I've revised a lot of my philosophy towards ADHD over the years. First of all - I've come to believe that it's probably caused by a huge range of different genetic issues and that it's fruitless to obsess about which one you have until genetic analysis gets a tad better (it's pretty good atm - if you get tested 3 times and average the results you can be fairly confident in them, but there's a huge chance that it'll be difficult to pin down exactly what phenotype is at play due to how many a person could have at once and the complex interactions between them. It's likely that current mainstream ADHD medication works universally whether you have ADHD or not - that it increases executive function, or more specifically, executive oversight. Reduces automatic thinking, shifting the balance more towards ordered thinking. Of course lower doses of dopaminergics also universally enhance working memory to some extent similar to caffeine's benefits on the general populace - it turns out a reasonable stimulant is going to have pro-motivation, pro-stamina, pro-cognitive effects on just about everyone if you get the dose curve right (too little results in unobservable changes, too much introduces too much "noise" into the neural networks - think of it like amplifying an audio signal - yeah you can hear it easier but the background noise can pollute the quality to the extent that you gained no advantage or have even more trouble understanding).
So with this in mind, I believe that methylphenidate is definitely the best go-to adhd medication. I specifically recommend a low-dose regimen, and that you do NOT ramp up the dose to maintain effects. Accept that the pro-motivation effects (originating from reward system stimulation) will fade rapidly unless you're one of the lucky few with a phenotype that hampers downregulation. Fortunately, the pro-working memory/executive function effects are form an entirely different part of the brain, the prefrontal cortext, which just so happens to not adjust receptor densities as much as the various reward circuits do. Pro-memory/self-inhibition increases should persist.
Secondly, I've really undergone a paradigm shift where I've become much more focussed on the psychology of ADHD and related conditions (depression, anxiety, etc). Specifically learned helplessness (i.e focus on medication as the solution completely ignoring/giving up on changing the self/beliefs/thought patterns), self-defeating behaviors (self-indulging coping habits such as procrastination despite knowing it's the wrong choice in the moment), negative internal messaging (a highly critical internal vs nurturing/encouraging internal voice), and motivation styles (push vs pull strategy of self-motivation - using fear/deadline pressure as motivation instead of various methods of immediate/baby-step type motivation). These are all areas I believe are actually far more important than the underlying neurological deficits, as evidenced by the hordes of people who have tried tons of ADHD medications with consistent failure to improve overall despite "feeling better" at times. A book that really got me looking down this road was "The Now Habit" - really really really helpful for dealing with procrastination. Changed my life - that's not to say I immediately started getting better, but I found an understanding (the real truth was deep down I had a behavioral issue - plenty of people have severe and I mean severe cognitive handicaps like Downs Syndrome etc and yet they still can achieve their dreams - then there's all of those ADHD people out there that are simultaneously very smart - we just tend to be very bad at dealing with our issues and those around us growing up often have limited insight into what we struggle with internally) and the journey really began from that point.
As for supplements, I've become a big believer that nutrition should be the focus before you even begin to consider herbal/chemical supplements. And the #1 way you should correct nutrition is with diet, falling back to supplements only to fill in the gaps. In terms of diet, we're talking making sure you get the RDA for protein, healthy fats, and insoluble+soluble fiber. After that, proper mineral intake (especially magnesium+zinc) is key too, particularly for those on stimulants due to the excessive peeing/salts loss they cause. When supplementing, avoid all supplements that megadose, and aim to take doses that are fairly close to the RDA as opposed to 3000x times it. That means not taking 2 grams of vitamin c for example, but instead just 100-250 mg.
The #1 supplement I recommend is Vitamin D. Yes very obvious but us Canadians literally need it. It struck me once that I basically never get real sun exposure. Most of the year I am heavily clothed, it's cloudy and I'm working indoors and inside of a car all of the time. How the hell does anybody get enough??? So 4000 IU is what I recommend, and combine it with cycles of Vitamin K to ensure you have sufficient to properly utilize the Vitamin D (K deficiency combined with supplemental Vitamin D can be bad for the health due to erratic calcium transport in the body).
After that I also recommend taurine 500 mg. Occasional fish oil is also probably good but it can actually cause issues. I do believe that dosing pure oil isn't the best way to get it into the body and for some can actually cause brain fog due to irritating the digestive tract (the digestive tract is very tied into the brain). This brings me to another big area I've found to be of interest - digestive health. After reading a ton of research I am very convinced that many cognitive issues can originate or be aggravated by gut issues. That being said, I skipped the probiotic pill fad as I believe they are shit quality 99% of the time (a powder pill just isn't the best way to transplant healthy organisms) - probiotic foods are way better. Kefir, saurkraut, kimchi etc (they all must be raw/unpasteurized to be of benefit).
Finally there are 3 lifestyle changes I believe are also KEY to improving mental wellness for literally anybody and I have noticed without doubt the largest benefits from these:
1. Improving sleep. I spent years sleeping 5,6,7 hours a night at varying times, this is bad for most people - most people really do need about 8 hours of sleep for the best cognitive function, and some studies indicate that even a half hour less can cause measurable deficits. Even worse, the feeling of tiredness is relative to what you're used to and is not an accurate gauge often. Strategies to improve sleep include: orange tinted wrap-around glasses at night to totally block the disrupting blue/green-tinged light, eating a fat heavy meal towards the end of the day (but not right before bed), avoiding sugar 3 hours before sleep, going for walks before bed. I do not recommend supplementing melatonin - I noticed reduced sleep quality and other issues while taking it, and I do believe the current methods of supplementing produce unnatural blood-concentration trends throughout the night that might not be aligned with sleep cycles/might induce unnatural cycles. If you do try it, take very very low doses (300 mcg)
2. Cardio exercise. Doesn't have to be crazy workout regimen, I found I preferred hitting a treadmill for 20 minutes at a time (not counting 5 min walking warm up and cool down). If you do not like the environment of a gym, I cannot recommend strongly enough just how much it is worth buying a treadmill yourself - plop that thing in front of your TV and you'll have no problem being regular with it. Exercise bikes are a good affordable version, though treadmills can be super affordable used since a lot of people just want to get rid of them due to how much space they waste when not being used regularly. Look no further than this excellent wikipedia article (https://en.wikipedia...ysical_exercise) for convincing that this is worth pushing yourself to do. Literally remodels your brain to be better all around. It really doesn't take much commitment, just a 20 min jogging session 3 times a week will give you benefits you will seriously feel. Do it more than that for even more benefits.
3. Saunas. This is a huge for me because they help a heap with anxiety/depression. I really enjoy bringing a book, they are seriously so very relaxing. There are a slew of physiological effects they have mediated by triggering and calibrating the stress response in a similar manner as exercise does, but purely via heat rather than exercises benefits which are more mediated by a negative-energy/glucose state caused by high cardio activity. Check this essay written by fitness doc Rhonda Patrick (https://www.foundmyf...auna-report.pdf), it cites tons of research. They are so easy to get into, if you think of them as uncomfortable you're probably thinking of the ones with people pouring water on the rocks - those are way too intense in my opinion - dry heat is more ideal because you can tolerate much higher temperatures for much longer. I recommend starting with 10 minute sessions at 70-80 celcius (yes celsius - remember that with low humidity in dry saunas that doesn't feel as hot as it sounds due to poor conductance through dry air) - working your way up to 20 minute sessions at 90C over a period of a few weeks or so. The best way to get into saunas regularly is to find an apartment or condo you can rent where the gym room has one - it's more common than you'd think. If not, check out gyms for saunas, even if you don't want to use the gym itself it's often still cheaper to get the membership just for the sauna than what you'd pay to go to a dedicated sauna place (typically charging spa prices).
TL;DR The order you should approach your problems in: A) Psychology (read "The Now Habit" first) B) Lifestyle (sleep, diet, exercise) C) supplements filling gaps in diet D) a core group of supps you've researched that help with certain issues you feel you need a bit of extra help on. Anxiety is probably the easiest to treat with supplements as it has a fairly consistent neurological cause, whereas depression and ADHD both have a huge variety of extremely different causes at play producing similar symptoms. Do not take any supplements prone to tolerance/addiction - i.e you should be afraid of any magic fixes like Phenibut. Just not worth adding another future problem to the list lol! Also big warning that doesn't get talked about enough - TONS of supplements (mainly herbal) interact with liver enzymes responsible for metabolizing drugs like caffeine or amphetamine. So if you're taking any non-dietary supps (anything aside from vitamins, minerals etc), look up if there are drug interactions. Sometimes you even have to first lookup the enzyme that metabolizes the medication you're taking, then google that enzyme and the supplement you're curious about.
Hope this has been of help - I feel for you, it can really be hard sometimes can't it, but I hope you can feel the optimism I've gained over the years and begin feeling it yourself - always remember just how fortunate we really are compared to just how bad it really could be. There are guys like this, out there simply fighting through their handicaps without getting stuck looking for magic pills to fix their problems - we can be like them too 
Edited by GetOutOfBox, 18 June 2019 - 02:59 PM.
and more reason to maybe take folic acid.
