury. Still, I'd personally say it's unlikely for two major reasons:
1. Presumably most injury deaths happen to adults, which are relatively quite unlikely to have the HI presentation.
2. There's just so many plausible causes of injuries, especially in a society with cars. The inclusion of "intentional injury" also introduces a factor that's no doubt strongly corellated with socioeconomic status (i.e. being murdered/manslaughtered), another very plausible cause.
Just an anecdote there, but I believe there's a study or two demonstrating a correlation between ADHD and car accidents - I imagine being inattentive in a car is likely to also increase your risk.
You are born with ADHD and it does not get better, so the "rare" in adults is not factual, some people just get better at managing it.
1. You are not necessarily "born with" ADHD. That's certainly a very plausible explanation, but ADHD is a disorder defined solely for diagnostic reasons, using only collections of symptoms; unlike a typical physical disease, no internal mechanisms or underlying causes are posited, on purpose. So saying with confidence that you can never develop it during lifetime is just invalid, putting aside the more philosophical discussions of nature v. nurture and free will that would come up if that roadblock were ever cleared.
2. In the new DSM5-defined paradigm, the three "presentations" of ADHD are assumed to present at different times at different intensities through the typical sufferer's lifespan, with the prototypical progression being Hyperactive-Impulsive or Combined in childhood that leads into Inattentive in adulthood. This is far from absolute, or at least it's supposed to be -- sadly many US psychiatrists still insist on seeing evidence of hyperactivity in childhood before trying out an adult ADHD diagnosis, based mostly on outdated, partial advice from the DSM4.
3. As the flipside of #1, it can also go away without explanation or reason, i.e. go into "remission"; I don't care to gather data on common that is, but I can say with absolute certainty that it cannot be ruled out. That's just how DSM-defined mental health disorders work on a fundamental level.
4. Either way, none of that is relevant to the question of how prevelant it is overall, which is simply a matter of empirical measurement. Without looking it up, I feel confident that it's well below 50%, so objectively "rare" in some sense.
5. I feel like the "some people just get better at managing it" thing is some personal axe you're grinding about people who are virtuous enough to just grit their teeth through psychiatric disorders vs. those who use drugs to cheat. If not: sorry! If so: please don't do that.
Finally, the "edit" button is inline, it just disappears after some amount of time for some odd reason. HN UI never fails to confuse me, as well!
i feel much safer though knowing that now when i sometimes get a little bit of the itch, i'll think about it for a few seconds and go "eh, maybe later," and return to trying to make a thing, or play some music, or why is that stupid thing still broken oh its because i broke it.
Fun fact, now that you're here: adhd is severely over represented in prison populations. Several times the baseline general population rate.
If I stop taking my meds and let my mental health deteriorate for five years, they apparently think I'm less likely to be a net expense for them
Usually when I hear about health insurance being unreasonable, it's the united States. However, denying health insurance for a pre existing condition is illegal in the United States under the affordable care act, and I'm not aware of any exception to this that would explain your situation.
I'm skeptical about meta analyses in general because, the times when I've dug into a meta analysis and traced the conclusions back to the original papers, I've always been disappointed, and ended up not being convinced of the conclusions of the meta analysis.
Anyway, I haven't done that exercise for this paper, but I will say:
- Although the authors say they did a "systematic review and meta-analysis of 19 studies", only 12 of the 19 papers are included in the meta analysis.
- Only one of the authors read all the studies they included ("Study quality was assessed by 1 reviewer.")
- That reviewer was Lucy Corrigan, BSc ("Full texts were screened (L.C.) against the same inclusion and exclusion criteria (165 articles)...")
Here is the abstract of one of the 12 studies they included (and marked as 'Good' quality, the highest rating they gave): https://www.tandfonline.com/doi/full/10.1080/19485565.2021.2...
Here is what they found:
... let me drop the website about the ADHD-comorbid health issues that you're probably not getting proper attention for. here, just go straight to the clinican details:
https://allbrainsbelong.org/clinician-resources/
and particularly this guide, which was absolutely life-changing:
https://allbrainsbelong.org/wp-content/uploads/2026/02/Every...
Speaking of treatment, do you also find LLMs awesome at getting you over the hump? For example, if I need to gather information across emails, chats, and documents for some form... odds are it will get done at the very last moment or later. But now that the clanker will do all that for me and put the first draft for fixes, I do it at the earliest possible moment.
I've often heard of elderly people who've got so many prescribed drugs that they begin doing really badly, and some whiz physician intervenes, sweeps away all their prescriptions at once, and suddenly the patient is doing far, far better. I've also seen friends of my parents who were so utterly bogged down by all the requirements, and my Dad valiantly authored spreadsheets and managed the regular refills and all that stuff for them. And my Dad is not an HCP by any means.
It is obvious that clinics and prescribers can effectively put a "leash" on their patients by tying them to at least one specific medication that keeps them coming back for more, on a regular basis. If you cannot live without your prescription, then you will learn to be loyal and compliant with your prescriber and your pharmacy.
The taking of medications is analogous to the sacraments of the Catholic Church. There are specific rituals to be followed for each. There are specific substances to be taken. We don't really know what these substances are (the Hebrew word "manna" actually means "what is it?") But the priestly class decrees how they are to be administered and taken. And obviously, we cannot have life within us if we do not partake in the correct sacraments.
And that is why I strictly limit the amount of medications that I take, because it is a slippery slope to being bogged down in intricate daily rituals, fasting, abstinence, and appointments to go get more.
People on ADHD medicine are also going through mental health treatments and get special care and privileges in society. At the same time, the effects of ADHD medication numb their responses and emotions to what seems outwardly stable and normal but deep inside it is an inhibitor of development.
So excuse me for saying so, but I don’t buy into the conclusions of this study at all.
Worth noting this feeling of calm comes solely as relief from spastic thoughts. Your body still responds in every other way as you would from taking a stimulant, and yet people feel calmer and more orderly because their baseline thoughts are so frenetic.
and I have pretty severe ADHD, so I strongly believe the diagnosis was correct. drugs just affect people differently. GP is talking about stimulants. I experienced what they describe.
they even took away my sense of humor. I'd rather die.
not everyone experiences this. I know people who love these drugs and report none of this. but some do
from the paper:
"Future research should consider psychosocial and sociodemographic factors to understand how being female, being of a minoritized race or ethnicity, and having experienced childhood maltreatment may contribute to the risk of mortality in people with ADHD. More diverse and representative samples are needed to improve generalizability and to identify inclusive pathways for intervention. Subgroups of people with ADHD who experience the highest mortality risk should be examined to support informing of initiatives to reduce premature mortality in people with ADHD. Clinically, these findings underscore the importance of long-term, comprehensive care for individuals with ADHD, with particular attention to identifying and addressing modifiable factors that may contribute to excess mortality risk. The association between medication use and lower mortality also highlights the importance of equitable access to evidence-based ADHD assessment and treatment."
> going through mental health treatments and get special care and privileges in society
1. How could you know ADHD medication numb their responses if you've never taken meds?
2. I hope you have the live you deserve. You seem like a happy person.
Zero…
There, done. What treatment for ADHD has done for me in the real world is drastically cut my anxiety and stress. Turns out the most challenging parts of my life involved knowing I had to do a thing, or I’d get fired or evicted or sued or such, and being utterly incapable of getting myself to do it until it became a crisis. What a piece of crap I must be, right, for ignoring the things a responsible adult would be doing!
And then I started taking meds for it, and found out I could, just, decide to sit down and gather my tax paperwork, or write that report, or balance the checkbook, even though those things didn’t need to be done for several more weeks. At first, it was utterly liberating. And then it was kinda soul-crushing. I could’ve been living like this the whole time, minus all the stress and self esteem issues and anxiety? And then it was liberating again. Well, bummer life use to be like that, but it’s not anymore, so yay!
And it didn’t do a single thing to my emotions, other than removing about 90% of the anxiety from my life.
(I have to get this in before the inevitable jackass opines: no, life isn’t suddenly “easier because you’re taking meth”. I get no stimulant sensation whatsoever from my dose of Adderall. My morning coffee has a much stronger effect. It just allows me to decide what I should be working on at any given moment, even when no one’s angry at me. It is not an energy booster in any way.)
I still need a list or five, but at least now I can remember I have a list, where I left my list, and to use my list.
I had 3 therapists I went through. After the first few meetings where they tell you you have ADHD, they all eventually stopped being helpful. Mostly I needed them to tell me what I needed to do to to build good habits or what I can do to work around my ADHD... and all they wanted to do was listen to me talk and provide no helpful information. None of them told me about the side effects of the medication, how I should use it, or anything. Now I have no therapist, and I'm not really any worse off. The medication helped me way more. But that's just my experience.
it makes no assertion like that.
> People on ADHD medicine are also going through mental health treatments and get special care and privileges in society
what privileges?
I'm unsure about the inhibitor of development bit also, do you mean physiological, intellectual, emotional... ...software?
Are you able to clarify what special care and privileges are you thinking of? I have seen a psychologist a few times, but I can't afford to do so nearly as much as I need to.
What mental health and special care privileges are you talking about ? Other than having to have a special aid in school nothing has been of benefit.
Anyway, as a side note:
I mean technically yeah, but the vast, vast majority of psychiatric medication management relationships don't involve therapy. Still more likely to pursue it though, I agree. Is that a bad thing, though? Absent of evidence pharmacological treatment doesn't help, this feels like a time we can just recommend and embrace both. Your musings are not at all based in science, but instead personal anxieties. That's fine for you, but please don't casually muse about the secret nature of lifesaving clinical treatments, especially the treatment that is possibly the most stigmatized yet effective treatment in our society (after PrEP, I suppose).Can someone let the fine fellows at the DEA know this so they can knock it off with being stupidly strict with the manufacture of the stimulant medications?
I'm sure this will be fine and you really have nothing to worry about.