The Unexpectedly Great Side-Effects of Getting my ADHD and Anxiety Handled
And one of a few shitty ones, too
Content note: Talk of mental illness, weight, etc. Take care of yourself. ❤
Before I got on a battery of pharmaceuticals to help my brain work better, I—like a lot of people!—was very sure that I was doing great.
Sure, I had some troubles regulating my emotions, but as long as I wasn’t removing my clothing in the street, getting jailed for shoplifting, or running my car into a building, I was pretty sure that I had it covered. Because those stories—the disrobing, shaving-your-head, nights-in-jail, Your-Honor-my client-has-no-memory-of-that stories—are what we hear about. That’s what mental illness looks like. Everything up until a catastrophe is fine.
In fact, it was kind of cute and I reveled in it.
Turns out, you can’t get healthy and hold on to all your bullshit ideas about sexy tragedy.theestablishment.co
What I didn’t realize—what a lot of us don’t realize—is a million little things that I didn’t like about myself, that I tried really hard to fix, that I felt like I had little control over, were also part of it.
There were symptoms that I didn’t know were symptoms because most often when we talk or write or make media about mental illness we do a piss-poor job of describing it accurately.
As a result (or perhaps because of this), most of us don’t have a super-nuanced view of how the three-pound meat-computer works, or how, when something goes wrong or isn’t put together quite right to begin with, the symptoms can be a lot more broad and squishy than we realize.
Like, if someone asked you to name a few symptoms of adult ADHD, what would you say?
Would you say “interrupts people”?
Would you say “road rage”?
Would you say “lethargic”?
We’re also really quick to ascribe behaviors, feelings, and actions to personality quirks or personal failings, rather than to conditioning; historical, mental, or physical trauma; systemic breakdowns, or something misfiring.
Mental illness is craziness, being stark-raving mad, or it’s nothing at all. Losing your keys every single day? Sweaty palms half an hour before the bus comes? Chronic lateness? A short temper? That’s just you, and no one likes you because of it. Unless you decide to own it! In which case, get it, girl!
To combat decades of slick marketing and a lack of visibility in media, we’re taught to be ruthlessly individual, our exact selves, and perfectly imperfect. Take me or leave me. If you can’t handle me at my worst, you don’t deserve me at my best. Flawless.
I’d ingested all of that, because that’s a kind of marketing, too.
But—at least for me—I have come to find out that ~living my best life~ requires making some small improvements to the wiring. Reveling in my own disfunction didn’t make me interesting or smart or authentic—it made me mean. It made me panicky. And it made me a shittier writer, worker, friend, daughter, sister, girlfriend, dog caretaker, and neighbor.
From small compulsions like biting my nails to much much larger interpersonal issues that had left people I cared about hurt and upset, I held these threads of shame without ever realizing that they were connected like a tangled ball of old dental floss.
Because I think it’s important to talk about this stuff, I wanted to share the—unexpected, delightful, surprising, sometimes shitty—ways that taking care of my brain has changed things for me.
This may not be true for you, but I suppose the thing I really want to say is: There are a lot of ways that mental illness crops up. Ways that we don’t really talk or hear much about. It’s possible that you’re not just a terminally flawed person who has to either accept it or die trying. It’s possible that trying something to help it might have a pretty cool ripple effect.
So here’s what it’s done for me:
My grandmother—who stands just about 4'9" but can fill her entire trailer with her voice and personality—grew up steeped in machismo and, as a result, seems to constantly be battling her own feminist (she wouldn’t call it that) beliefs and the internalized misogyny that’s woven into her.
To hear her tell it, “all women are bitches and all men only want one thing but thank heavens we have all found gentle men who don’t hit us and can put up with us” but also “I love how strong my girls are. They don’t take any man’s shit.”
Some of this is definitely also confirmation bias on her part; we are, in general, a fighty people. Meals get loud and hot and, to people who grew up listening to the sounds of flatware scraping plates and nothing more at dinner, it’s a bit overwhelming.
So I sort of always assumed that I was just raised like that, that it was in me to be a person who couldn’t back down from an argument, who was frequently an instigator, and whose own need to be right was, well, right.
Turns out! One of the (many) missed symptoms of ADHD in both adults and kids is a quick temper, anger, and even feelings of rage.
In The Distracted Couple: The impact of ADHD on Adult Relationships, Dr. Larry Maucieri and Dr. Jon Carlson explain:
People with ADHD tend to feel and display their emotions more intensely compared to people without ADHD (Surman et al, 2011). Although it is not part of the DSM-IV-TR or the proposed DSM-5 criteria, people with ADHD are often known for their strong reactions. This includes not just anger—every feeling may be more intense. When it is the positive emotions, such as such as happiness and humor, this can make people with ADHD more interesting and engaging. Unfortunately, anger and frustration tend to have the opposite effect.
As a kid, when forced to sit still for prolonged periods of time for something that wasn’t interesting to me (laundry mat, school assembly), I would sometimes become so physically uncomfortable and so frustrated that I would eventually get angry. I could feel it expanding in me and growing like vines through my limbs until I would either make an excuse to get up (go check the machines, find the restroom and wander the halls) or I would become disruptive.
My report cards frequently included notes like “pleasure to have in class; sometimes distracting to other students.”
As an adult, this manifested in a displeasure for going to the movies (I’d get anxious about what was happening outside of the dark, extremely stimulating and loud cave of a theater), a need to get up from my desk frequently, and an inability to walk away from even a casual argument without feeling like I’d not only won, but that I had completely decimated the other person.
Because I’m a writer and have a bizarrely encyclopedic knowledge for data, I could usually do exactly that thoroughly and with precision—but it wasn’t kind and it wasn’t empathetic and I wasn’t listening.
This isn’t easy for me to admit now. It’s not flattering and I don’t like it about myself.
But in the time since I’ve been figuring out my meds for both ADHD and anxiety (you know what’ll make you feel really angry sometimes? CONSTANT TERROR), I’ve found that I’m able to let someone say something that I don’t agree with and rather than immediately snapping why that’s terrible and here are ten million facts to back up why, I have this magical power called listening and then letting them say their bit.
This doesn’t mean I let people steamroll me—I will still reduce an Egg (they’ll always be Eggs to me) to a smoking pile of rubble on Twitter if they come at me with some nonsense, and I’ll collect my people in my real life when it needs to be done—but it has dramatically reduced the number of meaningless fights or unnecessarily mean snipes.
Also, I’ve learned a lot and I feel like I’m better at my job now; as a person who works in politics, marketing, and writing, being able to sit through someone’s explanation of why they believe something that I think is literally the most wrong thing of all time has helped me figure out when it’s possible to bridge the gap (which is sometimes! I used to feel like it was never!) and when to nod politely and walk away. And, maybe, when to punch them.
This is very much related to the previous point, in that anger and impulse control and being combative are all pretty similar. But it’s manifested in interesting ways, including a.) fewer late night online shopping sessions, b.) fewer times leaving a bar way later and more drunk than I meant to, and c.) fewer physical compulsions.
Specifically, I have found it much easier to stop biting my nails.
As I wrote on Instagram, I have been a lifelong nail-biter. Since I was an anxious child, I have picked and bitten my nails until they bled and lived with hands that were always in at least a little bit of pain. When I got older, I started getting acrylic nails just to cover them and keep them out of my mouth. When I didn’t have my fake nails on, though, it was open season.
Biting my nails was so compulsive that I didn’t even notice I was doing it. It was impossible to stop because nothing could stop me. The combination of fidgeting and nervous energy meant that having my preferred self-soothing devices conveniently located at the ends of my hands made it entirely too easy.
It wasn’t until a few weeks after I started my meds that I realized I just didn’t need to do it anymore. Which honestly, shouldn’t be surprising; studies have shows strong correlations between nail-biting and mental health issues. One paper in 2008 even recommended viewing nail-biting in children as a symptom of a large condition, rather than simply a bad habit.
…the most common co-morbid psychiatric disorders in [nail-biting] children were attention deficit hyperactivity disorder (74.6%), oppositional defiant disorder (36%), separation anxiety disorder (20.6%), enuresis (15.6%), tic disorder (12.7%) and obsessive compulsive disorder (11.1%).
The researcher noted that if present, the detection of nail biting in children “can then be followed by looking for other more subtle stereotypic or self-mutilating behaviors.”
My own nail-biting discovery has also lead to the realization that, as I’d suspected, they do also just grow extremely slowly, which has altered my vitamin routine some. So, that’s a double-win, right?
Weight gain, lagging libido
These negative side-effects of many SSRIs are true. It’s unfortunate but it’s not lethal. That’s where the meds and the mental illness differ; one could kill me.
Improved physical strength!
Fortunately, the weight gain has also come with a reduction in many of the physical symptoms of anxiety, which include:
Though I’ve always been pretty into physical activity (to the point of also being a compulsion!) I’ve also had plenty of days where I wanted to go pick up some heavy things or move until my heart beats harder but have instead opted to lie on the couch “reading” (looking at my phone) for 10 minutes at a time before wandering around and gazing at my various belongings or petting my dog.
ADHD can also make a lot of workout-type-things—yoga, running—extremely boring. My biggest challenge with fitness has never been the actual doing it, but instead, the doing it as consistently and for as long as I need to. Since doing the work and going to therapy and taking my meds, I’ve been able to actually remain on-task in a yoga class, even when it’s not so physically challenging that I’m incapable of thinking of anything else.
Similarly, despite clinical studies which have shown that meditiation can improve symptoms of ADHD, anxiety, and depression, that kind of focus is difficult for a lot of people who live with them.
One time I went to a meditation course and I had a panic attack because I had to sit still too long and also I was worried that I wouldn’t be able to get my car out of the tight parking spot it was in. Now I am reasonably sure I could go to a meditation class and not have that happen.
This is more the lithium but having perpetually shaky hands is not ideal. It makes selfies a lot harder.
Improved sleep (for both me and my partner)
You might think that the physical symptoms of ADHD and anxiety melt away when the conscious brain shuts off at night.
You’d be incorrect.
People who are hyperactive in the daytime are also often active at night when they’re supposed to be, you know, not. In fact, one study in the Journal of Clinical Psychiatry in 2001 found that “ADHD patients slept worse and showed significantly higher nocturnal motor activity at baseline compared with controls.”
Restless sleep, wakefulness, teeth-grinding, snoring, sleepwalking, restless legs, and daytime sleepiness (I Googled “narcolepsy symptoms” LONG before I considered it was ADHD-related which is, apparently, a really common source of confusion!) are all potential nocturnal occurances.
A very small 2008 study also found that “treatment with methylphenidate resulted in increased sleep efficiency as well as a subjective feeling of improved restorative value of sleep.”
Of course, these are all frequently symptoms of a lot of other things (stress, depression, poor sleep hygiene)—but the fact that few of us would ever thing to tie our nail biting or our inability to make it through Savasana or our habit of kicking our partner in our sleep indicates (to me) that we a lot of the time, we really don’t know what to look for.
For such a long time, we’ve accepted the narrative that getting help is necessarily an unpleasant experience, that the bad side-effects outweigh the good, and your only options are to live in misery or become catatonic on some kind of toxic cocktail.
Getting medication for diseases that don’t have to do with the brain? Totally fine and normal. But getting help for the thing that makes you cry for no reason, feel too afraid to leave the house, or thrash all night long? Cheap. Easy. A cop-out. A way to avoid your real problems.
And I get it; a lot of people still don’t trust physicians and pharmaceutical companies and there are a lot of good reasons.
But when I’m anemic, I take an iron supplement. When I have an infection, I take antibiotics. When I cut my finger slicing produce, I wash it and put antibacterial goop on it. Because our bodies—which our brains live inside of and are in fact part of!—require special kinds of care and interventions.
I’m vaccinated. I got the Gardasil shot. I use birth control measures. I get my teeth cleaned. I wear contact lenses. Because there are some parts of my physical self that aren’t flawless, that need correction and assistance and care.
And medicine to help my brain do its thing is part of that. Getting treatment hasn’t been about dulling my emotions or turning me into a husk of my Real Self—it’s about correcting what needs to be corrected, and connecting which dots need to be connected.