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Quick update on the ADHD. Saw a psychiatrist today who had already reviewed my diagnosis report, so the session was spent a lot talking. At the end we both agreed that methylphenidate would probably be a better choice among all the stimulants because I’m really prone to becoming irritable, as it has less severe side effect potential compared to amphetamines. He recommended I start with 5mg twice a day. I preferred 10mg tablets because I can just halve them and save money, and if needed I can easily up the dose. My plan is to only use the drug twice per week and evaluate how it’s affecting me.
Also, the good doctor gave me the tip to use goodrx.com for coupon discounts. You can get a 30 day supply of methylphenidate for around $12-25 depending on the pharmacy.
Welcome to the club! I also can get a bit irritable at times, not nearly to the point of having anger management issues, but stupidity sometimes annoys me. Meditation has helped me a lot in this regard, of course. Nonetheless, to some extent this has been a problem for me all my life. On MPH, I still notice morons and idiotic decision-making all around me, but I am emotionally detached instead. I am a more agreeable person on MPH.
Here in Europe, doctors are strongly opposed to prescribing you a higher dose of whatever meds you are on to help you save money. There are two main reasons, as far as I can tell. One is their sense of responsibility. If you are supposed to take a dose of x, but you get a prescription for 2x, with the expectation of cutting your pills in half, how can your doctor guarantee that you will do this every time or that you manage to always perfectly break pills in half? This may even be a liability issue. Also, it is not generally the case that the active ingredient in your meds is evenly dispersed, so even if you manage to cut your pill into two identical halves, you cannot guarantee that the amount of the active ingredient is also perfectly split between both halves. The other reason seems to be your medical record. If you are supposed to take a certain dose then there would be a discrepancy if there are suddenly prescriptions for twice the amount. In the case of MPH, my psychiatrist offered to issue two prescriptions at once the last time, basically a two to three months supply, based on my progress, i.e. stable health and virtually no side effects; me coming across as a responsible adult probably also helped.
I have a really busy week behind me, so much so that I took 2 x 10 mg on four days, and 1 x 10 mg on one day. I am extremely pleased with the outcome. For instance, I had to brush up on a complicated technical topic I used to be quite well-versed in but had not done any work on for a few years. On MPH, this took me less than two days. Without it, about a week to a week-and-a-half would probably have been more realistic. When you work on a topic deeply and for a long time, you enjoy staggering compounding effects of your learning efforts, i.e. if you are able to fully focus for seven to nine hours in a day thanks to MPH, you get a lot more done compared to getting perhaps three to four hours of serious work out of a day. Numerically, you may think that three days of the latter may be as effective as one day of the former, on MPH, but it’s probably closer to around five or six times, i.e. 1.5 days vs seven or eight days in the aforementioned example.
Regarding consumption of MPH, I have found that taking it about 45 minutes before a proper meal, or at least a bowl of muesli with a copious amount of full-fat yogurt, leads to the best results, i.e. I perceive a more steady rate of absorption. There is also the recommendation of taking it with a bite of food. This leads to faster absorption, i.e. it kicks in a bit sooner, more intensely, but it lasts less long. Taking it without any food is probably not a good idea. I have not tried this and do not plan to. Presumably, the effect kicks in really quickly but you only get about one to two hours out of it. Also, I read conflicting reports about interference due to vitamin C. I can confirm that it is better to avoid it. Oranges are not a good idea but I noticed reduced effectiveness even when taking MPH together with a banana. When eating an orange, the effect was greatly diminished.
Aaron:
It’s a function of the pH-level. Since oranges and orange juice are quite acidic, that’s likely the cause of the decreased effect you saw.
If you try taking the medication along with something basic, you should see an increased effect. You could try taking it along with a calcium tablet, or one of those tablets of a basic nature that you use for an upset stomach. That should neutralize the negative effects of something acidic like orange juice, at least partially, without interacting with the medication.
If you take something like that along with the medication, but without anything acidic for it to neutralize, you may just see an increased effect of the medication overall. Whether that would be a positive or a negative would depend on the individual and his situation.
Thanks for your input. I had not thought about this angle, nor did I look into it further. I had come across some remarks about vitamin C and MPH online, so I decided to see for myself if there was any truth to it. I find the approach you suggest interesting, but I am not sure I want to engage in this kind of experimentation as it seems error-prone, compared to taking my meds as prescribed. Besides, I can easily sidestep the issue of acidic food by avoiding its consumption. Also, I do not need to find workarounds to get a stronger effect as I am totally fine with 10 mg, as long as I do not eat oranges and other acidic food, presumably. My psychiatrist recently even suggested that I temporarily increase my dose to 20 mg, just to see if that would lead to even better outcomes. The reasoning is that if Ritalin works for you, then taking a higher dose would lead to a stronger effect. There is supposedly an optimal or near-optimal amount per individual and, ideally, you should get as close to it as possible. Of course, this has to be balanced with side effects, i.e. if you get much worse side effects, then increasing your dose may not be worth it.
So far, I have not even considered improving my dose. I am really happy with the results I get with 10 mg. My ability to focus goes through the roof and I only experience dry mouth, intermittently, as a side effect. As I take breaks for at least two days a week, I also do not have the problem of MPH losing its efficacy, like it was with one guy I know who speed-ran his prescription from 10mg/day to 80mg/day in three months. I could imagine taking 3 x 10mg on some days, if there is a very good reason for it. So far, this has not been the case.
“I also can get a bit irritable at times, not nearly to the point of having anger management issues, but stupidity sometimes annoys me.“
I would say my anger has gotten me in trouble a few times, but I think there are also other factors as to why I have baseline irritability and that ADHD just exacerbates it.
“Here in Europe, doctors are strongly opposed to prescribing you a higher dose of whatever meds you are on to help you save money.”
It could be a difference in standards of care, as in they could be higher in Europe. Even in my profession it isn’t uncommon to have administration instructions on a patient’s electronic medication administration record to score some like say, metoprolol 25 mg, and only give a 12.5 mg dose. Of course, if employees aren’t double checking their work this can lead to an error and possibly cause low blood pressure or heart rate.
“Also, it is not generally the case that the active ingredient in your meds is evenly dispersed, so even if you manage to cut your pill into two identical halves, you cannot guarantee that the amount of the active ingredient is also perfectly split between both halves.”
This sounds like a quality control issue and I think it’s actually the exception, not the general outcome. My methylphenidate is scored down the middle, btw, with instructions on the bottle to take 1/2 tablet twice daily, so there won’t be any discrepancies (technically) or liability issues. This only maybe saved me a couple dollars though. The pharmacy literally charged me $2.51 without insurance for a 30 day supply. I was amazed, and can only figure they automatically applied a goodrx coupon for me, so I just paid out of pocket.
“I have a really busy week behind me, so much so that I took 2 x 10 mg on four days, and 1 x 10 mg on one day. I am extremely pleased with the outcome.”
This is great! I took my first 5 mg dose a couple hours ago after getting some baseline vitals and filling out a questionnaire. At this dose so far I honestly feel really calm and relaxed. It’s hard to explain, but maybe it’s enough of a dose to calm my mind to the point to where I have less compulsion to seek dopamine. So, I’m just content relaxing with no guilt that I should be doing something else. At the moment, I feel like if I had external or intrinsic motivation to do something I could easily transition from relaxed to productive. Also, oddly enough my neck feels less tense than usual.
Thanks for the dosing recommendations!
Sounds like a wise choice, Aaron. 🙂
I’m curious about why your doctor wants to up your dose, by the way? From what you’ve written here you seem to already be getting excellent results.
The context was that if I wanted to explore if I got even better results on a higher dose, he sees no medical counter indication. His angle was to find the optimal dose. Perhaps 10mg is optimal, but apparently the standard approach is to vary the dose up- and downwards to determine the optimum. This is not at all uncommon in medicine. He is not pushing me to up the dose at all, though. However, after reviewing my recent EKG and blood screen, he remarked that everything is fine. He is very methodological. There seem to be some psychiatrist who just ramp up the dose willy-nilly but that is not part of his professional ethos.
Aaron:
Aha, I see.
Yeah, titration is usually a pretty drawn-out process with ADHD medication. You’ve been quite lucky, in a sense; it’s not uncommon for it to take many dosage changes before a satisfactory effect is achieved, or even medication changes after finding out that the first alternative (usually methylphenidate/Ritalin) isn’t a good choice for that particular patient. 🙂
Sounds like you’ve found a good psychiatrist, though!
Is there any possible way to be “invisible/unnoticeable” if you’re big and tall?
Self-defense wise, “invisible” is probably better than “more trouble than you’re worth”. However, for some people, becoming invisible just seems impossible, so the next best thing is being too dangerous or at least too much trouble to victimize.
I’ve definitely just realized another piece of the reason I got bullied as a kid. I TRIED to be invisible, but because I was the biggest and the tallest (and my clumsy mannerisms), it was a strategy that was just never going to work.
I think I’ve said before that one of the things I would have done differently if you sent me back in time is to absolutely demolish the first bully who ever tried me. I most definitely could have gotten away with it at that age.
That certainly would have sent the message to keep me off radar for the rest of my school years, first impressions are powerful. lol.
Unless you move in very strange neighborhoods, I don’t think you need to worry too much about it. School in childhood is a very strange environment, and most adult environments don’t work like that at all when it comes to violence.
“School in childhood is a very strange environment, and most adult environments don’t work like that at all when it comes to violence.”
I know man. I think I’ve been the one here saying for awhile that sadly, a lot of what would normally be good self-defense advice, goes out of the window in many school environments. I’ve seen Macyoung attempt to address the subject on facebook in the past. this is definitely one of the cases where he dun goofs at (you’d think he’d know better than to be so dismissive because he’s been precisely in that kind of toxic environment in the past, but oh well…), and where his friends Rory Miller and Wim Demeere have the more correct idea:
https://chirontraining.blogspot.com/2012/12/bullying-as-human-behavior.html
https://wimsblog.com/2011/03/big-kid-gets-bullied-one-too-many-times/
Maybe I’ll successfully become “less noticeable” should I successfully lose all the extra weight and move to the US one day. I’m really curious how I’m going to be perceived out there.
Well, Marc MacYoung is a bullshit artist of massive magnitude.
Don’t get me wrong, some of his writings are good, but as soon as he starts talking about anything personal or any anecdote from his own life, I either skip it or read it for entertainment purposes. The guy so obviously makes up, bullshits, and lies about his own life and history all the damn time.
If you’re overweight, then losing weight’s always good, for preventing bullying as well as a host of other reasons. 🙂
There’s definitely quite a good bit of exaggeration in his stories, but I don’t think all of it is bull. I’ve read a little bit of his book about improvised weapons (yes, arr!). I should get to reading it all in all one of these days, but you don’t figure out the stuff written in there without…actual experience using weapons on living human flesh, and folks trying to use said weapons on YOUR tender pink ass. How did he not end up behind bars? I guess it was just easier to get away with shit back in the day before we started having cameras everywhere and super computers we call “smartphones”, lol.
Anyway, I don’t care enough about Macyoung personally (He lost a lot of respect from me when I saw him be so dismissive about handling school bullying long ago.) to defend him. IMO, the biggest benefit I got out of Macyoung are discovering his friends/contemporaries. Rory Miller (Being a former LEO and prison guard, his story is much easier to trust and confirm. 300+ altercations with violent criminals..), Iain Abernethy, Wim Demeere, etc.
https://www.instagram.com/reels/DHBnDkpRgGJ/
Here’s a great example of good “RSDB” training, from a highly trusted organization of this sphere. I’d recommend Shivworks and Knife Control Concepts over Krav Maga. the latter of which has very bad quality control in the mainstream/public unfortunately.
*RBSD
is what I meant to write. lol.
https://conflictmanagermagazine.com/technical-virgins-and-the-world-of-self-defense-clint-overland/
Clint Overland is another contemporary of Macyoung, whose writing I’d recommend reading if you want the perspective of someone who has been on the wrong side of the fence and Macyoung rubs you the wrong way.
I’ve talked before that I’m glad I fought back against my bullies. Not only has doing so saved my long term mental health (I know people, including IRL, who didn’t stand up to their bullies. It fucks with them long-term, if not for the rest of their lives), but in doing so it netted me some valuable real life fighting experience. I have nowhere near the amount of experience in violence that Clint has, and I suppose that’s why I still have fully healthy and functioning body parts unlike him, but I’ve experienced just enough to know that he’s on the dot with his writing.
This part for example:
________
Nothing can completely guarantee your safety. Nothing is 100% effective all the time. Sorry, but it isn’t. I have shoved my thumb in a guy’s eye to the second joint and the fucker kept on trying to run a knife into my stomach, instead of trying to get off me like I wanted. I have had a drunk bust a chair across my shoulders and it didn’t turn out like he planned.
________
is absolutely on the dot. I’ve talked about the last fight I ever had, which was against the most feared bully of my high school, which I won by doing a “Chair Takedown” (I literally did a swimming pool dive on him while he was sitting, landing me straight into the high mounted position. knocked him out even though I didn’t notice it at the time, and ended up following it up by pulling his uniform over his head while my schoolmates were trying to pull me off of him, turning it into an unintentional improvised neck crank) on him, a move that, in hindsight, definitely had the potential to cause serious harm, if not death. Yet he turned out fine. The force inflicted was just enough to defeat him, but he didn’t have to go to the hospital. He just went absent out of embarrassment (I kicked his ass literally in front of the entire school) the next day.
On a much earlier occasion, I dealt with a bully by ambushing him and raining sucker punches to the back of his head. These are called “rabbit punches” and are dangerous. (A few boxers have died/got crippled before from these fouls) All that happened to the punk however is I gave him a huge bump on the back of his head and him crying to mommy.
And then there’s that time I got rocked in a fight for the first time in a fight that I managed to survive by clinching.
I recognize that luck played a non-insignificant role that things didn’t turn out worse than they could have, but I don’t regret these decisions because of what I’ve said above. At least post-highschool, I have not been in a fight in 14 years and still keeping it up. I think that definitively proves that the schooling environment I was forced into, was definitely the problem. Maybe I wasn’t 100% the good guy, but I definitely was not the source of the issue.
I recently learned that The Last of Us 3 is apparently officially cancelled. Gaming really seems to be getting better overall lately.
Their next big project is their non-binary space adventure, which unfortunately did not get a positive reaction from the audience. Naughty Dog also cancelled their online shooter with the working title Last of Us Online: Factions last year. I wonder if this franchise will now lay dormant for a decade or so until Sony feels like trying again. The Last of Us 2 was one of the most obnoxiously astro-turfed games in recent memory. Supposedly everybody had bought it but barely anybody played it. You could get it for $20 at Walmart.
Stellar Blade on PC in June.
Aaron,
Have you heard of radiocast.co and radiogarden? Apparently, its an interactive map that shows you tons of radio stations all over the world.
I have never heard of these services but they seem quite useful. The problem with radio, though, is that there are a lot of commercials.
You can listen to music from all over the world. Not all radio stations have commercials. I’ve been listening to Pyongyang Radio FM The Democratic People of Korea, and I have not yet come across one commercial.
This is a great angle. I had not considered that these sites also provide an opportunity for escaping the walled garden of mainstream media. In particular media of North Korea is basically inaccessible in the West. I have watched a few videos of their military parades as well as recordings of Pyongyang. Needless to say, I did not quite get the impression that it was the capital of a poor, communist backwater. ON a related note, North Korea is in the process of gradually opening up to tourism again, so you could even visit. I recall reading that it is difficult for US citizens to go there, though.
North Korean media actually has significantly more commercials than western media. It just isn’t products and services that they’re selling.
Pyongyang is definitely the capital of a communist backwater. Pyongyang itself, however, is mostly a playground for the communist party elite.
Your joke is great!
I am currently going through the Alien franchise. The first one is a classic, well worth watching. The second one brings in James Cameron, attempting to produce a big budget blockbuster that potentially sets up a franchise. It’s not bad but it is about as organic a sequel as Terminator 2. Alien 3 is complete mess: bad CGI, love story, big bad alien, Ripley channeling the Terminator and killing herself in order to kill an alien that somehow grows inside of her. Supposedly she got raped by an alien during “hypersleep”. In Alien 4, Ripley is back. Even though she had died at the end of Alien 3, she got cloned, from blood drops, a couple hundred years later and somehow the cloning process also causes her to have an alien fetus inside her. For some bizarre reason, these blood drops stored part of her memories, so the cloned version of herself is basically a functioning adult. This franchise is every bit as forced as the Terminator franchise and already in the 1990s demonstrated that Hollywood was creatively bankrupt.
The fourth alien movie sounds really retarded. You’ll notice that each film had a different director. It makes sense that Aliens was directed by James Cameron, doesn’t it? Ridley Scott was the director for Alien, as well as the first prequel by the name of Prometheus, which I thought was passable even though it is quite an unnecessary head scratcher.
The first Terminator was so sick. Say what you will about Arnold as an actor, but he was born to play the terminator
This is a fairly low effort post, but I just compiled my top 10 films.
1-5 in no particular order:
Once upon a time in America
Fight club
The matrix
Heat
The sandlot
6-10
Once upon a time in the west
Collateral
Memento
The godfather
Saving private Ryan
Almost: jaws, kill bill, pulp fiction, snatch, mulholland drive, first mission impossible
Not any particularly obscure films on here. All of them besides The Sandlot were critically acclaimed.
Curious if any contrarians on this blog hate any or all these films (there are certainly things to complain about in almost all of them).
Also, happy to read anyone else’s lists
I watched the Sandlot pretty recently for the first time and really enjoyed. I didn’t expect to, but it’s just one of those films that makes you yearn for the 50s even if they weren’t necessarily that great (what do I know?).
Technically, the Sandlot was set in the early 1960s, but the culture was pretty much the same. I think one can say that era was objectively better. The country wasn’t full of Third World immigrants, the middle class
was much healthier, therefore mothers
stayed home with their children, the hostility
amongst the population was much less. The
1960 election was as close as it gets, but it’s
not like Kennedy and Nixon supporters hated
each other. Another good anecdote was
brought up by a guy on Tim Poole’s show. He
brought up how Trump and Biden basically
said they would kick each others asses when
they were younger. Kennedy and Nixon
would never say that stupid shit. They had more class, the country has devolved on that level.
About the list. Pretty good. I don’t hate Saving Private Ryan, but I think it’s overrated. I’ve seen better WWII movies, and I’m personally not a fan of Hanks. One particularly agitating scene was when they killed the German soldiers who had surrendered. Supposedly war crimes are funny when are perpetuated against “Nazis.”
Great comments on The Sandlot. That’s my go to when i want to feel like a kid again.
All true, definitely makes me yearn for th 60s.
I can’t help but yearn for earlier times because I got medicated as a kid, which effectively destroyed my life (I’ve discussed this here elsewhere)
During those times, I’d have been classified as a rambunctious boy who sucks at school instead of someone who needs to get chemically fucked with.
What bothered me about Saving Private Ryan was the sentimentality.
I thought the scene with those Americans killing the Germans was honest. I didn’t take it as trying to be funny. I thought he was trying to show evil on both sides.
However, that was one of the criticisms of the film. It was an antiwar will that made people cheer for killing Germans (Spielberg went on record calling it an antiwar film)
Also, which WW2 flicks do you prefer GLAS?
I thought SPR was phenomenal in terms of camerawork, shot composition, acting, memorable moments.
I watched The Thin Red Line ages ago, but it didn’t really stick with me.
I liked Hacksaw Ridge well enough, but I can’t rate it over SPR.
Speaking of yearning for an earlier time, probably one of my favorite films of all time is Dazed and Confused. It’s like the ultimate feel good movie, and I probably watch it once a year. Lanklater’s follow-up, Everybody Wants Some which is set in the 80s, did not quite captivate me as much.
I watched Everybody Wants Some a while ago. The start is quite good, a bunch of college athletes bantering with the new guys. Then suddenly Diversity walks into the room and the movie start to feel forced. I am obviously not a racist, but multicultural friendship groups do not really exist outside of Hollywood and Nintendo commercials. Linklater made a somewhat similar film on growing up and adulthood, Boyhood, which comes across as being much more authentic as there little diversity pandering in it. Of course, the mother of the protagonist is a strong woman and all the men she married are deadbeats, but thankfully the movie is not about that woman.
I think Dazed and Confused and Stand By Me are most people’s go-to’s for this vibe. Sandlot was the one from my childhood though. Watched it countless times at home and with friends.
Feels bad not having a John Wayne flick on the list. The Searchers is great.
My fave of his is The Shootist, but there’s some cheesy moments and the ending is abysmal.
@Herk
I really liked When Trumpets Fade, even though it was made for HBO. You can watch the whole movie on YouTube:
https://youtu.be/DIbrTdbMkdg?si=Lxk0Pl1F8Gehn5Ot
Thanks for explaining the war crime scene in SPR. Good to know it’s an antiwar movie. Too bad the audience didn’t see it that way.
Aaron,
Since you are a fan of nature have you been to Harz Mountains in Northern Germany and Lake Eibsee in Bavaria region?
Lake Eibsee reminds me a lot of nature hikes in Wyoming and Montana.
I have not been to the Harz Mountains. It is possible that I went to Lake Eibsee as a kid as I took a few trips with my father, and some school trips. In any case, the Bavarian Alps are well worth a visit.