Comment by bootstrapping | Hacker News Reader

Comment by bootstrapping | Hacker News Reader

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I'll echo this; I'm a serial founder who was diagnosed with ADHD in his mid-forties. The stimulant medications do not make me "high", do not provide any kind of buzz. Rather, they have a moderating effect. Explaining this requires correcting the misunderstandings in the public realm of how adult ADHD presents, but in nutshell:

* 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.

> 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

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.

I got diagnosed as an adult and it was life changing for me, has been on them for 5 years. Here are some tips:

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.

> Take regular breaks from the 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.

Taking breaks simply isn't possible for many, like the withdrawals translates to sleeping 16 hours a day and not having an iota of energy to do everyday activities. It is a vicious cycle the deeper you get into taking stims and feeling normal baseline response by finding your therapeutic dose, why would you want to feel acute withdrawal symptoms and get nothing done on med 'vacation days'?

> why would you want to feel acute withdrawal symptoms and get nothing done on med 'vacation days'?

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.

The other thing your are not that well adapted for is parenthood (lots of getting shit together and going someplace on a schedule) and that is harder to take a break from

Do you really need to do that on a weekend though?

Yes? Kids don’t stop just because the name of the day starts with “S”.

But most of the import places you have to visit stops during weekends.

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.

Most people on Earth don't live in European cities. I grew up in the suburbs I couldn't go anywhere myself. Public transportation just isn't a thing around me. Not to mention all the stuff that has to be done around the house.

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.

Yeah, I think it's tough for a lot of people without kids to understand what weekends are like for the first few years. If you don't completely hate your job you'll probably at least somewhat look forward to Mondays, when you can get back to work for a rest. Doesn't last forever though; I'd say I'm past that phase now with the kids 8 and 6.

Anecdote from Asian lifestyle: Weekends are usually busier than weekdays with kids. Weekdays are school and study. Weekends are extracurricular sports, tutors, music, etc.

“Playtime” is a tool used to prepare the child for the next lesson.

> I like that though, just chilling for a day or two, do what you feel like and not what feels important.

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.

Best would be not to use medication in the first place. It can have severe side effects. Better would be learning how to solve the problems on your own like controlling thoughts with meditation.

I mean, yes. People aren’t taking them for fun. That is the point, that due to problems regulating our executive functions, we can’t properly manage our symptoms on our own.

> Take regular breaks from the medication [...] Sometimes try to do tasks without medication

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.

Also operating heavy machinery, your reaction time and attention span is dangerously diminished behind the wheel of a car so I simply would have to refuse activities of daily living taking a med vacation day which means I'm not getting anything done and when I have a family I will have dependants that I can't ignore at all.

> Take regular breaks from the medication.

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’ve tried following the “take a break once in a while” advice and it does not work for me. I started to write daily and was able to realize being inconsistent with medication led to inconsistencies for me.

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.

> Take regular breaks from the medication

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.

Since this may benefit others suffering from adhd, can you tell us the class of meds so at can discuss the combo with our specialists? I've never heard of switching meds this sounds beneficial to me, thanks.

They are both CNS stimulants, but one is believed to be primarily a NDRI and the other a slow-release prodrug for a TAAR1 agonist. I have somewhat dissimilar responses to each, and the variation in utility is sufficiently well correlated to the varying needs of work vs life, that I can allocate one to workdays, and the other to the weekend and holidays, and find myself maximising the benefits.

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.

Everyone always says "consult your doctor", it's safe advice, but the consensus from doctors I've spoken to, books I've read, and the fact sheets that come with medication make it very clear that you can totally take a day off. This is nothing like medication for bipolarity, epilepsy, or HIV where you can't miss a dose without terrible consequences.

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'm a serial founder who was diagnosed with ADHD in his mid-forties.

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.

Or in my case, I was a legit diagnosis during the period of over diagnosis and over medication. I hated being “different” and got off the meds as soon as I could and was in denial for the next 20 years and just brute force handled symptoms. Now after a couple years of reengaging with mental health and getting medicated, it is so much better than researching compression algorithms and ancient Roman battle formations while procrastinating my 2 month project until it is already past due and then working 18 hour days for a week to get it done.

i generally hate short, banal replies, but here we go:

this. all of this. yes. :)

I second that.

Me too

yes

I've learned never to take concerta when I'm tired, it will make me extremely sleepy and I'm liable to sleep the entire day (which is not necessarily what I want on days I have something very important to do).

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.

Interesting. When I take Concerta (54mg) it makes me unable to sleep for the next 12 hours.

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.

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