managing ADHD at work when you can’t use medication

It’s the Thursday “ask the readers” question. A reader writes:

I am looking for advice on managing ADHD at work, but the caveat is that I’m still nursing a baby, so most medication is off the table and when I do stop (hopefully soon – he’s over a year old and I’m actively working on weaning), I know it may take me months to find something that works. So I am really looking for non-medication strategies in the meantime.

I recently got diagnosed with ADHD (in my late thirties) after having my second child and going off the executive functioning cliff deep end (thanks, hormones!). I’ve always had symptoms and have nearly always managed okay enough, but after coming back to work post-baby I would just spend hours in front of the computer and get absolutely nothing done. Cue the diagnosis. It’s been an eye-opener and such a relief, and I’m working through years of internalized shame, obsession with perfectionism, and anxiety.

I did initially get on some rapid-release Adderall, taken just for work as needed (the only thing I can take while still nursing, since it gets out of my system fast enough between feedings). It was an absolute miracle at first, lifting my mood and getting me to concentrate seamlessly. And then a couple of months ago, it just stopped working, and if anything made things worse. So now here I am typing this out at noon, on double my original dose, having not even opened my work the whole morning. I’ve tried blocking websites, but then I find workarounds. Trello used to work, and just doesn’t. I’ve given up on zero-inbox. I find myself either deep-diving into the task and hyper-focused for hours (sometimes the right task, and sometimes not), missing appointments and calls, or jumping from one irrelevant thing to another like some squirrel on steroids. My kids and I have lots of medical appointments, and missing them is a big deal and not something I’ve ever done before in my life, so I’m absolutely reeling from missing three (out of about 10) in the past two weeks. And I know I’m coming off as kind of manic during phone calls and emails. (My contact recently called an email to a colleague “unnecessarily dramatic”… and it was! I’m a very high-functioning professional at a world-class organization. What am I doing?!)

My work situation doesn’t help. I’m a contractor, working from home half-time, with most of my contacts six hours ahead of me in Europe. I love, love, love my field and my job; it’s truly meaningful, full of passionate and incredible people, prestigious, and pays well enough. I need the flexible, limited hours to manage my health. However, I am working solo the vast majority of the time and I am the one in charge of driving the timeline for the project and getting other people to get things to me, and … so when I drop the ball, there is no one to prod me on it until something falls behind spectacularly. I’m currently primarily working on a non-urgent, least-liked task (writing an academic paper), and I’ve gotten maybe 10 hours of work done in the past two weeks total, when I should be averaging about 20 per week. If I damage my reputation with this organization – through dramatic emails, late work, poor quality, or otherwise being difficult – I will never get another contract with them and I’m unlikely to get another opportunity even close to this good. Our field has been decimated by the recent The President funding cuts, and jobs are scarce and competition is unbelievably intense. I’m worried it’s already happening, as I wasn’t invited to join another project that I really would’ve been a natural fit for, and I think the contracts will stop coming once my current multi-year project comes to an end sometime this year.

The readers have always been so kind and full of information and strategies, so I’m really hoping someone has been in my shoes and people can recommend things to try, so I can throw them all at the wall and see what sticks. I actually would also love to hear about experiences with medications, especially on what worked if rapid-release Adderall stopped helping.

Readers with firsthand experience, what’s your advice?

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