Before you begin…

If you’re picking up from part 1 and haven’t started on medication, I recommend you stop reading further and stay at that step until you’ve been on medication for a few weeks. Something that tends to happen to ADHDer’s is that we try to get a full picture of a problem before starting it (thus feeding our procrastination) and so you may be tempted to read this blog post in order to peer into the future for the sake of assuaging your anxiety over the thought of starting on medication before starting your search. I’ll tell you that from my own personal experience, none of the self-help advice or self-organization articles or self-motivational videos helped me as much as the medication did. I sincerely believe that none of what I will go into would have been possible without getting on some sort of medication first.

And so I urge you to consider stopping at this point and instead focus on simply finding a qualified psychiatrist, getting diagnosed, and starting on a trial regimen. Getting that done is already enough to have on your plate and if you pile more things onto that thought you may never get started at all and that would truly be the most counterproductive thing to do in your situation.

Just to satiate your appetite if you’re curious what this next part will be about, this blog post is going to be about how the medication affects you, how you feel on it, how to know if you’re on the right one. The next blog post will be about how you’re supposed to look at your medication as a tool in your toolbox and how to best utilize it in your daily life. And lastly, I think that it is important for you to experience this next part without any preconditions in your mind. That way you’ll be able to know how your medication affected you and it will truly be your own experience which I would not want to take away from you.

So for now, find some medication and simply take a few weeks to see how you feel on it. I’m sure you’ll feel amazing no matter what you end up with and I think everyone should know what that feels like for the first time before moving on. So once again, close the tab, get medicated, and come back later, this blog post isn’t going anywhere 🙂

Now having said all that…

What The First Time Feels Like

Many people who start on ADHD medication report feelings of elation and euphoria when they start on meds. The reason is multifold. First, let’s state the obvious which is that you’re basically high when you first start. And to be clear I’m still mainly talking about the stimulants. There are other medications such as SSRI’s that require a ramp up time to take effect. If you’re on one of those, then chances are you’ll have to wait to see any sort of effects. But I can tell you that when I first started on Adderall, I was over the moon.

For the first time in my life I felt like I could ACTUALLY focus, I could ACTUALLY do things. I didn’t need to force myself to get started on my work, I just sort of… did it. For anyone who doesn’t have ADHD, you cannot possibly imagine how liberating this feels. It’s like someone lifting up that iron ball that has chained your brain to the ground after decades of being stuck with it. This, coupled with the stimulation effect, threw me into a non-stop state of hyperfocus for the first week that I was on it. I just did everything. Anything I could think of. And it felt good. It really felt like I had FINALLY found the answer and that all my problems were about to be solved, and the feeling of euphoria which came with that thought was immeasurable.

I find, both in real life and online, that people who start on stimulants report a very similar experience to what I just described. There is this sense that life suddenly has come into focus. That the fog that has been blotting out the sun from your brain has finally been lifted. That all the things that required tremendous mental effort to achieve are now mere annoyances to be swatted away with your newfound mental acuity. It’s like for the first time, you feel power over your thoughts and environment.

And over the next few weeks I rode that wave for as long as it carried me. As it turns out, your body gets acclimated to the medication pretty fast, especially if you’re on low dosages which is what you should be starting out with. 5mg is the lowest dosage of Adderall they can prescribe you and the efficacy of taking it will last about a day, three days at most. Meaning that if you’re taking 5mg of Adderall extended release per day, you’ll feel the full effect on day 1 and by day 3 you’ll probably feel nothing at all. And so after your body starts to get used to the medication, you’ll have to start increasing the dosages to feel the same effect. After 6 months, I ended up taking 20mg of Adderall XR daily, with breaks on the weekends, after becoming used to the 10mg and 15mg XR dosages. Which is all to say that eventually that euphoric high wears off and at that point what you’re left with will be the actual effects of the drug, which I will now discuss.

What Stimulants Do for ADHDer’s

Stimulants have a paradoxical effect on ADHDer’s. No one is really sure why, at least not 100% sure and it’s hard to know since the inner workings of the mind and brain are still somewhat of a mystery to us. I’m going to give you how I frame it though and from that standpoint I think you’ll see that it lines up with what the reported effects are.

When people think ADHD, they think about some kid bouncing off the walls in an otherwise still classroom, or an awkward teenager being unable to stay quiet while a conversation is going on around them, or someone young adult who needs to be up and about and on the go all the time; and from this picture one may conclude that ADHD is simply an inability to regulate impulse control, hence the hyperactivity part in ADHD. This view of ADHD is misleading and while there is a lot more information about this disorder online than there used to be, many people still have warped views on what ADHD actually is and what it feels like to have it. So please, allow me to present my views and my take on what the root cause of ADHD actually is.

At it’s core, ADHD is fundamentally about dysregulation, and this is what most people who don’t have the disorder don’t understand. Dysregulation means you are unable to suppress or direct your thoughts. You are unable to resist your impulses. You lack the ability to self-manage your emotions. All of which is to say that while the state of your thoughts, impulses, and emotions can all be way up, they can also be way down as well.

Meaning that it’s not just the child bouncing off the walls that signals he has ADHD. It’s also the child who is staring off into space for hours every day because he cannot mentally control the line of thought he wants to be on. It is also the child who cannot bring himself to do any school work because he cannot force his brain to engage in a task it does not want to focus on. It is ALSO the child who cannot help but throw himself head first into some random topic that gives him pleasure to be immersed in, to the point of neglecting his own health needs (some people report literally ignoring the body’s signals for hunger when in a state of true hyperfocus).

This disorder isn’t just about impulsivity, it’s also about an inability to properly control when you are engaged and when you are not. It means that for any given task or state or emotion, you can be shooting through the sky of exuberance or sinking into the depths of despair; and sometimes both without any sort of rhyme or reason why. This is why the disorder can be so frustrating to both the affected and the ones attempting to help them. There is no consistency and so any sort of external tactics or strategies or tips or advice on how to ‘get organized’ or how to ‘focus on the task at hand’ is simply doomed to fail. Which is why we need medication.

In my view, medication, that is proper medication, is mainly doing one thing for us: it is giving us the ability to self regulate which in turn generates consistency. Proper medication is about smoothing out those spikes of impulse and disengagement into gentle curved hills of sustained execution and rest. It’s not about getting rid of the things that our brains cannot help but do; rather it is about smoothing out the experience of sliding from one extreme to another. And so as one can imagine, this smoothing is what in turn ‘quiets’ our brains down. This newfound ability to self-regulate our thoughts, impulses, and emotions is what provides us that sense of calmness and peace; that sense of sailing gentle waters after years of weathering the storms.

Now let’s say you’re a few weeks or months into your medication trial and your experience has stabilized. You can now tell what it feels like to be on it, what it feels like to be off. What parts are helping you concentrate, and what some of the side effects of the medication are. You may be wondering if you want to stick with this medication and/or dosage or to maybe try something else and see how that works for you. Something to keep in mind here is that everybody is different and everybody needs to do their own exploration to find the best medication that works for them and that may not necessarily be the first one you started on. What side effects you are and are not willing to live with is up to you. However, when making this decision there is one critical question you should keep in mind:

Do I Feel Like a Different Person When I’m on the Medication?

This is an important question and one that will guide you toward finding the proper medication that works for you. When you’re taking the ideal medication, you shouldn’t feel any different than your usual self. Ideally, you should feel, act, and behave like you normally would except more focused, more even, and more emotionally stable. What you shouldn’t be feeling is that you’re a different person when you’re on the meds. If you do, that should be a clue to you to try something different. Again, everybody needs their own specific combination of medication and everybody needs to make this journey for themselves. No one can determine what is right for you except for you. It doesn’t matter if your psychiatrist, your friends, your family, some internet celebrity, or whoever is telling you otherwise. At the end of the day, this is your life and you’re the one who has to live in it. The choice is always yours and it’s important that you understand and feel that way.

So what does not feeling like yourself while on the medication feel like? It’s tough to describe. My two best examples for you are when I was on Adderall and Vyvance (separately). Adderall made me feel fast, like somebody was pressing on the springs of my internal clock making it tick faster. It made me want to jump the gun, answer questions, insert myself into conversations (more than usual). It felt like my internal timer had been sped up and all my thoughts and reactions were faster as a result. This didn’t have too big of an impact on my social life but I could still tell in the back of my mind that I was a little ‘different’ than usual. And when I was on Vyvance I just felt weird. Like I just had this bodily sensation of oddness that made me uncomfortable while on it. Both of these experiences led me to trying out different rounds of medications of varying dosages until I found the one that works best for me, which turns out is Wellbutrin. And when I’m on Wellbutrin, I feel exactly like myself, except a little more even on my moods and a little more able to get up and do things when I choose to. This is what you should be shooting for. Feeling like yourself but with a little bit extra help to go with it.

It’ll take some time to find what works best for you, almost nobody gets this right off the bat. But as you’re working through your life issues with the medication that you (hopefully) got on from part 1, consider how you are feeling while you are on it and consider trying out some other ones (Modafinil and Ritalin are two other medications you may want to consider in addition to the 3 I mentioned above). Try them out, see what works, what doesn’t, don’t be tempted to go with the first thing that gives you results. Worst comes to worst, you can always go back to what you started with.

So that concludes part 2. In part 3, I will be going into how you should be looking at your medication as a way to set healthy habits and how you may be tempted to do the opposite. Stay tuned…