I was recently diagnosed with ADHD and was prescribed Adderall. When I received my diagnosis, I told the doctor and prescriber how nervous the idea of taking medication makes me. They both told me it will “change my life”, and it’s the most effective option. I also started seeing a therapist because I felt a multi-modal approach would be best for me.
It’s been over a month now, and I can’t bring myself to actually take my medication. This week I felt more comfortable with the idea of taking it, but each day I’ve either talked myself out of it or take until the afternoon when it’s too late to muster up the courage to take it. For the past two days I’ve stood in the kitchen with the pill in my hand for at least 20 minutes, on the verge of tears, fidgeting/rocking back and forth, staring at it just to end up putting it away again.
I’ve really tried doing my research about the risks of medicating and not medicating, but I just feel either more terrified or confused the more I read. Everything I find seems to be information from rehab clinics and people recovering from stimulant abuse (but they don’t make it clear whether they were being abused by ADHDers or non-ADHDers), personal testimonies that say either they can’t live without it or that it turned them into a zombie, the straight-up drug prospectus, or information regarding children. Are there really no long term studies about the affects of stimulants on adult ADHD brains? What makes it worse is that everyone keeps telling me it’s ultimately my decision - but I feel completely incapable of doing so.
I’m super frustrated, confused, and tired from literally crying about this everyday. Has anyone gone through this before, and how did you overcome this fear? Are there any resources (websites, articles, books, etc.) that have helped you in making a decision?
Taking stimulant medication for ADHD has been controversial from the very beginning. You’ll find many anecdotal stories raving about how effective and safe it is. Just as much you’ll find many anecdotal stories strongly advising against it’s use. Therefore it becomes a personal decision taking into account the best input from a knowledgeable physician you trust.
Of course you’ll never know if you might gain some very positive results unless you try it.
First, breathe. The fear and anxiety you have about medication is normal. It’s okay to be scared and overwhelmed by the prospect.
There is a lot of information out there about medication and a lot of misinformation as well. ADHD stimulants get a bad rap in the media because they can be abused. However, they are safe for most people. The risk of addiction is fairly small based on the research out there.
It can be helpful to write down some of your anxieties about taking medications. What are you afraid might happen? Are you afraid of side effects? Are you afraid of being judged? Are you afraid it will change your personality?
I find that in situations like this I will make a “decisional matrix” about what to do. In a square make four boxes. You read it from left to right, top to bottom. In box one, what are the pros or benefits of changing. In box two, what are the cons or risks of changing. In box three, what are the pros or benefits of not changing? In box four, what are the cons or consequences of not changing? I find this sometimes helps me realize some of the things I’m trying to work through and can help me decide what to do based on where my values are.
For me the medication has been life changing. I sometimes get emotional when I talk about how much better I feel and how much more manageable my life is now that I have it. It helps me complete things, keep track of things, calms my mind, helps my body feel less restless, and gives me the focus to pay attention when my significant other, my boss, or my friends are trying to talk to me. It helps me feel more confident because I can do those things. And it gives me insight into the fact that I have a diagnosis that can benefit from treatment.
I can’t tell you what to do. I can only suggest that you take the time to continue to educate yourself with legitimate sources. There are lots out there including podcasts, articles, research articles, and videos.
Whatever you choose, make the decision right for you. My therapist will sometimes say, “Look forward into the future. Which decision would leave you having more regrets?” That helps me sometimes too.
We’ve had stimulant medication such as Dextro-Methamphetamine since the 40’s, that being said it’s use with ADHD and safety had picked up during the 70’s and continued since then.
What your doctor said was true, stimulant medication has been statistically the most effective form of medication, works the fastest, and tends to have the best results, it may not be for everyone, and maybe one stimulant works for you and another doesn’t, all of this is due to many, many factors which are different for everyone, some are environmental and you have influence on, others are genetic and you don’t.
I will say this, I have done extensive research on this topic, it obviously affects me, and I have a complex perspective on drugs altogether, but at the end of the day, it is your decision, and you should try to make the decision as well educated as possible.
Dr.Russel A Barkley has said that those who don’t receive stimulant therapy and have at least 2 of the dopamine regulation gene mutations associated with ADHD, are projected to have a reduced life expectancy of 8 years, other sources such as ADHDmag have said that for ADHD altogether (it’s a lot more than 2 gene mutations) it could be a reduced life expectancy of 14 years.
But there’s other concerning factors, psychoactive central nervous system stimulants cause oxidative brain damage, and there’s a concern of paradoxical decompensation, or in simpler words, the worsening of ADHD symptoms over a long period of time.
This is really poorly written by me, and I might just come back and take it down and re-write it, so it’s better.
But there’s a few aspects I want to throw you way before I go study for SAT’s,
Try not to think of drugs emotionally or with morals, as they are simply chemical substances that do not hold moral characteristics, just as a chair and a table do not hold moral characteristics, a drug is neither good nor bad, great nor evil, they simply have pros and cons that have to be situational and subjectively weighed to see if it is of value to that person to consume, and this is not simply a weigh of pros and cons of OH I should or shouldn’t take Adderall, maybe in the start it should be that, but you should also analyze it constantly as our dynamic and circumstances change constantly, our lives are fluidly ever changing, so our decisions on which we consume a substance should be constantly re-evaluated, personally medication was one of the best things I’ve done, just because it’s medication doesn’t mean you should blindly take it every single day without precaution, you should know the purpose in which you are taking it for, and think that the purpose and benefits of the drug out weigh any negative aspects the drug has, this is easier said than done I get it, as to actually do this, it takes a lot of scientific literacy and reading medical journals etc. But i’m dyslexic and was told how bad my reading was in school, and i manged somehow, so have faith and resilience.
The point i’m trying to make with the constant analysis, is there is oxidative brain damage [ don’t get worried, brain damage is only relative, in fact, being awake, causes brain damage, it’s why we sleep, wakefulness causes brain damage due to toxic build ups of protein and oxidation, but if we don’t sleep and take good care of ourselves it can cause dementia, but if we do take care of ourselves that brain damage can be reversed via neurogenesis and other mechanisms], but like i’ll just give an example and i’ll clear this up better later, is that if I’m going to sit all day and watch T.V, I’m not going to take stimulant medication to do so, that would cause oxidative damage and increased drug tolerance for no beneficial purpose, which I’m currently on Dexedrine which is only the more psychoactive amphetamine salt that’s in Adderall, Adderall is mixed amphetamine salts, so mg for mg Adderall’s a littler weaker, but if i’m going to go study for my SAT’s which is the reason i’m making this short lived, well as short lived as I am capable of because I write term papers for everything whether or not im medicated, but if i’m doing something like academic or benefical overall to my life, I’m going to medicate if I need to focus and recall it, but i’m not going to medicate for leisure activities, it’s also good to take tolerance breaks.
Okay sorry for this jumbled mess, I was really not planning on responding to anything, but I felt the need to for this, I will when I have a bit more time, write a better, more well-thought, hopefully source cited, response but for now I’m going to go study.
And one last thing because my hyper activity won’t allow me to stop thinking and let go, a good portion of the time’s I’ve heard “horror stories” of adderall, it was from people using it illicitly, or just outright abusing it, anyone can abuse a medication even if prescribed to them, ADHD or not, but still a lot of time I’ve known people to have a problem with the drug, it’s mostly not people with ADHD, honestly a lot of the times I’d say, people’s with ADHD’s problem isn’t taking too much adderall, it’s not taking it when they should.
Also the zombie effect, tends to be caused by a exacerbated depression of the limbic system that these stimulants cause, it can very well be dose related, or changed for a different medication, I often find this depression of the limbic system to be very useful and not a side effect, but a therapeutic property, it enables me to resists temptations and distractions, it allows me to think clearly and be less brain fogged by emotions, it allows me to read better, that and other things as well. Like I said there’s clearly a lot here, And I’ve studied this, a lot. So I shall be back to better annotate.
Also you are very, very right, with a multi model approach, I had to comeback to this a quickly congratulate you on this insight.
Stimulant medication is without a doubt, scientifically evident to be the most effective treatment/intervention for ADHD, but it is not the only one, and pharmaceuticals are not the only form of treatment. And it’s a great idea to utilize the benefits of stimulants, with behavioral interventions.
Meditation is a great one, personally I use the headspace app, and exercise is another great one.
Exercise can acutally reverse brain damage caused by the stimulant medication, of course this is subjective to many confounding variables, but it’s important to note, and even if you don’t take medication, exercise still improves symtoms, there’s a long long list of scientific evidence on exercise, and it’s effect on ADHD, according to Dr.Russel A Barkley, one of the leading researchers on ADHD, exercise has the largest effect on ADHD, more than any other psychiatric condition.
But nonetheless I gotta go back to studying, honestly I should probably come back with a wall of information, on a lot of stuff, it might save you a lot of time, I may have actually already written this wall of information before although I’m not sure tbh, who knows, but Toodles!
There’s been lots of great advice here already, but I just want to add: you don’t have to keep taking it. Its capable of being this great big life altering thing, but it doesn’t have to be! If you decide to take it, you can stop anytime.
Here’s my suggestion:
Decide if you want to try it. Not necessarily take it forever and ever and ever, but simply trying it out.
If you don’t take: think about why, how you feel, what’s next?
If you do take it: ask yourself how do you feel about taking it, how does it affect your ADHD, do you want to continue taking this specific medication or any medication at all?
Talk to your doctor and/or therapist, let them know your thought process and how you feel. They can provide some very useful insight amd guide you on other options or next steps
Good luck, medication is a scary thing and it’s okay to feel overwhelmed!! In case it makes you feel better, I went though a similar process ( although not about stimulants ) it’ll be alright
The other issue is that your doctors said starting medication would "change your life". They’ve got to stop saying this for the following among other reasons:
No medication is a magic wand that will solve all of one’s problems - we still have to do almost all of the hard work! The most any drug should be expected to do is help a little bit towards developing the capabilities, motivation, and endurance for one to correspondingly build in themselves at least slightly better capabilities and skills; over a long amount of time (to grow out of adverse habits and into beneficial ones).
Them saying it likely boosted your anxiety in terms of how it could "transform’ you, which by #1 is already over-hyped. I recall having weird “side effects” when I started my ADHD treatment. Little yet noticeable things such as experiencing increased clumsiness. Long story short: time has since shown that this was likely only a psychosomatic reaction to subconscious anxiety about unrealistic possibilities.
I could suggest the following advice and insights, noting the usual disclaimer that I am not an expert and you should discuss all of this with your provider and doctor.
I saw that you were prescribed Adderall by a licensed provider on the advice of a licensed doctor; each of whom have a significant liability towards making decisions that will help their patients, else at least not harm them. Trust in their expertise, and give the personal research a rest for awhile. You’ve gotten a feel for the risks/rewards and had the initiative to agree to the treatment plan - now give it a try as others on this thread have suggested.
Take your first dose as instructed by your doctor; ideally at home. If you live with one or more people who know about your situation or whom you are comfortable sharing as such - let them know that you’ve taken the first dose and to please be around for awhile (depending on whether you’re taking an extended or regular duration dose). If not: your doctor should have an emergency number you can call. We’re here on the forum, too.
You might feel a bit different. No one can define what that means as we’re all unique; but as long as you are not experiencing any immediately adverse i.e. bad" side effects (within the first 3-4 hours?): you’re likely fine in terms of significant allergies and immediately noticeable side effects. It also means you can now answer the question of “is it helping me?”
From thereon: your doctor/provider should be requiring you to meet with them periodically, typically every 1-3 months depending on how stable you are with it; and as a requirement for refilling your prescription. The purpose of that meeting is for you both to assess how you’ve been over the previous period in terms of beneficial or adverse effects, specifically those that recently became noticeable. You might increase/decrease the dose, switch to regular/extended release, change the number of doses and quantity thereof per day, etc. as you become more stable.
Lastly: Adderall is not a magic wand! It’s a point worth repeating. Ideally: your doctor and you have ideas for how to start improving things with the help of the medication; else Jessica has a bunch of videos on building tools within ourselves to improve our productivity in all areas of life. And be easy on yourself - this will be a long but worthwhile walk towards even noticeable improvements. The key is at least small else same progress every day, and realizing that you will slip once in awhile.
this may help or it may not but what if you were if you are willing to try and take your medication and put it in the middle of an oreo or something similar to an oreo and take it that way if its a taste issue. Cause when I was younger (side note I am on many different meds for different things unrelated to ADHD but I do take meds for ADHD) that is what my parents did to have me take a certain medication since I couldn’t get it down with water so I ate it. It’s a different way of taking meds and may help ease your anxiety because you’re not taking meds in the traditional way
In cases where people are undecided about medication my thought is that trying the medications is a really useful step in figuring it whether it’s something you want to include in your ADHD toolbox.
Statistically stimulants have relatively high rates of effectiveness and fairly manageable rates of side effects. On an individual level it’s hard to predict response, though. In my opinion a trial run on the meds gives the most information about how much benefit you’ll personally get and what degree of side-effects.
How much you value particular benefits or dislike particular side effects is really personal, and knowing those details as they apply to you specifically is a big part of deciding if meds are a good fit for you.
I agree with the notion that Adderall is not magic, and personally almost bothers me when people view it as the positive connotation as a medication, but it’s just as bad as negatively viewing it as a evil drug of some sorts. As I seriously believe it is imperative to view such things without emotions and objectively weigh pros and cons in their current situational and subjective dynamic.
I don’t not believe it should be view or touted as a magical solve all pill, and the only option or solution for someone’s treatment, in fact, I think that even if you are on it, you should put focus towards behavioral interventions in all applications possible, as a multi factorial approach to treatment.
But life changing? Yeah for sure, it can be, it both ways, good and bad, just about all of that relies on the users responsibility and use of the drug.
Stimulant medication is not a magic solution, but it is statistically the most effective treatment, and I will say subjectively from my experience, I went through all of middle school struggling for so many things, discipline, attendance, academics, turning things on time, there’s been so many assignments I turned in late on my 3rd or 4th deadline extension because I forgot to finish, the list goes on and on, and I was trying hard to implement behavioral interventions such as I was exercising at the time, and meditation, which are some of the most effective behavioral treatments, but it still wasn’t really cutting it, no where close to where my potential was, my grades were spotty, my teachers didn’t know what to do to help, they all knew I was more than capable, and my grades were far from reflecting my intelligence, I had classes that I had over 100% for the year in, and that’s considering like 30-40 absences and 30+ lates a year, for every year, but I also had 60’s and 70’s and outright sometimes like 30’s, I managed to hyper focus and barely skid through every-time, but it was draining, felt damn near impossible, and I was still constantly reminded by myself, and those around me that I could be far more than this, but effort was not that issue as I was seriously trying but I could only realistically do so much.
Then later I got medicated in high-school, consistently no disciplinary action when prior just about a couple of times every year I was being suspended, my first suspension was in 3rd grade, in the same 3rd grade year they created a detention space solely for me because I was the only kid who needed one, but yet most of my teachers didn’t see me as I kid who was defiant for the sake of defiance and such, I had really no problem with authority for the most part as long as respect was mutual, but yet since elementary I had a lengthy discipline record, but the year I was medicated, there was no discipline record, no getting kicked out of class for talking, nothing of the sort. My grades went from largely in consistent in academic classes, to A’s and B’s in accelerated, honors, and AP courses, my previous guidance counselor told me I shouldn’t take a course above academic because of my track record, but yet there I was with an A in AP courses. All the little things that took so much mental effort and energy to attempt and fail, and then attempt again, didn’t even require conscious thought.
The year after I had issues, I had my medication lowered just because my course load during summer wasn’t big, my doctor had actually moved in the meantime, I got a new doctor, When school started I had a huge course load, and I had other issues at the time in personal life, I was under-medicated because my new doctor didn’t really want to up my medication, wanted to try other things out, the year became hell, and medication seemed to do little to help. But I had an issue of relying on my medication because it was so life changing, made everything so much easier, that I almost forget for a bit that I was the one who put in all the work, medication helped me for sure, I probably couldn’t get as far as I did without it, but I still did a lot. My medication situation wasn’t fixed for a long time, most of the school year, it took a lot of messing around, doctor wanting to change meds, trying to treat depression or anxiety which wasn’t the main issue, it took time, but even at a lower dosage now, I can efficiently do a lot more things than the midst of school year.
Also many side effects and things like comedowns etc. Were something that I could manage, by making sure I eat healthier, consume vitamins, and stay hydrated etc. But I wasn’t because I got into a mindset where I almost expected the drug to make me go do my work and be a solution, I forgot that I had to manage it responsibly and utilize it correctly.
So medication can for sure be life altering for both good and bad consequences, but a large sum of the end results with medication, ends up lying in the hands of the user, and how they utilize it as a tool to their advantage and don’t view it as a solution.
Being over-medicated and under-medicated both have dangerous implications to them, so constantly evaluating treatment for ADHD with a person’s ever changing dynamic is recommended.