spurts of extreme concentration

...does not sound like ADD.

I was about to say, that this is a real problem, with which many of us struggle, but ADD doesn't seem like a useful or accurate description.

Ah, my impression was that ADD suffers can, every now and then, sprint when they are sufficiently motivated, but it is not a dependable technique, happens fairly rarely, and frequently fails. And by spurts I mean in the range of an hour or a half hour.

I'm fascinated, having often vaguely wondered if Ritalin or something would make me a better or more effective person. But I don't know anything about it.

Was this promoted from comments, or in the e-mail bag?

The friend in question needs some sort of assistance: treating the depression, the stress, and whatever else is preventing him from functioning. If it turns out ADD is part of that, then get the treatment for that, but my suspicions are that treating the depression will take care of the pseudo-ADD.

Aside from all the other reasons it's bad to diagnose someone in a comment box, I'm leery of jumping immediately to "he has ADD" for someone who is unhappy in his boring job but presumably has had few problems concentrating when interested in the material. I'm not an expert, but from what I understand of ADD, the ability to pay attention isn't usually correlated with interest in the subject. (Just like not everyone who is an insensitive clout has Asperger's.)

I say this as someone who has joked that she could be diagnosed with ADD, with the feverish commenting, writing, wedding planning and inability to get her shit together. I haven't developed ADD at age 27; I'm just stressed.

Actually, yeah, it does. In my experience with it, I can focus on the occasional all-encompasing thing (like pulling an all-nighter to write a paper), but the day-to-day stuff is harder to handle.

I tried Adderall for a while, though don't use it anymore. After a while it started messing with my sleep and had me just sort of tweaked out overall, but this probably was due to my being so ridiculously overscehduled that I started using it as a bit of a replacement for sleep. But it was helpful, at least for a while. If you can manage the side effects, it works pretty well. It's worth a try, at least.

Oh, I sent it in. This person actually really likes his very exciting and new job, but all these other problems are eating away at it. He's been keeping them at bay for years now, but it's just too much now, and its unfortunate that it should come to a head just when he needs to prove himself.

Last year I read up on ADD a lot, and the writers seemed to indicate that a lot o times ADD underlies depression, not the other way around. That is, someone who feels they are constantly undercutting themselves, and living up to their potential, is going to be depressed a lot more. And people can often look back and see a long history of screwing up, but getting away with it--the problem is that as time progresses, it gets harder and harder to get away with it.

a lot o times ADD underlies depression, not the other way around.

This was the case with me, I found.

Questioner, could your friend broach it with his therapist?

You could mention it to him not as "we've figured out what you have" but as "maybe this would help you concentrate better, ask your doctor, see what she says."

sorry, 7 was to 5. To 6: So would it seem like a decent short term thing to try and get a hold of? I just don't want to even suggest that he look into it if its really awful or really problematic. I don't think he'll take anything for very long anyway, that's not his style, but it seems like he needs a bit of a life raft to get across the next month without things going really awry.

It looks like the criteria for a diagnosis of ADD/ADHD/Etc is as fuzzy as that for inclusion in "Autism Spectrum", with "hyper-focus" sometimes included and sometimes not.

I'm with Cala on this. Lots of things can cause lack of concentration, a solid work-up is a good idea before tinkering with the brain-soup.

9: Well, that's exactly what I want to ask him to do. But whenever I read about it it almost seems too magical, so I was highly suspicious that I was missing something. Also, once I suggest it to him, I think he might look for it on his own, so I just want to make sure it's not a terrible idea.

It's certainly possible that something like adult ADD is the cause, but you'd probably want to see a physician about it. I would be cautious, though. "Why am I not living up to my potential?" is a fairly common question, particularly here, and it's not clear to me that the desire for a straightforward answer--or a straightforward answer that can be solved--doesn't bias us towards certain types of answers.

That's whole nuther wrinkle. I'm assuming you're not in a position to talk to the person's therapist, so if you really think your friend would be tempted to self-medicate, it might be best just to broach it as "ask about the concentration thing, maybe it's like ADD and they can prescribe something" instead of "Adderall would help."

I tried Adderall for a while, though don't use it anymore. After a while it started messing with my sleep and had me just sort of tweaked out overall, but this probably was due to my being so ridiculously overscehduled that I started using it as a bit of a replacement for sleep. But it was helpful, at least for a while. If you can manage the side effects, it works pretty well. It's worth a try, at least.

This is the experience of a friend, who has now spent the entirety of a visiting on the stuff. (Now in the second semester of tenure-track badness, she's* moved on to your Presley-style amphetamines.) She has always kept vampire hours, but it was magnified significantly when she started the Adderall. When visiting us recently, because her flight left in the morning, she decided to pull an all-nighter, which was on the tail of another all-nighter the day before. She didn't sleep again until after midnight, and she was up by nine the next day. That her sleep's fucked up is obvious--that plenty of other things are also fucked up is obvious--and if that's a normal side-effect, as Matt F suggests, it's worth taking into consideration. It'd be very good to be reliably diagnosed first, too.

*My friend's gender may or may not have been altered.

9 is on the right track. The person should discuss it with his therapist, and if it's decided that Adderall or the like is warranted the therapist can refer him to a psychiatrist. If he just asks his PCP about getting a prescription or self-refers to a psychiatrist he probably won't be successful, given how loathe MDs have become in recent years to prescribe ADD drugs.

Low doses of amphetamines can also help you concentrate. However I suspect they are a very bad idea for anyone with a tendency to think that if one pill is good, two pills will be even better. So I would be cautious.

5: One of my unproductive habits is watching psychiatry grand rounds on the internet, mostly the ones at UCLA.

I saw a presentation by Joseph Biederman, Chief in Clinical and Research in Pediatric Psychopharmacology, on the validity of adult ADHD. He described kids who were able to focus on fun things like video games but not on more boring and repetitive stuff.

Generally:

A medical evaluation sounds like the way to go, because it's also possible to have more than one diagnosis.

Is the therapist a psychiatrist? He should probably make sure that he gets a thorough evaluation by a psychiatrist and maybe testing by a psychologist.

At the very least, you can tell him that you're concerned and suggest that he bring this up with his therapist. He should be clear that this isn't just his subjective feeling, but that his friends are worried about his performance.

I should say that my experience with ADD is with a friend's little brother who had a hard time concentrating on boring tasks and even when having fun, would be multitasking: could spend hours on Pokémon and listening to music at the same time, but not the sort of kid that could concentrate enough to put a puzzle together. Hence my (perhaps not universal) assertion in 5.

17: It should be noted that ADD drugs like Ritalin and Adderall are themselves technically amphetamines. Unsuprisingly, the abuse potential is high and the market for recreational use is large.

Not unrelated to yesterday's comment about [something highly confidential], but I have ADD and have been medicated for the past ten years now. I don't take Adderall or Ritalin though, but Dexedrine in time-released spansule form. Constant levels in the bloodstream alter the serotonin levels in the brain without the accompanying highs and lows. (Crashing off Ritalin? Not fun, not fun at all.)

In short, then, I'd recommend that (or its Ritalin equivalent, Ritalin LA) over the straight dosages. One of the advantages of knowing you're going to have an attention span for the next six hours is that you start to arrange your life around them -- in other words, the spansule form has therapeutic effects which help even when you don't take them. Also, they don't help you stay awake (although they do prevent you from going to sleep, a subtle-but-important distinction), so the problems with abuse mentioned above shouldn't be an issue.

And I've just decided -- short attention span, you know -- that I'd rather not have the above comments linked to my name. Could someone pretty please redact everything before "I have ADD" in 21, change my name in it and 22 and delete this?

Pretty please?

given how loathe MDs have become in recent years to prescribe ADD drugs

Not sure how most doctors are, but this wasn't my experience at all. I basically just said "I want some Adderall" to the psychiatrist, and had a prescription 10 minutes later.

I haven't developed ADD at age 27; I'm just stressed.

Cala's right: I think the major question with most of these disorders is, does it markedly interfere with your ability to function? Not in terms of "is this person doing things the way they should?" but rather, "is this person's emotional state unmoored from what they're doing?" If someone's scatterbrained, but reasonably content with being that way, and can hold down a job or get their school work done and get along reasonably well in the world, why would you want to jump on meds? On the other hand, if someone's scatterbrainedness seriously interferes with their ability to be content or function, then yeah, sure: it might be worth trying meds.

It's very tempting to jump on a diagnosis and drug therapy when someone is suffering from 'lifestyle difficulties'. I'd be very very wary of it.

Not only that, but ADD itself is hardly the least controversial putative disease condition out there.

24: No doubt some doctors are still open-handed, but this class of drugs is becoming one of the most heavily monitored (i.e., giving out lots of scripts for Ritalin is a sure way to get visited by the FDA). This isn't just anecdotal (although I know several people who've tried and failed to get prescriptions for Adderall); I have a couple of friends in mental health who say that this is a deliberate policy among psychiatrists.

a couple of friends in mental health

... meaning, people who work in the mental health field.

I've long wondered whether ADD drugs would be helpful for me. I suspect they would, but I've always been scared away by the whole "can't buy your own health insurance ever again" thing. What if some day I want to quit my job and try to write puzzles full time? Then I won't be able to afford having an ADD diagnosis on my record, right?

Waaay back to 5 - this was an email I got, not promoted from comments.

These drugs are heavily regulated. In [the place that I live], prescriptions must filled out in triplicate, insurance hassles me every time I try to fill one, the pharmacists are annoyed by the number I'm prescribed, &c. The reason being, the paperwork's a bitch (is what I've been told). Everyone has to keep track of exactly how many pills they've dispensed, have at the end of the day, &c.

29: I haven't had this problem at all. I could see it, theoretically, as being one. (Cancer, on the other hand, will fuck with your premiums forever. There's a fine line between "remission" and "recovered," only no one seems to know where it is.)

I don't know if I have ADD or not, but it really seems like it much of the time. See here and here. I've been on Concerta (time release Ritalin) for over a year now. I actually got off of it recently because it was making me more anxious and jumpy, which apparently is a quite uncommon side effect among people with ADHD. I've been taking omega-3 supplements and that's appeared to help with the symptoms, without any side effects. I also have depression and a fear of failure and some sort of social phobia and all sorts of other problems, though, so it's all hard to sort out and really get it straight.

My current idea of my problem (and I don't know how it relates to the Questioner's friend's problem) is that it's more about motivation and self-discipline (not to imply that it's necessarily not physiological) than it is about the ability to focus per se. If by "focus" you mean "focusing on anything besides the shortest-term of goals", then yes, I guess it's focus. But when tasks present themselves to be done, they can get done.

Part of it, I'm sure, has to do with dopamine, which I've pondered about some. The people who wrote the article from the praise thread mentioned dopamine as part of the response to praise, and I think that could be relevant.

I've always been scared away by the whole "can't buy your own health insurance ever again" thing.

This, the reason we need universal health care. You know what it's like deciding that you won't get your depression treated because it will be on your record? Fucking shitty.

And no, if you're self-employed, you can't afford insurance unless you're in perfect health.

To extend on 33, the ADHD meds don't help with the motivation and self-discipline, really, much. They help with short-term focus a little bit, but that's not really lacking in my case.

To extend more on 33, a lot of it more me is about the inability to act in a way to bring about medium or long term goals. I feel like I'm a slave to my impulses, though I'm not what you'd call impulsive. Though maybe that's just because my impulses aren't very typical.

27: Do you mean the FDA? I've heard pretty bad stories about the DEA. If it's both agencies, then, wow, that's a double whammy.

There are other non-stimulant drugs. Strattera is an SNRI.

I hear that there are all these people who want to jump on psychotropic drugs as an easy fix; i.e., there are too many people who don't need drugs taking them. In my experience, there are a lot of people who do need them who don't want to take them.

My grandmother was depressed for a good portion of her life and hospitalized for it. 15 years ago she didn't want to have anything to do with psychiatrists and, when doing reasonably well, she didn't think she needed medications; but she did.

34: Yup. My short-term solution is to refuse to move to a state without guaranteed issue and community rating.

I've never had any problems getting Concerta, and never experienced any resistence or hesitation or resentment or anything like that from anyone. N=1

37: I meant DEA; sorry.

27: It depends on what the chance of relapse is. I know that depression will kill your premium (since people who have had more than one depressive episode are quite likely to suffer another). But I don't know what the actuarial profile of ADD/ADHD is.

But anyway, I'd say not to hesitate to try the medication. If it really works (keeping in mind the thing about motivation vs. focus) then use it. But it could be that treatment for depression would be more appropriate. Wellbutrin, for instance, is a dopamine and norepinephrine reuptake inhibitor, just like Ritalin, so its effects might hit the spot.

40: Basically, ADHD isn't cured, just treated. So there's no such thing as relapse.

36: I'm the same way. If I take my medicine without a plan, I'll end up paying attention to...something, but not necessarily something productive. I could, for example, watch six hours of X-Files monster episodes perfectly well on my own. There's no reason I should be mining them for deep structural affinities with a particular cultural moment, because, damn it, I don't need to. And it's not healthy. But that's what happens if I lack motivation prior to acquiring an attention span.

(An aside: has anything aged more poorly than the "mythology" episodes?)

43: For me, probably because of the depression, just *having* a plan won't help, because it would still take motivation to start following the plan. So I don't.

Adderall is only a temporary fix for ADD and can be quite damaging over the long term.

I took it for an adult diagnosis for ADD- very similar to your friend's symptoms. I took Adderall for 6 months- the returns are diminishing and it does alter your personality- you slowly become more nervous and irritable. It did not interfere w/ my sleep and it did seem to help at first.

I would be VERY WARY of these pharmaceutical fixes. While I did not have this problem, others have described severe depression when stopping the Adderall- even with careful weaning.

33 is why I'd say your friend should definitely do it through medical channels instead of just trying to score some. My brother has ADHD and, while the meds really helped him focus, they made him terribly stressed and skittish. His doctor added in a really low dose anti-anxiety drug and now he's way way better.

I could, for example, watch six hours of X-Files monster episodes perfectly well on my own. There's no reason I should be mining them for deep structural affinities with a particular cultural moment, because, damn it, I don't need to. And it's not healthy.

What, this isn't normal?

46: My therapist says that the skittishness is really uncommon. I wonder why it is that so many people here are reporting it.

48: I don't know anything about this at all, but I have the vague impression that irritability and so forth are diagnostic -- that if stimulants make you skittish, you don't have 'real' ADD. But I'm not sure where I'm getting that from.

49: That's the same impression I have.

Also, Omega-3. See also this and the many other posts on Seth's blog.

47: I don't think so. At least, not the way I do it. (I'll post about it one day. You'll read it and think, "Hm, Mysterious Headless Guy's, that's not normal, no, not at all.")

49: That's what I've been told to, and the drugs don't (and haven't ever) made me skittish. Just the opposite, in fact: they calm me down, stop my mind from racing off in five directions at once. Which is what I meant earlier about them not keeping me awake -- I'm much more likely to stay awake with my mind racing then when I'm calmly focused on a single thing.

has anything aged more poorly than the "mythology" episodes?

Scully's hair? (OH NO SHE DID NOT!)

But I'm not sure where I'm getting that from.

I've heard that, too, but I'm skeptical since the largest source of information about it seems to be a Desperate Housewives' episode. More seriously, though, it's not surprising that a drug would have different effects on different people, especially drugs that screw with hormones or brain chemistry.

largest source of information about it seems to be a Desperate Housewives' episode

I wouldn't go quite that far.

I'm with 47. And those monster eps are often pretty awesome. I could watch the COPS-style search for the chupacabra or the town-full-of-vampires Mulder & Scully double narrative episodes over and again.

47, 54: When you do that sort of thing even at the same time as strongly regretting not being able to do something more productive and necessary like, say, paying your bills, and this doesn't happen occasionally but instead many more days than not, then no, it's not normal.

49: That, or that it's not the right drug for you. Wellbutrin made me kinda hostile (a not uncommon side effect), but I really do have depression.

Also, the scary side effects/withdrawal symptoms shouldn't scare people who need meds away from them. Effexor is supposedly the absolute worst for both, and I don't have major problems with either. It's good to try stuff with less frequent problems where you can, but "what if" shouldn't keep you from dealing with an actual existing problem.

has anything aged more poorly than the "mythology" episodes?

Duchovny's charm?

Also, the scary side effects/withdrawal symptoms shouldn't scare people who need meds away from them.

Although withdrawal shouldn't keep you from switching if it stops treating your primary symptoms, and you shouldn't use a drug if the side effects are not worth the change. For instance, a racing heartbeat? Kind of scary.

Not that the unfoggedtariat has ADD as defined medically/psychologically, but I find the idea of asking the Mineshaft about staying-on-topic a touch ironic.

54: Mulder & Scully double narrative episodes over and again.

You know, it wasn't until I rewatched that one recently that I realized the sheriff was Luke Wilson.

55: When you do that sort of thing even at the same time as strongly regretting not being able to do something more productive and necessary...

This sounds less like ADD and more like depression to me.

57: Harmless, but stay careful.

And 60.

60: Sure. Like I said, disentangling things can be tricky. (Depression is my current favored hypothesis.)

58: Obviously. If it doesn't work, there's no reason to stay on the thing.

60: Agreed re. depression, not that I have ADD.

So basically most of us are at least moderately depressive, can't focus on what we're supposed to be doing, and were probably praised too much and didn't have to work hard enough as children. But we're OK with that, right?

60: Which is another good reason to watch X-Files, to experience that moment of recognition, "Hey! That monster's...!" Looking hard at the patients on old eps of ER has the same effect.

I am in the first few months of an adult ADD diagnosis, taking Adderall (and 45 has now made me very nervous). I have a history of depression, and like the person described here, consequences of my behavior have been building up over time to approach train-wreck urgency in the past year. And, although I'd suspected for a while, and complained of attention problems when I was treated for depression years ago, it was impending disaster that finally made me seek medication. It's early on yet, but based on results so far, it appears to have the potential to be a truly life-changing/saving move.

Like some other commenters, one of the most remarkable things when I first started taking it is how much calmer I felt. Also, how much more present I felt when talking to people, because I could actually listen to them for the duration of a conversation. The only unpleasant symptom I've experienced so far is that when the stuff wears off, I really feel it. I get the stares really bad in the late afternoon. Even this, though, seems to be promoting better bedtime habits (ie, I actually go to bed when I'm tired).

It should be noted that ADD drugs like Ritalin and Adderall are themselves technically amphetamines.

Adderall is amphetamine. Ritalin is methylphenidate. Similar, but not as strong. Adderall sounds awesome. I've been meaning to go fake an ADD diagnosis for a while now to get some Adderall for once in a while when I really want to get a lot of shit done.

53: In popular culture? I'd lay money that 99.9% of Internet discourse about "if you don't have ADD, Ritalin just gives you a lot of energy" is straight from Felicity Huffman's star episode in a six degrees of separation sort of thing. This is perhaps my cynicism showing.

58 is exactly right. Side effects shouldn't scare someone away from getting help, but sometimes the side effects are scarier than what the drug is intended to cure. That's why they make lots of different drugs.

60: That was Luke Wilson? I haven't seen that episode since it aired.. but hey, you're right!!

67: The only unpleasant symptom I've experienced so far is that when the stuff wears off, I really feel it. I get the stares really bad in the late afternoon.

Maybe you're already trying this, but a lot of people find that caffeine and sugar help with the come-down.

69: *That's* not completely untrue, though. But my point was that the "ritalin makes you wired only if you don't have adhd" is an observation that holds up to scrutiny, regardless of its portrayal in pop culture.

Also, modafinil seems to be the new study drug of choice.

38: what does that mean? That sounds useful. That's certainly why *I'm* sort of not willing to get much on my record about *my* mental health issues. But he has good insurance. Actually, he has other health issues, and the real cause of *my* anxiety is I don't want him to lose his job thus lose his insurance.

He's an extremely fast thinker, and I'm not convinced he's ever *had* to concentrate much before. His depression seems a very steady function of his declining quality of life. And tasks present themselves and they increasingly don't actually get done.

I don't think he's going to self-medicate actually, now that I think about it. In fact, the more I think about it and sort of broach the subject lightly, the more it seems he might be the avoid-medication-at-all-costs type. So I guess the other solutions would be useful now--but. . . .what are the speedier ones? Any good books? Exercises? The Omega 3 is interesting. I ordered myself a copy of Mind over Mood not to long ago, for my own slate of issues--is there something like that for ADD?

Also, I can't quite remember the order of things--but the ADD diagnosis didn't just come from us but from his last round with a therapist.

I'm going to stop worrying about it soon--my anxiety on his behalf has really peaked this week, and I'm going to let myself listen to it for a couple more days before letting it go--but I find that when I ignore my desire to help too much *I* feel worse, so I'd at least like to try to see if I can help him look for solutions. Thanks for the help, gang.

The only unpleasant symptom I've experienced so far is that when the stuff wears off, I really feel it. I get the stares really bad in the late afternoon.

This happen to me quite a bit with Ritalin, but not at all with the Ritalin LA or the Dexedrine spansule. If you're taking the regular pills, I'd highly recommend trying the time-released versions. Doctors are also more willing to prescribe them, too, because they're not party drugs.

I'd be interested in taking one of the time-release ones. The one advantage of plain old adderall is that I can get it generic for cheap.

It's easy for me to see why depression and ADD are inter-related; depression always involves some kind of loss of control, and when you feel pretty smart, normal, and capable, and can't ever produce any evidence of it in your life, your actions-consequences association breaks down.

It's also easy for me to see how you can get away with compensating for it over a lifetime, until you finally can't, particularly if you weren't actually hyperactive as a kid, but just inattentive. Yet another of the remarkable things about the diagnosis has been reframing a lot of my own habits and attributes as compensatory behaviors.

73: In certain states--Massachusetts is one and New York may be another--the health insurers must sell health insurance to anyone who wants it. Community rating means that insurers are not allowed to consider one's health history in pricing an individual policy. In Massachusetts insurers can only consider one's age and zipcode. If you've gone more than 2 months without coverage insurers can refuse to cover non-emergency care for six months.

Absent a requirement of universal insurance, this does tend to make health insurance more expensive, because sick people who need healthcare tend to buy it and healthier people tend to drop it.

Wellbutrin made me kinda hostile

How could they tell?

A lot of people around here have far too high an opinion of themselves.

I have a friend who was diagnosed with adult ADD and has gone through a variety of medications for them; as a result, they have supplies of both the regular and time-release forms of Adderal and Ritalin, in various dosages, and I've been invited to help myself if I want to try it out. I keep being tempted, because there are days when I could certainly use some more stimulation and hyper-focus. I tend to think my ability to stay on-task is pretty good, though, considering that I work from home full-time and could probably spend a week watching TV instead of working before anybody noticed - but I don't.

I've done some recreational Ritalin. It's much mellower than actual, honest-to-God amphetamines, but amphetamine it is, nonetheless. Or at least it certainly was so for me. After it wore off, I realised I'd been grinding my jaw and talking very intently for about two-four hours.

My heavily medicated two cents:

ADD, depression, whatever -- the psychiatrist matters; find a really good one. I've had previous ones who were perfectly competent and would change my dose a little here and there, but now I have a fabulous one. I'm on a 3-drug cocktail, the result of almost 2 years of tweaking, that not only keeps me out of depression but also makes me more able to focus and gives me more energy to tackle some of those things on my impossibly long to-do list. I fucking love modern chemistry.

Hi

Ritalin is not amphetimine; it's methylphenidate. also has very different effects - makes me into an anxious, irritated bitch. kind of awful, actually.

Adderall, tho, is amphetamine, as is Dexedrine (tho Dex consists of just the D-isomer, I think). Dex is smoother, less jittery for a lot of people, and more concentrated. Both are often very, very effective for adults with ADHD. The theory goes that the part of the brain invovled in high level self regulation or whatever - mental steering, i guess, and/or impulse control - is not as active in people w/ ADHD. Giving them speed lights that sucker up, and allows them to direct and maintain their focus.

I honestly can't recommend meds enough. Even if your friend doesn't want to stick with it permanently, he should try it (under the care of a good psych, obviously) - much like antidepressants, adhd meds can give you the space to figure otu alternative ways of dealing with things.

Some things that have turned up unexpectedly often among family and friends describing this sort of experience, and that I highly recommend along with looking at depression and such:

1. Sleep apnea. This seems very common among the folks I know.

2. Adult-onset diabetes.

3. Adult-onset allergies to one or more of the big troublemakers - milk, wheat, soy, gluten, corn.

If your friend can get these things checked, he should.

I can't help but wonder if the demands of modern life are a more concrete problem, and I realize that I sound like someone's grandpa right now. There was a time when it was believed that technological advances would give us more time for leisure, for unstructured relaxation and socializing, and it seems like just the opposite has occurred: not only is more productivity expected, but there are a million and one ludicrously facile distractions at everyone's fingertips; the way in which what leisure busy people have is spent are also usually very alienating. It is entirely possible for people to create a world that is physically unliveable, as we all now know, so why is it hard to believe that the same is achievable with respect to psychological well-being? I think it's worthwhile to consider it as a structural problem, personally.

additionally:

1. the preceding was not a preamble for communist astroturfing, just to be clear.
2. sorry to derail.

I think the advice portion of our programming had run its course, and I agree with you that this is a structural problem. I tutored someone with ADHD and there was definitely something off there, but I haven't met many people like that, though a lot of people wonder if they have it.

In another thread, several commenters seemed prone to it during sex.

#85. Dave: Actually, good treatment for depression usually includes counseling, with just that as a major subject. I've seen friends benefit hugely from concrete advice and support for planing out some of the useless, draining connections the world pushes on them. It's bad that anyone would need a doctor's authorization for something like turning off a work-provided cell phone for blocks of hours and days. But good therapists know that it too often is, and are on it with the letterhead correspondence and such. And a lot of the therapy side of treatment for depression and other woes is about forming habits that are healthy and rewarding to the patient, supporting their goals and making it harder to fall back into the temptations of dumb, destructive behavior.

Which is to say, right on. Broken living is very much a problem right alongside broken biochemistry.

Er, that wuz me and I ain't shamed to say so.

recreational use-wise dexedrine is way better than adderall. dexedrine is hella fun.

85: Yeah, I'm old enough to be someone's grandpa and I've been saying that for years now. Western (or at least US) civilization is becoming well suited for fewer and fewer people and the technology is allowing people to make more bad decisions faster than ever. I'd be more impressed with all this "multitasking" if our management types didn't get 3 of the 4 things they're talking about wrong at each meeting.

My dad was a depressive MD and he wanted to give me a dex prescription way back in 1970-75 or so. (Dexamil time-release). I'm pretty sure he was self-medicating.

He was self-medicating by trying to give you drugs?

He was treating John's case of Munchausen's syndrome by proxy by proxy by proxy.

re 84/85 and 91: I'm also old, easily grandfather old, and I agree about this. I also think these environments are particularly hard on the personality type so well-represented here. YMMV, but the drugs didn't work for me, the talking has.

Be sure the word "Horsford's" is on the label. All others are spurious. Never sold in bulk.