I read that comment when you posted it!

Oh cool, I'm glad that it got to some of the right people.

I have no idea if stimulants will work well for me. I've definitely used caffeine to self medicate most of my adult life so maybe?

The take from one of the foremost global experts in ADHD is that stimulant meds cover about 80% of ADHDers - methylphenidate/ritalin works well for about 40% with amphetamine-based stimulants (Adderal, Vyvanse etc.) working for about another 40%, so there's a good chance that they'll work for you. Honestly I suspect those numbers are a bit low because there's probably another 5 or 10% at least who find that stimulant meds do work but that they can't continue using them because of certain side effects (e.g. weight loss, insomnia etc.)

If we throw in stimulants that aren't the classical ones, like modafinil, I think that number would probably get bumped up a bit higher too.

But either way I know it won't be a magic bullet, just one thing to try if a doc recommends it I guess.

That's the right attitude to approach stimulants imo.

I honestly don't know what not being able to mask would look like for me, but I work from home on a computer and have very accepting friends so hopefully the adjustment wouldn't be too rough?

Cool, that's one less thing to worry about then.

If you're in a customer-facing job or you're in social circumstances that require high masking it can be really difficult for some people because they often find themselves stuck between choosing to be functional and choosing to be a socially-palatable disaster.

I think not being able to mask often presents as being less concerned or less focused on determining the emotional state of others and attempting to match it, along with stimming more, and being less inclined to put a lot of flair into the way you speak and use gestures and stuff like that. There's probably some other stuff that I can't think of at the moment which I'm overlooking too.

I try not to downplay (or play up) my own struggles but all things considered I've lived a pretty chill life I feel like..Lots of self-repression and some serious struggles socially at times but you know, not outright horribly traumatic? So maybe that helps idk.

That's good to hear. It's definitely going to make things easier for you if you do end up being prescribed stimulants.

Though it's worth keeping in mind that often the self-repression and masking comes due to experiencing a lot of hard knocks socially. This is not to diagnose you or to pathologise what you've been through or anything but sometimes when it's the background noise you just get so accustomed to it being there that it becomes your normal. Stimulants often bring that stuff to a head; I am diagnosed with PTSD and I legit have this condition so this is me just hypothesising but if the stimulants bring that stuff to a head for me then I suspect that it would do the same thing, to a lesser degree, for people who are sub-clinical or who have had some tough battles but where they don't have symptoms of PTSD/they only have milder ones.

All of this is speculation though. This is a massive blind spot in research and as far as I'm aware there's no efforts to really understand this from academia yet. We need more neurodivergent folks in research asap.

Thanks for your prolific support and advice all over the site!

Ah no worries. I'm just glad to help and to do my bit to contribute to the knowledge base on these topics because there's such a gap that exists currently.

I just got new insurance so I'll have to see what it will cost to see someone this summer. I hate to say it but I want to see if I can get the ball rolling on this diagnosis stuff without telling them I'm trans... (is that a horrible idea?) Let's just say I don't want to be on that list given the way the US is going lately... My gender is none of their business and even barring government action, telling your doctor you're trans unfortunately seems like an excellent way to get subpar medical care. Or maybe I'm needlessly paranoid but I'd rather be paranoid and wrong than the target of fascist repression or plain ol discrimination.

Honestly it's one of those things where being cautious is something that I'd recommend, if someone were to ask me.

A lot of things stick with your medical records and, although I'm somewhere in the non-binary spectrum (meaning that I'm not cis so therefore that means I'm trans) I've never really hashed this one out with myself because I have had more urgent priorities so I am happy to sit this stuff out since I'm barely even an expert in my own experience. That means this next bit is just me making an educated guess here but I suspect that if you're trans in the sense of being opposite to your assigned gender and you're open about it with medical professionals then you're probably going to receive less quality of care and you run the risk of having anything you present with as being considered a "trans issue". Idk if I'm making sense here but for people with chronic mental illness they very often report that medical professionals just get locked in on the mental health stuff to the exclusion of everything else, so it's hard to get physical issues considered and often it just gets lumped in as being caused by mental illness or brushed off as a side effect of medication. I have no knowledge about this for trans people but I have a suspicion that, in a similar way, a lot of doctors would be quick to blame ADHD symptoms on a person being trans or on hormone therapy side effects and stuff like that. Hopefully a trans person who is knowledgeable about this stuff might chime in with their experience to let us know what it's been like for them.

Then, as you've mentioned, there's the overarching concerns about politics and long-term safety to consider as well.

So my general advice would be to try and go for an ADHD diagnosis first, if you're able to prioritise it, and go from there. Honestly an autism diagnosis probably only provides you with about the same study and workplace accomodations as an ADHD diagnosis would, and given the cost of an autism assessment it might not be worth the price of admission.

To be clear, my childhood wasn't severely traumatic, but stressful enough that I had forgotten most of my childhood.

I have been diagnosed with Autism and ADHD at an early age. Of course, the doctors said at that time that I would never be able to experience any emotion besides anger and sadness for my entire life, so I would be careful with the information you give to them and try to find a good psychologist/psychiatrist. I have had to jump between multiple as often they were on a grift to get me on a particular med that didn't work for me. This was during the med change after dropping out of college, but I had other doctors before that wanted to use me for profit when I was younger. Others were just backwards and refused to update themselves in their profession.

I have been on the max dose on methylphenidate since middle school. It does work for me, but I have taken it so long that I believe the effects are not enough to overcome my severe burnout. When I quit my job, I am considering going off meds for a week and sleeping all day. When I have had breaks with my stimulant, its effects have improved again for another period of time until the burnout overcomes it again.

I went on antidepressants for situational depression after dropping out of school, and then I continued going through a med change and ended up back on a stimulant again, but this time Vyvanse. It's effects were the same on me, but I believe I felt a bit weird (tingly in the brain?), so I think the side effects were worse on me. I went back to methylphenidate because I was poor and it was cheaper at the time. Going back on stimulants after around a year made me feel much more functional again.

I have also been drinking a lot of caffeine on top of my stimulants, sometimes even 600-1000 mg, because I have been struggling to do work. Once I drink around 900+ mg, I get a terrible headache and stomach ache, so I try to avoid that range.

I have been going very late to my job, and I use the restroom a lot out of anxiety and stress. It's a 35+ min drive to work and a 45+ min back home, and it absolutely sucks. I think I have managed to keep my job as I have made a lot of PowerShell scripts that have helped the company immensely, which I even received a large pay raise and multiple gift cards for. I feel as I have always relied on my ability to do work at a perfectionist quality to make up for my shortcomings.

I went on Jornay during my current job, which seemed to help me get to work on time a little easier, but I had to go back to my old meds because it was very expensive, and it would really suck when I forgot to take it the previous night.