So yes. I walked out of the nurse practitioners office yesterday with a prescription. While people in my life or anyone in the “non-ADHD crowd” may question it, it turns out that anyone who works with and diagnoses ADHD recognizes it in me pretty quickly.
I want to pause here and mention the value of a good therapist. I mean a GOOD therapist, who really sees you. I’ve been through many therapists over my lifetime, several who could prescribe and who diagnosed me erroneously. I’d like to say that I’m angry at them, but the truth is that I would only go start seeing new therapists during times of crisis, and because once the first one told me I was bipolar, I always went to the next psych with “I’m bipolar” as my leading line. I wish I could say that therapists should know better, but having studied psychology and neurobiology for a while, I know that sometimes it’s really hard to discern what’s what, and we know so much more today than we knew twenty years ago. It wasn’t until I walked into my current psychologist’s office ten years ago, announcing that I was bipolar, that I began to realize I wasn’t. She immediately told me that she didn’t think I seemed bipolar and also discouraged me from attaching myself to a label at that juncture. Years later, I began to realize some things, namely, that I was not bipolar. I do have “big” emotions and often found myself in chaotic situations, but I didn’t have manic and depressive episodes. I had bursts of productivity/hyperfocus and not. But I digress. My point is: do not immediately accept whatever a psych tells you if it doesn’t feel right. Learn and advocate for yourself. Don’t continue seeing a doctor if you don’t feel like they really understand you or listen to you. I don’t mean just find someone who will say what you want to hear—find someone you feel comfortable with, who seems to ask the right questions while also listening and taking in what you say.
Moving on. I got my prescription. I was given Adderall XR to start – that is, it’s an “extended release” form meant to be taking in the morning and will wear off around 8 hours later. Yesterday, I didn’t get home with my filled prescription in hand until about 1:15 in the afternoon, so it wasn’t the best time to take it. BUT, I wanted to know how it would feel, so I took it, knowing it might make for a rough night. (And oh, it definitely did make for a rough night. I had a really, really hard time sleeping since it didn’t start wearing off until around 9pm. However, I’m used to having trouble sleeping, so. It is what it is.)
It’s actually a little disturbing, the way these meds work. (Disturbing to me because you just pop stimulants as needed, within reason.) ADHD meds aren’t like SSRIs and medications for anxiety, etc. The latter needs to build up in your system and won’t take effect for a couple of weeks. Stimulant ADHD medications are immediate and wear off. The extended release lasts 8 hours, so I take it once a day, as needed. NOT extended release medication would last about 3-4 hours and be taken twice a day. You also don’t need to take it every single day. So for me, I’m planning on skipping weekends (I don’t really need to be productive or keep myself together over the weekend). Depending on how various projects go (an SEO class I’m taking, freelance work, a new business venture, writing, etc), I may skip days during the week, too.
Of course, this is all assuming it all goes well. These last two days, I haven’t felt all that great. I don’t know why people would take this on purpose, recreationally. I’m not saying I don’t understand recreational drug use, I’m saying I don’t understand recreational Adderall, etc drug use. I’ve done my fair share of recreational drugs (more than you’d know) which may be why I’m feeling extra cautious and concerned about taking stimulants frequently. Yesterday, the first day I tried it, I said it felt a little bit like Molly, without the warm fuzzies. (I’m not trying to make it sound enticing. What I mean is, Molly and mushrooms and lots of other drugs that “normal” people enjoy and dance all night on just make me feel quiet and tired. So yesterday, I felt quiet and tired and very aware of my heartbeat.) Physically, I felt kind of crappy. I’d had a rare, gigantic allergy attack the day before, so I was still wiped out from that. I *probably* should have waited. Then today, I was exhausted thanks to the lack of sleep last night. I was hesitant to try the Adderall again today, but I also want to give myself time to either get used to it, or decide I need to try something else. Being as tired as I am today, I can only describe how I feel, physically, as the comedown from Molly—I feel completely and utterly wiped out.
Again, I want to stress, I’m not comparing to Molly to make this enticing, it’s just the only sensation I can think to compare it to. People who take Adderall recreationally are infuriating and ruin it for people who actually need it. I’m not telling you it’s fun. I’m telling you it’s mentally quieting but physically exhausting. I had a couple moments today where I started to reconsider this whole thing and didn’t want to take another pill, ever. But I’ve been able to stay on task, get some things done that I’ve wanted to get done, and my anxiety is way, way down, including the anxiety about getting things done. My heartbeat feels odd, though I’ve been religiously tracking my heart rate all day, and it’s fine. (I’m going to talk to the nurse about it, to make sure it’s all ok, though I suspect my normally low blood pressure has something to do with it.) The uncomfortable sensation eased up considerably after the first couple of hours, and I’ve been drinking more water than usual (a good thing) because I’m apparently in the 35% of people for whom Adderall causes massive dry mouth. IT’S NOT FUN. Also not fun is the fact that I absolutely feel like I’m on something, and I don’t like walking around all day feeling like I’m “on something.”
These are all things that I’m going to take up with the nurse, and that I suspect may ease up after some time. I was started on a low dose, but maybe I can go even lower.
I’m old enough now, and I’ve had enough experience to be nervous about it all. I want to see results, I want to change my life, I want to find better ways to manage my ADHD… I want to give the meds time to see if they help—lots of ADHD people love what they do for them, my therapist has sung their praises, and people have also told me to be patient while I acclimate and find the right medication/dosage. But it really freaks me out to think about regularly taking a drug that contains amphetamine, ya know? I’m almost glad I didn’t get diagnosed when I was in my early 20s because I’d surely have been compelled to combine them with all the other drugs that passed my way. These days, though? Hell, no. (Being a parent has done wonders for my impetuous behavior and decision-making.)
When I start thinking about dealing with pills and medication for the next 10, 20 years, I do get anxious. Big pictures always make me anxious. So I need to continue only focusing on “today.” I’m torn about tomorrow (Saturday). I want to skip weekends, but for this first week, I’m wondering if I should just dive in and get used to it, and take this time to determine if I need to a different med or a lower dosage.
Last night, I spent some time googling, “How do I know if the Adderall is working?” I found a few helpful articles about setting targets for yourself to look for measurable changes. Here’s one of the articles with a follow up for suggestions on “10 targets” to know if your ADHD medication is working.
This is actually a really great idea because I’ve been pretty vague about why I’m taking medication for myself. “I want to change my life,” is great, but how? So I’m going to spend some time thinking about the targets I’m hoping to hit by taking medication. Just making that list will be a feat unto itself, quite frankly. My targets are largely related to getting more freelance work and being able to get back out there and network, but being able to finally complete some writing projects is a big one for me. I need some follow through. The other big one, though, is being able to strengthen my emotional regulation. I asked the nurse if meds would help with the “big emotions,” and she said something that really resonated with me. She said that it depends, and that some people just have big emotions. (Which I do.) But she also said that if I just dive right into every emotion as it comes up, such as anger, the meds will definitely help me to manage that. That’s the part that resonated with me, and it was such a perfect way to describe what I do: I dive headfirst, without looking, without thinking, into every emotion that comes up. That might sound a like a lovely, passionate, big way to live life, but IT IS NOT. That diving in headfirst has caused me more trouble than you can imagine, is the reason I was slapped with a bipolar diagnosis long ago, and is why it was so easy for certain people in my life people to use me as a distraction from abusive, shitty behavior. (Another story, a whole different website.)
So that’s that. Day two is coming to an end. I have not enjoyed the past couple of days, but I’m hopeful that the next few days will be better. I’m also weirdly looking forward to making that list of targets and goals.