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kls commented on It's Time to Mandate Treatment of the Dangerously Mentally Ill   commonsense.news/p/its-ti... · Posted by u/lxm
isitmadeofglass · 3 years ago
> what about the false positives (people who get forced treatment while claiming that they are not ill and don't need it and then that turns out to be actually true).

We have a criminal system even though the exact same is true in some crimes.

kls · 3 years ago
I will say this, I grew up in a time of asylums and I lived thru their gutting of them with the Reagan administration and back then law enforcement was very different it did not become militarized until the LA bank shootout and some other events in the same timeframe. To say it was a different world would be an understatement. In that world false positives where rare, usually there was a history of issue as well as close family that agreed that it was for their good.

Nowadays law enforcement does not know your name, they suspect you from first contact and family is not as tight knit as it was. I would be very leery of asylums in present society, due to the many ways in which society has changed.

kls commented on The Coronavirus Is Here Forever   theatlantic.com/science/a... · Posted by u/lxm
tdfx · 4 years ago
> "We go hard and we go early" works.

"We go hard and we go early" works *in a small, remote island nation that is willing to hermetically seal itself off from the rest of the world.

kls · 4 years ago
Right, I will second this, our law enforcement shut down the Florida Keys at what we call he 18 mile stretch. No one that is not a resident was allowed in. for a good deal of time it worked and to be honest, I am thankful that they did, as at that moment in time, we did not know what we where looking at.
kls commented on A Programmer’s Introduction to Mathematics   bit-101.com/blog/2021/08/... · Posted by u/ingve
j2kun · 4 years ago
Not that specifically. I switched from standard to PWYW after a year of sales and I felt I had made enough and wanted it to be open. I still get decent sales, but the majority of income was always from print books which are not PWYW
kls · 4 years ago
I personally appreciate this approach, I tend to do a first pass read on ebooks and if I find it of high value and the subject is not temporal (e.g learn Flash development). I always purchase the physical book for my library. I don't mind paying twice, if I have some confidence that the material will be of value, but it does cause me to pass on some texts that I may have found worth buying the physical book had I not passed on the ebook.
kls commented on Students flee field as computer 'fad fades' (1987)   pessimistsarchive.substac... · Posted by u/geocrasher
donatj · 4 years ago
I don’t hear much about it these days, but circa 2004 when I was going into computer science I had multiple teachers and a guidance counselor warn me that all the jobs would be going to India and tell me I should pursue something else. This seemed to be very much the prevailing wisdom of the time. I pursued it anyway as it was my passion.

I was one of five students in my program that had been a huge multi-campus program only a couple years earlier. We were the last cohort before the college discontinued the program entirely, and I was the only one to graduate. What I found however for maybe five years after graduation was a insanely high demand for developers.

There was genuinely a generation that was so strongly discouraged from becoming developers that there were very few. Seems to me like the folklorists have largely missed this.

kls · 4 years ago
It really was the prevailing wisdom of the time. I entered the job market in 92, a few months after CERN released their browser. I knew what was coming when I saw the web for the first time, but the only jobs at the time where custom desktop software for businesses. It was the same after the .com bust which is right around where you picked up. 04 and 05 where really bad years to be in the industry, as the only jobs left in the industry where internal corporate software gigs. Which meant most of the employment opportunities where not, out in CA, but rather in sporadic areas around the country.

As well, there was a waves of offshoring, so again the common wisdom was do not go into computing. With that being said, I hade the fortune of working with a company that was early to mobile, and was working with Palm on mobile web apps around 2000, so when the crash came, though I lost that job due to the company closing, I knew mobile was right around the corner and went back to grinding out internal corporate software for a few years.

The offshore projects started to fail to deliver and then Steve came back and launched the iPhone. My experience is software is a boom bust economy. It's been more robust this run and everyone learned that outsourcing was not the win-win they thought it was going to be. In the meantime software ate the world so there is not enough hands to do the work that is out there and to your point, a whole generation was discouraged from entering the market. If there is any market that has a bad track record of employment forecast software dev has to be top of the heap.

kls commented on Ask HN: How did an adult ADHD diagnosis help you?    · Posted by u/codpiece
adhd-thrwaway-0 · 4 years ago
Throwaway since I'll be discussing some fairly personal topics.

I was diagnosed over a decade ago at the age of 19 and have been in treatment ever since. The changes as a result of getting medication and attending therapy have be profound and decidedly mixed. One thing I'm just going to say upfront is that if anyone reading this thread decides to seek treatment, please don't solely rely on medication. The medication allows your ADHD to become manageable, but crucially it does not manage it for you.

Good changes:

1) Social life immediately and greatly improved. I was able to hold my attention when talking to people. My tangents became less wandering and frequent. I had the focus to make plans and actually follow through with them. I texted people back (this alone was huge).

2) I lose things less often. Before starting treatment I was notorious among my family and peer group for losing things. I still lose things all the time, but now it's usually because I put something down in my house rather than losing things in public.

3) Improved physical health. The appetite suppressant aspect of stimulants play a role here, but I think the bigger thing here is less impulsive food choices. Because I just don't feel as hungry, I have to plan my meals better and so I eat healthier. It's also easier to stick to an exercise schedule.

4) I can sit still and be quiet. Looking back at my childhood, it should have been fairly obvious what was going on, but I believe the mindset was medication was only for kids with poor academic achievement. The scale of lost time has been personally frustrating, but I am grateful for not being put on medication when I was young child.

Bad Changes:

1) Massively increased libido. The stimulants can increase sex drive, but can also make orgasm more difficult while also sometimes making it more difficult to maintain an erection. While these last two can be frustrating on a personal level, the hyper sexuality can be quite destructive when not kept in check.

2) The hyper focus aspects of ADHD are now basically on all the time. Medication is less a guided missile and more a laser. Instead of taking it and 'magically' getting things done, your attention is now dialed into whatever you point it at. This can be extremely productive, or not. I have less 'lost days' than I did before seeking treatment but those days now have a greater intensity.

3) It can be easy to get into stimulant fueled cycles of self-destruction. I need to be very disciplined about getting enough food and sleep. The drugs make it easy to shrug off a night or two of little sleep. But using drugs to ignore my body leads to much worse ADHD symptoms then if I hadn't been taking the drugs at all.

4) There is a distinct difference in my personality on days when I take my drugs and days I do not; see Good Changes, point (1). This can be hard for other people, especially romantic partners, to deal with.

Overall I'm happy that I've pursued medication in combination with therapy. It has let me get a handle on my life, but anyone who says it's all good is not telling the truth.

kls · 4 years ago
*1) Massively increased libido. The stimulants can increase sex drive, but can also make orgasm more difficult while also sometimes making it more difficult to maintain an erection. While these last two can be frustrating on a personal level, the hyper sexuality can be quite destructive when not kept in check.*

I had this on Adderall, I was switched to Desoxyn and had no issue with it. On Adderall even medicine like Viagra would not improve the side effects. That was a show stopper for me, and really frustrating that it actually increased drive.

*2) The hyper focus aspects of ADHD are now basically on all the time. Medication is less a guided missile and more a laser. Instead of taking it and 'magically' getting things done, your attention is now dialed into whatever you point it at. This can be extremely productive, or not. I have less 'lost days' than I did before seeking treatment but those days now have a greater intensity.* I would agree with this description for me as well, though I can choose where the focus goes and I can choose when to disengage. To me it had been a net plus.

*3) It can be easy to get into stimulant fueled cycles of self-destruction. I need to be very disciplined about getting enough food and sleep. The drugs make it easy to shrug off a night or two of little sleep. But using drugs to ignore my body leads to much worse ADHD symptoms then if I hadn't been taking the drugs at all.*

Agreed 100%, it is easy to fall into a cycle of well I can take my second dose later and squeeze some more hours out of the night. As far as food, that is the one really bad side effect of Desoxyn, Adderall suppressed my appetite, Desoxyn completely eliminated it, I can go days without eating and never have the urge to if I do not monitor it. At first I did not care because I was about 60lbs overweight, I am now slim could loose 10 more and be fit, but I am certainly not overweight anymore. I view this as a net positive given the long term ability to manage my weight, but now I stay on top of it.

*4) There is a distinct difference in my personality on days when I take my drugs and days I do not; see Good Changes, point (1). This can be hard for other people, especially romantic partners, to deal with.*

This is the one I hear from people but, the only thing my wife has said about me, is when my first dose kicks in, my feet hit the floor and I am going. I used to take an hour to get ready in the morning, I would do one thing, sit down, do another sit down. It took an hour to feel like I was just slightly awake.

kls commented on Ask HN: How did an adult ADHD diagnosis help you?    · Posted by u/codpiece
argc · 4 years ago
> dosing stimulants sporadically ("as needed" isn't standard practice),

Interesting, I take adderall "as needed" and my doctor is fine with it. He prescribed it for daily use but said I can take it as needed.

kls · 4 years ago
My doctor actually prescribes a regime of holidays from the stimulants. It is becoming a fairly common practice.
kls commented on Ask HN: How did an adult ADHD diagnosis help you?    · Posted by u/codpiece
username90 · 4 years ago
Not wanting to do it and not being able to do it are two different things. To an adhd person boring tasks aren't just boring to do, they are impossible to do even if they were paid a million dollars to do it.
kls · 4 years ago
I call it not being able to put one foot in front of the other. You will find all kinds of distractions to try to not think about it, because to think about it is almost physically painful.
kls commented on Ask HN: How did an adult ADHD diagnosis help you?    · Posted by u/codpiece
LurkersWillLurk · 4 years ago
> if you try to sit down and try to start the work and just CANNOT emotionally bring yourself to do the work or get your brain to engage, then it's probably something more than just normal procrastination

I've had so many problems with this in high school and college, it's unreal. I've only started to fully comprehend my problems with anxiety this past semester but reading all of this makes me wonder if there's something more to it than just that.

kls · 4 years ago
Would second this, if the though of doing the dishes is equivalent to someone shooting your dog emotionally then you have an issue. It just seems like life cannot go on to get yourself to drag yourself to the sink and start washing them. Now I do them almost every time I take a break.
kls commented on Ask HN: How did an adult ADHD diagnosis help you?    · Posted by u/codpiece
PragmaticPulp · 4 years ago
Stimulants including Adderall have been formally trialed for depression treatment. They don't work.

Don't confuse the molecular mechanism of a drug for its eventual outcome. There is far more to a medication than binding affinities.

kls · 4 years ago
With the exception of MDMA, MDMA has show to have effective outcomes on depression and PTSD in short term studies. They problem is they have to be interleaved with SSRI's or the down state is far worse. That has been the issue with MDMA, it drops a depressed person lower than they where on the down ramp. Therefore there are concerns that it could place someone who was not suicidal in that low of a state. Studies have shown regulating this with SSRI's can mitigate the down state.
kls commented on Ask HN: How did an adult ADHD diagnosis help you?    · Posted by u/codpiece
lowdest · 4 years ago
I've been on and off Vyvanse and Ritalin for a decade. Work with your doctor on side effects, I found Concerta to have the least side effects for me (long-lasting, tapers slowly at end of day, and fewer anxious feelings for me than Vyvanse.) I've also taken breaks from the medication for a year or more. It takes somewhere between 3 days and 3 weeks to feel like I'm not missing something when I stop the medication, but overall it's not that bothersome or unpleasant unless work/life is very busy at that time. Quitting coffee cold-turkey feels much worse, for comparison.
kls · 4 years ago
I had horrible physicals side effects with Adderall, I was switch to Desoxyn and I get no physical side effects from it. I just get clear headed with no speedy feel in the body or cramps. Adderall always made me clear headed, but also jittery in the body and gave me the worst cramps but the biggest one that I was not going to put up with is Adderall killed the marital bed performance, but funny enough not the desire, that was a deal breaker for me.

u/kls

KarmaCake day5358June 12, 2009
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