ADHD medication; A semi-accidental experiment

So I semi-accidentally conducted a bit of an experiment this past weekend, with results that are annoying, but also useful to know (and possibly helpful for others, hence the ridiculously long post)

First, some context (‘cause I can’t help myself)…

2020 was a hell of year, for just about all of us - for ME, one of the side-effects of all that stress was that the coping mechanisms I’ve used pretty much all my life sort of fell apart. Not exactly a good thing, BUT thanks to being connected to a number of folks who had been diagnosed with ADHD as adults, who were sharing their experiences at the time, the stress of 2020 did lead to my ADHD diagnosis in early 2021.

When I was first diagnosed, my Mental Health Practitioner prescribed me low-dose Adderall… that was in January, and at the time, I hadn’t yet decided if I was willing to go the prescription drug route. I had done my research, I knew there were possible side-effects, I knew that some people did not respond well to Adderall, and I knew there were concerns of addiction (or at the least, potentially severe side-effects if you ever stopped taking the medication).

I also had a friend who was VERY well-versed in plant medicine, who’d had personal (though second-hand) experience of successfully treating ADHD with herbal supplements rather than prescription medication. So with their advice in hand, I decided to try a more “natural” approach first.

(Side note: I do NOT generally recommend this route unless you are ABSOLUTELY CERTAIN of the qualifications of the person who’s advice you are taking - even “professional herbalists” can give bad advice if they don’t properly understand what they’re trying to treat. I’ve come across some HORRIBLE advice by so-called “experts” that made it very clear in their discussion of ADHD that they don’t actually know the bio-mechanics of how it works and WHY it presents the way it does, all of which is CRUCIAL for proper treatment)

… unfortunately, even after giving it a solid two months (‘cause I knew that herbal treatment can take a bit of time to build up and “kick in”), I was still struggling with the most basic functions of being human. So I finally made the decision to try the Adderall.

Now, full disclosure, the other reason I had been hesitant to try the Adderall was that I was still scared I might not ACTUALLY have ADHD… the thing about ADHD is that it’s not something you can run tests for - there’s no, “we ran your blood / tested your hypothalamus / screened you for X gene / {whatever}, and you most definitely have ADHD." You have a conversation with a Mental Health Professional who's been trained in the symptoms, they ask a bunch of questions, and then they tell you whether or not you fit the profile.

ADHD was a diagnosis that answered a LOT of questions about my life, and the things I had struggled with... but maybe I really was just bad at being human, and it wasn't an ADHD thing? That was the thought in the back of my head anyway.

(Another quick side note: one of the common misconceptions around ADHD is that it's something that can "develop" - I remember in 2020 people were claiming that TikTok "gave" them ADHD... and yeah, that's not how it works. ADHD is defined as a "disorder", but it's really just a different type of wiring in our brains. Clinically, if you didn't show symptoms of ADHD as a child, you can't qualify for the diagnosis. Because this is just how our brains are designed... some of us - women in particular - develop "masking" mechanisms to "pass" as neurotypical, which is why we go undiagnosed into adulthood. But you can't "develop" ADHD as an adult... you CAN however, experience high levels of chronic stress which create symptoms that are similar to ADHD. Like, for instance, living through a global pandemic of unprecedented proportions)

So anywho... here's another thing about ADHD; one of the reasons Adderall is used as a treatment is because it affects an ADHD brain differently than a neurotypical brain. When an NT person takes Adderall, they get high on it - can't sleep, hyperfocus with no "off" button, TONS of energy. When someone with ADHD takes Adderall, it just helps keep the brain from bouncing all over the place, unable to focus for more than 2.3 seconds (aside from hyperfocus, which is a thing ADHD folks due without drugs, thank you very much).

So here I am, diagnosed with ADHD, but secretly afraid that I may not ACTUALLY have an ADHD brain (despite fitting the profile so perfectly I could be the damn poster child)... and if I don't have an ADHD brain, then this drug is going to affect me in a way I'd really rather not experience. Not to mention, if the drug DOES affect me the way it would a neurotypical, that means I definitely don't have ADHD... and I'm back to just being broken and bad at humaning.

But I'd tried the herbal approach - which could have been helpful with my ability to focus and get my shit together regardless of brain type - and I was still struggling, to the point where I was seriously in fear of my life COMPLETELY falling apart (instead of just being in a constant state of Mostly Falling Apart, as it had been for years)... so I decided to take a chance on the Adderall.

Fast forward a little over a year. I've been on Adderall since Mar 13, 2021 (which, luckily, did NOT get me high, so I guess the MHP knew what they were talking about after all). It's not an "easy button" (which I had semi-joked about before starting my prescription) - I still struggle with a LOT of things, and being human is still a challenge... but I'm at least able to maintain a basic level of "getting shit done", to the point where my life is only Kind Of A Mess, instead of a Complete Dumpster Fire.

Unfortunately, the company I was seeing my MHP through has closed its doors... the good news is, I've confirmed that my Primary Care Provider can take over management of my prescription in their stead... the bad news is, there's going to be a "gap" in my prescription refill, 'cause it takes forever to get appointments at the Dr's office.

It's only a couple of weeks, so I figured it wouldn't be too big a deal... except that the timing of THAT two weeks is really kinda horrible (it falls right at the beginning of a new fiscal quarter, which means I have a TON of financial reports to gather, analyze, and prepare for bookkeeping clients, along with reports that need to be filed on behalf of clients - not a great time for my brain to be chasing squirrels)

So then I got the idea that maybe I could "shift" that gap a bit - take a few days off here and there between now and my Dr's appointment, instead of missing two whole weeks at once (with really bad timing)

I'd missed a day or two here and there in the past (mostly on days I was either sick, or running late and just forgot my morning meds), and hadn't experienced any horrible side-effects, so I figured it was probably safe. Especially if I "skipped" on days that I had minimal responsibilities that could get fucked up if it turned out it WAS a horrible idea.

Last week, I skipped Friday's pill - I hadn't specifically planned to, but I woke up to an injured cat and an emergency visit to the vet, during which I heard the Roe v Wade news. By the time I realized I'd skipped my pill, it was late enough in the day that it was TOO late to take it. Between the cat scare and the horror of SCOTUS' decision, I wasn't going to get anything done that day anyway, so I decided not to worry about it.

Saturday came, and I decided I may as well skip again - it would mean one more day I'd have a pill available when I really needed it. Same on Sunday, and again on Monday.

I wasn't deliberately testing what would happen if I stopped taking my Adderall for more than a day - though I was happy to notice that I didn't experience any of the worst side-effects I'd read about people having when they stopped. I just figured I didn't really NEED it that much for my weekend... I mean, there was stuff I wanted to get done, but mostly nothing that would be critical to NOT do.

Last night, I had to refill my little weekly day/night pill organizer (because I'm old, and that's a thing I have now *lol/sigh* I'm also on iron supplements, which have to be taken at night, and my "PM" compartments were all empty). I still had about half my "AM" compartments full, but I just filled everything while I was at it, figuring I could decide on a day by day basis when to take the Adderall (or not).

This morning, I debated whether or not to take it - again, there's nothing SUPER URGENT that HAS to happen today, and skipping would mean one more day of having it when I "really" need it...

Except... even though there was nothing SUPER URGENT that needed to happen these last four days, there WERE things I had wanted to get done, things that did need to get done (even if they weren't SUPER URGENT)

And the truth is, these last four days have been REALLY HARD. Because even though I genuinely WANTED to get things done... I just could NOT get myself to do them. Or - at BEST - it would take me ALL DAY to build myself up enough to kind of, sort of, START doing them...

So this morning I took my meds.

I wasn't necessarily expecting miracles - again, it isn't an "easy button" - but the truth is, it HAS been almost shockingly easy to see a thing I need to do, and then... do it.

Granted, there are still the Hard Things that I need to do, and those I'm still having to build myself up for. But like... getting a new bag for the trash can, so I can throw away the garbage that's built up the last few days. Took me all of MAYBE ten minutes to get the bag, put it in the can, AND gather and throw away the garbage... but I have been literally incapable of doing that for DAYS. Even though I knew it would be quick, simple, Not a Big Deal...

'Cause that's what it's like to have ADHD brain with no supporting factors.

I know that a LOT of people dislike the idea of pharmaceuticals... and I GET IT. I'm the type of person who will have a headache for two days before I even remember that Tylenol is an option - it is NEVER my first thought to medicate my troubles away.

I also know that a lot of people are afraid that medication will... change them, take away the GOOD parts of having a differently wired brain. Because there ARE good parts - we're incredibly creative, we have amazing ideas and insights, we're willing to take risks that can lead to glorious rewards...

But I've done life with an ADHD brain without support, and it is difficult in a way that NOBODY should have to suffer through. Creativity, ideas, and insights aren't worth much when we can't focus long enough to DO anything with them... and I know how much shame is felt, when we can't even do simple shit like clean up the garbage that's been building up, even when we WANT to do something about it.

Not to mention, a "willingness to take risks" can look an awful lot like poor impulse control that leads to bad decisions that leads to shit REALLY going sideways...

I would never suggest that medication is the right answer for everyone - but I do wish we could at least get to a place, as a society, where anyone who COULD benefit from medication can do so without being ashamed of THAT.

I haven't really talked about my experience since being diagnosed, or my experience being on Adderall... mostly just 'cause I've been going through a bunch of OTHER shit, and haven't had the spoons to be sharing much of anything.

But for someone who does NOT believe in medicating my troubles away, the last four days + today have shown me unequivocally that THIS medication, at least at THIS point in my life, is making a huge difference in my ability to just... show up and take care of the things that need doing.

This is also the first time in days that I've been able to focus well enough to put thoughts to words - writing has been a lifeline for me throughout so much of my life, but lack of executive function + emotional stress took that away from me. Taking my meds this morning seems to have given it back...

I'll be honest, I'd like to get to a point where I don't need medication to function. I do think the emotional stress I've been under is a large part of why the last four days were so hard... and, in theory, if I can (re)build my life to a point where stress is more of an acute thing vs chronic, I (like to) think that I could do without the Adderall.

Then again, the world being the raging dumpster fire that it is? Seems like chronic stress is the norm these days /sigh