I'm convinced I have ADHD. Where do I go from here?

September 23, 2007 8:19 AM

I'm convinced I have ADHD. Where do I go from here?

I've never been able to focus on anything for more than 5 minutes at a time - especially if there are multiple things going on. In spite of this, I've always managed to pull through - and perhaps even succeed on what is just sheer intelligence (as arrogant as that may sound). I've been a horrible procrastinator, and my grades are all over the place, but mostly thanks to the powers of persuasion have always ended in the A,B, and C range (there have been a few Ds I talked my way out of).

Even though my grades in HS were spotty, I was accepted into a semi-good school (thanks potentially to affirmative action and high SAT scores). At this school, I was able to succeed easily - I was simply smarter than my peers, and it showed. I worked little, but still got great grades. I skipped class often, oversleeping - a problem that I ascribe to my amazingly low locus of control. I decided to transfer to a very good school, based on how well I was doing.

There, things that were bad in HS only got worse, as in college, we are expected (rightfully) to take full responsibility for our actions, and manage our own time. I found/find myself depressed because I couldn't keep up with reading nor did I attend class frequently (usually because I overslept). And by overslept, I don't mean until 10 or 11, I mean until around 3pm - and this situation gets worse by the month.

Originally I tried to get around it by scheduling classes later and later in the day - but it just got worse and worse.

Recently, a friend with ADHD gave me a few of his Adderall (XR 20mg), and they more or less changed my life. I was able to study, with out being distracted, and generally more active in my life - actually listening to people when having conversations with them, going to class and actually taking notes, etc.

Now for the questions:

1. Who should I go to to have myself diagnosed? I'm guessing the options are psychiatrist or general practitioner. What are the advantages and disadvantages of those options? Bear in mind, I'm in a college town, one where I'm sure people use drugs like the kind I seek recreationally - how do I avoid being lumped into this group?

2. I feel like I haven't been diagnosed in the past just because I've done fairly well in school, and generally present myself as a member of the intelligentsia. Could this impression cloud a medical professional's judgement?

3. Is it wise to mention my experience with Adderall given that it's a prescription drug? I don't want the doc to throw me to the curb because I tried it - although I get the impression that this kind of thing (a friend giving you onee) isn't uncommon.

4. I do not currently have insurance. How much will all of this cost? I fear having to go to "doctor-shop", not to mention the cost of the drugs themselves. How much should I plan on spending?

Any other insights are appreciated, and you can contact me at [e-mail] for any further information or comments.

posted by anonymous to health (38 comments total)

1. A psychiatrist is better equipped to make sure it's not something else. A psychiatrist has also likely talked to more people with ADHD and who've taken Adderall than a physician has.

2. They'll ask you a lot of specific questions that will diagnose you. Not every person with ADHD flunks out.

3. No one is going to turn you in to the cops. A psychiatrist especially has dealt with people admitting they took all kinds of drugs they weren't supposed to, from vicodin to heroin. I think they will take this into consideration in assessing "what works" for you.

4. See your student health clinic, which should be free if you're still enrolled. If you're not, most mental health providers have sliding scales based on ability to pay and will have free samples of the drugs.

IANAD, and I don't have ADHD, but I love someone who does and who went through all of this as an adult.
posted by desjardins at 8:49 AM on September 23, 2007

Here is my insight:

Recently, a friend with ADHD gave me a few of his Adderall (XR 20mg), and they more or less changed my life. I was able to study, with out being distracted, and generally more active in my life - actually listening to people when having conversations with them, going to class and actually taking notes, etc.

This is not remotely persuasive - Adderall is a stimulant, that has this hyperfocus effect on anyone who uses it. The fact that taking Adderall gave you the stamina to study (or to stay up all night playing Halo 3, or whatever) is not a sign that you have the disease the medication is intended to treat. A good analogy - if you DON'T have depression but take Paxil, you'll STILL feel more social, more energetic, more upbeat, etc. But that doesn't mean you had depression in the first place.

I'm sorry, but have you tried logical behavioral interventions - for example there are some REALLY intense alarm clocks out there. I'm not a doctor at all, nor am I trying to be excessively judgmental, but your descriptions sound more like lazy, self-indulgent and wholly lacking maturity and self-disclipline in a non-clinical way, than truly ADD. Your main complaint is that you can't wake up for class on time, apparently. What time do you GO to bed? It sounds like you want an excuse to get a drug that will make management of your so-called "symptoms" a little easier, and are dissembling accordingly. And I lay this on you, because if I were a doctor and you came to me with this story, that is how I would feel, and I sense you've asked this question as a "trial-run" to see how your drug seeking behavior will go over with a medical professional.

Again, though, I'm truly not a doctor and if you do feel you have a medical problem, you should not hesitate to get treatment for it. But the doctor may not recommend your stimulant-of-choice.
posted by bunnycup at 8:51 AM on September 23, 2007 [1 favorite]

1. Who should I go to to have myself diagnosed? I'm guessing the options are psychiatrist or general practitioner. What are the advantages and disadvantages of those options? Bear in mind, I'm in a college town, one where I'm sure people use drugs like the kind I seek recreationally - how do I avoid being lumped into this group?

I would go to a doctor you've seen before. I've heard stories of being referred to multiple psychiatrists, and even a neurologist that gave an MRI! That's expensive without health insurance, and in all honesty, to keep their asses covered in case the DEA comes to them. I would make it known fairly early on that you're looking to keep costs down due to not having insurance. Keep in mind you have to get the prescription in person every month, so don't go to a doctor that isn't conveniently within traveling distance.

2. I feel like I haven't been diagnosed in the past just because I've done fairly well in school, and generally present myself as a member of the intelligentsia. Could this impression cloud a medical professionals judgment?

Possibly, but ADHD has nothing to do with intelligence. You might notice yourself becoming less neurotic, less hyperactive. These things aren't as easy to present to a doctor as better grades are.

3. Is it wise to mention my experience with Adderall given that it's a prescription drug? I don't want the doc to throw me to the curb because I tried it - although I get the impression that this kind of thing (a friend giving you onee) isn't uncommon.

I would not, it could jeopardize you ever getting a prescription for any scheduled drug in the future. Anecdotally, I've known a lot of people who self-diagnosis by taking someone else's prescription. I believe they really had ADHD/ADD as their was a vast personality improvement, they definitely didn't have drug abuse behavior.


4. I do not currently have insurance. How much will all of this cost? I fear having to go to "doctor-shop", not to mention the cost of the drugs themselves. How much should I plan on spending?

The drugs themselves are relatively cheap. Besides Adderall XR there are generic amphetamines. These are dirt cheap in comparison, I doubt you'd spend more than $20 a month. Say your dosage is 5MG a day, you might ask for 2.5mg pills so you can take one in the morning and one after lunch.
posted by geoff. at 8:52 AM on September 23, 2007

Does your school offer a health insurance plan? It might be worth it to sign up. ADHD isn't just a diagnosis someone is going to make in one office visit--especially an acute care "doctor shop" as you call it. You should also try to get in touch with your school's "Counseling and Psychological Services," as you may be able to receive a certain number of sessions without having to have insurance.

Some people do well with Adderall, some don't, and these meds also require frequent follow-up until the right medicine at the right dose is found, so you'll need multiple appointments with the same doctor. I highly doubt any acute care clinic is going to send you home with a prescription for any stimulant.
posted by gramcracker at 8:55 AM on September 23, 2007

This is not remotely persuasive - Adderall is a stimulant, that has this hyperfocus effect on anyone who uses it. The fact that taking Adderall gave you the stamina to study (or to stay up all night playing Halo 3, or whatever) is not a sign that you have the disease the medication is intended to treat.

I think this post addresses the issue quite succinctly:

First, a disclaimer: you should only get Ritalin for indicated disorders by prescription from a physician. Ok? Because the doctor will rigorously apply artificial and unreliable diagnostic categories backed up by invalid and arbitrary screens and queries to make a diagnosis. So after this completely subjective and near useless evaluation is completed, your doctor should be able to exercise prudent clinical judgment to decide if Ritalin could be of benefit. In other words, he will ultimately decide based on little else but his own prejudices and/or consult the Magic 8 Ball. That'll be $250, please. Cash appreciated.

Personally, I'm incredibly ADD. You're story sounds a lot like mine, except I had been prescribed various medications that I decided to give up during high school (and have not gone back on).

Stimulant medications are pretty habit forming. It's a very socially acceptable habit, especially if you're as chronically distractable as I am, but it's a habit none the less. You may learn to cope with all of these characteristics of yourself without drugs, but it's incredibly hard. I'm still trying.

Non-stimulant meds will also lead to dependency, and have some pretty harsh withdrawal symptoms (in certain individuals). They can also change you're personality in ways you may or may not be comfortable with.

My basic message here is that getting the drugs through a legit source does not solve the moral and philosophical issues of living a chemically altered life. Do you still want to be on the pills 20 years from now? Where do you draw the line, drug-use wise?
posted by phrontist at 9:29 AM on September 23, 2007

bunnycup: I'm not a doctor at all, nor am I trying to be excessively judgmental, but your descriptions sound more like lazy, self-indulgent and wholly lacking maturity and self-disclipline in a non-clinical way, than truly ADD. Your main complaint is that you can't wake up for class on time, apparently. What time do you GO to bed? It sounds like you want an excuse to get a drug that will make management of your so-called "symptoms" a little easier, and are dissembling accordingly. And I lay this on you, because if I were a doctor and you came to me with this story, that is how I would feel, and I sense you've asked this question as a "trial-run" to see how your drug seeking behavior will go over with a medical professional.

Wow, guy. "Don't want to be judgemental, but... [judge][judge][judge][judge]."

OP: what Bunnycup said is actually something a lot of adults with undiagnosed ADD have had said to them. A lot. Over the course of a lifetime. Say to say it's not such an uncommon opinion. And we've echoed it to ourselves -- that we're lazy or maybe not as smart as we think, that there's something just wrong with us, and we shouldn't be trying to seek help because we need to just try harder. But for people with ADD this is a legitimate problem, and a lifetime of trying to try and continually failing leads to a completely messed sense of self-esteem. I know because I was diagnosed last year with ADD after a life of hating myself for not being able to just DO things like other people did. After years of being told I was not reaching my potential in school. After beating myself and finally in my early 30s finding myself trying to accept that maybe, although I was tested as a kid as being super-smart, I really was just stupid, and had been deceiving myself all those years. So realising that I had ADD all that time was like being freed from all the years of shame that had piled up and made me feel like the stupidest, most lazy, most broken person alive.

I can't tell you if you have ADD because I'm not a psychiatrist, but I can say that some of the things you've said ring familiar. Especially that you're generally considered smart -- the reason that non-hyperactive ADD sufferers (who are usually women) go undiagnosed until adulthood is precisely because they've got the goods to slide through in their own inconsistent, not-trying way. I did the same -- graduated from high school with honours but my grades varied from the 60s to the high 90s. I can't help but wonder what I'd have achieved if I'd actually ever done a piece of homework or went to class 100% of the time.

You want to see a psychiatrist, but try to find one who specializes in adult ADD. Do some googling and you should find recommendations from other ADD patients. It seems that psychiatrists treating adults for this are not all that common. Check on addforums.com too.

Good luck to you, sincerely.
posted by loiseau at 9:29 AM on September 23, 2007 [2 favorites]

That sounds an awful lot like my college life, except I never transferred to a better school. I was recommended the book Driven To Distraction when finally coming to terms with my ADD, and it's a pretty good starting point. The next step after that is to see if medication is right.

Psychiatrists aren't going to be great sources of perspective. I went to one that thought medication was the solution to everything, and it didn't help when I wanted to know all options. In my experience, the meds get expensive and they can really wreak havok on your mood. From what I remember, generic Ritalin is pretty cheap and got the job done.

FYI, just knowing you have ADD and knowing what that means is a huge help in controlling it. It might be good to get a LCSW or other kind of therapist, one that works on a sliding scale, and one that has a background in ADHD.

Good luck, Annonymous.
posted by ambulance blues at 9:45 AM on September 23, 2007

I was prescribed Adderall XR. I was convinced I suffered from ADD. I was mildly depressed. My sister, a special-ed teacher suggested that I may have ADD that had manifested into depression. I latched onto this idea with a vengeance. I've always been a severe caffeine addict. I needed it to feel "normal". An epiphany! I was self-medicating! Finally, an answer why I was lazy, spacey, and forgetful!

I saw a psychiatrist and was diagnosed with mild to moderate ADD. I researched ADD a lot, and knew just what to say when I went in. I could identify with a lot of the traits. I wasn't lying at all. If I remember correctly Adderall XR 20 mg costs 200 bucks for a 30 day supply, or at most 60 tabs. This is at 20 mg per day. Either way, it's 200 dollars for a bottle. Generic Adderrall, and not extended release, is much less expensive, but I've read that a lot of people dislike it.

I feel like I haven't been diagnosed in the past just because I've done fairly well in school, and generally present myself as a member of the intelligentsia. Could this impression cloud a medical professional's judgement?

I would hope not. Although, I think my psychiatrist was a little doubtful when he heard I didn't have that many problems in school. This is why I got the mild to moderate modifier. I wouldn't consider myself as overly intelligent in the least. I'm average and I've always had poor study habits. The material just wasn't that difficult. There was a time in college that I participated in a study group and this helped tremendously. It was an obligation to study. It was less boring.

The first time I took an Adderall XR my sister said that I sounded 100 times better. I was speaking with her on the telephone and she said I was more coherent and clear. Before, my mind was thinking of a million things at once. I had trouble focusing and would say "um" a lot and ask her to repeat things.

I took Adderall XR for two months and quit. I noticed that I was getting snippy and short-tempered with my family. Anger and agitation while taking Adderall is a sign that maybe ADD isn't the case at all.

I convinced myself that I just a little lazy and a bit depressed and I didn't have ADD at all. Why wasn't this Adderall motivating me more? Why wasn't my house clean all the time and why was I still forgetting things? Adderall is not a magic bullet. There is no magic pill, of course. I should have talked about it with the psychiatrist.

My advice would be to see a psychiatrist. Pay for the visit(s) out of pocket if you have to and if you can. See what he has to say.

There are tons of tips and methods to manage ADD. I like this book, ADD Friendly Ways to Organize Your Life. Put it on your nightstand as a reminder to read before bed. There are a lot of good books on the subject out there.

In the meantime you can start an exercise program, stick up some post-it notes on your mirrors and front doors as reminders, hang up a few calendars with big blocks in your living situation, obligate yourself to a study group, and start ingesting a bit more caffeine if you can tolerate it.

Obligate yourself to a study situation when you're not in a group. Such as, "The library is where I'll be from such and such a time" I'm going to crack the book and study in 15 minute increments. I'll take 5-10 minute breaks and people watch or read the novel I'm interested in."

Timers are also very helpful. Working in short bursts increase productivity for ADDers.

I am not a doctor. I quit the drugs and am not sure I even have ADD. This is what works for me.

Jeez, this is long. I hope you can focus on this rambling. Good luck.
posted by LoriFLA at 9:45 AM on September 23, 2007 [1 favorite]

Don't diagnose yourself ADHD because Ritalin works for you. As bunnycup says, Ritalin works for everyone; it's basically speed. It's not a diagnostic tool.

Which does not, of course, mean that you don't have ADHD, and it certainly sounds like you want further evaluation. You're in school -- does your campus have student mental health resources? That would be my first stop.
posted by occhiblu at 9:47 AM on September 23, 2007

I have had a bad time with this situation.

1. You should go to a psychiatrist, not a neurologist or the learning disabilities office at your university. This is solely based on my personal experience, YMMV.
2. Being smart and already thinking that you have a particular problem makes any diagnosis difficult (whether it's because they or you are wrong and stubborn is hard to say). I'm not sure there's much you can do about that.
3. Adderall improves anyone's studying. It's speed. The question is whether your functioning is significantly poor enough to require it. You should mention it to a doctor, but don't expect it to mean anything.
posted by unknowncommand at 9:52 AM on September 23, 2007

Wow, guy. "Don't want to be judgemental, but... [judge][judge][judge][judge]."
This gal never said she didn't want to be judgmental. But I made an effort to reign in (and I quote myself, something you might do next time you inexpertly put words in my mouth) "excessively judgmental" analysis by giving the OP some benefit of the doubt.

Frankly, from reading the DSM diagnostic criteria for ADHD, I don't see them in this guy's question - his primary complaint is an inability to stop sleeping until 3pm, which seems to run counter to the "hyperactivity" aspects of the disease (though these need not be clinically present in each patient). I see "I want to tell a doctor I'm ADHD to get Adderall, how best to do so?" and stating as much is DIRECTLY responsive to the OP's Question 1. If you don't, you're welcome to your explanatory posted opinions.
posted by bunnycup at 10:27 AM on September 23, 2007

bunnycup, none of us can diagnose the asker, even if we are doctors (which, IIRC, you're not, nor am I). He mentions other symptoms aside from oversleeping. The asker's question is what he should do now, given his suspicions. The only reasonable answer is to see someone who CAN diagnose him, since none of us can. Hopefully that person is qualified enough to separate the drug-seekers from the ADHD.

Also, from what I've read, stimulants make an ADHD person feel more focused, and the rest of us jittery and hyper.
posted by desjardins at 10:50 AM on September 23, 2007

Keep in mind that I am not a medical professional, but I am a couple months away from a degree in psychology, so I feel that I can add something to the discussion.

First, I agree with bunnycup's point that what you have said doesn't fit with the DSM criteria. Even though Adderall may work for you, this is not proof positive for an ADHD diagnosis. As you've mentioned, Adderall is a highly abused drug on college campuses, and that's because it works for everyone.

Because you said that you don't have insurance, I would recommend going to your campus counseling office. These are good people, who can help you with the time management issues that you seem to be having. I saw time management, because it sounds more like that than ADHD. The good thing about going to your school counselors is that they will be able to see if you actually do have ADHD, and can refer you to a psychiatrist who can help you.

Personally, if I were in your shoes I would make an attempt to build a good schedule. I know there have been some good AskMeFi questions about how to condition yourself to wake up earlier, and that's a good place to start. I plan most of my day in Google calendar, and the alerts keep me on task. Also, you may want to start drinking coffee before/during class. It's a stimulant (like adderall) and will probably help you to concentrate. I stared bringing coffee with me to my 8:00 and 9:00 classes after doing poorly in one that should have been an easy A. And if you set it to brew automatically, the smell may help you wake up. Most teachers take no offense to this, but in smaller classes it's best to let them know that the caffeine helps you concentrate better.

Finally, don't let any negative comments bring you down. I am a firm believer in the power of therapy, and you have made a positive step just by coming here and describing what you have been dealing with.
posted by therumsgone at 10:55 AM on September 23, 2007

Also, from what I've read, stimulants make an ADHD person feel more focused, and the rest of us jittery and hyper.

Exactly. This is why doctors suggest to parents to give their ADD kid a Mountain Dew or an Orange Crush to temporarily calm them if they're in a situation without their meds.
posted by LoriFLA at 10:58 AM on September 23, 2007

Dextroamphetamine. Its cognitive and behavioral effects in normal and hyperactive boys and normal men:

The effects of a single oral dose of dextroamphetamine sulfate on motor activity, vigilance, learning, and mood were compared for normal and hyperactive prepubertal boys and normal college-aged men using a double-blind crossover design. Both groups of boys and men showed decreased motor activity, increased vigilance, and improvement on a learning task after taking the stimulant drug. The men reported euphoria, while the boys reported only feeling "tired" or "different" after taking the stimulant. It is not clear whether this difference in effect on mood between adults and children is due to differing experience with drugs, ability to report affect, or a true pharmacologic age-related effect. While there were some quantitative differences in drug effects on motor activity and vigilance between these different groups, stimulants appear to act similarly on normal and hyperactive children and adults.
posted by occhiblu at 11:02 AM on September 23, 2007 [1 favorite]

I think you need to see a psychiatrist, preferably one who specializes in ADHD (Driven to Distraction recommends seeing a child psychiatrist, as they're more likely to be familiar with ADHD than adult psychiatrists, but this may be less true nowadays). It's true that a lot of people think they have ADHD and definitely don't, but that doesn't mean that you don't. Here's a link to a list of symptoms for the two subtypes (Inattention, and Hyperactivity/Impulsivity). It's important to note that everyone has these problems to some degree, but the telling factor is whether you've had these problems significantly more than others your age, and whether they've consistently caused you impairment throughout your life.

Here's another post of mine on the subject - it addresses several of the issues brought up here.

That Ritalin and Adderall "work" or have the same effects for everyone, ADHD or not, is inaccurate. Stimulants such as Ritalin and Adderall actually have a calming effect on people with ADHD - they allow a person with ADHD to focus by quieting down his or her brain. Personally, sometimes I can take a nap after I take Adderall, and certain caffeine pills make me too sleepy to function.

Many methamphetamine users actually suffer from ADHD and use the drug to self-medicate (methamphetamine is actually prescribed, rarely, for ADHD - its Rx form is called Desoxyn) . I work with meth addicts every day in a research setting, and we control for those who have ADHD and those who do not because the motives for use and the effects on the users are so different. In fact, the rule of thumb is that a meth addict who doesn't have ADHD will have an opposite reaction to the drug from someone who does - meth mimics the effects of ADHD in a non-ADHD user, and vice versa, if that make sense. So, for example: typically, someone high on meth will be all fidgety and jumpy and ramble on in response to our questions; but if someone comes in high but they're totally calm and focused, then it's a good bet that they have ADHD and the meth alleviates their symptoms.

Illustrative example of what I mean: in the gay community, meth is frequently used as a sex drug because it enhances and increases sex drive and function. But I was talking to ADHD-diagnosed user and he was saying he loses interest in sex when he's using - the way he put it, some guy will put moves on him and he'll be like, "Umm...can't I just do your dishes?"

This, of course, isn't a perfect diagnostic measure of ADHD, but I bring it up because there are a lot of misconceptions about ADHD, all of which contribute to the pervading myth that it's not a "real" disorder. It is. If you recognize the symptoms as impairing your life, then you owe it to yourself to get checked out. Best of luck to you.
posted by granted at 11:03 AM on September 23, 2007 [1 favorite]

I forgot to mention that Adderall is a mixture of amphetamine salts, so it is structurally similar to methamphetamine.
posted by granted at 11:07 AM on September 23, 2007

That Ritalin and Adderall "work" or have the same effects for everyone, ADHD or not, is inaccurate. Stimulants such as Ritalin and Adderall actually have a calming effect on people with ADHD - they allow a person with ADHD to focus by quieting down his or her brain. Personally, sometimes I can take a nap after I take Adderall, and certain caffeine pills make me too sleepy to function.

This is crap, and repeating it authoratatively doesn't make it so. It's a popular myth because it allows people with ADHD to say "sure, I'm basically taking methamphetamine but it has a WHOLE DIFFERENT EFFECT on me." It doesn't. Give a proper dose of speed to anybody and they'll be able to study better. The reason people believe this is because people using speed for recreation take a much higher dose. Give 120mg of meth to somebody with ADHD and I guarantee they'll be pretty damn hyper too.

I've seen it. Really.

See occhiblu's post; amphetamines have the same effect on normal people and people with ADHD in terms of attention and jitteriness.

You guys realize that people have been taking speed to help them study for ages, right? It's not a new thing. Don't you remember Alex P. Keaton getting hooked on speed in a very special episode of Family Ties?
posted by Justinian at 11:12 AM on September 23, 2007

I've been diagnosed ADHD, and have been on Adderall, Ritalin, and lots of other stuff, prescribed and otherwise.

Amateur diagnoses aside, your course of action is simple here. Get yourself some health insurance, and then get yourself to a psychiatrist. Be completely honest with the psychiatrist about everything. If you don't feel comfortable with the psychiatrist, go to a different one. If you don't like the medication they give you, tell your psychiatrist.

This is the only bit of armchair medical advice I'm going to offer, and it's based on considerable firsthand experience. All the obsessive yammering in your question is just another example of your self-destructive procrastinatory tendencies. You are trying to complicate a situation that is not complicated, because if it's complicated, it's more interesting. Well, tough, it's not complicated. Get insurance and see a psychiatrist. Just do it.
posted by bingo at 11:12 AM on September 23, 2007

Ooops! I forgot to add for the original poster; You can't diagnose yourself with these kinds of illnesses. It's not like a broken arm where you can look and go, "yep I have a broken arm." The diagnostic criteria are subjective and hard to measure from the inside.

The fact that dextroamphetamine made you study better means nothing. As has been pointed out, almost anybody would study better with those pills. There is a huge secondary market where kids with ADHD sell their pills to other students for a profit. It happens every single day.

You should definitely see a doctor if you think you have a problem. But don't tell him about that or you'll look like you are drug seeking.
posted by Justinian at 11:14 AM on September 23, 2007

This is crap, and repeating it authoratatively doesn't make it so. It's a popular myth because it allows people with ADHD to say "sure, I'm basically taking methamphetamine but it has a WHOLE DIFFERENT EFFECT on me." It doesn't. Give a proper dose of speed to anybody and they'll be able to study better. The reason people believe this is because people using speed for recreation take a much higher dose. Give 120mg of meth to somebody with ADHD and I guarantee they'll be pretty damn hyper too.

Please explain why it calms some people's brains and allows them to focus, instead of creating more hyperactivity, especially in children? Are you saying ADHD isn't a real diagnosis?
posted by LoriFLA at 11:16 AM on September 23, 2007

Sorry, first half should be in italics.
posted by LoriFLA at 11:16 AM on September 23, 2007

Your story sounds familiar to me. I have ADHD.

1. Go to the school psychiatrist/mental health office and get referrals. Note, NOTE: ADD/ADHD diagnosis is incredibly vague. Some psychiatrists will throw pills at anyone who has ever had a daydream or two. Others (and you want this kind) try to be a thorough as possible. Misdiagnoses--usually to the positive rather than the negative--are very, very common.

2. No, because it's quite common for people to not be treated or seen for it until college because they're smart enough to make it through without it. This was the case for me.

3. No. You shouldn't have taken it, and Adderall helps EVERYBODY whether or not they're ADD/ADHD. You're taking a weak version of speed. Of course you could focus. My mom, the most not-ADD person ever, is now convinced she has ADD because she tried my little brother's Adderall (who is also arguably not ADD) and it, surprise, helped her focus!

4. Again, see the student clinic for recommendations. Generics are cheap.

Please, though, please, re-read this:
My basic message here is that getting the drugs through a legit source does not solve the moral and philosophical issues of living a chemically altered life. Do you still want to be on the pills 20 years from now? Where do you draw the line, drug-use wise?

You can get Adderall or Ritalin and it will help you focus. You will want to work, work, work all the time, you'll initially lose weight because you won't feel like eating, you'll feel happy and bright and energetic, and it will be great. And then you'll take it for half a year and realize if you don't keep taking it all that will go away and you'll feel even more sluggish and depressed than you did before. You're taking serious, serious, serious stimulants. You should not see that as a long-term fix.

If you are diagnosed, do not see the diagnosis as a way to get the magic pills that will fix all your problems. See the diagnosis as a way to meet a trained health care professional who can give you tips on how to change your lifestyle and study habits to work around your ADD. Think of the drugs as a crutch to make it easier to develop these good habits so when you begin to go off it you can be more successful. I don't know if there are long-term studies of people who have been taking prescription stimulants for fifteen years or more. I shudder at the thought. Me, I went off them. They changed my personality and I hated that I felt awful when they weren't there. You are truly better off doing the behavioral side of therapy long-term rather than the pharmacological.
posted by schroedinger at 11:40 AM on September 23, 2007 [2 favorites]

This is crap, and repeating it authoratatively doesn't make it so. It's a popular myth because it allows people with ADHD to say "sure, I'm basically taking methamphetamine but it has a WHOLE DIFFERENT EFFECT on me." It doesn't. Give a proper dose of speed to anybody and they'll be able to study better. The reason people believe this is because people using speed for recreation take a much higher dose. Give 120mg of meth to somebody with ADHD and I guarantee they'll be pretty damn hyper too.

You calling it "crap" authoritatively doesn't make it so, either. However, you might be shocked - shocked! - to discover that we may both be right.

It's currently hypothesized that there's sort of a bell curve with regards to catecholamine levels (catecholamines are the neurotransmitters released by stimulants) and attention/focus. Low levels mean poor attention and focus, moderate levels mean increasingly better attention and focus, and high to very high levels again mean poor attention and focus.

If (as it's hypothesized) ADHDers have naturally low catecholamine levels, taking stimulants knocks them into the moderate range, which allows them to focus as well as normal folk. Normal people who take stimulants may also improve their focus somewhat, but because their catecholamine levels are already in the moderate range, higher doses will more quickly start to impair their focusing abilities. The same will eventually happen to people with ADHD, too, but because they start out with lower levels to begin with, they'll require much higher doses than those required by normal people to make it to the other side of the bell curve.
posted by granted at 11:44 AM on September 23, 2007

Please explain why it calms some people's brains and allows them to focus, instead of creating more hyperactivity, especially in children? Are you saying ADHD isn't a real diagnosis?

LoriFLA, check occhiblu's post above. It's not that ADHD isn't real, it's that the effect of the stimulants used to treat it is not an indicator of an accurate diagnosis. If my forearm hurts I can put a cast on it and immobilize it, but that doesn't mean I have a broken arm instead of carpal tunnel syndrome.
posted by schroedinger at 11:47 AM on September 23, 2007

Please explain why it calms some people's brains and allows them to focus, instead of creating more hyperactivity, especially in children? Are you saying ADHD isn't a real diagnosis?

No, I'm saying that a proper dose of a stimulant helps virtually everyone to focus regardless of whether they have ADHD or not. ADHD just means that you need the help focusing much more than someone without ADHD.

Look; Xanax is a strong anti-anxiety sedative. It is great for treatment of anxiety disorders. But if you give it to a "normal" person they still get sedated. The difference is that they get by just fine without taking an anti-anxiety sedative. Dextroamphetamine is the same; if you give it to a normal person they still focus better but they get by just fine without taking it.

So, to bring this back to the actual question, the fact that taking Adderall helped the original poster focus isn't necessarily indicative of him having ADHD. It doesn't mean he doesn't have it, of course. He just shouldn't consider it proof.

Here is a quote from Dr. Daniel Kessler, director of the department of of developmental and behavioral pediatrics at St. Josephs in Phoenix:

"What is inappropriate is giving a patient suspected of having ADHD a trial on stimulants as a way to help make a diagnosis, he added. There is a misconception that the "paradoxical" effect of stimulants on concentration is a sign of ADHD. In fact, non-ADHD volunteers who take a stimulant also can have improved concentration.Attempting to use stimulants as a diagnostic tool "is an exceedingly dangerous practice."

Which is what is going on a bit in this thread.
posted by Justinian at 11:51 AM on September 23, 2007

Thanks for explaining further justinian and schroedinger. I now understand what you're saying completely.
posted by LoriFLA at 12:10 PM on September 23, 2007

You need a diagnosis.

I have no experience (that I know of) with ADHD, but a lot with depression, and honestly, that sounds more like depression to me. (The sleeping all the time is sorta symptomatic). IANAD, etc. But that's enough to make me wonder.

I remember my mother taking amphetamines in the late 50's, back when they passed out "diet pills" like candy mints. (As far as we know, she was not ADHD.) She would cheerfully tell you that although she did not lose an ounce, she "scrubbed and waxed the garage floor 3 times a day", because the rest of the house was already spotless. She felt more organized than she had the rest of her life, and focused and on top of things.

I had an employee who had insurance issues, and he claimed the generics did not do the same job, and he had a diagnosis of ADHD. We were never sure if he had it, or was a speed freak with a note from his doctor; I only mention it because he was pretty emphatic that the generics were less effective, in his case.

I don't think I would mention any previous drug experimentation. All it takes is one guy to write on your chart that you are guilty of "drug seeking behavior", and that could follow you the rest of your life. (Assuming it gets into some giant insurance company data base. If anyone knows about this, jump right in.)

The plural of anecdote is not data.
posted by unrepentanthippie at 12:52 PM on September 23, 2007

If you're having a tough time getting up in the morning, try using a kitchen timer. Or two of them, plus an alarm clock.

Set the clock to go off first with the radio. Then set the timers to go off at 5 minute intervals. They are incredibly annoying and loud. You can set up the timers in different places in your room. You'll have to get up to turn them off.
posted by wuwei at 1:24 PM on September 23, 2007

OP: One thing you can take from this very ugly thread is that you should discuss ADD with only people you trust... unless you like people trying to make you feel shitty about what is a legitimate disorder. Sad, but true.
posted by loiseau at 3:20 PM on September 23, 2007

OP: The other thing you should take is that some people will push the idea that you definitely have ADHD even if they have no clue if that's true out of a misguided sense of helpfulness.

See your doctor.
posted by Justinian at 4:39 PM on September 23, 2007

@Justinian: Are you sure it was Alex P. Keaton? I remember it being Jessie Spano on Saved by the Bell...I seriously don't remember Alex taking any speed.
posted by onepapertiger at 9:22 PM on September 23, 2007

Anon:

As an inexpensive, seemingly non-addictive substitute, you might want to try the pill called, none too encouragingly, "Spike". (The manufacturer's name is Biotest, if I remember correctly.)

It's marketed as a workout enhancer, and is easy to find at most GNC or vitamin shops, but in my experience, it increases focus and energy levels dramatically.

The cost for a bottle is $25-30, or was, the last time I checked, which was about a year ago.

I say that it's non-addictive, because, though I know that it seems to work very well with my neurochemistry, I only remember to take a Spike pill once every couple months or so... and I certainly don't feel a physical impulse to take it.

Actually, as soon as I post this, I think I'll move the pills from my medicine cabinet to my desk, so that I don't have to read MeFi to remember that I have this stuff sitting around.
posted by darth_tedious at 12:17 AM on September 24, 2007

despite what bunnycup says, last I heard reaction to stimulants IS a major tool for diagnosing ADHD.

I have been diagnosed as adhd and you could use the OP as a description of me up to that age. In my mid-twenties, feeling utter despair that there was simply no way I would ever make my life work, I got my doctor to refer me to a psychiatrist. It took him about 15 minutes to guess the issue was likely ADHD (most of which was him watching me in the waiting room with a camera I didn't know was there). He prescribed Ritalin AS A DIAGNOSTIC TOOL. He prescribed a short course of Ritalin to see how I reacted to it, as a diagnostic tool to find out if I had ADHD. I am not a doctor either, but that is what my fucking doctor told me he was doing.

My reaction to ritalin was precisely what the OP described. I took ritalin daily for about a year and a half, weekly or occasionally for 2-3 years, and now take it once or twice every 1-3 months. Basically, when I forget how to make things work. I doubt I would be around if it was not for ritalin. I never had a relationship that lasted more than a few weeks before ritalin. I never had a job for more than 4 months before ritalin. I don't remember EVER finishing ANY project of more than a few days duration before ritalin. I made it through high school & 2 years of university (computer engineering) solely by getting near perfect marks on all exams, which would make up for the zeros & incompletes on homework & projects.

So bunnycup, no offense but: shut the fuck up. I am not lazy, stupid or crazy. And yes, your ignorant reaction is so common that "You Mean I'm Not Lazy, Stupid or Crazy?!" is actually the title of a book about ADHD, one that helped me considerably.
posted by lastobelus at 3:16 AM on September 24, 2007 [2 favorites]

I was "re-diagnosed" with ADD in college after several years of no treatment, since I, like, you managed to perform fairly well even though I never did the reading (or any homework), didn't/couldn't study for tests in a meaningful fashion, and generally just never listened during classes unless i was required to be involved on multiple levels. Then when I got to college I realized that even though i hadn't been paying attention to all the boring crap in highschool, now I couldn't pay attention to all the really interesting stuff that I wanted to learn about. Still couldn't focus on it. Went to health services at my college. I had a very strong history of ADD, high school being the only time when I was unmedicated, simply because i'd refused to take the pills. Referred out to a psychiatrist for several sessions of testing and the diagnosis was confirmed, and they gave me adderall. Now, i know plenty of people that did not have to jump through those hoops -- i requested them because i had insurance and wanted to be sure, since I hadn't wanted to be taking medication. Lots of people i know just went to their GP, answered a questionaire and got the drugs. Which are expensive without insurance. I'm prescribed 20mg 3x a day for a total of 90 pills which cost 100 bucks or more depending on where i got it -- and that's the generic!!!

I wouldn't mention your usage of someone else's prescription. just go in and say that you are experiencing these problems and your new college life really throws into relief how much of a struggle it's been to make your life work so far.
posted by Soulbee at 6:48 AM on September 24, 2007

Justinian: OP: The other thing you should take is that some people will push the idea that you definitely have ADHD even if they have no clue if that's true out of a misguided sense of helpfulness.

See your doctor.


I assume this snipey bit was aimed at me, and if you read my posts you would see that I never made that suggestion at all.
posted by loiseau at 7:35 PM on September 24, 2007

loiseau, lastobelus, if you read this thread carefully bunnycup is not the only one arguing that discovering that stimulants do, in fact, stimulate people is not a way to diagnose ADD/ADHD. Occhiblu has provided links to a study and you can find plenty more. Lastobelus, I don't know when you were diagnosed but it does not sound recent. Our understanding of ADD/ADHD is constantly evolving. What may have been considered a viable diagnosis method years ago is no longer one now--furthermore, it is quite possible your psychiatrist did not know what they were talking about as ADD/ADHD is one of the most overdiagnosed disorders in the country. I'm ADD/ADHD and am not simply going from the opinion that its diagnosis is a mask for being stupid and lazy.

Anyway, OP, I hope you take a conservative route to this and don't stuff pills like there's no tomorrow (or develop the victim complex that other posters have picked up). I assure you that won't help anything in the long run.
posted by schroedinger at 5:53 AM on September 25, 2007

schroedinger: loiseau, lastobelus, if you read this thread carefully bunnycup is not the only one arguing that discovering that stimulants do, in fact, stimulate people is not a way to diagnose ADD/ADHD.

That has nothing to do with any of my comments in this thread; perhaps you are confusing my posts with someone else's. I personally do not believe that using Adderall to positive effect is any measure of whether or not a person has ADD. This is the first post in which I've even addressed that component of the question.
posted by loiseau at 5:25 PM on September 25, 2007