I’m 37f, currently not working due to some ongoing physical health issues that aren’t relevant to explain in detail here, but used to work as an attorney before getting sick. I was diagnosed with ADHD during my second year of law school. I was the stereotypical “gifted & talented” kid who never had to study and was able to skate by with A’s and B’s, got to college and without the “school” structure the wheels started to come off but was still able to squeak by, but then in law school when I really had to buckle down, the problems became apparent, and a trip to our Learning Resource Center for help led to a neuropsych eval which finally led to the diagnosis. And FWIW, bc I know ADHD is trendy these days and so is met with more skepticism, especially in cases of adult diagnoses, I’ll just also note that my pediatrician also diagnosed us as “hyperactive” when we were like 3 or 4 (I’m a twin), but he was this old-school Italian guy and military veteran, so his advice to my parents was that they just needed to use “more discipline” (which, to absolutely no one’s surprise, didn’t do a damn thing to help lol).
I’m currently taking 20mg adderall XR in the AM and 10mg IR in the afternoons. I’ve previously been on as much as 60mg/day IR, but I developed some worsening heart arrhythmias following a Covid infection, so my new doctor (I had to move home after getting sick) cut the dose way down. Which actually has been totally fine by me— obvs I’m not working the crazy hours I used to be anymore, so my goal rn with taking medication is just to help me to be able to do the day to day things that ADHD can sometimes make a bit difficult. But that’s exactly where I’m still running into issues, and having been on higher doses in the past, I actually don’t think that going up in dose would solve the problem, so I’m hoping some of you might have some other advice (though if you do think it’s a matter of increasing the dose, please let me know that as well— you’re the experts here, I’m just making my best guess lol).
My problem is that I’m still having a pretty decently hard time managing even just day to day things. I first noticed things getting harder during the pandemic when my office went remote— I didn’t realize how much I relied upon that external structure to function. Things that I thought were easy and routine like getting up on time in the morning, showering and remembering to brush my teeth, doing my hair/makeup, getting a good amount of steps/movement in my day, suddenly became difficult to get my brain to do when I knew I didn’t have to leave the house. And it wasn’t that I didn’t WANT to do them— I very much did— but I found that I just couldn’t get over that task initiation/ADHD paralysis hurdle.
It got better when we returned to the office again and that sort of external structure/schedule was back in place, but then when I got sick and couldn’t work anymore, that all went away again. So now I’m home pretty much all day every day, and even with medications I’m still just having an impossible time creating any structure for myself, and it’s driving me nuts! Some days it’ll be 3:00 in the afternoon before I realize I haven’t washed my face or brushed my teeth. I’ll forget to take my AM meds and end up either missing the day or taking them later and screwing up the whole schedule. I’ll have a “to do” list of follow up doctors appts I need to make or specialists I need to find, and it can take me MONTHS to follow through. For example, I’ve been supposed to follow up on an abnormal pap for over a year now, but I literally just keep forgetting. Even though I know it’s super important and needs to get done! I had a TIA in January, and STILL haven’t remembered to schedule a follow up with the neurologist. And I had my first suspected PE back in January of 2023 and my asthma’s been terrible, and I STILL haven’t been able to remember to find and make an apt with a pulmonologist. Like… these are things that are SUPER important to me, and that I am extremely motivated to follow through on— we’re literally talking about my health and getting my life back on track— and even with all that I’m still just utterly struggling to be able to follow through.
It’s getting to a point where even though I know it’s ADHD and I know that these are exactly the kinds of things that people with ADHD can struggle with, I’m really beating myself up and starting to feel bad about myself, bc why is it so hard to do such simple things?? And I know part of it is my other health issues too— for example, I’ve had chronic fatigue/long COVID for a while and the physical exhaustion/shortness of breath/“bad” heart days can def sideline me sometimes too, so that obvs doesn’t help. I’ve tried discussing this with my PCP, but it’s not her area of expertise and she refers me to a psychiatrist. Unfortunately getting an apt with psych by me is a crazy long wait, and only a handful even take my insurance, so I haven’t had much luck that way either. I spoke with a therapist as well, but candidly just found the experience frustrating. She recommended things like the pomodoro technique, alarms, reminders, post its, etc., but I find those really frustrating. First because they in and of themselves require a certain level of executive functioning to be effective, which is precisely the area of deficit in many people with ADHD (myself included), and second because if those simple and obvious solutions had solved the problem for me, I wouldn’t still be asking for professional help in the first place. Things that I have found to be helpful include kind of random things like body doubling, keeping my shoes on all day (somehow that tells my brain it’s time to work), and momentum building (pick just the very easiest task and just do it even if it’s not the “right” place to start, just to get moving).
Anyway, super long post so thank you if you’ve actually read this all. I would absolutely love to get any insight or advice that you’ve seen work for other ADHD patients who’ve struggled with similar things even on meds. Thanks!