Adderall endgame?
February 10, 2010 11:49 PM   Subscribe

What's the long term goal with Adderall? Can Adderall help you stop needing Adderall?

My s.o., who has ADD, has started using adderall to focus more on schoolwork, and it seems to help. For that I am happy, but I wonder -- what is the endgame? Neither she nor I want her to get to a point where she's only capable of concentrating with adderall, for the rest of her life. Have any of you used it and eventually reached a point where you no longer needed it? If so, I'd love to hear your thoughts on how that happened.
posted by malhouse to Health & Fitness (14 answers total) 4 users marked this as a favorite
I like to think of Adderall as a crutch. If you had a broken limb, you use the crutch to get around, then to help you move the limb a bit, and then eventually you should be able to use the limb without cast or crutch.

Adderall is there to make it easier to develop the study methods, routines, focus tricks, whatever that you need to work without it. If you don't build up those tricks and methods while you're on it you're never going to be able to get off (and you will likely end up needing to continually up your dosage as your body develops a tolerance).
posted by Anonymous at 12:39 AM on February 11, 2010

I recently took my self off of Focalin which is similar to Adderall.
I originally began the medication to help me through a very intensive school program and the begining of a stressful high energy high demand carreer and a new life as a homeowner and wife.
I'm not sure if my body began not requiring it as much or if I began noticing side effects but after 2 years I began noticing jitteriness, like I was "speeding" and a rapid heartbeat.
around the same time I had completed the school program and was begining to feel more comfortable in my carreer and home life.
I believe it was a combination of learning the coping skills and also reaching a plateu in the demands of life.
I have been off for 3 months and doing well. there are still somedays that I wish I had it, but I believe I am learning more each day to deal with my add/adhd. I never wanted the medication to be long term but was ok if need be.
I listened to my body and worked hard on "putting on my blinders" to keep me focused throughout the day.
If your s.o. is working with a physician that will help her with the coping mechanisms that will benefit greatly, if not I would recommend a physician who will.
Going along with the "crutch" idea, if you don't do any rehab, or physical therapy, the bone and muscles will not get strong enough to support it self without the crutch.
typically the work crutch is a negative term, but in this case I think the term works great; it is the middle man to support you to the next step.
Good luck!
posted by kgreerRN at 1:58 AM on February 11, 2010

Adderall per se changes nothing about one's ability to focus without Adderall. It does not necessarily train one to be able to concentrate without it, it does not teach one good study habits. In other words, it's a completely goal neutral medication, which is why it can also so easily become a drug of abuse.

There are, however, plenty of behavioral interventions that can teach the skills that Adderall seems to impart. If one's goal is to eventually not have to use Adderall, then seeking behavioral interventions for ADHD is your best bet.
posted by OmieWise at 3:53 AM on February 11, 2010 [2 favorites]

You and she both need to recognize and accept the fact that she may be on some sort of medication for the rest of her life and it's okay if she is. I don't know her particular story or how severe her ADD is, but some people truly cannot function in any meaningful way without medication. It doesn't make them bad people or lesser than those who don't need medication, it just makes them different. ADD/ADHD brains are wired differently than brains without those conditions. My husband and son both have ADHD. While we're currently re-evaluating our son's medication and it's efficacy, we know that my husband will need pharmacological help for the rest of his life.

The endgame here is a functional life. Some people get that with behavioral therapy, some people get that with a combination of medication and behavioral therapy, and some people - despite therapy and the best of intentions - get that with permanent medication.

That's not to say your girlfriend will be on this medication for her entire life. But if she does need to be, accept it.
posted by cooker girl at 5:20 AM on February 11, 2010 [8 favorites]

I was diagnosed with ADHD after my second semester of freshman year in college. I was very ashamed of it and didn't really believe in the diagnosis, but the Adderall sure made it easy for me to study so I stayed on it through college. I kept with it for about six months after I graduated and then decided to stop, because like you I never wanted to believe that I *needed* this little pill to get by. 

Fast forward two years, and my life had really started to unravel -- I couldn't pay my bills on time, couldn't keep my house clean, I was always late for work and had extreme troubles staying on task, to the point of almost getting fired. Eventually I broke down and went back on Adderall, and have never regretted it.

If you really have ADHD, your brain has a different chemical makeup from other people. If we keep with the crutch metaphor, i think that you're right, that the meds are a crutch, but you seem to be thinking that your SO's leg is broken, when actually she was born with a permanent deformity (forgive the harsh language, but the metaphor works). Crutches don't heal you, they just help you get around; deformities can't be healed, they can only be adjusted to. If her condition is very minor, she can learn how to get around without a crutch if she works hard at it, but the leg is always going to be abnormal, and she might never be able to consistently keep up with people who have normal legs. So there is no shame in doing whatever she can to help herself keep up!

Now, I think it's entirely possible for people to have ADD and not need meds. It all depends on the severity of your condition and what kind of coping mechanisms you have/can put in place. Think back to the leg metaphor -- if your leg is majorly deformed, there's no way you can get by without crutches. But if your SO has successfully dealt with ADD without meds for a long time before this, it's possible that she only needs her crutches in high-demand situations like school. But then again, work can be a lot like school. You have to sit through long boring meetings and be able to remember what was discussed, and some of us still have to write papers.  

What worries me a little is that YOU are so eager for her to be off these meds that you're posting here for her. I think it's important for you to internalize that there is nothing wrong with taking meds. She cannot be "fixed" because she isn't "broken" -- just different. And if she needs meds for the rest of her life, what's it to you? Would you rather have an SO who is capable of dealing with life on her own, or one who can't keep up her end of the bargain, who you have to babysit and nag and remind constantly to do things?
posted by roscopcoletrane at 5:23 AM on February 11, 2010 [13 favorites]

I agree with the others who have said it's there to hold you up while you learn skills to carry past the term of the treatment. I think that for a lot of people with life-long ADD it also provides perspective, and strips away the mystery of how other people seem to easily do things that to you are incredibly hard. You don't un-learn that when you stop taking the drugs, and so in that way I think there are lasting effects.

That perspective doesn't come without introspection, though. You have to do the work and acquire the skills and think about how you're going to do things without the chemical assistance, in ways that will work with your wiring. My husband made some really amazing changes during his year on Adderall (before the side effects became so bad that we both agreed they were worse than the ADD), and I'm not sure he could have done it without the space the drugs gave him for long enough to get a plan together.
posted by Lyn Never at 5:28 AM on February 11, 2010

The endgame here is a functional life. Some people get that with behavioral therapy, some people get that with a combination of medication and behavioral therapy, and some people - despite therapy and the best of intentions - get that with permanent medication.

Exactly. Depends on the patient and the manifestation of the disease/disorder. As I understand it, the disorder is always there. How it affects life changes as life changes. Sometimes its just needed as a crutch to get through a particularly rough time, sometimes you have to go on and off, sometimes it is a lifelong thing...

Good luck!
posted by gjc at 6:41 AM on February 11, 2010

While one of the things that's been great about taking Adderall for me is seeing "Oh, this is what it's supposed to be like." I now know what it's like to be able to focus (and to not hyperfocus unproductively) on a regular basis.

However, having that knowledge doesn't mean that I can do that without drugs. I still have the condition of ADHD, regardless of what I've learned while taking my medication. One of the fundamental revelations of treatment for my ADHD has been realizing that I don't lack ability or willpower: my mind just works differently, and it always will.

You say "Neither she nor I want her to get to a point where she's only capable of concentrating with adderall, for the rest of her life." Consider this: she may already (and always) be at that point. Adderall (and drugs like it) do not change the fundamental brain chemistry of a person with ADHD. Rather, it temporarily alters it.

For me, Adderall isn't a crutch to get through hard times; it is a necessary tool that I require to do the job of daily living, just as much as I need my computer and my editing pencil. I wouldn't think of trying to do my job without those tools, and I wouldn't think of trying to live my life without my meds.

Some people prefer not to use medication for ADHD, and that's fine. But there's no shame in needing it, and there's no need to "get better" and wean oneself off medication. Having ADHD isn't being broken or defective, so a person with ADHD isn't someone who needs to be fixed. A diagnosis of ADHD is useful as an identification of the way a person's brain works, so they can then identify the tools they need to live their lives well, whether those tools include medication or not.

Have any of you used it and eventually reached a point where you no longer needed it?

While I have not had any desire to stop taking Adderall since my diagnosis, Claire, one of my friends with ADHD, decided to stop taking it after college. Her reasoning at the time (she eventually decided at a different stage in her life to go back on meds) was that she liked her ADHD brain, and that way of thinking. Without the meds, she's still the same incredibly smart, capable person, but she chose to work on different kinds of projects than the ones she would have when she was taking Adderall because she knew she'd be better with projects that took advantage of her way of thinking than with those that required the kind of focus that Adderall gave her.

what is the endgame?

There isn't one. Whether or not your girlfriend decides to stick with meds (and there's nothing that says she has to) I encourage you both to not think of this as something that has a defined progression. ADHD is a lifelong thing; you never stop dealing with it, whether you're treating it with drugs, or therapy, or just your own mindfulness of it.
posted by ocherdraco at 6:48 AM on February 11, 2010 [5 favorites]

Not much more I can say that hasn't already been said, except to be wary of moralizing or thinking that working hard will make everyone with ADHD able to get off of Adderall. Life is unfair and working hard isn't always enough. ADHD is not caused by taking Adderall.

So the end game is living a happy life, whether or not Adderall is involved.

I always hear vague pronouncements about Adderall being abused or addictive or whatever, but I gotta say that for me, personally, it is not. I forget to take it on a regular basis. Never forget my coffee...

None of the shrinks who have prescribed it to me have worried about me abusing's really not a concern you should have if she's taking it as directed.
posted by kathrineg at 7:21 AM on February 11, 2010 [1 favorite]

Also, just after my diagnosis, when I was starting to take Adderall, I asked people on Metafilter to tell me about their experiences with the drug. There's a log of good information in that thread, from many perspectives.
posted by ocherdraco at 7:22 AM on February 11, 2010

Oh and check out Delivered From Distraction for more explanation of what Adderall, meds, and other treatments can do for you. As well as getting off of it and organizational tips.
posted by kathrineg at 7:53 AM on February 11, 2010 [1 favorite]

Seconding Delivered from Distraction. Both of you should read it.
posted by ocherdraco at 8:49 AM on February 11, 2010 [1 favorite]

ADD is not like the flu, its not something that you get over (at least so far). Its something you have, its something you are. Adderal is merely a tool for managing aspects of ADD when necessary.

If your s.o. does not want to use drugs full time, she may want to switch over to something more short-acting, like dextroanphetamine, one of the actives in Adderal, on a PRN basis. She does not have to be on meds all of the time.
posted by UncleJoe at 1:54 PM on February 11, 2010

I'm coming back to recommend all of the Halliwell books dealing with ADHD. They are so full of great information for the both of you.
posted by cooker girl at 11:20 AM on February 26, 2010

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