My ADHD founder toolbox
hypatia.ca
hypatia.ca
Regardless of anything else, I think the key thing to remember about ADHD is that you do not need to be a high-performing human being, at all, in life. You will forget things and get distracted and not get as much done. So what. You are still intelligent and caring and dedicated and responsible and a hard worker. You probably put more effort in (when you get around to it) than many others without the condition. And you will do about as well as everyone else, on average. And this is fine. Do not put pressure on yourself to live up to what someone else can do. Only do what you can do, in your time, and be at peace.
Anecdotally, I've watched a lot of friends and colleagues go through this exact cycle: Going on meds and then just focusing more intensely on their distractions. I really think we're doing a disservice to all the people who get a prescription and get sent out the door without a more involved framework for how to use the meds as part of their ADHD treatment strategy rather than a presumed cure in a pill.
It's a trap that took me too long to figure out, and one I still fall into quite often (the period between taking a pill and it kicking in is long enough that I may habitually start procrastinating), but wrt. differences in my life on vs. off meds, in times when I feel similar to what GP described, I'm reassured by my wife who can smell me taking a med break even if I don't tell her, because from her POV, I change for the worse in the scope of a day or two. She sees the change even before I feel it.
> I really think we're doing a disservice to all the people who get a prescription and get sent out the door without a more involved framework for how to use the meds as part of their ADHD treatment strategy rather than a presumed cure in a pill.
As much as I believe the meds are a net benefit overall (they definitely are for me), I 100% agree with this sentiment.
I stopped when I caught myself in a deep dive about the different types of flour in Germany.
It also affected my mood in really unpleasant ways, both for me and people around me. And it gave me a productivity boost at work at the expense of my life past 4PM.
Nowadays I just have a coffee before work.
... shit, that was today for me. Oops. (But in all fairness, I'm still recovering from a flu.)
You'll do everything you can to avoid it first though, until the stress of the deadline overweighs the dread to start.
It's like accidentally giving yourself a small burn when pulling things out of an oven, vs. having a 2nd degree burns on half of your body. Technically the same thing, but scale matters.
punching myself in the face for no reason
Last month I saw a psychiatrist and got a prescription for stimulant medication for the first time in 20 years. After a week I had to sit down and just cry: stuff which was difficult or stressful was just simple, and at the end of the day I have so much more energy to do things, to be present, to live my life. The medication is an aid, a crutch, sure, and I don't need it, but it makes my life better, easier, less stressful and less tiring.
Why are you punching yourself in the face for no reason?
Agree. It's important to remind people that the effects of the first few weeks aren't like the effects for the next 10-50 years.
It's especially concerning when people say the meds give them "more energy to do things" because that's more of a side effect that goes away after a while. The focus-enhancing effect is separate from the energizing/euphoric side effect that people experience in the first few weeks.
High-dose pyridoxine as an 'anti-stress' strategy
https://pubmed.ncbi.nlm.nih.gov/10859691/
Anxiolytic-like effect of pyridoxine in mice by elevated plus maze and light and dark box: Evidence for the involvement of GABAergic and NO-sGC-cGMP pathway
https://www.sciencedirect.com/science/article/abs/pii/S00913...
Your description perfectly matches my experience.
If I only get 80% of the stuff I need to get done before bedtime, there's no chance for me to do other. If I get the stuff I need to get done well before bedtime, there's time left for other things. Skewed self-assessment isn't really a factor in that.
And by the way, the effect on dopamine is secondary. ADHD meds work because they affect glutamate leveles. You all do not have low Dopamine, you have low glutamate.
https://www.nature.com/articles/nn0301_275
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966039/
https://www.brown.edu/news/2018-03-12/glutamate
And you all probably just need B6: https://pubmed.ncbi.nlm.nih.gov/24321736/
https://en.wikipedia.org/wiki/Aromatic_L-amino_acid_decarbox...
AADC is an enzyme in the path that converts amino acids into dopamine and PEA/NMPEA (see "biosynthetic pathways" in above link), the latter of which is an endogenous structural isomer of amphetamine.
You're not really making a strong case that this isn't about dopamine or that amphetamine is the wrong thing for it.
Moreover, B6 will make more of these things up until the point that it's no longer the rate limiter in their production, if it ever was. (The rate limiting step for dopamine is ordinarily AAAH converting Tyrosine into L-DOPA). And if you hit a different rate limiter before you have enough dopamine or PEA/NMPEA, what then?
Important note: This is also a thing:
https://en.wikipedia.org/wiki/Megavitamin-B6_syndrome
> Megavitamin-B6 syndrome has been reported in doses as low as 24 mg/day.
Meanwhile people sell 500mg B6 tablets and it has a half life of like a month. Ask your doctor etc etc.
https://www.uniprot.org/uniprotkb/Q99259/entry
https://www.researchgate.net/publication/340492849_The_Gluta...
I did not say it is not about dopamine, but it is, at a deeper level, about glutamate. Which is why coffee works so well for ADHD because the stimulant action from caffeine is produced by glutamate.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700297/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166758/
Regardless, here is so much evidence that B6 plays a large role in ADHD and what, you all just ignore it?
Caffeine also antagonizes adenosine receptors which modulate dopamine. (Caffeine is complicated. Nicotine too.)
> Regardless, here is so much evidence that B6 plays a large role in ADHD and what, you all just ignore it?
The problem is it's the same kind of thing as saying that eating more reduces nutrient deficiencies. It might be more effective than placebo. If you're deficient in one thing and you get more of everything, you get more of that. It might even be the right solution if your underlying problem is actually that you're not eating enough.
But you want the solution that solves the problem as effectively and as narrowly as possible. Unless your underlying problem is actually a B6 deficiency, it's completely plausible that B6 could be more effective than placebo and less effective than Adderall. At which point nobody wants to hear you telling them to give up their Adderall for B6.
The fact that I can read up on this as a civilian compared to your expert level knowledge is something I am deeply grateful for. Truly!
Energy still comes from food, and if you forget to eat on stimulants your body will eventually catch up with you.
Like coffee, stimulants let you better tap into that energy.
> The mechanism of action (norepinephrine and dopamine reputable inhibition) isn’t far from that of cocaine or methamphetamine.
Yep, they’re all stimulants. ADHD meds however, are manufactured in very controlled conditions, and taken in specific doses. Street drugs are more variable in quality, ratios, ingredients and strengths, and so not relevant to the treatment of ADHD.
Methamphetamine is a legitimate treatment for the most severe ADHD cases, it’s often a last resort. It’s sold as Desoxyn. It’s rarely used, but it _is used legally and successfully_.
> Let’s be real here. Amphetamine is known to skew one’s self assessment of their performance while on the drug.
If you don’t need it, stimulants are going to have a different effect.
People with ADHD are in my experience, going to be able to self-assess performance on their meds better than off them.
Don’t assume one experience is universal, especially when we’re talking about neurodiversity. Even among those with ADHD, experiences are not universal. We may rhyme, but we don’t always repeat.
Imagine doing the dishes. Unmedicated, thats 2 or 3 tasks. Each with a high failure rate, and high cognitive cost.
1. Stop what you’re currently doing. 2. Decide you next task will be to wash the dishes. 3. Wash dishes.
The spoon theory [0] covers this concept well, and can be a useful tool.
> The spoon theory[a] is a metaphor describing the amount of physical and/or mental energy that a person has available for daily activities and tasks, and how it can become limited.
Sure, there’s also some risk for patients using them properly, but for them it does not compare to the sheer benefits provided by the meds.
Instead, look to nutrition.
However there's a general understanding of ADHD (and related disorders such as ASD) as a spectrum of conditions with multiple contributing factors. Depending on the person ADHD will manifest with more or less hyperactivity, distractability, working memory issues, and lacking emotional regulation (among other things). Different causes combine to give a somewhat amorphous disorder with a range of common symptoms.
So adding a new treatment with fewer downsides (because stimulants can have a few) is great, especially as it might treat aspects of the disorder that aren't treated by stimulants. But this doesn't mean stimulants won't still be relevant in the future.
There's there's also plenty of research showing specific dopamine receptor dysregulations as contributing to ADHD. See for example https://www.researchgate.net/publication/364120700_Dopamine_...
So unless the research also shows that this is caused by pyridoxine metabolism problems, these hypotheses can both hold at the same time.
Picking some paper that talks about different causes doesn't mean other causes aren't still relevant. It will probably be decades before we can definitively rule out contributing factors.
PS It's generalizations like yours that are very stigmatizing towards stimulant use. We already know many people benefit from them enormously and significant numbers are not getting or taking them due to stigma.
Just try taking high dose P5P.
And probably zinc:
https://www.nature.com/articles/s41598-021-94124-5
If you knew the metabolic pathways thus would be as clear as day. We need enzymes to make neurotransmitter and those enzymes need cofactors to work.
These are the cofactors.
Two, If you did, how much did you take? And what type? Pyridoxine or Pyridoxal-Phosphate? For how long? Were you tested for a B6 defieicny, high homocysteine?
Three, it is in NO WAY common for deficiencies to be tested for mood disorders and even less common for a doctor nevermind a psychiatrist to do anything about it.
And calling me an asshole when I am advocating for better health is making everyone's life worse. I do not mind if people choose to take stimulants, but they are not being advised that there are other options.
That makes you an asshole.
> Three, it is in NO WAY common for deficiencies to be tested for mood disorders and even less common for a doctor nevermind a psychiatrist to do anything about it.
Why do you believe this? It is easy and cheap to do a blood test for deficiencies, I have done that many time and they found I lacked nothing. Do you have any evidence it isn't common to check for deficiencies, because to me it seems like that is one of the first thing they check.
Because I have worked with health care professionals for 20 years and they do not test for nutritional deficiencies unless you ask/beg them to. This is even more true with psychiatrists. I am advocating right now for a woman with a serum B6 deficiency that her doctor will not address. She has an actual serum B6 deficiency and anemia and depression and her dopctor thinks it is not importnat. That is why.
> It is easy and cheap to do a blood test for deficiencies, I have done that many time and they found I lacked nothing.
There are deficiencies and functional deficiencies. Plus there is serum B6 and RBC B6. Have you had your RBC B6 tested? Nope.
And Homocysteine levels will reveal more than serum B6.
And I do not believe you because you did not answer "how much did you take? And what type? Pyridoxine or Pyridoxal-Phosphate? For how long? Were you tested for a B6 defieicny, high homocysteine?"
Then reason you are an asshole is that you are asking questions that takes a lot of work to answer since most wont know the answer to them on the spot. That is a very common tactic when you try to push your pet theory on others, but you should know that nobody thinks you won the argument when you do that they will just see you as an asshole. Even if you are doing it to be nice, you will be seen as an asshole, so please stop doing that.
Edit: Another part of the label says its this, didn't notice it at first:
https://pubchem.ncbi.nlm.nih.gov/compound/Pyridoxine-hydroch...
People I know take 30 - 60mg of P5P to feel the effects.
You were not taking high dose B6, just the RDA, and that will not do anything. And it will not correct a deficiency.
You think it takes a lot of work to answer? What about all the work I do looking into this and asking? For who? For you. Instead of calling me an asshole understand that I am helping you, for free, unlike your doctors.
So you cannot say taking B6 did not work for you.
If a B6 deficiency cured your ADHD would you still want to take stimulants?
Assuming you mean “if treating a B6 deficiency”, and assuming I had strong expectations that I could expect a cure, I’d consider giving it a try. I’d be cautious about any transition, as it could mean either significant side effects while still taking stimulants, or significant regression without them if the B6 treatment doesn’t work as hoped.
But I don’t even have a strong expectation that I could expect equivalent or better management. The study you linked was conducted with children, and the conclusions based on observations of children’s behavior. Maybe that’s a good indicator that it’s helpful, but I have no clue. I wasn’t diagnosed as a child, my ADHD was noticeable to one adult in my adulthood enough to mention it, and my experienced symptoms are much closer to autism (again as experienced by adults, not as behavior observed in children, although those diverge much less for me). But the things mentioned improving in the study are very much not what I’ve struggled with having ADHD as an adult, nor things for which I sought diagnosis or treatment.
The way diagnosis and treatment saved my life was helping me manage crippling anxiety and helping me make chronic depression manageable. It’s possible that exploring a nutritional deficiency none of my doctors have found with supplements no one has studied for adult ADHD… it’s possible that would benefit me. It’s a very high risk proposition given I have meds which work for me and which present no side effects so negative I’d reconsider.
Moreover I haven’t had a single medical professional raise this possibility and with good reason. My treatment is working. Even if an alternative treatment might be promising… why would any responsible doctor propose disrupting a persistently successful treatment plan?
I don’t know why you’re so motivated to disabuse me of my effective medication, but you’ll have to do better than showing a study which made children more tolerable. I credit my life to the meds that I take now, and there’s very very little I could fault them for. Asking me to reconsider that is asking an AWFUL lot.
You go on and on about how you don’t think it would work, but have you ever had your B6 level tested never mind your red blood cell B6 levels?
I get it, you don’t care, you found a treatment that works, even though that treatment is not curing the underlying disorder. It’s just a treatment. I get it it works, until it doesn’t. I’ve been working with people with new disorders for 25 years and I’ve seen it over and over again.
So I’m not asking you to stop taking anything I’m asking you to keep an open mind which you seem to not be able to do. That’s OK.
> I mean you did not even bother to search for another paper.
I most certainly did. The search results I got were primarily ads, and few clinical studies I found were, like the one you linked, far less bold in the results they claimed than your claim of a “cure”.
> You make me assumption that I’m trying to disabuse you of taking your medication. I’m not. I don’t care, take it if you want. But by not being open to other methods of treatment, you aredisabusing people of that choice.
Excuse me, how?
> You go on and on about how you don’t think it would work
The studies themselves don’t support your claim of a cure.
> but have you ever had your B6 level tested never mind your red blood cell B6 levels?
No, I haven’t been to a doctor since some person on the internet mentioned this a few days ago. I did have a scheduled psychiatrist appointment in that time, but had to reschedule because il out of state for a family medical emergency.
> I get it, you don’t care
I don’t know where you got that impression. I took the time to reply thoughtfully and, despite your impressions otherwise, to look for other studies more pertinent to my own experience. In my thoughtful response I expressed caution and the reasons for that caution, which you completely ignored.
> you found a treatment that works, even though that treatment is not curing the underlying disorder
That’s right. And it’s important. It’s the reason I’m still alive. I’m cautious about upsetting treatment that works because I would very much like to remain alive.
> I’ve been working with people with new disorders for 25 years and I’ve seen it over and over again.
I don’t know if you mean the disorder is new in the world (it’s not) or in me (it’s also not).
> So I’m not asking you to stop taking anything I’m asking you to keep an open mind which you seem to not be able to do.
I don’t know where you got that impression. An open mind isn’t characterized by immediately accepting life changing “solutions” proposed by random people on the internet, regardless of whether they cite medical studies. I expressed an open mind, I said I’d consider giving it a try.
> That’s OK.
In your own words, I don’t believe you. You have talked past me and several others in this thread, and you don’t seem to want to accept anything other than a revelation that what I need is vitamins rather than the treatment that my doctor prescribes. You have even suggested that I’m preventing other people from treatment (or a “cure”) you think more appropriate simply because I haven’t dropped everything to try your preferred treatment. If this is how you “work with” other people who are hoping to treat their ADHD effectively, god help them. And it has nothing to do with the particular treatment, I felt the same way about my first psychiatrist who was just as zealous about stimulant treatment.
Maybe use PubMed and not google?
> you don’t seem to want to accept anything other than a revelation that what I need is vitamins rather than the treatment that my doctor prescribes.
I NEVER SAID THAT ONCE. Take stimulants if you want, but just because that is your choice do you need to be so outraged by the idea that B6 might work just as well?
>> But by not being open to other methods of treatment, you are disabusing people of that choice.
> Excuse me, how?
YOU: Moreover I haven’t had a single medical professional raise this possibility and with good reason.
You: But I don’t even have a strong expectation that I could expect equivalent or better management.
You: I don’t believe you.
This negative stance only feeds on this idea that medications are the only choice, the only answer, and that nutrition never works becasue "there are no studies" or "My doctor did not recommend it".
You are just shooting down the idea that this might be the root of the issue. And yet you have never even had you B6 levels tested. That is just willful ignorance. Have you worked in Nutritional Genomics? Do you even know why treating a B6 deficiency might be important not just for your behavior but your over all health? If you have a B6 deficiency and take stimulants to cover up the symptoms, what about all the other enzymes that need B6 to function?
Over and over they find B6 deficiency in ADHD. There will be no studies showing the efficacy of B6 because there is no funding for products that do not make a profit. You are on stimulants because they work and they are profitable.
Next thing they will get you to take will be Metadoxine. Ha!
https://pubmed.ncbi.nlm.nih.gov/25295645/
https://pubmed.ncbi.nlm.nih.gov/23290324/
Hmmmm...I wonder why they were trying out Metadoxine for ADHD, and wonder why it failed...oh....Metadoxine, also known as pyridoxine-pyrrolidone carboxylate. So they made a funked up version of B6? Why would all these smart science people want to make a funked up version of B6 if B6 was not linked to ADHD?
Do you think maybe they know something they do not want you to know? And maybe that is because ADHD meds brings in about $20 Billion for these companies?
Have you thought you do not want to hear anything but stimulants are the only answer for you? And that I am not talking past you but that there is no one there who wants to listen?
I normally hate to quote this but it fits: calmer than you are.
> You are just shooting down the idea that this might be the root of the issue. And yet you have never even had you B6 levels tested. That is just willful ignorance.
My gosh, you’re being a jerk. I haven’t had my B6 levels tested in the last few days because it’s in the last few days and my medical appointment was canceled because I’m out of state for a family medical emergency! Have you thought about the fact that I literally physically cannot meet your expectations of an open mind and that your expectations are totally unreasonable?
I was asking if you had your B6 levels tested ever, not in the last few days.
You’re reading what I wrote much more dramatically than it is implied. The fact you think I am really telling you to run out right now and get your B6 tested is distorted.
There was a decade between me first seriously suspecting it, and that.
Information about it is much easier to come by now, and more people talk openly about it. Without that, I probably would have struggled for much longer.
That is profound. Also says a lot about us as humans. Glad it's not raging anymore
Hard to see how this is "especially true" with stimulants, given they're the rare case of psychiatric meds you can get on and off safely at any time, and the bulk of the effects appear in hours to days after starting the treatment (and disappear just as fast after cessation). Contrast with e.g. depression treatment, where it takes a month or more before it's clear if the drug even works on you, and which of the bad side effects have a chance of eventually going away.
"Long-term positive" is impossible to know in individual, non-statistical sense, whether it's about stimulant medication, SSRIs, moving to another city, marrying, or starting a family - any of those is going to have cascading impacts on your entire life, and even if you think they're positive after a month/year, who knows, maybe few weeks from now you'll think they were negative. That (otherwise stupid) "Farmer's Son" story has a point here.
Maybe you can get off them safely, but not always easily. My alcohol/drug recovery group is filled with people who couldn't easily get off them, like my friend N., who rather than swallowing his medication (Ritalin?), he crushed it & snorted it like cocaine.
You're implying addiction, but in the more common case, people with ADHD can be apprehensive about getting off the meds for the same reason people with chronic pain can't easily get off painkillers, or people in general can't easily get off oxygen.
> like my friend N., who rather than swallowing his medication (Ritalin?), he crushed it & snorted it like cocaine
That's just drug use, not ADHD treatment. I wonder what your friend's dose was? Snorting instead of swallowing is massively increasing the absorption rate, but even then, I don't think you can get high like this, if you just do your regular regimen through the nose. But doing a week or month's worth of pills this way at once, I guess sure?
I don't have the data handy, but IIRC the difference in dose size between therapeutic effect and drug abuse that leads to addiction is ~100x.
There is no side-effect to glasses, you can put them on or off completely at-will any moment, and they make a very exact correction to one specific parameter (vision focusing ability).
ADHD meds are imprecise and affect many systems in different ways - some positive and some negative. You can only have them on/off daily. It might affect you differently depending on other factors. And treatment is not without risk.
It’s hard to understand how stopping will affect you due to the imprecision. It’s not as black-and-white as glasses.
But stimulant meds still don’t deserve any more stigma than glasses. For those who take it as part of treatment of a lifelong disability.
Edited to add: Btw, try playing squash or go swimming with kids. Suddenly your glasses aren’t the perfect solution that they may otherwise seem to be and they become yet another tool, like having the kids wearing bright swimming clothes so you can spot them in a crowd.
But you’re right, we’d love for ADHD meds to be as effective and universal as glasses, but they’re not. Probably because ADHD isn’t a single condition, but a spectrum of conditions with some overlap. So expecting a single treatment to take away all symptoms is a fantasy.
Anyways, I'm skeptical of that 100x number. Comparing 5mg of adderall to 50mg, I could easily imagine getting addicted to the euphoria from the latter and spiraling. I can't even imagine 500mg of adderall, that's just an absurd dose.
I could maaaybe imagine that the 50mg dose resulting in a sorta psychological addiction and 500mg being more physiological, but it doesn't really line up with the model I've built from my own experience. Of course, everyone's different
I’m sorry but this is just beyond silly.
You don't even need that much - a 10mg pill crushed and snorted (it will make a few lines) will fuck your shit up.
Its not a particularly fun high though, it comes with compulsive redosing, discomfort (skin crawling), and basically feels like the latter half of a cocaine bender - after the fun has ended but you are now just fiending.
Other fun ways to abuse methylphenidate at low doses include exploiting its synergy with alcohol and prozac to get, again, a rather cocaine like high, but much more enjoyable than just railing lines of the stuff, and lasts a few hours.
As for treatment of ADHD symptoms, personally I found dexamphetamine worked a lot better than methylphenidate for me, but its much harder to get prescribed.
I'm having a hard time pinning this on the meds honestly...
Having done exactly that (crushed and snorted Ritalin) in the past. I can't recommend it - its not a very good high.
They do not tell you that part for obvious reasons, but if you find the right doctor to explain the biochemistry of how they work it then becomes obvious.
Rhodiola is MAO inhibitors and so is Ginkgo, while 5-htp is the serotonin intermediate and corresponds to SSIs. Not to say that you need not to be careful, that still is required but with other cofactors consumed you can micro-dose.
Note, due to my understandings of what cofactors I need I do in fact micro dose L-DOPA as some recommend 500mg but I only consume 20mg daily.
Cofactors such as aromatic amino acids to increase tryptophan absorbtion across blood brain barrier including Macca extracts and fenugreek and Phenylanaline .
edit: feeling great only applies to some stimulant medications and seems to vary from person to person. Personally, I hated the pharmaceutical stimulant experience but they still helped me. I would be taking meds right now if I could afford it.
People say, medication is an aid, a crutch. Well guess what, when your leg is broken, you kind of need that crutch to move around. There's no shame in using a crutch. And if you lost your leg, or happened to be born without one, then guess what, using crutch for the rest of your life is not anything to be ashamed of, and it's rude to suggest it is.
Do what you need to do, don’t make other people feel bad for not doing what you do.
If, for example, you've been taught to walk without your leg (or if you have three legs, all left feet, whatever), using a crutch doesn't make much sense.
We can't safely poke someone's head and test their dopamine levels. So we aren't good at differentiating what could potentially be learned cognitive behaviors | brain structure | genetics from hormonal neurology. Hell, these could all be the same thing on so many levels, but it takes only one to mark a meaningful difference.
Point is, different people are different. And it's rude to think you know someone's experience well enough to liken it to "punching yourself in the face".
That said, if medications cure you altogether, there's nothing better. But ADHD, unlike other conditions, seems to relapse a lot.
Again with the stigma.
There’s little medical reason to expect stimulant effectiveness to change after the first couple of weeks, the “honeymoon period”, during which the mood lifting effects are most pronounced. It’s also that same effect that is the main attraction for abusers because it can give euphoria in high enough doses. And yes, that mostly goes away.
But other than a possible slight increase in dopamine re-uptake due to a long term increase in dopamine (over what’s initially a dopamine deficiency as far as we know), there’s no long term habituation (as far as we know).
If you feel better without medication, that’s fine, but please don’t guilt others into throwing away their metaphorical glasses.
Receptor density might increase, but that's negligible in the system compared to the starting density of transporters at therapeutic doses.
I already needed them as teenagers, but my mother was against it, because I should not grow too dependent on them. Because she says if you wear glasses, the eye adjust to the glasses, so you see as bad with the glasses, as you did without glasses. Then you need stronger glasses, and every time you get stronger glasses, they make the eyes worse, until they make you almost blind. The opticians are destroying your eyes on purpose, so they can sell more glasses
I only got glasses as adult because it was mandatory to get a driving license. I actually got an anxiety attack in the driving exam and failed the exam, when I had to put my glasses on because I was still convince they make you blind.
I wonder if I have ADHD, too. I am completely unable to participate in classes, but my grades in exams were good enough that no teacher suggested testing. It is like I have zero attention on anything said in class, but then hyperfocus on reading/writing/programming stuff. Anyways my mother would not have allowed me to go to a psychiatrist, because she think that psychiatry is a scam. The psychiatrists are only trying to get you addicted to drugs and destroy your health on purpose, so they can sell more drugs.
Or it might be because I could not see anything in class. Then I had to stare at something and try to recognize something in the blur, and that was taking away all my attention. But reading things in close range worked fine without glasses. Perhaps degraded sensory input is actually a cause for ADHD. The brain diverts too much processing power on processing sensations, and there is not enough processing power left for the actual task, and it makes any sensation (distraction) appear much more important. I still cannot participate in classes even with glasses
My partner always had a thing for amphetamines, and was more functional under influence. It just took a doctor to confirm and subscribe them to suddenly make it legal. I could not say the same about myself, amphetamines just make me more awake but not more functional.
But indubitably, the person on 2 hours needs it much more.
If you feel like you need stimulants to perform well in a job, you need to reconsider your career choices. It shouldn't be a rat race.
OR you may have a medical condition such as ADHD where stimulants are a useful prescribed tool to deal with it. Not everyone who needs stimulants to work is abusing them.
Would you say the same thing to someone with a physical handicap? I.e., "If you feel like you need a wheelchair to get around, you need to reconsider going outside the house"
I'm not trying to put words in your mouth, not saying you'd say something like that, but consider it from the medical perspective. Someone shouldn't have to struggle with a handicap just because it's mental instead of physical.
Medication is a useful diagnosis tool, because the effects when it helps can be utterly profound. For me it was like I’d fully woken up for the first time in my life. My body physically calmed down, and I went from spending the majority of my idle time daydreaming to being calm and present in the world.
Please don’t take other peoples pills though, they’re tightly controlled usually with no buffer. If you take someones pill, that means they’ll have to reduce or skip a day. Imagine stealing someones reading glasses for a day—they’re gonna have to persist and deal with the possible migraine/eye pain.
> I found myself focusing and intetionally task switching for about two hours (that and palpitations), but I wouldn't say they "help"ed me.
You don’t need them. What you experienced is not what your GF experiences.
If you put on someone else’s prescription glasses, would you complain that they didn’t help you?
> It shouldn't be a rat race.
Everyone I know on stimulants for ADHD (myself included) would agree that the stimulants help them escape feeling they’re in a rat race.
A trait of ADHD is know precisely what needs to be done, and being incapable of making it happen. Medication helps with that. It’s not a cure. It doesn’t fix everything. It just makes some things easier.
I never had a racing heart taking it and it didn't elevate my tension. It allows me to take a nap when I want without those racing thoughts about "life"
If you need Ed medicine to have sex maybe you shouldn't have sex.
If you need asthma medicine to breath maybe you should think twice about breathing.
Seriously, you don't have a clue about what you're talking about. Neuro divergents are almost an evolution good or bad (hyper focus can have it's benefits), most medicine for the brain is liable to do the opposite.
Caffeine and ginseng are like really good cold medicine to my wife she practically goes into a coma.
If you don't think people's brain work differently:
Do you have an inner monologue?
- yes? - talk to someone who doesn't, there's many, I found this absurd because mine is always going. - No? Talk to someone who does... Try to imagine what it'd
Repeat the above for people with synesthesia or aphantasia.
Reality, the brain, consciousness... It all exists within the circuitry of our brain and the flow of electricity and hormones paint your experiences in life
With a deficiency in dopamine which we all mostly have (ADHD), you do need help.
For you, you could end up overdosing on dopamine which itself can cause some major mental issues.
Best to lay off other people's meds.
Hell, I take Vyvanse my wife Adderall, when I ran out I took hers as she's on a dose that about matches my vyvanse but they have different internal mechanism.
Adderall gave me anxiety, depression, and jitters.
Even within ADHD circles it's probably best to stick with the meds you're prescribed.
Or if you dislike thinking of it as a disability (even if there’s nothing morally wrong with being disabled): a pair of glasses.
Do we really think less of people (or in this case likely ourselves) for using a wheelchair or wearing glasses?
But I've changed my phrasing, just to be clear.
I don't want to get addicted to another thing in my life, here in Europe we're quite familiar with (ab)using speed (amphetamine paste) and the idea of being on speed every single day seems pretty bad.
I don't feel "more like myself" on speed and I seriously doubt most positive effect would persist after a year of using and rising tolerance.
Why? Just because it comes in a pill form, instead of being conspicuous, doesn't make it any less of a help for a medical condition.
> I don't want to get addicted to another thing in my life,
The point of this comparison is that "being addicted to" ADHD meds is not in the category of "being addicted to heroine" - it's in the category of "being addicted to a wheelchair" when you could technically just use your hands to crawl around and grab things, instead of aiding yourself with technology.
> the idea of being on speed every single day seems pretty bad
Stimulant medication aren't speed, they're like "1/100 speed". It turns out that with medicine (not just psychiatric), the effects don't scale linearly or continuously with dose size. That's why those meds are helpful and safe to take in therapeutic doses, despite being technically dangerous, addictive drugs in much larger drug abuser doses.
> I seriously doubt most positive effect would persist after a year of using and rising tolerance.
Countless of people who have been treating their ADHD with stimulant medication continuously, for years or decades, will beg to disagree.
Nobody says you have to take meds for ADHD treatment, or that you have to take stimulants (there are other options available, although typically less effective). Hell, on some people with ADHD, stimulants don't work at all, or side effects are not worth the cost. But comparing them to speed is just wrong and irresponsible, as it makes people afraid of trying what could be effective treatment.
Seems pretty strange that I should take your sourceless claims as gospel over theirs.
>Stimulant medication aren't speed, they're like "1/100 speed".
These are literally two identical substances with almost identical effects (the only difference is the ration of amph salts). Difference is dosage.
Can't understand why would you claim what you say, when Adderall is used and abused in the same exact manner as amphetamine paste is in Europe. Anecdotally I hear in USA they throw it at you like candy.
>But comparing them to speed is just wrong and irresponsible,
I stand by what I said, if you saw the numbers of amphetamine addicts on the street in USA the same way you see opoid addicts, you would have a different national perspective on these drugs.
>it makes people afraid of trying what could be effective treatment
Yes, they should be cautions in my opinion.
I personally am not taking any new chances with addiction, even though I'm sure I would have benefits, at least short term.
I'll just hobble along. Using crutches can make physical rehabilitation impossible.
Excuse me? There's roughly 60 years of research into the effectiveness of stimulants as a treatment for ADHD. It is probably the single best researched psychiatric drug.
While it's always useful to discuss a proven treatments relevance in the light of newly discovered alternatives, there really is no (significant) doubt in the scientific community about the effectiveness of stimulants. Given the body of evidence, I would say it's more fair to ask you to add some citations to your comments.
> These are literally two identical substances
Yes, they are. That doesn't mean that in patients with a dopamine dysregulation they don't have great therapeutic effect. One could call the euphoria nothing but an unfortunate side-effect leading to abuse in the general population.
> numbers of amphetamine addicts
So, there are addicts. That has nothing to do with therapeutic use.
> Yes, they should be cautions in my opinion.
Since they aren't prescribed to self-diagnosed ADHD patients, there should always be a doctor involved. And I can tell you the titration and monitoring is taken quite seriously, at least where I'm from.
> Using crutches can make physical rehabilitation impossible.
If you're missing a leg, that rehabilitation is going to take a long long time. As will be the case with ADHD. You might learn to cope better, but your symptoms aren’t going anywhere. ADHD isn’t something that generally gets better with age, although better coping skills may mean some people don’t experience as much of an impact on life.
And yes, stimulants are a crutch, but they do help people function better despite their disability.
So instead of focusing on bespoke medications we try to ban them all if a small percentage of people have addictive natures or negative side effects.
How about we agree that drugs can be beneficial and harmful, but keep them legal for the large percentage of people it actually helps.
Not every disability is visible. By definition they have a significant impact on someones life, as such there isn’t use for competition.
A wheelchair is a great comparison. Both enable someone to do something they previously couldn’t. Both are temporary, and stop being useful when removed. Both have a very different effect on someone who does not need them.
> I don't want to get addicted to another thing in my life FWIW, among those I know with ADHD taking stimulant meds, addiction is not a concern but remembering to take them is.
> I don't feel "more like myself" on speed
Do you have a deficit of dopamine, serotonin and norepinephrine? If not you’re experience will be very different from someone who does. Even then, some stimulants work better for certain people, and for other only non-stimulants work. Our brains are complex, and our experiences are not universal. Speed is also a pretty catch all term, and the ratios of salts have a huge impact on the effect. It may not be very comparable to pharmaceuticals.
> I seriously doubt most positive effect would persist after a year of using and rising tolerance.
People have been taking stimulants for ADHD for decades, but I think its effect is not what you think to an ADHD brain. It’s more akin to reading glasses.
What evidence exists that points this is the cause of ADHD? Wouldn't a dopamine deficit be more akin to Parkinson's Disease?
Also, last I remember reading, I am pretty sure we are not fully aware of why stimulants help people with ADHD. I think the leading hypothesis is that dopamine plays a role somehow, but I thought that he yet to be fully observed.
I don't give a shit about my job but it allowed me to buy a house, take vacations and sometimes buy an extensive toy.
I would gladly stay in my own world and daydream away, doing some woodworking and see birds in my garden but if I lose my job all that will go away.
So I take my ~3€/day pill and try to do my best. I've lost so many opportunities before getting diagnosed...
I'd only manage that for about two days before giving up without the meds, heh
It allowed me to stop eating my feelings (which allowed me to lose 13kg and counting), made me stop drinking, I still play games but can stop whenever.
I know I will surely have to take it my whole life (days I don't, I'm a wreck) but I see it as a diabetic needing insuline.
For example, stim meds increase my focus but also seem to reduce my creativity and injure my sleep (to the point that I have occasional short-term memory loss). So every day I individually evaluate whether it will be worth it or not, and I make sure to take at least a couple days off a week to catch up on REM sleep.
I don't need meds to live. I need meds not to feel hollow in my soul. If I think about doing something that is meaningful, I need my meds to up and do it. Otherwise it's living the life of someone with really great plans that are unable to leave their head. It is hellish.
Now I have 35 unmedicated years to catch up to.
Edit: to clarify, I'm not telling anyone not to try medication. Everyone's response will be different. Just beware of the initial euphoria.
I did the titration regimen after my diagnosis with a licensed psychiatrist and ADHD specialist, so you start very low and test a dosage for a month at a time. You increase it slightly until side effects are noticeable, then you scale back. This was my timeline:
Euphoria lasts perhaps two days, and you're on the lowest dose so it's pretty mild. You're just doing something and feeling happy about yourself. Good, it's a side-effect, and needs to go ASAP. Many people start on too high a dosage, so euphoria lasts maybe weeks, and when it stops they think it stopped working. This opens the doors to abuse, especially in teenagers.
Adaptation, during which other negative side effects start to lessen, lasts about 10 days.
Then there's peak productivity with little side effects for 6 months or so.
Then you start to question if it is still doing anything. There are days that you just don't feel like doing much. Take a couple days off, and it's obvious it was working all along. Without it you're still unproductive and scatter-brained as you've always been without. Also, you've started getting good at using this new powerful tool, but still don't know what to do with it. This is where I'm at at the moment.
--
When you're used to having good days, good days become normal days and it is very hard to remain objective in your assessment.
This is key to appreciating the value of the medication and also benefits as a way to fight tolerance. "Medicine holidays" it's often called. Every month take a weekend off, and every 6 months take a week off. Those off days will leave you terribly lethargic. But going back on will make you really appreciate it. Or not in which case take a longer break and maybe lower your dose.
I wonder if the dopamine system might need more than a few days to reset. In my experience with addiction, it takes months.
I've been on adderall for 20 years and haven't ever had to increase my prescribed dose. I even usually reduce my dose in the summer after my week-long break. I bring it back up after subsequent holidays in the autumn.
The only times when I've thought it wasn't working, the med holidays brought it right back on track.
Could be placebo. Also n=1. There's very little lost in attempting (it assuming your dr is kosher with it).
What was good to know was that there doesn't seem to be any addiction potential for me at all. I hate being lazy and unmotivated without the meds, but there is no urge nor withdrawal whatsoever, which is fantastic, as someone that got addicted to half a dozen things in their life.
I was afraid I would start to enjoy the meds too much, but I am much more dependent on the cup of coffee I drink once a week (and every day during work I start craving a Coke) than amphetamine.
The fact that the medication is out doesn't make your dopaminergic system more sensitive by itself. It might take a while.
So, my dopaminergic system probably has holes burned through it.
I really hope it keeps working in the longer term because it's been life changing so far.
The best explanation I've seen is this comic: https://teddit.net/r/ADHDmemes/comments/pmrh5d/quite_possibl...
I quit my meds when I was about 16/17 failed out of my last year of highschool, went on to become a construction foreman for huge projects managing crews of 30-40.
During a layoff in 2009 because there was no construction, I installed linux on a laptop because I borked my OS and didn't have a key. Ended up getting a job as an ISP call center tech at a small ISP/hosting company a few months later, taught myself systems and networking administration and was running the whole place a few years later including the BGP peering, system automation, monitoring, and building.
I went to work for a FANNG for a decade, Built some cool shit, have a few patents.
When the pandemic hit, I really stopped for the first time and looked at what being able to perform at a high level was costing me and my family.
1. I was drinking too much, a small buzz would slow my mind down and let me focus on a single thing, It kinda works but at what cost?
2. I always knew what I needed to do, I understood how to build what I needed to build but there would be times, whole weeks, when I'd be unable to bring myself to read the docs I needed too or do what ever I needed to do, that would make me uneasy and lead to a lot of self-loathing. Not a great person for my family to be around during those times.
3. Always feeling like I needed to work but never working, so everything was an inconvenience because I should be getting something done at work but I wasn't, then things like dinner with my family felt like it might be taking away from some work I wasn't going to do anyways.
4. The lightning would strike, I'd find a deadline or whatever and I'd work, almost unbroken for days straight, online before my kids got up, get them to school, work, pick them up and make dinner/put to bed, work through the night or late into the night.
5. I'd build the thing I needed to and then I'd crash and be tired, and then I'd have a day or two to be the father and partner and person I wanted to be, but there's always the nagging feeling that next time, I'll be too late or won't pull it off . . ..
I spent 2 years in therapy (starting before the pandemic) addressing the symptoms and working on Cognitive Behavioral Therapy techniques to address a chemical imbalance in my brain. Working on being kind to myself, working on stress management, working on time management.
Part way into the pandemic, I ended up quitting, realizing I just needed a break and I was working so much harder than any of my peers for a similar or worse output. Them mental overhead of keeping up was excessive.
Eventually, I went back and got properly medicated. It was like a switch flipped. It took me a month or so, to get into it, but I found myself feeling like I could stop and be available for my kids whenever, because I started to realize, I could just turn my focus on and off whenever I wanted and I didn't have to wait for lightning to strike.
The thing that's most beneficial is a bit unseen, I'm not carrying a burden of self-loathing, fear, anxiety on my back, all stressors that were a result of my inability to entirely control my focus and do the thing that I wanted to do when I wanted to. That invisible weight that I carried everywhere vanished.
I've seen a marked improvement in my life over the last year or so. I'm a better father, partner, employee. I like myself for the first time in decades.
This is long winded, but I wanted to put this out there because there are a lot of us in tech. having ADHD is actually a great way to get into tech, we find something we don't understand or a blocker and dig deep. I was just trying to find a way around a license key and ended up learning internet routing . . .. I have a very broad skill set because I'll dig deep on anything that walks by. I see many like myself. But if you find yourself in a cycle like this, go get help. Life doesn't have to be that hard.
So I'm like this just not as 'successful' AND I haven't gone medicated as I'm on the cusp. Although, I've been putting something off for a while....;)
'The thing that's most beneficial is a bit unseen, I'm not carrying a burden of self-loathing, fear, anxiety on my back, all stressors that were a result of my inability to entirely control my focus and do the thing that I wanted to do when I wanted to. That invisible weight that I carried everywhere vanished.'
I am currently in the mindset that I don't get to choose what I do. I either do it, or I don't and that has forced me down a route to where I find myself. Which has really worked out. But only because I caught myself and that those knife edge moments went the right way.
The problem that I found as I got older is there's substantially less room for just going with the flow. It worked great for years. Now I have people that I'm responsible to and do it or don't do it doesn't work. I can't just leave it to chance if I sit down and read with my kids daily or cook them healthy foods. Their lives will pass by while I'm wondering around waiting for the inspiration to be a good parent.
So a heads up, that works great when no one depends on you much. It works a lot less great when you owe people things that you really care about.
This has helped me to do the things that I want to do. It more helps on the task level and less the overarching job level.
I still don’t subscribe to ‘it’s all ADHD’ where everything gets lumped into this block of behavioral reasoning.
I think it’s at an OS level but I think we are just a little more sensitive than non neurodivergents. And that comes with some huge benefits as well as negatives.
When I was young, it was just 'here take this'. No help with understand what was happening or how to work on it. And I think that's a bad place to be.
I've been experiencing the exact same emotions/habits you mention for the past 5 years especially, now that I have a wife and child and it's been extremely stressful and I've been less than fun to be around unless I'd found a way to be super productive that day or perhaps after a couple drinks.
I took adderall for the first time in years yesterday coincidentally, and felt like a new person. I could work through the stuff that I'd been putting off for weeks. My house wasn't a disaster zone with baby toys everywhere.
So all of this just to say, thanks for your write up. I'm going to look into CBT as well and maybe get back on the meds permanently. My only concern is the come down where I was left feeling terrible, but I hear they have better stimulants than adderall these days so perhaps I'll give another one a shot.
I can feel the medication starting to wear off around 4PM and get sucked into the time blindness and must work/play rather than spend time with my family.
Thanks for your message. Eyes opening
I think it’s good to experiment and figure out what works for you. I’m generally opposed to relying on drugs for things like this unless it’s really necessary, which is why I stopped taking meds for a while. But I’ve been having some real challenges recently with my focus & it’s been so frustrating. Hoping I’m able to find some sort of balance with it.
Guess my point is that it’s ok to let the meds help you too, and it doesn’t need to be problematic. I think I resisted going back on medication for a while because I was thinking “I don’t need anything, I can get by just fine with no help from meds!!” And while that may be true, it can still make my life significantly less frustrating to take the help sometimes.
Your adult life may have looked much differently, would you not have been medicated earlier.
Exactly! I was diagnosed later in life by which time I had experienced a significant amount of trauma expecting myself to be normal. Learning to embrace limitations and the "workarounds" needed to function helped me tremendously. Learning to "ride the waves" so to speak and working with your brain changes things day and night.
The other part is learning to stand up for oneself. There's often a lot of undue criticism from others because you need to do things differently. Being constantly criticized because you forget what often amounts to trivial things is one of the worse "symptoms". Many people also associate "togetherness" on unrelated items with competence or ability. Of course there's basic tasks that need to be handled, but many folks view even "struggling" with such things as evidence of incompetence.
For example, adhd'ers often pay a "tax" because they occasionally forget things at the grocery store, but at work they also tend to foresee certain problems long before others do. However many managers see or here about the former and ignore the latter and are too narrow in their mental models to comprehend the differences.
It's also acceptable to ask for help for those weird things your brain refuses todo. I've asked people to "hit enter" for me just to short circuit a procrastination loop. Now I can actually do it "in my head" as a sorta role playing game. :)
> Do not put pressure on yourself to live up to what someone else can do. Only do what you can do, in your time, and be at peace.
Right on. Ironically doing this also lets your brain work better!
Unfortunately this requires understanding from those around you too. Sometimes family members with undiagnosed adhd can be some of the worse due to internalizing all the normal criticisms.
Its great seeing so many adhd'ers sharing actually helpful advice nowadays.
When I stopped fighting them, my life got much easier. I found a way of working that suits this better.
Thank you.
Say you’re procrastinating on starting on a new work project. Neurotypicals might just type `npm init myproj` and “hit enter” to break it down into a smaller piece. Useful and seemingly simple..
However, ADHD’ers brain may interpret “hitting enter” as akin to putting your hand on a hot stove element. You literally just can’t do it! In that case type in `npm init myproj`, grab an (open minded) coworker to “hit enter”. Despite the odd looks, having the repo created will often override the blocker!
Though it’s the principal that counts as your brain could shift the blocker to the readme, etc, so you have to adapt as needed. The general premise is to ignore the odd looks, and get help despite the seeming inanity of the action. Involving someone else even trivially helps too, similar to the “body double” concept.
Generally you can use your ability to reason to overcome hind brain hindrances. It’s sort of like using reasoning to create a hot glove to grab hot things out of a fire, rather than “just try harder” to force yourself to have thicker calluses like everyone else. But first you have to accept you don’t have natural calluses and your brain won’t let you grab hot things because it hurts. Grab a glove, or get a friend to.
A lot of what you said resonates with me...
> Being constantly criticized because you forget what often amounts to trivial things is one of the worse "symptoms"
I spent a lot of effort removing "trivial" things from my day to day life. I have a rule of ever only doing a single "life admin" thing per day, ideally 0.
A lot of people act like I'm crazy when I talk about hating the dishwasher because it creates a future obligation of having to unload it later.
I'm actually writing a productivity book that revolves around doing less each day and avoiding tasks that create future commitments to avoid cognitive load. When I talk about it to some people, it really resonates. Other people look at me like I'm crazy and and tell me to stop being lazy.
I went back for a PhD program and got a diagnosis from the health services there, along with some CBT therapy.
I'd recommend going to a psychiatrist/ therapist with a good track record of diagnosing and treating adhd. Many doctors, even psychiatrists, are dangerously under-versed in adhd or even believe its fake.
haha and I feel the bit about cognitive loading.
It gets named once it becomes an issue in life. It doesn't need to be as bad as being unable to function to get diagnosed.
The lack of focus is a lure, an oversimplification. It's not just "I can't focus on something I don't like to do". It's more like "halfway into making a cup of coffee, the most important thing in my life became to clean the pantry". Imagine running late, but stopping dead in your tracks with only one sock on, and answering an email. You know it's mad, but you can't help it.
However if you have a job that's lenient enough, you can hide it well. I stopped treatment because I couldn't gather enough data. My job was too easy to know if it worked. It's still the case.
Another thing is that a lot of people learned to cope with it for decades before getting diagnosed. Their life is full of alarms and error-catching mechanisms, so the symptoms are well-managed. If you know your strengths and weaknesses, you pick your battles. It's not an issue unless your battles are picked for you.
"Hey John, did you fix that problem with the DB log crash?"
You look up, realize John and the boss are on the other side of the room and you are not part of the discussion.
You put your mind back to that task. Reading the product documentation, "click click, someone across from you taps their keyboard" ... wow, you noticed that 1 hour 30 minutes suddenly passed but you do not recall much of the documentation you just read.
Getting back to it.. a friend messages you a funny joke on whatsapp. 20 minutes of chit chat go by and you realize most of your team already left the office to go home.
There are also other things like fatigue. You'll be able to force yourself to keep up but it takes a toll and eventually you fatigue. Productivity then drops massively and people think you are a slacker.
There’s some breakdown between wanting things and being able to do them. Wanting to do the things but letting down everyone (teachers, friends, family, self). The thing you can’t do might be chores (frustrated that the house is a mess but unable to make it not a mess), keeping up with friends or family (never keeping in touch enough), hobbies (never able to focus long enough to really make progress), work (continuing to function after the initial learning curve wears off), being able to focus long enough to read books you want to read, having conversations with people who prefer to have one conversation at a time instead of four, listening patiently and not interrupting as someone continues explaining the thing you picked up on after their fifth word and they’re on their fifth sentence now…
Everything falls apart slowly and it’s easy to get frustrated with yourself and lose hope. Meds help but being chained to them is a shitty feeling too. They’re a pain to get and require frequent check-ins as stimulants are controlled substances in the USA. The other non-medicine interventions all help in little ways that add up too.
I stopped and changed my work environment as well as my self pressure. I can be super functional and motivated sometimes, if I give myself enough time to get there.
However, my partner is taking meds for her ADHD and for her it's honestly a life changer.
The moment I get an official diagnosis, I’m getting on meds. I don’t know what the side effects are, but I struggle to imagine that they are worse than barely being able to function as an adult IT professional.
Invest in your mental health. (Diagnosed 1 year ago)
Full disclosure: I've been taking Escitalopram and Wellbutrin for a few years now. I've been working on my CPTSD for a few weeks.
EDIT: Of course I don't just consume the material. I actively engage with my suppressed emotions to heal.
Problem is, even if you're perfectly comfortable with your own limitations, and being transparent about them, graduating up through the ranks as a software dev IC or w/e means meeting or managing the expectations that higher ups unempathetically and unilaterally apply. You have to get pretty (extremely) lucky with having a space to advance in the ways that you can. The reality is that you do need to be sufficiently successful to get by, and that bar is getting higher as everything increases in cost. If the smallest piece of real estate in my city for example demands the salary of a senior faang dev to pay for, the pressure is hard to avoid.
The way I got there is: My goals were not very high. I made a crapton of personal projects and taught myself an insane amount by 19/20 so that I actually knew a good deal more technically and practically than some intermediate positions. I was overconfident and good at seeming very talented. I took jobs that didn't require a ton of technical or incredibly hard interviews. And I coasted for about the first 10 years. The next 10 I overworked myself because I thought I needed to, because I didn't want to do the job anymore and figured if I just did it better than anyone else I'd feel better about it. And finally I took jobs where I was literally making the world and people better.
The whole time, I gave myself crap for not getting enough done, and much of the time felt bad for "wasting" my time. Now I realize that I have a ton of life left still and no particular goals in mind, so who cares if it's a waste as long as I can enjoy the waste? And I do (mostly) enjoy my job and my free time now. Sure I don't own a home and the things I want deem farther off than for many others. Same is true for many other people, and that's fine. Whatever happens is just life and it's OK. Just sucks that it took me so long to realize that who I am is fine and doesn't need fixing.
I was provided this article: https://invisibleup.com/articles/27/
It is such an accurate description of something I've been struggling with my whole life without ever knowing it. I'm now waiting the weeks and weeks it takes to get a doctor's appointment; going to try for meds and maybe a diagnosis. I've already been formally diagnosed with autism, but ADHD never came up.
If you have even a sneaking suspicion that you might have ADHD, read the article. It is absolutely an eye-opener.
I shared before on HN that I'm still ongoing investigation with my therapist, after some 2-3 years of therapy and working around some anxiety issues I had we're narrowing it down to a very likely ADHD diagnosis.
The more I read and educate myself about it the more I believe I might have it. It's still hard for me to properly accept that this might be it, and not that I have an inherent failure of character by never being able to keep my focus, motivation, planning, etc. as well as what others can.
To be very honest, something inside me still don't want to believe that I very likely have ADHD, that part still shames me by telling that I'm just using this as a crutch for my failures, that it's just a convenient excuse for not being good enough at some mundane tasks.
It's exhausting, I'm glad I'm finally getting help because for the past 3-4 years I have been on a steadily downwards spiral. It's been very gradual until I got to this point where I can definitely tell I'm suffering mentally because of it...
This.
Everyone has their own genius. Go find it. It might be
Being on meds destroyed my creativity and emotional life, gave me devastating crashes every day and made me feel like I had to fit my entire life into the 6-12 hours a day they were active. If my career required me to go back on meds I would choose a different career, and that is just fine. Structuring your life so that it fits your unmedicated, natural self is just fine. Taking medication if it truly makes you happier is also just fine. Don't judge.
I think the meds are a double-edged sword, and the compromise may be more appropriate for some than others. I also think even more strongly that despite real cases, ADHD medication is overprescribed in the West. If school was boring and I'm a daydreamer, do I need to be "corrected"?
Please don't discourage others from taking medication to treat a very real illness.
He tries to turn on the light, the bulb is dead, unscrews it, then as he's getting the bulb the shelf in the cabinet it's in is loose.
He gets a screwdriver to fix the cabinet, but the rails on the drawer the screwdriver's in are squeaky. He gets some WD-40 to fix that, but the can of WD-40 is empty. He then gets in the car, which refuses to start.
Then his wife gets home, and he's underneath the car covered in motor oil. "Hal, did you replace that light bulb in the kitchen?" "WHAT DOES IT LOOK LIKE I'M DOING?!".
Still, the reference to ADHD is definitely valid!
It would be if she came home and he's repairing his circular saw or something. Why is he doing that? It's because the ladder's broken, and you need the ladder to reach the light bulb, and to fix the ladder you need the saw.
So, a seemingly unrelated task that an outsider observing you might be surprised that you're engaged in, but which is required to allow you to solve the problem at hand. That's "Yak shaving".
Whereas he doesn't actually need to fix the shelf, or lubricate the drawer, or fix the car.
The only thing that would make it better is if he'd somehow managed to misplace the lightbulbs along the way, with Lois's looking annoyed over a forced candlelight dinner.
And he missed the obvious (with hindsight) options of, calling a taxi, catching a bus, etc.
I was a classic adhd child, at a time when diagnosis and treatment was rare.
Children whose dopamine regulation issues are treated early can leave medication as their brain adjusts while still plastic.
In adulthood you're stuck. I've battled addiction, terrible damage to relationships and failure to achieve my full happiness potential.
Founding a company is extra hard.
I'm glad I'm medicated now. The result has been life changing and profound.
The more we talk, treat and exercise compassion about this horrible neurological disorder the better.
It isn't like a broken leg or depression, the symptoms are varied and express in complex ways.
Thank you to anyone talking about this with kindness and compassion
I can think. I can maintain a single strand of thought, then act on it. I can think, feel appropriate impulse, then "do" based on that impulse without it being out competed by the noise of random impulsive dopamine sparks.
I'm the same, my emotions are the same, but there's more control. My brain isn't "hunting" for stimulation.
I've been in therapy for 10 years too.
I used to do therapy but I found my therapist was making videos on Facebook about a few things I told him (though I was never named but I felt this was a huge breach of trust).
I exercise quite a bit. (lots of cardio and core exercises, I particularly enjoy barbell squats and sledgehammer workouts ). But since I have had an injury on my foot for the past couple of days I have been taking it easy by not going to the gym and I feel really low cause of this.This is one kind of super positive thing I do. I don't like the gym I go to cause the instructors mostly pay attention to the girls and only ever paid attention to me to sell me some protein powder or when the tim comes for me to renew my subscription. (But that's only a specific issue for my gym, as I am shifting to a new city in a couple of months, I think I can try out a bunch of places before choosing one)
The other thing I do occasionally journal, most of the times,which I use it to vent out my thoughts. I also even more rarely do a workbook for CBT (which is for perfectionism which is another trait I found myself to have)
Anyway, what I wanted to know was has anyone tried not using any fancy 100$ subscription based apps OR meds to do their work and found success? What did you do and how did you cope with life in general?
Background info: I am 25, working in the IT field, I feel kind of directionless in life as I am still working on a plan to get into an MS degree abroad (though my parents really encourage me to do an MBA).
/end vent
my coping strategies have been: 1) carve out some time to do distractionless work. check calendar, put up away message, close email, turn on background music (cafe jazz, Bob Ross, or intelligent d&b) w/headphones, write down a small task to complete on sticky note next to monitor, set timer (maybe multiple). 2) have a routine. weekday: work 9-5, gym, cook, miscellaneous, sleep. sat: projects. sun: hike. 3) lists. shopping list, jira tickets, work journal, personal road map, calendar everything.
you have 3/4 of your life ahead of you. directionless is fine. try lots of things, keep what sticks, throw away the rest. do what feels right for you. if you don't know what to do, welcome to the club :) just be healthy, have fun, pay your bills, be a good friend, and the rest will come. it gets easier.
I've also abandoned social media due to doom scrolling. Still use HN way too much but whatever we all have our vices.
What it did give me is a look into what functioning normally-ish would look like, Which has helped enormously.
I'm not a huge fan of medication myself, but if I were you I'd definitely give it a shot. You can always stop if it's not your thing and there's a fair chance at lasting improvement even when you DO stop.
I also take Algae based Omega 3 semi regularly (but that stuff tastes like crayons).
I also have OCD, ADHD and a PD mom, so I know the pain of being unwell. I take Fluoxetine and Ritalin. While I have not used Finasteride use them with caution, because I do not won't any one to go through any more pain due to meds.
Something that I've wanted to try is creating or joining a group of people who meet on a regular basis (at least weekly for me), talk about principles, projects, plans, progress, and in doing so, hold each other accountable.
I've managed without diagnosis, medication or specific therapy for most of my life and I've struggled but like many with a late diagnosis I was able to compensate with intelligence and wits.
It is often said that ADHD treatment has three pillars, which don't always have to come together to work: Psychotherapy, Psychoeducation, Medical Treatment.
Psychotherapy is the professional help you can get to identify your patterns of behavior that might make your situation worse and change them (and probably more).
Psychoeducation is your own learning about the condition which can be supported by therapy session but consists a lot of reading books/articles, listening to podcasts etc. Support groups can be of great help, too. They exist online and offline and you should feel comfortable with the group you find. All of these are what helped me the most.
Medication helped me, as well but only really after I properly started learning about the condition. Some people report revolutionary effects but it's moderate for me. I also had to try a few different medications and doses, which is quite common and very individual. It can also change.
There are many that share your reluctance against taking meds and ultimately, all serious therapists and support groups will support that. However, they might want to talk to you about your reasons for not wanting to try the effect at least. A reason is, that they can often be a jump start for successful therapy because they can reduce the primary symptoms of ADHD (like inattentiveness) and let you work better on the secondary symptoms (e.g. low self-esteem), both of which differ from person to person. Even if you decide going without meds, it's a good step to know what's your concept of yourself and your mind and how meds would interact with that because it gives you a better understanding of your personal situation.
I hope that helped a bit even though I didn't go into how I managed myself before the diagnosis in my late 20s. It's been rough, to say the least. It still is but I have learned a lot about myself that lets me accept myself more easily for who I am (a sentence I would have laughed about in the years before). And that in turn makes everything a bit easier.
https://pubmed.ncbi.nlm.nih.gov/24321736/
Also, it is not about dopamine, it is about glutamate: https://www.brown.edu/news/2018-03-12/glutamate
This whole space is in need of more research, we’re not at stage where definitive statements can be made one way or the other.
I have existed with ADHD all my life without knowing. I knew something was different though.
I have a mini version of myself who has it a bit more severe which is where I finally worked it out and got a diagnosis. I am however only on the cusp and there are somethings that the Dr is 'confused' about.
I haven't 'needed' meds however IF i was growing up now I probably would be prescribed.
My personality (and if impulsive ADHD creates my personality, who knows) has led me down a tremendously exciting life. Curiosity kills the cat (but that is why a cat has nine lives).
I would encourage everyone to not use their ADHD on ADHD. So meta. Get Hyper Focus on it. I would encourage those to use it to find what they are about. What they like and interest in life.
Yes, its an absolute ball ache at times (procrastination) but there is magnificence out there and it unfolds when we look (in my opinion).
So, balance it. Know what is going to be good for you (sleep, exercise, healthy living) but also know that you can fuck around in life. It is a perfectly acceptable pastime and your internal guide will show you the way.
Do what you want in life. This is independent of ADHD.
How is that for woooo-hoooy?
And you know what? I figured out, it's just not a big deal. You get a slightly increased heart rate, so you'll feel a little warm the first couple days. Other than that, though, the effect is that you are able to ignore distractions and adjust your focus at will a bit better. It doesn't turn you into someone else, and it doesn't turn you into what you imagine a neurotypical person abusing stimulants is like.
If you're struggling in any way, and think it could help, it's worth a try. They're non-addictive (I don't have any particular desire to take them).
This blog post reads like an advertisement for InFlow (YC S21), which was roundly criticized for being exploitative of people with ADHD, when it was posted to HN last year: https://news.ycombinator.com/item?id=28877003
[Edit: the author has clarified below that this wasn't actually an advertisement, she just enjoyed the app. I'm sorry for jumping to conclusions and overreacting and ranting about it. My apologies for writing all the bullshit above and below.]
My impression.
If it was an ad it wasn’t a very good one, lmao (it was not an ad)
I'd also guess that many with the condition have tried all the common treatment options and will zero in on the one thing new that the person saying they have the condition under control offers as new treatment option.
As I said elsethread, I have no connection or financial interest in inflow aside from having met them through YC and generally finding them to be nice folks. I’m actually extremely scrupulous about noting when I do have a conflict of interest like that, for what it’s worth!
To me it sounds like one of those ADHD self-management guru talks that try to apply something generic to an issue that's very personal and individual. Some solution that gets ADHD folks interested, hyperfocus on it as the next productivity solution, just to lose interest after 2-3 weeks and forget to cancel.
I want to believe that I understand my ADHD better than anyone else, and my warnings signals go off when I see things like that, because I can absolutely see myself getting hooked on a new productivity paradigm for a short while
I found the content modules the most helpful; I joined their coworking sessions a few times and those were fun too. I found the sort of “task” things you’d get assigned in the modules less helpful as I’d just sign up for all of them and then do none of them lol. But the content itself was v good.
He got up and in the first 30 seconds said he thought ADHD had helped him, didn’t think of it as a negative, and just came because he wanted to tell his story. Like so many founders (esp of retail businesses, I find), he was super charismatic and had a very practical, easy to understand model of the business. It was the best talk I saw in my brief time at babson, and I saw a bunch of good talks by founders.
I believe the guy who founded jet blue also has ADHD and feels similarly. Everyone has their own perspective, but if you get a chance to see the Kinkos founder speak, I recommend it (he might be pretty old by now).
Can I ask why you find that weird? ADHD is, and is also comorbid with other learning disabilities.
ADHD has so many dimensions and interrelationships between those dimensions that everybody's lived experience is different. If you know one person with ADHD, then you know one person with ADHD, you don't know everyone with ADHD.
Heck my best friend growing up had severe ADHD, what used to be called "ring-of-fire". Both his parents are clinical experts in ADHD, and have been since he was young. Yet despite knowing me incredibly well over a couple of decades none of them suspected that I had it. To be fair, three psychiatrists and dozens of psychologists missed it too, until one had a hunch that finally led to me getting diagnosed in my late 30s.
edit: I would add there is some survivorship bias to it too. Successful CEO says ADHD helped? Huh. Cool. There is a reason alcoholism and substance abuse have significant overlap with ADHD communities. For example, I built and sold an infosec consulting firm and I have ADHD. I could tell you stories about how in some limited circumstances operating a business it helped. But that ignores all the times I struggled and had to dig deep into my well of ADHD management skills to stay focused and efficient on chores I don’t like doing.
That being said, some of most cherished achievements would not have been possible without it, and that's where the cognitive dissonance begins.
It's even worse than their usual "if I can do it - and I certainly have, just look at how awesome I am - then you can do it" spiel about business success.
Yes it can make you more reckless and impulsive to take risks like founding a company, but it's important to keep in mind that ADHD is a serious cognitive disability, and we should treat it as that. There is so much it messes with on a daily basis and it absolutely sucks.
So much coping, self-doubt, lack of motivation and drive, procrastination - it's not nice. Yes we get better in managing it over time as we learn about it, but it still comes back and bites us, and it's depressing to see coworkers being so much more organized and 'on top of things' compared to me, no matter how hard I try
I think the r/ADHD approach on Reddit nails it: even if it did have benefits for you, please don't refer to it as a superpower because there's a lot of people who will feel even worse about their own experience of the disability when you do that.
And, yeah, for me it's been very much a double-edged sword. I started a consulting company while in grad school; it was awesome for my (undiagnosed at the time) ADHD brain: new projects every couple of months! Learn something new every time! Hell, I went to grad school very likely because of ADHD; I couldn't handle the stale "every day is more of the same" feeling I had in the regular working world. I went to study a hard problem, but about 16 months after I started really digging into it, commercial solutions started appearing that essentially did the same thing I was researching... I lost interest quickly, especially when all of the research was done and writing and editing my thesis was all that was left.
I've worked on so many wildly varied projects over the years. I've got an EE/CS dual degree, and I've been down at the schematic and PCB design level and up at the web & mobile app level. I'm just as comfortable writing Verilog as I am writing React code. Deep GNSS work and software-defined radio, 2D high resolution imaging, 3D depth field imaging, audio processing, ultra-low-power sensors, level-sensing in 80,000L fuel tanks using a clever pressure-sensing approach, drone flight planning and control algorithms, yadda yadda yadda. And all of those different things all are related to each other in some tangential ways that I pick up on right away while others just scratch their heads.
On the other hand, I lose things all the time, forget to pay bills for months, lose touch with people I care about, struggled for years and years to maintain a romantic relationship, forget my bag in the car and forget to lock it (that was an expensive mistake). I've spent a ton of money starting new hobbies only to lose interest. I have a multi-year backlog of projects I've started but not finished. My house is a disaster. I'm almost 40 and have almost nothing saved up for retirement.
I got lucky and made it through undergrad and a masters program. Hell, I got lucky and made it through high school... if my teachers had followed their own rules to the letter I probably wouldn't have, but they saw "my spark" and made enough concessions that I ended up, just barely, on the honour roll instead of failing out.
I had no insight into any of this being related to a disability until last year.
Also, I totally get that picking up random links thing. I always found I could sort of link together certain kinds of concepts together really quickly. Never super deeply, but like, learning new programming languages, I could just dive in, look at code, and things would just click together pretty often. I also get having a disaster of a house, spending money on hobbies and losing interest <glares angrily at his very expensive mill and lathe he uses only occasionally>. Some of the time I read tech people’s ADHD experience and I feel so… understood. Like, are you me? You could be me.
Exactly what I thought reading this post :D
Strangely enough, I applied at your firm and we have traded emails.
Partner and I have been together for 13 years now. She’s almost certainly on the ADHD spectrum but less severe than me. Things are great besides the fact that we both neglect a lot of stuff that NT folks don’t really struggle with.
But retrospectively, that’s one of the most interesting things for me. I think back to a lot of the previous relationships I had, and the vast majority of them failed due to conflict that I can now see was ADHD-induced. Impulse control and finances, house cleaning, new random hobby obsession, boredom, substance abuse… When I finally realized a year and a bit ago what ADHD actually was and how a lot of my behaviours weren’t typical, I had this very profound moment where it simultaneously felt like all the air was sucked out of the room and everything finally made sense.
Edit: > <glares angrily at his very expensive mill and lathe he uses only occasionally>.
I swear to god I’m going to get the mill running again this year.
"Oh, you struggle to show up 100% on time every day to the standup? I saw an article on the top of HN about a CEO that used it to his advantage, so what's your problem?"
I wouldn’t even be capable of overstating the damage done to my life by it. Inattentive form is a curse in my personal experience, but of course I am one person and not all have such bad experiences.
The mentality can be harmful, for some of us there are no strengths and no benefits provided to us, just years of suffering and bad outcomes. Makes me feel worse about myself personally, but I’m glad for those who haven’t had the same issues.
I think of it like driving a car with busted brakes. You might be able to learn how to cope with that, and maybe you end up being really good at drifting thanks to this! Suddenly you treat the underlying issue, fix your brakes, and it feels like you've lost some superpower. But really you still have these skills somewhere! And you objectively have more control, it's just that the there's going to be a learning curve to find this again as the feedback loop is different now.
I like being able to go all out in hyperfocus mode, but I also like being able to have some impulse control for when it's nice to have. After adjusting I think I can do both under treatment.
If somebody gets told "you have ADHD, a debilitating mental disorder", and then does well in life anyway, what exactly are they supposed to think happened? Why were we telling them they're messed up in the head when clearly they're quite functional? "Wow, maybe ADHD is good" seems like a pretty logical jump to me.
Mental health is an important topic, but it's still really wishy-washy. Sometimes I wonder how useful all these vague labels really are. I also got diagnosed with ADHD when I was an adolescent, and I almost feel like that diagnosis just made me do even worse at school. I'd be like "well I have ADHD so it's physically impossible for me to sit down and do algebra. might as well not even try."
Everybody struggles. Typical people have different struggles. I’m not saying ADHD is equivalent, or easy, but it will invisibly bias people in a different direction with a different set of things that are easy. After all, as far as I understand, we believe the root is simply lower levels of dopamine which tunes you for discontent, alertness, loss aversion, disagreeableness, and so on. It makes it hard to be happy, but genes don’t care.
I rankle at the thought that genes could be quietly setting people up to be suited for different roles, but again genes don’t care.
Like, it's nice if you can use hyperfocus to do great things, that on the net outweigh the inability to handle "normal life" things like paying bills on time. Then you marry and start a family and at some point wake up realizing this new life is perfectly structured to prevent you from using the positive aspects of your brain, while exacerbating the negatives.
I've been thinking recently, how come all those blog posts and stories about success despite (or thanks to) ADHD come from people who are single?
I put everything I’ve got into a) making sure I don’t get fired because I earn about 4x more than her, b) pour all the energy I can into my kids because I see how fast they’re growing up, and by that point, I’ve already disappointed her too much to repair things.
I’ve tried countless strategies to get around this, but the unfortunate truth is that I’m a nice person yet an awful partner. I have serious limitations that I wish I was aware of before I “trapped” her in this.
Rule one of ADHD: you probably lack a lot of self awareness and it can be genuinely awful for people you live with.
> I do my best to reign in my disability, but it’s not possible for me to function the way she wishes I could.
Same here, and my wife is also willing to adapt to my needs, but here's a thing: I can't always tell whether some adjustment is an actual need, or just some random guess I came up out of frustration. I also have a life-long habit of molding myself into the person the people need me to be, and couple with being diagnosed well into my 30s... things are improving, but it's kind of a random walk.
> Rule one of ADHD: you probably lack a lot of self awareness and it can be genuinely awful for people you live with.
I'm not the best person to judge this, but I think I actually do have quite a lot of self-awareness, so I hesitantly propose Rule 1A: if you do have a lot of self awareness, it's even worse, because you can see how awful it is for people you live with, and can't do a thing about it.
Yes! I struggle with this a lot. Despite talking about things and me putting genuine effort into making improvements, I continually seem to make changes which miss the mark. It’s as though we speak the same language with different meanings.
> life-long habit of molding myself
Likewise, and it’s not always crystal clear to me when I’m doing it, either. It’s becoming clearer over time, but even when I know, it isn’t trivial to just stop.
Similar to you, I wasn’t diagnosed until age 35 or so, and a lot of these habits and mannerisms are very deeply baked in.
> Rule 1A
I agree completely. I won’t claim to be a bastion of self awareness, but I will say that the awareness I do have is a major source of pain and frustration at times. Similar to the author in the article, I’ve come to see the inevitability of it all and I try to be frustrated less, and more accountable and constructive instead. It can be sort of paralyzing to dwell on it.
Thanks for the thoughtful response. I hope you make progress on this too. We were diagnosed late, but there’s no reason we can’t gradually shift the tides and begin making steady improvements.
It sounds like at the very least, you’re doing two extremely important things well: providing financially and being engaged as a father. Whatever your weaknesses might be, those are two huge strengths. Don’t sell yourself short on those.
If they’re things I do well and they make my family’s life better, it’s something, right?
I think the key sometimes is forgiving myself for not being everything for everyone. It sounds absurd when it’s written out like that, but is something I genuinely struggle with.
Thanks, thinking that through has actually helped me feel better about things.
You’re right, and this is something I often forget to do.
You’re also right that my wife looks at things through a NT lens, and I often wonder if I wouldn’t too if I was NT. I don’t blame her at all, but it undoubtedly creates friction that seems unhelpful or unnecessary.
Thanks for the kind words and reminder to be kind.
It’s fundamental to my cognition! It just is.
I find it a waste of time to try to assign “good” or “bad” labels to different parts of my lived experience.
That is why I dislike it being called a “superpower”. Not because it is “bad”, but because it is just is who I am.
It's not that they didn't think I had it. It never occurred to them that it might be the problem, for several reasons. I presented very clearly suffering from MDD and general anxiety and have been medicated for that my entire adult life. But in fact the MDD and anxiety were just symptoms of living undiagnosed and trying to live as best I could with what worked for me.
> comments such as this can be incredibly harmful
For anyone reading this exchange, ignoring, or going against, the opinion of 30+ mental health professionals can also potentially be harmful.
In defense of GP, I want to caveat with this: if you go to a random psychiatrist and tell them about your issues, it's quite likely you'll get evaluated for the "usual suspects", such as depression. A proper evaluation (not just initial diagnosis, but matching treatment and noticing effects) can easily take over a year, since medication used in depression treatment usually take a month to kick in, and you might need to go through several before finding one that works for you, if at all - while also dealing with some nasty side effects.
Now, imagine a person with ADHD staring this path. How likely is it they'll go through the process diligently for a year or more, until the doctor figures out something else is going on? What's more likely to happen is, the person will keep taking the meds for a while, then forget to schedule a visit before running out, run out, enter withdrawal, then be unable to schedule a visit, leave withdrawal few weeks later, and feel too ashamed to talk to that doctor again. So in a few months or more, they may go to another psychiatrist...
... who will want to re-examine them for depression just to be sure, starting the cycle anew.
I wasted a decade of my life on exactly this.
Hence my standing recommendation: if you suspect ADHD, find a psychiatrist who's actually specializing in adult ADHD (and not just has it on a list of things they can help you with). ADHD can often be diagnosed or ruled out in days to weeks; going to an ADHD specialist isn't about trying to "get your favored diagnosis" (if you feel worried about this, just be up-front with them) - it's about minimizing the chance they'll dismiss this as an option, as (from copious anecdotal evidence) most other psychiatrists do.
Then he stood up, was clearly having none of it, said he thought it was an advantage, and then gave a long talk with no reference to it.
I guess it was weird because he didn’t seem into that angle at all.
But he was a great speaker, really inspiring.
Edit: I wasn’t necessarily trying to advocate that his perspective was correct for anyone else, but just reporting that this is what happened as a matter of fact.
I can be energetic and fun and charming (allegedly) and very social, quick witted, a natural comedian. Or I can be quiet and focused and studious. But I can never be both at the same time. Concerta is what lets me pick.
I’ve never seen it as a disability because it is an advantage in so many ways. I’m just so thankful I get to control it.
That was the problem for me before I was diagnosed and medicated. I wanted so badly to be able to be quite and focused, but it was practically impossible to do it through will. Sometimes I would get lucky and something would catch my interest (hyperfocus), but most of the time I was all over the damned place.
My boss truly doesn't seem to have a concept of some of these bits and I fear I might lose or have to leave my 7th job. There always comes a point where they want to micro manage things, and that just ruins everything.
One thing that’s helped me with modal switches through the day is to remember to eat lunch even though my body is completely disinterested in food. And yeah, I try to take it at a consistent time.
I'm not sure about building a business with ADHD. I see that path as extremely difficult unless your super focus happens to align with what your building long enough to get to a point where you can make money off of it. That seems unlikely. Once you're running a successful business, I believe coping with ADHD would be significantly easier. A CEO can delegate the things they are worst at to focus on the thing they are best at and which deliver the most value. The vast majority of individual contributors don't have that option.
ADHD keeps me on the move and has given me a very broad skill set and understanding of many different industries. I've worked in health care with medical devices to building interactive kiosks to writing device firmware to applying AI to livestock management to insurance and banking modernization. In that sense it's a super power. But I still cannot build myself a personal website or blog despite wanting to because that shit is really hard for me.
This doesn't even touch on the damage ADHD can do to relationships. I had a very difficult time connecting with my children when they were babies and toddlers because, let's be honest, they are boring most of the time. This became significantly easier as they got older and we were able to start actually having conversations. There are also times where my inattentiveness gets to the point where I literally cannot pay attention to what my wife is saying. It's a struggle to try to separate my brain from what it's trying to pay attention to and redirect it to her. When I don't see people they basically stop existing. I have no relationship with my parents or siblings and almost no long term friendships because of this. It's extremely easy for me to get disconnected.
I've found that management has left me in a better place of balance. Less hyperfocus (on the occasions it can be useful), but also better able to do the long term day to day because things are a bit more dynamic. Not without many challenges, especially in a world with more remote work. The combination of Zoom and Slack is devastating for my attention. Though slack reminders keep me tied together in more ways than one, too.
Will say that I recently went for rediagnosis to see if meds can help. Low dose, short duration meds have been pretty great for me since. Don't feel the need to take them daily, but having it as an option to achieve a normal executive function is something I should have done a lot sooner.
He did get in trouble with the school for buying us all booze once, which was pretty hilarious.
Wish I got diagnosed earlier — getting a mathematics PhD with untreated ADHD was double plus ungood.
I didn't know anything about ADHD, and was sure I don't have it because it's described as "deficit of attention" (spoiler: it's not).
I realized I need to look into it after relating to one too many ADHD memes.
In the aftermath, I have written an ADHD Meme Wiki[1], which helped me (and several other people!) get diagnosed and understand ADHD better:
I'm also not sure if it's caused by something else. I just really struggle to function and it's a killer. I have lots of projects and life improvement things I want to do, but I wake up and i'm like ughh, I can't concentrate, my brain is very foggy, I have a lack of energy, it's a nightmare and i'm no longer sure what to do about it.
I think my issues might be more related to brain fog, which does come and go, but there isn't a clear trigger and even when it 'goes' i'm never clear at all, it's just a little easier to function, I get a lot of small dull headaches, I struggle to think or concentrate, i'm confused often, my energy struggles, I feel blah about most things and just urgghh...
Lots of empathy for people going through this, as i'm sure others just think you are useless or dumb, when I know i'm trying really hard to be the opposite because those things really matter to me.
So, in the spirit of "pay it forward": this smells like ADHD; go and get yourself checked out if you can. It may be nothing. But it may be something, and if it is something - ADHD or not - an array of new options will open up for you.
Personal tip: if you do decide to get checked out, try and find an adult ADHD specialist. A random psychiatrist will likely first try to evaluate you for depression or some generic anxiety disorder, and you can waste a decade on it with little to show for it (guess how I know). ADHD is much faster to rule out (or in) than either of those.
I know, "only", but seeing as it had been 32 years at that point it wasn't a major wait. 2 months is good for the NHS and mental health haha.
Diagnosis itself once I'd got through the wait took about 2 hours in total across 2 weekly meetings.
If you'd rather spend money than time a friend of mine zipped through the entire process inside a week going private
This is all is relatively new for me (got diagnosed this year after being misdiagnosed with depression for a very long time) and it's working out OK. One thing I'm still struggling with is break days. They seem to supercharge my (inattentive) ADHD, and I'm kind of dead all day long; maybe there's still room for adjustment and I go back to 36mg Concerta.
I’m on 15 mg Adderall XR - Tried 20 but it was too much. I’ll sometimes take 10 mg short release as well. 500 mg Gabapentin (100 mg for cat), and 150 mg Prozac.
I imagine the "weekend break", like a lot of ADHD advice, comes from treatment of children and teenagers, which - for better or worse - tends to focus on school performance, to the exclusion of all else. I mean, every now and then I see an adult ADHD article talking about med breaks and mentioning both weekend breaks and summer vacation breaks. It's kind of a tell.
Disclaimer: this is personal anecdote, not a recommendation.
I've been very lucky to have such a positive response to such a low dose, as it's helped me tremendously with only the mildest of side effects (occasional high pulse, sore jaw).
Higher doses do nothing but increase my heart rate.
These are the maximum doses where I live, and to be honest, I've not noticed too much of anything from either. If anyone has any experience/literature on what makes medication work/what determines the required dose for an individual, I'd appreciate it.
The most helpful thing I've tried is meditation, which doesn't really alleviate any symptoms, but it has enabled me to accept and be self compassionate and grateful for the life I have.
In general, AFAIK, there is no rule. The best type of medication and minimum effective dose seems to simply be an individual thing. Fortunately, unlike with e.g. SSRIs, it can be homed in on quite fast - the limiting factor is how quickly can you get your doctor to switch things up and write you new prescriptions.
A combination of factors made me decide to stop taking Vyvanse: a probably unrelated health issue, 40 mg of dextroamphetamine per day gave me unpleasant physical side effects, and my realization that 5 years of medication had profoundly hanged my habits and self-concept. I decided to see if I could go off meds and sustain the benefits. So I tapered off (no dependence!) and for 6 years I relied on habits, strategies, exercise, nutrition, healthy sleep and meditation.
But I am now taking Vyvanse again and there is no doubt in my mind now that no amount healthy living can do what Vyvanse does.
My current dosing: on a day to day basis, I take 0, 15, 30 or 45 mg of Vyvanse depending on what I need to get done, my energy level, and my habituation. I drink coffee with it because I find that caffeine helps me keep the Vyvanse dose lower. I organize my life to maximize the value of my medicated time. I experience a clear step function in executive functioning between "slightly too little" and "enough" Vyvanse and I can feel the gears shift in my head, takes about 5 seconds, as the drug concentration in my body crosses the threshold. I move the dose up and down in 15 mg steps and when reducing my dose I spend 2-3 days at each level to avoid crashing. I take Vyvanse holidays two to six weeks long, two or three times a year to reset my habituation and fix any sleep deficit. After a holiday I get the full therapeutic effect from 15 mg. My goal is to generate enough high-quality executive function hours to fulfil my responsibilities, but keep my dose as low as possible. It seems to be working so far.
How about not getting normal, but finding a life/work that fits to you and your lifestyle.
I thought I had to be genuinely inspired to get work done, and chased that fleeting motivation like a mirage for years instead of just learning how to sit down and work.
I thought my sleep was just "different" and my physical and mental health (not to mention productivity) suffered horribly and pointlessly for years until I put my foot down and... just fixed it.
Since fixing my sleep, for example, my productivity went from about 2 hours a day (of solid, focused work) to over 10 hours a day. In the span of ten days. That's not a bad exchange rate for a bit of normalcy, is it?
Working up to meditating for ~30 minute sessions (alone or in groups) forced me to face my worst nightmare: sitting still against my will.
Gradually, the physical burning sensation to 'escape' the mental torture of doing nothing calmed down. Further into my practice, the same happened for the monkey mind constantly thinking about shiny things. On good days I can attend long meetings and not lose it, remember chores, calm the chatter in my head, avoid playing mind games to keep myself occupied (eg. "can I cross the road in less than 5, 4, 3, 2 ...").
Medication helped to bump me over to the other side, and meditation has helped me stay there.
A couple of weeks ago I found something which allowed me to stop taking meds - I started running. I did not expect this to help with my ADD, but my head is so much clearer and focused since I started to run, it's crazy.
I am on Aduvanz (Adderall equivalent) and it lifts me up an extra notch, or at least; is a good alternative when time is sparse. But being active is the single most important thing every person can do.
I hope doctors will push harder on exercising in the future as we see more and more "cures" in the form of pills in circulation nowadays which, in many cases; could be fixed by a little change in lifestyle.
This especially goes for people fighting obesity, insomnia and anxiety. Start using your body and your body will start healing - and your mind will too. All that with the added benefit of (if any) zero side-effects.
Then it makes sense that I manage to get by without meds and "just" sports. My case is not as severe as yours, in a way I needed the meds to be compatible with a corporate IT job, without them the stress and responsibilities made me really anxious etc. But the last three weeks since I started running have been surprisingly zen to handle, even though I quit the meds cold turkey.
> I hope doctors will push harder on exercising in the future
Definitely, yes.
It works unreasonably well.
However, different people need both different meds, and different dosages, so it’s not a substitute for everyone.
Genuinely glad it’s working for you, meds are one less thing you need to manage.
I know the topic might be delicate, but I would really like to understand better.
I was a sysadmin for a decade before I landed a role that pushed me so hard that cracks started to appear.
We are overrepresented in tech, relative to the general population.
In the most recent StackOverflow developer survey, respondents self-reported at a rate about double the global average.
> but I don't know if it's because ADHD is more invisible in life outside tech jobs
You almost certainly know or have met people in other industries with ADHD and didn’t know it. Masking is an unfortunate survival skill for most. It’s mentally taxing, and can take hours to recover from after doing it for a day.
There used to be a thought that people grew out of it as they got older. They don’t, they just get really good at masking anything that might indicate they have it.
We’re seeing an increase in adults with ADHD, not because more people now have it. They had it all along (by definition, ADHD is symptomatically present before 12).
> or because there is a relationship between ADHD and being good at software engineering
Software engineering has some of the fastest feedback loops of any creative endeavour, and that really helps keep ADHD brains on task. But I don’t think there’s a relationship between the two, other than people with ADHD have a tendency to go really deep on things they’re interested in—and then subsequently drop it and move on to the next thing.
Software always has a next thing.
People with ADHD thrive on novelty and external consequences.
Agile software teams, infra/ops roles provide both. See also fighter pilots, firefighters, ER nurses, as well as outdoor jobs like landscaping (exercise is very good for ADHD brains).
We also really hate being told what to do, but will gladly solve a hard problem given the opportunity. Software enables that in a way many other jobs don’t.
> I know the topic might be delicate, but I would really like to understand better.
I really hope it’s not a delicate topic. Our brains work differently, but with some accomodations we can fit well into a team. I think there’s a very complimentary overlap with teams composed of neurodivergent and neurotypical people.
It's not even clear what you are signing up for, and they start asking a bunch of personal questions...
My ADHD brain noped out of there in an overwhelmed browser closing act of defiance! :-)
I bookmarked it with the intention to go back. However, I know realistically I won't.
Not the craziest designed-by-marketing thing I've seen, but up there. But hey, it's not like I'm looking to them for UX advice.
However, as another founder with ADHD, there’s something to be said about being able to take the similar tactics we funnel into work tasks and place it into the day-to-day. Scheduling laundry with others, reading at the same time, running buddies, etc. I’ve found that work stuff is usually okay for me. It’s the “everything else” that’s ridiculously hard to do.
It’s more poorly understood by the general public. People seem to have the idea that spectrum refers to intensity of symptoms. In fact it refers to their diversity. Some people have strong social skills but lack executive function, others have sensory difficulties and struggle with daily activities like hygiene. There is no “high functioning” autism, there are people who are highly engaged at appearing “normal” to the detriment of their energy and identity, often referred to as ‘masking’.
https://carmenbpingree.com/wp-content/uploads/2020/07/Screen...
My synthesis of the research and anecdotes I’ve collected is that ADHD and ASD are distinct, but there is also likely a unique diagnosis likely to come in the future that represents the combination of the two. All of them are associated with the same regions of the brain, predominantly basal ganglia and cerebellum. It’s incredibly heritable. There is strong evidence that there are connections with endocrine disruption. There is a strong connection with non-conforming gender identity and ‘audhd’ which seem to be related to similar hormonal dynamics.
Many many founders and world-changing folks have ADHD, ASD, or some combo. It leads them to think in unique and powerful ways, and to see through established social norms to make real change possible. A lot of “former gifted kids” fall into this bucket. Their ability to learn rapidly and emulate social behavior actually prevents them from getting support for their very real needs which are often understood as symptoms of other disorders like depression. The challenges of real life eventually catch up and can lead to catastrophic burnout and diminishing abilities.
If you have an ADHD diagnosis just do yourself a favor and spend some time on embrace-autism.com for some good info and credible assessments.
I didn't trust myself to remember to cancel it in time and was disgusted at them weaponizing this dark pattern against ADHDers, so that was it for me.
If you go to the Play Store and search for the one-star reviews there are loads of people saying the same. And also for those that did try it, that it's mostly useless anyway.
So she switched to better amphetamines (Dextro) and side effects turned away. Leaving only the positive, expected, effects essentially.
I took a lot of amphetamines in my life. But Ritalin is the only one I can't stand myself on. It's like a neuroleptic is packaged in (I know it isn't) but it makes so thumb and cold. IMO
Hopefully their friends are supportive of them and not secretly denying the existence of their disease.
Because wow, that’d be really abhorrent of those friends.
Did you ask your friends how they are doing or did you find them annoying once and decided the problem was their medication?
It’s more likely still under-diagnosed.
The pandemic threw such a big spanner in the works that so many of us started to struggle enough to notice it wasn’t normal. This put the mental health system under significant strain. More people than ever have been diagnosed.
In the US, an ill-guided rule that limits the manufactured capacity of stimulants, not by demand, but by an arbitrary number, impact people recently.
They couldn’t refill their scripts. Supply effectively ran out.
> temporarily helpful to help someone with ADHD get their life in order and make meaningful lifestyle changes in order to get the symptoms under control.
A wheelchair is temporarily helpful, so are reading glasses. They could help someone to get their life in order, and make meaningful lifestyle changes to get their symptoms under control.
Somehow I think we’d both agree even after that you wouldn’t take someone’s wheelchair or reading glasses from them?
You are talking about greedy irresponsible doctors and bad faith "patients".
These are not the same thing.
Well, it’s you versus the entire medical community. Who do you think is more likely yo be right?
Your bad experience is unfortunate but does not reflect that of most people with ADHD. It’s the only disorder which responds incredibly well to treatment by stimulants, and you’ll find that fact proven out by medical science.
Until there's a blood test or concrete psychological proof, its just simply not a disease. These articles were great reads on this phenomenon of self diagnosis:
https://unherd.com/2022/11/who-decides-if-youre-mentally-ill...
Again, you versus the entire medical community. I am saddened to see you making such strong claims from a position of such ignorance.
You're talking about self-diagnosis, and I'm talking about medical professional diagnosing the disease.
If you take a peek at those articles, you'll notice that there's a big trend in people (usually young adults/teens) self diagnosing on the internet, whether its joining a forum/reddit/discord, then going to a doctor, saying, "I HAVE X" and more often than not, they get what they want. This takes away a good chunk of credibility of the 'medical community'. You can even get "diagnosed" via telehealth services now. No need to go into an office! How many people are they turning away? Hmm.
You have no clue because you have no pertinent experience.
I shared these articles in another comment, but this is what I fear is taking over the 'mental health' diagnosis situation atm:
https://unherd.com/2022/11/who-decides-if-youre-mentally-ill...
Does the educational system make age-inappropriate almost inhumane demands on children? Yes. Do many kids have attentional and behavioural issues that are not ADHD? Yes. That can be improved without medication? Yes. Should these be distinguished from true AHDH and treated differently? Yes. Should kids with ADHD try non-medical interventions first? Yes. Should kids who have clear diagnostic markers for ADHD and who respond well to stimulants be prescribed stimulants? Hell yes. Should psychiatrists try to weed out non-ADHD people looking for legal sources of speed? Hell yes. Are the fields of psychopathology and psychotherapy problematic? Somewhat. Are they "right"? Not exactly, no. Are they "wrong"? Not exactly, no. Do they relieve suffering? Sometimes, Do they create unintended consequences? Yes, more often than we'd like. Is the whole field conducted in bad faith? No! Is it a work in progress? Yes. Are there bad faith practitioners? Yes. Are there incompetent practitioners? Yes. Are there competent practitioners acting in good faith? Absolutely yes. Are there reliable signals to tell these apart? No, unfortunately, no. Is there an epidemic of performance-enhancing prescription drug abuse in the circles in which you run? Apparently so, and I've heard this elsewhere. Is there performance-enhancing prescription drug abuse in the circles in which I run? Not to my knowledge.
Life is complicated. You do no good by mashing all this stuff together and disposing of it with simplistic conclusions.
Both from people who do this, then decide the meds just get them high, so they must get everyone high—they don’t.
And from those who see this and use it as fuel attempt to discredit the condition itself.
> writes you a legal script for speed.
ADHD meds aren’t street drugs. There’s stimulant and non-stimulant options, that work for different people.
> its laughable this qualifies you for legal meth
Desoxyn is a rare treatment option, valuable to those who really need it.
Methamphetamine may be _very_ close to other amphetamines, but the methyl group unlocks access to other parts of the brain. It’s a different drug, with different effects.
I fully agree with you that this shouldn’t be happening, but the comparisons to street drugs only work in favour of operations like the one you describe in NYC.
The truth is that lots of people manage their stimulants just fine. Across everyone I know on stimulants, 8 friends and family, none are as you describe. These are people I physically see on a regular basis. No one is addicted, high, unable to function or experiencing material personality changes. Every single one of them is taking low to moderate doses, as needed, and says their stimulants changed their life for the better, allowing them to function "normally" at work or school.
> Regarding the long-range management of ADHD, it is important to point out that the relapse rate for ADHD is 100%.
What I think is maybe related to what is discussed about CBT... In the past I've relied on being able to set aside large spans of time to either get things done, allow myself time to be mindless (mindfulness?), organize things, etc before the interruptions started. This worked fantastically as I was up at 4-6 am every weekday (father duties at the weekend), reading, learning, working, writing, etc, before the slack messages, meetings, email started rolling in.
I guess I had a similar system long ago when I was single, staying up all night till the crack of dawn reading, writing, but mostly wasting time on the internet. That wasn't feasible with a family so I somehow managed to push everything over to the other side of my sleep schedule, despite NEVER being a morning person. It was tough, but I made it work and things got better. It still took me forever to do the most basic things, but at least I had more uninterrupted time to get them done. I feel like I had found a coping strategy for my ADHD.
Recently, everything came crashing down when my routine was disrupted by having to get my daughter up, ready and dropped off at school. I was able to figure out a way to split this responsibility to half of the week, but that's since become my whole responsibility. I also have to pick her up from school (50% of the time), make dinner, clean up, etc... I also put her to be every night. By the time that's all done and I've taken care of my own needs it's basically time to get to bed.
Now I've fallen so far behind at work, no time for professional or personal learning, no organizing, etc... Additionally my marriage is in a state that I could never have imagined (although this was on its way to happening either way). Now I think I'm battling some depression, anxiety, sleep deprivation... all of this obviously just makes everything even worse.
What I now recognize is that I became far too dependent on the luxury of having large spans of uninterrupted personal time. This is great while it lasts, but for some like me, not guaranteed. Instead, I've begun to rely on small increments of time and effort, and I think that some of these CBT techniques and the overall framework might help.
> This harkens back to our notion that CBT for adult ADHD provides a framework for understanding how dif- ficulties arise as well as companion coping strategies with which to make changes
It's tough, but I think it's the only way I'm going to survive. Btw, I am in therapy and have medicine, and despite all of this I am a happy individual and still love life.
> I also went from taking nothing on weekends to taking half my weekday dose. My life on the weekend doesn’t need as much executive function, but it doesn’t not need any
One thing that wasn't immediately apparent to me was that my ADHD isn't restricted to work hours. I need to be able to focus on my family, friends and self as much as whatever I'm trying to get done at work. I too felt shameful about being on medicine, but come to realize that neurotypicals just don't understand the effects and benefits of some of these medications.
I'll prob add more if i can find some time to come back to the article and this thread.
FYI, recently diagnosed with ADHD in my forties. I've been unknowingly dealing with ADHD all my life. It explains so many issues that I've been dealing with since I can remember. It's hard not to feel some kind of resentment and anger about why no one noticed long ago. In many ways I feel like someone has just woken me up from a 40 year slumber, like an adult that didn't listen during school and has to go back and learn everything from scratch. Whenever I heard about people with ADHD I always imagined they had some kind of focusing superpower. Fuck ADHD, I feel like it's trying to ruin my life.
In Australia we call this "Living the dream".