Adult ADHD General

My First Week on Ritalin

It has been right at one year since I was diagnosed with Inattentive ADHD. My psychologist told me that he felt that although ADHD is the reason for many of the difficulties that I’ve been experiencing, it’s also the reason for much of my success in life as well. He said it has been a catalyst for success as I’ve always been good at developing coping mechanisms that allowed me to leverage the strengths of ADHD (my superpowers as I now call them) instead of succumbing to it’s challenges–I just never knew that developing coping mechanisms is what I was doing. He felt that now that I knew what the problem was, I could probably work on developing new coping mechanisms instead of treating it with medication.

Over the past year I’ve learned so much about ADHD and about myself. I have discovered a number of motivational and productivity coping mechanisms, but there were still some areas I haven’t been able to develop coping mechanisms to deal with effectively. Last August I decided to try ADHD medication to see what benefit it might have. My psychologist who diagnosed me couldn’t prescribe the medication because clinical psychologists are PhDs, instead of MDs and only MDs can prescribe medication–so he referred me to my primary care physician. When I had my physical last August I talked to my doctor about prescribing ADHD medication. He said he wasn’t comfortable prescribing those kinds of drugs and monitoring them but he would be glad to refer me to a psychiatrist who could. I didn’t really want to do that at the time so I decided to wait a while longer.

About a month ago I decided it really was time to try medication and I couldn’t put it off any longer. I called my psychologist and asked for a referral and he said that he had never heard of primary care physician referring someone to a psychiatrist for this–general practitioners typically prescribe and monitor ADHD medication. So, with this in mind I changed doctors. Because I’ve read that there is some abuse with these types of drugs, I chose a doctor I go to church with to provide an extra level of accountability. I met with him last Monday, we had a long discussion, and he prescribed 20mg or 40mg of Ritalin-SR in the mornings. I started taking one tablet each morning last Tuesday.

I had done a lot of research on ADHD medication (there is a great section on ADHD medication in the book More Attention, Less Deficit: Success Strategies for Adults with ADHD by Ari Tuckman) but I still didn’t know what to expect for myself.

I don’t really feel different at all on the medication. One family member says she can tell a big difference in me though. I found that rather interesting. Since there wasn’t any “Wow!” kind of feeling, it made me wonder why these drugs are abused. Maybe they have different effects on different people. I’ve been journaling what I experience throughout the day so that I can share that with my doctor when I go back next month. I want to share some of the insights I’ve gleaned so far here as well. I think it’s important to note that anything I’m experiencing at this stage of the game could just be the placebo effect–I experienced initial improvement a couple years ago when my primary doctor put me on antidepressants too, but into the second month it seemed like they were doing nothing.

From the very first morning, I felt a little more peaceful and relaxed. It wasn’t a dramatic difference, but a subtle difference. It’s interesting that Ritalin is a stimulant but that stimulants have a calming effect on people with ADHD.

As I’m doing my work, I find that I still feel overwhelmed at times. I look at my task list and see that there is much more to do than I’ll ever have time to do it. Now it doesn’t feel so much like something that consumes me. I’m able to recognize that the feeling of overwhelm exists, but I can also make a decision about what I need to do in the midst of the overwhelm. Previously, this was often incredibly difficult if not impossible some days.

One of the big issues that pushed me to try medication was that I found myself hyperfocusing on some of the negative things in my life that I seem to have little influence on. I’m a problem solver and when my mind sees something that isn’t as it should be, it goes to work looking for solutions. Since I have little influence in these areas, my mind was like a car spinning its tires in the mud. I couldn’t seem to get it out of my mind and I would get more depressed and frustrated when I didn’t find solutions to try. I still have those negative thoughts and feelings but with the medication, I feel like I can make a conscious decision to stop dwelling on those things.  This has been incredibly empowering. I know that two mornings last week I told someone I felt, “Crummy,” because I woke up hyperfocusing on one of those areas. However, about a half hour or so after taking my pill I was able to recognize the feeling and decide to not focus on it and let it consume me. As I’ve been able to do that for several days, I’m also finding that I’m more empowered to do that after the drug wears off as well.

Another one of my big challenges has been tasks that require a lot of mental effort and creativity. Writing is an excellent example of this kind of task. Before I was on the medication, it could be really difficult to get started on this kind of thing. Just like with overwhelm, I still feel the resistance to the task. Now I seem to be able to accept the fact I have a resistance to the task but then to make a decision to move forward on it. Once I develop some mental inertia I’m then OK to continue on and stay focused. I still use the Two Techniques for Getting Started and Maintaining Focus that I shared yesterday, but now they work much better for me than they did before the medication.

I seem to be able to maintain focus better now on things where I used to get very distracted–and it’s not a hyperfocused type of focus where I can’t pull myself away either. It’s more of a relaxed focus. I still have lot’s of thoughts going through my head all the time, but I feel like I can better choose which ones to ignore and which ones to give my attention to. Rather than my thoughts controlling me, I feel like I control my thoughts better. This seems to be true for a variety of situations besides when I’m working, such as when I’m reading, talking to someone, or listening to a message at church.

I’m more aware of when I’m tired now. I think I’ve often pushed my mind to exhaustion because I didn’t recognize that I needed to rest. Mental work takes a lot of energy and that’s what I do most of the time. I think I recognized tiredness as boredom before. It has been said that the ADHD mind is like a race car–it’s always revved up and racing. So, when my mind would get tired, it still wanted to keep going, but I didn’t have the energy to keep going. My response was to find something I did have the energy to do. My mind was rarely at rest, even if I tried to make it rest. So, when I was tired, I would try to keep doing things, but they were often things that weren’t as important as something else, so I felt bad about the fact that I was avoiding and procrastinating working on the important thing. Now that I recognize that my mind is just tired, I’m better able to step away and just go site outside and enjoy nature, take a nap, or do something else more restful to refuel.

So far, my biggest downside, or side effect has been a feeling in my head that I can’t really explain. It’s almost but not quite like a tenderness after a headache. It’s almost but not quite a light-headed feeling. It’s almost but not quite a mushy feeling in the mind. I’ve began to wonder if this is just the feeling of having the brakes applied to a Ferrari  that’s always run at full speed. I’m not sure, and it’s definitely manageable.

In general, I feel like the Ritalin has helped lighten many of my burdens. Imagine you’re carrying four 10-pounds of groceries. Now imagine that a friend comes along and offers to carry two of them for you. Your burden is now cut in half. You still have to carry the groceries, but you have help. In general, this is how I see Ritalin. I still have the same burdens, but I recognize them for what they are, and then make a decision to do what I need to do.

As I said earlier, all of this could still be the placebo effect. But even if it is, I’ve learned a lot more about myself and I know that I’m capable of doing more and doing it better.

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