What should I do?

[Cavernio]

Originally Posted by Arch0wl

get an adderall prescription if you can (and if you're on disability this might be feasible, idk)

I mean, "nothing motivates me" is another way of saying "nothing excites me", since the emotions associated with excitement are strongly related to action, and amphetamines directly stimulate that activity (in addition to increasing feelings of reward)

Been trying to for years, granted not very strongly. Being a girl who breezed through elementary school, I do not qualify for the DSM diagnosis of ADHD. Therefore I am refused ADHD meds. Nevermind the fact that I could only half pay attention because I picked things up that easily, or that the lesson before I knew it was by far the most entertaining thing to pay attention to in a classroom.

[FoJaR]

ehh they have tests they can run for ADHD that have nothing to do with how well you did in elementary school.

[Arch0wl]

how much you were distracted in some time period doesn't really have anything to do with ADHD.

it's an arousal-response disorder. in the way that, say, people with darker skin might need to be in the sunlight longer to get vitamin D that way, people with ADHD have more difficulty getting dopamine from tasks. they're just in general less exciting or rewarding. so, they have less dopamine (and in some cases noradrenaline) overall than a normal person.

this is why both stimulants commonly used for ADHD (amphetamine/adderall and methylphenidate/ritalin) are dopamine-releasing, but the -phenidate variants tend to be relaxing while the -amphetamine variants tend to be more exciting. (in my case, being without stimulants feels like the way you feel without your first cup of coffee of the day but all the time.)

if you don't meet the DSM criteria for ADHD, it could be the way you're presenting yourself. you could also just fake the criteria -- people do this all the time. I do meet the criteria, but I'm close enough to the borderline where a person could believe I'm bullshitting, and in cases like that I could see it being worth playing up these traits to avoid it.

your call though.

[MinaciousGrace]

Originally Posted by Arch0wl

accurate observations about adhd and stimulants

I was going to write a relatively thorough account of my experience with this subject and how adhd is both over-diagnosed and under-diagnosed but really it would be redundant with everything archowl has already mentioned

Adderall totally transformed my life. It didn't turn me into the person everyone around me wanted me to be; it let me become the person that I wanted to be.

You don't need to fake criteria to get a diagnosis. You need to find a psychiatrist who actually knows what the fuck they're talking about because you present as a textbook high-intelligence adhd case.

[Spenner]

Just depends on your physical health too, especially with phenidates because of peripheral stimulation effects. Personal experience, they have worked well functionally but they are NOT for someone with hypertension (I didn't know it was chronic at the time) nor if you have excessive anxiety.

But if you are depressed and memory is a core failing function then getting your dopamine signalling up to speed is a good thing, whether with medicine or with activities that might prompt some activity to start (sometimes the most strange new things can trigger your brain to adapt weirdly, such as having a new idea that you know is good, something like that-- those are not consistent of course).

Personally wish doctors were more open to talking about the science going on behind the scenes are actively applying reductionism to their work. It makes me mad so many people walking around with disorders of low or no arousal are given things that even further inhibit the reuptake of neurotransmitter and make finding a solution 100x more painful and longer of a process.

This is because I think I'd be a good candidate for some form of dopamine releasing agent, that has fewer peripheral effects (phetamines, even a weak one) than mostly all of the options available. On a good day I have the attention span and memory capacity of a goldfish, which has gone bottom-up. Along with a mood disorder I find myself feeling like a dementia patient sometimes, forgetting what's going on, having no way of pulling myself out of those ruts.

Glad I'm seeing a neuroscientist in two weeks who will actually do some work on finding the best option for me, not the usual trial-by-error method people fall victim to with medication.

[DeadSignal]

Was thinking of making another thread for this post, but since I assume that part of the answers (if any) could likely end up being applicable to OP I might as well do it here.

I can certainly relate to OP in the sense that just about nothing in my day-to-day life brings any form of excitement or fulfillment to me at all. Although it could be argued in my case that happiness would not necessarily result in increased productivity which I regard as one of the main attributes that define my self-worth (as well as the very essence of the type of person that I ultimately want to become, coupled with a strong aptitude for higher-level thinking), I feel that my mental energy has become so disproportionately low as of lately to the point of it completely crippling my ability to get anything done at all.


I'm currently attending college. It sometimes kills me inside to perceive how "functional" everyone is compared to me.
My barely-passing grades do not really matter to me anywhere near as much as the fact that I have yet to develop an aptitude for programming logic that I deem to be anywhere close to being satisfactory in my eyes. Dropping out is not an option to me primarily due to the fact that I have zero connections or job experience whatsoever, let alone relevant skills to speak of, thus rendering a degree somewhat of a necessity to me. I have also tried small programming practice problems in my own time, but to no avail due to how quickly I get discouraged/distraught at not being able to progress at all if I spend even 5 minutes without really getting anything done.

My past experiences are as follows:

Back in high school, I was underperforming academically (which is still the case nowadays). My family values academic and professional excellence above all else which very much includes the social status resulting from it, thus leading to me having to deal with considerable pressure from them. As they perceived the issue as being more of a threat to their status if anything, no progress came out of any attempts to improve the situation no matter how radical they were. As I gradually ended up slipping into deeper layers of depression, I could feel things progressively take a turn for the worse as I was kicked out of home several times, and had to run away more times than I can honestly recall. I had even attempted to kill myself by sliding my body off of an elevated rooftop, but a neighbor caught me... and as far as anyone other than myself was concerned, it was as if nothing even happened at all. Afterwards, I decided to just finish this year with minimal mental effort as I would be moving out for college anyway.

Oh, and around this timeframe I was consulting a school psychologist every week or so. Not much came of it at all, other than me talking about how the previous week sucked and so on. I kept quiet about my suicidal tendencies, as I didn't want to alarm anyone (since would basically warrant a bad reaction) or otherwise interfere with my plan to finish high school and move out abroad to university/college. On our final session before I had to go, she encouraged me to rent a dorm room so that I could start slowly warming up to people. Ultimately I ended up not doing so, and to this day I currently live in an apartment alone.

Last year, I decided to talk to one of my main college professors about my underperformance and low self-esteem. He asked me what I do in my spare time, so I go ahead and answer him honestly by talking about the video games that I play as well as the meticulous/technical approaches that I actively apply to get better at them (e.g. frame-by-frame analysis in order to determine optimal routes/timing windows, a series of text files to outline accurate strategies for exploiting them, as well as the sheer length of my sessions which have sometimes exceeded the realm of 25+ hours per session with very few breaks). A while later he goes on to state that this serves as evidence that unlike what I have been led to believe, I do not have any willpower/concentration issues at all, and that my line of thought supposedly matches that of the most innovative/resourceful individuals on the planet etc which would also explain why I have such a hard time interacting with or relating to people. In spite of how meaningful it was for me to finally hear some encouraging words for once, this conversation obviously did not result in a complete improvement as far as my self-esteem goes. I do however credit this experience for inciting me to put even deeper thought into the kind of person that I would ideally want to become. However I still ended up failing the year in spite of that, and I'm currently in the process of retaking it.


Last summer (which I have spent with family as a result of me failing that year under the pretense that they would help me... big mistake) I have been prescribed Zoloft (sertraline), but as my psychiatrist from back then had been consistently demonstrating signs of ineffective counseling such as, but certainly not limited to, ignoring me, interrupting me, failing to assess the situation in ways other than "is the medicine working yes/no" and even lashing out at me over very trivial matter I decided it was not going to benefit me at all: I even completely stopped taking the medicine a couple weeks later purely on my own volition. The medicine itself didn't really have much effect other than a barely-heightened sense of inner peace, which ended up crumbling anyway due to my falling out with my family having occurred only shortly afterwards.

I don't really have any friends or family to turn to anymore, nor do I have the ability to really talk to anyone at all. Either people were too narrow-minded and stubborn to assess my situation through any perspective other than their own, or they simply had underlying motives that primarily catered to the person they wanted me to be, in aspects that were very antithetical to what I wanted to be. Small talk and casual conversations are very rare real-life occurrences to me, as I don't feel that I can relate to anyone in the first place.

Another thing worth mentioning is the fact that I'm very paranoid. I have had my power cut twice, and have had to spend two months without electricity or any place to stay at other than my own while simultaneously hiding from aggressive debt collectors. I have also had my freedom at stake due to someone having previously attempted to frame me for a crime I didn't commit. As such, whenever my doorbell rings, I have panic attacks which sometimes last for roughly an hour. My phone also blocks all incoming calls, not to mention I only actually make a single phone call every 2 months on average. I am mainly stating this to emphasize the difficulties that I would encounter if I were to try opening up to someone about my situation someday, which I am not entirely sure will even happen to begin with.

Originally Posted by MinaciousGrace

Adderall totally transformed my life. It didn't turn me into the person everyone around me wanted me to be; it let me become the person that I wanted to be.

You don't need to fake criteria to get a diagnosis. You need to find a psychiatrist who actually knows what the fuck they're talking about because you present as a textbook high-intelligence adhd case.

Originally Posted by Spenner

This is because I think I'd be a good candidate for some form of dopamine releasing agent, that has fewer peripheral effects (phetamines, even a weak one) than mostly all of the options available. On a good day I have the attention span and memory capacity of a goldfish, which has gone bottom-up. Along with a mood disorder I find myself feeling like a dementia patient sometimes, forgetting what's going on, having no way of pulling myself out of those ruts.

Glad I'm seeing a neuroscientist in two weeks who will actually do some work on finding the best option for me, not the usual trial-by-error method people fall victim to with medication.

Basically the main reason that has compelled me to make this rather-lengthy post would be due to my curiosity being stirred up yet again, as to whether another psychiatric assessment would end up truly benefiting me in such a remarkable manner if done right. As it is, I no longer live in the shitty third-world country I used to spend high school in, which significantly-improves my odds of being able to consult proper mental health professionals here. Nevertheless, I still have my doubts.

So my main question is: Assuming proper diagnosis and therapy, is medication truly worth it in my situation?

As it currently stands, my main personal suspicion regarding dopamine-releasing agents revolves around the possibility that it could potentially leave me feeling satisfied with something less than what would define the integrity of my ideal self (basically what I had outlined in red at the start). Though obviously, I could probably be wrong. Then again, when taking into consideration the endeavors that I have undertaken (aside from their trivial nature since they're related to playing games after all), it is apparent to me that most of my ability is derived from my constant dissatisfaction with it thus resulting in a constant need to improve upon it.

So to put it simply, my goal is not to achieve serenity by naturally lowering my expectations and fully taking solace in things for what they currently are. My goal is to grant myself the mental ability to persevere and get things done without being forever plagued by painfully-quick discouragement and a constant looming feeling of complete inadequacy.

Any input would be greatly appreciated, I would very much like to clear any and all doubts of mine on this matter in the event that I truly am just a few steps short of an effective path to recovery.

[Arch0wl]

I wasn't diagnosed with ADHD until I was 20

ADHD is usually under-diagnosed in people with above-average IQ or higher because ADHD is something people only think you have if you're having issues functioning

http://www.drthomasebrown.com/pdfs/H...ineversion.pdf

"Clinical interviews with patients in this study indicated that individuals with high IQ who have ADHD may be at increased risk of having recognition and treatment of their ADHD symptoms delayed until relatively late in their educational careers because teachers and parents tend to blame the student’s disappointing academic performance on boredom or laziness, especially as they notice the situational variability of their ADHD symptoms."

[Reincarnate]

Arch: What are your ADHD symptoms?

[Arch0wl]

my symptoms are the same symptoms you'll find on a criteria list, lol

I don't have as many of them now since I regularly take stimulants and find ways to get them outside of a psychiatrist, so if I went to a psychiatrist I'd probably stop taking stimulants to get the worst of my symptoms back

however, I am also high testosterone, and high testosterone *also* tends to induce some ADHD-like behaviors, so my low arousal and high test behaviors probably compound somewhat. anyway, I'll go into it a bit more:

http://totallyadd.com/do-i-have-add/

I am 6 on inattentive and more than 6 on hyperactive. on a separate test I took where the borderline is 40, I scored 42. I think the ceiling was 60.

off stimulants I am impulsive, extremely impatient, and have to dick around for an hour or two before I can start a task that I find really boring.

I cannot emphasize "extremely impatient" enough. the extent to which I get bored by things easily cannot be understated. I will blank out on entire lectures if the content is irrelevant to me. if there's no way to be competitive or better than other people -- like if there's no leaderboard-style thing I can look up, or it's just some tedious thing I'm "supposed" to do, then you can guarantee I'll either never do it or never care or drag my feet to the point where you have to pull me into it by my fingernails.

I was so bored by doing my taxes one year that I actually looked up the thresholds for filing and found out that I didn't have to file that year. when I was forced to look at spreadsheets for a job, I'd usually downplay how much I could do and act like the task was harder than it was so that I could spend extra time messaging female coworkers on facebook and then go downstairs and masturbate in the bathroom, then finish it on time with the speed of a normal idiot

in a class that I didn't want to pay attention to (but wanted to get an A in), I would sit in the back and look at porn for the whole class while thinking of having sex with the chick who sat in front. I eventually did hook up with her though and did get an A in the class.

I tend to default to anything stimulating on a base level when nothing is intellectually stimulating, which is a lot of things, because most things are not intellectually difficult.

porn is my default choice of media, but other things include:

* impulsive and risky sex, but you probably knew this (record is 7 in one month, in one instance this guy's wife walked in though he ended up dating a guy afterward and we're on good terms)

in fact, sex stopped being something I pursued as much once it started being a surefire thing, once I started having higher standards for women due to lifting and once women got more repetitive / more vanilla. like, right now a huge turn on of mine is taking drugs rectally and having sex for between 4 and 20 hours. do you know how many women are up for that? not many, and the number of women who lift who do is even fewer.

no STD's, though I did get a staph infection once and did get fired for getting my crotch massaged while I was working. the staph was treated and the crotch thing was worth it, but I'm mystified at how this organization justifies firing me when I did not establish consent. (it's a contract organization, so they could fire me for liking the color red or having brown hair, but I think they chose this excuse because it sounds better than firing me over calling in sick over 4 hours of overtime, which they were going to do right before they went with the crotch thing.)

* driving extremely fast (used to go out at 2AM-3AM to push my car to top speed on freeways. finished my 30-minute commute in 11 minutes)

* anything that makes me feel at risk of violence or death, like picking fights with people or pushing people to the point of yelling at me (crashed into a sign once, but left before police could arrive. eventually went back and leg pressed it into position so as far as they're concerned this criminal property damage doesn't exist)

* dramatic conflict of any kind. in fact the more emotional people get the more stimulating it tends to be.

when I'd go to bed as a child, I'd be in bed until 1AM even though my bedtime was 9PM.

without stimulants, which used to be all the time, waking up was easily the hardest thing to do in the day. I'd sometimes have coffee -- sometimes two cups -- but even then I'd be extremely tired and low-energy until something stimulating happened that day.

as a teen, this usually meant starting shit with people, since this was the most stimulating thing I could think of doing.

as an adult I know now that I'm just trying to turn my brain on when I do this, but I start the day with *extremely* low arousal. my body is anti-excited and the grumpiest you can imagine a person being. I probably look like I'm going to hit you if you so much as talk to me.

nowadays I just take whatever stimulant I have on hand and am fine. it solves a lot of problems, and probably keeps me out of jail.

[Arch0wl]

(that was a long post, sorry, but I listed everything that I can think of that's either a direct result of ADHD or not resulting from ADHD but exacerbated by it)

[Spenner]

Originally Posted by DeadSignal

So my main question is: Assuming proper diagnosis and therapy, is medication truly worth it in my situation?

As it currently stands, my main personal suspicion regarding dopamine-releasing agents revolves around the possibility that it could potentially leave me feeling satisfied with something less than what would define the integrity of my ideal self (basically what I had outlined in red at the start). Though obviously, I could probably be wrong. Then again, when taking into consideration the endeavors that I have undertaken (aside from their trivial nature since they're related to playing games after all), it is apparent to me that most of my ability is derived from my constant dissatisfaction with it thus resulting in a constant need to improve upon it.

So to put it simply, my goal is not to achieve serenity by naturally lowering my expectations and fully taking solace in things for what they currently are. My goal is to grant myself the mental ability to persevere and get things done without being forever plagued by painfully-quick discouragement and a constant looming feeling of complete inadequacy.

Any input would be greatly appreciated, I would very much like to clear any and all doubts of mine on this matter in the event that I truly am just a few steps short of an effective path to recovery.

I'm not an expert on this subject, even though I'd prefer to be-- I'm practically in your shoes circumstantially and ideologically. But you should take great care in figuring out what path to take medically. I don't mean medicinally, but the full spectra of your medical outlook, not just the pills you're prescribed. It's very important to take into account all of the peripheral things that are causing a lack of energy or arousal, be it an environment which is discouraging or if it really is just a cognitive architecture you have which disregards the need for a full blown reward response.

Psychiatrists can only give you an opinion of what you have observed going on in your head, unless they are extremely rigorous (or you exhibit very specific symptoms which reveal a root cause of something). I've been to a few myself and honestly, because I myself didn't fully understand what the finest, most fundamental problem was, I wasn't pursuing the right treatment, and I wasn't asking the right questions. It's worth your time and energy to learn how your brain is actually functioning, or underfunctioning, if there is a lack of activity going on.

Basically, map out on your own time, the aspects of your ill natured symptoms, and try to think and reduce reasons for that, and try to step away and look at the problem abstractly. Figuring out how you're disconnected from having a functioning reward response is a key part in knowing the right questions to ask a doctor that's studied the specifics.

I'm not saying to go out and get a degree in neuroscience, but I'm recommending you watch some lectures on human behavioural biology and learn to unravel this mystery partially on your own. It is valuable understanding, being able to see order in the chaos in the case of what goes on in our brains. Getting past a chapter like this should have nothing to do with having to lower your expectations of things, but it may very well have a lot to do with acceptance of things. Don't leave the question open, really do some research on it.

[Spenner]

Also Arch, while that is a very detailed portrait, I must ask the question of whether or not your excitation DOES exist but just in the wrong areas. Having stimulants in your system is going to help your neural networks start working together, having the energy to actually interact, instead of buzzing vigorously in their own circles, still with dopamine, but not in all the right areas.

When you take a dopamine releasing agent, the hierarchy to which places receive it is something I'm not familiar with. But I'd imagine it's different from person to person, and that we cannot simply generalize this one scenario and recommend it to everyone. Neuroscience is endlessly interesting because of our individual differences @_@

[Arch0wl]

sure, but pharma-dose amphetamine isn't harmful. it'll either be a night-and-day difference for you (which it was for me) or it'll barely do anything.

from my experience with dosages, it's a good benchmark to tell if someone has ADHD or not. I am currently about 200lb, and 10-15mg of amphetamine is more than sufficient. meanwhile, very non-ADHD sorority girls I knew in college would take 30 or even 60mg of Adderall to get whatever effects they wanted from it.

I gave some to one of my best friends and the only thing that happened to him is that he was slightly more awake. he's the opposite of me in this respect -- wakes up smiling like he just got his dick sucked by the sun and is ready to make pancakes or whatever, and can easily stay focused on an activity if he needs to.

[Spenner]

It's only harmful in a scenario when it's influencing a neural network which is fundamentally benign to work more efficiently, I mean you wouldn't give it to someone with a serious anxiety bound schizophrenia. At regular dosages it really is a remarkably and minimal drug.

I mean look at it



It's pretty sleek.

They really should have testing to see how people respond to things that increase levels of dopamine, i.e. observe if someone is becoming reliant on the drug itself or if they are beginning to have adaptive behavioural changes and whatnot that are good. If I was given a trial of it for say, 5 doses, and was monitored and scanned and honest about what was going on in my head, it'd be a way clearer way to tell if such a drug is something that would work for me. There's way too much guessing and too much assumption with psychiatric diagnosis.

[Arch0wl]

Originally Posted by Spenner

If I was given a trial of it for say, 5 doses, and was monitored and scanned and honest about what was going on in my head, it'd be a way clearer way to tell if such a drug is something that would work for me. There's way too much guessing and too much assumption with psychiatric diagnosis.

PREACH