Thanks, same. I tried so many methods, most do NOT work for me, but the ones that do make all the difference. This one will certainly also not work for everybody.

Main strategies right now:

• engineered staple foods always available in stock (Jimmy Joy, Soylent, Huel, “This is food”, …). So always the option to have a somewhat healthy meal with 0 effort.
• big freezer & hot air fryer. Good compromise of taste & health: salmon with vegetables in cream sauce. Less healthy: Fries (still best-health fries), fish sticks, vegan burger
• healthy-enough snacks. Currently binging on high protein, low sugar cookies. Obviously not that healthy, but otherwise I’d binge the really bad stuff when I lose control
• healthy snack plate with carrots, apple slices etc.: Just set it up at the desk and see what happens. Thinking about actually eating it is too much mental effort, and it happens automatically anyway.

Well where are you? Or is worldwide travel an option?

I managed to wire myself with a trigger to answer my inner dialogue of “I can’t …” with “Well what CAN you do?”

In case of the escalating snacking, I realised that I can’t just switch them out with something healthy. But I CAN make a plate of raw carrots, apple slices, cucumbers etc. and set it up at my desk. Surprisingly, that was already one big leap forward. Even my sloth mind - especially my sloth mind - would rather chew on a carrot right now than get a chocolate bar from the kitchen. Beat it with its own weapons.

Absolutely, people are very different. In my particular case, I used to get anxiety, and it got worse with caffeine. Got benzos for years as an when-needed fallback. ADHD had not been diagnosed yet. Turned out that much of it was a magnesium deficit, and magnesium replaced benzos completely. I also tried modafinil before I was officially diagnosed, and it worked pretty great. But that is just my very specific case.

The only general takeaway is to keep searching for what’s up and what works for you, and that is probably very different in your case.

She should try my chicken-method, then: Take half a minimum dose, e. g. 5g lisdexamfetamine, if it works go to something like 10 or 15.

Does she get bad side effects from coffee? If yes, stims really might not be for her.

It helps me with the exact same things, and the hard crash used to be similar for me. But the doc found that Vyvanse caused it only indirectly: I was working hard (even on things like cleaning), didn’t feel the need for pauses and rest, didn’t eat and drink enough. After doing these things by schedule rather than how I felt, it was completely fixed.

Your situation sounds like a different quality, probably with different causes.

Engineered staple foods. Huel, “This is Food”, Soylent etc.

Also pretty nice is a hot air fryer and a freezer. Grilled salmon right from the freezer, frozen vegetables with sauce included. Kind of a luxury dish, same effort as fries.

Caffeine Free Coca Cola is a thing, as I have read, although I never saw it in a store.

Same life-changing effect with Vyvanse for me. Did you stop all caffeine, even black tea? In combination, that can really get your heart racing.

Good question, and my mistake might have been that I asked straightforward: Do you feel better with meds? Do you like school better? Is it easier to get on a task such as cleaning your room?

He always says: No difference.

Maybe I should ask like: “How interesting was school today?” and then see how it correlates with meds.

I had a similar experience when I was much older. I had ONE good math teacher in 14 years, had him 5-6 and then again 11-12. Strange is that it took me a while to realise how good he is. I just wondered: Why is math so boring all through the grades 7-10, although it is so awesome otherwise?

So, maybe he does feel and grow better, but doesn’t realise it. But there is no proof. Only proof is that he is sedated, which makes the teachers happy, but that was not the goal.

I too suspect that the doc will have him try a lower dose again. Odd with lower doses was that even just 6 hours later, therapist and I saw 0 effect, and that is unlikely with slow-release; should be at least some left. Due to that, the doc decided to give the teacher’s observation (who said low is fine) less weight and increase anyway.

The problem really is that this is not an exact science when applied to individuals. Day A, teacher says he’s doing great, well maybe it’s because it was a classmate’s birthday and he brought cupcakes, and in German they were just reading an interesting story. I say 15 mg sedates him like an elephant tranquilizer gun, but maybe he was just very tired that day.

My fear is that this might drag on for months and years, and on the way, we’ll give up what would have been the solution just because it was applied on a few bad days.

And really infuriating is that in all this that they couldn’t even give him consistently the same exact meds! EUR / USD 1100 / month insurance premium and he can’t have his 20 cents pill!

I hope they find something better for you! Lisdexamfetamine fixes my motivation, to get started on a task, and my focus completely, but I’m super confused as always. And since I do 10x as many things with my fixed motivation, I make 10x as many mistakes. Joe Biden on speed, basically.

While I do hope for something that fixes the other things, my quality of life has improved tenfold. But for my child, it seems to just make life for the teachers easier by sedating him, and that’s not worth it. What are they getting paid for?

Don’t worry about Mg, all he ever eats is fries 😂

Research shows overall better outcome with medication, if indicated. Fewer mental problems in adulthood etc.

That doesn’t invalidate your experience - certainly it makes things worse for some, better for (more) others. It just says that the average is an improvement.

So hard to get useful feedback from a child. I can just observe what I see and ask the teachers. The teachers were happy with 5mg but said that 15mg had no effect. Doesn’t even make sense, so it was probably another factor playing in, such as a topic at school that he liked or not enough water / food during intake. The teachers even warned us to increase the dose unnecessarily, but with all information considered, the doc did it anyway, which made sense at the time.

I’ll try a lower dose myself again so I can give more feedback to the doc, and we’ll see if he needs something else. Pure sedation to make the teachers happy is not the goal here.

That is interesting! I’d expect that it is possible that neither helps with ADHD, but should still feel like a strong coffee at least.

Do you feel coffee when you had a coffee break of several weeks?

It is my understanding that stims have two effects:

They work a bit like a recreational stim in that they make you alert, awake (or calm, with some types of ADHD) and euphoric. This effect can very much help with symptoms, e. g. in a euphoric state, it’s easy to get on a task. This effect fades over time, very much like caffeine or a recreational stimulant drug.

But they also regulate noradrenaline and dopamine in the prefrontal cortex in other ways which may not directly lead to a heightened state nor effect the vegetative system, but help with many ADHD symptoms. This effect does not fade, possibly not even a little bit!

For the patient, it’s hard to distinguish, and a patient may even “mistake” the “recreational high” for all it does, but it’s actually kind of a side effect. I believe that this is where the notion of “needing a break” comes from.

The docs & society kind of wants us only to have the 2nd therapeutic effect anyway, and they only grudgingly tolerate that we might also get the high for a while, because we are not supposed to have good things.

I had the same experience. It felt like: This can’t be legal!

Still does a bit after almost a year, but to a lesser degree.

Anyway, I suspect that this effect will fade, and that it’s more like a side effect anyway, not the intended therapeutic effect. Although these might be hard to completely separate; the line is blurry.

I still have many symptoms, but two major things are completely fixed: Getting on a task just by thinking it, and sharp focus.

Already done, and it was found to be a side effect of the medication. Not a problem unmedicated.

Much of it sounds the same as me. I’m just 9 months ahead.

The effect of HOW it helps is a bit different for me, though.

I believe that especially initially, it gives a certain euphoria, similar to recreational stims like speed. And many patients feel like that is how it helps only, and that it stops working after a while. But what it is supposed to do, to regulate noradrenaline and dopamine in the prefrontal cortex, keeps working even after years - or so I’ve been told.

I think more focus should be put on how falling asleep was a primary symptom before. I can think of a couple of reasons: Comorbidity with something like narcolepsy, not enough sleep, or actual ADD symptom from sensory overload leading to tiredness or something. It will be hard to figure out whether Elvanse helps by keeping you awake, or if there is more to it. If it’s the former, I believe it’ll slowly fade over the next 6 months like high dose caffeine.

I did have the same problem before, but I realised I need naps. I have to work from home, because without my noon nap, things are bad. Often, I don’t even realise I need a nap; I just get cranky like a baby. My thoughts end up in a bad place, everything sucks and is wrong. It’s really a must for me. And I actually used to fall asleep at meetings or at my desk, no matter how bad it looked.

And I noticed that especially on Elvanse, I can’t trust myself. I lie down and close my eyes when I SHOULD feel tired based on what I did, not when I actually feel tired. Stims make it much harder to feel tiredness, exhaustion or hunger, but it’s super important to act as if I would feel it. This advice (from my doc) that was the biggest extra boost I got after getting the meds.

Oddly enough, I did use Modafinil, which is used against narcolepsy but also happens to work against ADHD, before I could get my hands on the good stuff.

So long story short, not sure if your situation is exactly the same, or very different. Chances are, I didn’t quite figure out mine yet either.

lol, nice! Well, it is a bit sus, because when something is food, you don’t have to stress so hard that “This is Food! Totally!”. It has a theoretically ideal mix of macro nutrients, like the perfectly healthy meal would, but it’s just a drink (or bar). Is it perfectly healthy? Who knows. But it’s probably better than the average pizza / fast food / fuel station sandwich.

That’s nice, I want to get there! Currently, I’m stuck with engineered staple foods as a fallback. Jimmy Joy, This is Food, etc.

It is a lifesaver, though. Especially before getting treatment, I cancelled wonderful ideas to do outside with the excuse that this would require portable food which would be too hard to make. Now it’s just one grab.

On stims, the hard bars don’t work anymore as my digestion is already way too hard now. But “This is Food” drinks work great when I have 0 appetite but need a whole meal worth of calories. It’s the easiest thing to jug down when you really really don’t want to eat but have to.

As for my other vice, binge eating when the meds wear off: I just prepare some raw carrots, peppers, cucumbers etc. and set them up at the desk. Usually, they disappear into my mouth without putting any thought into it.

Did you get diagnosed recently? It’s now very hard to find a therapist or psychiatrist for treatment with a “Kassensitz”, even when already diagnosed. For diagnostic, it was truly hopeless; however, I should be able to switch to a psychiatrist within 6 months and a therapist within 9 months when I really try. 5 or 10 years ago, it was much easier. With a therapist, people wait many months, and if it turns out to be a bad fit, the wait starts all over.

The many contradicting experiences are just chance, I think. For example for my kid, I did ONE single call and got an appointment for ADHD diagnostic within 4 months. But I am fully aware that this is was very lucky. For his occupational therapy, I did about 10 calls, until I found one who is just opening a new practice, which was also very lucky. Paid 0 out of pocket for very good treatment. If you say it can get better than that, you are lying.

My own experience was the other extreme so far, but you are right that it is absolutely possible to get it paid for on insurance IF already diagnosed.

Nice! My GP listens, takes time and does the extra mile for me. Despite my crappy insurance that pays him very little for it.

But sometimes I blame him for not catching the ADD earlier. He prescribed me benzos as early as 2009 when things were repeatedly getting “too much” in every job or relationship after a couple of months. On the other hand, when he finally did refer me to a psychiatrist, he didn’t catch it either.

It isn’t always instant-release, but helps a lot in the long run: Have time to think without being blasted by media. A walk, run or biking without music, any workout without music (or video; for me working only in an outside workout park or my home, not a gym with all the noise and people), work in the garden, simple work like painting a wall, again, without music.

Dr. K also strongly advises this, and it works for me, but I understand that understimulation can be hard for some. He says that it also helps with poor dreams and nightmares, as the brain gets a chance to process stuff. If we don’t let it, it gets its chance anyway - at night. And it will take it, leading to poor sleep with additional problems and possibly increased ADHD symptoms the next day.

It’s 17% of income, capped at 1.1k, including nursing care insurance. So it sounds like you need to make good money, before you even reach the 1.1k. But the problem is that you can’t write off a lot here. E. g. I pay for my own meds, doctor and therapy entirely out of pocked, since I can’t get appointments in my insurance network, which is an additional 600 per month. And that is not a write-off, so it doesn’t reduce taxes or the 1.1k insurance. Also, you can get unlucky with other things. I have a child, but they said there was a formal error with the city-run daycare receipt, so they counted daycare costs at 0 for calculating taxes.

So what I expect is that they move heaven and hell to make the 40 cent pill for my son available, even on a health ministry level.

Got to make a stash over time. But I get it; it’s not exactly the kind of thing we excel at.

Germany here, and I just learned that for the past month, my kid did actually not do so great at school, after his meds (Medikinet removed) were unavailable and he got a generic one with a completely different extended-release profile. Decided by pharmacist against doctor’s orders. Can’t believe it! Health insurance is EUR/USD 1100 per month here, and you’re not allowed to quit. Least I can expect is that he gets the 40 cents / day meds that help, after waiting a year to get diagnosed and treated!

Exactly the kind of experience I need to hear from, thanks!

I see. Modafinil was decent at getting things started & done without the “high”, but it is certainly not shy of risks and side effects itself.

Interesting, thanks! What was the reason go get off?

lol, this advice is excellent, but the sheer number of options is completely overwhelming with ADHD.

This kept me from deciding for one option for a long time. I settled with a hot air fryer eventually, but it doesn’t really matter.

What helped me a lot to take the pressure off is engineered staple food: Something that’s always ready, and much more healthy than most takeout. This is Food, Huel, all good. With 0 appetite on meds, a This is Food drink is perfect.

With that fallback in place, the stress of “must cook” is gone so I can actually cook :-)

I used to be sceptical about these things long before the word “degoogle” was used, but I realised that in my case, it’s worth the loss of privacy. So I put everything into google calendar, and I use the assistant with speech-to-text to input every event, appointment and timespan as soon as I get it for the first time.

A classical wall calendar will never work for people like us. Best we can do is IMAGINE how we’ll just put everything in it.

Still somehow mess up hilariously, but less often now.

I was so happy when I started with meds, just for the 4 hours before I crashed. Got more done than in a whole day.

Then the doc explained that crashing is not a must: I just have to eat by clock and calorie count rather than relying on appetite, not exercise / cleaning-frenzy more than I usually could, and take rests.

Now, the benefits last for an entire day.

Definitely at that dose! I started with a 5 mg tolerance test at 80 kg, was at 15 mg for a while and slowly worked up to 50 mg over 9 months.

How it affected me is quite different, but just as stunning! Especially in the first 2 - 3 months, I was in a constant state of euphoria; it felt like a recreational stimulant drug you’d get at a rave. But the main ADHD symptom that was gone immediately was that I couldn’t get myself to start on a task.

Other advantages came slowly and more subtle at higher doses. It’s still mostly that I finally do what needs to be done. But I do that in a very confused, easily distracted way. I’m basically Joe Biden on speed.

Very much life changing, as the anxiety from missed deadlines and built-up problems is gone.

Most absurd thing with dentists: They do this thing where they check the depth of the little pockets in the gums. It seems to have 0 medical value. Just to be like: “Watch out, it’s 2.5 mm now! Two years ago, it was at 2.3 mm. Just so you know what’s up.”

Ironically, it takes a long time for the whole mouth and is very painful, worse than fixing actual problems, e. g. by drilling.

Mostly for that, I left my reputable high-tech dentist of two decades for a small practice with old equipment that specialises in anxiety.

Thank you! That is encouraging.

It can be a nightmare. Without the extra stress of a child, we were very functional and undiagnosed, and things were going well. But the difference between Captain Picard and The Joker is 3 hours less sleep.

The only way this could ever have worked would have been with intensive individual counseling plus couple counseling.

Now I’m in a great place, as a single parent on peak treatment and with a good job. But the old person died in that struggle, broke completely and didn’t make it through. I’m something new, inhabiting the old body, someone who can do this.

Not sure if related, but I need to see everything I need for a task on the computer. alt+tab or virtual desktops don’t do it for me - I need 3 or more physical screens.

Just upped my productivity a lot by having a dedicated screen that always only shows the mindmap with the todos & plan.

Interesting insight! I travelled the same road in the other direction. As someone who loves science, I always saw my role as a patient to just report symptoms and let the doctors do their thing. And I’m sure this would be the ideal approach if everybody had the House M.D. team on their case.

But after decades of this failing, I realised that this method does not work with a real-world medical system where doctors have more bias than they should, work with methods from their studying days that assumed they had more time and resources per case, and wrong monetary incentives.

So Method 1: I say I have X, and make it clear that I’ll be a PITA if their test doesn’t confirm it. If there were no bias, there would be no harm to this, but if there is, it’s working to my advantage now.

Method 2: Just think of them as the idiot who is clueless but gatekeeper of the much wanted prescription.

Nobody wants to hear this, but a layman’s web research, LLM and 1000 hours of thinking often beats 10 years of medical training if the doctor interrupts the patient after 20 seconds and only thinks about the case for 5 minutes. (With 30 minutes, my money would be back on the trained professional, but nobody has 30 minutes.) A patient can also fixate on a premature assumption just like a doctor can, but my very subjective experience is that doctors are more prone to that.

What I do then is to observe myself making the list, or to observe the thoughts involved in making the list as they swim past me.

This could lead to an infinite chain, where I then observe myself observing and so on. But with practice and methods beyond normal thought and expression, that can fade into nothingness.