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The Door Frame
Dec 5, 2011

I don't know man everytime I go to the gym here there are like two huge dudes with raging high and tights snorting Nitro-tech off of each other's rock hard abs.

MJBuddy posted:

I can stop and listen to my heart beat or white noise and fall asleep in minutes. No jukebox, no thinking about my projects or analysis or football or games. Just one thing then sleep. I'm sure someone reading this just had their eyes get wider, so if that's you talk to your doctor about adding an alpha 2 med.

Holy gently caress, that sounds loving beautiful! I have started having to take Xanax to sleep before 4am, but this sounds like a godsend. The blood pressure reduction sounds good too

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MJBuddy
Sep 22, 2008

Now I do not know whether I was then a head coach dreaming I was a Saints fan, or whether I am now a Saints fan, dreaming I am a head coach.

The Door Frame posted:

Holy gently caress, that sounds loving beautiful! I have started having to take Xanax to sleep before 4am, but this sounds like a godsend. The blood pressure reduction sounds good too

Clonidine is also sedating when you first take it so it knocked my rear end out the first few days regardless but it's already tolerating really well.

It takes most of the edginess off of the amphetamine because it's blocking the adrenaline, so the jittery effects when the meds wear off are just gone. Still get hungry and tired but when I eat that's all I need.

Qu Appelle
Nov 3, 2005

"If a COVID-19 pandemic occurs, public health officials may have additional instructions, such as avoiding close contact with others as much as possible, and staying home if someone in your household is sick." - Official insights from Public Health: Seattle & King County staff

Does your appetite ever come back on Strattera?

I mean, I'm happy that I'm no longer considered 'overweight' BMIwise. However, taking more than an hour to eat a bowl of really delicious homemade soup is getting old. I know I need to eat more - but any semblance of appetite is just *gone*.

(Other than that, it's still working like a champ at 10 mg).

Baby Babbeh
Aug 2, 2005

It's hard to soar with the eagles when you work with Turkeys!!



Man, maybe there's something wrong with me because I take 80 mg and I still eat like a fat beast.

Boris Galerkin
Dec 17, 2011

I don't understand why I can't harass people online. Seriously, somebody please explain why I shouldn't be allowed to stalk others on social media!
I was started on 10 mg of Ritalin a day (split into two doses) and got that bumped up to 20 mg (still split into two doses) within the week. This worked really well for my inattentiveness and I could focus so much better at work, but every day around the 3-4 hour mark I think it would start wearing off and I'd feel absolutely horrible. Like I can sit there at work and feel the effects immediately. My thoughts slow down and I start getting anxious and "heavy." This all went away when I took the second dose though. For some reason that I don't understand, this comedown was never an issue for the second dose of the day.

I told my doctor all of this and was switched to generate metadate (20 mg). I actually found some literature about the exact drug I'm taking from the manufacturer. Anyway, it's been only three days now but it feels like I'm only delaying the terrible feeling comedown by a few hours. If you look at that link you can actually see a line plot showing serum concentrations over time. The comedown that I'd get on the IR around. 3-4 hours is smoothed out by the extended release, but a few hours after that it drops. In fact the serum concentration with metadate is actually lower all across the board than if I would have taken two IR pills of the same dosage.

So long story short, instead of feeling awful around 11am, now I feel awful around 1-2pm. Except now I don't have a second dose to counteract that. I'm going to wait and see for the rest of the week but I don't really expect it to magically get any better especially considering the science backs up what I'm describing.

What are my other options here? Ideally if I could have a constant amount of whatever medication in me during my entire waking hours that would be great, but I guess all medication is going to wind down at some point. So one option sticking with methylphenidate would be to try something that lasts longer?

Does any of the amphetamine based medication have longer half lives and aren't as bad wearing off?

My doctor also mentioned strattera, but if I'm going to be completely honest I'd rather stick with a stimulant.

Baby Babbeh
Aug 2, 2005

It's hard to soar with the eagles when you work with Turkeys!!



In my experience, there's a difference between generics in how the come down works. Some of them are better than others about softening and extending it a bit, although there's still a noticeable lull with all of them. Actual brand name Ritalin LA worked best for me when I was still taking stimulants, and for what it's worth my experiences with the IR were exactly as you describe: a good 3-4 hours that felt great and productive and then a horrendous comedown.

MJBuddy
Sep 22, 2008

Now I do not know whether I was then a head coach dreaming I was a Saints fan, or whether I am now a Saints fan, dreaming I am a head coach.

Boris Galerkin posted:

I was started on 10 mg of Ritalin a day (split into two doses) and got that bumped up to 20 mg (still split into two doses) within the week. This worked really well for my inattentiveness and I could focus so much better at work, but every day around the 3-4 hour mark I think it would start wearing off and I'd feel absolutely horrible. Like I can sit there at work and feel the effects immediately. My thoughts slow down and I start getting anxious and "heavy." This all went away when I took the second dose though. For some reason that I don't understand, this comedown was never an issue for the second dose of the day.

I told my doctor all of this and was switched to generate metadate (20 mg). I actually found some literature about the exact drug I'm taking from the manufacturer. Anyway, it's been only three days now but it feels like I'm only delaying the terrible feeling comedown by a few hours. If you look at that link you can actually see a line plot showing serum concentrations over time. The comedown that I'd get on the IR around. 3-4 hours is smoothed out by the extended release, but a few hours after that it drops. In fact the serum concentration with metadate is actually lower all across the board than if I would have taken two IR pills of the same dosage.

So long story short, instead of feeling awful around 11am, now I feel awful around 1-2pm. Except now I don't have a second dose to counteract that. I'm going to wait and see for the rest of the week but I don't really expect it to magically get any better especially considering the science backs up what I'm describing.

What are my other options here? Ideally if I could have a constant amount of whatever medication in me during my entire waking hours that would be great, but I guess all medication is going to wind down at some point. So one option sticking with methylphenidate would be to try something that lasts longer?

Does any of the amphetamine based medication have longer half lives and aren't as bad wearing off?

My doctor also mentioned strattera, but if I'm going to be completely honest I'd rather stick with a stimulant.

HL for the d-amp meds is double that of ritalin

miryei
Oct 11, 2011
What about Concerta? It's a different extended release version of methylphenidate, and supposedly lasts around 12 hours--it lasted 13 for me. That would at least push the comedown back to the evening, instead of while you're at work. Everything works differently for different people though. I've seen people complain about the crash/comedown from Concerta, so ymmv.

Wikipedia lists other extended release versions of the same here. If that drug works well for you, and the timing and comedown are the main issues, it's probably worth trying a few different release mechanisms.

Astrofig
Oct 26, 2009
Can Concerta cause anxiety when you come down? That was how it always seemed for me---I'd be sitting in class silently freaking out and hyperfocusing on every single word the teacher said. It was hellish.

Boris Galerkin
Dec 17, 2011

I don't understand why I can't harass people online. Seriously, somebody please explain why I shouldn't be allowed to stalk others on social media!
I just looked up bio equivalence and this is completely new to me. I always thought there were no differences between generic and name brands since eg amphetamine is amphetamine, but I guess it makes sense that they have different delivery methods and time release schedules.

So let's say I wanted to try name brand metadate cd, how would I go about doing that? I'm looking at my insurance's website and using their drug pricing tool and name brands all are higher in costs and/or say things like it requires pre approval. My plan has a low deductible and then 100% coverage so does the price not matter to me since it'll be covered fully after I pay the deductible?

Keep in mind my insurance is ridiculous. At my last appointment I asked my doctor to give me a script for a 90 day supply of Wellbutrin instead of 30 day and when I went to go pick it up... Found out the 90 day supply isn't covered. But the 30 day supply is. Same brand and dosage :downs:

Qu Appelle
Nov 3, 2005

"If a COVID-19 pandemic occurs, public health officials may have additional instructions, such as avoiding close contact with others as much as possible, and staying home if someone in your household is sick." - Official insights from Public Health: Seattle & King County staff

Astrofig posted:

Can Concerta cause anxiety when you come down? That was how it always seemed for me---I'd be sitting in class silently freaking out and hyperfocusing on every single word the teacher said. It was hellish.

Oh holy crap yes. OMG yes.

When it was on? Everything was great. Coming down? I wondered for a while why every commute would end with me in cold sweats over every possible doom scenario, before I realized it - yes, it was the Concerta. All of the Ritalin derivatives do that for me. The shorter the duration, the harder the comedown, and the worse the anxiety - until it culminated in actual panic attacks.

This is why I also love Strattera right now. (I also had a surprise 20 minute phone screen and interview for a job today; I thought it was going to be for tomorrow. So I didn't make any decaf coffee or plan for it or anything. But when they called, I was on top of it, and did a good job - and my resume is being sent to the Hiring Manager for a possible phone screen with him tomorrow. :hellyeah: )

Qu Appelle fucked around with this message at 23:01 on Feb 11, 2015

Astrofig
Oct 26, 2009
Go you! Best of luck tomorrow! *goon-five*

It's such a relief to know that wasn't just me, though. I thought I was just nuts and too broken a person to sit through a lecture like normal.

MJBuddy
Sep 22, 2008

Now I do not know whether I was then a head coach dreaming I was a Saints fan, or whether I am now a Saints fan, dreaming I am a head coach.
Going to parrot my earlier posts: look into an alpha 2 adrenal medication like clonidine or guanfacine (watch the spelling, not the cold med). Both result in less adrenaline effects which were the primary causes of feeling "edgy" on adderall or dex for me, but also control most of the comedown effects.

There's a 4x4 study on methylphenidate and clonidine that showed 85% of patients taking a combination of both had better results than either alone with a placebo.

I'm just becoming an advocate purely out of there being a lack of advocacy for a combo of meds that's got a ton of literature supporting it as improving side effect profiles and results.

Qu Appelle
Nov 3, 2005

"If a COVID-19 pandemic occurs, public health officials may have additional instructions, such as avoiding close contact with others as much as possible, and staying home if someone in your household is sick." - Official insights from Public Health: Seattle & King County staff

I'm wondering if low dose Strattera can be paired with low doses of Concerta or Metadate. Because, aside from the anxiety, those drugs were golden - and Strattera does wonders for my anxiety.

Horrible Smutbeast
Sep 2, 2011

Astrofig posted:

Can Concerta cause anxiety when you come down? That was how it always seemed for me---I'd be sitting in class silently freaking out and hyperfocusing on every single word the teacher said. It was hellish.

On the wrong stimulants I ended up wanting to die or spending the night crying when I came down. If you get it you should switch medications or your dosage.

Baby Babbeh
Aug 2, 2005

It's hard to soar with the eagles when you work with Turkeys!!



My psych was leaning toward a mix of low dose Stratera and a stimulant a while back — Stratera affects norepinephrine and stims mostly affect dopamine, so they can compliment each other nicely for some people. Didn't end up going that way because I was having good progress with the Stratera alone.

Boris Galerkin
Dec 17, 2011

I don't understand why I can't harass people online. Seriously, somebody please explain why I shouldn't be allowed to stalk others on social media!
Well I just emailed my doctor about giving Concerta a shot. I'm not exactly sure if it'll be better for me according to this picture: http://img.medscape.com/fullsize/migrated/462/703/pharm462703.fig6.gif cause the concentration at 8 hours seems similar for both but it's worth a try I guess (though it also looks like comparing 18mg Concerta to 20mg X isn't fair). Ritalin LA looks hella bad though. Those spikes, Jesus.

MJBuddy
Sep 22, 2008

Now I do not know whether I was then a head coach dreaming I was a Saints fan, or whether I am now a Saints fan, dreaming I am a head coach.

Boris Galerkin posted:

Well I just emailed my doctor about giving Concerta a shot. I'm not exactly sure if it'll be better for me according to this picture: http://img.medscape.com/fullsize/migrated/462/703/pharm462703.fig6.gif cause the concentration at 8 hours seems similar for both but it's worth a try I guess (though it also looks like comparing 18mg Concerta to 20mg X isn't fair). Ritalin LA looks hella bad though. Those spikes, Jesus.

Any extended release med that's going to drop the whole later dose looks like that. It's the same as taking two doses a few hours apart. The other curves are all just consistently released (or single instant release dose).

However, looking at that chart, one alternative would be to take an IR 10mg and then in 3 hours take another 2.5 mg and 2.5mg every 3-4 hours as needed; if your goal was to stay in the zone between 5-6, that provides superior coverage to any single solution (but a single IR small dose taken 8 hours after the initial dose would also provide that, but with less huge spike).

It's crazy what the effects of that short HL is. Ritalin basically caps out because you'd have to constantly be re-dosing at a certain point (I know nothing of ideal dosage for Ritalin).

internet inc
Jun 13, 2005

brb
taking pictures
of ur house
What made you guys go get help?

My ability to do stuff has always bothered me but I'm getting worried now that it involves stuff that matters (work, school, and my wife and baby depending on me to do other poo poo than study and work).

I talked to my GP about it and she said she will often get patients with high-stress/adrenaline jobs such as mine come to her once they go back to school and need to put their minds into something, as I am. She suggested I see an ADD psychologist before we do anything else which is perfectly fine with me because I'm not even fully convinced I need help to begin with.

So enough derail, what made you guys go get help?

MJBuddy
Sep 22, 2008

Now I do not know whether I was then a head coach dreaming I was a Saints fan, or whether I am now a Saints fan, dreaming I am a head coach.

internet inc posted:

What made you guys go get help?

My ability to do stuff has always bothered me but I'm getting worried now that it involves stuff that matters (work, school, and my wife and baby depending on me to do other poo poo than study and work).

I talked to my GP about it and she said she will often get patients with high-stress/adrenaline jobs such as mine come to her once they go back to school and need to put their minds into something, as I am. She suggested I see an ADD psychologist before we do anything else which is perfectly fine with me because I'm not even fully convinced I need help to begin with.

So enough derail, what made you guys go get help?

Good insurance and the realization that when I could do my work with focus I was drat good and had a real opportunity to get great results coupled with a couple of very bad days where I realized that on a horrible day I was practically useless and I didn't want to gently caress up my awesome situation.

Astrofig
Oct 26, 2009
Insurance, and the realization that since I was already treating the bipolar, might as well treat the ADD too.

The Door Frame
Dec 5, 2011

I don't know man everytime I go to the gym here there are like two huge dudes with raging high and tights snorting Nitro-tech off of each other's rock hard abs.

internet inc posted:

What made you guys go get help?

My ability to do stuff has always bothered me but I'm getting worried now that it involves stuff that matters (work, school, and my wife and baby depending on me to do other poo poo than study and work).

I talked to my GP about it and she said she will often get patients with high-stress/adrenaline jobs such as mine come to her once they go back to school and need to put their minds into something, as I am. She suggested I see an ADD psychologist before we do anything else which is perfectly fine with me because I'm not even fully convinced I need help to begin with.

So enough derail, what made you guys go get help?

I kept falling apart and went to get my anxiety treated, but the psych treated me for ADHD and I'm holding together significantly better than before

Effexxor
May 26, 2008

Hey guys, I figured that I should do a write up here on my neurofeedback sessions for my ADD. Neurofeedback involves measuring your brain waves and giving you positive and negative reinforcements based on the frequency of your brain waves. What it consists of is sitting in a char and having little electrode sensors put on to certain parts of your head. Those electrodes then feed information into a computer which is in charge of showing you something on a TV screen. My therapist shows documentaries or Disney movies, stuff that most people would like, and when you are focusing and your brain waves are showing that your frontal cortex is 'activated', the documentary goes to full screen. When your attention wanes and the brain activity is less, the screen shrinks. The whole goal is to keep the screen filled. If this sounds complicated and really loving weird, it's because it is. Here's a video that explains it better than I can: https://www.youtube.com/watch?v=H276cfkL5Lo

First off, I have to make some stuff clear. In a lot of double blind tests, real neurofeedback has shown no improvement of 'fake' neurofeedback, aka when the screen moves regardless of what your brain is doing. It's pretty clear that it's no real alternative to :catdrugs:. I'm torn on whether or not my experience is due to a placebo like experience or not. So this is kind of 'woo woo out there', but I still feel like it has some value, which is why I've been doing it weekly for about 3 months now.

I was having some issues with the ability to deal with being bored and not being stimulated all the time. If I had the option of going out with friends where I might be bored or staying in and surfing the internet when I knew that I could do things to not be bored for the whole time, I was staying in every time. Plus I was having some issues with depression and self worth and while I'm pretty good with CBT and ReBT, I still felt like I needed to see someone. I looked around for people who specialized in ADD and knew something about Tourette's, which I also have, and I found my current therapist through googling. I also saw that he did neurofeedback, and since my aunt does neurofeedback as well, I figured that it was worth a shot.

Irregardless of whether or not neurofeedback is useful to people with ADD, one BIG benefit to people trained in neurofeedback is that their clientele is usually largely made up of people with attention issues. My therapist totally gets ADD and from the first session with him, he said a hell of a lot of things that do make a lot of sense to me. People with ADD do have issues with their frontal cortex being a little.... slow, which is bad since the frontal cortex is where our centers for attention spans, planning and impulse control are. That's why stimulants work so well for us, because it brings our frontal cortex up to speed, so to say. It's also why people with ADD tend to like high stimulus situations, because that gets our frontal cortex going faster and we're finally able to calm down. For instance, I've always loved when we get slammed at work and I can just throw myself into a high stress situation. I get into the flow of things and it's so satisfying to be moving along at a nice fast clip and after it, I'm usually tired but happily so. The goal of neurofeedback for ADD is to encourage the frontal cortex to speed up by use of positive and negative reinforcement.

In that first session, he hooked me up, after going over thoroughly what my background was and what I knew and didn't know about CBT and all that. He explained that he usually plays 30 second clips of soothing things but that for people with ADD, that's usually akin to torture to be that bored so he generally preferred to show ADD patients documentaries so they didn't want to rip their skin off from boredom. I figured that I'd try the clips first and picked one that reminded me of the visuals from Windows Media player, with color changes and soothing music. I watched it for about 20 minutes, with him checking in sporadically from time to time to see how I was feeling. I wasn't getting much, but all of a sudden, I fell into this trance and just... relaxed. He got really excited and showed how my brainwaves got really focused and.... smooth, I guess, during that time and sent me off with a questionnaire to use to judge how I felt for the next 48 hours. I had been in that 'trance' feeling for about 30 seconds, apparently.

I got into my car and realized that it felt like I had taken a mixture of Xanax and a joint of weed and that the anxiety that had been roiling around in my gut was just... gone. Totally gone. I wasn't worried. I wasn't tense. I felt kind of stoned, but in a really awesome way. When I got home, I laid in bed and just breathed, reveling in the sensation of being calm. And that feeling did last for the next 48 hours, which was amazing. So I came back the next week. Since then, he's adjusted my frequency so that I don't feel quite that stoned (damnit) and has me watch documentaries and things that are interesting to me. And I have no idea how or why, but I have felt better.

I've told him that I don't really accept that this can be working in the manner that he says but that if it is a placebo, I don't really mind because well, placebos do usually work pretty well for people. And if it is a placebo, it's worked really well for me. After my sessions, I feel... better. I've come to love work on Thursdays because it's the day after my appointment and I'm usually able to focus and get things done in a way that is improved. Yesterday, I went into my session feeling like a hormonal, depressed wreck and left feeling good. The anger that I had at a coworker eased. I just felt better. And I seem to have tapped into this well of calm that I didn't think that I had, which makes stopping anxious, obsessive feelings much, much easier. All in all, I feel like I'm getting a real benefit. And since the cost is $25 after insurance, I feel like it's worth it.

I've been trying to be careful in this post to try and get across the fact that neurofeedback is not proven and that I myself think that it's a little out there. But I do feel that for some people, it's surprisingly valuable. At the very least, seeing someone who does neurofeedback makes your chances of finding someone who actually understands ADD much better. And even if you don't want to see them for neurofeedback, if they have training in CBT, they should still be really helpful in guiding you through ADD and how to deal with your life. The first half of my sessions always involve a traditional therapy session (how was your week? how did that make you feel? etc.) and that's valuable enough.

Sorry about the wall of text!

Smoothrich
Nov 8, 2009
Probation
Can't post for 2 years!
It is always nice to read this thread and hear people talking about restless minds at night, thriving in chaotic fast work environments, struggles with school and long boring drives, anxiety over potential boredom in a social situation causing you to prefer staying home on a computer..

Can't help the nagging feeling of being a gently caress up making excuses for myself when I reflect on things, but it is pretty hilarious how across the board similar all the posters are here, or at least have a poo poo ton of things like struggles peeves and coping measures in common. ADHD just sounds so tame or even fake till you add it all up and realize it's all tied together with our shared frontal cortex brain damage or whatever.

Effexxor
May 26, 2008

Smoothrich posted:

It is always nice to read this thread and hear people talking about restless minds at night, thriving in chaotic fast work environments, struggles with school and long boring drives, anxiety over potential boredom in a social situation causing you to prefer staying home on a computer..

Can't help the nagging feeling of being a gently caress up making excuses for myself when I reflect on things, but it is pretty hilarious how across the board similar all the posters are here, or at least have a poo poo ton of things like struggles peeves and coping measures in common. ADHD just sounds so tame or even fake till you add it all up and realize it's all tied together with our shared frontal cortex brain damage or whatever.

It's okay to be a gently caress up. It's okay to be bad at things that others are good at. There's another ADD lady in my department and yes, we are both very emotional about things, but we're also the ones who throw ourselves whole heartedly into what needs to be done and we're the ones who are super empathetic to everyone else. Our ADD makes us better in different ways. Yes, it does make our lives harder in some ways, but there are positives that come from being ADD.

I've had 3 guys from high school message me to let me know that I changed them, and I'm 26. Because of my 'don't give a poo poo, this is what is right, here's what I think!', I've changed 3 lives and made them change their minds on gay rights and women's rights. It's okay to be outspoken and weird. ADD gives the ability to jump into life with both feet and no fear. The trick is accepting those decisions that you make and finding the glory in them.

Smoothrich
Nov 8, 2009
Probation
Can't post for 2 years!
Yeah totally. I'll be all scatter brained until something comes up I care about and I begin soaring rhetoric and impassioned appeals to empathy and understanding that certainly makes some people uncomfortable but just as many might agree or at least reconsider their beliefs. I try not to be rude but I love good debates.

Not sure how ADHD related it is but I consider myself pretty drat witty with a deep vivid memory and I can recall stats, stories, or think of a quick joke like it's nothing. I can spit out exact quotes or concepts from an article I read in passing a decade ago when a conversation triggers the info in my memory but I struggle daily to remember where I left my keys five minutes ago.

I do my best everything when I'm able to write talk or work with no time to think like twisting a nozzle into a direct high pressure spray of creativity but before long I'll be dripping all over the floor without focus which is when all the half assed disappointments build up. Meds let me tap into and direct that gush a whole lot easier and longer though.

Above Our Own
Jun 24, 2009

by Shine
I'm thinking about ADD medication again, I was on Ritalin and Adderall for most of my childhood. Lately I've been enjoying generalized anxiety & occasional depression and I don't want to make those things worse but I think ADD does impair my adult life and work. Is there medication now that avoids the "emotional fugue state" that the OP talks about because god I hated that side effect

Mechafunkzilla
Sep 11, 2006

If you want a vision of the future...
Does anyone here have DSPD (delayed sleep phase disorder) that they are being treated for? I know it's genetically linked to ADHD.

Slaapaav
Mar 3, 2006

by Azathoth

Mechafunkzilla posted:

Does anyone here have DSPD (delayed sleep phase disorder) that they are being treated for? I know it's genetically linked to ADHD.

i probably have this

Culinary Bears
Feb 1, 2007

Mechafunkzilla posted:

Does anyone here have DSPD (delayed sleep phase disorder) that they are being treated for? I know it's genetically linked to ADHD.

Very probably, still on the waiting list for a circadian/sleep clinic.

Unfortunately, I've tried a lot of stuff that hasn't really fixed it: bright lights in the morning (useless), blue blocker goggles at night (might make it a bit easier to fall asleep but not a huge difference), a keto diet (helps me with my brain fog a lot though, so I'm still doing that), melatonin (lowest effective dose makes me groggy as hell the next day), modafinil (decent for being more aware in the morning, and awesome for my mood in general, but not really helping me "naturally" wake up earlier, nothing does so far).

Only thing I've got left to try really is having really huge breakfasts and not eating much the rest of the day. This one's a hard habit to get into for obvious logistics reasons.

It's a pretty major bummer really. Sometimes I wonder how much of my issues are DSPD vs ADHD. Sometimes I wonder if I ever do make it into a normal schedule, if that's going to entail living with ADHD symptoms all my life, and/or possibly developing the kinds of health problems "normal" people get when they have to do night shifts for years.

Dubstep Jesus
Jun 27, 2012

by exmarx
I find that since I've started on adderall I'm much better able to maintain a decent sleep schedule provided I really commit to it but even then I sometimes get random nights where I just don't sleep and it ruins my sleep schedule for the rest of the week unless I'm lucky enough to have a weed brownie to knock myself out for 12 hours with and no early commitments the next day.

Mechafunkzilla
Sep 11, 2006

If you want a vision of the future...

Culinary Bears posted:

Very probably, still on the waiting list for a circadian/sleep clinic.

Unfortunately, I've tried a lot of stuff that hasn't really fixed it: bright lights in the morning (useless), blue blocker goggles at night (might make it a bit easier to fall asleep but not a huge difference), a keto diet (helps me with my brain fog a lot though, so I'm still doing that), melatonin (lowest effective dose makes me groggy as hell the next day), modafinil (decent for being more aware in the morning, and awesome for my mood in general, but not really helping me "naturally" wake up earlier, nothing does so far).

Only thing I've got left to try really is having really huge breakfasts and not eating much the rest of the day. This one's a hard habit to get into for obvious logistics reasons.

It's a pretty major bummer really. Sometimes I wonder how much of my issues are DSPD vs ADHD. Sometimes I wonder if I ever do make it into a normal schedule, if that's going to entail living with ADHD symptoms all my life, and/or possibly developing the kinds of health problems "normal" people get when they have to do night shifts for years.

Did you just approach the sleep clinic yourself? Or did you have to get referred by a physician/psychiatrist?

For me, taking my 2nd daily dose of Adderall at ~3pm so that it wears off relatively late at night helps with falling asleep earlier, but the only thing that's really consistent for getting me tired earlier is intense exercise. The reason I think it's DSPD is because I don't have any problem staying asleep or falling asleep once I'm finally tired, and also because there's a HUGE difference in the way I feel when I sleep from Midnight-8am compared to, say, 3am-11am. Even though they're both 8 hours of sleep, I'm completely groggy and it's a huge struggle to get out of bed at 8am, whereas at 11am I'll wake up alert and rested. It's been like this basically as long as I can remember, going back to childhood.

Mechafunkzilla fucked around with this message at 16:18 on Feb 16, 2015

Culinary Bears
Feb 1, 2007

Yeah ditto (though 3AM-11AM is even pushing it for me, I'd be perfectly happy to go to bed past 6 in the morning :(). I found the sleep clinic myself while searching for one that didn't specialize in apnea like most of them, but then had to go to an actual physician at a walk-in clinic to ask them if they could refer me.

E: Getting to try the modafinil early though since A) my psych felt bad for me being on the waiting list so long and B) it helps with ADHD and depression. I like it a LOT for that compared to my previous medication (various amphetamines; though I'm still taking Wellbutrin with it). Find that it helps me notice/not lose stuff more, be more content, focus without getting antsy or sucked into something for hours, and... just being in the moment more. However, I've mostly heard the opposite w.r.t. effectiveness on various ADHD forums. So it's either one of those YMMV things or it's just more the sleep than the attention parts of my brain that are screwy.

Culinary Bears fucked around with this message at 16:48 on Feb 16, 2015

Mechafunkzilla
Sep 11, 2006

If you want a vision of the future...
Yeah, the experiences people have with medication for sleep phase disorders sound like they're all over the place. Seems like it's not an easy condition to treat.

Even so, just knowing that it's a physical thing and not a result of having bad habits or poor discipline or 'addiction' to the things I do late at night when I'm not yet tired, any of the other things I've been telling myself since I was 12 would be a huge weight off my shoulders.

Horrible Smutbeast
Sep 2, 2011
Medications for sleep disorders are scary as hell. Stuff like Ambien requires you to go to sleep IMMEDIATELY after you take it or else you'll actually get high. Worse cases you'll end up waking up from it not remembering where you were, what you were doing or why you suddenly have ordered 10 duplicates of the same item off amazon to be sent to you in separate packages. Pseudophedrin isn't much better.

I would rather feel like poo poo everyday and look like the child of rocket raccoon and an insomniac crackwhore than to ever take any of those pills ever again.

Mechafunkzilla
Sep 11, 2006

If you want a vision of the future...

Horrible Smutbeast posted:

Medications for sleep disorders are scary as hell. Stuff like Ambien requires you to go to sleep IMMEDIATELY after you take it or else you'll actually get high. Worse cases you'll end up waking up from it not remembering where you were, what you were doing or why you suddenly have ordered 10 duplicates of the same item off amazon to be sent to you in separate packages. Pseudophedrin isn't much better.

I would rather feel like poo poo everyday and look like the child of rocket raccoon and an insomniac crackwhore than to ever take any of those pills ever again.

From what I'm reading, stuff like Ambien doesn't even work that well for circadian rhythm disorders. Sure it'll knock you out at 10pm, but your body still won't be getting deep, restful sleep until your 3am natural bedtime and you'll still find it impossible to wake up and function in the morning as your brain is being inundated with melatonin and cortisol until 11am.

Ideal solution: find a job where it's cool to come in at 11:00 each morning. Easy peasy.

Interstitial Abs
Jul 11, 2008
Melatonin yo! Once I got the dose right (and I don't forget to take it on time... Thanks ADD) I got it so dialed in that I wake up five min before my alarm most mornings. At 5AM.


But yes, I know this thread is full of smart people who actively research stuff, so chances are a few of you already tried it and it doesn't do the trick... But if not, try it. For me it kicks in about an hour and half after taking, unlike the twenty min the bottle said, so I take it at 8:30, fading by 9, and better be near a bed or soft surface by 9:59 because I crash hard. But wake up feeling energized (most days... Winter has been rough)

Anyhow, my .52 cents.

Mechafunkzilla
Sep 11, 2006

If you want a vision of the future...

Interstitial Abs posted:

Melatonin yo! Once I got the dose right (and I don't forget to take it on time... Thanks ADD) I gt it so dialed in at I wake up five min before my alarm most mornings. At 5AM.


But yes, I know this thread is full of smart people who actively research stuff, so chances are a few of you already tried it and it doesn't do the trick... But if not, try it. For me it kicks in about an hour and half after taking, unlike the twenty min the bottle said, so I take it at 8:30, fading by 9, and better be near a bed or soft surface by 9:59 because I crash hard. But wake up feeling energized (most days... Winter has been rough)

Anyhow, my .52 cents.

How much do you take, and in what form?

Interstitial Abs
Jul 11, 2008

Mechafunkzilla posted:

How much do you take, and in what form?

I'm rather sensative to medz, so I bought a 5mg bottle of CVS brand, thinking I could make it last awhile by cutting in half. Well even 2.5 was too much, so I cut into (roughly) fourths.

Once that FINALLY ran out I bought another generic, but 3mg tablet and it's doing the trick. I think I built a little tolerance. I am 5’9 and 145lbs if that helps as a reference.

I'd also err on the side of too little and taking super early the first few times. Like I said, it feels like natural deep sleep, but for me it's like a switch on, then off, so I was late to work a few times till I figured out that timing. Or experiment the night before a day off.

E: I meant a switch off, then on, rather but you get the drift

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MJBuddy
Sep 22, 2008

Now I do not know whether I was then a head coach dreaming I was a Saints fan, or whether I am now a Saints fan, dreaming I am a head coach.
I've said this in the last few pages but I've had excellent results with chlonidine for sleep. It's been 2.5 weeks or so on it and it's probably the only 2.5 weeks in my life I was able to average the 8 hours of sleep I want to get by falling asleep before midnight and being up for work ready.

In studies they see that low doses speeds the time before the first REM sleep cycle, but in high doses you bypass REM sleep altogether (which is probably bad! with the caveat that we have a horrible understanding of sleep science).

I used to have the "Sleep of the Dead" effect that when I'm out finally, I'm 100% out and unmovable; I'm way more likely to wake up to my spouses' movements or the dog barking (from 0% to any percent, basically), and combined with residual stims I always have a problem getting back to sleep when I'm woken in the morning. I can't vouch that the sleep is pound for pound the same quality, but I have much more control over it and sleeping a little longer (on a weekend morning) isn't a nightmare sentence to remain awake all night.

No idea if it's related to DSPD; never tested or brought it up. I used to think that I felt better on an hour-shift rhythm but my school/work was too structured to ever try it, but I've comfortably had periods of time where I worked until 5 am and slept well for weeks without problems while in grad school.

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