Ask HN: Ways to deal with ADHD?

[throwaway_adhd]

I really value here the interesting and intelligent perspectives of the HN readers which taught me a lot, maybe even now for dealing with ADHD.

About me:

Had a huge crisis doing my bachelor degree was almost dropping out (same in high school), was also dealing with anxiety and feeling depressed and thus tried a lot of experimental things to "cure" me. In the end I just barely managed to pass my bachelor degree in CS (with an extension-semester) and doing now my masters.

The experimental things that I did so far: -Doing 3 10-day meditation retreats to make me feel less stressed and overwhelmed. -Meditating at home(although it's often difficult to maintain this habit) -2-3 times a year LSD to have a mental reset if I feel stuck(cleaning my turmoil, refocus on the important). Recently also two times mircodosed LSD on days where I'm stressed or depressed to have more energy. -Doing an Ayahuasca retreat last year in Peru was somewhat helpful to learn stuff about me, but did not help me be more productive

I feel like all these things are just a patch on my ADHD problem. I feel thrilled and motivated for a few days or weeks and then my usual self creeps back with only slight improvements that remain. I'm not really motivated and only get things done when I feel the guilt and pressure built up. I had several ideas to build my own little project but I never managed to make anything all these years on my own (motivation is gone after a few hours of work). I feel if I continue like this I will struggle through all my life: Always distract myself to hide from negative emotions(because I'm overwhelmed), always having trouble to have focus, always just do the minimum and as a result be miserable with myself because I won't satisfy my high ambitions and dreams.

An approach would be medication but prefer not to take this route or just as a last resort.

What were your approaches and experiences that helped you? (no matter how extreme or strange)

[hluska]

First off, see a doctor and get a diagnosis. Avoid the drugs. Ritalin or its time released bastard cousin Concerta are bad news...in my opinion (I'm not a doctor), they're both worse than cocaine.

Second, if you are on the ADHD spectrum, you will need to change your attitude towards ADHD. Yeah, it makes certain environments less productive, and it can create a whole world of problems in personal relationships. However, ADHD can also be extremely helpful.

For me, ADHD is my secret weapon. My brain is simply better equipped to see all sides of an issue. And, for me at least, ADHD is a big part of my creative process. When I brainstorm, my mind can move through possibilities faster than in a non-ADHD mind.

If you are going to learn to live with ADHD, you have to change your attitude towards it. Yes, it's tough, but it is also an incredible gift.

Third, while meditation is useful, drumming is likely the single best way that I found to treat my ADHD. The drummer's mindset and effortless focus are amazing training for those times when you really need to focus on one thing.

Fourth, carry around a notebook and diary out your life. Keep track of what you eat, drink, do and your moods. Make special note of times when your ADHD is worse than others and try to figure out the triggers. One of my major triggers is a lack of water. If I'm even slightly dehydrated, holy shit, I don't know who you are or what I was talking about, but a bird just flew by my window....

[throwaway_adhd]

>First off, see a doctor and get a diagnosis. Avoid the drugs. Ritalin or its time released bastard cousin Concerta are bad news...in my opinion (I'm not a doctor), they're both worse than cocaine.

If I should avoid drugs why going to a doctor? The symptoms match that good that I don't have much doubt anymore that I have ADHD(and not only the obvious symptoms match, but also stuff like eg terrible time management, I have barely any intuition about time and often am late with no ill will)

> Second, if you are on the ADHD spectrum, you will need to change your attitude towards ADHD. Yeah, it makes certain environments less productive, and it can create a whole world of problems in personal relationships. However, ADHD can also be extremely helpful.

Could you please expand on that. What environments do you avoid and which do you seek? (calm ones?)

>Fourth, carry around a notebook and diary out your life. Keep track of what you eat, drink, do and your moods. Make special note of times when your ADHD is worse than others and try to figure out the triggers.

Will try that out

Thank you for your input.

[hluska]

Thanks for your reply!!

If I were you, I'd still go to a doctor and get a complete work up, including blood and urine tests. That way, you can rule out any physical conditions that could be causing your symptoms. It sounds like you have ADHD, but that way, you know there isn't something underlying (and easily treatable) that is causing these symptoms.

It's more of an insurance policy, I guess.

As for environments, I know that some places just will not be productive for me unless I take strong steps. For example, fluorescent lights and total silence are a bad combination for me. If I work in a dev pit, I need headphones and carefully curated playlists. If I get bored and start hunting for better music, I'm screwed for the rest of the day. If I sit somewhere where people are constantly walking by in my peripheral vision, I'm going to have problems.

I sound like a lovely guy to invite to parties...

But, ADHD is my secret weapon, so sometimes I want to enhance the symptoms. If I'm in a group setting, I'm most productive when we deviate from the agenda. Little bits of small talk mixed in with 'business' get my creative juices flowing. If you let me go, I'll come back (eventually) with something. If I expose myself to chaos, chaos often rewards me with interesting ideas!

Good luck! And, if you need anything, my email is in my profile!

[PaulHoule]

It sounds like you are already using medication, just not ones that are approved by the FDA.

Do not be afraid of antidepressants, these are particularly helpful for anxiety and they don't have the drawbacks that benzodiazepines and other "downers" have in terms of impaired memory, learning and balance. For best results you might end up trying a few different dosages and/or medications, maybe seeing your doc every month for a few months, possibly making medication changes over the phone.

Meditation is good, but regular exercise should be the first line therapy for most mental health issues: a good goal would be to do 1 hour of cardio 5 days a week. It is good even if you do half of that, but it takes most people about 45 minutes to start experiencing the "Runner's High"

https://en.wikipedia.org/wiki/Neurobiological_effects_of_phy...

As for amphetamines, Ritalin, etc. I can say that I don't know any young adults who are taking those drugs to get into a high-functioning zone. I do know older (65+) people who use them to shake grogginess and I know children who seem to be doing OK.

I have been told, and I have learned, to give no quarter to negative thoughts such as you have described. It is not so easy to do because it so compelling, but trying to explore them in great detail tends to increase their power over you more than decrease it.

[throwaway_adhd]

>It sounds like you are already using medication, just not ones that are approved by the FDA.

For me the difference is not if something is FDA approved or not but if I depend everyday on something new.

Because of a difficult time in high school I spent most of my time before the computer as an escape. This escape showed me also my addictive personality and the following negative consequences. And thus I'm now very reluctant to add anything addiction-like to my daily life. I never even tried coffee so far.

> Do not be afraid of antidepressants

Don't they make you dull and feel nothing? Also I wanted to focus on ADHD and not on depression/anxiety because I want to have good grades. The depression & anxiety I think I can more or less handle until the end of my masters and get by.

> Meditation is good, but regular exercise should be the first line therapy for most mental health issues: a good goal would be to do 1 hour of cardio 5 days a week. It is good even if you do half of that, but it takes most people about 45 minutes to start experiencing the "Runner's High"

Thanks, did know that there are some benefits in doing sports but not to that extent. Already cycle 10m to the train station every day and sometimes make kettle bell exercises. Will try to do more sports.

> As for amphetamines, Ritalin, etc. I can say that I don't know any young adults who are taking those drugs to get into a high-functioning zone. I do know older (65+) people who use them to shake grogginess and I know children who seem to be doing OK.

Although I don't want to try ADHD drugs, here I read a counter point: https://news.ycombinator.com/item?id=12345234

>I have been told, and I have learned, to give no quarter to negative thoughts such as you have described. It is not so easy to do because it so compelling, but trying to explore them in great detail tends to increase their power over you more than decrease it.

Yes that's indeed true, it's so easy to think negative. Thanks for sharing your insights.

[PaulHoule]

Different people may experience it differently, but for me SSRIs improve my ability to "keep it together" under stress, particularly in terms of irritability. If not getting angry because somebody cuts in front of me while driving means my emotions are blunted, I am happy to have my emotions blunted. I certainly do feel pleasure, joys and pain, but I find negative emotions have less command over me.

What is a consistent observation is that SSRI drugs retard (delay) the sexual response so that in general you are less interested and take more time and more stimulation for the experience to progress.

This can vary from "I took a Lexapro and did not think about sex for a whole week but I've been so busy thinking about other things I just noticed now" to "My partner likes it that I last longer in bed" to "My partner is furious that I'm not as interested as they are" to "I feel like I am not myself".

[techjuice]

The best thing to do is for ADHD is to see a medical professional. I have meet so many people that self diagnosed their issues and were wrong on the treatment plan 100% of the time as none of them were medical professionals. By not doing so you are unfortunately just wasting time and money as the problem gets worse over time.

Most of the time they needed to take medication for awhile to help rebalance their brain because something was off balance. Over time things rebalance and they no longer needed to take as much medication or no longer need to take any medication because things rebalanced.

The bulk of answers people find online are temporary placebos that never actually helped to permanently solve or reduce the problem because what they were taking or doing were not carefully planned by a medical professional. So my recommendation is to go see the Doc, they will either work with you to do a non medical treatment plan and/or you may need to take medication to resolve the issue. Just note that since it is a mental disorder the only way to resolve it is by using professional medical help by a therapist, physiatrist and or a physician. Do not feel bad seeing a doctor, it is better to seek professional help to try and resolve the problem.

[throwaway_adhd]

Thanks for your insight but my anxiety and ego both make it difficult to look for help. And thus the easier option is for me right now to try the advises of the other users first and only afterwards (if still failing) go meet a physician. But you're probably right and I'm just stubborn and stupid

[Hasknewbie]

Two suggestions:

- Long term fix: try Cognitive behavioral therapy (CBT), an evidence-based form of psychological treatment that doesn't have a lot in common with your usual pseudo-scientific Freudian psychoanalysis where you get to pay a shrink every month for ten years and see no improvement. The main idea behind CBT is to go against the grain, so it's the opposite of bullshit spiritual retreats in Peru to do LSD (no offense). For example if you have agoraphobia and cannot take the bus, your 'exercise' will be to actually take it, but just for one stop, then two, etc, and keep doing that regularly to 'chip away' the phobia without triggering a panic attack. CBT is process-driven so there are quite a few self-help-style books, and you can start working on this by yourself. DO contact a professional if you feel this could work but are blocked, though. Books recommended by the ACBT (they list a few titles covering ADHD): http://www.abct.org/SHBooks/

- Short term fix: I bought a Xiaomi Mi Band 2. It's a shitty smartwatch, and an even worse fitness/sleep tracker. But. But I also bought a third party Mi Band control app (the official Xiaomi one is mostly useless), "Mi Band Tools" that can set an arbitrary number of vibrating alarms/reminders. Every morning I change/customize the alarm vibration to avoid getting used to it, decide what my main task of the day will be (i.e. what "idea" I associate with the alarm when it is triggered), then set that reminder to buzz every N minutes. During the rest of the day, every N minutes I am either already working on what I had planned to do, or am reminded I must refocus right now. It's not something I need when working as part of a team, but for some reason when I'm on a solo project I cannot get anything meaningful done without this hack.

Hope this helps.

[throwaway_adhd]

>Long term fix: try Cognitive behavioral therapy (CBT)

I started a few months ago David Burns Feeling Good book. But unfortunately procrastinated reading it further, thanks for reminding me to finish it finally.

>"The main idea behind CBT is to go against the grain" [...] "it's the opposite of bullshit spiritual retreats in Peru "

I had on my first trip some mixture of feeling of dying(the burning in hell kind of dying), a panic attack and an existential crisis. So I don't think that this is the opposite of going against the grain. I got really confronted with the negative aspects of myself (although nothing lasting came from it eventually). But I get your point, your approach is to grow oneself more stoic and stronger instead of having feel-nice experiences.

> Short term fix: I bought a Xiaomi Mi Band 2

Will buy one, thanks for your advice

[Hasknewbie]

>> I had on my first trip some mixture of feeling of dying(the burning in hell kind of dying), a panic attack and an existential crisis.

Yes, I should have kept the snark in check. I come from a family that drank the alternative medicine Kool-Aid, so am quite dismissive of it. My point was that alternative medicine usually sells itself as soothing / non-threatening, and sometime also (as in your case) as 'transformative', which in my opinion is no better: your attempt might very well have ended up badly and left you worse off, with an additional trauma. Opting for feel-good or miraculous solutions is often a red flag that one is caught in a pattern of avoidance. If you want to solve a personal problem, you have to sit down and do a thorough assessment, and accept any strong evidence that comes out of it, whether you like it or not.

[Bucephalus355]

I am going to come out here strongly in favor of medication.

All of the natural stuff you've been trying, the meditation, the emotional stuff, it's good and I appreciate it, but it just doesn't work significantly.

As a society we have lots of "medication guilt" I've noticed. I don't know where this comes from, but it would be interesting to have a sociologist explore.

Western Society is a very cognitively demanding society. It places lots of strain on our brain and mental capacities. The idea that most people can do very well using their limited cognitive resources is to me as unrealistic as the idea that most people can just fight "regular diseases" using their body and no vaccines, antibiotics, or other treatments.

I see a lot of guilt too around "being dependent" on medicine. I've never gotten this either. We're incredibly dependent on food. We take it everyday. Personality changes dramatically as well. That to me is an argument that while interesting and having good points, doesn't really help anyone at the end of the day.

Medication does have bad parts. A good example would be people increasing dosage of a medicine when in reality they need to get their diet in order. Also, as I write below, you'll probably get a non-effective / bad medicine your first go around since you have to find the right one and work at it.

So what approaches helped me? - Anticonvulsant medication. This medicine is an alternative to typical antidepressants. I've seen very little written about it, but seizure reducing medicines have been showing some very positive results in treating depression. This is very good for nervousness and social anxiety as well. - All-cash psychiatrist. Find a psychiatrist in your city who doesn't take insurance. I really believe in insurance, but in this case, those who don't take it will be the best. You are looking at $400ish for the first appointment. - Better diet. The book "How Not To Die" is very simply written. Ugh so many medicine people have elaborate programs and actually make their books hard to understand so you have to buy more materials. Dr. Greger is very good. Yeah I realize 15 other people are saying something different but just trust me on this.

[corporateslave2]

Have you tried ADD medication? It is legalized speed, all of it. Try taking that for ten years and see how your health and life ends up. Come back and reread this post.

Antipsychotics stop schizophrenics from going psychotic by shutting down dopamine receptors, essentially lobotomizing the brain. Patients are brain dead after 15 to 20 years of taking those.

Opiod addiction doesnt need much introduction.

Adderall/Ritalin/Concerta/Dexedrine are all cocaine analogs that force the brain to overuse dopamine. Results in long term structure of neurons that irreversible. The evidence of this is ampheatmine tolerance that does not reverse (the brain is forever fried/changed).

The jist of the matter is that what goes up must come down, there is no free lunch with drugs. The brain adjusts and down/upregualtes receptors.

[Powerofmene]

While it may be "legalized speed" Adderall for someone with ADHD causes the opposite affect of someone who takes it without ADHD. Adderall allows us to focus, it does not speed us up as it does a recreational user.

Bottom line, medication is simply a tool just as a wheelchair is a tool for someone who cannot walk. That being said, medication is not the end all do all for those of us with ADD or ADHD, we have to develop other coping mechanisms to assist us especially in periods of high stress or high activity around us (such as in noisy environments, or crowds where there is constant movement, etc).

[true_religion]

I have taken adderall consistently for the past 13 years. I began as an adult. As for my health, I am in better shape today than when I first begun despite now being well past middle age. As for tolerance, I will take a maximum of 15mg per day, which is the same limit I was first prescribed to. My daily regime still holds at 5mg, with holidays.

[Powerofmene]

I have taken Adderall now for 20 years and although my prescription has increased over the years, it is still well under the maximum daily allowable dosage.

It is important to understand that ADD/ADHD also affects sleep quality/quantity which in turn affects daytime sleepiness which further impairs focus/concentrate. In many ways ADD/ADHD medications are a viscous cycle so if someone can find alternative methods (to medications) for managing their ADD they are more fortunate than those of us who cannot. I, for one, see my prescription as a tool I use (not abuse) to be as productive and focused as I can be. Both I and my job deserve nothing less than my best.

[corporateslave2]

Nice, is it still effective for you at that dosage (compared to when you first started)?

Mind if I ask, have you ever taken above the prescribed dosage?

[Powerofmene]

I was at one time diagnosed with narcolepsy and was taking 20 mg Adderall tabs to get out of bed and 30 mgs Adderall XR 2x a day w/ 200 mg Provigil 2 x a day. Initially, I did not sleep for 2 days and on average only slept 3-4 hours after that. I finally saw a neurologist who specializes in sleep issues said my previous dr had me totally jacked up and dialed it back tremendously. Now, a 10 mg tab in morning and 1 XR a few hours later along w 200 mg of Provigil is my sweet spot for productivity and allows me to get 6 hrs of sleep a night. Six hours seems to be my optimal number of hours of sleep in order to think clear etc.

I can tell you when you are taking as much as they had me on initially, you tend to focus on the minutiae around you rather than the issues at hand. Over use of a drug like Adderall is not advisable. I would never intentionally over use my meds. I can tell you when I had to come off of the tons my first dr had me on in order to do a sleep study it was excruciating. My head hurt so bad I thought I was having a stroke. It was the worst 5 days of my life and I never want to repeat that experience. Don't overtake these meds and it is good to take med breaks when you can in order for them to be as effective as possible. However, I will tell you during med breaks you will be super tired but it is worth it in the long run.

[true_religion]

It's still effective for me. The heavy euphoric effects of it only lasted about 3 months in the beginning, and it'd take the maximum dosage prescribed to get even a semblance of that now.

I've never taken above the maximum prescribed. Though everyone is different, and you'd have to work things out with your doctor.

For me, the maximum prescribed is a high water mark, which shouldn't be needed daily but is available if absolutely necessary (e.g. I'm having a very bad day, and have something time critical to do).

The advise I have is to take the lowest effective dose, daily, and titrate downwards if it is less effective until you aren't taking it anymore for a while.

That's what's needed if you plan to take the medication for decades.

[JSeymourATL]

Are you SURE it's ADHD?

No blood test or CT scan can tell you if you have the condition — the diagnosis is made by subjective clinical evaluation and screening questionnaires. This lack of any bright line between pathology and eccentricity, Schwarz argues, has allowed Big Pharma to get away with relentless expansion of the franchise.

http://www.nytimes.com/2016/08/28/books/review/adhd-nation-a...

[throwaway_adhd]

Isn't the condition often genetic? [0] And thus would be at least partially detectable.

I agree there is no bright line to make a distinction between ADHD and non-ADHD but the more I read about it and the people who say they have ADHD, the more I'm convinced to have ADHD too.

This maybe medically relevant or not but there's at least a cluster of people with very similar experiences to mine. And thus the hope exists to get relevant and good advise from persons who struggle with the same stuff as me (be it with lifestyle changes or drugs)

[0] https://www.snpedia.com/index.php/Attention_deficit_hyperact...

[bsvalley]

Symptoms >> Doctor appointment

Doctor >> Diagnosis

Diagnosis >> Treatment

Treatment >> Positive results (if negative, Doctor will explore a different solution)

[ccarter84]

Little late, but check out Gabor Mate's "Scattered: How Attention Deficit Disorder Originates and What You Can Do About It"

I'll admit I only read about 1/5 of it and ...wandered off, but now that I'm thinking about it again it's time to put it back at the top of the book pile.

Since I've considered trying many of the same routes you've taken, but have only done Adderall and some anti-depressants at various stages in life.

It works to help realize how messy my place is or to get necessary (deadline-driven) work tasks done, but historically has also led to increased anxiety, tunnel-vision (lack of creativity) and often ends with me stopping for a period due to feeling exceptionally drained feeling after prolonged usage.

I don't like the concept of being on meds for life, but I also would like to keep the job I have until I find one that's more suited to my temperament in this regard...so, tbd on that. Good luck!

[starwaver]

that sounds like me a lot :) It doesn't sound like ADHD but rather a common procrastination habit (my apologize if you are actually medically diagnosed though).

I have problem focusing on things that I'm not interested in as well, but I've learnt to accept that and not feel too guilty about it. Especially since sometime procrastination has some pretty nifty benefits: https://www.ted.com/talks/adam_grant_the_surprising_habits_o...

What I've found really helpful for things I need to get done but have trouble doing is to make a to do list (highly recommend the Todoist app). And put in things to do in the list for each day. For example, do assignment A for 20 minutes, do assignment B for 20 minutes, exercise for 30 minutes etc. Make sure you make it simple enough such that it feels achievable (don't put things like finish an entire assignment as a task unless you know it's a short one). This helps me put myself in short burst focus mode and actual be productive instead of trying to be productive and totally failing at it. Not everyone can handle the 12 hour work day and I don't think you should force yourself to. I myself can only work for 3 hours most before getting exhausted (with plenty of rest in between), but I can do these 3 hours at hyper-focus mode and get more done than what other people can do in 8 hours.

The core things to do are: - accept the fact that not everything interest you and you'll be able to do it with focus. There's a myth in society that the longer you work the harder you work. Totally not true. - don't overwhelm yourself with tons of tasks, the key is to make it seem like it's really easy to do to get things done. The more overwhelmed you feel the less motivated you are to get started. - take a walk if you are getting depressed or overwhelmed, it helps A LOT! - And don't be afraid to try different things! Maybe you are just stuck in a bad career :)

[starwaver]

One other thing that helps. Try to figure out your personality style and see what you are like: https://www.16personalities.com/

[safanycom]

I would head to reddit r/adhd and spend a month watching the posts

Most of the comments here are low quality

[throwaway_adhd]

Am subscribed since 2 weeks but their general advise is to take ADHD drugs (at least as far as I can see).

I wanted to give my best try to find a non-drug solution first and thus wrote here.

[DanBC]

If you lived in England this is what you could expect from the NHS:

ADHD diagnosis and management: https://www.nice.org.uk/guidance/cg72

ADHD overview: https://pathways.nice.org.uk/pathways/attention-deficit-hype...

ADHD improving quality of treatment: https://www.nice.org.uk/guidance/qs39

[Mz]

Look up nutritional approaches and lifestyle approaches. If you want to avoid medication, that's the best way to do it.

[keithflower]

See a physician.

[mars4rp]

does anybody tried or knows about neurofeedback????

[corporateslave2]

I would stop using psychedelics they are not healthy for the brain. Also avoid ADD medications at all costs.

Try L-Theanine and Caffeine combination in a 2:1 ratio. L-Theanine is very safe, it is a calming drug that also enhances focus. When used with caffeine it reduces the negative effects of jitters/anxiety while increasing focus. It is the calming agent in tea.

I was on medication for a long time and it was a nightmare.

There is only one solution:

The combo I outlined above (which is actually amazing), good diet, good exercise, and good sleep.

[throwaway_adhd]

>I would stop using psychedelics they are not healthy for the brain

Source? So far I read the opposite, eg [0]

>Try L-Theanine and Caffeine combination in a 2:1 ratio

How do you consume this? Pills?

[0] http://www.telegraph.co.uk/news/science/12146975/Taking-LSD-...

[corporateslave2]

>Try L-Theanine and Caffeine combination in a 2:1 ratio How do you consume this? Pills?

Yeah, generally I take a 200 mg pill. It's worth giving a shot, the effects wont be as strong as amphetamines, but they will make a difference. People say to start with 200mg Theanine and 100mg caffeine, this depends on your caffeine tolerance. Coffee is preferable to caffeine pills, as there are beneficial additives.

>I would stop using psychedelics they are not healthy for the brain Source? So far I read the opposite, eg [0]

This was anecdotal, but everyone I know (and I know alot of people) who took a ton of psychedelics was noticibly slower. I have also dosed LSD and felt that it negatively affected my cognition. They have such a dramatic effect on the pysche, it is really hard to believe they leave no effects. Also, the amount of research that has been has been near zero. All we have are the acid casualities of the 60s.

Also levels of well being is seperate from ability to focus.