Comment by thenerdhead | Hacker News Reader

Comment by thenerdhead | Hacker News Reader

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The part I hate most today is that if you relate to a video on ADHD/DID/Depression/Schizophrenia/etc, you will be fed the content until you convince yourself you have a “character trait”. That’s a serious problem with long term effects on society.

I’m very sure I sit somewhere on the spectrum and have depressive disorder markers as well. But the last thing I want to do is to promote these traits. I am not proud of them nor hiding them. They do make me unique. But that’s my business, not the world’s.

What worries me is how easy it is to get diagnosed. TikTok for example will also show you ads for a simple single click ADHD diagnosis and medication plan. Almost as if it’s being handed out like candy.

I found tranquility by looking inward for answers, not outward. I go on my “mental health” walks/runs. I even have taught myself to be mindful enough to notice when platforms like TikTok are emotionally manipulating you and I’ll be half crying while coming to a realization that this keeps me addicted. As I separate myself more from tech and to more nature in the world, these “character traits” don’t seem to be so defining anymore. It’s just a personal observation I’ve made as screen time declines.

This.

I blame the medical profession for not better promoting the concept of normal human variability in these traits, too, and educational leadership for not differentiating career oriented education around people's strengths and weaknesses there in secondary school at least.

Contrary to the depiction above it remains as far as I know exceptionally difficult to acquire adhd treating medication; they’re almost all controlled substances, heavily regulated and consumption tightly monitored.

I imagine it depends on where you live, but in the US, it is insane how easy it is to get prescribed. Try to do it yourself, it takes literally a 10-minute phone call and you'll have a script at your local pharmacy -- https://www.donefirst.com/

Really? Where? Surely not in Europe, where the psychiatrist simply asks you a couple survey questions like "Do you have difficulty finishing tasks?", "Do you overanalyze things?" or "Do you frequently interrupt others in conversations?" before giving you a script for Concerta / Medikinet. The entire survey takes 5 minutes and if I was to take it seriously, then my entire family has ADHD including the dog.

One should draw a distinction between bad faith actors and good faith actors. For bad faith actors you are correct, but you could say the same thing about a lot of controlled substances. They (stimulants) are at least as controlled as benzos if not opiates. After all there is no objective test for chronic pain either from what I understand. For good faith actors I think there are perhaps the correct or at best too many burdens already, as given by the large percentage of people who are under-treated.

Where exactly in Europe it works like that?

Everywhere in the EU. It's not like ADHD can be diagnosed with a blood test, so you are asked questions from a standardized survey and you get a script if you answer "yes" enough times.

It definitely does not work like that here. It is quite hard to get those drugs prescribed. You wont get them with 5 min long visit.

I don't know what to tell you. I did get it exactly like I described, in Germany, and it was an online appointment.

> I don't know what to tell you.

Maybe try not telling them "everywhere in the EU".

My script is EU-wide and the survey is standardized, but you're right - I should have specifically contacted a psychiastrist in each of the 27 countries to make sure.

Just say "Germany" instead of "everywhere EU"

The US is quite more lax about it, state depending.

Outside of them, yes it is a nightmare that looks exactly how you would design a process someone with ADHD cannot go through.

I see no ill will behind it. It is just bureaucracy combined with moral panic.

Getting a prescription is only half the battle. In the US, you can't have more than a month supply. Maybe you're lucky and your doctor realizes this so writes you a larger than necessary prescription, but for most vehicles (extended release) it's not an option. Many people horde a backup stash of pills.

This means you have to get your prescription filled within a small window at the end of your previous supply if you want to avoid running out. You also can't have a recurring prescription, but a rare doctor might renew a prescription over the phone. And even then, you have to deal with pharmacies running out last minute, travel impacting your refill schedule, and health insurance coverage for the otherwise ludicrously expensive medication.

A nightmare process that someone with ADHD cannot go through indeed.

> In the US, you can't have more than a month supply

I've met one doctor before who believed it. But after switching to a few other ones (not due to that, but due to circumstances like me moving states or, later on, my doctor doing the same), I dont think that's true.

Every single doctor I had since then was able to write prescriptions for 3 months supply (because they are required to evaluate the patient every 90 days before writing a refill prescription).

Schedule II allows for multiple prescriptions for up to a 90 day supply, but in practice this is 3 prescriptions each for 30 days, and attached to each prescription is a start date.

So you're allowed to have 90 days worth of prescription, but pharmacies aren't supposed to fill more than 30 days at a time. Ultimately this means 12 trips to the pharmacy a year, if you're lucky.

I've heard of that rule before (explained to me in the exact same way you explained by one of my previous doctors), and it definitely worked in a similar way for me in the past too. But for the past few years, my process has been much easier and simpler.

My insurance provider (Premera) has their own mail order pharmacy (called Express Scripts[0]; technically independent, but Premera officially partnered with them), so i dont have to go at all. My doctor writes a prescription, sends it directly to the insurance, opting for the mail pharmacy option checkbox, and I get my meds in the mailbox. They arrive all at once, with a single pill bottle containing 90 days worth of medication.

Just in case it varies by state, that's how it works for me in WA.

0. https://www.premera.com/visitor/prescription-savings (the link talks about Express Scripts specifically on that page, it isn't just a generic Premera page)

To me its pretty unconscionable that you can't opt out of parts of suggestion algorithms.

The only ability to say "no" that you have is to not use the platform, and given how much useful content coalesces into just a few platforms, you're basically saying "no" to getting content in this fashion

> you will be fed the content until you convince yourself you have a “character trait”.

And who would benefit from that change in classification or public opinion? Health care providers, because why would e.g. the NHS or health insurance pay for therapy or medication or anything else that would help you for something that is "just" a character trait?

My girlfriend got diagnosed with ADHD in her 30's, but only because there was a very short-lived and quickly shut down (due to cost) program at the NHS for adult ADHD diagnosis. If she hadn't had that, she would never have been able to get a diagnosis or the relevant medication.

This seems oddly ignorant of the effect ADD/ADHD has on a person's ability to function in modern life at a similar level to other people. It's not something you can introspect away. If I'm not on ritalin, I can introspect all I want, nothing useful is getting done.

Can you please stop with the "candy" trope?

Here in the UK, ADHD drugs are controlled substances. They can only be prescribed as by registered psychiatrists as part of ongoing treatment with patient monitoring. There are not enough doctors qualified to do this, and as a result people who need the treatment are facing year-long queues.

Don't get medical advice from TikTok, and don't form an opinion of a mental disorder and its treatment from TikTok either. The "have you tried mental health walk?" thing is as infuriating as cancer patients getting "have you tried essential oils and yoga?"

> Here in the UK, ADHD drugs are controlled substances

They're controlled susbtances in the US too, but there appear to be a whole slew of sites in the US where you can fill out a form and they'll send you a perfectly legit scrip

> There are not enough doctors qualified to do this, and as a result people who need the treatment are facing year-long queues.

For anyone reading this who thinks they might need treatment and is putting it off, note that there are (expensive! ~£1k) private alternatives where you can get assessed and prescribed by a UK psychiatrist over Zoom with appointments as soon as today.

Link please because I've looked and can't find

The Effra Clinic is excellent. https://effraclinic.co.uk

I used them after struggling for a long time trying to get diagnosed via the NHS (“you’re a successful young man! You can’t have ADHD!”) and have recommended them to several people.

for the UK, I found www.adhdcentre.co.uk which wants £895 for an online ADHD consultation, and the next appt is 7am tomorrow

I had success with donefirst.com

The person you are replying to is well aware that it's a bad thing, that's why they pointed it out.

Maybe they have a hard time paying attention to the text? Or does ADD affect reading? I'm not really sure how it works

It certainly can affect reading. As the other commenter stated, it can affect people in may different ways. It affects my reading differently based on the content. Ask me to read a textbook for a history class and I won't make it more than a few sentences without serious distraction. If I somehow actually "finish" reading a chapter I still won't be able to tell you much if any of the content. But give me a good sci-fi book and I will burn through it in a matter of hours. And good luck getting anything else out of me during that time.

In order:

- They could

- Sometimes it does

- "It" doesn't work a single way, which is why there are so many different opinions of how to look at it :)

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