I sure do wish my friends were able to be strategic about such things when I'm not. (I bet there's selection effects for this kind of clustering.)
Do you actually find this to be a “sit down and do it” type task, though? (At least, that's how the post reads to me connotationally; maybe I'm misunderstanding it.) My experiences, at least in terms of “how it feels to do from the inside while depressed”, have been more along the lines of “make several ambiguous decisions on how to quantize your situation so it fits into the only form they'll accept while worrying about being judged on whether you'll be able to back that up with socially certified proof in front of unknown arbiters an arbitrary amount of time later” as the initial phase, followed by a foggy gauntlet of appointments in which you must continue to make decisions based on very little information, be perfectly reliable across long irregular time delays, never miss any postal mail, email, text messages, telephone calls, or Health Portal messages that require you to log in with 2FA every time and take five minutes to load, and never miss any lack of postal mail, email, text messages, telephone calls, or Health Portal messages that require you to log in with 2FA every time and take five minutes to load (except when the portal is down, in which case you have to make a note for yourself to try again repeatedly until it's up again) because sometimes they silently fail to send you a thing you need, and sometimes the receptionist can't understand you over the phone or misspells your name so the records are wrong which results in getting brick-walled later, and sometimes the one person doesn't fax the thing to the place and you get a blank stare or a nastygram or a giant bill two weeks later, which leads to another three phone calls, which… it's not usually every single one of those things, but you wind up having to be prepared for a functionally unlimited amount of it regardless. A friend who tried to support that process effectively would have to keep the task in context over a period of months and spend energy dealing with retries and eliciting communication and stuff; just getting the ball rolling and then letting go would have a terribly high failure rate. Is this just a Different Worlds thing?
US healthcare is deeply broken, very happy not to need to deal with it anymore, but there are definitely easier ways to manage this once you're diagnosed, and diagnoses aren't hard to get if you're definitely ADHD and can find someone with appointments available.
Part of the point of getting a psychiatrist is they can help you through figuring out this sort of thing. (I think I originally found mine off zocdoc.com although not entirely sure at this point)
I think this is also a thing Claude can probably help you (it'll probably refuse to give explicit medical advice but talking through your symptoms and asking both "how do I find a doctor" and "what should I ask them about when I talk to them" will probably work reasonably well).
That helps, but a real problem is that the experts will correctly tell you that it's about trial-and-error per person about which meds and how much.
Standard approach is to just try some of the famous stimulants, up the dosage if it feels like it works a little but not enough, then swap if it doesn't seem to work, then try some nonstimulants if a handful of stimulants seem to basically not help you; with a check before starting a drug to see if there's a drug interaction or if you have something like Drug-X-Will-Kill-Me-Specifically syndrome. Which one you start with shouldn't really matter. For stimulants I went in the order of Adderall (a combination of dextroamphetamine and amphetamine salts), Focalin (dexmethylphenidate), Ritalin (methylphenidate), then finally Concerta (methylphenidate but extended release).
I personally suspect that stimulants basically affect those "with ADHD" and neurotypicals in similar ways, and it's just that the lower baseline of those higher on ADHD means they get more benefit. So don't treat it like a drug that will hurt if you don't have a disease but help if you do. I think this is contrary to some common official claims.
For me personally, all of them seemed to have the problem of modifying an axis that wasn't actually my main problem, and upped my anxiety (I have anxiety and take meds for it) and led to harder to describe feel-bad. Adderall specifically made me angrier. All of these were tried at low doses because going higher would clearly have been counterproductive for me. Currently I treat the Concerta like a dangerous gamble, where it might make it a little easier to get work done and might make me feel terrible and end up not doing anything until it wears off. I expect most people to have better results than me.
For nonstimulants, I have tried atomoxetine, which either doesn't do anything or only does a little at my current dosage. I intend to try others, but haven't gotten around to it yet.
For nonstimulants, I would suggest looking into Wellbutrin or Tenex/Guanfacine, which are not ADHD specific but are often helpful.
I already take guanfacine to make me less fidgety, which also seems to make me less restless, but it mostly doesn't seem to help me get started on doing work once I try to get myself to try to start, which is my main problem. I've not tried wellbutrin/buproprion, perhaps after trying a couple more of the drugs specifically indicated for ADHD I'll go ahead and try the other stuff. After all, maybe I'm secretly depressed or pseudo-quasi-paradepressed despite being pretty cheery.
For context, I used to fidget so loudly that I would sometimes be unable to hear my teachers, and it was something like a motor tick where it could only be controlled with significant conscious effort - though it's no longer so bad even unmedicated. The anxiety medication (buspirone) also helps there.
If you're uncertain, you can just try ADHD meds or depression meds (shoutout bupropion) for a bit, and if they help they help.
Anecdotally I have heard some friends had wildly different experiences with different prescriptions. Calibration of dosage, frequency and drug were needed to find a regiment that actually helped the individual. So I would caution “just try it for a bit” by noting that negative signal for one prescription might not mean other, similar prescriptions won’t help. (This is 100% anecdote, would be curious to know if research supports)
Yes; many drugs need a week or more to have your body stabilize, especially various depression drugs, and you should absolutely not just try it once to see if it works.
I don't know enough about ADHD, but for depression helping to get CBT might be better?
https://pmc.ncbi.nlm.nih.gov/articles/PMC2748674/
"The evidence shows that that CT is as efficacious as ADM, and that its effects are more enduring"
this looks like a good overview for chossing AD vs CBT: https://kindsoulpsych.co.uk/blog/cbt-vs-medication-for-depression-which-is-best/
Relatedly, OCD and anxiety meds can also be quite helpful for some people.
For all my efforts at deliberate practicing rationality, by far the most actionable way to self-improve is "get on ADHD or depression meds, if you need them."
Your friends with ADHD and depression struggle to summon the motivation and focus necessary to get themselves a teledoc who can give them such meds. One of the most useful things you can do is sit them down and say "hey, wanna do the steps here to get some meds?" and then stare at them until they do.
(or, until they say "really I do not want that actually.")
This brought to you by ~2 years of Feedbackloop-first Rationality workshops and Thinking Assistance (where it often seemed like the most impactful bits were the 10 minutes of getting someone to sit down and get an appointment with a psychiatrist)