In all seriousness, I skimmed parts of the article and kept scrolling and it just kept going and going and going... like the Energizer bunny. I guess the author found a doctor to prescribe stimulants; they do make it easy to write long rants.

I can identify with some of his analogies, not all. The forgetfulness, standing at desk with power supply / getting “stuck”, lots of that sounds familiar. Some of the stuff he talks about is behavioral though and if it can be called lazy, it probably is at least partially lazy. I could never file TPS reports everyday, but I can do it occasionally. My brain’s capable of it. I just don’t like doing boring things. And yeah, I probably wouldn’t last if I had to do boring things everyday for a job. But the article makes it sound like he’s actually not capable of doing a boring thing.

The more interesting parts of ADHD are the stuff that is lesser-known and often overlooked, like mood swings and anger/irritability issues. Ironically stimulants pretty much cured lifelong mood issues for me. I used to blow up on people all the time; now I’m easygoing.

It's funny. People with ADHD suffer from attention deficit but at the same time they display hyperattention when they encounter a subject they like. I've experienced it as well: once I start programming I have no problem doing it for 12 hours straight. I've found this trait in many ADHD patients. There's usually something that really turns them on and I always try to find it.

I think of it as an signal/noise ratio problem. Very high signal is needed to grab their attention and there is very low tolerance for noise.

However it isn't until older age I finally been able to force my exert executive control to focus. It has taken a lot of practice and challenging myself and it wasn't until the age of 26 I finally been able to go to college. I keep challenging myself and I feel it get easier and easier every year.

So now I start to question the inability part. Or if it's something you can actually practice and get over.

Honestly, I think therapy had the least effect except realization what was wrong. Drugs I think helped the most.. lately it feels like they're not as good though, or I feel like I'm in a funk. I don't know if that's just life or being overworked or just I need a dose change. Maybe if I cut it cold turkey a week, then get back on it'd reboot or something.

TLDR: I just feel I'm getting off track a lot more lately than I was the previous 14 months. Not sure what I should do, maybe go back to therapy? Maybe focus more on mindfulness/stoicism? Up my dose of Vyvanse? Go back to the gym? All the above?

i also tried cold turkey for near a month in the hope it would lower my tolerance but sadly no such luck, it did however give me some spare meds with which to try the higher dose

My understanding is that tolerance is essentially inevitable when you're taking stimulants. I've made a point of checking in with a psychiatrist on a monthly basis so they can help me measure it semi-objectively and adjust if necessary. When resistance does start to develop, a psychiatrist will also have plenty of options for managing it; for example, I think that some people rotate between amphetamine salts, methylphenidate, and other stimulants over the course of several years. They'll also be able to help you figure out which other courses of action would be most helpful, figuring out what issues are actually causing you the most problems and how to address those effectively and so on.

TL;DR There are specialists for "I think my medication isn't working any more" and I'd strongly recommend talking to one, both for this specific problem and on an ongoing basis so you're not forced to try to observe your head from the inside.

There are many books on the subject of good exercises, and some therapists that specialise in helping adhd people.

This has nothing to do with ADHD.

> i would often under perform on the easier parts and over perform on the harder parts

It is very common that people with ADHD perform better on harder things and will have a problem focusing on simpler (and thus boring) problems.

it literally does have to do with it because it was part of the results of being tested for adhd. i had mentioned the iq thing because i meant to elaborate. it was explained to me that the testing is designed to be independent of iq. however, i am a little suspicious of that fact.

when i say performed well above average i meant that i fell statistically well away from results that point to adhd.

Those with ADHD spend 90% of their time imagining, thinking, doing everything and nothing. And to any observer they look stupid, or undisciplined, or lazy.

Like the hunt, when somebody with ADHD encounters an situation with very high (perceived) consequences, they will lock into intense hyperfocus, completely singular in their goal.

So the modes of operation are 1) philosophize and daydream or 2) hunt

Is this real? I have no idea, probably not, but it helps me reason about myself better than feeling like a permanent victim

My theory extends to my desire for action and my risk taking behavior as a younger person.

Some people think that a lot of ADHD people or misdiagnosed, others that it's just another symptom of ADHD.

Which is why some people have to fidget, or listen to music, or move around in order to get stuff done. Or why I'm a worse driver if I can't have the radio on.

The pinnacle of this for me was about half a dozen years ago, I was slugging out some code for a personal project. But I was also feeling nostalgic for an old movie (can't recall which, but let's say it was The Princess Bride). So I put it on in the background. But this isn't quite getting me in The Zone, so this is the scene my partner walks into:

I'm sitting on the couch typing. In all likelihood my knee is bouncing (makes laptops a bit tricky). There's 90's music coming out of my laptop, The Princess Bride is on the TV.

Her head is about to explode. You would think I was killing kittens. She has an ADHD diagnosis, and this plan I have enacted is so anathema to her coping mechanisms that she can't even bear to witness it. Which is too bad because I was getting rather a lot done.

The other part of this analogy is that when there is something that grabs my interest, it grabs it with all 12 brains and I bury myself in that interest until I burn out after a few hours.

I find that ADHD makes me a very good architect and a very bad regular programmer.

I know what you mean. I think if I could click with someone who's really organized and good at execution we could turn one of my 9 billion potentially-pretty-good ideas into an awesome company (I have a pet theory that this pattern is often why it takes 2 to found), but I have never really been able to connect with neurotypicals. They can play along where I can't even tune in, and worse, they are content where I am passionate.

But also that Flow state is often a bad way to write code.

One, virtually everyone has a tremendous case of Sunk Cost Fallacy around things done in Flow state. If someone spent 10 hours in a week working on code that you say is badly conceived in a code review, you'll get pushback and grumbling. Argue with someone who did the PR in a single sitting? They will fight you. Hard. This is the most amazing code ever written (because I felt amazing while I was writing it). The rush goes to their heads.

Two, writing code for other people requires empathy. Rumination. Flow state is considerably absent of both of those. So the problems and gotchas you know about ahead of time get handled, but anything you find along the way is very likely to get ignored. The quantity of your code goes way, way up, the quality goes considerably in the other direction.

I made a conscious decision a while back (making official an unconscious one I'd already made) to stop seeking out Flow state. I felt better, but objectively, it hasn't done me any huge favors professionally. From a practical standpoint, me writing less code means that people who write more baroque code than I do at my worst get to set the narrative for larger slices of the codebase. But I've also done something I hate: reason that if a lot of something is bad, none of it is better.

I need a new plan, and I need it bad.

Yeah, I thought "flow" required extremely low resistance in the task (i.e., someone sewing, playing an instrument, or playing a relatively simple game competently and with no interruption of confusion, frustration, or distraction).

I wish I could code like that. xD Constant typing to an ambient soundtrack. Instead, it's a minefield of "uh wait I have to Google this thing", "uh, what should happen here?", "oh no, an error with a complicated message I probably also have to Google".

And I can only carry on the rubber ducking to competently deal with those with a FULL MARSHALLING of my mental resources, which seems too strenuous for "flow" and is exhausting after a few hours.

But if you're sewing, you're just sewing.

There were times before I accepted that “massive refactor” is an oxymoron where I would keep some very complicated task lists in my head and manage to recall nearly all of them. Day to day? I can’t remember your name twenty seconds after you’ve told it to me, unless I work at it.

As a code reviewer they should be giving you a compliment sandwich where the criticism or constructive feedback is placed in between two compliments. As a coder, I've found adding async and await to functions does a lot to make your code look sexier to code reviewers even if it doesn't have a perceptible performance impact on non-network calls.

If I were to comment on a new plan for you, I'd say let flow state be your friend and not your enemy. After all, you have a chair you probably have to sit in for ~8 hours a day while you stare at a computer screen full of code and that's hard for anyone to do for that long let alone someone with ADHD. Flow state will give you an advantage over others. Invariably, your flow state will break. Use that time to spend more time talking to the stakeholders in your group because sometimes stakeholders want what they want and nothing else. They'll appreciate the time you took to listen to them, they'll trust and believe in you more (instead of you being an unknown variable), they'll be more confident that they'll get what they want, and you'll benefit from the confirmation bias. If you deliver what they want, it's less likely that their sandcastle will get kicked over -- though still not unlikely.

Getting away from the desk for 5 minutes can give you a lot of perspective, and unstick you from a host of problems. I think if I go back (when I go back?) I'll find a pomodoro app that lets you customize the intervals.

I think I agree with everything except this:

> As a code reviewer they should be giving you a compliment sandwich where the criticism or constructive feedback is placed in between two compliments.

Manageable when the code review is 50 lines. Not so easy to do when it's over 500 lines. Damned awkward when the person outranks you, too. I don't know where the cutoff is, but I feel like there's a point where this advice feels like victim blaming, or at least codependency. Don't put your coworkers in this situation, please.

As for knocking over the sandcastle, I agree this is something all humans wrestle with, maybe developers especially. Almost nobody wants to accept that their code is ephemeral. We always push back. Zen or a little horticulture can give you perspective. Kids might too, but that takes decades to play out. Plants are always changing, and they'll never be exactly the way you picture them in your head for longer than a moment. They're alive, and making them 'do' anything is a negotiation that often goes in directions you didn't anticipate. For good or ill.

Yep, and that something can drift over years, days, even minutes. I find code very conducive to hyperfocus, maybe more so than something like playing guitar - it's funny, because so much of coding can be mundane and repetitive, but that quality seems to help with getting started and finding a flow state.

I rarely hyperfocus on writing music or playing instruments anymore, but I used to zone out and play for hours. I'm not sure what changes in a person that makes that more difficult one day than the next.

Playing the same chords over and over again, making fewer and fewer mistakes, all while this song you used to love, you are now beginning to have serious doubts about.

Each time you try, just as you get close, they slide off one another and all around, until they stick at a different spot. Those sticky spots, are all the very stimulating tasks.

it makes it difficult to become good at things you naturally arent good at, once ive been knocked off my obsessive focus on something theres a solid chance ill likely never go back to it. at times i can become almost an expert at things in a very short space of time but as soon as something else takes my focus the new subject basically erases the previous one from my memory

medication has helped greatly but i think i may need to either get my dose adjusted or shift to an alternative medication as im starting to fall back into getting easily distracted again

crap i just noticed i spent so long reading and thinking about this that im now late for work, its this sort of thing that causes issues (and yet here i am wasting more time writing this!)

Poor executive functioning is why I could never make myself start writing a paper prior to the day or two before it was due, despite the rising sense of panic I would get for weeks. (This is key -- it's not laziness, because good lord did I wish I were able to do the work. To me, lazy ~= apathy, and what I felt was just about the polar opposite of apathy.)

Poor executive functioning is also why, unmedicated, it was sometimes difficult to not let my initial emotional reactions just come flying out. It was like there was an express lane between my limbic system and my action system, totally bypassing my ability to control it. I would find myself snapping out something and as it was coming out of my mouth, I would be kicking myself and thinking "Why in god's name am I saying this right now?"

Medication has helped with all of the above and more.

What I will say is that stimulants also can have a tendency to put some people on edge and increase sympathetic nervous system activity, so shorter temper could be a side effect for sure. If it's affecting you that strongly, maybe speak with your doctor about a slightly lower dose?

Or is there a possibility that you only became aware of your tendency to have a short temper once you became medicated? An interesting chicken/egg question; I'm just asking rhetorically, mind, because I have a lot of similar questions.

That sounds like a good explanation for why I've been avoiding studying for something for weeks but feeling guilty, even sick, the whole time about it.

I don't know though. It's hard for me to not call that lazy, and I don't think lazy denotes apathy. Isn't it possible to be lazy and still care about a thing?

Poor executive functioning is also why, unmedicated, it was sometimes difficult to not let my initial emotional reactions just come flying out. It was like there was an express lane between my limbic system and my action system, totally bypassing my ability to control it. I would find myself snapping out something and as it was coming out of my mouth, I would be kicking myself and thinking "Why in god's name am I saying this right now?"

I still struggle with emotional impulsivity anytime I take a few days off meds. Drug holidays can be surreal. Or sometimes they might not be special at all. But I've taken time off before and noticed everything - birds, wind in the air, music on the radio, and it felt so surreal that I broke down crying.

Why in god's name am I saying this right now...

Executive function may be involved, but the inability to filter sensory information is a pretty big part of things for many people.

When I'm two rooms away shouting "What is the dog eating?" to two people who are sitting in the same room as the dog, that's not about executive function.

The cars don’t even have to be that loud or close by. A few tens of metres away at 30mph and I still can’t hear anything anyone says.

Sometimes I have to swap places with a friend when walking down the pavement just so I can try to hold a conversation.

Actually, I'd argue that it is. The other people's executive function is what allows their sensory filtering: they can almost completely filter out sounds their brain has decided is unimportant.

Back to the topic of the irritability/temper, yeah it's basically when it's active. Afterwards I'm a bit tired but otherwise totally kosher. For context, I am also on a very low dose of 5 mg. 10mg starts putting me on "talk really fast, move really fast" sort of stimulant buzz. 20mg was utterly uncomfortable. IIRC the higher doses exacerbated the positives and negatives: even better focus, even less patience, even shorter temper.

In regards to your comment about shortened temper on stimulants, I think this is very normal and expected, and I have experienced the same at times. I don't know how to explain it, but I think overall I'm more agreeable than I was before I was medicated. This might be an age thing; I honestly don't know. Maybe I just grew out of it (I was the kid who threw tantrums lol).

I, on the opposite end of the spectrum, would get strong symptoms of depression, and a constant feeling of nausea and lack of appetite to the point of being suspected of anorexia/bulimia by my physician. I tried a wide variety of medications throughout grade school and high school, and eventually gave up because they all gave me negative side effects of some kind.

However, one symptom of ADHD is something my therapist refers to as "explosiveness" which is a very sudden change from not angry to extremely angry and then often right back to not angry. Note that this can also be a symptom of bipolar, and misdiagnosis between the two is why they tend to screen for bipolar before prescribing ADHD meds.

This is not what I experienced on Vyvanse; rather my baseline level of "being annoyed at things" was much higher, so it was easier to make me angry.

    That's interesting to hear about ADHD causing mood 
    swings/anger/irritability and the stimulants doing 
    away with them. Is that a common trait of the illness

The stimulants made me crankier and more high-strung.

However, sometimes it was a net improvement in my mood because I was getting my stuff done and therefore my stress level was lowered.

I use modafinil now which is less effective for the ADHD but also makes me less cranky.

This is not really a trait of the Inattentive-subtype. However, a person grows up:

- Being frequently told that they are a disappointment.

- Would have succeeded (at something they really cared about) if they'd actually cared.

- Being tuned out because they're talking in a way that seems scattered or boring to the listener.

Can develop an unhealthy relationship with anger.

That scans closer to my experience. I’ve been on Adderal for years, and when I started it I learned that I have the potential to get angry much quicker.

1. Sort of a vast simplification, but basically hulking out and raging - maybe physically, maybe passive aggressively, maybe verbally - the form it takes varies wildly.

I sent the article to my girlfriend though and she'll read all of it and ask me questions about it so I can cleverly get a proxy summary. ADHD Lifehack!

I think that's the hardest part of ADHD, you'll always find some exceptions to the "rules" used to diagnose it.

I think a lot of times ADHD is spotted because a kid is bright, but underachieving. There's a glaring disconnect between potential and performance... could be many reasons, many of which aren't ADHD, but it grabs teachers' and parents' attention.

But, what about a kid whose intelligence is not above average? If they are underperforming, would it be so obvious? I wonder if a lot of folks with ADHD in this category are more likely to go undiagnosed.

"Long form" is at least partly a function of reading speed.

I found that getting started and momentum going is my biggest challenge. Maintaining it for several days after was not as hard.

When writing to us... maybe just try bullet points.... Don't run past the page fold - or I'm out.

I'll admit, I skimmed it. But I bookmarked it!

How many bookmarks do you have left to read?

Yes, me too I didn't read all the article, as I skipped around parts in articles, books, and similar stuff.

For years when I would sit down to work I would go into an endless loop consisting of roughly three-four websites, almost back to back, where it was driven by muscle memory anytime something distracted me. I would almost like "wake up" finding myself in this endless loop.

On good days, I would look like an insanely talented and driven engineer, on bad days, I would look like the laziest piece of shit folks could know. It wasn't by choice, it wasn't because I was trying to "cowboy" or "rockstar" a single fucking thing, it's because that's how my attention span worked (or didn't rather).

"Smart and lazy" is almost an insult to me now, because its a moniker put on folks who are probably having trouble with something and "lazy" is rarely positive (even when its supposed to be). It kept me from believing I might have ADD for years despite tons of signs.

The downsides are of course that people don't believe you, or judge you for it (I switched pharmacies because they were treating my like shit when I would go to pickup my ADD meds)... but the upside, as the author said, is you have a life back you didn't know you were missing. You can choose to read a book, watch a movie, program, etc. you're not longer just forced into a vapid reflexivity of the world around you.

By lifestyle I don't mean some of the things enthusiasts like to advocate--weight training, etc, although by all means if you're so inclined. But just small stuff--kick caffeine, habituate yourself to completing boring tasks as quickly as possible, exercise (if only a few pushups in the morning), etc. Maybe you were already doing those things, but if you were doing them cyclically (weeks, months, etc), now you can do them consistently.

1. Weight change, either bulking on muscle or fat can change your optimal dose for medication... And it's my opinion (and totally just my opinion) that starting to treat ADHD usually leads to a weight gain, either by getting you more able to exercise or increasing your activity and caloric intake.

2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life.

Both of these are addressable though, in the first path any significant weight changes should be monitored by your doctor (go to your doctor regularly, blood pressure should be monitored while on stimulants) and ideally the medication adjusted up... for the latter, well, it's a pile of poo but if you're able to stick with it your doctor will likely take you on a tour of different methyl*s until you find one that works - then, try your damnedest to never let your insurance force you off of it.

Stimulant medications are strong appetite suppressants, and if not specifically paid attention to, the usual concern is weight loss.

To the point that an actual medically approved use of certain stimulants is for weight loss. You can in fact be prescribed meth (Desoxyn in the US when it's coming from a pharmacy and not the backseat of a 1996 Chevy Caprice) by your doctor for obesity if nothing else is working for you.

Speaking to personal anecdotes, while unmedicated there's always been a certain quantity of accidentally skipped meals, with medication I could go the day without eating much of anything and not be particularly bothered.

On the other hand, I'm better at sticking to structure with medication and eating at normal mealtimes more often, even without a hunger impulse. I do still wind up having to mentally (or otherwise) tally what I've eaten in the evening and sometimes shoveling in a pile of extra calories because it obviously wasn't enough.

So there are pulls in both directions, but IMO I'd say the weight loss is more likely to accidentally happen.

> 2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life.

The usual advice I've always been told is to not take it if there's times you don't need it. If I'm going out to have fun for the day on a weekend, or taking an unstructured vacation for a week or the like, I typically don't take it.

I don't think it fully resets those resistances, but it's allowed me to continue to get a noticeable benefit out of a steady, middle of the road prescription.

Best thing one can do is take chelated magnesium. Choline and fish oil help as well, but definitely take chelated magnesium every morning.

It helps prevent a tolerance build up (in turn helps prevent one from getting an increase in dosage) and helps replenishes the magnesium depleted from ADHD medication. Magnesium deficiencies are also common in those with ADHD who do not take medication. So if you're taking medication, the deficiency is caused by two sources.

Idk. I never gained much weight and ate a lot but the rilatin i take makes my appetite plummet completely. I eat a lot less during the day.

>"2. Resistances, stimulants build up resistances pretty quickly for most people so if you're unlucky you'll likely be med hopping for several years until you run out of options or find a winner - if you're lucky and don't build up a resistance then you're probably set for life."

I hope this won't be me. I think i am already largely resistant but i hope i can lose it and will try to go back to taking breaks.

In my experience, it's totally the opposite. More exercise, more activity, and less caloric intake... leading to weight loss.

Also most people can get away with generics so even without insurance the meds are cheap. The psych visits will cost $300-400 a pop though....

That said, at some point it's going to be worth it to just pay out-of-pocket for five minutes of your old GP's time to write a new script if things are dire... but the fact that this barrier can exist is troubling to me since being in that ADHD hole makes it so much easier to get over these barriers.

I feel going to a GP to get a very restricted stimulant is a uphill battle. Go to a ADHD specialist psych. Despite having diagnosed ADHD since I was ~6, my GP looked at me like I was crazy when I explored getting back on meds. I went to see a specialist instead.

So... I guess I got pretty lucky on the whole.

After I moved and got a new GP and asked for a stimulant prescription, they wanted me to come in every single month and do a urine drug screen even if I provided info from my former providers. I switched to an ADHD specialist right after that. It's much more expensive but they treat me with respect.

Wish my psych would do 3 month scripts.

It's kind of a chicken or the egg situation, do people have ADHD and because they have ADHD they are more susceptible to gaming addiction? or do they become addicted to these sites/games which then creates ADHD type symptoms.

Not saying ADHD isn't an actual thing, but I've noticed a reoccurring theme where people who have ADHD also were addicted to gaming or the internet.

I discovered this guy who has a youtube/twitch channel who is a harvard psychologist who explained how gaming/dopamine releasing web products can have a negative impact on our reward system. How gaming and these addicting products can paralyze you and prevents you from changing behavior.

It's an interesting question, because as I browse comments on sites like reddit and it feels like everyone has ADHD, and these comments about ADHD have massive amounts of upvotes. Which is weird because ADHD isn't supposed to be common, it's supposed to be like ~5% of the population, yet it feels like most people have it on these sites

Here's the links to the guy:

https://www.youtube.com/watch?v=aWbh2-tW2e0

https://www.youtube.com/watch?v=yEsFPaOQKoA&t=2s

People ADHD are definitely more likely to overindulge when it comes to gaming/internet usage (hyperfocusing). The reason is because it's stimulating. Sites like reddit is an endless influx of information.

Since I have ADHD it's a struggle to do anything that is boring. Sure most people can relate to that but the difference here is that my school/work/relationships have suffered greatly because of that and the other ADHD symptoms.

Some people who say they have ADHD probably don't but are suffering from something else (stress, depression, anxiety, etc.). It's a disorder that's over diagnosed because avoiding to do boring things, losing focus, and/or hyperactivity is pretty common (especially among youth).

Kids who are obsessed with gaming/internet usage might develop bad habits and behavioral issues but not necessarily something permanent. I seriously doubt it can cause ADHD. Traumatic brain injury would make more sense.

Perhaps to turn your comment on its head, people like my wife don't get much out of a place like Reddit so they don't visit it, while the ADHD crowd is constantly on there trying to up their dopamine levels.

Kind of like how constant sugar can spike insulin and with weight gain over time can creates insulin resistance/diabetes. It's like type 1 vs type 2. So in this analogy Type 1 people with ADHD would be people who are born with it and it's lifelong, and type 2 ADHD people acquire it after indulging in these dopamine producing addicting web products for years and your reward system/executive function is messed up, impacting daily life similar to people who are born with ADHD.

My hypothesis: ADHD is defined as X out of Y listed symptoms, almost all of which people experience in some way at some points in their lives. The difference is between "I sometimes have problems with some of these things" vs. "I have significant problems with many of these to the point where it is a big and constant problem in my daily life and causes me great pain".

So people who sometimes have trouble focusing see that it's on the ADHD list and take up this soft position of "Maybe I have ADHD" or jokingly talk about probably having a little ADHD or something like that.

It's the same with OCD. How many people have you seen on Reddit confess to having OCD or OCD-lite or "probably OCD" etc.? A lot more than the official diagnosis statistics right.

I don't think it's because Reddit creates OCD symptoms though.

And everything is a spectrum, everything - nobody is immune to indecision fog, getting sidetracked, feeling helpless in front of a decision that feels bigger than it rationally is, etc... but those moments usually happen rarely, for some people it is a constant fight that actively lowers their quality of life.

1. https://www.youtube.com/watch?v=Uo08uS904Rg

The best way I can put it, was the first time I got a pair of glasses, I didn't know how bad my vision was (I was like 12)... when I put them on for the first time, I was shocked, I was in disbelief, "this is how everyone else sees?"

Glasses are a tool to help you see better if your eyes don't work correctly, a "stimulant" is a tool to help your brain if you can't focus. The world, in both cases, I was missing, was one I had no idea existed until I had a tool to do so.

There are a lot of non-stimulant and non-drug options to explore.

There are a lot of options a neurologist can explore and everyone's brain is different.

That said... if non-pharmaceutical coping mechanisms work to your satisfaction that's great to hear.

I would highly recommend see a doctor if the only thing holding you back is not wanting to do medicine. Mine was supportive and left the decision up to me. I went for around a year before starting and once I started I could def feel the difference -- it's not huge, but it's...a gentle nudge? If you find a doctor who isn't supportive of not using meds, find another doctor. It can be a bit like dating, where if something isn't working or priorities aren't aligned, then you move on.

Best of luck!

That said, stimulants at doses that affect ADHD don't necessarily to come with other physical side effects.

With untreated ADHD, I was not aware of my attention issues and had trouble understanding the way my mind and the world around me worked, even though I could have fantastic focus and attention to detail when excited about things.

With atomoxetine, I feel that my attention still drifts, but I am able to notice it and respond to it without stress and turmoil. I get distracted often, but it’s actually EASY to just put myself back on task. It still sucks to get distracted, of course :-)

For me personally, it’s been fantastic. I have basically no negative side effects and no physical dependence (if I were to stop taking it, I would miss the benefits, but there would be no extra downsides.) It’s significantly less invasive than stimulants in that way.

A psychiatrist is always the right person to make the call, of course!

At first, I was given anti-depressants, because if you're very depressed sometimes things like starting/stopping projects is difficult (looks like ADD/ADHD). Also, most ADD medicine is heavily regulated; so, they pretty much put you through a gamut to make sure it's what's actually yer problem. At first this sort of felt like they weren't listening to me, but I do appreciate it now reflecting back (mostly because most health care professionals do want to help you, if you're in a bad place mentally though, it can be hard to realize).

I was at the time suffering pretty horrible depression due to a very bad couple of years; so, it made sense, and it helped my mood-- I didn't feel hopeless but it didn't really resolve my underlying stress of never being able to focus or finish anything (which was pretty deeply affecting me because I wanted to contribute more to my team, or rather more steadily).

After two or three months on anti-depressants, and checking in monthly, I was prescribed a pretty small dosage of Adderall; though, if my insurance was better for mental health I would have tried Vyvanse (I think is what its called). Since the dosage was low after about the first week or so, it would kind of wear off after like four hours... So, after the first month I asked to have it doubled and have been at that dosage since with no issues or complaints been about eight months now.

I've read and hear about a lot of people who sort of have enhanced ADD on drugs like Adderall and I haven't really experienced that at all, with the exception of a couple of days I was battling a lot of sadness. Which is why I think my mental healthcare provider did a really great job addressing it (my depression) first; so, that my ADD could actually be treated.

[1] It's really shitty to have mental health issues because almost everyone tells you to: try "diet X," that you have some bad habit, or that you don't do "Y or Z." If you had a physical injury though, no one is going to say "stop eating sugar to fix it." It's not that some diet, exercise , etc might be helpful, just like it would be to prevent a physical injury), sure... thanks hindsight-man.

By doing that what you're telling someone is: that their problems are completely within their control, that they are to blame, and it's their fault because they're choosing this for themselves. When in truth they cannot control it and should not feel blame or inadequacy for it.

Over the years to treat my ADD I tried:

1. Gluten free

2. Exercise

3. Keto

4. Smoking Weed

5. Not Smoking Weed (went a year without it, didn't help, actually made my ADD worse and I got fat(ter))

6. Vitamins of all fucking kinds

7. Cutting coffee/caffeine out

8. Steady sleep schedule

9. Various other weird "natural" shit too I'm sure

None of it helped but each thing on that list prolonged me from getting help [2].

[2] Having never suffered from that kind of depression before I can honestly say it was a heavy fog, that slowly rolled over my life, that was impossible for me to recognize until I was treated for it. If anyone else out there finds themselves angry or upset in ways that don't reflect who they feel they once were, get help, friend. Depression isn't just about being sad.

Imagine if there was a pill to reduce risk of cardiac arrest, with some increased risk of something relatively minor. Can you imagine the uproar if cardiologists denied prescribing the pill, instead forcing people to spend 30m a day running? Sure, it's "better" in some metrics to just run, but that's their choice to make. Doctors should be doctors, not moral guides.

Source: been there

It's kinda hilarious that, when going off Ritalin, things don't slow down (or become "less upped by the upper") they stop - this article touches on it but ADHD can feel the most torturous when it impedes even your leisure - especially when coupled with depression. Ever spent a day off staring at a wall dreading the possibility that you might waste a day until you realize the sun has gone down? Yup, so much fun.

This is literally every Saturday for me. I'm thinking about keeping my Ritalin by my bed. I don't understand why it's so difficult and it makes me really frustrated - I just can't get out of bed. I try to wake up and my mind goes "naw". I sit up to get out of bed, sit there for 40 minutes, and still can't get myself to get out of bed. Stare at my Pillow, some reddit posts, another 45 minutes are gone.

Now it's 2pm, I've wasted half the day. My depression tells me it's because I'm a lazy piece of shizzle.

Source: Diagnosed with ADD/Aspergers/Depression/Anxiety... Horaay :(

When you have those stuff, you need to take meds AND join the gardening club.

You can't go manic at the gardening club.

So, no, it does not seem like a "a pharmaceutical spiral brought on by a sick process", whatever the blazes that means.

It’s an extended release methylphenidate that you take at night time, and 12ish hours later it actually takes effect.

I got up 10 minutes early! I thought I was running on time! Suddenly I'm supposed to be there in 5 minutes! WHY?!!? It's like time isn't freaking linear!!!!

One thing that always goes through my head is just feeling like society is made for a model of human that just isn't me. There's a society out there that would suit me great, but I missed the boat on that. It was probably in the distant past before things got big, noisy, and complicated.

>Ever spent a day off staring at a wall dreading the possibility that you might waste a day until you realize the sun has gone down?

That sounds silly and boring. I was daydreaming instead of looking at the wall.

There are entire large groups of people in this world who feel the need to drag other people down with them. Some of them are extremely good at it. Pray you never attract their attention. It's a nightmare.

I surmise that the people who have a problem with the idea of someone taking medication feel otherwise.

Not trying to make any kind of judgment about this being good or bad. Just trying to point out reality. This is the world we live in - performance matters.

Are you kidding? Life in a capitalistic economy is _absolutely_ a competition.

Considering that those are some of the hardest and most dangerous jobs, it probably is better for you that it's done somewhere else for cheaper. This means that everything that depends on those jobs, such as the price of food, will also be cheaper for you. You can learn another job and do that. I realize that many people don't really want to do that, but it is an improvement for society.

>In capitalism you have to fight for your right to feed yourself, and if you are in the bottom x% of society, you quite literally have to live on the streets.

This is true by definition, because if you are homeless then you're by definition poorer than somebody that is not homeless. Essentially, it's not an argument, but I do understand that there are poor people under capitalism, but they are much better off than poor people 100 years ago, and they're much better off than middle class people 150-200 years ago. Society, especially the US, is so rich that almost anyone has a supercomputer in their pocket. All western countries offer lots of support for the homeless and poor.

Literally experiencing this right now while getting a degree in software engineering. Got diagnosed during my first year with AD(H)D and I'm currently in my fourth, final year. Looking back at things I have no clue how I even managed to pass the harder subjects/courses. All I remember is I took my meds and studied about 12 hours a day 3 weeks straight during the hardest parts.

Before I had never studied more than 2 hours a day and I would start only about 5 - 8 days before a test.

I often wonder if I could work at a software company without my medicine because of this and it actually worries me.

"either your performance, judged by coworkers, will be equivalent or below theirs and the stimulant is seen as the only thing keeping you in your job (which can get super depressing internally) - or, if you're doing well in your position, it can breed internal and external doubt as to whether your performance would just be normal and is being boosted by the caffeine."

the difference between them lies only in the degree of effectiveness. I dream that within my lifetime uppers will be as de stigmatized as weed.

No. Just don't entertain this idea. You can go 20 years since the first time someone told you you may be ADHD or depressed with subsequent diagnoses. Then tell yourself it's all in behavior no one needs drugs. But twenty years on you'll still find yourself in the same cyclical patterns of periodic depression or chronic inability to select your attention to a task. "Lifestyle changes" could help with the right crutch. But if you need Ritalin or another drug to learn those lifestyle changes so be it.

In your (not quite perfect) comparison. It's as if the pill will reduce cardiac arrest and improve peoples aptitude to learn to run for 30 minutes daily.

If I didn't have kids I probably wouldn't have gotten help. I did it for them. I'm glad I did now – everyone deserves help.

There are about a dozen factors with a positive correlation with each other, but they are not links in a causal chain. One does not simply "fix" them, they all have feedback on one another.

The knowledge of how they are related helps, but does not fix.

If anyone argued that stimulants are bad for my health, I could only point out that without them, my health suffers acutely through sheer neglect and it's a downward spiral.

(Some?) Antihypertensive drugs can contribute to harm to the liver. They're unlikely to cause anything on their own, but if your liver is already not the healthiest it can make things worse.

>Yes, I get that "lifestyle changes" could help, but I don't want to change my lifestyle.

As far as I've read about ADHD, nothing comes close to the effect that medication has in treating the issue.

As a diagnosed sufferer of ADHD, my experience is that Adderall works better than Ritalin, but the extended release stuff shortens my temper. If I'm still having a bad day, an energy drink can help.

On boredom: I can be bored, but lack the drive to do anything to make me less bored. When I'm having fun, it is difficult to switch to the next thing I need to do.

I am just a bit of a psych meds skeptic these days - I don't think the comparison to drugs like insulin carry as much weight as their advocates would like them to. For one thing, there's no brain scans or blood tests for any of these diagnoses. The diagnosis criteria is basically a "personality test", called the DSM-5, a manual heavily influenced by the pharmaceutical companies. Stimulants at least do in fact have research supporting they actually outperform placebo (unlike the massively prescribed antidepressants), but they come with a host of negative side effects.

If you're predisposed to mania, you shouldn't take stimulants. If you're predisposed to heart problems, you shouldn't take stimulants. My question is, how was I supposed to know that I was predisposed to these things short of finding out the hard way by taking the stimulants and having those negative side effects almost ruin my life/kill me?

Previously, on HN people have accused me of "doing it wrong" in some sense with the ADHD meds, but the truth is I got the diagnosis from the doctor and took the meds as prescribed.

The whole idea that we can neatly categorize this person as ADHD, this person as MDD, this person as Bipolar-2, this other person as bipolar-1, this other person as BPD, after doing a ton of investigating into mental health, I just no longer buy it.

I do think the answer is in lifestyle changes, the person who is at risk of cardiac arrest, yes they should exercise for 30 min a day and reduce sodium intake before relying on a pill if that pill carries with it a ton of other dangerous side effects.

I also agree with that other commentor, that our society, and my past self, is a bit obsessed with "success" metrics, usually judged by things like career success. The idea that, maybe if you just accept that your career won't be what it could be but that's better than drugging yourself up to achieve those goals, seem foreign to some people. Becoming "somebody" important becomes more important than just being stable and healthy.

Well, if you find yourself in my position, where you get diagnosed with heart failure and learn that ~50% of people in your position die within 5 years of diagnosis, all the sudden that big N promotion doesn't seem as important anymore. And the drugs that help you get there don't seem as worth it. So nowadays my mind still wanders constantly, my wife gets frustrated by how often I start day-dreaming mid-conversation with her, and I know that intellectually I'm capable of more career success but I'm held back primarily by my lack of focus and discipline. But I've come to just accept all that, being on stimulants to fix it, is not worth the downsides.

Most conditions improve when the metabolism is normalized. B-vitamins are pro-metabolic.

Sometimes doctors do good work. My girlfriend's doctors eventually figured out that she is a poor methylator, and can't convert folic acid into folate (Vitamin B-9). She therefore absolutely requires a dietary source of Folate, instead of the folic acid that is used to fortify many foods. She said this vitamin was profoundly helpful for her complaint of "depression".

Sometimes doctors make work for themselves. Using Stimulants to treat metabolic problems is an exercise in futility.

I don't know how they decided to run the genetic test, I just heard that they did and that folate really helps her. She eventually switched to non-prescription folate (from the supplement aisle), probably mostly because of cost, or maybe some other reason.

Folate is cheap enough to experiment with: if you notice something dramatic, keep taking it.

[0] https://deplin.com/what-is-deplin

This is something I myself have struggled with. I suffer from anxiety but I can't bring myself to take medication because I like the person I am and I don't want to change my behavior or personality.

No one should be stopping you from taking Ritalin, but each of us is entitled to our own opinion, so the only thing that is irritating is when someone calls out an opinion another holds even if that opinion has no tangible effect on anyone's life.

ADHD is an extremely harmful condition. You are more likely to end up in jail, crash a car, suffer from diabetes, smoke etc. than neurotypical people. 9 to 13 years in life expectancy, I mean, wowzah.

And opinions held in society or groups obviously have an effect on individuals. That's how social systems work.

This part of your argument is decidedly false. It's been an open secret for decades among public performers of several stripes (actors, public speakers, musicians, etc.) that beta blockers can prevent stage fright [1]. More recently, there have been multiple studies suggesting a link between statin use and increased irritability and aggression [2] [3]. Basically, the distinction between "psychoactive" and "non-psychoactive" drugs is more about the reasons people take them than it is about the drugs themselves. To a first approximation, there's no such thing as an objectively "non-psychoactive" drug.

[1] https://www.nytimes.com/2004/10/21/arts/mixed-reviews-for-a-...

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5005588/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488854/

I do not now. I used to -- I had a fairly major crisis of identity after my diagnosis, because a very large chunk of what I considered to be my personality turned out to be ADHD symptoms. I literally had to refind myself.

But it turned out very well, because now I define myself based upon what my actual qualities are, rather than defining myself based on symptoms of a disorder. I no longer feel like everything about who I am changed after meds; I'm still the same person I was ten years ago, I'm just now more easily able to express that self without ADHD getting in the way.

Also, in almost all cases, the "new qualities" are better than the old ones. Whereas before, "I just can't finish things" was unfortunately something I considered to be part of me, now I am able to finish things mostly the same as neurotypical people. That leaves me free to define myself based on positive qualities -- good humor, optimism, and so on.

The thing is, it became much easier for me to feel okay about taking medicine when I realized that the goal of medicine is simply to bring me back to a "normal" level. I had been operating at a deficiency of certain neurotransmitters; the medication simply brings those levels closer to normal. Once I had adopted a more biochemical perspective on my brain and identity, my initial reluctance disappeared.

A side effect of this is that I kind of no longer believe personality is fixed. I really don't find that the things we tend to call 'personality' are the sort of permanent identifying landmarks to a person we want them to be. Now I've adopted a view that puts a much stronger emphasis on the actions a person chooses to take, which I think is a better way to identify a person's qualities anyways.

---

I would hesitate though with ADHD in particular, because untreated ADHD reduces your lifespan in a statistically significant way, is literal hell to live through, and the treatments are perfectly safe and extremely effective. If someone has a child who is diagnosed with ADHD, I would beg them to not let their personal prejudices against medicine keep them from getting the child the help they need. As someone who lived through it as a kid, it was physically torture. The word "restlessness" sounds benign, but I find it to be quite similar to akathisia on bad days, which is really horrific.

Oh man, sure, the medication makes me a better member of society... but am I killing the old me? Am I discriminating against the old me? In taking the medication are we declaring the me I was born as a dysfunctional useless person?

I actually came to pretty much the same conclusion, I prefer being the me that is clear headed - the medication is a requisite for that and I dislike that chemical requirement, but I prefer this me.

I think I've gotten more over this after bringing someone bipolar(with some other issues) closely into my family, they are drastically different when off balance and constantly have to fight (adjusting meds, checking Li levels) to stay on balance... And the off-balance person isn't a bad person, but they're highly internally inconsistent, they constantly put roadblocks in their way and, even when the meds are way off balance - they'll come through stable for random moments and strongly want to rebalance themselves.

Their condition is rough enough that they can't self-correct, I can mostly self-correct, it's hard but if I've run out of meds I can make it into the Doctor and get more and I feel quite lucky to be able to do that.

It is gonna sound cheesy, but what got me into my current mindset regarding it was a quote from the recent Elton John biopic. When Elton was struggling with the identity crisis and trying to articulate the mismatch of who he was vs. where he saw himself being in the future, one of the characters told him "You got to kill the person you were born to be in order to become the person you want to be".

For myself personally, I concluded that we are simply who we are at any given moment. There is no "real me", there is only "me" at a point of time (given that I act genuinely, of course). If I act differently after drinking alcohol? That is still me. If I undersleep and act cranky for the rest of the day? That is still me. If taking the meds is what it takes to kill off the parts of me that I was born with that impede the current me, then so be it.

I realize that it is a really reductionist mindset not comprehensively describing the reality, but it helps me to come to terms with myself and somewhat describes the situation as I perceive it.

I definitely prefer the new me. There is a continual spectrum of mes from being a young kid to an adult (ship of theseus style[1]) but this is different (and I think Elton John's situation was similar). I can clearly see a me I like and an alternative me. In theory, every day of my life I make a choice to give that day to the me I like - but gods when I think about it it can get heart wrenching. Digging in, I'm basically denying that alternative me a chance to be alive... And I've never killed that other me, it's sitting there and I might be that me tomorrow, it's just that every day so far I've chosen that today won't be the day it is me... Similarly Elton John could always return to being Reginald (or however he identifies his older identity) he just doesn't.

As someone who waxes philosophically this is an interesting consideration to dive into but thankfully most days I skip right past it and don't perseverate. It's pleasant to share though, since I don't like vocalizing it with most folks.

1. https://en.wikipedia.org/wiki/Ship_of_Theseus

The way I see it, it isn't really "killing", as in, getting it to not exist at all anymore. That old "you" will always be there, just like a bunch of other possible "yous". The "killing off" part means getting to a point where going back to that old "you" becomes as difficult as it was for you to get to the current "you" from your old "you".

And I totally feel you on the part about thinking too hard about it. This outlook I have is definitely not comprehensive and just provides satisfaction at a cursory glance when my mind wanders there. Looking at it under a microscopic view, there are individual parts that can be deconstructed and found to be not super accurate. But overall, it seems to provide me with a good enough framework to look at my life through.

What are your goals? Was the "old" you getting any closer to your goals? Is the "new" you getting closer? It's OK to take the pragmatic view of your environment and situation in life. These things matter too, especially when you have to support a family.

It's quite the dilemma really.

I cannot think of a medication that doesn't in some way affect your psychological profile, because if you're sick then you'll behave differently.

I think it's a bit of a trap to believe that you are your authentic self only by denying yourself medication, I consider myself from 5 years ago a different person let alone pre-medication. Is it that valuable that you struggle and live unhappy for the limited years you have available?

There, that's my terrible analogy.

1. There's a flip side, staying with the marsh analogy, there are also some dykes someone built randomly in the marsh and it's really easy to run along those, and they're really comfortable... but they might not go to the far side of the marsh - but hey it's right over there and it'd be easy to get over there instead of trying to trudge through the marsh. Running on those dykes feels really good since you're definitely running, but you don't get to chose where the dyke goes and it might not be helpful for yourself to run along it.

I definitely do notice a sort of forgetfulness around the context of a project, particularly the reasons/motivation for doing it.

Thinking about this, I wonder if ADHD people struggle with being project managers? Especially when it's important to mentally keep track of the big picture and the contexts around various tasks.

--

I guess this is sort of different from working memory though, or it's more subtle (because I definitely don't have any actual forgetfulness, it's easy for me to remember things etc)

Ritalin functions as a DRI (Dopamine reuptake inhibitor).

One of the theories is that ADHD could be a lack of Dopamine.

The biggest thing I realized is how tightening feedback loops is the key to my productivity, I gravitated towards python because it's interpreted nature meant I could get feedback on my code in 20 seconds max as opposed to 3-5 minutes waiting for my code to build.

Adderall is a help but is not a cure all, it took me months to learn how to use it right, at first Adderall just fueled my ADHD and made everything worse. It's a constant struggle and maladaptive perfectionism is still the one thing I struggle with the most. I can't count the times of I've completed reverted my git sandbox to start from scratch after reaching a certain frustration level with code.

Also, your comment on python ... very very true

Don't feel trapped into one option that isn't working for you.

I believe this is NOT causative, but is instead a correlation between other diseases associated with Dopamine production and ADHD. I take and have continued to take stimulants for ADHD.

https://www.nature.com/articles/s41386-018-0207-5

In my family's case, we likely have something called Dopa Responsive Dystonia (DRD), and what the author is describing sounds to me like what I experienced prior to being diagnosed with ADHD, and later with DRD.

Having said that, I'm not a doctor, so please go see an experienced movement disorder specialist if you are reading this and have any concerns.

DRD is very hard to diagnose, but easy to treat. Because the stimulants (Adderall and Ritalin) made the DRD symptoms worse, my mother happened to get early onset Parkinson's, and my grandmother also responded to carbodopa/levodopa (carbo/levo), it was fairly obvious in retrospect, but if we didn't have a family member with early onset Parkinson's I doubt it would have been picked up.

https://en.wikipedia.org/wiki/Dopamine-responsive_dystonia

My sense is that anyone with ADHD who uses stimulants should see an experienced movement disorder neurologist or few about basal ganglia and cerebellum diseases and try out medications based on their assessment. From personal experience, it became extremely clear I had DRD after taking carbo/levo, but there's no way I would have really known without trying it. It also helps with some of the stimulant side effects, which I still continue to take because they are very effective.

My family has seen maybe six neurologists total, and only one really knew about DRD. The Dystonia Foundation has a decent doctor locator.

https://dystonia-foundation.org/living-dystonia/find-a-docto...

Please, don't read comments like these and distance yourself from treatment. There is always more to a study.

Source: Board-certified neurologist.

Am I trading my future brain function for quality of life improvements in the current?

The thought of irreversibly damaging my dopamine transport system later on in life feels like I am making a deal with the devil every time I take a dose of stimulants to correct my dopamine imbalance and cognitive deficits to feel neurotypical for a fleeting period of time soon after ingestion.

Any link to hemorrhagic stroke later in life as well? Thanks for you time.

Thoughts on any neuroprotective measures I can take now like memantine or bromocriptine(sp?)?

I'm sorry to appeal to authority here, but comments like these do actually harm people by shying them away from treatment (just look at your replies), and please don't write them. Again, I'm sorry you're dealing with Segawa's, but even your edits in response to my comment are making your statement more harmful because they're based in pure speculation.

I've been suffering from a myriad of symptoms that happen to match up with Segawa's... a disease I learned about less than ten minutes ago.

> please don't write them

Please don't make statements requesting that other's don't share their experiences with misdiagnosis and rare conditions. It's rude and furthers the stigma that some conditions are too rare for their sufferers to discuss.

It has been significantly, damned near whole cloth, edited in several ways since I said something, so I'd ask a little consideration that I'm coming from a good place. I'm not asking for anyone to avoid discussing Segawa's; I'm specifically responding to the speculation, across multiple comments, that the common element of dopamine as a neurotransmitter makes them related diseases. Given that people attack doctors when they try to arrest harmful discussion like this, I'm taking great pains to not be rude, so I apologize for coming across that way.

If you diagnosed yourself with Segawa's based on Wikipedia, please bear in mind that my single diagnosis across my entire career involved four months of differential diagnosis and observation, and led to a publication. It's simply that rare. There are several much more common possibilities, and I'd ask you to talk with your neurologist with an open mind rather than assuming the Internet has steered you correctly. That's also part of the reason I've responded as I have, exactly due to what you're saying.

I won't be diagnosing myself off of Wikipedia, next to no one in my family has the symptoms that I do so I doubt it's something like Segawa's.

I appreciate the apology and hope my reply didn't come off as too aggressive. Part of my tone comes from personal experience: doctors stating that I don't have a condition because it would be "statistically unlikely"... all without running a single test.

I added the first italicized sentence after their first comment, and after their second comment added the second italicized sentence and modified two other non-italicized sentences. I think... I may have just modified one non-italicized sentence after their second comment.

I don't intend to mislead anyone. However, I do want people to be aware of possible links between ADHD and other disorders so that they can evaluate their own situation and seek medical care if they would like to.

More to the point, my family has been misdiagnosed for decades, and this likely would have been avoided if we were more aware of other possible diagnoses.

I'm here because I'm learning to write software, but I wouldn't pretend to understand the paper or mathematic theory behind, say, Paxos because I recognize some terms in it. I know my limitations, and all I ask is that you consider them, as well. The problem with raising awareness as you are is that it's difficult to objectively remove yourself: Segawa's is _incredibly_ rare, making all of the events in your family difficult to explain. Scientifically, transferring your experiences to others is a very tall order without much further study (and I hope you, and your family, are being studied, specifically because the genetics of Segawa's are poorly understood). What people portray as medical professionals swinging the hammer on "the information that could make us irrelevant" is actually trying to stand fast to the exact same scientific discipline that you, and every member of this audience, does in _every single other context_.

Your speculation about the relationship between ADHD and Segawa's is so far off base that a second-year medical student could probably explain why; you just happen to have been diagnosed with both. Left unspoken: it is quite possible to have both, because they present and manifest in different ways.

My guess is that DRD is under diagnosed because of reduced or low penetrance in some cases. As far as I can tell, for the majority of our lives, no single person in my immediate family would fit the diagnoses, but as a family, we apparently do, especially if someone knows where to look and what to look for. I suspect my extended family on my grandma's side has it as well, but I doubt any family with it would be diagnosed unless they happened to have someone who presented with it in an obvious way.

The urgency you're detecting in my posts is because in my experience, 10+ doctors and 4 neurologists missed it and/or mistook it for other diseases. It was especially hazardous for my grandmother because they were insisting on doing the medical version of taking her out back and shooting her even though their treatment of her in medical and custodial care settings was causing the very symptoms they claimed were due to other disorders. And yes, I do not want someone else to go through that, especially since having other relatives who also respond to carbo/levo seems to be critical in helping establish a diagnosis when there isn't someone in the family who presents in a typical way.

If you want, I can modify my post, but like I said before, I strongly suspect the presentation of ADHD with other characteristics, which are admittedly not symptoms of either disorder, increases the odds that someone has DRD or some other neurological disorder that's also contributing to the presentation of their ADHD.

If you have some compelling evidence that there is no interaction between DRD or similar and ADHD, I'm happy to see it, but from personal experience that is not the case.

But ironically it helps me even enough as a cure on it's own. I no longer take or need stimulants.

Also that tends to go away once you build your tolerance, it's just kind of overwhelming at first because the weed these days is really strong.

I actually smoke to reduce my anxiety as well.

On the flip side, getting treatment for those disorders, provided you have one of them, can also help with some of the ADHD symptoms.

The genetic defects associated with this are I believe a spectrum though, and we happen to be close to one side of it. If you have any symptoms related to DRD, I would see a movement disorder specialist and ask for a trial of carbo/levo. It'll be immediately obvious if it helps, and if you don't have any problems with Dopamine production it won't do anything (except for some mild side effects).

It should be noted though that the study authors were pretty clear that the correlation is unclear given that untreated ADHD sufferers had a 2.5-fold increase in the same diseases.

> Researchers postulated that the association between psychostimulant use and BG&C diseases may be a result of a more severe ADHD phenotype, rather than a direct pharmacological effect.

https://scientonline.org/open-access/dystonia-and-its-treatm...

Neurodevelopmental Disorders (Autism, ADHD, Delayed Speech/language, dyspraxia)

>"hyper mobile joints are an uncommon finding in those who do not have attention deficit disorder/attention deficit hyperactivity disorder."

>Differences in the structural integrity of temporal and parietal cortices may underlie wider behavioural phenotypical expression of hypermobility: abnormalities in superior temporal cortex are also seen in autism.11 Inferior parietal cortex can affect proprioceptive awareness and hypermobility is itself linked to dyspraxia.1 Our findings suggest that processes compromising function in neuro-developmental conditions may occur in individuals with hypermobility, putatively enhancing vulnerability to stress and anxiety.

Autism, Joint Hypermobility-Related Disorders and Pain

ASD and HRDs, specially hEDS, are conditions with a strong genetic component, a polymorphic clinical presentation, appearing both in infancy, and sharing several phenotypical features (35). Although existing data does not allow to ascertain increase prevalence of ASD in HRDs, as well as shared underlying patho-mechanisms between both conditions, there is increasing evidence suggesting that these co-occur more often than expected by chance. This requires be confirmed by further investigation which should consider the recent nosological changes both in EDS and the hypermobility spectrum disorders [see (17, 38)], and in ASD (72). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292952

Joint hypermobility and the heritable disorders of connective tissue: clinical and empirical evidence of links with psychiatry

- In 1988, Hofman et al.[58], in a sample of 30 children with MFS,observed that 17% had attention deficit disorder with or without hyperactivity. A decade later, Harris[59] stated, based on his clinical experience with 200 patients with ADHD, that "hyper mobile joints are an uncommon finding in those who do not have attention deficit disorder/attention deficit hyperactivity disorder."

In Sweden,Hollertz[60,61] also pointed out the frequent co-occurrence of ADHD and JH in adults patients. He observed that an orientation to orthopedic and rehabilitation care was common in these patients due to joint problems. Thus, this author speculates about a possible genetic marker com-mon to ADHD and EDS.

Recently, Koldas Dogan et al.[62]explored JH using the Beighton score in 54 children with ADHD compared to 36healthy controls. In this study, JH was significantly more frequentamong patients than among controls (31.5% vs. 13.9%). In accor-dance with these results,

Shiari et al.[63]also found a higher prev-alence of JH, assessed with the same method of the previous study,among Iranian children with ADHD compared to controls (74.4%vs. 12.8%), confirming an association between ADHD and abnormal collagen conditions.

JOINT HYPERMOBILITY AND AUTONOMIC HYPERACTIVITY: RELEVANCE TO NEURODEVELOPMENTAL DISORDERS

> It is likely that the importance of hypermobility and autonomic dysfunction to the generation and maintenance of psychopathology in neurodevelopmental disorders is poorly appreciated. Work underway(autonomic testing, fMRI) will test the hypothesis that autonomic reactivity and interoceptive sensitivity predispose to the expression of psychiatric symptoms, particularly anxiety

- We demonstrate for the first time that rates of hypermobility and symptoms of autonomic dysfunction are particularly high in adults with neurodevelopmental diagnoses. It is likely that the importance of hypermobility and autonomic dysfunction to the generation and maintenance of psychopathology in neurodevelopmental disorders is poorly appreciated. Work underway(autonomic testing, fMRI) will test the hypothesis that autonomic reactivity and interoceptive sensitivity predispose to the expression of psychiatric symptoms, particularly anxiety. It is further hypothesized that inefficient neural co-ordination of efferent autonomic drive with imprecise interoceptive representations may be amplified in hypermobile individuals. In hypermobility, this mechanism might explain increased vulnerability to stress sensitive and developmental neuropsychiatric conditions. - https://jnnp.bmj.com/content/85/8/e3.40?utm_source=trendmd&u...

[Searching for a biological marker common for both ADHD and EDS].

- https://www.ncbi.nlm.nih.gov/pubmed/22468413 - speculated about a common biological base shared by ADHD and EDS after observing the frequent cooccurrence of both pathologies in a clinical setting.

Connective tissue problems and attention deficit and hyperactivity

Attachments - [ADHDBaeza-Velascoetal.2015.pdf](https://checkvist-prod-uploads.s3.amazonaws.com/u/OKFCuEQ7Zl...)

- To the Editor, The heritable disorders of the connective tissue are a group of genetic disorders affecting connective tissue matrix proteins that classically include Marfan syndrome (MFS), Ehlers–Danlos Syndrome (EDS), benign joint hypermobility syndrome and osteogenesis imperfecta (Grahame 2000). As connective tissue is found throughout the body, the clinical manifestations of these disorders are varied, including disturbances in different systems (skeletal, ocular, cardiovascular, etc.). A common feature of the heritable disorders of the connective tissue is joint hypermobility (JH), which is a highly heritable condition characterized by an increased range of motion of the joints as a consequence of connective tissue involvement.We encountered a 7-year-old boy addressed by teachers due to school problems. His mother suffer from MFS such as his maternal grandmother who died by cardiac complications. Considering familial antecedents, his morphotype (long bone overgrowth), JH and ocular ...

A connective tissue disorder may underlie ESSENCE problems in childhood

Attachments - [1-s2.0-S0891422216302402-main.pdf](https://checkvist-prod-uploads.s3.amazonaws.com/u/aghis3LMNv...)

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Attachments - [Screenshot_2019-06-27_at_16.53.23.png](https://checkvist-prod-uploads.s3.amazonaws.com/u/dm7JuPP8Gq...)

Attention-deficit/hyperactivity disorder, joint hypermobility-related disorders and pain: expanding body-mind connections to the developmental age.

>Recent research seems to indicate a degree of co-occurrence of JHS/hEDS and some neuro-developmental disorders including attention-deficit/hyperactivity disorders (ADHD) and developmental coordination disorder (DCD). In the area of ADHD, researchers found that adults with ADHD had higher rates of JH and problems with automatic control of body functions (dysautonomia) compared to healthy controls. Other researchers observed high co-occurrence of JH or EDS with ADHD. Concerning DCD, children with DCD have more symptoms associated with JHS/hEDS compared to typically developing children. The relationship between JH and DCD may be due to poor positional sensing in affected children.

- https://www.ncbi.nlm.nih.gov/pubmed/29446032

A Cohort Study Comparing Women with Autism Spectrum Disorder with and without Generalized Joint Hypermobility

- This research supports a growing body of literature indicating that immune-mediated disorders are a common comorbid feature in hEDS and GJH. In addition, we have also shown that this dysfunction may be paired with endocrine dysregulation, leading to complex immune and hormonal exophenotypes, such as autoimmune disorders, allergic rhinitis, asthma, endometriosis, and dysmenorrhea. While we have not addressed autism and GJH comorbidity rates in this study, their co-occurrence in the adult ASD female population suggests links between the dysfunction of connective tissue and the immune and endocrine systems in this subpopulation. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867488/

Rationale for Dietary Antioxidant Treatment of ADHD [[MDPI - 2018](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946190/)]

>ADHD might thus be a (non) allergic hypersensitivity disorder caused by an environmental trigger, based on a non-IgE dependent histamine release from mast cells and basophilic granulocytes, since the histamine H3 receptor is involved in hyperactivity and promotes dopamine release in the frontal cortex. Moreover, polymorphisms in the histamine N-methyl transferase (HNMT) gene, impairing histamine clearance, were found to affect the behavioral responses to food additives, which increase histamine levels #ADHD

It is extremely difficult for someone with ADHD to change their diet. It's difficult even for neurotypical people. I know that it and exercise are obviously beneficial, but from experience there's a "loss" in that trying and failing consistently to improve my lifestyle really takes its toll on my motivation and self-esteem. Not to say that I'm not still trying... but it's hard.

I'll do this when I find myself slipping, too.

No such effect exists for me. Plus, it would require following through on going shopping so I have roast beef and frozen veggies in the house (or remember to take them with me to work). That's not happening in an unmedicated state. I'm lucky if I can put together a remotely healthy meal while unmedicated.

In my case, I got some rather severe digestive issues similar to IBS that turned out to be similar to what vegetarians get after several years if they don't watch their nutrients and vitamins. I spent 2 years battling it without knowing what was causing it. After days of conversations with some very smart friends, one of them suggested a connection between tryptophan and serotonin (which is made from it in the gut).

Long story short, I started eating pork again (mainly bacon) after avoiding it for 20 years due to ethical concerns, and my digestive issues cleared up in a matter of days. My acne went away and my mood stabilized almost overnight. It was one of the most miraculous things I've experienced in many years. I also added psyllium husk fiber with meals 1-3 times a day and have maintained proper digestive function for several months now.

Some things that really help me are zinc gluconate for immune function and recovery from exercise 1-7 times per week (too much will make you feel bad, a headache in my case), omega 3 capsules and glucosamine/chondroitin (which is for joint health but the mechanism likely happens through the gut as well). I also eat 2-4 whole eggs per day based on how hard I'm hitting the gym. My feeling is that the lack of fat in our diet from the 1980s till today has really wrecked most people's metabolisms and they are simultaneously frantically starving, fat from eating too much, and chronically malnourished.

It would be interesting to hear the author's thoughts on this, and on alcohol.

EDIT: ...and on exercise.

That's one of the advantages of the prescribed stimulants; they're effective at doses that have no physical side effects.

When I eat regular meals I'm _constantly_ hungry and my focus goes to total shit. I tend to have to manage my weight because even when I expressly try not to, I eat too much. It's weird. I also eat worse food. It seems to be a vicious cycle.

I switched my diet from a high carb to high protein, high fat. Instead of a bagel for breakfast, I'll eat a couple eggs, a breakfast meat, and every once in a while a piece of toast. Tons of whole fresh fruit all day. Lunch is similar: think a chipotle style meal with a base of protein and rice and some light veggies. More fruit and raw vegetables and nuts for snacks. Dinner is the same thing - protein base but fewer carbs and more veggies. I'll have some candy in the evening from time to time.

I also started lifting weights 3x a week. I love it cause it's the most efficient way for me to exercise - I spend 60-120 minutes in the gym three times and work my whole body. Heavy squats, deadlifts and presses - strengthens the back and hips, makes sitting in a chair much easier, and is a really great vector for activating that hyperfocus we love so much. I read a book called Starting Strength that basically gave me all the info I needed to get started.

Since starting this routine about 8 or 9 years ago, I find I'm sleeping better, my focus is way better, I'm much more pleasant to be around socially, I'm way less impulsive and interruptive, I make fewer stupid rash decisions, and I'm generally in a better, chipper mood a lot more.

Edit: Might add: I drink coffee like it's going out of style and don't find that caffeine really affects my focus all that much - more my energy levels. They're similar but on different axes.

After just a day or two I experienced very unusual (for me) clarity. I googled and apparently it can help ADHD symptoms.

I definitely ate enough meat and various other things, so I'm not sure what the supplements did or if they're a placebo. Perhaps I just process iron poorly and need a big hit at once.

That said, it's always possible that an intervention works well in a subgroup of high-responders (this can be true even if the particular intervention is a placebo, not that that's necessarily the explanation here), so everyone saying it works for them should probably keep it up.

For example: https://www.ncbi.nlm.nih.gov/pubmed/23495677

This particular study found that phospholipid improves ADHD symptoms in children (4-14 yo).

There's some ongoing research about the neurotransmitters related to ADHD: https://psychcentral.com/lib/neurotransmitters-involved-in-a...

However, I don't know if any comprehensive studies have been conducted about the effects of diet to ADHD, it could be tricky to study that.

I find that it’s very much worth the time investment, and would recommend anyone struggling with focus/anxiety to try it themselves.

My personal hypothesis is that the inherent expectation of wanting/needing to feel some kind of effect every time I tried meditating ended up being the very blockade that prevented me from doing so. I kept falling into a negative recursive thought loop of, “I haven’t noticed anything yet. This isn’t working. There’s no point in trying to continue meditating” that cycled into a cascading growth of anxiety that prevented me from reaching a state of balance.

It took me many months to realize that I was trapping myself inside this loop, but once I became aware of it, I was able to almost immediately start seeing results. The biggest thing that helped me was coming to a realization that the thoughts in my head are, at the end of the day, just thoughts. They have no ability to harm or control me other than what I choose to allow them to. The thought loop I was putting myself into could only continue because I chose to let it.

When I meditate in the present day, you might think that I no longer deal with any of these issues. That’s actually completely not the case. In fact, I constantly still get it, especially at the beginning of my sessions, but now instead of stressing out, I just choose to let it go. By actively choosing to accept and let things go, the loop breaks right from the beginning.

This is probably one of the most important lessons i've learned in my life. Realizing this made a hugely drastic improvement to my emotions, my ability to control them and my ability to focus on things and pay attention. Learning to quiet that voice or just ignore it when I need to is a skill I think everyone should learn and would benefit from.