I used to keep fish. I loved learning about the nitrogen cycle, setting up the co2 diffuser, balancing tank parameters, designing the filtration system, researching, purchasing, and acclimating exotic fish. Fascinating, colorful and compelling. But once the set up was done and I had a mature tank I was bored and dreaded basic maintenance. The fish didn’t deserve a subpar home so I did my best, but when we moved and sold the set up, I never went back.
Ouch! Well, if you’re up, may as well read:
There’s a lot of research suggesting cis women with ADHD have symptoms (and metabolism of stimulant medications) fluctuate with hormone cycles. It’s not talked about enough that HRT would cause similar issues for trans fem folks. There isn’t great research on just how those effects would show up for trans people, but it’s reasonable to assume they would.
Conversely, estrogen and the like can mitigate psychotic symptoms so maybe that’s a side bonus?
This was a very brief explanation of many studies looking into this exact problem. The conclusion is from their research, not mine. You’re also making my point, that expressions of joy, happiness etc vary between cultures. This article talks about some of the research but I recommend reading the original studies or Barrett’s book.
We actually don’t have the same emotional expressions. The early studies on “universal” emotional expressions (joy, disgust etc) were extremely biased. The researches paid western actors to make facial expressions, took pictures of those expressions, then showed those pictures to various uncontacted / low contact tribes. However, the researches tended to ask the tribes what expression they saw repeatedly until they gave the answer the researches expected.
Even smiling isn’t universal. Think about cultural differences between smiling even in modern day Russia. There’s evidence that smiling might have been an expression of joy but was deemed socially inappropriate in Ancient Rome.
Emotional expressions in the brain differ between individuals and even differ within the same individual on separate occasions of the “same” emotion. Lisa Barrett has an excellent book on this topic: How Emotions are Made.
I’m so glad to hear your prescription works well and you’re feeling better. It can be hell to go without medication!
That being said, many people may take the exact opposite approach to their meds and that’s ok too. Some people only take them on days they need them and prefer to avoid the side effects / burnout that some feel from prolonged stimulant use. Both approaches are ok, just wanted anyone else reading this that the daily approach may or may not be what’s best for them or recommended by their prescriber.
OCD doesn’t have to have rituals necessarily but that’s what most people think of as a hallmark of OCD. A differential dx like this is important, but hard to do without a professional who can help you not just list your symptoms, but assess the qualitative nature of them.
Regardless, it does sound like this impacts your functioning and happiness, I’m glad you’re reaching out and getting some support.
I agree that sensory sensitivities are also more common in ASD, but ADHD, especially in more severe cases, can also have sensory sensitivities as can OCD and other conditions.
OP I think there’s enough here to justify an evaluation by a psychologist if you can afford it / it’s available where you are. If not, reading about ADHD and applying some of those strategies will not hurt you. I’d recommend ADHD 2.0 as a starting point.
ADHD and anxiety are also comorbid, and some of your symptoms may be more about anxiety and might respond well to anxiety related interventions. ACT (acceptance and commitment therapy) has several good workbooks about anxiety which could be helpful.
You could consider getting a psychological assessment that will give you an idea of your cognitive strengths and weaknesses. They can also administer instruments like the Strong Interest Inventory if you’re still looking for help deciding on a career.
It’s frustrating that an assessment is so expensive. And the psychologist will probably only get reimbursed for 4hrs of testing so your report will be short and cursory anyway… I’ll avoid going on a long angry insurance rant here.
Do you have any Universities near you? See if they have graduate psychology programs. Those students need people to practice giving assessments to and are supervised well. They usually give assessments for very cheap because it’s a training program.
I can’t sit down and read anymore either, but I found that audiobooks work well. I can take a walk, do the dishes, clean, laundry, commute, etc. while also being more entertained. I also listen to books with a sleep timer when I go to bed. That lets me distract my mind while I fall asleep and has been a huge help for falling asleep faster.
If you manage to find a way to make reading tolerable, start with ADHD 2.0. It’s worth it.
Hey, You’re in a tough spot and I know how hard it can be. I’m sure people have recommended everything under the sun to you and sometimes doing the work to accommodate ADHD feels like more work than just suffering the consequences. Especially as an adult. I love the Spoon Theory and I’m glad you have that as an analogy. I’m going to recommend a few things here, assuming that you don’t have a lot of clinical knowledge about ADHD.
Sleep and exercise are a must. Exercise can (temporarily) improve processing speed which is relatively low in many people with ADHD. You don’t have to be a mega athlete, but a routine of exercise that gets your heart rate up each day can and usually does help. Outside of stimulant medications, exercise and sleep are the two biggest things you can do for ADHD. Read / Audiobook
Why We Sleep by Matthew Walker
The meds you listed do not help with ADHD directly, but maybe some of the downstream emotional effects. Ask directly about stimulants, they can be a game changer for some, but you will need to be careful with sleep and appetite.
The recommendation to avoid food dyes and additives was huge in the 80s, recent research suggests only 1/3 of people with ADHD benefit from disarray changes. Read / Audiobook: Getting Ahead of ADHD: What Next Generation Science…” by Joel Nigg ^ Can be a bit dull but clearly explains research and evidence as well as examining what treatments are supported by science and to what extent. Use more as a reference than cover to cover.
For the love of all that is distracted, learn about ADHD for real from good sources! I’d start with ADHD 2.0, an update from Hallowell and Ratey, two psychiatrists who have ADHD and are big names in ADHD research. Some interesting suggestions about cerebellum involvement in ADHD and movement / balance therapies still under study.
As a personal tip, try not to get angry or down on yourself with the ADHD instances as much as possible. Forget your wallet in the house? You have to go back anyway, you can go back chuckling at yourself or furious, but you still have to go back. I’f you are angry or otherwise activated then you’re taking up mental resources, making it more likely that you’ll grab your wallet, but leave your sunglasses on the table.
Also look up Rejection Sensitive Dysphoria. Essentially a culmination of micro frustrations by peers and authority figures over the course of your childhood results in something like 20000 instances before age 12. That can lead to social sensitivity, overreacting to social stress, and a sense that people might be about to leave you / social self-doubt.
Also, if you have access and the money for it, go to a qualified psychologist and get a good psychological evaluation. Knowing your cognitive profile (relative strengths and weaknesses in cognitive functioning) as well as your memory abilities (visual often weaker in ADHD) can really help you assess how difficult various tasks will be for you and you can cope accordingly.
I hope this helps.
It takes about 5 half lives to clear 95% of a substance from your system. A quick google says the half life varies from 5-21hrs, so even if you’re on the slower end, a week should do it.
If you’ve been on it for a very long time then your CNS may need more time to get back to baseline, but you probably don’t need a perfectly clean slate to assess if a new medication works for you. Plus, switching from a nonstim to a stimulant is a totally different class of drug and you should feel the effects of a stimulant fairly quickly.
Just make sure you time and dose correctly to avoid messing up your sleep.