10 ms·

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 ne

by 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.
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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.

by siva7 1y ago

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.