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To go on medication or not

Apologies in advance for a long post. I am a 41 yo, diagnosed about 2 years ago. A neurologist confirmed that I have ADD but didn’t specify what kind. In doing my own research, I’ve concluded combined type.

I stopped going to her after receiving my diagnosis because she had very limited office hours (3days/week, 10 -3) and I had taken the maximum amount of time from work getting my diagnosis.

I’ve been “dealing” with my ADD since then, managing a very stressful and demanding job, a husband who also has ADD and our 2 daughters (ages 5 and 3).

I’m stressed out and needless to say, my ADD is kicking in in a fierce manner. I’m disorganized, anxious, confused, impulsive, I freeze and lose my words when speaking in meetings at work, have a hard time being clear about my thoughts and articulating them and am having a difficult time focusing to learn highly scientific material at work. I’m also not sleeping well, constantly anxious about everything and feel like it is all starting to spiral out of control.

I am hesitant to start medication because of the side effects of not sleeping. I already have insomnia due to anxiety which makes me irritable, more anxious and exacerbates all of my ADD symptoms.

I appreciate any experiences, thoughts, or guidance you can provide.

Replies

This is a tricky question of late for me personally, as well.

I’m also recently diagnosed (age 38) and have taken well to Adderall XR. It’s made a HUGE difference, combined with mindfulness meditation (I used Dr. Zylowska’s book to start.)

However, I’m in the middle of a career change. I have some previous experience working in the local gas field, and was looking to get back into that. Most of the local openings are requiring a CDL now for consideration, and so I enrolled in truck driving school.

I’m currently attending and doing well, and am not looking to drive a truck OTR or even daily for a living. That said, the opinions on stimulant medication within the field are WAY controversial and everyone seems to have an extremely biased opinion one way or the other. If I were looking to be a trucker, which I will be qualified to do soon, I would seriously consider going OFF the meds, but I’m not sure. My life is so much better on them, but I prefer to work “manually,” even if I were to find a more advanced position.

I’m not sure yet how to approach this. Any job I will take will require a drug test, which will pop positive. Now, as long as I receive contact afterwards from the MRO (Medical Review Officer) and can provide prescription info that result will show negative at the company, but I’m not sure whether or not to volunteer my diagnosis with my potential or new employer.

I know for a fact that I’d be a much better employee on the meds, but am not sure it will be possible. I’m currently weighing my options.

But I’d at least try the medication and see how you do. This is a problem definitely worth having, IMHO.

Posted by Bumr50 on Feb 16, 2014 at 5:46pm

Gina,
I think most of us can appreciate what you’re experiencing because we have probably experienced something similar. My recommendation for you would be to seek a new healthcare professional who will likely recommend meds at this time to get you through this period at a minimum.  I too dislike being on meds for a variety of reasons, but there are times when “I” and my support groups can’t do it for me. That’s when I seek the professionals out to get me back on track with or without the addition of meds. Thanks.

Posted by Bapa on Feb 16, 2014 at 8:52pm

I take a 12 hr extended release non-amphetamine stimulant (Concerta). As long as I take it before 10:00 am, it does not interfere with the quality of my sleep.  I do stay up very late and don’t get enough sleep.  However, I attribute it more to the fact that my meds have worn off and I’m wildly distracted and unfocused and lose track of time, rather than the stimulant effect.  I have historically not slept well. It is my perception that since I started the meds, my quality of sleep has improved.  I stay asleep all night.  I’m not sure how this could be related to the meds as I think they have cleared my system, but the better sleep did coincide with the starting of the meds.  Occasionally when I do have trouble falling asleep, I drink a little caffeine soda and it slows me right down. It powers my brakes. I cannot use caffeine with my meds or I get overstimulated - no mixing. I have to wait with caffeine until the meds are cleared out. Every med is different and behaves differently with each person and each dose and sometimes with different timing or with what it it taken with. Finding the right protocol can be an art. Keep asking others what their experience is. Good luck to you.

Posted by Juggler on Feb 17, 2014 at 1:10am

How about treating your anxiety FIRST with an SSRI?  I have ADD and Generalized Anxiety Disorder.  I take effexor SR for the anxiety, it works great.  It also has a great side effect of helping me to relax so I fall asleep easily!! 

I’d also like to know where it is written that everyone can and should keep up with the breakneck pace of raising small children, working a fulltime demanding job, and running a household??

Add ADD to this and I think it’s just too much.

Posted by shadowpoint on Feb 17, 2014 at 1:59am

Here here shadowpoint!!! Yes. Some of us earned our anxiety and ADHD by cramming too much onto our plates.

My anxiety is, in part, related to my ADD in that I am anxious about losing track of so many things. I do not tolerate SSRIs or SNRIs well at all. Provider thinks it would help me to treat the anxiety as well, but I have to be up for the challenge of trying to tweak meds enough to avoid the unacceptable issues I have had in the past with those classes of drugs.

Point for Gina G: it’s all very individual.

Posted by Juggler on Feb 17, 2014 at 2:59am

GinaG,

Same diagnosis, about the same time, although I am older than you. I take 70 mg of Vyvanse in the morning, and two months ago, started 20mg of Adderal in the afternoon. You will find some adjustment necessary over time. I would advise seeing a psychiatrist vs. a psychologist. The former is an MD and can prescribe meds. Going through my internist, who admittedly knew little about ADHD wasn’t the answer. Meds will get you part of the way, learning new organizational skills will fill it in. You can’t take steroids without pumping iron:). As for poor sleep, I think it is an ADHD thing. I slept poorly before taking meds and they didn’t get any better or worse with them. At a support group meeting the question was asked who has sleep problems. Everyone in the room raised their hand. The proper med and dosage will help with anxiety, so you may get a better night’s sleep.

Posted by bobinator on Feb 17, 2014 at 7:07am

My meds provider won’t write a scrip unless I am still in therapy w/ a cognitive behavioral therapist. It’s true, meds don’t fix everything.

Posted by Juggler on Feb 17, 2014 at 10:41am

Thank you for your responses, everyone. I really appreciate your time, responses and learning about your perspectives and individual paths. I’m definitely going to see a professional to get some help.

Posted by GinaG on Feb 17, 2014 at 5:43pm

Anxiety is a response to the perceived risk of failure or poor performance and such.  Developing anxiety starts in childhood when we respond to the actual and perceived failures that are part and parcel of living with ADD/ADHD.  Add the criticism that usually is heard about our “performance” during those earlier years, and you have been set up to have anxiety issues.  That is part of the reason why many psychiatrists will want a patient to have concurrent therapy/counseling.  Medication does not fix anxiety; it only helps the symptoms and not all of them or always.

It is often noted that removing the troublesome aspects of our ADD/ADHD results quite often in the reduction or elimination of the anxiety symptoms.  The problem for many of us is that we really are biting off more than we an chew and creating our own problems.

Superman and Superwoman were fictional characters!  Stop trying to live up to what is not even real.  Stop allowing society to dictate what you should or should not do.

Posted by Dianne in the Desert on Feb 17, 2014 at 9:18pm

Dianne in the Desert -that is the best way of putting the ADD/ADHD & Anxiety connection I have ever heard.

Posted by Juggler on Feb 17, 2014 at 9:36pm

My therapist recommended me going off of Vyvanse and just treating my anxiety.  I wasn’t thrilled with that suggestion, and I’m still not.  I tried going off “cold turkey” and the anxiety was overwhelming.  Now I am going off very slowly..10 mg. a month.  I am down to 40.  I really wish I could just stay on the 60.  It’s stressful though to have to try to convince him that I do better on the medication than I do without.  I worry that he’ll think I’m just an addict or something

Posted by basketcase on Feb 22, 2014 at 5:50am

As it appears everyone else has voiced, I agree that it will require very individual treatment to figure out what works for you. 

I didn’t discover my ADHD until my son was diagnosed with it.  I started reading everything I could on the subject and listening to the doctors, both to help him and, as I read more, amazed that it defined me so well.  I always thought of ADD/ADHD as the bratty kid running around in circles screaming at the top of their lungs which was not symptoms of my wife, son or I.

I was, now retired from, a military career which forced structure upon me and offset some of the symptoms.  Aside from that, I would, and still do to some degree, dose myself with caffeine through the day.  Even now, I take Adderall, drink coffee through the day, and usually sleep just fine. 

In fact, I even asked my doctor about the effects that adderall generally are reported to have from sleep difficulty to weight loss, neither of which affect me.  I’ve always had that 20 extra lbs and would love for some of that weight loss!  smile  She explained that it affects people that don’t need it like that and since I do, it doesn’t do that.

However, I do know that it is helpful to me.  I wear glasses and can remember the first time I put them on as a young adult.  I grew up poor and didn’t have them through my childhood and such till I bought my own pair.  I walked out of the store and it was night and day.  I thought I could see “ok” and this was just a minor help, but when I put them on and realized how wrong I was, it was, no pun intended, eye opening. 

Without the adderall, I tend to be easily distracted, unfocused, just uncomfortable with trying to get anything done.  I don’t have more energy with or without, just a sense of wandering attention and inability to keep my mind on target.  With it, everything just seems to work as it should. 

That said, work your way up rather than start at the top of the dosage.  I’ve tried both regular and extended release (XR) and finally discovered that I work best with taking half dosage, twice a day (Morning and Noon) as opposed to XR.  That carries me through my work day, but gone by evening.  It also gives me the freedom to not take one if I don’t need to.

At the same time, it’s not an “end all - be all” solution.  I know when I’m tired or stressed, then I still have difficulty, but at least I know why and it doesn’t feel overwhelming.  I just accept it, focus on the stress (or get more sleep that night) and know tomorrow will be better.  In regard to your anxiety, only you can determine if it’s something that needs to be dealt with separately, or as in my case, it was related to my ADHD and the feeling of failing or confusion and so on.  My own anxiety of that diminished because I could now focus and do what needed to be done.

As for employment, I do know that I couldn’t take anything while I was in the military which is why I didn’t do anything till after I retired.  As for the civilian world, I’ve had three separate employers (not due to the adhd, but due to company lay-offs), never thought to mention it to them and never had anyone ask me about it even though two have had drug tests requirements at employment.  I don’t know what the rules are there, but I would think that if you can show it is prescribed, they wouldn’t have concerns. 

Hope my experience gives some help…

Posted by Stonewyvern on Feb 25, 2014 at 7:20pm

i went on medication and i found out that not only do i function better, i am also less anxious. I feel more like i’m with it instead of pushing through a wall, which was how i felt off the medication.

Posted by Lilapsophile on Mar 05, 2014 at 9:56pm

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