View Full Version : What exactly are these meds supposed to do?


ajaxblu
03-28-17, 01:36 PM
How do I know if the meds are helping? I know the answer should be "If you don't know, then they're not" but I don't feel it's that simple.

I sometimes feel as though they may be helping, but I'm not sure what to look for.

dvdnvwls
03-28-17, 02:11 PM
There are different ways to talk about it, but you come out with the same answers in the end.

Most important, if they make you feel significantly worse, something is wrong that needs fixing right away.

Otherwise, your feelings aren't that important. If you feel about the same or better, with maybe a minor discomfort or two, then the feelings aspect is fully covered and you don't worry about that anymore.

The real expectation, and the real test, is that you behave more effectively at the things that were not going well for you. Some possible examples: You remember more things about your work or school. You can stick with an important conversation better than you used to, or read more effectively. You are able to get organized better than before, less scatterbrained.

Medication by itself doesn't really fix procrastination, probably because procrastination is a many-headed beast that needs all the strategies you can throw at it, in addition to the medication.

I hope that's a start!

ajaxblu
03-28-17, 02:52 PM
There are different ways to talk about it, but you come out with the same answers in the end.

Most important, if they make you feel significantly worse, something is wrong that needs fixing right away.

Otherwise, your feelings aren't that important. If you feel about the same or better, with maybe a minor discomfort or two, then the feelings aspect is fully covered and you don't worry about that anymore.

The real expectation, and the real test, is that you behave more effectively at the things that were not going well for you. Some possible examples: You remember more things about your work or school. You can stick with an important conversation better than you used to, or read more effectively. You are able to get organized better than before, less scatterbrained.

Medication by itself doesn't really fix procrastination, probably because procrastination is a many-headed beast that needs all the strategies you can throw at it, in addition to the medication.

I hope that's a start!


Thank you. This is the kind of answer I'm looking for - actual concrete things to look out for.

When I started meds, I told the Dr that I don't understand how any med is going to help me stick with doing my actual job while I'm at work instead of doing everything else I do there that's not my job. He said that the meds will help me concentrate more so I'm able to make better choices about the actions I take.

Well, nothing there has changed. I'm still doing everything but my job 7 hours/day and then scrambling at the last minute to do the stuff I'm supposed to be doing.

So maybe judging it on my job performance at a job I care nothing about is not a good way to tell. I need to find another way to judge it. My next Dr appointment is this Friday.

Thank you.

Fraser_0762
03-28-17, 04:26 PM
Medication won't help you to concentrate on something that you have no interest in concentrating on in the first place. You need to be doing something that gives you a sense of purpose. If you're just turning up to work for the sake of it each day and not because you have any interest or enthusiasm about what you do, then you need to reconsider your career path. Find something that is meaningful to you.

ajaxblu
03-28-17, 10:43 PM
Medication won't help you to concentrate on something that you have no interest in concentrating on in the first place. You need to be doing something that gives you a sense of purpose. If you're just turning up to work for the sake of it each day and not because you have any interest or enthusiasm about what you do, then you need to reconsider your career path. Find something that is meaningful to you.

Thanks - I totally agree.

I have been going to college to try to get a degree in something that's a good mesh of all the things I love to do. Since I work full time and have kids (one who has ADHD) and my husband often has to work out of town or long hours, my time is very limited. I've only been able to swing one class per semester (sometimes I can't even manage that, depending on the schedule).

It'll be another six years before I'm done. We can't afford for me to quit my job so I can take more classes, plus my job is the consistent one and I have better health insurance for the family.

Other than the classes, I do the things I love on the side when I can, but you can imagine how much time I actually have for those things and they aren't something stable enough to forge a career with. Add to that distraction, procrastination, and having far too many things I love to do and far too little time to do them.

Thank you, though. :)

Cyllya
03-29-17, 12:53 AM
It's hard to tell. The symptoms are surprisingly subtle. For a long time, I could only gauge my symptoms retroactively, but looking back at the end of the day and trying to remember how ADHD-ish I'd been. Nowadays, it usually doesn't take me as long.

Another complication is that things besides meds can affect symptoms. Like helpful meds + poor sleep will probably have a similar result as no meds + good sleep.

Here's my problems and how I know whether meds are helping:

Attention problems, in the sense of failing to notice things I should notice - It's pretty hard to track this.

Attention problems, in the sense of spacing out - This rarely happens while on meds, so if I realize I have spaced out, something's wrong.

Working memory problems - An example of WM failure is walking into a room and you can't remember why you went in there. It's normal for this to happen occasionally, especially in a distracting environment, but without meds it happens more often. I don't keep a precise count, just a vague idea of frequency. Also, meds seem to make it easier to speak verbally and make eye contact, but it's hard to tell. At once point when I had switched to a less effective med, I was dismayed at how much effort it was taking to express myself on a work-related phone call, but that sort of thing is usually only noticeable when it's a big difference.

Cognitive flexibility (?) problems - I often have a weird urge to keep doing whatever I'm doing. I'm not sure whether meds help with this, but withdrawal effects from Adderall seem to make it worse. It's hard to measure this, but I usually only find myself thinking something like, "Oh, God, I've been playing Sudoku for the last four hours and I'm so tired and I have work in the morning and it's not even fun anymore and I wish I could stop this," when I've taken Adderall earlier that day.

Initiation problems (description here (http://cyllyathoughts.blogspot.com/2016/10/initiation-motivation-procrastination.html)) - If I intend to do something, and I'm actually thinking about it (it's not forgotten), and it's not triggering any of my phobias, and there's no other obvious obstacles, and yet I still feel a weird all-consuming urge to not do it which is disproportionate to the actual unpleasantness of the task, that usually means the med is not helping enough. If I can't force myself to work on something, or if the effort of working on something is so much that I can't concentrate on the work, that means it's not helping enough. In those situations, I usually start some activity that's super-easy but bland or inappropriate, just because I'm overwhelmed by boredom, e.g. browsing the internet at work, lying in bed day dreaming, etc. In ideal situations, I can decide to do something and then just do it!

Sensory/stimming/fidgeting - I realized my new med was helping less than a previous med when I noticed that the inside of my mouth really hurt. (I normally bounce my leg or flap my hands a lot, but in situations where that's not comfortable, I end up chewing the inside of my mouth instead.) Adderall withdrawal makes me more inclined to fidget, and I've occasionally noticed that state because me leg muscles or foot will hurt from all the bouncing. Sometimes I have to bounce both legs simultaneously.

Planning, organizing, running a household like an adult - I don't think it helps much with this... :( other than the impact of the above symptoms.

Ideally, there should be no direct effects on emotions, sensations, or other feelings. (It's okay if there's some emotional side effects, if it's tolerable.) But of course it makes sense that treating ADHD symptoms reduces ADHD-related misery.

ajaxblu
03-29-17, 08:42 AM
Wow. Cyllya, thank you so much. This, and what dvd provided, are exactly the specifics I'm looking for. I'm also mostly unaware of symptoms or possible improvements other than retroactively at this point and by the time I look back, I'm no longer sure whether meds helped.

Do any of you think the opinions of others' around us are worthwhile or accurate? My first instinct is no, because my husband doesn't know when/if I've remembered to take the med, and he really has no clue what my internal issues are, only those that are glaring or show themselves verbally in some instances.

I have noticed that I seem to openly display symptoms, or ... allow the symptoms to come forward instead of ineffectively fighting them, far more than I did before I recently learned that I have ADHD. Again I recognize this post factum. I truly believe this is because finding out has been such a relief that I perhaps have subconsciously felt I don't need to hide (from immediate family) the symptoms any longer after all these years. This possible misleading scenario may or may not also my or my husband's opinion on whether the meds are working.

So after all of that... I'm still unsure. I wish there was some sort of definitive test. Perhaps I can design some type of experiment for myself using the parameters you both have shared with me here. I feel as though my Friday appointment is a sudden ticking time bomb when I should have been paying attention all month.

sarahsweets
03-29-17, 09:26 AM
Do any of you think the opinions of others' around us are worthwhile or accurate? My first instinct is no, because my husband doesn't know when/if I've remembered to take the med, and he really has no clue what my internal issues are, only those that are glaring or show themselves verbally in some instances.

The problem with asking the input of family has to do with their ability to be objective and their expectations. They want drastic change, immediate results, for you to operate like a non-adhd person.
They may have been sick of your symptoms and when you start treating them, they want all those symptoms to go away. They want to notice that you have taken your meds, they want evidence in the form of productivity they can see. They feel like they have put up with you long enough and now its about time you started acting like a "normal" person. Even the nicest spouse or family member may feel this way and not say it, or inwardly expect it, or ask you when you think you will feel 'xyz' enough to get to those projects that you have laying all over the place.
They may notice a little improvement and ask you when you will have a dose increase, or you could already be taking a high dose but they want the better you they've been waiting for-so why not go higher? Or switch meds, or increase it on your own? You may still have adhd symptoms forever, especially if you have severe adhd. Meds are supposed to level the playing field but for some, meds just get you on the team to play the game.
I am not saying that family members are bad for any of this. Their feelings and frustrations are valid-they just dont understand what the meds are supposed to do and how they work. Sadly, sometimes the only ideas people have for medication is by watching the movie "Limitless" and viewing meds as a performance enhancer that is easily tweaked vs treatment that takes time and consistency.
I am a believer that your medication and treatment when it comes to meds are between you and your doctor. The first time you start asking for input about these things..well then you have opened the door to more comments, unrealistic expectations and in some cases, disappointments.

ajaxblu
03-30-17, 10:50 AM
I'm glad I asked about opinions of family members - this makes perfect sense and I will not be asking them - thank you.


Okay, a followup question... I assume lack of sleep affects the effects of meds, yes? I wonder to what extent though. Thoughts?

I don't see a way for me to get more sleep with our schedule without taking away from my ADHD daughter the one thing she cares about; so I don't think my only getting 5 / 6 hours per night will change except for spring break and summer weeks.

aeon
03-30-17, 10:54 AM
I assume lack of sleep affects the effects of meds, yes? I wonder to what extent though. Thoughts?

It renders them nearly useless in terms of ADHD treatment efficacy.

Plain and simple, everything suffers from, and nothing makes up for, a lack of sleep.


Cheers,
Ian

sarahsweets
03-30-17, 01:43 PM
Do you have a good bedtime/wake up routine?Whats it like?

ajaxblu
03-30-17, 04:16 PM
Thanks Guys.

Nope. Our house is chaos all the time during the week. Much of this has to do with our daughter's sports schedule. Some of it has to do with the fact that my husband has to get up at 4:30am to go into work, so goes to bed by 9 each night (which is good because he works on dangerous machinery 10 hours/day).

This leaves it to me to take our daughter to her sports practices 3x/week which end at 9:30-10pm. Her ADHD causes her to take forever to shower and get to bed each night. I set the timer on my phone every 5-10 minutes to remind her to keep moving, but my ADHD causes me to often forget to reset the timer, then I get involved in something on my own, therefore forgetting to remind her to keep moving. Blind leading the blind.

So she often gets to bed anywhere from 11:15-12:00midnight, with me shortly thereafter. Sometimes I have trouble falling asleep so I don't usually get to sleep right away, on top of the fact that I'm a night owl.

My daughter and I both get up at about 6:30 am to go to school and work. Rinse and repeat.

I know there must be some way to fix this. I'm hoping to come up with some type of plan over spring break.

ajaxblu
04-07-17, 07:28 AM
Update...


At my appointment with the psychiatrist, when I said that the Ritalin was perhaps working but I wasn't sure, and what was I supposed to be looking for, he replied...

"There shouldn't be any of this wishy-washy stuff. If it works, it should be like an awakening. "

So he switched me from 10mg of Ritalin to 60mg of Strattera.

Does this sound reasonable to you guys? I ask because I've seen people mention here that increasing the dosage of what you're already taking is sometimes helpful, but he didn't even consider that with the Ritalin.

Bouncingoffwall
04-07-17, 09:50 AM
Medication won't help you to concentrate on something that you have no interest in concentrating on in the first place. You need to be doing something that gives you a sense of purpose. If you're just turning up to work for the sake of it each day and not because you have any interest or enthusiasm about what you do, then you need to reconsider your career path. Find something that is meaningful to you.

Or, in my case, I don't like the documentation and administrative part of my job, but I love the contact I have with clients. Those two aspects of my job are inseparable from one another, unfortunately. The medication does help me focus through the tedious parts of my job.

I find that even if I'm doing something I like, say playing a guitar, I get distracted.

Careful with telling impulsive people to chase their dreams with no viable way to earn money. I've been through over 25 jobs in my life, and looking back, I would've preferred more stability. I also dropped out of school to become a "musician" and "photographer." All it did was set me back in life, and it took that much longer to get my graduate degree. ADHDers are known for their reckless decision-making.

The sensible middle ground is: Keep doing what you're doing to pay the bills, and maybe work on the side towards your dream career. That way, you won't starve or have to live with your parents.

aeon
04-07-17, 10:34 AM
"There shouldn't be any of this wishy-washy stuff. If it works, it should be like an awakening. "

:yes:

So he switched me from 10mg of Ritalin to 60mg of Strattera.

:doh:


Sigh,
Ian

ajaxblu
04-07-17, 03:19 PM
Pardon me, I misspoke. It was 20mg of Ritalin (10mg morning and evening) and now 60mg of Strattera.

Is it the large change in dosage amount that prompted your disapproval, Ian?

dvdnvwls
04-07-17, 03:33 PM
I'm guessing Ian would have more to say about switching from something that pretty much always works, to something that may or may not sort of work for some people. Strattera is a second-string choice for sure. BUT... if it works it works, and no one can argue with that.

aeon
04-07-17, 03:54 PM
Pardon me, I misspoke. It was 20mg of Ritalin (10mg morning and evening) and now 60mg of Strattera.

Is it the large change in dosage amount that prompted your disapproval, Ian?

No, it was that the Ritalin dose seemed low to abandon that quickly without further titration, and that seems a heavy dose of Strattera to start with.

Also, I have some reservations about Strattera based on its chemistry and mechanism(s) of action, but thatís a personal thing based on my own experience of medications similar to it.


Cheers,
Ian

ajaxblu
04-07-17, 08:57 PM
No, it was that the Ritalin dose seemed low to abandon that quickly without further titration, and that seems a heavy dose of Strattera to start with.




Yes - exactly! That's why I asked the question here - it seemed odd to me to abandon the Ritalin without upping it first, and then the large dose of something new.

dvdnvwls
04-07-17, 09:18 PM
Makes it sound like this doctor wanted to make sure you were not prescribed anything with addiction potential, or maybe that you were not prescribed anything with street value.

Is this doctor near a large school of some kind? Or perhaps did the doctor suddenly hear anything about your history that he might not have liked? I don't believe that's why, but the possibility exists.

ajaxblu
04-07-17, 11:51 PM
Thanks, dvd. No, I don't think either is the case. I'm as vanilla as they come so no addictions (I've never even tried a cigarette) and I'd have no clue how to sell any kind of drugs.

The only new info I gave him was that I don't get much sleep, which he answered with a suggestion to slow down and say "no" more often.

ajaxblu
04-12-17, 07:43 PM
I called the psychiatrist to say I'm stopping the Strattera. It's been less than a week and there's an acne-like rash all over my face. I asked where we can go from here, and if he couldn't just increase the dosage of Ritalin to see if it would be effective. Despite the fact that I was just there last week, he's requiring me to go into the office again to discuss treatment. :eyebrow: