Concerta reflections

Time course

I do not really feel any strong come ups or wind downs
- It is rather smooth
I start noticing the effects between 20-45 minutes in
About 10 hours after I take it, I can tell that the effects have worn off a fair bit
- It is usually not the case, but once, I felt like I was totally trapped back into my regular ADHD behaviors and couldn't get out of it; couldn't muster up motivation to do other things, etc.
- On most days though, I just feel like I live a much healthier lifestyle and leave the evenings for a more chill time or at least to do something that I enjoy

Dosage

I notice strong positive effects at both 18 and 36 mg. It definitely feels like a handicap has been lifted off and I can do things at my actual potential.

18 mg

On the whole, I think this dose gets rid of a lot of problems
However, distractability remains quite an issue
I'm highly motivated but constantly jumping from one thing to another
Sometimes, the afternoons can be quite frustrating because of this

36 mg

I feel like almost all problems go away at this dose
Most cognitive load feels like it is lifted off so I can even focus on my feelings and emotions
However, I do something feel more like a machine than human. But maybe that's just because I associate being human with at least a little bit of suffering.

Effects

Below, I list some of the effects that I felt that were significantly different, at least noticeably so, from my regular (non-medicated) self.

Context switching

One of the best effects that I have experienced on the medication is the ability to switch contexts. I can switch contexts on both doses, but perhaps owing to less distractibility, it is easier at 36 mg than at 18 mg. Here are a few prominent examples:

Long time-scale

Say that I have two meetings at work, 1:00-2:00 pm, and 4:00-5:00 pm. When unmedicated, I find it close to impossible to work in between in this time period.
When I go home from work, I can be at home. I'm not thinking about work, still trying to solve the problem that I was stuck on.

Short time-scale

Even at much shorter time-scales, I can switch context.
For example, in a conversation, if someone changes the topic, I'm not still lost in the older topic. I can easily continue with the newer one.

Multi-tasking

Being able to multi-task feels like a superpower. I can cook when I talk. What a crazy new world!

I am aware that there may be no such thing as real multi-tasking, I suspect that I appears so in practice because it might be the same as context switching at short time-scales.

I can do this at both 18 and 36 mg.

Short-term memory

I never thought my short-term memory was bad. In fact, I knew it was excellent when I was hyper-focused. However, in many real-world scenarios, it was as if I did not have a short-term memory because distractions take up all the space. If I have to remember something, I had to constantly repeat it to myself.

Here are some examples of changes I have noticed on medication:

I can do groceries without having to pull out my phone to check every single item
I can remember more than one thing that, for example, my girlfriend asked me to bring to her/do around the house.

I find this easier to do at 36 mg than at 18 mg, perhaps because of lower distractibility.

Impulse control

Many of my unmedicated behaviors were unconscious. Medication seems to help this a lot. For an example,

In the initial days, I found myself putting my hand in my pocket to take out the phone, but realizing that I was doing that without thinking about it. For the first time, I had the thought, "Why am I doing this?"

I find this much easier at 36 mg than at 18 mg. I often jump from one thing to another, attending to each thought which I can now clearly process in my head.

Distractions

On medication, I find that I can see the distractions coming in and just look at them instead of having to attend to them or act. Also, I feel like my mind has way less random thoughts overall.

All of these effects are felt stronger at 36 mg than at 18 mg.

Relation to creativity

I wonder if on days when I'm trying to come up with ideas or doing something creative, I should take a lower dose or take nothing at all. Part of being creative is having random thoughts but somehow being able to put them together. I feel like I'm very creative and I don't want to lose that, but at the same time, I would really like to be functional.

Motivation

I feel way more motivated on meds than off them. It feels so nice. I don't see a difference in my level of motivation at 18 vs 36 mg.

Hyper-focus

When I was not on meds, I relied on a few things to get things done:

my ability to hyperfocus (for things I'm interested in)
some minimal amount of stress (waiting long enough until it cannot be postponed)
creating an environment with enough stimulation and lack of distractions (noise-cancelling headphones + techno music)

For most work-related things, my ability to hyperfocus was central to this.

Now, on medication, I can hyperfocus the same as before for the things that I'm interested in, but the jumpiness and constant movement is gone. In fact, I do not even need the noise-cancelling headphones to do this. I can just be engaged in tasks for long enough because I like them anyway.

One good effect is that when I was unmedicated, hyperfocus was a double-edged sword. I do not have control over what I hyperfocus on. Often, I ended up playing chess for way too long; so much so that it started feeling like an addiction. I always stopped when it did. But now, on medication, I don't have any of those negative effects of hyperfocus while retaining the positive effects.

Spatial awareness

I am so much more aware of the space around me. Everything from objects to people to abstract things like ideas.

I move out of the way of opening doors (or other things) long before I normally do.
I even think of, am aware of, and take into consideration how something I do might hit someone else.

I haven't actively tried to notice differences in spatial awareness on different doses yet, but I will try in the future.

Productivity

I feel like I can get so much more done on medication. I actually finish my to-do list. I can even keep track of and stick to my plans. Before, I could never stick to even making to-do lists consistently.

I have too few data points to judge differences in productivity for the two different doses. The level of motivation is the same for both, but I am a lot less impulsive and do not lean as much into distractions at 36 mg (vs 18 mg), so I feel that I may be much more productive at 36 mg.

Relationship

On medication, I feel like I'm much more in tune with the feelings and needs of my partner. I always listened to her, but didn't necessarily process everything. Now, I have the capacity to process everything because I can actually sit and listen. I feel like I am able to have conversations at a deeper level with her and also able to enjoy our time together.

Sleep

Same as when I was not on medication. I can always fall asleep face/belly-down, but I know that I don't breathe too well when I do that. Sleeping face up is a little more challenging, but not more so than it was normally.

One of the problems is that when the medication wears off, the mind starts stimulating itself with all sorts of thoughts. There is too much mental chatter.

Appetite

Didn't notice any differences in appetite on either dose.

Long-term effects

What happens when I go off them?
- Personally, I have not noticed any side effects when going off the meds. The only issue really is that my coping mechanisms aren't as sharp as they used to be when I was completely off the meds, so there's a little bit of adjusting.
Effects on resting heart rate?
- I have noticed that my resting heart rate is higher when I'm on the meds. This is well-known, but I'm not sure if it would lead to any adverse effects.