[grep_name]

I was diagnosed with ADHD at several different points and saw different professionals about it at different times, most notably in kindergarden, first grade, fifth grade, the beginning and end of high school, and college. (not all were re-diagnoses but for some reason took place at different locations) I don't really know why treatment was so off and on or varied, but I suspect it is because I don't respond well to stimulants. They make me feel extremely 'up' and anxious in very, very small doses. Everything from the amphetamines they prescribe to coffee.

When I was in college, I was prescribed them again just by my primary care physician. I didn't say I was having trouble focusing, I said I was having trouble with wakefulness. I still do sometimes. It was hard to stay awake in a lecture setting for some reason, borderline impossible on days when I had several in a row. Medication definitely helped me get through college but it was a rough time.

As an adult I don't take them, but it is hard to really work the full work day. I have always performed well enough that nobody questions it (and in some cases have brought so much value to a company that nobody cares), but it is a constant source of stress. I resonate with the top commenter in that I also have hundreds of unfinished personal projects across all domains. At this time in my life (33 y/o) I am more concerned about mitigating the constant stress I feel than I am about the actual ADHD symptoms. I am ok with my many personal projects clashing with each other.

At one point a few years ago I was stressed enough about my job to seek medication. For some reason I was not able to get the information about my diagnosis from my old primary care (from 8 years ago) and the one before that was pediatric and didn't seem to count. I talked to a therapist for a bit (which was not useful), got a diagnosis, and then talked to a psych briefly via zoom, and went on medication for a month before deciding (again) that it wasn't worth it. The whole thing was kind of disheartening.

Things are very weird when it comes to ADHD treatment and diagnosis. There seems to be a tendency towards the same 'easy button' when it comes to ADHD. I also don't think it's exaggerating to say that just about every single person I know well enough to have spoken to about these things says that they have been diagnosed with ADHD, often medicated. I don't think very many of them actually do have it. Sometimes I'm not even sure if I do, or there is something else going on.

I'm not sure what to conclude after all this except that maybe there are no answers for me in this space. It's frustrating, but I've never opened up to exploring this problem without the same exact solution being thrown at me, a solution I know is not sustainable for me. I've never spoken to a doctor who's ever suggested it could be anything else. Should I just find my own way, since I seem to be able to function well enough?

[jtrn]

This might not be relevant for you, but generally, such constellations of symptoms should at least trigger a differential diagnosis between anxiety and ADHD. Anxiety can be simplified as "energy mobilized to handle important challenges." Some people with high baseline activation are really focused on managing challenges, whether external or internal. This could resemble ADHD if the person is not avoiding their feelings but instead enduring them. This would explain both tiredness and low benefit from stimulants, scatterbrain, and high energy/activity levels. People usually think that anxiety just causes someone to sit in a corner and be anxious, but many people channel the energy into action and don’t even realize they are doing it due to an extremely high baseline activation of the nervous system. For these people, it’s almost more physiological than psychological. If the activation is always directed at managing and handling something, as opposed to reflexively focusing on the most interesting thing, I would suspect it’s more in the realm of anxiety, or perhaps better described as a really reactive, hair-trigger nervous system. Not saying that it is anxiety, but it might just be that you are the opposite of apathetic.

[grep_name]

Interesting, I have never been diagnosed with anxiety beyond 'well ADHD and anxiety go together, ADHD medication should help' and then a kind of shrug when it made things worse. All these things are possible and are food for thought (I am not saying it definitely is that either). This is kind of US-medicine specific, but everyone I know who is being treated for anxiety is being treated via methods I'm not interested in unfortunately.

> For these people, it’s almost more physiological than psychological.

This stands out to me. I have lifted weights in the past, have not been well physically conditioned in cardio activity since I was diagnosed with type 1 diabetes at 22. Cardio tends to cause my blood sugar to become unpredictable (or at least you have to actually be really rigid in maintaining your exercise patterns to keep things predictable). Maybe a bit of biking or running would do me some good. What would you do?