One Year Without Adderall

Haven’t posted in a while. I started writing this post and just noticed the date.

One year and one day ago I stopped taking Adderall.

Hell.

It was hell. I started taking Adderall five years ago for ADHD, which I do have. Adderall became my tool for escaping my depression, instead of merely aiding me with attention. Sad, stressed, annoyed? Take an Adderall.

I’ve had suicidal thoughts since third grade. Starting in middle school, as I began to fight my homosexual nature, I started having severe emotional lows. I’d hide somewhere, cry for hours, beg God to kill me, contemplate how to kill myself, this would between a few hours and a few days. Crashing, I called it.

Always had it, well middle school on. Once or twice a week I’d crash, have an evening of hiding, crying, wanting death and so on. Then I’d be fine the next day.

It became normal. Early in my prescription I realized if I took an Adderall when crashing, boom, I escaped it. Adderall let me focus on something else, get up and do something. It freed me from the crash.

Slowly I used it more and more to avoid my scary lows. 

The thirty days before I quit Adderall I was taking about 150mg a day. I’d been taking about 100mg a day for a few months before that.

I blogged about it. You can go back and see. It got scary. I hated myself. I had intense suicidal desires that I detailed on this blog. 

Most of those are gone. I don’t crash anymore, really. I do to some degree, but it is so different. It is just lows, not a real crash.

Nothing is perfect. I still think about killing myself, about how worthless life is, how meaningless existence is. In fact, I struggled with those thoughts much of the morning. They weighed me down.

Still, they are different. I’m not planning my suicide, or visualizing it. I’m not scared to wake up. Not scared to be alone. Scared to go to work, answer the phone, walk out the door. I was. It got so bad, Adderall fueled emotion mood swings. It turned on me. Instead of supressing my emotions, the feed them. Amplified them. 

Adderall started as a tool to avoid my depression, it became fuel for it.

My quality of life a year off Adderall, better. Much better. It isn’t even comparable to be honest.

Life is mundane. But I’m grateful it is that now. For so long, probably a year to a year and a half before I went off Adderall, life was a daily fight for survival. It was a daily battle with my own mind to push myself through a day.

Now, life seems dull.

Dull is nice.

Current Medication: Nuvigil 250mg, Seroquel XR 200mg, Strattera 100mg, Pristiq 100mg, Memantine 10mg, Lamictal 200mg

One Year Without Adderall

Medication solves depression

nwdlfse37ftwgupvi7d0zwcx8szlcfftynml2wnvyyaThis page has been blank for at least ten minutes. I am at a coffee shop. In a past life, before my depression consumed everything, I frequently dropped into a bunch of different local coffee shops. It is nice to get out of the house, work on whatever and people watch.

Of course, in the last few months before I entirely went off Adderall I rarely left the house other than for work. At work I was scared much of the time, a low level of panic throughout every day — all day. I feared social interaction, going to sleep, eating out, everything. The anxiety poisoned everything.

I’m fairly confident I’ve always operated in a state of mild anxiety. I know my first suicidal thoughts were in third grade. I relished the thought of the teacher telling everyone. The students would look shocked, some would cry, the boy who was mean to me would know it was his fault. Killing myself would solve so much.

At thirteen I began to grapple with my sexuality. Always, always had I been attracted to boys, to my friends. In fourth and fifth grade I’d play with myself while imagining my friends and I all  wrestling and rolling around naked. I didn’t know why I liked it, maybe I just want to check if I looked normal.

Growing up conservative I knew about the homosexuals. Perverts. Pedophiles. ——

You know what. Never mind. I want to explain why I am this way. I want to justify it. Tragic childhood. Self-hatred. Blah, blah, blah.

However, when I crash, when I want to die, taking a walk doesn’t pull me out of. Neither does going for a drive, or writing about it. Spending time with friends or having a dog also doesn’t interrupt my suicidal thoughts.

Telling myself my thoughts are just words, doesn’t help. Singing my suicidal thoughts to make them sound ridiculous, that is ridiculous. The thoughts still persist.

The desire to kill oneself isn’t rational. Even in those moments, the lowest of the low, when I am curled up into a ball screaming in my head to spray my brains on the wall, I know those thoughts aren’t rational. To some degree I’m aware I don’t want to die, even in those moments, it is why I am still here.

I feel fine right now, I’m glad to be at a coffee shop. I don’t feel fine because I got out of my house and went to a coffee shop. No, going out when crashing, terrifying, panic inducing.

Medicine can fix this. It is why Adderall got so out of control, it gave me access to a life I never realized existed. I hate myself, I hate myself because I view myself as a disappointment. And unless I become a tech billionaire and president, I’ll continue to be unsatisfied with my life.

Adderall showed me a life were I wasn’t paralyzed by the constant internal war. Adderall let me experience the world in the moment, it let me ignore my head and concentrate on now. Nuvigil is doing that right now. It goes up and down, part of the day/dose is better than others, parts are still bad.

I’ve always tried to fight this battle, always. There wasn’t a choice, you either fight against the suicidal thoughts or obey them.

The idea that my actions are useless, I hate. Partly because I feel personally responsible for every failure, I love torturing myself with those failures. Inability to function emotionally — failure. But I don’t think it is within my control. Medication is so different than therapeutic tools. Therapeutic tools comfort, to some degree, during those moments of internal warfare.

Medication removes the conflict from erupting, it prevents the war. There is no fight to lose, no carnage. There is just Saturday, me and a coffee shop.

Current Medication: Nuvigil 250mg (125mg at 7am, 125mg at 1pm), Memantine 10mg (new), Lamictal 200mg, Pristiq 100mg, Trazadone 100mg, Strattera 80mg, Seroquel XR 300

Medication solves depression

Nuvigil, ADHD and depression

ay00vjwOn Tuesday my psychiatrist and I decided to up my Nuvigil dose from 150mg to 200mg. Also, I am tapering off of Seroquel since my clinical psychological evaluation diagnosed me with treatment resistant depression, Dysthymia and ADHD – ruling out my bipolar diagnoses.

The main symptom of my depression is apathy. Desire, no. Interest, no. Motivation, no. We are hoping that tapering off Seroquel will give me more energy throughout the day. I’m now using Trazadone 50mg as a sleep aide.

I am more and more aware of how my ADHD contributes to my depression. Nuvigil definitely helps, it is also much much smoother of a release than Vyvanse. However, Nuvigil does start strong and dip during the day for me, and during that dip I become unengaged, bored. It is these periods where my mind wonders into the depressive thoughts. If I not being aided with a stimulant my mind always wanders to the negative.

Stimulants impact dopamine, maybe my depression is caused by low dopamine levels. It would make so much sense. Stimulant based medications work to combat my depression in a way that nothing else has come close.

Of course, I am writing this blog on a day I took more than my prescribed amount of Nuvigil. I cut my last 150mg pill in half and took half on top of my 200mg pill. More is always better. I’m so weak. My psychiatrist even commented that I will likely be asking for an increased dose of Nuvigil in two weeks. That I tend to seek the maximum dose. I concurred. But I seek the maximum because more helps more.

Although, maybe I am just trying to justify past abuse of stimulants and current prescription for Nuvigil. I don’t know. I never know.

Current Medication: Nuvigil 200mg, Lamictal 200mg, Pristiq 100mg, Seroquel XR 100mg, Trazadone 50mg, Strattera 80mg

 

Nuvigil, ADHD and depression

Nothing is enough

annieMy psychiatrist prescribed me Nuvigil last Wednesday, 150mg. I took it Thursday, in the morning, it was alright. Certainly not as energizing as Vyvanse, but Vyvanse is real strong at first, so I wouldn’t mind a step down.

However, by mid-day I was struggling. Low energy, no focus and back to my depressive state. Of course, I opened up one of my 40 mg Vyvanse capsules and took a third of it with Nuvigil the next morning. That was nice, almost perfect. The Vyvanse still comes in waves through out the day, every few hours I get a bump of energy that protects me from the depressive lows. The last one just hit, it does around 4pm, it is how I got off the couch to write this blog. Sigh.

Here I am again, abusing my prescription. But it is so difficult to choose to be unhappy, to choose to feel depressed. At times, I am just not strong enough. I fully understand that I do not want to get a high, I don’t want to go down the path of my past abusive behavior. However, I do want to have days where I feel present — where I feel alive.

In two days I see my psychiatrist, she gave me a seven day prescription. I am hoping she will up it to 250mg, we shall see. I will be honest with here. She’ll be disappointed, maybe angry. I’ll call Dan with her and tell him he needs to dispose of my Vyvanse. I don’t want to go back, these last few days, I’ve felt alive, I just wish I could do this forever. I know I can’t. 

To prevent myself from taking Vyvanse with Nuvigil I just gave Dan the pill bottle and told him to hide it. Tomorrow shall be interesting.

Maybe we will increase my Nuvigil prescription at my appointment on Tuesday. An increase in Nuvigil will help some, although, having experienced 150mg, I doubt even an increase to 250mg will be enough.

It won’t be, nothing is enough.

Current Medication: Nuvigil 150mg, Lamictal 200mg, Pristiq 100mg, Seroquel XR 200mg, Strattera 80mg

Nothing is enough

Begging my Doctor for Provigil

After receiving the results from my clinical evaluation, I sent my psychiatrist an email. The evaluation hit me hard. I ended up begging for Provigil. The text of my email is below.

Hello,

The clinical evaluation confirmed much of what we expected. Bipolar disorder isn’t present, instead Dysthymia, major depression and adhd are.

I’m, I don’t know. The antidepressants I think are helping some, I don’t know. The best part of my day is still the first few hours of Vyvanse, I get to feel alive.

Having read the eval, I am really defeated. Nothing is shocking in this report, it confirms our expectations. I just, I, I am so tired of being sad. Dan deserves more.

The paragraph below I found most depressing, particularly the bold part. It sounds right, and it feels right. My personality makes me unlikely to “experience pleasure in life.” And even if the pills work, none claim to change my personality, to help me experience pleasure. It is so damning.

The patient’s profile was developed using the D (depression), Pt (psychasthenia – fear, anxiety, tension, depression, intruding thoughts, and obsessive-compulsive symptoms); and, Pd (psychopathic deviant – rebellious, non-‐conforming; family problems; impulsive, angry, irritable, and dissatisfied) scales. Patients with this pattern tend to exhibit a pattern of chronic psychological maladjustment. The patient appears to be quite anxious and depressed at this time. He may be feeling some tension and somatic distress along with his psychological problems. He endorsed several items related to suicidal ideation and should be monitored for risk. He indicated a history of impulsive acting-out and substance abuse for which he expressed guilt and remorse. His personality is such that he may have only a small capacity to experience pleasure in life and tends to be pessimistic in outlook. It appears he is experiencing disturbed interpersonal relationships. Patients with this profile are prone to substance use and abuse disorders and all treatments involving medication should be carefully monitored.

I have been Googling about medications, I need, I don’t know, more help. Like, this can’t be it. I hope not.

Provigil is the only thing I find particularly hopeful. It would likely wake me up a bit, give me a bit of energy to get up off the couch. It has been used off label for depression and adhd. It has a lower rate of addiction, it being a category IV and Vyvanse being a category II. Tolerance is much less likely with Provigil, having had studies go as long as three years.

I just, I don’t know. I guess part of me is still hopeful. There must be something else out there, something that can help a bit more.

I am trying really hard, really. I just want to feel alive.

Current Medication: Vyvanse 40mg, Lamictal 200mg, Pristiq 100mg, Seroquel XR 200mg, Strattera 80mg

Begging my Doctor for Provigil

I want Provigil, I want it now

iran 1880Again, I did a bit of research this morning, sorting through the endless array of drugs for depression. The most significant problem I face is my lack of energy, my difficulty just getting up and doing things.
My psychiatrist has been resistant to Provigil before, given my history of stimulant abuse. But I’ve done relatively well with Vyvanse. Provigil appears to be less addictive. Below is my notes on the drug. Yes, I used wikipedia, and I am not ashamed.
If you take Provigil, let me know your thoughts on it, I’d greatly appreciate it.
Modafinil (Provigil)
 
Off-label use for fatigue
Modafinil has also found off-label use with the neurological fatigue
  • reported by some with multiple sclerosis.[12]
  • In 2000, Cephalon conducted a study to evaluate… A group of 72 people with MS… Participants taking a lower dose of modafinil reported feeling less fatigued and there was a statistically significant difference in fatigue scores for the lower dose versus the placebo. The higher dose of modafinil was not reported to be significantly more effective.[13][14]
  • Modafinil is also used off-label to treat sedation and fatigue in many conditions, including depression
 
Addiction and dependence potential
  • addiction and dependence liabilities of modafinil are very low.[1][2][33]
  • shares biochemical mechanisms with addictive stimulant drugs, and some studies have reported it to have similar mood-elevating properties, although to a lesser degree.[33]
  • In accordance, although very rare, case reports of modafinil abuse exist.[36][37]
  • schedule IV controlled substance, a category for drugs with valid medical uses and low but significant addiction potential.
    • Adderall and Vyvanse have significant more abuse potential, schedule II
 
Tolerance
Large-scale clinical studies have found no evidence of tolerance with modafinil at therapeutic dosages even with prolonged use (for 40 weeks and as long as three years).[39][40][41]
I want Provigil, I want it now

I want to feel alive or be dead

pin boys 1918I don’t want to blog. I don’t want to do anything. Why me? I should be stronger, but I am tired of being strong.

Yesterday I got the results of a full psychological examination I completed. My psychiatrist wanted it due to the difficultly we’ve had successfully treating my depression.

First, allow me to be boastful, I don’t take pride in much, probably a result of me hating myself, however, my IQ is in the 120s. That I am proud of. The actual diagnoses weren’t exactly surprising.

Bipolar disorder, nope. As expected, my psychiatrist and I have been doubting my bipolar diagnoses the past couple months. My manic episodes were a result of my Adderall abuse, not bipolar disorder. My depression is severe, my psychiatrist and I were also aware of this. The clinical psychologist stated that my depression is severe, the test recommended immediate intervention to prevent a suicide attempt. Again, no surprise.

Thankfully, the psychologist and I had chatted before the tests, she was aware that I have never actually been suicidal, I doubt I ever will be. But I do relish the thought of taking my own life on almost a daily basis.

One of the tests involved staring at a black computer screen and clicking the mouse every time a letter other than “X” appeared, every few seconds. The exam was a dull fifteen minutes. The results, 99% chance that I have ADHD. I took this test at 11am, three hours after I had taken 40mg of Vyvanse, meaning Vyvanse was at its peak. I also take Strattera for ADHD. And yet, 99%.

The ADHD results are validating. Maybe that is why I slipped into abusing Adderall, nothing calms my racing thoughts like stimulants do – nothing.

Unfortunately, the results are fairly useless. It confirms our suspicions, maybe I’ll go off some of the bipolar medications. But know what?

Pristiq is helping. I am no longer as concerned about my depression. Like, I the worry and guilt I used to feel about laying around and doing nothing is largely gone. But I still don’t have much desire to live. My emotions are mostly flat and I feel tired much of the day.

Adderall was such a miracle. Suicidal thoughts, gone. Self-hate, replaced by confidence. It gave me a bounce in my step, even when not manic. I am confident that those first two years on Adderall will remain the best years of my life.

Now I am left to piece things together, to tolerate life, to keep going through the motions. Part of my desire to die is due to already feeling dead.

Even this post, do you know how I am accomplishing it? Vyvanse abuse. I opened up one of my 40mg pills and took a third, on top of the 40mg I already took. I’m not remotely high, I wish. But I do have the energy to get up, to shower for the first time in four days and to sit at a computer. I’m not happy. I wish it made me happy. I am a void, nothing, but at least I am functioning.

I just want to feel alive – or be dead.

Current Medication: Vyvanse 40mg, Lamictal 200mg, Pristiq 100mg, Seroquel XR 200mg, Strattera 80mg

 

 

I want to feel alive or be dead