In order to control my ADHD devil I take Ritalin or Methylphenidate. This medication gives me the opportunity to take over control, to set goals and focus on them, to not get distracted by everything and reduce the chaos that is always present inside my brain. I see Ritalin as an eraser, a tool I can use to wipe out some of the chaos caused by my ADHD. But some things I like about myself are erased the minute I take the pills, without my approval. Besides methylphenidate does not only give me this eraser, it comes with a lot of other things, things I don’t want. Every morning when I take my first pill I ask myself if it’s worth it, if I am prepared to have another day with the side effects instead of a day without them, and (almost) every day I say yes, but not because of the mildness of the side effects.
The things that get erased
Whenever I am on medication I feel like a different person, I feel like a part of myself is missing, like the real me disappears the moment I take my first Ritalin in the morning. Parts of me are erased by the methylphenidate every day, some days more than others, but I do feel like a different person, in a way I become a different person. One of my friends always used to describe this as a sparkle in my eyes that would disappear the moment the methylphenidate would start working, and he is right, I do miss a sparkle in everything when I’m on medication.
Methylphenidate erases all emotions in the hours they are active, and sometimes this is a good thing but imagine a life not only without sadness but also without any joy. When I take my pills, feelings become irrelevant, they are no longer important and everything turns into facts. I stop feeling. Even on my most sad days, as soon as I swallow a dose of Ritalin, I can no longer cry or feel sad, neither can I laugh or really enjoy something, the pills make everything blank, or neutral. Without emotions I am not longer able to have a nice chat with another person, because it won’t make me feel nice, I no longer see the point of it. Without emotions I am not longer able to tell what I want, to listen to myself, I loose my opinion on things, I no longer care. I can no longer enjoy the little things nor the important things. When I take my medication I can no longer love, not anyone and not anything.
The lack of love results in a lack of passion. Without my medication I am a person that is truely passionate about the things I do. Whether I work, paint, read, talk, or kiss I do it with everything I have, I do it because my whole body and my whole mind want me to do it but due to methylphenidate this feeling disappears. A passionate kiss turns into a vague touch of lips, a conversation becomes a thing I do because someone is asking me something, it is no longer a opportunity to get to know the person that I’m talking with, nor a way to show the other person what I really think or who I really am. Even in my work there is a major difference between what I do between 9 to 5 and what I do outside of these hours. I might be more productive when I take Ritalin to help me, but when it comes to quality of design and creativity I am much better without the pills.
The lack of passion also makes it much harder to do things, or to see the meaning of doing things. Things become less interesting, life looses it’s colors. In a way everything becomes a sum up of things I have to do, without any challenges or interesting aspects that are created by emotions and passion.
This is a thing I am not really struggling with as much as all the other things I will discuss, but taking Ritalin every day really means giving away some of my freedom. In order for the pills to work properly I have to take them on the same time each day, which means no sleeping late in weekends or on holidays. Besides, if I go on a real holiday, in a different country, I have to plan this months before, because it is not allowed to take my medication into a country without at least 3 documents that say I need my medication for medical reasons, to proof I’m not a smuggler. And then there is the drinking, I can not drink when I have methylphenidate in my body, I accidentally did this twice and both times I was hallucinating and paranoid. Alcohol can increase the concentration of methylphenidate into the body and this is what happens to me, even after one glass of wine. I can not mix the two, but I am also not able to go for a party and drink till late and then take my medication the next morning, when there is still alcohol in my blood. I have to be careful and think about my medication with everything I do in my life.
The things I get for free – unfortunately
Methylphenidate comes with a very long list of side effects. For the pills I take even sudden death is present on the list for 0,01% of the people taking this medication, I think this is the same percentage as there is for getting pregnant while taking birth control pills every day, and I do know stories of this happening, but what to expect from a drug that was first used by someone with low blood pressure but perfect (I guess) mental health.
This image shows the long list of side effect that come with my medication and in green I have marked the ones that I experience, some everyday, some once in a while. For me, still, the amount of side effects is extremely shocking, and even more shocking is the amount of them that I actually have to deal with. Whenever I look at the side effects of other drugs the lists are not only much shorter, but also the occurrence of them is much lower. Methylphenidate has side effects that are experienced by more than 10% of the people that use this medication. I feel like with methylphenidate there is no chance to have no side effects, they will always be there. I wonder if I should still call them side effects, because it seems like some of these seem to be just the way in which this medication works.
The scary things
I notice a lot of scary things that happen in my body when I take methylphenidate. The first thing is that my heartbeat speeds up, not too much, the numbers are still ok, but it speeds up, I can feel it speeding up and in a way my heartbeat tells me when my medication is working or when I forgot a pill. Besides, and probably related, is dizziness. If I take my medication I know I should not stand up too fast, because if I do, I will get dizzy and I will see stars. Another thing is that since I started using Ritalin, my pupils response to light has decreased. Often I’m blinded, and almost always my pupils are dilated, and maybe related to this are the migraines I don’t have very often but I never had before my first Ritalin.
Besides these long-term and everyday side effects I also have bad days, that have even more scary things. About once a week, when my last pill is wearing off, I start shaking, sweating and feeling disoriented. I have spend many doctors visits on this problem but all without results, the cause remains unknown and so does the solution,so once a week around 5 PM I have to lay down for about an hour until I feel normal again and besides all of this I have headaches very regularly.
I can not remember a single time I was able to enjoy food while my medication was working. Usually I love food and I love cooking, but once the methylphenidate kicks in, there is no longer need for food in my body, I don’t feel hunger, I don’t taste, I even become nauseous very often and I can not remember the last time I did not have diarrhea. From 9 AM to 5 PM I have to force myself to eat, I have to set alarms and reminders, have prepared food around me and people that take me for lunch because otherwise I just won’t eat. I have spend so many days in my life without eating, especially the year I was also taking a pill in the evening (worst doctors advice I’ve ever had!) I missed every meal. You would think that this is a nice way to stay thin but the opposite is true. Because of all these years of not eating until after 6 PM, or not at all, my whole body is destroyed. And whenever I do give it food it tends to hold on to the food, saves it because it doesn’t know when there will be food again, so whenever I do eat normally now, I gain a lot of weight, and it takes months before my body is used to being fed and stops saving everything as reserve. Since I use Ritalin my weight has been jojoing all the time.
I notice that when I take my medication I show a lot of signs of nervousness. I am stroking my hair a lot, I start scratching my skin, I pluck my nails, I open my phone to look at the time about every minute, I can not look people in the eye, I start showing a lot of signs that relate to being nervous. Before my medication I was far from being a nervous person, I can not say I was calm, I was from from calm, but I was never nervous, never anxious. When I now need to go somewhere I have never been I try to find out as much as possible before going, walk around the building in google maps, look for pictures of the interior, maybe even a floorplan. I need to prepare myself and still I’ll be extremely nervous about going, no matter how much I prepare. Before I started taking methylphenidate I would not even try to prepare, ask for directions on the way and just go, without thinking about it. I am now not only nervous about new places, also conversations, crowded places, public transportation, groceries, appointments, phone calls, cycling, speaking, drawing, writing, well, basically everything can scare the shit out of me on a bad day. This nervous and anxious version of myself is hard to see, hard to understand, because it’s so far from the person I am without my medication.
Life between 9 AM and 5 PM seems numb. Not only when it comes to emotions, but also physically things become numb. Some days it feels like the filters that are created with the help from the Ritalin are too strong, everything seems slower and more vague. There are days that parts of my body become numb, my foot, a finger or my complete arm. Often this is caused by the extreme hyperfocus I can experience due to my medication. I don’t feel discomforts, or I don’t pay attention to them until it has gotten too far and a part of my body has become completely numb. This also counts for other, more external sources of input. Whatever someone will say to me, it will take at least 4 times as long as usual before the message has entered my brain and I can respond. I really notice this when I’m boxing, which becomes almost impossible when I take my medication. My trainer knows that when we train between 9 and 5 he has to take 4 extra seconds for everything, even when he is about to punch me in the face, I will not respond immediately due to the delay that is created by the methylphenidate. It is like my artificial filters don’t do their job properly, even the things that need to get in get lost somewhere, at least for a little while.
The last thing about numbness, a thing that nobody really talks about, is that I am not able to have an orgasm when I take methylphenidate. This must be linked to the missing passion and emotions, but also to the crappy filters that are all caused by the pills. When I’m on medication I don’t often feel like having sex, I don’t feel the need, which is a big contrast to how I normally feel about sex, I love it and I could do it every day, at least once, but just not when I’m on Ritalin. I don’t feel the need, even on the days I feel horny when I wake up, as soon as I take the pill the feeling disappears, and it won’t cross my mind until the medication is wearing off in the evening. But sometimes I decide to just try it, to have sex between 9 and 5, not because I feel like doing it, but because I figure I most be wanting to do it because it has been a while or something. Sex with methylphenidate in my blood is the worst thing there is, I just can not enjoy, I just don’t feel, I don’t experience the other person the way I do usually. It seems that my vagina gets numb, the nerves that cause the pleasure of an orgasm don’t exist anymore, in this moment I can not even believe that the way I’m touched than is the same as what usually causes an orgasm. I know I can live without sex from 9 to 5, and I know I can still enjoy enough when I’m not on Ritalin, but it shows clearly the numbness in my body, caused by the Ritalin.
Is this all worth it?
Yes, it is. All these side effects may sound like a lot, and to be honest, there are many more I did not even describe. But still life with a minimal dose of Ritalin a day is better than life without. In a way it is good it has taken long before I got my diagnosis, because of this I know how hard life without medication is, I know how I tried to run away, I know how I tried drugs and alcohol to just feel a little less of chaos. I am happy that I started taking my medication when I was old enough to be in charge of the amount of medication, old enough to tell my doctors when it was too much or when it was too little, old enough to understand the bad things, but also see the things it helps me with, and old enough to balance these things and consciously decide what is the best for me. I know I have to deal with a lot of side effects but as long as the medication also makes me able to create just a little bit of space in my head so I can be myself, I am still willing to take it. What I often forget, but what is really important, is that the Ritalin does not just work from 9 AM to 5 PM. If I would not take my pills during the day, I would not be able to do what I do in the night either. Because I take my medication there is a balance, and because of this balance my ADHD devil never gets enough control, also not in the hours my medication is not working. As soon as I take less Ritalin the balance gets disturbed, and I might have a nice afternoon with emotions and a glass of wine, but I will start paying for this in the night, when I’m not able to sleep or when I yell at a friend without thinking first. If Ritalin is what makes me balanced, it is worth feeling less good for 8 hours a day, because the other 16 I will be the best version of me, a version that would otherwise not exist and a version I can not live without.