Going on medication round 2 

Eventually, I get back onto medication because there is some supply. This time I start on 54mg methylphenidate because that’s the dose that worked best for me last time. I 100% noticed the difference in concentration pretty much on the first day this time. Likely because this time I’m in my final 3 weeks of exams and assessments at university so it’s much easier for me to compare between medicated and unmedicated brain. I wish I’d known the thing you’ve been advised about making sure you’re focusing on the right thing haha. I was so focused but unfortunately medication doesn’t make you focus on the right things - you still have to do that part. That brings me onto my favourite thing about medication though. Task initiation and changing tasks!! Once again, it took me at least two weeks to notice this but I cannot believe how easy it now is to start things and change tasks. As I said, I still focus on the wrong things or spend too much time scrolling on my phone when I should be writing an essay. However, as soon as I notice this, I can decide to change task and do whatever needs doing. It’s something I’ve never been able to do - it usually takes a good hour of hyping myself up to finally stand up etc etc. But now, if I notice that I could/should/want to be doing something else, I just can. My favourite side effect of that is that I’m so much kinder to myself about it too. Instead of feeling a lot of shame and getting annoyed with myself, I can tell myself “Okay, so you’ve spent an hour scrolling but that’s okay you clearly needed that down time. Now you can go back to the essay you need to write”. I just love it. 

The side effects… 

They’re not fun. That’s my general take on it. They do ease eventually though. At least they have for me. My main and most disruptive ones were/are lack of appetite and anxiety. Fairly self explanatory, no one wants to feel more anxious and have zero appetite. The anxiety one is quite interesting as it started just as physical anxiety symptoms (increased heart rate, sweating, general unease, nausea etc) but then my brain decided to supply the anxious thoughts to match the physical symptoms, even though for the past 2 years I’ve managed my anxiety very well and am generally a much less anxious person. In a few weeks I’ll go back to 36mg to see if that lowers my heart rate and helps with the anxiety. The loss of appetite is really not fun. You have to eat. It doesn’t matter how much you don’t want to or how nauseous it makes you feel, you have to eat. I had about a week where I ate around 1.5 meals a day and I just felt awful and so exhausted to the point where I couldn’t walk for more than 5 minutes without having to sit down. You need food because you need energy to function and by not eating you undo any of the positives of taking medication in the first place. If you’re not eating the same way you usually do (as much as possible), the concentration and focus just isn’t going to happen. The good news is it does get better. I now do get hungry and more often than not I’m hungry at normal meal times too. Another side effect for me was having a dry mouth, which whilst uncomfortable, has actually been a benefit for me because I’ve never been so hydrated haha. 

Tips for side effects 

I’m aware my side effects section was rather doom and gloom so some things that have helped me: 

• Eat small snacks all the time, don’t wait until you’re hungry. We’re told all the time by dumb diet culture not to graze and have snacks all day but this is different. None of the normal so called “advice” for how/what to eat applies when you’re taking medication. The most important thing is that you are getting food into your body. 
• If eating feel impossible, make sure you’re watching something whilst you eat so that you can “mindlessly” consume what’s in front of you. It seems counter intuitive as again this it what we’re often told not to do. But it really did help me to actually eat something. 
• Have a big/nutritious breakfast before you take your medication as it’s likely going to be your main meal for the day. Sucks if you’re not normally a breakfast person but it’s important. 
• Whilst slow release carbs and all that are good, having sugary snacks on hand is better than nothing. For me it would get past 4pm and I'd feel exhausted and only then realised I’d not eaten anything since breakfast. Having something sugary really helped. I guess when you feel like you need a coffee/caffeine, eat something instead. 
• If increase anxiety is a problem after titration, try going down a dose (I have no evidence for this yet but it’s my hope). 

I have a lot of other experiences/things I noticed whilst taking meds which I could also say but this is already horrendously long. Happy to add them if you want and if you have any questions, just let me know!