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ADHD in Women

I need some honest to goodness adhd women advice!!

I think I’m in the right place. Story goes like so…Been diagnosed for a year with adhd. Had it when I was a kid but they just called me “spirited.” Ha. I like that. I’m 39 and I go in and they say here is the TOVA test…you have adhd, let’s try Ritalin. I am also a recovering pain pill addict and alcoholic but I have really good docs that I can talk to and be open and honest with. Problem is…I get the ritalin crashes really bad so I want to take more than is prescribed to not feel the crash. I take 72 mg of Concerta and 4 10mg tabs of just plain ol’ Ritalin. This medication works so well for me but I don’t want to ruin it by over thinking and doing my old stupid addict thinking and behavior. Can’t get in to see my Dr for a month! Thinking of maybe trying Vyvanse again…I felt sort of odd on it and it wore off on me at about 4pm. See…that’s my problem. How do they know how to dose you? Trial and error obviously but is it by weight? How severely you have the disorder? I just want to take it and not worry about it all so much. Please be kind and give it to me straight. I only get one brain and I don’t want to hurt it. Thanks ladies!!

Replies

Hiya hon, first good on you for recognising the old temptations in a new setting! smile

I don’t take medication for my ADHD as I am Bipolar.  I have had some alcohol probs in the past, and my immediate family are all addicted to something, sadly. (Alcohol, heroin, crack)

I guess from what I know about dealing with addictions, and addictive urges (used to work in that area too) I would suggest rather than getting tied up with what the drugs can do for you, or looking at how the meds will solve your problems, have a look at other more natural things you can do.

For me taking high dose DHA, frankly, it is a total miracle.  It is strong fish oil, and it changed my life.  I also figured out that I was wheat/gluten intolerant, apparently that is common in ADHD people.  I also try to make sure I get some exercise, and fresh air each day, and also manage my moods using meditation and mindfulness.

By the way, I am not saying anything agains the taking of medication, because I do think it is important for some people.  I had no choice about being able to go on it, annoyingly, so I had to learn to deal with it in different ways.  BUt I think there is great opportunities for the two different approaches to be combined.

Re the medication, could you perhaps just adjust the time you take it, and perhaps spread out the dose of Ritalin, take 3 and then the 1 later in the day to top up a bit?  I would be seriously hesitant in mucking around with the doses yourself, because of your previous problems, it can open doors and go over the little boundaries, making it ok for you to carry on fiddling with the script and so on, and that is going to lead to bad places again.  Alternatively, try taking the whole lot later, so that the crash happens when it is easier to deal with, so you can have the space to relax and accept it a bit more readily, instead of feeling so frustrated.  Reading the boards etc, it seems that the crash is a really common problem.  Caffeine is also a good substitute, so perhaps first thing in the morning have a crap load of coffee, then take the dose a little later in the day, perhaps 2 hrs later, that might help.

Try calling the Dr, ask for him to call you back, or try to go in for a more urgent appointment, try explaining that you are concerned about falling into old bad habits again.

PErsonally I would say, don’t go down the road of trying to adjust the dose yourself, for me the alarm bells are ringing, and it is soooo easy to fall back into old habits, even via well meaning routes!  I have done it and I have seen my family do it, to disastrous results.  As you said, your brain is really special!

Good luck with it, and keep taking one day at a time, a month is shorter than we realise, when we aren’t looking at it (I know, I am now 28 weeks pregnant and starting to really crap myself at how fast the time has gone by!!)
xx

Posted by Wuftytufty on May 14, 2014 at 1:38pm

Dosing is not by weight.  It is based only on how fast or how slow you metabolize the drug.  Since there’s no sure way to predict your rate of metabolism in advance, dosing is always done by trial and error.

Posted by BC on May 14, 2014 at 4:25pm

Great advice from Wuftytufty above AND there are some caveats about meds. Vyvanse and Concerta/Ritalin are different animals. Vyvanse is a form of amphetamine (think Adderall) and Concerta/Ritalin are brand names for methylphenidate . So not surprising that you feel different on Vyvanse.

The trick with meds is to figure out what’s influencing their effectiveness. Docs call it the “theraputic window” when you’re taking not too much, not too little juuuuuuust right amount of your special mixture of meds.And it’s not easy to get that perfect mix. My clients tell me that they have tried several times (and given up several times) to get it right. As if having ADHD wasn’t enough of a distraction, we have to FOCUS on figuring out what’s going on with our bodies and then track back to the medication dose and type! Whew!

Fish oil is a miracle for ADHD—but you need to take quite a lot. Make sure you read the BACK of the label, not the front to find out how much EPA/DHA you’re getting - you need at least 2000 units a day ...Costco brand is one of the purest and cheapest out there.

I also take Focus Factor. Active ingredient is bacopa monieri which has been tested and found effective for focus.

Exercise is vitally important (another ADHD bugaboo - who can remember and who has time for exercise???).

Finally (here comes shameless plug for my profession), coaching does make a difference. We learn to cope with our ADHD as children without knowing what is “wrong” with us. Later life diagnosis turns everything on its ear. Getting help from coaching, professional organizers, personal assistants, etc is worth every penny- trust me, I’m so much better than I was when I was diagnosed at age 45 (for my ADHD story you can read my book - “Confessions of an ADDiva - midlife in the non-linear lane” - proud to say it won first prize for women’s issues in 2012).

Estrogen also affects your ADHD and effectiveness of your meds. Less estrogen (right before your period) equals worse ADHD symptoms. And many women with ADHD have trouble with PMS/PMDD - higher rate than in general female population.

My ADHD is getting worse with age (is it ADD or is it AGE???) so I am working with Dr Charles Parker who is a wizard at adjusting meds based on your own bloodwork, metabolism and twitchy little food sensitivities (like gluten, dairy and eggs). He has lots of videos you’ll find on YouTube https://www.youtube.com/user/DrCharlesParker

I am being tested next week so I’ll let you know what happens…???!! Fingers crossed that I get insight about what my body and brain needs to function optimally. It’s not cheap, but feeling foggy has its price, too…

Hang in there. You’ll get the right formula for you!!

PS—my psychiatrist says NO caffeine with stimulants. Hard to tell what is working and what isnt’ Plus caffeine has a big crash too—I always want to go to sleep so I have to drink more… roller coaster!!

Posted by addiva on May 14, 2014 at 4:34pm

I too am a recovering alcoholic. I was fast approaching an untimely demise when I got sober in 2000. I am now 43 and was diagnosed with ADHD when I was 40 after I quit smoking andy symptoms got so bad they were not only impairing my ability to function but also causing my stress levels to go through the roof. I see an addictionologist as my psychiatrist and also have a close friend/father figure who is a retired MD and a nationally known expert in the fields of addiction medicine and the 12 steps. Between the two of them, the only stimulant I was “allowed” to go was Vyvanse which is an extended release medication. Crashes or drug-induced mood or energy swings are NOT good for any alcoholic or addict and predispose us to relapse. Even taking Vyvanse, I have remained extremely vigilant and have worked closely with my sponsor and doctor about how it makes me feel and any thinking I have around it and my dosage. I have had to be rigorously honest about it and I would recommend you never alter the dose of ANY medication on your own (stinking thinking and behavior for an alcoholic/addict), but most especially anything that affects brain chemistry.

In addition to Vyvanse, I take Welbutrin which I have been on for probably 12 years. Well before I had an official diagnosis of ADHD, I happily noticed it improved the length of time I could focus on any given task.

Vyvanse is not a silver bullet (I still feel like I have my head up my ass most of the time) but I believe it has helped with my anxiety and level of irritability.

Hope this helps. Best wishes to you!

Posted by Lindsey R on May 14, 2014 at 4:43pm

Sorry about typos etc. Was posying from my phone!

Posted by Lindsey R on May 14, 2014 at 4:45pm

I am relieved to have found this group!  I am 34 years old and was diagnosed with ADD a little over a year ago.  I have been on anti-anxiety meds since my teens but the ADD diagnosis was missed.  When I received the diagnosis from my current psychiatrist (who also suffers from ADD), I was surprised, shocked, relieved, and scared all at the same time.  As I educated myself on ADD it is painfully obvious that I have always had it. 

I have had addiction problems (smoking, marijuana, alcohol, pills.. whatever was around) and I am currently trying to quit drinking altogether.  I have quit smoking and I have no access to any kind of pills.  The booze is most readily available and I fight it on a daily basis.  Around this time of day, everyday, my anxiety hits an all time high and I feel like I am freaking out.

I have so much housework that needs to be done, unfinished projects to complete, organization to figure out, paperwork and piles to put away, and acres of land that needs attention.  Every night before I go to bed I get excited about all of the stuff I am going to get done the next day, but in the morning I immediately feel overwhelmed and defeated.  So I plop myself down on the couch and distract my mind with the television.  I get ideas and urges to get things done from time to time, but they are crushed by my own negativity as quickly as they appeared.  Why even start it when there is so much and I am going to either not do it well or not finish it?  Anytime I do convince myself to tackle something the feeling quickly dissipates and I am left with something else left undone for me to stress about.

I am currently taking 60 mg of Fluoxetine and 70 mg of Vyvanse.  I feel like the medications have stopped working and my anxiety levels are unbearable.  Is this possible?  Should I ask my doctor to switch my medications again?  I took Concerta for the first couple of months after my diagnosis and it did not help my symptoms improve at all.  Once I started on the Vyvanse I felt like my symptoms were improving and the anxiety was lessening.  At the time, though, I was also taking Xanax for the sudden panic attacks and the doctor has slowly ‘weaned’ me off of it.  As she started weaning me off of it I began drinking more and more to calm my nerves and to be able to get stuff done.  She will not re-prescribe it to me for some reason and just increased my Vyvanse instead.  I need help! :(  Is it possible that a different medication would help me?  How do I convince her to let me try a different one?  In all honesty, the period in my life when I had the cleanest, most organized house and was able to get focus and get the most done is when I was smoking weed. lol. Unfortunately, this is not a feasible option for me so I need to figure something else out.  I can’t continue existing (not living…) like this.  It is miserable and I feel all alone.  My husband and family do not understand what I go through and how frustrating it is to deal with this on a daily basis.  PLEASE HELP!
Thanks smile

Posted by heat064 on May 15, 2014 at 12:09am

heat068:

Have your doctor take a look at this, from Dr. Charles Parker:

http://www.corepsych.com/2006/11/adderall-prozac-and-paxil-problem-not-solution/

The fluoxetine is interacting with your Vyvanse.  And increasing your Vyvanse will just make things worse.

Posted by BC on May 15, 2014 at 1:42am

Hi, there.

I can relate to a lot of that.  Also, I agree with most of the responses.  Also, I’ve read “Confessions of An ADDiva.”. Its a good book.

Call your doctor’s office and speak to the medical assistant.  That’s part of the service.  Explain the problems, and they’ll get back to you within 24 hours.  The doctor will get the message, look at your file. and follow through.  Your medication might be adjusted, they might have you go in.  Do not try to adjust it yourself.

I’m presently on Strattera, and am going to call my doctor’s office about a change.  My guy’s counselor is an expert on ADD.  In a recent joint visit, he explained that I’m having what he called “breakthrough symptoms.”  I’ve done some research, etc.

Hang in there!

Posted by Author58 on May 17, 2014 at 5:38am

Heat068, I would say, massively, to work on your morning routine.  And plan each day.  I have now got myself back on the organisational wagon (pregnant and my hormones have been a bit awkward!) and I use a daily planner. 

In it I have a section which is things I would like to do, then a section for things that must be done, and then a section for appointments.  It really makes a difference.  I fill in all sections, usually on a roughly weekly basis, and then check the night before so I know what I am doing and can adjust things.

Having a breakfast routine is critical.  And so things like keeping the kitchen cleared (FLY Lady is great for this) does a lot for my sanity.  Every day, get up, dressed, shoes on, breakfast, sort dishwasher, wipe down tops, sweep if needs be.  That tends to set me up for the day, because it is a quick and easy win.  I am learning to stay away from TV, or I try to clean the room or do ironing, if I want to watch it, so it’s not dead time, or I do some crochet, etc, and have it as planned down time.
Also I break chores into 15 mins segments (like flylady) which means I can do something for a while, but not be overwhelmed and not bored either.  The key is to focus on doing a little every day, and to have down time, and fun in between.  You can chip away at it.  IT really helps with my anxiety, and helps me get more focus and not keep missing things/appointments and so on.

Seriously, this planning thing has been a saviour!

Now off to spend 15 mins hoovering! smile

Posted by Wuftytufty on May 19, 2014 at 11:04am

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