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Tell HN: If you have trouble focusing on projects/meetings, see a psychatrist

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Re: Tell HN: If you have trouble focusing on projects/meetings, see a psychatrist

#171

I got on meds for ADHD and they objectively didn’t help that much. I also felt like my pulse and emotions were greatly elevated in confrontational situations to an uncomfortable extent (though caffiene was involved). The other aspect was that it was almost $300/month for a prescription. In social situations they did help a bit. Any impact on productivity was minor. I’d also say right after the meds kicked in I would…

I recently got an ADHD diagnosis as an adult, and similar to you it was a "no doubt, you 110% check every box in every aspect of your life" from both my therapist and psychiatrist.

My therapist obviously can't prescribe, but I have a fantastic relationship with them, and they did convey that they think I'd probably be a better fit for non-stimulant ADHD meds based on some of my other behaviors. My doc, however, started me on Adderall ER because I guess that's the standard medication to start ADHD patients on.

But I got some crappy side effects, kind of how you're describing: elevated heart rate, some nausea (especially if I didn't eat enough). My therapist was worried about some of the emotional intensity stuff, especially with stress and caffeine, but I felt like I was managing that okay.

In any case, my doc wanted to start putting me on _additional_ meds to counteract the side effects. Therapist was still prodding for non-stimulant (but I'm a bit skeptical of SNRIs in general, maybe a bad bias...)

But I really pushed to just....reduce the Adderall dosage. Doc knocked it down twice, I ended up at _half_ the initial dose, and now it's just _awesome_. Most of those side effects have gone away, I'm still getting the benefits I want out of it, and unlike a lot of other meds, I can choose on a daily basis whether or not I feel like I'm going to need it.

Obviously, I'm not your doctor, and I'm sure you did your due diligence far beyond what I'm offering here. But I did want to share my experience in successfully shaping medical decisions with multiple expert and personal inputs. Ultimately, I landed on a medication path that's been EXTREMELY beneficial for my happiness and productivity, and it was one that wasn't initially suggested by either professional.

Re: Tell HN: If you have trouble focusing on projects/meetings, see a psychatrist

#172

I got on meds for ADHD and they objectively didn’t help that much. I also felt like my pulse and emotions were greatly elevated in confrontational situations to an uncomfortable extent (though caffiene was involved). The other aspect was that it was almost $300/month for a prescription. In social situations they did help a bit. Any impact on productivity was minor. I’d also say right after the meds kicked in I would…

One thing that isn't talked enough is the importance of regular exercise for managing adhd. Humans are not to designed to sit on our butts all day.

Shared my Adderall experience in response to OP, but didn't mention exercise.

HUGE +1, since I started working out more even just a few weeks ago, my overall happiness, focus, sleep, etc. have all improved massively.

But I think it's worth noting two things:

1. Almost anyone, regardless of medication or diagnosis, can probably benefit from regular exercise. These benefits are well-documented in the general population.

2. The initial benefit of my medication _without_ exercise was enough of a catalyst to help me finally get off my butt, join a gym, and make the decision to invest in personal training as a forcing function to more regular and high-intensity workouts. Until I started taking meds, I had this illusion that I'd come up with a workout plan, commit to it regularly, combine a wide variety of aerobic/anaerobic/freeweight exercises, and all for free with home equipment, YouTube, and some books. All of that was (and still is) absolutely _possible_, but without medication, I procrastinated it all for the better part of 2-3 YEARS. With medication, I quickly came to the conclusion that the time, stress, and inaction of that plan was not worth the money I could spend on making progress. And now I'm regularly working out.

Re: Tell HN: If you have trouble focusing on projects/meetings, see a psychatrist

#173
A slight semi-tangential/related question for OP/others who've benefited so much from medication - did you receive any guidance from your doctor on how to use it, or do you use any strategies you figured out yourself?

I have been prescribed (generic) methylphenidate, but the doc essentially told me "Take the tablets twice a day, good luck!". The medication does give me more mental energy, but it's much closer to "being on a rollercoaster" where you're being flung around than driving a sports car that you're in control of. (I haven't received any particular guidance/therapy etc.)

To give an example, if I take my dose when getting ready, I'm probably going to be focusing too much on moisturizing my face or arranging my bag, rather than using the energy boost to "just" get off my butt and move out. I should probably add that I don't have very good structures/schedules in place.

I really would like to help "tame" the med and would be grateful for any HN'ers help/suggestions!

Re: Tell HN: If you have trouble focusing on projects/meetings, see a psychatrist

#174

My anecdata on ADHD: I know someone who was diagnosed around age 8. Her parents declined to give her the speed that was recommended. When she was 12, she went for a run one morning and found that it made a huge difference in her ability to focus and maintain emotional equilibrium. She ran as many days as possible since that first run and runs ~12 miles a day (in addition to doing multiple team sports and weightliftin…

FWIW, at least in some parts of Europe methylphenidate is the 1st medicine considered, not amphetamine derivatives. (Also suggesting that a medically prescribed and oft beneficial medicine is akin to "giving a kid street drugs" is an un-nuanced way of looking at (stimulant) medications. Not to mention all the "amphetamines are just like meth" folks who probably haven't studied biochemistry.)

Re: Tell HN: If you have trouble focusing on projects/meetings, see a psychatrist

#175
Can anyone elaborate on their ADHD diagnosis experience? The questionnaire-driven, experience seems very subjective. Has anyone tried a more extensive test, what does it entail? Doesn't it cost thousands of dollars and is not covered by insurance?

Re: Tell HN: If you have trouble focusing on projects/meetings, see a psychatrist

#176

My anecdata on ADHD: I know someone who was diagnosed around age 8. Her parents declined to give her the speed that was recommended. When she was 12, she went for a run one morning and found that it made a huge difference in her ability to focus and maintain emotional equilibrium. She ran as many days as possible since that first run and runs ~12 miles a day (in addition to doing multiple team sports and weightliftin…

FWIW, at least in some parts of Europe methylphenidate is the 1st medicine considered, not amphetamine derivatives. (Also suggesting that a medically prescribed and oft beneficial medicine is akin to "giving a kid street drugs" is an un-nuanced way of looking at (stimulant) medications. Not to mention all the "amphetamines are just like meth" folks who probably haven't studied biochemistry.)

FWIW, I was using "speed" as shorthand to summarize stimulants. In the US, methylphenidate is known as Ritalin and, while it is not "meth," it is an addictive stimulant with nasty side effects and withdrawal symptoms*

My point is that if there is a chance that a reasonably healthy habit like running could possibly alleviate ADHD symptoms, wouldn't it be clearly better to try that before giving kids drugs of any sort?

*Common adverse reactions of methylphenidate include: tachycardia, palpitations, headache, insomnia, anxiety, hyperhidrosis, weight loss, decreased appetite, dry mouth, nausea, and abdominal pain.[5] Withdrawal symptoms may include: chills, depression, drowsiness, dysphoria, exhaustion, headaches, irritability, lethargy, nightmares, restlessness, suicidal thoughts, and weakness.[1]

Re: Tell HN: If you have trouble focusing on projects/meetings, see a psychatrist

#178

Not ADHD, but some similar symptoms for me. I could not focus on anything at work. Massive procrastination. It was just brutally painful to try to finish things I was working on. Long story short: the culprit was sleep apnea. After a sleep test, I got a CPAP machine. After a bit of time to adjust to the equipment, it made a profound change to my life. The next year or so was perhaps the most productive of my life. My…

This is me as well! I lapsed too and felt it change back for awhile, it was maddening.

Sleep matters.

Re: Tell HN: If you have trouble focusing on projects/meetings, see a psychatrist

#179

Be careful. 1 month is not enough to make a judgement. I hope it'll work for you long term and not create any side effects. I'm worried for you in terms of medication you mentioned. As an extreme example taking cocaine/amphetamines for 1 month would probably make you best dad ever, best coworker and best husband straight away - but would fuck you up totally longer term.

> I'm worried for you in terms of medication you mentioned Pure FUD. ADHD meds, taken in prescribed doses, have been proven in studies to not have negative impacts on either your cardiovascular system or your brain.

Don't they prescribe Adderall for ADHD? It's a mix of amphetamine salts. Same with Dexedrine. Same with Zenzedi.

Other stuff like Ritalin is also potent stimulant - like probably all ADHD medications - with withrawal symptoms ie. suicidal thoughts, depression and other mental and mood changes etc. It's serious shit.

It will make you feel amazying. At first.

Re: Tell HN: If you have trouble focusing on projects/meetings, see a psychatrist

#180

Not ADHD, but some similar symptoms for me. I could not focus on anything at work. Massive procrastination. It was just brutally painful to try to finish things I was working on. Long story short: the culprit was sleep apnea. After a sleep test, I got a CPAP machine. After a bit of time to adjust to the equipment, it made a profound change to my life. The next year or so was perhaps the most productive of my life. My…

What made you decide to get tested for it?

In my case, my wife complained of my snoring. I also have been tracking my sleep every night since like 2013 with Sleep Cycle, which records snoring. I never snored, until last December. It recorded me snoring 20-30 min per night, which is a lot. Plus, my dad has apnea. Plus my Apple watch notified me of a SpO2 < 90%. At-home sleep test indeed confirmed apnea!
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