Emotional regulation is something that my kid’s occupational therapist is totally aware of and working on. It would be really surprising if a child psychiatrist or child therapist were as “baffled” by it as the article seems to suggest.

But it’s an important topic, especially in his case, and I learned a lot from the article.

I completely disagree with the replies. Doctors DO tend to prescribe an insane starting dose!

At least with stims, start very low to check for intolerance. If it’s lisdexamfetamine, 5 mg is very safe, but that’d typically be 1/4 of the minimum 20.

It’s one of the few instances where I’d even say: Don’t listen to your doctor. Stims on someone with ADHD are a wildcard. Might have a calming effect, or might feel like way too strong coffee. My doctor agreed to doing it this way, though.

Did the psychologist provide an official diagnosis that a doctor is allowed to fully rely on? Is the appointment with a psychiatrist?

Tricks to keep a long duration are definitely a thing, and I want to find them all. One of the most important for me is to eat and rest as if I did NOT take meds, even though they suppress fatigue and hunger.

I can do a 3 hour cleaning spree and then collapse, or force regular rests even when I feel “full power”, just because the clock says so, and then keep doing 30 hour intervals all day long.

Thanks for pointing out the potential (?) link to protein! After 1.5 years on it, I fell into the mistake to binge-eat junk food in the evening, which will probably make anyone feel less fit, but I wrongly attributed the following fatigue it to the dose and duration. Others report problems with caffeine.

Can’t say anything about the legal consequences; typically, an ADHD diagnosis does not affect any rights and is confidential anyway.

Keeping your health situation very private is a good idea for any health issue.

As for not needing them: Per definition, you don’t have ADHD if it does not significantly impact your life negatively. It’s a “must”-criterion, no matter how many other indications there are.

But if you benefit from it, my experience is that it only changes the things about me I disliked. Everything is only better. Only thing to watch out for is not to use the medication boost to focus even more on unproductive things.

Fantastic - just like me, then. I used 5 mg to check for intolerance, then stayed around 10 - 15 mg for quite a while.

Initially, the “high” effect was dominant, so it was super easy to get on tasks and finish them, but I still did it in a “silly” or “demented” way, for lack of a better word. As I built tolerance and increased the dose, it started to fix that as well, but the “high” became less and less.

1 1/2 years in now experimenting between 50 mg and 70 mg, it is still fantastic. But I might start experimenting with alternatives. Who knows if the first drug tried is really the best for me?

I agree; it’s even easier than before to live a few months without meds, because there are no stacked up chores and missed deadlines when you start. I work systematically with lists, and one important list is for things that would improve things “permanently”, such as getting and installing a dishwasher, improve finances, delegate and so on.

I had a similar experience with Lisdexamphetamine: Started at a ridiculously low dose to make sure I can take it, which surprisingly already had a significant effect for a few hours! Then I worked up to the normal dose over the span 9 - 12 months.

Especially during that time, it felt “too good to be legal”, like you can constantly be on a fantastic recreational drug AND get shit done!

My view of separating “desired medical benefit” and “recreational drug euphoria” is certainly very simplified, and the “recreational” effect also boosts productivity. And it is hard to tell which is which. Maybe I have not even found the perfect medication for myself yet, but it sure is life-changing already.

It is my understanding that part of the effect, especially the medically desired effect, does not build (much) of a tolerance. The part that feels like a recreational drug does, but it’ll still regulate noradrenaline in the prefrontal cortex all the same with the starting dose.

These are hard to exactly tell apart, though; it’s a blurry line.

My way around this is to do “incomplete” simulations. I just need an idea of how it’d feel to be on the task, not finished it. Never simulate to the end, or one of two things will happen: 1. waking up to the harsh reality where it is not done yet, 2. thinking it is done.

E. g. when I need to go grocery shopping, I simulate how I get up, shoes on, grab a bag, think about whether I need a jacket or umbrella, get out of the door, start walking. How would that feel?

I described it in more detail here: https://lemmy.ml/post/36147982

Hardly any responses are “unhinged”. But I’ll try my best.

Don’t force yourself to do it. Instead, look at your list*, and just simulate the items one by one in your head, as if you’d do it.

Sometimes it happens that I really, really feel like doing one of them, like a neurotypical. It doesn’t sound like it’d work, but it does.

There is never any pressure to do any of them; then it would not work, because starting the process would be the new thing to be stuck on. Quite often, I just don’t feel like doing any of them. But that was not the job, the job was to simulate them. And it’s done, and I can allow myself to do nice things then.

(*) If there is no list, making the list is the only job. Don’t start on any items on it, just create the list. Then relax and enjoy whatever you want, until you feel like doing simulations.

How the heck is that unhinged?

I got it done, so here is the best advice I can give:

• You may think it’s this one-time task, and then it’ll never get back to that state. Is that really realistic? Might be for some. But more common is that it’s deeply ingrained in the personality. A “decision” to be someone different will not work in that case. Might be subtle and thus undiagnosed mental problems, such as ADHD or trauma, or just habits, “lazyness” etc. Get on that, learn about yourself. Then you can make SLOW progress.
• Hands-on garbage: Don’t fiddle with little bags that you get one by one. Get a bunch of huge garbage bags ready and fill them. No recycling / separation (at least for now; feel free to sort through the bags later, like that’ll happen), just stuff in what is garbage. When something costs less than you make in 10 minutes and is not needed in the next 4 weeks, it’s garbage. Emotional value? Then not; that’s okay to keep in storage boxes somewhere for peace of mind. Instead of getting overwhelmed by the view, just think: I’ll fill this bag now.
• Hands-on boxing: Get several big boxes ready, don’t pick them up one by one. Fill with everything that you want to keep (for good reasons), but don’t need in the next 14 days. E. g. hair clipper, waffle maker, paperwork. Don’t get too caught up on sorting. Sometimes, it’s best to just fill the boxes. Tax forms from 2023 along with the waffle maker and birth certificate etc. Possibly label by “finding location”, which is fast and surprisingly helpful! But if it’s no hold-up, better to sort a little bit, e. g. boxes of “anything paper”, “electronics, cables and devices” etc.
• Hands-on means: Don’t pick up a box, realise that it has two home-baked cookies from Christmas in it and then wuss around with it through the apartment. Grab and stash.
• When the task is overwhelming, do something, and never underestimate the value of doing a little. For example, you are tired and didn’t get as much done as you wanted. It’s tempting to put it off until tomorrow. But instead, get a bag and fill it with garbage, then sleep with a clean conscience.

Exactly - my “autistic unload” is not really that interesting, and it’s hard to be my friend. All while I am having a hard time to understand and process their situation and FEEL something about it. Got to keep myself off calling people just because they expressed interest in something I did or said at some point. If I called the last 2 or 3 times, it’s time for them to make a move.

Pair that with various coping characteristics developed through decades, and I can be an annoying friend at times.

So much can influence it. For me, on Elvanse though, what I found is lack of sleep and a starting viral infection.

Reducing caffeine also helps. It adds up with the prescription stims, and they help more.

My son once had a complete stop of any effect a while ago. Doc couldn’t figure it out for sure. My theory: He took it on mashed apples with no water. Water might be crucial. It does say so in the instructions, but hard to say what exactly happens when it’s too little.

So many possible reasons …

Yes, things tend to become “too much” after a while, including work. Could be related to autism or ADHD, or neither.

Part of it is the environment and sensory overload, like grocery shopping. It might also be the wild thoughts shooting around in my head, of things to do, what could go wrong with them, what would happen then, what I know and don’t know. It’s hard for me to get into a new things that I didn’t choose, and that’s what many jobs are all about. Thus even finding a new job would add to the problem, not solve it.

My solution was, for a long time, to take advantage of the good IT pay of the 2000s and 2010s, then long periods of time off. But I missed out on the opportunity to save up for retirement at 50, and now it’ll be work until 70. My current job is 100 % remote, couldn’t sustain anything else.

I finally became more aware of this and realise mid-response that this is nonsense. But by then I’m invested.

My solution: A file “nobody-cares.txt” where I can paste it, which feels easier than just closing the tab.

Therapist says this is a fine first idea, but by doing so, I still attribute value to this nonsense. So next step is to just discard everything I had typed. Actually feels good sometimes.

Not sure if just trying more methods will help you, but here are some that happen to consistently work for me:

• Always work with a list.
• When everything seems overwhelming and I can’t get myself to start, just pick ONE item from the list.
• If there is no list, just making the list will do. It may be empty. Done for now, enough, no need to start on it yet.
• Granular items.
  • Instead of “pack suitcase”, break it down like “get suitcase out”.
  • Split the task of “read X” and “understand X”. That stops obstructive thoughts like “I wouldn’t understand it anyway, and then I’d need to as … but can’t right now because …”.
• The only new breakthrough from this year: When even doing one item from the list feels like too much, only simulate doing them in your head: https://lemmy.ml/post/36147982
• I have a section of “structural improvements”. Those are things that, once done, improve my life, forever. E. g. getting this diagnosis. Getting a dishwasher. Getting a maid. Unlike, for example, clean the kitchen, which is temporary.
• implementation intention: Might feel overwhelming to “stop browsing right now”, but set a timer to stop in 5 minutes. Or “when the timer finishes, I’ll do the simulations on list items”.

Real habit building still does not work for me, though, even with a specialist therapist. That’d be the real deal.

Yes, still do it, and it still works! The pressure from having to do something when I don’t feel like it is gone. Just the simulation is mandatory, and if none of the things appeal to me during the simulation, I’m off the hook, guilt-free.

Still enough gets done that way.

Same, but meds in combination with my learned copes and methods, before and after diagnostic, is a miracle drug.

For example:

• I catch myself focusing on a news site or lemmy -> set a 5 minute timer when to stop
• pick an item from my todo-list. If no list is present, only make the list, then allow myself to do whatever I want
• don’t feel like any of those things -> just simulate doing them in my head. If still none appeal to me, I can do what I want. It happens often enough that I want to do one after the “simulation”.