In brief: The title is a touch misleading, but the journey is long and an update was in order. My experience so far seeking treatment for ADD as an adult.
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Hang on. Before we start…yeah, I know you just clicked and started reading a second ago…I need to take some Adderall, though. Please enjoy this baby bear cuteness until I rejoin you momentarily:
Shit. I grabbed my meds, but then I got a DM and replied to that and totally forgot that I was writing this or that I needed to take my medication. Hang on. Here’s a goat:
OK. I took it. Should be good in about thirty minutes. Which is when I was hoping to be done with this because one of my nieces will surely be up from their nap at that point. I guess I should have taken the meds earlier….
That was three minutes inside my head. Right now, today. I essentially narrated for you what happens when I sit down ostensibly to write something — anything. Or read something — anything. Even if I’m SUPER into whatever it is, that above on repeat is what happens inside my brain.
And here’s the thing: This Is Better.
I know. You wouldn’t ever want to know what it’s like inside my head. My therapist says that to me (with love) regularly. Really, she’s fantastic.
Welp. There my brain did it again. I’ll spare you the subsequent six distractions in the last ten minutes that have kept me from doing anything while the Adderall kicked in.
What was I saying? Oh right. This is actually better.
With real for real comprehensive health insurance (thanks, California & Obamacare!), I’ve been able to see my primary care physician (PCP), a regular therapist, and a prescribing psychiatrist. My copays are only $3 (see: “ALL THE THERAPY: My love letter to the $3 copay. #GetWell2015 (01/31/15)”) so I’m able to go through a long-term, 25-years-in-coming process of getting the diagnoses and medications right. At this point, my doctor and I think I’m about halfway there.
Adderall is a helluva drug. It’s basically magic — which is why people crush it up and add shit to it to get high. (Adderall IS amphetamine. It’s not made out of it; that’s the ingredient on the label.) It lasts for about four hours during which time I am a wonder of focus and achievement.
It improves my mood in a way that makes me glad I was scared of drugs other than alcohol and pot during my heavy use 20’s and early 30’s. If I had tried something in the uppers category I expect I would have liked it and this post would not be getting written right now because I’d be on a rehab roller coaster. That’s not an exaggeration; when I reflect back, I feel intense fear and relief. I’m in a better place with substances now, so I can have the Adderall without worrying about abuse.
It only lasts four hours. So,
When my doctor asked me how many hours a day I need to focus, I said “All of them.” I’m a 9-10/10 in severity on the ADHD scale. If you’re shaking your head because I’m an adult and ADD is a “kid’s disease,” knock it off. Not everyone outgrows ADD, some people were never lucky enough to be diagnosed as kids, and constantly fighting the impulses your brain is attempting to impose on you makes every day tasks a fucking nightmare. Don’t be a jerk and add to the stigma that keeps so many from asking their doctor about treatment. Just because I’m not bouncing off the walls doesn’t mean that activity isn’t happening inside my head instead. And there’s not enough room in there for that nonsense, so shit is pretty awful.
Because of my severity in all four of the diagnostic categories, my doctor isn’t entirely sure how I’ve functioned to this point other than the lucky balancing genetics of a solid IQ and a ridiculously unpredictable childhood that forced me to learn to control my impulses and simply internalize the feelings. Yes, that causes anxiety. Yes, both my psychiatrist and my therapist think this is the biggest cause of my anxiety disorder beyond the life/environmental factors that would cause anyone anxiety.
I don’t just need help getting work done quickly — though, with a 50-hour/week job plus 40 daytime and 30 overnight hours with two kids under two, I definitely need to work quickly when the time is available. I would like, if possible, to also be able to focus while reading a novel, watching a movie, having a conversation with a friend, or simply relaxing with my thoughts, should I be able to find the time for any of that. I have no interest in being on the Adderall cycle where I have to remember (heh) to take a pill every 4 hours all day long just to feel relatively normal and engage with life in a meaningful way.
So I asked about Strattera. It was recommended to me by the doctor friend who actually first diagnosed me with ADD two years ago and encouraged me to get help. I never would have thought about it without her gentle doctoring while we were out having a drink. I wanted coffee at 8:30pm which was a warning sign to her and she prodded a bit. That moment changed my life and I thank her about it constantly enough that she might be sorry she helped me.
The beauty of this drug — for those who don’t have side effects — is awe-inspiring. It’s not a stimulant which means it has less long-term impact on my body and allows me to take the occasional Sudafed for my inevitable sinus infections (when I don’t sleep, they’re a guarantee for me). I take one a day. That’s it. Every day in the morning. And it just works all day. Without keeping me awake at night — another problem with the Adderall. You have to calculate whether you REALLY need to get another thing done and how long will it take. If you want to go to sleep in two hours, that means you have to try and do it without the help. And doing things without the help once you’ve had it is WAY HARDER let me tell ya.
The initial downside of this class of ADHD meds is how long they take to be effective Think the way that long-term anxiety/depression meds need the patient to be at a certain dosage and also have it in their system for a certain amount of time to become fully effective. After discovering that Adderall worked, thus confirming the diagnosis, we were able to talk about the Strattera. This was also a strategy from my doctor because Adderall is cheap as hell and Strattera is a name-brand that typically takes pre-approval to be covered; she’s found that prescribing a cheap drug first often makes the pre-approval process easier or — as in my case — allows you to skip right over it. The bonus is that I can have the Adderall as needed while increasing the Strattera because they don’t interfere.
At my last visit to my psychiatrist, I was happy to report that I have gone from 10+ cups of coffee a day to 1-2 per week. Maybe. If I didn’t sleep because the baby didn’t sleep and I like HAD to get something done, but didn’t want or need Adderall-level focus. The typical dose for Strattera is 80mg and I’m currently at 40mg. Which is good news. It has raised my baseline from completely non-functional to “meh.” I described the way I was feeling to my therapist this way: it’s like being outside on a hot day; you’d prefer air conditioning, obviously, but you’ll take a fan because that’s definitely better.
Right now I’m standing in front of a fan. I feel better because I was dying in the desert a couple months ago. But since we’re trying to get me all the way well, let’s shoot for air conditioning because I have shit to do and it would be nice to enjoy doing some of it.
She smiled. She’s a delightful, petite, abrupt-speaking Asian-American woman in her mid-40’s who’s demeanor I have grown to very much like. I speak in metaphor and she’s very direct, so it took us a couple visits; but she’s patient and gets me really well because she’s decided my metaphors aren’t an attempt to circumvent the question. She said “That’s great. You need six more weeks on this dose; we’ll know by then just how effective 40mg is for you. Then come back. Wait — how much is your copay?”
I really love this doctor because she understands the costs of our still mostly awful health”care” system. “$3,” I said. “Ok, you come back in six weeks. We’ll know and then we can raise you to maybe 50 and see if that’s the air conditioning.”
I can’t tell you how wonderful it is that all of my doctors (and I have several as I’m attempting to treat a host of long-term, unattended issues all at once) speak back to me with my words and terminology. ProTip: that’s how you indicate to someone that you’re listening AND understand them.
So I go back on May 1st. That sounds far off to people who have been asking how it’s going — part of why I’m doing a midway point update. But I have waited 25+ years to get this treatment; I am more than willing to do the journey as it needs to be done so that I can have long term health and success.
I have therapy to help me come to terms with having a mother who’s career as a special education paraprofessional means she should have caught my ADD when I was in grade school. I have some anger there; 25+ years of struggling when a few simple questions about how I was feeling around age 9 or 10 could have meant an entirely different life course for me is gong to take time to process. She also says she has ADD, so it’s a disorder she’s essentially an expert on. I’ve learned over the years to look my anger — or whatever feeling — in the face and call it valid. You’re feeling it; it’s happening; it’s real. Then, take the time to dig under the feeling and see why it’s there and address the causes to do some healing. Until my official diagnosis, I wasn’t really able to do that.
I add on the family drama at the end because it’s important. We all have it — albeit some much more dramatic and damaging than others. When you’re looking into your health and trying to get well, you have to treat your whole self. Part of that is being honest about the baggage you carry around and getting to know what’s in there and whether or not you need to take it out, wash it, and fold it nicely so it takes up less space when you put it back in the suitcase.
You can’t see your physical health as separate from your mental health. These things work together because — it turns out — your brain and your mind are INSIDE your body. (Much like your teeth; don’t get me started.) When I wake up and am able to breathe, I still feel anger for the three previous ENTs who never caught my severely deviated septum which could have been fixed and allowed me to not have the equivalent of sleep apnea my whole life. The anger hasn’t taken up residence in my home, but it still drops by unannounced for a visit now and then.
Not feeling your feelings and allowing yourself the space to heal keeps you sick. Anyone reading this likely has more than one health issue intersecting with some stigma or poverty or both. If you’re able to treat the illnesses and conditions that afflict you, don’t forget the self care that is feeling the anger, relief, exhaustion (yes, that’s a feeling), anxiety, sadness, happiness, pain, and possible mourning for your past self and what could have been possible. Greet it; sit down with it; give yourself the chance to heal and move on.
Now, here are some smiling bunnies to send you on your way:
Note:If you have something you want to rant about, let people know, vent over, or add to the #GetWell2015 project and discussion, just email me: KatieSpeakMail@gmail.com. I won’t be able to cover everything that’s important because I’m writing from a personal perspective and I haven’t been through everything there is to go through. Pitch me or send me what you’ve got — it can be short or medium-lengthed and I probably am not going to ask for edits. I’d like to include some other voices because poverty, wellness, and stigma affect a massive range of people and experiences.
This post is an entry in my year-long project documenting all the messiness and inconvenience and stigma of trying to get well in our culture. You can subscribe, follow, and join in the journey at #GetWell2015 here and on Twitter.