I’ve been taking a low dose of Adderall for about a month. How’s it going?
We weren’t sure what amphetamines would do to my brain. I have a real, bona fide ADHD diagnosis with real bona fide ADHD deficits, but most of the things I need immediate help with are more autism-related or in the grey area between ADHD and ASD.
- emotional regulation
- tolerating interpersonal ambiguity
- maintaining communication skills under stress
- managing sensory input
- managing inconsistent information processing speed
- recovery from deep burnout-related fatigue
In other words, the autistic side of executive function stuff and emotional and sensory overload.
Could Adderall help me in those areas, or would it just help with ADHD stuff like time-blindness, motivation, and poorly managed focus?
Here’s a story that illustrates how things are changing in my life with meds.
My day job is with a medium-sized digital experience company. We make the software behind the websites and apps through which you encounter your favorite really big consumer brands, and my team trains our salespeople.
I manage a shifting team of freelance instructional designers and own a large catalog of tech-heavy courseware. I love my job (especially at this company) and I’m good at it, but…
Over the last 5 or more years I’ve observed that I am just too emotionally and politically vulnerable at work for my comfort, seemingly always perched on the flimsy border between rock star and towering failure. My strengths (gentle humor, technological vision, inspiring a team, problem solving) have been consistently undercut by two persistent and often debilitating bugbears: executive function failures and a hefty emotional regulation problem that can remove all access to the communication skills and critical thinking I depend on. I’m really awesome… until my deficits catch up with me and I fail at something.
[editing later: just to feel a little safer about this level of public disclosure about my brain and work, I want to clarify that when I say the phrase emotional regulation problem in this context we’re not talking about tantrums and public ugliness, ever. I’m talking more about needing to slow down as I process strong emotions under stress and a strong sensitivity to toxic work relationships and conflicting priorities]
Basically, my unmedicated brain is a badly-wired tesla coil – beautiful, sure, but also sparky, dangerous, unpredictable, and potentially very damaging to its environment.
My past work disasters have mostly happened at the end of really big, really visible projects (the ones where, if you fail, everyone sees it… oof). Launch dates and major go/no-go inflection points have lately been accompanied by terrible sleep and a lot of ominous foreboding; I’m haunted by memories of past failures and near-failures that destroy my confidence and color everything an ugly, cloudy yellow in my mind.
Typically the disaster pattern looks like this: a last minute change to requirements or scope forces me to make a decision while secretly melting down, I make and execute that decision without asking for help because I can’t think or talk, and I communicate about it in a way that erodes trust with the folks whose trust is critical to my success. The post-action analysis is brutal.
When I first asked my doctor to help me try Adderall, I was beginning a very large project very much like the ones that have beat me up in the past. I knew that even with great planning and perfect execution I’d still be exhausted and at risk for bad decisions and poor communication close to the end. Also, the “last mile” of the project was risky by design: my team’s output would be the first thing to go live in a shiny new piece of digital infrastructure that I knew nothing about and had no control over. I didn’t have enough time or brainspace to experiment with this new environment and still meet our production timeline. So I was going to launch a complex curriculum absolutely blind to how it would look and work when we were done.
I could see a train coming through the tunnel straight at me, even 3 months before our launch date.
While asking for Adderall had been a longterm strategy for my whole life, it was also frankly a hail-Mary pass to save this too-big project that seemed like it was just designed to break me.
I asked for Adderall the same week this project kicked off, but it took over 2 months of doctors hesitating and insurance balking before I could get the Adderall prescription made and filled. My launch date was only 2 weeks after I finally took the first pill, and the work was trending catastrophically behind schedule.
Fast forward to 48 hours before go-live.
90% of the new curriculum was built and tested outside the new system, and I had only two days to make it all work within the new system while my team finished the last 10%. Emails and newsletter articles were already prepared, ready to go out on Friday afternoon. This was Wednesday night.
I’d stayed up the night before finishing a difficult piece of production work that I couldn’t delegate. Sleep deprived, my plan was to host a project status meeting, take a 2 hour nap, then make an offering to the gods of learning management software and load everything into the new system. If we encountered no problems, we’d finish on time and we could sleep all weekend.
Of course, we encountered a problem. Of course it was a big problem. Of course it wasn’t something we could skip or fix or handwave away. It was launch-critical stuff. Shitty user experience stuff. Trust-busting stuff.
That late-breaking problem should have triggered a call for help from me to leadership: “Sir, the new whatsit can’t do important things. Send help. Enjoy this perfectly acceptable stopgap in the meantime.”
And that’s where I landed eventually, but first I needed to fail at two kinds of communication, totally fumble the whole nap thing, and melt down spectacularly for about two hours (mercifully in private).
Adderall didn’t prevent the meltdown or the bad communication or the chronic lateness of everything we did, and it hadn’t been around long enough to fix the faulty planning I’d started the project with.
So… did Adderall help at all?
Yes. In fact, even though it didn’t do what I expected it to do (make me a golden god of productivity and leadership), it still made all the difference.
Let’s compare and contrast.
|– unforeseen problem emerges||– unforeseen problem emerges|
|– exhausting 24 hour meltdown|
– long tail of lingering personal and interpersonal damage
|– 2 hour meltdown|
– refreshed and clear afterwards
– only my cats as witnesses
– immediately able to devise solid solutions
|– lose ability to communicate or collaborate||– some communication impairment, not catastrophic, and collaboration OK|
|– can’t ask for help|
– can’t see the big picture
– just hoping to god no one notices me fucking it up
|– post-meltdown problem analysis|
– burst of creativity
– clear vision of solution
I. Asked. My. Boss. For. Help.
|– zero resilience or sense of humor||– sharing a laugh with boss while discussing my proposed solution|
– high quality sleep for the rest of the week
|– technically meet the deadline|
– spend weeks fixing problems we caused and calming angry stakeholders
|– move the goalpost and claim the win|
– new plan to fix the infrastructure problem (immediately greenlit by management)
– collected kudos from VPs for identifying a fix for an infrastructure problem that would have impacted our team for years
How did Adderall help? Did it reduce the spicier features of my autism? Did it make me less offputting to my managers? Did it make me more “normal”? Did it prevent me from melting down?
Nope. I’m definitely not less autistic on Adderall. I’m still a functional weirdo. I’m still pretty damn fucked when measured by neurotypical yardsticks. My project was absolutely headed for disaster.
To me, it felt like the drug cleared some extra space in my brain, so that even as I endured a series of trauma responses and melted down, I could see what was happening and change my path. I could see that I was entering the old shitty pattern. I could identify my emotions and understand what they were trying to tell me, even if I couldn’t stop them from happening. And I could actually consciously decide to step off the path of the oncoming train and do something new.*
*If you’ve seen Hannah Gadsby’s Douglas on Netflix, take her bit about the “funny zip” that expands a suitcase without opening it and apply that metaphor to my brain. I found my executive function funny zip and my brain went spsss whoomp and I had all the extra room I needed.)
Holy shit. I could freak out and find solutions simultaneously.
I must not forget what a shock it was to realize I could have access to the capabilities I needed most during a time when I was profoundly distressed and exhausted and under tremendous pressure.
Honestly, this is so new to me. 30 years of talk and group therapy have made me pretty good at analyzing emotional malfunctions after the fact, but this Adderall-fueled sorcery may have been the first time in my whole I’ve prevented a disaster I created as it was unfolding, while keeping an overwhelm meltdown contained.
*Dialectical Behavior Therapy – emotional regulation techniques for people who suck at emotional regulation due to trauma or mental health conditions
I hadn’t even realized I could dare to hope for that.
It’s kind of amazing, actually.
I can’t wait to find out what all else I can do with my new and improved brain.
Like, maybe I’ll try planning my next project well from the beginning.
Maybe I recognize earlier in the next project that some risks shouldn’t be resolved with creative workarounds (a lateral thinking flex but not the best skill to lean into). Raise a flag. Ask for help. Listen to my gut, not my self-doubt.
Ooh – maybe I’ll invent a time machine and slip early-90s young adult me some amphetamine salts and a whitepaper on neurodivergence.
If I can’t manage to bend physics with a low dose of speed, maybe I’ll just enjoy the remaining 30 or so years of my life as a more sane, more functional, more connected human.
It’s tempting to just end this post and let you think that a stimulant solved every brain problem I have. If you need that hope, hey, you do you, ya cock-eyed optimist.
But the truth is, I mean, I’m just months into this journey and medication is just one tool I was lucky enough to have access to. I still have a lot more work to do to understand my brain and give it the things it needs to thrive. And even more work to be the human I want to be in the world.
Still, with medication I have that little bit of extra room I’ve always needed, so that I can do that work and have some hope of lasting cumulative progress.
Right now, that’s everything.