There is a discord channel that has rooms you can join to study with others, including rooms with camera/screen share. It also tracks your time studied, has channels to talk about progress/goals etc. https://discord.gg/study
Is it proven method? If so, insurance should cover it so you don't have to pay subscription fees out of your pocket. If not, don't bother. There are thousands of services like this, and I have not heard any one of them that worked for the vast majority of people with ADHD.
Is this a legal term? Is there any real qualification, proven behind this? Or is it like in Germany, where anyone could call themself a "credentialed coach" and "help" other people.
Because professional help from a therapist would surely be called such, wouldn't it?
Especially from a platform that allows racist hatred onto their comment section.
The 2 credentialing bodies we hire from are International Coaching Federation (ICF) and National Board Health & Wellness Coaches (NBC-HWC).
But yes, anyone can call themselves a coach. They would not be credentialed though.
That's one of the challenges I personally felt when I was looking for a coach when I was diagnosed and couldn't really figure out what was legit and what wasn't. That's part of the mission behind Shimmer too, so that members know that if they come to Shimmer, they're getting a qualified coach who has went through a robust screening process, and undergo ongoing supervision, training, and community! Actually only 3.7% of qualified coaches who apply actually get through our 4-step process.
I'd love a "slimmed down" version of this since the UI looks really clean and usable. I don't need the coaches, and having an ongoing jump in/out session would be cool. Is something like that available or on the roadmap?
This is something that gets asked a lot. We're exploring what it would look like to have only body doubling and our other asynchronous features pulled out as a separate experience. Some things we're thinking through are
- What impact this will have on the current body doubling experience, where there's a certain "vibe" knowing that every other person in the room is actively engaging in coaching and you can ask them questions about their coaching etc.
- How that will change our team's focus since that product will require larger amounts of moderation, community management, and other tasks that we aren't currently focusing on. Since we're a small team (and mostly neurodivergent), we need to make sure we're super focused in our messaging and efforts
HOWEVER, it is definitely in the medium term roadmap. I think if we get enough people asking for it, it could get pulled forward.
Curious what you use now and what you like/ don't like about it — are you on other body doubling platforms?
Yes, exactly! You can do body doubling in so many different ways. In real life you can do coffee shops, libraries, having friends over to study/work, or even just calling your mom while you do dishes. These are all technically body doubling. Online there are also options that all have slightly different styles. Key is finding what works for you. For example, focusmate is 1:1 where you meet up with a stranger and what's cool about that service is that you can log on pretty much any time of the day and find someone to work with. There are also tons of communities and creators who will host body doubling as a part of whatever else they're doing!
We think a lot about how to structure our privacy policies so that it's not overwhelming, and is understandable.
In instances where it makes sense, we explicitly put the opt-in privacy choices right when that choice is necessary. For example, members have to opt-in (and coaches... double-opt in) before every single session if they want a summary to be generated after the call. We chose this route even though many of our members who opt in every time have given us the feedback that they wish they could just opt in once and never opt in again.
If you have an ADHD problem get a licensed therapist, get medication, get into a group, read about and study your condition and do sports. I.e. solutions are IRL.
Yeah it’s going to be way more expensive, but the solution to a medical condition is not some slick-UI $140/month gaslight snake-oil “coach” BS.
My question is why anyone but a few people would want to pay $140-$340/mo for a therapy-based approach not covered by insurance to a condition that is successfully treated in the vast majority of patients with medication that costs $10-20/mo with insurance?
It is a very cool approach to a well documented and tested therapeutic practice, I just don't see the value proposition unless you're someone that specifically could not find any class of medication that worked for them.
Medication has side effects, and it can be really difficult to access unless you can find a psychiatrist who is accepting of the idea that an adult has ADD/ADHD. I knew someone who tried to get it as an adult and she spent 3 years going between therapists and psychiatrists to build up enough history to be prescribed medication.
I am eternally grateful that a friend turned me on to a local doctor who does video calls[0]. I'd struggled with getting in to see someone willing to take my complaints seriously[1], but a week after signing up for an online visit I had a prescription for something that's been life-changing.
For me, personally, the whole effect of the meds are that I'm slightly more awake, as though I drank a cup of stout coffee, and I can more easily decide what to work on and then work on it. I'm fortunate to have had zero adverse reactions.
[0]And then, knowing their clientele, texts and emails the heck out of me to remind me about upcoming appointments, which isn't strictly necessary but is understandable and appreciated.
[1]One doc told me I had trouble focusing because of anxiety. "Do you know what you might be anxious about?" "Yeah, not being able to focus." That wasn't a productive visit.
Yeah, so many people have horror stories with medication, especially with the shortage going on right now and need immediate support. I've personally been impacted by the medication shortage, and many of our members.
My N=1 experience has been remarkable success with medication. Of course, it does require some work and time to find the right med(s) and dosing. Also, the shortage was previously a problem in my very large HMO but early this year it started getting better and by about 5-6 months ago supply has returned to normal.
I’m skeptical of the pricing, but I could see it having value for working professionals or students who are at risk of failing out and don’t have good support on campus.
I personally have ADHD, and I’m medicated. The medication makes it possible to focus on tasks, not guaranteed. I still have to engage cognitive skills and essentially implement a system similar to this, just without a coach. Specifically: break down tasks, use a Pomodoro timer, walk and make tea between focus sessions, put the phone away, use environmental cues like specific work music, etc.
Sleep and exercise are also incredibly important for success with ADHD, and the stimulant medications can interfere with both, so I could see coaching being useful there as well, not sure if the service offers help there.
I don't want to respond to the top comment so it doesn't look attackish, but expecting the medication to completely cure the symptoms for everyone is laughably wrong.
I've got decades of learned behaviors to deal with. And while my doctor was correct in that a medication that works will be like night and day (I'd rephrase it as life changing), I still struggle more than I like.
100%. Medication is one piece of the pie for many people but definitely not the whole for most. Thanks for sharing a piece of your ADHD story though, I think more people need to hear stories like ours (and others) so that they don't feel discouraged if they try ADHD meds and it doesn't act as a magic pill as they expected. This expectation is dangerous.
Love what you said about sleep and exercise. In the Shimmer app, we call this "Lifestyle Medicine" but it's basically the foundational pieces of your life that keeps your body running as it should. And this should 100% be considered before more complex treatments. For us we include sleep, exercise, and food/nutrition.
That's awesome that you have a whole bunch of skills that you've found that works for you! For some people, this takes months to figure out the right mix since what works for someone may not work for others. And also, HOW you do something is almost more important than WHAT skill you're using. I would also add that in coaching, in addition to skills, the coach is supporting in long-term thinking, goal setting, so that there's a direction forward as well, which is really important. I like the quote "medication is like glasses, it helps you see more clearer but it doesn't teach you how to read". I think about this quote a lot because for me, the value of coaching has been to help me set a new direction in life, be reflective in what I want, then work to build an ADHD-friendly life around me that helps me go in that direction.
Totally hear you on pricing. We're working on a few routes around reimbursement, partnerships with schools/workplaces, etc. Right now we are HSA/FSA eligible and also many of our members get it paid for through their work's L&D budget or disability/DEI budgets. Of course, that's a bit harder because it requires them to disclose. We also do a whole ton of scholarships for anyone with a financial need!
Coaching is different from talk therapy in that it's focused on more action-oriented, future-oriented concerns. For example, in therapy, you'll talk about WHY / WHERE a specific thought process came from, vs. in therapy you'll talk about how you can design your life in a way that minimizes impact of this thought process. Things like calendar design, routine design, how you do to do lists, skills you may need to learn, the list goes on. These are things that ADHD coaches are trained on and things that therapists likely won't support with. Also, coaching is about accountability so things like check-ins throughout the week and nudge/reminders are a key part of ADHD coaching but not therapy.
Also many of our clients have done (or are currently doing) therapy and come to Shimmer because their therapist suggested it.
And on your point of medication, many people do not want to take medication (cultural or other reasons), or cannot take medication (e.g. side effects or can't mix with their other meds).
1. Insurance doesn't always cover ADHD medication, and when it does it can be a pain; every time my employer switched insurers I had to change my medication because the new insurer wouldn't cover the same thing the previous insurer covered. I've never had insurance cover my psychiatrist either, which amortizes out to about $100/mo.
2. Stimulant medication improves symptoms for over 80% of people with ADHD but "normalizes" about 1/3. So If you are in the 2/3 people that still have some ADHD symptoms on medication, then you're still going to have to cultivate healthy coping mechanisms.
3. Sometimes you go on a trip and forget to bring your medication, or you forget to bring the monthly prescription into the pharmacy on time (no refills on Schedule II substances), or your pharm is out of your meds. Now you are temporarily unmedicated and still need to function.
Regarding #1: my insurance pays for 100% of my meds. It seems like the extended release versions are the hardest to get covered, but people who can get by with the plain old all-at-one formulations may have a much easier time with that. Also, insurance doesn't pay for my doctor directly, but their website has a place for me to submit out of network claims. I do that with my doctor's receipts and insurance cuts me a reimbursement check for a large portion of the bill.
It's a pain in the neck in the sense that getting all the insurance stuff straight is extra hard when you're in need of being treated for ADHD in the first place. It does give me something to hyperfocus on every couple of months.
My insurance also covers my meds but there's still a million things that end up getting in the way of me actually getting it. I won't get into the details but things like working memory with appointments, booking the right appointments, getting vitals, the med shortage and navigating calling different pharmacies, and much more. I have a lot of horror stories (that are mainly my fault and due to my ADHD) and similar stories from our members/community.
It's great that you've got it largely down though!
Personally, I like to know that I have a foundation (and a person) to fall back on when all the med stuff doesn't pan out the way I want it to (which is unfortunately frequently), and a big part of the value of coaching & body doubling too is community and not going through this alone.
I hear ya. It's a cruel situation. I've likened it to building an asthma clinic on top of a mountain: if I could jump through all these hoops, I probably wouldn't need the help in the first place.
I absolutely, 100%, completely agree that the medicine is only a small part of it. I have a hundred little rituals and coping mechanisms that had let me manage my life without it. Small examples:
- Appointments go straight to my calendar the instant I schedule something. If something's not on my calendar, it doesn't exist. I make liberal use of early reminders, too.
- I'm not a GTD purist, but I track it pretty closely. When I say I'll do something, I put it in my inbox. Same as with my calendar: if a to-do isn't in my to-do app, it's not getting to-done. There's nothing I've committed to that isn't in one of those 2 places.
There are plenty of others that I've been doing so long that they're unconscious habit.
These are the things that work for me. If the things you talk about work for you, and other people are willing to pay you to help get them on track, excellent!
I have heard ahem that you could get 30 pills that were each an entire day's dose, cut them in half, and take them as 60 separate doses. For example, you and the doc think you should take 10mg in the morning and 10mg at lunch, so get a prescription for 30 20mg pills and buy a pill chopper.
When I was tapering off a capsule med, I used to pull the two halves of the capsule apart, pour out a bit of the powder, and plug the halves back together. Not amazingly accurate I admit. But it shows that it's not impossible to disassemble and manipulate at least some kinds of capsule, tedious though it is to do.
Last time I tried that, I had to vacuum the stuff from the floor. Turns out some CR capsules are filled with a lot of tiny little frictionless spherical pellets instead of powder.
1. Agree, and to add in all the steps it takes to actually get meds consistently (not a 1-time solve) + the med shortage that a lot of people have been impacted by
2. Yes and some of our members can't take stimulant medication because of other conditions they have that require meds that don't mix with stimulants
3. Yup!
I totally agree with you, and find the price a big turn off. I pay $30 a month for my meds, this I’m sure would help but no way could I justify the expense.
I don't think medication "treats" ADHD in the sense of solving it completely. For one thing, we're living through an Adderal shortage, for another it doesn't last all day, and, most importantly, it isn't a cure-all, especially at the low dosages required for responsible long term use. As another commenter rightfully said, the downsides are also significant, especially in terms of exhaustion -- headaches are also a commonly reported one for methamphetamine.
It's a lifesaver, but it's kinda like Ozempic: it enables you to follow through on your self-improvement goals, it doesn't do them for you.
Also, some people don't have health insurance. We do exist, sadly -- 25 million of us, as of 2023: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/... Typically, a diagnosis/new psych appointment costs $250-350 OOP, and the monthly checkups cost anywhere from $100-200 (unless you can find someone willing to break the rules for you and prescribe without 30d checkins). The baffling coupon system does mean that the refills themselves are cheap, somehow, but I've paid $60 before just because the coupon wasn't working and I couldn't be bothered to go home and figure it out and go without meds for X days.
Of course that all becomes easier if you're willing to stick with non-controlled substances, but still
Guanfacine and clonidine are two non-controlled meds approved for ADHD. They are second line treatments; all the first line treatments are stimulants, because they have the best evidence behind them.
Yeah, medication does not solve ADHD at all. Medication is like glasses, it gives you the ability to see clearer (focus, etc.) but doesn't teach you how to read or give you direction.
A lot of our members come to Shimmer after getting a diagnosis and the right dose of medication, or even with a therapist. And from that more calm, ready place, can they engage in the thought processes around planning for the future, building skills, etc.
Some really great discussion going on in the replies here but this is where you’ve lost the plot.
For millions of people, medication does in fact solve ADHD. Making misrepresentative blanket statements about the efficacy of medical treatment to promote your product as more necessary is not okay.
If you are looking to have your program eventually treated as a covered therapy under insurance, this kind of messaging can really hurt you.
Sorry, maybe I should have reworded. I meant to say "medication does not solve all of ADHD", "medication does not solve ADHD for all". Hm, still thinking of the right wording.
I use medication myself, so by no means am I anti-medication.
I think the point I'm trying to make is that it's not a magic pill. And there are side effects as well. If you can layer in foundational lifestyle medicine and good, healthy choices, that makes the world of difference and can potentially allow you to take less medication.
The reason I say this is because we get SO many people who come to us feeling dejected that they put all their hope on medication and when their life didn't immediately get to where they'd like, they felt like there was no hope, like there is no other alternative.
I don't need people to use Shimmer, I just want people to know there's hope if your meds don't work, and there are other solutions beyond meds. This could be therapy, coaching, self-management, and other tools!
Ah, yes, thank you for pointing that out. Sorry OP, I thought you charged for every session like a normal therapist, but you charge for every 4.3 sessions. I’m deleting my comment to avoid false disparagement. This is a much more reasonable price. The imputed annual ‘salary’ is $260,465, which makes sense, given the cost of running a business and the development of the platform.
Here’s a thought: Outsiders can approximate your cash flow by scraping the number of unique therapists and calculating their hours worked by analyzing their availability windows. Something worth thinking about, I suppose.
I didn't see the original post, but yes we charge per month which is just over 4 sessions. The price also includes all of our events, body doubling, learning modules, and task list tools (in other apps these other features in itself cost $40+/mo., and events require maintenance as well).
Yes, agreed. People can probably back into our cash flow, but we have been pretty transparent at each funding round anyway. Not trying to hide anything!
I only shared this video with Hacker News today, so the comments are from this community. I just signed up for Tella today also, and they aren't allowing me to disable it or delete comments self-serve. I've contacted their support so hopefully I can hear back soon and disable it!
> One problem we discovered while running 1:1 coaching is that people weren’t able to actually follow through (in real life) on the ideas they came up with during their weekly sessions with their coach.
Really?
No, you did not discover this, it's quite predictable.
> since ADHD coaching is not reimbursed in the US, the price is hard for us to bring down because the largest cost component is the coach’s compensation.
Yeah, body doubling doesn't scale. The whole need for another human body thing is a real hurdle, huh?
> we’d love for you to check out coaching & body doubling and give us critical feedback.
Too much text with numbers too big. I already utilize body doubling the analog way, you've told me absolutely nothing about what on earth you're adding to the equation.
> No, you did not discover this, it's quite predictable.
Maybe I should have specified: We discovered this for a subset of our users and wanted to help solve that problem
> Yeah, body doubling doesn't scale. The whole need for another human body thing is a real hurdle, huh?
I'm referring to ADHD coaching that is not reimburseable yet. Though some types of coaching like health & wellness coaching and mental health coaching already are, and weren't in the past. So there is precedent and potential path to reimbursement by health insurance. I didn't mean scaling the human body
> Too much text with numbers too big. I already utilize body doubling the analog way, you've told me absolutely nothing about what on earth you're adding to the equation.
I'm glad analog way works for you! Finding the strategies/methods that work for you is key.
Unfortunately that doesn't work for everyone, especially our members. Many of them want to body double with other ADHD-ers but don't want to tell the people in their life about their ADHD. Others also just want an online hosted space because it's too much effort to organize these themselves and want a consistent, reliable space where they're not the one organizing. A whole bunch of other reasons!
The potential value in this is immense. You wouldn't experience success from some $40 course. Thank you for making helpful experts and tools accessible!
A tweet from them in 2022 says Shimmer partnered with them, you even follow them personally on Twitter (and their company on Instagram) so does Shimmer's Twitter account and both of your companies also follow each other on Instagram and Twitter.
And Shimmer has a blog post that mentions both them and their company as "partners".
There is a discord channel that has rooms you can join to study with others, including rooms with camera/screen share. It also tracks your time studied, has channels to talk about progress/goals etc. https://discord.gg/study
Nice, thanks for the share!!
Is it proven method? If so, insurance should cover it so you don't have to pay subscription fees out of your pocket. If not, don't bother. There are thousands of services like this, and I have not heard any one of them that worked for the vast majority of people with ADHD.
> credentialed coach
Is this a legal term? Is there any real qualification, proven behind this? Or is it like in Germany, where anyone could call themself a "credentialed coach" and "help" other people.
Because professional help from a therapist would surely be called such, wouldn't it?
Especially from a platform that allows racist hatred onto their comment section.
The 2 credentialing bodies we hire from are International Coaching Federation (ICF) and National Board Health & Wellness Coaches (NBC-HWC).
But yes, anyone can call themselves a coach. They would not be credentialed though.
That's one of the challenges I personally felt when I was looking for a coach when I was diagnosed and couldn't really figure out what was legit and what wasn't. That's part of the mission behind Shimmer too, so that members know that if they come to Shimmer, they're getting a qualified coach who has went through a robust screening process, and undergo ongoing supervision, training, and community! Actually only 3.7% of qualified coaches who apply actually get through our 4-step process.
I'd love a "slimmed down" version of this since the UI looks really clean and usable. I don't need the coaches, and having an ongoing jump in/out session would be cool. Is something like that available or on the roadmap?
This is something that gets asked a lot. We're exploring what it would look like to have only body doubling and our other asynchronous features pulled out as a separate experience. Some things we're thinking through are
- What impact this will have on the current body doubling experience, where there's a certain "vibe" knowing that every other person in the room is actively engaging in coaching and you can ask them questions about their coaching etc.
- How that will change our team's focus since that product will require larger amounts of moderation, community management, and other tasks that we aren't currently focusing on. Since we're a small team (and mostly neurodivergent), we need to make sure we're super focused in our messaging and efforts
HOWEVER, it is definitely in the medium term roadmap. I think if we get enough people asking for it, it could get pulled forward.
Curious what you use now and what you like/ don't like about it — are you on other body doubling platforms?
A little up the thread somebody linked a discord server that seems aimed at that kind of idea.
Shimmer, body doubling - inspired by the film Annihilation ?
https://www.youtube.com/watch?v=Gi3K-CApAS4
I suspect twitch is a pseudo form of whatever this is, also, coffee shops
Yes, exactly! You can do body doubling in so many different ways. In real life you can do coffee shops, libraries, having friends over to study/work, or even just calling your mom while you do dishes. These are all technically body doubling. Online there are also options that all have slightly different styles. Key is finding what works for you. For example, focusmate is 1:1 where you meet up with a stranger and what's cool about that service is that you can log on pretty much any time of the day and find someone to work with. There are also tons of communities and creators who will host body doubling as a part of whatever else they're doing!
I actually like this Idea.
Thanks! Let us know if you have feedback if/when you give it a try. Here to answer any questions!
Hello, have you considered switching to opt-in privacy choices? Not all ADHD persons will read the privacy policy, and yours is a doozy.
We think a lot about how to structure our privacy policies so that it's not overwhelming, and is understandable.
In instances where it makes sense, we explicitly put the opt-in privacy choices right when that choice is necessary. For example, members have to opt-in (and coaches... double-opt in) before every single session if they want a summary to be generated after the call. We chose this route even though many of our members who opt in every time have given us the feedback that they wish they could just opt in once and never opt in again.
These people are back again.
If you have an ADHD problem get a licensed therapist, get medication, get into a group, read about and study your condition and do sports. I.e. solutions are IRL.
Yeah it’s going to be way more expensive, but the solution to a medical condition is not some slick-UI $140/month gaslight snake-oil “coach” BS.
My question is why anyone but a few people would want to pay $140-$340/mo for a therapy-based approach not covered by insurance to a condition that is successfully treated in the vast majority of patients with medication that costs $10-20/mo with insurance?
It is a very cool approach to a well documented and tested therapeutic practice, I just don't see the value proposition unless you're someone that specifically could not find any class of medication that worked for them.
Medication has side effects, and it can be really difficult to access unless you can find a psychiatrist who is accepting of the idea that an adult has ADD/ADHD. I knew someone who tried to get it as an adult and she spent 3 years going between therapists and psychiatrists to build up enough history to be prescribed medication.
I am eternally grateful that a friend turned me on to a local doctor who does video calls[0]. I'd struggled with getting in to see someone willing to take my complaints seriously[1], but a week after signing up for an online visit I had a prescription for something that's been life-changing.
For me, personally, the whole effect of the meds are that I'm slightly more awake, as though I drank a cup of stout coffee, and I can more easily decide what to work on and then work on it. I'm fortunate to have had zero adverse reactions.
[0]And then, knowing their clientele, texts and emails the heck out of me to remind me about upcoming appointments, which isn't strictly necessary but is understandable and appreciated.
[1]One doc told me I had trouble focusing because of anxiety. "Do you know what you might be anxious about?" "Yeah, not being able to focus." That wasn't a productive visit.
Yeah, so many people have horror stories with medication, especially with the shortage going on right now and need immediate support. I've personally been impacted by the medication shortage, and many of our members.
My N=1 experience has been remarkable success with medication. Of course, it does require some work and time to find the right med(s) and dosing. Also, the shortage was previously a problem in my very large HMO but early this year it started getting better and by about 5-6 months ago supply has returned to normal.
I’m skeptical of the pricing, but I could see it having value for working professionals or students who are at risk of failing out and don’t have good support on campus.
I personally have ADHD, and I’m medicated. The medication makes it possible to focus on tasks, not guaranteed. I still have to engage cognitive skills and essentially implement a system similar to this, just without a coach. Specifically: break down tasks, use a Pomodoro timer, walk and make tea between focus sessions, put the phone away, use environmental cues like specific work music, etc.
Sleep and exercise are also incredibly important for success with ADHD, and the stimulant medications can interfere with both, so I could see coaching being useful there as well, not sure if the service offers help there.
I don't want to respond to the top comment so it doesn't look attackish, but expecting the medication to completely cure the symptoms for everyone is laughably wrong.
I've got decades of learned behaviors to deal with. And while my doctor was correct in that a medication that works will be like night and day (I'd rephrase it as life changing), I still struggle more than I like.
100%. Medication is one piece of the pie for many people but definitely not the whole for most. Thanks for sharing a piece of your ADHD story though, I think more people need to hear stories like ours (and others) so that they don't feel discouraged if they try ADHD meds and it doesn't act as a magic pill as they expected. This expectation is dangerous.
Love what you said about sleep and exercise. In the Shimmer app, we call this "Lifestyle Medicine" but it's basically the foundational pieces of your life that keeps your body running as it should. And this should 100% be considered before more complex treatments. For us we include sleep, exercise, and food/nutrition.
That's awesome that you have a whole bunch of skills that you've found that works for you! For some people, this takes months to figure out the right mix since what works for someone may not work for others. And also, HOW you do something is almost more important than WHAT skill you're using. I would also add that in coaching, in addition to skills, the coach is supporting in long-term thinking, goal setting, so that there's a direction forward as well, which is really important. I like the quote "medication is like glasses, it helps you see more clearer but it doesn't teach you how to read". I think about this quote a lot because for me, the value of coaching has been to help me set a new direction in life, be reflective in what I want, then work to build an ADHD-friendly life around me that helps me go in that direction.
Totally hear you on pricing. We're working on a few routes around reimbursement, partnerships with schools/workplaces, etc. Right now we are HSA/FSA eligible and also many of our members get it paid for through their work's L&D budget or disability/DEI budgets. Of course, that's a bit harder because it requires them to disclose. We also do a whole ton of scholarships for anyone with a financial need!
Coaching is different from talk therapy in that it's focused on more action-oriented, future-oriented concerns. For example, in therapy, you'll talk about WHY / WHERE a specific thought process came from, vs. in therapy you'll talk about how you can design your life in a way that minimizes impact of this thought process. Things like calendar design, routine design, how you do to do lists, skills you may need to learn, the list goes on. These are things that ADHD coaches are trained on and things that therapists likely won't support with. Also, coaching is about accountability so things like check-ins throughout the week and nudge/reminders are a key part of ADHD coaching but not therapy.
Also many of our clients have done (or are currently doing) therapy and come to Shimmer because their therapist suggested it.
And on your point of medication, many people do not want to take medication (cultural or other reasons), or cannot take medication (e.g. side effects or can't mix with their other meds).
I'm not a Shimmer user, but a few things:
1. Insurance doesn't always cover ADHD medication, and when it does it can be a pain; every time my employer switched insurers I had to change my medication because the new insurer wouldn't cover the same thing the previous insurer covered. I've never had insurance cover my psychiatrist either, which amortizes out to about $100/mo.
2. Stimulant medication improves symptoms for over 80% of people with ADHD but "normalizes" about 1/3. So If you are in the 2/3 people that still have some ADHD symptoms on medication, then you're still going to have to cultivate healthy coping mechanisms.
3. Sometimes you go on a trip and forget to bring your medication, or you forget to bring the monthly prescription into the pharmacy on time (no refills on Schedule II substances), or your pharm is out of your meds. Now you are temporarily unmedicated and still need to function.
Regarding #1: my insurance pays for 100% of my meds. It seems like the extended release versions are the hardest to get covered, but people who can get by with the plain old all-at-one formulations may have a much easier time with that. Also, insurance doesn't pay for my doctor directly, but their website has a place for me to submit out of network claims. I do that with my doctor's receipts and insurance cuts me a reimbursement check for a large portion of the bill.
It's a pain in the neck in the sense that getting all the insurance stuff straight is extra hard when you're in need of being treated for ADHD in the first place. It does give me something to hyperfocus on every couple of months.
My insurance also covers my meds but there's still a million things that end up getting in the way of me actually getting it. I won't get into the details but things like working memory with appointments, booking the right appointments, getting vitals, the med shortage and navigating calling different pharmacies, and much more. I have a lot of horror stories (that are mainly my fault and due to my ADHD) and similar stories from our members/community.
It's great that you've got it largely down though!
Personally, I like to know that I have a foundation (and a person) to fall back on when all the med stuff doesn't pan out the way I want it to (which is unfortunately frequently), and a big part of the value of coaching & body doubling too is community and not going through this alone.
I hear ya. It's a cruel situation. I've likened it to building an asthma clinic on top of a mountain: if I could jump through all these hoops, I probably wouldn't need the help in the first place.
I absolutely, 100%, completely agree that the medicine is only a small part of it. I have a hundred little rituals and coping mechanisms that had let me manage my life without it. Small examples:
- Appointments go straight to my calendar the instant I schedule something. If something's not on my calendar, it doesn't exist. I make liberal use of early reminders, too.
- I'm not a GTD purist, but I track it pretty closely. When I say I'll do something, I put it in my inbox. Same as with my calendar: if a to-do isn't in my to-do app, it's not getting to-done. There's nothing I've committed to that isn't in one of those 2 places.
There are plenty of others that I've been doing so long that they're unconscious habit.
These are the things that work for me. If the things you talk about work for you, and other people are willing to pay you to help get them on track, excellent!
Extended release was hard with some, but I had one insurer that would only pay for 1 pill per day, so I had to use ER with them.
I have heard ahem that you could get 30 pills that were each an entire day's dose, cut them in half, and take them as 60 separate doses. For example, you and the doc think you should take 10mg in the morning and 10mg at lunch, so get a prescription for 30 20mg pills and buy a pill chopper.
Purely rumor, I'm sure.
That would work if the pharmacy reliably provided tablets rather than capsules.
When I was tapering off a capsule med, I used to pull the two halves of the capsule apart, pour out a bit of the powder, and plug the halves back together. Not amazingly accurate I admit. But it shows that it's not impossible to disassemble and manipulate at least some kinds of capsule, tedious though it is to do.
Last time I tried that, I had to vacuum the stuff from the floor. Turns out some CR capsules are filled with a lot of tiny little frictionless spherical pellets instead of powder.
1. Agree, and to add in all the steps it takes to actually get meds consistently (not a 1-time solve) + the med shortage that a lot of people have been impacted by 2. Yes and some of our members can't take stimulant medication because of other conditions they have that require meds that don't mix with stimulants 3. Yup!
I totally agree with you, and find the price a big turn off. I pay $30 a month for my meds, this I’m sure would help but no way could I justify the expense.
I don't think medication "treats" ADHD in the sense of solving it completely. For one thing, we're living through an Adderal shortage, for another it doesn't last all day, and, most importantly, it isn't a cure-all, especially at the low dosages required for responsible long term use. As another commenter rightfully said, the downsides are also significant, especially in terms of exhaustion -- headaches are also a commonly reported one for methamphetamine.
It's a lifesaver, but it's kinda like Ozempic: it enables you to follow through on your self-improvement goals, it doesn't do them for you.
Also, some people don't have health insurance. We do exist, sadly -- 25 million of us, as of 2023: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/... Typically, a diagnosis/new psych appointment costs $250-350 OOP, and the monthly checkups cost anywhere from $100-200 (unless you can find someone willing to break the rules for you and prescribe without 30d checkins). The baffling coupon system does mean that the refills themselves are cheap, somehow, but I've paid $60 before just because the coupon wasn't working and I couldn't be bothered to go home and figure it out and go without meds for X days.
Of course that all becomes easier if you're willing to stick with non-controlled substances, but still
>non-controlled substances
Could you elaborate? The ones I know of are St. John's Wort(though that's more for depressive symptoms) and Phenylpiracetam.
Strattera and Intuniv are ADHD medicines that are not controlled substances.
Do not take St. John's Wort! That's got all kinds of side effects.
Guanfacine and clonidine are two non-controlled meds approved for ADHD. They are second line treatments; all the first line treatments are stimulants, because they have the best evidence behind them.
The stimulants also have fewer and simpler side effects. But they don't work 24/7, At least not if you want to sleep.
Yeah, medication does not solve ADHD at all. Medication is like glasses, it gives you the ability to see clearer (focus, etc.) but doesn't teach you how to read or give you direction.
A lot of our members come to Shimmer after getting a diagnosis and the right dose of medication, or even with a therapist. And from that more calm, ready place, can they engage in the thought processes around planning for the future, building skills, etc.
> Yeah, medication does not solve ADHD at all.
Some really great discussion going on in the replies here but this is where you’ve lost the plot.
For millions of people, medication does in fact solve ADHD. Making misrepresentative blanket statements about the efficacy of medical treatment to promote your product as more necessary is not okay.
If you are looking to have your program eventually treated as a covered therapy under insurance, this kind of messaging can really hurt you.
Sorry, maybe I should have reworded. I meant to say "medication does not solve all of ADHD", "medication does not solve ADHD for all". Hm, still thinking of the right wording.
I use medication myself, so by no means am I anti-medication.
I think the point I'm trying to make is that it's not a magic pill. And there are side effects as well. If you can layer in foundational lifestyle medicine and good, healthy choices, that makes the world of difference and can potentially allow you to take less medication.
The reason I say this is because we get SO many people who come to us feeling dejected that they put all their hope on medication and when their life didn't immediately get to where they'd like, they felt like there was no hope, like there is no other alternative.
I don't need people to use Shimmer, I just want people to know there's hope if your meds don't work, and there are other solutions beyond meds. This could be therapy, coaching, self-management, and other tools!
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There are 4.3 weeks per month, so you are off by a factor of 4.3
i.e. you get a little over 1 hour of 1:1 coach time per month for the 15 minute weekly sessions.
[edit] I originally wrote 4.3 weeks per year which is wrong.
Ah, yes, thank you for pointing that out. Sorry OP, I thought you charged for every session like a normal therapist, but you charge for every 4.3 sessions. I’m deleting my comment to avoid false disparagement. This is a much more reasonable price. The imputed annual ‘salary’ is $260,465, which makes sense, given the cost of running a business and the development of the platform.
Here’s a thought: Outsiders can approximate your cash flow by scraping the number of unique therapists and calculating their hours worked by analyzing their availability windows. Something worth thinking about, I suppose.
I didn't see the original post, but yes we charge per month which is just over 4 sessions. The price also includes all of our events, body doubling, learning modules, and task list tools (in other apps these other features in itself cost $40+/mo., and events require maintenance as well).
Yes, agreed. People can probably back into our cash flow, but we have been pretty transparent at each funding round anyway. Not trying to hide anything!
Why on earth do you have an open comments section on your landing page? One that is currently being deluged with racist and abusive messages no less?
I only shared this video with Hacker News today, so the comments are from this community. I just signed up for Tella today also, and they aren't allowing me to disable it or delete comments self-serve. I've contacted their support so hopefully I can hear back soon and disable it!
Why reinvent the wheel with something as glitchy as Tella!? Just post it on YouTube!!!!
I really wanted the Zoom feature, but maybe it wasn't worth it.
A better question might be why some people on HN think this is an acceptable way to behave.
Agree
Update, it's off now. Thanks for the flag!
> One problem we discovered while running 1:1 coaching is that people weren’t able to actually follow through (in real life) on the ideas they came up with during their weekly sessions with their coach.
Really?
No, you did not discover this, it's quite predictable.
> since ADHD coaching is not reimbursed in the US, the price is hard for us to bring down because the largest cost component is the coach’s compensation.
Yeah, body doubling doesn't scale. The whole need for another human body thing is a real hurdle, huh?
> we’d love for you to check out coaching & body doubling and give us critical feedback.
Too much text with numbers too big. I already utilize body doubling the analog way, you've told me absolutely nothing about what on earth you're adding to the equation.
> No, you did not discover this, it's quite predictable.
Maybe I should have specified: We discovered this for a subset of our users and wanted to help solve that problem
> Yeah, body doubling doesn't scale. The whole need for another human body thing is a real hurdle, huh?
I'm referring to ADHD coaching that is not reimburseable yet. Though some types of coaching like health & wellness coaching and mental health coaching already are, and weren't in the past. So there is precedent and potential path to reimbursement by health insurance. I didn't mean scaling the human body
> Too much text with numbers too big. I already utilize body doubling the analog way, you've told me absolutely nothing about what on earth you're adding to the equation.
I'm glad analog way works for you! Finding the strategies/methods that work for you is key.
Unfortunately that doesn't work for everyone, especially our members. Many of them want to body double with other ADHD-ers but don't want to tell the people in their life about their ADHD. Others also just want an online hosted space because it's too much effort to organize these themselves and want a consistent, reliable space where they're not the one organizing. A whole bunch of other reasons!
The potential value in this is immense. You wouldn't experience success from some $40 course. Thank you for making helpful experts and tools accessible!
Yes! ADHD is not a problem of knowing, it's a problem of doing. It's important to find the right support and strategies to actually get things done.
(This person is associated with Shimmer)
Why do you say this? I recognize the name, it's someone in the tech community. But they are not associated with Shimmer
A tweet from them in 2022 says Shimmer partnered with them, you even follow them personally on Twitter (and their company on Instagram) so does Shimmer's Twitter account and both of your companies also follow each other on Instagram and Twitter.
And Shimmer has a blog post that mentions both them and their company as "partners".
I'd definitely call that associated...
The tweet for anyone interested: https://x.com/ALiS0NLAURA/status/1580958381288091648
That's a social campaign with a discount code swap. We do that with hundreds of organizations, anyone that are mission-driven.
I thought you meant she worked for us or something like that
No, I didn't comment one way or another. Only referencing the tweet mentioned. I'm aware I'm lacking any context otherwise.
True, good points! I may have misinterpreted the intent of op's comment