Monday, August 31, 2009

Vyvanse and Celexa, the tango in my brain...

If I was sitting here right now with my Nurse Practictioner, I would not know what to say, because frankly...there is no defining throughline to what my medication is doing right now. It's only been about 12 days so it's not totally reasonable to expect a reliable result yet, but seriously...I feel like a tossed salad.

Nothing has rendered me non-functional, I've been going to work, going to meetings, doing all of the normal things that I do. I have also lived a life, overall, that has involved a wide array of feelings and emotional experiences anyway, so if I feel anxious or just a little "off" I know it's not going to kill me and I can push through it. But inconsistency is still rather unsettling, and it's certainly not something you can necessarily plan around.

One day I feel totally mellow, and very focused...the next day so anxious that I literally cannot think...then I might spend an afternoon driving the backroads of NH listening to classic rock (which I would normally NEVER do) and the breeze hitting my face and just driving with no aim because it just plain feels great...later that same day I might be so amped up that I can't stop talking and just hours later will sit in a crowd of people and have no desire to talk, at all. Yeah okay, it's a little eccentric, but everyone has fluctuations in mood and energy throughout a day...this is definitely more fluctuation than I am used to, and I am used to fluctuation, lol.

This kind of fluctuation is the thing that I think makes it hard for people to be convinced to comply with the instructions they are given for their medication. For example...if your prescriber says "this might give you some nausea at first, but give it a chance if you can and call me if you have a problem"...that doesn't mean decide that you are only going to take it every two days because you just don't want to deal with the nausea and then don't tell your doc. It is also hard for people, I suspect, to get used to feeling "different" from what they are used to. And sometimes, clearly, meds that mess with your brain just suck. Me, personally, I am extremely disciplined about following instructions, AND communicating with my prescriber when things aren't working the way I'd like them to. Even through the nausea of the last medication, even when the last one was like a big chemical baseball bat making me sit face down on the table giggling. I'm a tough nut. And this combo just isn't "that bad".

I am willing and able to work hard to see where this particular med combination goes. I'm not going to pretend I'm having fun right now while I'm not knowing quite where I'm going. But I have to remind myself that I am not in this for a certain outcome, but "to see what happens" and if medication is, in fact a good option for me.

It's a special challenge in my case and may require extra tinkering because I have a ton of anxiety along with ADHD. Most ADHD meds are likely to increase or induce anxiety...which is part of the reason I am taking an anti-anxiety/anti-depressant medication along with see the dilemma, the need for tinkering with dosages, the lack of exactness, and it sounds (and looks, in my pill case) like an afterschool special. "This one's an upper, man...and this one, this one will totally mellow you out..." Cut to the "good kid" taking a brightly colored pill and another smaller one and making the tragic mistake of swallowing them, and REGRETTING EVER MAKING THE DECISION!!!

I definitely do not regret making this decision. The definition of this aspect of my ADHD journey however, as much as I don't enjoy it, is uncertainty. That IS what this is about...until it's not. Either I will find a combo that works or I won't. The bottom line for me, that my therapist and I fully agree that my anxiety, both on its own, and as the result of ADHD will kill me. Not with immediacy...but it will slowly take its toll on my mental and physical health. It will chip away slowly at the various systems of my body, it will likely shorten my life and compromise its quality. I have had health problems in the past because of it...and I have seen family members haunted and killed by it because they did not have the ability or inclination to tell it "no". Their fates range from the humorous (fear of dentists, fear of hairdressers) to the tragic (fear of feeling, fear of commitment, fear of failure, alcoholism, fear of death, suicide).

If any of these are my fate, it will not be for lack of trying. The inconvenience of uncertainty, is not an acceptable excuse, for me, to give up. I refuse to simply surrender myself to fear.


  1. Wow K.
    It's gonna be a bumpy ride to find the right recipe, no doubt.
    I can think of about a dozen worse things to do than drive around aimlessly listening to oldies (oops sorry, classic rock) if for some reason it pleases you at that moment, and you have the time to do it...I say...DO IT!

  2. We've got great backroads for driving up here too, woohoooooo!