Add a decade, subtract the apnea, but otherwise: Welcome to my world, or an exact replica thereof.

The thing is, I can focus on stuff I really want to do, but I can't fake the want. So - my personal pet projects are doing fine. As for work, my life has improved tremendously since I sort of gave up careerwise. These days I drive a bus and actually have some mental energy left over for my sparetime. No medication. I don't like the idea.

Don't medicate but challenge yourself. Learn a new editor while doing your job. Try using Windows instead of using a Mac. Try typing only left handed. There are varioud challenges to overcome boring assignments. Also try a standing desk so if you skive then you must stand up for fifth teen mins.

the worst advice ever.

If you have medical issues - take care of medical issues in the best way possible.

Challenging yourself = denying yourself treatment.

Challenging yourself is not a treatment for something like sleep apnea.

Yes but the evidence for ADHD is dubious. We have a long way to go when it comes to understanding the human mind. Anyone, not just people with ADD, can increase their performance with narcotic stimulants. Just don't be disingenuous about it.

Just because ADHD is poorly understood and often diagnosed incorrectly does not make it any less debilitating to those who have it and certainly does not imply that they are not in need of medication. Yes the medication can be abused by those who don't need it to get an edge. This is what makes it a controlled substance. Opiates can be abused too and have the same effect on everybody. The difference is that people in server pain need opiates to function at a baseline normal level. People with ADHD need medication to function at a baseline normal level. The fact that some people abuse them to go beyond that is completely irrelevant

> People with ADHD need medication to function at a baseline normal level.

This statement is so out of line I had to chime in. I was diagnosed with ADHD as a child. I was medicated for a few years, before I stopped taking the pills without telling my parents (they were being pressured by the private school I was in to medicate, I was kicked out shortly after they found out I had stopped.)

Those years are a complete empty window in my memory, and left me with physical ticks that _decades_ later I still have to suppress, alongside no actual tools for dealing with the symptoms.

Medication is not a silver bullet. Not all ADHD cases need to be medicated. Find what works for you, whatever the hell that is, and don't listen to dogma. For me that was coping mechanisms combined with a realization that much of the "attention deficit" was because I _didn't want to pay attention to the shit I was supposed to_ and _that's completely reasonable._ To insinuate that I haven't tractably found success ("baseline normal") with a non-medicative approach in my life is frankly insulting.

In Adults outside a courtroom, mental health treatment focuses on easing distress because the person seeking out treatment is the patient.

Parenting is stressful and imposes a powerful incentive to reduce that stress. Consequently, too often in children, mental health treatment focuses on controlling behaviors because the person seeking treatment is the parent.

The first is a person seeking greater agency for themselves over a problem. The latter is a denial of agency of the child. I’m hearing you express your pain at having your agency suppressed and expressing skepticism at the tools used to suppress your agency.

But those same tools also grant some adults an agency they are desperately drowningly seeking for themselves.

1) have you ever had psychometric testing done? 2) what are you non-medication coping techniques?

Genuinely interested in hearing your story.

1. I might have when I was initially going through a ream of behaviorists, but I'd be lying if I said I recalled, this was around/after 3rd grade.

2. In large part, reminders. Notes, lists, alarms (calendar/phone alarms for _everything_, watering plants to finishing work shit), behaviorally trained prompts, anything to disrupt the "mental feedback loops" where I can find myself "unconciously" falling into something like tearing at my fingernails, reading HN, playing video games, or really any of the infinite things I'll come up with to not do what I should be doing.

e.g. even right now writing this, I'm being pinged to go back to reading PRs: after years of having automated browser alerts going "hey you shouldn't spend time in this video game/on hn, it's been 20 minutes and you have nothing to show." my brain has picked that up and is able to do it on its own. I found that hard blocking didn't work since I'd just find ways around it, but if I can remind myself this is something I _want_ in any way from pragmatism (mortgage) or emotional (getting wife nice things) whereas the games/Hn are actually _unwanted_ (despite what the dopamine might say) it's easier to force myself to focus on something I don't want, even in bursts. (getting myself to internalize and BELIEVE those facts took years and I still fight with sometimes when willpower is low.)

This was a bit of a ramble, and I'd be remiss to mention that the motivation to use the prompts would be missing without the philosophical context I assign to the things I do. (Disclaimer: I recognize not all people can use this technique, I simply use the fact that I have strong long-term motivations against my bad short-term focus) I mentioned it in passing (mortgage, wife, etc) but really finding things I _WANT_ and using my brain's likelihood to fixate on those, especially in periods of distraction, I can tie those things back to what I SHOULD be doing and create a virtuous cycle. Contrivedly: Distracted looking out a window at garden. Fuck, I can't afford this garden if I don't go back to coding. (Dang, this HN post is getting long. Better get back to work so I don't work late today and can spend time with the wife when she gets home :) )

You are spreading mis-information. Attention, and lack of it, is something humans have understood for thousands of years.

1) stimulants and narcotics are two very different things, with diametrically opposite effects.

2) Not everyone can improve performance, due to U-shaped response curve. Those that are functioning optimally will actually see their performance decline.

3) ADHD is one of the best understood disorders. Impaired working memory (i.e. ability to concentrate) can be easily diagnosed quite definitively with CPT: https://en.wikipedia.org/wiki/Continuous_performance_task

It is of course personal choice in the end to decide on treatment, but if the ability to concentrate is in the bottom 1-5% - it is going to be painfully obvious to any half-decent paediatrician.

I can say medication has done wonders for my professional life and has made me much happier overall. For anyone on the fence about trying medication, I would say it is certainly worth it.

Do you have any tips on finding a project manager whom you can videochat or email with and ask for help with the project of navigating the healthcare system?

(uk private in my case, though I imagine people in other places would benefit from wider answers.)

that's called a well-connected private GP, or, if you are rich enough - physician in chief of a large hospital/center.

That's bad advice for me. For instance, I was supposed to be working on finalizing a new feature. Instead I was obsessed with writing tool wrappers. I learn things all the time, but they seldom relate to the thing I'm supposed to be doing. I'll bounce around instead of deep diving through the codebase I'm responsible for.

Holy shit, same boat, same age, on CPAP for about a year now, can't remember what was said in the meeting I was just in this morning. And browsing HN while I should be writing tests ;)

Your apnea could be undertreated, or it could be a symptom of a bigger problem. Epiglottic collapse is not uncommon in apnea patinets (10-15% of cases), and is not treatable by positive pressure, as it is an inspiratory valve.

CPAP only works on the expiratory valve - which is your soft palate.

If you are having a large number of arousals, despite optimal CPAP pressure, and your respiratory waveform is jagged in certain ways (hard to describe in text) - you are very likely having epiglottic collapses.

However, epiglottic collapse can only be definitively diagnosed by sleep endoscopy.

Epiglottic collapse can only be treated surgicially.

Or simply go to a doctor specializing in it and check with him what they think. If they suggest trying something - try it and see if it works. I was in the same boat. Can't really say it was a miracle, but it definitely helped a bit.