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Ask HN: Discuss ADHD and your use of medication
I have a feeling I have developed late-onset ADHD as an adult due to recent/past events and I would like to hear from other founders/engineering people who have similar stories and how they overcame their situation and what medication or other treatment has helped.
- tanepiper 2y agoYou don't "develop late-onset ADHD" - you either have ADHD or you don't, it's a genetic condition (one of your parents had it). You have to fit the DMS criteria of having childhood symptoms, and they will want to speak to relatives and friends who can confirm this. Burnout can cause AuDHD traits but you don't catch anything - likely taking time to recover will be better than trying medication - for a start you have to find the drug and dose that works for you and you need to speak to a psychiatrist for that. FWIW I was diagnosed at 35 (I'm 42 now) and I'm on 60Mg Lisdexamfetamine per day. The medication is not a silver bullet, and there's day I forget to take it.
- bradhe 2y agoI predict that over prescription of ADHD medication in the US is going to viewed as a massive public health misstep in 40 years.
- sgarland 2y agoEven if your prediction is correct, the immediate benefits in day-to-day life for people with ADHD cannot be overlooked. Thus far, the only serious side effects I’m aware of are: * A slight increase in cardiovascular-related conditions in the first few years after starting stimulant medication. This can be mitigated to a large extent by not using stimulants if your resting heart rate or blood pressure are already elevated. * An increased risk of manic episodes for people already predisposed to bipolar disorder, again, for stimulant medications. If someone in your family has been diagnosed with bipolar disorder, don’t use a stimulant to treat ADHD. Here’s [0] a meta-study on the subject. [0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697582/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697582/
- giraffe_lady 2y agoPeople have been predicting this for 40 years already so any day now I guess?
- mrangle 2y agoAcknowledging that this is a pedantic correction: I think that there will be an acknowledgement of over diagnosis of ADHD. First line treatments are what they are. But also that, in tandem, there will be acknowledgement of under diagnosis of Type 1 Autism. Precisely because it is so diagnostically evasive "and can mimic ADHD". However, the correction that I'd make of the quoted phrase is that, likely, inattentive ADHD wholly is misdiagnosed Type 1 Autism in my opinion. And that ADHD will come to be seen as Spectrum disorder, for which certain manifestations (ie: not inattentive) do not necessarily crossover with the Autism part of the (soon to be wider) Spectrum. How that might look, in families, is that those with non-autistic ADHD individuals could be observed to more often contain autistic individuals. See, for example: https://scitechdaily.com/developmental-twist-new-study-links-autism-to-disrupted-dopamine/ https://scitechdaily.com/developmental-twist-new-study-links...
- theshackleford 2y agoWe all have uninformed opinions.
- P_I_Staker 2y agoADHD medication is heavily heavily under-prescribed. It's genocide.
- Spooky23 2y agoIt’s often not diagnosed or diagnosed as another problem and is difficult to diagnose later. I have a friend who discovered that ADHD was the root of a bunch of issues. They had developed some coping strategies organically that were contributing to other issues. Diagnosis and therapy made a dramatic improvement in their life.
- tanepiper 2y agoYep - being diagnosed and knowing helped a lot - I got through life pretty well until 33, but possibly moving country also helped in needing to go through it as things I got away with at home were less so here.
- kmos 2y agoI found out with 38 years old, but I always felt different since childhood, why the memorization in school was bad, to be bad at writing texts, and my second kid got diagnosed, so it made me search more about it. I am doing 30 mg of Paroxetine, but doesn't seem great. Lots of low dopamine and procrastination.
- boredemployee 2y agoWow. 30mg of Paroxetine sounds a lot. I use it for panic attack reasons since 2019, started with 20mg, nowadays I'm using 5mg. When I was using 10mg alone I felt lazy as hell, can't imagine tooking 30!
- evoloution 2y agoWhat tanepiper is saying is mostly correct, especially the part that late-onset ADHD is not really a thing. Genetic condition is kind of an inaccurate statement, though, in my experience as a psychiatrist-scientist. You can liberally say that ADHD is ~75% [1] heritable (based on twin studies) which is pretty high. However, data suggest that even though DSM requires a binary definition of the disorder, in truth it is more like a spectrum and less like e.g. bipolar disorder type I which you either have or you don't despite the fact that severity may vary. For example in a recent study, we found that among people, a high polygenic score (PGS; a kind of way to score individuals for genetic liability based on published studies that associate genetic variants with a disorder) is associated with typical deficits in cognitive functions found in ADHD even in the absence of a diagnosis [1]. I conceptualize it as another lever within the natural variation of how brains work and are tuned for different environments. Now visiting the late-onset part, I have mostly seen it in clinical practice in individuals who had ADHD traits already (may not have met diagnostic criteria) that got really worse after traumatic brain injury and/or worsening of a comorbid mental health conditions e.g. their anxiety or their depression. The natural progression of ADHD for most is to get better over the years as they develop compensatory habits and/or choose lines of work that make ADHD traits less of an obstacle; some believe that also brain maturation kind of catches up at some point which is an incomplete cure. However, the effects on confidence and self-perception are long-lasting... Another misconception is that high IQ corrects for ADHD traits, this has been mostly rebutted in both clinical literature and we have a genetic study under review that mostly replicates that. Finally, there is an overlap in signs when comparing "bored" gifted individuals and ADHD individuals which can be confusing... Unfortunately, smart individuals with ADHD (of the inattentive type) get enough performance to fly below the radar of diagnosis which ultimately hurts them or delays them from realize "their full potential". 1. https://doi.org/10.1038/s41588-022-01285-8 https://doi.org/10.1038/s41588-022-01285-8 and for open-access see manuscript at PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914347/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914347/
- tanepiper 2y agoThank you for a very good answer and you are right, it's not clear cut - as I've got older I identify more AuDHD now, have a relatively higher IQ and if wasn't for my wife (also AuDHD) suggesting we get diagnosed years ago I would have continued the "fly below the radar" - which usually means jumping jobs every two years. Knowing the diagnosis, with medication, I have much better coping strategies for life now - but at the moment my sink is still full of dishes and there's probably a load of laundry that finished washing 2 days ago still in the machine.
- ravenstine 2y agoWhile that may be correct for actual ADHD, thyroid conditions can mimic a lot of the same problems faced by those with ADHD (or at least ADHD-PI), as in attention dysregulation, brain fog, memory issues, tiredness, and so on. Hypothyroidism, for instance, advances slowly and one might not be diagnosed until well into adulthood. It would not be surprising if many people diagnosed with ADHD actually have a thyroid problem, especially if their medication gradually becomes less effective.
- mwpmaybe 2y ago> You have to fit the DMS criteria of having childhood symptoms, and they will want to speak to relatives and friends who can confirm this. I've often wondered why no teacher ever said anything to my parents about me possibly having ADHD. I think because in the classes I was interested in I was a star student and my teachers loved me, and in the others I was an absolutely hopeless case and my teachers didn't care to bother.
- navjack27 2y agoHow is your self motivation? Your ability to do everyday tasks like showering and cleaning up after yourself absent of any contact with another human? Do you get annoyed with other's inability to focus on things you can focus on? Do you lack patience and have to try very hard to give others grace? Edit: I was diagnosed at the age of two and now I'm 36. I've never worked in a professional setting.
- mnky9800n 2y agoIn full agreement with tanepiper. Also, you don't say what happened nor what it is you are currently identifying as ADD. that makes it hard to give you any feedback other than, you don't have it because if you did you would be born with it. Also, as someone who has ADHD, and was diagnosed as a child, took medication from childhood to adulthood, I learned to live with it. In my masters program I felt like taking Adderall made everything so easy and that I needed to learn to exist as I am. Of course that had some difficulties but I stopped taking it ten years ago and I think I'm all the better for it. I never need to forget taking medication, I've learned how to actively engage myself when my attention flies all over the place, I've learned how to handle the emotional disregulation. I'm not suggesting to others to do the same, but I find a nice balance in my life. I find that many things, such as getting distracted frequently wasn't actually an ADHD related issue. I wasn't constantly getting distracted by slack and emails, it's that I was surrendering my time to others in the fear that if I didn't it would harm me in some way. When I realized this through therapy and started to protect my time and engage my interests, suddenly these "distractions" went away.
- b20000 2y agoI went through a situation where I was forced to bankrupt my company as a founder due to maturing debt and refusal from family to help. This despite having customers and a distribution network. So I fear I might have PTSD. Concentration and focus has always been a challenge since college even though I've done well in school and college. I've also struggled with being tired all the time and with anger and frustration causing me to become tired.
- mnky9800n 2y agoIt seems like a scenario where you could have some trauma. I would go talk to a therapist. I recommend one who specializes in schema therapy, DBT, and acceptance and commitment therapy as that is a modern approach for PTSD.
- lkgbgjjugfffffg 2y agoI think I've always had it but not recognised it until recently. As I've got older the internet has got better at distracting me in and my job has got less interesting and these have combined to accentuate the problem for me.
- giraffe_lady 2y agoIt's a disability. You don't overcome it you find accommodations and supports that allow you to meet your goals and & obligations. The experience of having adhd for me is mostly that it is primarily an emotional regulation disorder. The focus and attention problems are downstream of that, and are prioritized because that's how a parent or employer experiences adhd.
- ldom66 2y agoCompletely agree with your second paragraph. I don't think it's helpful to label it as a "disability". Although the medical term is "disorder", at least for me, this kind of thinking got me digging a hole for myself that I had to climb out of. According to recent research, ADHD may be the fruit of evolution, making us focus on what's important and discarding the mundane. This makes us incredibly creative, out-of-the box thinkers and very efficient at tasks that truly engage us. Once I focused on that idea, I could start working on my strength, and stop "curing" my shortcomings.
- sgarland 2y agoUnfortunately, Jira work is sometimes massively important (to your boss), and also tremendously boring. That was the biggest obstacle I had, and the biggest improvement after medication – the ability to easily do work I’d rather not be doing.
- onemoresoop 2y agoBut do you agree that not everyone is meant to work on Jira tickets? I think a lot of people's ADHD flies under the radar until they face the unescapable tedium of corporate work and bureaucracy. Perhaps under different circumstances people with ADHD would shine without needing any medication.
- sgarland 2y ago> But do you agree that not everyone is meant to work on Jira tickets? Most definitely. There is probably some archetype of person who delights in creating tasks, epics, etc. More power to them. > Perhaps under different circumstances people with ADHD would shine without needing any medication. When I first got into tech (I did a mid-career shift), I was a shining star that would grind out ticket after ticket, so long as the work was interesting. It helped that we did Kanban, so there was always work to do. The first time I had to do some monotonous administrative work, though, I just kept putting it off, and putting it off, and putting it off... then when the deadline loomed, I suddenly had motivation to get it done. As an aside, this style of work did _not_ do well with Scrum, because of the absurd insistence on sizing tickets based on the average team member's capabilities. I have no idea how long it will take Person Foo to get that done; I already know exactly how to do it, and can knock it out in a few hours. Why don't you let Person Foo figure out how long things will take _them_, instead of making me artificially slow down? Presumably they have some specialties they could also zero in on, and the entire team would then move faster.
- nnnnico 2y agoWhat you might perceive as late-onset ADHD could be the cause of not being able to keep your coping mechanisms up due to stress? In my case, social anxiety (which I'm officially diagnosed with, but not ADHD) skyrocketed after a series of family events, which resulted in not being able to focus on anything mildly difficult or anxiety inducing, as my mind quickly started wandering out of nowhere, and becoming aware, shutting it off and getting back on track is really difficult. My anxiety medication is really helping, alongside therapy, and I feel way more in control, but not like before
- neonbones 2y agoI know this isn't an objective question, but what medication did your doctor prescribe you for anxiety?
- nnnnico 2y agoSertraline (an SSRI), from a local lab/brand called Insertec, no side-effects in my case after a year+ of treatment.
- b20000 2y agoWhat you are describing sounds very close to what i'm experiencing.
- mwpmaybe 2y ago> What you might perceive as late-onset ADHD could be the cause of not being able to keep your coping mechanisms up due to stress? In my case, taking a new job where I was responsible for everything (and couldn't delegate anything I wasn't interested in) was a key moment. Buying a house and starting a family was another. I realized that one of my main "coping mechanisms" was to work nights and weekends to get caught up when my brain chemistry was a bit better, but that time flexibility kind of goes away when you have little kids and a house to take care of. New stressors, new sources of anxiety, more chores and work to keep on top of, less sleep, etc. That really pushed me to seek help. "My kids are out of the house from 8:30–4 and I need to be able to focus and get my work done during that time... so what's wrong with me?"
- rideontime 2y agoI was diagnosed with ADHD as an adult by an overzealous psychiatrist and was prescribed stimulant medication. It certainly helped me overcome certain issues and become more productive, but it absolutely didn't help with my actual mental health, actually worsening it in several ways (insomnia, irritability, impatience). I later came to realize my focus and productivity issues could be addressed more effectively and healthily without medication. This is of course my own personal experience and is in no way meant to erase actual, clinical ADHD, the "genetic" kind that others have mentioned. Simply providing my own anecdotal experience as requested.
- onemoresoop 2y ago> sues could be addressed more effectively and healthily without medication How? Please do provide your anecdotal experience, it may surely help others as well. Thanks
- superchunk 2y agoWhen I turned 40, I had a few very enlightening discussions with a therapist that explained a LOT. For me, it wasn't that my brain had changed, it was more about understanding how my brain works. I started taking Adderall. It really helps. I don't take it on the weekend unless I have a project or two I want to focus on. I'd start with finding a therapist. Depending on who you talk to, they can describe the way your mind works in a technical (or not technical) way that I could relate to and understand.
- sgarland 2y agoI was diagnosed at 34, primarily inattentive type. Prior to that, I could excel in academics and my career IFF it was interesting or challenging. When it wasn’t, I couldn’t bring myself to focus. After diagnosis and medication, suddenly I could just do stuff. The best part is that my ability to hyper-focus on interesting work didn’t diminish, something I think most people fear when starting medication for ADHD. I started on Adderall XR, which worked fine for a while. A better way to say that would be that I got used to feeling normal, and so was more aware of when I wasn’t. I noticed that it was wearing off right when I needed it the most, mid-late afternoon. In theory it’s a 12 hour release, but my psych said most people don’t experience that. So, I shifted to Mydayis, which is the exact same drug, but with a triple release so it lasts longer. They claim 16 hours; IME it’s more like 10, but YMMV. The other thing to be aware of is that depression is often correlated with ADHD. I was diagnosed with mild depression, but didn’t really think it was a big deal (I felt happy enough), so I didn’t treat it. Then this last winter came. I’ve been aware that I have seasonal affective disorder for years, and have always treated it with Vitamin D supplements. That didn’t work this year. I then bought a light therapy box, which also didn’t work. I already exercise regularly, so that wasn’t it either. I went back to my psych, who recommended Wellbutrin XL, at the smallest dose. As an aside, this also has an off-label use for treating ADHD if you’d rather not use stimulants. After precisely 13 days of being on it, I realized I did not feel mopey, despite it being a gloomy day. It was incredible. I tried coming off Wellbutrin this spring, and it did not go well. My thought, and my wife’s, is that I had forgotten my previous baseline mood, and so it was a shock to realize the difference. AFAIK, and according to my psych, there are no known long-term effects from Wellbutrin, and I’ve exhibited zero of the known side effects, so I’m just on it for the foreseeable future. Hope that helps, and I hope you seek professional help. Anecdotes are great for getting a variety of opinions, but they’re no substitute for a trained medical professional.
- dole 2y agoThanks for sharing your experiences with Wellbutrin, and feeling comfortable that I've felt similarily about it. Hope this won't threadjack but I don't think it's uncommon for ADHD and antidepressants to be prescribed together (although you may not have taken them at the same time) so there's value in others' experiences too.
- BaculumMeumEst 2y agoIf you had no life stressors or responsibilities and the ability to work on whatever you're interested in, would you have trouble focusing?
- b20000 2y agono
- BaculumMeumEst 2y agoTo me this is the difference between ADHD and just being alive and having to do things that you don't want to do sometimes. I don't mean to be dismissive, I struggle greatly with the same things you do - but I avoid trying to solve things like this through medication.
- pseudalopex 2y agoYes would be consistent with ADHD or many other things. No would be consistent with ADHD also. Hyper focus is a common symptom.
- semi 2y agoDo you also avoid caffeine?
- BaculumMeumEst 2y agoNo, but I should. I suspect it does not really helps me focus, it just makes me feel alert and gives me a buzz. It is the last addiction in life that I have not been able to shake.
- fulladder 2y agoFor me, yes. But perhaps this is an area where there is high individual variation?
- kahnix 2y agoI was diagnosed with ADHD in my early twenties during university and didn't manage to get medicated until 3 years later (The queue was quite long and I ended up getting a prescription from a private doctor in my home country) I think it became really obvious to me when I would require a ton of discipline to do assignments around making applications, but doing something like configuring linux from scratch was so personally interesting to me I could stay up nights and days without any external stimulation. I found that medication (Methylphendiate 20mg) have definitely helped me focus, but the direction of what I'm focusing doesn't always yield productive results (hyperfocusing on reddit for example). I've also started worring that what I've really done is created a dependence, where eventually ill have to up the dose as what I'm currently on will make me feel like I did pre meds, and stopping will make me feel worse. I hope you find a treatment that works for you OP, but I agree with other comments that you might have just discovered you have had ADHD all this time because its not 'onset'.
- mwpmaybe 2y ago> I found that medication have definitely helped me focus, but the direction of what I'm focusing doesn't always yield productive results (hyperfocusing on reddit for example). I had this problem (and others) with Adderall. Vyvanse (Lisdexamfetamine) has been much better for me. I've also found that I get better results when I take my ADHD medication with protein, and about an hour before any caffeine intake. YMMV. > I've also started worring that what I've really done is created a dependence, where eventually ill have to up the dose as what I'm currently on will make me feel like I did pre meds, and stopping will make me feel worse. I worry about this too. I've been on 30mg Lisdexamfetamine for about two years and haven't felt a need to up my dose. But if I skip a day it hits hard. I don't know whether it's worse than before I started medicating or if it's just that my bar for mental function has been raised.
- everforward 2y ago> I've also found that I get better results when I take my ADHD medication with protein, and about an hour before any caffeine intake. YMMV. Regarding eating protein, lisdexamfetamine is basically just dexamfetamine bound to an amino acid. Your liver has to break the amino acid and dexamfetamine apart before the dexamfetamine is bioactive. That's basically how the time-release works; your liver can only break them apart so fast, resulting in a steady stream of dexamfetamine. It's part of why doctors like it, because opening the capsule and snorting it does basically nothing. Eating protein occupies part of your liver's processing abilities, which should result in a "smoother" come up. > I worry about this too. I've been on 30mg Lisdexamfetamine for about two years and haven't felt a need to up my dose. But if I skip a day it hits hard. I don't know whether it's worse than before I started medicating or if it's just that my bar for mental function has been raised. I don't take mine on the weekend, generally. I find it helps keep me grounded in terms of my capabilities on vs off the meds, as well as giving me some non-amphetamine-d time to work through emotions. The meds make me almost too focused, and I'll end up neglecting how I'm feeling to plow through another hour of coding. I also occasionally get worried about my medication, my tolerance and generally the effect it has on me. I typically ask my doctor to switch me to a non-stimulant medication. Atomoxetine is what I usually get, which is a norepinephrine modulator rather than an amphetamine. I don't find it as helpful, but it's good enough to keep me afloat at work for a month and it lacks the "speed" feeling amphetamines can have.
- neonbones 2y agoI was diagnosed at university. Around my freshman year, which is over 10 years ago. In my country there were not many ADHD specialists and medications in circulation at first, mostly atomoxetine was used, but it made me sick (nausea, stomach pain). Eventually Concerta was introduced to the local market and things got much better with it. After migrating to Europe, I was re-diagnosed by a good specialist with all the right methodologies and then got prescriptions for Elvanse (in the US it's kind of like Vyvanse, I think) 30mg and clonazepam 1mg to control anxiety. Been taking it for a couple years now, works pretty well. Not so long ago I have seen studies on which Elvanse is considered almost the best drug among analogs, so I can only recommend it. It is quite mild and has a long release. From personal experience: it is better to refrain from coffee and caffeinated drinks in general when taking medication.
- neonbones 2y agoAh, btw, hope it will be useful (just personal exp) I have tried different sleep medications, but the one that worked best for me was Mirtazapine. Although it is an atypical tetracyclic antidepressant, it works well before bedtime, plus it can be taken not regularly, but only when needed. My doctor and I tried escitalopram (lexapro?) and setraline, but the former turned me into a sleepy vegetable 18 hours a day, I could stay in bed all day, or even all week, even with the lowest dosage. The second one had no effect at all, whether I drank it or not. I also tried Quetiapine for sleep, it has a plus in that it does not cause any dependence and it is easy to stop taking it, but its effectiveness is so bad, although it is better than nothing if you have terrible problems with sleep.
- threecheese 2y agoI had to cease Mirtazipine due to nightmares - or more specifically, because I was waking my wife up from the screaming. Never happened before nor since, and I can remember some of them still. Terrifying
- organsnyder 2y agoThe best thing for my ADHD has been finding the right professionals to help me diagnose and manage it. Perhaps I'm reading too much into this, but I get the suspicion that you (or certainly others reading this thread) will take this information to try to self-treat. I've never heard of "late-onset" ADHD. Late-diagnosed, absolutely (I was diagnosed while I was in university), but to my knowledge there are no identified environmental causes that would cause ADHD to develop later in life. Professionals can help you determine whether you in fact have ADHD that was not diagnosed until now, or whether there are other factors.
- dpig_ 2y agoYou can develop it later in life from head injuries.
- KenArrari 2y agoI was diagnosed with ADHD as a kid. Medication made me extremely miserable and tried it again as an adult and it still made me miserable (made me focused, but completely on the wrong things). There are a lot of coping mechanisms that can help. Taking notes, leaving your phone behind, etc. I also switched from coffee to tea which helps a lot.
- guitarlimeo 2y agoCompletely agree with mnky9800n and tanepiper as well. I was diagnosed when I was 32 when suffering from a burnout. It surprised me how thorough the research was on "do I have it or not". Childhood records were needed and my parents were shortly questioned about my behaviour as a kid. For the medication, I currently don't use it. I tried some stimulants, but I have a non-operable arrhythmia (the good kind) situation which got worse every time I took the meds. With the help of therapy and my closed ones I've become better at regulating my emotions, so I don't feel the need to take medication. I still have some periods of hyperfocus or periods where my attention is certainly just all over the place, but then I just try to focus on stuff that is good to do when in those periods. Kind of stopped trying to force myself, a square peg, to fit through a triangle hole.
- hoorayimhelping 2y agoI was diagnosed 15ish years ago when I was 26. I tried medication and absolutely hated it. It changed who I was. Medication is a crutch. If you're completely crippled and you need it, then you should use it temporarily. But be very very careful developing dependence on it and using it instead of doing the work to deal with your behavior. What worked for me instead of medication: - Get on a sleep and wake schedule that follows natural sunlight. Try to wake up soon before or right around the time the sun comes up. Plan backwards on when to go to sleep to get the proper amount of sleep you need (I almost always wake up six and a half hours after falling asleep with no alarm, whether I want to sleep in or not), so I usually go to sleep around 11:30 to wake up at 6:00 AM. - Get on a meal schedule. Whether it's 3 meals or 5 or 6 meals, eat them around the same time, every day. No more skipping lunch, or working through lunch then eating it at 3:00 PM. - Eat some kind of protein and fat for breakfast. Don't eat breakfast made of sugary carbs (like bread or cereal). Eggs and a breakfast meat are really good. Steel-cut oatmeal cooked in a rice cooker and eaten with peanut butter and fresh fruit is also very good. - Workout regularly. I lift weights in the moring 4x a week, and I'm on a program that uses progressive overload, meaning I'm making continuous (but slow at this point) progress. Having a goal that improves yourself is the key here. - Spend time away from your phone and computer outside. Hiking, birding, fishing, surfing, hunting, etc. Do something that takes you out of your four walls and puts you into a place with plants and animals, and do it regularly. - Pay attention to your behavior. Be wary of getting into a hyper focused flow for hours where you ignore everything else (like lunch). Similarly, pay attention when you find yourself bouncing around. Becoming aware of when you're doing this is a big step to breaking the habit and forcing yourself to focus or take a break. I'm not saying getting into a state of flow is bad, I'm saying staying in a state of flow for hours on end where you ignore everything else isn't healthy or sustainable.
- theshackleford 2y ago> Medication is a crutch. If you're completely crippled and you need it, then you should use it temporarily. But be very very careful developing dependence on it and using it instead of doing the work to deal with your behavior. Your giving piss poor, dangerous advice that goes against established front line treatment. If you actually have ADHD, completely ignore this terrible advice and treat it in line with a qualified professional instead of getting your medical advice from unqualified HN posters.
- JohnBooty 2y agoThe number one thing is making sure I get enough quality sleep. Nothing else is even close! I say "quality" sleep because think I had minor sleep apnea for years and if you have anything like that going on, it won't matter if you get 8 or even 10 hours per night of sleep. As far as medication: - Stimulant meds were like a magic cure at first, but over time they lost efficacy and they made me more high-strung - Modafinil (if you can get it) is a little less effective for ADHD but seems to have less downsides Lastly, you may wish to consider treating anxiety as well. After years of semi-successfully treating ADHD directly I came to the conclusion that I had an anxiety issue as well. I'm not exactly an "anxious person" but even a little bit of anxiety really screws with my ADHD and can create a downward spiral.
- mwpmaybe 2y ago> The number one thing is making sure I get enough quality sleep. Sleep hygiene is a huge factor. > Lastly, you may wish to consider treating anxiety as well. I think it's a bit of a chicken-and-egg problem that will vary from person to person. Treating my ADHD and becoming more functional has reduced my anxiety and depression symptoms markedly.
- amanzi 2y agoI agree on the quality aspect of sleep. I've started to wear earplugs when sleeping, and now I get a much deeper, undisturbed sleep. I still struggle in actually getting in to bed. Not sure if this is common with ADHD people, but I'm a night owl and if I don't force myself to go to bed, I can easily stay up until 1 or 2am. Of course, that means I suffer the next day...
- hazmazlaz 2y agoAs far as my understanding of current science goes, you can't "develop" ADHD as an adult, it is something you are born with or perhaps develops at a young age. Perhaps if you had some kind of traumatic brain injury, which may be what you're alluding to. Either way, first step is go speak to a Psychiatrist about it. You might need to get a referral from your primary care physician. They will help you figure out what treatment options are available to you.
- in9 2y agosymptoms can change through time, and be triggered by life events. It can be that a person had the coping mechanisms for one manifestation of symptoms, but due to external events, they don't work anymore. The book I'm reading, Taking Charge of Adult ADHD, mentions that for an evaluation and diagnosis to be reliable in adulthood, the current form of symptoms should be happening for the past 6 months. great book btw, highly recommend it.
- jjj123 2y agoVery strange to me that people in the comments are jumping from OPs “I developed late onset ADHD” to “OP doesn’t have ADHD because late onset ADHD doesn’t exist” Isn’t it every bit as likely OP has had ADHD their whole life and is just now noticing the symptoms/the symptoms have recently been exacerbated in some way? To answer your question directly: I’ve been on stimulants for years. They helped me a ton, but more importantly they’ve helped me learn behaviors I can use when I’m off of stimulants to keep my focus where I need it. After 10 years, I’m taking them less and less, maybe 2 days a week. There are plenty of downsides to them (Andy Warhol said stimulants make you think the small problems are the big problems) so ideally you can use them as a tool not a crutch. I just read a book called ADHD 2.0 which was very enlightening for me, I recommend it.
- aaron695 2y ago[dead]
- jethro_tell 2y agoI wrote about this here[0] so I'm not going to post it again, and it's not a direct answer to you question but I hope it can be useful. A note that is extremely important is that medication without behavioral change and coaching is simply temporary at best and can even just have you hyper focused on the wrong thing. So, you really need to see someone, yes maybe you get medicated, but you also need to work with someone that can coach you through your executive dysfunction so you can understand what it is and how to work with it. 0. https://news.ycombinator.com/item?id=33633512#33639315 https://news.ycombinator.com/item?id=33633512#33639315
- deleted 2y ago[deleted]
- ldom66 2y agoI have been through hell becoming a new dad, thinking that my mind was broken, and I would end up making the same mistakes as my own father because of our common traits due to ADD. I tried all kinds of medication, started doing therapy, had sleep deprivation and started being extremely anxious. What I learned coming out of it is that I am not broken. ADHD is not a condition, it is simply the way my brain was designed. All that medication could not do what I wanted it to do which is make the ADHD disappear. That's not going to happen. It's just that the majority of people have non-ADHD brains and we are therefore expected to be the same. Think of it like being left-handed. It used to be that kids in school were punished for being left-handed until they became "right-handed". Turns out they were never right-handed in the first place, they were just forced to be. When that practice stopped, suddenly numbers of left-handed people in the world went up and stabilized around 10%. These people are not broken, but if all of the tools, scissors, cars, and everything they interact with were designed only for right-handed people, they would feel broken. The truth is a lot of what makes us "different" as ADHD people is also a strength. Creativity, great ability to recognize patterns, to think outside of the box, are all really great assets. Even some of our faults are simply there because our brain was designed to do that. For example, when you leave the house and forget the trash for a 100th time, it's not that you stupidly forgot the trash that was right in front of you. It's because your mind is really good at focusing on what's truly important to you, and the trash was automatically discarded from your thoughts so you could do that. There was a study where they had "neurotypical" and ADHD/Autistic people picking berries in a field and they found that ADHD/Autistic people were consistently able to pick more berries because they did not spend as much time on a single bush as neurotypical people [https://www.sciencealert.com/adhd-traits-may-have-evolved-to-provide-foraging-advantages-study-says https://www.sciencealert.com/adhd-traits-may-have-evolved-to...]. This study suggests that ADHD might have been promoted by evolution, and not a "disorder" like we may think. To conclude for my issues as a new dad, I have found that my own father's shortcomings are not due to his ADHD, but rather an overall lack of empathy and some unrelated mental issues he has to deal with. I have found it much easier now to accept my ADHD as a part of me instead of a disorder and have moved on from it to work on other aspects of my personality. Since then, I have found that even my shortcomings due to ADHD have been less severe because I understand and accept that they happen and give myself tools to work around them instead. Hope this can help you with your journey!
- CodeWriter23 2y agoWas diagnosed as a child. I take no medication. Instead I adopted the role of “hunter” (as opposed to “farmer”), as described by Thom Hartmann in his ADHD books. Which means I don’t sign up for “farmer”-like tasks and delegate them instead. My fundamental tool for staying on track with the work I do sign up with, pen and paper. It started with pencil and paper and the pencils of many varieties picked up from various bargain stores. The variety of colors and designs was what drove me to keep lists. But over years that evolved to a specially curated set of blue, red and green pens. I keep a book next to my dominant hand on my desk. Short term tasks are written in blue. Crossed out in red upon completion. This is a gamification strategy that gives me a little endorphine hit when I do it. On days where focusing seems difficult, I use the green pen to put a bullet point like some kind of human instruction pointer to indicate what I’m working on. Everything revolves around looking at the book. If there is an issue/inquiry for a teammate, it also gets written down. I have a second book, in which I allocate 2 pages to each project I have. This has a handwritten synopsis of the project and any large challenges the project entails. Very minimal on details. This book is the forest; it serves long term memory issues. The first book is the trees, for short term, is highly detailed and is a diary of sorts in log form. Things not completed yesterday are re-written today as a means of reinforcing my connection to the task or need. So this is all ritualistic for me. The pens I now favor have come through years of iteration. The “trees” books are Italian-made that my wife gave me and then I went to Home Goods to stock up on them. The paper is ruled and nice to write on and a little fancy. These weigh less than my phone, so I always grab one that I use as a free form note-taking pad in meetings. The “forest” book is thicker, has a specially-designated and fillable table of contents at the beginning. The paper is not lined and has a line or graph paper template to put under the page you’re writing on. My point here is not you have to have the same fancy pens and books I use. I have chosen things that just “feel right” to me. “Right” means something I enjoy visually and by touch. If you adopt a paper-based approach, absolutely find what works for you. I mean only to share what I have found as an example. I occasionally go shopping for alternatives; if I one day find something I like better I will repurpose the stocks on hand of books and/or pens and ruthlessly get rid of the old and bring in the new. Why do I go to such lengths to facilitate writing? For me, the motion and muscle activity of writing is a different way to form memories. Something written becomes more connected to me than something typed. I do use Notes on my Apple devices for certain things but these always seem very detached from me. If I remember or by random encounter a note in Notes visually, and it seems important, I then write it down. I also use Calendar and Reminders to trigger me, mostly in a reactive way into action. Siri is literally my administrative assistant. Oh, and my reasoning for avoiding medication: my ADHD is a gift that I do not want to squelch. Yours may be more difficult and maybe medication is your solution.
- threecheese 2y agoDiagnosed at 45, the best metaphor I’ve heard is “everyone has to carry all their marbles in a bag; adhd is like holes in your bag, or not having a bag at all”. I’d been diagnosed in the 1980s, no treatment no info; I was a “gifted” golden boy. As an adult I immediately failed out of college (and more), found that drugs relaxed me, lived with anxiety, depression, addiction, obesity, and loneliness for 25 years. Then, Vyvanse It didn’t fix everything, but helped me to understand that motivation is a chemical, I’m not just lazy and worthless. One can build on this. I’ve tried Vyvanse, Adderall, and now take Adzenys. Vyvanse was the most effective, Adderall was OK, had to move to Adzenys due to supply chain (it’s my secret, there’s no shortage of it). You should understand the pharmacology of amph, and how body stuff (like urine pH, malabsorption conditions) can affect it. You should experiment with diet, supplements, timing, hydration, and should be taking time off/titrating to reset tolerance. You should not continue to increase dosage arbitrarily, if you develop tolerance manage that within your dosage. See a cardiologist, they may want to counter it pharmaceutically. Beware of antacids and amphs. I hope you are young. I spent a lifetime trying to catch falling marbles, and problem-solve my way into preventing it again, not realizing that I’m supposed to have a bag. I could never look beyond that problem to new opportunities, and adding new marbles to my life was out of the question. If it wasn’t for my programming hobby, I’d be in a much bigger hole than I am.
- tailspin2019 2y agoThanks for sharing this, it resonated with me and also provided a bit of hope as I go through a similar journey.
- klowrey 2y agoVyvanse is dextroamphetamine, while Adderall and Adzenys are mixed dextro- and Levo-. While there are now generic versions of Vyvanse, they’re unlikely to be as effective until other developers work out the manufacturing kinks. However, generic extended release dextroamphetamine is generally not in short supply and 10x cheaper than Vyvanse. Might be worth a shot if that’s what worked best for you.
- UI_at_80x24 2y agoI'm in my 50's and just started taking 18mg Concerta/methylphenidate in the last 2 weeks. It's still super early for me to judge. I have noticed that it's much easier for me to procrastinate and avoid work (now I have much less guilt!). But the "working periods" are better. I do seem to get more stuff done when I can actually make myself do it.
- ferociouskite56 2y agoDiagnosed ADHD at 17. He said no medication necessary. I didn't become a decently clear writer until a decade later after trying marijuana. Walking hours a day helped. I was worsened by antipsychotics and would never use speed.
- fzeroracer 2y agoI was diagnosed earlier this year (at 33), ended up being prescribed Methylphendiate and after a months weeks it made me better understand what the issue is with my brain. Especially after skipping a dose for a few days to remember what my baseline used to be. The way I've always described my thought process is that it's like every thought is a fish in a barrel and all I have are my hands; I have to reach down to grab the specific thought I want to focus on and often it slips through my grasp. Medication slows down the fish and makes it so I can hold onto it. I still have to make an effort to grab the 'right' fish but I'm not fighting with myself. Prior to medication I had various coping strategies I'd employ. Mainly things like having multiple rolling things going on at once, but I was also a severe fidgeter. During college I was a stressed anxious mess so I figured that it was just a natural response to that sort of thing, but as I settled into my 30s and became far more stable with no stressors or contributors to anxiety my issues with ADHD became a lot worse.
- molloy 2y ago> due to recent/past events Look into cptsd, and mention what you’ve said here to a trauma/informed therapist. ADHD can be exacerbated by cptsd, so you might have already had ADHD but not as noticeably.
- boppo1 2y agoDiagnosed at 15, avoided prescriptions based on my friend's recommendation. Gave in and tried adderall at 19, turned certain parts of my life around. However, after ~6 mo. taking it, it gave me severe erectile dysfunction and muted my arousal. Like, vagina-of-the-most-attractive-woman-I've-ever-known-in-my-face and my arousal is a total flatline, dick totally shiveled & limp. I tried every ED medication, and although those would give me hard-ons, they were pleasureless. The arousal that feels like 'sexual electricity' in my veins was completely absent. This issue did not completely go away until I had been off of adderall for 3 years. All in all medication was a double edged sword. My life is a real challenge/mess as I fail to complete important things I'm demonstrably capable of in a timely fashion. However, while I was medicated, I was completely dependent on it to even get out of bed, and it made me feel extremely hopeless and pathetic w/r/t women.
- rishab1 2y agoI think no medication is eventually going to be the way to go. All of us will look back at the usage of chemicals as a mistake. Having society accept neurodiversity is going to be best outcome
- mwpmaybe 2y ago> Having society accept neurodiversity is going to be best outcome A lot of f-ing sh-t is going to have to change before this can become even remotely possible.
- jshaqaw 2y agoThere are sadly no easy fixes here. Approaching 50 with a life of ADHD here. I’ve managed to build a great life but always against that burden. Thankful that when I was younger I didn’t have the universe of constant connectivity at my fingertips or I don’t know that I would have had the strength to nail things back then. A few comments: - Most people start meds and feel like a superhero getting their powers. Like “wow now I can actually do all those things I dreamt of”. Be careful. The surge doesn’t last. Medication will always help but that initial WOW will fade. Don’t get so attached to it that you feel like crap when it does. - It sounds trite but nothing has helped me so much as trying to make serious meditation a habit. That and exercise/diet/regular sleep. I know - it’s boilerplate. That doesn’t make it untrue. - Give yourself a break. You are who you are. Try as much as you can to succeed within the grain. That doesn’t mean don’t try to be disciplined and ambitious etc… But dreaming what another you without ADHD might have been … well it just isn’t all that productive. We get the hand we get and it’s up to us to maximize our happiness within those constraints. Try to focus on (hopefully) all the good cards you did get.
- theoriginaldave 2y agoI've struggled with ADHD my whole life. And based on my behavior, you'd think it was obvious. I have the inattentive flavor. When I'm "locked-in" on a task or subject, I can focus on it completely, and be completely inattentive to the rest of the world: the house might be on fire, but I've only got one more piece of code to finish. Also, if I did manage to interrupt my fugue, it was almost impossible to finish the task: for a fossil collection that was half of my natural science semester grade, I spent a weekend walking a creek and limestone quarry and collected 500 fossils, twice the required, but after going home, I never sorted and labeled them, even though I knew what they were when I collected them. I ended up failing the class because of lack of 1 hour of cataloging. This continued through the rest of school. I entered university with 29 credits due to testing (I can ace any test), but dropped out after two semesters because projects and self-study just didn't happen. I got lucky in a job as a troubleshooter. Fly into a factory with a software problem, work 18 hour days to find and fix it, and leave a hero. Great for the career, but I would lose a fortune, because I would wait so long to do expense reports and pay credit cards. This type of ignoring things that you desperately need to do, in lieu of the current easy to focus things is one of the major diagnostic distinctions between being lazy or unmotivated, and ADHD. I was formally diagnosed with ADHD at age 42, and prescribed Adderall. And it was like shining a light on the world. I'm 53 now and still taking Adderall. There was definitely an Adderall honeymoon, but the lasting effects are also apparent. I now 100% pay my bills on time, I maintain my car on schedule, I keep the house clean. My credit score went from about 500 (poor) to about 800 (excellent). I still accrue debt and then have to work to pay it off, and lose money on interest, when had I planned I could have just paid cash. And I'm still constantly harassed (good naturedly) by my Managers to do expense reports (they know I have an issue and accept it and are willing to work with me). Probably with the right coaching, methods and strict oversight I could have done all these things without drugs, but I would have hated it. I think the drugs improve my quality of life, and reduce the stress in my life immeasurably (I could probably measure it by stop using them for a year, but I'm not gonna!) So I think the test needs to be: 1. Does ignoring the things you need to do make you miserable and feel like a failure? 2. Is your quality of life suffering? 3. Do you lose jobs,Relationships, because of these failures? 4. Does it prevent you from doing the things that would make you happy in life?
- user68858788 2y agoI have ADHD and perhaps undiagnosed autism. It’s severely affected my ability to build software, but lends itself well to supporting other teams in larger companies. I usually lose interest in my work within a few years. This leads to a lot of procrastination and a backlog of work that I just cannot force myself to do. I am prescribed Vyvanse. It helps but regularly gives me heart palpitations and insomnia. I can’t drink coffee while using it. This causes me to only use it when I’m fairly behind in work. I can’t really say I overcame ADHD, but I’ve managed to hold a few jobs long enough to reach financial stability.
- bilsbie 2y agoI didn’t know late onset was a thing? Could it be caused by burnout?
- gtirloni 2y agoDiagnosed at 40, suffered from it since teenage years, always treated for depression/anxiety. Started treatment with Vyvanse, now stopping with SSRI's because they were treating side effects not the root cause. I'd suggest you get tested by more than one doctor and seek medication. It'll help but it won't fix your old habits and how your brain has been wired up to this point. But medication will at least give you a chance to create some mental space to notice things and try to change them. You're are who you're. Acceptance also helps. Being neurodivergent is not bad, it's different. I wish I had been diagnosed decades ago, but where I live ADHD was considered something you grew out of, or didn't exist, or.. so at 40 in my session with the ADHD dcotor, I said the same things I told other doctors decades ago and they never connected it to ADHD, unfortunately.
- theriddlr 2y agoYou ran out of capacity for coping mechanisms. Psychiatrist Dr Stephen Humphries explains how late diagnosed ADHDers cope through life by being bright. https://www.youtube.com/watch?v=lSjHYiTEA4M https://www.youtube.com/watch?v=lSjHYiTEA4M I got on by having modular work (university, software engineer with Jira tickets overseen by a PM) which is small enough to still be done last-minute, constant manufactured anxiety to get me to get things done, being excused for being young and foreign (for being rude). Shit Life Syndrome and maturity (expectation to be responsible) meant exacerbated ADHD symptoms and a diagnosis.
- serenity-lab 2y agoBackground: - Diagnosed at 35 (last year). - Parents in the medical field, one has a psychological orientation - Sister on the "spectrum" - Mom diagnosed with Autism at age ~58 - Dad is un-diagnosed, but shows clear signs of ADHD (We're a carbon copy of the below). - Grew up in a small town where psychological, or for that matter, anything non-physical was considered a joke/not something you bothered even exploring. But friends didn't judge or make a point of (what should have been obvious) that I was different in terms of behavior. Everyone was essentially treated equally, even if you were clearly different. - Got a PC early on in life, and quickly bonded with its logic. Did great in school with anything related to practical things, engineering or IT. Flunked the rest but could compensate with "added curricular activities" relating to IT. - Dad always had projects, and I loved watching and picking up (what I thought to be) how to do stuff correctly. Repairing cars, computers, kitchen appliances.. you name it. - "Always" sabotaging or quitting relationships one after another (note: I am by no means a casanova, and did not intentionally sabotage relationships. But some relationships were purely destructive — most likely because the challenges it brought made me feel something, different? And I now know different=shiny=want. Or they just pushed buttons I didn't know I had so I reacted strongly - or vice versa) - Never had a job longer than 3 years straight (I was always the one who quit. I never got fired or lost a job. Not saying it to brag - but to emphasise boredom or lack of interest after a certain point. I would consider myself to have performed average or above average in all my jobs, because I worked with my hobby. This is not saying I was the best or even near best at anything - but it was easy to work because I felt love for what I did - until I didn't) Realizations and some serious soul searching after: - My current relationship almost imploded, and my current partner is the best thing, but also the most challenging thing, that ever happened to me. - Always changed jobs on the regular, even geographical locations at times. - I have too many projects, this should burn average Joe/Jolene out in a heartbeat? Why do I keep enjoying adding on top of the pile so much? - How can others save money when I almost live on a month-to-month basis despite earning more than the average person around me? - Stopped feeling "joy" in moments I know I should enjoy. I remember how it felt when summer came, or I saw those beautiful green hills that I liked as far as the eye can see, or the white powder snow bursting around me when carving the snowboard through fresh snow. Those moments stopped giving joy, why? Others take vacation all the time and have genuine joy - I equal amount of joy at home vs going to a new destination. - People have been joking about the fact that I clearly have "a letter combination" - I hyperfocus and can work 3 times as fast and much as anyone else doing the same thing... if it's technical and challenging.. but I never complete them. And completely forgetting people and other tasks around at the same time, such as eating. - I always had "easy access to my emotions" in the sense that, I can get frustrated quickly for things others can just "let go" - how do they do that? And why does it linger so long? - Why do I have different feeling towards attachments to people? I miss my partner if they're gone for a week, that's normal I suppose.. But I consider old friends to still be "best friends" despite not having talked to them for 15 years, and I feel the same way about them I did 15 years ago. But I don't miss them at all — in the sense "I have to go see them now" or "If I don't talk to them on the regular I fear we might drift apart". - Even tho I stopped using or looking at things a long time ago - why does it feel like I never stopped using or enjoying those things? I'm still emotionally attached to a car that I didn't even use in 10+ years. Most people would have forgotten about it by now — but for me they don't lose any value. - Why do I ramble and start talking about something I haven't thought through, and the process appears to be, "talk it out until it makes sense" and eventually something coherent would come out at the expense of, "everyone stopped listening half an hour ago" - or I annoyed someone in the process by using the wrong words. Others don't appear to have this issue? - Why is it that mundane tasks in general are so hard to do and people are right when saying "Just do it now? It's a bag - it should go into the trash outside - it's not rocket science?". And why does it help if there's a time pressure aspect to it? Like a date coming over, or the garbage man is about to come, or whatever silly thing. Today: - took a chance, paid for private healthcare (~2 100$) — despite it being "free" to do here, and got ADHD-evaluated. Waiting time was expected to be around ~5 years in best case scenario for the free option. If you're considered "successful in life", then you might not even be allowed to get a free diagnosis here because you "don't have any issues going through your expected lifespan". - Currently on Methylphenidate (Concerta 50mg / Medikinet 40mg + Ritalin 10mg) - Going through trial and error with medication dosage and health care professionals who really favors Concerta and Methylphenidate in general. And to quote, "Elvanse is a hip thing everyone does these days - we'll try Concerta first". - Working on myself. I feel I've done everything I wanted to do, now I want to better coalesce with others and see if I can do good for the future generation. - Being as honest as can be with everyone around me and myself whenever I'm in a situation that doesn't transgress "normal", that I might stumble and figure things out. Positives: - I can now focus better, I get more stuff done in a structured manner. And hopefully not causing concerns for people around me if X is going to get done or not - and at what quality level. - I don't randomly change subjects when I feel a conversation has stagnated in group conversations - I finally don't get so emotional when someone corrects me - I finally don't get so emotional when I realize I messed up and I can keep my composure - I finally don't spiral in conversations where I haven't formed a sentence in my head beforehand - It's not a physical constraint any longer to do chores, such as getting off the couch to take out the garbage. It used to be "inefficient" to do chores immediately when "I'm going to the kitchen in 10 minutes anyway" (which is a lie I told myself to release myself from the physical feeling of not being able to, wanting to, but not being able.. so I could let the feeling go. 10 seconds later I would forget about it, and when I do walk to the kitchen — you forgot you were supposed to efficiently also take out the garbage). Negatives: - People consider medication a risk, or it altering you, people worry in general - Physical problems such as potential mood changes, urinary incontinence, or sexual disorders to name a few - Common side effects are to be expected, headaches, increased blood pressure, etc. - Easy to forget the medication - Easy to be complacent, any "coping mechanisms" built up might not get as much love as it needs - Weight loss, it's genuinely harder to eat normal portions, and is awesome at first — until it isn't and you realize you swung the bar the other way on where you wanna be. - Potentially you can get curious, "what else might work?", to the point where you experiment too much Was it worth it? I think so. It's has not been a magical bullet to get diagnosed nor did I expect it to be. Same goes for the medication. But it sure felt good after having spent a few years without external help to some degree, self-analyzing, self-diagnosing, and now getting confirmation that the effort wasn't misaligned or time wasted. Now knowing that when I try a "tool", it's not a huge waste of time considering I will have to try quite a few. We only have so much time on our hands, and considering the diagnosis and aid came half way through the average lifespan in my country, I'd like to put effort into "tools" that should work rather than randomly stumbling after some that might work. People also tend to give you slightly more wiggle room while figuring stuff out which helps. It used to be that people saw a 35+ year old person "figuring out how garbage works" and giving you zero room for processing those things. This wiggle room has lead to less emotional blockades making it easier to go through with things. Your process and results will be unique - make the most of them.