During the diagnosis of autism, the doctor said that I probably had ADHD (Attention Deficit Hyperactivity Disorder) and asked if I wanted to be assessed for it as well. Why not, since the government was paying for the diagnosis? Even though it was obvious to me that I had ADHD (like autism). As a result, besides the diagnosis "Autism spectrum disorder, level 1, without intellectual impairment" (that's the current name of what was called "high-functioning autism" or "Asperger's syndrome" in the past - not a syndrome anymore, but still a disorder, and thank God at least for that), I was also diagnosed with "Attention-deficit/hyperactivity disorder: predominantly inattentive presentation".
This combination is quite common, and is even called AuDHD (Autism + ADHD). From my correspondence with ChatGPT:
Based on the results of the diagnosis, the doctor prescribed an amazing drug Vyvanse (called Elvanse in Europe), which I have been taking since November 2022. It has changed my life incredibly for the better, my work as a programmer has become much easier. The concentration is unbelievable, there are no distractions, and I can work like a horse. I used to look impatiently at my watch waiting for the end of the working day, and now I often continue to work even when the official time has over - I have a lot of ideas in my head, and it is great fun to implement them. Sometimes I wake up at 5 or even 4 a.m. and start working, though my working day begins at 7 a.m. (no, they are not beasts - I asked them to shift my working hours to an earlier time, because I usually get up early).
I noticed the effect of the pill an hour after the first intake (so, I could title this page "How I got rid of ADHD in one hour", and that would be true!). First of all, it was a lightness in my head that made me dread the fact that I had lived with a feeling of heaviness for so many years. It was implausible and amazing to look at the world through another person's eyes! The pill is said to last 12-14 hours, so you have to take it once a day in the morning. However, I have noticed that the action lasts much longer - several days. Vyvanse is needed only for work, so I do not take it on Saturdays and Sundays (it is called drug holidays). But even on Monday morning I can feel the action (even if it is clearly weaker), before I take the next dose (even though it's been 3 days).
An interesting "side effect" was that my eyes became less sensitive to bright sunlight. Before, I couldn't go out or drive in sunny weather without a dark filter on my glasses, but now it's easy. Mentally I know the sun is very bright, but no eye soreness or other negative feelings. I used to think it was more of an autistic trait, as many autists have an increased sensitivity to sounds, smells, light, etc.
SLOW AND STEADY WINS THE RACE
Since I started therapy, I am driving my car much more calmly. I used to want to go faster and faster, but now I drive in a measured way, not rushing anywhere - just like a real Canadian :-). So, although my ADHD has "predominantly inattentive presentation," the hyperactive component is also present. I used to not understand why two completely different phenomena were mixed into one diagnosis, but now I see that they are two manifestations of the same disorder. ADHD and car crashes are a special topic, it's on the YouTube (in short, ADHD people are much more likely to have an accident). If you've noticed that you're always trying to drive as fast as possible (even though you're not late for anything), that you're annoyed by other drivers who prevent you from driving like crazy, and angry about long red lights, then immediately jump behind the wheel and drive like Schumacher to the family doctor for an ADHD referral!
SOME NEURODIVERSITY AND PHILOSOPHY
I have an acute reaction to changing tasks, multitasking is one of my biggest problems at work. This is typical for many autistic people, but the ADHD pill has had a positive effect in this area as well (the problem hasn't disappeared, but has clearly diminished). Before, having to leave one task and start another caused internal shock - up to the point where I couldn't work at all. Now I perceive it less emotionally.
It also became easier to get down to some activity (or part of the work that I had been putting off). In the past, I had to force myself to take action, and not always successfully. But now everything happens more quickly and with less negative emotions: I have to do it - and why not? Suddenly I understand that it is easier to do things right away than procrastinate and then force myself to act. It is more than obvious that the pill has a positive effect on the "mechanics" of the brain associated with pathological demands avoidance (PDA), from which many ADHDers suffer (and autists too).
I had understood before that ADHD was a real disability, but now I physically felt what it meant. It is a pity that I was diagnosed only now, in my 50, and not in my youth - I could have avoided a lot of the suffering I went through in college, and during my 23 years of work. Even now I can't forgive myself for waiting a year and three months for a free diagnosis, even though I could have done it right away - paying a not-so-big amount. But I never thought that my condition could be corrected, and I signed up for diagnosis more for fun - not imagining that it would change my whole life.
However, Vyvanse had no effect on my other autistic traits - the need for clear and unambiguous instructions as well as for monotropism (this is a focus on details and a problem with seeing the big picture, and as a result - limited abstract, analytical and strategic thinking, in other words, I "see only what I see", and find it difficult to draw conclusions from this and "think" the missing).
It is generally accepted that ADHD is a form of neurodiversity (the set of non-pathological non-standard features of the brain structure) along with autism. That said, a great many people have both, and the borderline is sometimes blurred due to the commonality of manifestations (such as the aforementioned intolerance to multitasking). Nevertheless, lately I am not sure that ADHD should be referred to neurodiversity - it is more like an illness, which I have practically passed thanks to treatment (by "passed" I mean that the symptoms disappeared - of course, if you stop taking the pill, everything will come back). But I haven't heard of an autism pill. But that's a philosophy.
THE BUGS ARE NOT IN THE SOFTWARE, BUT IN THE HARDWARE
Some of the main neurotransmitters (substances used to transfer information between brain cells) associated with ADHD are dopamine (responsible for regulating mood, motivation, attention and behavior), serotonin (regulating mood and sleep) and noradrenaline (regulating attention and stress response). People with ADHD often have a lack of these neurotransmitters in the brain, and they can be transferred between neurons too quickly or not efficiently enough, which can lead to ADHD symptoms.
Vyvanse is a central nervous system stimulant that works by increasing the concentration of neurotransmitters in the brain and correcting bugs in information transfer between cells. You can find more details about this (but still briefly and "in plain language") in this interesting article: How ADHD medication works.
By the way, sometimes I feel a kind of lightness, detachment from the problems of this world, even euphoria, as if I were flying. It was especially noticeable in the beginning, perhaps because I was not yet used to my new state. But this is not just a lightness of the head, but rather a state of sharp, like a scalpel, attention. I have to assume people without ADHD don't know anything else, but I can compare the two feelings - I used to just have brain fog.
Vyvanse also works as a very powerful antidepressant. And it seems to me that the action takes place in two directions at once. Firstly, by affecting neurotransmitters (and malfunctions in their work also affect mood, and can even cause depression, as described here). And secondly, indirectly - work has ceased to be torture and poison my life.
Vyvanse is only prescribed for people who do not have heart problems because it has a stimulant effect (including on the heart muscle). I first had a thorough examination of my heart, including an ultrasound and a stress test on a treadmill. The doctor prescribed a dose of 20 mg, but I sometimes felt my heart jumping out of my chest and my heart rate increased. I asked to reduce the dose to 10 mg and it was fine. So it is better to start with 10. Over time I got used to the pill and returned to 20 (with 10 the effect was less pronounced). Always (and especially in the beginning) you need to monitor your heart rate on a smart watch. You also need to stop taking any supplements that affect the brain and mood (zinc, tryptophan, bacopa/brahmi, phenylalanine, tulsi, rhodiola, ashwaganda, antidepressants - remove absolutely everything and then gradually introduce one pill at a time if you were taking several). Vitamin D can be left. The thing is, other substances can also act excitatory, and their effects will overlap. I removed them all, and then tried to slowly go back to mucuna pruriens - my heart started beating so hard, so I gave up on that idea right away. And although many sedatives just "slow down the run" (lavender, passionflower, valerian root), it is better to temporarily give them up for the sake of the experiment (I repeat, Vyvanse acts also as an antidepressant, so the need for other sedatives may disappear).
Also it is necessary to remove caffeine, which has a stimulating effect - with it the attempt to improve life with pills may well end in failure. I got rid of caffeine addiction 3 years before I started taking Vivanse, which, I think, made the start of treatment much easier. And recently I decided to sin a little and drank 40 grams of coffee with caffeine. The reaction was immediate - my heart was beating in my ribs (well, figuratively speaking, of course!), and even for a few days after that my pulse was higher than usual. It was as if the effects of Vyvansei and caffeine were multiplying rather than adding up.
Weaning off caffeine takes time (see my diary), so if you plan to be diagnosed and get the much desired prescription from your doctor, start gradually reducing the dose right now (you have time). If it is not possible to remove it up to the end, it seems to me that, after you start taking the pills, it should be easier to refuse caffeine at all since the pills will take up some functions which caffeine is carrying out now (this is a purely hypothetical assumption). Anyway, with the beginning of taking the pills you stop consuming caffeine completely!
The doctor who diagnosed me told me to try either Vyvanse or Concerta. Since Vyvanse works fine, there is no point in experimenting with Concerta at this stage.
Autism (Part 1) • Autism (Part 2) • Autism and job • ADHD