There’s a lot of really good pieces of advice here, so I don’t have a tone to add. But there’s a few things that could help and possibly be prepared for.

Be prepared for:

• Maybe having to try different meds before you find the right one. There’s stim and non-stim, and the individuals meds in each category can vary in their effects, so be sure to stick with it while finding the right one. It’s definitely worth it.

• Medication is amazing. It’s a game-changer. But it also doesn’t fix it. It helps with the dopamine and can help with energy and motivation, but a lot of the other issues are still there. I definitely still really struggle with switching tasks that require my brain to change states. That’s why you have to still lean on the tools you develop outside of meds to make your day-to-day easier. Someone posted the How to ADHD Youtube channel. I love her channel and she offers a lot of advice for developing these tools.

• Some days, even with medication, it’s just not there. I’m on a stimulant, so when I’m short on sleep, it doesn’t put me in peak performance that day. It gives me the energy to be normal, but I’m not high-functioning. And some days I sleep fine but I’m still not there and nothing gets done, and that’s fine. It’s okay to just have a day where the thing you do is recharge and do some self-care if you can afford the time.

• If you end up on Adderall, be warned it is sometimes difficult to get. Don’t tell your doctor this, but any time you have a day where you can skip a dose because nothing needs to be done, do it and save that pill. When you get new ones, rotate in the saved ones and put aside the same number of the new ones and try to have an emergency stock for the potential time when you have to wait for your meds. This only works for Stimulants and I do not recommend telling your doctor Non-stimulants require you to take it every day to work, but they’re also less likely to be in a shortage. Stimulants just work when they’re in your system, so skipping a dose won’t lose you any progress. Plus, Stims aren’t great for you long term and you’ll need to take breaks to reset your tolerance, so skipping doses can prolong their efficacy.

Things that could help:

• I’m not a developer, but I am an artist (when I have time), I work full l time, and I’m in school. My meds are in a great place, but that doesn’t mean there still aren’t days I just can’t get anything done. Yesterday I should have been working on a paper due this week, but I had a couple meetings and a doctor’s appointment. When those were done, my brain just didn’t have the remaining spoons to be creative enough to write a paper. But I was able to go over my research and make notes that will help make it easier when I do write it (Hopefully today).

And that’s my best advice. Breaking down every part of what needs to be done, like was also stated here. But also, categorize those into things you need a good brain day for and things that you can just type out, or do without having to engage your brain. Maybe you can’t code, but can you make plans for what you need to code? Write it out and have a plan in place for when your brain kicks in. Then, when it’s time to do it, there’s less in your way and you can probably do more.

• Also, lean into whatever your brain is willing to do at that time. I’m not always going to be in a space to really clean my house, so when I’m in that head-space, I go all out and clean like a motherfucker. If my brain ticks over and I’m in a writing space, I write all the things and get ahead on my work.

• Also, in planning, I find it helps to use a highlighter to color-code them (I keep them written down in multiple places, and on a digital calendar). Pink for most important or urgent, yellow for standard urgency and blue for no real deadline, but I do need it done. And put due-dates next to all of them. On my daily or weekly to-do list I write them out in order of due-dates so I can just do the one closest to the top that fits how I’m able to work.

Most importantly, I want to stress how important it is to find habits that work for you and keep it up after you get medicated. Most of the tools I use I developed over years of struggle before getting a diagnosis, and without them, even the meds wouldn’t be enough.

And that Youtube channel is genuinely great. She works hard to find the best information according to science and also recognizes that the same things don’t work for everyone (unlike so many ADHD self-help stuff out there) so she doesn’t offer THIS ONE TRICK TO FIX YOUR ADHD!!! She offers a variety of tools that have been shown to help so you can find the one(s) that help you.

You raise some good points about VTTs, but on the other side, I’ll say that it also provides some tools that can make an immersive experience easier. I DM’d the first time on roll20 and got really into it.

We were doing Phandelver and I made a bunch of custom maps to supplement the default because it allowed me to have different music for each map so I didn’t forget to change it for atmosphere.

I uploaded a bunch of custom .pngs for tokens and stuff on maps.

Made handouts for monsters and important NPS so the players had a better picture of it than the small tokens.

Sound effects for events.

You can set dark vision and view distance for each character so you don’t have to keep track of who can see what.

You can put AC and HP on tokens for players and enemies only viewable by the DM for easy tracking.

You can have tokens hidden on the map that only the DM sees and can change the layer when the trap is sprung.

It actually made my fist time running a game a lot easier and the tools enabled me to be more creative as I found new things I could do. Also, I’m bad at voices so I got a voice changer program and it was much better for them than my poor attempts at sounding creepy or scary.

Do you have a degree of social anxiety? Over the years I’ve noticed that multiple sources of sensory input get overwhelming when I’m stressed. If I feel in control and “calm” I can just mentally filter it all as a single background noise but if my anxiety is real bad or I’m upset about something else I feel like I’m being assaulted from all sides.

If I’m at a bar with friends I’m comfortable with and we’re relaxed and chatting then I’m fine. The music and myriad of conversations all just become a single background noise. Drinking probably helps.

If I’m struggling to accomplish some task and it’s really getting to me, any noise from multiple sources puts me on edge and I’ll do pretty much anything to stop it.

And if it’s not an anxiety thing for you, it might just be that it’s from multiple sources. Sensory overload isn’t usually a physical thing, it’s how our brain interprets it, which means our state of mind or even our perception matters. The music you listen to you know is coming from one place: your headphones/speakers. You know it’s meant to work together so your brain can file that away as a single thing to comprehend. A noisy party with 20 different conversation that you know are all separate? Your brain is trying to view them all separately and ADHD can make you want to interpret all of them.

I think that last bit is most likely and could just be the basic of what your brain is doing. But for me personally, stress triggers my brains inability to filter all background noise as a single “noise” because it’s on high alert fight-or-flight mode and on the lookout for dangers so it’s taking everything in that it can to locate the danger.

I think something like that coffitivity thing could help you acclimatize you to it if you’re looking to change your reaction. Train your brain to view that kind of noise as a singular source and not 100 different sources. And with the internet being what it is, there’s almost definitely something out there that will imitate whatever environment you’re wanting to adjust to.

I think it’s definitely worth looking into. ADHD doesn’t have the stigma these days like it used to. More and more people are being diagnosed with it now, not because it’s over-diagnosed but because we know more about it than we ever have. 20 years ago when I was first diagnosed (and subsequently lapsed taking my meds until recently) it was seen almost entirely as a focus thing. Now we know it affects so much more. Poor executive function has an effect on both mood and our interactions and relationships with others. Impulse control can be an issue. I know the inability for my brain to easily switch tracks meant that I would get hung up on stuff that most people were able to just move on from easily. Since being medicated my mood is vastly improved. It’s not from the serotonin boost completely but more in the way that I don’t get stuck in a specific mindset that I can’t move on from.

And like I said, it’s super normal now. Social repercussions are almost nil and once you get your meds figured out, your day-to-day could only be improved. I still do all the things I used to, but now I’m able to find the motivation to get things done that I had been avoiding before. I clean more often and I don’t put things off.

I was diagnosed at 16, took a couple years to get my meds figured out and then around 20 stopped taking it for reasons I no longer remember. I’m around middle-age now and was talking to a coworker who got a diagnosis. I was telling them about my experiences with meds back in the day and we were talking about things to do to help. That’s when I realized that all of the coping mechanisms I’ve developed over the years to deal with depression and anxiety had a lot of overlap with ADHD coping mechanisms (planning everything out and waiting for a manic day to get everything done). So I went and got diagnosed again about a couple months ago. I did have an advantage in getting my meds set because I had already gone through that dance decades ago so we just skipped right to the Adderall that I ended up with back then. It was an amazing over-night change.

I say all this to say that I hope you don’t get discouraged if finding the right medication takes some time. The coworker I mentioned recently took a break from trying different meds because they got disheartened by the failures. I hope you stick with it. The results are definitely worth it. I used to have to wait until I had ample time to even sit down and plan out all my activities that needed to be done and often things that weren’t 100% necessary were just put off until I had a “good” day where I felt naturally productive. Then I’d knock them all out and get exhausted. Now I’m able to get things done before after and even during work (don’t tell my boss). I still plan things out and excessively, but it just makes me more productive. I used to be overwhelmed by the need to be productive but the inability to do so. Now I’m going back to school after 20 years and my life feels organized for the first time in my life. Stick with it. The work is worth it.

For me, the appetite suppression didn’t last beyond the first week on Adderall, so I’m not speaking from explicitly personal experience, but have you tried setting alarms to eat? Even just small snacks throughout the day? Like, medication has done wonders for me and has completely changed my life for the better, but it wasn’t a magic pill. I still use all of the coping mechanisms I developed throughout my life that helped deal with the problems of ADHD. Adderall gives me the energy and motivation to move and get things done but I still have to plan things. It sounds like planning to eat would be beneficial to you.

While I don’t deal with that particular side effect, I do still plan out my meals. Snacks included. During the weekend I pre-make and package up all meals and snacks I can so they’re ready in the fridge. If it can’t be fully cooked ahead of time I have it prepped up to the point of cooking so I just have to do that last step before eating.

ADHD requires work to live with, unfortunately. You’ve got to be actively involved in the process.

Before getting medicated, I had a multi-step process for getting those things done. On a typical day I’d struggle, but I would have good day/days where I was able to feel motivated and get things done. So I would plan ahead for these good days.

• Break the task down into as small of tasks as possible. For taxes or making appointments, this usually also means having a lot of documents ready and if there’s a phone call, an outline of what I want to go over during the conversation. Maybe some research on what the expected thing would be like if it’s a new thing.

• Don’t try doing all of that at once, back to back. Just do each part, one or two at a time in the days (or weeks if there’s time) leading up to my deadline. Get all the docs together in one place. Look them over to make sure they’re all there and I understand them. Organize them in order of need. All separate tasks for separate days.

Then, when I hit a good productive day, knocking it out is much less overwhelming and draining because the tedious work is done. It’s just the action of the task that remains. It’s worked for years. I still do it without realizing it often. I think it’s just a good plan of action in general for everyone to makes tasks manageable.