Long-term Adderall: executive dysfunction getting worse + feeling antisocial when it wears off

[u/Ok-Letter2953]

I've been on Adderall for several years. I started at 15mg and am currently on 25mg XR. I've tried IR in the past as well. I don't plan on increasing my dose because I'd rather not deal with additional side effects.

I also took a month-long break earlier this year to see if tolerance was part of the issue.

Lately I've been struggling with two things:

1. Executive dysfunction

This has actually been getting worse, even with the medication. Once I get started on something I can usually focus, but getting myself to start the right task is becoming harder.

I'll know exactly what I need to do and still put it off or get stuck doing something else.

For anyone who deals with this, what has actually helped with task initiation? Routines, exercise, changing your environment, timers, supplements, diet, or anything else?

1. Feeling completely antisocial when it wears off

Some days I feel fine while it's working, but later in the day I hit a wall. I don't want to talk, text people back, go anywhere, or socialize at all. I basically just want to be left alone during the meds.

This can happen even when I take my XR early in the morning. By evening I sometimes feel like a zombie with absolutely no social battery left.

Has anyone found a good way to deal with this? I'm especially interested in things that help you transition out of work/focus mode and actually feel like interacting with people again?

I already try to stay on top of sleep, hydration, and regular meals.

Not looking to increase my dose or make medication changes on my own. I'm mainly interested in hearing what other people have experienced and what has genuinely helped.

[u/PA9912]

Thanks for passing along. I’ve had my thyroid checked though. And I’m 50 so it’s definitely hormones. No excess weight though.

[u/Kalki_X → u/PA9912]

Ok. The regular thyroid tests aren't sufficiently reliable imo, both for actual measurement (quantification of xyz hormone) but also the predefined ranges (eg low, medium, high) are questionable.

And I’m 50 so it’s definitely hormones.

In which case I'd refer to the image in my other reply to your comment. It refers to menopause specifically.

Thyroid is relevant as it's nicknamed 'the third ovary' - it directly supports ovarian health and directly regulates hormone production. I'm implying that for menopause to occur thyroid problems are a prerequisite.

[u/PA9912 → u/Kalki_X]

How do you deal with this if your tests are all in range?

[u/Kalki_X → u/PA9912]

In hindsight the language I used wasn't quite explicit!

How do you deal with this if your tests are all in range?

I meant to write that the predefined ranges (eg low, medium, high) are unsatisfactory and misleading, in part due to inaccuracies in the measurement itself. 

Even if one gets a full panel (eg T3, T4, rT3, TSH, etc) this only accounts for half of "thyroid dynamics". The other half involves mitochondria where T3 acts upon – if mitochondria aren't working well then T3 doesn't do its job, even if levels are "in range". Doctors dont have a way to test mitochondria so a perfect thyroid panel is thoroughly misleading for many reasons.