No, not quite - there's a variety of different ADHD medications and I'd argue there's more popular ones like Vyvanse (lisdexamfetamine). Non-stimulants like Strattera or Intuniv absolutely can and are prescribed on their own, which are really useful for people that respond poorly to stimulants.
Perhaps you meant to say there's two main classes of stimulants (amphetamines, methylphenidates) that are worth investigating and shouldn't be skipped over?
The internet is really, really bad at pushing everyone toward ADHD diagnoses and then pushing them further toward stimulants. There's a darker part of some of the communities then pushes people to keep pressuring their doctors for higher and higher doses and also discourages people from trying therapy.
Outside of the internet I know several people who did the rounds with medications and ended up on the non-stimulant options and preferred them. This is an unthinkable conclusion if your primary source of information is Reddit, X, or TikTok ADHD influencers, but it's pretty common in the real world.
Stimulants have a habit of being enjoyable at first (meaning people like taking them, beyond their attention effects) and then the effects wane over the years, to the point that there are studies showing that the effects of stimulants taken long term in children are minimal to unmeasurable after several years. This is confusing to anyone who has been taking them for years and notices a difference on days when they don't take them, but that's explainable by the fact that it takes months (or longer) for the brain to adapt to not having them in the body. For some reason this same effect is not debated as much when you talk about people who drink 5 cups of coffee per day but then crash hard when they miss their coffee, but it gets protested and argued a lot when we talk about literal amphetamines.
Anyway, please don't listen too much to internet ADHD forums. They're just so, so bad these days with bad advice and poor psychology/therapy takes. You really need to engage with professionals with an open mind and not be single minded about acquiring and taking stimulants if you want to address this problem as a whole. The way the internet treats ADHD as a simple "low dopamine" state (which is wrong on many levels) and then points to stimulants as a "raise your dopamine" drug to neatly cancel it out sounds nice, but it's wrong on so many levels.
Strattera can help (I mentioned bupropion, another SDNRI). Of course if you try stimulants and don’t respond well, it’s totally fine to just use e.g. Strattera. What I’m advocating against is e.g. “try Strattera first, if it seems to help, don’t bother with stimulants”. (Some places, cultures, or medical systems do have surprisingly strong biases against stimulants!)
But IMO it's not really that incorrect to say there are two main types of stimulants.
You rarely (at least never where I'm from) get instant release methylphenidate. Always some delay mechanism. Shorter - Ritalin, longer - Concerta.
And the lizine particle attached to dextroamphetamine acts as a such delayer, but isn't active by itself -- being only an amino acid. So it's still kind of amphetamine just as Concerta is methylphenidate.
realized this one about myself earlier this year, it really helped to boil it down to something besides “I am just inherently bad at things.” that attitude worked as a dumb single kid, but it was harming my adult life and relationships.
therapy helped me get there. I have been on bupropion for about a year, and recently started on methylphenidate. it might not be the right one for me, or maybe too small of a dosage. I’m taking it slow and being deliberate with the drugs.
working with a personal trainer to get in shape and lose weight, as well as quitting my fully vested tech job to fuck off and be a cook for a while has also done wonders for me here. it’s cliche, but you really can’t replace fitness with anything else, and that took me 35 years to internalize.
I am also fantasizing about this and am only holding off from doing it because of the social stigma (what idiot would quit a well paid full-time job). My biggest issue with the software industry is the feverish shiny-new-thing syndrome that AI is causing (and my current company is all in on this, with "Hyper-Velocity Engineering" panels). Maybe I don't want to move at light speed and would rather stop and smell the roses.
but I don’t care. I put 15 years into my tech career. I am good at building software, and I will not let this ridiculous “resume gap” problem stop me from taking a break for my mental health. any tech employer that wouldn’t want me because of it is a place I wouldn’t want to work anyway.
also, to be honest, I’m writing more code now than I ever did in the last year of my tech job… working on a full CMS and custom website combo for my friends bar, such that I can copy that template over for future projects (want to help local businesses escape the bullshit machine). also building a cool web development desktop app. and more! I’m having a great time
This really struck a chord with me. I've spent the last 15+ years building up a craftperson's skillset (IMO) akin to a carpenter's or mechanic's. Yet, people still seem surprised when I tell them I'm not willing to run a slop cannon and excrete software which is _good enough_. I actually enjoy the nuts and bolts of writing and debugging software and using AI feels like cheating (if only myself). I'm really not sure where I go from here. I wish I had a work situation like yours to complain about but I know I'd have hit the eject button the minute someone started mandating anything about my workflow, so it's kind of moot.
Cue the usual propaganda: "Oh but that's just real life," "it's the nature of our industry," "I'll agree things aren't perfect, but {nothing must change}," "I understand, but the true problem lies with {mistake we'll gladly keep making}," "it's bad, but at least we're not {killing babies}."
It's become almost automatic to associate pondering with perfectionism, and perfectionism with flaw.
Are you doing entry level line cook work or something?
I'll re-enter tech later... maybe.
Really important to understand that depression can also manifest as poor concentration.
There's a huge problem right now with people getting locked into diagnoses found on the internet and then resisting advice of their doctors that doesn't match. It's scarily common for depressed patients to become convinced that they have ADHD and that ADHD explains everything, then to refuse depression treatment. They can jump from doctor to doctor until they find someone who doesn't care and just writes the prescription, but years can pass before they realize that stimulants aren't fixing their depression.
If you have depression, with or without ADHD, you need to address it. Don't get sucked into the "ADHD explains everything about you" mentality that gets spread on the internet.
Yep. I was diagnosed with ASD and ADHD about a 1.5 years ago... My whole life came into focus. Everything that didn't make sense suddenly started to make sense. What I thought were 15 different issues I was dealing with were really all just symptoms of the one (or two in my case). The internal tension I've always felt was also explained by the competing desires of ASD and ADHD.
Knowing this hasn't really "fixed" any of that, but it has given me an explanation, language to use to explain it, and permission to stop searching for what's wrong with me... which I've been doing for 20 years. It's been nice to have a break.
The trap is trying to externalize the diagnoses as a get out of jail free card that can be used to justify avoiding hard changes and difficult work. The more difficult version of this is when someone tries to externalize the responsibilities of their diagnosis on others. I've seen a couple situations where someone got an ADHD diagnosis and then took it straight to their employers expecting to receive more forgiveness for late work and mistakes, then getting angry when it didn't change their company's expectations. It's a hard conversation to have with someone who thinks the diagnosis is going to relieve the weight of all the problems they've been facing, when in fact it's only helpful for identifying what they need to work even harder on improving and coping with.
Ofcourse, no pill is magical, and I have no expectations of that. At least fluoxetine fixed my sleeping habits.
Hope you get it worked out OP. I will say, if it's ADHD, it's 100% worth trying to get the best treatment you can.