Question to my fellow ADHDers who take the meds, is fun still fun and happening? or has calmness become the new fun?
But the -crazy- fun is still accessible. I'm more risk aware, but still get the unconventional ideas. And I can always drop meds for a day and have a "high" day with less productivity and more "crazy" ideas. And I don't mean crazy as a negative, more like an adjective that describes it well.
However, it's important to love yourself (and this can be practiced and trained) and all your aspects. Even your ADHD self without meds, even your depression and dark thoughts. https://www.youtube.com/watch?v=9s9PbBfwDfo
Also, I went through a lot of meds, and one I ended up with was because the first one made me a little too much "robot" like for my own liking. I'm too used to being "me" and didn't like how much the first one changed me. But I'd rather people try for themselves than have an opinion based on mine.
Edit: moved a coma, added yt link.
I ended up with 30mg Elvanse (European analog of Vyvanse). That’s minimum dosage possible: I was prescribed higher before but side effects made it uncomfortable.
Alternatives that didn’t work: - Dextroamphetamine pills, immediate release: short effect, jittery, pronounced crash - Ritalin: feeling of being overstimulated and uncomfortable, inability to focus - Strattera: closer to an antidepressant, sexual side effects (no pleasure when ejaculating), brain zaps
I went through different kinds of methylphenidate delivery. First with Ritalin MR 20mg (mod release) analog - methylphenidate Teva MR. If I'm not wrong, it's 50% instant, 50% after 3 or 6 hours? I asked for just 10mg, because friend told me they'll start me on 20 or 30 and it's better to go lower. That was a little strong, but let me experience the "calm" effect for once. Tried Concerta 18m, who have their own way to slowly release mph over multiple hours. But in addition to "robot like" feeling, it was still a little too strong, super dependant on eating enough with the pill, and after few weeks started metabolizing way too fast, with a crash after just 5 hours IIRC. I was also having a hell of a time from doing too high for me doses of stimulants for few months.
And mph hates coffee. I have a funny story - was once on a friend's child's birthday. It was Saturday, and happened to be the day I tested Concerta 27mg, to test if upping the dose will sort the issue of meds crashing right after work and leaving me crashed until late evening, when it's time to go to bed and too late to study (evening school). So, on the party, we were toasting with alcohol free champagne. After the second glass (it was yummy) I read on the bottle that it was based on white tee. 30 min later it started feeling uncomfy. After 45 I said sorry and left, walked briskly for some time and got the initial urge to panic and run away down. And took a train home. 2/10, don't recommend. Coffe and MPH have a similar effect, but different mechanism and they just multiply each other. So you end up with panic level amount of neurotransmitters in your brain. But physical activity lowers them down. It's also super person specific, close friend takes very high doses of Concerta + upping with small ritalin in afternoon, and drinks lot of energy drinks together with that. Says he sees no difference. He was diagnosed around 19? and it's been many years, he says he just feels normal on meds.
So, after Concerta I had a break, and then tried lisdexamphetamine (Vyvanse). Doc wanted to put me on 30mg, I asked for less. She gave me 20, and advised trying half first, because they have more of an adjustment curve than MPH, or even, smiling, said 5mg maybe. I made the mistake of treating both meds the same. Expected calming effect with the 10mg, went shopping. Was mildly anxious, listened to piano music to keep anxiety down. Decided it was my regular anxiety because meds din't work, so I tried 20mg on the next day. Was just high on amphetamine, albeit not super high. Wasn't that bad initially, but later came crash. And very unproductive, got stuck at things, was jittery and such.
Now I'm using 10mg (using water bottle with markings to get rid of half). And use it in two doses, one in the morning, the other 5h later and it kind of works. Still a little to intense in the beginning and I'm currently experimenting with doing 2.5mg 4 times instead, over 6 hours. I'd love to get my hands on medical grade scales and be able to just get it into small capsules to avoid the hassle with water and be able to prepare them once for a whole week. But scales that can reliably measure 3 or 5mg with 0.5 tolerance are crazy expensive, so that's a later project.
Still, I can get much more done. I get less stuck on stupid stuff. I'm not fighting with my wife because it was too boring to do laundry or other stuff. And I'm still the lively person that greets and chats up everyone I know at work. And I'm also more resistant to anxious stuff. If MPH wouldn't make me so robotic and had an easier way to use lower doses, it could be preferable some days. With MPH I'm more organized and are better at task prioritization. With lisdex, it's still an issue sometimes. Getting stuck in sth fun, while supposed to do other things, but to a lesser degree.
It's been only a year so far. I'd like to get proper scales, find the EXACT perfect dose (whether it's 8 or 12mg). And also get a good schedule on when to introduce brakes each week. Most likely I just have to choose two weekdays, so the weekend can stay productive for school.
My psychiatrist advised against splitting vyvanse. The reason being that fillers are mixed into the capsule. Splitting the pill into two, for example, can give you the full dose in the first half and no dose in the second half.
Maybe shaking the bottle can account for that.
I suppose impulsivity in terms of working on what I should be working on instead of going into some rabbit hole is a type of impulsivity, and that's certainly decreased! I wouldn't call the former state "fun" though... more like "shameful", "irrational", and "distressing". Personally -- YMMV.
Anyway: yes that's plausible, as this review found pretty strong evidence of increased mortality from injury. Still, I'd personally say it's unlikely for two major reasons:
1. Presumably most injury deaths happen to adults, which are relatively quite unlikely to have the HI presentation.
2. There's just so many plausible causes of injuries, especially in a society with cars. The inclusion of "intentional injury" also introduces a factor that's no doubt strongly corellated with socioeconomic status (i.e. being murdered/manslaughtered), another very plausible cause.
Just an anecdote there, but I believe there's a study or two demonstrating a correlation between ADHD and car accidents - I imagine being inattentive in a car is likely to also increase your risk.
You are born with ADHD and it does not get better, so the "rare" in adults is not factual, some people just get better at managing it.
1. You are not necessarily "born with" ADHD. That's certainly a very plausible explanation, but ADHD is a disorder defined solely for diagnostic reasons, using only collections of symptoms; unlike a typical physical disease, no internal mechanisms or underlying causes are posited, on purpose. So saying with confidence that you can never develop it during lifetime is just invalid, putting aside the more philosophical discussions of nature v. nurture and free will that would come up if that roadblock were ever cleared.
2. In the new DSM5-defined paradigm, the three "presentations" of ADHD are assumed to present at different times at different intensities through the typical sufferer's lifespan, with the prototypical progression being Hyperactive-Impulsive or Combined in childhood that leads into Inattentive in adulthood. This is far from absolute, or at least it's supposed to be -- sadly many US psychiatrists still insist on seeing evidence of hyperactivity in childhood before trying out an adult ADHD diagnosis, based mostly on outdated, partial advice from the DSM4.
3. As the flipside of #1, it can also go away without explanation or reason, i.e. go into "remission"; I don't care to gather data on common that is, but I can say with absolute certainty that it cannot be ruled out. That's just how DSM-defined mental health disorders work on a fundamental level.
4. Either way, none of that is relevant to the question of how prevelant it is overall, which is simply a matter of empirical measurement. Without looking it up, I feel confident that it's well below 50%, so objectively "rare" in some sense.
5. I feel like the "some people just get better at managing it" thing is some personal axe you're grinding about people who are virtuous enough to just grit their teeth through psychiatric disorders vs. those who use drugs to cheat. If not: sorry! If so: please don't do that.
Finally, the "edit" button is inline, it just disappears after some amount of time for some odd reason. HN UI never fails to confuse me, as well!
But being a Category 2 controlled substance means health care providers are always pushing me towards off-label use of antidepressants that DO have very big and worrying side effects.
I've read: sexual dysfunction, food cravings, changes to insulin response contributing to hard to lose and large weight gain (increasing diabetes risk), general tiredness making exercise difficult, loss of enjoyment
I've known quite a few many people go from slim to balloon in months and then unable to shift the weight years later. The doctors parrot the line that low mood was just suppressing appetite...
It's like being invited to play Russian roulette. Literally, as suicidal ideation ironically is a known side effect of the antidepressants...
It's so bad I can't help but put on my tinfoil hat and wonder if someone went "these people are already down, let's kick them to keep them there permanently"
It's taken literally decades for the suppression of information around eg PSSD to be released
What I don't like about this study is that they only take meds into consideration, but there are other treatment options. For example cognitive behaviour therapy. Also, they included studies that included self-diagnosed ADHD. Self diagnoses are on the rise and very often wrong (I.e. trauma response might present with adhd like symptoms). Aside from some other flaws I think the significance of this study is limited...
I haven't been energetic about seeking stimulants because, well attention problems, but I hear there are shortages of the meds, they are a pain to refill (I can't even keep my non-controlled antidepressents going in the US system), and that docs nowadays don't really diagnose adults because they believe "it should have been diagnosed in childhood" even though the official pediatric diagnosis didn't show up in the DSM until I was 14. So close, but my parents who have their own issues _including_ attention problems, don't believe in mental health care.
Count yourself very, very lucky. For those not as lucky as you, meds can be a gigantic relief or make a "normal" life possible at all. Therapy helps too, but can't like medically directly affecting your brain chemistry.
But it does exactly that. There have been enough studies about this. CBT and medication combined improved faster, but CBT alone catches up in a few months. E.g. https://journals.sagepub.com/doi/abs/10.1177/108705471667119... or this study here: https://pubmed.ncbi.nlm.nih.gov/31280035/
>Stimulants are the gold standard treatment.
I'm not arguing that they don't help, but CBT also increases other metrics, e.g. self esteem, acceptance, self-efficacy, and so on.
I was recently diagnosed, and am on stimulants, which are definitely helpful.
That being said, I'd been going to therapy for about six years (currently winding that down), and I have to say that the therapy alone definitely helped with lots of the emotional/childhood stuff that I don't think would have been helped by medication alone.
I would be prone to believe that both therapy & medication are effective, and indeed my prescribing doctor called this out (although she focused on CBT, which is the easy one to test with controlled trials).
But does therapy help alleviate ADHD symptoms specifically? I doubt that very much.
The reasons for my expectation that therapy doesn't address ADHD symptoms generally (I know it didn't for me) is more fundamental though: therapy is helpful in making conscious changes. The whole point of ADHD is that you're not consciously aware of the decisions you make. Any therapy that tries to address the root cause of ADHD issues boils down to "try to remember to not do that" when the f'ing point is that I will not remember, and I can't control that. Stimulants fix this. No amount of therapy makes it better.
Where therapy is helpful is learning to live with the disability and to prevent or contain the worst outcomes that can result. Therapy helps manage symptoms, not address the root cause. Which is good because even stimulants are not perfect, and usually by the time you're seeking help there's a lot of damage already. But they're not addressing the same thing.
For all the guilt and shame associated with the consequences of those stupid reactions, therapy is incredibly helpful.
In my case my marriage was falling apart, among other things, due to problems that ultimately stemmed from my ADHD. Therapy helped me fix my marriage, but only medication corrected the behaviors that led to that situation & kept me from repeating the same mistakes.
The first psychiatrist I saw told me to do CBT alone, but I also needed to change jobs to a complete different field as doing boring excels would never be possible for me. I mean, it's true but not very practical and quite risky as a life path.
Self care is _hard_ for ADHD people. (diet, exercise, hygiene etc..). All these combined together could grind you down into an early grave.
i feel much safer though knowing that now when i sometimes get a little bit of the itch, i'll think about it for a few seconds and go "eh, maybe later," and return to trying to make a thing, or play some music, or why is that stupid thing still broken oh its because i broke it.