From Sonic speed to a brain trapped in an overload loop

Finding the perfect shower temperature is an art – somewhere between an unexpected plunge into icy hell and scalding oneself into Vecna’s long-lost twin.

Now, take that shower knob and make it control your brain settings. Except instead of instant feedback, you're playing the longest game of hot and cold ever – where each adjustment takes days, if not weeks, to tell you whether you're getting warmer or if you've just turned your mental thermostat into chaos mode.

Welcome to the world of ADHD medication titration, the process of slowly adjusting your medication dose until you find the right amount that works best for you. Each change needs time to show its full effects, which is why the process can take months.

The NeverEnding Story

I'm now in the midst of month four of titration, closing in on another change. It's been weird dialling up my brain and not knowing what to expect. Like taking control of a large boat for the first time and realising unlike a car, it takes time and thought to be able to turn the thing around.

Starting on 30mg, I mostly got the negative side effects from my medication debut, hello Hunter S. Thompson. But somewhere between 30mg and 40mg I started to see the positivity really hit home.

Sonic speed: the 50mg power up

Bumping up to 50mg seemed like the logical next step. The first few days felt like I'd become my own in-game upgrade, getting Sonic the Hedgehog's Power Sneakers that made my brain feel more productive than ever. But as the days moved on it also became weirder.

I might have been able to speed through the Green Hill Zone, but I wasn't in control anymore. I was so focused on finishing the level I was missing things and also felt trapped in a cage of my own making, my body a restless whirlwind, spinning faster and faster while the world outside blurred into nothing.

I found that 50mg had me in hyper focus without an off switch. Titration is a balancing act, made even trickier by the unpredictability of life. When everything is shifting at once, it’s hard to tell whether a new dose is working or if you’re just reacting to the chaos around you.

In January, those two forces collided – 50mg hitting like a Shinkansen, just as work hit a period of insane busyness.

Was it work pushing me too far, or had I locked myself inside a drug-induced Sonic’s Rotating Maze Bonus Stage – spinning endlessly, bouncing off walls, trapped in a disorienting loop with no way out?

Dopamine and Norepinephrine

Medication like Elvanse increases the levels of dopamine and norepinephrine in the brain, two neurotransmitters that help regulate attention, motivation, and impulse control. Dopamine plays a key role in reward and motivation, making tasks feel more engaging, while norepinephrine enhances focus and alertness. By boosting these chemicals, Elvanse helps sustain attention, manage impulsivity, and feel more mentally organised.

As work levelled out, I decided it was worth taking 50mg for a second month to see whether it was the right dose for me. But 10 days into month two of 50mg, I'm pretty certain that the focus dial is way too high.

The higher dose began with an initial rush of energy but quickly became tunnel vision overdrive, like my brain had been locked into one mode and refused to switch gears. The usual flexibility I had from taking medication – the ability to step back, shift tasks, or take a break seemed a distant memory.

Even writing for this site has been affected. I’ve written less, not because I’m distracted, but because I’m too focused. Case in point #1: I went so deep into the history of ADHD that I found myself reading extracts from The Homoeopathic Theory and Practice of Medicine (Volume II) by E.E. Marcy, M.D., and F.W. Hunt, M.D., published in 1868. The 50mg dose has turned my curiosity into a laser beam – fascinating, but not exactly productive. Still, the Victorian-era idea of ‘defective moral control’ is going to make for some interesting articles.

It’s as if my brain is clinging too tightly to details, not necessarily making it harder to reach the finish line, but insisting that one more lap around the track is a requirement. The balance has tipped with dopamine making tasks too absorbing, and instead of working efficiently, norepinephrine is keeping me stuck in a loop of overcommitment.

Instead of helping me complete work, it’s made me overcommit to each step – turning writing into another bonus round of Sonic the Hedgehog, where I’m stuck in loops instead of making progress.

I now understand what a few people had said to me about medication – that it had made them feel not like themselves. The sensation of feeling trapped in my own head, being productive but in an unhealthy way, has made me feel just like that.

Downgrading from Sonic speed to sensible jog

So now I’m dialing it back to 40mg from next week to see if I can regain some flexibility. The irony isn’t lost on me that after months of trying to find the right level, I’m landing somewhere between two fixed doses, knowing full well that the ideal range for me is somewhere in between 40mg and 50mg. But ADHD medication doesn’t come with a precision dial, more a clunky set of notches, and you just have to pick the closest one that works.

Case in point #2: this article was nearly not completed because I spiralled into an obsession trying to understand why medication often comes in doses that are round numbers. I don’t get why titration means making such huge jumps in dose. Jumping from 30mg to 40mg is a 33% increase, while 40mg to 50mg is a 25% leap. If there was a dial to be turned, it really feels like somewhere around 43-44mg might be my sweet spot.

But that’s the reality of titration. It’s not just about finding the right dose, but finding the best available dose within the options you have. And for now, that means stepping back and resetting. Back to 40mg – stepping out of scalding water, bracing for the ice blast, and hoping this time, I finally nail the level-up.