More threads by David Baxter PhD

David Baxter PhD

Late Founder
10,000 Days on Ritalin: What I’ve Learned, How I’ve Changed
by Janice Rodden, ADDitude
June 26, 2017

I was diagnosed with ADHD, Combined Type, in 1993 when I was 41 years old. It was not until the early ’90s that clinicians considered ADHD as a possible diagnosis for adults because it was erroneously thought at that time that ADHD was a childhood disorder that people grew out of in late adolescence. I first learned about ADHD at a professional conference that I attended and remember thinking to myself upon hearing the diagnostic criteria and validation of ADHD continuing into adulthood, “Well, this explains a lot about my life” and “I wish someone had told me about this years ago!”

I immediately sought the services of a mental health professional who had training in ADHD and, after testing and a diagnostic interview, I diagnosed with ADHD, Combined Type, and prescribed Ritalin. Over the years, I have tried several different ADHD medications and, despite a couple of negative side effects (which I have either physically adjusted to or learned to tolerate), I have taken 20 milligrams of brand-name Ritalin every 3 ? hours, since then.

Truth be told, I was much more precise in taking my medication the first 15 years of my treatment and confess that, over the last 10 years or so, I have become more lax in taking my medication on time. As they say, “the biggest problem for people with ADHD is not that they become addicted to their medication – it is that they forget to take their medication.”

I have been taking Ritalin for so many years that, unless I put mechanisms into place to remind me of when I took my last dose (so I can remember when I need to take the next dose), I will forget whether I took the medication. After taking this medication for almost 10,000 days, I have found it disconcerting that, at times, I confuse whether the dose I thought I took earlier in the afternoon was actually this afternoon or yesterday afternoon, because the days all seem to bleed together. I am also so busy that I don’t pay attention to when I took the medication and can’t remember if I actually took the medication or just thought about taking it, and then forgot.

Years ago, I used the backtiming function on my digital watch as a reminder to take my medication on time. These days, sporting a different watch, I have fallen back to just writing down the time I took the dose on my hand – both as a confirmation that I took the dose and as a reminder of when to take the next dose. Should you and I ever meet, you will likely see ink on my left hand and you will know what that means, but let’s just keep that a secret between you and me.

When I first started taking medication, I didn’t know what to expect. My hope was that it would solve all of my problems. Unfortunately, it didn’t happen that way. Fortunately, I had wonderful support persons – including my psychiatrist – who helped me understand that the only thing the medication would do is make my brain work more like it was supposed to work. Any personal growth was still my personal responsibility. It has been said, “old habits are hard to break.” I suppose that is true, but the older I get, the more I have come to realize that many of those habits (maladaptive as they may have seemed) were actually coping skills that I developed on my own in a vacuum of information about ADHD. Still, once medicated and able to access my brain power more successfully and consistently, things did start to change.

For me, a lot of the change came because I immersed myself in information about ADHD to better understand why I did what I did and what other possibilities there might be – other than what I had historically done to survive. I remember the story of an elementary school student who said, “The medicine doesn’t really change who I am, it just gives me a second to think before I do something.” That kid had a lot of wisdom and insight and I so appreciate having heard that story. It helped me have a more accurate expectation of treatment and recovery.

The amazing thing is – and I can see this only from the vantage point of looking back over the last 25 years – is that the medication actually has changed me, but that change was a slow process. I truly believe that due to 40 years of decreased activity in my prefrontal cortex (where executive function is housed) that my emotional/mental maturation was delayed because I could not process that kind of information effectively until I had medication on-board. I think I may finally be catching up, although some might take umbrage with that sentiment. The impatience is still there, but I am now better at overriding much of the impulsivity around impatience. I am no longer the adrenaline junkie I used to be, but perhaps that is accounted for by old age. I find that I am better at entertaining conflicting ideas rather than fleeing from the cognitive dissonance I had previously experienced and disdained. Perhaps all of these aforementioned things are the result of maturation (having lived long enough to finally grow up). One of the most amazing things to change has been an increase in my ability to spell words correctly.

Having multiple learning disabilities (none discovered until I was in my early 40s), spelling had always been the bane of my existence. I had suicidal thoughts when I was in high school because of the academic challenges I faced daily and feeling like a failure. Somehow I managed to encapsulate all of those feelings of failure (in several classes) into the statement, “I can’t spell,” to which I assigned the meaning, “I’m stupid, I’m an idiot, I’m a failure and there is no hope for me.”

I remember the breakthrough moment. I was 16 years old when I finally figured out, “There are more important things to life than spelling.” I am grateful to God for reaching through my haze of feeling like a failure to implant that thought into my mind. I can’t imagine that it came from anywhere else than God because I was so depressed and isolated at that time. As a result of that revelation, I was able to let go of a lot of the academic pressure I had placed on myself and, three years later, wrote my first book at the age of 19. It sold 20,000 copies worldwide. Not bad for an “idiot.” I am grateful for God’s intervention.

I don’t know if medication made me a better speller. It might have played some role, but more likely it is because I started paying more attention to how words were spelled and took the time to sound them out better. I think that, as I paid closer attention to words, I was better able to encode and decode words using my own paradigms that I had to develop in order to spell. Either way, my ability to spell words has improved over the years. Math? Well, that’s a different story.

As you may or may not know, I wrote one of the first books on ADHD and relationships, called ADD & Romance. That book was a compilation of stories from clients I had worked with clinically, along with my own personal experiences as someone living the relationship struggles associated with having ADHD. Over the years I have gotten better at relationships. However, I think the improvement has been caused only by an indirect relationship to taking medication.

Our brains are able to store a lifetime of experiences, even if we are unable to process those experiences. Likewise, it takes time, once the brain is working more like it is supposed to be working, to process all of those experiences and to learn and grow (mature) from them. It is much like the accomplished artist who, when asked how long it took for him to paint his most recent painting, said, “All my life.” It has taken me all of my life (after starting to take medication for ADHD) to process the experiences of my first 40 years to catch up (mature) to where I am today.

I remember the first time I experienced this catching-up phenomenon. It was shortly after I had begun treatment with medication for ADHD and while I was an intern at a private psychiatric hospital. Walking back to my office one day, after having conducted a group therapy session about relationships with some of the patients, I was musing over comments they had made in the group and began to reflect on my own life. I had an “aha” moment about my own relationships and recognized for the first time something that my therapist had worked with me on in therapy seven years earlier! The life experiences and the experiences in therapy were there —stored in my brain —yet unprocessed until that moment in time. It wasn’t until I had medication on-board that I was able to sufficiently use my prefrontal cortex (executive function) to process that information. The sad thing is that because of untreated ADHD, it took seven years before I was able to therapeutically process that information. The great thing – taking inflation into consideration – was that I received therapeutic benefit in 1994 with 1987 dollars!

Maybe you are new to this ADHD thing or maybe you, like me, have been on this journey for a while. If you are an older adult who has ADHD, it might be a good thing to read and/or share your experiences here and find validation – or provide validation – for yourself and for others. Perhaps here, we can just be ourselves and learn from each other’s experiences. Thank you for allowing me to share some of my experiences with you. I hope to soon read about yours.
 
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