Law of conservation of focus

Or why I stopped taking Methylphenidate

It’s been a little over a year since I stopped taking methylphenidate (Inspiral in India; Ritalin in the US). It was a spur-of-the-moment decision, soon after I had decided to quit my last job. “I’m not in a job any more, so I don’t really need to focus as much”, was my thinking then.

DallE, with some back and forth prompting for “methylphenidate and the time shifting of focus”. Notice this has both red and blue pills

This is not the first time I’ve stopped taking methylphenidate. I’d stopped once in 2013 (when I found that it was impeding my creative and lateral thinking), once in 2016 (forget the reason, but I hadn’t been taking it regularly anyways) and once again in 2023. In fact, 2020-23 is the longest contiguous period when I’ve taken methylphenidate on a regular basis. In fact, this was also the longest contiguous period when I’ve been in one job.

Mood crashes

In the last burst, I started taking methylphenidate in November 2020. This was a month after I’d been diagnosed (yet again!!) with fairly severe anxiety and depression. In addition to the antidepressants, my doctor felt like I should get back on methylphenidate as well to improve my focus and immediate interpersonal relationships.

It worked great for a year and a half, and I took it without thinking one bit. I’d occasionally skip it on weekends without any immediate adverse impact. Things started to change in mid-2022 when I suddenly got much more responsibility at work, which also suddenly made my job much more stressful.

I started noticing these mood crashes towards the end of the day (around 5:30 or 6 pm). I remember sitting through a few bad meetings post 6pm (that descended into shouting matches), and I was clearly not thinking well then. I mentioned this to my psychiatrist in my next meeting, and she decided to do something about it.

My experiments with Concerta

She read my evening mood crashes as a function of the effect of the drug suddenly wearing off, and she suggested that I switch to Concerta (a much slower acting form of methylphenidate; for the record, amphetamines such as Adderall are not licensed in India). It was an absolute disaster.

One thing I’d gotten used to with Inspiral was that soon after I took it, I would feel this sudden burst of concentration which I’d use to get started with work. After that it didn’t matter if it wore off - the start (unless there was some fight - the incidence of which shot up after my role change expansion in 2022) would carry me through.

The slower release of Concerta meant that this initial bump was absent, and I didn’t feel like I was on any drug at all. I don’t even think I finished my bottle of Concerta (I possibly let it expire and threw it away - I don’t even know what I did with it). Quickly I moved back to Inspiral.

Afternoon crashes

Sometime in early 2023 (I think) I started noticing these strange mood crashes around lunch time. I became especially prone to getting stressed out at this time, and fairly minor things would stress me out massively. My strategy at that point in time was to take one 10mg dose of Inspiral in the morning and then take another after lunch (which I would eat any time between noon and 2pm, subject to work and stuff).

If some minor stressor were to hit me around 1:30 or so, it would completely take me out for the day. It could be a work thing. It could be something simple someone told me. It could be a piece of news. I was extremely vulnerable at that point in time.

It was possibly during what has so far been my last consultation with my psychiatrist (in July / August 2023) that I told her about this. Now I forget what she told me, but she did concur with my hypothesis that this crash was happening because the effect of my morning Methylphenidate was wearing off. From what I remember, we continued to keep the dosage, but I would monitor if my mood crashes were indeed correlated with the effects of the drug were wearing off.

Being irregular

When I decided to get off Inspiral last September, I didn’t do it at one shot. I kept taking it irregularly - as a function of whether I had any work or similar thing to do. And that gave me a wonderful test bed to test my hypothesis - breaking out of my routine meant that I would monitor things more carefully.

Every single time I took Inspiral, I remember feeling down some 4-5 hours later (when its effects wore off). The correlation was uncanny. I remember the final occasion - I was going to speak on a TV panel, and my wife said I should take the drug so I don’t say something silly.

It was hardly a stressful afternoon - the networking was good and I got the soundbites I wanted in (excepts are here for your reference), but the crash came down rather heavily that evening. The hypothesis testing was done.

What might be happening

So here is my pure unbridled theory on what might be happening. Basically there is something that I can call as “law of conservation of focus”. Putting it simply, there is only so much you can involuntarily focus in a particular day. For people with ADHD, this limit is lower than that of neurotypicals (and note that I mentioned “involuntary” here - so you going off on rabbit holes you’re hyperfocussing on doesn’t count here).

What methylphenidate does (I can’t speak for other ADHD drugs) is to rearrange when you are able to focus - think of borrowing “involuntary focus” from later in the day, and using it up at a particular point in time. The thing with methylphenidate is that it easily enables such borrowing. So when the drug is acting you are able to display tremendous amounts of involuntary focus - but what you need to remember is that it comes at a cost - that later on, your ability to involuntarily focus becomes vastly diminished.

Methylphenidate doesn’t create focus out of thin air. It simply time-shifts it, or borrows it from one chunk of time and applies it to another.

The reason methylphenidate helps (this is my thinking as of today, 4th of October 2024) is that it bunches up the focus at a point of time when you can really put it to good use.

Think of a college kid on Ritalin - the drug is being used to focus in class and complete assignments, which results in improved academic performance. The focus is borrowed from what would be otherwise unproductive time.

As a parent, you really don’t have “otherwise unproductive time”. When you’re not working, you want to hang out with your family, and if you’re borrowing focus from there to give to work, it doesn’t work. In fact, my wife’s constant crib when I was on methylphenidate was that “it wasn’t helping”, since it had no impact on my relationship with her (which would mostly take place during times when I wasn’t on the drug, or it had worn off).

You don’t need to be on methylphenidate to see this “time borrowing of involuntary focus”. This afternoon, for example, I delayed lunch so that “I can finish off this bit of work”. When I finally sat down to eat, i was absolutely exhausted - the involuntary focus to finish off that bit of work meant I was gone. And this is where some bit of knowing yourself helps - I just took a longish lunch break (~2 hours), and things were fine once again!

There are days when I’m not able to focus on work, and wonder if I should take methylphenidate (my last batch is still there, and not expired yet). And then I remember the crash after my panel last September. And things can get worse - if you take the medicine and end up hyperfocussing on the wrong thing (it happens more often than you think), you have both paid with your later focus and not got anything done!

Your mileage might vary.