Wednesday, 29 June 2011

Day One

This blog is a first-person account of starting ADHD medication, at the age of 40.

This post is actually written on day two, in fact. It came from an idea yesterday when I took the first tablet, but it's a major feature of the condition that thoughts like starting a blog will quickly be replaced by some other, unrelated thoughts. Recovering thoughts at a later date can feel like a matter of luck.

It's a bit like having dodgem cars in your head, and you're driving all of them. It can be fun, and it can be painfully intense, but the bottom line is that it's exasperatingly hard to build a line of thought, and stick to it.  

Importantly, it's also variable. There is an ebb and flow to how much a condition will come into play on any given day, and this is true of a lot of mental health conditions. The cycle can be over hours, days, weeks, or even months.

So back to the first day.

I had a scheduled appointment with my psychiatrist for 10.00am. I arrived early, but I had some nervousness that had built over the last twenty four hours. It's no small thing to be looking at the possibility of life-long medication. I wanted this to work.

Before my entrance into the world of mental health care, I had stigma. I didn't ever see myself saying the words 'I have a psychiatrist'. Even as an reasonably empathetic person, I had very little understanding of what the reality of terms like depression, schizophrenia, and bipolar could mean. It's been a long, and painful journey, but the insight I have now is something I wouldn't trade for gold.

My psychiatrist is someone I can relate to. That's been very important to me. I'm also very much involved my own treatment - something which causes concern for some people, but I'll come back to that.

We ran briefly over how things were going, reviewed my blood tests, and ECG result from a few weeks prior, and then started to talk about the drug and it's effects.

I would be starting on a low dose of methylphenidate, consisting of three small five-milligram tablets each day. One for the morning, one for the afternoon, and one for the evening. I was already thinking - hold on - I can barely hold in my head the sequence of doing the dishes.

I parted with a feeling of optimism, and headed to a pharmacy. Just as my psychiatrist had warned, the prescription was knocked back. Medikinet (one of the same drug's many titles) is a highly controlled medication, as it can get used and abused as a recreational drug. I was asked to return to the outpatient clinic to have it countersigned, and an hour later I was picking up two weeks worth of methylphenidate hydrochloride, or forty two tablets to be precise. I'll be making a return journey to my GP, and then the pharmacy every two weeks if the treatment works. This is not an ADHD-friendly situation, but I wouldn't want a large stockpile at my house. It's understandable when this drug is on a pharmacological par with cocaine and base amphetamines.

There was no ceremony about it. There was a queue for the checkout in the pharmacy so I just took one out and put it on my mouth while I was waiting. I picked up a drink, paid for that and the medication's NHS Levy of £7.40. Then I was on a bus back home.

I've taken speed once before. It was during a fairly epic night in Hamburg. The subject of recreational drugs would be good to get back to, but perhaps later. The relevant part is that I had an idea of what to expect, which is very, very helpful.

About an hour, some effects starting to make themselves more clearly felt. Taste interference was the first sign. There's a metallic tinge to my mouth, but it's quite subtle. I have a tiny headache, but I think it's starting lessen already. Neither of those things are too unpleasant. Mentally there's a sense of a buzz of some sort. Not good, or bad, but just like an extra 'tone' has been added to my thought space. 

It's quite comfortable, and often it's hard to notice it's even there.

I took the first tablet at around noon, so I take another at 6pm. The advice is to take the drug all through your waking hours, but my instinct is telling me I don't need this one. However, I'm planning to take the medicine as prescribed for at least the first month or so. Being irregular about taking the medication is going to make assessing the benefits and harms that much harder.

Not much changes during the evening. I do manage get to bed earlier than I have been doing, and I'm slightly better at switching off.

That's promising, even at such an early stage, and it confounds my expectations of the Ritalin preventing easy sleep. I also haven't turned green, or held up my corner store at gunpoint.

I still feel like me.

Confound away...

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