What happened when I walked into a clinic expecting a pap smear and walked out with an Adderall prescription

Just another Wednesday

It might be the most ADHD thing I experienced all week when I checked in for my appointment one morning, believing I was due for a gynecological exam (and related procedures) only to discover I was in for a psychiatric evaluation.

I had requested one at a checkup with my primary care physician. I assumed my insurance would deny the request and I would have to bushwhack a forest of red tape. So when I received the appointment information from my clinic, I presumed it was for, well, the other thing.

Since late 2021, I suspected I had ADHD. Some symptoms had popped up during my meandering journey in therapy and trauma healing. But once I was in a situation where I had total control of my immediate environment, no longer had to navigate anxious and controlling housemates, and had the freedom to live exactly as I needed, many more alarms blared.

Fortunately my therapist and psychiatrists agreed. My symptoms overlap with trauma and other traits but psychotherapy was only so effective. I was running in circles and into brick walls. Processing old traumas while enduring new ones in real-life was so overwhelming I was at serious risk of regression. My internal resources were running low. I didn’t want to find out what could happen if I hit crisis mode again.

It was an enormous relief to be heard by someone trained and licensed to help me. Someone who understood that these struggles I faced were not just poor choices. That I needed a leg up to reach a better baseline so I could continue caring for myself and move my life forward.

The never-ending cycle of instant gratification

There is a connection between ADHD and a deficiency of dopamine and norepinephrine. It’s believed, but not proven, that our brains are looking for dopamine because it often attempts to transport more than it has. This leads to us losing track of tasks, motivation, and behaviors that look like laziness and procrastination. We will then engage in activities that offer instant reward such as gaming, social media, physical activity, or stimulation. We will get just enough of those chemicals to get back on track which deplete in short order and the cycle repeats.

I shared the news with other friends when I first received the diagnosis. Everyone who had a similar experience congratulated me. They shared their experiences with Adderall or other therapies. Everyone assured me that it would work right away if it was the right solution.

I worried about a placebo effect. Was it possible I could psych myself up into expecting results? People with ADHD often feel “nothing” on stimulants. It doesn’t make us high but it brings us to a normal baseline. There is little physical sensation or awareness it has taken effect.

I took my first dose at 6:30 am on a Friday, right after breakfast. By 7:15, I had already noticed a change. By noon, even with premenstrual hormones raging, I was staying calm, handling deadline snafus, wrapping up projects, and staying at inbox-zero most of the day.

In short, Adderall worked. It wasn’t without side effects, though.

Staying hydrated and restful sleep

The most persistent physical side effects I experienced were intermittent nausea and consistent drymouth. Neither were intense but noticeable. I would often feel hunger but not feel much desire for food (appetite) so I stuck to my regular mealtimes and foods. This often caused immediate but tolerable nausea that dissipated after an hour or so. With drymouth, I did not mind this so much as it meant I was drinking water more consistently.

After the first few days and the end of my period, I experienced no nausea at all. I have since learned how my appetite and hunger cues change. Sticking to my normal breakfast of scrambled eggs, bread, and coffee about thirty minutes before taking my daily dose has better results.

About three or four hours after my dose, I often experienced a brief change in my vision. It seemed sharper and I was less light-sensitive.

The side effect I was most concerned with was sleep disruption. Fortunately, Adderall made my sleep schedule easier. When the drugs wore off, I was able to wind down, experience the right amount of end-of-day fatigue, and get to sleep on time. Waking up in the morning was much easier and I felt more rested.

I believe in my case it is that I am no longer depleted at the end of the day. Instead, I experience a more gradual path to bedtime instead of crashing. This leaves less work for my body to do overnight while I rest. In short, I do not feel as though I have more energy throughout the day but that it is rationed more efficiently.

Downshifting from “hyperfocus” to just “focus”

I am a hypervigilant person. I am also hyperactive; constantly in motion, thinking, doing, stimulating. Even when sitting quietly at my desk, I am never mentally still. I am battered by impulsive thoughts and motivations at a rate I did not know most people do not experience.

During my first week on Adderall, I still felt those impulses and mental intrusions. But my thoughts didn’t feel like a minefield as much as it felt like an assembly line. I could complete a task, evaluate the next in my queue, re-prioritize if necessary, and complete the next.

A friend described her experience with these stimulants as “it turns the radio noise off.” I did not know, until my own “radio” was also silenced, that most others do not physically feel their brain functioning the way I do. I have always described it as trying to point a compass north but never getting closer than WNW or ENE. Or a transmission that slips into third gear when you wanted second, stalls, or won’t come down from fourth.

Adderall eliminated that sensation. That struggle of fighting against a machine that was not tuned to operate as designed. It just made my brain work the way it’s supposed to without any fuss—something I experienced for the first time at the age of 35. I could navigate the “traffic” of my life without a mechanical interruption.

Emoting without being overwhelmed and distracted

I never experienced a flood of emotions or euphoria but the impact on my ability to handle any emotions changed the game. I still experienced annoyance, anger, joy, amusement, grief, frustration, confusion, satisfaction, and many other feelings. But what I did not experience is any of them to an extreme. None of those feelings consumed me. For the first time in my life I understood what it meant to regulate my emotions, a skill that has eluded me for decades.

I would sometimes get choked up from the relief. I still felt like myself, just better able to cope. I didn’t doubt my choices or reactions because I knew for the first time that they were appropriate and accurate.

Some new grief has bubbled up, though. I expected it, even months ago when I first suspected that I had ADHD. I started wondering how things could have been different if this had been noticed earlier in my life. The signs were clear and present. The pain of being surrounded by adults entrusted with my care and development who didn’t notice how much I struggled stings. It is a real wound and it is fresh and angry.

But it doesn’t outweigh the gratitude and self-reliance I feel. I’m proud of my self-advocacy as an adult and taking charge of my own situation. I followed my instincts and was right. I’m thankful for having access to the tools and using them correctly with immediate and promising results.

Pics or it didn’t happen

On that Friday morning, I started documenting and taking notes of what I noticed. There was no noise in my head. It didn’t hurt to think and focus. I could just deal with feelings as they arose instead of derailing my whole day. I could listen to others better. I allowed details and context to come up naturally in conversation instead of scanning for them three steps ahead.

As the day drew to a close, I realized that not only was I on the verge of my period but also on the eve of a weekend. If there was ever a time to adapt to changing routines, different tasks, and wild emotions, this was it.

I decided to loosely document my weekend. Getting through a stressful workday, a busy Saturday, and a free-for-all Sunday while on medication designed to help me remain focused and productive for the first time was a learning experience. I’ve shared that compilation here though I admit I did little more than trim it down for time and redundancy.

Getting a diagnosis and treatment has been without exaggeration the best thing that happened to me this year. It’s not uncommon to have honeymoon periods like this with a new medication. I anticipate changes and adaptations as my body adjusts long-term.

But for the first time ever I feel as though I can finally catch up to myself.

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