> I do not personally believe that treatments that can improve one's life should be gatekeeped (gatekept?) sheerly by disorders

In my most libertarian moments I totally agree. But I also accept (even if I don't agree) that a large number of people believe that the detriments to society as a whole (including to some individuals in particular) caused by the misuse of powerful and addictive substances outweighs the benefits of un-controlled access.

> How was I diagnosed? I went through a gauntlet of exhausting interviews and somewhat pseudo-scientific psychometrics -- WAIS IV IQ test, Stop/Go test, and plenty of others that I cannot remember the name of. It's about as legitimate as one can hope for currently... or at least a decade ago.

The "fad" I was talking about was individuals showing up to a medical professional and having the totally unrealistic expectation that after a one hour consultation they would be diagnosed with a severe mental disorder and that they would walk out that same day with a prescription for a controlled stimulant.

The real path to treatment in our system is much more difficult. You have to demonstrate and document a history of symptoms and their effects on your life. It can take 6-12 months in many places to get into a specialist like a psychiatrist. Then it can take many more months of experimentation with alternative treatments before being prescribed medications.

That path is, frankly, atrocious. We are so starved for qualified resources that the system purposely slows things down. If you are able to work and live life even minimally - you are low on the priority list in many cases. There are enough truly horrible cases (severe schizophrenia, bipolar, etc.) that involve people unable to function at all that those who are merely suffering can get ignored. Front-line medical workers gate-keep access to specialists out of necessity, not out of malicious intent.

The patience you demonstrated to get the help you need is commendable but also proof that the system delivers for those who need it.

The alternative path that many choose to take is to become hostile, aggressive or abusive. They refuse to push through the system or to even attempt alternatives. They demand a specific diagnosis and a precise medication and they get angry when they don't get it.

> In some ways, I feel like I made a deal with the Devil.

This is is one reason why the system pushes people to try every alternative possible before going down the route of medication. If someone can find any alternative to medication to manage their symptoms - they ought to avoid the diagnosis and avoid the medicine.

It is just the case that many possible alternatives, including life-style changes, are explicitly forbidden to talk about. So while the medical practitioner may want to say: you need better friends, a better job, a better life in general ... they often cannot. Nor are some aggressive and hostile people willing to listen even if they could.

I completely understand where you are coming from. I really think it is a detrimental society that pushes people into that direction. I have noticed that I mainly take stimulants due to the demands of other people. Do I care if my project is not completed on time? No. Does my employer? Absolutely. I wouldn't be surprised if some of that parallels with others. I hate having to kill myself from the inside out just to function in this world, but I do what I have to do in order to survive.

> The real path to treatment in our system is much more difficult. You have to demonstrate and document a history of symptoms and their effects on your life. It can take 6-12 months in many places to get into a specialist like a psychiatrist. Then it can take many more months of experimentation with alternative treatments before being prescribed medications.

This is where I had a wildly different experience. I guess it is probably because I am not part of the "fad" you are talking about. However, my university had a psych on staff. I scheduled an appointment with him, and I saw him in like a couple days afterwards. He did a basic interview with me, and based on just my behaviors, mannerisms, etc.. He chuckled and said, "You are so ADHD. However, I need to you undergo formal testing out of policy, you should go to <insert name of place.>"

So, I scheduled an appointment, and did all the interviewing testing in two or three sessions, and I was being treated in like two weeks or less. Alternative treatments were actually never even attempted nor suggested. It was straight to medications.

I've still not had many issues getting into doctors, and perhaps I am just very lucky in that regard. I recently left my most recent psych and moved to my GP. He will only treat me because I have a formal diagnosis (e.g. documentation "proving" it). If a psych or another doctor diagnosed me and treated me, that would not be sufficient because my GP claims there wouldn't be enough "evidence" to prove I have the condition. So, I do feel bad for many people who were diagnosed in less formal ways.

I am all for the alternative path, and I am starting to investigate how to go down that path. I have not been very thrilled with psychiatrist. I have many qualms with how psychiatry as a field operates. I am not anti-medicine by any means, but I have never seen nor heard of such a punitive and unscientific field of medicine. Never forget, it's the only field of medicine that can make patients take medicine against their will and involuntarily hold someone against their will.

If you are diabetic, a doctor can prescribe you insulin, but the doctor cannot force you to take the medication. The doctor cannot not commit you despite the fact that abstaining from insulin would cause direct harm. Psychiatrist, however, do have that option depending on the case and the patient.

I have seen around 10 or more psychs/psych NPs in my life. I have always hated how I have had to walk on eggshells around them, so to speak. I feel like they have never taken ADHD seriously and that they act like they are doing me a favor and that I should get on my knees and kiss their feet. Medication not working well? Don't you fucking dare ask for a dosage increase -- what are you some kind of addict?

Not to mention all the random drug tests. Do they test for alcohol or tobacco -- two of the most damaging substances on the planet? Absolutely not. Take CBD with negligible amounts of THC, but enough to pop hot on a urinalysis? Doesn't matter, you are a drug addict. Kiss your prescription, your job, and your life stability good bye. In fact, my previous practice would refuse to treat you and would kick you out of their practice. We had to sign "Controlled Substance Agreements" and all this other horseshit.

Substance Use Disorders are so correlated with ADHD that they are damn near a symptom of untreated ADHD in teens/adults. What field of medicine punishes patients for a medical disorder -- isn't a SUD a valid medical condition? Should a diabetic have their treatment revoked due to a SUD? Not to mention, ADHD medication has plenty of research to back that it does not worsen and may prevent the development of SUDs in people with ADHD.

> So while the medical practitioner may want to say: you need better friends, a better job, a better life in general ... they often cannot.

I completely agree. In fact, I have noticed that myself. I am quite depressed as of lately, however I do not think there is something wrong with me. In fact, it's the opposite. My mind/body is working correctly. I am not in a good place -- miserable job, almost no social life, no hobbies, no goals, no passions, etc.. I mean, who wouldn't be depressed? However, I have been making small steps in the right direction (this isn't my first rodeo). I beat depressions ass many times before, and I will do it again. I refuse medication for it because I feel it would hinder my from making the right steps, and would rather sedate me enough to tolerate my shit situation -- it's what happened last time.

> If someone can find any alternative to medication to manage their symptoms - they ought to avoid the diagnosis and avoid the medicine.

I support this practice too. I do not think medication should be the go-to unless it is completely warranted. Besides, I hate to say it, but honestly, I am not really sure the ADHD meds work all that well to begin with. I often joke that I swear they work better for people without ADHD than those with it.

I mean, are they better than nothing? Absolutely. I still take them for a reason. However, they are far from a silver bullet. I feel like I get about 25%-50% reduction in symptoms, which is enough to help me achieve stability to some degree, but I wish they worked better. The average non-ADHD person is still probably far more productive than I am. Thus, I have been really been considering alternative approaches. It just seems no matter what I do I will always revert to the mean. Maybe that's just how I am supposed to be. =)

This disorder and the trauma that is has caused me will probably always hold me back in life. But hey, in the grand scheme of life, I have a lot to be thankful for, and I am lucky I do not have a worse condition. I'll never be a FAANG developer or work at some fancy start-up, but there is more to living a good life than a maxed out career.