So this is what Medication feels like

Miscellaneous and Personal Stuff I Must Share
1

Two weeks ago I spent a couple of hours talking to a consultant psychiatrist who diagnosed me with Adult Attention Deficit Disorder and prescribed Ritalin. Long story short, this was the culmination of a long process of realising that laziness didn’t seem to work for me like it seemed to do for everyone else, and that at 31 years old something has destroyed the best half of my life and that maybe that thing had a name.

After a rather frustrating process of trying to get taken seriously by the NHS psychiatrist but with a lot of support from my GP we eventually ended up paying to see an expert. I’ve had the prescription for a few days now and had put off starting it until this morning and things have not gone how I was expecting at all.

I was expecting to feel energetic because I know that the drug is a stimulant and I was expecting to get things done because there are so many things that I want to do in my life that, and I have built this day up enough in my mind I was expecting that some of them would have to happen today even if the drugs didn’t do a damn thing.

So I took the tablets and an hour later wasn’t really feeling any different at all and I was starting to think that nothing would happen today anyway just like it always doesn’t because despite the tablets I didn’t want to start on sorting my papers I wanted to read my book, but I watched myself sort the papers anyway (and leave the papers that need attention individually in plastic pockets in a single file, which is a tiny detail but it’s important to me because it seem to suggest to me that I can still be creative when I’m taking the pills).

The house is now very tidy, and all the things that I wanted to do today are done and then some, and I know that things are different because of little things like my seeing that I need a bin liner for rubbish in my room and going down to get one instead of thinking “I’ll do that later” and actually taking the full bin liner to the bin outside rather than leaving it in the hall to take down later and that the other things that I have done are actually all done instead of “just done enough” and that I saw the box of cakes on the side and didn’t have one because I just wasn’t hungry.

And I know that I should feel ecstatically happy because the tablets seem to be working better than I dared hope that they would but instead I feel dull because I’m watching me doing all the jobs and the tidying and it doesn’t feel like me, it feels like the cuckoo, the other one, that the fairies leave behind in the stories. And I’m scared that the tablets won’t work tomorrow. And I’m scared that the tablets will work tomorrow and I’ll have to keep taking them now for the rest of my life. And I’m scared that they do nothing and that I’m fooling myself like I was worried I might and that all the effort will come to nothing in a few days like all the other times “this week is going to be different”. And I’m irrationally afraid that I will go back to the doctor and he will say “aha we tricked you, those were sugar pills and you really were lazy all along” and that then I will be.

So now I’m waiting for my Mom to come home to a tidy house and I know that she will make a big fuss about that which I’m really not sure I can cope with right now. And I feel that I should apologise for all the times that the house hasn’t been tidy when she got home, because tiding it today was so easy even if it felt like the cuckoo was doing all the work, but I can’t because then there’ll be an even bigger fuss. So now I’m sitting typing his because I really need to tell all this to someone and get my mind off things which is so obviously not working because typing this means that I have to have my mind on things, so I’m very sorry if this doesn’t make much sense because, y’know, the tablets.

Why don’t I feel happy dammit?

2

Because you’re over-thinking it. Honestly, I’m surprised it’s worked this quickly.

If you think you had a problem, and a professional agreed, and they give you the tool they use to fix the problem, don’t be surprised when you don’t have the lifetime movie of the week outcome.

But you’ve spent so much time wrapped up in the problem, your brain doesnt know what to do when the problem is managed (at least for the time being).

Deep breaths. What are you going to do with your newfound time…the time you spent in a haze in the past?

3

I suppose, I was very prepared for the possibility that it wouldn’t work, or it wouldn’t work as well as it might, what’s weird is that it actually does seems to be working better than I honestly expected and yet I don’t really seem to feel as good about that as you’d think.

I have a lot of things I’m hoping I can address more effectively now, but top of the list is that I’ve been living at my mums house and unemployed for the last year, directly followed by the lack of any social life or relationships in my life at all outside family. I suspect even in this job market the former is going to be a lot easier than the latter.

4

I find it surprising that your medical professionals allowed you to get it built up in your head that after one pill you would be FIXED!~!~!~. That seems very unethical to me, because it’s not how it works. You’ll probably be fiddling with the dosage for a couple of a weeks at the minimum, and you have to give it time to see how the side effects will shake out.

Are you receiving any supportive counselling, or education on developing improved coping skills/study habits/relationship attitudes? If not, you need to find you some of that. ADD meds don’t magically bestow life skills. They make it more possible to aquire them, but it’s still a lot of work.

5

I was very aware that the medication has highly variable results (although what you know are realistic expectations and what you secretly hope will happen obviously aren’t the same things), and that it can only form part of the picture. I was warned that given the drug and type of formulation involved I should expect to see any effects that would occur very quickly which seems to have been borne out by what happened.

What feels weird to me is my lack of reaction to the fact that it does seem to be working. And of course I do have a tendency to over-analyse things anyway (I’m a scientist ;))

Dosage will certainly need work, they are supposed to be fast release short action tablets and things have definitely felt rather uneven today but I really have no clue how much of that is in my head. I’m feeling rather better now, not sure whether that means the last dose is wearing off.

6

IANADoctor, nor have I been on Ritalin. I have been on SSRI’s in the past for long term depression. It’s not going to be an easy fix, and it’s not going to happen quickly, and you MUST FOLLOW YOUR DOCTOR’S ORDERS. Even if you feel it’s not worth it, even if you feel you’re better. There are traps when you deviate from the process.

People categorize mental illness, for some reason, as something different than, say, a broken arm. From a process standpoint, they’re a lot the same. There’s a problem. It won’t get fixed by itself. There’s a LOT of expertise out there to solve the problem. Yet one is ‘crazy’, ‘I can get by on my own’, ‘I don’t really need to take these anymore’, and the other is ‘just a broken arm’.

My kids are 7 years old. I was in treatment for depression from the point they were about 6 months old, til they were about 4. I’m completely off the medication now. This stuff can work. (Despite what newsweek, Your neighbor, that friend of a friend might say.)

I can’t say I felt NORMAL while on the meds, but I can say they gave me the tools (plus a councellor) to put my skeletons to bed.

But that’s not ADD, listen to your Doctor.

7

Well, OP, you’re taking medication that changes your brain chemistry. Your thoughts and emotions are really just various brain chemicals anyway, so it follows that taking a tablet that alters the chemistry in your brain would alter the way you think and feel. But you’re a sentient being, so you’re aware that you think and feel differently, which makes you … think things and feel things about your changes!

It’s just a little cycle you’re stuck in, that’s all. Find a way to break that, to get out of your own head for a while. Take a walk, see if that helps. It sounds stupid and simple, I know, but it’s always helped me when I get stuck on those little mental hamster wheels.

Congrats on a tidy house, by the way. Doesn’t matter, really, how it got that way. Doesn’t matter, really, whether you kept it tidy in the past. You tidied it up today. Yay, you!

8

<not a doctor but have experience with meds>

Lazy or not, the fact you are taking pills to address the issue could easily have resulted in a surge of motivation not related to any medication. Especially in the first hours.

It doesn’t matter. You got things done today! Savour it. Memories like these offer hope when you realize there no such thing as a magic pill.

9

Try thinking like this. There is a problem with the chemistry in your brain. The pills are putting this back to normal. In other words the pills are necessary.

For example my mum had an overactive thyroid. The gland produced too much thyroid, so they removed her thyroid. She had to take a pill a day to put thyroid into her body.

Yes, she was dependent on pills for the rest of her life, but so what? She was far more healthier and happier without that overactive thyroid.

What I bet would be very helpful for you would be a group. Ask your therapist or doctor if there are any meeting groups in your area. If they don’t know check your local hospitals to see if they have any referals or go to meetup.com and see if there is a group. If not start one.

This seems scary to you because you think you’re the only one that’s going or gone through it. OK it’s new to you, but you aren’t alone by any means. Once you talk with others who went through you’ll now what may happen.

10

I went through the same thing. This is your story and not mine, so the details aren’t important, but two years ago I finally decided I either had to get this -whatever it was - solved or I was checking out. I wasn’t even depressed in the true sense of the word, but I was exhausted from feeling at loose ends and disappointed in myself for having zero follow-through. I felt like it had been 34 years of spinning my wheels and getting absolutely nowhere. A complete inability to keep a job, relationship, or home together for any length of time. I was also frustrated from at least a half-dozen previous attempts at solving the problem through either my GP or a therapist, only to end up zombied out on some inappropriate med, or being diagnosed as depressed and sitting through endless, useless sessions talking about my damn childhood.

I found a center that had both medical and therapeutic services and had bi-weekly sessions with an MD, a shrink and a therapist until they diagnosed me with Adult ADD. There is a long history of addiction in my family (and, indeed, unhealthy usage is how I managed to get through college) which made me want to ease into meds. My approach was two years of weekly talk therapy sessions with an ADD specialist, who taught me ADD management techniques and allowed me to talk out my frustrations before and during the process. I’m also on 300mg of Wellbutrin XL, which is a non-traditional, although not unheard-of, Adult ADD therapy, plus 10mg of Adderall as needed. I used to need the Adderall a lot more, but after the two years of practicing what my therapist has taught me, I can now manage myself in doing a lot of tasks like my job and cleaning my house. I mostly use the Adderall for homework (continuing education), which continues to, and will probably always be, a trial.

I know talk therapy isn’t for anyone, but I cannot express how important I feel it was for me to learn that there are ways of dealing with this, and I can learn some of those ways. Also, I learned to give myself a break. My brain doesn’t work the way other brains work, and while I can learn to manage it, there will always be days when I have to be kind to myself. And finally, I learned how to meet the meds halfway. All they do is give you the opportunity. You still have to decide what to do with it.

I, too, am scared that the meds will stop working on a general level. I’m personally scared I’ll have to go to something more hardcore and I’ll get addicted and be a junkie. It took me over a year to get my meds to where they are, and I tried two others before that, both of which made me nuttier. However, the reality is that I need them, and if they stop working I will do whatever is necessary to stop from feeling like living just wasn’t worth it. So, eff what might happen. I just can’t spend a lot of energy on the “what ifs” right now, because I have A LOT of stuff to catch up on.

I wish you luck. It’s a damn frustrating, finicky head issue to have, made worse by the difficulties in trying to explain what’s wrong, a split in the medical (and genpop) community on whether what you have even exists (:rolleyes:), and a hunt-and-peck approach to finding what works for you.

11

I don’t understand this idea that Ritalin does not work right away. It sure as heck does. There’s nothing about it that is slow. It’s not like SSRIs that need weeks or months to affect change. It works immediately, and leaves your body quickly.

That said, seeing improvement, but not being happy about it is very normal, for two reasons. One–the variable reactions include a slightly down feeling, oddly enough. Two, it’s very possible that what the medicine treating is not the only reason you fell bad. Even if it completely stopped the ADHD, there are other things in life that could be making you less than happy. I’m not saying you’ve built up the idea that the medicine is a cure-all, but you’ve definitely built up the idea that being more productive (and otherwise having less symptoms) will make you happy. It doesn’t always work that way.

I assume you are going to some type of therapy, so you can address what is making you unhappy. If it’s just the medicine, you’ll get used to it and be happy again. And if it’s other stuff, you can work it out.

12

Yes, Ritalin and Adderall are nothing like SSRIs. They affect the brain the same way as other stimulants like speed and cocaine, you take a pill and it’s in full effect within the hour. Depending on the medication you take (they have sustained-release now) it only lasts up to 8 hours.

To the OP: I’m right there with you. Thinking of starting with Adderall (I took Ritalin as a child, but had to discontinue because of the extreme appetite suppression), but I’m conflicted about it for a lot of reasons.

13

I’ve been in treatment for ADHD for the past 10+ years. I started with Dexedrine, moved to Adderall then, most recently, to Vyvanse. They all worked pretty well at first but I found it helpful to switch meds periodically as they would seem to loose their efficacy.
I did a lot of CBT too. YMMV.

14

When my son went on ADD meds (which worked almost immediately, as many ADD meds do), what we were told was to look for outward changes of behavior even if he reported not feeling any different. Our psychiatrist said that the situation is best when you don’t feel like they’re doing anything but from an outside perspective you can see the change.

So, in other words, you might not feel much different after all.

15

For anyone on Ritalin (methylphenidate), I would strongly suggest investigating Focalin (dexmethyphenidate). It is the more biologically active enantiomer (isomer, mirror image molecule) of Ritalin. Racemic Ritalin is a mix of levo- and dex- versions which are mirror images of each other. The dex version is stronger and has fewer side effects.

The downside is that I think it is still under patent protection so it will be more expensive if you cannot get it covered by insurance.

16

My son is on focalin and it’s been good. It’s not as long lasting as concerta (his first med), but the appetite suppression isn’t as extreme either. He was losing weight on concerta and he didn’t have it to lose.

17

That’s interesting. I was on methamphetamine for a long time and I gained weight. However it also would sometimes put me to sleep, so maybe that doesn’t mean much.

For anyone concerned with weight loss, I would like to mention a drug interaction which may or may not apply to you. I take a combination of Focalin and Straterra (a non-narcotic ADD drug). Straterra alone did cause significant weight loss for me but that seems to have been amplified by Focalin. Just some possible useful information I wanted to share.

I think the reason is that both work on the neurotransmitter norepinepherine (among other, like dopamine) and apparently that is one that has a strong influence on appetite.

18

To be clear I am aware that the physical effects occur immediately. But, my observation of friends diagnosed as adults, there is a “troubleshooting” period w/r/t drug type, dose, time of day, and other factors to determine what specific combination is the most effective for the individual.

Then, as I previously said, and others joined, there is a behavior modification component that takes time and benefits from experienced assistance (whether professional or peer in nature). As per the OP, he expected massive behavior changes to occur instantly and without any effort. That’s not realistic.

19

This is kinda what I was going to say, and the broken arm thing is really useful to think about. I sometimes think about mental illness as being cursed with a brain chemistry that makes you intoxicated by default, and the meds are the only way to be sober.

My son has been quite insane his whole life and recently started on lithium (he’s almost 12). His symptoms are basically gone now, but he’s still faced with being an extremely intelligent 12 year old with all the sense and social skills of someone half his age, and who is still going to be viewed by his peers as The Crazy Kid for some time to come. We’ve managed to fix what was broken (we hope!) but that doesn’t undo the damage that being broken did. That’s what counselling & support is for.

Hang in there OP. Now that you are able to make plans and follow through with them you will be able to start building the YOU you should have been working on for years. The fruits of this will come, but it’ll take some time.

20

I’ve worked with hundreds of kids who take stimulants for their ADHD, and only a handful have ever said they liked the medication. If the main effects outweigh the side effects, the meds are helpful.