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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Janice on September 19, 1999, at 16:48:16
Hi everyone,
I did a posting a few lines up about my tolerance level to Dexedrine rising. As I notice the affects of Dexedrine wearing off, I can feel my rapid cycling coming back. But the cycling is no longer about being manic (i'm on lithium), the cycle is about my ADD. The ADD is becomes significantly worse on the days that used to be my highs, and is better on the low days of this cycle. I've heard these two disorders often come together, but is ADD suppose to cycle? Any ideas guys? Thanks so much in advance.
Very confused, Janice
Posted by dove on September 27, 1999, at 9:36:19
In reply to Manic Depression and ADD. , posted by Janice on September 19, 1999, at 16:48:16
Hi Janice,
I am bipolar and adhd. I can say from my experience that these two disorders seem to feed each other. It is quite difficult to distinguish between what is the ADD and what is the mania from the manic-depression. When the Doc diagnosed me, one of the things he said was although my symptoms pointed strongly to attention problems the bipolar has a tendancy to show itself with agitation and attention-deficit problems on the mania end of the illness. I am on Adderall, which seems to prohibit my mania, which is characterized by super-sensitive senses, agitation, disorganization and antagonism. When the Adderall wears off I can feel those symptoms returning. Which is why my doc wants to increase the Adderall and add a mood-stabilizer after the next increase.I guess the short of it is, you may still be cycling in mania, though it is now different from before. Mania can be similar, if not the same, as ADD. Maybe the mood-stabilizer is prohibiting the high end of the mania and you're experiencing a different feature of medicated break-thru rapid-cycling mania.
Logically, you may have to up the anty with another mood-stabilizer. I read your other post about the dexedrine and I can relate to the night/day difference in daily life. You are taking a small dosage and maybe that needs to be acknowledged. You need to tell the dr. about these feelings and even your fears of tolerance and/or addiction. I think they could relieve your fears and possibly help get you leveled-out.
Take care.
dove
Posted by Janice on September 28, 1999, at 22:51:29
In reply to Re: Manic Depression and ADD. , posted by dove on September 27, 1999, at 9:36:19
thanks dove. I agree, sometimes the two are hard to tell apart and they do feed off each other. One way I differentiate is that the mania gives me an inflated sense of well-being (and lithium takes care of this). I have definately noticed the ADHD is significantly worse on the high days of my cycle and significantly better on the depressed days of my cycle. weird!do you think your manic-depression is a result of having had untreated ADHD for so many years? do you find mood stabilizers help with your ADD? God do I relate to the super senses. Are super-senses related to both disorders? Thanks for your help. Janice.
Posted by dove on September 29, 1999, at 10:25:14
In reply to Re: Manic Depression and ADD. , posted by Janice on September 28, 1999, at 22:51:29
Hi Janice.
I have had the adhd since I was born, according to my Mom, and the depression lows hit me hard in about 3rd grade and only worsened from there. As a teen-ager I exhibited my first mania's and I really don't know if these were caused by my hyper easily over-stimulated adhd or just the beginning of extreme mood-cycles known as bipolar. I do know that many generations in my family have the exact same combination of illnesses and it appears that you either have it all or nothing. So, there must be a connection, what comes first I really don't know. I am trying to help my daughter with this same inherited combo and it seems that the only thing that really helps with the adhd is the stimulants. The buspar has helped with the anxiety but there is this fear that it may throw her into mania at any given time just like the other AD's did.I am not on a mood-stabilizer right now and previously, when I took Tegretol, it was prescribed for migraines accompanied by fainting. The Tegretol made me into a zombie, I was in my second year of college and I was completely unable to function on any level. The adderall, in conjunction with the amitriptyline, has relieved a considerable amount of my depression. I can get all the kids going in the morning without breaking down in tears on the floor and scaring them. I have extreme difficulties with organization and I always have 50 things running thru my head at once, it takes an incredible amount of energy to have everyone ready in the morning.. I have little things I do to alleviate the pressures such as, putting all the kids clothes out the night before, having the table set the night before, everything that is needed for the following day has to be readied the night before. See a pattern :-)
I absolutely must get sleep. One night without sends me rapidly escalating into madness. If I haven't fallen asleep by 11:30pm I take melatonin and there are no exceptions. My teen years were completely deranged with one of the greatest precipitating factors being nights without sleep.
I haven't been taking the prozac yet, I am afraid of going into mania so I am taking my nightly small dose of amitriptyline and the morning/noon doses of adderall for 2 weeks. After which I will begin the prozac and hopefully not fall apart. My manias are wicked things, I affect my whole family with my out-of-hand behavior, even the mild manias cause so much distress to them,(flying to mexico with 1 days notice, shaving my head and piercing various locations on my face) maybe this doesn't seem consequential but my family feels like they're living with a freak.
Well, I've rambled on at considerable length. Regarding bipolar and the meds to treat it, I am newly initiated and am truly appreciative for any shared knowledge, perceptions and/or experiences.
dove~
Posted by Janice on September 29, 1999, at 21:22:32
In reply to Re: Manic Depression and ADD. [long], posted by dove on September 29, 1999, at 10:25:14
Hi dove,
you sound like superwoman to me. I've made a conscious decision not to have a family because i find being around children extremely hard on my nerves, plus all that mega amounts of tiny, weany
nonstop organizing and cleaning.If it makes you feel any better, I have always felt like a superfreak. I have spent 98% of my energy trying to repress myself and pass myself off as normal while despising every moment of it. I look normal and people often comment that I am charming and funny, so at least I've been pleasing them . I always thought this was the way everyone lived their lives, their fake personality on the outside, and then the real them inside (a storm brewing if not erupting). I bet you deserved that trip to Mexico.
Getting a good sleep; I've been noticing this lately too. Even if i am short 1/2 hour of sleep, my ADD is way worse. Good sleep (most important), good food, strict routine, almost okay...or as okay as I've ever been.
Thanks for the story about your family, I also suspect the 2 are completely intertwined in me also. Take care, Janice.
Posted by dove on September 30, 1999, at 10:05:15
In reply to Re: Manic Depression and ADD. , posted by Janice on September 29, 1999, at 21:22:32
Hello Janice,
Thanks for communique, it is reassuring that I'm not alone with all this :-)Yesterday, my mind went into overdrive and then dropped me hard. By 8 am I could feel the darkness orbiting around my psyche, waiting for a crack in my facade. Didn't you write about the cycling in connection to the ADD? Didn't I just offer you some advice, I think it's your turn to tell me what to do :-)
I felt so level just 2 days ago, and yesterday and today I feel like the same old me and I hate it. I had so much hope for a change, it seems like everytime I try a new med or therapist I think "This time it's going to work." And, at first it does. I have energy that isn't desperate and I feel so much love and contentment. Then, I realize that I am still me and I rapidly spiral down. Then up, then down.
Sigh... Will it ever cease?
I've written twice today and I do feel a little lighter. Do you think this is the bipolar? I think it might be, the cycle feels too depserate and irritable to be ADD. I think the Prozac alone (no mood-stabilizer) might send me rocketing.
My cycling seems to have sped up, is it the stimulant? My hands were shaking so bad yesterday after the adderall wore off. That worries me because I have no idea why that would happen. My cycle usually runs 7-10 days depressed, 1-3 days in transition (mixed) and 1-3 days in overdrive. After which, I drop like a rock over a 3-4 hour period into the dark again. I have never left the darkness after only 12 hours in it but I shouldn't complain I guess.
Maybe I'm getting better? or am I just rapidly cycling?
~dove (feeling better by the minute)
Posted by Noa on September 30, 1999, at 21:06:04
In reply to Re: Manic Depression and ADD. , posted by dove on September 30, 1999, at 10:05:15
Sure seems hard to distinguish between ADHD and Manic Depression sometimes.
Posted by Janice on September 30, 1999, at 23:43:55
In reply to Re: Manic Depression and ADD. , posted by dove on September 30, 1999, at 10:05:15
Hi dove,
I'm glad you know your cycles, this helps alot. I have/had (it is almost gone dove) 3 1/2 days up, 3 1/2 days down, just like clockwork. My ADD is worse on the days that i used to be high, and best on the days that I used to be depressed.I'm not sure which medications you're on but, SSRIs can induce more rapid cycling. Dexedrine (which is a stimulant like Adderal) completely cleared up my depression. But if you've just started taking these medications, expect a time of transition for your body and for your moods. I'm hoping this is your first stimulant and your depression clears like mine; it was like a miracle for me.
I have the impression you are hard on yourself for these mood swings. But it's all biology, I'm sure you know this though.
An inflated sense of well being is how i tell the ADD from the mania. As soon as i feel like 'I could do anything' - mania. Am i just filled with tons of good ideas - ADHD (Lots of ADD generally means a low self-esteem). This is how I tell the difference.
I've hope I've helped a bit dove. My only advice is a good mood stabilizer. Lithium stops my manic highs, and it also helps the ADD by preventing the wild swings that can occur in one day (that over reaction stuff from ADD). Janice. thinking of you.
Posted by Janice on September 30, 1999, at 23:52:38
In reply to Re: Manic Depression and ADD. , posted by Noa on September 30, 1999, at 21:06:04
hi dove, i just reread your posting down below. And I am kind of surprised you started on all these medications at once. This way you may not clearly realize which medication is helping with what. I started off on 5mg of Dexedrine, and built up to 15mg and now need more. At first I was very sensitive to it, and when it wore off my ADD was worse than ever. I'm not sure how powerful 20mg of Adderral is. Janice
Posted by dove on October 1, 1999, at 13:32:17
In reply to Re: Manic Depression and ADD. , posted by Janice on September 30, 1999, at 23:43:55
Good Afternoon Janice
I am feeling much more even today. I have been keeping track of my 'moods' ever since I started the Adderall. Writing every couple of hours, the time and how I'm feeling, even if it's only "I feel good." I think I am reacting to the stimulant wearing off. I recognized it today around noon and dealt with it and didn't fall apart. There seems to be a time period, after the Adderall wears off and before the Amitriptyline starts working, that leaves me pretty vulnerable.I think my body will adjust fairly soon and I can go from there (i.e. starting the Prozac and mood stabilizer). Today, just knowing when I was going to feel down, made for a much smoother ride. Thanks for thinking of me :-) I appreciate it!
~dove
Posted by Janice on October 2, 1999, at 22:48:54
In reply to Re: Manic Depression and ADD. , posted by dove on October 1, 1999, at 13:32:17
Hi dove,
You sound much better today. This may sound weird, but I can recognize myself in your sentences. You write, like me, with an urgency to get to the point; I can feel you rushing. This style of writing must be the ADD - I've always been very frank in all my communications. I can't afford the time not to be!
I think not taking the prozac until you get a stabilizer is a great idea. I'm glad you know now about your daughter. God, what I would have given to have known about this as a small child! I'm sure having ADHD made me more vunerable to the PSTD and caused the trichotillomania(I do this whenever i have to hold my body still, even for more than 15 seconds). Think of the grief and low self-esteem you have saved your daughter from.
Dexedrine for me - like Adderall for you, cleared my depression up completely. AFter years and years of trying this AD, that AD, all these different ADs together; all my combined ADs probably gave me only 15% relief. I use the slow-release, long lasting Dexedrine for stability; I could actually feel the cycle of the short acting one. I am curious as to what kind of medication Amitriptyline is.
I am a little curious as to whether if you can tell if your thoughts precede your depression, or your depression precedes your pessimistic thoughts. The past couple of days i've been coming to the conclusion, or accepting the fact,(I imagine this will be a process) that I will never be completely well, that at least this ADHD (I believe with medication and work, I can greatly reduce my other disorders) will always be with me. and I will have to continuously work at my mental health my entire life. Today I felt very sad for all the lives I could have had. But when i feel good, I know also with good care of myself, I can still have a spectacular life. I've just got to reign in this ADD and make the energy work for me and not against me. I'm glad you have a supportive husband. How many earings do you have? Janice
Posted by Noa on October 3, 1999, at 12:30:06
In reply to Re: Manic Depression and ADD. , posted by Janice on October 2, 1999, at 22:48:54
Janice,
I relate so much to what you said about feeling sad for what might have been.Every day, I take note of the fact that I am feeling a bit better. Yesterday, I was able to say to myself, "Today I notice a difference. I feel hopeful that my depression will be under control. I don't feel the gloom and doom". But later in the day, I started to feel sad, a sadness that felt like grief for all the lost years, what might have been if my depression had been properly treated earlier on. I recently turned 39 and am starting to feel the loss of my twenties and thirties. My early to mid- twenties were rough but after some therapy, my late twenties and early thirties were better. I had this idea that entering my thirties meant putting all of the identity formation and self-establishent issues behind me, because I had found a career and felt good about it. I thought putting these early adulthood issues behind me would keep the depression away. I would still get depressed sometimes, but I was able to get through the episodes faster, and I felt stronger. But after moving to a new city, starting a hot and heavy romance and having it end, and having a serious knee injury and surgery, my depression came back and seems to have never left. It has been 7 years, just about. So, my image of my thirties being so much better than my twenties never materialized. Now, I am hoping with the right medication, and a more realistic attitude about living with a depressive disorder, I can start to build my life back up. But I am sad about the lost years, because I lost a lot of time.
Posted by Janice on October 3, 1999, at 13:06:58
In reply to Re: Manic Depression and ADD. , posted by Noa on October 3, 1999, at 12:30:06
You sound like me Noa; I continually consider myself getting better each day. I've always considered myself to be an optimistic depressed person if there is such a thing. All those could have beens can really be hard on me. But my brain is such now that generally speaking, I don't want what others have, or even value it. Luckily by my nature I am unconventional. But like yesterday sometimes I do wonder what if... maybe without these disorders I could have been happy with a simple life. This may be some self-preservation mechanism for me, not to want what I don't think i could get anyway.Just once, for about 20 seconds, did the bottom fall out of my life; and there was hopelessness! I saw my future as a series of eternal moments like this, one after another, never-ending. It was unbearable and unbelievable. I went right back on my lithium and have stayed on it since.
God, how could you become realistic about having a depressive disorder? What would this entail, Noa? I can accept living and working with my ADD for the rest of my life (without depression it's not unpleasant). But depression seems to accompany all the disorders, so I too have been battling it all my life. And I have been successful to a large degree; but, presently, if i do not have it, I am living in fear of it. Do professional people, or experts (this is you and me-unopinionated at the time) suggest this - to become realistic about living with depression. Isn't that giving up hope willingly? Janice.
Posted by Janice on October 3, 1999, at 13:09:47
In reply to Re: Manic Depression and ADD. , posted by Noa on October 3, 1999, at 12:30:06
it's great you have a career you enjoy.
Posted by Noa on October 3, 1999, at 17:07:42
In reply to Noa, did you get out of the house this week-end..., posted by Janice on October 3, 1999, at 13:09:47
Thanks, Janice.
Realistic...let's see. I guess what I mean is acknowledging that it is chronic and cyclical, because I used to hang on to the hope that "this episode will be the last" and then I won't have depression. Now I know that that hope was part of the problem. It is hard to explain. I guess it made me live in fear and experience an extreme sense of failure each time I got depressed, because I had hoped it was gone forever. Now, I am working on accepting that it is something in my life. I am hopeful that I can get it more or less under control with meds, but I don't expect to be able to be med free. I don't really know if that hope is realistic, but I gotta go with it. Learning from people here about all the options has helped.
Yes, I got out. I went out yesterday and did some errands, and even bought myself some clothes. Today I was supposed to get together with a friend, but had a bad stomach cramp, I think from some stuff I ate yesterday. I am very disappointed, because I was feeling like going out, which you know is a recent development, and it feels like I missed out on a great day--great weather, being outside with a friend. Oh well.
Posted by Janice on October 4, 1999, at 22:26:56
In reply to Re: Noa, did you get out of the house this week-end..., posted by Noa on October 3, 1999, at 17:07:42
hi Noa, at this point, I can't stop fighting. I am more than fine with having to take medication for the rest of my life. One thing i do notice is that it is very hard to somehow not feel responsible for it (the mental illnesses). As educated as I am, I know how to think about all this, but emotionally, I still somehow, somewhere inside myself feel responsible for it all; like somehow this is my fault, it must involve me having a faulty moral character or something. I think this could be what I believe on some level.
Buying clothes is a great sign, Noa! this would mean for me, I am feeling fine. Sorry about your stomach. It must take alot of courage to accept that it may come back again. I hope science can find us all a cure for this within the next couple of decades. Janice
Posted by Noa on October 5, 1999, at 4:13:04
In reply to that's a hard pill to swallow..., posted by Janice on October 4, 1999, at 22:26:56
For me, accepting the depressive disorder as something to grapple with indefinitely is tied closely with avoiding blaming myself for having depression. I know they don't necessary have to be paired, but because I used to hope so fervently that each episode was the last, I would blame myself and feel like a failure when the next episode came around.
Posted by terraflux on October 7, 1999, at 17:41:19
In reply to Manic Depression and ADD. , posted by Janice on September 19, 1999, at 16:48:16
If you dont like Ritalin or Dexedrine (none of which I tried to be honest), you might wanna check out Nootropil (piracetam), taken together with Choline, and you could add some Omega-3 Fatty Acids, Glutamine and Chromium. These are all fairly proven things to take. The Nootropil and Choline is energising and helps with concentration, do some research on the web about dosages etc. You might find that soemtimes it energises too much, in which case you might wanna try Kava Kava to chill you out.As for depression, try going the Tryptophan route (or 5-HTP) initally with the Piracetam, I have previously had very good results. ADDers often get depressed about the lack of energy and ability, and once ability is back up the depression will lift.
I hope this helps in some way. Keep trying. Also, I bought a BRILLIANT book called "ADHD in Adulthood" by John Hopkins University Press... it's a bit pricey (41 Pounds in the UK), but well worth it.
cheers,
Posted by Janice on October 7, 1999, at 20:12:44
In reply to ADD meds, posted by terraflux on October 7, 1999, at 17:41:19
Hi, thanks for all the information. I will keep it in case I have to give up on the Dexedrine. I'll look into some of your suggestions. The only substances you mentioned that I know are the Omega 3s and Kava Kava. Perhaps medications are called different names in Britain than in Canada. Janice.
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