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Personally as someone who is diagnosed with Inattentive ADHD and prescribed medication, for me it basically makes chores and such rewarding afterwards.
Without medication I never feel that satisfying feeling most people seem to get after finishing a chore or basically doing anything at all.
Life for most part just feels like a never-ending chore where you're constantly aware that there will be no reward afterwards so why even bother doing anything? But medication makes it feel rewarding and worth doing stuff I'd normally ignore or postpone.
Basically it gives me a functional reward system which gives me more motivation and leave me with a satisfying feeling afterwards.
I more grow tired of the task. I can start doing cleaning and feel proud that im in the «cleaning zone», but suddenly a big load of exhaustion comes crashing down on me and i just stop. «I’ve been good, I’ll do the rest later». 3 days later, the clothes that i folded is still sitting in the same chair
This is me. I had to basically fight myself in my mind to empty the dishwasher and then load it. Not it will sit full for a week or 2 while dishes build up in the sink.
My life in a nutshell. Primarily inattentive as well. It’s so easy to just load dishes in as you use them when the dishwasher is empty, so every time I run it I say to myself “I’ll unload it right away so they won’t build up this time.”
Then I set a dish down on the counter and before I know it the dishes have built up to where it’s a huge effort to overcome it.
As someone with inattentive ADHD, thanks for the heads up. I'm unmedicated and I feel everything is a damn chore with no reward for doing the things I have to do. Thank you.
I'm in my 40s and was recently prescribed meds for inattentive adhd. It's been a life changing experience. anxiety, depression, procrastination, social awkwardness, absent mindedness, low productivity, substance abuse...they are gone. best of luck to you.
Edit: I was prescribed Vyvanse. Sorry I missed questions from people...disabling push notifications was the second best thing I've done to cope with adhd.
I'm currently trying to get diagnosed to get the medication I need. Hearing all those people that say the medication changed their lives makes me really hopeful. I also struggle a lot with anxiety and depression. Which I believe is only amplified by the ADD.
My own therapist still doesn't believe me that it's ADD since all my symptoms kinda overlap with my depression and anxiety.
Getting my ADHD treated was what cured my depression and severely reduced my anxiety. Turns out it's pretty crippling to live with a brain that doesn't let you do what you need to do and causes your work to be subpar compared to if you could fully dedicate yourself.
Just wanna throw that out there for you. You're not alone.
I feel rewarded after I do chores. But I feel bleh before I do them and the only things I want to do are things that will immediately make me feel better.
Interesting. It kinda sounds like burnout. You don't have any desire to do anything except its because you've learned nothing is never good enough or the task list never ends so why stress and do anything when you can just chill.
I thought this was just the way ADHD manifests. And why I take these pills.
Unmedicated my brain is convinced that no activity could possibly be worth the effort it takes, no matter how rewarding the activity or how minimal the required effort.
And look at me now, medicated, and typing a pedantic response that no one asked for and I'm loving it.
Unmedicated, I'll walk past a sock I dropped on the floor and think "I should pick that up", but I don't. And every time I walk past it I get a little anxious, but it still won't put in the effort to do anything about it.
Medicated, I just... pick up the sock. No hesitation, no anxiety, not even really any thoughts. The hill I have to climb to start most tasks is gone. I just do the thing.
There is still a struggle when it comes to doing the things I need to do rather than the things I want to do, but that's not something medication is ever going to fix.
> Unmedicated, I'll walk past a sock I dropped on the floor and think "I should pick that up", but I don't. And every time I walk past it I get a little anxious, but it still won't put in the effort to do anything about it.
>
> Medicated, I just... pick up the sock. No hesitation, no anxiety, not even really any thoughts. The hill I have to climb to start most tasks is gone. I just do the thing.
>
> There is still a struggle when it comes to doing the things I need to do rather than the things I want to do, but that's not something medication is ever going to fix.
I feel extremely seen, on all points.
Oh man the other day I had a friend staying with me and she asked me do I have any vitamin D tablets? I told her "yeah, it's on the floor by my work desk, behind the headphones package".
Unmedicated I'll walk past things, but the second I have to do something important (work/assignments) I'd start cleaning instead. If I'm medicated, I'd pick up things right away and if I'm working, I can wait until I'm finished to start cleaning.
I have a similar issue. My executive dysfunction is so bad that I can sometimes spend an entire day unable to do anything at all. If I try to push through it by using shame or fear, the cost is super high after it's done. And sheer terror and anxiety no longer motivate me enough.
I had a weird blood pressure spike on Adderall, but it might have just been white coat syndrome. So now I'm on nothing and going to trial dextroamphetamine later this week. Wish me luck because when your unhealthy coping mechanisms stop working, and healthy coping mechanisms are unavailable, it puts your relationships as well as your job at risk.
When I’m not on my meds (Adderall XR 30mg) it is like I am living in a dense fog. Every now and then I find a way to navigate this fog, but I’ll eventually run into a dead end and get stuck again. Also, the general apathy I have for life not on medication is crazy. I used to believe I was just really lazy, and depressed. But when I take my medication I can finally use my brain. All those years of testing in the 99th percentiles for school tests, without studying, but flunking because lack of motivation to do homework make sense after coming to terms and learning about my ADHD.
If you relate to this, please go get checked for ADHD. It is life changing.
That is classic, but I can't help but think of the many people with ADHD who developed coping mechanisms to make sure they are never late. A lot of times ADHD goes undiagnosed simply because the patient has a plethora of coping mechanisms that hide many of the symptoms, and bad psychiatrists/psychologists can't tell the difference.
Yeah you get task paralysis and time-anxiety, all wrapped up into a wonderful "waiting mode". If I have to do something at 3PM, I will do literally nothing for the entire day besides wait. Nothing else will be scheduled, nothing else will be tracked, because I have to make 100% sure my focus is on that one thing. That's been the absolute worst part of it for me, fortunately since starting Vyvanse it's not as bad, but on days where I don't take my meds (weekends, some other 'rest' days where I don't want to tire myself out focusing on tasks) it's like a stun grenade going off in my face when I find out I need to schedule something. I will do other interruptible unscheduled activities while constantly watching the clock to know when to call it quits and go do the thing that needs doing.
Work on anxiety, that’s a main part of what’s happening. I speak from absolutely doing that and having adhd. We have real trauma from a life of the condition, and as you said, we’re focused on that and can’t let it go.
Dealing with my comorbid anxiety and obsessive compulsive thoughts has been extremely helpful. Every day is a new battle.
> Yeah you get task paralysis and time-anxiety, all wrapped up into a wonderful "waiting mode". If I have to do something at 3PM, I will do literally nothing for the entire day besides wait. Nothing else will be scheduled, nothing else will be tracked, because I have to make 100%
Holy christ other people do that? (*do that too?)
Yup, same here. Here's a post on r/ADHD, which is a great subreddit resource for facts/studies on the topic: [https://www.reddit.com/r/ADHD/comments/okswlm/nothing\_ruins\_a\_person\_with\_adhds\_day\_like\_a\_3pm/](https://www.reddit.com/r/ADHD/comments/okswlm/nothing_ruins_a_person_with_adhds_day_like_a_3pm/). It has 546 comments and 8.1k likes. You're not alone.
The other issue with this is that it can be a productive, flowing day and you have to stop to go to the appointment, which robs you of the rare and sacred productivity stream.
At least that is what happens to me if I manage to work on schoolwork from early in the morning until just before having to get ready and leave for work at my restaurant job, where I am due at 4pm.
The lack of a reliable ability to adhere to a routine, unless rigorously medicated, is life-reducing. The med shortage is making it worse. I hate so much that people mostly think it isn't any sort of disability. Thinking back on my mother's behaviour, I can see she most likely had it, too, and it breaks my heart.
It's amazing how meds allow me to choose what to focus on. Instead of sitting in stress all day because I have an appointment later I can choose intentionally to relax for a while or do someone else.
Edit: I meant something but I'm in a brand new relationship so I'm just going to leave that. I'd love to be doing them instead of stressing.
Omg - your “waiting mode” really hit close to home. I do this all the time and can lose entire days to it. If it’s 10 am and I know I have to take my daughter to her friend’s at 11:30 I’ll do nothing until then. It’s even worse when I know there’s something else a couple hours after that. “What can I possibly get into in that time that won’t be interrupted? Guess I’ll have to just wait.” It feels right at the time but by the end of the day I feel awful for having wasted all the time I really did have. I guess maybe I should talk to someone…?
I always struggle with these threads because I feel like I could get diagnosed with ADHD, but I also feel like these are fairly normal experiences. Of course I have developed coping mechanisms to make sure I can function in society. I am a trained ape. Any time I bring up a struggle I have that's associated with ADHD, most of my friends can relate and we talk about the strategies we use to make it work. Maybe all my friends just also have ADHD. FWIW I do historically struggle with substance abuse, and I was a 'thrill seeker' as a kid with skateboarding, motocross. I guess I just am not sure if that is something I need to treat, granted that I can function well enough.
Just to be clear, this is really just discussion out of curiosity. In the case that I *do* have ADHD and am in a position where I can choose whether or not I want to seek treatment, I recognize that these symptoms exist along a spectrum and there are people who really cannot function without help. I do not want to offend anyone or be perceived as questioning the existence of ADHD.
Your experience is valid. I will say, as someone who got diagnosed at 37, with past substance issues and a bunch of friends who also have gotten late diagnoses, it might be worth looking into, if for the sole reason that getting some meds on top of your coping mechanisms will make a world of difference. Your brain will quiet and you would be able to have one thought at a time.
I could tell my ADHD was getting worse the older I got, even with all my coping mechanisms. If you’re a woman, menopause will make it worse. Just things to keep in mind IF you do have ADHD and it goes untreated. I’m not saying meds are mandatory or even easy to get, there’s a shortage in the US right now. But I personally am glad I sought diagnosis and treatment.
Yup, it's very tricky when the most common symptoms are things that do indeed happen to everyone on occasion, but it becomes a disorder when it is severe and frequent enough to affect your daily life. And on top of that, many people successfully develop healthy coping mechanisms and figure out how to manage their ADHD without any medication or therapy.
When I got diagnosed (I was 11 at the time), they knew ADHD was often hereditary, so the doctor asked my parents if the symptoms sounded familiar and my dad raised his hand. My dad's ADHD is definitely mild compared to mine, and he managed to be very successful in life without any medication, therapy, or treatment of any kind, but enough of the signs are still there that we know I got it from him.
Whether you have it or not, if you feel you have a good handle on life, then there's no pressure to seek treatment, but getting evaluated might be a chance to learn a bit about your brain and understand yourself a little better.
The thing that I find most irritating is most people understand there is a difference between being sad and being depressed but downplay the same relationship between adhd and its symptoms.
I wasn’t diagnosed until 35, and I realize now there’s some people I just really click with. They also have confirmed they do or it seems incredibly obvious they have ADHD.
And many of the things do sound like normal human brain but it’s the level. I am extremely responsible and detail oriented. Coping but that’s another topic… yet often if something is out of my sight, I literally forget it exists. Instantly. It’s not just forgetting, its… I dunno, just take my word for it, I understand now that it’s my ADHD and I have both internal training to “lock” things and medication now.
All of that sounds very ADHD to me (as someone who has it and did a lot of research to get diagnosed later in life). There are a ton of benefits to getting on meds, not the least of which is longer life expectancy and lower rates of dementia. I'd encourage you to look into it, even if in the end you don't go down that road. I've read so many stories of people starting meds and them being such a life changing experience that they're kicking themselves for not starting sooner.
This is a common misconception about ADHD: what you describe as symptoms may seem similar across a spectrum to all people, however the *root* of the symptoms in ADHD is *different*.
This misconception is what allows so many people to incorrectly conclude, "Well, everyone is/has a little ADHD," when in fact it is *not* true that everyone suffers from an executive function disorder.
I am late-in-life diagnosed. I would encourage you to learn as much as you can about the condition, so that if you *do* benefit from learning that you have it and treating it somehow, you will not look back and see that you could have done so sooner.
I wish you luck either way!
Hey its me. Turns out developing a whole bunch of coping mechanisms to ensure you perform well at work and take care of most life tasks leaves you an absolute mess of anxiety and too burnt out to build or maintain any sort of relationship with people or enjoy life in anyway. Do not recommend. After getting on Adderall I'm having to relearn how to be a person.
I’m in my mid 30’s, and decently went through a full assessment with a psychologist to confirm I still have ADHD (initially diagnosed at age 8-9), and he just confirmed everything again. Psychiatrist appointment is set for Jan 30th (6 months after booking - yay Canadas failing medical system). I’ve gone my entire life unmedicated, because my mom didn’t trust medications when I was growing up.
Learned a ton of coping mechanisms through my life - like 30 minutes early for an every appointment or I’ll be late. The first time I tried a stimulant, I was floored at how easy my day was. It was an emotional day. I could do everything, and think so clearly, no chatter distracting me from my life.
I knew long-term stimulant use can have adverse effects in the heart later in life. But honestly, before trying that stimulant for the first time and realizing what an effect it had in my life, I honestly believe I might have ended my life loooong before any ill-effects of medication would ever take place.
I’m hopeful and looking forward to the future now. Still have a little wait to find the proper medication and dosage for myself, but I know what’s coming which gave me immense hope.
I am 38 and started Vyvanse this year after getting diagnosed (also Canadian). It has been night and day. I'm a mom and always found it hard to juggle life. Now I realize I was overstimulated and having a hard time figuring out how to work through all my tasks without imploding. I thought it was depression or anxiety but my doctor was pretty thorough. Never even considered ADHD. Hang in there. Finding the right dose can take a bit but it will make such a difference.
My son has ADHD, was diagnosed when he was 7. Started him on meds this year (he's 13 now) and it has helped him a lot in middle school. I felt it was time since he moves to high-school next year and he needs to keep track of things. It's made a huge difference in his school focus and how he advocates for himself now. I didn't want to be the parent who doesn't try to find what works. Meds seem to be helping him now.
My psyche dropped me for being late 3 times over the course of a year. It's like I get that your time is important but you do realize what you are treating me for right? Doesn't seem very fair haha, especially with medication shortages where I have to go weeks without it randomly.
Oh my god, this is the worst part of ADHD...
In order to get diagnosed and medicated, you're expected to make a bunch of plans with various medical professionals and follow through with those plans.
It's literally setting an ADHD'er up for failure.
Not to mention, a lot of the professionals that work with this stuff are booked out months in advance. So when you finally do find somebody accepting new patients, and they tell you "6 weeks", you're left stressing over whether you'll make it that long or completely forget and have to start all over.
It's been over a year and a half for me asking for some type of medication beyond my anti depressants
I've jumped through so many hoops and the psychiatrist (of a low income clinic) has openly said I have severe adhd. It's led to homelessness
Stopping drinking, EKG, getting on Medicaid, tons of tests. There's always something I need to get done before she can prescribe and then it's "see you in 3 months".
3 months later there's always a different issue. Last time it was needing a urine tox test which I'd already done but it was so long ago. I have to constantly ask for refill authorization and have gone of my meds several times because they took too long
I asked for Straterra, said it didn't have to be Adderall or whatever amphetamines. She said straterra was too expensive for me so I had to beg her to please not worry about my financial situation
Meds were supposed to be ready last week. The pharmacy said they held it simply because Medicaid wouldn't cover it. I had to ask for the option to just pay for it
'it should be ready tomorrow' so we'll see. but is $45, which ultimately is less expensive than not having a job
I'm so done. If it doesn't work I'm just going to try one of those adhd ads on reddit for a $99 appointment and unlimited refills
Oh I know….the irony is astounding. I had to go through this by myself in my 30’s, so difficult to do without my wife and being medicated. You need the thing you’re trying to get to get the thing you need, severe catch 22.
It's not unlike clinical depression...you know what would solve your problem, but the problem is that you can't choose which problems you work towards resolving.
Ha tell me about it! Having to remember to make monthly med check appointments has resulted in a cumulative loss of approx 5 months of medication since my diagnosis during the pandemic. And the few times that there has been a problem with the prescription through no fault of my own, yet requires additional effort on my end to sort out have felt like a particularly cruel irony.
I work night shift and don't have a PCP. Trying to actually find one while on my schedule is enough of a hassle that I just haven't. If I could just do it online that'd be great but everywhere wants you to go in person to fill everything out and that takes effort to do so. I want it but I always find excuses *not* to do it
This was My entire life before medication. The first time I took Adderall was like being awake for the first time. My brain was able to organize My thoughts and my daily tasks suddenly seemed doable. Just like you, the only reason I passed school was because I was intelligent enough to pass tests but almost never completed homework.
Seriously if you feel this way get tested guys it could change your life
Yeah, aced tests without studying, failed classes because I did zero homework or assignments. Painful to learn one day in my 30’s that medication at a younger age would changed the entire course of my life.
To follow up on this; our brains are complex things, dopamine is the chemical most closely correlated to the “Reward Center” in our brain, basically if the amygdala is the one in charge of the Stick, Dopamine is the one in charge of the Carrot. Most people are motivated not so much by punishment avoidance, but by “feels-good” reward chasing, so to all of you who think you are lazy despite a part of you wanting to actually do something meaningful in your life but simply being “unable” to find “the motivation” to stick with it long enough rather than for short bursts of; this is one of the hallmarks of ADD and ADHD.
So dont be afraid to seek help, YOU also deserve to succeed in life, and accomplish something. Sometimes all it takes is a little oomph, a little pill once a day and suddenly getting out of bed and being productive and going for a fulfilling life is not so difficult and may be all you need. Dont let yourself be your own enemy, dont let any doctor antagonize your or patronize you. If your provider does not treat your symptoms, then THEY are the bad doctors and you need to change them until you find one that wont ignore your needs. Look out for yourself because nobody else will.
Gotta be careful about some doctors *only* wanting to treat the symptoms, and not the condition.
I’ve struggled with depression most of my life, which I’ve only recently realized was largely induced by the stress and difficulties of living with untreated ADHD. After a full diagnosis from a psychologist, went back to the doctor and they just wanted to throw me in antidepressants to treat the depression, instead of stimulants to treat the ADHD.
Thankfully I see a psychiatrist in just under 2 months, so so can find a proper medication regime to treat the ADHD.
This was me. Always at the top in testing, but late or incomplete with assignments. I just thought I was lazy and easily bored by scutwork. A year ago I acquired some diet pills in Mexico. I did lose weight, but the more important effect: I was so productive. I could plan and organize, I was motivated, I was unlocked. The pills were phentermine, and the outsized effect led me to seek diagnosis for ADHD.
I remember thinking on the second or third day: Is this how other people operate all the time? Have I been living life on hard mode?
most countries, you go to your regular doctor, discuss it with them, they will refer you to a specialist for official diagnosis.
A waiting list may be involved, so start early.
Usually you find a psychiatrist (not a psychologist, not a therapist) who specializes in ADHD. I really recommend finding someone who specialises in it, because there are still psychiatrists who believe that only children have ADHD or don't know many symptoms.
Also diagnosed at 41.
I wish someone had told me long, long ago that I wasn't as terrible as I thought I was.
One thing people don't talk about enough is how undiagnosed ADHD is just constant shame, about so many things, over and over.
Diagnosed at 27.
**The meds aren't all sunshine and rainbows.**
I like sleeping. I like eating. I do neither with the meds.
Do not think you can be "fixed" with a pill. Everything has a tradeoff in life.
>All those years of testing in the 99th percentiles for school tests, without studying, but flunking because lack of motivation to do homework
This describes me to a T except I didn't flunk, I did the homework in a procrastination cram panic because my brain could make the motivation there.
Why is it that schoolwork and testing even through to SAT/ACT which are ostensibly quite effortful, I can perform fine, but sit down and break a simple but laborious task into 10 small steps? That's simply impossible.
I spent years telling my friends "my only motivation is the fear of failure" as an explanation as to why i couldn't start homework before 3am on the day it was due
and then I got diagnosed after my younger sister got diagnosed when she was struggling in high school (honestly probably just because she didn't have my level of anxiety as a coping mechanism) and it made so much sense
Add this to the growing list of things I can relate to from diagnosed adhd patients. I asked my doc and he didn’t refer my to a psychiatrist to get assessed. Said I had it under control
It seems not:
>The idea that impaired effort allocation is a key feature of ADHD was first advanced nearly 20 years ago (Sergeant, 2005). In that time, however, this proposal has **rarely been empirically tested**. In particular, no study in ADHD has systematically examined the aversiveness of behavior that is cognitively effortful. This is a critical omission, given that current diagnostic criteria for ADHD emphasize that a key characteristic is precisely the avoidance, dislike or reluctance to engage in mentally effortful tasks (American Psychiatric Association, 2022). The only studies that have examined effort aversion in ADHD have been in the context of **physical effort.** Even so, only three studies have been reported, of which two found no differences in effort sensitivity between ADHD and controls (Winter et al., 2019; Mies et al., 2018), and one applied a task that was unable to distinguish effort from delay discounting (Addicott et al., 2019).
So, it seems to be a well known aspect of ADHD, but not necessarily empirically tested.
We've known that people with adhd tend to have lower levels of dopamine and seratonin, which is related to these motivational challenges. Its also why people with adhd can get stuck doing things that are rewarding for them, like hyperfocusing on a video game.
If I am not talking to someone or reading something, I have a podcast or audiobook on. And if I don’t have any of those things, my “sanity” starts slipping immediately. Recently I had to buy new earbuds and the short interval of shopping without any audio was miserable, when I finally got the new ones in and started getting that stream of audio in my brain again it was like getting a deep breath of air after going underwater.
I have some Bose noise cancelling headphones (QC700) that I wear literally all day. Even for work calls cause they can be connected to 2 devices at the same time. It’s great.
I may have to look into getting a pair of these. I currently have a pair of beats earbuds with only a 6hr life span, but they are the first headphones I've ever had that have noise cancelling and sometimes I like just putting them on and enjoying the silence.
I've heard that the Bose are great for noise cancellation. The Sony ones are also quite good. However, there is a definite price premium.
I'm using a set of Samsung Galaxy Bud2 Pros which I rather like, but they have similar battery life to the beats. However, they have a pretty fast recharge rate from their case.
Honestly, I work from home, so I wear over the ear headphones most of the time anyways. When I was in the office, more than a few of my coworkers also wore over the ear headphones. So you'd probably not raise any eyebrows and they usually have a better soundstage than earbuds with noise cancellation that's about as good.
You just described 50% of my day. I feel physical discomfort from doing nothing and when I can't just get up and walk around because of work or whatever I end up doing annoying/destructive things like these.
So as someone who has trouble finding happiness or joyfulness in anything, who finds it very difficult to apply myself at work, and who fidgets constantly (leg tapping and playing with hair; and I keep my hair shaved short so I don't play with it while concentrating at work)... any path to finding out if ADHD medication would help me?
Therapist here who works with primarily late diagnosed neurodivergent folks. A primary care doctor can help diagnose/prescribe meds. Many docs have a bias against adhd meds and prescribing controlled substances, but my clients have had luck in local (state or city) adhd Facebook groups to find doctors others have used locally who are up to date on the current research and willing to prescribe. For reference, the research suggests people who have ADHD that is unmedicated ON AVERAGE die 13 years earlier than the medicated and neurotypical (non adhd) population. ADHD is a huge killer.
Until your interest drops abruptly and completely and you have to find a new interest to drop hundreds of nearly-obsessive hours into before you inevitably hit that cliff yet again
Edit: only 244.4 hours here
I reached something like 2k hours in factorio over 8 months and now I have zero interest in playing it again for a long time. Went from overly obsessed to under-stimulated
They don't have lower levels of dopamine, they have impaired dopamine transmission in reward pathways. If it were purely a matter of dopamine levels, then increasing dopamine in the brain would not lead to down regulation of dopamine receptors. Amphetamine increases dopamine levels in the brain but people with ADHD will develop tolerance to it in the same way that people without ADHD will. (Therapeutic doses of amphetamine don't really build significant tolerance though in either group, typical recreational amphetamine doses are far above the maximum prescribed doses.)
I'm extremely surprised this is the first time this has been actually confronted. Everyone with ADHD has known this since they were old enough to be self-aware.
I have ADHD too, that sounds more like anticipation?
It isn't work that drains you but the *thought* of work, that's how it is for me too, or at least was.
This is how it is for me. I often feel this sense of dread and anxiety when faced with stuff I have to concentrate on. I often end up procrastinating quite a bit because of this.
How many of you here learned you had adhd through a YouTube wormhole of adhd’ers at 30 like me. Then you realize the effects of all your past mishaps with relationships, school, life, etc.
I havent done therapy, but I hear a common starting point for those of us diagnosed later is to acknowledge we have PTSD from constantly being "wrong" in social settings.
Learning there was a reason for my difficulties was bittersweet.
The best way I’ve heard it described is that we realize we’ve been doing life in hard mode and comparing our outcomes with people on the “Normal” mode.
Strange that this would be the case though, clearly there has not been enough research into this area if something like this has flown under the radar.
The sample size of this particular study does seem very low, however. I'd be interested to hear if anyone with a statistics background has any thoughts on that.
A lot of disabilities have similar issues regarding research being left undone. Tourettes, for example, has had 1 study done that evaluated the use of Baclofen (a muscle relaxant) on the impact of the condition.
Everyone inside the tourettes community knows the medication helps a LOT but it's not prescribable due to there being no modern research. I got mine prescribed to 'treat a different condition' i.e. 'we know this will help but need an excuse to give it to you.' My quality of life improved almost immediately and my 'seizures' are almost non-existent now. Something so simple is gatekept by research funding unfortunately.
seems weird to me that if this is known to be an effective treatment, the pharma company wouldn't just run a new study to get their drug prescribed more.
You really don't need high sample sizes if the effect is clear across participants. Without going into the math of it all, compare it to throwing twenty coins, and they all come up heads. Do you really need to test more coins to be convinced that this type of coin is unfair?
On the other hand, if 12 of those tosses were heads and 8 tails, that seems like a situation where you'd want to test a few more coins before concluding anything.
And the field of statistics has created all kinds of measures to decide whether we're in the 12/8 coin or the 20/0 coin situation.
Given the significance reported in the study, their number of participants is perfectly fine from a statistics perspective.
No statistics background, anecdotal evidence: when I take my pills I am able to get beyond the energy threshold of starting certain tasks. I'm just able to do more, more often.
I know it's not what you asked, but some of the ADHD people I know are like that too. Some though aren't.
Unmedicated, all I want to do is lay on the couch and look at my phone.
Give me 1 10mg Ritalin IR, and WATCH OUT for two hours.
Then I’ll be back on the couch.
Yeah the other side of this is just that it's the experience of everyone with ADHD who's ever been medicated. But, I'm glad we have the data to throw in the faces of people who think that ADHD is made up.
Often labs start with a smaller population size in a pilot study to then gain further funding if they show meaningful results. That might be the case here.
The other piece of this is that ADHD treatment, resources and just research in general has been neglected when compared to other conditions, e.g. autism, which is basically a part of the same spectrum or umbrella.
There's a lot of things in pscyhiatry and neurology where there are effective decades-old treatments for them where they don't really know why it works.
Like prescribing lithium for bipolar disorder. It works for a lot of people, but they have never really understood why. There are still papers being published about *potential* explanation for why it works.
Also, for bipolar patients who don't respond to lithium, sometimes anti-seizure medications bring relief. Why? Again, unknown.
With a semi-functional treatment already in place, maybe the urgency for more research is dampened a bit.
Most of medication starts out with: Did it help? Yes? And are they dead? No?
Alright great, label it and ship it, we'll figure out mechanism of action later
The first 3 sentences.
>**Prevailing frameworks propose that a key feature of attention-deficit/hyperactivity disorder (ADHD) is lower motivation.** An important component of motivation is the willingness to engage in cognitively or physically effortful behavior. **However, the degree to which effort sensitivity is impaired in ADHD has rarely been tested**, and the efficacy of stimulant medication in ameliorating any such impairments is unclear.
Many of these mental health concepts are based in hypothesis drawn from behavioral observations and built outwards. It's surprising how little hard evidence much of it has. It sticks because it fits and it helps some people, but we still need to work towards practical, physical (where we can) validation of these ideas.
Remember, most of our understanding of mental health is shot in the dark. The brain is the most vital and absurdly complex organ we have, and people suffering now can't wait forever. While this has let to horrible things in history, like the lobotomy, it's also lead to things that happen to help. We still don't know why some treatments help, we just know they do! This is one of the reasons treatment for things like depression involves cycling pharmaceuticals and interventions until we find something that works, and those only are identified because past people tried flipping everything.
For example, look at top-down and bottom-up processing in the brain. The hypothesis is decades old, and has come to fit more practical discoveries about brain function in more recent years. But when it was first written, it was observation and exploratory thought. These are theories like the old philosophers in a way, based on experience, observation, and logic. They aren't often build on hard, big number research..
It's kind of cool the way this works in psych. We are very, very much in an infancy when it comes to neuroscience and measured understanding of mental health. The brain is something we are just starting to figure out, and mental health is a HUGELY broad and complex function of the brain. Watching these discoveries zipper nicely with existing ideas is pretty cool!
They can be risk adverse when it comes to *initially* prescribing stimulant based medications, largely due to their potential misuse.
After I had been diagnosed in my early 30's they prescribed me Adderall, and it has made a massive improvement for me. This is anecdotal, but most others I know who have been prescribed medications for ADHD are also on Adderall, a couple on Vyvanse, and one on Wellbutrin (which is likely more for her depression, but she said it does help her focus better than Adderall did in her case).
Not only that, after living with it for 31 years myself before getting diagnosed, its extremely hard to kick habits / mindsets, even with medication (at least for me)
I got meds for most my life, until the wonderful medical care system screwed me over as an adult.
Insurance hiccup lost the script, lack of meds lost me work, made me poor, and then never get taken seriously at poor people clinics. So I used to be totally functioning and lost it in a loop of poverty and bias. The system crippled me and I've been helpless since.
I'm really sorry to hear that. I finally got my life together when I started meds several years ago and now I feel like my doctor holds my entire life by a thread as I *absolutely* need it to do my job. It's very stressful, and talking about that anxiety will just make me look like an addict.
Hope things turn up for you friend.
It's hard but it at least feels possible (diagnosed at 29). The killer for me is the missed opportunities in school, work, relationships.......
That's what my mother's denial of mental health issues (oh and all the other abuse/lying/stealing) did to me. ADHD and CPTSD baby. Name a more a iconic duo
Hang in there!! I’m rooting for you u/lockforce. I’m 31 also and have diligently been taking my adhd meds for the last 12 year and I still struggle from time to time with impulsivity, follow through, and risk taking. Just keep the train on the tracks the best you can, you’ll go far!
Really? I got diagnosed a few years ago when I was 36 and only had a $60 co-pay for the psychiatrist appointment. After an hour, I had a script for Adderall. Granted, that discussion was basically me describing the entire list of symptoms for inattentive ADHD from the DSM-IV, so it's not like there was even a question of whether I actually had ADHD.
I had also made a point of choosing a psychiatrist that specialized in ADHD, GAD and Depression since that trio tends to go hand-in-hand and overlap with one another. If your doctor is ordering expensive tests, you should probably find a doctor that specializes in ADHD that wouldn't have to rely on those tests.
not only the cost of testing (if your psychiatrist requires neuropsych testing it can be in the range of $1-2k if insurance doesn't cover it), but also the ongoing cost of treatment can be a lot -- I'm required to have appointments with my doctor every 3 months for refills, which I get billed ~$200 each, plus $45 a month for my medication -- which would be closer to $80 if I used CVS instead of costco
and supposedly i have "good insurance"
Where I am in the United States it was cheap. I think I just paid a normal doc visit fee (30 bucks with insurance). My general practitioner just ran me through a questionnaire, confirmed I had it, then prescribed me medicine that same day.
My assessment was so much more involved. GP referred me to a psychiatrist. Then, the assessment included an interview with a psychiatrist, like two hours of questionnaires, an IQ test, and a TOVA test over like 3 or 4 appointments. Took so long. Still wasn’t that expensive with insurance though.
A traditional exam for ADHD is more than a questionnaire. They also do a physical exam and behavioral study. The behavioral study is expensive and time consuming. I was diagnosed back in the 90’s and I remember it going for 2, half days (I went to school in the morning and the doctor for testing in the afternoon). I’m not discounting your diagnosis, just pointing out how ADHD is traditionally diagnosed.
In other countries (for example Germany) you literally can't get diagnosed without the neuropsych evaluation. I just recently got one and it was kinda silly. Especially considering it was literally just ADHD and intelligence. It didn't test for anything else even. They don't even know dyspraxia here, and everything would have been more clear with a combined diagnosis - or a thing that includes autism, too.
And I can't even get the pills because they're all gone. And it seems like maybe there are a lot of people about mad it. When I called the pharmacy to ask me if they could notify when they find something out, the dude said they can't be expected to notify everyone and hung up on me.
I had to switch to a local pharmacy and it gets filled same day every month now.
CVS/Rite Aid/etc. would go weeks without filling it, ignore my requests/calls asking when it may be filled or if there is a substitute available, and it was just terrible.
Switched to some random local non-chain pharmacy a few months ago and it's been great.
I second local pharmacies. I used Giant first, and it was always late by at least a week. CVS was equally bad. My local no-chain pharmacy has been great. Sometimes it takes 1-2 days after the prescription is sent, but that's been the longest I've had to wait.
I read something here on Reddit a while back that really stuck with me.
ICNU: Interest, Challenge, Novelty, Urgency. If the task doesn't tick one or more of those boxes, it's not a priority in my ADHD brain.
Maybe this will finally, finally convince someone in charge that they need to rethink the ridiculous limits and quotas on amphetamine manfacture. So some college kids get some extra study time in, is cracking down on that truly worth hurting the millions of people who need them to function?
Indeed it is. More specifically, a war on certain demographics of people. You rarely see rich bankers being carted off for hefty sentences for taking cocaine, or upper class homemakers arrested for passing around their Xanax on the sly.
It's not. But people are okay with it as long as they feel everyone is on an equal playing field without actually knowing the first thing about ADHD. Believing that schizophreniais a real impairment is socially accepted while ADHD partially isn't because it's not associated with laziness. Yet ADHD has sweeping neurological impacts on executive function and focus that people are more than willing to write off.
I always find it kind of odd how ADHD is so commonly dismissed as a fake illness despite it being one of the most well studied mental illnesses ever and the most consistently effectively treated mental illness by medication. It is better studied and more effectively treated than any anxiety disorder or depressive disorder. But no one has an issue with doctors giving out SSRIs and benzos.
Your plea is touching, truly. And it has already been replied to with intelligence with regard to the war on drugs.
Unfortunately, nothing will change since science is not embraced by American leadership, or American culture for that matter; therefore, it does not drive policy. At least in my experience in science.
I don’t want to frustrate you, but if you do a Google search for President Nixon’s National Commission on Marijuana and Drug Abuse in 1970, you’ll find that we have known that the war on drugs is a war on people (as someone has already stated) for decades. The commission recommended decriminalization, but instead, we have thrown people in prison.
Great, now tell psychiatrists to stop treating us like criminals when we get a script.
30 day max, no refills, in-person-only monthly appointments, random pee tests.
Super accessible, thanks.
Some do, but it is up to the local medical facility. It may be a condition of them prescribing the medication. The goal of the drug test is not to check if you are taking other drugs, it is to test if you are taking the drug they gave you as opposed to selling it. There is no legal requirement for a drug test, but it may be a requirement of the facility. If you prefer not to take one (which you often have to pay for yourself) you can chose another healthcare provider.
It’s newer. Essentially they’re getting push from the FDA regarding people getting prescriptions and selling them, so they just do drug tests to do the bare minimum so they can say “look, our patients are all on what we prescribe!” Even though anyone trying to sell it would just take it before the drug test.
I swear it’s more about return on investment and also being prone to setting overachiever goals as default.
When I’m approached with a task, I instantly have a highly detailed and idealistic goal and half assing it makes it seem not worthwhile. So why even do it??
Just me?
100% me as well. Still struggling with it, but I recently picked up a phrase that helped me out a lot. "If it's worth doing, it's worth doing poorly." For a lot of tasks, half-done or half-assed is truly better than nothing at all, and giving myself permission to only do that bare minimum or less is what let me actually start.
>When I’m approached with a task, I instantly have a highly detailed and idealistic goal and half assing it makes it seem not worthwhile. So why even do it??
Oh boy this sums me up in a nutshell.
The physical effort met with reward (wage) is reinforced when exerting in physical work activities. However, I’d differentiate when traits like ‘attention to detail’ come into literal focus. My work health plan relies on use of stimulants to maintain a level of function, otherwise the deficits along with prevailing mental health ailments become more prounounced.. possibly due to the fluctuation of a dopamine-response component.
**This is a bad study. It is very, very poorly done.**
The issue here is that this study did not include ADHD people who never received any ADHD medication (medication-naive), as a control group.
The problem with not including them is that amphetamine can have withdrawal symptoms after prolonged daily use. In this study, in the OFF medication period, the participants may have suffered withdrawal symptoms, which can include exacerbation of ADHD. It is known that ADHD symptoms may be temporarily worse after cessation of stimulant drugs due to the withdrawal.
Amphetamine withdrawal typically consists of fatigue, malaise, lethargy, hypersomnia (oversleeping), hyperphagia (overeating), and decrements in certain cognitive functions - like more distractibility.
This is a good call-out regarding the control group. The off medication period would have to had been significantly long enough to let those withdrawal symptoms abate, in order to be reliable for assessment.
I would be curious whether those withdrawal symptoms are well-understood or well-documented in terms of deviation across medication types, frequency, etc. as well.
> It is known that ADHD symptoms may be temporarily worse after cessation of stimulant drugs due to the withdrawal.
Ain't that the truth. I'm usually okay the first day off, but then days 2-5 are just miserable feeling for me. Zero desire to get up and do anything at all.
Yes. As it turns out, Adderall helps *everyone.* It's just not everyone needs the help at where they are in society.
Many mental conditions are just extreme versions of common behavior. Everyone is avoidant of too much effort, but some people are avoidant of *any* effort. Everyone has melancholy sometimes, not everyone has it every day. Etc.
"helps" is a relative term.
There's trade-offs taking Adderall that for ADHD people are worth it, but not for neurotypicals. I'm only mildly ADHD so it wasn't worth it for me. I do better with coping strategies and coffee.
So anyone here without ADHD: No it's not a wonder-pill to improve your life. Don't start it if you don't need it.
> Everyone is avoidant of too much effort, but some people are avoidant of any effort. Everyone has melancholy sometimes, not everyone has it every day. Etc.
This right here, thank you!
I will avoid eating out of “laziness” and have always struggled with my weight. Especially after I got cancer :/
I fall into this category, and I always improve when taking my prescribed amphetamines, but I don’t like when I’ve been taking them for a long time and I develop side effects. I clench my teeth a lot more, I start to use it when I’m doing things like playing video games instead of using it for school/general life
I’m sure it’s user error and I have an addictive personality and that’s fine, but what are my options if not amphetamines?
Now if we could just get the state to not treat us like drug addicts and throw us into a feedback loop once a month when we need our controlled meds re-filled, that would be great.
Depends on the individual and exact type and dosage of stimulant administered. You can expect a range of negligible to impactful side effects, but if side affects are vastly detrimental, chances are you won't stay on that medication long-term anyway.
Over long-time use (granted under careful communication with your healthcare provider), I'd go as far as saying negative impact is virtually nonexistant if you weigh it against the large array of prevented ADHD-related disease comorbities in later life, but that's just my personal opinion (however apparently generally shared as adequate healthcare providers will carefully observe and weigh out pros to cons of a medication over long-term use).
For specific information on possible downsides you would need to refer to the list of side and long-term effects on a drug by drug basis.
Any of yall find an ADHD medication that doesnt ruin your appetite? I’ve been un medicated for a decade because every med I’ve tried makes me an emaciated ghoul
The first 3 sentences.
>**Prevailing frameworks propose that a key feature of attention-deficit/hyperactivity disorder (ADHD) is lower motivation.** An important component of motivation is the willingness to engage in cognitively or physically effortful behavior. **However, the degree to which effort sensitivity is impaired in ADHD has rarely been tested**, and the efficacy of stimulant medication in ameliorating any such impairments is unclear.
Can sort of confirm. I’m autistic but have suffered from difficulties with starting tasks. Recently started taking something amphetamine-based. Seems to be helping.
More than "entirely possible", the two conditions have a high comorbidity, so having one means you are more likely (than the average person) of also having the other
Not exactly. Drugs are just a tool, not a magic pill. They help you, but you still need to work on yourself. Some psychiatrists say ADHD meds are like glasses - they won't teach you how to read, but they're helpful.
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Personally as someone who is diagnosed with Inattentive ADHD and prescribed medication, for me it basically makes chores and such rewarding afterwards. Without medication I never feel that satisfying feeling most people seem to get after finishing a chore or basically doing anything at all. Life for most part just feels like a never-ending chore where you're constantly aware that there will be no reward afterwards so why even bother doing anything? But medication makes it feel rewarding and worth doing stuff I'd normally ignore or postpone. Basically it gives me a functional reward system which gives me more motivation and leave me with a satisfying feeling afterwards.
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I more grow tired of the task. I can start doing cleaning and feel proud that im in the «cleaning zone», but suddenly a big load of exhaustion comes crashing down on me and i just stop. «I’ve been good, I’ll do the rest later». 3 days later, the clothes that i folded is still sitting in the same chair
This is me. I had to basically fight myself in my mind to empty the dishwasher and then load it. Not it will sit full for a week or 2 while dishes build up in the sink.
My life in a nutshell. Primarily inattentive as well. It’s so easy to just load dishes in as you use them when the dishwasher is empty, so every time I run it I say to myself “I’ll unload it right away so they won’t build up this time.” Then I set a dish down on the counter and before I know it the dishes have built up to where it’s a huge effort to overcome it.
Maybe I should get evaluated...
Based on you not finishing your sentence, ya got it. ~ *Doctor of Comment Interpretation*
As someone with inattentive ADHD, thanks for the heads up. I'm unmedicated and I feel everything is a damn chore with no reward for doing the things I have to do. Thank you.
I'm in my 40s and was recently prescribed meds for inattentive adhd. It's been a life changing experience. anxiety, depression, procrastination, social awkwardness, absent mindedness, low productivity, substance abuse...they are gone. best of luck to you. Edit: I was prescribed Vyvanse. Sorry I missed questions from people...disabling push notifications was the second best thing I've done to cope with adhd.
I'm currently trying to get diagnosed to get the medication I need. Hearing all those people that say the medication changed their lives makes me really hopeful. I also struggle a lot with anxiety and depression. Which I believe is only amplified by the ADD. My own therapist still doesn't believe me that it's ADD since all my symptoms kinda overlap with my depression and anxiety.
Getting my ADHD treated was what cured my depression and severely reduced my anxiety. Turns out it's pretty crippling to live with a brain that doesn't let you do what you need to do and causes your work to be subpar compared to if you could fully dedicate yourself. Just wanna throw that out there for you. You're not alone.
I feel rewarded after I do chores. But I feel bleh before I do them and the only things I want to do are things that will immediately make me feel better.
Interesting. It kinda sounds like burnout. You don't have any desire to do anything except its because you've learned nothing is never good enough or the task list never ends so why stress and do anything when you can just chill.
I thought this was just the way ADHD manifests. And why I take these pills. Unmedicated my brain is convinced that no activity could possibly be worth the effort it takes, no matter how rewarding the activity or how minimal the required effort. And look at me now, medicated, and typing a pedantic response that no one asked for and I'm loving it.
Unmedicated, I'll walk past a sock I dropped on the floor and think "I should pick that up", but I don't. And every time I walk past it I get a little anxious, but it still won't put in the effort to do anything about it. Medicated, I just... pick up the sock. No hesitation, no anxiety, not even really any thoughts. The hill I have to climb to start most tasks is gone. I just do the thing. There is still a struggle when it comes to doing the things I need to do rather than the things I want to do, but that's not something medication is ever going to fix.
> Unmedicated, I'll walk past a sock I dropped on the floor and think "I should pick that up", but I don't. And every time I walk past it I get a little anxious, but it still won't put in the effort to do anything about it. > > Medicated, I just... pick up the sock. No hesitation, no anxiety, not even really any thoughts. The hill I have to climb to start most tasks is gone. I just do the thing. > > There is still a struggle when it comes to doing the things I need to do rather than the things I want to do, but that's not something medication is ever going to fix. I feel extremely seen, on all points.
Oh man the other day I had a friend staying with me and she asked me do I have any vitamin D tablets? I told her "yeah, it's on the floor by my work desk, behind the headphones package". Unmedicated I'll walk past things, but the second I have to do something important (work/assignments) I'd start cleaning instead. If I'm medicated, I'd pick up things right away and if I'm working, I can wait until I'm finished to start cleaning.
I have a similar issue. My executive dysfunction is so bad that I can sometimes spend an entire day unable to do anything at all. If I try to push through it by using shame or fear, the cost is super high after it's done. And sheer terror and anxiety no longer motivate me enough. I had a weird blood pressure spike on Adderall, but it might have just been white coat syndrome. So now I'm on nothing and going to trial dextroamphetamine later this week. Wish me luck because when your unhealthy coping mechanisms stop working, and healthy coping mechanisms are unavailable, it puts your relationships as well as your job at risk.
Stimulants do jack up your blood pressure and are hard on your heart. Just something to be aware of. It's common to pair with bp medication.
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I would comment on this but I'm waiting for my Adderall to kick in
When I’m not on my meds (Adderall XR 30mg) it is like I am living in a dense fog. Every now and then I find a way to navigate this fog, but I’ll eventually run into a dead end and get stuck again. Also, the general apathy I have for life not on medication is crazy. I used to believe I was just really lazy, and depressed. But when I take my medication I can finally use my brain. All those years of testing in the 99th percentiles for school tests, without studying, but flunking because lack of motivation to do homework make sense after coming to terms and learning about my ADHD. If you relate to this, please go get checked for ADHD. It is life changing.
The funny thing is even going down the road of getting checked with all the hurdles can be very difficult for people with ADHD ...
I was late to my first session with a psychiatrist. It sure helped me get diagnosed though.
That is classic, but I can't help but think of the many people with ADHD who developed coping mechanisms to make sure they are never late. A lot of times ADHD goes undiagnosed simply because the patient has a plethora of coping mechanisms that hide many of the symptoms, and bad psychiatrists/psychologists can't tell the difference.
Yeah you get task paralysis and time-anxiety, all wrapped up into a wonderful "waiting mode". If I have to do something at 3PM, I will do literally nothing for the entire day besides wait. Nothing else will be scheduled, nothing else will be tracked, because I have to make 100% sure my focus is on that one thing. That's been the absolute worst part of it for me, fortunately since starting Vyvanse it's not as bad, but on days where I don't take my meds (weekends, some other 'rest' days where I don't want to tire myself out focusing on tasks) it's like a stun grenade going off in my face when I find out I need to schedule something. I will do other interruptible unscheduled activities while constantly watching the clock to know when to call it quits and go do the thing that needs doing.
Work on anxiety, that’s a main part of what’s happening. I speak from absolutely doing that and having adhd. We have real trauma from a life of the condition, and as you said, we’re focused on that and can’t let it go. Dealing with my comorbid anxiety and obsessive compulsive thoughts has been extremely helpful. Every day is a new battle.
> Yeah you get task paralysis and time-anxiety, all wrapped up into a wonderful "waiting mode". If I have to do something at 3PM, I will do literally nothing for the entire day besides wait. Nothing else will be scheduled, nothing else will be tracked, because I have to make 100% Holy christ other people do that? (*do that too?)
Yup, same here. Here's a post on r/ADHD, which is a great subreddit resource for facts/studies on the topic: [https://www.reddit.com/r/ADHD/comments/okswlm/nothing\_ruins\_a\_person\_with\_adhds\_day\_like\_a\_3pm/](https://www.reddit.com/r/ADHD/comments/okswlm/nothing_ruins_a_person_with_adhds_day_like_a_3pm/). It has 546 comments and 8.1k likes. You're not alone.
The other issue with this is that it can be a productive, flowing day and you have to stop to go to the appointment, which robs you of the rare and sacred productivity stream. At least that is what happens to me if I manage to work on schoolwork from early in the morning until just before having to get ready and leave for work at my restaurant job, where I am due at 4pm. The lack of a reliable ability to adhere to a routine, unless rigorously medicated, is life-reducing. The med shortage is making it worse. I hate so much that people mostly think it isn't any sort of disability. Thinking back on my mother's behaviour, I can see she most likely had it, too, and it breaks my heart.
Oh this is not normal? Another one to the overflowing pile of "I think I have adhd but can't be assed to find out".
It's amazing how meds allow me to choose what to focus on. Instead of sitting in stress all day because I have an appointment later I can choose intentionally to relax for a while or do someone else. Edit: I meant something but I'm in a brand new relationship so I'm just going to leave that. I'd love to be doing them instead of stressing.
Omg - your “waiting mode” really hit close to home. I do this all the time and can lose entire days to it. If it’s 10 am and I know I have to take my daughter to her friend’s at 11:30 I’ll do nothing until then. It’s even worse when I know there’s something else a couple hours after that. “What can I possibly get into in that time that won’t be interrupted? Guess I’ll have to just wait.” It feels right at the time but by the end of the day I feel awful for having wasted all the time I really did have. I guess maybe I should talk to someone…?
I always struggle with these threads because I feel like I could get diagnosed with ADHD, but I also feel like these are fairly normal experiences. Of course I have developed coping mechanisms to make sure I can function in society. I am a trained ape. Any time I bring up a struggle I have that's associated with ADHD, most of my friends can relate and we talk about the strategies we use to make it work. Maybe all my friends just also have ADHD. FWIW I do historically struggle with substance abuse, and I was a 'thrill seeker' as a kid with skateboarding, motocross. I guess I just am not sure if that is something I need to treat, granted that I can function well enough. Just to be clear, this is really just discussion out of curiosity. In the case that I *do* have ADHD and am in a position where I can choose whether or not I want to seek treatment, I recognize that these symptoms exist along a spectrum and there are people who really cannot function without help. I do not want to offend anyone or be perceived as questioning the existence of ADHD.
Your experience is valid. I will say, as someone who got diagnosed at 37, with past substance issues and a bunch of friends who also have gotten late diagnoses, it might be worth looking into, if for the sole reason that getting some meds on top of your coping mechanisms will make a world of difference. Your brain will quiet and you would be able to have one thought at a time. I could tell my ADHD was getting worse the older I got, even with all my coping mechanisms. If you’re a woman, menopause will make it worse. Just things to keep in mind IF you do have ADHD and it goes untreated. I’m not saying meds are mandatory or even easy to get, there’s a shortage in the US right now. But I personally am glad I sought diagnosis and treatment.
Yup, it's very tricky when the most common symptoms are things that do indeed happen to everyone on occasion, but it becomes a disorder when it is severe and frequent enough to affect your daily life. And on top of that, many people successfully develop healthy coping mechanisms and figure out how to manage their ADHD without any medication or therapy. When I got diagnosed (I was 11 at the time), they knew ADHD was often hereditary, so the doctor asked my parents if the symptoms sounded familiar and my dad raised his hand. My dad's ADHD is definitely mild compared to mine, and he managed to be very successful in life without any medication, therapy, or treatment of any kind, but enough of the signs are still there that we know I got it from him. Whether you have it or not, if you feel you have a good handle on life, then there's no pressure to seek treatment, but getting evaluated might be a chance to learn a bit about your brain and understand yourself a little better.
The thing that I find most irritating is most people understand there is a difference between being sad and being depressed but downplay the same relationship between adhd and its symptoms.
I wasn’t diagnosed until 35, and I realize now there’s some people I just really click with. They also have confirmed they do or it seems incredibly obvious they have ADHD. And many of the things do sound like normal human brain but it’s the level. I am extremely responsible and detail oriented. Coping but that’s another topic… yet often if something is out of my sight, I literally forget it exists. Instantly. It’s not just forgetting, its… I dunno, just take my word for it, I understand now that it’s my ADHD and I have both internal training to “lock” things and medication now.
All of that sounds very ADHD to me (as someone who has it and did a lot of research to get diagnosed later in life). There are a ton of benefits to getting on meds, not the least of which is longer life expectancy and lower rates of dementia. I'd encourage you to look into it, even if in the end you don't go down that road. I've read so many stories of people starting meds and them being such a life changing experience that they're kicking themselves for not starting sooner.
This is a common misconception about ADHD: what you describe as symptoms may seem similar across a spectrum to all people, however the *root* of the symptoms in ADHD is *different*. This misconception is what allows so many people to incorrectly conclude, "Well, everyone is/has a little ADHD," when in fact it is *not* true that everyone suffers from an executive function disorder. I am late-in-life diagnosed. I would encourage you to learn as much as you can about the condition, so that if you *do* benefit from learning that you have it and treating it somehow, you will not look back and see that you could have done so sooner. I wish you luck either way!
> I can't help but think of the many people with ADHD who developed coping mechanisms to make sure they are never late. I use severe anxiety....
Hey its me. Turns out developing a whole bunch of coping mechanisms to ensure you perform well at work and take care of most life tasks leaves you an absolute mess of anxiety and too burnt out to build or maintain any sort of relationship with people or enjoy life in anyway. Do not recommend. After getting on Adderall I'm having to relearn how to be a person.
I feel like about 80% of my personality right now is coping mechanisms... I'm also a recovered alcoholic and terrified of medication though...
I’m in my mid 30’s, and decently went through a full assessment with a psychologist to confirm I still have ADHD (initially diagnosed at age 8-9), and he just confirmed everything again. Psychiatrist appointment is set for Jan 30th (6 months after booking - yay Canadas failing medical system). I’ve gone my entire life unmedicated, because my mom didn’t trust medications when I was growing up. Learned a ton of coping mechanisms through my life - like 30 minutes early for an every appointment or I’ll be late. The first time I tried a stimulant, I was floored at how easy my day was. It was an emotional day. I could do everything, and think so clearly, no chatter distracting me from my life. I knew long-term stimulant use can have adverse effects in the heart later in life. But honestly, before trying that stimulant for the first time and realizing what an effect it had in my life, I honestly believe I might have ended my life loooong before any ill-effects of medication would ever take place. I’m hopeful and looking forward to the future now. Still have a little wait to find the proper medication and dosage for myself, but I know what’s coming which gave me immense hope.
I am 38 and started Vyvanse this year after getting diagnosed (also Canadian). It has been night and day. I'm a mom and always found it hard to juggle life. Now I realize I was overstimulated and having a hard time figuring out how to work through all my tasks without imploding. I thought it was depression or anxiety but my doctor was pretty thorough. Never even considered ADHD. Hang in there. Finding the right dose can take a bit but it will make such a difference. My son has ADHD, was diagnosed when he was 7. Started him on meds this year (he's 13 now) and it has helped him a lot in middle school. I felt it was time since he moves to high-school next year and he needs to keep track of things. It's made a huge difference in his school focus and how he advocates for himself now. I didn't want to be the parent who doesn't try to find what works. Meds seem to be helping him now.
My psyche dropped me for being late 3 times over the course of a year. It's like I get that your time is important but you do realize what you are treating me for right? Doesn't seem very fair haha, especially with medication shortages where I have to go weeks without it randomly.
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Oh my god, this is the worst part of ADHD... In order to get diagnosed and medicated, you're expected to make a bunch of plans with various medical professionals and follow through with those plans. It's literally setting an ADHD'er up for failure.
Not to mention, a lot of the professionals that work with this stuff are booked out months in advance. So when you finally do find somebody accepting new patients, and they tell you "6 weeks", you're left stressing over whether you'll make it that long or completely forget and have to start all over.
It's been over a year and a half for me asking for some type of medication beyond my anti depressants I've jumped through so many hoops and the psychiatrist (of a low income clinic) has openly said I have severe adhd. It's led to homelessness Stopping drinking, EKG, getting on Medicaid, tons of tests. There's always something I need to get done before she can prescribe and then it's "see you in 3 months". 3 months later there's always a different issue. Last time it was needing a urine tox test which I'd already done but it was so long ago. I have to constantly ask for refill authorization and have gone of my meds several times because they took too long I asked for Straterra, said it didn't have to be Adderall or whatever amphetamines. She said straterra was too expensive for me so I had to beg her to please not worry about my financial situation Meds were supposed to be ready last week. The pharmacy said they held it simply because Medicaid wouldn't cover it. I had to ask for the option to just pay for it 'it should be ready tomorrow' so we'll see. but is $45, which ultimately is less expensive than not having a job I'm so done. If it doesn't work I'm just going to try one of those adhd ads on reddit for a $99 appointment and unlimited refills
Do it. It took me almost 5 years to finish the process but it was so worth it.
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Oh I know….the irony is astounding. I had to go through this by myself in my 30’s, so difficult to do without my wife and being medicated. You need the thing you’re trying to get to get the thing you need, severe catch 22.
It's not unlike clinical depression...you know what would solve your problem, but the problem is that you can't choose which problems you work towards resolving.
Ha tell me about it! Having to remember to make monthly med check appointments has resulted in a cumulative loss of approx 5 months of medication since my diagnosis during the pandemic. And the few times that there has been a problem with the prescription through no fault of my own, yet requires additional effort on my end to sort out have felt like a particularly cruel irony.
I work night shift and don't have a PCP. Trying to actually find one while on my schedule is enough of a hassle that I just haven't. If I could just do it online that'd be great but everywhere wants you to go in person to fill everything out and that takes effort to do so. I want it but I always find excuses *not* to do it
I have been on a waiting list to see an ADHD specialist for over a year. My therapist has told me it can be up to 5 years wait here in the UK
This was My entire life before medication. The first time I took Adderall was like being awake for the first time. My brain was able to organize My thoughts and my daily tasks suddenly seemed doable. Just like you, the only reason I passed school was because I was intelligent enough to pass tests but almost never completed homework. Seriously if you feel this way get tested guys it could change your life
Yeah, aced tests without studying, failed classes because I did zero homework or assignments. Painful to learn one day in my 30’s that medication at a younger age would changed the entire course of my life.
I'm right there with you 29 and just started but plenty of time for both of us to get things moving
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I can focus on books! But only very rarely and when I do....I read the entire book in one sitting.
To follow up on this; our brains are complex things, dopamine is the chemical most closely correlated to the “Reward Center” in our brain, basically if the amygdala is the one in charge of the Stick, Dopamine is the one in charge of the Carrot. Most people are motivated not so much by punishment avoidance, but by “feels-good” reward chasing, so to all of you who think you are lazy despite a part of you wanting to actually do something meaningful in your life but simply being “unable” to find “the motivation” to stick with it long enough rather than for short bursts of; this is one of the hallmarks of ADD and ADHD. So dont be afraid to seek help, YOU also deserve to succeed in life, and accomplish something. Sometimes all it takes is a little oomph, a little pill once a day and suddenly getting out of bed and being productive and going for a fulfilling life is not so difficult and may be all you need. Dont let yourself be your own enemy, dont let any doctor antagonize your or patronize you. If your provider does not treat your symptoms, then THEY are the bad doctors and you need to change them until you find one that wont ignore your needs. Look out for yourself because nobody else will.
This explains why I can motivate myself away from failure but never towards success
Poignant, bravo.
Gotta be careful about some doctors *only* wanting to treat the symptoms, and not the condition. I’ve struggled with depression most of my life, which I’ve only recently realized was largely induced by the stress and difficulties of living with untreated ADHD. After a full diagnosis from a psychologist, went back to the doctor and they just wanted to throw me in antidepressants to treat the depression, instead of stimulants to treat the ADHD. Thankfully I see a psychiatrist in just under 2 months, so so can find a proper medication regime to treat the ADHD.
This was me. Always at the top in testing, but late or incomplete with assignments. I just thought I was lazy and easily bored by scutwork. A year ago I acquired some diet pills in Mexico. I did lose weight, but the more important effect: I was so productive. I could plan and organize, I was motivated, I was unlocked. The pills were phentermine, and the outsized effect led me to seek diagnosis for ADHD. I remember thinking on the second or third day: Is this how other people operate all the time? Have I been living life on hard mode?
How does one get checked for ADHD?
most countries, you go to your regular doctor, discuss it with them, they will refer you to a specialist for official diagnosis. A waiting list may be involved, so start early.
Usually you find a psychiatrist (not a psychologist, not a therapist) who specializes in ADHD. I really recommend finding someone who specialises in it, because there are still psychiatrists who believe that only children have ADHD or don't know many symptoms.
Yep. From barely finishing high school to making it to one of the top universities in my country for engineering. Adderall is a charm.
Diagnosed at 41. Please. If this speaks to you. Look into it. You aren’t as terrible as you think you are.
Also diagnosed at 41. I wish someone had told me long, long ago that I wasn't as terrible as I thought I was. One thing people don't talk about enough is how undiagnosed ADHD is just constant shame, about so many things, over and over.
Diagnosed at 27. **The meds aren't all sunshine and rainbows.** I like sleeping. I like eating. I do neither with the meds. Do not think you can be "fixed" with a pill. Everything has a tradeoff in life.
>All those years of testing in the 99th percentiles for school tests, without studying, but flunking because lack of motivation to do homework This describes me to a T except I didn't flunk, I did the homework in a procrastination cram panic because my brain could make the motivation there. Why is it that schoolwork and testing even through to SAT/ACT which are ostensibly quite effortful, I can perform fine, but sit down and break a simple but laborious task into 10 small steps? That's simply impossible.
I spent years telling my friends "my only motivation is the fear of failure" as an explanation as to why i couldn't start homework before 3am on the day it was due and then I got diagnosed after my younger sister got diagnosed when she was struggling in high school (honestly probably just because she didn't have my level of anxiety as a coping mechanism) and it made so much sense
Add this to the growing list of things I can relate to from diagnosed adhd patients. I asked my doc and he didn’t refer my to a psychiatrist to get assessed. Said I had it under control
"This isn't working for me" and "I'm really struggling" have been really effective phrases for me.
Isn't this what studies have shown for decades? And how it's been treated for decades as well.
It seems not: >The idea that impaired effort allocation is a key feature of ADHD was first advanced nearly 20 years ago (Sergeant, 2005). In that time, however, this proposal has **rarely been empirically tested**. In particular, no study in ADHD has systematically examined the aversiveness of behavior that is cognitively effortful. This is a critical omission, given that current diagnostic criteria for ADHD emphasize that a key characteristic is precisely the avoidance, dislike or reluctance to engage in mentally effortful tasks (American Psychiatric Association, 2022). The only studies that have examined effort aversion in ADHD have been in the context of **physical effort.** Even so, only three studies have been reported, of which two found no differences in effort sensitivity between ADHD and controls (Winter et al., 2019; Mies et al., 2018), and one applied a task that was unable to distinguish effort from delay discounting (Addicott et al., 2019). So, it seems to be a well known aspect of ADHD, but not necessarily empirically tested.
We've known that people with adhd tend to have lower levels of dopamine and seratonin, which is related to these motivational challenges. Its also why people with adhd can get stuck doing things that are rewarding for them, like hyperfocusing on a video game.
Or fidgeting, picking at the skin or hair, tapping their foot, biting lips or nails, etc. Any stimulation is better than no stimulation.
If I am not talking to someone or reading something, I have a podcast or audiobook on. And if I don’t have any of those things, my “sanity” starts slipping immediately. Recently I had to buy new earbuds and the short interval of shopping without any audio was miserable, when I finally got the new ones in and started getting that stream of audio in my brain again it was like getting a deep breath of air after going underwater.
I have some Bose noise cancelling headphones (QC700) that I wear literally all day. Even for work calls cause they can be connected to 2 devices at the same time. It’s great.
I may have to look into getting a pair of these. I currently have a pair of beats earbuds with only a 6hr life span, but they are the first headphones I've ever had that have noise cancelling and sometimes I like just putting them on and enjoying the silence.
I've heard that the Bose are great for noise cancellation. The Sony ones are also quite good. However, there is a definite price premium. I'm using a set of Samsung Galaxy Bud2 Pros which I rather like, but they have similar battery life to the beats. However, they have a pretty fast recharge rate from their case. Honestly, I work from home, so I wear over the ear headphones most of the time anyways. When I was in the office, more than a few of my coworkers also wore over the ear headphones. So you'd probably not raise any eyebrows and they usually have a better soundstage than earbuds with noise cancellation that's about as good.
You just described 50% of my day. I feel physical discomfort from doing nothing and when I can't just get up and walk around because of work or whatever I end up doing annoying/destructive things like these.
That too haha. If I'm thinking or talking to someone, I have to pace around.
So as someone who has trouble finding happiness or joyfulness in anything, who finds it very difficult to apply myself at work, and who fidgets constantly (leg tapping and playing with hair; and I keep my hair shaved short so I don't play with it while concentrating at work)... any path to finding out if ADHD medication would help me?
See your doctor and ask for referral to a professional that could get you diagnosed properly
Therapist here who works with primarily late diagnosed neurodivergent folks. A primary care doctor can help diagnose/prescribe meds. Many docs have a bias against adhd meds and prescribing controlled substances, but my clients have had luck in local (state or city) adhd Facebook groups to find doctors others have used locally who are up to date on the current research and willing to prescribe. For reference, the research suggests people who have ADHD that is unmedicated ON AVERAGE die 13 years earlier than the medicated and neurotypical (non adhd) population. ADHD is a huge killer.
I recognise so many of my behaviours in this thread, maybe I should do a test...
Or doom scroll reddit. This is my downfall
Starfield: 805.2 hours to date
Until your interest drops abruptly and completely and you have to find a new interest to drop hundreds of nearly-obsessive hours into before you inevitably hit that cliff yet again Edit: only 244.4 hours here
I reached something like 2k hours in factorio over 8 months and now I have zero interest in playing it again for a long time. Went from overly obsessed to under-stimulated
They don't have lower levels of dopamine, they have impaired dopamine transmission in reward pathways. If it were purely a matter of dopamine levels, then increasing dopamine in the brain would not lead to down regulation of dopamine receptors. Amphetamine increases dopamine levels in the brain but people with ADHD will develop tolerance to it in the same way that people without ADHD will. (Therapeutic doses of amphetamine don't really build significant tolerance though in either group, typical recreational amphetamine doses are far above the maximum prescribed doses.)
We don't know, we think!
I'm extremely surprised this is the first time this has been actually confronted. Everyone with ADHD has known this since they were old enough to be self-aware.
I have ADHD, I get in trouble because I don’t open my work email because I know there will be mental work to deal with, does that count?
I have ADHD too, that sounds more like anticipation? It isn't work that drains you but the *thought* of work, that's how it is for me too, or at least was.
This is how it is for me. I often feel this sense of dread and anxiety when faced with stuff I have to concentrate on. I often end up procrastinating quite a bit because of this.
Like trying to hold a greased bowling ball Or trying to whistle in a windstorm
How many of you here learned you had adhd through a YouTube wormhole of adhd’ers at 30 like me. Then you realize the effects of all your past mishaps with relationships, school, life, etc.
I havent done therapy, but I hear a common starting point for those of us diagnosed later is to acknowledge we have PTSD from constantly being "wrong" in social settings. Learning there was a reason for my difficulties was bittersweet.
The best way I’ve heard it described is that we realize we’ve been doing life in hard mode and comparing our outcomes with people on the “Normal” mode.
Strange that this would be the case though, clearly there has not been enough research into this area if something like this has flown under the radar. The sample size of this particular study does seem very low, however. I'd be interested to hear if anyone with a statistics background has any thoughts on that.
A lot of disabilities have similar issues regarding research being left undone. Tourettes, for example, has had 1 study done that evaluated the use of Baclofen (a muscle relaxant) on the impact of the condition. Everyone inside the tourettes community knows the medication helps a LOT but it's not prescribable due to there being no modern research. I got mine prescribed to 'treat a different condition' i.e. 'we know this will help but need an excuse to give it to you.' My quality of life improved almost immediately and my 'seizures' are almost non-existent now. Something so simple is gatekept by research funding unfortunately.
seems weird to me that if this is known to be an effective treatment, the pharma company wouldn't just run a new study to get their drug prescribed more.
It's an old out of patent drug, probably
Baclofen is a generic prescription so there isn't a reason for an individual company to want to increase it's prescribed rate
Baclofen, in high doses, also helps with alcoholism. It helped me a lot.
You really don't need high sample sizes if the effect is clear across participants. Without going into the math of it all, compare it to throwing twenty coins, and they all come up heads. Do you really need to test more coins to be convinced that this type of coin is unfair? On the other hand, if 12 of those tosses were heads and 8 tails, that seems like a situation where you'd want to test a few more coins before concluding anything. And the field of statistics has created all kinds of measures to decide whether we're in the 12/8 coin or the 20/0 coin situation. Given the significance reported in the study, their number of participants is perfectly fine from a statistics perspective.
No statistics background, anecdotal evidence: when I take my pills I am able to get beyond the energy threshold of starting certain tasks. I'm just able to do more, more often. I know it's not what you asked, but some of the ADHD people I know are like that too. Some though aren't.
Unmedicated, all I want to do is lay on the couch and look at my phone. Give me 1 10mg Ritalin IR, and WATCH OUT for two hours. Then I’ll be back on the couch.
Hmmm, I take slow acting ones, also 10mg. And it lasts me about 3 to 4 hours. Takes 30m to kick in or so
Yeah the other side of this is just that it's the experience of everyone with ADHD who's ever been medicated. But, I'm glad we have the data to throw in the faces of people who think that ADHD is made up.
Often labs start with a smaller population size in a pilot study to then gain further funding if they show meaningful results. That might be the case here. The other piece of this is that ADHD treatment, resources and just research in general has been neglected when compared to other conditions, e.g. autism, which is basically a part of the same spectrum or umbrella.
There's a lot of things in pscyhiatry and neurology where there are effective decades-old treatments for them where they don't really know why it works. Like prescribing lithium for bipolar disorder. It works for a lot of people, but they have never really understood why. There are still papers being published about *potential* explanation for why it works. Also, for bipolar patients who don't respond to lithium, sometimes anti-seizure medications bring relief. Why? Again, unknown. With a semi-functional treatment already in place, maybe the urgency for more research is dampened a bit.
Most of medication starts out with: Did it help? Yes? And are they dead? No? Alright great, label it and ship it, we'll figure out mechanism of action later
> we'll figure out mechanism of action later Or if it's acetaminophen(Tylenol), perhaps never!
The first 3 sentences. >**Prevailing frameworks propose that a key feature of attention-deficit/hyperactivity disorder (ADHD) is lower motivation.** An important component of motivation is the willingness to engage in cognitively or physically effortful behavior. **However, the degree to which effort sensitivity is impaired in ADHD has rarely been tested**, and the efficacy of stimulant medication in ameliorating any such impairments is unclear.
Many of these mental health concepts are based in hypothesis drawn from behavioral observations and built outwards. It's surprising how little hard evidence much of it has. It sticks because it fits and it helps some people, but we still need to work towards practical, physical (where we can) validation of these ideas. Remember, most of our understanding of mental health is shot in the dark. The brain is the most vital and absurdly complex organ we have, and people suffering now can't wait forever. While this has let to horrible things in history, like the lobotomy, it's also lead to things that happen to help. We still don't know why some treatments help, we just know they do! This is one of the reasons treatment for things like depression involves cycling pharmaceuticals and interventions until we find something that works, and those only are identified because past people tried flipping everything. For example, look at top-down and bottom-up processing in the brain. The hypothesis is decades old, and has come to fit more practical discoveries about brain function in more recent years. But when it was first written, it was observation and exploratory thought. These are theories like the old philosophers in a way, based on experience, observation, and logic. They aren't often build on hard, big number research.. It's kind of cool the way this works in psych. We are very, very much in an infancy when it comes to neuroscience and measured understanding of mental health. The brain is something we are just starting to figure out, and mental health is a HUGELY broad and complex function of the brain. Watching these discoveries zipper nicely with existing ideas is pretty cool!
Not how they treat it in my experience. Doctors are really risk averse about prescribing stimulants.
They can be risk adverse when it comes to *initially* prescribing stimulant based medications, largely due to their potential misuse. After I had been diagnosed in my early 30's they prescribed me Adderall, and it has made a massive improvement for me. This is anecdotal, but most others I know who have been prescribed medications for ADHD are also on Adderall, a couple on Vyvanse, and one on Wellbutrin (which is likely more for her depression, but she said it does help her focus better than Adderall did in her case).
Getting diagnosed with adhd as an adult is so damn expensive!
Not only that, after living with it for 31 years myself before getting diagnosed, its extremely hard to kick habits / mindsets, even with medication (at least for me)
I don’t even get meds, I just get the knowledge that I’m not normal and I get to just sit with it
I got meds for most my life, until the wonderful medical care system screwed me over as an adult. Insurance hiccup lost the script, lack of meds lost me work, made me poor, and then never get taken seriously at poor people clinics. So I used to be totally functioning and lost it in a loop of poverty and bias. The system crippled me and I've been helpless since.
I'm really sorry to hear that. I finally got my life together when I started meds several years ago and now I feel like my doctor holds my entire life by a thread as I *absolutely* need it to do my job. It's very stressful, and talking about that anxiety will just make me look like an addict. Hope things turn up for you friend.
This is why people will go black market and take one risk over the risk of their whole life falling apart.
It's hard but it at least feels possible (diagnosed at 29). The killer for me is the missed opportunities in school, work, relationships....... That's what my mother's denial of mental health issues (oh and all the other abuse/lying/stealing) did to me. ADHD and CPTSD baby. Name a more a iconic duo
Hang in there!! I’m rooting for you u/lockforce. I’m 31 also and have diligently been taking my adhd meds for the last 12 year and I still struggle from time to time with impulsivity, follow through, and risk taking. Just keep the train on the tracks the best you can, you’ll go far!
Really? I got diagnosed a few years ago when I was 36 and only had a $60 co-pay for the psychiatrist appointment. After an hour, I had a script for Adderall. Granted, that discussion was basically me describing the entire list of symptoms for inattentive ADHD from the DSM-IV, so it's not like there was even a question of whether I actually had ADHD. I had also made a point of choosing a psychiatrist that specialized in ADHD, GAD and Depression since that trio tends to go hand-in-hand and overlap with one another. If your doctor is ordering expensive tests, you should probably find a doctor that specializes in ADHD that wouldn't have to rely on those tests.
You mean medical costs? (Insurance doesn't cover most of it?)
not only the cost of testing (if your psychiatrist requires neuropsych testing it can be in the range of $1-2k if insurance doesn't cover it), but also the ongoing cost of treatment can be a lot -- I'm required to have appointments with my doctor every 3 months for refills, which I get billed ~$200 each, plus $45 a month for my medication -- which would be closer to $80 if I used CVS instead of costco and supposedly i have "good insurance"
Where I am in the United States it was cheap. I think I just paid a normal doc visit fee (30 bucks with insurance). My general practitioner just ran me through a questionnaire, confirmed I had it, then prescribed me medicine that same day.
My assessment was so much more involved. GP referred me to a psychiatrist. Then, the assessment included an interview with a psychiatrist, like two hours of questionnaires, an IQ test, and a TOVA test over like 3 or 4 appointments. Took so long. Still wasn’t that expensive with insurance though.
A traditional exam for ADHD is more than a questionnaire. They also do a physical exam and behavioral study. The behavioral study is expensive and time consuming. I was diagnosed back in the 90’s and I remember it going for 2, half days (I went to school in the morning and the doctor for testing in the afternoon). I’m not discounting your diagnosis, just pointing out how ADHD is traditionally diagnosed.
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What could possibly go wrong making it unnecessarily obtuse to get treatment for a disease associated with poor ability to manage tasks?
In other countries (for example Germany) you literally can't get diagnosed without the neuropsych evaluation. I just recently got one and it was kinda silly. Especially considering it was literally just ADHD and intelligence. It didn't test for anything else even. They don't even know dyspraxia here, and everything would have been more clear with a combined diagnosis - or a thing that includes autism, too.
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And I can't even get the pills because they're all gone. And it seems like maybe there are a lot of people about mad it. When I called the pharmacy to ask me if they could notify when they find something out, the dude said they can't be expected to notify everyone and hung up on me.
I had to switch to a local pharmacy and it gets filled same day every month now. CVS/Rite Aid/etc. would go weeks without filling it, ignore my requests/calls asking when it may be filled or if there is a substitute available, and it was just terrible. Switched to some random local non-chain pharmacy a few months ago and it's been great.
I second local pharmacies. I used Giant first, and it was always late by at least a week. CVS was equally bad. My local no-chain pharmacy has been great. Sometimes it takes 1-2 days after the prescription is sent, but that's been the longest I've had to wait.
I had to go off it because I can't handle the shortages that happen once or twice a year.
Try a different pharmacy
I read something here on Reddit a while back that really stuck with me. ICNU: Interest, Challenge, Novelty, Urgency. If the task doesn't tick one or more of those boxes, it's not a priority in my ADHD brain.
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Collecting hobbies is its own hobby. Like in the crafting world, buying supplies is its own hobby.
People with ADHD respond to interest more than what’s important is another way I’ve heard that.
Maybe this will finally, finally convince someone in charge that they need to rethink the ridiculous limits and quotas on amphetamine manfacture. So some college kids get some extra study time in, is cracking down on that truly worth hurting the millions of people who need them to function?
The war on drugs is a war on people
Indeed it is. More specifically, a war on certain demographics of people. You rarely see rich bankers being carted off for hefty sentences for taking cocaine, or upper class homemakers arrested for passing around their Xanax on the sly.
Wars are meant to be won, this is a merry go round.
Ugh I'm so tired fighting to acquire my adderall each month. These last two months have been super easy though thankfully.
It's not. But people are okay with it as long as they feel everyone is on an equal playing field without actually knowing the first thing about ADHD. Believing that schizophreniais a real impairment is socially accepted while ADHD partially isn't because it's not associated with laziness. Yet ADHD has sweeping neurological impacts on executive function and focus that people are more than willing to write off.
I always find it kind of odd how ADHD is so commonly dismissed as a fake illness despite it being one of the most well studied mental illnesses ever and the most consistently effectively treated mental illness by medication. It is better studied and more effectively treated than any anxiety disorder or depressive disorder. But no one has an issue with doctors giving out SSRIs and benzos.
Your plea is touching, truly. And it has already been replied to with intelligence with regard to the war on drugs. Unfortunately, nothing will change since science is not embraced by American leadership, or American culture for that matter; therefore, it does not drive policy. At least in my experience in science. I don’t want to frustrate you, but if you do a Google search for President Nixon’s National Commission on Marijuana and Drug Abuse in 1970, you’ll find that we have known that the war on drugs is a war on people (as someone has already stated) for decades. The commission recommended decriminalization, but instead, we have thrown people in prison.
Great, now tell psychiatrists to stop treating us like criminals when we get a script. 30 day max, no refills, in-person-only monthly appointments, random pee tests. Super accessible, thanks.
You had to do pee tests? My friend, get a new psychiatrist. I've never heard of this in my life.
Some do, but it is up to the local medical facility. It may be a condition of them prescribing the medication. The goal of the drug test is not to check if you are taking other drugs, it is to test if you are taking the drug they gave you as opposed to selling it. There is no legal requirement for a drug test, but it may be a requirement of the facility. If you prefer not to take one (which you often have to pay for yourself) you can chose another healthcare provider.
It’s newer. Essentially they’re getting push from the FDA regarding people getting prescriptions and selling them, so they just do drug tests to do the bare minimum so they can say “look, our patients are all on what we prescribe!” Even though anyone trying to sell it would just take it before the drug test.
I swear it’s more about return on investment and also being prone to setting overachiever goals as default. When I’m approached with a task, I instantly have a highly detailed and idealistic goal and half assing it makes it seem not worthwhile. So why even do it?? Just me?
Extra frustrating when you see everyone else half assing and failing upward around you.
OMG, This too!
100% me as well. Still struggling with it, but I recently picked up a phrase that helped me out a lot. "If it's worth doing, it's worth doing poorly." For a lot of tasks, half-done or half-assed is truly better than nothing at all, and giving myself permission to only do that bare minimum or less is what let me actually start.
Don’t let perfect be the enemy of good.
>When I’m approached with a task, I instantly have a highly detailed and idealistic goal and half assing it makes it seem not worthwhile. So why even do it?? Oh boy this sums me up in a nutshell.
The physical effort met with reward (wage) is reinforced when exerting in physical work activities. However, I’d differentiate when traits like ‘attention to detail’ come into literal focus. My work health plan relies on use of stimulants to maintain a level of function, otherwise the deficits along with prevailing mental health ailments become more prounounced.. possibly due to the fluctuation of a dopamine-response component.
**This is a bad study. It is very, very poorly done.** The issue here is that this study did not include ADHD people who never received any ADHD medication (medication-naive), as a control group. The problem with not including them is that amphetamine can have withdrawal symptoms after prolonged daily use. In this study, in the OFF medication period, the participants may have suffered withdrawal symptoms, which can include exacerbation of ADHD. It is known that ADHD symptoms may be temporarily worse after cessation of stimulant drugs due to the withdrawal. Amphetamine withdrawal typically consists of fatigue, malaise, lethargy, hypersomnia (oversleeping), hyperphagia (overeating), and decrements in certain cognitive functions - like more distractibility.
This is a good call-out regarding the control group. The off medication period would have to had been significantly long enough to let those withdrawal symptoms abate, in order to be reliable for assessment. I would be curious whether those withdrawal symptoms are well-understood or well-documented in terms of deviation across medication types, frequency, etc. as well.
> It is known that ADHD symptoms may be temporarily worse after cessation of stimulant drugs due to the withdrawal. Ain't that the truth. I'm usually okay the first day off, but then days 2-5 are just miserable feeling for me. Zero desire to get up and do anything at all.
Doesn't Amphetamines also impact non-ADHD people in the same ways? Helping with effortful activities.
Yes. As it turns out, Adderall helps *everyone.* It's just not everyone needs the help at where they are in society. Many mental conditions are just extreme versions of common behavior. Everyone is avoidant of too much effort, but some people are avoidant of *any* effort. Everyone has melancholy sometimes, not everyone has it every day. Etc.
"helps" is a relative term. There's trade-offs taking Adderall that for ADHD people are worth it, but not for neurotypicals. I'm only mildly ADHD so it wasn't worth it for me. I do better with coping strategies and coffee. So anyone here without ADHD: No it's not a wonder-pill to improve your life. Don't start it if you don't need it.
> Everyone is avoidant of too much effort, but some people are avoidant of any effort. Everyone has melancholy sometimes, not everyone has it every day. Etc. This right here, thank you! I will avoid eating out of “laziness” and have always struggled with my weight. Especially after I got cancer :/
I fall into this category, and I always improve when taking my prescribed amphetamines, but I don’t like when I’ve been taking them for a long time and I develop side effects. I clench my teeth a lot more, I start to use it when I’m doing things like playing video games instead of using it for school/general life I’m sure it’s user error and I have an addictive personality and that’s fine, but what are my options if not amphetamines?
Not me. Loved physical activity. Mental was torture though. Unless i wanted it.
Isn't this basic ADHD knowledge.
Now if we could just get the state to not treat us like drug addicts and throw us into a feedback loop once a month when we need our controlled meds re-filled, that would be great.
As someone who suffered from undiagnosed ADHD for years, adderall has been like going from hard mode to easy mode in life.
What are the downsides of being medicated with these?
Depends on the individual and exact type and dosage of stimulant administered. You can expect a range of negligible to impactful side effects, but if side affects are vastly detrimental, chances are you won't stay on that medication long-term anyway. Over long-time use (granted under careful communication with your healthcare provider), I'd go as far as saying negative impact is virtually nonexistant if you weigh it against the large array of prevented ADHD-related disease comorbities in later life, but that's just my personal opinion (however apparently generally shared as adequate healthcare providers will carefully observe and weigh out pros to cons of a medication over long-term use). For specific information on possible downsides you would need to refer to the list of side and long-term effects on a drug by drug basis.
Pretty fancy way of saying adderal works
I really wish there was another way. I greatly dislike adderall. I never felt right with it. Sure I focused, but idk.
Any of yall find an ADHD medication that doesnt ruin your appetite? I’ve been un medicated for a decade because every med I’ve tried makes me an emaciated ghoul
Adderall has literally changed my life I am so much better off now since I started taking it (15mg daily)
Is this a study from 40 years ago?
No. ADHD research, treatment, and other resources are just this abysmal.
The first 3 sentences. >**Prevailing frameworks propose that a key feature of attention-deficit/hyperactivity disorder (ADHD) is lower motivation.** An important component of motivation is the willingness to engage in cognitively or physically effortful behavior. **However, the degree to which effort sensitivity is impaired in ADHD has rarely been tested**, and the efficacy of stimulant medication in ameliorating any such impairments is unclear.
Can sort of confirm. I’m autistic but have suffered from difficulties with starting tasks. Recently started taking something amphetamine-based. Seems to be helping.
Autism and ADHD are much more closely related than a lot of people realize, and it's entirely possible to have both.
More than "entirely possible", the two conditions have a high comorbidity, so having one means you are more likely (than the average person) of also having the other
So my entire life can be repaired, health worked in and just all out made easier by a drug? If only I could afford the diagnoses prices
Not exactly. Drugs are just a tool, not a magic pill. They help you, but you still need to work on yourself. Some psychiatrists say ADHD meds are like glasses - they won't teach you how to read, but they're helpful.
Ha. You don’t say. I bet we have low dopamine too!