By Hannah McCarthy
First, she checks the post-it notes on the bedside table, the headboard and the walls around her to remind her of the day’s tasks.
Next, it is time to medicate. She takes a 40mg Vyvanse for ADHD and a peach pill for folic acid in the mornings, and Lithium for her bipolar disorder and to help her sleep at nights. Although the regimen has changed over the years, she has grown accustomed to this ritual.
After she throws on some running shorts, a sweatshirt and tennis shoes, she is off to start her busy day. Classes are interlaced with gym time and coffee after caffeinated coffee. Her schedule only holds a slot for a small sandwich and coffee because she says the Vyvanse makes her appetite almost disappear. She mostly eats at night when the medicine begins to wear off.
When her day is done, she heads back to her home to either do homework or hang out with friends. Generally, she settles for a combination of both because she says her friends help her stay focused on her homework.
Finally, the night ends as she winds down, aimlessly watching Netflix until Lithium-induced slumber overtakes her restless mind and body.
Louisville sophomore Amy Cory remembers a time before being diagnosed with Attention Deficit/ Hyperactivity Disorder, when she was free from the daily routine of medicating herself. Her hope is to return to that state, but multiple obstacles stand in her way.
“I don’t want to be just another zombie on ADHD meds all my life,” Cory said. “The more I take it, the more I wish I didn’t feel like I need to.”
Cory, like many others diagnosed with ADHD, struggles with a growing reliance on the pills she is taking to help the symptoms subside.
More than 10 percent of U.S. children ages 5 to 17 were diagnosed with ADHD, one of the most common neurodevelopmental disorders, from 2012 to 2014. There has been a gradual growth, up 4 percent since 1999, according to the Centers for Disease Control and Prevention. The percentage of U.S. children taking medication for the disorder also increased to an average of 6 percent in 2011, with more than 9 percent of children medicated in some states.
The estimated societal cost of ADHD is almost $32 billion, according to the CDC. Health care, education, juvenile justice and loss of family productivity are among the costs surrounding the disorder.
Some of the more common symptoms of ADHD in children and adults are squirming, fidgeting, talking a lot and forgetting or losing things often. However, studies also show that children with ADHD may also “make careless mistakes and take unnecessary risks” or “have a hard time resisting temptation.”
According to Federico Aldarondo, Ph.D., associate director of the University of Kentucky’s Counseling Center, there is some known correlation found between ADHD and substance abuse. People who are on stimulants but also struggling with another form of substance abuse are more likely to form a reliance on those stimulants in order to feel they are “maintaining control.”
Similarly, Karl Laves, Ph.D., associate director at the WKU Counseling and Testing Center, reiterated that there is often a dependence of the patient on the ADHD medication; however, a dependence is different than an addiction.
“Anything that alters how your mind functions can be abused or dependent…if the effect is pleasant or beneficial people will get used to it, expect it, and miss it when it is not available,” Laves said.
A patient will not experience a physical withdrawal by refraining from taking his or her medicine, but it is possible for a dependency to grow stronger the longer he or she takes it.
In the halls of Norton Elementary, a Jefferson County Public School, Amy Cory the rambunctious, outspoken second grader was not worried about being the “annoying girl” or talking too much. Her main fear, remembered her longtime friend Lilly Comstock, was that Ursula (the antagonist in Disney’s “The Little Mermaid”) would come out of the toilet and pinch her.
“We were just a couple of little kids,” said Comstock. “I didn’t notice any kind of difference between us.”
However, Cory’s mother, Amy Whelan, noticed that Cory got more frustrated with each year in school. She was not getting the academic attention the family thought she deserved. For this reason, they decided to pay for a private education at Louisville Collegiate School.
Cory remembered the switch with a grimace. She recalled being told on more than one occasion to “sit down and be quiet” in front of her peers. Little did she know at the time, there was a reason for her inability to sit still and focus like the other kids in the classroom.
Soon after beginning her time at LCS, Whelan recognized a decline in Amy’s academic performance.
“Her teachers would say ‘Gee, Amy’s great. She understands, but toward the end she just fades out,’” recalled Whelan. “She did great on the tests but then didn’t answer the questions at the end.”
Whelan decided to get Cory tested for ADHD, and she was diagnosed her sixth grade year.
Cory began her medical lineup with CONCERTA, a medicine “proven to help manage the symptoms of inattention, hyperactivity, and impulsivity,” according to the official CONCERTA website. The medicine worked for a while, but soon Cory felt that she was “becoming immune to the effects.” So, she began to take Vyvanse.
During her junior year of high school she felt a change. It was as if she could feel herself wearing down. She had started a new medication, 40 mg Vyvanse, which would be the strongest dosage she had ever taken.
“I was on Vyvanse for three or four years at this point, and once I hit 40mg rather than 20 or 30, it really made a difference,” Cory says. “I feel like my spark began to go out.”
Besides a feeling of overall fatigue, Cory recalls growing increasingly depressed. She also began to lose her appetite and lost large amounts of weight during this period.
A medical study by Joseph Biederman, M.D. of Massachusetts General Hospital outlines the effects of Vyvanse in adults, half of whom took the actual drug while the others were exposed to a placebo pill. While only around 5 percent of the participants using the Vyvanse experienced “feeling sad or down” and 20 percent felt “tense and jittery,” a larger 50 percent said they experienced a decreased appetite.
Although she would rather be off the medicine altogether, she is content with the three pills she takes daily and hopes that she won’t have to keep upping her dosage in the future.
“I feel as though half or more of my friends are almost addicted to some type of prescription drug,” Cory said. “I don’t want that to be me. I don’t want to be on it for the rest of my life.”
Even with the confidence Cory expresses for the future. Some of the people closest to her feel that she has a long way to go before being completely drug-free. Cory calls Louisville sophomore Anna Hall one of her best friends though they have only known each other since freshman year of college. Hall remembers asking Cory if she had ADHD about two days into the friendship.
Lying on her lofty new bed in her Pearce Ford Tower dorm room, Hall had just come back from one of her first nights of fun and freedom in college. About to go to sleep for the night, she heard her door open and a stranger walked in. It was a chatty brunette who seemed quite out of it. She walked in, stumbled a bit and sat down on Hall’s bed.
“And that’s how Amy and I met. A drunken night freshman year, and we’ve been pretty much inseparable since,” said Hall.
Something that Hall finds odd, along with other friends of Cory, is that she seems more calm when she isn’t on her medication. There are days when Cory runs out of her prescribed Vyvanse and cannot get back to Louisville for a few days to get more.
“She is so much more calm. She’s definitely not as talkative, and you can actually get a word in when she doesn’t take it,” says Hall.
As much as she wishes that Cory will become less reliant on Vyvanse, Hall is unsure that her friend will ever be able to stop taking ADHD medicine completely.
“I’ve never tried to get her to get off of it because she’s too convinced that she needs it,” says Hall.
Although friends may think differently, Cory is convinced that the Vyvanse is helping her be productive each day. However, she is beginning to wonder if it is all in her head.
“I wonder if someone gave me a sugar pill that I thought was Vyvanse, would I still feel anything at all, or is it just my state of mind?” Cory asks.
Recently, Cory’s encounters with doctors and pharmaceuticals have only grown more frequent. In December 2016, Cory was diagnosed with Bipolar Disorder. The diagnosis was not shocking, as doctors previously mentioned that she may need testing for Bipolar II. After the testing, Cory received the Bipolar I diagnosis.
Although her case is mild, she has added Lithium into her medical regimen and has begun to feel the effects.
“The biggest struggle I have with my medication and dosage of Vyvanse would be the imbalance of being bipolar while taking an upper and no legitimate stabilizer with nothing allowing me to relax during the day.”
Her days are often “go-go-go” and controlled by Vyvanse, while her nights end in a sometimes drowsy haze after she takes the Lithium.
Lately, her sleeping pattern has changed.
She wakes from deep nights of sleep with no recollection of her once-vivid dreams. Then she gets out of bed, takes her Vyvanse and begins the cycle once again.
Today she sits on her couch, legs crossed, feet tapping. It is a Saturday. She is not on her medication.
“I like the feeling of not being on it. But as you can see, I can’t stop talking,” she says. “I think Vyvanse shut me up.”
It is 2 p.m. and she has already been out to eat and driven around with friends. She is already thinking about what to do next.
“Honestly,” she says, “I’m already thinking about what I’m going to do once you leave.”