It really HAS changed my life. What I've found is that over the long term you're able to perform much much better.

By the time I was in my 30s I had developed coping skills which worked for the most part but I would find myself getting demotivated and defocused sometimes on long term priorities and sometimes unable to recommit to them.

Adderall totally changed that. I'm able to focus on tasks long term AND even if something bad happens in my life I'm able to keep right on track.

It's also helped me stay more positive knowing that projects get completed and there's nothing preventing me from accomplishing what I want to accomplish.

There are some downsides though:

- Adderall is illegal in most countries so you're not even allowed to travel with it in some places. I didn't really know this at first and I wish they would tell you. Most countries will overlook it but if you're China they could totally use it as an excuse to harass you if they wanted.

- It's very addictive. If I forget my meds it's basically impossible to function.

- It's VERY hard to get since it's a controlled substance. I'm only able to get it 72 hours ahead of time and if they're out of stock sometimes I have to wait. DO NOT wait until the last minute. Get it as early as possible.

- Some people have problems with off brands of XR (extended release) that has a different formulation. There's no standardization on the XR process and I think it's vendor specific.

I've been on Ritalin for a few weeks now, and the difference is remarkable. If this is how normal people feel most of the time, I don't know... I am both relieved to have a name for what was causing me problems, and also feel the need to grieve lost opportunities in life. It's a complex mix of emotions.

I didn't mean to reply and talk about myself, I actually wanted to ask (if you wanted to share), about what led you to the diagnosis at that age - what kinds of things were not working for you? What were you developing coping skills for?

It was a lot of shit, all at once, and it would be easy to shrug and say it would have been hard for anyone. But it was enough of a shock to my abilities that I was able to finally see that I just wasn't firing on all cylinders, even though I am otherwise intelligent and capable.

I have not lost my ability to focus. In fact, it's easier than ever. I've always been very distractible (another common symptom), and suddenly the kids making noise while playing next door, dogs barking, phones ringing no longer wreck the house of cards I'm holding in my mind while working on a problem. It's remarkable.

More that I gained “longer” focus.

I still got a degree in computer science but with that path I was put on... I’m now a photographer and still live in the same area I grew up in.

I realize you have more years “wasted” but I’ve had quite a bit of time to come to terms with all of that. I think it’s important to keep in mind we all have advantages and disadvantages in life, and chances are if you’re on here you’ve still had a pretty charmed life. You’re intelligent, in a developed country, etc. Most people don’t have that.

Interesting you mention that. I had a Bicycle->Car accident when I was 8 and I've always been told that's when a number of my behaviors started to change (and I became the black sheep of the family I am now.) I didn't get diagonsed with ADD until I was almost 30, but oddly enough my current care doctor also specializes in head trauma.

I’m guessing that’d be different now, though I don’t know what extra care they could give. At the very least I think my parents would have thought to tie my sudden energy and worse grades to what happened.

Also, every time a post on here comes up about elaborate methods of achieving focus the comments are full of people typical-minding what really might actually be ADHD (the whole "everyone is like this right?" thing) and I'm just sitting there like.. maybe you should look into this it probably shouldn't be that hard.

Of course if you post that you get a bunch of replies from people who insist that, "no, actually, it's cell phones' fault" or that it's totally normal to absolutely loathe doing any mundane task.

That's why we invented shell scripts and cron!

On a serious note, what type of tasks would you consider mundane that you attribute to your ADHD to cause you to not want to do them that any non-ADHD person would also not have procrastination problems? Are these specific to work like filling out time sheets or other TPS reports? Home tasks like laundry/dishes/trash? All of the above? As a non-ADHD person, I hate all of the above tasks and only do them because it's part of adulting. Can't get paid without time sheets (this is my biggest hate). I'd rather do laundry (folding/ironing) than fill out time sheets. I have no rational explanation as it is a rather simple thing.

The difference is that buckling down and focusing... Don't always work for me. That's the fundamental difference that normal people don't get. That rather simple thing is basically the problem.

I'm pretty good at "adulting" and otherwise coping with my life but I hit roadblocks that other people sail by. I can do very complicated, difficult and tedious tasks but sometimes get stuck doing simple things like paying a parking ticket. I know how to do it. I know when it's due. I know I'll pay a penalty if I pay it late. I think about it all the time. But doing it is like lifting an incredibly heavy weight. Normal people don't feel the weight and think I'm lazy.

Mundane is probably not exactly the right word tbh, but it's hard to find the right word. I think it would be more accurate to describe it as things with a lot of upfront planning involved. If I can basically react my way through something to completion I can get into hyperfocus and just blaze through it.

A lot of the time the way I've gotten around this is to force it to be an emergency so I can't think about it too much. Either by leaving it to the last second or just convincing myself.

And that's a really common pattern you see in people before they get ADHD diagnoses.

The difference being my wife breaks down in tears every 3 months because she woke up to dishes in the sink _again_ and wasn't able to use her coffee cup because, though I meant to do them and said I would, I wound up not doing them.

That was the first 5 years of my marriage. Repeat for laundry. Repeat for trash.

For work I was on a list of 5 people out of 1000 person company who's names had gone all the way to the CEO for not filling out timesheets correctly.

I hope that makes the problem a little clearer for those who think "but everyone has trouble with that stuff"

do you have some examples? i suspect the majority of mine are the former

When I think about that, it's kind of mind blowing.

For that matter, it is also crazy that we don't start giving children coffee at younger ages to help focus — since there are no known negative effects. It's just a cultural trope that it stunts growth, etc. It took ages before people recognized that there weren't really health downsides to coffee. We are so trained to expect that "every up has a down" — but what if that's just a relic of Calvinism and we are inhibiting our full potential because of misplaced fears?

I'll argue with the assumption that there is zero long term psychobiological consequences to exogenous psychostimulants (I personally don't buy this, but let's assume it was true). Increasing focus and task salience is only one of the many factors constitutive of human potential. They never give the answer for what to focus on, or whether a task is worth it or not, and rob the person of the opportunity for developing frustration tolerance. They turn people into indiscriminate doing machines, with little wisdom to guide it. Makes one think if prescription amphetamines being as widespread among plumbers as software engineers is truly a coincidence.

I will argue this is because our bioeconomics, our not wanting to do things is also part of our wisdom machinery. Having used for half a decade myself, I can spot some collogues who are on amphetamines; unnecessarily assertive, obsessed with orderliness of code, constantly in need of refactoring, huge bias for action with diminished wisdom to temper it (Well, also pees a lot.). There is a reason they are not being used by fighter pilots anymore because they can get too cocky and make decisions that kill their own.

No wonder everything looks like a good idea when your brain is swimming in dopamine and norepinephrine, but when everything looks like a good idea, how do you find what is the right thing to do in the medium/long term? Is that really the human potential? I would argue far from it. I think it is just enhancing the potential for a particular job description that requires you to sit on your bum all day and plumb boring stuff someone else tells you to.

I tick all the ADHD boxes but I managed to make it through college without meds so never should have started.

Psychiatry is broken and handing out prescription amphetamines to everyone who can’t focus is as bad as an idea as it initially sounds.

Someone in the same situation might feel much the opposite, but they also shouldn't use their experience to convince people that their attempt at treating a condition they have is inherently a bad choice.

Also you don't have to actually take the medications at all to get an ADHD testing battery. Then you'll know if you actually have ADHD or if you actually didn't. If you don't then your comments are a bit insensitive. Self-diagnoses of various medical conditions by the untrained is notoriously inaccurate.

If I got treatment for ADHD, maybe then I would be able to finally churn through all of my tasks and be a top performer in terms of closing stories. If I didn't pursue treatment, then maybe I continue to be unable to focus and completely burn out, resulting in the loss of my job. Maybe after that I pivot my career to where I'm doing something that I find to be more fulfilling. What's the better outcome?

It does help with "boring" tasks a little bit, in a sense, but they're still boring an uninteresting. It's not like I get a dopamine hit every time I do a piece of paperwork.

I usually describe it like this: for me ADHD sometimes makes things that are necessary for human life _really_ hard. Things like taking a shower in the morning or having breakfast, getting up to get water while working etc.

All these things take a toll on my day, I still do them but I feel like I'm doing something that I _absolutely_ don't want to do and at the end of the day I don't have any patient left for stuff that actually require my effort (e.g. listening to my wife when she's frustrated with me).

With medication I feel better about doing these necessary things so I can get to the end of the day without hating myself. That doesn't mean I'm gonna eat all the bullshit that gets thrown to me at work!

It's also not all roses, Ritalin is hard to manage, at least for me. I need to make a conscious effort to not devote too much of my attention to uninteresting details, etc. But it's not like it takes away your free will!

Focus and discipline is very useful when solutions to problems are known.

But put someone extremely methodical in charge of R&D and they will take a zillion years to explore a large search space. Meanwhile a neurotic will run around randomly and stumble upon all kinds of things on the map. The down side with the neurotic mind, is after a prospective gold mine is found and a lot of methodical, disciplined work is required to exploit it they flake out.

Now if you pair them up interesting things unfold.

We are quiet good at identifying people's strengths and weakness. But we spend a lot of time exploiting weakness and squandering strengths of people.

If only the opposite happened more.

With better and growing understanding of how different minds work, I think we will see people compensating for each others weaknesses more.

Without them, I actually have no problem focusing on certain things, but it's usually some unimportant problem or project that I become distracted by.

With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life. I become more attentive to my family, less irritated by distractions. And more a able to get important things done, like my taxes, that before would plague me.

I know some people seem to react to the meds by turning into a worker drone, But it doesn't do that to me. It does make me more excited to make progress and get things done right.

> With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life.

Executive function boost is non-negligible for sure, but it is still bound to operate in the short term.

Think your bioeconomics as a ledger, your energy levels as income and what you want to do as payments. Stimulants alter this ledger and as long as you can use them you will think you have a lot more income and you can sign up for more things to do. But do you really do have more income in the long term? Are you borrowing from your future income? Your future dopaminergic system? Your future neuroticism levels? I know the research is either missing or contested, but everything from evening crashes to need for increasing the dosage to long term dependence risk suggests that we are borrowing something from somewhere.

> I become more attentive to my family, less irritated by distractions.

Let me play the devil's advocate for a second: How do you know being more attentive to your family is the right thing? Maybe they are real assholes taking you for granted and getting irritated with them would make them get their act together and have a better chance in long term sustainable relationship. How do you know the distractions are not irritation worthy? Maybe they are things you need to get to the root of instead of enduring continuously.

I am exaggerating to make a point, and I'm sure you're mostly fine, but the danger is that thinking you have more "income" than you do will affect all your decisions in a way that accumulates and might not be long term sustainable. It can make you more conforming, and this will be praised by your family, boss, for the case with kids, their parents, but can we say with certainty that being more conforming all the time is really in one's best interest? Anger, irritation, anxiety, depression and even boredom, they are not there just as human failings but also as normal processes that can counter-balance over-exertion, over-exposure, weakly defended personal boundaries, meaninglessness, resentment.

Only way to know how continuous stimulant use is affecting you is to take a long break after multi-year use and evaluate where your life is, which for some people can be too late.

Now, if your goal is to swing for the fences and try to hit a home run, get to the top of your field, make a grand discovery, then ya, most of those kind of people are very non-coforming. But many are/were also very unhappy personally. In fact, many of the greatest outliers in our history suffered from manic depression or ADD or other mental issues.

Personally, I'm not swinging for the fences. I'm going to bunt if it means I have a much better chance of getting on base. Steve Jobs was very non-conforming. He was always very irritated and unpleasant with everyone around him. And sure, it seems to have had results. But I have no interest in becoming the next Steve Jobs if it means having what appears to have been an unhappy life with an early death.

Amps turn you into a drone. Any perceived benefit is met with equal or greater detriment.

This is a null hypothesis that hasn't been refuted due to lack of evidence, and not an alternative hypothesis that has been proven by evidence, right?

I ask because I've been looking into this before, and from what I remember there was virtually no evidence on long term use in reasonable amounts.

(There is evidence on short term use in reasonable amounts, and long term use in unreasonable amounts, though.)

But if we accept a "nutrition science" level of evidence, then I'd say there is strong evidence showing the naturalistic longterm use of adhd meds is not dangerous. Especially considering our baysian prior: a person off the street would estimate far stronger negative effects of taking speed every single day.

In fact, adhd meds are correlated with healthier outcomes (of course, huge selection effects. Yes, eating kale will be associated with increased health, but it isn't causal)

Here is the best recent review that I know of: https://www.sciencedirect.com/science/article/pii/S0924977X1...

I'd love to know your take.

Yeah, I'd say p much impossible to untangle there without experimental evidence.

So my impression (yeah I have to admit it’s a study of size 1) is rather that caffeine is more dangerous than I thought.

Might as well, we already load them up with sugar, which does have known side-effects.

Sarcasm aside, maybe not a direct negative side effect, but if you suffer from poor sleep, drinking too much coffee or drinking coffee too late in the day has correlation and lack of sleep certainly has negative side-effect.

Personally, I'll keep my kids off coffee and other drugs until they're old enough to buy it themselves.

Wow, that is truly amazing. I'm glad to learn about that.

I notice a slight depression if I stop taking my ADHD meds for a few days (perhaps up to a week), but after that I'm back to my old (ADHD-driven) self. So in a sense, it's not addictive at all. The depression can tempt one to get back on it, but that's about it.

One side effect of Adderall though is ED, and it's pretty bad. I guess it depends on the person, but for me, the ED was quite bad. The ED does go away after getting off of it.

You definitely have a withdrawal from adderall. A few days (up to a week) is typical of most drug withdrawals.

The drugs for that are very easy to get these days - you can get a prescription online by taking a survey and the pills will be mailed to you without ever talking to a human.

It's probably a lot better in the long-run to use exercise as a cure for ADHD.

(Instead of slamming your system with drugs upon drugs. With one drug taken to mitigate another's side effects, etc.)

[1] Nespresso is 63mg (5g of coffee), "average" espresso is 77mg (7g of coffee) https://www.caffeineinformer.com/caffeine-content/espresso

[2] https://www.coca-cola.co.uk/ingredients/caffeine/the-caffein...

That said, most coffee shop serve double espressos as standard, so if you factor that in, it seems on average your cup of cappuccino might have four time the caffeine than a can of coke.

There's also a couple Nespresso (maybe Keurig and others, too) capsules with double the caffeine content: Kazaar and Napoli.

Ok

a) There are downsides to coffee. I know of a clinical neurologist (Steve Novella) who, when working with a patient with chronic headaches, will always ask "how much coffee do you drink." Always remember, if a "medicine" is doing good, it will have side effects. Period. Note that homeopaths simply love going on about how homeopathy doesn't have any side effects - spoiler, that's because it's not actually doing anything at a physical level.

b) Yes, daily use of stimulants in people with ADHD has been show to be pretty much ok. In fact, there are studies showing that kids who are not medicated are more likely to end up as substance abusers, largely because they're self medicating (remember, drug abuse is a symptom++). However, the kids who were treated with stimulants? No more risk than their neuro-typical peers.

c) The above says NOTHING WHATSOEVER about neuro-typicals taking it daily.

++ Source: my partner, currently doing her neuro-psych masters on addiction.

After that 10, I tried amphetamine which blew holes in my persistent brain fog. I went on Adderall and (as we've often heard) it changed my life.

I'm not advocating you change a regimen that is obviously working for you. I'm just adding another possible plotline to that same story.

“Aderall” is a mixture of dextroamphetamine and levoamphetamine, in a 3:1 ratio. Unlike some other drugs, both enantiomers have a therapeutic effect, but slightly different effects on the brain.

If one takes pure dextroamphetamine (“Dexedrine”) instead, that is also available as an inactive prodrug lisdexamfetamine (“Vyvanse”). This is different from an XR formulation, in that the drug is absorbed immediately, but lisdexamfetamine itself has no effect on the brain. However, enzymes in your red blood cells gradually convert the lisdexamfetamine to dexamphetamine. The advantage of this, is unlike an XR formulation, there should be no difference between different manufacturers.

Because it’s basically dextroamphetamine with a lysine molecule taped on, the psychoactive effects are really similar, but I’d describe it as cleaner if that makes sense. The “killer feature” of the enzymatic release is it’s basically a fixed timing, whereas with XR formulations of Adderall you have a 50/50 blend of immediate and delayed release 3:1 amphetamines. I believe you are correct, it’s not standardized. This, combined with the acids / bases both hurting overall blood levels (think grapefruit juice) means you just have a wildly inconsistent time over long term use of the medicine. For example, I’ve had pharmacies change generics on me without saying anything, I’ve had an inability to get my preferred generics, and I’ve had days where it’s felt like I took nothing at all. The worst are Nuvo and Mallinckrodt in my experience (IR 10mg 2x/day).

I’ve only been using Vyvanse for a week or so, but I can say it’s a marked improvement for me and the lack of a generic is a huge boon with regards to consistency.

Here in Australia, one month supply (30 tablets) costs 30 USD. The Australian government subsidises prescriptions for all Australian citizens and permanent residents. I believe the actual cost, prior to the subsidy, is around 85 USD. The government negotiates prices with the pharmaceutical manufacturers, and the prices it negotiates are generally less than those that US insurers pay. Manufacturers generally accept less revenue for the Australian market, since if they can't get it subsidised by the Australian government it becomes quite difficult to sell it here.

https://bnf.nice.org.uk/medicinal-forms/lisdexamfetamine-mes...

28 * 20mg = £54.62

28 * 30mg = £58.24

28 * 40mg = £62.82

28 * 50mg = £68.60

That sounds amazing. I can't even imagine that. I've just been diagnosed at 32 this year. Been on Ritalin for a few months but it doesn't seem to make a difference. Maybe 3% better. Things going bad still derails me significantly.

They're fairly conservative with meds in my neck of the woods, but I'm going to persist with my doctor to try them all to find what works.

The struggle to push through actually going through all the phone calls, emails and appointments necessary to get to that point is very un-ADHD friendly. So many times I considered just to give up and forget about it.

He’s 33 and has been in college since graduating high school and still doesn’t have a degree, and he’s actually quite intelligent.

Completely life changing. My focus and energy level were on par with a normal persons.

Unfortunately it was far too hard on the body. Started stroking out on it. Plus it interacted with almost every Medicane I’ve been prescribed.

Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from that. Gave it up after a few weeks.

Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.

Kids have it strong. Wife wants them on meds, but weird reactions run in family so I’m highly reluctant.

Out of 120 students, I was the only one who didn't graduate that year. Sometimes I feel like I have the world's worst case of impostor syndrome because of how high school went for me. I was constantly testing top of the class but most everyone looked at me like an abject failure. I went into college with practically zero note-taking or studying skills and the first couple of years were a nightmare, even with medication.

All this is to say that medication can help when you need to feel normal, but it can't replace the skills you should have been developing. Some people can develop those skills and get shit done without medication and I applaud them, but I tried that route and ended up _years_ behind my peers.

Exactly. These articles about ADHD and dopamine are often misinterpreted by people who assume that ADHD is a purely chemical imbalance with only chemical solutions.

It's similar to the situation with depression, where decades of misleading ads and pop-neuroscience articles led people to believe that depression == serotonin. Most people are coming around to the idea that the "chemical imbalance" narrative has done more harm than good in the realm of depression treatment, but the idea that ADHD == dopamine and that ADHD is a pure chemical imbalance is still common online.

These studies should be interpreted as a snapshot of the brain's function in the disordered state, but they shouldn't be interpreted as an inherent property of the person's brain. For example, patients suffering from depression will show certain patterns of serotonin activity during depressive episodes that will change following remission, even if the patient doesn't take medication. The brain isn't a unchanging machine that only operates in a single, fixed way.

You said it best: Medication can't replace the skills that one should be developing. Many people take medication as a gateway to develop those skills and go on to do quite well in life. Unfortunately, some people assume the medication lets them off the hook for learning those important skills. They tend to struggle years down the road when they've built a tolerance to the motivating and stimulating effects of the medications (the attention-enhancing effects tend to be more robust against tolerance, but the euphoric/motivating/stimulating effects will dwindle over time).

This is important. When I went on anti-depressants (for pure-o OCD), my intent was to get some breathing room and learn to manage my symptoms better.

I've definitely been able to do that, but it's lead to a few cases of thinking 'hey, I should be able to stop taking these now', which have all gone poorly for me. I think I'm better able to cope now if I don't have access to medication, but I won't be stopping again any time soon, it's too risky for me.

With the aforementioned supplement stack I’ve been able to go off doses as high as 60 mg of adderall per day without any significant withdrawal symptoms. It’s been a complete game changer in terms of making this medication a sustainable option for me. I will say as a caveat that things which reduce drug tolerance formation also typically attenuate some of the effects. In my case, ALCAR + ALA basically erase the potential for euphoria but don’t seem to diminish the mental benefits.

I used to experiment heavily with all kinds of supplement routines and other nootropics when I had my Adderall Rx.

ALCAR works but like you mentioned, it does blunt things a bit.

https://clinicaltrials.gov/ct2/show/NCT03729128

https://link.springer.com/article/10.1007/s11373-006-9096-4

Dextromethorphan works for tolerance on things other than Amphetamine as well, but that's outside the scope of the conversation.

FWIW, the best I ever felt was on Adderall + 200mg l-Theanine + 10mg Noopept + 15mg Dextromethorphan.

Ordering the rest now.

My chief issue is nerve damage. Anything that helps them is a big win.

The only major side effect that's a problem for me is the utter loss of appetite. Frustratingly, it's not that I'm not hungry, I just don't want food. So my stomach will start hurting and I force myself to eat, but it's a challenge. Plus earlier this year I had to give up sugar to account for prediabetes, every day is a struggle to make myself get enough calories. Still, the ability to stay focused on a task for 15 minutes, or even just process my students' sentences, is worth it.

If they aspire to aviator,stay away. If you really, really worry about locking them into somewhere with access to a Schedule II, then consider not doing it, but I can't overstate how effective and life changing the right treatment regimen is. For me it was like life going from black and white to full color. It can be a bit depressing 20-39 years down the line, and I'm considering getting something started with a Congress person to dial back some of the draconian controls if at all possible, because, not going to lie, it is disruptive as all hell to the lengths things have been allowed to achieve

I've seen other parents with kids who clearly have it do nothing, and the Kids are the ones who really suffer because they don't have a clue what is "wrong".

I kick the wall I'm physiologically disincluded from aviating, but I wouldn't trade all the life experiences I've been able to navigate because of the medication for that, and there's nothing that says the world has to remain so unfriendly to Adderall/ADHD med takers as well.

The Hypertension can be a problem, but a small maintenance dose of a blood pressure meds (or Hawthorne!) Tends to do the trick for me, but work with your doctor.

ADD was REALLY hard on me when I was a kid. I had a difficulty making friends. I got really bad grades in school. Got in fights. Made me depressed and I thought something was broken with me.

You can start with 5mg and then ramp up from there. I'm on 15mg. I can't really feel 5m and 20mg is far too much.

At lower doses they won't really have any side effects and then you can keep them on for 90-120 days to see how they tolerate it.

One kid gets really bad headaches from less then 2mg pill. It’s a hard decision. Constantly monitoring them to see if they can manage without it. I think one is going to be okay with out.

Other one is probably going to have to go on. Still very young though

Was prescribed amatriptine for nerve damage. I had to get the lowest possible dosage, break pills into quarters. Even then it was still way too strong. ~1mg by my guess.

Doctors & pills straight up hate me.

Anyway, good luck!

Depression is usually easier to diagnose accurately. Schizophrenia can be hit or miss, depending on severity. In my case (I'm bipolar), psychosis was so much a part of my normal life that I was completely blind to it and my external symptoms weren't severe enough to be recognizable.

For just ADHD, There are also other classes of medication that can help. Atomoxetine, bupropion, guanfacine, and clonidine are alternative medications that work differently than first line stimulants.

In people I know who have experienced it, it was very debilitating, so I hadn't even considered the possibility of having it for a long time and still being able to function.

Edit... this ended up being an entire blog post, my blog and email are in my profile.

For example I have ADHD without autism and grew up thinking I was “smart but lazy” because I was > 99% as far as raw intelligence but had little motivation for the drudgery associated with school (or indeed life itself), yet I could play video games for hours straight without seeming to be at a disadvantage compared to neurotypical peers.

This is because ADHD, among other things, is a disorder of attention regulation as opposed to being completely unable to pay attention to anything.

It's cool af if you're young and single and you can just go and go and go on what it is that you're totally wrapped up in. It's shite when you grow up a little and other people have expectations of you and you constantly fail to meet them.

It seems like this is not uncommon, quoting Matthew Walker’s “Why We Sleep”:

> Based on recent surveys and clinical evaluations, we estimate that more than 50 percent of all children with an ADHD diagnosis actually have a sleep disorder, yet a small fraction know of their sleep condition and its ramifications.

For real though CPAP is life changing if you need it and you get on it.

I have an auto immune condition(Sjogrens) as well As a clotting disorder. Plus way to much sugar in 20s.

Took many many years to figure the above out. Proper treatment diet has been helping, but a lot of damage has accumulated.

Omg, I actually experience this very thing for myself. I thought I was unique in experiencing the "deepest most profound sadness imaginable" from Vyvanse. It's good to know it wasn't just me.

I did eventually connect the dots with Vyvanse, after taking it a bunch of times. I did several "test runs" where I took it some days, and not other days, and the deep sadness always and consistently occurred about 3-4 hours after taking Vyvanse.

Thankfully, Adderall doesn't have this horrible side effect.

> Aderral did remove most of the “pain” from boring things. So in that regards it taught me how to manage symptoms better. Focus is still a major problem, and I’m back to older trucks of ear plugs and a dim room. But not as bad as before.

I've read that exercise can go a long way in mitigating ADHD. I'm trying to now motivate myself to exercise -- which if I'm able to do would essentially solve the problem ADHD (at least partially), and create a positive feedback loop that could improve my life for the better in the long run.

I’m at my best when hiking hills 3-6 miles a day.

I've never heard this particular phrase before and I can only guess it's meaning vaguely from the context.

What does it mean?

The levo-amphetamine in adderall causes what is known as peripheral side effects. Higher heart rate. And so on. It doesn’t actually help the brain. Apparently it helps the dextro part last longer.

But its also potentially dangerous.

My blood is sticky(factor 5 Leiden), and cranial pressure runs high.

I tried going off blood thinners 2 months ago, for about a week. Dumb move.

My right side has regained most of its strength and sensation.

Neurologist chewed me out royal. I have to be very careful with meds.

Fewer stimulants I take the better. Vascular constrictors are dangerous for me.

Green Tea seems to not bother me. So I try and drink that or water.

Biab

ADHD diagnosis is much more strongly correlated with affluence than many other mental illnesses.

Eliminating the 504 accommodation would be beneficial in my view.

Source?

My understanding is it is the opposite way around. The lower down the socioeconomic totem pole you go the higher the rates of prevalence of ADHD.

Which would make sense given a) it runs in families and b) executive function disorders are correlated with negative life outcomes.

I can't imagine it makes you _more_ successful in life and thus more likely to be from an affluent family.

All the a-holes that abuse the drugs and the DX for any reason need to find another planet to live on IMO. It's so not cool.

> lower down the socioeconomic totem pole you go the higher the rates of prevalence of ADHD.

The key word in my original statement was "diagnosis". The rate absolutely seems to increase with lower SES, but diagnosis rate does not reflect that.

Your reasoning for why it is more common among poorer people seems to neglect the significant early environmental factors that might contribute to low SES high adhd prevalence in favor of a rich, genetically superior master-class.

> it can be difficult to find a psychiatrist willing to prescribe medication

Absolutely - my SO is diagnosed and I've been with her in the pharmacy where she was blatantly accused of trying to get it so she could sell it (nope, just a normal college student diagnosed with ADHD). That was wild.

I was working from home and the second it kicked in I started getting literal chills down my spine.

I ended up messaging a bunch of people on Facebook I haven’t talked to in years but felt a sudden affinity and empathy for.

I got distracted by a part of my apartment that I hadn’t cleaned in a while and missed a meeting because I ended up cleaning the whole place, including weird things like dusting the sides of books.

When I finally got to coding, it was like I was in the matrix. Hyper focused (and fwiw getting a lot done) but in a weird euphoric high feeling way.

I guess what I’m asking is is that how everyone feels the first time they take it?

And how long does it take to just feel normal on it, but like able to focus?

I want to try it again, because I need help focusing and know I can do better, but I’m genuinely afraid of the person I was on that stuff.

I eventually learned to redirect myself - which Adderall enabled me to do. The first step was qualifying my own good and bad behaviors.

It took time to deepen the reward association with beneficial behaviors. That helped me redirect away from counterproductive behaviors - not just revived behaviors but also the persistent ones. Making progress on those was huge.

During this process, the messy, euphoric edges smoothed themselves out. I never had to address it directly.

About 6 months in I came to the conclusion that I really would have benefited from a therapeutic guide, someone who was familiar with this specific experience. I'm not sure there is anyone like that out there.

I use it occasionally still but with no euphoric, overwhelming empathy or boundless energy to mow the metaphorical fields. It helps me push through brain fog when things just need to be done.

I haven’t managed to get past the tooth grinding. I barely feel that I’m on it now, but every single time... I grind my teeth. Even if I feel perfectly relaxed otherwise.

Ritalin causes side effects for me as soon as I start to hit the therapeutic dose when titrating.

Adderall is terrible for me.

My youngest daughter is undoubtedly ADHD, and the insurance company requires you to try the first two before they will approve a third...

Modafinil was The Answer for me after trying everything else. I don't know why psychiatrists always insist on a battery of other drugs first, which can cause everything from aggression to obvious personality shifts to mania to damage to the dopaminergic axons of the brain.

2. Insurance companies require extra paperwork for anything other than the 2 or 3 most common drugs. I ended up on Dexmethylphenidate after trying a few others; I rate it as "okay" but still so much better than unmedicated that I paid a few hundred dollars out-of-pocket for it while I was convincing the insurance company to approve it. I ended up on ER, which doesn't work as well because they wouldn't approve 2x 10mg of non ER but would approve 1x 20mg of the ER. sigh

After college I finally got diagnosed again after being off medication for 8 or so years. Grew up first doing Ritalin->adderall->concerta->no meds. I realized how needlessly difficult I made college for myself.

I don't have ADHD, but I'm curious what the modern one is.

Back in middle school, around 2001, I did a report on ADD and ADHD, and 3 of the medications that existed for it: Ritalin, Cylert, and I'm not certain of the third but from the other comments Adderall sounds like it could be it (though I think it started with a "D", is there one that does?). The only thing I remember from it is the conclusion that if I got diagnosed and needed medication, I'd refuse Ritalin, and that Cylert seemed like the best of the three.

Moda doesn't touch my affect and it's wonderful.

Modafinil makes me feel like myself but a more productive version. The big issue with me has always been starting a task and modafinil makes a scary task a lot more approachable. My thoughts are more ordered, I can see the bigger architecture of a thing, verbal fluency is improved. I cycle off it Saturdays and Sundays and that works just fine for me.

I am also using concerta because it is the only form of ritalin legal in my country. I don't really notice a difference compared to taking ritalin the other way.

I'm now on 2x 10mg methylphenidate (ritalin). It has definitely helped, but after a few weeks I now feel habituated (is that the right word?). Unless something is on fire or past deadline I'm back to getting no work done. I do notice positive effects when combined with (too much) caffeine, but ideally I want to quit soft drinks (and I don't like coffee).

I think I will ask my gp to switch to extended release. I hope he's willing to help me find something that works best for me.

As a sidenote, I do with people could be clearer when describing their medication. Just say the active ingredient, dosage, and frequency. Brand names can differ in different countries.

For reference:

- Ritalin, Concerta = Methylphenidate

- Adderall = Amphetamine

- Dexedrine = Dextroamphetamine

- Vyvanse = Lisdexamfetamine

Adderall is a mixture of several amphetamine salts including (25%?) dextroamphetamine and the formulas are subtly (and sometimes not so subtly) different between manufacturers. The key difference between Adderall and Dexedrine is the addition of those complementary amphetamines that balance out dextro's rough edges (Tracers!)

I've had panic attacks this year, I had depression years ago, went to therapy a lot better on that front. Enter: Xoloft followed by Trintellix (1 week in). I dealt w/ them pretty well, I'd go lay down, breathe and maybe take a cat nap, wake up in 30 minutes go back to work feeling like a million dollars. Now, not so much.

So, I started xoloft a month ago, it screwed up me libido and made me continually 'want it' but not able to 'deliver' (or it'd take way too long). Switched to Trintellix, still have panic attacks, sex is better, but anxiety doesn't seem affected. Now, I feel I'm actually more depressed though, and just not wanting to get out of bed. Motivation is rough.

I'm also taking Vyvanse for ADHD. It doesn't seem to be as effective as it was before adding anxiety meds.

Should I just scrap the anxiety meds altogether and just deal with adhd? Anyone else w/ similar experience want to chime in? It's really messing me up, and I've recently lost my main client so I really need to focus and get some income (web dev/laravel), or I'm gonna be homeless (40 w/ wife and 2 kids - so not an option).

Honestly my best advice is that, if you aren't having a good experience with your psychologist/psychiatrist you should find a better one. I've been lucky enough to be with a therapist who worked well for me as a teenager that I recently started seeing again for my anxiety. He recommends me to a local outpatient psychiatry department for my ADHD meds so I don't have to switch, but I don't know how much use the meds would be if I wasn't able to talk to him regularly.

Biology is complex, the drugs mess with that system in direct and indirect ways. Coupled with lag and resistance, it makes accounting for outcomes hard.

ADHD is interesting in that to me, our interaction and methods of coping with it need to be participatory. The drugs don't work on their own, we need to still make lists, walk around, exercise, crack jokes. Just realizing you have it pushes it off the mainline to a branch.

I'd say slow down, do some science and take great notes.

I was taking Dextroamphetamine for ~4 years, great for ADHD symptoms, focus and energy is amazing, but terrible for libido and really raised my anxiety. I tried switching from Dex to Methylphenidate, but after one day I quit because of how it made me feel (paranoia++).

Fluctuated on-and-off the Dex for a while (i.e. taking it a few days a week), but the whip-saws in dopamine levels really hit me hard, anxiety++.

Recently switched over to Atomoxetine (brand name Strattera) which has an off-script application to treating ADHD. It has a much more subtle effect than Dex, and has to be taken daily it to be effective. After about ~30 days of Atomoxetine I feel MUCH better, anxiety and stress is only at background levels.

Atomoxetine is nowhere near Dex in terms of focus and energy, but it does certainly address many ADHD symptoms + doesn't create the residual anxiety (at least for me). Libido isn't 100% of unmedicated, but nowhere near as bad as amphetamines.

First, I will echo what the other poster said - work with your doctor. Everyone is different and reacts differently to medication.

I can only speak from personal experience, but be very careful with Vyvanse. In the beginning, the effects were wonderful. Increased motivation, focus, etc. however, after about a year the effects began to wear off and my dosage was titrated really high (120 mg per day). Even at that dosage, I could barely get out of bed sometimes. I also began having panic attacks and severe paranoia. As another poster described, when it wore off, I had some of the most sad periods to where I’d sit there and cry for no reason. It was like staring up a deep dark well with little to no light.

I had life stuff going on, so reactions weren't completely unwarranted, but they were unnecessarily amplified. I’m not a doctor, but I felt like covers up depression and kicks the can down the road. Sometimes it gives people the motivation to change their circumstances, thus improving their depression. But, in many cases, it drives people to chase the high in order to keep staving off the lows. I don’t mean the euphoric high, I mean the motivation/focus high.

Listening to your post, and please don’t take this the wrong way, but it sounds like you are chasing the high without addressing the low. If you are taking a benzodiazepine for anxiety, it may be worth trying a different medication since those can make anyone groggy (with or without stimulants).

For me, it didn’t end well and I had to stop taking Vyvanse cold turkey (whew that sucked). It took a couple of years, but life turned out so much better for me once I addressed the anxiety and depression (or in my case, bipolar depression). I also take stimulants again, without any issues.

Then I by happenstance quit caffeine. And panic attacks went away. Sleep problems went away.

The meds were potentiating the caffeine!

Try quitting caffeine!

We've been working through the book, "Finally Focused", to help our son. Magnesium supplementation is recommendation #1, Iron supplementation (if deficient as demonstrated by the test) and then the over-the-counter, lithium orotate. We haven't gotten further than chapter 3, yet.

The lab doesn’t sell directly so you have to order it through a wellness center.

Fun fact: Methamphetamine naturally takes 3-3.5 hours to hit peak so Vyvanse has a more “meth-like” concentration curve as opposed to raw d-amp (or adderal which is 75% d-amp 25% l-amp) which hits way sooner. As an aside, Meth is very misunderstood and is in many ways a more ideal ADHD drug than normal amphetamine; and indeed it can be prescribed under the brand name Desoxyn. Methamphetamine when taken in low-moderate oral doses is completey safe and less jittery than amphetamine, but if abused (say, smoking 100mg d-meth) it becomes far more neurotoxic.

Understanding enantiomers (left-handed vs right-handed molecules in this case) is really important. For amp / methamp, the d enantiomer is 3-4x more powerful by weight yet is more cerebral as opposed to causing peripheral (body) stimulation. So d is almost always superior, although with adderall it has been found that the 75/25 d/l formula synergizes and has a bit longer half life

That's not entirely true, though. There is a lot of value in learning good habits to cope with ADHD and developing systems and mental models to improve your ADHD situation. ADHD isn't a purely dopaminergic "chemical imbalance" in the brain that can only be improved with chemical solutions, similar to how depression isn't entirely a chemical imbalance of serotonin.

One of the downsides of aggressive ADHD medication treatment is that it can handicap learning of good habits and coping strategies. Some, thought not all, patients quickly learn to rely on the stimulant effect of their medication to get anything done, assuming that medication is the only way to improve. This becomes a problem as the motivating effects of stimulant medication wear off after months or years, leaving only the concentration-enhancing side effects. Internet forums are full of 20-something ADHD patients who think the only way to address their ADHD is ever increasing doses of stimulants, but eventually they hit prescribing limits and increasing side effects. The solution is to approach ADHD as a combined treatment with minimal medication and heavy emphasis on self-discipline and healthy habits.

Regarding this study: Don't forget that ADHD medications aren't simply dopamine dispensers. All of the stimulant ADHD medications have significant norepinephrine activity, as well. There are many reasons why pure dopamine agonists aren't effective for ADHD.

> I wonder how different things would've been for me if I had started taking an effective medication at 16 and not at 25.

In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.

Many people take stimulant treatment for years or decades, but the unfortunate reality is that the long-term effectiveness of stimulants isn't exactly a sure thing. Clinical trials and studies rarely run for more than a few months. The studies on long-term patients are mixed, but not encourage for long-term effectiveness of stimulants ( https://pubmed.ncbi.nlm.nih.gov/11322742/ ). If you only recently started taking stimulants, you might be in somewhat of a "honeymoon phase" where the core effects are still strong. Note that after years of use, people will tend to overestimate the effects of the drug due to the severity of withdrawal symptoms on days off.

In short, I'd encourage you to continue addressing your ADHD symptoms with ever-improving self discipline, personal habits, and healthy lifestyle choices. The medication is part of a treatment regimen, but it shouldn't be the entirety of one's treatment regimen.

No, no, no, no. As someone who suffered remarkable mental turmoil over my inability to focus, despite reading books about it, asking everyone for help with my problems, just no, I hate this kind of puritanical thinking, it's exactly this kind of thinking which adds to the stigma of ADHD medication. The very first _day_ I took the medication I knew I'd stumbled upon something monumental. And then I realized that all those years of struggle in school and college, they were all for naught.

The only right answer is: see a psychologist if you think you have a problem, and get medicated if you and your psychologist feels you do have a problem.

> In reality, you may have benefited greatly by spending your formative years teaching yourself coping mechanisms and learning good study habits before introducing ADHD medication.

Nope. It just shit on my self-esteem and resulted in depression because I thought I was just not cut out for the things I wanted to be able to do.

> No, no, no, no.

I'm sorry you struggled, but I think you misinterpreted my post. I never suggested that people must go medication-free, or that therapy is the only option.

The point is that optimal medication treatment still requires effort to learn healthy habits, facilitate self-discipline, and improve one's ability to focus.

If you need medication to begin that process, so be it, but taking medication shouldn't mean that you neglect the self-improvement aspect of this. The medication can be a springboard, but it's a mistake to give up on self-improvement and hope that medication can do all of the heavy lifting.

I mean, my entire post was actually saying the opposite. One of the biggest downsides of having ADHD is the way it handicaps learning of good habits and life skills. I tried doing exactly what you describe in high school and the result was constantly failing to do extracurricular work and being branded as lazy by my peers and educators. There are a lot of comments in this thread on both sides of the argument that seem to take personal anecdote too far. My honest advice continues to be that medication is a great tool for those who need it, and therapy is something pretty much everyone should experience.

That aside, I _so_ agree with grandparent post about the negative stigma associated with medication for adhd. I’m so angry at society, parents, everyone for having done this to me in my early years — if only I had started earlier instead of in my mid-20s.

5mg of dexedrine at 8am gets me til 5-6pm and no crash afterwards.

But with the information and experience I have, I think if you get tested by a professional psychologist and he okays it, I’d be comfortable with kids as young as 5 getting medicated.

I can focus on my work all day with no medication if I'm doing something that I find personally interesting. However, when I have a week's worth of online coursework and boring bookkeeping to do it's impossible to get more than 5 minutes done without staring out the window, putting something on in the background, and twiddling my thumbs. I can still buckle down and get work done without it, but it's so much more mentally draining to do a week of work without any medication than if I were just to take what the doctor recommends. YMMV obviously, I just wanted to suggest something for people like me who have been 'proudly' living with ADHD un-medicated.

How do you know that other people have it harder? My suspicion is that we all suffer in quiet desperation.

In case you're still confused, there's this thing called the DSM that people use to diagnose/classify mental disorders. It's a pretty big deal.