Comment by scrapcode | Hacker News Reader

Comment by scrapcode | Hacker News Reader

I have recently, within the past 2 years, started to realize that I may be unintentionally self-medicating larger underlying issues and am attempting to put more trust into medical professionals.

Skipping the story book, I work rapidly changing shift-work and couldn't sleep, stay awake, or function when i was supposed to. I saw a specialist that diagnosed me with "shift-work disorder." The solution cocktail includes Ambien to go to sleep, and Modafinil/Provigil to stay awake. I only use them during the times when I'm on the odd-ball shifts (not days), and they work great. I've had no issues.

I have also recently gotten prescribed Adderall after voicing my (and former teachers) life-long concerns of possible ADHD. Low dosages did nothing, and I can "kind-of, maybe?" tell some improvements with a higher IR dose. I don't want to ask for more at risk of looking like a drug seeker, and I don't want the jitters to increase, but I'm also not really sure what I'm supposed to "feel."

Until I've recently went back onto one of those odd-ball shifts and took modafinil again. I can absolutely without a doubt tell that I'm on it. I am focused and am constantly completing something. This is what I imagined Adderall was supposed to be. The con is that it has this effect that I don't notice I'm hyper-focused until many hours later when it wears down a bit, and it's noticed in retrospect. It's weird enough that I take it as rarely as possible (I'd rather feel this then constantly falling asleep while at work, which is extremely dangerous at my job)

> I don't want to ask for more at risk of looking like a drug seeker, and I don't want the jitters to increase, but I'm also not really sure what I'm supposed to "feel."

If it's working correctly you should not "feel" anything physical, but you'll be able to concentrate and focus (within reason) on the things that previously took significant effort. It certainly isn't a 100% thing -- focusing on some things is hard with/without medication, just as it's hard for people who are not on the ADD spectrum to focus 100% of their time.

Regarding your comment about "jitters", I'll offer you a short anecdote of my own.

I was on a higher dosage schedule of Adderall XR (60 mg/day) for a couple of years before I started to experience jitters and moderate insomnia set in. After talking to my psychiatrist we decided to give Vyvanse a try (70 mg/day). A few days after taking it my jitters went away and my body's circadian rhythm started to return to normal.

Vyvanse may not be for everyone's system, but if Adderall or Adderall XR don't agree with you, it's worth talking to your doctor about it.

Happy to discuss further offline if it would be helpful, you can get in touch with me through any of the links in my profile.

> This is what I imagined Adderall was supposed to be.

It's worth noting that different psychotropic drugs work differently for different people.

For example: when I was diagnosed with ADHD a few years ago, I trialled three drugs. I definitely noticed ritalin. I certainly noticed dexedrine (and hated the experience). Strattera did nothing for me.

Other people have other experiences. YMMV.

How you noticed Ritalin? I mean, what it did that you noticed?

I was able to stay on task, at all, for more than 10 consecutive minutes. Without all the goddamn struggle and self-flagellation.

Oh, I see. That is very interesting!

I recently started to take adderall at 28 years of age. My doctor told me that they found out that at least 1/3 of the adderall will still be working the next day, and 1/3 of that the day after. And the 1/3 was the at least number. So he told me to take it intermittently and not every day. I do really like that stuff, although I have had 1 or 2 bad experiences, for the most part it makes me feel normal and relaxed.

Also, my doctor told me my diet will greatly affect how the adderall works in my body. And that really rang true to me. I usually eat pretty lean, so 10mg, or even 5mg is enough for an effective dose for me.

I tried to get provigil from the same doctor and he couldn't even believe I would ask for it, said it was too expensive to prescribe to someone like me.

I am at 20mg ir of adderall and if it weren't for the jitters I wouldn't know I have taken anything. But that low strength provigil is very very noticeable, for example.

> I'm also not really sure what I'm supposed to "feel."

Not all drugs work the same way for treating ADHD. If simply increasing the dosage isn't working, they may try (and you may suggest) switching to try out Ritalin or some of the other options.

It's well established that shift work destroys you. Don't do it.

Not everyone has the privilege to simply "n't do it".

Really? Scientific studies are now establishing that this or that "destroys you"?

I find it rather presumptive that you simply tell this person not to do something, period. They have more information about their own life and the trade-offs involved. As a straw man, maybe they earn enough from occasional shifts to pay for treatment of an otherwise deadly medical condition, or don't have other economic opportunities.

In addition, many jobs simply need to be done in shifts, and someone's gotta do it. Servers need monitoring, hospitals need staffing, power plants need running.

Ironically, I am an operating engineer at a power plant. So, yeah, I don't have much of a choice.

You can argue about his choice of words, but shift workers fare worse on just about every measure of physical and mental well-being. There's always a choice. If I were the OP, rather than try to band-aid the symptoms with medications, I would plan and prepare to change my career to something where I don't have to do shift work. Just the same as if I had a job that I hated. It's just a job, better to find one that doesn't have so many negative impacts on your life.

> Really? Scientific studies are now establishing that this or that "destroys you"?

I'm not going to go grab links for you, but yes, shift work is terribly detrimental to your health. Google "shift work health risks".

> In addition, many jobs simply need to be done in shifts, and someone's gotta do it. Servers need monitoring, hospitals need staffing, power plants need running.

Indeed. They can pay extra for the requirement, while we ensure we have regulations to keep people who have to do it as healthy as possible.

If you shift "backwards" doing shift work, you're significantly more likely to have a heart attack, accident, etc.

Take a few minutes and google it, this has been studied for 100 years or more.

I wish that were a choice! Unfortunately for me most of my career options are shift-work based at this time. Thanks for the suggestion, though.

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