Idk why I'm writing this. I guess it was just on my mind and felt like joining in the discussion.
Still good that we have the medicine available that we have right now. Born in a different time and ADHD wouldn't even be considered a real thing.
Hang in there and sometimes just let your brain do whatever it wants :) Constantly forcing and fighting things can get you stuck in a stress spiral.
That, and meditation also helps with being more aware of what your brain is doing
Up until the post-WWII era desk jobs were pretty rare. You'd be in a factory or a farm, or something else not-desk-related.
Anecdata: I did a working holiday in Australia and worked on a farm. No issues with ADHD or other focuses -- exercise, sunlight, no caffeine, and not-desk-related work kept me on task. I notice a big difference even now with carbs and sleep patterns, and how they effect my focus.
Genetically we're still cavemen, and are equipped to always be swatting mosquitoes and looking out for bears, not sitting still and thinking through abstract bit-shifting.
Most drugs need at least two weeks to start having any effect - and the drugs that are shorter-acting (AMP-family mostly) still have a “breaking-in” period before they have the desired effect.
Can you explain more? Are you implying you are paying a nurse to open your door and yell at you "get out of bed sleepyhead?" Or is your insurance paying?
Do they actually drive to your house and do this? Do they do anything else for you?
Yes. I use sites like Care.com and WellBeyondCare.com to find them.
> Are you implying you are paying a nurse to open your door and yell at you "get out of bed sleepyhead?"
They aren’t nurses. The going rate for a caregiver in the US is only slightly above minimum-wage which is awful - especially considering the “human” value of the work they do for us and our loved-ones.
> Or is your insurance paying?
I pay for it myself. A good chunk of my income is 1099-based and my CPA said I can deduct my caregiving expenses as a business expense because without their help I wouldn’t be working anywhere near as many hours as I do otherwise.
I pay them $30-35/hr - with a 1-hour minimum. They pay for themselves as far as I’m concerned.
> Do they actually drive to your house and do this?
Yes. They come-by around 6-7am and spend about 15-30 minutes with me before they go off to their main day job, so I imagine it’s a nice little (easy!) side-gig for them.
> Do they do anything else for you?
I’ve had a few that stayed for a full hour - they’d make me a proper cooked breakfast while I’m spending 20+ minutes just waking up in the shower.
...it’s like living with my parents again.
My generation likes to joke about “bed gravity” but it’s a real problem :/
I spent the last two years mulling over hiring an assistant, and told a friend I had $1000/mo for this in a heartbeat. Got in a fender bender without insurance (I could afford it, just never got the paperwork together), and my friend pointed out that had I gotten the assistant, they would have paid for themselves merely by mitigating the cost of that one incident.
I can totally relate to how this seemingly absurd expense is an absolute no-brainer for people like us.
Some of them do - you need to ask around. Every one of them has been lovely to me, but some are more capable of administrative and PA work than others - consider that most of them usually do work like being an orderly or care-assistant in a care home, for example).
But give it a go! You can mention in your job posting that you’re wanting to give it a try for a week at first and take it from there, for example.
No special paperwork is needed as far as I know - as it’s not the same as having a domestic-employee like a live-in nanny or au-pair.
I've also found I'm a hyper-metabolizer. Ritalin lasts about 90 minutes before crash, amphetamine about 6h, and straterra just makes me derp. There's a hysteresis effect to the crashes - topping off with more IR isn't the same as preventing a crash.
Current protocol is 15 mg Vyvanse (yes the dexamph prodrug that's supposed to last all day) when I get up around 9, another 15mg around 1300. And actually thinking about switching to 3x. All in an effort to get a really stable blood plasma. Otherwise, I turn into a zombie and can't make dinner.
Still a struggle, and side effects abound, but well worth it.
I can’t get my head round this at all.
But as I said - it literally pays for itself: say my time is worth $100/hr[1] and paid on an IRS 1099 schedule - so it’s a deductible expense. The extra 3-4 hours it gets me ($300-400) is worth the $35 opportunity cost, because that’s $5,000+ extra monthly income - so minus the $1000 as a pre-tax deductible business expense then that’s $4000 I wouldn’t have had otherwise.
Spreadsheets don’t lie!
Even if I was paid on a W-2 basis, I could probably pay for it using pre-tax money from my HSA - though that would sap all of my HSA contributions though.
[1]: Why yes, I do live on the US west-coast.
Adderal did a great job “teaching” me to stay on task. I do alright without it now, but energy level is just too low.
Diet definitely makes a huge difference. Carbs are evil. Audio books for when I need to do chores.
2) You could probably get a movie deal.
I imagine a film about kind middle-aged ladies bringing coffee to a young, possibly hungover, technology worker who suffocates on his own pillow at night would not make for good entertainment.
Although 5 years of that service (let's say minus the time I'd be on vacation) is about $40000...
Babies are the side project destroyers.
Yes - I'll sleep-in for up to 12 hours, sometimes more - which then means I won't feel tired until ~6am the following morning - or later, and then I end-up with a strange 36-hour body-clock in my head while my body feels bad.
> do yo need to be awake at such early hours or do you just not want to spend more time sleeping than you currently do?
With my current job I don't need to be up at a certain time, but I actually feel sad and it lowers my self-esteem if I sleep through daylight hours - and on the times when I miraculously do wake-up naturally at sunrise I feel a kind of satisfaction with myself.
Even so, I'm still not actually all-that productive in the mornings until the afternoon (which makes it a good time for meetings!), but I'd rather be slightly less productive than feel sad and depressed.
I can get myself to 24-hour rhythm with melatonin, which I do, but it doesn't reduce amount of sleep I need so I'm left with a shortened day.
Unfortunately, after getting used to waking up without alarm, I find getting up forcefully really painful. And I doubt it would help productivity much, because I'd be half-zombie if I do it more than 2 days in a row.
PaaS: Parents-as-a-Service.
I'm not totally joking about this. Someone get on this.
Edit: Read the rest of your replies about caregivers
I started lifting weights 2-3 times a week and I changed my diet from being carb-based to being protein based. In my 20s, I'd eat a bowl or two of spaghetti, or a pizza for a meal. Now, a meal is generally a protein source, a carb source, and a lot of vegetables (e.g. chicken and rice and a lot of kale, or steak and potatoes and a lot of broccoli). I think the most significant change was the diet, because in periods when I was injured or couldn't lift weights, I still sleep well.
I also started getting a bit more on a schedule. Eating breakfast between 7:30 and 8:30, lunch between 12:00 and 1:30, and dinner around 7:30, etc. has really helped my focus and attention and poise. It feels like the volume is turned down on the ADHD and it's much easier to remain calm and in control throughout the day.
Edit: I think I also have a mindset about this. I refuse to give myself permission to use ADHD as an excuse for not being the person I want to be. I think the thing I'm most scared of is looking back on my life with regret at the things I failed to do because I used some diagnosis as an excuse to not put in the work necessary to be the person I wanted to.
1. It might help to know you’re not alone (at all). I’m lost and burned out for the (n+1)th time myself.
2. For me at least, recovering from burnout needs to be an active process. Time alone does not seem to heal it, and actually seems to calcify it. I’d try volunteering or some sort of non-work related “work”.
3. Staying up (extremely) late is mostly behavioral for me—e.g. not being satisfied with my day and wishing I had done more, so I cling to the “day” and stay up til the birds chirp. Then I’m stuck in that schedule for a long while. I have no real solution to this and it’s not really advice, it’s just an observation that might resonate.
4. Try not to label yourself in such a way as, “I am ADHD, therefore I cannot do {x, y, z}”. Especially with mental health, it’s more accurate to think of it like, “I have a cluster of symptoms / patterns of behavior that could probably be classified as a type of ADHD”. Some of those patterns you may be able to control directly (like with meds or therapy/strategies/habits), some you may have leverage over indirectly via feedback mechanisms (e.g. relieving underlying sources of anxiety/burnout could help your sleep, which will keep burnout in check).
5. If you’re able, try doing a volunteer trip that forces you to go to bed and get up early. More specifically, if you like the outdoors, do a backcountry trail crew trip. It’s easier to fall asleep when there is social reinforcement, constant physical tiredness, few artificial lights, and plenty of weird sounds in the blackness. I did one week with (trailcrew.org) after an intense burnout period and it had a lot of benefits for me.
6. You could always find a more flexible job (remote, flex schedule, etc). If you work with a healthcare provider, you should be able to get reasonable accommodations—if you’re in the US you have this legal right. Go through HR, not your supervisor. If your company doesn’t have HR (startups?), try working for a megacorp where their incentives and ability to accommodate are probably higher. (PS: “Reasonable” doesn’t mean that it has to make managers feel warm and fuzzy, it just means you can’t insist on, say, teaching schoolchildren between the hours of 8pm-4am, for example. If anyone whines about “fairness”, just say: “I have an alternative work schedule for personal reasons” = “f..k off”). Anyways, don’t set yourself up to get fired because you didn’t arrange for fair accommodations—advocate for yourself.
What I find is that my judgement is impaired in the morning - and that I don’t act rationally: it’s like I prefer that nice feeling in my head I get when I’m half asleep - if I had responsibilities I’d just disregard them because at that point in time I value being in bed more than anything else.
It’s why alarm clocks, sunshine, Hue light bulbs with a Wakeup routine set, all don’t work for me :(
Also, reading your first two paragraphs makes me wonder, again, about whether I might have ADHD, especially without the hyperactive part.
I think about it like packet loss, but for intent. With healthy executive function, one's goals and intents are persistent streams that can be held on to like a train track. (This is based on other people's description of how their mind works – I would consider that ability a superpower). With ADHD, the tracks will just fall out like a trapdoor every so often – sometimes every few seconds. You have to reinitiate the connection, but because the thing that failed is the same thing that remembers what to connect to, I have to reestablish what I want to do in the first place, and it's usually not the thing I was doing before. So I end up shooting around in semi-productive bursts, unable to see things to completion.
The other counterintuitive thing is hyperfocus – people with ADHD periodically experience the inverse. I spent nearly every waking moment in the last 3 days working intently on a software project I'm interested in. Short bouts of intense concentration (especially if you don't feel in control of their application) do not mean you don't have ADHD. They could mean the opposite.
Here's the best explanation I've ever seen of the subject: https://www.youtube.com/watch?v=SCAGc-rkIfo
Haven't found a ton of research to back this headcannon yet but there's evidence that the D1/D2 ratio is extremely important.
I don't believe I fit the criteria for ADHD (maybe I do?), but I certainly have challenges with executive function. And those reduce a bit once the world goes to sleep.
I'd liken it feels going to a more "normal" schedule to...someone who feels fine waking up at 7am every day, shifting to then waking up at 2am every day. It's probably not going to work out too great.
Yeah, agree about the name too. It's terrible. Doesn't describe the lived experience remotely. Just how it annoys other people around you.
Hah! Yes.
I grew up when ASD and ADHD couldn’t be comorbid diagnoses - and as I wasn’t hyperactive or fidgety, and was considered professorial or studious it was never brought up. Academic problems caused by “not applying oneself” only started around the time I was 15-16, prior to that I just coasted my way through primary and secondary school with high grades.
Growing-up, I think I weirded-out people far more then I annoyed them - hence the primacy of the ASD diagnosis - my last psychologist said he couldn’t tell I was ASD at all until I told him - I think I’m just good at hiding it, but I definitely still have problems.
I remember talking to the psychiatrist who diagnosed me the first time:
"So did you fidget in class?"
"Not really, I mostly just got the work done quickly so I could read or talk with friends"
"Okay, so you still weren't actually focusing on the lesson"
"Well no, but the lesson was pointless and boring"
"Do you draw patterns on your teeth with your tongue?"
(Me, currently doing that while he was talking to me) "Uh, yes - how could you tell?"
"It is a common thing for patients with ADHD who don't fidget in obvious ways"
It was around there I starting taking the idea a lot more seriously
I've been told it can often be misdiagnosed as either or both of these two
The ASD and ADHD diagnostic criteria are still too broad and imprecise. I welcome DSM-V's changes from discrete Autism conditions to having an actual spectrum - but I feel the same should be done for ADHD because so many of ADHD's diagnostic criteria, even for the "Inattentive type" (let alone the Hyperactive-type) really don't apply to me.
I know a lot of people in real-life in geeky/nerdy fan subcultures and so many of them exhibit those "odd" behavioral traits of ASD - and I've asked them about it and they tell me they got tested for ASD but got an ADHD diagnosis instead - and I don't like that, because the diagnostic criteria for ADHD in the DSM doesn't really cover non-normative social behaviour at all (that's ASD's territory).
In summary: more research is needed!
One analogy has stuck with me. Defining mental disorders is like drawing up the constellations. The individual behavioral traits are the stars, and the constellation’s boundaries are as much a function of the culture who defined them as they are a function of how clustered these stars/traits really are.
I was kicked out of that program when I entered Grade 5: they said I wasn't applying myself in the class (naturally). In Grade 4 the class' "objective" was to write an anthology book (we got them printed and bound and everything!) - at the end of the year my anthology was physically the thinnest compared to the ~7-8 others in the same class (this was Southeast Asia - there's a lot of overachievers with Tiger Moms there, I remember one girl's book was almost an inch thick - I didn't know how that was humanely possible for a 10 year-old...).
When I was in primary and secondary school I did have IQ tests and other cognitive ability tests done by the educational psychologist assigned to me and I had results varying from 125 to 135 - but I don't put too much weight on them. There was an ASD test for face-reading ability that had a question I got wrong because I said there was nothing abnormal about a drawing of a face without eyelashes (what...). What's weird is every time I've taken the GRE (for Masters degree course applications) I've scored 97%+ percentile in the language questions... but only 75%+ in the quant sections - but that's because I keep on missing some quant questions because I run out of time. I know I can apply for extra time but ETS' instructions on their website for getting extra-time are contradictory and confusing.
In secondary-school in the UK for our GCSE qualifications the year-group's subject classes were split into ability groups and I was in the highest ability group in all of the subjects (but that really isn't saying much though). My second sixth-form did have a G&T program but no-one told me about it and I didn't think to apply - I imagine those who were in it had referrals from their feeder-schools whereas I was an individual student coming from a different Sixth Form (I was 18, everyone else around me was 16). I don't think I would have coped with the workload anyway - and I don't know what, exactly, if anything, a G&T program would have helped for A-Levels really - I only know one person who did 5 courses at A-Level and he wasn't in the G&T program.
Call me naive, but I was surprised to learn that G&T programs are still a thing in industry: When I got my first job after uni at Microsoft in Redmond I learned about their semi-secretive "HiPo" ("High-potential") employee program (think: SDEs and PMs who get fast-tracked for Director roles or executive positions beyond). To get in to it your skip-level will inform you in a private meeting, and you can't apply or ask to join (some joke that asking to join it instantly disqualifies you for life - or something).
Understanding the impact it has on adult life too is both fascinating and revealing.
I sadly can't recommend any English book on it, since all of those I read were recommended by French people, but I really insist; please do look into it :-)
Also, if you haven't already and are still open to seeing a psychologist, try finding one with some (preferably significant) experience with gifted adults :-)
Anyway, I apologize if I come of as too insistant or intrusive; it really is a personal and sensitive subject to me.
I might be an outlier but I feel the time of day when I can focus best and my general ability to perform tasks are independent of each other.
But there might also be some selection bias on HN. I have the feeling that in tech night owls outweigh early birds more than in other areas (maybe except for designers).
That's how my doctor described it to me anyway.
However, ADHD has many sub-categorizations.
ADHD: Mostly Inattentive
Is what used to be known as ADD. It is also the one that I have.
I used to attribute it to my horrible procrastination and how only in the night before a school or uni homework deadline I’d crank something out out of desperation, but it’s still an ongoing habit with my current day-job (er... night-job?) where deadlines aren’t really a thing (I love my boss) but I still feel most-productive in the evenings.
I’m ASD+ADHD[1] too - and I see similar things with other people I know with similar diagnoses. I believe they’re all related.
[1]: I really dislike the “ADHD” label because I’m not hyperactive in any way - or resemble stereotypical symptoms - if I could rename whatever it is I’ve got I’d call it “Motivation deficit” or similar.