So I have ADHD. Now what?
July 23, 2013 9:20 AM Subscribe
So it turns out I resoundingly have ADHD. Help me be the best ADHD-addled person I can be.
This was me. After three appointments, including one interview with my partner, the clinic has concluded I have ADHD.
We'll be working out my treatment plan next week. The psychiatrist who gave me the diagnosis said this will probably include medication - most likely Ritalin or Adderall, as Strattera is not covered by my insurance - and coaching.
I'm actually kind of in shock and unsure of what to do next. I'm very concerned about medication - I'm in very good health, but very anxiety prone, and while I'm totally fine in terms of cardiac health, I have experienced severe tachycardia as a side effect of multiple medications. I'm also concerned that stimulants like ritalin or adderall sometimes lead to psychosis and suicidal thoughts, as one of my parents committed suicide and, while I've never had suicidal thoughts, I certainly don't want to start (NB: my parent's suicide is not the issue here, I have been through years of therapy, this question is about my ADHD diagnosis).
I have SO MANY QUESTIONS and was hoping for some guidance from the green. A kind of ADHD 101. These questions include:
- What is it like to be medicated?
- What concerns should I raise to the psychiatrist about medication?
- Are there specific therapy modalities I should be investigating?
- What books should I be reading to better understand my dingy brain?
I'm actually good for organisational tips and tricks. Years of an (apparently clinically) impaired attention span has left me obsessed with organisational systems and methods. Honestly, reading about lifehacks and finding new ways to manage my todo lists are some of my best ways of procrastinating. I don't need another filing system; I need to be able to focus long enough to get shit done.
This was me. After three appointments, including one interview with my partner, the clinic has concluded I have ADHD.
We'll be working out my treatment plan next week. The psychiatrist who gave me the diagnosis said this will probably include medication - most likely Ritalin or Adderall, as Strattera is not covered by my insurance - and coaching.
I'm actually kind of in shock and unsure of what to do next. I'm very concerned about medication - I'm in very good health, but very anxiety prone, and while I'm totally fine in terms of cardiac health, I have experienced severe tachycardia as a side effect of multiple medications. I'm also concerned that stimulants like ritalin or adderall sometimes lead to psychosis and suicidal thoughts, as one of my parents committed suicide and, while I've never had suicidal thoughts, I certainly don't want to start (NB: my parent's suicide is not the issue here, I have been through years of therapy, this question is about my ADHD diagnosis).
I have SO MANY QUESTIONS and was hoping for some guidance from the green. A kind of ADHD 101. These questions include:
- What is it like to be medicated?
- What concerns should I raise to the psychiatrist about medication?
- Are there specific therapy modalities I should be investigating?
- What books should I be reading to better understand my dingy brain?
I'm actually good for organisational tips and tricks. Years of an (apparently clinically) impaired attention span has left me obsessed with organisational systems and methods. Honestly, reading about lifehacks and finding new ways to manage my todo lists are some of my best ways of procrastinating. I don't need another filing system; I need to be able to focus long enough to get shit done.
Agreed that your psychiatrist can answer all of this, but anecdotally, I'm on 20mg Adderall with no negative symptoms whatsoever. My doctor did say that even though he was prescribing me 20mg 2x/day, I should really play it by ear as far as what time of day to take it, or whether I need to take any pills at all. So most work days I take one in the morning and skip the afternoon one, and on weekends I usually completely forget about it and only take one at lunchtime if my husband reminds me.
posted by agress at 10:16 AM on July 23, 2013
posted by agress at 10:16 AM on July 23, 2013
Definitely discuss this with your psychiatrist, and make sure that the doc who is overseeing your medication is willing to talk to you if questions come up during a non-appointment time. If you start to experience cardiac issues or suicidal thoughts, call your doctor immediately or head to the emergency room.
What is it like to be medicated?
Calm. It feels like the moment after a car alarm, which has been going off for so long that I've tuned it out, finally stops blaring. That "oh, finally" moment. Do you ever have the experience of drinking coffee and then feeling pleasantly relaxed and productive? It's a lot like that for me. I can only speak to my own experience, of course.
If you're feeling jittery or you don't like the way you feel, definitely call your doctor. Stimulants start to work pretty quickly and their effect lasts only a short time, so it's not like trying to ramp up for six weeks on an antidepressant whose effects come on gradually. The nice thing is that if you decide you don't like the effects of the medication, you can stop taking it and the effects should subside pretty quickly.
But again, talk to your doc. They are there to answer your questions. (Or they should be.)
posted by corey flood at 10:27 AM on July 23, 2013 [2 favorites]
What is it like to be medicated?
Calm. It feels like the moment after a car alarm, which has been going off for so long that I've tuned it out, finally stops blaring. That "oh, finally" moment. Do you ever have the experience of drinking coffee and then feeling pleasantly relaxed and productive? It's a lot like that for me. I can only speak to my own experience, of course.
If you're feeling jittery or you don't like the way you feel, definitely call your doctor. Stimulants start to work pretty quickly and their effect lasts only a short time, so it's not like trying to ramp up for six weeks on an antidepressant whose effects come on gradually. The nice thing is that if you decide you don't like the effects of the medication, you can stop taking it and the effects should subside pretty quickly.
But again, talk to your doc. They are there to answer your questions. (Or they should be.)
posted by corey flood at 10:27 AM on July 23, 2013 [2 favorites]
Hey there - I'm pretty new to the diagnosis myself, so here's what it's been like for me.
- What is it like to be medicated?
For me, it was an interesting moment. My doctor started me on 30mg of Vyvanse. I was on the bus going to work and my brain was doing the usual hamster-in-a-wheel thing, running over the various things that had to get done, and how hard was this going to be, and how hard was that going to be, and oh God, that meeting is at 10 and I don't know what to do with this email I got - to completely calm and focused on each problem one at a time. It was like a switch had been turned in my head. I have tried to describe it to my wife and doctor as "the world coming into focus." It's hard to explain, because after a whole life of being one way and then I was suddenly able to deal with life calmly. Everything just felt less overwhelming, things that had been previously unmanageable were suddenly manageable.
That first day, I went to a co-worker who is also ADHD (and who had encouraged me to seek diagnosis and treatment) and asked her if this was what "normal" people felt like all the time, because it was an amazing moment. I happen to be lucky that I hit the right level of dosage very early in trying the meds, but there was no mistaking the moment. And if I miss a day of my meds, I feel it.
The great thing about most ADD meds is that they are short-term; if you are at a therapeutic dose you will feel it quickly; if you are outside the range on the low side, you won't note any changes, too much and you'll be jittery and agitated. The next day you get to try again.
- What books should I be reading to better understand my dingy brain?
I would recommend starting with Driven to Distraction and then Delivered from Distraction to start. I've also been finding TotallyADD to be helpful.
If you have further questions/want to share, memail me.
posted by nubs at 10:52 AM on July 23, 2013 [1 favorite]
- What is it like to be medicated?
For me, it was an interesting moment. My doctor started me on 30mg of Vyvanse. I was on the bus going to work and my brain was doing the usual hamster-in-a-wheel thing, running over the various things that had to get done, and how hard was this going to be, and how hard was that going to be, and oh God, that meeting is at 10 and I don't know what to do with this email I got - to completely calm and focused on each problem one at a time. It was like a switch had been turned in my head. I have tried to describe it to my wife and doctor as "the world coming into focus." It's hard to explain, because after a whole life of being one way and then I was suddenly able to deal with life calmly. Everything just felt less overwhelming, things that had been previously unmanageable were suddenly manageable.
That first day, I went to a co-worker who is also ADHD (and who had encouraged me to seek diagnosis and treatment) and asked her if this was what "normal" people felt like all the time, because it was an amazing moment. I happen to be lucky that I hit the right level of dosage very early in trying the meds, but there was no mistaking the moment. And if I miss a day of my meds, I feel it.
The great thing about most ADD meds is that they are short-term; if you are at a therapeutic dose you will feel it quickly; if you are outside the range on the low side, you won't note any changes, too much and you'll be jittery and agitated. The next day you get to try again.
- What books should I be reading to better understand my dingy brain?
I would recommend starting with Driven to Distraction and then Delivered from Distraction to start. I've also been finding TotallyADD to be helpful.
If you have further questions/want to share, memail me.
posted by nubs at 10:52 AM on July 23, 2013 [1 favorite]
I take 5mg Adderall twice daily, pretty low dose. I take it for hypersomnia and attention issues related to bipolar, IC pain, and fibromyalgia fatigue.
I started taking it about a year ago, and man I wish I'd done this earlier. It's really changed my life for the better. I'm alert and I can focus on my work and get things done. I'm actually happier too...it calms me down. Before Adderall, it took so much effort just to make it through the day; I had a hard time focusing, and I'd fall asleep at my desk, etc. It's really a miracle drug for me.
A lot of people who have a bad reaction to stimulants sometimes have something else going on, like bipolar or depression. Example, I'm bipolar, and my psych told me I have to take some sort of mood stabilizer or antipsychotic while I take Adderall, or I'll most likely have a really bad panic attack/bad reaction. I take my mood stabilizer diligently, and I have no issues with Adderall.
I think you'll know pretty quickly if you have a bad reaction, and in my experience, Adderall gets out of your system pretty quickly, unless you do the extended release. I notice a drop off about 4 hours after I take it. I don't take it every day either...you could take a break on weekends, if that makes you feel more comfortable. If you have a bad reaction to one med, you can always try a different one.
Also be wary of the nocebo effect. I work myself up about a new medication, and I think it makes me see side effects that aren't there sometimes. Starting a new med is definitely anxiety making, so try to be objective if you can. I try not to research meds too much before I start them...I want to know any major side effects and things to look out for, but that's about it. I try not to read too many online reviews, because those are usually slanted towards negative.
Good luck!
posted by hotelechozulu at 10:53 AM on July 23, 2013
I started taking it about a year ago, and man I wish I'd done this earlier. It's really changed my life for the better. I'm alert and I can focus on my work and get things done. I'm actually happier too...it calms me down. Before Adderall, it took so much effort just to make it through the day; I had a hard time focusing, and I'd fall asleep at my desk, etc. It's really a miracle drug for me.
A lot of people who have a bad reaction to stimulants sometimes have something else going on, like bipolar or depression. Example, I'm bipolar, and my psych told me I have to take some sort of mood stabilizer or antipsychotic while I take Adderall, or I'll most likely have a really bad panic attack/bad reaction. I take my mood stabilizer diligently, and I have no issues with Adderall.
I think you'll know pretty quickly if you have a bad reaction, and in my experience, Adderall gets out of your system pretty quickly, unless you do the extended release. I notice a drop off about 4 hours after I take it. I don't take it every day either...you could take a break on weekends, if that makes you feel more comfortable. If you have a bad reaction to one med, you can always try a different one.
Also be wary of the nocebo effect. I work myself up about a new medication, and I think it makes me see side effects that aren't there sometimes. Starting a new med is definitely anxiety making, so try to be objective if you can. I try not to research meds too much before I start them...I want to know any major side effects and things to look out for, but that's about it. I try not to read too many online reviews, because those are usually slanted towards negative.
Good luck!
posted by hotelechozulu at 10:53 AM on July 23, 2013
I can't emphasize enough how helpful non-psychiatric skills counseling and therapy can be in combination (or not) with meds. All the better if you can find a support group to see that other people struggle with the exact same issues. To be frank, most psychiatrists kind of suck; you need to think of them as expensive gatekeeper technicians who will work with you to find a proper medicine regimen, because that's all they will be for you. It's natural to want to look to them for some emotional support, but if you do, you'll be let down every time-- that's what a therapist, coach, support group, etc. are for.
posted by threeants at 11:05 AM on July 23, 2013
posted by threeants at 11:05 AM on July 23, 2013
One more book recommendation - my son also has ADHD, and my wife read a ton trying to understand it. She found Gabor Mate's book helpful in understanding what was going on. I haven't read it yet, but my concern with it was that he seems to place a lot of focus on the origin of ADHD with problems in parental/child attachment, which got my wife all upset and worried.
posted by nubs at 11:28 AM on July 23, 2013
posted by nubs at 11:28 AM on July 23, 2013
- What is it like to be medicated?
I think I read something similar to this before, but pretend that for your whole life you've been hearing background noise of voices chattering, dogs barking, people walking, etc., and you've never been able to tune it out. And then all of a sudden it is quiet. You can filter out the background noise, the things pulling you in a million directions when you have to get something done.
For whatever it's worth, I have had some pretty bad reactions to stimulants as a teenager. No psychosis or anything like that, but my emotions were absolutely out of control (far beyond normal teenage stuff) and I would pass out as soon as the medication wore off. 10 years later, I finally decided to give it another try and I have absolutely no side effects like that at all.
Raise every concern you have to your doctor about taking medication. I was terrified of taking medication because I had some pretty bad experiences with it, and my doctor was able to help me not be anxious about it. Now I wish I had done this years ago.
My psychiatrist was great, unlike pretty much every other one I had ever treated with, and she took the approach of "managing my treatment" more than being a dispenser of medication. She found me a therapist who specialized in adult ADHD, and would contact her regularly. I found her at the Halowell Center, if you're in NYC.
posted by inertia at 11:35 AM on July 23, 2013
I think I read something similar to this before, but pretend that for your whole life you've been hearing background noise of voices chattering, dogs barking, people walking, etc., and you've never been able to tune it out. And then all of a sudden it is quiet. You can filter out the background noise, the things pulling you in a million directions when you have to get something done.
For whatever it's worth, I have had some pretty bad reactions to stimulants as a teenager. No psychosis or anything like that, but my emotions were absolutely out of control (far beyond normal teenage stuff) and I would pass out as soon as the medication wore off. 10 years later, I finally decided to give it another try and I have absolutely no side effects like that at all.
Raise every concern you have to your doctor about taking medication. I was terrified of taking medication because I had some pretty bad experiences with it, and my doctor was able to help me not be anxious about it. Now I wish I had done this years ago.
My psychiatrist was great, unlike pretty much every other one I had ever treated with, and she took the approach of "managing my treatment" more than being a dispenser of medication. She found me a therapist who specialized in adult ADHD, and would contact her regularly. I found her at the Halowell Center, if you're in NYC.
posted by inertia at 11:35 AM on July 23, 2013
- What is it like to be medicated?
I find it to be really clear and for me, slow. Like for the first time I can look at something and not be distracted by SO MANY things going on around me. I was totally afraid to take meds (I take generic adderall - 25 mgs/day) but I find it really helps. Apparently, according to my family I am much more relaxed - less tense to be around.
- What concerns should I raise to the psychiatrist about medication?
I think everyone is afraid to take meds at first. If you have a history of substance abuse or whatever, start with that. I think they normally start you on the lowest dose anyway. Don't be afraid to say if its working or not. Although I tell you the first day I took adderall I was stunned, like I was missing seeing colors or something.
- Are there specific therapy modalities I should be investigating?
I don't know too much about therapy except that it was my therapist who suggested that I have ADHD and sent me to the psychiatrist. I really find that I need a therapist in addition to meds. Some of my behaviors which I really wasn't aware of respond better to therapy then meds alone.
What books should I be reading to better understand my dingy brain?
Your brain isn't dingy - it's just different. One of the best things I read in a book (which of course thanks to my adhd I can't remember) was to never compare yourself to other people. ADHD people tend to always look around at others and try to figure out where they went wrong. Our brains just do things a little differently. Totally nthing the Driven to Distraction and Delivered from Distraction books. I also really liked You Mean I'm Not Lazy, Stupid or Crazy by Kate Kelly and Peggy Ramundo.
BTW I'm a 47 yr old mom of 4, two of whom have ADHD. Neither takes meds, one because he wants to join the military the other because he opposes it right now but maybe later. As I watch my kids I can see them struggle in the same ways I did and I'm so happy I can recognize it and help them - something I really didn't get.
posted by lasamana at 12:03 PM on July 23, 2013
I find it to be really clear and for me, slow. Like for the first time I can look at something and not be distracted by SO MANY things going on around me. I was totally afraid to take meds (I take generic adderall - 25 mgs/day) but I find it really helps. Apparently, according to my family I am much more relaxed - less tense to be around.
- What concerns should I raise to the psychiatrist about medication?
I think everyone is afraid to take meds at first. If you have a history of substance abuse or whatever, start with that. I think they normally start you on the lowest dose anyway. Don't be afraid to say if its working or not. Although I tell you the first day I took adderall I was stunned, like I was missing seeing colors or something.
- Are there specific therapy modalities I should be investigating?
I don't know too much about therapy except that it was my therapist who suggested that I have ADHD and sent me to the psychiatrist. I really find that I need a therapist in addition to meds. Some of my behaviors which I really wasn't aware of respond better to therapy then meds alone.
What books should I be reading to better understand my dingy brain?
Your brain isn't dingy - it's just different. One of the best things I read in a book (which of course thanks to my adhd I can't remember) was to never compare yourself to other people. ADHD people tend to always look around at others and try to figure out where they went wrong. Our brains just do things a little differently. Totally nthing the Driven to Distraction and Delivered from Distraction books. I also really liked You Mean I'm Not Lazy, Stupid or Crazy by Kate Kelly and Peggy Ramundo.
BTW I'm a 47 yr old mom of 4, two of whom have ADHD. Neither takes meds, one because he wants to join the military the other because he opposes it right now but maybe later. As I watch my kids I can see them struggle in the same ways I did and I'm so happy I can recognize it and help them - something I really didn't get.
posted by lasamana at 12:03 PM on July 23, 2013
- What is it like to be medicated?
I think others have answered the main aspects of this question quite well, but I wanted to add this:
One of the very nice things about Ritalin and Adderall are that they are short acting (4-6 hour) medicines, and they take effect within about 30 minutes. So, if it's not working, or you experience an unpleasant side effect, you can simply not take your next dose and, if need be, call your doctor. It's not like certain other drugs which need 3 or more weeks to build up in your system in order to start working at all.
posted by Juffo-Wup at 12:06 PM on July 23, 2013
I think others have answered the main aspects of this question quite well, but I wanted to add this:
One of the very nice things about Ritalin and Adderall are that they are short acting (4-6 hour) medicines, and they take effect within about 30 minutes. So, if it's not working, or you experience an unpleasant side effect, you can simply not take your next dose and, if need be, call your doctor. It's not like certain other drugs which need 3 or more weeks to build up in your system in order to start working at all.
posted by Juffo-Wup at 12:06 PM on July 23, 2013
I wanted to add a couple of things;
Exercise regularly - your brain actually responds better when you do. It's been written that regular exercise is as good as meds. I work out every day for about an hour.
I take a meds break so on Sunday I don't take any adderall at all. I find it keeps me from having to bump up the dosage. Some people do this, some don't. For me it works.
posted by lasamana at 12:15 PM on July 23, 2013
Exercise regularly - your brain actually responds better when you do. It's been written that regular exercise is as good as meds. I work out every day for about an hour.
I take a meds break so on Sunday I don't take any adderall at all. I find it keeps me from having to bump up the dosage. Some people do this, some don't. For me it works.
posted by lasamana at 12:15 PM on July 23, 2013
For me, medication feels like nothing, until I realize that, oh hey, I just managed to clean the house without bursting into tears of frustration.
I did have to play with the meds and dosage for a few months until we found the right thing. Tried both Adderall and Ritalin and it turned out the lowest dose of extended-release ritalin is what works for me. I felt a tiny bit speedy on adderall (like I'd just gulped a big cup of coffee), and I know other people who like Adderall but felt speedy on Ritalin. So if one thing doesn't work, don't be afraid to try something else.
One thing I had to deal with the first year on the meds was unlearning some of the less-than-great coping mechanisms I'd spent a lifetime developing. Also, I had to re-learn what I was capable of. There were some great lifehacks that I'd completely written off because things like that had never worked for me, but once I convinced myself to try them while being treated, they suddenly did work.
For instance, I had never before in my life been able to keep to-do lists. Now I can. But to figure that out, I had to unpack and challenge a lot of longtime ideas I'd had about myself and my limitations. (I know you said you were good with lifehacks, just using that as an example - yours will probably be different!) I would think coaching would be great for this.
Finally, I would be totally open with the psychaitrist about your concerns re: side effects. Let her know about your personal and family history but that you want to try the meds anyway. Chances are that she'll have you start off on a low dose and have both of you watch the side effects carefully. FWIW, I know many people on ADHD meds with other mental health issues who have had no problem. In fact, with things like anxiety, it's possible that your ADHD makes it worse and that treatment will help with that as well.
posted by lunasol at 3:08 PM on July 23, 2013 [1 favorite]
I did have to play with the meds and dosage for a few months until we found the right thing. Tried both Adderall and Ritalin and it turned out the lowest dose of extended-release ritalin is what works for me. I felt a tiny bit speedy on adderall (like I'd just gulped a big cup of coffee), and I know other people who like Adderall but felt speedy on Ritalin. So if one thing doesn't work, don't be afraid to try something else.
One thing I had to deal with the first year on the meds was unlearning some of the less-than-great coping mechanisms I'd spent a lifetime developing. Also, I had to re-learn what I was capable of. There were some great lifehacks that I'd completely written off because things like that had never worked for me, but once I convinced myself to try them while being treated, they suddenly did work.
For instance, I had never before in my life been able to keep to-do lists. Now I can. But to figure that out, I had to unpack and challenge a lot of longtime ideas I'd had about myself and my limitations. (I know you said you were good with lifehacks, just using that as an example - yours will probably be different!) I would think coaching would be great for this.
Finally, I would be totally open with the psychaitrist about your concerns re: side effects. Let her know about your personal and family history but that you want to try the meds anyway. Chances are that she'll have you start off on a low dose and have both of you watch the side effects carefully. FWIW, I know many people on ADHD meds with other mental health issues who have had no problem. In fact, with things like anxiety, it's possible that your ADHD makes it worse and that treatment will help with that as well.
posted by lunasol at 3:08 PM on July 23, 2013 [1 favorite]
Speak to your doctor of course, but my experience is that adderall can actually reduce anxiety when used appropriately for treating legitimate ADHD. When you don't have EVERYTHING crashing down on you at once and are able to complete tasks correctly and on time, the baseline anxiety is much lower. And then the addition of some new anxiety is tolerable and manageable.
The effect of the medication is immediate, but how you react to it takes some time. I spent a lot of time at first sort of zoning into things. Hyper-focus can be a thing with ADHD people, and the stimulants can sometimes make that more of a problem.
Also, it is very helpful to get some kind of psychological/occupational counseling as part of your treatment. Relearning how to be productive can be daunting and confusing. It should be a mandatory part of any ADHD treatment, even if it's just "everything going OK?" once every couple of months.
At least for me, my ADHD manifested in everything being of the same importance. I hear every conversation, I see every movement, I bounce from stimulus to stimulus. Like a radio with every station playing at once. What medication does for me is to allow me to better tune things in. The distractions are still there, as they should be, but they aren't yelling quite so much.
As lunasol says, the right dosage of ADHD medication means that you don't notice it, except that you can think more clearly. You shouldn't feel "up" or "speedy". You should just feel more awake.
The only problem(s) I have with side effects are thus:
1- I am much more sensitive to caffeine. I love caffeine, but I have to be careful or I won't be able to sleep.
2- I have to titrate my dosage pretty closely or I will have afternoon crashes. Which can mean I'm grumpy and hungry. So instead of taking one 20 MG adderall xr in the morning, I will spread it out a bit to keep the curve of blood concentration a little flatter. 15 and then 5, or even 15 + 3 + 2. Basically just replacing what I metabolize away for a little while to keep everything steady.
If you are quite worried and prone to high blood pressure, test your blood pressure every morning before taking your medication. It should not go up very much, if at all, and then stay at a baseline. If it keeps going up, you need to figure out whether it's the medication causing it, or just exacerbating some other issue (caffeine, smoking, weight, etc.).
posted by gjc at 5:14 PM on July 23, 2013 [1 favorite]
The effect of the medication is immediate, but how you react to it takes some time. I spent a lot of time at first sort of zoning into things. Hyper-focus can be a thing with ADHD people, and the stimulants can sometimes make that more of a problem.
Also, it is very helpful to get some kind of psychological/occupational counseling as part of your treatment. Relearning how to be productive can be daunting and confusing. It should be a mandatory part of any ADHD treatment, even if it's just "everything going OK?" once every couple of months.
At least for me, my ADHD manifested in everything being of the same importance. I hear every conversation, I see every movement, I bounce from stimulus to stimulus. Like a radio with every station playing at once. What medication does for me is to allow me to better tune things in. The distractions are still there, as they should be, but they aren't yelling quite so much.
As lunasol says, the right dosage of ADHD medication means that you don't notice it, except that you can think more clearly. You shouldn't feel "up" or "speedy". You should just feel more awake.
The only problem(s) I have with side effects are thus:
1- I am much more sensitive to caffeine. I love caffeine, but I have to be careful or I won't be able to sleep.
2- I have to titrate my dosage pretty closely or I will have afternoon crashes. Which can mean I'm grumpy and hungry. So instead of taking one 20 MG adderall xr in the morning, I will spread it out a bit to keep the curve of blood concentration a little flatter. 15 and then 5, or even 15 + 3 + 2. Basically just replacing what I metabolize away for a little while to keep everything steady.
If you are quite worried and prone to high blood pressure, test your blood pressure every morning before taking your medication. It should not go up very much, if at all, and then stay at a baseline. If it keeps going up, you need to figure out whether it's the medication causing it, or just exacerbating some other issue (caffeine, smoking, weight, etc.).
posted by gjc at 5:14 PM on July 23, 2013 [1 favorite]
I was in basically the same situation as you last January. My psychiatrist was very careful to check about other issues that might conflict with adderall and I had to get some sort of EEG to check my heart even though I'm young and in perfect health. So definitely talk about it with him.
Being on medication is amazing. For me, it basically lets me think about one thing at a time and keep thinking about it even if I'm not actively focusing. (I think this is the quiet that people talk about). The first day I took it, I remember being blow away by the fact that I could be doing something, stop to plug in my computer and go back to doing the same thing without any problems. Maybe the most useful thing is basically giving me an extra second to make decisions, so I can think about the fact that my phone has email and then decide if I want to check it, rather than having it in my hand and reading email before it's occured to me that I shouldn't. It's also not a magic bullet and I find that it works best if you are at least trying to get stuff done before it kicks in, because sometimes I'll just get very focused on whatever I'm doing right then, even if it's not what I should be doing.
Something that helped me a huge amount was tracking medication, food and concentration for the first few weeks. It makes it easier to experiment with different time and dosages. I can basically set my watch by how it wears off, so I can plan my day around what times I'll be most productive. If you can start some routines, it can be helpful and even when I don't take the medication, it's easier to do stuff because it's habit and I can remind myself that this isn't as excruciatingly boring as I think it is and it's really nice to have a clean room/finished paperwork/no dishes/etc.
posted by raeka at 11:05 PM on July 23, 2013
Being on medication is amazing. For me, it basically lets me think about one thing at a time and keep thinking about it even if I'm not actively focusing. (I think this is the quiet that people talk about). The first day I took it, I remember being blow away by the fact that I could be doing something, stop to plug in my computer and go back to doing the same thing without any problems. Maybe the most useful thing is basically giving me an extra second to make decisions, so I can think about the fact that my phone has email and then decide if I want to check it, rather than having it in my hand and reading email before it's occured to me that I shouldn't. It's also not a magic bullet and I find that it works best if you are at least trying to get stuff done before it kicks in, because sometimes I'll just get very focused on whatever I'm doing right then, even if it's not what I should be doing.
Something that helped me a huge amount was tracking medication, food and concentration for the first few weeks. It makes it easier to experiment with different time and dosages. I can basically set my watch by how it wears off, so I can plan my day around what times I'll be most productive. If you can start some routines, it can be helpful and even when I don't take the medication, it's easier to do stuff because it's habit and I can remind myself that this isn't as excruciatingly boring as I think it is and it's really nice to have a clean room/finished paperwork/no dishes/etc.
posted by raeka at 11:05 PM on July 23, 2013
Being on medication is... amazing. I won't repeat what others said before... it gives me clarity. It gives me the ability to work on stuff I want to work on.
As for medication: give it time. Have patience (yes I do realize how hard it is). Too low dosages, too high dosages, requiring different meds, clashing with other meds... this all can happen. But it will get sorted out, and when it is, you will feel so much better.
Regarding books: I've read three adult ADHD books so far, and I highly recommend all three of them, in this order:
You Mean I'm Not Lazy, Stupid or Crazy?!: The Classic Self-Help Book for Adults with Attention Deficit Disorder. Yes, it's a self-help book, even if you hate those (I sure do), read it. It's eye-opening, and it was the book that got me to get re-evaluated as an adult (was previously diagnosed with ADHD as a teen but was taken off the meds at age 16-17). If you read one book, read this one.
Delivered from Distraction. Less self-help, more eye-opening stuff, slightly different angles than lazy-stupid-crazy.
Your Life Can Be Better: using strategies for Adult ADD/ADHD. VERY practical. Gives you loads of tips. Also it's still 2 bucks for the kindle edition which is nothing short of a steal.
posted by KTamas at 5:26 AM on July 24, 2013 [2 favorites]
As for medication: give it time. Have patience (yes I do realize how hard it is). Too low dosages, too high dosages, requiring different meds, clashing with other meds... this all can happen. But it will get sorted out, and when it is, you will feel so much better.
Regarding books: I've read three adult ADHD books so far, and I highly recommend all three of them, in this order:
You Mean I'm Not Lazy, Stupid or Crazy?!: The Classic Self-Help Book for Adults with Attention Deficit Disorder. Yes, it's a self-help book, even if you hate those (I sure do), read it. It's eye-opening, and it was the book that got me to get re-evaluated as an adult (was previously diagnosed with ADHD as a teen but was taken off the meds at age 16-17). If you read one book, read this one.
Delivered from Distraction. Less self-help, more eye-opening stuff, slightly different angles than lazy-stupid-crazy.
Your Life Can Be Better: using strategies for Adult ADD/ADHD. VERY practical. Gives you loads of tips. Also it's still 2 bucks for the kindle edition which is nothing short of a steal.
posted by KTamas at 5:26 AM on July 24, 2013 [2 favorites]
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Hang in there, your life is about to get better!
posted by Ruthless Bunny at 10:13 AM on July 23, 2013