> I am still struggling to get back to a decent baseline.

First, if you want to radically change your life by no longer taking stimulants, you need to recalibrate what you expect your life to look like.

You know they change how you think and behave, which is why you took them, and so it’s a given that your life just won’t look the same without them.

It’ll take time, but you need to figure out what your life can look like without them and make that your baseline. You’re always going to have an “additional strain on your emotions” when you try to make an unmedicated life look like a medicated life.

Maybe you work less or on different things. Maybe your home is less organized. Maybe you nap more. Maybe you’re friendlier and more empathetic with people you care about. Maybe you have a dozen slowly progressing hobbies instead of one diligent passion. Maybe you exercise or meditate more. Maybe you chill with woo hippie vibes instead of chasing life as a type-A achiever. Who knows. As you adapt, try to identify positive changes and define those as the new baseline you’re measuring yourself against.

You didn’t need medication in the first place. It’s a choice you made to live a certain kind of life. Now, you’re revisiting that choice and are pursuing a different kind of life. That’s exciting! But you have to embrace that rather than fear it, or you’re just going to torture yourself.

In addition to what commenter suggested I also suggest reading and trying out things on following books, I listen to the first one, it is really good, you can implement life style changes in that book.

I am hoping to read the second one, as I heard 2nd book need you be on meds, when working through the book, but I do not think you need to be on meds any longer than you change your thinking, since it is CBT book it will possibly help you to adapt your thoughts necessary. For meds I suggest you to try out lowest dosage of pro-drug(non abusable) like Vyvanse instead other stimulants, it is also long lasting, have ease in and ease out effect unlike other stimulants as I heard.

3rd book also will fit your needs, since it is also a CBT book.

All those three books are recommended by Dr. Barkley, first one authored by him.

1. https://www.amazon.com/Taking-Charge-Adult-ADHD-Second/dp/14...

2. https://www.amazon.com/Cognitive-Behavioral-Therapy-Adult-AD...

3. https://www.amazon.com/Mastering-Your-Adult-ADHD-Cognitive-B...

As someone who has suffered from various addictions over the years, from stimulants to alcohol, this rings so true. My life after quitting them was pretty rough for a while, and it took a long time to find my way. But I knew that pattern wasn't healthy, and things needed to change. Now, a few years out, things have stabilized and its a whole new world, and it looks entirely different than the one I was previously living in. It is possible to push through this, but the expectations had to change first.

I would also add that now is a good time to figure out what things could happen that would make you get back on your medication. Set yourself up a list of items that if you feel you can no longer accomplish, you will talk to someone about getting back on your meds. I am starting to realize that I should have saw someone last year about getting back on my adhd medication and I wont get that lost time back.

This is the best advice on the topic that I've seen.

1. ADHD and depression go hand-in-hand. If your emotions are starting to get strained, consider talking to a therapist before things get worse.

[1] https://www.betterhelp.com

2. I wrote a script to run my life for me, you should consider doing the same.

[2] https://taylor.town/nowify

3. Find something to obsess over! Everything comes to a screeching halt when the spark of life eludes me.

4. Consider using a service like FocusMate to stay on task. It's a form of "body-doubling".

[3] https://www.focusmate.com

[4] https://chadd.org/adhd-news/adhd-news-adults/could-a-body-do...

I'm especially intrigued by the prompts you have that direct you to reflect on the status of various aspects of your life. These questions reminded me a lot of a list that I started a while back of small inconveniences in my life that had been ignored long-term. I found that just by starting the list, I was instantly able to start recognizing all these little hurdles that I had just been quietly dealing with every day. For example, the knob on the lid of our pool pump was broken and it hurt my hand every time I had to unscrew it, but I would just deal with the pain. Once I made my list and identified that as a recurring inconvenience, it was clear that it was worth the effort to go to the pool store and buy a replacement. It was a cheap item and trivial to replace, both things I knew the whole time, but somehow did not really examine before the list.

I was happy with my little inconveniences list until now, but seeing all of the other various prompts that you've made for yourself, I'm thinking I should explore this strategy even further. Would you mind posting a link to the full text of the prompts? Some of them are cut off at the end from your screenshot. Thanks!

Here's my current list of routines: https://gist.github.com/surprisetalk/bc53ddd517c62ec7e98f2af...

On this list, you'll notice a lot of "never" routines. When I retire a routine, I change it to "never" so that it's easy to reenable it if I ever need it again. For example, I recently got laid off, so I'm allocating more time to personal projects than career stuff.

Training yourself to recognize things is difficult! Forcing yourself to look at something every hour or every day can force you to see the world differently within a matter of weeks.

Brains tend to tune things out, so nowify prints out randomized lists inline for many of these prompts. For instance, when I'm supposed to send memes to people, it prints 10 random memes and 3 random people to turn it into a little game.

I did a similar thing to nowify, but I have several multiple-times-per-day tasks (e.g. check inbox for new tasks), so I have time-slicing as well. It works very similar to an OS scheduler, where there are some high-priority low-timeslice activities and other lower-priority, high-timeslice activities. It won't preempt in the middle of a timeslice, so I don't get interrupted 30 minutes in to a one-hour activity to e.g. check my e-mail.

What do you use to make the beep sound? Is your computer always on?

Yep, computer is always on, and bluetooth headphones are connected when I'm elsewhere in the house.

At some point, I think this would actually work better as a phone/watch app.

Love the idea of the script. Is it open source?

Not open-source yet! It's very tailored to my personal workflow, but I'm planning on generalizing it soon.

I have a couple of thoughts as a guy in his mid 40's who was diagnosed at age 39 after a lifetime of hearing my brain tell me "You're so smart, why do you SUCK SO MUCH?" I take extended-release stimulants 5 days a week, but sometimes take a week off. Here's what works for me:

0. Be kind to yourself. You don't deserve to suffer. Your brain is always lying to you about how bad you feel. It's really hard to live your life "like everyone else" with the ADHD gremlins chattering away in there.

1. Remind yourself every morning you are starting a new day, and every evening that you did the best you could, that you succeeded in some things, and that tomorrow is a new day.

2. Make yourself do 15 minutes of intense cardio exercise every day no matter what. Think of it like brushing your brain's teeth. Set out your exercise clothes, car keys, and fill your water bottle several hours before you plan to do this.

3. Make a schedule for your sleep, food, water, and exercise. Every day, try to do the same routine. Moderate amounts of caffeine are good too. (A few cups of black tea during the day is just about right for me.)

4. Talk to a therapist regularly, and be honest with yourself and your therapist. Therapists helped me learn to be more kind to myself and less shameful. And that change in mindset helped me feel better and dramatically reduced my ADHD symptoms as much or more than the medicine.

Dopamine deficiency and Shame cause a feedback loop that makes your ADHD worse. Make it a routine to disrupt both.

I totally understand the desire not to deal with getting and taking the medicine. For me, I could only manage my ADHD with both medicine and therapy. It's OK if you need drugs sometimes. It's OK if you go without them.

I know it can be difficult to think putting your health and and mental well-being first especially during stressful bouts.

I’ve had undiagnosed ADHD since I was a teen (now 32) and recently got a diagnosis and started using medication (Vyvanse).

Without a doubt the only thing that has ever come close to helping me feel “normal” has been exercising regularly. Whether it was going for a run, or lifting weights, the stillness you feel through medication is something I only felt after a nice workout.

So that’s what i’d recommend. Put your physical health first, eat better, exercise regularly, and top it off with something low effort but high reward like yoga or meditation. That is the only way.

https://www.theatlantic.com/health/archive/2014/09/exercise-...

>the stillness you feel through medication is something I only felt after a nice workout.

I struggle going to sleep at night. I'll either ruminate on bad memories from the past and get myself all wound up, or I start mentally taking apart a coding problem.

The best way I've found to deal with this is exercise. It's hard to be wound up when you're physically exhausted. Afterwards I can actually feel my body relax, and I can drift off to sleep.

How did you convince/motivate yourself to exercise?

I think most people know the benefits of working out, but have trouble getting started.

Literally just by showing up.

People have a distorted view of exercise, thinking that every work out, every gym session has to be intense but in fact the most important thing is to do something.

Have a gym membership? Just show up and walk on the treadmill for half n hour and go home.

Don’t have a gym membership? Go for a walk around the block.

All that is exercise.

The magic happens when the repetitive act of showing up starts compounding in unexpected ways.

You feel the benefit so going the next time is less effort, and you may walk a bit longer.

That in turn affects the choices you make about what you eat, when you go to sleep, the quality of you’re sleep, the increase in dopamine from all those activities, which then feeds back into the cycle.

So literally the easiest thing you can do is do something, don’t expect overnight results because that kind of expectation informs the perceived effort (which is high), which results in people doing nothing.

An interesting thing after being 6 weeks into my first serious strength training program: I found you needed to build strength to build strength. In the beginning, everything feels a little sloppy because you’re just trying to stabilize your bodyweight in weird positions with the best form you can. It doesn’t feel like much is happening then, but you’re building stability you’ll use to build strength. If you keep showing up, then by like 3 weeks in the motion smooths out and you can more easily direct power where you want to train.

>That in turn affects the choices you make about what you eat, when you go to sleep, the quality of you’re sleep, the increase in dopamine from all those activities, which then feeds back into the cycle.

It's really hard to eat a candy bar when you know how much exercise is going to be required to burn it off.

This advice is repeated a lot, but motivation is fleeting and you just have to make it part of your routine in the same way that brushing your teeth, showering, paying your bills, cleaning your house, and so on are.

If it helps, you can think of it like "going to work". Very few people are lucky enough to feel any sort of intrinsic motivation to show up at work every day, but they do so because of the consequences are disastrous if they don't. The analogy isn't perfect since the long term consequences of ignoring your health are farther in the future, but the upside is that after exercise you get shorter term feedback in improved mood, sleep, concentration etc. You just need to show up and do the work.

"Having a routine" is exactly what doesn't work with ADHD. We can't do routine. Anything but this. Some of us are struggling with brushing teeth every day, or showing up at work. Even though when hyperfocused, we can do a week's work in a day, or successfully prepare for a difficult exam in a night, but doing something regularly — that's something we absolutely don't have.

If you're struggling with brushing your teeth,showing up to work or other basic self care, then I don't think the discipline to exercise will manifest itself and it is likely time to speak with a professional.

I do have a therapist who is an ADHD specialist, but it doesn’t help much. “Well yes, your case is quite severe, try to do what you can and see how it goes”. I’m trying.

One technique that I've found helpful is setting up triggers, rather than routines. A trigger being a commitment of the form, in circumstance X, I will do Y. e.g., When I enter the bathroom the first thing in the morning, I will do some pushups. At a high level, it accomplishes the same thing as a routine, but it doesn't require the global discipline of a routine. With triggers you're only responding to the moment.

That is a very neat idea. It might just work for me. Thank you

This is the answer. Use any fleeting motivation to construct the habit. Do not rely on “feeling like it”. Once you’ve created the habit, it will feel uncomfortable not exercising.

I, and I suspect other ADHD people, don't form those habits. I've for years read things like "you don't have to remind yourself to brush your teeth because it's a habit. You can make exercising a habit, too."

But for some of us, we do have to remind ourselves to brush our teeth, or eat, or whatever thing the average person does "automatically".

For me the Apple Watch and having my fitness metrics as the main screen is the biggest motivator. I just try to close my rings every day and that I say goal of the day.

+1 one for exercise tracker. I got the Fitbit Luxe a couple of years and I have been wearing it every time for exercise to get points. A bit like gamification.

Highly recommended. It's small enough that i don't notice it.

I’m not the above poster, but I would say reducing friction is key. I have no problem exercising, probably my greatest joy in life, but when my attention “tank” is low I can spend an hour failing to get on the damn bike and go. So I have everything I need, a change of clothes, bike pants, bike shoes, helmet right next to the bike, so I can’t waste time looking for things, wandering aimlessly, etc.

This is the only advice that worked for me. Before you settle down to watch TV for the night (or read a book, or whatever it is you do to unwind), prep yourself for everything you want to get accomplished the next day. Pack your gym clothes, put your car keys and gym badge next to them, find the time on your calendar when you're gonna go and block it off.

I do this for things that aren't the gym too. Need to grocery shop? Write a list, grab reusable bags and lay them down next to your keys, etc.

I think "exercise" and "working out" are probably the wrong target because they're kind of pointless all alone. The key is to find something physical that you can get (mildly) obsessed with doing, then create a mechanism to get you to do it regularly (e.g., a Couch to 5k plan, a pickleball league, a climbing course). At some point, doing that thing will become your default behavior, just as doing whatever you do now is your default behavior and doesn't require motivation/willpower. It might even lead to other training to get better at that thing.

Use whatever motivation and self discipline you can muster to set up and implement a new habit, not do a thing. Tie it to an existing habit you already do regularly. “Every day after X, I will Y” where X is something you already do and Y is new newly desired behaviour. Keep it brain dead simple at first (eg. Put on my gym shoes). Have compassion if you don’t do it perfectly. Be kind to your self. Do it every day.

The secret is to find something active you enjoy and is fun. Changing your lifestyle to become an enthusiast of it (cycling, sailing, tennis, whatever) Not going to the gym or trying to convince yourself to run for an hour around the block. Make it enjoyable, a hobby.

A nice TV right in front of my exercise bike, and an otherwise crippling Netflix addiction.

ADHD is a quantitative disorder that touches a spectrum of symptoms.

Yours might be heavier in some aspects and lighter in others. It's also often tied to other psychological issues.

Not everything works the same for everyone. For "vanilla ADHD" the most impairing factors will often be:

- Executive function. This can be organisation, getting started or keeping up with dopamine depleting tasks (chores, bills, etc.) and keeping track of time during tasks

- Emotional regulation. This can be emotional reactivity (often called RSD online), or other all sorts of difficulties dealing with emotions in a productive way. This one is often left out in discussions but the most harmful for life outcomes (especially frustration/anger based dysregulations)

- Short term memory issues. Part of executive function but should be noted specifically.

The first thing to note is natural external dopamine will help. This is getting proper sleep, nutrition and exercise. Exercise, especially intense activities like HIIT will help regulate dopamine naturally.

For executive function, the best is to have a system. There are plenty out there (bullet journals, productivity apps, etc.) Find one that you actually use without forcing yourself to. Can be a TODO list in google keep/apple notes, or a Bullet Journal or something like TikTik

For short term memory issues, write everything down. This often plays into the system above.

For emotional regulation, DBT is the best place to start. The DBT workbook can be freely found as a PDF online.

Russell Barkley has good information: https://www.youtube.com/watch?v=BzhbAK1pdPM&list=PLzBixSjmbc...

Getting a ADHD aware therapist, if financially feasible, is a good idea. Be critical of online communities, there's both good and bad in there.

Depends on the severity, but with my moderate ADHD I've found success by learning and embracing the ways my own energy changes over time and under different circumstances, to make better use of it. It's sort of like adapting to abundant but sporadic renewable energy, vs the steady gas energy everyone else has

Examples that I've found work for me:

- Instead of trying to force myself to do something I'm simply not motivated about, looking for an intersection between the things that currently sound interesting and the things that would be productive. Making the most of the energy I have, when I have it

- Even if I'm jumping around - sometimes I get tiny bursts of energy for several different things in rapid succession - over time I may end up making progress on all of them. Instead of trying to pin myself to focus on just one, embracing the interlacing lets me take advantage of as much energy as possible

- My energy is highly momentum- and dopamine-based; if I'm struggling to be motivated about one thing, sometimes I can "prime the pump" by doing something small/easy first, and then I'll have more energy to carry over into the bigger thing

- Learning ways to sort of re-frame a task, or "tempt" myself into becoming interested in it (pressure doesn't work, but there are other ways)

Everybody's different though. Best of luck

My wife has similar struggles. She told me that she hates dieting but every time she does atkins or keto (I don't think the specific choice matters much as long as it's healthy) her head starts to clear almost immediately. It may take a few days or a week, but she says the effects are very noticeable. At the same time she also starts jogging, biking or doing some other physical exercise daily.

It's nothing that addresses ADHD directly but it's the best thing she's found to cope and get her back on track.

I would advise some caution with ADHD meds and how you quit as well. I know it's extremely uncommon but someone close to me suffered a psychotic break directly after quitting cold turkey. The quitting may have even been an effect of the psychosis but in an abundance of caution please be mindful of your headspace and if there are any red flags, please talk to someone about it.

Our mental health is more fragile than we realize, we need to talk about it so we can all deal with these issues more effectively.

There's a lot of great advice here and I'm glad you reached out. Keep it up - you are not alone friend.

Diagnosed ADHD, taken a lot of meds over the years. At times I would have said it quadrupled my productivity. Over the last couple years I’ve focused a lot on lifestyle and feel my performance is at all time highs, without meds.

The most helpful frame I’ve found for self improvement is to focus on what’s happening in your own body/mind/environment and tend to it and make it better from where it is. As opposed to having a plan/dream and trying to contort yourself to achieve it.

Ok, specific tips:

1. Exercise is fuel for your mind. I walk every morning and punctuate long periods of work with walks.

2. Think in terms of ‘now’. Eg I am choosing to play video games now. I am choosing to ___ now - In order for something to happen, sometime it needs to happen ‘now’.

3. Something that has been helpful to me is talking through problems. (I do this on my walks using a voice notes app). I don’t understand what’s at work here but it’s deeply profound.

I've been in the same boat.

Here's the strategy that worked for me for more than a decade now:

1. Getting the chemical baseline right: Make sure you have enough Magnesium, Potassium, B-complex and Vitamin D. Without these, everything else, including therapy or spiritual explorations, will likely fail. If you have trouble sleeping Mg Glycine + 5HTP are a great combo sans the side effects of let's say melatonine or benzos. Eat LOTS of meat, at least a dozen eggs a week, fish oil and seafood in general. 2. Nootropics: Piracetam + L-Theanine + Black seed oil (pills) + Alpha GPC have significant effect over time. You won't feel the immediate boost like with Adderal but small increments that will change your life over time. 3. Being hyperactive means no carbs. Nothing makes me more hyperactive than an insulin spike. Staying on low carb, keto and one meal a day is the best way to maintain mood stability. 4. If 5HTP and Glycine are great for boosting serotonin, L-tyrosine is amazing for boosting dopamine. I've discovered it last year and it's been a gift that keeps on giving. I've tried Modafinil and ended up in super weird mental states (mild paranoia, anxiety etc). L-tyrosine has been nothing but wonderful. Complete game changer. 5. Sports&hormetic stressors – make sure you have enough physical activity and healthy levels of other physical stress (e.g. cold temperature). Your brain will thank you for those endorphin releases post workout.

Can we look back on this disorder and take in how truly awful it is to live with it?

For most of your life, people call you lazy, inattentive, annoying.

You try to keep up with schoolwork/work/taxes/chores/XYZ but the activity makes you want to vomit from the tightness in your chest and the mental fog that creeps whenever you want to just get done with it.

The majority of people believe ADHD does not exist, and keep leading you down a road where your self-esteem keeps getting destroyed more and more when no methods seems to work effectively.

When you get diagnosed, which in most parts of the world is so hard it'd be easier to plan your suicide; and you get prescribed medication, people call you a drug addict.

ADHD is one of the most researched disorders and the most treatable, but the majority of people who have it are hardly diagnosed and their problems are never taken seriously, because neurotypicals have a hard time relating with the experience.

You always have noise in your head. You can never relax. You always have to be doing something. You have a constant monologue going in your head and made up scenarios.

You're either stuck trying to start a task for two hours, or obsessively doing something for 12 hours.

Comorbid anxiety disorder is very common to have developed from all the childhood trauma resulting from ADHD.

I noticed that there seems to be a 3-6 month reset of my dopamine baseline after stopping stimulant meds, so things like emotional modulation, eating impulses, motivation, and even digestion took a bit to return to something I'd consider normal. Honestly, it took some discipline to get the physical habits right (overcompensation with caffeine caused problems with sleep, etc.).

Finally, for me at least, it was the harder task of prioritizing regular F2F social interaction and attention to developing quality friendships over many months that contributed to my biggest gains in executive function. I did this for other quality of life reasons at the prompting of my partner, and was surprised by this unexpected positive result.

Godspeed, stranger!

I've been off medications for 20 years, with diagnosed moderate ADD (now ADHD).

Doing work you actually enjoy helps, also task sequencing, for me at least, context switches are very expensive, so I try to schedule like-like work back to back.

I also tend to use the 'buddy' system for doing things like, organizing stuff around the house, and cleaning, which means someone to hang out with me, and often help me not get distracted. If I try to organize alone, I will get one box of shit taken apart, then as I go put it away, I find other things that need putting up, and move them, and at the end of the day the whole house is a mess, and I have no idea why.

My issues with stimulants is how much they interfered with my sleep; Focalin did have a goldilocks level, but HMO wouldn't cover a high enough dose for me, unless it was ER, which just didn't reliably maintain a theraputic level in my system.

Things that help:

1. No/few simple carbs before lunch (I used to skip breakfast until I realized it wasn't all breakfasts that were the problem). Focusing is hard enough without being drowsy from hypoglycemia

2. Exercise. You'll probably be able to force yourself to run regularly for a week or two and then give up, so find something more interesting. I personally do martial arts that have some form of sparring because competition gets me engaged. Less competitive people might want to find something else; there are several forms of dance that are highly technical, so can be mentally engaging for years.

3. Structure & Boundaries. As swatcoder says in another comment, you just aren't likely to be as "together" as someone who isn't ADHD, so maybe you decide "I'll clean for 15 minutes a day" or "I'll make my bed before eating breakfast" or whatever, but pick small, attainable, measurable goals for the things that are likely to fall through the cracks, and set aside specific times to do them. This will both keep you from looking like a complete slob and also help you feel like an "adult" (which is important for emotional well-being).

Try Strattera (atomoxetine). It's not a stimulant - the effects are not as powerful as a stimulant but it will help. Like SSRIs it will take a few weeks to notice improvements. A primary care practitioner would have no hesitation about prescribing a 90-day supply, and there aren't the same supply issues.

Not an answer but a question. I don’t have ADHD, so I lack any experience here. What’s the idea behind a system that puts people with ADHD on a perpetually recurring 30 day deadline to renew their pills? Isn’t that a bit like putting the obesity clinic at the back of the McDonald’s?

Funny you ask, that is not ideal to say the least.. It has caused unnecessary stress and I've had to do a few days without meds several times during Covid when I wasn't able to go pick them up due to the limited pharmacy openings.

Luckily I have an awesome and very understanding GP who stretched my prescription to 90 days permanently. As I understand it there's no hard limit here in The Netherlands, but this is about the maximum he can get away with in this case.

> Isn’t that a bit like putting the obesity clinic at the back of the McDonald’s?

Yes, except if pamphlets from the obesity clinic sold for hundreds of dollars on the street. It does suck, but I do see it at least a bit of a "this is why we can't have nice things" rather than just "Assholes make it harder for me to get my meds"

Amphetamine-based drugs are Scheduled substances in the US and other countries, so they keep a tight grip on supply. I've been able to get as much as a 90 day supply at once however, that was handy.

Yeah but, why can’t a psychiatrist sign a patient up for monthly delivery? Or something like that? Like a SaaS but for adderall?

Stick to a schedule, go to bed on time, reduce salt intake and eat right, hit the gym.

Worked wonders for me, I also follow rules like “if it takes less than 2 minutes do it now” and I make checklists in the morning

I haven’t needed medication for years now, am super productive, and feel 10,000% better

Going bottom-up rather than top-down to solve your problem, I'm going to treat your specific problem as "getting controlled substances is hard; how can I treat ADHD chemically while avoiding that problem?"

If so, here are a few leads:

• Buproprion (Wellbutrin) is an NDRI but is not a controlled substance. Its on-label use is for depression or anxiety, but has been used off-label for treatment of ADHD. Many people are prescribed it as an adjunct therapy to regular depression/anxiety treatment when they also seem to have some ADHD symptoms, or when the drug they're taking for treatment of depression/anxiety causes ADHD symptoms.

• Bromantane is a non-scheduled and in fact non-prescription "nootropic" drug (it's a licensed OTC medication in the countries it's produced in; but is just considered a "supplement" in North America) that specifically aims to treat dopaminergic receptor depletion, by — apparently — triggering the permanent growth of new dopaminergic receptors. Some people phrase this as it "healing" your reward system. (It can apparently be used to undo some of the long-term effects of meth use on the reward system.) ADHD is technically a syndrome, in that it has many possible root causes (etiologies); one of those potential root causes is a decrease in dopamine receptivity in the brain, or a decrease in dopamine production. Both of these problems are treated by growing more dopamine receptors. If your ADHD has that particular etiology, then it may benefit you to try this. (In practice, it worked, at least for me. I took some for a while when I ran out of Vyvanse myself, and it indeed treated my ADHD, though in a very different-feeling way than Vyvanse does. When I stopped taking it, and resumed Vyvanse treatment, I found that I needed a lower dose of the Vyvanse going forward.)

• Tricyclic antidepressants are dopaminergic and unscheduled. You'd have a lot of side-effects from these if you aren't also depressed / anxious; but if you are, they're a good solution.

• MAOIs are everything-ergic, and unscheduled. They're also pretty awful. (You can't eat cheese!) Last resort.

What has helped me (n=1):

1. Get enough sleep.

2. No Alcohol

3. Quit caffeine. It does help with attention for a very short period, but the sleep disruption outweighs any perceived benefit for me. Even a single coffee in the morning I find messes with my sleep.

4. regular exercise several days a week.

I still struggle, but since I've made these lifestyle changes I'm able to compensate much better, and my mood is much improved as well which helps with the self-defeating thoughts that inevitability go along with ADHD. Like you I was previously on stimulants but for multiple reasons opted to get off them years ago.

Check out this vid from Huberman - https://www.youtube.com/watch?v=hFL6qRIJZ_Y

Fasting always gets me into a high focus zone (but I don't have ADHD). Try doing a 48 hour zero-calorie/liquid-only fast. Black coffee and teas are fine. Get plenty of electrolytes, especially magnesium and potassium, or else you'll have a headache. Take an ibuprofen if you really need it. And reward yourself at the end. I always get an amazing amount of reading done in these periods.

I was diagnosed with ADD as a kid, not ADHD (that was my brother). I assume I have it with how much I jump around mentally, but who cares?

This is who I am. It's not any kind of problem unless you're being forced into some kind of work where it IS a problem, but then that kind of work isn't for you.

To keep myself feeling good and busy, I work on a TON of creative stuff, sci-fi stories, film scripts etc, and can just put in a note or whatever as I think of it, then back to doing work. And I do tech work where I can have a lot of different tasks and different ways to approach them, which allows for 'jumping around' while still staying ultimately on task.

Software can help a lot as well. For example I started using TeXStudio to organize my ideas because of their navigation pane (most of my tex files just have sections and subsections and no other LaTeX).

All of that is to say instead of trying to force yourself to fit into some kind of mold, create a new mold that fits you perfectly. A mold should come from you, you shouldn't be trying to force into one.

Here is a counterintuitive tip that is working for me. Instead of fighting my imagination which seems to then burst out in ADHD and distract me from what I am doing, I spend a lot more time actively encouraging it. I spend hours daydreaming. What I imagine then becomes reality. Neville Goddard is particularly insightful in this area.

I got a lot of value out of this book. "Mastering your adult adhd". I spent one hour a week going through one chapter at a time and practicing each new skill.

I think just the clinician book is enough but you can try getting the client book as well.

https://www.amazon.com/Mastering-Your-Adult-ADHD-Cognitive-B...

I don't take medication now but I think a year or two of medication can be very helpful. You can think of medication as a temporary tool to help build the habits.

I should note my adhd is only mild to middle and I think for some people medication is the best and only treatment

Getting sleep helps. If you go to bed at a time such that you wake up without an alarm and find it easy to get out of bed and on your feet, you’ll have a much easier time concentrating during the day.

You may want to look into a sun lamp to help you do this during the shorter days.

What helped me:

- Exercise.

- Change of diet. (No junk food, learned to cook)

- No/limit/control caffeine.

I only ingest caffeine when my behavior isn't critical, ie I can have coffee if my tasks are all computer related. But if there is a meeting with people in the day, I don't drink coffee because I know I will do or say something "wrong" at the meeting.

Caffeine at least it greatly increases the odds of me having a hard time in a particular event, especially if something unexpected happens.

It can turn normal event into a difficult one, and hard one into an unbearable experience.

- Forcing myself to remain calm.

The more I do this the better control I get. It's never easy, so I fail and try again. And again and again.

- Plan/train ahead of time.

I mentally practice an event that causes me issues. Everything from conversations, to procrastination, distractions, etc... I go through in my head how I want something to happen and how I want to react or choose to behave in advance. So when it does happen I have a fighting chance. A few go arounds with this (failing each time) and eventually I get a better result.

It took me practice and work and accepting discomfort on a nearly constant and daily occurrence, and to just accept this discomfort as normal. (the end secret)

I think you are in a harder place because you are used to something and now have to learn to "feel" different. Just keep trying and you will eventually feel different, it's just how life works. We get used to what we force our selves to accept. (within limits of course, right?)

Just don't give up. Fail thousands of times, but just keep going because you have already discovered you don't want to go back.

Try something new whenever you have to. These past years I've tried many, many new things because "I just don't want to keep doing what I've already done", which is similar to your situation, you have committed to something, the hardest part is over.

I had the same experience last time I tried quitting adderall cold turkey. For months I had a really tough time focusing on anything. The sleep was the worst part- I literally couldn't sleep without medication. Eventually I went back on.

This time around I quit in consultation with a really good psychiatrist (they are out there) and he had me slowly tapper my dose over a 6 months period. This was a WAY better experience then quitting cold turkey. My sleep has been better than when I was on adderrall and my focus has actually been better than when I was on a low dosage of the stuff.work

I went down this path and after much struggle, I learned the hard way that amphetamines can damage your nervous system. My current routine is to use samatha (calmness) style meditation to promote parasympathetic activity and taking Lion's Mane mushroom to promote nerve healing. It's been a decade since I stopped taking amphetamines and its the first thing that actually seemed to make a difference in restoring what was lost. Your not alone in struggling after going off medication.

>I learned the hard way that amphetamines can damage your nervous system.

I'm sorry, can you expand on this? Preferably with sources?

The personally confounding thing was that I assumed there would simply be a withdrawal period and I would start to feel normal at some point. That never really happened, even years later. After hearing rumors I started looking at articles like this https://www.scientificamerican.com/article/do-adhd-drugs-tak... and this https://www.acnp.org/g4/GN401000166/CH162.htm and I started to think that perhaps taking these drugs as a child over a period of 8 years might actually have had a much deeper impact that I realized and after trying various things over the years I found some that seemed to help. The causality was a little funny. I started lions mane, it helped. Herbals usually don't do much and I started doing research into why it might help so much. Lion's mane increases nerve growth factor, and that led me down the rabbit hole.

Gamify everything. Well maybe not literally everything but areas where you have trouble focusing. Make it a challenge, that will engage your hyper focus capability.

1. Cold showers

2. Meditation

Huberman’s supps formula:

300mg Alpha-GPC - 500mg Phenylethylamine - 500mg L-Tyrosine (sometimes)

*Note*: Don’t take these after 2-3 p.m. if you intend to sleep that night.

reading these replies almost never fucking works. you just have to be your own soldier and what you do in the present always matters.

Picking working strategies and tactics from peers is usual step. Considering this is HN, and a lot here deals with knowledge work, do you not read documentation and apply it? This is the same.

With the pills, I don't take them at the weekend. This stops me working too hard and I carry out manual work/exercise instead. This gives me a buffer. Also tell them you lost them and get a months buffer. Now the worries about that go away.

But I think you want to get away from taking them.

Went through hell getting my prescription filled last month. Decided to switch to an online pharmacy and so far I'm very impressed. Far less out-of-stock bs and prompt delivery. I use alto.com but there are lots of competitors in this space. Best of luck, I definitely feel for you.

Ritalin is readily available on the darknet. Not that I would advise anyone to do anything illegal! I'm sure these kind therapists have our best interests at heart and they're not just gatekeeping in order to profit from molecules they played no part in creating...

ADHD medication shortages are a reoccurring theme on reddit.com/r/shortages with a common recommendation being a doctor-assisted reduction in dose in order to build up a stock of the drug.

This is not strictly an answer to your question, sorry, but I still hope it helps.

--- Brain dump follows ---

Coping skills and support.

Coping skills:

- Structured decision-making for medium- and big-things

- Time management

  - Timeboxing

  - Time blocks

  - Timers

- Task management

  - Have a simple, algorithmic system such as GTD

  - Minimize interruptions

- Performance & goals management

  - Dispassionate self-evaluation, self-awareness, and seeking professional feedback at work

- Idea management

  - Set aside inessential thoughts, ideas, and concerns

  - Mind maps, idea repository, and/or notes

- Writing as a tool for thought refinement

  - Think like a lawyer: nuanced word choices' and 

arrangements' effects on meaning

  - Think like an editor: eliminate and rephrase copy until every word is both clear and necessary

  - Think like your audience: How is this relevant to them? 

What do they need to know?

- Accountability, both self and setting up external forcing functions

- Sharpen interpersonal effectiveness

  - Active listening - Pausing our thoughts and agenda to 

express internalization of another's with paraphrasing and asking questions

  - Meeting management - Encourage quiet voices, slow down 

louder ones

  - Mentoring - In many aspects of modern life, there isn't 

enough of this

Support: Work has a secret support group. Prevalence is 20%+.

In my case:

Methylphenidate and mixed amphetamine raised my blood pressure and did more harm than good.

Atomoxetine side-effects were untenable, including sweating, altered consciousness, urinary problems, and anxiety.

One anti-depressant helps in an off-label capacity, however the sexual side-effects were life impairing.

Treatment resistant depression is also present. 3 antidepressants currently. Looking at medical dissociatives, psychedelics, and TMS.

Perhaps:

Ask for a 90 day supply if that's an option.

Consider the benefits vs. costs rather than making a change because something is difficult. Life is difficult. Difficult things will need to be done.

Sleep. Lots of hard exercise. External reminder systems (calendar, alarms, reminders, etc.)

ADHD has become a group diagnosis for pretty much all letter combo diagnosis... so its like saying, I need computer help. So I ask, is the PC on? Is the cable connected? What OS are you running, what dist, which desktop etc

I am dealing with something similar. Sleep and exercise help, as can CBT or other psychological interventions, but nothing works as well as stimulants.

St Johns Wort

Chamomile tea

Passionflower tea

Lemon balm tea.

Lots and lots of water.

Oxygen

Dronezone

Pomodoros