Have you tried work that comes to you? Like clearing a queue of tickets in technical support or even accepting calls?

You basically have to show up to work and you are micromanaged by the queuing software. Sounds horrible, but it leads to consistent performance and when your shift is over your mind is clear from work. You are not stressed about procrastination - you just have to respond to stimuli.

You don't have to be very social, the communication is basically a ritual/protocol. If you can clear the first hurdle it might turn out that the formed habits will help you for life.

There are more technical support jobs out there, you just need to make sure they are not organized around projects or a particular big client, but a queue. You are in Eastern Europe so there might be some opportunities around you.

You can give it a try and see how it feels for you.

> You basically have to show up to work and you are micromanaged by the queuing software. Sounds horrible

Sounds like a godsend to me!

My suggestions will be unpopular and controversial, but I have been in your shoes, and medication has saved my life. Make it your goal.

If you can't get medicated, I would suggest copious amount of caffeine and nicotine, especially the latter. Perhaps don't get into cigarettes, patches are great if you understand that they take hours to reach peak nicotine concentration. Vaping is still 10x better than an unmedicated, unassisted life. Get some exercise in for that 15% boost in executive function, and it's great for your health anyway. Good luck starting an exercise routine unmedicated though.

If one day society decides I cannot take the meds that keep me ticking along, that is my plan. I'd rather die 10 years earlier because of nicotine side-effects than go back into the hole of self loathing and mental impotence I just managed to crawl out of.

Stay away from any dopamine binge. You are probably already binging on something. Drugs, porn, mindless YouTubing, food, sugar, sex, the Internet, video games are your best pleasure and your worst enemy. You crave that rush, you will seek it anywhere, it will make your ADHD worse and worse.

It's not going to be easy, but don't give much weight to "normal" people trying to convince you you're just one small trick away from a happy life. They don't know what the hell they're talking about. You have a mental imbalance, and unless you can afford not to work like a hamster 40h a week to get a salary, you need help to fix the imbalance.

And in any case if you are like me you will never be a cubicle monkey. Freelance. Work you own hours. Work for yourself if you can. It is possible to get to a point that your 0.2x productivity, if you're good, still keeps a roof over your head.

Hit me up, email in my profile, if you wanna vent. I have lived in your shoes for a very long time.

Thanks for the suggestion of nicotine patches for ADHD - I added it to my "in case I cannot access meds anymore" list :)

Why does nicotine work? Asking this as someone who has similar problems to OP (but an average programmer) and have been vaping every day, all day long, for the last few years, and don’t mind a shorter lifespan.

Basically, because nicotine is a stimulant.

Nicotine and caffeine seem to have a similar effect on ADHD as amphetamines, but on a much smaller scale.

There's also something to be said for the act of smoking. It's a consistent ritual with a direct and immediate reward for very little effort. Perfect for the adhd brain

I mentioned nicotine because in my experience nicotine is much better at releasing dopamine than caffeine does, thus improves focus more than the other. Coffee raises other neurotrasmitters with a little effect on dopamine.

That said, coffee and nicotine are two stimulants that go and feel great together.

Before I was diagnosed with ADHD, I used to chain vape whenever I was coding or before bed to calm down. It had a similar effect amphetamine has on me: holds my focus and calms my mind down, but with noticeable side effects such as high blood pressure, pulse rate and a house that smells of smoke or papaya blast.

Some ideas that work for me: - become a freelance, only accept short time jobs so you can deliver, get paid, and enjoy the free time when you can focus - ideate, advocate, and work on short interesting projects that can give you dopamine when your regular job becomes too boring to do. Example? I was feeling like this and I proposed I'd create an internal tool to read sms messages from Twilio to be used internally when we do manual QA of our app - try to change the physical location where you work at. Sometimes I go working at food halls in malls or at coffee shops, the change of environment resets something in my brain and I can focus again - find some sports that helps you. For me it's running, I tried other sports but it looks like what works for me is the prolonged effort and energy drain of running, which you don't get when doing weight lifting for example

Agree with the freelancer suggestion. Freelancers generally have a more equal business relationship with clients and clients will respect you when you decide to block off time for other projects, and/or your health.

Freelancing comes with its own challenges, especially when it comes to finding work, but the tradeoffs, higher remuneration and increased flexibility are worth it.

One caveat is you do need to be quite good, or quite specialized at what you do.

ADHD software engineer from Prague here.

Here are some things I do to be reliably productive. To be clear, I don't do everything written below everyday (except limiting phonetime). They are tools to stop the downward spiral. Pick what works for you.

- Get StayFree app to limit your fun unproductive screentime. Getting bored is good for you. - Generally limit things that gives you easy dopamine. It messes with your reward system. - Clean up your home. - Get a cheap A4 notebook. Write down stuff you need to do into bubbles all around the page to get them out of your head. Break down complex tasks into simple short defined actions. Connect the bubbles according to the order you want to complete them. Don't overcommit. It should be easy to follow. - Sport helps - Sleep and eat well - Monday is the day when I'm the most productive. It's crucial to get rested during the weekend. - Drink enough water - Frontend development is less stressful than backend - Try Headspace app

My medication: Elontril, Concerta

Don't give up, keep fighting

What is your age?

28

I also have ADHD/depression and go through similar cycles to you. I haven’t figured it out yet, but I’ve gotten to the point where it’s more like 50/50 on/off which seems to be fine with the people I work with.

The trick is to realize that staring at your computer while your mind is not ready to work is not the fastest way to getting the work done. Understand the things that bring you back into this state of mind.

It sounds like exercise is one of those things, but can also be unachievable sometimes.

Figure out something that’s even lower effort that brings you to the point where you can exercise. For me, this was cooking. For whatever reason, cooking doesn’t require a lot of mental energy for me, and puts me in a better state of mind consistently. There’s also a good reminder 3 times a day to do it, which helps.

Maybe your thing is walking, meditation, tending to plants, whatever. The important thing is that you nearly always have the energy to do it, and that it gives you a good, accomplished, positive feeling.

It also helps to be honest with the people you work with that you’re taking breaks to do this. If they’ve seen you during your 1-3 weeks, then they’ll want that version of you back.

check out this paper I found here recently https://pubmed.ncbi.nlm.nih.gov/16846100/

for self 'therapy' I highly highly recommend the book Focusing by Eugene Gendlin, it is the unlock key for all other self-help. Jump to ch3 and read a dialogue example, it's figuring out the inside forces, underneath the words and 'theories'.

You can do it by yourself (I use a stuffed animal) and there's a pdf on library genesis.

(Honestly better than pay-a-person therapy for me, where i just wasted time trying to out-smart my therapist with insightful theories, intellectualization is a defense mechanism, as is self-pity i realized of late)

A huge amount of 'distraction' is just emotional flinching in my experience.

the order i would do things

--Get the magnesium and the all the b vitamins (get the methyl b12 and methyl folate b9 if u can, they are the superior forms and cheaper than genetic testing),

--get on animal meat and fat keto or the carnivore diet, with fasting when the food is too boring. The high animal fat/ meat version is a must try for anyone with any hint of mental issues. Plus just eating one thing (meat) is easy, no planning, no distractions. If vegans don't like that, feel free to stay sick i say, it's your life...

--read the Gendlin book and do the process every week, instead of 'meditating on your breath' and other stuff that takes ten years to get anywhere. Focusing will bring up lots of dark emotions, good thing no one can see you sobbing so it does not matter

--Quit all caffeine, all my anxiety disappeared after a month.

These are all the interventions that legit helped me, take it or leave it

good luck

Carnivore diet will get you into ketosis. I believe this is the sole reason why it alleviates health issues.

Furthermore, you don't need to be a carnivore to achieve ketosis.

You have more options:

- water fasting (limited amount of studies; but humans in the ancient past did practice water-only fasting) - another form: Buchinger fast, where you limit your calorie intake to 500 kcal. You can drink juices such as coconut water. There is a clinic in Germany where people pay to fast. I think this is a littlle easier for people to get in. Helps you keep your electrolytes up (salt, Mg, K, Ca).

However, I am not sure if fasting alone will help you with a mental condition. It helps your body and brain though, but how much it will alleviate your mental issues is an open question.

I am also unsure if carnivore diet will be good overall for your body. Again, it is a way to get into ketosis, but there are more ways... I would argue more for less carbohydrates and more protein (tyrosine, tryptophane), if on a mental condition. Don't forget choline (acetylcholine). I vote for the Valter Longo approach.

Carnivore also reduces my tolerance for my meds. They last longer. In fact everything runs better for me on extremely low to zero carb. Mood, sleep, digestion, cardiac output, blood pressure, pulse rate, energy.

A suggestion you might want to explore. Find a place that practices pair programming. If you're not very social this might sound intimidating, but 1-1 interactions are much more manageable than group interactions. Pairing gives you a setup that tolerates distractions, because you have two people to absorb it. In the extreme case, one person can be completely checked out, but the pair together can still deliver.

But more importantly, two heads can complement each other to overcome limitations of either. Your pair can support you with things like navigating, communicating, discovery etc. while you may support them in things like solutioning, refactoring, craft etc. Of course you won't be playing a role exclusive to these attributes, but depending on who you are pairing with you can lean more on one side and get support on the other as suitable.

One option is get a job at a company where the expectations and pace of development are so low that it simply works with your current paradigm. Think big corporation with legacy software that needs to be maintained, and the work just is t that hard. Boring? Yes. Stable? Yes. The pay can be relatively good & interaction is often at a minimum. It also doesn’t have to be a long term solution. You can take a less than exciting job while you work on yourself & well being long term (e.g. get some exercise, do some therapy, build up some savings, etc.)

This was part of my solution after burning out at a previous job.

The other part was getting more sleep and preferring to socialize with people I met independently. Sounds rude but yes that means genuinely new people. Not your family, old friends from school, coworkers, ex-coworkers, or anyone you met through any of those people. Keeping your social life fresh has huge benefits across the board really.

The slower paced job made all this much more realistic. Work-life balance is important for your mental health. I used to scoff at the idea, but I don't anymore.

You could certainly look into temp or contract work for very short duration one-off projects, etc. That kind of work is out there, but setting up a pipeline to get it reliably is probably hard.

> Programming is the only thing I can do - and the only thing that makes me enough money to survive.

I think you may want to re-evaluate this. Some people with ADHD do better in environments where they are on their feet, actively doing work, rather than sitting at a computer screen. It sounds like you need a job that you can still do even when you are not at your mental/emotional best, and where minimum focus is mandatory but not hard to achieve. Programming may just not be that job, or not all the time.

There are now lots of "gig economy" jobs that you can do whenever you want to do them. They're not always the highest-paying, but in exchange for that you get a ton of flexibility. Maybe you could parley some of those into a hybrid approach - work in food-service or as an Uber driver or something else that is lower-paying during your downturns, and do short-term contract work during your upswings.

Plus, if you feel like a failure - and it kinda reads like you do now - having some small successes in another field could help you turn that feeling around.

Have you actually tried this? To me this creates an enormous liability of doing a horrible job at whatever 1 week project is received.

Is there actually 1-2 week projects?

If they end up not getting done, are they really going to be happy with a “Sorry it didn’t get done and I’m out of commission for a month”?

The up and down trends don’t really happen on a schedule. I wouldn’t be surprised if you get a surprise 2 day productivity boost and then can’t work for 3 weeks. And then this contract explodes.

I know my tone is like I’m trying to pwn your advice. I am skeptical, but if anybody has more to say about these concerns, I would like to hear them.

No, I definitely haven't tried it. I think your point is well taken. I am trying to think of something that'll work within OP's limitations.

But I do think that it is likely possible for OP to find some kind of hybrid arrangement that'd be better than their current situation.

Speaking from my ADHD, if a project is delayed I can generally keep focus for more - but the deadline has to be behind the corner

I'm in a similar situation:

You're super fortunate in that you at least have those short-term "best programmer" phases (especially in an industry with high pay and high demand for your skills).

My advice: use your ability to make yourself indispensable. Then you can lay out the terms and call the shots.

I use excuses for my long term absences because the stigma of my severe mental illness is too high. But if you perform well and deliver as promised, it doesn't even have to come up...

As far as explaining away the need for long absences, I personally keep it simple and vague, and Positive: that experience has taught you that you're happiest and most productive working on this bizarre schedule. It can even create a little "eccentric genius" aura and the illusion of confidence. Just be careful not to take this too far and enter jerk territory. They're still going out of their way for you, so gratitude & humility are important.

I'm very sorry to hear what you're going through. I understand it and it's incredibly difficult, but really admire that you're looking for ways to fight and work throughout it.

I'm just like you, I've some period of productive work and then cannot do anything. I'm shy of few courses to get a minor in business administration because I couldn't do the mandatory class presentation. Thankfully I managed to graduate with a very low GPA with help of meds. Most normal people don't understand the challenge you face, but fortunately there are some medicines that work, but it takes a while. It took me 10+ years to figure out what works and what to avoid.

What I'm currently on that helps me are

1. Trintellix

2. Wellbutrin

3. Adzenys XR-ODT (This is ADHD medicine prescribed to kids, it helps me better than Aderral or Ritlin.)

I hope this helps.

[1] https://en.wikipedia.org/wiki/Vortioxetine

[2] https://en.wikipedia.org/wiki/Bupropion

[3] https://adzenysxrodt.com/

Edit: formatting

Your ADHD might be trauma related. And that trauma is probably stored in the body. I suggest checking out this video on how to release that trauma:

https://youtu.be/kGYA8RCHxiI

I have a similar pattern of working hard and then hitting a wall. These exercises really help when I'm at the wall, mentally.

Some random advice from the internet, try to find out what works for you. As much as you're aware of your problem and looking for a solution, all should be good.

It might be a good idea to start writing a list of things which can help you overcome focusing issue, and things which exacerbate.

Random list of what to try - listening to music, specific playlist - working from co-working/cafe, separating workspace - amount of meetings - stress factors, how it affects the focus level - overall distractions (news, social feeds) - reading habits

and so on. In theory, it should be possible to find & maintain routine which works for you and things which can put you back on track once you notice your focus is drifting away.

There also could be unreasonable expectations from yourself, not enough rest and bunch of other things.

Good luck

> I'm unable to hold a job. I'm "the best programmer they've ever seen" but only for the first month - then they start to hate me because I'm not working.

I feel this lol

I've seen medication that can help with ADHD without necessarily having strain on the heart such as Semax - the problem being that it costs tons of money. There are also basic factors that can help you such as exercice and sleep. You can find them on PubMed and Reddit.

I've also found Beeminder+Toggl Track to help me get the initial boost to work even when unmedicated. It's a software combination that will make you pay e.g. 5€ if you don't work at least X hours today.

At small doses it's exciting, but depressing at high ones ;)

(I've spent +100€ on Beeminder but the ROI is wildly positive)

I definitely relate to this. Have you tried Upwork or similar temp work? I know it can be rough in its own ways, but it was critical for me to stay afloat during a particularly rough period.

Your best bet aside from temp work is finding a company whose culture is very open and compatible to your neurotype. You may even find success working with or even for an NGO/company which works with disability placement. We call them "Disability resource center" here, the name may vary.

Do you keep a mood journal, or otherwise track your productivity? I'd try to track what causes your down periods in the hopes of mitigating them. But also I know how random and arbitrary the fluctuations can feel.

I'm in a pretty similar position though I'm nobody's idea of "the best programmer they've ever seen". I currently have a low-grade contract with some old friends. They generally accept that I'm pretty erratic schedule wise. It pays enough to help with my expenses though I'm still mostly prematurely spending my retirement. Ultimately I think the only solution for me is to get the ADHD meds, which I understand there is a shortage of now, thanks to the war on drugs or whatever, in addition to the existing shortage of doctors in my area that could actually prescribe them. Hate the US sometimes.

In broad terms, I see basically four options:

1. Try to fix yourself, with medication or otherwise.

2. Find a coding job at a badly managed company (something like a large bank etc.) where they won't notice your performance is minimal. This is suboptimal, because it will be stressful for you and you'll probably end up being fired in 5-10 years anyway.

3. Find a different line of work - one without monotony and which doesn't require constant focus. Perhaps some varied, strongly stimulating physical work, like firefighting or police? I imagine people with ADHD might do well there.

4. Apply for disability, if it's an option where you live.

Are you sure, this is really ADHD and not something else, hardened by ineffective measures?

I mean, I spent half of life deal with non-competent medics, to finally understand, what I really have and how to deal with it (yes, my condition serious).

And I must admit, I still have very similar to your issues, but at least, now I can make plans for future.

We could talk more later. Now try to minimize pharmaceutics, ideally to zero, control your condition only by natural products and psychological training (also, may help yoga or eastern things, like kung fu or tai-chi), and find part time work, to pay your expenses.

And I must say, such rhythm is totally normal for large projects and for real life businesses - they usually first half of month do nothing, and after 20th, spent weekends and even nights at work.

Looks like managers have some condition and live under their rhythm, force other people to synchronize to their rhythm.

Whenever I get in such a funk I travel. I'm not talking vacation & fun travel - just to a completely different environment. I once visited Cuba and it got me off medication for a long while!

Something about change of evironment and flying resets me.

PS: I want to add that the reason I'm able to hold a job is because I own the company. So perhaps you being self-employed will help by forcing accountability on yourself and it's less demoralizing than getting fired... I'm open with my team about my moments.

Disclaimer: I am now medicated for ADHD, but I was unmedicated for most of my life. Most of these suggestions come from when I was unmedicated. In addition to medications I'm taking a multivitaminic / multimineral supplement to which I sometimes add more vitamin D (helps with depression) and magnesium (helps with energy).

I have similar phases - I'm personally trying to reduce this variability as it annoys me too (not only a problem with my job). I was feeling literally burned out after as little as a week of focus, and all the other aspects of my life tend to fail when I'm burned out.

What I find really helpful is having set routines that don't change easily or are easy to maintain - for example, eating at the same time everyday, going to sleep at roughly the same time. It can feel like jail starting to do this while unmedicated (and likely depressed)

For the routines, weekends are usually my bane as they are an interruption in most of them - I try to stick to my personal routines week-long.

If you can start work with a really low load - I ended up in sick leave for untreated ADHD and I'm currently ramping work hours little at a time, and it seems to help.

It also helps a lot to have set times for work and to drop work as soon as you are done with the hours - you won't be able to make up for lost time anyway, and it only adds to the stress. I'm planning to go to the gym every day after work, so that I cannot "slouch" back into working until late.

(This is with me medicated) To reduce the social media effect on me I time an hour from when I wake up to when I'm allowed to go to my phone and my PC - it's strangely effective, after a week I didn't feel the need to check social media anymore (this from being 8/9 hours a day on it). I got a lot of time and energy back from this. (If I check social media during the day I "get back" at when I was checking them all day long, feeling wise, but it's getting less and less difficult to do so). When I was unmedicated I used various timers for social media (leechblock, for example) and they helped a bit. I also had a routine for studying that required a couple of hours before starting to study (gaming a bit / checking social media / convincing myself to start studying). I prefer having time in the morning before work to do roughly the same now.

So many things to try. Many good suggestions already. A couple more:

I meet with an adhd coach, he essentially plans my week for me. The plan often falls apart after the first 2-3 days but it is enough to keep my life from falling off the rails. Something to consider.

I see in some of your other comments that you have a caffeine sensitivity — I do too; I started diluting coffee to something like 1:50 and taking 2-3 sips in the morning. Otherwise I get in a stress spiral all day.

>I have a strong case of ADHD. Can't take medication that would help me due to other medical reasons

? There are a ton of options so it's weird to be vague here.

Quite honestly, programming doesn't sound like a good fit. Have you tried doing something physical? Like post office delivery or something.

These jobs don't pay enough to afford housing and food around here... It's done by older people who got their real estate when it was still cheap 10-20 (or more) years ago. Younger people have absolutely no chance of making enough to get by from this job. There's also huge competition on these jobs - older people who want to supplement their pension income, etc. I'm not averse to physical work (I like working on my grandma's garden, for example) but I'm afraid it just won't be enough money and that I'll have the same kind of problems... It's not just mental work I have problems with. In my downperiods I am unable to clean my teeth.

Construction trades like electricians pay really well these days (>100k with a few years of experience). I have a similar issue and I’m trying to learn in case I can’t figure out the software development thing. I definitely don’t feel the same attention issues doing more hands-on work.

> In my downperiods I am unable to clean my teeth.

That sounds like a symptom of depression, not ADHD.

It's not emotional. I'm not feeling down/sad. I just can't focus on doing anything.

Brushing teeth doesn't require focus. There is definitely more than ADHD going on here. Extreme depression often isn't feeling down/sad, it's a complete lack of energy or motivation to do even the most simple tasks such as brushing ones teeth.

I'm not an expert, but I've never heard of such severe symptoms in ADHD cases. I think you should really consult a psychiatrist.

This is not ADHD

> In my downperiods I am unable to clean my teeth

This looks like bipolar disorder, and it is very controllable with right doctor.

I think you should read the book “faster than normal”. Gives some Great ways to use your ADHD for you. Find out ways to release your gates. For me it was the gym. I can’t get good work I’m unless I’m in the gym or doing some exercise. It’s a natural release anyways and I’m a more physical person so it did a lot for me mentally.

people here will give you advice on how to deal with this issue with good intentions, even from personal anedoctaol experience, but sometime advice given with good intention might lead to inaffective outcome or even end up making things worse, for you.

if you feel this issue is harming you even after seeing professional than you might have to switch who you are seeing.

Please add an email address to your profile so that people can reach you if they have potential solutions to your problems.

Made an account just to tell you this:

Wellbutrin is over the counter in Turkey. And much cheaper than Europe.

I'd also recommend Naval's 1 hour meditation for 60 days.

will it be easier for you if transition to a QA role ?

I had a relatively minor case that sounds very similar to this for a couple years. This is what worked for me, in case it works for you:

1) Reframe sunk-cost thinking on "not working" vs "working" by forgiving yourself on bad days. I would get into a state where I wasn't as productive as I could have been, and it made me feel bad when trying to be productive again. I would avoid engaging because of the emotionally painful feeling. Stimulants would allow me to push through, but at the cost of anxiety when coming down and other health issues. A lot of the framing and advice I got from friends and professionals ignored this highly emotional angle that I was not socialized to recognize and focused on either drugs or productivity tools to paper over it. However, recognizing that this was an emotional trap happening, and that the anticipated emotional pain was a self fulfilling prophecy, allowed me to forgive myself some days and focus on making small incremental progress. It is okay, normal, and probably unavoidable to have 0.5x or 0.1x days. The trick for me has been to not let them snowball by framing incremental progress as a win. Avoiding black and white thinking about productivity.

2) When that fails, as it will occasionally, try to harness the urge to disengage with emotionally risky tasks to do tasks you are less anxious about. Have a queue of productive but less stressful or exhausting tasks to do. Maybe you can get up from the computer and procrastinate by doing the dishes or cleaning. Maybe you can procrastinate cleaning by scheduling a doctor's appointment, doing taxes, or working out. Maybe you can procrastinate working out by writing unit tests and documentation. Eventually procrastinating the unit tests and documentation by writing features and closing the original tickets. This won't work for many jobs that do not provide autonomy, but has worked wonders for me. Part of what I think is happening here is that there can be a decoupiling between feeling rewarded and completing tasks, if tasks take too long to complete or are only followed by more of the same. Something akin to a low grade burnout can be stopped before it gets too serious by doing small immediately rewarding tasks when the urge to procrastinate is high.

3) Think of your productivity as part of a whole healthy emotional and physical life. Modern life makes it easy to ask absurd things of our animal body - we feed ourselves nothing but sugar, meds, coffee and nicotine designed to induce a flight or fight response for hours, then wonder why we are panicking at the thought of not finishing some minor task or the possibility of some bad behavior repeating. Shipping excellent code is a long voyage, one of many voyages in your life, and your mind is the irreplaceable vehicle that has to be kept in working order to complete all of them. Regular meals, sleep, and a little exercise, are not distractions from productivity but hard requirements for sustained productivity.

Many unmedicated people with ADHD have this problem and have figured out their own process for working through the funk period.

On a personal level, exercise and coffee have been magical for me. When I'm not feeling it, the task is getting to the coffee pot, but once I'm there the motivation comes on its own. Walking 40-60 minutes outside does wonders as well.

Unfortunately coffee even in small doses makes me paranoid and anxious so much I become absolute clusterfuck (literally start believing aliens are coming). Same with marihuana. This is part of the reason why I can't get medication - Ritalin does this to me too.

How about working out? I recently found out that the most productive engineer on my team runs every morning before work which makes a lot of sense. He's always firing on all cylinders.

I admit it feels great and it does help - but it doesn't really help me turn the tide when I'm in the 3+week phase of inability to focus on anything at all. It's also super-hard to do it in this phase.

But I will try again, thank you for reminding me it feels good.

Have you tried caffeine pills instead of coffee? I find raw caffeine a lot less troublesome.

I don’t get as stressed as you describe from coffee, but it’s not always a nice experience (same with tea). Caffeine pills (and L-Theanine aka green tea calm extract) are an option

Look into guanfacine for combatting anxiety especially around task initiation. And if you still have some Ritalin on hand try microdosing it. 10mg tablet dissolved in 1 litre = 10ug per ml. I see beneficial effects on 5-10ugrams.

Sounds like a sensitive amygdala to me. I would focus on enhancing my serotonine levels. And also GABA (LiOr) at night for insomnia. Prevent excess noradrenaline release (stress, cold showers).

Have you tried non-stimulant ADHD medications?

Wellbutrin works well for people who have blood pressure issues for example (it can affect blood pressure, but it's much less common than with stimulants)

Unfortunately I can't just choose what medication I'd like to try. The doctor had me try Ritalin and that worked great (on the focus/attention side) but I also developed pretty extreme paranoia after cca month and since then he doesn't want me to try anything else. I tried switching psychiatrist but so far I'm on several wait lists (have been for 5 months now).

I can’t say conclusively, but anecdotally, I do extremely well on a much lower dose of a stimulant than I was originally prescribed. I would try with the _absolute_ smallest amount of the extended release variant of your medication that is prescribed.

I was originally prescribed something like 30mg daily when I was in university and it made me super anxious to the point of dumping all of my medication. Years later, I gave it another shot with the understanding that it would be a tool and not a solution, and I would take the absolute minimum amount necessary and no more. It worked significantly better.

It’s unfortunate that so few doctors are willing to prescribe medication for people with properly diagnosed ADHD. I also can’t help but think that regardless of the condition, if your doctor is only willing to try one type and dose of medication to treat a condition, that sounds like a shitty doctor. This isn’t diabetes—there’s not a measurable target that’s needed to be hit for optimum performance.

ADHD conditions and symptoms are a spectrum and different people respond to different medications and doses differently. Every trial of medication should be exactly that—a trial, until something works.

You don’t go to an optometrist and have them say “you’ve got astigmatism, here’s your glasses” in a one size fits all scenario, you go through the different lenses until you reach the best one _for your situation at the time_.

You mentioned marijuana elsewhere. I really advise against weed mix with amphetamines/stimulants. It’s a recipe for schizo behaviour and I’m saying this from experience.

Have you considered umm religion? I’m gonna trigger lots of you anti Catholics out there. Done right I think religion is like practical psychology. You get support from others, practice managing your thoughts and learn how to recognize good vs bad thoughts.

My own path was to read Be Here Now a crazy psychedelic spirituality book, and then read books from that bibliography and choose something. I’m not here to shill my religious tradition, just to say there’s something there in that direction that may help you.

The wrong choice may make your life worse, but you will hopefully be able to recognize that and switch course. That would be your decisions to make.

A natural way to reduce paranoia is to increase GABA and GABA building blocks in your diet. Almonds are a great example, and I take lots of supplements to also help w/ Gaba quantity (my Gaba receptors aren't peak functional). I've had times I've tapped out my Gaba reserves (internally) and paranoia would flourish.

It might allow you to try Ritalin again (albeit in smaller doses).

Could you share which supplements?

Not GP, but you can supplement GABA by simply taking GABA. Eg https://www.amazon.com/NOW-GABA-500-200-Capsules/dp/B001DB6L...

AFAIK: caffeine blocks the neurochemical adenosine. Adenosine and GABA downregulate neuronal activity such as dopamine, noradrenaline. Dopamine and noradrenaline are the key transmitters where drugs like LDX inhibit their reuptake and causes more release of them. For dopamine (and noradrenaline), you need L-dopa, for L-dopa, you need tyrosine, for tyrosine, you need protein. For setotonin, you need tryptophane and thus protein. For acetylcholine, you need choline. You can also get enhanced release of noradrenaline for 5 h through cold showers. Likely, you need to downregulate your neurons at a certain time. You need GABA. However, taking GABA directly does usually not work. Lithium orothate does.

Creatine is likely also needed. Since creatine provides phosphates for your brain cells which keeps your energy metabolism efficient.

You might be a candidate for Disability.

Assuming US your best shot might be collecting SSI and supplementing with periodic contract work. Mind your billable hours though so you don't disqualify yourself. Work on open-source stuff the rest of your time to stay in the game.

If that is not tenable, consider changing careers to something more dopamine-driven-- firefighter, paramedic, etc. Social skills are beneficial but not required. Educational background is negotiable.

My reply to the user andrewmcarter who deleted their comment:

I thought I am an extremely lazy person who hates to work for 25 years. That it's ADHD was suggested to me a year ago and it was confirmed on EEG scans, by psychological evaluation and by taking medication that actually worked - however it also made me paranoid (extremely, pushing me out of normal reality) and I have other (physical) medical condition that made it unsustainable.

Yes, my code is in production and people (users as well as other devs) love it. Future maintainers always praise it for its readability and simple extensibility. I co-founded a startup (niche CRM/ERP kind of app) and got it working within a month and we got customers actually using the app and investors thanks to that. However the investors pushed me out when they found out I am not working for extended periods of time. I got some small amount of money but was forced to leave my stake.

Indeed, I am not comfortable with failing anymore. Now it's so bad I just can't have interviews anymore, I start shaking and can't think at all - a decade ago I used to have very high self esteem and didn't have this kind of problems, it's indeed a developed condition.

I'm not paying for my medical services. I pay mandatory health insurance which is priced by the state based on a minimum and/or a percentage of my income.

Academia/school is torture because the fuckers were screaming at me all the time for not completing homework, because I always shut down when I had to do something on the blackboard in front of the classroom, etc. I guess university might be different but I'd have to complete the 3 remaining years of high school to get there. Anyways from what my Gf experienced at the university it's terrible there too so I'm not really motivated to go this way, doesn't seem like a solution.

It's not like I am playing video games instead of doing the stuff I need to do. I really truly want to do it. I am sitting in front of it, I don't browse internet or whatever. I have the work in front of me, but my brain is shut down, unable to have a single thought. I am sitting like this for hours, wishing with all of my willpower to just do the thing, but can't have an intelligent thought.

Sorry, I didn't think you'd see my comment.

It sounds to me like you're asking too much of yourself. Since failing isn't an option, anything less than succeeding at what you do next will make you unhappy.

I hope that I can remind you that it's OK and normal for people to just not be able to focus for periods of time. That's the human condition.

Go easy on yourself and take it one step at a time. But remember too, all the world over, the majority of people are working individuals. We all have to labor. No one wants to work with someone not working for extended periods of time. You have to try. Just do it slowly and consider pairing with someone; it's OK.

I wish you the best.

To expand, I am in the European union but since I've never paid social insurance I'm not eligible for any state help. I'm already in debt, this is just something I can't afford to pay. I had a lot of trouble paying my health insurance debt so I could go to the psychiatrist.

Regardless, in the POV of the state I'm a high income individual so I am not eligible anyways. I make about $50/hour and they don't care I'm out of a job for 2/3 of a year. Unemployment allowance office actually tried to call the police on me because they thought I'm trying to steal from the government.

ADHD is not recognized adult medical condition here so I can't be recognized as disabled.

Where in European union?

Slovakia

How did the police situation happen?

I tried to go there for third time in 4 months and they called them probably because the companies they sent me to gave them feedback that I am not working - because here it's mandatory to be trying to get a job to collect the allowance.

Fortunately the guys who arrived were the most reasonable guys I ever met and laughed at them, but suggested I don't go back there again.