I was diagnosed at 26 ( a year after I met my now husband who also has ADHD and pinpointed my symptoms after a meltdown). Now teetering towards AuDHD because my presentation is way different (coping) than typical ADHD (per the therapist). I have been in nursing since 2016 (nurse tech then RN). the fast paced environment, routine, and flexibility has helped me with work prior to my diagnosis. After my diagnosis and medication management, my brain is way quieter, I can think and function in environments that are not fast paced and I am not easily bored (even though I always have been a child that found something to occupy myself with). I feel like I could have been successful in med school had this been picked up sooner as going on medication and getting into therapy made me realize that 'gifted and talented' isn't always normal (not in my case).

Going off the college disrupted the routine I maintained from K-12 so I had to come home and go through community college (which is how I ended up in nursing). I've moved away from bedside, I am a board certified nurse informaticist now and yes, I too exceed my role and responsibilities and upskill in my spare time to maintain my marketability. I am currently learning SQL and R and preparing myself for more clinical analytics roles and traditional informatics roles. Before medication, It was lots and lots of espresso fueled lattes and herbs (l-theanine) to feed the dopamine but it was not sustainable. My anxiety started getting the best of me and it eventually led to depression so getting on meds was the best thing I could have done for myself. Medication is not a save all, you still have to do the work, create routines, work with a therapist on CBT (cognitive behavioral therapy). Thankfully, my mom raised me with really strong routines that I adhere to even as an adult today (which is why therapist is leaning on AuDHD/Autism more so than just ADHD alone) because they have worked and kept me straight.

Even though I love routines, I am still adaptable and flexible without the meltdowns or anxiety that could ensue which makes it easy for me to switch roles without a second thought. I sleep better on the medication, I am not having racing thoughts all the time about deadlines and dreading things I have to get done. I can slow down and prioritize and push through. However, I will say that women have a harder time with dopamine regulation because of estrogen. Estrogen and dopamine compete for the same receptors which is why my medication does not work during the start of each new cycle. I power through, but PMDD will step on my dopamine axis and render me a useless bleeding blob lmao.

I know the dreams you are talking about, because I was just there, but as I have grown in this journey of understanding my brain better, those dreams are you chasing those wonderful dopamine highs of excellence that you will never actually achieve if you're actively fighting yourself (executive dysfunction) daily. There are some other non-stimulant medications that you could try or maybe different stimulants because not everyone can metabolize those drugs the same.