The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
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I wish I knew something else that worked my dude, India only has Ritalin as a useful stimulant, and while it's still a dirty feeling drug, it at least works. It's better than nothing, and I would be pretty screwed myself without it, at least when it came to academics. If you can't make do, such as by the grey market route, well, you work remote, and if this matters so greatly to you, you do have the option of moving to a country with more sensible laws.
It's a good thing you pinged me, because while we haven't met, that's literally me, I used to read while walking, shitting, eating, brushing, in class under the table, whenever it was physically possible. I guess smartphones are a little more convenient, but I do mostly read on mine.
Now, shame I don't have a nice paying remote job, because I would absolutely embrace the unabashed hedonism. But the hospital yells at me if I don't show up for work, so I gotta make do till I become a senior doctor who can make $$ through telemedicine (unlikely to happen at the rate of AI progress).
How difficult was it to get methylphenidate(ritalin) prescribed in India?
Not particularly. I saw a pretty famous psychiatrist, and he largely took me at my word since I was a med student and read up on it, I was already taking modafinil, and he ended up agreeing that I should try Ritalin.
I recently spoke to another doctor with ADHD from the other side of India, and she said she has issues with the doctors there being much more leery about prescribing it, which is retarded IMO. It obviously has abuse potential, but I think the benefits of giving the millions of underdiagnosed people with the disease here their meds outweighs the small risk that some of them will abuse it.
I would say most psychiatrists aren't particularly gatekeepy about it, and worst case you can shop around. I know my diagnosis was legitimate, I'd have failed many of my exams in med school if I wasn't able to take it to study, and thankfully that never happened.
I live in Eastern Europe (Bulgaria) and I've had a VERY different experience. I've talked to about 4 different doctors up to this point. One didn't even know what ADHD is, another didn't believe it's a "real" thing, the third told me I can't possibly have it because I finished highschool. The fourth told me that I do indeed have ADHD (after a year of insisting my real problem is depression) but she doesn't feel comfortable being a "legal narcotics dealer".
I've talked to my fellow countrymen on forums and the consensus is overwhelmingly the same: doctors here won't prescribe methylphenidate and pharmacies don't stock it. It's wild to me that India of all places has a more functional medical institution in this regard. I am quite envious of your situation.
My condolences, but it could be even worse. For example, while ADHD is known to be an actual disease in Japan, all stimulants worth a shit are banned, so I guess I know which country I never intend to do more than visit.
Do you have the option of telemedicine and getting it delivered from a country more understanding? Or just driving/traveling over in person?
I've got a list of 6 psychiatrists I've yet to talk to, at least one of them will probably prescribe it and I think I can find a pharmacy willing to stock it if I order a box. It's just been a very miserable experience, that's all.
In that case, make sure you stock up. I understand it's a pain, made all the worse because of the extra headache you're experiencing as someone with ADHD. Absolutely the last diagnosis worth gatekeeping, if you're making people jump through this many hoops, well, you're probably selecting out a lot of people who need the meds the most.
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I used to read while driving. Still not sure how I am still alive after this and similar risks.
Hah I’ve done the same…
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I can't drive, well, not legally, so I'm safe for now. At least you'll find out when you need more than reading glasses quickly!
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Are you not worried that the Ritalin will stop working after a few years? I’ve had friends who have had meds stop working after daily use for 5+ years and it’s been very tough for them. Assume the plan is to pass all your residency/training/etc then coast in the NHS, but I’m curious.
Tolerance is a well known issue, but I'm not a daily user. When I'm cramming for exams, I average anywhere from 20mg to 50mg max, and that's about daily usage for 2 to 6 months.
That's interspersed with long periods of minimal or no use. My ADHD is mild, I don't need to take Ritalin to make it through a working day, and in fact, doing so is actively unpleasant. I may not be the most hardworking and zealous doctor around, but I certainly do more than the bare minimum needed to avoid malpractice litigation, heh.
So I take it so I can study, acquire knowledge, pass exams, then use said acquired knowledge in my day job. The job itself doesn't need it, and I doubt I'd take it through residency. My internship was terrible in terms of workload and what it did to my mental health, and UK Residencies, while still a slog, really can't compare. If I take my meds as a resident, it'll be if I'm expected to keep studying particular topics, or for exams like the MRCPsych. Besides, Psych isn't nearly as high intensity as something like surgery or critical care.
You can't tell I have ADHD in normal conversation, or in my work. It's only when the textbooks come out that my eyes glaze over, and my usual coping mechanism that worked through high school of forcing myself to study through a combination of personal tutoring, extreme stress and lethal doses of caffeine all failed hard when the books became both big enough to kill a calf and too long to cover in a few days of cramming.
So I've been taking Ritalin for about 5 years now, and I can't say I notice a tolerance. At most, after 3 or 4 months of continuous daily use, I'll end up needing 30-40 mg, and that's impossible for me to disentangle from just needing more of it so I can study longer.
And if said tolerance does develop, well, the UK is a more enlightened nation in that regard and I can cycle through the better alternatives that aren't available here. It's not something I'm worried about.
I'm doubtful that most doctors will be employed after the 7 years it would take me to finish my training, leaving aside most humans, so after a certain point it becomes rather moot. I just don't currently have a better alternative than to act as if that's not going to happen, just in case it doesn't.
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