Elvanse I

My ADHD journey

Elvanse pills

I’m 34 years old. Ever since I remember my mind was racing. There is no exact number for thoughts per minute in the average person, but I was always sure that I would outperform whatever the average was going to be.

There is a constant background chatter in my mind. Mostly, it consists of relatively coherent speech, like a commentator that lives in my brain folds and just won’t shut up. My days have always been long and exhausting.

In fact, I usually wake up feeling exhausted already. That is because I don’t have a very deep sleep. I can count the nights that I’ve slept eight hours without waking up in between on one hand. Either I struggle with falling asleep, or with staying asleep. It’s mostly the latter. I’m plagued by nightmares. Little sounds will tear me from my dreams, and often enough I’m grateful for it.

My dreams are like watching a TV series. One chapter follows another. Sometimes, on the weekend, I try to sleep in and entertain myself with my dreams. This comes at a price, though. The more I engage in binge-watching the nightly products of my brain, the more I feel like I’ve been hit by a truck the next morning.

I have trouble sticking to routines. I desperately need them, but after a week or so doing the same thing over and over again feels like a good reason to jump out of the window of my third-floor apartment.

I have developed tools to deal with the chatter in my mind.

Mostly, when I get up from, let’s say, the sofa to get a glass of water from the kitchen, by the time I reach the kitchen I have no idea why I’m there. So, I repeat in my mind: Water, water, water.

My attention may still get caught by something else, like the trash, and while I decide to take out the trash I empty a plate with some food scraps on it and start washing the plate, and washing the plate reminds me that I should also wash my dirty laundry, and I go to the bedroom and collect the laundry from the laundry box, and I start making my bed, and think that it would be a good time to change the sheets, and then I realize there is a hole in the bedsheet and I open Amazon to order a new bedsheet, and then I remember that I wanted to reply to the email of a colleague, and when I open my inbox there is a new message from a job I applied for, and two hours later I still haven’t had my water. I’m dehydrated, my head hurts, my hands are sweaty and cold, and the chatter still hasn’t died down.

You wouldn’t think it’s like that when you see me. I seem pretty put together. Because after all, I do empty the trash and wash the dishes and make the bed and wash the laundry and answer the emails. I have coping mechanisms for all that. Lists, mostly. An infinite number of lists on my phone (many of which I have forgotten exist, so I listed the to-dos in other lists once more), a big whiteboard in my bedroom, and a baseline of anxiety that is so strong that I get all the things done that I would otherwise forget.

But it is so tiring, believe me. I always feel out of breath. It’s like I’ve inhaled once when I was born, and since then I’m trying to ration the air in my lungs. I live on caffeine, and for many years I accompanied it with cigarettes and the occasional stimulants that seemed to quiet my mind plus alcohol to numb the intensity of noises and bright lights, the horror of social interactions and the world in general.

I remember the first and only time that I took Ritalin, at the age of eighteen. It felt like I had entered a Tetris game in real life. My thoughts came in an orderly sequence, instead of stumbling over each other, tripping, falling, and leaving me desperately out of energy by noon. I felt a calm I had never sensed before. I chased that calm in my twenties, abusing alcohol and other recreational drugs.

What always kept me going, what helped me to complete my studies with honours and follow them up with a PhD, was my constant sense of impending doom. I felt like I was the glue holding the world together. If I allowed myself one misstep, just one moment of inattention, everything was going to fall apart.

When my mom fell sick and I became her caregiver, I had a burnout. I don’t think it was my first one. I believe it was the first one that I actively named a burnout because it felt reasonable to have one. All the other times that I miraculously became depressed without finding a good reason for it, the months that I woke up in terror every morning and didn’t want to leave the house, the many weird colds and low-grade fevers that lasted for weeks, all those – I know in hindsight – were small burnouts, too. I just didn’t have a word or a concept for that back then.

Because who would constantly burn out just from doing normal life? Who other than a deeply flawed human being that was simply lazy, overly sensitive and not apt for living?

I did therapy, twenty years of therapy. I therapized all my childhood trauma away, which, admittedly, I wasn’t lacking. I started taking antidepressants that took the edge off the anxiety and helped stabilize my mood. I joined A.A. and stopped doing drugs and quit smoking cigarettes and instead meditated and prayed and did yoga and martial arts. And all that helped. But it didn’t take the chatter away, the constant sense of urgency, the exhaustion with life.

Then I got diagnosed. I received a diagnosis that is sometimes referred to as “3e” – triple e, standing for “triple exceptional” (which is a very ironic way of calling something that makes you feel like an unlovable and insufficient alien with chronic fatigue and a preference for plain foods).

What it means: Giftedness (IQ of 130 or more), ADHD and autism.

Really? I thought. Well. It kind of made sense.

I looked back at my life. The signs had been there all along.

But 3e makes for a very specific appearance: Symptoms of each of the neurodivergences will level each other out. The disorganization often prevalent in individuals that purely have ADHD will be mitigated by the high need for organization that most autistic individuals present. The giftedness lets me compensate many of my social deficits that the autism brings through fast learning and assimilation. Most of this happens unconsciously.

Neurodiversity runs in my family. I was the first to receive an official diagnosis, but many others in the family are either self-diagnosed or on their way to an official diagnosis.

I let that sink in. I grieved; I celebrated. I wasn’t broken after all. Finally, I had an explanation for why I felt the way I felt, even after all these years of therapy and all the other things that I did to keep my fragile mental balance. No wonder I was exhausted, I thought. I was high maintenance. I don’t know any other reasonably functional person that spends as much time and money on maintaining their mental sanity as I do, and I know many people who spend quite a lot of time and money on it. One of them has yet to beat me at this.

Did this diagnosis mean that there was another way? A way that I hadn’t really considered before? I wasn’t going to give up on the tools that I had picked up along the way. Meditation, yoga, martial arts, journaling, 12-step meetings and my occasional session with my long-term therapist are all important assets that render me more independent, peaceful and generally stable. But was there another resource I hadn’t recurred to yet?

As a sober person I am sceptical of psychiatric medication. Everything that can be abused naturally poses a risk. And trust me – almost everything can be abused if you try hard enough.

And yet. More and more people in my circle mentioned that they were taking medication for ADHD. Meaning: Stimulants. Either methylphenidate products like Ritalin, or lisdexamfetamine products like Elvanse. Certainly, it had to be considered that these products have a very similar way of working as the good old street amphetamines like pep (or speed or whatever is your favourite name for it) has. Amphetamines have never been a big part of my addiction issues, but I had cast a minor role for them.

What I only understood after doing some research was this: Major parts of what looked like simply an addiction disorder was actually an attempt at self-medication. I’m not saying I don’t have an addiction disorder. The attempt at self-medicating certainly led me into an addiction disorder that I will keep on treating for the rest of my life if I’m lucky. But maybe the original intent wasn’t wrong.

ADHD is essentially a dopamine disbalance in the brain (this is simplified, of course. Still it helps to understand why medication works). The dopamine released into the synaptic cleft is reabsorbed into the nerve cell too quickly, disrupting the transmission of stimuli in the brain. This leads to a disruption in neuronal communication, the result being sensory overwhelm due to poor filtering of stimuli.

ADHD is not a personal failure. It is a matter of brain chemistry. And no matter how much I meditate, work out, journal or speak about the overwhelm and constant tension that I experience, I will not change my brain chemistry.

(Nota bene: I am sure some people will argue with this, and I am most interested in hearing what they have to say. I am aware of the concept of neuroplasticity. This still comes into play, even when using medication. In fact, in many cases, only the medication allows for a certain rewiring of the brain. Because to create new neuropathways we need to develop new behaviours or thought patterns. Eventually, though, even neuroplasticity apparently doesn’t fully make up for the lacking dopamine).

I understood – as I understood years ago when I first decided to take antidepressants after years and years of fighting depression “on my own”, thinking that if I only tried harder, I’d get better, not taking into account the underlying reasons of my depression (or possibly rather autistic burnout) – that I wasn’t succumbing to medication out of weakness. I was making an informed decision on a medical condition. Just as I would treat diabetes with insulin, there was a medication for my condition.

I decided that I would give it a shot. Just before I returned to Germany from a month-long trip that I made, I booked an appointment with a new psychiatrist (as my old one worked in a clinic where they don’t have permission to prescribe stimulants).

I didn’t know how much my life was about to change.