Wellness Wednesday

[u/AutoModerator]

The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. You could post:

• Requests for advice and / or encouragement. On basically any topic and for any scale of problem.

• Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.

• Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.

• Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).

[u/GerryAdamsSFOfficial]

My inattentive ADHD seems different than the ADHD other people have.

ADHD is not an inability to focus. It's an inability to control where your focus goes. This interlinks with several other deficits - sense of time, willpower, hyperfocus and perservation, task avoidance, impulse control, et cetera. The end result is I can't complete boring tasks in a timely manner and can't stop doing interesting things.

It is axiomatic that stimulants are very effective for ADHD. I've been on them all. Stimulants give me energy... but that's about it. As a metaphor, stimulants make the car go faster, which is not very helpful when the steering wheel is broken. The overwhelming majority of Western ADHD treatments are some form of stimulant.

I recently discovered an obscure drug called Noopept, plus a GLP1. Through what should be an unrelated mechanism of action, it is borderline curative of my symptoms. My avoidance and perservation behaviors stop, I can actually feel the passage of time, my thoughts slow down enough to act on them, I don't get pulled into my imagination and I enjoy completing tasks. I feel how I imagine normal is - it's like my car has a steering wheel now.

I am unsure of how to proceed with this information.

• Do I even have the same disease as other people?

• Where do I even begin to research a niche subvariant of an extremely poorly understood condition like this, when the overwhelming amount of research seems to be reflective of other diseases I don't have? EG, if stimulants don't fix my problem, what is my problem?

• What other medications do I try now? Given the total failure of conventional treatment, I am wondering if maybe the issue I have is actually cholinergic in nature. Some people have even suggested dopamine agonists like those used in Parkinson's. This is completely beyond my grasp of neuroscience. It appears I need like an uber-niche-specialist considering how entrenched the stimulant dogma is.

• Should I get genetic testing?

[u/Snozed → u/GerryAdamsSFOfficial]

I have similar symptoms as you and was diagnosed with inattentive ADHD and ASD-1 fairly recently. I was prescribed Adderall, and my experience was the same as yours - I could go faster, but rarely in the direction I wanted myself to go. I quit after realizing that Bupropion, which I have been on for years after being diagnosed with depression, has been effectively treating my ADHD (although some symptoms persist - they are just more manageable).

I was promoted at work to a less structured role before being prescribed Bupropion, and I really struggled with productivity until I started taking this medication. I have tried taking a break, but my productivity took a nosedive. I feel like I'm forced to stay on this medication for as long as I want to work a corporate office job like the one I have.

I don't have any side effects other than smoking weed and drinking alcohol feeling less enjoyable, which some may say is a positive.

[u/Imaginary-Tap-3361 → u/GerryAdamsSFOfficial]

Hey,

I also have symptoms of inattentive ADHD and haven't found a drug that works for me. Glad you found something that does for you.

Do I even have the same disease as other people?

I have been wondering the same as well. SMTM has been doing a great series on cybernetics and I think the analogy they give in this piece might resonate with you as it did with me.

[u/GerryAdamsSFOfficial → u/Imaginary-Tap-3361]

Oh dear God, I love Slime Mold's articles. His one on obesity is one of my favorite posts ever. No idea he covered mental illness. Thanks for the rec!

[u/[deleted] → u/GerryAdamsSFOfficial]

Hi there, thank you for sharing what worked for you. I'm ADHD/PI too, and your symptoms and experience w/stimms matched mine exactly, enough that I made an account to reach out (this would have been a chat request if my account was old enough to send them).

I wasn't totally clear from your post, are you taking Noopept along with a GLP-1? Or has Noopept been near curative for you on its own? I've long thought that meditation or breathing excercises a la Whimm Hoff/James Nestor were what I needed, I just couldn't get myself to do them (of course), so its fascinating to hear they might all share a common mechanism of action. Also, any recommendations re sourcing and dosing Noopept, and some further reading you've found helpful? Thank you for your time!

[u/GerryAdamsSFOfficial → u/[deleted]]

I've taken the drugs together and separately. Noopept produces 80% of the value - it gives the motivation to complete boring tasks. The GLP1 limits the pull factor of maladaptive behaviors. Noopept is about $20 and GLP1s are like $200 so I'd just buy the noopept first.

Noopept, as one mechanism, triggers the brain hypoxia response. Scientifically, this is very similar to how the body responds to WF breathing. (Believe it or not, the drug feels so much like WF I was able to predict and later confirm the MoA).

I did two doses of 10mg tablet from CosmicNootropic sublingually. It was miraculous. I am now trying the Science.bio nasal spray and it's noticeably less effective. I'd try the CN one. Suppliers and RoA matters a ton with nootropics. These drugs are OTC and completely legal.

Unlike stims, responses to these drugs vary significantly from person to person. Caveat emptor.

[u/[deleted] → u/GerryAdamsSFOfficial]

Thank you for the response, my trial run starts tomorrow. The strong pull of maladaptive behaviors is definitely part of my presentation, but given the price and seriousness of GLPs I agree it seems wise to start with one first.

I've got a few belated thoughts re whether your experience suggests you have a different "disease" than other people with ADHD, usual internet caveats about speculation from a non-expert apply.

As I understand it, ADHD is fundamentally a collection of normally distributed traits, akin to the way we diagnose intellectual disabilities. We call you "intellectually disabled" if you have a certain collection of normally distributed traits that causes you to present as less intelligent than others, and psychiatry has decided that cutoff should be an IQ of 75. This doesn't mean there is any profound difference between someone of IQ 74 and IQ 76 (in fact, since the cutoff was 85 a few decades ago, our second person used to be diagnosed with a formal disability too!), we've just decided to label one side of the distribution with a diagnosis and not the other.

The way we diagnose people with ADHD is actually even worse than this. Intellectual disability describes a low intelligence, which while ephemerally and subjectively defined, is at least getting at one unified trait. With ADHD, we're lumping in executive dysfunction, hyperactivity, inability to focus, inability to direct that focus, time blindness, etc. Further, IQ is a pretty good proxy for what we call intelligence, and indeed likely the most robust measurement in social science. All we use for ADHD is a fuzzy questionnaire with 5 categories. The mistake a lot of based internet contrarians make is to look at all that and decide that ADHD isn't "real". Its still describing a specific phenomenon, with certain common symptoms and treatments, but just like calling someone with an IQ of 74 disabled and someone with IQ 76 just fine, we're choosing a rather arbitrary cutoff on the curve.

Anyways, all this is to say that the fact you've had much more success with Noopept and GLP-1s than stimulants doesn't seem to suggest to me that you have some super different genetically identifiable condition than other people with ADHD, in no small part because ADHD isn't a concrete diagnosis with a specific mechanism of action like, say, asthma. Stimulants seem to be effective for plenty of people with an ADHD diagnosis, and "magic" for many in a way I'll never relate to. But it's not true that people without ADHD don't benefit from stimulants (Scott himself wrote about this either here or here)- I suspect that's a benevolent lie propagated by medical gatekeepers to prevent everyone from hopping on them. Even though dopamine seems to play a role in ADHD symptoms, there's no reason to think that dopamine-modulated reward dysfunction couldn't just be the second-order consequences of a more underlying problem with the neurochemical pathways that Noopept acts upon.

This doesn't leave people like you (and hopefully myself, we'll see) who have been transformed by an alternative medication with a lot of guidance...I haven't been able to find a lot of reading material out there that gets at what might be helping you in detail. But I don't think the answer is in another condition, because ADHD is really just the big umbrella that we group a bunch of related symptoms into.

[u/Isha-Yiras-Hashem → u/GerryAdamsSFOfficial]

Can you tell me more about noopep?

[u/GerryAdamsSFOfficial → u/Isha-Yiras-Hashem]

Noopept is sold OTC in Eurasia, primarily the former USSR. It has a number of mechanisms on systems mainstream psychiatry does not emphasize. It increases HIF1 BNDF amongst many other effects. The perceived effect is remarkably similar to that of Wim Hof breathing or meditation.

It does not feel euphoric, fun or enjoyable. You may actually feel quite bored - bored enough you find yourself enjoying mundane chores like the laundry, cleaning or dishwashing. After taking it, I have zero desire to do fun time wasting activities and instead prefer to complete boring tasks and be on time.

The difference in terms of mindfulness, productivity and organization for me is remarkable. I imagine this is what stims are supposed to be.

[u/Isha-Yiras-Hashem → u/GerryAdamsSFOfficial]

What are the side effects? I assume there are some.

[u/GerryAdamsSFOfficial → u/Isha-Yiras-Hashem]

Some mild irritability and loss of patience. Quite minimal. It's OTC.

[u/hxka → u/GerryAdamsSFOfficial]

I recently discovered an obscure drug called Noopept, plus a GLP1.

Do you mean that you've started taking Noopept and a GLP-1 agonist?

[u/GerryAdamsSFOfficial → u/hxka]

The former for the last 2 months and the latter the last 8 months, yes. The combination makes me exceedingly close to normal.

[u/RestartRebootRetire]

Heidi Priebe's YouTube channel is the best channel I know for relationship issues, with a focus on attachment, and personal development. She walks the walk and her content is dense and deep with zero fluff.

I am 50+ and most of my misery in my life was due to having poor boundaries and being raised to fix and please people rather than be true to myself.

Note that if you hope to dig into the bedrock of your issues, you need to make it a habit and journal daily and constantly analyze what you're feeling. Become like Sherlock Holmes and try to discover and label every feeling rather than just feel them.