The Addicted Generation
July 6, 2016 8:53 AM   Subscribe

There’s this frustration, this anxiousness, not knowing who I actually am without the medication. When I go off it now, I can’t get through simple chores, errands, tasks, anything. The biggest thing I hate about it is that I’m a drug addict. If I’m being completely honest, I’m dependent on it. There’s a lot of anger and self-loathing that comes with that. These are the thoughts that plague the medicated, the adults in their twenties who take prescription stimulants for attention deficit/hyperactivity disorder (ADHD) and have done so since childhood.

It’s not like I was ever an all-star in everything. I felt like just to be average I had to take these stimulants. Who would I have been if I could have just been left to my own devices and figured it out? I don’t know. By some accounts, the number of 26- to 34-year-olds taking ADHD medication rose roughly 84 percent between 2008 and 2012 alone. “Basically we have millions of people in a society-wide experiment,” says Lawrence Diller, a behavioral and developmental pediatrician and family therapist based in Walnut Creek, California.
posted by Bella Donna (113 comments total) 57 users marked this as a favorite
 
Nancy Reagan: "Understanding what drugs can do to your children, understanding peer pressure and understanding why they turn to drugs is... the first step in solving the problem."
posted by flabdablet at 8:57 AM on July 6, 2016 [1 favorite]


This wouldn't be a problem if society hadn't decided to demonize the use of mind-altering substances.
posted by Faint of Butt at 9:00 AM on July 6, 2016 [22 favorites]


Who would I have been if I could have just been left to my own devices and figured it out?

I'm exactly the opposite. I was diagnosed later in life and really wonder how much better things would have been if I had been medicated as a child. Where would I have gone? What would I have accomplished? Who would I have become?

I like me, I enjoy life now, but I can say with 100% certainty that I never even came close to reaching my potential.
posted by bondcliff at 9:02 AM on July 6, 2016 [161 favorites]


Yeah, I read this. I think a real problem is that the story is more complicated when you talk to people in this age cohort (hi) who were diagnosed as adults.

I was finally diagnosed with ADD at 27 and started a prescribed stimulant three years later. It was also prescribed for comorbid treatment resistant depression. It has only made my life better. "There’s this frustration, this anxiousness, not knowing who I actually am without the medication" is not something I feel or experience. I don't worry about whether the excellent work I've done is "mine." I don't worry about whether or not I'm addicted to it or whether I "should" come off of it. But I got to know "who I actually am without the medication," and I think that makes a difference.

But I also think part of what's going on here is that it is very difficult for people—especially those without comorbid psychiatric problems—to think of ADD the way I do, which is as a persistent cognitive disability (in my case, a pretty mild one) with a reasonable pharmacological treatment that I use in combination with other strategies. There are LOTS of medications I may "always have to take."

I think part of the narrative here is that ADD diagnoses are a crutch in this society to bolster people who are not ~successful enough on their own~ for whatever reason (and "successful" here involves meeting very specific upper- and upper-middle class white standards for financial, social achievement) (so people who have some sort of moral failing—they don't work hard enough, whatever) and not an indicator of an actual problem that legitimately needs correction, pharmaceutically or otherwise. Which isn't to say that this isn't true, and which may be part of "overdiagnosis."

Yet it is not only that and the stories here about regret and anxiety aren't the only stories. It's not something I really talk about in my personal life, though, because it's the first narrative that people impose, no matter what I say—and no matter what their other impressions of me might be.

I still don't sweat it too much, though.
posted by listen, lady at 9:04 AM on July 6, 2016 [42 favorites]


I feel so, so fortunate that my son was first diagnosed and treated by one of the best children's hospitals in the country. We tried EVERYTHING before medication. Everything. And he continued in therapy throughout his childhood while taking medication. During high school he chose to stop taking his meds off and on (he was on Ritalin then and there wasn't a physical dependency). He found a method that worked for him then and worked for his first year in college. I'm not sure what he's planning for his sophomore year; he's an adult and he gets to decide how he copes with his ADHD. But he has no issues with taking medication when he feels he needs it; he doesn't feel "less than" or like his meds are a crutch. They're a tool that he uses to get through life, just like my glasses are a tool I use to get through life.

My husband was diagnosed as an adult and definitely has those feelings of "what could I have accomplished had I been taking meds" every now and again. He figured out coping mechanisms when he was a teenager but they're not all that effective and he struggled a lot when he probably didn't have to.

But what I want to stress is that therapy PLUS medication made a huge difference in their lives. The therapy maybe even more than the meds, sometimes, what with comorbid diagnoses of anxiety and OCD (not both of them).
posted by cooker girl at 9:11 AM on July 6, 2016 [7 favorites]


What Bondcliff said. I'm part of that lost generation of women who were diagnosed as adults, and I can't help but think my childhood would have been better if I'd had that diagnosis. I respond so, so strongly to a relatively low dose of medication, and it clears my system so quickly. I think Cooker Girl's analogy is best - it's a tool, like glasses, to help with a very real cognitive impairment.
posted by nerdfish at 9:13 AM on July 6, 2016 [35 favorites]


Yeah, I was diagnosed as a kid, and my parents chose not to medicate me. I don't blame them—it was the early 90s, the whole thing was new to them, and all of that.

I'm a grown ass adult, and I want to get medicated. This ADHD shit is fucking with my life, and I need help. It's such a fucking pain in the ass to find a psychiatrist in New York City, especially one that takes insurance.
posted by SansPoint at 9:14 AM on July 6, 2016 [11 favorites]


This will be an interesting discussion for me. I've been taking Concerta as an adult, but it was a decision I made with my doctor as a young adult. As a child, I was never prescribed anything like it but did struggle immensely to participate school in the 'appropriate' ways. I remember being at an early job, feeling my boss's frustration with my vacillating tempers, being a whirlwind of creative productivity at one moment and utterly useless the next. The drugs certainly even things out for me, but I wonder now is I should have instead just quit that job then instead of later.

Recently I've gone off the drugs, less as a conscious decision and more for practical reasons relating to my schedule, my budget and the hassle of constantly renewing the prescription. Since, I've been frustrated again by old familiar patterns of behavior. I'd better keep reading before I comment anymore, but thank you. This is timely .
posted by Evstar at 9:16 AM on July 6, 2016 [4 favorites]


This wouldn't be a problem if society hadn't decided to demonize the use of mind-altering substances.
I can only speak for myself. I faithfully took prescription stimulants for years, starting in elementary, and never viewed myself as an addict in any way. But I found myself made miserable by the negative side effects of these drugs, and decided to get off of them. And yeah, it wasn't easy.

This is not a simple conversation, but demonization of drug use is not the only problem here.
posted by billjings at 9:17 AM on July 6, 2016 [16 favorites]


I'm exactly the opposite. I was diagnosed later in life and really wonder how much better things would have been if I had been medicated as a child. Where would I have gone? What would I have accomplished? Who would I have become?

I like me, I enjoy life now, but I can say with 100% certainty that I never even came close to reaching my potential.


ugh yes, this.
posted by sutel at 9:18 AM on July 6, 2016 [2 favorites]


I was diagnosed as a kid but didn't take any medication for ADHD (inattentive) until I was 30. It has demonstrably changed my life.

I also take it in conjunction with a physician with whom I do quarterly assessments and adjust the medication accordingly. I was on adderall for two years but have since switched to Vyvanse, which is much more effective for me.

I'm keenly aware and afraid of longterm dependency challenges so I will take "drug holidays" whenever I fee safe to do so (usually around vacation or actual holidays when I don't need to do anything critical).

If you are getting treatment for ADHD it's not enough to just get a prescription and move on. It requires constant monitoring with a medical professional who knows you and is committed to helping you manage your whole health.
posted by Doleful Creature at 9:21 AM on July 6, 2016 [12 favorites]


I've mentioned this before but the look on my mom's face after she asked me if my life would have been better if she had me tested for ADHD as a kid instead of assuming I was "lazy" and just being perpetually mad at me for mediocre grades and shitty personal habits was something I wouldn't wish on anyone.
posted by griphus at 9:21 AM on July 6, 2016 [47 favorites]


I like cooker girl's analogy to glasses. I don't have ADHD but I do have anxiety, and without drugs I'm barely able to leave the house. I don't care if I'm dependent on it. I also know I'm a difficult person to be around when I'm anxious, and people with ADHD are difficult for me to be around when they're unmedicated (I lived with such a person for years). Therefore it's completely mystifying to me that an adult wouldn't take a medication that allows them to function and makes their relationships better. I don't know anyone who would rather give up driving than wear glasses.
posted by AFABulous at 9:30 AM on July 6, 2016 [21 favorites]


I absolutely, absolutely do have a psychological dependency on Adderall. Maybe once a year I mis-time my prescription refill (which I actually have to retrieve from my psych's office every month) and I have to go without a pill on a random Sunday, or else stretch out my normal twice-a-day dosage to fill the gap. It fills me with dread. I'm quite certain that going without on a random work day would make me incapable of doing my job. If there emerged a non-stimulant ADHD treatment that was anywhere near as effective as Adderall, I'd be happy to give it a try, even though I'd worry quite a bit about doing my job well during the transition period.

Hence I really did think this article was going to resonate with me. But it ends up retreating to the trope where the author asks “are we over-medicating our children?” and then doesn't have the courage to answer it. Of course I think that children should start off with behavioral therapy before pills. Of course I think that adults, even medicated adults, need to learn coping mechanisms.

But when the author says “as adults, many find themselves unable to get off the drugs” she makes no more sense than if she had said “as adults, many find themselves unable to slay dragons with magical swords.” Why on earth would you presume that adults want to get off of a medication that helps them live their lives?

Saying “but… amphetamines!” doesn't make the point on its own. She conflates psychological dependence with physical dependence, and only once does she assert that there are physical withdrawal symptoms for Adderall — which might be true, though I've never experienced those symptoms myself. You certainly don't build up a tolerance; my dosage has remained the same for ten years and is actually lower than it used to be.

Of course there's a psychological dependency that develops. I suspect you'd find it to be similar to the psychological dependency that develops within anyone who is taking a medication to treat a life-long mental health problem. You worry about which version of you is the “real” you, or if that concept even means anything. I like the medicated version of myself much better — he gets stuff done, he has hobbies, he is a fully-formed individual for whom the world is actually an interesting place.

This identity struggle is a real thing. It's worth writing about on its own without trying to find a way to segue into the tired drugging-kids scare-mongering. I want to read that article, and I hope some day someone writes it.
posted by savetheclocktower at 9:32 AM on July 6, 2016 [31 favorites]


I was diagnosed as a child and struggled a lot in school. I never was prescribed medication or therapy, and it took me years to find ways to be productive and focus with the way my brain works. That being said, I find myself more frustrated with the school system that tried to force me to conform to the learning style and needs of most of their students, instead of acknowledging that my brain worked differently and needed different allowances in order to thrive.
When I finally ended up at a college that let me push deadlines sometimes and doodle incessantly in my notebooks instead if taking notes, I did really well.

I now understand that in order to focus, I have to often take breaks and work on several things at once, and have multiple forms of stimuli. I like my brain now and the way it works. This is just me, and I do have friends who have benefited from medication, but instead of forcing my mind to fit into a non ADHD box, I've benefited most from accepting the way my brain works and going from there. Maybe not so condusive for a nine to five. And I might sometimes drive my husband crazy when I clean the house by not working on one project at a time, but instead working in circles all around the house. But it works for me and I question the panicky culture around kids who can't sit still and focus in the same way as others.
posted by branravenraven at 9:33 AM on July 6, 2016 [5 favorites]


I'm exactly the opposite. I was diagnosed later in life and really wonder how much better things would have been if I had been medicated as a child. Where would I have gone? What would I have accomplished? Who would I have become?

Oh, gods, this. Though, in my case, it's not ADD, it's exceedingly deep clinical depression since early childhood. I wasn't diagnosed until into my 30's and it took a good long time to hit on a medication that did anything for me. I often wonder how different life would have been had I been able to be diagnosed earlier.

The caveat, of course, is that "earlier" would mean "in the 60's" when treatment for depression would have been comparatively barbaric. Medication back then meant, almost literally, drugged into a stupor.

Still...All those decades wasted in inner turmoil.
posted by Thorzdad at 9:34 AM on July 6, 2016 [6 favorites]


I've mentioned this before but the look on my mom's face after she asked me if my life would have been better if she had me tested for ADHD as a kid instead of assuming I was "lazy" and just being perpetually mad at me for mediocre grades and shitty personal habits was something I wouldn't wish on anyone.
And yet I was medicated at that time, and I wasn't happy in the long run. Stimulants were not like glasses to me, they had a negative impact on how I socialized with people.

Would I have been happier had I, like you, not been medicated at that time? I don't know, to be honest. It was a rough position to be in.
posted by billjings at 9:34 AM on July 6, 2016 [1 favorite]


I'm exactly the opposite. I was diagnosed later in life and really wonder how much better things would have been if I had been medicated as a child. Where would I have gone? What would I have accomplished? Who would I have become?

I like me, I enjoy life now, but I can say with 100% certainty that I never even came close to reaching my potential.


Oh, god, yes. This is me. I was diagnosed at 35 and when I talked to my grandmother (my only real parent) she was like, "oh, I always figured that was probably what was wrong with you." With, like, a shrug. Like, whoops, sorry, forgot to actually get you medical treatment for the life-derailing disorder I always thought you had, it was just way easier to let you think you were stupid and worthless and unable to do anything right than it would have been to take you to a doctor and have you tested, tra la la.

I am still incredibly angry about this and it's definitely negatively impacted my relationship with my grandmother. What I would have given to have been diagnosed and treated as a child. Maybe I would have gone to college after high school instead of waiting twenty years because I was too scared and too full of self-loathing to believe that I could be successful at anything. I also wish I was medicated now, because I work full time and go to school nearly full time (associates degree will be complete in December, woooooo), and without medication I'm just barely able to hold down work and school... but I have basically no other life. My house is always a shambles, I barely socialize, I'm behind on most TV and books because I can't let myself watch engrossing shows or read interesting non-school books without getting sucked in to the detriment of the work... goddamn, I miss Vyvanse in the morning with instant-release Adderall supplemental doses in the afternoon. I functioned so close to normal back then.
posted by palomar at 9:35 AM on July 6, 2016 [30 favorites]


“as adults, many find themselves unable to get off the drugs”

"As adults, many find themselves unable to [do able-bodied thing] without [an assistive device]."
posted by XtinaS at 9:35 AM on July 6, 2016 [46 favorites]


I suspect you'd find it to be similar to the psychological dependency that develops within anyone who is taking a medication to treat a life-long mental health problem. You worry about which version of you is the “real” you, or if that concept even means anything.

Maybe, maybe not. I think it's important to say that those are not anxieties I have, and I am on a complex cocktail and have been for a while. I know the "real" me. (The unmedicated me was pretty much the same, just more suicidal and living in a pigpen.)
posted by listen, lady at 9:36 AM on July 6, 2016 [12 favorites]


Yeah, I'm another one diagnosed later in life who has been wondering just how different my life would have been. I probably wouldn't have dropped out of college. Twice.

Part of the dianostic process was looking at my childhood school files, which I happened to have saved. I didn't look at them before I handed them over to the psychologist, but I did after and was pretty amused by the teachers comments like "needs to pay attention in class!" I was smart, and yet my grades were abysmal.

I have complicated feelings about stimulants. There does seem to be a crazy number of people in the US on adderall and the like and its recent. Do we really know how it's going to be long term? Am I screwing up my heart? Asking for a stroke? Other? But I am so much more functional on them. The fear of not doing anything off the drug presented here? That's how I was before getting treatment. That's not the drug, that's ADHD.
posted by [insert clever name here] at 9:37 AM on July 6, 2016 [3 favorites]


I was diagnosed & started on medication quite late in life - about 3 years ago (age 42). So, like listen, lady above, I feel like I know who I am without the medication. And I know who I am on the medication. So maybe I can't judge someone in their 20s who has always been on it their whole lives, but this to me is no different from the fact that I need glasses to function fully effectively as well. I can go without both, but I'm much much better with them than without.

I had a lot of emotions when I was diagnosed, a lot of regret and wondering what might have been, and that might be the specific struggle of those of us diagnosed as adults compared to those diagnosed as children who wonder who they might have been or become without the presence of meds. But a lot of the struggle seems to be that because ADHD is something that happens from the neck up, there is a lot of second guessing about how real it is, how much of this is a "crutch" or an excuse or whatever you want to call it. It gets the same stigma of mental illness, along with some other baggage that has occurred in both (IMO) some over-diagnosis and some overblown media. And that stigma and second-guessing applies inside our own heads just as much as in the outside world.

I have tried, unsuccessfully, to explain to my wife and others for whom this isn't an issue, the feeling I had the first day I was on an effective dosage of my stimulant meds. I haven't been able to find the words for it to help them understand what it was like inside my head at that moment, but I remember it clearly - the sudden moment when the feeling of my brain being a bunch of overstuffed drawers in a dresser went away and I could open and close them as needed (this is my current metaphor) - and on the heels of that, the sudden insight that this was how everyone else was all the time ("those fuckers", some part of me went) and that this was great.

It didn't mean that I was suddenly, miraculously on top of everything. But it has given me the space and the chance to figure out how I want to go forward from here, and to explore what strategies and techniques I might need to be using to manage myself and my plans - and I'm still not great at that (just witness the amount of time I spend here). It's beyond just the medication - the medication is one tool that I need to be effective and allow me to find and use other tools. This isn't a crutch, this isn't an "unfair advantage"; this is what I need to be my best self and so I'm going to make use of it. I know other adult ADHD people who go without meds, and hey - if it works for them, more power to them. For me, it is important.
posted by nubs at 9:37 AM on July 6, 2016 [23 favorites]


the sudden moment when the feeling of my brain being a bunch of overstuffed drawers in a dresser went away and I could open and close them as needed (this is my current metaphor

lolol my first day included sitting through an extremely tedious accounting training and finding myself actually unable to think about something else the entire time because i could focus on one thing at a time, which was great but also annoying. also i had a nap.
posted by listen, lady at 9:39 AM on July 6, 2016 [8 favorites]


Being dependent on a substance is not addiction. Not. I'm dependent on my thyroid meds but no one implies I'm addicted. It frustrates me so much when people stigmatize and shame themselves for being dependent on a prescribed medication.
posted by gingerbeer at 9:40 AM on July 6, 2016 [57 favorites]


I didn't look at them before I handed them over to the psychologist, but I did after and was pretty amused by the teachers comments like "needs to pay attention in class!" I was smart, and yet my grades were abysmal.

I have distinct memories of being All Prepared And Organized for a new year at school, and then completely losing the plot about two weeks in. "But you're so smart! Why can't you get good grades?" (As an aside, I plan to never ever ever say that to my child. "But you're so smart! You must therefore be failing [thing] on purpose!" Augh no.) I got medicated when I was 30, and I would not give up being able to think and focus for love or money.
posted by XtinaS at 9:41 AM on July 6, 2016 [9 favorites]


I've mentioned this before but the look on my mom's face after she asked me if my life would have been better if she had me tested for ADHD as a kid instead of assuming I was "lazy" and just being perpetually mad at me for mediocre grades and shitty personal habits was something I wouldn't wish on anyone.

I haven't talked to my parents about my diagnosis at all. My wife was encouraging me to do it, and I'm just of the opinion that there is no point - they are/were great parents who did their best and while I wasn't an easy kid, we got through it. I see no point is stirring up feelings of regret and guilt in them for no purpose; I'm here now and the job is to move forward.
posted by nubs at 9:43 AM on July 6, 2016 [4 favorites]


Here is your obligatory objection to the misuse of the term "addiction", which stigmatizes long-term pain patients and genuine addicts with real problems alike.

Addiction—or compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal. The latter reflect physical dependence in which the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal). Physical dependence can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed. Thus, physical dependence in and of itself does not constitute addiction, but it often accompanies addiction. This distinction can be dificult to discern, particularly with prescribed pain medications, for which the need for increasing dosages can represent tolerance or a worsening underlying problem, as opposed to the beginning of abuse or addiction. (NIDA)

In short: you are not "addicted" to yoga or lattes any more than you are addicted to drugs used appropriately to treat medical problems. Stop it.
posted by Dashy at 9:54 AM on July 6, 2016 [19 favorites]


the sudden insight that this was how everyone else was all the time ("those fuckers", some part of me went) and that this was great.

My first few weeks on Concerta, I just kept marveling at how quiet and different and useful my brain felt while on medication. I wrote things down on my to do list and then... I did them. I completed tasks 100 percent instead of hastily doing 80 percent and thinking, "Well, good enough" and then feeling guilty that I hadn't put in 100 percent. I was also a little angry just at life, like I was finally getting a glimpse into how a "normal" brain worked and how it wasn't fair that I didn't have such a brain. But mostly it was relief.

It's been about two years and my life isn't perfect. I still struggle with a lot of stuff, but things are better. To know that I wasn't stupid or lazy was amazing. To know that I wasn't a fundamentally bad person - that I just have a weird quirk in my brain that can be helped along - made my life 100 times better.
posted by sutel at 9:56 AM on July 6, 2016 [6 favorites]


My 7-year-old twins just finished their first full year of school, second grade, on ADHD medication - one on Focalin (non-amphetamine stimulant) and Intuniv (non-stimulant); the other on just Intuniv. They both struggled through first grade, but once medicated, they both did a complete 180. One of them now has an IEP for a learning disability, but couldn't accurately be evaluated until the ADHD piece was addressed. The other one was doing okay academically, if he was able to stop roaming around the classroom and inappropriately touching people, which he usually couldn't do, even in a relaxed classroom setting with adequate breaks and recess and a patient teacher who didn't expect first-graders to be able to sit for hours.

Before making the decision to medicate, they had full neuropsych evaluations done, and continue to have regular monthly meds management sessions with a prescribing psychiatrist who carefully monitors side effects and dosages. We have been trying to get them into therapy but it is almost impossible to find a practice that takes our insurance *and* treats their age group *and* has any openings. But we are still looking. In the meantime, the child in special ed has behavioral goals and skills included in the IEP, which has been helpful.

I have no regrets about medicating for ADHD. They were becoming so angry and anxious and emotional because they knew that they were struggling and couldn't understand why. One of them even said they didn't want to be alive. Now they are both building their confidence and have made amazing progress in both school and in social situations. Are they meltdown-free? No, they still have sensory issues and just regular life-stuff like any other kids their age. ADHD medications aren't magic pills. But their bodies now have increased ability to think through a situation, to analyze choices and consequences. They both are happier to feel more in control of themselves.
posted by candyland at 9:59 AM on July 6, 2016 [13 favorites]


You worry about which version of you is the “real” you, or if that concept even means anything.

I used to worry about that, and then I decided that the real me had been caged, and that my ADHD diagnosis was the key to let myself out. I had been looking out at the world and trying to function as if I was walking around draped with an opaque shower curtain. I could still move, I could still see, but it was very hard to actually get anything done. It's still me walking around either way.

And maybe long-term use will have adverse health effects, but holy shit, I'd rather have a few less years and a much better quality of life than have a lifetime of the kind of misery, anxiety, and general feelings of uselessness the constant struggle of life without meds gives me.
posted by barchan at 10:11 AM on July 6, 2016 [16 favorites]


This article makes me angry for several reasons. But just one thing for now: If kids/young adults (well, adults too) aren't given the ADHD meds they need, they may start self-medicating with illegal drugs. I didn't see any mention of that important consideration.
posted by trillian at 10:15 AM on July 6, 2016 [19 favorites]


Ah, moral panic over the uptick in ADHD prescriptions. Never change.

By their 18th birthday, nearly 1 in 3 kids will be wearing eyeglasses. The vision correction industry, bad teachers, and a corrupt optometry racket are conspiring to prescribe corrective lenses at the first sign of any nearsightedness, rather than recognizing that kids are just lazy. 20/20 is an arbitrary standard of vision, and our ancestors didn't have glasses; they just toughed it out, like nature intended. We wouldn't have this problem if kids spent less time reading and more time outside. When I took vision tests as a kid, corrective lenses gave me headaches and made my vision WORSE, so the whole thing is an elaborate farce.
posted by Mayor West at 10:18 AM on July 6, 2016 [70 favorites]


At the risk of this turning into an AskMe thread, 48 hours after I started taking Lexapro (at age 30), all I could think was, "All that suffering, for 17 years, and for what?" I didn't seek help (or even think to) until radicalspouse put zir foot down (ze rarely does). My GP was like, "Wow, it sounds like you've been miserable this whole time except when you were drinking, which you did a lot." Yep!

I think the self-loathing comes from a generational transition (or I hope it's transitioning, anyway) from viewing mental illness as a disability brought on by not trying hard enough or not thinking positively enough or not worrying so much, to viewing it as something that 20% of Americans will suffer from at one point or another. By comparison, about 16% of men will get a prostate cancer diagnosis at one point or another.

Erasing the stigma is surely a majority of what needs to be done.
posted by radicalawyer at 10:18 AM on July 6, 2016 [13 favorites]


20/20 is an arbitrary standard of vision, and our ancestors didn't have glasses; they just toughed it out, like nature intended.

oh man now I am trying to remember the details of the (possibly crackpot) theory that civilization had an evolutionary jump due to small doses of psilocybin giving us sharper vision than normally afforded.
posted by griphus at 10:23 AM on July 6, 2016 [2 favorites]


For a full analysis on a generation on medication to be productive members of society. I cite you this serial documentary which has some pretty serious analysis on such a light hearted topic.
posted by Nanukthedog at 10:27 AM on July 6, 2016 [1 favorite]


I like the medicated version of myself much better — he gets stuff done, he has hobbies, he is a fully-formed individual for whom the world is actually an interesting place.

This.

To me, the most disturbing part of identity politics is the way essentialism has become weaponized. "Born this way" isn't some kind of neutral statement or starting point -- it's something to aspire towards, and something to move mountains to achieve. I can see why that is, and I can sympathize with that. Saying you can't change or saying that you're miserable if you are forced to change are both incredibly powerful arguments in our culture, and they're quite frequently true. But it has its downside, too, and, in part, that downside is the way that others are taught to feel guilty about the part of ourselves that we've 'rejected' to be the person we want to become.

I like the medicated version of myself better than I do the non-medicated version of myself. I like the glasses-wearing vision of myself better than I like my non-glasses wearing vision. My sister likes the version of her hair with blond highlights better than she likes the version of her hair without them. My grandmother prefers the version of her mouth with partial dentures than she does the version of her mouth without them. None of these opinions should be controversial, and yet somehow my feelings about drugs are the ones that are written about. (And maybe hair dye, because that can be portrayed as frivolous -- and that's a political issue all its own.)

And you can say that questions about one's 'authentic' identity ought to be written about (I'll confess to wondering, sometimes, what I would be like without drugs), but the fact that this essay exists and not the essay about glasses or dentures is itself a political statement. It's a political statement in the same way that an essay about women who regret having abortions is political -- because it uses a single framing to address a question that's acceptable to ask in our culture in ways that the other framing (drugs are great! maybe we should all go out and take them for everything that ails us!) somehow isn't.

Ultimately, I'm enough of an existentialist to see an obsession with defining one's authentic self as fundamentally a kind of bad faith (in the Sartrean sense). I know a woman who became uber-organized after a (mild) traumatic brain injury. So far as I know, she didn't lose any cognitive function, but, the day she got out of the hospital, she went and bought a bunch of highlighters, a to-do notebook with an index, and a set of tabs to mark pages in her notebook. Is it somehow more 'authentic' for her to become organized after a TBI than for her to do so after going on drugs?

I wasn't born a researcher. I wasn't born anything. But this is the person I choose to be, and part of the person I chose to be includes taking medication.
posted by steady-state strawberry at 10:29 AM on July 6, 2016 [18 favorites]


This article is all anecdote and blather.

The amphetamine dosages in ADHD meds are really pathetically tiny. If you are worried about dosing your children, take some of their pills, scaling up for your body weight. The things are like No-Doz.

I am of the generation before meds, manage my attention deficits and excesses through habit and self-discipline, and am a kind of semi-human robot as a result. I have always to do everything the same way to stay organized. It is good being a semi-human robot, though I really do think shiny armor and superhuman strength should have come with the deal, but it is no more a normal state of affairs than being mildly speedy all the time. The problem is the condition, not the meds for the condition.
posted by ckridge at 10:32 AM on July 6, 2016 [7 favorites]


I got my diagnosis at the age of 43. I had struggled mightily my entire life to meet deadlines, be productive, focus, do one thing at a time, prioritise, etc. I managed to graduate from college (barely, after nearly flunking out my first semester), got work at places I loved and still suffered enormously because I had to work more than full-time, including weekends, just to get my work done. And it wasn't a crazy workload, it was my crazy brain. So I know what I'm like unmedicated. I feel the same medicated and not. But my behaviour is different. Unmedicated, I get very little done. I am more impulsive, less filtered, more apt to say snarky thoughts the minute they come into my brain and, thus, hurt people I love. Medicated, I get more done, I'm more professional, and I can fucking focus. Imperfectly but without the life-and-death battle it used to be.

For me, my ADHD medicine is not like wearing glasses. Or rather, it's like wearing glasses that aren't a perfect match. The analogy for me is that my meds are more like a crutch--and that's a good thing. I still can't run. But I can walk decently, and move quickly when I need to. And I'd never be able to do that without my medication. ADHD meds are an assistive technology that I need in order to function as fully as I am capable.

My late diagnosis made me bitter for years. I'm over it now but jeez was I angry in the beginning. I first went to therapy in my early 30s because of missing deadlines at work. Then I spent at least 10 years in therapy with different therapists before I finally read an article about ADHD, recognised myself in it, and asked for a referral to a neuropsychologist who did a huge battery of tests. Then he told me I had ADHD--but it was a really mild case. Bullshit. I didn't believe him, I'd been miserable all my life. (Then he asked if I'd heard of the New Yorker. Since I was a writer, maybe I should try writing for it. That's when I realised people should never give advice outside their own areas of expertise.)
posted by Bella Donna at 10:32 AM on July 6, 2016 [9 favorites]


I just noticed that the last three words of the article are "kids these days." How much more perfect a conclusion can you get to an article like this?
posted by radicalawyer at 10:34 AM on July 6, 2016 [8 favorites]


In some ways, this seems a lot like male circumcision. Without getting into any kind of debate about medical necessity/tradition/etc., you've got a situation where parents are often trying to do what's "right" for someone who is too young to consent. Then those kids grow up, and some of them are happy with the decision, and some are angry, and some are left wondering about "what-ifs."

Maybe some kids who were diagnosed young could have found coping mechanisms to let them get by without medication. But in many ways it's impossible to know, even if one of those kids grows up and flushes the pills and manages to make it work with vigourous exercise and a washi-taped planner, we can't got back 10 years and find out if that could have worked for them then.

I think that it's good to listen to the stories of these adults who grew up medicated, and I hope that real researchers are doing what they can to catalogue them, because this kind of decades long study isn't something that you can really do in a controlled way.
posted by sparklemotion at 10:39 AM on July 6, 2016 [3 favorites]


I was diagnosed sometime in grade 3 or so with ADD. However, my parents didn't like how that was done, it felt like meds were just being shoved at me and were quite lucky to then get a child psychiatrist who specialized in Autism-spectrum, which I also have. The first thing he did was a detailed interview and observing me (apparently, don't remember that, I just remember his toys were not as good), then he did a blind trial with me where I got a full does of Ritalin some days, a half does others, and no does others, and my teachers and parents had to fill out a log on my behavior without knowing which is which. If I were in charge that would be mandatory, as it apparently gave a VERY clear view of how the meds worked for me.

That said, I've never had to take them all 7 days a week; They've always just been for when I need to focus, so if I didn't have homework on a weekend I didn't take them, or during summer vacation. I actually find if I take them too long they don't work nearly as well. So I never wondered what I was like off them. I was the same, but more focused, and with a better handle on my emotions. I liked not failing at school.

That said, they kicked my ass. If I felt any negative emotion while they were wearing off, it was magnified. They murdered my appetite, had issues sleeping, it was bad. But I knew of people who should be on them and weren't, and they had SUCH trouble in school. I knew someone who finished an assignment then lost before school THE NEXT DAY, not one, not two, but THREE TIMES.

In grade 11 I switched to Concerta, and the side effects weren't as bad, and for a long time it also worked better. Also, I was only going through the side effects once a day.

But yeah. There is no way I would have made it to university without it, and now I'm working on my PhD. They don't work as well as I'd like, but hell, I made it this far, when I'd have had trouble passing high school without it.

Also, it doesn't change my hobbies, interests or who I am. When I was young and had trouble focusing in social situations I'd use them when playing D&D. Now I don't. I enjoyed the game a lot either way. I still write stories and campaign settings in my head on the way to work, no matter if I take them before heading out, or after get there. I still have a blog for creative writings (though it isn't updated much anymore.) Heck, often being on meds makes my creative writings better, as it lets me focus enough to get the ideas down before I get distracted and forget what I was about to say. These aren't zombie pills, no matter what people who never have taken them claim. If they are dong that to you, you either don't have ADHD, or are very much on the wrong meds.

I wrote this up on Reddit back when I used that, which made me remember a few things as well. When I was doing math as a kid, on my meds, I would still make up stories about the numbers I was doing math on, that they were battlefleets or such. So even doing addition worksheets and stuff I was being creative and writing stories while on meds.

So no, I don't think of myself as addicted, or feel bad about it.
posted by Canageek at 10:42 AM on July 6, 2016 [6 favorites]


Someone gave me a book on adhd when I was in my early 40's. At that point I had actually learned to cope with most of the things that make it so hard to live with- but the relief was amazing. I wasn't a terrible person bent on hurting those who cared for me with my willful indifference. I tried adderal- it didn't work for me, as most of the prescribed stuff doesn't on my personal chemistry. If it helps people- then it is a Good Thing.

Someone upthread talked about how it was essential to do therapy in addition to the meds. Good habits are things everyone aspires to. Any help you can get to beat the dragon ever day, whether you are neurotypical or not - is a good thing.

One of my nephews is on all the meds ever- when he was under 5 he was kicked out of three daycare facilities in a row. He has somewhat learned to control himself now, and I am grateful his parents spent the time to understand he wasn't a "bad kid". His nickname was "The hurricane" because he could create chaos in about 5 minutes. I personally didn't get that option, but I know how hard it was to be outside the way the world works. I'm glad he has the breathing room the drugs afford so when he does get to adulthood, he can keep a job.
posted by LuckyMonkey21 at 10:49 AM on July 6, 2016 [1 favorite]


I'm exactly the opposite. I was diagnosed later in life and really wonder how much better things would have been if I had been medicated as a child. Where would I have gone? What would I have accomplished? Who would I have become?

I was finally diagnosed with ADD at 27 and started a prescribed stimulant three years later. It was also prescribed for comorbid treatment resistant depression. It has only made my life better.

I've mentioned this before but the look on my mom's face after she asked me if my life would have been better if she had me tested for ADHD as a kid instead of assuming I was "lazy" and just being perpetually mad at me for mediocre grades and shitty personal habits was something I wouldn't wish on anyone.

Yes. I know this story, because it is also mine.
posted by clockzero at 10:52 AM on July 6, 2016 [6 favorites]


I can't be the only one who is worried about the long-term effects of being on an appetite inhibitor, can I? I've been on a dosage where I just don't eat, which was awful, and now I'm on a dose where I'm just less hungry all the time. Even when I don't take the medication, I just eat way less than I used to. I've lost some weight without trying - and I started out at a perfectly healthy weight. With these eating patterns, I'm worried about long-term screwing with my metabolism and missing needed nutrition. If I someday have kids with ADHD (and I have a gut feeling that I will), I'm really worried about putting them on stimulants long-term while they're growing.

I know not all dosages/medications inhibit appetite, and certainly they don't do that for everyone, but anecdotally most of the people I know on stimulants do experience some degree of appetite suppression and just put up with (or enjoy it) and don't consider it an impediment to long-term usage.

To be perfectly clear, I'm sure that this side effect is not everyone's experience and that it's not a harmful side effect for some as long as they end up eating a healthy amount of food one way or another. But I do worry for me and I worry for my future hypothetical kids.
posted by R a c h e l at 10:54 AM on July 6, 2016 [2 favorites]


he did a blind trial with me where I got a full does of Ritalin some days, a half does others, and no does others, and my teachers and parents had to fill out a log on my behavior without knowing which is which. If I were in charge that would be mandatory, as it apparently gave a VERY clear view of how the meds worked for me.

Hah. When my oldest was diagnosed (which is what lead to my own), the school went really pear-shaped about it when we let them know he was on meds. Like, complaining every day about his behaviour and that the meds must be making him more aggressive or something and we should go and do something about it. He'd had behaviour problems before, but they were indicating that it was significantly worse. The teachers set up this meeting with me, the school psychologist, and themselves to talk about what needed to happen and for the month before it happened (about the only time I was glad that it takes forever to see a school psychologist) I started playing around with dosage levels. I kept a calendar, and had days where he was full dose, days where he was half-dose, and days where I gave him no dose. And then I would mark whether or not there was a note about his behaviour that day or not. And there was no pattern.

So we go into the meeting, and the psychologist asks me a bunch of questions about the assessment report - which made it quite clear he and I were the only ones in the room who had read it - and then got the teachers to describe what was going on, and turns back to me and says "But you see none of this at home?" And I agree with that, say that his at-home behavior is actually much better now than before which is why we don't think it is a medication issue, and then whip out the calendar, which the psychologist looks at and then says "Well, it clearly isn't the medication then. So what is happening here (at school) in terms of triggering these behaviours? What has changed and how are you approaching him? And have you read the recommendations for accommodations that this report makes?" I could have hugged him. It just completely changed the atmosphere of the room from one in which I felt like I was being ganged up on to one in which the teachers were suddenly on the spot, and I could help them by making suggestions and discussing strategies we were using. I would have loved to have been a fly on the wall after that meeting, because the notes stopped altogether, the scheduled follow-up meeting to continue problem solving got cancelled, and the teachers in question were not back at that school the year following.

I can't be the only one who is worried about the long-term effects of being on an appetite inhibitor, can I

I don't worry about it for me, but do for my son. We keep an eye on his weight and food intake and have consulted with a dietitian to make sure he's getting enough caloric intake during the day.
posted by nubs at 11:10 AM on July 6, 2016 [9 favorites]


Being dependent on a substance is not addiction.

If you could give me a giant megaphone that would somehow reach entire societies with a message, this is probably what I'd shout from the rooftops.

The idea of being "addicted" to life-saving medications hits the intersection of two great American cultural myths; the idea that we're all "self made" people who worked hard for everything we have, and the idea that any kind of disabled body is shameful and needs to be hidden away. Put those two strains together, and you get the destructive idea that needing any kind of medication is a sign of weakness and an inability to just work harder. ADHD happens to be a ripe target because its signs are subjective, and because the number of diagnoses is rising, clearly because kids are getting pills left and right because big pharma and not because teachers/parents/clinicians have gradually become more adept at identifying symptoms or anything sensible like that.

I once watched one of my mentors, an amazing nurse practitioner, get more frustrated than I'd ever seen before as she tried to explain to a patient with huge diabetic ulcers that increasing his insulin dosage wouldn't make him "addicted." This is the point we get to when we demonize medications, and articles like this aren't helping.
posted by ActionPopulated at 11:11 AM on July 6, 2016 [30 favorites]


In some ways, this seems a lot like male circumcision.

N–no. When you actually "get into any kind of debate about medical necessity/tradition/etc." your parallels collapse.
posted by listen, lady at 11:11 AM on July 6, 2016 [7 favorites]


In some ways, this seems a lot like male circumcision.

It's really not.

Without getting into any kind of debate about medical necessity/tradition/etc.,

Well hey, that's convenient. Let's not discuss motivation at all. That will surely add to the discussion.
posted by zarq at 11:12 AM on July 6, 2016 [8 favorites]



To be perfectly clear, I'm sure that this side effect is not everyone's experience and that it's not a harmful side effect for some as long as they end up eating a healthy amount of food one way or another.


Well, track what you eat. That way you'll know whether or not you are.
posted by listen, lady at 11:13 AM on July 6, 2016


Obviously, ADHD medications are helpful and necessary for people with ADHD. But my kid was in grade school in the 90s, and I assume because the medications had been so effective, there was a tendency to try to diagnose kids wholesale.

In grade school, my kid came home one day with a long, incredibly intrusive psychological assessment test they'd handed out to all the students, for some 'study' sponsored by a pharmaceutical company and a local TV news channel, and there were a lot of clearly ADHD oriented questions on it. When I called to ask what it was, all they'd tell me is that it was free. I didn't fill it out, but they harassed me for quite a while about it.

There was also a time when my kid was bored and distracted in a specific class for a while. The material was way below his level and the teacher was just handing out piles of worksheets consisting of simple but tedious work every day. Rather than working with me to find a better solution for him, though, the teacher suggested I "get him on" Ritalin. It was obvious and already known that his problem was boredom, but I figure she'd just seen that work for other kids who were distracted, so she just figured that was the solution for all of them.

So it certainly seems plausible to me that there are people who were wrongly diagnosed with ADHD and put on the medication unnecessarily, and that their dependence on it really is addiction. Just like someone without chronic pain taking medication for that.
posted by ernielundquist at 11:16 AM on July 6, 2016 [1 favorite]


Real talk, I fucking love Adderall and it literally improves my productivity and end net income by a significant percentage (my guess is 30-35%).

On top of that, in the last 3 years since I started taking fairly high amounts, my ability to be on time, punctual, not a flake, and in general a reliable dude has reached an all time high.

It's a wonder drug for people like me, who need part energy, part euphoria, part mental confidence to achieve at our highest level.

But, real talk - when I run out early or have to go 2-3 days without it, fuck me running does life become impossible. The immediate and noticeable dropoff in all positive output is astounding, and I can't imagine reverting to that state permanently.

They're totally inappropriate for young children, but I think any adult who is aware of what they're getting in to by taking d-amphetamine every day for years to come should have the option to do so.

But that's just me, a guy who needs pharma-grade speed to get anything done at age 32.
posted by GreyboxHero at 11:18 AM on July 6, 2016 [9 favorites]


You worry about which version of you is the “real” you, or if that concept even means anything.

This really resonated with me. I have almost exactly the same story as Evstar's. And - in the opposite of what someone said above - I like the unmedicated version of me (the messy, disorganized, at times airheaded, more challenging to love, much more ravenously hungry version) better than the medicated. That doesn't mean I think I was addicted, or I think those who choose to medicate are any less real. I just, for some reason, do not feel at home with myself when I'm on my ADHD meds...I don't know why. And that's ok too.

(I don't like wearing my glasses either. What can I say, I'm weird.)
posted by sallybrown at 11:25 AM on July 6, 2016 [2 favorites]


I can't be the only one who is worried about the long-term effects of being on an appetite inhibitor, can I?

My weight got a bit low at one point when I was growing up. They put me on Boost shakes until it hit the proper weight for my age. No harm. Just have to make sure that they get enough healthy food.

I found eating my lunch over a long period would help, as I wouldn't realize how much I was eating, and I could finish my food then, by eating one item at a time. Apple, ten minutes later sandwhich, etc.
posted by Canageek at 11:42 AM on July 6, 2016 [2 favorites]


The first thing he did was a detailed interview and observing me (apparently, don't remember that, I just remember his toys were not as good), then he did a blind trial with me where I got a full does of Ritalin some days, a half does others, and no does others, and my teachers and parents had to fill out a log on my behavior without knowing which is which. If I were in charge that would be mandatory, as it apparently gave a VERY clear view of how the meds worked for me.

I kind of feel like this may have gotten lost among the other discussions in here, but: sweet fancy Moses, this is emphatically not what we need to do with kids who are on medication regimens that allow them to function.
posted by Mayor West at 11:44 AM on July 6, 2016 [1 favorite]


ernielundquist, yes, OF COURSE what you describe is a real problem—it's just the only problem that is getting public traction, and that traction is useless hysteria besides. which makes it harder for the people who need treatment to get it.
posted by listen, lady at 12:03 PM on July 6, 2016 [2 favorites]


We wouldn't have this problem if kids spent less time reading and more time outside.

Well, actually...

"Spending time outdoors is one of summer's delights. Now, eye research suggests it may also be a key to our eye health, as long as we avoid over-exposure to sunlight. Although spending too much time outdoors without protection from the sun's ultraviolet (UV) light can damage eyes and skin, new studies show that natural light may be essential for normal eye development in kids."
posted by leotrotsky at 12:07 PM on July 6, 2016 [2 favorites]


Reading all this, I realize how lucky I was. I was diagnosed when I was 6 and was finally put on medication when I was 10. We tried every single fucking behavioral therapy we could find. I was almost kicked out of school twice. And then, boom, suddenly I had friends, I wasn't behaving inappropriately in class, I could slow down enough to actually learn coping strategies. When I was diagnosed, my parents were told to forget about college and just work to keep me out of prison. Part of me thinks that that might have happened without the meds. (Thinking back to knocking out a kids baby tooth after hitting him in second grade and kicking a teacher in the crotch in third grade. There are probably others that I'm forgetting.)

My uncle managed to get his PhD despite having pretty bad ADHD. It took him three tries in college to get through and a pot and a half of coffee habit he still has to this day. My mom took all kinds of speed to get through college. People know when they need a stimulant to focus. And they will find it.

Also, apparently, only some stimulants are ok, while others are a no-no. I don't see anything decrying giving kids caffeine in the article. Which is the default solution that I see if they aren't medicated. I wasn't on ritalin on the weekends and instead drank a 16oz bottle of Mountain Dew before every soccer game.

Ritalin is one of the most studied drugs out there. We don't know what really long term effects it has over the course of a life, but on a short and medium basis (several years), we know it is not harmful.

I've run into enough trouble elsewhere (yay comorbidity of depression and ADHD) that I cannot be anything but incredibly grateful that I got help with my ADHD so early.
posted by Hactar at 12:14 PM on July 6, 2016 [8 favorites]


I was only formally diagnosed with ADD in adulthood, a few years back when I was seeking help for more acute issues aggravated by a series of very unfortunate life events, but mine was severe enough to be recognized even before the ADD/ADHD label was created as an "organizational dysfunction" in school, and I was given accommodations. I was a heroin baby and statistically there's a slightly elevated risk of ADD/ADHD in that tiny cohort of the population, so it seems likely it's definitely a chronic, physically-manifested condition in my case, but none of the usual medications for treating ADD have worked out for me long term, most of them triggering a level of aggression and irritability after a few weeks of regular use that isn't acceptable to me. Nicotine delivered through vaping works better than any of the prescription meds I've tried, but the most effective therapy has always been having an uncomplicated, secure and relatively routine home life. My son started showing signs of the disorder this last year in school, and when I consulted with his doctor about getting a diagnosis and starting treatment for him, I told the doctor I wasn't really comfortable with the idea of my son being forced to start medications so early and being essentially dependent on them, given my own reactions to the usual medications and the family history on both sides toward addictive disorders and substance abuse. He explained that in my son's case, the recommended approach would be to get him on medication temporarily to help get the more acute issues he's been having under control, and then use a combination of therapy and simplified home routines to help him learn to manage the condition on his own. The fact is, not every condition can be managed alone. I've always needed a little extra help from friends and family to keep my disability from being crippling and I'm sure he will, too, though his mother and I are not really in a position to focus on him and give him that extra help and structure right now due to other ongoing circumstances. It's a shame that either way, he's going to have to go through life with people constantly accusing him of and berating him for being lazy, inconsiderate, irresponsible, self-preoccupied and aloof. When I was a kid, people at least charmingly thought of it as being adorably "absent-minded" and didn't stigmatize or judge me defective and "broken" for my weaknesses. I'm still hoping to get some benefit from recognizing and beginning to help him manage his condition early, but who knows when there's going to be time for that. Ugh. Mental disabilities and illness are the worst: even people who should know better can't help but take the symptoms personally and see them as intentional acts of passive aggression or as personal failings. It's frustrating.
posted by saulgoodman at 12:18 PM on July 6, 2016 [3 favorites]


“There is no biological test or even marker for ADHD,” Diller says. “All those things create ambiguity. And so the range of people who have it, to who continues to have it after childhood, is very variable in all the studies.”

That quote from the article infuriates me. There are lots of studies that confirm that ADHD is a real thing. (Are folks misdiagnosed? Of course. For that and many other things, which sucks. That's not the point of TFA, however.) Researchers are looking for biomarkers for ADHD. The failure to discover them thus far hardly makes ADHD a pretend ailment. There are no confirmed, established biomarkers for depression, either. Both are real, and both create suffering if untreated.

That there are several ways to treat both is great, but I wish we had more. I have friends with such severe ADHD they are unable to hold down jobs. Unluckily, existing treatments haven't worked for them. Which makes me truly sad. But then, the state of mental health care worldwide makes me sad. And thanks to everyone who has shared stories; that means a lot to me. It's so hard dealing with folks who have no idea what it's like inside my brain but are convinced that everybody is a little ADHD. Nope, not at all.
posted by Bella Donna at 1:10 PM on July 6, 2016 [11 favorites]


I tried stimulants once, in my twenties, when a girlfriend was studying for a test and had something she called "black beauties", so I took one.

I have always wanted to be able to draw -- my mother was a "natural" at it, apparently -- but to call my work stick figures would be to slander the accomplishments of average five year olds, yet when I came up on the drug, without even intending to I produced a very recognizable caricature of my girlfriend's face, which she immediately snatched away as some kind of momento.

But while I was high on that drug, I had a very pronounced sensation of burning the furniture, and I've never tried anything like it since.
posted by jamjam at 1:30 PM on July 6, 2016 [1 favorite]


> To me, the most disturbing part of identity politics is the way essentialism has become weaponized.

Of all things, this reminded me of something I read in a dog training book, responding to a hypothetical objection which struck me as odd: “Can't you just let dogs be dogs and do what they like? Why do you have to make them play by your rules?” I'd never heard anyone say this before, but apparently the author must have.

Her response was that trained dogs are happier dogs. The dog that has to be locked in another room when Grandma comes over is not a more authentic dog than the one that can keep itself from jumping on people. Dogs actually like to please us, and the dog that can be a full-fledged member of the family is definitely happier than the dog who digs up the flowerbeds and snarls at the neighbors.

I guess that makes me canine, because I've never once felt that ADHD medication “normalized” me and made me fit some sort of capitalist mold. I do make more money than I would if I were unmedicated — though if I were unmedicated I'd have trouble holding down any job at all — but the value of the pills is not earning potential but the ability to be good at something. To have an idea and see it through to completion.

Being true to some sort of arbitrary self nature means nothing to me; succeeding at tasks within the framework of the society I live in means quite a bit.
posted by savetheclocktower at 1:40 PM on July 6, 2016 [21 favorites]


Oh dear. Does the author of the article know anything about the condition, or is she just drawing on anecdote and myths about Big Pharma? I see an awful lot of opinion and not much science. But I did learn that Ritalin is named after Marguerite, so there's that. I'm calling it Rita from now on.

I'm approaching 50 and I got my diagnosis last year. I do wonder how life would have been different if I'd sought help sooner but I always found a way. It is what it is.

Ritalin has improved my quality of life in ways I couldn't imagine. I'm the same hyperfocus ninja I ever was and now I do tax returns too! Sometimes I even turn up on time. But it's a learning curve - there's a whole area of discipline and routine I need to learn to rebuild my life. It's meaningless without structured therapy and sympathetic coaching. I've been lucky in that respect too.

What bothers me most about the personal accounts in this story is that medication seems to be inadequately supported with appropriate care. These stories are consistent with things I've heard from younger people who've been stigmatized by employers, educators and yes, therapists. The condition is incredibly easy to treat and yet we're doing a terrible job of helping people.

The challenge everyone with this diagnosis faces, whatever their age, is the idea that there's anything really wrong with you. As a way of experiencing the world, ADHD arguably confers evolutionary advantages to the group, but it's completely at odds with the demands of modern living. In this respect, it's inaccurate to describe it as an impairment, it's just another way of being. The down side is that to it becomes harder to accept medication when it's not your problem, it's our highly structured civilization that's at fault. I think many people understand this at an intuitive level, and so chemical assistance becomes problematic. But you can never win, because your atypical wiring is interpreted by everyone around you as a moral failing, and you end up hating yourself for your shortcomings.

Ultimately, if you live with the fucker then stimulants are going to be part of your life. If it's not methylphenidate, it's coffee, nicotine, chocolate, cocaine or whatever else you can get your hands on to feel remotely normal. And plenty of excercise.

We need less hysteria and more science. Misinformation like this doesn't help.
posted by Elizabeth the Thirteenth at 2:03 PM on July 6, 2016 [11 favorites]


The fact there is no definitive medical test for a condition doesn't mean it's not real, of course, but it does often mean that diagnosis can be tricky, and can err on both sides.

If you make it too hard, some people aren't going to get the treatment they need. If you make it too easy, some people are going to be be unnecessarily medicated. Neither one invalidates the other, but if there's an increase in stories about the latter, it's probably because some of the kids that got caught up in those sort of mass diagnoses in the 90s are realizing now that they've been medicated inappropriately all their lives and have ultimately suffered for it. Their experiences need to be taken into account, too.
posted by ernielundquist at 2:06 PM on July 6, 2016 [1 favorite]


I think part of the narrative here is that ADD diagnoses are a crutch in this society to bolster people who are not ~successful enough on their own~

Yeah, speaking as hyperactive ADHD dyslexic etc. person, fuck that patronizing bullshit narrative. Ritalin was the only treason I was able top get through school. And I was damn good at it until my neurochemistry changed.

Do diabetics or people with cancer have to deal with this much instant expertise? I mean seriously, unless you have a degree in neuropsychology or educational therapy I do not want to hear your solution.

I do not need one more person telling me what I really need is EST or diet changes, or meditation, or whatever bullshit is currently hitting Google. I do not need another friend aiming me at the South Park "Sit Down and Study" episode as if it's a joke.

What I need is a lot more research to give tribe the medications, until I get one that works best for me. And overmedication scares from people who stupid happily sacrifice 10% of the children to prove their philosophy? That I don't need.
posted by happyroach at 2:10 PM on July 6, 2016 [12 favorites]


Do diabetics or people with cancer have to deal with this much instant expertise?

Ha. Yeah, probably even worse, with cancer.
posted by thelonius at 2:42 PM on July 6, 2016 [4 favorites]


Nearly all disabled people have to deal with armchair expertise. (I have to assume you're joking, for my own sanity.)
posted by XtinaS at 3:11 PM on July 6, 2016 [7 favorites]


It also occurs to me that this article, like many, assumes that all kids with ADHD live in an environment that is conducive to non-pharmacological treatment: stable, with parents/caretakers with enough resources to access consistent, high-quality therapy. Speaking as someone who's spent time (as a student/provider) in a children's psychiatric crisis center serving mostly lower SES families: nope.

The most unambiguous case of ADHD I've ever seen was a little guy at that center. Kid literally could not sit down for more than ten seconds at a time, could not answer a straightforward question from the doctor, climbed on every available surface and structure. And he was in foster care, with a goal of eventual return to mom; he came to the center with his birth mom and a social worker who seemed to be facilitating parent contact. It's not much of a stretch to say that going between foster care and parental custody, or between foster homes, disrupts the routines that ADHD kids like him need so badly. Not that folks shouldn't try, of course, just recognize that "just set a routine and you won't need meds, it's easy" isn't always actually easy. (And in the case of this particular kid, he needed the medications he was already on to stand a chance of even being able to sit still long enough to grasp a routine.) I saw so many current or former foster kids with ADHD pass through that center.

The other part of this equation is that you can't possible overstate the extent to which insurance rules EVERYTHING, especially if we're talking about Medicaid, SCHIP, and other programs that cover care for kids from low SES backgrounds. If insurance doesn't cover enough therapy sessions for a kid to really develop a routine that works, sucks to be them. Ditto if the only therapy places insurance covers have a rotating cast of providers, or just don't have therapists a client can click with. (How many times do you see the AskMe advice to "just keep looking until you find a therapist that fits?) Ditto if you drop into foster care or a family shelter and suddenly your provider is two long bus rides away.

Tl;dr ADHD is not just a condition for rich people with stable family situations, and that's basically what all the moral panic articles about ADHD epidemics imply.
posted by ActionPopulated at 3:12 PM on July 6, 2016 [22 favorites]


Yes! I know it's just anecdata, but my son didn't really even struggle with his issues until our family structure started coming apart and we started struggling with serious financial shortfalls, rather than just background stress.... (He had all As on his report card last year; this year, he barely passed fourth grade. Of course, he's at an important transitional age, developmentally. But he was doing so much better before our family life came apart.)
posted by saulgoodman at 3:57 PM on July 6, 2016


I kind of feel like this may have gotten lost among the other discussions in here, but: sweet fancy Moses, this is emphatically not what we need to do with kids who are on medication regimens that allow them to function.

Actually, this is the ideal way to find the medication that works the best. It's called titration and it's not used nearly enough in treating ADHD. My son has been on titration three times I his life: the first time when we first tried meds, the second time when he had a huge growth spurt, and the third when he turned 18. When the body/brain changes, it makes sense to do a titration to make sure the medication is its most effective.
posted by cooker girl at 6:02 PM on July 6, 2016 [1 favorite]


To add: ideally, the titration is done during a low-stakes part of a person's life (for kids, summer is good), doesn't take more than about four weeks, and the psychiatrist already has a decent grasp on what will most likely work for that specific person.
posted by cooker girl at 6:03 PM on July 6, 2016


"When I go off it now, I can’t get through simple chores, errands, tasks, anything."

That's ADD, honey. That's literally the major symptoms of ADD. It's a lifelong condition which you have and take medication for. Because if you don't, the condition starts impacting your life in negative ways. facepalm

Do people go around telling diabetics 'You didn't do that, the insulin did that'? No.

Medication doesn't run errands, graduate school, or do any of those things. People do those things. Sometimes people need wheelchairs, braces, surgeries or medication to be able to do those things necessary for a modern life. All of these are tools and they're all OK.

There's a serious conversation to be had about prescribing kids medication vs intervening via teaching methods (the latter is harder and takes longer to see results, but works better in the long-term). That said, there is a reason people with ADD take medication, and it is a very good reason.
posted by Ahniya at 6:14 PM on July 6, 2016 [8 favorites]


Has ADHD become so deeply ingrained within our society that widespread stimulant use is simply accepted?

Hmm, judging by this thread, the answer is "yes".

Sigh. As someone still coming to terms with how I was drugged through adolescence, I can only hope one day we see the medicalization of childhood and life under capitalism for what it really is.
posted by Wemmick at 6:20 PM on July 6, 2016


Wemmick, that was an incredibly dismissive thing to say about a medical condition that seriously impacts millions of people. That you got misdiagnosed is incredibly sad and frustrating, but doesn't change the fact that medication is an important part of helping people with ADD function.

If you want to complain about widespread stimulant use, coffee and energy drink use is much bigger (and un-regulated!) than legal, prescribed stimulants.
posted by Ahniya at 6:24 PM on July 6, 2016 [14 favorites]


Also, cigarettes.
posted by Cookiebastard at 6:44 PM on July 6, 2016 [2 favorites]


It's a medical condition because we've medicalized it. Read sociologist Peter Conrad's work — he's described the historical process from "hyperkinesis" and "minimal brain dysfunction" to "ADHD" and it's expansion to further expansion to "adult ADHD". These things are socially constructed, and most of the conversation in this thread essentially follows a narrative shaped and promoted by the drug industry. Outside the U.S. the conversation is different, though the American perspective is gradually being exported to the rest of the world. Now, none of this to say that some people don't benefit from stimulants (or, to be more precise, to function according to the expectations of modern life), but "ADHD" is more or less a label invented to pathologize certain kinds of behaviors, certain patterns of thinking and feeling, and to justify the use of stimulants. (The quest biomarkers and biological underpinnings is essentially an attempt to find science that justifies what we've already been doing for ages.) I fear decades from now we'll look back and realize it was a mistake.
posted by Wemmick at 6:52 PM on July 6, 2016


These things are socially constructed, and most of the conversation in this thread essentially follows a narrative shaped and promoted by the drug industry.

Please stop dismissing the lived experiences of many, many people in this thread. I, for one, find it both insulting and condescending.
posted by steady-state strawberry at 7:17 PM on July 6, 2016 [14 favorites]


You all it's not a medical condition it's chemtrails from fluoride in the water and if we all just went gluten-free and stopped taking baths no one would need medication.

Jesus people can be stupid about medical intervention. The only thing my adderall does for me is make it easier for me not to forget where my keys are and not constantly forget everything else so my life is not staggering from disaster to disaster. alack for my capitalist consumerist mindset that values being able to do basic life skills.
posted by winna at 7:21 PM on July 6, 2016 [16 favorites]


I would like to make this very real to anybody who's reading: In the space of 2 years I went from being on the brink of losing my job (pre-ADHD amphetamine therapy) to receiving (post ADHD amphetamine therapy) 2 promotions, finishing my degree, and DOUBLING MY INCOME.

When I say it's had a demonstrable impact on my life, I really do mean it. If I had not sought treatment (and, therefore, druuuuuuuuuuuuuugs) I would still be barely hanging on to my job, hoping nobody noticed what a fuck-up I was, constantly wondering why I couldn't just "get it together".

If that's addiction or dependency, fine then. I'll take it. I'll take it every damned day.
posted by Doleful Creature at 7:24 PM on July 6, 2016 [17 favorites]


I always hope we can have these discussions, just in general, without framing addiction as the failing outcome or weakness. Addiction is a mental illness too, and it too often this gets positioned as Good Mentally Ill Responsible Medication Takers vs Bad Addicts.
posted by ariadne's threadspinner at 7:39 PM on July 6, 2016 [7 favorites]


Like many adults with ADHD, I was diagnosed after my daughter was. Once I knew the signs, I could look back at my life and say YES, oh YES THAT IS ME. I had always had this mental image of what ADHD was, some hyper kid, it's nothing... oooh someone needs to run a bit, big deal. And I should have known better, because I have OCD and I absolutely HATE when someone posts a Buzzfeed article "How OCD are you!" with pictures of cans with the labels facing the wrong way. No, that's not OCD, and you making these stupid jokes is belittling a crippling condition. Because it's a mental condition making fun of it is fair game? No.

So anyways, daughter got diagnosed, and she's brilliant. I mean top of her class, everyone likes her, she is not at all what I would have pictured as ADHD (comorbid with OCD, like me). When I brought up to her pediatrician that she was diagnosed (by a child psychiatrist) he said yes, I believed that was the case. I stated that I thought that I had it too, and he said I did not have it because I didn't have bad grades in high school. Which as I learned, is also a huge misconception. I love to read, I love logic puzzles, I can concentrate just fine on what I am interested in. I just am not able to focus that attention wherever I need it to go.

So now I'm on Adderall, and... my personality didn't change. The first few days I felt like maybe I had taken a bunch of caffeine. The jitters went away, and now the only side effect I really get is I forget to eat lunch a lot. It doesn't magically make me able to work more, I still need to start doing the things I need to be doing, it just makes it easier for me to stay on task once I start. I will focus on whatever it is I'm doing when I take it. That can be work, but if I'm not careful that can also be Wikipedia or Netflix. Not magic, still work.

But surprisingly, my lifelong insomnia seems to be much BETTER on stimulants!
posted by Hazelsmrf at 7:41 PM on July 6, 2016 [4 favorites]


And I see we've reached the inevitable "wake up sheeple" portion of these threads, in which we are told what dupes we are and our experiences are dismissed with some sad shakes of the head and some gently expressed disappointment at how wrong we are.

Wemmick, it sounds like you were misdiagnosed and as a result received treatment you didn't need and your life was made difficult and hellish as a result. I'm sorry about that, and I wish it hadn't happened to you. And if one of your concerns around this is overdiagnosis and overmedication, I'm in agreement with you that it is happening. But, I'd like you to take a moment and think that where you were misdiagnosed and suffered because of it, there might be people out there who were also misdiagnosed: as behavior problems, as space cadets, as lazy or unintelligent or whatever other label got applied and that this made their lives difficult and hellish. That it is possible that there is/were/are cases of "mis(sed)diagnosis".

Because, frankly, coming into a thread where people have shared some pretty personal stories of impact and change with sweeping dismissals and the assumption that we all just haven't done our homework and reading assignments during the years we struggled and worked towards diagnosis and appropriate treatment for ourselves and/or our family members is condescending as hell.
posted by nubs at 7:43 PM on July 6, 2016 [13 favorites]


(I was actually really surprised that I got prescribed stimulants because I do have a history of drug abuse, but thankfully my doctor realized that THAT had likely been self medication and not an indication that I would abuse Adderall or Ritalin. I have NEVER taken more than my prescription or tried to rationalize taking more.)
posted by Hazelsmrf at 7:43 PM on July 6, 2016


Fuck this noise. And fuck the people who don't believe in ADHD or who refuse to get treatment for their children. No one should have to live that way. It hurts. Like having sunburn and a migraine all the time, and being blamed for it.

But you just need to concentrate, and will it away! Because that totally works.

When you've taken over 20 different psychiatric medications over several years in an attempt to treat what is essentially severe anxiety and resistant depression caused by ADHD, before finally trying Adderall and suddenly being able to function in a way that resembles a Normal Person... I'm still broken, but at least I can have a conversation and leave my house if I want to.
posted by monopas at 7:43 PM on July 6, 2016 [9 favorites]


Wow Wemmick you are so wrong in every way. ADHD is not a social construct, it's a very real issue in the brain that is highly genetic. I'm not sure what crackpot you've seen but there are a LOT of weird ones out there that claim you can treat it with a special diet or whatever. I highly recommend you look into the works of reputable ADHD researchers like Russell Barkley.
posted by Hazelsmrf at 7:45 PM on July 6, 2016 [3 favorites]


And you know, those views are HIGHLY destructive. To try to teach a teenager that maybe they don't need to be medicated and then you give them a car and a license? When they can't even pay attention? Do you know how many people die or are killed by inattentive drivers? Unmedicated ADHD can kill, because it leads to risky behaviors. It's SO irresponsible to try to convince people otherwise.
posted by Hazelsmrf at 7:47 PM on July 6, 2016 [5 favorites]


Wemmick do NOT walk into a thread like this spreading judgements like that about our lives, unless you have at least a degree in neuropharmacology. Where's your medical license that gives you the authority to call all of us deluded?

As an ADHD person, and as someone who teaches ADHD students, I have dealt time and time again with quacks who have done incredible harm by denying the neurobiological nature of ADHD. This is no different.
posted by happyroach at 8:44 PM on July 6, 2016 [3 favorites]


I was also diagnosed at 42 and started medication 10 months ago.

I definitely know who I am without medication. On medication, I'm the same person, but I don't have to work so goddamn hard to keep things straight in my head. It doesn't take me tons of mental effort to stop the wheels when I finish one task, and spin them up when I start another. I remember things with far less difficulty.

Someone above made a neat analogy, but I likened my experience to having spent my entire life listening to a radio that was just off the station. Sure, I could still hear the music, but there was a lot of interference and I couldn't count on consistently being able to enjoy a song. Adderall metaphorically dialed me straight onto the signal. No more interference.

Is it perfect? No. I still forget a lot, particularly if I forget to take my pill in the morning. If I do, well...been there before. Mine is extended-release, so if it gets later than 10 in the morning, I'll just skip it so I'm not up super late. I can still accomplish things if I'm not taking a pill that day, but it does take more effort and I often don't have the energy.

As for the bullshit opinion that ADHD is an industry shill, whatever. I had the symptoms for decades before I was ever screened, and it was obviously not the result of "the pharmaceutical industry" or the "pathologizing of certain behaviors." Instead, I was told constantly by my parents that I was "overreacting" and a "hypochondriac" and that there was nothing wrong with me, any time I wondered if I had ADHD. My mother launched into that exact speech when I told them I got diagnosed. Christ. People are stupid. What does anyone care if I take medication to help my brain's focus and memory? I take medication to assist my endocrine system because my ovaries shut down about 35 years early, yet nobody goes around talking about the "pathologizing" of menopause, and how I should just be content to get osteoporosis because that's how people lived a hundred years ago. People got polio a hundred years ago too. People died of the flu by the millions, guess that means I should skip my flu shot! /s

I know my own mind. Thanks. And now I can use it to its full potential, too. I'm sick of this cultural anti-advancement streak, like benefiting from improvements in medicine is somehow "bad" because we accomplished it through the application of knowledge instead of accidentally finding it on the ground.
posted by Autumnheart at 9:47 PM on July 6, 2016 [11 favorites]


Unmedicated ADHD adults are actually 58% more likely to become addicted to illegal drugs than ADHD adults on medication, probably because one of the things medicating ADHD does is... improve attention, self-regulation and impulse control. (via)
posted by en forme de poire at 9:57 PM on July 6, 2016 [14 favorites]


I actually had someone look down on me for having my daughter on Prozac since she's 7 years old, and Ritalin too since she was 8. Some people have some really weird views on mental illnesses, it's as if I had admitted to giving her brandy to make her sleep at night or something! Her OCD came on very suddenly and VERY strongly. She's always been underweight but her anxieties made her stop eating completely. Do you know how scary that is? And how horrible it is to see your child suffering so much and be SO SURE that if she goes to sleep she will die, if she eats food she will die, if she goes to school she will die... But yeah, I'm horrible for drugging my kid. I am SO thankful for the advances in medicine that allow my daughter and I to lead mostly normal lives.
posted by Hazelsmrf at 10:01 PM on July 6, 2016 [2 favorites]


It's a medical condition because we've medicalized it.

This sounds damning, but is really kind of trivial: schizophrenia and Alzheimer's are among the many other phenomena that have been "medicalized" relatively recently in human history, for instance. The question is whether or not ADHD represents a phenomenon that has been inappropriately medicalized. The mere involvement of marketers and the drug industry is not sufficient to prove that this is the case: these people are also involved in, for example, the marketing and production of medicines used to treat cancer and HIV. Instead, one would need to actually argue that it is harmful, either to individuals or to society, to conceptualize ADHD as a medical phenomenon — and one would need to be very clear about what the alternative is.

The quest biomarkers and biological underpinnings is essentially an attempt to find science that justifies what we've already been doing for ages.

Again, this only sounds like a problem: in fact, it describes any effort to understand the mechanism(s) of action of a drug. Indeed, many of our oldest and most effective medical treatments were found empirically, based on what appeared to help people, well before there was any understanding of mechanism.
posted by en forme de poire at 10:28 PM on July 6, 2016 [22 favorites]


This study makes it more difficult to accept that most of the syndromes diagnosed as ADHD in childhood and adulthood are similar, or enjoy a continuity of illness within specific individuals. Which has implications for long-term prescribing.

Is Adult ADHD a Childhood-Onset Neurodevelopmental Disorder? Evidence From a Four-Decade Longitudinal Cohort Study. PDF
posted by meehawl at 10:34 PM on July 6, 2016 [2 favorites]


From what I understood, in order to be diagnosed ADHD as an adult you HAD to have it a child, that was a prerequisite. If the adult ADHD population did NOT have it as children, would that not also mean they have a completely different issue? I know that the reason that ADHD is so hard to diagnose is that so many symptoms of ADHD are also symptoms of other disorders like anxiety based disorders, depression, bipolar disorder, Asperger's etc. So I don't understand how the study says that the adult ADHD population had no overlap with the childhood onset population, wouldn't that automatically also mean that the adult ADHD people did NOT have adult ADHD because they did not meet the diagnosis criteria? Aie it hurts my brain.
posted by Hazelsmrf at 10:41 PM on July 6, 2016 [3 favorites]


They leave out the "by age 12" criteria in this sample but keep all the others, Hazelsmrf.

It's an interesting finding for sure but while they say that the childhood onset ADHD cases no longer met the DSM diagnostic criteria on adulthood, they also still have objective measures of suffering (more criminal convictions, lower educational attainment, worse performance on cognitive tests as adults, etc), and almost none of them were taking stimulant medication in adulthood. So I don't think you can use those results to argue against medication as an adult for people who were diagnosed in childhood.
posted by en forme de poire at 11:29 PM on July 6, 2016 [4 favorites]


Holler from an adult ADHD patient who stimulants didn't work for. I've got a first annual med review next week but I don't think they're gonna try anything. Just saying hi to anyone else reading this thread who's like me. It's miserable.
posted by lokta at 4:35 AM on July 7, 2016 [3 favorites]


Did you try the non-stimulant options? Adderall was my first attempt and seems to work fine for me, but my psychiatrist had also recommended Clonidine. My daughter is on Biphentin (methylphenidate) but has also tried Strattera. I also take Wellbutrin but honestly can't tell that it did anything for my ADHD (I take it for comorbidities).
posted by Hazelsmrf at 7:54 AM on July 7, 2016 [1 favorite]


I'm a person with ADD who did find that stimulants helped, and I took them for 13 years. But then I developed a heart arrhythmia which scared me into stopping Ritalin at age 32. I've been off the stimulants (except for coffee) for 9 years. I did try Strattera for a while, which did nothing but make me have difficulty peeing (which continued for YEARS after I stopped taking it!!), and I do take Wellbutrin now, which helps with mild depression which probably stems from having ADD, but doesn't do much for the ADD itself. So every day is a struggle. There are days that, even with all the coping strategies I have in place (and have talked about in other ADD threads), I get nothing done. I'm constantly afraid of being "found out" as lazy even though I want to be productive. It suuuucks. Damn right if I could take Ritalin I would, it's even harder now because I know what it's like to feel "normal" because the only time I felt normal was when I took Ritalin.
posted by rabbitrabbit at 8:40 AM on July 7, 2016 [2 favorites]


It's a medical condition because we've medicalized it.

You bore me.
posted by listen, lady at 9:08 AM on July 7, 2016 [7 favorites]


Researchers are looking for biomarkers for ADHD. The failure to discover them thus far hardly makes ADHD a pretend ailment.

There's some pretty decent research suggesting that one can develop ADHD as a consequence of early childhood trauma, too. No biomarkers, but certainly some neuroplasticity.
posted by listen, lady at 9:11 AM on July 7, 2016


From what I understood, in order to be diagnosed ADHD as an adult you HAD to have it a child, that was a prerequisite.

Having had it as a child and having been tested for and diagnosed with it as a child are two different things. Lots of people, girls especially, are misdiagnosed or not even treated at all.
posted by listen, lady at 9:15 AM on July 7, 2016 [8 favorites]


listen, lady There's some pretty decent research suggesting that one can develop ADHD as a consequence of early childhood trauma, too. No biomarkers, but certainly some neuroplasticity.

*looks back on childhood*

Well, shit.
posted by SansPoint at 9:21 AM on July 7, 2016 [3 favorites]


Did you try the non-stimulant options? Adderall was my first attempt and seems to work fine for me, but my psychiatrist had also recommended Clonidine. My daughter is on Biphentin (methylphenidate) but has also tried Strattera. I also take Wellbutrin but honestly can't tell that it did anything for my ADHD (I take it for comorbidities).

I'm one more of these people with decades of treatment-resistent depression who was diagnosed with ADHD in adulthood and think this article is a load of old shit that can only possibly serve to further stigmatize ADHD and cause more parents to do what mine did and say, "Oh no you don't, you drug pushers!" ... only to put their kids on one wholly ineffectual SSRI after another when they fall behind because they can't organze anything, never get anything done, and all ther peers are running laps around them, which is really fucking depressing but not Depression. After stimulants -- which worked absolute magical wonders -- caused me a little too much tachycardia, my doctor bounced me to Stratera, to Wellbutrin, to something else I can't remember, then to nothing (hoo-fucking-ray...) because none of them did anything but dehydrate. But I guess if stimulants don't work for some folks, maybe those will do the trick. Eventually.

(I should say, I get where this article is coming from, as they don't really have the perspective of knowing the abject misery of going untreated their whole lives, but jesus christ, people, you were diagnosed young and got the treatment you needed when you needed it most; you should be down on your knees thanking everyone involved. You're not a "drug addict" any more than someone on AZT. Stop talking like Scientologists.)
posted by Sys Rq at 9:55 AM on July 7, 2016 [4 favorites]


I kind of feel like this may have gotten lost among the other discussions in here, but: sweet fancy Moses, this is emphatically not what we need to do with kids who are on medication regimens that allow them to function.
posted by Mayor West


Why the heck not? This confirmed that drug worked for me (remember, my parents and teachers didn't know what was in each capsule), what dose I needed to be on (some people can get away with less, which reduces the side effects), and the school can't argue about the nurse taking time to give me the meds at lunch each day, since we have empirical evidence it worked.

ALSO, not every drug works for every ADHD sufferer. Sometimes Adderall-based drugs work a lot better then Ritalin based ones. Sometimes one won't work at all. You don't know unless you test it, removing confirmation bias from the equation. This is EXACTLY what you need to do. Not shove drugs that may or may not work for the kid at them. This helps over-prescription, and removes a lot of the bias in one go, since you can SEE it helps.
posted by Canageek at 10:06 AM on July 7, 2016


Having had it as a child and having been tested for and diagnosed with it as a child are two different things. Lots of people, girls especially, are misdiagnosed or not even treated at all.

Oh definitely agree! People are saying that ADHD is overdiagnosed but if anything it is very under diagnosed in the adult population, I think they say that some 90% of adults with ADHD are not medicated or do not know they have it. There's a stigma attached to it like it's a joke diagnosis too, a joke disease, an excuse for not working hard enough or not wanting to study.

But I meant that in that particular study that was linked, they had followed the patients their whole lives, and those patients that were diagnosed as adult ADHD had not shown any signs in childhood and they were looking for them. If that is the case, then either the diagnosing criteria for ADHD is wrong, OR they are seeing a completely new disorder that mimics that same symptoms.
posted by Hazelsmrf at 12:24 PM on July 7, 2016


There's some pretty decent research suggesting that one can develop ADHD as a consequence of early childhood trauma, too. No biomarkers, but certainly some neuroplasticity.

If you look at the symptoms for frontal lobe injuries you see that they are virtually identical to ADHD symptoms. I believe they've also identified which genes are likely linked to ADHD, and most of them were related to dopamine, relevant video. Also anyone wanting to learn a ton about ADHD, this whole video series was absolutely great. It's mostly related to children but it applies to adults too.
posted by Hazelsmrf at 12:29 PM on July 7, 2016 [1 favorite]


Ok, some personal ramblings now:
"I wish that I had been able to do something about it when I was 15," Brittany says. “I feel like I still would have had it in me at that point to re-learn things. And because I would have still been at home, I would not have been in charge of my own care so much.” As an adult with rent and bills to pay, she feels she has a lot more at stake now.
This really spoke to me because I think I really recognize this feeling. I think it's totally fair to be frustrated by a lack of access to appropriate resources when you were growing up, and to wonder what your life would have been like with them. And I even share that feeling that it's kind of "too late" to catch up in terms of my executive deficits: I feel like it's so much work to keep afloat with the stress of work + household that adding even more training, structure, and practice to my day would exceed my ability to manage it.

On the other hand, unlike Brittany, I was never actually medicated for anything before adulthood. In fact, my parents sometimes brag to me about how they didn't "resort" to medication like other parents might have, and talk about an ADHD (or any other psychological) diagnosis as though it were an outcome they protected me from.

For a long time, I also thought my problem was that I'd never been forced to develop executive function in a safe environment. Knowing what I know now, though, I think that this is kind of a fantasy. I now suspect that given more independence, I would have failed just as hard, but earlier. After all, I didn't really develop any of those executive skills in four years of college, where I fell apart on a number of axes (financial, physical, academic, social), despite being highly motivated to succeed. Instead, I mostly spent a lot of time feeling bad about my failures and feeling incompetent and powerless.

Likewise, in the counterfactual world where Brittany wasn't medicated, or stopped taking medication early, I guess it's possible she would have been more motivated to develop executive skills in a safe environment. But it's also totally possible that without the medication, she would have just been overwhelmed and frustrated, like I was, with all the motivation in the world to change but not very much ability to make any changes stick. I don't know her, of course, but if anything, her current struggles coping without the medication make that seem likely to me. Probably both of us would have really benefited from both medication and behavioral therapy.

So again, I think this feeling is real and not very fun, but it doesn't have much to do with medication vs. no medication. Instead I think this kind of wishing/regret is inevitable for anyone who struggles with things other people don't, and who didn't get the most helpful care at the right time.
posted by en forme de poire at 3:29 PM on July 7, 2016 [11 favorites]


btw, it really, really sucks to be put on stimulant medication as an adult, just long enough to see first-hand how completely it solves problems you thought were fundamentally insoluble character defects, and then to have to be taken off of it because of cardiovascular side effects.
posted by en forme de poire at 3:36 PM on July 7, 2016 [3 favorites]


Amen to that.
posted by Sys Rq at 3:39 PM on July 7, 2016 [1 favorite]


From what I understood, in order to be diagnosed ADHD as an adult you HAD to have it a child, that was a prerequisite.

I don't know if it's required, but the behavior which got me thinking I had ADD was something from when I was a teenager (junior high or high school; not enough locational markers to know when). My mom and I wrote down all the ways I failed to turn in my homework. The list was over twenty points long. The most depressing one was when I did the other 20+, including getting the homework physically into class, then forgot to turn it in.

When I was in graduate school, my family systems prof said that if there are more than 3-4 fail states for turning in homework, start thinking ADD. It took me five more years to seek treatment. Everyone I mentioned this to before I sought treatment tried to talk me out of it - I was successful, how could I have ADD? - and one friend Wemmicked all over me.

Adderall may not end up being the med I'm on long term, but it's made a marked difference in my life in just the past week and a half. lokta and rabbitrabbit, I'm so sorry it didn't work for you. 8( I have nothing helpful to say, but I see and understand your suffering. You are good people doing the best you can.
posted by Deoridhe at 4:47 PM on July 7, 2016 [4 favorites]


The big lie is that our brains are supposed to be perfect, and that the problems of the mind are best fixed with some moral prescription of self discipline and trying harder. That any problem in our brains that does not resolve itself through that prescription, is proof that you are failing morally.

Can you imagine if we said the same thing about a knee brace, eye glaseses, or any more outward physical ailment? All these school kids in eye glasses, what they need is more discipline, they just aren't trying to see hard enough.
posted by humanfont at 7:54 PM on July 7, 2016 [1 favorite]


Just my experience, but I have a lot of feelings about ADD meds. This thread made me feel that I should write something, and it may as well be here, even if it's just for my own benefit now.

I was put on Ritalin in third grade. It calmed me down a lot, and kept me from angry, aggressive, anti-social behavior against other students. It also made me perseverate a lot harder, and any autistic tendencies I have were strengthened a lot more. I might not have been running up to kids on the playground and punching them because I thought that was the 'cool' thing to do anymore, but I definitely wasn't able to think outside of the article I had just been reading to go play with kids either. My appetite was non-existent in lunchtime, and I never realized that my complete inability to sleep at night, where I would stay awake for hours watching the clock turn to 4 am, might have been linked to the meds they had me on, so I didn't tell anyone about it. By the time I hit adolescence, I knew I didn't like the meds I was on. I told my psychiatrist I didn't like the side effects, that I felt like I was less creative. She told me to think of myself on medication as the "real me".

I stopped taking the medicine every so often in 7th grade. My parents were determined that I take it; they would check my mouth to make sure I had swallowed it down after I realised that I was hiding the pill under my tongue on occasion. I basically stopped taking them completely come 9th grade. My parents would tell my psychiatrist, even as I wasn't taking the medicine, that they noticed a "significant difference" between how I acted in the mornings "on" the medication and evenings when I "wasn't". In 11th grade, because I felt bad that my parents were spending money on a medicine that I wasn't taking, I called them to a conference with my psychiatrist that I "try" taking my high school classes without medication.

I had to go through a humiliating process of revealing to all of my teachers that I had been diagnosed with ADD, and that I was "testing" going off the meds and would need their feedback as I did so (although I had not regularly taken my medication since 6th grade). And they all gave the feedback that I was, curiously, "improving" over the course of the academic year, even as my parents told me that they saw a negative impact. I didn't tell my parents what I had done until 10 years later.

I've wondered if my feeling completely powerless, and learning that it was easy to vomit back up the pills I had taken led to the bulimia I developed, but would not admit to myself that I was engaging in, just as I "officially" went off the medication.

Many people in this thread have commented how they felt that they were the "real themselves" for the first time when they were put on medication, but although I was always told that was how I should feel, I was never comfortable with that, nor given a different option or accepted for feeling opposite. ADD is definitely a real thing that I definitely have, but out of sheer stubbornness, I've developed my own coping strategies. I've often wondered how much easier I would have developed them, or how much better I would have performed as I learned how to stop starting 20 different projects and finish none of them and concentrate instead on one task had I had access to any alternative presented to me outside of medication. But I found my own solutions, after being told that I could not, and although the process has made me suffer, I do not regret my choices. That's a perspective I haven't seen in this thread, and I felt the need to share it here.
posted by Theiform at 8:09 PM on July 7, 2016 [7 favorites]


Theiform, thanks for that. Because I wasn't diagnosed until middle age, I've been picking away at some of the coping strategies I developed because some of them (not all), frankly, aren't really healthy and I still rely on them. But I do think it's valuable to remember that I did cope and function. And that undermines the whole stream of negative self-talk that got internalized along the way.
posted by nubs at 8:38 PM on July 7, 2016 [2 favorites]


I will definitely listen to my daughter if she decides that she wants to stop taking the medication or if the side effects are too harsh for her. She's on a pretty low dose right now, she can eat her lunch, she's very underweight so I'm not sure I would keep her on them if her appetite was completely suppressed.
posted by Hazelsmrf at 9:46 PM on July 7, 2016 [1 favorite]


Can you imagine if we said the same thing about a knee brace, eye glaseses, or any more outward physical ailment? All these school kids in eye glasses, what they need is more discipline, they just aren't trying to see hard enough.

I know that comparisons like these are well-intentioned, but there's actually a pretty long and horrible history of children's physical differences, disabilities, and even illnesses being ignored or interpreted as character defects (forcing left-handed children to write with their off-hand is a prominent example), and it still happens, albeit mainly to kids who aren't white, neurotypical, and middle-class or wealthy.
posted by Krom Tatman at 10:30 AM on July 8, 2016 [4 favorites]


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