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Ask HN: Discuss ADHD and your use of medication

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Re: Ask HN: Discuss ADHD and your use of medication

#81

I was diagnosed 15ish years ago when I was 26. I tried medication and absolutely hated it. It changed who I was. Medication is a crutch. If you're completely crippled and you need it, then you should use it temporarily. But be very very careful developing dependence on it and using it instead of doing the work to deal with your behavior. What worked for me instead of medication: - Get on a sleep and wake schedule tha…

The issue is that most of these are incredibly hard to do for someone with ADHD who is unmedicated. Hell, I'm medicated, and I still find myself skipping lunch entirely too often.

When your brain is rewarding you for solving complicated problems, you really don't want to stop. This is probably easier for people who don't love what they do, but for me, my main hobby is also my career. I have a server rack in my house. I do deep-dives into databases for fun.

I can confirm that being in nature is wonderfully calming, but unfortunately my two preferred biomes – mountains or ocean – are several hours' drive from my house, so I can't easily do so. My back yard doesn't exactly cut it.

Re: Ask HN: Discuss ADHD and your use of medication

#82

Earlier quoted context omitted.

Excuse my ignorance, but what is the line between ADHD and interest/geekery in the scenario you outlined above? I imagine most of the HN readership could spend hours on something they love, and struggle to engage as deeply with many or most of the tasks that are required of them at work. But ADHD would not be the diagnosis for most people. Just boredom. What tips the experience over the line?

To be completely fair it might not be exclusively ADHD. Research is discovering that Autism and ADHD are both on the "same" spectrum, and ASD covers both. Meaning they are not necessarily separate things. My ability to do bullshit work, is practically zero. If it isn't a task that I find challenging/interesting/important then there is negative motivation (or tolerance) to do that thing. I can and will find something…

First, obligatory xkcd [0].

> This challenge/solution consumed my entire interest for that day. My dopamine hit was because I wouldn't have to do the BigBoringTask ever again.

Yep. Occasionally I have to stop and remind myself that all I'm trying to do is rename 10 files (for example), and by the time I remember the {ba,z}sh-ism for parameter substitution, I could have probably manually renamed them. I usually tell myself that it's not nearly as fun, though.

This does occasionally present detrimental facets, though. I have a homelab, and as most people with one, its primary purpose is storing and serving media files (I promise I do other things too, but let's be honest – Plex is what people care about). I run apps in K3OS, which has been dead for quite some time. The NAS is in a VM under Proxmox, and I build images with Packer + Ansible. I've been wanting to shift K3OS over to Talos [1] for some time, but I had convinced myself that it was only worthwhile if all of it was in IaC, starting from PXE. I got most of the way there, and then stopped due to work taking more of my life than I wanted. Unfortunately, around this time the NAS broke (as in a hardware failure, not a software issue), and I was refusing to bring it back until the entire homelab was up to my absurd self-imposed standards. Eventually I convinced myself this was a ridiculous punishment, replaced the dead hardware, and brought it back.

[0]: https://xkcd.com/1319/

[1]: https://www.talos.dev/

Re: Ask HN: Discuss ADHD and your use of medication

#83
There are sadly no easy fixes here. Approaching 50 with a life of ADHD here. I’ve managed to build a great life but always against that burden. Thankful that when I was younger I didn’t have the universe of constant connectivity at my fingertips or I don’t know that I would have had the strength to nail things back then.

A few comments: - Most people start meds and feel like a superhero getting their powers. Like “wow now I can actually do all those things I dreamt of”. Be careful. The surge doesn’t last. Medication will always help but that initial WOW will fade. Don’t get so attached to it that you feel like crap when it does.

- It sounds trite but nothing has helped me so much as trying to make serious meditation a habit. That and exercise/diet/regular sleep. I know - it’s boilerplate. That doesn’t make it untrue.

- Give yourself a break. You are who you are. Try as much as you can to succeed within the grain. That doesn’t mean don’t try to be disciplined and ambitious etc… But dreaming what another you without ADHD might have been … well it just isn’t all that productive. We get the hand we get and it’s up to us to maximize our happiness within those constraints. Try to focus on (hopefully) all the good cards you did get.

Re: Ask HN: Discuss ADHD and your use of medication

#84

It's a disability. You don't overcome it you find accommodations and supports that allow you to meet your goals and & obligations. The experience of having adhd for me is mostly that it is primarily an emotional regulation disorder. The focus and attention problems are downstream of that, and are prioritized because that's how a parent or employer experiences adhd.

A huuuuuuuuge note for others: Woman and men (on average) experience and present symptoms very differently for the "four" mental disorders, ie anxiety, autism, ADHD, and bipolar disorder. For a lot of women this sucks, because most medical professionals have been trained on the "male" symptoms, and basically left in the dark about how to properly assess/diagnose a female patient. My mother and girlfriend and sister h…

> In my case: I am near physically incapable of doing things that I "need" to do, with the more I "need" to do something, the harder by brain and body will rebel against doing it.

This is interesting to me. I find my own behavior is the exact opposite; I have no internal concept of need. I will do everything in my power to avoid starting a task until someone says it "needs" to be done. So in my experience the need is always externally motivated: it's usually just a deadline, or some other authority micro-managing me. ("I'm meeting with [customer] tomorrow and would like to show them [x] from project [y] is that ready?" => I will move hell and earth to do [x], and not a minute sooner. There's some activation threshold there. It is definitely not calibrated where it needs to be, but my ability to "thrive under pressure" has allowed me to cope, as long as someone/something holds my feet to the fire.)

Also I find deadlines are a lot more effective for adult-me than they were for child-me. I think that's mostly because I've got project managers to lean on who are creating those schedules, tracking them, and keeping them visible. Whereas in school child-me was expected to be my own project manager. (Yeah, that was never gonna happen. Many tried to get me to jot dates down in my little day planner. Many failed.)

Disclosure: I'm not clinically diagnosed with ADHD, but from all I've heard/read about it I would not be terribly surprised to find out I have it. (Although I would be surprised to find myself having sufficient motivation to go out and get proper help. ;-P)

Re: Ask HN: Discuss ADHD and your use of medication

#85

The number one thing is making sure I get enough quality sleep. Nothing else is even close! I say "quality" sleep because think I had minor sleep apnea for years and if you have anything like that going on, it won't matter if you get 8 or even 10 hours per night of sleep. As far as medication: - Stimulant meds were like a magic cure at first, but over time they lost efficacy and they made me more high-strung - Modafi…

I agree on the quality aspect of sleep. I've started to wear earplugs when sleeping, and now I get a much deeper, undisturbed sleep.

I still struggle in actually getting in to bed. Not sure if this is common with ADHD people, but I'm a night owl and if I don't force myself to go to bed, I can easily stay up until 1 or 2am. Of course, that means I suffer the next day...

Re: Ask HN: Discuss ADHD and your use of medication

#86
post #34

Earlier quoted context omitted.

no

To me this is the difference between ADHD and just being alive and having to do things that you don't want to do sometimes. I don't mean to be dismissive, I struggle greatly with the same things you do - but I avoid trying to solve things like this through medication.

Yes would be consistent with ADHD or many other things. No would be consistent with ADHD also. Hyper focus is a common symptom.

Re: Ask HN: Discuss ADHD and your use of medication

#87

Earlier quoted context omitted.

>I think it became really obvious to me when I would require a ton of discipline to do assignments around making applications, but doing something like configuring linux from scratch was so personally interesting to me I could stay up nights and days without any external stimulation. >I found that medication (Methylphendiate 20mg) have definitely helped me focus, but the direction of what I'm focusing doesn't always…

Excuse my ignorance, but what is the line between ADHD and interest/geekery in the scenario you outlined above? I imagine most of the HN readership could spend hours on something they love, and struggle to engage as deeply with many or most of the tasks that are required of them at work. But ADHD would not be the diagnosis for most people. Just boredom. What tips the experience over the line?

With adhd it’s virtually impossible to do something not extremely stimulating - regardless of consequences later on.

With meds it’s still possible to procrastinate etc, just not to the levels as before.

Re: Ask HN: Discuss ADHD and your use of medication

#88
post #34

Earlier quoted context omitted.

no

To me this is the difference between ADHD and just being alive and having to do things that you don't want to do sometimes. I don't mean to be dismissive, I struggle greatly with the same things you do - but I avoid trying to solve things like this through medication.

Do you also avoid caffeine?

Re: Ask HN: Discuss ADHD and your use of medication

#89
post #56

Earlier quoted context omitted.

> Medication is a crutch. If you're completely crippled and you need it, then you should use it temporarily. But be very very careful developing dependence on it and using it instead of doing the work to deal with your behavior. Your giving piss poor, dangerous advice that goes against established front line treatment. If you actually have ADHD, completely ignore this terrible advice and treat it in line with a quali…

That is a bit harsh. I think the OP had good intentions, but I agree that focusing on breaking habits might be the wrong way to go here. I think medication works for some, therapy for others. But the focus really needs to be on finding your strengths, which are also part of your ADHD brain, and working on those.

It’s not harsh when it’s advice that can literally destroy lives. People like me, who allowed such nonsense to prevent them seeking an actually effective and proven treatment for years whilst I flailed and failed to exercise/meditate/productivity/diet it away. My failure to seek real treatment due to listening to such shit for a long time robbed me of years of productivity, capability, time and outcomes that I’ll never get back.

It’s like telling a diabetic to not take the insulin crutch. “Just eat a salad bro you don’t need insulin pffft.”

People with ADHD should do all those other things as well, in fact most people should. However it’s not going to adequately treat many more, who can be treated, provably and effectively with a real medical treatment. A treatment that has again and again proven to be an effective, gold class standard of treatment and outcomes.

Telling people to break bad habits is one thing, convincing people with real medical problems to explicitly avoid proven frontline treatment for which we know can improve/prolong and save lives is an entirely different thing.

Re: Ask HN: Discuss ADHD and your use of medication

#90

Earlier quoted context omitted.

> Medication is a crutch. If you're completely crippled and you need it, then you should use it temporarily. But be very very careful developing dependence on it and using it instead of doing the work to deal with your behavior. Your giving piss poor, dangerous advice that goes against established front line treatment. If you actually have ADHD, completely ignore this terrible advice and treat it in line with a quali…

I remind you that bloodletting also was the first line treatment back in the day. And it's fair to say that our understanding of the human brain and how most drugs work are very rudimentary. I have heard advice resembling some of points above from a qualified medical professional, specifically the "temporary" part. And I didn't appreciate it at the time - mentally I already was on "medication for life" bandwagon. Few…

> mentally I already was on "medication for life" bandwagon.

I was the other way around for most of my life, from diagnosis as child, through to my early 30s. I was surrounded by people telling me it wasn’t real, didn’t need drugs, and that if it was real, that instead I could just eat/sleep/exercise/meditate it away, that I just had to “try” harder. “It’s a scam from doctors to get you hooked on drugs you don’t need bro.”

And so that’s what I did, I tried harder and I tried harder right into an eventual psych breakdown at a hospital at what my life had become despite all I was doing and had been doing for years.

Since being medicated, my life has been fundamentally altered in ways that leave me with significant regret in not having more seriously medically addressed it earlier. I’ve lost years of capability and capacity for growth and education I’ll never get back. Years of unstable emotions and outbursts and associated outcomes that could have instead been avoided.

It’s now going on almost eight years of being able to have stable relationships, stable emotions, stable capacity to learn and grow, etc. Without what the meds have done for me, I was on the road to suicide. I was broken, battered and constantly disgusted and ashamed that no matter how hard I tried, or what I did, I simply couldn’t do what others around me could. And every increase in effort, to only see the same failures drove me further into that spiral of shame and depression.

> low carb diet

Already been on one for years as an attempt to control an inflammatory autoimmune disease. I don’t know if it helps the ADHD to be honest, but it became easier to stick too at least once drug treatment for ADHD began. When I’m not drugged, my craving for carbs is beyond what I could even describe. Along with the huge addiction I had to “non prescribed” stimulants such as caffeine and nicotine. (Apparently I was effectively without realising it attempting to self medicate.)

> don’t be afraid to stop your meds

I take holidays all the time (to which the professionals don’t love). If I don’t have to work/learn/be productive, I don’t take them. Aka weekends, holidays, etc. I try to minimise how much and how often, but I do that for all my medical issues. (For instance I’m prescribed permanent high level dosages of lyrica/opiates/valium for a spinal cord injury, but for which I take considerably less than I’m prescribed, and from which I take as many holidays from as I can humanly tolerate.)

I didn’t mean to infer that drugs are the ONLY option, to the exclusion of anything else and to do nothing else. You should focus on sleep, diet, exercise, building yourself coping systems etc, but really, that’s applicable to everything, and in many cases, it’s going to be a lot easier to build these things if your treated and stable first.

Before and after medication, I run my life with what’s effectively a running “blog” that is also my todo list/life goal tracker. I write down everything I hear/see that I think I’ll need to remember/action/do in the future. This blog runs my life and serves to provide a function that my own brain often can not. A stable memory of what’s important, and what’s not.

Anyway, sorry for the blog I suppose. Currently in Vegas, ironically, un-medicated because it’s a holiday and when unmedicated, I tend to have a tendency to drone on and on.

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