TLDR: What is ADHD medication supposed to feel like? Is it supposed to feel like anything at all? Will someone with ADHD feel really gacked out/high? does it change based on food intake or other factors?
So I received an unofficial diagnosis from my AuDHD psychologist a while ago, and then my psychiatrist did a very short written assessment on me and determined a positive diagnosis. I really want to get a full assessment one day, but for now I was prescribed Focalin (dexmethylphenidate). I originally wanted it as a prn.
The first time I took it, I definitely felt "peppy", needing to stand while gaming, needing to move around more frequently, generally more awake. I didn't eat breakfast, and had coffee. My blood pressure was also very high. Within a couple of days I took it again, but being good and eating in the morning with no coffee. I couldn't even tell if it was working. I may have taken it another time soon after and did not notice a difference, so I stopped taking it. I've been extremely fatigued and my executive dysfunction has been off the charts so I tried taking it again. Yesterday I didn't eat right away, and I felt gacked. Tight jaw, jittery, like definitely felt like I was on stimulants. I felt like that today as well; I tried to eat a little something this morning but it didn't seem to make much of a difference. It kicked in during a client appointment, too. Jaw tight, jittery, making a ton of typing mistakes, my body feeling fuzzy.
So, is it something where you should be able to notice a difference when you take ADHD meds? I'm assuming that I felt it so intensely because I didn't eat, but when I do it it literally doesn't feel like anything has changed. I may also not even have ADHD at all and was misdiagnosed (I was informally dx'ed with ADHD, Autism and bipolar disorder).
Alright, as promised here's part two of my reply:
Diet
Your diet is important to focus on as an ADHDer, especially if you're noticing that you are skipping meals due to the stimulants reducing your appetite.
Make sure that you're hitting your daily protein intake consistently. Proteins are made of amino acids and amino acids are the building blocks for neurotransmitters.
If you aren't getting enough protein in your diet then, over time, you'll find that the meds won't be working effectively because your brain is running on an empty tank, neurotransmitter-wise.
(If you switch to amphetamine-based medication, keep in mind that acidic foods/drinks will inhibit the absorption of the meds and things like vitamin C acidify your urine which will cause the amphetamine in your system to crash.)
Burnout
Burnout is a heck of a thing. Note that this section is going to be primarily personal anecdotes and based on other people's reports.
When you're talking stimulant meds while burnt out, it's important not to push yourself too hard. Having stimulants on board means that you're going to be much more likely to be able to push through but doing this can deepen the burnout and prolong it. No bueno.
It's really tricky to puzzle out the effects of burnout. There are days when I feel like my meds are doing literally nothing and that's a reflection of my baseline level of burnout.
Let's take sleep deprivation as an analogy here:
If you are sleep-deprived, stimulants will help your cognitive function however they aren't ever going to fully compensate for the sleep deprivation. It'll probably help to some extent but if you're seriously sleep deprived then there's no amount of stimulants that will resolve the underlying cognitive impairment.
Burnout is similar to this in a lot of respects (as are other factors like depression.)
Ultimately, your ADHD symptoms will be worsened if you are in burnout and the effectiveness of stimulant meds will definitely feel as though they fluctuate, or they might not have a noticeable effect at all, until you're out of burnout/you have made significant strides towards recovering from burnout.
Autism in relation to ADHD
Autistic ADHDers tend to be more sensitive to stimulant meds than pure ADHDers, from people's reports.
Autistic ADHDers often report "the autism" coming out more when appropriately medicated. I think this can be attributed to a lot of things but if your ADHD is unmedicated then it's easier to be oblivious to your autistic traits; you're much less capable of keeping track of the score, so those social faux pas you make are much more likely to slip by your recognition and your memory but when you're medicated it's the inverse. If your brain is in a constant flurry, bouncing from one thing to the next, or if you are constantly vagueing out because of inattentiveness, then being appropriately medicated will suddenly allow you to focus in on your special interests and you'll be better able to sustain your focus which can make you feel "more autistic". A lot of ADHDers, especially unmedicated ones, use social interaction as a way to milk dopamine out of life but when you are medicated that urge for seeking out novelty and social interaction will be reduced and this can manifest as being more inwardly focused and socially withdrawn, which can feel like your autistic traits are being amplified. Often AuDHDers stim more and they can have heightened sensory sensitivity when on stimulant meds too.
I have other half-finished thoughts about the AuDHD experience but I'm struggling today.
I think that a pure ADHD experience of appropriate medication is one where a lot of the worst symptoms are alleviated and their general function is markedly improved.
The AuDHD experience is more complex, broadly speaking, and the experience of being medicated for ADHD is generally not as stark a contrast because there are a lot of reasons why autistic folks struggle with stuff like executive dysfunction and task initiation. With regards to task initiation some of the confounding factors are autistic inertia, difficulty with task switching, and perseveration and these can be underlying causes for difficulty with task initiation. What this means is that treating the ADHD with meds doesn't necessarily result in a huge shift in how much difficulty an AuDHDer has with task initiation compared to the experience of an ADHDer who isn't autistic.
Anyway, this turned out to be more of a ramble and it was less structured than I would have liked but I hope it's helpful to you all the same.
Omg, your second paragraph in the "Autism in Relation to ADHD" section was really, really incredibly eye-opening for me and made sense of some medication issues/dissatisfaction I was having. Thank you so much for taking the time to write all this out, this was super helpful to me. ❤️
very helpful ramble, i'm in a similar boat so thanks!
this bit about autism is also really interesting to me. I have no autism diagnosis, but I feel like I have maybe half the symptoms people mention, and I relate to this paragraph a lot.
Wow, your responses were awesome, I really appreciate your thoughtfulness! Sorry for taking a while to respond, all of the helpful replies were kinda overwhelming and I wanted to just reply to everyone all at once (lol).
I really resonated with your point about how autism and ADHD interact, and how being medicated for ADHD can "exacerbate" autistic traits. I have always attributed my mental health struggles to C-PTSD as I've experienced pretty intense childhood trauma as well as ongoing trauma. I then was diagnosed with Bipolar Disorder, and officially/unofficially diagnosed with Autism and ADHD. In my mid 20's, I think more sensory sensitivities started cropping up. I remember for a few years, I always felt very dirty; my skin just felt dirty, like I could feel all of the oils on my hands and face and it was really distressing. How I talked about it was that it was the opposite of dissociating; that maybe being triggered cause me to be extra-inside my body. Could never figure that one out, therapists were so confused. Then with my bipolar diagnosis, I got medicated, and my mood is more stable (for the most part) but now my stimming, infodumping, sensory issues, distractedness, and extreme social anxiety seem to be more intense. So it all unravels but then becomes more complicated, lol.
Also, I believe that I am in a state of extreme burnout. I explained it a bit in another comment, but my burn outs last for months; I feel like it's been at least a year that I've felt this way. It's not just that at work I'm irritable and curmudgeony, I am just too exhausted to even entertain doing any of the things that make me happy. The thought of riding my bike or hanging with a friend is painful to think about. Also the inertia piece has been increasingly difficult to contend with; I think I noticed it getting bad around 8 years ago and it seems to not be letting up at all.
I think the biggest thing that I hope for with ADHD meds is being able to muster the motivation to do things I enjoy without them feeling like a chore, focus, and keep routines. I hope that, if I do in fact experience ADHD, that something will work because I feel like I can't go on like this