executive functioning

Wide Eyed with Fright

Concerta

At the age of 32,  I was recently diagnosed with ADHD and Secondary anxiety.

ADHD medication attention

Concerta and ADHD treatment

For me, this specifically means I have trouble with executive functioning.  My mind has trouble choosing what to concentrate on.  I’m easily distracted by any thought that comes into my head.  Because of this, I have trouble carrying out plans or executing ideas.  This results in loosing lists, leaving car keys in the car, keeping my plans.   I also have trouble sitting still.  Going to the movies is a torturous experience.  I often find myself leaving in the second half of the movie and walking around the hallways of the theater until I can convince myself to go back and sit in the seat for another 30 min.

Secondary anxiety refers to the anxiety I create in myself related to actions/ events that are more controlled by my ADHD than by design.  An example of how my poor executive function can cause anxiety is the anxiety of experience when I park my car and put my keys in my purse.  I’ve locked myself out of my car many times because of my absentmindedness in ADHD, so I’ve built up anxiety that I will lock myself out again.  So, when I park and lock up my car I start to get anxious that maybe I forgot my keys in the ignition.  I’ll checking my purse three times to make sure I put my keys in it and didn’t lock myself out of my car.  An example of how my restlessness causes secondary anxiety is how I avoid being in a car for more than 30 minutes, because I worry I’ll be so restless that I won’t be able to stand being cooped up.

This month I was prescribed ADHD mediation for the first time.

The doctor started me out with 27mg of Concerta for 10 days- then after a follow up with her, 36 mg of Concerta for 5 days and 54mg of Concerta for 1 day.  Concerta was chosen because it’s known to help people with anxiety.

The first day: I felt so relaxed.  All I did all day was watch movies.  When the med wore off I felt nauseous and sleepy.  I fell asleep at my normal time, and woke up feeling terribly tired.

27 mg for Day 2-10: difficulty waking up.  Lots of ups and downs as far as energy level goes.  At times I was so sleepy I had trouble finishing sentences and eating.  This was probably one of the least productive 10 days of my life. Nauseous was on and off.  When the medication was worn off (about 7 -8 hours) I had some hot flashes/ sudden sweating.  I still had an appetite, which is unusually on this medication and is a sign that I needed a higher dose.  How exactly the side effects played out throughout the day differed from day to day, but the benefits (calmness, less restlessness) didn’t change.  As far as focus went- well that was untouched.

I felt calm. I wasn’t restless, but it didn’t help me focus.

36 mg for 5 days

I actually had less side effects.  The dr. said that the higher does, with less side effects meant that the previously smaller dose was too low to be maintained in my body and the side effects I felt with the 27mg was the constant withdrawal as the drug entered and left my system throughout the day.

54 mg for 1 day

It’s been 5 hours since I took the 54 mg.  My energy level is higher today than on the lower doses.  I’m not feeling tired or nauseous- yet.  I pooped more than usual, but that often happens when adding any stimulate (like morning coffee). I was hungry for lunch. I decided to try to type up a blog and have found it easier to concentrate on my writing today than usual. However, I suddenly have a headache.  Is that because I skipped my normal morning caffeinated beverage? 30 min after drinking my normal latte my headache started to subside.

Things I’ve done to test my concentration today:

Typed a blog: result, typed much faster than usual.  I’m finding myself a bit restless at the laptop though.

Read a new book for about an hour: Maybe I was more focused, but I’m not sure.

Major Side Effect

I realized my sleep was so poor because I was having bad dreams.  This is unusual for me.  When I’d wake up during the night (which was frequent with Concerta) I’d wake up worried and anxious.  Sometimes I’d wake up panicky about a perceived danger or threat.  Like one night I had a leg cramp and couldn’t go back to sleep for hours- not due to the pain of the leg cramp but because I was too scared that if I went to sleep I would die of a leg blood clot.

I guess a major side effect for me was nightly withdrawal, withdrawal that resulted in minor panic attacks.

I stopped taking Concerta.

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