Posts made by Kestrel

@Vixanic sorry for the maaassive wall of text though it probably isn't that hard to get through if you're just starting on Elvanse, lol.

One final recommendation: I found it difficult to get enough calories, maintain a balanced diet and remember to eat in general while taking Elvanse. Since as mentioned this kinda fucked up my body, I realised I needed a serious solution for this and did actually find one.

Huel works really well for me, it's quick, convenient and very easy to keep track of for calorie/portion control purposes. I've personally seen a lot of health benefits from having this on hand alongside my ADHD medication. I'm not affiliated with the company in any way. (I can pass on a discount/referral code but swear that's not why I recommend it.)

I also got some blood tests through private referral to ensure there weren't nutritional factors in my inability to concentrate etc. and recommend that if you fall into the trap of forgetting to eat or something. (Did have a couple deficiencies for a bit and addressing them did help.)

@vixanic said in The ADD/ADHD Thread (cont'd from Peeves):

So, I guess this is the thread to say that as of last week, I have a formal diagnosis for ADHD. I'm starting new medication tomorrow - Elvanse, the active ingredient of which is lisdexamfetamine dimesylate, an amfetamine. (Edit: I am told it is called Vyvanse in the US)

Does anyone else have experience with this drug or a similar one, for ADHD treatment? Any advice, anectodal evidence of how it helps, etc?

Congrats on your diagnosis. I'm in the same boat as you and know how powerful that can be. It's also a lot to process, especially starting out on the medication ... good luck.

When you first start out on Elvanse (or any ADHD medication), you're going to be given a relatively low dosage, typically 20mg or 30mg, and it'll then be gradually increased by your psychiatrist depending on what you report back to them. With this in mind, here are my tips:

• Report back to your psychiatrist as instructed and be completely honest with them. Unlike many other types of psychiatric medication (e.g. antidepressants), the effects of stimulants like Elvanse should be apparent the day you take them. If a few hours after taking it you still don't feel anything, or if the difference is only subtle, it isn't working and you probably need a higher dose.
• Don't increase your dose without first discussing it with your psychiatrist. There's a reason they take you up a little at a time; there's a sweet spot for how much you need for it to be optimally effective, and taking too much, resulting in excess dopamine, actually has the opposite effect of what you're probably trying to achieve.
• Don't give up hope and don't despair if it doesn't seem to be working as expected. (I speak both from experience of feeling this way and from talking to other friends who've recently gone through the same journey.) Just trust your psychiatrist and communicate. It takes time to find the right dose and they'll adjust until you get there, but you will get there.
• The max dose for Elvanse is 70mg. Your doctor will probably take you up/down around 10mg at a time as needed. Typically what will happen is that every time you go up a dose, you'll feel better, and then your brain will gradually adjust to that dose until it no longer works. Then your doc will take you up again, until you reach a stable dose where the effects no longer seem to be decreasing over time.
• If the dose is too high, you'll feel high. And honestly this is an amazing feeling, I thoroughly enjoyed it until it wore off. (And it will wear off so don't get too attached to it.) When the dose is just right, you won't feel high but you'll just feel like a normal adult who can do normal adult things without it being difficult. Other than that no one in your life should be able to tell you're "on drugs" because you'll just seem like a normal person, more normal than you have been previously. I know people who take a very negative view of amphetamines (because it's commonly abused by normies as a "study drug") and they're surprised when I inform them that I take them, since I don't act like the people they've encountered who were using it without a legitimate diagnosis.

For me, 30mg did nothing. Two days later my doc boosted me to 45mg (instructing me to split the capsules and take 1.5 instead of just 1). On 45mg I felt high for 2 days which was cool and fun, then it wore off and stopped working again. I got boosted to 50mg which worked pretty well. I told my psychiatrist it was working but that the effects were subtle (though still good) at which point he took me up to 60mg. This is currently my stable dose, with a few other caveats:

• Elvanse decreases your appetite and you're going to want to eat less. This is exciting if you're trying to lose weight, especially since ADHD is often comorbid with obesity and binge-eating disorder; if you're anything like me, food is one of the few things that gives you a dopamine boost normally, which makes you think about and crave it all the time, and that goes away when you're on stimulants. That said: don't get carried away, 'cause I did, and it was not a good time. If you aren't getting enough calories, all the ADHD meds in the world aren't going to help you focus. It's OK to use Elvanse to help you lose weight and reduce calorie intake, but make sure you're making time for breakfast and dinner before/after the effects are felt. Maintain your physical health; your mental health absolutely depends on it.
• No idea what your biological sex is, but female sex hormones have a profound effect on dopamine levels, and therefore also the efficacy of ADHD medication. It's very common for the effects to fluctuate depending on which point of your cycle you're on. If female, I recommend using a fertility tracking app if you don't have one already and trying to schedule your productivity around that. Additionally I'd recommend insisting on either a female psychiatrist or at least one whose online profile lists "ADHD in women" as part of their specialisation. You will also want to do your own research on the topic because the institutional bias against women & female bodies in medicine means many doctors simply aren't informed/educated about these nuances. I've had to take a very active role in understanding my own healthcare needs to ensure that they're met. If you're AFAB and suspect you may have an endocrine/fertility condition in addition (such as PCOS, endometriosis, menopause, perimenopause, a history of hysterectomy, or are on hormonal birth control) I highly recommend seeking out a female endocrinologist in addition to seeing a psychiatrist for ADHD. Controlling/tracking your sex hormones is absolutely key to managing & treating ADHD for AFAB individuals.
• Elvanse is a slow-release stimulant. I recommend tracking the times you take it, the times you start to feel an effect, and the times when you start to feel it leaving your system. For me, it takes about 2 hours to kick in and lasts for 8 hours after that, but I've noticed my metabolism of the medication differs throughout my menstrual cycle and has slightly increased over time. Therefore I notice a sort of "bell curve" effect throughout the day, giving me about 2 hours of peak productivity and a slight decrease before/after that. I communicated this to my psychiatrist and was prescribed a quick-release stimulant (dexamfetamine) in addition to the Elvanse to help ensure I'm still functional in the morning and evening when the effects of Elvanse are greatly lessened. I take up to 2 doses (sometimes 0) of this throughout the day depending on whether I actually need it. (E.g., Do I have important tasks to accomplish? Am I liable to forget my keys when I leave the house if I don't take it this morning?) Typically that would mean one in the morning with the Elvanse, and one in the afternoon without.
• It's OK and even good to take breaks from the medication now and then. I find having a rest day or two per week helps ensure I'm able to relax and unwind more since the medication increases my productivity to such an extent that I will genuinely forget to goof off and have hobbies, which are still necessary for optimal mental health. On those rest days I'll also increase my normal calorie intake to ensure I'm not overdoing the weight loss or compromising my body's basic functioning.
• Taking Elvanse with or without food will modify its effects to some extent. In particular fat intake can dull the bell-curve effect mentioned, and ensure you experience a slower, more sustained release of the medication. Too much fat can dull the effects to the point where you won't feel it at all, too little will cause it to be absorbed too quickly and create a sharp/abrupt productivity peak followed by a crash straight after. Once you're on a stable dosage you should experiment a little with the optimal amount of food to take with the medication. Elvanse will be fully absorbed into your system 20 minutes after you've taken it, so you'll want to eat any food intended to aid absorption either right before or during that window. My doctor recommended a light breakfast; I found a heavy one worked better, since being vegan my diet's lower in fat/calories than most people's is regardless.
• If you wake up really late, don't take the medication that day. It'll keep you up and you won't be able to sleep. If it interferes with your sleep regardless you may want to talk to your doc about some sort of nightly sleep aid in addition, e.g. I take Trazodone and have done so historically for insomnia, even prior to being prescribed Elvanse. (Though I needed it that much more after.)
• Because amphetamines are a Class II controlled substance in the UK, and because many people do abuse amphetamines without a diagnosis/prescription, doctors are often reluctant with how much they prescribe, to whom and when. You may need to prove to your psychiatrist through consistent communication and adherence to their instructions that you can be trusted. Elvanse is considered a medication with a low abuse potential due to its gradual release mechanism; this is why it tends to be the first line of treatment offered for new patients in the UK and why you're unlikely to be offered a quick-release version upfront. If you feel like you need a quick-release medication like dexamfetamine, just be patient and give it a few months of trial/error/discussion with your psychiatrist. It's unlikely to be offered until you seem to be on a relatively stable dosage of Elvanse and have enough experiences to draw on.

I realise that was a lot but I hope it helps. It all would've certainly helped me when I first started taking the medication, and a few friends of mine on a similar journey have reported the same.

I'm UK-based. (London specifically.) If the above helps and you want someone to chat to about specific doctor recommendations in that area or just experiences with Elvanse that your psychiatrist doesn't have the time for, feel free to drop me a private message.

Unfortunately, getting seen on the NHS is difficult to the point of feeling practically impossible (especially for adults, especially for women ...) and private psychiatrists are overbooked, overcharging, and provide too little time. There's a gap in this country right now between the available knowledge/expertise on ADHD and the amount of people currently realising they need help for it.

Good luck.

@greenflashlight

She gave a fiercely powerful speech advocating for the desegregation of trans healthcare in my country. (E.g., the same access to HRT that cis people have without an arduous interrogation & waiting list.)

Upon realising she was in the area (I genuinely had no idea she would be there, a lot else was going on around this) I had a mini excitement freakout during which I secretly professed my undying love for her to two nearby acquaintances of mine. They gently cajoled me into approaching her, flanked me en route, and then graciously held back a step while I did my very best to seem like a normal/healthy/respectful adult in expressing my cordial admiration for her work. We complimented each other's style, I am elevated to a new plane of existence by this, and then I extracted myself so as to stay out of her way for the rest of the day and confine my remaining 'OMG's to said acquaintances who helped me navigate the aftermath of this emotional time.

I have good wingpeople, and also good boots. One of said wingpeople had actually complimented the boots separately before Abigail did so, and was smugly validated in their judgement.

I actually hate the boots but I guess now I have to keep them forever.

I met PhilosophyTube in person and she liked my boots.

I die happy now. My life is complete.

Social desires:

I want to be respected. @Ganymede phrased this as 'I hope to entertain' and that resonates but I'll go a step further and admit that I have a certain need to be admired and appreciated. I rarely do things with intention to harm other people, but this is partly because if others feel bad because of me, I feel bad about myself; I want my contributions to add positive value.

I want healthy separation. Despite the above, what I want from the community is to feel wanted, not needed. If I start to feel like people are making demands of me or that my contributions are no longer seen as voluntary but an expectation I have to meet, I peace. I want the freedom to come and go as I please, RP with others outside of my usual circle, and choose what I participate in without being judged for what I choose not to. I never want to have to explain why I do or don't want to do something.

I want a "professional" relationship, with fellow members of the community being more akin to colleagues than friends. This is a controversial one, I'm aware. This relates especially to displays of affection and familiarity and especially one-to-one. My interest in engaging with someone communally or for RP purposes doesn't necessarily mean I want to engage with them individually for OOC purposes, and expressions of admiration on my part are not an offer of lower social/sexual/romantic boundaries between us. I take care not to invite the assumption that it should, and will avoid people who show signs of misinterpretation/desperation.

Personal desires:

I want to pursue omniscience in a world full of mystery. To find out what makes every character tick, what the relationships are between them and the overarching story. For this reason I tend to play spies, scientists, hackers and detective types — people who have an excuse to go digging or interrogate people one-to-one. When I get into romantic storylines, it's likely to be with a character I find complex and interesting to try and figure out, who throws me a lot of curveballs and maybe even starts out as a rival, so there's initial resistance to tease out curiosity. I avoid characters who come across as very flat or don't give me a lot to work with, and I avoid settings that feel too predictable.

I want social commentary. (I think this is also a controversial one.) The setting has to provide some room for ideological conflict that goes beyond just light vs. dark, good vs. evil, nice vs. bully. My characters aren't often a reflection of my RL values, in fact they'll often be the opposite specifically because I want to act as a foil, make people think and give people something to criticise.

I want shock, horror, awe, action, adventure, impossible choices and exceptional circumstances. Take me outside the confines of RL humdrum, I'm here for a thrill-ride. If I engage in bar RP it's to set up the connections/investment for when things go awry or to decompress/commiserate/celebrate whatever cool big thing we just survived. But I want what really drives and holds our IC relationships together to be those major events, not day-to-day or smalltalk.

I want tension tolerance. It's fine if our characters don't get along. It's fine if things don't always go our way. It's fine if our lovebirds won't get their happily ever after. It's fine (good actually) if the stakes feel high. It's fine if I can't cleanly put your character into a box of friend or enemy. I like it when things aren't straightforward and am comfortable with uncertainty, changing dynamics and unexpected roadblocks. Don't make things too easy for my character; it'll bore me and the story I'm pursuing is more often about the challenge they face than the finish line.

These are not all needs, some of these are just wants. And if other people communicate their needs, I will often be happy to accommodate as long as I'm likewise having fun. I'll adjust my playstyle to the setting, community, and my current RP partner and can slow-roll things until I understand their comfort levels. (I will default to the assumption that you don't want an epic rivalry, for instance, and keep things ICly cordial and fluffy until I get the go-ahead to assume otherwise.)

So is constantly entertaining way more character concepts at any given time than I could ever see into fruition an ADHD thing, or just a special kind of multiple personality disorder?

At this point, I kind of feel like I should be paid to play someone else's MU*.

The cringe I feel reading old posts of mine on MSB.

Part of me is glad this place will be going up in smoke simply because it will erase all my cringe post history.

The reason this isn't a "gripe" but a "thing I love", though, is that it's cathartic. I'm glad my past self is cringe-worthy to me, it's an encouraging sign that I'm in a better place now than I was 2+ years ago.

@macha said in Health and Wealth and GrownUp Stuff:

Got some unexpected cash from a lawsuit. See stuff I've wanted to buy so I could make cold process soaps. Do math. Realize if I order this now, I can have soaps ready for early December.

Proceed to panic for even thinking it, because I don't even know if I could sell them.

Put on repeat in brain.

I don’t visit MSB daily so if you posted elsewhere about the context of that lawsuit I might’ve missed it. But from a few posts of yours I’ve noticed here and there referring to totally inappropriate working conditions and behaviour, I’m very glad to hear (hope? suspect?) that you’ve seen some justice for that BS. Congrats, rooting for you.

I don't know whether to post this here or in the Dog Thread, but ...

Canine hyperactivity, impulsivity, and inattention share similar demographic risk factors and behavioural comorbidities with human ADHD

Studies suggest that 12–15% [19, 20] and 20% [20] of dogs naturally manifest high levels of hyperactivity/impulsivity and inattention, respectively, making the domestic dog a highly potential animal model for ADHD [21–23]. Moreover, these traits are mediated by the same behavioural [21, 24], biological [17, 25] and genetic [24, 26] factors in both dogs and humans, and dogs also respond to medication used to treat ADHD in humans [27, 28].

There is even a study specifically on ADHD in Siberian Huskies, where they managed to locate the specific gene alleles associated with unusually high levels of hyperactivity, impulsivity and inattention.

As the happy (and sometimes tired) owner of one particularly hyper husky zoomster, I am now super curious to have her genetically tested.

I decided to dedicate 30 minutes before bed tonight to read up on the nitty-gritty science of dopamine, stimulant drugs, nutrition and sex hormones. I wanted to prepare notes for an upcoming shrink appointment and had left it to the last minute.

Well, it's 4 hours later, but I did obtain a lot of useful information, and will now be increasing my intake of matcha tea, probiotics and velvet beans.

I will never get tired of watching all the gratuitous murder shenanigans on You.

@coin said in Good or New Movies Review:

Woody Harrelson will not make enough of a difference

heresy

Waiting a month to be contacted by a specialist about what should be a fairly straightforward medical referral; contacting them to check in on the hold-up; finding out I'm on a one year waiting list.

I'm glad my country offers free healthcare but it's kind of also a gigantic lie.

@macha said in The Dog Thread:

@kestrel So that song led me to another of their songs.. and I may fall into a hole.

Until the Ribbon Breaks are so great and so underrated. Their self-titled album and A Lesson Unlearned are just ... chef kiss.

But, on the topic of dogs, let me show off what I got to wake up to today (and every day).

Way better than other types of dog a woman might wake up next to.

I love the unique connection I feel with other people in this hobby who share my story-oriented mode of thought in a way that most people in my life don't. Even when we aren't actually talking about the games we play(ed) together.

Honestly, I am all for paragraph, even multi-paragraph RP. But I tend to prefer at least 90% of that to be action, body language and scene setting with just one or two lines of dialogue. And I prefer realism over inclusion, meaning that with people I'm comfortable with I may not respond to everyone in the room, and trust they'll know it's a matter of what makes sense in the scene right now rather than purposeful exclusion. (But like most people I'll adjust for etiquette around strangers and newcomers.)

I don't think there's a right or wrong way here, mind you. The person I mentioned in my previous post is, after all, one of my regular RP partners for a reason. I rib him about this with sporting respect and affection.

Meanwhile, reading Kurt Vonnegut fills me with a bitter sense of shame and inadequacy because it shows me a perfect example of a writing style so very different from mine which I can't at all match. He's a master of snappy dialogue and years of exercising my writing skills on MU* have taught me the opposite skill (though I feel I'm good at descriptive nonverbal writing).

The way people RP conversations is incredibly unrealistic.

You have people monologuing without room for others to interrupt or prompt with a few questions, nor telegraph their disgust/disinterest which would normally make the person talking pause and start to feel awkward.

And, you have the thing where someone is trying to be as inclusive as possible, so their pose includes a sentence of dialogue directed at every single person in the room, addressing every topic that's been raised, leaving nothing out, lest others feel ignored.

I have a regular RP partner I annoy on these fronts because he'll consistently drop a paragraph of text with 5 different talking points and I just have my character react to the very last thing he said. Usually the quip portion instead of the actually important stuff. And then he gets frustrated I didn't comment on the actual plan or whatever, to which either my character replies, 'sorry, that was a lot to take in' or I tell him OOC that he needs to give my character room to respond if he actually expects me to.

These are two people talking! It's not an email exchange! There are no paragraphs and subheaders in a normal conversation.

@arkandel said in Good TV:

Same as Saruman's 'voice' it made the wielder extremely manipulative, and even that not in a direct 'mind control' kind of way.

Wormtongue too, and the Arkenstone.

I think these concepts work as metaphors too, but I concur it is a shame we don't get to see the victims of this show humility when the spell is broken. Because it was "just" magic.

So when I first got Andi I had just discovered this song and had been replaying it to death, all day, every day, and singing along.

The lyrics actually have nothing to do with her, they're about falling out of love and abandoning someone which adds a layer of irony here. But, because it's the song I had on repeat most often during her early puppyhood, it is now her favourite song.

It's the most adorable thing in the world 'cause I have it on my normal playlist (which is 547 songs, 32 hours long) and anytime it comes on, even if I don't immediately notice, she does and lets me know. She could be in the other room and will immediately walk in howling excitedly and tossing her head about. She could be asleep and will at once perk up and look over at me expectantly.

So, 9 times out of 10 I of course give her what she wants when she reacts this way, and start serenading her back, or get up to dance with her in the living room. My day will also be improved times a hundred.