How do you know if your medications are working? What does it even mean to say they are “working”? How long does it take to see if there is a real change in your situation as a result of taking (or changing) medications?
A recent conversation with a patient, let’s call him Jim, highlighted some of these issues. Jim is a careful observer who has experience with balancing treatment for ADHD, anxiety and bipolar. He notes that it isn’t easy to tell right away if a change will be beneficial. “I feel like I’m on an effective dose now, even though at first I don’t think I got the full benefit of it. I had to live with it for a while. Now I feel like, after having benefited from it for several weeks, it’s assisting me in accomplishing things and staying calm in situations.”
Our bodies and brains take a few days to adapt to a new medication or a new dose of a medication. And the immediate effects may not be at all the same as the long term effects.
In Jim’s case, he was not impressed with the early effects of a new stimulant dose, but with time he found that he could use the new mental state created by the medication as a tool to change how he approached the day. And by 4 weeks after the change in medication he could see big changes taking place in his experience of life.
“So I mean from my perspective, I start the new dose, the side effects are worse for a few days, and then I kind of settle in and see what it’s going to feel like.
Before, I felt like every day was different, and how it turned out depended a great deal on how it started. If I was scatterbrained, the whole day was mentally scatterbrained or messier. I was always a step behind. I wasn’t very comfortable going through the day. Everything felt kind of rushed. And it’s very hard to just calmly approach something, or if there was some kind of setback to just deal with the setback and move on.
But with the meds being more effective, that helped me to start slowly changing my mindset. I had gotten used to expecting certain things to be difficult and that tended to make them difficult. As I adjusted to the meds, I gradually realized, oh this can feel easier; I can be calmer during this; this can be better.
And then that became more of the norm. I think it took a little while for that to set in, but I mean, I could also definitely see someone not experiencing that at all. I think it took some effort on my part, right? I was like, Oh, this tool that I have. This medication is like a tool that can help me make changes in my life. But I’m still in the driver’s seat. I have to make the changes and so, yeah, I just once I had that tool and it started being helpful more than once.”
“I’m just feeling calmer now, not rushed or overthinking, and I’m getting a lot more accomplished each day.”