ADHD and PTSD. What to treat first? Could they be treated at the same time? Ritalin and Clonazepam: Is it safe to take both? Are there side effects? PTSD, ADHD and Ritalin: Could the use of psychostimulants help patients with PTSD and ADHD?
Long story short, those are the questions I began wondering about when two things happened: one, when my ADHD medication wouldn’t work as expected; two, when I realized I wouldn’t find the answers in my doctor/s “knowledge”.
Looking forward to having a dignified quality of life and brain health, I considered myself as a sample in a study: my own. Over the course of the past three years, I researched. I tried things out and I took notes. I failed a few times and tried again. And today, I am succeeding.
My main goal with this article is to contribute with my example, in a copy with a length that won’t make ADHD brain take off.
And my objectives, to help reflect on the following:
- Many psychiatrists don’t have the answers we seek, and some give us the wrong ones.
- Hence, educating ourselves on our diagnosis and the effects of the medication we’ve been prescribed with, is what will ultimately help us to make informative decisions for our brain health.
Introduction
I’ve been on this earth for 46 years to this date (I came from Jupiter) and my story of misdiagnosis and lack of guidance regarding brain health is, sadly, the one of many people like me.
I had been told I was “hyperactive” as a child, and that was it. On the outside, I was a smart good girl. On the inside, …, “wrecking balls inside my brain.”
At age 19 I began having brain health problems. But given that I was “doing good in Law School”, I was diagnosed and medicated for depression, chronic stress, anorexia nervosa, panic attacks. Even hyperacusis slash “suck it up.”
The brain health problems were the result of the traumas I had experienced. First trauma at age 7; last one at age 39; a few in between. Actually, first trauma at day “birthdate + x”, if we consider the fact that I was separated from my biological mother a few days after having born… which I discovered at age 37 in a new city after having filed for divorce.
(Please excuse the “x”. No one knows when I was born.)
How am I still alive? Subscribe.😉
(Spoiler alert: humor helps)
I tried therapy many times with no luck.
I took antidepressants two times (at age 19, and mid 30s) for no more than a month or two. I noticed they weren’t right for me, and – as matter of fact – I asked for “something to lift me up.” Hence, I coped with my lack of energy for two decades with nothing by vitamins.
I am extremely sensitive to any kind of medication. 400mg of ibuprofen (the smallest dosage in Argentina), puts me to sleep. I tried 200mg in the US and I fell high. For this reason, mostly, I was always very reluctant to take any kind of medication.
And finally, I never knew what ADHD was, nor what Ritalin could do for me, until I was properly diagnosed with ADHD in my adulthood (in 2019)
But something didn’t work as expected. The side effects of the Ritalin were unbearable. I tried a few other options available in Argentina, and they didn’t work either. Hence coming up with the routine of a cloister nun to avoid Ritalin’s side effects seemed the best way to go.
That until I got tired of that “life”, and I began researching more.
I am going to focus in this article on the diagnosis and medications that led me to reconsider the treatment I was receiving for my brain health:
- Panic attacks and clonazepam (2003-2023)
- Brain collapse and apathy, due to PTSD of “a lifetime” (2017) On this occasion, I refused the medication I had been offered and I exercised my brain to recover my executive functions (and my will to live)
- ADHD and Ritalin (2019-2023)
So, here’s my story in a nutshell. What happened to me. What doctors did and didn’t do for me. And what I did to pursue a dignified quality of life.
Treatments and Answers I Was Given
2003 – “Dr. Snow, Could You Please Notice My ADHD?”
When I visited Dr. Snow for the first time, I was worried about three things:
- I was having episodes of anxiety that made me feel as if I was dying.
- I’d forget the simplest things.
- I had started doing cocaine and I wanted to talk to a professional and see how I could do it “safely” (Feel free to laugh)
Regarding my ADHD, the only thing he said was, “Don’t drink more than a can of Red Bull per day.”
And regarding my worries…
“Doc, What are these episodes?”
“Panic attacks”, he said. And he prescribed me with 0,5 mg of clonazepam. It worked.
But he gave me a 2mg pill to cut in four. So eventually, when I needed more, I added another quarter and then another (always with a doctor’s approval) Almost twenty years later, I was taking 2 to 3 mg per day.
“Why Am I So Forgetful?”
At the time, I was working as a ghost writer. I’d write thesis for professionals of all sorts of fields, sometimes five theses in three months or so. If I had to work on two theses at the same time, I’d make sure they were for different fields so I wouldn’t get bored.
My memory as I was working, was outstanding. However, I had begun noticing that it wasn’t that good for the simplest things. I’d make a list to do the groceries and forget the list at home.
He said,
“Oh, don’t worry. That’s because of the job you do. It’s too much information! Your brain is simply screening what’s important to save and what isn’t.”
“Ok!”
“And, …, I Just Started Doing Cocaine…”
“How much?”, he asked.
“A few lines, once per month… twice per month…”, I answered with all honesty.
“Well, …, just be careful.”
“Ok!”
Three years later, I overdosed.
I quit cold turkey.
But, to cope with the anxiety I began taking more clonazepam and eating as it if was the end of the world. And the drinks I used to have only over weekends, well, I increased the dosage of those too.
2019 – “Dr. K, Could You Please Notice My Clonazepam Dosage?”
Dr. K received the updated data. I was taking 2 to 3 mg of clonazepam per day for panic attacks, and I had been diagnosed (by a neurologist) with “PTSD of a lifetime”, “broken connections in my brain” and “apathy.”
I understood the apathy as being a biological asshole, but eventually I learned more.
My worries this time, were the following:
- I couldn’t work. I had recovered from my brain collapsed (on my own) and managed to reach a three-hour session of writing. But then I’d get stuck.
- I was drinking a bottle of champagne every other day because “since I couldn’t work, I’d get bored.”
- All those bubbles had turned me into a big fat bubble. I wanted to take care of myself but at the same time I didn’t care. (Very odd. I know.)
So! I wanted to work, quit drinking and lose the weight. (Great things come after ending an abusive marriage)
“Why Can’t I Work As I Used To?”
“You’re totally ADHD”, Dr. K said, “But still, I need to be absolutely sure. Please take these 1,243 screening tests and then I’ll give you Ritalin.”
And he added,
“It would be nice if you could quit the clonazepam.”
“I’m afraid”, I replied, “I believe it’s the only thing that has been helping me with my PTSD. And how could I quit it after 20 years?”
“Ok. Don’t worry. You are taking a small dose. We’ll come back to this later.”
As I mentioned, the Ritalin did help me, but the side effects were unbearable.
“I Honestly Don’t Want To Drink This Much, And No One Believes Me”
A curious thing would happen to me. I’d only drink in Argentina. During my long stays in New York, I’d share a bottle of wine with a friend from time to time. Every single day I wanted to be wide awake.
Dr. K said,
“Well, this is clearly happening to you because of your environment. You don’t like it here.”
“Yes. I know that.”
“So, you gotta find a way to like it here.”
Yup.
“I Want to Lose This Weight, But It’s Like I Don’t Actually Care”
“Do you like sports?”, the Dr. asked me.
“Yes! But I can find anything to do in this city”, I said.
“Well, you gotta find something.”
Sorry I don’t have a punch line for this one.
Treatments and Answers I Found By Taking The Reins of My Life
In case you didn’t do the math, I began taking Ritalin and healing from my PTSD during a freaking global pandemic. It was… 🤯 (subscribe)
Out of the six worries I mentioned, two of them have straight forward answers:
- The panic attacks stopped as soon as I started taking Ritalin.
- Regarding the forgetfulness, “I do my best.” It helped me to discover that it has ADHD written all over it.
The two worries regarding drug abuse (cocaine and alcohol), deserve much more than a section in this article, but I’ll keep it short for the sake of addressing my “main” topics: the final two worries.
“Why can’t I work as I used to” and “How to lose weight when I want but I don’t”, are the two concerns which are strictly related with the questions that are the object of this article:
- Regarding my work: Ritalin and Clonazepam were colliding in my brain.
- Regarding my weight loss: I found the answer in my “Apathy” diagnosis.
Now, let’s break it down.
ADHD and Drug Abuse
After twenty years of having quit cocaine cold turkey, I still wonder and reflect how I did it. Hence, as I mentioned before, I won’t address it in this instance.
I could have died, as many people do. As many people with ADHD do.
A conversation I had with Dr. K in 2019, has been helping me to “begin” understanding how I survived and, as a matter of fact, has helped me to quit drinking. He explained to me the role of dopamine on an ADHD brain and how we seek for it. And he mentioned that coffee, cocaine, alcohol, sort of boost that dopamine.
To know that my brain was vulnerable to addictions, helped me to reflect and – eventually – to change my habits. Today I drink only “one day” over the weekend; some weekends I simply don’t.
That’s all I can say now, mostly out of respect for every single person who is battling with addictions and for my own story. Surviving was far from being easy. I feel blessed and even lucky for having done so.
Ritalin and Clonazepam: The Collision In My Brain
By 2022, I had my life quite under control and peace of mind. But the Ritalin wasn’t yet helping me to work me as it should.
So, I wondered,
“Should I quit the Ritalin? No, I feel is helping me with my PTSD. Could this be right?”
I considered,
“Maybe the Ritalin is indeed good for me, and the clonazepam is truly getting in the middle.”
And I decided,
“I’ll try quitting the clonazepam first.”
Even though Dr. K had told me that the clonazepam could reduce the positive effect of the Ritalin, he never made a strong decision regarding my intake. As a matter of fact, he advised me to take a small dose every time I’d feel the Ritalin exploding in my brain.
He never made up his mind, but I did.
When I decided to get off the clonazepam, the doctor instructed me to cut off a 25% every 10 days or two weeks. The first morning I woke up after having reduced the dose, I almost had a panic attack.
So, I came up with my own plan. For a year I did an ants’ job, reducing only 0,125 mg at a time. Every month I do an emotional check-in: Am I stable enough to reduce the dose again? Sometimes it’s a yes, and sometimes I run.
I felt more clarity of mind and more energy after having reduced 0,5 mg, and a big change after having reduced 1mg. To this day I am taking 0,75 mg (hashtag yay)
The result in bullets:
- I have more clarity of mind when I work.
- I have more energy. I don’t need my power naps anymore (but I do chill for a couple of hours)
- My working memory improves day after day.
- When I drive, even when the sun blinds me, I don’t feel anxious.
- If I have drinks one day, I don’t feel “depressed” the next day.
- I sleep like a log! (less of course, but still)
- I feel like a person again (even though, let’s not forget, I’m from Jupiter)
The True Effect of Apathy
Apathy feels like a lack of feelings regarding others and things. It is a very odd sensation.
I told Dr. K once:
“What is odd about this, is that I do feel a strong love and connection with my cats, animals, nature… Even the world! The world pains me.”
And he said,
“Who hurt you?”
“Oh… Humans did…”, I replied, as if I had discovered a new planet.
“That’s right…”
He led me to believe that my lack of empathy was towards people. Did I take his word? Nope.
Researching online, I learned that apathy is not only the lack of feelings towards people, things, etc., but also regarding ourselves.
The “moment” I read it, I thought,
“Ok. So, my brain doesn’t care if I lose the weight. But the person I was before this lesion did care. I am still that person. I simply have a lesion in my brain. I’ll start eating healthier with this in mind.”
I have lost 10 pounds in six months, and I am still fully committed to reach a healthy weight. Because an odd thing happened: now, I do care. (hashtag “neuroplasticity is a thing”, or “fake it until you make it.”)
Conclusion
In my personal experience, I have found that the use of Ritalin has made a positive impact on my PTSD. As I felt in control of my emotions, I was able to: reflect on my traumas, research about them and understand them. To this date, I don’t experience PTSD symptoms nor panic attacks.
I have also found that clonazepam does collide with Ritalin in my brain. Every time I reduce the dosage of clonazepam, I feel a little bit anxious for two days and on the third day I feel a boost of energy. To this date, my ADHD symptoms manifest when I am stressed.
Hence, I believe that:
- In some cases, ADHD and PTSD could be treated at the same time.
- In some cases, Clonazepam collides with Ritalin.
- The use of psychostimulants to help patients with PTSD and ADHD, is something that deserves a serious and extensive research.
When I began taking Ritalin, I was devastated by my loss of identity and the traumas I had experienced. I was surviving – like all of us – a global pandemic. And I’d add “alone”, but the companionship of my cats is something I cannot overlook.
I had “PTSD of a lifetime”, and the use of Ritalin helped me to sort of put on display my traumas and look at them. I was able to analyze them as if they were “objects”. Maybe the apathy helped… But I honestly believe the use of psychostimulants to treat PTSD is to be widely studied.
There are of course, a lot of variables and details I didn’t mention. My one goal was to describe, shortly, how I arrived at my conclusions and spread the word.
Each brain is a world on its own, and doctors and scientists don’t have all the answers. Some of them can provide us with significant guidance, but I believe that the work we do, whether is on social media or working as advocates, is what will make the difference. Scientists need our help, as much as we need theirs.
I have wondered, and I still do, where my resilience comes from. Or why there are so many ADHD traits I do not have. Recently I watched a TED video, “The benefits of a bilingual brain”, where it is explained that being bilingual – apparently and for some – triggers more activity and strength in the “dorsolateral prefrontal cortex.” I am bilingual. I began learning English on my own at age 10.🤔
I am still ADHD, with all the good and the bad. With all the funny things and the frustration. With the daily exhausting job of surviving exhaustion. And I still carry the load of the traumas I experienced.
But I am still here. And I still want more. As far as I am concerned, I am succeeding. And I really need you to succeed as well.
