What My Stimulant Prescription Did (And Didn't) Do
Deciding whether to take medication for mental health can be a tough, personal process. At age 28, I finally made that decision and spoke to my doctor about my attention deficit hyperactivity disorder (ADHD) symptoms. Throughout my 20s, I'd struggled to keep a job for longer than nine months and began to suspect something was going on when I realized how few of my friends had the same issues. But I didn't start taking Adderall until age 30, after careful research and trying lifestyle interventions such as list-making and color-coded calendars first.
Over the past three years, I've spoken with six providers (as well as holistic practitioners, such as my acupuncturist) while searching for the right combination of medications for me. Each of the providers I saw handled the "stimulant conversation" differently, underscoring how vital it is to find the right support.
What are stimulants?
Stimulants are a class of medication often prescribed for ADHD. Adderall, Focalin, Ritalin and Concerta are common brand names for stimulant drugs approved for treating symptoms like short attention span, hyperactivity and impulsive behavior.
As the name suggests, stimulants stimulate the levels of specific brain chemicals, such as dopamine and norepinephrine, making you feel energized and helping you to sustain focus on the tasks at hand.
How do you get a prescription for stimulants?
In most cases, you need a formal ADHD diagnosis from a psychologist before a doctor will prescribe stimulants. But even then, not all doctors are comfortable doing so.
My primary care provider first insisted that I try Wellbutrin, an antidepressant that can sometimes treat the symptoms of ADHD. It instantly made me feel relaxed, but I weaned myself off it after six months of feeling little effect on my ability to focus.
Another physician reluctantly agreed to prescribe me a one-month dose of Adderall but didn't like the idea of prescribing it regularly. She encouraged me to go to a psychiatrist who specializes in mental health drugs. Finally, I found a psychiatrist through my insurance portal who prescribed me 10mg of Adderall to be taken daily.
Are stimulants dangerous?
In college, Adderall and Vyvanse were pills people slipped into other people's palms in the bathroom at a club or sold for $5 to $20 a pop from their dorm rooms during finals week. People take stimulants recreationally (often in too-high doses) for their euphoric effects, which can lead to long-term drug abuse. More common side effects of normal stimulant use include loss of appetite, nervousness, insomnia and tics.
I experience dry mouth and an elevated heart rate while on Adderall, both of which my psychiatrist says are normal. During my first week on Adderall, I experienced social anxiety since I was self-conscious about how the medicine would change my personality, but this eventually passed. In short? If taken per your doctor's specific instructions, and if you check in with them about any concerns, you'll likely be just fine.
Are stimulants worth the side effects?
Doctors had a hard time seeing how much I was really struggling due to ADHD because of my performative sense of confidence. Since I had been living with an undiagnosed condition for so long, I'd learned to present myself as successful. I fooled everyone. I therefore had to insist on the validity of my symptoms for nearly two years before I found providers who believed I needed an Adderall prescription. I often asked myself: Is this even worth it?
Yes, it was. Adderall changed my life for the better. I've been onboarded to a demanding new job, and I've actually kept it for almost a year and a half. I needed to prove to myself that I could do that. I can also now complete work without getting up from my desk eight or nine times an hour. I no longer start five tasks at once before completing one.
Yet, sometimes on Adderall my heart rate races to well above 110 to 120 beats per minute (bpm). Prior to taking Adderall, my normal resting heart rate was below 70 bpm. I often find myself gnawing at the inside of my cheek from anxiety. Some days, I can barely take a full breath due to the tight knot in my chest.
After listening to these concerns, my psychiatrist recently prescribed me the lowest dose of Lexapro, a selective serotonin reuptake inhibitor (SSRI), so I can try weaning off of the Adderall. It's possible, she says, that I have underlying anxiety in addition to ADHD. The two conditions share common features (excitability, impulsivity, inability to focus), so anxiety may have even been a culprit all along.
When I take the two together, Adderall no longer makes me feel so jittery. And on days I don't take Adderall, I feel lighter and carefree. I may never "nail down" a firm diagnosis or settle on one medication regimen for the rest of my life, but that was never my goal. One year and three months ago, my goal was simply to keep a job. Now, my goal is to surround myself with support, continually refine my knowledge and treat myself with more compassion than I ever have before.
These goals might be the best medicine—and certainly must-haves—on the slow, patient road to healing.