Ask HN: Should I medicate my ADHD?

That person is now a different person than before. Some good things, some bad. I want to stress that my family member is very accomplished and has now started to medicate (under MD supervision), after completing a PhD in STEM from a top 25 school with many honors.

The good things are that they are calmer and easier to talk to. They report that they feel more 'together'. They don't freak out at all the little things as much now. They seem to float along now, their eyes are less darty.

The bad things are that they act like a crackhead. I know that's glib, but it's the best analogy I have right now. Appointments and deadlines are flying past like never before. They seem to really not care about the rest of the family as much as before. They are now doing a lot of very colorful art projects in areas that don't really take them (during weddings, on their work desk, on the ceiling of their bedroom, etc). They interject themselves and their feelings into conversations that are not about them (talking about an elderly family member's time left, they make the conversation about them now). Their spouse is very concerned and has expressed this to the rest of the family. They get very angry when talk of becoming unmedicated is brought up. I fear they are addicted to the amphetamines.

My advice would be to go to a good MD and talk with them. Try out the medication for a certain amount of time (~3 months) and then go back off the medication for the twice the amount of time (~6 months). Do an in-depth analysis about the effects it's had on you and determine if the benefits are worth whatever costs you see. Involve close friends and family in this process. Be very blunt with yourself. You've managed to have an effective life thus far, I would be very careful about gambling that.

I don't have ADHD (or think I do not anyway), but my wife (late 30s) has been diagnosed as an adult and started taking Vyvanse six months ago.

This is fast acting, slow release, non-accumulative medecine. Her doze kicks in within 20 minutes and slowly tapers off over the day. There is probably some minor residual effect crossing into the second day, mostly because if she takes it for many days stright, she needs a day or two break.

Her taking Vyvance saved our marriage and she is feels that the person she was before taking Vyvance is "gone". The day she took the first doze, she wrote about 20 pages of notes of what was different. Off-pill, she could not write 20 pages on demand, online in full hyper-focus mode. The pill is less effective now, but it sure still makes a difference.

I think having "on pill" and "off pill" perspective on the same issue by the "same person"(you/her) can help break a lot of bad patterns where the person thinks their position is the only valid one. Suddenly, they get a range of options from the "inside of their head". It also allows her to still have access to traditional creative ADHD super-powers (off-pill days) but then balance it with productivity of on-pill days.

As an anecdote. Before the pill if we would walk up to a traffic light blinking green with 20 seconds left - she would refuse to cross. Just too worried about not having enough time. Probably not ADHD itself, but one of co-morbidities. But also maybe not having enough focus to make a snap decision. On pill, she will cross with 5 seconds left. Because she has the focus and the drive.

As another anecdote. Our arguments/negotations (pre-pill) would be like floating on a stormy sea, always changing direction and shape of the argument. And even if we reached a conclusion, it would only be about the very last point discussed, ignoring the journey. The first serious discussion "on the pill" felt not that dissimilar, but at the end she turned to me and said "So we discussed these 6 things (named 1, named 2, ...) and agreed on X". I was blown away, as I was very used to the old ways.

Books I found more helpful than others:

* Melissa Orlov's book about ADHD and marriage: https://archive.org/details/adhdeffectonmarr0000orlo * https://www.amazon.ca/ADHD-2-0-Essential-Strategies-Distract... - this one, among other good bits, includes a table of all ADHD medecines and their effects, including a comment that off-brand Concerta (I believe) does not actually work

P.s. She also feels that Focus Factor non-prescription pills work partially (she discovered these pre-pill and still uses them on off-pill day). I am reserving an opinion and provide a link purely to clarify the brand, as the name alone gets lots of matches: https://www.focusfactor.com/products/focus-factor-original?v...