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Concerta v. Vyvanse
Parents please be encouraged.
I am a 50 year old dad with a gifted mind. Graduated from a Big Ten school and secured an MBA from a Top 5 school.
That said, being a student was an awful experience, especially non-recreational reading. Prior to medication, in order to maintain focus while reading I would literally punch my thigh if my mind wandered from the topic within a page. I rolled buttons in my mouth to provide physical relief to the mental anxiety brought about by non recreational reading.
That quick summary comes only after beginning concerta 4 years ago. 72 mg per day, 36 early AM and 36 late AM. A more effective me was created. Prior to meds I self medicated, somewhat and arguably effectively with lots of caffeine.
Unfortunately over time, with the concerta, I came to understand the "come down" at end of day was really unpleasant. As the med wore off, all of the days stresses and unfinished deadlines seemed to physically grab me, each seeking completion in the moment. More on that later. My response was to have a drink. Truly just one or two. That was fine in the moment but the recurring pattern caused me to question the source of the habit and so I stopped it. The resulting 3 weeks was truly unpleasant. Especially since I am the first responder with our 4 children, 9, 11, 15 & 16. Their post school schedules are enough to frustrate two non-ADD parents, let alone this ADDult.
Regarding TICs, I'd invite you parents with ADD to read about Dabrowski's overexcitability syndrome. Dabrowski theorized and observed, some humans have a more than significant connection between physical activity being linked with mental and emotional stimulation. Get us thinkjing and we have to move. Tell us to think and sit still....you want me to do what?
Now take that perspective and translate it from interpersonnel interaction, ADD with outside world, to intrapersonal interaction-inner dialogues, us ADD's within ourselves. This is my personal experience with Tic's and end of day tourette like verbalizations. What you call tic's were simply my inner dialogues leaking to the outside world. I would shake my head to free myself from the perceived physical grip of a "deadline". Perhaps your little one's with Tics are revealing inner dialogues? Maybe something on TV or physically nearby triggered an inner vision or projection, e.g. a truck drives by and they imagine it in an accident, that trauma impacts them and they shudder. Maybe ask them. "What are you thinking about? Were you just thinking about?" etc. You're a parent. Have you ever seen your child near a ledge? or too close to a street? or near the top of the steps? You lunge, retrieve your child and possibly shake for a few moments as you inner dialogue the negative outcomes averted? Perhaps I can say welcome to our world. While it requires a significant trauma to physically stimulate you. Many thoughts, many less traumatic by the outside's world stimulate physical reactions and the desire for us to move. Please know my summary will partially fit for some of your offspring and not for others. A wise man once pulled of his glasses and handed them to me. He said, "these help me see better they'll work for you." Just about everyone can relate to the inaccuracy of that statement. Eye glasses are truly variable and personal in their creation. Please know the same is true for sculting the med prescription for your child.
My 3 week journey through end of day TIC ville was unpleasant enough to mention it to my doctor. He recommended Vyvanse. 14 days and counting. Tic's gone, far more "accessible' to those around me. This new me leaves me able to contrast my inner thoughts with Concerta and the post switch, modality. Here are some observations for the outside world.
My personal coping mechanism was to attempt to leap from task to task quickly enough to race through my days. Unfortunately, if I couldn't foresee the tasks completion it self selected out of my day's work. Short term work on long term tasks were left undone and my work suffered. For me Concerta exacerbated that cycle. I did more short term completions, was presented with more long term opportunities, and left more of those undone, which lead to more deadline anxieties as the undones outpaced the short term dones. These undones, were what "rendered" me physically at end of day.
I recently desribed my inner world as managing the starting gates of the Kentucky derby x's 5. Each task, and each of its myriad sub-tasks is a riderless horse in the starting gate. Each is bursting to come out and be completed. I know if I let one out, 3-6 gates open and those horses follow the one I selected. So I'm torn between riding the optimal one, co riding 2, and forcing three back into the gate. Concerta afforded me the dilusion I could do this. And in some degree of accuracy it worked, but with negative outcomes as well.
Each request is seen in my head from the moment of request or inception. You say feed the kids breakfast, my mind spins from cabinet, to fridge, to stove, to sink, to drawer, to dishwasher and I either move or opt out. Changes of path were unwelcome so I micromanged compliance with the kids. "here's the routine, let's not digress." This became less effective as they grew. I bore the disconnect. I became less accessible to my more "feeling" children.
Attention Deficit is truly a tongue in cheek mis-label. We don't have attention deficit we have Volitional Deficit. (Unfortunately that acronyn is taken so I'll contract to v-def.) In some respects, we aren't deficient in attention, we pay attention to every thing! The sounds, sights, stories, back stories, etc. We simply don't have the volitional control to self select what interests us most. Our world is Direct TV's 735 channels and we dance on the remote for the next engaging show, inner or outer world. Not effective from a task list perspective, but it is our world, and in some respects enjoyable. We see more of the world than single minded people and can make connections sooner because you haven't been there and back as many times. One colleague once persisted in telling me "You think too much!" He said this repeatedly for about 6 months. One day I replied, "you breath too much" he replied "I can't help it. I have to." I replied..."there you go." I never heard it again.
As I matured to 50, I started unmasking my inner self and simply learned to self select to venues that rewarded my fast moving attention. I left corporate america because 50 minute meetings that slowly revealed conclusions I had in the first 5 minutes were torturous. School may be similar for some of your offspring. Find the right garden for them to blossom, don't box them in the typical k-12 scenario, no disrespect to same. It works for so many, but is torture for us.
As you can tell many topics and perspectives leak or pour out. This may be a foreshadowing of life with your adult child?
With respect to the Vyvanse, I find I'm more patient with others and can work on longer tasks, it has quieted the horses in their gates. Frankly some even graze waiting for me to call. Physically, it has allowed far better and deeper sleep. It has significantly altered my taste for alchohol. I was historically, through college and there after a chronic to occasional binge drinker. The other night I reached for nice merlot to accompany lasagna, it was bitter and chemically unpleasant. I poured out the bottle. I attended a college football game, walking through miles of tail gaters. Not only did I not have but didn't even desire a beer. Wayyyy not like me..even on the concerta.
I am also finding my caffeine habits, 4-7 cups per morning, are unwelcome as they combine with the Vyvanse and result in stomach upset, gerd like throat discomfort and some breathing hypertension. Decrease the caffeine and these maladies subside.
This is a long post. It is intended to help you gain some hopefilled inner window of the world inside your ADD offspring. We're okay in here, we frustrate you alot. ( My elementary school report cards were full of "DADD can't stay in his seat." and "talks with those nearby too much" That was the 70's. ;-)
By the way, here's the kicker. My oldest is ADD. Even with my insights he's really frustrating. Whoops gotta run. I shoulda checked in with the office 90 minutes ago, but I gave priority to sharing with you and now my 15 year old just texted me I need to pick her up for her ortho appointment.
My oldest and I have coined our own motto. When we have a failing, ADD related we sigh and share. "It's not easy being us....but it is still good." For those of you around us. It isn't easy. But ultimately you can still share the later observation..."it is good."
Keep probing, find what works. I leave you with an encouraging phrase I developed. "Almost all good ideas arrive hiding behind a bad idea."
Maybe Vyvanse is the answer, but maybe it's less? Maybe if metabolized too quickly, lower the dose and take two to span the day? Hard to say.
Be assured we really enjoy the world, and often strive to enjoy more of the shared world you offer.
In time and with patience and lot's of a parent's love, the right balance for all can be found. Keep looking. Keep loving.
DADD
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Last edited by DADD : 20 Sep 2011 @ 10:40 AM.
Reason: Found a trailing thought mislocated.
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26 Mar 2011 @ 1:32 PM
