First of all: DEAR NSA I KNOW YOU'RE READING THIS PLEASE NOTICE THAT I AM NOT SELLING DRUGS OR ANYTHING K THANKS.
A friend of mine recently contacted me about a friend of his who had been diagnosed with Adult ADHD (and no, not in that "asking for a friend" kind of way). As I'm generally quite public and unashamed of my condition, I was delighted to give him some advice, and as I typed to him and organized my thoughts, I realized this was something that was probably worth sharing with other people as well — especially those who don't have ADHD, but know someone who does, so they can better understand the daily struggles, including the mental and emotional exhaustion of basically having your brain on overdrive 24-hours a day.
Despite what you've been told, living with ADHD is not all fun and games and shiny objects. It's both a challenge and an asset, and often at the same time. Our brains don't work in quite the same way as everyone else's, which isn't necessarily a bad thing — it's just different. This is probably why people don't tend to take it as seriously as other learning disabilities or forms of mental healthcare. As far as the rest of the world is concerned, "being really annoying to go grocery shopping with" is a far cry from, say, being bi-polar (although that can sometimes be a symptom as well). But that still doesn't mean it's easy.
Adderall: Before & After
I've been on adderall for about 8 years now. When my doctor first spoke me about the possibility of having ADHD, I was at first incredibly resistant to the idea of medication, for fear that it would affect my personality or creative, as mental health treatments tend to do (I'm pretty sure I was the only college student in history who had his doctor recommend that he try adderall and then initially said no thank you). Once I got on a regular rhythm of medication, the difference when I was not on the drug became very pronounced. It still makes me wonder how I ever functioned without it. I think, pre-adderall, I had trained myself to function(ish), but once I started taking it, the difference became that much more obvious by comparison. What used to be my status quo now feels like hell. Sometimes this is fine, like when I'm on vacation or whatever, but if my prescription runs out and I plan on doing things, I end up with a lot of anxiety. It's like, I know that I am capable of doing X, but I suddenly can't do it, and I feel powerless and impotent and embarrassed and angry and then hey look there's a pony but no I can't look at the pony right now I have to do this why is the pony so cool where was I what the hell am I doing here anyway?
Anxiety, Frustration, & Impulsiveness
But just because you're medicated doesn't mean that everything is perfect. Sure, you might get used to superhuman brain function (or maybe that's just me?), but there's still plenty of downsides, including anxiety, which can manifest in a few ways. The first, I'll let my friend Quicksilver of the Avengers / X-Factor explain:
I mean, okay, for him it's a little different because he actually has mutant speed powers and also his father is a raving lunatic anti-hero who can control metal with his mind. But the sentiment is still the same. Some people with ADHD have specific things that they still have difficulty with, even on medication, and those frustrations can be exacerbated by the fact that your adderall'd brain is used to working so efficiently. For me, I tend to struggle with general book-keeping and administrative practices that lack a sense of accomplishment. Sometimes it's harder for me to do or work on things that will not provide me with a tangible result. While sure, my brain is scattered and all over the place, the compulsion to reach moments of accomplishment is sometimes overwhelming. I'm sure plenty of non-ADHD people deal with this, too, but sometimes for me it can cause extreme levels of anxiety and stress if I'm not able to reach that plateau of accomplishment as I had planned, for whatever reason. If I have a huge list of things to do, and some of those things include sending a few check-up emails, my brain will be compelled to do the things that will give me a sense of completion, and therefore satisfaction; and as long as those kinds of tasks still linger, it will continue to be my impulse to tackle them instead. Generally speaking, most people don't like bureaucracy, but in my case, it actually makes it harder for me to function.
Also on the note of frustration and anxiety, it should be noted that adderall is a Class 5 controlled substance in America, which is the most highly regulated level for legal drugs. This means that there are lots of restrictions about when and how your prescription can get filled, and like all bureaucracy, there are often factors well beyond your control which could potentially prevent you from obtaining your prescription, which then further agitates your already-high anxiety (especially when everyone at the hospital treats you like a dope fiend for trying to get narcotics, even if they are legally prescribed). I'll write more on this later, because that's a whole other horrible blog post...
Organization & Translation
My means of organizing things is actually similar to the bureaucratic struggles / tangible results mentioned above — when I do organize things, I do it very, very thoroughly, but it's not always done in the way that other people would do it (this might also be a symptom of being "creative"). I can eventually work within other peoples' organizational structures (such as spreadsheets, etc.), but it sometimes takes me longer to process that information and translate back into my brain's organization structures, which can make me irritable and anxious because the time it takes for me to translate those things feels like time spent without any tangible productivity, and so on.
Rejection & Depression
Also, as some even more recent studies have shown, we take rejection and disapproval very, very personally. When I read this article a few months ago, it blew my mind, knowing for the first time that there was a reason for some of my occasional extra-rational emotion reactions. I'm usually pretty level-headed with my emotions, but some things would still hit me inexplicably hard. It was nice to know that I'm not crazy.
(Now imagine how it feels when your ADHD itself is the cause for rejection and disapproval, and the wormhole that makes you start to sink into. Because trust me, that kind of discrimination happens, and it hurts more than you can understand.)
Hunger & Hanger
One of the biggest and most apparent side effects of the medication for me is actually hunger suppression — apparently adderall blocks the hunger receptors to your brain somehow. I lost about 12 pounds in the first few months that I was on it (I've since balanced out — unfortunately, really, because I could really stand to lose those 12 pounds). It basically makes you forget to eat. I've since trained myself to eat normally again (hence not keeping those pounds off, damn!), but it's still hard. Some days I'll be at work and so caught up in something that I look up at the clock and I see that it's 3:30 and I haven't eaten since 8am. When that happens, I am suddenly overcome by hunger because my brain is like OH YEAH I NEED FOOD I TOTALLY FORGOT TO MENTION THAT EARLIER SORRY BRO. This can also make me a little hangry — generally speaking, if I'm working hard enough during the day that I forget to eat, I'm probably already cranky, and then the not-actually-eating makes it even worse.
Can't Stop, Won't Stop...No Seriously I Can't Stop
One of the weirdest adjustments to being on the drug is hyperfocus. Which is a symptom of un-medicated ADHD people, but it gets amplified when you're on adderall. Sometimes I get so into a project that it's hard for me to stop. Once that chemical starts going on, it's like a high. On those days when I forget to eat until 3:30, sometimes I don't eat at all because even once I realize that I'm hungry and haven't eaten in 8 hours, I am so in the zone that I can't stop it. Physically and mentally, I am literally incapable of stopping. I have trouble getting writing in when I have small increments of free time because it takes a bit to get into the groove, and then once I'm there, I don't want to stop, and then I'm a half hour late for work. Again. At work, I tell people to email me, because I have two monitors, and I can see the email popup out of the corner of my eye and will get to it in order. When people come to my desk or call my desk while I'm in the middle of something, it's really, really hard for me. I can be very short with them for interrupting my flow. It's not intentional, or personal, but I get irritable when they take me out of that zone, because then I have to get back into it.
Multitasking & More
On the bright side, adderall makes me very good at multitasking, so I could, for example, keep typing this email while absorbing information that my boss is saying to me while standing right beside watching me work (which is not actually happening right now, but is certainly feasible). I only feel bad about this because I fear it comes off as rude, that I'm not giving them my attention. When I am actually giving them my attention, but I'm also working on this other thing that has my attention because again, it's hard for me to stop.
"The Wall," or When It All Wears Off
The downside of all of this is what I call "The Wall." It's that exact moment when you realize that your adderall has worn off. You're going, going, going, going, going, going, moving, thinking, can't stop, go — and then your brain starts melting out of your ears and staining the shoulders of your favorite blazer. This moment hits at some pretty inopportune times: in the middle of writing, or at the very end of the work day when your boss suddenly asks you to build a photo library before you go home and that photo library would normally take you maybe a half hour but suddenly it's 7:45 and you're still at work because your brain is not sharp as it was before, but if you let yourself take a break, then all momentum is gone and you'll never finish it.
There's another struggle that comes into play with this as well, which someone else once explained to me with a pitch-perfect metaphor: imagine your mind is a bucket, and your focus is water within it. Once that water's gone for the day, you have to fill the bucket up again. But that takes time — and unfortunately, the faster you empty the bucket (i.e., drain your brain's ability to focus), the longer it takes to fill it back up again.
Regimenting Your Workload
Fortunately, I've gotten pretty good at kind of regimenting / compartmentalizing my work in these ways, both at home and on the job. It took a while, but I've had to train myself to know what I can and cannot do at different times in the day. It helps to structure things, and keep to those structures. Familiar patterns and schedules make it easier for people with ADHD to get and stay organized and accomplish all of the things that they have to. This can be tricky, because our impulses drive us towards anything but a well-regimented and structured life. That's part of why I prefer writing in the morning / midday, for example — if it's a habit that I do every day, it's much more likely to happen, and when I fall out of that pattern, it makes a harder for me to get back into it, or find other times to make it work. I do get lots of ideas at nigh as well, and sometimes an urgency to work on something, but it's a lot harder for me to get into that groove once the drug's worn off, and then I'm frustrated and cranky because again, I feel impotent. Certainly your brain still has chemicals in it and residual drug stuff that can help you get into that zone even after the drug has worn off, but it's harder to get there.
By way of example, imagine you're working on some code in Dreamweaver and you blink and suddenly that really simple HTML is written in Chinese characters. And all you want to do is remove the damn <b> tag but for some reason it looks like this 比 and is therefore impossible to locate. Trust me, it sucks.
Energy & Sleep
ADHD can also make it harder to sleep. Sometimes, it's just because your brain refuses to shut off when you finally crawl into bed (did I say 'sometimes?' I meant 'all the times'). On top of that, Adderall is a super powerful stimulant, and even after you hit the wall, that residual bit of drug stays in your system and can keep you energized (I'm kind of in a pattern now where the drug wears off around dinner time and I eat food and then I get really drowsy and then an hour or so after my meal I am SUPER PUMPED just not very good with details).
On the bright side, when you wake up tired at 8am because you went to bed at 2am, you just pop that pill and once it hits your system, you're WIDE awake. I've gotten used to this by now, so it's not as pronounced of an effect, and I usually need a little bit of caffeine to get going (think of it like priming the engine). But even then, caffeine only has a limited effect on me. At a point, it stops waking me up and just makes me vibrate, which is no good. I guess some of this depends on how much your friend actually sleeps and how much they overstimulate and overextend themselves in every aspect of life like I do. (Apparently that takes a lot of energy after your 25th birthday. Who knew?)
A Heart Like a Kick Drum
And finally, your brain tends to produce things like the above. Although I also have hypomania, which often tags along with ADHD, but is not an added bonus for everyone. Part of both of those things — which it's important to be aware of, just in case — is that I have an insanely high heart rate as well. My actual blood pressure and cholesterol and all that is pretty close to perfect, it's just that my heart beats like a gattling gun. So I have to be extra conscious to not get bad cholesterol or whatever. So if you or your similarly ADHD-addled loved one already has heart health concerns or issues, be careful and check with the doctor about that.
So. That's my brain on ADHD — and that mess of word vomit above is my brain responds internally to every question you ever ask, and everything you ever say to me. Any questions?