I was diagnosed just this last December. And am not sure if u should consider medication because my issues are mainly with mental hyperactivity and impulsivity. I can be absentminded but not to the point where I am suffering from it.
I also have glaucoma and migraines. And mild psoriasis but no systemic effects just skin symptoms.
And am age 67. My blood pressure us pretty normal but when stressed can go up to 130s/mid 80s. And my A1C is 5.7. Borderline of prediabetes. My weight is normal range.
I also have anxiety. And would want to treat that too. I guess I should go to a psychologist who is experienced on treating ADHD. The clinician is consulted cannot prescribe but I could give the doctor her letter.
But wondering if any of the above rule out medication?
But I am thinking some of my conditions may be stress related. So.perhaos treating thr cause OF the stress could possibly help?
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Hello and welcome. Medication can increase the heart rate and in some people will also increase anxiety. There are some non stimulant options available but really you need to be assessed by a clinician.
You basically have a long list of things you don't know are relevant or not. And maybe this and that etc.
What you need is a proper assessment. A proper assessment looks at all your issues and goes from there. Which may mean making more than one doctor talk to each other. If you need medication, go to someone who can prescribe it. If you are getting good therapy from a psychologist, than why not go to both a psychologist and a psychiatrist? I can't really see a psychologist who does not likely have training on drugs sending a letter to some other doctor in regards to prescribing something. Psychologists are not medical doctors. Psychiatrists are. Psychologists and psychiatrists fill different roles although they can overlap on some things.
Are you working with a doctor to address your non mental health issues? Granted, physical and mental health issues can effect each other so they are not completely separate.
Anxiety for instance can increase blood pressure and present like ADHD. As can over 2 dozen other disorders. When diagnosed, did they rule out other things? Why were you not diagnosed with anxiety? Did you get a medical evaluation with blood tests to rule out nutritional source of problems? etc.
If the hyperactivity and impulsiveness is ADHD, then ADHD meds would usually address that. But what role anxiety is playing needs to be whittled out. Is it comorbid with, or caused by ADHD? Is the anxiety caused by negative thought patterns, a neurological dysregulation, etc. A partial diagnosis and partial solution to me is just not finished yet.
Existing issues can help determine what meds to try. Adderall or other amphetamine based med I would assume to be the last resort. Higher potential for BP increase, can potentially push you over the edge into diabetes, can raise cortisol which can make anxiety worse.
Guanfacine is a blood pressure medication repurposed as an ADHD medication. Most who take it, take it with a stimulant. Some take it by itself. Can have sedative effects that most people get over in a few weeks.
Clonidine - similar to guanfacine
Strattera, technically a non stimulant but is stimulating to a degree. Has a usually small effect on blood pressure on average.
Qelbree - similar to strattera
Ritalin and other methylphenidate meds. Stimulant but not usually as strong as amphetamine based ones. Less potential than amphetamine to exacerbate existing issues or have side effects.
May be other things like Wellbutrin. It's an antidepressant that has been shown to help anxiety and help with ADHD.
Probably other off label options as well. But, not everyone responds to meds the same way. And you may need to work on multiple issues at the same time. There is something called "integrative psychiatry". Which usually included more than one professional involved in your treatment, Along with a psychiatrist they may have a neurologist, nutritionist, primary doctor, etc. on staff for a more holistic approach. Just watch out for the ones with gimmicks who try to sell you on their line of products. Look for one that is an accredited integrative psychiatry practice and look for reviews etc.
The letter she wrote was not a request for a prescription. Did not mention that. but was a description of what she observed and the results of the tests she administered. At the time I was not interested in medication and am still not sure if I should just continue with working on strategies. Maybe the latter with coaching.
I agree a psychiatrist who has expertise in ADHD and other conditions would be appropriate if i did want a prescription.
And if they tell me no I don't have it, ok. Amd if they do tell me i do, ok. ind if they say it is something else, example autism or OCD, ok. I was given screening tests for OCD and bipolar and autism and these were not detected but maybe a psychiatrist would look deeper . She said there is a faint tendency to OCD but not diagnostic level. I am not sure autism can be ruled out just by a screening test. And evaluations for that are pricey. Most adults come for these o confirm a suspicion they have autism. Why spend money to get told you are right you do not have it?
And actually on the GAD test , generalized anxiety was not detected but my regular counselor feels I have mild social anxiety and so do I. And I think it is because of my worrying how I come across to others.
I have known all my life i was different and what i seek is self awareness of what this looks like for me not a pill. Was just wondering if these could help. But you are right. They will not work if I have something entirely different.
My brother and I were both "diagnosed" with hyperactivity at ages 9 and 7 (i put it in quotes because it was the 1960s ie dark ages) by a pediatrician neurologist. I had behavior problems in school on the playground and my brother could not pay attention or finish any assignments. I was considered gifted and got As and Bs. Most school subjects fascinated me . I am a clone of my Mom. She was always in motion and never still and always busy with dozens of hobbies and her job as a kindergarten teacher and a constant talker.
I am current on my physical blood work which is basically normal. No nutritional issues. And I would have had to have had the same exact issue all my life had that been true. I see specialists for the other physical issues. These have been confirmed. With glaucoma I do not need to borrow trouble by claiming additional issues. I have enough worries with that.
My conversational interrupting does not ebb or flow with my moods or level of relaxation and feels hard coded. Like if we were all YouTube videos most people are 1.0 speed. Some are slow paced at .75 or even. 5
I am a 1.25 or 1.5. And I have to concentrate to bring it down to a 1.25 speed. But it requires energy.
If it were environment. Upbringing. I could code switch as needed and decide not to do it. I suspect my environment did not help as my parents regarded my patterns as just normal. They could have trained me better to slow down but never saw an issue until school.
It has been like this all my life. I also concentrate on not fidgeting. It is not a tic. I can stop it. But it happens much of the time no matter if feeling relaxed or not.
I can conceal by moving my feet in my shoes unseen. Even when I read or go on my phone I think the typing is also a form of fidgeting.
I have been exercising more recently and find it feels like an unmet need to be in motion. It does not fix the fidgeting but it helped me realize what is behind it
I do not feel agitated or hyped up and my moods are pretty even.
It just feels normal for me to do this. I think it is my mind's way to help me take in the data that is coming in and to listen if it is words coming in. It is not a habit. Also I understand the social nuances and rules. I just get ahead of my restraints amd I break these.
When I interrupt I have learned to stop as soon as I am aware and apologize. "I am sorry. I cut you off. Please continue!" But I need more help to try not do DO it without devoting so much energy to it.
Based on writing this response and the helpful info you gave I think I am going to go with coaching not medication.
Whether I actually have ADHD or not o think that coaching could allow me to accept my being different but find ideas for how I can work on traits that impact others negatively.
Your response is refreshing. Sound a lot more together than the original post.
The thing with medication, if it doesn't work, you can just stop taking it. So, you can approach it as a trial period, an exploration. And make a decision based on the results. Just keep in mind, some people may respond better to one medication or another. So if you don't like the first one, don't just write them all off. Sometimes a therapist will tell you the side effects are strongest at first, it may take a week or 2 to get used to them. If something seems too strong, just tell them you would rather try reducing your dose first. Something like Ritalin, Adderall IR or other immediate release non-enteric coated pill you can usually just take a pill cutter and cut it in half. Many have a score mark to make it easier to break. Adderall IR for example usually has score marks. You just put your thumbs on either side of the score, and push down. No need to even cut it. But Concerta, absolutely cannot mess with the pill because it has a specific design that gets messed up if the pill is broken. Adderall XR, Strattera, Vyvanse, can empty half the capsule into apples sauce or something and swallow it. As long as you do not crush any of the spansules.
Obviously I am not a doctor so best to talk to them first. No guarantee they will not just default to don't alter the meds. They don't' always know themselves what can and can't be done and may err on the side of caution.
If an amphetamine based medication comes up as something to try, definitely go with Vyvanse over Adderall, Dexedrine, Zenzedi, Evekeo, etc. Least chance of side effects or building tolerance, or being over stimulated.
You do mention a lot of ADHD common behaviors/symptoms. Also, symptoms going back to early childhood is one criteria for an ADHD diagnosis. So, nothing off hand that is a flag saying to look for something else. I grew up in the 80s. Had seen therapists a couple times for other issues. They never realized I had ADHD. Or my brother had ADHD and Bipolar disorder. My brother was either hyperactive or combined type in adulthood. My brother did have behavioral issues and did go to the special Ed classes because of that. Me being inattentive type, by comparison, they never realized I had ADHD also. Even then, no one believed me the first time I told them. Had to explain and give them examples. Then it made sense to them.
They know a lot more now than they did back when you or I was growing up. And therapists and other people have much more exposure into identifying related behaviors. The biggest thing was the push I think in the 2000s that made ordinary citizens aware of ADHD.
Looks like you are already aware that self awareness is one of your best tools. So you can catch yourself and reset as needed. That was something I learned in increments during my life. There are plenty of tools that you can develop working with a therapist to manage symptoms better. It also helps to just talk about life and they can often point out were we have negative or dysfunctional thought patterns. Which helps with new avenues of awareness,
"accept my being different but find ideas for how I can work on traits that impact others negatively."
People with ADHD often "monitor" things. We self monitor during interactions and use some of our attention to assess or behavior in real time, how we act, present, react, respond, etc. We also use some of our energy and attention to monitor others we interact with. We try to guess what they are feeling about us and what they think of our behaviour, appearance, etc. Which can also be a reason some of us do not do as well interpersonally, as we can't always give our full attention. It is often divided and used to "monitor". Which can also make us self conscious due to our less than stellar performance. This can also make some of us self conscious. As can all the monitoring, as we don't realize, we are the ones doing all the monitoring. Other people are not so critical of us as we are of ourselves. One thing that helped me, was to accept that I don't always present my best self and sometimes fall short of my capabilities in person. When you don't worry so much about others around you, and are comfortable enough with ourselves to accept our flaws and not care so much how we may come across. It is empowering. Also, it takes effort to realize, no one else is being as critical of us as we are of ourselves. People aren't constantly judging us. And when we do something wrong or not how we wanted it to go, it is not a big deal to them. We just feel like it is.
When you realize your impulsiveness and apologize for cutting someone off, it doesn't feel so bad does it? Acknowledge the mistake, accept it, account for it as needed. The moment is over and the conversation moves on. They may even say something like "oh, no problem" etc. But, with anxiety, we ruminate over little flaws and wonder if things were noticed or how we meant to do something another way, etc. This was all explained poorly, and no idea how much if any applies to you in particular. Hopefully you kinda get the point. Social Anxiety is all in our own heads. Nobody is staring at us, judging us, taking anything not perfect and holding it against us, etc. We are not having a negative impact on their life.
" I can be absentminded but not to the point where I am suffering from it."
The difference between a symptom everyone has sometimes, and a clinical symptom is how much we are impacted by it. Everyone is absent minded here and there. If it is not something that bothers you a lot, something you need coping mechanisms to manage it, etc. Then it wouldn't be a symptom. It would be human. For example. I had to always put my keys and wallet in the same place when I got home. And count to 3 before leaving home checking for my keys, wallet, and hat. That is clinical because I required a coping mechanism to handle it. Not the same as an "aid" people may have that is helpful. Granted, there have been a few times I almost left home without pants on, LOL.
I have a double whammy. I am comorbid with Sluggish Cognitive Tempo. People with ADHD/SCT are more impacted than either alone. I have additional problems with early selective attention and it takes time to process and figure out what was just said. Under pressure it gets even worse. If introduced to 5 people, if lucky I will remember 1 name. I forget the question while trying to think of the answer. But, I did very well in job interviews etc. Because I realized I am my own worst critic. And, I can take time to pause and think. That pause for the other person is many times shorter than I feel like it is. And told myself it was ok to ask them to repeat the question, even after a pausing for a bit already.
stimulant medications can raise blood pressure or give you more anxiety. I would talk to your doctor about trying a non stimulant. I am on stratera and am having more success than I did with the stimulants.
I have decided when I am ready to seek out an psychiatrist in my area witn expertise in differentiating ADHD from other conditions. I found out that this kind of consultation would be covered by Medicare Part B and probably my supplement plan. And if he says no. That is not what it us. I can still research online how to manage my symptoms that resemble hyperactivity, chiefly my issues with conversational flow AND written info dumping (the length of my previous post is an example) looking at how others who have this specific issue hace applied strategies abd learned to forgive themselves when they slip up and feel whole inside
Any psychiatrist should be able to help with your issues. Even if they are not an ADHD specialist, or if you do not have ADHD. Their training in particular involves differential diagnosis of tons of disorders. Which involves things like ruling out disorders that present the same way. Determining if other issues are comorbid with or caused by another. If something is caused by external factors that can be mitigated or if the patient just needs to work on themselves. Providing both medication and/or non medication therapies. What ever it is, if they can diagnose it, they can probably treat it. That is what their profession is for.
Best to focus on their reviews and finding a good therapist. A small number of therapists don't prescribe medications or limit which ones they will prescribe. You can decide if they make a good argument or not for that and if you want to see them, or someone who has all the options on the table. I also prefer "evidence based" practices. They are more likely to be open minded and may have deeper knowledge of things like medications. Nothing you have said so far makes me think you are a difficult case. Again, no relevant credentials myself. Just overly opinionated.
Finding things online can help. Plenty of guides etc. that are helpful. Just keep an eye out for sites with an ulterior motive or quack information. Like some quack claiming there are 7 types of ADHD, who even opened several treatment centers.
Youtube.com, you can search on their for topics relevant to you. The following is a link to one of the top ADHD researchers and also a go to guy for people to learn more from. He has tons of videos that help with anything from diagnosis , understanding, coping mechanisms.
You do Kinda show your age though. You come across like you think it is a bigger deal than it really is. Growing up, mental health was always a big deal, and for people who were really screwed up. At least, that is how society made us feel. On the contrary. It is just a tool to help us think in a more constructive way, to recognize counter productive thought patterns. And if there is more need, manage a disorder or 2. Most people (I think 80%) with ADHD are diagnosed with at least one other disorder in their lifetime. ADHD/ SCT mild narcolepsy I was born with. OCPD I developed as a coping mechanism for moving to a $#% area . I'll skip explanation.
"manage my symptoms that resemble hyperactivity, chiefly my issues with conversational flow AND written info dumping (the length of my previous post is an example) looking at how others who have this specific issue hace applied strategies abd learned to forgive themselves when they slip up and feel whole inside"
By now, I assume you know I have the same issue. There are actually several components for why I am the way I am. I'll skip the full explanation. I don't want to scare you off from trying medication and seeing if it is for you or not. But the primary issue for me is medication side effects. But, I am an unusual case with a ton of factors others don't have to deal with. It moved me from inattentive to combined type. Which is new for me to deal with, but also impairments make it not fully manageable yet.
For you, medication would more likely calm the mind and allow you to be more constructive and able to organize your thoughts. Stimulants actually focus people with ADHD and calm those with hyperactivity. So don't let the contradiction fool you.
My strategy for dealing with it. Stopped giving a #$@^ what others think. Even if you think I am the biggest nut in the world, does that in any way impact me for real? I have a ton of information in my head. I see it as people can skim through and if they find something relevant to them, good. They can go from there. If not, then the 5 minutes they used to determine that is not going to have any real effect on their life. On the other hand, I did learn some stuff in college that can be relevant, have spent hundreds of hours the last 2.5 years researching, learning, etc. Sometimes there is someone who it actually helps, or gives them information to build on for a better outcome. Or just to understand things that weren't understood before can be helpful. So much I know now would have totally changed my life for the better if I knew it 20 years ago. If not for desperation, I may never have found out. Maybe I can spare someone some of the issues I have already come across.
In person, yeah, just need to be self aware and slow down. I already got into that a bit more in another response. But, you mentioned you are doing that. It is also beneficial to learn how to listen. And to not automatically try to predict what the other person is saying. Don't let trigger words, "trigger" a thought that guesses what they are going to say. Or a response based on that trigger that is not right for their statement. Let them finish their thought before trying to answer. If you get hung up during a response and they take a pause incorrectly like you are done, it is ok to say something like "Hold on a moment please, sometimes it takes me a moment to gather what I want to say". Or what ever you feel comfortable saying. It is ok, to give the other person queues or instructions that help you better or more completely engage the conversation. Or to disclose that you may have ADHD and it takes a moment sometimes. Or, you can give them permission to let you know if you start going off the rails. How well you know someone, how comfortable you are with the situation, etc. You do not have to bear the burden of it all yourself. You can structure the conversation too. Often people are happy to work with you in the conversation. Feeling helpful, showing understanding, often makes people more engaged in the conversation.
Was only going to give a short 1 paragraph response. Oh well...
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