“I went to the doctor, said I’d like to give Adderall a try. There were no diagnostic procedures. Doctors give in too easily. I did not think there could be a risk later on. I started on 20 milligrams. I went from D’s and F’s to straight A’s. But your brain adapts, you have to increase the dose, and by 2011 I was up to 45 milligrams.

“In the spring of that year I started to feel Adderall was my best friend and my worst enemy at the same time. Because I could not sleep I went to see my psychopharm, and she prescribed me Ativan to sleep. That worked O.K. for a while. But I really ran into trouble last year. I was up to 65 milligrams, and then during finals went to 80, even 120, milligrams, and I was just locked into this Adderall-Ativan cycle. My doctor seemed scatterbrained. She’d prescribe something but not follow up.

“It’s a complicated dependency. I mean I never took Adderall to get high, never took it in a way that was not academically oriented; and I think there’s a distinction between dependency and addiction, taking something for a purpose or for a rush. But I feel awful. My baseline anxiety level would be most people’s highest anxiety level. The drop of a pin makes me spin around.

“I am living at home. My parents are clueless, and it is hard to discuss with them, although my Mom helps me now. I alternate between ‘on’ and ‘off’ states — I come off the Adderall, take Ativan and sleep for days. I miss appointments. I know I need to go to the appointments, but I wonder if I will be functional enough.

“Adderall suddenly turned its back on me. It enabled me to focus, got me to a higher place academically. But then I could no longer rely on it. I was on my own. And although I have less than three credits to go, I may have to withdraw from school because I have not been able to make it to enough classes.

“Look, I am in a culture that constantly justifies the means to an end. So how do we persuade people not to take it? All you hear is how impossible it will be to get a job when you get out, and you are going more and more into debt, and you think without this I won’t be top of the class. With other drugs you know you are ruining your life. But Adderall manipulates you into thinking you are doing what is needed to have a great life.”