ADHD Medication Revealed My Autism | The Day My Brain Went Quiet

What really happens when you start ADHD medication?

In this episode of Dating on High Alert, Ilja Abbattista shares her honest personal experience of being diagnosed with ADHD in her 50s and starting stimulant medication for the first time.

From the fear of losing her creativity to experiencing a quiet mind for the first time in her life, Ilja explores the reality of titration, side effects, dopamine-seeking behaviours, and the unexpected discovery that ADHD medication revealed something else entirely - autism.

This episode explores:

• The reality of waiting years for an ADHD diagnosis
• Why social media gets ADHD medication wrong
• Medikinet vs Elvanse – Ilja's personal experience
• Side effects including cold hands, numb feet, headaches and appetite changes
• Dopamine-seeking behaviours and what happened when she stopped medication for a few days
• How stimulant medication can uncover underlying autism (AuDHD)
• ADHD, trauma and why medication cannot heal your past
• Dating, relationships and neurodivergence
• The grief, relief and identity shifts that can come with diagnosis

This is not medical advice. It is one person's lived experience of navigating ADHD, autism, trauma and relationships later in life.

Whether you're considering medication, newly diagnosed, supporting a loved one, or simply trying to understand your own brain, this episode offers an honest and nuanced perspective on a conversation that is often oversimplified.

To learn more about Ilja's coaching, speaking and consultancy work, visit:
www.iljaabbattista.co.uk

If you'd like to support me and buy me a coffee I'd really appreciate that more than you'll know. If you left me a review or shared this with someone else it would also make me very happy. Thank you for being here.

Transcript

SPEAKER_00 0:00

Welcome to Dating on Higher Let. I am Illya Abatista. I'm a speaker, lived experienced consultant, coach, and somebody who has spent a significant portion of her life figuring out why her brain works the way that it does. And what that means for every relationship she has ever been in, including the one with herself. Now, I'm not a therapist. I'm not a psychiatrist. I'm not a medical professional of any kind. What I am is somebody who talks openly and honestly about lived experience. My own and the patterns that I see in others. And that's true whether we're talking about trauma, neurodivergence, relationships, or, as we are today, medication. Now everything I share in this episode is from my own experience. It is not medical advice, it is not a recommendation. We will all experience this differently, and the right conversation to have about whether medication is right for you is with your prescriber, not with a podcast. What I can offer is, though, is the honest version of what this journey has actually been like for me. Because I think that matters. And I think it's largely absent from conversations that are being had around us. And right now, the conversation around ADHD medication is quite loud, contradictory, and in some corners, frankly, quite dangerous. And here is the landscape that we are walking into. Right now, in England alone, over 735,000 people may be waiting for an ADHD assessment. Average wait is eight years. In the worst affected areas, it could even be up to 15 years. And of those who are waiting, nearly two-thirds receive either no information or poor information during that time. Which means that by the time people get a diagnosis, if they ever get one, they are already exhausted, already partially self-educated from whatever they could find online. And already carrying years of misunderstanding about why they are the way that they are. Into that vacuum walks social media. And social media, as you may have noticed, is not always helpful. High-profile voices have called ADHD medication big pharma's biggest scandal. Politicians are questioning whether stimulants are over-prescribed. And there are posts with hundreds of thousands of views telling parents that discipline and screen time limits are the answer. And that medication is unnecessary, harmful, or both. And on the other side of that, there are people sharing their day one medication diaries like it's a revelation. Building an expectation of transformation that the medication cannot always deliver, or at least not in the way that they imagined. Neither extreme is honest, and dishonesty in this space costs people years. And then there's a subtler problem, which can do more quiet damage than those big loud headlines. Social media is full of personal experience being shared as if they are universal. Somebody has a difficult week on medication and posts about it. Suddenly, thousands of people in similar situations absorb that experience as a template for their own. Somebody discovers that cutting out sugar improved their focus and presents it as an alternative to diagnosis. Somebody lists 20 traits and says, if you relate to any of these, you probably have ADHD. And half of those are just traits related to being human, tired, easily distracted sometimes, occasionally forgetful. That's not a diagnostic profile. That's simply just another Tuesday. The problem isn't that people share their experiences. Sharing is, of course, very valuable, and it's why I'm doing this. The problem is when personal experience gets generalized into universal truth without the context that makes it honest. What's true for one person's nervous system, one person's medication response, one person's particular presentation of ADHD is not automatically true of yours. And when people absorb generalized experience as fact, they arrive at their prescriber or at a diagnosis or at the decision about whether to medicate with a map that doesn't match that territory. And then there is the thing that people say, which is, you know, maybe meant kindly, but often meaning to be reassuring. And that is actually one of the most dismissive things that you can hear when you try to understand your own brain. Everybody has a bit of ADHD. Everybody has some trauma. No, they haven't. Not the way that you mean it. Everybody gets distracted sometimes. That's not ADHD. Everybody has experienced something difficult. That is not trauma in the clinical sense. That kind, well, the kind that reshapes your nervous system, changes how you process threats, lives in your body long after the event has passed. And when somebody says everybody's a bit like that about your neurodivergence or your trauma history, they are not being inclusive. They are erasing the specific part of your experience. They are making it smaller so that it fits somewhere more comfortable for them. And I say this without any anger because I don't think most people who say it mean any harm, but it's but it is harmful. And it's, I think it's worth naming. Trauma and specifically how trauma lives in the body, the responses, the patterns, the way that your nervous system learnt to protect you, that is a whole conversation of its own, and one that we will come back to in a future episode. Today, we're going to be focused on medication. But the two are not unrelated. And by the end of this episode, I think you'll understand why. But what's also true and worth naming is that the research on long-term efficacy of stimulant medication is more complicated than the headlines suggest. Studies have found that while medication is highly effective in the short term, the picture over years is more nuanced, which doesn't mean that it isn't worth taking. It just means that it's not necessarily a cure. It means that it could be a tool. And what you do with that, with the space, it creates matters enormously. And I say all of this not to alarm you and certainly not to put you off. I say it because you deserve to have the full picture. Not the sales version, not the horror story, the honest, complicated, personal, occasionally inconvenient truth. And that's why, well, that's what this episode is at least. And I want to start with, excuse me, something that I wrote a few weeks into taking medication for ADHD. Starting ADHD medication felt terrifying. Not because I didn't want help, but because I was scared of losing myself. I had heard horror stories of it changing you. I was scared that my creativity would go and that my ideas would stop, that I'd become some quieter, flatter, more manageable version of myself that other people would prefer and I would hate. And I was also, if I'm honest, quietly hoping that I might lose a bit of weight because that's where we are, isn't it? Terrified and hopeful at the same time, holding grief and relief in the same hand. And this episode is about what actually happened so far four months in the good, the difficult, the surprising, and the things that nobody warned me about, including what medication revealed about me that had absolutely nothing to do with ADHD at all. Now, everything I'm sharing is from my own personal experience. And as I said earlier, we all experience this very differently. So please talk to your prescriber. These medications are prescribed for you specifically, and what's true for me may not be true for you. But I am sharing because I think honesty helps. And silence, as I've said before in many of my podcasts, silence serves the wrong people. And by the time I got to the point of being prescribed ADHD medication, I had already waited several years to understand why my brain worked the way that it did. I had a diagnosis and I had some relief. And then I was handed a prescription and the fear rushed in. What if the medication takes away the thing that makes me me? When you've spent your whole life not knowing you have ADHD, the ADHD becomes indistinguishable from your personality. The racing thoughts, the ideas arriving in clusters, the way that your brain leaps between things. That's not a symptom to you, but that is you. And the thought of somebody chemically altering that is yeah, genuinely quite frightening. And I also wasn't sleeping particularly well around six hours a night, and I was worried that the medication would make that worse. I also had questions about my creativity, about about my work. I make a living from thinking in ways that other people don't. What if the medication smooths that out? And after several conversations, blood pressure and pulse monitoring, I was started on 10 milligrams of Medikinet, and I noticed absolutely nothing. Following a week, 20 milligrams, and it was here that something happened that I was not prepared for at all. For the first time in my life, and I mean that literally for the very first time, my brain went quiet. Not silent, you know, not empty quiet, but it was so peaceful. And it was so utterly alien to me that I just had to sit have a sit-down. And I sat there and just listened to it. And this stillness that I had never experienced, it made me cry because I had just never known this. I've always related to my brain as Spaghetti Junction. And I genuinely had not known that everybody else had this, that this was available to me, but I just didn't have any access to it. And if you've ever lived in a house that's very close to a motorway, and then one day the traffic just stops, and you don't realize how much noise there was until it's gone. And that was me at 20 milligrams, sitting in the quiet of my own mind for the very first time crying because I hadn't known that I was missing it. And that moment wasn't just relief. It was it was also a grief, really. Grief for the years of noise, for the for the exhaustion of it. And for the version of me that had fought so hard without knowing what she was fighting against. Now medication didn't give me something new, it showed me what had always been there underneath all of that noise. And the next week was 30 milligrams, but I was concentrating better, I was finishing things, and I did start to notice a side effect that I hadn't expected. My fingers and my feet were getting really cold and numb. And by the time we got to 50 milligrams of Medikinet, my body was in what I could only describe as, you know, and this is this is my description, it's not a medical one, as a complete revolt. It wasn't just my fingers and feet that were cold. I was freezing to my core. Three hot water bottles at the same time, fireplace on full blast. Room was reaching around 25 degrees, had a hot shower, and I still couldn't get warm, couldn't get anything done. The cold was making me so incredibly exhausted. And when the medication did finally wear off around 6, 7 pm, oh, I just had nothing left. And this certainly couldn't go on. So I was moved to Ilvans, starting at 50 milligrams, and that difference was immediate and significant. The coldness was still there, but it was far more manageable. And I had also discovered that a protein breakfast, which yeah, I practically had to force myself to eat because I don't naturally notice hunger, helped enormously, as did moving. Getting close to around 10,000 steps, or, you know, as a minimum 5,000, um, as did having my coffee before I take the medication rather than during or after it. And it was those little things that really, really mattered. Then came 70 milligrams. Oh my goodness. My heart rate sitting down hit 120. I had a headache. And I hadn't yet understood that food, fluids, at movement were going to be very protective. I knew they were good for me in general, yes, I know. Um, I just hadn't connected them to how the medication would land in my body. And I don't reliably recognize when I'm hungry. I skip food without realizing. And that day was definitely my wake-up core. So I was told to sip fluids slowly that day, eat protein, don't go for a walk and just wait. So after four to five hours, it finally started to bring down my pulse. And it was that day that I stopped ignoring my body signals, which, if you know my history, is a significant sentence. Anyway, I dropped back down to 60 milligrams for a further two weeks. And then I tried 70 milligrams again when I felt ready because it kind of scared me. And this time my body felt prepared. This time it worked. Now, and this is something that I want to flag to anybody who has had chill blanes as a child or who has ever been asked about rain outs phenomenon. The questionnaire that you have to fill in before being prescribed, it asks about rain outs for a reason. Now, I'd never been diagnosed with it, but as a child, I used to come in from the cold and cry from the pain in my fingers and my toes as they would get back to normal temperature. They'd go white, go numb, oh, come back with incredible pain. Um and I thought that I had outgrown that. So I didn't mention it because it hadn't been a problem for many years. Now, stimulant medication can bring it back with a vengeance. Mine did. And if any of this sounds familiar, please talk to your describe your prescriber. And let me also tell you the good side because it it's real and it deserves its full weight, too. Now I can concentrate on tasks and finish them. I wrote 47,000 words in just under two weeks, which resulted in a book that had been sitting in me for absolute years, waiting for the conditions to exist where I could actually get it out. The ideas are all still there. The creativity has never left. What has changed is that the thoughts are no longer all over the place simultaneously. I can choose one and I can stay with it. And that's not losing something, that's gaining access. What was already there. I'm less impulsive. So my worst impulsive behavior, and I say this with full awareness that the algorithm knows exactly what it's doing as well, is spending money. Clothing, cookery books, self-improvement courses, more books. Whatever appears in my feed at the exact moment that my brain is looking for a hit of something, oh my God, that is genuinely dangerous for any ADHD mind. And I say that without any irony. Stimulant medication hasn't completely eliminated this, but it's given me a pause between the impulse and the action. And that pause is everything. So I'm making healthier food choices without consciously deciding to. I've lost about four kilograms, which is, I think, about nine pounds or so. Now the menopause kilos didn't entirely surrender, but some of them did negotiate. I feel calmer in general to some extent, but there is one other thing that I would really like to talk about. Um so I had never considered that I had autism. It was actually my psychiatrist who raised it. He felt that it was possible, and he was right. And since being on medication, it has become very clear to me that I do have autism. And here's the part that I think that is important for this podcast specifically. For those of us that are navigating identity relationships and how we show up in the world, medication reduced the ADHD noise. And when the noise reduced, the autism became very visible. Not because it just arrived, because it's always been there underneath the hyperactivity and the racing thoughts that had been masking it. Situations I used to be able to push through are sometimes now a bit unbearable. Such as a pack tube train on a really hot day and bodies press all together, the smell of heavy perfume and bad body odour, but the screech of the rails, oh, multiple conversations and music happening simultaneously. I used to white knuckle ride through these environments, but now I just can't do that. The tolerance I thought I had wasn't tolerance. I think it was suppression. And the medication stopped suppressing. And um, I was on my way to a book launch and I was really excited to be going. And once I was there, I hit my limit well within the hour. The people, the noise, the social performance of it, and I needed to leave. Now, before medication, I would have stayed, I would have masked harder, I would have got home and crashed and maybe not understood why. Now I know why, and knowing why is both useful and sometimes devastating. I prefer my own company a lot more, I have less patience for small talk, and I find it easier to avoid contact. And I have to watch that because being alone for too long, I don't think is particularly healthy for me. But if I'm not careful, that pull towards solitude will win more and more often. And this is where I think it gets interesting for this particular podcast, Dating on High Alert specifically. Before medication, I got on the dating apps. I was looking, I had the energy for the project of getting to know somebody new. Now, oh, the very thought of it exhausts me before I've even begun. Getting to know them. Eventually having to tell them my past story because they'll need to know at some point. Learning their personal quirks, the mirroring, the masking. The performance of early dating that I used to do so automatically and now cannot face. And I don't know whether it is the medication or the autism becoming more visible or just me being more honest with myself about what I actually want. It's possibly all three, all three of them. What I do know is that this version of me is different. No more real. Um, I have never considered myself fake. Um, the masks I've worn were never a pretense, in my view. They were just the mechanism that brought forward the version of me that would otherwise have stayed hidden. The one that could function in that particular room and hold that particular conversation and get through the day. Um, and those masks did their job very well. And they did cost me a great deal as well, because although they did their job, um, but what changed is that some of those mechanisms are now much quieter. And in that quiet, I am meeting parts of myself that I didn't know were there. And that's not a relevant a revelation of authenticity, it's just a different view of the same person that has always been there. I want to talk about this because I said that I would be open, and this is that part. I had a few days off of the medication as I'd got out of bed too late and missed my window. Elvance stays in my system longer than Medicinette did. So taking it too late means possibly not sleeping, and that isn't something that I am open to exploring. I made the call to skip it, and the next day I forgot, and by then it was too late. And I'm going to tell you what happened because it really did help me understand something important about my own brain. So I wanted to eat absolutely everything within reach, comfort food specifically. I wanted to drink alcohol, I wanted to have sex, and I felt impulsive in a way that I hadn't felt in months. It was urgent, seeking restless in my body. And luckily I had company which helped with all of this. I ate far too much, but not catastrophically. I had half a glass of wine more than I normally would, which is not a lot because I'm not really a big drinker. Sex wasn't available, so that particular impulse was managed by circumstance rather than willpower. And I didn't buy anything because I wasn't alone and I didn't spend any time on my phone. And my prescriber explained it very clearly. My brain was deliberately or desperately searching for dopamine because we don't process and regulate it the same way as others. The issue is primarily in how dopamine is transported and received. And without the medication, every instinct I have was pointing towards anything that would give me a hit of it. Food, alcohol, sex, spending, all of it simultaneously. Now, this didn't frighten me off. It did, however, clarify something. It showed me exactly what my brain is doing all the time underneath and what the medication is quietly managing. And I don't say this to alarm anybody. I say it because understanding your own brain, really understanding it, not the sanitized version, is the whole point of this podcast. We cannot date well, work well, live well, or even love well from a false map. Medication has changed my brain chemistry. It did not change my history. Trauma responses, the ways my nervous system learned to protect me long before anybody understood what was happening to me. Those are still all there. The hypervigilance, the scanning of the rooms, the reading of the people before I've even decided whether I can trust them. The way certain situations make my body go to threat before my mind is caught up. Medication gave my brain breathing room, but the nervous system that was shaped by what happened to me as a child that doesn't respond to dopamine regulation. It responds to time and safety and the kind of work that I've spent years doing. And I'm still getting to know this version of myself. I I genuinely don't know yet which version of me I prefer. The one who got things done through sheer chaotic force, or this one who gets things done more steadily, more quietly, with more awareness of her own edges and limits. But what I do know is that right now I get things done. And I love that. I love it with a particular kind of love of somebody who has spent decades not knowing that she could. And here's where I'll leave you. Or you're wondering why things feel harder rather than easier, even though that you're finally getting help. You're not doing it wrong. Medication is not a destination, it's one tool. It won't reach your history, it won't reach the shame, it won't reach the relationships that you've built while you didn't understand yourself. And it won't explain yourself to you overnight. But it might, if you're lucky and the right medication at the right dose lands correctly, give you a moment of quiet. And in that quiet, you might hear things that you've never heard before. And some of those things might be very beautiful. And some of them might even break your heart a little. But both are worth knowing. Do your own research. Learn about you. If you're curious, ask the questions. Talk to your prescriber. Tell them everything, including the stuff that you think that you've overgrown. Including the chill blanes. This is your body, it's your brain, it's it's your choice. And the choice is completely yours and it should be. Before I go, I want to talk to a specific few people. If you're the person that has spent years being told that you're too much or not enough, or both in the same week, who has worked harder than anybody around you just to achieve what looks effortless for everybody else who has arrived at a diagnosis, ADHD, autism, or both, and felt relief and then felt the grief underneath the relief. You may be carrying trauma on top of all of that too. And now you understand the cost of all of those years of not knowing if you're the partner, the one who loves somebody with different wiring and is trying to understand why the same conversation just keeps on happening, why closeness feels complicated, and why the person that you're with can be extraordinary in one context and completely unreachable in another. And you're exhausted by the misunderstanding, even though you don't want to be. If you're the couple, trying to find language for something neither of you has found the words for yet. Watching the gap between you widen even though neither of you wants it to. Here's what I know about navigating this without support. You spend years developing workarounds that cost you more than they should. You build relationships on a version of yourself that is sustainable short term and exhausting in the long term. You reach for the goals that matter to you and watch them stay just out of reach. Nothing to do with being incapable, but because the body has never helped you understand the specific way that your brain is working against you in that moment. You keep arriving at the same patterns in relationships, in work, and how you feel about yourself, without ever quite seeing what's driving them. And the thing about not having a guide isn't that you can't manage. You can. You have. But managing and thriving are not the same thing. And the gap between them, the years of misunderstanding, the goals that stay frustratingly close but never quite arrived at, the relationships that almost worked, the gap has a cost that compounds quietly over time. What changes with the right support? Well, you start to see patterns instead of just living inside of them. You understand not just what you do, but why, which means that you finally have a choice about it. And you stop spending energy, your energy, on the performance of being fine and start spending on actually building the life and the relationships that you want. And if you're a couple, you stop fighting about the symptom and start understanding the source, which changes everything about how you talk to each other. I work with people on a one-to-one, whether that's you navigating your own wiring, the person alongside somebody whose brain works differently and who is trying to understand rather than fix. Or couples finding a language for what's been wordless between them. I don't shy away from difficult parts. I talk with openness and honesty always. And what I bring that I think is genuinely helpful is that I can see patterns because I've lived enough, worked with enough people, have understood my own complexity deeply enough that I can often see what's happening in a dynamic before the other people inside of it can. And I'm not here to give you answers, I'm here to help you find the shape of what's actually going on. And if you're curious about working together, you can find me at iliaabatista.co.uk. And if today's episode brought something up for you, please leave a comment, send a message, or just sit with it for a while because of course that's allowed to. And as always, until next spiral. But one last thing, and I'll keep this brief because it's not why you're here. This podcast takes time, research, thought, and a specific amount of emotional honesty to make. And if today's episode was useful to you, if something landed, if you felt less alone, please share it with somebody who really needs to hear it. And if you would like to help me keep making it, there are a few ways that you can do that. You can buy me a coffee. The link is in the show notes. It's a small thing that makes such a big difference. Um, especially to an independent creator working without a production team or a budget. You can um share this episode with a friend, a partner, a colleague, or somebody who is waiting, you know, for a for a diagnosis and doesn't know what to do with that weight. Word of mouth is absolutely everything for a cast like this one. You can leave a review, which would be amazing. It takes two minutes and it helps more people find the show. And if you are curious about working with me, then you know whether that's through coaching, speaking, or anything else, please have a look in the show notes and you'll find everything at iliabatista.co.uk. I want to thank you for being here. Thank you for listening, and thank you for caring enough about your own understanding to spend your time this way. It matters, and you matter.