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I have moderately severe ADHD, and have good reasons to not use medication. My first response to this is that it solves problems that I don't have, and ignores

by btilly 3y ago

I have moderately severe ADHD, and have good reasons to not use medication. My first response to this is that it solves problems that I don't have, and ignores the ones I do have. Organizing my day on paper is trivial. I'm also married to someone with a good partnership, and we offload different types of tasks to each other. She might enjoy having software assistants to be more productive, but I don't need that. I have her. The trick for me is that it is important that my life be organized around engaging with things that I want to do. And thereby having my wants reinforce executive control so that I can do what I think that I should. This involves a lot of managing of my emotional state, and a lot of REJECTING of outside demands by the world that I conform to how the world wants me to be. I see nothing about this app that helps me do either thing. Yes, yes, I know the idea of eliminating distractions so that I can focus. Honestly, that's crap that leads to disasters every time I try it. If I have positive motivations to do X, distractions are easy to set aside. If motivations are negative, I will be unable to resist creating distractions. And a straightjacket that prevents that leads to insanity. Which returns me to my point. The key, for me, in handling ADHD is emotional tools to find positive motivations, and social tools to resist the world attempting to load me with tasks through negative motivations.

mrcncpt 3y ago
I've never heard this take before but it makes a lot of sense. Do you mind clarifying the kind of emotional tools you refer to?
- btilly 3y ago
  Mostly a lot of mind-body stuff to develop self-awareness, and adjusting my life, routines, and priorities to fit the needs that I find are not being met. I can ramble on for ages about it. But it is also a highly personal journey - what works for me won't for the next person and vice versa. However KNOWING that it is important is huge.
  - d4mi3n 3y ago
    I found your original comment very informative. Did you pick this up through your own experiences? Would love to hear if you’ve read anything in particular that helped you form a routine that worked for you.
    - btilly 3y ago
      I picked this up through a lifetime of curiosity, a ton of experience, and then trying to be a parent. Dr. Sabrina Schuck is where I really learned the importance of tying shoulds to wants.
  - thereisnojesus 3y ago
    [dead]
brianjking 3y ago
I'd love to hear how you get around not taking medication and if you're comfortable sharing why you choose not to.
- btilly 3y ago
  See my other answers for more on that. I will say that it isn't easy. But the flexibility that can come with being a programmer really helps.
ryanklee 3y ago
I'm hesitant to make any assumptions about your decision to not medicate, but if it has anything to do with addictive properties, you should look into guanfacine. I have very severe ADHD and was unable to use the common medications for the reason listed. This last year I stumbled upon guanfacine, which is usually a blood pressure reduction med, but is prescribed off-label as an ADHD med. It has no noticeable effects other than having basically been a miracle for me in its reduction of my ADHD symptoms. No addictive properties. YMMV but it changed my life after 41 years of struggling with ADHD.
- copperx 3y ago
  As someone in the spectrum with Demand Avoidance, guanfacine has been a godsend. It's cheap, not controlled, and for me, it works better than any stimulant in regulating my attention.
- btilly 3y ago
  I have not tried guanfacine. My problems are loss of appetite, trouble sleeping (leading to sleep deprivation that itself causes loss of executive control), and irritability. This is in addition to the fact that I have high blood pressure, and would rather not have to increase the cocktail of medications that I'm taking for that.
  - gochi 3y ago
    You might already be taking it if you have high blood pressure, potentially under a branded name. One of the things it's used for is high blood pressure, and due to not being a stimulant and also not being FDA approved for ADHD adults specifically (only children for now), doctors are far more likely to prescribe it under the high blood pressure umbrella for adults. Believe one of the brands is called Intuniv.
    - btilly 3y ago
      It isn't in my current list, but I saw that. And find this fact interesting. If it can potentially replace another medication, that would be nice.] It certainly seems better for me than a stimulant.
claviola 3y ago
> If I have positive motivations to do X, distractions are easy to set aside. If motivations are negative, I will be unable to resist creating distractions. And a straightjacket that prevents that leads to insanity. How do you deal with chores?
- btilly 3y ago
  First, a direct positive emotion - I'm aware of how much my doing routine chores helps my wife and family. And it is a trade, I'd much rather do the chores than the routine paperwork that my wife does instead! Second, I use doing routine chores as meditation and thinking time. It does lead to doing the chore less efficiently - I might break off loading the dishwasher to pace, think, and jot down a note. But it is also personally productive time for me.
  - beardedmoose 3y ago
    These are really good tips which have an added benefit mentally with the positivity you are bringing to your own headspace. I think meditation is overlooked in favor of medications as a valid aid in folks with executive function disorders. I personally just listen to music with noise cancelling headphones while doing chores. It also helped that I took the time to explain to my family that I am not trying to ignore them but sometimes I need to unwind after a mentally taxing day at work with some distraction free cleaning.
- cstoner 3y ago
  Not OP, but I give myself a little reward. Specifically, I "X" out the task on my daily task list. I take this so far as to add items I just completed to my list just so that I can mark them off. It's stupid, but it works. At least for me. I think it comes down to 2 different types of positive reinforcement: 1. It feels good to mark a task done. 2. It feels good to look at a list of all of the things I did that day, even if they were the size of taking out the trash.
  - btilly 3y ago
    Yup. Reward early, reward often. 50 small rewards works better than one giant one. Even if the 50 small rewards were just + points TOWARDS getting the one giant one.
tivert 3y ago
> My first response to this is that it solves problems that I don't have, and ignores the ones I do have. That's the hallmark of applying technology for technology's sake, which is a lot of what engineers and tech entrepreneurs do nowadays. Especially for technologies that are getting a lot of hype. AI is blockchain all over again, a lot of "let me try to shoehorn this sexy tech where it doesn't really belong."
MisterTea 3y ago
Do you have any comorbidities with ADHD? My issue is moderate ADHD with severe anxiety. Wonderful combo.
- btilly 3y ago
  My son has anxiety. That's no fun. I'm glad I don't have that. I'm sure a psychologist could load me down with some list of diagnoses if I was particularly curious. I haven't been curious, and I'm rather skeptical about the current state of psychology.
- ChrisRR 3y ago
  I believe this is very common to be honest. Issues with serotonin can cause anxiety, depression and ADHD, so it's common to have multiple. I have all three and I'm on Elvanse. When I first started it sent my anxiety through the roof, but my clinician wanted me to stick with it for a few weeks to wait for me to level out, and we increased dosage a few times. When I found a dose that worked for me, it's a bit of a trade-off. I am a bit jittery for the first hour or two of the day, but that's "jittery" anxiety rather "doom" anxiety. The sort of fidgeting in your chair kind of feeling but the rest of the day is fine. I find the trade off is worth it for me. When i tried methylphenidate, it gave me the "sense of impending doom" sort of anxiety. That deep feeling in your chest that something terrible is imminent, I didn't like it at all and that's part of why I started antidepressants in the first place.
- scns 3y ago
  Two things that all types of ADD have in common are impaired emotional regulation and impulse control. A combination with Anxiety/Depression meds and therapy might help. Some types only need an offlabel antidepressant like Bupropion for both impairments. All the best. https://www.amazon.com/dp/0425269973 https://www.amazon.com/dp/0425269973
  - P_I_Staker 3y ago
    Bupropion is not very effective, I don't want people to get too excited
- 3y ago
worstname 3y ago
This hits the nail on the head for me and why productivity apps usually aren't worth much. > This involves a lot of managing of my emotional state, and a lot of REJECTING of outside demands by the world that I conform to how the world wants me to be. A hallmark of ADHD is emotional dysregulation and impulsivity, so what exactly does rejecting "outside demands" look like? How exactly are you managing emotional state if not with medication? Ironically the only way I've managed my emotional state off medication is by conforming to outside demands and ignoring my individual desires/motivations as much as possible.
- btilly 3y ago
  An example of rejecting outside demands is seeking out work environments where I can cooperatively seek out tasks, rather than having someone try to order me to do what they want me to do. If I encounter someone who wants to order me around, I'll ignore if possible. And if not possible, I'll change jobs before complying. Trying to do things because someone is pushing me to do them will result in my becoming resentful, and losing my ability to get into an effective state of flow. But enough places in tech provide enough flexibility that I've been able to find places where I can be productive. And, in a virtuous cycle, productivity can make all sorts of oddities acceptable in an employee. As for emotional dysregulation, let me address that. ADHD is caused by weak executive function. People with ADHD are slow to realize that we SHOULD do X, and the SHOULD is fairly weak. Therefore it becomes hard to resist emotions telling us we want to do Y instead. I have two tools to address that. The first is that at a purely emotional level, I strive to be fairly balanced. I work to address things that cause me negative emotions, like resentment, so that I don't have negative emotions to fight against. The second is that I attach my "shoulds" to my understanding of what I actually want and care about. As a result the idea "I should X" is reinforced by a DESIRE to do X. And this emotional reinforcement makes it easy to do it. Ironically, it is always easier to motivate myself in the short term with negative emotions. But the effect of doing so is a breakdown of the positive feedback loop that I'm using to maintain myself. Thus forcing myself only works for a limited time, and then falls apart. And so that short-term solution is toxic for me. I suspect that it is toxic for most people - but my ADHD makes it harder to deal with for me. That said, everything that I do for me involves doing the opposite of what society pushes me towards. This makes for an interesting balancing act.
ilc 3y ago
In reading your replies.. you've got it straight, from another long time ADHDer. Tools are useful in as much as they help you control your attention. The only ones I've found truly useful are ER4SRs. (In ear monitors, -35DB to the environment. I listen to music while I work, at ~70DB. If you do the math about the only thing I can hear is a fire alarm... and that's about right. :) )
- sudosysgen 3y ago
  If you ever wanna go wireless, I find my WF-1000XM4s to be slightly more effective, and it's easier to turn off the isolation.
  - justinc8687 3y ago
    Have you tried the ER4s? I own both and find the ER4s much more isolating (and for me, as a mainly classical listener, a bunch cleaner sound).
    - sudosysgen 3y ago
      Yes, I did, I used to own ER4s. To be fair, I'm not using the integrated tips and instead use Comply tips. It may have been that my ears just seal better using foam than with the three flange oddity Etymotic puts on these? I do agree the Etymotics sound better out of the box, but after using AutoEQ they sound pretty similar.
      - justinc8687 3y ago
        Oh yah, the silicone tips aren't that isolating. The foam ones, however, are magic.
- skjoldr 3y ago
  I'm now very sad about Etymotics not sealing in my ear canals properly lol Currently on the lookout for other IEMs with decent sound, I heard good things about Crinacle's 7Hz Dioko that have a flat-ish signature similar to Etymotics.
simplemts 3y ago
You nailed it on the end for me as an Adult with ADHD diagnosed in my 30s. Motivation has been my biggest A-Ha with ADHD and trying my absolute best to align what I do with what I want to do otherwise I am setting myself up for failure and others for disappointment with me.
- acchow 3y ago
  Learning to create motivation is the ultimate hack for insufficient executive function. People tend to think of motivation as some innate property of your person. But it's actually an emotional response to inputs.
  - anoojb 3y ago
    Seems like you're describing motivation as a psychological skill that can be cultivated beyond some innate baseline. How does this work?
    - btilly 3y ago
      It is. I've been trying to offer tips on how it works in my comments in this discussion. If you want some personal books for yourself, try Meditations (by Marcus Aurelius), The Gentle Art of Not Giving a F_ck, and Atomic Habits. If you want some management books to help with your team, try Peopleware (a classic), First, Break All The Rules (much better than the title suggests), and Tribal Leadership.
  - copperx 3y ago
    I'd like to subscribe to your newsletter, if what you say is true. Can you expound on that idea?
  - ip26 3y ago
    It’s more insidious. The condition mucks with your priorities & how you think you should approach problems, so even if you know how to hack yourself to be motivated, will it be for the right things? As far as I can tell, focus and motivation are just a symptom of the deeper discomfort and anxiety caused by lower neurotransmitter levels. In turn, that shapes your relationship with the world.
pmarreck 3y ago
> but I don't need that. I have her. Yeah, about that. I fell into the same trap. Now I have someone who thinks her relative superpower makes her more mature and me more infantile even though she grew up dyslexic and still cannot distinguish to/too/two (and even though my income, while more highly variable than hers, is also far, far greater). Apparently it's fairly common for this to very negatively affect relationships. How in the heck did you manage that?? (assuming you did)
- btilly 3y ago
  I wish there was a simple recipe. But the principle is to have each focus on the other person's good qualities. How do actually do it will vary widely from couple to couple. The book The 5 Love Languages may help. It was one of many that helped me.
wnc3141 3y ago
I'd be curious to hear about lessons learned from your experience, if you ever were to write a blog type post of your experiences.
code_runner 3y ago
Oh my god you’re describing all of my days every day. I’ve thought maybe I had ADHD or something but I’ve never read a more accurate depiction of my day to day.
ughitsaaron 3y ago
> it solves problems that I don't have, and ignores the ones I do have This is exactly what I suspect of virtually any kind of app, software, platform, etc. I’m advertised as intended to help me with ADHD. ADHD is expresses itself in such a broad variety of ways. I just don’t trust that any kind of app is actually so tuned into my experience of ADHD that it could actually be helpful. I hesitate to say this: but, it’s hard hard not to feel offended at times by the ways in which ADHD appears to be radically oversimplified to fit into a narrow product specification and pitched to people who might really need help.
- jamiek88 3y ago
  Yeah it’s way more than being scatter brained.
- kuhewa 3y ago
  Productivity apps miss the mark but I get good value out of Forest on Android, just that slight nudge reminding I just absentmindedly picked up my phone to doom scroll and it's only been 12 seconds since the last time I tried is valuable when the executive function is really bad
- mtlmtlmtlmtl 3y ago
  The problem with any kind of organisational system like GTD, software like Rescuetime, org-mode, and probably this thing, is that they don't really help me because I don't even have the executive function to get started using them in a structured way in the first place. I'm unable to establish routines, and using these things is just yet another routine to fail at. At least this seems to be free to use. I really hate when solutions like this cost money and advertise specifically for ADHD. Because, being impulsive, of course I sign up for the thing, use it for maybe a couple days, then stop using it, but forget to unsubscribe for like 5 months, wasting a bunch of money...
  - swifthesitation 3y ago
    I feel seen... Have you been able to find something that works for you?
code_biologist 3y ago
Great video I came across that expresses similar ideas about it being executive function that's the challenge, not attention. "This is how you treat ADHD based off science, Dr Russell Barkley part of 2012 Burnett Lecture" https://www.youtube.com/watch?v=_tpB-B8BXk0 https://www.youtube.com/watch?v=_tpB-B8BXk0 Edit: here's a newer one by the same speaker "ADHD as Motivation Deficit Disorder" https://www.youtube.com/watch?v=bR3RJU6838c https://www.youtube.com/watch?v=bR3RJU6838c
- btilly 3y ago
  I've seen that first video before. He does fine until he starts spouting dogma about what all interventions must look like. That part is BS. BY FAR the most effective intervention that I've seen for ADHD in children is https://www.cdc.uci.edu/ https://www.cdc.uci.edu/. It does none of what he claims you need to do. And it routinely takes people who can't perform in a normal classroom, and turns them into people who can. I just watched a bit of the second video. One problem with his model. One of the classic presentations of ADHD is hyperfocus. A state in which everything he says about ADHD is wrong. The problem with both videos is that he is focused on control as accomplished through executive control. But there is a second path towards emotional control involving dealing with our emotions. And if you succeed in THAT, then your basic emotional makeup is supporting your self-control. Rather than imposing control through executive function, your executive function is being supported by your emotional makeup. I've found this to be a far more effective way to do things. But it requires unlearning a whole lot about how we think that things should be done.
  - Robotbeat 3y ago
    Can you be more specific about what you do?
    - btilly 3y ago
      Not in a comment, sorry. I could write a book, and it would still feel vague. And what I do for myself, isn't going to work the same way for you. I will say that my path involved a lot of work on self-honesty. A lot of work on body awareness. (A lot of emotions show up in your body.) A lot of work on building empathy and gratitude. Meditation played more than a small role. All of that just to get to the point where I'm aware of what I need to be aware of to start finding what works for me.
andsoitis 3y ago
> moderately severe ADHD I have a hard time understanding what this means
- i-use-nixos-btw 3y ago
  It seems like a contradiction, but is not. Many things are measured on a scale that goes from mild, to moderate, to moderately severe, to severe.
- annie_muss 3y ago
  A rough scale might be: Mild ADHD: You're more distractable and forgetful than most. You have techniques to get around this such as reminders, planners, assistants etc. Moderate ADHD: You struggle with important task completion all the time. You've experienced consequences from it such as job loss or dropping out of college You may have depression or anxiety related to your ADHD Severe ADHD: You're in prison because of a violent outburst caused by your emotional disregulation. You're homeless because you can't hold down a job or a relationship. You're dead because you crashed your car while distracted.
- ChrisRR 3y ago
  ADHD is not a true or false thing, which is what leads to the "everyone is a bit ADHD" myth. Some people struggle in some situations, but with behavioural management can control it. Some people will find any excuse to not do what they're supposed to do, and have to fight the urge all day every day. I personally had a bit of the latter, in that I often found myself just unexpectedly walking off mid work and finding myself across the building for no reason. It was just a physical urge to get up and do anything apart from work
EdwardDiego 3y ago
Everyone has differing manifestations. For some people, this could be helpful.
anshumankmr 3y ago
my number one problem is motivation and number two problem is forgetfullness. The forgetfullness part is something I have been working on recently, using stuff like Alexa. I don't see any app ever solving that. I could use a pen and paper for this stuff and I am also seeking a therapist to talk to (had one before but had a negative experience)
diob 3y ago
Do you struggle more on days where you don't sleep enough? I find that on 9hrs of sleep, I'm able to manage my focus, but any less and it's a waste of a day.
- btilly 3y ago
  Lack of sleep reduces executive control in everyone. For me, that happens with chronic lack of sleep. Particularly when combined with stress. But in general I'm not too sensitive to sleep. I just start with a low baseline of executive control.
Kiro 3y ago
> but I don't need that. I have her. Good for you. Not everyone is that lucky though.
- bob-09 3y ago
  Sounds like a co-dependence to me. There will be a day they no longer "have" her.
rpastuszak 3y ago
> The trick for me is that it is important that my life be organized around engaging with things that I want to do. > Yes, yes, I know the idea of eliminating distractions so that I can focus. Honestly, that's crap that leads to disasters every time I try it. If I have positive motivations to do X, distractions are easy to set aside. I don't have ADHD but this is something I struggle with/keep at the back of my head constantly. It took me a very long time to accept that (to put it bluntly) it's almost impossible for me to force myself to work on something I find useless. I wrote about this here: https://sonnet.io/posts/hummingbirds/ https://sonnet.io/posts/hummingbirds/ and here: https://sonnet.io/posts/sit/ https://sonnet.io/posts/sit/ Do you have any resources on the subject you could recommend?
catsarebetter 3y ago
This is the first post I've read about ADHD that makes me think that there are multi-dimensional qualities and that the general public treats ADHD as a binary yes/no. Very interesting and great self-awareness too.
- skjoldr 3y ago
  ADHD is the same kind of spectrum that autism is, it's different for everyone.
  - scns 3y ago
    Daniel Amen thinks there are seven to eight types.
Meculitio 3y ago
Doesn't work for me at all. I have high motivation/curiosity and struggle hard to do things even if I know like and enjoy them. Medication helps tremendously with this and I reduced it for a few years and still have behavior patterns I learned on medication
- btilly 3y ago
  We are each individuals. I just know what works for me and those I care about. That said, I would not discount that it works. Motivation only works for me if it is either overwhelming, or I'm in a good space. And that mostly means only when I'm in a good space. Getting into that good space requires keeping my shoulds only things I want for a long enough time to condition my brain to the idea. This is hard to arrange, takes a good while to start working properly, and is easy to accidentally undo. It certainly isn't something I can just turn on.
ChrisRR 3y ago
I didn't know up until the last few years that I had ADHD, and had just always assumed that I was just crap at organisation and lazy. I've been through a degree, a masters and years of work using every trick in the book to force myself to work and not get distracted. I have super detailed plans, all of my work is accountable, I write down everything I have to do. It goes on and on how I micro-manage my day just to force myself to work or do my tasks. Then I got an ADHD diagnosis, started medication and my life changed. Suddenly I can just sit down and get to work instead of fighting myself to put the phone down and close reddit. I don't get up and wander off unexpectedly, I don't feel a physical urge to walk off out of my seat and in my 30s I realised that's what normal is. I don't put off every little 5 minute task, I just do them without a second thought. Sure, I can survive without the meds, but life is so much easier not having to fight against myself for every single damn task. I also take antidpressants and I view them in the same way. The tablets don't "cure" me, but they clear my head enough so that I can make the conscious decision to improve my behaviour.
- vanderZwan 3y ago
  It's crazy, huh? Nobody would ever say "how dare physically disabled people rely on things like wheelchairs to be less disabled" (well, nobody I would consider worth listening to at least). Yet medication for ADHD, depression, and other mental health issues are stigmatized.
- sgarland 3y ago
  I assumed I wasn’t applying myself, or didn’t use the right learning style, or whatever else was being offered as a suggestion. It didn’t help that I was a kid in the early 90s, when Ritalin was getting big, and some parents (like mine) were staunchly opposed to medicating kids for supposed normal behavior. I found much later in life that the only things that consistently motivated me were a looming deadline, or severe consequences to failure. The lone exception was computer puzzles, by which I mean things like “how do I get this obscure Chinese sound card running in Gentoo,” or “how does a file actually get written to a drive? oh look blkparse…” About a year ago, I got an ADHD diagnosis for primarily inattentive type, and my life changed. There have been some tweaks here and there to medication and dosage, but the amount of focus I can now devote to tasks which previously would be monstrously difficult - like writing Jira stories - is amazing.

by btilly 3y ago

mrcncpt 3y ago

I've never heard this take before but it makes a lot of sense. Do you mind clarifying the kind of emotional tools you refer to?

btilly 3y ago
Mostly a lot of mind-body stuff to develop self-awareness, and adjusting my life, routines, and priorities to fit the needs that I find are not being met. I can ramble on for ages about it. But it is also a highly personal journey - what works for me won't for the next person and vice versa. However KNOWING that it is important is huge.
- d4mi3n 3y ago
  I found your original comment very informative. Did you pick this up through your own experiences? Would love to hear if you’ve read anything in particular that helped you form a routine that worked for you.
  - btilly 3y ago
    I picked this up through a lifetime of curiosity, a ton of experience, and then trying to be a parent. Dr. Sabrina Schuck is where I really learned the importance of tying shoulds to wants.
- thereisnojesus 3y ago
  [dead]

brianjking 3y ago

I'd love to hear how you get around not taking medication and if you're comfortable sharing why you choose not to.

btilly 3y ago
See my other answers for more on that. I will say that it isn't easy. But the flexibility that can come with being a programmer really helps.

ryanklee 3y ago

I'm hesitant to make any assumptions about your decision to not medicate, but if it has anything to do with addictive properties, you should look into guanfacine. I have very severe ADHD and was unable to use the common medications for the reason listed. This last year I stumbled upon guanfacine, which is usually a blood pressure reduction med, but is prescribed off-label as an ADHD med. It has no noticeable effects other than having basically been a miracle for me in its reduction of my ADHD symptoms. No addictive properties. YMMV but it changed my life after 41 years of struggling with ADHD.

copperx 3y ago
As someone in the spectrum with Demand Avoidance, guanfacine has been a godsend. It's cheap, not controlled, and for me, it works better than any stimulant in regulating my attention.
btilly 3y ago
I have not tried guanfacine. My problems are loss of appetite, trouble sleeping (leading to sleep deprivation that itself causes loss of executive control), and irritability. This is in addition to the fact that I have high blood pressure, and would rather not have to increase the cocktail of medications that I'm taking for that.
- gochi 3y ago
  You might already be taking it if you have high blood pressure, potentially under a branded name. One of the things it's used for is high blood pressure, and due to not being a stimulant and also not being FDA approved for ADHD adults specifically (only children for now), doctors are far more likely to prescribe it under the high blood pressure umbrella for adults. Believe one of the brands is called Intuniv.
  - btilly 3y ago
    It isn't in my current list, but I saw that. And find this fact interesting. If it can potentially replace another medication, that would be nice.] It certainly seems better for me than a stimulant.

claviola 3y ago

> If I have positive motivations to do X, distractions are easy to set aside. If motivations are negative, I will be unable to resist creating distractions. And a straightjacket that prevents that leads to insanity. How do you deal with chores?

btilly 3y ago
First, a direct positive emotion - I'm aware of how much my doing routine chores helps my wife and family. And it is a trade, I'd much rather do the chores than the routine paperwork that my wife does instead! Second, I use doing routine chores as meditation and thinking time. It does lead to doing the chore less efficiently - I might break off loading the dishwasher to pace, think, and jot down a note. But it is also personally productive time for me.
- beardedmoose 3y ago
  These are really good tips which have an added benefit mentally with the positivity you are bringing to your own headspace. I think meditation is overlooked in favor of medications as a valid aid in folks with executive function disorders. I personally just listen to music with noise cancelling headphones while doing chores. It also helped that I took the time to explain to my family that I am not trying to ignore them but sometimes I need to unwind after a mentally taxing day at work with some distraction free cleaning.
cstoner 3y ago
Not OP, but I give myself a little reward. Specifically, I "X" out the task on my daily task list. I take this so far as to add items I just completed to my list just so that I can mark them off. It's stupid, but it works. At least for me. I think it comes down to 2 different types of positive reinforcement: 1. It feels good to mark a task done. 2. It feels good to look at a list of all of the things I did that day, even if they were the size of taking out the trash.
- btilly 3y ago
  Yup. Reward early, reward often. 50 small rewards works better than one giant one. Even if the 50 small rewards were just + points TOWARDS getting the one giant one.

tivert 3y ago

> My first response to this is that it solves problems that I don't have, and ignores the ones I do have. That's the hallmark of applying technology for technology's sake, which is a lot of what engineers and tech entrepreneurs do nowadays. Especially for technologies that are getting a lot of hype. AI is blockchain all over again, a lot of "let me try to shoehorn this sexy tech where it doesn't really belong."

MisterTea 3y ago

Do you have any comorbidities with ADHD? My issue is moderate ADHD with severe anxiety. Wonderful combo.

btilly 3y ago
My son has anxiety. That's no fun. I'm glad I don't have that. I'm sure a psychologist could load me down with some list of diagnoses if I was particularly curious. I haven't been curious, and I'm rather skeptical about the current state of psychology.
ChrisRR 3y ago
I believe this is very common to be honest. Issues with serotonin can cause anxiety, depression and ADHD, so it's common to have multiple. I have all three and I'm on Elvanse. When I first started it sent my anxiety through the roof, but my clinician wanted me to stick with it for a few weeks to wait for me to level out, and we increased dosage a few times. When I found a dose that worked for me, it's a bit of a trade-off. I am a bit jittery for the first hour or two of the day, but that's "jittery" anxiety rather "doom" anxiety. The sort of fidgeting in your chair kind of feeling but the rest of the day is fine. I find the trade off is worth it for me. When i tried methylphenidate, it gave me the "sense of impending doom" sort of anxiety. That deep feeling in your chest that something terrible is imminent, I didn't like it at all and that's part of why I started antidepressants in the first place.
scns 3y ago
Two things that all types of ADD have in common are impaired emotional regulation and impulse control. A combination with Anxiety/Depression meds and therapy might help. Some types only need an offlabel antidepressant like Bupropion for both impairments. All the best. https://www.amazon.com/dp/0425269973 https://www.amazon.com/dp/0425269973
- P_I_Staker 3y ago
  Bupropion is not very effective, I don't want people to get too excited
3y ago

worstname 3y ago

This hits the nail on the head for me and why productivity apps usually aren't worth much. > This involves a lot of managing of my emotional state, and a lot of REJECTING of outside demands by the world that I conform to how the world wants me to be. A hallmark of ADHD is emotional dysregulation and impulsivity, so what exactly does rejecting "outside demands" look like? How exactly are you managing emotional state if not with medication? Ironically the only way I've managed my emotional state off medication is by conforming to outside demands and ignoring my individual desires/motivations as much as possible.

btilly 3y ago
An example of rejecting outside demands is seeking out work environments where I can cooperatively seek out tasks, rather than having someone try to order me to do what they want me to do. If I encounter someone who wants to order me around, I'll ignore if possible. And if not possible, I'll change jobs before complying. Trying to do things because someone is pushing me to do them will result in my becoming resentful, and losing my ability to get into an effective state of flow. But enough places in tech provide enough flexibility that I've been able to find places where I can be productive. And, in a virtuous cycle, productivity can make all sorts of oddities acceptable in an employee. As for emotional dysregulation, let me address that. ADHD is caused by weak executive function. People with ADHD are slow to realize that we SHOULD do X, and the SHOULD is fairly weak. Therefore it becomes hard to resist emotions telling us we want to do Y instead. I have two tools to address that. The first is that at a purely emotional level, I strive to be fairly balanced. I work to address things that cause me negative emotions, like resentment, so that I don't have negative emotions to fight against. The second is that I attach my "shoulds" to my understanding of what I actually want and care about. As a result the idea "I should X" is reinforced by a DESIRE to do X. And this emotional reinforcement makes it easy to do it. Ironically, it is always easier to motivate myself in the short term with negative emotions. But the effect of doing so is a breakdown of the positive feedback loop that I'm using to maintain myself. Thus forcing myself only works for a limited time, and then falls apart. And so that short-term solution is toxic for me. I suspect that it is toxic for most people - but my ADHD makes it harder to deal with for me. That said, everything that I do for me involves doing the opposite of what society pushes me towards. This makes for an interesting balancing act.

ilc 3y ago

In reading your replies.. you've got it straight, from another long time ADHDer. Tools are useful in as much as they help you control your attention. The only ones I've found truly useful are ER4SRs. (In ear monitors, -35DB to the environment. I listen to music while I work, at ~70DB. If you do the math about the only thing I can hear is a fire alarm... and that's about right. :) )

sudosysgen 3y ago
If you ever wanna go wireless, I find my WF-1000XM4s to be slightly more effective, and it's easier to turn off the isolation.
- justinc8687 3y ago
  Have you tried the ER4s? I own both and find the ER4s much more isolating (and for me, as a mainly classical listener, a bunch cleaner sound).
  - sudosysgen 3y ago
    Yes, I did, I used to own ER4s. To be fair, I'm not using the integrated tips and instead use Comply tips. It may have been that my ears just seal better using foam than with the three flange oddity Etymotic puts on these? I do agree the Etymotics sound better out of the box, but after using AutoEQ they sound pretty similar.
    - justinc8687 3y ago
      Oh yah, the silicone tips aren't that isolating. The foam ones, however, are magic.
skjoldr 3y ago
I'm now very sad about Etymotics not sealing in my ear canals properly lol Currently on the lookout for other IEMs with decent sound, I heard good things about Crinacle's 7Hz Dioko that have a flat-ish signature similar to Etymotics.

simplemts 3y ago

You nailed it on the end for me as an Adult with ADHD diagnosed in my 30s. Motivation has been my biggest A-Ha with ADHD and trying my absolute best to align what I do with what I want to do otherwise I am setting myself up for failure and others for disappointment with me.

acchow 3y ago
Learning to create motivation is the ultimate hack for insufficient executive function. People tend to think of motivation as some innate property of your person. But it's actually an emotional response to inputs.
- anoojb 3y ago
  Seems like you're describing motivation as a psychological skill that can be cultivated beyond some innate baseline. How does this work?
  - btilly 3y ago
    It is. I've been trying to offer tips on how it works in my comments in this discussion. If you want some personal books for yourself, try Meditations (by Marcus Aurelius), The Gentle Art of Not Giving a F_ck, and Atomic Habits. If you want some management books to help with your team, try Peopleware (a classic), First, Break All The Rules (much better than the title suggests), and Tribal Leadership.
- copperx 3y ago
  I'd like to subscribe to your newsletter, if what you say is true. Can you expound on that idea?
- ip26 3y ago
  It’s more insidious. The condition mucks with your priorities & how you think you should approach problems, so even if you know how to hack yourself to be motivated, will it be for the right things? As far as I can tell, focus and motivation are just a symptom of the deeper discomfort and anxiety caused by lower neurotransmitter levels. In turn, that shapes your relationship with the world.

pmarreck 3y ago

> but I don't need that. I have her. Yeah, about that. I fell into the same trap. Now I have someone who thinks her relative superpower makes her more mature and me more infantile even though she grew up dyslexic and still cannot distinguish to/too/two (and even though my income, while more highly variable than hers, is also far, far greater). Apparently it's fairly common for this to very negatively affect relationships. How in the heck did you manage that?? (assuming you did)

btilly 3y ago
I wish there was a simple recipe. But the principle is to have each focus on the other person's good qualities. How do actually do it will vary widely from couple to couple. The book The 5 Love Languages may help. It was one of many that helped me.

wnc3141 3y ago

I'd be curious to hear about lessons learned from your experience, if you ever were to write a blog type post of your experiences.

code_runner 3y ago

Oh my god you’re describing all of my days every day. I’ve thought maybe I had ADHD or something but I’ve never read a more accurate depiction of my day to day.

ughitsaaron 3y ago

> it solves problems that I don't have, and ignores the ones I do have This is exactly what I suspect of virtually any kind of app, software, platform, etc. I’m advertised as intended to help me with ADHD. ADHD is expresses itself in such a broad variety of ways. I just don’t trust that any kind of app is actually so tuned into my experience of ADHD that it could actually be helpful. I hesitate to say this: but, it’s hard hard not to feel offended at times by the ways in which ADHD appears to be radically oversimplified to fit into a narrow product specification and pitched to people who might really need help.

jamiek88 3y ago
Yeah it’s way more than being scatter brained.
kuhewa 3y ago
Productivity apps miss the mark but I get good value out of Forest on Android, just that slight nudge reminding I just absentmindedly picked up my phone to doom scroll and it's only been 12 seconds since the last time I tried is valuable when the executive function is really bad
mtlmtlmtlmtl 3y ago
The problem with any kind of organisational system like GTD, software like Rescuetime, org-mode, and probably this thing, is that they don't really help me because I don't even have the executive function to get started using them in a structured way in the first place. I'm unable to establish routines, and using these things is just yet another routine to fail at. At least this seems to be free to use. I really hate when solutions like this cost money and advertise specifically for ADHD. Because, being impulsive, of course I sign up for the thing, use it for maybe a couple days, then stop using it, but forget to unsubscribe for like 5 months, wasting a bunch of money...
- swifthesitation 3y ago
  I feel seen... Have you been able to find something that works for you?

code_biologist 3y ago

Great video I came across that expresses similar ideas about it being executive function that's the challenge, not attention. "This is how you treat ADHD based off science, Dr Russell Barkley part of 2012 Burnett Lecture" https://www.youtube.com/watch?v=_tpB-B8BXk0 https://www.youtube.com/watch?v=_tpB-B8BXk0 Edit: here's a newer one by the same speaker "ADHD as Motivation Deficit Disorder" https://www.youtube.com/watch?v=bR3RJU6838c https://www.youtube.com/watch?v=bR3RJU6838c

btilly 3y ago
I've seen that first video before. He does fine until he starts spouting dogma about what all interventions must look like. That part is BS. BY FAR the most effective intervention that I've seen for ADHD in children is https://www.cdc.uci.edu/ https://www.cdc.uci.edu/. It does none of what he claims you need to do. And it routinely takes people who can't perform in a normal classroom, and turns them into people who can. I just watched a bit of the second video. One problem with his model. One of the classic presentations of ADHD is hyperfocus. A state in which everything he says about ADHD is wrong. The problem with both videos is that he is focused on control as accomplished through executive control. But there is a second path towards emotional control involving dealing with our emotions. And if you succeed in THAT, then your basic emotional makeup is supporting your self-control. Rather than imposing control through executive function, your executive function is being supported by your emotional makeup. I've found this to be a far more effective way to do things. But it requires unlearning a whole lot about how we think that things should be done.
- Robotbeat 3y ago
  Can you be more specific about what you do?
  - btilly 3y ago
    Not in a comment, sorry. I could write a book, and it would still feel vague. And what I do for myself, isn't going to work the same way for you. I will say that my path involved a lot of work on self-honesty. A lot of work on body awareness. (A lot of emotions show up in your body.) A lot of work on building empathy and gratitude. Meditation played more than a small role. All of that just to get to the point where I'm aware of what I need to be aware of to start finding what works for me.

andsoitis 3y ago

> moderately severe ADHD I have a hard time understanding what this means

i-use-nixos-btw 3y ago
It seems like a contradiction, but is not. Many things are measured on a scale that goes from mild, to moderate, to moderately severe, to severe.
annie_muss 3y ago
A rough scale might be: Mild ADHD: You're more distractable and forgetful than most. You have techniques to get around this such as reminders, planners, assistants etc. Moderate ADHD: You struggle with important task completion all the time. You've experienced consequences from it such as job loss or dropping out of college You may have depression or anxiety related to your ADHD Severe ADHD: You're in prison because of a violent outburst caused by your emotional disregulation. You're homeless because you can't hold down a job or a relationship. You're dead because you crashed your car while distracted.
ChrisRR 3y ago
ADHD is not a true or false thing, which is what leads to the "everyone is a bit ADHD" myth. Some people struggle in some situations, but with behavioural management can control it. Some people will find any excuse to not do what they're supposed to do, and have to fight the urge all day every day. I personally had a bit of the latter, in that I often found myself just unexpectedly walking off mid work and finding myself across the building for no reason. It was just a physical urge to get up and do anything apart from work

EdwardDiego 3y ago

Everyone has differing manifestations. For some people, this could be helpful.

anshumankmr 3y ago

my number one problem is motivation and number two problem is forgetfullness. The forgetfullness part is something I have been working on recently, using stuff like Alexa. I don't see any app ever solving that. I could use a pen and paper for this stuff and I am also seeking a therapist to talk to (had one before but had a negative experience)

diob 3y ago

Do you struggle more on days where you don't sleep enough? I find that on 9hrs of sleep, I'm able to manage my focus, but any less and it's a waste of a day.

btilly 3y ago
Lack of sleep reduces executive control in everyone. For me, that happens with chronic lack of sleep. Particularly when combined with stress. But in general I'm not too sensitive to sleep. I just start with a low baseline of executive control.

Kiro 3y ago

> but I don't need that. I have her. Good for you. Not everyone is that lucky though.

bob-09 3y ago
Sounds like a co-dependence to me. There will be a day they no longer "have" her.

rpastuszak 3y ago

> The trick for me is that it is important that my life be organized around engaging with things that I want to do. > Yes, yes, I know the idea of eliminating distractions so that I can focus. Honestly, that's crap that leads to disasters every time I try it. If I have positive motivations to do X, distractions are easy to set aside. I don't have ADHD but this is something I struggle with/keep at the back of my head constantly. It took me a very long time to accept that (to put it bluntly) it's almost impossible for me to force myself to work on something I find useless. I wrote about this here: https://sonnet.io/posts/hummingbirds/ https://sonnet.io/posts/hummingbirds/ and here: https://sonnet.io/posts/sit/ https://sonnet.io/posts/sit/ Do you have any resources on the subject you could recommend?

catsarebetter 3y ago

This is the first post I've read about ADHD that makes me think that there are multi-dimensional qualities and that the general public treats ADHD as a binary yes/no. Very interesting and great self-awareness too.

skjoldr 3y ago
ADHD is the same kind of spectrum that autism is, it's different for everyone.
- scns 3y ago
  Daniel Amen thinks there are seven to eight types.

Meculitio 3y ago

Doesn't work for me at all. I have high motivation/curiosity and struggle hard to do things even if I know like and enjoy them. Medication helps tremendously with this and I reduced it for a few years and still have behavior patterns I learned on medication

btilly 3y ago
We are each individuals. I just know what works for me and those I care about. That said, I would not discount that it works. Motivation only works for me if it is either overwhelming, or I'm in a good space. And that mostly means only when I'm in a good space. Getting into that good space requires keeping my shoulds only things I want for a long enough time to condition my brain to the idea. This is hard to arrange, takes a good while to start working properly, and is easy to accidentally undo. It certainly isn't something I can just turn on.

ChrisRR 3y ago

I didn't know up until the last few years that I had ADHD, and had just always assumed that I was just crap at organisation and lazy. I've been through a degree, a masters and years of work using every trick in the book to force myself to work and not get distracted. I have super detailed plans, all of my work is accountable, I write down everything I have to do. It goes on and on how I micro-manage my day just to force myself to work or do my tasks. Then I got an ADHD diagnosis, started medication and my life changed. Suddenly I can just sit down and get to work instead of fighting myself to put the phone down and close reddit. I don't get up and wander off unexpectedly, I don't feel a physical urge to walk off out of my seat and in my 30s I realised that's what normal is. I don't put off every little 5 minute task, I just do them without a second thought. Sure, I can survive without the meds, but life is so much easier not having to fight against myself for every single damn task. I also take antidpressants and I view them in the same way. The tablets don't "cure" me, but they clear my head enough so that I can make the conscious decision to improve my behaviour.

vanderZwan 3y ago
It's crazy, huh? Nobody would ever say "how dare physically disabled people rely on things like wheelchairs to be less disabled" (well, nobody I would consider worth listening to at least). Yet medication for ADHD, depression, and other mental health issues are stigmatized.
sgarland 3y ago
I assumed I wasn’t applying myself, or didn’t use the right learning style, or whatever else was being offered as a suggestion. It didn’t help that I was a kid in the early 90s, when Ritalin was getting big, and some parents (like mine) were staunchly opposed to medicating kids for supposed normal behavior. I found much later in life that the only things that consistently motivated me were a looming deadline, or severe consequences to failure. The lone exception was computer puzzles, by which I mean things like “how do I get this obscure Chinese sound card running in Gentoo,” or “how does a file actually get written to a drive? oh look blkparse…” About a year ago, I got an ADHD diagnosis for primarily inattentive type, and my life changed. There have been some tweaks here and there to medication and dosage, but the amount of focus I can now devote to tasks which previously would be monstrously difficult - like writing Jira stories - is amazing.