My therapist wants to explore an ADHD diagnosis, run tests and dive deep. My question to you is; how did this help you or impact your life?
I am in the later half of an adventurous and successful career. I continue to grow, have a long-term stable marriage, good savings, great life. I went to my therapist to handle a lingering family issue and now we've come up to the ADHD talk.
They want to run neurological tests, said I'm 'twice exceptional' and I see this as an expensive and time consuming diversion of my goals. I do admit that there is some validity in the idea, I do see symptoms, but how would this help me at this point in my life?
Anecdotally, I've seen a huge uptick in posts of the format "how an ADHD diagnosis changed my life" on Reddit, TikTok, HN, etc. Talk to your doctor about your issues and concerns but don't forget the incentives of pharma companies to push these drugs on as many people as possible.
I was blown off by doctors for years when I was seeking a diagnostics because I was a successful person, but make no mistake: I was suffering. I am a textbook case. The stigma around this disorder is pervasive and it’s extremely easy to reinforce that stigma.
Stimulant medication doesn’t give me superpowers, it improves symptoms. I still have all the problems that come with ADHD, just... less.
Google is failing me, but a study a few years ago indicated that stimulants do not have a meaningful impact on the output of those who do not have ADHD. People often think they do because of the euphoria effect, but the euphoria is actually a transient side effect.
Stimulants should be paired with therapy, to better understand the nature of the disorder and developer additional coping tool.
(I’ve been on stimulant medication to treat ADHD for about half a decade. I was diagnosed well into adulthood.)
Lead to a burnout-like state that started developing while basically being a stay-at-home dad for a year or so. It got worse, and now there are several years of my daughter growing up that I don't remember almost anything from.
The best parallel I can think of is that getting effective medication for ADHD is like getting glasses. Suddenly a part of your life that doesn't work (and maybe has never worked) is suddenly functional. People tend to be pretty excited about their glasses when they first get them, too.
If someone describes Adderall like the magic drug that Bradley Cooper takes in the movie Limitless, they probably haven't been taking it very long. Tolerance quickly builds to those effects.
People who have been taking Adderall since childhood or for a decade of adult life tend to have more mixed reviews. That's not to say it doesn't have a place in treatment of life-impacting ADHD disorders, but it should be noted that it's not a miracle drug that automatically turns you into a motivated, organized person. Even patients who take stimulants must make an effort to build good time management habits and self-discipline. Those who rely too heavily on the motivating effects of stimulant drugs can end up worse off when they inevitably build tolerance to the euphoric effects and still haven't learned how to manage their ADHD.
I've also noticed a huge uptick in ADHD misinformation in the form of overly broad diagnostic criteria. If you see infographics that describe ADHD symptoms as common behaviors like "have trouble remembering names of new people" or "I sometimes forget to do all of my tasks" then it's likely junk science. Don't confuse normal human behaviors for ADHD. ADHD is something far more debilitating.
For one person I know that is actually how it was. From unemployed and living at home to phd studies in mathematics and publishing in prestigious journals.
Every adult I met that is "on" stimulants has echoed the sentiment that they don't understand why on earth anyone would take them recreationally. Ergo, they don't feel euphoria, because then it would certainly be obvious why.
If you get euphoria from those doses, well then what you suffer from is probably not typical ADHD.
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I sought behavioral therapy because the side effects became too much of a burden. I hold a job and remain productive, but I still struggle dealing with my adhd without medication. I'm not sure there's a point I'm trying to make here, just wanting to share some of my experience.
Posts like those are what gave me the confidence to seek an ADHD diagnosis.
Moreover, some of the comments are literally about starting drugs a week or a month ago. God forbid, the long term effects could be entirely different. I started struggling with my dependencies after about a year or so.
Yes and note that you know that. We're aware that long term things might change, so we point out that we're only a week in. Use your judgement from there, add as many pinches of salt as you like.
Additionally people new to a thing are WAY more likely to talk about it than others, because it is new and novel and interesting to discuss. See also: vegan, keto, crossfit, peloton, etc. Old timers tend to jump in when there's misinformation, but aside from that they stick to the sides.
But agree, can do all the above plus therapy and support / plan, and it’s not even comparable.
I feel it’s like eyeglasses and I’m being told “you can see it if you squint! It’s clear to me”. Well yeah, but would rather have eyeglasses
This post is just conspiracy thinking. You're far more likely to find people dissuading you from accepting an ADHD diagnosis in your life than people encouraging you. Even doctors don't really like to give a diagnosis of it unless you really clearly fit into a particular hyperactive bucket.
This is incorrect. If anything I'm more calm, definitely nowhere near what you describe. I'm happy, but just that. I've been happy before, I've been high as balls before. This is the former.
I'm (with my doc) finding the lowest dose that works. I'm sure if I took 4 or 5 of these in the one I'd be bouncing off the walls, but that's not the plan.
Just like someone lacking insulin needs an insulin shot, someone lacking in stimulation needs stimulant medication.
> Anecdotally, I've seen a huge uptick in posts of the format
Ya being in mostly-isolated lockdown for over a year fucks with you mentally, wherever your starting point is.
Anecdotally back it just takes one person in a community to figure it out and get a diagnosis for everyone else who exhibit similar behaviours to start thinking "wait that is a symptom too??" and get checked out. New relationship energy then fuels the desire to spread the word to anyone else who might be suffering.
But drink coffee and mix? Bad news bears.
Though drugs are only part of the solution for most people with ADHD, it's almost always what enables other kinds of intervention to be effective.
For me, medication doesn't work too well. I tolerate it just fine, but it just isn't as effective as for most people.
It has still changed my life completely. I can accrue life experience in a way that was impossible before, probably as I had basically no perception of time before medication.
Maybe my daughter put it best when she (on her own volition) got diagnosed at 17'ish: "It great to not have to feel like you are going to die tomorrow." With which she meant that when you perceive time passing, you can also perceive the future ahead.
It's not the only thing that changed, and not all change has been easy. But the diagnosis has still been one of the most important things in my life, even getting it as late as at 36 years.
Anecdote: I'm one of those who tried behavioral approaches for years before agreeing to try medication. I bounced back and forth between different types and doses and ended up on small, regular doses of adderall because I could have some control over when it tapers off. I'm disheartened by the smugness of commentary here from people who see nothing but stimulant abuse.
To give a solid example of why it can sometimes be seen as giving you superpowers, consider my experience: I have three degrees. I was in graduate school for...far too long. Anthropology isn't a quick in and out. I could wrap my head around anything, but sitting and writing multiple drafts of 50-100 page papers regularly was unimaginably difficult. I loved writing, and I wasn't sure why it was so challenging for me. Several years ago, I had the "opportunity" to write an NSF grant with (read: for) a pretty famous researcher. The downside is that when I was asked to write it, I was told the deadline was in four days. I spent some time setting up a perfect writing environment with no distractions, comfortable lighting, and everything I could think of, but when I was working, I could almost physically feel my brain constantly switching to some other track. It was deeply upsetting. The following year, I finally gave in to my doctor's medication recommendation. When I first sat down to read an article in a journal while medicated, the only thing I could hear in my head while reading was my own voice reading the words on the page. It actually brought me to tears because I realized that was probably what everyone else was able to experience normally. The glasses analogy everyone is using? Yeah, it's a bit like that, but imagine being in your 30s not even knowing that you can't see properly until someone put glasses on you. It changes your entire perception of the world and your place in it. It makes small things seem like superpowers. Like you finally have the ability to do all the things you're expected to do as a productive member of society. It's liberating. At the same time, all I can think about is how much more I might have been able to achieve if people had considered putting me in some sort of treatment as a kid rather than telling me that I wasn't working hard enough and making fun of other kids with ADHD.
> Anecdotally, I've seen a huge uptick in posts of the format "how an ADHD diagnosis changed my life"
You are seeing an uptick because admitting to being neuroatypical is now far more acceptable. Similar to how "there are so many more people claiming to be gay/trans/bi" on Reddit isn't suspicious either.
The meds changed my life because I have ADHD. My dad's heart medication changed his life (well, gave him a life) because he has congestive heart disease.
My GP became much more relaxed about my medication when I reported that my medications DIDN'T result in euphoria or bursts of energy as that is often the case with ADHD. I am simply much more focused.
The effects were underwhelming to say the least. I literally could procrastinate with more focus, but my thoughts were just as scattered and I noticed myself veering off topic faster than I'd normally do.
I guess I, like many others, would benefit from some coping mechanisms and therapy perhaps instead of or in addition to medication. I wish it were a miracle pill, but it only seems to be it for some.
For what it's worth, I started by trying ritalin and didn't like it. Like you, small doses of methylphenidate did the trick, but affected my mood too much. Once I learned some other coping strategies, I tried adderall again and find it to be extremely effective now. After you level up those other skills, talk to your neuro again if you feel the medication isn't actually helping.
If they were my reports I would have fired them.
People use all kinds of substances: caffeine, alcohol, nicotine, marijuana, modafinil, a myriad of sleeping pills, antidepressants, and painkillers. At different points in time some of them have been banned or regulated, at others available to everyone. As things stand some of them require a prescription from a doctor.
In the vast majority of cases there's little danger to at least trying out stimulants like Adderall or methylphenidate, or substances like modafinil. If people want to try them I think they should be free to do so. If they have to jump through some hoops I see no reason to frown upon it.
Their body, their choice.
If not for the exact discussions you’re speaking about at work, I would likely have ended up unemployed.
Can't speak for others but my encounter with stimulant medications (under the care of a therapist, of course) provided none of those things. It only gave me severe insomnia, which left me worse off than before.
ADHD medication is heavily controlled. As an adult, it is very hard to get but yes, there are likely people who got it without really needing it.
The wording of this comment ("some" vs "many") makes it seem like the majority of people got it without needing it. This is almost certainly not true due to how strictly it is controlled.
This comment is extremely diminutive and places a lot of assumption in the prescription process of medication.
I experienced euphoria for a month or so when I first started treatment, but now it feels similar to a morning cup of coffee.
I took it again after college and can say that yes if you take a high enough dose it will make you slightly euphoric but I think it's different than the high of recreational drugs. If your mood is too heightened when you take it then probably you should cut back on your dosage.
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I just turned 40 and I never thought I had ADHD until recently. Before I just thought my lack of attention on things was just the price of being a 10X on productivity (and I was a little arrogant because of it).
The reality was that I chose to put my time on tasks that I found interesting and engaging and when that choice was not available, I would feel anxious, stuck and totally unfocused. Still, I thought that was just normal procrastination that everybody goes through.
Some changes in my life and goals limited my time to act and required me to be more focused, but instead of getting into action I got more stuck than ever and very anxious as the deadlines got closer and got missed.
Treating my ADHD helped me change my relationships for better and widened the possibilites in my work and I would recommend to anybody in the same situation.
All my therapy was about struggling with my ADHD for so long because it was unkown and untreated. Once I figured the ADHD part out, everything else fell into place.
Knowing this about myself has been nothing but positive for me.
I’m trying to triangulate a course for myself and still can’t pull the trigger on any of these for fear of side-effects or dependence.
His personal preference is Intuniv (Guanfacine). He says the only reason it's not more popular is that the start-up side effects can be unpleasant for a while and proper dose titration takes more work on the provider's side to get it right.
Stimulants don't necessarily lead to dependence, but I have seen enough adults become dependent on stimulant medication or even fall into the trap of doubling up doses or seeking extra sources that it's wise to approach it with caution. Most patients seem to use as directed, but the people who go down the path of addiction and dose escalation aren't necessarily the ones you'd expect.
Adderall isn't a wonder drug for me but it tips the scale in my favor. I just take the standard release pills 'as needed' in the morning. It does tend to mess with my sleep a bit if I take any after 10am and definitely curbs my appetite (+/-). I'm 47 and recently have been paying closer attention to heart health, it definitely increases heart rate and blood pressure. Not alarmingly so, but if you're in any way marginal for either it's something to consider.
People with ADHD have a tendency to hyperfocus on things they enjoy, to the detriment of other things.
ADHD is not a lack of focus, it is a lack of Executive Function. Sometimes the Executive Function looks easily distracted because it doesn't want to do chores so it bounces from room to room cleaning one single surface in each one.
Sometimes the Executive Function looks like a 10x programmer beast because you get so wrapped up in programming whatever you're making that it's all you can think about, you skip meals and sleep and ignore friends and family until it's done.
Pre-treatment OP sounds like me now.
I am arrogant in that I am always confident I can finish the tasks I have later. The problem is that even though I consistently do, it doesn't feel good, and sometimes unexpected outside influences will kill the tight margin I've left myself.
I can also if not properly focus on tasks at least force myself to finish whatever I'm working on before wandering off. I'm going to give it another week then ask for a bump on the dosage to see if that helps that one
Negatives:
Sweating a bunch, especially at night. Then again we are just about cruising into summer and in my old place I had aircon so that might be unrelated, but it is a possible side effect.
Appetite seems to have taken a hit too. While I am fully for that (I could lose a bit of weight no bother) I will keep an eye on it
Due to covid restrictions I've not been seen for talky therapy or anything yet, this is purely medicinal treatment currently but it's been a MASSIVE positive move for me
In my experience with adderall... everything initially good about this particular Rx eventually fades away. Amphetamine makes you feel great. At the beginning really, really, great. It certainly helped me focus on whatever was in front of me, whether it was math homework or an iphone game. It became very important to ensure the right thing(s) were in front of me before taking meds (e.g. homework textbook or open IDE; not, for example, wikipedia, or email, or HN). Not getting enough sleep was the most acute negative effect of the meds. The battle for sleep continues to this day. The meds do suppress my appetite - they still do. It didn't help me lose as much weight as I'd hoped; turns out staring at a computer screen doesn't require a ton of calories.
These days I take as little Rx as possible, and I feel a lot better. I attribute a portion of this mood improvement to using a treadmill desk, which I started using ~2 years ago. I walk about 15-20 miles a day, while working (coding/writing/etc). I feel like it helps me focus, because I am "burning off" pent-up ADHD restlessness while working. And probably most helpful of all, I'm tired at the end of the day, so I fall asleep much easier.
I hated taking it. Yet it would in fact improve my performance. For 3 years since my last filled prescription circa 2012 I had enough adderall to just take it whenever I felt like I 'needed it', which was rarely, because I hated taking it so much. Since I've run out, I do have issues with ADD still, but fortunately have been able to cope as an adult in my (now) 30s.
I do think having it on hand is really great for some people, but I don't think 'feeling great' is a unanimous experience.
I'm on the one the US would call Ritalin. If indeed a tolerance does appear then that will be disappointing and I'll have to figure it out from there. Unfortunately I don't tend to get anything other than "I'm physically tired now" from exercise
Now if I don't take my adderall on a given day I have trouble focusing and by midday I get pretty restless and antsy.
While on its effect, I've learn what it feels like to be focused, how ones mind works when in "not easily distracted mode", and I've very slowly learnt to apply some of these things even then not taking the medication.
Stimulants are not always necessary long term, but they usually are to start effecting enough change to be able to function in the present society.
For some (me probably) it'll be a lifelong thing, but it definitely doesn't have to be for everyone!
I'm happy for your success!
I really wish I had access to more talk therapy, physiotherapy, guided relaxation, mindfullness'ish sessions, and some other forms of support. The medicine helps me to stay mostly functioning, but with talking to a therapist and practicing "basal body knowledge" I was feeling so much better!
I've already had some systems in place (if it's not in Todoist it's not getting done) but I was falling behind even my norm. If I can get to a point where I can function well enough without meds that will be brilliant, here's to hoping :)
My first few weeks were a rollercoaster, but the negative effects reduced significantly over time as I got used to the medicine and stabilised my dosage. And the positive effects are life-changing.
A sense of euphoria can be a side effect of early treatment, but that's not to be confused with an actual anti-depressant effect.
Some (unfortunately many) users get stuck chasing that initial sense of euphoria with continued dose escalation requests, or by playing games to only take doses on certain days of the week or even by doubling up doses on some days. This is a road you don't want to go down.
- Slept better. No more tossing and turning for an hour or two before I fell asleep.
- Ate more regularly. My stomach starts to hurt if I wait too long between meals.
- Remembered people's names when meeting them, at least to the point where I could say it again after they introduced themselves and started talking.
- More realistic outlook. Things aren't perfect and they aren't the worst, they just either kind of suck for now or this is a good moment.
- No longer have to make a giant mental effort to get something done on the weekend. If I want to read a book, I read it. If I want to play video games, I play them. If I want to clean the house, I clean the house.
- No longer a giant mental effort to get something done at work. Need to send an email? Send it. Need to annotate some data? Annotate it. Need to schedule a meeting? Schedule it.
After my diagnosis, I felt like ADHD became my superpower. I know how to play to my strengths rather than my weaknesses. I know if I have an interest in something, I can dive into it and produce great output, and for tasks that need doing which aren’t interesting, I have coping mechanisms and medication if necessary.
Do these symptoms cause me struggle with my everyday life? Are things that normal people do all the time oddly difficult for me to complete?
If so, go get a diagnosis. Everyone struggles with procrastination to an extent, but if you try to sit down and try to start the work and just CANNOT emotionally bring yourself to do the work or get your brain to engage, then it's probably something more than just normal procrastination. If you are frustrated with your inability to remain focused and complete things on time that are just not inherently interesting to you, recognize that most people don't struggle like that. It's not a discipline problem it's an emotional regulation problem which is common of ADHD.
Emotional stability. My girlfriend had massive ups and downs, almost bipolar; the medication (slow release, concerta or its cheaper but equivalent alternative) evened things out. I have a friend who doesn't want the diagnosis or treatment because he's fine with it, and you can tell he struggles with keeping his emotions under control. He mainly gets really frustrated and loses his patience if things aren't going as fast as he wants to.
The other one is getting overwhelmed and/or having meltdowns, because one comorbidity of ADHD is sensory processing disorder. It's things like grocery stores with music and children screaming that can get too much.
Another one is things being "loud / busy" in your head, maddeningly so. I've heard that taking the meds quiets things down, and it's a relief.
Anyway, a diagnosis won't hurt, it'll improve your self-awareness. You won't be forced to take medication or anything if you don't want to. A diagnosis is usually a questionnaire and a "take this ritalin and tell me how you feel in a bit".
This is a big one for me. I pretty much always have a podcast or audiobook going because otherwise my head is just so loud and non directed. I'll have some fragment of a song repeating in my head for 9 hours straight and I don't even realize it until my partner tells me to stop humming it.
I agree, this is a big issue. It’s like having a lightning storm in your brain. I literally count how long it takes for a random racing thought to pop in my head when this becomes an issue. I also talk to myself way more than an average person.
If there’s one thing my psychologist friends tell me not to do, it’s exactly this: make up diagnoses for myself and others around me to explain behaviors post hoc.
I recall the computer based testing before and after the short-term dose of Ritalin. The graph of my body movement and failure rate - I became normal. I could do the task and it wasn't hell under Methlyphenidate. I was relaxed.
On the downside - the change in my behaviour and my ability to be more independent with administration etc. caused my partner and I to separate. My change was too much for her. It makes me sad, however I was an utter pain-in-the-ass for her the way I was. My invoicing and personal accounts were always such a mess, but now I can do these things myself. I'm next-level organised compared to how I was before.
My core work as a strategist / developer has also improved remarkably. I don't rush in and make stupid moves so much these days - and I find myself taking the time to understand things I never had the patience to understand.
In short, I feel like I've been living my life on hard-level my entire life. At 45 everything changed. It's just a shame I wasn't diagnosed earlier, but I didn't believe ADHD was actually a valid disorder.
ADHD can be harmful and comes with a bunch of comorbidities that can also develop later in life. If you have trouble listening, tend to hyperfocus on things but also emotional states, etc. I recommend going forward with a diagnosis.
[0] https://news.ycombinator.com/item?id=27495535 [1] https://www.raptitude.com/2021/03/what-raptitude-has-always-...
I don't have trouble listening, but the opposite. I empathize so strongly when people talk to me about their problems that I end up exhausted.