Feels like every week someone here is touting the idea of ADHD meds being this solution, all these people are just undiagnosed, there’s an unfair stigma against, and I feel compelled to bring up that I bought into that thinking, got a legit diagnosis and took meds as prescribed, they triggered mania in me and nearly ruined my life.

I tick all the ADHD boxes but I managed to make it through college without meds so never should have started.

Psychiatry is broken and handing out prescription amphetamines to everyone who can’t focus is as bad as an idea as it initially sounds.

I mean comments like this are the reason there's such a stigma against medication. It's kind of ignorant to say that "psychiatry is broken", "my meds ruined my life", or "I made it through school without them so I never needed them" as if none of those things had anything to do with you.

Someone in the same situation might feel much the opposite, but they also shouldn't use their experience to convince people that their attempt at treating a condition they have is inherently a bad choice.

You might just be smart / high IQ so you could still stumble through college. Imagine what more you could of accomplished if you didn't? Higher abilities need higher standards.

Also you don't have to actually take the medications at all to get an ADHD testing battery. Then you'll know if you actually have ADHD or if you actually didn't. If you don't then your comments are a bit insensitive. Self-diagnoses of various medical conditions by the untrained is notoriously inaccurate.

Thank you for writing this. As someone who has recently been weighing the pros/cons of seeking treatment for ADHD, this has been one of the best points I've read on the potential downsides to it. Currently, in my career (software dev) I've been feeling increasingly burnt out and like it's impossible to focus on anything. I have to sit back and ask myself, is the problem that I can't focus, or is the problem that I'm doing something that I feel is meaningless?

If I got treatment for ADHD, maybe then I would be able to finally churn through all of my tasks and be a top performer in terms of closing stories. If I didn't pursue treatment, then maybe I continue to be unable to focus and completely burn out, resulting in the loss of my job. Maybe after that I pivot my career to where I'm doing something that I find to be more fulfilling. What's the better outcome?

If anything ADHD medications (ritalin) make me _more_ prone to burning out, not less. Just FYI.

It does help with "boring" tasks a little bit, in a sense, but they're still boring an uninteresting. It's not like I get a dopamine hit every time I do a piece of paperwork.

I usually describe it like this: for me ADHD sometimes makes things that are necessary for human life _really_ hard. Things like taking a shower in the morning or having breakfast, getting up to get water while working etc.

All these things take a toll on my day, I still do them but I feel like I'm doing something that I _absolutely_ don't want to do and at the end of the day I don't have any patient left for stuff that actually require my effort (e.g. listening to my wife when she's frustrated with me).

With medication I feel better about doing these necessary things so I can get to the end of the day without hating myself. That doesn't mean I'm gonna eat all the bullshit that gets thrown to me at work!

It's also not all roses, Ritalin is hard to manage, at least for me. I need to make a conscious effort to not devote too much of my attention to uninteresting details, etc. But it's not like it takes away your free will!

Very well put. Focus is a double edged sword.

Focus and discipline is very useful when solutions to problems are known.

But put someone extremely methodical in charge of R&D and they will take a zillion years to explore a large search space. Meanwhile a neurotic will run around randomly and stumble upon all kinds of things on the map. The down side with the neurotic mind, is after a prospective gold mine is found and a lot of methodical, disciplined work is required to exploit it they flake out.

Now if you pair them up interesting things unfold.

We are quiet good at identifying people's strengths and weakness. But we spend a lot of time exploiting weakness and squandering strengths of people.

If only the opposite happened more.

With better and growing understanding of how different minds work, I think we will see people compensating for each others weaknesses more.

I'm not sure that the affects of stimulants for ADD are across the board, as you describe. That is, for lots of people, me included, add meds seem to boost my executive functions.

Without them, I actually have no problem focusing on certain things, but it's usually some unimportant problem or project that I become distracted by.

With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life. I become more attentive to my family, less irritated by distractions. And more a able to get important things done, like my taxes, that before would plague me.

I know some people seem to react to the meds by turning into a worker drone, But it doesn't do that to me. It does make me more excited to make progress and get things done right.

I might have over-emphasized the worker drone persona. But I think the potential for self-deception and long term foolishness is still there across the board.

> With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life.

Executive function boost is non-negligible for sure, but it is still bound to operate in the short term.

Think your bioeconomics as a ledger, your energy levels as income and what you want to do as payments. Stimulants alter this ledger and as long as you can use them you will think you have a lot more income and you can sign up for more things to do. But do you really do have more income in the long term? Are you borrowing from your future income? Your future dopaminergic system? Your future neuroticism levels? I know the research is either missing or contested, but everything from evening crashes to need for increasing the dosage to long term dependence risk suggests that we are borrowing something from somewhere.

> I become more attentive to my family, less irritated by distractions.

Let me play the devil's advocate for a second: How do you know being more attentive to your family is the right thing? Maybe they are real assholes taking you for granted and getting irritated with them would make them get their act together and have a better chance in long term sustainable relationship. How do you know the distractions are not irritation worthy? Maybe they are things you need to get to the root of instead of enduring continuously.

I am exaggerating to make a point, and I'm sure you're mostly fine, but the danger is that thinking you have more "income" than you do will affect all your decisions in a way that accumulates and might not be long term sustainable. It can make you more conforming, and this will be praised by your family, boss, for the case with kids, their parents, but can we say with certainty that being more conforming all the time is really in one's best interest? Anger, irritation, anxiety, depression and even boredom, they are not there just as human failings but also as normal processes that can counter-balance over-exertion, over-exposure, weakly defended personal boundaries, meaninglessness, resentment.

Only way to know how continuous stimulant use is affecting you is to take a long break after multi-year use and evaluate where your life is, which for some people can be too late.

I think you are probably right that "conforming" may not always be the best way to handle things. But most people that end up being diagnosed with ADD are already very non-conforming and they want to just be nudged closer to average.

Now, if your goal is to swing for the fences and try to hit a home run, get to the top of your field, make a grand discovery, then ya, most of those kind of people are very non-coforming. But many are/were also very unhappy personally. In fact, many of the greatest outliers in our history suffered from manic depression or ADD or other mental issues.

Personally, I'm not swinging for the fences. I'm going to bunt if it means I have a much better chance of getting on base. Steve Jobs was very non-conforming. He was always very irritated and unpleasant with everyone around him. And sure, it seems to have had results. But I have no interest in becoming the next Steve Jobs if it means having what appears to have been an unhappy life with an early death.

+1 thanks for this

I’ve read a lot of comments around amphetamines. This is probably my favorite.

Amps turn you into a drone. Any perceived benefit is met with equal or greater detriment.