Finding help after ADHD diagnosis post menopause

[JacksonB]

I am a 67 yr old female who has had a rough 16 years since menopause, with still no resolution for the correct meds for me. I was put on antidepressants at the start of menopause at 51, then wasn't diagnosed with ADHD until 61 - after 10 years of utter brain fog and apathy (and lost 4 jobs in a row). I was only prescribed Wellbutrin 150, 300 and even 450 for the next 18 months but felt no change. When I protested I was "allowed" to try 10 mg of Adderall and my brain was so calm I thought I was falling asleep, but instead just calmly went about doing every errand I had planned for the day. I don't remember how I felt on day two, and I know that within a few months did not feel it was working anymore.

Then my insurance changed and the company found a REAL ADHD psych who could help me determine the right dosages. I was on 50 to 60 mg of Adderall for 1 1/2 yrs until my doctor wanted me to try Vyvanse because it was "smoother." I was on 50 mg for 6 months and felt no motivation and had brain fog again! When I turned 65 I went on Medicare with Kaiser. Since Vyvanse was not working I requested to change back to Adderall and, because the drs in the DC believe stimulants are over-prescribed (!!), they would only change it to 25 mg Adderall XR.

I have switched to another plan and am trying to get my life back in order, but am finding that none of the medication management drs recommended by my Medicare insurance company, nor the medical group my primary is associated with, will take Medicare, or are not taking new patients, or don't treat adults. The doctors I have previously seen do not take Medicare and charge out of network prices. I am seeing one of them because I have no other recourse. Why why why are those of us over 65 ignored by the medical establishment?? Especially since, as one psychiatric nurse explained to me, estrogen binds dopamine to neurotransmitters so it follows that with 65% less estrogen that a more specific treatment should be prescribed. But no psych's, not even the female ones, even know about this so are of no help.

Has anyone else found a doctor who understands how to treat post-menopausal women with ADHD? I want to be a productive member of society again but feel as if there is no one who understands how to help me.

[mer3]

I actually was not even diagnosed until I was in menopause. I am managing fairly well on Methylphenidate ER 40 mg and Wellbutrin 100 mg. I take both in the morning. However, I have wondered whether another way to approach this would be to talk to your OBGYN about hormone replacement. I haven't had time to research the pros and cons, though. I think what happens to many women is that after menopause their ADHD gets really bad, but because they are older, others mistake it for early aging or demention symptoms. I have seen and heard very little awareness about this issue.

[JacksonB in reply to mer3]

I'm glad you have found the right meds combination, I have had mine changed every year or two and am still trying to find someone who can truly help me! I was already 10 years past menopause when diagnosed and heard that hormone replacement therapy is key - but you have to start it while you are going thru menopause, not 10-12 years later.

[mer3 in reply to JacksonB]

I know that is what they say, but I am gathering information to challenge that. I know it is not common practice, but so far nobody can give me a reason why that is so.

[SleeplessinMaryland]

I really feel for you. That is so frustrating I'm sure. I wanted to make sure I was understanding correctly - did you say that your primary care physician would not prescribe your medication for you? You live in the D.C. area?

[JacksonB in reply to SleeplessinMaryland]

Hi, no my primary care doctor can prescribe everything other than Adderall, and maybe clonidine for Rejection Sensitive Dysphoria. I have been trying to find a psychiatrist for medication management who is In-Network with United Healthcare to manage my Adderall prescription and to write the scripts. I was directed to a program at UMD College Park but they wrote back and gave me a dozen names of places for meds management in Maryland, but I live in Alexandria VA. I will persist that United Healthcare find someone for me that accepts their insurance! And to add another wrinkle, I am interviewing for another job in my field and am terrified that I will fall into the same pattern I always do after 18 months of employment - by then I have become frustrated with hierarchy, and politics, and back-stabbing, and egos, and just wish everyone would support everyone else instead of wanting control... and I am usually bored....! So I want to find a coach to help me with every learning transition I have to go through in order to stay employed!

[Maker61 in reply to JacksonB]

I feel like I may have written your post. I joined this group 3 days ago and this is my first time reading posts. I’m a 58 year old woman who was diagnosed at age 50. Despite meds etc I STILL feel as you do. Right now I want desperately to leave my company for another job that’s more challenging and leverages my experience but (in addition to they’re being zero market for a woman my age), I dread changing jobs because I know I’ll go through the same cycle you describe all over again. It’s a struggle I can’t handle again - the humiliation and frustration is unbearable.

My dr is in Bethesda - wonder if she might be in network - Dr Nancy Clark. I only see her for meds, no counseling (which I need but can’t find someone in network!)

You are smart to look for a coach - I am seeking the same as I’m desperate for coping mechanisms .

Hang in there - hope you get the support you need to succeed and be sane!

[mer3 in reply to Maker61]

I am in the same boat. In a dead end boring job with great benefits. But OMG, I'm going to die from boredom. As I do my Wellness Recovery Action Plan daily plan, I realized that I keep solving this dilemma with sideways moves that only help for another 18 months until I get bored with the next job. I decided to do what Stephen Covey recommends in his book First Things First, and do exactly what I've wanted to do for years. I have reframed my current job in this way. One of the good things about my job is it only takes 30 hours a week. Any lateral new job will take up over 40 until I get proficient. Therefore, I spent 5 hours yesterday working on my unfinished grad school thesis which I hope will become--STRIKE THAT-- which I plan to publish in book form eventually. Therefore, I am choosing to stay at my boring job, because I am going to go around with a secret smile on my face because I am working on my book. Again, I also love the affirmation in the title of another book that makes me want to go for it. This one is called The Gifts of Imperfection: Let Go of Who You Think You Are Supposed to Be and Embrace Who You Are by Brene Brown.

[SleeplessinMaryland in reply to JacksonB]

I am sorry you have United Healthcare in this situation. My son also has United Healthcare and needed a provider. He went on the website and searched for one near his home. Many names were in the directory near his home. It turns out that none of them accept United Healthcare any longer. Then why are they in the directory? Did they fail to inform UH? Did UH fail to update their website? Who knows? All I know is that it is very frustrating for the subscriber who is looking for treatment. Especially, when they have two or three minutes a few times throughout the work day when they can get on the website and perform a search.

The reason I put you through that whole boring explanation is so you would understand if the names I give you do not pan out. I did find one for you to call in Alexandria. Spencer Marcus, M.D. [phone]. If that does not work out, let me know and I while find another person for you to try.

[JacksonB in reply to SleeplessinMaryland]

Thanks for the refferal!

[JacksonB in reply to JacksonB]

I finally bit the bullet and went out of network, to Kathleen Nadeau's Chesapeake Center in Bethesda. She wrote the first book on Women with ADHD, I am "seeing" a doctor in her Women's Clinic, but it is $225/month. Since she does therapy and meds I only get 20 minutes of therapy because she wants to discuss meds at the end. I may go back to another out of network dr in DC who has an Adult Anxiety and ADHD Clinic, where fees were only half for the same visit time, but parking there is always an issue. She only does meds, not coaching, so I would need to find a coach - and they are all out of network too.