Nice! It worked out great in my case, but I had to lower my expectations regarding the timeline and how much I had to keep pushing for the next step. They’ll probably get you evaluated by a psychologist now and take care of the series of appointments, but you probably have to be quite pushy to get the formal diagnostic, either from a licensed psychological psychotherapist or a psychiatrist. Then, push again to get an appointment with the psychiatrist for the prescription. (Or find a local one yourself; it’s good profit for them when you are already diagnosed.) Would seem more efficient to me when the psychiatrist also does the diagnostic.

Still 100x easier than the “normal” method. It would be a great improvement when they take care of a series of appointments until you hold the prescription in your hands.

Sorry. This got way longer than I wanted it to lol

Same happened with my post …

Yes, the one thing that got better from meds alone is that I can just make the decision to start something, and I’ll do it. And that is fantastic! But my forgetfulness and “senile” behaviour is the same. I’m basically Joe Biden on speed. Mistakes happen, but things get done.

And it feels like I got “better” at doomscrolling. New trap, but I’m on it.

The thing with the spreadsheet is absolutely justified, keep it. I use my mail client to mark things as “todo”, “urgent” etc., but guess what happens … nothing.

There is a private clinic that is more streamlined: GAM Medical. You have to pay out of pocked, but honestly, even without a high paying job, it’s easier to get the money than it is to jump through all those hoops. My insurance (GKV) costs me € 1100 per month, but I still pay a few 100 out of pocket for meeting their psychiatrist once and paying for my meds.

It’s not perfect, though. They too seem to miss the point that it’s hard for us to keep pushing and prodding for the next step. I wish it were just a series of automatic appointments. It’s slow, you’ll have to keep pushing, mailing, calling them for the next and the next and the next step, but in like 6 months, there’s a good chance you got your diagnosis and your treatment, be it therapy, meds or both.

I got pretty frustrated with them, but unlike every other option I tried, they delivered - eventually.

You could, in theory, also use them just to get diagnosed. Then, it would be easier to find a psychiatrist for the prescription, because at that point, that’s a lot of money for very little effort for a doctor. Could even have insurance pay. Extra work, though.

Well 60 mg is still not stronger than a fat line of speed, which people usually survive, and you have the extra benefit that they checked you for heart and other problems that would change the odds.

Consider that the half-life is long, so 24h later, you’d still have the equivalent of 1/4 of the extra 30 mg, so you should take about 7 mg less, which would be about 23 mg. NAM (not a mathematician).

First test: 5 mg (~ 15% of 30 mg) at 8:30 am.

It kicked in really hard, like a thick line of quality speed. It didn’t feel like something that a doctor would prescribe. Got a lot done, then hard crash at 12:30, lying down and dozing off for 20 minutes. The mental effect was at least as good as it was with Modafinil: I tackled the most urgent todo without mental effort and little chores just “happened”. But with a high like from recreational drugs.

Maybe what contributed was that I did a quick, but intense workout.

So it was perfect - a very safe dose, yet also the productivity boost I needed for the day. 10 mg might also have been fine, but taking the entire 30 mg (or even 20) would have been a mistake. Certainly no risk to not feel anything.

I wonder if I should take another 2.5 mg for the afternoon, or just use tea and coffee as usual.

This strange effect regarding intensity and duration was no surprise - I observed that with other medication and drugs before, the doctor understood it and took it into account, thus the individualised instructions.

I don’t know why he does what he does, but he said that I should find the ideal dose, which often is between two capsule sizes. He encouraged me to take any dose lower than 30 mg for the first month, and after he sees me again to fine tune it by dissolving in water.

I dissolved it in some water in a protein shaker with marks, so I can take exact 3 mg doses (10 % steps).

Only thing I don’t like about this is that children are in the house, and there should not be deadly poison water standing around anywhere. The capsules are in a lockbox.

Thanks! I’ll play it safe and would rather start with 5 than 10 mg.

Not sure if related, but I have absolutely no problem getting things in the household done when I’m voicechatting with a friend. Odd as it is, videos that don’t require watching while listening (e. g. youtubers that just talk into the camera) also work, but podcasts don’t (must be mental).

When I can’t get my “fix”, no friends with time online and no interesting video of that type, I end up searching for it so long that I get too little sleep, rather than just do the 15 minutes work without.

I think it should work exactly like the fire department. Entirely tax funded, no hassle. A hospital is, in my eyes, more similar to a fire department or a police station than it is to a super market, and that’s how it should work.

But it only works well all-in. A strange system of compromises forged between parties with entirely opposing views over 50 years is terrible.

Most recent example: Started freelancing in July again, got to pay nearly 1k per month. First money received is EUR 4400 end of September.

I tried the alternative route last time, and it’s no fun: Write in certified mail that I make less and need a lower rate, they’ll ignore it, say they didn’t get anything, I’m not insured any more. Go to a lawyer with the proof of certified mail, win, get the lower rate and they have to pay back medical bills, EUR 500 lawyer costs though. Have to pay back 1k per month anyway if it turns out I make enough in the last few months of the year, so it was all for nothing.

I will never understand how the land of fast food and unnecessarily pre-packed products fills pill bottles by hand in the pharmacy. Like, milk I would understand; I lived near a farm, and we would go over with huge milk cans and have them filled there by the farmer. But that same concept seems strange to me for a pharmacy. Like, even our weed and coke dealers have pre-packed little plastic bags, you don’t like bring your joint papers and have them individually filled.

Also, this seems like a really complicated process that causes lots of problems. Isn’t it pretty much likely that even in your best state of mind, you’d fill about 1 out of 200 wrong, and about 10 % of those mean near certain death for the patient? So weird.

It’s nice that US still ALLOWS to not be insured. In Germany, it’s mandatory, it’s nearly EUR 1,000 if you don’t provide proof that you can’t afford that (and they accept the proof), and if you dodge them and they catch you later, you have to backpay for the uninsured time.

So in contrast, we go a little broke always, but we don’t go more broke when we get sick.

It happens, even with popular kids. A friend from daycare invited many people for her 5th, but due to bad timing with vacation, nobody showed up. Nobody. Her 6th was fine, as about 8 out of 14 came.

My son invited 5 for his 5th, but due to some misfortune with sickness etc., only two siblings came. It turned out to be one of his best birthdays ever.

Best to ask for a commitment, a clear yes or no. But in your case, 5 is a good number for a party! 1 or 0 would have been kind of awkward.

The biggest issue was that when I was in a phase where I pursued something worthwhile, such as a science project, electronics, programming, they stopped me and said I obsessed too much over it, took it away, said I needed to focus more on something else. Which then did not stick, as it was forced, of course.

That’s exactly the kind of obsession that leads to success, though, and it took me years to recover after moving out. Wish I had those skills I wanted to get in all those areas, but I had to focus on one thing at that point, as the end of my 20s was approaching.

Also when they forced me to do something like “clean your room, immediately, until it is done”. With the tools at hand now, I know that I have to talk to myself like “in 20 minutes, set a 15 minute timer and get as much done as you can” or “pick one aspect (garbage, floor, desk) and do that immediately”. Or with homework: I know now that one tool I needed was to set everything up at the desk ready to start to get over that first step. An order like “all homework needs to be done immediately to perfection” does not work.

With my own child, the problem is that I don’t know who he really is down to the core. Is “10 minutes of cleaning on a stopwatch before dinner” just the right push, or too much sometimes, or too little?

I think a little push is right, to yourself and to your children, but it needs to be a “relative push”, depending on the person, the day etc. Some days, just staying in bed and crying is already the best you can do. At our best, we might be capable of doing 10 hours focussed tasks and just need a little “come on, do it”. Which of those is it? That’s the question. I find that meditation helps best to get a feeling for that. Sometimes, I just need a nap and didn’t realise, and that’s why it felt like the world is ending.

Engineered staple foods (such as Jimmy Joy, Huel, …) really took the pressure off for me. I can still cook or make something else, but having this very decent fallback plan puts me at ease.

Relatable. Fuzzing around going to an appointment early in the morning with poor preparation is one of the worst things about it. Being in place X at time Y, having packed A,B,C and being showered and dressed appropriately is something I’m struggling with. For decades, I thought the reason was that I’m just an assclown.

A typical day can feel like a series of appointments, to which I show up late, unshowered and sweaty, stammering my excuses, getting scolded and doing some kind of sad clown performance.

A perspective that helps me sometimes: It’s all just a quest to keep the pets alive and well, in a world of arbitrary rules and events.

Regarding the specific water bottle thing: The only thing that helps me is to place these things BLOCKING the door.

But indeed, Modafinil got me in a state where I could handle normal everyday things like that with ease like normal people. Had to stop it due to handling side effects poorly and hoping for new meds next month. Try to find the right thing for your specific situation. Like others pointed out, it might be an anti-depressant, can’t tell from just one text.

Over the years, I actually managed to change my inner monologue narrative. When a day like yours happens, I pat myself on the back and say: Pretty impressive how you pushed to the absolute personal limit, even towards a goal that turned out to be too high.

Dishwasher is really crucial. I knew that and wanted one for 20 years, but, well, ADHD. Finally 2 years ago got my first 0-installation dish washer, one of those small ones where you can just pour the water in. When it broke, I got a small real one. Installation required a little more mental energy, but so worth it.

I’m currently shooting low, and one pomodoro unit per day already makes a productive day. So much better than nothing! I think of it like squid game: I got 50 minutes to study, then they shoot the ones with the least knowledge on the subject. That means no glance at the phone even when it makes a sound, no toilet breaks, no water breaks (water that is in direct reach may be used while one hand is free).

If I had done even 25 minutes per day after official education, I’d be such an expert 15 years later!

My current goal is to become an absolute unit within 8 years. My CV looks like one, but I’m not.

I realised just after decades that some things that tend to fly around all the time over and over again have no defined place. My solution: There needs to be an all-default trunk. Old rubber bands, Covid tests, screws from an old laptop I’ll totally reassemble one day, socks with holes that are not broken enough to throw away, …

Also, recycling is nice in general, but in a cleaning frenzy, all garbage needs to go into the bag. If future-self wants to recycle, have fun with the bag in the basement.

It works!

Thanks! For my kid, I gamify it up a notch: His life works on “quests” such as 10 minute room cleaning, letter to a grandparent, 10 minute reading, homework etc., for which he gains loot boxes. Those are little physical boxes containing a made-up currency and other small rewards such as candy, 5 cents - $ 1 real money (his only way to get allowance!), stickers etc. The made-up currency can buy prices such as puzzles, books, toys. About 2 - 3 times per year, there is a legendary coin in it which can be traded for a huge price worth $ 50 - $ 100.

Not sure if saving him or messing up his reward system, but the stuff gets done and he’s doing great!

Thanks, hope that helps OP! Paroxetine also comes close, at least. Prescribed against both depression AND anxiety. My feeling that it works against ADHD is anecdotal, though, as it started a massive productivity phase with no problems to balance workout, family and a challenging job, but one quick search finds this: https://pubmed.ncbi.nlm.nih.gov/16669726/

Paroxetine had no effect on ADHD.

Light alarm clock sure is a game changer. Isn’t there something that is primarily an anti-depressant, but also works with panic disorder and ADHD? I just know that there are many where 2 of the 3 overlap. But sure, a stimulant would be bad for you.

I have strangely also been in states, over years, where caffeine induces panic. In hindsight, it might have been as simple as a magnesium deficit, but no doctor bothered to check.

I’ve even had benzo prescriptions over years, and cut it down to 0 with relatively high magnesium supplements. Not saying it is the same in your case, extremely unlikely even, just the general concept that something has been missed.

Chaining dozens of coping methods together helps a little bit, including:

• strictly working with lists. When I do it and it’s not on the list & checked off, it doesn’t count as done. What’s not on the list doesn’t get done
• implementation intention: Since my brain refuses “must do now” situations, use a trigger like: “If it’s not done by 8 p.m., work on it with a stopwatch for 15 minutes”
• for the list, turn everything into a module. Instead of “do the kitchen”, have subitems like “collect all garbage”, “sort by food / non-food”, “clean surface 1/2/3/floor”. For studying & work, a module is always 25 or 50 minutes of full focus, no distractions. When I have to get up to get water or pee, it counts as failed and is not checked off

Yay, life on hard mode.

Take into account that Modafinil is very unsafe in combination with many other drugs, such as all benzos. I don’t know how much time you need to be safe, but I’d wait at least a whole day (48 hours after taking Modafinil) before using something that is definitely unsafe with it.

Did you also get it through a EU prescription from a semi-shady, but legal site?

The splitting advice is correct in theory; it can become instant-release and thus briefly stronger, even dangerous. But in this case I trust my belief over science that trying 1 % - 5 % first is always the safer option. Splitting a slow-release by 50 % - that might cause this problem, yes.

There is also the theoretical possibility that the active component(s) are not evenly distributed. Even a split marker is supposedly not safe, only instructions that say so. But - doubt

I can see it

Interesting, I’m also like that with many meds. Currently using Modafinil, and it’s the same there. 1/4 or 1/2 was the right dose for me initially, now I can take a whole one. Supposed dose is two whole ones, always, from the start.

Many meds come with an insanely high dosage. The worst is Venlafaxine - the smallest dose give many people a terrifying inner pain that lasts for a long time, easily the worst day of your entire year. Against all recommendations, I now start with like 5 - 10 % of any new stuff, and only if that has no effect at all, I go for like 50 %. With Modafinil, that method proved already quite daring.

What’s your experience with Modafinil? I find that it works pretty well, but I am working on getting alternatives to try soon.

I also felt bad about it for a while. I’m a scientist by heart, 100 %, and I knew I had the intellect to get a degree. I thought the reason why I didn’t anyway was because I was also some kind of assclown.

Fortunately, my degree attempt coincided with a useful obsession, for a change: My old programming hobby. The obsession ended like all the others, but the knowledge that stuck from going 14 hours per day was enough to get food on the table for decades to come.

It’s just now that I realise I never was an assclown, and I never “decided” to quit my degree. It was ADHD, and I never stood a chance, not with “discipline” or just “deciding” alone. Knowing it, with treatment plus self-acquired methods & tricks, it would have been an option back then, and maybe I’ll go for it again, if time allows.

Pushing yourself is good, but it needs to be a “relative” push based on your ability. Could be 5 hours of hard studying / cleaning / whatever for some. For others, or the same person on a different day, getting one bag of garbage and filling it, or studying 25 minutes is already the best.

Your post is a good start to collect ideas for moving forward, at your own pace. It won’t be easy, but your situation is objectively not as bad as it feels to you. Maybe it can be a small step towards improving your condition?

I was just thinking how at times where I used it, I was much better at detecting and avoiding inappropriate / cringe behaviour on my part. Even when looking back at times where I took a break.

Just imagination from overthinking? I think I’m just terrible at it, and overthinking is just the right amount of thinking for me.

Currently using Modafinil, which is rather bad on side effects and risks, hoping for an upgrade next month. So I had to work with that.

The Plan: Use it on about 50 days per year, and make them count. E. g. not on days full with unproductive meetings, but when I have a clear task and time to execute it. A task with high visibility. It’ll look to others as if I were rolling 200 days like that.

Reminds me of this “Life and times of Tim” episode where he just wants to buy some weed, and he knows a guy already, but it turns into this insane circus where he has to watch bad alternative theatre for hours, and one wrong comment about it cancels the whole deal: https://www.dailymotion.com/video/x3bop1d

Stimulants having a calming effect is not an absolute must with ADHD.

I can only recommend to keep going for an official diagnosis & treatment. It’s the single best use of your time. Cheapest, even free, is the way from a psychiatrist, with a referral. But you probably noticed that it’s nearly impossible to find one.

Very nice and completely remote is GAM medical, but it’s not paid for by GKV. I got the impression that it’s pretty thorough and responsible. Not fast though; if you start now, it would still take months to get a prescription, if necessary.

Quite shady and only technically legal are sites like expressdoktor.com. They take advantage of the fact that any EU doctor can write a prescription that works in any other EU pharmacy. It works more like a webshop, pretending to include a doctor consultation, and it is certainly not safe. Especially the only ADHD drug they have, Modafinil, would require a thorough consideration and check-up when used for ADHD, because it has significant risks. It’s the fastest way, but I don’t recommend it.

I think it should be relative to the person’s abilities. 8 hours of work, laundry, 50 minutes focussed studying, healthy dinner, remembering aunt’s birthday and bedtime at 10 might seem reasonable to most. Some with ADHD might also pull it off. For others, their best is to do one of those things after work.

Different people, good and bad days. Absolute measure & judgement for everybody is the problem.

Absolutely, I mean, we should still do our personal best when it comes to important tasks, but some days, our best feels like very little to nothing.

I already try to work with lists and break down tasks into smaller tasks, but that can lead to 30 items per week. If it’s going really great, I do 25. But among the 5 failed tasks could be something really important, like a last deadline for a bill before it goes to court, tax filing before thousands are lost, even watering a flower etc. To others, it may appear like I achieved nothing, but honestly I’m already happy it went that way and some stuff got done.

Funny thing is that this is the ONE ADHD thing I don’t have. My trick: Super-panic about being late.

The broader strategy is that I set an exact time that triggers the “panic mode”. So for example when I need to take a 3 day trip, I put my open suitcase in the middle of the room and fill it only casually as is convenient, starting days before. Hours before departure, I’m putting what is still missing in, but very relaxed, and do other things such as shower, eat, whatever needs to be done. But like 20 minutes before departure, the “panic mode” is triggered. Whatever is still missing then is done with maximum stress, only absolute show-stoppers, no optionals, complete panic the whole time.

Knowing that panic mode is still there to help last minute, allows me to do the entire thing very relaxed.

What can really work well is an ambient background noise, such as the TNG engine ambient noise or whatever you are into (SWTOR station ambient, …), wind, ocean.

The trick then is to put it on exactly when the focussed studying starts, and to turn it off abruptly when you (have to) interrupt, e. g. for phone, door, water.

That prevents you from the half-assed “I’m technically working right now” when you are really not.

Even after I became aware that I have ADHD in my 40s, additional years were still wasted after not getting treatment, with lost jobs, money etc.

Sitting on a referral from the GP for 18 months now, and they don’t even give me an appointment in a distant future. The only thing that worked for me in my 20s: Set the bar low enough. Stop “planning” to study for 3 hours “tomorrow”, or half-assing 2 hours while a video plays, you are on the phone and get coffee 5 times. Instead, admit that you’ll only get 25 minutes in. But do them today, completely focussed, no distractions, not even getting water, no toilet break etc.

Think of it like squid game. The team that gets the best test score after 25 minutes studying lives. You’d rather pee in your pants than to get up and certainly wouldn’t check your phone.

Worked for me, can’t say if it will for you.

I use plain old mindmaps for many things. When they are related to tasks and todos, I use a tool where it has little checkmarks, possibly completion progress bars, failed-icons, blocker-icons etc.

For understanding a topic, e. g. from a textbook or a job problem, hand-drawn works better with the additional freedoms it provides, such as this one: https://www.uni-frankfurt.de/53571999/Mindmapping

It fits in nicely with how I work through a text:

• Think about what I want to get out of this
• Flip through & glance over everything. Whatever draws my personal attention, be it drawings, graphs, tables, the headers - different for everybody. Might occasionally look at one of those things for a bit longer.
• Read the TOC
• Do the actual reading start to end and draw a mindmap
• Possible do-over the mindmap once I understand where I did it “wrong” due to my previous assumption of how things categorise and relate

tl;dr: software developer

Software developer. Unable to thrive at school or university, I had phases ever since I had a PC where I self-improved with more or less intensity. A few years where I had neither energy nor motivation, but discipline to do a little bit most days. Just a solid hobby-level.

Then out of nowhere It became an obsession for 5 years, like it usually does for a substance or gaming addiction. Just wake up, immediately study, trying to get everything perfect, to understand all the competing approaches and their reasons to every problem, only sleep when I can’t keep my eyes open.

Finding mentors online, big names in their niche. Most people think that these people are annoyed from hundreds of “fans” who want to learn, but actually, that rarely happens, and when they see how much effort you put in, they are happy to help. One day, the phase ended as quickly as it had started. But I still had the knowledge.

That was 20 years ago. Much of the stuff from back then is still relevant, but there are the massive changes to web clients, and there are “clouds”. In relation to relevant frameworks and standards, I’m far less skilled now, but I have two decades of reference projects which make me LOOK better.

A problem is that working away from home really doesn’t work for me, thus having to refuse > 95 % of offers (they just come, I don’t apply). But since 2020, that is no longer an issue.