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I'm in a similar situation. The diagnosis changed everything for me and I really wish someone had noticed it when I was a kid.

All my therapy was about struggling with my ADHD for so long because it was unkown and untreated. Once I figured the ADHD part out, everything else fell into place.

Knowing this about myself has been nothing but positive for me.

Did you ever experiment with Adderall, Vyvanse or Ritalin? How did you end up with Strattera?

I’m trying to triangulate a course for myself and still can’t pull the trigger on any of these for fear of side-effects or dependence.

Not the person you're replying to but Vyvanse gave me excruciating neck cramps, brain zaps and really cold fingers. My doctor said that I had a bit of an outlier reaction to it so YMMV but if you decide to go that route at least ask about the cramps lol.

Adderall isn't a wonder drug for me but it tips the scale in my favor. I just take the standard release pills 'as needed' in the morning. It does tend to mess with my sleep a bit if I take any after 10am and definitely curbs my appetite (+/-). I'm 47 and recently have been paying closer attention to heart health, it definitely increases heart rate and blood pressure. Not alarmingly so, but if you're in any way marginal for either it's something to consider.

To be fair, caffeine also increases heart rate and blood pressure. I think it's common of stimulants

...and disturbs sleep, and can help treat symtoms of ADHD

I was prescribed Adderall XR which did wonders for my symptoms but eventually I stopped taking it as my heart would race after doing any strenuous exercise. I wish that wasn't the case, as it did help.

I've been on and off Vyvanse and Ritalin for a decade. Work with your doctor on side effects, I found Concerta to have the least side effects for me (long-lasting, tapers slowly at end of day, and fewer anxious feelings for me than Vyvanse.) I've also taken breaks from the medication for a year or more. It takes somewhere between 3 days and 3 weeks to feel like I'm not missing something when I stop the medication, but overall it's not that bothersome or unpleasant unless work/life is very busy at that time. Quitting coffee cold-turkey feels much worse, for comparison.

I had horrible physicals side effects with Adderall, I was switch to Desoxyn and I get no physical side effects from it. I just get clear headed with no speedy feel in the body or cramps. Adderall always made me clear headed, but also jittery in the body and gave me the worst cramps but the biggest one that I was not going to put up with is Adderall killed the marital bed performance, but funny enough not the desire, that was a deal breaker for me.

For what it's worth, my psychiatrist friend who has ADHD and specializes in ADHD practice swears by non-stimulant medications for long-term treatment.

His personal preference is Intuniv (Guanfacine). He says the only reason it's not more popular is that the start-up side effects can be unpleasant for a while and proper dose titration takes more work on the provider's side to get it right.

Stimulants don't necessarily lead to dependence, but I have seen enough adults become dependent on stimulant medication or even fall into the trap of doubling up doses or seeking extra sources that it's wise to approach it with caution. Most patients seem to use as directed, but the people who go down the path of addiction and dose escalation aren't necessarily the ones you'd expect.

I've used Guanfacine. It gave me heart palpitations and high blood pressure without helping my ADHD at all.

Non-stimulant medications can be good, but none of them worked for me. ADHD too broad a category to have a good idea of which medications will work for one individual or another.

The only ADHD medication that's worked for me is Adderal (and XR which I'm currently on). Otherwise the only other medication that's helped me was memantine (an Alzheimer's drug) that helped with sensory processing disorder.

The doctor recommended that I tried Strattera first and see if worked before trying stimulants. Atomoxetine is one pill per day and works 24 hours. But doesn’t work for everybody and some people have some undesired side-effects. I had some of the “undesired side-effects” in the beginning but they went away after a few days. Also, in my case, it took 20 days until I felt that it was working. I noticed it started working one day after a looked back at one situation where I would normally get stuck and dread and it had gone as without any issue.

What does "10x on productivity" mean? I thought ADHD would lead to lower productivity.

You can work exceedingly long hours with high focus on something you like.

For me that means that I can be intensively productive in intense bursts when I am engaged.

Pre-treatment OP sounds like me now.

I am arrogant in that I am always confident I can finish the tasks I have later. The problem is that even though I consistently do, it doesn't feel good, and sometimes unexpected outside influences will kill the tight margin I've left myself.

This is a common misconception about ADHD.

People with ADHD have a tendency to hyperfocus on things they enjoy, to the detriment of other things.

ADHD is not a lack of focus, it is a lack of Executive Function. Sometimes the Executive Function looks easily distracted because it doesn't want to do chores so it bounces from room to room cleaning one single surface in each one.

Sometimes the Executive Function looks like a 10x programmer beast because you get so wrapped up in programming whatever you're making that it's all you can think about, you skip meals and sleep and ignore friends and family until it's done.

It should be noted that "hyperfocus" is more of a fringe idea in ADHD science than a well-accepted feature.

Hyperfocus can also be a side effect of stimulant medication. It's not uncommon for newly diagnosed ADHD patients to take stimulants and end up hyperfocusing on the wrong thing, such as video games or other vices.

Be careful about interpreting something like increased focus as ADHD. The pop-culture definition of ADHD has become so blurry that nearly everyone could be considered ADHD under certain criteria. When focusing too much and focusing too little are both supposedly symptoms of the same disorder, it's easy to misconstrue normal behavior for disorders. It's best to leave the diagnosis to a professional.

The idea hyper focus is a strength is pop psychology. Its existence isn't.

> Hyperfocus can also be a side effect of stimulant medication.

This doesn't address the fact that the hyperfocus behavior is a side effect of the poor executive function and is present in unmedicated ADHD people. In fact stimulants in an ADHD brain tend to improve executive function and make hyperfocus less likely for them.

> Be careful about interpreting something like increased focus as ADHD.

As I said before, it's not about focus at all. It's about executive function. It just manifests in ways that look like focus problems. And yes, hyperfocus is absolutely as much of a problem as completely lacking focus.

You're totally right about it being an executive function disorder.

There's a variant of ADHD that tilts to the other end of the scale. Where the executive function doesn't fire by stimulus that ought to "execute". Less things overall catches the attention and leads to action, but the things that do, does so in the focused, engaged way.

Turns out I have ADHD then!

The flip side to ADHD is hyperfocus on things that draw your attention. This can manifest as a 12-hour coding session without breaks or even noticing the time.

When you spend 40 hours mentally preparing yourself to do a task then you are extremely productive when you actually do it. But the overall performance is still horrible.

I honestly can't comprehend what this means or why it's called "10x productivity". You're productive, but overall performance is horrible? So you do lots but do it badly?

If you spend 40 hours mentally preparing yourself to do a 4 hour task. Then during those 4 hours you are way more productive than other people, but since you had to spend all those extra hours to even get started your productivity sucks. It isn't hard to understand.

So then you take medication and now get started on the task immediately, but the task now takes 10 hours to do instead of 4. Your productivity during the task thus got reduced, but your overall productivity greatly increasied.

What does it even mean?

That sounds like me! 10x productivity, sometimes so profoundly bored I'm a blank slate.

what's the difference between strattera and ritalin?

You better search it, but I believe the difference is Ritalin is an amphetamine.

Ritalin is not a form of amphetamine. Ritalin's active ingredient is methylphenidate.

Ritalin is not "an amphetamine" but rather a psychostimulant. It's a DEA schedule II regulated drug.

Strattera works via a different mechanism and (supposedly) is likely not to be habit-forming. Ritalin definitely can be habit-forming.

They are different drugs with different mechanisms of action. One notable difference from my experience is that Ritalin has a stimulant effect, whereas Strattera actually made me tired.

Had a similar experience. Was on this for a bit when I had a GP who seemed hesitant to prescribe stimulants even though I had historically taken ritalin and it was fine (all side effects were manageable).