Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?
This is your opportunity to ask questions. No question too simple or too silly.
Culture war topics are accepted, and proposals for a better intro post are appreciated.
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Notes -
Give doctors the right to point firearms at their patient and tell them to take their fucking meds on the pain of death.
It's a good day at work, can you tell?
I think there's something deeply important about this issue which we haven't figured out yet.
I want to be productive. My dream is to be extremely productive. Maybe I'm lying to myself a little bit, but as far as I can tell, if I could press a button and make myself productivity-monster, a man who enjoys working and spends only perhaps an hour a day doing anything unproductive, I would. I'd like to switch all my current hobbies to more productive ones (swap reading for creative writing, for example) and spend my days accomplishing things.
That button exists, it's Adderall, and when I take it I temporarily do become very productive, and enjoy being productive. It's a great state of mind, quite pleasant to experience, and increases my overall wellbeing a lot. Emotionally I do better (because I get work done and am less stressed about it), and of course the work getting done is a big deal as well.
Before I take the pill, though, I have an aversion to taking it equal to my aversion to actually doing the work. My values are the same, I think--I want to get the work done--but on a base level it seems that my desire to do anything else is deeper than simple ADHD and has to do with base hedonism, or time preference, or something. In other words, I had thought that ADHD just means "you have a harder time focusing and getting work done", but it seems to be deeper than that. Despite deeply wanting to get work done, another part of me actively hates the idea of working in its own right. Even though I know that work under Adderall will be very enjoyable, it's still something I don't want to do. This can't be explained by simple hedonism or time preference; if it were just a case of wanting the happy chemicals, I'd be an Adderall abuser by now.
There's a phenomenon I'm sure you know more about than I do where some mental illnesses seem to involve wanting to be mentally ill on a level. Depressed people want to stay inside in the dark and avoid doing things which would snap them out of it. Some people of all types don't take their meds, even if they're capable of it, know the meds will work, and don't have any conscious reason not to take them.
I've heard bipolar people such as Freddie DeBoer describe the experience of taking meds as making them "not feel like themselves". Maybe this is true--he's certainly pretty bright, and seems to believe it--but connecting it with my own experience taking Adderall, I wonder if part of what they are going through has less to do with some vague feeling of "offness", disassociation, or feeling like their personality is being changed, and more to do with their actual subconscious values encouraging them to remain mentally ill.
It makes me wonder how much of mental illness is, at least in part, due to basic values and personality rather than anything actually wrong with the brain on a chemical or physical level. I would never have expected to develop an aversion to Adderall--it seems to solve basically all my problems--but to some small extent that has happened. My only explanation for why is that, unbeknownst to me, on some level I really did enjoy and value my hundreds of hours of playing videogames and stressing about the work I wasn't doing.
Anyways, sorry for the spew of words, it's a thought I haven't had time to explore in too much depth, but I think there's something to it.
Also, man, I always wondered how you put out so much content, but it's so easy on stimulants.
There are some researchers who believe ADHD primarily involves a defect in emotional regulation, working memory, and time projection. Which adds up to having a harder time focusing and getting work done, but the emotional regulation part is doing a lot more than that. If you have ADHD, you may have less capacity to make yourself feel something different than you are currently feeling, or to blunt the edge of a strong emotion. That could explain the strong desire not to do any work.
EDIT: Also, to your main point, I do find it interesting that you have an aversion to taking your Adderal. If I'm off my Dexedrine then I'm miserable. Irritable, unproductive, lethargic...mostly irritable actually, I snap at people a lot more when I'm off my meds, which is usually ever weekend because I don't want to build up a tolerance.
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If downers like alcohol bring out the "real you", then uppers like adderall and coke bring out the "fake you". The real you genuinely just wants to laze around and play games, so even if it hurts being a depressive P.o.S., there's always catharsis in the fact you're doing what your brain wants you to do. And if you drank some booze instead of popping an adderall, you'd go, "Work? Who gives a fuck about work! I'm just gonna drink myself into a coma and die in a couple years" etc. Even if it's wrong, that is how you actually feel about things, and adderall doesn't solve that so much as cover it up.
Can you pop adderall every day to stay productive? Sure. Build a career from that if you want. But the underlying problem remains. Stop taking adderall and all the problems come back. So will you take it every day until you retire...? This drug which stifles your creativity, which makes things feel somehow phony?
When we feel extremely sad or whatever, there's a massive wave of catharsis which makes us feel oddly satisfied and complete. And every time a depressed person boots up League of Legends at 2 AM and sips another cup of coffee, there's a mini wave of catharsis. It's his version of what happy people get when they do happy people crap like take a stroll through nature. You take that away from him, and he doesn't really have anything.
If.
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I genuinely feel many different ways at once. I think it's fair to say a part of me wants to simply laze about, while another part wants to work constantly and achieve things. Drugs seem to bring out one side or another, but both sides are equally real, if not equally strong.
If I quit my job and just coasted, the achievement-oriented side of me would get much more insistent on change, and I think I'd start thinking of that side of myself as the "real me."
It does seem to stifle creativity a bit but it doesn't make things feel phony. I still get incredible enjoyment out of my usual pastimes--in fact, I find both videogames and fiction much more enjoyable--but there's less of the creeping dread which fights to keep me from getting started with work.
I didn't think I had ADHD--certainly, I can focus for very long, intense periods of time on things I'm interested in without chemical intervention--but objectively, looking at how my life was going, I think I have a pretty severe case of it. Some of this was biochemical or neurological or whatever you want to call it, and some was due to bad habits compounded over years.
Previously, on a good day I was lucky to get 80 minutes of concentrated work in. The rest of my time was generally split between videogames and mindless doomscrolling, while stressing about all the work not getting done. Now I take 10 mg and get 200 minutes done (more than enough for my job), then spend time afterwards doing things I've wanted to do for ages such as build businesses.
I guess I'm saying--on Adderall, I enjoy the same things in the same way as my "true" self. In fact I enjoy them more. And I have other desires, which I'd argue are just as "true" to the "real me", which are now also being satisfied.
It's impossible to understand people at all without understanding that some of their desires are confused, contradictory, or even actively harmful. We have the power to excise such desires from our personalities with enough work and training. I've discovered in myself a desire along those lines which I didn't know I had--one which seems actively interested, not in basic time-wasting pastimes, but in harming me--and now that I know it exists, I can watch for it and reduce its influence over me.
Doing so is the basis of mortality and possibly the only decision we can make that really means anything.
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Well, we differ significantly on this regard. I'm precisely as productive as I need to be (sadly quite a lot now), but I don't want to have be to super productive. I mean, maybe a little, but if I didn't have so many pressing concerns, I'd be content with just relaxing and enjoying my life.
And I very much do not like Ritalin. It certainly makes me more productive in the sense I actually can force myself to open textbooks, but the subjective sensation is unpleasant. It's a dirty feeling drug, like a combination of energy and anxiety, even at the lowest doses and with sustained release formulations.
Maybe I'd feel different on Adderall or other stims, but they're not available here in India, though I will try to get my prescription changed there.
I don't like Ritalin. I don't want to take it. I simply feel compelled to, if I want to make anything of myself. And I guess it's worked out?
Bipolar people alternate between mania and depression. But mania feels good. It feels fucking great. Not enough to outweigh the negative consequences from both itself and the subsequent depression, but I think that if I had to pick an ideal mental state for the rest of my life, it would hypomania. You know all the people famous for getting shit done? They're probably there or close. Or maybe just obsessed with their work.
If he's taking mood stabilizers, they're killing the buzz.
Then again, what do I know? I've been moderately depressed for most of a decade. Nothing I tried so far helped. But actually having achieved some of my career goals has genuinely helped, and there are better treatments I can look out for.
You're correct. One example is them listening to sad music, which turns out, actually makes them sadder. But Scott has discussed that at length and I have nothing novel to add.
Depression feeds on itself and seeks to perpetuate more depression. Many people don't seek treatment of their own accord after all.
Ever tried chronic sleep deprivation? I write best at 5 am when I'm dead tired yet sleep eludes me. It brings out the latent poet in me.
(And surprisingly enough, sleep deprivation can temporarily reverse depression, though it's hardly a sustainable method. Maybe that's one of the rare times when I'm not depressed. I still write plenty when I'm not on my meds. Most of what I write is, but it certainly helps.)
I've heard the same from virtually everyone. In my mind, these two things are connected. I feel a constant sense of anxiety over the many, many problems in myself and the world. It feels like morally bankrupt idiots are in charge virtually everywhere, and nearly anyone really trying could do a better job. Politics: IRL I've never talked to a single person who's actually read over a single study looking for flaws in the methodology. This is a super low bar that everyone with an interest in public policy shoild have done at some point. The same applies in creative fields (I find most books and movies very flawed), business, religion, etc.
This means there's tons of low-hanging fruit in every field. There are millions of people suffering needlessly due to bad policy, bad economics, etc. There are countless stories that just don't hit the themes they were going for, suffer cyclic-character-development-itis (where a character has a single flaw they continuously work on without ever actually growing), or otherwise could have been done way better. My own family and friends have big problems I can realistically help with if I put the time in.
If the low-hanging fruit wasn't there--if life wasn't absolutely overflowing with horrendously visible flaws in everyday things--I'd be more than happy to sit back and enjoy the simple things in life. I do really enjoy most aspects of life. But, given how easily improvable most things seem to be, I'm sure I can get more (in terms of satisfaction, status, hedonium, etc.) from improving them.
You seem to have a similar (if not better) attitude in this regard towards writing. It's not necessarily about writing per se,, it's about creating a story which really should already exist, if people were really on their game and up to snuff. The fact your story does not already exist is a sort of affront against nature.
So, going back to whether adderall causes anxiety--I'm not sure. To me, the anxiety is already there, and adderall just helps me channel it.
Hmm.. I do kinda agree with you.
I just spent a while speaking to a suicide survivor. Well, he's hardly out of the woods yet, given that he was in the ICU. But he wasn't my patient in the first place, and I might not be done with psych training, but by god I was the best one I know available at that time, and I walked the dude through a very bad place. And then made sure the cops didn't make things worse, while probably doing better than the poor bastard actually responsible for that particular HDU.
And I talked a suicidal girl I met on a dating app out of it, back to back.
Maybe I do like psychiatry because I see so many psychiatrists doing a fucking terrible job, and I'm confident I can do better. I actually probably can, but perhaps that's only true in India where standards are lower. But I'm heading abroad to learn my shit.
And you're absolutely correct that I wrote my novel because I was pissed at perceived inadequacies and flaws in otherwise decent ones, and thought I could do better.
I've heard of much worse. If it's not obviously making you anxious, then it's likely a better drug than methylphenidate/Ritalin. And when Scott did a survey on the topic, users ranked it higher, though it's been a long time and I can't remember what the post was.
From his Lorien Psychology page:
I personally think the 25% of Adderall that is left handed amphetamine is unpleasant. Go Vyvanse if possible imo (or Dexedrine), for that mellow, pure right-handed goodness.
Thanks for hunting that down! It's not quite the same as the post I remembered, since that used user polled data from SSC/ACX readers and even claimed that meth (which is available on prescription, as rare as that is) was the best option (according to users). Still, this one states much the same, so I appreciate you looking it up.
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Have you ever read "The Spirit Catches You and You Fall Down" by Anne Fadiman? It is a pretty tragic book that should be read by any medical professional. Whenever someone doesn't take their meds or has a bad experience with a doctor I think about this book.
Spoilers, a little Hmong girl with epilepsy is treated by American doctors who run into issues such as 1) her family doesn't know how to read instructions in any language, 2) her family doesn't understand time the same way, and 3) her family isn't really certain that epilepsy is a bad thing and think the doctors are possibly harming her by trying to take her seizures away.
Sometimes there isn't much a doctor can do.
Well the cure for a 9mm headache is also a 9mm headache, and while death certificates are a PITA, so is handling people who want to get there the slow way, with more to put on the damn thing.
Hmm, I've heard about the book, I'll give it a whirl, thanks!
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