Hi everyone. I apologize that I've been MIA for so long. I'm back to posting on Wednesdays, for real. --Mary
The last time I posted on this blog, I shared my ADHD diagnosis. I have not written since then, partly because of the holidays, partly because I was busy going through the grief cycle about this diagnosis about five times. It’s a lot to realize you have this thing that’s never going to go away, that some things will always be hard. And it’s especially hard when you also realize that regular medications like Adderall aren’t going to work for you.
To be clear, by not working for me, I don’t mean that Adderall was ineffective. The week I was was on Adderall absolutely incredible. The cold, damp fog over my brain lifted and I felt AMAZING. I had more energy. I had more focus. And most surprisingly to me, I felt much more emotionally stable. I had read that ADHD affects your emotions but didn’t realize how much it did until then. And on top of all of that, doing so well on Adderall gave me official confirmation that I did, in fact, have ADHD (because of course I doubted that maybe I just hadn’t done the test right and this was all a lie and I was, in fact, just a lazy, unfocused mess). If I didn’t have ADHD, Adderall would make me feel like I was on speed. But I wasn’t--I just finally felt like a normal person.
Adderall and I will always have that one glorious week together. But alas, it wasn’t meant to be forever. Why? Because of my other health condition, endometriosis.
I’ve mentioned in the past that I have endometriosis. What I haven’t mentioned is that this fall I had to have my second surgery to remove a 8.5cm cyst (yikes) and other endometrial tissue. The surgery was very successful, but I also found out that my endometriosis was at Stage IV, the worst stage, which is not great for your health in general, including your fertility. Sobered by this news, I doubled down on my efforts through diet to prevent it from coming back or getting worse, including giving up drinking regular coffee, which, with its caffeine, is thought to have an estrogenic effect, which is bad news for endometriosis. I love coffee, so it was already hard to give it up, but it was even more sad to me because I’d learned about how caffeine, because it is a stimulant, is a way that many people help manage their ADHD symptoms. In the few times I’ve had a regular cup of coffee since my diagnosis, I can tell IMMEDIATELY how much better I feel. (And I know exactly why I drank so much coffee in college and grad school.)
But then I started thinking about it more -- if caffeine, which is a stimulant, is bad for my endometriosis, wouldn’t Adderall, which is a MAJOR stimulant, be REALLY bad for my endometriosis? I’m sorry to say that there’s little definitive information about this (after all, most ADHD specialists don’t know anything about endometriosis, and many OBG-YNs, in addition to not knowing much about ADHD, don’t even acknowledge dietary effects on endometriosis), so the default seems to be, “It’s probably fine.” But I did find enough information that suggested that stimulants would make endometriosis grow faster to make me want to stop taking them.
So I stopped taking Adderall and dealt with both the withdrawal symptoms and the sadness and anger of feeling like my body was working against itself. Why did I have to have these two specific conditions which, if I treat one, make the other one worse? How unfair was that? It was really, really hard.
But as is usually the way with these things, I realized that all wasn’t lost. I’ve come across some research about an amino acid supplement that could help a lot with my ADHD without (I think) making my endometriosis worse -- I still have to discuss it with a doctor. In the meantime, though, I’ve found an even more guaranteed method to feel better with both my ADHD and my endometriosis -- exercise. According to one broad survey, exercise is the most consistently effective treatment for ADHD, even more so than prescription medication. And women who exercise consistently are less likely to have endometriosis. You’re also less likely to have anxiety and depression if you exercise regularly, too.
I’ve seen this in my own life -- the time when I felt the best mentally was the semester in college where I did a Navy workout five days a week. (I’m still not sure how that actually happened, but somehow, it did.) I had my first surgery for my endometriosis right after that semester, so it was in a pretty advanced stage, but I don’t remember feeling the effects of it that much during that time. So dang it, exercise works! I’m trying not to be too hard on myself for having a hard time exercising regularly in my life (like, literally besides that one semester)-- if you feel bad, physically, mentally, and emotionally, exercise is often hardest thing to do. But now that I know how effective and important, nay, crucial it is for my life, it’s been a little easier to get past the initial hurdle. I’m trying to make exercise and especially getting outside (some people think that ADHD is in some ways a nature-deficit disorder!) a non-negotiable part of my day, the way I have with eating well.
In the end, I’m (almost?) glad I’ve been forced to find other ways to deal with my ADHD besides stimulant medication. Not because I think medication is bad or doesn’t have its place--I’m still taking two antidepressants, after all, and was happy to find out that Wellbutrin is kind of secondary medication for ADHD. But, in general, I’ve found that I feel most comfortable with treating chronic conditions like endometriosis or ADHD with “chronic” lifestyle changes because it seems like they can get more to the root causes of the issues without bad side effects or risks. And no matter what, I know I’ll be better off in general if I’m eating well and exercising regularly. At the same time, I realize that sometimes lifestyle changes aren’t enough, or aren’t feasible given your life circumstances, or aren’t even doable without a little boost from medications, and that taking medications long-term, even with those risks and side effects, is absolutely the right call. I know that I could NEVER have started changing my diet and exercise habits without the boost from my antidepressants, and even though I’d love to be able to get off of them someday, I acknowledge that I may never get to that point, and that’s okay. And sometimes you need to take more intense measures, like having surgery for endometriosis. And hey, maybe someday when I’m not worried as much about the effects of endometriosis, I’ll take Adderall again. I just have to keep working with what I’ve got and where I am, and so does everyone else.
But for now, while I’ll always have a special place for Adderall in my heart, I’m going to try to live without it. If you’ll excuse me, I should go take a walk.