Comment by nashashmi
6 hours ago
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
Those are extremely common side effects. The benefits just make it worth it for most.
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There are non stimulant ADHD meds like strattera (snri) that seem to work very well for people that issues with the stimulant type.
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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.
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.
Social mobility at scale is largely a myth. In fact, income growth isn't even normally distributed.
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."
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.)
> with severe ADHD, who has never taken any medication
> going through mental health treatments and get special care and privileges in society
1. How could you know ADHD medication numb their responses if you've never taken meds?
2. I hope you have the live you deserve. You seem like a happy person.
> It uses statistical correlation to indicate causation
it makes no assertion like that.
> People on ADHD medicine are also going through mental health treatments and get special care and privileges in society
what privileges?
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.
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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.
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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.
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.
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.
odds are you don't have severe ADHD.
What mental health and special care privileges are you talking about ? Other than having to have a special aid in school nothing has been of benefit.
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.
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:
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.
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).