Howdy all, new to ADHD / this group and this is my first post in any sort of ADD community.
Summary of my current state and the journey to get here:
Typical 'good grades super involved' school experience, stumbled in college but through sheer stubbornness managed to graduate. Recently (within past 1yr) got a job in my field of study, and found myself struggling worse than before. Finally conceded I probably needed help, got ADHD diagnosis in July 2020. Doc and I have been cycling through meds and doses trying to find that sweet spot of effective treatment w/o side effects since then.
My question is, how do I know when it's working? What is that 'aha it all makes sense now' feeling or moment to point to when trying to decide if the current prescription is the one to keep? We've gone through Ritalin, Adderall, Focalin, and currently ramping up through Vyvanse doses. I'm trying to supplement it with better sleep and diet, productivity habits, but it still does not feel like progress or improvement in my general daily focus/self-control. There are no noticeable side effects (anxiety, insomnia, etc) so I'm not sure if there are any noticeable benefits either.
Am I expecting too much of an obvious 'night vs day' transition for these meds? Should I be keeping an eye out for more subtle indicators? I'm worried that meds may not work, as both my family and I have a predisposition for resistance in general - substances like caffeine, pain meds, anesthesia, etc. My doctor keeps trying to describe experiences other patients have told her but I don't know if something is getting lost in the exchange, so I figured I would try asking others directly.
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SpaceyCadet
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Hi there and welcome. My experience has been that it’s pretty apparent within the first hour of taking a short-acting stimulant whether there is a positive effect. For me, it’s like a settling of all the chatter in my head. It’s easier for me to get started on things (but I need to already have a plan in place for what I am going to do), and to stay on task while I’m doing them (I still get distracted, but it’s much easier for me to return my attention to what I’m doing than without medication). I also find it easier to make small decisions, which means I can work more quickly (e.g., I don’t labor over writing as much). I can also tolerate noise and chaos better. So, for example, if my kids and husband are all talking to me at the same time while I’m trying to do something else, I don’t get as flustered. That said, I’ve never experienced an “aha” moment, nor have I found the difference dramatic. I find the effect is fairly subtle, actually. I don’t especially notice the medication when it’s working (I probably noticed it more in the very beginning since I wasn’t accustomed to it, especially when it was wearing off, and my mind would become a maelstrom of thoughts again), but I notice that things just feel less effortful. It’s not that I *can’t* do these things without medication; they’re just harder. I do notice more of a difference when I don’t sleep well. Then, the medication will make me feel more alert, but doesn’t do much for focus. So if you’re getting less than 7-8 hours of sleep a night, you’re not going to get the full benefit. Anyway, hope there’s something in there that helps. Good luck.
Thank you for sharing your experience! I am definitely trying to get a better sleep schedule going (still on the bed @ 3am and wake at 7 habit from the college days), and definitely understand the mountain of effort to even get started on a task. Who knew that's not how you're supposed to approach work??
Yeah, I remember those days. Four hours of sleep a night is enough to give anyone ADHD and anxiety symptoms on its own. If you need more motivation to prioritize sleep, consider reading “Why We Sleep,” by Matthew Walker. My doctor had me read it before we started medication, and I found it very eye-opening (no pun intended)!
The meds won’t do it all, at least not for me. There will always be behaviors that sneak by your filters. When my Vyvanse wears off, my verbal filters are gone. Keep learning about ADHD and you unique presentation. Before my diagnosis, my behaviors were normative, I have to understand the behaviors and impacts before I can know were to start mitigation.
I leveled with my wife that, “I can take meds and do cognitive therapy; but I can guarantee I will have impacting behaviors that will make you feel hurt.”
Focus on mitigation but focus on self educating. The meds will fold in when you find the right one.
It's hard to describe, but I definitely feel it. Sometimes people like to compare it to putting on glasses, and as someone who also wears glasses, it's an apt comparison. At least in my case, it made my mind feel less "hazy"; I was able to think more clearly and focus a bit easier on things.
Of course, there were still some issues and it took me a while to find the right medication for me. I use stimulant medication and in my case if the dose is too high it makes my heart pump like crazy and makes me feel uncomfortable in a way that's too distracting.
It's also important to remember that everyone is different. For me it was night and day, but for you it may not be. I think the only advice I can give is that you should be open to working with your doctor with finding the right kind for you, and that that process can take a bit of work.
My doctor definitely used that exact same glasses comparison in our appointment today! And thank you for the response - I know everyone takes meds a lil different, heck I can chug a large coffee and take a nap immediately while my roommate just smells the caffeine from the other room and gets heart palpitations, so it helps to get a few more perspectives of what I could potentially be on the lookout for.
I was also diagnosed in December 2020, and have been given Adderall to help. At first I was just taking it "as needed" so if I had exams or really needed to get things done, but now I have switched to taking it daily. My brain lacks so much dopamine that I was struggling so much with daily life. Used to get these horrible anger outbursts, and thought I was bipolar/depressed/the whole nine yards. After taking these meds I feel like the best version of myself. No emotional "issues," my brain has calmed the hell down, and I can execute tasks that used to be impossible for me. Keep trying to find a great fit! It has seriously changed my life and I am still within the first week of taking it all the time.
Comorbid things like depression can be really hard to separate from/hide the ADHD diagnosis, so it's great that your meds seem to be helping with that! Doctor constantly asks about my anxiety level on the meds and tbh I don't need stimulants to be anxious, this is all 100% organic farm-to-table anxiety courtesy of my brain. Still on my journey to find that combo and find my best version of my productive self!
Would love to hear how you got on after this...?I was already on Venlafaxine for anxiety/depression and have recently added Lisdexamfetamine for ADHD
...weeks later I'm still trying to navigate lack of appetite, sweating, agitation, muscle tension, cheek/lip biting, fluctuating emotions... I really need a higher dose of the stims for more concentration, focus, motivation... but can't face all I mentioned above besides the lack of sleep and resulting exhaustion, mouth ulcers, nausea, run down feeling and weight loss which all happens in the first days on a higher dose.
Is it down to metabolism, anxiety, or what. Wrong meds, or wrong dose...?
Thank you for sharing my life before meds and my current situation to find meds that work for me! I’m exactly in the same situation as you are and have been exactly the same in school. Also got the diagnosis in 2020. Things had somehow worked in the past and the struggle now is real. Adderall, Vyvanse, Wellbutrin and Provigil haven’t worked for me and coffee doesn’t do much to me with or without meds. Currently trying Ritalin and I think I may be seeing some effects but still can’t tell like it’s night and day. Would love to know your experience when you do find something that works.
🖐Hi-5 to you, fellow STEM professional and attention sufferer (how did we manage this all these years???)
Still haven't found the perfect concoction, but I feel like I am getting closer. So far Vyvanse seems to be the closest, and I've been supplementing it with a tiny Adderall dose in the morning to carry me into the start of the day before the long-term release kicks in. I've also recently added a fish oil (supposed to help brain concentration?) supplement to my mornings, will report on it once I have more data to compare. These have been coupled with an attempt to lean into some of my tendencies (difficult to rise in the morning, so just accepting that my day is more 10am-7 than 8am-4pm like my coworkers) in exchange of making other changes more palatable, like increased exercise throughout the day/week and reduced sugar intake. I've also been fortunate(?) in having a boss who's as much of a chaotic to-do tornado as me, so he readily welcomed my suggestion of more frequent targeted tag-up calls to keep us on the same page for projects and tasks. We have them just about every other day now, and timed with my morning meds it feels like the perfect set-up of momentum for the rest of the day.
Unfortunately this does not seem sustainable for long as I frequently find myself losing steam/focus before it's even mid-afternoon, which isn't all that far into my schedule with as late as I get started. I've got about two more weeks on this dosage before another report with my doc, and if this doesn't pick up I think the next trial we were going to consider was pairing the Vyvanse with Strattera to see if a combo treatment might hit that sweet spot.
So far it is definitely a mix of meds, habits, and environment that gets the best results but that many variables certainly makes it a difficult juggling act. My suggestion based on this experience is find the things you can let slide (your house isn't catalog-perfect but its clean and housemates don't complain; maybe work is flexible enough to let you adjust the majority of your shift to your naturally productive window of time) so that you and your meds can focus the heavy lifting on changing things that can't stay the way they are, like actually making decisions at work rather than procrastinating it to the last minute. If you're fortunate enough to be WFH right now, try to make a designated work zone and time it so you take your meds right before you settle into this zone. Eventually the area itself will help you focus, and the meds can support other things like task organization or decision making.
It certainly sounds like you're figuring out a workable framework for your whole scenario. I have been on Adderall for so stinking long now, I'm honestly surprised that my addled (nee-"uniquely-able") brain still responds to it.
It certainly should: after 23 years we've climbed all the way to 180x30mg IR per month. My Doctor writes it for 60mg tid, but I've come to the realization that 45 a bit more often (with his blessing) is what ends up being needed to keep me from crashing before even three hours elapse. But, I certainly know when it is doing its job.
Here's to hoping that you have many many years ahead of you without tolerance and/or physiological changes sending your doses that high, but don't be too scared if your doctor suggests a moderate increase in the discovery phase to get you situated. Sometimes it takes a bit.
Good luck! I really enjoyed your candor, SpaceyCadet
Really good indicator is if you start looking at your bank account and obsessing over how much your spending and constantly using a calculator to see how much things cost you.
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