So I’m not quite a full month in to this ADHD medication experiment. I had my check-in appointment this past Thursday, and I’m still in the “tritation” phase—that is, slowly upping the dosage to find the best one for me and deciding if Adderall XR is the right medication. On Friday, I bumped up to 15 mg (from my initial 10 mg). I spent a lot of time on the ADHD Subreddit and all over Google reading about what to expect and how it should work. Some people made it sound like a miraculous, overnight change where everything was possible. It’s not actually so drastic, and I don’t think it should be. But when you’ve been struggling for so long, the subtle changes and ability to make change can FEEL like overnight magic, so I get why people say that.
But realistically, I wanted to know what to expect.
I read posts saying that ADHD medication was more like a “ladder” that helped you climb the wall and look around at all that needs to be done (the infamous ADHD wall that we all feel we need to climb, but can’t, to get anything done). Some said the meds helped to break down the wall between who feel you are and everything you want to do. Several people cautioned that you still need to organize, prioritize, and make decisions, that obviously the meds don’t do the work for you. There’s also that “how do I know the meds are working for me?” post I wrote a couple of weeks ago. I googled that exact phrase and found a great post that talked about creating “targets” for yourself to measure your progress and whether the meds are doing their job for you. (*cough cough* I still need to do this.) She also cautioned that you should be looking for results over time, not overnight. Even though ADHD medication is “instant” (unlike SSRIs and the like, which take time to build up in your system), it’s still going to take time to develop new habits.
I’ve finally settled in to this medication thing, and in the past few days I’ve been able to really think about what it’s been doing for me. I’m really fortunate that I haven’t had any side effects past the first day or two. The first couple of days on the meds were rough as my body got used to them. I’ve always reacted strongly to any and all medication, and I’m pretty sure I had some panic-induced reactions about taking a drug that has such a bad reputation. I was anxious about going down this road again after several bad experiences in the past with other psych meds. But then… I was fine! I barely noticed I was on anything. It didn’t seem like enough, though, so after three weeks, I bumped up to 15 mg. Bumping up gave me a rough day again, and then I acclimated and was fine. (I’ve also discovered that taking them when I’m overtired will just exacerbate the awful, overtired feelings, so I’ll just skip them on those days.)
So. This Monday I took the new dosage and felt fine. Tuesday I took my meds and felt fine, but I decided I felt too “fine.” I felt fine and found myself getting “stuck” working on a website and writing a post. I was annoyed because I’d spent a long time writing that particular post but I wasn’t feeling it, and I spent far more time on it than I wanted to. I thought, “Wow, I’m still just sitting here wasting time doing one thing and losing the day.” I found myself feeling really… dejected? Disappointed? I started to go down a rabbit hole of negative thinking about how these meds weren’t working for me, I needed a different dose or drug, nothing was going to change…
And then I stopped and went for a walk.
Stepping away, I had some time to think about this experience more objectively and realized a few things:
I was “stuck” on what I was doing, but I wasn’t hyperfocused. I was very conscious about how much time was passing by and, even though it was still a little too much time, I stopped myself to go for a walk. I think I got “stuck” because I was trying to force the post I was writing. I didn’t like it, and it just wasn’t “flowing.” I guess I was expecting these meds to give me the ability to write at any given moment. I was stressed about not having written for a week or so—I thought that meant the meds weren’t working. I’ve always been a writer, and I’ve always had clusters of days when I feel inspired and write a lot and days when I don’t. I produce enough on those “inspired” days to make up for the not-so-inspired days. That’s kind of how creativity works! The problem before was that when I was inspired to write, I couldn’t focus to do so. I would sit at my laptop and skip all over the internet until it was either too late to do anything, the frustration took over, or I’d occasionally be able to get into it and hyperfocus but rarely finishing anything. I have thousands of unfinished posts saved as drafts on various websites. (Did you know many people think Leonardo da Vinci had ADHD? He left behind piles of unfinished work. It’s the curse of ADHD—lots of big ideas but trouble starting and finishing. This is so true for me. Once I get past the hurdle of starting anything, I’ll hyperfocus in the middle, and then lose steam over the final details and finishing up.)
So I think the medication is working! I still need to respect that creative “flow.” The problem is that I was trying to force myself to write yesterday. ADHD medication removes barriers and fills a deficit. If I don’t feel like writing, meds won’t change that. (And I am talking about personal, creative endeavors here, not work for other people.) But today I feel inspired, and here I am! In looking back over the past few weeks, I had several “inspired” days and when I took the meds on those days, I wrote and finished things. I wrote several blog posts and a few essays for a collection I’m working on. I finished them and stayed with it—I didn’t go web surfing or keep checking my phone. I got up to eat, get water, or go to the bathroom when I needed to. I even stopped in the middle (like I’m about to do now) to take a walk, and then I came back to what I was doing and finished it!
That last bit is a big fucking deal. HUGE. I still need to respect my own creative “cycle,” but when it comes around, the Adderall XR gives me the help I need to stay with it.
There were a couple of other things I needed to get done, but I just didn’t feel like it. I was avoiding them, but it wasn’t my usual anxiety avoidance where I obsess about it while doing everything I can to procrastinate. It was just, “Meh. I don’t feel like it.” When I procrastinate on the meds, I procrastinate by doing one thing, not bouncing all over the place. But then I told myself I should just do the thing I didn’t feel like doing and get it out of the way, so… I did! I told myself to “just do it” and I did!
Mind blown. Yes, the Adderall is working.
I’m also noticeably less anxious on the Adderall and able to filter out more sensory information. (I have misophonia, and I don’t get as rage-y when I hear trigger sounds. I still don’t like those sounds, but it goes from rage to mild irritation.)
Part of my squirreling around on the internet and my phone included some “hate reading” of blogs and Instagram accounts (oh, c’mon, you know you do it, too!), along with a few obsessive behaviors. Only yesterday I realized that on Adderall days, those obsessive behaviors are gone, and the “hate reads” don’t even cross my mind. I was warned that stimulant medication can make OCD and anxiety worse. But often the anxiety is because of the ADHD and the five hundred channels blasting in your head at all times, in which case the medication can help. My anxiety is way down, and those obsessive behaviors were definitely part of the anxiety. My OCD seems to be fine, though it generally isn’t bad unless I’m stressed. (I count things here and there, but my OCD really ramps up in times of high stress, so it will be interesting to see what happens in high stress times with the Adderall.) And, my emotions don’t feel as sharp and all-consuming on the medication, either. I don’t feel “flattened” or zombified like I did on depression and anxiety meds back in the day, I just feel like I react to things in ways much closer to what they actually warrant.
The biggest takeaway from these past few weeks is that it’s true about still needing to do the work myself. There are days I’ve felt kind of aimless while on the Adderall XR. That bothered me because I thought it means the medication wasn’t “working.” But now I understand. I didn’t have a plan or list of things I wanted and needed to do that day. Those were days when I had very loose ideas of hoping to write or see how the day panned out.
Adderall will not make plans for me, prioritize, or even motivate me to come up things to do.
What it WILL do is support me as I climb the hill, so to speak. I’ve spent my life compensating and allowing fear and anxiety to motivate me. I’ve rationalized my way out of things I really wanted. I’m programmed to extremes: do everything all at once in a mad rush or nothing at all.
I think what’s happening here is that the medication is lifting me up to where “normal” people start each day. With that ADHD wall analogy, the medication is boosting me up to juuuuuust below the very top of the wall. It’s my job to pull myself up and over. They put me in the position of every other “normal” person who’s trying to develop new patterns and habits, but *I* still need to DO THE WORK. I’m kind of looking over the wall thinking, “What the fuck am I supposed to do now?” It’s a little overwhelming! But I can do this.
The other piece that’s missing is structure and routine. I’ve been freelancing and doing odd jobs for so long, it’s given me an excuse to keep floating around in days that are pretty shapeless. Yet another contradiction of ADHD is the hatred of structure and routine while also desperately needing some structure and routine. I’ve always relied on external factors to take care of that for me: jobs that required I be in an office, my husband’s work, my son’s schedule when he was in school, other people. I always have this desire to “do something,” but I become paralyzed with indecision. I have a huuuuuuuge list of stuff I want to do, from little tasks around the house to activities with The Kid to big life endeavors. I have the time and resources, but I get overwhelmed and turn to something random or go down an internet rabbit hole for two hours.
Adderall cannot make these decisions for me.
So I think what I need to do is, as I said, be like everyone else and start doing the work to create new habits and routines. I have some lofty goals, and I know from experience that I need to start small—things like getting up at the same hour every day, walking at the same time, etc. My usual habit is to get up, check email, etc, and then get online to write or do client work while still in my pajamas or robe and oh! look at that, it’s noon already. I wanted to go for a walk, but it’s lunchtime, so we should eat first. (My son is home schooled, but he’s done a great job of creating a morning school work routine all by himself.) Anyway. So it goes… we eat lunch and next thing you know it’s 5pm. I hate the feeling of still wearing my robe or whatever I woke up in at noon or even midmorning. I hate it, but I’d never been able to stop it. I know this must sound so fucking ridiculous to people who don’t have ADHD but even though I hate it, I’ve never been able to just get up and decide to get dressed earlier. There are so many stupid little things that seem so easy that I just. cannot. do. On the days I take Adderall, I’ve actually gotten up to change within ten minutes of being aware that I’m still in my robe and feeling like shit about it. It’s usually still later than I’d like, but it’s a start!
I’ll take this up with my therapist because after a lifetime of struggling to just barely get important things done, I don’t know how to manage the rest. I don’t know how to manage free time or choosing from a huge list of things I want to do but don’t need to do. I kinda don’t know how to do anything without chaos all around me or in my head. I don’t know how to choose for myself or manage my time without being goaded by a sense of doom or feelings of dread.
I guess I have two Herculean tasks ahead of me, then. One, create some sort of structure and routine to my day—some simple, basic life habits like getting properly dressed by a certain time and creating a plan for the day. Two, start thinking about what I really want to be doing with my “downtime.” In terms of work, I have that figured out. But like… for me. The “self care” shit everyone keeps talking about that I avoid like the plague and bigger things I want to finish. Things like going to museums once a week, going to events I usually avoid because of my social anxiety, creating a real plan to finish my book of essays, finishing up our bathroom renovation… I’m perpetually paralyzed with indecision. My therapist would say I avoid these “fun” things out of some deeper fear but I have no idea what. I know I could finish and accomplish some big stuff, but something always holds me back. ADHD medication can’t break that stuff down. Creating new habits and routines will be the easy part. The “chasing my big ideas” part will be an emotional shit show. But fuck it, I’m ready.