[herdyderdy]

So you are on stimulants now that seem to help with your long term focus? Is there a concern of tolerance and dependency, like coffee/caffeine, where you'll have to keep upping the dose to get the benefit? Sorry if I'm being nosy but this is rather eye-opening to me and makes me think it might be worth speaking to my doc about this.

[tylermac1]

I'm recently diagnosed with ADHD-like symptoms and started on a low dose of Focalin about a month ago.

I can say for short-term focus and motivation it's been life-changing.

I would frequently flip-flop between getting sucked into rabbit-holes and having too many things going on at once. I now find that I can focus on tasks much better throughout the work day. My quality of work has improved as I've been able to better focus my time on what matter.

My doc has warned that over time I likely will need dosage increases, but for now it's been a wonderful experience with very few side effects (headaches the first day or two).

[hirvi74]

I apologize if my response is kind of all over the place. I am somewhat of rush this morning, but I wanted to throw my hat into the ring.

To contrast the other user who replied, I have been on stimulants for 8 years now.

I will say that there is a very notable drop in efficacy. Not enough to justify stopping them all together, but I'd say I get about 50% of the benefit on my best days.

I would consider my current experiences much like that of caffeine. It worked amazingly in the beginning, but now I feel like they are necessary to achieve a baseline sense of normalcy. I could raise the dosage, I suppose, but I do not want to go down that path again because it is just a temporary fix.

Honestly, taking time off stimulants has been more effective than increasing dosages. Most people can stop stimulants with little to no issues, but since I have adapted to them over the years, the withdrawals are pretty fucking uncomfortable and debilitating. Though, according to my medical professional of questionable quality, my experiences are still unusual. Still, I try to take weekends off, and it's been helpful none the less.

Going forward, I am thinking of switching to a non-stimulant, which may be an option for you as well if you are indeed ADHD. Despite how ever effective stimulants may be, I believe I am starting to lose more from them than I am gaining from them. At least where I live, the constant drug-testing and various laws surrounding controlled-substances makes stimulants almost not worth it.

The medications can be life-changing, but in the ADHD community, it's well known that there is a honeymoon phase (it's not uncommon to experience stimulant-induced euphoria), thus the real judge of how effective they are should be determined once that period is over. However, not everyone gets that honeymoon period, but I sure did for a few weeks.

If I must be entirely honest, I think that the medications do help, but I never have thought they helped enough. They make life easier, but not easy, and that is something I think I have really struggled to come to terms with. I went in with expectations of a silver-bullet, but left with a tool. My fair warning would be to be careful what you read about ADHD medications online.

One other point that I feel I should warn others about -- something no one ever told me -- is to not let meds give you enough rope to hang yourself. What I mean is: I built a career and a life while having access to these medications. Recently, there has been a nationwide shortage in my area. Every pharmacy was out of stock -- literally none in my area had anything. Zero. Nada. I was working on a big project at work, and basically had to put the entire thing on hold for three weeks because once I ran out -- I was flat useless. I couldn't believe how much I depended on them to do my work. It caused me a lot of stress and anxiety realizing that I am basically living a variant of the plot of "Flowers for Algernon" and that without these medications, I seriously do not think I could maintain the life I was able to build on them. I am not trying to scare you away, but I feel like it would be dishonest to not include both the good and the bad.

If you have anymore questions, I'd be more than glad to try to answer them.

[addisonl]

Does limiting the number of days you take medication (mon-fri and/or doing x weeks on, x weeks off) help in any way? I've always read threads like these and thought, yes that definitely sounds like me, but I have always been hesitant to get dependent on a medication...

[hirvi74]

As far as I am concerned, we are all dependent on "something." Prior to medications, I was dependent on moderately high consumption of coffee and tea.

Many patients and providers are both afraid of "dependency." However, what seems to escape me is -- isn't that somewhat of the point?

I depend on the medications to help treat a chronic condition. I see it no different than being dependent on eye-glasses for poor vision.

What many are worried about is the potential for addiction. I do not feel addicted to the medications in the slightest. I do not "crave" them or anything like that. I just crave/am addicted to not fucking up my life any further, and losing what I have barely been able to piece together. I do not feel "high" or feel "good" from these medications. If another medication provided similar level of functionality and was not a stimulant, I'd be on it in a heartbeat (I've heard the non-stimulant options are of dubious efficacy in adults... to say the least).

To answer your questions, does taking weekends off or weeks off help? Well, in the beginning -- yes. Taking weekends off for the first few years was highly effective. I noticed a notable increase in efficacy upon resuming my treatment.

However, something changed down the road once I stopped taking weekends off. I started taking weekends off again, but once I resume treatment, it now takes me like a day or two to "get back" to normalcy while on the treatment. However, the mild side-effects seem to be stronger upon resuming (this was always true).

From what I understand, it takes longer than two days to clear the medication from your system (half-life is around 10-12 hours), so weekends might not be enough time off for me.

As for weeks, I have not taken weeks off in probably 6 years, because I have not been at a point in my life where I have been able to do such. This has more to do with my employment than the medication i.e. the longest I have had off work is 5 consecutive work days in 6 years, so that is the main reason (I need a new job).

Though from what I have discusses with others, taking weeks off here and there is far more effective than weekends off. Current research claims there is no tolerance build-up, and the only tolerance that one acquires is to the negative effects, but I call bullshit.

However, I will leave you with this. I have always felt that these medications were a gigantic help -- especially in the beginning. Though when I look back on my life, things really aren't, nor were they truly ever, "better." I did not magically turn from a struggling developer into a FAANG prodigy. I was your below average, struggling dev in a bottom-of-the-barrel job. After all the time, effort, and treatment, I am still in the same situation.

The doctors handed me a rx and I thought that'd I'd be on my merry way towards achieving the things I wanted in life, but I have come to realize over the years that it's not that simple.

[addisonl]

I really appreciate your thoughtful and insightful reply—gives me a lot to think about, thank you!

[herdyderdy]

Thank you very much for your perspective. This is useful to know.

I've basically found some methods to cope with my weird attention issues but since my methods are so unusual and essential for me to be focused it makes it difficult to work with others or keep up my own self-motivation.

I was wondering if there was a magic pill to solve some of these problems, but you've cleared up that it's a double-edged sword.

[hirvi74]

A wise psych once told me, "Find me a perfect pill, and I will show you a pill that does nothing."

Medications very well may alleviate your focus issues too, and you might have entirely different results than I have, but do what you think is right.

I hope my comment did not persuade you not to seek treatment, I just felt it would be dishonest to not share some of the less than favorable aspects.

[dashmeet]

Would you be willing to share your coping mechanisms? Or is there a way I could reach out and ask?

[herdyderdy]

Sure, though I don't know how helpful it'll be to you or others. I basically had to change my career to get through things long term, but I do have some day-to-day techniques I follow listed down below. Hopefully some of it is useful.

I was a developer for 4 years after college, but I noticed I was struggling way more than my coworkers and friends in terms of just staying on task in a long term project for more than a few weeks at a time. In the short term I was at least as good as most, but after a while things just became impossible to keep focused on. I constantly asked my manager to be given different tasks or parts of the code to work on. This wasn't terrible because I was useful in many different parts of our code base, but eventually there weren't any parts of our project that I was interested in, and I couldn't see myself being interested in any other role where I had to code for the majority of it. I ended up switching into Software Sales Engineering.

Sales Engineering is, for me right now, the perfect role because I still get to think and work on some technical stuff, but no project is longer than 2-3 weeks which is about right for my ability to focus. There is also a huge dopamine hit at the end of a project because there's a clear endpoint. I'm not one of the Sales Engineers who needs to 'close' I just need to build out demo projects for a client until it's deemed a 'technical success'.

Some short term techniques I've learned for my own mind in just being productive (these were a lot more necessary when I was a developer but I still follow these in some way): * Change my physical working location every 2 hours (COVID has sucked for this, but going to coffee shops and libraries helps a lot) * Drink 1-3 cups of coffee in the morning, and 2-3 cups of tea the rest of the day (I've had to experiment with timings and doses a lot) * Keep a hand-written TODO list and keep my eye on it throughout the day -- For very boring topics or in difficult times, literally write down the scheduled time blocks I will spend on specific topics * Also in very difficult times, I TRY not to look at the computer unless it's to work on my required tasks. Internet to me is seriously more addictive than anything I've experienced