Does anyone else have this? The benefits it gives me are immense but it comes at a cost, and I can’t decide whether I’m better on or off it.

About 6 months ago I was diagnosed with inattentive ADHD. At first, Dexedrine, alongside exercise and healthy eating, was like a miracle cure, but I’m now noticing the downsides more and more.

To give some context, I work as a program manager for a large IT program. Sometimes I go for a few days without Dex and I find I’m interacting well with my colleagues and stakeholders; I’m good in conversations, confident and upbeat and I have positive interactions with my colleagues. However, when I take Dex again I realise how incredibly behind I am on my workload. I become comfortable with things taking me forever to do, with being very slow at writing IMs and emails, with being poor at planning/organisation and with generally being behind the curve. I think my sociability and charisma keeps me above board, but from a work perspective I’m really unproductive.

When I take Dex again suddenly I’m all over my to-do list. Things that have been languishing for days I do, and quite easily. I knock out huge amounts of work and do so in a way that is fit-for-purpose, versus a agonising over every last detail and taking forever to complete anything. The problem is that I also feel like I become less good with people - almost like I’m operating on a different wavelength. I can’t decide if it’s anxiety from the Dex or something else, but I worry more about what other people think, and when I talk I feel like people don’t always follow what I’m saying. Instead of getting agreeing nods over zoom calls I sometimes get silence, and a sense of unease. Instead of people laughing at my jokes and me feeling relatively witty, I feel a bit socially inept. Almost like I’m thinking at 100mph per hour, but others see me as being a bit scatter brained or all over the place.

I saw a psych a while ago who diagnosed me with BPD type symptoms, although I fell short of an official diagnosis. I essentially worry a lot about what other people think of me, have fears of rejection, seek approval from others and can feel quite fundamentally defective.

I think what’s happening is that taking the meds makes me more proactive and driven, which in turns increases the likelihood of me pushing opinions and driving things forward at work, but a natural side effect of that is the potential for disagreement - I.e. if you’re always passive and plodding along you’re likely to keep most people happy, but you do so at the cost of getting anything done. When Intake Dex, start pushing things and I find someone disagreeing with me it massively activates my fear of being rejected or abandoned, which slowly leads me to think I should stop taking it. When I do I feel like I improve my relationships with others, but fall back into being generally inept at work - like a passenger who is always trying to keep the peace and keep everyone happy, which I do well, but at the expense of actually getting anything done.

Can anyone else relate to this?