Psychiatrist Tells The Truth About Adderall & ADHD Meds

Summary

The video script discusses the concept of medication dependence, particularly in the context of ADHD medication. It clarifies that dependence is not inherently negative and is often necessary for treatment effectiveness. The speaker differentiates between physiological dependence and the need for medication long-term, emphasizing that lifestyle changes and therapy can reduce medication reliance. They also address common misconceptions about stimulant medications being superior to non-stimulant options for ADHD, highlighting the importance of individualized treatment plans.

Takeaways

• 🤔 The concept of 'dependence' on psychiatric medication is nuanced and depends on whether the medication is effectively managing symptoms and if the patient wishes to continue its use.
• 📝 A patient's daily use of ADHD medication does not necessarily indicate harmful dependence, but rather a need for consistent symptom management.
• 💡 Dependency can be physiological, where the body develops tolerance, leading to withdrawal symptoms if medication is stopped, but this is not inherently negative.
• 🛑 The effectiveness of ADHD medication should not be solely judged by immediate effects; long-term benefits and lifestyle adaptations are also crucial.
• 🧘 Evidence suggests that both medication and psychotherapy are equally effective for ADHD in terms of symptom reduction, with psychotherapy potentially offering longer-lasting benefits.
• 🏋️‍♂️ Healthy lifestyle changes, such as diet and exercise, can reduce the need for medication over time by improving overall health and symptom management.
• 🤝 The decision to use medication daily for ADHD should be personalized, considering the individual's life demands and the potential for non-pharmacological symptom management.
• 🔍 Stimulant medications are often perceived as more effective due to their rapid onset of action, but this does not necessarily equate to a larger reduction in ADHD symptoms compared to non-stimulants.
• 💊 The fear of dependence on psychiatric medication is common, but understanding the purpose and effects of medication can alleviate concerns and guide informed treatment decisions.
• 👨‍⚕️ It is important to seek clarification from healthcare providers when terms like 'dependence' are used, as they may have different meanings to patients and medical professionals.
• 🔄 A diagnosis of ADHD can significantly improve a person's life by enabling access to appropriate treatments and support, rather than leaving symptoms untreated.

Q & A

What does the term 'dependent' on medication imply in the context of psychiatric medication?

In the context of psychiatric medication, 'dependent' can imply that the medication is effectively managing symptoms and the individual feels the need to continue taking it for its intended effects. It does not necessarily imply an unhealthy addiction but rather reliance for symptom control.

Why did the doctor suggest that the patient has become dependent on their ADHD medication?

The doctor suggested dependence because the patient reported taking the medication daily and feeling the need to do so, indicating that the medication is effectively managing their ADHD symptoms and they rely on it for daily functioning.

What is the difference between stimulant and non-stimulant medications for ADHD according to the script?

Stimulant medications work faster than non-stimulant medications, providing immediate benefits, which can create a perception that they are more effective. However, studies show that both types of medications have similar effect sizes in reducing ADHD symptoms over time.

Why might a patient feel confused or scared when told they are 'dependent' on their medication?

A patient might feel confused or scared because the term 'dependent' can carry negative connotations associated with addiction. Without proper explanation, it may lead to unnecessary anxiety about the need for ongoing medication use.

What is the role of psychotherapy in the treatment of ADHD as mentioned in the script?

Psychotherapy plays a significant role in ADHD treatment by teaching organizational skills, prioritization, and other coping mechanisms that can help manage ADHD symptoms. It can be as effective as medication and may provide longer-lasting benefits after treatment ends.

How does the script differentiate between the immediate effects of stimulant medication and the long-term benefits of psychotherapy?

The script explains that while stimulant medication provides immediate relief, psychotherapy offers long-term benefits by teaching skills that can be applied even after treatment has ended, potentially reducing the need for medication over time.

What are some examples of lifestyle changes that can potentially reduce the need for ADHD medication?

Examples include developing a healthy diet, regular exercise, practicing meditation to improve focus, and learning organizational and prioritization skills through psychotherapy.

Why might a general practitioner (GP) be more inclined to prescribe stimulant medication for ADHD?

A GP might prefer prescribing stimulant medication due to the immediate feedback they receive from patients who report significant and rapid improvements in their symptoms, which can reinforce the perception that stimulants are more effective.

What does the script suggest about the relationship between untreated ADHD and the development of depression later in life?

The script suggests a causal relationship where untreated ADHD can lead to factors such as academic underachievement, social isolation, and loneliness, which in turn can increase the risk of developing depression later in life.

How does the script address the concern about overdiagnosis of ADHD?

The script acknowledges that ADHD can be both overdiagnosed and underdiagnosed. It may be overdiagnosed in cases where parents misinterpret normal child behavior or lack of attention training as ADHD. Conversely, it may be underdiagnosed in smart children who develop compensatory mechanisms to hide their symptoms.

What is the potential impact of a correct ADHD diagnosis on an individual's life?

A correct ADHD diagnosis can lead to appropriate treatment and support, potentially improving the individual's quality of life, academic performance, social interactions, and overall mental health by addressing the symptoms that were previously affecting their functioning.

Outlines

00:00

🤔 Confusion Over Medication Dependence in ADHD Treatment

The speaker discusses the complexities of medication dependence, particularly with ADHD medication. They recount a conversation with their doctor about becoming dependent on stimulants and express confusion over the doctor's advice. The speaker also mentions plans to see a psychiatrist to explore alternatives like non-stimulant medications or lower dosages. They delve into the broader topic of medication dependence, using the analogy of a heart transplant patient needing immunosuppressive medication to illustrate the purpose of medication. The goal is to sustainably help people, and dependence is not inherently negative; it's about whether the medication is effectively serving its intended purpose.

05:01

💊 Daily ADHD Medication and Its Implications

The script addresses the common practice of taking ADHD medication daily and the misconceptions surrounding it. The speaker, a psychiatrist, explains that while stimulant medications are often recommended for daily use due to the consistent demands of daily life, this does not necessarily equate to harmful dependence. They clarify that physiological dependence, such as experiencing withdrawal symptoms if the medication is stopped, is not the same as needing the medication to function effectively. The speaker also touches on the importance of individualized treatment plans and the role of therapy in managing ADHD symptoms.

10:02

🧘‍♂️ The Role of Therapy and Lifestyle Changes in ADHD Management

This paragraph delves into the effectiveness of psychotherapy and lifestyle changes in managing ADHD symptoms. The speaker contrasts the immediate effects of stimulant medication with the longer-lasting benefits of therapy, which can teach organizational and prioritization skills to mitigate ADHD's impact. They discuss evidence-based data showing that medication and psychotherapy have similar effect sizes, but the benefits of therapy can extend beyond the treatment period. The speaker also dispels myths about the necessity of stimulant medication, explaining that non-stimulant medications can be equally effective, albeit with a slower onset of action.

15:03

💡 Understanding the 'Best' Treatment for ADHD

The speaker challenges the notion that stimulant medications are the best treatment for ADHD, explaining that while they may work faster, they are not necessarily more effective than non-stimulant options. They discuss the subjective experience of patients who feel stimulants work better due to the immediate reinforcement they provide. The speaker also addresses the issue of long-term dependence on medication, suggesting that adopting practices like meditation and developing organizational skills can reduce reliance on medication over time.

20:04

🚑 The Impact of Untreated ADHD and the Importance of Accurate Diagnosis

In this paragraph, the speaker discusses the potential negative outcomes of untreated ADHD, such as increased risk of depression and social isolation. They highlight the importance of accurate diagnosis and the potential for ADHD to be both overdiagnosed and underdiagnosed. The speaker emphasizes that a proper diagnosis can lead to improved treatment and quality of life, and they encourage seeking second opinions and specialist consultations when necessary.

🧠 The Overlap and Misdiagnosis of ADHD

The final paragraph addresses the complexities of ADHD diagnosis, particularly in intelligent individuals who may develop compensatory mechanisms to mask their symptoms. The speaker suggests that this can lead to underdiagnosis, as these individuals can appear to function well despite their ADHD. Conversely, they also discuss overdiagnosis, where parents may attribute common childhood behaviors to ADHD without considering other factors like lack of attention or emotional dysregulation caused by environmental influences.

Keywords

💡Psychiatric Medication

Psychiatric medication refers to drugs used to treat mental health disorders. In the context of the video, it is central to the discussion on dependency and the management of ADHD symptoms. The script mentions concerns about becoming dependent on such medications, highlighting the complexity of treatment decisions.

💡Dependency

Dependency, in a medical context, can refer to physiological dependence where the body has adapted to the presence of a substance, or psychological dependence where an individual feels a need for a medication due to its effects. The video explores the concept of dependency on ADHD medication, emphasizing the difference between needing medication for symptom management and developing a harmful addiction.

💡ADHD (Attention Deficit Hyperactivity Disorder)

ADHD is a neurodevelopmental disorder characterized by inattention, impulsivity, and hyperactivity. The script discusses the challenges of managing ADHD symptoms with medication and the potential for dependency, as well as the importance of understanding the role of medication in treatment plans.

💡Stimulant Medication

Stimulant medication is a class of drugs that increase activity in the brain and are commonly prescribed for ADHD to improve focus and reduce impulsivity. The video script contrasts the rapid effects of stimulants with non-stimulant medications, discussing their perceived effectiveness and potential for dependency.

💡Non-Stimulant Medication

Non-stimulant medications are alternatives to stimulants for treating ADHD and may take longer to show effects but can be equally effective. The script addresses the misconception that stimulants are inherently better due to their quick action, whereas non-stimulants may provide long-term benefits without immediate noticeable effects.

💡Psychotherapy

Psychotherapy involves therapeutic practices aimed at treating mental health disorders through psychological methods rather than medication. The video emphasizes that psychotherapy for ADHD can be as effective as medication, teaching organizational and prioritization skills to manage symptoms.

💡Efficacy

Efficacy refers to the effectiveness of a medical treatment or intervention. The script discusses the efficacy of both stimulant and non-stimulant medications for ADHD, noting that while they may feel different to patients, studies show similar effectiveness levels.

💡Withdrawal Symptoms

Withdrawal symptoms occur when the body has become dependent on a substance and it is discontinued. In the context of the video, withdrawal is mentioned as a potential consequence of physiological dependence on ADHD medication, highlighting the need for careful management of medication use.

💡Comorbidity

Comorbidity is the co-occurrence of two or more disorders in an individual. The script uses the relationship between ADHD and depression to illustrate how untreated ADHD can lead to other mental health issues, emphasizing the importance of proper diagnosis and treatment.

💡Organizational System

An organizational system refers to the strategies and tools used to manage tasks, time, and information effectively. The video discusses the development of such systems as a key component of psychotherapy for ADHD, helping to mitigate symptoms and reduce reliance on medication.

💡Medication Refill

A medication refill is the process of obtaining additional supplies of a prescribed medication. The script uses the scenario of a phone call to get an Adderall prescription refilled to introduce the topic of dependency and the ongoing need for medication management in ADHD treatment.

Highlights

Dependency on psychiatric medication is determined by its effectiveness and the patient's need for its continued use.

The concept of 'dependence' on medication can be misunderstood and may not necessarily be negative.

Stimulants are often perceived as the best treatment for ADHD due to their rapid effects, but this does not mean they are more effective than non-stimulants.

The effectiveness of medication is not solely about immediate effects but also about long-term benefits and lifestyle changes that may reduce the need for medication.

Psychotherapy can be as effective as medication for ADHD, teaching organizational and prioritization skills to manage symptoms.

Medication for ADHD may lead to physiological dependence, which is not inherently negative but should be monitored for safety.

The fear of medication dependency is common among those taking psychiatric medication, but understanding the purpose of medication can alleviate this fear.

The benefits of psychotherapy for ADHD can last much longer than the effects of medication after treatment ends.

Untreated ADHD can lead to a higher likelihood of developing depression later in life due to social isolation and academic underachievement.

ADHD is both over-diagnosed and under-diagnosed, with smart kids often developing compensatory mechanisms that hide their ADHD, leading to missed diagnoses.

The diagnosis of ADHD should ideally lead to treatment that can improve the individual's quality of life.

Medication is prescribed to sustainably help people, and whether one becomes dependent on it depends on the individual's response and lifestyle changes.

The perceived effectiveness of stimulants may be due to the rapid reinforcement felt by patients, not necessarily their superior efficacy.

The duration of benefits from psychotherapy can be more significant and longer-lasting compared to medication.

Lifestyle changes such as diet and exercise can reduce the need for medication in managing conditions like type 2 diabetes and potentially ADHD.

The fear of dependency on ADHD medication should be addressed by understanding the medication's purpose and potential alternatives like psychotherapy.

A proper diagnosis of ADHD can provide opportunities for treatment that can prevent the development of related issues such as depression.

Transcripts

but in terms of like whether you're

going to become quote unquote dependent

on a particular psychiatric medication

the first question is is it doing what

it's supposed to do and do you want it

to continue doing what it's supposed to

do my doctor just told me I've become

dependent on ADHD medication what does

that even mean I got off the phone with

my doctor just now to get my Adderall

prescription refilled during the call he

asked me do you take it every day or as

needed so I told him honestly I take it

every day because I feel I need it every

day my ADHD doesn't just vanish but on

the odd day that I forget to take it I

do just fine it's when I forget for

multiple days that it becomes an issue

and he said it sounds to me like you've

become dependent on stimulates okay so I

told him that I actually was planning on

visiting a proper psychiatrist my

prescription was given by a GP and

seeing about altering my prescription

maybe a non-stimulant would work or a

lower dosage and he replied no

stimulants work best for ADHD symptoms

so now I'm very confused as to what he's

going on about to be honest I shouldn't

take my medication if I don't need it

because I'll become dependent on

stimulants but I also need to take

stimulants because it helps me the most

therefore making me dependent it's

really confusing logic and I don't know

how I feel about about it he didn't

really elaborate either no concerns

about my blood pressure or anything he

just said hey you're dependent just

letting you know your prescription is

ready for you to pick up it's just

really confusing and I'm paranoid about

my health as it stands so this is really

tough because especially if you've got

ADHD like anyone who's taking

psychiatric medication usually has a

concern that they're going to become

dependent on it I've seen this whether

people have OCD whether I have major

depressive disorder whether they have

bipolar disorder whether I have ADHD

people are afraid of becoming dependent

on medication and then sometimes you'll

have clinicians who will be like oh yeah

you're dependent on this medication now

like a doctor is telling you this and

that's kind of terrifying like isn't

dependency on medication like a bad

thing and then you're like not really

sure and sometimes you'll even ask your

doctor like okay like is there some way

to get off the medication and they'll

say like no this is the most effective

treatment so I disagree with a lot of

what this GP says I'm pretty sure the

evidence backs me up better than it

backs the GP up we'll talk about that

for a second but what I'd love to do is

talk to you all today about what

medication dependence means is it okay

is it not okay and how people wind up

being dependent on medication and is

that scary so the first thing to

understand is that the reason we

prescribe medication is to sustainably

help people right so I'm going to ask

you all a question let's say I have a

heart transplant and as part of my heart

transplant I have to take

immunosuppressive medication every

single day why do I have to take

immunosuppressive medication so let's do

a quick jaunt into physiology and

transplant rejection not what y'all were

expecting today but let's explain this

principle so I have a body my body has

an immune system my immune system learns

what is me and what is not me and then

what the immune system does is starts to

attack things that are not me right

pretty easy turns out out that I got a

bum ticker and I need a heart transplant

so what I'm going to do is I'm going to

get a heart transplant and in order for

my immune system to not destroy the

transplanted heart because it comes from

another person I have to take

immunosuppressive medication now this

begs the question am I now dependent on

immunosuppressive medication like sort

of right I'm not I mean like I guess I

could stop taking it so this is a key

thing to understand medication is there

to accomplish a particular goal that's

really the the beginning and the end of

it right we'll add a little bit of

nuance in a second but in terms of like

whether you're going to become quote

unquote dependent on a particular

psychiatric medication the first

question is is it doing what it's

supposed to do and do you want it to

continue doing what it's supposed to do

so when people take an antidepressant

medication or anti-anxiety medication

for example they're like do I have to be

on this the rest of my life that's

usually like one of the earliest

questions they ask the short answer is

you don't have to be and we'll get to

that in a second but this is where I'd

say the purpose of medication whether

it's cholesterol medication

immunosuppressive medication weight loss

loss medication or ADHD medication or

depression medication the goal is the

same it's to try to keep you healthy now

just like with many of those medications

if you do particular things as a patient

you will no longer need the medication

to do that to do that job for it so

let's say I have type 2 diabetes which

means that due to the number of

adipocytes or fat cells that I have in

my body this is an oversimplification my

body has become resistant to insulin and

so since it's resistant to insulin I can

take certain medications that will

increase my insulin sensitivity and what

I can also do is adjust my diet reduce

my the level of my adipocytes right

start to exercise and do other kinds of

physiologic things that make it so that

I no longer need the medication so am I

going to be dependent on this medication

for the rest of my life well that

depends on my other behaviors and what

else I do so let's talk a little bit

about ADHD medication so some people

with ADHD require medication on a daily

basis generally speaking stimulant

medication from most people that are

prescribed for ADHD I will actually

recommend it on a daily basis so the

goal with people with ADHD is generally

speaking the ADHD kind of screws up

their life right if I go to work every

day and I need to pay attention every

day I don't want to be like missing some

days and be like okay other days like if

I show up three hours late to work once

a month because I didn't take my ADHD

medication every single day like I'm

gonna lose my job so what I found is a

as a psychiatrist working with people

with ADHD is you can't afford to have

ADHD 20 of the time like you can't treat

80 of it you're still going to get

screwed if you like your 20 like if your

ADHD is like active 20 of the time there

are some cases where for example like

people don't need it for work what

they'll do is they'll like not take

their ADHD medication on the weekends or

things like that there are individual

plans that you can kind of come up with

but it's okay to take ADHD medication

every single day does that build

dependence oh before we go on so people

are asking about weekends so like here's

the thing sometimes you need your ADHD

Medical education on the weekend as well

why because you have to do all the crap

that you don't get to do during the week

on the weekend like you got to do

laundry you got to pick up groceries you

got to drop off packages to return to

Amazon you gotta you know pick up

birthday cards you got to be on time to

social events so it's fine to use my

ADHD medication every single day so does

that mean you become dependent well

there's two issues to consider with ADHD

medication the first is that there may

be a physiologic dependence so this is

neither good nor bad it's not a value

judgment it just means that if your body

develops a physiologic tolerance and

dependence on a particular chemical

substance that means if you don't take

it you're going to have withdrawal

symptoms and that could be bad so we

develop different kinds of you know

symptoms with ADH I mean different kinds

of Tolerance with ADHD medications

that's not necessarily a bad thing it's

just something that you need to be aware

of almost from a safety standpoint so

that's where like we can become

dependent on caffeine is that does that

mean that morally we're bad people and

we're addicts not necessarily it just

means that if you don't have caffeine

you may have a headache that's it it's

just to understand the physiology now

the second thing about pendant says do I

have to take this medication for the

rest of my life that's what basically

people are asking when they they're

saying am I dependent on this medication

and that's where that depends it depends

and then you may say well Dr K that's

weird like how can you say that depends

what does it depend on just like any

other medical illness or not any but

many other medical illnesses how long

you need to be on medication the dose of

the medication that all depends on what

else you are willing to do as a patient

so let's go back to our diabetes example

if I start exercising every day if I eat

low glycemic index Foods if I start you

know doing other particular things like

doing yoga or other practices that

support type 2 diabetes and stuff like

that then I may not need to be on the

medication for the rest of my life right

so if I can like get to where I need to

go without the medication then I won't

be dependent on the medication I won't

need it so the question is okay what

does that mean for ADHD what's the

equivalent of eating healthy and

exercising for ADHD first of all eating

healthy and exercising both do help ADHD

D we go into some of that stuff in the

guide that we've got hopefully coming

out in about a month on ADHD so we'll go

over a lot of different treatment

options and stuff like that in more

detail the key thing to remember about

ADHD let's talk about science okay what

is the evidence-based data suggest so

first thing that evidence-based data

suggests is that medication and

Psychotherapy are equally effective

roughly in terms of effect size what

does that mean that means that if I have

a hundred people with ADHD and I put 50

of them into Psychotherapy and 50 of

them into medication or give them

medication the symptom reduction that

they get in terms of of ADHD is the same

okay you actually don't need a pill you

can just go to therapy and you will get

roughly the same effect size now people

may ask like how do you get therapy for

ADHD it gets complicated there's also a

bunch of info on this in the guide but

basically a lot of the Psychotherapy for

ADHD is developing structures and

systems to account for your ADHD

essentially putting up guard rails so

that your ADHD does not negatively imp

impact your life it is literally

teaching people things like how to

organize how to prioritize how to set

alarms how to set reminders we go into a

lot of detail about how to develop a

good organizational system in the guide

but it teaches people these kinds of

skills and so just like any other

psychiatric illness there are certain

skills you can learn that will mitigate

or prevent the illness from harming you

so a simple example of that is anxiety

and meditation so if I have an anxiety

disorder and I'm feeling very anxious

and I learn to meditate that can reduce

the symptoms of anxiety and reduce my

quote unquote dependence on anxiety

medication ADHD is no different we can

learn particular skills that's what

Psychotherapy teaches us now here's

where the data gets interesting so when

you take people who have been given

Psychotherapy and people who have been

given ADHD medication effect size is

roughly the same difference is duration

of benefit after ending treatment here's

where the dependence comes in so when I

take ADHD medication if I stop the ADHD

medication I'm more more likely to go

back to square one whereas the cool

thing about Psychotherapy is if I do

Psychotherapy for let's say 20 weeks and

I'm done seeing my psychotherapist I

will still get the benefit of that

therapy for a year two years maybe even

three years or even somewhat quote

unquote permanently depends on the

person but what we know is that the

benefits of ADHD medication even last

after you've done taking the medication

so people will still get positive

benefits for six months nine months

after stopping medication so their

symptoms don't return back to normal

right away necessarily over long you

know large populations and longitudinal

studies so the duration of psychotherapy

far outweighs the duration of medication

which is an important consideration so

when people ask me am I going to be on

medication for the rest of my life it's

like well that depends on whether you

develop an organizational system that

will protect you from your ADHD and if

you can learn how to organize if you can

learn how to prioritize if you learn all

these things chances are you don't need

medication so the GP said stimulant

medication works the best oh so there's

something really tricky about stimulant

medication which is not necessarily that

we're works the best so there are

head-to-head studies that show that

non-stimulant medications and stimulant

medications basically work the same in

terms of the effect size the big

difference between stimulant

non-stimulant medication is first of all

stimulants work faster than

non-stimulants so there's a medication

called bupropion for example that is

just about as effective as stimulants

the difference is that bupropion takes

like a month to really kick in whereas

stimulants you'll feel the benefit

within 24 48 or 72 hours so stimulants

are better in terms of acting fast but

they don't necessarily work they don't

reduce your ADHD symptoms more than

non-stimulant medications on the whole

the second thing about stimulants that

makes them feel like they work the best

and I'm not surprised to hear that from

a GP is that patients think they work

the best so there's a very simple

principle in our brain that the more

rapid the reinforcement the more

behavioral reinforcement we see sorry

the more rapid the benefit the more

behavioral reinforcement we see so for

example like stimulants work instantly

so what happens from a patient

perspective is patients will tell you

stimulants work the best for me nothing

else works and why do they say that it's

because they notice the benefit

immediately whereas non-stimulant

medication takes days or weeks to really

kick in so people don't notice it but if

you actually do studies where I take 100

people on stimulant medication 100

people on non-stimulant medication and I

measure objectively how bad their ADHD

is let's say three months after they

started medication what I'm going to

find is they're both equally effective

but the subjective experience of the two

patients is going to be very very

different the subjective experience is

going to be any day I miss my medication

with ADH with a stimulant people notice

it right away so there isn't a

difference in efficacy what there is is

a difference in sort of noticing or kind

of like an awareness bias where you can

really feel the difference of the

medication whereas when you're on a

slower acting medication you don't quite

feel it as much so that's part of the

reason why people say stimulants quote

unquote work the best I don't think they

actually the data suggests that they

don't work substantially better than

non-stimulants it's just the difference

is a lot more noticeable and therefore

is much more likely to reinforce the

behavior so a lot of people are

genuinely concerned about am I going to

be dependent on my ADHD medication the

answer is maybe right so what we what I

tend to see as a clinician is that a lot

of people will find it very convenient

to just take a medication every day

because they don't have the time or the

energy or wherewithal to learn

organization prioritization whatever

especially if we're talking about like

people who are students right so

sometimes like I'll get someone who's

like a sophomore who's coming in during

midterms you know you can teach me

organization and planning but in the two

months it takes me to like figure out

how to use a calendar effectively like

my midterms are going to be gone and

I'll have failed them so sometimes

people will need medication because it's

the easiest thing to do now how

dependent on it you become not just from

a physiologic perspective but we're

talking like long term do you need to

take a medication for the rest of your

life the answer is that depends it

depends on the severity of your Ada HD

it depends on what other kinds of things

you're willing to try so we also know

for example that meditation strengthens

frontal lobe function and the goal is

going to be over time to like literally

like reduce your mind's distractibility

through practices like meditation the

more of that kind of stuff you do the

less dependent you're going to become on

your medication and the last thing about

people sort of saying stimulants work

best well I think they work fastest and

they work most noticeably but fastest

and most noticeable does not technically

mean best but it oftentimes looks like

best because think about it from the GPS

perspective when I give someone a

non-stimulant medication they come back

in two weeks and they say the medication

isn't working I'm still having problems

then as a general practitioner I switch

them from a non-stimulant to a stimulant

they call me the next day and they're

like this medication has changed my life

and so then as a GP I don't blame the GP

for you know they can't stay experts in

everything you know I don't blame them

but they'll sort of say like oh okay

like so it seems like stimulants work

better and then then what what happens

is the GPS the next time someone comes

in in with ADHD I just start them on the

stimulant and then I don't ever hear

from them again except when it's time

for refill ask them how's the medication

working they say it's working great so

these kinds of biases not really the

gp's fault in a sense right because they

can there's very natural ways why GPS

will get to that conclusion last thing

that I I kind of want to say is that if

your doctor uses terms with you that you

don't understand or terrify you like to

say like oh yeah you're dependent on

this by the way that may mean something

different from to them than it does to

you and if your doctor says things that

scare you ask them to explain themselves

be like what do you mean by that what

does that mean what are the implications

of being dependent on ADHD medication is

this a bad thing like what do I do about

it second thing is by all means get a

second opinion if a doctor is not

talking to you enough if they're not

explaining things enough then by all

means get a second opinion explain to

them that you need more explanation and

also like by all means go see a

specialist so someone's asking how does

one's life of lie 2915 is asking how

does one's life change if they get

diagnosed with the ADHD chances are

their life gets substantially better so

that's kind of a weird thing to say

because remember getting diagnosed with

ADHD or not getting diagnosed like you

have the ADHD whether it's diagnosed or

not it's affecting you whether you have

the ADHD or I mean whether you get have

the diagnosis or not you've got ADHD

either way it's impairing your function

whether you have a diagnosis or don't

have a diagnosis the only thing that the

diagnosis hopefully the main thing that

the diagnosis does is gives you the

opportunity to do something about it

engage in treatment now what we do know

is that living a life of untreated ADHD

leads to all kinds of problems we've

probably got a lecture that we're going

to share with you all in about a week or

two about this about the ADHD Iceberg

but for example we know that something

like 50 to 70 percent of people with

ADHD let me think about this the

statistic that sounds High even to me I

think I may be misquoting this but if

you look at the comorbidity of ADHD and

depression three three to five percent

of people with depression will grow up

to later be diagnosed with ADHD but of

the people who have both 50 to 70

percent of people with ADHD will be will

also have depression later in life for

that comorbid population so what does

that mean does that mean that if you've

got ADHD you have a 50 chance of getting

depression no there's four people who

have both if you take that subset of

people who already have both what you

see is that there is a causal

relationship ADHD leading to depression

and it doesn't go the other way it's not

just correlated one causes the other and

why is that it's because growing up with

ADHD especially untreated ADHD shapes

your life to be depressed later so I'll

give you a simple example of this very

fascinating study that found that kids

with ADHD are less likely to be invited

to birthday parties than neurotypical

kids think about that for a second so if

I'm an ADHD kid why does it mean I'm

going to be less less likely to be

invited it's because I don't pay

attention so all the other kids are

talking about Pokemon cards and I start

randomly talking about something that's

completely unrelated and the kids all

look at me like I'm weird because I'm

highly distractible I can't keep Pace

with the conversation I also don't pay

attention when they're talking to me

right so over time like those kids

aren't going to want to invite me to

their their birthday party and then over

time if I stop getting invited to

birthday parties what does that mean for

the development of my social skills I

don't get opportunities to like develop

my social skills because I get invited

less can't level up if you don't Zone in

to where the fighting is right like you

can't get any XP if you're not invited

to the game and so over time kids with

ADHD experience more social isolation

and loneliness Rusty social skills which

in turn makes it harder for them to get

promoted at work because a lot of

getting promoted at work has to do with

social skills and so what we tend to see

with kids with ADHD especially when it's

undiagnosed and untreated is that living

a life of undiagnosed ADHD predisposes

you to depression through features like

under performance of academic

underperforming in an academic sense so

it's under achievement academically for

kids with ADHD there's lack of social

opportunities which leads to isolation

and loneliness this there are all these

different factors where you can almost

this is what we do in the lecture that

there's a whole lecture about this and

Dr K's guide to ADHD and doing stuff

where you can map it out how growing up

with ADHD leads to particular factors

which later in life lead to depression

because what ADHD does is all of these

factors over here are risk factors for

depression later in life so hopefully

getting diagnosed changes your life for

the better scalicious is saying I often

hear people say that ADHD and other

diagnosis disorders are being over

diagnosed do you think that this is true

so I've said this before I'll say it

again I think ADHD is both the most over

diagnosed and at the same time the most

under diagnosed psychiatric illness so

you may ask a question wait how can

something be over diagnosed and

under-diagnosed what I mean by that is I

think that ADHD is oftentimes missed in

people who have it so this is why we're

seeing a lot more adult ADHD diagnosis

why is that it's because the diagnosis

was missed when they were kids why was

it missed when they were kids because

the kids were super smart and built up

compensatory mechanisms that did not

that allowed them to hide the ADHD so

when you see a smart kid with ADHD

oftentimes that kid won't get diagnosed

because even though they can't pay

attention they can use brute force

reasoning to figure out what is going on

so I'll give you all just a classic

example so kid isn't paying attention in

math class I'm my mind is wandering I

can't pay attention teacher says my name

twice and then suddenly I snap back to

it I can see the whole classroom is

looking at me teacher is looking at me

and I can see that people are upset

using my ADHD brain which can quickly

interpret information I glance around

the classroom I see teachers holding

chalk I see there are four problems on

the chalkboard three of them have

answers I look at the fourth problem

that doesn't have an answer I calculate

very quickly because I have a high IQ I

say the answer teacher looks at me with

suspicion because they were sure I

wasn't paying attention but I came up

with the answer they write the answer

and then they move on kids with ADHD

develop compensatory mechanisms leads to

under diagnosis of ADHD at the same time

people over diagnose ADHD parent parents

are frustrated with their kids kids

don't listen all they ever want to do is

watch the iPad parents never train

attention in their kids anytime the kid

is upset anytime the kid is distracted

anytime my nanny doesn't show up I'm

guilty of this as well take the iPad

turn on the screen shatters the kids

attentional span incl increases

emotional dysregulation kid has problems

at school because I never sit down and

read with them at home parents are like

kid doesn't listen because I don't have

healthy boundaries at home kid gets

diagnosed with ADHD so it's both over

diagnosed and under diagnosed sounds

like me oh yeah you betcha

foreign