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Notes on Managing ADHD

• siva7 1y ago
  This is one of the best linked articles about ADHD i've seen on HN. Especially because it gets quickly to the most important point which often times is still neglected: > The first-line treatment for ADHD is stimulants. Everything else in this post works best as a complement to, rather than as an alternative to, stimulant medication. In fact most of the strategies described here, I was only able to execute after starting stimulants. For me, chemistry is the critical node in the tech tree: the todo list, the pomodoro timers, etc., all of that was unlocked by the medication. This means: You do have to see a physician and psychologist to get diagnosed and to get a therapy plan. Just reading articles or books about managing ADHD won't do the trick.
  • margor 1y ago
    I have to add my 5 cents to that because I've experienced something I've not seen anyone else experience and I think it might be worth to share it with others that might struggle with the same. I had various neurological issues for the past 10 years, some of them common like visual migraine auras, GAD, panic attacks, and some of the less known and frankly hard to describe - visual snow, poor night vision, problems with adapting to light/dark places, constant fatigue, over stimulation (pins and needles over the whole body when overheating, as an example). On top of that, ADHD and I was really afraid of any and all kinds of medication, especially mind altering ones. At one moment, I was in a really bad shape and place mentally and I decided to get professional help and start medicating, as I felt nothing else can help me anymore. And believe me, I did try all kinds of therapies, exercising (how do you do it with constant fatigue?), mindfulness and meditation (closing eyes when stressed was horrible experience for me!), nothing helped. Look, you can tell me it's placebo or whatever, but I started on SNRIs and later on stimulants for ADHD. It took me _2 weeks_, to cure 80% of my neurological issues. It was almost like someone flipped a light switch in my nervous system. I still can't fully believe it or even try to understand, but my theory is that I've been genetically destined to have these problems, and "just trying hard enough" was not enough and would've never been enough. SNRIs cured my neurological issues, and stimulants like Ritalin gave me willpower to start making positive changes and for the first time - start making habits. I believe, at least in my case, it would've been impossible without medication, or it would take me half my life to get to a place where I would've felt comfortable with myself and my problems. I believe my life is too short to fight with all of these issues alone, and I'm really glad I did start that. tl;dr: medication gave me my life back, not just from ADHD but from variety of other issues, that ADHD just exacerbated. Please do try medication, it's not a one way door and we humans don't have infinite willpower to deal with all the issues on their own.
    • danparsonson 1y ago
      Thank you for sharing your experiences - can I ask specifically about your visual snow syndrome? Is it improved now? Totally cured?
      • margor 1y ago
        I always thought any kind of SSRI or alike will make it much worse, as many people on reddit indicate they caused it for them. I seem to be in opposite camp where SNRI actually lift like majority of visual snow syndrome, but that was not the only syndrome I had. I believe I had something more like HPPD. Believe me, I was scared as hell as I thought these meds will make it worse, and I am really glad now that I did try them and they did work for me. I still have a really small amount of snowing, but I can ignore it entirely and carry on with my life.
        • danparsonson 1y ago
          Thank you, that's good to hear and quite surprising to me - I have a friend with VSS, and so far they've just been told that there is no known treatment for it. This will be something to look into I think.
    • kstrauser 1y ago
      Absolutely. If you're having problems, please consult a doctor! Medicine can't fix everything, but there's a whole lot that a good doctor can help with. If you had diabetes, you wouldn't feel hesitant to take insulin. It's not a moral failure. It doesn't mean you're weak or bad or a disappointment. It just means you have a medical issue that can be treated. Well, same here.
    • simonbw 1y ago
      In a similar vein to "try medication", I'd like to add "don't write all medication off after one doesn't work". The first seven medications I tried had basically negligible effects, and then the eighth one I tried (also an SNRI) had absolutely life changing effects within hours. I had the same moment where it seemed like a switch flipped and I couldn't believe the difference one medication could make. A big realization I had was that doctors don't necessarily start by prescribing the medication that's most likely to help, they prescribe the one that's got the highest expected benefit to negative side effect ratio.
  • phoronixrly 1y ago
    Just chiming in to mark the importance of the seeing an actual physician part. To get diagnosed, prescribed medicine and have treatment follow-ups.
    • AlecSchueler 1y ago
      Problem is I'll keep putting that appointment off...
      • tonyarkles 1y ago
        Heh, the psychiatrist who diagnosed me laughed a little when I showed up rushed and late to my first appointment. The good news is that after you’ve been diagnosed, getting near the bottom of the bottle of pills is a great reminder to call the pharmacy for a refill. Plus… shortly after noticing that you’re almost out happens to coincide with the medication taking effect, so you’ll be in the perfect place to make that call!
        • snuxoll 1y ago
          Assuming you're lucky in a couple of different ways, as regulations around stimulants in many countries really screws people with the executive functioning issues caused by ADHD. Running out? Your physician needs to write a new prescription, since they can't write one with multiple refills. Maybe your physician will write multiple with "don't fill before" dates on them, but overzealous regulators make many uncomfortable writing more than your next 28-30 days of medication. Called your physician and got them to send your new script in? Hope your pharmacist isn't an ass, because some will straight up refuse to fill until the exact day you run out. Oh, and hope they have it in stock - because limits regulators and/or distributors put on ordering make the lives of retail pharmacies just buying these medications a special kind of hell. I've been extremely lucky, my physician wisely writes me 28 day scripts so I can consistently time my requests for a new prescription be written, so every fourth Monday I send him a message and no later than Wednesday I get a text saying it's been sent to my pharmacy. The pharmacy I get my medication filled at doesn't treat me like I'm scum that's going to be selling my medication, so I can easily pick up my next 28-day supply a few days before I would run out if it works better for my schedule. But more than once I've had to play the game of figuring out which store actually has my medication in stock, and have the script pulled and resent to a different location....
  • kstrauser 1y ago
    I wish I could go back in time and drill this into my own head. I evolved a large set of coping mechanisms that let me get by alright without medicines. I was putting food on the table and a roof over our heads. Still, it took a phenomenal amount of mental effort just to get started with critical things. I'd have all my tax receipts scanned in and organize and just needed to make an appointment to send it all to my accountant, but I'd sit on that until the last minute. I knew it needed to be done. There was no reason not to do it. I wanted to do it. I was ready to do it. And yet, I couldn't freaking do it. It was the equivalent of running a marathon carrying an 80 pound backback. Yeah, with enough work you can do it, but you're not going to be setting any records. Stimulant meds have been lifechanging for me. I'm not magically doing more than I was before. Those coping mechanisms took me pretty far. It's that I'm doing it all without delaying them until they became emergencies, which is what it use to take before I could even get started. My life is so much easier and less stressful now. I took that backpack off and how I can run the same race as everyone else. And you know what? When you've been practicing your whole life with an extra weight on your back, and you take it off, sometimes it's surprising how fast you can go. In before "of course it's easy, you're on meth!" Yeah, that sounds reasonable if you know nothing about ADHD. I've talked about this here before, but Aderrall has no noticeable stimulant effect for me at all. I feel a good cup of coffee much more than my daily meds, which is to say, not a lot. It doesn't give me extra energy or alertness or anything else. It just tells my brain, hey, did you know you're allowed to get started on things before they become emergencies?
    • tonyarkles 1y ago
      Late diagnosis here (38 when diagnosed, now 42)… I agree with everything you said. I had an amazing set of systems and coping mechanisms in place to get through life without realizing I was playing the game on hard mode. In retrospect, the signs were all there my whole life but I just hadn’t had the realization. Now that I’m medicated (methylphenidate), I still lean on those systems but they serve me very very well. I remember details much better than I did, but don’t always remember them long-term. The note taking system and habit that I developed years ago is now… supercharged because I am so much better about keeping good notes. On the coffee/meds thing, I agree. I don’t get a buzz from the medication the way I do from coffee, but before my diagnosis I was drinking a ridiculous amount of coffee every day just to stay focused, with the associated buzz and jitters. I still have a cup or two of coffee in the morning, but drinking anywhere near as much as I used to is pretty much unbearable.
  • gooodvibes 1y ago
    Thank you - I've been putting off getting an assessment and seeking medication for a while, and I've just booked an appointment with a psychiatrist after reading your comment.
  • leoc 1y ago
    Getting diagnosed and medicated should absolutely be the first port of call and one should do it without delay. However I should add that they never made much concrete difference to my "clinical outcomes". Now I'm sure I was holding them wrong (or holding the wrong model of iPhone), and I should get around to getting prescribed again, but if your main problem is anxious procrastination I honestly think you should temper your expectations about what drugs (or certainly methylphenidate or amphetamine) will do for you.
    • steezeburger 1y ago
      Do you mean this because the stimulants can also cause anxiety?
      • leoc 1y ago
        No, not that (though I'm sure they can cause anxiety under certain circumstances, consult your physician etc.) It's just that IME they do basically nothing one way or the other about anxious procrastination, so if that's the thing that's killing you ...
        • liotier 1y ago
          Excess caffeine poured on anxious procrastination makes me a disaster of a person.
        • neutronicus 1y ago
          Similar experience here with Adderall. I go unmedicated now because it's a pain in the ass to get the prescription refilled (not the best, but whatever). But my experience was that the anxious procrastination mostly still happened when on the crank (I was a lot less absent-minded though which was something).
      • nerdsniper 1y ago
        They can for some people on some days or parts of days (my anxiety peaks when stimulants are wearing off). But like the other poster said, its more that they do nothing to solve it. I found a beta blocker in addition to stimulants was good at unlocking my productivity. YMMV. Additionally, the boost in dopamines rewards anything you happen to be doing, so it can lock you into your avoidant behavior that day once you start doing it.
  • niemandhier 1y ago
    True to a point: Noting that has an effect has no side effect. Some of us have to deal with the decision of a loved one taking meds and increasing their probability of a sudden cardiac death ( by qt Interval prolongation ) or staying unmediated. Strategies to deal with ADS without meds are valuable I situations like this.
    • __float 1y ago
      > Some of us have to deal with the decision of a loved one taking meds and increasing their probability of a sudden cardiac death... Why is this such a concern to you? At some point, everything has _some_ risk, and this feels like you're putting a lot of guilt on someone else for making a medical decision they deserve to make on their own.
      • niemandhier 1y ago
        The parent is explicitly endorsing stimulants. Those work well to some extend for treating ADHS, but in general evidence is rather weak for then improving academic achievement, while evidence is rather strong for behaviour changes that makes it easier for teachers to deal with kids, see e.g. https://pubmed.ncbi.nlm.nih.gov/38871418/ https://pubmed.ncbi.nlm.nih.gov/38871418/. Pharmacology is not my main area of expertise but I used to do a lot of work in cardiology, and anything that increases the QT interval in the ecg increases the risk of Torsades de Pointes. Rule of thumb is 5–7% more TdP risk per 10 ms QTc. Quite a few adhs meds do this moderately, not enough to make an ecg mandratory. I still believe that making medications the default for adhs is not warranted given the side effects, especially since in many cases it’s not clear if it treats the condition or just makes the lives of education professionals easier.
        • torben-friis 1y ago
          I’m reading this as a person diagnosed in their thirties and it feels a bit detached from reality frankly. I, and millions other people, could tell you that it does immensely benefit with issues like executive dysfunction. Medication quite literally made the problem I had been battling for decades disappear instantly. Associating adhd just with childhood is in itself an obsolete view that causes issues for people.
  • throwingawayusr 1y ago
    One thing I haven’t ever seen mentioned in these threads is how do people who can’t handle stimulants get by?
    • dns_snek 1y ago
      There are non-stimulant medications for ADHD but I think their effectiveness is more variable, they work well for some people and not at all for others. Strattera, guanfacine, and wellbutrin come to mind. Outside of medication there's therapy, cognitive training, coaching, etc.
    • Mordisquitos 1y ago
      There is at least one non-stimulant ADHD medication which may help them: https://en.wikipedia.org/wiki/Atomoxetine https://en.wikipedia.org/wiki/Atomoxetine
    • zozbot234 1y ago
      Coffee and chocolate (plus potentially tobacco) are technically stimulants, 100% legal, and people seem to handle them just fine. Just take them strategically as opposed to recreationally (i.e. only as support for building up healthy habits; go cold-turkey otherwise!) and you should do just fine. The effect is way stronger than most people might think, provided that habituation hasn't built up and the existing tolerance has been dissipated.
      • dns_snek 1y ago
        I wouldn't necessarily recommend nicotine. It works and alleviates ADHD symptoms at first which is great but that also makes it really addictive. I can't comprehend the level of discipline I would need to use nicotine without becoming addicted and I'm not prone to addiction generally.
        • zozbot234 1y ago
          The interesting thing wrt. this is that nicotine replacement products are widely available without a prescription. Would people really get seriously addicted to e.g. wearing a transdermal patch?
  • volemo 1y ago
    The country I live in prohibits stimulants and moving is not an option for the time being. What are my options besides atomoxetine?
    • Otek 1y ago
      Caffeine perhaps? Yerba mate? Also CBT therapy on its own is pretty good.
      • volemo 1y ago
        Yes, caffeine works but I’m very cautious not to build up tolerance, i.e. I’m afraid that if I start drinking tea/coffee regularly, it’ll loose the jolt it gives me now and I’ll just become addicted.
    • whycome 1y ago
      Nicotine. But not the smokeable kind. And low dosage. But not if you’re likely to get addicted. The absurdity is that your country definitely makes it legal for historical reasons rather than useful less addicting stimulants.
      • dingnuts 1y ago
        nicotine is ridiculously addictive. everyone is likely to get addicted to it
        • whycome 1y ago
          I agree that it’s ridiculously addictive. There’s a big correlation to delivery type and how your brain can associate it to drive that compulsion. It’s very fast acting, esp when smoked. https://www.pbs.org/newshour/amp/science/column-recent-research-sheds-new-light-on-why-nicotine-is-so-addictive https://www.pbs.org/newshour/amp/science/column-recent-resea...
      • cardanome 1y ago
        Nicotine is amazing... for a week. Then you will be chasing the dragon forever. Tolerance builds up crazy fast and doesn't meaningfully lower even when you cease smoking for years. Plus pretty bad for your health and crazy addictive. Absolutely not a good recommendation.
  • bumblehean 1y ago
    I really wish my body could tolerate stimulants. I tried the major ones (Adderall, Ritalin, Vyvanse, Concerta, etc.). They all made dealing with ADHD significantly easier, but even at the lowest doses they turned me into an extremely anxious and irritable person. I had never experienced anything close to a panic attack or nervous breakdown in my 30+ years of being alive until I started taking stimulant medication. I decided that living with untreated ADHD was the better alternative, so now I'm back to copious amounts of coffee to deal.
    • InMice 1y ago
      Same here, the lowest dose concerta keeps me wide awake for 24 hours. The non stimulants give me side effects not touching those with a 10 foot pole. Did you try 2.5mg ritalin? i think thats the lowest dose.
      • klipklop 1y ago
        If you can’t sleep, for sure avoid extended release meds like Concerta. Stick with immediate release with no afternoon doses. Take it the second you get out of bed. You want to time things so it wears off after your work day and you begin to get tired.
      • DrewADesign 1y ago
        I can take pretty high doses of Ritalin and sleep as long as it’s not the extended release. The lowest dose extended release medications didn’t touch my symptoms and reduced my average sleep to about 4 hours per night. My wife gets good results with atomoxetine, which isn’t a stimulant.
    • kamranjon 1y ago
      Just a heads up, Ive taken stimulants on and off as a treatment for ADHD for many years but my body/emotional health always felt compromised as a result. I've recently started on a non-stimulant ADHD medication called Atomoxetine and so far it has not had the emotional blunting, irritable effect of stimulants at all, and I haven't noticed any negative effects so far. It seems to help me get over the hump of being able to start things and stay with them which has always been my biggest downfall. We will see if I stick with it, but just wanted to mention that there are alternatives. There is also another medication called Guanfacine that I may try if this current medication does not work out - I don't think I can go back to stimulants.
  • nnoremap2 1y ago
    As someone who is struggling with ADHD and tried Ritalin at one point. The Ritalin did not really change anything for me, I was calmer, but it didn't help me get a better grip on my life so to say. Do you think there is a chance this would be different for other stimulants? Just looking for some experiences people had I guess.
    • kstrauser 1y ago
      I think it's worth trying. I started with Focalin but found Adderall works better for me. It's a little different for everyone.
    • hnick 1y ago
      A study I glanced over a while ago said something like 40% of people respond to dex or ritalin, around 80% to either (I'm in this group but dex had more annoying side effects), and the last 20% to neither (but there is other stuff out there). So it's definitely worth trying both branches of the common meds first. You should also talk about dosages because there is titration period where they need to monitor and adjust to see how your specific body responds.
  • anonymars 1y ago
    Here's a fun fact. In the US, if you would like to fly a plane, and you have undiagnosed and thus untreated ADHD, no problemo. But if you do end up taking stimulant medication for ADHD, that's not allowed. So unfortunately sometimes (rather often with the FAA) it's better not to ask questions you don't want the answer to.
    • _moof 1y ago
      The amount of undiagnosed ADHD (and secretly treated anxiety and depression, for that matter) in the aviation industry is off the charts. I have a lot of respect for most of the FAA, which is professional, reasonable, and evidence-based. But the FAA aeromedical division is a joke. They're bullies with a stone-age mentality about treatments and medications that have been accepted for decades.
      • zozbot234 1y ago
        I might agree in principle, but aviation pilots are glorified bus/truck drivers. It's the farthest thing from a job that might cater to a typical "ADHD" skills profile. What you really want in that role is people who can be dependable without relying on intoxicating substances that might have weird side effects.
        • anonymars 1y ago
          This is the same fallacy that always comes up. People are already flying this way! What is the difference between someone with ADHD who passed their pilot lessons but doesn't have a diagnosis and is not taking medication vs someone with ADHD who is getting help? Why is this an aeromedical issue and not a certification issue? What is the training and testing for if not to confirm that someone has the capability to successfully fly a plane?
        • repiret 1y ago
          There is a large adult population with undiagnosed and untreated ADHD. A generation ago that population was even higher. A bunch of them are pilots. So then the question is, if in a professional pilot and I think I might have ADHD, do I follow up on that hunch? Of course not, because a diagnosis would cost me my career. There’s good research to show that stimulants reduce the rate of car crashes in people with ADHD. I have no doubt that if we encouraged pilots to seek ADHD treatment, it would improve safety. IMO the diagnoses that should exclude someone from flying are those that could cause them to become suddenly incapacitated. For everything else, we can just test whether someone can safely fly an airplane, which we already regularly do for pilots.
  • sapphicsnail 1y ago
    > This means: You do have to see a physician and psychologist to get diagnosed and to get a therapy plan. Just reading articles or books about managing ADHD won't do the trick. The cruel paradox of ADHD treatment. I only got meds in the first place because my husband was able to follow through with getting me the appointments. It's been life changing. I needed a ton of support before and now we've reached parity with chores and finances. I never could have gotten that first step without someone helping me though.
  • ttul 1y ago
    I can’t agree more. I spent a lifetime trying to master every productivity hack, reading books, doing hundreds of hours of therapy (this is not a joke - hundreds of hours), and organizing my desk and using tools and … everything. And then I did a psychoeducational assessment and found out I have ADHD - and not just a little hint of ADHD, but really quite profoundly terrible ADHD. I learned about how much my brain had short changed me in my personal life too; because real ADHD affects you in many areas of life. It’s not just about “getting things done.” Medication is a must have to make any progress. If you’re like me, you already tried everything else. Maybe you’re also really intelligent and even managed to get a great job and somehow maintain it. But you can’t ever follow a plan for long and never go to bed on time and always seem to be burning the candle at both ends? Yeah, this is where you need some help from meds. And good god do they help. That being said, your brain is a responsive self-correcting system. So my advice to anyone taking this journey post-diagnosis is to not give up if things stop working. You may need to pivot, change dose, switch to something else, or add a non-stimulant option. But, don’t ignore meds. ADHD is neurochemical in nature and it’s a joke to expect anyone will manage it without drugs.
  • trod1234 1y ago
    I disagree with this article on fairly foundational grounds. This does nothing long-term for ADHD, and in fact creates a dependency on drugs which in many cases are not necessary because ADHD and other Spectrum Disorders fall into catchalls. It treats symptoms not the cause. Sure you can manage so long as you get your SOMA, but the moment its gone you are back to square one, and the risk is not zero. The best thing for managing this is meditation, and a disciplined lifestyle regiment. Meditation being the intentional practice of stilling ones thoughts, which anyone can do with a little practice. In my opinion, not a lot of people actually have ADD/ADHD, but the rhetoric gaslights towards this label because the diagnostic criteria are catchalls and ambiguous. Additionally, it has no cure, and treatments may have side-effects and other risk factors. Fun fact, you can actually induce ADHD temporarily with a bit of hypnosis, its just a heightened state of awareness. Most literature on ADHD, and other spectrum disorders doesn't pass muster, and they are just looking to sell you on an incurable ailment where you have to keep coming back for more.
    • PaulStatezny 1y ago
      > The best thing for managing this is meditation, and a disciplined lifestyle regiment. What would be your reaction to the numerous comments on this page where people are saying that they tried and failed to "discipline" themselves for years or decades, only to discover medication later and find that it instantly turned everything around for them?
      • trod1234 1y ago
        I'd say they weren't addressing the core issues, or they think discipline is something that it isn't, and then kept trying ineffectively. Here's what discipline is and isn't. Discipline is an extremely simple concept to develop but few actually know how to do it in any reasonable way because of so much misinformation out there, and malign influence seeking to take advantage and increase suggestability, and by extension addiction. Discipline just like meditation is really a fundamentally simple practice. Just like with meditation, where you don't use willpower, but instead simply focus your thoughts back towards a single point, and then relax that focus slowly, which stills your thoughts. Discipline is simply the repeated practice of limiting when and where you choose to change your initial decision or choice, for all of the choices you make. You take your time considering before making a choice, and once made you only change it when there is some new information that becomes available after the fact, whether that is a new consequence you didn't consider, or completely new information you received later. Its a simple rule. You don't give yourself the choice except under those circumstances. When you are tempted, you remind yourself you don't have the choice. When you cave and fail, you don't beat yourself up because that destructively interferes with your psychology which only works towards outcomes framed in the positive. If you make a mistake you examine what led to it right away, and mitigate those circumstances moving forward. You imagine what you will do next time, with a successful outcome a few times that day. With this repeated ritual comes an understand that willpower is always finite, and you pick and choose what you will spend that on each day. You recognize when its running low, and defer important decisions pigeonholing them for a later time. With repeated practice in everything this become a unconscious ritual with good outcomes. You do what you say you will do, and you don't compromise yourself, and people recognize that level of discipline. It becomes easier with each successful choice, and its so damn simple. These two things together make a world of difference in coping with everything. It places the locus of control for your life within your grasp. > only to discover medication later and find it instantly turned around everything. First, medication in most cases in psychology doesn't instantly ever turn around everything. You still have the problems that led to your mental state, they are often subtle which have built up over time. You are just better able to cope with them where you weren't coping before, and following the initial euphoria of relief you still have those problems. I know quite a number of people that have been diagnosed and use medication to cope with professional burnout. Eventually you pay the piper. Sure you can take a drug, and maybe you feel better, but also maybe you feel like everything is 100x worse and to relieve the pain and suffering you end yourself; (a known sideeffect) or you have a chemical reaction that ends up in sudden death (a known sideeffect). Few actually consider this, minimizing it. There is no panacea. Soma is just treating the symptoms. What you do, and things you choose to live by are far more important, especially in contrast to the fact that many medications make one more suggestible. For good or ill.
  • Gud 1y ago
    Thanks for this. The only times I've felt my brain was executing how I should was while doing coke. the only times my anxiety is at rest is when smoking high CBD weed. I'll go to the doctor, see if I can get the right pills.
  • alecco 1y ago
    I strongly disagree. First line is a reasonable very rigid schedule where you sleep 8hs, exercise/walk in the morning, and contain your distractions to a specific time in the day. A strict healthy diet. Plan when to interact with people and when to go to nature. Do a lot of visualization of what you want the day to be like (be reasonable). Time-blocking is very good (see Cal Newport) IMO, only when you mastered the basic of a routine like that you should try prescription drugs. And even when you do, figure out how to need the least possible dosage. For example, eating a high-protein breakfast 1 hour before taking the medication and zero/low carb until evening. Then taking vitamin C foods with dinner to clear it out and prevent crashing or insomnia. Try well-timed over-the-counter supplements to improve how the medication works (magnesium, tyrosine, etc). IF YOU DON'T DO IT THIS WAY YOU WILL GET LESS DESIRABLE EFFECTS AND MORE SIDE EFFECTS. And you will risk spiraling into more and more mg and addiction. Remember: if you have ADHD you are very, very prone to addiction! Ask your psychiatrist for a slow-release medication (Lisdexamfetamine or XR). And time how you react to it so it matches your ideal schedule. Have detox and reset days where you don't take the medication and don't study/work. (e.g. weekends or at least Sunday)
    • klausa 1y ago
      Cool, how do you propose people who _notoriously_ have trouble adhering to schedules, start and _stick to_ a "very rigid schedule"? If only there was something, like, some kind of pill that could help with it...
      • alecco 1y ago
        Turn your ADHD obsession into doing the perfect schedule. Turn off your phone and computer. Add reminders of your schedule everywhere. Hang it on your walls. Post-it notes on things you have to avoid. BE BORED for hours without social media, music, podcasts. Use strategic fasting and breakfast to stick to bedtime (same trick used to adjust for jetlag). Get out of your house and walk in silence for an hour. Write with pen and paper everything that keeps you mind over-excited. Add drawings to engage your whole mind. You have to train your brain. If you always walk with a crutch you will never walk properly. IMO, you should only try drugs once you can sort of stick to the schedule and you are still not reasonably productive. If you start with drugs you'll become dependent and will need more and more. There is no magic pill.
  • ChrisRR 1y ago
    The first line of therapy is not stimulants though, this is a massive falsehood that gets spread by those seeking ADHD treatment. The first way to tackle ADHD is to manage your behaviour and manage the way you deal with ADHD. If you can't handle the pattern of behaviour, then stimulants don't make you magically able to concentrate. If you're in a pattern of seeking out distractions, then stimulants can potentially can increase that behaviour What stimulants do help is for you to be able to get over the hump of wanting to get back to what you should be doing. It reduces the difference between boring task and other tasks and you need to be able to address your behaviour so that you can take advantage of the boost that meds give you Unfortunately I've seen way too many people intentionally mess up their titration so that they're overdosed, bouncing off the walls and claiming that they're cured because they can clean the house for 10 hours straight. That's totally missing the points
  • mcv 1y ago
    Getting a real diagnosis is a big obstacle. Waiting lists are ridiculous, and the medical landscape is confusing. In recent years, I've become increasingly convinced that I've got ADHD. Before, I used to think I've got Asperger's or something. Before that, motivational problems (that was an actual diagnosis when I was a teen). By now, I'm ready to give chemicals a try, but I can't get them without the diagnosis. (Well, except caffeine, but I'm actually trying to reduce that.) Also, I'm trying to channel that hyperfocus. It rarely works, but sometimes it does.
  • moi2388 1y ago
    Bullshit. It’s just easier. I’m doing fine without any medication tyvm, no need for speed in my ADHD brain.
    • theshrike79 1y ago
      I'm happy it works for you. For many others unmedicated life doesn't work, especially if we need to work to live. I'd be off my meds too if I was independently wealthy and didn't need to hold a stable job. I could start SO MANY projects and never finish them :D
      • moi2388 1y ago
        My apologies if it read like I don’t think medication is ever an answer. I merely disagree with it being the first tool one should grab.
  • deleted 1y ago
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  • psyclobe 1y ago
    I just wish my stimulants didn't make me such a shut in.
  • addaon 1y ago
    > You do have to see a physician and psychologist to get diagnosed and to get a therapy plan. Although be aware that this might be a career limiting (or career ending) move. From the FAA, "Taking ADHD medication or symptoms of ADHD are incompatible with aviation safety." This is one of many areas where the upside of diagnosis and treatment needs to be balanced against being locked out of various careers and hobbies.
• zahlman 1y ago
  > Here’s an example: you (having undiagnosed ADHD) try to set a schedule, or use a todo list, or clean your bed every day, but it doesn’t stick. So you get on medication, and the medication lets you form your first habit: which is using a todo list app consistently, checking it every morning. How exactly is this supposed to work? (Even assuming a health care system that actually cares about ADHD in adults, "just get a diagnosis" seems like a much higher bar than "just clean your bed every day".)
  • StefanBatory 1y ago
    In Poland, you are basically unable to get diagnosed if you are an adult. You will be treated like drug-seeker. You did okay at school? Clearly it's not ADHD. And so on. Heard similar stories from my friends and colleagues. Americans have that one easier, ngl.
    • phoronixrly 1y ago
      You need to look for a psychiatrist that specialises in attention disorders. You also need to work with them on a therapy -- you don't go to them and ask them to give you amphetamines, but instead go talk to them about the issues you have in your day to day life. Speaking as a fellow European that until recently had the same views as you.
      • StefanBatory 1y ago
        With therapy I of course agree - I do think that people are overmedicated. It should be the last resort. But even on that, it's unlikely that someone will concur it might be that. General vibe I got was that, as I said - it's something you grow out. And sometimes I find myself doubting, maybe they're right and it's something wrong with us? Many times I have wondered if it is just my subconscious way of trying to avoid responsibility for myself.
        • phoronixrly 1y ago
          > And sometimes I find myself doubting, maybe they're right and it's something wrong with us? Yes. The thing wrong with us is that our life style is not a good fit but we persist to it despite knowing that. But why? Well we are more or less forced into it because society currently values dicking around with the JS library of the day much higher than herding a flock of sheep.
• chopete3 1y ago
  If it helps anybody experiencing ADHD type symptoms. >> The symptoms of ADHD and thyroid disorder are similar. Ask your doctor to check that first before ADHD.
  • dns_snek 1y ago
    Definitely make sure to check since it's easy to test and easy to treat, but remember that it could be both. What blows is that some doctors can become really dismissive of the idea that you might have something like ADHD if your chart already carries a different label (thyroid, personality disorders, depression, etc.) so watch out for that, it can be a challenge to get them to take it seriously.
    • notrealyme123 1y ago
      The cognitive bias of humans to "explain away" is one of my great pet peeves.
  • BenjiWiebe 1y ago
    My thyroid was checked multiple times and always was fine. Now (recently) I got diagnosed with ADHD.
  • hinkley 1y ago
    Generally you’ll have both a blood test for thyroid dysfunction and possibly a sleep study because chronic sleep deprivation also presents with adhd like lack of focus.
• lifeisstillgood 1y ago
  >>> An example: you have to fill out some government form. You’re averse to it because you worry about making a mistake. And just the thought of opening the form fills you with dread. So, take the boxes in the form, and make a spreadsheet for them. If fonts/colours/emojis/etc. if that makes it feel more personal, or like something you designed and created. Then fill out the form in the spreadsheet. And then copy the values to the form and submit. Oh wow this spoke to me - do it a lot …
• albert_e 1y ago
  question about the first line of advice anyone from India willing to share some pointers on how to get an evaluation signed - someone who has been procrastinating on it for a few years now
  • bentt 1y ago
    My doctor in the states was willing to do what she called a "clinical diagnosis". After filling out a short questionnaire, my score indicated I may have ADHD. She prescribed a medication for me to try. The idea was if the medication helps, and doesn't make me feel bad, then it would indicate I have ADHD. It helped. I do. That was it!
    • xdfgh1112 1y ago
      It makes so much sense but the UK is too risk averse to do this unfortunately. Multi month waiting lists for us
    • kranner 1y ago
      Unfortunately in India it’s nearly impossible to get a prescription for stimulant medication because of “abuse potential” even if the psychiatrist acknowledges you exhibit ADHD traits.
      • quantamiser 1y ago
        I am fortunate in that regard. My doctor maintains the inventory needed for his patients purely because it’s almost impossible to get the good stimulants in local pharmacies
  • quantamiser 1y ago
    I am from India and got diagnosed in my mid 30s. If you live in a tier-1 city it’s not that hard to get diagnosed. Go to a psychiatrist. Reddit has a lot of good recommendations based on your city
• jijijijij 1y ago
  > If being organized makes you feel good > If you are very OCD Please educate yourself, OCD is serious shit: https://en.wikipedia.org/wiki/Obsessive%E2%80%93compulsive_disorder https://en.wikipedia.org/wiki/Obsessive%E2%80%93compulsive_d... Some people with OCD literally starve to death, because they can't leave their house. Commonly you find those affected washing their hands repeatedly until they bleed... and then some more. It is absolute not a "what makes you feel good" kinda thing, it's a dysfunctional and irrational mental world model enforced by a crippling sense of doom, anxiety and shame, which will consume life (especially if "very OCD"). Most importantly, for those with actual OCD, you absolutely aren't advised to embrace that destructive, irrational world model by leaning in on compulsions. You cannot really exploit it for good, by definition. And by definition, it isn't benign. I wish people would stop attributing a quirky/controlling personality, a desire for order, symmetry and tidy rooms to a serious mental disorder. You wouldn't twist major depression, schizophrenia, or cluster B disorders like that. If you feel left out on the identity game, go read Lord of the Rings, or Das Kapital, try horse riding, or golf. Quite honestly, for me this casts serious shade on the whole article. Because "ADHD" is similarly misattributed and casually "self-diagnosed". Maybe the author just got very ADHD by browsing too much Insta and later found stimulants to be stimulating. Much easier to cure that kind of ADHD through abstinence and structure. (Although coming up with elaborate routines and revolutionary hacks, which are a total breakthrough for a whole month, is a very ADHD thing...)
  • margor 1y ago
    Do you really believe there is only one kind of OCD, specifically one you described? I'm sorry to tell you, but both ADHD and OCD exist on a spectrum. Furthermore, ADHD like symptoms can be caused through other illness than actual dopamine deficiency.
    • allworms 1y ago
      There are many kinds of OCD! There are zero kinds of OCD that aren't a disorder. A helpful mnemonic is: you could imagine OCD stands for "obsessive compulsive disorder".
    • jijijijij 1y ago
• danielfalbo 1y ago
  I feel like this is amazingly useful and not only to people with ADHD! Or maybe I suffer from undiagnosed ADHD
  • DrewADesign 1y ago
    Take one of the more reputable questionnaires... they never require a login or anything. If you score high enough, see if you can get proper neuropsychiatric testing done. Really think about the questions and be honest with yourself… is easy to gloss over problems we have that we learned to compensate for, or be too eager to answer yes to everything if we’re just looking for an explanation for having a hard time at work, for example. Some primary care doctors will refer you to get proper testing, but many will either ask you a subset of the questions you took on the questionnaire and say “yeah you have it,” or ask you nothing further and say “no you don’t have it,” depending entirely on their personal feelings on the matter. Testing isn’t cheap if your insurance doesn’t cover it but if you work in a knowledge field, being informed is an investment. Medication, if it makes sense for treatment goes beyond controlling attention to tasks at a higher level — like not getting squirrel brain distracted trying to code. It also has much lower-level cognitive effects that I can’t directly perceive, but are completely obvious looking at my raw capability. A modest dosage of methylphenidate makes complex math problems that previously made me drop classes after putting in 20 hours per week of hyper-focused study time effortless. I don’t ‘feel’ smarter on it, or dumber off it— I can’t even perceive the specific threads of thought getting derailed in my normal state that make some cognitive tasks so difficult. The proof is entirely in my ability to do things that were incredibly difficult before. Barring any of this, regular physical activity and good sleep have huge benefits. For some, it increases the dopamine enough to make medication totally unnecessary. I see dramatically worse results if I get super busy and drop sleep and gym visits staying up late working. But seriously, getting medicated absolutely changed my life.
    • akshitgaur2005 1y ago
      could you suggest some of those reputable questionnaires
• pyuser583 1y ago
  Having a ton of apps is not the solution to managing ADHD.
  • k__ 1y ago
    "One app is better than two: the more disjoint things you have to pay attention to, the worse it is."
  • Bloating 1y ago
    Wait... Silicon Valley is the cure fir all that ails!
• zaptheimpaler 1y ago
  IDK if I have ADHD but I started taking Bupropion to help me quit smoking and stayed on it because I feel better on it, and naturally have picked up a lot of this organizational stuff over the past few years like lots of reminders, notes, managing inboxes, calendars, pomodoro. I don't think I've had or have any of the main symptoms of ADHD but sometimes I see a post like this and think maybe? It's also hard because the list of symptoms of ADHD in pop culture seems to be growing out into infinity and it's difficult to separate what's actually ADHD and what's not.
  • bflesch 1y ago
    Also there many are other potential factors such as desk-job, sports, sun exposure, and nutrition. HOWEVER, there are also birth defects such as the MTHFR gene mutation which reduce Vitamin B12 utilization of your cells by as much as 70%. It has far-reaching consequences for every single cell in your body. Modern medicine is mainly symptom-based and things like chronic Vitamin B12 deficiency are hard to diagnose (unlike famous low Vitamin D levels). In many countries you can't even sequence DNA of your own child, and for a hereditary gene defect in a core chemical reaction of the human metabolism this is just staggering. For example as someone who has the MTHFR gene defect, my organism needs the "bio-available", methylated version of Vitamin B12, because it can only use 30% of the Vitamin B12 in my bloodstream. The effects of Vitamin B12 (methylcobalamine) supplementation after many decades of Vitamin B12 deficiency is staggering. Within 30 minutes it felt like someone lifted a very heavy baseball cap off my skull. If someone would've told me methylcobalamin is a potent anti-depressant or some illegal drug I would've believed them based on the effects. If you scout google scholar or NCBI for recent studies on Vitamin B12 you will find recent case studies that use Vitamin B12 supplementation to treat infertility, long covid symtpoms, and autism in children. And if nature gifts you with the MTHFR gene defect(s), Vitamin B12 can be really rare in your cells. Yet here we are, even in one of the wealthiest countries in the world you need to do gene sequencing on your own if you want to learn about basic genetic defects, because doctors won't touch anything involving "genes" if the disease is not named after yourself. According to Wikipedia roughly 20-30% of all people have this exact MTHFR defect. Here is some more info: https://www.snpedia.com/index.php/gs192 https://www.snpedia.com/index.php/gs192 PS: ADHD is often linked to depression, and I've been discussing with a good friend what comes first. If you have chronic disease, there is first the disease, then comes the depression. But then doctors or others see you and only focus on the depression which - funnily - increases the depression / anxiety even more. I wish I knew at a younger age that methylated Vitamin B12 / folate supplementation is needed due to a genetic defect.
• fudged71 1y ago
  This maps pretty closely to the theories of Dr. Russell Barkley! However. The article encourages a diagnostic approach—it asks the reader to introspect and identify the root cause of their inaction. But by omitting both PDA and RSD from its list of potential causes, it creates a "diagnostic trap" that can lead to misdiagnosis and self-blame. The omission is particularly damaging because PDA and RSD are two of the most powerful (and often invisible) drivers of severe, persistent avoidance.
  • Arch-TK 1y ago
    I am obviously not a psychologist, I got kind of worried reading this that maybe I had misdiagnosed myself and that going the route of official diagnosis would lead to a lot of wasted effort. But reading into these two things you describe (Pathological Demand Avoidance (PDA) and Rejection Sensitive Dysphoria (RSD)), I am glad to note that I don't think I've ever had anything of the sort. But I agree it's good to spread awareness of these kinds of things.
    • fudged71 1y ago
      These are the two articles that got me to get diagnosed: https://gekk.info/articles/adhd.html https://gekk.info/articles/adhd.html https://miniver.blogspot.com/2021/08/the-subjective-experience-of-adhd.html https://miniver.blogspot.com/2021/08/the-subjective-experien...
    • kzrdude 1y ago
      I have the sinking feeling of having both, they both explain me very well.
      • novok 1y ago
        It's not just ADHD people who are like this, ASD people can be too.
        • tonyarkles 1y ago
          While I do think the distinction between ADHD and ASD is still useful in some ways, mostly around having signposts regarding where to start for treatment… a number of people in my life, myself included, are basically “mix-and-match from both lists of symptoms”. Some very clearly are majority from one list or the other, but most are both to varying degrees.
• Arch-TK 1y ago
  It's heartening to read the comments in these threads and see that this might actually be the problem I have dealt with for 29 years and that there might be a solution for it. Now the hard part is getting myself to fill out the paperwork required to get the NHS to pay someone to look at it.
  • dmbche 1y ago
    You might want to just have a chat with your dr, as you'll likely try something like concerta if you are diagnosed - but you can skip the long process of diagnostic and just try the medication if you fill out a few questionnaires. At that point it's pretty self evident if the medication helps the issue or not and bam, you might have solved your problem without going through the hurdles.
    • Arch-TK 1y ago
      Tried to speak to my GP and my local surgery told me to either register for the NHS waiting list (probably 100 years long at this point) or use the right to choose process to get the NHS to pay for me to see a private clinic (takes 2-8 weeks to see someone instead of years). They didn't even suggest that I could/should speak to my GP first. And I can't actually get an appointment with my GP other than the way I specifically tried to. At least not my local GP.
      • dmbche 1y ago
        That sucks, I'd love to be of more help, but I'm in Canada. If you're able to, I'd go for the private option. Really, the medication helps tremendously and having access to it makes every other step easier to take - I really wouldn't have thought that's how it would make me feel. Good luck going forward!
      • dashdashu 1y ago
        I had to pay for diagnostics myself too since here in Germany, adulthood ADHD diagnostics are unfortunately not paid by the health insurance. Cost me around 600 €. The hardest thing really was fighting myself to actually get an appointment
• bentt 1y ago
  Here's a TODO hack that really helps me: If you finish a task that wasn't on your TODO list, don't fret. Just add it but don't check it off. Then when you come back to the list later, you check it off. This reminds you that you did it and gives you the gratification of completing it. Otherwise, the finished task will slide into oblivion and poke at your self-worth along the way.
  • rzzzt 1y ago
    I will forget to check it off...
    • tra3 1y ago
      I will forget to add it.
      • AbuAssar 1y ago
        I will forget to do it.
        • ariejan 1y ago
          I will forget.
          • quantamiser 1y ago
            I will?
            • NoBeardMarch 1y ago
              "I"
• isamuel 1y ago
  For reasons of personal history, stimulant medications like Adderall are a hard no for me. I am curious, though, about non-stimulant options like atomoxetine, if anyone has views.
  • SkyPuncher 1y ago
    Stimulants are a front line defense because they pretty reliably treat the symptoms in just about everyone. There are many other medications that _can_ help with symptoms, but their effectiveness is largely dependent on your body chemistry. It can take trialing several drugs to find one that works best with you.
  • primenum 1y ago
    Methylphenidate was a no-go for me too, was emotionally unstable and burnt out at the end of the day. However, this is my second month on atomoxetine and so far, I have only words of praise. There are one or two months to go for full effectiveness but I am satisfied so far. Focus is better, my mind is much more quieter, I've been able to kick some dopamine seeking behaviors and am working on new habits. I really feel positive and ready for change in life -- speaking this as an anxiety ridden person for more than ten years. The only negative is that it slightly increases heart rate, but I think this is supposed to go away too. I'd note that I am on some supplements as well and beforehand I did a simplistic dna check to see my methylation/detox profile (wanted to see why methylphenidate was a no-go).
• nikkwong 1y ago
  Stimulants are still first line therapy for treating ADHD but I think mindfulness meditation is wholly underrated. People with ADHD have too much activity and overly-robust neural nets in the default-mode network in comparison to healthy controls. There is a network above this network, the salience network [0] that is responsible for the switching between the default-mode and executive control networks. ADHD may present with many brain-network anomalies, but I believe the classic case is one where there is more default-mode activity, less executive control activity, and ineffective switching occurring from the salience network. Mindfulness meditation is honed at training the salience and attention networks towards playing closer attention, which offsets the deficits observed in ADHD. That's my lay interpretation; but actually, I believe that people who suffer from ADHD probably have even more to gain, relatively, than those who don't from taking up the habit of mindfulness meditation. It's not an easy fix--I've read that it takes about twice as long for those with ADHD to benefit from the practice. But it seems like it's worth it; after all, your mind is really the only tool that you have. Those interested in this topic should read about ADHD and it's relation to the salience and executive networks; and how mindfulness sharpens the function in these areas. [0]: https://en.wikipedia.org/wiki/Salience_network https://en.wikipedia.org/wiki/Salience_network
  • schneems 1y ago
    I’m not clear. Are you someone who has ADHD or is this recommendation based on experiences with someone with ADHD? I have ADHD and meditation, for me, is very difficult. Painful even.
    • zozbot234 1y ago
      Meditation practitioners have been writing for thousands of years about the problem of "quieting the monkey mind" which reads just like your typical description of ADHD, only in the specific setting of a meditation retreat (which is typically an intentionally challenging, spartan, uncomfortable environment - hence one where pretty much everyone is enticed to get fidgety and hyper). It's difficult for everyone at first!
      • 1y ago
• pflenker 1y ago
  I have set up my projects in a way that whenever I work ok it, all the context I need is available from one single starting point. My goal is that zero friction is needed for to resume work on any project, no matter how long it was paused. My habit to keep the context for each project fresh is a at-least weekly, timestamped, append-only Captain‘s Log, which - just as its namesake - is a very brief 1-2 sentence summary of what’s going on for everyone to get back into the story after the commercial break. „No updates“ is a valid update. Since its append-only, retrieving more context is just a matter of keeping on reading after having read the latest update.
  • LtdJorge 1y ago
    How do you remember to update it?
    • pflenker 1y ago
      Recurring todo list entry.
• Bloating 1y ago
  adult diag ADD (prob some ASD also). Kids were diagnosed, had one of those ahah moments. At least in my generation, the quite, bored as hell kid in the back of the room. Thankfully, I think the ASD made me determined, hardheaded, and perceptive, and my parents encouraged and supported me to set good goals. That served me well, but I look back and wonder what could have been if I could have stayed awake in high school classes. My longest friend is hyper, smartest dude in the room but could not stay out of trouble. Right now, he is literally climbing up a mountain. Even today, I get so pissed at my adult peers who don't understand that that distracted kid is just wired different, not undisciplined. You can't change your neurology anymore than you can change your eye color. Stims helped much more that antidepressants, but I burn thru catecholamine quickly. Vyvanse lasts maybe a few hours, by example. I've had days where I could take a stim, then fall asleep waiting for it to kick in. Its burn-out, and it sucks. One thing that helped was NALT and Phenylalanine. Initially, 700mg of NALT was miraculous. Doesn't help so much any more, but I continue to take it. I suspect there are other things causing dopamine production bottlenecks and-or low storage of dopamine. Gene test indicates I may not convert folate to methylfolate, which is important for the stress hormone cycle. You can supplement methylfolate but so far I've not seen improvement. The ASD makes it very difficult for me to not call a spade a spade, especially around touchy-feely people. My ASD daughter is now in college, like me, struggling greatly with social. She's as liberal as it gets in a free society, but when the college offered group therapy she refused for the same reasons I hated all that groupology crap; you can't really speak your mind without getting ostracized.
• dzhar11 1y ago
  I appreciate the author's notes on managing ADHD. I was glad to find I didn't learn much new, because I'm already applying many of these practices. I've tried several to-do apps, but centralized systems didn't work for me. I now use multiple to-do lists across different media: some on paper, some on my phone, others in markdown files within project folders... sending email to myself. It may seem messy, but it works for me. One system doesn't fit everyone. And any customization and tweaks are encouraged. Books that helped me: Atomic Habits by James Clear emphasizes small, consistent changes. Over time, they build into significant improvement. It’s better to improve your system gradually than attempt a major overhaul. The Now Habit by Neil Fiore offers tools to overcome procrastination and start tasks. It helped me understand my resistance and find ways to move forward. Getting Things Done by David Allen focuses on reviews and planning. I struggle to make time for them regularly, but even occasional reviews help. Marcus Aurelius' Meditations, especially annotated versions, provide a Stoic perspective. His reflections on virtue and responsibility inspire me. He seemed to dislike being emperor, preferring philosophy, but accepted his role out of duty. That example helps me do necessary tasks, even when I don't feel like it.
• Aerbil313 1y ago
  Preach, this is a great post. The author has approximated the same system I (and many others) independently found to be working well for themselves. The bad news is that it’s very hard, if not impossible, to teach masses with ADHD all these elaborate, often very personal systems. The good news is you can make an app which will automatically make it work for individual people. Which is what I’m working on right now (not out yet).
• kamranjon 1y ago
  Has anyone used the Todoist app? What are the apps that you find the most helpful in supporting ADHD - I am thinking to get this app, but also have never used Obsidian before, would love to hear what others are using. Edit: Oh also want to mention that I generally prefer privacy oriented apps - so if there is something, even paid, that will keep my notes on device without sharing them with a server I'd love to hear about it.
  • xdfgh1112 1y ago
    Obsidian is the best then, it's just text files. You can sync them anywhere or keep them local. It has plugins for todo and daily diaries etc.
    • theshrike79 1y ago
      Obsidian for todo lists is a bit of a square peg and round hole situation. And for someone who likes to "work on their productivity", it's a never ending swamp of plugins and optimising data views and reports. I just switched to Things3 and couldn't be happier. It has very little customisation and options. It just lets me write down my TODO-lists.
      • xdfgh1112 1y ago
        I use obsidian mostly just for markdown and the tasks plugin but I can see how you could get caught up trying to create the perfect setup lol.
  • dpkirchner 1y ago
    (Edited to add: this is an app I use to help with my likely-ADHD, however it is not a note/taking app) I'm on an iPhone and I use Streaks https://apps.apple.com/us/app/streaks/id963034692 https://apps.apple.com/us/app/streaks/id963034692 . I really dig it. It's easy to set up, easy to add or pause tasks, and easy to correct past mistakes (I often forget to record I took my meds even though I can see I remembered by looking at my pill organizer, fixing this takes a couple taps). You can configure it to remind you to do a task N days a week. I use this feature to track checking the mail. You can also make a daily task and configure it with a "2 day rule" that gives you a little wiggle room. I want to read a book and practice chess every day but sometimes I miss a day -- this rule lets me miss one day but not two days in a row. It's well designed with lots of color choices and icons for each task, plus it has Apple watch support. I'm pretty sure it's all entirely offline other than backups to iCloud, which can be disabled. Finally, it's a one time purchase. If it wasn't I wouldn't have given it a try.
• Aerbil313 1y ago
  On the chemical note, I found glycine supplementation to be actually helpful in avoiding hyperfixation (not being able to stop on a task). In contrast, stimulant meds solve the issue of not being able to start on a task (not enough motivation/dopamine). Make your own N=1 experiments though.
  • N_Lens 1y ago
    Glycine makes me feel depressive/anxious if I take more than 1-2g per day, for more than a few days. Very calming otherwise. Common effect for many people.
• xianwen 1y ago
  I read at one place regarding an ADHD drug that is non-stimulant and makes people a little drowsy, which is why it is good to take before going to bed. I don't remember what the drug is called. Does someone know?
  • jawon 1y ago
    Guanfacine.
    • xianwen 1y ago
      Yes. That's the one! Thank you!
• deleted 1y ago
  [deleted]
• leroux-cifer 1y ago
  > I can notice if something has not been worked on for a while, and act on it. Otherwise: out of sight, out of mind. A visual indicator for task age works wonders for me. I use parentheses to show the age of a task. As the parentheses accumulate it's very obvious what I'm behind on. e.g. ")))))))))) respond to important email". Works especially well for recurring tasks: the parentheses disappear when the task is marked complete. I try to keep my lists as small and up-to-date as possible and this serves as a staleness indicator as well. I use Todoist and have a script to manage the parentheses. https://github.com/leroux/todoscript https://github.com/leroux/todoscript Credit to intend.do. I shamelessly stole the concept from NotDone Propagator. https://intend.do/features#notdones https://intend.do/features#notdones
  • swah 1y ago
    Interesting - how is this used? Run every day or its a long-lived server?
• hxii 1y ago
  I guess I have some reading to do tomorrow! Which is also a great reminder that I should update my own posts with all my current techniques of managing with ADHD.
• amelius 1y ago
  > Using OCD to Defeat ADHD Does this also work in the opposite direction?
• coldblues 1y ago
  For those who cannot be prescribed amphetamines, I recommend seeking out Modafinil. It works really well and a regular psychiatrist should be able to prescribe it.
  • jawon 1y ago
    I found it made me think and act sleep deprived even though I didn't feel it and also increased anxiety. Guanfacine is also an alternative, and it's method of action also makes it anxiety reducing.
• throwpoaster 1y ago
  Lost me at “salt water”.
• PacketDoc 1y ago
  As a life long member of the decision paralysis club, this was incredibly refreshing to read. Have been getting better, but reading this has brought it back to the forefront of good habits.
• idkfasayer 1y ago
  [dead]
• octo888 1y ago
  Oh man, this article is timely! "Decision Paralysis Procrastination". I've been going round in circles for 3 days trying to decide where to go travelling. I can go pretty much anywhere I want to and there are lot of places I want to go. I've even found some /really/ good deals but couldn't pull the trigger. > One thing to consider is that thinking in your head is inherently circular, because you have a limited working memory, and you will inevitably start going in circles That REALLY resonates. It's crazy how much I will put off writing things down. Like my mind keeps telling itself "that's too simple to actually help"
  • hinkley 1y ago
    On deciding I think you’ll find that most of use are sort of bipolar in this regard. But moreso introverts, particularly ASD and HSP ones. Some decisions you want to sit with so they need to be made early, and then god help you if they change last minute. Doom for ASD, lots of emotional energy spent twice or three times for the rest. Others you’re more afraid of deciding wrong than not having prep time. Things like writing papers in an adrenaline fueled marathon versus just writing a fucking outline on day 3.
• e2e4 1y ago
  https://www.saner.ai https://www.saner.ai is a handy AI Personal Assistant made specifically for ADHDers
  • Shruthi398 1y ago
    This looks good, gonna test this out
• fennec-posix 1y ago
  I'd be taking my meds if the pharmaceuticals didn't keep having many-month long shortages of the ones I'm taking... I need the higher doses, so I'm practically screwed. Makes me so damn frustrated, cause I'm 4-5 months down without meds and I'm REALLY STRUGGLING. Depression, zero motivation, practically no executive function. Really needs to be accountability on these companies to ensure they can supply.
• joe_the_user 1y ago
  ADHD has a biological cause and drugs are the first-line treatment for good reasons. I was diagnosed with ADHD as a child and spent several years in special classes as well as receiving a lot of private therapy/tutoring. I'm not a self-diagnosed adult (as is common). I've managed my situation in various way for a long time (50 years) and refused medication the entire time. Phone alarms really helped me when I started using them. There may be good reasons for drugs but there are also bad reasons - especially, they're a quick "fix" allowing a care provider to do this and wash their hands of the situation. Further, of course ADHD has a biological cause - human beings are biological beings so every human behavior has a biological cause when you come down to it. But the implication that proscriptions drugs designed based on a deep and verified understanding of the mechanisms of ADHD is completely false - ADHD drug prescription, like all behavior-altering drug prescription, is based on just "bucket chemistry", maybe-educated guess work. Which isn't implying drugs don't work for some people. But I think it's important to be clear the various drugs aren't ADHD cures in the way that antibiotics are cures for infection. But again, I support the right of people want ADHD drugs to have them. But I think drug use shouldn't be automatic.
• RossBencina 1y ago
  The article mentions sleep, which is very important to us all. But something not mentioned is that the symptoms of Sleep Apnea can look a lot like ADHD, and if you have sleep apnea and ADHD then you get a double whammy. Sleep apnea can start at any age, which could be one reason why your attention suddenly got worse. If you're waking up unrested, or have any of the other signs of sleep apnea, get it checked out. In my case my doctor resisted testing "because I wasn't obese," (more or less, perhaps I'm being unkind), so you may have to work at it. But an in-lab sleep study will give you a clear diagnosis. I have seen reports of people who were able to stop ADHD medication once their apnea was treated.
  • teunispeters 1y ago
    My ADHD meds (mostly) cured my sleep apnea. The remainder has to do with allergies.
  • protocolture 1y ago
    I was treated for sleep apnea 3 times trying to get ADHD treatment. I eventually found a dental/nasal engineer guy and his testing was more thorough than the sleep studies I undertook. I paid for his device (300 bucks or so) but in the process he gave me a lot of techniques and understanding. He diagnosed me as borderline, despite 2 sleep studies telling me it was severe and chronic. Largely through blood oxygen levels and mouth position.
    • Citizen8396 1y ago
      as someone who has been down this road, this doesn't sound scientific... but I'd love to be proved wrong. sleep studies (PSGs) are rather detailed, and that price doesn't align with medical-grade oral appliances
      • protocolture 1y ago
        I dont know what you pay for either scenario. But where I am, sleep studies are heavily government subsidised, and cost me less than the oral appliance, which did not attract any subsidy. The issue there is that theres an extreme incentive to push you back to another sleep study. The people who run the sleep studies also sell/rent government subsidised CPAP machines. And the sales pitch is very forceful. On my large treadmill of doctors doing anything they could possibly do to not send me to a psych for an ADHD assessment, I was offered the option of the oral appliance. I found that gentlemans practice, knowledge and understanding of the issue to be quite thorough. His approach was more engineering than science for sure. I don't doubt the sleep studies results, in that I was getting extremely poor sleep. I doubt the interpretation of the results towards a diagnosis of extreme OSA. What really got me my best sleep was ADHD stimulants. Its like I have a normal humans circadian rhythm now. But spending 6 months on the oral device, learning about jaw positioning, sleep positioning and other things, probably did me better than a CPAP machine would have. Probably some important context, is that the doctor who referred me to 2 sleep studies and a whole bunch of other shit, had diagnosed me with subclinical thyroid problems. And on the basis of that diagnosis was unwilling to ever refer me to a psych because he believed his diagnosis explained all of my symptoms that OSA did not. I do have subclinical, treated, genetic hypothyroidism. My current doctor is inclusive of that diagnosis, and doesnt use it to exclude others. YMMV.
• AbuAssar 1y ago
  if you are on Android, you may use Google Tasks or Samsung Reminder as a simple and good enough Todo app. Google Tasks has the advantage of allowing you to manage your Todo list through its web interface, while Samsung Reminder is a mobile app only.
• taw1285 1y ago
  Thank you for this article. I have yet to discuss with my doctor about this. But I have noticed several issues that are severely lacking for me compared to my peers: 1. My brain drifts away very easily. Even in an important work conversation, my brain just starts thinking about a completely different project or upcoming meeting. 2. I have a hard time remembering things/events that my spouse and others can easily recall (ie: which restaurants we have been to) 3. I can't seem to form an opinion on very basic things like do you like restaurant A or restaurant B better? do you like option A or option B? I can't decide or come up with any heuristics. At first I chalk it up to I am being too critical about myself and others are having the same issue. But that doesn't seem to be the case. Can these all be rolled up in the same conversation with my doctor?
  • Aerbil313 1y ago
    Probably all part of possible ADHD, except point 2, which might be a sign of SDAM (Severely Deficient Autobiographical Memory). It’s recent and not well known.
• defundef 1y ago
  This is all good advice but it presupposes that you have enough energy and motivation to organize yourself. For me, most of the time, the challenge is lack of energ and motivation to do anything outright. Even on 50mg Lisdex.
  • quantamiser 1y ago
    Came all the way down to see if someone has a comment like this. I have tried all possible frameworks but finding the energy to execute them is the hardest part. Has gotten slightly better after I started meds but a lot depends on how my energy and emotions are at that moment
    • Aerbil313 1y ago
      For me, first came the stimulant meds, then slowly and over time the energy, as I started being more organized and putting my day into a routine. Try Bullet Journalling, it was created (discovered?) by a guy with ADHD.
• escapedmoose 1y ago
  > I often fail to finish projects simply because I forget about them. I start reading a book, but I don’t write it down anywhere (say, in Goodreads) that “I’m reading this book” is something I have committed to. I don’t have a history of ADHD symptoms. But I’ve been happier and arguably more productive since I abandoned the idea that I must complete projects just because I committed to them at the start. Sometimes you learn, halfway through a book, that it doesn’t contain the info you thought it would; then it’s best abandoned. The same applies to many commitments, I think. We learn more about them as we undertake them. Something might stop being engaging because deep down we’ve realized that it won’t serve us as we expected. But maybe I’m able to discern productive vs nonproductive commitments because I don’t have ADHD? I just hate to see people beating themselves up about not following through with ideas which really don’t deserve follow-through.
• martin82 1y ago
  I searched the article for "meat" and "carnivore". Zero mentions. First paragraph admits that this is a biochemistry issue and then immediately jumps to the conclusion that MEDICATION is needed. Insane. Eat a proper human diet, and your ADHD symptoms will mostly go away.
• ddmf 1y ago
  Way too much information, brain wouldn't let me read it.