Can unproductive people ever become productive?
August 19, 2016 8:45 AM   Subscribe

I'm an anxious, ADHD serial procrastinator and I hate it and sh*t is hitting the fan. It's a longstanding pattern. Is there any hope? How can I possibly move past this?

I’m a woman in my early-mid 20’s. I’ve always struggled with my work ethic, with completing things on time, and especially with procrastination and avoidance. I think many people would see themselves in that, but I do it worse than anyone I know. I faked it through undergrad and grad school and got some impressive degrees, but leaving a lot of bad grades and burned bridges in the dust. Now that I’m working, I can’t just move on when I slack and I’m really in trouble now.

I do better with group-type work, because that accountability and momentum keeps me going for a while (and when I’m going, I’m good at what I do! I like it! I’m intelligent! I’m personable!) but then at some point things get hard or I get behind and the whole avoidance/procrastination cycle takes over until I’ve literally destroyed things for other people. I feel AWFUL AWFUL AWFUL about it and most of the time I literally hate myself. It’s happening on my (amazing and supportive) work team right now and I’m so unhappy all the time and I’m definitely worried I’ll lose my job over this and never really be able to do work this great again (among other things, I'm definitely not gaining positive references here...).

I’ve been diagnosed ADHD (inattentive-type) and I suspect I’d meet the definition for clinical anxiety as well. I have a psychiatrist who has me on a stimulant and some antianxiety medication but I don’t think that they’re really helping at the heart of the issue at all. I take them because I want to think that I’m doing what I can but really I don’t feel like they help. I do want to try CBD, but I’ve had trouble finding a doctor that will see me (that I can afford) and I’m skeptical that it’ll work in time. The last CBD-offering psychologist I said literally told me that if I’m having trouble getting things done, I probably won’t put in the work to get anything out of therapy, so he didn’t really feel like I wanted this and I shouldn’t be in therapy with him. Encouraging.

Interestingly, one of my siblings struggles with almost exactly the same thing (and our other sibling is noticeably and completely different). Both of us find that when we have momentum and/or when we’re happy about other things, things get easier, but when they’re bad it’s easy to spiral. We both have some coping mechanisms but they’re just not that powerful when the spiral hits.

It’s just depressing, because I feel like I’ve tried a lot (healthy and unhealthy) and it’s just so intractable. It’s my entire life – I can remember these kinds of spirals as early as 4th grade – and I just don’t know if things will ever get better or if I’ll ever be able to be the dependable, productive person I feel like I should be able to be. Or how to cope if I’m not that person. Does this ring a bell for anyone? How do you work with it or move past it? It’s just…so frustrating.
posted by anonymous to Health & Fitness (17 answers total) 61 users marked this as a favorite
Yeah, ADHD can be hard. But it's the anxiety that's causing you to doubt yourself like this. You faked your way through impressive degrees? Unless you sent someone else to take those tests and stole papers off the internet, those degrees and the work they represent are real. Your anxiety around this sounds like a cognitive distortion. (I am not a therapist on the Internet or in real life.)

Get yourself to a good therapist who focuses on ADHD. They'll help you set up routines and the system you need right now. You must make time for this!

Being in school can work well for ADHD folks who require hard deadlines. What's tough in the working world is that we have to set our own deadlines, and then we know they're not hard deadlines.

You can do this. It will take some effort, but I think a good therapist is a great place to start. Good luck!
posted by bluedaisy at 9:19 AM on August 19, 2016 [4 favorites]

Me too to AAAAALLLL OF THIIIIIIS. And it's so frustrating and agonizing to look back on decades during which everybody I went to school with did all the stuff you do as an adult and now has like kids and books and divorces and PhDs and all that shit that they can quote on their gravestones. Here is what I do, when I'm doing anything, which is sometimes.

I have a black moleskine and black warrior pencils. Every day I open up the moleskine and sharpen my black warrior. I write the date. Under the date, I draw a rectangle, which I divide into four smaller evenly sized rectangles. Every two hours, I stand up from my chair and walk down a short hill and up six flights of stairs in a neighboring building. Then I turn around and walk down the top flight to the first riser and walk up it again, this time taking the steps two at a time. I do that twice, starting first on the left leg and then on the right leg, so I'm even. When I'm done with that, I see if I got any texts and I write a text to someone. (texting being one of the approximately 5,973 things I'm addicted to doing instead of writing books or doing my job or keeping children or plants alive or getting a doctorate or flossing). Then I walk back and I sit down and fill in one of the little rectangles with crosshatches--different slants on the crosshatches, depending on which square I'm filling in.

Sometimes I manage to do work in the two-hour blocks between these walks. Sometimes not. Sometimes I actually do all four of the stairclimbs. Very very often not. But I always write the date and I always make the little rectangles. On days when I'm productive, I write down all the stuff I'm doing as I'm doing it, and when I actually do a thing I plan, I put a little checkmark next to the thing. So my moleskine is full of little crosshatched squares and checkmarks on productive days and weeks, and just dates and empty rectangles on bad days and weeks. I don't know if this is helping. But I'm generating a record. I'm observing myself. SOMETHING may come of it. If not, they can list the number of moleskines I fill up on my gravestone. It's something. I'm doing something.
posted by Don Pepino at 10:58 AM on August 19, 2016 [25 favorites]

I am at work and don't have the chance to write a lengthy response, but this is word for word me, only I am a few years older. I think we'd have a lot to talk about. Please feel free to memail me. I have a lot of experience with navigating what you describe and still struggle, just not as much as I did earlier. I would be happy to share advice, tips, or just commiserate. Hugs.
posted by nightrecordings at 11:19 AM on August 19, 2016 [2 favorites]

I don't know if this will help you, but something I've noticed about certain unproductive people is that their attitude towards taking action is negative rather than positive.

In many ways I've had a pretty hard life. And part of having a hard life means having little opportunity to right things that are wrong. Having little or no opportunity to make something good. Rather you just have to sit there and accept that there is nothing you can do but live through the shittiness. Just one example: Being diagnosed with cancer more than once throughout my teens and 20's. But there are many examples. The one good thing about having to live through the shittiness is that I don't take for granted when there's something I CAN DO to change the inevitable. When others are dragging their feet and depressed because they have to get a project done in order to obtain a result. I'm SOOOO grateful and happy that I am able to get a certain result and I can do something to obtain it. Not everyone gets that opportunity man! Just think- There are so many people in the world right now who don't get to say- If I devote two hours into this project right now, I'll be able relax with my family for the rest of the weekend. Or - If I do a few tasks to renovate now, I'll have a nice apartment to live in and have friends over in a few months. Or even- I put in some time to do the laundry now, I'll have nice clean clothes to wear for the rest of the week. So many people in the world CAN'T say these things because they don't have the opportunities that you and I have. Should I tell you about the time I was a minor and couldn't go to the doctor even though I was very sick because my guardian at the time refused to believe I was sick? When I wasn't a minor anymore I was SO GRATEFUL I had the opportunity to pick up the phone and make an appointment with the doctor. Yes, making appointments and trecking to the doctor and waiting there isn't the funnest thing in the world, but I'm really happy to have that opportunity when I didn't before. A lot of people in the world don't have the opportunity to trek to the doctor even as adults. Yet people around me complain that they "have" to do all these things without realizing that being able to do them is a treasure. It's a gift from God. It's hard for me to see others throw those gifts away because I have some sense of what it's like not to have them.

In other words I think it might help if you trained yourself to have a different attitude towards getting things done. Rather than thinking you "have to" do something. Realize that you "want to" do it. Realize you are lucky to have the opportunity to do something that will change your experience of the inevitable future. After a lifetime of having a crappy attitude towards work, it's going to take a while for your brain to take on a grateful attitude, but if you remind yourself daily the inevitable result is that you'll get better and better at it over time.

I'm not saying that you won't have to do other things as well because there are many reasons why someone might have your issue. But I honestly feel that this lack of gratitude is something I see in basically everyone who has a deep procrastination issue no matter what their other issues may be. So I think trying to make this form of thinking a habit will be helpful.
posted by olivetree at 11:20 AM on August 19, 2016 [11 favorites]

I suggest you get some basic testing. You sound twice exceptional -- gifted and learning disabled. Getting an identification can help enormously.

In the mean time, google up info on "twice exceptional" or "2xE" and start reading. Perhaps join some online support groups.

2xE individuals are bright people. Like any bright person, they get bored and cranky and fail to focus when they have to do stuff that is not sufficiently engaging and mentally challenging. But they often wind up stuck with such tasks because they appear "average" to outsiders looking in. They can also get tripped up and completely derailed by something seemingly small that wouldn't be an issue for most bright people.

This combination often results in them being stuck in classes or jobs that make them simply miserable. They get held back from doing things that they could do well because of some minor failure that serves a gatekeeping purpose. Ironically, once you have Made It, you may have an assistant taking care of the thing that trips you up so bad. But first you have to get there.

A proper identification is the first step in escaping this "you just can't get there from here" trap. I was able to go back to school and eventually got a job after being unemployable for most of my adult life and hiding out behind the label of "homemaker." A proper diagnosis of my handicap was extremely empowering. I get a lot more done these days. (Mine is medical in nature.)
posted by Michele in California at 11:22 AM on August 19, 2016 [8 favorites]

I relate to a lot of what you've said. This might sound counterintuitive, but I'm feeling a bit better about myself at work now that I have more projects and deadlines to juggle. It forces me to produce on a somewhat regular basis, and this enhances my self-esteem and confidence. When there isn't as much to do, it's like riding a slow-moving train, and I'm more likely to disembark and play around in the woods before realizing that, oh shit, the train is a mile away now and I have to run to catch it.

Can you pack your days more tightly? Take on projects with fast-ish deadlines? Volunteer to do things that help colleagues, so you have to pass a deliverable to them at a certain time? I think the goal is to have more deadlines in your day and your week, so that even if you're producing at the last minute (like me), you're still guaranteed to produce several times a week, due to the tyranny of the deadline.

I predict that if you're hitting send on several deliverables a week, you'll start to feel better about yourself at work. Address the anxiety on an ongoing basis, but in the meantime, set yourself up to crank through tasks and get them into expectant hands as much as possible.
posted by delight at 11:42 AM on August 19, 2016 [7 favorites]

Oh, ditto to what nightrecordings said--please memail if you would like.
posted by Don Pepino at 11:44 AM on August 19, 2016

I'm so sorry. I know what this panic can be like.

First, tell your psychiatrist what's going on and that you need help getting through the current crunch time, and beyond.

Second, get the work done that you're behind on. Or confess to someone that you need help catching up. The goal here is to take the pressure off so that you can focus on getting good strategies in place. Finding a good therapist does take a little time.

Third, do find a therapist to address the underlying anxiety. This really is a good one for CBT. You'll be amazed at how fast change can happen. If you can't afford a therapist, ask MetaFilter again to learn the kind of mantras and tools people use.

Good luck! You can overcome this.
posted by salvia at 1:42 PM on August 19, 2016 [1 favorite]

DISCLAIMER: I help people exactly like you as my job.

This means that I've had a ton of conversations with people who feel disorganized, because they present in a certain way or have a medical issue such as ADHD. But what most people don't talk about is that there are different organizational/work styles - it's somewhat similar to the way different people learn (eg auditory, visual, kinaesthetic) or the way some people are detail-oriented while others are not.

My biggest piece of advice is to (1) be kind to yourself, (2) slow down, and (3) once you find something that works for you, stick with it even if you don't know anyone else who approaches things the way you do.

Best of luck! (And feel free to memail me of you ever have any questions)
posted by A hidden well at 2:21 PM on August 19, 2016 [7 favorites]

I'm you 30 years later, and I've worked it out. I work calmly and consistently, with great commitment. I've learned to be a happy worker ant (blithely rebuilding destroyed anthills, blithely moving grains of sand from over here to over there, etc) without losing higher perspective or enthusiasm (i.e. I haven't turned numbly mulish). Here's the short version:

Your natural drive is obviously to do the work, enjoy the camaraderie, and get things done. Take solace in knowing this as bedrock truth. That's clearly your basic, engrained inclination, and that's very good (it's not true of everyone!). You are, however, thwarted by ambivalent impulses. Like computer daemons, these are background programs, many having long ago outlived their usefulness, creating complexity and friction and generally perplexing the heck out of you.

They're not complicated (they're the flotsam of previous floundering attempts to address primal fears), but, in sum, they create the appearance of complication.

I'm not convinced it's a MOOD thing. You've got the underlying work ethic (you write about it with convincing passion; you couldn't fake it so well!), so you don't need artificial means to goose your enthusiasm or perk up (those options are for people lacking the basic, engrained inclination). It sounds like it's an AMBIVALENCE thing - your natural inertia gets disrupted by unconscious counter-currents (i.e. daemons). Stimulants and such would simply hop up the entire mixed bag of conflicted impulses.

Here's the revelation: all those impulses and daemons can stay! You needn't erase them (and couldn't if you wanted to). But you can learn to let go, generally (any sensation of "letting go" is always a release of exactly that sort of back-of-the-mind stuff). Therapy (where the unconscious stuff is made conscious, so it's no longer this daunting invisible force) is one way, and works for some. I went another way.

I did five years of intense yoga asana, in the widely-popular Iyengar system, which is extra rigorous re: form and safety (Tai Chi is also good, or any other martial art, or dance, or even just intense very regular exercise...just BODY stuff, y'know?).

Once I was calm enough, I took on a twice-daily meditation practice (this is the simplest, most non-idealogical practice I've found, and it works wonderfully, though I'd recommend avoiding the author's web site and extended product line, aside from the Pranayama book; just steal the (excellent) bait).

Fifteen years after THAT, the counter-currents/daemons remain, but I watch them kindly from afar, and they're well-known to me - as familiar and neutrally accepted as my bookshelves and flower pots. Who I really am at heart - the guy who likes the work and the camaraderie - is what's expressed. The other stuff hovers, but no longer drives the car.

It's a process of simplification, of letting go, of quieting, and of feeling less and less at-stake. Your urge to do well, again, has some passion to it. You can channel that passion without having it sour into neediness, guilt, exasperation, and self-hatred when the universe fails to match up with your expectations. When myriad strings pull at you, the thing to do is embark on a passionately eager systematic course of letting go. You won't fall, you'll float.
posted by Quisp Lover at 2:44 PM on August 19, 2016 [23 favorites]

I dealt with similar feelings in my 20’s, though perhaps not as acute. I've gotten better, and A hidden well said it much more succinctly than I could:

(1) be kind to yourself, (2) slow down, and (3) once you find something that works for you, stick with it even if you don't know anyone else who approaches things the way you do.

Of course, this is all easier said than done. These are the things that helped me become more productive and less anxious. They may not work for you but are examples of how you might work with your temperament rather than against it.

In terms of being kind to myself, I remind myself that I'm probably overestimating how productive others are. Most people can only get a couple of things done per day before running out of time or energy, and often those things are useless meetings. So when I have a slow day I try not to beat myself up for being what is probably average. I also try to just get jobs done rather than done perfectly. I was an anxious person and tried to make everything perfect. But my “perfect” is not necessarily everyone else's. I realized I'm almost always going to get some kind of feedback, so I have tried to just get things done and worry less about being perfect. Slowly, I've gotten used to the idea that “just good enough” is often all that's needed. This has helped my procrastination a lot.

Slowing down - I try to choose just 1-3 things to do each day, and that's it. If I have a big task, I'll give myself several days to work on it and not do much else those days. Doing less actually makes me more productive because I make real progress on one or two tasks rather than flailing on 5. Not everyone can structure their workdays this way, but the point is focusing on fewer things can relieve some pressure and let you get more done long-term.

Finally, something that works for me. This may not work for you but is just an example system: I have embraced my smartphone addiction as a strength. If I try to remember everything, my mind will fail me every time, so I outsource what I'm bad at. I'm always on my smartphone, which doesn't forget and can remind me of what to do. Every task goes in one of 3 places: 1) “to do later” list (i.e., things I will probably never do but feel guilty forgetting) 2) “to do soon” (needs to get done but not urgently enough to schedule) 3) on my calendar with time blocked off to do it. I always allocate twice as long as I expect things to take. If I finish early, great, if I procrastinate or go slowly then there's still time to jet to work. If I don't know exactly when I'll do something it goes on the calendar for an arbitrary time this week or next, and if I get distracted or just don't finish I forgive myself and just move the appointment later. But I'm much more productive if 9-10:30 is document writing time and 10:30-11 is break time / MeFi time. Scheduling realistic breaks helps - I know I'm not getting back to work in 15 minutes, but I can probably hunker down after lunch.

Like I said, these examples may not work for you. But maybe you can begin to find a rhythm where you feel happy and productive. It took me until I was 28 to start to feel that way and at 31 I have finally hit my stride. So be kind to yourself and give yourself some time.
posted by Tehhund at 6:01 PM on August 19, 2016 [5 favorites]

Just popping back in to note that A hidden well's note to "be kind to yourself" is really smart. Tendency toward self-criticism, self-sabotaging, and self-hatred are a big chunk of the "daemons" I referred to. That stuff's all headwind, sapping energy and disrupting momentum. Minor shifts of perspective can be surprisingly effective - perspective gets frozen when we forget we have the freedom to make another choice. "Be kind to yourself" is an important shift for you. And it pays off a lot sooner than my long term program of letting go.

Mind you, that's not advice you'd want to give to just anyone. Lots of people (maybe even most) need to be much more self-critical! But as I said (and it looks like A hidden well gets the same vibe), your fundamental drives are good. Your oceanic currents are fine, the disruption comes from an aggregation of mere minor waftings. As is very often the case in life, cause/effect may be topsy-turvy here. Maybe you're not getting upset with yourself because you derail; maybe you're derailing because you get upset with yourself.

Maybe you need to see in yourself what me and A hidden well see....someone who deserves believing in. Shoot, in your original posting, you yourself seem to recognize your "basic, engrained inclination" as I described it; you've got sufficiently clear witness to recognize this, which is helpful. So work from that clearer witness, and ease up drastically on the self-criticism, which is starting to become your Mazlow Hammer. Be kind to yourself. Yup.

(Also, A hidden well seems wise; I'd take her up on her PM offer)

Finally, I'll bury this little easter egg: work for the good of your coworkers, or for the users of whatever you're building, or for your favorite deity or your dead ancestors, or for those of us (including us right here) who believe in you. Work for any reason but to "prove yourself" or "be successful". Don't do stuff for you. Do what you do to delight the angels.
posted by Quisp Lover at 9:12 AM on August 20, 2016 [5 favorites]

I did five years of intense yoga asana... Once I was calm enough, I took on a twice-daily meditation practice... Fifteen years after THAT, the counter-currents/daemons remain, but I watch them kindly from afar

The beauty of CBT is that in about, I dunno, four months, you can make decent progress identifying a fair number of these daemons* and writing programs that counteract them. And fairly quickly, your mind will clean up the code to eliminate the redundancy of "Daemon1" followed by CBT-installed "Counter-Daemon1." I am impressed by the decades of effort described, but you can make serious progress much more quickly that that if you want to.

* I don't really know what a daemon is, so hopefully I'm doing this right.
posted by salvia at 11:04 PM on August 21, 2016 [1 favorite]

Popping in to say that this is NOT just you. I have a slightly different diagnosis, but other than that, what you're describing is exactly what I feel much of the time. The self-hatred, the guilt, the overwhelming anxiety, the unshakeable belief that you're wasting your life -- I get that. The downward spiral is a beast.

I do find that it's worse when I'm in a more unstructured environment. If I'm relatively busy, I actually get things done and don't have much time to be in an anxious spiral -- though there is a balance to be struck, because if there are TOO many things on my plate, I get overwhelmed and shut down.

Also, I find that there are elements of perfectionism and need for external validation to my anxiety, which I think is pretty common among people like you and me. Does that sound familiar? I always have to remind myself that good enough is good enough. The paper or report or whatever doesn't have to be brilliant and groundbreaking; it just has to be DONE and good enough. You may not always receive the A+ or the "wow awesome job!" -- but that mark of external validation doesn't actually MEAN much. The thing will be done, which is loads better than not done, and you can move on. (I say this as if it's easy to internalize, but it's not, and I still struggle with it every day.)

Feel free to MeMail me if you need commiseration. I don't have it figured out at all (to wit, it's 2am, and I'm on MeFi, so what does that tell you), but I'm happy to chat.
posted by Ragini at 1:32 PM on August 22, 2016 [3 favorites]

I'm in a similar boat as you. Starting a bullet journal has been completely invaluable to me in terms of remembering appointments and events, making sure I get things done on time, and planning upcoming next steps.

When I say "bullet journal" I'm not talking about the #studyspo, washi taped, handlettered artsy kind of bullet journal. That's all gorgeous, but it's totally unsustainable (at least for me).

I'm talking the bare bones system--future log of upcoming things to do or remember, list of monthly events and to-dos, and a daily to-do list where every item at the end of the day is either checked off, moved back to monthly to-dos, moved forward to tomorrow's to-do list, or scratched out. You can add whatever other pages you want/need, but that's really the engine that keeps this going for me.

This is the only to-do list I've ever used that I've been able to use and stick with and that actually helps me keep track of things that I have going on and get them done. I suspect it's partially because I love stationery anyway and this gives me an excuse to buy awesome pens and notebooks?

Either way, I think the trick is finding something (or multiple somethings) that will serve as a motivation tool as well as a planner/tracker. The hardest part of work projects (for me, and maybe also for you?) is getting started on them and not skiving off and ignoring it when you run into a minor obstacle. Having a big sexy checkbox to cross off makes it easier for me to power through the pain of writing an email or working on a project I don't want to do.

Quick aside: do you have the kind of relationship with your boss or team where you could speak frankly with them about this issue? You don't have to tell them anything you don't want to, but just to let them know that you're working to improve at work and ask them for what you need from them to make it easier for you, whether it be hard deadlines or more collaborative projects or whatever works best.

Don't let this mess with you. You are clearly wanting to do better and are smart enough to have made it this far, and that's not nothing, even if you're feeling stressed out by missed deadlines. Once you find what works for you, things are going to feel so much better. :) Good luck!
posted by helloimjennsco at 10:53 AM on August 23, 2016 [1 favorite]

I am impressed by the decades of effort described, but you can make serious progress much more quickly that that if you want to.

I'm the one whose decades of effort impressed you.

People don't change much. This becomes much clearer as you reach your 50s, and get to observe people over a long run. There's truly very little latitude. And what's being discussed is deep, fundamental change, which is very rare indeed. Perhaps it can be done quickly. But I'm shocked the other way - by the surprising speed of it. I never thought it would be possible at all, so a couple of decades seems like nothing. It's a worthy lifetime's work.

And (this is the important part), it felt great the whole way. Opening up and letting go feel so fantastic that I quite honestly wonder why anyone would turn to drugs. I wasn't plowing mulishly toward radical change, just enjoying each step of getting a little looser and clearer. I'm not sure I even believe in fast change. As-is, I'm 100% confident I won't snap back, because I went one step at a time, and "brought myself along" the whole way, in all the fractured components that comprise a person. Faster process would have probably constituted more of a bandaid.
posted by Quisp Lover at 2:15 PM on December 16, 2016 [2 favorites]

This post is from a while ago so I don't know how you're doing now anon, but I could have easily written this post myself. I have ADHD-PI, and have struggled with depression and anxiety issues my entire life. I got diagnosed with ADHD in my late 20s and when a trial run with Ritalin didn't prove to be the magic "it's like I turned on the on switch" bullet that so many ADHDers claim it to be, I gave up on the idea of ADHD meds and tried talk therapy for the next few years.

Fast forward several years later, and despite talking about behavioural modifications at length for 1 hour every 2 weeks with a therapist, I had made very little progress. I had identified some coping mechanisms that worked for me, like external structures (e.g. your group work where there is an accountability system that keeps you in check), but I still had immense difficulty accepting my failures, my successes, and the fact that I was making progress so slowly. I had difficulty accepting the fact that I would just wallow in nothingness and sit on my ass doing absolutely nothing for hours and spacing the fuck out. It was depressing me, because I too have always had a high work ethic (or so I thought) and wanted to accomplish something with my life, and I felt like my ADHD was letting me down, and for years I was internalizing all of these feelings.

So I finally did some research on ADHD medication and decided to give Strattera try. Now, this is the second path of ADHD meds, what doctors might prescribe if stimulants don't work or if the patient has some medical issues with stimulants or abuse history, etc. I'd heard nothing but horror stories, as the side effects can be quite extreme. It also takes a lot of time to kick in—like 4-8 weeks. But I figured I had nothing to lose at this point.

Around the third week, I started to notice the benefits:
- I am a lot calmer.
- I feel more rational. I can think in a straight line.
- I am much more cogent in my thoughts.
- I am less likely to space out during a conversation, and can actually pay attention to what another person might want or need in an exchange, instead of being caught up entirely in my own head and thinking only of myself.
- I can stop myself from blurting out mean things to friends and family.
- I have more motivation to get up in the morning, make a day plan, and stick to it.
- I no longer overreact to someone's response to what I am saying or doing, and this has freed me to express myself more openly.
- If I'm doing something, I can easily detach myself from it and switch to doing something else.

In the beginning, there was a slight overstimulation that has since settled down, but these same benefits have stuck around 3+ months into treatment. What I didn't realize until I found a medication that worked for me was just how much of my ADHD was connected to the emotional dimension of my neurochemistry. So many of my emotional responses to stimuli—deadlines, people's words or facial expressions, etc.—were actually a product of emotional dysregulation and rejection sensitivity dysphoria. These are elements of ADHD that are often underdiscussed.

That's what Strattera has helped me with. I also feel compelled to actually make a plan to achieve a goal, and then do that activity consistently every day to achieve a result. In other words, over the last few years I have honed my ability to understand certain behavioural strategies that will aid my productivity, but until recently I lacked the tools to actually make those goals happen. Now I have that knowledge AND the ability to actually implement those strategies. Before, if I wanted to do something simple, say a load of laundry or a work task, I couldn't help but imbue it with so much emotional involvement that my ability to start, work on, and finish the task seemed like a huge hurdle. Now, I can easily talk myself into realizing that my fears or anxieties are unfounded, and actually do it. In other words, I'm doing in my head what talk therapy only helped me do for one hour every two weeks.

Strattera hasn't been a magic bullet. I have to push myself to be determined to work on things. I have off days. My hormonal cycle can dampen Strattera's effects. But generally, and I say this now taking the medication for over 3 months, I feel like I now have the actual means and mindset to do things.

I've also realized the huge importance of self-care: I can do things if I've slept enough, eaten enough food, exercised, and meditated. Like any individual, neurotypical or not, I must deal with stress, and making sure I decompress lets me optimize my periods of productivity. Before, I'd punish myself for needing breaks, and then letting those breaks go on for hours or days. Nowadays, if I realize I need to take time off, I just set a timer for the amount of time I want to take off, and I take a nap, or do something mindless, and let myself space out. Once the timer goes off, I assess if I need more time. Usually a quick jaunt around the block helps me realize that I am more than ready to get back into the swing of things. Sometimes I need more time, so I block off another period of time and repeat.

Now, YMMV and IANAD, but since you also have mood and anxiety issues in tandem with your ADHD, I'd recommend you give Strattera a try (or Guanfacine or Reboxetine, drug that work somewhat similarly), if it's available and your pdoc is willing to prescribe it. Be warned that the first 4-8 weeks will be hell, there can be MANY side effects, but most are manageable and transient. One is suicidal ideation, so please work with family, friends and your pdoc quite closely. The standard dose for adults is 80mg which you titrate up to over the course of a few weeks. I found that 80mg made me extremely depressed and hopeless (not quite suicidal, but wow was I getting close). When I went back down to 60mg, everything went back to normal and I got the awesome benefits again. So yeah, YMMV.

I just want you to know that if ADHD stimulant meds don't give you quite the results you want, there ARE other meds out there. And everyone responds differently, so don't give up on something just because other people didn't find success with it. We're still figuring out how ADHD affects the brain, and how it affects people DIFFERENTLY. I'm convinced that there are different types of ADHD outside of the three "presentations" in the DSM. Since we're still unravelling the great mysteries of the human brain, for now, the best option is to try different drugs with our doctor and see how things turn out. Through trial and error, we might find something that actually works for us. Yes it's time consuming and annoying, but omg, if and when you find that special something, it's so worth it.
posted by Menomena at 6:16 PM on April 26, 2017 [5 favorites]

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