ADHD?

Hey Issah. I have ADHD. Got diagnosed less than a year ago, but obviously had it my whole life.

ADHD comes first. Any addict, be that alcohol, gambling, hard drugs, shoplifting, porn, etc., has a 30% chance to also have ADHD. The disorder is a dopamine deficiency, and addictive behaviors provide a disproportionate amount of dopamine. Your addiction is essentially self medicating for that lack. This is where an "addictive personality" comes from. If you beat one, you're still vulnerable to others. It's not inevitable though, and some "addictions" are acceptable coping mechanisms, when they don't interfere with a healthy and productive lifestyle. Gaming, for example, is popular with ADHD people because it's easy to pick up and put down, and they are designed to give you regular dopamine hits. If you can do it without obsessing, and most of us can, it's fine.

First, medicate. I don't like medicating my problems away. My mom recognized I would have been diagnosed with the disorder, had I been in the public school system. She thought ADD (as they called it then) was over-diagnosed, and she reasoned that these people had always existed and found a way to cope. She didn't want me living with the stigma, and she didn't want me to believe I was unacceptable unless I took pills. However, while the condition has existed long before we had a label for it, we live in a different world. ADHD people have not had to deal with smart phones, and all the accompanying distractions and cultural expectations that go along with them. My wife told me, when she first decided I had it, that it was my body and I could choose to medicate or not. I chose to not. I later found out that was passive-progressive sneakspeak for "I strongly prefer you manage your disorder the way I want you to, and if you don't I will consider leaving." Honestly, I have been able to function as a productive member of society within acceptable parameters my whole life to this point (P addiction aside), but now I'm a stay-at-home dad to five kids, one of whom inherited my lovely condition. It's ADHD hell, so I started meds.

The first medical line of defense most ADHD people use is caffeine. It's a temporary stimulant you can take as needed, it's temporary, it's cheap and available. Too much can make you jittery, and the literature says stimulants work the opposite on ADHD people and make us more focused, but I found that's not always true for me. So, dosage goes as follows, starting from most caffeine per ounce to least: coffee, black tea, green tea, most "energy" drinks, Coca-cola, white tea. If you want something more consistent, though, Adderall is the most popular choice. I hear it works well, but the idea of a regular stimulant didn't sound appealing to me so I opted for the less commonly prescribed Strattera. It's a norepinephrine (adrenaline) suppressant, and it works by clearing out that adrenaline so dopamine doesn't have to compete with it for the same neural receptors. In other words, less excitement, more reward for common behavior. Nausea can be a side effect, but it does work. I have more tolerance for my kid's BS, I think it cut down on some impulsivity, and it made quitting P easier. I also sometimes use an herbal tea, no caffeine, for stress and anxiety. But the specific blend I use is a loose leaf, tea is kind of a "thing" for me, I'll not burden you with my geekiness unless you want. In general, lavender, jasmine, chamomile, and chrysanthemum work for that kind of thing. I only mention it because you said anxiety is currently a problem.

Another good thing I did was increased my overall dopamine levels with more exercise. I prefer running for various reasons, but any kind of intense exercise for a 15 minute minimum has been shown to positively affect depression. I assume it's roughly the same for the dopamine dump for ADHD, but more to the point, when I paid more attention I noted the same icy sensation creeping in my brain about a mile and a half into a fast run, as the sensation I got from O. Definitely harder won than through P, but I think it's the same thing in terms of filling that neuro-chemical need & it doesn't have the side effects of P. Other coping mechanisms for recruiting more dopamine are gaming, as mentioned earlier, engaging in hobbies, adult coloring or dot-to-dot (fine motor skills and concentration are great for focusing), etc. Social media is less than optimal. Those algorithms are specifically designed to give you just enough dopamine to keep you clicking and scrolling, but not enough to satisfy and allow you to quit and move on to something more productive. It's a nightmare for people like us, I quit FB and YouTube almost entirely, and never started Twitter, IG, TikTok, or whatever the kids are using these days.

Positive self-talk, and avoiding negative, is one that does not come easily to me, but substantially helps. It helps to know I have a dopamine deficiency, so I don't naturally get the benefit from positive behaviors that most people do. If I do something good, even if it's a normal thing like switching the laundry, it helps to take a moment to say "good job." Yes, it's just my job. No, people don't get kudos just for doing their job. The reality is, though, sometimes I don't do it because I am not interested, and it's harder for me to remember to do these things, but I did it now and that's a good thing. Same goes for the negative. If I forget to switch the laundry because I was hyper-focusing on something stupid and non-productive, well, that's life. It's not because I'm stupid or lazy, it's because it's harder for me to do it and listen; not switching laundry is not the end of the world. Make a plan to remind myself next time. There's a fine line between making excuses to enable sub-optimal behavior, and being realistic about the challenges you face on a daily basis. If you're like me and a lot of ADHD people, your natural inclination is to self-criticize. Unnatural and unearned as it may seem, go ahead and consciously err on the side of self-forgiveness and commit to working on it next time. Depression and anxiety are incredibly common side effects of ADHD, as we frequently compare ourselves to other people and think, "why can't I perform at normal levels?" We assume it's a personality or character defect, and turn the focus inward. Shame and guilt are terrible motivators, though. They seem like they should work, but they mostly undermine your mental health.

You already are doing therapy, that's good. Some specialize in ADHD, but I recommend going a few more sessions with your current therapist to see if it's a good fit. If not, don't hesitate to shop around. Good fits are sometimes difficult to find, and it's necessary to have productive sessions. Meantime, you've always had this. Without even knowing it, chances are you've already developed lots of coping mechanisms for dealing with your condition. Being aware and looking specifically for more will come fairly naturally to you.

Beyond that, there's not a lot of general advice I can offer. There's a YouTube channel full of tips called How to ADHD. I haven't covered a lot of content myself because YouTube, and the host is kind of attractive to me and I just don't want that distraction right now. She has some tips on specific things like time management, though, and you might find it helpful.