Why do you not believe in ADHD?

Great Debates
61

(Emphasis mine.)

And in the case of stimulant therapy for ADHD, this still holds true.

The effect stimulants have on a person with ADHD is different from a person who doesn’t. In a way, it is unfortunate that stimulants can boost the performance of “normal” people too (albeit in a very different way) because this leads to a lot of the skepticism we see.

It’s something of a destructive, distracting, and very unhelpful coincidence that it happens to be a class of drugs so often abused and used recreationally that also happens to help ADHD folks function at a more normal attentional level.

If cod liver oil produced the same therapeutic effects instead of amphetamine, we probably wouldn’t be discussing this.

62

If you read the literature, you will see that this is nothing more than a handy fiction.

In both ADHD and neurotypical individuals, Adderal affects the exact same neurotransmitters in the exact same ways, producing pretty much the same results- increased concentration, better focus, and more useful energy. It’s not like it makes a different chemical reaction in ADHD brains. It’s the same effect.

63

Moving the goalposts is not the way to conduct this discussion. I Love Me, Vol. I said nothing about brain receptors, but noted the affects on the person. Adderal, (and Methylphenidate/Ritalin and other amphetemine related products), very likely do act in the same way on the same receptors. The difference, however, is that the brain of a person suffering ADHD does not appear to use the same receptors for the same tasks. For example, while much of memory processing occurs in the verbal sections of the brain for most people. Julie Schweitzer, previously of Emory, now at UC Davis, has found that, for persons suffering ADHD, memory processing occurs in the visual sections. Similarly, your claim regarding “increased concentration, better focus, and more useful energy” very cleverly ignores the features of ADHD that are different. While amphetemines increase activity, especially nervous activity, among people not suffering ADHD, they calm persons who do suffer from it. Similarly, there is less impulse control under amphetemines for persons who do not suffer from ADHD, but better impulse control for ADHD sufferers. Cherry picking a couple of data points such as an increased GPA for one person or the vague “greater concentration” for larger groups appears to be simply a way to ignore any other relevant information.

In contrast to carm’s complaint of “subjective” diagnosis, P.E.T. Scans, MRIs, and other physical exams, while preliminary at this point, have been revealing significantly different brain function between those who do and those who do not suffer A.D.H.D. for a couple of decades, now. E.g.,
http://www.adhd.org.nz/neuro1.html

64

At the university I go to it is very easy to acquire ADHD prescriptions. All one must do is go to an appointment at the med center, meet with a pyschiatrist for 15 minutes, tell him/her your symptoms of an inability to focus, maintain good grades, etc. and one can be prescribed meds for ADHD. My brother did this last year and all he had to do was meet with a pyschiatrist for 15 minutes every month. Now that he is no longer at the university, his med’s can be refilled with no check-up. It is horrifying to for me to know how easy it is to get a medication that you don’t 100% know you need. I wish they would create some form of genetic research that would prove you had it 100%. I, personally, am not in my brother’s mind, but after being close to him for 20 years, I can say I don’t think he has ADHD. How can I prove this to him? When he believes he has it and doctors take less than twenty minutes to sit and diagnose him? How do I trust those doctors when I know I can get a prescription tomorrow for ADHD and not have it?
I believe ADHD is real, but I certainly also believe it is misdiagnosed.

For those who believe it should be sold over-counter to anyone, I say you’re asking for a world of trouble. People who do not have ADHD and take things like Adderall can acquire ADHD. It will do you no good in the long run. It’s not safe, it’s not smart, and that’s why it’s gotten only by prescription. Stick with coffee. Something called karma might be knocking on your door if you take the easy way.

65

I don’t understand how the fact that certain medications have a positive effect on both healthy and disordered individuals is supposed to prove anything. Most people who take anti-anxiety medication are going to experience depression of their sympathetic nervous systems. That doesn’t mean that anxiety disorders are overdiagnosed or overmedicated.

I don’t even think this “fact” is generalizable enough to be considered a real fact. I’ve taken ADHD drugs before (off-label use). They did nothing for my repetitive thoughts or adventitious movements. They just made me sleepy and non-useful.

66

As someone who took it legitimately and recreationally, I can tell you, there’s a big difference between swallowing one 10mg pill and crushing up and snorting a 10mg pill. Also, there’s something to be said for extra buzz you get when you do this with a group of friends. Sort of like the difference between having 3 beers by yourself or having 3 beers with a couple of friends.

67

Is your brother living outside the U.S.?
All the amphetamine related drugs prescribed for ADHD are Schedule II drugs that no legitimate pharmacist is going to fill without an M.D.'s prescription. And prescriptions for such drugs must be supported by notes taken during an examination. The drugs cannot be supplied indefinitely in the U.S.
This anecdote does not hold together, well, at all.

68

I would also like a citation to a reputable source that this has any correspondence with reality.

69

I would highly recommend Judith Warner’s "We’ve Got Issues," which is all about children and psychiatry. I thought it was pretty good. She was going to write a book about overmedication and horrible parents…and then she started talking with real people and looking at facts instead of listening to rumors.

70

That’s been my experience, too. To get the prescription I had two one-hour sessions with a psychiatrist, who was evaluating me for possible reasons for memory problems. I was surprised with the diagnosis and he was very up-front about the difficulty of picking ADHD-PI and depression apart.

After that it was half an hour every two weeks until we had a settled dosage (three months) and then every two months after that. When my insurance changed, my regular doctor was willing to pick up the prescription.

She doesn’t interview me every month, and she’s trusting the psychiatrist’s report, but I do have to come in and get a paper prescription. Phoning or faxing it to the pharmacy is illeagal. Refills are illeagal.

I’m not saying that you can’t find a candy store, but that’s not the way it’s supposed to go.

71

I had to see my doctor every three months. She would give me three scrips, each for a months worth of meds.
Now, CII scripts expire after a month if I hold on to them, but the pharmacy can hold on them for longer (a year I assume). So I would go to Walgreens and get the first one filled and hand them the other two that would have today’s date but say “Fill 12/26/11” and “Fill 1/26/12”. Then on those days I would call up Walgreens to tell them I’d be in in a few hours and they’d have it ready for me.

72

I feel like people are interpreting even sven’s posts unduly uncharitably, and then holding against her opinions she never claimed. Just wanted to say that.

73

Notwithstanding she posted in disagreement with my last post, I pretty much agree that she might be getting a bit more grief than is warranted. I disagree with some of her premises, but I think she is debating honestly and logically and she raises some points that should be considered; and then, if appropriate, countered.

74

It makes me extremely angry when people characterize ADHD as laziness or compare someone else’s experience with ADHD as the same as ones’ own bouts of laziness. My 7-year-old has been diagnosed with ADD and I’m quite sure I also have it, although I’ve never been diagnosed. My school years were terrible…I’ve been accused of laziness, of underachieving, of not caring about my work, about having no sense of pride. And no matter how many times these things were said, they were not true. As a matter of fact, I was a rather earnest child who very much took things seriously, and I’m still like that. I know my daughter is the same way. She wants to do her best, but she just cannot stay on track. If you have a job to do and you’re saying to yourself, “eh, I just don’t feel like it, I’d rather do X,” I can assure you that this is not at all the thought process of someone who isn’t getting something done due to ADD or ADHD. The fact that someone would compare the two shows a fundamental misunderstanding of this particular learning disability.

75

I have worked with children quite a bit, and have encountered a fair amount of ADHD kids. I found the more experience I had, the easier it became to pick them out and also distinguish them from children who were just lazy/undisciplined etc. It seems like fairly distinguishable & specific behaviour so I don’t really doubt its “existence”.

I haven’t a clue if it’s actually over-diagnosed, but I think it might be over-medicated. I would like to hear if anyone on these boards has had the experience of growing up with AHDH but adjusting to it and actually preferring it over being medicated? I’ve heard that from several people.

Here’s what sometimes worries me though:
I really do think that we need to remember Everyone Is Different. The more we go into the details of the brain & behaviour, the more deviations from our imagined “norm” we could notice. It seems autism & AHDH are the latest instalments (they would’ve been “withdrawn” and “naughty” but no big deal, for the most part), but we could move on to any number of behaviours that we now perceive as being within the normal spectrum. Doesn’t mean it’s not real, it’s all just our description nature.

I’m not saying medicate or not either way. The most important thing is that everyone feels they are happy & able to reach their full potential, what ever that may be. I just worry that “normal” is getting narrower, we get less accepting of People Being Different & happier to adjust people to our version of the norm. I might be wrong.

I also see what even sven is saying. Substances can alter the chemical balance in your brain. That can have a positive effect (of some description). We just decide that for certain people that is legit, for others it isn’t. It’s confusing.

76

It’s not confusing to me. It’s the difference between helping someone achieve As and Bs rather than Ds and Fs, and helping someone achieve A-pluses instead of A-minuses. Or keeping a kid out of detention and helping another one be the star student. Or helping someone experience clarity of mind so that they can hear what people are saying, and helping someone else have extra social energy in the morning.

It’s a matter of degrees.

But if ya’ll want to go pop some Adderall or Intuniv and balance the side-effects (bed-wetting, hello?!) against being star pupils, why not go to the doctor and see if you meet the criteria? If it’s as easy to get medication as common wisdom tells us it is, you shouldn’t have a problem.

77

Exactly.

From the prescriber side of the room the key word is “disorder”. The cognitive processing style has to be causing significant disability in more than one venue for it to be labelled as a disorder - otherwise it is just a cognitive processing variation. Is there a bright line that labels "significant disability? Could the same cognitive processing style be functional for one person in one environment and disabling for another in a different one? Yes.

78

No, he’s still in the US, but in a different city. I think it’s more a problem with how our university’s doctors can only rely on what the patient tells them. He’s been on Strattera for less than a year now. At the beginning he was meeting for 15 minutes every three months with a pyschiatrist in his new city, but that’s changed for some reason and now he can just refill. No one in my family knows the full details anymore because he stopped discussing it with everyone. But my parents know if he goes to a doctor or refills because he is on their insurance. I really think he needs a new doctor who spends more time with him because his personality has changed drastically now that he’s taking it.

I was going based off of the information my psychology professor told our class. I’m not sure there is enough research out there to be able to say it is possible 100%. However, I have seen the symptoms and personality changes in two of my friends from highschool who were abusing it enough to gain a tolerance to it. One of my friends had to take 6 30mg pills of Adderall in a day to get the “buzz.” It makes sense that since adderall alters the brain’s chemistry, it could possibly alter it for the long-term if abused in great quantities. Schizophrenia, psychosis, and other disorders can be caused by Adderall abuse.

One of many adderall abuse websites:
http://www.adderallabuse.net/adderall-withdrawl-symptoms.html

79

Well if they were using it to “get the buzz” they were definitely abusing it. At the dosages it’s prescribed (at least for me, and IME) there is no “buzz” there is just a better ability to focus on things, pay attention without attention wandering, remember things without having to write everything down, etc. The closest I feel to a “buzz” is just feeling awake, as if I’ve had a cup or two of coffee in the morning, without having to actually drink the coffee.

80

I’ll add my anecdote; since the OP is looking for opinions, I hope it’s valid.

I was a great student pretty much up until high school, when I stopped caring about a lot of things and realized I could still get solid grades without putting forth a lick of effort. I think I graduated with something around a 3.5 GPA. I got into a honors engineering program at a good state school, and promptly got my ass kicked. The combination of real courses requiring real effort, plus ample access to alcohol, video games, and women, meant my grades plummeted and I fell into a spiral of depression that caused me to blow off class more often than not.

On my way downhill my parents, understandably concerned, convinced me to seek mental help. My mom made all the appointments, I just showed up and did my best to be honest. After less than an hour with a psychologist and another 45 minutes or so with her ex-husband the psychiatrist, I was diagnosed with ADD and depression, and given scrips for Adderall and Prozac.

I hated both drugs. The Adderall made me anxious and would make my heart race, so I stopped taking it after a week. The Prozac made me listless and destroyed my libido, but I lasted a couple of months.

Ultimately I dropped out, got my shit together, got a degree in a subject I could handle (unmedicated), and have gone on to live a model life. I’ll readily admit that the depression was real, if not caused completely by my environment, but the ADD was completely bogus. I couldn’t concentrate at the time because honors chemistry is feckin impossible to concentrate on for a 19 year old who just wants to chase tail. And the thing is, if someone had said to me, “Maybe computer engineering is too heady for you, why don’t you just get a generic CS degree?” I would have graduated on time and nobody would have ever accused me of having a mental illness.

So to the OP, there’s where my skepticism of AD(H)D comes from. What I learned back then was that you can be smart, like really smart, and still be better suited to a blue collar job. I think I’d be happier as a mechanic, honestly, but the track I was on tried to shoehorn me into a life I wasn’t ready for. And when I failed, instead of anyone admitting that maybe I just wasn’t as good as I thought I was, they readily accepted that I had a mental illness. That’s just bonkers. And the shitty thing is, my diagnosis was a slap in the face to kids who are actually struggling.

I have no doubt that there are D and F students who can benefit from medication and/or a proper diagnosis, but any problem I had with concentration had no major impact on my ability to lead a normal, even successful life. So, count me among the over-diagnosed.