Ask HN: Dealing with ADHD Without Medication?
Any tips and tricks? I have been on-and-off stimulants for the last decade but recently quit cold turkey because I got sick and tired of dealing with all of the availability issues. I also hate being so dependent/reliant on psychiatrists who in my experience don't really give a shit about you or your wellbeing. I hated needing to ask for refills every 30 days, hoping that they would respond in a timely manner and that the stars would align so there was no interruption.
That being said, my life has almost come grinding to a halt. It has been 3 months and I am still struggling to get back to a decent baseline. I am beginning to wonder if it is possible to live life without them, which is an additional strain on my emotions.
Has anyone here gone down a similar path to treat this in their own way without schedule I controlled substances?
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[ 5.8 ms ] story [ 48.7 ms ] threadI’ve had undiagnosed ADHD since I was a teen (now 32) and recently got a diagnosis and started using medication (Vyvanse).
Without a doubt the only thing that has ever come close to helping me feel “normal” has been exercising regularly. Whether it was going for a run, or lifting weights, the stillness you feel through medication is something I only felt after a nice workout.
So that’s what i’d recommend. Put your physical health first, eat better, exercise regularly, and top it off with something low effort but high reward like yoga or meditation. That is the only way.
https://www.theatlantic.com/health/archive/2014/09/exercise-...
I think most people know the benefits of working out, but have trouble getting started.
People have a distorted view of exercise, thinking that every work out, every gym session has to be intense but in fact the most important thing is to do something.
Have a gym membership? Just show up and walk on the treadmill for half n hour and go home.
Don’t have a gym membership? Go for a walk around the block.
All that is exercise.
The magic happens when the repetitive act of showing up starts compounding in unexpected ways.
You feel the benefit so going the next time is less effort, and you may walk a bit longer.
That in turn affects the choices you make about what you eat, when you go to sleep, the quality of you’re sleep, the increase in dopamine from all those activities, which then feeds back into the cycle.
So literally the easiest thing you can do is do something, don’t expect overnight results because that kind of expectation informs the perceived effort (which is high), which results in people doing nothing.
It's really hard to eat a candy bar when you know how much exercise is going to be required to burn it off.
Highly recommended. It's small enough that i don't notice it.
If it helps, you can think of it like "going to work". Very few people are lucky enough to feel any sort of intrinsic motivation to show up at work every day, but they do so because of the consequences are disastrous if they don't. The analogy isn't perfect since the long term consequences of ignoring your health are farther in the future, but the upside is that after exercise you get shorter term feedback in improved mood, sleep, concentration etc. You just need to show up and do the work.
But for some of us, we do have to remind ourselves to brush our teeth, or eat, or whatever thing the average person does "automatically".
I do this for things that aren't the gym too. Need to grocery shop? Write a list, grab reusable bags and lay them down next to your keys, etc.
I struggle going to sleep at night. I'll either ruminate on bad memories from the past and get myself all wound up, or I start mentally taking apart a coding problem.
The best way I've found to deal with this is exercise. It's hard to be wound up when you're physically exhausted. Afterwards I can actually feel my body relax, and I can drift off to sleep.
[1] https://www.betterhelp.com
2. I wrote a script to run my life for me, you should consider doing the same.
[2] https://taylor.town/nowify
3. Find something to obsess over! Everything comes to a screeching halt when the spark of life eludes me.
4. Consider using a service like FocusMate to stay on task. It's a form of "body-doubling".
[3] https://www.focusmate.com
[4] https://chadd.org/adhd-news/adhd-news-adults/could-a-body-do...
At some point, I think this would actually work better as a phone/watch app.
I was happy with my little inconveniences list until now, but seeing all of the other various prompts that you've made for yourself, I'm thinking I should explore this strategy even further. Would you mind posting a link to the full text of the prompts? Some of them are cut off at the end from your screenshot. Thanks!
On this list, you'll notice a lot of "never" routines. When I retire a routine, I change it to "never" so that it's easy to reenable it if I ever need it again. For example, I recently got laid off, so I'm allocating more time to personal projects than career stuff.
Training yourself to recognize things is difficult! Forcing yourself to look at something every hour or every day can force you to see the world differently within a matter of weeks.
Brains tend to tune things out, so nowify prints out randomized lists inline for many of these prompts. For instance, when I'm supposed to send memes to people, it prints 10 random memes and 3 random people to turn it into a little game.
Doing work you actually enjoy helps, also task sequencing, for me at least, context switches are very expensive, so I try to schedule like-like work back to back.
I also tend to use the 'buddy' system for doing things like, organizing stuff around the house, and cleaning, which means someone to hang out with me, and often help me not get distracted. If I try to organize alone, I will get one box of shit taken apart, then as I go put it away, I find other things that need putting up, and move them, and at the end of the day the whole house is a mess, and I have no idea why.
I'm sorry, can you expand on this? Preferably with sources?
You may want to look into a sun lamp to help you do this during the shorter days.
Yours might be heavier in some aspects and lighter in others. It's also often tied to other psychological issues.
Not everything works the same for everyone. For "vanilla ADHD" the most impairing factors will often be:
- Executive function. This can be organisation, getting started or keeping up with dopamine depleting tasks (chores, bills, etc.) and keeping track of time during tasks
- Emotional regulation. This can be emotional reactivity (often called RSD online), or other all sorts of difficulties dealing with emotions in a productive way. This one is often left out in discussions but the most harmful for life outcomes (especially frustration/anger based dysregulations)
- Short term memory issues. Part of executive function but should be noted specifically.
The first thing to note is natural external dopamine will help. This is getting proper sleep, nutrition and exercise. Exercise, especially intense activities like HIIT will help regulate dopamine naturally.
For executive function, the best is to have a system. There are plenty out there (bullet journals, productivity apps, etc.) Find one that you actually use without forcing yourself to. Can be a TODO list in google keep/apple notes, or a Bullet Journal or something like TikTik
For short term memory issues, write everything down. This often plays into the system above.
For emotional regulation, DBT is the best place to start. The DBT workbook can be freely found as a PDF online.
Russell Barkley has good information: https://www.youtube.com/watch?v=BzhbAK1pdPM&list=PLzBixSjmbc...
Getting a ADHD aware therapist, if financially feasible, is a good idea. Be critical of online communities, there's both good and bad in there.
First, if you want to radically change your life by no longer taking stimulants, you need to recalibrate what you expect your life to look like.
You know they change how you think and behave, which is why you took them, and so it’s a given that your life just won’t look the same without them.
It’ll take time, but you need to figure out what your life can look like without them and make that your baseline. You’re always going to have an “additional strain on your emotions” when you try to make an unmedicated life look like a medicated life.
Maybe you work less or on different things. Maybe your home is less organized. Maybe you nap more. Maybe you’re friendlier and more empathetic with people you care about. Maybe you have a dozen slowly progressing hobbies instead of one diligent passion. Maybe you exercise or meditate more. Maybe you chill with woo hippie vibes instead of chasing life as a type-A achiever. Who knows. As you adapt, try to identify positive changes and define those as the new baseline you’re measuring yourself against.
You didn’t need medication in the first place. It’s a choice you made to live a certain kind of life. Now, you’re revisiting that choice and are pursuing a different kind of life. That’s exciting! But you have to embrace that rather than fear it, or you’re just going to torture yourself.
I am hoping to read the second one, as I heard 2nd book need you be on meds, when working through the book, but I do not think you need to be on meds any longer than you change your thinking, since it is CBT book it will possibly help you to adapt your thoughts necessary. For meds I suggest you to try out lowest dosage of pro-drug(non abusable) like Vyvanse instead other stimulants, it is also long lasting, have ease in and ease out effect unlike other stimulants as I heard.
3rd book also will fit your needs, since it is also a CBT book.
All those three books are recommended by Dr. Barkley, first one authored by him.
1. https://www.amazon.com/Taking-Charge-Adult-ADHD-Second/dp/14...
2. https://www.amazon.com/Cognitive-Behavioral-Therapy-Adult-AD...
3. https://www.amazon.com/Mastering-Your-Adult-ADHD-Cognitive-B...
Finally, for me at least, it was the harder task of prioritizing regular F2F social interaction and attention to developing quality friendships over many months that contributed to my biggest gains in executive function. I did this for other quality of life reasons at the prompting of my partner, and was surprised by this unexpected positive result.
Godspeed, stranger!
0. Be kind to yourself. You don't deserve to suffer. Your brain is always lying to you about how bad you feel. It's really hard to live your life "like everyone else" with the ADHD gremlins chattering away in there.
1. Remind yourself every morning you are starting a new day, and every evening that you did the best you could, that you succeeded in some things, and that tomorrow is a new day.
2. Make yourself do 15 minutes of intense cardio exercise every day no matter what. Think of it like brushing your brain's teeth. Set out your exercise clothes, car keys, and fill your water bottle several hours before you plan to do this.
3. Make a schedule for your sleep, food, water, and exercise. Every day, try to do the same routine. Moderate amounts of caffeine are good too. (A few cups of black tea during the day is just about right for me.)
4. Talk to a therapist regularly, and be honest with yourself and your therapist. Therapists helped me learn to be more kind to myself and less shameful. And that change in mindset helped me feel better and dramatically reduced my ADHD symptoms as much or more than the medicine.
Dopamine deficiency and Shame cause a feedback loop that makes your ADHD worse. Make it a routine to disrupt both.
I totally understand the desire not to deal with getting and taking the medicine. For me, I could only manage my ADHD with both medicine and therapy. It's OK if you need drugs sometimes. It's OK if you go without them.
Here's the strategy that worked for me for more than a decade now:
1. Getting the chemical baseline right: Make sure you have enough Magnesium, Potassium, B-complex and Vitamin D. Without these, everything else, including therapy or spiritual explorations, will likely fail. If you have trouble sleeping Mg Glycine + 5HTP are a great combo sans the side effects of let's say melatonine or benzos. Eat LOTS of meat, at least a dozen eggs a week, fish oil and seafood in general. 2. Nootropics: Piracetam + L-Theanine + Black seed oil (pills) + Alpha GPC have significant effect over time. You won't feel the immediate boost like with Adderal but small increments that will change your life over time. 3. Being hyperactive means no carbs. Nothing makes me more hyperactive than an insulin spike. Staying on low carb, keto and one meal a day is the best way to maintain mood stability. 4. If 5HTP and Glycine are great for boosting serotonin, L-tyrosine is amazing for boosting dopamine. I've discovered it last year and it's been a gift that keeps on giving. I've tried Modafinil and ended up in super weird mental states (mild paranoia, anxiety etc). L-tyrosine has been nothing but wonderful. Complete game changer. 5. Sports&hormetic stressors – make sure you have enough physical activity and healthy levels of other physical stress (e.g. cold temperature). Your brain will thank you for those endorphin releases post workout.
Luckily I have an awesome and very understanding GP who stretched my prescription to 90 days permanently. As I understand it there's no hard limit here in The Netherlands, but this is about the maximum he can get away with in this case.
Yes, except if pamphlets from the obesity clinic sold for hundreds of dollars on the street. It does suck, but I do see it at least a bit of a "this is why we can't have nice things" rather than just "Assholes make it harder for me to get my meds"
If so, here are a few leads:
• Buproprion (Wellbutrin) is an NDRI but is not a controlled substance. Its on-label use is for depression or anxiety, but has been used off-label for treatment of ADHD. Many people are prescribed it as an adjunct therapy to regular depression/anxiety treatment when they also seem to have some ADHD symptoms, or when the drug they're taking for treatment of depression/anxiety causes ADHD symptoms.
• Bromantane is a non-scheduled and in fact non-prescription "nootropic" drug (it's a licensed OTC medication in the countries it's produced in; but is just considered a "supplement" in North America) that specifically aims to treat dopaminergic receptor depletion, by — apparently — triggering the permanent growth of new dopaminergic receptors. Some people phrase this as it "healing" your reward system. (It can apparently be used to undo some of the long-term effects of meth use on the reward system.) ADHD is technically a syndrome, in that it has many possible root causes (etiologies); one of those potential root causes is a decrease in dopamine receptivity in the brain, or a decrease in dopamine production. Both of these problems are treated by growing more dopamine receptors. If your ADHD has that particular etiology, then it may benefit you to try this. (In practice, it worked, at least for me. I took some for a while when I ran out of Vyvanse myself, and it indeed treated my ADHD, though in a very different-feeling way than Vyvanse does. When I stopped taking it, and resumed Vyvanse treatment, I found that I needed a lower dose of the Vyvanse going forward.)
• Tricyclic antidepressants are dopaminergic and unscheduled. You'd have a lot of side-effects from these if you aren't also depressed / anxious; but if you are, they're a good solution.
• MAOIs are everything-ergic, and unscheduled. They're also pretty awful. (You can't eat cheese!) Last resort.