I am a 5th year whose ADHD was diagnosed in June 2017. In what I assume was some sick joke, I got the call to arrange my UofT ADHD assessment the day everyone else in my class was graduating. I had emailed Health & Wellness in February, desperate for help, after years of filling out the same intake forms about basic anxiety symptoms and not being deemed troubled enough. I am absolutely going to die furious over that negligence, but it’s not why I’m writing today.
Nouran Sakr’s recent article about amphetamine use among students without ADHD gets a lot right, but in attempting to educate herself, her “both sides” critical approach does not refute many common stigmatizing misconceptions about the condition and its treatment. These must be addressed.
Despite never having been suicidal, my symptoms resembled severe depression. I couldn’t stay awake in my favourite classes, but had incessant, repetitive daydreams. I had no extracurriculars, dying hobbies, and almost no social life, and couldn’t stop picking at my skin. I lacked the wherewithal to put together emails that made sense, but tweeted fifty times a day. Multiple days a week, I was not organized enough to get up, eat, shower, put clothes on, and then walk outside. Beneath my veneer of laziness was a woman who loves being alive, screaming at herself to move.
The process I am describing is executive dysfunction. ADHD is a disability caused by deficient dopamine signaling. Dopamine’s reputation as a “pleasure” chemical fails to describe its role in performing regular actions like, “I should get a drink and go pee and catch the TTC so that I will not be late to my job and get fired and die”. It’s impulse control. In a person with ADHD, stimulants restore this normal “go” function, so describing how amphetamines induce euphoria at high doses in regular people does nothing to inform people on ADHD.
The implication that people with ADHD are addicted to their meds is false, stigmatizing, and easy to disprove. People with ADHD are twice as likely as the average person to develop addictions, and 14-23% of people with a substance use disorder are thought to have ADHD. Addiction can be an attempt to compensate in the wake of no official diagnosis. Last February, I started taking Benadryl to help me sleep. I know that sounds tame but my symptoms were ruining my life. I knew the risks and I knew it could escalate anyway, because I didn’t want to live in a black hole anymore. What does a person without this knowledge do?
[pullquote]The implication that people with ADHD are addicted to their meds is false, stigmatizing, and easy to disprove.[/pullquote]
Treating ADHD with stimulant medication, meanwhile, has been shown to lower this risk of developing addictions by restoring brain function in a controlled manner. It is much more dangerous to people with ADHD, who are already heavily stigmatized, to insinuate its most common and effective treatment method will hurt them. 75-90% of ADHD patients respond positively and safely to either amphetamines or the stimulant methylphenidate (Ritalin). By “positively”, I suggest you reread my symptom paragraph and imagine what it might be like for those to go away. A stranger’s issues with Big Pharma are not worth me living as a corpse.
If all that sounds too scary and dangerous, it’s worth noting psychiatrists do not ignore patient risks related to cardiac conditions or side effects. ADHD does not need to be treated with stimulants in every case. They’re just usually what works.
Therapeutic doses of stimulants aren’t high enough to make you high. I am not sitting around railing 120mg of crushed Adderall or selling pills to desperate overachievers (though given the level of public ignorance, it’s a hilarious prospect). If I stop taking Vyvanse, I stop functioning, not because I’m addicted, but because it’s my medicine. If I don’t eat or sleep enough, it doesn’t even work! Non-ADHDers complaining about focusing on the wrong things on stimulants don’t realize that’s my entire life. They’re tourists. But I don’t blame them; some doctors can’t even recognize ADHD. Countless women go undetected well into adulthood. I was lucky it only took me 22 years.
I got help when I got too angry to care whether a doctor would think I was lying about my symptoms to cheat my way into a 3.3. That shouldn’t be normal. Some students who buy amphetamines illicitly may have ADHD and have merely fallen through the cracks of our broken mental health system. Making people feel ashamed of a possible disability, or scared they’ll be arrested, while not informing them on how ADHD works, is irresponsible. Our illness is not a secret club. I hope I’ve set the record straighter, and I hope any undiagnosed people reading feel seen.
I love my amphetamines and I’m not sorry.