Help getting ADHD meds?

[distracted2019]

I was diagnosed with it but was also diagnosed with depression and anxiety. Psychiatrist would only prescribe meds for depression, said we needed to work on that first. I am desperate to get a handle on my mind because my life is literally falling apart. I'm depressed and anxious because I can't concentrate enough to even manage my finances. I guess I made the mistake of asking for ADHD meds. Apparently what you ask for you will never get. Is that the way it works?

[Jezzibird]

It really depends, were you able to take a symptoms test, I space what it's called at the moment. I quit taking my meds when I was a kid but having a clear diagnosis at a younger age made it much simpler to resume my treatment as an adult. I did however a few close friends take a symptoms quiz for me on what they saw in my family life and interactions, an employer as well could fill out the same form. Having others around you with contact information on the form can back tour concerns. Also there are so many options for medications that are not a stimulant that there is not reason they couldn't start you on a low dose of something. If they really wanted you to start there then they must have had high concerns. I know my husband has said that my emotional withdrawal from rejection sensitive dysphoria sounded very close to suicidal in my frustrations with myself. Even though I never felt "suicidal" I have thought that my families life would be easier without having to deal with my struggles, impulsiveness and failures and that led to me being very depressed but better ADHD management helped with that. Often I have needed both meds to cope.

[HadEnuf]

When ADHD is involved, “working on the depression first” is frequently like giving Percocet for pain to someone who really needs emergency root canal therapy: frequently, the depression and anxiety are CAUSED by the consequences of ADHD “hard-wiring” in a world custom made for neurotypical brains.

Unfortunately, those who only see the symptoms from the outside have no idea how badly unmitigated ADHD screws up day-to-day life—how much failure, fear and genuine danger it generates.

Also, the most popular antidepressants (SSRIs) are precisely wrong for many ADHD patients: cranking up serotonin can suppress dopamine, making the primary neurochemical imbalance even worse.

However, there are ways to treat both symptom sets under the appearance of attacking only the depression: certain medications used for “atypical depression” target different neurotransmitters—including dopamine—and in the case of ADHD, often help ease it, too.

Indeed, I returned to bupropion (Wellbutrin—labeled as an antidepressant) after several years on stimulants, when my extended-release methylphenidate (Concerta) failed to appear in a urine screening: it eases the same problems, for me, that stimulants did—as it had done, before. (I had tried the stimulant treatment in hope of broader efficacy that never materialized.)

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HadEnuf

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P.S., The screening had become required (for political reasons), in Indiana, by the time I moved back there, for a year; but, regardless of that, if medication wasn't showing up in its normal, excretory path, I didn't want to find out the hard way what damage it might do, going wherever else it was!

[quietlylost]

I've had a similar experience. The only thing I can really say is to be patient. Doctors are reluctant to rush into prescribing controlled substances, so it takes time for them to trust you and also for them to feel like they've come to the ADHD diagnosis themselves. At some point you can be an advocate and ask to treat both at the same time. That's really the only effective way to get both issues better anyway.

There are also antidepressants that can be used to treat ADHD, specifically Wellbutrin. I started on that before I moved over to a stimulant. While you're treating the depression, also take note of the ADHD symptoms you still notice and bring those in to your sessions. "My sleep/mood is better, but I still keep losing things, can't sit still, etc."

Try not to get discouraged. It takes time. But it can get there.

[Lujan]

I’m here trying to reach out and was moved by your blunt honesty and sincerity. I hate that it’s so hard to get treatment, but I feel like I’m not alone. I just have a hard time dealing with time. How hard must we try. 2 years I’ve been fighting to get treatment. And it’s like I’d rather just get Adderall off the streets or even turn to meth. It’s like I understand Adderall and Vyvanse are drugs but if drugs are what I wanted I wouldn’t be going to a dr.

[Cmcastle317784]

You are not alone! I went through this being diagnosed as an adult. They wanted to give me all kinds of Benzos and depression meds, when that wasn't even the problem, the anxiety was from the untreated ADHD! Keep trying! I finally found a doc that did not do that, you will too! I am here if you need to talk!

[nk1820 in reply to Cmcastle317784]

I am hearing much of what I been experiencing. I’ve been taking adderalxr for years, and for the past three years, a doctor prescribed Viibryd 20mg, the 40mg was too much with Adderal but I question the efficacy of the Viibryd. My biggest issue is getting started each day being retired. I think that I need more life skills than meds. I need help at life and learning the “norms”. Being kind and helpful to myself as I am with others.

[Giggles0303]

I think the best idea is to talk it out with your psychiatrist. They seem to think that treating your depression first is a good idea, maybe find out why that is and explain to them that you think the ADHD is a bigger problem for you. I suppose that to them, depression seems more urgent because it can have more dramatic effects (self-harm) but maybe if you point out to them that you think the ADHD is the most likely cause of the depression and anxiety then you can convince them that treating the ADHD is more important.

I'd use the term 'treatment' rather than 'medication', just because ADHD meds are so often used as recreational drugs, a lot of doctors have an inbuilt suspicion if you just come out and ask for them. The psychiatrist doesn't have a stranglehold on your treatment, you aren't in a mental facility, you can and should still make your own choices about your mental health. If you've been diagnosed with all three then I see no reason why they can get away with only treating one of them if you haven't chosen to.

And I would seriously consider talking about non-medication therapies. There's a bit of a stigma against them, but when treating multiple conditions it's probably your best solution if you can't take medication for all of them.

If your psychiatrist refuses to budge on the depression thing then maybe they aren't the one for you.

[distractonaught]

Hi there (great name btw). I'm a bit confused, because if you have an ADHD diagnosis in the UK I assume, you should be getting access to meds as part of your treatment. I don't understand why your psychiatrist wouldn't prescribe them, particularly if you asked directly.

Is there any option to change and see another doctor? Are you seeing a general shrink? My worry is that some don't go in for treating ADHD at all, and you may be better off seeing a specialist or at least a generalist who understands ADHD a bit better than your current doc. Most will be aware that fixing the ADHD symptoms generally leads to overall better wellbeing and reduction in symptoms of other MH problems.

[JacksonB]

I wasn't given the option of stimulants at first either - I was on Wellbutrin for 150, 300 and then 450 mg for a year before they understood me when I said IT DID NOT WORK for my ADHD. You have to go through the paces unfortunately, but hopefully for only a few months. And make sure the anti-depessent is a LOW dose. Even after being on stimulants for 5 years, when I changed health insurance to Kaiser here in DC I found them to be dangerously unknowledgeable of ADHD (everyone had a 30 minute class) and fearful of medicating for ADHD, and they had a random limit for stimulant scripts - only up to 30 mg no matter what the stimulant or YOUR NEED. What are they prescribing for you? At menopause my dr diagnosed me for depression and anxiety (this is typical for women with ADHD!) and put me on a 40 mg SSRI which completely clouded my brain and I could not hold a job for over 10 years until i was finally diagnosed with ADHD. Let me know if you want some more suggestions than those already given.