Any advice on how to stay focused?

[G_Camilla]

Hello everyone! My name's Camilla and I'm 26. In October of last year I've been diagnosed with combined ADHD and I'm still trying to adjust to the news. I'm writing because I would like some advice on how to live a healthier life!

(TW: mention of antidepressants)

I've been in therapy since 2010 circa, when I was 14 and struggling with severe anxiety, but I've changed therapist 4 or 5 times. I now have a therapist that I can trust, but she's not specialized in ADHD - I've moved to Rome in March and I momentarily stopped therapy because it's too expensive; however, atm I'm doing fine here. I've started taking antidepressants in 2017; at first I was on Daparox (paroxetine, 20 mg) and Xanax (0.25 mg extended release). I was on Xanax for a couple of months, then just on Daparox; started from one whole pill, then half a pill and finally a quarter one in a period of time of three to four months - it was my neuropsychiatrist's advice. However, my doctor had some problems with the law, so I couldn't see him anymore and decided (on my own) to stop taking my medication in November of 2020 (big mistake). Following a nervous breakdown, I had to start taking antidepressants again around March 2021 (I'm with a new psychiatrist that is amazing) and I have been on 20 mg of paroxetine since. Plus, since I've been suffering from insomnia ever since I was little, my current doctor also prescribed Circadin (Melatonin) and Zolpeduar (Zolpidem), but this therapy lasted just around a month. Zolpeduar is an hypnotic, so he said that I shouldn't take it regularly because it could be addictive. Once that drug cycle "fixed" (it really helped but oc it didn't fix it...) my sleeping schedule, I stopped taking both Circadin and Zolpeduar. My psychiatrist also said that if I ever had a period of time when I couldn't sleep for the love of me, I could start taking Zolpeduar again, but only for a maximum period of time of one month (one cycle). I'm prone to have heavier insomnia when the warm season comes, so I've been taking Zolpeduar to sleep for a couple of weeks now and I'll stop this cycle soon.

I need some advice. I'm a postgraduate student in Italy and I need to study for my exams, but lately I've been having a lot of troubles concentrating and staying awake. I usually try and get up around 8:00-8:30 am.

Up until now I've tried:

1. Walking up early, having a healthy breakfast and sitting down/laying down without any distraction - it's still hard on me, I can't read for an extensive period of time without falling asleep;

2. Same as point 1, but while listening to white noises and joining a zoom call for students - it's definitely better, but most time I'm still super sleepy;

3. Starting to study in the early hours of the evening, around 4 to 5 pm, when the sun is not that high in the sky so it's not so hot and I've had enough time to enjoy a good lunch and some entertainment; it's way better, but I lose a lot of precious time!

4. Studying in the evenings or waking up super early to study - it's the worst thing I could do... If I wake up to early my anxiety fires up;

5. Drinking lots of caffeine - needless to say, it makes me sleepy as hell, but I didn't realize it was because of my ADHD until I discovered it was one of the symptoms;

6. Not drinking caffeine whatsoever - a bit better, but the flavour of caffeine gives me a placebo effect in the mornings and that allows me to have around 1h autonomy without getting too sleepy (it also helps me p00p and that unfortunately doesn't work with decaffeinated coffee...) and if I manage to stay awake until 4 pm, the sleepiness reduces considerably;

7. Sleeping less (5 hours) or more (9-10 hours) than my usual 7/ hours - sleeping less actually works, but only when I do not take a nap in the afternoon; sleeping more IS A NO, my head hurts the whole day;

8. A mix of everything and anything.

I don't know what to try anymore 😭 Do you have any piece of advice for me please?

Thank you very much for reading

🐱 Here's a kitty for you

[CatMoose]

I'm not familiar with all of the medications you mention and may have missed something about this, but have you tried ADHD medications? I have found that all of the changes you list here help me a bit, but they can't fix the fact that my brain just does not create enough dopamine. There are some ways I've heard to try to boost dopamine, like listening to music that you really like.

One trick that sometimes works for me is picking a small piece of the project I'm trying to accomplish (5 minute task - could be something like study one specific concept or term for the exam) and commit to finishing it. Usually that buzz from finishing something will spur me on to do related work. When I can't break it down, I'll call a friend who does similar work and talk about the project and usually after I've talked about the pieces I think are interesting for a bit, I'm fired up to do it when I get off the phone.

[Tim_Othy]

You are very clear on your symptoms and have gone to great lengths to remedy your issues, which is great.

I love Adderall and caffeine. I have always been attracted to the stimulants and it addresses certain issues for me.

With regard to depression and anxiety (stimulants may exacerbate these issues), I have found that Wellbutrin and Xanax works well assisting with my anxiety. I was on 150mg of Wellbutrin with mediocre results for executive function, et al and it did not help with the anxiety. However, when I went to a Psychiatrist instead of my GP, he doubled the dose (of Wellbutrin) and my anxiety disappeared. Interesting, but I still have a hard time enjoying what I used too. I am not amused at humor and that was always a significant aspect of my personality. My Psych recommended a combo therapy of Wellbutrin and an SSRI, first dose today.

Btw I thought I would define my anxiety which stopped me from doing stuff because I would think through what the situation MIGHT be like and decide whether it would be sufficient (usually from a critical, safety first, negative mind set) Guess what, that is debilitating and distorted. Additionally I would wake up in the early morning hours (usually at 3am) and distressing thoughts, catastrophic thinking over and over again was the norm, without the ability to go back to sleep (90% relief with the 300mg of Wellbutrin)

I hope some of this will be helpful I certainly typed a lot of words. I wish you the best life possible. Peace ✌️

[Beemyneighbor]

Omg the same thing happens to me and I have tried a lot of those things too. Sometimes I can focus on the things I need to do but lately most of the time when I sit down to do something I get soooo sleepy and my eyes start closing and I just want to crawl into bed. Sometimes I do. Right now I made a time block for myself to work on job apps and I'm using focusmate but i came here because I'm falling asleep and it's really frustrating.