Talking about my experiences with medication matters to me given the impact it’s had on my life and I believe it’s responsible for me even being able to commit to something as big as writing a blog. I’ll cover general changes in my life that medication has brought in a separate blog post, but I’ll use this one to talk more about the first few weeks of medication as I felt it was important to distinguish this from my general journey with it.
I take 70mg Elvanse and 2 x 10mg Dexamfetamine daily and have been settled on this dose for over a year having previously explored other dosage options. In between diagnosis and beginning medication, which was around 8 months in total, I became consumed with learning more about the medication and the potential for so many changes in my life.
I began on 30mg and was warned the onset could be a little strong as my brain wouldn’t be used to an influx of neurotransmitter activity at first. I had breakfast, a rare occurrence in itself as I forced down some porridge with a banana and sat with my partner as we were both off work thankfully. It was a lovely sunny day and we were sat in the garden as I waited for the quoted 90 minutes for the onset.
There’s a lot of hype in ADHD communities around the positive feelings associated with medication for those who have reported benefits. It’s been described as euphoric when first taken with some people likening it to the effects of recreational drugs but on a weaker scale. My own experience, starting on that very first morning, was similar.
After around 60 minutes I vaguely noticed what I could only describe as a change in how I was processing noise around me. Some sounds were being pushed into background noise whereas conversations were sounding almost crisper, potentially due to unwanted noise being more filtered. After an hour and a half, I indeed noticed a slight euphoric sensation slowly wash over me as me and my partner chatted and I noticed how easy it was to listen to her, to process what she was saying and respond in a way that carried more intent.
It was certainly a nice feeling. I remember going inside and tidying up the kitchen but feeling taken aback by how much I wanted to do it. The actions felt more mindful too; I was doing everything slower and in a more controlled way instead of dropping a piece of cutlery or bouncing a cup off the cupboard on the way in because I was trying to do it all at 100mph.
We went upstairs to get ready for the day and, to my partner’s surprise, I was ready before her and went downstairs and sat patiently waiting. I’m always the one to procrastinate because I get ready quickly, but then I mis-time how long it takes and end up being the one causing the delay. Time management, motivation and task initiation was just a few of the improvements I clearly noticed within that first couple of hours.
I felt calm and composed as we left the house to do some errands. Even just speaking to people felt strangely different, as I found myself saying the right things at an appropriate speed without stumbling or tongue-tying myself, or rehearsing quick sentences before I approached someone to feign composure. I could barely stomach food as we stopped for some dinner, leaving half of my pasta to further add to my partner’s bewilderment. I was eating slower too, going back to the mindfulness actions at home that morning. It’s like I suddenly had space to comprehend behaviour and being able to control the urge to do something, whether it was eating fast or interrupting somebody mid-conversation. It all felt very intentional.
We got home early in the afternoon and I could still feel things were different. I described it many times like something had taken excess noise out of my mind and put it into my body, such was the feeling that there wasn’t this invisible barrier in place when needing to do something.
I remember thinking about emotional regulation difficulties and not knowing when a trigger would pop up so I could see if there was any change in my reaction. Instead, I replayed situations in my head that had annoyed, angered or upset me recently. A surreal realisation crept over me as I could no longer justify the intense and hostile feelings that those situations triggered. As soothing as it was, it left me wondering how one tiny capsule could simply dissolve emotions that I couldn’t help but stew on and aggravate further.
As the afternoon progressed I began to notice little changes that pointed towards a return of my symptoms. I suddenly had a craving for sugar which wouldn’t go away and felt like my thought processes were becoming more muddled instead of the sharpness I experienced throughout that day. My mood dropped sharply in a couple of hours and I felt deflated, hopeless and fatigued, signs that I’d read about anecdotally on the internet. I could barely function to go and make food or even look at my phone and my mood was dysphoric to the point I wouldn’t talk to anybody.
This lasted for a total of 2 hours where I somewhat returned to my typical state before medication. All in all, the positive effects lasted around 5-6 hours which was very short considering the intended amount of time it was intended to last. The “crash”, whilst temporarily expected, was nevertheless unpleasant and an unfortunate obstacle I’d have to tackle going forward.
I repeated this daily for the 30mg before moving up to 40mg. It followed a very similar pattern at first, where the significant positive effects allowed me to experience and think about my day in a completely different perspective before the crash took shape and rendered me almost incapable of functioning for a couple of hours. The crash began to mellow on the second week despite going up in strength and my prescriber mentioned it was an expected phenomenon. Whilst there were a lot of variables that can impact your beginning experiences on medication (water intake, food intake, sleep, current stress levels etc.), I found the crash to be significantly worse on the one day I didn’t eat a meal within a few hours of taking the medication.
Once I began taking 60mg and 70mg I started to notice a stronger onset where I felt a rushing feeling for a couple of hours. It came with a lot of energy and motivation to do whatever came into my head. Whilst it’s not a sustainable and long-term target of medication I look back and describe it as the time where I truly felt invincible. My symptoms of ADHD were almost completely eradicated and I became much more emotionally relaxed, whilst having intense productivity during these hours. This lasted a few weeks before becoming a bit more stable.
I learned quite quickly that this was a typical experience as I naively thought until that point that this would be how life would be, that this was how people without ADHD felt every day. It’s less about the euphoric feeling but more the way symptoms were being managed during that time and how nice it was to experience.
I had issues with duration which were reported to my prescriber despite the crashes being quite a minimal sensation now. He put me on a booster known as Dexamfetamine which is an instant release, shorter-acting tablet. It was difficult to find the right timing to take this but eventually settled on taking it around 5 hours after my onset which resulted in the smoothest transition when the effects of Elvanse dwindled. My experience wasn’t great on the booster as I didn’t feel it was providing the similar effects. As I moved through titration I felt I wasn’t getting enough positive effect as I still had to spend several hours of my day with my usual symptoms out in full force. People might say I’m fortunate, but it’s quite likely those same people didn’t feel like they were running through treacle for most of their lives, with everyday tasks feeling like a burden and being unable to shake the feeling that I was lazy, unmotivated, rash, inconsiderate and more.
After experiencing the life-changing effect in full flow (which I’ll dedicate a whole blog post to discussing soon), having to experience the second half of the day with my typical symptoms presenting is incredibly frustrating. I went back and forth with my prescriber over six months trying different variations of dosing until I settled at 70mg Elvanse and 2 x 10mg Dexamfetamine boosters, a slightly off-licenced dose.
Whilst it was a journey filled with highs and lows, I’m eternally grateful for the opportunity to utilise medication to help manage some symptoms. It’s given me a newfound belief that I can achieve goals and I have the motivation to do the repetitive, mundane things in my life that needed doing. I also look after myself a lot more and have put routines in place to help with this which have now become more automated and no longer fill me with dread thinking about them. Above all else, it’s helped me to understand my capabilities, my limitations and the need to be kinder to myself now that I have the awareness of how ADHD has truly impacted me throughout my life.