In Search of ADHD Medication in Northern Maine

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In Search of ADHD Medication in Northern Maine

By Pauline Campos 03/30/18

What if my doctor refused me my ADHD medication because I’d asked to resume medical treatment for anxiety and depression? 

Image: 
A doctor explains something to patient.
"I need to ask several dozen more questions before I decide whether or not to give you your medication."

“The nurse said you made this appointment because you want a prescription for ADHD medication,” she said briskly, cutting me off. “Is that right?” 

I nodded my head, silent. I was living in northern Maine, an area affected so heavily by a meth epidemic that this was the only doctor’s office within an hour’s drive that treated anyone over the age of 18 with medication. By the time we moved, even Sudafed—which normally can be bought over the counter to treat sinus infections—required a prescription from a doctor. The county I lived in at the time, I knew, was so resigned to people with addictions working the system that patients like me, with legitimate need, were treated like drug-seekers by default. 

I’m not making light of a very real epidemic. I understand how frustrating it may be for doctors who may feel their hands are tied in the midst of a problem too big to ignore. If I ever forgot, Halloween was a reminder. My husband made sure that I connected with a local friend to accompany us trick-or-treating. This was the only way to make sure we steered clear of the known meth houses, lights on, signaling kids in costume to their door for candy.

ADHD, or Attention-Deficit/Hyperactivity Disorder, is a mental health disorder characterized by a variety of difficulties, including low frustration tolerance, hyperactivity, and trouble coping with stress. According to the Anxiety and Depression Association of America (ADAA), less than 20 percent of the eight million adult Americans with ADHD have been diagnosed and treated, and less than one-quarter of that number seek help. I fall into this latter category. And I have caught hell for it. 

The Cliff Notes version: I am a life-long recovering bulimic, will always have body image issues, and have severe ADHD with anxiety and depression on the side. This is reality. It's as real a part of my identity as my role as a mother to a child on the spectrum and my kinky curls…even my fear of spiders. Please don't tell me that labels are bad because to me labels are roadmaps helping me navigate the unfamiliar terrain that comes with each new day. I like my labels. Labels are answers to questions I never knew I had.

ADHD. Anxiety. Depression. Bulimia. Recovery. Mother hoping like hell I don't screw my child up by handing her a gift-wrapped package of my genetically-coded issues. My anxiety and depression are controlled, for the most part, when my ADHD is controlled. All hell breaks loose when that first domino falls. That's me knowing myself. 

“I have a few more questions for you,” my doctor says. “You have a history of suicide attempts? Are you suicidal now?” 

I was diagnosed with depression as a teen and with anxiety and ADHD as an adult, only a few years ago, by a doctor with the same condition.

It was life-changing. 

The doctor who diagnosed me told me that the condition is very similar to bipolar in that we have ups and downs, but much less extreme. My up is creativity and short bursts of focus and the ability to not only start a task, but follow it through to completion. My down is depression and sensory overload and I hit what I refer to as ADHD Full Stop. I can't focus, so the little things pile up and the pile doesn't stay little for very long and then it's big and bigger and biggest and because I can't focus on any one thing, I don't do any of it. 

For three years, I took my medication as directed, never once abusing my prescription. It was more likely that I’d forget to take my medication at all, because that’s how ADHD works, but I can always count on my daughter to hand me my prescription bottle when “mama’s brain is working too fast.” I took the doctor recommended “drug holidays” every so often, just to keep my body from adjusting to the medication and rendering it useless. My doctor at the time had also prescribed an antidepressant and anxiety medication. I took the antidepressants daily, as prescribed, and the anxiety medication was saved for panic attacks. Mental illnesses often present in tandem with others. It is not uncommon for individuals with one condition to have one or more additional diagnoses, as I do. 

I attempted suicide twice in my early twenties. I have a family history of depression. I am not a drug seeker. I am not an addict. Maybe it was to prove to myself that I wasn’t either of these things or maybe it was because I had convinced myself that I could treat my ADHD naturally, but I decided to stop taking my medication over a year ago. At first, I felt fine. I hadn’t really needed it, I convinced myself.

I was wrong. 

“No,” I told her, talking faster than I meant to. I knew I only had moments to state my case; to prove I was truly in need of what I was asking for and not just a junkie looking for a high. I wanted to ask why would I be doing this the hard way; it was probably less soul-crushing to avoid doctors who looked at you like everything you said was a lie.

“I did try. I am very depressed and anxious now, which I know is connected to my ADHD, and I’d like to get treated for all three conditions.” 

She looked at me. She looked at my records. She could see that I was telling the truth, but I felt like I messed up. It seemed that the unspoken rule was ‘one and done.’ Asking for more than one medication is only something addicts do, I think, or I wouldn’t have been squelching the urge to beg for what I suspected she was not going to prescribe. Or maybe that’s just what she wanted me to think.

My depression returned with a vengeance when I stopped my medications. I had not experienced dysphoria this intense since my last suicide attempt. I slept until early afternoon, barely dragging myself out of bed in time to take over care for my daughter when my husband left for work at 1:30 in the afternoon. I was anxious and jittery. My mind raced and I talked too fast and had to force myself to speak slowly enough to be understood by my own child. I could not sleep, and cried so much that I imagined I might eventually run out of tears. 

The symptoms worsened as time went on and my husband was taking days off work just to try to keep up with the housework I was not doing. I wasn’t detoxing, as I had first suspected. It took months to realize I was back to square one. 

I needed help. Admitting this fact, that we need help, should be the hardest part of this whole ordeal for anyone ever. 

But it isn’t.

Sometimes, I find myself thinking that I should have known what I was walking into before we moved. It’s common practice to check for the best schools and the best housing in our respective price ranges, but why didn’t it occur to me to make a few calls and ask a few Facebook friends what life is really like for an ADHD adult in northern Maine. But I hadn’t, so I was sweating my way through what should have been a standard medical appointment. The judgment in the air was so heavy that breathing was difficult. Knowing that I looked as nervous as I felt only magnified my fight-or-flight response. 

Knowing that my doctor was aware that I was desperately hoping she would believe me—even with medical records to back me up—only served to remind me that I had every right to feel as nervous as I was. 

ADHD doesn't just go away. We are ADHD sufferers with medical histories and records of faithfully taking medications as prescribed and we’re caught in the crossfire of an epidemic we did not create. We are not the problem, but we are made to feel as we are. We are shamed and made to question our own motivations. I sometimes still wonder if the problem was self-created; it made sense to me that adult ADHD patients would look to find ways to self-medicate: we turn 18 and yesterday's truth automatically morphs into today’s lie. 

All I wanted was to feel normal again. I wanted to be able to function as a whole person. I wanted to be there for my husband and daughter. I had puffed up my chest proudly and listened to the inspirational memes telling me that I was strong for showing up to the appointment it took me four months to get. I was strong and unashamed. I needed help and was smart enough to ask for it. 

For two years, I had to take a state-mandated driving test with an instructor to prove that I was not a danger to myself or others on the road—even though I have a good driving record and no accidents—because I had naively checked the boxes for my conditions on my state license application. I am not ashamed of who I am or the conditions I deal with. But it sure as hell felt like I was supposed to be. If I refused the driving test with an instructor, my license would be revoked, no questions asked. I was livid and called a disability lawyer located in Maine. There was nothing they could do, they told me. I should have left the boxes empty, they said.

Shame replaced pride. 

I breathed a sigh of relief when the next year rolled around and I was spared a letter mandating another road test. I guess two years of proving I am not just my mental illnesses worked in my favor. I was warned, however, that every year lived in that state meant any future demand for a driving test could not be ignored. And yet, there I sat in front of my doctor, hoping like hell that she would not deny me medical treatment for the very condition the state held over my head every year, making me wonder if I had been wrong to ever feel pride in and acceptance of who I am…and the conditions I live with. 

My doctor was looking at me again. I felt small. I shuffled my feet. I held my breath. Dread filled my bones. What if she refused me my ADHD medication because I’d asked to resume medical treatment for anxiety and depression? 

But she didn’t say no, at first. She told me that she would prescribe the same medication, same strength, for my ADHD, as this is obviously my most pressing concern. Relief flooded through me. But then she turned away, busying herself as she avoided my gaze. She told me too many of her patients had overdosed—going into comas on benzos like xanax—for her to prescribe it again while practicing where I lived. It was a no, also, for any antidepressants. 

“But you just asked me about my history and my suicide attempts and my therapist said I need to be on…” 

She cut me off again. No. 

I stopped talking. I forced a smile and thanked her for her time. We shook hands. She left and a nurse took her place with a drug contract. I’ve lived in three states since being diagnosed with ADHD. Only in Maine was I required to sign a contract stating that I agreed to random testing. If anything other than what I was prescribed was found in my system, I would be kicked out of the practice. I didn't bother telling her I wouldn’t have put myself through the hell I’d just experienced if I had any intention of not following my prescription to the letter. I didn't bother asking why my doctor chose to refuse treatment for anxiety and depression with this kind of system of checks and balances in place. 

I signed. 

I left with prescription in hand and drove straight to my pharmacy. They were out of my medication. Before I could check the next pharmacy in town, I had to call my doctor’s office because the drug contract I signed also stated I could only fill this prescription at the pharmacy I named on the form by name and location. Not checking in first could have gotten me banned. Thankfully, the nurse cleared the request.

The next pharmacy I tried only had enough for a partial fill and told me I’d have to wait five days for their next delivery, but partially filling a prescription for a controlled substance voids the rest of the prescription. Before I called my doctor’s office again, I called the only pharmacy left in town to see if they had my medication in stock. They did not, but probably would in five days. My husband and daughter and I were leaving the very next day to visit family in Michigan. I called my doctor’s office again. 

“Didn’t you just call? What happened to the other pharmacy?” She sounded annoyed I was following their rules. Every call meant more paperwork for them to fill out and add to my file. 

“Yes, but they didn’t have enough to fill it. I leave for a family trip tomorrow. Is it possible for me to just this once get the prescription filled at any pharmacy in Michigan? Can an exception be made?” I knew I sounded desperate. 

“Just this one time,” the nurse said. Then I am reminded that upon returning home, I would be required to abide by my drug contract. 

That night, my husband, daughter, and I packed ourselves up. They slept while I continued to overthink and overpack. I was showered and dressed when my husband woke up at 4 a.m. After checking to make sure we were ready to go, we woke our daughter and drove 20 hours to Metro Detroit. Bags were unpacked. Running jokes with the longtime friends we were staying with were brought back into circulation. And we slept. 

In the morning, my husband woke before I did and drove to the nearest chain pharmacy with my prescription. There was no inquisition. No contract to sign. He only needed to show his ID. Fifteen minutes later, he was on his way back. 

“Here,” he said, waking me up and handing me my medication. “That was easy.” 

We laughed together, because it was sad and funny and true. And as the medication worked its way into my system and I remembered what normal felt like, pride replaced shame.

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