Adderall & I

"I sent what you asked for to your Gmail account, make sure you read the email and understand the terms. Xo, Mom."

I opened my inbox. Sure enough, there was the email from my mother, with the subject line: “Emily and Adderall” and, curiously enough, an attachment. I had asked her to write a few sentences about what life with me on Adderall was like—instead, I received an entire document. I opened the email:

You cannot use this against me at any time… If you can't promise that, delete the below file! Xoxo”

I read on:

“When you were first diagnosed with ADHD we did not really understand what it meant. Of course we knew you had focusing issues, and that your legs were always in motion, and we used to joke about the fact that your perfect job would be working at McDonald’s, as all your school reports tended to mention that 'you would do so much better if you weren’t looking out the window all the time.' Little did we know that these were just a few of the many obstacles you would experience in your daily life.” 

For five years, I struggled with Attention Deficit Hyperactivity Disorder (ADHD), taking heavy dosages of Adderall, the powerful drug prescribed to relieve it. For five years, my mother had apparently been reducing my dosage. Behind my back, she poured out some of the medication, refilling the capsules with brown sugar so I wouldn’t notice. 

“In the 10 mg capsule you took, I replaced the Adderall entirely with organic brown sugar, I would decrease the 30 mg capsules as well, ever so slowly, so that you would be down to a total of 10 mg Adderall, and you would smile again, and easier, happier and less anxious person to live with.”

I slammed my computer shut. For over five years, my mother had lied to my face. Every time I had accused her of reducing my medication, she had looked me in the eyes and lied. Every time she made me feel horrible for even suggesting such that she would do such a thing. But I had been right; it had been true.

She not only deceived me, but she ignored my doctor’s advice, decided she knew better. All those years, I thought I was going insane. Why else would my symptoms have continued, despite taking Adderall at higher and higher dosages? At one point, I was taking 90 milligrams a day, triple the average dose. After finishing the document, I called my mother to demand answers. Asking “How could you?” again and again. “You lied to me for years. You tricked me. You made me feel like I was losing my mind. I lost complete faith in myself!” Nothing she said could alleviate the burning, stabbing sensation I felt in my chest. The extent of her deception was almost unfathomable. 

Three weeks passed before I could bring myself to speak to her.

***

I was a mediocre, below-average student. My report card was mostly Cs and comments of “Emily has issues sitting still and keeping her attention inside the classroom.” with well intentioned suggestions like “Maybe she shouldn't sit near a window?” or “She shouldn't sit with people she is friends with.” A few months into ninth grade, I was diagnosed with Attention Deficit Hyperactivity Disorder. Shortly after, on the advice of my first doctor, Dr. Brooks, I began taking Adderall. Everything changed.

Adderall was the answer to all my problems. “In your eyes, it was a new world,” my mother wrote. And what a wonderful world it was. My grades, in one quarter, went from mostly Cs to all B's. I began with 10 mg daily. The effects were immediate and strange: I wanted to study, I had a new desire to be productive. But the effects were short lived. My body became quickly accustomed to 10 mg and the dose was steadily increased, bumped up every few weeks. Soon, I was taking 70 mg a day.

For us it was a gradual loss of ‘you,’” my mother wrote. “With the increased dose you became so aggressive and short tempered, the rest of the family felt like we all had to walk on eggshells whenever we were around you.”

But I never noticed a change in my personality, and at first, not a single family member said anything. Not my mother nor my father, nor either of my younger brothers. I thought I was a just normal teenage girl, fighting with my parents and brothers like you’re supposed to do.

My mother recalls a different story. “Screaming profanities and door slamming became a daily event. The smallest things would set you off, and you were having constant 'disagreements' with your friends.”

As I read her words, the initial shock wore off, replaced by anger. Yet I forced myself to keep reading. “You were clearly addicted to the Adderall, it scared us all, and so we decided that behind your back we would decrease your dose bit by bit. When you had time off and no academic or athletic pressure, your dose would be reduced to a more manageable level for the sanity of the family.” I painfully remember all the times we would fight over my Adderall dosage. Whenever she got the chance, my mother would remark “Emily, I think we need to talk about your prescription.” Every month, when it was time for a refill, she broached the matter. Every month, I reacted with anger. It happened in front of my brothers, my father, our housekeeper, anyone who happened to be in the kitchen. When my brothers were present, they would bow their heads in discomfort and try to keep eating as though they heard nothing.

Every time the argument was the same: “Seventy milligrams is way too much for someone as young as you to be on,” she continued.  My anger would flare in my stomach and I felt the urge to scream. It was only a matter of time until I would hiss “I am prescribed 70 mg BY A DOCTOR” spitting out the last three words one at a time. “You are not a doctor. You don’t know ANYTHING about Adderall. Stop trying to take away THE ONE thing that’s actually helped me. We ARE NOT REDUCING the dose. Stop fucking bringing this up.” I would grab my small bowl of vitamins, but I only cared about the two blue and white capsules.

I would pick one of the pills up, looking for signs of tampering, After these constant conversations, I had my suspicions. But nothing was ever confirmed.

Whenever I visited my pediatrician, my dose was increased. The main side effect of Adderall is weight loss. Because I played on a highly competitive soccer team, this was never an issue. The monthly “check-ins” with the doctor would always go the same way.

“So, Emily, how are you doing? You look great!”

“I'm good!”

“Any trouble sleeping? Loss of appetite? Hmm, weight looks stable. That's good.”

“Nope, not at all! But, I was wondering, I feel like my medication isn't working as well as it used to. I feel really tired all the time, and I'm having issues trying to stay focused in school the whole day.”

“Really? And you're still taking, 70 mg correct?”

“Yes,” I would respond, “but my body seems to metabolize medicine faster than most.” This was my go to line. The truth is, I had no clue if it was accurate or even biologically possible. However, I introduced many doctors, therapists and psychiatrists to Emily's Metabolic Theory. No one had contradicted me yet.  I decided it had to be supported by scientific fact that I needed more medication. “Okay, why don't we try adding 10 mg? I don't like it, but I know Pingry is a high stress environment. How's soccer going?”

And so it went. Time and time again, until I was up to 90 mg of Adderall a day.

What the pediatrician missed, my mother knew all too well. “With the increased dose of Adderall, we also noticed an increase in your level of anxiety,” she wrote. “You lived an extremely stressful life, academic pressure, social pressure, athletic pressure, and we thought these were responsible for your moods and your temper.”

I took my medication every day because I knew I needed it to be functional member of society. But Adderall got in the way of my most basic needs. Sleep became my worst enemy, exercise my best friend. The only way I could sleep at night was after running 5 miles on the treadmill in my basement. Days without exercise were impossible. Anything less than a five mile run was pointless.

Yet other than sleep, anything was possible on my medication. I could sit for hours with total concentration and was envied by my peers. Many, some half joking, asked for some my medication. My answer was always the same: No chance in hell. It was mine and I was never going to share it with anyone. 

The only reason I was able to stay sane at such a high dose was soccer. I played on one of the best teams in the country, which meant practices every other day and tournaments every weekend. It was the outlet for all my anger, frustration and pent up energy that resulted from being on so much Adderall. Soccer was the only thing I was good at, and the only area where I had excelled pre-Adderall.

“You were totally impaired when it came to judging when to stop,” my mother wrote, “Later on, we found out that Adderall actually prevents you from feeling the normal signs of getting drunk, you would believe you were 'fine' and then you blacked out.”   

I had no redress to this part of her email; it was something I couldn’t deny. I began drinking when I was a sophomore in high school and was one of the last of my friends to try; it quickly became the center of our social life. I was shy when I was younger, and I learned that drinking freed me of inhibitions. When I drank I was funnier, I was bolder and I didn't have to feel stressed or worried.

Adderall causes an increased risk of suicidal behaviors. The first suicidal thoughts I can remember began when I was eleven, before going on the drug. 

I tied a belt around my neck and stood on the foyer, on the wrong side of the bannister. I just thought about it, thought about taking the extra step. I remember little, only my father’s horrified expression when he saw me. For the first time, I suspected something was wrong with me. I was different from the other girls my age. I was sadder than most. This sadness has stayed with me for as long as I can remember.

The odds were never in my favor. Blacking out became almost unavoidable.At one party I was so drunk that my 14-year-old brother, terrified of what could happen, stayed in our basement bathroom with me. I lay on the floor, unable to move, insisting I was fine.

“Henry, I'm okay,” I told him. I attempted to sit up and slammed my head on the shower door. I was too drunk to express any pain. I groaned and laid back down on the ground. That night my mother gave me a bath, after the rest of my friends had been put to bed. I was in drunken tears, babbling nonsensical excuses sprinkled with half-sincere apologies.

The next morning, looking like a disheveled raccoon, I stumbled downstairs where my mother lay in wait. She confronted me “Emily we have to talk about your drinking.” I said nothing. “When you are on a medication as strong as Adderall, you CAN NOT drink! It is so bad for your brain, and last night shows you what happens when you mix the two.” I stayed silent. I knew no matter what she said I would keep drinking. It was the only time I could escape. I was convinced I just had to learn how to drink “properly” on Adderall. Head down, I acknowledged her concern with a contrite, “I know.”

“You also owe Henry an apology,” she continued. “You really scared him last night.”

I owe Henry many more apologies. He had seen his older sister in that state far too many times. A familiar shame crept into my stomach.

One day, some of my pills went missing. Adderall is a controlled substance; doctors are legally allowed to prescribe only a certain number of pills per month. If you lose them, you're basically screwed. My mother instantly accused me of stealing them. “Emily. You are THE ONLY ONE who could have taken them.”

The accusation of stealing my own medication was so absurd that I flew into a rage. I wanted to run around my house and flip furniture, pull things off walls, and break everything. No matter how much I protested my innocence, my mother didn’t believe me. Even today, no matter how much I still protest my innocence, she still doesn’t believe me. So, my mother took charge of my medication. Each morning she would lay out just a single blue and white pill.

On certain days, I felt more tired than others. I always inspected the bowl of vitamins my mother provided, carefully checking that my Adderall was there in the proper dosage. Sometimes I felt sluggish, as though a layer of fog choked my brain. My motivation dropped; I was content to lie around and do nothing. I blamed the Adderall. Since my mother had full control of my medication, my suspicions instantly focused on her. For years she had been trying to decrease my dose. And now, she had every opportunity to do so. 

On the mornings I felt up to it, I interrogated her. It was always the same pattern: I sat at our kitchen table, while she stood by the cabinet with the vitamins. “What dose is this?” I would ask, “Did you lower it? You know I can always tell when I have a higher or lower dose,” I would warn her. “I know you are decreasing my medication. You won't even let me have control of my own medication!” She would respond, rebuking me that “You are not mature enough to handle your own medication! You would lose it, and after you stole that medication, we don't trust you with it” I became furious. My brothers, often in the room, stared at their soggy cereal, head down. 

I would scream. “I did not steal my medicine!” barely spitting the words out through my anger. It would escalate until my inevitable stormy exit from the kitchen up to my room, ending the conversation with the loudest slammed door I could muster.

After a few months we were both exhausted; I decided to take her word for it.

***

Convinced there was a better answer than medication, my mother put me in therapy. Every session followed the same exact format. I would sit on an uncomfortable gray couch in an inoffensive office decorated in neutral tones. Before long, I knew exactly what to say to get the therapists on my side.

“So Emily, tell me about yourself,” said a petite old woman with snow white hair wrapped in a tight bun. She crossed her leg and looks at me inquisitively. I saw her as an opponent, and this conversation as a chess game. I knew that I was depressed, but I did not want this woman inside my head. I began listing all the traumas in my life:

“Well, I moved here when I was nine years old from London, England. I have ADHD and I play soccer… a lot of soccer. I take Adderall, and I have a bad temper. One of my best friends has FOP (fibrodysplasia ossificans progressiva), which is really hard for me. I’m not happy.”

I gave her my background methodically, managing to get my basic history and defining characteristics summed up in about three sentences. They never expected such a logical response from a thirteen year old, and this when I realized how easy it was to manipulate therapists. That isn’t to say that at first, I didn’t try to be honest, because I did. However all the therapists ended up doing the same thing, pushing more pills, and my mother adamantly refused to let that happen.

I wasn’t happy. When I looked into my future, I saw nothing but a hopeless gray cloud. The therapy never worked, much to my mother’s dismay, but not surprise.

“I tried to discuss it with you, but it was impossible to reason with you about reducing the medication,” my mother wrote. “You were an absolute nightmare as you were convinced you needed the maximum dose to cope, which we knew very well was not the case.”

I arrived at Dartmouth in early August. I was recruited for soccer and arrived for preseason, hopeful and anxious for a new start. I prayed that drinking and depression were behind me. I loved soccer and I loved my new team. At first, I was happy, I was still blissfully unaware of my parent’s betrayal. But then, our first season was miserable. We lost most of our games, and the new coach turned out to be a miserable, malicious human being. I was not recruited by her, and she reminded me on a regular basis. More than once, she chided me “Emily I don’t know if you’re even good enough to play here, I didn’t recruit you.” I was Dartmouth’s first recruit and had committed during my junior winter. During that winter term, when only six freshmen were on campus, I out-lifted and out-ran my future teammates. Other coaches had regularly told me they looked at me to lead the team. 

I sank further into depression. Here, it was harder to hide. Home and school were blurred. I couldn’t hide my depression from friends the same way I used to.

By March of my freshman year of college I broke down. I had pneumonia three times within three months and I never recovered. My self worth was grounded in soccer and my physical performance. Being unable to perform, betrayed by my damaged lungs, was devastating. So I cracked.

It was the morning of our first spring fitness test. We arrived at the track in nervous anticipation, fueled by a winter of training, ready to run the three mile test. After just three laps, I collapsed. My body and my mind broke together. I sat down. I never said a word. I went back to my room and laid in bed for two days, and refusing to eat. My teammates brought me food and I pretended to eat, but I was done.

The next day I walked to our team’s academic advisor and, with tears of desperation rolling down my cheeks, I told her how miserable I was. I had given everything I had to a sport that in turn left me shattered.

I was forced to take a break from soccer and agreed to go to counseling at the campus infirmary three times a week. I hated therapy. I agreed to do whatever it took this time, to “fix me.” I hated being overmedicated but dutifully took the medications they prescribed. I took 90 mg of Adderall, 30 milligrams of Lexapro (after a brief stint on Zoloft), sleeping pills, and an anti-anxiety medication that was supposed to “even out my moods.” I felt numb. Nothing. There was no happiness, or even sadness, anymore. I hated every second on those medications, but I took them because I wanted to be better. I wanted to get better. But I didn’t.

All my parents could do was watch me unravel. “We had, in fact, seen that you coped better and were so much happier and easier going when you were on a lower dose of Adderall. We were despairing, but you heeded no advice. We knew you had to hit rock bottom before you were forced to come off the drug.” I was close to the end of the letter, and still, each line triggered a memory more painful than the previous.  

When my prescriptions failed me, I turned to the only thing that seemed to help, alcohol. The medications and alcohol were a lethal cocktail. In April, I was rushed to the hospital, with a blood alcohol content (BAC) of .33.

My head throbbed. I opened my eyes and looked around. Where the hell am I. I looked down at my arms and saw tubes coming from both of my veins. What the...I ripped them out, blood streaming down my arms. I ripped a catheter out as well before sliding out of bed. Barefoot, in the dress I had worn out the night before I made a run for it. I left bloody trail, running through a waiting room, directionless and confused.

A trail of nurses chased me, the bloody, crazed barefoot girl, demanding that I stop. I escaped outside, into a beautiful morning.  I could make it back to Dartmouth, I thought. My feet would hurt but it’s not that far, I could definitely make it. Then, for the first time, a voice of reason spoke louder than my impulses did. You can’t run away. It will just make it worse. I found a bench and resigned myself to wait.

After my hospitalization, I was required to follow certain procedures. I talked to my coach in her office a few days later, a Hanover Police Officer and completed Diversions. I had some of my medication modified, although the Dartmouth therapists were adamant that I continue taking the antidepressant. The therapist at Dick’s House even increased the dose.

Mentally, I wasn’t ready to begin playing again, and thus alienated the only people I was close to at Dartmouth. I was still a member of the team, but I did not attend practices or play in any games. The captains watched; they knew I wasn’t okay, had seen me crumble. I still followed the team rules, but for my own reasons. For a few weeks, I stayed away from alcohol. Instead I took to making little cuts on my wrists with tweezers. I say this casually, because to me it was. I never considered that I was one of those people who cut themselves.

***

It was an innocent idea. Three friends, just grabbing drinks. We met up with more teammates at a frat, but I decided to leave early and go home. Instead S&S picked me up. Once again, I was deposited in the campus infirmary. The next morning I sat there, hands in my lap. Still clad in my yellow blouse and black shirt I said nothing when my college-appointed therapist came in and sat on the bed across from me.  

He sighed, as if he had known this would happen all along. “How are you feeling?” I wanted to punch him.

His voice was kind, but then again it always was. That was his job. As tears welled up and threatened to overflow, I managed to choke out, “Not that great.” He feigned a smile, which looked to me more like a sympathetic grimace. I wanted none of his sympathy.

“I’ve called your mother, she’s on her way up,” he informed me. I remember thinking, this, this is rock bottom. There I was, yet again in my clothes from the night before. A strange green paint was smeared on my hands. My eyes were thick with mascara. When my parents arrived, that was it. They decided this was the time for change.

“You were convinced it was very hard to come off the Adderall but we felt it would be possible since your dose had been reduced in the past...When you were eventually totally off the Adderall, the fun, relaxed, and charming Emily that had been so hidden behind the anxious and aggressive stranger you became on Adderall, emerged.” And so, the letter ended.

My second hospitalization left me with nothing. I lost soccer, my teammates and my only friends. I lost the one thing I was good at, the only thing that was consistent in my life. When I met with my coach, she promised that she would not make any sudden decision in terms of my spot on the team. Less than a half hour after I left her office, I received an email sent to the entire team that said I was no longer a team member. I couldn’t fight anymore; so, I agreed. I would listen to the changes my parents wanted to make to my medication. 

With that, I lost the last constant in my life, my Adderall. If I didn’t let it go, I don’t think I would have survived much longer That day, that very last day of my Freshman year, was the last day I ever took Adderall.

Looking back on these events, two years later, I don’t know how I made it through them. Initially, life without Adderall was miserable, but my suffering proved to be worth it. After two months or so of no medication, I was in the car with my brother Henry, and he turned to me and said, “You know, this is the first time we’ve seen your actual personality in like four years.” When I first stopped taking Adderall, I thought I was becoming a different person, but it has taken me years to realize that who I thought I was, was simply a collection of symptoms from a strong medication. I had no idea who I was. I’m at least five years of self-discovery behind my peers and rapidly playing catch up. Turns out I don’t need anger management, I’m not half as confrontational, and I am not an alcoholic. When I see my friends take Adderall as study help I want to flush it down the toilet. Few understand the drug’s capabilities. There is a price that comes with total concentration, and it is not a price anyone should have to pay.