KnotMagick Studios

So, to recap: I went to my doctor for my extreme and long lasting fatigue, which has been causing things like brain fog, difficulty understanding/remembering instructions, short term memory loss, etc. Because I have both fatigue and insomnia, she suggested I get tested for ADHD.

The neuropsych diagnosed me with mild ADHD with very low dopamine, and autism. Because I was hesitant to start a new brain med with everything going on, we waited until appointment 3 of 4 do discuss medication. We did talk about options a little bit earlier on, and I explained why I was hesitant: I already take medication for anxiety/depression, so I want something that's going to play nice with those meds. Second, because of my sleep issues, I didn't want to start on a stimulant until my sleep was under control because I didn't want to mess things up further. He listened, understood, and agreed with my concerns, so we put medication on hold for the time being.

This process started on January 1. December 1, my energy levels just crashed and took my immune system with it. I had zero energy and got sick twice between Christmas and the first week of January. I put my writing and creative work on hiatus until further notice because I just had no energy and couldn't meet any kind of deadlines. All I wanted to do was sleep. I felt like trash.

Between appointments 2 and 3 I had a brainwave that made me feel like an absolute idiot: A big chunk of my sleep problems were caused by sensory issues. I made some changes to my bedding, night clothes, and general sleep set up, and it helped a lot. It's not perfect. I'm not where I want to be. But I feel a lot better and can do more than I could in December.

But back to the meds. Because I was feeling both desperate for relief and more stable than I was before, I felt ready to start a new medication. Essentially, there are 2 options for ADHD: Stimulants (like Ritalin) and "off label" meds. These off label meds are usually designed for depression, but because they increase dopamine levels they also help with ADHD, which is exacerbated by low dopamine. I'm already taking Lexapro, which increases serotonin levels. We didn't want to mess with the Lexapro since it's working, so he suggested adding Stelara, which is the med that plays nicest with Lexapro. I was still worried about things like mood swings or severe reactions that might impact my day job--I'm already having trouble with details, focus, etc, and didn't want them to get even worse.

We spent most of the 30 minute appointment going over the side effects, what to look out for, and how to manage them. Most of the side effects are things I'm either already experiencing due to my chronic illness. The main dangers to look out for were extreme jumps or drops in blood pressure. The rest of the side effects were typically temporary and are supposed to go away after a week or two. The medication itself could take a few days to a month to reach full effectiveness.

We decided the smartest course of action was to start me on a half dose (25mg) for 2 weeks, and then go up to the recommended 40mg at our next appointment.

So far I've been on this new med for about 4 days. The only side effect I've noticed is that it's even harder than usual to regulate my body temperature (I can go from freezing when I'm sitting still to being covered in sweat the instant I move), but that's the only side effect I seem to have. I can't judge my sleep too well because my cat has been an asshole for the last four nights and keeps waking me up for food at 4am, so it's hard to judge things like quality of sleep or fatigue levels.

I am open to adding a stimulant later on, but I want to get some other things evened out first since most of the people I know who have issues with ADHD meds have them with the stimulants. Also, right now meds like Ritalin are hard to get, so I really don't need the headache of withdrawal symptoms or trying to find a pharmacy with it in stock. Hopefully in a few months my sleep will be better, my fatigue will improve, and the inventory issues will clear up, and we can talk about it more then.

So that's where things are. I have 1 more regular appointment, and then we're going to schedule a follow up for some point in the future. I know I was super lucky to get a GP and a neuropsych who have been so great, and that isn't the experience of everyone in this boat. I hope that if you are considering or are trying to get a diagnosis, you get providers who have been as great as these two (trust me, I've dealt with some shit doctors in the past few months, including one who flat out refused to see me).