Me and ADHD
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For folks without ADHD, you should know that stimulants, like Ritalin and Adderall, do not usually cause the same response as in non-ADHD people. I've spoken with many people on stimulants, and none of them enjoy taking the medication, beyond what it has done to improve their lives. Furthermore, most ADHD people develop tolerance to medication over long periods of time -- eventually the drug does little-to-nothing itself. For myself, taking even high doses of a Adderall regularly produces no result -- might as well be taking sugar pills. I have to take them periodically (a few times a week at most) to get any sort of benefit.
The proper medication and dosage should not make you feel "high" -- if anything it's almost the opposite. You get some clarity, an ability to direct your focus without a thousand distractions a minute, and perhaps even a sense of time.
I let some non-ADHD friends try a low dose of Ritalin when I had switched off of it and had some left over, and they were bouncing off the fucking walls -- I would strongly not recommend taking stimulants unless medically necessary.
For people with ADHD, they can be truly life saving. For recreational use, avoid.
I had to make it clear I was interested in pursuing a proper diagnosis, and that I wasn't just looking for some help to "cram" for a test or something, which apparently would have been good enough for a prescription.
Getting a proper diagnosis is a royal pain in the ass, but worth it. You shouldn't be screwing around with these drugs for fun.
I've been considering trying to get a prescription for years, but I don't present most typical symptoms of ADD (maybe some inattentive ones?) so I suspect psychiatrists would be reluctant and just try to get me onto SSRIs, which have done nothing for me.
This is what Cocaine, MDMA or alcohol in reasonable doses would do to you. Stimulants generally do this to everyone.
I was sort of responding to the claims 1) that non-ADHD people "bounce off the walls" when using stimulants and/or 2) that ADHD people couldn't use stimulants socially because it calms and focuses them rather than amping them up. Either I'm in the former category, and then claim 1 doesn't really track because it genuinely is a calming sensation for non-ADHD people (sample size 1, myself), or I'm in the latter category and then claim 2 doesn't track because stims really can help ADHD sufferers (same methodology) with socializing.
Personally I am the other side of what you said lol I can't imagine that people don't feel it or don't enjoy it!
addiction science is cool and evolving. i wonder if people have different inherent dopamine regulation/Glutamate chemistry in their brains causing this difference of 'fun' [1]
and or maybe it's like cocaine or opiates where some people have to do it a couple times to 'notice' the difference. and then that difference drives your life lol
[1] https://www.intechopen.com/books/attention-deficit-hyperacti...
* The (largely mental) hyperactivity is controllable, that is, I retain my creative ideas generation and interest in new things, but I am no longer governed by it, and
* The rarely discussed hyperfocus behaviour (which I frankly regard as a superpower) is more easily snapped out of.
To the uninformed, the most paradoxical outcome is that I can take a powerful stimulant medication, lie down in bed, and fall asleep easily, when normally I'd be staring at the ceiling pondering anything from CSS to soldering and unable to sleep for the rush of ideas.
This response to medication is not diagnostic, but it is indicative that the medication I have is correct. Moreover it allows me to both retain the two traits that have made me a successful systems maker, but permits a less chaotic engagement with the neurotypical-oriented processes of modern human society, so for example I renew my passport before it expires.
I self-medicated with a variety of over-the-counter substances for decades, including nicotine, sugar, and coffee. I am super grateful for the medication since I have now dropped the nicotine and sugar.
My psychiatrist believes the condition is a) misnamed, and would be better titled "Attention Difference Disorder", and b) points out that the twin traits of rapid ideas switching and hyperfocus are only a problem in some aspects of engagement with modern society and that in an pre-agrarian society they'd be excellent traits for a hunter.
this. all of this. yes. :)
As a person who is in their 1st week of medication, that is a HUGE relief. Thank you.
I have a lot more to comment here but have a quiz (engineering undergrad) to do rn..lol. But I gotta say your description of you experience is the most comprehensive thing I was ever able to relate to. I found a lot of people on r/ADHD articulating individual feelings/experiences that I felt but was not able to talk about, but yours just covered a lot more base with me personally.
> anything from CSS to soldering and unable to sleep for the rush of ideas.
That hit hard XD.
> would be better titled "Attention Difference Disorder"
Yes, a lot of people are don't like that it was named mostly based on the symptoms most annoying to the people around the person ADHD with. Many people suggest something along the lines of "Executive Function Dysregulation" to remove the "hyper" part that many people don't suffer from and include emotional-dysregulation in the symptoms.
Ok enough. time to go.
1. Never take stimulants to have fun, just take them to do tasks to progress your life. ADHD doesn't prevent you from having fun, and having fun with stimulants is what makes them addictive.
2. Take regular breaks from the medication. You wont get much done the first day or two after, so don't plan on doing anything except stay at home and procrastinate those days since your inattentive symptoms will be worse than usual.
3. Sometimes try to do tasks without medication. Having worse focus helps in some way since it means you must master a topic much more before you can complete the task. My guess is that many of the PRO's of ADHD comes from this, since it means instead of just completing a task and moving on you have been forced to master the subject way more than other people with similar grades/achievements. Think of two people with similar grades, one worked hard and did lots of practice problems while the other was lazy and never worked. Who do you think understands things better? What do you think happens if the lazy guy suddenly puts in the effort? That is what happens with ADHD medication.
"Medicine holidays." They're a necessary part of ADHD treatment to deal with tolerance and to ensure you still need the medication at your current dose. After you take a few days off (I do one weekend a month and one week a year) try taking a smaller dose.
Everyone's tolerance and needs can change drastically over time. If you stay at the same dose forever without breaks you'll have no concept of if the medication is still working for you - much like your 3rd point. I took 40mg/day in my 20s, down to 30mg a year ago, and now up to 35mg/day in covid times.
I like that though, just chilling for a day or two, do what you feel like and not what feels important. If your life doesn't give you the opportunity to do that I'd suggest try to get more flexibility, you don't need to be super attentive and productive every day. ADHD isn't a disease, it just means you are badly adapted for modern office work and bureaucracy, and having vacations where you can go back to your simple carefree self is very valuable.
Edit: For example, when I was a kid I spent most of my time at home playing with toys during weekends. I don't see why that would be a bad life for a kid. When they get older to 8-10 they can get around on their own so no need to baby sit them any longer, at least if you live in an European city.
As for parenthood its not just about bringing your kids places. They want to play, they need to eat, they need diaper changes. Kids are a ton of work I love every minute of it, but man is it difficult.
“Playtime” is a tool used to prepare the child for the next lesson.
Even non-ADHD people should be doing that. I rarely take medication on the weekends and if I do, it is strictly only one day.
The other day I allow my brain to do whatever it wants; play video games, lay in bed, work, it's free to tell me what to do. It's relaxing.
I can't and won't speak to your experience or your medical advice, but from my experience this is advice I would strongly advise considering your own experience before taking. My experience is that if I miss a dose I'll find myself, hours later, with my brain catastrophically grinding gears and in tears from a panic attack. This isn't from addiction, this is because I've actually adjusted to having a brain chemistry that isn't broken. I was just as much a wreck before I was medicated, I just didn't know and had a lot of really unhealthy self-medication techniques.
I'm well near the highest dose on my medication (Vyvanse) and I still have many of the pros and cons of ADHD. I don't need to play chicken with my brain chemicals to exercise the unique heaven and hell that's in there.
I'm not sure this is universally necessary. When my pre-adolescent son forgets to take his medication in the morning it's immediately obvious, so it's clearly still having pronounced effect. He's been on the same dosage of the medication continuously for five years.
I was hesitant to take any medication. I was concerned it would make me anxious or similar.
Instead, my anxiety was greatly reduced. I had the thought, “is this what normal should feel like?” I don’t like the idea of being dependent on any one tool, but I’ll use a tool if it helps.
As others have said, this is definitely something you must discuss with your personal brain care specialist first.
What others have not suggested, and again this is something I have been able to arrange in conjunction with my shrink, is medication switching. Since each has slightly different benefits, I use a different medication on a workday than at the weekend or holiday/social time.
In this regard I've been fortunate to have access to a healthcare system, and specialists, that respect the individual and aren't reflexively invoking a) cookie-cutter solutions, or b) contrived histrionics about substances with abuse potential. The only raised eyebrow came from my pharmacist: "You're on both of these?" "Yes, but on different days, not together." "No worries".
NB: I'm hesitant to specify which medications, because individual responses vary dramatically, and advice gleaned from one person's experience may be exactly wrong for another.
What's more, holidays from either (inadvertent or otherwise) have not provoke the catastrophic withdrawal sometimes described, for me it's more of a reversion to type.
And at the risk of labouring the point, this all comes with a whopping YMMV notice. In particular, I am not reliant on self-assessment; I am privileged enough to have access to both psychiatric and familial help that is willing, able, and qualified, to provide external observation.
On the other hand, you may forget to take your medication, that can really be a problem. The rule of thumb is, if you forgot if you took it, it's because you forgot to take it.
I've seen this a lot.
A lot of parents were in complete denial about their children having ADHD, and the rampant diagnosing of ADHD at a point in time. Turns out a lot of children actually had it, and it is not the most compatible with the environment they are in and will be in.
All things did happen: rampant diagnosis, misdiagnosis, and parents in denials. But none of that means any particular child didn't have ADHD.
I've brought this reality up to other parents repeating the same things.
I'm an extremely light sleeper and always had a very hard time falling asleep, so my guess is that concerta quiets down my brain enough that the chronic lack of sleep catches up on me.
It doesn't make me any more awake/less tired than I normally would be, and I can lie down and kind of zone out, but I never completely drift off. Pseudo-meditation is the closest I can get to sleeping when I'm on Concerta.
> dosage should not make you feel "high" -- if anything it's almost the opposite
Even when I was young and fit, many years before I started taking any meds, my blood pressure and pulse rate were consistently on the high side. I've always had what could be called somewhat of a 'jittery' or 'high strung' personality.
In my 30s, I started taking a low dose of Ritalin, and it made a hell of a difference. For the first time in my life, I was actually, fundamentally calm. I gathered some pretty detailed data over a pretty long period of time, and there was an iron-clad correlation: when the Ritalin was in my blood stream, my blood pressure and heart rate were lower.
> most ADHD people develop tolerance to medication over long periods of time
From the beginning, in order to defend against this possibility, I always took the meds sparingly, only on work days, and not all of them. For a number of years, I organized my schedule around taking the meds three days a week. On those three days, I did most of my deeper, focused software development. On the other work days, I'd focus more on meetings, digging into operational issues, troubleshooting, basically everything except deep focused software development.
Prior to starting the meds, I had many successful years in technology at various organizations. That continued after the meds, but with one big difference: while I was able to sit down and focus before the meds, it took an enormous amount of effort and energy. I'd come home from work and immediately nap for an hour before waking up with enough mental energy to go about the rest of my evening.
On the meds, my total ability to focus was roughly the same, but it didn't take nearly as much energy. A 9 hour day at work would not leave me drained.
I've always had the fortune of having the prescribing docs break up my maximum daily meds into many small dosed tablets, which gave me a lot of flexibility.
Thankfully, after all this time, the meds still work very well for me.
Isn't that normal? That's certainly been my experience of work over the last decade. And I haven't even been working 9 hour days (more like 7.5 on average).
Try one of these:
donefirst.com
helloahead.com
I get the same reaction as you - I'm calm, still, patient. Much more "present" with my wife and far less likely to argue. If I need to plan, or organize something, the initial feeling of "oof" is no longer there. I just do the task.
I have however noticed that my heart rate (normally in the low 50s) hovers in the low 60s. I assume (but have not checked) that my blood pressure is also increasing. Both of these things are concerning.
It's definitely true that there is wide individual variance (modafinil does nothing but disrupt my sleep and make me more sleepy over time, alas), but it is less clear to me that the differences follow cleanly along boundaries like ADHD/not ADHD.
I don't have ADHD, but I am prescribed Ritalin to help with a sleep disorder. There's no high, euphoria, or hyperactivity, just a boost to wakefulness and general mental function. Descriptions of the effect from people with ADHD sound familiar, just starting from a different baseline.
Most people will experience increased focus when first taking stimulants, ADHD or not. Many ADHD patients will experience euphoria with their first doses. The idea that ADHD people have polar opposite responses to medication is largely a myth.
Most long-term patients don’t identify with the euphoric or energizing comments because they’ve built a tolerance to those effects. There’s nothing wrong with that, because the therapeutic value doesn’t derive from inducing euphoria.
However, a drug-naive college student taking a double dose of Adderall will certainly be buzzing. For a short while. They will then suffer a rebound on the following day or days. There isn’t really a free lunch here.
The challenge is that non-ADHD people often try Adderall once, like the effects, and assume a positive response means they have ADHD. That’s blatantly wrong, but it has lead to many people pursuing unnecessary stimulant prescriptions in hopes of feeling that way every day. They are always disappointed when they discover that the long-term effects are very different than those first experience effects.
This isn't true, studies has shown that taking stimulants has no effects on grades for normal people. The "increased focus" they experience is just perception and not fact, it can even hurt their ability to focus. Being able to sit with a task for hours isn't "focus".
https://www.webmd.com/add-adhd/news/20180726/adhd-meds-no-he...
> The students also showed an improvement in their alertness and their ability to focus, the researchers found.
The idea that only ADHD people see improved focus from stimulants is purely false, as indicated by the article you provided. It's a dangerous misconception, as many people use this misunderstanding to self-diagnose as ADHD when they take their friends' stimulant medication and experience improved focus. We need to be clear that non-ADHD patients still feel increased focus from stimulants as well.
You are correct that over-medicating with stimulant medications can harm certain types of cognitive function, in both ADHD and non-ADHD people. Dopamine has a well-known inverted U shaped response curve for certain cognitive processes. Going too far past the optimal point can worsen, not increase the focus changes.
The study also used a strangely high dose of Adderall. 30mg of instant release Adderall (equivalent to 60mg of Adderall XR) is actually beyond the recommend prescribing guidelines for ADHD. That's the type of dose that would typically only be prescribed to patients with severe narcolepsy or severe, intractable ADHD. I'm not sure why they thought it was a good idea to give it to medication-naive study subjects.
Also I'm not sure what your point is. Yes many people abuse stimulants in this manner and hurt their life due to it. However many people also greatly improve their life using stimulants. The existence of the first group doesn't mean much for how I need to use the medication, all I need to know is that the medication greatly improved all aspects of my life going from an almost certain failure to a top performer. If you don't see life changing improvements in grades or job performance then you probably don't have ADHD, at least not the same kind I have.
Many prescribers will also start patients on very low doses and titration up to minimize the distraction of the euphoric effects.
Unfortunately, many mew ADHD patients mistake the initial euphoric effects for the medication “working” and get frustrated when the effects go away. They start chasing bigger prescriptions, shopping around for prescribers willing to give higher doses, doubling up doses and so on.
Everyone going into stimulant treatment should know that excessive stimulant dosing can worsen focus. If you’ve ever seen someone abusing stimulants, you’ll know exactly what this means. People on too high of a dose tend to be overly energetic, or overly focused on the wrong things.
Ideally, you want to be on the lowest dose you can get away with. Contrary to what is often repeated online, it’s best to take the medication continuously rather than skipping days. The medication should blend into the background while you work on improving ADHD. Don’t fall into the trap of leaning on the stimulant to solve everything for you.
I don't like being on stimulants though. When I'm on stimulants I can't just let my thoughts wander and do whatever feels right at the moment, and I really like that part. If I don't have work to do I greatly prefer not being on them.
The only time I feel the need to abuse them is when I am over burdened with work and I feel I need the extra focus to complete tasks. At those times I try to do the opposite, quit taking the medicine and calm down and tell people that I don't have time to do the tasks now.
> I don't like being on stimulants though.
It's very possible that you're on too high of a dose, or that you'd do better on an alternative medication. There are at least 4 different classes of ADHD medication, 2 of which aren't traditional stimulants. Guanfacine is remarkably effective, for example, but it's nowhere near as popular because it's much less enjoyable than stimulants during the ramp-up phase.
> The only time I feel the need to abuse them
Yikes. If you ever find yourself feeling the "need to abuse" a medication, I strongly recommend you keep an eye on those tendencies. That's the kind of warning sign than can spiral into addiction if you ever find yourself burdened by some unfortunate life circumstances (the trigger).
I don't abuse them though. Its just a thought in my head that pops up that I quickly dismiss.
> The real problem is the people who associate taking the pill with getting work done, to the point that they forget how to accomplish anything without first reaching for the medication.
Well, I couldn't accomplish anything before taking the pill. I didn't forget, I just couldn't get anything done ever. I learn stuff ridiculously fast though so I had no problems passing exams, but anything which required effort and focus like doing homework was never possible. Basically I was the best in class at exams and the worst in class at homework, to the point it prevented me from graduating. And as we know a job is more like doing homework than exam, so I never could do the things needed at a job.
Helps focus. Zero boost to energy.
It’s kind of like when it’s really late at night and your mind quiets and you get into the zone for a couple hours.
Factor 5 leiden, so different then most people.
It’s kind of between a TIA and a full stroke. I used to Get TIAs a lot, but ignored them as they lasted under 30 seconds. Now they are much worse.
Blood thinner mostly Prevent. Side effects can be brutal though. I seem to have permanently lost ability to write by hand. Thankfully typing is mostly intact.
Anything that acts as Vascular constrictors is seriously off limits for me.
Otherwise though, it checks all the usual boxes - way easier to sit still and be quiet, way easier to do the thing I intended to do when I sat down to do it, way easier to get in and out of focus. Also improved my sleep schedule a surprising amount - between it and melatonin, I've moved from 6am-3pm to ~12am-8:30am, which is wildly outside any of the expectations I've seen set for pharmaceutical remedies, and puts me firmly in 'able to hold a normal adult job without killing yourself through sleep deprevation' territory.
Honestly almost annoying it has such a positive effect since the practical difference between that and addiction are pretty minimal on a short-term basis. I'm deeply uncomfortable with the idea of having to go without it or something filling the same brain-holes for a long period of time precisely because I'm basically worthless without it, in a way I didn't really come to appreciate until after starting medication.
I've always assumed that this is the "right" response?
When people talk about stimulant medication and ADHD, the reactions tend to fall into two categories: Hypes you up, stimulates you, makes you talk fast and move fast, etc... Or calms you down, soothes you, allows you to think clearly, methodically, etc....
I bring this up because it's concerning to me that the "right" response is setting off "never abuse this" alarms. Is it the right response, or is it not?
Personally, I get that same sense of calm and wellbeing. It's why the drug works. My mind quiets down, my ability to hold attention increases dramatically, and my sense of well being ensues. I speak slower and calmer. I am less likely to argue with my spouse. Yes, I feel "good" but I've always assumed that's what its like to feel normal. Normal people get their prefrontal cortex for free, mine is unlocked through a drug.
I’ve always assumed that because I receive a sense of calm, well being, and presence of mind that I must actually be ADHD since everyone else takes these meds and bounces off the walls.
Now I’m thinking maybe that isn’t true, and maybe I’ve rationalized taking meds because it’s easier than forcing myself to sit for hours and get quality work done. Uhg.
I can confirm; I have ADHD and this even applies to stronger stimulants like cocaine. Cocaine doesn't do much for me, so I never understood why my friends were always bouncing off the walls while I was just chilling, like "what's the big deal with this drug". I didn't get it until I was diagnosed with ADHD and understood how our brains are wired differently.
Now he just smokes a ton of weed everyday, but you would never know it, he's very normal, stable. Off weed? He's a mess, bouncing off the walls.
When I started on Vyvanse after diagnosis, the biggest effect I noticed at first was that my mind just felt quite calm compared to usual. No high or anything like that, just .. not as many uncontrollable thoughts rushing around my mind like they usually do.
Can anyone break down the neuroscience for me and any meta-analyses studies on ADHD amph stims effect on early onset neurodegenerative disease?
https://www.medrxiv.org/content/10.1101/2020.05.06.20089748v...
I found no relationships with Alzheimer's.
The only big negative found seems to be blood pressure, but you can manage that just by keeping your weight in check and exercising regularly. I take medication and my blood pressure is at normal levels, I go for regular checkups.
The study authors actually mention:
"The association of ADHD patients prescribed psychostimulants with higher risk of diseases of the basal ganglia and cerebellum may reflect a more severe ADHD phenotype rather than a direct association between prescribed stimulant use and basal ganglia or cerebellum disorders."[2]
It's somewhat encouraging to see that this seems to be true and increased chance of Parkinson's is likely due to the severity of ADHD and not due to medication which helps people with ADHD be functional.
[1]: https://healthcare.utah.edu/publicaffairs/news/2018/09/adhd-... [2]: https://pubmed.ncbi.nlm.nih.gov/30209407/
My experience aligns with this. When I take one I feel normal. Like how I should be in society. Unfortunately it causes me vascular inflammation as headaches.
So had to give it up. I use a non stimulant one now. Seems to be helping.
My daughter just started Vyvanse. Report from teachers is that her behavior is dramatically better.
It does not make "high" in any sense. It does not create dependency (unlike, say, coffee). If I don't take it (and I often don't), there are no negative effects, just a lack of the positive.
Metylofenidat helps me a bit, but it gives "deadline-like focus". Focus, but rush, with increased anxiety.
(Ar)modafinil gives sniper-like focus. Decreased anxiety and emotional reactiveness, while still maintaining full emotional clarity. Non-deadline flow.
The first time I took Modafinil, I didn't feel like "on drugs". I felt the opposite - for the first time distractions (like checking FB every a few minutes) were not dopamine hits I craved. I understood a lot about "other people" and things people kept telling me for two decades. It seems that being less distractible was an everyday experience.
The only downside I saw is that it needs to be taken well before bedtime (as in: morning, noon) and that it makes one way less social (immunity to jokes, increased sensory sensitivity, "OK, but what's your point" approach to conversations, etc).
Readings: https://slatestarcodex.com/2014/02/16/nootropics-survey-resu... and https://www.gwern.net/Modafinil
I don’t think I have ADHD but i want to take ADHD drugs to help with focusing. So I think I can be categorized as the Non-ADHD people.
I definitely feel an euphoric high when I take it, although it is less intense than MDMA, marijuana, or even alcohol.
You are correct to point out it doesn’t really help me focus more or improve performance. Its smart drug reputation is really misleading.
I found it less potent than coffee, which makes me very focused.
It’s most noticeable effectiveness is the suppression of my appetite and sleeplessness. When I am on it, I don’t feel hungry or sleepy at all.
I couldn’t work without drinking an insane amount of coffee, which makes me sleepless.
I plan to alternate between adhd drugs and caffeine.
> Stimulant drugs do improve the ability (even without ADHD) to focus and pay attention. One function, which is reliably improved by stimulant medications, is sustained attention, or vigilance. Stimulants improve sustained, focused attention, but “selective attention” and “distractibility” may be worsened, possibly because of a drug induced increase in impulsivity. [1]
I currently take a small dose (5mg) of Evekeo with only very mild side effects. On 30mg of Adderall XR I felt some euphoria for the first two weeks and the insomnia was pretty bad for the first week or so.
I'm sorry but you clearly haven't even tried to research the subject, so I'm not surprised you don't believe it. People with ADHD have been scientifically proven to have deficiencies in specific neurotransmitters, namely norepinephrine and dopamine. There's multiple studies on ADHD and reward pathways you could find with a simple google search.
If you understand how amphetamine based stimulants such as adderall work, you'll know these are 2 of the major neurotransmitters that they target along with serotonin.
The entire reason for using these types of medications is to improve availability of neurotransmitters to those with abnormal production that impedes cognitive function. Sure people with normal levels can take stimulants and see effects, since these drugs don't balance levels, they just increase them. In a person with normal dopamine production it's just going to lead to an imbalance, and result in the euphoria feeling they're seeking, whether they want to admit it or not.
Edit: the article you posted doesn't even support your argument. It seems in people without ADHD, the medication resulted in increased impulsivity and distractibility.Most likely as a result of abnormal levels of norepinephrine. This is evidence of the drug having literally the opposite of it's intended effect when taken by people without ADHD.
This is another passage from the same paper:
> As it remains unclear whether stimulant medication has the same effect on healthy individuals as for those with ADHD, it is possible that many reported effects of prescription stimulants in healthy individuals may stem from placebo effects.
If you have a citation that argues that stimulants affect people with and without ADHD differently I’d love to read it.
Here's my anecdote which runs quite opposite yours: As another person with ADHD who has been prescribed a low dose of Adderall XR in the past, it's always been an unpleasant experience for me, to the extent that the prescription bottle said "as needed for academic work". It did help me focus for a few hours, although whether I focused on the important things or distractions was up to my non-medicinal coping strategies among other factors. Unfortunately, disruptive and uncomfortable side effects lasted far longer than the period of improved focus.
Nothing I just described matches my understanding of how neurotypical people enjoy Adderall as a recreational drug.I don't think I've ever once in my life actually wanted to take it or enjoyed the experience, not even on those occasions where I chose to take it (the last of which was almost a decade ago) because of the beneficial effects it was prescribed for.
> People with ADHD have been scientifically proven to have deficiencies in specific neurotransmitters, namely norepinephrine and dopamine
Please cite your specific evidence, and make sure it is not studies that do not replicate.
> evidence that for non-ADHD adults, taking ADHD medication in doses that it would have been prescribed, does something significantly different than it does to adults with ADHD
I was asking after.
I believed the idea of imbalanced neurotransmitters readily, as you hear it from authoritative-sounding sources, until some reading made it clear that not only is it not true, that most serious practitioners know it is not true. I remember a talk by the author of "Mad in America" (obviously not an unbiased source) saying that when he discussed this with practitioners they said "of course we know the chemical imbalance hypothesis is not correct" and he said "well you forgot to tell the American public"... That really stuck with me.
Off topic to your comment, but germane to the thread: I keep wrestling with this, but as I move beyond just reading abstracts and summaries of the research, I have to question the idea that ADHD is easily explainable, has any single cause, or is even manageable long term with stimulants [1][2][others, but I am still reading the literature]. I am still trying to answer questions I thought were clear: Does ADHD exist in a meaningful way[3]? If so do stimulants treat it long term [4]? If so at what cost[5]? I thought these were settled questions but the more I read the less convinced I become (I know there are many studies showing different results or debating the results of studies I have linked)... I just put these thoughts out there for anyone on a similar journey. Not to undermine anyone's personal experience; I tried many meds, some helped significantly but side effects ultimately made me stop, I do not doubt people have these symptoms (I do) and that medications have an effect. Good luck to you all! I appreciate reading everyone's input.
[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5510202/ [2]https://ww2.health.wa.gov.au/-/media/Files/Corporate/Reports... [3]https://doi.org/10.1136/bmj.c547 [4]https://pubmed.ncbi.nlm.nih.gov/19318991/ [5]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670101/
The idea that the drugs "cure" or "treat" is just a social construct to justify their usage.
From first hand experience, it doesn't take much to get an ADHD diagnosis, as long as you seem credible and not drug seeking. I could ask my psychiatrist for practically any drug I wanted. It does not seem like a viable long term solution for me.
Then why do you think stimulant medications were ever approved for adhd treatment?
Of course they were work differently for people with and without adhd. For people without adhd the stimulant medications do not treat the adhd. If you try to sort of isolate out that part of it... what are you expecting to find?
Stimulants will help anyone focus, ADHD diagnosis or not.
To refocus the conversation, the specific trope I see again and again is “stimulants will make a person with ADHD calm and a person without ADHD hyper”, which I do not believe is true. If there’s a paper that provides evidence for that I’d still love to see it.
> specific trope I see again and again is “stimulants will make a person with ADHD calm and a person without ADHD hyper”, which I do not believe is true This statement is compacted and leaves out some things. I have a bad case of the inattentive adhd variant. With that came that I am really bad at filtering out sensory stimuli of any kind, sound, light, touch. They feel "loud" and prevent me from focusing for example on a conversation with a person. However stimulants increase my ability to tune out these distractions. For me stimulations were such a relieve after over 35 years to not be bombarded with sensory stimuli and finally being able to quieten this noisy mess, that made me a lot calmer - even when I am pausing medication for a few days. So believe what you want, me and others who take the medication are glad for the relieve it provides. However many websites use tropes you mentioned in a way that makes ADHD seem not very credible. It is important to differentiate between medical facts and for example websites that try to make people seek treatment by a healthcare professional. With such deseases often come secondary psychological problems that may cause a suffering person not to seek treatment. So some websites try to break through this barrier.
Neither is such a statement made on the product labels.
I have seen such absolute statements along such lines made in the popular press and their online equivalent, but I'd rather leave toilet paper out of the discussion.
So by all means, do not believe the statement is true, but understand that there is, in fact, no broad acceptance or community belief of such an absolute statement being true, and furthermore, rather crucially, that what you may believe has no bearing whatsoever on the veracity of individual experiences.
Consequently, even the anecdotal reports have continuing clinical relevance, because:
* Medicine is the field of treating a patient, and if the result is a better adjusted, rested, and socially engaged individual, then any such observed effect for the individual patient calls for psychiatric consideration. What such effects are not, is diagnostic, or the basis for a product claim; and,
* Science is the field of explaining phenomena, and the reports are not adequately explained by the research, in large part because the wide gamut of behaviours, symptoms, mechanisms, measures, and outcomes collectively labelled "ADHD" are themselves a very poorly explained and haphazardly classified selection of neurological variations from the population majority. This being, of course, a very common circumstance in the young field of psychiatry.
All of which means there is no such paper, and besides, no-one is even writing one.
Only if you're not used to it there is this "bouncing off the fucking walls" effect. But it goes away if you know this effect already.
Than amphetamines can increase focus, and make you chill instead of hyper-active. That's why people take it to study for example actually.
After a few days of continual use only the increased focus effect stays. But it doesn't have almost any effect on one's mood any more. Actually it can even cause a significant drop in mood.
Still it's addictive. Like tee or coffee, which won't make you feel full of energy any more when your addicted, it just becomes a necessity to "function". You can show all physical symptoms of "being sky-high on speed" like pupil dilation and such, but just go to sleep for example.
I don't question that the effects of stimulants like amphetamines may help overcome some medical conditions, only that I don't think that the effects are much different in otherwise healthy individuals.
Stimulants help everyone focus, it’s why people drink coffee.
Everyone would perform better on a low dose Ritalin. I think people just rationalize a special need for them. Erdos famously took amphetamines.
I’d buy people have variable baselines, but I think everyone would benefit from stimulants if they could take them.
>For people with ADHD, they can be truly life saving. For recreational use, avoid.
Just so you are aware, amphetamines are and have been used widely, and successfully, by people without ADD/ADHD. It has addictive qualities for sure, but I appreciate that people are allowed to try whatever substances they would like to try.
Beyond everything else you've said which is all correct and reflects my experience, I want to point out something that doesn't seem well known in the general fabric of the ADHD topic:
Addiction and substance abuse are a common trait in adult undiagnosed/untreated cases. Alcohol abuse, amphetamine abuse, you name it. I can speak from personal experience here: before I understood I had a real chemical imbalance affecting my whole life, I had used and abused alcohol to the point it significantly damaged my life, and some important relationships. I can't say for sure that wouldn't have happened if I'd been diagnosed and treated earlier, but I can say the knee-jerk reaction about medically prescribed treatment that has very little risk of abuse/addiction is inappropriate given the outcome that's much more likely without treatment.
Yes! I took Vyvanse for a little over a year. It was the best thing ever at first. The effects got progressively weaker until I could no longer justify using it due to the cardiovascular risk. Now I only take it before a high pressure test or performance.
Wish I could go back in time and take that drug again as if it was the first time...
> The proper medication and dosage should not make you feel "high"
This high is correlated with how fast the stimulant enters the brain. Drugs that enter the brain quickly and in large quantities often give this subjective experience and they're more addictive because of it. Route of administration can influence this. Safer drugs with lower abuse potential are designed to be released steadily in lower quantities over a long period of time.
Vyvanse is just an Adderall that gets released slowly over a long period of time. Therefore it has lower abuse potential than Adderall.
Is this not aso a common effect on the non a.d.h.d. sufferer,? which is why it is so commonly taken on exams, as a means to increase performance.
> For people with ADHD, they can be truly life saving. For recreational use, avoid.
Avoid it more than any other recreational drug?
Take 5-30 mg of Dexedrine, you'll be focused, a bit euphoric, maybe some jaw tension and anorexia. You'll get a lot done. Mild crash? It's a risk.
Smoke a point of meth and you'll be taking apart your toaster in no time. That's 100mg for those of you who grew up on the right side of the tracks.
I'm diagnosed ADHD, by the way. I prefer modafinil over amphetamines, I find the high milder, the wakefulness promotion is a nice bonus, it lasts longer too.
But this is, to be frank, what we used to call an old wives' tale. There is no medical basis for saying that stimulants hit ADHD brains differently. It seems to be a combination of wishful thinking, and doctors choosing to not let the general public know that low doses of stimulants will improve their focus and executive function as well.
Honestly I think that's a pity. Stimulants are a useful adjunct for productive work, at a reasonable dose. America did just fine, for decades, with de-facto legal amphetamine, nor has criminalizing it done much of anything to blunt the epidemic of abuse.
The difference between ADHD and the elusive "normal brain" is that a lot of us need our meds to function. I've taken a few months off, even a few years at one point, and looking back it was a disaster. I still take weekends off whenever I can, and the lowest dose I think I can get away with.
https://astralcodexten.substack.com/p/know-your-amphetamines
My girlfriend is on a slow release ADHD medication, once a day; for her, it has to be a daily thing because else it just stops working. Is adderall a slow release one? May be more beneficial.
That said, what effect are you expecting? She describes the main effect of her medication to be a mood stabilizer.
Interesting. I have ADHD (inattentive subtype) and am quite the opposite. My apartment is never cleaner than when I have an extremely important, open-ended project with multiple stakeholders to address. Seriously, I end up dusting the screws that hold up the door frames.
A technique I use is to break down the project into smaller pieces. What's the smallest well-defined task/goal I can work toward. Even if it's just setting up the repo, or writing out a README. It's amazing how often this little step can help kick things off.
Here's a large, open-ended problem I want you to solve this quarter. I'll secretly wait while you fix a thousand other unrelated problems that make our business better despite making no visible progress on the open-ended problem. Then I'll reframe your work to show management that the thousand other things you improved are more valuable than the open-ended problem, and get you promoted.
I miss that guy.
It seems obvious after it being mentioned, but I noticed a useful corollary: a list of done tasks actually makes me unhappy. So I avoid todo pages where a done list is visible. Hiding done tasks (i.e. archiving done cards on Trello, deleting a row on your todo list instead of strikethrough), etc. has led me to use it better.
This isn't your problem, clearly, but just wanted to share a useful tip.
The key though, is not just "making to-do lists".... it's right-sizing the items on them.
Every task should have a finite end state and (this is crucial) shouldn't be longer than 15-20 minutes or so. If they are longer than that, it almost certainly needs to be broken down into constituent tasks.
So even something like "clean my office" probably needs to be broken down a little more -- when I'm on my game I break it down into "vac office", "dust office", "organize desk drawer", etc.
This pairs nicely with the "Pomodoro method" if you've ever tried it.
1) A tough project can be engrossing. Getting started is always tough, but after that it's relatively easy to keep up momentum.
2) Menial tasks are not engrossing and are usually quick, so they require a level of attention control to stay focused on them that I'm just not capable of. It's like "getting started" over and over.
There’s a growing tendency for newly diagnosed ADHD patients to try to explain all of their mental habits and preferences through the lens of ADHD. Some times they have helpful feedback for other people with similar habits, but other times they just paint ADHD with an overly broad brush. They often have unrealistically lofty ideals of what a non-ADHD person looks like, or describe basic human nature as ADHD (for example: it's perfectly normal if you'd prefer to play video games than do your homework. We've all been there, ADHD or not)
One thing I would recommend: Don’t let an ADHD diagnosis define your personality. A diagnosis is simply a guide map for treatment. It shouldn’t become a stereotype that defines you as a person. Use the diagnosis to learn techniques to overcome difficulties, but don’t let the diagnosis become a convenient excuse to let yourself off the hook or explain away concerns that would be better served by some personal growth.
I've noticed this a lot on the ADHD forums. Agreed, it's uncomfortable to read.
Personally, I'm very embarrassed and ashamed of my ADHD (hence the throwaway account here), so I try to minimise what I consider its scope as much as I can. When I was eventually diagnosed, even though I sought out being investigated for ADHD, I was disappointed! I said to the psychiatrist, I was hoping you'd tell me it's something else. But no, it was ADHD, and the medication does help.
Also if I am explaining it to someone for whatever reason, I'll make sure to point out that it might be a reason for some things, but not an excuse. I hate the thought of not taking responsibility. I mean, it's still my broken brain at fault, even if I didn't break it myself.
"... but don’t let the diagnosis become a convenient excuse to let yourself off the hook or explain away concerns that would be better served by some personal growth"
I totally understand this perspective and I do think it's a healthy one, but, where do you draw the line?
I've been diagnosed with ADHD but personally hate the diagnosis. I don't want to be viewed through that lens, nor do I want to view myself that way.
That said, there's just no denying that I'm a different (better) person when I'm treating the condition. I get more work done. I fight less with my wife. I'm way less frustrated angry on a daily basis, etc. Small tasks that normally seem like mountains, become mole hills.
I've done counseling and I've done exercise, diet, sleep. I've seen the most dramatic results when I've just accepted I have ADHD and taken medication. Yet comments like yours re-ignite my desire quit taking the medications, and return to what feels normal ... even if feeling normal was so bad for me.
What I'm trying to say is ... I think some people DO need to lean into the diagnosis. Accept that it's part of their life. If treatment improves your life, don't shy away from it.
I don't know. I'm still just trying to figure it all out myself. I hate the idea of being "ADHD" but I'm starting to form the belief that I need to do what's right for my future, and my family, even if it means accepting I have a condition that requires something as dramatic as taking medication.
Totally with you on this. And I think I understand why some people make it their entire personality, but that just feels all wrong to me. To be honest, I regret telling anyone at all about it (outside of anonymised discussions such as this).
The way I see it, it's okay to feel really bad about being afflicted with this condition, and coy about acknowledging it publicly, while still quietly continuing to take the medication to mitigate it somewhat.
But it's difficult to come to terms with even so. I sincerely hope you find peace of mind.
A lot of conditions are normal human traits, but amplified / exaggerated. This makes them understandable to neurotypical people, but also easily trivialized and misunderstood.
I follow some ADHD accounts on Twitter, and to parody a little:
"A dog with floppy ears barked at me. It think this is a typical ADHD trait - dogs with floppy ears never bark at neurotypicals."
it does dry out your oral/nasal cavity. It can cause your body to produce mucus to compensate. I commonly feel like swallowing is slow as if there is a thin layer of mucus lining my throat. Even had yellow mucus drip out of my nose as if it were a nose bleed (happened 3-4 occasions), which comes from having a sinus infection.
This is one of the reasons I switch to micro-dosing on an empty stomach and supplementing with coffee to limit exposure to amphetamines.
It's possible for it to lead to increased clenching/grinding of teeth.
With that said....a decent diet and doing all the things you're supposed to be doing anyway in terms of oral hygiene and you ought to be fine. It's not a "you're going to ruin your mouth", it's a "pay more attention to this".
Been taking Adderall XR for >10 years, no cavities or other dental concerns personally speaking.
Go ahead and take legal cocaine though, hope your post helps you sleep at night
Do you know their entire medical history? How severe the ADHD is? Any other issues they are treating or not treating? If you can point to a study to back up what you are saying then by all means go for it. Otherwise all you have is anecdotal evidence and pretty weak evidence at that.
I get a new pharmacist every time I fill a script and I never share one iota of my diagnoses with them, they just fill the Rx and advise on contraindications and unusual doses they see.
Can you see into a person's brain with your own 'two eyes' as well? A neuroscientist can actually see our neural activity with fMRI and other tools to study brain science unlike your pharmacist buddies and yourself talking to random customers for 5 minutes in a grocery store.
I'm certainly guilty of that last one. Since getting diagnosed I've been making a point to never leave a health problem ignored. Sure, it might take 6 months to a year for me to eventually book the appointment, but I'm getting them under control at my own pace.
Edit: smokers have reduced rates of Parkinson's disease, and nicotine is a stimulant.
Consider
Lifetime Remaining x Quality of Life
If QoL is negative but can be switched to positive at some cost of LR it's not a hard deal to make. Especially in a world with car accidents and deadly diseases.
If taking Vyvanse most days knocks a few years off my lifespan, it doesn't matter. I'm going to die anyway, eventually.
As we all are, ADHD-medicated or not.
It's also worth noting that ADHD often comes with other mental health comorbidities; in my case, it exacerbated my depression. I would often fall into a spiral of inability to focus -> feeling bad about myself for not completing work that I was generally more than capable of doing -> even less ability to focus. I still have depression, but starting on ADHD medication all-but-removed my most frequent trigger.
I had the same issue!
I told my prescribing doctor this same thing and she trusted me enough to try out Adderall before SSRIs again. Turns out my hypothesis of my depression + anxiety largely being tied to my sense of productivity was right.
After going in for an EKG check-up on orders of the prescribing doctor, I found a fairly benign heart issue that the cardiologist believes may be the cause of my "panic attacks" (eg: my attacks may be heart racing -> panic, not panic -> heart racing!)
All of that from just treating "I feel bad because I get nothing done".
Not sure. My provider asked me to get one done. I talked to the cardiologist about this and she didn't seem surprised it was requested nor that I was the first to get it done.
Did you get a big boost when you first started with it that reduced as you developed tolerance with habitual use?
I've always been pretty careful with caffeine consumption in order to avoid tolerance, because I didn't want to get into a state where all it did was boost me back to my "normal" (i.e. feeling crappy until I got my coffee, and having to use increasing amounts to get past my baseline).
Similar to the feeling (although much weaker) hydrocodone gave me after I had oral surgery.
I've been toying with the notion that I may be having an undiagnosed ADHD for a while now (I've noticed that about 70% of the stuff in any ADHD thread on HN, like this here, tends to reflect my life or at least resonate with me...). I became more confident of that when, at one point recently, I realized - hey, I'm drinking some 10+ cups of black tea every day, and I did that since being single-digit years old. Turns out I may have been unconsciously self-medicating for as long as I remember.
BTW. I suffered from the same type of spiral you described in the past. I've managed to mostly overcome it for now, though I took it from the other end - I've manged to minimize "feeling bad about myself for not completing work that I was generally more than capable of doing", to the point of preventing the positive feedback loop. I wish I could do something about the focus part, though.
After that, realizing that my preferred decongestant was not only helping my cold symptoms, but also allowing me to pay attention when people were talking and complete plans in a "this seems like that thing other people are really good at, but I'm not" kind of way... that was a major tell.
Interesting. Was it pseudoephedrine? I took Allegra-D every day in high school and college to manage allergies as wells as colds and sinus infections. (I hear that's not advisable, but I didn't know any better then, and somehow my allergist didn't either.) I wonder if it was helping me concentrate also.
I've never been diagnosed with ADHD, but many of the things people are describing here are familiar. Overall I've been pretty successful in life despite this, but I've had my ups and downs. The pandemic has been a down; I'm really struggling with concentration, so much so that I left my job and am taking a sabbatical before finding another. There are certainly valid reasons it's been hard (e.g., I have two young kids, went entirely without daycare for a while, and am helping my son with online kindergarten now) but they seem to affect me much more than my wife, whether that's due to undiagnosed ADHD, anxiety, the different natures of our work, burn-out, or some other factor.
I do wish I hadn't waited 15+ years between diagnosis and medication, because it is life changing. I can now read HN/reddit without getting sucked into a vortex of endlessness. Pomodoro actually works. And the inner chatter, they still exist. The TVs in the head are still on with all the channels going at once. But you now have a remote control with a mute key and you get to choose which channel you wanna focus on.
p/s if you're Aussie, Vyvanse is now on PBS so you no longer need to pay $100+ a month - rather it's now $6 to $40 depending on your cirumstances.
Many newly diagnosed ADHD patients make the mistake of thinking that they don't need therapy or self-help techniques now that they have stimulant medication. That's wrong. The stimulant medication should be used as an adjunct to therapy, self-habit, and developing good self-control techniques. The initial motivational boost of a new stimulant prescription won't last forever (concentration-enhancing effects do persist, though). However, good self-control habits will last a lifetime.
A (rather iffy) analogy is like a man trying to lift weights with very low testosterone. Going to the gym still helps, but it's an uphill battle to put on muscle until the underlying issues are corrected. However, fixing testosterone alone won't get you into great physical shape. You still need to put in the work to make the most of the corrected physiological condition.
Anyone with ADHD severe enough to warrant stimulant medication is absolutely in need of good self-control habits and other such improvements. Therapy is one way to get it done, but I never suggested it was the only way.
It's a common mistake for newly diagnosed ADHD patients to assume that medication will automatically build good habits for them. That's not true. Medication is best combined with a deliberate effort to improve self-control and create positive environments for focus, as many ADHD patients have explained elsewhere in this comment section.
I think the mistake in your line of thinking lies here. Why do you think is the case? Could you not imagine a person who tries medication first before anything else?
As a Aussie who is currently prescribed Dextroamphetamine, this makes me happy to hear.
I've been keen to switch to Vyvanse for a while now and my psych is open to the idea, but I haven't done it because of the cost and apparently there was a supply shortage for a while and I wouldn't have been able to get it at my pharmacy.
Now that I know it's on the PBS I'll have the conversation with my psych and hopefully be able to switch over too it.
Dex is too much like a rollercoaster for me, the idea of taking one extended release tablet in the morning I think would be a much smoother experience.
It's really hard to make people understand what the effect is, because everyone says "yeah I am distracted often too when I work", but it's not that you get distracted, but the intensity of distraction.
I usually describe it like: You have thought A and thought B. And between there is a lot of noise like "AFEWFVWRGBWIHGiwgbsigbeiscgedhtbvhrbdrtbhvdbhktvrbre". And with my medication it's like "rgerbdjtfkvsg".
It's a game changer.
Thank god for TheGreatSuspender, and SessionBuddy extentions.
1. asks for permissions like "Read and change all your data on the websites that you visit" / "Read and change your browsing history", and
2. either
a. auto-updates, or
b. includes by reference code that isn't contained in the extension bundle (so it could change day to day)
I just can't bring myself to close them.... What if I forget one of the things?!
Then paste it into Joplin or something.
I've also stopped saving links to stuff I found on-line, because I never revisit them anyway. I once thought my "to read" list was my most prized possession. Now I realize it was just a way of making my procrastination seem productive.
(Also, I use the Pocket extension to stash things away that I will "read later" even though I never do until I'm on a flight and need something to read.)
One of my favorite signs you might have ADHD. Caffeine doesn't do anything for you and/or makes you sleepy. You've never know what other people talk about when they describe being "wired" after drinking an energy drink. Bonus points if despite "doing nothing" you still intake lots of caffeine. Congrats! You might be self-medicating without knowing it.
Everyone will recommend the book The Disorganized Mind for lots of good non-medication strategies and I'm no different. It's fantastic.
Mark Suster’s posts were what set me on this track of self-realization (along with my best friend and fiancée telling me to consider it), so I’ll leave them here in case they help anyone else too:
[1] https://bothsidesofthetable.com/how-to-know-if-you-have-add-...
[2] https://bothsidesofthetable.com/why-add-might-actually-benef...
[3] https://bothsidesofthetable.com/developing-an-action-plan-fo...
Caffeine is an adenosine A2A antagonist, which has therapeutic potential in ADHD, except the half-like makes it an improbable candidate.
Ironically, I just started taking an adenosine a2a antagonist, known as Nourianz (istradefylline) (link: https://www.nourianz.com/), as a last-resort drug for my severe restless legs syndrome, which has been going phenomenally well. I also have ADHD combined type (inattention and hyperactivity), and fairly severely. I take Vyvanse for my ADHD.
Anyways, I have been taking the the istradefylline for a week now, and it has made a tremendous difference in many of my ADHD symptoms. Additionally, it greatly increased my sense of wellbeing within 1-2 hours of initially taking it, and it has been sustained for the entire week.
Thanks to istradefylline I can now focus seamlessly and without effort. I can just "lock in" to whatever I want to do. Before, it would require some static force ("friction") to be able to "lock in" my concentration to do the task. I can also now just focus, without hyperfocusing. It now comes naturally to me. I also no longer find myself pacing around the house aimlessly. I also do not randomly get up from my seat or fidget hardcore. I can also lock back into a flow state without effort if I am disrupted.
I hope you find this interesting! The adenosine a2a antagonist made a huge difference in both my restless legs syndrome and ADHD symptoms. I cannot imagine NOT being on this medication for my ADHD.
Does tea count? Drinking coffee does sometimes (not always) make me more awake, and usually also makes my whole body feel weird (in a bad way) - but if I drink coffee, I do that on top of 10+ cups of black tea I drink every day, as I drank ever since I was 7 years old or something.
In the United States, there are two tests for ADHD I would vouch for: Conners' Continuous Performance Test (CPT) and the Test of Variables of Attention (TOVA). Both are computerized. Both rely solely on your reactions and your restraint, they are not questionnaires. We had plenty of patients who had been diagnosed via questionnaire who did not show up at ADHD to a significant degree on those tests. Rather, they had some other underlying disorder that can also mess with attention, such as, sadly, early onset schizophrenia.
The other benefit of these computerized tests is that you can use the to titrate your medication to an appropriate dose, as most stimulants have an inverted U-shaped response. Too much and you get to feeling like a zombie. Gain weight? Retake the test. Maybe you hit puberty. Retake the test. Maybe you have side effects and you need a different formulation or a different medication all together. Retake the test. By doing this, you can figure out what your optimal dose is, even figure out at what time you "peak."
The other way to diagnose is through a PET scan but I don't know anyone in their right minds who does that.
CPTs and TOVAs, I don't know how much they cost today but I would say that they are worth it, both for peace of mind (I really have it, my parents didn't just answer the questionnaire hoping to get certain results) and for the ability to tune your medicinal needs.
I'd much rather not fork over my precious currency to some rent-seeker just so they can let me do the test on their computer and the give it their stamp of approval.
If there's nothing but a description then I'll go and implement it myself and release it on sourcehut.
1) Which types of attention will you measure and how do you differentiate between them?
2) Do you have an extensive body of testing to establish baselines, normals, standard deviations, and the like?
3) Do you expect a psychiatrist to write a prescription of a scheduled drug for anyone based on something they downloaded off of, say, sourceforge, or cloned out of GitHub?
Even if you valued your time at a buck an hour, you're not gonna get cheaper than forking over your precious currency to some rent-seeker.
Also it takes much less than to get a scrip, just those shitty questionnaires.
And I would if it time well spent if it helped me and others to manage their illness.
They're not going to give you the source and they're not going to give you the base data. You can test people for times but you don't know the cutoffs or the norms for those times. You don't even know if high or low of a norm is a sign of attention or inattention. You'd have an easier time replicating the MMPI.
But go for it.
I don’t like how stimulants make me feel, even though I know they might make it easier to fit into society. It is probably hard to describe how they make me feel to someone who does not have the underlying condition, like trying to describe how it feels to get a prosthetic arm to someone who has never lost their arm to begin with.
Compared with other people, my internal experience/world seems frantic. If I sit for more than 30 seconds alone without my phone I will have wild daydreams—-my mind works kind of like the old website StumbleUpon. Or like being in a crowded restaurant and trying to follow everyone’s conversations. My favorite quote regarding ADHD: “my brain never takes the same route twice”.
But I don’t think that stimulants make me have a “normal” experience like “normal” people do. Yes, on one hand the increased dopamine means that I am actually able to maintain a mental checklist for more than 5 minutes. I’m sure I would be the best employee ever, and the yessiest of yes-men. There is an element of taking stimulants that feels just like putting on noise-cancelling headphones and produces the same focusing effect.
But there is also a dark side. I can’t relax. I feel absolutely driven to accomplish things. The outside world impinges so much more heavily on my mind. My access to my intuition and creativity are diminished. My jaw is clenched. Instead of forgetting to eat like normal I am just not hungry, my stomach is churning. It makes me feel like a golem. There is a chance that minus the physical side effects normal people do feel this way mentally, but it is so much more sterile. It’s like trading the lush forest of imagination for a cubicle farm of execution.
My personal theory is that ADHD is just at the far end of the normal distribution of personality and that it is a trait that is very useful for raising children. In a real way there is a childish wonder that I have never lost, even as I see those around me “grow up” (i.e., become rigid). I have heard other theories regarding it being adaptive for hunting. Either way, I enjoy my existence as a space cadet. My whole life is shining with such a rich and imaginative inner experience and I don’t think I owe it to anyone to dim that brightness just so I can fit into their terribly boring, rigid, and repetitive world more easily.
It's also terrible for raising kids in my experience as because of the large genetic component it's likely one of your kids has it too. So now you have this little firecracker who won't sit still and bugs you near constantly while you just want to retreat into your world and get sucked into what it is that you want to do. You get frustrated and aggravated when they disturb you and they get frustrated and aggravated when you seem disinterested in the thing they're intensely interested in.
At least that's how it tends to go in my household.
You might be overdosing or particular drug is not for you - try another one.
Two days after I suspected I had it I saw my doctor. One month later I was on medication. A few more months and I am in weekly counselling. For me personally, the positive changes from medication and counseling have been dramatic and immediate.
After only 4 months, my coworkers impression of me is starting to shift for the better.
ADHD is a serious mental illness. I'm so thankful that the help I'm getting is working.
"Taking Charge of Adult ADHD" by Barkley, helped me understand ADHD and how I should deal with it.
I waited until 25 yrs old. Took a break for a bit but restarted at 33. I don't think I'll look back. The medication is such a night/day experience but it's only half the battle for me. Gotta break the bad habits (not filing away, not reviewing the day, etc).
---
In the end of 2019, YouTube randomly recommended a video to me, in which a guy talked about his experiences of growing up with ADHD. I never thought that I had it, but what he said resonated with me so strongly that it scared me. At about the same time, my GFs younger brother was diagnosed with ADHD. Started reading more about it, because my knowledge at that point was "kids who can't keep still".
A book which particularly shocked me back then was "ADD stole my car keys" by Rick Green. It felt like reading my own diary, it was very creepy.
So I started wondering if I had it. Talked about it to my doctor and he recommended a specialists who diagnoses ADHD. So I went there, and after months of questionnaires, tests etc. I got the confirmation which said, that I indeed had ADD.
After that, there was a time period where I was able to live with ADD and actually start organizing my life etc. Then Corona hit, I was fired (got a new, better job, no worries) and it kinda reset my progress.
Now the critical thing was the medication. It seemed to work, but in a way I didn't completely like. I was able to focus more, and my emotions were in check. But I wasn't hungry, it made me apathetic and my creativity went away. Granted, my job does not require creativity, but it feels weird to take a pill, which sole purpose is to make me compatible with the capitalistic world we live in. I was able to work, but my personality was lost while being on meds.
> It's either, take that pill and turn into a robot, or...
Might I suggest you think of it this way: Take that pill and realize my enlightened self or try to love myself in spite of my chemical imbalance in the brain.
> can't even summarize without writing a wall of text...
Although I'm not currently taking my advice here. Might I suggest that if you JOURNAL your personal thoughts, it's really helpful to realizing what you're trying to say to yourself. There is nothing wrong with a wall of text, even for summaries. I found that journaling was a great way for 'someone to listen to my random rapid thoughts'. (Note: This doesn't need to be everyday, nor some big burden. Just do it as often as you think about it and for as long as you desire in any given moment :D This will pay dividends for your awareness in just a few months of sporadic posts, even without the meds)
> But I wasn't hungry, it made me apathetic and my creativity went away.
Hmm. I'd suggest you try a different medication. There are multiple meds that help with this. (spelling probably wrong) Modfinil, Adderall, Vyvanse, Ritalin, Dexadrine, etc
I've tried them all and honestly, if I was able to, I'd want a few different meds, at different dosages because I know it would be a better combination for me than just one med. Ritalin is a non-starter for me, the side effects are too serious. Vyvanse and Modfinil were 'gentle' but not aggressive enough on my symptoms (no side effects but maxing out the dosage still felt too little of a positive effect on me). Dexadrine worked with another med I was taking (prozac) but I wouldn't 'get things' done as efficient. Then I changed my other med to Wellbutrin (a better depression med, imho, super cheap too) and Adderall worked perfectly in concert with it (this is now affordable for out of pocket care in the USA). [Note: This is my personal experience. This paragraph is over 2 years of trial and error. Some things worked for a few months but didn't actually work, after some introspection. Try things and be aware of what's happening to your body. My situation is unique to me, yours will be different but try to understand your situation better]
Finding the right meds, for your unique biochemical makeup, is a very large task. Most doctors aren't as detailed and provide a Bespoke service. Try to give yourself a Bespoke level of care. Do it with the counsel of a doctor, many doctors will be okay with this because you're under their care and they tend to only put in the level of effort that you request. So, talk with them and try to find something better for yourself. It make take years but realize, being on some meds, you're learning about yourself and you're making progress on what you want (not what capitalism demands).
Sometimes I get a good feeling, and this comment section gave me one :) Seems like the place to write about ADHD.
> Take that pill and realize my enlightened self or try to love myself in spite of my chemical imbalance in the brain
That's actually a good quote, thanks for coming up with it :)
> JOURNAL your personal thoughts, it's really helpful to realizing what you're trying to say to yourself
That's such a good point. Lots of times I spend months thinking about stuff, but rarely come to a conclusion. Sometimes gets to a point where I think so much about something, that it starts to pull me down mentally. But everytime I write these thoughts down, most of the times because I stumble upon a comment which talks about the same topic, I feel like it allows me to summarize these thougts and understand them fully. Somehow I only noticed this now, with you telling me that a journal could help. So thanks again, I should probably start writing a journal, after all, I liked writing stories as a child.
> I'd suggest you try a different medication
I probably should, yes. Funnily enough, I (illegally) self-medicated with Modafinil, a year before I even suspected that I had ADHD. I was just always tired with no motivation, Modafinil helped quite a bit. But it's not an official medicine in Switzerland, so I ordered it over the internet. Obviously that's a terrible solution, so I stopped after 2 blisters.
The official med they gave me was Concerta, which is basically Ritalin for adults in Switzerland.
I spend like 99% of my time on the internet on US-centric platforms. When I informed myself about ADHD, I exclusively read from US sources, Russell Barkley as an example. Now the annoying thing - Adderall, as an example, is just not prescribed in Switzerland. You can only get it in very rare occasions, or if you migrate from the US. Lots of times when I talk about meds or ADHD-theories with my doctor, they either don't exist here or they have another name, which makes that whole ordeal a bit complicated.
I should call my doctor to renew my Concerta prescription. That's another thing, the prescription has to be renewed constantly, but with 'rona you can only get appointments for urgencies. Plus, at the pharmacy I get treated like a drug addict. Last time I tried to pick it up, the prescription expired like a week before. I didn't know that, because the prescription is stored at the pharmacy. The pharmacist then decided to look at me very sincerely and state with a loud voice, that he "can't just give Concerta with an expired prescription, we are talking about extremely strong narcotics here." Was really nice of her, especially because everyone in that pharmacy was able to hear, that this young man over there consumes "extremely strong narcotics". Got some weird looks after that. They also constantly treated me like they suspected that I was only getting them to resell them, had to justify me picking them up both times I went there.
I guess, overall the experience I had with meds was just unsatisfactory. Should probably just try out a different pharmacy, the last experience demotivated me so much that I just completely gave up on meds.
Well anyways, thanks for reading my TED talk, and many thanks for your great tips :)
While concerta did help in some sense, I had the same side effects as you. In my experience, Elvanse feels more like it "cures" my ADHD while retaining my personality and creativity. Oh, and (almost) no side effects!
Me too! I've been identifying more with my Quaker belief system and meditating more. I'm trying to be more consistent with it but man, it's opened up a whole new world.
Keep up the great work! :)
Damn, if you have the mental fortitude to get out of bed at that time, you're probably fine. Every time I wake up before my alarm, especially now when it's super cold, I instantly think of this Calvin and Hobbes single-panel classic: https://www.pinterest.com/pin/316729786269578409/
Fast, driving, intense techno of some sort is a game changer for me in terms of focus. Not a replacement for medication, but a useful tool with or without.
I also find bright, flashing lights useful for focus. Think those cheap led bulbs which a prism and motor. I think expensive night club versions would be better, but I’m not willing to drop $100s to find out.
I think I might just need stimulation in all forms - visual, audible, physical, chemical - to be at my best.
Anyone else experience that?
[1] https://www.webmd.com/add-adhd/news/20140129/drivers-with-ad...
That has helped me a bit in making progress on things that are important, but not really exciting, such as documentation.
Mandatory Note, this does not work, if you have a lot of such things to do,in which a team or role change would help.
Get diagnosed and get a low-dose of meds. It helps _a lot_. You will likely hate the feeling they give you for the first week (you will genuinely feel high even on 10mg Adderall XR), along with nightmares and night sweats but after a few weeks, you'll suddenly be productive at a very normal level.
I don't feel strung out nor is it some addiction. Ignore the people screaming about Adderall being "literal meth" and how it will certainly kill you. Even with an addictive personality, it's very easy to avoid over-doing it (hint: only take it as prescribed).
Medication is intended as a stop-gap to build a system so you won't need high doses forever. If you go into thinking meds are all that needs to be done, you are going about it wrong. You need to build a system and reflect on how to improve your baseline productivity and keep yourself on rails (planners, calendars, checking your work, reviewing work with a fresh mind before sending out, etc).
Additionally, it does help if you like what you are doing. I'd imagine ADHD is much easier to maintain if you are self-employed or have a large leeway to define how work gets done or what work gets done. If you are in a command-and-control / top-down power structure, you need to leave; you'll never thrive there and will ultimately get tossed out.
Lastly, caffeine does help from my testing, especially caffeine combined with L-Theanine. I used to take 100mg of HVMN "Sprint" pills as a test whether I had ADHD; it helped quite a bit. It didn't make me jittery and it let me focus much better.
There are serious negative long-term effects from taking amphetamines regularly. Such advice as above is very one-size-fits-all, and in my view is thus really bad advice.
> Ignore the people screaming about Adderall being "literal meth" and how it will certainly kill you.
You can ignore those people because they're wrong, amphetamine is not methamphetamine. But do not ignore the people who tell you that even normal amphetamines (adderall) are not harmless. They cause harm, even at low doses.
The harm they cause may be mitigated by the benefit they bring; it may also be extremely difficult to estimate their harm in advance. Ceasing regular use of amphetamines for some people can result in subsequent YEARS of oversleeping, lethargy, and depression from dopamine receptor downregulation.
> I don't feel strung out nor is it some addiction.
Amphetamines are a highly addictive substance, if you are taking them every day it is likely that your body has developed at least some physical dependence upon them. Addiction doesn't make itself known until you stop.
When I realized there was a low dose medication that could basically cure me of ADHD (thus cure me of underperformance, procrastinating my ambitions, low professional self-esteem), the choice was obvious. Know what also does harm? Underperformance, procrastinating my ambitions, low professional self-esteem. Far worse than any side-effect from amphetamine. And I'd take on much worse harms if they would cure my ADHD like amphetamine does.
Edit: lol, when I started my reply to you, your comment was two sentences long. Take it easy.
Btw, I'm in my mid-30s and I've been taking amphetamine since I was 18. Perfect bill of health. Though, granted, there's plenty of life left.
I don't think most people would consider someone servicing an active physical dependency to have a "perfect bill of health", even if you are totally free from disease.
Is taking immunosuppressants also a physical dependency or a functional addiction?
You’d be right, but it does not do significant harm, especially given how therapeutic the right drug can be in the right doses.
Can it do significant harm? Sure. So can Ibuprofen.
(As an aside, the reason I've gone days without meds is because my insurance company has a harmful policy of requiring "prior authorization" from the same doctor who prescribes the pills, and more than once I've found out it needed renewed from a pharmacist who was only allowed to try filling it the day I took my last pill. I'm tired of this incredibly helpful medication, and the people who depend on it, being thought less of.)
Of course, many medications that aren't psychotropic fit the bill. Corticosteroids, for a common example, lead to physical dependency too. Most medications lead to some kind of physical dependency after prolonged use, it's just sometimes of very low grade.
The second option is much better from any pathological point of view.
To note, perfect health doesn't exist. We're all broken in some way :)
The goal of almost any medication is to create a stop gap to create or find non-medication solutions. Without Adderall, I can't focus on creating systems and tools to help me stay on track.
Demonizing Adderall isn't helping anyone. No one should be afraid of taking a medication that will change their life for the better. If someone goes through normal channels and gets properly prescribed it, they should be treated no different than any other ailment.
Your comment opens with:
> Get diagnosed and get a low-dose of meds.
Immediately suggesting that someone seek a somewhat dangerous medication as a solution, without qualification, is an extreme and dangerous view. "You have ADD so you should try low doses of speed!" is not wisdom. There is a reason that these are prescribed by doctors, and monitored.
Medication helps a lot. You could struggle with no medication, trying to build a system to help yourself, possibly fail and never be who you can be or you can seek out professional help (potentially with medication) and begin building support today and have a good shot.
---
Would you say the same if I encouraged a depressed person to do their best to get diagnosed and get on 'anti-depressants'? I am doubtful.
We have invented medication for a reason. People go to decades of med school for a reason. Medical professionals know what they are doing and are very upfront about it not being a panacea and needing to still work on non-medication solutions (as with any medication).
I will admit my first sentence ("Get diagnosed and get a low-dose of meds") was too strong to start with.
Don't be: many studies have shown CBT to be equally as effective for depression (for most people) as medication. If you are equally likely to cure your issues with a book on CBT versus a pill, that is something you should consider, even if you do end up deciding for the pill.
I encourage people to evaluate the costs and benefits of ALL their options before seeking any specific treatment for issues that involve neurochemistry. My entire thrust is "medication is not a panacea and you should not bias toward using it, over any other option, as a solution".
For some it may be the best choice. For many it is not. Don't bias toward it (as you advocate). Evaluate, don't just go get pills because some random person on the internet said it worked for them that one time.
If you put the wrong thing in your body, you can fuck yourself up for a very long time. I am speaking from direct personal experience.
But this is not the case for ADHD. ADHD has one of if not the strongest case where there is a direct curative effect of medication.
What's the alternative? CBT is not sufficient when your brain doesn't want to work. Executive function disorder is a huge part of being ADHD.
> There are serious negative long-term effects from taking amphetamines regularly
Citation needed for therapeutic dosages.
> They cause harm, even at low doses.
Citation definitely needed for therapeutic dosages.
> Ceasing regular [...] subsequent YEARS of oversleeping, lethargy, and depression
Citation really really needed here for therapeutic dosages.
Anecdotal advice like this is exceptionally harmful to those who need these meds to just reach "functional adult" levels of normal.
My comment isn't saying that you shouldn't, it's saying that there are downsides that are not apparent that must be weighed against the upsides—same as any medication. Even ibuprofen can fuck up your stomach, each remedy must be evaluated on its risks and merits.
I speak from extreme personal experience. Same team!
We're not telling folks to go on a meth binge. We're telling folks that this doctor prescribed medication actually works, and can help improve their lives.
To use your own ibuprofin example - what your parent statement is proposing equals: "Don't use ibuprofin for your chronic inflammation, even though your doctor prescribed it for you."
EDIT: If COVID has taught me anything, it's that we as human beings are poorly equipped to make appropriate cost/benefit analysis when it comes to medical advice. Especially when it comes to anecdotal experiences. And doubally especially when you're already suffering from untreated ADHD.
There is at least one non-stimulant drug that can be prescribed (atomoxetine), but it doesn't work for a lot of people (including me).
However, I want to mention modafinil (particularly as no-one else has mentioned it in this discussion). It has worked for me and there is evidence to its effectiveness as a non-stimulant medication for ADHD - https://pubmed.ncbi.nlm.nih.gov/11191692/ - although it's technically an off-label use.
I've tried to kick caffeine multiple times but always fall back during stress. I just can't find another (cheap) drink I enjoy sipping on.
My harm reduction is a Soda Stream, which at least lowers my overall sugar intake. I don't understand sparkling water, I've tried it and it is less enticing than plain water.
It is inappropriate and rude to assume what others need. I am the complete opposite of what you assume on Adderall, I am more verbose, my thoughts are more coherent and I can keep up with meetings because I can actually pay attention to them. The first time my spouse heard me conduct an interview after medications, he told me how much more cohesive, steady and assured my speaking was.
It helps no one, not even yourself, to tear down someone else because they are using a different solution than you.
What you describe sounds more like symptoms of untreated ADHD rather than treated ADHD.
I don’t take it on a day when I’m being creative or brainstorming, because the lateral thinking required does that is actually something ADD helps, but I take it when I have to get something done.
Take it from a guy who has had ample coping mechanisms, got a CS degree from MIT, founded and sold a security startup, etc.; all of those coping mechanisms worked, but got much easier once I accepted the ADD and found the right meds. It only made me more productive and a better contributing member of the team.
YMMV, but I suspect your assumptions about how it affects people are very wrong.
It wasn’t until after I was diagnosed and medicated that I finished my undergrad after almost a decade, started my career, and started grad school. You do you, but don’t be sanctimonious about mental health treatment based on your anecdotes.
Methylphenidate is the only authorized substance for ADHD treatment here in Germany. I had to pay for my Amphetamine treatment by myself. I had the impression that the pharmaceutical industry doesn't have an interest in getting an authorization for amphetamines as that substance can be produced by a local pharmacy on site. Even thou I can confirm that the side effects are much less with amphetamines.
Now age 35 I haven't taken any medications for ADHD for 8 or 9 years. It was good to help me with school and university but now I don't need to put myself into a position where medication could be helpful. Still wouldn't want to work in an open floor plan office. Not sure if that is an medical condition.
I got it from my doctor and have been taking it for a year after trying Methylphenidate which did not show any positive effect on me.
I'm currently on a rather high daily dosage of Medikinet CR (2x30mg + another 1x20mg on long days if anyone's curious). It works but too inconsistently. It's also rather expensive here in the Netherlands.
Now I am on 50 mg. The medicine stimulates my focus and makes me more enthusiastic about activities, which can be annoying since I need to control not to apply my new powers on wrong or useless activities. I am also very verbose for couple hours after taking a pill. I would not say I am completely cured from ADHD. In the evenings, positive effect disappears, so I need to plan accordingly.
I avoid drinking coffee in the morning now, as the combination of two stimulants makes me shaky, I experience muscle tension, and it affects my ability to interact with people.
We tried 70mg with the doctor as well, but it made me aggressive and grim in couple months without noticeable improvements over 50mg. To manage tolerance I often skip taking pills on weekends. I also lost a few kilograms, which is good.
All in all, I am only half satisfied with the result - based on what I read I expected a better effect. I think my type of ADHD may be addressed with more sophisticated medication. Unfortunately, in Germany there are not a lot of other options to try, and my doctor seems to lack experience in treating ADHD. I try to combine pills with diet, exercises, and sleep management.
With regards to the effects this particular type of medication has on your behaviour, you have essentially described me - but on Medikinet, on those odd days when it decides to just work that way.
In the Netherlands we have a specialised ADHD treatment centre called ADHD-Centraal. I've been extremely impressed with their methods, their high level of competence, and with their care and involvement. The fact that they really know what they're doing also shows in the tiny practical adjustments they've made to their workflows to accommodate or even compensate for "the likes of us"!. I'll gladly provide you with direct contact details for you to pass on to your doc or call directly if you believe there's something to be gained in that.
Unfortunately, as you mention, the medication options are limited and at some point you're going to run out of things to try.
The main reason I'm not on Dextroamphetamine is that it registers on the quick saliva drug test that the Dutch police carries. It is amphetamine after all. When that happens, you'll get fined for driving under influence, and won't be allowed to drive for a few hours which is very annoying. The bigger problem is that if you're ever involved in an accident and the presence of amphetamines in your system was registered, you might even get a criminal record plus the insurance might decide not to pay out. Impractical to say the least...
Long acting or slow release Methylphenidate medication - such as the Medikinet I'm on, is only partially covered by Dutch health insurance. Legislators have decided that the short acting variants are identical and that anything else is essentially a luxury. They would quickly change their minds if you'd lock them in a room with me when I'm suffering from disastrous rebounds every hour on short acting Ritalin :)
Strict routines? Good diet? Exercise???
Good luck doing any of these if you have even moderate ADHD. It's hard enough getting out of bed.
As a sibling mentions, your description of people who are "drugged" sounds more like people who have undiagnosed-ADHD and are not medicated.
The drugs don't make you drugged -- that's sorta the default state. The drugs make you functional enough to try and develop coping mechanisms in the first place.
For some of us this is the experience without any medication. I still get this now with medication, but it's definitely less frequent.
Low dose meth does work pretty similar to Adderall. Everyone who does meth does not become a meth addict. Most don't. But the people who become meth addicts are the same people who end up using adderall like methheads.
Which is why I personally don't have an Adderall prescription. Because if I have a bottle of Adderall I'm going to attempt a prescribed dose on day one and start snorting it by day three.
The fuck?
Adderall is one of many medical options for treating ADHD. Not all of which are stimulants. And some of which are chemically designed so they can't be abused (like Vyvance).
EDIT: The OP pulled the "in my opinion" phrasing from their post, but I'm going leave mine as-is. There's a lot of anecdote based FUD about ADHD meds going on in these threads, and it makes me mad. My above thoughts stand.
All stimulants are addictive and you will have physical side effects from discontinuing use.
I love those side effects though. It is so nice to stop taking them and feel cozy and rest for a few days. The best description I have for it is that it feels like when you get home from a hard days work and are tired and go sit down in your sofa and just relax. Just that the feeling lasts for days! Awesome, right?
I hate being on the meds and I never take them when I don't work, but I have to take them to do any kind of work requiring focus like for example filling out a form.
It sucks there aren't any good meds for addiction treatment for stimulants yet (naltrexone/bupe etc).
Quitting meth, cocaine, prescription stims is really really hard.
If you have, please point to a source - there's a lot of anecdotal FUD running rampant throughout this thread.
Statistically, because of the addictive effects of untreated ADHD, the likelihood of substance addiction with or without amphetamine treatment is almost equal. There is of course a risk of getting addicted to Adderall, but amphetamines with long releases are not very addictive as far as drugs go and the risk of getting addicted to other things is drastically reduced.
Methamphetamine as used illegally is a lot more addictive than Adderall because it is generally consumed in ways that lead to much more immediate effects and not orally, and even when orally it is generally formulated to be released more quickly. More rapid effects seriously increase addiction potential.
The doses are also much smaller for Adderall than meth in 99% of cases.
Because of these factors, methamphetamine is much more addictive than pharmaceutical amphetamine salts.
One thing that made me look into adderall was finding out I was a slow metabolizer of caffeine via 23andme, and was consuming an unhealthy level of caffeine. I did some research and determined that the health risks of low doses of adderall were smaller than those of high doses of caffeine.
Scott Alexander’s review of the research on Adderall are also worth reading:
https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...
I hadn't seen that before, so thank you!
I ran into this same thing accidentally, I was regularly 'overdosing' on caffeine by drinking 300 - 400mg of caffeine per day in college.
The safe dosage is ~200mg for an adult if I recall, but I can only do about 100 - 125mg absolute max or my heart starts pounding. I am not sure if this lowered limit is due to 'abuse' or if I also have different caffeine metabolization. I will have to take a look at my data.
I completely agree with your comments about looking for opportunities to use medication to bootstrap into better habits around exercise, mindfulness, and building better systems and habits.
No? It is 400mg
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h...
My doctor put it this way: Caffeine triggers a useful dopamine response, but the side effects are strong at "useful" levels.
Ritalin and Adderall provide a stronger dopamine response with fewer side effects at "useful" levels.
They're all stimulants, but the magnitude of the useful vs. non-useful effects differs.
Both have an impact on cardiovascular health, but my impression is that Ritalin and the like are much safer than what people self-medicate with.
I wonder if I could have persisted long enough with Adderall to find a theraputic effect if it had been during lockdown. 10mg of Adderall made me unsafe to drive to work (I would suddenly get the subjective sense that my car was completely still and instead all the parked cars on the side of the road were hurtling at me at 25 mph).
My doctor actually started me on a higher dose (15 or 20mg maybe?) because I needed such a high dose of Ritalin to get a theraputic effect (and at that high of a dose it greatly impacted my sleep). I took it exactly once and I didn't feel tired for 36 hours and was completely non-productive. For the first time I finally understood what all that clinical language describing the symptoms of a manic episode were all about.
Vyvanse did not feel nearly as bad subjectively, but my wife insisted I change meds because I was (in her words) "an asshole" while on it.
Finally settled in on 20-30mg of Focalin a day. The year of titrating the doses of each medication was hell. And then when we finally figured it out, my company switched insurers I had to change the pill sizes (not total quantity) to get it covered with the new insurance.
The one thing I'd like to add is that diet for me made a huge difference. I might as well not be taking the meds if I have a carb-heavy breakfast. Prior to taking the meds I had quit eating breakfast altogether because I felt like such crap around lunchtime if I ate breakfast. Obviously taking stimulants on an empty stomach is not a great idea, and my psychiatrist helped me out to go for a breakfast that doesn't provoke such a strong insulin response.
Definitely feel you there. It's the worst part about psychiatric drugs and why I've bailed on almost everyone I've ever been on. It's that initial hump and having to struggle through ~two weeks of hell.
My partner has run the gamut so he constantly assured me it was normal and that I'd be fine.
>The one thing I'd like to add is that diet for me made a huge difference. I might as well not be taking the meds if I have a carb-heavy breakfast. Prior to taking the meds I had quit eating breakfast altogether because I felt like such crap around lunchtime if I ate breakfast. Obviously taking stimulants on an empty stomach is not a great idea, and my psychiatrist helped me out to go for a breakfast that doesn't provoke such a strong insulin response.
Diet is my next interest but haven't gotten tools perfected to track the variables that I think will be affected (productivity, happiness, energy and sleep).
I am vaguely on the train of diet affecting productivity but my daily lunch is a McDouble and large caffeine-free soda to sip on so... non-conclusive currently. I also skip breakfast because of the same reasons (too heavy + no good breakfast foods, even 30-in-30 always slows me down)
I have found that many 'healthy' foods make me feel sick or worsen productivity so I am tentatively sticking to my weird diet for now. I have suspicions I may have food allergies and that could be causing it.
Bacon is my go-to breakfast food; can cook up a bunch at a time and heat up what I need in the morning. I make some eggs to go with it if I have the time. The great thing about bacon for me is that it's so salty that I cannot overeat on it.
Caffeine is an adenosine A2A receptor antagonist.
See: https://en.wikipedia.org/wiki/Adenosine_A2A_receptor_antagon...
You may want to check out this paper, Adenosine A2Areceptor as potential therapeutic target in neuropsychiatric disorders: https://scihubtw.tw/10.1016/j.phrs.2019.104338
Caffeine has a problem though:
> Moreover, considering that caffeine has a half-life of 2.5-4.5 hours [137]the once-a-day schedule of administration used in clinical trials in ADHD patients could be insufficient to antagonize A2AR throughout the day; thus, in future trials different administration schedules should be used or, as an alternative, selective A2AR antagonists could be tested in animal models of ADHD. In particular, it would be interesting to test the efficacy of the A2AR antagonist istradefylline in view of its approval for the treatment of Parkinson’s disease in Japan [138].
Ironically, I just started taking Nourianz (istradefylline) (link: https://www.nourianz.com/) as a last-resort drug for my severe restless legs syndrome, which has been going phenomenally well. I also have ADHD combined type (inattention and hyperactivity), and fairly severely.
Anyways, I have been taking the the istradefylline for a week now, and it has made a tremendous difference in many of my ADHD symptoms. In addition, it greatly increased my sense of wellbeing within 1-2 hours of initially taking it, and it has been sustained for the entire week.
I hope you find this interesting! I take Vyvanse for my ADHD.
Thanks to istradefylline I can now focus seamlessly and without effort. I can just "lock in" to whatever I want to do. Before, it would require some static force ("friction") to be able to "lock in" my concentration to do the task. I can also just focus, without hyperfocusing. It now comes naturally to me. I also no longer find myself pacing around the house aimlessly. I also do not randomly get up from my seat or fidget hardcore. I can also lock back into a flow state without effort if I am disrupted.
¹ As much as I want to.
I am interested in getting my private pilot's license and I _should_ be able to get a Class 3 Medical from what I've seen, but that will be a bit away so I have time.
What I've seen and heard from others is to just lie. Seems like many have gotten to the point of realizing trying to do it right is only going to put you in months of bureaucracy and spend thousands proving your viability.
The FAA needs to figure out how to either commission studies to reduce their list of disqualifications or streamline the process of appealing your medical certification.
ADHD does not fall under CACI, and will trigger a deferral to the FAA. The FAA will then refer the applicant to a HIMS AME. (Human Intervention Motivation Study.) HIMS is really about substance abuse, not ADHD, but it's doing double-duty now for things like ADHD and the four conditionally approvable SSRIs. ADHD can also trigger expensive neurocognitive tests ("CogScreen"). So ADHD really is in a separate class of conditions when it comes to getting a medical certificate.
Current use of stimulants is a denial no matter what.
As a flight instructor I think this is completely bonkers. The nature of ADHD is such that if it keeps a person from being able to fly safely, that will show up during training as a failure to meet performance standards. It's completely different from something like a heart condition, where a pilot will fly just fine until suddenly their heart stops. I've taught lots of folks with ADHD diagnoses; almost all of them did great, and the few that didn't were very obviously not able to handle the airplane.
And yes, I do love acronyms in acronyms. My first job was in the government, the US gov't truly loves their acronyms.
I used to drink multiple cups of coffee a day and felt like it was almost baseline requirement just to attempt to focus. Actual ADHD medication makes coffee almost obsolete. The first time I took Ritalin it was almost scary to realize how chaotic my mind was minute-to-minute, every day without fail. Suddenly the noise all went away.
It feels like I can actually create coherent sentences. I stop getting overwhelmed by asynchronous communications (Slack, email). The "volume" of every single distraction that used to monopolize my attention gets turned way down. Yeah, I still get distracted -- but now it's a conscious choice to either let that distraction take precedent or to re-focus to the task at hand.
The day to day benefits are great, but the big picture / life-style benefits are the most appreciated. In general my anxiety and stress management is honestly 10x better. I've gone from being stressed over my career choice every week to finally feeling like I can thrive. I stop getting irritated by the most innocuous things someone might say or do. I stop waking up anxious every weekend trying to process the million things I need to get done just to exist and make forward progress in my life. I could go on and on and on about how "real" ADHD is, without even having a formal diagnosis yet.
I'm sure the discussions in this thread regarding the utility and risks of these medications sounds intriguing if you don't have ADHD and already know how to sit still and focus at will. But anyone who doesn't have our experience should understand this shit is honestly helping people live their lives for the better. My only regret is I didn't know sooner.
Yep!
Always scored 90th percentile in standardized tests (how? no clue.), curious, the lot... just couldn't care about homework or listening in class.
I struggled through 5.5 years of college then years later snapped out of the mindset of "just having to try harder". My parents knew... they had me diagnosed as a kid, but were scared off of stimulants by their church.
I try not to think about what my life could've been.
I do appreciate and understand that ADHD tends to be over-diagnosed to children due to them being... children.
I don't necessarily know what I would've done if I had been in my parent's shoes beyond actually listening, being empathetic and using my adult knowledge of the world to help. They took the meds away before I even got used to them and that was the end of meds until I got them myself last year (16 years later).
There is a whole pit of co-morbid issues in my adolescence that I believe being a considerate parent would entirely avoid. I can't definitively say that ADHD was the one thing that changed my life trajectory or made me bad at my day-to-day schooling.
I am not a doctor but I can't see the harm in starting low to get your kid into building an organizational system, study habits, learning what helps them work best, etc, so they can hopefully come / stay off the meds. No one wants to be medicated for life, not even doctors want you on any medication forever; the less you can put in, the better. Meds may not be needed, meds may be needed. It entirely depends on how much your kid is struggling, what kind of relationship you have (do they feel they can trust you and say bluntly what they need and are struggling with, is that something they are emotionally capable of voicing, etc.).
Medication isn't a panacea obviously and if you can help your kid get organized, both of you feel they can stay on top of work according to what's reasonable for their age and listen to them with patience and empathy, that will likely be as much as you can do as their parent.
My parents had high standards for me but rather than asking "how can we help? what do you need?" kindly and being someone I could rely on for help, they would scream at me and say various things that seemed helpful ("You're not average, average isn't good enough") but just ingrained that I was broken and worthless because I was trying, I was doing as much as I could and still wasn't making it.
The only reason I got diagnosed as a kid was that my brother was being diagnosed at the same time. There was no concern for me individually, it was a 'package deal' of pushing all the kids through the pipeline to figure out what was 'wrong with us'.
I am ranting now... :)
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Not to assume, but I figured I'd include this because this is _my_ next mental health adventure of figuring out officially: ADHD is co-morbid with Asperger's. The two also have many cross-overs (emotional sensitivity, sensory issues, seeming aloof, etc.) so it's worth a mention to totally rule out or gain a better context of how to give your kid the best shot. Asperger's is not at all an awful sentence of misery and awfulness to not be caught until later. Both ADHD and ASD are better 'caught' early obviously, so you and others can help create support systems to improve quality-of-life.
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I feel like my parents viewed parenting as factory line; each kid gets the same input and we expect the same output; if we don't get the same output, the kid is broken not your parenting style. Maybe this is just good parenting, but I would encourage you to consider the perspective of meeting each one (assuming you have multiple!) where they are at individually rather than where you or others expect them to be. Something I wish my parents had done was tell anyone and everyone to "fuck off" with their expectations rather than tossing me under the bus for being 'weird'.
I was frustrated with these side-effects in college, so I quit the meds as a freshman. I got through college and even a masters degree, but it was a slog. While working at my first "real" job, I felt like I'd hit a brick wall. It was near impossible for me to stay focused during the day. I went back to my doctor and started taking Vyvanse, which I've been on for ~5 years now. This drug has been really amazing, and I don't feel totally sapped at the end of the day. (My layman's understanding is that it's a pro-drug, so your liver has to chop the molecules apart to produce the actual amphetamine. It has a slower ramp-up and ramp-down than the Concerta did.)
One thing to consider is sleep quality. It turns out I had an obstructive sinus blockage for many years. I got it removed surgically and feel amazing. I still take meds to deal with underlying ADHD symptoms, but I could actually be a functioning adult without the meds at this point.
If you're worried about the effect medication might have, I understand, I'm a parent and I'm 99% sure my boy has it as he's exactly like me. I would implore you to consider the abject danger that untreated ADHD presents to its sufferers. Shorter life span by on average 12 years. It's a much worse diagnosis than people realise. The transition into adulthood took me a decade. It was rough. Really, really rough. I only got diagnosed last year at 32. Medication or not, what you should endeavour to do is monitor if it goes into remission in early adulthood for them or not, and keep them educated on the topic so they can understand how/why they experience life the way they do. I'm not medicated myself at the moment (because thus far I haven't responded to it) but being aware of it has made a big, big difference.
First of all, make sure you get that diagnosis. Don't go wild with the medication thing, because the first thing that the medication should do is bring you from the "giving up in advance" level to the "ooh, I can learn about and try some things that might help me to take control of my own life" level.
And for now, start ignoring "anyone who doesn't have our experience" and what they think and shout, because I think you won't start to feel any better after reading all of that.
Hans
P.S. my un-scientific explanation for the overload of stress reactions (and anxiety and panic attacks) is that in absence of 'neurotypical' ways to get us going, the body goes into an emergency stress loop, producing stress hormones and adrenaline all the time, to try get us going to do anything at all.
The most fascinating part of this journey is finally understanding myself better. I've been spending hours every week reading others experiences with ADHD, watching videos (Dr. Russell Barkley is awesome), and in general just figuring out who I am and why I'm that way. I'm beginning to understand that habits I've had, such as being "hyper organized" (actually, being utterly dependent on my calendar) were just coping mechanisms needed to get things done. It almost warrants an entire self-evaluation.
Your description of the stress response seems plausible. All my life I've oscillated pretty strictly between hyper-anxious and utterly indifferent, the latter probably serving as a coping mechanism. Suddenly now I'm able to comfortably live in the middle ground. I'll do what needs done today, and know that what needs done next week/month/year will get addressed when it's time.
Anyway, I really appreciate the feedback and wisdom. Wishing you the best of luck.
Just a fun fact: Literal meth is called deoxyephedrine when it's prescribed for ADHD. Anyone that was awake for intro Chem will know why.
Not trying to be insensitive, but doesn't that describe everybody? At what point does difficulty motivating yourself to do something unpleasant become an actual pathology? I identify with a lot of the symptoms he lists, but I've never thought that meant there was anything "wrong" with me, I thought everybody felt that way. Are there really people out there who can cheerfully do things they don't want to do?
Does it incur any impact on your life? Was it a thought or a challenge?
If you answer yes to this, I would recommend talking to a professional. No one can diagnose you online (with the exception of professionals offering remote sessions).
But seriously, a lot of conditions are just universal human experiences that are severe enough to impact your daily life. We all get depressed, but we all don’t have depression
I've been like this since I remember, and I really can't do anything to fix it. It has a large negative effect on my life. But of course, it's not just that, for example often I literally cannot pay attention to a direct interlocutor, or can't keep myself focused during final exams.
I tried all of those things you mentioned for over a decade and was often driven to tears trying to do simple things. I never did assignments for courses etc, causing some of my grades to stay bad even though I did great on the tests since tests kicks up your adrenaline making it easier to focus. Not because I didn't care about the grades but because I simply couldn't do the assignments. Then I got medication and suddenly everything in college and later work just became trivial. I stay on the lowest dosage and that is still enough for me to stay at normal levels of focus where I can program for a few hours a day when I need to do it to keep my job and earn money.
So, since medication has been so life changing for me I really hate when people say that you can manage ADHD symptoms just with lifestyle changes. Maybe in some cases, but many people absolutely need medication and discouraging such people from receiving it will ruin lives.
If I regret anything, it's not getting diagnosed until I was in my 30s. I wasted years of my life doing poorly in school, being depressed about it, blaming my performance on being depressed, and then dropping out of school. I eventually graduated, only 10 years late and with a 2.2 GPA. After getting diagnosed and treated, I went to graduate school and finished in the top 15% of my class with a 3.7 GPA. I think I've redeemed myself, but I won't get any of those wasted years back.
* Everyone encounters back pain at some point. It's only an illness when acute or chronic.
* Most people have some desire for ordered patterns so lots of people will do things like avoid cracks in tiles because it is satisfying. Not a disorder until you absolutely must not step on a crack or it will cause you to need to go through some ritual.
I find it hard to focus on things unless I'm hyperfocused, partly because I'm distracted by the thing I'm hyperfocused on.
I also tend to always be hyperfocused on one thing at a time for a while and then switch over to a new thing.
Things that I may not like or want to do kind of melt away when I'm hyperfocused on something, and feel like they're amplified when I'm not.
I went to the doctor for depression, but she said that it seemed a lot like diagnosed ADHD (which often manifests itself as depression because of dissatisfaction with many aspects of your behavior). Before I start that I'd like to say something that the psychologist that evaluated me told me. The key aspect to ADHD is the dysfunction it causes. I'm not a psychologist or a doctor, but basically the thing that clearly signifies ADHD is the severity of the negative impacts in different aspects of your life.
For me some things that I always hated about myself and frustrated the hell out of other people:
She would ask me to do things and I'd completely forget about them after she left for the day. She'd call on her way home and it would immediately trigger my list of things I was supposed to do. I'd stress out and rush to do them before she got home. It wasn't that I didn't want to do them, or that I didn't care enough to do them. It was that they literally never entered my mind without an external trigger. I tried writing todo lists, and I would just not look at the todo list.
On the opposite end of the spectrum, if something is interesting, I can literally sit in my chair for 20 hours without eating or drinking. If someone tries to talk to me, I literally do not hear them. I don't ignore them, I just don't hear it. This was a lot worse when I lived by myself. I would regularly sit down in the morning to do something and find that I'd completely forgotten to go to class, eat, drink anything, and that it was now 7 in the evening. If I was lucky, then the original task would be complete or almost complete. If I wasn't then I'd spent the last 10 hours weighing the pros and cons of various ways to properly install python on a fresh computer (venv, virtualenv with or without virtualenvwrapper, etc.). For my uses, it literally does not matter, but I've still done this multiple times. I've spent way too much time responding, in excruciating detail, to Reddit/HN comments when all I'm going to get out of it is, "Cool. Thanks."
I know this can sound like standard procrastination, but I absolutely don't want to do these things. I have been in so many arguments about forgotten obligations or accusations of ignoring someone. It's so frustrating. You start to see yourself as someone that's unreliable and incorporate being forgetful and flighty into your own self image.
I and my wife were pretty skeptical at first, but, after my first month on medication, I took care of so many important things that I just hadn't done for years (like applying for the master's degree that I earned as part of my PhD) and got more done on my dissertation than I had in the last four. It's still not easy, but it makes it easier for me. I can actually remember to look at all the lists I make now, and I can stop myself after 10 minutes of an obsessive rabbit hole now instead of after 10 hours when my bladder is bursting.
It's not about cheerfully being able to do things we don't want to do. It's about actually remembering to do them. ADHD isn't about not being able to pay attention to anything. It's about not being able to regulate the things you pay attention to. It's about being able to even out the deeply obsessive blessing/curse attention black hole that is your natural state.
It isn't about cheerfully doing it, it is about most menial tasks being impossible to do without days or even weeks of mental preparation and/or lifestyle changes. Imagine filling out a paper form causing as much anxiety as proposing to the love of your life and you understand better what ADHD feels like. You can learn to live with that, but if you have it you are pretty sure not everyone feels like that all the time.
That's a good dividing line between 'actual pathology' as you say and normal experiences.
I always felt like something was wrong with me. From childhood, I was different. Never could put my finger on it, but a lifetime of experiences gave me some intuition that I was different, in a bad way, and that was just my lot in life. Fast forward to my early thirties, and after being fired from every job I'd ever had I reached rock bottom. I was a 'gifted' student, elite engineering degree and a law degree, but just consistently failed to live up to my potential. I finally dragged myself in to a therapist's office because I had intense and intrusive suicidal thoughts nearly all day every day for months. I didn't want to kill myself, I had a lot to live for, but some part of my subconscious was absolutely fed up and done. I never once thought that I was someone who could have ADHD. I was bright, I had a decent academic record, and I had gotten several high paying jobs. ADHD was about jittery kids or losers working menial jobs, not me. By the end of my first session, as my therapist would later reveal, he knew I had ADHD. It took some time for me to accept it. But once I did, and got on board with treatment including medication and regular therapy, my life changed. It made so much sense in retrospect. I did have a good academic record, but that's only because I could hyperfocus and ace exams - I never did homework on a regular basis from grade school through grad school. I wanted to, but never did. I did get high paying jobs, but would wind up being fired a year or two later because getting a job is exciting, keeping a job and, you know, doing a job, is boring. At least to a part of my ADHD brain it is. Everyone experienced boredom, but how many people let that boredom get them to a point of being unemployed when they have a wife and children to support? It's not a choice.
Frankly, I'm lucky that I happened to meet the right therapist at the right time that recognized the ADHD that was causing so much turmoil in my life, and I am forever grateful because I truly believe that without realizing it was ADHD and treating it, my children would have lost a father. ADHD is real, and it's serious. I ask you and everyone reading this who doubts ADHD is real to please try to find some empathy.
When it comes to tasks that you don't "want to do", it could be really ANY other task than what you want to do.
Imagine that you have some homework that's due, a work deadline that's absolutely imperative that you can meet, bills that have to be paid, or important call with your doctor - for the discussion, think of any task that's really important that you do.
Now imagine that your brain fees like...looking up some trivial thing on wikipedia, or similar. Just silly stuff that has no real importance - and is orders of magnitudes less important than what you need to focus on.
Now imagine that your brain and body is fighting all it can, for you to continue with the trivial task, and blocking the important stuff. You almost go into a trance.
You might be able to detach from some trivial task for a minute or two, only to get sucked back in.
Because it's such an invisible condition, it's hard to really know how bad it is. In the same way that people that have never suffered from migraines, might believe that migraines must be regular headaches, and that people that suffer from migraines might just be on the softer side.
For me it was when I actually could motivate myself to do it... and then still didn't because of shiny external stimuli and daydreams. And a lot of "I know you're really upset, so I promise I'll get my act together and next time that you expect me to... wait... what were we talking about?"
The difference is in frequency, severity and duration.
In my case I've spent north of 1000 nights in the past 5 years doing the dishes at either 1am, 2am or 3am because I cannot stop doing what I want to do and direct my attention towards the dishes until it's the absolute last possible minute of the day. Often then it's just so painful to me to do it. It nearly caused my marriage to break down because I would leave them undone. No matter what I try I can't get myself to do them straight after dinner. Night after night I would wonder to myself "I wish I knew what this was called". I didn't seriously think there was something wrong with me, I just couldn't understand why I couldn't , despite my best efforts, get myself to behave in a different way.
And that's just one facet of my life and how it affects me. There's more and they just pile up. When you add it all up together and you consider pound for pound how I'm doing you start to appreciate the frequency, severity and duration that can be considered pathological.
It presents pretty differently across people, but by and large a diagnosis is a huge penny dropping revelation.
At the point where it causes a significant and ongoing problem in your personal or professional life.
"Lost track of time and wasted half an hour on HN" - Not a pathology.
"Wasted half a week on HN and was unable to stop even though you really, truly wanted to get your work done?" - Maybe pathology.
"Did that most weeks for months on end." - See a doctor.
You see "hard time focusing" and you think "I, too, find it difficult to focus on things I don't like"
But: you do it. When we say "hard time focusing" we mean things like, oh, driving an unregistered and uninsured car for six months because the idea of going to the DMV is, uhh.
Look it's hard to explain. But it's an inability and one that significantly interferes with living our lives, on a regular basis.
I couldn't possibly read your comment as insensitive, because the opposite is on my mind every day. I fundamentally don't understand how people can consistently do most types of software engineering or any other kinds of boring office job, day in day out, because it's their job. It's so foreign, as to be a completely alien idea.
Yep. As has been mentioned, in this context you're basically using it like Adderall. Unfortunately, the body will build up a tolerance quickly, so I find myself needing to use them sparingly, Adderall especially, otherwise end up feeling the withdrawal symptoms (excessive irritability, more trouble focusing than before medicating).
Not suggesting medication or that you take something you shouldn't; absolutely do your own research!
Look into HVMN Sprint. Pretty long shelf-life, well-controlled dosage and focused on focus rather just ENERGY TO THE MAX.
I loved Monster back in the day but its taste makes me sick just thinking about it.
Here's what is working well for me:
- reducing the amount of decisions to make. The less, the better. Even my meals are now precooked and I just take them out of the freezer at lunch or dinner time
- 30 minutes of cardiopulmonary exercise
- Ritalin doesn't work really well for me. I don't know why, but muscle relaxers operate wonders. They make me feel a bit slow, but, after all, I think that is what I need. To slow down. It doesn't work 100% of the times, but when it does, the effect is really positive. It allows me to focus and think through things without other ideas popping in my mind.
- I used to feel all the guilt related to unfinished projects, and to punish myself really hard because of them before finally letting them go. My ex-wife was very detrimental on this aspect, making me feel real bad for my "lack of willpower" and stuff like that. Now I have a completely different attitude about unfinished projects. I just keep a file for every project, and register every idea when it pops up (during a walk, or when I'm having trouble getting asleep, for instance). The lack of sense of guilt by itself has been producing a very positive effect. I don't mind anymore if I don't finish even 1% of them. Life is more than that. And now I'm getting benefits from my "divergent" thinking, turning it into creativity. This last week I finished a challenging personal project thanks to an idea I had during some nights of insomnia I endured those days. And I'm feeling great.
- caffeine helps up to a certain point. I don't drink more than 400ml of coffee per day anymore. If I drink too much, I have some 30 minutes of high productivity and creativity and, then, my day gets ruined with lack of focus, anxiety, regrets for not having followed some great career paths when I had the chance, and so on.
- I still watch Netflix, but now during scheduled times. However, I try to be disciplined but not too hard on myself.
- Background white noise help a lot, especially working place noises now that I work from home. There are some nice ones on youtube. And, when I sleep, I always use a big and noisy fan (but I live on a warm region of my country).
Regular cardio makes me feel "functional" most of the time and I see some advantage on not taking this sort of medicine. But it would be nice to have some "fail over" strategy whenever I be unable to workout or on the not so rare occasions the workout doesn't work.
For myself, I say a therapist regarding my OCD, and it really helped me come to grips and understand my OCD. It really helped answer questions I didn't know I had, and helped me better get a handle on both ADHD and OCD.
Thank you for sharing. =)
1. https://www.slideshare.net/jasonlotito/getting-things-done-4...
To be up front, my ADHD is quite manageable through "tricks" similar to how the post describes but not as strict/many of them.
At 35, I always wondered what it would have been like if I had been medicated. Who could I have been if focus was easier?
I went to the doctor to get formally diagnosed and get my hands on Ritalin. For me, it was a double edge sword.
For 1 week, the focus was incredible.
I describe the feeling as if I'm a ball. Normally, I'm a ball on top of a hill, where I'm unstable and easily pushed off the hill. Text, emails, news all so easily nudge me and roll me down the hill. It takes incredible effort to stay focused and on the correct spot at the top of the hill.
While on Ritalin for the 1 week, it was as if I was at the bottom of a valley. Texts, coworkers, whatever tried to distract me but it was so easy to return to the thing that I needed to work on even when it wasn't desirable. Things like eng docs or management reviews. Basically, non-coding things.
Sadly, I couldn't continue. My high blood pressure (HBP) was simply too high, 140/100, and my heart felt like it was going to burst out of my chest. The benefits weren't worth the drawbacks for me. We tried non-stimulant alternatives, but they weren't as effective and, to a lesser degree, still had HBP issues.
It covers a few common myths and misconceptions (eg, around addictiveness).
some comments about this article:
1) i fsking HATE when people self-diagnose and then trumpet to the world that they're almost certain they have ADHD. if you think you've got it, go find a clinical psychologist and get tested.
2) he's done a great job of regimenting his life. this is really, really important for me to do and helps a lot (until something distracts me, like a squirrel)
3) removing distractions is SUPER important. i was a musician for large portions of my life, and i can't listen to anything when i'm working.
4) meds can help, a lot. they help me. a lot. i use them daily, but take 'breaks' when i'm sick, on vacation, etc. i'm one of the 'usual' people that doesn't have side effects and i definitely don't get a 'high' feeling.
anyways, i liked the article, and he has some really great points and routines. but i still wish he'd gotten tested before posting. :)
Nothing worked until I got medication. The funny thing is that I lived undiagnosed like that until I was 30. Imagine if ADHD was better understood when I was a kid...
I've been lucky enough to be able to get treatment from my GP (who is actually a PA) for mental health conditions I've been diagnosed with previously in other states, and prescriptions for (admittedly lower stakes) meds that have worked reliably for me in the past. But she's not able to evaluate me for ADHD -- only refer me to clinics where I've already been on the waitlist for a year.
Anyway, some of us self-diagnose because it's literally the only fsking option. Not everywhere is the SF Bay Area where there are excellent free and low cost clinics on every other street corner and world class treatment options for those able to pay more.
I found that sleep quality is the number one metric that determines the level of ADHD sympthoms I experience. I do yin yoga before sleep every day, and have fully quit caffeine. I also make sure to not eat at least 4 hours before bed and to not look at any screens 1 hour before my bedtime. Sleep is absolutely my number 1 priority in life.
Starting my day with some heart-rate elevating exercise is the second most helpful habit. I really got into power yoga during lockdown, I highly recommend it.
Having elevated blood ketones, either through fasting or eating low carb, are the third most helpful tool. My level of focus is just incredible when my body has switched to fats as the main fuel source.
My ADHD is quite manageable this way. I feel like having to work for mental clarity is better for me than relying on amphetamines.
* sleep as you mentioned
* omega 3 and multivitamins (including vitamin D)
* exercise in the morning if possible then on the evening if not possible.
* no strong lunches ( eat something that energizes you but for a long time, lately I have been eating just cooked beans and the energy I get from that is very stable and durable, beans is so cheap and so nutritious ) this avoid lethargy feelings after lunch
* not too much coffee not too less, Coffee does help but too much, it actually increases the chatter in my brain.
* One of the latest things I applied is pomodoro and daily TODO, this I feel solved for all my adhd problems. Keeping focus is an habilitie that you can train, forcing to be focus for 25 minutes is a good enough time. I get more work done and get less at the end of the day.
To me, all the ADHD symptoms listed in this article sounds like nothing more but normal human traits.
Also, author hasn't been diagnosed with ADHD, and the tips can be helpful to everyone.
I also don't think the examples you give are great analogues to the situation (although highly related) as I've not meet a lot of people using alcoholism, bulimia and asthma as a way to avoid everyday tasks in contrast to ADHD.
And it's worthwhile to remember, sometimes people have debilitating conditions that make them worthless for tasks. It is sad that some people are paraplegic. Those people cannot be wildfire firefighters. It's not an excuse or anything. I would not want to pay that person to be a wildfire firefighter because they cannot fight wildfires. If I were paying someone to be a wildfire firefighter, and then they lost all their limbs, I cannot indefinitely employ them as a wildfire firefighter anymore. If they were to say "It's not my fault I don't have limbs", I'd have to say "No, it isn't, but also, you can't fight fires. So I'll fulfill my responsibilities to you, but I can't employ you in this capacity any more".
If someone has ADHD and they can't do a job, then they can't do the job. Any general requirements you have as an employer are to make "reasonable accommodations", not to sit there as your employee sits there on their fourth year of doing nothing because they "have ADHD".
https://medium.com/@mosaicofminds/the-curb-cut-effect-how-ma...
2 years ago a friend who was diagnosed with ADHD started describing some of her symptoms and I realized it sounded exactly like what I experience. I started seeking treatment a few months ago (currently therapy, and undergoing screening for medication), and just reading through the list of symptoms while I was filling out a questionnaire recently was like suddenly being able to see color for the first time.
Knowing that what I experience is not just "normal human traits" and is in fact an identifiable disorder with concrete causes and solutions has totally reoriented how I think about some issues I face and has enabled me to actually address them in a way that wasn't possible before.
I think there is an argument that western medicine sometimes pathologizes people having normal responses to the insane demands of our society and economy. In my case, I have been struggling with my healthcare provider's bureaucracy to get a diagnosis because I really, really need help.
I'm the same way, and once I stopped trying to "fix" this "disorder", I've become not only much happier, but also more productive. Just one anecdatapoint.
Social media, I use it carefully. I keep asking myself, "am I learning something useful from this?"
I do know that medication helped me a lot, I got diagnosed as an adult though. I don't think I would have liked it if I was diagnosed as a kid and got pills with ever increasing dosage forced on me just so I would stay quiet in class.
Here's a question I posed a while back, with some helpful responses. https://news.ycombinator.com/item?id=21716306
Also, it's worth diving into the literature on a number of conditions if you're unsure or curious. For me, I only started to think something was really different when I compared my interests and how obsessively I'd learn about them, with the friends I'd be talking with over coffee. There was something seemingly absurd about how much I'd think about an idea or subject, compared to the most I was able to get someone talking about anything they were compelled by. Usually this had to do with systems or cities or the like, and so at first I was leaning more towards high level autism. It's hard to analyze yourself from the outside, so a practitioner who can ask hopefully specific questions about your family and history is very helpful.
Otherwise, if you've found something that works for you, then it probably doesn't matter what your label is, just roll with it.
Lastly, I do appreciate the sharing of personal experience. I'm a SE who has been out of work for 7 months and doesn't have a damn clue how to succeed or how to keep pushing. Have lost 6 jobs over 8 years for varying reasons, and it's a tough life for someone with ADHD symptoms. It's extremely easy to burnout, because to be motivated means to be very motivated to a fault, among other reasons. Then when you do burnout, you realize that nobody actually gives a shit about the work you do, and you sink to the bottom when you get fired.
Can anyone break down the neuroscience for me and any meta-analyses studies on ADHD amph stims effect on early onset neurodegenerative disease?
I think what finally got me to do the thing was realizing how often I was now not able to parse my partner speaking directly to me even when I was 100% listening, no distracting noises, interested in what they had to say, etc. At the worst it was more than once a day for at least a minute or two. I could see their mouth moving and recognize that they were making words but was unable to understand a word of it no matter how hard I tried.
Vyvanse has been helpful. It's made it possible to put the work in and build routines to get stuff done. It's not a magic bullet but it brings me much closer to the starting line. I started struggling more with insomnia since starting it but that's a trade I'm willing to make to be able to function at all.
I suffer from misophonia in a way that is similar to this. There are certain high, mid-high sounds that cause a painfully disorienting "touch" sensation for me, along with the usual suspects like chewing. I hear sonic animal repellents that most people out of their teen years don't.
> Noise cancellation headphones to eliminate distracting sounds
I was skeptical about these in the past. I received a pair as a Christmas present and they've been literally life-changing, especially in COVID World with the kids at home. They're Bose and probably cost more than I would spend on myself, but they are priceless to me now.
On the one hand, I struggle with the diagnosis. Everything I read about ADHD felt like a horoscope. To me, it seems everyone will recognize at least parts of the symptoms. People often respond by saying "Oh yeah, I got that too". I have a firm belief everyone is responsible for their actions and, ADHD seems like an excuse. And I don't want to have excuses.
On the other hand, I have taken Ritalin -I stopped when we COVID forced us to work from home- and it helped. A cloud was lifted. Also, I don't longer try to fight and apologize for all the little sounds that make me go bananas.
I can say that having a purple hair and sleeping less then 6 hours a night is a Purple Hair Sleeping Disorder (PHSD).
Bottom line is, we have no real idea what are the actual physical and mental causes - what is the REAL illness, the pathological anomalies - that ADHD is the symptom of, and accepting ADHD as a THING means we are not digging deeper to find the real cause.
And as a side note - the DSM (which defines ADHD), once defined being gay as a disorder (and hence treatable).
Side note: Most governments and most people didn't look too highly upon homosexuality, and we don't know everything about it, but things have changed and we haven't invalidated everything that said something different than we currently believe.
Cancer is diagnosed in a very methodological and strict way, and the fact that we discovered it doesn't mean we discovered the cure for it (sadly, curing cancer is very hard).
I have no problem with ADHD being a defined disorder that we can ask questions about - as long as we understand that it is not a thing, cannot be objectively diagnosed (and therefore treatments are as vague as the diagnosis), and people cannot have it (the same way we have a flu or COVID-19).
About homosexuality - it was just an example of how the psychiatric bible - i.e., the DSM - can get things horribly wrong and therefore should be taken with a grain of salt.
I have ADHD and have found that being on a strict sleep schedule and really making good sleep a focal point has helped maybe more than taking a stimulant
Just because other people have easy time doing boring work tho, why do we call this “attention deficit?” Why not call it “boring works sucks, and distractions are awful,” or whatever.
The best most interesting people I know all (probably) have adhd. It’s kind of a good thing, or the world would be very boring.
That’s all. Just a thought.
ps. As I am reading other comments, many focus on how other people have perceived them as better/easier after medication. But my question is, why do you care? I mean, 9 people will think you are nuts. So, hang out with the one that doesn’t? Seem better than taking meds for something that is “normal,” for a small percentage of the population. Why not give meds to the other people? :p
People don't give me money unless they perceive me as valuable. That is pretty important for me. Also I care about delivering on my personal projects for my own sake. Other than those two I don't care what others think.
i'm tempted to argue that ease of access to amphetamines plays a huge part in the US continuing to maintain a thriving tech industry. along with being able to siphon the best and brightest from every other country that can't match US comps, of course
Whenever you read someone's personal description of ADHD, it helps to remember that many of the traits they describe are common to everyone, ADHD or not. The distinction lies in the severity of the symptoms, and how resistant those symptoms are to more typical (non-medication) interventions.
The bigger problem is that some of these overly generic descriptions of ADHD are so broad that you'd be hard pressed to find any young person in 2021 who doesn't fit the description.
For example, consider what the inverse of this person's list of bullet points would look like:
- Very, very easy time focusing on things they don't like or don't want to do
- Easy time reading physical books
- Hard to distract with construction noises
- Enjoys sitting still for extended periods of time
- Easily gets back to a flow state after being interrupted
Taken to extremes, overly generic descriptions of ADHD tend to paint unrealistic pictures of what a non-ADHD person looks like. When was the last time you met any young person who is unaffected by distractions, interruptions, sitting still for long periods of time, and has no issues focusing on things they don't like?
The list of recommended techniques provided by the author is excellent. Everyone could benefit from it, frankly. ADHD people especially.
Newly diagnosed (or self-diagnosed) ADHD patients often make the mistake of letting their diagnosis become a convenient excuse. They might start speaking about their ADHD as if it's a separate entity, holding their true self back (For example "It's not my fault I have ADHD" or "If it wasn't for my ADHD, I would be more successful"). While this is short-term satisfying, it can be extremely counterproductive. If anything, an ADHD diagnosis means you need to put more effort into building routines, improving your self-discipline, creating focus-conducive environments, and other healthy habits that everyone benefits from, ADHD or otherwise.
If you find yourself identifying with some of the points in this article, bookmark the article and spend some time implementation the recommended bullet points. If you find the issues are interfering with your life to an unbearable degree, consider engaging with a professional psychiatrist for a conversation on ADHD. You don't want someone who will simply prescribe stimulants and send you on your way. You want someone who will create a long-term plan. Medication can help, but it's not as straightforward as it sounds. Worse yet, some people mistake medication for a free pass around building self-discipline, which fails when tolerance develops (and it will). Healthy habits and self-discipline last a lifetime, so it's worth investing in building those up front.
Most likely you will not even get the job though, since you will get stuck trying to apply for jobs, or maybe even earlier you will get stuck trying to do boring assignments in college and therefore wont even graduate.
The rest of the time, I was a right mess. Changed entire careers twice because I figured what I was doing just wasn't my thing. Turns out it was more fundamental than that, and I'm doing better now medicated.
I know others afflicted with ADHD who had similar experiences of flying just under the radar of being fired, before they found out what was really going on.
"Due to similar symptoms, an undetected visual dysfunction can be misdiagnosed as ADD/ADHD, dyslexia or a reading disability. A comprehensive eye exam, which rules out a binocular vision dysfunction, is critical to determining if vision is a contributing factor."
See: http://walesby3d.com/vision-learning/ and http://walesby3d.com/what-is-vision-therapy/
For years I had trouble concentrating and sticking with a task. It felt like my eyes were exhausted even after a few hours of simple computer work, so I was constantly getting up and looking away and taking breaks. This led to not even wanting to pay attention or focus on anything at all, especially on screen, because I knew I wouldn't be able to stick with it. It felt like my brain was mush.
Fast forward almost five years of twitching from one task to the next, it started to feel like my vision was getting worse. I wasn't having any luck getting my prescription right with the eye doctor I had been seeing, so I went to another doctor, then another, then another, until one doctor refused to write me a new prescription because she picked up on a slight muscle imbalance in one of my eyes, which was preventing my eyes from tracking and converging together.
She sent me to a pediatric vision specialist (they'll see adults) who primarily deal with muscular dysfunction in the eye—these folks quite literally changed my life.
Turns out I have all sorts of muscular issues with one of my eyes, which causes both eyes to work overtime trying to coordinate and focus together. This led to tired eyes, and a tired, sleepy brain. Long story short, it took a few months to get the prescription just right, along with some initial vision therapy, but once I got used to the new glasses, my ability to focus returned almost overnight. Everything felt so much calmer—reading, writing, thinking, driving, speaking.
These days, after a handful of changes to my prescription over the years, I've reached a dead-end with lens corrections, so surgery is the only option left if things get worse. But so far, the glasses with appropriate corrections have been absolutely incredible.
Anyway, I just wanted to post this in case it's helpful to someone who is lurking with tired eyes and a fractured attention span. You want an optometrist with F.C.O.V.D after their name, someone who specializes in binocular vision and muscular dysfunction.
Does a standard eye exam cover that? An optometrist recently told me that my eyes are "boring" and my mild prescription hasn't changed in years. So I've been trying to address my tired eyes with the basics: "20-20-20" (every 20 minutes, look at something at least 20 feet away for 20 seconds), actually wearing my glasses, drinking enough water, exercise, stress reduction, and getting enough sleep. If I continue to have trouble, should I ask for some more comprehensive exam?
> Anyway, I just wanted to post this in case it's helpful to someone who is lurking with tired eyes and a fractured attention span.
I suspect there are a lot of such folks, but the obvious suspect is the pandemic. Among other things, it often means fewer unplanned vision breaks and generally worse self-care.
> You want an optometrist with F.C.O.V.D after their name, someone who specializes in binocular vision and muscular dysfunction.
To rephrase my initial question more precisely: do I need to get the person who does the exam to have that qualification, or is that just who I'd go to after seeing something is wrong on a standard exam with any optometrist?
If it turns out that you don't have any muscular issues, they'd still be able to help with your standard prescription if you're trying to get it right!
Hmm, is there any relation between this sort of problem and eyelid twitching ("blepharospasm")? WebMD doesn't seem to think so, but maybe you've heard differently.
- What are the symptoms? I read here that some argue that they cannot do menial tasks or get up from bed, others get up at 5am regularly or are exceptionally able to do chores. Some can't achieve anything in their life, losing one job after another, others are serial entrepreneurs and feel like having superpowers. I am confused by the broad and (apparent?) conflicting set of symptoms.
- How does the "evolution over time" of ADHD look like? What I mean is: is it a condition that "starts with you" since when you are born, or does it "begin" at some point, like a normal illness? Likewise, can it end? Can you heal from that? Can it be reduced? And in the "in between part", if you were to graph its intensity/presence, would draw a constant(ly high) line? Or are there periods of higher and lower intensity? If so, what is their frequency? And if you were to draw only the segments "controlled for other confounding factors", for example ignoring big impactful events like big successes, personal losses, breakups, particularly happy or particularly bad relationships (even long ones), periods of medication or drugs, turbulent hormonal teen years, periods with second jobs or complete lack of jobs, how would the graph change? I had up and down periods, mostly long downs (even years) and short noisy high frequency ups. Often I was able to identify the causes behind the intensity of my mood (identifying does not imply solving), and I wonder how this time series looks for everybody else, and if and how ADHD people's curves are different from the cluster of "normal" curves.
- What are the tests that are used to assess and quantify it?
- Any scientific study on the effect of various medication on people with ADHD and without? I'm particularly interested in the reported effects for "normal" people in control groups. The effects of some medicines that I often see described sound wonderful: stability, being able to focus, being able to do what is useful (chores, big projects), stopping train of thoughts, etc. Disregarding the fact that, much like with symptoms, it looks like the effects are wildly varying, overall they seem impressively useful, and I ask: are there reasons why anyone would not want improved focus, cognition, productivity and stability? Some of these drugs are indeed famous for being (ab)used by students or even workers, in some parts of the world, to push through stressful times. Why wouldn't and shouldn't everyone have access to those? And, related to this, how does one recognize that they may not be 100% genuine and objective with perceiving and describing their ADHD symptoms to a doctor, but maybe one is exaggerating something unconsciously just to get to those miraculous meds?
- How do you explain (or, better, do you have any paper that explain) the differences in the percentages of diagnosed cases throughout the world (thus, differences over space) and during the last decades (thus, differences time)? Is the incidence naturally different in different countries? Has it naturally changed over time? If so, was that due to a change in other causing factors? Or, more worryingly, did the way of diagnosing it change in time / is different across the world? If so, do you think (or have papers about) the current criteria for diagnosis are accurate and precise (identify the "true value" and with low variance) and uniform? Or is there still work to do? Maybe in 100 years they could have mutated into disgnoses for 10 different more specific disorders, that "our ancestors [we] thought it was just one thing", maybe the disorder won't exist anymore like hysteria evolved from the 1800 to today, or maybe they won't change that much.
- Same question as the above one, but on differences in treatment (over time and across countries). Any anecdotes on people being diagnosed in a rest-of-the-world (non-US) country? Was your experience similar to the ones you read about, from American fellows? Were your symptoms and treatment different? I am particularly interested in hearing more from the rest-of-the-world, being from a non-US country myself. It's hard to understand how much one is in a bubble of American experiences and anecdotes, when reading from the internet. For example, I never even heard in my country the word ADHD. My only experience is from reading about it on the English-speaking part of the Internet. Never heard stories of hyperactive kids taking medicines, or students or adults being prescribed stimulants to push through. I am sure such cases exist, but from my experience these things are just "not in the culture". For almost all the people I know from my country it would be unthinkable to even consider a hyperactive kid to be something to "medically treat". I'm not saying I come from a place where kids with problems are not treated, on the contrary, kids with autism, dyslexia, learning impairments, all sorts of disorders, are followed and given the attention they deserve. I'm just saying that the perceived threshold in the public opinion for what deserves medicines seems to be wildly different than the American one, when it is applied to hyperactivity (or hypoactivity, lack of motivation, etc) and to adults. (I'm from a big country in Europe).
I hope my questions don't come out as provocative. I acknowledge the ignorance in them, because I am ignorant (unknowing) on these topics. And that is the reason I want to find more (and help people like me to understand better). I appreciate any scientific study, paper, or any article with sources that you can offer. Thank you :)
ADHD is defined as a cluster of symptoms like many other disorders. Probably there are different etiologies. But the treatments are the same.
Mild ADHD was less of an impediment before industrialization. It's less of an impediment if you have a secretary at the office and a wife at home. Self medicating can help. And what does a severe case look like if you don't know what you're looking at? Maybe shiftless, maybe dim, maybe accident prone, maybe hot headed, maybe a drunk. So it's no surprise diagnosis varies.
Really I've never seen so much nonsense in one place... congratulations though on finding a steady supply of a drug that you like, just don't pretend you're any different from the rest of us junkies.
Nice, tell me what your uninformed arse thinks.
https://www.healthline.com/health/gamma-aminobutyric-acid#us...
It makes sense to use a neuroinhibitor if you have hyperactivity.
Plus, they will make you sleep more and better, and good quality sleep will take care of a bunch of other issues you might be having.
Using stimulants for anxiety will push you deeper into anxiety.
https://www.psychologytoday.com/us/blog/sleep-newzzz/201901/...