Got the goods, but need a plan.
April 23, 2012 7:46 PM   Subscribe

I am about to start taking ADD meds. My approach to work has been haphazard in the past, and I'm I'm hoping to improve my habits. What strategies should I attempt to make the most of any improvements in attention that I experience?

I'm a working adult. I have my first-ever prescription for an ADD medication (Vyvanse) and I am going to start taking it tomorrow. I'm not asking for medication advice (I have a physician for that), I'm asking for suggestions on the non-medication side of this: strategies, habits, etc. This being my first time taking a med for ADD I have no idea whether it will help, but if it does help I want to get the most out of it. So I'm wondering: what did you do (besides take the meds) to get the most out of your ADD/ADHD meds? What work habits, strategies, behaviors, etc should I consider adopting to make the most out of this?

While I certainly hope it helps, I don't assume that I'll take it and my thoughts will suddenly 100% organize themselves forever. From reading others' accounts, it seems that I'll have to organize myself, but if the med works it will help me pay attention long enough to get organized instead of messing around all day as usual.

I once took antidepressants for a year and experienced some improvement. The goal was always to use them to put me on a more even keel while I read books and went through talk therapy - and those were the things that would help me develop the techniques I needed to really deal with my depression. I'm happy to say that I haven't needed antidepressants or even considered myself depressed in six years. The key was the techniques that I learned, and the meds were a good stepping stone but not the final answer. But it seems that ADD medications may be a little different: if I see improvement, will I be able to learn techniques that will keep me focused? Or might I always need medications? Anyway, I'm looking for techniques - I am willing to take meds that I need, but if I can learn techniques and habits that make me more effective then I want to use this opportunity to do so.

So if you took ADD meds and they helped, what did you do when you found that they helped you concentrate? What work habits did you adopt to take advantage of the medication's effects? Did you do something like the Pomodoro Technique? Getting Things Done? Something less formal? Did you just create a to-do list and try to plow through it? I realize that it could take a few tries to find the right medication for me. No, I don't think everything will be peachy tomorrow. But I want to go into this intentionally and with the idea that I will be working on my productivity beyond taking medication.
posted by anonymous to Health & Fitness (6 answers total) 31 users marked this as a favorite
Make to-do lists. The drugs don't organize you, they just help you follow through. Give yourself time every day to plan your day, to whatever extent you find necessary. If you need to ease into things, just start with one "task" each day, fit in between the regular stuff.

Also, don't try to take on too much. Take some time to discover how the Vyvanse affects your ability to focus. After that, figure out how to leverage whatever that change is. Don't start out looking for instant success, rather, start out looking at ways to improve what you already are trying to do. Don't take on new projects, finish old ones.

(You may find that you feel a little "speedy" or even high if this is your first experience with amphetamines. That is a side effect, not the intended effect. It will go away quickly, but don't be fooled into thinking that the drug no longer "works". You really can't "feel" the intended effect of the drug. You can only notice it. You notice that you can complete a paragraph without stopping to play solitaire. You may notice that you are less able to do three things at once, but that you can do one thing at once more effectively. Etc. It might be hard to get to sleep the first few days. Don't alter your sleep schedule too much or you'll start bad habits.)

But it seems that ADD medications may be a little different: if I see improvement, will I be able to learn techniques that will keep me focused? Or might I always need medications? Anyway, I'm looking for techniques - I am willing to take meds that I need, but if I can learn techniques and habits that make me more effective then I want to use this opportunity to do so.

It depends on the person. Some people just need the drugs temporarily to learn new habits, some need them on an ongoing basis. That decision is far in future, don't sweat it.
posted by gjc at 8:02 PM on April 23, 2012 [5 favorites]

Yes, to-do lists! As someone who also started taking ADHD meds as an adult, to-do lists are a freaking revelation. I could never keep them before - now they help me stay sane and organized, especially when things are crazy.

You might never have learned how to manage tasks and time before. It took me a long time after I started meds to get out of the "last minute" mindset. I never bothered with the whole "break a big job into small tasks and give yourself deadlines for those tasks" approach before because I knew I would just end up doing things right before the deadline anyway, so what was the point? But I've gradually been able to learn how to do this and it's made my work both better and less stressful.

You might also need to learn how to focus your attention. This was a big surprise for me. Because, again, I was so used to being at the whim of my attention, instead of being able to direct my attention, that it took me a while to get used to the fact that I could actually choose what to focus on and that it would be good to be smart about it.

But I also agree with gjc that you don't want to rush things. Actually, you might even want to give yourself a month of taking the drugs and just observing how they affect you. You'll probably notice good effects very quickly even without doing much differently (I cleaned the whole house my first day on meds, no joke. My roommates were amused and thrilled.). But if you try to do too much at once, you run the risk of burning out and getting discouraged, which is bad news, especially for ADHDers.

One aspect of ADHD that gets short shrift is the effect on social and personal life. I've been amazed at how much easier it is to manage my finances and keep my house reasonable clean with the meds. I also think my personal relationships have improved as well. So if you have things you want to improve in other areas of your life as well, definitely think about how you can use your time to do that, too!

if I see improvement, will I be able to learn techniques that will keep me focused? Or might I always need medications?

It really depends. I've been on them for two years and I feel like I still have a lot more habit-development to do. However, I forgot to take my meds on a really busy work day last week and was able to make it through with a to-do list which was pretty exciting. On the other hand, I have friends (mostly who have been diagnosed since childhood) who rarely or never take the meds and do OK. So I'd say just focus right now on learning how to use your focus and building some skills, and then talk with your doc down the line about trying some days off.
posted by lunasol at 8:19 PM on April 23, 2012 [3 favorites]

Taking Vyvanse makes me feel like I'm in that fairy tale about the woman who hopes to spend three days measuring cloth, but instead spends it sneezing. I've mentioned here before sometimes it just means that I read AskMe really, really well. I still need to remember to do the dumb things I've got to do. To Do lists and calendar entries work best for me.

Remember that your body still needs food even if you're not hungry. Same for water. Otherwise you'll a) get cranky in the afternoon and b) eat everything that stands still once the Vyvanse wears off in the evening.
posted by The corpse in the library at 9:14 PM on April 23, 2012 [4 favorites]

I've found to-do lists only work if I read them. So actually what I do is add them as "events" on my phone, set a time for them, and an alarm (often several alarms!) to go off to remind me to do it. I'm never not with my phone (I rarely forget it) so it's a great tool.

I keep fantasizing about creating the ultimate ADHD app for the mobile phone:
  • Either based on past travel or by manual entry, it would know how long it takes to get to/from work/school
  • Based on that, it would start nudging you to get going in the mornings (or evenings before heading home) and listing the things you need to take care of in the morning and how much time you have left ("10 minutes before you have to leave for work! Make sure you have all your belongings packed up in your bag; don't forget your lunch, computer, keys, books, etc.").
  • At the end of the day, it would start posting reminders of when you have to start wrapping up your work, especially if you need to catch a train or bus home.
  • It would remind you about day-to-day/week-to-week things, the kinds of things no one normally puts into their calendar (when have you last cleaned this room/have you organized your bills for this week yet/gotten refills of your meds [this is a particularly big deal since most ADHD meds are controlled substances normally so you have to go threw hoops to get them (no refills; have to have the physical prescription on hand)].)
  • As soon as you arrived at work/school, it would pop up a quick dialog asking about main goals for the day and how they break down into smaller tasks. Throughout the day, it would gently nudge you about the small tasks and goals, and also let you add additional tasks
  • At the end of the day it would let you review what you wanted to get done vs. what you did get done, and if you fell short, would start figuring this out so that next time it might say something like "Hmm... that seems like a lot of items. Maybe focus on just a few of these so you're not overwhelmed?"
  • Also, it'd be cool if somehow it could reassure you every so often, let you know that you're doing just fine and that you have people who think you're awesome.
Until then (i.e. never), you're going to have to rely on a hodgepodge of technology and habits to get everything done.

If you've never ever taken ADHD meds before, I think you'll be very pleasantly surprised at how profound the change will be.

I would recommend holding off on specific strategies other than basic reminder systems until you can discover how your brain works on the meds.

Someone upthread noted appetite suppression. I've taken the meds for so long that it's not as much of a problem anymore, but I can definitely forget to take lunch if I'm medicated; this never happens if I'm not. You may find it is easier to establish routines when medicated. If so, go for it and definitely make lunch part of that routine.

Your focus *seems* to be on work. I found that ADHD meds had a *profound* effect on my social interactions with others. If you find yourself unable to shut your mouth during conversation, try having talks with friends and coworkers while medicated and see if there's a difference.
posted by Deathalicious at 12:53 AM on April 24, 2012 [4 favorites]

Remember that your body still needs food even if you're not hungry. Same for water. Otherwise you'll a) get cranky in the afternoon and b) eat everything that stands still once the Vyvanse wears off in the evening.

Yes, keep an eye on food intake. Vyvanse made me (or allowed me to?) not eat all day long. This was not good for my health. You may also need a bit more protein than normal, as the drug seems to make you burn through neurotransmitters more quickly than normal. It did for me.

As for the evening hunger games- I get this really bad with Adderall, because in my system it washes out quicker. Never had the problem with Vyvanse. (The opposite, really. It actually lasted too long for me and built up over time. *) The first solution is to make sure you are eating enough during the day, because hunger denied is hunger delayed with these drugs. If I eat sensibly, no problems. If I don't, I end up at Taco Bell at 9pm.

More organizational stuff- I found it a bit disconcerting at first to actually complete things I started, because I had lived my entire life with a sword of Damocles over my head of unfinished stuff. The stress of this was a way of self medicating- the adrenalin of trying to do two hours of laundry in 45 minutes before an important appointment really has a way of focusing the mind, and I equated that stress with being productive. So when I am medicated and am able to just complete things without stress, I can feel unproductive. Because my measure of productivity was how stressed I was, and the bursting of the stress bubble (that awesome feeling of completing a project at the last possible second), instead of actually just dispassionately looking back at things that were done.

(*) Get a blood pressure cuff and try to get in the habit of taking your blood pressure in the AM before meds. Vyvanse will likely raise your BP a little, but then it should stay steady after a week or so. If you note that it keeps going up, mention it to your doctor.
posted by gjc at 6:35 AM on April 24, 2012 [3 favorites]

Agree with others on to-do lists. I'd always used them to some extent, but I've gone into overdrive now. I used to flag messages on Outlook on occasion, and then forget about them; now my Tasks list & flagged emails are a crucial part of my workflow. Everything is sync'd on my iPhone and I update my Reminders (which syncs with Outlook Tasks) from everywhere, every time I think of something I need to do. I also use Evernote for longer lists and to make notes on other topics. These ideas used to flit through my head but I never took the opportunity to write them down. It's so much better. I also notice that I recognize much sooner when a system is not working for me, which is great.

I also immediately noticed the problem of dry mouth, and had to start carrying water bottles everywhere at work and home. I'd never really been one to notice being thirsty before, but now I am thirsty all the time. I haven't had much issue with not eating, though.
I do suggest that you avoid caffeine entirely at first, maybe introducing it later once you can see how the drug works with you. The combination of caffeine and stims is something I am still working out, but I can tell you that caffeine renders the drug slightly ineffective for me.
posted by aabbbiee at 9:37 AM on April 24, 2012 [1 favorite]

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