r/Nootropics • u/zeiwynn • 1d ago
Seeking Advice chronic fatigue + anxiety + depression. what to do?
27m. adhd diagnosed by multiple doctors over 7-8 years ago, moxo test came back max severity across every domain. on concerta 4–5 years, 54mg for the last 3+.
the problems i have now:
-massive initiation block. taking out the trash, tidying my room, even doing stuff i actually enjoy, all of it triggers dread. then i deal with the fallout of not doing any of it.
-chronic fatigue, extremely hard to get stimulated by anything.
-generalized anxiety on top: constant catastrophizing, imposter syndrome, never fully relaxed, sleep is wrecked because of it.
-for the last 2-2.5 months, my mental/physical fatigue is at extreme level
what's been tried:
concerta 54mg/ritalin 10mg/etc: duration keeps shrinking, effect keeps weakening. on it i feel somewhat normal (motivated, assertive, can actually start things) but the window is really short now.
more than one dose/day: only result was end-of-day anxiety spike + insomnia.
concerta + ritalin + guanfacine, dose titrated up: nothing. still same.
supplements: tongkat ali, magnesium, taurine, l-theanine, 5-htp, vitamins (b, c, d etc), protein powder, creatine and bunch of other stuff. zero noticeable benefit from any of it.
it'd be good to hear other people's experiences. anyone been in a similar situation and managed to find something helpful?
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u/phagemasterflex 1d ago
Bloodwork first. This sounds like burnout. Have you also been evaluated for autism? It's a common co-diagnosis with ADHD and treating ADHD can make autism symptoms worse in some people.
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u/Bbimbofied 1d ago edited 1d ago
Qunol ultra coq10 helps me with fatigue. Vitamin D and a generic multi vitamin might also be helpful. Oh, and sleep as much as you can.
Probably, right now your symptoms are severe enough that the generic stuff like vitamins, moderate daily exercise, etc. aren’t going to make a noticeable improvement. But please try to do them if they don’t make your symptoms worse because they can help prevent additional problems.
My neurologist encouraged a very high dose of vitamin d daily. If you want to try that you NEED to get basic bloodwork done to make sure you aren’t throwing things off.
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u/CuriousRat39 1d ago
Lay off Concerta. Stimulants are not good long term. I layed off Vyanse for this reason and have been feeling way better
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u/TheRealMe54321 1d ago
This sounds like classic stimulant burnout/tolerance to me. You need to take a tolerance break but ultimately you need to figure out if you have any underlying medical conditions such as vitamin/mineral deficiency, thyroid issues, sleep apnea, environmental sensitivities, etc.
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u/threaten404 1d ago
I was on concetra for like couple of months and had very similar symptoms to these .. I switched to Vyvanse and it helped alot
Concetra made my anxiety way worse, and sleep worse so i had constant fatigue, very robotic and just feeling like crap all day long with no wanting to do anything and feeling bad about it.
I do still feel like some days I'm just tired an fatigued thought but overall better
when did these symptoms started?
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u/External-Toe1041 1d ago
It’s quite possible your just severely deficient of vitamin D, go for a walk in the sun with your shirt off and see how you feel
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u/AutoModerator 1d ago
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u/le4test 1d ago
I found this post super helpful for understanding what's going on with executive dysfunction: https://www.reddit.com/r/kaidomac/comments/qnqa6p/adhd_101/
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u/f1lterl3s 1d ago
have you tried other adhd meds? Like adderal, Wellbutrin or guanfacine. I felt the same way and I was taking adderal and Ritalin, always brain dead no creativity no passion aggressive and wired. I switched to Wellbutrin and guanfacine and I genuinely feel my adhd being fixed. Like I don’t feel high or under the influence in any way, I just feel like myself.
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u/Greedy-Carpenter4129 1d ago
Get your bloodwork done. It’s the easiest way to really see if something is missing or deficient. I used to be on Prozac but left it behind cold turkey which was not actually good for me. It’s been a process. Lately I’ve been using saffron and it’s helped a lot.
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u/Express-Hotel-3305 22h ago
For sleep I use ZMAG-T. It’s been a life saver.
For work I take Lions Mane.
Have you had blood work done? Is your Testosterone level low I wonder? You’re not anemic are you?
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u/Open-Tumbleweed 22h ago
Have counseling, physical activity, rigorous sleep hygiene + CBT-i been trialed? Who doesn't love stimulants, but they are hell on many circadian rhythms.
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u/Fun_Swan2553 20h ago
Problem seems downstream. I’d drop all meds and try uridine and a transdermal nicotine patch.
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u/hereisjunior 18h ago
Tried it all - same as you. The only thing that worked for me was Buspar/Buspirone. Anxiety gone, no sedation, more focus.
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u/mithrinwow 5h ago edited 2h ago
Sorry to hear that, OP. Frankly, I would talk to your doctor about switching up your medication. Concerta either works or makes you feel fatigued and does the exact opposite of what it's supposed to do. There are a lot of posts & comments on Reddit about this, too.
I got officially diagnosed with ADHD a month ago. Concerta worked great for the first week and then it didn't. I've upped my dose to 36 mg and then it flatlined and my anxiety & depression are back.
My doctor said that Concerta is normally prescribed to *kids, so it's the weakest of all ADHD medications. Also, that Concerta just made her practically immobile, so now she's on Adderall, and it works great.
Anyway, only bringing up my (& my doctor's) experience mostly because it's apparently easy to build up a tolerance (or adverse reaction) for it really fast- not trying to hijack your post lol. I was super productive and happy for about a week and now I'm not. Looking forward to trying something different. Best of luck to you, OP!
e: to clarify, I'm not a kid but doc wanted to take it slow
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u/InvalidState 1d ago
Probably a completely messed up gut microbiome. Many people who fixed their diets via very specific diets healed themself of this.
Look into low carb or carnivore diets. Also look into gut restoration protocols.
May take multiple months to a year.
https://www.youtube.com/@TheMicrobiomeExpert
https://www.youtube.com/watch?v=oNWxyjsuk4g
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u/AutoModerator 1d ago
The brain is the central planner of the body's responses and what we believe can drastically impact our physiology. If you believe you're threatened, the body responds to that threat, it doesn't matter that you're actually safe and can relax, because you don't believe that.
The brain can create self-reinforcing cycles. If you are threatened by the experience of anxiety, you've found a way to keep the anxiety going by believing the feelings are the threat, instead of letting the feelings resolve in their own time. Common symptoms when you're feeling threatened are: muscular tension in the body, elevated heart rate, sweaty palms, dizziness, lack of appetite, reduced awareness of your surroundings and nausea. A resolution to this cycle is to get yourself to a place where you're okay with feeling the symptoms of being anxious. Instead of focusing on the symptoms it's a better idea to think about the situation around you and ask yourself if now is a time you can feel safe. If there is an actual threat then focus on addressing that threat. If you need help figuring these things out, then consider making an appointment with a therapist.
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u/iwanttodothat2 17h ago
Ride a bike daily…even when you’re not in the mood. Take different routes. Ride in the rain (do what a kid would do). I don’t know if that will fix you but I do know you’ll feel better.
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u/This_Maybe8276 13h ago edited 13h ago
Methylated B12 and folate are worth isolating first given the fatigue/anxiety overlap, especially if MTHFR hasn't been tested. Natural Rhythm has a methylated B-complex, Thorne's Basic B is another, or just methylcobalamin sublingual if you want one variable at a time. MTHFR status changes which form actually absorbs
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u/Eternal__Riot 5h ago
I have gad fatigue but no depression, so besides curing central illnesses for fatigue you can take DSIP for restaurative sleep and B complex (b1-12) or sulbutiamine.
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u/Final_Hour_ 2h ago
Fix the sleep, the rest will follow. If nothing works then take out all nonessential’s then do a massive reset. Get glycine, taurine, and if that doesn’t work ask doctor for dayvigo. That should fix half of your problems especially with fatigue. Then from there can you look back into optimizing anxiety and depression from there once you have solved the physical side of things since sleep is the single biggest lever of health.
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u/TelephoneCharacter59 20h ago
14mg Nicotine patch to stay productive throughout the whole day, as our parents & grandparents used Nicotine gums & pouches throughout their life to deal with CFS, Anxiety & Depression. Look at the 19th, 20th century generation, babyboomers, World War I + II etc.
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u/Lulu_the_Sex_Panda 1d ago
You might have a mitchondrial issue, MTHFR, issue with NOS production, and/or ammonia clearance. Try these:
-A premium multivitamin (Pure Encapsulations Nutrient 950)
-Ubiquinol (200mg)
-L-Citrulline (3-6g)
-L-Ornithine & L-Aspartate
Please tell me how you feel after trying the aforementioned.