I'm wondering if anyone here has similar experiences and could share their advice.
I was diagnosed with inattentive ADHD 3 months ago and was put on concerta. Throughout that time, I focused so hard my shortfalls as a person and mistakes I made throughout my life. I realized that I focus a lot on the negative and anxious thoughts. I was prescribed Zoloft a month later to help with that.
Previous to my diagnosis, I didn't even realize I was an anxious person, but it has been a driver for most things I've accomplished.
One of the biggest issues for me throughout my life has been fatigue, my short working memory and free recall of information and memories. For example, random facts, conversation topics, directions in my own city. Common ADHD problems.
I was hopeful that medication would have helped this, but I haven't seen much improvement. I find the side effects of Zoloft have outweighed any benefits. Rather than continue upping my dose, I'm trying to reconsider my options.
Thank you
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Jroc1080
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Hi there!There is hope! There are other medication options.
I have ADHD, primarily inattentive type, and since my diagnosis, medication adjustments have been made at every single dr appointment. Wellbutrin has been a huge help with my anxiety and negative thoughts, on top of another antidepressant. It also helps counter act any negative effects a stimulant might have. The first stimulant I was prescribed heightened my anxiety and paranoia, and an a conversation with my psychiatrist about the positives and negatives helped her identify what would be most helpful. Finally in a good place, one year in.
It takes time, and a knowledgeable psychiatrist who is able to listen to you and roll with the punches.
A new ADHD diagnosis takes time to adjust to. It's common to have feelings like, "Why didn't anyone catch this sooner?" Or like, "My life could have been so different."
You can expect to experience the grief process (any or all of feeling: denial, anger, depression, bargaining, acceptance). Grieving iss not a straightforward process, and we don't just grieve over lost loved ones, but also over bad experiences and also "what might have been". I've learned that recognizing that I'm grieving, and getting therapy when I need it, helps me get to acceptance sooner. I also consciously chose to accept my ADHD diagnosis as my new normal.
Getting stuck in negative thoughts might be "ruminating". This is often associated with anxiety or depression, but frequently ruminating is also a common experience among people with neurodivergent conditions, including ADHD, autism, and I think also OCD. (I observed this based on what people have shared on forums like this. I don't know offhand what research says about this shared experience.)
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It can take time (months, or even years) to find the best medication for you. Try to keep notes of how each medication affects you. Share your observations with your doctor. This can be useful feedback on how well the medication is working for you, and whether a change or adjustment is needed.
You may need to try other dosages or other medications. I had to change medications to get the treatment I needed.
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My ADHD medication story:
(TLDR: I had to change to a non-stimulant.)
I originally started on an SSRI for anxiety (Escitalopram, aka Lexapro) and a month later started on Adderall XR . The SSRI helped greatly, reducing my ADHD symptom severity back to my baseline. (Severe anxiety had magnified my ADHD symptom severity to at least 3 times what's normal for me.) After months on Adderall XR, it was obvious that it wasn't the best medication for me. It treated some of my symptoms partially, and others not at all.
During my early learning process about ADHD, I watched lots of ADHD videos on YouTube and read/listened to several books. I got to trust info from Dr. Russell Barkley, an ADHD researcher (who is now mostly retired). One topic he covered in a video is another condition called SCT (Sluggish Cognitive Tempo), which appears much like inattentive ADHD but has it's own distinct symptoms, and is often comorbid with ADHD. I recognized that I had all the traits of SCT, as well as Inattentive ADHD.
* Dr. Barkley said that the research in SCT found that it responds well to atomoxetine (Strattera), a non-stimulant ADHD medication.
* Note: SCT has been researched for over 20 years, but it's still not a recognized diagnosis in the DSM 5.
When it came time to consider other medications than Adderall, I asked my doctor to try me on atomoxetine, he agreed to give it a try, and in less than a week I was already experiencing more improvement with my ADHD symptoms than I had on Adderall. By the end of two weeks, I found it was twice as effective for me as Adderall was. I've been on it ever since (almost 2 years), besides running out once because I was between doctors, during which time my symptoms crept back.
Note: my experience with atomoxetine is atypical. Most people who take it so not experience as much in the way of ADHD symptom improvement as I do, and I have had barely any negative side effects during my time on atomoxetine (while some people experience extremely negative side effects).
Coming from a stem background as well, my mind is fairly logical, so trying and checking different medications is a challenging process for me to understand! So many variables at play and so hard to discern what is working and what isn't. I'm also very bad at identifying how I'm feeling, as well as remembering that for future reference which compounds the problem. I've been journaling, which has been some help.
The ruminating definitely strikes true and is another quality I'm trying to address.
Are you still taking anxiety medication?
How was your experience stopping or transitioning any of your medications, I've only heard the horror stories unfortunately.
I initially took the SSRI for anxiety for a few months. After two years off of it, I'm back on the same SSRI for treatment of mild depression.
It works great, but my life is busy and I sometimes forget to take it for a couple of days in a row. But the way it works, I have to keep a certain level of it in my system all the time... It's not good to miss days.
I've noticed that if I take it in the morning, then I feel sleepy much of the day. So, I take it in the evening. But if I take it too late, then I'm sleepy the next day until late morning. After two months back on it, I'm still trying to make it a part of my daily routine.
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I rarely miss a dose of my ADHD medication (atomoxetine, a non-stimulant SNRI) because I take it with breakfast. But I try to take my SSRI as soon as I get home, not with a meal.
The thing is, I'm now a divorced father, so I get home at one time on the days I'm by myself, and at different time if I have my kids that day.
I've found that mindfulness and Cognitive Behavioral Therapy (CBT) have been helpful for me with the ruminating. If I'm ruminating because I'm grieving over something, then I do my best to accept the thoughts and feelings. I cannot change the past, but I can choose to accept it, and consider myself wiser by learning something from it. (Journaling can also work well for this, and I see that you mentioned doing journaling. Write to get the thoughts out, and process the thoughts...be intentional about finding something to take away from it, even if it's relief that it was a difficult experience that is over with.)
When I'm really stuck in ruminating, I will use a grounding technique to get myself out of my head and more focused on the world around me. One exercise that worked well for me was the 5-4-3-2-1 technique:
* Name 5 things you can see
* Name 4 things you can hear
* Name 3 things you can feel
* Name 2 things you can smell
* Name 1 things you can taste
(The order of the senses isn't important. It's the process of focusing on your senses, to get grounded in the physical world, so you get unstuck from your mental world.) As someone who's naturally introverted, I can easily get lost in my thoughts. Very often, the world inside my head is more real to me than the world around me.
You said, "I'm also very bad at identifying how I'm feeling, as well as remembering that for future reference which compounds the problem."
I had to take notes in real time, which often meant stopping what I was doing (and hopefully not forgetting what I'd been doing) to write a note.
When starting a new medication, I'd try to note that I'd taken the meds that day (ideally also note at what time), and what effects/side effects that I'd experience as I'm experiencing them.
If the effect was too hard to describe in specific words, then I'd write an analogy that I could liken it to.
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In your original post, your said:
"One of the biggest issues for me throughout my life has been fatigue, my short working memory and free recall of information and memories. For example, random facts, conversation topics, directions in my own city. Common ADHD problems."
The short working memory and "free recall of information... random facts" were the first areas of improvement that I noticed on ADHD meds. (I improved on Adderall XR, but improved more on atomoxetine.)
* Before ADHD meds, I would randomly change topics 5 times in a 10 minute conversation, but not remember any topic but the one I was talking about. I couldn't remember a list of more that 2 items; if I tried to memorize a 3rd item, I would probably forget one of the other two.
* After meds, I'd still sometimes randomly change topics 1-2 times in a conversation, but could recall the previous topics and return to them. I could memorize a list of 8 unrelated items without problem (it was an actual test I conducted, going to the grocery store without a list, to test my memory).
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I've improved across the board. I still have trouble with time management and organization, but those are learned skills/habits. I haven't done much to address them, because my life has been in chaos for the last few years, and seems to finally be settling down. (COVID lockdown only added to the chaos, not caused it.)
Thank you. That's actually a very similar approach I've taken. Fortunately I've been able to keep up on it. I find my journals getting longer and in more detail every day which is good. You're probably the same as me, where you would prefer data or a graph rather than words. Tough to do with this one!
hi I had a previous question about anxiety and Concerta and the group have helped a lot with their answers.
My story sounds very familiar to yours, anxiety and fear driving me to success/ hard work without realising it.
Taking the medication combined with therapy (cbt for me, although years of counselling not knowing cause was adhd) has helped me uncover what I call inconvenient truths about myself. I don’t use them to beat myself up, but look to them as opportunities to challenge myself and shape away some of the rough edges.
I hadn’t realised how anxious I was as a person, people just saw the calm relaxed person I project. I’m now leaning into anxiety and challneg8ng some of the thought patterns that push me down that path. I’m not always successful but am getting better.
I am deeply reflective and have been journaling for a number of years, catching my triggers to ex0lore by myself and sometimes with therapist help.
That's really helpful, thank you. I'll check out some of your old posts, thanks for the pointer.Being raised in a time where mental health and medication were looked down upon makes it challenging.
Did you waver back and forth when you began medication? I imagine this is a very common occurrence.
From your experience reflecting, do you have any tips on differentiating between medicine side effects vs mental state affects? That's one of the biggest challenges I have at the moment.
it’s super tough, I really struggled trying to figure out what was me and what was the meds. When I was on adderal that was very. Clear cut.. felt anxious on low dose and then had an anxiety attack day 1 after increasing my dose. Dropped meds right away and it went away.
This time I did experiment a little with dropping my meds (was taking 2x27mg, took 1x27 for a weekend) and when I did this the anxiety stayed. Wasn’t conclusive but now I’m out the other side I can see it was just life stuff. The medication has helped increase confidence and now I’m finding that I put myself in situations where previously I would have shied away or got annoyed and not said anything. Now I will tackle the situation….it’s just getting used to the extra stress/ feelings that come from these new interactions. The CBT and reflective journally on how I’m feeling really helps.
Yes! Completely relate to this realization. For the first 8-10 years of my career, I struggled with getting out of bed on time - the commute, the workday, ugh, everything was a drag. And then I got a new job with a lot of responsibility and visibility, reporting to the ceo, and immediately I "found" the motivation to get out of bed and start work came easily to me - I opened my eyes and sprang out of bed. I was actually thrilled by this development until ten years later, I realized that I was waking up with severe anxiety and fear driving me - my stomach hurt and I was fixated on getting deliverables done because I was terrified that I would drop something and my ceo would no longer think I was the best thing that ever happened. And the more I did this, the more I sacrificed my health and wellbeing, and the more everyone loved me and rewarded me, till I developed a host of really damaging coping mechanisms, slammed into the burnout wall, and quit to work on my mental and emotional health. Then I learned that I have ADHD and the world shifted on its axis for me as I have unlearned a lot of things that actually fueled my anxiety but made me miserable.
As everyone has said, it takes time to adjust to the diagnosis and develop a new way of being in the world. You are doing it! You are figuring out what works and doesn't work for you and that takes some trial and error and really tuning into your body and experiences. I have found that working with a therapist is life-changing to get to the roots of anxiety, because we ADHDers are often carrying around complex trauma on top of masking our executive dysfunction. And finding a therapist can be really overwhelming, so let us know if you are interested in tips for that too. Sending you support.
Of course! And I did not include this but for what it’s worth: my experience with Zoloft is outdated, occurring in the years prior to that job shift in the early 2010s, but the main impact Zoloft had in me was metabolism slowed to nothing and I gained insomnia and exhaustion. I response my provider gave me Ambien, and that didn’t work out as I developed a dependence. None of that worked well for me. My body is sensitive to medication so I take a low dose of Strattera and that + the therapy + somatic practices + exercise seems to be helping. Wishing you well
that’s a great reply. I too find I’ve been masking some much trauma and have also risen in my career due to anxiety…. Feels good to slowly unmask these things and figure out what really is important.
In retrospect, it seems easy to spot the familiar story but very hard to see it when it’s happening in real time over the years. Cheers to unmasking, friend, it does feel so good.
It’s possible some of your anxiety is linked with coping mechanisms you used to get by prior to diagnosis. With time and learning new coping strategies and executive functioning skills it may reduce.
Any mindfulness or exercises that help you get reconnected with yourself will build your confidence and reduce stress. Yoga, pilates, weight lifting etc.
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