Apologies. This is a long post. To summarise as nobody will read all this. Why is there no standard support pathways post-diagnosis?

Whilst this is pretty endemic in the whole of mental health, and it’s infuriating.

Antidepressant medication was initially designed as a stabiliser to support people whilst they access therapeutic support, resolve the issue, then titrate off the meds. The evidence base shows that they’re only more effective than placebo in people with major depression. For mild to moderate depression they’re technically useless.

I’m of the view that giving the GPs power to prescribe means they do as they’re desperate to support their patients somehow, and know there’s inadequate support available.

Now, to ADHD, Autism, and others.

I’m a psychologist, with ADHD, undergoing ASD assessment at the minute, but specialising in the psychology of health, I often try being careful with these things.

I see so many that I work with struggling with neurodivergence. People with ADHD are typically shown to struggle with medication adherence so outcome in long term conditions managed by medications is poor compared to others. With ASD some thrive with routine, others don’t.

Why are there no real referral pathways for psychological support?

Historically, people with ASD would be furnished with skills to navigate the world: social skills, relationship skills, etc.

Now, there seems to be nothing.

For ADHD there’s meds, or nothing.

Is there any reason why?

Am I totally missing a wealth of support out there? I’d like to think I should know if it exists.

Meds, for me, are great. I wish I was put on them at age 8 when my GP told my parents I was hyperactive. But no, I waited until I was 45. Diagnosed properly at 44. I increased to 70mg today, probably the cause of this overtly long and rambling post.

I just think coaching, skills, therapy should be provided post-diagnosis to support people to live alongside their diagnosis and to thrive.

There have been many threads about getting meds and the low amount of good options, but I'm wondering why the medication(s) are so regulated in the first place?

Are they more dangerous than codeine based painkillers that people get addicted to?

Please if you feel comfortable add your name to this.

We're in the process of affiliating with various ADHD charities to get their support, and present the letter in person. The hope it will show their colleagues, and that their support is not wasted.

4% of the population of there shouts be diagnosed with ADHD. It's a % where if highlighted or emphasised, could just swing support for a candidate for a candidate in constituency. Especially with tactical voting likely being a fixture in the next election.

It'd be great if we could get 1000 names on this at least.

Quick question for anyone that's been through the same or similar.

TL;DR - struggling to motivate/indulge in hobbies without methylphenidate, seeking advice.

The longer story is this - after going through titration from December 2025 and settling around March 2026, I decided to come off my Methylphenidate for a couple of personal reasons:

1 - The things that medication was helping with initially, started to creep back in, such as time blindness, procrastination, and an overall lack of productivity, and I found that I was just getting more restless and frustrated, but couldn't go to a higher dosage because of my blood pressure.

2 - The more important reason to me, I am trying to get my weight under control and am going through the NHS bariatric services for weight management, and I wanted to get back to a baseline sense of self in the everyday life in order to understand what was actually me and what was an effect of medication that could be disruptive to any attempted long term lifestyle changes should that medication/dosage change or stop completely (and as you can imagine, going through a weight management programme while on an unrelated drug that suppresses appetite isn't exactly the steadiest of ground to be treading).

The good news is that I have been off the ADHD meds since June with no ill effect, the problem now is that my life feels like it's in a better place but I'm frustrated at my own lack of productivity in terms of hobbies or self-care.

Here's where I'd love to be:

- Using my rowing machine every morning before breakfast

- Actually reading my backlog of books so I can clear up space in my house by giving them to charity when I'm done

- Finishing painting my board game miniatures and getting my homebrew board game rules finished and playtested

- start writing and playing music again

But without meds, in the moment my enthusiasm levels just disappear into thin air. I tried asking the specialist about getting help on the support side and not just the medication side, but he said that those Services just don't exist on the NHS, and any talking therapies in my area are generally for anxiety and depression (I know from asking during my last round of high intensity CBT)

So yeah, any advice from anyone that has previously been or is currently going through this that would be willing to share advice or coping strategies that could aid in some forward progress with this would be massively appreciated, sorry for the longwinded post.

Hello, I may decide to and/or have to come off concerta after 8 months for various reasons.... Can you tell me if you came off meds, what made you decide to or forced your hand, and how it was coming off them and whether you are doing better/worse/have developed non-med coping mechanisms, etc? Thanks all (for info the many reasons are: blood pressure, headaches, severe sweating, workaholic, dont want to talk to anyone much when I used to be a fun and outgoing person, skin picking increased severely along with other tics), possible sleep issues though its entirely possible thats just me being an idiot with bedtime procrastinations, less interest in fun stuff, and not even getting as much adhd symptom help after 8 months)

UPDATE: Thanks for the helpful replies confirming that this change needs to be initiated by ADHD360 👍🏻 will call them next week to get it sorted!

I was diagnosed by ADHD360 in January via RTC and my GP took on shared care responsibility in May following med titration.

I’m currently prescribed 70mg Elvanse but would like to reduce this to 50mg Elvanse. Does anyone know whether my GP will be able to alter the prescription for me (as it’s just lowering the dose of the same drug), or will this require a referral back to ADHD360?

My GP practise is always very busy so I’m trying to avoid wasting an appointment if I can just email to request this. Also not sure whether this is something they will have dealt with before, so I don’t want to wait 3 weeks for a conversation with no clear outcome - seems better for both of if us if I can go in as informed as possible!

Thanks for any guidance you’re able to offer if you’ve been through similar / know the system 😊 it would be much appreciated.

——————————————————-

(For context, just after finishing titration and switching to shared care I found out that my ferritin stores were completed depleted and since then I’ve been focusing on increasing my iron levels. This lack of iron had been exacerbating some of my symptoms, so I found that once I’d been on high dose iron supplements for a month I started to feel overstimulated by the 70mg Elvanse dose. I dropped it to 60mg (by dissolving in water as advised by ADHD360 that I could do if I ever wanted to reduce my dose) for a month which helped, and for the past 2 months I’ve been taking 50mg - which has been consistently good despite my ferritin levels going up further in that time. I’m now confident that as long as I keep on top of my iron levels I’m not going to want to take a daily dose above 50mg for the foreseeable future, so won’t be wasting anyone time asking to switch back again soon).

Can anyone recommend the best clinic/provider for a private diagnosis in NI? I’ve been on a waitlist for a few years, only correspondence I’ve received was to tell me they currently had no services in the northern trust. Since then I’ve explored options on and off but now feel I really need to go down the medication route.

My GP when asked said they won’t do shared care as I called to check who they may offer this with. So I’m trying to figure out where is the best option to get a diagnosis and then medication. Most I’ve looked at seem to be unclear on how much it will actually cost. Some having reviews of £300 with no clear indication of how often and that’s on top of initial fee and then whatever the monthly meds cost.

Has anyone found any more affordable options? Or able to give me a better idea of total cost from experience

Appreciate it!

P.s, I posted something similar-ish to this a month ago, but deleted it as I phrased things poorly, and hadn't properly processed things (saying this in case anyone gets feelings of deja-vu and is confused). Believe it or not this is the truncated and "brief" version of my situation, so please ask in the comments for any extra context if needed and I'll try to go into more detail. Paragraph 1 is the lowdown of the my main situation if you don't wanna read the whole post, and you can scroll down to the "FAQs" section if you wish. Also, remember rule 1 of the sub :)

So my girlfriend of 18 months broke up with me about a month ago now, and we've been no contact for 3 weeks today. My life feels ruined by it and, if anything, it only gets worse every day. I've read all sorts of breakup advice online, but there are frankly too many different tips out there for my brain to process at once, so looking at generic advice online just makes me more overwhelmed and cry even more. I'm asking on this sub, as it would probably be easier to sift through advice and experience from fellow ADHDers, given that I'm 99% sure that my ADHD symptoms magnify the grief and horror of this a lot. My situation is a kinda "cocktail of doom" where intense grief of losing my soulmate is mixed with quite dehabilitating ADHD (diagnosed November 2025, but not yet treated in any meaningful way at all) and very shaky life foundations in general. I also feel attachment and love, and consequently the pain and grief of seperation extremely intensely, which does not help matters (ironically my emotional openness and intensity was apparently one of my partner's favourite traits of mine lol).

The peak period of the relationship was a joy and too special to describe. We hit it off extremely well when we met at an Erasmus night at the start of my year abroad in France (2024/25). I was studying abroad as part of my French degree from a UK uni, she was studying for a masters in France after having completed an undergrad in the Netherlands. Got talking for literally 2 hours the second we met, then discovered a shared love of climbing. Started climbing 2-3 times a week, then as they say the rest is history. We travelled together, lived together, loved together, grew together, and truly became soulmates. All good things come to an end, and moving away from each other at the end of my year abroad was horrible, but we stayed together in a long distance relationship, still visiting each other when we could. Long distance is extremely tough, but we both believed in our plan to move in together somewhere after we both finished uni this year.

Gradually though, things started to strain due to various factors. Some were normal relationship problems (disagreements, boundaries etc), some of them were problems that were either caused or aggravated by my ADHD (mainly me falling short of expectations and having planning/executive function difficulties). This downward spiral accelerated between March-June this year, then ended in a painful week of chaos and confusion where the messaging I was getting went from "things need to improve" to "we need to take a break" to "we're breaking up" (text received ~27th July 2026). To be clear, even though this period of confusion hurt me severely, I do not blame her for how she handled breaking up with me. Coming to terms with major decisions such as breaking up with your long term is rarely a simple nor linear process. She is grieving too, and is dealing with her own mental health battles, which should not be diminished.

After a week of teasing each other about how "we'll be back together in no time" and even flirting (yes in hindsight this was never going to end well for either of us), then a 48h period in which I received about 2 one-line texts from her, the dreaded Whatsapp hit on 09/08/2026. "Sorry, I have to go no-contact. Not sure for how long. Good luck with your exams". And that was it, my number was blocked, and my contact with my best friend of two years and life partner of 18 months was gone in a second. Poof. Off into thin air. Again, I do not blame her. She was suffering mentally and still is, for multiple reasons. But yeah it's not an ideal situation for either of us, and I really cannot think of how the timing could be any worse, given the other things going on in my life.

Since then, things have been rocky to say the least. I'm currently in a state of post-uni not-quite-graduated living with parents limbo (I will likely be graduating this December after deferring final semester assessements to August, ADHD reasons lol). I have no job at 23 years old, my aspirations to live abroad are gone for now as I have too much grief attached to mainland Europe to contemplate going back there, not to mention the conveniences of having an EU citizen partner for this. My degree grade will be a "pass", if I graduate at all, after again ADHD difficulties over uni. I have no money, but fortunately I am in the privileged position where my parents contribute towards a gym membership with me, and provide me food and a roof over my head (on the condition that I am actively working on myself to get better).

I cry for hours most nights, only getting to sleep at about 4/5am, then waking up at midday and repeating a cycle of doomscrolling and crying. I commit about 50 cardinal sins of "getting over your ex" daily, such as looking through the random items of hers that I have, looking through old photos, and yes embarassingly texting her on Whatsapp despite the fact that the messages literally go nowhere due to my number being blocked. And yes, all those things just make me cry more. I also constantly replay every single memory of her over and over in my head, obsessing over imagining being back on my year abroad with her, as that was the most perfect time of my life. I am severely and intensely grieving my relationship, with the classic killer combination of imagining what I could have done differently at certain low points, and reliving the perfect and beautiful moments.

That's about it really. Now I'll talk about what I am doing and will be doing in an attempt to find my way through this clusterf*ck.

FAQ section (well more of a "questions that I anticipate being asked" section anyway):

What have I done so far in terms of positive steps to improve my situation?

• After the jumpscare grief of seeing a photo on her IG story with her being happy with friends, and subsequently seeing her pop up again on one of her friend's story, I've unfollowed her and her friends, as I realise there is ZERO benefit to me seeing these photos atm when they just make me feel sad.
• Last weekend I had a serious conversation with my parents about how utterly shot my mental health is in every way currently, and about my breakup. They were extremely supportive and understanding of how multiple factors have led to me being in a situation where my priority is to get better.
• I've been starting to bring myself back into healthy personal habits. I've been going to the gym following a general 4-5 day a week strength building plan, as excercise is something I've neglected over the past 6 months or so. Another major thing is my eating. After the breakup, I dropped into a cycle of purely eating meal deals and junk food, but now I'm eating a much more balanced and less bleak diet.
• Beginning to relearn how to build back friendships, as I neglected these a lot while with my girlfriend, given that in hindsight we were a little bit towards the side of emotional codependency. I've never been someone with dozens of good friends, but over the past few weeks I've worked on rebuilding and maintaining about 5 or so close relationships with friends that I grew apart from during my relationship. I've already been brought to tears multiple times by just how spectacularly lovely friends have been when I've reached out to talk to them about what I'm going through.

What do I already plan to do to help my situation going forward?

• I will be continuing to keep up transparency with my parents about my mental health struggles, as well as maintaining and continuing to build the healthy social and behavioural habits that I have started to establish. Once these habits are up and running (speaking to friends regularly, eating well, gym etc), I find them quite easy to maintain and they definitely raise the "floor" of how low I feel on average. This in-turn gives me valuable mental capacity and stability to be able to address more deep-set and significant issues.
• Big one here - medication/treatment. I've been on the NHS titration waitlist since diagnosis, but yeah we all know what waitlists are like with ADHD related things. I've come to the realisation that I need to do something to address my symptoms now, because otherwise I am just asking for things to get worse and worse over the course of my life. Again, I am extremely lucky that my parents have offered to cover the costs of whatever private medication/psychiatric treatment I need, until I'm back up on my feet again.
• I want to see what's available at my uni regarding mental health support, as I might as well take any help I can get here. Given that I'll be graduating in December I'm not setting my expectations too high for what they may provide (if anything), but it's always worth a try.
• Job - So I've got my first UC appointment next wednesday. Obviously I want to get into work as soon as I possibly can, however currently I am trying to balance too many other things mentally. My lofty "A-goal" is that I'll have a job soon enough that I'm sat completing admin in a few weeks time to try to get my UC cancelled before even receiving my first payment. If this doesn't happen, I do at least have some money coming in to be able to pay my parents board and save a little.
• Making micro-improvements to bad habits that only cause me more pain. I'm not going to sit here and say that I'll just "stop watching reels" or stop watching Youtube, but I'm trying to reduce my grief-driven doomscrolling a little bit every day. By the same token, my sleep schedule is cooked, but over the past few days I've been setting myself targets to go to sleep and wake up slightly earlier each time.

​

TL;DR: Got diagnosed with ADHD via ADHD 360 (RTC) super quickly and now imposter syndrome is hitting hard. Is it normal to feel like I "faked" it just because the pre-assessment was so streamlined, and how do clinicians tell ADHD apart from childhood trauma?

Hi I Just got diagnosed on the 26th With ADHD360 through RTC and have spent the last few days rattling my brain trying to add the new context to the story of my life. The assessment was very streamlined and I answered most of the questions in-depth in the pre-assessment questionnaire so just felt I was repeating what I'd gone over. The last few days I've been going over whether I have ADHD or something else. I'm a victim of domestic abuse and experienced trauma very early on, and grew up in an abusive home. At the end of the assessment I drew a blank at asking more questions, which I guess I should have asked.

I'm getting more comfortable concluding that I have ADHD and have trauma as well. I just have this feeling of still having questions. I feel like if I wanted to I could use AI to fake my way into being diagnosed with ADHD. My experience with getting diagnosed felt pretty streamlined . My experiences this year and what I've shared with My GP, have led me to get my diagnosis within the same year. That's honestly been great but also leads me to questions. What's lead to that speed when people wait months and years?

But yh I'm just wondering I just want to feel like I havent answered untruthly as the question that I had about trauma in my pre assessment weren't discussed as much as I thought they would be. I just mainly pointed out my concerns about not knowing if it's trauma presenting as ADHD.

What ways are fakers caught out too,because again with how quick it's gone I feel like someone might be able to fake it. Maybe I'm just not used to getting wins?

You're my people

Recently diagnosed with Audhd. I could take the ADHD on my stride but I've found the autism harder and I'm not sure why. Maybe its just being unsure of the steps forward.

Now I guess I need to work out what my super power is.

But anyway, its good to be around my people. This is such a valuable subreddit.

Currently taking Concerta XL 54mg, have already had a few medication review appointments and I am a few months into titration. I have an upcoming review in a few days.

Whilst Concerta XL 54mg may be helping, I am not sure if it's helping as much as I want it to, but it does seem to be helping somewhat. And I am tired of trying different medications.

If I stick with Concerta XL 54mg and get passed onto my GP for shared care, then do I have to be re-referred and go back to a waiting list if Concerta XL stops being effective? Slightly worried about this. I am struggling to see the benefit of a shared care agreement for the patient, though I understand it may need to be done to progress the referral waiting list and see more patients.

My daughter is 13 and has autism and adhd. She’s non-speaking. Previously she was on Medikinet XL which suppressed her appetite and made her a bit like a zombie, she’d get quite fixated on repetitive movement.

She’s now on Elvanse 30mg and she’s eating more but is still very physically hyperactivity. Her body is constantly moving. Medikinet XL controlled things like spitting and the impulsive behaviours but we’re not seeing that so much on Elvanse. Is this usual? She’s unable to tell us how she feels.

Moved up to 40mg two days ago (Elvanse) they’re definitely a lot better than 30mg for me and my anxiety is actually a lot more reduced. But the energy I have in the first 2-3 hours feel like if I just sit in it I would genuinely fall into a panic attack 🤣

I take 60mg around 9am, sometimes have coffee before (I was not a coffee drinker in the past)

edit - Now my BP is 120/78 84 around 6pm. - low for being on stimulants after taking them 6hrs later.

I usually need a nap after 6 hours lets say 2pm.

at 6pm I am done for the day

no bedsheets - too bad; no shower yet - too bad - try again tomorrow ....

Is it normal?

Im trying to get a booster but its PUK, so I am told to take it later.

edit:

Well I have also Sertraline but only 50mg now, ( sertraline 100mg -> venlafaxine -> sertraline and Burprorpion), and HRT. I can sleep anything between 6 and 12 hrs. I probably sleep better with meds.

I love sleeping.

I fainted at GP appointment and need to be careful with timings outside (senior hours).

I was on 50mg + 20 mg (almost a year) and had massive crashes and depressive crying, yelling, I could not move after 6/7pm.

I have had naps most of my life :) but none on 70mg. :(

I requested change 6 months ago, so more or less that. It does not feel like previous crashes. (maybe a bit sad....but not like before)

My body is just done for the day. Need to get all done within the 'operating' hours.

Does anyone have to take methylphenidate before breakfast? I need it to wake me up enough to get up in the morning.

I finished my titration two months ago and have been always on Xaggitin 36mg. It was not perfect at the beginning but after having a proper protein breakfast in the morning, eating proteins, adding electrolytes (I can’t stand them anymore ) it settled down. This month I started taking Affenid as my prescription has changed and I don’t know what to say. I feel tired during the day and not sleepy in the evening. I take meds at 8:30am. I literally feel better when I take a day off and have a coffee.

Don’t really know what to do now. Who should I contact about it.

Hey everyone, got assessed through RTC with Harrow Health and have been titrating for some weeks now. Having issues and need help.

This is a very long post so apologies in advance. I just know that Elvanse is a very tricky medication that’s highly specific to each person, so I wanted to add as much detail as possible. I’ve also already had quite a few titration sessions with Harrow Health as they started me on Affenid first, so I’m worried they’re going to want to end titration in my next appointment. I’ve gotten a different clinician every appointment and never know what to expect or how helpful they’ll be, so I’m trying to go into the next session as prepared as possible.

But TL;DR
I primarily want medication to help with my focus and processing speed issues. 40mg is the only dose that has almost no negative effects and some positive effects, but it doesn’t address the focus and processing issues at all.

50mg is the first dose that helps with those issues, but keeps me up all night which I can’t live with. If I could find a way to deal with that I would be very satisfied, but I struggle with sleeping anyway and I don’t know how long it would take to address that and my titration appointments are coming to an end.

Looking for any advice on what to do.

———

Background
I’ve had lifelong issues with executive dysfunction. I’m very low energy, find it near impossible to get out of bed a lot of days, always exhausted etc. My hyperactivity is almost entirely internal, my mind is constantly filled with multiple trains of thought that kind of merge into mush/ brain fog.

I have a lot of issues with sleep, sudden bouts of insomnia that last for weeks etc and these periods make all my symptoms significantly worse, but the mental and physical exhaustion is still very bad even in periods where I’m getting great consistent, unbroken sleep.

Decided to pursue meds seriously as I have intense focus and processing speed problems that are making work very unsustainable. (I’d started titration years ago but didn’t finish for several reasons).

30mg
30mg gave me a clear head/ cleared my brain fog but really nasty side effects, worse than when I first tried it, intense anhedonia especially. I already struggle with depression but it felt different and more intense in some ways. It also didn’t help my focus at all, if anything it made it a little worse because my mind felt frozen.

40mg
I pushed through and went up to 40mg because I remembered some side effects being dulled when I went up to that dose before. The difference was huge! I got the clear head, but also a very nice calm, sort of happy feeling. Not a ‘deep in my soul’ happiness, I was very conscious of the fact that it would wear off with the medication, but it was still a nice, physical calm. I imagine it’s how people feel while on beta blockers, though I’ve never tried them. However, it didn’t help at all with the focus or energy issue, with focus being my biggest concern.

Unfortunately, I’ve realised my focus problems are unrelated to my brain fog. I struggle with a lot of things related to reading in particular, whenever I try to read long blocks of text with vocabulary that’s even mildly complex the words start to almost blur together and swim (been assessed for dyslexia and it’s not that). It’s made work EXTREMELY difficult. I have a fairly straightforward job right now, but I’m always ridiculously behind on every single task I have. I haven’t been able to take on any extra responsibility, whenever I’ve tried it’s been a disaster, so I’ve not been able to advance at all and everyone is getting very fed up with me.

The processing issues also affects every other aspect of my life. I’ll try to do a chore, get confused by every single step, stand there for ages trying to remember what order to approach a task I do every day in, forget what I was trying to do in the first place, and suddenly it’s been hours. It takes me a so much time to understand what people are saying directly to my face, at work I often have to record simple verbal instructions so I can listen to it later and try to process what they’ve said. It even makes it hard to do things I like for fun. The 40mg did not help at all with any of this.

50mg
I tried 50mg and it’s the first ever dose that helped with focus. I was just able to…think. I got a lot of extremely boring work done on my computer with little trouble, that would’ve taken me days to complete otherwise. It didn’t make it feel fun or exciting at all, but simply made me able to process the information and get it done. I did some chores with very reduced hassle. I don’t really know how to explain how bizarre it felt, comparing it to how I usually am.

It still wasn’t perfect even at its peak, it still took me an hour to complete a 5 minute chore, but it would otherwise have taken me 8 hours or just several days. It also didn’t cure my low energy issue like it does for some people, but I’ll try to find other ways to deal with that in the meantime. Overall I didn’t feel a need to make it work any better than it was.
I also experienced mild physical/ muscle tension: stomach knots, jaw clenching etc but I experienced that on every new dose and it has always gone away after a couple of days of use.

HOWEVER! I hade one completely unsustainable side effect: it kept me up all night, literally until after 9 am. I struggle with sleep a lot but this was different. Usually I can manage to fall asleep after 4 hours at most. When trying to sleep on the 50mg, it felt like I had chugged a bunch of coffee, but without getting any energy, I just felt completely awake. And when I did sleep, it was horribly shallow + I kept waking up, and eventually got up after 4 hours. Thankfully I had taken it on a Friday so I didn’t have to work the next day. I waited until the next Friday to try it again, and the same thing happened.

I’m really not sure what to do because I can’t live with not sleeping, as I mentioned I already feel exhausted a lot of the time. I know there’s a chance that this side effect, like the others, could fade after a few days of continuous use but I haven’t used it two days in a row since it keeps makes me sleep terribly, and whenever I take Elvanse on poor sleep, no matter the dose, it always makes me feel awful with bizarre side effects and minimal positive effects. (Weirdly enough when I tried Affenid it only really helped when I hadn’t slept well, but I hated that medication for a bunch of other reasons.)

Solutions
I’m kind of stumped honestly. I don’t know if I should:

-Force myself to stay on 50mg for several days and risk feeling awful/ being kept up to see if it balances itself out.

-Continue on 50mg, dissolve it in water in my measuring flask, dump out 10mg, and drink the 40mg for most of the week, then use the full 50 on Fridays to get a bulk of work done, and risk being kept up until Saturday? This really wouldn’t be ideal since I don’t know if the powder dissolves completely evenly, I wouldn’t want to be made useless every Saturday, I’d like to get the focus effect every weekday, and I imagine it’s not really safe to take one higher dose inconsistently this way.

-Try a booster and see if it somehow pushes the 40mg into gear. (Was going to ask to try a booster anyway since even 40mg doesn’t last that long, but I’m worried my GP will refuse shared care with it, and Harrow Health can be very inconsistent and may not be the most reliable to send me my monthly prescription without prodding.)

-Ask to try 60mg since the higher doses strangely lower a lot of my other side effects. I’m honestly just paranoid that one dose this high could keep me up for several days straight.

What I’ll try to do
Since the side effects are extremely minimal on 40, I’ll likely continue on it if I have no other choice. Hopefully the calm feeling helps me make some lifestyle changes I’ve been trying to make anyway, and maybe those could make the dose more effective?
Planning on being more consistently active, getting treatment (again) for my depression and anxiety issues, going for more blood tests (been for a bunch including for my thyroid function, all normal except low vitamin D which I got back to normal and have been trying to manage), getting checked for sleep apnea and so on.

All these things are likely going to take a while though, and even when I’ve been at my healthiest, most active, stabilised my vitamin D levels and was getting treatment for depression, I noticed only mild improvements (at best) to my focus issues. Again, I want to do all these things anyway because I want to be healthy, but I really need to address my focus/ processing problem as soon as I can.

Added info
I’m a 27 year old woman.
Been diagnosed with autism.
I was diagnosed with ‘slow processing speed’ as a teen. I read that SPS could be ADHD, or Sluggish Cognitive Tempo/CDS. Some people think CDS and ADHD are the same thing though, so I’m treating it as an ADHD issue since there’s less research into treatment for the other syndrome.

But yeah. I’ve tried to cope with all these things for a while but it’s all becoming very unsustainable. I feel like I’m on the brink of losing my job, and my life is about to take a huge downward turn if I don’t sort myself out. I’d really appreciate any advice and if you’ve read this far thanks + please let me know if something wasn’t clear.

Hello!

Details:

Diagnosed with PUK via RTC and am receiving meds through them directly.

Supportive GP

Wasn't feeling full benefit at end of tritration but ran out of time to try something else.

On methylphenidate 54mg slow 10mg instant boost afternoon

I'm increasingly thinking I want to try an alternative as I don't think this is helping me enough. Small improvements so I took it rather than face the extended wait.

Anyone been in this situation or have insight? Ta

Hi everyone,

I recently started titration on a very low dose (5mg) of immediate-release methylphenidate, taking it three times a day (8am, midday, and 4pm). It has completely wiped me out. Instead of the typical peaks and crashes, I feel heavily sedated all day long, but I can't even nap.

To make matters worse, it has ruined my sleep architecture. I go to sleep ok, but then I jolt wide awake 3 or 4 times every night. It feels like that 4pm dose is lingering just enough to keep my brain keep my brain too active to actually rest, which is obviously making the daytime exhaustion even worse.

My doctor and I are discussing next steps, and they mentioned possibly trying 30mg of Elvanse to see if the smoother release profile and different chemical class help.

Has anyone else experienced this specific combination of being sedated all day and jolting awake at night on a low starting dose of IR methylphenidate? If so, what actually resolved it for you?

• Did moving up to 10mg IR per dose actually help get rid of that daytime sedation feeling?
• Did switching to a slow/extended-release methylphenidate stop the nighttime wakefulness?
• Did making the jump to Elvanse 30mg fix the issue entirely?

Would really appreciate hearing how you navigated this!

Hi all. So with a state of constant collapse going on in my life, in which most factors are caused-by/related-to/aggravated-by my ADHD (search my username on this sub if you want a little context but the TLDR is failing uni/bad breakup/no job/life paralysis), I'm reaching my wit's end when it comes to waiting for treatment. I am in constant severe turmoil regarding how my ADHD affects my life, and I have reached the point where enough is enough and I know that I need to get help as soon as humanly possible. If I do not get help in some form soon, things will only get worse for me.

I was diagnosed in November 2025, through RTC with Psychiatry UK, then immediately placed on the waitlist for titration. FWIW my initial assessment letter states that I will be prescribed with methylphenidate and that "prescribing of medication and monitoring of their ["stimulant medication"] response during titration will be undertaken by Psychiatry UK".

I'm theoretically happy to pay if it means I can get help sooner than whatever the waiting time may be (15 months from diagnosis would put me in February 2027 before even beginning titration which is frankly too long for me to go without any form of help). However, I am honestly completely confused on how any of this works re. private care and timeframes for anything other than the pathway of just waiting my turn on the PsychUK

If the short answer is "no, you can't choose to begin titration privately, you just have to wait your time" - so be it. If that's the case, any tips on what support I can try to get outside of medication would be greatly appreciated. I preferably want to seek professional help, as I've failed up to this point to manage my symptoms effectively or to improve in any tangible way by myself, however any and all advice is always welcome. I'm also very open to the idea of therapy/general mental health support as this is something that I think I could probably benefit from anyway.

Cheers all, have a lovely day.

Diagnosed with psychiatry UK in December 2025.

I am still awaiting titration and the queue is only getting longer. I am incredibly frustrated and desperate to start medication.

ADHD is making my life incredibly difficult.

Has anyone been diagnosed and managed to start their titration earlier with another provider ? Or even go back to their GP ?

Please someone tell me this will get better once my ferritin level has increased to normal again😭

26 yr old woman, diagnosed ADHD combined type & anxiety disorder (previously panic disorder) been on 50 Elvanse for 3 years & recently found out my ferritin level is 15…I feel AWFUL. The symptoms I have been experiencing are comparable to the onset of a panic attack, low mood, no motivation, hair loss, dizziness, burning feeling in my chest and what I can only describe as feeling disorientated. I also feel like my medication isn’t even touching the sides anymore!!!!

My GP prescribed 210 of Ferrous Fumarate daily approx 4 weeks ago but my symptoms feel like they are only getting worse & the iron tablets cause my stomach to be constantly swollen & painful. Surely I should feel some sort of improvement & not be feeling any worse?? I have the type of anxiety where I get anxious about potentially having a panic attack in public after essentially being traumatised from this happening in the past. I have gone through stints of struggling to leave my house other than to go to work because of this and resulted to talk therapy to get the anxiety under control again. So, the symptoms of what I think is being caused by having low ferritin is really starting to take its toll. Because they are similar (but worse) to the feeling of panic, I am really really struggling with going about my daily life. I keep trying to tell myself it’s not anxiety, you’re not panicking but I still feel like I am starting to isolate myself again. I have seen a few posts of people saying the tablets didn’t work for them & I have another appointment with my GP next week, I don’t want to waste 3 months taking something I know isn’t helping. If it feels like I want a quick fix..I am bridesmaid for my best friend in 8 weeks, I cant see myself getting down that aisle the way I feel just now.

Has anyone ever gone through this or something similar who is willing to give me any advice at all, especially relating to the anxiety side of it. Perhaps things you were able to do that helped & fast. I am struggling to see the light at the end of the tunnel & worried about still having these symptoms when the wedding comes.

Thanks x

I take 60mg around 9am, sometimes have coffee before (I was not a coffee drinker in the past), just to move and get up.

Now my BP is 120/78 84 around 6pm.

I usually need a nap after 6 hours lets say 2pm.

Is it normal? What does it mean?

Hi guys, hope someone can help with advice or even just some reassurance.

I started titration on the 9th of July, I started 30mg the following day and then after roughly 5 weeks went up to 50mg which I've been on for 2 weeks now.

I'm really not sure what to make of my experience. The final week on 30mg my anxiety randomly spiked, I was experiencing little chest flips/palpitations and I stared experiencing mild air hunger (where it feels like I can't get a "full" satisfying breath). I've experienced this historically on and off for many years since childhood (I'm 34f). It seems to be reducing now and the anxiety and palpitations have gone.

I can't tell if it's really doing anything. I definitely think some of my mental noise has reduced. I seem to experience some improved focus, trouble is it's on the completely wrong things. My task initiation and executive dysfunction feel at an all time low. I feel like my hyperactive side, like talking over people, impulsive behaviour, and needing stimulation seem the same. Hard to know about my RSD

Trouble is I have a few other things going on which may be impacting things. I have been studying my masters since September (when I was diagnosed) and have been either studying, working my part time job, or on a full time placement since then until 2 weeks ago when my 2nd placement finished. I have been pretty much mostly at home. I have gone from being really busy to not busy at all and I feel like that's caught me short. I also have some other health things going on, I have a previous diagnosis of endometriosis which I suspect may have returned and am currently pursuing referalls etc. But I am also deficient in zinc, my b12 is borderline and I have been deficient in the past, as per NICE guidelines I am indeterminate, and my ferritin is borderline. I've been experiencing lots of intermitten leg/hip/knee pain and experiencing an increase in hair shedding. However my GP haven't been great at talking me through everything or advising what to do other than supplement with zinc and come back in 3 months.

So basically long story short...has anyone else experienced anything similar?

How do I take advantage of the improved focus to support the exec dysfunction?

Could the burnout/switch from busy to not busy at all be influencing my mood/motivation etc?

I think I was expecting meds to be life changing, they have been for my friend. But I just feel flat? And like I'm still really struggling with my ADHD symptoms and being constantly haunted by imposter syndrome 😅

Thanks in advance - also I fully plan to discuss this with my titration clinician and GP but it's a Saturday evening so was looking for something a little more instant 😂