Hyperactive Prescribing? Ctd

A reader writes, “I figured I’d chime in on the ADHD thread, since there’s still apparently one voice missing: someone who was diagnosed as a child”:

That’d be me. At the age of six, in my second marking period in first grade, I was diagnosed with ADHD. Though my memory is hazy of that time, what I recall is being inattentive in class and extremely disruptive. I remember one time being at a hospital for something unrelated, and they put me in a straitjacket to calm me down.

I can’t emphasize enough how hyper I acted as a child, and how quickly that changed when I began to take Ritalin.

Quarterly report cards in my school district would give you a checkmark for everything you weren’t doing well in (ability to work with others, self-control, etc.), and after one full marking period with the help of Ritalin, I went from having every box checked to only two. I will never forget the pride I felt then.

My adolescence, life, and identity were very much entwined with ADHD. But my academic and social life settled down significantly when I started taking meds. I was a very good student, usually in the advanced classes. The pills gave me the ability to focus on the school work, and I know I could not have calmed down without them. Everything else, from Little League to karate, was easier with the pill. Days I forgot it were long and tedious.

As I began dating my now-wife, we talked about going off the drug. Those conversations were driven by my primary care doctor suggesting it (fearing the effects of 20 years of daily amphetamine intake at a level of anywhere from 10 milligrams to 54 milligrams!), as well as my wife getting her master’s degree in education, where she gained academic insight into ADHD. (She was shocked, for example, that I was merely prescribed medication but never forced to have therapy or visit a psychologist, something she claimed is mandatory for people diagnosed nowadays, though your thread seems to imply otherwise).

While my energy level initially fell, I have found that coffee does a pretty good job of compensating for the lack of stimulant in me. I now realize the pill also was the deciding factor in my day-to-day life. On days I felt sick in the morning, I could take the pill and feel better. I could eat shit food that should have knocked me out and brought down my energy (so many carbs!), but the pill overruled it. Since then, I have a much better diet, and when I get sick, I actually need to take a day off to rest before I feel better. These things are new to me in my life as of my mid-20s.

The ADHD is still certainly there. Little things still manifest. When I write a song with my band, I’ll write most of the song, but eventually I trail off. It’s mentally finished for me before I actually finish. I’ve noticed this my entire life. Still, being off the pill, I’m more even-mannered than ever before. Though the ADHD seems to act up a little late at night, I’m mostly pretty-even throughout the day. Being well-fed certainly helps, and I can definitely concentrate best right after some food or caffeine. But maybe that’s the same for everyone, not just those of us with ADHD.

I’m very happy being off the pill now, for sure, and this thread has been a great read.

Update from a reader:

I’m the college student with ADD who wrote in a few years ago about using pot to even out the effects of my ADD medication. You put my email in The Cannabis Closet, which was great, but also eternally mortifying because I used the word “coeds” for some Adderall-induced reason. Yikes.

Anyway, I thought I’d chime in to help flesh out the topic. I was diagnosed in the 5th grade, after my exasperated neurologist dad was complaining to a coworker about all the troubles I’d been having in school. His coworker happened to be another neurologist specializing in ADHD and one of the leading researchers on the disorder in the country, and she told him that my behavior matched almost exactly. That’s when I started getting to visit my dad at work during the week, taking a battery of tests.

The most memorable test involved a box with one large button and an LED screen that flashed numbers. The doctor would give me a series of instructions about when to push the button (always on a 9, when the same number happened twice in a row, when a 5 came after a 6, things like that) and then leave me to do the test on a table full of puzzles, toys and games. My dad still likes telling the story about driving me home after the first one and I could describe every toy in detail but couldn’t remember the rules of the test.

After trying these tests under a bunch of different medications, I was only then officially diagnosed with ADD without hyperactivity, and began seeing a psychiatrist once a month to help me not only manage my medication, but also to teach me the tools to adapt to my disorder, to figure out how to take something that can be debilitating and turn it into a benefit. Without those developed skills, I’m not sure I would’ve even graduated high school, much less college. I’ve been on and off my medication since then depending on my life circumstances. My experience, however, gives me two takeaways:

1) My experience with medication was largely positive, but only in the long run. I went through several medications as I grew up, and found types and amounts that worked for me through a close working relationship with my psychiatrist. There were periods where I felt like a hollowed-out zombie, where I didn’t eat or sleep, where I got into fights at school all because of the meds. The idea that kids now are just being given prescriptions without any accompanying therapy is shocking. Medication is an an effective tool, but only when used correctly.

2) I’m currently unable to get any medication at all. My psychiatrist retired, and it’s been impossible to find another psychiatrist who is willing to prescribe me Adderall. Doctors are so worried about people who don’t have ADD using it or selling it that I come across as exhibiting drug-seeking behavior. All I need is someone who can give me the prescription I need, occasionally consulting and checking in to see if any adjustments have to be made. I’m fine for now, my current job doesn’t require that I be medicated, but I want to go back to school, and even the application process feels impossible without meds. I’m not sure what I’ll do. Drug dealers don’t take my insurance.

The issue is so complicated. There are too many drugs floating around, but not enough of them are getting to the people who need them.