Actually ADHD | Medication Strategies & Clinical Wisdom20 Heinä

ADHD Reddit, Groupthink and the Guanfacine Controversy

Why guanfacine keeps getting mistaken for a first-line ADHD medication. Jonathan Murphy, PMHNP-BC, walks through the clinical reality of guanfacine, the Reddit dynamics that promoted it, and the groupthink pattern that keeps patients on medications that don't actually treat their condition.

This episode covers:

What guanfacine actually is: an antihypertensive with pediatric ADHD approval, not adult approval, not first-line
Why guanfacine gets prescribed to adults with ADHD anyway, and what that says about prescriber bias against stimulants
Dr. William Dodson's rejection sensitivity dysphoria article, its amplification through How to ADHD, and how it entered the Reddit ADHD tribal vocabulary
The Gustave Le Bon group psychology framework, sentiment, ideas, and custom, applied to online ADHD communities
Why tribal identity on Reddit doesn't map to individual psychiatric diagnosis, and how that distortion produces bad treatment
The 95/5 clinical reality: stimulants work for adults with ADHD roughly 95% of the time; non-stimulants roughly 5%
The "medicine show" metaphor for online misinformation and where the licensed prescriber fits in the wilderness
Why guanfacine feeling helpful for a specific patient doesn't make it an ADHD medication

The book The Process: An Adult's Guide to ADHD Medication is available on Amazon: https://www.amazon.com/dp/B0H2Z6PM4T

Find the YouTube channel Focus Path | PMHNP-BC for the full clinical education catalog.

For educational purposes only. Not medical advice. Consult your own provider for clinical decisions.

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Reacting in Real Time to the Lindsay Clancy Medication List | A Prescriber's First Read

Jonathan Murphy, PMHNP-BC, reads through the Lindsay Clancy medication record for the first time on mic, reacting in real time as he goes. No script, no preparation, no edits. Just a psychiatric nurse...

26 Syys 16min

Why the Lindsay Clancy Case Spread Like It Did (It's Not a PSYOP)

People keep asking whether the Lindsay Clancy case is a psyop. Jonathan Murphy, PMHNP-BC, grew up in Duxbury, and his answer is no — it looks organic. What's worth understanding is why a local tragedy...

24 Syys 10min

High Masking Autism: The Most Misunderstood Psychiatric Diagnosis

Autism spectrum disorder is the diagnosis Jonathan Murphy, PMHNP-BC, sees the most confusion around — from patients and clinicians both. People get evaluated, spend a lot of money, and come back witho...

15 Syys 18min

Got Adderall From a Friend? Here's What a Prescriber Wants You to Know

Is it illegal to share ADHD medication? What happens if you got Adderall or Vyvanse from a friend? Jonathan Murphy, PMHNP-BC, answers both the legal question and the one that matters more clinically: ...

10 Syys 11min

Understanding Creativity and Critical Theory

After the Clancy deep dive I was in a bad mood, and the antidote is always nerding out. So I pulled some books, took notes, and thought out loud about why the things we look at run us more than the th...

8 Syys 15min

ADHD and Creativity: Build the Structure First

Creativity can be the difference between depression and feeling motivated for someone with ADHD. It can also blow up your life, because the ADHD brain goes all or nothing and the hobby you barely pick...

5 Syys 14min

Lindsay Clancy DSM 5-TR Deep Dive

Jonathan Murphy, PMHNP-BC, opens the DSM-5-TR and works the Lindsay Clancy case the way a clinician actually works a differential, starting with the forensic cautionary statement at the front of the b...

4 Syys 34min

Media literacy amid true crime mobs and ADHD

Psychiatric nurse practitioner Jonathan Murphy, PMHNP-BC, connects the dots between true crime consumption, mob psychology, and ADHD executive function. In this episode of Actually ADHD, we discuss ho...

1 Syys 21min