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Had the same addictive personality. Latter diagnosed with ADHD which is a brain imbalance that has difficulty regulating dopamine.

Unmedicated, I have a constant drive to find something that gives a little reward. Cigarette, beer, doom scrolling Twitter, unhealthy foods, other forms of unhealthy and impulsive behavior.

Medicated, I don't have that feeling where I just need SOMETHING. And my 'addictive personality' is just none existent.

I've also done some work on myself as far as identifying triggers and feeling and being able to identify where that drive is coming from.

I think the addictive personality trope is really harmful and it's more likely untreated trama or feelings or untreated mental health.

Mental health is so overlook at least in the US health System. It's a real bummer but I don't think any of us are beyond hope and I hope that we can start to recognize and address that.

What medication did you end up with? I started recently trying a few that haven't worked well for me.

I started on Wellbutrin which had a bad side effect for me and had to stop, and now Vyvanse which doesn't seem to be helping my focus at all.

Vyvanse changed my life, truly. Most of the amphetamine class of drugs "work" for me but their side effects are/were nearly intolerable, especially in hindsight (high school was miserable; daily stomach cramps & tons of social anxiety, despite being very focused/incredibly effective).

When Vyvanse came along it completely changed my life -- all of the benefits of the 'basic' existing drugs, zero side effects. I can barely tell if I've taken my medicine in a given day or not, aside from the ability to focus; but I eat, sleep, and am socially the same as "normal" with Vyvanse, I don't feel it 'coming on' or 'wearing off', etc...

The only downside is that it's still not generic -- so it runs me around $10/day. My ideal dose really seems to be two lower-doses per day and no insurance will cover that, meaning it'd cost me $20/day+ (this is with $1500/mo+ insurance), which means I just make do with what's reasonable.

That said, it truly has changed my life -- I went from being a low-GPA high-school student who could code, but couldn't focus (or stay motivated) about much anything, for any period of time. To founding a company, having a mildly successful exit at 18, and then going on to be CTO, and subsequently founded multiple companies.

Don't get me wrong, I still have my personal struggles (like anyone else) but, if it wasn't for Vyvanse, I think I'd be lucky to own a house -- much less live in a paid-off house & be happily married with amazing children.

for me, ritalin helped most with my focus, adderall xr helped most with my motivation, adderall ir helps me currently with my energy + motivation. i’d say adderall xr is the best of the three, though i prefer vvyanse — but vvyanse is prohibitively expensive, and adderall xr is 4x the price of the instant release. also, i had to take adderall xr twice a day; the “extended release” formulation only seems to add a few hours of duration over the instant release. i’ve yet to try dexedrine, but i’ve read good things about it.

overall though, i’d not rely on anecdotes about add meds. people’s experiences are vastly different in-practice, and the only things you’ll really find in common with other’s treatments are the more pronounced side effects. not to say that there’s anything wrong with asking for advice, just be sure to temper your expectations a bit based on what you read and try not to get too discouraged.

my advice is: if your doctor is willing, have them write you seven-day prescriptions for the different medications you’d like to try and see which one works best. keeping a short journal about sleep, eating/drinking, mood, energy, motivation, and productivity during this time also helps gather some perspective. when you find one that works, try it for a month, and then make a decision from there.

From what I’ve heard from doctors, xr is equivalent two doses released into your body, its not a steady state release as you might expect. Its basically one ir and another ir wrapped in a package that takes a few hours for your body to digest. So if you don’t really have issues with timing and xr costs you more money then ir is totally equivalent and ok to use. If it feels different, then it might be manufacturing differences. To really determine the difference you would need to get it from the same manufacturer for both the xr and ir versions. Which doesn’t surprise me after listening to a podcast about a book called bottle of lies.

this is how i’ve understood it to work, yeah. the “feeling” of the ir is much different than the xr (for me, that is). i’ve tried comparing the teva generics of each formulation, and the xr just didn’t last as long as two perfectly-spaced ir doses — about five hours for one xr dose, eight hours for two equivalent ir doses. i have a feeling that it’s a combination of manufacturing (as you mentioned) and body chemistry to a lesser extent. vvyanse seemed to work the best, but the 70mg capsules felt slightly too weak, and a month’s prescription for them is literally 9x the cost of the adderall.

I don't really want to comment on that. I think that's a thing that people should work with a doctor on and I don't think that what works for me would work for everyone.

I will say that It took a bit to get it right, and the best thing you can do there is try to keep notes every day so that you can look back and say 20/30 days this worked and keep track of it on a larger scale.

> best thing you can do there is try to keep notes every day so that you can look back

This is key. My doc had me start keeping a log my mood twice daily. I was surprised at how low my accuracy was for self-assessment beyond the last couple of weeks. It really help codify the effects of changes to treatment.

I’m curious about what works for you as well. I have to date been able to regulate this through other behaviors - overwork for one - that I can no longer do due to other constraints on my time. It’s becoming unsustainable.

I mean, what honestly worked was going and getting medicated.

I built a pretty good life for myself by working extra hard. With ADD I didn't ever really know when I would be able to be productive, so I'd just always be ready, always plugged in waiting for lightening to strike. And then once I get going, I'm afraid to stop, so I'd get rolling and stay up all night and into the morning and basically do 20-30 hours of work all at once, but then the next day is a write off, and really the whole rest of the week.

This is great for ops work, the stress/intrigue of production systems that needed to be diagnosed and fixed always got my brain going but at some point, I need to be working on building stuff and delivering on a schedule and not just being on 24/7 oncall. As I started to move into those types of roles, I really hit a wall and that's when I realized I needed to go back and get medicated. (I was diagnosed as a teen and was on meds until my insurance dropped in my 20s)

It started to take a toll on me and my family. There are a lot of feelings of depression on days when I wasn't able to focus entirely and anxiety that I won't be able to focus enough to get things done. Oscillating between those feelings constantly makes it difficult to be functioning part of a family, not to mention keeping your schedule clear or breaking promises because things are finally clicking and I felt like I needed to skip on some activity to get enough done to keep my job. Always working, never getting anything done.

I finally decided that I needed to be able to focus my mind on demand so I can do family stuff during family time and work stuff during work time. I can sleep in and know that I can just get up and start working when I'm ready. I can watch a dumb movie with my kids for the 100th time without it feeling like a wasted opportunity. I can work and just do the things I need to do and at the end of the day, I know I've made that 8+ hours of progress toward my deliverables (generally, we all have trouble with this from time to time because of unexpected complexities and unknowns but I don't feel bad that I wasted a bunch of time). And then I can relax, and just do other things, like hobbies and family time.

There's lots of ways to help mitigate your ADD symptoms, there's counselors out there that can help with behavioral techniques to help increase your ability to focus. If that's what you want find one of them and they can help quite a bit. The danger there was that I still had problems focusing on demand and then I felt even worse about myself because I knew I had this problem and I knew things to do to fix it and I still couldn't get it done. Add a dash of meds in there and everything is clicking. And I can take all that extra hard work that I used to use to try to focus and turn it into real output.

I think everyone is different for sure so if this is something you're struggling with, then get help, get a coach or mental health counselor to help you build strategies to focus at the right times. Talk to a dr or see if your counselor will recommend someone who works specifically with ADD meds.

The best thing you can do here if you realize this is becoming unsustainable is to start getting help from people who work with this stuff.

I can relate to this. Drank heavily through my twenties. But I went sober for two years during which time I identified privately as an alcoholic and addict. I did the emotional healing. I started to meditate daily and exercise and talk about my problems. I had to slowly learn who I was as I had drunkenly buried away and neglected so many aspects of myself. After those two years of cultivating a healthier life and mind I started to drink again. I can do so in moderation and with an awareness of why I’m doing it. The takeaway for me was that I wasn’t an addict or alcoholic, although they served as helpful labels while I grew and healed. I just hadn't taken the time with myself to figure out why I was unhappy and I was subsequently stuck in a feedback pattern of bad, unhealthy behaviour.

Edit: Just wanted to add that I understand this isn’t everyone’s experience and sometimes moderation isn’t a possibility. Just sharing my experience.

There are no “patients” in AA; just self-identifying alcoholics. And I understand where you’re coming from, but for every story of someone who was “disempowered” by a belief that they are an addict for life I can give you a story of someone who started drinking again after decades of sobriety and completely destroyed the good life they had found.

Alcoholism is what you might call a hard problem, in that every case is unique and there is no good way to know which “kind” of alcoholic you are dealing with, or which approach is going to have the most success, just by ticking off symptoms. AA clearly works, and works astonishingly well, for a non-negligible portion of the people who try it.

The true long term success rate of AA is about 1 in 20, which is absolutely terrible!

> I'd been an excessive drinker from my late teens through to my early 30s. "Alcoholic", I'm not sure about; I've seen others who were formally diagnosed alcoholic, including one friend who ultimately died of it, and I wasn't that bad, but I was at least very socially dependent.

Modern addiction specialists have mostly moved on from this kind of definition of an addict in favor of a view that says, more or less, that addiction is characterized primarily by repeated use in the face of adverse consequences.

I've noticed that I tend to get pushback on this whenever I mention it, so here are some sources.

Here's the American Psychiatric Association:

> Substance use disorder (SUD) is complex a condition in which there is uncontrolled use of a substance despite harmful consequence.

Here's the National Institute on Drug Use:

> Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain.

Here's the American Society of Addiction Medicine:

> Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.

Any links you can share on the emotional healing work you do?

It's hard to answer without triggering backlash in places like this, as the whole world of this kind of healing is a minefield of quackery and woo. It's taken me a long time to work through it all and be able to winnow out the practitioners and practices that are solid. And it's tricky to recommend stuff online, as some of it is linked to chiropractic (which I'm still not generally a fan of), and there are big-selling authors who have written multiple books about these topics, some of which is great, but some of which would be a dealbreaker for many.

Having said all that, if you're keen to research this stuff yourself, look up "Neuro Emotional Technique" and Psych-K, and look for books by Dr Bruce Lipton and Bradley Nelson.

But I'm happy to share more about my own experiences and practices if you contact directly. Email address is in my profile.

Also I interested in learning more

> I think organisations like AA do great harm when they tell their patients that you're an "addict for life".

I really don't think you are the kind of "addict" that AA is designed. They are often for people who have hit rock-bottom due to their alcoholism.

I think I could have ended up at that kind of rock bottom had I not found the path I ended up on. And more importantly, there's no reason why the techniques I've found wouldn't work for people in AA; they're just not widely known about. I guess mainstream psychiatry and Christianity are the sources for AA's methods, and they're just not aware of what else is out there that could be more effective.

My experience was that the AA “methods” are just a vehicle for the true healing, which comes from the people. The magic is not in the 12 steps, it is in the genuine companionship and selfless service of the other alcoholics who walk with you all along the way.

> there's no reason why the techniques I've found wouldn't work for people in AA

Respectfully, I don’t think you have any idea what you’re talking about. Spend some time in a few AA meetings, maybe a meeting in a prison, and reconsider your hypothesis.

> My experience was that the AA “methods” are just a vehicle for the true healing, which comes from the people

I can believe that, and I'll happily grant that's an extremely valuable spect of it, given how much social isolation is an exacerbating factor in addiction and relapse.

> Respectfully, I don’t think you have any idea what you’re talking about. Spend some time in a few AA meetings, maybe a meeting in a prison, and reconsider your hypothesis.

That's not respectful at all, regardless of the reality of my knowledge of the topic. I've been very close with people who went to AA, including one who lost his life after several years in it. I've been close with others with other substance addictions, including at least one who ended up in prison. Though I wasn't understanding of it at the time, in retrospect I can recognise what was powering their addictions. These techniques would have helped those people the way they helped me. It's been demonstrated by at least one prominent researcher, Dr Gabor Mate - https://drgabormate.com/topic/addiction/

Can you expand a bit on the "deep emotional healing techniques", or point me in the right direction to read more on the topic?