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I don’t, my psych straight-up told me they’re not recommended or frankly needed for most people, definitely something you should consider talking to your doctor about your treatment plan. Personally I’ve not seen any decrease in efficacy with 4 years of vyvanse not due to work stress or poor sleep, but every person reacts differently to medication.
First and foremost, I don’t know your circumstances but I can relate and I’m sorry. Your worth isn’t measured by “productivity” or “what you amount to”, you matter. Work Culture and general North American society isn’t great for us with ADHD, all we can do is try our best. I swear to you that even when things look dark and there’s no way out, it does end. I’m going to put a ramble of my experience in a spoiler.
Long ramble of my experience
My ADHD got me into a pit of credit card debt, small compared to others at just under $19k CAD but I still had $20k+ in my student loan and I couldn’t see a way out, struggled hard, kept deferring payments and hitting overdraft, legit at my worst point I was $20 from bankruptcy, I probably could have got support from family and my at the time girlfriend (now partner) but I was too ashamed of it, I didn’t want to admit it to my partner (and she knew it, I don’t lie well, not that that’s a skill I really want to have). It put a lot of strain on my relationship, made me the most anxious I’ve ever been and very nearly ended my relationship, my life was on the verge of falling apart completely, I’d be lying if I didn’t have the exact same thoughts.
I was diagnosed 3 years ago at 31, I did what my dad (who’s likely got ADHD if not AuDHD, but won’t get evaluated) did and expended all my energy on work to the detriment of other parts of my life, I also struggled with binging (spending is obvious, but also alcohol and food) and emotional regulation.
My partner is the reason I got evaluated, she convinced me to get into therapy (I have a good therapist who has ADHD, didn’t know that when I found them). After diagnosis, it took me at least a year to begin accepting that I have ADHD (funny that putting a name to it changes things right), that it effects everything I do and that I have, and will always have it. Hardest thing was realising just his much of my personality is influenced by it. Medication is helpful but it’s not perfect, but with therapy, it’s helped address some of the maladaptive coping mechanisms I developed.
If you have access to therapy and aren’t already, it helped me immensely. Depending where you live there may be resources you can access through your health authority. We’re here if you want, even just venting can be helpful.
I have the belief that ADHD is both over and under diagnosed. If you mask or compensate, even hyperactive or combined get passed off as “quirky behaviour”, loss of structure was massive for a lot of people getting diagnosed during the lockdowns, while I was in that boat too I had already been working towards getting an eval for years.
Also super annoyed about the hoops we have to jump through to get treatment, feel like I’m a criminal for having my meds and I have to call in a refill every single time I need them, the entire processes to even get diagnosed is almost hostile to ADHD (multiple appointments, evaluations, shit my psych gave me homework)
There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild.
Actual journal here
Can’t link directly but from the gov site there ar 6 under review
My partner suspected it like a decade ago, pandemic rolled around, masking got harder. Started with my current therapist, who has ADHD, they worked with me exploring why I thought I may and helped me navigate diagnosis, seeing others lived experiences was big and is why I’m open about it at work and otherwise.
Had my preliminary consult with my psych and was given an eval that I passed with flying colours. Looking back, I check lots of boxes, I failed a course in uni because I got stressed and binged wow as an outlet, loss of structure hit me hard going from highschool. Courses I wasn’t interested in I had a hard time investing in. My masking at work didn’t do great for my mental health or personal life, food & alcohol were the drugs I used (incidentally vyvanse is used for binge eating disorder as well), hit financial issues from impulse spending. I’ve written about my experience with that in the past, was not a good time in my life (mentally or physically) but I’ve worked through it (with therapy) so it’s a chapter I don’t want to repeat.
I went through stages of acceptance after my diagnosis, which is totally normal, I’d get frustrated realising how much of my behaviour is linked to my ADHD, either directly or as a coping mechanism. Was annoyed initially I got the diagnosis in my 30s but hey, can’t change the past and I wouldn’t be who I am without my experiences. I’ve still got work to do and maladaptive coping mechanisms to unpack, but hey it’s a journey and diagnosis was absolutely vital, I’m super grateful to my partner for really pushing me towards it, they’re also nd so we help support each other.