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All of the productivity, none of the hyperhydrosis or raised heart rate?
April 12, 2012 11:42 AM   Subscribe

How do I replicate the motivational mindset I have while on Adderall when I'm sober?

About 3 months ago I tried Adderall for the first time on a whim and it was the most eye-opening experience of my life. For the first time in my life I actually wanted to not only start tasks, but complete them and then move onto another task. As someone who's struggled with motivation and task-completion issues throughout his life, I'd never experienced this mindset before. I began buying pills of my friend every month because neither I nor my parents have health insurance (I'm 24) and I'm not in school right now so getting tested for ADD/ADHD is out of the question.

When I'm not on Adderall I get distracted very quickly and have a tendency to mentally say "fuck it" when I realize I have a partially completed project/task. It could be as simple as putting away my laundry or as important as filing my taxes on time; either way I end up either not doing it at all or doing it after the deadline. I'm currently working 3 part-time jobs and I'm regularly late to all of them because I decide that browsing Reddit while half-dressed/watching TV/engaging in a distracting activity is more important than getting to work on time.

Because of my insurance circumstances and because my friend can't give me 15 pills out of his prescription every month, I want to know how I can effectively replicate the desire to sit down and create a time management plan, decide what tasks I need to finish, and then do them one by one without Adderall. What worked for you?


(bolded the important stuff)
posted by bumpjump to Health & Fitness (28 answers total) 22 users marked this as a favorite
 
You can't. It's like asking how you can see as well as you can with glasses, but without glasses, because you can't afford glasses.

I'm not unsympathetic, but I'm afraid that's the answer.

I'm sorry that there's no healthcare in the US, but if it's any consolation, the only practical choice for me was private treatment in the UK as well, since there's only minimal provision for mental health on the NHS. I was earning £225 a month and I had to spend £375 on my first appointment. It was worth it though.
posted by tel3path at 11:48 AM on April 12, 2012 [7 favorites]


You began the process of getting things done by taking a pill. Start with that mindest: putting something in your mouth and swallowing it is Step 1 in the process of doing ______________, and then take a multivitamin.
posted by carsonb at 11:49 AM on April 12, 2012 [1 favorite]


Coffee has some benefit. Start w/ 1 cup, then 1/2 cup every 2 hours (I read an article about how to maximise coffee benefits; this is my best recollection). Are you looking for work? See if you can get vocational rehabilitation funding to get the health care you need in order to get/keep a job.
posted by theora55 at 11:52 AM on April 12, 2012 [1 favorite]


I'm you, several years from now. I've tried all manner of "Get Things Done" courses, coffee, etc.

I sat down with my doctor recently and told him exactly what you told us, and he wrote me a prescription for a very low dose of adderall, and really, the difference has been night and day.

Yes, you'll have to shell out of pocket for the doctor's appointment, the cost of the adderall XR is all over the place (I'm paying $10 a month, thank you university benefits), but it's totally worth it.
posted by Oktober at 11:57 AM on April 12, 2012 [5 favorites]


Seriously, I hate to sound like I'm lecturing my 24-year-old self here, but I am.
posted by Oktober at 12:01 PM on April 12, 2012 [1 favorite]


Have you tried to look for local, community health center?

I live in a mid-sized city in the midwest and there are several organizations that will take care of your mental health needs (and other health care for that matter) sans insurance.

The big pharma companies have programs that give tens of millions of dollars worth of free meds to low-income patients that these clinics have access to.

And, there are more millions of dollars coming from state/local/federal government to take care of people without insurance, use it.

Go to the Health Resources and Services Administration and search
posted by thylacine at 12:05 PM on April 12, 2012 [1 favorite]


Can't you find a way to see a neurologist and pay out of pocket? Most Drs. give a discount for cash patients. The testing isn't all that intensive and thus, not all that expensive. I pay $65 a visit in the LA area.
posted by Ideefixe at 12:09 PM on April 12, 2012


Tel3path has a good point, which is, ADD is, among other things, a lack (misbalance?) of neurochemicals. And theora55 has another good point, which is, try the stimulants that are available to you (Coffee is good), and see how they work for you. And Oktober has the best point, which is, it IS possible to get health services without insurance. FWIW, the pharmacy price is per pill regardless of dosage, so if you don't take XR, having your doctor prescribe half the number of pills at double the dosage is worthwhile. Of course, you may not be able to find a doctor willing to do this without building up a relationship first.

I'd recommend reading Driven to Distraction. It's more about understanding ADD/ADHD then about steps to dealing with it, but I found it very eye opening.

I also found making lists to be very helpful. The smaller a task is to do, and the more I can see a short list of easy to accomplish tasks, the better. And, of course, try to remember what you do (and how you feel) when taking addreall and accomplishing your tasks. Not that remembering your past satisfaction is a substitute for adderall, but it might help.
posted by Phredward at 12:15 PM on April 12, 2012 [1 favorite]


Generic versions of the stimulant meds are relatively cheap even without any insurance or other benefits at all. Consumer Reports, who I think are still a reliable source for this sort of thing, say that generic Ritalin is as cheap as $15 a month (for 2x10mg per day) and generic dextroamphetamine as cheap as $37 a month for a similar dose, if you're willing to take instant release. You could easily spend more than that on Starbucks coffee in a month, and get less benefit.

Seeing a psychiatrist to get the prescription will, of course, raise the price. But even then, there are psychiatrists who will work on a sliding scale, and you may have access to some sort of mental health clinic.

Suppose you have to pay $150 a month, all things considered, for psychiatrist visits and the presecription itself. This is a very high estimate, and you can almost certainly do it for significantly cheaper. But let's just assume the worst case: suppose you can't find any reduced-price options for getting psychiatric care, not even someone who will give you a discount for paying cash. Even still, it would be worth it. That's five bucks a day. It's cheaper than eating out. It's cheaper than smoking. It's cheaper than drinking. It's cheaper than a coffee habit unless you're religious about brewing your own at home. Hell, it's probably less money than you're losing by showing up to work late every day, if you get paid by the hour and have to punch a clock.

I know you're asking for a way to do this without medication. But none of the options (too much coffee, too many cigarettes, "herbal supplements," illegal stimulants) actually work very well, and none will actually be much cheaper than getting yourself proper treatment. So just get yourself proper treatment. Your brain is totally worth it.
posted by nebulawindphone at 12:17 PM on April 12, 2012 [5 favorites]


You could easily spend more than that on Starbucks coffee in a month

Fixed that for me. If you find a community clinic you can visit for free, at $15 a month for the pills themselves, even brewing your own coffee at home would be more expensive.

posted by nebulawindphone at 12:20 PM on April 12, 2012


Seconding nebula here: It's entirely worthwhile to explore your options and fit it into you budget. You'll be in much better shape being able to get shit done than you will by just scraping by.
posted by Oktober at 12:35 PM on April 12, 2012


What nebulawindphone said. Be warned that a lot of people find generic Ritalin ineffective (I did), but as it's so old-fashioned I don't think the brand-name stuff is very expensive.

You probably don't need the newer, more expensive formulations like Adderall, in fact we don't even have Adderall here in the UK because its formulation is too fancy for it ever to be licensed. There are probably a few people who can only work with Adderall, but I think they're in the minority.
posted by tel3path at 12:48 PM on April 12, 2012


A warning about "Driven to Distraction:" It operates on the assumption that the only appropriate way to deal with ADD is by medicating.

Wearing a watch is helpful. Staying away from sugar is helpful. Exercise is key.
posted by aniola at 1:04 PM on April 12, 2012


I would recommend giving meditation a try. I used to take something similar to Adderall and through meditation I was able to quit using it all together. Not saying this will work for everyone though I started with something like 8 Minute Meditation and worked my way to more advanced techniques from there.
posted by kitsully at 1:08 PM on April 12, 2012


I just want to add that even getting a prescription for Adderall won't solve your problems. I was also completely unfocused without Adderall. I finally got a prescription, however when you take it regularly your tolerance builds up QUICK and it wasn't working for me anymore like it used to. Also when I take it several days in a row it makes me weirdly blank and kind of irritable. Now I take it about 2-3 times a week and on days when I don't I just drink A LOT of coffee and accept that I'm just not going to be as productive. Exercise really helps.

Also, I tried two different forms of Ritalin before Adderall and not only were they not nearly as effective, they made me CRAZY.
posted by ad4pt at 1:10 PM on April 12, 2012 [2 favorites]


neither I nor my parents have health insurance (I'm 24) and I'm not in school right now so getting tested for ADD/ADHD is out of the question.

Is the issue that you don't have insurance, or that you don't have any money? Because you certainly can make an appointment to see a doctor, and just pay out of pocket. You could probably call beforehand and ask how much things cost. (we've got a high deductible, so I can tell you that every time I take my kids to the doctor, it costs $155, which i'm responsible for.)

If you think that getting a diagnosis and getting treated for potential ADD/ADHD could make a significant difference in your quality of life --- and in your ability to keep your three part-time jobs--- then maybe it's worth trying to get in to see a doctor.
posted by leahwrenn at 1:12 PM on April 12, 2012


So, yeah, a lot of us are focusing on the medical aspect, I think mostly because you do say that medication has worked for you in the past. But as far as keeping shit organized when you're unmedicated, I found autofocus (basically a glorified to-do list system with some rules for keeping the list items simple and manageable) to be a big help. It won't make you more motivated or more focused, but it will make it easier to translate moments of motivation or focus into useful activity.
posted by nebulawindphone at 1:15 PM on April 12, 2012 [1 favorite]


i got diagnosed and medicated for adhd through a psych study (so i was the one getting paid). if you happen to live in nyc, i can pass on some info to you, but if not, maybe you can find a study where you live. i now have a letter from the study psychiatrist that says i have adhd and did well on strattera (the med for that study), and i can give it to any other doctor and they'll write me a prescription -- very handy.

that said i'm not on medication right now. i exercise five days a week, i haven't had sugar/dessert in almost a year... and i still can't start or finish tasks and am always late. the best coping technique i have found for myself is just to structure my life and work in the most manageable way possible. for example, i don't do any kind of project management; my work is moment-to-moment, so there's no planning; i do a lot of physically active work that doesn't require sitting still; and i work with jobs/people who don't mind if i'm late (or i make an effort to arrive half an hour early and manage to get there about on time). i wish i knew of a good answer to your primary question.
posted by nevers at 1:16 PM on April 12, 2012


I'm currently working 3 part-time jobs and I'm regularly late to all of them because I decide that browsing Reddit while half-dressed/watching TV/engaging in a distracting activity is more important than getting to work on time.

Look, I know you're looking for options besides meds because it's expensive to get meds. But think about the bigger picture here. Will it cost more than losing one or more of your jobs because you're late? (Are you actually already losing money every time you get there late anyway?) What will it ultimately mean for your earning potential if you're finally able to get your act together and pursue your goals and dreams in a motivated and effective manner? Think about it as an investment.

(As folks have said, some of the ADD meds are quite cheap. You'd still have to pay for an assessment/diagnosis, and the bigger issue is that unfortunately you have to get a new prescription every month, but if you find a doctor who'll work with you then they'll sometimes write you three months of prescriptions post-dated at a time, or let you pick up the prescriptions at the office without charging you for an appointment every time.)

I mean, yeah, there are some non-meds strategies that help some, like setting artificial deadlines. And there's coffee, which helps me decently for a couple hours at a time at least. But really, there's nothing quite like being properly medicated and that's probably your best strategy.
posted by EmilyClimbs at 1:16 PM on April 12, 2012 [1 favorite]


I'd like to point out that doctors will not prescribe such drugs to some people, especially those with any history or family history of substance abuse. I've had several psychiatrists tell me that I don't have ADHD because I've always had good grades, and that between that fact and my family history of addiction, there is no way in hell they would ever prescribe me Adderall. So for various reasons drugs sometimes are really not an option. OP is looking for non-drug options.

The only legal things I can think of to suggest are Yerba Mate tea (much better than coffee for focusing without the jitters) and white noise (such as from www.simplynoise.com). That and regular exercise, preferably yoga.
posted by désoeuvrée at 3:47 PM on April 12, 2012 [2 favorites]


There are several herbs and things out there called nootropics. Longecity has a forun where people talk about these things. There is no magic bullet, however. Different things work for different people.

The big one people seem to talk about is piracetam.

Adequte exercise helps as Adderall releases dopamine (which exercise does).

Adderal is not always a cure-all, remember. It may stop being as effective and/or cause side effects, too.
posted by eq21 at 4:49 PM on April 12, 2012 [1 favorite]


Before getting a proper diagnosis, I would use pseudoephedrine and green tea.

For me, there is something in coffee (besides the caffeine) that whacks me out. Some other kind of stimulant. So try other forms of caffeine.

I just want to add that even getting a prescription for Adderall won't solve your problems. I was also completely unfocused without Adderall. I finally got a prescription, however when you take it regularly your tolerance builds up QUICK and it wasn't working for me anymore like it used to. Also when I take it several days in a row it makes me weirdly blank and kind of irritable. Now I take it about 2-3 times a week and on days when I don't I just drink A LOT of coffee and accept that I'm just not going to be as productive. Exercise really helps.

I think there is a significant variation in how well people metabolize amphetamine. You were probably taking too much. Also, take this for what it's worth, you are supposed to build tolerance to the "speedy" aspects of stimulants, but the actual effects of helping focus still supposedly remain. It's just that when the tolerance kicks in, you aren't Super Excited About Everything.

Also, I tried two different forms of Ritalin before Adderall and not only were they not nearly as effective, they made me CRAZY.

I concur wholeheartedly. Mood swings ahoy!
posted by gjc at 5:58 PM on April 12, 2012 [1 favorite]


OP here, thanks for all the responses.

I currently live at home with my physician father who swears I don't have an attention disorder but who won't refer me to a psychiatrist to be screened either. Because of this, I'd have to pay doctor visits out of my own tiny pocket so I'd rather stay away from a formal diagnosis until I get health insurance again.

I've tried non-substance methods (deadlines, timers, etc.) but I just end up completely disregarding them anyway. Although coffee doesn't really help me focus I'll look into maximizing its benefits. I'm definitely going to try yerba mate and meditation. I exercise 5-6 times a week and don't eat very much sugar but I'll try cutting it out completely (does the sugar in milk count?) and see what happens.

nebulawindphone, translating moments of motivation and focus into useful activity is exactly what I'm talking about, you worded that really well.
posted by bumpjump at 8:36 PM on April 12, 2012 [1 favorite]


You're 24. You're an adult. It's up to you. No more excuses.

Since you don't have health insurance, you don't have to deal with in-network BS. Find a local GP or psychiatrist and pay the first appointment yourself. Tell them you'll be paying on your own, and you're low income. Call around and see if there is a community health clinic.

You're clearly motivated, and these other options will help you too.

But stop trying to create a roadblock where there isn't one. Your dad is not your doctor. He cannot prevent you from talking to a doctor.
posted by barnone at 9:46 PM on April 12, 2012 [5 favorites]


theora55: "Coffee has some benefit. Start w/ 1 cup, then 1/2 cup every 2 hours"

This is a fantastic way to turn your ADD into an anxiety disorder. Yerba Mate is much, much better, especially if you don't want to wreck havoc on your sleep schedule.

nevers: "the study psychiatrist that says i have adhd and did well on strattera"

Strattera works really well for some people, and really poorly for others, and is very different from any other meds on the market. The argument's been made that the people for whom it works either don't have ADD, or have different biological underpinnings for their ADD. There are a lot of horror stories out there for this med, so I'd be really apprehensive of trying it first, especially if adderall works for you.

Be very weary of folks who claim that there's a single cure for ADD that works on everyone; they're grossly misunderstanding and simplifying your situation. Fortunately, it sounds like you've already figured that out.

desoeuvree: "I've had several psychiatrists tell me that I don't have ADHD because I've always had good grades"

Wow, that makes my blood boil, because it goes so directly against the current body of research. People with ADD can be very "high-functioning," and do fantastically in some environments (ie. school), but suffer greatly in others. There is absolutely no correlation between ADD and general intelligence or mental capacity.

bumpjump: " I exercise 5-6 times a week and don't eat very much sugar but I'll try cutting it out completely (does the sugar in milk count?) and see what happens."

FWIW, I tried dietary restrictions to improve my focus, and they just made me very angry all the time*, not to mention that the folks promoting those methods always seemed full of woo woo ("It's not working? Oh, that's because you're still eating all that poison. You need to just not eat at all.").

Yeah, if you have an allergy or weird food intolerance, certain foods can trigger psychological reactions similar to ADD, but I don't believe that dieting holds the key for everyone.
*You wouldn't like me when I'm hungry.... also, it seems intuitively obvious that constant hunger isn't exactly a great cure for ADD.

Exercise is good, especially if it's got lots of cardio. I find that exercising outdoors helps even more, whether it's because of the sunlight, or simply because a run through the woods or the neighborhood is a great way to clear my mind.

If you actually do have health insurance, I believe that there are ways of keeping your medical information private from your parents. It varies by state, but could be worth a shot.

But, really, you should be trying to find a doctor to treat this properly.
posted by schmod at 12:52 PM on April 13, 2012 [2 favorites]


IIRC there is something funny about the way ADHD brains metabolize glucose.

Also, you know that brains run on glucose, right? And that consuming some glucose before doing a thinky task helps you to think? There are certain costs to that of course (weight gain etc) so chugging down sugar water all the time isn't the answer. But cutting out sugar in any form is highly likely to make your symptoms much worse.

In general, don't try dietary solutions unless it's an elimination diet supervised by a professional - in which you'd cut out pretty much all foods except brown rice, then gradually reintroduce one foodstuff at a time and see how you react, getting proper scientific verification as you go. Anything other than that is just bullshit.
posted by tel3path at 4:46 AM on April 26, 2012 [2 favorites]


you know that brains run on glucose,

Brains can run just dandy on ketones, too. I'm always more functional on low, low carb and lifting really heavy weights.
posted by Ideefixe at 11:49 AM on April 26, 2012


You're 24. You're an adult. It's up to you. No more excuses.

Since you don't have health insurance, you don't have to deal with in-network BS. Find a local GP or psychiatrist and pay the first appointment yourself. Tell them you'll be paying on your own, and you're low income. Call around and see if there is a community health clinic.

You're clearly motivated, and these other options will help you too.

But stop trying to create a roadblock where there isn't one. Your dad is not your doctor. He cannot prevent you from talking to a doctor.


I have to second what barnone and others have already said. I'm sorry to hear your Dad isn't more supportive or open-minded about this, but remember most doctors and even many psychs are still relatively uneducated when it comes to adult ADD/ADHD. After a string of doctors and psychiatrists, I wasn't properly diagnosed until I was 39...trust me, you don't want to wait that long.

I only found out about ADD/ADHD because my friend's son was diagnosed and he suggested I look into it. It was a revelation to say the least. I read about 8 books on it in the following weeks. (Attention Deficit Disorder: The Unfocused Mind in Children and Adults by Dr. Thomas Brown is my personal favourite, btw). Hallowell's books are also good. Gabor Mate's book Scattered Minds also highly recommended.)

It changed the way I looked at everything but it was a full year before I had the confidence to approach my doctor about it. He knew very little about adult ADD, so I had to be thorough when presenting him with my self-diagnosis and fairly assertive in asking for meds...he knew me long enough to know I don't like taking medication, so he agreed to let me try Ritalin. It's not that expensive and it changed my life: the eyeglasses analogy is perfect. I prefer the extended release kind...effect is more evenly distributed and I don't have to remember to take them 3 times a day.

*NB self-diagnosis is NOT recommended so be very careful, thorough and conservative if that is your only option: everyone gets ADD symptoms from time to time, and ADD symptoms can be caused by lots of different conditions. Once I could afford it, I had my self-diagnosis confirmed by a specialist, but I'm glad I didn't wait.
posted by Russell123 at 7:01 AM on June 4, 2012 [1 favorite]


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