My Adult ADHD Experience: Day One

I’m thirty-eight years old. Over the past several years, I have been noticing problems with my mental state that could be described as ADHD. I’ve had trouble with alertness, attention, focus, motivation, executive function, energy levels, mood, and cognition that I didn’t have before at this level; and those things were causing problems in my work life and in my home life. I’m getting treatment now, and while I know that everyone’s brain and experience is different, I’m hopeful that my experience can be helpful to others.

It was only a year or two ago that I was willing to call this a problem. Growing up in a rural community in the 90s, that diagnosis (well, as ADD) was reserved for students who were doing poorly in school and who were running around all over the classroom; I was doing well academically, and even though I had trouble with focus and attention, I was able to make up for it. I came up with coping strategies, and found things I liked, and simply made it through.

In college, the problem compounded as I essentially lost the ability to read long books. I was a voracious reader in high school, but the combination of boring textbooks and a more difficult workload that caused reduced sleep made my brain connect reading with sleep. My coping strategies began to fail, and I found myself struggling more. It took eight years for me to graduate, and I wandered through four different majors in the process. Still, with the development of new coping strategies and the help of my wife (whom I met in 2006 and married in 2010), I was able to graduate and eventually get a job in the tech industry, doing something I enjoyed.

Identifying what was wrong with me became a greater priority a few years into my career, as my family began to grow and my ability to focus on work began to dwindle. It was like I had a certain number of lanes in my brain; and with my work, church, wife, children, and hobbies, there simply wasn’t enough bandwidth to go around.

I first talked to my doctor about this experience a few years ago. He suggested that we rule out other possible issues; things like depression and sleep disorders. First he recommended increasing my activity, so I made it a point to take daily walks or bicycle rides; this worked great to improve my mood and energy levels, but didn’t affect the other issues I was having.

Iterating on the problem, he suggested that I get assessed for a sleep disorder. I did indeed have sleep apnea and began on a CPAP nearly two months ago. While I was cautioned that I probably wouldn’t see immediate results, I actually did: my alertness, motivation, and cognition increased almost immediately. Still no real impact on focus, attention, or executive function, though.

Independent of my own journey, my children were also being assessed for potential ADHD. While filling out the assessment paperwork for my oldest two children, I noticed a lot of things that not only apply to me now, but also would’ve applied to me as a child. What are the odds that a disorder which runs in the family would show up in at least two of my children (and maybe more) but not in myself or my wife? So I made an appointment to follow up on the treatment.

In that appointment, I laid out essentially everything I noted above. The nurse practitioner performed a similar assessment on me to the one that I had filled out for my children, and noted that while I scored high for ADHD, I scored low for depression and anxiety. When diagnosing the disorder, she said, the usual process is to identify the symptoms and then make sure that they couldn’t be explained by anything else; and that our previous attempts to solve the problem with exercise and better sleep indicated that ADHD medication could be a good next step.

It was there that we encountered another problem, though. See, it is mid-2023 as I write this, and there’s a nationwide medication shortage for ADHD stimulant medication (such as Adderall). The Adderall shortage in particular is making other stimulant medications more scarce, leaving only very expensive non-generic stimulants behind. So we made the decision to begin our medication attempts with a drug called Atomoxetine (the generic name for Strattera), a Selective Norepinephrine Reuptake Inhibitor (sNRI) which reduces the brain’s removal of norepinephrine, the neurotransmitter that mobilizes the brain and body for action. sNRIs are related to SSRIs like Prozac and Zoloft, and are also classified as antidepressants, but are FDA-approved for adult ADHD treatment. We began with a low dose of 40mg, with the understanding that seeing the full results would probably take a few weeks.

I took the first dose this morning.

Initially, I didn’t notice any changes. About an hour after I took the medicine, my brain felt “warm;” not in a bad way, per se, but in a way that felt like it was using more energy.

In the hour after that, my brain activity started to feel “smoother.” I’m not entirely sure how else to characterize it. While I would ordinarily experience sharp spikes in mental activity, motivation, and reward, it felt more regulated. The experience was noticeable, but not game-changing.

It felt in the hour after that like my brain had more capacity; like the lanes that I had were operating at a higher rate, or maybe that there was another lane. And the fact that I’ve written this entire blog post in one sitting (and intentionally begun every paragraph with the letter “I”) either means that my focus is better or I’ve found a new hyperfixation.

I can tell that there are changes going on in my brain, but I don’t know whether they’re good ones or not; and I don’t know what effects are the medication and what are placebo. Still, I’m willing to follow along with it for at least another day or so.

I hope that this account of my experience was helpful to someone. I’ll continue documenting this journey here and on Mastodon.

The Vibes of Mastodon

Back in December, I decided to leave Twitter and joined Mastodon: the federated social network that’s not owned by any one person or company. Shortly thereafter, I tweeted for the final time on Twitter. I had originally intended to test out several options for replacing the newly-Elon-Musk-purchased social network; but after dabbling with Post, Hive Social, and Tribel Social, I discovered that none of them really had the same “feel” as Mastodon. The “vibes” were—are—really different, and I like it.

So if you’re interested in joining Mastodon, here’s what you can expect:

It Feels like the Internet of 1999

If you remember the internet of 1999, you probably remember it feeling like the wild west: frontier town websites, scrappy discussion forums, and no algorithm guiding, gatekeeping, or filter-bubbling what you saw.

Imagine those heady times, add some better moderation, and you have Mastodon.

The spirit of old-school webrings is alive in the niche Mastodon instances that have gathered around various professions, scientific research topics, and fandoms. The spirit of discussion forums is on the platform in the way hashtags are used across the “Fediverse” (a collective name for all of the interconnected ActivityPub servers) to connect with people who are interested in the same topic across the world.

Now, this also means that you’re not spoon-fed interesting content like on big social media sites. If you’re interested in NASA, you’ll need to follow the #NASA hashtag. A lot of new users have reported the Mastodon experience being a solitary one; but that’s just because they haven’t gone looking for people and topics they are interested in.

Mastodon doesn’t need algorithms or recommendations to surface the people users want to follow; instead, we just see their posts come up in hashtags (oh, did I mention you can follow hashtags? More on that later). But in short, it feels like the old-fashioned, turn-of-the-century internet; not least of which in the way that…

It feels more cooperative

One of the first differences you’re likely to notice between posting pictures on Mastodon and posting pictures on Twitter is that people on Mastodon are much more interested in utilizing image descriptions. Not only are they a huge quality-of-life improvement for people with vision problems and slow internet, some people use them for further explanations and even extra jokes. People want others to see what they share, so they make it more accessible.

People also don’t tear other people down as much on Mastodon. In fairness, this may be a personal experience, but since there’s no algorithmic advantage to tossing off a hurtful zinger at an opponent, you’re a lot more likely to see people answering kindly, or just muting or blocking troublemakers. It makes for fewer mic drops, but it’s still nice to see such kindness and cooperation.

That cooperation also comes up in the form of hashtags. Since there’s no algorithm pushing content you’re likely to interact with, people often find others using hashtags; just like in the old days of Twitter. See a topic you want to learn more about? You can follow a hashtag just like you follow a user and see all the federated posts a server knows about with a particular hashtag in your timeline. This also means that which instance you choose doesn’t have to be particularly important, as you can follow topics and users from essentially any server from your account.

That cooperative nature also leads to users donating to their instance administrators to keep the site going because they like it; kind of like with public media. Some servers have a Patreon account with perks, while others simply put up a PayPal or Kofi tip jar. Compared to a big social media company that requires advertising and subscriptions to stay afloat…

It feels more solid

Early in my experience with Mastodon, I put my coding and development account on a smaller, up-and-coming server; but shortly after I joined, the massive increase in signups from people fleeing Twitter caused some uptime issues on the small, self-hosted server. In order to relieve the load, I moved the account to Universeodon, a bigger server (which interestingly also hosts George Takei‘s Mastodon presence).

The move took all of five minutes, and I didn’t lose any followers or follows. In essence, I was able to pick up exactly where I left off; I didn’t have to rebuild my network on a new server. Everyone just came with me, and it was very simple.

This gives me a lot of confidence for all of my accounts; if one server goes away, I can go to another instance. In fact, if Mastodon itself goes away, I can go to another service altogether, such as Pixelfed or Friendica (or the inevitable Mastodon fork that will inevitably be released within hours), and since it’s all based on open standards, there’s no way for a billionaire with a trollface gif to pull the rug out from under me.

In a lot of ways…

It feels like the future

Honestly, Mastodon feels like the type of social media that Starfleet would use; my instance is my starship, and it plays nice with all the other instances in the fleet (though there are a few Romulan warbirds out there that we don’t interact with since they’re trying to do devious stuff).

Maybe we won’t be using social media by then. But if we are, I hope it’s something federated and standards-based; something a single bad actor can’t destroy without our consent.

We’re building a new social internet out there. Won’t you join us?