11 articles
Ferritin is the lab I check before changing an ADHD medication dose. Low ferritin impairs the dopamine synthesis pathway that ADHD medications depend on. At levels below 50 ng/mL, stimulant medication can work less effectively — or iron deficiency alone can produce an ADHD-like clinical picture.
Founders drink more than the standard clinical intake captures. Patients describe alcohol reliably reducing anxiety, and reliably feeling worse afterward. The cycle is slow enough to miss and fast enough to maintain psychiatric symptoms indefinitely.
Cannabis for anxiety and sleep is common in San Francisco's founder and tech community. The clinical picture often shows the opposite of what patients expect: worsened REM sleep, increased baseline anxiety, and attention problems that look like ADHD medication failure.
Brain mapping and neurofeedback have reached San Francisco's optimization market. The question I want answered before any of it starts: has the standard differential been done, or did the patient jump straight to brainwave training because that is what was sold to them?
Stimulants plus caffeine plus GLP-1 appetite suppression plus high workload is a very San Francisco pattern. When the stack collides with under-eating, the result looks like medication failure but the medication is not the problem.
Sleep debt can wear an ADHD costume convincingly enough to fool a clinician. Before treating distractibility, working memory gaps, and task-initiation problems as ADHD, sleep duration, sleep quality, and sleep apnea need to be in the room.
"My ADHD medication stopped working" is not one problem. Before escalating dose, the differential includes sleep debt, nutrition, caffeine load, blood pressure, and whether the original diagnosis was complete.
ADHD does not begin at 48, but perimenopause can make compensated ADHD impossible to ignore.
A founder can look productive and still be clinically deteriorating. Burnout, ADHD, sleep debt, stimulant load, low ferritin, thyroid disease, and mood disorders can all collapse focus in different ways.
ADHD in women can look like anxiety, perfectionism, burnout, cycle-related brain fog, and emotional exhaustion. The diagnosis gets missed when clinicians only look for the stereotype.
Many adults confuse ADHD symptoms with burnout because both involve exhaustion, focus struggles, and low motivation. This post breaks down the daily patterns, subtle differences, and recovery strategies to help you tell them apart, and know when to seek support.
