ADHD meds

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jacob
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Re: ADHD meds

Post by jacob »

scottindenver wrote:
Sun Mar 17, 2024 10:23 am
Also if could share any strategies and tactics for better executive function that would be great as we could all benefit.

To start off, I found it helpful to finally have a yearly planner and I have a task list and obligations list (two separate lists helps keep me organized). Also I cross off stuff that isnt that important but only after I get everything out of my head and onto paper. Super simple but I just never did it.
Sorry for derailing. (My usual moderation rule is that anyone is free to derail any thread---cross-pollination often results in interesting insight---unless staying on-topic is requested by the OP. So you have the power... just ask.)

Executive functioning is to a large degree a comprehensively learned skill that is eventually internalized as a habit and becomes the boss manager part of your superego. This is done over very many years of growing up---and nobody ever gets too chronologically old for continuing to grow up. It's not a course or a list of tricks but rather habits turned into character and personality. It is harder to do if your neurochemistry tends to light up your brain whenever its cued by input. Hey look! Shiny butterfly! Followed by a cascade of random associations. Point being, EF is not something anyone is born with but acquiring it comes easier to some than others and it is rather useful for focusing in order to get things down in a world where focusing to get things done is important. Note this is not required in all situations. Case in point, lack of EF and its associated tendency to overplan is useful when "act first, ask later" is more useful. Like when the fryer is on fire or when a SWAT team enters a building. In that case, doing anything as long as it's something is better than freezing like a normal person.

Regardless ... there are some tools to make the (re)construction easier.

Get familiar with the Eisenhower Matrix and start using it for---well---everything. The Eisenhower matrix distinguishes between what's important (or not) and what's urgent (or not). EF is the sorting mechanism for this. I suspect ADHD kinda lacks that kind of automagic sorting and so everything gets thrown into the mix regardless of whether it's urgent and important or non-urgent and non-important. Applying this filter before doing or speaking might work wonders. Turn it into a habit. Insofar you had the natural talents for this kind of behavior you might be surprised it even has a name. However, not everybody has that particular talent. This is why it's even a thing and has a name in the first place.

Another if rather crude way is to control the input: Remove non-important distractions from your environment. Minimalism is your friend. Also see spoon-theory. If you only wear one uniform of clothes and only have a collection of blue jeans and white tshirts, what to wear never becomes an focus in the first place. You'll see people deleting youtube and other apps insofar they're unable to EF-control the impulse to look at them. An old personal finance trick was to freeze your credit card inside an ice cube in order to increase the barrier to using it. (Maybe freeze your smartphone? j/k). The point here is to arrange your environment to help you rather than hurt you. The easiest way to avoid temptation is to avoid being exposed to temptation. Be very deliberate here. What seems like a weakness can also be a strength. If you work in a creative-anything-goes industry (fashion), random associations are probably a good strategy. If you work in accounting or public speaking, probably not.

However, you can't really control the input when it comes to associations that are internally generated in your own brain. (The i-functions mentioned above.) Instead, you have to focus on how you act on them. I have two suggestions. First, stick to a limited number of interests. A good balance is doing something meaningful; doing something fun; and doing something that grows you as a human being. That's 3 different things you can do. Pick 1 (only one!) in each category. Do not pick another until the previous one is either finished or terminated (because it can never be finished). You generally don't want to pick more than 1... maybe 2 ... because the human capacity to focus multiple projects is limited and tends to take mental energy away from the others. IOW, you don't want to be debugging 2-3 complex software projects at the same time. That just won't do. OTOH, your brain might have room for and even benefit from playing volleyball while finishing the debug. Just don't think you or your body can endure playing 2-3 different sports at a productive level at the same time. In summary, try to avoid picking up a new focus until you've gotten closure on a current focus.

The brain can be trained just like a muscle. The analogy is not great though. A muscle gets stronger through training but the brain gets different. The reason for this is https://en.wikipedia.org/wiki/Chunking_(psychology) For example, as you grew up you might have gone from not knowing what 7*5 meant to seeing as 7+7+7+7+7 to seeing it as "35" to seeing it as a rectangle of a certain shape and size. Basically your perspective changed. The same holds with muscles but only in the combinations that allow for agility. There's a difference between the leg press, the squat, and jumping over an opposing player as if they were a hurdle. Basically, the previous and simpler levels are "chunked" and this allows operating at a higher level. EF is similar in that regard.

Good executive functioning is built on a foundation of having internalized and chunked a set of simpler functionality AFTER determining that is is correct or solid and then moving onto the meta. If you know that 5x7=35 or that being able to lift this much weight is solid, you can just accept it as a given (not urgent and not important) and take your focus to the next level using what you know to get things done. (There's a bit of a GTD cult on the ERE forums, so search that out as well. It tends to work better if the project can be chopped into milestones but if that's your environment, the GTD system might very well work for you.)

But I suggest starting using the Eisenhower Matrix as a rule of thumb.

Bonde
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Re: ADHD meds

Post by Bonde »

@scottindenver
Have you asked your physician if you can get another type of medication?
In Denmark concerta/methylphenidate or strattera/atomoxetine are less expensive and the evidence for effect is the same (as I remember, new evidence could have emerged in the last couple of years).

7Wannabe5
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Re: ADHD meds

Post by 7Wannabe5 »

jacob wrote:I don't think we are anymore?! IQ is easy to test, but having the multiple symptoms in the Venn diagram above requires more than just having a high g-factor.
The source for the Venn diagram does not offer any further guidance, but in the olden days when I was a child in the U.S., being "Gifted" meant somebody gave you an IQ test and you scored over 130. Then at some point, mainly for political reasons, they stopped IQ testing kids, and being placed in a gifted program was more a matter of teacher recommendation and/or standardized academic testing and/or parental pull/push, which was towards defeating the purpose of the program, by turning it into just another "Best Students" program. How many humans do you know with IQ less than around 115 who display a good deal of "abstract thinking", "skip thinking", "fascination with theory", and/or "need for complexity?" How many humans do you know who verifiably have an IQ over 130 and don't display any of these traits? Obviously, although INTJs are a small group, not all of them can have an IQ over 130, and the ones I know of whom I believe don't, do still tend towards being very frugal, very much concerned with physical fitness, and quite cold-blooded, but not-so-much abstract thinkers. For example, my ex-father-in-law, a Metallurgical Chemist who biked the entire Lewis and Clark trail, and trapped chipmunks in a cage and drowned them in the pond by his potato patch. I think its the existence of these somewhat lower IQ chipmunk-drowning INTJs that may be contributing to the tendency to frequently cast INTJ as villain in bingeable series ;)

@scottindenver:

"The Renaissance Soul", which is also on the "ERE" reading list is one of the best books for helping scattered generalist types find some focus. "Refuse to Choose: Use All of Your Interests, Passions, and Hobbies to Create the Life and Career of Your Dreams" by Barbara Sher is similar and also quite good. The title is kind of misleading, because it's actually towards helping scattered generalists feel okay about narrowing their current focus somewhat. I very much like some aspects of the primarily bottom-up-organizational program GTD (Getting Things Done), but it might not be the best program for somebody who is scattered-creative to the extent of considering medication for ADHD. At the juncture when my lifestyle was the most out-of-control chaotic (early Mom years), and I started integrating organizational systems, I found that addressing household mess had to be prioritized even if it wasn't the most important issue at hand or the most efficient manner in which to proceed. For instance, the FlyLady Program for S.H.E.s (scattered household executives) starts with the simple daily practice of thoroughly cleaning and shining your kitchen sink in order to create a very small aesthetically pleasing oasis of order to which you circle back as you expand your habit matrix.

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Re: ADHD meds

Post by jacob »

7Wannabe5 wrote:
Tue Apr 02, 2024 5:32 pm
The source for the Venn diagram does not offer any further guidance, but in the olden days when I was a child in the U.S., being "Gifted" meant somebody gave you an IQ test and you scored over 130. Then at some point, mainly for political reasons, they stopped IQ testing kids, and being placed in a gifted program was more a matter of teacher recommendation and/or standardized academic testing and/or parental pull/push, which was towards defeating the purpose of the program, by turning it into just another "Best Students" program. How many humans do you know with IQ less than around 115 who display a good deal of "abstract thinking", "skip thinking", "fascination with theory", and/or "need for complexity?" How many humans do you know who verifiably have an IQ over 130 and don't display any of these traits? Obviously, although INTJs are a small group, not all of them can have an IQ over 130, and the ones I know of whom I believe don't, do still tend towards being very frugal, very much concerned with physical fitness, and quite cold-blooded, but not-so-much abstract thinkers. For example, my ex-father-in-law, a Metallurgical Chemist who biked the entire Lewis and Clark trail, and trapped chipmunks in a cage and drowned them in the pond by his potato patch. I think its the existence of these somewhat lower IQ chipmunk-drowning INTJs that may be contributing to the tendency to frequently cast INTJ as villain in bingeable series ;)
The definition of gifted has somewhat expanded from raw IQ. A high IQ is now considered semi-required but not sufficient. See 1.1 of https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9680488/ to see what is currently being measured and why. https://www.psychologytoday.com/us/blog ... difference might explain the difference more clearly.

One of the big disappointments I had with academia was how it was full of (very) bright yet not particularly gifted(*) people. In other words, people who were were good at doing their homework (or job) but not very interested in much beyond that. Much like normal people, they were happy to be good at their job while enjoying a hobby on the side. Bright people are certainly capable of answering abstract questions, but they're not particularly into asking them. Bright people are also capable of learning theory or dealing with complexity, but they're only interested if it's part of the homework or job ... they're not interested in it for its own sake. A confounding factor is of course that the gifted also tend to be "bright enough", but it is not the defining characteristic. People who are bright are not necessarily gifted in the Venn diagram sense. The main difference is the lack of [intellectual] curiosity. Gifted people simply want to know. Bright people are mostly interested because it's going to be on the test. I think this is also why the conditioned probabilities on IN**-types---P(gifted|IN**)/P(gifted|ES**)>5---is so high, because these types have the introspective Ni, or Ti or Fi with auxiliary N as their dominant function. Their brain is driven towards building an understanding the world or themselves.

(*) See https://arxiv.org/abs/astro-ph/0310368 ... the "second rank scientist" described on page 13--14 of the pdf is likely gifted.

Unfortunately, "gifted" does come with some baggage on account of sounding like a blessing. In reality, it's more like "cursed", because the world is not really set up to deal with people who want to explore and aren't sufficiently inspired to "merely" achieve. This in turn is what can lead to classroom or job difficulties or general problems fitting in. The bright person puts in full effort on getting an A+ or a promotion and stops once achieved. The gifted is satisfied with "good enough" effort for the job, because there are so many other interesting things in the world. Insofar you account for the full effort, the gifted outdistance the bright, because it's literally who they are; not just something they do at their job.

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Re: ADHD meds

Post by 7Wannabe5 »

@jacob:

Gotcha. We're on the same page now. I was identified as a gifted under-achiever by the time I was in the fifth grade, as was my INFP sister and my INTP son. My DD32 (The Diplomat so towards XXXX) was a bit more towards Very High Achiever in the sense that she got a full-ride scholarship to top university on the basis of grades and test scores, although she had her own form of "gifted-drop-out" crisis at a later age. It just strikes me as a bit odd that the ENTP (known as The Explorer) might be less likely to be "people who want to explore and aren't sufficiently inspired to "merely" achieve." I suppose it would be due to the fact that lower IQ and/or more highly Extroverted ENTPs are more likely to explore places, people, and activities vs. books, ideas, and interests. Also, ENTPs are far more likely to fall out of the academic system altogether towards some form of entrepreneurial effort at a relatively early age.
jacob wrote:In reality, it's more like "cursed", because the world is not really set up to deal with people who want to explore and aren't sufficiently inspired to "merely" achieve.
True, and for better or worse, this might also apply to the "solved problem" of FIRE within "ERE." Especially for those of us who spent a year or two indulging curiosity by studying the behavior of a self-made multi-multi-millionaire. Reducing spending towards zero is a more interesting challenge, but there's an easy "cheat" for this available for any reasonably attractive female. So, it comes down to measuring actual energy/resource flows, or basically defaults to a high quality of life permaculture (broadly defined towards the philosophical) project or roughly QofL* Resilience/Waste.

OTOH, this may simply be exactly the sort of rationalization* most likely to be offered by a human lacking the focus (due to ADHD??) and grit (due to somewhat spoiled/entitled monkey princess??) necessary to complete 5 more pages of long division problems for the reward of an additional marshmallow. :lol:

scottindenver
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Re: ADHD meds

Post by scottindenver »

Bonde wrote:
Tue Apr 02, 2024 4:43 pm
@scottindenver
Have you asked your physician if you can get another type of medication?
In Denmark concerta/methylphenidate or strattera/atomoxetine are less expensive and the evidence for effect is the same (as I remember, new evidence could have emerged in the last couple of years).
Yes I may switch to something else. I am trying some days taking no medication and I find it’s actually less anxiety and stress, at least right now. Also Strattera/atomoxetine is not a controlled substance as far as I know and after some reading many say they respond better with atomoxetine than a amphetamine based drug.

Scott 2
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Re: ADHD meds

Post by Scott 2 »

@Jacob
(E.g. when someone just had a baby, you're supposed to say...
This is something I run into. I honestly told my friend, about their shy baby - "well, I don't like him either!" Weak response inhibition, a sub-trait of the executive function. It's called out in one of the ADHD books.


I read the Fe/Fi article. While I understand the content, integrating with my own mental model won't happen. I struggle with various personality frameworks. I suspect that reflects trait deficits bundled under my autism. Kinda like asking someone who can't figure out algebra, to learn calculus.

Maybe I could get there eventually, but it wouldn't be fun for anyone involved.


The neuropsychological tests I took, specifically used IQ. During the results meeting, we spent at least 20 minutes going over the aggregate and individual numbers. Interestingly - the written report converts those to qualitative scales, perhaps reflecting the inherent imprecision. A favorable deck of tests could swing the score significantly.

IMO, that happened to me. I maxed a couple tests. Each one throws a 150 into the average. But brain training video games also use them. I've been playing those for 20 years.

So I crushed the number recall, even though I experience working memory impairments. My weakness shows as a strength. Not helpful. It's a discussion point for my testing follow-up.

The tester was excited about my IQ, but the word giftedness was never spoken or written.


Executive functioning is...
One ADHD book uses a gas tank metaphor. Once it runs out, no amount of skill matters. For those who have ADHD, the tank is small and burns fast. Strategies center on slowing burn rate, as capacity increases are limited.


Gifted people simply want to know. Bright people are mostly interested because it's going to be on the test...Unfortunately, "gifted" does come with some baggage on account of sounding like a blessing. In reality, it's more like "cursed"
A couple books referred to this as interest based vs. importance based nervous systems. I've seen it in resources for both Autism and ADHD.

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Re: ADHD meds

Post by Scott 2 »

scottindenver wrote:
Wed Apr 03, 2024 8:50 pm
I am trying some days taking no medication and I find it’s actually less anxiety and stress
Did the doctor offer mitigating strategies, for the medication induced anxiety?


A failed trial with an anti-depressant, caused me to recognize untreated anxiety. That kicked off my motivation to try more active interventions:

1. A weighted blanket at night
2. Monitoring heart rate for unusual spikes
3. Carrying an object to fidget with
4. Exercising early on stressful days
5. Blocking recovery time after stressful situations
6. Identifying and meeting my support needs

The challenge is - I think urgency created by anxiety diminishes my traits that look like ADHD. If I get a handle on the anxiety, I don't know what happens next. It's why I've been interested in the ADHD materials, specifically behavioral strategies. Giving an anxious person stimulants, seems ill advised.

scottindenver
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Re: ADHD meds

Post by scottindenver »

Scott 2 wrote:
Wed Apr 03, 2024 11:33 pm
Did the doctor offer mitigating strategies, for the medication induced anxiety?


A failed trial with an anti-depressant, caused me to recognize untreated anxiety. That kicked off my motivation to try more active interventions:

1. A weighted blanket at night
2. Monitoring heart rate for unusual spikes
3. Carrying an object to fidget with
4. Exercising early on stressful days
5. Blocking recovery time after stressful situations
6. Identifying and meeting my support needs

The challenge is - I think urgency created by anxiety diminishes my traits that look like ADHD. If I get a handle on the anxiety, I don't know what happens next. It's why I've been interested in the ADHD materials, specifically behavioral strategies. Giving an anxious person stimulants, seems ill advised.
I am trying to switch doctors. My current doctor is more of a pill pusher and I am not impressed. Currently looking for a doctor who can prescribe and is licensed in Colorado and ideally has a very good understanding of different ADHD medications and their effects. Not easy to find and I am still searching. If anyone has a name they would recommend please share or PM me.

scottindenver
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Re: ADHD meds

Post by scottindenver »

Also for managing anxiety there is a fairly good series on YouTube callled Therapy in a nutshell.

https://m.youtube.com/@TherapyinaNutshell/videos

I picked a few of these videos and tried some of the methods for reducing anxiety and they do work sometimes. Also one helpful bit I learned is that anxiety in modern society is much more difficult to address since the threats we face or perceive are often not physical but more abstract. A physical threat produces a response and we move our body to deal with the problem. She offers example of farmers getting up in middle of night to save their crops from a danger and after being exhausted their body can relax. But if a perceived threat is abstract then the stress response in the body can persist which is not good for humans. Our evolutionary history is built for responding to physical danger.

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Re: ADHD meds

Post by jacob »

Scott 2 wrote:
Wed Apr 03, 2024 11:17 pm
I read the Fe/Fi article. While I understand the content, integrating with my own mental model won't happen. I struggle with various personality frameworks. I suspect that reflects trait deficits bundled under my autism. Kinda like asking someone who can't figure out algebra, to learn calculus.
That's interesting. I'd practically be lost w/o those frameworks (I was during the first 20 years of my life before learning about them). They form the basis for cognitive empathy which becomes very helpful when your mind isn't located near the center of the map along with the majority of people. One benefit is that you can lean on cognition rather than similarity(*), or mirror-neurons and conversation(**) to understand or at least model people's objective responses as a function of their subjective state. Like with proving a theorem in calculus, it's not necessary to be able to figure this out on the spot. Rather, the frameworks are something that can be built up over time for each person you know.

(*) @7wb5 usually uses similarity with various fictional characters to understand/describe people. Even if I happen to know [of] the particular character from reading the book or watching the movie, this would rarely be enough information for me to have anything better than the roughest guess at their personality. Fortunately, real life will over time provide more data than that.
(**) Fe-types in particular will often desire to "have a conversation" to get to know you. This is likely to see what kind of emoting you're doing with your face or voice intonation based on the conversation. This is not necessarily a conscious research project on their part, but rather an automatic familiarization + figuring out how you vibe or resonate together. Personally, I find this a complete waste of time for my part.
Scott 2 wrote:
Wed Apr 03, 2024 11:17 pm
The tester was excited about my IQ, but the word giftedness was never spoken or written.
ASD skews towards lower IQ, so the IQ test might have served as a counterindicator for traditional (see my posts to @7wb5) giftedness, since they do share some traits as per the Venn diagram. Of course, one can be both.
Scott 2 wrote:
Wed Apr 03, 2024 11:17 pm
One ADHD book uses a gas tank metaphor. Once it runs out, no amount of skill matters. For those who have ADHD, the tank is small and burns fast. Strategies center on slowing burn rate, as capacity increases are limited.
Sounds like ego depletion theory. Also see "spoon theory".

Scott 2
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Re: ADHD meds

Post by Scott 2 »

scottindenver wrote:
Thu Apr 04, 2024 6:17 am
Currently looking for a doctor who can prescribe...
That was a recent discovery for me. Stimulants are a controlled substance. Doctors may be reluctant to prescribe them. Since my path started with feeling tired, it was an idea I raised to my doctor. Especially after being told I was depressed. Low energy? Let's make more energy! She was very much opposed. Didn't like my supplemental testosterone idea either, haha.

A challenge with youtube videos and mental health, is I don't know where to stop. That lead me to favor books via my library. Though those too get out of control. I don't read one book, but a couple dozen. What if the next has critical information I've missed??? With the anxiety, I'm trying to adopt vetted strategies from others first. Since it's been completely untreated, I expect there's low hanging fruit.

Advice I've seen for managing hyper focus, is one has to recognize topics that will kick it off. Then decide if it's worth risking that investment, especially right now. Consuming media on anxiety is currently in my "too risky" bucket. Centering on it is especially draining.

Another example - My wife wants to replace our non-stick pans. They are killing us! I have declined to participate, because I don't want to be an expert in cookware. That also means abdicating my right to complain when she makes the change. I am historically bad at the 2nd part. Now that I can articulate what is happening, I expect it to be better.


jacob wrote:
Thu Apr 04, 2024 8:10 am
That's interesting. I'd practically be lost w/o those frameworks
Who says I'm not? :D I have other strategies, some adaptive, some maladaptive. Simply asking, is the change I am working on.

Current theory is to combine asking with being vulnerable about my own limitations. Not "I'm so autistic! 101010110!!!" but "I haven't been through anything like this. I can't imagine how you must be feeling. How are you doing?" I think it'll do alright, with less mental overhead.

Maybe the only thing worse than not understanding, is acting as if I do understand, while getting it completely wrong. Ugh. With the poor theory of mind, this was a common problem. After digging into emotion related authors, like Brené Brown, it maybe got worse.

There are also translation scripts I am working on integrating. IE - I think about apology differently than most. Especially if there was no malicious intent on my part (almost always the case). I simply made a mistake - why focus on the past, place blame, or state the obvious?

But no, when I care about a person, better to mad libs an NT script, like:

Code: Select all

I'm sorry I X and maybe made you feel Y. I've changed Z so I won't X again. Will you please forgive me?
It's honest and no different than using a language translator. I'm helping to solve our "double empathy problem". Historically I've favored people who can meet me more than halfway. Some emotionally gifted people can casually translate. Others have a high tolerance for misbehavior.


Worth noting - both autism and ADHD resources call out models of friendship. Both groups tend to take a binary approach. Someone is either a friend or not. Once they are a friend, it is forever and full disclosure is immediately on the table.

This is directly opposed to NT models, where friendship develops over time. People feel each other out. It waxes and wanes. Constant upkeep is required. Disclosure needs to match circle of intimacy, etc.

I've historically made friends with those who share the former model. NT relationships tend to fizzle, again due to an unsolved double empathy problem.


My autistic brain favors bottom up over top down thinking. I think it's part of why systems thinking felt so pivotal. But in this case, the pattern of identifying and elevating one constraint, works very well with my mindset. I may eventually grasp a unified theory, but only once the entire pyramid exists. If I do, my understanding will be very deep.


jacob wrote:
Thu Apr 04, 2024 8:10 am
counterindicator for traditional (see my posts to @7wb5) giftedness
When I see the tester to re-review, I'll ask about the term.

jacob wrote:
Thu Apr 04, 2024 8:10 am
Sounds like ego depletion theory. Also see "spoon theory".
Yes, the gas tank metaphor seems very similar. The shift to working _with_ limitations is fundamental. For me, at least, the idea one can eradicate weakness is so much more appealing. But ask for help? Admit I struggle? No way.

One author quoted from Rosenberg:
Every criticism, judgment, diagnosis, and expression of anger is the tragic expression of an unmet need.
Nothing has been so effective at reducing my desire to complain. Betray my needs? Never!


Of course, anyone could apply these strategic changes positively. It's part of what makes me cautious around identifying with an ADHD label. Who wouldn't enjoy improved executive function or extra working memory slots?

It's also why I'm happy to trial the behavioral strategies. If they help, they help. At an actionable level, the label tends to be irrelevant.

Bicycle7
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Re: ADHD meds

Post by Bicycle7 »

jacob wrote:
Thu Apr 04, 2024 8:10 am

(**) Fe-types in particular will often desire to "have a conversation" to get to know you. This is likely to see what kind of emoting you're doing with your face or voice intonation based on the conversation. This is not necessarily a conscious research project on their part, but rather an automatic familiarization + figuring out how you vibe or resonate together. Personally, I find this a complete waste of time for my part.
I resonate with this (secondary Fe). I'm interested in talking to people to get to know them. While we're talking, I'm taking in a bunch of feeling related information and judging how much of a vibe I feel with someone. I certainly pay attention to the tone of voice and expressions. It's helpful to remember that not everyone does this.

I think the combination of Ni, Fe for me can lead to occasional rapid MBTI typings of people. Sometimes, I'll pick up on as little as 2 or 3 impressions and have a decent guess at what their type is. Sometimes it can take a lot longer than that, if I'm just not that interested in connecting with them, or I'm not getting a strong signal.

At the same time, with secondary Fe, I'll joke that I feel like a cold-blooded intj around dominant feeling types (EXFJs and IXFPs). Especially around those with strong Fi, I can't as reliably describe how I feel and I don't hold as strong of convictions. It's very easy for me to agree with someone and rare/unusual to see me take a stand opposing someone.

I can struggle relating to sensing types. I'm ok at making them like me, I can translate to their language and please them with Fe, but I feel unfulfilled from the interactions. Indeed, the sensing types set the appropriate social behavior and conversational topics in many settings.

Scott 2
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Re: ADHD meds

Post by Scott 2 »

Thought I'd note a couple of the strategies that have been working well for me:

1. Working memory and free recall memory issues.
1.1 Preparing for activities with a launch pad. Get everything to start my day ready, in one spot.
1.2 Visible point of proximity organization. IE - all my toothcare items on the counter, not in the medicine cabinet
1.3 Visual cues for activities in process. IE - I put a bracelet on when I put my food in the microwave
1.4 Visual cues for activities I need to do. IE - my wife leaves a sign on the counter, for a chore I need to do in the bathroom
1.5 Being honest and transparent that I won't or don't remember. Writing it down or creating a visual cue instead.

2. Distraction issues
2.1 Filling the focus meter - using something like an audio book to get myself to 100% engagement, so I don't get distracted
2.2 Being honest with myself about multi-tasking ability
2.3 Filling my hands with a fidget toy, again to sustain 100% engagement. I'm especially liking Fingears, magnetic toy rings

3. Relieving motivation issues
3.1 Behaviorally activated motivation - just start doing the thing
3.2 Creating artificial urgency - telling others I'm going to do the thing, or committing to convening on the results at set time
3.3 Dropping todo tasks off my list by circle of priority (ie cleaning is low) rather than whatever I "feel" like doing first

4. Weak Time-based prospective memory
4.1 Relying upon event based propsective memory instead. IE - instead of I'll do X in 30 minutes, I'll do X after Y. Of course, this requires remembering Y, going back to the changes in item 1, above.


Anyway, it's all a work in progress. But this is what I've been changing. Concurrently, I'm trying to manage the anxiety as well.

scottindenver
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Re: ADHD meds

Post by scottindenver »

Another behavioral intervention that has worked for me is recognizing when a task is trivial but a part of my brain is avoiding it because of some combination of a it won’t look nice or be perfect, b I am not completely sure how to do it and c I think learning more is a solution. Sometimes learning more is okay but I set an explicit or implicit limit, say 1 YouTube video and then stop, put phone down and try the thing and fix it quickly. Although I clearly value learning it can lead to procrastination by learning. And in my case since I like to learn it can lead to hours avoiding something but feeling like I am doing something useful.

Also after years in higher education I can say this is a massive problem. I see very bright students who just cannot function or prioritize and in general struggle to manage their time once they leave a structured classroom environment. And frankly it’s not their fault, it’s the adults who either don’t have these skills or just do not teach them or provide proper mentoring and guidance. Everything in higher education is way over optimized for learning in controlled setting with defined answers and in very narrow subjects and contexts. Real life is way more dynamic with lots of uncertainty and students don’t have enough life experience to understand that. My friend works in job placement and recruiting and he has shared multiple times that most hiring managers he knows or interacts with explicitly tell him they do not hire people with a Masters degree straight out of school and definitely no PhDs and it’s mostly because of the above problems.

Scott 2
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Re: ADHD meds

Post by Scott 2 »

Saw the guy who ran my psych tests today. I asked why giftedness didn't come up. He said that's not typically a term used in his practice. When he's seen it used, it's more typically applied to children in a classroom setting.


We also talked about the working memory test, where you relay back progressively longer strings of numbers. First forwards, then backwards, then sorted. I'd "hit the ceiling" in his words.

Well, turns out the chunking I learned to do, kinda breaks the test. Remembering three 3 digit numbers is not the same as 9 individual digits. Says a lot about the perils of IQ as a metric.

So a stupid human trick I learned at 17, confused my healthcare 25 years later.


The entire conversation was a window into why simply taking an online test is not diagnostically accurate. Even the expert ran, peer reviewed diagnostic exam is limited. The patient might have tricks, be bad at self reflection, or have co-occurring conditions. All can confound results.


He also acknowledged that in the professional realm, support for adult autism and ADHD is limited. That many professionals won't diagnose either in adults. And most treatment guidance focuses on children.


So he did more surveys with me, as well as some repeats from before. Only now that I've figured out my body expresses the emotions I can't feel, the results were significantly different. Then there was another 90 minutes of interviewing, to tease apart conflicting factors, account for how autism impacts answers, understand childhood experiences, etc. He'll peer review that with a senior mentor, then create a final diagnostic report. Only then would a diagnosis change.


It's a lot. I lucked into an especially motivated young guy, who has personal experience in the space. Retirement gave me time for testing and self reflection. And I happen to have insurance that makes it all financially attainable.


He was a big proponent of working with a psychiatrist when taking brain drugs. Especially if one is neurodivergent. Dunno if I'll play that card.


One of the ADHD books describes an "I have so much potential, if only..." trap. It's a tempting mindset. Glad to have seen it called out as broken.

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Ego
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Re: ADHD meds

Post by Ego »

Scott 2 wrote:
Thu Apr 11, 2024 11:28 pm
Only now that I've figured out my body expresses the emotions I can't feel, the results were significantly different. Then there was another 90 minutes of interviewing, to tease apart conflicting factors, account for how autism impacts answers, understand childhood experiences, etc. He'll peer review that with a senior mentor, then create a final diagnostic report. Only then would a diagnosis change.


It's a lot. I lucked into an especially motivated young guy, who has personal experience in the space. Retirement gave me time for testing and self reflection.
Can one do too much self-reflection / introspection? If so, how much is too much and what would the effects be?

Are there better and worse ways to do it? If so, what would the better and worse ways look like?

No need to answer. Just food for thought.

Scott 2
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Re: ADHD meds

Post by Scott 2 »

Ego wrote:
Fri Apr 12, 2024 5:51 am
Can one do too much self-reflection / introspection...
This is worth answering. IMO there's a gap in mental healthcare. It's hard to access. Especially if one is poor, or there's a "life just be that way" mindset. Unfortunately many in the Gen X and older generations grew up with the latter. And so, they quietly suffer. Especially men, who often also lack other social supports.

In my own case, I'm learning mental healthcare also hinges on the privilege of security. Only now have I found the space to be vulnerable, ask for help and receive support. Will it pay off? I'm biased, but think so. The problems I was ignoring, only got my attention because they began to manifest physically. A determination to become anti-fragile was simply not enough.

My motivation for a freedom from retirement, was largely driven by mental health challenges. Which I could not articulate. With the benefit of hindsight and an improved lens, it's very easy to see how things were breaking. Does that mean I could have fixed them? Dunno. It does mean the underlying problems, didn't go away once I retired. I experienced relief, but only through a shrinking of life. It is a limiting strategy.


Not to say I hadn't attempted introspection. But one cannot escape internal bias. An external observer is needed. I sought resources to confirm my own biases. About minimalism, being present, anti-capitalism, etc. Everything to justify a pattern of running from unnamed stressors. Instead of learning to recognize and manage them. Which is especially difficult, because typical strategies don't always work for atypical wiring.


TLDR - If a freedom from retirement appeals, maybe there's an untreated mental health need. Don't go at it alone. Find support.

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Re: ADHD meds

Post by jacob »

@Scott2 - Giftedness is generally seen as a problem for the teacher/institution who are dealing with a bored/unruly child rather than a problem for the gifted child and eventual gifted adult. IQ testing is a quick and easy CYA institutional solution for sorting in a school setting. The attitude towards adults remains fairly close to "since you're so smart, you can figure it out on your own". So ... that's what people end up doing. If people have support, like from a similarly gifted environment (perhaps parents, family, a particular teacher, or mentor), ... they may be steered into professional milieu that is sufficient. If it's neutral, they'll likely end up in some rather creative lifestyle. If it's negative, they'll end up hiding their gifts or diverting them away from the public by focusing on esoteric stuff like, say, learning Ithkuil or building a CPU in excel.

Just because something isn't professionally recognized doesn't mean it isn't a thing. 15 years ago (in the heydays of the ERE blog), the general understanding of burnout was similarly simplistic. The advice from the medical community was to "take a break for a day or two" and "do some exercise" and all would be well. Since then, it's become more nuanced ... (I suppose another thing to keep in mind is how doctoring is usually focused on the most expedient solution for the average customer^H^H^H...patient with the diagnosis(!))

Also, consider the specialist trap. There are doctors, psychiatrists, and therapists. They each have a differently constructed framework; complete with both overlaps and corresponding lack of recognizing perspective.

@Ego - This is a difficult one. Introspection is essentially the mind using its CPU cycles to reflect back on itself for extra insight. This is a positive (here meaning "more of the same"... like compound interest) feedback loop. Two ways this could go. If done well, this will lead to additional insight and more insight into yourself and your relation to other people and all the combinations that obtain. If done poorly, it will create a biased feedback loop that rapidly goes down a neurotic rabbit hole of anxiety and conspiracies where the ego of the brain becomes its own echo chamber.

Much of this direction towards personal heaven(?) or hell(?) is controlled by what constructs and frameworks are available to the introspector. (In general, that's not a lot, because this stuff is not generally taught and it's extremely hard to come up with independently. As a result, humans are left to flounder. Floundering works okay for the middle of the curve. It's shite for the extremes though.)

So how much is too much and how little is not enough? The majority actually does very little introspection. Instead they take their cues externally. They're literally the average of the five people they've most recently met. Nothing more, nothing less. Most are literally a local statistic of their surrounding sentiments.

If anyone has solid maps of the territory, they can go quite deep. OTOH, if anyone gets their frameworks from social media feeds or friends and family, they should probably stick to the kiddie pool.

A 50+ something relation of mine once shared an astounding insight they just had: "Did you realize that everybody carries an image of how you are as a person in their own mind?!?!?" Well, hot damn!? Well, yes. Well, I actually know the numbers, so I can respond with scientific backing that some 5 out of 6 adults (post teenage-socialization) actually do realize that(*). Whereas this person was just realizing this at age 50+. Better late than never. Welcome to the other side. Perhaps if they had thought more about how they came across to others, they would have struggled less with their social relationships.

(*) If we narrow this down to "how to act appropriately for more than one cultural setting", this drops to 1 out of 3.

Likewise, there are various levels of insight in terms of how one comes across to oneself. For example, one can be oblivious. An example of this would be acting out anger without realizing one is angry. Ditto other feelings. In this case, the person is literally a slave to their emotions.

The next level would be being aware of how their emotions influence their feelings and what kinds of thought and responses they have. Add in a theory of mind when it comes to other people. If you know all that whether intellectually or intuitively, you'll know more about some random person than they know about themselves. This level of insight is simply just not that common.

If I was king, I'd make this part of the school curriculum. Technically it already is ... except it's dominated by a paradigm that's not aware of itself.

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Re: ADHD meds

Post by Scott 2 »

jacob wrote:
Fri Apr 12, 2024 4:32 pm
If I was king, I'd make this part of the school curriculum. Technically it already is ... except it's dominated by a paradigm that's not aware of itself.

Brings to mind this book I just read, on trauma:

https://static.macmillan.com/static/fib ... ed-to-you/

Symptoms of trauma are often mistaken as ADHD. Hence the branching interest.

The book talks about attempting to heal people from traumatic experiences. Those kids are often left behind by the dominant paradigm. If one hasn't reached an age appropriate level of development, it's not feasible to absorb the next institutional lesson. Game over.

The treating therapist attempts to figure out where in the development curve a person got stuck. They then attempt to manually enable growth through each stage. A 10 year old might need to be treated like they are 2. It takes a combination of experiences, environments, relationships, etc. Way more than simple talk therapy.

A key part of the effort, is working with the parents or caregivers of the children. Because if their development is also stuck, the child has little chance. Traits that are generally maladaptive, could be adaptive in the child's home environment. Destabilizing them could cause more harm then good.

In practice, the work of maturation becomes generational. It is a very difficult problem to solve.

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