Medications and Your Job

Pills, originally uploaded to Flickr by GenBug.If a change in your medication affects your job performance, how do you handle it?  Reader K writes in with an interesting question, specifically about pregnancy and ADD medications:

I am interested in how women who have been on ADD meds for years have handled going off of the meds before and during pregnancy (and nursing for that matter), while keeping (and continuing doing great work) in their job. The docs all say I can do it, and I think I can, but figured others might be in the same dilemma and it may be worthy of a discussion!

I think this is a great question, as there are a slew of reasons that people go on or off medications, and there are also times when doctors need to experiment with the dosage, medicine, or even the cocktail of medicine that people can get. And all of that can affect your energy levels, your focus, and ultimately your job performance. (Pills, originally uploaded to Flickr by GenBug.)

Now the harder part: how does one handle it? I’ve read a lot of different articles on pregnancy (including lots of articles warning women which drugs you can’t take while pregnant) and I don’t think I’ve ever seen it talked about for women. Personally, I have limited experience here because I’ve never been on any medication long term, other than birth control pills (although sometimes it feels like going on or off of those have a dramatic effect, as well!). Here are my tips, but I’m curious to hear what the readers say here.

– Ask your doctor how long it will take you to adjust, either to the new drug, to the lack of the drug, or to the combination of drugs. If they can pinpoint it at all, you may want to try to time it so any effects will hit you on the weekend (or, if possible, on a vacation day). As this article suggests, for ADD meds in particular, you should probably time it right if you can, and avoid periods of high stress.

– Depending on what side effects you’re expecting, do your best to compensate at your job.  For example, if sluggishness is something you’re expecting, I would cut out all social activity while you’re going through the transition so you can get as much rest and sleep as necessary without it affecting your job.  If loss of focus is something you’re expecting (such as when you go off your ADD meds), make sure that you have “belt and suspender” systems — be extra sure you know your deadlines, minimize distractions, and have another time management system that you’re using. You may find this book to be helpful: ADD-Friendly Ways to Organize Your Life, which I found to be really helpful even though I don’t have ADD.

– Consider telling HR the situation, as this article in Psychology Today advises people regarding bipolar disorder.  You don’t need to get into why you’re going off drugs, but you may want to tell HR that you’re changing your medications and you want to work with them to make sure that the transition is a smooth one — and also that if they begin to hear about any problems they’ll know to immediately open a dialog with you.

Readers, have you had to transition on or off medications while working?  How have you handled it?


  1. Really interested in what people say about this.
    Like Kat, never taken anything beyond OCPs but those wreaked enough havoc in their day!

    • Yes, indeed.

      I’m thrown for a loop when I’ve got a bad cold and have taken over-the-counter cough meds, so I really take my hat off to those who have taken more powerful stuff and still tough their way through the workday.

      • I need to take SINUS medication some times, and the manageing partner always see me and askes me if I am SNORTEING!

        I did NOT know what he was talkeing about, so I asked him! He said it was a joke, but I did NOT find it funny once he explained it to me. FOOEY on him!

        I do NOT do druegs, so FOOEY on him for makeing me feel funny!

        • I honestly think it was a joke… it’s 2012, we’re all doing whip-its at work. Get with the times!

        • Oh, Ellen, don’t you know that sinus medications are more effective if you grind them up and SNORTE them? They go directly to your sinuses that way!

          I think the manageing partner was just trying to be HELPFUL.

  2. While not immediately attention-focus related, I found myself in this position at my job when I had to start taking pain meds. The first day I took them, I found out quickly and unexpectedly how “off” they could make me feel. Fortunately, the pain meds made my sometimes dreary and repetitive work “OMG So Exciting!!!” – and people noticed. I suspect that my enthusiam stemmed from the fact that I do really love my work, and when I’m not in pain at all, I would be enthusastic and energetic about it. Since people knew I was in pain, they shrugged off my unexpected vigor and I’ve since learned how much to take, and when.

    If I could do it again, I would remember to try them *before* I went to work, rather than at work for the first time. So that’s my suggestion.

    • I was on prolonged pain med treatment while working several times and I was going to comment to say several things:

      (1) With any drug, learning how they effect you and learning when best to take them is going to make it easier to adjust.
      (2) With pain meds in particular (if you’ve been on them a long time especially), talk to your doctor about the possibility for physical withdrawal symptoms. This was harder at work than the actual meds themselves, weaning off was key.
      (3) While I would generally say you should “tell your boss when you go on drugs” — I’m not entirely sure with pain meds since there is such a stigma.
      (4) I also agree on the … I’m so happy I’m not in pain anymore, in fact I’m kind of hyper, thing. Its hysterical if you actually know whats going on.

  3. I’m not too familiar with the specifics of ADD medication, but I do know that fish oils are really helpful with this and are also recommended for pregnancy.

  4. I remember a very enlightening discussion on ADD on this site, some months ago. Cant for the life of me remember when, though! Some of you may find that useful.

    I work with patients as the super smart will remember, and its so sad to see the problems that medication, ad more specifically, swapping them around, can do. D***ed if I do, d***ed if I don’t!
    One word of advice, that occurred to me is; don’t take it for granted that your medical team understands just how busy you are, or how crucial your performance during period X is. Tell them.
    Not so much, that thereafter your medical management is purely defensive, but unless you mention specifics, people will be working on assumptions; something that rarely goes well.

  5. goirishkj :

    No experience with ADD meds, but I’ve had to take multiple rounds of prednisone. And I’m not talking about a 7 day round of prednisone, but several months of tapering. For me, it causes mood swings, hunger, insomnia and weight gain. The last three side effects definitely make the first even worse. What I usually do is make sure to tell my assistant, as she’s the one who might notice my new short temper. I explain what’s going on and ask for patience. Then I usually ask for her to be extra careful about giving me a head’s up over a difficult partner coming my way and to generally be my ally until I’m back to my usual self. It helps to know what side effects I’ll experience and to know what sorts of help I need–hopefully the OP’s doctor can help go over side effects with her. Also, I’ve heard of friends waiting to switch medications until the weekend to have an idea of how the meds will affect them, so that might be an option.

    • Oh god prednisone. Gah.

    • So much prednisone sympathy. I took it for 9 months and I swear I think it left me an awful person. My doctor mentioned mood swings as something that happened to “so few people that you won’t need to worry about it” and that was bull. To the OP- make sure you get a realistic assessment of what side effects you could get. I’m always one of those people who suffers from the “fewer than 10% may see signs of” and then I end up with blue fingers, permanent scarring, or wishing death on people. Doctors often don’t want to worry you with things they doubt you’ll suffer from but reinforce just how much you need to know these potential changes.

    • Yeah, I have asthma that only becomes clinical when I have a cold. When it first started, the doctor would just throw prednisone at it, hoping for the best and it never worked. I would cough for 3 months (death rattle) after a cold. Like you, I was constantly hungry and could not sleep. I switched to an inhaled steroid that I’m on every day and it keeps the tissue built up on a normal basis. I haven’t had the horrible cough in more than six years and I hardly ever get sick. Thank goodness for maintenance drugs!

      • What inhaler are you taking? I’ve had asthmatic allergies since birth, but lately, the post-cold hacking has been getting ridiculous. I went and saw an allergist and got all my allergy meds updated, but I think I may need a stronger inhaler. Thanks!

        • My two maintenance drugs are a low dose of fexofenadine (Allegra – 60 mg) and 2 puffs daily of Pulmicort. It’s not a an albuterol rescue inhaler. It’s a powder that you inhale. When I’m sick, I use the same dosage but twice a day. It has made a huge difference!

        • Flovent changed my life. I used to use my rescue inhaler at least weekly and now it’s maybe once a month. Amazing.

    • I have a friend who has to take prednisone for a few months every year due to gastro issues (that weirdly seem to be seasonal.) I can tell when he’s taking it because he gets really puffy, especially in the face. I feel for you so much if you have to go through this regularly in our appearance-obsessed world. :(

  6. When I first started at my current company, I was undergoing a lot of anxiety in my life. My well meaning GP put me on Paxil. Needless to say, the few weeks I was on Paxil were some of the worst of my life (By week 3-4 I felt like I had the flu with a 104 fever). My doctor advised I stop the medication, which seemed logical, but BAM from flu symptoms to “discontinuation” symptoms.

    I was dizzy, could barely see straight and sick feeling for weeks. I honestly thought I would be fired from my job because I was not productive. I had just started at the company, I didn’t feel comfortable explaining the situation (I probably still wouldn’t – I might be continuing the stigmatization of people with mental health issues, but so be it. My body, my choices.)

    Some things that helped me….

    1) Talk to a pharmacist. Doctors are great, but pharmacists specialize in DRUGS. I luckily had one in my office building which whom I confided the situation to one bad day at the office. she recommended things I never would have thought of (Dramamine for my nausea/dizziness – and it actually REALLY HELPED, who knew this helped with non motion sickness situations. ) B vitamins, running/walking at lunch and dark chocolate were also good suggestions made by her.

    2) It’s probably not as noticeable as you may think. Although for me, lots of people asked if i was okay. A lot. I just said I wasn’t feeling well and they understood. You don’t have to share details. People lose focus when under the weather, it happens.

    3) Do your best to really take care of yourself. Eat nourishing meals. Sleep a lot. Take time off to deal with this if you have it. Go easy at work, if you can’t focus or feel sick, take work home and catch up then. Continue to exercise.

    4) Remember you can and will succeed and the withdrawal symptoms won’t last forever. Be positive.

    5) Have a plan for managing your ADD when not on the medications. With my anxiety, I had a “back-up plan” for how I would cope with it once the meds were out of my system and my initial problem was back. This could mean therapy, journaling, being super organized, asking for help, or whatever helps you focus best.

  7. For everyone who posted yesterday, I took my little boy to the vet and he is spitting mad at me now. They shaved a patch of fur off his back and had to slice into it pretty deep but it was an abscess. He’s now crying miserably in a cage in my room (to keep him from bleeding everywhere) being watched on a fairly regular basis and I’m back at work!

    The vet did say it could have been serious and it’s good I didn’t wait much longer. I’m trying to decide if I’m going to bring him with me this weekend. I feel like I should but I think my SO might kill me. And my little boy hates riding in the car so he wouldn’t be too happy either.

    • Glad to know he’s doing okay! But sorry he’s so angry :(

    • I was guessing it was an abscess – my kitty had two last summer (darn neighbor cat kept fighting with him – he’s an inside cat now). Make sure he can’t scratch at it, my cat scratched his stitches open twice and it made the healing process that much more miserable for both of us. Since your cat’s abscess is on his back, that may be less of a problem.

      I obviously don’t know much about your weekend/relationship situation, but if I were you I would stay home with your cat this weekend. He shouldn’t be left at home alone (he’s at a heightened risk for infection and could open up his wound again, so he should be watched carefully). Cats truly hate to be taken out of their territory even for short periods, so a weekend would be miserable for everyone involved even outside the car ride. Additionally, if you brought him with you and were watching him carefully, what would you do if something came up and you had to take him back to the vet quickly? I think being at home near the vet that first treated him is kind of what your cat needs.

    • Awwww, your poor cat. Glad he’s been seen to by the vet, but I feel for him- it’s no fun having your “look” messed with, and pain is no fun. I’d bring him with you. (Why would the SO be irritated? What would he prefer– that you leave the cat and be worried sick all weekend and unable to enjoy yourself?)

      • I would actually be taking the cat back to my house, where he was born and raise, and which my SO has vacuumed approximately 25 times since the cats moved out and is STILL finding cat hair.

        It doesn’t seem likely that he will need to go back to the vet, he has no stitches, etc…so I will talk to my SO and see if he would prefer to come here this weekend or me to bring the boy. He’s only recently moved into my house so he’s still kind of living out of boxes and the last two weekend have been kind of eaten up with my stuff, so this weekend was his. We also have a birthday party in my old town to go to.

        My SO will be fine, he actually called and left a voice mail while I was still at the vet to check up on the cat, it was cute “I’m just calling to see how you’re doing tell you I love you, I thought you might know about the cat…not that ‘m calling to check on the cat, I’m calling to check on you ABOUT the cat…does that make sense? Well, call me, let me know how you both are…”

        Some guys just think they have to be tough and can’t let on that they’re actually fond of the little creatures.

        • Then there is my husband, who refers to our two cats as “papa’s little ladies.”

          • I love your husband! That is super cute.

            I have to be honest, if there was one thing I wish I could change about my SO it is his attitude towards pets. Pets are outside animals, never to become inside. They are pets NOT family members. But he has been fabulous about my 4(!) inside cats, though he wants me to encourage them to go outside and they really do need to be out of the bedroom when he’s over. I sleep pretty heavily so they don’t bother me, but they keep him up all night.

            Also, his FIL (previous marriage, deceased wife) who lives with us has an indoor dog and his son (who also lives with us) has a dog that is really indoor/outdoor and he hasn’t been too grouchy about that yet…

          • La Suisse :

            Adorable! Mine calls our two cats “her ladyships!” animal lover and Downton Abbey fan- I’ve got a keeper.

        • Also, I’m glad to hear that your cat will be ok.

          • thanks for the update – glad to hear it’s all working out. does the vet also offer boarding services? maybe you can leave kitty there while you’re away.

  8. This is particularly poignant for me today. I am currently on Lamictal for bipolar disorder, and I just started Tramadol for pain relating to my fibromyalgia. I am pretty open at work about my mental and physical illnesses, in part because if something were to go wrong – an allergic reaction or other reaction to medication, inability to walk due to muscle spasms, whatever – and in part because I think the stigma for mental and even physical disability is stupid, and by being open about it and still being able to do my job well, I think it enforces that idea.

    The tramadol has some weird effects. I have hiccups, am a little tired, and get a dry mouth. It makes me a little spacey but that will fade after about a week on the medication, if past experience is still relevant. I do at least notify one of my managers of the medications I’m on, and if not a manager, another employee. When changing medications, it’s a good thing to have another person know because if you have any sort of dangerous side effect while at work, someone there can communicate it to emergency personnel.

    Good luck!

    • I am bipolar too! No one at work knows. Next week I am switching fro
      Lamictal to Topamax. I’ve read some pretty gnarly stuff about it and am nervous that I’ll turn into an idiot. I don’t have any court dates scheduled for about a month but don’t want my boss to find out. Am very nervous about it.

      • I would be careful with Topamax. It is the first medication I took for my bipolar, and I still have memory damage from it. Not all people suffer that side effect, but be aware.

        Notify your boss! Seriously, at the very least notify your HR person and your immediate supervisor. With bipolar alone, not even considering medication, it is risky to not have anyone at work know. With medication, it’s even more important – what if you were to have an allergic reaction or something, and no one knew what you were on? Side effects from anticonvulsants can be risky, so please, please let someone know. The easiest way to do it is

        “I have had x illness for x years, and I am changing my maintenance medication regimen. During this time, I may suffer some side effects, but I am working with my doctor to keep them under control and monitor them. I’ve reviewed my schedule to ensure that I have enough time to adjust to the new medication without risk of it affecting my work. Do you have any concerns?”

        That’s what I did with my fibromyalgia. My boss was great about it. Unless it severely impacts your work, they can’t take any sort of action against you employment-wise without risking a court case, and that way if you DO have any impact on your work, you can speak with your boss to help reassign work and consider taking time away.

        It’s just best to be safe! Ignore the stigma. If you act like it’s normal and accepted, they should, too. Just make sure you are confident when you talk to them about your ability to cope with the change.

        • I once took Topamax in a low dose for migraines with aura. That stuff is not to be messed with! I tried to tough it out but I only lasted two months.

          • I thought of trying it for migraines, but my doctor laughed that it could make me skinny and stupid. :-) While I’d love to be skinny and stupid theoretically, the stupid part just doesn’t fit into my schedule right now.

            So now I’m just dealing with it. Tried Inderal and it made my hair fall out.

        • yeah my SO has a prescription for Topamax but takes as low a dose as possible… it really messes with him. He gets cluster headaches so only needs to use it once in a while, but occasionally needs to readjust the dosing with his doctor. Those weeks are miserable.

        • Thank you for your concern and advice. My bipolar symptoms are being medically managed very well and have been for several years. A predecessor at my office had bipolar disorder and went off her meds and ended up being terminated. I don’t know how bad it got but it makes me very fearful to tell anyone because I don’t want them to think the same thing about me. Prior to my diagnosis and once since then when I went of my meds, I went really crazy and attempted suicide. I have been in therapy and dealt with it but I have a TON OF SHAME surrounding the condition and could never tell anyone that I work with. I don’t even tell my friends. I can’t believe I am telling anyone on the internet. Maybe I should take a couple of weeks leave – which I have – to see how I read to the Topamax.

      • Rose in Bloom :

        I have been on a very low dose of Topamax for about six months for migraines. The only side effects that I noticed were that food tasted funny for the first two or three weeks (particularly soft drinks), and even now I feel full after eating only a little bit of food, which has resulted in me inadvertently losing 5 or so pounds. I haven’t noticed any mental confusion-type effects.

        • I never ate and it was around the holidays, so I guess I was the only one losing weight? I was lucky in that my migraines aren’t frequent and switching to Axert as needed was a better solution. I felt like a a dope on that stuff. I do hope it works for those of you that need it – trying out meds is arduous.

      • Anonymous :

        I’d also recommend care with Topamax as well, I took a very low dose for migraines for less than a month. It caused me to feel fuzzy and have violent mood swings. My husband and kids generally thought I’d suffered a personality transplant since the doctor failed to tell me that mood swings were a possible side effects.

    • Just wanted to commend you on being open and honest about your illnesses, especially bipolar. I don’t have any mental illnesses, but I work in a field where we work with many people who do and you are completely right about the stigma. It is great to show that you can be a fully functional, “normal” (whatever that means) professional person while still being treated for a mental illness.

      • Thank you. It can be difficult (especially on days when the medicine is not easy to manage), but it’s better to be truthful, I think.

  9. watchthecityglow :

    Threadjack alert.

    I’m one of the many people looking for an entry-level job in DC. Currently interning on the Hill (since June 2011, I’ve been with a member office and a committee office); several news internships (in several TV markets); two years of being a communications assistant (not in DC); working on finishing up my MA in journalism.

    I know it is uber-competitive to get a job, and I feel a little bit behind everyone else since I am still learning the ropes. I’ve been using my contacts to get interviews/reach out to offices and have been consistently getting interviews.

    On paper, I know I’m qualified for more than general admin assistant work, but I *know* that is how you start out in D.C. Long story short, is it wrong of me not to want to commit to one or two years as a staff assistant?

    Recently, I was among the final two people for an entry-level position, but the HR person said since I can’t commit to 1-2 years, they want to look somewhere else. (I said I would commit to a year to a year and a half) But how am I to know what will happen a YEAR from now? I didn’t want to commit to their timeframe since I hope to get into a more communications type role eventually.

    Basically, am I doing this whole interviewing thing wrong? Should I have said I could stay for 18+ months, even if it wasn’t the whole truth?

    • Others might disagree, but I say, yes, you should say you’ll stay for 18+ months even if its not the whole truth.

      Getting started on the Hill requires a huge learning curve, the reason people start in administrative positions is because they need to learn the who, what, wheres, and hows of everything and you don’t learn that in a week. But seriously, its hard to find these jobs.

      • Unless you currently have a commitment in the future lined up- tell them you’ll commit to it. You don’t know for sure you can’t, and it doesn’t sound like they’re asking you to sign a contract

      • watchthecityglow :

        This was an off-Hill job, and I definitely see your point! I’ve been with my current office so long I don’t think of myself as an intern anymore, as I’m doing staff asst. level work (compiling and making briefing binders, writing legislative language, etc.) not the usual phone/copy work the “younger” interns (that I trained) do.

        And it doesn’t help that I am 25 years old and still interning. Ugh. I’m just a horrid liar, and it was only remotely connected to the field(s) I want to go into. Oh well.

        • AnonInfinity :

          Unless I’m misreading your OP, it doesn’t seem like it’s a lie, though. I feel like you’re saying that you can’t 100% say you’ll be there in 18-24 months because something you want more might come along. Like A says, you don’t know for sure that you will leave after 8 months. Positions that fit your interests might not open up or you might not get them within the 18-24 months. I suggest this as a way to reframe the way you’re viewing your interview answers so that you don’t feel like you’re lying (because you’re not!).

        • dancinglonghorn :

          The company would not hesitate to hire you, tell you that the job is for at least 2 years, and then let you go at the first sign of trouble. Do what’s best for you – not for some hypothetical employer. You are not even hired yet and you are bending over backwards to accommodate them!

          Also, read “Nice Girls Don’t Get The Corner Office.”

      • I don’t think anyone here would advocate being dishonest, but I tend to agree that perhaps if a similar situation arises, you shouldn’t write off a 2 yr commitment because a lot of life things could happen in that time that are out of your control (unless you have really firm plans on where you’ll be in 2 years). Maybe use the conversation to segue into things you’d like in return — be considered for more communications-type tasks, re-write the job description after you’ve been there a while (I’d be surprised if a majority of the people on Corporette actually do what their job description says) get a mid-year review, join a steering committee, start x initiative. Who knows, you could like the job, you could get promoted, they might downsize/cut back positions, merge/get bought out by another company, etc. Also, there’s some truth in the saying that “it’s easier to find a job when you have one.”

        • If it’s a Hill job and asks you for a 2 year commitment, I would try to honor that. I think most people would understand if you are in there for 18 months and get offered a dream position, but it would be a good opp to work up the ranks.

          If it’s a non-Hill job, unless they make you sign an contract, I would say something pro-actively that you are excited about the position because of the opportunities you’ll have to learn and advance with the organization. You don’t know how long you’ll be with any organization or what the work would be like. If someone point blank asks you, will you be here for 2 years, say I expect to and look forward to growing with the company while I’m in this position. Make it positive! Once you’re in a position, its easier to maneuver and get more substantive work.

    • watchthecityglow :

      All: thanks for the “rethinking” thoughts — I just couldn’t see myself there for that long, but I’m at the point where I just want. a. job. please. There wasn’t promotion potential, and it wouldn’t add much to my skill set besides the title. But I’ll keep y’all’s thoughts in mind in the future. All’s well that ends well, I guess.

    • anonymous :

      I would also add that you shouldn’t expect that to be the norm everywhere. In our Hill office, we definitely view staff assistant jobs as “paying dues,” realize how boring and taxing (and low-paying) they can be, and try to promote our staff assistants into better positions as soon as possible. Don’t get discouraged and definitely do keep applying for staff assistant positions — you never know which one could turn into an opportunity for LC (or equivalent position in your area of interest, if that’s press) in just a few months. The key is getting the chance to prove yourself as a full-time, paid staff member.

      If your ultimate goal is to do press on the Hill, you could also consider leaving DC (if this is a logistical possibility for you) and doing press on a 2012 campaign. There’s no guarantee that you will get to return to the Hill, but campaign experience is definitely valued and if you go to a competitive race you will make great contacts.

  10. HR rep's kid :

    The HR discussion shouldn’t be overlooked…especially for something like ADD. My understanding is that such conditions are covered by the Americans with Disabilities Act (so reasonably accommodations may be required).

  11. Stink Eye :

    Threadjack, but on the topic of dealing with others’ perception:

    I no longer wear eye makeup. After a nasty, horrible eye infection where permanent scarring/blindness was at issue, I just decided enough was enough. This includes no eye shadow, no mascara, no liner. Pretty much nothing around my eyes. I also wear a more neutral lip color now.

    Issue: How many times are people at work going to ask me if I’m sick, or tell me I look tired and need more rest? And when did people decide it was socially acceptable to tell someone to get more sleep 10 days in a row? I’ve been going sans eye makeup (I do wear mineral foundation and light concealer, like always) for just over a month now, and not. one. day. has gone by without a comment about how tired my eyes look.

    I’m getting lots of sleep, no dark circles, and I feel great. Nobody in my friend circle or on weekends makes these comments – only at work. How can I politely reply to these people that I just look ‘different’ because I no longer wear eye makeup? Especially the ones who ask every. single. day. – and make it clear that I look much worse. It’s pretty much everyone on my floor – not just one or two people, so it’s not just that someone is trying to be mean.

    • Can you just say, “I’m fine on sleep, but I’m not wearing make up due to some eye problems so perhaps you see that difference?”

      I can sympathize. I had a corneal ulcer in 2006. I didn’t wear contacts/eye make up for 2 years (even though the Doctor cleared me after a few weeks). I just didn’t want to risk anything. Because I was wearing glasses, it probably was less noticeable I wasn’t wearing make up, but I got lots of comments on the glasses.

    • Salit-a-gator :

      That’s so annoying. I’ve gotten that before when I haven’t worn “enough” makeup. Why don’t you just tell them what you’ve told us? That you had an eye infection and have given up wearing eye make-up; that you’re plenty rested, just sans eye make-up. They’re making it a big deal, and its making you uncomfortable. Tell them the issue and they’ll stop bothering you with unsolicited comments.

    • Honestly, I am not sure why this is happening to you. In my office, lots of people just don’t wear makeup and no one says a word about it.

      I would – for the sake of preserving my own happy sense of place – try to take it in the best way possible, these people are probably a) trying to be nice or b) just trying to have something to say without giving it too much thought. It’s misguided and thoughtless, and frustrating, I’m sure, but there you go. If you want to stop them, you could always firmly and politely say something like, “I’m actually getting plenty of Sleep, Bob/Carol, I’m just not wearing any eye make up.” Smile and move on. I bet that person will never say that to you again.

      Or try wearing blush. I find that if my cheeks are rosy, it doesn’t matter what the rest of my face looks like, I just look well rested.

      • Second the blush. It makes a world of difference. I also get comments when I’m not wearing makeup, that I look unwell or something. It sucks. Blush helps.

      • Anon from 3:36 comment :

        second blush and I’ll also add the suggestion of penciling your eyebrows to darken them if needed. I have really blonde eyebrows/eyelashes, so it can be really apparent when I don’t have make up because I look really washed out. without the eye make up, at least a bit of dark brown/black shadow (applied with an angle brush) can really make my face pop. you can also pay to have them professionally darkened.

        Obviously, since I can’t see you I don’t want to make assumptions about your skin tone/facial hair color and need for this. But if the lack of eye make up is that noticeable, then I was thinking perhaps you also have pale/thin brows…

        • Anon from 3:36 comment :

          * i meant the brown/black shadow is applied to your brows, not eyes.

    • Jacqueline :

      For what it’s worth, I can sympathize. I naturally have deep bags under my eyes — they’re there even after 10 hours of sleep. And unless I’m wearing plenty of eye makeup to counteract them, they’re fairly obvious. I once had a cashier at Target ask me if I was overtired (I wasn’t wearing makeup). I said (in a nice but firm way), “No, I’m just not wearing any makeup. I get plenty of sleep. You really shouldn’t say that kind of thing to people; it just makes them feel bad.” She seemed mortified, and I almost felt bad, but seriously, I would NEVER say that kind of thing to a person, no matter how exhausted they looked! It just doesn’t lead to anything good. Either the person is going to think, “Yeah, I know I look awful; I haven’t slept for three nights,” or they’re going to think, “Actually, I’m sleeping perfectly well, so I guess I just look awful regardless.”

      Anyway, I would just say (nicely), “I’m getting plenty of sleep — I’m just not wearing makeup. You’re just not used to it yet,” or something like that. I would think that would make the person feel sheepish, but if they say it to you again the next day, be firmer.

      • I think I may have shared this story before, but I, too, have very dark under eye circles that are a gift of heredity. For years and years my MIL would exclaim that I “looked so tired.” Finally, to shut her up, I told it it was because her son was keeping me up all night! ;)

    • Well, can I be the first to say — did everyone at your office grow up in a barn? Seriously, maybe a day or two it would be acceptable. But after that, when someone said “Oh I’m fine” you let it go! Geesh.

      And while I agree with everyone about being polite, I think if people continue after you’ve been polite about it, I think you should start being a little curt. Because frankly thats a bit much!

      • AnonInfinity :

        Yes. If they’re being rude, you don’t have to be polite back! I’m not saying you should go off on them, but when people ask really intrusive and rude questions, I think it’s perfectly fine to make them feel slightly uncomfortable so they’ll learn not to ask rude questions.

      • Disagree with all the alternate makeup suggestions. The reason ppl are “concerned” when you don’t have eye makeup on is bc they don’t know how you really look. If you start with some other makeup daily, then if you develop an allergy to it you’ll just have to go through the same thing again. Drop it altogether and let them get to know the real, healthy you!

      • I Love TCFKAG! :

        My mom used to say “Was s/he raised in a barn?” about people with no manners, too! I’ve never heard anyone else use it.

    • Honestly, I would say “I’m perfectly fine and well rested. Why do you ask?” Make them squirm. If someone says oh you look a bit different, say you could add a “thanks for your concern” with a cooler tone.

    • Once when I was actually really tired and did in fact look like sh*t, my boss leaned into my face like he was inspecting it and said in front of several people, “Is everything alright? You look tired or something.” I shrugged and just responded: “That’s just the way my face looks.” No one has ever told me I looked tired since then.

  12. I took Ritalin in HS and then Focalin in college and during the first half of my MBA. When I went off it I was going to school FT and business school FT @ night. I felt in control of my ADHD at the time that I decided I wanted to get off the meds. I had little appetite and felt like I was developing anger and emotional problems due to the side effects. I felt like I was a zombie for 10 years and went off without the help of a Doctor (not advised).

    The medication really teaches you what works for you (work/sleep/study habits). In the long-term I did well. At first there were periods of anxiety and frustration. I felt like I knew I needed to do X and I knew how to get it accomplished, but I couldn’t put the two together. It was so frustrating b/c the focalin turned me into a Type A perfectionist. Before medical treatment I was the exact opposite. I am now happy in between the two extremes.

    I did find that green tea helped me get through this period. Most likely it was in my head, but who knows!

    • typo …”I was working FT and going to business school FT @ night”….

  13. I’m an employment lawyer. I usually tell clients to inform HR if you are in a situation like this, because you may not be protected under the ADA if you do not let your employer know you have a disability. Notification triggers the employer’s obligation to start the “interactive process” to find a reasonable accommodation. Hiding your disability, while certainly understandable, can lead to bigger problems down the road, especially if your ability to interact with your co-workers or your productivity are impacted long-term. This isn’t legal advice, of course, but merely encouragement to weigh your circumstances and do some CYA research.

  14. anon today :

    This is a really pertinent topic to me. For years I have struggled with extreme sleepiness. Not, “oh, I didn’t get enough sleep last night” sleepiness, but fall asleep at the wheel every day and nearly crash sleepiness. After I was done procreating and nursing and the kids were sleepign through the night, I couldn’t blame it on anything like that.

    As it got worse and worse, I know my performance slipped. I was so sluggish that I got easily distracted and had a really hard time getting things done. Since I’ve always been a “super-achiever” I don’t think this was immediately apparent, because me at 70% was still pretty good. But horrible for my morale.

    When I began pursuing diagnosis and treatment, I had to take a lot of time off of work for appointments, 36 hour sleep tests, etc. That’s the point at which I told someone at work. I have a friend in HR that I told, and asked her if she thought there was any merit in reporting up the chain. Ultimately I told my boss I had a medical condition that was being tested and treated and that I hoped to be back at 100% in a specified timeframe. No issues from her.

    It felt good to know that at least one person in the office knew I was going through something, but that not everyone was chatting about it behind my back.

  15. I just started taking ADHD medications (for something other than ADHD), and I’ve been working with my doctor on getting the dosage right. I haven’t told HR about the medicine specifically, although I have told them about the underlying medical issue. I thought about mentioning the medication, but to what end? I’m not sure I would want my supervisor to know, and I’m not requesting an accommodation based on the medication.

  16. Like the OP, a colleague of mine had been on ADD medications for years, and decided to go off them so that she could have a child. At the time, I was the only peer she was working with and she told me, but no one else. Overall, it did not go well. Her work quality suffered. She made lots of errors, had difficulty organizing her thoughts, etc. By the time she took her mat leave, she was miserable, and had some legitimate concerns about whether she would be welcomed back to the office.

    That said, I was grateful that she told me what was going on. I had to spend a lot of time editing her work, and I think I would have been resentful had I not known what was going on. In hindsight, I suspect that she should have told the people she was working for, and not just me. YMMV, of course.

  17. One of the things I struggle with is allergies. Good God, my allergies are terrible and they’ve gotten worse as time goes by. I’ve spent hundreds of dollars per year treating symptoms and managing the sinus congestion and headaches that are also triggered by allergies. When I get these headaches, I literally *cannot* think and spend the whole day surfing the net. It took me a while to realize that hey, this isn’t ADD, I can’t think straight because my head and body are miserable and got myself an allergy test. I’m taking allergy shots now and it’s better. A little.

    I do still try to push through my allergy/sinus/headache/migraine fog but it really does affect my work sometimes. A few people in the office know about my allergies but I haven’t really brought it up to supervisors as “an issue” in my performance. I don’t know if I should but I am working with my doctor on it. And until then, people, please stop it with the perfume at work. Please. I actually get up and move around on trains because I can’t deal with the migraine you give me.

    • I swear, you could be me. I dread whenever the weather changes since I know it may trigger a sinus headache. And don’t get me started on coworkers with perfume. Or on airplanes. Or in movie theaters. I’ve gone home some days from work at the point of not seeing straight. I never had any problems with allergies when I was younger and used to think people who complained about perfume or smoke often were high maintenance types or something. Whole different world once you’ve been there.

    • lucy stone :

      I have terrible allergies and one of my biggest triggers is smoke. A coworker smokes and whenever she comes back from a smoke break, I sneeze for an hour. Normally you’d talk to HR, right? Said coworker IS HR. Sigh.

  18. Severe ADD :

    I would recommend the program “ADD and loving it” which was a program put on by some comedians who have ADD on PBS. I believe you could order it or maybe even get it for free online. In the show, I learned that the medications are not something you will always NEED if you do not WANT to take them. Instead, they help to rearrange your brain chemicals to make it more like normal brains. While taking the medications, the person can help to understand what they need to do to manage their condition. Then, once off of the medication, they can continue the same things that help them. Examples were to do lists, always putting certain things in one place, checking e-mail only at one time, always making notes so that you will know what to do when you get back to that project, etc. This program helped me AND really helped my SO understand what I was going through at the time.

    My personal experience with taking the medication was that even if I took it, I still was not productive if I did not want to be. Or at least I was productive but at online shopping. I did not like the side effects. In fact, I felt paranoid that people hated me a lot while on the meds (for no reason). I never took anything until I was almost 27 years old though because I really did not even understand that I had severe ADD until I could not finish my reading in law school.

    Sometimes repeating a manta (a suggestion given to a reader who hates the last semester of law school) like “I have to do good work today, or my bills I cannot pay” works. It sounds silly but when I catch myself distracted it works. (I will say this to myself in just one minute! Right now I am busy posting this!)

    Finally, anything that gets oxygen to the brain, helps your ADD. So exercise, deep breathing, yoga, meditation, and of course those airplane oxygen masks that drop down in cases of emergency can all help. So if you print something, get up and go get it off the printer or if you need to bring something to someone, get up and do it right then. This helps me when I am having a bad organization day, even if it is not the most efficient way to work on things. I work at a couple places in my office too, I have one side of the desk where I can read things away from the computer and one side by the phone and computer. I also sit on the floor sometimes when I am going over a file (if my outfit permits anyway). Good luck to OP!

  19. I’m an AD(H)Der who’s never done the meds. When I recently read “Add Moms” (or something like that), I found the author recommends a lot of things I already do: figure out your priorities and don’t get caught up trying to do everything, use timers & alarms (my phone has: wake, absolutely must be out of bed, take my son to school, work out, leave to pick him up, half hour notice for extra-curriculara, get ready for bed, lights out. I also set timers throughout the work day), set up routines like a place for your keys and do not vary from them. That book was published in 2000. There are plenty of other more recent books and articles about building on the positives of ADD that might be helpful in this time without meds.

    • A couple other ideas:

      Write out what you want to say before you say it, if your ADD leads you to blurt things out.

      Get super-detailed in organizing your writing. For some people, outlining down to the paragraph works. For me, it helps to put a sticky note on top of my computer screen that told me what exactly I am supposed to be writing about. Every couple of days, I printed it all out, got out the scissors & did a literal cut & paste to make sure the logic was correct. My dissertation committee praised the very solid logical analysis in my diss.

      In anything more formal than a blog (ha! Just gave myself an out), set your writing aside for a while to see if any more ideas come to you before you hit “send”.

      In general, be aware of what your main issues/symptoms are and set up steps that require you to be extra methodical about those things. And don’t hate yourself for who you are!

      I also totally agree with the strategy someone me tioned above of telling your PA or close work buddy what’s going on and drafting their support in helping deal with the most common problems.

  20. I’m actually really glad someone posted this. I take Adderall, and last year there was a period where EVERY pharmacy was out of it… some problem with the manufacturer. My doc prescribed me Ritalin, but I felt like it didn’t work as well. Here’s how I coped:
    1) I kept my desk bare. Unless it was a project I was working on at that moment, any papers were filed away or placed on a shelf. Papers = clutter = distraction.
    2) I would tell myself that, OK, I’m going to work on this project for one hour, and then take a ten minute break. I felt like breaking up my day into smaller manageable pieces helped.
    3) I disconnected my outlook so I wasn’t checking email every ten seconds.
    4) I read somewhere that people concentrate better if their hands are busy. I kept a stress ball on my desk and if I felt myself zoning out, would just turn it over in my hands instead.

    That said, I was only Adderall-less for a few weeks and am terrified of what may happen if I ever get pregnant!

  21. This topic triggered something that I hadn’t considered about a co-worker of mine. I’m not her supervisor, but I direct her work because we’re on the same team and I have a higher job position. She’s pretty scatterbrained and lacks common sense, but with structure and supervision, she gets her work done. However, recently, two major things have happened: (a) she’s TTC, and (b) she seems to be unable to do her work. She makes mistakes all the time, gets distracted, and blames other people for mistakes she’s making. I wonder if she’s off some medication because she’s TTC. If it’s true, she should definitely talk to HR because right now, no one knows if there’s a valid reason for the change. If she doesn’t tell someone what’s going on, then we have to operate under the assumption that she just can’t do her job, and that won’t be good for her.

  22. I have not read the comments so I apologize if this duplicates any of the above. But I missed out on the last comment someone posted last week re: going of ADD meds while pregnant. And it’s late, and I’ll have no time tomorrow, but I feel an obligation to comment because I’ve done just this in recent months.

    Here’s what has worked for me: Know what sort of things the ADD meds have helped with and find ways to compensate. And know beforehand that your first trimester will make it that much harder to feel rested and focused. Some suggestions on coping techniques: lots of sleep, make lists, set short-term goals and long-term goals, enlist help on the homefront, target your less organized spaces (desk, purse, closet, etc.) and make them work for you so it’s one less thing to get distracted by. I know lots of people recommend exercise, but it was the last thing I felt like doing my first trimester, even though I was a regular exerciser before. Also, I would recommend going off the meds gradually.

    In some ways this has been easier than I would have expected. But my issues seem to manifest more at home than work. The one thing I wish I would have done is got the tasks I put off at home done before going off the meds because now it’s that much harder without the meds and with being pregnant.

    Also, I would recommend getting a blood draw to see if you are low on vitamins that add to fatigue. For instance, I am low on vitamin b12 and d and so I take supplements, which I think help.

    One last bit of advice: Be kind to yourself. You take medication for a reason, and you’re going off it for a reason. You may be extra tired and unmotivated for awhile, but you will find a way to make it work. Just because one thing works for someone else doesn’t mean it will work for you. Try to pay attention to what you need.

    I hope this helps! I will ponder it more tomorrow and if I think of any other tips, I’ll add them tomorrow night.

    • I didn’t read most of the other comments either but I think we both said exactly the same things. Good post!

  23. Anon for this :

    Regular poster here, anon for this…yeah, the stigma…I’d love to hear from others who are on anti-depressants and have gone off them during pregnancy. We are TTC and I plan to go off the meds as soon as I know I am pregnant for at least the first trimester, but I am worried that my work will suffer (not to mention my relationship)…any experiences? tips?

    • I don’t know what kind you’re on, but most of them have some kind of withdrawal syndrome. Your first trimester will be hard enough on your body; please don’t put it through withdrawal, too. Get off the meds and then TTC. You can also talk to your psychiatrist about transitioning to medication that isn’t so very bad for Baby, meds you can keep taking straight through pregnancy. If you’re only on one or two different drugs, Baby should be okay.

      …I say this, naturally, as someone who is on five. But my brain chemistry predisposes me to all kinds of fun if I get pregnant and stay that way, so I won’t be TTC, oh, ever. I think my never-born child is thanking me from some other universe. :)

  24. This thread is very interesting to me. I recently changed my antidepressent and birth control at the same time and I was an absolute mess for about a week, then it took about a month for me to adjust. (I was also studying for the bar exam and working so it wasn’t ideal, but there was a medical reason for the switch) I told a couple co-workers who I’m friends with outside of work, but I didn’t mention anything to my boss. The thing is, if my boss was a woman, I think I would have felt like I could say something. Does anyone think that should matter? Or should I have just mentioned that I was going through something?

  25. Anon for This :

    I used to be on Adderall, which worked very well for me. I stopped taking it last year because my state requires a specific screening test every 6 months to make sure I am taking it rather than selling it on the street. My health insurance does not cover the test, so it was out of pocket each time. I decided I had better things to spend my money on. While I really miss how well the drug worked for me, I have found a way to live without it. Everything that needs to be done gets put on a to-do list. I changed the settings on my work computer so there were no pop-up notifications that there was e-mail waiting for me in my inbox. I have a set eating and water schedule (i.e. drink my coffee 8-9, 1 glass of water before lunch and 1 glass of water after lunch, snack at 10-10:30, lunch at noon, snack at 3:00-3:30). My desk needs to be organized with my to-do projects. I only do one project at a time. If I start a new project, the other project gets picked up and back on the to-do list (I liked to work in layers on my desk). I set what time I can surf on the internet, usually while I eat my snack. Lots of sleep.
    Be ready for a weight gain because for me Adderall supressed my appetite (seriously I was a working machine and didn’t eat-why did I give it up?).
    I have also started cleaning up my diet, which has helped me have more energy and lose weight. I am on the HCG Diet right now. I think artificial sweeteners were sapping my life. Don’t get me wrong, those foods taste so good, but seeing the scale go down and actually having energy after I leave work is so nice.
    It isn’t easy. I find myself sitting at my desk staring out my window because I can’t focus. I have to force myself to think about all the great shopping that can be done because I am not paying for meds and drug screenings.

  26. be very careful with topamax…i was on it for about 2 years for migraines and i couldnt taste my food for the first few months. also had such bad tingling in my hands, feet and face, that at times it even went numb. took about 6-8 months for that to go away. just recently transitioned off of it and definitely had some withdrawal side effects.

  27. It wasn’t for pregnancy but I actually ran out of my adderall prescription while working at my first job out of college. I couldn’t get it right away and spent a whole weekend without it, during which I felt incredibly sluggish and restless. On Monday I finally had to face work without medication. I think the hardest part was retraining my body to wake itself up every day without a stimulant. The first week was pretty awful but after that I figured “Hey, I can’t take this stuff forever, let’s see how I do without it.” After all, I had already made it through the worst part, which is the initial withdrawal.

    Granted, my ADD isn’t an extreme case, but I eventually just learned to cope. I was able to stay focused at work by listening to NPR(background noise seems to help), and challenging myself each day to see how much work I could get done, constantly trying to break my own records. It seemed like initially my productivity slowed way down and it was hard to stay focused and awake, but after a while things pile up enough that you have to find a way to get things done, even without your medication! It goes the same at home too- it’s hard to motivate yourself to pay the bills that come in and pick up after yourself, but eventually it just gets to the point where you HAVE to do it.

    I went off adderall over a year ago and now I am proud to be “clean” and also productive at work and at home. And honestly I’m really glad I did- I feel more like myself than ever!

    • I want to add that I didn’t initially mention it to my boss, but I would have if anyone had commented on my productivity. I mentioned it to a few people who noticed my behavior was a little different- like I was laughing more and being a little silly. I just told them my prescription ran out and I was seeing how I could do without it.

      One other thing- let yourself indulge in those breaks when you need to have them. Even if you have Corporette up in the background the entire day and check it constantly but only for a minute each time, your mind will be happier. Just set a goal for yourself as far as work goes and if you spend too much time being distracted in the beginning of the day, you need to put on a dance music playlist and just crack down after lunch. Eventually you won’t need so many breaks or you’ll get so busy and backed up that you honestly won’t have time to take them. But to start with, give your body (and your brain) what it wants!

  28. You could, I suppose, call it “working” in that I was busting my chops to survive my junior year of high school and a part-time job, but I wasn’t in a corporate environment, so take this as you will–I spent the first three months on Lexapro and Ativan in and out of the nurse’s office. This was spring, so I had exams to prepare for and concerts to perform. I know I was less efficient at work; it’s hard schlepping books around a library when you’re fighting nausea, and I took a lot more sick days than before. More often than not, if the head librarian wasn’t there, I simply had to request desk work (I was responsible for processing books as well as shelving them) and leave the physical stuff to the other pages. Said head librarian was not best pleased; it didn’t help that her family was going through difficulties, and she herself may have been menopausal, so she was taking it out on everyone. Still, I know I wasn’t the old standby I had been, and I’m a little disappointed that I didn’t talk that out with her. I should have made more of an effort.

  29. I’m a junior associate in a large law firm. Several months ago, I started a new cholesterol medication that had the potential to cause memory lapses, and since my job depends heavily on my ability to remember things, I figured I’d best head this one off at the pass if possible. I told my assistant and one trusted partner with whom I work very closely, and I asked them to let me know if they noticed me being unusually scatterbrained. Ultimately everything was fine, but it was good to know that two people I trusted were looking out for me.

  30. Very neat blog post.Thanks Again. Great.

  31. :

    Hey this is somewhat of off topic but I was wondering if blogs use WYSIWYG editors or if you have to manually code with HTML.
    I’m starting a blog soon but have no coding know-how so I wanted to get advice from someone with experience. Any help would be greatly appreciated!

  32. I have ADD and currently take adderal, not sure how I’d get through a normal day let alone a work day without it. I recently sought out behavioral therapy bc I don’t want to be on meds my whole life. Not always but often after the therapy, people don’t need the meds. That’s always an option.

  33. Angiolytic :

    Late comment, but I’ll share anyway. Great advice all around – the only thing I would suggest is NOT to cut out all social activity while you adjust. Your social activities are likely your time with your personal support network – you may especially need time with friends and family during a pharmacological transition. Instead, 1) limit your activity so you aren’t overbooked and overtired; and 2) prioritize it so that you are only socializing in ways/with people who build your energy instead of draining it.

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