Been there many times on different consulting gigs.

I presume you are not part of the executive suite. If so -- get out!

When in the trenches, I have found the best approach is to recognize that you can't change "them". It is not personal and you certainly need to look upon it all as absurdist theatre. Read some Albert Camus or Jean Paul Sartre to realize that your experience if far from unique.

You don't need medication; just shift your viewpoint.

I think Andreas Kling behind Serenity OS, and now the Ladybird Browser, has broadly the right ideas, and Serenity OS is actually named after https://en.wikipedia.org/wiki/Serenity_Prayer .

You might be burned out, especially if you're experimenting with substances to try and maintain previous momentum. Some people can seemingly do that for years, but for most people it's going to end in a crash at some point.

No. Getting worse with time as well.

I recently decided to double up on my Vyvanse dose (without telling my doctor), and that was effective. For a day.

Reframe and reset your viewpoint. Look at the past five years; What value have you created? What mistakes have you made? What have you learned? Then turn that into a new reason Why you are doing what you’re doing.

See a psychologist or counselor. If you an underlying diagnosis, you could be suffering more than necessary.

1) diagnose, are you burned out or depressed, or adhd etc? Then 2) treat accordingly, concerta and sleep does wonders for me

The gruesome twosome are very helpful, if controversial:

- get enough sleep

- get regular exercise (most days of the week)

Yeah I’ve had that in various forms through my life. I’m now in probably my best state. One thing that helped was switching from vyvanse to concerta. I don’t know why but vyvanse didn’t really help. It just made me hyper focus on anything but work.

Another is starting a new job. I don’t think I realized how bored or burnt out I was until I left and joined a new company.

Other than that all the basics: sleep, food, and exercise.

But it’s hard when it gets bad. The only other advice is have a good therapist and psychiatrist that you trust.

Unfortunately, it will likely require hard work on your part rather than relying on pills. One thing that's worked for me is therapy focusing on Acceptance and Commitment Therapy (ACT). Essentially, you identify your goals and values, and then reframe your thinking to question whether what you're doing aligns with those goals and values.

Depending on what you struggle with, try batching tasks. I used to have a long list of things to remember to do regularly (wash up, clear the bench, put the kids' toys away, etc.), and I would often ignore it because it became annoying. All I did was change it to a plain note that I can look at and see if the task was completed, and eventually those tasks became a habit.

I did about 10 years ago but unless my underlying cause was the same as yours I'm not sure it will help.

Anti depressants and vyvanse? Do you have adhd or are you depressed or both? I don't have adhd and mine was caused by depression and life circumstance at the time.

“ Have tried a ton of antidepressants and vyvanse, nothing's worked.”

Could just as easily make it worse. I had gone on a lower dose of an antidepressant and had exactly this problem. I had to go on medical leave until I could get back on my previous dose and stabilize.

Sleep and exercise, especially cardio, are all that worked. The drugs interrupt sleep. They can easily hurt more than help.

No advice, I just hope you find your way, whatever that may be, to make life work for you. I am sorry you are struggling.

Get your blood work done, just to be sure there isn't some physiological issue, like chronic inflammation.

Don't expect any miracles from meds.

Diet, exercise, sleep.

Find things to look forward to.

Take it one day at a time.

Perhaps it's not a success story, but I have a definite improvement story.

I find accepting and making peace with my problems (paradoxically) helps improve the problem.

I am going through a particularly low dip right now. I haven't done any work in the last 4 days. I tried a 4 minute pomodoro timer yesterday and 2 minutes in I was already completely off task.

In the past I would panic, worry, think "Why me and my terrible executive function?" or "What if I can never do anything again ever". Instead I am accepting that this is the issue I have and keeping a curious, open mind to possible solutions. I'm trying out taking longer breaks, changing up my workspace, body doubling, nutrition, timers, not trying to do anything etc.

I'm sure it will swing back the other way in its own time.

Of course I would love to be able to be consistently able to work, but that is not a reality for me. In the same way I would love to be able to run 100m in 9.6 seconds but that is also just not realistic.

Other comments here are good too: eat well, sleep enough, exercise regularly. This is a good baseline to have but these things alone never fixed my issues.

My technique is to go for guaranteed wins no matter how small. Open one email without demanding I do anything else. Hit the heavy bag once instead of planning for 15 minutes. Give my son a sandwich for dinner instead of the ideal four course meal.

Had these sorts of issues all my life, I'm pretty sure most people do to a greater or lesser extent.

Life asks a fuck of a lot of us. More as we age, but more as the world changes.

On a good day, I naturally don't think about it. On a bad day, it's all I can think about. On an average day I've come to accept peaks and troughs.

I can't be running on all cylinders all the time, most people can't.

Mood for me is key. Others have mentioned sleep, exercise and diet, the holy trinity.

Alcohol is guaranteed to mess me up and I generally avoid it these days. Time outside without the phone is also magnificent, I might do that now.

Don't beat yourself up.