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Tell HN: If you have trouble focusing on projects/meetings, see a psychatrist

• machiaweliczny 4y ago
  100% upvote from my side. Not an ADHD but getting psychiatrist help was one of best decision of my life. I got meds (SSRI) that relived my stress, demotivation, social anxiety and helped me regain control over life. I can't emphasise how big this is.
• sruffatti 4y ago
  If you don't mind me asking, what medicine were you prescribed? What kind of topics do you go over in therapy?
  • thegginthesky 4y ago
    > If you don't mind me asking, what medicine were you prescribed? What kind of topics do you go over in therapy? First of, I suggest you talking to your doctor about the medicine. For me, I use Vyvanse 30mg, but the same medicine can have a much different impact on you. I do recommend therapy and really opening up to your therapist. I started out with current struggles, how I felt and handled, and then I talked about past events, formative stuff from my childhood and teenage years. I also covered topics about inadequacy and frustrations with how I manage my time, my attention and my energy. Before each sessions I make a list of certain topics I want to cover and I use it as starter, then I let the therapist guide me through some stuff.
• tapoxi 4y ago
  I've been diagnosed with ADHD since I was a teenager, but the shift to working from home and additional responsibilities made it far worse, so I started seeing a psychologist earlier this year to help me reinforce organizational skills while adjusting medication. Some things that have worked for me: * Less medication. I dropped my Concerta to 36mg which avoids many of the side effects. * Frequent calendaring, even for personal life. This helps visualize time commitments. * Use of a pen and paper notebook throughout the day, reducing cognitive load. I've tried a lot of digital note taking tools but I end up spending too much time fiddling with them. To encourage myself to take notes I just have a loose structure of one page a day.
  • specialist 4y ago
    Emphatic agreement on calendaring, journaling, pen & paper. I also created a habits tracker. Everything I'm supposed to do every day, plus common stretch goals. Spreadsheet format, with days across the top, and tasks along the side. Kind of inspired by Seinfeld's "don't break the chain".
• throwawaytemp29 4y ago
  100% this. I have been struggling with this for the last 5 years and only after my son was diagnosed with ADHD did I realize that I have it as well. Just having an explanation for the challenges makes life easier and I don’t have to beat myself up about it so much.
  • geocrasher 4y ago
    I learned I had ADHD last year. I'm in my mid 40's. Just knowing I had ADHD, and learning that I don't think the way normal people think was a huge burden unloaded for me. I'm not lazy, I'm not stupid. I'm atypical. I have executive dysfunctions. It's Normal for ADHD people to do things the way I do. That doesn't mean I like it, but it empowers me to recognize it. THEN I can work around it.
    • AlwaysRock 4y ago
      This is true for me as well. I've never taken medication for my ADHD but therapy and KNOWING has helped me tremendously.
• nja 4y ago
  How did you find your psychiatrist? As someone in a similar situation who has decided several times to get a consultation, it seems like the whole system is set up to be as difficult as possible! Just finding someone taking new patients is hard enough, then you have to worry about whether you have to have a PCP in their hospital, if they are allowed to do telehealth, whether they take your insurance, ..., ... It was hard enough finding a therapist (and retaining them -- my therapist dropped me because the office only allows them to see someone for 1-2 years max). If anyone has tips on more effectively finding therapists and psychiatrists, I am all ears. (I'm in the US if it helps)
  • deleted 4y ago
    [deleted]
  • devde 4y ago
    > my therapist dropped me because the office only allows them to see someone for 1-2 years max interesting. I've never heard of that happening. I found my therapist on PsychiatryToday- just added a bunch of filters and scheduled a couple phone consults (most offices will do these for free). Went with the one I found that had availability and seemed to work well with me. They referred me to a psychiatrist. It's definitely easier if you have a plan that doesn't require a PCP or anything, I think mine is a POS so I just call up any providers I need, no referrals or anything.
  • y-c-o-m-b 4y ago
    Here's what I wrote for someone else that asked the same question: > I went a different route. I went through my primary care doctor. I told him I'm getting in trouble at work due to procrastination and lack of attention. I also said my wife and friends/family have been complaining that I never listen anymore. I asked if I could be evaluated for ADHD. He sent a referral to a provider with https://lifestance.com https://lifestance.com. It was only two appointments with the LifeStance provider to get a diagnoses. Once my doc got the diagnoses back from LifeStance, he's been in charge of prescribing the meds.
• weatherlite 4y ago
  I don't think I have full blown ADHD but if distraction and procrastination is a spectrum (I believe it is) I'm probably somewhere in the middle. Though I've found ways to battle procrastination and improve it's always there lurking. I wonder if for cases like me (which I think is a huge proportion of the population) meds should be considered.
• segmondy 4y ago
  Or figure out a system that works for you. Medication is not the only way.
  • sdf4j 4y ago
    Madication is not the only way, yes. But these "just get your sh*t together" in disguise are NEVER the way.
  • kshahkshah 4y ago
    OP didn't recommend medicine, they recommended seeing a psychiatrist.
  • falcolas 4y ago
    AKA the "stop hurting" solution to chronic pain, as applied to ADHD.
  • thegginthesky 4y ago
    > Or figure out a system that works for you. Medication is not the only way. Exactly, it's good to talk to a professional and see your options. I believe each person can have their own healing mechanism, could be a therapist, exercise or even spiritually related. I understand everyone is different, made differently with unique physiology, mind and needs. Sometimes medication can help or harm, for me it's been a positive but not the focus.
• prego_xo 4y ago
  I do hope that you're learning good habits in tandem with your medicine. Stress-management and self-control habits start small but end up being just as effective, if not more than your medication.The idea isn't to make you dependent on a prescription to be productive, you're to learn how to manage your ADHD to the degree where you can lower your dosage.
• AnIdiotOnTheNet 4y ago
  Sure, great advice. Know where I can do that in a reasonable time frame? Because I've been trying to find a psychiatrist to check my work on my Bipolar 2 self-diagnosis and of the 5 clinics I found only 1 ever got back to me about appointments, which are several months out for availability.
• pwillia7 4y ago
  come hang out at /r/adhdmeme at Reddit. That's how I figured out I probably had it and have had a similar experience to you since then, starting about a year ago. While it's trying having your 'personality' shown to you as just coping mechanism of your disorder, but it's nice to feel so included too ;)
• xyzzy4747 4y ago
  I don't think the problem is that you can't focus - the problem is that the reward isn't high enough. I know your post isn't money-related, but let me digress. What is the point of fixing your procrastination? What goal are you really trying to achieve? If you can't pay attention in project meetings, so what? It's not like you'll get a $100,000 bonus for doing so. If there was a $10 million gold bar in the bottom of your backyard pond I don't think you'd procrastinate learning how and going about recovering it. It would probably occupy all your attention. In my opinion the solution is to change your focus in life to things that pay out higher rewards. I.e. instead of paying more attention in meetings, do the minimum to not get fired and figure out ways to make more money (find another job, start a business, etc.). If your job is already high-paying then focus on things that are high impact on impressing your managers. If the result of fixing your "procrastination" gives very negligible long-term financial benefits then it's not really worth it. I also often don't listen to my wife - unintentionally - but it's because she often says things without a lot of substance. So it's hard for me to keep focus. I've had lifelong procrastination issues too. Maybe I have an attention disorder as well (but undiagnosed). But I have a few million in my brokerage/retirement accounts, and my own startup with millions in funding, so do I care? Nope not really. Anyways, my advice is to figure out where the metaphorical gold bars are and go after those instead.
  • ghostbrainalpha 4y ago
    What's the startup if you don't mind sharing?
  • lgleason 4y ago
    That is not how ADHD works. A person with untreated ADHD will not improve much even with incentives like this without treatment. The problem is that when it is untreated the executive part of the brain is not firing correctly because of a chemical imbalance. The meds help to fix that.
    • xyzzy4747 4y ago
      I'm not really sure about that. I used to have a full-time job out of college where sometimes I'd spend 30 minutes working per week. Serious, serious procrastination. Got panic attacks about it too. It took lots of introspection but eventually settled on "do one thing per day" for a while, i.e. the Seinfeld method, then eventually after a few years started job hopping. I was also actually diagnosed with bipolar - around the same time as the bad procrastination - but I stopped taking my meds a decade ago (against the wishes of my doctor) and I'm basically fine now.
• whynotkeithberg 4y ago
  I think this is something more people should share/talk about so I'm glad you did so and I hope people listen. I had done the same in the past and was prescribed Vyvanse which I liked much better than Adderall. Adderall was enjoyable & worked but it also felt really good and I wanted to take more when it was wearing off for the day. Vyvanse seemed to be even more effective at helping me focus, it would last its 8-10 hours and then I didn't have any desire to take more for the day. It did make my stomach hurt for a short period when it was wearing off though(not for the whole day or even very much of it). After a couple Iraq tours I had such difficulty concentrating and became someone who procrastinated & then got days worth of work done in a few hours once the deadline was there. Vyvanse really changed things for me as I was able to not be in such a rush slamming out work and that made me so much less anxious and less depressed. I learned a lot of my depressed feelings were because of my anxiety from knowing I was behind and not doing the things I needed. So getting my ability to focus improved helped me immensely in more than just the one way.
• mirekrusin 4y ago
  Be careful. 1 month is not enough to make a judgement. I hope it'll work for you long term and not create any side effects. I'm worried for you in terms of medication you mentioned. As an extreme example taking cocaine/amphetamines for 1 month would probably make you best dad ever, best coworker and best husband straight away - but would fuck you up totally longer term.
  • falcolas 4y ago
    > I'm worried for you in terms of medication you mentioned Pure FUD. ADHD meds, taken in prescribed doses, have been proven in studies to not have negative impacts on either your cardiovascular system or your brain.
    • dragontamer 4y ago
      I'm generally trusting of pharma studies. But a bout with Zyrtec has convinced me that psychological effects aren't always well studied, even for common drugs. I'm convinced that prolonged use of Zyrtec makes me angrier for example. I've experimented with my allergies, and when I'm off Zyrtec, I'm sniffling and sneezing all the time... But generally happier and healthier from a mental perspective. Every medication you take, especially with prolonged use, should be considered an experiment IMO. Even if the studies are show safety and efficacy... there are plenty of other side effects that could diminish quality of life. Allegra doesn't have this problem for me, so I just switched to that.
      • sgeisenh 4y ago
        Fatigue is a common side effect of Zyrtec (and other antihistamines). From purely anecdotal evidence, I think most people have to experiment with allergy medication to find one that works best for them. I know that I'm dysfunctional when taking Zyrtec but Claritin doesn't bother me at all.
        • shade 4y ago
          I definitely had to experiment as well - I bounced around between Claritin and Allegra for a couple of years. I did try Zyrtec and experienced significant fatigue with it, which led me to stop using it pretty quickly. Earlier this year I discovered Xyzal (expensive, but does have generic versions, too), which appears to be a close relative to Zyrtec. Interestingly though, they recommend taking it at bedtime rather that in the morning, the idea being you'll get a better night's sleep from not being congested AND you'll sleep through the worst part of the fatigue from it. This has worked out well for me - my allergies have bothered me less this year than they have in the last ten years or so, and I sleep better at night (I've had problems with insomnia off and on for ~20 years). RE: the OP, I'm in my mid 40s and have always had some issues with following through and not procrastinating, and my sister was recently diagnosed with ADHD, so it's probably something I should at least discuss with my doctor at my next physical.
• pbiggar 4y ago
  Similar thing for me. Went to see a psychiatrist for memory issues, she diagnosed ADHD, and a bit of ritalin helped me focus a lot.
• bvanderveen 4y ago
  A tautology: Adderall improves everyone’s ADHD symptoms! <=> ADHD is just what life feels like when you’re not on speed. Cut down on pot and booze, move your body, avoid stressors, and take control of your things in your life. Don’t rationalize/medicalize your way into a permanent cognitive disability. You’re in control!
  • deleted 4y ago
    [deleted]
  • annie_muss 4y ago
    ADHD does real damage to people's lives. Unemployment, divorce, secondary health effects. These are serious issues. The disorder is bit sooner vague feeling of disorganization. Before I was diagnosed I had a good exercise habit, ate well, used a calendar and a todo list and my life was still a mess. After getting diagnosed and medicated I see a steady gradual improvement in all aspects of my life.
  • waprin 4y ago
    5 years ago I would have downvoted you. Based on some unfortunate personal experiences I have to emphatically agree. I would also throw cut down on social media / porn / addictive games as very important if you’re identifiying as ADHD. Amphetamines like Adderall have issues with long term tolerance and can have adverse effects on your cardiac health and mood, both of which I unfortunately experienced. They mostly work by spiking dopamine which there are non pharmaceutical ways to accomplish such as cold water therapy and being more cautious with your baseline dopamine levels (hence the importance of avoiding cheap , easy spikes of those levels). It’s obviously a complex issue still being figured out by scientists but there is a zeitgeist pushing people towards pills as the simple solution when increasingly the science demonstrates that lifestyle change is both more effective long term and lacks adverse side effects. I do think psychiatric meds can be appropriate in extreme circumstances and in cases where they temporarily help people “course-correct” . But people viewing them as a panacea because someone’s having a stimulant honeymoon should dig deeper. Finally, I get ADHD meds advertisement on Facebook constantly. There is simply a financial incentive to push people towards pills over lifestyle change and it’s irresponsible to pretend that doesn’t impact any narratives.
• potamic 4y ago
  I've seen a few anecdotes of people starting ADHD medication and seeing drastic improvements immediately. But at the other end, also some from people who regret going on medication, that it is more depleting than helpful in the long term. Would love to hear any experiences from people who were able to successfully treat the condition and wean off the medication for good.
  • phaedrus 4y ago
    I got diagnosed late as an adult and was on ADHD medication for a year or two. It allowed me to actually get things done in my work and personal life like paying bills on time, making appointments, setting up retirement contributions, and filing work paperwork on time. Being able to sit down with the intent to do something and just... do it... was something I never experienced before. It was very much akin to getting glasses the first time after not knowing you needed glasses. I did worry the stimulant effects of the medication led to me daydreaming "fanciful" ideas that I questioned whether I would have found as profound if not on it. And my wife felt that it made me "snappy". But otherwise I found it helpful and the benefits well worth the side effects. Why I ended up going off the medication came down to the inconvenience of filling it monthly culminating in not being able to get it. I don't know if it's like this across the USA or just my state (or just how my doctor's office did it?), but I was required to obtain a handwritten/hand-signed paper prescription chit from my primary care provider every month. I couldn't get 90 days' supply, I couldn't use the Pharmacy drive-thru when filling it, and my wife couldn't pick it up. I had to physically go in the doctor's office and pick up a piece of paper with a scribble on it and physically go in the pharmacy to fill. Even medicated, remembering to do this every month is challenging for a person with ADHD. It came to a head when my primary care provider hired a new office worker whose job it was to be a middleman between the doctor and managing prescriptions. There ended up being some sort of communication breakdown and my prescription chit wasn't ready, then the doctor was out, then I thought the middleman guy was reassuring me he was going to get it taken care of by Friday, but he was actually telling me I needed to get it taken care of before Friday - something like that. By that time I had run out a couple days before, and as often happens with Murphy's Law, it was going into a long weekend due to a holiday so it would be four days before the doctor was back. I ended up going through cold-turkey withdrawals which were pretty awful. By the time my doctor's office was open again, I was fed up with everything. I had already gone through the worst of the withdrawals by this point. Instead of restarting the medication I decided why not just finish getting over it and never have to deal with this again. Even though I don't take ADHD medication anymore, I still feel like the experience of having once been able to know what it's like to be able to sit down and pay bills or get boring work done still helps me. It's harder now, but just knowing that it is possible to do is like the difference between seeking a scientific discovery you don't know if it exists versus trying to engineer an experiment you know what the outcome could/should be.
• thebigspacefuck 4y ago
  I got on meds for ADHD and they objectively didn’t help that much. I also felt like my pulse and emotions were greatly elevated in confrontational situations to an uncomfortable extent (though caffiene was involved). The other aspect was that it was almost $300/month for a prescription. In social situations they did help a bit. Any impact on productivity was minor. I’d also say right after the meds kicked in I would do something like get on hacker news and write a long post about how everyone should get their ADHD checked and how life changing meds are. That always felt like the meds talking to me. Not that anyone shouldn’t try it. I’m glad I did, even though I decided it wasn’t for me, because otherwise I would be wondering how much better I would be on meds. Now I know for me it’s not much better.
  • bmitc 4y ago
    Is it possible that you don't have ADHD? I am not an expert, but it is my understanding that the medications affect those with and without ADHD totally differently. In reponse to the original post, I don't think psychiatrists are really the ones who should be diagnosing ADHD. It is again my understanding that neuropsychologists should be the ones administering the tests and diagnosis, where psychiatrists will then manage the medications. For myself, I was convinced that I had ADHD but went through neuropsychological testing. It turns out that the primary diagnosis is that I just have severe anxiety, which shares a lot of the symptoms but with completely different cause mechanisms.
    • mid-kid 4y ago
      Not all medicine, and especially not adhd meds, have the same effect on everyone.
      • bmitc 4y ago
        Yes, of course, but in this specific case, it is my understanding the effects are opposite, as in calming versus agitating.
        • runnerup 4y ago
• ynniv 4y ago
  I did the same two years ago and it's been transformative. There are people who will tell you that medication isn't a complete solution, or that it's not the best one. They're not wrong, but telling someone who is drowning that they just need to learn how to swim isn't doing them any favors. I was 40 when I was diagnosed, and understanding the implications of that diagnosis has made my life much better. My first couple weeks of medication made me far more aware of the people around me, which was totally unexpected. I wrote down that it was like putting on snow shoes, or adding a block warmer to your car. Obviously those metaphors won't mean much to people who didn't grow up in a cold climate, but the crux is that easy things are much harder than they are for other people. The weird part is that because you're so used to easy things being hard, hard things aren't that much harder, and when you're warmed up you perform as well or better than your peers. But soon everything cools off, and making a sandwich is a grueling decision again. One thing that eventually pushed me towards trying medication is that I realized I had already been self medicating with coffee. Sometimes when people say "they aren't a person until they've had coffee", that might be true. The problem is that coffee lasts an hour or so and makes you jittery and hungry, while Adder-all lasts 4 ~ 8 hours and mildly suppresses your appetite(s). They're not wrong: sleep, exercise, diet, being social, etc also improve your emotional state, but when making a sandwich seems impossible, the first step might be to stop drowning.
  • falcolas 4y ago
    > I had already been self medicating with coffee Very much this. The nice thing about stimulant medication is it provides more of the ADHD brain regulation with a lower impact on your body (jitters, increased heartrate, etc).
    • ynniv 4y ago
      You do need to lay off the coffee for a bit though. At first I stopped altogether, then went back to some decaf, now I'm back to drinking some regular, but always careful about how much. Also, decongestant medication, though Adder-all is a mild decongestant so I don't use separate decongestants very often.
• zug_zug 4y ago
  Interesting. I'm among the wide swath of people who is trying to decide exactly what proportion of my disinterest in work comes down to me. But I'd love to hear from people who have been sticking with a drug for over a year (or conversely people who tried a drug but it didn't stick for a full year)
  • falcolas 4y ago
    I've been on them for closing in on a decade. My dosage is stable, and they make it possible to use other coping methods. Which is to say that without meds, I can't concentrate long enough to use a coping method, or the coping method just doesn't work. "You can't sit down until you do X" doesn't work when you're bouncing all over the place, or hyperfocusing on Y - when your brain can't concentrate enough to view sitting down as a reward.
• whalesalad 4y ago
  Do we all have ADHD or are stimulants just good? Seriously. Pretty soon all of us will be on legal meth and we sit back and go "hey this is fun I get this from my doctor it's good" and yet as a society we judge meth, crack and cocaine addicts. Nearly anyone will respond well to a stimulant.
  • phaedrus 4y ago
    The difference is a person with ADHD will be calmed by a stimulant rather than amped up by it. The ADHD brain can't focus because it doesn't produce enough dopamine to reward the neural circuits for maintaining focus. So there's this paradoxical effect where something that in typical brains would lead to hyperactivity leads to calmness and clarity in an ADHD brain. It's qualitatively different.
    • whalesalad 4y ago
      this is the classical DSM-V answer you hear thrown around but honestly times are changing, our understanding of this disorder is changing, and I do not think that is unequivocally true.
      • deleted 4y ago
        [deleted]
    • frgtpsswrdlame 4y ago
      I don't think the way you've phrased it can possibly be true. I would assume whether you have ADHD or not an amphetamine is going to raise your heart rate.
      • falcolas 4y ago
        Not at ADHD clinical doses. And not all ADHD meds are stimulants.
    • deleted 4y ago
      [deleted]
• psyman 4y ago
  Good for you, unfortunately some of us with ADHD want to fly airplanes, and soon enough, realize that the FAA still lives in the early 1900s, where you have to "man up" and "deal with it". So we just silently suffer, every single day.
  • falcolas 4y ago
    As a former pilot with a late-in-life diagnosis of ADHD - I'd not want to be a commercial pilot. I'm legitimately concerned of a loss of concentration during landing. Looking back, I saw a few of those happen in my training and in my solo flights. It's a risk v reward decision, one which I fell on the "nope" category. :)
    • psyman 4y ago
      I have no intention of commercial flying, though I can feel the pain of commerical pilots suffering from ADD. Ironically, the only time I am not able to "not concentrate" is when I'm flying the plane, as flying requires a state of constant change of focus, i.e. radios...instruments...see and avoid...controls...ipad...etc
      • falcolas 4y ago
        > as flying requires a state of constant change of focus That didn't work too well for me, since I'd hyperfocus on one thing (my heading, rate of turn, altitude, etc) and develop blindspots to the other 5 instruments. Not to mention radios and checklists and visuals and maps, etc. And god forbid I had to use my flight computer (the rotary slide-rule type, ipads didn't exist then). That thing was pure crack to my brain. Instrument flying is when these weaknesses became most apparent to me. VFR was enough like driving a car that it wasn't as much of an issue.
  • ryandrake 4y ago
    It's nuanced, and explained pretty well by this HN commenter[1] in a past article. Generally ADHD that is currently being treated is disqualifying, and reliance on medication is definitely disqualifying. Past diagnoses are a toss-up and you're gambling on the system / your AME. 1: https://news.ycombinator.com/item?id=25996306 https://news.ycombinator.com/item?id=25996306
• sokoloff 4y ago
  If you think you may have mild ADHD and have desires to become a pilot, you are probably better off going without a diagnosis. You won't be able to fly if you're on any medication for ADHD and will have hoops to jump through if you have a history of diagnosed ADHD even if you're not taking medication for it. (If you have severe ADHD, becoming a pilot is probably contra-indicated anyway.)
• green-eclipse 4y ago
  Not ADHD, but some similar symptoms for me. I could not focus on anything at work. Massive procrastination. It was just brutally painful to try to finish things I was working on. Long story short: the culprit was sleep apnea. After a sleep test, I got a CPAP machine. After a bit of time to adjust to the equipment, it made a profound change to my life. The next year or so was perhaps the most productive of my life. My boss & coworkers remarked it was like I was a different person. Good quality sleep is important, it turns out! (Side note: I dropped into REM sleep before my CPAP machine, with lively dreams and stuff. So I didn't really think I had apnea. My faulty mindset of apnea was that you basically couldn't dream at all. But once I had the CPAP machine, my dreams turned into unreal, epic sagas, as my brain started to repair and catch up on all the REM sleep it had missed over the years. My dreams are no longer so crazy, but that first 3-4 months was really interesting)
  • haffi112 4y ago
    What made you decide to get tested for it?
    • kawfey 4y ago
      In my case, my wife complained of my snoring. I also have been tracking my sleep every night since like 2013 with Sleep Cycle, which records snoring. I never snored, until last December. It recorded me snoring 20-30 min per night, which is a lot. Plus, my dad has apnea. Plus my Apple watch notified me of a SpO2 < 90%. At-home sleep test indeed confirmed apnea!
    • green-eclipse 4y ago
      Wife told me I was snoring. But then my dad was diagnosed with apnea, and I decided to get a test. So glad I did.
  • pomatic 4y ago
    This, I was permanently exhausted. On a bit of whim, I bought a Chinese SpO2 sleep monitor - which then lead to a conversation with my GP and access to further tests, and ultimately a CPAP.
• carapace 4y ago
  A friend of mine who's a neuroscientist likes to say, "Psychiatry is not a branch of medicine." He means it in a constructive way, the implied follow on is "that would be good though, and we should strive to do that." My point is, there are lots and lots of different kinds of therapy, and lots and lots of variation in therapists. If you are having problems seek help please! You're not in this alone and it's important to take care of yourself. My advice is to try several different therapists until you find one that helps you. OP got lucky, the psychiatrist they met didn't try to have them committed or anything gnarly like that, and it sounds like they got good results from the weekly therapy with a psychologist and some medicine. You might not be so lucky. Start with diet. Most of us are making ourselves sick by eating some kind of crap. Check physical things: are you getting enough sleep? Too much light or noise at night can act like slow poison. Or you might have sleep apnea!? Is your house next to a freeway or an airport? Some chemical source? Does your spouse or child or neighbor drive you crazy? Your commute is too long? Next, try mechanical interventions: massage, Rolfing, etc. If it's not food, environmental, or something in your muscles or bones, then maybe just maybe you might need therapy of some kind. Scientifically, we are no better off than witch doctors and fortune tellers. Psychiatrists are trained as medical doctors, which is strange when you think about it, because they don't use any of that training in the practice of psychiatry.("Psychiatry is not a branch of medicine." is "funny" because it's true.) (E.g. When you go to a psychiatrist they do not draw blood. There's no point because there's no tests they can run on your blood to know what's wrong with you "psychiatricaly" (because that's a word that means "Western-flavored voodoo".)) So, to sum up, if you got problems get some help. But beware of psychiatrists because they are even more crazy than most therapists and they often have leverage with hospitals and police to do really messed up violations of your human rights if they get the idea that you have "demons in your blood" (demons with names like "Schizophrenia" and "Bipolar". They can conjure with these names to put you in jail for days or longer even if you have committed no crime or criminal acts.)
  • ecshafer 4y ago
    The reality is that Psychology and Psychiatry are not built on top of science and are in no way legitimate studies of science or medicine. They have a loose cargo culting of science, built on some philosophy of the mind, but they are illegitimate and given far too much credence in our modern day society. The fields have basically 0 studies that have been reproduced in the last 100 years, have no theories that can be proven as per mechanism, just some loose studies on a few people with surveys.
• friedman23 4y ago
  I had the same experience. Recently got put on vyvanse and have been on it for 2 months now. My life has changed over night. I used to struggle to wake up to the extent I needed to keep the window open at night and set multiple alarms. All the coping strategies and social pressure I had when working from the office disappeared due to WFH and I could not get myself to do anything. It's hard to describe to people what it's like to not be able to do something you actually want to do. Every night before bed I'd tell myself, "tomorrow, I'm going to get out of bed and get ready for the day in 30 minutes" and I would constantly fail at this simple thing. I would stay in bed for 2 hours awake wanting to go and do things but it was just so hard.
• max182 4y ago
  I was self medicating with massive amounts of nicotine and coffee, which probably was worse for my health than ADHD meds. Before I was on meds I was all over the place, could hardly write code even though I knew what needed to be done. Got booted from company I started because of ADHD/Depression. Didn't graduate high school. All the signs were there. I just started seeing a psych from Stanford and he dismissed a lot of my preconceived notions around taking medication. I was almost homeless before I started and thinking about working construction. Started meds. Got a FAANG-tier programming gig without even studying for the interview. No harm in trying things out if you're having trouble. I can take an Adderall and take the best nap of my life which is the exact affect it should have.
• thenerdhead 4y ago
  Sometimes you need help from others before you can help yourself. Good for you to go get the help you needed.
• piva00 4y ago
  I brought up here on HN in a similar ADHD thread just a couple of months ago that I was going through an investigation with my therapist for ADHD. Yesterday we finalised it and I got the diagnosis, I have ADHD. When reading through resources like this: https://invisibleup.com/articles/27/ https://invisibleup.com/articles/27/ I could relate to an extreme extent to a lot written there. Both in the blog post as in some of the further resources linked in the end. I've gone downhill since the pandemic started, it was bad before but I've definitely tumbled down (and hence why I also started searching why I was like that). Initially I thought it was just some bad behaviour: being lazy, being tired and/or that my anxiety was getting worse due to the pandemic. I never had major issues with anxiety before but it runs in my family and I started feeling it physically. Yesterday I finally understood myself better. I've felt guilt and shame through my whole life for simply not being able to perform with the same work ethic as my peers. Guilt and shame for feeling overwhelmed when I have tons of messages from friends and family to answer. Guilt and shame for procrastinating seemingly mundane tasks, being a time optimist when planning my day, not being able to organise myself with to-do lists and long-term planning, etc. I did very well in school but could never do homework, or any kind of school project I wasn't interested in the subject. Just sheer pressure from stress could move me to do the minimum to get a decent grade. On the other hand, the projects I had an interest about the topic were always a breeze, I'd go above-and-beyond the assignment because I had so much fun with it. I collected many hobbies and always thought that was fun and exciting, lately I've been more overwhelmed by the feeling of never actually finishing a project or getting as good as I would like to in some skill/hobby. At work I've always been productive in the end. I've always delivered the projects I've worked on but I learned strategies to do it. If it's boring work I'd fiddle around, with bouts between procrastination and discovery work, to find exactly why something was requested, how that ties to a larger vision. Then I'd develop a personal vision for the project matching the "why"s of requests/plans with my overarching story and view of a codebase or product, just so I could have a thread that made sense to me and kept me interested. When I found those I enter a hyperfocus state and just work until the vision I created in my head is achieved, I've been very good in finding ways to match my visions to the overall business needs, and also being able to pushback on things that I believe don't make sense when considering all the constraints and needs. This ability to pushback has been praised multiple times in my career. I think the near future holds for me a slow discovery of many facets of myself, facets that I always treated and viewed with shame and guilt for feeling inadequate and not living up to expectations, not being able to just do work on boring tasks that others seemingly do with a breeze without caring too much. Just sharing my experience as it's extremely fresh in my mind and life, I'm still going through the acceptance that I might just have a brain that works in a different way. It's a little bit refreshing and relaxing while at the same time still making me think that I'm just faking it. That I'm actually just lazy, disorganised, etc. It's a strange feeling, like I'm gaslighting myself. Only doing this investigation I discovered that my parents and siblings always saw these behaviours in me, my therapist interviewed them and the way they talk about me as a child ticked so many boxes. I might not be the cliche rowdy boy that never keeps quiet or stays put but I've always seek stimuli, I've never had a moment in my life where my mind was actually quiet.
• teucris 4y ago
  > and it got worse due to a more demanding lifestyle. Thanks so much for posting this! I went through a similar journey about a year ago. I was told I had been able to work around my executive dysfunction until I had kids. But even “working around” it, ADHD was holding me back. A manager at one point described me as being “stuck in second gear”. I may not be in fifth yet, but I’m definitely moving faster.
• specialist 4y ago
  Agreed. I struggle with focus and executive function. It took me years to get actionable diagnoses. Though my root cause was ultimately physical (pinched nerves in my spine), addressing the mental health aspects is also required. The kinds of stuff addressed in the book The Body Keeps the Score. The skills and knowledge I learned from Swedish Pain Services were the missing puzzle pieces for me. My life advice to all other patients: 1) You must have a patient advocate. Life coach, fights for you, keeps you accountable. 2) Never accept "no" or "I don't know". Someone, somewhere has the answers you need. Keep digging.
• deleted 4y ago
  [deleted]
• wintermutestwin 4y ago
  My anecdata on ADHD: I know someone who was diagnosed around age 8. Her parents declined to give her the speed that was recommended. When she was 12, she went for a run one morning and found that it made a huge difference in her ability to focus and maintain emotional equilibrium. She ran as many days as possible since that first run and runs ~12 miles a day (in addition to doing multiple team sports and weightlifting). She is doing great in life - about to finish college and is generally happy. She's quite dependent on her exercise though and if she misses a day for some reason, she is pretty miserable. I'm not a doctor and have no idea if this would work for anyone else, but I have to think that there are better solutions than giving people speed.
  • bobleeswagger 4y ago
    It's not speed. How in the world is this myth still around?
    • wintermutestwin 4y ago
      https://en.wikipedia.org/wiki/Adderall https://en.wikipedia.org/wiki/Adderall Isn't amphetamine = speed?
      • bobleeswagger 4y ago
        METHamphetamine is speed. Adderall is adderall. Why be this way?
        • wintermutestwin 4y ago
          I am being quite sincere. It was an honest question. When I was in HS, long before Breaking Bad and Meth, party kids took "speed," which was amphetamines. https://en.wikipedia.org/wiki/Speed_(disambiguation) https://en.wikipedia.org/wiki/Speed_(disambiguation) To reiterate from elsewhere in the thread: My point is that if there is a chance that a reasonably healthy habit like running could possibly alleviate ADHD symptoms, wouldn't it be clearly better to try that before giving kids drugs of any sort? I am stating that as an opinion - not a fact.
• bottlepalm 4y ago
  Has anyone ever gone to a therapist where they weren’t recommended weekly sessions?
• joshcsimmons 4y ago
  Psychologist? Yes. ADHD medication? No. Ritalin, Vyvanse, et al. are are legalized forms of speed. They mask the issue and will erode your reward system's ability to work naturally. > Following advice from my wife, friends, father, and here on HN, I looked for a psychiatrist to understand what was going on. After a lengthy consultation, the doctor told me I most likely had ADHD, and it got worse due to a more demanding lifestyle. To a hammer everything is a nail, why did you not see a psychologist first to see if the condition could be improved with lifestyle changes? --- I am concerned because I have worked with so many people in tech that are on legal speed and I believe that this medicated state of productivity will become the norm in our industry as we continue to lose focus on the aspects of life and work that make us human.
  • uberduper 4y ago
    You should probably educate yourself on the topic before jumping feet first into making such absurd accusations.
    • gjvc 4y ago
      Big Pharma applauds your confidence.
  • striking 4y ago
    Lifestyle changes work for some people, but coping with ADHD is not for everyone. Most of the folks taking the meds are not looking for some "medicated state of productivity" that is beyond human, they're trying to stop feeling the urge to get up and run around during meetings. I spent 24 years of my life without the meds. When I started taking them, I didn't become substantially more productive at my workplace. I became substantially more able to deal with my personal life, my chores, my upkeep. That's it. And I felt like I had been wasting so much of my life looking for coping mechanisms, like I hadn't fully lived until I started taking them. Or to put it briefly, the fact that I wasn't medicated made me feel less human, made me less able to enjoy the aspects of life and work that make us human.
• madaxe_again 4y ago
  I have had quite a number of professionals tell me I have ADHD - but I do not believe them. Firstly, I only loosely fit the diagnostic criteria. I am more inclined to think that that which they identify as ADHD is just me being a lazy and impatient asshole - I could probably act differently if I cared enough to try, which I kinda don’t. I can make myself focus myopically on practically anything, which is, as I understand it, contrary to the core facets of ADHD. My life is a garbage fire on a train wreck, but that’s ok, it takes me interesting places. Which brings me to secondly - I have a problem with even accepting that ADHD exists. So many kids at school would go get diagnosed as ADHD or dyslexic or whatever, when they patently weren’t, so they’d get the extra time and grade bonus in exams. So many other kids would be forcibly diagnosed and drugged, when all that was wrong with them was that they were being bullied. It feels like the psychiatric industry invented a new product to sell, and needed a diagnosis to stick it on. It’s convenient for schools, as you can label and drug anyone who shows any hint of individuality, and likewise for parents, as it allows easier management of vivacious children. For adults, it’s convenient as an explanation for failure to meet one’s own expectations in life. Me, I just accept that I am a bit of a disappointment - “If madaxe would only apply himself, he would be an exceptionally brilliant pupil”, said everyone, ever - and I do not like to apply myself, as as I said, I am a lazy asshole intent on coasting through life.
• nvarsj 4y ago
  I'm becoming more of an adult-onset ADHD skeptic. I mean, there is even a crisis now because of an Adderall shortage [1]. People who legitimately need them (they cannot hold a job without it) are not able to get them. I think there is certainly a spectrum of ADHD. Those with severe ADHD literally cannot function in society, they can't hold jobs, they can't get university degrees, without medication. Then you have the mild ADHD induced tech worker which is becoming more prevalent. Yes, meds are going to help as well. Possibly less social media, less dopamine hits, more exercise, and better sleep would help too. Another thing to keep in mind is that burn out symptoms look an awful lot like ADHD symptoms. And burn out is very common in our industry. 1: https://www.fda.gov/drugs/drug-safety-and-availability/fda-a https://www.fda.gov/drugs/drug-safety-and-availability/fda-a... edit: Updated to be clear I mean people being diagnosed with ADHD as adults, not everyone with ADHD who is an adult.
  • thenaturalist 4y ago
    Are you affected by ADHD? Do you know someone really close to you affected by ADHD? I am really frustrated by regular people with affiliation to the tech industry at best and stories about chemically induced productivity enhancement "lifestyle" experiments to question the existence of the condition. I am right there with you when it comes to criticizing prescribing stimulants to anyone on a whim. I can say that here in Germany any typical diagnosis includes submitting early school year report cards to establish the fact that what the patient is describing as lived experience was already recognizable during child/ early teen years. I can say that getting the diagnosis and access to medication has been absolutely life changing. I am 30 years old. I can say that having talked to other adults who were diagnosed late, they mostly share this perspective. People are really suffering and anyone discrediting that fact is piling on top of said suffering for literally no reason.
    • nvarsj 4y ago
      I believe ADHD exists. I've worked with children who have moderate/severe ADHD and it is very apparent. What I'm skeptical about is the rise in ADHD cases only diagnosed in adulthood. I think there are likely other explanations for it rather than ADHD.
• anonym29 4y ago
  For struggles with executive functioning like you are describing, traditional ADHD meds (variants of, and combinations of variants of amphetamine salts) have been demonstrated to increase self-reported perception of productivity more than actual productivity. Try out Modafinil or Armodafinil sometime. They are not chemically amphetamines, and the actual productivity increases on those appears to match the elevated self-perception, rather than falling short.
  • danr4 4y ago
    where is it cited?
  • Spooky23 4y ago
    Before doing that, make sure you’re taking care of other aspects of your health. A colleague was struggling with what he self diagnosed as ADHD, but after being dragged to the doctor by his wife, he was actually having blood sugar problems.
• pdntspa 4y ago
  Sure, better get on that 6 month waitlist!
• vbezhenar 4y ago
  My personal anecdote. I have issues with focusing and prioritizing work. What helped me is getting a work with absolutely floating work time. For example today I went to work office at 19:30 and I'm going to leave it at 7:00 or something like that. It doesn't matter. What matters is: I work prolonged hours (because I still procrastinate, but I've found out that I start to focus on work after 4-5 hours or something like that. And I can sleep as much as I need, without any alarm clock or calls. I usually sleep 8-9 hours, my whole day is something like 25-27 hours, so it's slowly rotating. With these weird conditions I'm starting to unleashing my potential and it makes me feel so much better than before. When I'll get to work "late" to 11:00 in a sleepy state, will procrastinate until 18:30, when office is closed I'm going home without completing good work, then work overtime to finish sprint, getting burned out and this cycle repeats again. I don't think that my current life style is sustainable and I plan to adjust it to a "normal" style slowly, but it's important to feel that I don't just slack at work and I actually do enough work to warrant my salary. This makes my soul happy and then I can move on with other things. Because when I feel uneasy, I can't really proceed with anything. I don't trust psychiatrists, but it's just me. I prefer to find issues and ways to solve those issues. I tried to visit psychologist, but I felt that it's absolute loss of time and money.
  • orev 4y ago
    It sounds like you might have a sleep problem instead of a focus problem. Without good sleep, you can’t focus. One thing to try is melatonin (0.3 to 0.5 mg). Take it around 8:30 PM, then stay up past the point it makes you drowsy (it will kick in in about 30 minutes after taking). Got to bed at a normal time like 11:00 PM. You’ll probably wake up around 7:00 and be wide awake, and have much better focus during the day. Doing this will help you align to the rest of the world’s schedule, which like it or not, is really when most people are expected to be working and available, and will also help to align your social schedule with others.
    • lewispollard 4y ago
      Fwiw, I believe there is a significant correlation between ADHD and sleep disorders (at least, that's what my psychiatrist told me when discussing my sleep problems during an ADHD checkup appointment recently - but I haven't researched this independently), so it's not necessarily one or the other.
• tarokun-io 4y ago
  I got on ADHD 2-3 months ago and my life changed. Up until now, every day was an uphill battle, causing me tons of stress and anxiety. I, too, self-medicated. I never thought anything of it because I was always able to work and finish stuff. It was my normal. Now I know it shouldn't be that way. I did try many other options before starting meds. They helped a little bit, but not significantly.
• bergenty 4y ago
  Is this really all that surprising? I’ve taken adderall a few times and it becomes very, very easy to do a lot of work. It’s an amphetamine.
• uuddlrlrbaba 4y ago
  This approach sounds lovely, but have you tried scrolling HN comments for hours instead?
• kstrauser 4y ago
  Please tell me how you got it taken seriously. I feel like this is literally killing me with the stress it causes, and I discussed it with a psychiatrist. Their response was "your coping mechanisms seem to be working, so why upset the cart?" Well, because I'm spending an incredible amount of energy on said coping mechanisms. Yes, I'm doing OK for myself, but I wish it didn't involve heroic efforts. Posted under my real name because I'm beyond sick of this being some kind of a taboo. No one's ashamed of talking about, say, thyroid meds.
  • jasonladuke0311 4y ago
    Find a specialist that works primarily with ADHD patients. I never felt like I was taken seriously until then.
  • y-c-o-m-b 4y ago
    I went a different route. I went through my primary care doctor. I told him I'm getting in trouble at work due to procrastination and lack of attention. I also said my wife and friends/family have been complaining that I never listen anymore. I asked if I could be evaluated for ADHD. He sent a referral to a provider with https://lifestance.com https://lifestance.com. It was only two appointments with the LifeStance provider to get a diagnoses. Once my doc got the diagnoses back from LifeStance, he's been in charge of prescribing the meds.
  • thegginthesky 4y ago
    I searched for a specialist in the area that worked with mainly ADHD, Eating Disorders and so on. In my country, it's easy to find one if you are willing to pay out of pocket, you can also try insurance but the quality of processionals depends on the city you are in. After I found a few, I was brutally honest with them. I told them about how I truly felt, as for example, when overwhelmed with things around me my mind blanked and I lost complete focus on anything. I settled with one that had a more balanced view, listened to me, gave me practical advice, and didn't rely on the on just meds or the strongest med. When it comes to specialists, it pays to search. Although the first consult can be expensive. It's also good to do prior research on their name, my specialist had mostly very positive reviews on many sites, and the reviews didn't seem bots or friends and family.
• rs_rs_rs_rs_rs 4y ago
  "Nothing like regular amphetamine use to make you appreciate how dumb a lot of normal, non-medicated human experience is"
• vcvzsa3221 4y ago
  yes taking amphetamines generally makes people more productive
• luxcem 4y ago
  I don't know if it's only the Baader–Meinhof phenomenon or a real impression but for the past few weeks I've seen a lot of testimony and articles on ADHD (on hn and other media). Some friends also started to mention it more than before. I always recognize myself in those testimony and I think it's time to do something about it. So thank you for your message!
  • zorr 4y ago
    I have noticed the same thing lately. I don't think it's Baader-Meinhof as I've seen my personal BM-uptick in ADHD content 2 years ago after my own diagnosis. My theory is that it is a general increase of awareness around both ADHD and autism (and some other neuro-divergencies) in mainstream media. Fueled by the pandemic/lockdown situation which seems to have surfaced a lot of pre-existing ND problems for many people. I'm in Europe and before COVID, going to a therapist was often viewed as only necessary for trauma. During and post-COVID everyone and their dog is seeing a therapist for focus/burnout/anxiety/motivation issues. Which could lead to an increase in diagnoses, which in turn leads to more people talking about it. Feed that into the Twitter/TikTok/Insta feedback-loop combined with the media jumping on it and we get the current situation. It's either that or the vaccines do cause autism... /s
    • dataexporter 4y ago
      My guess is that the increase in number of posts related to ADHD could also be attributed to a form of astroturfing by YC Companies (Inflow - one that I had seen being recommended a few weeks back).
      • zorr 4y ago
        That sounds plausible as well and I don't think both theories are mutually exclusive. The Get Inflow LTD was incorporated in May 2020 which loosely fits the above COVID-induced mental health crisis narrative. A worldwide event like that has an impact across various fields. Just like we've seen a general uptick in video-streaming and remote working tech companies since then.
  • 4y ago
• OhNoNotAgain_99 4y ago
• mawadev 4y ago
  I tried taking medication to deal with a demanding lifestyle before, but then I analyzed how my environment shaped me. Turns out I spent most of my waking hours at work and no matter how much I optimized myself, it never stopped. What helped was switching jobs and where I live. I simply needed to do maintenance on the base levels of the hierarchy of needs to keep the upper levels intact. It may not work for you, but most of your effort should first go into evaluating whether what you do still works in your favor.
• Dendilion 4y ago
  Thanks to Ritalin I'm were I'm today. Unfortunately it also made me more annoyed so I stopped taking it after taking it a long time. Still think it's super shitty that it was so difficult to try it in the first place.
• throwaway_51122 4y ago
  A slight semi-tangential/related question for OP/others who've benefited so much from medication - did you receive any guidance from your doctor on how to use it, or do you use any strategies you figured out yourself? I have been prescribed (generic) methylphenidate, but the doc essentially told me "Take the tablets twice a day, good luck!". The medication does give me more mental energy, but it's much closer to "being on a rollercoaster" where you're being flung around than driving a sports car that you're in control of. (I haven't received any particular guidance/therapy etc.) To give an example, if I take my dose when getting ready, I'm probably going to be focusing too much on moisturizing my face or arranging my bag, rather than using the energy boost to "just" get off my butt and move out. I should probably add that I don't have very good structures/schedules in place. I really would like to help "tame" the med and would be grateful for any HN'ers help/suggestions!
  • rumblerock 4y ago
    As someone who just started on methylphenidate this year with good results: - I initially started on Concerta but found that I was burning through the dose way faster than advertised (4hrs vs 8hrs) and experiencing an unpleasant crash at the end where I felt zoned out, emotionally flat and unable to focus at all; and this was with the supposed holy grail Janssen variant. - IR was slightly better but the rush up and crash down wasn't stable enough for me throughout the day, and managing the doses is an imperfect science / requires awareness of time (obviously not my strong suit). - Going onto an XR variant (generic for Metadate, capsule with extended release beads) has been the best so far. It lasts throughout the workday, has a smoother onset and "landing" that for the most part doesn't send me into a crash, and is available to me as a very cheap generic. - I take it first thing in the morning, take my dog out for a walk (~30 mins), and the timing works out perfectly for when I get back and get started with work. If you have a gauge of how long it takes to start working, then maybe work backwards and build a routine around that (e.g., when you arrive at work, before you leave, etc.). Ideally it's latched to something in your existing routine so you don't forget. - Regarding the period where medication is wearing off, this tends to align with when I finish up my work throughout the day (which the proper dosing should achieve), and I usually go to the gym to lift weights shortly after. This works for me as a transition to doing something productive / good for my health, and the exertion seems to help with the slight withdrawal sensation during this period. Otherwise I tend to trail off into mindless internet browsing once I check out of work. - Organization-wise I just maintain a simple to-do list so I have it on hand when I get started with my day. It seems to work best when I have it updated from the day before so that I can just sit down and get started without having to figure out what to do first. Granted I do still have a tendency to jump around between things throughout the day, but having that reference on hand definitely helps me to stay productive instead of going down rabbit holes. - I also somehow semi-quit social media after years of trying to no avail. Namely Instagram, which for me was the lowest resistance / easiest to slip into an endless time-suck on, as well as my Reddit homepage (I only check two sports subreddits which don't move that quickly). I hid Instagram from my home screen, and created two browser bar bookmarks to the individual subreddits to avoid going to the homepage so if I have an impulse I can take a quick break, but won't have enough content to stay on for long. The endless scroll is a son-of-a for folks like me. YouTube time has gone up, but at least with the content I watch there I'm learning something related to my hobbies. - I'm sure you already know but always good to mention food and water, I went through a short stint where I had to take antacids because the combination of medication + some acidic foods (I think it was greek yogurt) were messing with my stomach. Definitely still doing some fine-tuning myself, but the medication has been so helpful in the sense that I can actually implement lifestyle / habit adjustments without them immediately falling by the wayside. Currently my main issue is managing my sleep schedule - I've always been a night owl but also know that I feel much more calm when I can wake up earlier and get a good start to the day. Seasons have also always hit me pretty hard energy / mood wise, especially during the daylight savings transitions. I use light therapy to help stave that off.
• Apocryphon 4y ago
  Can anyone elaborate on their ADHD diagnosis experience? The questionnaire-driven, experience seems very subjective. Has anyone tried a more extensive test, what does it entail? Doesn't it cost thousands of dollars and is not covered by insurance?
• achrono 4y ago
  In the same boat as your previous self, thanks for this timely reminder. What did therapy look like? What were the most impactful things for you?
• BulgarianIdiot 4y ago
  So. What medicine?