Twelve years ago, I was working in the pharmacy when I noticed a man looking very anxious walking quickly toward the pharmacy. He was in his twenties, was wearing scrubs and his name badge from the hospital said “Victor.” Before he could even get within 10 feet of the pharmacy counter, I came around to meet this fellow healthcare worker.
He said, “Something’s wrong—my heart is racing, I’m anxious and nervous. I think I’m having a panic attack.” I asked him if he ever had a panic attack before, and he said that he hadn’t. He was a nurse and knew the signs of a heart attack, so we ruled that out. I asked him what happened before he came rushing into the pharmacy.
He said that he got into a confrontation with his boss, and he was upset about it. Work had been stressful. He had not been sleeping well. I asked him what medications he was taking and he said, “Vyvanse for my ADHD.”
I said, “You’re having a drug-drug interaction.”
He said, “But a drug-drug interaction is when two or more medications create a bad reaction in someone because the medications conflict in some way.”
Victor then added, “But I’m only taking ONE drug.”
I said, “But that Vyvanse is interacting with your own chemistry—the “drugs” your body makes.”
I explained to Victor that his lack of sleep and state of anxiousness, his body produced stress hormones like cortisol and adrenaline. Those chemicals were interacting with his Vyvanse, which is very similar to adrenaline in chemical structure. His body was in essence, overstimulated and that’s why it felt like he was having a panic attack.
Victor smiled with relief and said, “You’re right!”
I discussed a few strategies with Victor so that he could continue to take his medication while remaining calm and relaxed at work without fear of another one of these panic-like attacks.
You may not take Vyvanse or another drug to treat ADHD, but you might take medication for anxiety or depression. The same rules apply. If you have a body, then you have an inner pharmacy. When you learn more about how your inner pharmacy works, you’ll feel better. Your medications will work better. You may even be able to prevent an adverse effect or wean off of your medications (if your doctor agrees that’s a good option for you).
Be Your Own Pharmacist
You, like Victor, also have a stressful job. To help manage that stress and prevent your body from releasing stress hormones, you need to get adequate sleep. Sleep is restorative. When you’ve gotten enough sleep you feel refreshed instead of groggy in the morning. When the body hasn’t gotten enough sleep, it acts as if it’s under stress (because truly, it is) and produces those stress hormones. In addition, if you’ve gotten enough sleep, you won’t need to force yourself to be alert with caffeine.
Caffeine is a stimulant, so too much caffeine is not healthy. For example, if you’re really stressed out, that nervousness may feel like the beginning of a panic attack. If you’re not sleeping well and have too much caffeine, your body will release the hormone cortisol. This cortisol increase can cause your blood sugar to dip, and you might experience shakiness or a loss of focus, which can feel like being anxious.
Consider getting some exercise. Working out releases endorphins, those feel-good chemicals that I wish I could sell in the pharmacy. To help you feel calm and happy is one reason why you take medication. Exercise helps stabilize blood sugar. Most importantly, when you suffer with anxiety or depression, exercise can also help clear your mind of all the worry. When you move your body, it gives your mind a chance to rest. Besides, the feeling of confidence after a good workout is something that can’t be bottled.
Take some time to have some fun! Having fun is a great stress reliever, and having fun also gives you a dose of your own endorphins. My brother, Greg, is a nurse on a Covid ward. He has discovered that he loves playing frisbee golf- even in the cold of Erie, Pennsylvania. A few times a week before he goes home after his night shift, he stops to play his new favorite game with some friends. Be like my brother and find something fun and give yourself permission to do that thing a few times a week. Greg gets a double dose of good chemistry because his fun includes exercise. It’s possible that what’s fun for you is also good for your body. It’s like writing a prescription for yourself for the most wonderful medicine that only you can dispense.
Good self-care includes being aware of your own chemistry. Pay attention to what you put in your body. What situations and conditions make you feel anxious, nervous, or frazzled? Remember when you are in these states, you are releasing chemicals as if you are your own pharmacist. The good news is you can always make a course correction. Do things that produce happy chemicals: rest, hang out with people you love, don’t overconsume caffeine or alcohol, and have some fun.