Am 42 and unmedicated my whole life, adhd coaching can help alot, I find my focus for doing stuff is also terrible, however it’s things I’ve convinced myself are unneeded bullshit, do I need to send that email today? sort the insurance paperwork? yes I actually do and once it’s done I can go treat my self to some creative time to relieve the ‘ugh’ feeling of emails.

Also an immense amount of coffee, but that’s probably not great advice in your situation.

I totally understand what you’re going through. I took Adderall for the better part of 10 years, and it started making me feel lousy. And my blood pressure started to climb.

So, I switched to Straterra, a non-amphetamine medication, which may still have some risk of HBP, but it doesn’t seem to do anything to mine. That might be an option.

It takes several weeks to take full effect, and it’s not as effective as Adderall was for me, but it’s difficult to function without it. Later on, I still had to face high blood pressure. I could possibly go back on Adderall, but I’d prefer not to have the medications “fight” over it. ;-)

Ask your doctor about guanfacine (Intuniv). It is taken both as an ADHD medication and a blood pressure lowering medication. It might be good either by itself or in conjunction with your current medication to offset the stimulant’s effects on blood pressure.

My therapist recently had me (mid 40’s) reconsider everything that has worked for me in the past and to list it all out in my journal (or something visual that I can keep relatively handy). I do forget to keep looking at it and choosing a tool from the toolbox so I probably need to rethink what I write it on and how I display it. She also advised that when I notice the helpfulness of the list falling off, that I REWRITE IT and change up the order.

The tools in my toolbox evolve all the time. Some of them work better for some tasks vs others. Some of them have lost their punch over time and need to be benched for a while. My current favorite tool on the list is to plop headphones on and crank some EDM or anything karaoke-worthy. This doesn’t work for work-work where I need to concentrate, but it works fantastically for anything physical like DIY projects or non-thinking things like laundry or dishes. For work-work, I still haven’t found one that is no-fail, but playing lo-fi instrumental hiphop like the study girl video does ok to keep me on task once I can get myself kickstarted. Oh and ChatGPT is my new work bestie for writing anything, especially emails. Sometimes it hits the target where I can just copy/paste, but usually it gives me enough material to edit into something intelligible. I also have to keep reminding myself to add a sensory something when I start getting off track. I have bicycle pedals that fit under my desk. They worked great when I first got them. They’ve been benched for a while now, and maybe it’s time to bump them back up the roster. I have an accupressure mat, back massage cushion, will light candles or incense, chew gum, just basically try to layer not-too-distracting sensory things on top of what I HAVE to do, and that usually gets me through it where I can then go be a potato for a while.

My blood pressure spikes with stress. In my doctors office, we took a reading and it was high. Then we took another one 5 minutes later after I intentionally relaxed myself and it was normal again.

She prescribed guanfacine to take in combination with the vyvanse. Should theoretically help. Won’t know until I start it next month