Anyone reading this should be extremely skeptical of internet strangers recommending drugs that gave them "superpowers", changed their life, etc. Taking these drugs will make anyone feel more focused, motivated, etc because these drugs are strong stimulants that cause euphoria, focus, and bursts of energy.

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.

Everything you’ve said is correct, but please don’t demonize a medication that I depend on to be functional. ADHD is a disability, there’s more nuance to this than black-and-white.

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.)

My story is the same, blown off by doctors for years because, I don't know, but not being "too successful" was definitely part of it.

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.

ADHD is not a disability. It's an evolutionary set of traits. It is covered under the Big Five.

I would argue that ADHD presents as a disability in a post-industrial society. ADHD Institute suggests that the diagnosis is commonly associated with substance abuse, major depression and a wide range of other conditions, in higher frequency than baseline populations[0]

[0]: https://adhd-institute.com/burden-of-adhd/comorbidities/

In Sweden at least it is classified as a disability, because whether or not it's a evolutionary adaptation, people that present typical ADHD traits are functionally disabled in modern society. Society should change to accommodate these traits, but we can't expect people with those traits to live in misery until then.

Yeah not to sound like a "deep" 15 year old but I think being able to function in our modern society is much more unnatural than the behaviors associated with ADHD. But since is the society we're in, having it really is a disability.

TL;DR: "we live in a society"

As what, lack of conscientiousness?

When you've grown up with executive dysfunction and excessive difficulty regulating emotion, the ability to choose to sit down and do a task that doesn't grab your attention sure FEELS like a superpower, but all it's doing is effectively medicating your condition.

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.

I would definitely say that glasses are a great comparison.

I recommend discarding any anecdotes from people who recently started taking stimulants like Adderall, Vyvanse, or Ritalin. The parent comment is correct in that early stimulant usage is associated with euphoria and motivation that do not last.

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.

> 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.

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.

Personally same order of magnitude improvement in terms of gap from worse to best. 10 years later also agree with OP but (long lasting delayed) medications have been 70% life changing, 20% maybe could have taken a day off, 10% “I drank a coffee too I’m jittery/euphoric/etc”.

A typical characteristic of people with ADHD is that typical doses of - say Ritalin - creates no euphoric effect at all.

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.

People who take stimulants as prescribed for many years don’t understand the euphoric effects because they built a tolerance long ago. Their experience cannot be compared to someone just starting the medication.

The idea that ADHD medications do not cause euphoria in ADHD patients is a myth. It’s one of the reasons some practitioners are moving to titration schedules that start with low doses and move up over time.

As an adult-diagnosed ADHD person and someone who's taken Concerta (time-released ritalin) for about 12 years, I wouldn't be so quick to dismiss a differing experience of stimulants as a myth. I had stopped taking it for about one year while I was undergoing chemotherapy, and recently started taking it again, so I have a pretty clear recollection of what it feels like to get started. No euphoria, but a feeling of mental fog clearing.

I've never experienced euphoria from stimulants, and I've always felt like I've processed caffeine differently than neurotypical individuals. I've spoken with several people with ADHD who have the same experience. Perhaps it's more accurate to say that not everyone feels euphoria from stimulants and there's some correlation between ADHD and stimulant non-euphoria.

I do agree with the titration schedule being a good idea. With any potentially mood-altering substance it seems wise to start slow. It gives time to gradually understand its effects (some good, some less so), and after some experimentation, I decided that a low dose was best for me to provide just enough of the "glasses for the brain" effect without otherwise affecting my mental state.

Anecdotal, perhaps. But enough anecdotes to point to some signal in the noise.

Spot on. People treat medication like some free lunch without understanding they come with real and significant costs.

You can comment anytime, but people who have been using it less than a decade won't be able to comment on the medications post-tolerence decrease in effectiveness and side effects.

If it takes a decade to build up tolerance and a month to completely get rid of it then sustainability seems clear, no? The problem isn't physical dependence but mental dependence, ADHD forces you to become super strict with yourself to get anything done at all, medication makes you lazy since you just pop a pill and get things done, if you stop trying after getting the pills you will start having problems again just like normal people, but if you keep working as hard as before you took the pills then their effects doesn't go away.

Tolerance to the euphoric and motivating effects builds much faster than a decade. More like a few weeks.

It’s a common problem with new ADHD patients. They mistake the euphoria and motivation for the therapeutic effect, then complain that it isn’t “working” any more and ask for progressively higher doses. Some eventually start doctor shopping to find someone who will prescribe higher doses when their provider refuses.

On the decade time scale the negative effects I've heard reported are mostly clustered in the amphetamine psychosis category

Have searched Google scholar for quite a while for long term studies (I believe vyvanse was FDA approved 2009), could you help guide on this?

Warning anecdotal but a close neuro doc friend sees 70+ Year olds who took their medication as prescribed still fine when adherence was high. But much more interested in your link if at all possible, I believe there’s maybe 8 million prescriptions outstanding in the USA so any large cohort would be helpful.

Another anecdote: I was diagnosed in middle school and prescribed Vyvanse, which I took for the duration of my k-12 education. Some side effects I lived with were loss of appetite, social anxiety, difficulty sleeping, and later on a complete suppression of sex-drive. These were brought to my doctor's attention but were more or less considered costs to a greater good.

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.

I wish you luck in finding a successful treatment plan.

This is also exactly the line of thinking that happened to keep me away from an ADHD diagnosis for such a long time. The point of the “superpower” language, when used by someone who is actually ADHD is that you feel impaired and are lead to believe by everyone and everything that this just the way you are - that you’re lazy, that you’re incompetent, dumb etc. And those successful focused people, they’re just more hard working, they put in more effort. ADHD drugs are life changing because suddenly you’re perfectly fine sitting still, being focused, not interrupting people.

Posts like those are what gave me the confidence to seek an ADHD diagnosis.

Anyone reading this comment should be extremely skeptical of internet strangers like Matlin who do not have the condition thinking they know what is best for you. These medications do not work the same way on people who do not have ADHD. I get zero euphoia from these medications, and they got rid of serious insommnia problem. If you don't have ADHD your experience will be far different.

Except, ya know, the lived experiences of ADHD sufferers like myself. I get zero euphoria from my meds.

The idea that you think people with ADHD are just normal people who have trouble focusing are missing it by a mile. Caffine makes me sleepy.

I got the euphoric/ebullient effect for the first 2-3 weeks of 30mg Adderall XR I was on when I was first diagnosed (and not for the remaining 2 years I was on it). That's the only med I've had that effect from (and I've now trialed all the ADHD medications available). Currently on a low dose of Evekeo and it's the best so far.

Thank for tip towards Evekeo. The lower dextro seems promising. If you can tell (if it’s perceptible) to adderal XR / vyvanse / mydayis or some of the longer release that would be interesting. But will Google regardless :)

Thankfully this living experiences is not how we conduct science. Some people get euphoria and done don't, there is no relationship between someone diagnosed.

Right, I’m extremely add and get euphoria. I also feel a lot of the people who treat this as “my medication” types (they’re common) should realize the worst thing about adderall is that it makes you happy doing stupid menial stuff

Uhhh... no. Like that's not at all how stimulants affect people with ADHD. If you need me to waste 6 straight hours of my life stuffing wedding invitations I'll skip taking my meds that day. Stimulants help me have focus when I am physically unable and let me direct it at at what I want to be doing instead of it being outside my control.

Like it doesn't make you happy. That's silly. If the only issue with me doing menial tasks was that it made me unhappy I would be so much better off because at least I would be able to do the task.

Thank you for posting this. And since these are all basically just anecdotes, I would also like to add mine. I got hooked on anxiety pills after a diagnosis (not the same thing as ADHD, but still), and the withdrawals were genuinely the worst things I've ever faced. Like I wouldn't wish that on my worst enemies. With drugs, especially habit forming ones backed by Big Pharma, you should always be on the side of caution.

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.

Thanks for this, my big fear is the effects of long-term use. I've had friends who were superheroes on Adderall, lost tons of weight, changed their lives. They couldn't see how manic they were.

It is an amphetamine. Go to r/ADHD and read the thousands of enthusiastic stories of people that just took it for the first time and are basically just high. I took medication for a while and it helped me surmount a bunch of issues. Now I can do well without. I never liked the effect on my body and mind.

The effect doesn't go away, you just start expecting more of yourself. Without medication I was really happy if I could focus 30 minutes in a day, that would have been like a once a month event. On medication I feel like shit if I just got 4 productive hours on a day. So sure not every day is like the first days after you start, but it never goes down to even close the level you are at without medication.

> Moreover, some of the comments are literally about starting drugs a week or a month ago

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.

I've been over a magnitude more productive for many years thanks to medication. That it can't have massive long term impact is just nonsense. It doesn't make focusing trivial, but it makes focusing possible and that is all I need. If I was diagnosed earlier I'd not have wasted a decade of my life, but at least I can do stuff now.

As as person who got diagnosed with ADHD as an adult and looked back to a life of potential wasted, and while I don’t agree with calling the benefits of any drug “superpowers”, I can understand why some people would. I exercise almost every day, meditate, eat and sleep well and yet, it was a pill that made the biggest difference in treating my difficult on keeping focus.

Same (19) BUT arguably if you need X, take more than X, then adjust to Y because of that unneeded “boost” it would sort of be a fair criticism.

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

There are a lot of positive anecdotes in threads like this because, shock of shocks, a field which is well known for having people get into it because of obsessive interest-chasing in their teen years is also dominated by people who fit the diagnostic criteria of ADHD, and also shock of shocks, medication known to help people with those criteria tend to help a lot of people in that field.

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.

> Taking these drugs will make anyone feel more focused, motivated, etc because these drugs are strong stimulants that cause euphoria, focus, and bursts of energy.

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.

Anecdotally I’ve worn a chest strap monitor and tracked HRV over several days at work. Much calmer.

But drink coffee and mix? Bad news bears.

Also don't forget that drugs have changed the life to the better for so many on the ADHD spectrum.

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.

It's interesting to me that your daughter phrased it that way. There's actually a ton of research (some old, some new) about perception of time among ADHD sufferers and how that affects modern life. In a nutshell, the idea seems to be that there's a shorter time horizon (ADHD folks can only see or imagine themselves so far into the future) which is what makes long-term planning, budgeting, etc so difficult and why many are also seen as procrastinators or bad with money. Hop on any research database or google scholar and give it a look. You'll also find in that research an overwhelming bias towards studying younger folks. We're only recently starting to understand how missing diagnoses affect adult livelihoods.

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.

Can you link the time horizon, that’s super interesting. At least most YouTube medical lectures I’ve watch sort of focused on the norepinephrine reputake inhibition and how dopamine in the (forget the name) chain somehow hinders task ability.

The concept to search for here is 'time blindness'

Also be extremely skeptical of internet strangers telling you that you DON'T need medication or vaccines or therapy.

> 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.

I have ADHD diagnosed by a neuropsychiatrist and I've tried a handful of medications now. Currently I have Concerta, methylphenidate, and only on the largest dosage allowed do I even see any effects.

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.

One of the things I learned pretty quickly is that it gave me the ability to focus better on anything, but my lack of prioritization skills became more noticeable. So yeah, it helps you focus, but you still have to practice picking what you should be focusing on.

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.

Yeah I definitely need to work on how I actually work and create a mindset and space that supports that. But for me, only the maximum dosage of methylphenidate had any effect. I've heard of people getting the gurn on it and obviously it's a decent amount of speed for anybody, so I haven't felt comfortable continuing on it.

At my last company engineers openly bragged about strategies to get prescriptions and increase dosages. I find this behavior reprehensible.

If they were my reports I would have fired them.

Why?

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.

People abusing ADHD medication like that is the reason that the medication is so tightly controlled and hard to get as someone who actually has ADHD though.

It stops being "Their body, their choice." when tangible harm is being caused to people who actually need the medication to treat a neurodevelopmental disorder.

You get 30 pills for 30 days. I can’t buy alcohol on Sunday morning either, and I get the personal freedom aspect, but it’s very predominantly used in children, CVS literally has one variant that’s just “methamphetamine” (a hilarious generic), so having some constraint seems reasonable.

This isn't a "personal freedom" thing for me.

I'm talking as someone who was denied medical treatment for 7 years because the first specialist I saw assumed, based on my age, that I was trying to scam them for a prescription.

Those years were basically lost, and that wouldn't have happened if there wasn't so many people seeking phony diagnoses.

After moving halfway across the country in 2013, I had trouble finding a doctor who would prescribe Vyvanse - after having been on if for years and basically relying on it to remain productive.

If not for the exact discussions you’re speaking about at work, I would likely have ended up unemployed.

You clearly have never experienced medical gatekeeping. It can be really frustrating to be forced to change doctors or insurance and have to fight for years to continue the treatment regimen that actually works for you.

Your PCP is the tier-1 tech support of the medical world. They have basically zero specialized knowledge to evaluate different medications outside the brochure the sales rep gave them. There's a reason PCP's punt the responsibility for a diagnosis to a psychologist and then play the game of "spin the wheel of stimulants" to find something that both alleviates their symptoms and has tolerable side-effects. Having to go through the process all again for no reason other than weird politics or a doctor on a power-trip is the worst.

Ugh.

Rather presumptive to think I haven’t been through the medical system or ran into bad doctors. My experiences will be left as an exercise to the reader.

You get medical records sent and see multiple doctors until one is aware of your ailment. Strategizing on how to lie is unacceptable to me. Happy to agree to disagree on this one.

If one of my reports used work resources to collude for substance abuse I would do everything I can to fire them.

So "lying to get a treatment that alleviates the symptoms of their medical condition in a system that punishes honesty" is substance abuse now?

I literally wish every time I go to the doctor that stimulants didn't get non-ADHD people high so I wouldn't have to deal with this crap.

> If one of my reports used work resources to collude for substance abuse I would do everything I can to fire them.

They actually used work resources to discuss medical treatments so firing them over this would likely be very illegal.

> Strategizing on how to lie is unacceptable to me.

Where are you getting this? Who lied?

> My experiences will be left as an exercise to the reader.

I assume that you've sought medical care and been criticized for it, and now spread that unfortunate rhetoric to others?

He did. The state discouraged prescribing it.

I wasn’t seeking “drug seeking”, I was seeking the only medical intervention that I’ve found that ameliorates a diagnosed condition.

You really equate that with someone looking to get high?

I was under the impression that without peer coaching you couldn’t get a prescription. If state guidelines are at fault how did you find a in state doctor sympathetic?

I apologize but I can’t get over the notion it’s drug seeking and/or doctor shopping.

I must assume that there was a reason for the doctor not wanting to prescribe you that medication. If state guidelines were the true root why was another doctor amenable?

Using performance enhancing drugs is a losing game. It makes it harder for those who wish to use their natural cognitive abilities.

In time it forces everyone to dope up.

>Using performance enhancing drugs is a losing game. It makes it harder for those who wish to use their natural cognitive abilities. >In time it forces everyone to dope up.

With all due respect, say less things like this.

You're wrong -the drugs treat a medical condition. Its not "doping" or "performance enhancing".

> It makes it harder for those who wish to use their natural cognitive abilities

Our society is full of people enhancing their natural abilities... with things like cars and escalators and calculators. Treating a medical condition is fixing a medical "flaw" but it is NOT some sort of get-ahead scheme.

This sort of diminutive language leaves people feeling bad about themselves instead of seeking adequate medical treatment.

> I was under the impression that without peer coaching you couldn’t get a prescription. If state guidelines are at fault how did you find a in state doctor sympathetic?

I think you’re misunderstanding - I had an existing, active prescription for Vyvanse when I moved into the state. It took me months to find a doctor who would refill it for me. I had already been through years of counseling at that point.

> I must assume that there was a reason for the doctor not wanting to prescribe you that medication. If state guidelines were the true root why was another doctor amenable?

The state “looked more closely” at doctors who prescribe stimulants. Basically none of the doctors I spoke to in the beginning was willing to add another prescription to their practice because of this.

> Using performance enhancing drugs is a losing game. It makes it harder for those who wish to use their natural cognitive abilities.

How does this logic not apply to cardiac drugs? It “makes it harder for those who wish to use their natural cardiac abilities”?

> "Taking these drugs will make anyone feel more focused, motivated, etc because these drugs are strong stimulants that cause euphoria, focus, and bursts of energy."

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.

Absolutely. There are some who need this medication to function, but there are many who weren't sure if they needed meds, got prescribed anyway and - surprise - feel a burst of focus and motivation now they're regularly taking stimulants.

> There are some who need this medication to function, but there are many who weren't sure if they needed meds, got prescribed anyway

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.

Different drugs have different effects on different people. People with ADHD are often calmed down by stimulants, at doses that would have “neurotypicals” bouncing off the walls.

The original poster is in therapy, so presumably there is something going on that he or she is unhappy with.

That's pretty dubious, especially about 'medicine' in general. If that was true it would double as a surefire test for ADHD. As well, all it takes is a little stronger dose and I know of a friend with ADHD that abuses it to party

The dose is managed to be the minimum that treats your symptoms. A massive dose of amphetamines will obviously get anyone high, but we're talking about the response in a clinically relevant range of doses.

It is Europe and that is what I thought. Aka, anecdotes

This is false - if the dose is high enough with a drug like Adderall or Vyvanse you will get the euphoric and high energy when first starting out. Over the course of a week or two your body adapts and that feeling fades.

This is a common misconception. The euphoria is a transient side-effect. Some people don’t experience much euphoria from amphetamine.

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'm commenting just to balance out everyone saying this is false. I took Ritalin in middle school and never felt high whatsoever. One day my mom took it (once) because she was curious and she said she felt high (she told me this many many years later).

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.

A normal dose can make you high or euphoric the first few times you take it. Eventually your body down-regulates and you don't experience a high, but if you read ADHD experiences on the internet you will often come across people who have just had their first dose and are clearly geeked up.

That's really interesting to me. I take methylphenidate as a (doctor prescribed) stimulant and don't get the euphoria much at all. Maybe a little bit the first time I take an increased dose. 5 mg made me feel drugged and tired the first time. At 10 mg, I very nearly puked at about 2 hours and 4 hours after the dose the first week but no euphoria. I just had a more normal amount of energy compared to how tired I am naturally. 15 mg and I'm pretty bright and alert, but wouldn't call it euphoria by any means. I don't know what a recreational dose is. I just got my prescription upped so that I've got a couple 20 mg doses available. If I have a suspiciously lovely day, I'll let you know. I'm definitely not addicted. I feel no need to take it except when I know I need it to get through the day.

What did give me euphoria and hypo-manic behaviors was Nuvigil at 250 mg after having been off it for 2 weeks. That was an inexperienced mistake on my part, but it was really fun.

I just don't see how people become physically addicted to these drugs. I am on Desoxyn have been for years and at a pretty high dose for a clinical dose. 35mg twice a day. I have went weeks without taking my medication with no ill effect. Not a single withdraw, the only thing that happens is the foggy head comes back and I cannot seem to put one foot in front of the other to get things completed. there is only one company that makes Desoxyn and it always has to be ordered, so I have times that my pharmacy does not have it and no pharmacy stocks it by default because it is pharmaceutical Methamphetamine. I do not take anywhere near a recreational dose, but I cannot for the life of me, understand how people on prescriptions for these class of drugs get junkie level addicted. I don't have any literature to back it up, but I would assume by the street drugs, if any of these meds would be the most addictive, it would be the one whos active ingredient is methamphetamine. I just go oh well it's going to suck for a week and not much will get done. Recreational meth users are generally taking anywhere from 100-200mg at recreational doses. For me to take that my months prescription would be used up in about 8 doses. certainly not enough time to develop dependency. So where are these people getting such high doses that they can continually take, to develop physical addition.

I also have no idea why anyone would want to abuse something like Adderall. The levoamphetamine targets the bodies nervous system rather than the brain. On very low therapeutic doses it cause all kinds of peripheral physicals problems for me.

It is also good to keep in mind ADD/ADHD meds have one of the highest success rates in the pharmacological field of psychiatrics care. It's one of psychiatrics success stories and there is a mountain of evidence that supports it. It is sad that it is still stigmatized as just wanting to get high. I avoided treatment for years due to that. Not accepting the proven track record of stimulant based treatment for ADD/ADHD is doing a lot of harm to a lot of people. Is it over diagnosed sure, but that does not negate that it does work for people who suffer focus disorders.

Oh, I wasn't physically dependent. But taking it at a young age contributed to a polysubstance abuse disorder. I have no issue with adults taking ADD meds by the way. I just don't like the way it's prescribed to kids so frequently (I was on it when I was 9). I'm not sure why the fact that it's evidence based matters because I never questioned that it works (I've taken it more than enough times to know that it works, lol). I'm questioning whether the pros outweigh the cons from a holistic, social perspective.

Yep. As someone who has been taking these medications for over a decade, I can say the danger of physical and mental addiction is very real. I've also stopped medication several times over this period and the withdrawal can last weeks or months.

Have also done breaks and it’s hard, but it’s confounded with the accompanying massive drop in life functioning. I’d argue it’s 50/50 but anecdotally. The research on street addiction of amphetamine (think homeless not Ivy League SAT prep) and recovery is fairly robust. Doable but hard.

Have been taking Strattera for a few months and wonder how many years of my life I would have not wasted if I had been diagnosed with ADHD earlier in my life.

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.

I'm in a similar situation. The diagnosis changed everything for me and I really wish someone had noticed it when I was a kid.

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.

Did you ever experiment with Adderall, Vyvanse or Ritalin? How did you end up with Strattera?

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.

For what it's worth, my psychiatrist friend who has ADHD and specializes in ADHD practice swears by non-stimulant medications for long-term treatment.

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.

I've used Guanfacine. It gave me heart palpitations and high blood pressure without helping my ADHD at all.

Non-stimulant medications can be good, but none of them worked for me. ADHD too broad a category to have a good idea of which medications will work for one individual or another.

The only ADHD medication that's worked for me is Adderal (and XR which I'm currently on). Otherwise the only other medication that's helped me was memantine (an Alzheimer's drug) that helped with sensory processing disorder.

Not the person you're replying to but Vyvanse gave me excruciating neck cramps, brain zaps and really cold fingers. My doctor said that I had a bit of an outlier reaction to it so YMMV but if you decide to go that route at least ask about the cramps lol.

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.

I was prescribed Adderall XR which did wonders for my symptoms but eventually I stopped taking it as my heart would race after doing any strenuous exercise. I wish that wasn't the case, as it did help.

To be fair, caffeine also increases heart rate and blood pressure. I think it's common of stimulants

...and disturbs sleep, and can help treat symtoms of ADHD

I've been on and off Vyvanse and Ritalin for a decade. Work with your doctor on side effects, I found Concerta to have the least side effects for me (long-lasting, tapers slowly at end of day, and fewer anxious feelings for me than Vyvanse.) I've also taken breaks from the medication for a year or more. It takes somewhere between 3 days and 3 weeks to feel like I'm not missing something when I stop the medication, but overall it's not that bothersome or unpleasant unless work/life is very busy at that time. Quitting coffee cold-turkey feels much worse, for comparison.

I had horrible physicals side effects with Adderall, I was switch to Desoxyn and I get no physical side effects from it. I just get clear headed with no speedy feel in the body or cramps. Adderall always made me clear headed, but also jittery in the body and gave me the worst cramps but the biggest one that I was not going to put up with is Adderall killed the marital bed performance, but funny enough not the desire, that was a deal breaker for me.

The doctor recommended that I tried Strattera first and see if worked before trying stimulants. Atomoxetine is one pill per day and works 24 hours. But doesn’t work for everybody and some people have some undesired side-effects. I had some of the “undesired side-effects” in the beginning but they went away after a few days. Also, in my case, it took 20 days until I felt that it was working. I noticed it started working one day after a looked back at one situation where I would normally get stuck and dread and it had gone as without any issue.

What does "10x on productivity" mean? I thought ADHD would lead to lower productivity.

This is a common misconception about ADHD.

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.

It should be noted that "hyperfocus" is more of a fringe idea in ADHD science than a well-accepted feature.

Hyperfocus can also be a side effect of stimulant medication. It's not uncommon for newly diagnosed ADHD patients to take stimulants and end up hyperfocusing on the wrong thing, such as video games or other vices.

Be careful about interpreting something like increased focus as ADHD. The pop-culture definition of ADHD has become so blurry that nearly everyone could be considered ADHD under certain criteria. When focusing too much and focusing too little are both supposedly symptoms of the same disorder, it's easy to misconstrue normal behavior for disorders. It's best to leave the diagnosis to a professional.

> Hyperfocus can also be a side effect of stimulant medication.

This doesn't address the fact that the hyperfocus behavior is a side effect of the poor executive function and is present in unmedicated ADHD people. In fact stimulants in an ADHD brain tend to improve executive function and make hyperfocus less likely for them.

> Be careful about interpreting something like increased focus as ADHD.

As I said before, it's not about focus at all. It's about executive function. It just manifests in ways that look like focus problems. And yes, hyperfocus is absolutely as much of a problem as completely lacking focus.

The idea hyper focus is a strength is pop psychology. Its existence isn't.

You're totally right about it being an executive function disorder.

There's a variant of ADHD that tilts to the other end of the scale. Where the executive function doesn't fire by stimulus that ought to "execute". Less things overall catches the attention and leads to action, but the things that do, does so in the focused, engaged way.

Turns out I have ADHD then!

For me that means that I can be intensively productive in intense bursts when I am engaged.

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.

When you spend 40 hours mentally preparing yourself to do a task then you are extremely productive when you actually do it. But the overall performance is still horrible.

I honestly can't comprehend what this means or why it's called "10x productivity". You're productive, but overall performance is horrible? So you do lots but do it badly?

If you spend 40 hours mentally preparing yourself to do a 4 hour task. Then during those 4 hours you are way more productive than other people, but since you had to spend all those extra hours to even get started your productivity sucks. It isn't hard to understand.

So then you take medication and now get started on the task immediately, but the task now takes 10 hours to do instead of 4. Your productivity during the task thus got reduced, but your overall productivity greatly increasied.

What does it even mean?

The flip side to ADHD is hyperfocus on things that draw your attention. This can manifest as a 12-hour coding session without breaks or even noticing the time.

You can work exceedingly long hours with high focus on something you like.

That sounds like me! 10x productivity, sometimes so profoundly bored I'm a blank slate.

what's the difference between strattera and ritalin?

They are different drugs with different mechanisms of action. One notable difference from my experience is that Ritalin has a stimulant effect, whereas Strattera actually made me tired.

Had a similar experience. Was on this for a bit when I had a GP who seemed hesitant to prescribe stimulants even though I had historically taken ritalin and it was fine (all side effects were manageable).

You better search it, but I believe the difference is Ritalin is an amphetamine.

Ritalin is not a form of amphetamine. Ritalin's active ingredient is methylphenidate.

Ritalin is not "an amphetamine" but rather a psychostimulant. It's a DEA schedule II regulated drug.

Strattera works via a different mechanism and (supposedly) is likely not to be habit-forming. Ritalin definitely can be habit-forming.

I've been on medication for about a week now and I've not thought about offing myself once since starting. That seems dramatic but honestly that used to be the default go-to answer for any problem that couldn't be resolved within a day or so. Seems a bit excessive of a response to problems now.. It really looks like my depression might be rooted in undiagnosed ADHD.

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

I'm not sure which med you are on, but I've been on adderall for about 12 years. Started during 1st year of a phd program.

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 was on Adderall for roughly 10 years, and it really didn't make me feel great. I tried taking larger doses when I was going through my 'experiment with all the new drugs' phase in high school, and didn't really get the euphoria I hear about. In general, Adderall in any dose makes me sweaty, smelly, and antisocial.

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.

With he sleep thing, I experienced the opposite. The ability to just lay down, decide to sleep, and sleep, combined with a bit of a chemical cue from the comedown really helped to regulate the insomnia I had struggled with since adolescence.

This was the biggest benefit for me.

I may have been overenthusiastic in my wording. I don't feel great, I just don't feel shite now because I'm able to do the work instead of sit there stressing about it all day. My happiness balance was in the overdraft, it is now just above 0.

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

I had a similar experience, but after the 1st year both the positives and negatives wore off (now it doesn't feel like I'm taking anything it just feels normal) and I was simply left with the ability to choose my focus (about 80%).

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.

Can you tell me more about your experience with selection, use, and pitfalls of treadmill desks?

Sure I have a few nuggets. I went through a couple cheap treadmills before I finally took the advice of another long-term treadmill desk user and bought a lifespan fitness:

https://www.lifespanfitness.com/workplace/treadmill-desks/tr...

It's an incredible sturdy and reliable treadmill. It has built in shock absorption and can autodetect your steps. Although I wear a clip-on fitbit to sync steps to my phone (wrist fitbit isnt going to work well to count steps since your hands will be typing or whatever).

I transitioned from a standing desk to a treadmill desk and was surprised that walking is actually much easier to sustain for long periods than standing. I started very slow. 1.2 mph. I gradually (and naturally) have made my way up to 2.4 mph.

If you get one, make sure to get good shoes! Something that a marathoner would use (e.g. Brooks, Asic, etc).

Getting a treadmill desk is among the best decisions I've ever made.

btw the friend who helped me choose treadmill made a long video about treadmill desks and health:

https://youtu.be/27KT8bvDCw0

Medication helped a lot in the beginning, but what really helped in the long term was talk therapy, and setting up helpful systems and habits such as exercising, diet, journalling. But this would not have been possible without taking Ritalin in the first place. I'm mostly off-meds now.

I found the medication useful in interesting ways.

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.

This is a good point!

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'll be starting the talk therapy side of things soon I believe! Bit of a lag on that due to covid etc.

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 :)

Definitely try some of the alternate first-line medicines. For me, methylphenidate (Ritalin/Concerta in US) works wonders. Many people seem very happy with Strattera or Adderall.

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.

Ritalin (the UK version of anyway) is the one I've been put on yeah. Adderall equiv is on the table if this doesn't work but so far it seems to be the right track

Obviously different medications have different side effects, but I started taking fluoxetine (Prozac) over a year ago. The first 6-8 weeks were ROUGH. The mood swings were unbearable. It did even out after that and I’m stable now. The night sweats are real though, it’s annoying. My room can be 65° F and I’ll still get them.

ADHD meds are definitely not antidepressants.

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.

Stimulants do have an anti-depressant quality in a similar sense to SNRIs. They stimulate release of extracellular neural serotonin and norepinephrine (SNRIs block reuptake of serotonin and norepinephrine. Before the accidental discovery of the first front-line antidepressants in the 50s, they were prescribed for depression.

However, for the reasons you mentioned, they aren’t very good antidepressants. It’s easy to mistake the early euphoria of amphetamine for reduction in depression. Without careful management, it’s easier to become tolerant or even addicted to amphetamine.

Stimulants including Adderall have been formally trialed for depression treatment. They don't work.

Don't confuse the molecular mechanism of a drug for its eventual outcome. There is far more to a medication than binding affinities.

What studies? The information that I’ve found on PubMed and clinicaltrials.gov indicates that this is a poorly studied question, not a decided one.

A 2015 survey (Raymond Pary, MD, et al) found evidence that many psychostimulants were effective adjuncts for MDD and Bipolar depression. The results weren’t extraordinary but they were statistically significant. The authors noted in the results that the topic was generally poorly studied and double-blind clinical trials were limited.

In 2010-2011 Shire ran Phase II FDA trials on Vyvanse as an adjunct to traditional antidepressants for MDD with mediocre but also statistically significant positive results. Considering the age of most psychostimulants in use, that’s a fairly recent result from a clinical trial.

I certainly agree that psychostimulants are not a good choice to treat depression but that’s a far cry from “formally trialed for depression... don’t work”.

With the exception of MDMA, MDMA has show to have effective outcomes on depression and PTSD in short term studies. They problem is they have to be interleaved with SSRI's or the down state is far worse. That has been the issue with MDMA, it drops a depressed person lower than they where on the down ramp. Therefore there are concerns that it could place someone who was not suicidal in that low of a state. Studies have shown regulating this with SSRI's can mitigate the down state.

> or by playing games to only take doses on certain days of the week

This is something I’ve always done, under the close supervision of my doctor. I’m not sure if he initially recommended it or not, but it’s been extremely effective for me in terms of keeping my effective dosage low and limiting tolerance.

My prescribed dosage of Vyvanse stayed consistent for about a year after beginning taking it, but began to escalate after that. I didn’t like that and was resistant to continuing to increase it. I went from 40mg initially to 70mg at the highest. I’m back down to 50mg today and am able to keep it at that level by limiting taking it less often. I typically end up taking it 4-5 days per week.

There are significant long-term side effects of these medications - limiting tolerance building and keeping the effective dose as low as possible is a viable means of reducing the chance of experiencing them.

Why do you assert that this is a “road you don’t want to go down”? Is it merely because my reason for doing so is so different?

If they're also antidepressants why was I not taken off the antidepressants (citalopram) I was already on?

It's been about 9 years and I'm still on the original dose of the first medication my psychiatrist prescribed. I'm really glad I managed my pride enough to make that first appointment.

- 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.

What medication were you prescribed if you don't mind answering?

Before my diagnosis, ADHD was my kryptonite. I thought I was lazy, I couldn’t accomplish the things I needed to. It pushed me into depression and was quite hard.

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.

How did you get your diagnosis? Every time I read the symptoms it sounds like me, but it also kinda sounds like everybody. What's the signal that it's a pathology worthy of treatment?

Not the person you are replying to, but generally speaking I look at getting a diagnosis (for most mental health problems) like so:

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.

> 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

I've had so many problems with this in high school and college, it's unreal. I've only started to fully comprehend my problems with anxiety this past semester but reading all of this makes me wonder if there's something more to it than just that.

If it's really that hard to get engaged into something that you aren't innately interested in but that you know you "should" do, I would seek an ADHD diagnosis. It's a pretty big symptom. Sometimes it really is not possible and even if it is it's extremely difficult and you feel dumb for it (but obviously you shouldn't, it's not your fault). It's like your mind throwing a tantrum and refusing to engage with the work at all.

This is my struggle. But also, nobody likes to focus on something uninteresting. What's the difference between ADHD and just not wanting to do it?

The difference is really not being able to focus if it's not interesting. Your brain will constantly turn to other stimulation if it's not getting it from the current task. Sometimes you might be able to do it, and other times you won't. That's one of the most frustrating parts of ADHD. You feel like you've done it before, so why can't you do it now? "Normal" people can still focus (or get started) even if something is not interesting, they just have to start.

Most people won't like to do uninteresting things, but the threshold for boredom is extremely low in those with ADHD so they will struggle a lot more to stay focused. It's a spectrum unfortunately, so there's no one definitive measure that says "that's definitely ADHD". To be honest, if you find yourself seriously questioning/wondering about whether or not you have ADHD it probably means you're struggling to an extent and aren't 'normal'. Otherwise, it wouldn't be something you are questioning.

Not wanting to do it and not being able to do it are two different things. To an adhd person boring tasks aren't just boring to do, they are impossible to do even if they were paid a million dollars to do it.

I call it not being able to put one foot in front of the other. You will find all kinds of distractions to try to not think about it, because to think about it is almost physically painful.

Would second this, if the though of doing the dishes is equivalent to someone shooting your dog emotionally then you have an issue. It just seems like life cannot go on to get yourself to drag yourself to the sink and start washing them. Now I do them almost every time I take a break.

You may have "non-problematic" ADHD, or not consider it a problem. But there may be a few things you struggle with that you aren't telling.

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".

Getting overwhelmed is totally spot-on. I do need to remove myself on occasions. My family always remarks on my sensitive hearing and sense of smell.

Hypersensitive sense of smell and hearing, plus need for solitude, and you mentioned in another comment "hyperempathy" when listening to people... could be autistic spectrum. Often comes hand-in-hand with some ADHD symptoms as well. Do you have difficulty reading people's facial expressions, or at least did as a child?

I don't. In fact, people often look to me for more nuanced interpretations during meetings and social interactions.

>> 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.

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.

>>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.

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.

So you, a non-professional, casually diagnosed your friend with ADHD, and then went on to explain his behavior with this.

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 was diagnosed last year, the change in my life has been nothing short of profound.

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.

Do you mind me asking a little about the separation? I’m shocked I am in a solid marriage. I am a nightmare...

I read this post from 2015 yesterday and was amused because the guy clearly seemed to have ADHD in my opinion [0]. Then in the comments on HN somebody mentioned that the author recently wrote about being diagnosed at 40, which may be an interesting read here [1]. The author says it was like living the Truman show.

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-...

Thank you. I'm reading both now. Funny how his blog is about 'living your best life', the exact reason I went to therapy to begin with.

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.

It saved my life.

I went from always being clouds in the sky, never finish any project, always in my head, wasting days away on social media, both kind and loud and inconsiderate, and seriously depressed, to somebody I can face in the mirror.

It's not a cure all and it took a lot of counselling and some time to find the right medication but it turned my life 180 degrees.

I no longer feel like all my dreams are running through my fingers, and that every new endeavour I start will end in failure. I have much better personal relationships, and am a much better listener with the same kindness I had before.

I've learned to appreciate things that I never thought I could appreciate before. Working on a project for an extended period of time with progress so small you barely see it, and then realising how much you've accomplished over a long timeframe is such a rewarding experience. Before I couldn't study, either I was immediately gifted at something or I just couldn't bring myself to invest time into it. Simple things like, being able to read without getting bored or distracted by every little breeze, or not spending every night coding because you didn't get stuff done during the day and feel like you have to make up for it, is just nice.

Don't fear medication, there's so much stigma around it, but it helps more than anything else. If you got an inflamed thumb you also get antibiotics. The ones I tried first were making me emotionally very detached, but me and my doctor tried around a bit and found something that works really well, it's part of the journey.

Without the meds I feel like a prisoner in my own head. With them I still suck at cleaning my place, I still talk over people when I'm excited, and I still procrastinate regularly, but at least I got enough of a fighting chance to feel like I'm in charge of my life and no longer feel like a leaf in the wind.

What meds worked for you?

Keep in mind that different ADHD medication might have completely different effects for different patients, and that what works for me might not work for you and vice versa.

That being said, I started with two doses of Ritalin (Methylphenidate) with 30mg in the morning and another 20mg past noon. And then switched to Elvanse(Lisdexamfetamine) with a single 30mg for the entire day.

I'd describe the difference between the the two (personally, again, mechanisms of action and cause of illness differ between people), as my ADHD being like driving a car with flat tires. The Ritalin gave me a more powerful motor, so I could simply power through the flat tire, while the Elvanse is like a spare tire.

Also as a general note, I prefer to be slightly under-medicated than over-medicated. Ideally I'd take barely enough to make me overcome my inner barrier, and then work from there with taking breaks, going by my own timing, doing sports e.t.c. which then act as a compounding and self reinforcing positive feedback loop.

This is interesting, I used to take Methylphenidate twice daily (Ritalin LA) but stopped due to increasing side effects. A few years back I was able to switch to Lisdexamphetamine. I realized that one tablet a day was not enough for me, even upping my dose didn't help; it didn't last longer than 6 hours for me..

I think unfortunately that some of the marketing material and advertised duration by Shire isn't telling the whole story w/r/t the drugs duration.

Is it healthy for me to basically have amphetamine in my body 24/7? Probably not, but it has certainly helped me the 5 or so years I've been taking them.

I can be a bit more strict &straight to the point now than before, but I don't find myself behaving very differently now vs before. I'm on the autistic spectrum for sure, and with ADHD as well it's hard to judge if it's just me or the medication.

Lastly, if I had gotten the opportunity to take medication to help the symptoms earlier I probably would have had a better education and been better off than I am today. Way too much time at school was wasted just looking out the window and doing other things rather than paying attention, and yes it wasn't becuase I wasn't interested per se, it's just that putting effort into focusing short term in order to get the gratified response of a good education (years later) is not something someone with ADHD can easily do.

So my take maybe isn't the healthiest on this, not sure.

If you believe you have ADHD, and your therapist believes you have ADHD, BUT your life isn't negatively impacted by it, why start treatment now?

Ask yourself if you have any negative impacts from ADHD. Ask your spouse. Personal relationships, professional work, all aspects. If the answer is no, then why bother?

Source: ADHD treatments that left me a zombie when all I really needed was therapy and help to figure out realistic, functional coping mechanisms.

ADHD impacts my life very much, but I was diagnosed as an adult. I honestly have no idea how I operated pre-diagnosis (and pre-medication). I think about some of the struggles I went through (e.g. my entire educational experience or my entire experience as a founder) and I really suffered in those times.

However, I absolutely agree with you.

Daily stimulants are a frustrating balancing act. Anti-depressants have frustrating side-effects. If I operated well without either or both, I would drop them in a hot second.

I DO benefit from medication to a degree that it has vastly improved my quality of life. I also benefit from therapy and the development of coping tools — in fact, I think anyone who benefits from medication should also seek therapy because it’s SO helpful.

This isn’t really a counterpoint to your experience, but more of a companion-point. Your post doesn’t make me think that you are an irrationally anti-pill person or anything like that. I’m just reinforcing what you’ve implied: treatment isn’t one-size-fits-all (although, at least in America, the medical system sure tries to make it that way). It’s incredibly important for anyone with ADHD to find the right tools for them.

I think sometimes it’s hard to tell whether something is interfering or not. If you’ve been squeaking by your whole life you might think this is “normal” simply because you’ve never experienced actual normal.

I go back and forth with ADHD meds. I’d say every 18 months or so I decide to take a week or two off. Sometimes that break goes on for a while because I think everything is fine and dandy. I think the longest I was off medication since starting (as an adult) was about 18 months. I can sometimes get by okay without meds, and sometimes that’s my preferred course of action, but invariably when I start taking them again I “remember” what it’s like not to have a crippling inability to do exceedingly simple tasks. And honestly, it’s kind of nice. Much less mentally exhausting.

As someone who has found ADHD medication to be hugely beneficial, I completely agree with you. Treatment has its tradeoffs. In general, stimulants greatly improve my quality of life. But at the same time, they can wreck my appetite and make me prone to anxiety and irritability. And dealing with the bureaucracy of scheduled medications is a serious headache. If someone is happy with their life and their symptoms aren't negatively impacting them, then what's the point?

> If you believe you have ADHD, and your therapist believes you have ADHD, BUT your life isn't negatively impacted by it, why start treatment now?

If your life isn't negatively impacted by it then you might be hyperactive or have trouble paying attention, but you don't have ADHD, by definition. It only becomes a disorder when it's causing a significant ongoing negative impact on your life.

I don't think you are correct. Just because the name has disorder in it does not mean you have to have a significant negative impact on your life.

It is a mental disorder. My brain functions differently than a normal functioning brain without ADHD. I have built my life in a way so that does not negatively impact my life significantly.

That's the crux of it right there. I've had a wonderful, wonderful life, a rewarding career, a 30 year marriage and raised intelligent, well-grounded kids. Not just by _my_ definition, but by those around me whom I respect.

On the one hand, it doesn't sound like any possible ADHD tendencies you might have are causing you much grief. Also remember that ADHD is hugely situational - I've had a pretty great career and up until a year or two ago I wouldn't have ever suspected I fit the bill. It was only during a perfect storm of overlapping stressors that I really felt like I was struggling.

On the other hand, just because you can survive doesn't mean life has to be this hard. And looking back I now realise that much of my life I was doing just that. I was surviving, when I could have been doing so much better.

It’s literally only a disorder if it interferes with your life. Otherwise, it’s not a disorder. Like, it’s in the definition.

https://www.cdc.gov/ncbddd/adhd/diagnosis.html

This is true of almost all of these disorders: no interference with life means not a disorder.

Saying “if you have no negative effects from ADHD” is the same as saying “if you’re alive when you’re dead”.

My personal experience with ADHD is that you are told it is a problem that needs medication, regardless of whether or not it impacts your life in a serious way.

Often, psychologists/psychiatrists/medical doctors will fail to include the literal definition of disorder. ADHD is one of those things that is a popular target for medications as a knee-jerk reaction.

That was sort of my point, I guess.

On the other side of this, I wasn't sure if my life was negatively impacted or not. I decided to try out medication to see, and my wife and I instantly started noticing improvements in our lives. I was getting more done with less mental strain, and there were tons of tiny little things that she wasn't having to remember for me or worry about because I wasn't losing track of them.

YMMV.

I concur, and I think OP has the answer already. I went to a psychiatrist (diagnosed at age 34) because of significant problems that were getting in the way of life, but if that's not the case for you then there is no justification for the time and expense of treatment.

That's the healthiest take. Severity of any disorder is a function of its effect on the person and the person's social and life function. If these are minimal and minimal, IMO pursuing medication is really not warranted.

> Source: ADHD treatments that left me a zombie when all I really needed was therapy and help to figure out realistic, functional coping mechanisms.

A good psychiatrist will have you do all of the above.

I don't think treatment is always a necessary outcome, but awareness probably is. Medication helps with doing things, but if all you did was take medication, your family would still have no idea why you constantly lose your housekey or why you chronically show up late. Simply being able to establish that "these are things I'm not going to be good at" or something along those lines is an improvement.

One of the DSM criteria is literally "There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning." So if there isn't something being affected, you don't meet the diagnosis criteria.

Thanks for your more nuanced take.

I'm a successful 33 year old adult in a career ideally suited to the way my brain works, so I was VERY skeptical about whether it would make any difference to my life to get diagnosed or go on meds. Now that I have, I can confidently say that it was a total game-changer and I wish my parents had gotten this done for me when I was a kid. It would've made so many things so much easier.

I currently only use my meds (specifinally, Vyvanse) once per week, because I don't love the side effects and I can manage fine without most of the time. On that one day per week, I do everything that my brain chemistry usually makes difficult, which is mostly paperwork and cleaning.

The difference it's made is HUGE. I went through a whole grieving process when I realized how much easier I could've had it all along. I can sit down, spend four hours doing my taxes, and then be done (and then realize the bathroom needs cleaning, and also do that), instead of sitting down, getting a snack, doing ten minutes of taxes, cuddling with the cat, starting a conversation, going on hacker news, doing ten minutes of taxes, going on hacker news, and finally finishing the taxes ten hours later at a quarter to midnight.

It's also made a huge difference to accept that some things are simply symptoms, and not signs that I'm a disorganized failure who'd too stupid to manage daily life. It's also helped to live with people who know and accept this about me, and who know that although I'm very good at managing my symptoms, sometimes things go wrong.

Yes, sometimes everyone is mildly inconvenienced because we were about to leave and now I have to go on a ten-minute WHERE IS MY WALLET tear through the house. It's fine! Sometimes, we're mildly inconvenienced because my girlfriend's insulin pumped is clogged and she needs to spend ten mins fussing with the catheter. These are things that happen when you have a chronic health condition, and no reason for anyone to get upset or berate anyone else. Accepting that has made me a much happier person.

> I went through a whole grieving process when I realized how much easier I could've had it all along.

I was diagnosed six months ago and I have absolutely been going through the this same process. At one point I cleaned up a bunch of old boxes (some of which I'd been meaning to unpack for over a decade... yes the meds help!) and came across a folder of my old school reports. Reading through them and seeing the lifelong pattern of struggle with focus and attention that I'd just thought was normal, and that didn't have to have been that hard... I cried, a lot.

The grieving process was intense for the first few months. It was somewhat amazing to notice the "stages" as they happened. Anger, towards my parents and my teachers and my psychiatrist, was the hardest to deal with.

But acceptance came, and it's the best I've felt in years.

Glad to see others in this thread like yourself with such similar experiences.

thanks for giving me some word for what i felt. it has definitely been a grieving process.

Does it matter? The important part is that you can manage it long term, and taking it once a week is sustainable.

> Does it matter?

I view the euphoria as an unsustainable side effect.

People can tell when you are high, and normally not for your positive attributes during those moments.

The therapeutic does you get doesn't make you "high", you get a small burst of energy similar to caffeine at most, nothing unsustainable. And since "euphoria" isn't a well defines concept you could see caffeine as causing "euphoria". Certainly seems that way when people say they can't function before they get their morning coffee.

> I view the euphoria as an unsustainable side effect.

So?

Without it i would have never been able to succeed in life. For me it was the single greatest decision i have ever made in my life. I simply could not focus on anything important, I was a miserable mess.

I was a consistent grade D student in high school, I was that werido in class who everyone hated. In my final year my parents realizing I was not going to have a great future, decided to bring me to our doctor, I was prescribed Dexedrine for ADHD.

That Pill completely and utterly changed me in my final year, i could think clearly. I understood what was being said, it completely changed me. I suddenly decided to go to University for CS, forcing me to do a victory lap in high school. I was able to get into University on an amazing scholarship.

However the biggest thing was the few people who i was vaguely friends with me praised my 180 personality change, they liked being my friend.

I am now 36 years old taking the same dose of meds i have been for the last 20 years. It works for me, immensely. At the same time there is a huge stigma around ADHD medication. My ex hated the idea of me taking meds saying its big pharma pushing this, i don't need this, i just need exercise, etc. She changed her tune after she saw me not on my medication.

I know there are probably people out there that don't need this or abuse it. Sure, but that is true for almost everything.

It's important to note that an ADHD diagnosis does not necessarily end with stimulant medication. Stimulant medication can be helpful for some people, but it's not the only way to treat ADHD. Having an ADHD diagnosis could help you choose appropriate therapy methods, self-help practices, and other self-improvement measures. Of course, an ADHD diagnosis isn't necessary to begin implementing better time management practices, so I'd suggest addressing any issues you might have with time management, time boxing, and organization whether or not you have an ADHD diagnosis.

When it comes to stimulant medication anecdotes, it's important to separate them by how long the person has been taking the medication. You'll get very different answers from people who have been taking stimulants for 1 month, 1 year, or 10 years. One of the side effects (key phrase: side effect) of the first few weeks or months of stimulant medication is a sense of euphoria and extra motivation. Be careful, because this effect fades with time.

In general, I'd recommend focusing on anecdotes from people who have been treated for at least 1 year or more, while taking any reports from someone who just started medication with a huge grain of salt. In particular, I'd recommend ignoring any reports from people who are taking excessively high doses of stimulants, dosing stimulants sporadically ("as needed" isn't standard practice), or who just started taking a stimulant medication. The realities of decades of prescription stimulant have pros and cons, which aren't apparent in the first few weeks or months.

Also beware that some psychiatrists greatly overdiagnose certain conditions. Unfortunately, some practitioners are known to overdiagnose their pet condition, from depression to ADHD to anxiety. If a practitioner is pushing you toward a diagnosis or treatment you don't feel comfortable with, don't hesitate to get a second opinion.

> It's important to note that an ADHD diagnosis does not necessarily end with stimulant medication. Stimulant medication can be helpful for some people, but it's not the only way to treat ADHD.

One may not need medication, but also don't be TOO reluctant to use medications. After my diagnosis, I fell back into the "Now that I know, I should be able to do this with will power and todo lists" trap and resisted medication for too long. Going on medication was, and is, life changing for me (16 months later).

The rest of your advice is dead on!

> dosing stimulants sporadically ("as needed" isn't standard practice),

Interesting, I take adderall "as needed" and my doctor is fine with it. He prescribed it for daily use but said I can take it as needed.

My doctor actually prescribes a regime of holidays from the stimulants. It is becoming a fairly common practice.

> It's important to note that an ADHD diagnosis does not necessarily end with stimulant medication

I expect this is truer for adults, as they have agency over the matter. Children don't get a choice.

ADHD diagnosis didn’t help me live a better life, it helped me live a normal life.

During college and my first job, I was constantly stressed and depressed from my terrible productivity. I couldn’t even bring myself to do things I wanted to do —- the only thing that mattered was the next dopamine hit. I made so many goals and failed every single one, and with each failure I blamed myself even more. The problem with having ADHD is that it causes you to procrastinate on getting the diagnosis in the first place! In the end, I had to accept that “just try harder” isn’t a valid strategy.

OP, I know my experience isn’t similar to yours at all, but just know that mental illness treatment almost always helps you reach your goals, and don’t procrastinate on it.

Living in Europe, my perception (AKA: anecdotal / unscientific / non-measured) is that most of the ADHD-diagnosed people I know live in the US, while I only know one European person in my network who received similar diagnosis from a professional psychiatrist. Counterintuitively, I know way more European people than Americans, which makes my perception feel even more skewed.

I very well know that my sample(ing method) could be wrong, it can be a coincidence, etc etc.

So my questions are:

* anyone else have similar experience in their friend circles?

* is there a higher number of ADHD diagnosis in tech / wealthy population? (considering that most of my American friends/colleagues are from tech, this would somewhat explain)

* do I miss something obvious? (e.g. maybe Europeans would never discuss their diagnosis with friends, etc.)

One hypothesis is that, in the country where you live, there is more stigma around ADHD in adults and it is more frequently ignored or dismissed.

It is an easy condition to ignore —- adults with ADHD are frequently not very “hyperactive” because even if they were as children, they’ve learned to modulate that behavior through experience.

The traits of inattentive-only ADHD are often written off as laziness when in reality that person is experiencing executive dysfunction that makes prioritization of tasks difficult. A common feature of ADHD is to be frequently paralyzed by indecision.

It’s not uncommon for those first diagnosed as adults to be completely blindsided by the disorder.

It's kind of like needing to wear glasses; all you know is that everything looks blurry, and as far as you know that's how everyone sees. And if you struggle to see clearly, well, that's your problem.

My guess is that it stays undiagnosed because doctors aren't trained to make the connection between untreated ADHD (as an adult) and the disparate consequences it has on one's life.

My wife was diagnosed with ADD (ADHD-I) at 20 (no points for H at all, literally none).

When all stimuli hit you at the same level it's really tiring. Someone clicking their pen, bird chirping outside, someone coughing in the hallway or the classroom next to you, someone picking his nose in the corner of your eyes etc. She isn't able to filter them at all.

I've come home to the place being flooded because she ran a bath but remembered she needed to do something in the kitchen, and that prompted something else, etc. We've fought because of little things, but those little things combined with having to process every single stimuli the world throws at you is difficult. If you're focusing on work, or just sitting around do you even register the things going on outside? She does. At the same 'volume' as the thing she's trying to focus on.

In high school she missed more classes than she went to. She was deemed lazy, dumb, and uncaring. We have three levels in the Netherlands and she barely completed the lowest one. Mainly because she was home sleeping, or just wandering off with her mind, migraines - you name it.

When she had to write school reports for a specific class the teacher would be baffled by the report. It went from the actual subject to a few pages of an English report, then a chapter of economics. I always imagined it as her having to go to the bathroom, coming back and remembering 'Shit I needed to write that book report for English class'. Because, obviously, this was only started just before or even after the deadline.

You'd think the schoolsystem would raise an alarm right? Nah, she wasn't exactly 'trouble' as in being busy / shouting / name any typical bad behaviour. She was just chaotic and 'dumb'. Real easy conclusion, especially when you have kids getting in fights and smoking joints - at least she was trying to do her homework.

So she missed a lot of opportunities, felt really bad about herself to put it lightly, and the migraines are a bitch too. I don't know if that's how bad it can be when undiagnosed but yeah. When the psychiatrist did the sessions / tried medications they also took an IQ test which indicated that when the world is not throwing stimuli at her (well it still is, but with the help of the meds she can filter it) she's actually really fucking intelligent (remember the lowest level she barely passed, could've easily done the highest level and moved on to university). After years of hard work catching up she did complete a BA and I couldn't be prouder. It's not easy believing in yourself after so many years of people saying you're dumb and lazy.

Thanks for the elaborate answer.

> If you're focusing on work, or just sitting around do you even register the things going on outside?

I actually do, and took me a while to realize that not everyone experiences surroundings as I do. Definitely can relate to this, and some of the other patterns you and others described here.

She sounds lucky to have someone that would take the time to understand her experience. Good job man.

Its the difference between being capable of joining Google and being unable to get anything better than McDonalds or similar. Sure you can go through life working minimum wage jobs and never see a doctor about it, but I certainly feel my life is better on medication. Basically it is the "I could do it if I just wanted/tried', and adhd was what prevented the person from wanting/trying.

How bad can cancer be, if it stays undiagnosed?

There are lots of serious conditions that, if left undiagnosed, are quite damaging or fatal.

Plus, it's often especially difficult to see how psychological/psychiatric problems affect oneself. It's easy to misattribute causes or misunderstand conditions. There are posts in this very discussion that tell how damaging undiagnosed ADHD has been.

American here. Lived the first 30 years of my life in the States, the next 20 in France/UK and have worked (temporarily at least) in most major European cities.

I think you are on to something with you last point. One long-standing joke about Americans is that within 5 minutes of meeting them you'll know more about their bank account, hopes/fears/dreams, and their lower colon than you'll ever know about your best European friend in a lifetime.

I'm not judging. We (Americans) are simply open about lots of personal details to everyone. We're a bit like the golden labs of humankind. If someone will listen, we're happy to talk about anything.

Europeans on the other hand (this is another BIG generalisation) are definitely much more private especially when it comes to health. I've been in the UK for quite a while now and I struggle to even learn the names of my neighbours two doors down. Good luck borrowing a cup of sugar around here. In the states I actually let someone use my shower! I knew him from passing in the hallway and he had a job interview in an hour but lost his keys.

Anyhow...I digress. #4 is my choice. Access to good healthcare is NOT a cause. But I don't want to go there and start a discussion on the pros/cons of socialised medicine. It always ends in shouting. :D

> Access to good healthcare is NOT a cause.

It is one of the causes, Europe is more than France/UK.

Fellow European here - at least in Poland it is virtually impossible to get diagnosed as an adult, and there is very little knowledge of ADHD among mental health prpfessionals.

ADHD affects around 5% population, as various studies have shown. In Poland we have virtually 0% adults diagnosed an on treatmnt, and I don’t know a single therapist that wI could confidently recommend to a person seeking diagnosis/treatment. (And I looked and asked around a lot).

By comparison, in SF there is a dedicated clinic for adult ADHD, not to mention therapists aware of such thing.

I’ve been diagnosed in France at 29. I had the chance to find a therapist that was aware of ADHD and transferred me to a specialist at the local hospital.

But it looks like I had been really lucky because France health authorities does not currently acknowledge the existence of adult ADHD.

That would explain why no one in Europe talks about it. I would add that since symptoms are really vague when explained, there is some sort of taboo when you talk about it because ADHD is just a sum of symptoms that, individually, are very common amongst the population.

I live in a smaller EU country and I tried to have a professional check me out, as I have a lot of problems with procrastination, productivity, paying bills on time etc.

I tried asking around (including asking some organization that deal with ADHD in children) for a recommendation for a psychiatrists that deals with ADHD in adults and couldn't get any.

After months of deliberation I finally hyped myself up to get an appointment with any psychiatrist in the local hospital, just to see if they will be of any help and could maybe refer me to someone else. They didn't even seem to know what I was talking about, said that I was obviously fine as I managed to graduate from a university and recommended that I have children to give me a sense of direction in life. So, yeah, good luck to anyone who has adult ADHD here.

The obvious answer is that in America drugs are advertised on TV, and if you see a lot of ads for ADHD medication you might be more aware of the possibility that you have ADHD, and it could be normalised. After all the stereotype of American zombie kids on Ritalin was being bandied about 10-20 years ago? Whereas ADHD is still relatively not well known in most European countries.

The UK was the same for autism about 10-15 years ago, it was barely talked about, now every class has 10-20% children diagnosed with autism and we have autism-friendly hours in cinemas/shops etc, nobody blinks an eye if you go out wearing big headphones etc. The same may happen for adult ADHD too.

I’m American in the tech industry. A majority of my close friends and I are diagnosed with ADD (I count 4 off the top of my head). Some people on my work team are open about their diagnoses as well.

It was difficult for me to admit to my family, friends and colleagues that I was being medicated for ADD. It took me four months before anyone besides my wife knew. The reason I came out with it is because some of the struggles reared their heads again. I realized that the people around me who have struggled with similar problems might also need a sympathetic ear, as I do.

Ultimately, my hesitance to discuss my diagnosis is due to fear of judgement (will people think I’m lazy or a druggy?) or fear that people may begin attributing my successes to the drugs.

tech / wealthy people have more access to healthcare in the USA

That might explain why in america more people in tech are diagnosed with ADHD, but would provide evidence against fewer people in europe being diagnosed with ADHD than in america (which is what the poster is asking about) since they have more access to healthcare, and it's not income dependent.

To answer the OP's question, I seem to recall that people with ADHD are more prone to be entrepreneurial (I believe a higher appetite for risk is the general explanation). Here is an article [0].

This would explain things if the people you know in tech happen to work for tech startups.

[0] https://www.forbes.com/sites/dalearcher/2014/05/14/adhd-the-...

Same in Canada. I haven't even bothered pursuing the diagnosis as it's a massive pain to get doctors to take things like this seriously in a socialised system.

In Europe, drugs cost the government money. In America, drugs cost you (and your employer) money.

An adhd diagnosis helped me a lot in my late 20s.

I took Ritalin for a brief period and it opened my eyes to different ways of seeing things. I actually believe in Ritalin more than adhd diagnoses. But it stopped being effective for me after a while, and same for most people i know. Also, side effects. But getting perspective helped me change certain behaviors which were causing problems for me.

But honestly, and this is very forward to say, I would stop seeing this therapist. I have had similar experiences to you, where I try to go to a therapist for one thing, and they send me down some other road entirely. This has never been helpful. Generally it has been destructive. Therapists are like everyone else, in that many of them aren’t that good. And just like how a bad mechanic can cost you money and ruin your car, so can a bad or even mediocre therapist screw up your life. Seriously. Don’t be pushed into some random diagnosis by some therapist who has some idea in their head.

Thank you for articulating a concern I have.

I was diagnosed about a year ago (I'll be 34 tomorrow).

I went to the therapist to ~figure out if~ confirm that I was on the Autism spectrum, and they pointed out that it sounded like there was some ADHD too, so it was something very unexpected for me. In hindsight, very obvious too.

It's been very insightful. On the more personal side, it's helped me understand a lot about my life and why so many things went they way they went. It's now clear that some teachers were _hinting_ the issue at my parents in school, but they never picked up on that.

On a more practical side, medication has helped a lot in focusing better and work and alike. However, it IS a tool, and you need to learn to use it. Having ADHD is like aiming your attention at things with a shotgun, and medication turns that into a sniper -- you can direct your focus very well, but it takes some training to learn _how_ to do that.

It's also important to balance it out. I take far less on the weekends since that helps wind down a lot.

I came across this youtube channel recently which is pretty interesting. It's always useful to hear how others have dealt with the same struggles: https://www.youtube.com/channel/UC-nPM1_kSZf91ZGkcgy_95Q

“How to ADHD” is a fantastic resource. She’s honest, funny, and reaches out to professionals to make sure she isn’t fertilizing her audience.

I was diagnosed with ADHD 7 months ago. The diagnosis and medication have been life-changing.

I was 'high-functioning', in much the same way as OP: stable marriage, successful career, not much savings but at least not in any debt.

But I also suffered from depression, anxiety, extreme procrastination, substance abuse, risky and impulsive behaviour.

Of course I saw psychiatrists, and they stopped listening the moment I said "depression" and prescribed the usual drugs, which did nothing for me. Luckily my 3rd psychiatrist listened a bit better and referred me for tests.

Since diagnosis I have started medication (methylphenidate/Ritalin, the only real option in the country I live in) my life has significantly improved. My procrastination is almost entirely gone (now maybe 4 hours a week "wasted" instead of 3+ days of being unable to do anything productive), my work performance is drastically improved, I'm losing weight (no longer dopamine-hunting with food), my wife says I'm doing more 'chores' and forgetting little things (spoon in the sink instead of the dishwasher) less often.

My depression and anxiety have disappeared. I still get overwhelmed in loud/busy environments. I still have emotional overreactions to small annoyances. I still forget things, and procrastinate a little. But the key thing is acceptance. I understand why these things are happening now, and that understanding makes them less hard to do live with.

Even if you don't start medication (and I suggest you do, it's provably incredibly effective for most cases) the biggest thing you can do is learn. You will be amazed for the first 6 months at least that such a massive amount of your life has truly been affected and so much of your 'unique personality' is shared with other ADHD adults.

My psychiatrist answered my same question "How can I have ADHD if my life is like this?" with "But how hard was it?". Success despite ADHD doesn't mean it doesn't exist. It just means you developed coping strategies for your deficiencies. And if you're in therapy for family issues then clearly those strategies are not working sufficiently.

Thanks! Sounds like we share similar experiences.

I was diagnosed with ADHD as an adult, and unless it's actually having a negative impact on your life, I wouldn't bother trying to get it treated. I saw a therapist because I was really struggling with college, like taking an hour to read a single page in a textbook because I would get distracted and forget what I read.

Personally, my ritalin prescription makes me irritable so I take a reduced dose when I'm not actively working on things. My wife has told me that she prefers my personality when I don't take the medication.

Finally, and take this with a grain of salt because I'm not a doctor of any sort, but I don't think having ADHD is necessarily a problem, and is more a problem with how society expects people to spend their life sitting still and focusing on one thing all day.

you may want to talk to your doctor about other options for medications. I'm not going to name names but there are much slower, longer acting meds that are precursor drugs that you metabolize into the drug, for example.

I finally decided to talk to someone about this about two years ago, in my mid-30's. I was always able to achieve satisfactory results in school, work, etc. without have to dedicate myself too much. As I got older, it became clear to me that other people were able to focus substantially more than me for longer periods of time. The more I read up about Adult ADHD, the more it became very obvious that I had it.

I've found that adderrall, for me, has been very helpful and has not really produced any negative side-effects. I don't take it on the weekends and will skip a week or so every now and then, just to get a read on how I'm feeling without it.

One thing to keep in mind is to check your expectations. Normal stimulant dosing for treating ADHD is not going to make you limitless. Your mind will be able to stay more focused but you need to actively use that focus to start developing organizational frameworks that you can work within. Building these frameworks and habits and sticking to them was extremely difficult prior to medication but now that I have them, I find it much easier to skip the meds and still be able to be as productive as I want to be.

I would recommend you find someone who specializes in Adult ADHD, especially one that has experience dealing with otherwise competent professionals because they'll be able to help you make the most of your treatment.

Also, no matter how much you might beat yourself up over lot being able to live up to the standards you'd like, please be grateful for what you've accomplished even with your limits. Unfortunately a lot of people with untreated (and even treated) ADHD fall into vicious cycles of risky behavior and end up with crippling addictions to drugs, gambling, sex, and other dopamine-producing behaviors.

I was 30 (8 years ago) when I was diagnosed with it, but my teachers and friends had joked about my “ADD” since I was a kid.

A coworker was talking about their kid’s diagnosis and mentioned a bunch of the things they checked for and a little light bulb went off like “maybe I really do have it?”

I did well in school, tested extremely high in everything, and the few times my IQ was tested it was quite high. I also spent a lot of time in the hallway at school because I was a disruptive pain in the ass. Impulse issues (not violent) like class clown type stuff. I was popular, was good at sports, and got good grades- had any of those things not been in my favor I likely would’ve been sent to an alternative high school due to disciplinary issues.

I managed to accidentally find many of the coping mechanisms they teach about by myself over the years: - EVERYTHING goes in the calendar - Everything has a place and ALWAYS goes there or it will not be found - I cannot over schedule my day, but I must have routines

After my formal diagnosis and months of therapy I reluctantly agreed to give a stimulant a try. I opted for one that is longer acting and takes longer to activate so as to avoid any “sped up” feelings.

It’s been amazing for me. We found the right dose fairly quickly, and I don’t even notice when it kicks in. Usually an hour or so after I take it.

It’s just like if a loud party was going on in your brain and you stepped outside and shut the door. All your competing thoughts quiet. I am so happy to have found it and it has allowed me to be more present and less internally anxious in most of life’s situations.

Could I live without it? Yep. I did for most of my life. Would it be as effect without all the work I did before? Maybe. I wouldn’t bet on it though.

My recommendation for anyone is basically this: the pills can do wonders but some day you won’t have them or can’t take them anymore. Make them the backup to the skills you’ll have for the rest of your life. Do the therapy, read the books, get the help. Then try the pill.

That's a pretty wise take on meds and skills.

I've recently considered if I've always had ADHD and have gone back and forth on it in my head. On one hand, symptoms sound common to most people. On the other there's a lot of anecdotes that match my life to a tee.

I was "gifted" in school growing up. I breezed through school ages 5-12 with ease but loathing homework. At 11, a teacher told my parent and I that I'm able to get great grades now by intellect, but when college comes I'll come to a reckoning unless I also learn to study and put in time to do the work.

Ages 13 - 20 were just a continuous slide down in academics. I spent all my time zoned into various MMORPG's, video games, and obsessed about an outdoor sport. Couldn't stay awake in class and never did any homework. But I'd manage to skirt out some A's on math and chemistry tests (learning on the fly), do some crucial projects at the last possible minute, midnight to 5am the night before, and managed to graduate with a 2.5 gpa (C's and B's).

When it came to college, it was the same until I realized I needed to get better grades to transfer to a real University, so I had one amazing year I got A's, got in, and then it was business as usual. Worst person at staying on top of homework in friend groups, constantly more distracted by video games, only completed C's by doing projects at the last absolute moment midnight to 5am.

At work, I'm constantly distracted by HN, and only get through projects by a sudden burst of sheer deadline fear at the end. I was falling behind and finally buckling, until I tried some Adderall secondhand. Suddenly I felt like I had X, Y, Z to do, and I spent my day going from X to Y to Z and couldn't believe how much I was getting done. Eventually I lost this source, used it 1/3 tapered down to little effect, and stopped, conflicted. Due to various reasons, I've burnt out and haven't been able to attempt any real work for 6 months, basically spending half my time on HN.

Guess I'm just hoping someone knowledgeable would be able to confidently tell me what's been going on. I probably need to see a psychologist.

Yeah, go to the doctor man.

Not taking care of yourself is one of the worse symptoms of ADHD/mental illness. I stopped taking my meds back in December and just started seeing my psychiatrist today.

I spoke to my doctor last year about this, was referred to a therapist, and was diagnosed (I’m a bit younger (32) and like you continue to grow, have a long-term stable marriage, good savings, great life. There were a lot of signs, but primarily I had trouble staying focused even for a few minutes. To have a productive morning and not get derailed, I would need to have an app like Routinery to walk me through what I needed to do step by step before work.

I decided against medication for a few reasons, but to deal with it is a daily exercise. I have to put up guardrails or I can lose hours / day with distracted activity. I find it’s tightly correlated to how much time I spend on technology.

Meditation, prayer, down time from technology (physical news paper and Economist in the mornings) all help to start the day focused. I’m considering re-arranging the house to have a room dedicated to technology and everything else in the house be low-tech, higher quality forms of recreation (books, musical instruments, board games, etc). That will, in theory, allow me to put time boundaries on how often I’m around technology. Another big thing I did was stop drinking. I did an A/B test at the start of 2020 - 2 months not drinking followed by 4 months of drinking, and by June I decided I was done. I still taste different things if my wife has one or I’m making drinks for others, but haven’t had a full drink since last June. NA beers have been great.

Books that helped me: make time, essentialism, digital minimalism, (an extreme but easy read recommended on here) - “better off”

Part of my hesitancy for medicine was that I didn’t want it rooted in self-improvement / optimization. I think there was some burn out mixed in and I was looking for the next step to optimization with medicine. I figured it would be better to fix the system rather than over-optimize for what I was doing. If I can’t naturally deal with it, then maybe I shouldn’t be running that hard.

If I get two-three hours of focus now per day it’s great.

Perfect is the enemy of the good, and I am generally happy and see no need for that much optimization. If it was really impacting my work and life, I’d reconsider medicine.

You and I share similar methods! Most of my technology is in the office, and we are surrounded by books and musical instruments. I am an artist (designer by trade, moved into technology consulting).

I definitely agree with drinking (and weed), it is very negative, and the effects last days for me.

I have recently been diagnosed while being in a very similar situation as you. I have had and still have a successful career, I'm in a stable relationship, have good savings and a great life.

I've been seen as gifted as a child so fit within the so-called twice exceptional criteria...

I don't regret getting diagnosed and having confirmation of it (I ran relatively extensive tests to confirm this which took 8 hours in total and cost me quite a bit).

In my case, it's been helpful because I'm moving more and more towards management and ADHD is sometimes detrimental to some of my new responsibilities. Knowing that I have ADHD and reading about resources to manage it has certainly been helpful.

I was prescribed Concerta which is helpful on some days when I need to work on things that are extremely boring and that I'd normally have a hard time doing. However, I take it less than 4 times a month, so extremely rarely. I have however noticed that I cannot take it on days when I am sleep deprived as it would cause me to become extremely sleepy.

My wife and I both started Adderall in adulthood. She has the hyperactive, can't watch a whole movie type ADHD and I have the absent-minded, a couple hours can go by before I realize I'm not working type.

She got her life together after starting treatment and can now handle a lot of responsibilities and a demanding job. It only helps me a little, and I still have trouble with motivation and self-discipline. She divorced me.

Since this post will likely attract my people, I'm curious how folks with an ADHD diagnosis have adapted to working from home. If possible, separate the comfort of it from the productivity of it.

I find personally that it's much more comfortable working from home, and while there have been many 'blown days' due to lapses in discipline, I can have days where I crush it as well. Open plan office environments are like someone is jamming my brain with a microwave, I can't accomplish anything. High-walled cubicle environments are better but all it takes is someone with a smelly lunch or wheezy breath and I'm off track.