Hello again, adult ADHDers.
We are on to part two of my series discussing different aspects of adult ADHD. And, for this next post I am going to talk about one of the easily more abstract (at least, for me it was!) parts of ADHD treatment: medication.
Medication was something very new for me. In all my years, I had never taken meds to manage mental health or chronic neurological issues (such as ADHD). I had always had a “I can do it without meds” attitude, because for anxiety it was something that I knew was beatable.
When I started exploring ADHD, and began doing research, I found that medication was the one of the best options for managing symptoms and I reluctantly started talking to my husband about it. Once I decided to take that leap, I had no idea what to expect, and the first doctor I saw made the experience even more terrifying (I’ll get to that later).
So, I decided to write this post to give you a list of the most important aspects of medication for ADHD that I wish I had known prior to going on stimulants.
- Not all people see changes on medications; stimulants or nonstims. In some of my research, I found that most meds have a scale of effectiveness. Most people who go on medications fall into a range that that qualifies as normal improvement with positive results. On the right side of that bell curve are people who will find the meds are “life changing”, and on the left side of that bell curve are people who find they don’t work at all. Not all people who start meds for ADHD will find meds work for them, and that’s okay. It’s important to remember that just because ADHD meds do not effect your symptoms, or exasperate other symptoms from comorbid diagnoses, does not mean you don’t have ADHD.
- Too low (not just too high) a dose can cause unwanted side effects. I think most people who look into meds, and specifically stimulants, for ADHD know that too high a dose can cause unwanted side effects that can be either physical, emotional or both. However, I think most people forget to consider that even too low of doses can negatively effect you. In my personal case, I went on the lowest dose of one stimulant, and I found it made me incredibly groggy and would cause my anxiety to flare up. Once I upped my dose to the next dose level, that took away most of those symptoms it out. This isn’t always the case for everyone, but too low a dose can cause for weird peaks and valleys that the right dose will smooth out. It’s a fine tuning process that takes time, so be patient and trust your doctor!
- ADHD medications balance you out, but don’t fix all your issues. Ah yes, the curse of the ADHD black and white thinking strikes again. Especially if, like me, you’ve never been on meds before and you have no idea what to expect. I am constantly reminding myself that stimulants and other ADHD medications only serve to balance me out to 0 (plus or minus a few depending on the day). This means that I am as close to neurotypical as I can be in that moment; but I am not invincible. Motivation may still be something you struggle with, and you may still end up forgetting things or not working as effectively some days. But, once you balance yourself out and get yourself to a level where you can manage the majority of your symptoms, you can begin implementing coping skills and other techniques to help you maintain structure even on the hard days. After all, pills don’t teach skills, but they do level the playing.
- It’s okay if the meds don’t feel like they’re working. So, this is a two fold concept. The first being, it’s okay if you don’t “feel different” on meds; and the second being, it’s okay if they don’t feel like they aren’t working (and perhaps aren’t). I know, with me, I very rarely notice that the meds are working because I feel no different than usual; except now my mind is just a bit quieter and I find it’s easier to get up to do things when I need to do them. My first few weeks on medication was me constantly asking, “Are they working? How do I know they’re working?” My husband would just laugh, and then would ask me to do exactly what I’m going to talk about in point number five. Honestly, if you don’t notice you’re on meds while you’re on them, I take it as a good sign! Treating your ADHD shouldn’t mean you feel weird or struggle with major side effects while on your proper dose. If you feel just like yourself, just slightly more focused and willing to work, you’re probably on the right track. In regards to the second point, see point number one.
- Look at the big picture versus hyper focusing on tiny details. This ties in to black and white thinking again, but when you’re looking for ways to help you notice if your meds are working, think big picture. When I’d ask if my meds were working, my husband would always laugh and ask me to look at what was done today. I’d tell him all the chores I completed, even if it was just one, and he’d go, “And how often do you usually get that done?” That was usually my check back to reality. I was always looking for these weirdly small details to confirm my meds were working, when in reality, the fact that I had managed to do chores 3, 4, or 5 days in a row was actually a larger indicator they were working… instead of me trying to decide if I actually was able to start a project faster or find my keys a bit quicker (which, spoiler alert, some days that wasn’t possible!).
- Even proper doses will see fluctuations in effectiveness. I briefly touched on this in a previous paragraph, but I’ve noticed my ADHD fluctuates. Most days, I’m at my baseline: which is usually quite unproductive and fantasizing about how awesome it would be to do chores (and never actually doing them). I’ve noticed my meds are most effective on those days, but there are some days where my symptoms are worse and my meds bring me to my personal ADHD baseline. There are even days where my symptoms are slightly improved but still impairing, and when that happens, I notice my meds make me slightly groggy but I can still focus and do chores. I’ve also found from talking to other people with ADHD, that even the right dose is only effective part of the time. Again, these meds help balance out chemicals in our brains that allow us to function; which means variations are going to happen. Like I’ve said already? These meds aren’t fix alls, which means as your mood, situations and stress fluctuate, your meds can only help you so much. Be patient and remember, fluctuations are okay – especially once you’ve found the proper dose.
- Needing meds every day is just as normal as needing glasses to see. If you’ve ever felt some shame about taking meds for mental health, raise your hand. If you didn’t raise your hand, I envy you – or you’re a liar. Either way, this point is just to remind you that taking meds to fix the chemicals in your brain is just as natural as needing glasses to correct your eye sight. It’s okay to need it to bring yourself to a normal range, and you should never let anyone – yourself or others – make you feel less worthy of existing or needing meds simply because you need something extra to keep you at your best self. We don’t (well, most good people don’t) make those who need contacts and glasses to fix their eyesight feel bad, so why should we be worried about meds that serve the same purpose as glasses and help us live our best life? Trick question: we shouldn’t be.
What other tidbits do you wish you knew when you started meds? I’ve found these are the best reminders, but I’m sure there are more! Let me know what your tips are below in the comments, and perhaps I’ll make a part two in the future!
Until next time, internet.
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