So this tweet connected some dots for me and inspired me to do my own thread: ADHD and interoception. https://twitter.com/ItsEmilyKaty/status/1391342722330550272

I'm a recently diagnosed, 39 years old non binary person on meds for about a year.

All experiences are my own, except for the examples I stole from my ADHD partner.

Interoception and hunger:

V1: Eats a single bowl of cereal in a day.

V2: *grumpy and uncomfortable*

Gets progressively worse until I remember food is a thing

*eats until I don't feel grumpy anymore*

This may explain why people with ADHD have a much higher rate of obesity than the general population.

Interoception and bladder:

Me: realizes I have an urgent need to pee.

Me: dances around the house looking for my phone for 5 minutes instead of going to the bathroom for 2 minutes because I don't want to pee without it.

Interoception often means that by the time you know you have a need, it's severe. ADHD means that you still struggle to prioritize that need.

Interception and thirst:

Me: *feels something*

Could this be a desire for food?

I drink so much more water now that I am medicated. Some of that's dry mouth caused by Adderall but I sincerely don't think I knew how thirsty I was because I couldn't tell the difference between thirst/hunger

And again back to disordered eating caused by ADHD

Interoception and BM's:

Me: *nauseated and miserable with mounting lower back pain*

*lies motionless on the sofa disassociating into their phone*

UNTIL

*Madly dashes toward bathroom because my bowel is about to perform an emergency evacuation*

Interoception can also mean that you miss simple cues. Most days I don't feel a basic urge to go number two. I've learned to associate certain painful sensations with the need to poop because I don't often feel more subtle hints.

Interoception and cold:

*Wanders around barefoot in snow because I lack the spoons/patience to put on socks + boots and tingly sensation is stimmy.*

I did this more than once as a child. It's a combination of impulsivity and executive dysfunction. Dumb luck that I didn't get hypothermia or frostbite.

Interoception and exhaustion:

It's going on one in the morning. I felt tired two hours ago. I'm tweeting this thread instead of going to sleep. I don't feel tired per say but ime, on nights like tonight, I usually stay awake until I just pass out.

The list goes on. I could talk about heat (I've had heat stroke and not realized it), pain (why am I dizzy and achy? Oh well. *Keeps going until something gets really effed up*) or even pleasure. (What normally feels good just tickles )

You get the jist. Signals get lost or misinterpreted. Distraction causes sensations to be unintentionally ignored until they're painfully urgent or it's too late. Sometimes the search for dopamine means we ignore signs something is wrong.

I'm going to go to bed now because I really should. Maybe I'll come back to this later and we'll talk about how medicine has changed these experiences for me.

Okay it's been a long day and I am totally out of spoons. Time to mine Twitter for some dopamine.

Let's talk about what happens, for me, when you add Adderall to the interoception + ADHD equation.

Hunger: This one's tricky. Adderall suppresses appetite. I think most stimulant ADHD meds do. So I eat less overall. However I also am more aware of my hunger before I become ravenous.

I'm less likely to forget about food until the last second.

Another interesting side side effect of medication on hunger awareness is I'm much more aware of what I want to eat.

I have a physically demanding job so with dopamine supplementation, I'm aware enough of my hunger to know that I crave protein and vegetables.

I don't actually crave sweets or starches nearly as often as I used to. (Serotonin self-medicating anyone?)

I'm also much more aware of fullness. I can stop eating when I'm full instead of continuing to eat because my brain wants chemicals.

Meds and bladder: Planning to pee is possible now.

I can feel the urge building and start thinking about what I'm going to do about it before I'm doing the antsy pants dance.

I can also prioritize actually going to the bathroom instead of looking for my phone.

Meds and thrist: I drink a lot more because Adderall dries out your mouth. I'm also much more aware of thirst. I don't confuse it with hunger near so much.

One thing I'll note is that I actually crave water now. I seldom drank it before. I usually only drank when I wanted caffeine and I grabbed whatever the easiest source at hand was.

Much like food, I wasn't drinking to hydrate. I was drinking for chemicals.

I was probably low key dehydrated most of the time.

Meds and BM'S: What a fun topic right? Why did I choose to share this on the internet?

Seriously this is more complicated because I do have an additional chronic illness that messes with my gut. So nauseating painful sudden bowel movements are definitely still a thing for me.

However I do have more and more 'normal' days. Days when going to the bathroom is no more surprising or painful than it is for most people.

And much like the bladder thing, I can feel it coming and plan to find a bathroom better when I have my meds.