Adult ADHD without medication
August 4, 2016 7:35 AM   Subscribe

Some people have commented that they think I have adult ADHD. I'm starting to believe them. What can I do about it if I don't want to take medication?

After some recurring issues at work, I reached out to a former manager who was really critical of me when we worked together, but with whom I now have a good relationship, and asked her for advice. She mentioned that she has a new employee who reminded her a lot of me. Apparently he was recently diagnosed with ADHD and prescribed Ritalin or whatever, and now he's like employee of the year. It got me thinking. I asked my wife, who's a therapist (she specializes in a different area of mental health), and she agreed that I fit the criteria, although she obviously won't diagnose me herself.

Specifically, what I'm most concerned about is my inability to finish projects. For example, I've played around with web development for my own amusement the past couple of years, and recently I've thought about taking it more seriously - putting together a portfolio and maybe applying to some jobs. But when I look at the projects I've "done", they're all half-finished. The front page looks nice, but there are no individual pages, or they're littered with alt text because I haven't actually bothered to create images yet. I want to be able to complete the projects I start before I'm distracted by another idea. There are other examples in other areas of my life, but this is what's on my mind now.

So I'd like to do something about it. The thing is, I have ZERO interest in medications like Ritalin, Adderall, etc. Just not something I want to mess with. Between the side effects, the possibility of being dependent, and the fact that they're commonly abused, I'm not interested. I don't really have much interest in therapy, either. My wife is pregnant, so I'm saving my PTO at work for when the baby's born, and I'd like to save money for it as well. A $20 copay or whatever for a therapist won't break my budget, but it's money I could be putting toward the baby.

So for the time being, at least, my option is self-treatment. I'm looking for suggestions for managing my possible ADHD/definite distractability myself, at home. Everything from therapist-suggested practices to pseudoscientific life hacks are welcome. For reference, I've already tried the Pomodoro technique (it works for me at home, but not so great while I'm at work, due to the nature of my job), and meditating through Headspace (put me to sleep). What else do you suggest? Thanks in advance.
posted by anonymous to Health & Fitness (24 answers total) 45 users marked this as a favorite
Meditation works. Give yourself the space, time and permission to step outside of yourself and just sit.

Let your mind have a designated time during your day to roam as freely as it likes, and very soon you'll discover that it will settle down some.
posted by Lipstick Thespian at 7:39 AM on August 4, 2016 [2 favorites]

Calm, clean environments in which to work are super important to me. If stuff around me is disorganized, my ADHD flares up and, medication or not, I have trouble working.
posted by griphus at 7:41 AM on August 4, 2016 [5 favorites]

Maybe meditating in the morning instead of the evening so you can "Set an intention" for the day and then keep that with you and return to it. For me the big difference between the way my (ADHD) partner thinks and the way I do is that he rarely "circles back" to whatever else he was thinking and doing so he can be like "OK let's start this project" and work on it, but if something else comes up he'll literally never get back around to "What was that thing I was working on...?" so different techniques for that--from post-its on a monitor to a rubber band on your wrist--can help.

Other things that worked for him (besides Wellbutrin which was a game changer for him and not a Ritalin/Adderall thing, just tossing that out there)

- aggressive exercise - like he works out for an hour+ a few days a week and this tires him out a bit so he can focus
- going easy on the caffeine so he is not self-medicating with it
- LOTS OF LISTS - he uses an app called Wunderlist and a ton of reminders and his smartphone is basically his offboard brain, pinging him all the time that a thing is coming up or did he remember to do the thing
- managing stressors because when he gets stressed is when his ADHD "flares" and when other things fall apart, exacerbating stress and spiralling, same with getting enough sleep, he works on sleep hygiene like it's his job

A $20 copay or whatever for a therapist won't break my budget, but it's money I could be putting toward the baby.

Money spent on good therapy that works is actually money that is going towards the baby. A lot of people who are dealing with various minor stressors spend too much time and energy looking at what they don't want to do for "reasons" that are actually just low-level anxieties about dealing with the thing. The metaphor that a lot of people use is one of a parasite. The ADHD brain doesn't WANT to be different and so tosses up roadblocks to keep you from learning to better manage these things. Once you get used to seeing this in people managing depression, anxiety (that is me!), ADHD, OCD and a host of other things, you start seeing the patterns on how people first approach these things. And often the partners of ADHD people wind up shouldering a lot of the responsibility for keeping the ADHD person on track at home and that can be tiring.

You don't have to try therapy or medication now or ever, but don't close them off as routes that might help. Different people respond well to different things and you should keep your mind open to what works for you.
posted by jessamyn at 7:50 AM on August 4, 2016 [34 favorites]

- aggressive exercise - like he works out for an hour+ a few days a week and this tires him out a bit so he can focus

Oh, yes, very much this. My ability to concentrate is definitely more consistent when I am regularly exercising.
posted by griphus at 7:55 AM on August 4, 2016 [1 favorite]

Hi, I am a cisgender woman who was diagnosed with adult ADHD (inattentive type, vs hyperactive type) almost a decade ago. ADHD can be a very different experience depending on your sex and gender identity, as well as the type of ADHD with which your symptoms tend to align.

It was about 2-3 years of therapy before I ever started any ADHD medication. When I did take medication, it was my choice and my psychiatrist was pleased that I had already been seeing a therapist for ADHD-specific cognitive behavioral therapy for several years.

ADHD medications are tools. Hell, they are power tools. And like any power tool, you need to understand its limitations - as well as its risks - before you begin to use it. You need to know how to be a responsible user. (Otherwise, you just end up organizing your sock and silverware drawers for four hours while every other important thing fades to the background.) So even if you WANTED to be on medication, I wouldn't advise you to do that, anyway, without first seeking therapy for at least several months. You don't need ADHD meds to succeed. There are so many other options available to you. That's the great news!

Once you're in a position to pay for a therapist: it is so, so critical to your health, happiness and productivity that you find a great therapist, ideally who specializes in adult ADHD, to help you learn who you are: what are your habits (both good and bad), what are your problem areas (executive functioning? focus?).

In the meantime, I would recommend finding the following books at your local library. If reading is difficult, I'd see if your library has the audiobook version, or if they can Interlibrary Loan (ILL) a copy of the audiobook for you:
- Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder
- Driven to Distraction at Work: How to Focus and Be More Productive
- You Mean I'm Not Lazy, Crazy or Stupid? The Classic Self-Help Book for Adults with Attention Deficit Disorder
- The Mindfulness Prescription for Adult ADHD: An 8-Step Program for Strengthening Attention, Managing Emotions, and Achieving Your Goals

Join an ADHD discussion board online. That way you can talk to others in similar situations, which will help you not only make sense of the information in these books, but feel less 'alone' as you explore the nuances of ADHD.

You may discover, after reading these books, that the ADHD profile doesn't suit you. But until you can afford to see a therapist, this is a great way to learn what your specific needs are, and what strategies may be best for you to work with those needs.

Also, nthing others who emphasize exercise. Exercise exercise exercise. Wear your butt out. I love to talk about High Impact Interval Training (HIIT) on here- it's perfect for ADHDers. Stimulating and doesn't last too long; has so many options to prevent boredom. You can be done with your cardio workout in 15 minutes.
posted by nightrecordings at 7:56 AM on August 4, 2016 [18 favorites]

Respectfully, I think you might need to rethink your stance on medication.

I'm pretty leery of psychoactive medication, but a surprisingly low dose of ritalin has been life changing. I take a small amount about three times a day when I'm at work, as it clears my system pretty quickly, and I don't take any over the weekend. Taking ritalin feels like putting on glasses. It's like the chatter goes down in my brain. I feel calm and focused.

If you really want to deal with this, find a psychiatrist and get diagnosed. You may not have ADHD at all. Then talk about treatment options with someone who specializes in this. Please don't dismiss medication. For me, they've been pivotal in getting my (frankly, pretty severe) ADHD under control.
posted by nerdfish at 8:01 AM on August 4, 2016 [9 favorites]

This askme and its (excellent not grumpy!) meTa are full of people sharing symptoms and strategies - including medication - for managing their ADD/ADHD.
posted by rtha at 8:09 AM on August 4, 2016 [9 favorites]

A person doesn't have to plan on taking medication for the rest of your life to see the benefits. I took meds for a period of a few years and it gave me the clarity I needed to straighten out my understanding of social cues and my own poor habits. I haven't taken any meds in probably ten years, but I still benefit from the things they gave me a chance to learn.

You might consider meeting with a psychiatrist and discuss your concerns about meds with them. Respectfully, the alarmism you're voicing about medication sounds more like the terrible misinformed things people say as part of prejudice against treatment for learning disabilities and mental illness than it does well-founded concern.

If you had an issue in your lungs that made it difficult for you to get things done at work, caused you to regularly crap out before finishing projects... you'd take meds for that without blinking. Don't let people convince you that if the problem is fifteen inches higher and you take meds for it that you're abusing drugs or failing morally in some way. You deserve to be able to help yourself the same as anyone else.
posted by DirtyOldTown at 8:17 AM on August 4, 2016 [6 favorites]

You're doing yourself a disservice my dismissing all medication without speaking to a professional. To start with there are a huge variety of medications these days, all of which work and act completely differently -- so to dismiss them en masse, is a bit reactionary. There are the traditional stimulants (adderall, ritalin), the newer 'defanged' stimulants (strattera), anti-depressants (wellbutrin), and even completely novel mechanism of actions (modafinil, armodafinil). All of these are prescribed at some level to people for ADHD.

Keep in mind that when you look at a list of side effects, or read a bunch of stories on the internet about how bad these medicines are -- it's just as easy to find the exact same article with the word 'vaccine' instead of 'adderall'.
posted by so fucking future at 8:20 AM on August 4, 2016 [3 favorites]

You may choose not to go forward with weekly (or whatever) counseling, but you should get a diagnosis. Your doctor will also help you find ways to manage your symptoms and clear up some of those misconceptions around medication. They will also tell you that medication can't learn the skills for you - you still have to find other ways of managing your symptoms, which is what you want and are asking for here.

Instead of crying on the floor with socks scattered all around from my BS procrastination project, saying, "I can't do this, I can't do school anymore," I'm finding myself saying, "I already did it, and a bunch of other things."

Find a doctor and see what they say.
posted by meemzi at 9:16 AM on August 4, 2016 [1 favorite]

I've found the book ADD-Friendly Ways to Organize Your Life to be tremendously helpful. Let me tell you why.

First off, it really opened my eyes as to what ADD is. Like most people, I thought of the disorder as just being easily distracted and unable to focus. But it actually affects many aspects of cognition, including memory and time perception. Assuming your self-diagnosis is correct, I expect the book will be a real eye-opener.

Secondly, although the book doesn't talk about this directly, it's important to realize that many symptoms of ADD are not greatly affected by mediation. I can focus much better with Vyvanse, but if anything that extra focus exacerbates my difficulty with judging the passage of time. I remain very much in favor of medication for adults when appropriate, but it's not a cure-all.

And thirdly, as you might expect from the title, the book gives practical information on living with ADD that does not assume that you're medicated, much less that the medication is all you need.

I can't recommend it highly enough. I'd suggest you check it out even if you don't seek a diagnosis.
posted by lore at 9:48 AM on August 4, 2016 [6 favorites]

In terms of ADD/ADHD, everything that jessamyn said - especially the exercise bit.

Also, according to my doctor, the meds that I take don't work as well if you don't get adequate sleep.
So, even if you don't go with the medication route, give your mind time to process with sleep (and meditation). Even when I feel I'm strapped for time, I try to take a walk at lunch time while listening to a walking meditation to help me center for the afternoon.

I also suggest finding some productivity method to go along with list. Until I get into a project (or when I have lots of little tasks), I really need to chunk my list into smaller parts and use the pomodoro method (25-30 min work/5 minute break) to keep moving. It isn't always perfect, but reminding yourself "15 minutes until I can take a break" is a whole lot easier than "I need to focus to get this done".

And try to see a therapist to figure out your options - ADD/ADHD can lead to depression (among other things) and it is much easier to get a handle on things if you catch it early.
posted by TofuGolem at 10:00 AM on August 4, 2016

I have ADHD, as well as some learning disabilities. I didn't take meds until I was 38 years old (almost 4 years ago). I can tell you that meds have helped me a lot-my best example is now I can do laundry, fold it and put it away all within a normal amount of time. For things like this-day to day stuff I struggled to get done, it has been great, and it has lead me to recognize the tasks and modifications that I can do to help me feel more in control of my life. It has helped with things that have an A, B, C or 1, 2, 3 pattern. When it comes to work projects or projects for the degree I am working on, medication helps me to sit still, but it doesn't help me write my papers, or really be able to see the many steps that a work project where there aren't clear steps, and some of the steps require stepping backwards or sideways in order to move on, if that makes sense.

Just recently the stars aligned and I am able to have a full neuro-psych re-evaluation for the first time in 24 years- before now my insurance didn't cover it and I didn't have a flexible spending account. So much of what we know about ADHD, as well as other learning disabilities have changed in recent years, and I highly recommend, if you can access it, having that sort of evaluation done.
posted by momochan at 10:02 AM on August 4, 2016 [1 favorite]

Stimulants don't help me (they make me feel terrible, in fact), but seconding that you might want to look into other types of meds such as Strattera or Wellbutrin.

For me, the things that help the most are, as mentioned numerous times above, vigorous exercise, every day (sometimes multiple times a day), being out in nature, avoiding the hell out of sugar, eating lots of vegetables every day, and drinking light stimulants such as green tea when I'm feeling dazed and unfocused. At work, I also write down absolutely everything I need to do on a to-do list that will never get lost or misplaced, and refer to it multiple times a day.
posted by whistle pig at 10:23 AM on August 4, 2016

In terms of self-help resources, I've heard great things about The Adult ADHD Toolkit by Russell Ramsay and Anthony Rostain, who run the adult ADHD program at the University of Pennsylvania.
posted by Keter at 10:24 AM on August 4, 2016 [5 favorites]

I don't have ADHD but I have anxiety. It's really helpful for me to identify anxious behaviors and label them as such. For example, sometimes it's hard for me to get out of the house in the morning because I am triple-checking that I have everything, second-guessing the jacket I'm wearing, etc. I realized recently that this is an anxious behavior, so I'm able to say "Brain: shut up, you're fine, let's go."
posted by radioamy at 10:40 AM on August 4, 2016

There are the traditional stimulants (adderall, ritalin), the newer 'defanged' stimulants (strattera), anti-depressants (wellbutrin), and even completely novel mechanism of actions (modafinil, armodafinil).

There's even vayarin which is basically fish oil targeted directly at your brain (currently only FDA approved for children, but I know it is also prescribed to some adults). Not everything is a stimulant, and not everything has potential for abuse!

There are also people working on developing more and more ADHD-targeted CBT. If you're absolutely not willing to consider a professional (though I agree that it is to the baby's benefit, as well) maybe consider trying to do some of the exercises by yourself (this book is one specifically written for professionals but reviews say it helps us plebes too).
posted by R a c h e l at 12:28 PM on August 4, 2016 [2 favorites]

My life under testosterone boymode + ADD required a lot of coffee and cigarettes, for a few years I medicated with green tea.

My life now is estrogen girlmode + ADD. I no longer smoke but I still medicate with coffee. I now take GABA and a "cortisol calm" that has ashwagandha in it to help me get to sleep at night.

I find strict adherence to ritual is important. My experience with having young babies really exacerbated the worst parts of my ADD so I recommend taking space for yourself and trying to maintain some kind of routine if you can.

Basically for me it's coffee, routine and good sleep that keeps me *somewhat* on the rails, but I still struggle to finish projects and all the related depression that comes from feeling like I'll never measure up, etc.
posted by Annika Cicada at 2:01 PM on August 4, 2016 [1 favorite]

You can always get screened for ADHD to see if you have it, and you can engage in CBT and other time management routines. And you can drink a shitload of coffee, since caffeine stimulates the central nervous system in the same way ADHD stimulants do.

I didn't know there was a name for the productive time/break time thing! I do that on weekends when I have big projects or a lot of chores to do, and now I have a way to describe it. Cool.
posted by Autumnheart at 2:05 PM on August 4, 2016

caffeine stimulates the central nervous system in the same way ADHD stimulants do

Ugh, I wish, but the evidence that caffeine actually helps for ADHD is very thin. Caffeine and amphetamine/Ritalin-based stimulants work differently, so I guess it's not super surprising.
posted by en forme de poire at 7:14 PM on August 4, 2016

My own ranking of things that helped: regular CBT < an SNRI < mindfulness meditation (daily plus one 45m session a week was my minimum effective dose) ~= exercise (heavy weightlifting or heavy cardio) << mixed amphetamine salts.

Regular CBT and an SNRI made me more sanguine about my situation but didn't change a lot of my ADHD symptoms. I've noticed changes from mindfulness meditation and exercise in the past. However, honestly, neither helped nearly as much as amphetamines.

The nice thing about amphetamines/methylphenidate is that you can really just take them for a couple of days and then stop. They're out of your system really fast, unlike something like Prozac where the half-life is measured in weeks. It's kind of bittersweet looking back (I don't take them anymore because of stupid thorax problems), but trying amphetamines really put into perspective how much struggling I had just accepted as "normal" that I no longer had to, and I think that was a worthwhile experience.

There are some specialized CBT programs for people with ADHD that might be worth looking into as well. From what little I've read they tend to focus on executive function training, which to someone like me came across kind of like "stuff you know you should be doing already: a program" -- just training yourself to use a planner, and to always have a watch on, and etc. But they have shown some effectiveness in the literature (though mostly the test subjects are already taking stimulants).
posted by en forme de poire at 7:53 PM on August 4, 2016 [3 favorites]

I say this as a mother and a former wife: the best possible gift you can give to your future self as a parent and to your partner is to take your symptoms seriosly enough to get a diagnosis and, if you are determined to have ADHD, to be open-minded enough to consider a variety of approaches. Experiment and see what works best for you. This is your health and saving the $20 copay may be penny wise but pound foolish. You are really going to need all the executive function you can muster when your child is born. So get cracking on the health front and good luck. You're welcome to message me if you like.
posted by Bella Donna at 9:54 PM on August 4, 2016 [4 favorites]

Oops, forgot to mention that I got my ADHD diagnosis in my early 40s. Knowledge is power!
posted by Bella Donna at 4:19 PM on August 5, 2016 [1 favorite]

Just want to chime in to say there is no shame in being dependent on medication prescribed by a doctor. If it helps, it's better then the alternative. That said, amphetamine dependence is nothing like opioid dependence. It's relatively easy to kick even if you've been on it for months or years

The relief in symptoms would be a greater help to you as a new parent than the extra money unless the $5 or $10 copay for generics would literally leave you unable to buy enough food or whatever. It's worth trying if your doctor agrees that it's what you need. If it does work for you, you will be a much better co-parent.
posted by wierdo at 5:53 PM on August 5, 2016 [1 favorite]

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