Yes, executive dysfunction makes it more difficult. But it's really not out of the realm of possibility that a person with ADHD can eat a side of salad and go for a jog. Or would you disagree with that? There are extreme cases but we're clearly not dealing with that here.
Furthermore, at least we I live (and I hear even more so in the US), it's well known that psychiatrists readily hand out stimulant medication with zero therapy. They give you a questionnaire (which is easy to bluff), and if you answer yes to enough they'll hand you a prescription. They don't ask about your diet, sleep, exercise, etc.
I'm not doubting the effectiveness of stimulant medication. As I said, I take them! But let's not pretend there are zero side-effects, and that it's not a big decision to make.
Particularly when oftentimes it's lifestyle choices that are the main driver of OP's symptoms. It seems pretty reasonable to me to suggest taking a look at those first, before rushing to stimulants. Is that wrong?
I'd also like to reiterate my advice to seek therapy, as if you are struggling they can give excellent, tailored advice for dealing with many of these issues.
And once again - I'm not against stimulants. I'm just suggesting a reasonable amount of caution before seeking them out. I'd say that's pretty sensible?
But it's really not out of the realm of possibility that a person with ADHD can eat a side of salad and go for a jog.
Depending on the person, it can be really really hard. I for one could never get the hang of it, and I really tried. This is the case for most people that get diagnosed with ADHD; after all, executive dysfunction is the primary symptom.
You may not be asking for the impossible, but what you are asking is unreasonable. Most people with untreated ADHD have a very difficult time building healthy habits, but as soon as they start treating their ADHD, healthy habits become quite manageable.
Furthermore, at least we I live (and I hear even more so in the US), it's well known that psychiatrists readily hand out stimulant medication with zero therapy.
Yes, it's so well known that most psychiatrists who do prescribe medication for ADHD have to deal with very serious threats of malpractice even based on unsubstantiated claims of misdiagnosis. Even if a claim of stimulant abuse is legitimate, that isn't necessarily the prescribing physician's fault. The reality is that ADHD can't be 100% proven or disproven to exist in a patient. Stimulants can only be prescribed for three consecutive months at a time between doctor/patient visits, and patients are expected to lock their medication away, or be held criminally liable as victims of theft. If a patient loses their medication, they cannot have it refilled. Dextroamphetamine and methylphenidate are Schedule II drugs: the most strict federal control for drugs that can be legally prescribed. Other Schedule II drugs include fentanyl, PCP, and cocaine.
On top of that, many insurance providers refuse to cover stimulant medication outright, all because of the very fears and stigma you are sharing. This is incredibly problematic, because stimulant medication is the most effective treatment for most ADHD patients, and has been thoroughly studied and peer reviewed.
We have a very serious problem in the US, and elsewhere, of putting fear above science. A sensible risk analysis that incorporates peer-reviewed data is not being used - or even considered - when creating public policy. ADHD is the most well-studied mental disorder there is. To pretend there is some unknown danger lurking in a dark corner where we haven't bothered to look yet is entirely disingenuous; yet this is the approach that many take with stimulant medication.
It's easy to understand why fear is so much more effective at influencing policy than science: selection bias. We all hear about the worst case scenario, but almost never hear about the best or median cases. As humans, we are wired to predict cases we hear about as more likely than those that we don't hear about.
Particularly when oftentimes it's lifestyle choices that are the main driver of OP's symptoms.
That's the point. If OP has ADHD, then it's not their lifestyle choices that are the main driver of their symptoms: it's their ADHD symptoms that are the main driver of their lifestyle choices! And if that is the case, then they will need to start treating their ADHD in order to effectively manage their lifestyle choices.
What you have recommended is that OP, "think hard about that route" before seeing a psychiatrist. You have recommended that OP make, "many lifestyle changes [they] can and should make before [they] leap immediately to a ADHD diagnosis." There's a serious problem with that recommendation: If they don't have ADHD, then avoiding a diagnosis just keeps them from knowing so with reasonable certainty. If they do have ADHD, they will almost definitely struggle to make the lifestyle changes you recommend, and never be able to get to step #2 (see a psychiatrist about ADHD diagnosis).
You are very seriously asking OP to put the cart before the horse, for fear that the horse might shit in their face. People have been putting carts behind horses for over three thousand years; and despite the position of the horse's ass in front of the driver's face, it's still considered the best positioning method available.
Practically everything we do has a risk attached. Stimulant medication has plenty of risk. Leaving ADHD untreated has far greater risks: an assertion backed by peer reviewed study. The most effective and safe way to deal with potential ADHD is to make that treatment readily available.
We can both agree that, clearly, we don't know whether or not OP has ADHD. They merely listed some issues around focus/motivation.
OP mentioned that the onset of this coincided with access to online video games & social media, which are distracting by nature, and that they are much better on days when they've had good sleep.
Yet somehow it's putting the cart before the horse, to suggest that lifestyle might be a large factor, when OP listed lifestyle as a factor?
Yet it's not putting the cart before the horse to jump to seeking an ADHD diagnosis? And it is over-diagnosed, and stimulants are overprescribed. I'm sure you'll disagree, but it's true. Of course stimulants will work, it's basically just speed. You can give them to anyone and they'll feel great. There's a reason overachieving students buy them off the street for exams.
And I must now step back from HN today as, surprise surprise, I'm distracted by it!
Yet it's not putting the cart before the horse to jump to seeking an ADHD diagnosis?
No. It's not.
There is a huge difference between seeking a diagnosis, and seeking a positive diagnosis. None of us here recommended OP just walk to a psychiatrist and say, "I have ADHD, now give me meds." No one told OP to lie about their symptoms to coerce their doctor into giving them meds.
And it is over-diagnosed
That is absolutely not true. In fact, the opposite is true for adults. ADHD is a lifelong disorder, yet the overwhelming majority of diagnosed people are children. It's expected that most adults who have ADHD have not been diagnosed.
and stimulants are overprescribed.
Some people who do not have ADHD are mistakenly diagnosed. Some who do have ADHD are mistakenly undiagnosed. Many who are correctly diagnosed do not have stimulant medication available to them, despite it being the first line of treatment, all because there is so much fear and stygma about them. It's a complicated situation involving millions of people that won't be solved by OP avoiding a diagnosis.
The fact that mistakes happen isn't a good enough reason to just avoid diagnosis and treatment all together. There is a significant chance that OP has ADHD, and if that is the case, they need treatment for it.
Of course stimulants will work, it's basically just speed. You can give them to anyone and they'll feel great.
There's a reason that coffee and tea are the most popular drinks in the world: caffeine. It turns out that everyone can benefit from a small dose of stimulants. Those with ADHD see a much greater benefit because we reuptake dopamine too quickly.
Having too much of a stimulant, on the other hand, can be harmful and lead to a substance abuse disorder. Thankfully, some formulations - like the prodrug Vivanse - cannot be abused.
There's a reason overachieving students buy them off the street for exams.
And no one is recommending OP do that. Yet here you are equating a diagnostic visit with a psychiatrist with buying drugs from the black market!
You distrust the diagnostic ability of trained physicians, yet you take prescribed medication yourself! Are you the only one allowed to benefit from Ann ADHD diagnosis? No. OP deserves the very same opportunity.
Comments
Yes, executive dysfunction makes it more difficult. But it's really not out of the realm of possibility that a person with ADHD can eat a side of salad and go for a jog. Or would you disagree with that? There are extreme cases but we're clearly not dealing with that here.
Furthermore, at least we I live (and I hear even more so in the US), it's well known that psychiatrists readily hand out stimulant medication with zero therapy. They give you a questionnaire (which is easy to bluff), and if you answer yes to enough they'll hand you a prescription. They don't ask about your diet, sleep, exercise, etc.
I'm not doubting the effectiveness of stimulant medication. As I said, I take them! But let's not pretend there are zero side-effects, and that it's not a big decision to make.
Particularly when oftentimes it's lifestyle choices that are the main driver of OP's symptoms. It seems pretty reasonable to me to suggest taking a look at those first, before rushing to stimulants. Is that wrong?
I'd also like to reiterate my advice to seek therapy, as if you are struggling they can give excellent, tailored advice for dealing with many of these issues.
And once again - I'm not against stimulants. I'm just suggesting a reasonable amount of caution before seeking them out. I'd say that's pretty sensible?
Depending on the person, it can be really really hard. I for one could never get the hang of it, and I really tried. This is the case for most people that get diagnosed with ADHD; after all, executive dysfunction is the primary symptom.
You may not be asking for the impossible, but what you are asking is unreasonable. Most people with untreated ADHD have a very difficult time building healthy habits, but as soon as they start treating their ADHD, healthy habits become quite manageable.
Yes, it's so well known that most psychiatrists who do prescribe medication for ADHD have to deal with very serious threats of malpractice even based on unsubstantiated claims of misdiagnosis. Even if a claim of stimulant abuse is legitimate, that isn't necessarily the prescribing physician's fault. The reality is that ADHD can't be 100% proven or disproven to exist in a patient. Stimulants can only be prescribed for three consecutive months at a time between doctor/patient visits, and patients are expected to lock their medication away, or be held criminally liable as victims of theft. If a patient loses their medication, they cannot have it refilled. Dextroamphetamine and methylphenidate are Schedule II drugs: the most strict federal control for drugs that can be legally prescribed. Other Schedule II drugs include fentanyl, PCP, and cocaine.
On top of that, many insurance providers refuse to cover stimulant medication outright, all because of the very fears and stigma you are sharing. This is incredibly problematic, because stimulant medication is the most effective treatment for most ADHD patients, and has been thoroughly studied and peer reviewed.
We have a very serious problem in the US, and elsewhere, of putting fear above science. A sensible risk analysis that incorporates peer-reviewed data is not being used - or even considered - when creating public policy. ADHD is the most well-studied mental disorder there is. To pretend there is some unknown danger lurking in a dark corner where we haven't bothered to look yet is entirely disingenuous; yet this is the approach that many take with stimulant medication.
It's easy to understand why fear is so much more effective at influencing policy than science: selection bias. We all hear about the worst case scenario, but almost never hear about the best or median cases. As humans, we are wired to predict cases we hear about as more likely than those that we don't hear about.
That's the point. If OP has ADHD, then it's not their lifestyle choices that are the main driver of their symptoms: it's their ADHD symptoms that are the main driver of their lifestyle choices! And if that is the case, then they will need to start treating their ADHD in order to effectively manage their lifestyle choices.
What you have recommended is that OP, "think hard about that route" before seeing a psychiatrist. You have recommended that OP make, "many lifestyle changes [they] can and should make before [they] leap immediately to a ADHD diagnosis." There's a serious problem with that recommendation: If they don't have ADHD, then avoiding a diagnosis just keeps them from knowing so with reasonable certainty. If they do have ADHD, they will almost definitely struggle to make the lifestyle changes you recommend, and never be able to get to step #2 (see a psychiatrist about ADHD diagnosis).
You are very seriously asking OP to put the cart before the horse, for fear that the horse might shit in their face. People have been putting carts behind horses for over three thousand years; and despite the position of the horse's ass in front of the driver's face, it's still considered the best positioning method available.
Practically everything we do has a risk attached. Stimulant medication has plenty of risk. Leaving ADHD untreated has far greater risks: an assertion backed by peer reviewed study. The most effective and safe way to deal with potential ADHD is to make that treatment readily available.
Maybe a step back is in order.
We can both agree that, clearly, we don't know whether or not OP has ADHD. They merely listed some issues around focus/motivation.
OP mentioned that the onset of this coincided with access to online video games & social media, which are distracting by nature, and that they are much better on days when they've had good sleep.
Yet somehow it's putting the cart before the horse, to suggest that lifestyle might be a large factor, when OP listed lifestyle as a factor?
Yet it's not putting the cart before the horse to jump to seeking an ADHD diagnosis? And it is over-diagnosed, and stimulants are overprescribed. I'm sure you'll disagree, but it's true. Of course stimulants will work, it's basically just speed. You can give them to anyone and they'll feel great. There's a reason overachieving students buy them off the street for exams.
And I must now step back from HN today as, surprise surprise, I'm distracted by it!
No. It's not.
There is a huge difference between seeking a diagnosis, and seeking a positive diagnosis. None of us here recommended OP just walk to a psychiatrist and say, "I have ADHD, now give me meds." No one told OP to lie about their symptoms to coerce their doctor into giving them meds.
That is absolutely not true. In fact, the opposite is true for adults. ADHD is a lifelong disorder, yet the overwhelming majority of diagnosed people are children. It's expected that most adults who have ADHD have not been diagnosed.
Some people who do not have ADHD are mistakenly diagnosed. Some who do have ADHD are mistakenly undiagnosed. Many who are correctly diagnosed do not have stimulant medication available to them, despite it being the first line of treatment, all because there is so much fear and stygma about them. It's a complicated situation involving millions of people that won't be solved by OP avoiding a diagnosis.
The fact that mistakes happen isn't a good enough reason to just avoid diagnosis and treatment all together. There is a significant chance that OP has ADHD, and if that is the case, they need treatment for it.
There's a reason that coffee and tea are the most popular drinks in the world: caffeine. It turns out that everyone can benefit from a small dose of stimulants. Those with ADHD see a much greater benefit because we reuptake dopamine too quickly.
Having too much of a stimulant, on the other hand, can be harmful and lead to a substance abuse disorder. Thankfully, some formulations - like the prodrug Vivanse - cannot be abused.
And no one is recommending OP do that. Yet here you are equating a diagnostic visit with a psychiatrist with buying drugs from the black market!
You distrust the diagnostic ability of trained physicians, yet you take prescribed medication yourself! Are you the only one allowed to benefit from Ann ADHD diagnosis? No. OP deserves the very same opportunity.