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Comment by nisa | Hacker News Reader

This is all true but but I've been recently been diagnosed with adult adhd in my mid-30ies and on a low dose of slow release Methylphenidate and it's all the difference between getting things done and procrastinating like hell. If you exhausted all the articles and nothing worked and you have big problems for years (like this: https://gekk.info/articles/adhd.html) give it a try. In the last weeks I managed to really learn in a structured way for the first time. Of course it's no magic solution to all your problems but it's a stark difference for me. I just want to leave that here as I've read these articles every other week and nothing sticked. Neither did counseling or talk theraphy - it helped but didn't solve the procrastination / time issues

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As a person with ADHD - there is one more layer: why some things cause stress in the first place—in my case, sending official letters causes a PTSD-like panic reaction. Usually, I procrastinate. If I try too hard to get over procrastination, I freeze or fight (which ends up with a meltdown, sometimes as hard as one culminating with a migraine aura).

Only a few months ago, I started looking at it. It turns out that sending a letter is a multi-step process. From printing something, signing it, writing the address (I hate my handwriting), going to the post office (often too loud, with long waiting times), sending it (with a proper type of email). All with delayed feedback (a killer for ADHD-like motivation). All in a way that a SINGLE mistake (e.g. sending 2 copies instead of 3, page 5 being unsigned, a missed deadline, etc).

Yes, therapy won't solve it. I am meeting weekly with a therapist for emotional stuff (but who is virtually clueless about sensory processing issues related to Autism/ADHD) and a "Psychologist on the Spectrum" (it's her FB page) purely for talking about such matters.

Ad substances, in my case, Modafinil works better than Methylphenidate. Modafinil makes me focused while reducing anxiety.

https://news.ycombinator.com/item?id=25996353

What you are describing sounds like rejection sensitive dysphoria: https://www.additudemag.com/rejection-sensitive-dysphoria-an...

I struggle with it too and have not found a solution to it. There is a class of tasks which is really hard for me to get started on due to having failed at similar tasks in spectacular ways in the past.

100%. I was considered bright but lazy / performing below potential throughout my schooling and first years of work. In my thirties I was diagnosed with a combination of anxiety and ADHD and the prescribed medication is immensely helpful. I view younger years of frustration/boredom/hyperactivity as somewhat wasted and I wish that the adults in my life has realised what was happening when I was a child.

The physician who ultimately prescribed the medication informs me:

1. Methylphenidate aka Ritalin is not addictive (and I had no problem stopping it for some years when it made sense)

2. Probably every adult could benefit from its use at specific crunch times. (But not permanently unless you're actually diagnosed with ADHD)

The FUD I've experienced when I mention Ritalin always surprises me.

I'm curious, what does that specific anxiety+ADHD combination mean for treatment, in your experience?

I'd imagine it could first of all be difficult to diagnose because the symptoms might occlude each other (i.e., 'getting important stuff done' despite the ADHD, thanks to the panic of failing something, up to a point) and also a challenge to medicate both at the same time, since I'd expect anything 'raising vigilance' to also cause anxiety and vice versa.

Yes, totally interlinked! I didn't even realise that "anxiety" fit what I was experiencing until after lots of counseling.

The doctor and psychologist I worked with prescribed a small dose of medication that affects multiple neurotransmitters. In addition I've found some mindfulness exercises and aerobic exercise helpful.

How does one get started with addressing those problems? Do I talk to a general practitioner? Are there specialists I should seek out?

Yep talk to your GP and they should be able to refer you (or they might feel comfortable assessing/prescribing without doing a referral).

Same here. Diagnosed last year at 32 years old after a lifetime of struggle.

20mg instant release Methylphenidate makes an incredible difference. I can actually prioritize things properly and take care of family, housework, my body, and long term goals and all that before bedtime!

It used to be night after night doing the housework dead last at 2am or not doing it at all and experiencing marital strain.

Pretty life changing.

I have very similar story, it was mind-blowing to me how methylphenidate pharmacotherapy helped me not only with procrastination but also gave me capacity to work on anxiety/depression and interpersonal issues.

In no way I want to advertise mph as a silver bullet for such problems, but at least for some people it works like a charm.

unsolicited tip: Find your minimum effective dose and do some unmedicated work days too.

interesting - why would it be useful? my doctor said it's better to keep the dosage mostly constant because there are studies that switching on and off actually could increase the addiction and it's better for the brain to have not to adapt to these changes every other day.

Accounting for all the factors that need account is above my pay grade, so I'm not sure I can comment. Actual medical guidance is often considered more reliable than random internet advice.

That said...let me start with my premises. (1) I don't think risks are very high/unknown, and this point (2) but let's face it... an adhd regimen is an "uppers" regimen. So... my bias is moderacy. At the least, it encourages you to be specific in your aims. Are you trying to be more productive 9-5, minimize pathological behaviours, or are taking uppers to handle that 9th or 12th hour of work.

Okay, sure I understand. At the moment it's really going from being a mess to managing life to that extend that I can at least be an mediocre student that passes exams and actually albeit late finishing some projects at work that require some upfront planning and reading. It's all pretty new for me and also working on getting exercise, relaxation and planning to work. The plan is to make a longer drug holiday 6 months in at the moment. But your are correct it's something to be careful with - but I've struggled with these issues all the way from middle school and I had so much trouble, lost opportunities, lost health, lost money due to messing simple things up so at the moment I'm just thankful that I have a tool in my toolbox that helps with these issues.

I didn't mean to be negative. A tool for a job is a good mindset.

Goal is to have a working brain every waking hour.

I do believe I have a form of ADHD. How does one get a confirmed diagnosis. I don't think mine is bad in such a way that interfere with my duties. But often at work, if I'm assigned a project or a task that isn't clear, I find myself spinning and ignoring other duties untill I have built enough momentum and clarity for the new task. Is this a symptom of ADHD?

A litmus test is "is harm coming to the individual?"

I'm diagnosed and experience exactly what you describe, but there is also a decade of severe underemployment, risky impulse behaviour, big financial hits, marital strain and a litany of health problems.

The harm can be pretty subtle despite being obvious in retrospect.

Not to say that one definitely doesn't have it if these life problems aren't present, but they are for me. You don't go seeking help if it's a matter of sometimes you're spinning your wheels, but generally you've never had really problematic life issues. I haven't paid taxes in 5 years, because I've never been financially comfortable for long enough to get it done, because I keep getting fired from jobs, in part because I can't consistently show up on time, and in part because about 6 months into a new job things catastrophically diminish in novelty, difficulty, or urgency, or a number of other things including being very susceptible to burnout.

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