Cautiously Optimistic

November 24, 2024

I’ve Been on an Adventure Lately

There have been some ups, some downs, and quite a bit of time spent stuck somewhere in the middle.

When I finally saw my doctor, I was prepared. I wanted to go in with a thoughtful plan and a clear idea of what I wanted to do next so that there would be no ambiguity in our conversation—at least not on my end. I know I struggle to advocate for myself. Avoiding conflict, confrontation, or rejection is always my first instinct. Preparation is my best weapon against that instinct.

Needless to say, I gave my plan a lot of thought and ultimately decided I wanted to try stimulant medication. I was prepared to start slow, pursue recommended behavior changes, and reduce my cannabis use. I was also open to changing my mind if it didn’t feel like the right fit. So, after answering more questions about my sleep and caffeine consumption, promising to monitor my heart rate and blood pressure, scheduling another ECG two weeks into medication, and booking a follow-up for three weeks later, I left with a prescription for Vyvanse.

Almost immediately after starting on a subclinical dose, I noticed a difference. I was using my time more effectively, feeling more energetic, and experiencing less of my usual social anxiety. While I was feeling phenomenal, I still couldn’t quite turn off the part of my brain whose sole purpose seems to be overthinking any good feeling and questioning its validity. So, while the first two weeks on medication felt like a success, I couldn’t help but wonder—was it just a placebo effect? Was I just trying harder to stay on task because I wanted the medication to work? Maybe it was all just a temporary wave of productivity and hyperfocus spurred on by the newness of it all. I had no choice but to wait and see.

Unfortunately, I didn’t realize how much waiting there would be.

After my second week on Vyvanse, I was ready to try an increase. I had started at 10mg in week one, then increased to 20mg in week two. Midway through week three, I was registered to compete with a team in a women's jiu-jitsu tournament. I’d been training regularly since starting the medication and had been monitoring how I felt during and after training, with no issues. But I knew the intensity of competition was different. I didn’t want to risk adverse cardiovascular symptoms during the tournament—and I didn’t want to have any extra worries on competition day. That alone would be enough. So I held steady at 20mg until the following week.

I’d love to tell you the competition went off without a hitch, but that wasn’t the case. Still, I don’t think it had anything to do with the medication.

First of all, I lost my first match in under a minute, and ultimately, our team came in last place. But none of that really mattered. We were three hobby athletes with a combined weight of only 400lbs—spread evenly between us—usually competing in the masters category (ages 35–45). This tournament, however, featured opponents who were not only bigger than us, but younger too. Still, we put up a damn good fight and deserve to be proud.

That said, after my second match—which I won, by the way—I sat down next to my teammates and immediately noticed all of my toes and part of my feet had lost circulation and turned white. On its own, this wouldn’t typically concern me—it happens sometimes when I get cold—but I was dripping with sweat. I started to feel lightheaded. As my teammates noticed the color drain from my face, I recognized the feeling in my head as the one that precedes fainting, and I chose to lie down.

Truth be told, I’m not sure if it was adrenaline, a drop in blood pressure or blood sugar, or something else entirely. It was an experience I hadn’t had in years. Thankfully, after some supine-time, drinking electrolytes, eating some dried fruit, and having a cry, I started to feel better—well enough, in fact, to finish two more matches. One was a slightly less speedy loss to the same opponent as my first match, and the last ended in a draw. By the end of the tournament, I felt like myself again and was bursting with pride. Of course, the unconditional support of my team, a soak in the hot tub, and a delicious dinner with the girls helped too.

I was pleased with my decision not to increase the medication at that time. I still don’t know if it had anything to do with how I felt that day—maybe I didn’t eat enough breakfast, drink enough water, breathe properly while fighting, or maybe I just pushed myself really hard. It's hard to say. Ultimately, after I got home, I decided to try another increase.

My first week on 30mg did not go off without a hitch. But this time, I knew it wasn’t just about the medication. It was the trauma.

Forget this Whole ADHD Business...

October 20, 2024

I was originally booked to follow up with my doctor about my ADHD assessment in mid-September—the day before my much-anticipated girls’ trip to Austin, Texas, where I was attending a three-day women’s jiu-jitsu and wellness retreat.

True to form, in the days leading up to my trip, I overstretched my schedule and was feeling beyond overwhelmed with everything I had to do before I left. In my frazzled state, I decided to reschedule my appointment for after my trip. Thanks to the state of our healthcare system, that meant it would be another month before I’d see my doctor.

Ultimately, this delay turned out to be a good thing. It gave me the time I needed to really think through my options.

When I first walked out of my psychiatrist appointment, I was flooded with relief, just knowing that there were options. I quickly made a plan to explore them, starting with a break from cannabis. After that, my initial idea was to begin treatment for anxiety and, depending on the outcome, proceed to explore treatment for ADHD afterward.

But as I took more time to consider my options, that plan didn’t feel quite right.

After six years in therapy and countless hours spent reading, writing, and learning about mental health, anxiety, personal development, mindset change, attachment styles, grief, trauma, and behavior change—I’m not going to say I’ve mastered my anxiety, but I’ve definitely developed a vast and powerful skill set to help manage it.

I’ve used those skills time and time again, and they’ve helped me accomplish and experience so much. I’ve left relationships that didn’t serve me and developed deeper connections in relationships that do. I’ve changed many patterns of thinking and incorporated new behaviors that nourish me—mind, body, and spirit.

Do I still get anxiety? Absolutely. 

Does it sometimes get the better of me? Sure. 

But overall, I no longer fear ending up in a situation where anxiety takes the wheel.

When I shared my diagnosis with a good friend—who also has ADHD—she reassured me: “Of course you’re going to have anxiety. Having untreated and unacknowledged ADHD would make anyone anxious.”

At first, I felt a little defensive. It was like the idea that my anxiety might be caused by ADHD somehow diminished the validity of my generalized anxiety. I had subconsciously decided that anxiety was the real problem—so maybe I could just forget this whole ADHD business after all.

But she was right.

The more I thought about it and reflected on everything I’ve done to manage my anxiety up to this point, the more I could see that the things I still struggle with are different from—but just as valid as—my anxiety.

As I came to that realization and inched closer to my rescheduled doctor’s appointment, I had some decisions to make.

I See The Sun on The Horizon

August 11, 2024

It’s been about ten days since I had my consultation with the psychiatrist, and let me tell you—it’s been a trip.

Unlike with my doctor’s appointment, I tried not to put too much pressure on this assessment. Still, going into it, I was overwhelmed with anxiety. I had never spoken to a psychiatrist before and didn’t really know what to expect from him or the appointment.

I did get a chance to speak with my therapist beforehand, and she helped me mentally prepare. She reminded me to focus on the difficulties that I experience, like decision-making, procrastination, and time management, for example.

The appointment itself went well. The psychiatrist was kind and soft-spoken. His tone felt non-judgmental, and he genuinely tried to understand my concerns. He asked why I was seeking an ADHD assessment, and I shared the difficulties I had discussed with my therapist.

He asked about other areas of my life—my work, relationships, and family—and explored my mental health from various angles. We talked about my cannabis use, and I tried to be as transparent as possible. He asked about other substances too, and I mentioned my family history of alcoholism.

I also shared that I’ve experienced trauma and that I’ve been working with a therapist for many years. He responded with compassion but didn’t press me to go into detail about anything I didn’t want to.

We talked a lot about my anxiety—something that’s been part of my life for as long as I can remember, though I only began recognizing it for what it is in adulthood. The anxiety has been with me since I was a child, but for a long time, I didn’t have a name for it. I didn’t know what it was until therapy, and even then, it took me a while to realize that my level of anxiety wasn’t just “normal.”

There have been times in my life when anxiety took such a strong hold that it controlled everything—my thoughts, my actions, even my appetite and my bowels. At its worst, anxiety would rampage through my guts, and I’d sweat and hyperventilate until I felt like the only relief came from purging it physically.

Thankfully, it’s been a while since I’ve experienced anxiety to that extreme. I have therapy, supportive friends, plenty of personal development and consistent self-care to thank for that—as well as changes in my relationships and other life circumstances. Still, it’s fair to say that anxiety continues to drive a lot of my thoughts, behaviors, and habits.

I’m in a wonderfully supportive relationship now. Recently, my partner and I went to see Inside Out 2 in theaters. He and I often joke about our relationship dynamic—because while we have a lot in common, we embody very different energies when it comes to managing stress and problem-solving, and the way we each move thought the world. I’m the highly anxious, emotional partner, and he’s the calm, logical one.

In truth, I think our dynamic has created a beautiful balance. But that’s only possible—at least on my end—because I’ve done the work to be able to share my anxieties and emotions with him. And he’s learned how to support me without trying to fix everything.

If you haven’t seen the Inside Out movies, I won’t spoil them, but I definitely recommend watching them. In Inside Out 2, several new emotions are introduced, including anxiety. Watching the frazzled little anxiety character run frantic circles around the others, trying to come up with preventative solutions for every possible problem the main character might face—I felt an intense wave of recognition.

As anxiety spiraled on the screen, my boyfriend rested his hand on my knee, and I felt hot tears welling up. He looked at me with an understanding smile and a wink, and said something like, “Hey babe, it’s you.”

Seeing that little creature scrambling to prepare for all the “what ifs,” trying desperately to protect her human from discomfort, hit me hard. Sometimes I forget that anxiety often still fuels my action. Even after all the work I’ve done to manage it, it will always be part of me.

As my consultation wrapped up, the psychiatrist shared his thoughts and offered some options:

“It seems likely that you do have ADHD, but it can be difficult to say for sure because of your anxiety.”

He had me complete some assessment forms for Generalized Anxiety Disorder and, with what sounded like certainty, told me I have GAD—even though, through therapy, I seem to manage it fairly well.

“The way I see it, you have a few options,” he said. “You can pursue treatment for anxiety first, and see how that goes. From there, you can decide if you’d still benefit from ADHD medication. Or you can try ADHD medication first, and go from there.”

He also noted that cannabis use can complicate things, explaining:

“Prolonged cannabis use can cause anxiety. And it’s not recommended to use cannabis while on ADHD medication, because the two work in opposing ways.”

He added:

“If you’d like to take things slowly, I recommend taking a month off from marijuana. Then, you could consider starting either an anxiety or ADHD medication at a subclinical dose, and build up to a low clinical dose over a month. We’ll reassess as you go.”

Ultimately, he left the decision up to me and said his report would be sent to my doctor within the week. I could then discuss next steps with her.

When I left the appointment, I felt like a weight had lifted. I drove back to my neighborhood, picked up a pre-rolled joint at the local pot shop, and smoked my last one—for the next month, at least.

I haven’t fully decided what to do yet or what my next steps will be, but for the first time in a long while, I feel hopeful—just to have options.

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I can’t begin to describe 

The relief I felt 

When the doctor who just met me 

Gave a name to my experiences.

I’m not just sensitive. 

Not just a people-pleaser. 

Not just traumatized.

I’m not just disorganized, 

Not just someone with poor time management, 

Not just someone who talks too much.

I have options. 

Wow.

I didn’t think it would feel this good. 

I spent so much time getting to a place 

Where I could even accept that I might need more help.

To decide that maybe, just maybe, I don’t just need to work harder. 

Or build better habits. 

Or take another course. 

Or stop being so fucking lazy. 

Or stop getting so stoned. 

Or stop being… whatever it is I am 

That just hasn’t been quite enough.

I thought I simply needed to find what was broken, 

And fix it.

But I am not broken. 

I just need a little more help.

I haven’t felt this mix of relief and validation 

Since the first time my therapist told me 

That my difficulties made sense, 

Given my history.

Before moments like these, 

I used to gaslight myself.

Telling myself it wasn’t that bad. 

That I just needed to do better. 

Be better.

And in some ways, I did. 

I approached self-improvement 

From every angle available to me.

But the biggest shifts 

Always came 

When I asked for help 

And received it.

And now, 

Finally 

A name for it all.

New avenues to explore 

I see the sun on the horizon.