Despite the claims of South Park’s Mr. Mackey, not all drugs are bad.
I’ve recently been trying medication following a diagnosis of ADHD as an adult. The experience has been interesting, and largely beneficial. However, when I tried finding stories sharing the subjective experiences of other adults trying this type of medication, I was frustrated. Most available content describes drug interactions, typical effects, or changes another person might notice (most often, the parent of a child diagnosed with ADHD).
For most of my adult life I’ve worked in the mental health field. I don’t have formal education is psychology, but I do have a lot of hands-on experience with varied individuals. Anyone who knows me personally would probably agree that I’m not a “fluffy” individual. I’m not really someone who believes in coddling mental health challenges, because from my experience that approach’s ability to succeed is limited. This extends to myself. However, challenges with mental health absolutely are stigmatized and hushed up, and this is something to which I’m opposed. I firmly believe that mental and emotional difficulties can be overcome with work and support. Doing so may not be trivial, but just like most other health issues symptoms will improve if the individual puts in the work. Stigmatization makes this task more difficult.
So today I want to share my subjective experience of physical and cognitive symptoms when I first started taking ADHD medication. I’m going to avoid reference to actual personal medical information (such as specific health conditions or medications). I think it would be stupid for me to just blab that on the internet. I want to share these experiences while they’re still relatively fresh to provide anecdotal descriptions of the medication’s effect, and to reduce stigma around the use of medication as a supportive tool.
Of course I am not a doctor, I’m not saying others will have the same experience as myself, and I’m not advising a particular course of action beyond “listen to your medical professionals.” None of this is meant to help others diagnose themselves, suggest taking (or not taking) particular medications, and so on.
That clear? Cool? Alright, let’s rock.
Physical Sensations
The first time I tried ADHD medication was intense. This intensity wasn’t being “energetic.” I wasn’t bouncing or fidgeting. I wasn’t planning a thousand projects; I wasn’t manic. Perhaps the best way to describe the sensation is being “present,” or being “embodied.” I was extremely aware of my physical self, like when practicing mindfulness techniques to re-center and break out of a negative cycle of self-talk. But this sensation was constant, enduring. The best comparison might be to having a fever. I wasn’t hot or burning up, but the full-body awareness of warmth and aching I have when feverish is quite similar to the full-body awareness I experienced when starting medication.
This feeling of awareness extended to other sensations. There was a constant, mild, taste of something in the back of my throat. Not unpleasant, and it didn’t alter my ability to taste food. It’s still there now—I’ve been taking medication for a few weeks at time of writing—but I have to search to notice it. The sense of pleasure after eating a meal, drinking a beverage, or taking a walk was stronger. For the first time in my life, I’m pretty sure I’ve experienced the energy of a caffeine high after drinking coffee. I now see why people like that stimulant. Prior to medication, my experience was that coffee was pleasant, but more relaxing than energizing.
A common side effect of ADHD medications is reduced appetite. My experience with this, I think, is interesting. I don’t exactly have reduced appetite. I’m often aware of when I’m hungry, especially if I’m hungry enough to have that twang in my belly. That awareness doesn’t vanish when I’m on medication. It just becomes less urgent. The amount I eat during meals is reduced, but it feels more like I’m aware of how full I am, rather than lacking hunger. I’m less inclined to snack or binge eat not because I’m less hungry, but because food feels more satisfying.
Cognitive Sensations
The primary goal in trying medication was to improve my ability to focus. My hope is that improved focus will lead to completing more work, which in turn will increase satisfaction, and reduce stress. My expectation was that either medication would do nothing, or that it would give razor-sharp clarity of thought. I’ve been in that space exceedingly rarely, just enough to know what it’s like when a problem wholly absorbs my attention.
In practice… in practice, the cognitive effects are difficult to describe. I was surprised to find little information about subjective physical experiences, but mental experiences were less surprising. Even as someone who, bluntly, is hyperaware of their own cognition (thanks, philosophy!) and whose work is intellectual labor, I find much of it difficult to explain or quantify.
Executive function is a person’s ability to do the things they want to do, when they want to do them. While medicated, mine is significantly improved. I sit around staring at social media and stupid memes for about the same frequency, but with much shorter duration. I’m better able to step away from something entertaining—like a YouTube video—and choose to finish it later in the day. The first few days, this felt like I had “grabbed the reins” of my own brain. This took place even from the first dose—the first day, I wrote 2,000 words and submitted a freelance project, changed the filter in my vacuum, vacuumed my downstairs, cooked dinner, and washed dishes. That might sound like a pretty normal amount of work + chores for a day, but I never get that much stuff done, especially not after a productive writing session.
A decent anecdote about this is that daily hygiene took 10 less minutes while medicated, time I didn’t even know I was using. Instead of getting lost in thought while showering, I would just do it.
This ability to do tasks sort of intersects with the ability to focus. For me, focus feels like when my brain has less chatter. My internal experience is very vocal; I pretty much always have an internal monologue going in my noggin. To be clear, this isn’t “Austin hears voices!” This is all my own brain, my own thoughts, verbalized as my mind decides to wander whatever directions it chooses. When I’m focused, this chatter is minimal. For example, I’m reading the text of a book and following word-by-word. When I’m unfocused, my eyes follow the lines of print, but my brain drifts into thought-association games as my attention slides in and out of the text.
This contrasts with hyperfocus (or hyperfixation) on an idea or topic. I do this irregularly, but strongly, when unmedicated. If you like my books, you’ve read the results of my hyperfixation! For example, The Throat of Winter actually began as a hyperfixation on writing an adventure site for Forbidden Lands from Free League! I’d finished reading the core box, and didn’t have anyone to play with, so I wrote instead. The Jonstown Compendium announcement came out about a year later, so I decided to convert Throat to RuneQuest.
I’m not really sure what hyperfocus looks like while I’m medicated. I’ve had a few moments of it, but they’ve been relatively short and in my experience fixation for me lasts hours (like while reading a good story) or days (like while chasing a writing idea). This type of deep fixation happens about monthly while unmedicated, so I don’t yet have a good feel for new patterns.
Another interesting facet has been memory. I’m not sure if this is really focus, or executive function, or something else. When I first started the medication, though, I stopped leaving objects around the house. I stopped having that “what was I doing?” sensation, stopped wondering “why did I come in here?” As I’ve continued the medication at first memory lapses were a warning sign that the drug was wearing off. Currently, my attentiveness in this regard feels pretty much like it was without medication.
The result overall, though, is that I have been able to get more done. I keep personal records of hours worked, wordcounts, etc. as a way of keeping myself honest, and those metrics have consistently improved since I started medication. I don’t really feel like I have more energy. It’s more like I can spend the energy I have more efficiently—like if doing a chore would cost 2 points, now it costs 1.
Duration of Effects
The first few doses I felt strong effects for eight hours or more, and then lingering changes longer still. Currently, I don’t feel many physical effects unless I’m looking for them. I tend to think they’re still present, and that my internal experience is normalizing the medication. I typically do notice caffeine still—I’m trying to cut down since the med says to restrict caffeine usage, but withdrawal sucks and I don’t have the willpower to cold turkey—and likewise with enjoying food.
Mentally, I’m still much better able to have a real workday. I’m having a fall-off of effects in my home life (the getting chores done type stuff), but I’m still getting a better return on energy invested during my writing day. I honestly feel like my focus is pretty much back to pre-medication levels, but that I’m better able to redirect toward the work and avoid falling down rabbit holes.
I’m pretty much drained at the end of my workday… but I do like my work. Especially when I get to do fun RPG stuff! (Which is probably 30% of my total hours in a given month, not including marketing and articles, etc.) Even when the job isn’t my favorite topic, I do still enjoy the process and act of writing. In many ways it feels like I’m still just at the beginning of improving my craft, and I find that terribly exciting.
Medication has given me increased hope that I can understand how my brain is wired, and be able to work with that wiring to continue building toward a sustainable career as a writer. We’re not there yet. But I keep inching closer.
Well, until next time, then.
Want to keep up-to-date on what Austin’s working on through Akhelas? Go ahead and sign up to the email list below. You’ll get a notification whenever a new post goes online. Interested in supporting his work? Back his Patreon for early articles, previews, behind-the-scenes data, and more.
You can also find Austin over on Facebook, and a bit more rarely on Twitter.
Akhelas 