It is a very cool approach to a well documented and tested therapeutic practice, I just don't see the value proposition unless you're someone that specifically could not find any class of medication that worked for them.
For me, personally, the whole effect of the meds are that I'm slightly more awake, as though I drank a cup of stout coffee, and I can more easily decide what to work on and then work on it. I'm fortunate to have had zero adverse reactions.
[0]And then, knowing their clientele, texts and emails the heck out of me to remind me about upcoming appointments, which isn't strictly necessary but is understandable and appreciated.
[1]One doc told me I had trouble focusing because of anxiety. "Do you know what you might be anxious about?" "Yeah, not being able to focus." That wasn't a productive visit.
I personally have ADHD, and I’m medicated. The medication makes it possible to focus on tasks, not guaranteed. I still have to engage cognitive skills and essentially implement a system similar to this, just without a coach. Specifically: break down tasks, use a Pomodoro timer, walk and make tea between focus sessions, put the phone away, use environmental cues like specific work music, etc.
Sleep and exercise are also incredibly important for success with ADHD, and the stimulant medications can interfere with both, so I could see coaching being useful there as well, not sure if the service offers help there.
That's awesome that you have a whole bunch of skills that you've found that works for you! For some people, this takes months to figure out the right mix since what works for someone may not work for others. And also, HOW you do something is almost more important than WHAT skill you're using. I would also add that in coaching, in addition to skills, the coach is supporting in long-term thinking, goal setting, so that there's a direction forward as well, which is really important. I like the quote "medication is like glasses, it helps you see more clearer but it doesn't teach you how to read". I think about this quote a lot because for me, the value of coaching has been to help me set a new direction in life, be reflective in what I want, then work to build an ADHD-friendly life around me that helps me go in that direction.
Totally hear you on pricing. We're working on a few routes around reimbursement, partnerships with schools/workplaces, etc. Right now we are HSA/FSA eligible and also many of our members get it paid for through their work's L&D budget or disability/DEI budgets. Of course, that's a bit harder because it requires them to disclose. We also do a whole ton of scholarships for anyone with a financial need!
I've got decades of learned behaviors to deal with. And while my doctor was correct in that a medication that works will be like night and day (I'd rephrase it as life changing), I still struggle more than I like.
1. Insurance doesn't always cover ADHD medication, and when it does it can be a pain; every time my employer switched insurers I had to change my medication because the new insurer wouldn't cover the same thing the previous insurer covered. I've never had insurance cover my psychiatrist either, which amortizes out to about $100/mo.
2. Stimulant medication improves symptoms for over 80% of people with ADHD but "normalizes" about 1/3. So If you are in the 2/3 people that still have some ADHD symptoms on medication, then you're still going to have to cultivate healthy coping mechanisms.
3. Sometimes you go on a trip and forget to bring your medication, or you forget to bring the monthly prescription into the pharmacy on time (no refills on Schedule II substances), or your pharm is out of your meds. Now you are temporarily unmedicated and still need to function.
It's a pain in the neck in the sense that getting all the insurance stuff straight is extra hard when you're in need of being treated for ADHD in the first place. It does give me something to hyperfocus on every couple of months.
Purely rumor, I'm sure.
I had a way to avoid spilling them, but it's too long ago and I don't remember what it was.
It's great that you've got it largely down though!
Personally, I like to know that I have a foundation (and a person) to fall back on when all the med stuff doesn't pan out the way I want it to (which is unfortunately frequently), and a big part of the value of coaching & body doubling too is community and not going through this alone.
I absolutely, 100%, completely agree that the medicine is only a small part of it. I have a hundred little rituals and coping mechanisms that had let me manage my life without it. Small examples:
- Appointments go straight to my calendar the instant I schedule something. If something's not on my calendar, it doesn't exist. I make liberal use of early reminders, too.
- I'm not a GTD purist, but I track it pretty closely. When I say I'll do something, I put it in my inbox. Same as with my calendar: if a to-do isn't in my to-do app, it's not getting to-done. There's nothing I've committed to that isn't in one of those 2 places.
There are plenty of others that I've been doing so long that they're unconscious habit.
These are the things that work for me. If the things you talk about work for you, and other people are willing to pay you to help get them on track, excellent!
Also many of our clients have done (or are currently doing) therapy and come to Shimmer because their therapist suggested it.
And on your point of medication, many people do not want to take medication (cultural or other reasons), or cannot take medication (e.g. side effects or can't mix with their other meds).
It's a lifesaver, but it's kinda like Ozempic: it enables you to follow through on your self-improvement goals, it doesn't do them for you.
Also, some people don't have health insurance. We do exist, sadly -- 25 million of us, as of 2023: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/... Typically, a diagnosis/new psych appointment costs $250-350 OOP, and the monthly checkups cost anywhere from $100-200 (unless you can find someone willing to break the rules for you and prescribe without 30d checkins). The baffling coupon system does mean that the refills themselves are cheap, somehow, but I've paid $60 before just because the coupon wasn't working and I couldn't be bothered to go home and figure it out and go without meds for X days.
Of course that all becomes easier if you're willing to stick with non-controlled substances, but still
Could you elaborate? The ones I know of are St. John's Wort(though that's more for depressive symptoms) and Phenylpiracetam.
Do not take St. John's Wort! That's got all kinds of side effects.
That's to simple, but be aware of the side effects when you take it. I still prefer it to any other antidepressants, especially for short time use. Except maybe 5htp.
A lot of our members come to Shimmer after getting a diagnosis and the right dose of medication, or even with a therapist. And from that more calm, ready place, can they engage in the thought processes around planning for the future, building skills, etc.
Some really great discussion going on in the replies here but this is where you’ve lost the plot.
For millions of people, medication does in fact solve ADHD. Making misrepresentative blanket statements about the efficacy of medical treatment to promote your product as more necessary is not okay.
If you are looking to have your program eventually treated as a covered therapy under insurance, this kind of messaging can really hurt you.
I use medication myself, so by no means am I anti-medication.
I think the point I'm trying to make is that it's not a magic pill. And there are side effects as well. If you can layer in foundational lifestyle medicine and good, healthy choices, that makes the world of difference and can potentially allow you to take less medication.
The reason I say this is because we get SO many people who come to us feeling dejected that they put all their hope on medication and when their life didn't immediately get to where they'd like, they felt like there was no hope, like there is no other alternative.
I don't need people to use Shimmer, I just want people to know there's hope if your meds don't work, and there are other solutions beyond meds. This could be therapy, coaching, self-management, and other tools!
I'm medicated and I still need therapy and support from disability support workers. Therapy should just be practiced by people qualified, trained, registered, and regulated. Support workers are such a better value prop than these ADHD 'coaching' scams.
It's also amazing how high efficacy ADHD meds have. There's loads of reasons why they don't work for people but they're so effective! Every time I see that stupid 'prescription' video game I get frustrated that it exists and it marketed particularly towards kids who I assume aren't getting the most effective medical care (meds and therapy) because people are still fearmongering over meds (and therapy lol). Also the whole war on drugs thing. Inhumane and not necessary. Just let people who want to be be medicated! Still need therapy tho. The meds don't suddenly cure everything