The ADHD Homestead

Building a good life with ADHD.

Category: Medication (page 1 of 2)

“We’re all a little ADHD sometimes” happens to people with ADHD, too

This post is adapted from an excerpt of my upcoming book, Order from ChaosPreorders will open on Amazon soon. Stay up to date by joining my mailing list!

Most of us with ADHD have heard the refrain, “but this happens to everyone. You just have to power through it.” Nobody loves paying bills or doing housework. Everybody feels scattered sometimes.  Why should some people get to use ADHD as an excuse, while the rest of the world just has to suck it up?

It can be hard to answer this question. There’s a grain of truth in it. Under enough stress, even the most put-together person can develop ADHD-like symptoms. ADHD traits are, at the end of the day, magnified human traits.

The key difference between “it happens to everyone” and “it’s ADHD” is context. For someone without ADHD, the struggle is caused by something external, like a big deadline or a family crisis. True ADHD emerges in childhood, usually by early elementary school. It also impairs us in multiple roles (e.g., both at home and at work/school). It sticks around, no matter how we change our environment or our diet.

This isn’t an excuse. People with ADHD can bring our symptoms under control with medication, adequate self-care, and other coping strategies. And we should, if we want to lead fulfilling lives and maintain healthy relationships.

Doesn’t medication fix ADHD?

Some people believe stimulant medication does the hard work for us, or even gives us a leg up. Sorry, but no. There’s a difference between making something easy and making it possible. Medication gives us a choice we previously lacked. It allows us to begin the hard work in the first place.

And sometimes we find ourselves in a catch-22, because our environment can make ADHD symptoms worse. If a neurotypical person appears to have ADHD during a time of stress or upheaval, imagine how a person with ADHD will react  — even on medication.

People are usually surprised to learn that every one of my elementary school report cards had a bad grade in the “behavior” column. When my husband and I finally took the plunge and gut-remodeled our kitchen, I saw myself become that kid again.

Chaos without = chaos within

“Major life disruption” barely scratches the surface. Our kitchen, dining room, and part of the living room were out of commission for six weeks. Contractors knocked down two full walls, took down a plaster ceiling, and built a new kitchen from scratch.

Construction noise invaded through the floor of my office for 8+ hours per day. I fielded frequent interruptions when the workers had questions. I cooked all our meals on a camp stove on the front porch and washed dishes in the bathtub. Clutter and dust invaded everywhere. Our cabinets were delivered before the room was ready, and the boxes turned our entire downstairs into a rat maze. Meanwhile, I tried to stay on top of my pieces of the puzzle: picking up backsplash tile, choosing appliances, writing checks, keeping drinks in a cooler for the workers.

In other words, this was one of those times when a neurotypical person would’ve developed ADHD symptoms. I felt like a crappy friend, a lackluster writer, an impatient mom, and an unproductive human. One afternoon, I was outside and saw a kid I did not know being mildly irresponsible with a stick. Instead of asking him nicely to stop what he was doing, I grabbed the stick and broke it into little pieces in front of him. I was stunned by my lack of impulse control. Living in my house was like living without ADHD meds.

The ADHD management catch-22

Meds allow me to function like a reasonably normal person — under the right conditions. That’s where it gets fuzzy. While meds make those conditions possible, they don’t let me sail through life. That is to say, if I keep my house/office organized, exercise regularly, maintain a daily yoga practice, prioritize and guard my time, and eat a healthy diet, meds fill in the missing piece of the puzzle. They prevent me from destroying all of the above.

It’s a delicate balance. Managing my ADHD symptoms has allowed me to build an organized life. At the same time, that organized life is a critical part of my symptom management. Give me a chaotic environment, and meds won’t help. Without them, I’m powerless to tame the chaos.

Maybe it happens to you, but it’s not your normal

So, yes, this stuff does happen to everyone sometimes. And for the six weeks I spent in the thick of that renovation, I did just have to suck it up and power through it. What I don’t expect myself to do: suck it up and power through every day of my life as though it’s an extenuating circumstance.

If you find yourself turning ADHD into a character judgement, imagine one of your toughest times. A time when you felt like you were barely keeping your head above water. Every move you made was to put out a fire. The whole world felt like it was working against you, and you felt sure you’d never get caught up and settled down.

Now, imagine that’s your normal. It’s all you’ve ever known. Imagine asking yourself to power through that feeling every day, for the rest of your life. That — daily, hard-wired impairment — isn’t something that happens to everyone, and it’s not something you can expect to get through on willpower alone.


Canaries in the coal mine

Sometimes, I don’t know if I’m managing my ADHD effectively. After all, the right type and dose of stimulant medication should feel pretty unobtrusive. It doesn’t make ADHD’ers feel drugged, hyped up, or otherwise not ourselves. Once the novelty wears off, we don’t sit around and say, “wow, things seem awfully normal around here!”

Those of us with supportive, ADHD-literate spouses can benefit from their outside perspective. Sometimes only they can tell us when our ADHD is out of control.

As medications, hormones, and life have evolved over the years, I’ve also improved my self-observation skills. It’s an advanced-level ability. Pre-diagnosis and treatment, I had zero self-awareness.

Now I’ve identified what I call my canaries in the coal mine: little indicators that reflect the overall success of my ADHD treatment.

canaries coal mine ADHD

Observe with detachment, not judgement.

Objectivity is key to spotting canaries: observing my own behavior with equanimity and pragmatism, and not getting carried away by emotion and judgement. This has required a lot of work. We late-diagnosis ADHD’ers reach adulthood without positive language to describe our struggles. It takes time, effort, and compassion to eliminate negative self-talk and start believing in ourselves. My default reaction to falling off the wagon used to be, “this was inevitable. I can’t sustain anything good. I’ll always fail eventually.”

Now, I try to approach my life like a scientist. I observe, I keep detailed notes (ADHD and motherhood have wrecked my memory), and I try to keep my own biases at bay. When a system begins to break down, that’s a clue. I’m becoming a detective in my own life — a problem-solver, not a basket case.

My canaries: more than a stressful week.

One of my canaries is my weekly review, an every-Monday ritual that keeps me on top of active projects and open loops. I once noticed myself skipping it for weeks in a row. I eventually ended up talking to my doctor about switching medications.

Likewise, when I haven’t even opened my to-do list for over a week, something isn’t right. When I keep looking at my list, but never find anything I feel like I can do, something isn’t right.

While some of life’s details can slide during a high-stress time, others indicate a bigger problem.

Staying organized is possible — if ADHD symptoms are under control.

Staying organized is possible with ADHD — when it’s well-managed. When something slips out of balance, my previously-airtight systems begin to collapse. ADHD makes it hard to notice it happening before it’s too late. I may not feel different right away, or I may wave off red flags with excuses about sleep or a busy week.

The key, for me, has been to disconnect my emotional reaction from the content of my observation. Put-downs and criticism, directed inward or outward, stop problem-solving before it begins. Rather than figuring out how to fix the problem, our brains fixate on the problem itself, and how big and awful it feels.

When a system malfunctions, I ask why, and figure out what adjustments will fix it. Sort of like a car: what’s going to keep it safe, running smoothly, and doing what I need it to do? I once had a car that sputtered out right after starting unless I gave it a very specific amount of gas. Once it settled into a good idle, it was fine. The next owner couldn’t figure this out and thought the car wouldn’t run at all. I probably could’ve gotten several more years out of it.

Now I apply this approach to my entire life. It’s how I knew my medication changed effectiveness after having a child, and I wasn’t just suffering from so-called “mommy brain.”

When I spot one of those canaries, the early warnings that tip me off before my entire life derails, I don’t make excuses. I recognize them as canaries, not black swans. The earlier I recognize a problem, the better my chance of minimizing the damage and getting back on track.

What are your canaries in the coal mine? Have you discovered any early warning signs of poorly-managed ADHD? What do you do when you spot one?


Unfortunately, every parenting win springs from impulse control.

Parents with AdultADHDAn interaction I had with my three-year-old a couple months ago blew me away. I should’ve been delighted. Instead, I felt deeply sad. And I knew I couldn’t say a thing.

We’d talked about his books before. He had too many to fit on his shelves. One day, he looked at me and said, “Mommy, I want to give Little Critter Snowball Soup away.”

I was flabbergasted. This was one of his favorite stories, one we’d read over and over and over again. He hadn’t asked for it lately, but I was still shocked he’d get rid of it. We talked more. He understood what he was saying: he didn’t enjoy the book anymore and wanted someone else to love it as much as he’d loved it. It needed to become someone else’s favorite.

Then he started pulling more books from the shelf, saying “I only wanted to read this one five times,” and “I don’t enjoy this one anymore.”

Our children mirror us.

As anyone who knows me will attest, my son did only what I taught him to do. I’m an aspiring minimalist, and I believe minimalism has special benefits for people with ADHD. I also believe self-efficacy is the most important gift I can give my child.

My son is generous, thoughtful, and capable of making his own choices. He’s learning to part with material things — even old favorites — that he no longer enjoys.

He needs a mom with impulse control. A mom who knows how to keep her mouth shut and let him do his thing. I haven’t always been that person, but I’m working at it every day.

We don’t start out choosing our reactions.

My core values as a parent, homemaker, and person demand a pretty high level of impulse control. This is something I totally lacked at the beginning of my ADHD journey. Before I started learning about and medicating my ADHD, I didn’t choose my reactions to people and events in life. I didn’t know a choice existed. I thought what happened inside also happened outside — for everyone.

During my first week on stimulant medication, I described in my journal this gap that had opened up between stimulus and response. I felt like I’d discovered a time warp. I gained a few critical seconds (maybe even milliseconds) to notice what I was feeling and attempt to control how I expressed it.

Kids need parents who stay out of the way

Getting out of the way: tough for any parent, tougher for ADHD parents.

Plenty of parenting books warn against emotional reactions when we’re angry. What about when we’re bittersweet, or when we doubt our child’s choices? It broke my heart to part with some of those books. I desperately wanted to intervene, even though intervening would question his judgement (you’re getting rid of that one?) and undermine his generosity (what if I just hold onto these on my bookshelf?).

I didn’t intervene. He wanted to wish the books well on their journey to someone else. I was as proud of myself as I was of him. My ability to keep my mouth shut empowered him to make his own choice and stand behind it. He felt capable of solving a problem on his own, and I got out of his way. I trusted him. He gained confidence in himself.

This would be hard for anyone, but for someone with a clinically diagnosable deficiency in shutting up? Let’s just say, I never thought I’d see the day. I gave myself time to mourn the books, but after my son was asleep. Burdening him with my complicated emotions — at least in this context — wouldn’t benefit him at all.

Be quiet and leave space for others.

Sometimes, keeping quiet and leaving space for others in our relationships is the most supportive, loving thing we can do.

For adults — and especially parents — with ADHD, it’s also the hardest thing. Our emotions overwhelm us, our reptile brains take over, and we often stop to think long after we’ve already spoken.

But the rewards make it worth it to keep trying, and to take good care of myself and my brain. Because I owe it to my kid, who’s already a better person than I am.


Bad ADHD memes, & my real reason for taking stimulants

Memes. They strain my personal ‘no trolling’ policy.

Maybe you’ve seen memes like this, too. I feel like they’re everywhere.

Bad ADHD memesAt best, they’re ignorant and insulting. If you see one, please — don’t share it, don’t like it, and if it makes you feel crappy about your own life experience, feel free to tell the original poster.

We need more balanced perspectives out there. To that end, I started thinking: what’s the real reason people take stimulant medication for ADHD? The real reason parents give their kids ADHD meds? Actual people and actual parents, not the generalized “they” targeted by memes.

I take stimulant medication every day of my life: when I’m working, when I’m on vacation, when I’m sick, when I’m going for a hike.  I do it to stay safe, calm, and content.

Scandalously boring, right?

Meds don’t make us zombies

Some people think stimulants are part of a conspiracy to turn our children into obedient, conformist zombies.

I know some people have a bad first experience, especially if the dosage is too high. With Ritalin, this can lead to a zonked-out feeling.

It can take a while to find the right medication and dosage. When it’s right, you don’t feel like you’re ‘on’ anything. Many people don’t invest this time and assume their first experience is a representative one.

But obedient zombie sounds a bit lofty, don’t you think?

Clearly these folks are in a different place. I’m not yet able to worry about being obedient, conformist, or zombie-like.

I’m just trying to be safe, calm, and content, like everyone else in the world. I take meds so I can drive a car without killing myself or anyone else; pay my bills; keep writing; be creative; curb my temper; connect with a small handful of friends; remain in a healthy marriage; and avoid living in a constant state of chaos, stress, anxiety, and despair.

When I have all that under control, I’ll look into the obedient zombie thing.

Meds let me do what I want to do

Stimulant medication helps me get where I want to go in life. I’m happy when I’m creating. I’m happy when I’m working hard. I’d be working hard with or without medication, but not necessarily in the right (or any) direction.

When I’m unmedicated, I’m not doing what I want to do. I don’t pay bills or write stories or sing while playing the guitar. My most valuable projects stagnate, clutter accumulates, and I’m not a very good friend. I get angry often and always seem to be in a crabby mood.

Meds don’t give me a competitive edge or allow me to stay up all night writing the next great novel. They help me reconcile my inner and outer selves, bringing me closer to the person I know I can be. And maybe, after several years of slow and steady effort, I’ll actually finish that novel.

Having ADHD often means struggling with the things we want to do. It might mean struggling so much across the board, we can’t figure out what we want to do, let alone how to do it.

I’ve been there. It’s awful, and I wouldn’t wish it on anyone. I wasn’t calm or content, and because I was young, I probably wasn’t particularly safe, either.

What I really wish I’d medicated (not childhood)

Looking back, I don’t wish I’d medicated away my adventurous, tomboyish childhood. I hope we all know childhood isn’t a disease. I never would’ve wanted a dose of meds that stopped me from climbing trees, running around at recess, playing paintball in the woods with my friends, and catapulting myself from the swingset (even at age 17).

But I wish I’d learned how to keep myself safe, calm, and content at a younger age. I wish I’d had more than one friend in elementary school. I wish I’d been able to stay out of trouble and stop getting my parents called in for disciplinary meetings. I wish I hadn’t damaged my hearing by fighting through mosh pits to stand right against the speakers at every concert. I wish I’d had the sense not to drive too fast. I wish I’d felt in control of my brain and my behavior, instead of feeling constantly at war with myself.

I was experiencing something more than the general anguish of youth. I wish I would’ve known that. I’ve worked hard to craft a satisfying life for myself. Sometimes I wonder, what if I’d started that process sooner? What if I’d had a full toolbox?

Every time I see a meme claiming ADHD is just a result of bad parenting, a broken education system, Barack Obama, and greedy pharmaceutical companies, I think: how ignorant. The system is imperfect, but some people are really suffering. And who are these meme-spreaders to delegitimize our experience? Who are they to tell us we don’t deserve a chance, even if it comes from a prescription drug?

How about you? How do you respond to memes that tempt you toward online conflict?


Supplements & natural remedies for ADHD

Recently, I received a reader email asking about supplements and natural remedies for ADHD.

My short answer: buyer beware.

People have many reasons to try supplements: older adults may have concerns about taking stimulants with heart problems. Parents may yearn for an alternative to stimulant medications for their children.

Maybe supplements just feel more “natural.”

Natural they may be, but supplements aren’t necessarily safer or healthier than prescription drugs. Some may even be less safe.

ADHD supplements 101

Supplements: safety not guaranteed

The FDA treats drugs and supplements very differently. From aspirin to amoxicillin, medicines are vetted before hitting the market. Manufacturers must prove their drugs are not only safe, but effective for the conditions they claim to treat.

Compare that to the FDA’s treatment of supplements:

Although FDA has oversight of the dietary supplement industry, it is the supplement manufacturers and distributors that are responsible for making sure their products are safe before they’re marketed…FDA does not review supplements for effectiveness (as it does for prescription and OTC medications) before they enter the market. If the dietary supplement contains a new dietary ingredient, the manufacturer must submit for FDA’s review data on that ingredient’s safety—but not its effectiveness.


Vetting is up to the manufacturer, who profits from selling these products. But that’s okay because it’s natural, right?


“Natural” doesn’t always mean “safe.” Remember: arsenic, cyanide, and lead are natural substances, too. Consumers often mix and match supplements, unaware of how those substances will affect their unique body chemistry.

Getting too much of anything, even an essential nutrient, can harm your body. Some supplements will even alter the effectiveness of other medications.

If you’d like to learn more, the FDA provides a Dietary Supplements 101 overview on their website. NIH also offers guidance on using supplements wisely.

Big Pharma isn’t the only agenda in town

For all the conspiracy theories about “Big Pharma,” many consumers seem to trust supplement manufacturers implicitly. However, they’re also big businesses trying to make a profit. And they’re less accountable for the quality of what they sell.

We, as consumers, need to read everything with a skeptic’s eye. Where there’s money to be made, there’s often bias.

For example: I recommend Dr. Daniel Amen’s Healing ADD from the Inside Out to anyone interested in using supplements to help with ADHD. I also suggest reading with a grain of salt.

Dr. Amen is very knowledgeable and his book contains valuable insights. He’s also selling his own line of specialty supplements (among other things). It’s easy to read the literature and feel like the right combination of dietary supplements will solve all our problems.

Dr. Amen isn’t the only one to discover this niche. Sales of dietary supplements in the U.S. totaled over $30 billion last year. A savvy entrepreneur can put a line of supplements on the market quickly, without the research and development overhead of a drug manufacturer.

Are supplements a no go for ADHD?

Hop online or pick up Healing ADD and you’ll find plenty of anecdotal support for supplements. Maybe you’ll even discover they help ease your own symptoms. How we treat a chemical imbalance in our body is always up to us. I’ve written on this blog about my own experience taking a GABA supplement for migraines and mood swings.

However, we lack evidence that supplements can meet or exceed the effects of traditional ADHD medication for the average person. If something sounds too good to be true, it probably is.

As always, it’s important to look at where various messages are coming from, and who stands to profit from us believing what we read.

Have you tried supplements for ADHD? What was your experience?


Of course behavior therapy helps kids with ADHD…for now.

When I see ADHD trending on social media, I perk up my ears. Today, it’s the release of new study results supporting behavior therapy as a first-line treatment for children with ADHD.

NY Times behavior therapy ADHD thumbnail

This raises important questions. It also fans the flames of controversy among those opposed to medicating ADHD in children.

I see this study as an incomplete answer to a complex question: what’s the best course of treatment for childhood ADHD?

Interpreting results: why start with behavior therapy?

Starting with behavior-based interventions may emphasize the importance of teaching coping mechanisms. I’ve long said that neither medication nor behavior therapy can do it alone. Medication balances our brain chemistry, making coping mechanisms easier — or possible — to implement.

Starting meds with no therapy or parent training may set the wrong expectation: that meds can do all the work. Starting with behavior therapy, then adding medication, allows families to compare and contrast the difference.

Taking an example from my personal life, I talk a lot about David Allen’s Getting Things DoneI swear by it. Did you know I’ve only been able to maintain it while taking medication? Without it, I can’t keep up.

However, medication in no way alleviates my need for such a rigid system.

We should teach children this symbiosis from the beginning. Offering medication alone is like offering eyeglasses to a near-sighted child and expecting those glasses to teach him to read.

Why I’m skeptical about behavior therapy’s long-term benefits

I’m not jumping on the behavior modification bandwagon just yet. I think we need a longitudinal study to evaluate the effects well into adulthood, when we’re expected to create our own structure and motivation.

Behavior modification therapies, as explained in Stephen P. Hinshaw and Katherine Ellison’s book ADHD: What Everyone Needs to Know, require “clear expectations and explicit, frequent rewards, as well as occasional, nonemotional discipline.” Think sticker charts to help kids earn a reward for improving target behaviors.

My own parents promised me a TV in my bedroom if I could produce a few second-grade report cards with no failing grades in the ‘behavior’ column. My burning desire for that television supported the herculean effort required to stay out of trouble. I got the TV.

Looking at this one academic year, anyone could conclude that behavior-based interventions improved my most problematic symptoms. However, as Hinshaw and Ellison point out in their book, “the difficulty for children is to maintain their progress once they’re out of the tightly managed environment.”

My third-grade reports reflect missed homework, inconsistent effort, and frequent run-ins with other students.

Should we expect parents to maintain a highly structured environment indefinitely? What happens when children grow too old for sticker charts? What happens when parents aren’t there to light a fire under a kid’s butt?

I’ll tell you what happened to me: my life spiraled out of control. My desk at work was covered 8-12 inches deep all around with papers, and I frequently lost important documents. I fought with my husband all the time. I suffered wild mood swings. Bills went unpaid. It took so long for me to take checks to the bank, they often expired before I could deposit them. My house was a mess. The list goes on.

Does behavior therapy prepare kids with ADHD for the future?

I’m not surprised to see a study confirming the effectiveness of behavior therapies — that is, rigid systems of externalized rewards and consequences — in the short term. We’re talking months, or even a few years.

I worry that we’re failing to teach kids true independence and long-term coping mechanisms. As Vicki Hoefle explains so effectively in her lovely book Duct Tape Parenting, parents should measure success not by how kids behave right now, but whether they’re ready to fledge at age 18. Childhood gives kids an opportunity to learn crucial skills in a safe, supportive environment.

Creating a system of made-up consequences robs them — and us — of that opportunity. Sure, I was able to control my outbursts to earn that TV. What did I learn about myself during that time? What tools did I put in my mental toolbox, to be carried into adulthood?

Yes, this study addresses an important issue. I hope it reinforces the symbiotic relationship between medication and other interventions. I hope fewer parents, teachers, and doctors see medication as a way to make ADHD an open-and-shut case.

Parents need to ask: what’s our goal here? Do we want the best of both worlds? To refuse medication for our kids while putting a stop to failing grades and uncomfortable parent-teacher conferences?

Or do we want to deepen our relationship with our kids while teaching them how to succeed as adults?

For that, we need to examine the effectiveness of behavior therapy once the subjects reach age 25, 30, and 35.

What do you think we’d find? I’m curious about others’ reactions. Did you read about this study? Have you had any first-hand experience with behavior modification? Please chime in with a comment below!


Identity, eyeglasses, and self-improvement

Last week, I had corrective eye surgery.

When my husband first suggested this surgery years ago, I waved it off. I gave excuses ranging from, “I don’t want someone messing with my eyes” to “what if I was the only person in history who was incapable of keeping my eye still for the procedure?”

Really, it was a threat to my identity. Having exceptionally poor vision is part of who I am. It’s something I share with my dad. It’s a fashion statement. It defines how I see the world around me. It’s something that makes an impression and sets me apart. It’s part of the very fabric of my reality.

The same could be said for ADHD.

This relationship to identity can be terribly difficult for others to understand. My husband, born with 20/10 vision, can’t imagine why I wouldn’t want to be able to see like everyone else. Why I’d fear waking up in the morning and being able to see everything in my bedroom.

For those on the outside, refusal to treat crippling ADHD symptoms can seem like madness.

Despite our impairments from ADHD, treating and managing it can, to some, feel like a threat to our identity. It requires us to shed our skin, to give up membership in some kind of weird club. Many people — myself included — fear starting ADHD medication for the first time because we worry we’ll lose a part of ourselves we actually like.

Just because we have the means to improve our lives doesn’t mean the choice is always easy. Altering a fundamental piece of our identity is scary. Any change is scary. Even though removing a functional impairment should feel like a 100% win, it’s not always.

Because my glasses make everything appear smaller, I have trouble seeing tiny things. I almost always ask my husband to remove splinters for me. I like that. I don’t usually accept much help or care, but it’s nice to be cared for every once in a while.

Maybe some of us cling to the impairments wrought upon us by ADHD, too.

Maybe it’s easier for us to say “I have no social skills” or “I don’t care about stupid paperwork” or “I’m just a terrible friend.” Anything else would force us to admit we’re working hard — and still failing.

Sometimes our ADHD can provide a certain level of security. Others know what to expect from us. We know what to expect from ourselves.

But just because we’ve taught ourselves — or been told by others — this is how we fit into the world doesn’t mean we’re stuck here. Just because change is scary doesn’t mean we shouldn’t try. And if we’re disappointed in ourselves today, it’s okay to admit we’re trying.

Honestly, my adjustment to ADHD medication felt a lot more natural than my recovery from this surgery: more like putting on a pair of glasses for the first time. I’m trying to take the long view, though, tough as that may be for someone like me. In both cases, it’s a leap that leads to long-term quality of life improvement.

And if I can give that to myself…why not try?


An indie pharmacy will make your life easier

I’ve had my share of hassles filling stimulant prescriptions. Maybe you have, too. It’s not always easy.

There was the 2012 shortage, when pharmacy after pharmacy dismissed me with a simple, “yeah, we don’t have that.”

Even under normal circumstances, I’ve felt limited to whatever generic the pharmacy happens to stock. I recently switched to name-brand Ritalin, and that’s when I promised myself: no more chain pharmacies ever. 

After meeting with my doctor and asking her to indicate ‘name brand only’ on my prescription, I drove around to several pharmacies. Most — in our area, at least — stock a generic methylphenidate from Mallinckrodt. Many people have reported issues with their generic Concerta, and from my experience their Ritalin substitute is no better.

independent pharmacy

I don’t mean to be cynical here, but your local chain pharmacy probably won’t entertain this conversation. Don’t expect to save a trip by calling to ask about special orders, either. They want to see you, your prescription, and often your driver’s license before having a chat about which stimulants they have in stock.

Not only that, Rite Aid, CVS, and a nearby hospital all promised around seven business days for a special order to arrive. Thanks to federal regulations around when doctors can write stimulant prescriptions, that lag time would mean going meds-free for a few days.

My advice: stop giving these pharmacies your business. ADHD adults don’t have time or energy to waste on crappy generic drugs and pharmacy techs who view us first and foremost as potential criminals.

Instead, visit your local independent pharmacy. During my fruitless search for Ritalin, I remembered a small pharmacy I’d visited months earlier. (My kid bit through his lip the morning after the April riots, and this place gave us antibiotics when every chain pharmacy was shuttered with National Guard troops out front.)

My indie pharmacy didn’t have name-brand Ritalin either, but the pharmacist promised it the very next day. When I picked it up, she told me she’d keep it in stock for me if I liked it. She acknowledged the differences in generic vs. name-brand drugs, especially psychiatric drugs, for which a tiny variance can have a huge impact.

In other words, she treated me like a customer, someone whose satisfaction and happiness were important to her. She even remembered me the next month and asked how my experience had been with the new medication.

Of course, not everyone feels they can afford a name-brand drug over the generic, especially if insurance doesn’t cover it. In that case, you may want to seek out a supportive pharmacist who’s willing to order in a few different generics for you to try. Some people even prefer a specific generic over the name brand, only to be thrown for a loop when their pharmacy changes the manufacturer without notice — as happened when Mallinckrodt replaced Sandoz as the generic of choice for Ritalin.

Whatever solution you choose, you ought to reduce your overall stress level, as well as the number of administrative tasks associated with filling your prescription. I’ve always thought it a cruel irony that maintaining stimulant prescriptions requires so much of our executive functioning capabilities.

After years of struggle, I couldn’t be more pleased to have a friendly, helpful pharmacy at my disposal. They offer free delivery, a one-day turnaround on special orders, and they’ll keep my name-brand meds in stock for me because I’m a regular customer. Finally, a customer experience that doesn’t feel like the universe is conspiring against me.

How about you? Have you struggled to keep your prescription filled consistently? What solutions have you found?


Trying supplements for temporal lobe ADD

Stimulant medication makes ADHD symptoms manageable for a lot of people, but some will always choose supplements and dietary changes instead.

And some — myself included — will experiment with supplements in addition to stimulants. Stimulants have been a lifesaver for me, but I still suffer from emotional and memory problems.

After reading Daniel Amen’s Healing ADD from the Inside Out, I decided to experiment with a few of the supplements he recommends. It’s been about a month, and I’ve learned a lot.


The many faces of ADHD

ADHD doesn’t just mean lack of focus: it often comes with emotional disregulation, forgetfulness, and a host of other problems.

When I read Healing ADD, I related to Dr. Amen’s description of “temporal lobe ADD” quite a bit. While Dr. Amen’s ADD subtypes haven’t been adopted by the wider community, they can be useful to guide conversations about common groupings of symptoms.

For example, Dr. Amen describes people with temporal lobe ADD as having a quick temper (often with little or no provocation) and suffering from dark thoughts and unpredictable moods. Some are especially prone to déjà vu, and others experience odd sensory effects: objects changing shape, shadows that aren’t there, buzzing sounds, etc.

In Healing ADD, Amen goes into more detail, talking about memory issues, violent thoughts, and patients whose personalities changed completely following a minor head injury.

My experience with supplements

Intrigued by Dr. Amen’s claims about supplements, I decided to try adding GABA (gamma-aminobutyric acid) and ginkgo biloba to my standard medication routine. GABA can help with mood stabilization, while ginkgo has long been touted as a memory aid.

I can’t really say whether the ginkgo has helped my memory — it’s possible it went from unbearable to pretty bad, but that’s a crude measure — but I’ve noticed some surprising changes since starting the GABA.

GABA is actually an inhibitory neurotransmitter, meaning it keeps your brain’s activity in check (low GABA levels have been linked to anxiety and panic attacks). GABA supplement supporters claim its calming effects can soothe ADHD, anxiety, mood instability, sleep troubles, and even PMS. In some cases, Dr. Amen suggests trying it before prescription anti-convulsants like Depakote, which works by increasing GABA production.

A science-y aside: now is a good time for a reminder that correlation doesn’t necessarily imply a causal relationship, and there are very few controlled studies on the effects of supplements. Some scientists argue that GABA doesn’t cross the blood-brain barrier and, consequently, has no real effect beyond placebo.

Then again, some parents of children with autism or ADHD have reported big successes with GABA.

The reality is, there just isn’t enough science for us to be sure. All we can do is try it, and if it doesn’t work, scrap it and move on.

And what has my experience been with GABA supplementation?

Most noticeably:

  • Increased mood stability; tamer peaks and valleys; fewer “all-or-nothing” moods
  • Reduced intensity and frequency of migraines
  • Reduced morning coffee cravings
    This is similar to my experience during pregnancy, where I could do with coffee or tea in the morning, whereas previously I needed coffee to feel even minimally functional
  • Possibly even reduced overall food cravings
  • Gentle lift in mood; more calm, controlled energy/motivation in the morning after taking supplement

Though I was on the lookout for mood changes, the migraines (or lack thereof) were a nice bonus, if not a surprise. While Dr. Amen goes into detail about the temporal lobes’ effect on mood, memory, and social skills, the temporal lobes also play a huge role in epilepsy and migraines. Interestingly, Depakote is prescribed for all three issues — as a mood stabilizer and to prevent seizures and migraines — so there is a clear link. I wonder how many of Dr. Amen’s temporal lobe ADD cases also suffered from migraines.  (Fun fact: migraines are not all that dissimilar from seizures, so if you find them debilitating, cut yourself a break.)

While I don’t see any way a GABA supplement could eliminate the need for prescription medication, it does provide — for me, at least — a helpful boost. Of course, there’s also a chance I need to adjust my medication and dosage to manage my ADHD symptoms more effectively. There always is. But for now, combining traditional stimulant treatments with a few natural supplements seems to work better than either would on its own.

Have you tried treating ADHD with natural supplements? What was your experience?

Note: hopefully I’m stating the obvious here, but I’m by no means a doctor, and this post is not medical advice. Before starting any new supplement or natural remedy, you should check in with your doctor to make sure it’s safe for you — especially if you’re already taking other medications. Just because it’s “natural” doesn’t mean it’s zero-risk!


Book Review: I Always Want to Be Where I’m Not

cover: I Always Want to be Where I'm Not by Wes CrenshawA lot of people I meet just don’t get ADHD — I’m talking spouses, parents, even the ADHD’ers themselves.

If you really, truly want to get it, read Dr. Wes Crenshaw‘s I Always Want to be Where I’m Not: Successful Living with ADD & ADHD. Dr. Crenshaw targets ADHD’ers ages 15-30 — though all ages will benefit — as he outlines his “13 principles” for successful living. But don’t mistake it for a mere collection of handy tips: a diverse selection of case studies help get to the heart of what life is like for people with ADHD.

While reading these case studies — one of which opens each chapter — I found myself both laughing and crying. I was impressed by Dr. Crenshaw’s ability to capture how this complex disorder really feels for those who struggle with it. This, coupled with his deep knowledge of his subject — gleaned from his own parenting journey and decades of experience in his professional practice — makes his book a must-read if you love someone with ADHD.

Each chapter stands on its own and includes an “is this chapter for me?” checklist at the beginning. Every ADHD person is unique and you’ll find some more useful than others, especially if you’re over the target age range. However, don’t skip the final two chapters: a medication crash course and a “where are they now?” review of the case studies.

While most books about neurological or mental health conditions contain case studies, this was the first time I encountered such a follow-up at the end. I’m surprised more authors don’t structure their books this way. Seeing the result of each case study’s choose-your-own-adventure journey reinforced the importance of choosing the right (i.e. hard) path over the easy one, developing good habits and coping strategies, and finding a medication regimen that works for you.

Speaking of meds, would-be readers should know Dr. Crenshaw is strongly and unapologetically pro-medication. He contends (and I agree) that medication is a critical tool to implement his 13 principles and become a successful, content, independent adult. Critics may dismiss this viewpoint out of hand, but if you have any feelings at all on the subject, read this book. Dr. Crenshaw’s deep care and concern for his clients is evident on every page. Even if you end up agreeing to disagree, his compassionate and well-reasoned approach deserves an open mind.

For those feeling lost, frustrated, intimidated, or curious about ADHD meds, Dr. Crenshaw provides insights that will empower you to seek out the right provider, not just the right prescription, to get yourself into a good place.

Of course, covering 13 principles and the many shades of a grossly misunderstood disorder makes I Always Want to be Where I’m Not an overview, not an instruction manual. Dr. Crenshaw is equipping you to converse intelligently with your loved ones and your doctor. He’s not providing an alternative to seeking proper treatment and support for your ADHD. This is far from the last book you’ll ever need, especially if you fall outside the 15-30 target age range.

Overall, I Always Want to be Where I’m Not is a fast and easy read that tackles a lot of not-so-easy topics. I never found it too negative, condescending, or dry, and it appealed to the heart as much as the mind. It won’t deliver a wealth of practical tips to cure your life’s organizational woes — you’re better off with something like Getting Things Done or ADD-Friendly Ways to Organize Your Life for that — but it will give you (and those who love you) a much deeper understanding of who you are and why. I’d argue that’s a great place to start.

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