Super exhausted now. Some of the failed (red) tasks were crucial and are really going to bite me in the arse, and I didn't even get half a day for a relaxing walk or something. 0 income generated, 0 rest, just catching up at least 80 % on general life stuff. Had to skip all work-out, too (usually 3x per week).

So here is my "routine":

• snooze the alarm and can't get out of bed for 25 minutes
• protein shake, Lisdexamfetamine immediately
• usually guarana / black tea right after
• sit down and wait for the kick - but that takes an awfully long time!
  • managed to avoid dopaminergic things like doomscrolling while waiting
  • often watch a show as a compromise, though
  • manage todos, like even starting the list for the day helps a lot when the kick comes
  • start drinking a lot (no caffeine) within ~10 minutes, fast fill-up 1l, then slow down

A faster way is to take the meds immediately with water only, or even in bed, but it doesn't last as long as with the protein shake. Maybe a mix of both would work, like meds on empty stomach, but then protein shake and food 10 minutes later?

Showering works great for some reason, but I lately prefer an occasional bath at night. Is it the "thinking time" with no screens and the simple routine?

In order to deal with executive dysfunction, what works sometimes is to just do a little. E. g. instead of a full workout, I say: I can't do a full workout, but I CAN do 1 pushup, or 1 set.

Sometimes, I can do more with 0 mental effort, only the first one is hard.

At other times, I still don't feel like it. And here is the trap: I could force it like "come on, now you started, you finish!"

But the problem with that is that next time, the "just start" method does not work. The devil on my shoulder would say: "You know it's never just one pushup, more will be forced and squeezed out of you!" And he would be right.

Better to deal with nearly 0 progress occasionally than to lose the method! Be honest to yourself. If you said just 1 pushup, just do the one. More only when it's 100 % motivation-driven.

One thing about tasks and the probability that I'll take them on is the ratio:

reward* : required energy**

But faced with a task, I might remember situations where I did a thing that didn't take long but had great results, and I felt so good after doing it. That is normal, but it can also be a trap. Example:

It's late, but I do have time for a little think such as taking the garbage out or cleaning the sink. But then I think: Yes, the effort is not that great, I could do it, but what difference does it make? Might as well take on all the remaining chores tomorrow. And I don't find a task with a good reward/energy ratio, so I do nothing.

It's always a fallacy.

What works?

1. Simulate tasks in my head and see if one of them appeals; not picking any is fine as long as I simulate them, as it works often enough.
2. Just fuck it, fight back. Screw you, brain, and your dopamine hunt, I'll just do a little thing with almost no gain. Making my bed 3 hours before sleep. Getting an only 70 % full garbage back out. Clean the dust on top of the shelf that nobody sees. Take that!

*(measured in dopamine, visible results, satisfaction, ...)

**(motivation, effort, discipline, time)

Realising more and more how this is related to my ADD.

Forms are just hell for me. The things I have to sign at every new doctor or dentist, government agency forms, residency, new ID, sign the kid up for an activity, ...

I end up asking myself: "What do they want to hear?"

This year at a new dentist, first appointment, they wouldn't let me see him before I finished the forms, and when I had them done, he didn't have time for me anymore. I got in early! There was also a misunderstanding of whether I say when I'm done or they call me in.

A really odd exception are tax forms. I have a business and do my own taxes, but the forms make perfect sense to me. Of course I know the answers to: How much money did I take, how much of that was VAT, what were my expenses and in what category, what percentage did a major purchase lose in value when I bought it in March and its assumed lifetime is 7 years. It's my business, those are very reasonable questions, unlike those on doctor, government agency or school forms. Those would ask things such as: What is the exact date when the child benefit switched from the other parent to you, on what legal grounds did it switch, how many back and forth switches were there, and why? Provide a list with reasons and the address of the department that handled the request at the time.

One possible explanation is that the tax forms are done like a personal interest in hyperfocus. But I think another reason is that there are very powerful lobbyists who want their taxes to be simple and make sense. So a mix of objectively simpler and an ADHD thing.

Regarding UIs, I learned in the early days of web design that ONE menu is what a website should have. That works best for me. The modern sites with a menu on top, side menu, gadgets, menu left, not sure if one of the side menu is subcategories of the top menu or its own thing ...

I'm a backend developer, and 15 years ago, it was a good thing that I liked to work with a console / CLI whenever possible. But these days, a lot happens in UIs. Jenkins, Nexus, Github, Kibana, .... Do an image search for "Jenkins UI", for example. Why are they even all different? Different config, context, hidden menu?

When people try to explain it to me and go like "just click pipeline", the only chance to find it is ctrl+F, and when it's a button or image with text, I'm lost. They have to lead me like: Mouse a little more to the right, now go up, too far, back down, little more left - click!

A coworker in pair programming always stops me when I want to enter a git command in the console and is like: "Oh, you don't have to do that anymore! Just go to the IDE, now click the icon with the tree, ... no, not that one. Left. Well, obviously not the project tree, less left. Down now, where the other icons are ... no, the tree! The tree! Great, now see the new thing that pops up. Just go to the dropdown - no, the NEW dropdown. Pick the one that says whatever, now all you have to do is ..." And that is supposed to be easier that entering a quick command? Even when I have to look up the help, it'd be faster!

Are you like that as well, or is it not relatable?

I mean, seriously: Now that I'm in treatment, that is how I finally contain the messes! Clothes in the laundry basket, not flying around everywhere, shoes stuffed all in one place (that is even a god-damn shoe rack!) dirty dishes IN THE SINK (!!!), all the paper on the desk nicely in ONE stack ...

If that is rage bait, they sure got me.

The whole video makes no sense to me. Why does she have to throw away the shoes she likes? She looks like she has a decent income and can certainly afford a hobby that takes up as much space as 50 shoes. (I'm not like that, I have ONE pair, but to each their own.)

And what's up with the pens? I never have enough pens, wish I owned a glass of pens! I often consider buying a whole drawer of pens and thrown them around the house, but never get to it. How do you accidentally acquire so many working pens that you have to throw them out?

I have used many methods in my life, couldn't get enough of finding and trying more and more. And some worked, even pre-diagnosis.

But here is a new one that I just found recently after watching Dr. K. here, and reading about Rubicon model in more detail.

When to use

• Already got a todo-list
• hard time getting started

General idea

Create internal motivation, rather than the pain of being driven by external motivation, such as deadlines or hunger.

How to do it

• Take the todo-list
• Look at each of the items for 30 seconds and run a "simulation" in your mind: What would it be like to start that now, what would be the effort/pain, and the short-term gain. Short-term gain is not when it is all done, but a few steps in. E. g. what it feels like when I just put the first piece of laundry into the machine. I even write notes about the "simulation".
• Then pick one, IF you really feel like it. Otherwise, back to your shows & Lemmy - have fun!

Example

Initial list:

• shopping
• laundry
• cleaning
• online form

List after "simulation" phase:

• shopping
  • get up from comfy chair
  • away from tea & cookies
  • shoes, bag
  • outside in the rain
  • at least would be on the way
  • probably a no
• laundry
  • get up
  • some spread around, collect
  • might just not do that one
  • pretty low effort,
  • feeling ok about it
• cleaning
  • do I even have the cleaner
  • probably better after shopping
  • nah, let's not
• online form
  • at least not getting up
  • one hell of an annoyance though
  • show could keep playing
  • might take 10 minutes
  • could do

Based on that, I'd pick the online form task and go.

It's weird, it makes no sense, but it works! This weekend, I got 6 out of the 10 things done I was supposed to do (better than 0, right?), but getting started required no discipline or pain. I just wanted to after doing the "simulations". Other semi-successful weekends, I had to force myself to do at least the ones that create the most pain when not done, and it hurt.

For myself, the Elvanse (Vyvanse) is fantastic. It stimulates (I do not have the typical ADHD thing where stims calm down), makes it easy to get started on things, gives me focus, makes me motivated and euphoric.

Since I usually don't see the 6 hours at school after my son took his meds, I decided to give him some on the weekend (doc said it's entirely up to us when there is no school). 15 mg slow-release Methylphenidate (Medikinet). We kept it to that one dose in the morning, without the optional instant-release afternoon hit.

The effect was quite shocking:

• He appears to be strongly sedated. It's like when I take a pretty hard benzo dose. The hyperactivity stops completely, and he just wants to sit on my lap and lean on me / cuddle. Not sure it's tiredness, though; he still wants to go outside and play and follows through with it.
• Inside, he also does his usual projects. But instead of storming into my office for a quick hug as usual, he waddles in and sits in my lap for a long cuddle. He was very focused on an ambitious Lego project, but that has happened before.
• He does not find it easier to get on an unpleasant task all. Had to clean his room and was as unhappy as always, although I offered to do only a quick unit of work.
• At the playground, it was the first time in weeks that he wanted to get picked up earlier. It coincided with the first day in weeks where all friends were gone early, too, so might not say much. He just sat in the sand and looked sad when I arrived; usually it's all laughter and dashing around. Maybe just no friends, but then again, he usually finds a quick instant-friend.

So, I'm not happy with that result. Sure makes it easier for the teachers when he is sedated, but the idea was that he could follow his passions like chess and math even better, get tougher challenges at school. Instead, they just gave him As and let him sit sadly in the corner, is how I picture it now.

What do you think, childhood medicated ADHD folks and others?

Additional notes:

• Of course, I'll keep communicating my and the teachers' observations with the doc. But medical care is limited; we are so glad that he has someone who writes the prescription.
• The dose was increased from 10 mg to 15 mg for two reasons: 1. 6 hours later, I and the occupational therapist saw 0 effect. 2. The teachers reported a strong decline in effect, after being very happy with 10mg initially. It's also possible that he didn't take it properly with enough food and water, or that the generic medicine he got as a replacement is at fault.

My child had to switch from Medikinet removed to the Zentiva version. Teachers said the generic is hardly working at all.

Can it really be so much different? Both claim to have a 50 % instant-release part.

Medikinet removed has a similar curve as Ritalin LA with a stronger peak between hour 3 and 6. The Zentiva isn't even documented that well. German article with interesting comparison graphs: https://www.ppt-online.de/heftarchiv/2022/04/individuelle-adhs-therapie-mit-methylphenidat-removedpraeparaten.html

The question came up during therapy.

Reasons:

• The lisdexamfetamine is completely out-of-pocket, while the methylphenidate could be paid for by insurance. Even tried, failed and documented, future lisdexamfetamine would be paid for by insurance.
• There might be a co-occuring autism spectrum disorder, and methylphenidate sometimes does a better job / less side effects, then.
• While the Elvanse/Vyvanse completely fixed two symptoms, ability to focus and getting started with a task, more would be nice.

But, I'd like to stay functional, so is this attempt worth it?