View Full Version : Using stimulants on as need basis due to tolerance.


john2100
11-14-16, 09:25 PM
Any opinions on using stimulants only 2-3 days a week to avoid tolerance?

I stopped using stimulants after I noticed very little effectiveness after prolong use. Even increased dosage didn't have any positive effect on controlling add symptoms.I was at 20-40mg a day IR total.

After a longer break I'm thinking of taking them only 2 max 3 times a day .
My last pill was after a longer break and I could feel it working at about 60% compering to what I would call the ideal performance.

I'm happy with 50% effectiveness.

Has anybody been using them is this manner to avoid tolerance issue?
Does it work,compered with everyday use?
If so ,how long have you been using it this way.

Thanks,


I tried it all from ,ritalin,concerta,focalin,vyvanse,adderal,the only thing I havent tried was dexedrin and desoxyn ,from the common meds. I'm tired of trying all there is.

Cyllya
11-15-16, 12:02 AM
I figure it's worth a try.

I haven't done this myself, but the main thing I'd worry about is withdrawal effects. However, some people get worse withdrawal effects than others, so maybe it wouldn't be an issue for you. The fact that you're taking it for only a short amount of time between each "break" will probably mean the withdrawal will be less bad.

(There's also the fact that "as needed" pretty much means "almost every day," but if getting the treatment you need isn't an option, partial treatment is obviously better than nothing.)

sarahsweets
11-15-16, 03:45 AM
Tolerance does happen but IMO its not as common as people say it is. I am not sure if you are looking to reduce tolerance somehow or be able to feel the effects of meds or have them work better? IMO taking breaks doesnt magically make tolerance go away because if that is truly the issue than you will be right back to where you were as soon as you take the medicine. Its not something that can be remedied by taking days off if it is truly tolerance. Sure, if you have a few days break and then resume taking it, you will "feel" it more for the first few days but IMO it wont do squat for reducing tolerance.

I am a believer in taking medication daily, consistently assuming it works for you.

Pilgrim
11-15-16, 07:39 AM
I agree with Sarah's new avatar. I think you have to see Stimulints as something akin to performance enhancers, an Adder no this just puts the goal posts in the right place.

I think to have days off as you say this wii achieve very little. I've just started taking daily doses of fish oil and I swear this is good for me, I feel more balanced.

More efficacy of medication comes down to 2 things ; the bodies condition and how the body reacts to medication; nutrition, and this can be a taxing experience, if I could afford them I'd take a lot more supplementation.

I'm sorry if everyone doesn't agree, my 2 cents

john2100
11-15-16, 08:52 AM
Tolerance does happen but IMO its not as common as people say it is. I am not sure if you are looking to reduce tolerance somehow or be able to feel the effects of meds or have them work better? IMO taking breaks doesnt magically make tolerance go away because if that is truly the issue than you will be right back to where you were as soon as you take the medicine. Its not something that can be remedied by taking days off if it is truly tolerance. Sure, if you have a few days break and then resume taking it, you will "feel" it more for the first few days but IMO it wont do squat for reducing tolerance.

I am a believer in taking medication daily, consistently assuming it works for you.


I'm trying to get adderall working again for me for adhd . I'm not sure if it is the tolerance issue, or my untreated depression that makes it feel as if I wasn't on meds at all.

With MPD I had a little success.
Adderall was an amazing change in my life first 2 month maybe, then after 2 yrs on it, it slowly stopped to help me to control the adhd symptoms.

Executive function and distraction was so bad by the end of 2 yrs that I stopped eventually taking it. It made no difference if I was on it or no.
We raised the dosage to 20mgx2day for a short time. For about a week I 'd say I felt it working , but then the symptoms started to show again. Doctor suggested to go even higher,but at that point I wasn;t comfortable anymore,also adding of welbutrin or stratera might by a possibility.



I' off meds right now, but I'm thinking if I start I may just take adderall 2d a week .

Is it a tolerance? Not sure. If I increase a dosage ,I will get the desired effects,but then I see the the symptoms slowly to appear.

Also after taking breaks I can see it working better,but then again the symptoms come back.

Is it a tolerance or there is a different medical term that would better describe this situation.

thanks

C15H25N3O
11-15-16, 09:40 AM
There are two types of tolerance from my point of view.



First is the tolerance you develop while you are adjusted to AMP and euphoria decreases.



Second is a tolerance you develop due to a to high dosage which is similar like being ampheburnt

and increasing the dosage might work but is wrong because less is always better.



MyVyvanse works great and I am adjusted to a dosage that keeps a good balance between

hypoactivity and hyperactivity. I have both under control so I can switch if I want.

The idea or concept of using it only 2-3 days a week is quite common to me because I have

positive aftereffects over 4 days when I dont take it. I have these positive effects because

my dosage is not too high. If it was too high I would crash without taking it the next day.

I have developed deveral concepts of reliable use but I am still not 100% sure which fits

best to my personality and life.



One concept is microdosing it to 1/10 or 1/20 of my stimulation dosage to let it work as a anti-dullant.



The other concept is to benefit of the after effects and use Vyvanse like a "recreational user"

in the weekends to recover with stimulation or get the overload for the days at work when I must function.



Taking the pills every day means palliativ medication to me because ADHD cannot be eliminated

and we have to arrange with it.

collegeprof
11-18-16, 04:59 PM
Thanks for the thoughtful post. I take my Vyvanse 40 mg three times a week when teaching. I do notice depression on the off days, but I try to use them selectively since I don't want to put years of stress on my adrenals. Any opinions?

john2100
11-18-16, 06:54 PM
One concept is microdosing it to 1/10 or 1/20 of my stimulation dosage to let it work as a anti-dullant.

What do you mean by that, how is it helping?

Lunacie
11-18-16, 06:56 PM
Thanks for the thoughtful post. I take my Vyvanse 40 mg three times a week when teaching. I do notice depression on the off days, but I try to use them selectively since I don't want to put years of stress on my adrenals. Any opinions?

People have been talking about this supposed "adrenal deficiency" for years,
but there doesn't seem to be any factual research showing it to be true.

As far as stress, untreated adhd is horribly stressful.

dvdnvwls
11-18-16, 07:43 PM
Depression - untreated or even treated - throws a wrench into absolutely everything. Never doubt that that is a major part of what you're noticing here.

Anything you can do to help the depression will have a positive effect on everything else too.

Pilgrim
11-18-16, 09:55 PM
I don't really like jumping on the, ' let's treat the ADD 24/7 ' , to give one a rest from meds, they will work a bit better.

However a couple of points here. Your tolerance will be helped a bit if you take say a few days off meds.
I found in myself that to help me mentally I had to be medicated as much as possible. Now I'm afraid to even go and jump in my car and drive down the street if not medicated.
I say the wrong thing, put myself in more difficult situation and generally just don't handle myself well. I would luv Dex to work better, but striking a good balance probably takes good experience. This condition lives on a continuum, I've found the further I'm in front of it the better for everybody, cause once the rot treally sets in its hard to work back in. Watching my health is important because once I get sick the meds don't work real good anyway.

sarahsweets
11-19-16, 02:54 AM
Thanks for the thoughtful post. I take my Vyvanse 40 mg three times a week when teaching. I do notice depression on the off days, but I try to use them selectively since I don't want to put years of stress on my adrenals. Any opinions?

Amphetamines havent been proven to stress the adrenals. Treating your adhd everyday makes more sense then worrying about your adrenals.

ToneTone
11-19-16, 02:18 PM
Here's the thing.

With my ADHD, there are days I miss the medication without even trying. I am having a hard time thinking that I am alone here. On weekends, I can be very very lazy and I get up late and often skip my meds. By the time I remember, it's late and I don't want the med to keep my up too late.

This past week, I had a hard time waking up one day and was running really late to work. So I had to skip washing my face and brushing my teeth and I inadvertently skipped taking my meds. (I deliberately skipped the face-washing and brushing, but I didn't mean to skip the meds.)

So I'm impressed that there are folks out there who reliably take their meds and have to plan for official holidays. My lack of organization provides holidays without any planning.

Sleep is key to executive function ... and no med can overcome sustained sleep deficits. And when I'm consistently tired, I notice the feeling that the med isn't working so well. At first a med can seem to provide focus even when I'm behind on sleep. But the more I'm behind on sleep, the less the med works.

Depression absolutely needs to be treated separate and a part from ADHD, either with therapy or with meds or for many people (like myself) with both!

Tone

dvdnvwls
11-19-16, 03:01 PM
"To prevent tolerance" is an assumption that isn't generally in line with the facts. To me, that's the main response needed for the original post. Preventing tolerance has been tested and found not to work. Some of us still carry the superstition of tolerance-prevention because it makes us feel as if we're accomplishing something.

DJ Bill
11-19-16, 07:52 PM
Tone Tone said:

"With my ADHD, there are days I miss the medication without even trying. I am having a hard time thinking that I am alone here. On weekends, I can be very very lazy and I get up late and often skip my meds. By the time I remember, it's late and I don't want the med to keep me up too late."

Unless I set an alarm for the time I'm supposed to take my meds(Ritalin generic) I can easily get like that..Overwork, viruses and infections, poor diet, etc, make it even more often.

The only good thing about it is that I have almost a 20 day supply of meds left over after 3 months.

And of course, it has me thinking...do I really have ADD? and then I forget something in nanoseconds and realize....ummm......what were we talking about?

Never a dull moment when I'm trying to be "normal"..lol.

Good topic.... My thoughts are to keep to a strict schedule except when sick, etc. and it works better for me.

I really need to set the alarms on my phone again.........maybe tomorrow I'll do it. :o

sarahsweets
11-20-16, 07:02 AM
Dvd made a good point: you cant prevent something that hasnt happened yet.

namazu
11-20-16, 04:02 PM
Dvd made a good point: you cant prevent something that hasnt happened yet.
The only things you can truly prevent are things that haven't happened yet.

Did you or dvdnvwls read where the OP said:
I stopped using stimulants after I noticed very little effectiveness after prolong use. Even increased dosage didn't have any positive effect on controlling add symptoms.I was at 20-40mg a day IR total.

I understand that you don't want people to worry prematurely about a problem that may never happen to them -- and that's reasonable -- but you're both making claims that are unsupported by evidence* and blithely dismissing the real concerns of people whose medication is not as effective as it once was.

In my experience, stopping meds for a while and starting them again does lead to short-term increases in efficacy, but they are short-lived, and there are withdrawal effects.


*About the frequency of tolerance -- which is currently unknown -- and about how to treat people whose medication loses efficacy over time -- which is also poorly studied.

sarahsweets
11-21-16, 06:28 AM
The only things you can truly prevent are things that haven't happened yet.
OMG I cant believe I typed it like that. I cant even... totally Not what I meant.

I understand that you don't want people to worry prematurely about a problem that may never happen to them -- and that's reasonable -- but you're both making claims that are unsupported by evidence* and blithely dismissing the real concerns of people whose medication is not as effective as it once was.

In my experience, stopping meds for a while and starting them again does lead to short-term increases in efficacy, but they are short-lived, and there are withdrawal effects.


*About the frequency of tolerance -- which is currently unknown -- and about how to treat people whose medication loses efficacy over time -- which is also poorly studied.

I wasnt trying to dismiss what the OP said and I believe tolerance is possible-do I think its usually the problem? No I do not. Do I believe people may need higher doses overtime due to long term use? Yes.
( I do. I myself have been on stimulants for nearly 15 years and HAVE had to increase the dose/ change the combo.

I do not believe in 'pre-treating' the tolerance by skipping days or reducing the dose. If you are someone who will end up with a tolerance, IMO the only way TO treat that would be with a higher dose. I do not think planning for or trying to avoid it in the ways people talk about it has any bearing or benefit to tolerance due to long term stimulant therapy.

C15H25N3O
11-21-16, 09:00 AM
Is a tolerance after a long time of use maybe related to a change in neuro-chemics or metabolizm?

Could the body maybe be overstressed from stimulation? There will never be an evidence as it is a individual thing.

aeon
11-21-16, 10:49 AM
Is a tolerance after a long time of use maybe related to a change in neuro-chemics or metabolizm?

Highly unlikely inasmuch as those things do not change over time at clinical doses.

Could the body maybe be overstressed from stimulation?

Unlikely given clinical data derived from research of therapeutic doses.

There will never be an evidence as it is a individual thing.

There’s plenty of evidence, but it can only be applied to aggregate populations, not to an individual.


Cheers,
Ian

C15H25N3O
11-21-16, 06:13 PM
Highly unlikely inasmuch as those things do not change over time at clinical doses.

Of course neuro-chemics change also below clinical doses. You are what you eat. But no one dares to stay off stimulants
for months to check it out. There is also clinical data people became more hyperactive and impulsive after stopping
amphetamines. There is also clinical data Ritalin makes divergent thinking more convergent. There is also clinical data
SSRI make people fat and it is hard to get rid off it. Science calls it political correct deposition phenomena but it can be
worse than addiction withdrawal symptoms. I will never try heroin but I would prefer 1 week of heroin withdrawal symptoms
to 3 months deposition phenomena.

Unlikely given clinical data derived from research of therapeutic doses.

Before I was dxd ADHD I stimulated myself mostly with cigarrettes and coffee. Being under permanent stress and increasing
the consume of both stressed my body a lot and I had to smoke less and to get rid off coffee many times for weeks to feel comfortable.
Now someone could say I abused coffee and nicotine. I say, yes Sir, I have ADHD and I am always looking for neuro-chemical balance.

So if the mainstream stimulant can stress the body there is no reason to exclude heavy stimulant medications. Does science tell us
coffee is bad? Nope, so why looking for evidences if everyone is different. I know some can drink a gallon of coffee/day and are healthy.

There’s plenty of evidence, but it can only be applied to aggregate populations, not to an individual.

Thats why I would like to ban the word "evidence" from science and replace it by "courageous possibility", while medicine has too many
fears to give us patients the real good stuff because someone will abuse it. "Evidences" can be true or false but they always implement
highlighting someones opinion/point of view.

I have an ADHD diagnosis. It is no evidence I have it and no evidence ADHD exists. But I use or will use it as an evidence in need or wanting
my damn stimulants. The only evidence I see is ADHD seems to be the wrong word/classification as its spectrum is so wide and people
could be helped better if there was less classification but more individual treatment – meaning docs think too much in labels and should
have more empathy.

Sorry for excessive replying. Today I am off LIS-a and multiquotes trigger me a lot without amphe-vibes. Ouch!

:grouphug:

Greyhound1
11-21-16, 07:09 PM
I have an ADHD diagnosis. It is no evidence I have it and no evidence ADHD exists. But I use or will use it as an evidence in need or wanting
my damn stimulants.
I believe there is a lot of evidence that ADHD exists. We have a good thread here that discusses evidence. http://www.addforums.com/forums/showthread.php?t=16812

C15H25N3O
11-21-16, 10:23 PM
51 pages? Wanna tranquilize me? :faint:

Greyhound1
11-22-16, 01:21 AM
Having ADHD, I realize how easy it is for us to go off topic on tangents. I am certainly guilty with my last reply to this thread. I apologize for that. Please, let's all try and stay on the thread topic of stimulant use as needed due to tolerance. Thanks!

Pilgrim
11-23-16, 12:08 PM
Is a tolerance after a long time of use maybe related to a change in neuro-chemics or metabolizm?

Could the body maybe be overstressed from stimulation? There will never be an evidence as it is a individual thing.

No, I know where your going. No, sleep fixes everything.

C15H25N3O
11-23-16, 05:08 PM
If sleep fixes everything how can there be tolerance? :scratch:

@john2100: I would really like to know if your need based pattern works for you.

john2100
11-23-16, 08:22 PM
If sleep fixes everything how can there be tolerance? :scratch:

@john2100: I would really like to know if your need based pattern works for you.

I think pilgrim meant: No sleep , fixes everything,. That would make more sense(sleep doesn't fix everything)

I haven't started yet with as need bases.

sarahsweets
11-24-16, 04:17 AM
I think pilgrim meant: No sleep , fixes everything,. That would make more sense(sleep doesn't fix everything)

I haven't started yet with as need bases.

I thought he meant No(pause, comma) sleep fixes everything.

C15H25N3O
11-24-16, 07:30 AM
We have to ask Pilgrim for clearing, Pilgrim?

john2100
11-24-16, 08:01 AM
We have to ask Pilgrim for clearing, Pilgrim?

Or maybe he meant : NO! SLEEP! AND FIX EVERYTHING!:)

C15H25N3O
11-24-16, 12:02 PM
(pause, comma) :faint:

Pilgrim
12-22-16, 10:27 AM
I had to think about this for a month.

' Sleep heals ', I try never to miss my sleep.

someothertime
12-22-16, 11:08 AM
Can you just drink a coffee on days your going to be busy?

I think this is more a question of efficacy and brain chemistry stability rather than tolerance.

In short it won't work. There may be few who can physically tolerate minor dosage fluctuations..... The more scattered they are... The less effective they become. I could see at the far end of the scale rare dosing providing some scope for benefit. i.e. major events months or weeks apart.... although i can't think of any examples where this has been authorised sadly.

bluefoxicy
12-22-16, 12:22 PM
Any opinions on using stimulants only 2-3 days a week to avoid tolerance?


Current medical opinion as per numerous studies by state-commissioned task forces leans toward lower dose stimulant therapy. The strategy in the 90s was to cycle off on weekends to restore functioning throughout the week.

In general, children aren't people. The focus of ADHD treatment in children and adolescents is manageability by caregivers: we measure the effectiveness of ADHD treatment by asking their parents and teachers how much stress the children cause them. The children themselves don't actually matter.

When we started focusing on adult ADHD, it came to light that adults have to work all week without destroying their careers by being rambunctious overgrown children and they need to be able to enjoy the things they want to do during the weekends. Nobody actually cared about the quality-of-life of children, so weekend treatment was never a concern because parents just stick the child outside on the weekends and tell them to go play somewhere.

This shift in attention from the annoyances children cause adults to the annoyances ADHD causes adults with ADHD has lead to a focus on more-effective treatment to maximize the success of the patient, rather than on treatment designed to minimize their negative impact on others's quality-of-life. Hence Atomoxetine, Modafinil, and low-dose stimulant therapy have drawn more focus, searching for a way to keep ADHD well-managed without the side-effects or tolerance classical treatment caused.

sarahsweets
12-24-16, 08:22 AM
Current medical opinion as per numerous studies by state-commissioned task forces leans toward lower dose stimulant therapy. The strategy in the 90s was to cycle off on weekends to restore functioning throughout the week.

In general, children aren't people. The focus of ADHD treatment in children and adolescents is manageability by caregivers: we measure the effectiveness of ADHD treatment by asking their parents and teachers how much stress the children cause them. The children themselves don't actually matter.

I dont believe this is the case.I have 3 kids all with adhd and when they took meds it had nothing to do with stress they caused to me or anyone else.
They were evaluated based on how well they were doing academically as far as making progress educationally. They were evaluated based on their level of
independence and whether or not they had gotten better at caring for themselves. The "issues' that the meds were addressing had very little to do with behavior in the sense of them being wild or out of control. My son is my best example and I wont rehash cause its a sticky in children's diagnosis, but any stress he caused me was more limited to the fear that came of his extreme risk taking behavior. The fear of him causing harm to himself was what I would have said was stressful. I think a lot of people who do not have kids or who only remember the swing of meds given to kids in the 90's, think that the way to evaulate meds in kids is to talk to the people that have to "deal" with them. While kids can be more self evaluators, when asked the right questions without judgement they can be surprisingly accurate about explaining how they feel.


When we started focusing on adult ADHD, it came to light that adults have to work all week without destroying their careers by being rambunctious overgrown children and they need to be able to enjoy the things they want to do during the weekends. Nobody actually cared about the quality-of-life of children, so weekend treatment was never a concern because parents just stick the child outside on the weekends and tell them to go play somewhere.

Any parent who is an active participant in caring for their child would know that adhd is a 24/7 thing and that weekend treatment wasnt an option it was a necessity.

bluefoxicy
12-27-16, 11:22 AM
Any parent who is an active participant in caring for their child would know that adhd is a 24/7 thing and that weekend treatment wasnt an option it was a necessity.

You must not live in North America. These concepts sound strange and archaic, like something from a fantasy novel.

aeon
12-27-16, 11:52 AM
You must not live in North America. These concepts sound strange and archaic, like something from a fantasy novel.

Incorrect, she does, and actually, it sounds like clinically-validated, best-approach treatment.


Cheers,
Ian

Little Missy
12-27-16, 01:02 PM
I have NEVER heard of tolerance nor on an as need basis. Ever. Until I read it on here and I still don't believe it. To use it that way seems archaic and never have I known it to be prescribed that way. Ever.

But hey, whatever if it is true. Not my problem to ponder.

john2100
12-27-16, 03:01 PM
Research regarding tolerance build-up in ADHD patients on stimulants are inconclusive.

sarahsweets
12-27-16, 08:33 PM
You must not live in North America. These concepts sound strange and archaic, like something from a fantasy novel.

What parts?

Little Missy
12-27-16, 09:49 PM
What parts?

Surely a sweeping series covering more than one continent and time.

sarahsweets
12-28-16, 03:48 AM
Surely a sweeping series covering more than one continent and time.

lol!!!

Jenn1202
01-17-17, 01:58 AM
Any opinions on using stimulants only 2-3 days a week to avoid tolerance?

I stopped using stimulants after I noticed very little effectiveness after prolong use. Even increased dosage didn't have any positive effect on controlling add symptoms.I was at 20-40mg a day IR total.

After a longer break I'm thinking of taking them only 2 max 3 times a day .
My last pill was after a longer break and I could feel it working at about 60% compering to what I would call the ideal performance.

I'm happy with 50% effectiveness.

Has anybody been using them is this manner to avoid tolerance issue?
Does it work,compered with everyday use?
If so ,how long have you been using it this way.

Thanks,


I tried it all from ,ritalin,concerta,focalin,vyvanse,adderal,the only thing I havent tried was dexedrin and desoxyn ,from the common meds. I'm tired of trying all there is.

I took stimulants 3-5 days a week as needed for several years, mainly due to side effects. I was on a very low dose and it seemed to work for me, but I don't know if it works on high doses. I don't know of it works on higher doses. However, I had to make sure not to go more than 48 hours without taking the medication otherwise I'd get withdrawal symptoms. So I couldn't skip more than 2 days. If you're on a higher dose you're probably more likely to get withdrawal symptoms sooner than 48 hours after taking the medication. Withdrawal symptoms can get really bad and potentially harmful on higher doses, so you may want to consult with your pdoc before attempting this.

It seemed to work just fine. I took Ritalin for a few months and then switched to Daytrana for a few months and then back to ritalin (5-10 mg once a day). Several months later I switched to Dexedrine (5mg in the morning and 0-2 mg in the afternoon). I think I was on it for a couple of years.

sarahsweets
01-17-17, 06:57 AM
I took stimulants 3-5 days a week as needed for several years, mainly due to side effects. I was on a very low dose and it seemed to work for me, but I don't know if it works on high doses. I don't know of it works on higher doses. However, I had to make sure not to go more than 48 hours without taking the medication otherwise I'd get withdrawal symptoms. So I couldn't skip more than 2 days. If you're on a higher dose you're probably more likely to get withdrawal symptoms sooner than 48 hours after taking the medication. Withdrawal symptoms can get really bad and potentially harmful on higher doses, so you may want to consult with your pdoc before attempting this.

It seemed to work just fine. I took Ritalin for a few months and then switched to Daytrana for a few months and then back to ritalin (5-10 mg once a day). Several months later I switched to Dexedrine (5mg in the morning and 0-2 mg in the afternoon). I think I was on it for a couple of years.

What do you mean by withdrawal symptoms?

Jenn1202
01-17-17, 09:40 AM
What do you mean by withdrawal symptoms?

Sleepiness.
My heart palpitations would get worse.
Worse ADD than ever.
Mental confusion.
Feeling kind of blah.

I don't think withdrawal symptoms are the same for everyone...

C15H25N3O
01-17-17, 10:29 AM
Renaturalization takes time to recultivate flowers on tarmac.

Lunacie
01-17-17, 11:26 AM
Sleepiness.
My heart palpitations would get worse.
Worse ADD than ever.
Mental confusion.
Feeling kind of blah.

I don't think withdrawal symptoms are the same for everyone...

I guess you could call sleepiness a withdrawal symptom. It happened with the
first med I took for high blood pressure. So sleepy as I adjusted to it, and again
when I switched to a different med.

Was the ADHD really worse, or did it just seem worse in contrast?

Fraser_0762
01-17-17, 12:08 PM
They say that when the medication wears off, Dopamine levels return to baseline, but i'd argue that they fall below baseline level during withdrawal periods which would make the symptoms worse.

Jenn1202
01-17-17, 05:29 PM
I guess you could call sleepiness a withdrawal symptom. It happened with the
first med I took for high blood pressure. So sleepy as I adjusted to it, and again
when I switched to a different med.

Was the ADHD really worse, or did it just seem worse in contrast?

I think my ADHD was actually worse than usual.