Last Friday, at the age of 35 the psychiatrist decided to trial me on Methylphenidate. In the weeks since she prescribed firing the therapist that referred me to her, the hypothesis moved to considering actionable space to work on unfucking my brain. This my three pot of coffee a day habit and the fact that bupropion, a mild NDRI stimulant marketed as an antidepressant had almost been doing something positive lead to trialing methylphenidate. Apparently my present situation and history hit every single box for an ADHD diagnosis.
Of course this comes no less than 20 years after it could have influenced my early adult life.
My brain is the Columbia shuttle. Broken during the launch process with every prior person I've consulted on the matter denying the possibility that my gross executive dysfunction could be in the structure of the meat of my brain.
Never mind every university I went to offering mental health services that included "Comprehensive ADHD screening" on request. Comprehensive in practice always meant in my experience "unless you have a childhood diagnosis or are in danger of failing out, shit luck." Venlafaxine, fluoxetine, lamotrigine,1 quetiapine, risperidone, clonezapam, alprazolam, lorazepam, and any other number of substances "controlled" or otherwise were routinely offered. Polypharmacy was common as well as prescribing ever so slightly different drugs of the same class despite debilitating side effects and absent therapeutic effects...
By contrast here in the civilized world, my2 psychiatrist was able to work with me and my history to skip replaying entire failed classes of medications.
The psychiatrist's screening was short, but included basic questions including "Do you have any family members with ADHD?" to which the honest answer was of course I do. Grandma and Grandpa on mom's side had 8 children and plenty of my cousins got diagnosed with ADHD. The screening appointment happened over videocall for her convenience which allowed her to see my living space along with my habitual coffee and cigarette consumption.
After filling the prescription and getting a night's sleep here comes the Ritalin diary:
- Day 1: Took pill, drank coffee. Intentionally started cleaning. Ended up doing a rather deep clean and organization. Made the third pot of coffee decaf. Productive. Calmer than I remember ever being as an adult. Urge to compulsively smoke cigarettes disappears
- Day 2: Took half pill. Calm persisted. Didn't start the day with any set task sink to dump stimulant focus into. Had a pleasant day.
- Day 3: Took half pill. Calm persisted. Focus endured. Having a third consecutive day of calm productive focus without being in acute crisis begins striking me as alien. Become incredibly resentful towards surviving parent for going through life with a nearsighted frontal lobe.
- Following days: Holy shit this feels so normal and the opposite of intoxication
I don't know what comes next, but never have I ever been this resentful in my life. My capacity to forgive has never been lower. I had always though something was off. There has always been a tremendous disconnect between my ability to project what's happening around me into the future based off of what I know, and my disappointingly short sighted ability to make decisions based on what I know. It's as though the knowing part of my brain and the deciding part of my brain had been separated and are only just now meeting each other.
A month ago I was ready to feed myself to the Orcas out of nihilism. Now I want to go to war. So many points of discontent with how my own brain works ameliorated with one tiny pill a day and all I want now is blood for the blood god.
- The much feared sided effect of sudden total skin necrosis missed me in favor of "exploding head syndrome" as a side effect... [↩]
- Any this is a profound difference between how the civilized world works in contrast to the failed USSA. I have my psychiatrist, at a reasonable price. [↩]