ADHD Treatment Without Medications For Adults & Teens (Without Testing) - Pt 2
*In Part 1 we discuss the signs of ADHD. In Part 3 we discuss how to to treat it WITH medications.
The Level 1 Gamer spends all his time gaming so when it's time for school or work he can't even focus. He tells himself he's going to study for that test or work for that promotion but he just can't focus. He always buys games on Steam sales that he never plays. He never finishes games cause he always hops from game to game. He sets fitness and diet goals but he just gets distracted and forgets about them. He sits down to do something and next thing you know he's on reddit or binging memes. His parents and teachers call him lazy. His friends think he's ignoring them. He feels like he's getting left behind while everyone else his age is moving on and he hates it.
The Level 100 Gamer wakes up refreshed every morning and crushes it at work, school, and the gym. He's focused all day, and never forgets appointments or things he has to do. He only buys games he knows he'll play. He reaches every goal he sets, and everyone thinks he's awesome. He uses his neurodivergence to be creative AF with his hobbies. He feels like he's killing it for his age. He’s set up his life so that his ADHD doesn’t bother him. And best of all, he enjoys gaming fully without it affecting his life.
One of the clients I worked with was a 20 year old guy (let's call him Erwin). Erwin had dropped out of high school and lived in his parents’ attic bedroom. He didn't have a driver's license. He was obese and his only exercise was walking to/back from his part-time Walmart job. His goal was to get his GED, but he never was able to sit down and study for it. Elden Ring had just come out, and he was playing that nonstop until 5 am. And then he’d sleep in until the afternoon. He'd buy games on Steam sales that he never played. He jacked off every morning and before bed. He wanted to get his driver's license renewed but he could never figure out the steps to do it. But most of all, he felt like he was falling behind in life and hated he couldn't get his life together.
ADHD is a huge problem in gamers. It causes us to not focus on many areas of our life, then hyperfocus on others.
ADHD is what we call an executive function disorder. Basically means that tasks requiring critical thinking and impulse control are way harder.
Two simple explanations are cause:
In our brain's frontal lobes, our serotonin and dopamine neurotransmitters aren't at ideal levels. When they're too low or jacked up, we focus on the wrong things. And we get inattentive, hyperactive, or impulsive.
The frontal lobe isn’t able to properly suppress the other areas of our brain responsible for impulsive and compulsive behavior, so that takes over and can be stronger than for the average gamer.
This makes us inattentive, hyperactive, or impulsive. It also makes pleasure feel that much more rewarding. It’s why gamers can hyperfixate on gaming but not focus on important, “boring” tasks.” Or scroll on Reddit / 4-chan for hours while others only spend 10 minutes. It can make normal life seem way harder for you than for the average person.
I've never been diagnosed with ADHD, and I’m pretty sure I don’t have it. But I've most certainly experienced the symptoms when things in my life were lacking. More importantly, I've treated tons of patients with ADHD and learned the best strategies to help them. And now I give them to you.
Why it’s worth mastering this:
Think of the damage ADHD is causing in our lives. Having ADHD is like starting off a game of Smash Bros with 50% handicap. So our game has to be tighter to win. Just like we increase our defense stat in any RPG to reduce the damage we take, we can increase our ADHD defenses skills IRL to reduce the damage ADHD causes. Think of it like building our fortress in a tower defense game.
The normies will never get it. They think we're lazy, we just need to try harder. They say it's not a real diagnosis. They say we just want pills to fix our problems. The phone companies and apps push their notifications down our throat constantly distracting us. They throw these hyper-edited 10 second videos videos at us that are destroying our attention span. The world pushes down anyone with ADHD.
But just like any other challenge, we understand and we adapt. So here’s the best tips I’ve found to work for me and my patients.
Sleep
My sleep got destroyed in med school. In my first year I somehow got hooked on Benadryl for sleep. I'd take Benadryl to fall asleep, wake up in the morning feeling groggy, go to class, pound a caffeine pill, hit the gym, then crash afterward in the afternoon. I'd fall asleep in class. I'd rewatch the same lectures over and over again, I'd miss the easy flashcards I should've known. I had horrible cravings for junk food, and binged peanut m&m's and Little Caesar's pizzas. And then at night I couldn't sleep until 3 am unless I took a Benadryl.
Bro let me tell you. This cycle went on for WEEKS until one weekend I committed to going clean turkey off Benadryl. I stayed up all night, forced myself not to nap in the afternoon, and then it finally fixed itself. And then my other problems went away.
If I had to pick ONE tip out of them all, this would be it. Sleep is where our body cleans up the crap in our brain, and its where our neurotransmitters regenerate. So if we don't consistently get the rest we need, we can't focus, we give into cravings, we're tired, we zone out of conversations. Aka our ADHD gets worse.
Now I get 7-9 hours of sleep consistently / night. I track my sleep phases with an Apple Watch. You can also use a Fitbit, Oura ring or sleep mat tracker. Stay tuned for a separate guide on how to get the best night of sleep in your life.
Diet
In med school we'd take a test every 2 weeks and our professor would say "make sure to have tons of carbs before your test cause your brain runs on carbs." So I'd always have a big bowl of cereal in the morning. And what would happen? I'd feel foggy AF during the test. This happened for months, and I never made the connection. As I started getting more into fitness, I learned about intermittent fasting particularly for fat loss. So I tried it where I wouldn't eat until noon. And I noticed that when I took our tests, I felt so much clearer.
I've seen this pattern even nowadays. I fast until 1 pm most days, and the times I get my best work done (like studying or writing this blog), is in the morning, fasted. I only have water and 1 cup of pure black coffee (or 100 mg caffeine pill). And I can work for hours straight without losing my focus. It's incredible.
Similar to above - I've had times where I worked out fasted at lunch time, then eaten a big bowl of cereal after. Problem was, the cereal made me crash in the afternoon where I couldn't focus for shit. I'd nap half the time, and then couldn't sleep at bedtime. If I didn't nap, my focus would be horrible cause I'd feel full and sleepy! Since I was getting into weightlifting, I switched to a protein-heavy diet, and had tuna & broccoli right after working out. And what do you know? My sleepiness stopped, and my focus got better.
This is the second best secret I've learned in regards to diet and ADHD. Eat a low-carb diet, or mainly have low-glycemic index (slow digesting carbs). Think veggies, beans, brown rice (not white bread, pasta and donuts).
Why? Carbs stimulate insulin. Insulin is a parasympathetic hormone that stimulates a rest-digest state. Insulin stores carbs into our body (aka fat cells). It tells our body we're in relaxation mode. That's why we feel tired after a big meal. *If you're a diabetic on insulin, this section does not apply to you, and your diet should be managed by your PCP or endocrinologist.
Other dietary strategies include: Eating whole foods (single-ingredient). Removing artificial sweeteners, processed foods. Eating a mediterranean diet. Adding prebiotics. Removing gluten and dairy.
Side note: I know many people with ADHD have trouble eating in the day cause of their meds. Or they can't tolerate their meds without food. In their case I recommend eating a moderate sized LOW-CARB meal before their meds. If you can tolerate meds without food you could also fast throughout the day and eat in the evening when your meds wear off. Everyone's different so you'll have to experiment with what works for you.
If you want personal help with tailoring your diet with ADHD meds, book a free consult call now.
Exercise
Wanna know my fvorite part of the whole day? It’s when I’m in the gym, middle of my routine, my arms are pumped, I’m wearing a tank top, i can’t hear anyting except the music in my headphones, and I just crushed a PR on my last set. I feel aggressive, I feel intense, I feel FOCUSED. Nothing else matters except me and the weight.
That’s the level of focus exercise gives us. It makes us present. It shows us what’s possible. Obviously no one’s like that all the time. But reaching that state lets me know its possible to reach that other times as well too.
You can also do cardio, yoga, hiking etc. But we’re young men full of testosterone who want to get jacked. So let’s channel that desire. Let’s go lift.
Environment
In med school I was always surprised when some of our top students studied in a coffee shop. I thought it would be too distracting. So I tried it one afternoon. Horrible idea. One - I got anxious cause I wasted 30 min parking, waiting for a table, waiting in line for a coffee I felt like I had to buy. But 2nd, every time someone walked by I looked up. Or when people around me talked loudly. Or I'd run into someone I knew. Before I knew it 4 hours had gone by and I studied maybe 1 lecture. Never again, I said.
But I know many people like public places. They have a clearly separate space designed for work. I make sure to do that with my desk at home - I only sit down when its work time. That way when I do sit down, my mind is automatically conditioned for work mode. People with ADHD have also told me they like busy places cause it feels like that's how their mind is normally. Find the optimal work environment for you.
Thought experiment. Which room would you rather work in?
I spend 5 minutes before working to make sure my desk is clean. It's worth it for when I do start working. A messy environment = a messy mind.
Eliminate distractions
In med school I used a flash card app on my phone called Anki to study. The problem with studying on my phone is I'd view a few flash cards, then someone would text me and I'd reply. Or I'd get an Ig notification and I'd check. Or reddit would tell me an interesting thread popped up. Mentally I said I'd only check them for 30 seconds. But then it'd be 10 minutes before I realized I got sucked in. Or even if I did only check for 30 seconds, when I came back to the flash card, I completely forgot what it was talking about. Or I'd get it wrong when I knew I should've got it right.
There's a book called Deep Work by Cal Newport where he talks about how it takes time for our focus to build up to where we can work in a flow state. But if it that focus is snapped, then it takes us 10 minutes just to get back into it. And that's for neurotypical brains. Now imagine bro when we have ADHD. It's gg.
I've turned off all social media notifications on my phone, even Whatsapp. I turn off all those stupid app notifications that remind us to review or tell us about a new feature. My phone's on Do Not Disturb 90% of the time. When I'm entering a period of serious work, I'll put it in an entirely separate room.
It boggles my mind how everyone keeps their notifications on. Facebook, Instagram, email. And on loud! They’re literally falling for their simplest trick. But we're not like them. We know the social media companies are fighting for our attention, they want to keep us hooked to their garbage. So that's why we rise up against them.
I've personally never had a problem with websites. But I've turned off desktop notifications. But if you go on sites like Reddit, Twitch, Pornhub, put a timed blocker on them. Eventually with the other strategies here, you’ll be able to not need a blocker at all.
Batch tasks
One of my friends always impressed me cause he got a biology degree, but went off into a business and made $100k his first year. I asked how he did it, and he said one of the best books he read was Tim Ferris's "4 hour work week." And he said he had difficulty focusing for a while, but one tip stood out for him. Ferriss particularly talks about "batching tasks." Basically it takes our brain a while to switch from task to task. Most people read for 15 min, then study for 10 min, reply to 3 quick emails, check their texts, then jump back. Instead he says to get your reading done all at once, do your studying at once, then reply to all your emails at one time.
I tried it. And this shit works. When I'd do practice test questions in med school, I'd do a question, then look at the answer, then study the answer, then write a flash card about it. And move on. But this was slow AF, and it hurt my brain after like 30 questions. Instead when I did 60 questions at once, then reviewed the answers and made flash cards, I got faster.
A girl I dated once told me she'd start to vacuum, then see something she'd pick up and put away, then see the laundry basket and do laundry, then do the dishes etc. As a result, cleaning was impossible for her.
All of this is especially important for you bro if you have ADHD. Think about how can you batch up similar tasks in your own life.
Schedule
This literally just happened as I wrote this. I didn't plan a schedule for today. I ate in the afternoon and started getting sleepy. I needed to work on this article so I said I'd meditate for 10 min, then get back to it. Well… I still felt sleepy after that, and my Switch was just innocently sitting there. So what'd I do? I picked it up and played Breath of the Wild for an hour. Did I regret it? Not really. But could I have avoided it? Yes. If my Switch wasn't sitting there (environment) + if I had something scheduled for that time (writing), then I would've been a lot more likely to follow my schedule.
ADHD causes us to be impulsive. So we need every buff against it if we wanna achieve our goals. The beauty of a schedule is, the plan is laid out in front of us. So all we have to do is follow. The best time to set a schedule is the night before. So that when we wake up, we don't need to spend our freshest time thinking and can immediately get to work.
Wanna know the next level secret every succesful man knows? Here how I learned it. I used to do my apartment cleaning and workout first thing in the morning, eat after, then get ready to study or work on my business. But the problem was, it was afternoon and I was sleepy and unmotivated AF. Then I read an Alex Hormozi tweet that said "in the afternoon when you're feeling tired, you can nap or you can workout. But only one of them is gonna get you more jacked." And then it hit me. I should put my workout, and all my other less intense work in the afternoon. So now, that's when I shower, clean my apartment, watch some educational youtube videos, read a book etc. And during my best times (first thing in the morning and late at night), that's when I get my hardest stuff done. That's when I'm most focused and motivated.
Our circadian rhythm and brain activity is in waves throughout the day. So knowing that, we can optimize our schedules to get our most important work done during that time. So think about when you're the most focused, and put your hard tasks then. When you're least focused, put the easier tasks there.
Dopamine Detox
My roommate in med school was insanely smart. I’d notice that whenever he was watching tv he’d be checking reddit or viewing dank memes on his phone at the same time. He'd study purely by listening to the lecture while eating popcorn or snacks. Or he'd fall asleep in class and the professors would get mad at him. And despite all this he'd make the same grades as me, and I had to study with complete focus or else I wouldn't remember anything. But years later, he told me he'd been diagnosed with adult ADHD, and suddenly everything he did made sense. In his case he was able to compensate for his ADHD behavior with his intelligence, but imagine if he didn't have that handicap.
DA is the motivation chemical in our brain. It makes us motivated to work to get a reward. Problem is, gaming, TV, phones, junk food, porn - all give us free dopamine without the effort. So our brain downregulates those receptors, meaning we need more dopamine to get the same motivation. You can see the slippery slope. ADHD people are even suspectible to the pleasurable effects of dopamine with less ability to regulate themselves. Basically if we constantly stimulate ourselves with crap, it's even harder for us to focus on what matters. We already have a handicap.
In college I was always a night-time masturbator cause it helped me sleep. But I remember one specific time in college, I jacked off before my organic chemistry recitation (group practice problems). And OMG, I remember feeling so tired, draining, and not-social during that class. The fact that memory is vivid in my hear 10 years later should tell you something. I never did that again.
But the big tech companies don't care. They want us to be addicted to our phones. Big food and big porno don’t care either.
FYI dopamine detox especially includes drugs. ADHD people are prone to them because of impulsivity and the increased reward feeling. So quitting these is a must. But that’s a topic for another post.
CAUTION: We don't fall for the propaganda that bad decisions are ok if we have ADHD. There's a lot of Tiktok soyboys and victim mindsets out there who use ADHD as an excuse why they ignore people or don't get their work done. We're not like those ultra-liberal softies who tell us being 300 lb is ok. We as Level 100 Gamers understand that we all have challenges and heroes overcome challenges. No one cares if we beat Elden Ring with mods. They care if we beat it naked with no armor. We handle whatever challenge life's developers throw at us at whatever difficulty.
Mindfulness meditation
The big problem I used to have was I’d pull up Facebook or Ig to check it real quick, then end up being on there for 20 minutes. WTF. That’s a big deal in med school when we’re given so muchto remember, we have to use our time efficienctly. What happens is we start scrolling without even realizing we’re scrolling. What meditation does is it lets us catch our own thoughts and behavior, and snap us out of what we’re doing.
We’ve all heard about this. I will break down meditation in a no BS way.
Meditation is becoming mindful of our thoughts so that when they stray, we can catch them and bring them back. It's basically practicing focus. We’re training our FRONTAL LOBE. Just like we train our bicep to make it stronger, we train our frontal lobe to make it handle paying attention better
Here's the no BS way to meditate. Sit somewhere quiet, close your eyes. Focus on breathing in deeply, from your stomach for 5 seconds. Then breath out for 8 seconds. Count 1 for breath in, 2 for breath out. Keep breathing in and count, count up to 10. When you get to 10, restart the count.
Anytime you get distracted, you might not notice for a while cause you're indulging in other thoughts. When you catch yourself, don't judge. Then bring your attention back to your breath.
That's it. Set a timer on your phone. Starting out you might need to do 3 minutes. We build it out with time. I'm at 20 minutes now.
Habit Tracker
Writing down what I need to do has been the single most important habit I’ve kept throughout my academic career. If I think back I’ve been doing it since elementary school, using those free planners they used to give us every year. I’d write down “math homework pg 45-49” and “talk to mom about field trip.”
But the next step which took me some time to do was tracking habits across days and weeks. For a while I struggled with going to the gym on a consistent schedule, rather than whenever I felt. But then when I got on a plan, such as 4X this week on these days, it was easy.
The most satisfying thing about habit tracking I’ve found, is checking off the boxes once we’ve gotten a streak going. It feels great to keep the streak going, and awful to get rid of it.
Even above we discussed a ton of things. We’ve got to write them down if we want a chance at success. Here’s an easy one we can print or just draw our own.
Cut Out Girl Drama
Easier said than done, but I stick with it.
In early med school I was seeing this girl and she took me to a friend’s Halloween party. There long story short, she left me to go hookup with another guy in the bed. Unfortunately, I kept seeing her after that. Seemed like things were going ok for a month. One day she went on a ski trip, and she hadn’t responded to my text for a while. I remember sitting in class and couldn’t stop checking my phone. Obviously not paying any attention in lecture. I kept having thoughts like “she’s probably hooking up with someone.” Lo and behold, she never contacted me ever again. I couldn’t focus for days after that.
We have an optimal amount of norepinephrine and serotonin in our frontal lobes that has us paying the right amount of attention towards something. With stress, our fight/flight systems are flared up. There’s too much stimulus for our frontal lobes, and we don’t focus on what’s important.
When I was studying for Step 1 (the most important exam in med school that affects our residency), I didn’t go on a single date for 6 months. All I did was school, study, and gym. And its not even the few hours a date entails. It’s the mental headaches that often come after.
As young men what do we spend all day thinking about? We get horny randomly, we get morning boners, we think about sleeping with new girls constantly. Ladies will never understand this because they have a fraction of the testosterone we do. Just like we'll never understand their period pain.
Point is, cut out the drama. If there's some beef with our girlfriend, we address it or we cut it off. If some girl we're texting is not responding or playing games - we don't engage. Life's already hard enough with ADHD, we don't need to make it harder.
This applies to other stresses of course. But this is one of the biggest one young men deal with.
Fix Your Nutrition
Often there’s a nutritional or gut issue going on that we have no idea about. One adult patient I saw had ADHD symptoms that came out of nowhere as an adult. She worked as a banker and needed to be constantly “on top of it.” She almost lost her job cause she wasn’t performing her duties as precisely as she used to. It wasn’t until we did bloodwork and found she had a vitamin B12 and magnesium deficiency that she got better.
Here’s some key labs that can be out of whack: Vitamin B6/B12, folic acid, vitamin B6, Vitamin D, Magnesium, Iron, Zinc.
In these people supplements can be really helpful. Omega-3’s are my favorite. But I’ve also used Magnesium, Zinc, Iron, L-theanine, and L-tyrosine for clients.
If you want 1-1 help in figuring out if you have nutrition issues or finding the best supplement for your unique body, learn more about my services here.
Stay Healthy
I remember one time waking up in residency sick AF. I had some crazy bloating and no idea why. It felt like my stomach was tearing up. So I called off work that day. But since I as home, I was like “why don’t I at least be productive and script Tiktok videos?” Nope. Literally couldn’t focus. All I wanted to do was sit there and play Resident Evil Village. And that’s what I did.
This is obvious for a major illness or when we suddenly get sick. But what about those minor things like allergies, cramping, bloating, headaches? These are the thousand cuts that add up.
We must do whatever we can to prevent getting sick. Exercising, eating a nutritious diet, restful sleep, handwashing, getting our flu shots etc.
Conclusion
It may feel like you were dealt an unfair hand with your ADHD, and the world only shits on it. I hear that. That’s why I want to bring this information to you. With the right preparation, we can live a normal life and use ADHD to our advantage. Imagine a life where we’re able to get all the stuff we start done. Where we don’t give in to the bad stuff we know we shouldn’t do. Where people don’t keep thinking we’re lazy. That’s what’s possible for you.
I’m a psychiatrist who specializes in treating Young Men and Gamers with Depression, Anxiety, ADHD and Video Game Addiction. CLICK HERE to book your free consult call.
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Real life’s the video game.
So let’s level up.
Agam
