Disclaimer: This blogs refers to my own experience of medication only, and does not constitute medical advice. Everyone responds differently to treatment but please speak to a healthcare professional for advice.
So I got rediagnosed with Combined Type ADHD after my NHS-funded private provider closed. The process wasn’t too bad, although I was angry for having to go through it all again. As I was working in an adult ADHD service, I had already filled in my own DIVA in preparation. I had been on meds for 18 months that made very little difference. I know “pills don’t teach skills” and a lot is about working differently (some of which I already did thanks to living with this for so long) but not being adequately treated made it much harder to function. I wish I’d sought to change meds sooner, but there was a reason for that. I was on a combination of prolonged and immediate-release methylphenidate. The stigma of that felt bad enough, but the alternative stimulant- lisdexamfetamine felt worse. It’s that word within, “amphetamine” that as a healthcare professional, I tended to associate with recreational illicit use. I began to realise that I had completely shot myself in the foot. This group of drugs have been used safely for many years, including for ADHD. My experience of my previous stimulant was very different to how a person would feel taking stimulants as a party drug or similar- I was virtually horizontal for the first week. Sadly, society and the media seems to have great difficulty separating illicit use from medical use and the effects are very, very different. There also isn’t sufficient evidence to support the use of stimulants as “smart drugs” in people without ADHD and I would guess it’s partly the ability to stay awake all night and partly a placebo effect.
Moving on, the new provider was lovely. I was quite honest about being a healthcare professional and working in an ADHD service. The Nurse Practitioner asked my views on alternative treatment at the end of the assessment and completely agreed. I was ver tired the first few days of taking medication, but noticed changes from day one. My handwriting improved, I could sit still for longer and I wasn’t as fidgety. It was easier to focus for longer (I mean longer than my usual five minutes before being distracted). I still have problems starting things but don’t feel overwhelmed by “small” tasks such as cleaning, laundry, dishes and stuff. The first day, I managed to leave home for a barre class after work without the usual fuss and forgetting everything I needed. I felt jittery for the first few hours, and my heart rate went up a little but not to cause any concern). A few days later, I managed to clear a corner of clutter without even realising it. I found the boring bits of my PhD (logging found literature and other bits of paperwork) much easier to deal with, and I wasn’t putting them off. I also noticed to-do lists were being completed more often than not. I was coming home exhausted after work though, and felt I could go to bed at 6pm. This did improve thankfully, and I can now function better in the evenings and the “crash” isn’t as bad as ny previous meds. FYI: “Crash” isn’t a comedown, it’s when the ADHD symptoms return with a vengeance in the evening and you start figdeting, losing everything and forgetting what you were just doing. Side-effects wise, my mouth was dry but easily sorted with water. My appetite left the building and I had to be strict about taking my meds with breakfast, or I probably wouldn’t eat until the evening. I found high protein yogurt, fruit and homemade granola (with high fibre stuff added) worked best for me. I cut my caffeine down to one single espresso (down from 3-4). I struggled to muster up an appetite for lunch (and still do) so I tend to have Huel on hand for days when I don’t feel up to eating. In the evening, my appetite comes back but not to the extent where I could eat an entire village as it did on methylphenidate. I also noticed less craving for sugar, crisps and other snacks- probably down to having enough dopamine circulating around. I’m also not buying stuff impulsively as much. The emotional dysregulation (also controlled by executive function- who knew?) got better too and I felt less anxious. The higher dose tipped the balance, making my symptoms worse, and making me tired and my mouth dry to the point of being very uncomfortable. I made the decision with my clinician to reduce to the smaller dose.
I’ve made the decision now that I don’t give any time to anyone who thinks I shouldn’t take medication. I’m done with stigma as I hesitated with treatment in the first place, and then it affected my decision to not switch to something that is actually effective, helps me to function and improves my mental health. Part of this is down to people’s belief that “everyone is a bit ADHD” because the symptoms are things we all experience from time to time. However, in ADHD, the symptoms become very impairing, to the point I consider myself to have a disablity. It can also be a super power. I have some very out of the box ideas sometimes that lead to great things. I’m creative and can speed through things where my brain is more engaged, and cope well under pressure (down to stress producing dopamine I believe). ADHD is confusing at times!
The treatment results aren’t “spectacular” as some people with ADHD experience. I haven’t just become neurotypical (nor would I want to be). I just feel that I have another tool to be able to function better.
In other news, I’ve moved into academia. It’s much better in terms of support than struggling through a Ph.D. in the NHS, and I’ve started teaching students about neurodiversity too. It’s early days but the variety of the work should keep boredom at bay (the nemesis of ADHD brains) and I felt comfortable disclosing my condition and asking for adaptations. I feel like my ADHD will be an advantage in this role, rather than a hindrence.
My ADHD PhD 