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Comment by colordrops | Hacker News Reader

Interesting. My answer is an emphatic yes to all of those questions. In the back of my mind I've always suspected that I would be diagnosed with ADHD, but never talked to anyone about it. In the end I just chalked it up to being a different kind of person and catered my life around my behaviors instead of trying to force my behaviors into some ideal notion.

Looking back at the age of 40, my life has been much richer for it, having met interesting people, traveled to strange places, and worked on amazing projects. Most of the behaviors you listed have naturally attenuated through experience and age.

But to be honest I still struggle (albeit somewhat successfully) daily with a lot of it, so I'm wondering what treatment you got that worked so well. I'm definitely not interested in drugs for myself, but would still like to hear your thoughts on that if your treatment included them.

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I've come to appreciate my ADHD, as well. I realized that it was the spark in my personality everyone seemed to always recognize but never be able to put their finger on. My intensity, my creativity, my wit (I don't mean to brag here, I'm no world-class comedian..), etc. are all part of a charm that I believe directly come from my impulsive, no-filtered ADHD brain.

It has also caused me to be less risk adverse and take career moves that have really helped me over the years. I haven't been afraid to try new things, to gain new experiences, etc.

But those upsides all had their downsides. The same impulsivity that let me drop everything and move to NYC for bigger and better things is the same impulsivity that saddled me with an embarrassing number of speeding tickets and car accidents, substance abuse issues (alcohol), etc. The same intensity that is a large part of my charm is also a large part of the reason many of my relationships become strained.

Being diagnosed and getting a handle on it has curbed the negative side effects greatly while still allowing the positives to shine through.

Adverse: preventing success or development; harmful; unfavorable. Averse: having a strong dislike of or opposition to something.

So, I'd say you are less "risk averse". (Trying to be helpful, not a grammar nazi... I hope)

I.. did say less risk-adverse. Did I miss something?

It's a common mistake. The word "adverse" almost makes some kind of sense but the correct word is averse.

Just realized you had asked for what treatments I had.

I use medication and cognitive behavioral therapy. They are a tandem duo and neither alone would be nearly as effective.

First, do yourself a great favor, read the book Driven to Distraction. It's a super easy read and will give you a great amount of insight.

Second, try to really re-evaluate your fear of medication. ADHD medication gets a bad rap. My opinion is that it's because it's over diagnosed in children and abused heavily at the college level. For those who truly have ADHD, however, it can be a life-change overnight. I mean that.

The ADHD brain lacks dopamine, this shortage is a major component of the behaviors that follow. A low amphetamine dosage should have no ill effects on the patient (you're not trying to get high on speed here..), but what it does do is artificially boost the dopamine levels in the brain. This covers the shortage that your brain is constantly trying to fill by jumping from exciting thought to exciting thought or through thrill-seeking. Suddenly, your executive functions are much better and you can direct your focus far better. You'll never be "normal", but it's a world of difference. For me, not only did I immediately regain better control over my focus, but I also found I could transition better, I didn't procrastinate as much, and I wasn't as emotionally reactive as I normally was which has always been a major issue in my personal relationships.

This alone, however, won't fix all the issues. Once you have the medication and are able to wield your focus, the next step is unlearning all those bad habits you've learned over 40 years of struggling and compensating for your ADHD. This is where Cognitive Behavioral Therapy shines.

These two things together, along with accepting and learning to appreciate your brain for what it is and making use of tools (lists, calendars, regimented scheduling, written goals, etc.) that complement your way of thinking will go a long, long way.

Anyway, your mileage may vary, and your feelings on medication are between you and your doctor, but this is what worked for me and what I recommend to everyone I know who is thinking of seeking treatment. Best of luck.

> Second, try to really re-evaluate your fear of medication.

Seconded.

And know that those medications works wonders for lots of people, at least Ritalin which is the one I have seen in use.

Only be aware that the effects seems to differ from person to person, so work with a qualified person when trying these things out. I have seen some weird examples (same dose giving wildly different effect, even on siblings, same weight and generally similar) which is why it seems most professionals will generally start at 10mg and work carefully up to around 40 - 80mg/day. As long as instructions are followed however, highly recommended.

OP here — I am on treatment now, including medication. Didn't help me strategically, but it was worth it being diagnosed nevertheless. At least, medications helped me stopping losing things.

That $50K hole needs filling next I think.

Just a suggestion from an outsider (I'm not a programmer). What is your 'time constant' (like an RC circuit) in terms of getting bored? You mentioned a month up the screen. Can you get contract work on tiny projects that last less time than your 'time constant' and thus generate some income and give yourself time to see how the treatment goes?

This is actually a great suggestion provided OP has the organizational skills to keep clients happy and his obligations in order. He also needs to ensure he does not procrastinate.

I found out the hard way that the freelancing life did not work for me. Double booking clients on accident, forgetting deadlines, not being able to motivate myself to start projects, etc.

I certainly don't mean to project my experiences onto OP as fact, but ADHD often makes a lot of the skills that are required to run your own freelancing business very difficult to master and stay on top of, alas.

That being said, I think it's a really great suggestion if OP finds himself out of a job again. Especially if he can do projects serially and try not to overlap them. That's where I got myself into trouble.

You may want to continue to look for better treatment options. Your medication may not be right.

Additionally, Cognitive Behavioral Therapy has been huge for me. Since I was diagnosed late in life, I had just shy of 3 decades of bad habits to unlearn and replace with better ones. I still struggle with some things - punctuality, sleep schedule, for instance - but I'm far more productive and far happier.

I'm confused, you ask a question like this (which is already hard to answer without knowing your full background) and you leave out the fact that you were diagnosed with ADHD recently (and are on treatment), only to mention it in a reply-comment? Do you think these are unrelated?

Based on his other replies, it seems he's given up on adhd treatments and probably didn't want all the replies focusing on that (oops!). I guess he was hoping there were some strategies others use that weren't related to treating an underlying neurological condition. /shrug

I currently take Elvanse (the long-action form of Adderall). It works for some issues (like forgetfullness and occasionally focus-related things), but it does nothing for novelty cravings. Before recently, I considered it to be a good thing, but when I understood that it is a primary driver of everything I do in life, I had doubts. Hence the post.

Aye, I understand. The impulsiveness is a big part of ADHD. I believe you should continue to work with your psychiatrist. Point this out to them specifically and let them know that while you are seeing improvement in some areas, this one is particularly bad for you and that you would like to explore some other medication options - either dosage change or new medications all-together. Worst case scenario is you go back to the medication you're on now which at least helps somewhat.

Hey OP, I'm not keen on publicly talking about my exact medications / treatment specifics (though most can be gleaned), but if you are interested in talking offline more about what has worked for me, leave me an email address or some way to contact you and I'd be happy to offer any insight or help that I can. I'm not some professional expert, just another guy who can relate to you emphatically and who's happy to share what he can.

sorhed at gmail

> Interesting. My answer is an emphatic yes to all of those questions. In the back of my mind I've always suspected that I would be diagnosed with ADHD, but never talked to anyone about it.

Same here, I always suspected it, but as I'm 25 and don't want to take medication, I never thought there's much that could be done.

I would love here what y0y did to work with his condition as well.

Medication is not the only choice. Although it's the one where you might see small results at the earliest. CBT and biofeedback are promising new treatments, but not mainstream yet.

May I ask, where this bias against medication comes from?

Y0y's other comment answers this pretty well

Medication and Cognitive Behavioral Therapy.

Don't be afraid of medication. Find a healthcare professional that you trust and will work with you.

There is a book I recommend to everyone who suspects they may have ADHD: Driven to Distraction

It's a very easy read and will give you a lot of insight.

One of the lines I use from that book often with regard to medication and the stigma it has is: would you deny yourself glasses if you couldn't see? The medication helps focus your mind the way glasses help focus your eyes. The medication is the catalyst for other treatment options to be more effective. Cognitive Behavioral Therapy, for example, works far better when you are able to actually concentrate and do the exercises properly without your mind wandering on you.

Most people find that the medication dosage they need of amphetamine is actually quite low. You're not trying to get high and become a speed freak like college kids popping Adderall the night before Finals to cram. Your brain simply lacks dopamine and is forever craving a fix for it - thus always latching on to the most exciting thought and causing impulsive thrill seeking behavior. A small dose of amphetamine feeds the brain this dopamine, rids you of the shortage, and restores the balance you need to be the person you expect yourself to be+.

+Very simplified explanation, obviously. But, it's the best way that I can relate to my brain's behavior - by always thinking of it in terms of a dopamine imbalance. While it's true, other factors are likely involved and ADHD is also often comorbid with anxiety and depression as many of the same chemical pathways are shared.

Just out of curiosity ... if medication is an effective treatment for you, why the resistance to it? Do you avoid medication generally? Are you worried about side effects?

Some people see negative stigmata with medication and will try to find alternate methods first, which there is nothing wrong with too. IANAD (I Am Not A Doctor)

Avoiding medication purely because of the stigma and not because of any of your own concerns from your own research is short sighted, imho.

That being said, as I mention in another comment, there are valid reasons to be cautious with ADHD medication. And as for the stigma, I am very careful about who I talk to about my ADHD in real life. A few of my coworkers know, my boss knows, and a couple of my friends and family members. I discovered very quickly that ADHD itself has a pretty bad stigma, let alone the medication. Everyone thinks you just want to get high. So, I just don't talk about it anymore, even though I so often want to explain to someone that the reason I did something rude (like interrupt them 5 times in 10 minutes) is because I'm ADHD and my medication has worn off, ha.

There are some really valid concerns with ADHD medication, to be honest.

Long term amphetamine usage has been shown to potentially be toxic to the brain, especially at high doses. It also increases risk for high blood pressure, heart attack, and renal failure for those with pre-existing conditions or who are at-risk for other reasons: genetic conditions, obesity, etc.

Most of us (myself included) will take long breaks from their medication. I don't take it while on vacation, I take most weekends off of it, etc. I take it when I need to be at my best for work and I take it if I am on vacation and feeling like my emotional reactivity is too high, etc.

Ritalin is actually shown to mitigate the effects of amphetamine toxicity, as well, surprisingly, because while it also work on dopamine it uses a different strategy. Instead of causing your brain to produce it (thus potentially frying the cells that do so), it simply prevents the brain from re-absorbing it, much like an SSRI does with serotonin. So, I've heard of some people switching back and forth between amphetamines and Ritalin, though I have not done so myself.

Lastly, there are other drugs such as Cymbalta and other SSRI/SSNRIs that seem do help some people. SSRIs have a whole slew of side effects (especially weight and sexual side effects), and, while SSNRIs tend to have far fewer side effects (Cymbalta seems to have barely any for most people), they are still a fairly new class of drug comparatively so I could understand someone being cautious.

All that being said, the risks are worth it for me. Even if it took 10 years off my life, I'd rather have the remainder of my life be productive, happy, and have healthy relationships than continue to be the shit show I was at times in the past.

People are mentioning treatment for ADHD. Here's what you can expect in England: http://www.nice.org.uk/Guidance/CG72

It's currently being re-evaluated, but it's good enough at the moment.

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