That Sinking Feeling. Episode 5. My Mother Loved Me on Ritalin.
Paula
She is currently on Wellbutrin.
Noah
Adderall.
Annalivia
Ritalin.
James
Prozac, Paxil, Zoloft.
Allison Landa
Methylphenidate.
Rachel Blatt
Maybe Focalin. Maybe. Did we try Adderall back then? I don’t remember.
Annalivia
Stimulants make me go crazy. They make me acutely suicidal.
Lauren
I don’t really know if the medication helped.
Nick Petty
I think meds are really good.
Annalivia
I wish that there was medication that worked. I love Red Bull.
Tony Kaplan
My mother loved me on Ritalin.
Elizabeth Rynecki
I’m Elizabeth Rynecki. You’re listening to That Sinking Feeling. I don’t have ADHD, but my younger son, Owen does. And in this podcast, I share my dad’s ship salvage stories and explore the insights they’ve given me about my son’s ADHD challenges. In this episode, we’re talking about medicating ADHD. We can’t stress this enough: if you’re in danger of losing a large oceangoing vessel, please hire a ship salvage engineer. And we are not giving pharmaceutical recommendations. For that, please speak with a professional.
But no podcast about ADHD is complete without some discussions of meds, because choosing to medicate your child is one of the hardest decisions a parent makes. By the time Owen graduated from high school, I felt more relief, than cheer, that he’d finished. I struggled to maintain joy in his accomplishment. Instead, I moved onward to a new list of hopes and expectations.
I thought he should get a summer job, or volunteer his time with a local nonprofit. And if he wasn’t going to do either of those, I suggested he register for summer classes at our local community college. I just felt he needed to be doing something, almost anything. But after the trauma and drama of the previous 18 months, Owen had nothing left. He was completely burnt out. He wanted to stay in his room, read books and play video games.
I thought allowing our 18-year-old son to have a lazy summer with zero responsibilities was a horrible idea and a waste of time, but my husband Steve supported the low-key plan of Owen taking an emotional breather and rebuilding his energy for college.
But after bickering with Steve about it one too many times, our therapist gently reminded me that just because Owen had graduated high school, that didn’t mean his ADHD had suddenly vanished. A high school diploma did not mean that he could now do all the adulting things he’d wrestled to do just the week before.
Tatiana Guerreiro Ramos
The notion that any 18 year old these days is gonna go off unsupervised and unscaffolded at college, seemed like — whoever decided that 18 is an adult like needs to pay their salary back, because 18 is not an adult at all.
Elizabeth Rynecki
Everyday tasks were still overwhelming Owen. I couldn’t ask him to do the dishes because they represented just about everything that made navigating life with ADHD hard.
Owen
It can take a while to empty the dishwasher, figure out where everything goes, and then often I get frustrated with the last person who did the dishes not putting them away in a style that I like, which of course is always the issue with not doing the dishes yourself.
But then the big issue comes transferring from emptying the dishwasher to putting everything in. I think the main way that feels to me is like undoing progress. Even though clearly that’s not how anything works — you’re pushing the task forward. But to me it feels like I go from empty and done to now I’m starting over. And on some bad days that can lead from me emptying the dishwasher very quickly to just sitting around doing nothing. Just trying to get over a small hurdle.
Elizabeth Rynecki
In some ways, my battles with Owen were the same ones the parents had with teens every day. No one wants to do the dishes. It’s boring. But for someone with ADHD, it’s even harder because ADHD isn’t about an inability to pay attention. In fact, people with ADHD have an abundance of attention. The challenge is in controlling it. And it’s not just dishes. Dishes are simply emblematic of all the things that are boring and harder for a person with ADHD: filling out forms, making phone calls, cleaning and organizing messy rooms.
But neurotypical people struggle to understand that. Because for them, control isn’t a biological thing. It’s a personal choice. For many people, not exercising that control appears to be a weakness. “All he needs to do is buckle down.” And as a parent, all I need to do is to “be a better disciplinarian.” But the more I pushed Owen and he pushed himself to do the things that were expected of him, the more taxing it was on his emotional well-being.
And so the choice was either fighting with my husband and our son, or dropping the rope. I could let go of my demands and expectations, because getting my son to be a great dishwasher wasn’t the most important thing on the to-do list. What was important was getting him to a better mental health space, and we thought that trying a new medication might help with that. And I would happily do the dishes if it meant Owen could find his way to a more even keel.
I wanted him to try Guanfacine, a non-stimulant medication. And while I knew Guanfacine wouldn’t magically erase his ADHD, I hoped it would help soften his extreme emotional reactions. And that it wouldn’t send him into the desperately low space that stimulants had. I want to be clear: I’ve never pushed my son to take mental health medications. In fact, for a long time, putting my kid on any medication was something I was against. I worried about the potential negative side effects, and that a long term prescription might be a step toward substance abuse.
Anonymous Mom
With my older son, I remember I cried, like the night before I was preparing to give him that medication. Here I am, a mother, and tomorrow morning I’m going to wake up and give my child amphetamines. That was horrible. But you wouldn’t deny a diabetic insulin.
Nick Petty
I don’t take Adderall anymore. I feel like my chemistry, my brain chemistry has to be a little different from that high of a dose at a young age. But it really did me no favors with high school, because I got into painkillers.
Elizabeth Rynecki
And I worried that no matter how well-intentioned and how well-informed it was, it might still be the wrong thing to do. But after the nail-biting roller coaster experience of Owen’s senior year of high school, I knew something had to change. And that was partly because of a lesson learned from a 420-foot barge made for a sewer project. She was called the Betty L and was built specifically to lay four and a half miles of concrete pipe into the Pacific to disperse treated sewage in deep ocean water. But in the spring of 1983, only a week after going into service, fierce winds and waves were too much for the seven anchors holding the Betty L in place. The barge slipped free and began making her way towards the shore. Equipment, tools and steel pipes began washing overboard as the barge drifted northwards, where she ended up perpendicular to San Francisco’s Ocean Beach. Basically, she T-boned the shore. This was bad news for a large ship.
My dad, the ship salvage engineer, made the short drive from our house to check out the situation. It was the rare salvage job that he could commute to from home.
Alex Rynecki
It looked like a real dire situation to me. The thing had to be stabilized right away. I was afraid that it would broach.
Elizabeth Rynecki
If she ended up sideways and entirely beached, the waves would sweep away the sand beneath the hull at both ends, what a salvage engineer called scouring.
Alex Rynecki
As soon as it scours the ship loses support in the bow and the stern. And that causes a significant load which the hull can’t stand, and the hull breaks. And once it breaks in that situation it has been lost completely.
Elizabeth Rynecki
Obviously, my dad is talking about stabilizing the Betty L, but in my mind he was talking about Owen. I worried that if I didn’t find a way to stabilize Owen, that his emotional dysregulation would get worse. His fight-or-flight response to situations where his ADHD had reared its head or caused outbursts might become even more problematic. I worried that might lead to a verbal altercation, which might result in his being kicked out of community college, or worse, a physical fight that might lead to an arrest. If I didn’t find some way to anchor Owen, he might not have much of a future.
But I also understood he very much needed extra time to mature. And I needed to be able to imagine a future in which he was a happy adult out in the world. Because what really frightened me was that he would always struggle to do things on his own, and that he would, for the rest of my life, be dependent upon us for everything. But Owen’s medication journey had so far been a frustrating one.
Owen
I have this really weird thing with meds that happens where the first dose is insanely strong. Like advertisers would love me if that’s how everything went. Like the effects as listed working perfectly, and then each time after it is a mere fraction of that. And so really figuring out what med is actually working versus what med is just currently giving me a spike of usefulness is annoying. It’s really frustrating.
Elizabeth Rynecki
Like many people diagnosed with ADHD, Owen’s came bundled with a number of other mental health issues. He had sensory processing disorders, anxiety and depression, and he tried more than a half dozen medications to better regulate his thought patterns and reduce symptoms. He tried everything from Ritalin and Prozac to Adderall and Lexapro. Some seemed to help for a day or even a week. But then he didn’t want to take them. He hated all of them. Some messed with his appetite. Some gave him insomnia. Some made him — and this is hard for me to say — suicidal. He swore he’d never try another prescription. And while side effects vary dramatically, Owen is not alone in disliking how the meds made him feel.
Annalivia
I did get prescribed Ritalin. I have been on a lot of stimulants. I hate all of them. I already had anxiety. I was on them in high school for months, which is a crazy thing because they would wear out for the school day and I would go home and lay in bed for the rest of the day because that was all – physically all I could do.
When I take stimulants for like an hour, maybe half an hour to an hour, there’s a sense of like clarity. And I’m like, ‘oh, I get it. Like, I understand.’ But the side effects are too much to continue taking it.
Nick Petty
I was given medicine and I would spit it out, you know, and stuff, because I didn’t like it restricting my feelings.
Shannon Watts
So my doctor, she prescribed Adderall. And I think she started me out at ten milligrams, which she said was a very low dose. It made me so, even more hyper focused than I already am, and also feeling slightly high, that it was just a horrible feeling. During the day, I didn’t really feel like myself. My husband said I wasn’t acting like myself, and then I couldn’t sleep because that Adderall was still in my body. Even though it has a short life span, it was still enough to keep me awake at night.
Elizabeth Rynecki
While these stimulant medications are essentially speed, most psychiatrists will tell you stimulants do help a lot of people with ADHD.
James
If you are somebody who responds really well and gets relief from a stimulant, that’s great news.
Allison Landa
He’s Quillichew, which is methylphenidate. My kid was in the principal’s office a lot because he was being very disruptive. And now it’s like knock on wood, you know, it’s been a lot more relaxed. We don’t hear from the principal. I think his inner voice has calmed down a little bit, to the degree that he can manage a little better.
Rachel Blatt
Once he got on Ritalin and we saw what it could do for him, it was amazing to see when the medication kicked in, the kid he could become. The control he could have, how he would act with others. It was – it was truly amazing.
James
It’s not as if you were born with a stimulant deficiency, right? To say that that tells us a whole lot about your brain, I think is – is a bit much. People will say, “I’m ADHD. So when I take a stimulant, I feel calm. Whereas people who don’t have ADHD, they take it one, they feel hyper.” There’s something at the core of that that is valid, but that has been sort of turned into gospel truth and it should not be. And here’s why. Stimulants improve vigilance. They increase wakefulness in everybody for the most part. If you have significantly more trouble with those things, of course you’re going to notice more improvement when those things are reversed or alleviated. The problem, I think with – with turning that concept into a gospel truth, almost like a diagnostic trial, leaves the folks who – who have symptoms of ADHD and do not do well on medications, it leaves them sort of adrift, wondering, “Do I not have ADHD? And what do I do now?”
Elizabeth Rynecki
Given Owen’s history with medication, I knew that getting him to consider trying a new drug was an especially big ask. And it was an ask because he was now technically an adult, and the decision really was his to make. But even if he agreed to try a medication, I knew it could take a while to find one that would actually help. Because a psychiatrist will tell you: it can take time to find the right drug to treat ADHD.
James
When it comes to medication, it really is trial and error. You want to scratch medications off your list and say, “We did it. We went to the mat for that medication”. It either was terrible for you or we went to the full dose for as long as they say you should and we didn’t get the results, so let’s bail. We don’t want to commit to something that isn’t earning its keep as a medication.
Paula
Seventh grade, maybe, we tried medication, we tried to – the stimulant, and it – it was just not a good fit at all. It just flattened her. It took away her — she started to lose weight, you know, a lot of weight. And she’s already a tall, kind of thin kid. and she’s like, “this is not — I’m not liking this at all.” And so we stopped it.
Steve
So for Owen, when he tried kind of traditional ADHD meds like Ritalin or Adderall, his reaction was: it got him through the day. And at the end of the day, he had a strong emotional crash and he would cry or feel suicidal. Successful medicine works for about a third of people, doesn’t work for about a third of people, and has side effects for about a third people. That’s true for broad classes of medicines. Your mileage may vary.
Elizabeth Rynecki
While finding the right ADHD medication often requires a fair amount of trial and error, in ship salvage, there isn’t room for that sort of guesswork. And that was particularly true in the case of the 420-foot Betty L. Because what my dad saw wasn’t a question of maybe trying this or that and hoping everything might work out. What he saw was trouble that needed to be fixed immediately.
Alex Rynecki
I think we were very lucky. I vividly remember the chief engineer for the company, asked me what the odds were of being successful, of saving it. And I told them 50/50. And he said, “it can’t be that bad. The whole thing’s intact.” And I said, “About 50/50 chance of saving it.”
Elizabeth Rynecki
When my dad explained to me how he called for the anchors to be strategically placed, and how he engaged a series of tugs to keep the ship from broaching up onto the beach, I continued to see a parallel story with Owen. I saw that he was struggling, that he was having a hard time, and kind of like the barge, Owen was stuck between the beach and the ocean. He wasn’t exactly ready to leave home, go to college and establish a career trajectory. But he was in a kind of holding pattern.
And while I thought his odds of getting out of the holding pattern and onto a path towards his future self weren’t as dire as the 50/50 chance my dad gave the Betty L, I was worried that if I didn’t do something, things for Owen could go sideways. That summer, after high school, and after some thought and discussion, Owen started taking Guanfacine. The doctor told him to start with one milligram and to work his way up to three milligrams per day. He didn’t love it, especially at the higher dose. And while it seemed to reduce his over-the-top tirades against everything from loud noises in public spaces to my less frequent reminders to do his homework, I saw the medication helping to smooth out his rough edges. But he hated the way it blunted his emotional experiences, crushed his adrenaline. Adrenaline he relied on to do the things he dreaded, things like schoolwork and self-care responsibilities like brushing his teeth and showering. He threatened to stop taking it. I begged him to find an acceptable dosage. We compromised. He reduced the dosage and stayed on it. And then that fall, Owen signed up for two college classes, an architecture class and a history class. To help reduce Owen’s anxiety about starting college, we did a dry run and visited the building where his classes would meet. At first the classes seemed to go well. Owen liked the professors. The discussion seemed interesting. He even chatted with a few friendly classmates. But then all sorts of issues began to gnaw at Owen. His classmates didn’t wear Covid masks. The instructor got off topic too often. The assigned reading was stupid, a waste of time. The homework stifled his creative freedom.
And then Owen’s complaints escalated. The teacher was crushing his dreams. And besides, his classmates were, quote, “morons.” In fact, they were all so stupid, Owen thought he should teach the class himself. For Owen, the intense frustration with the class was real, awful. But what I saw was the repeat of a pattern I’d seen time and again with Owen. The challenge is that his feelings become so strong, that intense rage is his go-to defense mechanism.
Noah
She has trouble regulating emotions. She has those meltdowns. She has a tendency to fly off verbally, and slam doors. I mean, just losing it on the ground, and like, grabbing shoes and throwing them and kicking and screaming. It’s so exhausting. And then what’s sad, is that she’ll wake up and nothing ever happened.
Elizabeth Rynecki
What I wanted to tell Owen was to stop being melodramatic, to suck it up and deal with it. But after the anger subsided, Owen worked up the courage to tell us he wanted to drop the class. For some parents, a kid dropping a class is disappointing. But for me, I saw it as a huge accomplishment. Because for Owen, figuring out what was wrong and finding a solution to the problem all without going into further rage was profound. And it was exciting to see that change. Change I’d been waiting for for more than a decade.
You can see when a ship goes around: the problems to be solved, if not exactly obvious to the general observer, are well understood by ship salvage engineers like my dad. But ADHD isn’t like that.
James
We cannot do a blood test on somebody who has ADHD to tell them if they have ADHD. Nor can we do one to tell them if their meds are right.
Elizabeth Rynecki
And because there’s no easy way to test if the meds are the right ones, parents and teachers and loved ones are often left to determine if the impact of the medication is good or bad or not making any difference at all.
Allison Landa
At one point he was definitely overmedicated because his eyes were wild and he was just like, not himself. And we really had to dial back. I was like, ‘This is awful. We don’t want to do this.’
Rachel Blatt
We tried different medications. But I know we finally ended up on methylphenidate. So then we had to figure out the amount to give him to make sure that he wasn’t a zombie, but it gave him the control over himself.
Elizabeth Rynecki
My dad doesn’t have ADHD, and he hasn’t had to navigate the struggles of parenting a kid with ADHD. So his insights about reckoning with own struggles aren’t much better than my own. He keeps asking if Owen might just snap out of it one day, and when I explain that will never happen, his go to advice is to share a proverb.
Alex Rynecki
A problem well defined is a problem half solved.
Elizabeth Rynecki
Part of me loves that saying — that idea that if you know what’s wrong, you can better find the solution. And that’s worked a lot for Dad over the years, influencing his ship salvage problem solving. But parents just don’t have the kind of control over their kids as they might like to think that they do. And even if I absolutely understood all the intricate elements of ADHD, it doesn’t mean Steve or I can fix it.
Steve
So here’s the thing. As a parent, you have the illusion of control. You don’t actually control your child. You try to guide them in the right direction. We have two boys, and they popped out with polar opposite personalities. It has very little to do with my style of parenting, which has been very similar for both the boys, how they are, and so I’m just trying to do the best I can. And if that’s not good enough, you know, I have to live with that. But I don’t feel shame about it.
Elizabeth Rynecki
Dad’s anchoring of the Betty L kept her in place. Her bow was stuck on the beach, but the stern of the barge was anchored in place just off the beach. He eventually refloated the Betty L after offloading 140,000 gallons of diesel fuel and positioning tugs to pull her off the beach at high tide. The whole job took a little less than two weeks. But there was extensive damage to the hull as well as to the motors, generators, and onboard equipment. And because of the damage to the ship and the needed repairs, the clean water project was delayed by more than a year. It took as long as it needed to take.
It seems to me that we are so much more forgiving of projects that take longer than originally expected, than of our own kids who need extra time. There’s this idea that kids must follow a predetermined trajectory. They finish school magically graduating with a full set of adult skills, and ideally, some promising career path options. But life isn’t an industrial factory, and kids aren’t widgets to be moved along the assembly line at faster and faster speeds. As a parent, you might be able to open doors for them, give them exposure to different ideas or areas of interests. But as much as you would love them to walk a certain path and think you know best how to help them, they have to blaze their own trail. And that was and still is the case for Owen. And now, at the age of 20, Owen has begun to more actively participate in directing his future.
But that’s a story for the next and final episode.
While I definitely follow more than my fair share of ADHD influencers on social media, and I have learned a lot from their postings, this is the friendly bit at the end where I remind you that I’m not a psychiatrist, an ADHD coach, or a family therapist. If you have questions about ADHD, please speak to someone licensed to dispense medical and mental health advice. Also, I hope there are no errors in the description of the Betty L salvage job, but if there are things I explained poorly or just got wrong, my apologies. A big thank you to all the people who took the time to share their stories with us, and whose voices you’ve heard throughout this series:
Owen
I’m Owen. I’m the son of Elizabeth Rynecki.
Alex Rynecki
My name is Alex Rynecki.
Steve
I’m Steve, I’m Owen’s father and Elizabeth’s husband.
Annalivia
I’m Annalivia.
Ann Rivello
My name is Ann Rivello. I am a therapist and mom.
Noah
My name’s Noah. And my daughter has ADHD.
Anonymous Mom
I’m a mom in the San Francisco Bay Area. I have two sons with ADHD.
Allison Landa
My name is Allison Landa.
Katherine Ellison
I’m Katherine Ellison. I’m a journalist and the author of Buzz: A Year of Paying Attention.
Paula
So I’m Paula from the East Bay.
Lauren
My name is Lauren.
Rachel Blatt
My name is Rachel Blatt. I have two boys. They both have ADHD. And I also have ADHD.
Corey
My name is Corey. I hope I am some form of new A.D.D.
James
My name is James. I’m a medical doctor and a psychiatrist.
Anonymous Dad
I am a parent and a musician, and I have a wife with ADHD and a six year old with ADHD.
Tatiana Guerreiro Ramos
My name is Tatiana Guerreiro Ramos, and I’m the co-director of Classroom Matters, and I have ADHD.
Linda Lawton
My name is Linda Lawton, and I’m an educational therapist.
Shannon Watts
I’m Shannon Watts. I have ADHD, and I’m the founder of Moms Demand Action.
Tony Kaplan
That Sinking Feeling is produced by me – Tony Kaplan – Elizabeth Rynecki, and Jacob Bloomfield Misrach. Audio engineering provided by IMRSV Sound.