ADHD - Should I Medicate?
Updated: Nov 10, 2020
In honor of ADHD Awareness month I’m going to share my own story and tell you why you should consider medication as part of yours or your child’s treatment plan. I'm not a medical professional and although I have worked in the mental health field, my confidence in sharing my recommendations on ADHD treatment come from personal experience with the condition.
According to chadd.org, “Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting 11 percent of school-age children. ADHD is characterized by developmentally inappropriate levels of inattention, impulsivity and hyperactivity.”
When I was 19, I was diagnosed with Attention-Deficit/Hyperactivity Disorder.
Wait. Diagnosed at 19?! Isn’t ADHD a kid thing?
According to Harvard, “Many children with attention deficit hyperactivity disorder (ADHD) continue to experience symptoms after reaching adulthood. One study based on a nationally representative survey estimated that slightly more than 4% of U.S. adults meet the diagnostic criteria for ADHD listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).”
You guys… when I went in for ADHD testing, I didn’t even believe it was a real disorder. I thought it was just a turn of phrase that ditsy girls used to excuse their flaky behavior.
So, how did I end up going to a psychiatrist for testing at 19 years old?
While attending community college, I had a part time nanny job watching a little girl whose parents owned a psychiatry practice. After working for them for a few months, her father approached me hesitantly and politely wondered aloud if he could ask me a few personal questions. I’m all about the TMI so, obviously, I was fine with it.
He asked me, “How often do you lose things? Your keys for instance?”
Um. Often. Is this not normal? I locked my keys in the car and campus police had to unlock my car for me not once, not twice, but THREE times in two years. Other times, I was lucky and just left my keys in the lock of my car or house only to find them right where I needed them when I needed them.
He asked me, “Did you struggle in school as a kid?”
Struggle? If you mean crying over math homework from 3rd grade through 12th grade and failing geometry all three times I took it… then, yes.
I thought I had a learning disability as I fell far behind even in some of my favorite subjects in my sophomore year of high school. I went to my school counselor and asked for testing but she took one look at my standardized test scores and said I didn’t qualify. So I got tutoring. I showed up to school early to work with my teachers on the things I didn’t understand. I tried HARD to improve.
I wondered if I might just be stupid. I barely graduated high school and I couldn’t get into the colleges I would have hoped to attend.
He asked, “Do you miss appointments, classes, forget to turn in homework?”
I mean, I’m late to everything. I forget what day it is sometimes and go to the wrong class or miss an important doctor’s appointment. Sometimes I make it to the appointment or to class but without the correct paperwork.
Based on my answers to his questions and some other symptoms he had surely observed during my time working for him, (accident prone, fidgeting, doing things my own way, procrastination, disorganization, interrupting, talking fast or too much, trouble concentrating in conversation/active listening, making careless mistakes) my employer recommended I make an appointment for ADHD testing with his colleague in the practice. He couldn’t test me himself because it would be a conflict of interest.
The testing was long. It included an IQ test as well as other testing to rule out learning disabilities and mood disorders. It was BORING. I, literally, fell asleep during one of the computer tests. I was embarrassed but my psychiatrist told me that was normal for someone with my condition.
My condition? What condition?
Doc said, “Well, the good news is, you have a very high IQ. The bad news is, no one will ever know due to your severe ADHD.”
That sounds super harsh when I read it now but what I felt at the time was…
Relief. I’m not an idiot!
I was right all those years ago. Something was wrong. It wasn’t my fault that I struggled in school.
There are three sub-types of ADHD; Inattentive, Hyperactive, and Combined Type. Like the majority of females with the condition, I fit into the Inattentive sub-type. As I learned more about ADHD, I began to see how it truly affected my entire life.
ADHD has a huge impact on my executive functioning and self regulation.
According to Harvard, “Executive function and self-regulation skills are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully. Just as an air traffic control system at a busy airport safely manages the arrivals and departures of many aircraft on multiple runways, the brain needs this skill set to filter distractions, prioritize tasks, set and achieve goals, and control impulses.”
As a child, I might work all night on homework and then forget to bring it to school the next day. Or I might bring my homework to school but forget to turn it in to the teacher. I’d make silly mistakes on tests because I didn’t remember to read all the instructions or because I got distracted by the air conditioner turning on or a fluorescent light was just barely flickering overhead. Projects took me twice as long as other students.
As an adult, I have often forgotten to pay bills on time despite having the finances available. I dip in and out of conversations (even ones that interest me) only to end up missing 50% of what the other person has said and too embarrassed to ask them to repeat it. I accidentally stop at green lights, have had so many speeding tickets in a year that I had to take a defensive driving course, and I miss turns even when my GPS is giving me clear instructions. I struggle to keep my house clean even though I want it clean and organized.
Tasks with multiple steps feel extremely overwhelming for me. For example, planning meals for the week, making a grocery list for meals plus additional staples, going to the store, checking off the list as I collect the items, planning the appropriate amount of time needed to cook those meals, and then remembering to actually use all the food I bought for that week is such a daunting task that it’s truly anxiety inducing. Imagine, as a wife and a mother, how it feels to be in charge of this task and repeatedly fail at it.
Time management is a huge struggle for me. As a child, it took me longer to do most tasks than other kids my age. As an adult, I’m always rushing around and running late. I experience time blindness as if time works differently in my world than for everyone else.
According to an article in ADDitude Magazine, “Are You Time Blind? 12 Ways to Use Every Hour Effectively” written by Ari Tuckman, PSY.D., MBA, “A good sense of time is one critical executive function. It involves knowing what time it is now, how much time is left, and how quickly time is passing. Folks with attention deficit disorder (ADHD or ADD) tend to be "time blind," meaning they aren’t aware of the ticking of time. As a result, they often struggle to use time effectively.”
Having a diagnosis allowed me to find some grace where I had once been so hard on myself... even hating myself for repeated failures. My psychiatrist recommended that I try medication and occupational therapy. At the time, occupational therapy seemed far too complicated and overwhelming to arrange but I felt perhaps trying some medication was a step in the right direction.
Working in a combined effort with my primary care provider, my psychiatrist and I set out to find the right medication and dosage for me. Every body and mind are different so what works for one person may not work for another. It’s a case of trial and error.
First, we tried Ritalin at several different doses and found it to be completely ineffective for me. I was lucky because the second medication I tried, changed my life.The day I started taking Metadate, it was as if a fog cleared and someone turned the lights on.
I didn’t know that I had been living in foggy darkness until I saw and heard clearly for the first time. I went to class and I actively listened. I retained the information I heard. I was able to take notes without distraction. I was able to control my impulse to speak out of turn. I didn't put my foot in my mouth. Work was a breeze. I checked off my list of tasks at the rate of a neurotypical person and I felt so successful. I can’t even describe how much safer I felt driving home without distraction.
After a couple years of taking Metadate, I moved cities and changed doctors. While in between doctors, I stopped medicating. Upon trying Metadate again, after the break in medication, it was no longer as effective for me. My new doctor worked with me to find an alternative. We started with Adderall. It helped me focus and be alert but it had no impact on my impulse control so we tried Vyvanse. Talk about a miracle. This medication works so well for me - arguably better than Metadate had years before.
Maybe you are a parent who is wondering whether you should medicate your child with ADHD or maybe you are an adult who is weighing the pros and cons of trying medication for your own ADHD. In my experience, ADHD medication is a miracle and absolutely worth working with a doctor to find the one that works for you or your child.
I am so very grateful to have a diagnosis and a treatment plan that works for me as an adult but I often wonder what my life would be like if my ADHD was diagnosed sooner. ADHD is often missed in girls because it presents differently. Girls, more often than not, present as inattentive daydreamers. This doesn’t fit society's stereotype of the hyperactive, troublemaker, boy, bouncing off the walls, with obvious ADHD.
Had I been diagnosed and medicated as a child, things might have been different. Easier. I might not have fallen behind in third grade mathematics, ultimately making each following math class more and more challenging. I might have had more success at learning organizational skills that could contribute to stronger housekeeping skills as an adult. Maybe I would have passed my driving course the first time instead of the third. Perhaps I could have avoided years of accusations like, “You never listen.” And “If you cared, you wouldn’t have forgotten.” I could list numerous failures that might have been avoided. Things that my neurotypical peers were successful at achieving the first time, left me trying again and again to achieve at a passing level. All this repeated failure and disappointing those around me resulted in something called Rejection Sensitive Dysphoria or RSD.
According to WebMD, "Dysphoria comes from a Greek word that means hard to bear. People who have RSD don’t handle rejection well. They get very upset if they think someone has shunned or criticized them, even if that’s not the case. Up to 99% of teens and adults with ADHD are more sensitive than usual to rejection. And nearly 1 in 3 say it's the hardest part of living with ADHD."
RSD causes me to set unrealistic expectations for myself. I set myself up for failure as I attempt to please everyone and then I hate myself for not meeting the standards that I set - assuming that whoever I was trying to please hates me too. It makes me watch the people I’m close to for signs of disappointment. I constantly try to read them so I can make the right move or give the right answer. I react deeply to criticism - sometimes to an extreme where I consider hurting myself.
ADHD has its challenges but it’s not all bad. Some even consider it a super power! Agree to disagree… but some characteristics can seem that way. As a person with attention differences, I can do something called hyperfocus.
MedicalNewsToday calls hyperfocus, “a state of fixation on something that interests a person.”
For me, this means that if I get to working on something I love and am good at, I can drown out the world around me and hone in on that task. For someone who struggles to focus on everyday tasks, when hyperfocus sets in, it does feel a little like a superpower but its really just a silver lining on the storm cloud of ADHD.
So, should you choose to medicate your child or yourself? The answer is personal. For me, medication puts me on a level or almost level playing field with my peers. Something about asking a fish to climb a tree…With medication, I need fewer accommodations. It improves my focus, memory, and impulse control. Medication has improved my self-esteem, helping me to see my full potential and believe I can reach my goals. In my opinion, treating ADHD with medication is the same as treating poor vision with glasses or diabetes with insulin.
Are there other options?
Sure. Other options are worth exploring (perhaps in conjunction with medication.)
What if I can’t afford medication?
Depending on your medical insurance, medication may seem out of financial reach but there are some resources that can help.
www.GoodRx.com is a great resource for comparing prices at pharmacies in your area, finding free coupons, and possibly saving up to 80% on your prescriptions.
Ask your doctor or pharmacy about switching to generic drugs.
ADHD Medication Manufacturer Programs:
Zenzedi - Copay Savings Program
FocalinXR - $10 Copay Program
Ritalin - Patient Assistance Program
DyanavelXR - Savings Card
QuillivantXR - Savings Card
QuilliChewER - Savings Card
Evekeo - Copay Savings Program
Mydayis - Savings Card
Vyvanse - Paper or Mobile Savings Card
Aptensio - Patient Access Support Program
Strattera - Lilly Cares Service
Tofranil - Patient Assistance Program
In my experience, ADHD medication is a miracle. It’s one I want all my neurodiverse peers to get the opportunity to try. You owe it to yourself to seek out the best treatment for you/your child and I hope by reading my story and having access to the resources I shared, you will have an easier treatment journey.