9 ms·

I would unironically say this is the how of how adderall works for me. I am distracted from work by anxiety. With medication, I'm not distracted.

gigaflop 1y ago
Generic Adderall Gang here, and in hindsight, I'm surprised at how little of it I need to realize a much better headspace. Makes me wonder if all of that caffeine in my undiagnosed youth was saying something...
- static_void 1y ago
  I'd be interested in your thoughts more here. The problem with amphetamine is you pay for every benefit: focus now, lethargy later; energy now, anhedonia later. But taking a small, consistent dose. Does that work? Do you feel you net benefits in life from taking the drug, discounting for withdrawal and/or tolerance?
  - Aurornis 1y ago
    > The problem with amphetamine is you pay for every benefit: focus now, lethargy later; energy now, anhedonia later. > But taking a small, consistent dose. Does that work? Do you feel you net benefits in life from taking the drug, discounting for withdrawal and/or tolerance? There's a reason these medications are supposed to be taken regularly at the same dose in clinical practice. Patients should not be going through cycles of taking stimulants and then withdrawing all of the time. There's a disconnect between the way some people try to use stimulants ad-hoc versus the therapeutic modality. The initial burst of confidence, energy, and positive mood that comes from intermittent use is a side effect, but people confuse it with a primary effect. They can get into cycles of chasing it with dose escalations or taking it on random days while they exist below baseline on others. This isn't a winnable battle over time because the brain will adapt, not to mention all of those off-days start to add up and people around them notice the extremely inconsistent mood and performance. Unfortunately, misinformation about ADHD is all over the internet. I recommend ignoring basically anything that comes out of Reddit, Twitter, or TikTok because it's really that bad. Take medications as directed and set yourself up for some stability. Resist the urge to play with doses, take excess doses on some days, or try to play tolerance games. These never work in the long term. There's a simple heuristic: When you reach stability, you shouldn't really feel the medication. It should be background noise. There's a reason why young people who have been properly titrated on stimulant medications don't understand what the big deal is with their peers taking large doses (without tolerance) and then speeding around for a while. It's where the myth about ADHD people reacting differently to stimulants comes from. Proper treatment will settle to equilibrium and shouldn't produce overt feelings of being drugged or hyperfocused.
    - hirvi74 1y ago
      The one issue I have never been able to overcome is that the medications are completely ineffective unless they induce hyperfocus. Now, it doesn't take me a lot to get into this state. I could easily enter such a state prior to medication, though I often needed (and still need) some kind of fuel -- intense desire or passion, impending deadline, etc..
    - static_void 1y ago
      What do you think about this? With XR, I feel less hyperfocus and more sleepytime disruptions. It's less strong so I take more, but it lasts longer so I get its effects when I don't need it. I feel like IR is actually less amenable to abuse.
  - andoando 1y ago
    In my experience, no. You just get used to it and it does fuck all. Maybe worse even. Adderall seems to take my creativity away entirely and I just feel like a zombie. Theres a host of physical symptoms that come with it to that are not fun to manage: decreased appetite, dehydration, headaches, sleep loss, heart palpatstions. I would say its far better to take it on a needed basis once in a while
    - dns_snek 1y ago
      Have you tried any other medication? Concerta/Ritalin, Strattera/atomoxetine, or any other non-stimulant medications?
      - andoando 1y ago
        No I havent, maybe its worth trying. Adderall worked so well for me initially I didnt want to experiment but yeah over time the negatives have outweighed the positives. I mean seriously first day 5mg worked better than 20mg a month or two later I imagine the tolerance thing holds with all drugs so Im surprised people say it works for them long term (maybe placebo, or they're comparing it to withdrawal "Ive been on adderall for 10 years, if I go a day without it I feel like shit and cant function, so it works!" but maybe...
        dns_snek 1y ago
        I think I know what you mean but the theory, as far as I understand it, is that those initial feelings of stimulant medications aren't meant to last, and a lot of it is technically a side effect For the first few days we can experience significantly increased energy and some euphoria, along with the therapeutic effects. That's a really novel experience at first (which in itself helps ADHD brains focus) so it often works extremely well for a short while. People get in trouble if they try to chase that initial feeling (high), mistaking it for the therapeutic value that the medication is supposed to provide. Eventually we're not supposed to feel it at all, and if it's the right medication for us at the right dosage, it should just quietly provide therapeutic value in the background, improving our executive functioning challenges, emotional regulation, etc. As I understand it, the data on tolerance with stimulant medication is a bit mixed[1], some people develop tolerance but many people don't. In your situation I'd definitely give different medications a try, it shouldn't make you feel like a zombie. It's pretty common for people to respond poorly one class of medications and respond well to another class. If Concerta (methylphenidate) didn't work for me I would personally consider Elvanse (lisdexamfetamine), then atomoxetine (an SNRI). There are also some other non-stimulant options like guanfacine and a few antidepressants that have been found to work well for ADHD but I don't know much about those. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC9332474 https://pmc.ncbi.nlm.nih.gov/articles/PMC9332474
  - gigaflop 1y ago
    > Focus now, lethargy later IMO, that's always just been me. Now vs Later is hard to judge, though, because I tend to have "good focus" blocks of time, and "chill blocks". Exact timing depends on my overall weekly schedule leading up to a time period. Also, I mentally classify different types of energy. Physical, social, and mental energies all have their different places in a day. > small, consistent dose For me, yeah, but YMMV based on brain chemistry and environmental variables. Since I use El Cheapo, I max out at 10mg 2x/day, but rarely adhere to that unless I'm planning ahead for it/have been on that roll for a while. This helps a lot with tolerance, especially when I have lazy weekends. And from a personal perspective: It's a very simple drug to understand, which makes me feel at ease. Brain goes vroom, like an engine hitting a more comfortable RPM. Not every situation needs my full power.
  - hirvi74 1y ago
    Been on the various stimulants for a decade now: > But taking a small, consistent dose. Does that work? Typically, no; however, it's context dependent. > Do you feel you net benefits in life from taking the drug There are diminishing returns overtime, but there is still some benefit to be had. > withdrawal and/or tolerance? Both are real and awful to deal with. Is it all worth it? I tend to flip-flop back and forth a lot on this.
  - hnick 1y ago
    I can't find it right now but I recall seeing somewhere that around 40% of ADHD patients reported better effects on Ritalin (methylphenidate) or dexamphetamine roughly equally, another 40% says both are about as good as each other, and the final 20% don't find either very effective. In my personal testing the Ritalin was much better, dexamphetamine was more up/down and shorter lived. However I didn't really get a crash or lethargy with either, it's just the focus wearing thin (and yes, the benefits were real and massive starting for the first time in my forties). According to my psych, both have been around 70+ years and are fairly well understood. Longer term therapeutic doses shouldn't be habit forming and tolerance is minor after the initial phase, there's no withdrawal effects and it's easy to forget to take a dose if your routine changes. My morning coffee is far more demanding in that regard.
- RansomStark 1y ago
  I'm worried about my caffeine intake. ADHD diagnosed but never medicated. I've been a heavy coffee drinker since i was a teenager. I'm sitting at 13 double espressos today which is about average. Lately the instant sleepiness post coffee isn't worth the focus, and I'm starting the think medication would be a healthier choice
  - gigaflop 1y ago
    Take this with a grain of salt, but I use it as an ad-hoc benchmark: FDA recommended maximum daily limit on caffeine is 400mg. If you're regularly going above that, then (politely) consider whether you should be.
    - RansomStark 1y ago
      400mg is only about 3 doubles. Thanks for the heads up
  - hnick 1y ago
    Ritalin was a game changer. After the initial adjustment it just feels like it brings me up to normal, I'm not particularly stimulated (in fact my lack of wandering mind makes it easier to doze during the day), I just prefer coding to games etc. It feels like it unlocks access to natural reward mechanisms instead of chasing artificial feel-good rewards. I can't even listen to a YouTube video while coding when using it, which was a normal activity for me since my brain felt bored and went off on its own without it. Just mentioning because curiously it almost entirely put me off caffeine. I still enjoy my morning coffee as a ritual, but sometimes don't finish it. If I have another then the side effects are severe, Ritalin massively boosts those - nerves, jitters, hitting the toilet. Not terrible or dangerous, but just interesting, and honestly caffeine never did a whole lot for me mentally so it's no big loss.
  - anton-c 1y ago
    You sound like me and diet dew before I tried "the good stuff"(Vyvanse) instead of the Strattera I took as a kid that just made me sick. I still consume some but not for tons of caffeine. Check out some meds. Vyvanse is significantly less "cracky" than Adderall imo.
SequoiaHope 1y ago
Indeed, I was surprised both at the fact that it literally makes me feel better because the drug makes you feel good but also that it calmed my brain down and let me access some inner peace. But also the focus modification is big and I learned so many good habits that now I need much less of it to get stuff done. I wake up and start doing my chores before I even have my first dose!
- hirvi74 1y ago
  > it literally makes me feel better because the drug makes you feel good but also that it calmed my brain down and let me access some inner peace. I mean, there is a reason why it's a controlled substance and is heavily abused all across the world. It works and it works well. Though, I've been on it for about a decade now, and I have lost a large majority of the benefits it once provided.

gigaflop 1y ago

Generic Adderall Gang here, and in hindsight, I'm surprised at how little of it I need to realize a much better headspace. Makes me wonder if all of that caffeine in my undiagnosed youth was saying something...

static_void 1y ago
I'd be interested in your thoughts more here. The problem with amphetamine is you pay for every benefit: focus now, lethargy later; energy now, anhedonia later. But taking a small, consistent dose. Does that work? Do you feel you net benefits in life from taking the drug, discounting for withdrawal and/or tolerance?
- Aurornis 1y ago
  > The problem with amphetamine is you pay for every benefit: focus now, lethargy later; energy now, anhedonia later. > But taking a small, consistent dose. Does that work? Do you feel you net benefits in life from taking the drug, discounting for withdrawal and/or tolerance? There's a reason these medications are supposed to be taken regularly at the same dose in clinical practice. Patients should not be going through cycles of taking stimulants and then withdrawing all of the time. There's a disconnect between the way some people try to use stimulants ad-hoc versus the therapeutic modality. The initial burst of confidence, energy, and positive mood that comes from intermittent use is a side effect, but people confuse it with a primary effect. They can get into cycles of chasing it with dose escalations or taking it on random days while they exist below baseline on others. This isn't a winnable battle over time because the brain will adapt, not to mention all of those off-days start to add up and people around them notice the extremely inconsistent mood and performance. Unfortunately, misinformation about ADHD is all over the internet. I recommend ignoring basically anything that comes out of Reddit, Twitter, or TikTok because it's really that bad. Take medications as directed and set yourself up for some stability. Resist the urge to play with doses, take excess doses on some days, or try to play tolerance games. These never work in the long term. There's a simple heuristic: When you reach stability, you shouldn't really feel the medication. It should be background noise. There's a reason why young people who have been properly titrated on stimulant medications don't understand what the big deal is with their peers taking large doses (without tolerance) and then speeding around for a while. It's where the myth about ADHD people reacting differently to stimulants comes from. Proper treatment will settle to equilibrium and shouldn't produce overt feelings of being drugged or hyperfocused.
  - hirvi74 1y ago
    The one issue I have never been able to overcome is that the medications are completely ineffective unless they induce hyperfocus. Now, it doesn't take me a lot to get into this state. I could easily enter such a state prior to medication, though I often needed (and still need) some kind of fuel -- intense desire or passion, impending deadline, etc..
  - static_void 1y ago
    What do you think about this? With XR, I feel less hyperfocus and more sleepytime disruptions. It's less strong so I take more, but it lasts longer so I get its effects when I don't need it. I feel like IR is actually less amenable to abuse.
- andoando 1y ago
  In my experience, no. You just get used to it and it does fuck all. Maybe worse even. Adderall seems to take my creativity away entirely and I just feel like a zombie. Theres a host of physical symptoms that come with it to that are not fun to manage: decreased appetite, dehydration, headaches, sleep loss, heart palpatstions. I would say its far better to take it on a needed basis once in a while
  - dns_snek 1y ago
    Have you tried any other medication? Concerta/Ritalin, Strattera/atomoxetine, or any other non-stimulant medications?
    - andoando 1y ago
      No I havent, maybe its worth trying. Adderall worked so well for me initially I didnt want to experiment but yeah over time the negatives have outweighed the positives. I mean seriously first day 5mg worked better than 20mg a month or two later I imagine the tolerance thing holds with all drugs so Im surprised people say it works for them long term (maybe placebo, or they're comparing it to withdrawal "Ive been on adderall for 10 years, if I go a day without it I feel like shit and cant function, so it works!" but maybe...
      - dns_snek 1y ago
        I think I know what you mean but the theory, as far as I understand it, is that those initial feelings of stimulant medications aren't meant to last, and a lot of it is technically a side effect For the first few days we can experience significantly increased energy and some euphoria, along with the therapeutic effects. That's a really novel experience at first (which in itself helps ADHD brains focus) so it often works extremely well for a short while. People get in trouble if they try to chase that initial feeling (high), mistaking it for the therapeutic value that the medication is supposed to provide. Eventually we're not supposed to feel it at all, and if it's the right medication for us at the right dosage, it should just quietly provide therapeutic value in the background, improving our executive functioning challenges, emotional regulation, etc. As I understand it, the data on tolerance with stimulant medication is a bit mixed[1], some people develop tolerance but many people don't. In your situation I'd definitely give different medications a try, it shouldn't make you feel like a zombie. It's pretty common for people to respond poorly one class of medications and respond well to another class. If Concerta (methylphenidate) didn't work for me I would personally consider Elvanse (lisdexamfetamine), then atomoxetine (an SNRI). There are also some other non-stimulant options like guanfacine and a few antidepressants that have been found to work well for ADHD but I don't know much about those. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC9332474 https://pmc.ncbi.nlm.nih.gov/articles/PMC9332474
- gigaflop 1y ago
  > Focus now, lethargy later IMO, that's always just been me. Now vs Later is hard to judge, though, because I tend to have "good focus" blocks of time, and "chill blocks". Exact timing depends on my overall weekly schedule leading up to a time period. Also, I mentally classify different types of energy. Physical, social, and mental energies all have their different places in a day. > small, consistent dose For me, yeah, but YMMV based on brain chemistry and environmental variables. Since I use El Cheapo, I max out at 10mg 2x/day, but rarely adhere to that unless I'm planning ahead for it/have been on that roll for a while. This helps a lot with tolerance, especially when I have lazy weekends. And from a personal perspective: It's a very simple drug to understand, which makes me feel at ease. Brain goes vroom, like an engine hitting a more comfortable RPM. Not every situation needs my full power.
- hirvi74 1y ago
  Been on the various stimulants for a decade now: > But taking a small, consistent dose. Does that work? Typically, no; however, it's context dependent. > Do you feel you net benefits in life from taking the drug There are diminishing returns overtime, but there is still some benefit to be had. > withdrawal and/or tolerance? Both are real and awful to deal with. Is it all worth it? I tend to flip-flop back and forth a lot on this.
- hnick 1y ago
  I can't find it right now but I recall seeing somewhere that around 40% of ADHD patients reported better effects on Ritalin (methylphenidate) or dexamphetamine roughly equally, another 40% says both are about as good as each other, and the final 20% don't find either very effective. In my personal testing the Ritalin was much better, dexamphetamine was more up/down and shorter lived. However I didn't really get a crash or lethargy with either, it's just the focus wearing thin (and yes, the benefits were real and massive starting for the first time in my forties). According to my psych, both have been around 70+ years and are fairly well understood. Longer term therapeutic doses shouldn't be habit forming and tolerance is minor after the initial phase, there's no withdrawal effects and it's easy to forget to take a dose if your routine changes. My morning coffee is far more demanding in that regard.
RansomStark 1y ago
I'm worried about my caffeine intake. ADHD diagnosed but never medicated. I've been a heavy coffee drinker since i was a teenager. I'm sitting at 13 double espressos today which is about average. Lately the instant sleepiness post coffee isn't worth the focus, and I'm starting the think medication would be a healthier choice
- gigaflop 1y ago
  Take this with a grain of salt, but I use it as an ad-hoc benchmark: FDA recommended maximum daily limit on caffeine is 400mg. If you're regularly going above that, then (politely) consider whether you should be.
  - RansomStark 1y ago
    400mg is only about 3 doubles. Thanks for the heads up
- hnick 1y ago
  Ritalin was a game changer. After the initial adjustment it just feels like it brings me up to normal, I'm not particularly stimulated (in fact my lack of wandering mind makes it easier to doze during the day), I just prefer coding to games etc. It feels like it unlocks access to natural reward mechanisms instead of chasing artificial feel-good rewards. I can't even listen to a YouTube video while coding when using it, which was a normal activity for me since my brain felt bored and went off on its own without it. Just mentioning because curiously it almost entirely put me off caffeine. I still enjoy my morning coffee as a ritual, but sometimes don't finish it. If I have another then the side effects are severe, Ritalin massively boosts those - nerves, jitters, hitting the toilet. Not terrible or dangerous, but just interesting, and honestly caffeine never did a whole lot for me mentally so it's no big loss.
- anton-c 1y ago
  You sound like me and diet dew before I tried "the good stuff"(Vyvanse) instead of the Strattera I took as a kid that just made me sick. I still consume some but not for tons of caffeine. Check out some meds. Vyvanse is significantly less "cracky" than Adderall imo.

SequoiaHope 1y ago

Indeed, I was surprised both at the fact that it literally makes me feel better because the drug makes you feel good but also that it calmed my brain down and let me access some inner peace. But also the focus modification is big and I learned so many good habits that now I need much less of it to get stuff done. I wake up and start doing my chores before I even have my first dose!

hirvi74 1y ago
> it literally makes me feel better because the drug makes you feel good but also that it calmed my brain down and let me access some inner peace. I mean, there is a reason why it's a controlled substance and is heavily abused all across the world. It works and it works well. Though, I've been on it for about a decade now, and I have lost a large majority of the benefits it once provided.