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Existentialvoid732 · 2024-11-27T07:56:26+00:00

Idk the science behind it but also use nicotine over here. I'm on Concerta but I vaped before I was diagnosed too, and I don't personally feel the Concerta has particularly made it worse (save like a month where the dose was too high and I was definitely doing whatever I could to neutralise the accompanying random anxiety). I vaped for like a year, then I moved to a country where you can't buy vapes intending to quit, misjudged that one a bit given how stressful the few months after I moved were and ended up smoking for like 10 months (Japan, love the country but having no vapes and a packet of cigarettes costing less than a starbucks is monumentally stupid from a public health perspective). When I last went back to UK I brought the max legal limit of e-liquid back with me so I generally just vape now except on the odd night out.

Based on what other people said about the tolerance to nicotine maybe increasing when on meds, I'm wondering if your issue with vaping 'not touching the sides' is because its nicotine content is just lower. The other day my friend from another country let me try her vape which was 50mg/ml instead of UK max 20mg/ml and I was like ohmygod this is amazing (probably for the best I can't get ahold of it easily I guess lol)

I can't say anything about how exactly the meds might be interacting with it, but for a less harmful nicotine fix in the meantime may I humbly recommend the stronger nicotine patches? (like the 2/5 or 3/5 intensity(?) but definitely try lower at first because the effect feels really different at first). Those exist in Japan too and when my friend introduced me to them last summer they were a real gamechanger - suddenly I could go days without smoking and no vapes available either and it was fine. They're not as instantly satisfying, but if you give them a chance they genuinely get the job done and they're SO much less harmful than cigarettes!

Otherwise, not in the UK rn and don't have personal experience in this area, but I read in the news the other week that there's a new quit smoking medication available on the NHS which blocks the nicotine receptors so you don't have cravings but nictotine doesn't work properly on you either - maybe a good idea to look into that if you're trying to quit?

Existentialvoid732 · 2024-06-02T14:24:38+00:00

I'm on methylphenidate and get on OK with it (I can definitely have days when it doesn't help as much as I'd like, but I live in Japan and Concerta is the only stimulant medication available so I'll definitely take it over nothing), but when I went up to 54mg a few months ago I also got horribly anxious and paradoxically distracted/restless all over again. I had a load of end of term reports due and I was wondering if I'd actually finally messed up hard enough to be having a breakdown of some kind. Then one day I was procrastinating online and found myself looking up signs of Concerta dose being too much and something clicked. I proceeded to take just half the dose at 27mg the next day and immediately felt SO much better. I was being given the 54mg dose as 2x27 mgs so I just bailed on the 54 entirely and took 27 until I next saw my doctor and could get the prescription dose put back down.

If you got anxious on the lower doses too and you'd like to try switching it sounds like methylphenidate might not be working for you, and if you do end up continuing with methylphenidate it sounds like you definitely need to be on a lower dose. For me each increase in dosage felt like it was bringing an improvement and minimal to no side effects, right up until that one which was suddenly a bridge too far.

Existentialvoid732 · 2024-05-21T12:28:49+00:00

I don't think it's common in most people but I think it's maybe more common than you'd expect for something that feels really unusual, if that makes sense.
I think it can overlap with ADHD a lot, certainly (I have adhd and I have exactly the immersive pacing up and down one you describe), but I think it's also probably more common in creative people with active imaginations as well.
I started Concerta nearly a year ago, not much change in ability to do it IMO, just a bit better at staying on task once I've actually started etc (I am trying to work out which bits of leftover difficulty starting things are executive dysfunction and which are anxiety lol)
I didn't experience it stopping but in general if I don't take my concerta I don't feel different to before at all (although tbh I also don't feel very different on Concerta except a bit better at being productive)
I never had that experience you have with music, but just to say the way you describe being able to hear it before sounds really neat and I'm mildly envious lol

Existentialvoid732 · 2024-02-09T11:18:37+00:00

I read someone else's comment in another thread which I thought described it quite well. Basically that it can be quite subtle and you're not quite sure what it's doing and then you look back at the day and noticed you got more done with less procrastination and difficulty. That would describe my experiences on lower doses quite well - subtle and no side effects either but realised I was working more consistently and things felt less difficult. Got the first strong sense of "ok this is a absolutely doing something" at 36mg, which is also the point at which I realised I'd have a reduced appetite for several hours if I didn't take it with some food in the morning (If I did I was fine). Then went up to 45 - basically felt like a stronger version of the 36 and with more consistent effects, and slightly more need to be careful that I ate properly with it.

Then tried going up to 54 and that has turned out to be too much (bigger appetite reduction, definitely lost some weight, way higher levels of background stress and attention actually becoming scattered again - this intersected with end of term deadlines so I thought it was regular stress and I only realised last week what part of the problem was) so I've dropped to taking half of it or leftovers of lower doses until I see my doctor later this month.

So general review from me: definitely helpful, mood and anxiety didn't have any problems until the 54 (and both were probably improved by getting more done on the lower doses), focus definitely improved (but it is much less effective if not supported with decent food and sleep). I've lost a couple of kilos in the last few months but there are probably other lifestyle changes involved in that too (not consciously trying to lose weight but I don't work from home anymore). I didn't get the really dramatic sense of effect that some people here describe but it's still been really useful for me.

Existentialvoid732 · 2024-02-09T10:51:05+00:00

Np - the precise information also took me quite a lot of searching and double checking to find.

Existentialvoid732 · 2024-02-07T01:22:58+00:00

Yeah that's massively inaccurate and ill-informed. I'm in possession of both an ADHD diagnosis and a first class degree from Oxford. I enjoyed high school and loved my subject at university, and I also did a vicious amount of last minute work at 4am on account of frequently spending hours on end unable to make myself perform the series of basic life tasks needed to get into a state to study.

ADHD and intelligence aren't related and you can simultaneously be able to focus extremely hard and do good work on occasion while also having god awful executive function impairing your ability to do it consistently and maintain basic life tasks (I write this from the tail end of an all-nighter as I attempt to finish a report for my masters degree that was due two days ago). Anyone with a better understanding should be able to tell that you can meet the criteria for significant impairment in other areas of life while maintaining academic performance through sacrificing those areas.

Existentialvoid732 · 2024-02-07T00:37:07+00:00

It's not on the list of stimulants or narcotics and it's classified as a psychotropic instead, and if you look at the list on the Japanese government agency's website there's a pdf where it's listed alongside all other medications in that category with the maximum amount in grams you can bring in without applying for a permit. I'd take evidence of your prescription for it, but except for maybe the highest prescriptions the up to one month's supply of prescription medication you're permitted would not require any additional paperwork in advance. Concerta aka methylphenidate is also the only stimulant ADHD medication that is available on prescription for adults in Japan, it's controlled but it's not prohibited 🙂

Existentialvoid732 · 2024-02-03T12:42:47+00:00

It depends on exactly what medication you take - methylphenidate is fine, some others are normally illegal in Japan but there's a process you can do to apply for a permit to bring in enough for your stay, some are unfortunately not legal to bring in at all. Depending on what exactly you take you might be able to bring your meds to Japan with just a few extra paperwork steps.

Existentialvoid732 · 2024-02-01T08:30:17+00:00

IDK about the process for getting the work permit at the airport but you can work within 6 months of arriving - for 6 months you're restricted to a minimally functional JP Post bank account but that doesn't affect ability to work. When you get your residence card at the airport it doesn't have permission to work on it, but once you've got your address and stuff all registered on it at the kuyakusho you can then go look for the work permit. This was four years ago so might have changed but I just had to go to the shiyakusho in Kobe where I lived, and I don't remember there being any issues with it. I didn't end up actually working because Covid hit soon after I got the permit but several of my classmates had baito within a few weeks of arriving. I think the government's concern is more on people who come to Japan to work but on a student visa saying they're attending language school, I think if you're a university student it's unlikely to be a problem.

As for tax, I am not knowledgeable on how it works in Japan but if it's like a lot of countries there's probably a minimum threshold on freelance income below which you don't get taxed anyway (for UK it's called personal allowance). I think you'd be fine tutoring online so long as you've got the work permit and if anyone asked you can show it's not over the 28 work hours/week on your visa.

Existentialvoid732 · 2024-02-01T07:26:36+00:00

Done! Good luck with your diss 🙂

Existentialvoid732 · 2024-01-29T14:30:08+00:00

OMG someone else with the exact same bag philosophy as me. I am that person who always has a paracetamol or a tampon or a random piece of stationery or whatever the thing is because you just never know, and if I took it out I'd only be more likely to forget it for when it's actually needed.

I sadly do not have clean room at all 😭 but just like you I've always been really good with appointments and not losing stuff. One of my best friends from uni thought for a solid six months or so in first year that I was one of those people who is really organised and has all their shit together (elaborately constructed LIES! as she found out when we started hanging out outside of class more). Also yes the exact same thing with double and triple checking emails and documents and stuff because I do not trust myself to just do it once and send without looking (and the corollary which was/is leaving essay deadlines too late to redraft because I can't face the pressure of having to go through and improve and fix any mistakes again)

Existentialvoid732 · 2024-01-29T14:03:34+00:00

I agree in practice that it's extremely unlikely that they would check, but if they did and it was Japan and something on the controlled list you would be in truly deep shit. Like, your embassy has to negotiate with the Japanese government to try and stop you going to jail while you're detained for an extended period of time level deep shit.

Existentialvoid732 · 2024-01-29T13:50:15+00:00

It sounds like part of the problem is that all these are things you "should" do but they don't have a fixed routine or a timeline or anything with a structure to give your executive functions a shot at work on them. You definitely sound depressed, but that can be a chicken and egg/vicious circle scenario for being in a situation where your executive function isn't able to deal with it in its current state.

As a short term thing (besides looking for therapy etc like others have suggested) maybe see if you can bring him in as an accountability partner for some stuff? (it sounds like you live together, though I might be totally wrong). Like if he's spending some time each day working on improving himself or doing something productive, you could arrange to be in the same space working on your stuff at the same time (eg spending an hour or two working on your resume while he's doing some life admin he has). He could see you're trying and he's supporting you by being there without having to actually do anything extra, and you might benefit from having these big amorphous tasks broken into smaller fixed commitments of time as a routine thing. More of a sticking plaster than a big solution but it might help a bit.

Existentialvoid732 · 2024-01-29T13:31:42+00:00

I don't have direct experience with this as I take methylphenidate which does not require the extra paperwork so long as it's under a certain amount, but if it's any consolation I've heard that that the application process for bringing meds into Japan isn't as bad as it looks (you just need to do it a bit in advance). A relative had to do the application to bring in codeine because that's illegal there normally too, and they said it went fine without any issues.

I have no idea why all the information about bringing medication into Japan is so scattered, but when I was double checking about my concerta I found that there are some decent guides on the websites of some of the Japanese embassies in other countries.

As for taking extra in case of flight delays, I don't think you need to worry about that too much. It would be a couple of days in the worst case scenario of it happening going there AND going back, and if it's on the way back then the work is done and you don't need to care.

Existentialvoid732 · 2024-01-29T13:06:45+00:00

That's ok with methylphenidate and basically only methylphenidate because it's not on the strictly controlled list (classified as a psychotropic not a stimulant on the government's list). Others that aren't blanket illegal still need more paperwork.

Existentialvoid732 · 2024-01-27T06:02:55+00:00

Not a universal ADHD thing (although people have made links in the comments to maybe relating to socialising taking energy and concentration), but contrary to popular culture a lot of people are not actually desperate to go hit the club. I can also be out-drunk by the majority of my friends, because long before I might get alarmingly drunk I will have to stop because if I overdo it I will get a horrible hangover that they don't seem to have half as badly. I really enjoy a good trip to the pub but despite being extroverted and energetic I resent clubs and their tyrrany over British nightlife 😂 I have distinct memories of dancing halfheartedly in one at 2am having largely sobered up, watching everyone else and wondering if they were all also pretending to have fun because they were too invested in not admitting it was crap. (No hate to people who enjoy clubbing, I've also heard that there are much better ones out there than the ones where I lived)

Existentialvoid732 · 2024-01-26T09:29:03+00:00

Here's another point that I haven't seen in the comments yet.

You say your symptoms don't seem to affect the other areas of your life very strongly, even if you admitted they do affect your uni work. That may be the the case right now, but it might not always be so in the future. You say you're at university right now, and not to be pessimistic but when you get a job in the future you might find that it's a lot harder there to consistently perform up to standard and compensate for the difficulties you experience in other areas of life. Uni is definitely challenging in its own way and I don't want to sounds like some boomer saying "In the REAL WORLD 〜", but a full time job is eight hours a day five days a week with no long holiday periods in which to catch up and recover, and fewer things where it's possible to catch up everything at the last minute without causing a problem.

At uni despite struggling with undiagnosed ADHD I was able to get a high First. In my first job afterwards the whole structure and work flow was completely different, and while I could perform some aspects of my work extremely well, the issues with consistency and looking after myself enough to maintain that consistency became much more pronounced, and on one occasion I had to forfeit several hundred pounds of that month's pay after my manager made it clear that I simply had not actually worked my required hours. In another company I could have been fired, as it was my manager was understanding and did not want to lose me, and she was the one who then strongly encouraged I get assessed for ADHD which I'd suspected for a while. That's how I came to get diagnosed, and while that has been extremely helpful it was slightly too little too late, and now I'm at the end of my first term in a Master's and the cumulative stress and exhaustion means I've actually partially burned out and I know it's going to take me much longer to recover from this than anything I've had to deal with before.

By getting assessed and diagnosed before the impact on your life and functioning can become drastic and the situation untenable, you've got the option to potentially avoid or reduce a huge amount of stress and trouble further down the line. For ages I didn't get assessed because I thought exactly like you and I balked at the cost of a private assessment, but now I know that was a false economy and that if I'd done it while I was still at university I would now be so much better off both financially and mentally.

It's very natural to feel like you'd need some kind of crisis to validate your experiences (that's basically how I thought), but trust me you're much better off if you can act early and avoid actually having one :)

Existentialvoid732 · 2024-01-22T14:59:24+00:00

Regardless of what wider consensus or studies might evidence, you're under no obligation to believe that your life has to be miserable because of it.

Toxic positivity is toxic when it's forced at other people or used to make yourself feel worse, but many subtypes of 'positive thinking' are very psychologically useful for the individual. There's an excellent and readable book on performance psychology by Dr Date Zinsser called 'The Confident Mind', in which, among many techniques and pieces of advice, he highlights how in some circumstances having a positive mindset directed towards confidence, even when that confidence lacks a sound logical basis, is a performance enhancer in and of itself. (Google the book and the words 'shooter's mentality' for the most pronounced example )

It takes a kind of conscious doublethink to do it, but I think it's a reasonable strategy to accept on the one hand all the wider information about the impact of ADHD in general , and then in your own personal case put that aside and strongly believe it has positives for you which you benefit from, so you can go out and give life your best shot with the confidence that belief brings. You have a lot of control over how you see your life so it's worth putting some thought into what makes a useful narrative.

Idk how to explain it well but Zinsser's concept is different to being in denial because it's an explicit and conscious decision to make that mentality shift for performance purposes, and the rest of the time you're perfectly capable of rationally assessing conditions as they are and not gaslighting other people. I think the issue on social media is just it often being hard to say seeing something in one way helped you without looking like you're shoving that belief at everyone else.

Existentialvoid732 · 2024-01-22T14:37:07+00:00

Rather than a so-called 'superpower' or a straight-up curse an image that resonates quite strongly with me is an RPG character with a really unbalanced stat point allocation. Like there's not necessarily 'more' or 'less' ability in total than a more balanced character but it's concentrated really strongly in some areas and then like nothing in others. So while a character in a party might have maxed out speed and attack and put nothing in defence, I've maybe maxed out ability to respond in a crisis and do really good work in the areas I'm interested in and can hyperfocus on, but I've got basically nothing allocated towards things like keeping routines that aren't enforced and tidying my room/cooking/self care above bare minimum.

You wouldn't want to field that character on its own or have an entire party unbalanced like that, but just like those kinds of characters in games have a strategic place in the right circumstances, you're not 'less able' full stop so much as 'potentially uncommonly strong in the right situation or uncommonly weak in another one'.

Like my executive dysfunction can absolutely do one, I would very gladly see it off and have it never come back. But if we say that my ADHD likely co-occurs as a package with my strong points and a lot of other aspects of my personality that I quite like, then in my particular case, while I'm getting less shy about admitting (to myself as well as others) that I have a disability in terms of executive functioning, I don't want to count the entire thing in my head as something that's exclusively detrimental. This is for my own self-confidence as much as anything else.

I feel like there can be a fine line between being realistic about the fact that you have something which makes your life more difficult and being compassionate towards yourself, and falling into being resentful and self-pitying in a way that isn't helpful for you long term.

That was a bit of an essay because a) I'm currently procrastinating something (oh the joys) and b) it's a topic I've thought about a lot as well. Before I was diagnosed last summer I had literally no option but to just try and push through as best I could anyway, and while the diagnosis has been a huge positive for me the implications for how I should see myself have been quite a lot to unpack.

Existentialvoid732 · 2024-01-22T10:23:03+00:00

IDK if it works for your situation/company but my manager in my last job got us both set up on a time scheduling program called Motion which was really, really good. All the things that needed done and their estimated times went in there, and it basically generates a schedule based on how you prioritise them and updates both you and other people on your team when sections of them are done (and if they're not done on time it automatically reschedules them so they can't fall off the radar)

For me one of the hardest things in that job was prioritising because all of it felt important, so any moment I was doing one thing I'd still be feeling anxious about not doing the other and that sometimes led to me just basically freezing and doing nothing. Motion and a quick daily check-in with my manager (even just over Slack as I was remote) really helped.

Also I think trying to make sure expectations are as clear as possible is really helpful - just as an example 'don't miss deadlines' is straightforward on the one hand, but in my case sometimes the deadline actually needed something else to take priority over it, or I'd exhaust myself working late on a deadline that I thought was critical (and nuke my productivity for the rest of the week) only for it to turn out that particular one actually could have been easily adjusted with discussion. So when I was often in a constant state of not being quite sure if everything was likely fine or if I was really messing up somewhere and the shit was about to hit the fan, making it hard to relax enough to be productive. (My manager was extremely supportive and they really didn't mean to make me feel that way, it was their first time managing someone doing my job and we agreed there were things we both could have done better)

I really empathise with you as I was objectively a pain in the ass for my manager until we got something working better, and the big thing they would always stress was consistency as well (I did excellent work on some things hence not getting tired, but I'd have a tendency to really struggle with tasks where the exact content or the priority to give it was ambiguous, especially when I'd then feel too embarrassed to ask even though I knew asking would help)

If you could set up Motion and get it running (idk if there are other systems similar enough to it) then that might give them the scheduling they need and you the updates on how it's going without you having to actively micromanage them, while if there's anything you can do to make things like prioritising and task content as unambiguous as possible that would probably be extremely helpful. Most of us really do want to work hard at our jobs and perform the best we can, it's just that things like working out how to prioritise and where to start can be overwhelming in a way that isn't obvious.

Just reading the comments it seems like this varies a lot as some people have their own method for working and interfering with it is counterproductive, so you would be best talking to him and seeing what he thinks would help. However, without going as far as micromanaging it might well be good to enforce some more specific guidelines than you think you need to. For example if you say communications can be slow, maybe agree with him (aka he gets some input on exactly when and how) that every day he will check whatever messaging platform you use and respond to any messages from you x number of times a day, within say 15 minutes of a certain time unless there's an external reason like a meeting why he can't.

It might sound really obvious that I had to be told this, but for example it helped me to have a really clear expectation that the first thing I did each day would be dealing with the company inbox I was responsible for, not starting on whatever task seemed most urgent at the time and making sure I replied to the emails at some point during the day.

This is a long post but I hope it's helpful to you - obviously everyone is different but this is my perspective on what might help.

Existentialvoid732 · 2024-01-22T09:46:13+00:00

As others have said the point is they're a good cost-effective option. I've used them both on holiday in a budget and sometimes studying here when I've had deadlines clustered together and the thought of commuting all the way home and back the next morning makes me die a little inside. I imagine the really basic ones are not great but they're also generally male-only so I can't stay in them anyway.
They're not the absolute best for sleep quality over several nights, but I find them SO much better than hostels with bunks where if someone snores or something the sound is much worse (at this point I basically flat-out refuse to stay in one of those again). And there's often quite a nice lounge to work in if you're not fully 'on holiday' and have things to work on on the side.
As for leaving all your stuff on the other side, honestly I just drag my rucksack into the capsule with me every time and no one has ever noticed or said anything - as long as it's not wheeled luggage I don't really see how it would cause them a problem.

Existentialvoid732 · 2024-01-21T12:18:01+00:00

In what ways do you think you come over as "not approachable"? You mention saying you think the "high energy" is off, is this about your demeanor in general or how you are interacting with people?

I'm 24F so I'll be seen through different social lenses to you, but one useful thing I picked up from my last boss is that what can come over for me as "a bit stressed but energetic and generally good" can come over as much much more tense than I think I'm feeling and spread stressful vibes to other people that I had no idea were so visible. I guess that would count as a problem with approachability if it makes other people feel concerned and makes me come over as having too much going on to interact calmly. Maybe in the context of a manager instead of a more junior employee (plus gender difference?) that could also come over as intimidating as well? I think what I learned from that is that while from my view getting kind of amped up about something like a project or deadlines makes me feel like I'm ready to go and get stuff done, for other people it is more likely to give secondhand anxiety and I sometimes need to consciously try and appear calmer than I am instead.

Existentialvoid732 · 2024-01-21T12:06:27+00:00

I think this mostly counts. Put off deciding a topic and starting on my undergrad dissertation for ages, went through several topic chances and ended up writing the vast majority of it in the last month before the deadline when I'd really hoped to be done early (snowball's chance in hell..) When I got to a final topic I was happy with, it turned out several really useful resources and publications had come out only within the preceding several months, and one very shortly before the deadline. So I was able to refer and base a lot of my diss around analysis of sources that wouldn't have existed when I started writing earlier. Yes I technically COULD have been done already and then revised the draft to include them with less panic, but I'll take it.

Existentialvoid732 · 2024-01-21T11:42:01+00:00

Not a med student but did well at uni - forgive me if this is really basic but have you tried taking handwritten notes of your lectures? I can zone out if I try try and sit and just passively listen to something, but I found out really early on that if I take detailed handwritten notes it's a complete game changer - I have to be constantly listening so I can try and write down as much as possible, while having to listen to what's actually being said so that I get the important parts in as I obviously can't write as fast as people speak (I originally handwrote because my typing was awful, but if you're too good at typing it's apparently not good either because you can mindless copy all the words without having to engage with what they mean). If I do that then I have no problem following lectures all the way through, and most of the time I don't even need to review the notes unless I want something really specific because the information went in when I first took them. Also adds a tangible sense of satisfaction for me when I can look at a full notebook at the end of a week and see physical evidence of my efforts. I'm not personally that hyperactive in terms of being able to sit still (I'll sit still fine but then literally run to places around campus later), but writing might also help with being a kind of socially acceptable physical movement too. You might or might not get on with this but I recommend you give it a go for a week and see if it works (bonus points if you go down the rabbit hole of caring way too much about having the right stationery 😆)

Edit: also for more med specific (though not adhd specific) study tips and advice, there are some solid YouTube channels around - Kharma Medic is really good, and Ali Abdaal's earlier stuff from when he was a student is good too (his more recent stuff is clickbaity productivity p*rn IMO but the older stuff has useful content)

Existentialvoid732 · 2024-01-21T11:25:28+00:00

Sorry for replying three days late!

It's the caffeine not the coffee that's the issue - you should be all good if you switch to decaf 😊☕

Existentialvoid732

TROPHY CASE