Well, I admit I'm biased because I started taking ADHD meds and then had a manic/psychotic episode, that involved me getting involuntarily committed to a psych ward and burning all my career bridges, and also got diagnosed with heart failure, and I attribute a huge chunk of the blame to the ADHD meds. Both my psychiatrists and cardiologists insisted I needed even more meds or things would get worse, but instead I just said, I'm going to disregard medical advice, I'm going back to a no meds baseline, and focus hard on lifestyle changes, and everything improved. I've been emotionally stable and my echocardiogram and cardiac MRI showed my heart is back to normal. So that's my bias.

I am just a bit of a psych meds skeptic these days - I don't think the comparison to drugs like insulin carry as much weight as their advocates would like them to. For one thing, there's no brain scans or blood tests for any of these diagnoses. The diagnosis criteria is basically a "personality test", called the DSM-5, a manual heavily influenced by the pharmaceutical companies. Stimulants at least do in fact have research supporting they actually outperform placebo (unlike the massively prescribed antidepressants), but they come with a host of negative side effects.

If you're predisposed to mania, you shouldn't take stimulants. If you're predisposed to heart problems, you shouldn't take stimulants. My question is, how was I supposed to know that I was predisposed to these things short of finding out the hard way by taking the stimulants and having those negative side effects almost ruin my life/kill me?

Previously, on HN people have accused me of "doing it wrong" in some sense with the ADHD meds, but the truth is I got the diagnosis from the doctor and took the meds as prescribed.

The whole idea that we can neatly categorize this person as ADHD, this person as MDD, this person as Bipolar-2, this other person as bipolar-1, this other person as BPD, after doing a ton of investigating into mental health, I just no longer buy it.

I do think the answer is in lifestyle changes, the person who is at risk of cardiac arrest, yes they should exercise for 30 min a day and reduce sodium intake before relying on a pill if that pill carries with it a ton of other dangerous side effects.

I also agree with that other commentor, that our society, and my past self, is a bit obsessed with "success" metrics, usually judged by things like career success. The idea that, maybe if you just accept that your career won't be what it could be but that's better than drugging yourself up to achieve those goals, seem foreign to some people. Becoming "somebody" important becomes more important than just being stable and healthy.

Well, if you find yourself in my position, where you get diagnosed with heart failure and learn that ~50% of people in your position die within 5 years of diagnosis, all the sudden that big N promotion doesn't seem as important anymore. And the drugs that help you get there don't seem as worth it. So nowadays my mind still wanders constantly, my wife gets frustrated by how often I start day-dreaming mid-conversation with her, and I know that intellectually I'm capable of more career success but I'm held back primarily by my lack of focus and discipline. But I've come to just accept all that, being on stimulants to fix it, is not worth the downsides.