Is ADHD a real disorder?

yes!

So while it's not necessarily a big deal in the lives of the neurotypical, I thought I would peek in here to mention that, since getting back on my meds like a month and a half ago after a muddle-headed year and a half pandemic abstention, I managed to methodically plug away at job searching and applying and interviewing (among my worst and most hated things in life) such that I wound up with several offers and one that I've now accepted. And this after nearly nine years of slogging through a temp-to-hire job that didn't suit me in the slightest and that was tolerable at best but which I clung to partly because I dreaded looking for something else and partly because...I guess I didn't think I deserved better? Or would fail if I tried? Good ol' imposter syndrome? Something? And for the first time in my entire working life, I found something that I actually wanted and pursued and that will actually be personally fulfilling rather than just taking whatever piece of wage slave crap fell into my lap. And I'm genuinely excited about it, and they seem genuinely excited to have me. And there's the potential for a lot of big and even life-altering opportunities to come out of this. Like personally enriching opportunities (I'm even taking a pay cut to make the move because what the fuck is money anyway).

I'm experiencing a whole lot of cognitive whiplash atm. Like I can't quite allow myself to believe that something this big and this positive happened to me (even though it's just a new job and totally nbd to most people). That I made this happen to me. It's like...magic or something. I'm still not-so-secretly waiting for innumerable shoes to drop (maybe I'm on the verge of getting Punk'd?) but...holy crap. Get on the meds, fellow ADD-ers. Things are possible if you can clear out that stupid fog.

― Rep. Cobra Commander (R-TX) (Old Lunch), Tuesday, November 23, 2021 2:36 PM (six hours ago) bookmarkflaglink

Ah man, I relate to this so, so much. I'm really happy for you. Getting on meds were a massive catalyst for my career - it was really not going well at all and I was racked with self doubt, and after getting on meds, I found a work situation that suited me much better and it was like "holy shit, there are people who actually work in a way that makes my strengths valuable and doesn't make my weaknesses a constant albatross." I went through everything you're describing, disbelieve, waiting for the other shoe to drop (still do sometimes, still working on that in therapy). I can't say the meds were the *sole* thing that caused the change (also a work crisis, therapy, exercise, habit changes) but the meds were really the thing that made me realize "Oh, it's actually possible to just sit down and focus on a project even when I'm not *in the zone*. Maybe I'm not a lazy POS. Maybe that fog was real and wasn't my fault." Like I'm actually really good at my job now, and demonstrably successful, and four years ago I wasn't even sure I should be in this field at all, and wasn't even sure I should be in any kind of career that had any kind of performance pressure.

congrats OL

i got diagnosed last year (twice!) and finally started vyvanse a few days ago and i'm fairly underwhelmed so far? not really noticing any improved ability to concentrate on work or anything, beyond it just eliminating most fatigue. that part is both expected and nice but not the main thing i was hoping for. the part of my brain that does constantly want to flick between five different things at once hasn't really calmed down at all or anything. the dehydration is really annoying too.

You might have to bounce between medications and doses to figure out what works best for you (Concerta was a big fat dud for me iirc). But do give this one a little breathing room first. ADD meds aren't a panacea ime but rather more like training wheels. They give you some breathing room in which to do the work of learning to better focus.

Re: my new job, there is no way on earth I would ever have been able to do this without meds. It's the biggest non-stop infodump, eighteen simultaneous things flying at u face job I've ever had, and I love it so far but I would've noped out in the first week were I left to my own neurological devices.

I have work I need to do and I don't know why I'm not doing it. It's boring and I want to get it right i.e. not let people down, but I can't see how, so I keep letting Twitter absorb my attention instead, because whenever 1% of my attention goes unabsorbed then anxiety & guilt about the work makes my brain feel itchy. But why not even try to do it and solve the problem for good until the next time?

The above is a recurring theme of my life since late teens. Every so often (nowish) it intensifies until I can't even seem to start simple tasks. I hate myself for it; my entire life feels untenable, irredeemable. Then I get put on antidepressants & my CBT 101 therapist says "poor concentration is a symptom of depression" - yeah, but I'm nearly this bad even when my mood is fine? No answers yet except "try harder", and I just... can't, but why?

Meanwhile the pills take away the anxiety that feels like it stops me working but I still don't do the work. Maybe I do even less without panicking myself into it occasionally.

Is this ADHD? What does ADHD distraction/task avoidance feel like? Is it brain-itchy? Is it anxious (and what kind of anxiety, i.e. task guilt vs social re coworkers vs unrelated, or any/all of the above)? How do you tell if ADHD causes the anxiety or if it's all anxiety all the way down?

Or is it all sorts of feelings, different every day: too many meetings; too tired and sluggish one day, too buzzy the next; train of thought constantly derailed by mundane noises; just couldn't settle somehow; an appointment later is all you can think about all day? And when you finally get a quiet anxiety- & distraction-free day, that in itself feels too unsettling? Or it's just so nice not feeling on edge for once that you should relax and not spoil it?

Sorry to scream into the void. I don't know how I expect anyone to read the above. But.

tl;dr: ADHD - what does it feel like? (Hi! Thanks!)

I tried a few different things -- ritalin made me feel shitty and the positive effect was short lived. Stratera worked almost too well, it made me feel like I had no desires and was just a work drone, and then it also led to ED (TMI I know) which cleared up as soon as I stopped. Wellbutrin is the best for me so far - it does agitate me sometimes but cutting back on the caffiene and getting more sleep usually eases that. I think part of why it works for me is that it's also an antidepressant and SAD exacerbates my ADHD real bad. Anyway, worth trying different things and good luck. xp

strattera is mf trash, no one has ever had a good experience with that shit

spacecadet: I feel your post a lot and want to respond to it, will try to later.

What ADHD feels like is neurotransmitter malfunction, which
being described in the lexicon of mental health and serving as a mechanism of feeling itself, is hard to explain, but it certainly involves a disconnect between what "should" be done and what the brain is currently interested in doing. For me, it was first identified as procrastination; a personal failing, a psychology of self-sabatoge, which led to depression, which led to antidepressants, which felt like they were just stopping the spiral by flooding my brain with serotonin & dopamine. I didn't get diagnosed as adhd until after my kids did, in my 40s, but that led to my current regimen of stimulants which seem to help my brain spark the serotonin and dopamine instead of getting flooded by it, which feels like maybe I still procrastinate, but sometimes I can sneak past starting a task and go right to finding something interesting about it and finishing it instead of turning it into a big psychological dragon that i need to slay. But that's probably just me.

IME, ADD and anxiety and depression have historically been super comorbid and deeply intertwined for some of the reasons mentioned. Like for the longest time, my inability to accomplish goals I set for myself just left me feeling like shit about myself, and it was only after I was able to slightly alleviate that inability that I noticed the depression starting to fade into the background. I'm at the point now where I'm better able to recognize those inciting factors, which helps me to deal with the attendant side effects (i.e. being REALLY FUCKING OVERWHELMED AND ANXIOUS at work today but recognizing that it was because my ability to focus on way too many new things at once was severely overclocked). It's taken some work to get there (and I have a long way to go before I'm there with any real consistency), but it definitely helps me to release the pressure valve on potential meltdowns.

spacecadet - your experience sounds pretty similar to mine, seems worth looking into at the very least.

One thing I would say is that while anxiety and ADHD are definitely intertwined, I'm married to someone who clearly suffers from anxiety but has no resulting signs of ADHD. The anxiety can be paralyzing, but it doesn't lead to the kind of constantly disrupted focus I have experienced.

Whereas when I'm anxious it makes my ADHD symptoms WORSE, and they're always there to an extent.

Yes. And sometimes when I'm particularly anxious, my meds cease to do anything for me. Which is why I've found it essential to do the supplementary work to compensate for those instances when the training wheels pop off and roll down the road.

spacecadet your post describes adhd imo. like accurately

I’m currently navigating adhd / bipolar hell

Not meaning to be rude to you in particular Brian, but those "balance of the humors" descriptions about "dopamine levels too low" or "flooding with serotonin" are well-meaning fiction peddled by psychiatrists to avoid acknowledging that they don't really know how most of the drugs they prescribe actually work at the systems level. Many of these drugs have describable actions on different receptors, but it's just guesswork and inference as to what they are doing to systems of billions of neurons, which are actively monitoring and regulating their own chemical interaction. I'm putting this here because a lot of people are initially satisfied by these explanations and find them useful metaphors, but end up confused or poorly served by such simplistic descriptions which don't really capture how radically different the drugs are in their actual effects. I'm not suggesting that they don't work or that they don't affect the neurotransmitters mentioned, but (a) we have very little knowledge of how these systems work in regulating such subtleties as behaviour and mood in the undisturbed brain, and (b) these drugs have massively complicated effect profiles which interact with dozens of systems in addition to the ones which are described.
Not wanting to be negative or critical (except of "experts" who claim these are good descriptions) but the most honest position is to say the drugs affect behaviours, and each individual often has to try a few before they find the right mix of on- and off-target effects that give them the best day-to-day living. For a medical professional to claim "this is how the drug works" is oversimplifying at best and actively confusing at worst, when similarly described drugs feel very different to the people taking them. It can even lead to people feeling inadequate if e.g. depression or ADHD is described as a simple "deficit of X" or "excess of Y", a drug which supposedly fixes that is prescribed, and the person continues to experience difficulties.
Contrast this to Parkinson's disease, where a genuine, well described deficit of dopamine in a single system is backed up by clear evidence, for which the prescription of extra "dopamine fuel" (L-dopa) restores the effectiveness of the system in the great majority of cases. Psychiatry sees that kind of simple cause-and-effect with some envy and found that people were accepting of descriptions of *far* more complex mental issues in similar terms, which led to the well-meaning deception. Even the British Psychiatric Association is on record as backing away from such accounts, in recent years.
On the other hand this thread is massively useful, I think. Personal experiences and the accounts of how hard it can be to find a mix of therapy / medication which makes life more liveable, are worth a thousand drug company consumer-advice statements.
For background I'm a neuroscientist who specialises in the cerebral cortex and how these systems interact to shape behaviour (and not a medical professional!).

covid stressors are making all this shit fucking bug out

Like Peter Lorre’s eyes, OTM.

Thank you matttkkkk, I was hoping someone with a working knowledge of brain chemistry would reply here as I was grasping to connect how adhd feels to what is actually happening in my brain based on some cursory googles. I've definitely experienced meds that didn't work and I suspect that my current meds just crack open the door to a more cognitive approach that is the real solution, and i still struggle with that, but my psychiatrist retired a few years ago and my pcp just signs my scripts without considering a different approach.

I was just coming back to apologise for “well actually”ing the thread but your experience is such a good example of where that mindset leads. It’s as if ADHD was like diabetes and just needed a simple chemical fix, keep the prescriptions up and anything else is the patient’s fault. But the”opening a crack” thing seems much closer to the truth of it. A psychiatrist I once worked with, told me that quite a few in his profession have a couple of go-to drugs which they give to people in the hope of opening a dialogue, rather than “curing” their illness.

i don't think that was a well actually! pretty consistent with my experience tbh. i enjoy my moderate dose of adderall but it doesn't make me behave the way i "should." if it kicks in while i'm wasting time it just makes me better at wasting time.

just to note that in referring to the "undisturbed" brain above, I didn't consider that it could be read that people who have ADHD are "disturbed" by contrast, that's not what I intended. All I meant was that we don't know how these systems work in brains which aren't being affected by medication, thus claiming we know how these medications achieve their effects is dishonest.

I made an appointment! It is for the end of November. thanking harbl for that post, which rattled around in my head for a week or so before I picked up the phone and called.

― peace, man, Monday, October 25, 2021 9:42 AM (three months ago) bookmarkflaglink

Just wanted to note that I've been on medication since Nov 29th. Started on Strattera. I struggled to find the right dose on that because it effected my sleep in a really negative way (I have pre-existing sleep issues, but this added a few really unpleasant twists). Just last week my psychiatrist switched me to Wellbutrin, which also has sleep side-effects, but not nearly as bad as the Strattera. The problem with both of these medications is that they are supposed to take over a month to actually have any effect on ADHD symptoms. In addition, lack of sleep is one of the key factors in whether I'm going to have a difficult day with ADHD symptoms, so I'm not sure if the Strattera ended up having any effect at all! I don't have the best impression of my psychiatrist or his front office staff so far, but I'm sticking with him because of the difficulty of trying to look for a new one.

I'm also seeing a psychologist in conjunction. We've only met 5 or 6 times so I can't really judge her too much. She has given me some advice on changing my daily habits. I've been working on putting this advice into practice, but I think it's still too early to know how helpful it is, especially while struggling to adapt to the medications.

Anyway, it's taken me years of procrastination and waffling to get to the point of even seeking treatment, so I'm happy about that and pretty committed to sticking with it even if things don't seem to be working all that great in the short term.

Then I get put on antidepressants & my CBT 101 therapist says "poor concentration is a symptom of depression" - yeah, but I'm nearly this bad even when my mood is fine? No answers yet except "try harder", and I just... can't, but why?

Meanwhile the pills take away the anxiety that feels like it stops me working but I still don't do the work. Maybe I do even less without panicking myself into it occasionally.

Is this ADHD? What does ADHD distraction/task avoidance feel like? Is it brain-itchy? Is it anxious (and what kind of anxiety, i.e. task guilt vs social re coworkers vs unrelated, or any/all of the above)? How do you tell if ADHD causes the anxiety or if it's all anxiety all the way down?

as someone who has anxiety and depression but not ADHD (I mostly lurk on this thread because several of my closest friends have ADHD and I kinda want to be able to more understanding and supportive), this doesn't resemble my experience. It sounds more like an ADHD experience. I take meds to improve distractibility because I tend to be very good at concentrating ... on things that make me miserable.

I'm married to someone who clearly suffers from anxiety but has no resulting signs of ADHD. The anxiety can be paralyzing, but it doesn't lead to the kind of constantly disrupted focus I have experienced.

Yeah, your spouse's anxiety is more like my experience as an anxiety/no-ADHD person.

one of my friends with ADHD has a framed drawing on his wall that says "FINISH WHAT YOU" ... this is my impression of an ADHD trait

https://franklycurious.com/wp/wp-content/uploads/2014/08/CollegeOfArchitectureAndPlanning.jpg

exceptionally LOL based on what my friend does for a job

Chiming in to agree with sarahell, APC (here on my husband’s behalf). Also, my understanding is that adhd presents quite differently in women and misdiagnosis is very common. Maybe find an adhd test online that you can fill out and take to your dr and say “hey these are my concerns”?

I think trying to identify ADHD can be a little like trying to identify climate change. Hey, there's a really bad hurricane, did climate change cause that or do hurricanes like that just come about every so often? The answer is yes and the answer is no. You can't point to one hurricane and say "that's climate change." There have long been really bad hurricanes. But climate changes is intensifying the conditions that create really bad hurricanes and is likely increasing their frequency. Similarly, we are all complex human beings with a lot going on in our brains and emotional lives and a lot of societal and environmental factors influencing us. We are all capable of anxiety, we are all capable of distraction, we are all capable of being more distractable as a result of anxiety. But the oceans are a lot warmer in ADHD people.

i feel like there is a greater tendency to suffer from feelings of low self-worth related to professional and/or academic accomplishment in ADHD people than non-ADHD people with anxiety/depression, where the feelings of low self-worth are more likely to be related to other areas of life. This is just my personal observation from folks I know and ilxors' posts I recall.

OTM. I sometimes can't even believe how differently I feel about my own competence now vs before meds. Obviously some of that is also age and experience, but I don't think the old me could believe he would become the current me. I still find myself reading my own bio/resume sometimes because it feels weird that it's me.

Just the fact that I manage my kids' extremely complex breakfast and lunch preparation every morning, get them to the bus without fail, get the dishes done, remember when all their activities are, and virtually never forget to take out the trash or recycling feels huge, for that matter.

hmm

https://techcrunch.com/2022/01/17/inflow-a-science-based-app-for-adhd-raises-2-3m-seed-led-by-hoxton-ventures/

meds definitely open the door for the needed dialogue with your brain

it's strange, i am currently set to do some biofeedback sessions. the night before last i dreamt i was undergoing a session, and the following day was profoundly different in terms of my ability to listen to my intuition, not force myself to do what i imagined i was 'supposed' to do (or what a 'normal' person would do), avoid procrastination, etc etc. like all the barriers my brain was conditioned to set for myself were suddenly not an issue. obv the dream itself probably wasn't the reason, it's the months of conditioning i've been able to undergo thanks to the meds. and this makes me even more excited for the biofeedback sessions proper, which anecdotally can apparently be life changing

what i'm saying is even if you have a 7k deductible on a meager income it is still probably worth it to finally take care of yourself! and then once you hit that deductible go absolutely hog wild on taking care of yourself

i mean if i could get an appointment with a psychiatrist...

Do you guys have the thing where you get really obsessed with something and you HAVE TO talk and thing about it nonstop, and it's thrilling but also alarming bc you literally can't switch your brain off it, and then, little by little, it starts to bring you declining returns of interest and joy until one day it is GONE and you are free but also bereft?

think, not thing

Yes

I can't exactly say I hate it because I owe a lot of interests to it, but it's very weird to be jerked around like that by your brain. I'm no longer obsessed with Bruce Springsteen, and it feels very weird to say that because being obsessed with Bruce is what brought me to ILX and has kind of been my defining thing here.

And of course you never know what your next obsession is going to be, and it could be something you really don't want.

I spent an entire year able to listen to, and talk about, almost nothing but Elvis Costello. It’s nothing short of a miracle that I’m still married.

I have been deeply, deeply obsessed with bluegrass music since July 2021, both listening to and learning to play. The only three COVID era concerts I’ve seen have been bluegrass and one of them was a concert I hosted at my house. I really hope I don’t just suddenly burn out on it because it has brought me a lot of new musical life but I fear that may happen and my family has joked that it will.

I never thought of this as an ADHD thing but now it makes sense.

Do you guys have the thing...

yes

I never thought of this as an ADHD thing but now it makes sense.

i've prob thought of this as more of an Asperger's thing but idk. I don't have ADHD.

And of course you never know what your next obsession is going to be, and it could be something you really don't want.

That's exciting! A few of my past obsessions started as more cursory interests that i never imagined I could become obsessed with.

fwiw i haven't been obsessed with anything this way in at least a few years (personal record?) and don't know that i'm any better off, really. nowadays when people ask what i'm up to i have no idea what to tell them. i'm always "drawing a blank" lately when catching up with friends.
it was always a little embarrassing to talk nonstop about something nobody else really cares as much about and not be able to help myself... but i'm kinda the most boring person in the world now.

Last year, I became obsessed with insects. I took pictures of every insect I could on my daily walks and uploaded them to iNaturalist to find the species. Of course, insect sightings taper off in October around here. I've read a couple books about them, but probably didn't pursue my enthusiasm as much as I could have during the winter months. I am hoping that my interest in them picks up again when they start reemerging in a couple months. I would be sad if it didn't.

I went through kind of a Grateful Dead obsession a couple years ago (although not as big as my bluegrass obsession) after previously not liking them much. I even was in an informal Dead cover band for a bit. It’s weird because now I feel zero urge to listen to the Dead. This was made worse when I recently went to a Billy Strings concert, which reminded me why I used to hate deadheads.

That's what I'm afraid of with Springsteen. That, and losing something that made me take a more active interest in music in general. I always felt very ignorant about music, and being obsessed with Springsteen was an entryway into learning about a lot of things that had previously been huge mysteries to me. I hope that part of it doesn't go away.