I was just wondering if anyone can relate to what I'm experiencing and answer some questions.



I’m a 21 year old college student and I have always had problems getting things done. I’ve always thought of myself of as being fairly smart (I had gotten by in high chool without any studying at all although I didn’t do as well as I wanted to in a few classes). I came to college and I ended up having the same habits as I did in high school… procrastinating, barely studying for tests, and not going to class. Ended up having a 2.8 gpa at the end of my freshman year. This pattern continued for the next two and a half years (I am now a senior). After every semester I would say to myself that this was it… next semester I’m going to get better organized, study more, etc etc. Every time though I would once again fall back into the same patterns. Even when I tried to study I would be constantly losing focus and daydreaming. I finally convinced my self to go see a psychiatrist (why I didn’t do it sooner I’m not sure).

The psychiatrist ended up prescribing me Adderall XR 20mg to take once every morning. Sure enough my concentration and focus improved just like I thought it would. But it also did so much more for me. Before I started taking Adderall I was probably the most self conscious guy you’d ever meet. I always felt like people were watching and judging me. I would get extremely embarrassed at the smallest things. I would care way too much about what everyone thought about me and never ever felt totally confident. I acted confident, though, just because I tried to make up for my inner insecurities. I hated going places by myself and didn’t like going to new places. I never liked going to the first day of class, walking into that full room of people because I felt everyone was just watching and judging me. My whole personality was basically an act. I only said and did things that I felt would make people like me more. I used to absolutely hate taking criticism. Because of this I always felt this anxiety. Also I had a really hard time handling stressful events. I didn’t ever want to think about the bad parts of my life because it just made me sad and frustrated and I could never get myself to deal with problems that I had to deal with (for example I hated checking my grades at the end of each semester and most of the time I only did it months afterwards when I absolutely had to).


I was aware of all these issues but I always thought everyone felt some of these to some extent. I never even brought any of these issues up when I went to the psychiatrist because I thought they were issues that I just had to suck up and deal with. I had even bought all these self help books (feel the fear and do it anyway, 7 habits for effective people, etc.) to try and deal with these things.

Well once I started taking Adderall all these issues disappeared. No more anxiety and I was much more confident. I noticed that I wouldn’t get embarrassed at small issues anymore and could deal with all my problems so much better. I no longer constantly dwelt on what people thought of me. Even my tolerance for pain and discomfort increased dramatically!

So my first question(s) is: Has anyone else experienced something like this? Do most people with ADD deal with these issues? And why exactly would Adderall help with all these things? I obviously had some type of social anxiety (however minor) that is related to my ADD. I went to the psychiatrist for the second time and told him all these changes I was noticing expecting him to expand on it. Instead all he told me was that Adderall has a calming effect and the response I had to it was normal

During that first month on Adderall I felt more content and happy than I ever felt before. Every psychological problem that I had been trying to deal seemed to be solved. I was also able to do everything that I needed to do. I used to hate going and getting something as simple as a haircut. Things I had put off for over a year (getting my car stereo fixed) were done once I started taking Adderall. I told the doc that I needed the dosage to last for about 14-16 hours on some days (I take it at 8:30 am and sometimes I don’t finish with my schoolwork until after 12am). So he gave me a script for 10mg Dextrostat to take around 5 pm if I still had more work to do in the day.

Its now been about a month and a half since I was first prescribed Adderall and about three weeks since that last trip to the psychiatrist and I was wondering If I need to increase my dosage. I take my Adderall XR 20 mg at around 8:30 am and the first three or four hours are great. I feel really focused and sometimes even get this buzzed feeling that makes me really motivated and focused (though that’s been waning off lately which I expected). I still have problems totally focusing in class though. Even when I am trying to pay attention to the lecture I still inadvertently start daydreaming. This gets worse as the day goes on. When I am studying or doing some homework I can pretty much get through it without losing focus, though (I used to go to study and I would literally spend ¾ of the time daydreaming to myself). When I have studying to do later in the day I usually take the 10 mg of the dex (I ended up getting the Barr generic dextroamphetamine) around 5 or 6 pm. This gets keeps me going for another four or five hours. But since I am still not able to totally keep my focus in class when I am on the Adderall XR 20 mg should I need to increase it? What is normal? Should I just be able to make up my mind to focus on a class lecture and not find myself inadvertently daydreaming or losing my attention periodically throughout the hour? This is really only a problem during class lectures… when doing bookwork I can keep my focus and attention for the most part. Also some I’ve been experiencing some anxiety again lately, although nowhere near as bad as before (for example when I am walking on the sidewalk I feel like everyone on the road in there cars is watching and judging the way I walk etc... I know, its weird).

The reason I’m kind of standoffish to ask the doc to up the dosage is because he said that I’m not going to build up a tolerance to Adderall and that once I find my ideal dosage that should be it. Well I told him about all the great changes I was experiencing the after the first month and I told him that for the most part I just needed it to last longer (that’s what the Dextrostat was for). The thing is I don’t feel like the Adderall is as effective as it was the first few weeks. Before I would be able to take the XR cap at 8:30 am and I could basically work until 10 pm if I wanted to. Now by 4 or 5 pm I can’t concentrate in class at all and am forced to take the Dextrostat on school nights. I had also told the doctor that I took a capsule and a half of Adderall XR (20 mg plus ~10 mg, he told me it was alright to take half of one even though I read that your not supposed to) and that it helped but I was up till 3 am. He said that 30 mg was too much cause it kept me up that long (even though 20mg used to keep me up late too but now I get extremely tired by 12 or 1 am if all I take is 20mg).

So should my dosage be upped until I feel like I did that first few weeks? I’m not talking about feeling that general euphoria that people experience the first few weeks on Adderall either. That feeling is basically gone now and I realized that is normal. I am talking about getting my dosage to the point where I am not feeling any anxiety and that I can completely concentrate on class lectures if I wanted to. My motivation level has receded from how it was that first few weeks, too. I’m guessing this is normal since that first few weeks on the drug is like a revelation and basically I tried to do everything that I had been wanting to do. Now that its old news maybe my motivation level has dropped a little bit, which wouldn’t be a chemical imbalance problem. Just so you know what I am talking about, when I initially started taking Adderall, if I took one in the morning I could just sit there and study for all my stuff without having an urge to get up and do other things. Now when I sit down to study after taking Adderall after about an hour I start getting this urge to go do other stuff and I basically have to ‘talk’ myself into studying longer.

So my question finally: what should I be able to do on the ideal dose of Adderall? Should I be able to sit and concentrate in class without inadvertently daydreaming? If I have a test to study for and I start studying should I still be getting a pretty strong urge to do other stuff rather than study? If you need more information please tell me and I can describe in more detail.

The reason I don’t approach my psychiatrist about this rightaway is he didn’t seem to take this minor social anxiety I was feeling into consideration at all. Actually during my second visit he really didn’t tell me anything at all that was useful. Basically I would like to have a second opinion. Anyways, thanks for reading this long post and any insight or comments would be appreciated.

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I can relate to this very well ..... I would suggest that you read all of the threads under Adderall, there are 13 pages that I can find with many of those threads about Adderall XR . Going back on these pages and reading all of pages of past threads has been invaluable for answering many question that I had .

Like this one on page 8
http://www.addforums.com/forums/showthread.php?t=10622

Like you and many others said ..... you take your XR and after 3-4 four hours it stats to wear off and not last anywhere close to the 8-12 hours that it is suppose to . This is why so many people find the need to keep raising their dosage or changing the drug. For me getting the right dosage was always the $64 question and I did not want to ever get above 50 or 60 mg a day which is what the PDR suggest . But as you will see there are many here who are on doses much higher than that . Again your Dr is always the most important person to work with on this . I also find that getting a second opinion and seeing more than one Dr. on matters when it comes to just about any important medical decisions . Going back and reading past posts and educating yourself as much as possible will not only answer many question you may have but will help you talk to your Dr in a many ways .

fiend007,
I may have missed it, but I can't find the word "distraction" in your post. If you have ADD / ADHD, there is no medication available to keep you totally interested and focussed on something that bores you.

My first attempt at post-secondary education in my early twenties was no different than my previous school experience. I did well in subjects that interested me and underachieved in subjects that bored me. I was not on medication.

My second attempt at college was in my early forties and I discovered the joy of doing well in subjects I found boring and irrelevant. For the first time in my life, I learned good study skills and made sure I sat by a time management wiz who was happy to share her skill. What a difference twenty years can make. I was not on medication.

My ADD intuition isn't making a connection with your post.
L.

Imnapl,

I'm not sure if I totally understand your post but I guess let me clarify somethings. I am a pre-health major (something I've always wanted to do) and yes it is pretty demanding. The past few years have been tough. In highschool I got by without ever studying because it was never demanding. I was able to do the minimum work and able to basically accomplish what I wanted to. I graduated with a 3.35 GPA which isn't great but I really wasn't worried too much because I knew I'd be able to get into the college that I wanted to. This obviously doesn't cut it in college. Many hours have to be put in. But I wanted to do well badly so I tried. It took an immense amount of will power to get myself to start working hard but I realized I had to. For some reason, though, every time I sat down to study I had this overwhelming urge to constantly do something else. And it was overwhelming. My first year was a result of giving into this urge. The second year I made up my mind that I had to just get things done so I took a class on study skills and basically just tried to be as productive as I could be. So even when I sat down to study and had this urge to be constantly getting up and doing something else I just had to constantly talk myself into working.

But now another problem revealed itself. I would sit down and study but I found most of my time constantly thinking about other things. I would be constantly daydreaming and losing focus and barely getting anything done while studying. For whatever reason I convinced myself that this was a will power and motivation problem and that everyone goes through it and that if I really want to do well I was just going have to control my thought process better. You have to understand I never really studied before college. I had gotten by, and gotten by pretty well I might add, by just doing the minimum work possible. I always found it amazing how some people were just able to sit down and work for hours and hours on their studies. I tried to emulate that. But it was very difficult because I would get distracted very easily and always had this overwhelming urge to do anything but study a subject like cell biology. And my retention skills sucked. What it took some students a couple days to study, I had to plan out a week in advance to study every day. I would sit there thinking I was studying but what I was mainly doing was day dreaming and never really focusing on the material that much. I really took a hit to my confidence during this time. I felt like I was putting in a lot of hours and my grades had only marginally improved. Everyone had always told me that I was so smart and that it was too bad I was so lazy. But this time I felt like I had put in the hours and I just couldn’t figure out why my grades weren’t drastically improved. My motivation and confidence was again very low and I started to fall back into my old ways. I realized I had to deal with these issues so I started buying all these self help books trying to better every part of my life but for whatever reason some of the same old patterns reemerged (procrastinating and just a general feeling of not wanting to do anything at all).

I realized there was something wrong but for some reason I never approached anyone about it. I’m not really sure why I didn’t realize sooner that I had ADD. I finally got diagnosed with ADD and I was put on Adderall. With this I could actually go to my class lectures and come out of it learning something. I would go to study and I wasn’t constantly distracted and didn’t have an overwhelming urge to get up and do other things anymore. You see, a normal person doesn’t have to be interested in a subject in order to pay attention. My classmates all complain about cell bio and organic chemistry just as much as I do. They also want to learn it just as much as I do. So they are still able to pay attention in class and learn and then go home and work hard and study without being distracted and having overwhelming urges to do other things. This is because they are motivated and they want to do well. And I am too. The first few years of college were years of self discovery. I tried to analyze every part of my life that was lacking and fix it. I bought books such as The Now Habit, 7 Habits, etc… I have more than ten self help books on how to be more effective, stop procrastinating, and optimize my thinking (I never got myself to totally finish one of these books, and at one point I literally had a bookmark about halfway through seven or eight books. I would always lose interest halfway through and want to start a new one). These helped but I still felt this void in my life where I wasn’t truly happy cause I just hated doing things in general.

My doctor told me he has patients who are lawyers and doctors with ADD who function fine on medication. I know I am smart enough to be whatever I want to be. The only thing is a chemical imbalance in my brain hampers my ability to totally achieve what I want to do. Adderall has fixed that for the most part. I made the highest grade on my last physics test and the second highest on my last biology 361 class not just because of the Adderall but because I worked my *** off. I studied for days and days because I wanted it badly. I finally felt like I had some grasp on what it feels to be ‘normal’. The Adderall made it so I could do things that I wanted to do.

Sorry for going on, but I hope this clarifies things a little bit. Believe me when I say that I have ousted all the non medication resources when it comes to dealing with my problems. I have tried, and tried incredibly hard to do well in school and used every type of self motivational tool I could. And like I said, school isn’t all that’s been affected by medication. My stress levels are incredibly lower and if I need to do something now I can do it without having this incredible urge to not do anything.

So back to my original questions. For those of you who feel like their Adderall is helping tremendously, what should I look for in my ideal dosage? What is your distractibility level like? How well can you keep your concentration in work or school? For example, when you have to listen to something that might be abstract or ‘boring’ material but is very important, how well do are you able to do in these situations? What exactly should I be expecting to accomplish on an ideal dosage (I know its different for everyone but personal experiences would be nice)?

Thanks

You sound very much like myself with respect to school, studying and such! The ideal dose thing is difficult to figure out. In my case I increased the dose til I realized that it was too much and cut it back - when the drug makes it harder for you to focus, you know you've taken too much. I take regular release dexedrine myself (Adderall isn't available in Canada - anymore) and prefer the regular release because I can "top up" my dose if I feel I need more in the afternoon or evening without having to worry about it lasting for 8 or 12 hours, like the XR formulations, and keeping me awake.
The effect that Adderall has had on your life is similar to my experience as well - stimulants have helped me with things that I previously thought of as character flaws and that can't be help you feel better about yourself! I would think by your descriptions that you are pretty close to an optimum dose, but not there yet. A bit more should be able to help you with the distractability - but be aware that too much will also cause distractability, so if it makes it worse, you might want to back off on the dosage instead. I don't know if it will help with the really boring material - there is only so much that a drug can do!
Good luck - and I'm glad that Adderall is helping you - I'm sure you'll figure out the doseage issues in good time.
Regards,
Greg

Yes, fiend007, your second post does clarify some things.

Congratulations on your hard work and high marks!
L.

I appreciate the kind words Gregster and Imnapal.

I told the doctor that the 20 mg XR wears off about halfway through the day so he told me to to take another one later in the day. I see him again in a few days but I think I am going to ask for 20 mg instant release so I can control it better.

fiend007,
I'll be interested to know whether or not your Dr. has anything to say about the whole FDA/Adderall issue when you go in for your visit.I see my Dr. tomorrow as he wants to switch me to Concerta due to the latest controversy with the meds.I have a problem with his wanting to make changes as I have tried Concerta etc.... and Adderall has worked well for me up until the last week or so and what I am feeling is that I just need a dose adjustment from the 20mg.I have been taking to a bit higher.I myself have attempted college but knew I was in way over my head and bailed out soon after starting.It is my dream/goal to go back and make something of my life but have known that without meds I was wasting time,money,etc.... .I am the type that has extreme problems getting from point A to B and so even though I have seen improvement since starting Adderall I now have to wonder If my world is about to take a down-hill spiral back to where I was....(wandering around in a fog).Please update on your next visit's progress.

Fiend007

I can TOTALLY relate to the part in your first Post about the anxiety level mellowing out and actually thinking you are ok....or confident in your self. i have always worried about what others thought of me, am i doing my job well enough, am i too quiet, i never felt like I ever fit in..:( at 42 yrs of age and 3 months into Aderrall xr and ADHD professional diagnosis i am the most happiest lady in the world.. I'm OK!! I'm pretty, i'm a goo dperson and I desrve better in life, my self esteem has came from somewhere i have Never been..so it feels wonderful to feel whole again. My medical doctor just told me that the anxiety level for me as mellowed so much (and she apologized for not catching my ADHD issues) that I am just "glowing".. I can feel that after glow too when I speak, when I go to my job, Im so confident in me..have never been this way..thank Goodness for getting a correct diagnosis..i have been diagnosed depressed for over 10 years and countless therapists and antidepressants..:( to no avail. It feels so good to be a functioning person..and kinda like everybody else....not always the outcast or different person in the room.

Good Luck!! and just know you are not alone..I too have experienced the personality change for the better..SELF CONFIDENCE..:) that I have never had...

Wow, to the original poster, your story is very similar to mine. I also whizzed by high school and now that i'm in college, I find it much more harder to keep up. I also used to worry about what people thought of me too and now that I'm older(29), those insecurites have greatly subsided, although not completely.:cool: I was initially put on ritalin and that worked pretty good without any of the side effects that i'm experiening now. FOr example, stomach upset(gassy feeling), weight loss, muscle aches, and teeth grinding. I now take 30mg of adderall xr and I take it at noon so it lasts long enough so I can sustain enough attention for my night class. I noticed that my memory has improved and I'm more "interested' in what is being taught as opposed to before the meds I would be quite bored and always confused about what is going on. I especially had problems with following directions and I would end up saying to a class mate, "what did she say?" Or "What did she mean?" So, since I take my adderall at noon, I noticed that the effectiveness lasts till about 10 or 11pm. I've only been on it 2 weeks now, and I think I may need more time for my body to adjust to this new med. Like on ritalin, I didn't feel this way. Some of the side effects or wearing off. I'll edit and come back cause I have to go for now since I have more things to say.:D

Wow, to the original poster, your story is very similar to mine. I also whizzed by high school and now that i'm in college, I find it much more harder to keep up. I also used to worry about what people thought of me too and now that I'm older(29), those insecurites have greatly subsided, although not completely.:cool: I was initially put on ritalin and that worked pretty good without any of the side effects that i'm experiening now. FOr example, stomach upset(gassy feeling), weight loss, muscle aches(actually THESE went away), and teeth grinding. I take 30mg of adderall xr and I take it at noon so it lasts long enough so I can sustain enough adequate attention for my night class. I noticed that my memory has improved and I'm more "interested' in what is being taught as opposed to before the meds I would be quite bored and always confused about what is going on. I especially had problems with following directions and I would end up saying to a class mate, "what did she say(teacher)?" Or "What did she mean?" So, since I take my adderall at noon, drink coffee in the morning, and I noticed that the effectiveness lasts till about 10 or 11pm. I've only been on it 2 weeks now, and I think I may need more time for my body to adjust to this new med. Like while I was taking ritalin, I didn't feel this way. Some of the side effects from adderall are wearing off. I'll edit and come back cause I have to go for now since I have more things to say.:D
Anyways, I plan on going off adderall xr in about a month after the semester ends and trying the short acting kind for when I'm in dire need of extensive concentration. If these side effects don't wear off to the point where it's unbearable, then I'm going back on ritalin. I too know what it's like to study for DAYS and not even realizing that I was daydreaming about 80% of the time.:rolleyes: Being in college is very demanding and I think many add people cry for help during this time. Also, people that are in challenging(maybe not as challenging for that matter) careers probably face many challenges associated with add. And unfortunately, tolorance to the medications can be a real bummer. So, did you ever think about "drug holidays?"