ADHD and nootropics: part I

Notes for this blog post: 

This is a very rough edit right now, because I’m optimizing for posting content as quickly as possible and being “so prolific you don’t recognize yourself” rather than optimize for perfect editing. The reason for this is that my perfectionism and desire to talk about EVERYTHING all at once, is leading to procrastination. So, in the interest of actually getting this off the ground, I will make many posts/attempts and edit them continuously, reaching a final edit by successive approximation. Some of these posts might be quite bad and illegible – that’s okay if you don’t read them! If you like something in particular, send me an email and I’ll evolve my writings to focus on the things I like to talk about and my readers like to learn about. Thanks! – Nick

Best nootropics for ADHD, and quick explanation of what ADHD is.

The best nootropics and drugs I’ve taken for ADHD have been, in no particular order, vyvanse, phenylpiracetam, modafinil, caffeine, nicotine, kratom and oxiracetam. Obviously not all of these fall under the strict definition of “nootropic” but that discussion is for a different post. For one of the best resources into learning about nootropics, including research, quick summaries and personal accounts on experiences with many, you should check out the /r/nootropics subreddit, especially the sidebar FAQ. Here’s a quick breakdown of the pros and cons I’ve found of each:

Vyvanse: Expensive and potentially tricky to get prescribed. Vyvanse is a pro-drug of  methamphetamine which makes the experience smoother up and down unlike ritalin which feels very “methy”. Can acutely reduce libido, potential to hyperfocus on wrong thing. 

Phenylpiracetam: Need to take with a choline source, works really well if you cycle it frequently. Unfortunately tolerance builds fast. Some of my best “inspirations” or flow state of ideas came from phenylP. Easy to get from places like Nootropics depot. 

Modafinil: Takes forever to ship from India, some evidence that the pills don’t contain as much active ingredient as claimed. Will screw up your sleep cycle if it’s taken too late in the day. Some evidence it’s as effective for ADHD as stimulants without the downside of addictive potential. Can find it here: https://sharkmood.com/ (previously afinil express)

Caffeine: It’s amazing and I’m obsessed with espresso. But caffeine is easy to get addicted to and it stops working. I recommend alternate sources like Yerba Mate which has other theobromines as well as caffeine, which yields a smoother stimulation. Stack with Theanine for nice relaxing ride at the peak of the “stimulant curve”.

Nicotine: Cigarettes are extremely addicting and pleasant if you are naturally ADHD and or anxious. Risk of cancer is X, which is bad. Nicotine chewing gum could be a safe alternative, as well as vaping. Interesting drug, wish the health risks were lower. Possible to engineer safer strain?

Kratom: Almost single handedly got me through chemistry undergraduate at the Kava and Kratom bar in Asheville. Technically a mild opioid, but increases dopamine in brain which is what ADHD needs. Can make you dizzy/nauseous if you take too much. Downside is cost, easy to get addicted to and build tolerance, withdrawals can be uncomfortable if you’re not used to them. 

Oxiracetam: Less stimulating than phenylpiracetam but can be taken daily. Good start point if you don’t know anything about nootropics and don’t have access to pharmaceuticals. Non-addictive, but also not super strong. Take with a choline source. Can also stack with other racetams. Can find many nootropics here: https://nootropicsdepot.com/

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ADHD is a disorder characterized by a lack of dopamine (DA) in the prefrontal cortex, the center of the brain responsible for “Executive Action”, such as attention, focus and decision-making. The most common prescription medications are stimulants: methamphetamine salts, such as Ritalin and Adderall. Stimulants work by binding to XXXX receptors and directly increasing DA in the brain. 

Genes associated with ADHD:

Dopamine related: D2, D5, 

Like almost all other entries in the DSM-IV, ADHD is primarily diagnosed by comparing a checklist against a patient and ticking off boxes that fit. If the person has a high enough number, they can earn their diagnostic code. However, there is a much cooler way to self-diagnose: by reaction to stimulants such as caffeine. Most people have a normal amount of DA in their PFC, so adding a stimulant boosts that and they become hyperactive and possibly anxious. Those with ADHD however, finally, have enough DA in the right place to chill out. They’ll relax, sit still, do their work mostly without interruption. If you know someone who can have 8 cups of coffee and then fall asleep, congrats – I’m not a doctor and can’t diagnose people over the internet, but it sounds like a paradoxical reaction. Paradoxical reactions are opposite of what usually happens when someone takes a drug – for stimulants that means someone relaxing, less locomotion, perhaps falling asleep. But they can occur for all kinds of drugs for reasons not well understood, GABAergics can give bad anxiety, antidepressants can make you suicidal, antipsychotics can well, make you more psychotic. If you think of it in terms of the fact that drugs are like assembly programming for the brain, the really surprising thing is that these compounds have consistent effects at all rather than that they occasionally do the opposite of what we want. 

Headings Practice:

  1. Introduction should be TL;DR of nootropics with clickable links to elsewhere in the essay, also include honorable mentions or “hope to try soon”.
    1. Top summary should be most important takeaways (cuz adhd remember)
    2. For honorable mentions, list maybe top 3, others buried in section
  2. What is ADHD?
    1. Simple explanation: lack of DA in PFC means that Executive Actions are trickier for us.
    2. Diagnosis:
      1. Taking a history, DSM-IV or DSVM-V (should post requirements) 
      2. Paradoxical reaction to stimulants
      3. Can SPECT work? Lightly touch on Dr. Amen’s work? Basically I like the idea of using brain imaging equipment > just DSM-IV especially if it can resolve “sub-types” of psychiatric disorders in a way that improves treatment course. But the $ making makes him a bit of a pariah
      4. Genetic screens
    3. Are there “types” of ADHD?
      1. Hyperactive, Inattentive or mixed
      2. Dr. Amen 7 wacky types: Classic, Inattentive, Overfocused, Temporal lobe, Ring of Fire, Anxious, Limbic.
      3. Co-morbid as fuck with like 80 other things
    4. How often do stimulants work?
  3. Medication, supplements, Nootropics:
    1. Classic stimulants for treating ADD. New drugs on the market, can tell cool story about Vyvanse prodrug. Include other medication like Concerta, wellbutrin etc
    2. What are nootropics? Quick summary
    3. Supplements
  4. List of things I’ve found helpful:
    1. Vyvanse
    2. Phenylpiracetam 
    3. Modafinil 
    4. Caffeine
    5. Nicotine
    6. Kratom
    7. Oxiracetam
  5. Honorable Mentions and “wish to try”
    1. Examine: https://examine.com/topics/adhd/
      1. Modafinil, Fish Oil, PS, Ginkgo, L-Car
    2. Bromantane: cool fucking structure and works VERY differently in that it upregulates DA receptors! Possibly inducing TR? Also long term effects, and very safe. 
    3. Melatonin for sleep

Friendly, Ambitious, Nerds

I’ve followed @visakanv for a few months now on Twitter and found his posts there extremely engaging. All of this content is hyper-threaded and tight, threads which reference other threads, linking back to old work, notes at the end to himself to where he could pick the thought back up, etc. On a whim I decided to buy his e-book Friendly, Ambitious, Nerds on Gumroad for about $8. Now I have a horrible habit I’m trying to correct of buying books that look interesting and then never getting to them. I have an entire BOOKSHELF of books that are on my to read list one way or another. So in the back of my mind I knew that FAN could be just another and I wouldn’t finish it. 

I read it in about 2 days, entirely off my phone. 

I never, ever read things off my phone. I can barely use a kindle it’s so weird to me. The past few months though, I’ve read 3 this way: FAN, Harry Potter and the Methods of Rationality (which I’ve almost finished re-reading it’s so good) and Harry Potter and the Natural 20 (don’t ask why so many HP related works, I couldn’t tell you. Maybe I just needed something lighthearted). So the format was very significant to me, something about the short chapter length and having it easily accessible meant I could squeeze in pages here and there throughout the day, whereas sitting with a book in hand always seems like initially a greater time investment, the way that sometimes I go down Youtube clickholes looking up movei trailers instead of picking an actual movie on Netflix. 

Anyways, on a whim I decided that I would do my best to start nerdposting on Twitter more and produce more blog content. I haven’t written for a blog in years now, and my last work was…pretty juvenile? So I’m out of practice. As such, this post is not meant to be a super deep reflection of everything in FAN or about Visa. Readers can explore both work for themselves. This is a collection of bits I found interesting, interjected with some of my own commentary that I might follow up with later. Also, since I’ve decided that all my blog posts will be more or less in an “editable” state, I will apply rules 3 and 5 from Lichtenbergianism, a mental system for leveraging procrastination to get more done, which I highly recommend to anyone who struggles with ADHD or procrastination. So while I may be a worried about the “incompleteness” or “imperfection” of this post, I’m overriding it with my desire to complete the task, rules 3&5 and the knowledge that I’ve threaded some good things in here to other work that I think people will find useful – and they may need that utility right away, even if the writing is tight yet. 

Bearing that in mind, let’s start the show: 

“I’m writing this because I want to encourage you to become a friendlier, nerdier and more ambitious person.” – Visa

Visa is nice enough to summarize his whole book for us in the first few pages.

1 page summary of the book:

FRIENDLINESS is about being a nourishing presence. It’s about becoming somebody who people (including yourself!) love and enjoy. It’s about creating supportive, encouraging spaces where people can feel comfortable sharing their honest feelings. Humans are a social species, we’re practically wired to desire kinship, to be a part of something bigger than ourselves. So why not get good at it? To be a great friend, I believe that it’s necessary to learn to address your own neediness and insecurities, and to cultivate an abundance mindset in relation to other people. Learn to give sincere compliments, to be a gracious host, to be artful in conversation, to always be a cherished asset in any social space you inhabit. 

Why this speaks to me: “Asshole in Recovery syndrome”. When I was younger, I lacked a filter. You can call it ADD, or being a class clown, or having low executive function capacity. When I was a happy kid, this was mostly positive as I’d crack jokes or make connections that were mostly entertaining and harmless. Puberty however, hit like a rocket-boosted Mag-lev train directly into my skull. You don’t grow to 6’6” without a lot of changes, not to mention high school was not the most fun experience for me. So my jokes got darker, more cutting, more ad-hominem and over the line. I upset a lot of people and rationalized “Their loss, I’m hilarious and if they don’t get my black humor they don’t deserve my smart funny time.” But this was a lie I told myself and pushed a lot of people away. Unintentionally though I stumbled upon a weird benefit which I call the “Asshole filtering mechanism”. Whenever I found myself in a new social group I’d say something horrible and piss off 50% of people, 45% were indifferent, but the other 5% became friends for life. Perhaps it’s because they recognized that I way playing a game, and the game wasn’t “hurt people intentionally” it was “cross social boundaries intentionally and humorously, and note the reactions.” As such, I had a few very close confidants that I’d consider brothers, and a few more acquaintances who liked me, but would push back when I crossed their personal line. This took a long time for me to understand why it was wrong, both ethically and pragmatically. First of all, humor is like flirting – you need to find the right audience and the right game level to play it at. I was using a very acquired taste of humor on 100% of people I met, who didn’t necessarily like the game. And although other people’s reactions were not in my control, picking who to play the game with was something I could. The second is the general utility of “Friendliness”. Being friendly is extremely useful actual, and if you can make friends with many people or at least get along with them, they will open many doors for you. When I have my compulsion for dark or dirty humor, rather than drop in front of everyone like a bag of heroin at a New Years Eve party, I get my other friends who like heroin and we shoot up in private. (Note: this is a metaphor about dark humor being like a socially acceptable but extremely pleasant feeling and addictive drug, not ACTUALLY doing heroin, don’t do that kids). So in short, lesson learned. Hopefully. Be friendly, and if you have unconventional tastes that might make other people uncomfortable, find a scene or clique that enjoys the same and get it out there. Sort of like a safe space for being an asshole. Close friends are one for me, and stand up comedy is a second. 

AMBITION is about daring to dream bigger. It’s about realizing that you can live a much “larger” life. It’s about recognizing that your own imagination is a bottleneck that limits the amount of good you can create in the world. Imagination deficit rules everything around me.” 

My most ambitious projects were almost universally seen as “impossible” by people around me, from starting my university’s first iGEM team, to Asheville Fencing club. 

NERDINESS is about cultivating taste and curiosity. It’s about developing the courage to be honest with yourself about what you find interesting. A lot of what is beautiful in the world was made by nerds – music, technology, science, movies, books, you name it. It’s a fundamentally nerdy thing to decide to sit down and spend years of your life exploring your interests. Doing this is a joy in itself, and it’s also a great gift that you can give to others. To be a nerd is to liberate yourself from over-preemptively worrying about what other people think. By doing the nerd’s work, you will develop a healthy, rigorous and honest regard for your own opinions. You’ll find, delightfully, that others start valuing your thoughts more, too!

Being a nerd is hard work and requires suppressing the wooly mammoth of judgement

It took me two decades to really begin to aspire to be kind. The smartest

people embrace their ignorance…Kindness nourishes (not coddles) fragile things and makes them strong.” New ideas are worth protecting and help blossom into something strong. If you expose it to criticism right away (Editor mode) you will kill it and dis-encourage your Creator mode.

A lot of the most interesting information in the world is locked up inside other people’s heads…People only started opening up to me in private in the last 3-5 years or so, and it’s completely changed my life. I mean, I did have conversations with a handful of close-ish friends a decade ago, but now I have people actively coming to me and telling me things that they wouldn’t dare say publicly. Sometimes you get people asking, “how do you compete with smarter people?” I find myself instead asking, “How do you win the love, trust, support & goodwill of smarter people, so that THEY are on YOUR side?”

Don’t fall into the local maximum of the “Asshole filter”, find a higher maximum called “Be friendly to everybody, and darkly humorous to a select few who enjoy that sort of thing.”

“You want to be so curious about people that you make them freshly curious about themselves. Why did you cringe, why did you flinch? Why did you frown, shudder, laugh, scoff? The body keeps the score.”

…the first person who offers you your first cigarette or drink tends to appeal to your independence. They’ll ask, “Why are you worried about what other people think?” Owning a decision is a powerful, heady thing, even if it’s a really stupid decision. Tattoos, piercings, boyfriends, whatever. “I will what I want.” 

This is exactly how I first started smoking, trying pot, drinking, and experimented with other drugs. No tattoos yet though. Eschewing rules as a sense of independence is a powerful trip, but then you tend to find out exactly why those rules exist. 

Any small group of people loosely-but-truly aligned on something can create powerful vectors by producing public-facing work that’s directed at each other. In reality, scenes seem to need like maybe around 2 dozen people. You need the conflict and collaboration and one-upmanship to push people far out of homeostasis.

Relationships are fucking hard, and to work they need a sort of functional

“economy” (gratitude, laughter, kindness) and waste elimination system (pain,

resentment). Killer signs: contempt, dismissiveness, indifference, constant apology.

you’re choosing the person in life who’s going to upset, disappoint, annoy and frustrate you more than anybody else. See the worst part of the other person the most frequently. Schedule syncing very important. If you don’t have a system You Are Fucked. schedule 1–1 meetings in advance. This is an idea I stole shamelessly from work. Basically, have some time set aside (at least once a month) for the EXPLICIT purpose of discussing difficult things. how to spice up your relationship’ – people think it’s about toys and lingerie but it’s really about exposing vulnerable bits of your psychology to one another.

Flirting is basically this – give moderately strong signals of interest with plausible deniability (for you) and outs (for her), and then be attentive for returned signs of interest and riff off of that.

All communication is lossy and involves trade-offs. A good faith discussion and/or disagreement is sensitive to the fact that the other person has made those trade-offs. If we have a disagreement, we need to identify our respective assumptions, and talk about our respective experiences. 

I have a soft spot and lots of compassion for people that are High-decoupling vs those that are low-decoupling. It’s not that one type is better or worse in general, but I bet that most high-decouplers find themselves in STEM and would find it extremely stressful to do something like palliative care nursing or teaching. Likewise, people-people and high-empaths won’t necessarily enjoy dark humor or engineering. For me, dark humor is a form of flirting or play, but for many years I didn’t understand why many people were so uncomfortable with it. I thought everyone was like me. 80% were indifferent, 10% were very hurt and 10% became fast friends for life. As I got older I learned that sort of play is okay, but you have to read the room and make sure everyone involved knows the game you are playing. 

Don’t tolerate contempt

Safe spaces are for nurturing, not coddling. The problem is that it only takes 1-5% of clueless outsiders to ruin the experience/atmosphere for everybody. 

Ambition: 

 If you want to make ambitious people waste their time on errands, the way to do it is to bait the hook with prestige. Paul Graham: How to Do What You Love

What would my heroes do? (Need to find some Indie Scientists) – Alexander Shulgin

You should be tweeting what *you* want to see more of. If in doubt, I recommend nerdposting. 

I don’t know if it can really be as simple as “just act as if you already knew you could do it”, but sometimes it actually can be. You could maybe distill this down to “be confident”. 

Positive affirmations by Scott Adams – it’s like finding out you’re a green-type reality bender and will make you think you live in a simulation. You are likely under-imagining what you can become capable of.

“You have a far greater shot at tasting greatness and fun if you simply write as much as you possibly can, and then some.”

The pottery class story goes like this: A ceramics teacher decided to test a hypothesis experimentally. He split his class into two groups and told the first half: “You will spend the whole semester making one clay pot, and into that you will pour all your energy, thought and skill to make it as perfect as possible.” To the second he said, “I will grade you by quantity, make as many clay pots as you can by the end of the semester.” At the end of the semester he surveyed their work and noted the following: The students that were optimized for quantity produced better clay pots than the perfectionists. By repeating the process over and over and over again, they gained skills, learned taste and had created a short feedback loop to inform the next production cycle. The perfectionists in the meantime, hit their skill ceiling early on with their one pot and spent the remaining time fiddling. Lesson: optimize for quantity. This will create a short Design-Build-Test-Learn (DBTL) cycle which will push your skill ceiling higher. Additionally, since the work will naturally fall on some sort of bell curve of “goodness” with a large body of work one can select the top 10% to present or refine. 

“‘I can tolerate anything except intolerance’ sounds cute, silly, paradoxical, like a parlor game. ‘Tolerate anything except contempt” seems like a more intuitive directive to me. Contempt justifies abuse. Contempt is the stepping stone to all kinds of dehumanization.” (64)

Hypothesis: if you do barely anything with your life but take little notes every day, journal, diary, whatever – snapshots of your opinions, impressions, perspectives, predictions – and then you thread these notes over time, say, 10 years… …by the end of it, if you reflect, review, corroborate, verify and discuss them with others, you will have an incredibly robust… mind? worldview? You will deeply appreciate the nature of human reality in a way that you cannot get from any single book or person or experience.

The first rule of smart writing is you must recognise what smart writing is. The cool thing is, you don’t actually need to find the smart angle! Writing is cheap, basically free. Write all the angles. Whatever comes to mind, whatever tickles your fancy. Write stupid, edit smart.

Twitter Thread: https://twitter.com/nicholasfwhite/status/1274856733614186497

Nick and the Fox video: Treating PTSD with EMDR and a critique of CBT

Jeremy Fox is a licensed counselor, who is an expert in EMDR (Eye Movement Desensitization and Reprocessing) therapist, and has treated hundreds of patients. Jeremy has seen spectacular recovery from traumatic events, through this particular modality. Mr. Fox also speaks frequently about the different structures in the brain which control traumatic responses, and understands how PTSD and other anxiety disorders can affect men and women in different ways. Although he does not practice psychedelic therapy, we had a wide ranging conversation which followed up on the REBUS article I discussed earlier with Suspended Reason.

Critiques of CBT:

Maria Bamford, one of my favorite comedians:

The Antimemetics Division of the SCP: http://www.scp-wiki.net/antimemetics-… (Lovecraftian, conceptual horror + classic Internet 2.0 culture)

Libidinal Economy and Orgone Theory with Matthew Gilinson

Matt and I discuss Wilhelm Reich, a disciple of Freud who eventually broke away and formed his own theories on psychiatry, the most influential of which was orgastic potency. This was a wild episode, had a lot of fun with it.

I. Libido – A basic definition of libido
II. Introduction to Libidinal Economy – A brief survey of the quantitative problem of libido
III. The Orgasm Theory – Part 1 – An overview of the orgasm theory and its development
IV: The Orgasm Theory – Part 2 – On the orgasm reflex
V: The Orgastic Function – Part 1 – The biomechanics and electrophysiology of the orgastic function
VI: The Orgastic Function – Part 2 – The recapitulation of the function in other expressions

Anchor app link: https://anchor.fm/nicholas-white80/episodes/Libidinal-Economy-and-Orgone-Theory-with-Matthew-Gilinson-eb36bl

South African medicine with Camillo Coccia (part 1 & 2)

We stuck two sessions together, testing the Anchor app stringing function. I think it worked fairly well. Camillo has a really interesting life story as a doctor in South Africa and I learned more about the horrific AIDS epidemic and how much it’s affected every other aspect of health.

Below are the two youtube videos that we recorded, but if you prefer to listen, here is the anchor app podcast link:

https://anchor.fm/nicholas-white80/episodes/South-African-Medicine-with-Camillo-Coccia-eb36ah

And here is the Spotify link, embedded: