The question of whether or not one decides to take medication to treat their ADHD symptoms is both deeply personal and highly controversial. It seems as though everyone has an opinion on the matter, regardless of their level of personal experience with ADHD. On one side of the spectrum are those who are forcefully against any pharmacological treatment for the disorder. People in this camp tend to be deeply mistrustful of pharmaceutical industry and have a limited awareness of what ADHD is, not appreciating its physiological dimensions. All the way on the other side of the spectrum are those who advocate for the use of medication as the primary, and often only treatment of individuals with ADHD. They view medication as an ADHD “cure,” or as a quick and easy fix to the problems ADHD causes in the lives of those who have it, as well as those close to those who have it.
My own ADHD medication journey has been complex, as I, in typical ADHD fashion, have vacillated between each of these extreme poles since receiving my diagnosis when I was 17 years old. Years prior to getting diagnosed with ADHD I had been diagnosed with and medicated for depression and anxiety. In retrospect, I suspect much of my depression and anxiety as a teenager stemmed from my ADHD. However, it wasn’t until my sophomore or junior year in college, about three or four years after receiving my original ADHD diagnosis, that I decided to give ADHD medication a try. I think I put off going on ADHD medication because I was unconvinced of the legitimacy of ADHD as a real disorder, and regarded it more as a made up medical excuse for my disorganization, procrastination, lethargy, and laziness.
I’m not clear on what precipitated my change of mind, but in college I decided to see a psychiatrist for my ADHD symptoms and was proscribed the amphetamine and dextroamphetamine combination medication Adderall. Psycho-stimulants like Adderall stimulate activity in the cerebral cortex by balancing the levels of the neurotransmitters (chemical messengers) in the frontal lobe of the brain and in other centers concerned with arousal and attention. I remember experiencing an immediate, marked increase in my ability to focus and resist distraction. I could suddenly spend hours in the library, studying productively. I could decide to clean my room and, within an hour, thoroughly complete the task. I even made straight A+s one semester. For a time, I was a ADHD medication convert.
The version of Adderall I was proscribed was Adderall XR, which is a once daily extended-release medication that lasts in one’s system for 10 to 12 hours. I soon realized that if I woke up at 8 AM and had classes or worked on campus until about 6 PM, the medication was nearly out of my system by the time I sat down to study. I felt I didn’t need the Adderall’s effects to attend classes or work my on campus job, and so, without consulting my psychiatrist, I began to put off taking the medication until I was done with those responsibilities. This often meant I would take the medication late in the afternoon, resulting in me staying up through the early hours of the morning, and sometimes all night, studying. I also found that the medication made me lose my appetite, which for a time appealed to me from both a weight loss and productivity perspective. If I didn’t get hungry, I didn’t have to interrupt my studies to go to the cafeteria. Soon I was sleep deprived and undernourished. I was also, unsurprisingly, extremely irritable and short with my friends, boyfriend, and sister, all whom were attempting to support me. And while my ability to focus had improved, the medication was doing nothing to improve my self-esteem, decrease my perfectionism, or address my lack of self-knowledge.
One night, after staying up to the wee hours of the morning studying for an International Relations final, I took what was meant to be a few hours nap and ended up sleeping through it. That mishap shook me sufficiently enough to make me realize just how unhealthy and out of control my Adderall use had become. I didn’t like feeling so tired, cranky, and anxious, and I didn’t trust myself to use the medication responsibly. Soon thereafter, I decided to stop taking my Adderall and to give up on ADHD medication altogether.
Partially thanks to the boost that Adderall gave my grades, I ended up graduating from college magna cum laude. Five years later I decided to apply to law school. I scored well on the LSAT and chose to attend UCLA Law. However, I never felt the same passion or excitement in law school as I felt as an undergraduate, and my ADHD symptoms made my law school experience extremely difficult. At this time in my life I was also experiencing a spiritual awakening of sorts. I was attending services as at spiritual center in Los Angeles, developing a meditation practice, and embracing Los Angeles’ alternative, new age culture. I felt unsuccessful and out of place in law school, and I was beginning to sense that Spirit had other plans for me. When a thirty-year-old friend of mine passed away from stomach cancer just months after being diagnosed, near the end of my first year of law school, I couldn’t bring myself to continue one day longer. I felt what I have now come to understand to be a common sensation for ADHDers: the need to run away, and fast.
Understandably, my family was very concerned for me. I had worked my behind off in college and in studying for the LSAT, not to mention throughout the first year of law school itself, and I seemed to be throwing it all away. What’s more, I had gone through that year of law school without receiving any support for my ADHD. I was unmedicated, not in therapy, and observably depressed. In reflecting on this time in my life, I found this email my father sent me when I decided to drop out of law school. I’ve decided to include it in this post because I believe the frustration that is palpable in his words will feel familiar to a lot of people who have love ones that suffer from ADHD.
Dev, I love you so much. I hate that you are feeling overwhelmed, depressed and scared for your future. I can only imagine your pain and disappointment. You know that you have my support no matter what direction you choose to take.
I believe that now, at this time, your decision making is being hampered by depression. It’s bullshit to not accept this and realize this fact. You have been gifted with many talents including brains, beauty, integrity, and athleticism, but more importantly a great heart and soul. You have proven yourself many times over, showing your goodness and compassion with your career choices up until now.
But, you are not perfect. Your refusal to acknowledge your ADHD and deal with it, is, I believe, the main reason you’re in so much pain now. I know multitudes of amazing people, successful and otherwise, not just in our family, who have similar handicaps. Both your mother and I have spent our entire lives dealing with our personal chemistry.
It is time for you to acknowledge your issues and deal with them with therapy and meds. I do not care if you become a lawyer or not. I have full faith that you will find your path and have a fulfilling life, but only if you deal with your issues medically. There is no yogi, guru, diet, etc., that will do this for you. You have some f*cked up reasoning that is not allowing you to take meds and to try to find a chemical answer. There is no rational excuse to not try the drug therapies that are available. You need to give yourself a chance to not only be successful in your career but to be happy. Do you have any idea how many times I have heard from both you and your mom, “I have never been really happy?” WTF. That never ceases to break my heart. It is not an unreasonably expectation, happiness, although maybe not as a first year law student. Happiness with you and your life may not be available without some help. Until you understand and accept this, you haven’t given yourself a chance to find it. I don’t know why you developed this animosity towards drug therapy for yourself, but I believe that you accept and acknowledge that it’s changed the lives for millions of people for the better. So once again, WTF.
Dropping out could be the correct answer. But quitting without having dealt with your depression and organizational handicaps is bullshit. There are thousands of people who will find law school easier than you. That doesn’t make them natural leaders like you. The degree doesn’t give them integrity, nor the ability to have people trust and follow them, as people trust and follow you. Either finish or take a medical leave, but don’t leave feeling like a failure because that’s the real bullshit here. The system sucks, your personal chemistry sucks, but you are and incredibly successful, proven person, who I believe is in a depressive funk and can’t see the forest from the trees.
Honestly, despite my unwillingness to acknowledge them at the time, my father made a lot of legitimate points here. I agree with him that by refusing to get support for my ADHD while in law school, I never gave myself a chance to be successful there. However, I wonder how much of unwillingness to seek treatment lay in my attitude towards ADHD and its medications, and how much of it was a symptom of the ADHD itself. I found, and still find, navigating my way through the health care system in the United States to be overwhelming. When I gave up on Adderall in college, I did so without the guidance of a psychiatrist, partially because I just couldn’t get it together to keep track of my insurance information, and to make or keep the appointments.
Furthermore, in leaving law school I was attempting to find my way to a career and lifestyle for which I was better suited. That journey continues today. While I often wonder where I would be if I had taken my ADHD more seriously earlier in my life and showed more persistence in following through on receiving treatment throughout college, law school, and the different careers I have pursued, I also have a lot of gratitude for finding myself where I do today. Perhaps my unwillingness or inability to get the support I needed to be successful in my previous paths is the very reason I am today able to envision and begin to manifest a life that better suits my natural brain chemistry.
My ADHD medication journey is not over. After all the research I’ve done on the disorder, I am not ideologically married to either side of the ADHD medication divide. Depending on my future goals, I may very well decide to work with a psychiatrist to find a medication and dosage that works for me to help alleviate some of my ADHD symptoms. Just as important, however, is the work I’ve done and continue to do in therapy to address the inner pain and emotional hurt that ADHD has caused me with regards to my self-esteem and relationships, as well as the proactive decisions I’ve made to create a life for myself that is better aligned to my unique constellation of strengths and weaknesses.
What about you? Where are you on your ADHD medication journey? Have you decided to try medication to address some of your ADHD symptoms? How has it helped you, and what side effects have you experienced? What other treatments have you undertaken? I’d love to hear from you in the comments below.