I'm much better in the mornings, so I wake up early, 4 or 5AM, and I spend some time reading interesting technology stuff. Then I start casual reading on the task, not really trying to work on it, but just loading my brain. I set up my visual workspace (I have 3 monitors because visual context assists my shitty memory.) After an hour or two I reach a point where I can really focus and make great progress. I guess it's a way of getting into flow.
But a morning meeting that isn't directly relevant will wipe most of that prep away, and then I have to start again. So I avoid early meetings like the plague, unless it's purely an exercise in optics and I can ignore it completely and continue working.
When I'm medicated, it's way easier. I can direct my attention and it is resistant to distraction. My short-term memory doesn't keep reloading on every stimulus. I can get into flow in a reasonable amount of time throughout the day.
I'm off medication last few years, but plan to go back on in the next year. I love the cognitive benefits, but I have a couple of the rare side effects.
I appreciate if you don't want to answer, but I've been diagnosed in my mid 30s (it came out of the blue, I was not seeking the diagnosis) and wonder what you mean by "managing your cognitive state"? I have so far not sought medication but wonder if I should do so.