Mortality Among People with Attention-Deficit/Hyperactivity Disorder

On the flip side to addiction, my prescriber did not know or care what she was doing and when there was an Adderall shortage she gave me Vyvanse and said it "wasn't as effective" and almost tripled my dosage. I believed her but I basically became an addict to other things - social media, video games, spending, alcohol, porn because I was hyperstimulated all the time (being terminally alone did not help either). I am the type of person to say "oh this is just an onboarding phase, I'll wait and see" too which definitely contributed to it as well.

Thankfully, I am past that phase in my life but am still picking up the pieces. I am properly medicated now and the right combination of medications and care really does make a world of a difference.

Thanks for sharing. May I ask what medications have been most effective for you?

I really wish adhd meds had an effect on me. Both me and my brother have tried them and seen no benefits from them. I've tried multiple different medications but I forget exactly what they were. All I noticed was my heart feeling a bit weird. With the amount of people saying it's had such a positive effect on them, I really wish I could experience what it's like to be properly medicated :/

Research on kids show that as long as you do 5d/week 10m/y, the effects on height are not noticable. If kids are on drugs all the time, they will be on average about 1.5 cm (IIRC) shorter.

Based on that, and my experience with taking meds everyday (diagnosed at 35, weekend school), where they tend to "accumulate" tension and I eventually have to take few days off, I'd extrapolate that side effects of 5/7 10/12 dosing are minimal.

But there's a whole other dimension to thinking about side effects. Based on research (I believe on thousands of Scandinavians) on pregnant women with ADHD, giving them stimulants during pregnancy is better for their children than not. (Based on lectures by Jarosław Jóźwiak, Polish MD, psychiatrist, specializing in ADHD, which themselves are based on current research). There's so many side effects of having unmedicated untreated ADHD other than deaths and accidents, that, quoting Joe Rogan's common sense comment, "giving amphetamine to kids (end of quote)" is a no brainer. Obesity, drug abuse, poor diet, depression, anxiety, emotional disregulation in general, ppl at school hating and mobbing you for being overly emotional and "crazy", poor school and life results, avg. age of first sex at 13 vs 18 for women, not having sex at all for young guys, and the general feeling that something is wrong with you compared to others.

In light of all these and other ADHD symptoms and effects, treating it with a well adjusted dose of stimulants sounds like the much better alternative. Just talk to your doctor early, when you suspect sth wrong with meds. They change how they work through lifetime, sometimes requiring dose adjustments. You might have to consciously eat more food (due to less appetite and burning more calories), than feels needed.

When I hear the "giving amphetamine to kids" crowd, i.e. the people who oppose medicating children with hard drugs, I instantly think of an article from 1930's, where a bunch of farmers burned down a radio station, because it "interfered" with their crops.

Just knowing that drugs are bad, without understanding the underlying mechanism with mutated dopamine pathway system and how it benefits from miniscule (for that individual) doses of stimulants is such a bad Dunning Kruger example. And it will hurt people (unmedicated ADHD sufferers) until the general population level of awareness rises. Or until people stop distrusting science and doctors, but I think that ship has sailed.

Did your parents have an outdoor cat before you were born?

If yes, check for [1]

[1] https://en.wikipedia.org/wiki/Toxoplasmosis

ADHD meds unlocked a new dimension of -social, normal people- fun previously inaccessible. Hanging out with people without annoying them, not being late to events, remembering to call friends.

But the -crazy- fun is still accessible. I'm more risk aware, but still get the unconventional ideas. And I can always drop meds for a day and have a "high" day with less productivity and more "crazy" ideas. And I don't mean crazy as a negative, more like an adjective that describes it well.

However, it's important to love yourself (and this can be practiced and trained) and all your aspects. Even your ADHD self without meds, even your depression and dark thoughts. https://www.youtube.com/watch?v=9s9PbBfwDfo

Also, I went through a lot of meds, and one I ended up with was because the first one made me a little too much "robot" like for my own liking. I'm too used to being "me" and didn't like how much the first one changed me. But I'd rather people try for themselves than have an opinion based on mine.

Edit: moved a coma, added yt link.

Stimulants don’t dampen the fun. More fun, if anything. Very few downsides.

But being a Category 2 controlled substance means health care providers are always pushing me towards off-label use of antidepressants that DO have very big and worrying side effects.

I have the inattentive version but it's simply not bad enough to take meds.

What I don't like about this study is that they only take meds into consideration, but there are other treatment options. For example cognitive behaviour therapy. Also, they included studies that included self-diagnosed ADHD. Self diagnoses are on the rise and very often wrong (I.e. trauma response might present with adhd like symptoms). Aside from some other flaws I think the significance of this study is limited...

Fun? No. Free-solo rock climbing, 7-days-per-week CrossFit, the "oh look I learned to play accordion to the amazement of everyone I know but it's been 6 weeks and now I am intent on becoming an expert in first-flush tea" kind of thingy, that was fun. I don't do any of that anymore, which I guess extends my life expectancy, but at the cost of who I am. It's not so much "not doing" these things as it is "not having a desire to do these things anymore" that bothers me most. Honestly, when (or if) I get to retire, the first thing I'm doing is trashing the meds and living.

I got diagnosed super late in life and I'm currently enjoying the fun cessation phase of said medication. Calmness is not the word I would use to describe it, but I'm glad it works for other people. Couldn't pay me a million dollars to take another pill, I'll just procrastinate and get bored often

For me, yes, I still have all the fun. I just have a much lower baseline stress level to compare the fun times to. Like, if now I’m going from 70% joyful on a normal day to 100% fun on a special occasion, it’s not as much of a swing as when going from 5% joyful to 95% happy.

Still had the fun, just stopped taking it too far. It really seemed to help my long term thinking.

The concerta I take will occasionally leave me to be less talkative and less curious to the point where if I want to be in a more social context, I want to either time it right or not take it, but it also depends on hydration and diet that day. Otherwise I find it pretty important. I did downsize from 36mg to 27mg.

You may have the Hyperactive-Impulsive presentation (or the Combined one), which is relatively rare among adults. I have the other one of the three (Inattentive), and I wouldn't say it raises my impulsivity, though I guess it's hard to know. The meds literally saved my life and career, but I also almost exclusively take them when working or in lowkey social situations so it's hard to say what they might do when, like, rock climbing or whitewater boating or something.

I suppose impulsivity in terms of working on what I should be working on instead of going into some rabbit hole is a type of impulsivity, and that's certainly decreased! I wouldn't call the former state "fun" though... more like "shameful", "irrational", and "distressing". Personally -- YMMV.

Anyway: yes that's plausible, as this review found pretty strong evidence of increased mortality from injury. Still, I'd personally say it's unlikely for two major reasons:

1. Presumably most injury deaths happen to adults, which are relatively quite unlikely to have the HI presentation.

2. There's just so many plausible causes of injuries, especially in a society with cars. The inclusion of "intentional injury" also introduces a factor that's no doubt strongly corellated with socioeconomic status (i.e. being murdered/manslaughtered), another very plausible cause.

there is a lot more of me getting to choose what it is i end up doing each day. i find fun in doing those things now pretty regularly. cracking a tough problem can feel as good as jumping out of a plane did. that is to say, my brain is still not a great judge of how relatively cool something is, because even something like scuba diving or fast sports were wildly cool the first time and then the second time it was like "this again?".

i feel much safer though knowing that now when i sometimes get a little bit of the itch, i'll think about it for a few seconds and go "eh, maybe later," and return to trying to make a thing, or play some music, or why is that stupid thing still broken oh its because i broke it.

That is a fun fact. Do they receive medication for it?

What country is this?

Usually when I hear about health insurance being unreasonable, it's the united States. However, denying health insurance for a pre existing condition is illegal in the United States under the affordable care act, and I'm not aware of any exception to this that would explain your situation.

Great point about LLMs! There's like a 1:1 overlap with stuff I hate to do and stuff LLMs excel at. Now all of the things I find extremely tedious, I just feed to AI (especially with MCP servers that connect to my email, slack, docs...) and it's done in an instant.

Society is generally stacked against the outliers in all areas.

I have come to believe that medications are the primary method to bamboozle normal people, even with normal executive function, and tie them up in knots of nonsense about when/how/if to take the doses on a daily basis.

I've often heard of elderly people who've got so many prescribed drugs that they begin doing really badly, and some whiz physician intervenes, sweeps away all their prescriptions at once, and suddenly the patient is doing far, far better. I've also seen friends of my parents who were so utterly bogged down by all the requirements, and my Dad valiantly authored spreadsheets and managed the regular refills and all that stuff for them. And my Dad is not an HCP by any means.

It is obvious that clinics and prescribers can effectively put a "leash" on their patients by tying them to at least one specific medication that keeps them coming back for more, on a regular basis. If you cannot live without your prescription, then you will learn to be loyal and compliant with your prescriber and your pharmacy.

The taking of medications is analogous to the sacraments of the Catholic Church. There are specific rituals to be followed for each. There are specific substances to be taken. We don't really know what these substances are (the Hebrew word "manna" actually means "what is it?") But the priestly class decrees how they are to be administered and taken. And obviously, we cannot have life within us if we do not partake in the correct sacraments.

And that is why I strictly limit the amount of medications that I take, because it is a slippery slope to being bogged down in intricate daily rituals, fasting, abstinence, and appointments to go get more.

Sorry, best we can do is make you cycle back off your can't-live-without-it but physically addictive medications again for umpteenth time this year.

I'm sure this will be fine and you really have nothing to worry about.

Nah, best we can do is idiots saying ADHD is not real (on both sides).

I mean, if you care enough, Ollama + Heretic tuned models, few basic chemistry supplies and you can make your own "version" of medication.

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.

Those statistical correlations don't come out of nowhere.

> 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.

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.

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.)

> It uses statistical correlation to indicate causation.

Up front, it doesn't. It's a meta study, the authors actually go out of their way at one point to note it's not causative, this is unfair on your part.

>As a person with severe ADHD, who has never taken any medication, I find this study troubling. [...] 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.

You've never taken the medication but you're suddenly an expert on what it does and how it feels? Right. Why not be honest and just say you don't buy the conclusions of the study due to your emotional response to the topic?

> 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.

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.

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:

  People on ADHD medicine are also going through mental health treatments and get special care and privileges in society

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.

  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

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).