Why do stimulants work when you have ADHD?

ADHD

Advertisements

Inattentive, hyperactive, and impulsive children often suffer from a lack of attention. This is because those with ADHD have an imbalance in certain neurotransmitters within their brains which help control how they behave as well as their focus. In the brain, there are two main neurotransmitters that play a role in ADHD: norepinephrine and dopamine. Norepinephrine helps regulate arousal in the brain, while dopamine is responsible for focus and attention. When a student with ADHD takes drugs that raise levels of these neurotransmitters, they are often able to concentrate better and behave more appropriately.

Ritalin or Adderall

Advertisements

It has long been known that stimulant medications such as Ritalin or Adderall can help to treat symptoms found in ADHD. The problem is that these medications ‘help’ the neurotransmitters get used up faster, meaning they would need to be taken more often or in higher dosages. Stimulant drugs work by binding to dopamine and norepinephrine transporters (DATs) which are proteins on neurons that take neurotransmitters away after they have been released. Blocking the reuptake of these neurotransmitters, therefore, means more dopamine and norepinephrine are available to bind to receptors in the brain, leading to increased focus and concentration.

Advertisements

The most common stimulant drugs used for ADHD treatment work by blocking DATs. Drugs like methylphenidate (Ritalin) and amphetamine (Adderall) are very effective in treating ADHD symptoms, but they also block the reuptake of two other neurotransmitters: serotonin and norepinephrine. These drugs increase the levels of all three neurotransmitters, dopamine, norepinephrine, and serotonin, although to varying degrees.

Medications that increase dopamine levels in the brain are typically effective in reducing symptoms of ADHD. A study at Stanford University found that children with ADHD had fewer symptoms when they took doses of methylphenidate. The findings were based on magnetic resonance imaging (MRI) of the brain, which showed reduced levels of dopamine transporter binding in participants.

Advertisements

The study at Stanford used a technique called functional magnetic resonance imaging (fMRI) to measure the amount of dopamine in specific regions of the brain. In participants diagnosed with ADHD, brain scans showed that drugs like methylphenidate did result in a significant increase in dopamine concentration. This is important because an excess or shortage of dopamine can lead to hyperactivity or inattentiveness. In fact, according to a study done by Harvard Medical School, drugs that increase dopamine concentration have been used for decades to treat schizophrenia and Parkinson’s disease.

Advertisements

Methylphenidate can be an effective drug in treating ADHD symptoms because it blocks the dopamine transporter, making more dopamine available within the brain. However, for this to work, the drug needs to cross the blood-brain barrier. A study at Cardiff University found that administering drugs that are too ‘large’ or have a complicated chemical structure often has problems crossing this protective layer of cells. According to the study, one factor that affects how well drugs can cross into the brain is their size and complexity.

Advertisements

Methylphenidate is a psychostimulant medication that is used for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. The drug works by increasing levels of dopamine and norepinephrine in the brain, which results in increased focus and concentration. Methylphenidate can be effective in treating ADHD symptoms, especially in children. However, the drug may not be able to cross the blood-brain barrier as easily because it is too large or complex.

My Experience?

I take Contramyl XR 36mg every morning. It has saved my life because it ‘calms’ my brain. This allows me to focus on whatever task I am working on, and since I work from home, this is highly beneficial.

Day 14 post failed suicide attempt – There and back again…

Advertisements

5:00am

Nurse takes my blood pressure.

Breakfast. Alone…

I have porridge, not too hot, not too cold, just right…

I have yogurt and fresh fruit. I enjoy an omelette with cheese and bacon bits. I wash it down with a cup of coffee. I take my medicine with a glass of apple juice. I take a shower and get dressed. Today is Saturday…

Advertisements

The nurse informs me that the Psychologist is here to see me. I go to the consultation room to find him sitting there in his usual chair already. He hands me multiple stacks of papers. They describe the diagnostic requirements according to the *DSM -V criteria manual which Psychologists and Psychiatrists use globally to align their understanding of mental health conditions.

*Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.

I scan through the headings on each little bundle:

  1. Autism Spectrum Disorder
  2. Attention Deficit Hyperactivity Disorder
  3. Obsessive Compulsive Personality Disorder
  4. Major Depressive Disorder
  5. Borderline Personality Disorder
  6. Bipolar Disorder
  7. Dissociative Identity Disorder

“I hand you these today to go through when you want to. I picked up that you presented with possible signs in all of these areas, some more prevalent than others.” he states. “I can point out that most people will present with symptoms in general, but not enough to be diagnosed as such.” He continues.

“Thank you.” I say. “Just to be sure, I think I will read through all of them to see if I recognize myself. I will naturally entertain the thought without accepting it.” I continue.

“I do however feel very certain that my Psychiatrist hit the nail on the head when he confirmed that I was on the spectrum. He is also treating me for ADHD and OCD symptoms. The rest would still be interesting to read.” I say whilst reading through the first booklet he assembled with photocopied paper and staples.

He did a rush job because the sheets are not aligned and the streaks he made with the highlighter is not entirely covering only the parts he wanted to accentuate, but also irrelevant blank spaces on the side of the paper. This tells me that he tried to turn the page too quickly post highlighting a word or phrase and the tip of the highlighter grazed the side of the page as he turned it. I conclude that he must have been in a hurry to get it done and hand it to me to make a point. It feels like he want to show that I have a multitude of mental health challenges and I would need his help for at least a year to make sense of it all. It felt again like he was chasing money…

Advertisements

Then again, he is running a business, so technically he has to book sessions with clients in order to keep his boat afloat. I get that, its just kind of feeling like he’s dragging out the sessions, that’s all…

“Thank you for all the information. I appreciate it.” I say.

“Your welcome, I really enjoyed our conversations up to now and I hope you stay around for another week in order for us to really dig deep into your psyche and see where we can uncover unknown past memories which you haven’t dealt with’. He replies. “We can then unpack and come to terms with those feelings during our sessions over the next couple of months.” he adds and hands me his business card.

I let him know that I will see my Psychiatrist later that morning and that I will know what my next week would look like after my session with him.

We greet each other and he leaves.

I have a cup of tea.

Advertisements

11:00am

The nurse calls me and informs me that my Psychiatrist is here to see me.

“Good morning.” He greets me, dressed in relaxed clothing similar to last Saturday.

We exchange pleasantries for 2 minutes (I don’t particularly like small talk)

“So, did you consider the possibility of returning to your life soon?” he asks.

“I did, yes” I say, “I think it would be great to plan my exit strategy and start facing reality again.” I finish.

“Okay, good, that’s a good sign. I’m glad you feel up to it.” he says, “When would you like to go home?” he asks.

“Well, today if possible, ha ha, but I assume you don’t release patients over the weekend so Monday would be fine. Just to give you time to prepare all the paperwork.” I say.

“No problem. We can do it today if you are sure you can handle it?” he states.

“Really?! I was not sure if it can happen today, it was just a quip really to lighten the mood. If its too much trouble Monday is fine, really.” I reply.

“Not at all, I just need to pop over to my practice next door to get my Prescription Pad and your file and I can complete your Release From, sign it, and let you go back to reality and your family and your home.” he smiles. “I’ll be just a minute…”

He gets up and leaves the room to go and fetch his paperwork…

Advertisements

It dawned on me that I now had to go back to Normal…

I feel kind of nervous, anxious, but in a healthy way. So anxiety and excitement has similar physiological symptoms, so it’s in how you frame it mentally really. I make a choice: I feel excited to go back to my life, my daughters, my home, my Alaskan Klee Kai, my family, my future!

My Psychiatrist returns and completes all the necessary documentation. He hands me my prescription for my medication for the next month. We book an appointment to come and see him in 2 weeks time. I gather my belongings and sign out at the Nurses Station. I thank all the Staff and wish them well, and I head out of the front door, through the security gates towards my SUV. I throw my bag in the back, get into the Driver seat and sit.

I see blood on the steering wheel, blood on the seat, blood on the gearshift, blood on the hand-break, blood on the passenger seat and a massive pool of dried blood on the plastic floor mat. I see the open switchblade with dried blood on the blade lying on the floor at the passenger side. I take everything in and I sigh…

Advertisements

It feels so long ago, a feint memory of a series of unfortunate events. I was a completely different person back then. I have come a long way out of the valley of the shadow of death. I’ll clean it up when I get home…

I start the engine and I start driving back to my house. To start my new life!

I have been there, I have visited Normal.

I always struggled and didn’t know why I felt like I do not fit in. Now I know. I am different. I am awesome and I am fantastic, so:

Awesome + Fantastic = Autistic!

I have been there, I have visited Normal, and now I am ready to go back there again.

There and back again…

Day 6 post failed suicide attempt – what is religion really?

5:00am

Friday morning.

Nurse takes blood pressure.

Breakfast

Alone. Bandage still on my wrist covering the 11 stitches used to close the wound I caused with my switchblade. All the other patients avoid me, probably because I am the only one in the Psychiatric Ward who tried to commit suicide.

Advertisements

Shower.

Get dressed.

Wait…

Psychiatrist arrives and we discuss the Ritalin trial run we did yesterday. He is happy with my feedback and adds it to my list of medication daily, but the slow-release version which lasts for between 10 and 12 hours. He informs me that although it is weekend that he will visit on Saturday and Sunday.

After the session with the Psychiatrist I have a cup of tea.

Advertisements

Psychologist arrives. In our session we talk about my teen years. We talk about High school years. We talk about my current relationships with family members. We talk about my experience so far, almost a week in hospital. We talk about personality. We talk about personality disorders. We talk about ego states. We talk about the concept of his understanding of Autism. We talk about high-functioning Autism. We talk about ADHD. We talk about OCPD. We talk about Depression. We talk about medication. We talk about therapy. We talk about healing.

He assures me that he will visit me on Saturday, but not on Sunday. He leaves.

Advertisements

Lunch

I go to my room, and I start thinking…

Why not Sunday? Was it because he is religious? I used to be…

Advertisements

I don’t understand religion.

How is it possible that I was born into the right religion? How is it possible that I was just raised into that way of living since birth without knowing an alternative? How strange that everyone we know were also part of the same religion. It is confusing to me that only our religion is the right one. It bothers me that I had to read a book I didn’t understand. Think of myself as a bad person by just being born. Think of myself as not worthy because of having to prove to an invisible figure in the sky that I love him? Be afraid because he saw everything. Be afraid if I ate something and forgot to say thank you to him. Be afraid to offend him by thinking anything which I wasn’t supposed to be thinking. I never understood what prayer is or the reason for it. Why do I have to ask him to change things in my life if he has a plan for my life? Why is he going to punish me if I do the sins that I was supposedly born with, when he is the one that created me? So that means he gave me those sins. He then instructs me not to be the way he created me, but to love him and accept him as my savior. Saving me from what? Oh, saving me from what he is going to do to me if I do not worship him. He built a place full of fire and pain: hell. This is where I will go for eternity if I am just my normal self. He also created the guy that runs that place. So let me get this straight:

  • I am made in his image, born because he spoke me into existence without me having a choice of: gender, race, nationality, physical appearance, talents, parents, culture, family, siblings, IQ, sense of humor, the town I was born in, the language I had to speak.
  • I have free will, but I don’t because if I do not accept him I will burn in hell. So I am forced to choose him if I want to prevent eternal suffering. That is not free will.
  • I have to pray to ask him for forgiveness for doing things which he created me with the ability to do in the first place.
  • I have to believe that he has a plan for my life, which means all the suffering and humiliation and pain I endured my entire life was part of his plan?
  • Oh, and I have to give him money every Sunday when I go to a building with other humans to meet and be present in a place where he never shows up.
  • I have to believe he exists, contrary to my own experience.
  • Apparently he exists as a creator, his own son and a spirit. They are all supposedly one, which is confusing. That means that the father impregnated Mary to give birth to himself. So that means the son was intimate with his own mother? Incest…I just don’t get it.
  • The son then gets crucified, and we have to think about this while drinking wine and eating bread. The wine is his blood (vampires?) and the bread is his body (cannibals?). Weird…
  • So if the creator can create anything, why all the suffering on the planet? Why not just create a cure for all the bad things?
  • Also, if you believe in him your prize when you die is not die but to live forever in a place up in the sky where you sing his praises every day for eternity. I do not want to do that, it sounds boring…
Advertisements

So, I am here in this hospital trying to come to terms with the fact that I have a condition or 2 or 3 which caused me to try and kill myself, and he never even tried to assist or intervene? he let me suffer for 4 decades? Why? That’s just mean, man… What is religion really?

Dinner

I take a shower.

I continue my reading on Autism, or more specifically as the Psychiatrist termed it: High-functioning Autism Spectrum Disorder.

I recognize myself in almost each and every article, medical journal or blog post I read. It is amazing and refreshing and sad and fantastic and tragic and overwhelming that I finally ‘meet’ myself after 40 odd years of darkness. 🙂

“Nice to finally meet me!” I think with a smile on my face, the first genuine smile in a looooong time…

I take my medication and I fall into a deep sleep

Day 5 post failed suicide attempt – Ritalin to assist with High-functioning Autistic Savant Syndrome

Rise

Rise against the dying of the light…

On the 5th day in the Psychiatric Hospital I was about to test medication called Ritalin.

Advertisements

Ritalin (methylphenidate) is a nervous system stimulant that’s commonly used to treat ADHD in adults and children.

It’s a brand-name prescription medication that targets dopamine and norepinephrine in the brain to reduce common ADHD symptoms.

Though Ritalin is a stimulant, when used in ADHD treatment, it may help with concentration, fidgeting, attention, and listening skills.

http://www.healtline.com
Advertisements

I have been using 4 types of medication during my stay at the Hospital up to now, so this will be number 5:

  1. Sleeping pills (strong)
  2. Anti-depressant
  3. Anti-psychotic
  4. Painkillers (strong)
  5. Ritalin (New!)

The Psychiatrist instructed the nurse to give me the fast acting Ritalin just after breakfast and I had to pay attention (no pun intended) to what effects I felt. Did I feel anything different?

Advertisements

Lance Armstrong used performance enhancers in his quest to win the Tour de France 7 times. He still had to train extremely hard, and the stuff he took merely ‘enhanced’ his performance.

Ritalin was the performance enhancer I never knew I always needed. Now, I have always been a very perceptive person:

  • I would memorize everything, everywhere, constantly.
  • I would use ALL my senses to navigate through the world.
  • I would be on high alert every waking moment.
  • I would think, over-think, analyze and over-analyze everything.
  • I would asses and scrutinize small changes in mood, facial expression, body language and eye-movement when I was having a conversation, trying to figure out what the person’s intentions were in order to act appropriately on all the social cues I had to map and adhere to in order not to stand out.
  • I would start to anticipate people’s next moves, or next words or next thoughts to such a point where people became predictable in their behavior.
  • All of this DRAINED me mentally and emotionally…

Which led to my Autistic burnout and an attempt on my life by myself…

Advertisements

The strange thing is I was under the impression that everyone did this in their minds. The Psychiatrist assured me that none of the normal people did this. I was surprised…

So when the Ritalin started to take effect I felt an immediate sense of relief. I had a calm mind, I had a focused mind, I felt stable, I enjoyed the intensity of my mental application. The dedicated focus and the control I had over my thoughts. Ritalin changed my Life!!!

I was on top of the world!!!!!!!!!!