Pills don't give skills
I didn’t get diagnosed so I could take medication. I was hesitant. I didn’t want to change who I was or lose the spark that made me, me. I wasn’t sure what medication would do, or even what I wanted from it. I just knew I didn’t want to feel like a different person.
There is a lot of misinformation about ADHD medication, especially for adults. Some say it is dangerous, that it is only meant for children, or that by the time you reach midlife it is too late. That simply isn’t true. Research consistently shows that stimulant medication is both effective and safe for adults, including older adults, when prescribed and monitored appropriately (Cortese et al., 2018). Even in later life, studies show continued benefits. The risks of not treating ADHD, including chronic stress, burnout, accidents, poor sleep, and emotional exhaustion, are often far greater than the controlled, carefully monitored use of medication.
That was enough for me to give it a chance. My psychiatrist explained that methylphenidate works for about eighty percent of people and is usually well tolerated. He talked me through the differences between stimulant and non-stimulant medication, how they worked, and that they weren’t addictive. He told me the short-release form would last about three hours, like a cup of coffee. “If it doesn’t feel right, stop taking it. You’ll know.”
I took my first pill on a Saturday morning so I could see how it went over the weekend. I was nervous, like I was about to sit an exam. I half expected to transform into a taskmaster, ploughing through all the things I had spent my life avoiding. The reality was... not that.
Nothing happened, at least not in the way I had hoped. I didn’t suddenly spring into action or become laser-focused. My personality didn’t change. I was still me, still curious, still fun loving. That was a relief. But something else happened that was harder to describe. My mind went quiet. The jumble of thoughts, the competing voices, the endless self-criticism all stopped. It was like walking into a soundproof room after living in traffic noise your whole life. At first, it was spooky. Then it was peaceful.
If this was all the medication did, quiet the constant anxiety and internal noise, it was worth it.
Leanne Maskell, who has been training me in ADHD coaching through her company ADHD Works, says that “pills don’t give skills,” and she’s right. The meds didn’t hand me new executive functions. They just gave me enough space to start building on what I have. The first thing I had to learn was to take them consistently, which, ironically, is one of the hardest habits to build. You might think stimulants would be addictive, but remembering to take them is still one of my daily struggles.
After a few weeks I noticed something small but profound. I was remembering to check my calendar more often. That was new. I started to remember to look ahead, to plan, to create structure. I looked at my next week’s meetings in advance, declining ones I couldn’t attend and rescheduling my time. For the first time in my life I had the ability to form routines. It wasn’t perfect, but it was something. It was the start.
The psychiatrist had warned me that medication would likely give me more capacity, but not more energy. “The brain is a machine,” he told me. “It takes fuel to run. You’ll be able to focus for longer, but you don’t suddenly have more fuel in the tank. Pace yourself.” He also told me not to spend all that new capacity on work. “You’ll probably feel like you can do it all now,” he said. “Use some of that focus for other parts of your life, friendships, finances, hobbies, rest.”
I nodded. I understood. But I didn’t listen.
When the quiet settled in and my focus sharpened, I felt unstoppable. I wanted to see what I was really capable of. Around the same time my boss left the firm, and I found myself navigating a reorganisation, feeling responsible for my team and the mission we had built together. So I did what I had always done. I pushed harder. The difference this time was that the meds made it possible. I could now work longer, think more clearly, and hold it all together, at least for a while.
The battery, though, was draining quietly underneath it all. My drive, my need to prove myself, and my lifelong people pleasing turned into a dangerous cocktail. I wasn’t just running hot. I was redlining. For ten months I worked 120-hour weeks, convinced I was doing what needed to be done, until my body disagreed. It shut down completely.
Medication didn’t cause that burnout. My usual habits did. The meds just let me push harder for longer. It took burning out to realise that working longer hours isn’t the solution, and that productivity isn’t proof of worth.
Looking back, the medication didn’t fix me. It gave me the opportunity to start fixing my environment, to learn skills, build routines, and finally see the patterns that had always run me into the ground. It was the reset button I needed. It cleared the noise and left me staring at what was underneath, the beliefs, habits, and expectations that had been quietly draining me for decades. The meds didn’t give me a new brain. They gave me access to the one I already had. I just needed to figure out how to use it, to focus on what mattered, and how to balance work and non-work life. I needed to find lasting equilibrium, and a sustainable life.
If I were coaching someone about to start ADHD medication, I would invite them to reflect on a few questions. What are you hoping the medication will change, and what do you want to stay the same? Where in your life might new capacity turn into overextension if you are not careful? How will you know when you are using this new energy well, and when you are running into the red?
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Medication can unlock potential, but only if we learn how to handle what it unlocks. For me, it began with silence. What came next was learning how to live inside that quiet, without letting it consume me.
Does this resonate with you?
Everything in this article is written from personal experience. I am not a trained medical professional. Please consult with your doctor before considering action.
Cortese, S. et al. (2018). Comparative efficacy and tolerability of medications for ADHD: a systematic review and network meta-analysis. The Lancet Psychiatry, 5(9), 727–738. https://doi.org/10.1016/S2215-0366(18)30269-4
Lee, D. Y., et al. (2024). Combined methylphenidate and SSRIs in adults with ADHD: Safety outcomes in a nationwide cohort. JAMA Network Open.https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824665
