In reponse to the original post, I don't think psychiatrists are really the ones who should be diagnosing ADHD. It is again my understanding that neuropsychologists should be the ones administering the tests and diagnosis, where psychiatrists will then manage the medications.
For myself, I was convinced that I had ADHD but went through neuropsychological testing. It turns out that the primary diagnosis is that I just have severe anxiety, which shares a lot of the symptoms but with completely different cause mechanisms.
I do have a free floating anxiety and that was something the meds helped with.
There are a lot of different causes / paradigms / regimes for ADHD that all get lumped into “ADHD”. Various therapies have hugely different effects on different types of ADHD.
And some ADHD drugs tend to have the same effects on non-ADHD people as they do on ADHD people.
My doc also told me that everyone is different, and not all medicine works for everyone and most medicine doesn't work at all for some people.
That's why I didn't put emphasis on medicine alone, but I do think it's important to seek for professional help in general. It was important for me, but now I understand it's not a silver bullet.
Thanks a lot for sharing, as it put some new perspective for me and others in this thread.
Also tried Straterra and had a bad reaction to that, so decided to just go without and manage. As a mid-40s adult I feel like I have all sorts of ways to cope that I didn't make consistent use of when younger, esp. using GTD tooling and taking copious notes to keep things on track.
Interestingly enough my 'normal' concentration off these drugs seems to be improved... as if they were training wheels.
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.
1: Though it's by no means easy to get ADHD people to exercise; most cardio is boring and there's also: "I'm behind on all of my work and personal projects, and you want me to set aside time for recreation?"
I had 3 different types that didn't work for me until I settled on an extended release dose of an aderall derivative.
0. This is how you treat ADHD based off science, Dr Russell Barkley part of 2012 Burnett Lecture: https://www.youtube.com/watch?v=_tpB-B8BXk0
For anyone else taking them both that may not have made the connection yet.
my blood pressure is high but I never tested it with specifically caffeine + Adderall, I just know it was high with Adderall.
This effect has been linked to polymorphisms on the A2a receptor gene (https://pubmed.ncbi.nlm.nih.gov/12825092/).
Edit: are low quality replies like this appreciated on HN or no?
> Empty comments can be ok if they're positive. There's nothing wrong with submitting a comment saying just "Thanks." What we especially discourage are comments that are empty and negative—comments that are mere name-calling."
Adderall and I were just not meant to ever go together. The first dosage had no effect other than a slightly elevated resting heartrate, and when the dose was increased, I was awake for 40 hours straight with mild psychosis.
OTOH, some people respond great to Addreall, and I've heard great things about Vyvanse (a prodrug for Adderall) for an all-day treatment for ADHD in those who do.
There are different meds for ADHD. One not working isn't indicative of all meds not working. Neither are they all $300/month.
The wrong meds can have no effect; be much worse than not taking at all; have benefits early in the day and then negatives later on; side-effects; etc.
They can also be expensive. I know several people for whom medication is coffee in the day, weed at night. Actually cheaper.
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.
I always wondered why the aggression - for me it was mainly directed to situations where I needed to advocate for myself (and would "slip" before medications) while being less aggressive overall
I’d also say right after the meds kicked in I would do something like get on hacker news and write a long post about how everyone should get their ADHD checked and how life changing meds are. That always felt like the meds talking to me.
Not that anyone shouldn’t try it. I’m glad I did, even though I decided it wasn’t for me, because otherwise I would be wondering how much better I would be on meds. Now I know for me it’s not much better.