The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Tolerance is a well known issue, but I'm not a daily user. When I'm cramming for exams, I average anywhere from 20mg to 50mg max, and that's about daily usage for 2 to 6 months.
That's interspersed with long periods of minimal or no use. My ADHD is mild, I don't need to take Ritalin to make it through a working day, and in fact, doing so is actively unpleasant. I may not be the most hardworking and zealous doctor around, but I certainly do more than the bare minimum needed to avoid malpractice litigation, heh.
So I take it so I can study, acquire knowledge, pass exams, then use said acquired knowledge in my day job. The job itself doesn't need it, and I doubt I'd take it through residency. My internship was terrible in terms of workload and what it did to my mental health, and UK Residencies, while still a slog, really can't compare. If I take my meds as a resident, it'll be if I'm expected to keep studying particular topics, or for exams like the MRCPsych. Besides, Psych isn't nearly as high intensity as something like surgery or critical care.
You can't tell I have ADHD in normal conversation, or in my work. It's only when the textbooks come out that my eyes glaze over, and my usual coping mechanism that worked through high school of forcing myself to study through a combination of personal tutoring, extreme stress and lethal doses of caffeine all failed hard when the books became both big enough to kill a calf and too long to cover in a few days of cramming.
So I've been taking Ritalin for about 5 years now, and I can't say I notice a tolerance. At most, after 3 or 4 months of continuous daily use, I'll end up needing 30-40 mg, and that's impossible for me to disentangle from just needing more of it so I can study longer.
And if said tolerance does develop, well, the UK is a more enlightened nation in that regard and I can cycle through the better alternatives that aren't available here. It's not something I'm worried about.
I'm doubtful that most doctors will be employed after the 7 years it would take me to finish my training, leaving aside most humans, so after a certain point it becomes rather moot. I just don't currently have a better alternative than to act as if that's not going to happen, just in case it doesn't.
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