Ask HN: Should I medicate my ADHD?

You are asking the wrong question. When it comes to medication: is there a specific problem you want fixed with a target objective?

You can try medication but without asking the right questions I suspect you will be disappointed. If you try it monitor for how you feel and what others observe as differences.

Imo that depends. If you don't encounter any major issues in your life, then I'd skip the meds. Not only they're really expensive, they're also really difficult to get ( especially recently, for some reason they rarely appear in the pharmacies ). They also don't always work - this is most likely different for each person, but I feel that they provide only a slight boost in my concentration and motivation ( in my case though, this is does make a difference ).

I’ve had ADHD my entire life, too, and never tried medication until my early 30s. After being unmedicated for so long and learning to adapt with it as a superpower as you say, I found meds to mostly be ineffective. They do remove the random side noise that can sometimes be detracting, which helps when you need single-minded focus without much deviation. Otherwise, it makes me feel jittery when it’s active and physically tired when it wears off. I tend to dose when I need it as needed, which my Psych says is fine if it works for me. Eg. a quarter of a tablet 30min or so before I need the effect. This is with plain methylphenidate and not an extended release variant. I’ve also known others to start meds later in life and shortly thereafter be unable to work effectively without them. In such cases, I am unsure if having a strong dependence on a med is worth it over trying to work with ADHD. Dependence on meds can have lasting effects.

That being said, I quite enjoy ADHD outside of times where it can make focus or work harder. I see things in, IMO, more interesting ways, and learn and notice things I might not otherwise. Some of these things have significantly contributed to my personal and working life in a positive way.

As a side-note, I also take Wellbutrin for depression, though it has a stimulant effect. I am unsure if this effect contributes but I haven’t noticed a significant change when I forget to take it for a while.

TLDR; depends. Try meds, see how it is for you. Try not to entirely depend on them to be productive.

What impact are you hoping it will have? If you're worried about losing your flame try micro-dosing it. I've found < 10 micrograms of ritalin can have a useful impact - gets rid of some of the background noise but without the negative effects of too narrow a focus.

Sounds like you are living the dream. I have multiple family members with ADHD, and my observation is that everyone's ADHD has different results. Some of my people get nothing done, despite starting a lot of projects. Some get a lot done, but only under certain circumstances. Some get a reasonable amount done, but only if they have a plethora of choices to choose from - they cannot focus their focus, so to speak.

So if you are getting incredible amounts of work done -- why fix something that isn't broken?

At the same time, if you think it might help your life, you can talk to a doc about your thoughts, maybe try it for a bit to see what it changes, and then make an informed decision whether or not to keep doing it.

Why not try it for a month or two, if it's not any better you can go always go back. I read comments here that some take it during the week to get stuff done and go without on the weekends when they want to be more creative or whatever.

Are you smoking? if so, you are already medicating yourself

I would at least try the meds for a couple of months. I started taking conserta, and it was kind of magical. My mood would improve a lot and I felt more sympathetic with people and problems I needed to solve. As if I had the energy of thinking all trought, with more points of views. Some time later I would get used to effect and it kind of wore out. Today I feel my antidepressants are more effective than the adhd meds.

  - Amphetamines are physically addictive
  - Being productive is psychologically addictive
  - Take time off, or the productivity effect will even out, just like too much coffee.

> I’ve always thought of my ADHD as a superpower, as I have the ability to intensely hyperfocus and get incredible amounts of work done.

This is the literal opposite of what AD(H)D is. You either don’t have ADHD or you have (arguably) ADHD primarily with hyperactivity.

ADHD drugs are stimulants— they don’t treat hyperactivity, they treat the attention issue… and as a side effect they are likely to worsen hyperactivity symptoms.

I can’t see any rationale for medication based on anything you’ve said.

(Disclaimer: everything I’ve said is based on inferences and incomplete information.)

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Are you already self-medicating with coffee (or other stimulants)? Is the caffeine contributing to sleep disorders or physical shakes? One little-mentioned aspect of meds is that they can replace the useful effects of caffeine without the negatives.

Ive never been diagnosed for something like that, but I am inclined to say you should avoid that type of medication unless your condition is dibilitating.

It could be the case that you are working harder than you need to, im going to make an assumption about how you approach problems, hopefully its pertinent. I would recommend thinking critically about any given task before getting into the work. When assigned a task, I look it over and try to establish the plausability of its subcomponents first; think of this as reading the instructions and questions on a timed test before foolishly attempting to solve the first equation you see. I also try to think about who cares about that task, for what reason, and why; you can think about this as using the education you received leading up to the test, rather than using math you learned outside of the class and subverting the intent of the test.

I dont know what huristics and values will be most important to you, I dont know you; but I do think you could find an efficiency benefit from first evaluating a task based on that type of thought process, rather than immediately beginning the work.

Nah don’t do it. From your description your ADHD isn’t a huge impediment (save for the overwork) and one’s brain chemistry isn’t something to be messed with lightly. I’d posit that you’ll miss the hyperfocus if that goes or diminishes, so I’d look for other strategies like meditation or forced timeout from working rather than medication.

Also think if you hadn’t been “diagnosed” with ADHD - you’d think this was just how you were and you wouldn’t look for a pharmaceutical alteration for your unique manifestation of the human condition.

If you have a psychiatrist, do talk to them about that.

It might be the case that you have enough systems and mitigations set-up in life that really only the parts that feel like superpower remain. Some part of that could be some degree of self-medication, i.e. I assume that many people that live on coffee, nicotine and spite do in fact have undiagnosed ADHD and switching coffee to some sort of modern amphetamine prescription would improve quality of their life.

I did get medicated fairly recently. Spent a year really flailing at work, in a way that was not usual for me, but I got to a team with little structure and deadlines, with a team-lead where we often didn't understand each other but not to a degree he would care?

I figured I hav adhd-like symptoms (the innatentive-kind) for most of my life and that I might be at a point I actually need help, took me several months to find a psychiatrist, she agreed that I fit the diagnosis, and in my country I basically had the choice between Strattera, Ritalin and Concerta. Tried Ritalin in mornings for two months and wow, for that time, 4 hours every day I could do stuff ... piles of invoices I have usually been avoiding for weeks disapeared. For the first time in my life I had the experience of actually finishing some work I thought was completely pointless. But I didn't like that after lunch I literally needed to lie down for ~hour.

Changed to Concerta, which is ~slow release version of Ritalin, effect is not that big, but still noticeable, I am capable of creating piles of invoices on Concerta, but when I take it I don't scroll on tiktok for 15 minutes before I gear up to get out of the car and go to office and instead I can just ... go work, and I like that.

While anecdotal advice can be useful to contextualise stuff like this I would strongly be to urge you not to base this decision on advice from semi-anonymous people, and get a proper psychiatric assessment of your ADHD if you are able to. If you were diagnosed as a child it’s entirely possible that the nature of your ADHD has evolved over time. It used to be thought people “grow out of it” but this seems less well supported clinically now.

However, the impact and nature of ADHD is very much down to the individual and it sounds like you have either developed strategies to harness your ADHD or you may have ADHD impulsive/hyperactive without significant attention deficit/distraction. There is not “one type” of ADHD and this means that two people diagnosed with ADHD can have very different experience of things.

Before starting medication you should get an adult ADHD assessment and in particular the Qb Test. For me the Qb Test was particularly useful in diagnosis.

Diagnosis of, and thinking around ADHD has come on significantly in the past couple of decades so it’s likely that reassessment as an adult could have upside for you - even if you don’t end up going down a medication route - by giving you greater insight into the specific nature of your ADHD.

FWIW I was undiagnosed as a child but the symptoms were very clear - very hyperactive, very inattentive in class but due to good levels of general intelligence, ability to recall texts in detail after reading, and ability to hyperfocus (writing essays last minute, cramming for exams the day before) got high marks throughout school and college - but at significant cost to my overall wellbeing.

I was then diagnosed as an adult and have significantly benefited from medication.

As someone who used to use hyperfocus as a “superpower” and used to be able to deliver huge pieces of work by using it I fooled myself into thinking there wasn’t a problem, even though I knew there was. I actually get more done with less need to hyperfocus and feel less stressed and less “backfooted” now that I take medication. I’ve not lost the ability to hyperfocus but am bale to combine it with the ability to manage and plan, something I did not used to be able to do.

Give it a try, before your real life troubles start mounting.

I waited too long, until my wife and I were on verge of getting divorce, and I was struggling at my job. Medication put both back on track, but man do I wish I'd started earlier.

Yes, OP. In fact you should try see a doctor for this as soon as you can. People with ADHD have spoken about how they lost years of their lives through unrealized potential. People that might have otherwise gotten degrees, had more successful careers, and easier lives. It adds up massively.

If you do go on meds make sure to be honest with yourself about how you perform. You'll want to pay close attention to your sleep because many people find they can't get healthy sleep on the meds. If that happens a doctor may be able to prescribe something to help or switch to shorter acting stimulants.

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Talk to the doctor and all that. But for added context, some stuff I learned which I don't see often mentioned:

- most ADHD meds wear off in hours, even the extended release ones, so you can always try it without long term changes

- people talk mostly about stimulants, but there are non-stimulant options too, with the benefit of easier prescribing and avoiding the shortages

- HN (thanks @Podgajski) pointed me at an interesting paper https://sci-hub.se/10.1016/j.mehy.2013.11.018 and letter I was sent https://www.cambridge.org/core/journals/bjpsych-open/article... which work really well for me, so you could even try checking for vitamin deficiencies first (daily b6+b2 worked better than other things I've tried)

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You seem to be functioning well and may no longer meet the criteria for ADHD. This is actually not uncommon, nor unexpected: the frontal lobe of your brain, responsible for executive functioning, isn’t done developing until you’re 25.

Ok so these are my personal experiences as an “intelligent” scattered ADHD type. Meditation works, exercise works, medication works, talk therapy works, organisational systems work. Organisational systems emerge as a result of effort applied and previously mentioned interventions. Read about your disability and understand it. Learn to understand your own limitations. Medication may be the spring board to form habits that do not cure your ADHD but manage its impact.

Some psychiatrists feel that ADHD is a manifestation of a deep discomfort with societal rules that were forced upon someone from birth, without consent. I feel some truth to this. This paragraph is not advice but speculation.

> Just try one or two months

Seen this posted a few times.

I've seen it completely destroy a person and it took years to recover.