ADHD - what are your experiences on and off medication?
January 23, 2014 3:14 AM   Subscribe

At the grand old age of thirty five I was finally diagnosed with (mild) adult ADHD, the inattentive kind. I'm still adapting to the diagnosis but curious about your experiences on medication. This mostly affects my planning, organisation and time management skills. It's mostly forgetfulness, losing things and poor ability to do anything before the very last minute (I have an incredible capacity to hyper-focus). I've succeeded academically, excelled even, and have an academic job I am good at but I know my issues have interfered with my ability to do my best and have created a lot of anxiety and agitation for me. I'm curious to know about your experiences with medication and alternatives as I think through my next steps. I'm nervous medication might interfere with my creativity or mask my personality. Your thoughts?
posted by JayAlfred to Health & Fitness (21 answers total) 24 users marked this as a favorite
I'm in pretty much the same boat - though I work in private sector. I've got a Masters in a very difficult field, and did very well in both grad and undergrad. I recently was diagnosed with the same form of ADD and started taking ritalin.
The only personality change is I am not as grumpy and hard to get along with at work, where I've recently gotten two substantial increases in salary, neither one asked for or even hinted at. My employers commented on my "positive attitude". I'm much happier now that I can get things done without waiting til the last minute and not doing as good of a job as I'd like. It's really nice to have your work come back from review with very few corrections and comments, where before, I dreaded the sea of red ink on my drawings.
I had a severe depressive episode way back in 83 or so, probably caused by my inability to complete work in grad school. I had to take some time off. I was put on prozac when it first came out. I'd been on it ever since. After I started taking the ritalin I don't really need the prozac any more.
It's not like you have to taper off these meds if you don't like them, so why not give it a shot?
posted by rudd135 at 4:59 AM on January 23, 2014

If you are thinking of starting on a drug like Ritalin (methylphenidate) or Adderall (amphetamine / dextroamphetamine), then I would recommend that you first read an excellent book called, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, by Robert Whitaker. Or, at least, read the parts that have to do with ADHD drugs. The book gives an excellent overview of psychiatric drugs and their side-effects (though, as I recall, the sections on ADHD pertain more to children taking the drugs than adults). In any case, it's a good read.
posted by alex1965 at 5:10 AM on January 23, 2014 [1 favorite]

Strattera basically felt like "me but able to actually do stuff once I think I should do it", period, unfortunately it also gave me extreme nausea. I am still a big fan of it if you can tolerate it, because I miss how it basically worked 24/7. I was not able to stay on it long enough to really see long-term effects, but did not notice any particular mood changes for the couple months or so that I managed. (Er, except as related to the nausea, which sucked, but I've been told that the severity was atypical.)

Adderall feels like "me but a bit more anxious and able to do stuff, usually, for about 8-12 hours a day". Evenings are still difficult. I take an IR dose but split it up so it works more like an XR. I have an existing anxiety problem, so I have to keep my dose low, because it tends to give me panic attacks and heart palpitations. Even so, eight hours a day is way better than zero, and while I'd do a lot better if I could go back to my regular 20mg/day dose (I'm currently taking 10mg/day) it's worlds better than when I wasn't medicated at all. Does not flatten me emotionally at all.
posted by Sequence at 5:20 AM on January 23, 2014

I find with adderall I do better, I can concentrate, I'm less impulsive, I think before acting. However, I do take a break every Sunday just to be "me". I find that a day off helps recalibrate me but since it's not a weekday, my family is probably more tolerant. Taking a day off also means I am more aware of my behavior and hopefully ways to to address it. The way it's been explained to me is that adhd drugs are not a magic pill and make everything better, they are one of a few things that can help you. You are well advised to keep working on your organization and thinking skills as well and not to expect the medication to cure all.
posted by lasamana at 5:20 AM on January 23, 2014 [4 favorites]

BTW I'm 47 and I take 20 adderall IR mg/day
posted by lasamana at 5:21 AM on January 23, 2014 [1 favorite]

Oh, and off meds, I am definitely not a hyper-focusing kind of person. I got counseling along with meds to help with organizational skills and planning around my weak points. But life without meds is markedly harder than life with meds, which is why I tolerate the side effects.
posted by Sequence at 5:26 AM on January 23, 2014

I had the same fears you did when I first got diagnosed with ADD back in 2004 when I was 26. What I've found, after ten years of using Concerta and working with various therapists and life coaches, is that, if anything, Concerta has helped me do things I never thought possible. I could finally focus, I can quickly process things that used to trip me up, and I multitask like never before. Instead of my life being a jumbled mess of jumping from thing to thing with no follow through I could finally take a task, break it down to actions, execute, and move on. Just a total change from my life prior to ADD treatment.

Having said all of that, there have been downsides to using Concerta for 10 years. Five years ago I wound up in a medically induced coma that kept me from taking Concerta for almost six weeks. While it's a "take it, feel it" medication, it took me a while to get used to how it worked with me when I started taking it again. Short layoffs (two to three days) aren't really issues but, in my case, a long layoff usually triggers bad withdrawals. Another issue that I've discovered with Concerta, and part of this could just be a byproduct of the rest of my ADD treatment, is that I can be very clinical and detached during times when most people would be emotional.

If you're not already working with a therapist that specializes in ADD treatment definitely consider doing so. The first psychiatrist I worked with dealt mostly with children and teenagers but worked with me and my eating disorder therapist very well to develop strategies for me to succeed in life. My insurance covered the majority of my ADD treatment for the first four years (outside of the TOVA Test) but one of the life coaches I worked with was cash only but I struck a deal with her to do five hour long sessions for $800.

Good luck on your treatment. If you have any questions on life coaches or my experience with ADD therapists feel free to MeMail me.
posted by playertobenamedlater at 5:40 AM on January 23, 2014

I have had your exact symptoms. I just got prescribed Adderall a bit more than a month ago. I'm still working out the correct dosage with my doctor, but the most noticeable thing is that before, I felt like I was living at 60% capacity, and now I feel like it's closer to 80%. I still have a lot of trouble getting started on things, but once I do, I can continue until I'm done usually. As far as personality and creativity changes, I have honestly not noticed anything. I still feel like me, just somewhat more competent.
posted by polywomp at 6:45 AM on January 23, 2014 [1 favorite]

Adderall does affect my creativity, but positively: it makes me more able to actually follow through on projects as opposed to just having ideas and then procrastinating on them. It doesn't really change my personality much, except for the better - I find that there's an emotional component with ADHD, at least for me - a lot of impulse control and mood swings. Adderall levels me out, and I'm on board with that.

I remember the adderall shortage in 2011 and it was kind of hellish for me. It reminded me of what life was like before I got on medication. I had shitty mood swings and couldn't really control my emotions much. I remember one day I was sitting around my apartment and I had all these things I wanted to try (games I hadn't played, projects I wanted to work on), but I kept finding that as soon as I was doing one, I wanted to do something else.

All of which is to say, I have never really bought into the idea that medication will mask one's personality in a sense of you not being you anymore. I'm still me but now I can concentrate on things for any length of time, and I find I'm more pleasant to be around.
posted by FAMOUS MONSTER at 6:51 AM on January 23, 2014 [3 favorites]

Best answer: I could have written your question a year ago. Like you I was diagnosed inattentive (also impulsive), but can hyperfocus incredibly. I've been academically successful up to a point (I'm ABD) but procrastination has caused me (and sometimes loved ones and bosses) untold stress. Started medication at age 50 and and an hour after the first time I took Ritalin I went and found my husband and said, "Things are really quiet in here." *pointing to head*

I now take Concerta daily and this is what I notice: My mind is quieter and I don't have the noisy internal self-talk all the time. I can switch tasks more easily, e.g. get off this computer and get into the shower, or retrieve myself faster from interesting rabbit holes. Instead of being overwhelmed by multiple choices/tasks I can pick something and go with it. I can stay on task much more easily and am not derailed by problems that pop up--I can just deal with them and then continue.

Personality wise I recognize myself fine when medicated. Emotions aren't really affected except I feel capable and less anxious. My husband definitely notices when I have taken my meds or not and likes me both ways. I have to say that when I write (fiction, essays), I am more creative without the Concerta, so for me a good time to generate first drafts is in the early a.m pre-medication. But I do better with revision (decision-making, staying with the task) after medicating.

The comedown can be noticeable with the instant release Ritalin but the extended release Concerta is much less like that for me. I take Buspar in the early evening for anxiety and if I'm feeling my ADHD meds drop off then that really smooths it out.

Like the folks above I hope you will be partnering with a medical practitioner who has a lot of experience treating ADHD. I was in grad school when I got my meds and I had to agree to coaching, too, which was very valuable. The meds aren't magic by any means, but just to have the ability to decide, to switch tasks, and to stay on non-thrilling tasks is such a huge help.

If you have a counselor who can help you look back on your life pre-diagnosis and see where your brain-interestingness was in play, that might be helpful, too. Letting some of the guilt and regret go regarding things I couldn't and didn't do, and going forward from there has also been very helpful.

I hope you will come back here with questions if you still have them later. There really is something of an ADHD community here and folks' willingness to share their experiences helped me lots when I first was diagnosed and took meds. I wish you luck.
posted by sister nunchaku of love and mercy at 6:59 AM on January 23, 2014 [2 favorites]

I'm 30 and started on 10mg Adderall about a year ago when I was diagnosed with inattentive ADHD. I'm supposed to take it twice a day but frequently just take it in the morning, skipping the lunch/afternoon pill, and sometimes on the weekends I forget about it altogether. I have had ZERO negative side effects. As far as positive side effects, it feels like I'm "a better me", so to speak, a me who can get not-necessarily-interesting things done without constantly getting distracted or completely forgetting about them. As far as creativity, I'm much more on the musical end than the writing end but I find that I'm much less self-critical on the Adderall than off. (As a random example, when singing in the car, off Adderall I give myself tons of crap for missing notes, and on Adderall I am able to relax and just enjoy myself more.)
posted by agress at 7:11 AM on January 23, 2014

Ever since I was in about sixth grade, my nickname was "the absent minded professor." It wasn't until a loved one, related by blood, was diagnosed with adult attention deficit that I began to think I might also. We are similar enough that I began to consider that my lifelong struggle with deadlines and staying on task might be somewhat alleviated chemically.

I seem to be the opposite chemically of those for whom stimulants are the answer. I started to have massive anxiety over NOT finishing an academic degree, though, like others upthread, I was an academic whiz: I just couldn't deal with, again, deadlines and staying on task. My doctor prescribed Xanax for the anxiety, and for the first time in years I could focus on one task at a time.

Fast forward: Xanax, of course, is not an ADD drug, and the anxiety backed off when I realized that academia and I, while lovers, could not live together. For the last year, I've been taking bupropion and I fell like it has helped me lessen my normal habit of starting 20 projects and finishing none to being able to (mostly) prioritize one to three tasks, complete those and move to the next.

YMMV, but since the OP was in general about whether one might see efficacy in ADD/ADHD meds, for me the answer is a qualified yes. Sometimes I think I might achieve the same results if I were given a placebo and told it was an ADD drug (since I notice no physical changes with bupropion), but that also is a sympton of the adult ADD sufferer, who thinks this might all be psychosomatic.
posted by beelzbubba at 7:13 AM on January 23, 2014

Best answer: I really disliked the idea of medicating, and tried just about everything else first. And, yeah, meditation, eating well, exercise, they helped a little. But it was a difference of degree, and not a great one (though certainly they have other benefits, too.)

Ritalin and Adderall, they made a difference in kind. (I grew tolerant of Ritalin, and switched to Adderall.) There's just suddenly not the same monkey-mind experience of routinely feeling a compulsion to pursue ten other things that aren't the thing I know it's most appropriate to do now. I've noticed no diminution in creativity, or change in my feeling of self. (My experience is basically the same as agress', above.)

I also tried Strattera and had a bad response to it. That doesn't mean you or any other given person will, which gets to the point that a dozen MeFite's anecdotes can't really do anything to predict your experience.

But I think there's a good enough chance that it'll reduce suffering that I'd recommend trying it. If you don't like the results, you can stop.
posted by Zed at 8:05 AM on January 23, 2014 [1 favorite]

I've taken Adderall SR for over 10 years. As a freelancer, I tend to either have a tsunami of work or a drought. Adderall lets me cope with multiple projects and deadlines without freaking out or losing an important element in a pile of stuff. As was said above, it leveled me out. And there's plenty of artists in history who used some sort of stimulant--Balzac and all that coffee for example-- with no loss of creative force. I trust and adore my neurologist and thank him for giving me the tools I needed to actual have my career.
posted by Ideefixe at 8:25 AM on January 23, 2014

Best answer: I'm similar, I did fairly well in school, up to a point. My insane ability to hyperfocus basically kept me afloat for a long time, although it got exhausting, and I knew I could be doing better.

I've tried a few types of medication--what's been working for me the past several years is 72mg of Concerta (extended release Ritalin). For what it's worth I had a terrible reaction to Adderall, but I tolerate Concerta very well--so if you have a reaction to one stimulant does not mean you will not tolerate any stimulants.

In my experience, the only ways it effected my personality is that I am a more patient person overall, although I have less tolerance when people are constant interrupters. I find that annoying in a way I never did before, I think it's because I have some friends who do this constantly, but now I'm actually able to finish a thought when speaking!

I don't think it effects my creativity in a negative way at all. I still have a thousand ideas running through my head, but I'm more able to remember them and see projects or ideas through to completion. It's finally quiet.

For the most part, however, I don't think about my medication at all anymore. I don't feel like a different person--it's sort of like if you took the hyperfocus-me and gave her the ability to regulate focus.

Make sure that you discuss any reservations you have about taking medication with your doctor. I was anxious about taking medication as an adult, and found a great doctor who was able to answer all my questions, and explain things to about the safety and side-effects of long term use and things like that.

I also saw a cognitive behavioral therapist who specialized in ADHD. It felt pretty silly at first to be talking to a therapist, as an adult, about things like how to keep track of a schedule, not lose my keys, or keeping my life organized, but it was really helpful. For me, at least, there was also a lot of guilt and anxiety about my inability to focus or do regular adult stuff, like stay organized, and it was helpful for that as well.
posted by inertia at 8:37 AM on January 23, 2014 [1 favorite]

I just started Adderall recently and posted this question yesterday: , which has some good advice and a bit more of my own background. I was diagnosed a few months ago with inattentive-type ADD at age 26.

I've been trying to control my symptoms through non-medicinal means for a VERY long time. My inability to follow through on ideas and to not procrastinate caused me undue stress and had a very negative effect on my self-esteem. I managed to make this worse by putting a huge amount of pressure on myself to fix myself "naturally", and then felt more like a failure as I fell off the horse repeatedly over the course of the past few years. I'm glad I put the effort into learning different focus techniques, but I REALLY should have been doing this with the guidance of a therapist a lot sooner. I started seeing a therapist about a year ago, and she promptly informed me that I was doing a great job, wasn't a failure and I should really consider seeing a doctor for an official ADD diagnosis so I could at least give meds a try. The funny thing is that I knew they would work well for me because I had self-medicated a bit in college, but I felt so guilty about this that I almost thought it disproved the fact that I had legitimate ADD symptoms.

Anyways. I started taking Adderall about two and a half months ago. I started at 5mg/day which is the lowest possible dose, which was helpful, and have been moving up slightly. I'm having some trouble getting a proper dosage/dosing pattern (as described in my question) that doesn't cause side effects, but the side effects aren't unbearable.

My favorite thing about Adderall is that I can actually really make use of all of those coping mechanisms that I learned in the years before I had a diagnosis. I'm in love with the Pomodoro technique (google it if you don't know it), lists and calendars. Before, I had those things but they caused me more stress because the ADD was so deeply rooted. I knew what to do, but I just couldn't do it. With Adderall, I feel like I'm teaching myself to really live and work this way. I also feel like its not going to be a big deal if and when I want to stop taking Adderall, as long as I continue to supplement meds with other strategies.

I'm basically able to do a list of things that would normally take me days in an afternoon. All of the things I love that I would feel so sad that I wasn't able to pursue, I'm now pursuing. I don't feel "high", I feel more like myself if anything. My other favorite thing is that all the brainstorming and conceptualizing that used to be "trapped" inside my thoughts can now be externalized. If I have a great idea, I can do it. Less rumination. Less emotion rumination, which rules.

Give it a shot, but also work with a therapist who can help you develop good habits. That will help you feel less guilty if you feel guilty, and give you an easier way out if you don't want to stick with meds. Good luck!
posted by supernaturelle at 8:45 AM on January 23, 2014 [2 favorites]

Much of what I would have said has been covered above. I would suggest browsing past questions here about Adderall/ Ritalin as they gave me some good perspective on what I was going through (I'm now in my late 30s and started with Adderall about 4-5 years ago). This is my second go-round with Adderall and the experience both times has been positive, it was only that the first time I chased the dose, which apparently is pretty common, and wound up stopping because it was making me jittery. This time around I've stuck with 10mg XR and that's been good. If I really focus over the course of a day there can be a bit of a crash in the early evening, but it's not that common (and given we have a two month old, it's hard to say which is more at fault).
posted by yerfatma at 9:00 AM on January 23, 2014

Just want to add if you're in the habit of using caffeine to get motivated, focused, etc., I would be very careful about combining it with a stimulant ADHD drug. I used to drink coffee and tea all day (esp. during recent stint in grad school) and now have 1 cup of coffee a day, 1 hour before Concerta. In my experience, more caffeine than that is troublesome for me. YMMV of course, but it is something I wish I'd taken into account when I started my meds.
posted by sister nunchaku of love and mercy at 9:33 AM on January 23, 2014

Meds make me a nicer person because I am not constantly interrupting people or feeling as if I am about to come out of my skin because I cannot sit through a meeting. I think meds have also helped be to become more in tune with my own feelings, as opposed to taking in (and worrying about) too much outside information. My creativity seems to be unaffected, while projects seem much less terrifying.
posted by quixotictic at 2:55 PM on January 23, 2014

Best answer: Adderall was a life-changer for me. I was finally able to make use of my intelligence. I can't wait to get back on it now that I have insurance again.

You can always stop taking it if you don't like the way it affects you, but you owe it to yourself to at least try it.
posted by Jacqueline at 5:06 PM on January 23, 2014

Response by poster: Thank you all so much for your honesty and generosity. I have decided to at least try meds...we'll see. It's great to know I'm not alone and to hear the experiences of others. I'm so, so grateful!
posted by JayAlfred at 11:13 PM on January 26, 2014

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