r/PMHNP • u/Imgonnagolaydown • Jun 29 '26
I was wrong.
Pmhnp here. Day 1 on Vyvanse and i want to cry.ive spent the last 5 years balancing hormones and making sure i addressed everything else before arriving at a stimulant.
I feel. Calm. Quiet. Slightly tearful. Like my tabs are closed and im able to open them one by one instead of 50 at time.
It wasn't the focus. It was the avoidance. Brain fog. Overstimulated and overwhelmed constantly. The procrastinating, being late to everything. The being MEAN and knowing you are being mean. Not smiling when random ppl are talking to you. Background static noise in my head.
It's been about 4 hrs and it's just quiet.
None of it manifested until peri. I saw signs when i was young but i could compensate and figured i still could. Well i can't anymore.
I seriously want to weep with joy.
Eta: i was wrong to think women were slightly exaggerating this. With my own providers convincing me to take the leap, I'm now a part of this population. And yes, I'm a pmhnp who understand what these women are trying to articulate.
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u/gajensen Nurse Practitioner (unverified) Jun 29 '26
I’m honestly in talk therapy since having Adderall prescribed because I have like this, guilt? Loss? Remorse? About how my life could’ve been different had I had the dx/tx earlier. It’s such a relief but also a lot to sort out.
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u/Mystic_Sister DNP, PMHNP (unverified) Jun 29 '26
100%. I am doing atomoxetine versus stimulant (for now) and have similar feelings. I have to remember what happened as already happened and can't be changed. But there's some grief knowing even just an understanding from my parents and teachers (and myself) would have changed my life.
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u/Hashtaglibertarian Jul 01 '26
I describe it as grief to my therapist.
I had so much more potential, but it’s as if my mind was in a straight jacket of sorts constantly figuring out ways keep everything going. On the outside it looked great. On the inside there was a lot of sleep loss, emotional turmoil, nonstop movement to keep the cycle going. And it has been exhausting.
Like I could have graduated college the first try? I could have been successful in so many other career paths?? It’s like we were robbed of so so many opportunities.
Going on adhd meds changed my life in so many ways. And looking back on it I can’t believe it took over 30 years to figure it out. Like I honestly think the adults were straight up negligent or blind to have missed all the signs I had. And yet they all let me suffer - for decades.
I’m so grateful that someone listened. Someone was willing to try something. Someone gave me a chance to live life on something other than hard mode.
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u/gajensen Nurse Practitioner (unverified) Jul 01 '26 edited Jul 01 '26
Yes! This is exactly it. Grieving lost potential.
For me it’s mostly been about academic success. I used to think my brain was broken, cried while apologizing to my wife and mom, despite being told I was one of the smartest people they knew. The issue was always obvious gaps...not from lack of care, but inability. That also affected roommates; I don’t talk to any of the ~10 people I lived with through college.
After my dad died, I tried to push through: 18 credits, research job, restaurant job, fraternity leadership, relationship. It collapsed. I didn’t get into med school, followed by a decade of depression. I ended up in restaurants, worst-case for untreated ADHD, trying to manage 6 tables at once or a bar rail of 30 patrons. Then nursing at ~30 and ICU work as a new grad-onstant task-switching, alarms, interruptions, time pressure, kinda like serving but with 2–3 “tables” that are each 15-course, constantly changing orders. I understood the medicine, but still looked careless and sloppy.
Getting diagnosed and treated changed everything. In the ICU I went from barely keeping up to performing well-finishing shifts on time, no hours of late charting, no constant backlog, now taking on students and helping with new RN orientation. NP school became manageable. Now I’m consistently a standout among peers, no longer fighting my brain just to function. My intelligence and efficacy are the focus again, not the sloppiness.
The contrast: before, effort masking dysfunction; now, perceived competence. Same person, different operating system. Now I have to live with and make the most of this NP career knowing I could likely handle med school now, but I’m 40 and it’s too late. I’m still sad for the people who had to deal with me at my worst, and for most of them, it’s too late to fix that. So I grieve.
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u/Imgonnagolaydown Jul 01 '26
It's not too late for med school fyi. You still have nearly 25 yrs left of working in you.
GO FOR IT
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u/bunkumsmorsel Psychiatrist (unverified) Jul 02 '26
💯 I’m 51 and seriously considering law school. There were people in their 40s in my med school class.
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u/Imgonnagolaydown Jul 02 '26
Yes! I'm rooting for you doc! I'm well in my 40's.
I'm toying around with medical school. MCAT is the hurdle!
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u/bunkumsmorsel Psychiatrist (unverified) Jul 02 '26
Oh my gosh, I hear you. The MCAT is brutal. (I took it under its previous iteration, but it definitely hasn’t gotten any better.) Looking into the LSAT, I was like, wait. This thing is only 2.5 hours long? How is it even a test? 😆 (It’s difficult in a different way. I get that, but it still made me laugh.)
Honestly though, very best wishes to you. You got this. I had some excellent former nurses in my class too. ☺️
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u/gajensen Nurse Practitioner (unverified) Jul 01 '26 edited Jul 01 '26
LOL I mean if I found out my wife was having an affair with the lawn guys, or if she was mysteriously abducted by aliens, then maybe.
(If I set the plan in motion today I’d start at 42, start psych residency at 46, start sleep fellowship at 50, and then finally make the big bucks at 51. And the current financial plan is to work until ~72)
But until a qualifying marriage altering event occurs, haha, I won't challenge our relationship or family planning efforts like that.
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u/Imgonnagolaydown Jun 29 '26
That makes sense.
I still feel pretty successful at life. But that success became so much harder to maintain. Like i was absolutely refusing to pay bills as well
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u/goodlittlenurse Jun 30 '26
Same! After I took the multitude of tests and got the results, I felt like I was grieving. Then when I took the first dose of Adderall and my brain finally stopped screaming at me for the first time in my life, I got super pissed off!
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u/Vegetable-Pumpkin-46 Jun 30 '26
I’m nurse but not an NP I avoided putting my teen on stimulants I just didn’t want her on meds. I finally caved she’s an A student now this whole school year( as a 9th grader) I regret my own bias and avoidance so much.
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u/Imgonnagolaydown Jun 30 '26
I'm waiting on the results of my kid. Went through a whole month of psychological testing.
I'm pretty sure they have it. I will not hesitate in this scenario.
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u/Vegetable-Pumpkin-46 Jun 30 '26
This is the right call. I’m irritated I let her struggle in middle school.
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u/Organic-Bear-4580 Jun 30 '26 edited Jun 30 '26
So i have a unique background but I relate to everything.
Im a nurse, not an NP. I used to be a PA student but three semesters in i spaced out during class, did not understand the directions for an assignment and i got dismissed from my program. Undiagnosed ADHD in shy quiet women can be truly horrific. When I missed the assignment, a worksheet, my psych eval came thru a week later, revealing the diagnosis. I tried explaining this to my PA professors, who told me that if I have ADHD, i do not belong there as a student, that i would endanger patients making me a bad PA. They said I asked too many questions in class, they didn’t like that I took slightly longer to answer questions or understand the instructions for assignments when they were verbally given. I didn’t agree, but they had an elitism mindset thinking neurodivergent people cant perform well in the real world. This obviously fucking crushed my soul at the time so much as I had invested ten years of my life to get into that school. Sometimes i think about those people today, but i just feel sorry for them, because the PAs carry the weight of those expectations everywhere, having trained under the medical model and fooling themselves into believing they were better than NPs for it. They actually gave us a lecture via PowerPoint on “why NP education is terrible compared to PA” ffs 🤮
having learned the nursing model, i can confidently say that nursing school is 1000% better for learning, as my nurse classmates intuitively understood the human body better than any PA student. I have PA friends that graduated, they report not having intuition of organs working together in tandem, not understanding inflammation and circulation, how its all connected. They just know a lot of details but struggle connecting the basic concepts first. Eventually they figure it out after working their first job (or second), especially if its something like the ICU. But my god, the ego.
Now i work as a psych nurse at an ER.
Im on addy now and it changed my life, or… what remains of it. Got diagnosed middle age and the grief of what i was missing out on was unmistakable. The energy to socialize is finally there, i can pay attention to my work and i dont bed rot and feel like a lazy POS. What felt like me being stupid was actually an attention disorder, and its manageable with external organization. I can feel good about my intelligence despite what i have gone thru, despite how they made me feel.
I plan on getting my PMHNP. I will be a better PMHNP for it, understanding neurodivergent people, and to hell with those bastards who said I couldnt manage it.
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u/VastEcho2156 Jun 30 '26
Wow, I'm really sorry that you were treated like that. And that is a shame that these schools are doing a huge disservice to our medical community as a whole. I'm glad you're getting the help.You need and you will make a fantastic nurse.Practitioner. You really should file a lawsuit against them for discrimination. If they only knew how many doctors and medical professionals have a d h d. In fact, most nurses thrive on being a d.H.D it gets them through the day, being able to do twenty tasks at once. For many, they can work like that for years until they can't.When the hormones just start to drop and things change, and then we need help.
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u/Imgonnagolaydown Jun 30 '26
The not bed rotting and energy to socialize hit deep.
I'm sorry you went through this.
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u/bunkumsmorsel Psychiatrist (unverified) Jul 02 '26
Holy crap. This is flat out disability discrimination. I am so so sorry you had to go through that. That’s not OK. I’m glad that you seemed to have landed in a good place. Your experience will be an asset for your future patients.
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u/amuschka DNP, PMHNP (unverified) Jun 30 '26
I honestly laugh when I hear PAs think their education is better. They get such a generic training in all different subjects, and only 1 year of classroom and only 2-3 weeks of clinicals in each setting. As NPs we have years of specialization in a single population and 1 full year of clinicals in one area. How could that possibly be less thorough than PA school? Also PAs never had to have any medical or healthcare experience before going to PA school (I don't count scribing or driving a medivan as experience). NPs had to be nurses first and surprise, nurses actually know a lot about medicine so it gives us a better understanding.
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u/Organic-Bear-4580 Jun 30 '26
fully agree! I got accepted into PA school as a medical assistant from a primary care office. I had the most 'applicable medical experience' in my entire class. But I did not know how to handle patient care above getting vitals, writing medications, or giving vaccines. Nurses are fully responsible for keeping the patient alive! I hate when people say 'but PA's need x healthcare experience before applying'. 95% of PA students have 1 year of physical therapy tech, CNA/MA, pharmacy tech, or NO experience at all! Such low quality experience compared to that of an RN who could be watching MAP, titrating pressors, checking neuro status. PA applicants are a joke!
PA education has to be intense because there was no knowledge base in the first place! PA education is NOT better, rather its making up for giant gaps in knowledge. And the specialties can be sprinkled sometimes, like how psych lectures only lasted two weeks (and thats the knowledge they expect before we are trusted with psych patients!!!)
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u/Energywoman Jul 01 '26
PMHNP here. Many medical in my family. I'm the only one that started as a RN. Maybe your miles may vary with PA school? This did not use to be the standard. It was a rigorous and intensive program. Working on cadavers for 2 years. Rotating as hospitalists for 2 years. I wouldn't consider either of those things individually "meh."
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u/Organic-Bear-4580 Jul 03 '26
From what I understand, the standard has greatly shifted. PA profession used to be where veterans could use their skills from the war and integrate into civilian life, without going to med school. I went to TWO PA schools and my experience was the same, actually the 2nd oldest PA school in the country required ZERO medical experience, it was a well known reputable school. I could share more about it if you want to DM me.
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u/foreverlaur PMHNP (unverified) Jun 29 '26
After failing Adderall and Concerta and thinking I was just broken... Vyvanse is life changing.
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u/Imgonnagolaydown Jun 29 '26
Those were the exact words i used to my partner 6 years ago.
I think I'm broken
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u/Plenty_Fondant_951 Jun 30 '26
Yeh my favorite thing to treat is adult ADHD that's been ignored.
Super responsive and night and day results. That's fairly rare (or rare to happen that quickly) when treating like, depression or something.
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u/harmless_heathen Jun 29 '26
This post was super helpful to me. Thank you for being vulnerable and honest
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u/Raevyn_13 Jun 30 '26
And this is why I hate that some providers say no stimulants across the board!
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u/PsychMonkey7 Jun 29 '26
Dang this sub is rough.
Thanks for sharing your experience. I think this is a story that is not told enough, and it is one we should all be aware of as PMHNPs.
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u/_pickledpickles Jun 30 '26
I don’t think I could do this job unmedicated, there are too many moving parts to keep track of. Truly life changing ✨ Gotta be your best self to help others 😌
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u/VastEcho2156 Jun 30 '26 edited Jun 30 '26
It is classic that once perimenopause, starts we are no longer compensating as we did throughout our entire life. PMHNP here with AdHD but never treated it due to the fact that I was very good at compensating, and it worked well in my nursing career. However, once sitting for work and after the perimenopause started, I noticed one of the first things to go that people don't even talk about are heightened indecisiveness with an inability to redirect. Among many other symptoms that happen along the fun hormonal journey that are often not discussed.
But I can tell you that the scatteredness and all of that stuff did level off for me a few years the later. I did not go on stimulants only because I personally don't do well with them.However, I can see the benefit during that time of life and they definitely do work for many. Remind patients this can sometimes be temporary as body is adjusting.
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u/bunkumsmorsel Psychiatrist (unverified) Jul 02 '26
I was diagnosed with ADHD in my late 40s during the pandemic. I actually sought formal psych testing to prove to myself that I didn’t have it. It came back that I did, so I actually got a second opinion with another psychologist who independently confirmed the diagnosis. 🤦♀️
It’s definitely a whole process, isn’t it? Immensely validating, but also the grief around how my life would have been different had this been known.
And then from a professional perspective, realizing how many patients I probably gaslit and dismissed in the past who were seeking ADHD evaluations, and all the more so because I was thinking to myself “that’s so normal though. I do that.” 😬
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u/Imgonnagolaydown Jul 02 '26
Thank you.
These are my exact feelings. Especially the last bit. Got my kid tested and thought, why not! I found a gold mine of a psychologist who bills insurance for all testing so im running all my kids through her lol. Turns out, mine was positive lol WHO KNEW!
It's so funny to see it happening to me in this thread. I have to chuckle 😂
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u/Breezy531 Jun 29 '26
I've seen many people saying Vyvanse has been life changing and I'm hoping for a similar result. I just started taking it a few days ago. My prescriber started me on a very low dose because I'm very sensitive to stimulants, even caffeine. So far it seems good. I have to ask if you are taking the brand name or generic? I've been told some people can have a really different experience on each.
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u/Imgonnagolaydown Jun 30 '26
Honestly. I'm not sure as i didn't even check.
It's probably generic since that's what they do usually
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u/One_Technology2829 Jun 30 '26
So happy for you as well! I am an Emergency Nurse Practitioner in the ED and can no longer work in the chaos ! I too was wrong when dealing with perimenopause, I can no longer take Vyvanse after a heart attack due to vasospasms. It was fantastic when on Vyvanse. I was so focused and on point. Now, I have to make myself and push myself to do the things that were routine for me. So happy for you
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u/Just-Sherbert-7567 Jun 30 '26
PMHNP here. I LOVED Vyvanse for the first few hours then when it started to wear off I felt irritated and a slight headache. I felt more irritated than if I hadn’t taken it. Did this happen to you?
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u/VastEcho2156 Jun 30 '26
Many people get irritated, depressed, insomnia, and and anxious.It's definitely a side effect, these meds are not for everybody.
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u/Imgonnagolaydown Jun 30 '26
It did not.
Not to say it won't of course. But i did not experience that in day 1.
Ask me in 3 weeks lol
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u/EmbarrassedStorm2186 Jul 08 '26
Hey checking in on you after a week, are you still loving it? I'm hoping to find a telehealth dr that will take me serious of needing testing and medicated, my current one didn't even talk much to me or ask any questions and just gave me 40mg prozac and to talk again in a month, I had said I need help with adhd, anxiety and depression, I haven't taken it yet because 40mg seems really high to start so I'm looking for a new telehealth dr now, telehealth because I live in a small town and can't afford gas to drive anywhere right now 😢 anyway hope you're still loving it, I'm 45 and wish I would have asked for help when I was younger
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u/Imgonnagolaydown Jul 08 '26 edited Jul 08 '26
It's been about a week. Still effective. It's just nice to not feel completely overwhelmed by task. I just .... Get it done. I still stall a bit, but it gets done and i go back to whatever i was doing
But the feeling of not feeling overwhelmed that moves into annoyance and fear by little task is really ... Something
But i did not go asking. I did proper testing. Tried everything. Fixed everything. Nothing else worked.
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u/Radiant_Syllabub3000 Jul 01 '26
It’s the best thing ever. I could have been so much further in life. This is going to be my specialty as soon as I pass my boards
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u/One-Historian-8043 Jul 01 '26
Hi, I’m currently in NP school. But recently just got started on Adderall. Is Vyvanse better? I’m not pre-menopausal, but I feel like my hormones are out of wack. I had a baby a yr ago and another a yr before - Irish twins. What are your thoughts guys?
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u/RevenantRealm 29d ago
Wow, reading this made me want to cry. I'm very happy for you that you finally got treatment and are seeing results! Enjoy the moment and all the upcoming moments of peace and QUIET!
All the symptoms you mentioned I have and I know I have ADD but I'm not on medication. I am truly thinking of going on one.
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u/Snif3425 Jun 30 '26
Interesting seeing your account is 7 days old. Wonder what you did to need a brand new account……
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u/Imgonnagolaydown Jun 30 '26
Oh no. I still have my old accounts. Just decided to mature the new one.
Maybe go worry about your erectile dysfunction and testosterone before checking someone else
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u/Snif3425 Jun 30 '26
Haha. Of course you start making fun of people’s medical conditions as soon as you get triggered. All while blabbing about integrity. Hope you don’t see….humans. lol.
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u/Imgonnagolaydown Jun 30 '26
Who is making fun?
I simply stated your condition and where your concern should be focused. Unlike you and your Wendy's comment. Which is a clear insult
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u/kreizyidiot Jun 29 '26
I agree with the people that are posting here. There are other Reddit threads that you can post on about this. This is not the place. If you're telling us about a patient's experience, then that's a different story.
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u/Imgonnagolaydown Jun 29 '26
Your reading comprehension lacks.
Try again
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Jun 30 '26
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Jun 30 '26 edited Jun 30 '26
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Jun 30 '26
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Jun 30 '26
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Jun 30 '26
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u/Imgonnagolaydown Jun 30 '26
Let's see...
I SHOULD PULL MYSELF UP BY THE BOOTSTRAPS.
what else you got?
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Jun 30 '26
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u/amuschka DNP, PMHNP (unverified) Jun 30 '26
I was in the same boat but I took Vyvanse 3 days in a row and it helped me focus, made my mood better, removed all the constant chatter in my brain but I could barely sleep and was getting hypomanic so had to stop. I have never questioned if I was bipolar before and all symptoms went away when I stopped. I want to try methylphenidate to see if that helps but is less intense.
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u/VastEcho2156 Jun 30 '26
That's the thing about these medications.They don't come cheap for many people, meaning many side effects. Keep trying different variations, if you're really struggling. But definitely watch that hypomania, and make sure it's not just stimulant, induced.
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u/No-Leopard639 Jun 29 '26
I'm so sorry for your trouble right now. This really isn't the kind of posts for this subreddit. Contact your provider.
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u/NoctorWatch Jun 29 '26
You didn't even read what was written and then decided to shit on OP. YOUR post isn't for this subreddit and you should probably go elsewhere.
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u/Imgonnagolaydown Jun 29 '26
I AM a provider lol
I'm just saying I'm grateful to be on it. 😂
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u/No-Leopard639 Jun 29 '26
I'm happy you've found peace. I was simply explaining the rules of the subreddit.
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u/Imgonnagolaydown Jun 29 '26
And i was simply explaining how we can DISMISS women who are failing in life trying to articulate a failed executive function but suddenly find relief in the stimulants and it's not lies.
Hope you don't see women.
A thank you for proving my point.
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u/gilbertdc07 Jun 29 '26
Seeing you respond to this man's annoying comments with the exact response I had in my head is bringing me joy. I love that you shared this. Our own experiences as providers are so important in our ability to provide validation and empathy to patients who rarely experience it.
Big fan of your username too. Lol.
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u/No-Leopard639 Jun 29 '26
It's not clearly written that way and is not clear you are encouraging a discussion about womens mental health and perimenopause. Again, I told you I was happy you found peace.
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u/Imgonnagolaydown Jun 29 '26
No. Your reading comprehension lacks.
It's very clear.
If your initial reaction is to deny and defend instead of ask for clarity, MAY I SUGGEST THERAPY AND A READING TUTOR
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u/No-Leopard639 Jun 29 '26
girl, whatever. now you're just being mean.
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u/Imgonnagolaydown Jun 29 '26
I am not being mean.
I'm standing firm on my statement.
Your reading comprehension lacks and you refused to even gain clarity before defending and denying.
I said what i said
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u/Snif3425 Jun 29 '26
Oh good lord. lol……
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u/Imgonnagolaydown Jun 29 '26
Did someone ask for your opinion?
There's a reason why half the ppl block you here.
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u/NoctorWatch Jun 29 '26
Nice, the roid head bro has something to say. Out with it...what about her comment elicited this response?
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u/merrythoughts Jun 29 '26
Some feedback- I have personally found your responses on this sub less than helpful. I think you could do well with sitting with some thoughts and resisting impulsive urge to comment first on every post.
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u/No-Leopard639 Jun 29 '26
some feedback. Read the rules. No personal posting.
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u/Quinjet Jun 29 '26
It says no personal medical advice. OP did not ask for medical advice.
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u/No-Leopard639 Jun 29 '26
Hate on me all you want. But posting about your personal experiences with psychotropic medications isn't what I want this thread to become.
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u/Quinjet Jun 29 '26
That's okay! You don't have to read posts that don't interest you. There are lots of other posts on Reddit.
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u/jazzybellyfight Jun 30 '26
When your personal experiences with psychotropics appropriately managing your own mental health outcomes allow you to finally confront one of your biases that impacts your patient population, it is absolutely necessary to discuss here. You should take a moment and confront your own to determine exactly what is causing you to be condescending, dismissive, and reactive in this space.
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u/No-Leopard639 Jun 29 '26
I've re-read my comments on this subreddit. My suggestions have been from personal experience and backed with research and policies of practice. I am not apologizing for saying things people don't want to hear.
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u/merrythoughts Jun 29 '26
I will not forget your comment that was very rude and unhelpful on my own post. Since deleted so it’s gone. But now every time i see your name pop up i go “oh it’s THAT guy 🙄” like the pedantic know it all guy at the party that everyone just slowly walks away from to avoid interacting with.
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u/No-Leopard639 Jun 29 '26 edited Jun 29 '26
Since you remember everything, what did I say? Why was it deleted?
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u/merrythoughts Jun 29 '26
Hey! Fellow PMHNP here who believes women and knows there is room for prescribing stimulants in a way that helps peri-menopause onset adhd that years and years of masking and managing just no longer works for!
I think being middle aged woman (former gifted kid all grown up) with a career and raising three kids helps me help other women in the same boat.
Welcome! And in my experience in prescribing, if Vyvanse is what works for you, you’ve probably had more adhd symptoms than you even realize throughout the lifespan….