I've been on Ritalin for a few weeks now, and the difference is remarkable. If this is how normal people feel most of the time, I don't know... I am both relieved to have a name for what was causing me problems, and also feel the need to grieve lost opportunities in life. It's a complex mix of emotions.

I didn't mean to reply and talk about myself, I actually wanted to ask (if you wanted to share), about what led you to the diagnosis at that age - what kinds of things were not working for you? What were you developing coping skills for?

It was a lot of shit, all at once, and it would be easy to shrug and say it would have been hard for anyone. But it was enough of a shock to my abilities that I was able to finally see that I just wasn't firing on all cylinders, even though I am otherwise intelligent and capable.

I have not lost my ability to focus. In fact, it's easier than ever. I've always been very distractible (another common symptom), and suddenly the kids making noise while playing next door, dogs barking, phones ringing no longer wreck the house of cards I'm holding in my mind while working on a problem. It's remarkable.

More that I gained “longer” focus.

Also, every time a post on here comes up about elaborate methods of achieving focus the comments are full of people typical-minding what really might actually be ADHD (the whole "everyone is like this right?" thing) and I'm just sitting there like.. maybe you should look into this it probably shouldn't be that hard.

Of course if you post that you get a bunch of replies from people who insist that, "no, actually, it's cell phones' fault" or that it's totally normal to absolutely loathe doing any mundane task.

That's why we invented shell scripts and cron!

On a serious note, what type of tasks would you consider mundane that you attribute to your ADHD to cause you to not want to do them that any non-ADHD person would also not have procrastination problems? Are these specific to work like filling out time sheets or other TPS reports? Home tasks like laundry/dishes/trash? All of the above? As a non-ADHD person, I hate all of the above tasks and only do them because it's part of adulting. Can't get paid without time sheets (this is my biggest hate). I'd rather do laundry (folding/ironing) than fill out time sheets. I have no rational explanation as it is a rather simple thing.

The difference is that buckling down and focusing... Don't always work for me. That's the fundamental difference that normal people don't get. That rather simple thing is basically the problem.

I'm pretty good at "adulting" and otherwise coping with my life but I hit roadblocks that other people sail by. I can do very complicated, difficult and tedious tasks but sometimes get stuck doing simple things like paying a parking ticket. I know how to do it. I know when it's due. I know I'll pay a penalty if I pay it late. I think about it all the time. But doing it is like lifting an incredibly heavy weight. Normal people don't feel the weight and think I'm lazy.

Mundane is probably not exactly the right word tbh, but it's hard to find the right word. I think it would be more accurate to describe it as things with a lot of upfront planning involved. If I can basically react my way through something to completion I can get into hyperfocus and just blaze through it.

A lot of the time the way I've gotten around this is to force it to be an emergency so I can't think about it too much. Either by leaving it to the last second or just convincing myself.

And that's a really common pattern you see in people before they get ADHD diagnoses.

The difference being my wife breaks down in tears every 3 months because she woke up to dishes in the sink _again_ and wasn't able to use her coffee cup because, though I meant to do them and said I would, I wound up not doing them.

That was the first 5 years of my marriage. Repeat for laundry. Repeat for trash.

For work I was on a list of 5 people out of 1000 person company who's names had gone all the way to the CEO for not filling out timesheets correctly.

I hope that makes the problem a little clearer for those who think "but everyone has trouble with that stuff"

I still got a degree in computer science but with that path I was put on... I’m now a photographer and still live in the same area I grew up in.

I realize you have more years “wasted” but I’ve had quite a bit of time to come to terms with all of that. I think it’s important to keep in mind we all have advantages and disadvantages in life, and chances are if you’re on here you’ve still had a pretty charmed life. You’re intelligent, in a developed country, etc. Most people don’t have that.

Interesting you mention that. I had a Bicycle->Car accident when I was 8 and I've always been told that's when a number of my behaviors started to change (and I became the black sheep of the family I am now.) I didn't get diagonsed with ADD until I was almost 30, but oddly enough my current care doctor also specializes in head trauma.

I’m guessing that’d be different now, though I don’t know what extra care they could give. At the very least I think my parents would have thought to tie my sudden energy and worse grades to what happened.

do you have some examples? i suspect the majority of mine are the former

When I think about that, it's kind of mind blowing.

For that matter, it is also crazy that we don't start giving children coffee at younger ages to help focus — since there are no known negative effects. It's just a cultural trope that it stunts growth, etc. It took ages before people recognized that there weren't really health downsides to coffee. We are so trained to expect that "every up has a down" — but what if that's just a relic of Calvinism and we are inhibiting our full potential because of misplaced fears?

I'll argue with the assumption that there is zero long term psychobiological consequences to exogenous psychostimulants (I personally don't buy this, but let's assume it was true). Increasing focus and task salience is only one of the many factors constitutive of human potential. They never give the answer for what to focus on, or whether a task is worth it or not, and rob the person of the opportunity for developing frustration tolerance. They turn people into indiscriminate doing machines, with little wisdom to guide it. Makes one think if prescription amphetamines being as widespread among plumbers as software engineers is truly a coincidence.

I will argue this is because our bioeconomics, our not wanting to do things is also part of our wisdom machinery. Having used for half a decade myself, I can spot some collogues who are on amphetamines; unnecessarily assertive, obsessed with orderliness of code, constantly in need of refactoring, huge bias for action with diminished wisdom to temper it (Well, also pees a lot.). There is a reason they are not being used by fighter pilots anymore because they can get too cocky and make decisions that kill their own.

No wonder everything looks like a good idea when your brain is swimming in dopamine and norepinephrine, but when everything looks like a good idea, how do you find what is the right thing to do in the medium/long term? Is that really the human potential? I would argue far from it. I think it is just enhancing the potential for a particular job description that requires you to sit on your bum all day and plumb boring stuff someone else tells you to.

I tick all the ADHD boxes but I managed to make it through college without meds so never should have started.

Psychiatry is broken and handing out prescription amphetamines to everyone who can’t focus is as bad as an idea as it initially sounds.

Someone in the same situation might feel much the opposite, but they also shouldn't use their experience to convince people that their attempt at treating a condition they have is inherently a bad choice.

Also you don't have to actually take the medications at all to get an ADHD testing battery. Then you'll know if you actually have ADHD or if you actually didn't. If you don't then your comments are a bit insensitive. Self-diagnoses of various medical conditions by the untrained is notoriously inaccurate.

If I got treatment for ADHD, maybe then I would be able to finally churn through all of my tasks and be a top performer in terms of closing stories. If I didn't pursue treatment, then maybe I continue to be unable to focus and completely burn out, resulting in the loss of my job. Maybe after that I pivot my career to where I'm doing something that I find to be more fulfilling. What's the better outcome?

It does help with "boring" tasks a little bit, in a sense, but they're still boring an uninteresting. It's not like I get a dopamine hit every time I do a piece of paperwork.

I usually describe it like this: for me ADHD sometimes makes things that are necessary for human life _really_ hard. Things like taking a shower in the morning or having breakfast, getting up to get water while working etc.

All these things take a toll on my day, I still do them but I feel like I'm doing something that I _absolutely_ don't want to do and at the end of the day I don't have any patient left for stuff that actually require my effort (e.g. listening to my wife when she's frustrated with me).

With medication I feel better about doing these necessary things so I can get to the end of the day without hating myself. That doesn't mean I'm gonna eat all the bullshit that gets thrown to me at work!

It's also not all roses, Ritalin is hard to manage, at least for me. I need to make a conscious effort to not devote too much of my attention to uninteresting details, etc. But it's not like it takes away your free will!

Focus and discipline is very useful when solutions to problems are known.

But put someone extremely methodical in charge of R&D and they will take a zillion years to explore a large search space. Meanwhile a neurotic will run around randomly and stumble upon all kinds of things on the map. The down side with the neurotic mind, is after a prospective gold mine is found and a lot of methodical, disciplined work is required to exploit it they flake out.

Now if you pair them up interesting things unfold.

We are quiet good at identifying people's strengths and weakness. But we spend a lot of time exploiting weakness and squandering strengths of people.

If only the opposite happened more.

With better and growing understanding of how different minds work, I think we will see people compensating for each others weaknesses more.

Without them, I actually have no problem focusing on certain things, but it's usually some unimportant problem or project that I become distracted by.

With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life. I become more attentive to my family, less irritated by distractions. And more a able to get important things done, like my taxes, that before would plague me.

I know some people seem to react to the meds by turning into a worker drone, But it doesn't do that to me. It does make me more excited to make progress and get things done right.

> With meds, I find it much easier to step back and get a clear picture of not just my work, but my whole life.

Executive function boost is non-negligible for sure, but it is still bound to operate in the short term.

Think your bioeconomics as a ledger, your energy levels as income and what you want to do as payments. Stimulants alter this ledger and as long as you can use them you will think you have a lot more income and you can sign up for more things to do. But do you really do have more income in the long term? Are you borrowing from your future income? Your future dopaminergic system? Your future neuroticism levels? I know the research is either missing or contested, but everything from evening crashes to need for increasing the dosage to long term dependence risk suggests that we are borrowing something from somewhere.

> I become more attentive to my family, less irritated by distractions.

Let me play the devil's advocate for a second: How do you know being more attentive to your family is the right thing? Maybe they are real assholes taking you for granted and getting irritated with them would make them get their act together and have a better chance in long term sustainable relationship. How do you know the distractions are not irritation worthy? Maybe they are things you need to get to the root of instead of enduring continuously.

I am exaggerating to make a point, and I'm sure you're mostly fine, but the danger is that thinking you have more "income" than you do will affect all your decisions in a way that accumulates and might not be long term sustainable. It can make you more conforming, and this will be praised by your family, boss, for the case with kids, their parents, but can we say with certainty that being more conforming all the time is really in one's best interest? Anger, irritation, anxiety, depression and even boredom, they are not there just as human failings but also as normal processes that can counter-balance over-exertion, over-exposure, weakly defended personal boundaries, meaninglessness, resentment.

Only way to know how continuous stimulant use is affecting you is to take a long break after multi-year use and evaluate where your life is, which for some people can be too late.

Now, if your goal is to swing for the fences and try to hit a home run, get to the top of your field, make a grand discovery, then ya, most of those kind of people are very non-coforming. But many are/were also very unhappy personally. In fact, many of the greatest outliers in our history suffered from manic depression or ADD or other mental issues.

Personally, I'm not swinging for the fences. I'm going to bunt if it means I have a much better chance of getting on base. Steve Jobs was very non-conforming. He was always very irritated and unpleasant with everyone around him. And sure, it seems to have had results. But I have no interest in becoming the next Steve Jobs if it means having what appears to have been an unhappy life with an early death.

Agreed! Not that this is going to make me stop taking it as needed because this is the society we live in (and I'm currently in college), but yeah. I was just talking to a parent of a 5th grader the other day and they were telling me all about how often their kid got in trouble at school (like I did in elementary school), and how she read up on the neuroscience and decided medicating was appropriate. They had me thus far, until they went on about how they didn't tell anyone at the school (it's beneficial t share this with teachers...) until the staff sent emails regarding the kid's improved behavior. One person even reached out and said "your kid hasn't been himself all week." SO I THOUGHT THE PARent was going to say that's what made them change the dose, BUT THEY DIDN'T!!! They took "your child hasn't been himself" as a COMPLIMENT. Something is very wrong here and it's not the parent's fault, it's our priorities in America regarding an outdated school system and long work week. Obedience is valued more than creativity. How are we supposed to improve with that mindset?

Amps turn you into a drone. Any perceived benefit is met with equal or greater detriment.

This is a null hypothesis that hasn't been refuted due to lack of evidence, and not an alternative hypothesis that has been proven by evidence, right?

I ask because I've been looking into this before, and from what I remember there was virtually no evidence on long term use in reasonable amounts.

(There is evidence on short term use in reasonable amounts, and long term use in unreasonable amounts, though.)

But if we accept a "nutrition science" level of evidence, then I'd say there is strong evidence showing the naturalistic longterm use of adhd meds is not dangerous. Especially considering our baysian prior: a person off the street would estimate far stronger negative effects of taking speed every single day.

In fact, adhd meds are correlated with healthier outcomes (of course, huge selection effects. Yes, eating kale will be associated with increased health, but it isn't causal)

Here is the best recent review that I know of: https://www.sciencedirect.com/science/article/pii/S0924977X1...

I'd love to know your take.

Yeah, I'd say p much impossible to untangle there without experimental evidence.

So my impression (yeah I have to admit it’s a study of size 1) is rather that caffeine is more dangerous than I thought.

Might as well, we already load them up with sugar, which does have known side-effects.

Sarcasm aside, maybe not a direct negative side effect, but if you suffer from poor sleep, drinking too much coffee or drinking coffee too late in the day has correlation and lack of sleep certainly has negative side-effect.

Personally, I'll keep my kids off coffee and other drugs until they're old enough to buy it themselves.

Wow, that is truly amazing. I'm glad to learn about that.

I notice a slight depression if I stop taking my ADHD meds for a few days (perhaps up to a week), but after that I'm back to my old (ADHD-driven) self. So in a sense, it's not addictive at all. The depression can tempt one to get back on it, but that's about it.

One side effect of Adderall though is ED, and it's pretty bad. I guess it depends on the person, but for me, the ED was quite bad. The ED does go away after getting off of it.

You definitely have a withdrawal from adderall. A few days (up to a week) is typical of most drug withdrawals.

The drugs for that are very easy to get these days - you can get a prescription online by taking a survey and the pills will be mailed to you without ever talking to a human.

It's probably a lot better in the long-run to use exercise as a cure for ADHD.

(Instead of slamming your system with drugs upon drugs. With one drug taken to mitigate another's side effects, etc.)

[1] Nespresso is 63mg (5g of coffee), "average" espresso is 77mg (7g of coffee) https://www.caffeineinformer.com/caffeine-content/espresso

[2] https://www.coca-cola.co.uk/ingredients/caffeine/the-caffein...

That said, most coffee shop serve double espressos as standard, so if you factor that in, it seems on average your cup of cappuccino might have four time the caffeine than a can of coke.

There's also a couple Nespresso (maybe Keurig and others, too) capsules with double the caffeine content: Kazaar and Napoli.

Ok

a) There are downsides to coffee. I know of a clinical neurologist (Steve Novella) who, when working with a patient with chronic headaches, will always ask "how much coffee do you drink." Always remember, if a "medicine" is doing good, it will have side effects. Period. Note that homeopaths simply love going on about how homeopathy doesn't have any side effects - spoiler, that's because it's not actually doing anything at a physical level.

b) Yes, daily use of stimulants in people with ADHD has been show to be pretty much ok. In fact, there are studies showing that kids who are not medicated are more likely to end up as substance abusers, largely because they're self medicating (remember, drug abuse is a symptom++). However, the kids who were treated with stimulants? No more risk than their neuro-typical peers.

c) The above says NOTHING WHATSOEVER about neuro-typicals taking it daily.

++ Source: my partner, currently doing her neuro-psych masters on addiction.

After that 10, I tried amphetamine which blew holes in my persistent brain fog. I went on Adderall and (as we've often heard) it changed my life.

I'm not advocating you change a regimen that is obviously working for you. I'm just adding another possible plotline to that same story.

“Aderall” is a mixture of dextroamphetamine and levoamphetamine, in a 3:1 ratio. Unlike some other drugs, both enantiomers have a therapeutic effect, but slightly different effects on the brain.

If one takes pure dextroamphetamine (“Dexedrine”) instead, that is also available as an inactive prodrug lisdexamfetamine (“Vyvanse”). This is different from an XR formulation, in that the drug is absorbed immediately, but lisdexamfetamine itself has no effect on the brain. However, enzymes in your red blood cells gradually convert the lisdexamfetamine to dexamphetamine. The advantage of this, is unlike an XR formulation, there should be no difference between different manufacturers.

Because it’s basically dextroamphetamine with a lysine molecule taped on, the psychoactive effects are really similar, but I’d describe it as cleaner if that makes sense. The “killer feature” of the enzymatic release is it’s basically a fixed timing, whereas with XR formulations of Adderall you have a 50/50 blend of immediate and delayed release 3:1 amphetamines. I believe you are correct, it’s not standardized. This, combined with the acids / bases both hurting overall blood levels (think grapefruit juice) means you just have a wildly inconsistent time over long term use of the medicine. For example, I’ve had pharmacies change generics on me without saying anything, I’ve had an inability to get my preferred generics, and I’ve had days where it’s felt like I took nothing at all. The worst are Nuvo and Mallinckrodt in my experience (IR 10mg 2x/day).

I’ve only been using Vyvanse for a week or so, but I can say it’s a marked improvement for me and the lack of a generic is a huge boon with regards to consistency.

Here in Australia, one month supply (30 tablets) costs 30 USD. The Australian government subsidises prescriptions for all Australian citizens and permanent residents. I believe the actual cost, prior to the subsidy, is around 85 USD. The government negotiates prices with the pharmaceutical manufacturers, and the prices it negotiates are generally less than those that US insurers pay. Manufacturers generally accept less revenue for the Australian market, since if they can't get it subsidised by the Australian government it becomes quite difficult to sell it here.

https://bnf.nice.org.uk/medicinal-forms/lisdexamfetamine-mes...

28 * 20mg = £54.62

28 * 30mg = £58.24

28 * 40mg = £62.82

28 * 50mg = £68.60

That sounds amazing. I can't even imagine that. I've just been diagnosed at 32 this year. Been on Ritalin for a few months but it doesn't seem to make a difference. Maybe 3% better. Things going bad still derails me significantly.

They're fairly conservative with meds in my neck of the woods, but I'm going to persist with my doctor to try them all to find what works.

The struggle to push through actually going through all the phone calls, emails and appointments necessary to get to that point is very un-ADHD friendly. So many times I considered just to give up and forget about it.

He’s 33 and has been in college since graduating high school and still doesn’t have a degree, and he’s actually quite intelligent.