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There is the potential that you have ADHD, because what you're describing sounds similar to my situation. I eventually ended up on stimulant medication to help, but there's non-stimulant medication available (if you're opposed to eating amphetamines for breakfast), as well as counselling and other treatment options that don't involve medication.

Even if you don't want to seek professional treatment, you could look up articles on solving problems and achieving goals written specifically for people with ADHD and see if those help.



Someone doesn’t have to have ADHD to shirk from hard problems.

Expecting technical/intellectual problems to be easy to solve is something that is drilled into most people by the school system, which rarely if ever present problems that take more than a few minutes to solve, and pretty much never expect students to try tackling problems that require weeks of effort.

The result is that when many people encounter a hard problem, if they can’t make progress after spending a bit of effort on it, they give up and conclude that either the problem is too hard or they are too stupid to keep going.

There is probably an influence from inherent personality differences, but I would speculate that building up stamina for tackling hard problems comes down substantially to practice.


> There is probably an influence from inherent personality differences, but I would speculate that building up stamina for tackling hard problems comes down substantially to practice.

I was diagnosed with ADHD my senior year of college. Before that, the mindset you're advocating got close to breaking me.


I completely agree, as someone who was diagnosed at about the same time in my life. It was one of the best and worst days in my life the first time I took medication: best because a mental fog had lifted for the first time ever, worst because how different would my life be if I'd been diagnosed sooner?

Fifteen years later, I am still stably medicated, and life is what I had always wanted it to be: productive and fulfilling. I hope anyone reading this does not let a stigma of medication bar them from talking to somebody about it if they've faced years of frustration over not being able to do what others seem to do easily: just getting shit done.


My “mindset” (if you can call it that) is that most people don’t get much experience tackling hard problems, at least up through school. In light of that, what I would “advocate” is that people should try to get practice working on problems at their current level of stamina/ability (which might be very low), and slowly work their way up, instead of beating themselves up when a problem much more difficult than what they were used to seemed like an impossible challenge.

Maybe you can elaborate about what “mindset” you were thinking of, and why it came close to breaking you? I suspect you were misunderstanding my intended message, and that the “mindset” you are imagining is pretty far from my own set of beliefs.

Note that before I was not advocating anything; only stating an observation that most people don’t get much practice tackling hard problems, and that people with or without ADHD can have difficulty tackling hard problems. Do you think that is inaccurate? It seems pretty uncontroversial to me. I know a lot of people who have difficulty with hard problems, and some of them definitely don’t have ADHD.

* * *

I am taking care of a 3.5 year old full time, so I’ll give you some relevant examples from that context:

If I try to read a book aloud which is much too hard for him (say a novel pitched at teenagers), he gets bored and wanders away. But his attention span, vocabulary, grammar, etc. are gradually improving, so the books he understands now (e.g. Pippi Longstocking, The Cricket in Times Square) are much more sophisticated than the books he could understand a year ago (e.g. Henry and Mudge, Frog and Toad), which are in turn much more sophisticated than the books he was interested in a year before that (e.g. Go Dog Go, The Very Hungry Caterpillar).

If we try to work on some 1-player logic puzzle games, the ones that say “age 7+” on the box are currently too difficult for him and he gets bored/frustrated and wants to do something else. The ones that say “age 5+” are pretty good, and he can do them with some external help. The ones that say “age 3+” are getting to be easy by now, and he can do them independently.

If we go out to practice balancing on a vehicle, a 2-wheeled scooter is now getting to be okay if we go carefully, but 6 months ago it was too difficult and therefore very frustrating. A year ago, he was just starting to figure out the (pedal-free) balance bike, and now he can zoom around on it. If I tried to get him to ride a skateboard I predict he would fall off and not want to try (heck, that’s probably what I would do if I tried to ride a skateboard).

One of my son’s friends has no experience with a balance bike, and is embarrassed to try in front of anyone, because my son (who has more than a year of practice) can zoom all around, whereas any kid just starting finds it to be a great challenge. But the same kid can swing across the monkey bars, something my son cannot, because that’s something that boy has practiced for a few months.

* * *

Activities like writing computer programs, playing music, writing essays, playing sports, cooking, etc. are similar: they require many challenging skills which must be slowly built up over the course of years of practice, and are very daunting for someone who is unprepared. The way to get better at these is to start at your current level and practice, in a playful and low-pressure environment, slowly improving until you can handle high-level challenges.

And the same is true of meta skills which apply to many domains like searching and reading academic literature in a field you are unfamiliar with, coming up with a few choices of high-level problem solving strategies and then picking one to apply, breaking the problem solving process down into smaller manageable chunks until you get down to a chunk small enough to just dive in, taking organized notes, trying many small examples when you don’t yet have a solid conceptual understanding, finding and tackling a simpler related problem instead, stopping occasionally while working to check if you’re making progress and if the current strategy still seems promising, recognizing that you are badly stuck and finding the right person to ask for help ...


I usually just lurk here but something in your comment made it impossible for me to ignore. I do not want to be rude but think you are behaving exactly like a pushy parent who would cause the sort of trauma OP is facing right now.

This constant push for a 3.5 year old to read books that clearly require more mental effort than is okay for his/her age, play 'logic' games that he/she can get no joy from are a huge red parenting flag. You might have good intentions but your relentless need for him to raise up to these arbitrary standards of yours that have been created without any regards for his/her happiness are going to put so much unsustainable pressure on the kid.

By forcing your kid to play with the games he can not understand or reading the books he doesn't like, you are just stealing his/her childhood. I can only hope that you realize this sooner than later.


I missed this before, as it was posted long after the original comment.

> pushy parent

This is funny. Other parents at the playground (back when playgrounds were open) are constantly telling me how unusually non-pushy I am (sometimes critically, sometimes admiringly). Example: “I’m glad to have you as a reference for how laid back a parent can be with kids still doing okay, so I won’t feel so bad when my immigrant inlaws give me trouble for being too lax with my kids.”

I admit I have been pushier than I would like recently when it comes to the kid running down the hallway at 1 AM (which causes complaints from the neighbors downstairs), shoving or hitting his 1-year-old brother (which makes me more anxious than it probably should), or wanting to dump yet another bunch of toys on a floor already covered by the previous two bunches of toys.

> books that clearly require more mental effort than is okay for his/her age

What are you talking about? We read those stories which the kid enjoys (sometimes over and over, at his insistence), and stop reading those which he does not.

If he finds the content of a book to be too over his head, too boring, too scary, ... then we set the book aside. (For example, recently William Steig’s Dominic was too scary, and St. Exupéry’s The Little Prince was too abstract.) We might try to return to those in a year when his tastes and abilities have changed, but at that point might decide to leave them aside for another year.

He is the one who most wants to spend a lot of time reading together. I just indulge that desire because I enjoy it too.

Why do you think listening to chapter books as a 3-year-old requires a “more than okay” level of mental effort?

> play 'logic' games that he/she can get no joy from

Huh? I bought a bunch of logic games because I personally enjoyed the first two I tried, for myself. Some of them are targeted at age 3+; others say age 8+ (and are enjoyable for adults). But those numbers are at least somewhat arbitrary, based on the age at which it would be appropriate to hand a not-otherwise-prepared child the puzzle with minimal additional direction/support, and leave them to figure it out for themselves.

The 3.5 year old really likes playing the puzzle games! They are fun and interesting. Some he likes to do mostly by himself. Some he likes to help me with. If the challenges get frustrating, we set those aside and do something else instead.

I promise you that we are not doing any puzzles which “he can not understand” or which he “can get no joy from”.

> relentless need for him to raise up to these arbitrary standards

There is no relentless need for anything, and no standard, arbitrary or otherwise. We just introduce a wide variety of tools, materials, and activities, and let him engage with them at his own pace.

> stealing his/her childhood

What do you consider to be a “not stolen” childhood? Parents leaving their kids entirely to their own devices and not engaging when the kids want to do things together? Parents leaving their kids in front of animated TV or iPad games for hours per day? Parents leaving kids with only a few toys/materials because they don’t want them to gain experience with a broad variety too fast? Whatever happens to be on offer from the nearest preschool?

Recently the 3.5 year old spends at least half of his time playing independently with whatever toys he feels like – his younger brother takes a lot of adult attention too – and unfortunately (due to Covid-19 shelter in place) we are stuck inside away from other people instead of visiting the playground for a few hours or walking around the neighborhood chatting with all of the nearby retail/restaurant staff, as we used to do before lockdown times.

It’s frustrating that we can’t get together with other kids of the same age too much right now. (I’m sure things are even harder for older kids; 3-year-olds are just starting to make friends and learning to play together with other kids, but for a 7- or 10-year-old being stuck away from friends must be really tough.)

* * *

With repeated practice and a little bit of help/guidance kids can learn all sorts of skills to a quite high level.

Witness the enjoyment and rapid improvement of Shinichi Suzuki’s young violin students or Mona Brookes’s young drawing students. These are ordinary children, given a little bit of structure and guidance, put in an environment where practicing a little bit every day or a few times a week is enjoyable, and then allowed to flourish for themselves.

It doesn’t take any draconian pressure, just enough adult time and attention to make a space for it.


Taking your example of your 3.5 year old's book reading attention and interest ...

What would you say if they were bored / distracted by everything you read to them, not just the difficult things?


That is a description of my 3.5 year old when he hasn’t had enough exercise for a day or two and is tired and/or hungry.

I haven’t spent an appreciable amount of time with a kid who is always completely uninterested in stories of any kind. But I can speculatively imagine a variety of possible causes for that: other distracting stimuli, malnutrition, exposure to toxins, disease, congenital brain abnormality, emotional abuse, ...

Do you have some particular kid in mind?

Or if this is an analogy to problem solving: if someone literally can’t manage to attempt any kind of problem no matter how trivial, then “easily give up when I face a hard problem” would not be an accurate description of the situation.


> Someone doesn’t have to have ADHD to shirk from hard problems.

At least 3-4 people with ADHD have already spotted the potential, and I expect that more will while the question is up. You're right that it doesn't have to be ADHD, but I don't really see the value in dismissing it either.

Edit:

> There is probably an influence from inherent personality differences, but I would speculate that building up stamina for tackling hard problems comes down substantially to practice.

For those of us who do have a chemical imbalance, many of us have coping mechanisms which look a lot like building up this stamina. But it's important to understand that this can come very unnaturally for some people and be considerably more difficult and unstable.


James Clear in book `Atomic Habits` talks about the Goldilocks rule, https://jamesclear.com/goldilocks-rule

which recommends to work on problems slightly higher than your capability


There's a difference between "finding it difficult to get started on the thing you don't want to do" and "literally would not be able to choose to do it for more than a few minutes even with a gun to your head".

I don't know the OP but this seems a bit like telling someone that "everyone feels tired sometimes" when they might have undiagnosed chronic fatigue syndrome.


The original post is consistent with many different types of difficulties, including plenty that have nothing to do with ADHD.

If you told a new parent, an alcoholic, or someone living on a toxic waste dump that everyone who is frequently tired probably has CFS, that would be equally irresponsible.


Fellow ADHD sufferer here to second this. Thinking about ADHD as a deficit of motivation, which is much more accurate than an attention-oriented view, tends to clarify this sort of situation.


Giving a third +1 here. I had (have) similar issues with motivation and got diagnosed with ADHD at age 25.

I'd describe it as "a disability of knowing how to do something, but not actually doing it unless there are external consequences involved"


Oh wow... you just described me with frightening accuracy. I’ve never seen my issue described so clearly and concisely. Basically, if there aren’t negative consequences for me not completing a task, my brain simply never gets motivated. It’s almost as if my brain is saying: “meh... you don’t really have to do this... so go play on Facebook some more”. If I could resolve this issue which has plagued me for years, it would revolutionize my life and career.


When in doubt always best to talk to a doc. Best case you are completely fine, but doesn't hurt checking. (The irony is that people with ADHD are probably the least likely to get up by themselves and make an appointment given that there are no consequences of not doing it lol)

ADHD is of course not just motivation but a spectrum of symptoms. I'd highly recommend listening to Dr. Russell Barkley talk about ADHD on this playlist - https://www.youtube.com/watch?v=wg6cfsnmqyg&list=PLzBixSjmbc...

Watch from 1B onwards and see if you feel like it describes you


How do you differentiate this from laziness/apathy?


The feeling can feel similar which is probably why a lot of people think they are just lazy. But ADHD is more of a reduced / lack of self-drive combined with a self-regulation + internal prioritization problem. Maybe a bit like laziness but the feeling is multiplied.

I of course have moments when I feel lazy and just don't want to do anything, but then there are the other moments when I want to do something, work on a project, practice a hobby but just don't. There is this disconnect, it's hard to explain

Best to look at other key ADHD symptoms as well like emotional regulation, rejection sensitve dysphoria, focus, (mental) hyperactivity (= your brain can't just chill), the need to constantly do something, impulsiveness (like with money), etc etc etc.

It's of course a spectrum and some people are worse in x while other people suffer more on y.

Best to talk to a doc if it affects your life. Could be ADHD, could be something else. It's very common though so admitting that there might be a problem is the first step to getting better


Laziness and/or apathy are value judgments; they offer no useful insight into behaviour unless you believe that sin is a real thing.


Not really. You're choosing a definition those words that involves a value judgement.


apathy can be part of dysexecutive syndromes, such as ADHD.

To be pedantic, apathy is lack of emotion and interest.

Often that is not the case in ADHD. The hallmark of that syndrome is the inability to follow through/self-regulate behavior/plan actions to achieve the objective they are interested in.


Anybody feels that ADHD or similar issues are often a sign that you're not doing things that you need to to be happy ? Like running after something for the wrong reasons ?

Kinda like Bukowski "don't try" ?

ps: to explain more, there were times where

a) I was slowly but surely inspired by a topic and would just keep wondering and thinking about it, 'hard' or not, it was similar to walking a mental park

b) I was motivated by desires (greatness, potential financial gains, social status, some faith that the outcome would make me feel happy) but now my feelings about them have changed so it feels pointless. I feel a lot better when doing things that have no real goal but actually procure a lightweight joy.

For instance, I used to equate more study to more possibilities and capacity to 1) create more (joy) 2) get a good job. But my experience was that these efforts weren't useful in reality. Even though I got some FP moocs, solved problems alone, I'm still stuck too often, and recruiters don't give a damn. It all erodes your happiness/ROI center.


Depression (and many other illnesses, autoimmune, hormonal deficiencies, sleep disorders, all kinds of dementia and other neurological illnesses) will produce a dysexecutive syndrome that's very similar, if not indisginuishable, from ADHD.

In your specific case you may want to read up on something called "learned helplessness". Essentially you are being conditioned by failure to quit prematurely.

That is different from ADHD. ADHD in itself is really a diagnosis of exclusion, where no clear cause can be found.


In practice, ADHD is what you have when stimulants make you get better.

If your laundry lists of symptoms (depression, sleep disorders, lack of motivation etc) get better from stimulants, count yourself lucky. Stimulants work right away, if they work at all, and have few and relatively mild side-effects.

Some of the side-effects, like weight loss, are even seen as welcome by many people. Others like having to pee more often and cold hands are relatively easy to deal with.

For comparison, antidepressants take months to show even mild positive effects; and have major side-effects.


> Essentially you are being conditioned by failure to quit prematurely.

Funny how my conclusions today are the opposite. I didn't quit early enough somehow. Well it's hard to tell, tbh, I've spent years learning hard stuff without any real benefit. So many a different course of action would make sense :)


I have trouble focusing on work most of the time and lack the motivation for almost everything, unless not doing it would cause problems.

But everything I've read about ADHD doesn't sound like a me at all.

Never heard of your way of describing it though.


I just posted a comment below that sounds like that - https://news.ycombinator.com/item?id=22920256

Adhd feels like knowing how to do something and knowing you should do it, but not actually doing it. It’s like your inner drive is very weak unless there is an external consequence involved, like a deadline.

Dumb examples are

- your homework unless the deadline comes closer

- a amazon box that you know the contents of but currently don’t need it, so it stays packaged standing around until you need the item or the space

- dishes

- a todo list item that’s floating around for weeks that takes minutes to complete but has no deadline

Then at other moments something just grabs your attention and it becomes the most important thing right now even if you should be doing something else. Like finding a new tool or programming language that you really want to use immediately, or randomly cleaning your entrance area NOW even though you should be leaving for the train to make a meeting.


Adhd feels like knowing how to do something and knowing you should do it, but not actually doing it. It’s like your inner drive is very weak unless there is an external consequence involved, like a deadline.

Yes, that would be me. I know what I need to do in so many ways. But doing it? If it isn't a habit or some form of negative emotion forces me to do it, almost impossible. There are, of course, exceptions. But in general, absolutely.

Homework

Yes, same with tasks / Jira stories today.

Amazon box

There is a printer inside a box in my living room that I need to print a work related document. It's now there for like 8 days? My office wrote me, that they need that document and boy don't I care about it, as it is merely a formality. So yes, total check.

Dishes

See, this is why I'm not completely convinced ADHD matches me. I never leave dishes behind. When I'm done cooking, even before I take the first bite, the kitchen is in perfect condition. Vacuuming my room on the other hand...

Todo lists

I need them to be productive, but my personal todo list tends to remain on my whiteboard for weeks or months until I do everything possible in one rush. I guess that is also a match?

Your last paragraph sounds like doing things compulsively, things that aren't important right now. That is also a no match for me. I get hyper focused from time to time, although that has gotten quit rare in recent years. But I've never not went to a meeting or something similar because of it. If I need to do something, if I start to feel negative about it, I'll get it done no matter what. I'd feel quite awkward not getting to meetings, so that doesn't happen. Maybe this is still a match?

Edit:

On the other hand, I should complete a Jira story right now. But now I'm here and listening to a ADD related talk from another comment. But I really should work on that story to finish it. But I kind of have an open deadline. But it gets steadily more embarrassing that I haven't finished it. Uh oh.


There are different ways for ADHD to manifest.

https://www.nhs.uk/conditions/attention-deficit-hyperactivit... has a list of symptoms in adults.

> But everything I've read about ADHD doesn't sound like a me at all.

If the symptoms listed there don't match, you probably don't have a ADHD, I guess.


Went through the list. I'd say at least 50% matches me completely, but some items are situational or are not even close.

- Keeping still? As a kid, I had always a problem keeping my leg still.

- Excessive talking? Nope, I was the quite kid. Also never interrupted anyone and still don't.

- Acting without thinking? The polar opposite. I didn't act because of all the thinking. That problem remains to this very day.

- Not caring about details? Painfully correct, why did I end up as SWE where details are all that matters?

- Appearing forgetful? 100%. I can't remember most of my childhood and have a bad memory in general. But I never misplace things. Can't remember work stuff if I don't write it down. Onenote saves me daily.

- Listening to instructions? Well, I'm very good at listening to people in bilateral situations. But during meetings? My mind goes places. And reading docs and instructions is almost impossible. Even if I can force myself to go through everything, I still miss details!

- Difficulty organizing? Absolutely, although I get it done if I'm forced to do it. But I hate it.

- Short attention span? Well, depends on the situation. In gaming, I can stay focused all day long. I can read a book for hours. No problem staying focused doing physical activities (sport). Staying focused on coding is really difficult and I constantly zone out.

- Taking risks? Ha, no. I don't take risks, at all. It's actually a problem.

- Impatience? Yes and no, depending on the situation. But I'm mostly quite patient. Maybe because I'm in my head most of the time?

- Mood swings? Not at all. At least not within one day. But during the week? There a bad days and good days.

- Not completing tasks? Not really, I tend to finish what I've started, if it is manageable, can be done in one go. But complex tasks, that may not be well defined? Personal hell.

- Inability to deal with stress? I'm a Jedi. I don't get stressed easily and if the situation becomes stressful, I get more focused. But I need a lot of downtime to keep my sanity.

That I went through these lists in a not so orderly fashion is also not the best sign, isn't it?


Not everyone has all the symptoms. For example, I don't really display hyperactivity nor mood swings, nor do I have trouble dealing with most kinds of stress.

> - Short attention span? Well, depends on the situation. In gaming, I can stay focused all day long. I can read a book for hours. No problem staying focused doing physical activities (sport). Staying focused on coding is really difficult and I constantly zone out.

Sounds like the flip side: hyperfocus. See eg https://www.healthline.com/health/adhd/adhd-symptoms-hyperfo... Direct quote:

> Hyperfocus is the experience of deep and intense concentration in some people with ADHD. ADHD is not necessarily a deficit of attention, but rather a problem with regulating one’s attention span to desired tasks. So, while mundane tasks may be difficult to focus on, others may be completely absorbing. An individual with ADHD who may not be able to complete homework assignments or work projects may instead be able to focus for hours on video games, sports, or reading.


Maybe I should I give it a go. I really don't want to. But this has been frustrating for a long time. Thanks for the effort!


Have a look, maybe it helps.

The good side about the common ADHD medications (various stimulants) is that they mostly help within half an hour, if they help at all.

So apart from the hassle of getting a diagnosis and prescription, at least you won't have to endure months of side effects before you know whether you can get any better.

(I'm contrasting that with eg anti-depressants here.)


That sounds promising. On a side note, today I've tried Nicotin for the first time. I've heard that it helps people with ADHD and as this has been on my mind for a couple of months by now, I figured that this might be an easy way to check myself. Your post was the last push and I have a shop right next to my door.

Well, it seemed to work. Maybe placebo, but I'd say that I had high concentration burst in 30-45 minutes intervals (after inhaling). I kind of forgot that I've taken it a couple of minutes in, because I was so focused on the code. I heard that Nicotin works as neuroenhancer in general, so nothing is proven. But no matter why, it seemed to help.

I really don't want to get addicted to Nicotin, so I'll see how I can find a doctor to verify/falsify this.

Thanks again!


Some Researchers propose 7 types of ADD, which are quite different on the surface symptoms. Check out this talk by Dr. Amen: https://www.youtube.com/watch?v=UWnJ4wjVu9k


ADHD is best described as impaired self-directed behavior.

The kernel of motivation may exist, but an ADHD victim would fail to follow through on that motivation, to their own detriment.

Either due to lack of concentration, lack of planning, or lack of execution. Often all of the above.

It is a general dysexecutive syndrome that that may impact all higher order cognitive functions.

Motivation, on the other hand can also be impaired by depression (aka "learned helplessness" - which is not uncommon in ADHD), but that would not be ADHD in itself.


I highly recommend checking out this thread about stimulant medications: https://news.ycombinator.com/item?id=16033574

As someone who has ADHD and has taken stimulant medications for a long time, I would like to share my experience. There is a very faustian aspect of taking these medications. Don't think that you can change your brain chemistry and not change who you are.

I would not have the career I have today without it. Before I started getting treated, I was barely supporting myself financially, and struggling to get through community college. I felt so powerless, while my peers rocketed ahead of me. After I started taking medication, I was able to take control of my life, and do things I had previously ruled out doing. I did great academically, and then made more money than I ever thought I would. It was such an amazing feeling to feel like I had been given a second chance at life.

However, it changed me, and I lost something. I wonder what could have been. I remember the moment I noticed I was changed. For a year before I started taking it, I had been dating someone for over a year, and not once had we ever had a fight. But a month after I started taking adderall, I screamed at her when I got frustrated because she changed plans we had made. I was so horrified, and I wanted to stop taking it that day, when I still could. Our relationship didn't last three more months. I gradually lost touch with my old friends.

I was only supposed to take it to get through college, but the choices I made on adderall were such that I chose a lifestyle that required it. I pushed myself really hard for years and I was able to prove that I wasn't a slacker or stupid; I got a fancy .edu email and coauthored scholarly papers and presented at conferences.

I miss who I was before I started taking it. Things just didn't annoy me. I was so cool with stuff. I think I was much more emotionally resilient, and much better able to read people. Stimulant medications make me more "autistic", for lack of a better word. I think I have really regressed emotionally.

I would strongly advise anyone who starts taking these medications to not lose touch with yourself. See a therapist, even if it does not seem necessary. Try to maintain relationships and keep yourself emotionally anchored. Give your soul room to breathe. Take emotional sabbaticals where you are able to ruminate on important decisions. Consider not taking your meds on the weekends. Listen to music and play video games, even if they don't seem to entertain you as much. I have a theory that your "right brain" still likes these things, but that your impulses for entertainment are just suppressed.

As for me, I am seriously considering trying to live without these medications, or at least severely cut them back. Besides the problems that I talked about, there is also evidence that stimulant medications can reduce brain mass over the decades. I don't want to discourage anyone from doing the best for themselves, but everything has a cost. If you want to do well in college and build your career in your 20s, that is understandable. But keep yourself grounded.


I was diagnosed with ADHD a few years ago when I was 30.

I tried a few medications. When I as on Vyvanse, I noticed similar personality changes as what you described. Most notably, my sense of humour suffered. (And before on dexamphetamine, I was really grumpy when it wore off. So I did get into fights.)

Things got better after I changed to methylphenidate. For me, it's milder in the side effects.

Modafinil and nicotine patches also work reasonably well with only mild side effects. (See https://www.gwern.net/Nicotine about nicotine. Please don't start smoking.)

Caffeine never worked at all for me. Just messed with my sleep. L-Tryptophan seems to help me very slightly, but I have friends who report great effects, especially with sleep and mood.

Enough ranting, my point is: you can try different stimulants to see if there's anything else that works better for you.

Finding the minimal dose that still works is of course still a good idea.


What was the diagnosis process like? I'm in my early 30s and have been putting off trying to get an ADHD diagnosis (and medication) even though the symptoms clearly resonate, because I'm concerned that I'll be dismissed as just seeking pills. In college I tried to get diagnosed and was dismissed as lazy and just seeking a prescription. Did you have to deal with any of that skepticism?


In the United States, there are controlled substances, and federal law requires that a psychiatrist write a new prescription every month, with no automatic refills.

However, it is heavily streamlined. My university medical center and on campus pharmacy had me in and out with a week supply of adderall in about two hours. There were weekly followups for about four weeks, then monthly followups every three months, and then it was just five mins with a psychiatrist for minor adjustments thereafter. After graduation, most psychiatrists will do monthly followups over the phone, and may only require you to come in a few times a year.

I have however heard it can be much harder if they suspect that you are unstable or "drug seeking". But if you don't appear to be a risk, and you can clearly explain your situation, then they will usually offer you a week supply and you report if it helps you. I think a big factor is just what your life situation is.

Private psychiatrists are much more likely to help you. Make an appointment with an "ADHD specialist". As long as you don't have any red flags, they are likely to give you a test prescription"


If you can afford it, go to a specialist (ie Seattle's Hallowell Todaro ADHD Center). It will probably be more expensive and might take longer to get evaluated, but you'll be taken seriously and it's easier to advocate for yourself and your medication when the medical providers don't automatically jump to "pill seeking".

I'm not sure about my current provider, but the place that diagnosed me would let patients complete evaluations at a slower pace if they couldn't afford everything right away.

Also, before I switched to a specialist after moving, I tried asking my GP for my RX and they went straight to "pill seeking", however, they would still allow me to get my script if I came in every month for a drug test.


I was lucky that I was living in Australia at the time where adult ADHD seems to be taken more serious by shrinks than in most other parts of the world. I also splurged and saw the shrink privately.

So the diagnosis process was mostly answering lots of questions and filling out some questionnaires.


I know that the plural of anecdote is not data, but modafinil can have some not-so-mild side effects.

I have been pretty healthy my whole life, exercise regularly and eat a healthy diet, never had any allergy nor anything alike... until I took (ar)modafinil. After 2-3 weeks of occasional consumption (1 pill every 2/3 days) I started with a mouth full of ulcers (aphthae), which progressed to a full-body rash. Apparently I had Erythema multiforme major, one of the potential side-effects of Modafinil, and honestly it was worrying.


That does sound pretty worrying!


Yes, I have had good experiences with methylphenidate (Ritalin) as well. One thing I noticed is that on adderall I stopped yawning completely. On Ritalin, my body is actually able to signal to me when I'm tired, hungry, etc. The problem is that I had to take ever larger amounts of caffeine to compensate.

I just know that I don't want to be taking adderall when I'm 40.


Yes. I had similar reaction: I was very relieved that I could take a nap on Ritalin. That never worked on dexamphetamine.

Though I also heard from some other people for whom Ritalin has intolerable side effects, but Adderall works.

Honestly for me, if methylphenidate wasn't available, I'd go with nicotine patches and perhaps modafinil instead of dexamphetamine.

Thanks to billions of smokers we a have pretty good idea of the long term effects of nicotine. Eg we know that it protects against parkinsons. (And there are some indications that Parkinsons and ADHD are linked.)


I'm obviously not a doctor, so take my words with a healthy dosage of salt, but do understand that different medications can have different effects on you. There's multiple types of ADHD medication (the two most common families are Adderall and Ritalin/Concerta), and because they're composed differently, it's possible that one can help more than the other.

For me personally (YMMV!!!), I was recently diagnosed with ADHD and was offered stimulant medication for it. I first tried Adderall, which did in fact work, but after a while it made me quite moody and depressed and miserable. I later switched to Concerta and I'm doing quite a bit better.

That said, definitely don't feel pressured to stay on and medication that isn't helping you, or that you feel is hurting you. It's ultimately your choice what you put in your body.


There's an easy experiment OP can do: see if nicotine patches help.

Nicotine is a safe stimulant that available over the counter; and works really well against ADHD and can help normal people too. Arguably much better than caffeine for the vast majority of people.

See https://www.gwern.net/Nicotine for details.

One thing to keep in mind: stay away from smoking. That's vile and addictive.


As someone who just quit nicotine (e-cigs/NRT/tobacco-free “dip”) after nearly a decade, stay away from it at all costs. Nicotine is a wonderful brain stimulant (nootropic), but it’s far too easy to become and stay addicted.


Interesting. I only ever tried the patches on and off, and never had any problem stopping. The research that Gwern collected at https://www.gwern.net/Nicotine seems similar.

I never smoked or tried e-cigarettes, though. Smoking is awfully addictive.

I tried half a nicotine gum once. But the stimulant hit was too much at once and made me nauseous for about half an hour. (Similar to eg the effects of way too much espresso, but with much shorter duration.)

Did you ever smoke burnt tobacco?

What was the process of quitting e-cigarettes (and the others you mention) like?


I am currently getting help with ADD and this is a similar situation to me as well. However, I was diagnosed because I'm trying to get help for insomnia. Specifically, I have a lot of trouble falling asleep. I'm just adding another data point in case anyone is relating to OP, the comment I replied to, AND has difficulty falling asleep. It's always good to have a clear picture of what your mental health is like.


I got diagnosed with ADHD as an adult.

I also had sleep issues, but never bad enough to seek help for them. Fortunately, the ADHD meds fixed the sleep issues, too.

Have you tried taking some L-Tryptophan in the evening? For some people it works wonders for sleep and mood. L-Tryptophan is an essential amino acid that you can buy over-the-counter. Your body needs it to make melatonin and serotonin amongst other things.


My sleeping issues were never bad enough either until my team started having daily 9AM meetings. Ugh

I haven't tried L-Tryptophan! But I'll give it a go. My medication hasn't really started taking effect yet but hopefully I don't have to take sleeping medication once it does. Thanks for the suggestion. :) Hopefully that helps also.


L-Tryptophan is a pre-cursor to melatonin. See eg https://slatestarcodex.com/2018/07/10/melatonin-much-more-th...


Looks like you posted while I was writing my response, and another has chimed in on this sub-thread. I expect a bunch of us will recognize ourselves a bit in this AskHN.




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