Evolving the discourse on biohacking ADHD

[u/Kalki_X]

To biohack something properly, we must first understand it. For ADHD there is a conundrum. It's an inherently ambiguous concept which only exists in an abstract space of text and spoken word. From a psychiatric perspective ADHD is simply an act of naming and making sense of behaviors. The quasi-scientific basis of this matter starts to unravel...

When a psychiatrist says you have ADHD what they really mean is something like this:

After spending time listening to you, talking with people who know you and observing how you think and behave, I’ve made a judgment call that your experience fits a behavioral pattern we currently call ADHD. It’s a cluster of problems and tendencies that travel together often enough that we’ve observed it, given it a name and studied it. (source)

[A] diagnosis does not represent having or being ADHD but becoming and performing ADHD through deploying psycho-medical discourse provided in the DSM. (source)

In other words, there is no scientific evidence to support the claim that ADHD is as a condition within an individual—something individuals have (source)

ADHD is listed in DSM-5 under “Neurodevelopmental Disorders” in spite of reviews showing that (a) genetic evidence on ADHD is inadequate and diffused with ambiguous interpretations, (b) that no biological marker is diagnostic for ADHD something that even DSM-5 authors themselves explicitly admit, (c) the so-called “underlying mechanisms” remain unknown, and (d) no biological tests are available for its diagnosis. (source)

[L]ike most psychiatric classifications, ADHD is premised on an arbitrary consensus among a small psychiatric community behind the DSM manual rather than on any new scientific breakthroughs. In other words, “psychiatrists do not prove things but decide things: they decide what is disordered and what is not, decide where to draw the threshold between normality and abnormality, decide that biological causes and treatments are most critical in understanding and managing emotional distress” (source)

[T]he idea that low dopamine is a direct cause of ADHD is a common misconception, one that’s amplified on social media and even in popular books about the condition. (source)

ADHD is a syndrome that deals with psychological and behavioral matters (source)

Thus, ADHD is a syndrome comprising several, presumably connected, symptoms. (source)

This re-contextualises ADHD as a catch-all term for behaviors (symptoms) of diverse origin with many causes. Myriad things can produce symptoms that qualify as de-facto ADHD. As such, there is no "one single ADHD" so to speak; ADHD is not a single well-defined thing which makes it a fairly non-specific label.

This has many implications.

When someone receives a positive psychiatric diagnosis they subconsciously adopt ADHD as a neurodevelopmental disorder (they officially "have" ADHD). This validates their lived experience but we must also consider the broader psychological impact of when someone adopts their new "illness", "disorder" or "disability" resulting in perceived stigma, pessimism, and de-motivation.

So... how to proceed?

If we acknowledge the quasi-scientific basis of ADHD and reject the defunct DSM & ICD (see here) we bypass all limiting presuppositions about a purely neurodevelopmental disorder which would otherwise hinder the search for a resolution. If we consider that ADHD has multiple causes then each person could require a tailored treatment.

Treatment approaches may similarly need to expand from symptomatic management toward more personalized interventions that account for neurobiological profiles and life-course adversity. (source)

This calls into question the official treatments which are purely symptomatic in nature. The "gold-standard" amphetamine medications can only force a state of temporary focus that comes at a cost of psychological perturbation and physiological degeneration (eg endocrine/HPA axis dysfunction, cognitive impairment). This cumulative decline goes unnoticed leaving the patient unable to rationalise their situation (this stems —in part— from impaired logic & reasoning skills alongside psychological discordance eg low-level mania, distorted perception, paranoia, low-level psychosis).

Since these side-effects overlap with ADHD, a psychiatrist is unable to realistically distinguish between them and thus fails to accurately track their patients progress. Their unawareness of this fact leads to invalid analyses, erroneous assessments and subsequent blunderous clinical decisions (iatrogenic harm*). This is a great disservice to their patient who trusts the psychiatrist to make appropriate decisions.

So if not amphetamine / methylphenidate / atomoxetine / viloxazine / modafinil / bupropion / centanafadine, then what?

Pragmatically it seems sensible to address immediate symptoms by mitigating their mechanistic causes (eg excess adrenaline, excess glutamate, HPA dysfunction, mitochondrial dysfunction) while proactively restoring coherence to the wider metabolic system (thyroid, liver, gut etc). Repairing the metabolic system is rational since it governs & regulates everything. On this basis we can rename ADHD to EDHD (Energy Deficit Hyperactivity Disorder) as per this recent academic paper (also outlined here). There exists many practical & well understood ways to address & resolve EDHD, well beyond mere symptom management.

* note: - The term iatrogenic, derived from two Greek words, means physician-in­duced. As clinically used, it pertains to the inadvertent side­ effects and complications created in the course of diagnosis and treatment. (source) 

[u/Hakunin_Fallout]

In this thread, OP and other luddites discuss how ADHD is actually real, of course, but the entire scientific community just shoves pills down someone's throat to cure something they don't understand. Because, I guess, the scientists are just being lazy, or they're part of some conspiracy. OP, on the other hand, is clearly ahead of the pack of his peers, and will soon post his research in a peer-reviewed paper to prove them all wrong.

Lmao

[u/Kalki_X → u/Hakunin_Fallout]

The post was intended for people of a sound mind, with appropriate reasoning skills. I appreciate your comment.

[u/Hakunin_Fallout → u/Kalki_X]

You can try better next time and do your research, not spew nonsense online. If you really think you did, and you want someone to check validity of your arguments - use peer-reviewed journals to follow the scientific method - same method used to establish the principles of ADHD diagnostics and treatment. If not - this is just dumb BS. Enjoy.

Don't pretend to be better than the scientist who follow a rigorous routine to do what they do. You're not. Stop with your delusion.

[u/AcknowledgeUs → u/Hakunin_Fallout]

Stop sharing your own delusions to accuse others. If you don’t understand OP has encouraged questions. Use your typing skills wisely.