As a person with severe ADHD, who has never taken any medication, I find this study troubling. It uses statistical correlation to indicate causation.
People on ADHD medicine are also going through mental health treatments and get special care and privileges in society. At the same time, the effects of ADHD medication numb their responses and emotions to what seems outwardly stable and normal but deep inside it is an inhibitor of development.
So excuse me for saying so, but I don’t buy into the conclusions of this study at all.
It sounds like you are confusing ADHD meds, which are stimulants (basically speed) with benzos, which they give for depression/anxiety. First you have to understand what ADHD even IS, which is a lack of executive function. All that means is it is harder to know what to do out of the millions of things floating in front of your brain every second. Stimulants, which usually make people feel more wired, tend to make those with ADHD feel more calm. Because they aren't flitting between thoughts and the stimulant empowers them to have a more normal executive function to actively choose what to pay attention to.
Worth noting this feeling of calm comes solely as relief from spastic thoughts. Your body still responds in every other way as you would from taking a stimulant, and yet people feel calmer and more orderly because their baseline thoughts are so frenetic.
maybe what you're saying is true for some patients but I tried the stimulants when I was diagnosed and they just made me feel uncreative, suppressed my appetite until I was a dangerous weight, and overall felt horrible. also made my dick temporarily smaller while I was on the drug. but sure, explain to that person how their brain works. I'm sure you know better than them. And me too, I obviously made up those effects and chose to go back to being unmedicated because I'm wrong about the effects of the drugs.
and I have pretty severe ADHD, so I strongly believe the diagnosis was correct. drugs just affect people differently. GP is talking about stimulants. I experienced what they describe.
they even took away my sense of humor. I'd rather die.
not everyone experiences this. I know people who love these drugs and report none of this. but some do
What a wild, unsubstantiated take. It's wild to suggest ADHD medications are dulling emotions and wild to suggest that this effect is less damaging than the developmental disorder which is unmedicated moderate to severe ADHD. I have watched this disorder destroy people to the point of homelessness. I've had my own struggles with it in the past. And your comment isn't even accounting for comorbidities such as severe anxiety or depression, or complications from broken executive function such as not taking care of your body, not exercising and not eating healthily. I don't think you know much about ADHD at all.
All of those outcomes are totally understandable and imaginable. I don’t want to rail against medications. People find them to be of benefit and it is tough to say how their life would turn out if they didn’t have that.
But I also resist these ideas that I should be on medication. I know it dulls responses because I have seen people change. They become less exciting. And more robotic. And their adhd lasts longer unevolving. Think of it like the hulk who never had a chance to grow until he was on a different planet and remained hulk entirely.
ADHD is a genetic disorder that does not get better, so again "lasts longer" and "unevolving" indicate that you need to study the disorder better before making claims about how it works. I don't use analogies from the Marvel universe, when I can just study the disorder directly. It's a dopaminergic disorder where your brain has less dopamine receptor sites and there are fundamental consequences of this which cannot be meditated away.
I can personally attest that taking amphetamine does not make me "more robotic" or "less exciting". For people struggling with ADHD, developing behavioral and cognitive coping mechanisms can be a non-starter if they are not properly medicated.
I refuse to believe ADHD is (only) genetic. I am convinced it is induced and I know why. I have come to a nice 6 year period where ADHD was not present in its usual form. It drastically changed. It came back recently about 5 years ago. I know why it came back. And external factors are the reason. Those factors took a break for 12 years before resuming.
i think you mean inheritable. you are right, in a way. ADHD as a disorder is a description of a disease state involving the medial temporal lobe and orbital front cortex of the human brain. you can acquire this disease state from environmental interaction. however, ADHD is known to be a inheritable trait as well.
in some forms, it will get worse as you age. that is especially true if you have environmental pressure, like alcohol use, lack of exercise, amphetamine use, etc.
those with ADHD tend to fuck up everything anyway. the only real cure is a "genetic" one. it is necessary to stop those risk taking behaviors that compound the initial disease state.
however if you cure risk taking, you fuck society and the economic progress of humanity. the disease state known as "ADHD" is a net positive for the whole, even if it isn't always a net positive for the individual. so, it is selected for, in terms of natural selection. though "artificial selection" (i think this term is meaningless, really it describes self-reflection, which is a normal trait.) allows for humans to pass this trait on much more often now, as humans have corrected many life-ending disease states that used to curb things like ADHD from being passed on.
As someone who deals with ADHD and whose immediate family tree all have it, whose parents fell deep into drug addiction and fucked their and my life up, who has watched both his sister and brother destroy their lives from drug addiction and untreated ADHD, it is not a net good. Romanticizing mental illness is not good. This disorder sucks and I would rather not have it at all. It's not a "creative thinking" disorder, it's an executive function disorder that gets in the way of everything.
i am sorry that you have had a rough life, but using ADHD as a root cause for substance use disorder is confusing. ADHD is a behavioral phenotype that can arise from a number of different genotypes. it isn't one thing. also, i am not romanticizing anything. i was halfheartedly theorizing about selection pressures and ADHD.
It's only confusing if you don't understand the direct correlation between ADHD and drug abuse statistics as well as a host of other things that compound to ruin people's lives. No one said it was a root cause, either. It's well established that ADHD, while having genetic foundations, can be part of positive feedback loop which worsens the condition as well as your ability to cope with it. No need to argue about it; these correlations are well-established in literature.
i understand the correlation of SUDs and ADHD. ADHD is also correlated with the population of adults in prison. it doesn't mean if your mother had ADHD you will end up in jail.
then resist them. you are doing what you accuse others of doing, even though they aren't. you are demonizing those who take medication here. apparently, in light of this comment, in a form of transference of your anxieties. it might be useful to reflect on that.
Well they dull emotions as you probably don't snap and hit some bystander/teacher/parent/friend, but also you probably feel as normal people feel as 'fine' which might be issue for some people eg if you are musician and you need strong emotions to perform. But good thing with stimulants is that effects are pretty short term and if you feel that they dull emotions too much for now you just can stop taking those for moment and then continue when you need it.
Emotional regulation does not mean you're unable to experience "emotion". In fact, the emotional numbness you can experience from depression, which is often comorbid with ADHD, is actually well-documented. For many people, medicine can actually improve their ability to emotionally engage with the world and themselves.
The other problem with the study is that it does not take income into consideration. This is my largest pet peeve with so many studies, they're basically ignoring a major indicator of quality of life and then make weird conclusions.
But ADHD has been shown to significantly affect income. It’s hard to excel in a high paying career when it’s affecting you strongly. It’s probably pretty hard to normalize for income, then, because it’s a confounding factor.
But that too largely depends on your parents income and wealth as well, ADHD is less of a problem in higher paying job than lower paying job. In fact, for higher paying jobs where you can delegate, AHDH can be an advantage.
If you can brute force your way through all the intermediate years to work your way up to it. I did that. It was brutal. I highly recommend not doing that unless misery is your thing.
it is a review of existing literature. maybe someone will attempt to explore those factors in the future.
from the paper:
"Future research should consider psychosocial and sociodemographic factors to understand how being female,
being of a minoritized race or ethnicity, and having experienced childhood maltreatment may contribute to the risk of mortality in people with ADHD. More diverse and representative samples are needed to improve generalizability and to identify inclusive pathways for intervention. Subgroups of people with ADHD who experience the highest mortality risk should be examined to support informing of initiatives to reduce premature mortality in people with ADHD. Clinically, these findings underscore the importance of long-term, comprehensive care for individuals with ADHD, with particular attention to identifying and addressing modifiable factors that may contribute to excess mortality risk. The association between medication use and lower mortality also highlights the importance of equitable access to evidence-based ADHD assessment and treatment."
How would we know which way that runs? Lower income could expose you to stressors that make ADHD worse, maybe especially in childhood. But ADHD could also easily make it harder to earn money or hold a stable career down too.
Ooh, let me count the privileges I get, starting at zero.
Zero…
There, done. What treatment for ADHD has done for me in the real world is drastically cut my anxiety and stress. Turns out the most challenging parts of my life involved knowing I had to do a thing, or I’d get fired or evicted or sued or such, and being utterly incapable of getting myself to do it until it became a crisis. What a piece of crap I must be, right, for ignoring the things a responsible adult would be doing!
And then I started taking meds for it, and found out I could, just, decide to sit down and gather my tax paperwork, or write that report, or balance the checkbook, even though those things didn’t need to be done for several more weeks. At first, it was utterly liberating. And then it was kinda soul-crushing. I could’ve been living like this the whole time, minus all the stress and self esteem issues and anxiety? And then it was liberating again. Well, bummer life use to be like that, but it’s not anymore, so yay!
And it didn’t do a single thing to my emotions, other than removing about 90% of the anxiety from my life.
(I have to get this in before the inevitable jackass opines: no, life isn’t suddenly “easier because you’re taking meth”. I get no stimulant sensation whatsoever from my dose of Adderall. My morning coffee has a much stronger effect. It just allows me to decide what I should be working on at any given moment, even when no one’s angry at me. It is not an energy booster in any way.)
> (I have to get this in before the inevitable jackass opines: no, life isn’t suddenly “easier because you’re taking meth”. I get no stimulant sensation whatsoever from my dose of Adderall. My morning coffee has a much stronger effect. It just allows me to decide what I should be working on at any given moment, even when no one’s angry at me. It is not an energy booster in any way.)
I started medication recently, and it was very much You Can Just Do Things.
Before, I'd need to force myself to start working, and was easily distracted. That appears to be significantly reduced once I started the meds, which makes basically everything in my life much easier.
One interesting thing I noted was that when not taking them (at weekends) then I can still do most of what I need to (have kids, so lots to do), but I was much, much more tired by the end of the day, presumably because it takes more energy to force myself to get up and move.
But yeah, it's super weird that stimulants have this impact on ADHD, but they are definitely really helpful for me.
Honestly your description of the medicine tells me I should try it, but I’m going to hold back. The benefits you describe are the sweet spot of what I need, even today.
But come again, I have excess anxiety and that is getting in the way of how I do things. And work only happens when in crisis mode. Or rather I should describe it as the stress of not doing a task overcomes the anxiety of doing the work wrong.
The reality is I need all of those emotional responses even though they come in the way. And I also need a healthier mind so that when anxiety (aka a brick wall) starts building up, I have mental tools on how to address it.
The privileges and extra care I mentioned are the responses other people give to your ADHD by backing off from putting you under pressure. Or demanding stuff in excessive form. Or the passes they give you for the stupid stuff you do. I didn’t get anything like this amd sometimes I wished I had. My mind would have been less traumatized and I would have had a greater ability to learn healthier responses.
I am so glad it works for you. I hope that one day you can have healthier responses to the anxiety you face. I hope we become stronger and less dependent on privilege and passes.
> work only happens when in crisis mode
That’s a textbook case of ADHD behavior where one can only do things when urgency hits a threshold.
It seems as if you are concerned that medication may remove this urgency, resulting in zero work done at all. Positive scenario is that you would not need the urgency to deal with what you deem important.
The meds are intended to allow you to work without needing to be in crisis mode and the anxiety of it. That's standard for the condition, but it's not a very healthy strategy long term and you'll find yourself unable to do normal tasks without the crisis mode the longer you use it as a crutch.
For instance, do you struggle to keep your home clean until someone is visiting and the anxiety of them seeing compels you to focus on it?
Well, you've made some incorrect assumptions. You seem to think yourself verysmart, so you should understand a snap judgement like this is worth very little. You don't need psychological treatment alongside it and the results are pretty obvious and immediate. Try it or don't, but I have trouble seeing the value in your narrow and uninformed opinion.
It is more efficacious to have therapy alongside the medication, according to various studies I've read, but I have trouble accessing the therapy because it's expensive, so the meds alone will do for now.
I still need a list or five, but at least now I can remember I have a list, where I left my list, and to use my list.
There’s also the chicken-and-egg problem here. Know what makes it super hard to get organized and motivated to start therapy for ADHD? ADHD! Dealing with insurance companies is the exact kind of demoralizing nightmare that makes it extremely hard for the people who need the treatment to actually get it.
Fuck this is so true. My first therapist I tried immediately told me she'd be annoyed if I missed appointments or was late. Half my goddamn problem was forgetting appointments and not being organized enough to use a calendar consistently. Decided fuck this, and took me a long time to try and find another one.
I put my list on the mirror in the bathroom, right in front of my face, to try to build a morning routine. I got sick of forgetting to brush my teeth, or put on deodorant, etc. That list sat on my mirror for 2 years, and every morning I would forget to use it. Fuck I hate it.
I had 3 therapists I went through. After the first few meetings where they tell you you have ADHD, they all eventually stopped being helpful. Mostly I needed them to tell me what I needed to do to to build good habits or what I can do to work around my ADHD... and all they wanted to do was listen to me talk and provide no helpful information. None of them told me about the side effects of the medication, how I should use it, or anything. Now I have no therapist, and I'm not really any worse off. The medication helped me way more. But that's just my experience.
I feel you on the "My list is right there!" and then it becomes invisible, or if you ever do perceive it, it's only a source of guilt, not organisation.
> It uses statistical correlation to indicate causation.
Up front, it doesn't. It's a meta study, the authors actually go out of their way at one point to note it's not causative, this is unfair on your part.
>As a person with severe ADHD, who has never taken any medication, I find this study troubling. [...] People on ADHD medicine are also going through mental health treatments and get special care and privileges in society. At the same time, the effects of ADHD medication numb their responses and emotions to what seems outwardly stable and normal but deep inside it is an inhibitor of development.
You've never taken the medication but you're suddenly an expert on what it does and how it feels? Right. Why not be honest and just say you don't buy the conclusions of the study due to your emotional response to the topic?
I mean, does it though...? The strongest claim they make is that "timely diagnosis and treatment" (via medication) "may reduce the risk", which seems like a pretty indisputable statement based on the observed corellations.
Anyway, as a side note:
People on ADHD medicine are also going through mental health treatments and get special care and privileges in society
I mean technically yeah, but the vast, vast majority of psychiatric medication management relationships don't involve therapy. Still more likely to pursue it though, I agree. Is that a bad thing, though? Absent of evidence pharmacological treatment doesn't help, this feels like a time we can just recommend and embrace both.
the effects of ADHD medication numb their responses and emotions to what seems outwardly stable and normal but deep inside it is an inhibitor of development
Your musings are not at all based in science, but instead personal anxieties. That's fine for you, but please don't casually muse about the secret nature of lifesaving clinical treatments, especially the treatment that is possibly the most stigmatized yet effective treatment in our society (after PrEP, I suppose).
No offence, but how do you know what the effect of the medication is, if you've never taken it? Your description doesn't match my experience.
I'm unsure about the inhibitor of development bit also, do you mean physiological, intellectual, emotional... ...software?
Are you able to clarify what special care and privileges are you thinking of? I have seen a psychologist a few times, but I can't afford to do so nearly as much as I need to.
I hope you don't find my experiences as a guiding principle for your own decisions. Sharing on HN in the age of AI sometimes makes us tight lipped so you never hear the full story here.
I have seen others who took it and something changed in them. I have taken other psych medications for stuff other than ADHD. And I saw myself change. It made me less vulnerable and more protective. I sought stable situations rather than be open to new experiences.
The special care and privilege is how people back off and lay low around you. They don’t expose you to the full line of emotions they are feeling. They give you more time to come around. They give you less stress. It is the external awareness that has the benefits.
When you are protected from stressful situations, or you are deafened to excitement, you are like in a state of peace and preservation. Never growing. Just calm. Never encountering problems. Never finding solutions. Never developing. Medication gets you there, not fully but just enough that you learn and develop slowly.
ADHD is basically the overactive absorption of dopamine. Dopamine is the hormone that basically activates neural pathways in stronger form, which is the "motivation" feeling to go do things.
If you have ADHD, you can have a lot of secondary effects from your inability to motivate you to go do things.
ADHD medication, which is basically meth, basically prevents the reuptake dopamine, meaning that it says bound to the neurons. You fundamentally get the tool to go and actually do things. But a tool is not the solution without knowing how to use it, for that you need additional support, which is most commonly is therapy.
> The special care and privilege is how people back off and lay low around you. They don’t expose you to the full line of emotions they are feeling. They give you more time to come around. They give you less stress. It is the external awareness that has the benefits.
meanwhile, as a fire-breathing, unicycling, sensation-seeking, self-care-neglecting, bad-choice-making, person with severe adhd on medication, I dont buy what you dont buy. This shit's rough.
People on ADHD medicine are also going through mental health treatments and get special care and privileges in society. At the same time, the effects of ADHD medication numb their responses and emotions to what seems outwardly stable and normal but deep inside it is an inhibitor of development.
So excuse me for saying so, but I don’t buy into the conclusions of this study at all.