I was somewhat recently diagnosed with ADD and the diagnosis has truly changed my life. I, for the first time, in roughly 12 years of writing software professionally, am able finish a project enough to open source it-- and I am days away from being able to do so. It feels insanely good. Like something I've only dreamed of as silly as that is, and I don't even care if folks use it (it's not that good), but it's the fact I have even been able to do so...
For years when I would sit down to work I would go into an endless loop consisting of roughly three-four websites, almost back to back, where it was driven by muscle memory anytime something distracted me. I would almost like "wake up" finding myself in this endless loop.
On good days, I would look like an insanely talented and driven engineer, on bad days, I would look like the laziest piece of shit folks could know. It wasn't by choice, it wasn't because I was trying to "cowboy" or "rockstar" a single fucking thing, it's because that's how my attention span worked (or didn't rather).
"Smart and lazy" is almost an insult to me now, because its a moniker put on folks who are probably having trouble with something and "lazy" is rarely positive (even when its supposed to be). It kept me from believing I might have ADD for years despite tons of signs.
The downsides are of course that people don't believe you, or judge you for it (I switched pharmacies because they were treating my like shit when I would go to pickup my ADD meds)... but the upside, as the author said, is you have a life back you didn't know you were missing. You can choose to read a book, watch a movie, program, etc. you're not longer just forced into a vapid reflexivity of the world around you.
Warning: there can be a honeymoon phase where after diagnosis and beginning medication you enter this ecstatic period of normalcy on the one hand and insane productivity on the other. Don't get lulled into complacency. Use this period to improve lifestyle routines and get to a place where you can cruise at a better pace than you otherwise might once the acceleration stops.
By lifestyle I don't mean some of the things enthusiasts like to advocate--weight training, etc, although by all means if you're so inclined. But just small stuff--kick caffeine, habituate yourself to completing boring tasks as quickly as possible, exercise (if only a few pushups in the morning), etc. Maybe you were already doing those things, but if you were doing them cyclically (weeks, months, etc), now you can do them consistently.
Not to be too depressing, but there are two factors that can contribute to this honeymoon phase that I'm aware of:
1. Weight change, either bulking on muscle or fat can change your optimal dose for medication... And it's my opinion (and totally just my opinion) that starting to treat ADHD usually leads to a weight gain, either by getting you more able to exercise or increasing your activity and caloric intake.
2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life.
Both of these are addressable though, in the first path any significant weight changes should be monitored by your doctor (go to your doctor regularly, blood pressure should be monitored while on stimulants) and ideally the medication adjusted up... for the latter, well, it's a pile of poo but if you're able to stick with it your doctor will likely take you on a tour of different methyl*s until you find one that works - then, try your damnedest to never let your insurance force you off of it.
> 1. Weight change, either bulking on muscle or fat can change your optimal dose for medication... And it's my opinion (and totally just my opinion) that starting to treat ADHD usually leads to a weight gain, either by getting you more able to exercise or increasing your activity and caloric intake.
Stimulant medications are strong appetite suppressants, and if not specifically paid attention to, the usual concern is weight loss.
To the point that an actual medically approved use of certain stimulants is for weight loss. You can in fact be prescribed meth (Desoxyn in the US when it's coming from a pharmacy and not the backseat of a 1996 Chevy Caprice) by your doctor for obesity if nothing else is working for you.
Speaking to personal anecdotes, while unmedicated there's always been a certain quantity of accidentally skipped meals, with medication I could go the day without eating much of anything and not be particularly bothered.
On the other hand, I'm better at sticking to structure with medication and eating at normal mealtimes more often, even without a hunger impulse. I do still wind up having to mentally (or otherwise) tally what I've eaten in the evening and sometimes shoveling in a pile of extra calories because it obviously wasn't enough.
So there are pulls in both directions, but IMO I'd say the weight loss is more likely to accidentally happen.
> 2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life.
The usual advice I've always been told is to not take it if there's times you don't need it. If I'm going out to have fun for the day on a weekend, or taking an unstructured vacation for a week or the like, I typically don't take it.
I don't think it fully resets those resistances, but it's allowed me to continue to get a noticeable benefit out of a steady, middle of the road prescription.
> for the latter, well, it's a pile of poo but if you're able to stick with it your doctor will likely take you on a tour of different methyl*s until you find one that works
Best thing one can do is take chelated magnesium. Choline and fish oil help as well, but definitely take chelated magnesium every morning.
It helps prevent a tolerance build up (in turn helps prevent one from getting an increase in dosage) and helps replenishes the magnesium depleted from ADHD medication. Magnesium deficiencies are also common in those with ADHD who do not take medication. So if you're taking medication, the deficiency is caused by two sources.
>"1. Weight change, either bulking on muscle or fat can change your optimal dose for medication... And it's my opinion (and totally just my opinion) that starting to treat ADHD usually leads to a weight gain, either by getting you more able to exercise or increasing your activity and caloric intake."
Idk. I never gained much weight and ate a lot but the rilatin i take makes my appetite plummet completely.
I eat a lot less during the day.
>"2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life."
I hope this won't be me. I think i am already largely resistant but i hope i can lose it and will try to go back to taking breaks.
> And it's my opinion (and totally just my opinion) that starting to treat ADHD usually leads to a weight gain, either by getting you more able to exercise or increasing your activity and caloric intake.
In my experience, it's totally the opposite. More exercise, more activity, and less caloric intake... leading to weight loss.
You can avoid becoming resistant to the medication by taking "holidays". I usually do this Friday-Sunday most weeks. A daily alternative can be wellbutrin or aplenzin as well.
Also most people can get away with generics so even without insurance the meds are cheap. The psych visits will cost $300-400 a pop though....
Most of these are still schedule 1s though, so if an insurance change forces you to a new GP you can get the prescription yanked - there's no guarantee of access to methylphenidate in the US, there aren't any over the counter methylphenidates and any other acquisition route would probably break the law (like buying it in Mexico or from a friend).
That said, at some point it's going to be worth it to just pay out-of-pocket for five minutes of your old GP's time to write a new script if things are dire... but the fact that this barrier can exist is troubling to me since being in that ADHD hole makes it so much easier to get over these barriers.
For some folks wellbutrin/bupropion can be used to treat ADHD. It is schedule IV so access is easy and generics (I think generics kinda suck for me with this med) are very cheap. Does it work as good as stimulants? Nope, but its certainly easier to get and can help some people.
I feel going to a GP to get a very restricted stimulant is a uphill battle. Go to a ADHD specialist psych. Despite having diagnosed ADHD since I was ~6, my GP looked at me like I was crazy when I explored getting back on meds. I went to see a specialist instead.
My personal experience here is a bit limited - I grew up in the states but after college I emigrated up to Canada so... yea I generally get scripts from my gp up here for a full year's supply at a time and end up paying something like 1/30th of a cent (CAD) per pill for it. While I was in the states I had to fight to keep my script when I transitioned from my parent's insurance to my employer's in college, and ended up paying 9$/pill for a few months but I accessibility was always maintainable without ever seeing a psych except for initial diagnosis in middle school.
My experience with US ADHD medical providers is that they require an appointment every 3 months where you get another 3 scripts (with 2 being dated for the future months). One let me go a whole year without having an appointment but I also didn't ask for a script every month. Generics stimulants have been cheap with and without insurance (or with GoodRX).
After I moved and got a new GP and asked for a stimulant prescription, they wanted me to come in every single month and do a urine drug screen even if I provided info from my former providers. I switched to an ADHD specialist right after that. It's much more expensive but they treat me with respect.
Yeah I have to go in monthly to get mine as well. Thanks to college kid abuse and the opiate crisis doctors cover their ass when it comes to writing stimulant scripts. This means monthly visits (and they get $300 each time) and sometimes drug tests.
I sometimes wonder how much gaming, and stimulating websites like youtube, reddit play a roll in actually creating ADHD.
It's kind of a chicken or the egg situation, do people have ADHD and because they have ADHD they are more susceptible to gaming addiction? or do they become addicted to these sites/games which then creates ADHD type symptoms.
Not saying ADHD isn't an actual thing, but I've noticed a reoccurring theme where people who have ADHD also were addicted to gaming or the internet.
I discovered this guy who has a youtube/twitch channel who is a harvard psychologist who explained how gaming/dopamine releasing web products can have a negative impact on our reward system. How gaming and these addicting products can paralyze you and prevents you from changing behavior.
It's an interesting question, because as I browse comments on sites like reddit and it feels like everyone has ADHD, and these comments about ADHD have massive amounts of upvotes. Which is weird because ADHD isn't supposed to be common, it's supposed to be like ~5% of the population, yet it feels like most people have it on these sites
ADHD is complex and can involve multiple causes. To date, all of the major ones fall in the realm of neurology and genetics (biological causation) with no evidence that social factors alone can account for the condition.
People ADHD are definitely more likely to overindulge when it comes to gaming/internet usage (hyperfocusing). The reason is because it's stimulating. Sites like reddit is an endless influx of information.
Since I have ADHD it's a struggle to do anything that is boring. Sure most people can relate to that but the difference here is that my school/work/relationships have suffered greatly because of that and the other ADHD symptoms.
Some people who say they have ADHD probably don't but are suffering from something else (stress, depression, anxiety, etc.). It's a disorder that's over diagnosed because avoiding to do boring things, losing focus, and/or hyperactivity is pretty common (especially among youth).
Kids who are obsessed with gaming/internet usage might develop bad habits and behavioral issues but not necessarily something permanent. I seriously doubt it can cause ADHD. Traumatic brain injury would make more sense.
It probably doesn't help, but I'd view it as self-medicating in many cases.
Perhaps to turn your comment on its head, people like my wife don't get much out of a place like Reddit so they don't visit it, while the ADHD crowd is constantly on there trying to up their dopamine levels.
Yeah, I agree. But also it's curious that so many people feel like they have it. Makes me wonder if in addition to people that were born with ADHD, these sites like youtube/reddit and video games can create ADHD symptoms over time as your brain adjusts to constant dopamine.
Kind of like how constant sugar can spike insulin and with weight gain over time can creates insulin resistance/diabetes. It's like type 1 vs type 2. So in this analogy Type 1 people with ADHD would be people who are born with it and it's lifelong, and type 2 ADHD people acquire it after indulging in these dopamine producing addicting web products for years and your reward system/executive function is messed up, impacting daily life similar to people who are born with ADHD.
> But also it's curious that so many people feel like they have it.
My hypothesis: ADHD is defined as X out of Y listed symptoms, almost all of which people experience in some way at some points in their lives. The difference is between "I sometimes have problems with some of these things" vs. "I have significant problems with many of these to the point where it is a big and constant problem in my daily life and causes me great pain".
So people who sometimes have trouble focusing see that it's on the ADHD list and take up this soft position of "Maybe I have ADHD" or jokingly talk about probably having a little ADHD or something like that.
It's the same with OCD. How many people have you seen on Reddit confess to having OCD or OCD-lite or "probably OCD" etc.? A lot more than the official diagnosis statistics right.
I don't think it's because Reddit creates OCD symptoms though.
I mean, that's sort of normal with neurological disorders though - a few have really clear symptoms that are blindly obvious to anyone from the outside. We, as humans, both can't see into other minds and can't let others see into our minds. If you analogy for ADHD is building a wall of awful[1] then normal people do place bricks in front of their actions, it just doesn't spiral in the same way as people with ADHD tend to do regularly - most of the bipolar people never act "inhuman" they just spend a lot of time at extreme emotional levels that most of us, thankfully, only visit occasionally... OCD (specifically, as a disorder) isn't liking things neat, it is harming yourself trying to keep things in a certain state - being late to a meeting because when you locked the car the click of the keys didn't sound like they should.
And everything is a spectrum, everything - nobody is immune to indecision fog, getting sidetracked, feeling helpless in front of a decision that feels bigger than it rationally is, etc... but those moments usually happen rarely, for some people it is a constant fight that actively lowers their quality of life.
The flip side is being stuck in a high paying job that requires me to take stims and feeling like I have to in order to keep making good money and it really sucks to be honest, the older you get the more of a toll it takes and I am afraid that I am shaving years off of my life just for money but I have bills to pay D:
I would encourage you to really ignore the stigma that comes along with it, because I think it's endlessly harmful and only delays treatment for folks.
The best way I can put it, was the first time I got a pair of glasses, I didn't know how bad my vision was (I was like 12)... when I put them on for the first time, I was shocked, I was in disbelief, "this is how everyone else sees?"
Glasses are a tool to help you see better if your eyes don't work correctly, a "stimulant" is a tool to help your brain if you can't focus. The world, in both cases, I was missing, was one I had no idea existed until I had a tool to do so.
I've taken stimulants, both Adderall and Ritalin and I can't stand the way they makes me feel. I don't have a very severe problem though but I do struggle sometimes with procrastination.
I don't know how much patience you have for trialing drugs but some people have reported responding very well to Wellbutrin. In my own life, ritalin was terrible for me but switching over to concerta - a slower dispensing XR methylphenidate - did wonders.
There are a lot of options a neurologist can explore and everyone's brain is different.
That said... if non-pharmaceutical coping mechanisms work to your satisfaction that's great to hear.
I was also diagnosed recently and have moved to taking medication; however, that really only lowers the resitence for me to doing the "right" thing. I still heavily rely on the mental tools that I've learned with my psych. Even before I started medication, those tools were incredibly helpful. Parts of it was just sitting and deconstructing some of what I think and how I act and try to find ways to insert reminders into life. Also, just having a diagnosis helped me personally accept that things like breaks and timers and things that other people don't need to get work done aren't something silly, but very useful devices to help me focus on the things I want to be, not just things that strike my fancy.
I would highly recommend see a doctor if the only thing holding you back is not wanting to do medicine. Mine was supportive and left the decision up to me. I went for around a year before starting and once I started I could def feel the difference -- it's not huge, but it's...a gentle nudge? If you find a doctor who isn't supportive of not using meds, find another doctor. It can be a bit like dating, where if something isn't working or priorities aren't aligned, then you move on.
There are non-stimulant treatments, but they're not as effective. The increase in dopamine is what helps the ADHD brain work more closely to "normal", and stimulants are great at releasing dopamine.
That said, stimulants at doses that affect ADHD don't necessarily to come with other physical side effects.
I take a non-stimulant ADHD medication named atomoxetine (marketed as Strattera) and I’ve found that it’s been life changing.
With untreated ADHD, I was not aware of my attention issues and had trouble understanding the way my mind and the world around me worked, even though I could have fantastic focus and attention to detail when excited about things.
With atomoxetine, I feel that my attention still drifts, but I am able to notice it and respond to it without stress and turmoil. I get distracted often, but it’s actually EASY to just put myself back on task. It still sucks to get distracted, of course :-)
For me personally, it’s been fantastic. I have basically no negative side effects and no physical dependence (if I were to stop taking it, I would miss the benefits, but there would be no extra downsides.) It’s significantly less invasive than stimulants in that way.
A psychiatrist is always the right person to make the call, of course!
I'm happy to share, mental health carries a stigma and it should fucking not... it was really hard for me to seek treatment, I thought about it for years, but the social stigmas [1] kept me from seeking help.
At first, I was given anti-depressants, because if you're very depressed sometimes things like starting/stopping projects is difficult (looks like ADD/ADHD). Also, most ADD medicine is heavily regulated; so, they pretty much put you through a gamut to make sure it's what's actually yer problem. At first this sort of felt like they weren't listening to me, but I do appreciate it now reflecting back (mostly because most health care professionals do want to help you, if you're in a bad place mentally though, it can be hard to realize).
I was at the time suffering pretty horrible depression due to a very bad couple of years; so, it made sense, and it helped my mood-- I didn't feel hopeless but it didn't really resolve my underlying stress of never being able to focus or finish anything (which was pretty deeply affecting me because I wanted to contribute more to my team, or rather more steadily).
After two or three months on anti-depressants, and checking in monthly, I was prescribed a pretty small dosage of Adderall; though, if my insurance was better for mental health I would have tried Vyvanse (I think is what its called). Since the dosage was low after about the first week or so, it would kind of wear off after like four hours... So, after the first month I asked to have it doubled and have been at that dosage since with no issues or complaints been about eight months now.
I've read and hear about a lot of people who sort of have enhanced ADD on drugs like Adderall and I haven't really experienced that at all, with the exception of a couple of days I was battling a lot of sadness. Which is why I think my mental healthcare provider did a really great job addressing it (my depression) first; so, that my ADD could actually be treated.
[1] It's really shitty to have mental health issues because almost everyone tells you to: try "diet X," that you have some bad habit, or that you don't do "Y or Z." If you had a physical injury though, no one is going to say "stop eating sugar to fix it." It's not that some diet, exercise , etc might be helpful, just like it would be to prevent a physical injury), sure... thanks hindsight-man.
By doing that what you're telling someone is: that their problems are completely within their control, that they are to blame, and it's their fault because they're choosing this for themselves. When in truth they cannot control it and should not feel blame or inadequacy for it.
Over the years to treat my ADD I tried:
1. Gluten free
2. Exercise
3. Keto
4. Smoking Weed
5. Not Smoking Weed (went a year without it, didn't help, actually made my ADD worse and I got fat(ter))
6. Vitamins of all fucking kinds
7. Cutting coffee/caffeine out
8. Steady sleep schedule
9. Various other weird "natural" shit too I'm sure
None of it helped but each thing on that list prolonged me from getting help [2].
[2] Having never suffered from that kind of depression before I can honestly say it was a heavy fog, that slowly rolled over my life, that was impossible for me to recognize until I was treated for it. If anyone else out there finds themselves angry or upset in ways that don't reflect who they feel they once were, get help, friend. Depression isn't just about being sad.
For years when I would sit down to work I would go into an endless loop consisting of roughly three-four websites, almost back to back, where it was driven by muscle memory anytime something distracted me. I would almost like "wake up" finding myself in this endless loop.
On good days, I would look like an insanely talented and driven engineer, on bad days, I would look like the laziest piece of shit folks could know. It wasn't by choice, it wasn't because I was trying to "cowboy" or "rockstar" a single fucking thing, it's because that's how my attention span worked (or didn't rather).
"Smart and lazy" is almost an insult to me now, because its a moniker put on folks who are probably having trouble with something and "lazy" is rarely positive (even when its supposed to be). It kept me from believing I might have ADD for years despite tons of signs.
The downsides are of course that people don't believe you, or judge you for it (I switched pharmacies because they were treating my like shit when I would go to pickup my ADD meds)... but the upside, as the author said, is you have a life back you didn't know you were missing. You can choose to read a book, watch a movie, program, etc. you're not longer just forced into a vapid reflexivity of the world around you.