I finally broke the chains and more or less replaced these bad habits with healthier ones, which has been great. However, I can barely function at work and my contributions have dropped to near zero. It’s causing me immense stress in a culture that is cutthroat.
How can I rebuild a normal way of working?
I ended up getting a prescription for Provigil (modafinil), a non-amphetamine stimulant.
It’s not nearly as dopaminergic as amphetamine, decidedly non-euphoric, but more motivationally stimulating than caffeine.
I found that the dose response lends itself well to former addicts, where taking the recommended dosage (100mg for me) does not result in a “high” nor does taking 3-4x that dosage, and is quite unpleasant to do so.
As well as being long lived, a single dose lasting 10-12 hours, not a time release formulation mind you, reduces the moreish hunger of short duration stimulants.
Effexor caused suicidal ideation, Strattera was too abusable, Wellbutrin worked ok at first but caused hives when I increased the dose to the recommended level.
Modafinil is more commonly prescribed for narcolepsy, or shift work sleep disorder, requiring a sleep study. But allows for off-label use at doctors discretion.
It has a fairly low addiction profile, which I was suspicious of given my history, but I don’t feel the need to take it every day, and usually abstain on weekends.
I also tried Nuvigil (armodafinil), which works similarly but for longer and at a lower dose. But it was a bit jagged, and overkill, I don’t need 16 hours of stimulation.
[0]https://pubmed.ncbi.nlm.nih.gov/15991923/ [1]https://pubmed.ncbi.nlm.nih.gov/22640618/
Anecdotally, despite being a very subtle effect, in my specific set of circumstances, modafinil has been life changing.
Fermented fish tops the list, which, personally, sounds profoundly unappealing for breakfast.
But to each their own, maybe a cup of coffee and a can of surströmming is the ultimate morning combo
I was able to come back to 30mg Vyvanse daily, 50mg made me super impatient, fight with my gf and just be short-tempered with everyone, plus the productivity window was always reducing after some time.
But even at 30mg, it's just not the same effect as 14 years ago of course, and taking breaks can only do so much. Now 30mg feels like enough just for getting out of bed and doing a normal day.
Low dose (25mg) sertraline for a few months fixed the temper thing. Good sleep is a must. Still finding a way to take it easy and reduce the stimulant further, I'm still able to engage on technical things deeply that interest me and live my life fine, but I'm not cut out for the stress of a more senior position, not unless I start to make compromises, so that's not the avenue I'm pursuing at least.
I do have ADHD, diagnosed as a kid and the pattern worsened in college until I started treatment, if that matters.
you're chasing two rabbits here: a short-term one and a long-term one.
you're smart enough to know which of those two matters more.
you're smart enough to know all those energy and focus you had is just borrowed time.
you're smart enough to know you've been digging yourself in a hole of massive withdrawal which can take weeks and months.
you're smart enough to know that substituting it with other uppers like caffeine, nicotine, will still keep you dependent.
just rawdog it cold turkey, exercise consistently, get rid of junk food, eat meats and veggies, hydrate properly, and rest enough.
just suck it up and etch in your head that getting yourself back kn track takes time and there will be no immediate results.
sculpting art from a block of marble takes time, it will be days and weeks of you doing the same damn thing even if you dont enjoy it, even if you dont feel good about it, even if you dont see your desired outcomes yet.
Or am I being really naive right now?
If it's anything stronger than coffee, here's my recommendation:
1. Wim Hof Method from time to time (it boosts adrelanine temporarily)
2. Exercise (boosts all kinds of stuff)
3. Breathing meditation to train your attention
1. NAC. I don't like this because it also seems to cause heartburn and blunts me.
2. Home brewed kefir. Overbrewing has the opposite effect, so you have to be diligent about changing the grains every 24 hours.
3. Saline + iodine + baby shampoo nasal rinse. The weirdest one, but I swear it's true. Literally clears the head.
All of these are relatively cheap and low risk.
Amphetamine Stimulants affect those with ADHD differently to neurotypical people, so use with much caution.
In the case of recreational or dependant use (non-medical use etc) Perhaps seek professional help. Additionally consider the pressures of a FAANG workplace and whether it is the right fit for you.
No matter the money, I could not work in a fast-paced, cutthroat environment. I need fair-paced and understanding etc
There are literally online zoom meetings 24/7, google around. You don’t have to say anything, just listen.
I ask because it sounds more nuanced than another person’s “it works on my machine” is likely to address.
And your employer probably provides an EAP benefit that covers it. This is why.
My flow has been massively stable since I started doing this.
Go see a doctor urgently. If they say you don't have anything and should never take stimulants, see a therapist to learn to live with the reality of who you are and where you want to be.
Once the tolerance kicks in (1-2 weeks of use) the high becomes mild / nonexistant and it no longer boosts my productivity
Idk, it's complicated. I think a lot of the moral handwringing about stimulant use is misguided and it shouldn't be stigmatized. But I'm somewhat biased in that stimulants literally saved my life, after I had been avoiding medication for years prior based on the stigma. I for sure have ADHD though.
Have you talked to a psychiatrist? You may have a serious mental condition that needs treatment, even if it isn't ADHD treated by amphetamine salts. Modafinil, maybe.
From what I understand, ADHD folks do not get the high part, so the addiction risk is not there.
But I am very curious about how people like you describe the effect of these drugs, as it is so foreign to me. What do you even mean by “heavenly”?
Some people can retreat to a mind palace in their head. I have a mind bouncy castle. It’s like confetti in a wind tunnel. Stimulants calm the storm and give me control over my inner thoughts, and mastering oneself is the first step to having any agency in the world. That’s all they are to me.
But a “high”? Never experienced that, other than the psychological high that comes with being high agency.
Maybe, but I wouldn't say serious. Just standard life malaise.
I have talked to a psych - he gave me a concerta prescription after talking for 20 minutes lol. That's the stimulant I'm talking about. It's basically super coffee that lasts all day, and like I said, the high is by far the best part.
- if he's exercising consistently
- if he's eating properly without junk food
- if he's hydrating properly instead of other beverages
- if his overall physical activity has a good baseline
- if he's in a line of work where his interest, competence, and the challenge of the work is a good match.
most people's inability to focus comes down to lack of self-discipline and self-care, or just being in a wrong place, wrong time, or wrong environment.
Like: open word document, review section 1, save document, email link to x.
This makes getting started easy enough and hopefully I pick up momentum and engagement as I go.
Maybe change teams or even downlevel?