The Concerta Diaries

Dang, my writing has exploded since I started taking medication. I can’t tell if it’s causal in an energy way or if it’s coinciding with me having the focus to write more. 

I feel like this phenomenon was embedded in the blog culture back in the day as well, Ambien and Adderall-driven, hyper-detailed logs of one’s day. Then maybe everybody got really embarrassed. I remember I used to re-read my diaries when I was younger and I’d shred them, wanting to erase this younger self. A few years ago a friend of mine I was visiting at her home, also a writer, found some of her old diaries and immediately started reading them out loud to me. They were hilarious and a little grandiose, but raw and with moments of real beauty, and surprisingly mature, so glimpses of her more polished writing were there as well. What struck me was that she genuinely got a kick out of her younger self. “Listen to this,” she’d say, laughing, then she’d share whatever she wrote. 

In the past I always had a sense of shame about my younger self and wanted to erase her thoughts, her flaws, her uncoolness. Hence the shredded or burned pages. I’m more compassionate with my younger selves now, but who knows—maybe I’ll look back at this blog and think, “Oh god, that’s when I first got on medication and had this extreme hypergraphic response and blogged everything! How embarrassing. Oh well, at least my mildly curious exes finally had something to read.” DELETE.

I was telling Ryder, who has been noticing my unavailability this weekend due to my epic scribing, about the term hypergraphia. “It’s a real term! It means an intense urge to write, I think that’s what’s happening right now.”

”Hypergraphia? To me it looks a lot like hyper-sit-on-your-ass-ia.”

James Ochoa, an Austin psychotherapist who specializes in ADHD and also has ADHD, writes that people with ADHD are the original high maintenance partners. I don’t know why Ryder has put up with my ADHD ways for so many years. I love Ryder and know he loves me, and I also think we have lucky compatibility on certain traits. He probably does get frustrated with some of my behaviors, but he always seems to choose a good one-liner over criticism. I think when it comes down to it, he just likes my laugh.

So that I may soon get off my ass-ia, I will copy and paste my medication diary here. Edited for brevity and clarity and to add one funny thing my doctor said.

March 13, 2018

8:34pm

My doctor prescribed Concerta and I gotta say, I’m pretty excited to try it. Now that I know I have ADHD I’m seeing signs of it all the time. I knew I was forgetful at times and that I had a hard time with planning things, and that my career was inexplicably collapsing before my eyes, but what I didn’t realize was the sense of overwhelm I had been experiencing from that, as well as feeling of deep insecurity about my competence.

Today, I talked over the med options with my doctor. My doctor is really thoughtful and hilarious. One silver lining about the ADHD diagnosis is that I get to spend more time with him so I can check in about the meds.

One of the things I like about being his patient is he’s never in a rush, it feels like he has all this time to spend with you and he’s very tuned into what you’re saying. Unlike most doctors I’ve come across, if he doesn’t know the answer to something he will tell you. “I’m not sure. Let me research that first.” Then he gets back to you right away. I’ve never met a doctor like that. That’s why I trust him completely.

Once, when I had a health scare from a weird test result and had to be referred to a specialist, he said, sensing my dread, “See, this is just the kind of result I hate. It’s the kind where we have to get it checked out because it isn’t normal, but it’s also the kind that can be totally meaningless or temporary. So I want you to know when your head hits the pillow tonight that there’s a very, very good chance that there’s nothing wrong.” And there wasn’t, it was fine.

I run a little toward being a hypochondriac. Unfortunately, this sometimes includes my husband. When I was cutting Ryder’s hair a few weeks ago I noticed a spot on his head and said, “Since you’re going to the doctor anyway, can you get this checked out? It’s probably nothing.” In the meantime I thought, well, here we go, it’s skin cancer.

The doc said, “You know what? It might be better to tell her that I gave you a quick biopsy, sent it to a specialist, and that it came back benign.”

At the visit, I asked him about ADHD medications and their pros and cons. He said I could take Adderall or Ritalin, but with my lifestyle, time-release probably would be a better option. “You don’t have to sit through boring lectures or complete multiple assignments by their due date or anything like that.” He agreed that Concerta would be good to try first. He wrote me the prescription for 27 mg.

“So should I take one tonight?”

“Yeah,” he said, “and then I want you to do a head-to-toe skin check on Ryder just to be sure he’s totally clear.” How I love a good callback with deadpan delivery.

March 14, 2019

7:55am

First day on Concerta. Last night I had a really weird dream that I was making my own Concerta pills with all of these annoying little tools – I had glycerin pill capsules and had to fill it up with all of this red liquid and a miniature sponge. I didn’t have any space on my dresser to do it so I kept losing pieces of it. I remember feeling frustrated and wondering why the pharmacist hadn’t done this part herself, wasn’t it her job?? Anyway, I never did take it in the dream because my youngest came into my room saying she had a bad dream that she was being kidnapped. Where had she heard such a thing could even happen, this isn’t 1982. “I didn’t like that dream,” she said. I let her crawl into our bed. 

When I woke up I had a cup of coffee as usual and realized I’d forgotten to research if that was okay. I figured if I googled caffeine and Concerta I would probably see everything from “no effect, totally fine” to “OMG DON’T EVER DO THIS I DIED” on various discussion threads, upvoted or no.

Within the first hour I already felt like I had more focus. I always feel there is a din of activity around me at all times, and I still did to a degree because it was the morning and my kids like to do things like listen to dance music while bouncing on my exercise ball and say things like they know where their shoes are when in fact they have no idea and then I have to herd them to their things, which if you have ADHD is harder than you’d think.

It surprised me to find that the din of activity that always felt behind me and around me was more in front of me and manageable, and not thrust against all of the other tasks I needed to do for that day. I was able to tune some of it out. Another notable absence was my underlying sense of irritation. Whether this was placebo effect or not, I got the kids out the door on time.

My doctor said that it’s not so much that people with ADHD can’t remember things or can’t focus, it’s just that they can only focus for short periods of time and have trouble connecting past and present events to future events so they end up being just a little too in-the-moment. The neurotransmitters that I’ve been apparently missing all of my life, norepinephrine and dopamine, will be restored and I will be able to connect things, which will make it easier for me to plan and to use working memory in everyday tasks.

8:46am

I just went on a walk in my neighborhood with the dog and by the time I got to the park, I thought, “Hey. I feel bitchin’.” What I mean by that is I felt a tad euphoric, like the kind of euphoria that is led by your chest and not necessarily connected to thoughts, although I did have some pleasant thoughts, maybe as a result of the euphoric feeling. It wasn’t MDMA level euphoria (and yes, I know the difference) but it was kind of a lift of feeling, “yes, I like life.” This may have been influenced by my feelings about the park by my house–I genuinely love this place.

Not only is it a very nice park, but I also have memories with my children attached to it. Pecan-cracking memories, throwing rocks in the creek memories, arguments about bicycle safety and when we would be leaving and playing peek-a-boo in the playscape memories. The first time she swam across the pool on her own, the first time they jumped off the diving board. It was as though all of my feelings of pleasantness became compounded by 100. I looked down at the dog and felt fondness for her quick little white feet, her expressive ears.

And on top of that, I was getting my 11,000 steps in today for sure.

I found that I was able to access some of my ideas for articles much more clearly. I began writing this while on the track. I also considered ideas under the title “In Defense of Heartbreak,” in which I thanked all of my exes, both friends and lovers, for all of the gifts they had given me from knowing them.

Is this middle age? 

March 15, 2019

Second day on Concerta. I’m taking 27 mg, which is the second lowest dose, one they frequently use with kids.  

I felt generally alert and focused yesterday, although I still forgot things at times and wasted tons of time. I think it’s important for me to remember that I’m not doing this to be more productive. I’m doing it to gain focus for things that matter to me. I was trying to explain it to Ryder yesterday, how it felt yesterday. It all went back to feeling that the thrum of things had died down, like the way your ears feel when you leave a concert, but this was my brain and involved several senses.

At times I felt like my actual vision was sharper than it was. Imagine going from a kind of soft focus to something with total clarity. A friend of mine once told me that when she was a kid she was prescribed glasses and she sat on the table with her arms crossed, refusing to wear them. The doctor said, “Oh you’ll wear them. You’ll want to.” She said she put the glasses on and went outside, looked up at the trees. She could see the leaves.

That’s kind of how it felt. I had to put together a bunch of web content for this site as well as another one. I had been dragging my feet on it, not knowing where to start. When I sat down to do it yesterday, it made so much more sense. It was as if what I needed to do became clear to me, the steps more intuitive, and I could stick with it.

That said, I slept like shit last night. I tossed and turned and finally fell asleep at midnight. Woke up around 5, so I don’t feel really rested today. I have energy but it feels like I’m stealing it from somewhere, like I’m using my neighbor’s water to wash my car. Ryder tried to get me take a melatonin last night but I was like, “I’m already fucking with my neurotransmitters, I’m scared to add anything.” 

“I’m sure it’s fine. Go check reddit.”

What an age we’re living in. Results inconclusive.

I sent a note to the doc through MyChart and asked him about the melatonin. Re: the meds, I added, so far, so good. Midnight head-to-toe check on Ryder unremarkable and free of abnormalities. Please note in his chart.

March 19, 2019

I think the drug is working fine and I actually don’t feel that interested in keeping a record of it because it is cutting into my time to finish things I really want to finish. I organized my garage, it was crazy easy. I put up shelving. I gave shit away. One thing that stood out is I didn’t feel a sense of urgency or overwhelm about it, I just followed the steps required to get it done. This is definitely new.

When I’m not cleaning my garage or noticing piles that really don’t need to be there, I’m seeing leisure time as more leisurely, I don’t feel like I have to get up and do things to earn the leisure time. Which god, how fucked up is that anyway? Fucking capitalism!

One thing that surprised me after learning about my diagnosis is that I became retroactively angry at so many teachers. They didn’t really know anything about ADHD, of course. But I don’t remember one person taking the time to help me organize my things or plan my projects. I can actually do this for other people, weirdly enough. My job includes teaching executive functioning tasks and I’ve done it very successfully and have even incorporated some of the organizational tools into my own life.

It was never super intuitive for me to teach these skills, of course, but there are plenty of speech language pathologists who specialize in it so I used their materials with a lot of success. Sarah Ward stands out here, she has an excellent program for executive functioning skills in her website. One of the things I love about being a speech language pathologist is that teaching someone the skills we do requires that we set aside judgment and figure out what is going to work for that child. Every child does something for a reason, and it’s our job to find out what that reason is. I didn’t know it, but it’s been healing for me to be that kind of teacher.

The ’80s were weird. People just expected you to be a certain way and punished you when you weren’t. They didn’t really think about learning styles and ableism and inclusiveness, because that research hadn’t been emphasized yet, and the Individuals with Disabilities in Education Act (IDEA) had only passed in 1975. If you didn’t have a clearly identified or obvious disability, they just thought you weren’t trying hard enough. After being in education for ten years, I can tell that it’s changed a lot since then and is still changing.

I was telling my friend who is a nurse about being on the drugs and she had a hard time with it. Her body language (on which I am casually an expert) completely changed. “I wouldn’t ever take them,” she said. I felt a tad slighted. I remembered something one of my therapists told me to do when I’m in this situation where I feel questioned or criticized. He suggested speaking up and shifting the attention to what comes up for them, so it can no longer framed as a criticism.

“What is it about the idea of taking drugs that bothers you,” I asked. She said the side effects, she didn’t want to endure those, and she had a distrust of some of the medications that are sold to consumers.

“Yeah, the side effects do seem unpleasant. I haven’t had too many so far,” I said.

“I’m glad it’s helping you,” she said. The interaction softened a bit.

In Eula Biss’ excellent book On Immunity: An Inoculation, she describes a history of distrust for medicine as it pertains to vaccinations. It obviously persists today. But ADHD drugs have been around a long time and have been used effectively for so many people. For me, the side effects that I no longer want to endure are related to my ADHD.

After living with it for 45 years, I’d like to see what it’s like when it’s not running my life. So far, I’m liking it.

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