Episode 20 – Medication and Psychiatrists

Jane McFadden:
Hello and welcome to the next episode. For a while there on this podcast I started to feel like I needed to be a bit more professional, I needed to be a bit more together. However, the beauty of becoming a little bit more comfortable is I’ve become a bit more outward with my true personality, which was a bit of a clown to be honest, which is one of the reasons that I wanted to do a podcast on ADHD from a regular mum point of view, because I felt like there’s so many expert podcasts out there who are awesome.

I don’t want to compete with those people, they are there and they are killing it. But what I wanted to do and what I found when I got my diagnosis and I immediately went searching for information was it just that wasn’t that relatable. They would bring in a story and I’d be like riveted like seeing myself in it and having more questions, but there wasn’t enough stories around and there wasn’t enough Australian podcasts around.

For me I wanted to hear about typical Australian women and I was desperate to meet someone or talk to my friends about it and when I became really outward about who I am, how I was feeling, I felt more of a level of acceptance that I’d had before and maybe it was a relief too, you know, to not have to have it all together and to have people that understood and we could have a bit of a laugh about it. So for me I really wanted to bring in who I am and I want to really acknowledge right now that this episode on medication is from a personal perspective. Clearly you need to see a psychiatrist, clearly you need to visit a GP.

The only reason I’m doing this episode is because I really want to acknowledge that there’s a lack of resources around for people. Even if you’re lucky to have the thousand dollars that you need, you might not have that resource available in your local area, you may not be able to get in for a year. A lot of people are battling to get into any care at all.

I want to talk about my personal experience today that you might resonate with, you might not. Regardless whether you resonate or not, it’s always best to talk to your doctor. However, I was answering a lot of inboxes with the same questions and I felt this is a great opportunity to put it out there.

So in the Facebook groups what I see over and over again is women particularly asking a lot of questions around medication, dosages, how it’s working, what effects to find, what to ask for, because people are obviously nervous. They’ve been waiting a long time for an appointment, they finally got their diagnosis, they’re ready to go and they don’t know what’s going to happen. And one of the ways that we combat anxiety is to look for more information.

So I’m hoping to give some more information today and hope that it helps somebody. If you haven’t listened to the podcast on how to get a diagnosis, I recommend highly that you do that first. If you’ve listened to that and you’re like, okay cool I’ve got my diagnosis, what do I do now? Then this is a good podcast for you.

Jane McFadden:
My personal opinion, I think there’s two groups of people that are looking for a diagnosis. I think number one, you could be in the group who are not a hundred percent sure that you have ADHD. You’re looking for information, you’re finding similarities, you’re just not sure.

Is it ADHD? Is it ASD? Is it depression, anxiety? I don’t know, I’m confused. I don’t understand what’s happening and I need more information. You’ve got lots of questions, you might have a little bit of a family history, you can see yourself in some parts but not in others and you’re questioning, you’re questioning.

And you would like to see a psychiatrist or a psychologist, you don’t know which one. Two is I know that I have this. My family has it, I’ve never read anything that makes more sense to me. I know that I have ADHD, I can feel it in my soul and it makes sense every step of my life and I know that I would like to get some help right now and I’m impatient to get it. Maybe you have a verbal diagnosis from a registered psych already and you’re pretty confident that you’ve got it but you’d like to try medication. So there’s really two routes, you’re either sure or you’re not sure.

There’s really a couple of paths forward at this point. Obviously the clinical psychologists all really believe and want everybody to go through a neuroaffirming psychologist assessment. Price-wise they’re around $1,500 to $3,000. They can be done in person or online. They can be done in anywhere between three, five more sessions. It’s obviously very reliant on the psychologist and what they believe works.

Now by the way I’m friends with a few clinical psychs that do this work. Tell you they are pretty cool people. I do recommend that highly. However you don’t need a referral because you don’t get a Medicare rebate on this one. So for a psychologist assessment the $1,500 to $3,000, I’m not sure you have to give your private health a call as to whether they would cover some. I know that they don’t for Medicare.

Benefits, my point of view, is that you get a full understanding of who you are. I actually haven’t done one of these assessments because I was diagnosed by a registered psych in therapy for burnout that I was already kind of in. I haven’t done one of these but I messaged Jacinta Thomas who I highly recommend recently and I was like, I still think I want to do one.

Obviously price is always a factor in there but for me I wanted to really run through my life, how it worked, why I am the way I am, the challenges, the ups and downs, the roller coasters and be more aware. So for example, sensory processing disorder, I know that I have that now. It’s made a massive difference with my kids, with my husband to have an understanding of that.

My husband and I have a great relationship. So for example, one of the things that he would say to me is you’re not a very affectionate person and you know we all know men what they’re really getting at they are but also he means like just genuinely, like he wants to have a bit of a hard touch. It’s not always about sex, it can be about just feeling affectionate.

For me, especially having children, before having children I feel like I was a bit more affectionate. My husband probably begged to differ on that but afterwards really having kids on top of me, crying, sensory overload, which I didn’t know was sensory overload. So we had three kids.

I was like seven years deep into parenting when I figured out I had this. Solves a lot of questions around my middle son who cried for six hours a day every day for like three years. So obviously a bit of mending happening there.

Even when he cries now I just have this get away from me vibe. Anyway I digress from what we’re talking about soon as you get back onto that. But basically when my husband goes out to touch me, particularly if I’m not medicated and my mind is flying and we’ll get to that later but anyone on this podcast knows what it’s like when your mind flows.

Like it’s flying, it’s a hundred miles an hour. I am not very present a lot of the time because my mind is working so quickly. And then if my husband comes to touch me in the middle of that I’m like get off me because I’ve got so much going on. From him looking at me he’s thinking oh she might be up for a hug here and I’m like not up for a hug because my mind is flying.

So having a neuroaffirming psychologist assessment could be really helpful to explain yourself to others, become more aware, know who you are. I think that’s awesome. I love that. However we need to be mindful not only not everyone has between $1,500 to $3,000, not everybody has three to five sessions in them and not everybody necessarily wants to have an understanding either. Sometimes there can be a lot of grief in that.

Sometimes people don’t want to unpack it. They just want to move forward and that’s cool too. So with the neuroaffirming psychologist assessment if you are somebody who’s already on the NDIS, let’s say you’ve been diagnosed with bipolar, borderline, schizophrenia. Let’s say you’ve got really severe depression, really severe anxiety and you’ve managed to get on the NDIS.

A neuroaffirming psychologist assessment, I don’t know if it’ll be covered by the NDIS if you ring them but I do know that report can be used by them. So if you’re on the NDIS, ADHD isn’t a primary diagnosis. You can’t just have ADHD and get on the NDIS but you can have it added. So if you had ADHD added you would be able to do therapy types for ADHD. You could go to get an ADHD coach. You could get some sensory overload like maybe get some earplugs, something like that.

So with the neuroaffirming psychologist assessment you also need to be aware that they cannot prescribe medication. So let’s just be really aware here they’ve got their place.

God I love them. They do the NDIS and they also can do therapy with you afterwards. It’s a good idea to ask about that if you find things you want to work on. Are they able to do that with you? Personally I love myself a person with lived experience of being neuroaffirming. So that means that they are somebody who has ADHD or ASD or another neurodiverse disorder condition whatever you want to call it but they can’t do meds. So just be aware that if that’s the end of it and you get to the end and you ask them for medication they’re just not going to be able to do that.

If you do go and get a neuroaffirming assessment it might be a good idea to also contact a psychiatrist and just get on a wait list. That can be a really positive thing to do as well.

Jane McFadden:
So number two, psychiatrist.

If you are somebody like me who is hardcore and patient and you just want to get there and you just want to find something anything at this point to help you, psychiatrist is definitely a bit of a quicker way forward. You’ve been to see a registered psych or you’re just convinced that you’ve got ADHD and you know that’s what you have. Maybe you’ve heard great things about ADHD medication and you’re like oh my god I’ve waited like 40 years for this just give me the meds I want to try them.

Often a lot of people feel like that because they’re quite short acting so you know they only last three or four hours. Someone recently said to me in one of the interviews it’s like an ADHD panadol they only last for three or four hours. So you know you don’t have to commit to taking them for three months and then try and figure out if you’ve got an effect or not and have a withdrawal.

It’s a pretty low bar for entry you just literally can take it and see how it feels for you which I love it’s about the only easy part about having ADHD the medication when you can get it. Let’s just get back to that but it’s not a big commitment of time and it’s not like a big lifestyle change and also you don’t put any weight on a lot of the time with antidepressants you put a lot of weight on. With stimulants a lot of people do find that they’ve got an appetite suppressant which everybody needs to eat healthfully don’t get me wrong but I do find that I don’t eat from my kitchen lunch boxes as I’m making them.

When I do take medication everyone will probably you know you’re like oh one pretzel for the lunchbox one for me. So be prepared with a psychiatrist that they might not read the psychologist report. So I know a few people have said that to me that they spent a lot of money on this psychology report they felt that they had a really good expression of their ADHD in that report and they walked in the psychiatrist put it to the side and then proceeded to just do their own diagnosis.

That could be really confronting if you were kind of relying on the report to speak for you. Some people do find a lack of confidence with ADHD which is probably a self-esteem thing so just be prepared that you might need to bullet point it for them maybe write a few things down in your own words because perhaps from their point of view I’m not a psychiatrist I wouldn’t know they need to do their own assessment. Perhaps they don’t want to go off a psychologist report perhaps that’s part of it for them they’re handing out the medication.

You are going to need a referral for a psychiatrist and often they won’t even triage you without one so that can be difficult because you go to your GP and you’re like hey can I have a referral for a psychiatrist and they give you one that’s booked out for two years or not taking new clients. A lot of people don’t want to take an ADHD client too because there’s a fair bit of maintenance you know you need to follow up with dosages and medications so for some psychiatrists they’re like no no I don’t really want those clients.

So I always do it the other way with a GP I always call around look in the mums groups or the Facebook groups ask some questions find a psychiatrist that suits you and then get a referral afterwards otherwise you’re gonna be bringing up the GP 50 times probably literally 50 times changing the referral.

I think it’s really important to mention here that there’s two types of psychiatrists so there’s a telepsychiatrist and there’s an in-person psychiatrist both of them are completely different in my opinion. Let’s just recap for a moment so either one of two people you either want to do a proper diagnosis in person you’re willing to waitlist for quality and drive a distance that means that you are looking for somebody an in-person psychiatrist you are one of those people my friend get ready to wait because that’s where you are.

The other type of person as we pointed out earlier is I know I have a diagnosis I’ve been verbally diagnosed by someone else or I’m very confident I’m feeling good about it and I can advocate for myself there’s two people the first group of people that want to be in person you really need to ring around a lot be prepared to drive and make sure you do your homework about who that person is.

I hear a lot of stories people wait 6-12 months they drive they drive a long way they get there and this person is like oh no only hyperactive eight-year-old boys get ADHD and they they just misdiagnose them with something else and they leave and they’re completely let down there’s nothing wrong with not being diagnosed with ADHD not everybody has it but if you don’t get the diagnosis then we just want to make sure that the person that we get really has the chat to us really understands where you’re at and they are very aggressive with their approach and their education around ADHD because you can’t make that assumption just because they’re a psychiatrist.

So if you are going to go down that in-person route I would be very careful who you choose really look at that although I’ve had some guests on our show who swear by their private psychiatrist who said they’re an absolute legend and I wish I had one of those to be honest unfortunately I don’t.

The in-person ones you do need to be aware if you are doing medication you know they might say we review you in eight weeks you go out to reception they don’t have an appointment for six months it is slower I think we need to acknowledge a private in-person psychiatrist is a bit slower but if you get someone that’s high quality maybe that doesn’t matter for you.

I had a look online I’ve done a bit of research obviously everything changes you know per clinic but what I have had a look at is for psychiatrists in person if you’re going to do an ADHD assessment it’s $980 over two sessions this is a couple of clinics I looked up in Brisbane different areas might be slightly different it is very expensive the total Medicare rebate you get back for both sessions is $316.

Now I’m not masking my lack of calculation ability anymore so I’m just gonna let you know I just got a calculator out because I can’t do that in my head for those of you who are driving or washing up dishes and are like what does that mean I don’t know can you just tell me what that is that’s $663 out of pocket for a ADHD assessment just in Brisbane in an in-person clinic.

Now if you were to do a follow-up with that same clinic so let’s say you get your assessment they say yep you’ve got ADHD come back for a follow-up to discuss medication because I probably won’t do that first one you know you’ve got to wait which sucks but okay so let’s say you do that your follow-ups are going to be 15 minutes is $180 with a Medicare rebate of $39.55 so that’s about $140 for 15 minutes.

Now be aware I haven’t seen any psychiatrists actually do 15 minute appointments generally they do 30 minutes and then don’t you love this what they actually do is you have to sit there while they do their paperwork and you have to wait so you talk to them for five minutes and they spend 25 minutes doing paperwork and for that privilege that’s a 30 minute follow-up is $280 total the Medicare rebate if you’re eligible is $78 which I’ve just done the calculator is $201.15 per follow-up.

That’s for in-person just a Brisbane appointment obviously getting the appointment is difficult and the follow-ups can be difficult to get in however if you find someone quality that might be where you’re at if you’re someone who’s not sure that could be a good way to go about it if you’re not sure you also could go to the neurofirming psychologist get sure and then you can go to any psychiatrist you like but if you are unsure you probably want to pick a quite a good one in person and then they will be able to do the medication as well.

The problem with the neurofirming assessments is that if you are financially not in a great position let’s say you get a deal on the neurofirming assessment that’s two and a half grand then you do your psychiatrist appointment for the assessment you’re up to three and a half grand you get a rebate you get a couple of follow-ups to get your meds I’m not very good at math but you’re looking at quite a bit of money.

In my experience we’ll get to this not always the medication that works for you is the first one offered so then you’ve kind of got to go back a fair few times which is very costly. I’ve had a couple of people on here that have chosen to go unmedicated because they haven’t been able to get the dosage right and they just can’t afford to go back all those times to get a slightly different script and play around with it and so they choose to go unmedicated. That’s obviously up to them I’m just giving information on the process.

Jane McFadden:
Your other option for psychiatrists is a telehealth psychiatrist. There’s a pretty big difference between telehealth psychiatrist and an in-person one. First one would be the speed. I see a telehealth psychiatrist. I won’t say who they are because I probably wouldn’t really recommend them.

You can get in you know three weeks, two weeks. It’s not a very friendly process. They send you an email with all of these things you’ve got to do which is really hard to navigate and confuses you. You have to do all those questionnaires and then send them back in one email and pay like so much money up front to see this person that you’re probably not even sure is very good.

One good thing about the telehealth psychiatrist is if you know that you have it and you’re pretty textbook they will kind of mark you off pretty quick. The assessment tools are pretty good in some ways because you get to write a lot of it down, you email it back, they say they’ve read it whether they have or not I don’t know.

They rang my husband for five minutes which was pretty funny because they’re like oh can you make sure you’ve got someone around, a family member, like we want to talk to someone. And I was like oh okay that’s a bit weird. I told my husband the completely wrong time so then I said to the psychiatrist oh I’ve told him wrong time he’s not here and then he had to call him on his mobile.

And I think it was very ADHD of me that I got the whole thing completely confused which was funny. So I actually was on speaker which I also thought was weird. So he rang my husband on Zoom then put him on speaker so I could hear what my husband was saying about me which was pretty funny.

He’s like oh what symptoms do you think she has and then I think he asked something else which was like really non-event question and my husband’s like oh I don’t think she’s very good at multitasking and she’s like walks off and leaves the rice cooking a fair bit. And then he said oh no you have ADHD. Diagnosed me in like under 10 minutes.

So that was good for me because I was pretty sure I had it, I was pretty comfortable, we had a good family history and I was pretty keen just to get to try the medication.

Total fees for the telehealth — it is a bit cheaper in some ways than not in others. So when I went it was $450 for an assessment. It’s literally gone up to $600 because I just checked it before and I was like I didn’t pay $600 surely for that and I just had a look and the email that I was given it was $450.

I just looked it up before and I was like didn’t I pay like $325 the other day for a follow-up? And I did. And I noticed it had gone up from the $250 it used to be. So I mean it’s gone up like six months. It’s out there to be honest the amount of money.

But I suppose what I really wanted to highlight with this medication chat is that it can be really expensive to keep going back.

Jane McFadden:
One of the problems that I found I was very frustrated with, and I don’t know if this is all psychiatrists or just the one that I see, he said oh we’re going to give you some Ritalin. And I said oh I’m pretty keen actually to try the Concerta which is the long acting.

So there’s two different types of medications. The first is dexamphetamine and then the second is Ritalin. So they’re both the short acting versions. A lot of people call dexamphetamine dex. So there’s Ritalin. So then they’ve got long acting versions as well.

So for me I had heard really good things about Concerta which is the long acting Ritalin. So you take one tablet in the morning and that’s pretty much it for the day. And he said no no I can only prescribe Ritalin. You are not able to have Concerta in the first script. It’s legally you have to try Ritalin.

So I took the Ritalin and I felt like I became aggressive. There was a very strong up. If you want to feel good oh my god the Ritalin was up really fast and I was down really hard too. So I felt the dosage was just so high like I think he did five 10 milligram tablets a day. I could only take half at a time because the comedown was so bad and then I was trying to like not take as much of it and I was still getting affected by the comedowns.

I felt really irritated but I also didn’t think I had a choice so I just kept on with it and then eventually I was like oh I think I want to try the long acting. So I’d already had an assessment and I’d already had a 30 minute consult to get this Ritalin so then I go back and say can I try Concerta and he’s like oh okay you can try Concerta.

And we had a like three minute chat about that and I said to him like what are the other options if I don’t like the Concerta? I said I’m reading a lot about Vyvanse and online and I’d really like to try that. He’s like oh no you have to try Concerta next. And I was like okay but if it doesn’t work what do I then do? He’s like oh you come back.

And I’m thinking okay it’s another $300 but okay. So I get on the Concerta and I take it for one day and it was like the walking dead was coming for me and my life was ending and we were all going to die soon. It was such severe anxiety.

I took it a second day just trying to figure out like what’s wrong with me, am I okay, is this the meds, what is this? It was second day I was done. I was like this is awful. Anyways then I was really frustrated because I’d already had a $300 appointment and 48 hours later I was like that didn’t work.

So I waited a few more weeks. I don’t know why. I went back to the Ritalin and I actually did that RSD story about it because in hindsight I think that was a Ritalin issue to be honest because I got so upset so quickly and I ended up yelling back. If you haven’t heard my RSD story online you can go back and check it out. But I wasn’t really feeling like myself and I thought well at this point I just need to try everything, like that’s what I want to do.

So I had a chat with my husband. He’s like holy moly this is getting expensive. And I went back and so I said to him look the Concerta gave me really bad anxiety I’m really not convinced Ritalin’s the right one for me can I try the other one I really want to try the Vyvanse which is the long-acting dexamphetamine.

And he’s like no no short acting is the best for you. I know people and they like to control how they feel. And he just he loves the short acting right. And I’m like oh my god I just want to try Vyvanse like I’ve said that from the beginning. Anyway so now he’s given me this dexamphetamine short acting and he said oh no you have to take it like four times a day or five times a day.

I have a bit of a problem with the dose that they give you. Like honestly he gave me this dose and I don’t know if it was that I read it wrong. Actually I’ve got the bottle in front of me so I’m going to read what it says. Oh my god it’s not even my fault. It says on here Jane McFadden take five tablets daily.

So I look at this and go oh five tablets daily. I think he might have given me like some kind of management plan which I don’t think I even got his email or maybe I don’t know ADHD right? I don’t know. I got the bottle and I’m like five tablets. So I took five tablets the first day and let me tell you I was flying.

My teeth were grinding. I ended up going back to the pharmacy and I was like oh I need a mouth guard because I’m getting a headache from all the teeth grinding. And they were like oh my god how much have you taken? They said that is not the right dose for someone who’s just starting out. Anyway I was actually supposed to be taking two.

Whose fault that is I don’t know if it was him or mine but I suppose if you’ve got someone with ADHD maybe don’t put five tablets daily on top of it. You might want to say see management. I don’t know. But so that first day was a bit of a ride let me tell you.

But I do find the dexamphetamine a lot more chilled. I actually played Uno with my kids the other day which I haven’t done for years. I’m definitely nicer, kinder, more compassionate, a bit more loving on the dexamphetamine for sure. I don’t find it such a ride.

What I do have a problem with is that I still would like to try the Vyvanse because pretty much having this tiny white bottle with me all the time is really difficult. I do kind of feel it when it starts to come off and I do feel a little weird or not agitated like with the Ritalin though but I do really feel it.

And of course I never have the right bottle with me and I actually worry that I’m going to lose the bottle and then I’m going to have to try and go back to the psychiatrist and convince them that I’ve lost the controlled substance. But it really feels like I’m going to lose this little white bottle because I’m constantly having to carry it around.

I suppose I could put some pills in a Glad Wrap bag or something and put it in my wallet but I don’t even carry my wallet around anymore. It’s just keeping up with the dosage is a real pain. I just emailed him before to ask if I could go back. How many appointments is that now like it’s so much money.

And literally you have to sit there for 30 minutes while he does his paperwork and you talk to him for such a short period. I don’t even find that he really problem solves what’s happening for me very often either. Like I’m trying to figure out the dose myself.

It feels like I don’t know if I need to be more open with him or I don’t know. I just I don’t find him mind-blowing. I really don’t. But I do know I can get in with him in under a week which might really say something about him. But I suppose for me I feel like I have the education and knowledge and body awareness to try to monitor myself and find my own dose.

I would love to have someone I could talk with a little bit more about, it’s a bit more experienced, which is why I’m doing this podcast because some people don’t have psychiatrists they can get in with or talk to.

Jane McFadden:
I ended up problem solving because I was initially taking half because I was worried about the comedown and I ended up taking the full one and I do find the effects to be better.

So when we talk about effects being better I really try and be specific not just I feel better. The effects for me would be having a clearer mind so I’m less distracted, I’m more able to finish tasks. Like for example today I’ve had my medication, I’m actually able to do this as opposed to plan it, think about it, open 60 tabs. And when I say 60 I’m not joking, I’m saying 60 tabs.

Open 60 tabs. I have two phones, one work phone, one personal phone. I start texting on both, I start things, I stop things, I think about things, I call people and I feel like I’ve achieved a lot sometimes but I often haven’t.

I do find on the dex I am able to do jobs that I don’t really like. So for example I’ve got to organize a few family things. My pet hate is doing events or having anybody at my house. Might be an ADHD thing, I’m not really sure, but I do find that to be quite triggering for me. I don’t enjoy it.

So I actually find that I can organize family events that we need to do a bit more easily, do jobs that I don’t like. So I do find that is quite good.

There is a little bit of a comedown in the afternoon. I do start to feel quite tired. Apparently then you have to pop up another one. Sleep-wise I don’t think it affects me if I take it much after 2:30, 3 o’clock. Once I start moving towards 3:30 I do — it does keep me awake.

And I’m one of those people, I like to go to the gym in the morning so I get up around quarter past five. So you know if I’m going to sleep after 10 o’clock at night it’s pretty late. So sleep-wise I think it’s okay but you just got to time it.

I read on Facebook the other day someone said oh you just got to time it like take it as late as you can so you’re pretty fresh for the bedtime but don’t take it so late that your sleep’s affected. So see what that is for you. Some people obviously are going to be a bit different. I think that’s just a balancing act.

So there’s pretty much two stimulants that there’s prescribed. For example if you took the Concerta and you had really bad anxiety sometimes they might prescribe you an anti-anxiety as well. So there is mixes, there are different options that you can do. But I’m just talking about this particular one.

If you look at the research on how a stimulant reduces hyperactivity, stimulants can actually turn down the chatter in the head and it also ramps up and switches our ability to be able to multitask. It makes it easier for us to turn back from one attention to the other which can be really difficult for us especially if something’s not interesting. It can help us be able to do that.

It also as well, if you think about the just absolute drain which is ADHD, so the level of exhaustion and just fatigue that you would feel in your brain, I feel like a lot of that is to do with how difficult it is for us to pay attention to all of the thoughts in our brains, the speed of which we’re working at all the time and how difficult it is to change tasks.

So for example if your thoughts are just like running, running, running about your kids and an issue that you’ve got and all these thoughts about whether you should email, what you should do, should you book them in for counseling, all of the thoughts, and then let’s say you’re trying to work, the amount of time and energy and stress to divert your attention away from where you feel it needs to go to what you should be doing — that can be really taxing.

The professional opinion is that medication makes that easier to do.

I also notice that walking around my house if I’m unmedicated I often get overwhelmed. I think about all the things I’ve got to do, I try to pick up things, I move things around, I think about different systems, I try and do some washing but I don’t really finish it, then I do the dishwasher.

If I’m medicated I feel that I just go I’m going to clean out the fridge, it really needs it done, and I just do it. That is a big difference.

It’s hard to put that into words sometimes if people go what is the big difference, do you get more done? It’s like you might not feel that you get more done but you might notice you get more outcomes. Might be more of it.

I know someone the other day, they were telling me they’ve been trying to do their PAFRA application for six months and they took medication for the first time and they just sat there and it was so easy and they just did it and they were like what was that?

It does feel a little bit more like flow state. And I don’t worry as much. I do find my anxiety is decreased and I have difficulty not being present, so I have difficulty worrying about things that don’t matter, whereas that’s obviously something that comes easy to most of us.

So I definitely feel there’s less anxiety. And I always said I wasn’t someone who got anxiety. I’ve really started to come to peace when I interview people who have anxiety. I’m like wow I actually feel like that most of the time. So I definitely don’t feel as anxious when I’m taking medication.

Jane McFadden:
So basically overall you know from the research that I’ve done it shows that your brain starts to work easier, it understands what to focus on, what not to, it directs you, it makes things easier.

Where you’re not, if you think about driving around your car unmedicated, could feel like your manual. You’re literally going, you’re really having to push, push from first to second to third to fourth up to fifth to really get moving. Whereas if I’m medicated I do find that I feel like I’m a bit on like automatic. Everything seems easier and it’s not as hard to move from one thing to another.

Definitely sometimes when I feel like my husband goes to touch me or one of the kids talks to me it’s difficult for me to concentrate because I feel like I have like heavy metal music going on in my brain. And obviously it’s not very nice for them because they probably don’t feel that I’m present, which I’m not, because I’ve got so much going on. Definitely feel more present when I’m taking medication, that’s for sure.

I’ve also worked in the canteen at school on medication and done it without. Very different experience. Being able to remember with your working memory, very different experience. You know like someone says can I have three Sprites and a hot dog and I can — it’s not never quick — but I can add that up in my mind, walk over to the fridge and 90% of the time I’ll get it right.

Whereas probably the anxiety of someone ordering, me having to remember and then calculate, like I don’t even really hear what they’re saying at that point, that’s probably playing in there a little bit a lot as well.

Okay so here’s a question that everybody wants to know the answer to I reckon is why would stimulants improve the symptoms of ADHD? There’s all these myths around it. I’m not a neuropsychologist, let’s not go into how the brain works.

If you want to understand more about it you can always look it up, look up dopamine in the brain and neurotransmitters and ADHD, read your heart out. I’m just going to make it really simple and remember I’m not an expert.

We’ve got dopamine in the brain. Now a lot of people with ADHD are quite addicted to the phone because you get a dopamine hit. We know with ADHD that you have low levels of the neurotransmitter dopamine. This is a chemical that’s released into the nerve cells into the brain.

Because of this lack of dopamine, people with ADHD are chemically wired to seek more. So we’ve got a heap of people who are just wired to seek dopamine.

So your question might be why would we want to seek dopamine? What are you talking about? Okay, so dopamine is linked to the reward system. It can make it really difficult to get a reward from ordinary activities.

So for example if you have a star chart for your kid to get ready for school, probably everybody hands up if your kid just like never uses it and it just like it’s the most wasteful hundred dollars you’ve ever spent, three reward charts that no one uses. Yep, that’s me too.

So ticking off a list might not be enough of a reward for a dopamine-seeking brain. It can be difficult for us to do the same activities that don’t interest us because we don’t have the same reward center in the brain.

Low dopamine can feel tired, moody, unmotivated. It’s linked to a bit of procrastination and you’re looking for dopamine to help you feel good, that’s what you’re looking for.

So you can be sitting in a low tired mood, unmotivated — this is literally my children — and then they’ll seek out dopamine hits to bring them up. And this is a biological thing, this isn’t them being naughty, this is just who they are as people. And having that understanding really helps you parent them a little bit better in my opinion.

So at times it can feel like it’s never enough. It can feel like your ADHD brain is craving, it’s craving dopamine, it’s craving that hit. And how do we get dopamine? It can be through like video games, sex, substances, shopping. Some kids with ADHD try to antagonize others to see what happens. It can be they’re just craving stimulation because they don’t have enough dopamine.

So for us to be functioning well we need our brain to be alert, receptive, and ready to attend and to learn, generally like a non-ADHD brain. So they can shift from activity to activity whether it’s exciting or a little bit slower pace. They’re able to continue, they can self-regulate and they have a decent amount of control over their behavior.

ADHD brains — not so much. We are motivated mainly by stimulation rather than what others think are important.

It really depends on whether it’s internal or external. If we want to do something obviously we’re more motivated. If it’s an external demand we don’t make conscious choices to ignore the external demands, however it can appear like that to others. But for us if we’re internally motivated it’s more meaningful to us and that’s when dopamine becomes more readily available which means it’s a quicker.

Sometimes we’re looking for the quick hit of dopamine rather than you know consequences of time or getting into trouble are often disregarded in the seek of a short hit of dopamine or a quick pleasure.

So the aspects of the ADHD brain can make it really difficult to get reward from ordinary activities because we have dopamine-deficient brains. We get a surge of motivation if it’s a highly stimulating behavior and we get a high hit of dopamine quickly. But the aftermath of that surge in reward can be a drop in motivation.

We can see here that behaviors, or we can see here the tasks that we need to do that aren’t very compelling, that we aren’t interested in doing, we need a much bigger reward to get us there or we need a last minute deadline.

For example, my husband’s passport application. I had a friend ask us to go to Fiji with them and we were looking like we were going to book. Next thing you know he had his passport application ready and he’d printed it and I was completely blown away.

But when we realized the hotel was sold out and we couldn’t go — oh he never went to the Australia Post to actually put it in. And I know he won’t do that until the trip’s booked which really frustrates me if I’m honest but I know that’s how he works.

Jane McFadden:
So there’s particular activities that can even amplify dopamine production. So driving fast, motorbike riding, water skiing, food, exercise, competition, ski jumps, skydiving — really spike up that dopamine. And it can you know involve careers like emergency doctors, firefighters, paramedics, defence force. There’s lots of different ways we can look for dopamine.

So we know that nicotine, caffeine, alcohol, gambling, risk-taking can increase dopamine even more. We know that there is a link between addiction and ADHD which we’ll do another episode but we know that that is there and that you can go back looking for that hit over and over and over again.

So I don’t want to get too much into dopamine but I do want to give a bit of a background as to how it worked. The reason that I mentioned this is because this is why stimulant medication works.

So we have this whole question okay so I don’t want to give my kid a stimulant because they’re already hyperactive. If you have stimulants in your system we know that it creates more dopamine and then your brain is operating more like a neurotypical brain where it’s not seeking dopamine.

You can then look at your impulse control like let’s say online shopping or things that you don’t like to tell people about that you do. That stuff should be decreasing. For me I know that does. I’m much more controlled, I’m much more focused, I know what to focus on and there’s less anxiety and overwhelm because my brain is working better.

So if that’s a question for you around dopamine and how it works, you don’t need to feel an automatic fix necessarily but you might start to realize what a neurotypical world looks like when you’re taking medication if it’s the right medication for you.

So you might notice small shifts. It might not feel the way that you think it’s going to feel and you should always check in with your medical practitioner. But you might find that you stick to tasks more.

I had a friend, she took some medication for the first time, she said it didn’t work. And I said really, what were you doing? And she goes oh we did my garden. I said really? She goes yeah I usually can’t do that. And I said how long did you wait for? She waited for four hours and she reckoned the medication didn’t work.

And I said to her but was that a task that you wanted to do? She was like yeah I really wanted to do that I just could never be motivated. And I was like well there you go, that’s how it works. So by giving your brain what it needs it doesn’t need to seek it out and we don’t become as distracted.

Again this is just a ADHD mum’s take on it. Love you to bring in a medical practitioner and perhaps they could shed a little bit more advice. If there’s a professional out there that you’d love to recommend to bring on the show, god that would be amazing as well.

But for now that is my take on medication. Go back to your medical practitioner.

And look I see people online all the time saying the psychiatrist is giving them a prescription and they’re just trying to make it work. And the great thing about this medication is it’s only a system for four hours so what you can do is take it at different times, try it, keep a log, keep something on your phone of how you’re feeling, what you did that day and how you felt and what that little, that comedown can sometimes be quite rough too, how that felt and play around with it.

For me I was probably taking too less and then I took a bit more and I felt a bit better. You know I’ve come to terms with the fact that I was initially taking it just for work and I didn’t — I felt like I shouldn’t be taking it all day. So I was only taking it in the morning, getting a rough comedown in the afternoon and then having my kids.

For me that was completely stupid. There’s a lot of research in that slow release as well. I think I said earlier I am going to try that Vyvanse, that long release, the long release dexamphetamine. I’m really excited to try that. I might do another podcast on how that feels.

I do enjoy the dex but I do think it is a bit of a rollercoaster. Like I’m currently about to jump in the car and go somewhere and I’m like where’s the bottle, I don’t know where it is, I gotta take it with me, when will I be home, I haven’t eaten. I think I just prefer the one tablet.

But each to their own, it’s all a journey.

I hope this was helpful for you. Have a great day. Thanks guys.