• make sure you are getting as good sleep as you can
• if you havent tried coffee, give it a go. I havent tried nicotine, but ive heard some people say zyns help them. All anecdotal but in the absence of pharma stimulants you gotta get whatever you can
• avoid alcohol especially, and maybe avoid weed and other drugs. Again, alcohol is gonna fuck your sleep and anything that will make you feel worse tomorrow is going to make it even harder to stick to your plans
• i found exercise actually does help me focus a lot, but this is more since i started my stimulant. But i guess it is worth a try, maybe moreso if you have hyperactive first adhd (i have the innatentive first type)

Hopefully countries with regressive stimulant regulations will learn in time that they are so necessary and useful. And the abuse potential frankly is not that bad if you stick to the newer longer lasting or timed release types. I pop a 36mg concerta when i wake up and am good for the day, so i really dont have to think about it at all.

Strattera helps some people, but i think stimulants are still considered the best treatment in terms of percentage that respond well to it.

You may not like the alternatives, cause it’s gonna include stuff like therapy (specifically CBT) - this is proven to help. Some people who aren’t medicated self-medicate with a lot of caffeine (please stick to safe levels). There is some limited evidence that maintaining a good level of fitness and visiting natural spaces regularly help, I know it can be quite difficult to stick to fitness so instead of setting aside time for fitness, I’d say integrate it into your daily life (walk instead of drive/transit for example). There is no evidence for any diet change or supplement, but that doesn’t mean it can’t help even a little.

Some people find body doubling helpful, I don’t know actionable it is for you to have someone physically next to you for tasks is. Apparently even remote body doubling by being able to voice or video call can help.

For now, the only empirical treatment we have that is proven to work for everyone is medication - I’m sorry. There’s been some limited evidence that you can train your working memory but there is not evidence that it works long term. Other than have someone else remind you - and importantly YOU ACCEPTING THOSE REMINDERS - I don’t know what can be suggested to help you stay on task besides something like body doubling. I was my exes reminder person and one of the things that contributed to the break up was them being very hostile about reminders, that they asked for, so maybe show some grace to people youve asked to help when they get you back on task.

I know you don’t wan’t to or can’t go the diagnosis route but those people are going to be able to set you up with supports. Perhaps besides medication although getting you on something might be more beneficial than nothing. You will have an easier time getting supports with a diagnosis. Yes, it will probably be difficult to stay on task/schedule but ironically, any psych worth their salt would see that struggle and conclude you likely have ADHD lol. It may be easier if you are at a university that has a health clinic for the student population.

Without medication, you are likely going to have to rely on friends and family for some amount of time. You are probably going to feel embarrassed asking for this help. You are probably going to feel anxious about rejection (adhd is very linked with rejection sensitivity, which is a much smaller word than how being rejected/failing feels to someone with it implies). You are going to have to get past any embarrassment and anxiety you may feel because battling this alone is a mugs game. It is hard to ask for help, you are going to have to anyway.

I’m also interested, I can’t take medication for a few reasons, it reacts poorly with me, it’s a controlled medication meaning expensive psych visits everytime I want a script, etc. so any management advice would be great

I’ll start by saying I do take stimulants and am bad at functioning without them. But these are things I do when I’m on a tolerance break and need to not lose the momentum of my self care. Playing loud high energy music is good for getting me energized when I’m having executive dysfunction. I religiously put everything into my calendar on my phone and get multiple push notifications for every event. I drink caffeine when I can. And then I try to let the impulsivity take its course sometimes because it’s preferable to being couch locked.

This is less immediately actionable advice, but I’ve intentionally gone out of my way to find jobs where having a bad ADHD day isn’t a deal breaker. I did this by getting fired over and over again until I finally landed at a company that’s more laid back. Can’t say I recommend this method but it’s what I did. I’ve heard it said that people with ADHD have an interest-based nervous system, so it helps that my job is doing something I’m interested in. Any other job I would get so bored that I could physically not force myself to body to work. Having a podcast or video constantly running in the background did help with that, though.

I’ve also tried a bunch of those apps that are basically todo lists but try and gamify it. The only one that I’ve stuck to is Finch, maybe because it’s cutesy? Maybe because I started doing it with my partner? I don’t know.

EDIT: Initially had some supplement info which I decided to delete since it isn’t relevant.

Meditation is supposed to help quite a bit, but that’s hard for me to stick to.

Exercise is your friend. I don’t know the science behind it, but I can personally attest to the effects of exercise. Daily. At least 30 minutes and you gotta get your pulse up. I cannot emphasize enough how big of a difference I could feel between the periods where I exercised regularly and the periods I didn’t.
Now I have meds, so it’s not as important.

Limiting dopamine shortcuts like social media and video games also did wonders. I stopped using headphones when I was outside and it helped a lot as well.
When I say these things help, I mean that they helped me stay organized, mask in social settings and not feel tired all the time. It seems like these are some of the things you seek.
If you can afford it, an ADHD friendly therapist is also a good aid.

Things like “create a schedule” and “calendar” are mainly advice coming from neurotypicals that only seek to limit how ADHD negatively affects them, rather than give you tools that improve your life. They do not understand what the actual challenges are and what helps.
With those that you feel safe with, communicate that you have ADHD and that you have a lot of difficulty managing your time. Tell them that you are not asking for advice, but you are telling them this in the hopes that they are understanding, because knowing that it is accepted actually relieves tension and makes it so that you are less stressed and thus less often struggling with time management.

While creating a routine is good, don’t beat yourself up about it. Focus on what it is about yourself that is good rather than what you feel you cannot do. This isn’t as a sort of “accept yourself” thing, but a sort of way to again alleviate stress/tension. If you are always procrastinating on large projects until the last second and you wish you didn’t, wishing you didn’t and beating yourself up about it doesn’t work. If it did, you would have stopped by now. Instead focus on the fact that you know you are able to handle large stressful tasks and complete them well in short periods of time. Focus on the knowledge that you know you will do the task. Build up from there.

Work towards a healthy sleep schedule. Do not use your phone in bed. Consider journalling if you aren’t already.

You seem to have some practical and pragmatic challenges, so it might seem like my suggestions are coming out of the left field, since I am focusing on something adjacent to mental health. My thoughts are that these things are connected. Your struggle with routine is in part due to a question of mentality.

Well, I’ve been to a psychiatrist who will not prescribe me stimulants or even fucking ask me questions about how I’m feeling until I have a neuropsychologist’s assessment that I have ADHD. He only prescribes me arbitrary amounts of Wellbutrin and sends me on my merry way. It helps with my mood but does fuckall for my focus, so what I do is drink a lot of coffee and chain-vape the whole day, but I don’t know whether or not that helps or is simply a habit of mine.

What does in fact help me is to make much use of my Google Calendar to remind me of all my work commitments (I absolutely will forget them if I don’t set up reminders) and if there’s a specific thing I need to focus on, I use the Pomodoro method with some app for convenience. That is assuming I remember that I have a task to do and manage to muster the initiative to actually get started, which often doesn’t happen.

I don’t take stimulants and don’t plan to, because I am of the mind that enforced neuronormativity is oppression and I don’t see the way forward to be making the oppressed like the majority.

But for doing this I have the privilege of working from home in the mornings and many other structural things that help me, like a partner who is unemployed and aids me in being a functioning worker. We have made a deal on this, he washes the dishes and I work. We are both neurospicy and so is our kid. I did study again to get here, because I could not do the type of work I previously did anymore. I have also accepted that I just can’t expect myself to live like the majority does, so these days I lean into that difference and try to embrace it.

I have also developed countless toxic mechanisms of masking after living into late adulthood as an undiagnosed audhd woman and have a few burn outs behind me. These probably “help”, but also drain me.

I have stripped all things I don’t actually have energy to do from my life. I am still in the process of figuring out what I actually like and don’t like. I rest so much more. I am learning my triggers and things that drain me. We had a workplace outing day on Friday that is supposed to invigorate us, this has cost me until today, I am still very very spent from it. In the past I might have ignored this tiredness and pushed myself to do stuff because weekend.

I try to keep my day to day as simple as possible. We often cook a big batch of food for days for example. I energy save from most things.

I have accepted that I can focus well on just one thing. I no longer try to do all the things at once. I do everything mandatory right away, because I know if I don’t I will forget it and the ADHD-tax happens. If I absolutely can’t do a thing right away, I write it down somewhere where I cannot miss it, but this already raises the chances of forgetting it a lot. I always try to stay on top of my work email because of this, I can’t let it get out if hand. I pay a bill the moment it comes if I can. These took me decades to get down. This way I don’t have to try and carry the things in my memory which often fails and drains me plus makes me anxious.

I try to accept that I can’t control this fully. I keep in mind the structural issues of neuronormativity and tell myself that in this environment functioning is made really hard for us and that it definitely is socially constructed, we are no worse than anybody else.

Sometimes my systems fail me, but I still see these as ways of trying to make things as easy for myself as possible. I don’t try to force myself into habits and into becoming neurotypical anymore because I can’t get there. It’s just a road to self-blame and frustration. I try to work with what I got and lean into the different temporality and way of life instead.

I am unlearning things I previously did just because “you should do this” too. I have also ended up learning a lot of good coping mechanisms that work for me over the years just by living my life, like exercise and music. I use a lot of environmental help in getting stuff done that motivate me. Things that others might call hedonism: If I have to read for an exam, I light a candle and put on brain rewarding music, brew myself a nice caffeinated thing to get it going for example. It doesn’t always work, but often it does. It’s good enough.

Sometimes I just procrastine on purpose and wait for the drive to do a thing to kick in, because I now know how I work. I am learning to trust my different way of doing stuff. If a particularly boring task requires three hours of idling in the inertia or procrastination, I allow it. Sometimes I can’t do anything and I have tried to learn that when this happens, I probably need to let it and just let my brain idle and browse hexbear. It usually means I need the rest. I don’t see the idling and procrastination as negatives anymore, but as parts of the different process of doing stuff I have. Because when I do stuff, it happens very fast. Probably ending up being just as “effective” as the neurotypical way.

I still sometimes grief the way I can never probably achieve “my full potential” because I just don’t have enough spoons for it. But at the same time I try to learn to appreciate the at least 15 careers and skills my neurotype has already taught me that I am actually very good at. I try to remember that the image of a motivated and driven “normal” person is scewed and manufactured by neoliberalism. Nobody has it that easy.

I use to do lists and put things in the same places, I only own a controllable amount of clothes that don’t need ironing ever, there are a lot of these little big things I do that I have just learnt over the years and by having to parent a human into adulthood, which was doable for me.

Before I knew these were adhd things, I just thought they were “quirks” that I have.

My point I suppose is that I think it is possible to do just fine without the meds, but as long as we live in a word of neuronormativity, it takes a lot of work that we shouldn’t have to do. But by being kind to ourselves and giving ourselves a break I think we can at least cope.

This might not make you better at remembering stuff but one thing that might help make your life more tolerable could be to align expectations with people in your life. Tell them about ADHD and tell them how is is not because you don’t care or because you’re an asshole that you fail to remember things but because you have a disability that makes you forgetful and unfocused.

Stimulants are likely still available. Not the kind you want. However before I got on meds I had a suspicious caffeine habit. So while this is not an advisable route some days having an option is good even if it isn’t a great option.

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So as someone who’s lived with it unmedicated for decades at this point, my advice is coffee, always having something playing in the background, and small breaks. I am an absolute shit-show, so my methods are more of a basic survival by the skin-of-your-teeth.

I went unmedicated for 30 years. A few things I found that worked:

• Exercise Having a consistent exercise schedule helps so much with energy and mood management. Keeping myself on a constant energy baseline during the day without constant up/down spikes really alleviated ADHD symptoms in the workplace. I did mostly resistance training with occasional cardio.

• Strict scheduling / using a planner This worked in the last few years but it required a level of emotional maturity and self-belief to utilise properly. You need to believe it is necessary to follow this schedule to the best of your ability but also not put yourself down for getting behind and missing tasks. For a long time I would inevitably fall behind at some point and start hating myself and get stuck in a zero productivity hole.

• Working conditions This is by FAR the hardest to control but it made the most difference. I never fit into a 9-5 unmedicated but I did well at a job where I could do all my work after midnight as long as it was completed in time. I would do what I wanted to during the day and then start getting all my work done from the evening. If you are the opposite and prefer mornings then the other way round might be better but the same overall idea still applies.

I just drink 300mg+ of caffeine daily.

I usually don’t go over 400mg, since that’s when my heart starts paying for it.

For me, rigid scheduling and body doubling helps the most besides my medication. For studying, using the Pomodoro Method worked wonders and helped me chunk through the material. You’re just going to have to try lots of things to see what does and doesn’t work for you because it’s so different for everyone.

It’s going to be very difficult but you can’t be the only one in your area going through the same thing. As TerminalEncounter mentioned, CBT should help a lot. You could also reach out to your therapist and ask if there’s a group or something for support.

Last but not least, if there’s something you remember to do- go do it right away. You’ll forget or put it off.