ADHD Medication: Getting the best of both worlds, not the worst
For most of my life, the ability to Get Things Done™️ has come and gone, without me getting much of a say in the matter. This article about procrastinating and the panic monster seemed to be written just for me. Then, in about 2015 I got my ADHD diagnosis (woah..! 10 years ago…!). It was a wonderfully affirming time.
I discovered medication, and suddenly—BAM—I could Get Things Done™️! I was ticking off to-do lists like I was in a motivational 80s montage.
Suddenly, I could:
Start setting up my own flourishing private practice and, before I knew it, start offering clinical supervision.
Tackle the NDIS triple maze of bureaucracy to become a Registered Practitioner and pass the audit (which is basically the Olympics of compliance paperwork).
Still process information quickly and make original connections between ideas—but now actually follow through on them.
Feel the heady boost of self-efficacy—I could finish 'important but boring' tasks when I decided to...! I could just shoosh the voice of self-doubt by simply deciding to!
Sadly, there are no perfect fixes in life. This is my story of the other side of the coin.
Sure, ADHD meds give me the ability to harness my focus and energy, but sometimes they make me too effective or the wrong effective. Suddenly, small tasks can feel life-or-death in my body. For example:
We have guests coming over in 20 minutes? It is critical I scrub every grimy fingermark off the kitchen cabinets in a panic, with the urgency of running from a fire.
Slightly demanding emails (“Just following up re: the above”) suddenly arrive in quick succession? My body reacts like a trapdoor has opened up under me.
It’s like my brain suddenly has a CEO and an intern, and the CEO has given the intern way too much power. The intern decides that the success or failure of every single task is a reflection of my success and worth as a person, and I find myself overwhelmed by things that, pre-medication, I would have blissfully ignored.
Enter: Executive Function AND the Panic Monster
This 'panic monster' sudden-urge-to-tidy-because-visitors-are-coming thing is very familiar territory for most ADHDers. We’re used to our brains substituting dopamine with adrenaline—hence why last-minute deadlines were often the only way assignments ever got done. But now? Now, if I don't watch it, I have both executive function and the panic monster running at full tilt.
Instead of being unable to start a task until it becomes urgent, I can now start at any time—but my body still reacts like the deadline is right now. It’s the worst of both worlds: I can do the thing early, but my nervous system still acts like the house is on fire.
I can logically know that rescheduling a coffee catch-up isn’t a personal betrayal. But my body? My body is convinced that pressing send on that text is a high-stakes social disaster. I can recognise that a slightly formal email isn’t a sign I’ve done something wrong, but my nervous system insists I must now overanalyse every word and possibly flee to Ecuador.
I'm somewhat of a CBT fangirl, so as I wig out about the smeary cupboards with visitors imminent, I will duly challenge my thoughts with logic:
“You know that other people never care about mess as much as you do—and if they do, it's probably because they're worried about making you uncomfortable” (Boundary Acceptance)
“You are juggling a lot of plates; be kind to yourself about staying on top of housework” (Reframe Expectations)
“The state of the house is objectively not 'a dumpster fire’“ (Reality Check)
......but sometimes my body just isn't buying it.
So, What’s Actually Happening Here?
This is what we know is happening physiologically:
Sympathetic Nervous System Activation: Stimulant meds increase norepinephrine, sharpening focus but also amplifying the fight-or-flight response. That’s why small stressors—an email, a mess, a to-do list item—can feel physically urgent, even when they’re not.
Interoceptive Confusion: It can be a struggle to interpret body signals accurately. A racing heart or tight chest might mean excitement, stress, or urgency—but the brain defaults to “this is bad, fix it now!” rather than recognising it as a natural fluctuation.
Cortisol and Overwhelm: If your brain is used to only waking up under real urgency (procrastination + deadline = productivity), then medication can leave it on high alert all the time. A steady sense of executive function combined with heightened stress sensitivity can create a constant low-level urgency, making even small setbacks feel overwhelming.
The challenge? Finding ways to step out of that urgency spiral without losing the benefits of meds—learning when to trust the productive energy and when to gently guide it away from, say, alphabetising the spice rack at 11 PM.
Here’s what I’ve found actually helps me stay grounded and use that ADHD-fuelled productivity so it’s well, productive:
Engage in sensory resets like holding something cold, stepping outside, or stretching to break the intensity of hyper-focus.
Say out loud what’s happening—“I am freaking out because I can't find the exact tupperware container I want.” My therapist told me that speaking your unhelpful thoughts aloud engages the prefrontal cortex (the logical, decision-making part of the brain). This can make problems seem more manageable - plus, you can hear how bonkers they sometimes sound.
Redirect the energy to something that will genuinely reduce stress later (instead of reordering every app on my phone by colour). I've found weeding in the garden a 'twofer', because it's outside, I'm literally touching grass and it's something something somatic.
Disconnect from screens. I love a deep-dive research spiral, but my brain functions so much better when I set actual limits on how long I let the hyperfixation rule the day.
Final Thoughts
ADHD medication has been a game-changer for me, but it’s not just about being more productive—it’s about learning how to work with my brain, rather than constantly trying to outrun it. Over time, naturally, I’ve found that medication is just one tool in the toolbox. Because sometimes, the biggest challenge isn’t getting things done—it’s knowing when to pause, breathe, and remind myself that even people with grimy kitchen cabinets are worthy of love.
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What’s your go-to strategy for managing overwhelm? I’d love to hear what works for you!