Comment by HansKerneue | Hacker News Reader

Comment by HansKerneue | Hacker News Reader

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Some perspective from someone like your family member. ~2 years ago I self-diagnosed with ADHD and paid for a private assessment. I learnt everything about it before being assessed and therefore knew exactly how to respond, and was put on a prescription for methylphenidate.

The reason I went looking for the diagnosis was 10+ years of utter misery. I had been on various treatments for depression & anxiety, but found them minimally effective. I was getting by but was pretty apathetic about life. Over the years I'd investigated various other mental illnesses, but never came across one that seemed to fit me. I came across ADHD purely by chance, when an acquaintance was diagnosed and I looked it up. Previously I had probably ignored it assuming that it was just for hyperactive kids.

This one did seem to fit, and frankly I was desperate. The though of a pill that could actually fix some of my issues made it worth a try at the very least.

For the past two years I've been happier than any other time in my life that I can remember. Life was just easier. The most telling point for me was when I realised that I was no longer apathetic about life, I actively wanted to live, I had things that I wanted to do, goals to achieve - and I was actually able to do them.

I don't know if I actually have ADHD, I still question the diagnosis. It worries me sometimes that maybe I don't have it and that instead I'm just not very good at life. The truth is that it doesn't really matter, the diagnosis and treatment worked - If I payed for a placebo I don't really care.

Perhaps your family member is the same - maybe they have ADHD, maybe they just needed something to help them through life, maybe they had run out of alternatives - it just gets to a point where you wonder 'how much does it matter even if I'm wrong?'

Personally, my philosophy is that drugs should be viewed as tools. Now I don't recommend this to anyone else because there are a lot of negatives. Encouraging people to find their solutions in chemicals can be dangerous. For a non-trivial amount of people, though, I think a lot of their life's problems could be solved with responsible and moderate usage of certain drugs. But again-- I don't actually recommend this because most human beings are irresponsible with drugs.

Thank you for that. The fact is that a lot of conditions are on a spectrum, and only the individual can decide whether it's affecting their happiness enough to be A Problem. For example, social anxiety plus executive dysfunction seems to be a super common combination among the students at my local high school. But really, who doesn't have at least a little of both? By identifying their vague "issues" as a specific thing that affects more than just them, people might be able to find a community that can provide support and useful advice, or professional help and perhaps even medication. That's what taxonomy and terminology are for: to be descriptive, not prescriptive, and thereby to understand the world. I've seen it help in far more cases than I've seen it cause harm - though the latter does happen, and it's a thing professionals know to look out for.

Also, gotta say, as much as I hate TikToxic there are even worse places to look for mental health advice. :looks at some of the other threads:

ADHD is a different pattern of brain function than a 'normal' brain, and generally detect-ably so. ADHD medications, and particularly the stimulants, have a very different effect on someone with ADHD versus without. Assuming the medication is successful, properly dosed, and without side-effects, a person with ADHD will report an experience a lot like yours, and a person without ADHD taking it will have mood swings, hyperactivity, loss of appetite, etc. [1]

I'm paraphrasing from "Taking Charge of Adult ADHD" which I highly recommend. Unfortunately I don't have it on hand so its not a very good paraphrase.

[1] https://www.seasidepalmbeach.com/addiction-blog/what-does-ri...

This is oft-recited but never backed up with evidence.

The linked article, for example, is unsourced and undoubtedly biased (as an addiction treatment center).

there is plenty of evidence that these amphetamines show very different effects in ADHD vs non ADHD individuals.

this is my first google hit for the search phrase "methylphenidate in non adhd vs adhd"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489818/

this is referencing several clinical studies in that vein.

and the search result has several more results, some just clinics which make the well founded claim in simpler terms, others more clinical papers.

I'm sure you find more going to Google scholar with your search.

We still don't have a super strong idea of exactly what is going on but we know that it has to do with dopamine and norepinephrine and that a number of brain structures are noticeably different in people with ADHD.

https://en.wikipedia.org/wiki/Attention_deficit_hyperactivit...

it's actually kind of hard to find an array of good medical sources googling for the second claim because there is so much anti-abuse stuff flooding results for a non-medical professional like me, but its somewhat intuitive in that raising dopamine levels from low to normal will have a different perceived effect than raising them from normal to high. There is perhaps a philosophical argument to be had but from a clinical standpoint my understanding is that there is a world of difference in the outcomes.

Have you ever heard of implicit bias? Bias is unavoidable.

I’m in this exact same boat right now, word for word, other than I haven’t had the assessment yet (very soon though).

I’m quite literally desperate for any answers at this point, my teen years and 20s were on the whole, an absurd nightmare.

The only thing that worries me is they’ll tell me I have it because that’s the easy thing to do. I don’t want a diagnosis unless they’re 100% sure and I worry that paying for the assessment will bias the outcome.

I will add then that while the meds have been very effective, equally helpful was accepting the diagnosis. It made it easier for me to accept some of my failings and forgive myself for them.

And secondly just to say that things definitely can get better (which I found very hard to be believe for a very long time, no matter how many people would say it)

Whatever happens, best of luck to you!

I'm certainly at a point where I no longer think things will get better and well I'm skeptical of the entire psychiatry industry, even the slightest chance is worth taking at this point.

Thanks for the well wishes, I really hope in a few months from now I can look back and see some progress.

I would recommend you check out "Taking Charge of Adult ADHD" by Russell Barkley. [1] It covers a lot of topics and dispels a ton of misconceptions about adult ADHD. On top of that one of the stated goals in the synopsis is "how to get an accurate evaluation"

[1] https://www.amazon.com/Taking-Charge-Adult-ADHD-Second/dp/14...

If you’re looking for a comprehensive, accurate diagnosis you’ll want to find a good neuropsychologist. They aren’t cheap, but if you find a good one they can really help you uncover specific issues.

> ... was put on a prescription for methylphenidate .... If I payed for a placebo I don't really care.

What do you mean? Methylphenidate is not a placebo no matter how you look at it.

Fair - it would be more accurate to say "If I paid for treatment and it's effective then I don't care whether it's treating ADHD or some other issue - or if it's treating nothing but I have the impression that it is"

i.e. The outcome is important to me regardless of the how and why.

I wonder if there's a term for that? Feels like there must be.

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