What actually happens when a person starts taking ADD/ADHD medications?
At a most basic level, ADD/ADHD medications work to increase an individual’s arousal level to some greater or lesser degree. In addition to becoming more alert, he becomes more reflective, less distractible, and better able to focus and sustain his concentration for longer periods of time. He begins to tune in to the impact of his behavior and the quality of his performance.
As a result of these improvements in attention, the person’s overall awareness of himself improves; he begins to think – to use that little voice in his head. This, in turn, makes for improved self-control and more effective problem-solving.
How these dramatic changes in attention actually affect individuals with ADD varies considerably depending upon their underlying temperament, status of their skills and abilities, and the circumstances of their lives. For the majority of individuals, at least initially, this can be an awe inspiring experience similar to that which I went through when I first got my glasses: “Wow, there are leaves on the trees.” I was obsessed for several days with looking at people’s faces, enthralled with the features I had not noticed for years and I rejoiced that I really didn’t need to buy a new TV . . . the picture was sharp and clear!
I have had many individuals express this same type of wonderment about their new world when starting medication. Some voraciously read for hours at a time, some started obsessively cleaning the house, some marveled at their ability to think clearly, and some talked incessantly sharing ideas that had been bottled up for years.
On the other hand, for some, the honeymoon is short lived. That’s because everything that happens when someone starts paying attention for the first time is not necessarily positive. For a child, this might mean a sudden realization that he is flunking at school, is behind the 8-ball at home, and that others have been laughing at him, not with him. Similarly, with an adult, it can be devastating for her to tune into the fact that she has $40,000 in credit card debt, is 50 pounds overweight, and is in a relationship based on need, not love.
Such sudden realizations of the circumstances of life and ADD’s impact can precipitate the emergence of new problems like depression and anxiety, which require support, management and, sometimes, other medical treatments. This is one of the key reasons I believe the medications should never be used by themselves, but always in combination with other supportive therapies.
Dr. Liden is the Founder and Medical Director of The Being Well Center, located in Pittsburgh, PA. For more of his 30-years’-expertise insights into effective treatment of ADD, download ADD/ADHD Basics 101. Join our discussion on the 7 Keys to Successful (and Safe) Medication Treatment.