Adult ADHD Treatment Challenges - CHADD's Adult ADH...

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Adult ADHD Treatment Challenges

ScientistWithADD
ScientistWithADD

Got my diagnosis 8 months ago (Inattentive) and have only seen one doctor. I've taken Adderal, Adderal XR, Vyvanse, Lamotrigine, Bupropion, and Bupropion SR. My doctor thinks I have Cyclothymia and Depression while finding the treatment for ADHD. I don't think any of these medications have worked for me so far and I don't think I have any other disorders other than ADHD. Currently doses:

Adderal - 50 mg per day

Lamotrigine - 100 mg per day

Buproprion SR - 200 mg per day

My doctor says we have tried everything and the treatment is working but I don't think the same. She also says it is not working as well because I am not getting therapy but I don't have the time for that right now in life and I feel the medication should do at least something without therapy. We haven't even tried Methylphenidate yet. Suggestions on what I should do? Should I try finding a new doctor? I find that very hard to select a good doctor. She went up to the 50 mg on Adderal very reluctantly and I still don't think it helps me.

13 Replies
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Hello, Scientist with ADD~

Welcome to the group. Medication ALONE is NOT going to cure ADD. You need to also change behaviors and use strategies that work in life.

Thing of it like having diabetes. Sure, you can take insulin, but if you're eating sugar donuts and cookies, you are overloading your systems and you're going to kill yourself, or start losing body parts.

ADD is going to still be there whether you have time or not, and there is no "good time" to have it. 50mg of Adderal is A F** lot of medicine in your body. MAKE the time to change your attitude AND behavior. It's scientifically proven that ADHD or neuro-diverse people have smaller frontal cortex in our brains, along with other brain areas plus we lack a lot of executive functions.

You need to do these things NOW:

1. Get a referral to a good ADHD therapist!! NOW.

2. If you don't believe me, who has had ADHD my whole life, I recommend that you pick up the book called "Taking Charge of Adult ADHD" by Russell A. Barkley PhD He is an internationally recognized authority on ADHD.

3. One of the first things people do with ADHD after diagnosis is anger and denial. I went through that too about a year ago... After sitting on my pitty pot and having my own little pity party... "Oh, it's dehabilitating, I can't do anything... poooooor little me"... I finally decided to educate myself about what ADHD is and went to a Cognitive Behavior Therapist. While she was pretty sucky, (ended up finding someone else), I learned about strategies for dealing with ADHD and got a book called "Mastering Your Adult ADHD A Cognitive Behavioral Treatment Program, 2nd Edition by Steven A. Safren, Susan E. Sprich and more.. HELPFUL STRATEGIES when you have ADHD.

4. Don't consider yourself too smart to learn anything new. My fiance is also a scientist with an IQ in the high 160's and he's super supportive and helpful to me. He also knows that medication alone will NOT achieve a better life all by itself. If there was, don't you think a non fat pill would have been invented by now??? It's called exercise!! There's always someone out there who knows more than you will in a certain subject.

5. Last; Excellent resources include: ADDitudeMagazine additudemag.com/

ADD Organization with links and other great resources: Http://add.org

I'm just here to help, and hopefully get you going in a good direction. Good luck on this awesome journey of life.

Take care~

GatsbyCat

Thank you for sharing your views and what you have learnt over time. I agree with all of that and have never thought I am too smart to learn more. That is why I came here and continue to keep putting myself in situations that challenge me to not stop. I am finishing research for a PhD, supposed to have a major chunk of my thesis written (that I haven't been able to start), messing up at the lab running a lot of experiments because of the condition, loosing focus while writing research articles and researching, doing a job while doing all this, and had our first baby a few months back. I am not saying I don't want to take out the time, I am not able to do it right now because it is the last couple of months for me to get through a lot of things. I have tried CBT through an app, with a coach call every week for 8 weeks (ended the program after week 7), I have tried to accept challenges to workout and been very regular to compete and have stopped now when the time is such and the challenge isn't there anymore. I am not trying to have all my problems resolved with a pill, but I would expect at least some change to occur after getting on a medication. And if the 50 mg is not doing that, should I not be put on the other category to see if that will work?

I am sure this group will be a great resource for me and I will incorporate the suggestions you shared. Thanks!

I truly understand your concern with your meds. 50 MG of adderal is a good amount to have in your body. I understand that U R busy, but out of experience, I would definitely recommend therapy. Since I'm on Medi Cal, and it is the time of COVID, I am only able to have telephone therapy sessions with my shrink once every seven weeks for only 20

minutes at a time. This doesn't please me but I do understand what is going on. Also I have been seeing my therapist for 4 years for about 4 years so we have a solid understanding.

U can also learn to use cognitive therapy which can help rein U in and focus on what is

bothering you. Also I don't know where U live but there is NAMI, National Assn. of Mental health, where they can listening and hopefully interject on the issues that R of concern to U.

Also, I don't know your age, but if U R over 50, there is an organization called

Golden talk, where the listeners who R not psychologists, but have been trained by therapists, R very compassionate. Usually these sessions can only last for 15 minutes,

so please time yourself according as to what issues U which to speak about with the intake assistant. Good luck, I'm in your corner. Stay safe.

You might need an antipsychotic. The guideline is usually to take care of the depression first, then the adhd. At the end of the day, everything needs to be balanced. If depression isn't treated enough, it will affect the adhd. If adhd isn't treated enough, it will affect the depression. I have bipolar/adhd, and for me, everything works in tandem. If my depression is bad, it will make the already low motivation even more difficult to deal with.. If the adhd is acting up, it will affect my self confidence which will exacerbate the depression. Good luck in your journey. I wish you all the best.

Thank you and I will discuss that with my doctor. Although, I don't feel that my Depression and Cyclothymia diagnoses are correct. I feel that way because I have always been a very positive person. I have been emotional, but not negative, neither do I have depressing thoughts. This was true before the diagnosis. I feel some of ADHD symptoms were thought to be symptoms of depression because there is an overlap.

When I was diagnosed this year (age 32), it was like my entire life played in rewind and explained so many things that happened when I was a kid. Different from a lot of adults diagnosed late though, I was not angry, I just thought I got a lot of answers just by the diagnosis. I did thought that there were some things I could have done better if I was receiving treatment then, but I wasn't really sad about that. I guess that is another behavioral trait showing I don't have depression.

Bipolar and adhd symptoms can be eerily similar. In my previous post, I mentioned how you treat the depression first, then the adhd. In your case, it may in fact be the opposite - to treat the adhd first, then the depression. Everyone is different. If you truly feel that the adhd meds aren't enough, try asking your doctor for genetic testing. You might be a rapid metabolizer and need a higher dosage. Or you may in fact need a different medication, as you stated. Usually adhd'ers respond much better to one than the other. In my case, you couldn't pay me to take ritalin again. I made me feel terrible, whereas adderall is much more compatible with my personal biochemistry. You may be the opposite of me and have a better response to methylphenidate meds. If your doctor is good, he/she should be open to trying it out. I've been to bad doctors that say "well, if you're having problems with one i don't see how the other will be much different." BS. There is a difference. I wish you the best of luck and keep me updated!

Those are some really great points! Thank you!

I didn't know I could ask for genetic testing to help guide the dose! I also know now what kind of response to keep an eye out for to see if I need to change my doctor :)

Hi 👋 it’s shnookie again. Happy 😃 I could help. The good thing about this group is that we R supportive of each other and bring our own life experiences into the conversation

that is exactly what I had been looking for!

Great! Your input especially with a scientific perspective is a good addition to the mix

When your doctor says "the treatment is working," what does she mean? What effect is she seeing? You say you "feel the medication should do at least something without therapy," so it sounds as if you're just not feeling any effect from it at all. I mean, sure, medication isn't everything, but if it's not anything at all, that's a different question. So first, I would want to get really clear with the doctor what effects she thinks the meds are supposed to have.

Also, since your doctor is saying cyclothymia and depression, which don't ring true for you (and I have been exactly there), it sounds like she's working from an out of date definition of ADHD. Nowadays "emotional dysregulation" is understood to be part of ADHD. It's relatively new research, though, so probably a lot of doctors are out of date. Ask her to look at this: apsard.org/adhd-and-emotion...

For me, I feel like I need a doctor to convince me of the diagnosis before I'm willing to take the treatment -- she needs to hear why I think it's this and not that, and then she needs to take the time to make sure I understand why she thinks it's that and not this. And if I think she's wrong, especially after trying what she prescribes and it's not working, then I'd want a second opinion. I mean, obviously not if a diagnosis is based on a lab culture or something, but this is based on your subjective experience -- so your subjective experience needs to be paid attention to!

So -- can you get a second opinion? Tell your PCP how this is going, and ask for a referral for that?

Good luck!

That makes so much sense and those should’ve been my questions. Instead, I was thinking of experiences to share before each appointment that I thought were symptoms.

I have an appointment this week and I will try to ask all the right questions and if it feels like she is not willing to consider my approach, I’m getting a second opinion.

Thanks!

Hey, ScientistWithADD~

Sorry if I was too hard on you in my first response. It just sounded like you were not willing to put any time into therapy at all, and that you felt the meds should completely "cure" you.

One thing to note, and you may already know this, is that it does take a couple of weeks or more for new medication to "work". Agree with our other members that you might want to switch doctors if you are unhappy with her diagnosis, as it does sound outdated.

Unfortunately, many ADHD patients have to try different medications to find one that is just "right". If your doctor is able to answer your questions satisfactorily, then you may consider staying with her.

BTW, there are online ADHD therapists, as well as ADHD Coaches who have great backgrounds, and are very effective. Here's a few links for you to check out:

e-counseling.com/alp/online...

expertadhdcoaching.com/

psychologytoday.com/us/ther...

Good luck to you.

Best~

GatsbyCat😃

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