7 ms·

This could be due to ADD, I am still getting tested. Granted, that's a diagnosis, not a root cause. No, it’s a diagnosis of the root cause - in fact, it is pla

by fwlr 3mo ago

This could be due to ADD, I am still getting tested. Granted, that's a diagnosis, not a root cause. No, it’s a diagnosis of the root cause - in fact, it is plausibly the root cause of everything else described in the post. Inability to complete work, procrastination/distraction by focusing on nearby tasks, the pervasive sense that you struggle with things that other people do not, even the depression (untreated ADD causing repeated failures, repeated failures causing depression). To understand why it really could be the root cause, you can read up on “executive dysfunction”, which is what ADD really is. The treatment for ADD is one of two medications, methylphenidate or dexamphetamine. You can try other things in addition to these, but not instead of these, and you should try both - there really is just no substitute. (In some places, bupropion can be prescribed as an antidepressant. It has effects that also help with executive dysfunction, so you may find it to be more effective than serotonin-based antidepressants.)

imrehg 3mo ago
It's scary how your first paragraph describes by recent (but not long term) experiences. Looks like I have some checks to do as well.
SkyPuncher 3mo ago
ADHD is unlikely to be the root cause as there is unlikely to be any single root cause. Treating ADHD will reduce or eliminate a component of this, but will not address the issues entirely.
corytheboyd 3mo ago
> untreated ADD causing repeated failures, repeated failures causing depression realized this one about myself earlier this year, it really helped to boil it down to something besides “I am just inherently bad at things.” that attitude worked as a dumb single kid, but it was harming my adult life and relationships. therapy helped me get there. I have been on bupropion for about a year, and recently started on methylphenidate. it might not be the right one for me, or maybe too small of a dosage. I’m taking it slow and being deliberate with the drugs. working with a personal trainer to get in shape and lose weight, as well as quitting my fully vested tech job to fuck off and be a cook for a while has also done wonders for me here. it’s cliche, but you really can’t replace fitness with anything else, and that took me 35 years to internalize.
- loa_in_ 3mo ago
  Fitness also contributes to most common physical tasks becoming trivial, you can literally jump out of bed in the morning if it strikes your fancy.
  - corytheboyd 3mo ago
    yeah! it's pretty cool when I start doing something that used to be difficult and now it's just... not. weird how long your old form sticks with you in your head like that.
- tayo42 3mo ago
  >quitting my fully vested tech job to fuck off and be a cook Are you doing entry level line cook work or something?
  - corytheboyd 3mo ago
    yeah, at a local pizza/taproom place. they share tips with cooks, works out to ~$35/hr. I'm not expecting it to replace a tech salary, but it helps offset the savings burn (which was specifically set aside for this). engaging with real people in real life about real things is also an indreeeedibly nice change of pace (even the stressful/tense moments of shit hitting the fan). I'll re-enter tech later... maybe.
    - tayo42 3mo ago
      Oh interesting,that doesn't seem to bad.
      - SoftTalker 3mo ago
        I mean you can burnout on kitchen work as easily as tech work. Maybe easier. I know that first hand. The one nice thing is that when you clock out you can not think about it until the next shift. There is some peace in knowing you'll never get a call at 2am because some bird's nest of technology fell apart and people can't order their custom cat pic coffee mugs.
graysnow86 3mo ago
> The treatment for ADD is one of two medications, methylphenidate or dexamphetamine. You can try other things in addition to these, but not instead of these, and you should try both - there really is just no substitute. No, not quite - there's a variety of different ADHD medications and I'd argue there's more popular ones like Vyvanse (lisdexamfetamine). Non-stimulants like Strattera or Intuniv absolutely can and are prescribed on their own, which are really useful for people that respond poorly to stimulants. Perhaps you meant to say there's two main classes of stimulants (amphetamines, methylphenidates) that are worth investigating and shouldn't be skipped over?
- fwlr 3mo ago
  Vyvanse is dexamphetamine. I suppose you can say “amphetamines” instead, I imagine the subtleties of the terminology differ quite a bit in different places. Strattera can help (I mentioned bupropion, another SDNRI). Of course if you try stimulants and don’t respond well, it’s totally fine to just use e.g. Strattera. What I’m advocating against is e.g. “try Strattera first, if it seems to help, don’t bother with stimulants”. (Some places, cultures, or medical systems do have surprisingly strong biases against stimulants!)
  - wafflemaker 3mo ago
    To be specific, Vyvanse/Elvanse is lisdextroamphetamine. But IMO it's not really that incorrect to say there are two main types of stimulants. You rarely (at least never where I'm from) get instant release methylphenidate. Always some delay mechanism. Shorter - Ritalin, longer - Concerta. And the lizine particle attached to dextroamphetamine acts as a such delayer, but isn't active by itself -- being only an amino acid. So it's still kind of amphetamine just as Concerta is methylphenidate.
- Aurornis 3mo ago
  Intuniv gets a bad reputation because the patient has to be titrated up to the final dose and it takes a long time to see the full effects. It's the opposite pattern of stimulants where the patient feels great (unnaturally so, due to stimulant euphoria at the start) and the effects wane over time. The internet is really, really bad at pushing everyone toward ADHD diagnoses and then pushing them further toward stimulants. There's a darker part of some of the communities then pushes people to keep pressuring their doctors for higher and higher doses and also discourages people from trying therapy. Outside of the internet I know several people who did the rounds with medications and ended up on the non-stimulant options and preferred them. This is an unthinkable conclusion if your primary source of information is Reddit, X, or TikTok ADHD influencers, but it's pretty common in the real world. Stimulants have a habit of being enjoyable at first (meaning people like taking them, beyond their attention effects) and then the effects wane over the years, to the point that there are studies showing that the effects of stimulants taken long term in children are minimal to unmeasurable after several years. This is confusing to anyone who has been taking them for years and notices a difference on days when they don't take them, but that's explainable by the fact that it takes months (or longer) for the brain to adapt to not having them in the body. For some reason this same effect is not debated as much when you talk about people who drink 5 cups of coffee per day but then crash hard when they miss their coffee, but it gets protested and argued a lot when we talk about literal amphetamines. Anyway, please don't listen too much to internet ADHD forums. They're just so, so bad these days with bad advice and poor psychology/therapy takes. You really need to engage with professionals with an open mind and not be single minded about acquiring and taking stimulants if you want to address this problem as a whole. The way the internet treats ADHD as a simple "low dopamine" state (which is wrong on many levels) and then points to stimulants as a "raise your dopamine" drug to neatly cancel it out sounds nice, but it's wrong on so many levels.
deleted 3mo ago
[deleted]
sudosteph 3mo ago
Atomoxetine's effect size is surprisingly similar to methylphenidate, though in my experience it treats different aspects of ADHD than stimulants. Some doctors (mine) are open to combining it with a long-acting stimulant, which actually can be a really nice setup, especially if you're sensitive to stimulants. Hope you get it worked out OP. I will say, if it's ADHD, it's 100% worth trying to get the best treatment you can.
- astrange 3mo ago
  > Atomoxetine's effect size is surprisingly similar to methylphenidate, though in my experience it treats different aspects of ADHD than stimulants. Some doctors (mine) are open to combining it with a long-acting stimulant, which actually can be a really nice setup, especially if you're sensitive to stimulants. I tried this for several years and only afterwards realized it was bad for me - one because of personality changes, two because of high blood pressure. It will give you a lot of stamina and ability to continue on the life path you're on, but I got metaphorical tunnel vision and basically wasn't able to do anything after the stimulant crash around dinnertime.
al_borland 3mo ago
> No, it’s a diagnosis of the root cause - in fact, it is plausibly the root cause of everything else described in the post. Yep. I was diagnosed with ASD and ADHD about a 1.5 years ago... My whole life came into focus. Everything that didn't make sense suddenly started to make sense. What I thought were 15 different issues I was dealing with were really all just symptoms of the one (or two in my case). The internal tension I've always felt was also explained by the competing desires of ASD and ADHD. Knowing this hasn't really "fixed" any of that, but it has given me an explanation, language to use to explain it, and permission to stop searching for what's wrong with me... which I've been doing for 20 years. It's been nice to have a break.
- shermantanktop 3mo ago
  Finding a label for personal problems typically results in a honeymoon of self-acceptance and relief. The honeymoon usually ends and the problems remain, but now there are possible paths forward.
  - neetle 3mo ago
    The other thing it does is give a path towards resolution (or at least mitigation) for some issues. Wife was diagnosed adhd, and got a shrug wrt an autism diagnosis. We looked into interventions that specifically tend to work for ADHD, and she’s now thriving. She also tends to respond well to some of the interventions for autistic people that we’ve found useful for our AuDHD daughter, so we’ve taken on the policy of “labels be damned, if it works it works”. The labels sure as shit help with getting started finding your bearings though
    - xThree 3mo ago
      Would you care to elaborate? Potentially in private? If so, send me an email to coterie.watcher.0e@icloud.com
  - Aurornis 3mo ago
    There are some traps along this path, too. A number of younger people I've worked with (in the double digits now) have gotten ADHD and/or ASD diagnoses and then become overjoyed that "everything makes sense now". But the diagnoses are only useful as tools for knowing what to work on. The trap is trying to externalize the diagnoses as a get out of jail free card that can be used to justify avoiding hard changes and difficult work. The more difficult version of this is when someone tries to externalize the responsibilities of their diagnosis on others. I've seen a couple situations where someone got an ADHD diagnosis and then took it straight to their employers expecting to receive more forgiveness for late work and mistakes, then getting angry when it didn't change their company's expectations. It's a hard conversation to have with someone who thinks the diagnosis is going to relieve the weight of all the problems they've been facing, when in fact it's only helpful for identifying what they need to work even harder on improving and coping with.
ramon156 3mo ago
I will discuss this with my GP. You're right that fluoxetine is a serotonin kicker, and it didn't stop my dysfunctional habits. Ofcourse, no pill is magical, and I have no expectations of that. At least fluoxetine fixed my sleeping habits.
- fwlr 3mo ago
  Best of luck!
Aurornis 3mo ago
> (untreated ADD causing repeated failures, repeated failures causing depression) Really important to understand that depression can also manifest as poor concentration. There's a huge problem right now with people getting locked into diagnoses found on the internet and then resisting advice of their doctors that doesn't match. It's scarily common for depressed patients to become convinced that they have ADHD and that ADHD explains everything, then to refuse depression treatment. They can jump from doctor to doctor until they find someone who doesn't care and just writes the prescription, but years can pass before they realize that stimulants aren't fixing their depression. If you have depression, with or without ADHD, you need to address it. Don't get sucked into the "ADHD explains everything about you" mentality that gets spread on the internet.
doright 3mo ago
I would be careful going straight in this direction without considering alternatives. I thought for my entire life that my issues were explained by ADHD, but it turned out all the symptoms you described (procrastination, depression, lack of focus, damaged self-esteem) were not symptoms of ADHD, but of childhood trauma. ADHD was the label my parents gave me to cover up their abuse of me, and not knowing any better as a child I decided to carry that label into adulthood. That choice did more harm to me than I can convey in words. ADHD is a real condition, but the terminology is so muddled that any number of underlying problems can manifest as lack of attention and be called "ADHD", putting off any ability to truly recover for years or decades. I should have been more suspicious when stimulant medication had no long-term effect on my performance, even though it has helped actual sufferers of ADHD. My own problem was elsewhere.

by fwlr 3mo ago

imrehg 3mo ago

It's scary how your first paragraph describes by recent (but not long term) experiences. Looks like I have some checks to do as well.

SkyPuncher 3mo ago

ADHD is unlikely to be the root cause as there is unlikely to be any single root cause. Treating ADHD will reduce or eliminate a component of this, but will not address the issues entirely.

corytheboyd 3mo ago

> untreated ADD causing repeated failures, repeated failures causing depression realized this one about myself earlier this year, it really helped to boil it down to something besides “I am just inherently bad at things.” that attitude worked as a dumb single kid, but it was harming my adult life and relationships. therapy helped me get there. I have been on bupropion for about a year, and recently started on methylphenidate. it might not be the right one for me, or maybe too small of a dosage. I’m taking it slow and being deliberate with the drugs. working with a personal trainer to get in shape and lose weight, as well as quitting my fully vested tech job to fuck off and be a cook for a while has also done wonders for me here. it’s cliche, but you really can’t replace fitness with anything else, and that took me 35 years to internalize.

loa_in_ 3mo ago
Fitness also contributes to most common physical tasks becoming trivial, you can literally jump out of bed in the morning if it strikes your fancy.
- corytheboyd 3mo ago
  yeah! it's pretty cool when I start doing something that used to be difficult and now it's just... not. weird how long your old form sticks with you in your head like that.
tayo42 3mo ago
>quitting my fully vested tech job to fuck off and be a cook Are you doing entry level line cook work or something?
- corytheboyd 3mo ago
  yeah, at a local pizza/taproom place. they share tips with cooks, works out to ~$35/hr. I'm not expecting it to replace a tech salary, but it helps offset the savings burn (which was specifically set aside for this). engaging with real people in real life about real things is also an indreeeedibly nice change of pace (even the stressful/tense moments of shit hitting the fan). I'll re-enter tech later... maybe.
  - tayo42 3mo ago
    Oh interesting,that doesn't seem to bad.
    - SoftTalker 3mo ago
      I mean you can burnout on kitchen work as easily as tech work. Maybe easier. I know that first hand. The one nice thing is that when you clock out you can not think about it until the next shift. There is some peace in knowing you'll never get a call at 2am because some bird's nest of technology fell apart and people can't order their custom cat pic coffee mugs.

graysnow86 3mo ago

> The treatment for ADD is one of two medications, methylphenidate or dexamphetamine. You can try other things in addition to these, but not instead of these, and you should try both - there really is just no substitute. No, not quite - there's a variety of different ADHD medications and I'd argue there's more popular ones like Vyvanse (lisdexamfetamine). Non-stimulants like Strattera or Intuniv absolutely can and are prescribed on their own, which are really useful for people that respond poorly to stimulants. Perhaps you meant to say there's two main classes of stimulants (amphetamines, methylphenidates) that are worth investigating and shouldn't be skipped over?

fwlr 3mo ago
Vyvanse is dexamphetamine. I suppose you can say “amphetamines” instead, I imagine the subtleties of the terminology differ quite a bit in different places. Strattera can help (I mentioned bupropion, another SDNRI). Of course if you try stimulants and don’t respond well, it’s totally fine to just use e.g. Strattera. What I’m advocating against is e.g. “try Strattera first, if it seems to help, don’t bother with stimulants”. (Some places, cultures, or medical systems do have surprisingly strong biases against stimulants!)
- wafflemaker 3mo ago
  To be specific, Vyvanse/Elvanse is lisdextroamphetamine. But IMO it's not really that incorrect to say there are two main types of stimulants. You rarely (at least never where I'm from) get instant release methylphenidate. Always some delay mechanism. Shorter - Ritalin, longer - Concerta. And the lizine particle attached to dextroamphetamine acts as a such delayer, but isn't active by itself -- being only an amino acid. So it's still kind of amphetamine just as Concerta is methylphenidate.
Aurornis 3mo ago
Intuniv gets a bad reputation because the patient has to be titrated up to the final dose and it takes a long time to see the full effects. It's the opposite pattern of stimulants where the patient feels great (unnaturally so, due to stimulant euphoria at the start) and the effects wane over time. The internet is really, really bad at pushing everyone toward ADHD diagnoses and then pushing them further toward stimulants. There's a darker part of some of the communities then pushes people to keep pressuring their doctors for higher and higher doses and also discourages people from trying therapy. Outside of the internet I know several people who did the rounds with medications and ended up on the non-stimulant options and preferred them. This is an unthinkable conclusion if your primary source of information is Reddit, X, or TikTok ADHD influencers, but it's pretty common in the real world. Stimulants have a habit of being enjoyable at first (meaning people like taking them, beyond their attention effects) and then the effects wane over the years, to the point that there are studies showing that the effects of stimulants taken long term in children are minimal to unmeasurable after several years. This is confusing to anyone who has been taking them for years and notices a difference on days when they don't take them, but that's explainable by the fact that it takes months (or longer) for the brain to adapt to not having them in the body. For some reason this same effect is not debated as much when you talk about people who drink 5 cups of coffee per day but then crash hard when they miss their coffee, but it gets protested and argued a lot when we talk about literal amphetamines. Anyway, please don't listen too much to internet ADHD forums. They're just so, so bad these days with bad advice and poor psychology/therapy takes. You really need to engage with professionals with an open mind and not be single minded about acquiring and taking stimulants if you want to address this problem as a whole. The way the internet treats ADHD as a simple "low dopamine" state (which is wrong on many levels) and then points to stimulants as a "raise your dopamine" drug to neatly cancel it out sounds nice, but it's wrong on so many levels.

deleted 3mo ago

[deleted]

sudosteph 3mo ago

Atomoxetine's effect size is surprisingly similar to methylphenidate, though in my experience it treats different aspects of ADHD than stimulants. Some doctors (mine) are open to combining it with a long-acting stimulant, which actually can be a really nice setup, especially if you're sensitive to stimulants. Hope you get it worked out OP. I will say, if it's ADHD, it's 100% worth trying to get the best treatment you can.

astrange 3mo ago
> Atomoxetine's effect size is surprisingly similar to methylphenidate, though in my experience it treats different aspects of ADHD than stimulants. Some doctors (mine) are open to combining it with a long-acting stimulant, which actually can be a really nice setup, especially if you're sensitive to stimulants. I tried this for several years and only afterwards realized it was bad for me - one because of personality changes, two because of high blood pressure. It will give you a lot of stamina and ability to continue on the life path you're on, but I got metaphorical tunnel vision and basically wasn't able to do anything after the stimulant crash around dinnertime.

al_borland 3mo ago

> No, it’s a diagnosis of the root cause - in fact, it is plausibly the root cause of everything else described in the post. Yep. I was diagnosed with ASD and ADHD about a 1.5 years ago... My whole life came into focus. Everything that didn't make sense suddenly started to make sense. What I thought were 15 different issues I was dealing with were really all just symptoms of the one (or two in my case). The internal tension I've always felt was also explained by the competing desires of ASD and ADHD. Knowing this hasn't really "fixed" any of that, but it has given me an explanation, language to use to explain it, and permission to stop searching for what's wrong with me... which I've been doing for 20 years. It's been nice to have a break.

shermantanktop 3mo ago
Finding a label for personal problems typically results in a honeymoon of self-acceptance and relief. The honeymoon usually ends and the problems remain, but now there are possible paths forward.
- neetle 3mo ago
  The other thing it does is give a path towards resolution (or at least mitigation) for some issues. Wife was diagnosed adhd, and got a shrug wrt an autism diagnosis. We looked into interventions that specifically tend to work for ADHD, and she’s now thriving. She also tends to respond well to some of the interventions for autistic people that we’ve found useful for our AuDHD daughter, so we’ve taken on the policy of “labels be damned, if it works it works”. The labels sure as shit help with getting started finding your bearings though
  - xThree 3mo ago
    Would you care to elaborate? Potentially in private? If so, send me an email to coterie.watcher.0e@icloud.com
- Aurornis 3mo ago
  There are some traps along this path, too. A number of younger people I've worked with (in the double digits now) have gotten ADHD and/or ASD diagnoses and then become overjoyed that "everything makes sense now". But the diagnoses are only useful as tools for knowing what to work on. The trap is trying to externalize the diagnoses as a get out of jail free card that can be used to justify avoiding hard changes and difficult work. The more difficult version of this is when someone tries to externalize the responsibilities of their diagnosis on others. I've seen a couple situations where someone got an ADHD diagnosis and then took it straight to their employers expecting to receive more forgiveness for late work and mistakes, then getting angry when it didn't change their company's expectations. It's a hard conversation to have with someone who thinks the diagnosis is going to relieve the weight of all the problems they've been facing, when in fact it's only helpful for identifying what they need to work even harder on improving and coping with.

ramon156 3mo ago

I will discuss this with my GP. You're right that fluoxetine is a serotonin kicker, and it didn't stop my dysfunctional habits. Ofcourse, no pill is magical, and I have no expectations of that. At least fluoxetine fixed my sleeping habits.

fwlr 3mo ago
Best of luck!

Aurornis 3mo ago

> (untreated ADD causing repeated failures, repeated failures causing depression) Really important to understand that depression can also manifest as poor concentration. There's a huge problem right now with people getting locked into diagnoses found on the internet and then resisting advice of their doctors that doesn't match. It's scarily common for depressed patients to become convinced that they have ADHD and that ADHD explains everything, then to refuse depression treatment. They can jump from doctor to doctor until they find someone who doesn't care and just writes the prescription, but years can pass before they realize that stimulants aren't fixing their depression. If you have depression, with or without ADHD, you need to address it. Don't get sucked into the "ADHD explains everything about you" mentality that gets spread on the internet.

doright 3mo ago

I would be careful going straight in this direction without considering alternatives. I thought for my entire life that my issues were explained by ADHD, but it turned out all the symptoms you described (procrastination, depression, lack of focus, damaged self-esteem) were not symptoms of ADHD, but of childhood trauma. ADHD was the label my parents gave me to cover up their abuse of me, and not knowing any better as a child I decided to carry that label into adulthood. That choice did more harm to me than I can convey in words. ADHD is a real condition, but the terminology is so muddled that any number of underlying problems can manifest as lack of attention and be called "ADHD", putting off any ability to truly recover for years or decades. I should have been more suspicious when stimulant medication had no long-term effect on my performance, even though it has helped actual sufferers of ADHD. My own problem was elsewhere.