Finding HopeMy First Experience With ADHD Medication
Posted on December 18, 2021
TW: Mentions of self harm and suicidal thoughts.
And ten months after being diagnosed, I finally started taking medication for my ADHD. If you’ve been following this blog, you may remember that I was diagnosed back in January and, due to the disruption it would’ve caused at a crucial point in my Masters, I had to wait to come off my antidepressant (Phenelzine is contraindicated with stimulant medication for ADHD) and then start the ADHD meds. But, as of mid November, I could start taking Xaggitin XL (definitely my most strangely named medication so far); I’d researched it and read multiple accounts that it hadn’t affected creativity and my ADHD specialist didn’t have a problem with trying it when I suggested it. And as I always do, I kept notes; it helps me to remember what each medication was like and hopefully it can be helpful to anyone who might be taking or about to take the same medication. But, as always, it’s important to state that this is a medication I was prescribed by my doctor, according to a plan that we decided on together. This is just my experience; please speak to your doctor if you have any questions about your medication.
WEEK 1 (18mg)
I started to feel the side effects straight away. From the second day, I was experiencing overwhelming, almost constant nausea. It got worse if I rushed around or even stood up for too long and I’d end up curled up on the floor, focussing on just breathing until it passed (by the end of the week, I had figured out and was getting better at avoiding the things that made it worse). That combined with a massive loss of appetite meant I really wasn’t eating much, although most days I managed to force at least one meal down. I also started having trouble with my sleep. It would take me hours to get to sleep – usually between two and four am – which meant that my sleep schedule started to shift. It was so hard to wake up in the morning and that just meant I ended up going to sleep later and as hard as I tried, I couldn’t keep my routine from moving several hours around the clock.
My mental health also took a hit, which wasn’t entirely surprising since I no longer had the Phenelzine in my system. I started to feel overwhelmed and fragile. My anxiety increased and I even had a panic attack, not something I usually struggle with. My depression started to creep back in too; it wasn’t too bad but it was there.
The cough was still hanging around and I had multiple migraines (some that I managed to cut short with medication and some that took me out of commission completely) but both of those could’ve been left over from coming off the Phenelzine, having been big problems throughout that process. I’m not sure.
WEEK 2
The nausea, the lack of appetite, and the trouble sleeping persisted. As did the cough (I’ve taken several COVID tests since it started and they’ve all come back negative). I also felt even more scattered than usual: I couldn’t focus on whatever I tried to do and I started losing my train of thought mid-thought, which was very stressful. I felt completely unable to do anything.
By the end of the week, it felt like everything was starting to fall apart. I was really struggling to write. What I’d thought was just a few bad days (unpleasant but not unheard of) turned into an awful week; the internal flow that makes writing so easy and so calming was suddenly absent and even the forms of writing that have always felt easy (regardless of whatever’s going on with my mental health) felt awkward and forced. My mental health had started to get really bad – my anxiety and depression had gotten a lot worse – and that just made it worse. And on top of that, I had started to have suicidal thoughts again, which I haven’t had – consistently, at least – for years.
WEEK 3 (36mg)
The nausea and lack of appetite were still really bad so I wasn’t eating much. I tried but it was really hard. Sleeping was also difficult. I was wide awake all of the time – like I was highly caffeinated – even late into the night, which didn’t help in my attempts to get my sleep schedule back to normal. Most of my nights were disturbed one way or another and I had one night where I never went to sleep at all; I didn’t even start to feel sleepy until I’d been awake for over thirty six hours. It feels very strange considering that even three months ago I could barely stay awake, even with two Red Bulls in my system; talk about from one extreme to another…
I was still struggling with concentration and my mental state was only declining. I was consistently depressed – feeling hopeless and alone – and there were days where I struggled to get up, not just because of the nausea but because everything felt so overwhelming and difficult. The suicidal thoughts continued and I did self harm once. My anxiety also got worse and I had another panic attack.
WEEK 4
The nausea got even worse, lasting all day and making it even more difficult to eat (or do anything at all, to be honest). And having no appetite didn’t help with that. My sleeping was still awful too, despite how physically exhausted I was starting to feel after so many nights of poor sleep. The cough and difficulty concentrating continued and I had a couple of days that were monopolised by migraines (or maybe one migraine that never quite went away).
My mental health deteriorated further. I was incredibly anxious and my depression just got worse. I’m pretty sure it’s the worst my depression has ever been, based on what’s been going on in my head. The suicidal thoughts continued but they are different to what I’ve experienced in the past. It’s been a lot. I can’t know for sure whether this is down to the lack of antidepressant in my system, a reaction to the ADHD meds, or both.
That last week was a big week, which was unfortunate considering how awful I was feeling; it made it hard to enjoy or get the most out of those events – going back to therapy after several months away, my Mum’s birthday, and a visit from a friend for both work and fun – and then I felt physically worse afterwards, physical exhaustion and pain in addition to the ongoing side effects of the medication.
So it’s been a rough month. The nausea and trouble sleeping has been awful but the anxiety, depression, and suicidal thoughts have been worse by far. And losing the ability to write has been unbearable. After speaking with both my psychiatrist and ADHD specialist, it’s been decided that I’m going to stop taking the Xaggitin and try Bupropion, which should – hopefully – help my depression as well as my ADHD. So that’s another month gone and the waiting game begins again.
A Somewhat Reluctant Birthday Post
Posted on November 27, 2021
My birthday this year was definitely weird, hence why I’m only just writing about it a couple of months after the fact. I’ve been struggling to process the last few months just because of how much stuff has happened: the final project of my Masters wrapping up, the final assessment, the Masters being over, the sudden death of my Granny, her funeral, performing again for the first time in eighteen months, changing my medication, graduation, the celebration of life for my Granny… It’s been a lot and I honestly have no idea how I feel most of the time. But I’m hoping that, by putting it into words, it’ll help. Somehow.
So, for the last few years, I’ve been trying to ease my anxiety around birthdays with some birthday rules I picked up from Tumblr a while back. My first post about them is here, but the basic idea is to do something you wouldn’t normally do and buy yourself something you wouldn’t normally buy, to make each birthday unique and special. For some reason, this year was harder than the previous ones and I really struggled to commit to an idea for both rules. But, given that it’s now two months later, I think I need to let it go and stop obsessing. Whatever’s causing my anxiety over this, it’s taking up too much energy that I need elsewhere.
So, I’m writing it down and putting it to bed…
Rule #1: Do something you wouldn’t normally do.
I was going back and forth on what to do when the perfect thing fell into my lap: the opportunity to perform again for the first time in about eighteen months! And not only that but it was two gigs, the first at the original Hard Rock Cafe in London and the second at the Hard Rock Cafe in Piccadilly Circus. So, while I was very nervous, I was also very, very excited. Given the tight turnaround between getting the gigs and them actually happening, Richard and I only managed to practice together once. Fortunately, we are very well practiced at the Honest EP songs and picked them up again quickly so we could, for the most part, focus on the other songs we were playing.
The first night was actually the night of my birthday and I was so nervous that I could barely breathe. My body felt so awkward and it was almost like I couldn’t remember how to perform, how to hold my body, how to not bump into the microphone, how to talk between songs… But, by the second half of my set, it was all rushing back and I was just overflowing with that unique joy of getting to do the thing you love most in the world (well, other than the songwriting itself but you know what I mean). I was SO HAPPY. I was positively giddy with it. It wasn’t my strongest performance ever but after eighteen months of playing to my living room, I wouldn’t have expected it to be. It was jumping in at the deep end. And although it felt so awkward at the beginning, it all came back very quickly and I couldn’t wait for the next night so I could do it all over again.
The second night went well, on the whole. Despite the night before, I was still nervous and it was a very different space; the lower ceiling meant that the sound bounced around differently and it took a while to adjust (just like everything, adjusting to the space you’re performing in is a skill that requires practice) but, again, I had so much fun. Performing songs that I’ve written about things that matter to me… it’s when I’m doing that that I feel most comfortable in my own skin, most in sync with the world around me. It’s the best feeling. Everyone was so lovely and I had such a great time.
It was just so fun to perform again. And it was so fun to perform with Richard again (and what a trooper he was, having moved house the day of the second performance). I loved getting to play the songs from the Honest EP, I loved performing some of my unreleased songs, and I loved playing a few brand new covers (including ‘Lullaby’ by Kalie Shorr and ‘this is me trying’ by Taylor Swift, both of which are among my favourite songs). I’m so grateful to everyone at both shows – those working in the venues and the other performers – and my friends and family who came to support and celebrate with me; it was just a complete joy and I wouldn’t have wanted to spend my birthday any other way, even if I was beyond nervous about it.
Rule #2: Buy yourself something you wouldn’t normally buy.
I was very aware that Taylor Swift was releasing Red (Taylor’s Version) in November and given how much the original means to me, I knew I would want to spend money on it when it came out. So I tucked some money away until the album was released on the 12th November. As much as I loved it before, I fell in love with it all over again, not to mention the new songs: they’ve added so many new layers to the world of the album. It’s a stunning album and every time I listen to it, I feel like I’m learning even more about songcraft.
Along with the album and the vinyl, I treated myself to some of the accompanying merch, including the scarf and the notebook. Oh, and the jumper with ‘Taylor’s Version’ across the front; that was just so perfect. What she’s doing with the rerecordings is incredible and, as someone entering the music industry, it’s both encouraging and inspiring to have a woman like her advocating for the rights of songwriters and artists. Plus, it seems fitting. Her music has had such a huge impact on my life; I wouldn’t be who I am now if not for her music.
So while both of these things were Good Things, it was a weird and hard birthday. There’s just been so much to process – so much change – and so much anxiety; it was hard to settle on a decision because nothing felt right. But I’m starting to think that, given everything going on, nothing was going to feel right. So it’s time to move on. It’s time to stop worrying about it. I did the best I could with that birthday I had and it was good, even if it was messier than I would’ve liked. Such is life.
Farewell Phenelzine 2.0 (The 2021 Edition)
Posted on November 20, 2021
The decision to change my medication has been a long time coming. I was diagnosed with ADHD back in January but, for various reasons, I haven’t been able to take any medication for it up to this point. As I said in this post, my specialist wouldn’t allow me to take any of the classic, stimulant medications for ADHD while I was still taking my current antidepressant, Phenelzine. So, in order to take anything for my ADHD (other than the less common medications that would only make me even drowsier than I am currently), I would have to come off the Phenelzine and either try a different antidepressant or try going without one. That all felt too much to manage while I was doing my Masters – it feels like a lot to manage now – but now that the Masters as is over and I’m already in a period of transition, it felt like it was time to come off the Phenelzine. The side effects were going to throw a wrench in several plans but that was going to be the case regardless of when I decided to do it and I hated the feeling of having it hanging over me. I know I need to do it but a big part of me really didn’t want to (and is still sceptical to a certain degree): over the last ten years, I’ve found it all but impossible to write songs during the periods when I wasn’t taking Phenelzine so it’s not surprising that it’s not exactly an easy decision. But if I want to get out of this limbo state, then I need to try.
So, beginning the 18th November, I started to reduce the dosage of the Phenelzine. For two weeks, I took half my normal dose and then I went another two weeks without anything in my system, giving my body the time to filter out any traces of the Phenelzine (known as the wash out period) and ensuring that way any new drug I take won’t result in a negative interaction. As always, it’s important to point out that this is a plan I’ve worked out with my psychiatrist and my ADHD specialist and is specifically tailored to me. If you’re making any changes around any medication you’re taking, please consult your doctor first.
REDUCTION PERIOD
WEEK 1 (Monday 18th October – Sunday 24th October)
For most of the week, I felt fine, which surprised me: usually, if I miss a dose of Phenelzine, I get hit with a headache pretty quickly but for some reason, that didn’t happen this time. I was tired and a bit more emotional than usual but nothing that out of the ordinary, nothing that couldn’t just happen anyway. I think those first four days lulled me into a false sense of security.
It hit me on the Friday. I felt weak and shaky and had a really unpleasant headache. And that turned into feeling absolutely awful over the weekend: I had debilitating migraines; I felt nauseous, shaky, and lightheaded; I thought I might faint every time I stood up. I also developed an annoying cough and, after multiple COVID tests, I had to assume it was part of the withdrawal and not COVID related (thank goodness – I don’t think I could’ve coped with that as well and I’m glad my family didn’t either).
WEEK 2 (Monday 25th October – Sunday 31st October)
The cough and the migraines continued into the middle of the week and then, fortunately, they started to let up. My sleep schedule was utterly screwed up: I was struggling to get to sleep and not drifting off until between two and five am and then, because I was so exhausted, I was sleeping in to the middle of the afternoon. And as hard as I tried, I couldn’t correct the schedule. I also had really weird, really vivid dreams that took me a while to drag myself out of and separate dream from reality. I did have a sudden, deep dip in mood where I felt really awful and discouraged about the various things I’m currently working on, which was scary: my big fear about coming off the Phenelzine has been returning to that really depressed place I was in before so to feel it happening was horrible. But fortunately it didn’t last and I’ve tried to just stay away from things that trigger those kind of feelings, for the duration of this changeover at least.
By Sunday, things had started to improve and I was feeling a bit more human. Having said that, I was not looking forward to the rollercoaster that the next two weeks were likely to be.
WASH OUT PERIOD
WEEK 1 (Monday 1st November – Sunday 7th November)
The beginning of the week was okay with just minor headaches and some nausea, both of which were pretty ignorable. And apart from sleeping really deeply and the continuation of the weird, vivid dreams, I felt okay. But by the end of the week, I was feeling very tired and just generally unwell again. The cough had faded but it picked up again and then, on Sunday, the nausea was back in full force.
WEEK 2 (Monday 8th November – Sunday 14th November)
This was a very big week. Unfortunately. It was a really bad time to be coming off a medication but, as I said, it’s almost always a bad time. There’s always something happening so I just had to get it over with. But this week held both my graduation from university (I had a great time but physically, I did spend the day counting down to the next dose of painkillers and – on several occasions – actively focussed on not throwing up) and my Granny’s Celebration of Life service (thankfully, by that point, I was feeling a bit better and was able to just focus on the day without too much distraction). Given those two huge things, I spent a lot of the week dealing with a lot of physical exhaustion and pain.
The cough was ongoing and I had migraines for most of the week, although they did lessen in intensity by the end of the week. I was nauseous, shaky, and overly emotional but, again, that had mostly passed by the weekend. On the Sunday, I was a bit weak and nauseous but I felt a lot more human than earlier in the week.
So, four weeks later, I’m finally starting medication for my ADHD. I’m excited but I’m also nervous; I haven’t had many good experiences with medications and it’s taken a lot of trial and error to find the only one that’s helped so far. So it’s a bit scary to be starting over with a whole new category of medications but I’m trying to stay… cautiously optimistic. I’ve started Xaggitin XL and now, I guess, I just have to wait and see.
Finding Hope 