Some of you may be aware that there is a serious shortage of medications for ADHD and other meds for anxiety, psychosis and more.
Currently, despite ordering mine 2 weeks in advance, I am now 4 weeks without a prescription. This has caused me to currently be almost 2 weeks without my meds. For any medication that works on the brain, it is recommended that you taper down in order to stop. The current issue means I have gone from meds to nothing overnight. So I have been in withdrawal! How fun!
Symptoms of withdrawal
"Stopping ADHD medication suddenly can result in withdrawal. Symptoms of withdrawal include trouble sleeping and fatigue. Withdrawal increases the risk of developing severe depression" - [1]
"withdrawal results in uncomfortable symptoms like severe cravings, mood swings, nervous tics, tremors and agitation, aggressiveness, hallucinations, migraines, muscle pain, insomnia, abnormal hyperactivity, and paranoia." - {2}
I don't have any choice about this and there is a delay in gaining advice for alternatives as I am under shared care of Psychiatry UK and my GP. My GP is worried about the options and wants further advice. (Remembering, I am aware of the issues and so I have been to seek advice etc well before I ran out of my medication and we are still awaiting). The best part of it, my GP asked me to send a message via the PUK portal and no word of a lie, I recieved a message from the medical secretary who's signature sign off read "GATE KEEPER"
It is well know that people with ADHD and some other neurodivergence (ND) and some mental health issues including as a result or ND, self medicate with alcohol, illegal drugs, prescription medication and more recently, sharing medication with friends to make their prescriptions go further. It is an absolute crisis and not enough is being done about it!
Supply issues
"The Royal College of Psychiatrists is aware of the severe disruption in supply that is being experienced in relation to ADHD medications. We know that this is causing significant worry to those who use the medication and the clinicians who treat them. The update provided in this communication is based on information we have received via NHS England. The current disruption to supply is worldwide in its impact and the expectation is that there will not be an immediate resolution in the context of all products, although there is progress on certain medications. It may take time for supplies to reach the front line even in these cases. The NHS are working with Governments across the UK who are responsible for managing all medication shortages. As part of this, there have been alerts issued to advise on the shortages, which include the guidance not to start new patients on any affected products until the supply situation resolves." - [3]
Impact on me...
So, as someone who has major cycles of insomnia and is due to have a sleep clinic review in a couple of weeks, tonight (night of 28th/morning of 29th Nov), I have not slept. It is currently 5:30am and so far I have not even been able to relax in bed. I was so aggitated and hyper-manic with my thoughts, I have put away a load of washing, washed and hug a load, repainted my to do notice board, updated the board with updated information, planned dinners for next week, loaded and set the dishwasher, packed for a weekend away with my family, filled my medication and vitamin box for the week and now I'm writing this. All of this since 3am this morning.
By hyper-manic, I mean a rush and flood of every thought, fear, worry, stress, idea... that has ever crossed my mind have all been on loop at 4x speed. This makes me fidgety because I want it all to slow down and I want to be able to think clearly. The second part of it is rushing from one task to another over and over until I either miraculously manage to finish a task or I get overcome by all of the things that need to be done paralyses me with either decision paralysis or overwhelm paralysis. This is where the notion that people with ADHD are lazy.
These are often referred to as ADHD paralysis: is seen when someone with ADHD has a very difficult time focusing, thinking properly, or executing tasks. [4]
ADHD paralysis manifests differently in different people, it’s generally associated with the following symptoms
Overthinking or overanalysing problems
Unable to start a project, even when high-priority
Unable to prioritise and manage tasks
Unable to maintain focus and easily distracted
Poor time management
Time blindness (unaware of ticking time)
Rapid mood and emotional changes
Difficulty making decisions
Unable to listen actively
Jumping from one task to another
Losing train of thoughts
Lack of focus
Lack of clarity (brain fog)
Avoiding tasks requiring sustained focus [5]
So now, after all of this, I have to get the mini me up, fed and ready for school, get myself showered, changed and off to work (I'm in the office for the first time this week because of the withdrawal). Now, I can hear many of you saying, but how can you go to work if you have been up for over 24 hours???
Well, firstly going 24/36/48 hours with 0 - 6 hours of sleep is not new to me. It is a regular parts of my life.
Why not get signed off - If I get signed off, remembering I currently have very little dopamine and therefore depression and anxiety symptoms are high, Being signed of will cause, isolation, lack of stimulation and will cause the depression and anxiety symptoms to worsen with no treatment (remember I'm still waiting for find out if I can go on alternative medication...)
You won't be productive - In less that 3 hours, I have done what would take most people 5./6 hours to do. Daily, even on my meds, I work at a furious rate. I remember a former line manager sending me home early when I was unwell one day but I didn't want to let the team down, saying " you do more on a regular day when you are feeling well within yourself than most do without any of the barriers that you have"...
Aren't you tempted to swap back to your previous meds - Yes! Very much so however, I have to think about the implications swapping may have on my other conditions and medications. I know it is safe for me to take them as I have had the combination before but, there is a risk (even though I really have no serotonin) that if I start my previous meds too soon, I could get serotonin syndrome...
Serotonin syndrome occurs when the levels of a chemical called serotonin in your brain become too high. It's usually triggered when you take an SSRI or SNRI in combination with another medicine. [6]
They joys and complications of being invisible30something with a myriad of invisible conditions (sometimes feels like I have 3o something of them!).
Anyway, now to make banana waffles for breakfast as I have bananas to use up and need to get moving again as I'm ticking and getting agitated...
Reference material
[1] - BRC healthcare
[2] - Craig Castle
[4] - ThriveWorks
[6] - NHS antidepressants
Additional references