IT’S NOT ADDERALL-ING UP
I remember the first time I took Adderall vividly. I was nineteen. I took it before my Introduction to Neuroscience class, taught by the beloved Director of the Psychological and Brain Sciences Department, Professor David Bucci (who, coincidentally killed himself 4 years later at the age of 50, though that is not relevant other than perhaps some poetic irony at the expense of tragedy).
A friend from a neighboring college was visiting that week. She had a bunch of Adderall on her. She sold them at UNH, but didn’t take them herself. She was hoping to make some extra cash off Dartmouth kids (including me, as it turns out). I told her I was having trouble feeling awake and focused (I later realized that my symptoms were that of chronic depression). She gave me a pill.
As I walked into the neuroscience lecture hall about 30 minutes later, I felt more than euphoric. I felt omnipotent. Like a fog had enveloped me my entire life and I didn’t know it. The fog cleared. My vision narrowed, dilated, and then steadied. I walked through the dissipating fog with Dropkick Murphys playing in my head, a grin plastered on my face, and the answers to the universe tickling my fingertips.
I plopped myself down in the front row of the lecture hall (a spot I never usually chose) with a glowing halo around my pen and notebook in front of me, ready to exercise my genius. This time, I could not only pay attention to the neuroscience lecture, but I could deeply understand it.
Action Potentials. That’s what the lecture was on. An Action Potential – the rapid rise and subsequent fall in voltage, or “membrane potential” across a brain cell’s membrane, which follows a characteristic “up and down” pattern – is the most fundamental electrical exchange in the brain. Imagine the pattern on a heart monitor, the kind that beeps in hospital rooms. This is that same up and down, sinusoidal pattern. The “heartbeat of the brain,” if you will.
Action potentials are what allow neurons (aka brain cells) to communicate with each other, and therefore for our brains to think properly.
People with epilepsy randomly get too much of a blast of electricity and their action potentials short circuit, causing them to seize. Electro-shock therapy is given to people experiencing psychosis or debilitating depression in the hope of innervating action potentials into proper, “normal” patterns of undulating communication.
In a flash of blazing light, all of this suddenly made sense to me.
For the first time in my life, it felt like I could truly explain the science I had just learned to somebody else, instead of just regurgitating a memorized sequence of facts. I actually understood why the membrane potential grew based on the flow of charged ions in the system. I saw the bigger picture, I understood that everything was connected – that what goes around comes back around, and therefore those same ions that raised the membrane’s charge would eventually cause it to fall, and the cycle would repeat.
But it didn’t stop there. Once I left the lecture hall, I turned to Youtube. I started watching videos about the Pythagorean Theorem, the Fibonacci Sequence, the Golden Ratio. I started thinking about math as a language, about the relationship between geometry and algebra and how they merge to form calculus and how that manifests in physics and then folds back into geometry again. For the first time, mathematical formulas actually made sense – they visually aligned with the tangible world around me.
As soon as I could, I got my own prescription.
And it was not difficult. In fact, it took one call and one trip to the psychiatrist before I walked out with a full bottle of extended-release Adderall. Once something feels rewarding to you, you follow it like Alice chasing the White Rabbit.
A leading hypothesis for the cause of Attention Deficit Hyperactivity Disorder (ADHD) is that there is not enough Dopamine in the brain. For all intents and purposes, Dopamine equates to “reward.” Adderall, or Amphetamine, works by increasing Dopamine levels.
Dopamine is a neurotransmitter fundamental to attention (we pay attention to things that feel rewarding) but also many other critical parts of our cognition, such as eating behavior, sex behavior, competing in games, and any kind of addiction. The leading hypothesis for the cause of Schizophrenia is that there is too much, unregulated and overly-produced Dopamine in the brain. A leading hypothesis for the cause of BiPolar Disorder is that the brain eats through Dopamine too quickly at once without an ability to produce more, making people manic before crashing and feeling no reward at all for a period of time. According to neuroscience textbooks, 90-100% of Schizophrenic and BiPolar patients chainsmoke cigarettes; this is one of the most significant behavioral data points in the study of mental illness. Around the time that I began taking Adderall, I also became addicted to vaping nicotine.
Amphetamine works by blocking the re-uptake of Dopamine in the spaces between neurons, and causing the neurons themselves to produce more Dopamine, which together make whatever you are focusing on feel more rewarding. Amphetamine’s mechanism of action is identical to that of Cocaine, but Cocaine doesn’t cause the brain cells to actually produce more Dopamine – it only blocks Dopamine re-uptake. In this way, Amphetamine is stronger than Cocaine.
The chemical structure of Amphetamine is also almost identical to Methamphetamine, aka Meth; the only difference is that Meth has an additional methyl group added to it, which allows it to penetrate deeper into the blood brain barrier and, therefore, eventually deplete the brain entirely of its Dopamine storage and production.
Like an action potential, what goes up must come down.
It feels really great, until it wears off and you need more otherwise you can’t get out of bed. It feels really great, until you realize that between all of your intellectual pursuits, you forgot to eat, brush your teeth, text your mom back, sign up for classes, and talk to your friends. It feels really great, until you realize that while you were furiously writing raps in your iPhone notepad, two weeks have passed since you felt genuine human emotion. It feels really great until it doesn’t, and you realize that you can’t function with the drug, but you also can’t function without it.
Fun fact: when rodents are administered Amphetamine, they self-groom until they have no fur left on their bodies.
Over the past two decades, Amphetamine use has increased globally. From 2006-2016 (coinciding with the explosion of the internet) the rate of prescribed stimulants doubled in America.
According to a New York Times article from July titled, ‘The Age of Distracti-pression’: “Among Americans ages 20 to 44, numbers of ADHD medications went up 7% from 2017 to 2019, but they increased by 16.7% from 2019 to 2021. According to IQVIA, just under 77 million prescriptions were written for ADHD stimulant medications in 2021, nearly six million more than in 2020.”
New, online telehealth companies that offer virtual therapy, such as Cerebral, now provide customers with stimulant prescriptions after a 30-minute, online-only consultation.
My hypothesis is that overstimulation from technology is causing the attention networks of developing minds to exhaust themselves, leading to depression and a subsequent inability to find anything rewarding enough to truly focus on.
The internet has made the world (especially for young people) into a nauseating fun-house of moving mirrors.
But Amphetamine as a solution only makes the problem worse; instead of actually re-connecting the attention of these people with their physical environment, giving them stimulants causes them to simply close their eyes while still standing in this house of mirrors. It causes them to narrow in on their attentive rabbit holes, further disconnecting them from reality. There’s a line in Frank Ocean’s song “Novacane,” a song about emotional numbness after falling in love with a pornstar at a music festival, that goes, “I’ve been trying to film pleasure with my eyes wide shut but it keeps on moving”.
An Amphetamine prescription might help someone get out of bed and it might even help them have enough energy to do the tasks essential in keeping the country’s economic machine churning. But these people are no less depressed. Because they are no more present.
In the words of American Psycho: “There is an idea of a Patrick Bateman. Some kind of abstraction. But there is no real me. Only an entity. Something illusory. And though I can hide my cold gaze, and you can shake my hand and feel flesh gripping yours, and maybe you can even sense our lifestyles are probably comparable, I simply am not there.”
