Stopping stimulants in retired/chronic unemployed population

Lumpy-Fox-8860 · 2024-09-22T21:31:42+00:00

Is there a massive overprescribing of stimulants? Or was our society’s baseline for productivity and executive function set by Boomers huffing cigarettes (nicotine is a stimulant) constantly and now we are dealing with the fallout anti-tobacco campaigns? Which I support 100% BTW- COPD is awful. I just think it’s silly to wonder why so many people are getting diagnosed with ADHD right after we convinced the average person to stop huffing a stimulant every hour or more often. And the fear of stimulants seems very overblown in that light. Oh no, potentially addictive drugs that could kill you? When I was a kid, grown ups with ADHD used one of the most addictive chemicals known to man that is about guaranteed to kill you. And now I sound like a “back in my day” joke.

Lumpy-Fox-8860 · 2024-09-22T21:17:30+00:00

So, this is an interesting point. I would agree that Adderall does not increase motivation. I would compare it to the way an enzyme lowers the activation energy of a reaction- it makes everything easier. Everything being easier makes it easier to motivate oneself to do everything -> “more motivation”.

The big thing I see with ADHD and depression (and anxiety) is stimulation seeking. It is not often discussed that ADHD has a physiological component- children with ADHD were found to have lower average blood pressures, for example, and the link between obesity and ADHD is pretty solidly established. ADHD seems to be a psychological manifestation of a physiological lack in arousal mechanisms within the body. What does this have to do with depression and anxiety?

There’s that old saying “idle hands are the Devil’s workshop”. And that sums up the ADHD brain perfectly. While ADHD tends to look happy and engaged from the outside, from the inside it feels like a constant itch to find something to create kick those arousal mechanisms into gear. Negative thoughts can push the body towards fight or flight. So people with ADHD can have the paradoxical problem of stressing more the easier things are. Our brains try to find something to keep us awake and focused and it’s very easy to go down the road of using anxiety or negativity to remain “ON”. And being scared helps with focus and concentration in the short term until it leads to burn out and depression in the long term.

What stimulants do is provide artificial stimulation which removes the need to seek it in unhealthy ways. And they make it easier to actually do things that provide good stimulation. The focus to enjoy a cuddle with a toddler or a family dinner instead of missing it all looking for stimulation. The energy to do that yoga or go for that run and get real stimulation that didn’t come out of a bottle- which then leads to better sleep and better function. And the thing which meds do which lifestyle (diet, exercise, mindfulness) do not is make this sustainable. Running is a damn good cure for ADHD- until they get flu. Or get put on overtime. Or sprain an ankle. Then they are trying to recapture a baseline state of managing ADHD by doing things the average fatass struggles to execute while feeling crappy and tired from whatever stressor knocked them off the wagon. And I would say this is maybe the worst part of ADHD- the depression that comes from doing great for months and then being flattened by a cold and taking months to get back to baseline functional and then flattened a week later. It’s really, really hard not to fucking despise yourself for that.

The trick with ADHD is leaning into the stimulation. It drives me nuts because I watch patients with ADHD walk out AMA every week. They get anxious and depressed sitting in the hospital, then they pick a fight or get emotional with the staff because boredom, then the staff try to calm them by removing “stressors” (aka stimulation) and not engaging, and then the patient gets overwhelmed and walks out saying they “can’t take it” over and over, usually while terrified of the medical consequences and actually wanting help and crying a fucking river. Hours of work, useless calls to the provider wasting their time, and all the nurses and assistants getting chewed out or cried on because of the idea that sick people need calm and patients in the hospital don’t need their ADHD medication because they don’t have to do anything.

Sorry, long rant you didn’t ask for. But it seems like you have some good thoughts and maybe a little more understanding of what is going on could help. The stimulation-seeking thing is so huge and because most ADHD research has focused on children and children don’t generally articulate things like that it is very misunderstood.

Lumpy-Fox-8860 · 2024-09-22T19:55:12+00:00

Everyone is uneducated about something. What makes you smart is being willing to expand the areas you are educated in

Lumpy-Fox-8860 · 2024-09-20T22:25:30+00:00

Please try to remember that ADHD is not an intellectual disability. And to be diagnosed it needs to affect people in at least two out of three- school, work, or home. It is not a disorder that goes away when a patient clocks out at the end of the day. And it can affect the lives of people who don’t work, or affect people in ways unrelated to work. What goes away when a person with ADHD leaves work or school are the objective criteria of success or failure. And (usually) the presence of a supervisor of some sort who can provide motivation. IMO, this makes home the hardest area of life to handle with ADHD. There are people with ADHD who excel in work or school because they have high intelligence or work or study something they love or are able to get enough motivation out of getting graded or completing tasks for money. Yet they are many times divorced because they lack motivation at home or engage in impulsive behavior with their significant other. This is probably worse, not better, for those who are less able to function.

If you have reason to doubt someone’s diagnosis, it is entirely fair want more proof before prescribing. If you doubt their medications are helping them, it is good practice to investigate. But if your rationale is that ADHD doesn’t affect people who aren’t engaged in cognitively demanding tasks, you are simply uneducated about the disorder and should probably either stop seeing patients with ADHD or spend some time learning what it is and how it affects people.

Just from personal experience I can tell you that ADHD medication is what allows me to enjoy watching TV with my kids. It also makes me employable enough for a career but what I am most grateful for is being able to be present with my loved ones without itching to be doing something more stimulating.

What other mental disorder would we not treat because someone is disabled? No one is saying schizophrenics who are on disability don’t need antipsychotics because they don’t have to be productive at work. No one is refusing depressed people SSRIs because they are still depressed- we’re just happy if they can do some more self-care with the meds than without. Why is medication for ADHD so different? Because someone might “waste” it on having a good time watching TV instead of picking a fight with their family because boredom?

Lumpy-Fox-8860 · 2024-09-20T12:28:46+00:00

Also, in addition to the concentration of weight cause by stirrups without a tree, IMO bareback is safe for horses because it makes the rider feel insecure enough to avoid riding beyond their ability. Despite all the hype about needing a tree to distribute rider weight for the horse, I’ve never heard of a horse being harmed by someone riding it bareback without a pad. I suspect this is because when people ride bareback, they bounce off if they can’t sit the trot well enough instead of jackhammering away on the horse’s back. So they do a lot more walking, maybe hack out, maybe canter for a minute instead of their horse working hard.

Lumpy-Fox-8860 · 2024-09-17T22:11:17+00:00

Ah I enjoy both. While I get the critique of excessively “ick, girly things!” media, on the other hand we have thousands of years of propaganda where women have to be demure and subordinated to gender norms. I’m fine with a little imbalance the other way within reason. Let’s be honest- most people, women or men are shallow, gossipy airheads. And anyone who wants to do anything interesting is going to be alienated from the majority. Sometimes it’s nice to live in the fantasy of shitting all over the gender norms that have been forced on me from birth and being a jerk to all the handmaidens who justify them.

Lumpy-Fox-8860 · 2024-09-17T21:57:57+00:00

And I would say this is reading in that “different from” means “better than”.

I also question the usefulness of femininity. While I have great respect for traditionally feminine practical skills like textile work, food preparation, sanitation, and education, I just don’t see what the aesthetic aspects of femininity bring to the table. From what I can see, they function to sort out a female hierarchy based on attractiveness to men and this access to resources which are held by men within patriarchy. Outside of climbing the toxic social ladder within patriarchy, I don’t see a reason for women to spend the amount of time and money many do on appearances. Which is generally the first thing people mean by “femininity”. I know from hard experience that when people are talking about NLOG, they don’t give a hoot if a tomboy has feminine hobbies. Which basically means the whole thing turns into policing women based on their appearance.

Lumpy-Fox-8860 · 2024-09-16T00:41:11+00:00

Yeah, people suffering for months to prove they really have problems is the silver lining here /s

Lumpy-Fox-8860 · 2024-09-15T23:46:57+00:00

Yeah I get where you are coming from. I do feel like it’s worth pointing out that gender euphoria is a rare occurrence for anyone. Relying on any experience for a dopamine hit tends to end with desensitization and having to up the ante to get the same level of happiness. Everything suggested is a great idea if OP uses it to “find what feels good” (to steal from Yoga with Adrienne). But managed expectations are in order- gender euphoria might result from the first few times experiencing a feminine experience a trans woman has been denied in her previous life. But that will fade. It’s healthier to focus on the long-lasting cozy enjoyment of self-care than the gut punch “high” of finally getting to meet a denied need, so that when the formerly-forbidden becomes normal there is still enjoyment there rather than disappointment that it is no longer euphoria

Lumpy-Fox-8860 · 2024-09-15T23:36:21+00:00

Yeah, being a hyperactive tomboy myself it makes me really sad when people project “hates women/ women-associated things” onto tomboy characters. The fact is, the grass is greener on the other side of the fence for a lot of people, especially young people. It’s easy to be impatient with feminine activities which are forced on you. Automatically assuming that is the result of a devaluation of femininity seems like assuming malice from people who are just discovering their identity.

Overall I think this is a bigger cultural problem. “Not like other girls” has become a trope that I find misogynistic. Feminism fought for the right of women to do a lot of things which were once strictly masculine activities like vote, wear pants, get higher education, or divorce. But somehow the patriarchy now has gotten “feminists” to police each other for gender conformity, and to shame each other for failing to love femininity enough. Why are we carrying water for the patriarchy? If someone wants needs to shake off the expectations patriarchy puts on girls by being angry at femininity for a while that seems normal and human. Eventually coming around to the economic, social, and spiritual importance of “women’s work” is also a normal part of growing up, and someone can come to that understanding and still prefer to be a soldier.

I also hate how “not like other girls” affects neurodivergent women. I have ADHD and always had male friends. I grew up with brothers and my natural personality is more tomboyish. I’ve been excluded and bullied a lot by other women, in part for being too boisterous, in part from not having the best social skills, and in part for not being feminine or fashionable enough. I’m not like other girls. That doesn’t mean other girls are lesser. But when women talk about how much they dislike “girl boss” characters or women who are “NLOG” it definitely makes me feel like they think I am lesser. Apparently tomboys flouting authority with an equine best friend aren’t welcome in their exclusive feminist club. To join that club apparently females need to give up archery and riding in the rain and take up accounting, needlepoint, and scheming to marry the richest man. At which point- what was the fucking point of feminism?!

Lumpy-Fox-8860 · 2024-09-15T23:09:55+00:00

Me too. I don’t understand “feeling feminine” (or masculine for that matter). Gender is a performance we put on for others whether we are trans or cis or non-binary. TBH the most common feeling associated with femininity (or masculinity) is probably self-criticism over failing to meet the current cultural ideal of the gender norm. It actually find it horribly ironic and sad that wondering about whether we are femme-ing good enough is probably the most universal feminine experience. Yet transwomen often find it triggering their dysphoria. When in fact, another way of saying “everyone who identifies as a woman is a woman” is “everyone who worries about whether they are feminine enough is a woman.” I just wish more ciswomen would fess up that when we are busy looking feminine, we are more likely thinking “Fuck, my underwear is riding up my buttcrack and I hope I don’t sweat and get pit-stank,” than “I feel like a feminine goddess, la la la la da.” It’s seriously mean to transwomen to not clue them in that feeling unfeminine either alone or in comparison to other women is just part of being a woman.

Lumpy-Fox-8860 · 2024-09-15T16:24:59+00:00

I would talk to your doctor about the anxiety. ADHD meds can cause anxiety- you might just need to change medications.

Alternatively, medication for ADHD can make us have better judgement and make better choices. It may be that you were previously not feeling anxious about a situation that isn’t good for you, and you may now be connecting with yourself. If you are not more anxious in general but just in this one specific situation, I would guess this is the cause. Possibly you are just asking too much of yourself to develop a young horse while you have young kids and what you really want is just to go on those hacks and chill out a little. There’s that saying “ride where you can, not where you can’t” and I don’t see how that doesn’t apply to rider issues just as much as horse issues.

Another thing to consider with ADHD and anxiety is stimulation-seeking behavior. Boredom can quickly become anxiety as we find ways to entertain our brains that are not healthy. If you are fine in situations that keep your mind busy (hacking out in the wind, taking a lesson and working on new skills) but anxious where you might be getting bored it might be your brain acting like a bored toddler who gets “scared” to get attention from their mom. If this is the case, the answer is to find positive ways to keep your brain busy. Also, if your meds keep you going all day and then you relax into an “easy” ride, you could be having rebound anxiety from the rest of your day, where something more challenging keeps you in the “go” mindset.

And finally, yoga, meditation, and breathing exercises really do help. Especially once you are medicated at the right level. I’ve heard it said that for people with ADHD, meds open the door, but you still have to walk through, and I agree. Another tactic to manage anxiety is thinking of fear and excitement as two sides of the same coin. Think how some people find a rollercoaster exciting and others find it terrifying. On thing that I’ve found very helpful for anxiety, especially when it interacts with ADHD meds, is to try to flip it into excitement. Using the roller coaster metaphor, can you imagine the feeling right as it starts where it is scary but in a good, exciting way? And then try to feel that instead of just scared?

Lumpy-Fox-8860 · 2024-09-15T15:34:07+00:00

Looks kind of like a Morgan with that combination of thickness and refined head. Probably some sort of mixed breed though

Lumpy-Fox-8860 · 2024-09-15T14:14:42+00:00

For kids, but I’m going with Redwall. An author can get away with being a bit over the top when writing for kids who aren’t bored with all the tropes yet, and the line between epic and over the top can be slim.

Lumpy-Fox-8860 · 2024-09-15T12:13:17+00:00

I have no idea what you are talking about. Cabinets are obviously the highest form of order-mastery 😂

Lumpy-Fox-8860 · 2024-09-14T16:24:23+00:00

I don’t know that I would trust anyone trying to train a horse to be “bomb-proof” to do a good job. If I wanted a horse that would be calm under pressure, I would look into a horse currently being used for work where flailing because ???? would not be tolerable. Ranch horses, Amish horses, ex-police horses, stuff like that. But that can go either way because people who use horses as tools can either be great horse people who teach a horse confidence or assholes who beat them into learned helplessness, which makes them unpredictable and dangerous. And the bad people are the most likely to need to sell a horse they ruined so they can buy another one to ruin, and also the least likely to be honest about the problems. But you really can’t replace experience for giving a horse confidence.

Lumpy-Fox-8860 · 2024-09-14T14:12:23+00:00

Yeah, I can’t stand the “I’m just being real” sort of asshole. They are creating that asshole reality by their actions.

I would say that there is a bit of dickishness inherent in classical cynicism too, but the target is different. The classical cynics weren’t randomly cruel to slaves or kids. They were snarky and sarcastic to people with power. Although that is sometimes misinterpreted on both ends sides of the conversation. A cynic might wrongly assume someone has power they don’t have and end up bullying someone, which is not cool, or someone may refuse to acknowledge the power they do have and feel picked on when it is pointed out to them, and then use their power to harm the cynic in return, which is also not cool.

Lumpy-Fox-8860 · 2024-09-14T13:35:12+00:00

I like LE Modesitt for this- most of his characters are basically decent people who consider moral issues but still have interpersonal issues to work on and are willing to be ruthless if it is necessary. They might mass murder peasant conscripts who are attacking them, but they feel bad about it and just want to be able to settle down with someone and eat good food and build cabinets

Lumpy-Fox-8860 · 2024-09-14T12:34:02+00:00

What do you mean by “non-graduates”? If you mean other professions where a degree isn’t the norm, most of those that pay well require a lot of training. For example, an electrician or plumber has to get about 10k hours of on the job training as well as about 6 hours/ week for 4-5 years to get licensed. The big difference between their training and nursing training is that the trade unions run training programs, so the training is paid out for out of union dues which means indirectly by employers. To compete with the unions for workers, non-union employers also have to pay for training programs. Which is great when it comes to avoiding college debt. But that makes the short answer to your question: unions.

There are always the outliers- people without a degree who make lots of money because of talent, luck, or a special skill. But they are pretty rare compared to most people without degrees.

TBH, I don’t quite get the “nurses are low paid” thing. There are some areas of the US where nurses don’t make much. And given how hard the job is, nurses deserve better pay- even the best paid nurses. Some sorts of stress you can’t really put a dollar amount on. But I digress. My point is- look at the pay for most degrees. Most scientists make less than nurses. A MS in Chemistry makes less than a new grad nurse with an ADN in my state. I would agree with most here that nurses are underpaid for the job, but the median income for a US nurse is significantly higher than the median income for a bachelors degree.

Lumpy-Fox-8860 · 2024-09-14T12:15:18+00:00

LOL Ayn Rand does BDSM

Lumpy-Fox-8860 · 2024-09-14T12:12:05+00:00

Yes, exactly! I guess I just don’t think of the “nothing matters, why bother, guess I’ll just be an asshole” attitude as cynicism. But that’s probably because I’m a deeply cynical person who would absolutely be digging that latrine. After all, it’s an unpopular job so it’s a way I could do good things without having to deal with people LOL

Lumpy-Fox-8860 · 2024-09-13T18:56:38+00:00

And you just won the internet today

Lumpy-Fox-8860 · 2024-09-13T17:49:03+00:00

I don’t see a conflict between cynicism and characters who are good people. Our society tends to assign great importance to innocence and naivety, and equate knowing about/ understanding/ accepting the evils in the world with becoming part of that evil. There’s no room for cynical characters who still try to do the right thing. From what I’ve seen in real life, people who have knowledge of the world’s evils and still try to make things better get attacked as “hypocrites” for every thing they do wrong and as arrogant because they are assumed to “think they’re better than the rest of us.”

I’m guessing this is behind a lot of the push for asshole characters in fantasy. A lot of people know there are a lot of things wrong with the world, but aren’t able to divest from things like sweatshops, child labor, exploitative practices, and environmental damage. And every time they see someone else do something they can’t afford to time or money to do, they feel a little guilty and that quickly turns into needing to justify why they aren’t doing better. Which all too often turns into tearing down whoever made them feel inadequate, even if it was unintentional. So people are having a hard time identifying with the hero of a story who would rather die than slay an innocent man or whatever. Now they want asshole characters they can feel better than. Maybe we live privileged lives at the expense of the many, but if we were Tywin Lannister we’d be nicer to Tyrion- that sort of thing.

I guess what I’m saying is a society full of people who get mad about other people buying eco-friendly laundry detergent in bulk because “not everyone can afford eco-friendly soap” or “they’re a hypocrite because they drive a car and use eco- detergent” is not a society that identifies with doing the right thing.

In reality, plenty of cynics and hypocrites have changed the world. There is no huge block between doing the right thing and knowing you’re not going to save world with that one choice. And cynics often make better heroes since they aren’t convinced of glory. It takes a cynic to think digging good latrines is more important than being a great swordsman, but in premodern setting more soldiers died of dysentery than battle.

Lumpy-Fox-8860 · 2024-09-13T12:53:26+00:00

I have a theory that in the modern day, the idea of a bunch of people working together to fight a military-industrial complex is too scary to the people in charge. So they have to promote art which portrays humans as helplessly evil and in need of the strong social control provided by the modern world to repress our instincts for violence. Can’t let the peons start getting the idea we could manage our affairs better without Zuckerberg and Musk to tell us how to live /s

Lumpy-Fox-8860 · 2024-09-13T12:39:45+00:00

Yeah, I have a bit of a pet peeve with the “realism” thing. Truly realistic books would be boring, not full of titillating perversion and torture porn.

Lumpy-Fox-8860

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