ADHD, a Lifelong Struggle (2018)
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gekk.info
In all seriousness, I skimmed parts of the article and kept scrolling and it just kept going and going and going... like the Energizer bunny. I guess the author found a doctor to prescribe stimulants; they do make it easy to write long rants.
I can identify with some of his analogies, not all. The forgetfulness, standing at desk with power supply / getting “stuck”, lots of that sounds familiar. Some of the stuff he talks about is behavioral though and if it can be called lazy, it probably is at least partially lazy. I could never file TPS reports everyday, but I can do it occasionally. My brain’s capable of it. I just don’t like doing boring things. And yeah, I probably wouldn’t last if I had to do boring things everyday for a job. But the article makes it sound like he’s actually not capable of doing a boring thing.
The more interesting parts of ADHD are the stuff that is lesser-known and often overlooked, like mood swings and anger/irritability issues. Ironically stimulants pretty much cured lifelong mood issues for me. I used to blow up on people all the time; now I’m easygoing.
It's funny. People with ADHD suffer from attention deficit but at the same time they display hyperattention when they encounter a subject they like. I've experienced it as well: once I start programming I have no problem doing it for 12 hours straight. I've found this trait in many ADHD patients. There's usually something that really turns them on and I always try to find it.
I think of it as an signal/noise ratio problem. Very high signal is needed to grab their attention and there is very low tolerance for noise.
However it isn't until older age I finally been able to force my exert executive control to focus. It has taken a lot of practice and challenging myself and it wasn't until the age of 26 I finally been able to go to college. I keep challenging myself and I feel it get easier and easier every year.
So now I start to question the inability part. Or if it's something you can actually practice and get over.
Those with ADHD spend 90% of their time imagining, thinking, doing everything and nothing. And to any observer they look stupid, or undisciplined, or lazy.
Like the hunt, when somebody with ADHD encounters an situation with very high (perceived) consequences, they will lock into intense hyperfocus, completely singular in their goal.
So the modes of operation are 1) philosophize and daydream or 2) hunt
Is this real? I have no idea, probably not, but it helps me reason about myself better than feeling like a permanent victim
My theory extends to my desire for action and my risk taking behavior as a younger person.
Some people think that a lot of ADHD people or misdiagnosed, others that it's just another symptom of ADHD.
Which is why some people have to fidget, or listen to music, or move around in order to get stuff done. Or why I'm a worse driver if I can't have the radio on.
The pinnacle of this for me was about half a dozen years ago, I was slugging out some code for a personal project. But I was also feeling nostalgic for an old movie (can't recall which, but let's say it was The Princess Bride). So I put it on in the background. But this isn't quite getting me in The Zone, so this is the scene my partner walks into:
I'm sitting on the couch typing. In all likelihood my knee is bouncing (makes laptops a bit tricky). There's 90's music coming out of my laptop, The Princess Bride is on the TV.
Her head is about to explode. You would think I was killing kittens. She has an ADHD diagnosis, and this plan I have enacted is so anathema to her coping mechanisms that she can't even bear to witness it. Which is too bad because I was getting rather a lot done.
The other part of this analogy is that when there is something that grabs my interest, it grabs it with all 12 brains and I bury myself in that interest until I burn out after a few hours.
I find that ADHD makes me a very good architect and a very bad regular programmer.
I know what you mean. I think if I could click with someone who's really organized and good at execution we could turn one of my 9 billion potentially-pretty-good ideas into an awesome company (I have a pet theory that this pattern is often why it takes 2 to found), but I have never really been able to connect with neurotypicals. They can play along where I can't even tune in, and worse, they are content where I am passionate.
But also that Flow state is often a bad way to write code.
One, virtually everyone has a tremendous case of Sunk Cost Fallacy around things done in Flow state. If someone spent 10 hours in a week working on code that you say is badly conceived in a code review, you'll get pushback and grumbling. Argue with someone who did the PR in a single sitting? They will fight you. Hard. This is the most amazing code ever written (because I felt amazing while I was writing it). The rush goes to their heads.
Two, writing code for other people requires empathy. Rumination. Flow state is considerably absent of both of those. So the problems and gotchas you know about ahead of time get handled, but anything you find along the way is very likely to get ignored. The quantity of your code goes way, way up, the quality goes considerably in the other direction.
I made a conscious decision a while back (making official an unconscious one I'd already made) to stop seeking out Flow state. I felt better, but objectively, it hasn't done me any huge favors professionally. From a practical standpoint, me writing less code means that people who write more baroque code than I do at my worst get to set the narrative for larger slices of the codebase. But I've also done something I hate: reason that if a lot of something is bad, none of it is better.
I need a new plan, and I need it bad.
Yeah, I thought "flow" required extremely low resistance in the task (i.e., someone sewing, playing an instrument, or playing a relatively simple game competently and with no interruption of confusion, frustration, or distraction).
I wish I could code like that. xD Constant typing to an ambient soundtrack. Instead, it's a minefield of "uh wait I have to Google this thing", "uh, what should happen here?", "oh no, an error with a complicated message I probably also have to Google".
And I can only carry on the rubber ducking to competently deal with those with a FULL MARSHALLING of my mental resources, which seems too strenuous for "flow" and is exhausting after a few hours.
But if you're sewing, you're just sewing.
As a code reviewer they should be giving you a compliment sandwich where the criticism or constructive feedback is placed in between two compliments. As a coder, I've found adding async and await to functions does a lot to make your code look sexier to code reviewers even if it doesn't have a perceptible performance impact on non-network calls.
If I were to comment on a new plan for you, I'd say let flow state be your friend and not your enemy. After all, you have a chair you probably have to sit in for ~8 hours a day while you stare at a computer screen full of code and that's hard for anyone to do for that long let alone someone with ADHD. Flow state will give you an advantage over others. Invariably, your flow state will break. Use that time to spend more time talking to the stakeholders in your group because sometimes stakeholders want what they want and nothing else. They'll appreciate the time you took to listen to them, they'll trust and believe in you more (instead of you being an unknown variable), they'll be more confident that they'll get what they want, and you'll benefit from the confirmation bias. If you deliver what they want, it's less likely that their sandcastle will get kicked over -- though still not unlikely.
Yep, and that something can drift over years, days, even minutes. I find code very conducive to hyperfocus, maybe more so than something like playing guitar - it's funny, because so much of coding can be mundane and repetitive, but that quality seems to help with getting started and finding a flow state.
I rarely hyperfocus on writing music or playing instruments anymore, but I used to zone out and play for hours. I'm not sure what changes in a person that makes that more difficult one day than the next.
Playing the same chords over and over again, making fewer and fewer mistakes, all while this song you used to love, you are now beginning to have serious doubts about.
Each time you try, just as you get close, they slide off one another and all around, until they stick at a different spot. Those sticky spots, are all the very stimulating tasks.
it makes it difficult to become good at things you naturally arent good at, once ive been knocked off my obsessive focus on something theres a solid chance ill likely never go back to it. at times i can become almost an expert at things in a very short space of time but as soon as something else takes my focus the new subject basically erases the previous one from my memory
medication has helped greatly but i think i may need to either get my dose adjusted or shift to an alternative medication as im starting to fall back into getting easily distracted again
crap i just noticed i spent so long reading and thinking about this that im now late for work, its this sort of thing that causes issues (and yet here i am wasting more time writing this!)
Poor executive functioning is why I could never make myself start writing a paper prior to the day or two before it was due, despite the rising sense of panic I would get for weeks. (This is key -- it's not laziness, because good lord did I wish I were able to do the work. To me, lazy ~= apathy, and what I felt was just about the polar opposite of apathy.)
Poor executive functioning is also why, unmedicated, it was sometimes difficult to not let my initial emotional reactions just come flying out. It was like there was an express lane between my limbic system and my action system, totally bypassing my ability to control it. I would find myself snapping out something and as it was coming out of my mouth, I would be kicking myself and thinking "Why in god's name am I saying this right now?"
Medication has helped with all of the above and more.
What I will say is that stimulants also can have a tendency to put some people on edge and increase sympathetic nervous system activity, so shorter temper could be a side effect for sure. If it's affecting you that strongly, maybe speak with your doctor about a slightly lower dose?
Or is there a possibility that you only became aware of your tendency to have a short temper once you became medicated? An interesting chicken/egg question; I'm just asking rhetorically, mind, because I have a lot of similar questions.
In regards to your comment about shortened temper on stimulants, I think this is very normal and expected, and I have experienced the same at times. I don't know how to explain it, but I think overall I'm more agreeable than I was before I was medicated. This might be an age thing; I honestly don't know. Maybe I just grew out of it (I was the kid who threw tantrums lol).
I, on the opposite end of the spectrum, would get strong symptoms of depression, and a constant feeling of nausea and lack of appetite to the point of being suspected of anorexia/bulimia by my physician. I tried a wide variety of medications throughout grade school and high school, and eventually gave up because they all gave me negative side effects of some kind.
However, one symptom of ADHD is something my therapist refers to as "explosiveness" which is a very sudden change from not angry to extremely angry and then often right back to not angry. Note that this can also be a symptom of bipolar, and misdiagnosis between the two is why they tend to screen for bipolar before prescribing ADHD meds.
This is not what I experienced on Vyvanse; rather my baseline level of "being annoyed at things" was much higher, so it was easier to make me angry.
That's interesting to hear about ADHD causing mood
swings/anger/irritability and the stimulants doing
away with them. Is that a common trait of the illness
The stimulants made me crankier and more high-strung.
However, sometimes it was a net improvement in my mood because I was getting my stuff done and therefore my stress level was lowered.
I use modafinil now which is less effective for the ADHD but also makes me less cranky.
This is not really a trait of the Inattentive-subtype. However, a person grows up:
- Being frequently told that they are a disappointment.
- Would have succeeded (at something they really cared about) if they'd actually cared.
- Being tuned out because they're talking in a way that seems scattered or boring to the listener.
Can develop an unhealthy relationship with anger.
That scans closer to my experience. I’ve been on Adderal for years, and when I started it I learned that I have the potential to get angry much quicker.
I sent the article to my girlfriend though and she'll read all of it and ask me questions about it so I can cleverly get a proxy summary. ADHD Lifehack!
I think that's the hardest part of ADHD, you'll always find some exceptions to the "rules" used to diagnose it.
I found that getting started and momentum going is my biggest challenge. Maintaining it for several days after was not as hard.
When writing to us... maybe just try bullet points.... Don't run past the page fold - or I'm out.
I'll admit, I skimmed it. But I bookmarked it!
How many bookmarks do you have left to read?
Yes, me too I didn't read all the article, as I skipped around parts in articles, books, and similar stuff.
For years when I would sit down to work I would go into an endless loop consisting of roughly three-four websites, almost back to back, where it was driven by muscle memory anytime something distracted me. I would almost like "wake up" finding myself in this endless loop.
On good days, I would look like an insanely talented and driven engineer, on bad days, I would look like the laziest piece of shit folks could know. It wasn't by choice, it wasn't because I was trying to "cowboy" or "rockstar" a single fucking thing, it's because that's how my attention span worked (or didn't rather).
"Smart and lazy" is almost an insult to me now, because its a moniker put on folks who are probably having trouble with something and "lazy" is rarely positive (even when its supposed to be). It kept me from believing I might have ADD for years despite tons of signs.
The downsides are of course that people don't believe you, or judge you for it (I switched pharmacies because they were treating my like shit when I would go to pickup my ADD meds)... but the upside, as the author said, is you have a life back you didn't know you were missing. You can choose to read a book, watch a movie, program, etc. you're not longer just forced into a vapid reflexivity of the world around you.
By lifestyle I don't mean some of the things enthusiasts like to advocate--weight training, etc, although by all means if you're so inclined. But just small stuff--kick caffeine, habituate yourself to completing boring tasks as quickly as possible, exercise (if only a few pushups in the morning), etc. Maybe you were already doing those things, but if you were doing them cyclically (weeks, months, etc), now you can do them consistently.
1. Weight change, either bulking on muscle or fat can change your optimal dose for medication... And it's my opinion (and totally just my opinion) that starting to treat ADHD usually leads to a weight gain, either by getting you more able to exercise or increasing your activity and caloric intake.
2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life.
Both of these are addressable though, in the first path any significant weight changes should be monitored by your doctor (go to your doctor regularly, blood pressure should be monitored while on stimulants) and ideally the medication adjusted up... for the latter, well, it's a pile of poo but if you're able to stick with it your doctor will likely take you on a tour of different methyl*s until you find one that works - then, try your damnedest to never let your insurance force you off of it.
Stimulant medications are strong appetite suppressants, and if not specifically paid attention to, the usual concern is weight loss.
To the point that an actual medically approved use of certain stimulants is for weight loss. You can in fact be prescribed meth (Desoxyn in the US when it's coming from a pharmacy and not the backseat of a 1996 Chevy Caprice) by your doctor for obesity if nothing else is working for you.
Speaking to personal anecdotes, while unmedicated there's always been a certain quantity of accidentally skipped meals, with medication I could go the day without eating much of anything and not be particularly bothered.
On the other hand, I'm better at sticking to structure with medication and eating at normal mealtimes more often, even without a hunger impulse. I do still wind up having to mentally (or otherwise) tally what I've eaten in the evening and sometimes shoveling in a pile of extra calories because it obviously wasn't enough.
So there are pulls in both directions, but IMO I'd say the weight loss is more likely to accidentally happen.
> 2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life.
The usual advice I've always been told is to not take it if there's times you don't need it. If I'm going out to have fun for the day on a weekend, or taking an unstructured vacation for a week or the like, I typically don't take it.
I don't think it fully resets those resistances, but it's allowed me to continue to get a noticeable benefit out of a steady, middle of the road prescription.
Best thing one can do is take chelated magnesium. Choline and fish oil help as well, but definitely take chelated magnesium every morning.
It helps prevent a tolerance build up (in turn helps prevent one from getting an increase in dosage) and helps replenishes the magnesium depleted from ADHD medication. Magnesium deficiencies are also common in those with ADHD who do not take medication. So if you're taking medication, the deficiency is caused by two sources.
Idk. I never gained much weight and ate a lot but the rilatin i take makes my appetite plummet completely. I eat a lot less during the day.
>"2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life."
I hope this won't be me. I think i am already largely resistant but i hope i can lose it and will try to go back to taking breaks.
In my experience, it's totally the opposite. More exercise, more activity, and less caloric intake... leading to weight loss.
Also most people can get away with generics so even without insurance the meds are cheap. The psych visits will cost $300-400 a pop though....
It's kind of a chicken or the egg situation, do people have ADHD and because they have ADHD they are more susceptible to gaming addiction? or do they become addicted to these sites/games which then creates ADHD type symptoms.
Not saying ADHD isn't an actual thing, but I've noticed a reoccurring theme where people who have ADHD also were addicted to gaming or the internet.
I discovered this guy who has a youtube/twitch channel who is a harvard psychologist who explained how gaming/dopamine releasing web products can have a negative impact on our reward system. How gaming and these addicting products can paralyze you and prevents you from changing behavior.
It's an interesting question, because as I browse comments on sites like reddit and it feels like everyone has ADHD, and these comments about ADHD have massive amounts of upvotes. Which is weird because ADHD isn't supposed to be common, it's supposed to be like ~5% of the population, yet it feels like most people have it on these sites
Here's the links to the guy:
People ADHD are definitely more likely to overindulge when it comes to gaming/internet usage (hyperfocusing). The reason is because it's stimulating. Sites like reddit is an endless influx of information.
Since I have ADHD it's a struggle to do anything that is boring. Sure most people can relate to that but the difference here is that my school/work/relationships have suffered greatly because of that and the other ADHD symptoms.
Some people who say they have ADHD probably don't but are suffering from something else (stress, depression, anxiety, etc.). It's a disorder that's over diagnosed because avoiding to do boring things, losing focus, and/or hyperactivity is pretty common (especially among youth).
Kids who are obsessed with gaming/internet usage might develop bad habits and behavioral issues but not necessarily something permanent. I seriously doubt it can cause ADHD. Traumatic brain injury would make more sense.
Perhaps to turn your comment on its head, people like my wife don't get much out of a place like Reddit so they don't visit it, while the ADHD crowd is constantly on there trying to up their dopamine levels.
Kind of like how constant sugar can spike insulin and with weight gain over time can creates insulin resistance/diabetes. It's like type 1 vs type 2. So in this analogy Type 1 people with ADHD would be people who are born with it and it's lifelong, and type 2 ADHD people acquire it after indulging in these dopamine producing addicting web products for years and your reward system/executive function is messed up, impacting daily life similar to people who are born with ADHD.
The best way I can put it, was the first time I got a pair of glasses, I didn't know how bad my vision was (I was like 12)... when I put them on for the first time, I was shocked, I was in disbelief, "this is how everyone else sees?"
Glasses are a tool to help you see better if your eyes don't work correctly, a "stimulant" is a tool to help your brain if you can't focus. The world, in both cases, I was missing, was one I had no idea existed until I had a tool to do so.
I would highly recommend see a doctor if the only thing holding you back is not wanting to do medicine. Mine was supportive and left the decision up to me. I went for around a year before starting and once I started I could def feel the difference -- it's not huge, but it's...a gentle nudge? If you find a doctor who isn't supportive of not using meds, find another doctor. It can be a bit like dating, where if something isn't working or priorities aren't aligned, then you move on.
Best of luck!
That said, stimulants at doses that affect ADHD don't necessarily to come with other physical side effects.
At first, I was given anti-depressants, because if you're very depressed sometimes things like starting/stopping projects is difficult (looks like ADD/ADHD). Also, most ADD medicine is heavily regulated; so, they pretty much put you through a gamut to make sure it's what's actually yer problem. At first this sort of felt like they weren't listening to me, but I do appreciate it now reflecting back (mostly because most health care professionals do want to help you, if you're in a bad place mentally though, it can be hard to realize).
I was at the time suffering pretty horrible depression due to a very bad couple of years; so, it made sense, and it helped my mood-- I didn't feel hopeless but it didn't really resolve my underlying stress of never being able to focus or finish anything (which was pretty deeply affecting me because I wanted to contribute more to my team, or rather more steadily).
After two or three months on anti-depressants, and checking in monthly, I was prescribed a pretty small dosage of Adderall; though, if my insurance was better for mental health I would have tried Vyvanse (I think is what its called). Since the dosage was low after about the first week or so, it would kind of wear off after like four hours... So, after the first month I asked to have it doubled and have been at that dosage since with no issues or complaints been about eight months now.
I've read and hear about a lot of people who sort of have enhanced ADD on drugs like Adderall and I haven't really experienced that at all, with the exception of a couple of days I was battling a lot of sadness. Which is why I think my mental healthcare provider did a really great job addressing it (my depression) first; so, that my ADD could actually be treated.
[1] It's really shitty to have mental health issues because almost everyone tells you to: try "diet X," that you have some bad habit, or that you don't do "Y or Z." If you had a physical injury though, no one is going to say "stop eating sugar to fix it." It's not that some diet, exercise , etc might be helpful, just like it would be to prevent a physical injury), sure... thanks hindsight-man.
By doing that what you're telling someone is: that their problems are completely within their control, that they are to blame, and it's their fault because they're choosing this for themselves. When in truth they cannot control it and should not feel blame or inadequacy for it.
Over the years to treat my ADD I tried:
1. Gluten free
2. Exercise
3. Keto
4. Smoking Weed
5. Not Smoking Weed (went a year without it, didn't help, actually made my ADD worse and I got fat(ter))
6. Vitamins of all fucking kinds
7. Cutting coffee/caffeine out
8. Steady sleep schedule
9. Various other weird "natural" shit too I'm sure
None of it helped but each thing on that list prolonged me from getting help [2].
[2] Having never suffered from that kind of depression before I can honestly say it was a heavy fog, that slowly rolled over my life, that was impossible for me to recognize until I was treated for it. If anyone else out there finds themselves angry or upset in ways that don't reflect who they feel they once were, get help, friend. Depression isn't just about being sad.
Imagine if there was a pill to reduce risk of cardiac arrest, with some increased risk of something relatively minor. Can you imagine the uproar if cardiologists denied prescribing the pill, instead forcing people to spend 30m a day running? Sure, it's "better" in some metrics to just run, but that's their choice to make. Doctors should be doctors, not moral guides.
Source: been there
It's kinda hilarious that, when going off Ritalin, things don't slow down (or become "less upped by the upper") they stop - this article touches on it but ADHD can feel the most torturous when it impedes even your leisure - especially when coupled with depression. Ever spent a day off staring at a wall dreading the possibility that you might waste a day until you realize the sun has gone down? Yup, so much fun.
This is literally every Saturday for me. I'm thinking about keeping my Ritalin by my bed. I don't understand why it's so difficult and it makes me really frustrated - I just can't get out of bed. I try to wake up and my mind goes "naw". I sit up to get out of bed, sit there for 40 minutes, and still can't get myself to get out of bed. Stare at my Pillow, some reddit posts, another 45 minutes are gone.
Now it's 2pm, I've wasted half the day. My depression tells me it's because I'm a lazy piece of shizzle.
Source: Diagnosed with ADD/Aspergers/Depression/Anxiety... Horaay :(
It’s an extended release methylphenidate that you take at night time, and 12ish hours later it actually takes effect.
One thing that always goes through my head is just feeling like society is made for a model of human that just isn't me. There's a society out there that would suit me great, but I missed the boat on that. It was probably in the distant past before things got big, noisy, and complicated.
>Ever spent a day off staring at a wall dreading the possibility that you might waste a day until you realize the sun has gone down?
That sounds silly and boring. I was daydreaming instead of looking at the wall.
Literally experiencing this right now while getting a degree in software engineering. Got diagnosed during my first year with AD(H)D and I'm currently in my fourth, final year. Looking back at things I have no clue how I even managed to pass the harder subjects/courses. All I remember is I took my meds and studied about 12 hours a day 3 weeks straight during the hardest parts.
Before I had never studied more than 2 hours a day and I would start only about 5 - 8 days before a test.
I often wonder if I could work at a software company without my medicine because of this and it actually worries me.
"either your performance, judged by coworkers, will be equivalent or below theirs and the stimulant is seen as the only thing keeping you in your job (which can get super depressing internally) - or, if you're doing well in your position, it can breed internal and external doubt as to whether your performance would just be normal and is being boosted by the caffeine."
the difference between them lies only in the degree of effectiveness. I dream that within my lifetime uppers will be as de stigmatized as weed.
No. Just don't entertain this idea. You can go 20 years since the first time someone told you you may be ADHD or depressed with subsequent diagnoses. Then tell yourself it's all in behavior no one needs drugs. But twenty years on you'll still find yourself in the same cyclical patterns of periodic depression or chronic inability to select your attention to a task. "Lifestyle changes" could help with the right crutch. But if you need Ritalin or another drug to learn those lifestyle changes so be it.
In your (not quite perfect) comparison. It's as if the pill will reduce cardiac arrest and improve peoples aptitude to learn to run for 30 minutes daily.
There are about a dozen factors with a positive correlation with each other, but they are not links in a causal chain. One does not simply "fix" them, they all have feedback on one another.
The knowledge of how they are related helps, but does not fix.
If anyone argued that stimulants are bad for my health, I could only point out that without them, my health suffers acutely through sheer neglect and it's a downward spiral.
(Some?) Antihypertensive drugs can contribute to harm to the liver. They're unlikely to cause anything on their own, but if your liver is already not the healthiest it can make things worse.
>Yes, I get that "lifestyle changes" could help, but I don't want to change my lifestyle.
As far as I've read about ADHD, nothing comes close to the effect that medication has in treating the issue.
As a diagnosed sufferer of ADHD, my experience is that Adderall works better than Ritalin, but the extended release stuff shortens my temper. If I'm still having a bad day, an energy drink can help.
On boredom: I can be bored, but lack the drive to do anything to make me less bored. When I'm having fun, it is difficult to switch to the next thing I need to do.
I am just a bit of a psych meds skeptic these days - I don't think the comparison to drugs like insulin carry as much weight as their advocates would like them to. For one thing, there's no brain scans or blood tests for any of these diagnoses. The diagnosis criteria is basically a "personality test", called the DSM-5, a manual heavily influenced by the pharmaceutical companies. Stimulants at least do in fact have research supporting they actually outperform placebo (unlike the massively prescribed antidepressants), but they come with a host of negative side effects.
If you're predisposed to mania, you shouldn't take stimulants. If you're predisposed to heart problems, you shouldn't take stimulants. My question is, how was I supposed to know that I was predisposed to these things short of finding out the hard way by taking the stimulants and having those negative side effects almost ruin my life/kill me?
Previously, on HN people have accused me of "doing it wrong" in some sense with the ADHD meds, but the truth is I got the diagnosis from the doctor and took the meds as prescribed.
The whole idea that we can neatly categorize this person as ADHD, this person as MDD, this person as Bipolar-2, this other person as bipolar-1, this other person as BPD, after doing a ton of investigating into mental health, I just no longer buy it.
I do think the answer is in lifestyle changes, the person who is at risk of cardiac arrest, yes they should exercise for 30 min a day and reduce sodium intake before relying on a pill if that pill carries with it a ton of other dangerous side effects.
I also agree with that other commentor, that our society, and my past self, is a bit obsessed with "success" metrics, usually judged by things like career success. The idea that, maybe if you just accept that your career won't be what it could be but that's better than drugging yourself up to achieve those goals, seem foreign to some people. Becoming "somebody" important becomes more important than just being stable and healthy.
Well, if you find yourself in my position, where you get diagnosed with heart failure and learn that ~50% of people in your position die within 5 years of diagnosis, all the sudden that big N promotion doesn't seem as important anymore. And the drugs that help you get there don't seem as worth it. So nowadays my mind still wanders constantly, my wife gets frustrated by how often I start day-dreaming mid-conversation with her, and I know that intellectually I'm capable of more career success but I'm held back primarily by my lack of focus and discipline. But I've come to just accept all that, being on stimulants to fix it, is not worth the downsides.
Most conditions improve when the metabolism is normalized. B-vitamins are pro-metabolic.
Sometimes doctors do good work. My girlfriend's doctors eventually figured out that she is a poor methylator, and can't convert folic acid into folate (Vitamin B-9). She therefore absolutely requires a dietary source of Folate, instead of the folic acid that is used to fortify many foods. She said this vitamin was profoundly helpful for her complaint of "depression".
Sometimes doctors make work for themselves. Using Stimulants to treat metabolic problems is an exercise in futility.
This is something I myself have struggled with. I suffer from anxiety but I can't bring myself to take medication because I like the person I am and I don't want to change my behavior or personality.
No one should be stopping you from taking Ritalin, but each of us is entitled to our own opinion, so the only thing that is irritating is when someone calls out an opinion another holds even if that opinion has no tangible effect on anyone's life.
ADHD is an extremely harmful condition. You are more likely to end up in jail, crash a car, suffer from diabetes, smoke etc. than neurotypical people. 9 to 13 years in life expectancy, I mean, wowzah.
And opinions held in society or groups obviously have an effect on individuals. That's how social systems work.
I do not now. I used to -- I had a fairly major crisis of identity after my diagnosis, because a very large chunk of what I considered to be my personality turned out to be ADHD symptoms. I literally had to refind myself.
But it turned out very well, because now I define myself based upon what my actual qualities are, rather than defining myself based on symptoms of a disorder. I no longer feel like everything about who I am changed after meds; I'm still the same person I was ten years ago, I'm just now more easily able to express that self without ADHD getting in the way.
Also, in almost all cases, the "new qualities" are better than the old ones. Whereas before, "I just can't finish things" was unfortunately something I considered to be part of me, now I am able to finish things mostly the same as neurotypical people. That leaves me free to define myself based on positive qualities -- good humor, optimism, and so on.
The thing is, it became much easier for me to feel okay about taking medicine when I realized that the goal of medicine is simply to bring me back to a "normal" level. I had been operating at a deficiency of certain neurotransmitters; the medication simply brings those levels closer to normal. Once I had adopted a more biochemical perspective on my brain and identity, my initial reluctance disappeared.
A side effect of this is that I kind of no longer believe personality is fixed. I really don't find that the things we tend to call 'personality' are the sort of permanent identifying landmarks to a person we want them to be. Now I've adopted a view that puts a much stronger emphasis on the actions a person chooses to take, which I think is a better way to identify a person's qualities anyways.
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I would hesitate though with ADHD in particular, because untreated ADHD reduces your lifespan in a statistically significant way, is literal hell to live through, and the treatments are perfectly safe and extremely effective. If someone has a child who is diagnosed with ADHD, I would beg them to not let their personal prejudices against medicine keep them from getting the child the help they need. As someone who lived through it as a kid, it was physically torture. The word "restlessness" sounds benign, but I find it to be quite similar to akathisia on bad days, which is really horrific.
I cannot think of a medication that doesn't in some way affect your psychological profile, because if you're sick then you'll behave differently.
I think it's a bit of a trap to believe that you are your authentic self only by denying yourself medication, I consider myself from 5 years ago a different person let alone pre-medication. Is it that valuable that you struggle and live unhappy for the limited years you have available?
There, that's my terrible analogy.
1. There's a flip side, staying with the marsh analogy, there are also some dykes someone built randomly in the marsh and it's really easy to run along those, and they're really comfortable... but they might not go to the far side of the marsh - but hey it's right over there and it'd be easy to get over there instead of trying to trudge through the marsh. Running on those dykes feels really good since you're definitely running, but you don't get to chose where the dyke goes and it might not be helpful for yourself to run along it.
Ritalin functions as a DRI (Dopamine reuptake inhibitor).
One of the theories is that ADHD could be a lack of Dopamine.
The biggest thing I realized is how tightening feedback loops is the key to my productivity, I gravitated towards python because it's interpreted nature meant I could get feedback on my code in 20 seconds max as opposed to 3-5 minutes waiting for my code to build.
Adderall is a help but is not a cure all, it took me months to learn how to use it right, at first Adderall just fueled my ADHD and made everything worse. It's a constant struggle and maladaptive perfectionism is still the one thing I struggle with the most. I can't count the times of I've completed reverted my git sandbox to start from scratch after reaching a certain frustration level with code.
Also, your comment on python ... very very true
Don't feel trapped into one option that isn't working for you.
I believe this is NOT causative, but is instead a correlation between other diseases associated with Dopamine production and ADHD. I take and have continued to take stimulants for ADHD.
https://www.nature.com/articles/s41386-018-0207-5
In my family's case, we likely have something called Dopa Responsive Dystonia (DRD), and what the author is describing sounds to me like what I experienced prior to being diagnosed with ADHD, and later with DRD.
Having said that, I'm not a doctor, so please go see an experienced movement disorder specialist if you are reading this and have any concerns.
DRD is very hard to diagnose, but easy to treat. Because the stimulants (Adderall and Ritalin) made the DRD symptoms worse, my mother happened to get early onset Parkinson's, and my grandmother also responded to carbodopa/levodopa (carbo/levo), it was fairly obvious in retrospect, but if we didn't have a family member with early onset Parkinson's I doubt it would have been picked up.
https://en.wikipedia.org/wiki/Dopamine-responsive_dystonia
My sense is that anyone with ADHD who uses stimulants should see an experienced movement disorder neurologist or few about basal ganglia and cerebellum diseases and try out medications based on their assessment. From personal experience, it became extremely clear I had DRD after taking carbo/levo, but there's no way I would have really known without trying it. It also helps with some of the stimulant side effects, which I still continue to take because they are very effective.
My family has seen maybe six neurologists total, and only one really knew about DRD. The Dystonia Foundation has a decent doctor locator.
https://dystonia-foundation.org/living-dystonia/find-a-docto...
Please, don't read comments like these and distance yourself from treatment. There is always more to a study.
Source: Board-certified neurologist.
Am I trading my future brain function for quality of life improvements in the current?
The thought of irreversibly damaging my dopamine transport system later on in life feels like I am making a deal with the devil every time I take a dose of stimulants to correct my dopamine imbalance and cognitive deficits to feel neurotypical for a fleeting period of time soon after ingestion.
Any link to hemorrhagic stroke later in life as well? Thanks for you time.
Thoughts on any neuroprotective measures I can take now like memantine or bromocriptine(sp?)?
But ironically it helps me even enough as a cure on it's own. I no longer take or need stimulants.
On the flip side, getting treatment for those disorders, provided you have one of them, can also help with some of the ADHD symptoms.
The genetic defects associated with this are I believe a spectrum though, and we happen to be close to one side of it. If you have any symptoms related to DRD, I would see a movement disorder specialist and ask for a trial of carbo/levo. It'll be immediately obvious if it helps, and if you don't have any problems with Dopamine production it won't do anything (except for some mild side effects).
It should be noted though that the study authors were pretty clear that the correlation is unclear given that untreated ADHD sufferers had a 2.5-fold increase in the same diseases.
> Researchers postulated that the association between psychostimulant use and BG&C diseases may be a result of a more severe ADHD phenotype, rather than a direct pharmacological effect.
https://scientonline.org/open-access/dystonia-and-its-treatm...
Neurodevelopmental Disorders (Autism, ADHD, Delayed Speech/language, dyspraxia)
>"hyper mobile joints are an uncommon finding in those who do not have attention deficit disorder/attention deficit hyperactivity disorder."
>Differences in the structural integrity of temporal and parietal cortices may underlie wider behavioural phenotypical expression of hypermobility: abnormalities in superior temporal cortex are also seen in autism.11 Inferior parietal cortex can affect proprioceptive awareness and hypermobility is itself linked to dyspraxia.1 Our findings suggest that processes compromising function in neuro-developmental conditions may occur in individuals with hypermobility, putatively enhancing vulnerability to stress and anxiety.
Autism, Joint Hypermobility-Related Disorders and Pain
ASD and HRDs, specially hEDS, are conditions with a strong genetic component, a polymorphic clinical presentation, appearing both in infancy, and sharing several phenotypical features (35). Although existing data does not allow to ascertain increase prevalence of ASD in HRDs, as well as shared underlying patho-mechanisms between both conditions, there is increasing evidence suggesting that these co-occur more often than expected by chance. This requires be confirmed by further investigation which should consider the recent nosological changes both in EDS and the hypermobility spectrum disorders [see (17, 38)], and in ASD (72). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292952
Joint hypermobility and the heritable disorders of connective tissue: clinical and empirical evidence of links with psychiatry
- In 1988, Hofman et al.[58], in a sample of 30 children with MFS,observed that 17% had attention deficit disorder with or without hyperactivity. A decade later, Harris[59] stated, based on his clinical experience with 200 patients with ADHD, that "hyper mobile joints are an uncommon finding in those who do not have attention deficit disorder/attention deficit hyperactivity disorder."
In Sweden,Hollertz[60,61] also pointed out the frequent co-occurrence of ADHD and JH in adults patients. He observed that an orientation to orthopedic and rehabilitation care was common in these patients due to joint problems. Thus, this author speculates about a possible genetic marker com-mon to ADHD and EDS.
Recently, Koldas Dogan et al.[62]explored JH using the Beighton score in 54 children with ADHD compared to 36healthy controls. In this study, JH was significantly more frequentamong patients than among controls (31.5% vs. 13.9%). In accor-dance with these results,
Shiari et al.[63]also found a higher prev-alence of JH, assessed with the same method of the previous study,among Iranian children with ADHD compared to controls (74.4%vs. 12.8%), confirming an association between ADHD and abnormal collagen conditions.
JOINT HYPERMOBILITY AND AUTONOMIC HYPERACTIVITY: RELEVANCE TO NEURODEVELOPMENTAL DISORDERS
> It is likely that the importance of hypermobility and autonomic dysfunction to the generation and maintenance of psychopathology in neurodevelopmental disorders is poorly appreciated. Work underway(autonomic testing, fMRI) will test the hypothesis that autonomic reactivity and interoceptive sensitivity predispose to the expression of psychiatric symptoms, particularly anxiety
- We demonstrate for the first time that rates of hypermobility and symptoms of autonomic dysfunction are particularly high in adults with neurodevelopmental diagnoses. It is likely that the importance of hypermobility and autonomic dysfunction to the generation and maintenance of psychopathology in neurodevelopmental disorders is poorly appreciated. Work underway(autonomic testing, fMRI) will test the hypothesis that autonomic reactivity and interoceptive sensitivity predispose to the expression of psychiatric symptoms, particularly anxiety. It is further hypothesized that inefficient neural co-ordination of efferent autonomic drive with imprecise interoceptive representations may be amplified in hypermobile individuals. In hypermobility, this mechanism might explain increased vulnerability to stress sensitive and developmental neuropsychiatric conditions. - https://jnnp.bmj.com/content/85/8/e3.40?utm_source=trendmd&u...
[Searching for a biological marker common for both ADHD and EDS].
- https://www.ncbi.nlm.nih.gov/pubmed/22468413 - speculated about a common biological base shared by ADHD and EDS after observing the frequent cooccurrence of both pathologies in a clinical setting.
Connective tissue problems and attention deficit and hyperactivity
Attachments - [ADHDBaeza-Velascoetal.2015.pdf](https://checkvist-prod-uploads.s3.amazonaws.com/u/OKFCuEQ7Zl...)
- To the Editor, The heritable disorders of the connective tissue are a group of genetic disorders affecting connective tissue matrix proteins that classically include Marfan syndrome (MFS), Ehlers–Danlos Syndrome (EDS), benign joint hypermobility syndrome and osteogenesis imperfecta (Grahame 2000). As connective tissue is found throughout the body, the clinical manifestations of these disorders are varied, including disturbances in different systems (skeletal, ocular, cardiovascular, etc.). A common feature of the heritable disorders of the connective tissue is joint hypermobility (JH), which is a highly heritable condition characterized by an increased range of motion of the joints as a consequence of connective tissue involvement.We encountered a 7-year-old boy addressed by teachers due to school problems. His mother suffer from MFS such as his maternal grandmother who died by cardiac complications. Considering familial antecedents, his morphotype (long bone overgrowth), JH and ocular ...
A connective tissue disorder may underlie ESSENCE problems in childhood
Attachments - [1-s2.0-S0891422216302402-main.pdf](https://checkvist-prod-uploads.s3.amazonaws.com/u/aghis3LMNv...)
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Attachments - [Screenshot_2019-06-27_at_16.53.23.png](https://checkvist-prod-uploads.s3.amazonaws.com/u/dm7JuPP8Gq...)
Attention-deficit/hyperactivity disorder, joint hypermobility-related disorders and pain: expanding body-mind connections to the developmental age.
>Recent research seems to indicate a degree of co-occurrence of JHS/hEDS and some neuro-developmental disorders including attention-deficit/hyperactivity disorders (ADHD) and developmental coordination disorder (DCD). In the area of ADHD, researchers found that adults with ADHD had higher rates of JH and problems with automatic control of body functions (dysautonomia) compared to healthy controls. Other researchers observed high co-occurrence of JH or EDS with ADHD. Concerning DCD, children with DCD have more symptoms associated with JHS/hEDS compared to typically developing children. The relationship between JH and DCD may be due to poor positional sensing in affected children.
- https://www.ncbi.nlm.nih.gov/pubmed/29446032
A Cohort Study Comparing Women with Autism Spectrum Disorder with and without Generalized Joint Hypermobility
- This research supports a growing body of literature indicating that immune-mediated disorders are a common comorbid feature in hEDS and GJH. In addition, we have also shown that this dysfunction may be paired with endocrine dysregulation, leading to complex immune and hormonal exophenotypes, such as autoimmune disorders, allergic rhinitis, asthma, endometriosis, and dysmenorrhea. While we have not addressed autism and GJH comorbidity rates in this study, their co-occurrence in the adult ASD female population suggests links between the dysfunction of connective tissue and the immune and endocrine systems in this subpopulation. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867488/
Rationale for Dietary Antioxidant Treatment of ADHD [[MDPI - 2018](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946190/)]
>ADHD might thus be a (non) allergic hypersensitivity disorder caused by an environmental trigger, based on a non-IgE dependent histamine release from mast cells and basophilic granulocytes, since the histamine H3 receptor is involved in hyperactivity and promotes dopamine release in the frontal cortex. Moreover, polymorphisms in the histamine N-methyl transferase (HNMT) gene, impairing histamine clearance, were found to affect the behavioral responses to food additives, which increase histamine levels #ADHD
It is extremely difficult for someone with ADHD to change their diet. It's difficult even for neurotypical people. I know that it and exercise are obviously beneficial, but from experience there's a "loss" in that trying and failing consistently to improve my lifestyle really takes its toll on my motivation and self-esteem. Not to say that I'm not still trying... but it's hard.
I'll do this when I find myself slipping, too.
In my case, I got some rather severe digestive issues similar to IBS that turned out to be similar to what vegetarians get after several years if they don't watch their nutrients and vitamins. I spent 2 years battling it without knowing what was causing it. After days of conversations with some very smart friends, one of them suggested a connection between tryptophan and serotonin (which is made from it in the gut).
Long story short, I started eating pork again (mainly bacon) after avoiding it for 20 years due to ethical concerns, and my digestive issues cleared up in a matter of days. My acne went away and my mood stabilized almost overnight. It was one of the most miraculous things I've experienced in many years. I also added psyllium husk fiber with meals 1-3 times a day and have maintained proper digestive function for several months now.
Some things that really help me are zinc gluconate for immune function and recovery from exercise 1-7 times per week (too much will make you feel bad, a headache in my case), omega 3 capsules and glucosamine/chondroitin (which is for joint health but the mechanism likely happens through the gut as well). I also eat 2-4 whole eggs per day based on how hard I'm hitting the gym. My feeling is that the lack of fat in our diet from the 1980s till today has really wrecked most people's metabolisms and they are simultaneously frantically starving, fat from eating too much, and chronically malnourished.
It would be interesting to hear the author's thoughts on this, and on alcohol.
EDIT: ...and on exercise.
That's one of the advantages of the prescribed stimulants; they're effective at doses that have no physical side effects.
When I eat regular meals I'm _constantly_ hungry and my focus goes to total shit. I tend to have to manage my weight because even when I expressly try not to, I eat too much. It's weird. I also eat worse food. It seems to be a vicious cycle.
I switched my diet from a high carb to high protein, high fat. Instead of a bagel for breakfast, I'll eat a couple eggs, a breakfast meat, and every once in a while a piece of toast. Tons of whole fresh fruit all day. Lunch is similar: think a chipotle style meal with a base of protein and rice and some light veggies. More fruit and raw vegetables and nuts for snacks. Dinner is the same thing - protein base but fewer carbs and more veggies. I'll have some candy in the evening from time to time.
I also started lifting weights 3x a week. I love it cause it's the most efficient way for me to exercise - I spend 60-120 minutes in the gym three times and work my whole body. Heavy squats, deadlifts and presses - strengthens the back and hips, makes sitting in a chair much easier, and is a really great vector for activating that hyperfocus we love so much. I read a book called Starting Strength that basically gave me all the info I needed to get started.
Since starting this routine about 8 or 9 years ago, I find I'm sleeping better, my focus is way better, I'm much more pleasant to be around socially, I'm way less impulsive and interruptive, I make fewer stupid rash decisions, and I'm generally in a better, chipper mood a lot more.
Edit: Might add: I drink coffee like it's going out of style and don't find that caffeine really affects my focus all that much - more my energy levels. They're similar but on different axes.
After just a day or two I experienced very unusual (for me) clarity. I googled and apparently it can help ADHD symptoms.
I definitely ate enough meat and various other things, so I'm not sure what the supplements did or if they're a placebo. Perhaps I just process iron poorly and need a big hit at once.
That said, it's always possible that an intervention works well in a subgroup of high-responders (this can be true even if the particular intervention is a placebo, not that that's necessarily the explanation here), so everyone saying it works for them should probably keep it up.
For example: https://www.ncbi.nlm.nih.gov/pubmed/23495677
This particular study found that phospholipid improves ADHD symptoms in children (4-14 yo).
There's some ongoing research about the neurotransmitters related to ADHD: https://psychcentral.com/lib/neurotransmitters-involved-in-a...
However, I don't know if any comprehensive studies have been conducted about the effects of diet to ADHD, it could be tricky to study that.
I find that it’s very much worth the time investment, and would recommend anyone struggling with focus/anxiety to try it themselves.
My personal hypothesis is that the inherent expectation of wanting/needing to feel some kind of effect every time I tried meditating ended up being the very blockade that prevented me from doing so. I kept falling into a negative recursive thought loop of, “I haven’t noticed anything yet. This isn’t working. There’s no point in trying to continue meditating” that cycled into a cascading growth of anxiety that prevented me from reaching a state of balance.
It took me many months to realize that I was trapping myself inside this loop, but once I became aware of it, I was able to almost immediately start seeing results. The biggest thing that helped me was coming to a realization that the thoughts in my head are, at the end of the day, just thoughts. They have no ability to harm or control me other than what I choose to allow them to. The thought loop I was putting myself into could only continue because I chose to let it.
When I meditate in the present day, you might think that I no longer deal with any of these issues. That’s actually completely not the case. In fact, I constantly still get it, especially at the beginning of my sessions, but now instead of stressing out, I just choose to let it go. By actively choosing to accept and let things go, the loop breaks right from the beginning.
Instead of trying to magically concentrate perfectly, I focused on identifying when my focus would move to something else. I noticed meditation is a practice of becoming quicker at identifying when I would lose focus, giving me the choice to come back to focus.
After a couple of months of meditating I was able to go off of adhd medication. Then maybe a half a year later I noticed my concentration was above average and had been for a while.
Meditation does work well on ADHD, but you have to be willing to take a break from your day to day worries, giving a mini vacation away from mental work. It's quite enjoyable.
I get obsessive about things, so I tried to use those obsessions to shape a regular routine that helped everything else fall into place. I focused my obsession on exercise, specifically jiu-jitsu, because once I got to class, I didn't have to think or motivate myself, I was just there and focused on learning and fighting. Then it turned into a positive feedback loop, I'd get external validation from my teammates, I was improving, I was doing it in the morning, so I absolutely had to get out of bed, and of course after class, I had nowhere else to go but work. So that fixed my habitually late problem as well. Being 10 minutes late to class was fine as long as I was on time for work. Then I could ride that dopamine rush to have a productive morning.
Then life happened, my routines where interrupted, and I haven't been able to get it back.
Take five to fifteen minutes. Focus your attention on, and notice your breathing. You will immediately become distracted. Notice thoughts as they arise, and attempt to return your attention to your breathing. Repeat as necessary or desired.
The subjective experience of this loop changes the more practice you get. You haven't failed if you can't reach a steady-state. You're already in steady-state of yourselfness.
Attempts at meditation immediately becomes rumination, where I play through all the conversations I could possibly have in the coming day (and exploring the worst case scenarios), which leads to elevated stress, which makes the ADHD tendencies worse.
For example, try this: Sit down in a mildly uncomfortable position and close your eyes. Take slow deep breaths, focusing entirely on your breath. Count each breath. If your focus wanes at all from that task, stop counting and see how high you got. When I first start this exercise, it's pretty common for me to not even be able to hit 5. But after 6-7 days of this I can usually get up to the 45-60 range.
It’s about training yourself to become better at 1) noticing you’re distracted and 2) bringing yourself back into focus. It’s pretty much muscle training except for your brain, specifically on improving executive functioning.
Very little of meditation actually follows the “pure zen enlightenment” that’s commonly associated with it. Of course sometimes I do get a few minutes of that close to the end of my meditating sessions, but it’s not my main priority when I meditate and the majority of the benefits really come from the portions where I’m getting distracted and working on improving my ability to get back to focus.
Oddly I get the bit about sleep deprivation. It can be oddly effective. I also sometimes do more effective work when I have a cold/flu as well.
Ugh, this. So many lost days, weeks, months to ADHD. Just trying to keep up. Can't focus for a day? There goes the weekend. Shame, fear of losing my job, fear of work piling up - all of it. I have to make up for it at some point.
The answer was "No". His response was "well, then what's the problem?"
The longer answer from me should have been "no, but keeping up appearances requires Herculian effort, and I pay a tremendous emotional and personal cost, I am distant from my wife and 2 kids, and at night time, the anxiety is enough to materialize a cold ball of steel in the pit of stomach".
I managed to get a diagnosis anyway, and my psychiatrist got me started on Ritalin, and then onto Concerta (I take Vyvanse now). The difference was like flipping a switch. My work output improved out of sight, I stopped being a zombie at night time because I didn't have to go through a cycle of wake up -> work -> burnout -> sleep -> recover every day, and I'm earning more than twice what I was at the time of my diagnosis, and I don't think any of that would have been possible if I'd remained in the same situation.
What I've learned over the years is that the problems associated with ADHD don't "go away" with medication, they just become more manageable, and knowing how my brain works both on and off medication has been TREMENDOUS tool for increasing self-awareness and understanding that the anxiety/procrastination/apathy etc is a function of neurochemistry, and not a harbinger of doom or destruction.
Keep pushing to at least get a trial run with the medication and seeing if it helps you. Also if your doctor is seriously ignoring your concerns, consider looking for a better doctor. People often place way too much confidence in their doctors and stick with crappy doctors who don't make efforts to resolve their patients concerns.
Best of luck finding something that helps you get away from those coping mechanisms.
Note: This post is a little rambly since I am typing this up while doing something else but I felt the need to comment.
It does seem to me that ADHD is over-diagnosed for kids, especially since the condition as described in the article really looks like what a small child seem to experience (the inability to focus, the constant distraction, etc.). And because it is much less rare to see someone in their 20s saying they have ADHD than to see some parent saying their kid has it. It is convenient for a parent to think that their kid has ADHD to explain why the kid is "late".
Here the problem really is about "lateness". Children grow up at different paces, and if a 6-year-old boy behaves like an "average" 4-year-old, people will think he has ADHD, while his brain might just need more time to develop.
There are kids who finish high school before hitting 10. Do we diagnose them with anything? Like Attention Surplus Disorder? No, because it doesn't seem to induce any trouble.
The ADHD as described in the article sounds like a nightmare to be honest, and I really wish scientists find some way to help these people.
- Poor academic performance
- Hyperactivity
- Poor social skills (gets in trouble, fighting, etc.)
Then they're most likely gonna get recommended to ADHD evaluation. But as you might guess, a lot of kids suffer from those things without necessarily having ADHD.
Some kids, like myself, mellowed out, and lost pretty much all the traits other than those of ADD. But I did just well enough in school - despite putting zero effort into it - that I flew under the radar.
Teachers figured I was just too busy fooling around / lazy / uninterested in some topics, while my parents argued that I was too hung up in sports / gaming / playing instruments.
And unfortunately, by the time you're a teenager, you only have one idea of what ADHD looks like: It's the troubled kids in class that got diagnosed early on, and can't cope in school; The "academic losers", as they are unfortunately branded.
In fact, that's the reason I didn't get diagnosed until my late 20's. My ex-gf hinted to me that I scored very high on ADHD / ADD checklist, but no way I thought, the only people I know with ADHD are those that never graduated from HS, and now are either criminals or minimum-wage workers.
Well, got myself evaluated, and sure enough, ADD. It was a thorough process, and took a LONG time.
Back in the 60s or 70s ( I can’t remember what he said) people were starting to notice that kids were having behavioral problems, trouble focusing etc.
So what they did was collect a group of symptoms, and then arbitrarily said “if the child has 6 out of 11 of these symptoms then they have ADHD.”
The reason why they chose 6 was because if they chose 5 then too little number of children would get diagnosed, and if they chose 7, then too many children would get diagnosed. Having 6 would mean that 7-10% of kids would get diagnosed which “looked right” so they chose 7.
It’s not a real disease like other diseases, it’s a collection of symptoms. Which is why kids get misdiagnosed all the time. Anxiety can produce ADHD-like symptoms. Other things like giftedness and boredom can also fry diagnosed as ADHD.
There really are children with focus issues where medication like adderall will absolutely help. It will make kids with anxiety worse though so a misdiagnosis will ruin lives. But the origins of where ADHD came from explains why there is so many issues with ADHD disgnoses.
Any disease with "syndrome" in its name is just a collection of symptoms. That's literally what syndrome means. Your information about ADHD is offensively wrong, and its underdiagnosis and undertreatment due to misinformation ruins far more lives than than there are people with anxiety being mistakenly prescribed stimulants.
Downs syndrome as a counter example has a known messurabe causal model.
It is truth, regardless if it is offensive or not. Regardless of your interpretation.
I guess where it becomes a problem is when we try to find the most suitable treatment for it. I know from experience that these labels can dictate the whole treatment plan in public hospitals/clinics without much further investigation whether that label's approved standard treatment plan really is suitable for your particular case or not.
Stop it.
If you're on the flipside and benefit from the drug prescriptions: good for you. I think if it were more generally acknowledged that there can be sub-clinical or contextual forms of ADHD my life would benefit.
In the US there is a larger percentage of the population who are diagnosed than in other countries, but even there, adult ADHD is under diagnosed.
There are a core set of people who definitely have brains that are different and need medication etc.But the way it is currently diagnosed lumps too many people and makes it useless to call all people with ADHD the same.
My son with Generalized Anxiety Disorder was diagnosed with severe ADHD. This is the problem because many things can cause the same set of behaviors so a diagnosis of ADHD is not accurate enough.
But not diagnosing anything would also not resolve the problem for the patient, if there really are specific symptoms.
Then kids not paying attention in school, maybe it's boring or they feel it's useless to them so forcing them to do what they don't want, instead of tailoring their education instead it's one size fit's all. Plus teachers recommend getting kids checked, because then you are labeled as disabled and the school gets extra funding to go into the teachers pension program.
There's someone I know who was told their kid didn't have ADHD, so shopped around and went to another doctor, and then eventually went to another doctor. Kinda like the whole antibiotics resistance thing, people expect if they have a cold that the doctor will give them pills even if it isn't going to really help. Seems like doctors in general just love drugging people, instead of fixing a symptom at the root of the cause drug them and then drug them more for the side effects to cover them up. It'd be like taking your car to the mechanic for a check engine light, and instead of checking the OBD codes and stuff they just unplug the check engine light.
I think a lot of psychiatry is just a form of massive insurance fraud, there's a nonprofit organization that makes documentaries called CCHR. However CCHR is founded by the church of scientology which I know many not a fan of but I think they have some good information. I really wish CCHR would disconnect it self from scientology so it could stand on it's own as I really like their message, but I feel a bit of a conflict since it's related to scientology which is an entire topic on it's own, I guess you have to pay thousands just to level up and all these other horror stories about scientology.
I think drugging children is also a form child abuse, and destroying childhood creativity. Probably if they pushed this stuff when Albert Einstein, Steve Jobs or other successful startup founders were children, who knows if they'd be as successful as they ended up being. One of the pills pushed ended up making males grow large breasts too. Then there's reports another drug can cause brain damage too along with heart conditions(which usually you think it happens in older people but young people can have heart attacks too on this crap). They even want to drug 3 and 5 year olds too. If I was in power, I'd have these drug makers and so called doctors imprisoned for life. Also diet and exercise some believe also helps, add these GMOs and other chemicals in the food, artificial sweeteners can mess with dopamine receptors, etc. So I think I see the larger picture, but many just want a pill and then go back to watching TV or smoking instead of trying to improve their families healthy lifestyle. Kinda like how parents don't even try to teach their children, they just send them to school. Lazy parenting is also part of the problem.
But I guess not a one solution fits all, some people say the pills and stuff helped them. I think counselors could be valuable too, maybe even help you see things from another prospective but some insurance companies won't pay for a counselor unless you also are on drugs. Some people don't even feel like anyone cares about them either, so I think having someone to listen and who seems on your side with issues is also a positive, but I know some counselors want to record your sessions so I find that kinda creepy also as feels less private so you could be less open about things.
Another interesting thing to consider is that a lot of psychological disorders are culture bound (and therefor in my humble opinion irrelevant as groupings even for psychiatric purposes).
Unscientific personal observation, but I wonder if TV has a role in this. Didn't kids start watching a lot of TV around that time?
Also, I feel kids in poor countries with no TV (not that there's much of that left now) have little to no ADHD.
The hardest part of the test for me was to stop pushing the button when it told me to. It's hard to describe how difficult that was for me. By the end I distinctly recall the familiar sense I had in school of feeling dumb, inadequate, and frustrated.
In the T.O.V.A. results I was normal range for Inattention and Reaction Time. My Inconsistency was 75/100 but the shocker was my Impulsivity. My commission errors put me at 52/100, what the psychologist said was more or less a mentally retarded range.
On 10mg of Adderall, I retook T.O.V.A. and scored normal ranges across the board.
That helped me better understand why I was a class clown underachiever who barely graduated.
I cried the first time I studied a tech manual on Adderall. It was as if my brain were a radio that tuned into a clear channel for the first time. I wondered if that was how "normal" people are able to concentrate.
Soon, however, the stimulant honeymoon wore off as my tolerance increased and side effects ensued. Today I take nothing. I've noticed the symptoms being less disturbing since my mid-40s.
A weird part about being on Adderall is it slowed down my brain and reduced my quirky left-field personality to such a degree that I didn't feel like myself anymore, though I felt much more confident. One of my children also has the diagnosis and says the exact same thing. He only takes Adderall as needed for school challenges that require extra concentration. An early diagnosis for him helped him dodge the co-morbid problems that plagued me for years.
I don't tell friends or co-workers about the diagnosis. Even my spouse has expressed doubt about it.
I did so badly that I felt the need to "apologize" to the test giver, explaining that I really did understand the instructions I just (physically) couldn't catch myself when the "X" appeared. What would happen is I'd start off slow and increasingly react faster and faster to the O's until I hit an X. Then I'd go oh crap I messed up OK gotta slow down. Next thing I knew I was reacting to O's again within 10th's of a second and of course unable to stop in time when the X appeared.
It was a concrete demonstration of the idea about an ADHD brain being like driving a car with a responsive accelerator but the brakes barely or don't work.
Edit: almost forgot - after getting prescribed adderall I was able to read research papers for the first time in my life. Prior to that I couldn't concentrate well enough to actually read them. This despite having participated in a Research Experiences for Undergraduates program. I was able to "fake it" for two years and never admit I couldn't actually read or buckle down to write research papers. I had always felt some shame about that but after ADHD medication I realize it was a disability and not just laziness. I no longer take medicine for ADHD but just having had the experience of being able to focus changed my outlook on things.
This article works best in Clean Mode, which also reformats the text into a column.
Sorry if this is too off-topic/self-promotion-y, but hopefully it helps some folks.
1: https://chrome.google.com/webstore/detail/beeline-reader/ifj...
https://chrome.google.com/webstore/detail/blink-find-finding...
This extension makes your CTRL+F actually blink
Even when they work well there will be some collateral damage with stimulants. I was a great employee on them, but I was a shitty, narcissistic friend. The focus many people get from stimulants is an inward focus, which makes it easy to get things done but hard to empathize with other people. As a result I didn't have many friends, and once I started wanting more out of life I realized the stimulants were holding me back from personal growth. The inward focus clouded my ability to understand why people didn't like me -- I couldn't make enough space for another person to even see why people didn't want to be around me.
I'm not saying that stimulants don't help (they totally do) but you should understand what you want out of your life and how that aligns what you get out of the drugs.
I have had no temptation to abuse the stimulants. I don't really enjoy them, on the balance, but they make an incredible difference that meditation, high quality diet and physical activity can't even begin to approach. They really calm me down.
My wife prefers me medicated. I'm apparently nicer, more patient, more even-tempered and easier to get along with.
However, exercise, diet, and prayer cause my symptoms to almost vanish. In particular, keeping sugar content extremely low. Also being aware of my cues when I know my leg is going to start bouncing up and down and the impulse of doing anything _but_ my work is about to kick in (such as viewing this site for hours), and using behavioral modification techniques to mitigate this. Making good habits is especially important for ADHD people. It's not easy, but take comfort knowing it is doable. You can make progress today.
I have wondered if I have ADD many times in the past. Mostly, because I was in school and being forced to do a task that I didn't enjoy, nor wanted to enjoy. When I have found things that I do genuinely enjoy, I can focus for hours and hours on end.
I am not opposed to any diagnosis or treatment, but I really have never met anyone who can truly focus on anything, at any moment for a super long amount of time. From my own experience and the conversations I have had with friends that take Adderall/etc. it seems like we have believed that there exists a significant portion of the population that has an uncanny ability to focus on tasks, both fun and boring. I certainly think there are a few people out there like this, but anecdataly, most people I know are more towards to the distractable/ADD/ADHD spectrum than the focused types.
I bring this up, because if our perception of how many people around us have this god-like ability to focus is wrong, I suspect many people will take medicine under a misconception.
Like I said, don't want to ignore the extreme cases, but genuinely would like to hear from a few people that read this and can confidently say they can do most/all tasks without breaking focus.
I think much of the modern issue with focus can be attributed to the Digital Age. How can anyone focus with all these alerts and dings and emails and sounds everywhere all the time? And multitasking is worshipped like it's the modern man's solution to all problems. We're still drinking the 60s Kool-Aid, as if the modern, fancy, carefree Jetsons' lifestyle is right around the corner. It isn't. We're still the same human beings with the same old problems, except now we have additional problems due to the onset of technology.
(Not that technology doesn't solve certain issues, of course.)
One of the hallmarks of ADHD is not being able to get started and stay focused on things you do enjoy, not just things anyone would find unenjoyable.
Most people think of dopamine as the "pleasure chemical," but in reality it is the "anticipation chemical." Dopamine says: "You got this. Almost there!" And it is up-regulated when an uncertain profit presents itself, implying that all you need is a little bit more focus and practice.
Too little dopamine and you get OCD and hoarding: the inability to decide. You can think of a hoarder's room full of stuff as decisions left unmade. When you can't decide, you open & close your car door 45 times until it sounds "just right".
And when you have too much dopamine, you do stuff with zero anxiety, but you don't stop to consider the best course of action because you pick the first, best path. Useful when running from a predator, but not when solving complex problems. Just look at people on cocaine to see how this pans out.
The best personal advice I have to handle the ups & downs of ADD/ADHD condition is to build supportive todo & reminder systems around the bipolar highs and lows. Exploit the manic highs and outsource as much rote work as you can. Find ways to help you remember and reward life-sustaining tasks during the lows.
I've been working on some software that helps me get the most out of life in this manner, which would also potentially help older, mentally-compromised patients. If this is something you are interested in, please do reach out.
> Exploit the manic highs and outsource as much rote work as you can.
This. 1000x this. If I’ve found a flow I tell my partner that I’m canceling plans so I can exploit the focus as long as it lasts. Those bursts of work every few weeks will pay dividends for years
After being diagnosed with ADD, and having rejected drugs, this is the first text that has allowed me to first get all the puzzle pieces in front of me and then let me build a proper picture of everything that has been happening to me for the last 20+ years.
I know I am getting late to the conversation and probably this comment will be buried, but I would strongly recommend anybody suffering from this to take a look at this book. It has been eye opening and healing as no other text has.
But, yes, it's awful. For me, the worst parts are:
- Uncontrollable "hyperfocus" on things you really don't have control over. It would be awesome if you could control your interest, but it's usually the other way around. Something finds you, and you can't stop focusing on it. Everything around you becomes irrelevant, it's like a drug.
- Poor time management. For some reason, things just fly by you. Because you have a hard time focusing on different things, they get neglected really fast, and you suddenly find yourself hours / days / weeks later, remembering that you should have done some thing. Taking out the trash, paying your bills, handing in homework, getting your car looked at, etc.
- Having a hard time reading long pieces of text. During college I absolutely loathed classes with a lot of reading, as I'd read the same part 4 times over, zoning out each time.
- Zero sympathy from other people. You easily get branded lazy. My teachers said year after year that I was bright, but lazy - so I figured there's nothing wrong with me, I'm just lazy.
- Depression and anxiety etc. that comes and goes. I especially remember back in college when I studied Engineering, and most of my classmates would study 12 hours a day, deep into the books. It was impossible for me to do the same, so I pretty much lived from one all-nighter to another, feeling like a total fraud because I couldn't dedicate 1/10th of the time to school, as my buddies did. My anxiety was over the top.
> Uncontrollable "hyperfocus" on things you really don't have control over.
This is the bane of my existence. I have moments reading about things (most recently, how to repair air conditioning systems in vehicles I don't even own!?) in which I'm aware of how insane it is but I just can't stop. I need to know more.
> Poor time management. I once went snorkelling for an hour... for almost 4 hours. Everyone thought I was dead.
> Zero sympathy from other people. Yeah. All those people who thought I was dead subsequently believed I went snorkelling for 4 hours on purpose - not at all because I had no idea it had been that long. In my mind I thought "I better get back, it might be closing on 1.5 hours by now!". The ocean was too beautiful for time to exist though. I really had no idea. I was shamed for being so selfish and self absorbed for ages... I suppose I still am, actually. This happens with countless things. My family refuses to believe ADHD causes you to do things like this; they think I'm looking for excuses when I point to ADHD.
> Having a hard time reading long pieces of text. This is the one thing I'm alright at. I love getting lost in text, even if it's not that interesting. The problem is that I do it too often.
> Depression and anxiety Yeah. This is soul crushing.
I can't get to "first I need a bucket and water." "
This is so true! I'm ADHD, diagnosed and tried medications for a while, they helped, but had other issues so I stopped. What really helped was the realization that there are tasks where I can't even begin. I then gradually trained myself to think about the first thing and just focus on that. Don't feel like getting up from bed? Thing about moving my hand, then make it move the covers off, then move my legs and so on. Soon the momentum develops and I find it easier to do whatever I didn't feel like doing. Now my default is to just think about the very first thing and take it from there. It took me a while but has worked wonders for me.
An example might be if my ex would ask me where we should eat dinner. Maybe I'm actually hungry at the moment, but I really don't know how to go about solving the problem of where to eat. My brain won't go there. I have an internal urgency to solve this because I know my ex will be annoyed if I don't have ideas, but my brain is completely blank. I fumble around with the same 2 or 3 bad ideas after 30 seconds or so, both struggling to rationalize them as choices and thinking of more places.
Soon my ex decides I don't have ideas because I'm either not hungry (which means I'm selfish because I should at least care to help her with ideas!), or I don't want to go out with her (if I wanted to I'd think of something - anything!).
I find similar mechanics in a lot of relationships, and it's never that I'm actually being selfish or even uninterested. My brain just goes blank.
If you're able to get by without it then good on you - but I thought I'd mention that things have improved somewhat.
I also find that a vegetarian diet, low in carbs helps a lot for me. But I can' t keep to it very well without the adderall unfortunately.
One day, I did LSD and it permanently alleviated my major symptoms. I felt like my brain had a major reset, and I finally knew what it was like to be in the present moment. I stopped taking medications, and 9 years later, I’m doing fine.
I later learned from other psychedelics that traumas and not having emotional connection to my authoritarian parents contributed to my ADHD symptoms.
I can guarantee that psychedelic therapy will be huge for ADHD sufferers in the near future, especially with the potential effects like neuroplasticity and neurogenesis.
I truly wish more people would see ADHD as a neutral brain difference than a ~disease~. There are just as many positives to having ADHD as there are negatives. It's not like a broken bone which is a damage that will heal, it's a different type of brain from the get-go from which we see and live in the world differently.
The key is not trying to "cure" this difference, the key is using its strengths to your advantage while working on (or working around) the weaknesses.
The long term solution is, then, not eradicating ADHD's existence, but building a society in which individuals with ADHD can prosper in their unique ways.
A lot of our institutions (education, employment etc) are a good fit for the "neurotypical" among us, which makes coping with ADHD difficult, even though it does go hand-in-hand with a lot of positive traits (empathy, creativity, "hyperfocus" etc).
We can use the associated strengths to our advantage as much as we like, but for me, that means working staggered hours (my focus/drive follows a cycle that means I could be a 5am-er for a few days, then back to being a night owl when it comes to work output), and that just isn't possible with a day job, unless I put up with being half as productive. When I was consulting and working mainly from home, it was great as I could "surf the wave" of this cycle, so to speak, but with a day job, and the expectation that I can work regular hours alongside other people, it's no longer an option.
That example is specific to me, but I'm sure there are loads of other ADHD traits that make life difficult simply because they don't fit the mold of "regular people" - my kids are a good example, especially my 11-year-old... he'll annihilate a book in a single sitting and he's an incredibly bright kid, but he's a straight-C student.
ADHD people are incredibly creative! They are those whose brain naturally refuses to conform to "what is not fun", in the words of the author. This feeling is right behind Artistry itself! Your mind is trying to say something very important.
I advise you to invest in finding what your flow is. For a moment think the way your brain works is a gift of the universe and things like Distraction, Hyperactivity and Never Ending Stream of Thoughts might in turn be confused with Graph Exploitation, Mind Stamina and Infinite Power of Association.
How can you take the most utility out of your "condition"? By using it as a tool for Creative Expression. We are all blessed to have so many options to do that. Fall in love with a project - something you care about so much you will likely be always motivated by it.
The System is totally broken. Many know that. Companies should see ADHD collaborators as a unique and rare kind of Problem Solvers and work hard to make sure their gift is well exploited. The full equation has got many parameters, but a good starting question is "how can we design an environment where my ADHD (or any other condition) can give their absolute best?".
Personally, I like to use my abilities thinking about The Future of Technology and expressing those thoughts through Software Development. If you vibe with that, message me. I would very much want to be your friend.
I'm an artist and a programmer, the kind of 'creative' you are talking about, and see myself mirrored almost exactly in the original post. There are many things I care so much about I 'will likely always be motivated by them'. I am in love with all of these.
The problem is that same motivation likes to vanish for weeks, months, years at a time. I have no control over this. That's what ADHD does. That's why it's a disorder, not just misunderstood creativity. We ghost on our own dreams, inarticulately.
I already consider myself "blessed" to know what I like. I would just really like to be able to like it for more than one maniacal sprint at a time.
A solution to the problem of our clumsily entering and exiting a role (above the level of temp work, turking, etc) would be nice - in no small part because it seems like this would help people without ADHD too and, therefore, scale. I've been looking for a solution to this for most of my adult life. The only remotely consistent one I've found is 'long tail' type things - things one makes once and doesn't have to think about, like resources (books, writing, references), assets ('crafts', reusable design, etc).
That isn't enough to build a career off unless you get astronomically lucky - or come upon the necessary resources to delegate the less ADHD-friendly parts of this kind of business - promotion etc - to someone else.
That being said, I’m fortunate in that I’ve worked with a therapist who saw the ADHD (along with PTSD) symptoms and put a name to them. They pointed out that I’d basically been self-medicating with caffeine since I was a young kid. Even just having the acknowledgment and having words put to it has made a huge difference for me. Now I know it’s not some moral failing and laziness. My brain is just different and I have to figure out ways to make it work (currently those ways are medication, writing, therapy, and some incorporation of Buddhist teachings in my life).
"My OCD is kicking in, it needs to be aligned!"
OCD is not wanting things straight. That's human nature.
OCD can be crippling. It can take over your thoughts and your life. That's the compulsion. It takes you over. It's doesn't help with programming, it doesn't make your code neat.
It's a terrible combination since stimulant medications tend to increase anxiety and therefore worsen OCD symptoms.
My OCD is largely under control now. It took a few years of CBT; figuring out how much sleep (5 ± 1 hours for me) I need per night; and nailing-down a daily routine featuring bounded compulsive activity in order to, for instance, enable me to get out of the door in the morning.
I wished I had known that book before. I got diagnosed only the last year, being 33 years old. Before turning 30 I hadn't suspected having ADHD, as I had quite a few misconceptions both about the condition, and what is "typical" in humans.
Overall he seems pretty happy in life and has some friends and things he likes to do, so I'm not feeling like it's really urgent to get him help, but also don't want it to escalate to the point where it's harder for him to get help later or starts self medicating as a teen.
My mom really pushed for me to get extra support and I was diagnosed with a Learning Disability (auditory processing sucked, spatial cognition was low too) back in the 1980's, but when I was in my early 30's something"snapped" and I went in and got diagnosed as having ADHD which explained a lot to me.
I always felt that my parents supported me and have told me they "always thought I would turn out great" despite my school issues (Basically like the guy who wrote the original post - I wouldn't finish anything). They just did what they could to help me along, extra support from techers, tutors (although they didn't help much), hobbies, etc.
I think the hardest hing for my parents and teachers was seeing that I loved computers, but couldn't do anything with computers without math, which I detested. Product Managers weren't very well known positions back then :) In the end, I have had a 12+ year career as a PM, and my ADHD is a pain everyday. But, I was able to do it because I always felt like my parents believed in me, even when they know I can't do my laundry.
I knew a neurologist who had ADHD.
Everything: Smart, but lazy every since I was a kid. Having to have a list when I am shopping, the endless and heartbreaking failed projects I desperately want to do and achieve but have been unable to do so. The reminders not working. I have to be going somewhere or doing something. 90% of the time I am just staring off into space and telling stories to myself, it has been this way ever since I was a kid. I slept through pretty much every single one of my classes. We would do reading around the classroom and I would always read ahead.
It causes a lot of friction with my SO. I can't go shopping with her because I HATE standing around waiting for her to select fruit and shop how she likes. I struggle to motivate myself to do the dishes and other household chores.
I have tried to organize my days but in the end the time falls away like water through my fingers. I have things I want to do, the time to do them, but I just... can't. I have piles of goals, plans, schedules, all of it falls to the wayside in day to day life. I read books on mindfulness and try to meditate, with some success.
I have been to many many therapists to try and MKULTRA myself into being more productive. I tell them all the same thing: I'm not depressed, I just want to achieve more of what I want out of life. It doesn't help. I am still just treading water.
I've been on ADHD medication before, and it is truly a miracle. I am a like a different person. I do extremely well as a programmer when I am on medication. Unfortunately, it is difficult to get, and I have to visit a doctor's office once a month to keep my prescription filled... honestly typing all this out makes me think I should go back on it though.
It is like my mind is screaming. My thoughts rush through me like a river and the things I actually want to do get swept along with everything else.
I crave dopamine. I work myself into a frenzy thinking about conflicts at work and between friends. I used to smoke cigarettes like a chimney. I smoke weed, I (used to) cut myself, I drink heavily. I hyper focus on comic books and video games and animation and novels.
I feel so much shame for all of these things I have never accomplished. I am ashamed I am not the person I should be.
One thing I have found is that truly mindless chores like dishes are great because I can let my mind wander and do whatever it wants. The chores that I struggle with are ones that require focus/attention/thinking. Stuff like organization, where I have to sit and think about where each thing goes, and arrange and rearrange, those are a nightmare.
> Unfortunately, it is difficult to get, and I have to visit a doctor's office once a month to keep my prescription filled
Not sure where you are but my psych used to make me come every month for a refill. I moved and before I found a new psych I had to make an appointment with a regular family doctor. She was more than willing to write my script and only asked me to come every three months. I think the key was that I had been on the same dose for years and was organized with all my medical history. But don't take it as a given that monthly appointments are required.
My parents absolutely loathe people with mental illnesses and it took me a decade after moving out to get things together enough to visit a doctor for my long lasting depression, which eventually lead me down the path to a diagnosis of ADHD. They required parental interviews which made the doctor rule out ADHD at first, but every single thing my mother reported was a lie, and after contacting estranged grandparents who met me a lot as a kid it was diagnosed.
I landed a job as a COBOL developer and spend all free time trying to learn more technologies, but I hate myself for not finishing a degree, which is the only one thing I've always wanted to do, and letting so many people down and never making any friends during my studies because I was always too far behind to dare work together with them.
So now I'm in debt from a loan I took years ago to not end up homeless, no degree and crappy work experience from jobs requiring no qualifications, working on legacy tech on a dying project without being able to afford relocating and nothing to show for if applying to more modern tech stack jobs.
Now I feel great, started reading and learning things, but I just resent myself from before I got on this medicine that makes me work.
I can relate to the symptoms on the NHS website (for adults) but I'd rather not self-diagnose. One thing that doesn't seem to fit is that I can focus very hard (by my standards at least) (for short periods of time) on things but not things I actually need to focus on - I always have about 9 books open at the same time, physically or virtually, constantly skipping between them (sometimes literally, sometimes on "academic" timescales i.e. a day). This stops me from sleeping which is probably partly why I can be very neurotic. Who needs sleep when you could be reading a FEA textbook.
I have never done as expected on a formal exam - I can't seem to put the effort despite wanting to, but I think that is part arrogance and part personality in the sense that I can't take it seriously enough. Attention to detail and time management, usually.
I have now realised that I made it about ~100 internalized words into the article before zoning out but I have managed to write this without making any new tabs.
So I'll be that guy: Consider giving it a shot. I took d-amphetamine sulfate by prescription for a few years, couldn't tolerate the side effects, and modafinil helps a lot.
Case in point: my now 14 years old kid was diagnosed with severe ADHD when he was 6. Medication improved his condition a lot. Last year we started to notice that he would have brief periods of absence, resulting in a battery of neuro tests. He has been diagnosed with generalized absence epilepsy and he is now on valproic acid. He is now much better - especially with mood stability - since started epilepsy meds.
Yet, I am afraid that epilepsy is again, just another symptom. Structural damage was discarded (brain mri was normal), but we are now running a battery of genetic testing to find out. First test - cgh array - came out negative and we are now waiting for a whole exome sequencing to see if we are able to identify an underlying genetic condition.
My take away: If you have severe ADHD, go to the neuro and ask at least for an EEG and a brain MRI to discard underlying conditions.
As far as I know, my brain is "normal" (whatever that means.) But I still think I have plenty of problems concentrating, forget what I'm doing in the instant, get hyperfocused on some topic and get very aggravated if I'm interrupted, etc. How do we know whether my problems concentrating are worse than someone else's? Maybe everyone's brain has the same innate issues but some people have just happened to develop coping strategies that work better for them?
It just seems really difficult to have a rational discussion about something where literally no one has a shared experience with anyone else.
Side note: I am also diagnosed with the other two ailments the author compares ADHD to, lol; diabetes and depression. Although I suspect that second one is just caused by years of untreated ADHD making me feel like a lazy asshole.
I just discovered yesterday that I suffer from task anxiety related to ADD/ADHD, after a lifetime of struggling against falling into patterns of depression. It's felt as almost a pain in my gut between my chest and belly whenever I go to start working on something I have to do. I just worked through this series of exercises and it really helped me identify what's actually going on, with some solutions:
https://addandsomuchmore.com/2012/01/29/taskmaster-getting-t...
https://addandsomuchmore.com/2012/02/11/task-anxiety-awarene...
https://addandsomuchmore.com/2012/02/14/virtue-not-own-rewar...
https://addandsomuchmore.com/2012/02/16/doling-out-the-cooki...
https://addandsomuchmore.com/2012/02/24/when-the-game-is-rig...
Some other keywords to look for are "impossible task" and "executive dysfunction", both maladies being seen predominantly in millennials. I just happened to get them 10 or 20 years ahead of time by starting computers when I was 12 as a Gen Xer.
Ouch.
At first I was relieved to get meds. Then I started to learn more and more about what ADHD is actually doing to me and my life. I read through dozens of papers and probably know more about it now than my doc who just gives me whatever his book says he should prescribe.
I hate ADHD and I would pay a lot to get rid of it. I hate not being able to focus like a normal person (despite hyper focus bursts) without meds. I hate that my mood is impulsive and all over the place like an emotional hurricane. I am very sensitive to negative feedback (thanks RSD, but also thanks to guanfacine for now being somewhat able to treat this) and can't deal with conflict.
I can't push through with things, my focus and thoughts play ping pong. One moment I obsess with a new hobby and throw a lot of money at it, then a few weeks later I don't bother touching it again. I start a dozen software projects, finish it 80% then lose interest and do something else.
If I have no interest in something I can't do it at all. It's like getting a tooth pulled out. If something grabs m attention I have to drop everything and do it now and if I don't it will bounce back and forth in my head until I do it (like writing this comment).
I procrastinate everything until the last minute. If something doesn't have external consequences I just won't do it. If there is a deadline or it will impact something, I will push it until it's due, then panic and rush through it.
My brain feels like it's always on overdrive and works in extremes without middleground. Either I hate or I love, either I'm interested or not a single bit. Either I'm fully committed on something or I won't touch it at all
But thanks to ADHD I became a very good software engineer. I was able to quickly pick up new technologies and hyper focus through it in no time. I am very good in designing systems because of how fast my brain works. I can quickly sort through heaps of ways to do something and look at things from many different sides at once to find the optimal path (though sometimes overlook things due to gaps in working memory).
Still I hate it. It's also a completely mislabeled condition. If it was just attention I'd be so much happier.
The most important point and deservedly bolded. Looking inward with a negative mindset is guaranteed to yield the worst result if you're dealing with an adversity like ADHD.
There is science behind the former though:
+ Hunter, fighter, wader theory; having ADHD got us out of our caves and increased random or policy driven exploration [1]
+ ADHD has benefits to society through neurodiversity [2]
[1]: https://www.ncbi.nlm.nih.gov/pubmed/8955426 [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1578754/
Rather than taking SSRIs, I would prefer taking time out to meditate for an hour. It will give you focus for 8-9 hours the same as meds (I think) but without side-effects. Just my 2 cents.
"If I'm not interested in doing something, I can't process any thoughts about how to do it. No, I don't mean it's not fun, I mean my brain will not do it. If I don't want to wash a fence, I can't think about how to wash the fence. I go into complete lockup. I ask the question, "how do I wash the fence?" and the answer will not come to me."
I am officially diagnosed with ADHD and am in my 40s - and its not great :-)
I have a perfectly healthy lifestyle - I run 5 days a week, about 40 miles total, eat healthily and sleep well. During my runs (which physically feel painful) I have few moments of clarity in my head. Other than running though my mind has a thousand thoughts all at once that I cannot control...
I tell a story, interrupt myself, get 6 levels deep and then essentially have a stack overflow and can't recover to my main point that took me down that spiral. Nobody can follow my thought process. What I do know is that my mind is stimulated by strong feelings.
I sit at my desk to do work, notice a story about the DOT / airlines soon banning ESAs and proceed to research the legal authority according to the ADA and other provisions in U.S. Code. I waste a lot of time thinking about the stuff I need to do, but I can't get myself to do it. So I don't do anything that is fun for me, nor the work I need to do itself. Only under immense stress due to deadlines (and the potential negative consequences of failing to deliver) I can force myself to crank out work that is of reasonable quality. This is how I went through all of high school and college for example. I was completely sleep deprived as a result.
Never in my life have I been able to finish reading a book for school - I'm bilingual (learned English as a second language), but this isn't a language problem for me. I simply don't know what I read at the top of the page when I get to the bottom. I read incredibly slowly (I have to imagine hearing someone speak the words - this is called subvocalization). If I focus on reading for fun it will probably take me 3-4 months to get through one fantasy books. If I can read 3 books in a year I had a very good year.
At a dinner in a restaurant I cannot pay attention to my friend (or date) in front of me, because other conversations around me draw in my attention and trigger my brain when interesting subjects are raised.
I am not able to focus without extreme stimulation and am completely at the mercy of my brain / mind. This means I can't listen to people well, I get impatient and interrupt people at inappropriate moments.
Yes I'm high-functioning and I do well, I have a crazy amount of energy, but this isn't a healthy way to live. I am not lazy, but my mind is. I am convinced I'm only operating at 20% of my true cognitive potential and output potential.
For these and many more reasons I will be seeking diagnosis for ADHD (or ADD?) soon.
From experience: First thing to go with the stimulants is healthy sleep; it's often hard to sleep on amphetamines. But in the morning, because you've got a script, you can take a pill and not worry about it (but the body remembers). Next thing to go is healthy eating; you simply don't need to eat when under the influence, or you do -- but you forget. Soon, those things combined could have the potential to turn a high functioning and healthy life into quite the opposite. But in the beginning -- especially if you've never experimented with stimulants recreationally -- you'll feel better than you ever have. Stimulants are euphoric. It's a trap, it wears off. Side-effects are likely. I've said it in a previous comment, but it's profound and interesting until it's not, and once the stimulants are gone a dark depression is very possible.
Attention is like a muscle, but also -- attention isn't everything. It could also be ones attitude towards these things.
Be skeptical -- understand that there might be blind spots in your thinking about your problems.
1. Take the ADHD Self-Report Scale screening survey. It's been extensively validated and it's only 6 questions long: https://www.hcp.med.harvard.edu/ncs/ftpdir/adhd/6Q_ASRS_Engl...
2. If you get a positive result, go see a psychiatrist (not a psychologist; they can't prescribe medication). A positive result isn't a diagnosis, but it's the closest you're going to get without a professional.
3. If you have ADHD, your psychiatrist will almost certainly start you on a stimulant like methylphenidate (Ritalin) or amphetamines (Adderall, Dexedrine, Vyvanse). Take the medication; it is the most effective treatment for ADHD by a wide margin.
4. Be ready to adjust. The right choice and dosage of medication varies so much between people that the state of the art is "try it and if it doesn't work try something else". Your psychiatrist should work with you to zero in on the right medication and dosage. This takes a while, so be patient and take notes so you can tell what's changed over time.
If you're looking for more comprehensive information, I find the practice guidelines aimed at medical professionals a good mix of practical and rigorous:
[AU] https://www.racp.edu.au/docs/default-source/advocacy-library...
[CA] https://www.caddra.ca/wp-content/uploads/CADDRA-Guidelines-4...
[UK] https://www.nice.org.uk/guidance/ng87/resources/attention-de...
[US (child-specific)] https://pediatrics.aappublications.org/content/pediatrics/14...
How do I know this is ADHD and not my bad habits?
My main piece of advice that I write on every post about ADHD is the following: Get plenty of sleep, exercise, and look into meditating. Using the Waking Up app by Sam Harris has really taught me so much more than I was expecting. For the first time last year I went 3 months without medicine. I wanted to gauge how strong my attention/focus muscle was without medicine. At the end of 3 months I was able to start noticing when I was distracted or in my head and that was such a be improvement for me, because it allowed me to start paying attention again. I also noticed how I was communicating with myself. I went from being negative towards myself because I knew i should be paying attention. To understanding where my mind is at that day and knowing that today might be a harder day than yesterday, but that is okay. Just take it one step at a time.
TLDR: Exercise & Meditation. Mindfulness will help keep you present and away from the endless mind games you can experience with ADHD
Un-Diagnosed ADHD can lead to a whole bunch of other life issues. Its nice to at least be aware of it.
I got fired for performance at my last job about 2.75 years ago. The first two years of working there I had great performance reviews, things went well. It was a high performing YC-backed success story, and I felt just as successful. I was promoted to Lead QA Engineer, and oversaw several projects going at once that I was interested in.
About two years in, it started going south when I lost my Adderall prescription. Eventually I got fired. It was devastating, and the best job I ever had.
I guess after some change at Kaiser Permanente, my primary care doctor was no longer able to write me Adderall. He sent me to psychiatry, which at Kaiser is less than stellar.
Psychiatrist said that unless I can provide proof from elementary school or doctors from my childhood, he’s going to have to reevaluate me; from the looks of what he said I might not get a diagnosis. Offered me Wellbutrin. The entire visit was a slap in the face. He thought I was there to get stimulants because I have a drug problem.
Indeed! I do have a drug problem in that no longer am being prescribed the drugs that make me function. I never abused drugs.
Even after talking to a manager, Kaiser refuses let me switch psychiatrists. This was about 2.5 years ago. It took me two months even get an appointment with that Dr; only to have him tell me get lost.
Meanwhile, I’ve been doing the best I can given the situation. ADHD Affects me greatly and I’ve lost so much since then.
For one, disorganization resulted in me missing out on exercising my stock options. I thought I had three months, it was 90 days. Missed it by a day!
This was problematic because the company was purchased by Autodesk about a year after I got fired. Would’ve been a nice liquidity event. ($600K)
I’m still falling incredibly short. I have a lot of trauma around getting fired and feeling like I am insufficient. I have not even applied for a job since leaving. Once unemployment ran out I started ridesharing; i’m doing that off and on for about two years. It barely pays rent but better than being broke and homeless in San Francisco.
Today, it’s a struggle to stay relevant. I have pretty much given up on finding a psychiatrist in San Francisco as they all appear booked for months. I have found success in self medication although it’s harder to find therapeutic pharmaceuticals then street drugs; not a viable alternative for me.
I’m sort of losing interest in tech. I find enjoyment in many things technical but cannot seem to get myself together. Thinking without finishing my college degree, no relevant work for the last 2 1/2 years, and no treatment for my condition; nobody will want to hire me. Even if they did I am not sure I’d be able to be successful.
Where am I at now? Still ridesharing, trying to make ends meet. My resume is almost rewritten, I have looked at some jobs but not applied for any yet. My world has gotten a little bit smaller than I would like.
Absolutely I need some more structure than what I have.
Hmm looked it up and their website says you can change your doctor unless maybe it depends on the state... That URL is coming up for WA, so maybe in CA it's different since insurance companies are usually licensed and separate in every state but share a common brand name.
https://wa.kaiserpermanente.org/html/public/member-guide/cho...
> You can change your doctor at any time, for any reason. Just follow the same steps as above to select a new doctor.
But I guess every company and plan is different anyways. Seems like an entire racket. Someone I know who recently moved wasn't feeling too great but didn't want to go to the hospital as worried about costs, and called to speak to someone at the front desk and they said they couldn't tell you over the phone if covered or not, would have to see the card in person and specific plan and group numbers. Ended up being nothing though, but what if they were having a more serious issue.
So stupid you can't just pick the best-rated doctor and go to it. Then some cheaper plans probably have crappier doctors who are more disparate. Seems like the whole medical system doesn't let you take control over your own health. Then some doctors end up actually making people sicker too.
Many of my ADHD friends say something similar... they can't follow orders, so they have to make sure they find something in the work that they can obsess over.
This article spoke to me, I bookmarked it and will probably recommend other people around me read it. I was especially moved by the parts about being traumatized by people treating you like you’re a bad person. Made me realize that I’m trying to fight off a depressive episode currently that was probably made significantly worse by my former lover(the breakup/cheating being what caused the episode) constantly acting this way, despite knowing I had ADD.
One part sticks out though as being overly optimistic,
> “and even if you stop taking them or can't get them later you'll still have those accomplishments. Maybe the emotional impact of seeing yourself finally achieving things will be so encouraging that it'll eradicate your feeling that you can't accomplish anything - speaking from experience, it will.”
I have to put this in context: So a little over a year ago I lost my job, I had been able to, thanks to adderall, move up to a pretty good position at a small business, that very unfortunately went belly up due to a new landlord who no longer wanted said business in their space and an inability to move due to the business being effectively grandfathered in. About a year later, as part of my breakup I suddenly lost my place of living and as a result, my new semi-decent job. Even with my good job I had been mostly priced out of psychiatric medicine for a couple of years. I didn’t get employer based health insurance, and individual ACA insurance has been getting more expensive every year. This was fine at first, which made me not make the necessary sacrifices to keep myself medicated, but over time my symptoms regressed. I’m now making like 20% of what I was when I was medicated and the hill to get back to a satisfactory career position feels utterly monumental.
I now feel effectively trapped by my ADHD, which is completely resistant to being fixed by healthy routines. Since I broke up and moved back in with my parents I’ve been exercising daily— lifting weights and running—have a pretty amazing diet, meditate, have a group of old friends to socialize with, have good sleep hygiene, and after 4 months of all this I’m still struggling to improve my situation, I’m still depressed, my ADHD is as bad as ever and I’ve made basically no headway in terms of reestablishing a career. And the fact that when I was on adderall I was the me I’d always wanted to be, able to start (and finish!) things I wasn't interested in, not waste (mountains of) time losing things and keep track of time effectively is now completely out of my reach, really brings me down, a lot.
I SO BADLY want to update my website and work on a software/tech project. I’ve even gotten as far as figuring an original project out, doing research and wire framing the design. But I’m now stuck in analysis paralysis and my road to Getting There(tm) keeps shifting. I should obviously get on benefits, I paid into the system and deserve unemployment, but every time I’ve tried to get on it there’s problems. I‘m on Medi-Cal but apparently I need an office visit to get reregistered in my new county, I ironically got my benefits card after I got kicked out, after a 6 month process; ADHD makes signing up and getting benefits a nightmare, I’m constantly forgetting to do the next step or miss an appointment. Doubly bad when you’re depressed as I struggle with feeling persecuted.
I recognize I’m really an asset in the workplace but I need to make moves to find a job and prove my skills. I see people’s job hunt infographics where they apply to like 100’s of companies, and it’s honestly baffling to me, it takes me the better part of a day to tune my resume and write a cover letter I’m happy with.
Long story short, I ended up discovering marijuana and quit taking my Adderall. Marijuana also made me an A student. After smoking it, I could actually read books instead of just looking at words.
I doubt it would work for everyone but it has certainly worked for me and anytime I need to study, I smoke some weed now. It surprises me how well I understand the subject after I finish. If I try sober, I don't retain anything and I don't understand anything.
In fact, some newer studies show that marijuana is actually an effective treatment for ADHD [1].
It's really hard to tell when adderall is working from the inside. If it's working correctly, it shouldn't be noticeable. I finally realized when the following happened: I was working on some homework when I noticed that the trashcan next to my desk needed to be taken out. So I took it out and finished my homework. After I finished, I realized that, were it not for the medication, I never would have come back to my homework. I would have got to do something else after I brought the trash can back in, or before I took it out, or I would have not been able to get back to work after even noticing the trash can, "taken a break", and just never started again.
It was a genuinely emotional revelation.
May I ask: which strain do you use?
I've been treating my ADHD with (sparing, irregular use of) the main stimulants, which has worked fairly well.
I've only used cannabis a couple of times, and each time I rather hated how it made me feel.
1. https://www.theguardian.com/science/neurophilosophy/2012/mar...
If I were a doctor or a pharmacist, I'd be more interested in inducing this condition than curing it.
Personal procrastination deep-dives have rewarded myself and my family more handsomely and more permanently than any wage labor ever has.
ADHD: Essential Ideas for Parents - Dr. Russell Barkely
is essential to understanding ADHD at the neurological level.