I used to keep fish. I loved learning about the nitrogen cycle, setting up the co2 diffuser, balancing tank parameters, designing the filtration system, researching, purchasing, and acclimating exotic fish. Fascinating, colorful and compelling. But once the set up was done and I had a mature tank I was bored and dreaded basic maintenance. The fish didn’t deserve a subpar home so I did my best, but when we moved and sold the set up, I never went back.
Ouch! Well, if you’re up, may as well read:
There’s a lot of research suggesting cis women with ADHD have symptoms (and metabolism of stimulant medications) fluctuate with hormone cycles. It’s not talked about enough that HRT would cause similar issues for trans fem folks. There isn’t great research on just how those effects would show up for trans people, but it’s reasonable to assume they would.
Conversely, estrogen and the like can mitigate psychotic symptoms so maybe that’s a side bonus?
This was a very brief explanation of many studies looking into this exact problem. The conclusion is from their research, not mine. You’re also making my point, that expressions of joy, happiness etc vary between cultures. This article talks about some of the research but I recommend reading the original studies or Barrett’s book.
We actually don’t have the same emotional expressions. The early studies on “universal” emotional expressions (joy, disgust etc) were extremely biased. The researches paid western actors to make facial expressions, took pictures of those expressions, then showed those pictures to various uncontacted / low contact tribes. However, the researches tended to ask the tribes what expression they saw repeatedly until they gave the answer the researches expected.
Even smiling isn’t universal. Think about cultural differences between smiling even in modern day Russia. There’s evidence that smiling might have been an expression of joy but was deemed socially inappropriate in Ancient Rome.
Emotional expressions in the brain differ between individuals and even differ within the same individual on separate occasions of the “same” emotion. Lisa Barrett has an excellent book on this topic: How Emotions are Made.
OCD doesn’t have to have rituals necessarily but that’s what most people think of as a hallmark of OCD. A differential dx like this is important, but hard to do without a professional who can help you not just list your symptoms, but assess the qualitative nature of them.
Regardless, it does sound like this impacts your functioning and happiness, I’m glad you’re reaching out and getting some support.
I agree that sensory sensitivities are also more common in ASD, but ADHD, especially in more severe cases, can also have sensory sensitivities as can OCD and other conditions.
OP I think there’s enough here to justify an evaluation by a psychologist if you can afford it / it’s available where you are. If not, reading about ADHD and applying some of those strategies will not hurt you. I’d recommend ADHD 2.0 as a starting point.
ADHD and anxiety are also comorbid, and some of your symptoms may be more about anxiety and might respond well to anxiety related interventions. ACT (acceptance and commitment therapy) has several good workbooks about anxiety which could be helpful.
You could consider getting a psychological assessment that will give you an idea of your cognitive strengths and weaknesses. They can also administer instruments like the Strong Interest Inventory if you’re still looking for help deciding on a career.
It’s frustrating that an assessment is so expensive. And the psychologist will probably only get reimbursed for 4hrs of testing so your report will be short and cursory anyway… I’ll avoid going on a long angry insurance rant here.
Do you have any Universities near you? See if they have graduate psychology programs. Those students need people to practice giving assessments to and are supervised well. They usually give assessments for very cheap because it’s a training program.
It takes about 5 half lives to clear 95% of a substance from your system. A quick google says the half life varies from 5-21hrs, so even if you’re on the slower end, a week should do it.
If you’ve been on it for a very long time then your CNS may need more time to get back to baseline, but you probably don’t need a perfectly clean slate to assess if a new medication works for you. Plus, switching from a nonstim to a stimulant is a totally different class of drug and you should feel the effects of a stimulant fairly quickly.
Just make sure you time and dose correctly to avoid messing up your sleep.