Thanks for sharing your journey. Since one of my children was diagnosed with ADHD I’ve come to realize I almost certainly have it myself, and so does my dear mother who has beaten herself up for chronic lateness for over 70 years. When I explained time blindness to her I could hear the relief in her voice that maybe her behavior isn’t a moral failing, after all. I feel the same relief.
Funny how you finally decided to get tested around collge age; that's around the time when I also decided to get tested! I think it's something about the illusion of flexibility in time management & the lack of hand-holding that make it way harder to be untreated ADHD in college vs. untreated ADHD in high school
Started 40 mg Vyvanse my sophomore year and it, without question, completely changed my life.
Thanks for writing this. There's way too many voices right now talking about how ADHD is fake and it's akin to "just being addicted to meth". Curious as to why you like Adderall instead of pure-dex like Zenzedi?
I find Adderall to be very messy and the levo net-negative.
“My executive function is weak and benefits hugely from interventions like Adderall and GTD” over “I have ADHD”
I agree with the former framing. Too many people don’t quite qualify for the latter but do for the former, and both deserve the opportunity to do something about it.
I take it too but doesn't set me up like it has for you and others. It helps but not to the same degree. It varies widely. I'd happy with uninterrupted focus for 15 mins!
hmm, very strange. this is not a common issue. I would think that you could get a solution that works for you by digging in with a compotent prescriber.
Non-stims are absolutely not the answer tho. They are a borderline scam.
Thank you for writing this, Gena! Your self-account around sustained intentionality really hit a nerve, somehow piercing the protective layer I had called "there's no way I have ADHD, it's just a character issue" that once again shows that our mental prisons are always locked from the inside.
I am the type of person in possession of many unscheduled compounds, including a passable adderall analog. I woke up today and tried an approximated intro dose. And wow. I believe I'll back off future doses a bit but holy shit. Sustained intentionality?! It wasn't just character flaws and/or trauma? Big if true. More experiments required but this very comment is the type of thing I would have written half of and then closed the tab.
Thanks so much for sharing. I’m fairly certain I’m an undiagnosed ADHD adult, and I struggle with it daily. I’ve considered trying Adderall, but I’m terrified of possible long-term side effects, like heart disease. Is there strong evidence of this? I also wonder: if I already struggle with focus, would taking Adderall just be a crutch that could end up worsening an underlying physiological issue as I age?
The latest research shows either no long-term risk of stimulant meds on heart disease (e.g., https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798903 ) or some small alleged risk that’s likely explained by confounds (like having ADHD vs not!). Of course I’d encourage you to do your own research and cost/benefit calculus, since everyone’s risk profile is different, but I for one am way less likely to drop dead of a stroke or heart attack if I keep taking Adderall vs not. 😅
if you think you have it, you should seriously consider getting a diagnosis and trying out medication. You can always stop taking it and I'd be willing to bet a lot of money you'll be telling people how it changed your life like Dr. Gorlin
Here I was, yesterday, in this exact spot in the house, thinking I'd be trying to do stuff and not doing it for the rest of the day, kind of as always, and lo, this article. I admit I only skimmed it at first, with smug raised eyebrows. When I got to the not small print, and skimmed that, my internal monologue went from "nananana" to "oh shit not this again, NO, I AM NOT ANOTHER ADHD PERSON" very quickly. I consulted some diagnostic criteria and then went straight to Claude to complain ("how is this a diagnosis, these are all normal people things, i refuse to call myself adhd when everyone online uses diagnoses as badges"). Claude did not agree with my yammering, but took me through the criteria step by step, and about an hour later, I sent an email to a psychiatrist, asking for a diagnosis of both me and my son. I was distraught for the rest of the day, confused about reality, missed (forgot) an appointment, laughed and cried about the irony, etc.
Later, I read your article again, this time it soothed me considerably. Still, the prospect of *not* constantly beating myself up for just not being able to do what I *want* to do just does not compute.
Thank you for framing this the way you did, as accepting support, not a new identity. For me, it may have changed everything.
Oh wow, thank you so much for this honest and raw account of how the post affected you, Esther. The possibility that it might impact someone in exactly this way was the whole reason I wrote it, so this means the world to me. <3 Rooting for you and your son to get the insight and support you need, and let me know if I can ever help in any way!
The part that resonates with me most is the trouble in transitioning to the workplace. I remember being on my first co-op software job, sitting down after lunch and looking at my colleagues as they all just... started programming. I just could not understand how they could do that. So I felt a lot of guilt about not being able to just... work.
Took me a few years to find out about ADHD, and then later ASD. The combination of the two is really annoying. I both crave routine and structure, and absolutely abhor it. It makes transitions really hard. I'm either locked in on something and can't think about anything else (even if I physically remove myself from whatever it is I was doing), or my mind is searching for something, anything other than whatever it is I'm supposed to be doing. Vyvanse makes the latter more manageable.
Either way, my output is really lumpy. If my brain is currently obsessed with something, I can move mountains. But if it's on to something else? Forget about it. Makes it hard to take on long term projects because I'll be really into it for a week or two, and then I'll want nothing to do with it. I at least recognize that a lot of my interests are cyclical, so I do sometimes come back to it.
It's hard not to feel fundamentally broken. I have the intellectual capacity to do hard things, but I don't feel like I can work with myself.
I don’t think we know enough to know what the “reward/emotive system” even is or how distinct it is from the executive control system, but insofar as we do, something like depression would be much more of a clear-case cut of “reward/emotive” deficits. A person with vs without ADHD experiences the same range of emotions and reward-based motivations, but more erratically given how easily our attention wanders off and how hard it is to keep a given reward in view.
Thanks for sharing your journey. Since one of my children was diagnosed with ADHD I’ve come to realize I almost certainly have it myself, and so does my dear mother who has beaten herself up for chronic lateness for over 70 years. When I explained time blindness to her I could hear the relief in her voice that maybe her behavior isn’t a moral failing, after all. I feel the same relief.
Funny how you finally decided to get tested around collge age; that's around the time when I also decided to get tested! I think it's something about the illusion of flexibility in time management & the lack of hand-holding that make it way harder to be untreated ADHD in college vs. untreated ADHD in high school
Started 40 mg Vyvanse my sophomore year and it, without question, completely changed my life.
This is very helpful, both as a therapist and as someone recently diagnosed with ADHD at age 40.
Thanks for writing this. There's way too many voices right now talking about how ADHD is fake and it's akin to "just being addicted to meth". Curious as to why you like Adderall instead of pure-dex like Zenzedi?
I find Adderall to be very messy and the levo net-negative.
“My executive function is weak and benefits hugely from interventions like Adderall and GTD” over “I have ADHD”
I agree with the former framing. Too many people don’t quite qualify for the latter but do for the former, and both deserve the opportunity to do something about it.
I take it too but doesn't set me up like it has for you and others. It helps but not to the same degree. It varies widely. I'd happy with uninterrupted focus for 15 mins!
increase your dosage
Didnt help. Makes me lethargic, like im stoned.
what medication are you taking and what dose? This is a common experience for some people taking Vyvanse.
This doesn't happen for people who take Adderall/pure-Dex
I take Adderall. I've tried Ritalin. Both work, but the same way. I've tried non stimulants too, they don't work at all.
hmm, very strange. this is not a common issue. I would think that you could get a solution that works for you by digging in with a compotent prescriber.
Non-stims are absolutely not the answer tho. They are a borderline scam.
Thank you for writing this, Gena! Your self-account around sustained intentionality really hit a nerve, somehow piercing the protective layer I had called "there's no way I have ADHD, it's just a character issue" that once again shows that our mental prisons are always locked from the inside.
I am the type of person in possession of many unscheduled compounds, including a passable adderall analog. I woke up today and tried an approximated intro dose. And wow. I believe I'll back off future doses a bit but holy shit. Sustained intentionality?! It wasn't just character flaws and/or trauma? Big if true. More experiments required but this very comment is the type of thing I would have written half of and then closed the tab.
Thanks so much for sharing. I’m fairly certain I’m an undiagnosed ADHD adult, and I struggle with it daily. I’ve considered trying Adderall, but I’m terrified of possible long-term side effects, like heart disease. Is there strong evidence of this? I also wonder: if I already struggle with focus, would taking Adderall just be a crutch that could end up worsening an underlying physiological issue as I age?
Sure thing, Zach- thanks for reading!
The latest research shows either no long-term risk of stimulant meds on heart disease (e.g., https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798903 ) or some small alleged risk that’s likely explained by confounds (like having ADHD vs not!). Of course I’d encourage you to do your own research and cost/benefit calculus, since everyone’s risk profile is different, but I for one am way less likely to drop dead of a stroke or heart attack if I keep taking Adderall vs not. 😅
if you think you have it, you should seriously consider getting a diagnosis and trying out medication. You can always stop taking it and I'd be willing to bet a lot of money you'll be telling people how it changed your life like Dr. Gorlin
What is an honesty log and how do you use it?
Ah, thanks for asking; I meant to link to this piece where I previously described it: https://www.psychologytoday.com/us/blog/the-art-and-science-self-creation/202008/5-steps-earning-your-own-trust/amp
This post also has some relevant material and examples, if you’d like to go more in-depth: https://builders.genagorlin.com/p/vision-or-delusion-why-ambitious-eae
Thank you Gena!
Sure thing! Would love to hear your impressions if/when you give it a try :)
Here I was, yesterday, in this exact spot in the house, thinking I'd be trying to do stuff and not doing it for the rest of the day, kind of as always, and lo, this article. I admit I only skimmed it at first, with smug raised eyebrows. When I got to the not small print, and skimmed that, my internal monologue went from "nananana" to "oh shit not this again, NO, I AM NOT ANOTHER ADHD PERSON" very quickly. I consulted some diagnostic criteria and then went straight to Claude to complain ("how is this a diagnosis, these are all normal people things, i refuse to call myself adhd when everyone online uses diagnoses as badges"). Claude did not agree with my yammering, but took me through the criteria step by step, and about an hour later, I sent an email to a psychiatrist, asking for a diagnosis of both me and my son. I was distraught for the rest of the day, confused about reality, missed (forgot) an appointment, laughed and cried about the irony, etc.
Later, I read your article again, this time it soothed me considerably. Still, the prospect of *not* constantly beating myself up for just not being able to do what I *want* to do just does not compute.
Thank you for framing this the way you did, as accepting support, not a new identity. For me, it may have changed everything.
Oh wow, thank you so much for this honest and raw account of how the post affected you, Esther. The possibility that it might impact someone in exactly this way was the whole reason I wrote it, so this means the world to me. <3 Rooting for you and your son to get the insight and support you need, and let me know if I can ever help in any way!
@Dr Gena thank you!
Gorgeous. 💕
The part that resonates with me most is the trouble in transitioning to the workplace. I remember being on my first co-op software job, sitting down after lunch and looking at my colleagues as they all just... started programming. I just could not understand how they could do that. So I felt a lot of guilt about not being able to just... work.
Took me a few years to find out about ADHD, and then later ASD. The combination of the two is really annoying. I both crave routine and structure, and absolutely abhor it. It makes transitions really hard. I'm either locked in on something and can't think about anything else (even if I physically remove myself from whatever it is I was doing), or my mind is searching for something, anything other than whatever it is I'm supposed to be doing. Vyvanse makes the latter more manageable.
Either way, my output is really lumpy. If my brain is currently obsessed with something, I can move mountains. But if it's on to something else? Forget about it. Makes it hard to take on long term projects because I'll be really into it for a week or two, and then I'll want nothing to do with it. I at least recognize that a lot of my interests are cyclical, so I do sometimes come back to it.
It's hard not to feel fundamentally broken. I have the intellectual capacity to do hard things, but I don't feel like I can work with myself.
Adderall is lots of fun; doesn't mean you have ADHD. Just not enough time running around outside.
Could it be a physiological disorder in the reward/emotive system?
I don’t think we know enough to know what the “reward/emotive system” even is or how distinct it is from the executive control system, but insofar as we do, something like depression would be much more of a clear-case cut of “reward/emotive” deficits. A person with vs without ADHD experiences the same range of emotions and reward-based motivations, but more erratically given how easily our attention wanders off and how hard it is to keep a given reward in view.