So I’ve been on Guanfacine for about 2 weeks, and I think I notice some changes. First of all, I’m sleeping like the dead. I am a rare ADHDer who doesn’t have a co-morbid sleep disorder. I’ve slept well my whole life, though I’m pretty sure I had delayed sleep phase syndrome when I was a kid. Even at 7 years old I couldn’t fall asleep before 1030 or 11pm.
I feel a little more balanced. But it’s a weird balance that tips to the side of… blank? When I’m sitting by myself I kind of feel like I’m empty. Not in a missing-something way, but more like a void. Hanging out with M, if we’re not interacting, just watching a show, I get this weird feeling of flatness. I asked him about it and he said he hasn’t noticed.
The thing is, on one end is the flat void, and on the other side is… normalcy? I did become dysregulated when I got some work news that pissed me off. But I feel like that’s not an overreaction, given the circumstances (which I’ll get to), it’s not too bad considering how much of a rollercoaster my emotions have been. I respond appropriately in social situations, can crack jokes, feel good, access the normal range of emotions. Everything feels very… appropriate. It feels like such a strange word to attribute to something that has been like a storm surge, crashing against the rocks my entire life.
And I also feel like I have a better brain experience. This requires additional details:
Last week after talking to my boss we arranged for me to work from home this past week. I have coursework to do, so I had lots to fill my time. This gave me flexibility to take M to appointments, and get more time to myself and with him that wasn’t at his worst or when he was going to bed (which had been our pattern because I was on fucking afternoons for like, 3 weeks).
It was a good week. We started seeing some real improvements, and by Friday M could drive himself to his own doctors appointment (under my supervision, in case his vision went haywire).
On Wednesday I got a call from my superior (not boss) telling me I had to work both Saturday and Sunday. I was like What The Actual Fuck? Cue the emotional dysregulation I was talking about. Why bother putting someone on an alternate work plan because they can’t handle life and work and then make them work the fucking weekend?? I called my boss and he was like, oh, yeah, I was just trying to call you about that. He’d said it was okay for my superior to put me on the weekend. I literally said to him, “oh, okay. I wasn’t sure if I was being an asshole or not”. sigh.
He said he’d see what he could do, maybe get me out of one of the days, but in the end there was no one else, so I worked Saturday and Sunday.
Back to my point, though, I did work from home all last week. I know how much I struggle staying on task when there are so many fun things around me. I didn’t want to put too much pressure on myself, this was supposed to be a bit of a rest, so I bargained with myself, two honest hours of work, in whatever increments, twice a day (minus our various appointments). And I beat this expectation. I did between 5-6 hours on days we didn’t have appointments, and 3-4 on the days we did. On several of those days I sat, literally in one sitting, for 2 hours. That is unheard of for me. It was also clear that I was interested in some of the material, since even after I’d managed my 2 hours, twice I sat down and picked up my work computer instead of my personal one, and did some more coursework for funsies.
There have been some other situations that are a little less tangible, I’m not sure if I’m correct, but it feels like my brain is working a little more smoothly. That said I did leave my car keys in the ignition yesterday, so it’s not all fixed…
The greater piss off is that these meds are not covered. I was quoted $90 a month (one pill a day). Turns out that wasn’t for a proper dose. So my first month of meds cost me $170 (2 pills a day). No coverage for the meds, but also no deductible. Apparently for us it’s 100% coverage or 0% coverage. I’m currently unimpressed that there’s a possibility I need three pills… at this rate I will get something back on my taxes, but that’s a kick in the teeth every time I have to fill my prescription, in an organization that tells its members that they have 100% healthcare coverage. grumble
Oh man, I’m so relieved. Last night when I was done writing this entry, I hit publish, and got the sad panda. I tried to get back to this entry, but it was all sad panda. So I rage quit. Even this morning I checked drafts on my phone, and it wasn’t there. But when I hit new entry on my laptop, here it was!!
I don’t remember how this ended the first time. The only thing I remember writing about that is missing is a description of what guanfacine does, and why I thought it’d be effective for me.
Years ago sarahbaby and I talked about long term stress and its affect on how you function. She gave me some tips about natural remedies, and they did a good job on evening me out a bit. They worked by affecting the adrenal system, which is your fight flight freeze fawn response.
Guanfacine is a centrally acting alpha2A-adrenergic receptor agonists, which is a pre-synaptic autoreceptors that dampen adrenergic tone. So many big words. They don’t actually know how guanfacine works on ADHD, or why, but the assumption is that it affects dopamine and noradrenal receptors. There’s a whole thing about “neuropsychological weakness” in adults with ADHD, which feels like an accurate description to me. I’ve lost so much resilience because of the trauma of existing without diagnosis, then the tangible traumas of so much failure between 2016 and 2020, the pandemic, losing so many people in two aircraft crashes, a mass shooting (I don’t know how Americans do it, every 16h? Feels like a really shitty lottery no one wants to win).
Anyway, I want to get my capacity back. I think guanfacine might help in a way that stimulants can’t (not just for me as stimulant resistant, but in taking a different approach entirely). Meds can only get any of us so far, but there was a time that I was just me, a person with undiagnosed ADHD, with plenty of struggles that I Just thought were my own failings. But I was coping then! I felt strong enough. To get back to that baseline, with meds and the help of therapy, I think it’s possible. And I think it’s possible to improve on the baseline with all of the knowledge I have gained over the last 3 years.
I am hopeful.