Another way to look at this is how many people need more sun and regular sleep and instead are doing unnecessary treatments?
But the majority will not. Treating ADHD through stimulants usually has fantastic outcomes for patients.
Sleepy therapy (CBT-I) may be the best supported treatment for insomnia, but it's still quite shit. ~50% of people will see little to no improvement after going through therapy.
does it though? this comment section should be testament to everyone on meds still struggling
"ADHD" symptoms can manifest for a variety of reasons, and that's why good ADHD testing involves multiple exams alongside the traditional ADHD ones to help figure out what actual issues are present.
Also, comorbidities make this all the more complicated. Your assertion that people need "more sun" and "regular sleep" could very well be true, yet someone can still have ADHD.
Protocols however are always changing depending on new findings. Not saying this is the case, but not considering something unknown at the time doesn't make a doctor not worth a damn.
> Your assertion that people need "more sun" and "regular sleep" could very well be true, yet someone can still have ADHD.
if that was the case the treatment wouldn't be unecessary, like I specifically wrote in the comment you are replying to.
My son has severe ADHD. The sleep deprivation is why he can only use medication for special events like tests. He can't sustain it for any long-term period.
And people should drop the cynicism that just because there are doctors around everyone is well cared for. Just look at the opioid crisis in the US, fuelled by respectable doctors chasing financial incentives.
This is the kind of absurd thing that people say when they know drugs from 2000s teen comedies, I fear. Just cause you've vaguely heard about people doing adderal at parties doesn't mean it's anything like meth, which is the common layperson misunderstanding. It's not a difference in degree, but a difference in kind.
oh man, just reading these three words spikes my blood pressure
Sun and proper sleep is certainly helpful for people with ADHD but the likelihood of them getting that is vastly increased if they’re medicated correctly.
Plenty of people with ADHD manage just fine (or better: sleep) without stimulants. Now if the ADHD is of the ‘late diagnosed’ kind, no one knows what reliably works or if the construct has been bent beyond its breaking point.
That seems pedantic but it's really important, here: ADHD (& MDD & ASD & all of em) are not singular physical diseases with a shared cause, but rather a bucket of symptoms that is used as a heuristic for picking treatments (which almost always means some sort of physical intervention, though therapy alone obviously helps in some cases). This isn't cause psychiatry is bad, but rather because we live in a pre-Gallilean era of cognitive science, and lack the theoretical tools to even begin describing these sorts of systematic, structural disorders in strictly neurological terms.
This is why psychiatrists prescribe off-label so often, and don't treat "diagnosis" like the big ceremony we expect as laypeople; you never truly "have" ADHD on an ontological level, you just have a psychiatrist who thinks that assignment is the best rough bucket to put you in to pick treatments. If you go to a different psychiatrist for more than a makeup/temp arrangement you'll have to get rediagnosed, technically speaking.
Some relevant tidbits to try to avoid a wall of text:
- Many, many providers still hold ~DSM4 ideas about ADHD being extremely rare in adults, and only valid as a diagnosis if you have solid proof of hyperactivity as a child. (ADHD has three "presentations": hyperactivity, impulsivity, and inattention, where the final one is dominant in adults by far). This is especially frustrating in light of the aforementioned methodological facts.
- As that hints at, ADHD treatment is marred by the absurdly harmful sentiment that there's some huge class of lazy jerks who just want to cheat out there, and that we have to carefully separate those lazy people from the people who have executive dysfunction through no fault of your own. Hopefully it's obvious that that's absurd, even if you're not as Sapolosky-pilled as I; if that's a coherent worry in the first place, it's like shutting down SNAP in reaction to a 1% fraud rate.
- ADHD diagnoses have been skyrocketing, which makes some clinicians assume it's overdiagnosed. See also: v***s + tylenol => ASD. Again, hopefully that doesn't need refutation here.
- In practice, getting an accurate sense of whether ADHD drugs help you is a huge rigamarole that is far harder than basically any other disorder (with the possible exception of BPD?); if you don't get educated upfront and choose providers carefully (which feels scummy and plays into the shame that prevents people from seeking treatment already), you can easily just spend hundreds of dollars and get a clinician who will never seriously consider ADHD treatment. They'll shower you in serious drugs of all kinds with aplomb for disorders that arguably fit some of the symptoms (usually MDD, GAD, and/or BD), but they've decided far before they ever met you that adult ADHD is a myth/conspiracy/mass hysteria.
- Finally, 'get more and better sleep' is just a goofy alternative to treatments that we know work, especially when it's heavily relying on the little 'melatonin only as your doctor recommends' disclaimer, which is hiding the fact that melatonin is not meant to be taken long term. It's like "use a planner" or "have you tried writing stuff down?" -- that stuff surely helps, but people go to psychiatrists because they've been trying their hardest for years and still feel like they're drowning.
Is it our (let's be real lol) fault that we are incapable of doing what we want to do to the extent that it causes persistent, serious distress? IDK. But I can personally report that I stumbled into an ADHD diagnosis and actual treatment (dextroamphetamine + bupropion) changed my life; without it I would be a constantly-stressed coaster terrified of getting fired and spending much of my workday staring at my hands, rather than feeling like the most capable engineer I've ever been by far.
And I only got there because I went to a psychiatrist for suspected GAD and she recommended it. Only later (through loved ones and close friends) did I learn how uniquely awful it is to try to find out if it helps you in the first place, which goes against the underlying ethos of our entire psychiatric system.
TL;DR: As a debugging principle for programs, yes, but for psychiatry in general and ADHD in particular, no.
The community guidelines suggest the answers become more thoughtful and deep, and thus maybe more lengthy, the more we exchange ideas, but that's not what happened. The sudden spike is not justifiable and aggressive regardless of the language sugarcoating it.
Also:
Be kind. Don't be snarky. Converse curiously; don't cross-examine. Edit out swipes.