Every screening and official diagnostic I’ve taken has me scoring max ADHD points and every time someone describes a symptom I’m left confused that other people don’t have them.
Will my personality change? I feel like being a disorganized disheveled loud interrupter is most of my personality at this point idk.
I’ve never done any stimulants beyond drinking a million coffees per day so i have some anxiety about this
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ADHD medication isn’t a magic cure that makes all of your ADHD symptoms vanish, it just makes it easier to deal with them.
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Stimulant meds will vary in effect depending on the person. Dr Russell Barkeley, a recognised global expert in ADHD, puts the efficacy of stimulant meds at about 40% for the amphetamine-based meds and about 40% for methylphenidate, so about 80% of ADHDers respond well to stimulant meds. For me, I barely respond to methylphenidate. For others methylphenidate is a game changer. Go into it open-minded but without any particular expectations.
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It’s a good idea to go easy on caffeine, especially in the early days of stimulant medication.
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Generally ADHDers find that stimulants reduce their anxiety levels.
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Starting on stimulant meds usually comes with mild euphoria. Enjoy it while it lasts, don’t go chasing the euphoria though.
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If you have a history of significant trauma then often stimulant meds give your brain enough breathing room to start processing that old trauma, like it or not. This can get a bit hectic for people who have a lot of unresolved trauma so if that’s you then make sure that you have the right supports in place.
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Stimulant meds will change how you manage things and how aware you are of stuff in general. This is almost certainly going to change your close relationships, sometimes for the better and sometimes for the worse. At its best you’re going to be a better friend and partner because you’ll be able to attend to other people’s needs and be more consistent with coming through for them. At its “worst”, you might come to the realisation that you are being taken advantage of or you are being abused. Just be aware of this.
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If you are also autistic, auDHDers find that their autistic traits become much more apparent and that they find it more difficult to mask when taking stimulant meds.
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You will have a lifetime of unhelpful habits and beliefs that you have accumulated over your life up until this point which are unsuitable or downright counterproductive for an ADHDer. Meds make the doing side of things easier but the habits and beliefs will have a much longer lag time and you’ll have to work on those, ideally with someone who understands ADHD well.
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ADHD meds will give you the ability to focus and sustain that focus, which is wonderful. They don’t instantly provide you with the self-discipline to focus on the most urgent priorities though so you might find yourself furiously researching some historical event or reorganising your kitchen when you really need to be packing your bags for your flight.
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Often ADHD symptoms and an individual’s psychological response to them can mimic depression and treatment-resistant depression. You might find that if you’re prone to depression that some of this is alleviated by the meds.
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Overall it’s better to stay consistent with taking ADHD meds even on off-days or weekends because it will make it much easier to establish different habits and a new attitude towards things, however it’s also okay to take medication vacations particularly in the early days as you’re adjusting. My general advice would be to avoid taking medication vacations more than once a fortnight, except where there’s good reason (e.g. you’re sick, you’re having difficulty with side effects, you need to sleep in).
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You will be able to push through without food, breaks, or sleep. Don’t do that. Schedule in breaks, make sure that you are eating well and getting enough sleep or you will crash and burn.
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You may find that you have a significantly reduced appetite. Try to have a good, high-protein breakfast in the morning to carry you through. Protein shakes and smoothies are ideal.
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Depending on what you get prescribed, you might benefit from a prescription that is somewhat higher than your baseline level of need - stress, lack of sleep, poor eating, unusually high demands, lack of physical exercise, and similar things can all make the meds feel less effective or ineffective so having some wiggle room to adjust upwards on the meds based on your needs is Ideal.
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If you menstruate then you go through a hormonal cycle where you will naturally have less dopamine in your nervous system. ADHDers who menstruate very often suffer from PMDD. ADHD meds can often help relieve symptoms of PMDD however the meds often feel less effective or ineffective so it’s ideal if you are able to increase your medication dosage around your period.
I can talk more about managing insomnia and increased anxiety on ADHD meds as well as second-line ADHD meds if you need the info but that’s likely something for down the track, if you encounter these things.
Edit to mention that I’m also pretty knowledgeable about the less commonly prescribed ADHD meds and all of that stuff as well so if you have any questions about ADHD (not to mention autism, mental health, and medications more generally) then let me know.
This was an excellent writeup.
Lifelong medicated inattentive ADHDer. I would recommend giving the meds a shot; start with a low dose, ramp up a bit, see how it feels. I have had some make me feel suicidal. I have had some make me feel no different at all. I have had some give me involuntary movement disorders. I have had some that caused constant rage. As long as I was able to keep “this is medication, not me” at the front of my mind, I was able to finish the test script and ask to switch to something new.
I would not have a career without them. The script I am on now has been an absolute game changer and I’m putting out the best work I have in my life, with minimal side effects (appetite (I was very overweight anyway, I see this as a bonus), sleeplessness). My depression and anxiety are almost entirely handled by just the ADHD stimulants now, since I’m capable of handling and reacting to things without getting distracted, before they become disasters.
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absolutely goated
I don’t think I’m autistic but I certainly noticed a lot more of my ADHD symptoms when i got my depression under control. I really appreciate the informative post thank you
I wish I had read your comment before I started medication! 😂🤦 Especially points 6-8.
definitely need to work on 9
thank you for this ❤️
You and me both, comrade.
Stimulant meds thoroughly turned my life upside down. I wish I had a bit of a warning about it but oh well, too late for that now.
I was recently diagnosed as well and I feel like non-stimulant meds would be the right choice for me for a number of reasons. I already have disordered sleep and eating habits, as well as pretty bad anxiety. Would be interested if you have any experience with them o7
I already have disordered sleep and eating habits, as well as pretty bad anxiety.
So the neurochemical side of anxiety is a bit tricky to pin down because often, especially for ADHDers, it’s a lack of norepinephrine (adrenaline) that causes it however you may be very sensitive to it or you may have an excess of it which is causing anxiety instead. Because of course it’s not just a simple matter of it being an excess - that would be too simple.
There’s really only one way to find out and that’s via tinkering with your norepinephrine levels. Sorry that I don’t have a clearcut answer for you.
If you’ve ever taken a medication that is an SNRI or that has similar norepinephrinergic effects, e.g. venlafaxine, you’ll be able to get a decent understanding of which side of the norepinephrine equation you find yourself on.
It’s hard to know exactly what would be the right path forward in a general sense because it’s important to understand the causes in order to address them. For example, one person might have disordered eating due to being extremely anxious all of the time and then the fix is “simply” to treat the anxiety and voilà. On the other hand if the disordered eating is rooted in something like body dysmorphia then doing something to increase appetite such as trying mirtazapine may help appetite but it might aggravate the underlying psychological issues and make things worse.
As very general advice, for ADHDers who experience anxiety and insomnia I think one of the best options is trying clonidine. This doesn’t work for every ADHDer but it helps with impulsivity, anxiety and the trauma response, rejection sensitive dysphoria, and insomnia.
I have also had really good success with amantadine for treating anxiety, plus it’s a dopamine reuptake inhibitor which is an added bonus for ADHDers although its usage for mental health and ADHD is still very very much in its infancy and I’ve been trailblazing its use where I live and you’d probably need a prescribing doctor who is comfortable with prescribing off the beaten path. Amantadine has a very low side effect profile and it seems to be very well tolerated.
I feel like non-stimulant meds would be the right choice for me for a number of reasons.
Fair enough. Don’t go over sharing beyond what you’re comfortable with but if the concern is addiction issues then keep in mind that appropriately medicated ADHDers have a way lower risk of addiction because that need for dopamine is already addressed by prescription meds and so the urge to engage in behaviours that provide that kick are usually dramatically reduced and much more manageable. There are some meds like Vyvanse that are pretty difficult to abuse as well. Stimulant meds will reduce your appetite so this can be a problem for people who are prone to disordered eating like anorexia. It’s a bit of a crapshoot to figure out if stimulant meds will increase or reduce anxiety too.
As for alternatives, I think that guanfacine is a pretty safe bet - the side effects aren’t wild and it can help with anxiety, although I think that clonidine works better in this regard. Dosage for adults is a bit tricky but I’ve heard reports of very high doses working for some people - in the vicinity of 6-8mg. Guanfacine usually works best as an adjunct medication.
There’s a lot of norepinephrine reuptake inhibitors that may help but I won’t go into depth on them. There are a few dopamine reuptake inhibitors, such as atomoxetine, but as these are mostly antidepressants they tend to come with significant side effects (atomoxetine especially) and it takes a while to taper up to the right dose. That being said, for some people a medication like atomoxetine is a complete game changer. Atomoxetine also increases dopamine in specific areas of the brain, which is unique to it, and thus it lacks the broad-spectrum effect that a classic stimulant has so it can work really well for some people but for others who have a more global dopamine issue it may have a limited effect or no notable positive effect.
One medication that I think is grossly underrated by psychiatrists for ADHD is modafinil. While this is technically still a stimulant, it’s not the same as the classic stimulants and it does not have any significant norepinephrinergic effect nor does it have significant addiction potential. The lack of norepinephrinergic effect can make it less useful for certain people but, where classic stimulants are not tolerated, it can be a good option. Just keep in mind that it’s drug that has sulfonamide and thus if you have any allergic reactions to meds this may not be suitable for you and you want to know the symptoms of Steven-Johnson Syndrome just to be aware of it if they start to manifest while taking modafinil. It’s not a huge thing to worry about but there’s a small chance of it happening so it’s always worth mentioning when talking about modafinil.
I can speak to personal experience with a lot of this stuff but tbh my experiences are a bit more uncommon and it’s probably better going into this stuff with the understanding of how these meds generally tend to work than it is understanding my less-usual response. I hope this is helpful!
I have taken Straterra(atomoxetine) before. It made me feel “normal”. I had to stop taking it because of some gnarly physical side effects, and that annoyed me because I felt I was able to integrate into society better while on it.
Great writeup! For me I’m struggling with a situation where I know exactly what helps me but I can’t tell my doctor how I know that 👀
If you have auADHD you might find that you’re especially sensitive to medication, and the starting dose might be a very unpleasant experience. A “normal adult’s” month supply lasts me 4.
less commonly prescribed ADHD
Which are these?
The less commonly prescribed ADHD meds that are still common-ish imo are:
Atomoxetine
Guanfacine
Bupropion
Viloxazine
VenlafaxineThe much less commonly prescribed ADHD meds imo are:
Methamphetamine (not a joke btw - Desoxyn is prescribed in the US occasionally)
Clonidine
Modafinil (technically still a stimulant but without most of the issues that may come with stimulations such as potential for addiction)
Tricyclics like desipramineThere’s a few more that are really off the beaten path such as amantadine, which I’m a bit of an evangelist for, as well. It’s worth keeping in mind that non-stimulants aren’t a class in and of themselves so there’s not a huge amount in common between, say, atomoxetine and guanfacine.
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i feel like adhd meds are the closest thing to the drug from the movie limitless in real life but i still lose my keys all the god damned time so they’re not magic like the drug in limitless but they actually did cure my alcoholism, do incredible things for my social skills, and helped me move from dysfunctional to semi-functional. it’s a huge improvement for me.
I forgot to mention that I wasn’t medicated until I was an adult. When I started to date my wife I was basically homeless. Things are different now, definitely. And still getting better actually. Been on meds for 10 years now but only recently got on meds for my migraines which at low levels can cause adhd like symptoms so i’m only now starting to see what I can really do with chemical assistance. it’s life changing stuff.
i’d love to write you a real detailed and meaningful response as I’m 33 and had the same thing, but I’m in the middle of my work day and have two things to do that are literally due this afternoon by legislation, so i’ll maybe get back to you
this isn’t a bit, i got diagnosed at 30 and it’s the middle of the day in australia
also you can tell it’s real because i work off legislative and regulatory timeframes and i still only complete them on the final day
edit: this is making me look like a terrible advocate for the relevant medication, jesus
These are pretty short posts, I think you’re doing well
30 minutes to 5pm comrade
(Besides if there aren’t offence provisions attached to statutory timeframes, does it really matter?)
I don’t have 1:1 experience, but I think I have an apt metaphor for processing trauma and having clear focus. It’s like if your everyday life were like a musical album, you’d be better able to sit and listen to the lyrics and chord progression from start to finish and recognizing themes from song to song. With horrible executive dysfunction and left to your own devices to cope, it’s like skipping around the song and looking for moments in the song and then listening to the album out of order, sometimes skipping songs entirely. Instead of waiting for the song to pick up, you skip to the energetic part with caffeine and then that has its drawbacks. You’d miss major themes and through lines that life is trying to show you because you’re too unfocused to see the bigger picture.
In that sense, the song that’s playing doesn’t change. In the presence of professional help and meaningful desire to see improvement, I wouldn’t expect you to change dramatically unless you mean to (e.g. I don’t like having to be loud to be funny and now I feel free to use my indoor voice). Your medication endeavors to help you have a better time enjoying the music of your everyday life.
Thanks for the metaphor I appreciate it
This is a beautiful metaphor!!
If trying to keep a train of thought while having ADHD is like trying to have a conversation with the person seated next to you while a festival parade passes around you both, medication moves me to a nearby porch or balcony instead. All of the noise and madness is still there, it’s just a little more quiet and feels less oppressively overwhelming, so it’s easier to tune out and stay on track.
Medication changed my life for the better. It gives me the ability to stay on top of my responsibilities.
It also changes my demeanor. I personally prefer not to take it on my days off work, so that I can let it all hang out and relax fully. I like to be more “myself” on my days off. Some other people (like my partner) prefer to take medication every day.
Prescription-dosage amphetamines are so much nicer than caffeine, there’s no comparison for me. Adderall fixed my sleep schedule. Caffeine makes me anxious and jittery; ADHD medication has none of those side effects for me.
Caffiene makes me sleepy usually once I’ve hit half way through my day. It would be cool to be able to stay on top of stuff
My partner got diagnosed as an adult, and she’s exactly the same person on meds than off, only without the executive dysfunction
I feel like the avatar of executive dysfunction sometimes. The drugs may cause me to cease to exist
Like you have been living nearly blind and just put on glasses. Unfortunately it doesn’t feel like that forever but oh man the contrast is insane at first
I only notice being off my medication, and Im much more erratic when running chores and more easily stressed out since I feel like I have to keep track of a gorillion things.
Also its basically impossible for me to listen to a lecture I just copy the blackboard and read it later, and if I do read it I find it impossible to motivate myself to start or to keep going.
Ritalin has been a game changer for me. Its still not easy, I cant keep pace with my wife in terms of running chores but I dont take three times as long anymore, unless Im very tired or stressed out but without medication I wouldn’t be able to do anything at all so it’s still an improvement.
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I have a friend with ADHD who was diagnosed and started using prescription stuff later in life, predictably I think he’s a lot more evened out. When he was unable to get his prescription filled at one point, he made a joke about putting somebody through a window. They had a pretty good working relationship but it wasn’t a good thing.
I’m suspect I’m undiagnosed, but luckily some weed I’ll never be in short supply of works for whatever is going on with me. When I get a bit stoned I can focus on things things and work on them rather than think about all of them and do nothing.
I self medicate with weed for sure
You’ll be you but like, better. Even when I was on amphetamines or now when I’m self-medicating with caffeine or phenylpiracetam, I still have my symptoms and the quirks of personality that are associated with ADHD, they’re just more manageable and less annoying.
I’m already pretty great… Sounds like a good idea
I tried Ritalin for a few months, but I didn’t notice anything besides more anxiety and a sense of dread.
I don’t really get anxiety so maybe that’s a sign it’ll work better for me? Or I get a cool new problem
Man I need to look into getting meds. I already see a psychiatrist for the depression but I’ve only come to realize the ADHD recently when my partner started pointing out some of the the things I do. It does sound nice to be able to remember to do things.
If you suspect you’ve got it, I reccommend the book Scattered Minds by Gabor Mate. It helped me a lot to make me realise that all kinds of things I was doing were ADHD symptoms that I would never have considered otherwise. @Acute_Engles@hexbear.net this book tip might also be useful for you.
Yeah being on depression meds exacerbated my ADHD symptoms for sure
I don’t feel that adderall changes my personality at all. Certainly not at the low dose I take.
Concerta (a time release stimulant) gave me mood swings in high school but adderall extended release did not.
Then I tried Concerta again as an adult and the only side effect was annoyingly high amount of sweating in my feet.
annoyingly high amount of sweating in my feet
I already slip out of flip flops on a moderately warm day lmao
Uncommon side effect but that was on the Ritalin side of drugs, not adderall. Which I think(?) Concerta is one of?