Square Pegs Vol 7: The Double-Edged Sword of ADHD Medication
- sarah89335
- 7 days ago
- 5 min read
If you had told me a year ago that I’d be starting my 40s (October is getting closer!) by staring down a prescription bottle of stimulant medication, I probably would have laughed. Yet, here I am, diagnosed at 38, navigating the wild, unpredictable, and deeply profound waters of titration.
For the past few weeks, I’ve been conducting a live science experiment on my own brain. I started on 30mg of Elvanse, and recently stepped up to 50mg. It has been a revelation, a relief, a physical challenge, and an unexpected identity crisis all rolled into one.
Because as it turns out, clearing the neurodivergent fog comes with a price tag. Medication is a tool, but it’s also a trade-off.
Here is the raw, unedited reality of my first week as a medicated ADHDer.
Diary of a Brain on Elvanse
Day 1: The Rollercoaster
I wake up feeling sluggish (like every day for me), take the tablet (knowing that it takes an hour or so to kick in). I’ve taken the day off work, unsure of how this is going to affect me, good move I think!
Hour 1: A slight notice of a quieter brain.
Hour 2: The alertness kicks in, accompanied by a desert dry mouth. I sit down to watch TV and experience a bizarre sensation: I am actually taking in what is happening, scene by scene, without scrolling my phone or thinking about ten other things.
Hour 3: I’m very calm and slightly spaced out. I completely lock into a game on my phone. I realise it’s 2pm and I haven't eaten as there is no brain noise about food anymore!
The peak: 3pm - 7pm I smash out four hours of solid, unbroken work. Even though I scheduled a day off, my brain wanted it. I am completely locked in. But when I finally stand up, the room spins. I’m wobbly on my feet and realise I’ve barely touched my water.
The Crash: By 9.30pm, I realise I am hungry again. By midnight, a blinding headache arrives. By 3am, I am still wide awake, staring at the ceiling.
On Day 2, I take the tablet at 7.45am. From noon to 3pm, I am utterly consumed by the garden (good job it’s the weekend!). The constant itch to check my phone or reply to messages just… vanishes. But the midnight headache returns, and I can’t get to sleep till 4am.
By Day 3, I am hyper-productive but floating. I organise a massive food shop (high in protein as recommended by my prescriber) but feel completely spaced out navigating the bright lights at Tesco. I don't eat a single thing until 4pm. I am ticking everything off my to-do list like a machine, but by 1am, I’m awake and feeling physically sick.
Days 4, 5 & 6: Getting the hang of it now, ensuring I eat at the right times and the side effects begin to dull, but so does the improved focus. I’ve developed a routine: I set an alarm for 8.30am, take the tablet, and snooze for an hour. By 9.30am, the medication has kicked in and I wake up feeling genuinely energised and ready for the day.
Week 2: I’m Titrating up to 50mg at the start of week 2. The Day 1 side effects are back, but so is the laser focus which had been lacking. The rest of the week follows a similar pattern with the first few days being a struggle to sleep, super dry mouth and headaches; but add in the bank holiday heatwave and caffeine withdrawal and it’s hard to know where the headache has come from!
Re-Learning How to Eat (and Drink)
One of the steepest learning curves of this journey has been physical survival. When Elvanse wipes out your appetite, food becomes an administrative task. If a meal requires five steps, executive dysfunction wins and you don’t get the nutrients you need.
I’ve had to completely re-think my diet for a low appetite lifestyle. It’s all about low-prep, high-density nutrition. I've leaned heavily into: high protein yoghurts, eggs, chicken, salmon, rice, and freezer veg including edamame beans for a satisfying snack.
Then there was the beverage crisis. I used to be entirely dependent on full-sugar Coca-Cola for that sweet, bubbly dopamine hit.
I was once introduced to a new Chief People Officer as the girl who's addicted to Coke!
Dropping down to one can a day to avoid over-stimulating my heart on Elvanse gave me horrible caffeine withdrawal headaches.
The fix? Digging out my old SodaStream. I found that if I carbonate water to get that intense, sharp "throat burn" Coke has, and mix it with a fiery ginger cordial, my brain gets the sensory stimulation it’s craving, minus the caffeine crash. Also, thank goodness for Pepsi Max caffeine free.
The Double-Edged Sword
Now that I’m on 50mg, the daily headaches have settled, the task paralysis is gone, and I’m making incredible progress, and the weight loss is an added bonus.
But as the dust settles, I’m noticing a quieter, more bittersweet side effect. It's muting my magic.
The 50mg dose has successfully dialled down the ADHD chaos, but it has also slightly muted some of the bits of my ADHD that I actually love.
When I am delivering training, my unmedicated brain is hyper-intuitive. I can scan a room, read the collective energy of twenty people simultaneously, pick up on the micro-shifts in body language, and pivot my delivery in a split second. It’s a fast, brilliant, creative superpower.
On medication, that feels slightly dimmed. I am focused, I am on track, and I deliver the material flawlessly, but I feel less connected to the invisible energy of the room. The "superpower" has been replaced by a consummate professional. And honestly? There’s a little bit of grief in that.
Titration is teaching me that medication isn’t a magic wand that turns you into a "normal" person without a cost. It’s a compromise. It gives you the executive function to organise your life, clean your garden, and smash your workload. But sometimes, it dials down the volume on the very empathy and intuition that make you you.
As a square peg, I'm learning to navigate this new shape. I’m incredibly grateful for the focus, but I’m making a conscious note to hold onto the magic, too.
Let’s Chat
I'm Sarah, a People Development Consultant who champions the 'Square Pegs' in business. I work with high-achievers, unconventional thinkers and teams who are exhausted from trying to fit into traditional 'round holes'.
Essentially, I cut through noise to help businesses figure out why their people are struggling. I help individuals move from just enduring their week to actually enjoying it, and guide teams on how to stop judging their differences and start leveraging them as strengths.
Whatever the problem, my aim is to help individuals and businesses embrace their 'square edges' with creative strategies and solutions that genuinely respect how different brains work.
If you’re neurodivergent or not, I’d love to hear how you are learning to embrace your Square Edges?
Stay Square,
Sarah
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