Hiya these boards are frustratingly quiet 🤣 I was late dx in my late 30s with inattentive Adhd, now mid 40s and edging toward perimeno.
My psychiatrist told me that some ADs help more with focus and motivation than others. These are vortioxetine, escitalopram and citalopram. Also said there is some scientific evidence that a meditarranean diet helps with symptoms.
Anecdotal experience - (before taking ADHD meds) Sertaline killed my motivation. It only began to work when I took it at exactly the same time every day and instigated an exercise routine at the same time.
In answer to your question. I wasn't on sertraline when I started ADHD meds. I suspect you'd have to come off ADs to start ADHD meds, as not sure you would know what was doing what. A psychiatrist would be best to advice. But best to be prepared for that as a possibility.
Re. titration , a GP cannot do titration, as they are controlled meds, only a psychiatrist can. Before you start have a read on the different types and consider whether you want to start by trying long or short acting meds, and if you have any preferences based on other people's experiences and what side effects you think you'd hate having to tolerate.
Theres so many long acting ones you can try.
One of the biggest movers for me was getting rid of the shame, it feels such a barrier to learning and progress as it always comes back to a faulty negative belief with ADHD (this is my fault, I'm rubbish etc.).
I also needed to have some EMDR therapy to get rid of layers of trauma as I have CPTSD from multiple events. It's so good now being able to see all sides of things more clearly. Feel much less stuck. I try and stay away from too much negativity now.
Re getting fit, losing weight, managing life, I hear you! It's great you recognise you want to carve out more space for health. This in itself is it's own goal and can benefit from coaching.
What worked for me in the past was starting slow, try and cut one thing out, replace it with something else, crowd in healthier food, start with going to something physically active purely for fun, get up to two sessions a week, with ADHD we naturally get curious so just run with that, keep trying new things, gradually hone in on some fitness challenge. I ended up swimming, then doing gym classes, then got a PT.
What has worked for you before? What interests you? Tennis seems like it could be fun and I know lots of people rate it for being good for bone density, social etc. Joining groups can really help I think at the start.
I 1000% have PDA when it comes to exercise! For me there's quite a lot of anxiety (as I have a health condition) plus the voice that goes yeah but you never stuck with the routine last time did you 😂
There's lots of tips and strategies for getting started (make the environment conducive to success, tell someone for accountability, start with what you can do etc.), but also its remembering the negative voice is never fully going to go (we have anxiety to keep us safe). It's the same voice that will say yeah I did one exercise class so now I deserve a treat 🤣 No! Keep going 🤣
Fuelling yourself for exercise - muscles need carbs before and after.
There's lots of positive podcasts about late diagnosis now as well so dipping into them is helpful.
I think there's a balance between dopamine and serotonin that needs to happen, and IMHO its about having challenge and positive social connection.