Get diagnosed and get a low-dose of meds. It helps _a lot_. You will likely hate the feeling they give you for the first week (you will genuinely feel high even on 10mg Adderall XR), along with nightmares and night sweats but after a few weeks, you'll suddenly be productive at a very normal level.
I don't feel strung out nor is it some addiction. Ignore the people screaming about Adderall being "literal meth" and how it will certainly kill you. Even with an addictive personality, it's very easy to avoid over-doing it (hint: only take it as prescribed).
Medication is intended as a stop-gap to build a system so you won't need high doses forever. If you go into thinking meds are all that needs to be done, you are going about it wrong. You need to build a system and reflect on how to improve your baseline productivity and keep yourself on rails (planners, calendars, checking your work, reviewing work with a fresh mind before sending out, etc).
Additionally, it does help if you like what you are doing. I'd imagine ADHD is much easier to maintain if you are self-employed or have a large leeway to define how work gets done or what work gets done. If you are in a command-and-control / top-down power structure, you need to leave; you'll never thrive there and will ultimately get tossed out.
Lastly, caffeine does help from my testing, especially caffeine combined with L-Theanine. I used to take 100mg of HVMN "Sprint" pills as a test whether I had ADHD; it helped quite a bit. It didn't make me jittery and it let me focus much better.
> I don't feel strung out nor is it some addiction. Ignore the people screaming about Adderall being "literal meth" and how it will certainly kill you. Even with an addictive personality, it's very easy to avoid over-doing it (hint: only take it as prescribed).
Low dose meth does work pretty similar to Adderall. Everyone who does meth does not become a meth addict. Most don't. But the people who become meth addicts are the same people who end up using adderall like methheads.
Which is why I personally don't have an Adderall prescription. Because if I have a bottle of Adderall I'm going to attempt a prescribed dose on day one and start snorting it by day three.
Low dose meth has a lot of similarities but quite a few, significant, differences to Adderall. The biggest are tropism and release.
Statistically, because of the addictive effects of untreated ADHD, the likelihood of substance addiction with or without amphetamine treatment is almost equal. There is of course a risk of getting addicted to Adderall, but amphetamines with long releases are not very addictive as far as drugs go and the risk of getting addicted to other things is drastically reduced.
Methamphetamine as used illegally is a lot more addictive than Adderall because it is generally consumed in ways that lead to much more immediate effects and not orally, and even when orally it is generally formulated to be released more quickly. More rapid effects seriously increase addiction potential.
The doses are also much smaller for Adderall than meth in 99% of cases.
Because of these factors, methamphetamine is much more addictive than pharmaceutical amphetamine salts.
To paraphrase, "I think adderall is kinda like meth, so it's obviously addictive."
The fuck?
Adderall is one of many medical options for treating ADHD. Not all of which are stimulants. And some of which are chemically designed so they can't be abused (like Vyvance).
EDIT: The OP pulled the "in my opinion" phrasing from their post, but I'm going leave mine as-is. There's a lot of anecdote based FUD about ADHD meds going on in these threads, and it makes me mad. My above thoughts stand.
> All stimulants are addictive and you will have physical side effects from discontinuing use.
I love those side effects though. It is so nice to stop taking them and feel cozy and rest for a few days. The best description I have for it is that it feels like when you get home from a hard days work and are tired and go sit down in your sofa and just relax. Just that the feeling lasts for days! Awesome, right?
I hate being on the meds and I never take them when I don't work, but I have to take them to do any kind of work requiring focus like for example filling out a form.
It's a much more difficult withdrawal for many/heavy stimulants users. brain fog, zaps, depression lasting months, messed up dopamine/glutamate and other brain crap.
It sucks there aren't any good meds for addiction treatment for stimulants yet (naltrexone/bupe etc).
Quitting meth, cocaine, prescription stims is really really hard.
I have never heard of someone having withdrawal symptoms from a prescription dosage of Adderal. I've kept my ears open for one, since this is an exceptionally common anecdote that someone's heard from someone else.
If you have, please point to a source - there's a lot of anecdotal FUD running rampant throughout this thread.
I'm working on ADHD diagnosis now and my doctor was kind enough to let me begin taking Ritalin and then switch to Vyvanse. Medication is literally, demonstrably changing my life for the better.
I used to drink multiple cups of coffee a day and felt like it was almost baseline requirement just to attempt to focus. Actual ADHD medication makes coffee almost obsolete. The first time I took Ritalin it was almost scary to realize how chaotic my mind was minute-to-minute, every day without fail. Suddenly the noise all went away.
It feels like I can actually create coherent sentences. I stop getting overwhelmed by asynchronous communications (Slack, email). The "volume" of every single distraction that used to monopolize my attention gets turned way down. Yeah, I still get distracted -- but now it's a conscious choice to either let that distraction take precedent or to re-focus to the task at hand.
The day to day benefits are great, but the big picture / life-style benefits are the most appreciated. In general my anxiety and stress management is honestly 10x better. I've gone from being stressed over my career choice every week to finally feeling like I can thrive. I stop getting irritated by the most innocuous things someone might say or do. I stop waking up anxious every weekend trying to process the million things I need to get done just to exist and make forward progress in my life. I could go on and on and on about how "real" ADHD is, without even having a formal diagnosis yet.
I'm sure the discussions in this thread regarding the utility and risks of these medications sounds intriguing if you don't have ADHD and already know how to sit still and focus at will. But anyone who doesn't have our experience should understand this shit is honestly helping people live their lives for the better. My only regret is I didn't know sooner.
Always scored 90th percentile in standardized tests (how? no clue.), curious, the lot... just couldn't care about homework or listening in class.
I struggled through 5.5 years of college then years later snapped out of the mindset of "just having to try harder". My parents knew... they had me diagnosed as a kid, but were scared off of stimulants by their church.
I try not to think about what my life could've been.
I'm a parent who's scared about my child's potential need for this. We're just entering the diagnosis pipeline now. I'd like to give you an opportunity to convince me that I shouldn't be resisting that sort of thing, which is my (admittedly somewhat unfounded) reaction.
I was diagnosed around age 15 and started taking Concerta. It was life-changing for a while, but it started feeling less helpful over time. I remember feeling like my energy/attention was a zero-sum game, and I had to pay it back at the end of the day.
I was frustrated with these side-effects in college, so I quit the meds as a freshman. I got through college and even a masters degree, but it was a slog. While working at my first "real" job, I felt like I'd hit a brick wall. It was near impossible for me to stay focused during the day. I went back to my doctor and started taking Vyvanse, which I've been on for ~5 years now. This drug has been really amazing, and I don't feel totally sapped at the end of the day. (My layman's understanding is that it's a pro-drug, so your liver has to chop the molecules apart to produce the actual amphetamine. It has a slower ramp-up and ramp-down than the Concerta did.)
One thing to consider is sleep quality. It turns out I had an obstructive sinus blockage for many years. I got it removed surgically and feel amazing. I still take meds to deal with underlying ADHD symptoms, but I could actually be a functioning adult without the meds at this point.
Although I feel like my childhood was OK, I dropped out of highschool and from the age of 17 to age 27 I worked a _total_ of 1 year split across 5 different jobs.
If you're worried about the effect medication might have, I understand, I'm a parent and I'm 99% sure my boy has it as he's exactly like me. I would implore you to consider the abject danger that untreated ADHD presents to its sufferers. Shorter life span by on average 12 years. It's a much worse diagnosis than people realise. The transition into adulthood took me a decade. It was rough. Really, really rough. I only got diagnosed last year at 32. Medication or not, what you should endeavour to do is monitor if it goes into remission in early adulthood for them or not, and keep them educated on the topic so they can understand how/why they experience life the way they do. I'm not medicated myself at the moment (because thus far I haven't responded to it) but being aware of it has made a big, big difference.
I don't think there is anything wrong with questioning, if anything it is great that you are questioning whether it is the right path.
I do appreciate and understand that ADHD tends to be over-diagnosed to children due to them being... children.
I don't necessarily know what I would've done if I had been in my parent's shoes beyond actually listening, being empathetic and using my adult knowledge of the world to help. They took the meds away before I even got used to them and that was the end of meds until I got them myself last year (16 years later).
There is a whole pit of co-morbid issues in my adolescence that I believe being a considerate parent would entirely avoid. I can't definitively say that ADHD was the one thing that changed my life trajectory or made me bad at my day-to-day schooling.
I am not a doctor but I can't see the harm in starting low to get your kid into building an organizational system, study habits, learning what helps them work best, etc, so they can hopefully come / stay off the meds. No one wants to be medicated for life, not even doctors want you on any medication forever; the less you can put in, the better. Meds may not be needed, meds may be needed. It entirely depends on how much your kid is struggling, what kind of relationship you have (do they feel they can trust you and say bluntly what they need and are struggling with, is that something they are emotionally capable of voicing, etc.).
Medication isn't a panacea obviously and if you can help your kid get organized, both of you feel they can stay on top of work according to what's reasonable for their age and listen to them with patience and empathy, that will likely be as much as you can do as their parent.
My parents had high standards for me but rather than asking "how can we help? what do you need?" kindly and being someone I could rely on for help, they would scream at me and say various things that seemed helpful ("You're not average, average isn't good enough") but just ingrained that I was broken and worthless because I was trying, I was doing as much as I could and still wasn't making it.
The only reason I got diagnosed as a kid was that my brother was being diagnosed at the same time. There was no concern for me individually, it was a 'package deal' of pushing all the kids through the pipeline to figure out what was 'wrong with us'.
I am ranting now... :)
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Not to assume, but I figured I'd include this because this is _my_ next mental health adventure of figuring out officially: ADHD is co-morbid with Asperger's. The two also have many cross-overs (emotional sensitivity, sensory issues, seeming aloof, etc.) so it's worth a mention to totally rule out or gain a better context of how to give your kid the best shot. Asperger's is not at all an awful sentence of misery and awfulness to not be caught until later. Both ADHD and ASD are better 'caught' early obviously, so you and others can help create support systems to improve quality-of-life.
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I feel like my parents viewed parenting as factory line; each kid gets the same input and we expect the same output; if we don't get the same output, the kid is broken not your parenting style. Maybe this is just good parenting, but I would encourage you to consider the perspective of meeting each one (assuming you have multiple!) where they are at individually rather than where you or others expect them to be. Something I wish my parents had done was tell anyone and everyone to "fuck off" with their expectations rather than tossing me under the bus for being 'weird'.
Hi justasidenote2, I'm at 60% scrolling down this whole hacker news crap thing, and I finally found a post that I think makes any sense at all.
First of all, make sure you get that diagnosis. Don't go wild with the medication thing, because the first thing that the medication should do is bring you from the "giving up in advance" level to the "ooh, I can learn about and try some things that might help me to take control of my own life" level.
And for now, start ignoring "anyone who doesn't have our experience" and what they think and shout, because I think you won't start to feel any better after reading all of that.
Hans
P.S. my un-scientific explanation for the overload of stress reactions (and anxiety and panic attacks) is that in absence of 'neurotypical' ways to get us going, the body goes into an emergency stress loop, producing stress hormones and adrenaline all the time, to try get us going to do anything at all.
I 100% agree with not just relying on the meds and moving on, even though the new ability to maintain focus and context switch without overwhelm is so novel in its own right. But yeah, I'm currently on a waitlist for the diagnostic testing and am seeing a therapist who specializes in the condition.
The most fascinating part of this journey is finally understanding myself better. I've been spending hours every week reading others experiences with ADHD, watching videos (Dr. Russell Barkley is awesome), and in general just figuring out who I am and why I'm that way. I'm beginning to understand that habits I've had, such as being "hyper organized" (actually, being utterly dependent on my calendar) were just coping mechanisms needed to get things done. It almost warrants an entire self-evaluation.
Your description of the stress response seems plausible. All my life I've oscillated pretty strictly between hyper-anxious and utterly indifferent, the latter probably serving as a coping mechanism. Suddenly now I'm able to comfortably live in the middle ground. I'll do what needs done today, and know that what needs done next week/month/year will get addressed when it's time.
Anyway, I really appreciate the feedback and wisdom. Wishing you the best of luck.
> Get diagnosed and get a low-dose of meds. It helps _a lot_. You will likely hate the feeling they give you for the first week (you will genuinely feel high even on 10mg Adderall XR), along with nightmares and night sweats but after a few weeks, you'll suddenly be productive at a very normal level.
I wonder if I could have persisted long enough with Adderall to find a theraputic effect if it had been during lockdown. 10mg of Adderall made me unsafe to drive to work (I would suddenly get the subjective sense that my car was completely still and instead all the parked cars on the side of the road were hurtling at me at 25 mph).
My doctor actually started me on a higher dose (15 or 20mg maybe?) because I needed such a high dose of Ritalin to get a theraputic effect (and at that high of a dose it greatly impacted my sleep). I took it exactly once and I didn't feel tired for 36 hours and was completely non-productive. For the first time I finally understood what all that clinical language describing the symptoms of a manic episode were all about.
Vyvanse did not feel nearly as bad subjectively, but my wife insisted I change meds because I was (in her words) "an asshole" while on it.
Finally settled in on 20-30mg of Focalin a day. The year of titrating the doses of each medication was hell. And then when we finally figured it out, my company switched insurers I had to change the pill sizes (not total quantity) to get it covered with the new insurance.
The one thing I'd like to add is that diet for me made a huge difference. I might as well not be taking the meds if I have a carb-heavy breakfast. Prior to taking the meds I had quit eating breakfast altogether because I felt like such crap around lunchtime if I ate breakfast. Obviously taking stimulants on an empty stomach is not a great idea, and my psychiatrist helped me out to go for a breakfast that doesn't provoke such a strong insulin response.
Definitely feel you there. It's the worst part about psychiatric drugs and why I've bailed on almost everyone I've ever been on. It's that initial hump and having to struggle through ~two weeks of hell.
My partner has run the gamut so he constantly assured me it was normal and that I'd be fine.
>The one thing I'd like to add is that diet for me made a huge difference. I might as well not be taking the meds if I have a carb-heavy breakfast. Prior to taking the meds I had quit eating breakfast altogether because I felt like such crap around lunchtime if I ate breakfast. Obviously taking stimulants on an empty stomach is not a great idea, and my psychiatrist helped me out to go for a breakfast that doesn't provoke such a strong insulin response.
Diet is my next interest but haven't gotten tools perfected to track the variables that I think will be affected (productivity, happiness, energy and sleep).
I am vaguely on the train of diet affecting productivity but my daily lunch is a McDouble and large caffeine-free soda to sip on so... non-conclusive currently. I also skip breakfast because of the same reasons (too heavy + no good breakfast foods, even 30-in-30 always slows me down)
I have found that many 'healthy' foods make me feel sick or worsen productivity so I am tentatively sticking to my weird diet for now. I have suspicions I may have food allergies and that could be causing it.
My theory is I get a bit hypoglycemic with the typical American breakfast of pastry/bagel/cereal, but I kind-of don't care why.
Bacon is my go-to breakfast food; can cook up a bunch at a time and heat up what I need in the morning. I make some eggs to go with it if I have the time. The great thing about bacon for me is that it's so salty that I cannot overeat on it.
Low carb and one-meal-a-day intermittent fasting both make a huge difference for me. There's something about eating, carbs especially, that just dulls my ability to focus. My wife has been pushing me to get tested for food allergies and I plan to this year. Diagnosed ADHD as a child, fwiw.
Counter-anecdata here: meds aren't always the best option for people. Don't bias toward taking amphetamines as the parent comment instructs you to do.
There are serious negative long-term effects from taking amphetamines regularly. Such advice as above is very one-size-fits-all, and in my view is thus really bad advice.
> Ignore the people screaming about Adderall being "literal meth" and how it will certainly kill you.
You can ignore those people because they're wrong, amphetamine is not methamphetamine. But do not ignore the people who tell you that even normal amphetamines (adderall) are not harmless. They cause harm, even at low doses.
The harm they cause may be mitigated by the benefit they bring; it may also be extremely difficult to estimate their harm in advance. Ceasing regular use of amphetamines for some people can result in subsequent YEARS of oversleeping, lethargy, and depression from dopamine receptor downregulation.
> I don't feel strung out nor is it some addiction.
Amphetamines are a highly addictive substance, if you are taking them every day it is likely that your body has developed at least some physical dependence upon them. Addiction doesn't make itself known until you stop.
We're talking about ADHD though, not someone looking to just pull some all-nighters or cram on a Sunday night.
When I realized there was a low dose medication that could basically cure me of ADHD (thus cure me of underperformance, procrastinating my ambitions, low professional self-esteem), the choice was obvious. Know what also does harm? Underperformance, procrastinating my ambitions, low professional self-esteem. Far worse than any side-effect from amphetamine. And I'd take on much worse harms if they would cure my ADHD like amphetamine does.
Edit: lol, when I started my reply to you, your comment was two sentences long. Take it easy.
Btw, I'm in my mid-30s and I've been taking amphetamine since I was 18. Perfect bill of health. Though, granted, there's plenty of life left.
Stimulant addictions are one of the most common functional addictions.
I don't think most people would consider someone servicing an active physical dependency to have a "perfect bill of health", even if you are totally free from disease.
Mental disease is a disease too. The options are either to have ADHD, which is a potentially very destructive disease, or to have a low-grade dependency on stimulants with few side-effects that can be severed in a week or two.
Of course, many medications that aren't psychotropic fit the bill. Corticosteroids, for a common example, lead to physical dependency too. Most medications lead to some kind of physical dependency after prolonged use, it's just sometimes of very low grade.
The second option is much better from any pathological point of view.
To note, perfect health doesn't exist. We're all broken in some way :)
You are making assumptions the parent did not imply. You can be on ADHD meds and not be addicted to them, ffs. I am on low-dose adderall xr on days that I need it and I have never had an issue. Everyone is different, but to imply that the adderall has caused an “active physical dependency” is no different from stating that too many people drink caffeine (except that because I only take it as needed it’s not even a fair comparison).
You’d be right, but it does not do significant harm, especially given how therapeutic the right drug can be in the right doses.
Can it do significant harm? Sure. So can Ibuprofen.
I take ADHD meds, and I will admit I have a dependency. When I go without my meds, I'm in a really bad mood the first day and get much worse the following days. That said, I don't have an addiction disorder, because it doesn't impair my ability to work, maintain relationships, pursue goals, or remain healthy. In fact, it does the opposite. That's why my doctor prescribes them.
(As an aside, the reason I've gone days without meds is because my insurance company has a harmful policy of requiring "prior authorization" from the same doctor who prescribes the pills, and more than once I've found out it needed renewed from a pharmacist who was only allowed to try filling it the day I took my last pill. I'm tired of this incredibly helpful medication, and the people who depend on it, being thought less of.)
What's harmful is telling people without qualification that they should seek dangerous and addictive medication without a careful cost/benefit analysis.
My comment isn't saying that you shouldn't, it's saying that there are downsides that are not apparent that must be weighed against the upsides—same as any medication. Even ibuprofen can fuck up your stomach, each remedy must be evaluated on its risks and merits.
I speak from extreme personal experience. Same team!
> that they should seek dangerous and addictive medication
We're not telling folks to go on a meth binge. We're telling folks that this doctor prescribed medication actually works, and can help improve their lives.
To use your own ibuprofin example - what your parent statement is proposing equals: "Don't use ibuprofin for your chronic inflammation, even though your doctor prescribed it for you."
EDIT: If COVID has taught me anything, it's that we as human beings are poorly equipped to make appropriate cost/benefit analysis when it comes to medical advice. Especially when it comes to anecdotal experiences. And doubally especially when you're already suffering from untreated ADHD.
I do agree that it can cause harm long term. It's the same with all medications, that's why I pay doctors to prescribe medication and monitor my health while taking it. I already have physicals every six months because of another condition. With the Adderall, I get blood pressure taken monthly and an EKG every three months.
The goal of almost any medication is to create a stop gap to create or find non-medication solutions. Without Adderall, I can't focus on creating systems and tools to help me stay on track.
Demonizing Adderall isn't helping anyone. No one should be afraid of taking a medication that will change their life for the better. If someone goes through normal channels and gets properly prescribed it, they should be treated no different than any other ailment.
I didn't demonize anything, and if you think I did, you should probably re-read my comment dispassionately and stop trying to do battle on the internet.
Your comment opens with:
> Get diagnosed and get a low-dose of meds.
Immediately suggesting that someone seek a somewhat dangerous medication as a solution, without qualification, is an extreme and dangerous view. "You have ADD so you should try low doses of speed!" is not wisdom. There is a reason that these are prescribed by doctors, and monitored.
One requires getting diagnosed to get medication. I am not advocating buying Adderall from a dealer. I am encouraging people not to be afraid to pursue the medication route because it is so demonized.
Medication helps a lot. You could struggle with no medication, trying to build a system to help yourself, possibly fail and never be who you can be or you can seek out professional help (potentially with medication) and begin building support today and have a good shot.
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Would you say the same if I encouraged a depressed person to do their best to get diagnosed and get on 'anti-depressants'? I am doubtful.
We have invented medication for a reason. People go to decades of med school for a reason. Medical professionals know what they are doing and are very upfront about it not being a panacea and needing to still work on non-medication solutions (as with any medication).
I will admit my first sentence ("Get diagnosed and get a low-dose of meds") was too strong to start with.
> Would you say the same if I encouraged a depressed person to do their best to get diagnosed and get on 'anti-depressants'? I am doubtful.
Don't be: many studies have shown CBT to be equally as effective for depression (for most people) as medication. If you are equally likely to cure your issues with a book on CBT versus a pill, that is something you should consider, even if you do end up deciding for the pill.
I encourage people to evaluate the costs and benefits of ALL their options before seeking any specific treatment for issues that involve neurochemistry. My entire thrust is "medication is not a panacea and you should not bias toward using it, over any other option, as a solution".
For some it may be the best choice. For many it is not. Don't bias toward it (as you advocate). Evaluate, don't just go get pills because some random person on the internet said it worked for them
that one time.
If you put the wrong thing in your body, you can fuck yourself up for a very long time. I am speaking from direct personal experience.
Adderall is not the only medication. Other stimulants are from different families and all of them come in a variety of formulations / dose releasing mechanisms.
There is at least one non-stimulant drug that can be prescribed (atomoxetine), but it doesn't work for a lot of people (including me).
I found atomoxetine only mildly useful and the side effects (slight increase in blood pressure) to bother me enough to stop using it.
However, I want to mention modafinil (particularly as no-one else has mentioned it in this discussion). It has worked for me and there is evidence to its effectiveness as a non-stimulant medication for ADHD - https://pubmed.ncbi.nlm.nih.gov/11191692/ - although it's technically an off-label use.
This is a super-edge-case but if you happen to want to be a pilot (either small planes all the way up to airlines), the FAA considers ADHD and other attention-deficit conditions to be disqualifying. If you're taking medication for ADHD or similar conditions and want to be a pilot, you're dead in the water until you get off them and can show that you don't have some kind of attention difficulty. FYI!
You need the non-ADHD people to fly the the regular boring things from A to B, and you need the ADHD people to be able to take the right decisions about what to do in a split second while being under extreme duress in a war zone.
Almost any medical condition disqualifies you. Almost any medication taken regularly does too.
I am interested in getting my private pilot's license and I _should_ be able to get a Class 3 Medical from what I've seen, but that will be a bit away so I have time.
What I've seen and heard from others is to just lie. Seems like many have gotten to the point of realizing trying to do it right is only going to put you in months of bureaucracy and spend thousands proving your viability.
The FAA needs to figure out how to either commission studies to reduce their list of disqualifications or streamline the process of appealing your medical certification.
Most common medical history items fall under something called CACI: Conditions AMEs Can Issue. (Yes, that's an acronym in an acronym. Welcome to the FAA. AME is the doctor you see for your flight physical, which you probably already know, but other readers might not.) The vast majority of folks walk out of their flight physicals with a medical certificate thanks to CACI.
ADHD does not fall under CACI, and will trigger a deferral to the FAA. The FAA will then refer the applicant to a HIMS AME. (Human Intervention Motivation Study.) HIMS is really about substance abuse, not ADHD, but it's doing double-duty now for things like ADHD and the four conditionally approvable SSRIs. ADHD can also trigger expensive neurocognitive tests ("CogScreen"). So ADHD really is in a separate class of conditions when it comes to getting a medical certificate.
Current use of stimulants is a denial no matter what.
As a flight instructor I think this is completely bonkers. The nature of ADHD is such that if it keeps a person from being able to fly safely, that will show up during training as a failure to meet performance standards. It's completely different from something like a heart condition, where a pilot will fly just fine until suddenly their heart stops. I've taught lots of folks with ADHD diagnoses; almost all of them did great, and the few that didn't were very obviously not able to handle the airplane.
I empathize 100% with your frustration. I went through the wringer to get my first medical and have watched a lot of students go through this. It sucks, and there’s no good reason for it to.
Fascinating, but appears to make sense. Hopefully, some day we will be able to quantify the difference so that people like me (who do worry that they can't stay on top of all the details in a plane) are excluded from flying¹ while other people who have a similar condition to mine but are capable of flying are allowed to do so.
Seconded on L-Theanine, definitely helps if I get jitters. I usually avoid caffeine bc of this, since the adderall at a correct dose seems to work great but socially it’s hard to avoid caffeine.
I love soda too much to kick caffeine entirely. Never got on the coffee train thankfully.
I've tried to kick caffeine multiple times but always fall back during stress. I just can't find another (cheap) drink I enjoy sipping on.
My harm reduction is a Soda Stream, which at least lowers my overall sugar intake. I don't understand sparkling water, I've tried it and it is less enticing than plain water.
> Lastly, caffeine does help from my testing, especially caffeine combined with L-Theanine. I used to take 100mg of HVMN "Sprint" pills as a test whether I had ADHD; it helped quite a bit. It didn't make me jittery and it let me focus much better.
> Moreover, considering that caffeine has a half-life of 2.5-4.5 hours [137]the once-a-day schedule of administration used in clinical trials in ADHD patients could be insufficient to antagonize A2AR throughout the day; thus, in future trials different administration schedules should be used or, as an alternative, selective A2AR antagonists could be tested in animal models of ADHD. In particular, it would be interesting to test the efficacy of the A2AR antagonist istradefylline in view of its approval for the treatment of Parkinson’s disease in Japan [138].
Ironically, I just started taking Nourianz (istradefylline) (link: https://www.nourianz.com/) as a last-resort drug for my severe restless legs syndrome, which has been going phenomenally well. I also have ADHD combined type (inattention and hyperactivity), and fairly severely.
Anyways, I have been taking the the istradefylline for a week now, and it has made a tremendous difference in many of my ADHD symptoms. In addition, it greatly increased my sense of wellbeing within 1-2 hours of initially taking it, and it has been sustained for the entire week.
I hope you find this interesting! I take Vyvanse for my ADHD.
Thanks to istradefylline I can now focus seamlessly and without effort. I can just "lock in" to whatever I want to do. Before, it would require some static force ("friction") to be able to "lock in" my concentration to do the task. I can also just focus, without hyperfocusing. It now comes naturally to me. I also no longer find myself pacing around the house aimlessly. I also do not randomly get up from my seat or fidget hardcore. I can also lock back into a flow state without effort if I am disrupted.
> caffeine does help from my testing, especially caffeine combined with L-Theanine.
One thing that made me look into adderall was finding out I was a slow metabolizer of caffeine via 23andme, and was consuming an unhealthy level of caffeine. I did some research and determined that the health risks of low doses of adderall were smaller than those of high doses of caffeine.
Scott Alexander’s review of the research on Adderall are also worth reading:
>the health risks of low doses of adderall were smaller than those of high doses of caffeine.
I hadn't seen that before, so thank you!
I ran into this same thing accidentally, I was regularly 'overdosing' on caffeine by drinking 300 - 400mg of caffeine per day in college.
The safe dosage is ~200mg for an adult if I recall, but I can only do about 100 - 125mg absolute max or my heart starts pounding. I am not sure if this lowered limit is due to 'abuse' or if I also have different caffeine metabolization. I will have to take a look at my data.
Yeah, without diving back into it myself right now, the health effects of caffeine are quite different depending on a single SNP. For fast metabolizers some doses of caffeine above 300mg/day can actually have net positive effects on cardiac health, while the opposite is true for slow metabolizers. I got into a habit of 400mg+ doses per day and the cumulative effect that had on sleep quality alone was a good reason to find an alternative.
I completely agree with your comments about looking for opportunities to use medication to bootstrap into better habits around exercise, mindfulness, and building better systems and habits.
I'm still not sold on the medication and prefer to follow strict routines + good diet + exercise. To me, it's obvious who is taking ADHD pills. People are almost zombie like or they space out, or even on low-doses they almost can't "keep up" in conversation or meetings. Not being drugged and finding coping mechanisms has allowed me to plow through multiple degrees and find career success, albeit at the cost of "other things", relationships, social skills, health, etc. I'm not going to risk my livelihood when life is good-enough atm.
Good for you, I am glad you have found something that works for you.
It is inappropriate and rude to assume what others need. I am the complete opposite of what you assume on Adderall, I am more verbose, my thoughts are more coherent and I can keep up with meetings because I can actually pay attention to them. The first time my spouse heard me conduct an interview after medications, he told me how much more cohesive, steady and assured my speaking was.
It helps no one, not even yourself, to tear down someone else because they are using a different solution than you.
You prefer to do the exact things that people with ADHD struggle with. This is like saying “for depression I prefer to just not be sad.”
It wasn’t until after I was diagnosed and medicated that I finished my undergrad after almost a decade, started my career, and started grad school. You do you, but don’t be sanctimonious about mental health treatment based on your anecdotes.
To make matters worse ADHDers often have terrible sleep quality due to not being able to get to bed on time because there's almost always something more interesting.
Good luck doing any of these if you have even moderate ADHD. It's hard enough getting out of bed.
As a sibling mentions, your description of people who are "drugged" sounds more like people who have undiagnosed-ADHD and are not medicated.
The drugs don't make you drugged -- that's sorta the default state. The drugs make you functional enough to try and develop coping mechanisms in the first place.
ADHD medication has different effects on people, and you’ll
know very quickly what it’s effect is on you. Furthermore, it does not make me spaced out or zombie like, nor does it make me strung out. It simply calms my brain down so I can actually focus on the problem at hand, rather than the opposite of that, with my brain flitting back and forth with other thoughts.
I don’t take it on a day when I’m being creative or brainstorming, because the lateral thinking required does that is actually something ADD helps, but I take it when I have to get something done.
Take it from a guy who has had ample coping mechanisms, got a CS degree from MIT, founded and sold a security startup, etc.; all of those coping mechanisms worked, but got much easier once I accepted the ADD and found the right meds. It only made me more productive and a better contributing member of the team.
YMMV, but I suspect your assumptions about how it affects people are very wrong.
I got diagnosed with ADHD age 15. Methylphenidate gave me these zombie like spacing out symptoms. I later switched to Amphetamine and didn't feel the negative side effects of Methylphenidate.
Methylphenidate is the only authorized substance for ADHD treatment here in Germany. I had to pay for my Amphetamine treatment by myself. I had the impression that the pharmaceutical industry doesn't have an interest in getting an authorization for amphetamines as that substance can be produced by a local pharmacy on site. Even thou I can confirm that the side effects are much less with amphetamines.
Now age 35 I haven't taken any medications for ADHD for 8 or 9 years. It was good to help me with school and university but now I don't need to put myself into a position where medication could be helpful. Still wouldn't want to work in an open floor plan office. Not sure if that is an medical condition.
How is Lisdex for you? I've recently been considering asking my doc if I can try it out.
I'm currently on a rather high daily dosage of Medikinet CR (2x30mg + another 1x20mg on long days if anyone's curious). It works but too inconsistently. It's also rather expensive here in the Netherlands.
I started with 50 mg, and I experienced a heavy effect for first couple weeks: very calm and clear thinking, but the focus was too heavy - I often fell into “deep thinking / introspection sessions” with my body frozen and an unfocussed stare. It could happen in the middle of a conversation. I thought I would need a lower dosage, but this initial heavy effect was gone soon, and the focus became milder.
Now I am on 50 mg. The medicine stimulates my focus and makes me more enthusiastic about activities, which can be annoying since I need to control not to apply my new powers on wrong or useless activities. I am also very verbose for couple hours after taking a pill. I would not say I am completely cured from ADHD. In the evenings, positive effect disappears, so I need to plan accordingly.
I avoid drinking coffee in the morning now, as the combination of two stimulants makes me shaky, I experience muscle tension, and it affects my ability to interact with people.
We tried 70mg with the doctor as well, but it made me aggressive and grim in couple months without noticeable improvements over 50mg. To manage tolerance I often skip taking pills on weekends. I also lost a few kilograms, which is good.
All in all, I am only half satisfied with the result - based on what I read I expected a better effect. I think my type of ADHD may be addressed with more sophisticated medication. Unfortunately, in Germany there are not a lot of other options to try, and my doctor seems to lack experience in treating ADHD. I try to combine pills with diet, exercises, and sleep management.
Thank you for the detailed response! There does indeed seem to be a lot of hype surrounding Lisdex in the more common places were ADHD is discussed.
With regards to the effects this particular type of medication has on your behaviour, you have essentially described me - but on Medikinet, on those odd days when it decides to just work that way.
In the Netherlands we have a specialised ADHD treatment centre called ADHD-Centraal. I've been extremely impressed with their methods, their high level of competence, and with their care and involvement. The fact that they really know what they're doing also shows in the tiny practical adjustments they've made to their workflows to accommodate or even compensate for "the likes of us"!. I'll gladly provide you with direct contact details for you to pass on to your doc or call directly if you believe there's something to be gained in that.
Unfortunately, as you mention, the medication options are limited and at some point you're going to run out of things to try.
The main reason I'm not on Dextroamphetamine is that it registers on the quick saliva drug test that the Dutch police carries. It is amphetamine after all. When that happens, you'll get fined for driving under influence, and won't be allowed to drive for a few hours which is very annoying. The bigger problem is that if you're ever involved in an accident and the presence of amphetamines in your system was registered, you might even get a criminal record plus the insurance might decide not to pay out. Impractical to say the least...
Long acting or slow release Methylphenidate medication - such as the Medikinet I'm on, is only partially covered by Dutch health insurance. Legislators have decided that the short acting variants are identical and that anything else is essentially a luxury. They would quickly change their minds if you'd lock them in a room with me when I'm suffering from disastrous rebounds every hour on short acting Ritalin :)
Get diagnosed and get a low-dose of meds. It helps _a lot_. You will likely hate the feeling they give you for the first week (you will genuinely feel high even on 10mg Adderall XR), along with nightmares and night sweats but after a few weeks, you'll suddenly be productive at a very normal level.
I don't feel strung out nor is it some addiction. Ignore the people screaming about Adderall being "literal meth" and how it will certainly kill you. Even with an addictive personality, it's very easy to avoid over-doing it (hint: only take it as prescribed).
Medication is intended as a stop-gap to build a system so you won't need high doses forever. If you go into thinking meds are all that needs to be done, you are going about it wrong. You need to build a system and reflect on how to improve your baseline productivity and keep yourself on rails (planners, calendars, checking your work, reviewing work with a fresh mind before sending out, etc).
Additionally, it does help if you like what you are doing. I'd imagine ADHD is much easier to maintain if you are self-employed or have a large leeway to define how work gets done or what work gets done. If you are in a command-and-control / top-down power structure, you need to leave; you'll never thrive there and will ultimately get tossed out.
Lastly, caffeine does help from my testing, especially caffeine combined with L-Theanine. I used to take 100mg of HVMN "Sprint" pills as a test whether I had ADHD; it helped quite a bit. It didn't make me jittery and it let me focus much better.