adhd — i live in a world where shoes magically move

after i told the doc how the alarm i’d set to take the second dose of ritalin tended to help me make sure to eat lunch and refill my water bottle but didn’t always translate ALL THE WAY to actually taking the pill even though it said to, he switched me to the generic for Concerta. it’s basically time-released ritalin.

at first, it was giving me a bit of a rush late in the afternoon, cheeks flushed and a bit tingly and a bit euphoric. so i guess that’s when its dosage maxes out. now, i’m not getting much effect that i can feel.

it’s been a complicated time to try to evaluate things. primary side effects i was told to watch for are blood pressure and anxiety increases. but i EXPECT my anxiety to be high right now. ex-to-be moved out two days after i switched the medication. i suddenly have a house that GLARINGLY needs rearranging. it’s start of the new fiscal year at work, so we have lots of just the kinds of tasks that cause me issues — boring, glorified data entry, where waiting on a webpage to load tends to lead to pinging off-task.

and… i still can’t tell if the drugs are making much of a difference or not.

to the extent there’s an effect, it’s more like being able to -see- my tracks than being able to intervene and keep myself on task yet. the Family Circus comics where Billy makes a giant circuit of the neighborhood between the school bus stop and home — i feel like i live in that now. i’m still not aware as i do it, but i can answer the “what happened to the time?” question after the fact more often now. the laundry basket abandoned with wet clothes isn’t a mystery. “oh, i remember: i was taking the clothes out and started musing about whether the door screening the washer/dryer serves any purpose, and before i knew it i was off looking to see if i still owned a screwdriver.” i don’t know yet if the -noticing- is sufficient to start retraining my brain, or if a higher dose will transform it into being able to Just Say No to the intruding urge to multitask inappropriately. but it’s frustrating.

somehow this heightened awareness of how i meander from point A to point B led to a fit of empathy for all the people who have to deal with me on a regular basis. for my parents, who i assume at some point were faced with this seeming mix of high ability in a lot of areas and total incompetence in some that are kind of key to maintaining everyday life. they gave me a lot of tools, and figuring out which ones actually serve purposes and which ones are just camouflage is a new task i’ve given myself. (example: notes! i always take notes, that’s what “good” students do! turns out, when i think about it, i rarely to never look at or study notes later, but note-taking keeps me awake when my brain is at risk of passing out from boredom. understanding MY real purpose for them is freeing — now there’s really not much need to ponder whether they’re legible or not or if they give a good record of what’s going on unless i’m actually expected to write up details of a meeting for others’ consumption.)

and realization: i’ve traditionally lived in a world where stuff… just moves. unmedicated, i DON’T generally have the ability to retrace and figure out how my shoes went from a designated spot that they belong to someplace else. is it any wonder that i’m a little extra-aware of the amount of cognitive smoothing i do? that i probably put up with more dissonance than most people? I LIVE IN A WORLD WHERE SHOES MAGICALLY MOVE, and where i assume that i did it but don’t have the time to worry too much about when or why. (i fixate on shoes now, since the recounting of how painful it is to watch me take off shoes and tell a story by ex-to-be was a major spur to SEE this lens pre-medication and finally seek treatment.)

so tldr: i’m a bit frustrated with the state of my brain right now, i think things might actually be harder than they were when i could just live in a world where time mysteriously disappeared sometimes and objects moved seemingly of their own accord, but it’s opening all kinds of new insights. and even if this is the best we get, it’s certainly worth the journey.

the ritalin adjustments

i FINALLY got a local psychiatrist. only, what, five years after a campus psychiatrist suggested that if the university setting let him prescribe controlled drugs, he might try treating me for ADHD when i came in complaining of focus issues. during pandemic, i got generic strattera via an online portal which i was really sallying up to more in expectation of a possible anxiety prescription. anxiety levels honestly haven’t been that bad (or at least with the pandemic going, anxiety feels like it has solid CAUSE and appropriate response), but a comprehensive psych eval had said to try treating anxiety for a year first before looking too hard at ADHD… but both psychiatrists now have looked vexed and moved along to discussing ADHD treatment options.

i’ve spent the last two weeks transitioning from strattera to ritalin. the doc expects ritalin to not be my final drug — my blood pressure is too borderline high, and he likes options that time release better… but it’s apparently the order in which we must try things for insurance purposes.

after getting the strattera back to a minimal dose, i started 5 mg of ritalin. and went up to 10 mg after about a week. today i’m adding in an extra 5 mg at lunchtime to try until next appointment with my doctor.

i hadn’t thought the strattera was doing much. the 5 mg ritalin and none of it made it clear that it HAD been. afternoon meetings were painful, with all the fidgeting and begging to be released so i could go get my laptop and DO something. on 10 mg, i feel like i’m more or less back where i was.

i’m becoming more aware of how much i really DO interrupt people… as i was initially reading up on ADHD, i brushed that one to the side as a “nah.” my habit of hyper-participating in classes and meetings now looks like a coping strategy — if i’m JUST taking notes, i risk much more mind wandering. it’s honestly pretty startling how much the picture starts to fit together.

this feels so slow. i’m at a year of therapy, four months of trying psychiatric treatment. but compared to decades never seeking assistance… six months is really nothing, i suppose.