Anxiety & ADHD

[NotAChevy]

We’re all aware of folks who are suffering from anxiety and are misdiagnosed with ADHD, or vice versa. The symptoms are so blooming close that most can't differentiate between the two. And, once placed on meds, the symptoms continue, much to the chagrin of the doctor.

But, my question is this:

I've now been on Strattera for approx. 2 years now. It’s working wonderfully, and I can't find any reason to change. But, I've noticed my anxiety level rise and fall depending on my remembering to take my meds daily.

Allow me to explain:

On Tuesdays, because I don't work, I have a tendency to not take my meds. So, i notice my anxiety/ worry is through the roof by early afternoon. So, when i first get up on Wednesday morning, i take my meds and by that afternoon, it (anxiety/worry) is back under check.

So, my question is this:

Why/ how does a nonstimulant, like Strattera, balance my anxiety levels? I could see this from a stimulant med, but a nonstimulant can too?

[starsallover]

I'm trying to figure all this out also. Following this thread.

[breyerrose]

Your medication balances your deficient brain chemicals, and when you don't take it, they get out of balance and up pops your anxiety. ADHD is a real physical condition, so acknowledge that, take your medicine daily and you will feel much better all the time, not just on days you work.

[Gettingittogether]

Presumably the medication strengthens your executive function. With a strong executive function working, our brains can prioritize life. And can help us follow through on those priorities. Those effects could reduce your anxiety---which for you might be when your mind is unfocused.

Or ... could be just random: that for whatever reason, your med lowers your anxiety. I think my stimulants lower my anxiety because I feel less overwhelmed in the world.

BTW: yours is a great question to ask your provider. Now here's something strange: providers for example really don't know---I mean even the serious med scientists don't really know--why a lot of antidepressants work. Which is not to say scientists think they don't work.

There are lots of medications and treatments that through trial and error medicine has figured out can help people--even though it's not clear the exact pathway and mechanism by the which the treatment does it work.

For example, the placebo effect is real. And from what I can tell, there's no consensus on why it works.

So I would say don't get lost in your question. The more important question is that you notice that this med DOES indeed help with your anxiety and that you remember what having low anxiety feels like so that if you ever can't take this med, you'll know how well you can function when your anxiety is low.

[FocusAndFlow]

Agreed -> Don't get lost in your question, to be sure. If you're overanalyzing, which you likely are when you don't take it, that's a fairly good sign that you should take it, even on 'days off'. I do take my ritalin, for example, on weekend, but usually only the morning dose. This is because to say that I wake up on the wrong side of the bed is putting it very, very charitably. I now know that when I take it in the morning right after waking up, in 50-60 minutes, I feel better. Not because I actually feel better physically, but because I feel a lighter cognitive load; it's easier for me to focus and get things done.

All that is to say that, like all of us, you need to experiment with it a bit and see what works best for you. The above is just my example of my weekly routine and I'd rather not deal with the 'noisy brain' in the mornings, especially. I take it three times during the week (IR) every 4.5 hours, and I'm all set. On the weekends, it helps me get in the right 'frequency', per se, and it's much easier for me to manage the rest of the day, even only taking it once in the morning.

I've also noticed that even after it wears out during the week (I never take a 4th dose), and as the increased cognitive load sets in, I am better able to take out the trash, do the dishes, etc. I wasn't able to do that for the last 1.5 decades, basically, and now I take care of that to a fault. Yes, even after the Rx has worn off, and after planning, going grocery shopping, making dinner and putting everything away. No muss, no fuss. Wow. Who'da thunk.

That tells me that I'm getting better and more used to it, so overall, my overall cognitive load is decreasing, even at night after the Rx wears off. I still have to take the Rx the next morning, but days turn into weeks and weeks into months and I am getting fairly close to being my old self, and, frankly, I'm pretty excited about going beyond that here soon. I am fairly confident that I will because I now know what this ADHD thing is, how to leverage tools to stave off the various symptoms throughout the day as they present themselves (as yo know, there is a wide constellation of said symptoms, and they looooove to compound each other and gang up on us if you let them) and I have 'gotten to know myself' under this rather peculiar lens very well in the past 1.5 years. I can honestly say that in the last 8 months I've turned into a rock star compared to where I was just before my diagnosis 1.5 years ago. I can't wait to see what's next. I am very close...

Even with all that -> I still wake up feeling terrible and basically hating the way I feel, etc. Every. Single. Morning. The difference is that now I am much better able to remind myself based on that, to take the right steps, Rx and behaviorally, to feel much better in short order, and start making the wins compound instead of the symptoms.

It is definitely a life discipline. Play around with it; you'll dial it in more and more every week.

Obviously, talk to your provider. That's a general disclaimer, as I have zero (ZERO) faith in the medical community, especially psychiatric. However, regardless of my opinion of the Symptom Profeeteering, er... Health Care industry, bottom line is we each have to put in a lot of personal effort every day into getting better. It's way beyond 'having some skin in the game'. Yes, it super frustrating, causes tons of anxiety, causes us to lose sleep, self confidence, etc... until it doesn't. And it does take A LOT of time, but there is definitely a light at the end of the tunnel. Get to know yourself even better. Anxiety is also called 'the disease of having to know'. When we have increased cognitive load, the tendency is to lose executive function, and that lack of predictability feeds into that need to know wholesale. I get it now and it makes total sense. Yes, yes, talk to your provider to make sure your playing around with your routine, Rx, etc. is within the bounds of what is considered practicable/reasonable, and have fun making tons of personal progress within those reasonable constraints. The answer is in there; not just for anxiety on 'off days' with or without Rx; for everything.

To thine own self be true. That is true freedom.

Godspeed.

[ABJESO in reply to FocusAndFlow]

I appreciate having words to this feeling of needing answers. This was all cathartic to take in.

“Anxiety is also called 'the disease of having to know'.”

[FocusAndFlow in reply to ABJESO]

We're all in this together, no matter how alone we feel most or all of the time. I can't walk in your shoes, but I can walk alongside you, so we can both walk in a straight(er) line.

Happy to help.

Sursum Corda.