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).

  • iie [they/them, he/him]
    ·
    10 months ago

    thanks for this writeup

    As for task initiation, there's often a sort of lag or a "stickiness" to this for a late-diagnosed ADHDer. (If you are burnt out this is a confounding factor too.) Essentially, as an ADHDer, you have probably had to drag yourself through doing the tasks you hate and you've almost certainly built up a serious, deep-seated negative association because of a lack of dopamine. ADHD meds help with the lack of dopamine and they make starting on tasks easier however you should expect that it will be a long-term process of shifting your attitude towards those tasks that you particularly struggle with or dislike. You should find that it's easier to get started on those tasks and that you're more capable of seeing them through to the end however if the cumulative effect of literally forcing yourself to do these tasks over years and years is negative then there's going to be a significant adjustment period because your psychology won't just magically adjust instantaneously, despite your brain chemistry making things easier for you.

    What this looks like in practice might be that you are still really resistant or reluctant to start on those undesirable tasks and so you continue to put them off as you did prior to being medicated but if you set your mind to it, you should find that doing those tasks feels much easier than you expected.

    this bit especially

    I tend to not take my meds enough because of some vague paranoia about tolerance and needing ever higher doses to function, but I think I've swung way too far in the other direction, and after years of undermedicating I think this task initiation issue has crept back into my life, and probably never fully left.