Worried about friend after ADHD diagnosis

[Anonomom12]

My friend has always been a bit wacky and I think we all knew she was neurodivergent in some respect. Anyhow she has been struggling more for some time and decided to get herself a diagnosis and some help.
She was diagnosed as ADHD and put on some medication (I do not know what) I hadn’t seen her since the diagnosis and medication started until last week, but we’d been in touch via messages frequently and she’d told me how much better she’d been feeling and how much more in control and on top of her life. All good.

I was shocked when I saw her, firstly she looked almost emaciated, she seemed absolutely wired. Her eyes were bloodshot, she was rambling on almost incoherently, she was almost ticking and twitching, her hands were shaking. Her usual somewhat crazy behaviour was a hundred times worse and I came away extremely worried about her.
Is this kind of thing normal when you start medication for ADHD?
I’ve not mentioned anything to her because she thinks and feels like she’s ‘normal’ now but honestly she comes across far from it.
I don’t really know what to do. Another friend who was there at the time agreed and said she’d seen her another time a couple of weeks before and she was the same then.

Is this what everyone on medication for ADHD becomes like? I’m really shocked and concerned

@Anonomom12 it’s exactly this. Wrong meds, wrong dose, or wrong diagnosis.

I went through the same thing with a friend a few years back. There was definitely something going on, but she was adamant she had ADHD and she managed to get a diagnosis online during the lockdown period.

It was awful to watch as she just kept saying “I feel great - better than ever”. But she was incoherent most of the time, totally buzzing and everyone was asking me if she was okay - and what was she taking. Totally driven by the effortless weight loss and went from a size 12 to a size 4 very quickly.

Over time I found it too much to be in contact with her as she presented as a drug addict… taking time off work, losing her accommodation, disappearing for weeks on end and then only resurfacing to ask for money.

I have another friend’s daughter who is also presenting the same - and I have tried to warn him that this is not the norm, but I am met with “She’s feeling great - best ever”. When she couldn’t get hold of her medication the phone calls he received were very worrying.

We have individuals in my family with decades old diagnoses of ADHD and they do not present like this at all!

So this is what everyone medicated woth ADHD is like all the time? Why do people take the meds??

Erm, nope!

Could she be taking something else on top of the prescribed meds? Has she ever used illicit substances, could this be a possibility?
My experiences of ADHD meds = calm & focussed.
Unless I have PMT, then I'm just manic with meds or no meds.

I have an online provider (NHS service through an independent provider). I asked my other half to note down what he noticed too as it’s really tricky to objectively analyse the effects on yourself and I’m aware that I’m not physically in the room with my titration team. I’m sorry - sounds like it’s wishful thinking on the part of your friend. Definitely try to get through to her - it’s not good to have the wrong meds/dosage. I used to keep caffeine pills by my bed as they helped me calm down and sleep - stimulants shouldn't be making her wired!

Just to follow up because I forgot to say…normally, I feel quite flat. Exhausted by life. I didn’t take them today (forgot until it was too late and I wouldn’t sleep). It’s like wading through treacle. Can’t focus on any one think. Like thoughts in my brain are a pinball machine with multiple balls, setting off lights and noises in a chaotic manner. On meds, I’m focused. The thoughts are more coherent. I’m motivated. I can get stuff done. The side effects have eased off. I’m a much happier person on meds and that’s why I chose to take them. But my brand and dose doesn’t work for everyone,

Goodness this is worrying. How is your friend now? Did she ever improve?

@Anonomom12 honestly your friends situation is serious. She risks significant health consequences including addiction (which isn’t possible if you have adhd and are on the right dose).

No I really don’t think so. If she was she’d say so , she’s not one to hold back. Has always been an oversharer so if she was taking something else I’m certain I’d know about it

My ADHD meds make me focussed and quieten my mind, but early side effects were rapid weight loss and some ‘tics’ - licking my lips and chewing my mouth were the main ones (caused by dry mouth). I also felt a bit ‘high’ initially.

The side effects started to wear off after about a month, and decreased further once I was on the right dose.

Do you think you could broach this with your friend?

If she has only just started taking meds, then it could just be an initial adjustment period. The side effects should settle after a couple of months. It is a good sign that she is feeling calmer and more focused. ADHD on the inside can be different from ADHD on the outside.

Stimulants don’t in fact have the opposite effect for people with ADHD. We do have more or less the same brain as everyone else, despite the dopamine deficiency, and we can have the same reactions to stimulants. Anecdotally yes, but people without adhd experience this too and it’s often the effects of having a fast metabolism (the calm feeling can be the after-effects of having metabolised the drug quite quickly).

That said, if she’s not eating enough with it (or in too high a dose as people have suggested) it will also have this effect. Same as for anyone.

Unfortunately until they create something more sophisticated, stimulants (along with their occasional side effects) are the only drug we have to help with focus but the feeling it invokes is probably not really like being neurotypical.

If it’s the right drug for her she should be able to get therapeutic benefit on a dose that doesn’t have those side effects

I don’t think there’s a straightforward answer to this @BonifaceBonanza@Pinkclarko . Different types and doses of medication = different effects for different people etc. Some people with ADHD don’t take medication, because the side effects outweigh the benefits for them. Others do well on one drug, but not another.

I agree with you, though, @BonifaceBonanza that a stimulant is a stimulant, and some of the physical effects of some drugs (particularly the amphetamine concoctions, like Elvanse) will be present whether you have ADHD or not.

I personally don’t feel ‘calm’ on my medication, but I feel focussed and my brain chatter shuts the fuck up for a bit so I can actually make decision and be productive. That can spill over into being a bit manic around my cycle, but I’m aware of it and lower my dose for a few days when I recognise it. I definitely have (combined type) ADHD.

I also remember feeling ‘high’ in the first few weeks of being medicated, which I think was because I was getting so much done and it was a buzz to feel like a functioning human being! It wore off, though, as I got used to the ‘new me’.

The people I know with adhd who take medication are more focused for some hours until the effects slowly wear off later the same day. Then they seem their normal self.

In someone with ADHD it wouldn't have this effect though, it would regulate not stimulate

My meds don't affect me like this. They calm my brain and have reduced my anxiety to the point where I no longer need separate meds for it.

I can focus, reflect and control my impulsivity. I sleep well and whilst I lost a small amount of weight at the beginning, that stopped.

I would hope that your friend will have a meds review very soon. She should be weighed and get blood pressure taken. Meds don't work for everyone or she may be better on one of the non stimulant ones.

Be honest with her though, she may well be feeling better in her head but really not want to let go of something that part works, despite the risks and side effects.

If you're on too high a dose it can still have a stimulant effect in someone with adhd though, just the same as if someone with adhd took cocaine or speed it wouldn't send them to sleep.

Ritalin used to have a speed effect in many people- it was often diverted- as are other drugs with a psychoactive effect.

Sounds like it’s not doing her any favours as a drug.

Sounds like she’s either being prescribed or is taking far too high a dose.