So I’m awake after 3 hours of sleep, again, and my thoughts are going at a zillion kph, again, but one of the ones I can grab onto is “the problem here is that we don’t get medicated at night and so my brain will do this and that’s probably why my sleep is so utterly crappy and I wonder if there’s stuff about this on the Internet”.

(Yes, that was a single sentence. Trust me, I am slowing TF down to even get it to that state)

So I grab my phone and search for “ADHD stimulants racing thoughts sleep” and one of the first things that comes up is this: simplypsychology.org/adhd-raci…

And I want to say lots of things about this. Which one to start with?

Ok, firstly whilst this has a bit about “what you can try if this is you”, it’s clearly not written FOR us because it’s written in that very neurotypical style. You know the one: “90 percent of this article could have been not labouring the point and getting on with it and will you bloody chaos goblins PLEASE stop interrupting?”

Secondly, there’s a lot of stuff on the Internet of this type that ends up being “have you tried NOT having ADHD?” which this isn’t, at least for some people because I recognise the strategies it talks about, eg mindfulness, journaling, grounding, creating a routine, etc as stuff that some of my friends do, and they DO help.

But thirdly and finally, it still feels like that for me because pretty much everything it suggests is stuff I just can’t bloody do.

And I’m NOT being oppositional defiant or stubborn or wilfully obstructive here. I promise, I have tried this stuff, and most if not all of it I just can’t bloody do (except, maybe I’m literally doing one of the things now, ironically, maybe. Will come back to that).

Let’s look at the suggestions, and this is specifically about SLEEP, so the ones that are “just take the goddam speed” don’t apply here. I take the goddam speed in the daytime and that stops them and I quite often nap as a result, because I’m fucking exhausted (that’s literally the thought that started this cascade).

I’m gonna group a few: mindfulness and grounding, acknowledge and let go.

I have had people get intensely frustrated with me because they insist, pretty much to the point of yelling at me sometimes, that I should be trying these things. It seems some people can do them and they work, so perhaps a lot of that evangelism comes from a place of kindness and the subsequent frustration comes from what is seen as my stubborn dismissal.

I get that. I really do.

But I have TRIED to do all this stuff and here’s the issue; it all relies on me interrupting myself to do the shit it’s suggesting, and having the attention span and willpower to keep doing that.

And for me that interruption induces monotropic split; that stressful adrenal surge when pulled out of hyperfocus, except this time I’m doing it to myself.

And so there I am, having just caused monotropic split, literally fight or flighting myself, and now you want me to “concentrate on my breathing”, or some shit?

Yeah, cool story bro. The fucking LOOK I’m giving you, yes, you know the one, do I need to go on? I don’t? Excellent.

Sleep hygiene. SLEEEEEEEEEP HYGEINE. Well. What’s that? Develop a routine? Limit screen time before bed? Be slow and methodical and self disciplined at the point the stimulants are wearing off and gather all your executive function to act like you can actually have a rigid routine that you stick to, day after day, or at least most of them.

Trying that relies on the novelty trigger. And I suspect it will get so old so fast that it might get tried once. Or half a time. Or not at all. Look at all the pretty fucking squirrels.

I do not do routine. I can just about manage “take your lisdexamphetamine with breakfast to make it work better and rescue you from chaos goblin mode” most days.

Most

Yeah. No. Not doing that shit. Not happening. That’s AAAAAAAAAAAALL the way into “have you tried not having ADHD?” territory and actually, I have tried not having ADHD, sort of. It actually rules but it also relies on me doing that thing I’m not supposed to do: take speed in the middle of the night.

Do you do, like, maybe benzodiazepines? Yeah, I know, they stop working. Melatonin has never actually done shit when I’ve tried it. Maybe i seriously need to investigate finding someone who will let me try amphetamine and SNRI (atomoxetine) combination therapy? That might work.

Sorry. Squirreled there. My bad.

Physical exercise and movement. I’m in bed. I have needed to piss for the last 90 minutes and yet I have not pissed. Point made? Good.

Reframe. Ok, these are mostly not “I wonder why we have ten toes?” Thoughts. Ok. Some of them are. Squirrel. Most of them are actually “given the state of the world let’s dwell on the actually not implausible scenarios in which I could die quite horribly and quite soon”.

Not thanking my brain for those. Not imagining them in a silly voice. Just mostly being actually shit scared of them.

Time blocking: doesn’t apply. I’m in bed. Also stuff that’s “time management” coded falls into the category of “things that caused my worst burnouts in the half century I had no fucking help for any of this” and so there trauma-coded. That sucks.

Healthy distractions:journaling. Used to be quite the blogger but burned out. More recently I tried using the iPhone’s journaling app for a bit. Made lovely journal entries. Novelty trigger wore off. Phone reminding me to journal my day served as a repeating monument to failure. I deleted the app.

But here I am. I wrote this. It’s probably full of typos. I wrote it on my phone. Might cone back and tidy it up later. Probably won’t.

Suspect this is a once only thing. Also it took me well over an hour and it’s now half past eight and I still need to piss, and I still need to sleep.

Might be able to manage the first one at least. Finally.

God, I fucking hate having ADHD.

I’ve been struggling with my HRT levels for a while after finding out I was effectively menopausal earlier this year. I noticed this by my FSH being high. Since then I switched from pills to gel and it got me back into the non menopausal range, but only just.

I know this because I’ve been having regular blood tests. My metabolism is quite fast and clears stuff from my system quickly, so the longer release of gel (it builds a reservoir in the fat) works for me.

Anyway, since starting lisdexamfetamine for ADHD, I’ve checked my FSH using urine tests and it got a lot lower still. I figured it was somehow calming down my liver and letting the oestrogen last longer in the body.

Got a new blood test result yesterday. FSH is now MUCH lower, which is good.

But it’s not from oestrogen.

It’s from TESTOSTERONE!

Elvanse seems to have kicked my adrenal glands up a notch. I guess this makes sense. It is a stimulant. It’s taken my T from the very bottom of the female range to the middle of it. Impressive, given I have no ovaries (in cis women, testosterone comes from both the ovaries and adrenals).

Explains why my sex drive has been a bit higher of late, I guess.

Noticed when driving on Elvanse that I have to actively scan for hazards which I just knew about before.

This is making me be super careful when driving.

For those who don’t have ADHD, it’s really badly named. We don’t have an attention deficit at all. We just can’t control what it’s focusing on for long.

Basically our brains are constantly processing the entire input stream from our environment. All of it. You have no idea how utterly overwhelming this is until it switches off for the first time.

And then there’s a moment of clarity, before which you were listening to every radio station in the world simultaneously and always have been.

And now you’re just listening to one.

But with driving, I think that was actually making me a safer driver because it’s hard to become target fixated when your neurology basically can’t do that.

Something for me to be aware of. Now I have to choose to scan for hazards.

Or drive unmedicated.

Apparently if you’re a pilot with ADHD, your medical requires you to fly unmedicated. I now understand why.

Just over a week on ADHD meds now (Elvanse), and honestly, still life changing.

My clinician thinks that 50mg may be “my dose”, but it’s perhaps a little early to tell and we’re going to pick this up in a week’s time.

I’m not averse to at least trying the 60s, but we shall see.

Anyway, apparently a few people who know me find it a bit weird, or even startling to encounter me on Elvanse, especially now I’ve stepped up my dose.

Picture someone you know who has always been a “chaos goblin”. I’ve always been very outgoing (it’s a mask. I’m terrified), mercurial, eager to say my piece, etc.

Now picture such a person on speed, which is basically what Elvanse slowly converts to in your red blood cells.

The picture in your head probably isn’t someone sitting still, waiting their turn in conversation, speaking slowly and with consideration.

I’ve been told I look “drugged”, in a way vaguely reminiscent of benzodiazepines.

Nothing could be further from the truth. I am alert and focused. More than I have ever been before. I just don’t feel the need to interrupt you and finish your sentences any more.

At least, not until the evening, when it wears off. Then I’m the chaos goblin again.