The pharmacists breaking down ADHD stigma

ADHD
Krysti-Lee Patterson and Lauren Haworth MPS

To increase awareness about ADHD, two pharmacists share their journey of adult diagnosis and medicine optimisation.

Lauren Haworth MPS, pharmacy owner

I was diagnosed with ADHD around 3 years ago after a fellow pharmacist with whom I share a lot of the same ‘quirks’ suggested I get screened.

At the time, I’d often have to pull over for a nap during my hour-long drive to work so I wouldn’t fall asleep at the wheel.

After receiving a sleep apnoea test, which is comorbid with ADHD, I began using a CPAP machine each night. But still, the drowsy driving persisted.

Upon researching ADHD at my pharmacist friend’s insistence, I realised a lot of the female-specific characteristics rang true. I couldn’t remain focused on tasks that didn’t provide enough stimulation – including driving.

As a pharmacist, I found myself spending longer on day-to-day tasks, which I compensated for by working back late.

With time, I realised that having ADHD made me a better pharmacist.’

Lauren Haworth MPS 

I would also frequently lose my place while counselling patients, and either had to repeat myself, or double check that I’d mentioned something important.

Post-diagnosis, I felt a lot of anger. It took me 5.5 years to complete my 4-year pharmacy degree, and I was placed on academic probation for failing three out of four subjects in first year. But not once was I screened for ADHD. 

Eventually I managed to look past that anger. I knew I was a good pharmacist – I just needed to put strategies in place to help me manage my ADHD in the workplace.

Now, I have a standing ‘Lauren’s to do list’ that I print out and add to throughout the day. I’m also candid with all my staff about my diagnosis. They know if I haven’t done something in 10 minutes to ask me again or write it down.  

When I get home and realise I’ve forgotten to do something, I’ll send myself an email to the work address saying, ‘Hey, Lauren, don’t forget to do this tomorrow.’ 

With time, I realised that having ADHD made me a better pharmacist. 

I can easily shift from dispensing a script, chatting to someone on the phone, helping another patient who walks in to pick up their Dose Administration Aid (DAA) and helping a staff member with a query about a Schedule 3 medicine. 

But importantly, pharmacists with ADHD need to find their niche. I love chatting to people, so I’m good at engaging patients, talking with them about their medicines and getting to the bottom of problems. 

When it comes to treatment, I’m still struggling to find the right balance 3 years later. I take 80 milligrams of atomoxetine daily, and short- or long-acting methylphenidate as required. As a pharmacist, it’s frustrating to know how the medicines should work, without ever experiencing that ‘switch-on effect’ into sudden concentration myself.

It’s not my first choice to take more than one medication, but each works differently. I would advise pharmacists dispensing ADHD medicines to ask open questions before making judgements, such as, ‘Can you explain to me what place each of these medicines have?’ or ‘How are these medicines working for you?’ 

While it’s pharmacists’ responsibility to ensure medicines are supplied safely, we should be careful how we approach patients with ADHD and other neurodivergent or mental health conditions.

If you notice someone is regularly misplacing their medicines, you could offer to split the monthly supply, or keep their script on file.

ADHD is an area that has developed significantly, so we could all do with some reskilling in this space. While an updated version of the Australian evidence based clinical practice guideline for ADHD is coming out soon, my top tip for pharmacists is to add some further education about ADHD to their CPD plan for the year.

Krysti-Lee Patterson, pharmacy industry consultant and locum pharmacist

It took me until the age of 33 to realise the puzzle of my life had a missing piece. After experiencing a severe case of burnout, I was working with a psychologist to manage my anxiety when we uncovered something unexpected – ADHD.

This diagnosis, late as it was, brought with it a unique set of challenges that I had to face head-on.

Many pharmacy tasks, such as checking scripts, require meticulous attention to details, which I found challenging – not because I didn’t care, but because my mind often wandered. 

Managing emotions in the workplace has also been a struggle. Some managers have criticised me for being too emotional or not empathetic enough, but I lacked an explanation. My frustration with inefficiencies and slow processes presented challenges in the fast-paced world of pharmacy.

One of the most difficult tasks was packing DAAs. If I had 100 packs to check, I’d break it down to 20-minute increments so I could maintain focus. 

ADHD is not a disability; it’s a different way of seeing the world.’

Krysti-Lee Patterson

Other strategies included ensuring the dispensary and packing/checking areas were organised and distraction-free. For focused tasks, I needed a quiet, separate space, far from the hustle and bustle of the dispensary.

My anxiety medications, crucial for managing my mental health, required a carefully crafted strategy. My GP wrote a reg 24 supply, allowing me to manage them at home, and I pre-packed handbags and travel bags in case I misplaced or forgot to take them.

But my frequent travels for work meant getting prescriptions filled at different pharmacies, where I’ve encountered pharmacists who questioned my need for both long-acting and short-release medicines at varying doses, along with prn dexamphetamine. 

However, the reason my psychiatrist prescribed this combination is that it’s still a trial-and-error process. While I was initially prescribed immediate-release twice daily, I’d often forget to take the second dose.

From there, I was advised to take a long-acting dose and top up with immediate-release methylphenidate.

ADHD medicines are often taken as required. I take my medicine when I’m busy at work and need to maintain focus. But I rarely feel the need to take stimulants on the weekend. It’s also helpful to have the flexibility of switching between an immediate-release and a long-acting stimulant.

ADHD can fluctuate, depending on anxiety and stress levels. I’lll naturally have much better focus if I’ve had enough sleep and exercise. If not, I tend to lean on my medicines more.

For pharmacy managers or owners who have neurodivergent staff, I’d advise asking them what they find challenging about their role.

While it might seem they are underperforming in a certain area, there may be other aspects of the role they excel at.

When I was a pharmacy manager, another pharmacist loved packing DAAs while I preferred engaging with customers on the floor or in consultation rooms – so we crafted our roles based on these skill sets.

Overall, I feel that ADHD has gifted me with resilience, adaptability, and an unquenchable thirst for knowledge. 

I’ve come to realise that labels can be limiting, and embracing my uniqueness has been empowering. ADHD is not a disability; it’s a different way of seeing the world.