A complex relationship with prescription ADHD medication.

After being re-diagnosed with ADHD back in 2019, I suggested that my prescriber put me back on Vyvanse, and she readily obliged.

Vyvanse was the last ADHD medication I’d taken, around a decade earlier, before I had decided to stop taking the medication entirely, cold turkey and unsupervised.

The reason I wanted to return to Vyvanse was because I’d tried both Ritalin and Adderall XR in my teens and I didn’t like the feeling of them “kicking in” — it was too similar to the way cocaine felt when it kicked in, and I was trying to stay away from my “drug of choice” at the time.

For anyone curious, I haven’t done cocaine since 2008 and I no longer consider this an issue for myself. I figure it’s worth mentioning because this experience directly informed my decision to try Vyvanse back in the day.

Vyvanse, by comparison, felt much smoother as it entered my system. It wasn’t a jarring jolt of energy, it was more subtle.

I’ve never tried non-stimulant prescription ADHD medication, for no real reason other than… I stopped trying other medications after trying Vyvanse. 🤷

Anyway, it’s 2019 and my prescriber gives me Vyvanse again. It immediately allows me to focus much more easily in my Anatomy & Physiology class and I’m suddenly able to hold onto tons of information (for better or for worse) as my case management clients unload their trauma onto me.

Prior to this, A&P was extremely interesting to me, but I could not retain any of the lectures. This had been the case for the majority of undergrad, but I’d mastered the art of curating study groups and pulling timely all-nighters, so you wouldn’t have been the wiser had you gotten a peek at my transcript.

Prior to this, when talking to my case management clients, my thoughts would often drift away into the abyss, particularly when they would discuss their difficult and traumatic pasts, as I had a habit of dissociating due to my own unresolved trauma history. I would feel horribly guilty for this and did everything in my power to mask it. As far as I know, it wasn’t obvious to them and I was often still able to offer relevant and useful resources.

Of course, this sudden ability to focus and have some semblance of a working memory was pretty amazing to me. One of my complaints about Vyvanse as a teen was that it “took away my creativity” and “dulled my personality.” But it had been many years since then, and I suppose I no longer needed as much “creativity/personality” to talk to sad people and take A&P anyway.

So I kept taking it. Very consistently. For a solid 4 years. Through a pandemic, through months of unemployment, through a new corporate job. Through getting married and moving into an RV full-time. Through adopting and training a(nother) puppy. Through grief, through trauma therapy. Through starting a business. Through some of the most intense changes I’ve experienced in my whole life.

It never felt like… an option. It felt like a part of me. I took it like clockwork and I swore I could “always” tell if I’d somehow missed a dose. In fact, I was more likely to accidentally take it at night, then again in the morning, rather than to ever actually forget. I’ve always been very diligent about taking medication despite the forgetful ADHD stereotype.

This continued, as I mentioned, for 4 straight years. Now, I’ll mention here that I’m also diagnosed with Generalized Anxiety Disorder (GAD) and complex trauma (C-PTSD) — among a couple other things. 😅

Anxiety has always felt like a part of life, for me. It started at a very young age (linked to complex trauma, ADHD, grief, and likely undiagnosed Autism) and I have rarely gotten much relief from it, even with prescription medication. So when my anxiety continued (and worsened) throughout the pandemic, unemployment, starting a new corporate job, and all the other chaos happening around me, it didn’t come as a surprise.

Naturally I would be anxious when people are dropping like flies from an invisible and insidious virus! Naturally I’d be anxious when I don’t know where my next paycheck is coming from! Naturally I’d be anxious when my new job requires me to either talk about trauma all day or onboard and train a new group of strangers every week! Of course I’m anxious! How couldn’t I be?!

Along with this anxiety came intense hyperfocus. Not the cute, fun, “superpower” kind of hyperfocus, either. I’m talking “start-building-a-presentation-no-one-asked-for-and-suddenly-lose-8-hours-before-realizing-I-hadn’t-eaten-all-day-so-I-bite-my-wife’s-head-off-as-soon-as-she-gets-home” kind of hyperfocus. Not cute. Not fun.

And forget about making decisions or trusting my own nervous system. Every single decision required meticulous research or it’s straight to meltdown town. My wife asks me what I want for dinner? How could you ask me that? I’m already hungry. This is now an emergency. I have no clue what I want, but it’s probably nothing that you suggest and I will make it seem like it’s somehow your fault because my tone is so seething.

My hyperfocus would amplify my anxiety. I would hyperfocus on my anxiety. Or on my hunger. Or on all the bad things happening in the world. Or on social media. Or on how scared I was to walk my dogs with all the scary dogs in our neighborhood. Or on following through with plans I agreed to when I was originally invited out, but now I can no longer imagine going outside and being around other people.

I’ve been paralyzed… for 4 years. And this whole time I thought it was strictly from external factors beyond my control. As soon as the external factors calm down, I’ll be good. I’ll feel better then. I’ll be able to use those coping strategies my therapist told me about. I’ll be able to practice what I preach. You’ll see!

So, imagine my surprise when I decide to skip my Vyvanse for one day, on a whim, just as an experiment… and… my mind is somehow… quieter? 🧐

So, I skip the next day… and the next… and the next.

Don’t get me wrong… I still have ADHD. I’m still symptomatic. But I’m not so anxious that I swing all the way into irritability. I can suddenly… sense when I’m hungry. I can make intuitive decisions without batting an eye. I can trust my own nervous system. I’m not ruminating on things beyond my control. I can allow negative thoughts to float by without commandeering my entire day. My doom-scrolling has decreased significantly. I can leave the house almost whenever I feel like it. Talking to strangers? Stranger who? Let’s go! I don’t hate myself. What is going on?

So, dear reader, I have a theory. This isn’t intended to be ground-breaking or to persuade anyone to stop taking their medication. I’m a huge advocate for medication and I know it can be life-changing for some folks. It was life-changing for me… until the cons started to outweigh the pros.

My theory is that, for the majority of the last 4 years, I required Vyvanse in order to function (see: mask) at the level expected of me by my A&P class (at the time) and my 9–5 job(s).

There’s no doubt in my mind that my accomplishments over the last 4 years would have been extremely difficult at best, and nearly impossible at worst, if I had been unmedicated. So, like, that’s cool. I appreciate that about Vyvanse. Thanks, pal.

But… I’m a different person than I was 4 years ago. I’ve learned so much. I’ve grown so much.

Something very important that I learned this year?

I have no interest in working a 40-hour per week, 9–5 job. Ever again.

I was not built for that. That would require that I take stimulant medication daily again. It would require that I mask every day for work (regardless if I’m medicated or not). It would require that I either suffer in silence without accommodations, or that I go back through the exhausting accommodation process that is rarely accessible for anyone who needs them.

It would have an impact on my overall happiness. It would impact my marriage. It would impact my mental, physical, and spiritual health. I’m not interested. I’ve been abused enough by this capitalist system and its unrealistic expectations — of everyone, not just neurodivergent or disabled folks.

I would be remiss if I skimmed over the obvious privileged position I’m able to write this from. Not everyone has the option to avoid a 40-hour per week, 9–5 job. In my distant daydreams, there exists a world where all companies recognize that, 1) these requirements are unsustainable, 2) humans are more productive when they have ample time/space to take care of themselves and spend time with their loved ones, and 3) ethically they should only require 25- or 30-hours per week with full benefits and PTO included, all while offering a living wage.

I would also be remiss if I skimmed over the fact that… there’s an ADHD medication shortage in many parts of the world right now. And it’s absolutely devastating. If my medication had been ripped away from me at any point before, say, this past summer? Let’s just say, I would have been a force to be reckoned with. It’s unacceptable, and I know that my ability to go any number of days without medication is something that many ADHDers would kill to be able to do. It’s not fair, but I’m sharing my journey as it’s happening to me. I never would have anticipated that I’d make this change and actually consider sticking with it.

This has been a liberating experience for me and I feel incredibly fortunate to even get a taste of what life could be like without constant, debilitating anxiety. It’s still early on in my experiment and I’ve accepted that I might need to take medication again at some point.

But for now?

I’m just going to ride the wave and go with the flow to make up for all the years when doing that was literally unimaginable to me.

Stay weird, folks ✌️