> I've always been one to 'just deal with it' but after a few years of working through school and seeing my younger brothers go through the same thing with medication, I realized that I was essentially just handicapping myself.
That's not entirely true, though. There is a lot of value in learning good habits to cope with ADHD and developing systems and mental models to improve your ADHD situation. ADHD isn't a purely dopaminergic "chemical imbalance" in the brain that can only be improved with chemical solutions, similar to how depression isn't entirely a chemical imbalance of serotonin.
One of the downsides of aggressive ADHD medication treatment is that it can handicap learning of good habits and coping strategies. Some, thought not all, patients quickly learn to rely on the stimulant effect of their medication to get anything done, assuming that medication is the only way to improve. This becomes a problem as the motivating effects of stimulant medication wear off after months or years, leaving only the concentration-enhancing side effects. Internet forums are full of 20-something ADHD patients who think the only way to address their ADHD is ever increasing doses of stimulants, but eventually they hit prescribing limits and increasing side effects. The solution is to approach ADHD as a combined treatment with minimal medication and heavy emphasis on self-discipline and healthy habits.
Regarding this study: Don't forget that ADHD medications aren't simply dopamine dispensers. All of the stimulant ADHD medications have significant norepinephrine activity, as well. There are many reasons why pure dopamine agonists aren't effective for ADHD.
> I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.
In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.
Many people take stimulant treatment for years or decades, but the unfortunate reality is that the long-term effectiveness of stimulants isn't exactly a sure thing. Clinical trials and studies rarely run for more than a few months. The studies on long-term patients are mixed, but not encourage for long-term effectiveness of stimulants ( https://pubmed.ncbi.nlm.nih.gov/11322742/ ). If you only recently started taking stimulants, you might be in somewhat of a "honeymoon phase" where the core effects are still strong. Note that after years of use, people will tend to overestimate the effects of the drug due to the severity of withdrawal symptoms on days off.
In short, I'd encourage you to continue addressing your ADHD symptoms with ever-improving self discipline, personal habits, and healthy lifestyle choices. The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.
> In short, I'd encourage you to continue addressing your ADHD symptoms with ever-improving self discipline, personal habits, and healthy lifestyle choices. The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.
No, no, no, no. As someone who suffered remarkable mental turmoil over my inability to focus, despite reading books about it, asking everyone for help with my problems, just no, I hate this kind of puritanical thinking, it's exactly this kind of thinking which adds to the stigma of ADHD medication. The very first _day_ I took the medication I knew I'd stumbled upon something monumental. And then I realized that all those years of struggle in school and college, they were all for naught.
The only right answer is: see a psychologist if you think you have a problem, and get medicated if you and your psychologist feels you do have a problem.
> In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.
Nope. It just shit on my self-esteem and resulted in depression because I thought I was just not cut out for the things I wanted to be able to do.
>> The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.
> No, no, no, no.
I'm sorry you struggled, but I think you misinterpreted my post. I never suggested that people must go medication-free, or that therapy is the only option.
The point is that optimal medication treatment still requires effort to learn healthy habits, facilitate self-discipline, and improve one's ability to focus.
If you need medication to begin that process, so be it, but taking medication shouldn't mean that you neglect the self-improvement aspect of this. The medication can be a springboard, but it's a mistake to give up on self-improvement and hope that medication can do all of the heavy lifting.
GP seems to be arguing that medication is absolutely appropriate as part of a solution. You seem to be vehemently arguing that medication was critically important for you. There’s probably less contradiction than it appears you’re arguing.
>One of the downsides of aggressive ADHD medication treatment is that it can handicap learning of good habits and coping strategies
I mean, my entire post was actually saying the opposite. One of the biggest downsides of having ADHD is the way it handicaps learning of good habits and life skills. I tried doing exactly what you describe in high school and the result was constantly failing to do extracurricular work and being branded as lazy by my peers and educators. There are a lot of comments in this thread on both sides of the argument that seem to take personal anecdote too far. My honest advice continues to be that medication is a great tool for those who need it, and therapy is something pretty much everyone should experience.
That's not entirely true, though. There is a lot of value in learning good habits to cope with ADHD and developing systems and mental models to improve your ADHD situation. ADHD isn't a purely dopaminergic "chemical imbalance" in the brain that can only be improved with chemical solutions, similar to how depression isn't entirely a chemical imbalance of serotonin.
One of the downsides of aggressive ADHD medication treatment is that it can handicap learning of good habits and coping strategies. Some, thought not all, patients quickly learn to rely on the stimulant effect of their medication to get anything done, assuming that medication is the only way to improve. This becomes a problem as the motivating effects of stimulant medication wear off after months or years, leaving only the concentration-enhancing side effects. Internet forums are full of 20-something ADHD patients who think the only way to address their ADHD is ever increasing doses of stimulants, but eventually they hit prescribing limits and increasing side effects. The solution is to approach ADHD as a combined treatment with minimal medication and heavy emphasis on self-discipline and healthy habits.
Regarding this study: Don't forget that ADHD medications aren't simply dopamine dispensers. All of the stimulant ADHD medications have significant norepinephrine activity, as well. There are many reasons why pure dopamine agonists aren't effective for ADHD.
> I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.
In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.
Many people take stimulant treatment for years or decades, but the unfortunate reality is that the long-term effectiveness of stimulants isn't exactly a sure thing. Clinical trials and studies rarely run for more than a few months. The studies on long-term patients are mixed, but not encourage for long-term effectiveness of stimulants ( https://pubmed.ncbi.nlm.nih.gov/11322742/ ). If you only recently started taking stimulants, you might be in somewhat of a "honeymoon phase" where the core effects are still strong. Note that after years of use, people will tend to overestimate the effects of the drug due to the severity of withdrawal symptoms on days off.
In short, I'd encourage you to continue addressing your ADHD symptoms with ever-improving self discipline, personal habits, and healthy lifestyle choices. The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.