ADHD have crippled my life, I do not know what to do?

Question

I was diagnosed with OCD at 17 with depression and recovered, I thought OCD was the most debilitating illness. Then after college unemployed for years struggling to concentrate and finish things, was diagnosed with ADHD at 29. Got okay job small consulting firm (7 people) but left after being bored. I love coding but get dissapointed when I cannot concentrate, brain chatter keep me dragging in dozens of directions. I live in a developing Asian country where available meds are Atomoxitine, Methylphenidate(MPH) IR. Both does not improve focus even though it help with procrastination. Atomoxitine cause exhaustion, sexual dysfunction, MPH crashes leads to depression. Also tried following off labels- Buproprion: 300mg No improvement, increase irritability. - Modafinil: 200mg No improvement, headache, irritability, insomnia. - Clonidine: 0.2mg, no improvement, irritability, insomnia.Tried talk therapy not helpful at all, there are no trained therapist for comorbidity. Psychiatrist's knowledge also lacking about ADHD(MPH good drug since ADHD patients should respond to it, they also think release formulations does not matter). I run daily for about 15 minutes, practices focused breathing about 15 minutes. But I do not see improvement. I'm 32 years old, jobless, unmarried, never in a relationship. Even though comparisons are odious, my younger cousins have surpassed me even though I really have good knowledge of things than them. I struggle to execute things.I'm also slow at processing social things so I think, I'm on ASD spectrum. 2024 my mom passed away after suffering from Parkinsonism. My dad is old, relatives are asking to get married, I do not know how to take care of someone else when I cannot pull my shit together, I'm trying hard everyday. I just want go to other country and get treated but I'm not in a financial position. It is really unlucky when you have ADHD and living a developing Asian country. I'm not sure anyone would hire me, wish I could do some project consistently and finish it. On one hand I think better to leave tech and do apply for Ausbildung. Then think I'll regret not trying harder. I also hate lying act pretend to get jobs wish world was more accepting.Actually I'm tired of trying out meds, having to endure side effects, it is torture

hereme888 · Accepted Answer

It must be tiring to keep seeking relief and finding the "right" solutions. Besides ongoing learning and research on your own, I encourage you to keep searching for the right psychiatrist you feel works for you, because the way they gather, organize and look at your data in a systematic manner that allows them to start trialing various plans besides just medications.
I'm sure you spent time writing what you shared, but from a physician standpoint it's not sufficient for actionable insight.
If your developing Asian country doesn't have the right physicians, then hopefully at some point you can see one in another country, and share that data with your own physicians.

codingdave · Answer

> Tried talk therapy not helpful at all, there are no trained therapist for comorbidity.
Try different providers. There are absolutely therapists who are trained and specialize in various comorbidities as well as ones who are good at collaborating with other providers including your medical/pharmacist. You have to make the effort to find the right one for you. It is a legit challenge, but it is also the most likely correct answer.
I should add that it doesn't need to be long-term therapy. A short course to help teach you some skills to help you with your struggles will often suffice.

austin-cheney · Answer

I recommend finding another doctor and getting an ASD evaluation. There is a 60% comorbidity overlap between ASD and ADHD. You can treat ADHD with medication but those same medications are substantially less effective on someone with ASD even with identical symptoms.As for concentration try to improve your serotonin output. This will have no direct impact on concentration but it has a tremendous indirect impact by improving everything else. The key to improve serotonin is to reduce your intake of caffeine, empty carbs, and alcohol. All of those are microbiome destroyers. Refocus your diet around meat and vegetables and fermented foods like kimchi, kefir, sauerkraut, and such. It takes about 3 weeks for the healthy diet to take effect. 90% of serotonin produced in the body is in the gut, but it&rsquo;s most impactful to brain activity and gut hormones do not quickly become neurotransmitters in the brain.

BoredPositron · Answer

I am not going to say more because that's for your doctor but if none of the medications you mentioned improved your focus it's not ADHD. 70-80% respond to first line stimulants. 10% who have unbearable side effects (your described side effects are standard for starting phases of these meds) but improved cognitive features. The last 10% is misdiagnosed.Your next step could be genetics (CYP2D6, COMT, DAT1) but for 90% of cases I suggest therapy to find the underlying cause.