am currently on 72 mg of Methylphenidate. I take a rapid release in the morning, and then 54 mg ER later in the day. I have been on these meds for 8 years, and to be honest I really like who I am in where I am in life both personally and professionally.
However, I can not help but think about the long-term sustainability of me being on these meds for the rest of my life. Given the high amount I take and how long I have taken them for, the withdrawal symptoms I feel start immediately after the ER in the morning wares off. This makes sense due to the chemicals my brain is used to. That being said, as I love who I am, and I am doing well in life, I can not help but think IF I am going to be on these meds until I am in my 80s or 90s when I die?
My favorite part about myself is my brain, I love that I feel smart and that others say that I am. I am a professionally ambitus and want to accomplish a lot in my life . As I get further into my 20s, I think how much of this is related to my meds, will I be able to accomplish things in life without them? The times where I have been off of them have made me terrified about this, although I know it is the withdrawal.
I want to talk to my doctor about it, but honestly, I am terrified. I have accomplished a lot for my age, gone to some of the most elite universities in the world, all while taking these drugs. It is worth noting that during the same time when I was on these meds, I barley graduated from high school but then made up for it in undergrad to get to where I am now, but I can not help but think if this was all made possible, going from someone barley graduating high school to attending the University of Cambridge from these meds. In short, I am scared of what life will be like without them, and I do not like that feeling.
Any advice/ thoughts would indeed be so much appreciated.
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youngprofessional12
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It's great to learn of a medication success story, such as yours. I'll share my perspective, but since I was diagnosed only about a year and a half ago at age 45, I'm still learning a lot about ADHD.
First of all, I believe you are the same person, both on and off the medication. The difference is how the meds enable you to be. One well understood analogy is that it's like how wearing glasses can help a poorly sighted person to be able to see clearly. I totally get that analogy, because I'm nearsighted with astigmatism, and I've been wearing glasses since I was 8 years old.
My nearsightedness is somewhat severe, my left eye moreso than my right. Without my glasses, my life would be very different. I wouldn't be able to drive, I would have to hold books or my phone inches from my face, and I'd probably have a permanent hunch from leaning forward to get a closer look at everything. I'd be dependent on other people to get around and maybe even need help shopping for groceries.
Glasses make me functionally effective, which is similar in concept to the effect that methylphenidate has for you. But it's not the glasses that made me a good driver or successful in my work as a computer technician. I made decisions, I put in effort, I learned and grew and accomplished what I did, with the glasses as a factor that enabled me.
You deserve the credit for your accomplishments.
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Your dosage and even the medication that you take will have to be changed from time to time. Like how my glasses prescription has changed every few years, and even the material my lenses are made of has changed twice along the years.
You may respond best to methylphenidate, but there are related medications. (Indeed, you mentioned that you are on two forms, the instant release and the long term release.) Other related meds may also be very effective for you, and may have less severity of side effects. Maybe the addition of another type of medication will help, and may make it possible to lower the current prescribed dosage level. Or you may also respond well (perhaps just as well) to a different medication, such as meds in the dextroamphetamine (Adderall) family of medications, or even a non-stimulant such as atomoxetine (Strattera).
I started on Adderall XR, which worked for me, but it wasn't as effective as I was hoping it would be in treating my ADHD traits, and the withdrawal every evening made me irritable (not a good thing, especially considering that I've got two rambunctious kids under 10 years old). At my request, my doctor switched me to atomoxetine (generic), which is similar to an SSRI antidepressant in that it builds up in my system to keep working 24x7. It's also twice as effective for me as Adderall was, so I have even less difficulty with my ADHD (which in my case is Predominantly Inattentive, I have no Hyperactive-Impulsive traits). Another benefit is that it's not a drug that has potential for addiction or abuse, thus is not a controlled substance, and I can get 90 day refills and see my doctor once every 6 months, instead of 30 day refills and have to see my doctor every 90 days.
New ADHD medications come out every so often, which have benefits for some people. One example is venlafaxine, a medication derived from Adderall, but which has a different delivery system (it MUST be digested to enter the bloodstream) to prevent potential for abuse and greatly reduce the likelihood of addiction.
Some people discover that they respond as well to either methylphenidate or dextroamphetamine types of meds, enabling them to be switched to a lower dosage of the other type of medication every so often. This can help when your body has developed a tolerance to the one you've been on.
Some people require less ADHD medication as they age (though others may require more). It's said that the brain changes of youth don't end until 25-27 years old for males and a earlier for females. (Although, due to neuroplasticity, brains are still capable of change, just not as rapidly as they do in youth.) So, your ADHD traits and medication needs may still get somewhat better in due course.
Other factors within your control that may have a significant impact on your ADHD include:
* diet - proper nutrition, supplementing deficiencies [it helps me to take Omega-3 and Vitamin D supplements], avoiding sensitivities [I know a few people who cannot have a certain red food dye (common in processed foods in America), one of whom is triggered to his most full hyperactive level by it within 5 minutes of ingesting the dye and lasting for at least 2 hours]
* exercise - any form of exercise may help treat ADHD, especially full-body movement and exercise which challenges balance & coordination [e.g. yoga, martial arts, cross training, sports]
Venlafaxine is NOT derived from Adderall. Venlafaxine is Effexor, an antidepressant. You're probably thinking of Vyvanse, which is a prodrug of Adderall.
Hi. You've found an Rx that works tremendously for you. This Rx has allowed the 'Real You' to come out and succeed. I've been on Adderall for 13 years. You said "the withdrawal symptoms I feel start immediately after the ER in the morning wares off" says that your Rx is working as it should (you're getting a great response from it), and that since you know/feel it's wearing off, you need to take another dose. And I know all to well of the feeling when my Rx wears off. Slowly but surely, fear, anxiety, depression, and my mind starts revving back up to 100mph. I should ask, what are the withdrawal symptoms you experience?
I don't know: I don't see the problem here. Heart patients could ask the same questions. Depression patients, anxiety patients. People without a lot of money in the bank, people like me who had major surgery that contributed to my life. People who had the right therapist come into their life at the right time (I''ve had several) ... people who had the money to fund the right therapist at the right time, people on statins, on heart meds of all types, people who wear eyeglasses, people who wear hearing aids, I know a young person with a pacemaker, people with diabetes ... people who go to the dentist ... do you think all of those treatments compromise people's individuality?
Sounds you are someone who needs stimulants to function at a high level. What's wrong with that? If you can live a thriving life without stimulants, then more power to you.
You can gradually ease off the stimulants. I've never felt dependent on them or addicted in any way. I don't have withdrawal symptoms at all.
I think the top dose I reached on ritalin was 64 mg a day ...
I had depression and anxiety in periods of my life. Your thinking reminds me of me of my periods of serious anxiety and depression. My brain would go looking for problems, far off into the distance.
You are taking these medicines to live a good life. Now, I happen to think that the stimulants help me build habits that would allow me to live with a lower dose over time ...
But you're free to stop at any time. I would go gradually with your provider.
I heartily agree with all of the replies below. I take Adderall and Vyvanse and my major side effect is crankiness on the downside. All in all, though, I thank my LUCKY STARS that these stimulants were invented and that somebody figured how to put them to good use. I take medication for several physical and mental health issues and would be total wreckage if I wasn’t so fortunate to have them. Please, give yourself a break. Medication well prescribed and monitored is a tremendous gift that enables us to live as our better or even best selves.
There’s no need to obsess with going off your meds. ADD doesn’t go away. Yes, you learn to cope better over time, but you still need a treatment plan of some sort. You’ve got one and until/unless it loses effectiveness or becomes the way you get high (you don’t sound like a crack-head!), you are in good stead.
Let go of the anxiety! Grab onto gladness! Keep living well!
Dear young professional,I would like to start with I’m not a doctor. There for, this is a lay opinion of someone who has been struggling with add all her life and found out about it three years ago.
It’s not bad to feel scared you know. You worked very hard to be where you are and you have a vision for your life. Embrace this feeling. Sit with it, meditate on it and write your feelings and thoughts about it down so you can read it after as an spectator. It’s best to get to the core of what is really frightening us. Sometimes we think we are afraid of something but it’s actually a different thing that is impeding our movement.
Is it the approval of parents and family and friends you don’t want to lose? Is it the financial status you planned for your life that you are afraid it’s gonna be out of your grasp? The dream of a big house, expensive cars and I don’t know a beautiful someone in your life?
When I was young as you are,I remember people telling me: “ you must find something you want and go after it”
The issue is: I have MANY interests I live laterally. I don’t follow a strait line so that never worked for me actually it confused me. So, I froze. I could not decide and left feeling Something was wrong with me… there are something’s we can only be sure once we lived it, really so make sure you know what is in stake and make your gamble. Know yourself for real and move in even if you’re afraid. Do it slowly every day a little bit. I am going on 50 and all I know is that I’m still learning and will probably die knowing a little bit more than when I gained conscience. Life , lessons and personal growth are disguised under layers of every day boredoms and nonsense in this loud world we live in. For example: a job might pay you well so you can afford the big house and awesome car and etc but are you free? Can you freely think and speak and do according to your conscience? And most importantly, can you live with that? An ok job will not give you means to delight in all money can afford you but, are you free to be yourself and be true to who you are? Can you live knowing you could’ve chosen to be part of the 1percent and decided against it? Don’t get lost in the decisions… get on living. I restarted so many times that I found out that it’s not a big deal at all. The house protects the peoples and their dreams, cars takes us to where we want to go, hopefully safely. Talk to your doctor and explore possibilities. Find a therapist who can help you develop skills and strategies to cope and exercise. Lots of exercise and find a hobby that will get you in contact with nature. And remember: parents friends love you not what you can do. Parents may relax knowing they don’t have to worry and that you are gonna have a fulfilling life but deep down they want you happy and no one can live our lives in our place. The shame and glory are ours alone it’s an untransferable experience. You are not alone. And you don’t have to go about it alone. Help and let yourself be helped. Love and let yourself be loved. Give and let others contribute to your growth. In life we win and we lose if we didn’t how would we grow in experience and knowledge?
May peace finds you dear and May family and friends embrace you in their love and understanding.
BTW: The meds are NOT totally responsible for your happiness and sense of success. Plenty of people take the medications withOUT--not even close--getting the results you're reporting.
So you do have other strengths that are helping you. The meds help remove particular barriers and obstacles to thriving in our lives. They don't solve all our problems. They make it easier to apply our intelligence ... they don't teach us how to read ... or to do our job or how to interact with people and on and on.
Likely you are overlooking the gifts you accumulated in your life before ADHD. Some of those gifts may have been covered up ... and the meds freed you. But the meds do not guarantee that someone will get through college and do well.
The replies to your question are outstanding and come from lifetimes of experience and wisdom (yes ADHD types are super smart)
Which leads me on to my main point about life with and without meds and the fear of being medicated “till death do you part…”
I used to take meds to support me in my work function weekdays only over the last 3 years with great success.
Recently I’ve been taking them over weekends as well,as the benefits it offers in all multifaceted aspects are huge albeit the trade off of some mild side effects.These however can be managed and minimised with help.
The thought of not having a break from meds did play on my mind and I totally get what you’re saying about the thought off always being medicated.
Here’s the catch though think of all the missed opportunities that might have passed you by if your brain chemistry was out of sync and the inherent risks and problems that go with it.
The benefits for me and as each person is there “own universe” outweigh any doubt I may have had about taking weekend drug breaks.As someone told me recently you’re ADHD doesn’t stop on weekends!
I’m 43 years old and started meds 3 years ago and it’s changed my life.I feel like along with the daily benefits my brain has benefited from the sustained use and I’m no medical professional but new neural pathways have been created that otherwise wouldn’t be achievable.
I can’t explain but my life feels more balanced and trust me people have noticed, I’m fact my boss mentioned to me in the recent past that it’s almost like I’m a different person!
Looking at your story young professional you should count your lucky stars you’ve had the benefit of meds and you’ve achieved so much at your age!
The benefits of lifelong and holistic approach to ADHD using meds and supplementing with supportive interventions are in my humble opinion a game changer for people who have these challenges.
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