The elephant in the room… taking ADHD medication
I confess…have a love/hate relationship with ADHD medication. While I do not like taking it, I do not know how I would have ended up where I am without it.
Attention surplus
Do not get me wrong, I do not credit it with all of my successes but I do know, I struggle to focus on just one thing at a time. As I like to put it, I do not have an attention deficit, I have an attention surplus, I pay attention to too much. When I am standing in a circle of people, I pick one or two words that each person is saying and I combine them all into one sentence, one thought, and that is what I take away.
Activity level
In addition, I cannot help it, I have to move all the time. I shake my legs, I bounce my legs, I fidget with my hands, I change how I am sitting, I chew gum… My brain moves faster than I will ever be able to, which causes me to talk very fast (even though I always try to slow myself down). I pay attention to too many things and constantly move off of ADHD medication. The good news is, even on medication, my brain moves at lightning speed, which has proven to be extremely beneficial.
Ability to focus
On top of that, I struggle to find motivation to do things. Which is funny because I am honestly one of the most driven and motivated people I know. When I put my mind to something, I make it happen. However, no matter how hard I try to put my mind to cleaning the house, studying for a licensing exam, or doing nonpreferred tasks, I have trouble completing them when I do not take my ADHD medication until I am in panic mode, but I always get them done. It is beyond annoying! The good news is, I love what I do for a living so I do not have this problem when it comes to getting work done.
My history
I will come back to the medication after I tell you about my past. I was in fourth grade when I was diagnosed with ADHD (see profile for more information). For the first time in my life, I learned why things seemed to be harder for me than my peers, why my backpack looked like a bomb went off in it, and that I am actually very intelligent I just struggle to show it in conventional ways. I am the oldest of three girls; I have two sisters 5 and 10 years younger than me. My parents were thrown for a loop. It was not an easy journey for me or my family (see My life with ADHD, nevertheless I persisted- Part 2) but one of the hardest parts was my parents having to decide whether I should take medication or not.
Few options for medication
When I was diagnosed, the only real medication out there was Ritalin and there was minimal research on it. My father was nervous to put me on it. He wanted to find other means to manage it and make sure it would not impact my future. My mother understood how he felt but she did not feel as strongly about the medication. My grandmother was a teacher and served as a family consultant which also helped. She had seen the difference medication had made in the lives of her students. My parents tried everything and finally decided I would try Ritalin, which was never the best match for me but it helped some. I still had to be in Special Education and Section 504 for periods of time but it helped. Then I found a stimulant medication that worked much better for me.
Medication effects
ADHD medication positives
Finding the right medication changed my life. I was taught how to be organized and did it. Then, I started turning in assignments; I started rocking my schoolwork. It still took me more time and effort than my peers but I did it. I graduated high school and I was accepted into The University of Texas (UT) at Austin. After graduating from UT, I obtained a great job, was accepted into graduate school, and graduated with my doctorate. My accomplishments cause me to wonder what would have happened without ADHD medication.
ADHD medication pitfalls
While I am grateful for ADHD medication, I also do not like it. It changes me and flattens my affect. I do not fully feel like myself. If I am worried or anxious when it goes into effect, it exacerbates that. Similarly, if I take it too late, I am up all night. My friends and coworkers notice whether I am on it or not. They joke about needing me to take it to calm down (due to my undying levels of energy) or take less because I am not as fun on it. It is hard to find a middle ground. Stimulant medication also kills my appetite but then when I am not on it, I eat everything in sight. People try to chit chat at work and if my meds have just kicked in, forget it. I have to hyper-focus on my work. I DO NOT LIKE IT.
Cost
The cost of medication can make it even more difficult. Insurance is so beneficial in many instances but makes obtaining stimulant medication difficult. They are highly regulated substances and as a result, insurance does not always cover much of the payment.
Options for medication
The extended release medications are typically significantly more expensive than immediate release, but it is not as easy as just switching from one to the other. Extended release gives a dosage slowly throughout the period of a day. There is no huge burst like there is with immediate release. Conversely, with immediate release, you can try to take the same dosage (e.g., 20 mg) but it hits the system like an explosion and dies off rapidly. For those who try doubling it, taking it at the beginning and halfway through the day, they could experience other side effects (e.g., becoming highly emotional and anxious) because it does that burst twice a day with high doses of medication.
Once people find something that works, they cross their fingers hoping insurance always covers it well because they don’t know what they will do otherwise. Then when people try to do something to help cut the cost, it does not always work. It can drive them, and everyone around them, nuts.
Adulthood
It is so much harder to obtain a prescription as an adult.
Personal history with doctors for ADHD medications
I went to a psychiatrist when I was first diagnosed. When we moved to the DFW metroplex, I began seeing a neurologist. I stayed with that neurologist though graduate school because he was concerned about what someone else would try to do. He did not want my prescription altered because it takes so long to find the right medication and the right dose.
Changing doctors
When I graduated, I needed to switch doctors. This was hard to do because doctors have to protect themselves and their licensure, especially when ADHD medication is so easily abused. Most family practitioners will not prescribe ADHD medication because of the liability of the stimulants. Therefore, you typically have to go to a psychiatrist, which costs the same as a specialist copay and that adds up quickly.
Finding a doctor for ADHD medication
I found a family doctor that prescribes ADHD medication but I had to find all the records I could to verify my diagnosis. If I had not been able to provide all of the records, I would have had to undergo psychological testing. Yes, the type of testing I do on a daily basis. Therefore, I tracked down records from when I was 15 but they still wanted me to call the psychiatrist who prescribed me medication in fourth grade and then the psychologist who diagnosed me; that was not possible. I do not even remember the psychiatrist.
Next steps
Once I found the family doctor and provided my records, I scheduled regular appointments due to the controlled nature of stimulant medications. It still blows my mind that people want to take these. If I did not have to, I would not; it is not my idea of a good time. While it is frustrating to obtain medication I need, I was lucky enough to be able to do that. I cannot fault the doctors out there. It can just be a rough road at times.
Interesting tidbit on possible side effects
It is not uncommon for individuals to need more than a stimulant alone. Most stimulants can add such a high degree of anxiety to someone that another medication is needed to counteract the anxiety. So people take medication so they can focus like others do naturally and then more medication so they can get rid of the side effects. Regardless, and most importantly, they can often pay better attention!
Takeaway
At the end of the day, I have a love/hate relationship with my ADHD medication. When parents ask me what to do with their kids, I tell them they know their kiddos best. Then, I talk them through the positives and negatives, I explain what to look for, I talk about how to monitor it all, and I share my personal experience when necessary.
There is no doubt, I did as well as I did, in part, because of finding the right medication. I have a ton of drive and was made for my career but I needed some extra assistance and you know what? That is okay. It may drive me crazy at times but I am thankful for it every day. ADHD is my biggest blessing and ADHD medication helped make it that way.