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Ask HN: How to deal with ADHD on your own? (If you have to)

18 points by d-1 ↗ HN
This is not an anti-medication or -therapy post. The purpose of my writing is to inquire about the best self-help strategies for managing ADHD. This might be useful for people who don't have access to a therapist or to medication. It would be nice if those strategies are backed up by findings. So without further ado, here are my best ways to deal with this condition on your own:

1. Fish oil (EPA should be higher than DHA) [1][3][4] 2. Zinc[1] 3. Lithium (has severe side effects, but seems to be effective)[1] 4. Meditation/Mindfulness & Yoga[2]

References: [1] https://www.webmd.com/vitamins/condition-1021/attention+deficit-hyperactivity+disorder+(adhd) [2] https://pubmed.ncbi.nlm.nih.gov/18025249/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321799/ [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175558/

Disclaimer: use your own brain first! Or if you can, listen to your therapist. Again, this is aimed for people who have no access to professional help. I am not an expert in scientific literature.

38 comments

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ta_202010061019
Tried every medication which is legal in my country. Side effects where always too strong to use drugs on a regular base.

What works: - Enough sleep + naps - Sport - Walking - White noise to cancel out distractions - Logging almost everything which happens during a work day in a work journal - Having checklists/templates - Setup work days - Setup free days - Recurring todos for day of week - Coherent breathing works better for me than meditation

ta_202010061019
I second that you should get properly diagnosed by a doctor and try the available medication. If the medication works for you sustainably it will make your life that much better and easier.
d-1
To be clear, therapy and medication is the best available option, but not everybody has access to it. In that case, what would be the next best option? (That is what I am actually asking.)

Also, there are some restrictions on medication in certain countries (e.g. Japan):

https://addadhdblog.com/adhd-in-japan/?doing_wp_cron=1601997...

ta_202010061019
First of all, IMHO it is really important to get diagnosed by a good doctor and to rule out other reasons which could cause ADHD symptoms.

ADHD is a broad spectrum and every life is different.

The next best option I could recommend is to learn about symptoms from ADHD, examine how they are affecting your quality of life and have 'physical' crutches in place where you need them. This is highly personal, takes time for experiments to see what works for you right now, and when your situation/environment changes, you must adapt and perhaps change or create new crutches.

Still, there is a lot of stuff you simply cannot fix w/o medication: Impulsivity and focus are my biggest Achilles heels.

If there is no way for you to get medication you have to learn what problematic situations will be for you and try to avoid them from the start, because there is no way you can trust in prolonged self control if you have ADHD.

bot41
I am interested in how you manage your work journal. Do you use a physical pen and paper or do you use a digital tool? Online or offline? Do you archive or throw away old notes or do you revisit them?

Info about your checklists could be handy too.

d-1
This is somewhat unrelated, but the things that help me most are:

1. The Johnny File System: https://johnnydecimal.com/ 2. The PARA System: https://fortelabs.co/blog/para/

I mix the PARA system with JFS by numbering it in the JFS manner. For example, I have a note called "Minimalism", so I store it in "02-AREAS" like this:

"2.01 Minimalism"

Now let's say I want to totally change my minimalism list, then I am going to archive that in "04-ARCHIVE" like so:

"4.01 2.01 Minimalism"

Then I reuse the 2.01 for my minimalism list again.

Another side note: Bullet Journaling is something that I am looking into, but I am not yet familiar with it. My take on it is: you are an operating system scheduling tasks out of a task list.

This is what a key in a bullet journal might look like paired with Standard Notes:

• task x completed > moved forward < scheduled task (future) ~~cancelled~~ ○ event - note ! important

Regarding JFS:

https://www.reddit.com/r/datacurator/comments/cucufy/my_pers...

This is what I used as a reference to organize my folder system with JFS.

d33lio
For me it's all about routine, sleep and unfortunately accepting that stimulants make my life orders of magnitude more productive and enjoyable. However, my ADHD is also what gives me the ability to think in very creative and obtuse ways / also derive my anxiety into huge decision trees that have unfortunately proven to be very accurate.

As someone who was finally diagnosed by two different neuropsychs (involved days of testing) at 22 it's something I'll regret the rest of my life. Basically, the fact that my parents just thought ADD was a "fake disorder" and struggled through a majority of high school / college.

Frankly, I've also found significant benefits micro-dosing a liquid psilocybin mushroom extract a few days a week.

Please talk to a psych if you think you might have ADHD!

HelloFellowDevs
> As someone who was finally diagnosed by two different neuropsychs (involved days of testing) at 22 it's something I'll regret the rest of my life.

I don't think I understand what you meant. The diagnoses made your life worse? Or made you more aware?

ta_202010061019
I guess the regret comes from not knowing sooner. I was around 30 when I was finally diagnosed. When I think how this diagnose could have helped me 25 years earlier to get the right knowledge and support to manage life it really makes me resentful.
emit_time
I got diagnosed junior year of college, knowing sooner would’ve been very helpful.

Probably would’ve been more social in high school if I took meds because it probably would’ve been easier for me to complete homework, and I would have had more free time.

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shahbaby
Very similar story here but I'm not resentful of the late diagnosis.

Getting through most of my 20s without meds gave me more confidence in my own abilities.

If I had them earlier? Maybe my life would have been easier but maybe not.

Even today there are times when a bit of ADHD helps me make better decisions by just letting my mind wonder.

I think that using stimulants to control the ADHD like an on/off switch is the best of both worlds.

d33lio
Without a single doubt, a net positive. Important context to add is that I also had my tonsils removed at 23 when my PCP let me know that if I didn't have them removed I might suffocate in my sleep. Years of what was likely tonsilitis and the latent sleep apnea is likely what lead to my ADHD (strong scientific evidence to support this).

What still scares me to this day is how much more calm and witty I am when taking stimulants. Otherwise, I have a fog that seems to distract me or nag me away from doing anything that I'm otherwise interested in or makes me happy. Fortunately, I no longer have to drink 3-4 cups of coffee to get "in the mood" for work.

throw51319
How much cybin do you take? What time of day and how many days a week?

I tried recently and really think it helped, but the first hour or so i was a little off

d33lio
Maybe 2ml of "blue juice" in a cup of tea. It's hard to know what the actual active concentration of my extraction is though :(
throw_this_one
What’s the equivalent in dried material?

I have 2g-equivalent vials. I tried about an eighth once, which is about 250mg. That worked really well but just for a day or two.

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sosodev
Routine has been the best way of coping without stimulants for me too. Developing strong routines got me through college.
fatnoah
My (about to be a teen) son has ADHD and strong routines have helped him greatly. Any tips on how to build and stick to strong routines?
d33lio
Be gentle, but consistent and always outline how routine makes his/her life better. For instance, lay out your desk a certain way and you'll finish your work earlier and have more time to spend gaming. Acknowledging productive tasks that allow for dealing with pent up energy is also important.

My parents for some reason thought hanging negatives over my head always mentioning "think of what would go wrong if you don't do the right thing". Honestly, this just left me with a bunch of hugely negative self-talk issues that took a while to unpack since many of those things also had to do with my ADHD.

fatnoah
Thanks for the reply and sharing your own experience. We've definitely noticed positive reinforcement is HUUUGE. He's so proud of himself when he remembers to get to bed on time, or completes the morning routing w/out reminders.
sosodev
ADHD teens tend to be rather oppositional. Personally, I always had a really hard time accepting unsolicited advice from anybody and that includes loved ones.

The best thing somebody with ADHD can do is externalize everything they want/need to remember. Preferably in something centralized and always accessible like a notebook or planner app. Then make it a routine to read through and take care of the stuff in it daily.

https://www.youtube.com/watch?v=sPFmKu2S5XY

Watching that video helped me put my behaviors in perspective and really understand how my brain works. He even says in the video that “chaining a notebook to yourself” is the best thing you can do if you have ADHD. If your son believes that he has ADHD that video, or others like it, might help him understand what that means and he’ll probably start to draw the correct conclusions.

I wish you and your son nothing but the best. Growing up with undiagnosed ADHD was both the best and worst experience of my life. The highs are high and lows are so unfortunately low.

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fatnoah
>If your son believes that he has ADHD

Thank you for your reply.

We actually did a full neuro psych evaluation when he was in 4th grade and that was eye opening. It let me "see" how his brain was working, and, for my wife, opened her realize that she probably has undiagnosed ADHD. My son and wife were constantly butting heads and the eval helped my wife understand and reason better, too.

zbq
Aren't there potential side effects from taking stimulants and psilocybin at the same time?
chunky1994
Disclaimer: I am not a doctor, please do not take this advice as infallible and especially please do not mix medication that is self administered based solely off of the following paragraph.

I don't think OP is suggesting they be taken at the same time. The answer to the question however is that would depend on the stimulant being ingested. If it is an amphetamine like adderall, there isn't that much cross interaction in their pharmacology. Adderall (amphetamines) in ADHD medication based doses primarily act in increasing dopamine in between neurons while psilocin is primarily acts on serotonin and its receptors. While there might be some compounding sympathetic nervous responses at standard therapeutic doses it is unlikely to cause any noticeable side effects.

d-1
Any experiences with lion's mane?:

https://www.medicalnewstoday.com/articles/323400#potential-b...

There are more supplements. You better do your own research on these:

- Tyrosin - Theanine - Creatine - Protein - 5-HTP - GABA

At best they might help, at worst, you wasted your money. PS: Have you tried fish oil (or perhaps algae oil) and zinc? According to the findings I provided, they might help you too.

d33lio
I have not, only since the latest "health supplements" scam of our time is exactly these kinds of "healthy mushroom boosters". Claiming all kinds of insane health benefits from "mushroom extract" etc. But wrapping it in an earthy Goop-esque marketing cascade targeting rich house-wives and wall street types. You'd be surprised how much BS wall street types fall for (even when something is just priced idiotically high), for instance Molekule air purifiers (literally fake science and work half as well as a $12 HEPA filter) and anything made by Dyson haha.
d-1
Fair enough. I suspected that my posting above could come off as "bro-science".

But regarding the supplements or nutrients omega-3 & zinc. They do help. I provided the findings. Meditation also works.

Some links supporting my case:

https://www.additudemag.com/slideshows/treating-adhd-without...

https://www.psychologytoday.com/intl/blog/the-best-strategie...

https://www.helpguide.org/articles/add-adhd/treatment-for-ad...

Key points I made out of these links above:

- Mindfulness/Meditation - Omega-3 (EPA > DHA) - Zinc - Protein - Exercise 30 min/d (walking, calisthenics) - Low sugar, caffeine, and carbohydrates - Schedule/"game plan" (calendars, task lists)

I am also disappointed with how this "Ask HN" of mine unfolded. It is perhaps my fault. I should have clarified things from the start. My intention was to (prematurely?) optimize self-help strategies without medication, but my point wasn't well taken it seems.

d-1
Okay, you handled some of your ADHD symptoms with stimulants, routines, and sleep. How did you fix your social/interpersonal skills? Don't you have trouble interpreting social cues correctly?

What about organization? How did you fix that? Or will medication fix all of the above automatically?

zrkrlc
My take on this as someone who's been on atomoxetine for a year is that, no, this won't automagically fix your problems.

But it gives you a chance.

Me on atomoxetine means I can actually: a) slow down, b) get an intuitive feel of passing time, c) tune out anxiety-inducing thoughts, which in combination are enough to get me through most days. Think of it as learning how to work again for the first time. Most people have had decades of practice on this and you're essentially starting from scratch. What would you do differently?

companyhen
Meditation works best for me. 15 minutes when I wake up every morning at a minimum. 25-30 minutes gets me really focused through the day. Started during lockdown, around day 130 right now. Best habit I picked up. Morning works best for me, if I wait until later in the day I don't feel like making time for it.

I use the insight timer app which has nice analytics and you can see everyone around the world and your city meditating with you, which is a nice social feature.

[dead] peapek
Meditation is a lifechanger if you stick to it. Not just to deal with ADHD, but life in general.

For anyone interested in getting started, I can absolutely recommend Waking Up by Sam Harris. (The idea behind the app's name is just what you do - starting the day with a mindfulness meditation.)

The App has a great 28 day introductionary course (easily digestible 10 minute sessions), among others, and is expanding its content right now. If you can't afford a subscription, you can easily unlock it for free simply by sending a mail to the support.

logicslave
Either find something that excites you enough to be really interested in or take medication
d-1
Thank you for your input, gang! :)

Okay, to summarize, here are the list of things that might help when you are unable to get medicated or therapy:

1. Supplements: Omega-3, Zinc, Lithium (has severe side effects, but it works) 2. Mindfulness: Meditation/Yoga 3. Routines (according to HN answers)

Here is the list of things that I personally (!) think that might help:

4. Digital organization: Johnny File System, PARA Method

Here is the list of things I am personally (!) unsure about:

5. Offline organization/planning: Bullet Journaling 6. General organization: minimalism? Decluttering?

The list of things that need also attention:

7. Social skills & interpreting social cues correctly 8. Interpersonal skills & soft skills (manners?) 9. Effective "crutches" for things like impulsivity

Some more ideas that might help or not - these are rather experimental:

10. Fasting (for mood improvement?): https://www.hal.inserm.fr/file/index/docid/789122/filename/F...

And remember: use your own brain first don't trust anyone so easily! :) (Except your therapist/doctor, if you have access to one.)

Final note: we need a Scott Meyers type of book for "Effective ADHD".

godot
I never actually was diagnosed, though I've taken these online ADHD tests and I've always scored pretty high. Based on my own experience, it would seem I have some level of it as well. I feel like in the past few years, after working a decade in software engineering, I've learned to utilize my ADHD tendencies pretty well. In several companies now I've acted in a role of some kind of lead engineer where difficult problems or live issues get thrown my way (I seem to get myself into such a role more often than not). Juggling several high priority tasks at once lets me focus really well on each in short bursts of time, and after that, I seem to enjoy the context switching way more than most other software engineering peers would (everyone else seems to hate it). I would add that, as an unrelated point to ADHD, I'm a person who can handle stressful situations fairly well, so it definitely helps with being the guy tackling production fires all the time. Not sure if it works for everyone, at least it does for me and I've had a thriving engineering career for 15 years and counting now. I don't use any medication.