I was 16 when I was prescribed my first mood-altering drug.
I’d been a dreamy, drifty child. But when adolescence closed in, I became tall and clumsy and socially inept. The flood of hormones seemed to unsettle my mind. I was silly and giddy one minute, bursting with rage the next; running around excitedly in the afternoon but impossible to rouse out of bed in the morning. I lost friends almost as fast as I could make them.
By 16, my concentration had ebbed so low and my grades had plummeted so deep into the alphabet that my parents decided to send me to a child psychiatrist. I was concerned, too, and put up no resistance.
So, six Halloweens ago, my father, my mother, my kid sister, and I went to the office of an upright fellow in his late thirties who wore a cardigan sweater and a narrow, straight-edge bow tie. All of us found the psychiatrist charming—except my sister, Daisy, who called him Dr. Titrate because he talked incessantly about “titrating” the drugs he prescribed.
“What’s titrate mean?” I asked during that first session.
“I’ll explain the term as simply as possible,” Dr. Titrate said, grabbing a dictionary from the bookcase. “Titration is the process of determining the concentration of a dissolved substance in terms of the smallest amount of a reagent of known concentration required to bring about a given effect in reaction with a known volume of the test solution.” Though it didn’t sound simple, we all nodded our heads in agreement.
I described my symptoms and family medical history (depressed aunts, a schizophrenic uncle) to Dr. Titrate, who wagged his head wisely and asked me a few questions to screen for attention deficit disorder:
“Do you have trouble following through on things?”
“Are you often sidetracked?”
“Do you make careless mistakes?”
I answered yes to every one. Then again, so did my father. And my mother. And my sister. Not only was I a candidate for ADD, but so was everyone else in my home.
Satisfied that I was suffering from ADD, Dr. Titrate gave me samples of Ritalin.
Metadate, Dextrostat, Dexedrine Spansules, Adderall, Adderall XR, Strattera
Discovering that I had a recognized syndrome brought my parents tremendous relief. The news was comforting to me too. All I had to do, I thought, was pop a few pills and I’d be as focused and success-driven as everyone else in my school. I’d be normal.
But the Ritalin made me feel spacey. Classes were easier to sit through, but if a teacher asked me a question, I’d answer with a disoriented “Whaaat?” When I explained this to Dr. Titrate at our next session, he turned pharmacist. Over the next few months, he plied me with a small galaxy of ADD drugs: Metadate, Dextrostat, Dexedrine Spansules, Adderall, Adderall XR, and Strattera, alone and in various combinations. The non-stimulant, Strattera, had no effect on me. The stimulants turned me into a tweaked-out whiz kid. It was as if I had been nearsighted and now had X-ray vision.
Adderall XR was my drug of choice. It turbocharged my brain during the school day, but when I got home, I crashed hard. Sometimes I’d lie in bed for hours and sob. To supplement the Adderall XR, Dr. Titrate prescribed the short-term amphetamine Dextrostat for after-school studying. Taking so many stimulants made it hard to sleep more than six hours a night. It also made me rapidly lose weight. At first, I liked this side effect. But when my classmates started calling me Anna Rexic, the thrill faded. I always felt queasy, and food tasted like sand.
Hopped up on stimulants, I gained confidence. After Dr. Titrate wrote to my headmaster that I had ADD and needed more time on tests, my performance at school improved dramatically. A C student in tenth grade, I was pulling A’s by the eleventh. After Dr. Titrate wrote the same note to the College Board, I got a near-perfect score on my SAT. I turned from a basket case into an overachieving young adult. But I was dimly aware that the ADD medication was also doing something else, something I didn’t like. I felt impatient, irritable, explosively angry. I’d scream at my father for buying me the wrong toothpaste. I’d scream at my sister for borrowing my hairbrush. I’d scream at my car for running out of gas.
When I told Dr. Titrate about this, he nodded empathetically and said, “Remember to take your medicine.” To be honest, I didn’t always. My only friend with ADD took Concerta, a kind of slow-release Ritalin. Occasionally, we’d have “no-medicine days” when we’d skip our daily doses and giggle and act random. The problem with skipping the meds was that I’d want to sleep all the next day.