Posted by Libby on July 14, 2000, at 13:19:47
In reply to Ritalin augmentation questions. PLEASE HELP!-LONG, posted by shellie on July 13, 2000, at 22:49:07
Shellie... I wanted to post a little of my experience in the hope some of it may be helpful
to you...My symptoms were primarily depressive also. I definitely got some benefit from Effexor XR, but it was only partially effective. When I went back to work (in a new job, this one more boring, sedentary, and routine than the last) I noticed some old behaviors had gotten much worse:
- my tendency to "drift off" in conversations
- my daydreaming
- my extreme distractability
- my inability to process some types of information. In my case, I had difficulty gathering info in meetings, in phone conversations, and in written reports.Of course, these symptoms can indicate a number of disorders. In my case, I had been treated, with mixed results, for depression. There was no reason to suspect a dissociative disorder, so I wasn't left with much to go on. I finally decided to stop worrying so much about cause and research how to correct the symptoms. That led me to the idea of augmenting with stimulants. The reasearch I found indicated that even if I wasn't ADD, stimulants might address my symptoms and allow me to function. By that time, I had been functioning at such a low level for so long that I was on the verge of giving up.
I asked my doc about Ritalin and the possibility of ADD. He asked a few questions and said it was a possibility, but he thought I might be Bipolar II, Rapid-Cycling. Because my advanced degrees and previous success at work, he went with the Bipolar trials first... So I went through mood stablizers, anti-psychotics, tranquilizers, anti-convulsants... Most of them made me feel much worse. Zyprexa helped with the daydreaming, but nothing else seemed to have a beneficial effect at all.
Eventually, I felt so much worse that I refused to take any more "Bipolar" drugs and pretty much insisted that he consider ADD. He FIRMLY insisted on an evaluation by and Adult ADD specialist, concurrent with a trial of Ritalin. Ritalin was a miracle for me. From the very first dose, *everything* got better... I was eventually diagnosed with severe ADD, as well as dyslexia.
It turns out that my ADD was helped by growing up in a very structured home by parents who started teaching me to read and do simple math before I could talk in complete sentences. I was also helped by a very high IQ, which allowed me to generate some pretty effective adaptive behaviors for school. The area where my ADD was most evident was in personal relationships. There, my extreme moodiness, inattentiveness, distracability, and impulsivity were clear. A little reading helped me see these as potential ADD symptoms. I had always thought of them as strictly emotional problems. The reading helped me see that lots of women's ADD symptoms manifest as relationship problems. Because my problems mostly all in the area of relationships, I think I tended to focus more on my emotional symptoms rather than the cognitive disturbances that were behind the emotions. For example, the reason I cried when I locked my keys in the car wasn't that I was having a Bipolar mood swing. It was because I literally couldn't figure out what my next move should be. Simple problems like this seemed more than I could manage because they required a series of actions: finding a phone, figuring out which locksmith to call, giving him directions, waiting for him to arrive (a BIGGIE)... etc. To most people, these are little things, but for me, especially at the end of a tough day, they were literally more than my brain could handle. No one believed me when I tried to explain that to them. They'd usually say, "That's ridiculous. You're an intelligent person...surely you can handle a simple problem like that."
Even my therapist didn't understand this until I finally got it myself and was able to tell him WHY I reacted so emotionally to "little" things...
The process of ADD diagnosis was useful in that it forced me to look at my work and school behaviors from a different angle. I can see how
distractability and impulsivity can be acted out in ways other than grades and performance ratings.
I also see how lucky I was to have discovered amphetamines as a study aid in college and grad school... and how fortunate to find a job that was pretty much a perfect match for an ADD... *conceptual* design. When I was forced to move to a more structured environment, my performance at work fell completely apart.What I find strangest about my experience is that my doc was more willing to diagnose me with rapid cycling Bipolar II than to consider ADD, even though I had no history of manic behavior at all! That's pretty scary... and to me it makes a great case for taking responsibility for your own treatment! No doc or therapist can know my experience as well as I know my own... I went into his office talking about my emotions, so he focused on emotional disturbances. When I started focusing on cognitive symptoms, so did he. In my case, now that the cognitive symptoms are under control, there just haven't been that many emotional problems. Disclaimer: I haven't been taking Ritalin that long, so I expect there are still some emotional problems, but they are no longer everyday concerns.
If I had been willing to accept a diagnosis of depression or Bipolar, both of which seemed wrong to me, I might still be taking the wrong meds and might never have experienced what life can be like when a person is able to pay attention!
Best...
L.
poster:Libby
thread:40375
URL: http://www.dr-bob.org/babble/20000708/msgs/40434.html