The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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How to overcome your extremely low conscientiousness?
TL;DR: Basically the question in the title.
I have a problem that I believe is somewhat common among people here, at the least I'm definitely sure that, for example, @self_made_human mentioned something like this about himself - high intelligence(Hadn't taken any official test in psychologist office, but Raven Matrices or Mensa Norway test show 135+ IQ) hindered by low conscientiousness. It is monstrously hard for me to do anything other than to procrastinate, the only things that can motivate me to do something are the deadline tomorrow(even then I thinking about waiting till the next day's morning), need for a life necessities or a sudden bout of inspiration. Of course I still did and do things required from me by the society, like getting useless degree to secure myself from military conscription but I will always do the basic minimum, late and with much struggle.
I have a very nice remote relatively high paying job so I theoretically could just accept my own weakness in that department and live a life of enjoyable hedonism. But sadly in my mind mythical laziness lives together with countless ambitions and planned great lifepaths that I should immediately start working towards. Of course it sounds like self-imposed problem but I am genuinely at an impasse here. I tried the whole standard motivation spiel, dividing my goals into smaller ones, scheduling my tasks, being mindful and grateful(whatever it truly means), etc., and nothing worked.
I want to spend additional time to talk about currently popular notion of dopamine fasting: restricting yourself from the wonders of civilization and plain old masturbation. It also hasn't helped but I think my case slightly unique here because I was doing the opposite of restraining myself from hyperstimulation my whole life. From the moment I became literate, I read something basically every waking hour, I mean it quite literally, I woken up and then the first thing that I did was picking up a book that I was reading while falling asleep, after I would be going around doing my morning routine like brushing teeth, while holding it in my left hand. I even read on the go, nowadays with smartphones it's really common, but I'm emphasizing this so much cause I never met a person that did this thing with printed books. I'm continued this tradition to this day and majority of my procrastination consists of reading, mainly useless information that is not in any way related to my job, degree or surroundings. This became especially apparent when I learned enough English to read in it, I probably know much more about US politics, culture wars and general trends, than of my country's. I did try to limit myself, both in electronics and in the other things, nofap included. In the end it became clear that even in the absence of any stimuli I would still rather lay down and think about ideas for articles, posts, videos, memes, novels, businesses and world domination instead of actually doing something in that direction.
I have had some amount of success with a YouTube channel, several blogs on different platforms and meme pages, but it was always limited(4k subscribers not 40k) and this is always limited my motivation. Most of the time when I start and complete a project it's because I was inspired in that particular moment and finishing it brings me joy every time. Almost always reception to them is very good. Across all of them I have hundreds comments thanking, complimenting me or asking for more and it is great to hear. But these positive emotions just aren't enough for me to motivate myself.
I already got distracted several times while writing this so I sum up my problem: I want to do things, but I also can't force myself to do them regularly enough to reach some level of success and this situation is eating me alive.
P.S. Forgot to add this - I tried the medical route, but I live in the country where psychostimulants that work are prohibited and what was proscribed to me had either zero or no effect.
For the record I also grew up reading constantly all the time, to the point I got in trouble at school and home for it. You aren’t alone!!
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https://www.lesswrong.com/posts/W5HcGywyPoDDdJtbz/trigger-action-planning
Basically, you can find the trigger that causes undesirable behavior and change it through intention and repetition. You can also build productive routines using this algorithm.
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I wish I knew something else that worked my dude, India only has Ritalin as a useful stimulant, and while it's still a dirty feeling drug, it at least works. It's better than nothing, and I would be pretty screwed myself without it, at least when it came to academics. If you can't make do, such as by the grey market route, well, you work remote, and if this matters so greatly to you, you do have the option of moving to a country with more sensible laws.
It's a good thing you pinged me, because while we haven't met, that's literally me, I used to read while walking, shitting, eating, brushing, in class under the table, whenever it was physically possible. I guess smartphones are a little more convenient, but I do mostly read on mine.
Now, shame I don't have a nice paying remote job, because I would absolutely embrace the unabashed hedonism. But the hospital yells at me if I don't show up for work, so I gotta make do till I become a senior doctor who can make $$ through telemedicine (unlikely to happen at the rate of AI progress).
How difficult was it to get methylphenidate(ritalin) prescribed in India?
Not particularly. I saw a pretty famous psychiatrist, and he largely took me at my word since I was a med student and read up on it, I was already taking modafinil, and he ended up agreeing that I should try Ritalin.
I recently spoke to another doctor with ADHD from the other side of India, and she said she has issues with the doctors there being much more leery about prescribing it, which is retarded IMO. It obviously has abuse potential, but I think the benefits of giving the millions of underdiagnosed people with the disease here their meds outweighs the small risk that some of them will abuse it.
I would say most psychiatrists aren't particularly gatekeepy about it, and worst case you can shop around. I know my diagnosis was legitimate, I'd have failed many of my exams in med school if I wasn't able to take it to study, and thankfully that never happened.
I live in Eastern Europe (Bulgaria) and I've had a VERY different experience. I've talked to about 4 different doctors up to this point. One didn't even know what ADHD is, another didn't believe it's a "real" thing, the third told me I can't possibly have it because I finished highschool. The fourth told me that I do indeed have ADHD (after a year of insisting my real problem is depression) but she doesn't feel comfortable being a "legal narcotics dealer".
I've talked to my fellow countrymen on forums and the consensus is overwhelmingly the same: doctors here won't prescribe methylphenidate and pharmacies don't stock it. It's wild to me that India of all places has a more functional medical institution in this regard. I am quite envious of your situation.
My condolences, but it could be even worse. For example, while ADHD is known to be an actual disease in Japan, all stimulants worth a shit are banned, so I guess I know which country I never intend to do more than visit.
Do you have the option of telemedicine and getting it delivered from a country more understanding? Or just driving/traveling over in person?
I've got a list of 6 psychiatrists I've yet to talk to, at least one of them will probably prescribe it and I think I can find a pharmacy willing to stock it if I order a box. It's just been a very miserable experience, that's all.
In that case, make sure you stock up. I understand it's a pain, made all the worse because of the extra headache you're experiencing as someone with ADHD. Absolutely the last diagnosis worth gatekeeping, if you're making people jump through this many hoops, well, you're probably selecting out a lot of people who need the meds the most.
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I used to read while driving. Still not sure how I am still alive after this and similar risks.
Hah I’ve done the same…
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I can't drive, well, not legally, so I'm safe for now. At least you'll find out when you need more than reading glasses quickly!
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Are you not worried that the Ritalin will stop working after a few years? I’ve had friends who have had meds stop working after daily use for 5+ years and it’s been very tough for them. Assume the plan is to pass all your residency/training/etc then coast in the NHS, but I’m curious.
Tolerance is a well known issue, but I'm not a daily user. When I'm cramming for exams, I average anywhere from 20mg to 50mg max, and that's about daily usage for 2 to 6 months.
That's interspersed with long periods of minimal or no use. My ADHD is mild, I don't need to take Ritalin to make it through a working day, and in fact, doing so is actively unpleasant. I may not be the most hardworking and zealous doctor around, but I certainly do more than the bare minimum needed to avoid malpractice litigation, heh.
So I take it so I can study, acquire knowledge, pass exams, then use said acquired knowledge in my day job. The job itself doesn't need it, and I doubt I'd take it through residency. My internship was terrible in terms of workload and what it did to my mental health, and UK Residencies, while still a slog, really can't compare. If I take my meds as a resident, it'll be if I'm expected to keep studying particular topics, or for exams like the MRCPsych. Besides, Psych isn't nearly as high intensity as something like surgery or critical care.
You can't tell I have ADHD in normal conversation, or in my work. It's only when the textbooks come out that my eyes glaze over, and my usual coping mechanism that worked through high school of forcing myself to study through a combination of personal tutoring, extreme stress and lethal doses of caffeine all failed hard when the books became both big enough to kill a calf and too long to cover in a few days of cramming.
So I've been taking Ritalin for about 5 years now, and I can't say I notice a tolerance. At most, after 3 or 4 months of continuous daily use, I'll end up needing 30-40 mg, and that's impossible for me to disentangle from just needing more of it so I can study longer.
And if said tolerance does develop, well, the UK is a more enlightened nation in that regard and I can cycle through the better alternatives that aren't available here. It's not something I'm worried about.
I'm doubtful that most doctors will be employed after the 7 years it would take me to finish my training, leaving aside most humans, so after a certain point it becomes rather moot. I just don't currently have a better alternative than to act as if that's not going to happen, just in case it doesn't.
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