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Old 09-07-08, 10:39 PM
georgesperec georgesperec is offline
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Question Writer New to Adderall: Relief Followed By Agony

Hi there. I was just diagnosed with ADD last week.

I'm a writer and have struggled with terrible anxiety, much of it surrounding writing, for many years. I've been on every medicine out there for anxiety, none of which seemed to work over the long term. Lately, the anxiety had stopped me from working: I was scared all the time, feeling guilty about not writing (I'm an author and my editor is expecting a new book proposal from me), feeling terrified of sitting down to write, worrying as I always do about everything under the sun.

Last week, a light on the horizon. After meeting with a pdoc that specializes in ADD, I started taking 5mg Adderall IR (XR isn't covered by insurance). 20 minutes after the first dose, I was seated at the computer, doing my work, feeling calm, centered, *normal* for the first time in years. "This is exactly where I need to be, I can do this, I am safe, I can do my work." I was shocked. I had been very resistant to trying any stimulants as my anxiety had been so crippling in the past, I was terrified of the Adderall making it worse. To find this stillness, this focus, this ability to work was amazing

The following day the same thing: 5mg Adderall in the PM, working for several hours, feeling a little less enamored of the "magic," but still amazed at the way I could stop worrying and start working. I was told by my doctor and others with ADD that this was the answer: if it weren't, I'd have felt a huge increase in my anxiety. I thought I'd been saved.

Day 3: 5mg AM, 5mg in the afternoon when I started to work. When I wasn't working in the morning, I felt okay, but not the same focus and stillness as when working. When I worked in the afternoon, it was wonderful: I was just as calm, normal, working, not scared, not worried while getting work done. I was taking risks in my writing, not overanalyzing or worrying about organizational details that have plagued me in the past. The calm stayed with me through the evening out with friends. I had two drinks. I realized I hadn't eaten all day and was starving and ate late at night. The not eating didn't cause a problem, but obviously I know I should have eaten earlier.

Day 4: Yesterday, Saturday, gave myself the day off from working, decided not to take any Adderall. No problems, inside hiding from the hurricane.

Day 5: Today, Sunday. I didn't plan on working but thought I should allow myself to feel as normal and unworried as possible so I took 5mg in the morning. I went for a run and felt very anxious during the run. Running tends to calm me so I ran a bit farther than usual, breathing deeply, trying to focus, trying to feel calm. No dice. Took the 5mg in the afternoon and felt calm again: while the anxiety still seemed to roil under the surface, I was okay. I went out with a friend and was doing fine for an hour or two when anxiety set in with a vengeance. We were wandering around, in bookstores and cafes and I was just feeling the physical terror of anxiety everywhere in my body. I was talking to her but I felt terrible. We didn't eat until 5pm--this, again I know was not wise, but I don't eat before exercise because of gastrointestinal issues, and hadn't had a problem with not eating on Adderall two days earlier.

I eventually broke down and started to cry because I was feeling so terribly anxious. I had also felt so certain that Adderall was a magic bullet, that since I'd not experienced any anxiety on it when working all week, it was right for me. This onslaught of anxiety is so puzzling and upsetting to me.

Now the questions, which I'm sure this forum is all too familiar with, and perhaps even saw the red flags through my tale.

1. What is going on? I did experience this amazing normalcy and ability to work for 3 days on Adderall. Then today: Anxiety! Worse than ever!

2. Is the anxiety a side effect? I had experienced trouble sleeping but didn't expect this, the very malady I'd been combatting. Or is it possible that those three days were a fluke, that I am on the wrong medication?

3. Is it possible Adderall only works for me with writing? This would be distressing, as organizing and time management and their attendant worries are problems outside of writing as well.

4. Could skipping a day have caused this? I was under the impression I could take the IR as needed and didn't experience withdrawal the day I didn't take it.

5. I am seeing the doctor Tuesday and expect to be prescribed an extended release stimulant. I'm currently terrified of taking it again as I don't know what the effect will be. I thought I'd be able to have another productive day working tomorrow, but now I fear taking the drug and having an anxiety attack.

6. How much does food/water influence the potential for such a reaction.

7. I've heard Dexedrine extended-release is smoother with fewer anxiety-related side effects. Is this true?

I'm calling the doctor first thing in the morning, but hoped to get some relief tonight. I'm very anxious and worried about both my reaction and the possibility that those three glorious work-filled days were a fluke.

Please advise. I know this is a lot, and I have no idea if I am taking advantage of your good will by asking you to read such a detailed newbie's story. Thank you so much. I can't tell you how much I have been inspired by all your stories and experiences, and hope that I will be able to continue with the ADD meds successfully and help you in return.
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Old 09-08-08, 12:55 AM
RoboticPaper RoboticPaper is offline
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Re: Writer New to Adderall: Relief Followed By Agony

Hey nooby (in an endearing tone, not condescending, yes i'm feeling neurotic today),

In my personal experience, if I don't begin the "task at hand" almost immediately after taking adderall, then I don't get the same concentration effects. I wouldn't say it's a waste of medication, but I will say that it's not putting it to it's full cause.

After I take the medication, I have a small window of about 40 minutes to "lock on" to what I need to be doing (this is an issue more so if the effort requires more concentration because of it's difficulty). Miss this window and the full benefits, and it's intended purpose isn't being realized.

It's been this way for me since I was a kid, and it's still true to this day. My experience is from taking the instant release adderall (which just means it's not the extended release) in 5 mg increments.

I noticed you said you take the medication and go running. First, you need to be advised that strenuous activity right after taking an amphetamine (or in this case, "amphetamine salts") places additional stress on the heart.

You are at a very early stage and you are just learning your tolerance level. You should not be doing that in my opinion. You can after you know your tolerance level a little better. Not trying to scare you or anything. I train and workout constantly.

But more importantly, in my opinion, is that you are missing what I dubbed the "lock on window" by going running. Even if the run is only 15 minutes and you come back and immediately get to work, your bodies energy is going to be focused on your physical recovery. Go running after you're finished working on what you're doing, or at least when the medication isn't at full force (which might mean inbetween doses).

#6 - food and water do influence the effect of the drug. It's recommended you take with food. Although if you aren't feeling any of the effects, and you do have a full stomach, then take it before a meal (watch out for stomach cramps and getting diarrhea, at least with the IR version, I don't know if the XR version is any better).

-RoboticPaper
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Old 09-08-08, 01:41 AM
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Re: Writer New to Adderall: Relief Followed By Agony

Hello, George, and welcome!I am glad you found us.

I cannot answer all of your questions, but I will tell you what I can.

First of all, I empathize with you. I have had issues with anxiety for years, and it was ironic that a stimulant helped me. Instead of jazzing me up, Adderall made me calm. I felt like I could think, and therefore eliminated a lot of what made me anxious: I was no longer paralyzed by my ADD, and therefore could get through anything that worried me. But it took some playing to get the dose correct so that this was consistent.

The meds take time to get used to, and there is often a lot of unlearning and relearning to do. What you thought and felt once, and reacted to, may not be the same on the meds. It can take conscious effort to recognize this. The meds are not a magic bullet, just a way to balance your neuro-chemistry so you can learn what you need to do and how to do it.

So, for me, a rolling tummy used to mean I was anxious. On Adderall, it means I am hungry or ill. But for weeks after starting, if I felt that sensation I braced myself for an anxiety attack. At the same time, I had chest pains, which I never had before. I thought the Adderal had uncovered some hidden cardio issue. I lowered my dose and had an EKG. Everything was normal, and continued to be even when I raised the dose again. Afterwards, I realized I was having a lot of stress at work, but the stress did not manifest as gastro issues, it manifested in a raise in pulse and blood pressure. It's a normal reaction, and actually was probably always there, but the belly issues masked it. So, I didn't realize it was anxiety.

Exercising on Adderall is a bit different from exercising without it. Perhaps your body is adjusting to being on the med? Off Adderall I am sluggish at the gym. On it I am much more energized, but I sweat like CRAZY and my heart rate increases at a faster rate.

Perhaps you did have a bit of a rebound from skipping a dose. Not everyone has this, but some do, and I think personally it is more common when the med is new. Your body is still adjusting to the medication, and it's going to react. In my experience at the beginning, when the meds wore off I felt like I was incredibly tired...and shortly thereafter felt like I was TWICE as bad as before. In another post I noted "It felt like the ADD symptoms were making up for the time they lost." If what you felt the other day is like your anxiety, but magnified, perhaps that is it.

I also find I have my worst time with blank time. If I am at work or responding to posts, I am all fine. If I have plans to watch a movie, all is well. If I have no plans, I still find it hard to focus on one task. My doctor's theory is that there is still a lot of "noise" going on in my brain, and it's not easy to shut out without a purposeful act. It helps me to look on each action as a choice and to them execute it as such. So, for you, maybe you still have time when your mind is running free, and is slipping back into patterns of worry and such. It can take time to unlearn this and re-learn the new ways.

Food can affect the meds. Some things (citrus or anything high in citric acid like soda, etc.) can inhibit absorption of the meds. Some other things (like Tums) can cause you to absorb the meds too fast, so they kind of..."spike". Not eating affects your blood sugar, and that can affect the way the meds act on you. Adderall causes you to dehydrate faster, so water is important. Caffeine can cause you to get racy instead of focused. If you are a coffee drinker, this could be a big factor!

In some cases it helps to change meds. In some it helps to take a HIGHER dose. I am not trying to prescribe, but just pointing something out as a possibility. Maybe raising one or more of your doses would help, or an XR would give you more coverage. You can raise doses slowly, a bit at a time. This might be worth exploring with your doctor.

I think you need to make a complete list of everything for your doctor, both positives and negatives. It will help point the way towards a different med or dose, or tell if you should try this exact thing a bit longer. If you tell your doc "I can focus and write, but my hands tremble and my anxiety is worse", it can help a LOT. It can tell your doc that a stim is good, but not Adderall, or suggest that a different dose or pattern of taking it would be a good thing to try. Or, maybe something different altogether, or adding something to the mix will help.

Be as specific as you can: it happens at this time, in these circumstances. This is what is better; this is what is not changed; this is what is worse. This is what I can tolerate, this is what I cannot cope with.

Also, I wonder if you have thought about using an ADD coach or seeking a therapist who works in the area of ADD or at least knows cognitive/behavioral therapy. Someone who can help you learn how to think in a new way and handle the changes. Also, sometimes meds will help clear a person's mind a bit so that old issues and traumas and upsets are now able to be heard. No more ADD fog for me meant I could remember and think about some old childhood issues I had buried. That was very hard, but the meds also helped me focus on learning ways to let it out safely.

It is so HARD to feel all better one day, and have it crash the next! I really do feel for you, and I know it is difficult. The fact that the meds work in some manner means that there is hope, in my opinion. You will find your path if you keep looking for it. Take heart, you are doing well, and you can make a change that will help you!

I hope this helps a little bit. Please keep letting us know how you are doing, okay?
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Old 09-08-08, 02:00 AM
Captain Sanity Captain Sanity is offline
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Re: Writer New to Adderall: Relief Followed By Agony

A book I have found helpful is The Now Habit.

It's important that you don't build things up in your mind as negative or lock yourself away to do things until they are done. Trying to force it is counterproductive.

I have sarted to do my work in short spurts like 2-3 hours and to log it and decide beforehand that's when I will do my work, then do it. This helps me to keep track of tie and to do QUALITY work any time I am working.

Most of the time when you get into this negativity you are spending only a small fraction of your time 'working' actually accomplishing anything. Also don't use work as an excuse to turn off the rest of your life or you will come to hate it even more. Of course, amphetamines help, too They don't last 24 hours a day, though.

This kind of procrastination is endemic for people with ADD, because ADD leads to a lot of inexplicable failures and disasters and a lot of outside pressuring to get your work done and people constantly telling you to try harder and telling you that you are not living up to your potential. All day seemingly every day, so it's no wonder you are a wreck when it comes to working on your own. It's not easy for anyone but with ADD it's a serious challenge, but if you can let go of the negativity and get some success under your belt then it will get easier and easier the more you do it.
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Old 09-08-08, 08:41 PM
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Re: Writer New to Adderall: Relief Followed By Agony

Quote:
I noticed you said you take the medication and go running. First, you need to be advised that strenuous activity right after taking an amphetamine (or in this case, "amphetamine salts") places additional stress on the heart.
Ok, exercise (or any other physical activity) will increase your metabolism. Your body says "I've got a demand placed upon me, it's time to increase the rate of my chemical reactions to keep up demand."

You may see an additive, or even a synergic, effect between stimulants such as adderall and exercise. Consult your doctor. Don't take a chance with your ticker. You may end up having a EKG, EEG, or even a cardiac-stress test.

Another thing that's likely to happen is the increased metabolic rate that's induced by exercise may cause your body to 'use up' the adderall in your blood serum and spinal fluids. The result: You loose out on your "relief" phase sooner. Again, consult your doctor regarding the issue.

You may find that you'll want to exercise before taking any meds. You may find that you want to exercise after all demands for your attention are met (at the end of the day.) Your doctor may have another solution different than these.
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Old 09-08-08, 09:38 PM
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Re: Writer New to Adderall: Relief Followed By Agony

Thank you for the info on running--I won't do it again. I'm most concerned about the horrid increase in anxiety I felt when I took the Adderall. I called my doctor today and he said he thought I should only take it when writing, that if I wasn't concentrating on a task he was "not surprised" I'd experienced anxiety.

I'm going to see the doc tomorrow and ask about Neurontin for anxiety and taking Adderall just when working. I'm scared of taking it again after the terrible reaction two days ago.

Thank you so much.
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Old 07-25-09, 09:32 AM
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Re: Writer New to Adderall: Relief Followed By Agony

George, stop obsessing and just go with the flow.
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Old 07-25-09, 09:49 AM
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Re: Writer New to Adderall: Relief Followed By Agony

Quote:
Originally Posted by georgesperec View Post
1. What is going on? I did experience this amazing normalcy and ability to work for 3 days on Adderall. Then today: Anxiety! Worse than ever!
Anxiety is a typical side-effect. If you are naturally neurotic (I am a little bit), the side-effect can be very unpleasant. The good news is that you might be able to adjust to the medicine so that the side effects subside. It helps a bit to remember that you feel anxious because of the meds, not because there is really anything external to be anxious about. Eliminating caffeine from your diet can help.

Quote:
Originally Posted by georgesperec View Post
3. Is it possible Adderall only works for me with writing? This would be distressing, as organizing and time management and their attendant worries are problems outside of writing as well.
It can give you more focus. You can use that focus for whatever you want.

Quote:
Originally Posted by georgesperec View Post
4. Could skipping a day have caused this? I was under the impression I could take the IR as needed and didn't experience withdrawal the day I didn't take it.
Probably not. Although, you might try to take it steadily for a few weeks to see if your body is able to adjust to the medication.

Quote:
Originally Posted by georgesperec View Post
5. I am seeing the doctor Tuesday and expect to be prescribed an extended release stimulant. I'm currently terrified of taking it again as I don't know what the effect will be. I thought I'd be able to have another productive day working tomorrow, but now I fear taking the drug and having an anxiety attack.
An XR might be more "smooth" and could allow you to have a steady but lower amount of medicine in your system. That might help. Maybe try Vyvance.

Quote:
Originally Posted by georgesperec View Post
6. How much does food/water influence the potential for such a reaction.
You should drink lots of water because the stimulant will dehydrate you. Food can be a problem as well, but it's complicated. I suggests you search for threads about that.
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Old 07-26-09, 01:50 AM
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Re: Writer New to Adderall: Relief Followed By Agony

Yours is the second post I've seen tonight that says that "I've had problem A for many years, but then I started Adderall and for a few days the problem seemed to go away, but now I'm experiencing problem "A" again and I'm just wondering if it's possible if the Adderall is causing problem "A?"

Here's a fact: As far as I've been able to discern from my own experiences with writing (and my interactions with other writers, and the writing books I've read by other writers) anxiety is pretty much a given. I highly recommend Ann LaMott's "Bird by Bird." Pay particular attention to the chapter on radio station "K-F***ed.

I'm not trying to minimalize what you're feeling, but just to say that anxiety over getting your butt in the chair (the famous BIC method) and putting words on a blank page is nothing new for writers, and, as far as I can tell, nothing new for you.
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Old 07-26-09, 10:58 AM
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Re: Writer New to Adderall: Relief Followed By Agony

I agree with the first response about the "lock on window". I find that I need to be sitting down and putting my attention on what I need to focus on within 30 minutes of taking the pill, or else it won't happen. The med only lasts about 3-4 hours for me, and when it starts wearing off I do feel a little irritable/cranky, which I can't explain.

I also don't think it's a good idea to go running while on Adderall, you could very easily over-do it without even realizing what you're doing. I find that I also can't get too hot while taking it, or I will start feeling sick.
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