Myth vs Fact: Do Stimulants Work Differently for People with ADHD?

Image by @miloezger via Unsplash

Stimulant medication is a first-line treatment for ADHD. There is a lot of misinformation surrounding stimulants, and that misinformation leads to stigma. So, let’s take a closer look at some of the most common stimulant medication myths. 

Myth: Stimulants Work Differently for People with ADHD

Nope! Stimulants work exactly the same way in ADHD brains and neurotypical brains: by raising dopamine levels. What’s different is how our brains react to that increased dopamine. 

When people without ADHD take a stimulant, their baseline level of dopamine skyrockets. Ironically, this may cause some neurotypical people to experience ADHD-like symptoms, like scattered thinking and hyperactivity. 

ADHD-ers have lower dopamine levels than neurotypicals, or at least that’s the prevailing theory. So when we take stimulants, our levels go from low to relatively normal. This results in better focus, motivation, and emotional regulation. 

Myth: Stimulants are a Gateway Drug 

I will never argue that stimulants are not addictive, because they are. And if you have a history of substance abuse, then you and your doctor may want to pursue other options. 

However, there’s an interesting paradox when it comes to ADHD, addiction, and stimulants. Even though stimulants are addictive, and even though people with ADHD are more vulnerable to addiction than most people, stimulants can actually protect ADHD-ers from addiction. 

For one thing, stimulants relieve ADHD symptoms (like impulsivity and emotional dysregulation) that can lead to substance abuse. 

And for another thing, they can prevent self-medication. Some ADHD-ers seek substances for relief. With proper treatment, the need for self-medication can be drastically reduced. 

Now, if you don’t have ADHD, narcolepsy, or another stimulant-dependent condition, then yes, stimulants absolutely can be a gateway drug. But that doesn’t mean that people who need stimulants shouldn’t have them. It’s not right to punish ADHD-ers for other people’s struggles. 

Myth: Stimulants are “Basically Meth” or “Legalized Meth” 

NOPE! Nope nope nope nope nope. No. Adderall, Ritalin, and other ADHD meds are NOT the same thing as meth. Out of all of the myths about prescription stimulants, this one is my least favorite. 

True, meth is a type of stimulant. However, it’s much stronger and more dangerous than ADHD medication. Adderall is like meth in the same way that drinking a cup of water is like drowning. It’s disingenuous to compare the two.

Stimulants are substances that increase the brain’s dopamine. Illicit stimulants, like meth, take it to an extreme. Prescription stimulants do it on a therapeutic level. And some, like coffee and energy drinks, provide a relatively small boost. 

That’s right. Caffeine is also a stimulant. Your morning cup of coffee has something in common with meth. And yet nobody is jumping to conclusions about it. Nobody’s demonizing it or putting it in the same category. Interesting, isn’t it? Perhaps that’s because coffee drinkers aren’t stigmatized, while ADHD-ers are. 

Part of the confusion comes from the names of these medications. Adderall is the brand name for dextroamphetamine, which sounds a whole lot like “methamphetamine.” And Ritalin is a brand name for methylphenidate. 

It makes sense that some people are confused, but it still doesn’t mean that these medications contain meth. If that were the case, you could say that playing solitaire is good for your heart because “cardiology” has the word “card” in it. Or that going to a cosmopolitan event makes you an astronaut. 

Myth: Stimulants Give ADHD-ers an Unfair Advantage 

No, stimulants do not give ADHD-ers an unfair advantage. Let’s take a look at it another way. 

Picture me, a 5’5” woman, standing next to my friend Vera, who is 5’9”. Let’s imagine that Vera and I share a house, and we keep our Christmas decorations on a high shelf. 

Vera has no problem reaching everything on the shelf. She can see everything clearly. She has long enough arms to grab the ornaments in the back corner. I, on the other hand, can’t reach anything. I can’t even see most of what’s on that shelf. 

Now, if I used a ladder to get what I needed from the same shelf, do I have an unfair advantage over Vera? Should I continue struggling because Vera doesn’t have a ladder? Should Vera complain because I have a ladder and she doesn’t? Of course not, I’ve just leveled the playing field. I’ve accommodated myself, and I’ve temporarily reduced the advantage that Vera otherwise has over me. 

Stimulant medication is like that ladder. It doesn’t give me an unfair advantage over neurotypical people. Just like glasses don’t give nearsighted people X-ray vision, and hearing aids don’t cause super hearing. These are not advantages, they are accommodations. Stimulant medication temporarily makes up for the disadvantage that I would have without it. 

Myth: If Stimulants Don’t Make You Tired, It Means You Don’t Have ADHD 

A lot of people with ADHD say that stimulants make them sleepy. I believe it. The first stimulant I tried made me sleepy, too. Some people say that if stimulants make you tired, it’s probably a sign that you have ADHD. So, that means that if you don’t get tired on stimulants, you must not have ADHD, right? 

Not quite. And this is a prime example of that ADHD “all-or-nothing” thinking. 

Not everyone with ADHD feels sleepy on stimulants. Some people feel an energy boost instead. Some people, like me, feel sleepy on certain stimulants but not others. So if you’ve been diagnosed with ADHD, and your medication doesn’t make you feel tired, this does not automatically mean that you were misdiagnosed. 

The truth is that we don’t all share the same genes or brain chemistry. Yes, our brains do struggle with dopamine, but there are so many other factors that determine how we react to medication. 

I have ADHD, and my current medication doesn’t make me sleepy at all. It doesn’t mean that I don’t actually have ADHD. It’s just how this type of medication works for me. 

Myth: If You Can Focus While on Stimulants, You Must Have ADHD 

Like a lot of myths, this one started with a little bit of truth. Like I said, stimulants can cause ADHD-like symptoms in neurotypical people. If you don’t struggle with dopamine, and your brain gets a big dopamine surge, you’re going to have a lot of energy. The kind that might make you impulsive and hyperactive. 

Under those circumstances, it’s really hard to focus. So, the faulty conclusion is that if you can focus when you take a stimulant, it automatically means that you have ADHD. Because if you didn’t have ADHD, you’d be bouncing off the walls, right? 

In reality, it doesn’t quite work that way. Stimulants don’t always make neurotypicals lose focus. Some neurotypicals actually experience laser-level focus while on stimulants. They may experience the same benefits that ADHD-ers get, but on an extreme level. 

Basically, an ADHD-er who takes a stimulant is like a person with astigmatism who puts on glasses. A neurotypical who takes a stimulant is like someone with perfect vision looking through a magnifying glass. Both experience better vision, but for one person, it’s symptom relief. For another, it’s an advantage. 

Myth: Stimulants Take Away Your Personality 

Oh, to be clear, they totally can. If you’re on the wrong one. Or the wrong dosage. 

Remember when I said that my first stimulant medication made me sleepy? It also made it very hard to have a conversation. I felt like my words were buried under a thick layer of molasses. Every sentence took effort. I had to pull each word to the surface individually. 

I’m a writer. And an actor. Words are a big part of my life. Obviously, this medication wasn’t going to work. 

Oh, I did focus better. Because I was only having one thought at a time. I miss that. But I wasn’t me. Now, I could have decided that stimulants turn ADHD-ers into zombies. Because I took one stimulant that didn’t work, that must mean all of them will make me feel the same way. Stimulants are only good for dulling creativity and making hyperactive kids less inconvenient for their teachers. 

See? It’s the all-or-nothing thinking again. 

Instead, I told my doctor that this medication wasn’t the one for me, but I would like to try a different one. 

Now, I’m on a medication that does work for me. It provides symptom relief, helps me enjoy things, and doesn’t blunt my personality at all. In fact, it lets me share more of my personality. 

Myth: If I Had a Bad Experience with Stimulants, It Means that Stimulants are Bad for Everyone 

I can’t even be angry at people who believe this one. I’m too busy being fascinated by them. ADHD-ers aren’t the only ones who do this, either. I’ve seen the same pattern with depression and anxiety. 

Not every ADHD-er will have a good experience with stimulants. That’s normal. The same applies for every condition and every medication. 

But imagine believing that just because you had a bad experience with a medication, it’s bad for everyone.

Again, I’m not angry. I’m fascinated. Imagine thinking that your body, your brain chemistry, and your genetic makeup are the template for all of humanity. 

What even makes a person think like that? I mean, I’ve taken antihistamines that didn’t work for me. That doesn’t mean I yell at people who get good results from them. I don’t insist that everyone should cure their allergies by meditating. For one thing, that whole “deep breathing” part is harder to do when your sinuses are clogged, but I digress. 

What is it like to be that confident? Can I take a masterclass from someone who’s reached that point? 

Anyway. So yes, different people can get different results from the same medication. Even within the same family. Even if stimulants didn’t work for you, it’s still possible for them to work for other people. 

Myth: Stimulants are an Easy Quick Fix 

I once read an article by a woman who manages her depression with lifestyle changes alone. Good for her! That’s not sarcastic. I’m genuinely happy for her. For some people, that’s all it takes. As someone who also has depression, I know how much better I feel when I’m meditating and taking regular walks. 

But then the article started med-shaming. She said that antidepressants were an easy way out. Oh, she could have just “taken a pill,” you see, but she didn’t want a “quick fix.”

We see this rhetoric used against all kinds of medication, including stimulants for ADHD. 

Now, unlike antidepressants, stimulants do work quickly. While antidepressants can take several weeks to show results, stimulants usually start working within an hour. 

But they’re not a quick fix any more than a pair of glasses is a quick fix for people with vision problems. (Look, if I find a metaphor that works, I’m going to stick with it.) 

For one thing, it can take a long time to find the right medicine. And for another thing, they don’t just magically fix all of your problems. 

Take my current medication, for example. (No, wait. I’ll take my current medication. You just think about it as an example.) 

It accomplishes a lot of things that my first medication didn’t. It especially helps with task initiation, which is a bigger problem for me than sustained focus. And I can use words, so that’s a plus. But it doesn’t give me that clear, one-thought-at-a-time feeling that my first medication did. I miss that feeling. I’d love to get that back. 

So, my current medication doesn’t fix everything. It helps with the things that are most important to me, and I handle the rest on my own. 

And by the way, it’s not the only tool in my toolbox, either. It’s just one of many things that I use to make my life more manageable with ADHD.