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Mental Health Use this forum to share your mental health concerns and to seek advice.

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  (#1 (permalink)) Old
Silver Halide Offline
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ADHD - March 26th 2011, 01:56 PM

Background

I'm seeing a new doctor on Monday to discuss my mental health. They will be getting my records from my previous doctor so they know the full story.

I've been treated by my old doctor and a counselor for depression and anxiety before. The anxiety medication works like a charm. The depression medication didn't work too well but eventually I was taken off of it. A number of times my old doctor probed into the "focus" issue for me as many of the symptoms I attributed to depression lacked certain factors (low energy wasn't really low energy and the lack of enjoyment in things I normally enjoy had specific qualifiers). However, whenever he brought it up I quickly shut him down as I had been brought up to do.

When I was in Kindergarten my teacher tried to get me diagnosed with ADHD. My parents were very against that as they held some preconceptions about ADHD, mostly negative. "Their child," did not have ADHD. So when they went to the child psychologist they filled out the surveys and vehemently claimed I did not have it. That was the end of that.

However, I have many pervasive issues to this day that I've been trying to attribute to something.

Symptoms

First is my issue with reading. Unless the text is really easy to read (low reading level, broken up into manageable chunks) or I find it extremely interesting I have difficulty reading. I've been tested and I read at a high level and very fast, but I have to labor through reading a book even if it's interesting. An example would be that I'd read a chapter and after every chapter I'd get up and pace around the room for a few minutes. (Note: I noticed after I finished writing this whole piece that it instantly sets off my "holy crap this is too long and thus will be difficult to read" alarm. Sorry about that.)

At first I thought it was a sight issue: so I got my eyes tested and sure enough, I needed glasses but not very much. That didn't change my experience with reading (except by sometimes giving me a headache).

I also have issues with remembering things as well as organizing my life. I've set up various systems to manage this but they only go so far. If I write a task list it's hard to make myself check it.

Other issues involved with my start of projects and margin of error. Sometimes I get really interested in a particular topic and I spend some time working on it, but rarely do any of them get finished unless there is a very strong operating force pressuring me to finish (such as for National Novel Writing Month where I have a daily goal, an overall goal, and people encouraging/monitoring me to help me finish). Related to this is the error rate in my work. I will make careless mistakes, even in writing at times. Sometimes I'll think about writing two sentences and I'll decide on writing one of them but I'll have put one of the other parts in there and I'll forget to remove it until later (if I have the ability to, eg: post editing).

Diagnostic Tools Used

I also took an ADHD inventory and scored a "high likelihood" of moderate ADHD-PI (Predominantly Inattentive).

My two questions:


What does TeenHelp think -- do I have I? (The doctor will be the final arbiter of this, but it'll be nice to get input.)

If you think I might, what about the medical treatment options? (Input from those who are actually on some of them would be excellent.)
I've looked at a lot of the treatment options and they are, quite frankly, pretty scary. I've had side effects from psychological drugs but some of those on the ADHD medications are horrid.



   
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Re: ADHD - March 26th 2011, 07:19 PM

As you know we aren't professionals however, when asked I do try to give my best suggestion of what you possibly could have. For ADHD, there is a potential diagnostic problem and that is, the DSM-IV-TR the symptoms cannot be accounted for by mood disorder, anxiety disorder, etc... . There are various types of anxiety disorders and depression can present itself in many ways so without knowing how they present, I can only say there may be a difficulty in the diagnosis of ADHD-PI.

The other diagnostic problem is there is an age limit and outside the age limit, the diagnosis cannot be applied. You are well beyond that age limit, which is around 7-8 years of age. However, because you mentioned previous diagnosis with ADHD, a clinician may be willing to consider it. This depends on whether the doctor whom your parents harassed did put ADHD on your medical record. If you see another doctor, you can have them obtain your medical record information and all the information gathered by the previous doctor, as long as you sign a form that's usually about 1-2 pages long allowing that. From there, the doctor can tell you what is on your medical record because they need permission to look into it. A doctor cannot look into your medical record without you knowing or giving permission as it's a federal crime and they can surely kiss their clinical license good-bye.

Ignoring the 2 diagnostic problems, you do meet the diagnostic criteria for ADHD-PI.

There is a possibility that in the DSM-V (meant to be released around 2013), ADHD-PI won't exist because many researchers consider it to be a distinct disorder from ADHD, not a form of ADHD. I won't go into explaining why, it's quite detailed and not fully supported by all researchers and doctors.

I haven't taken any medications for it but I study neuroscience and pharmacology, so I can tell you about them. The most common ones are stimulants, such as Ritalin, Adderall and Vyvanse. You also have non-stimulants, which are newer such as Intuniv (approved in 2009) and Strattera Oral. I won't lie and say these work perfectly, nobody studying pharmacology or neuroscience will ever say this as it's rarely true. They are shown to be effective however they should be combined with therapy addressing strategies for remembering and staying on focus because the symptoms come back quite fast once you are off the medications. Side-effects can be anything from increased risk of suicide, depression, worsening your anxiety disorder, increasing aggression and impulsivity, psychosis (mostly hallucinations), etc... .

Some of those are less common but the official less common ones involve jaundice. For that, doesn't matter what you're doing, if you're in class, leave and go to the hospital. Others can tell if you're experiencing jaundice. Additionally, other rarer side-effects needing hospital treatment are changes in your cardiac system or severe allergies to the medication (i.e. anaphylaxis, which I've had before, need to get to a hospital ASAP and although I'm not violent I would say to punch someone if they're slowing you down).

For more details in a more coherent way, here are some links about the medical treatments from Web M D
http://www.webmd.com/add-adhd/guide/...-drugs-therapy

http://www.webmd.com/add-adhd/stimul...ivity-disorder

http://www.webmd.com/add-adhd/guide/...mulant-therapy

Lastly, an e-book about the adult psychotherapy interventions. It's kind of long, I tried looking for other sources online but none were that great.

http://books.google.ca/books?id=g89R...ulants&f=false


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Re: ADHD - March 26th 2011, 08:29 PM

I did sign a release to have my medical records from my current doctor transferred to my new doctor. However, the issue would be that the clinician I saw when I was in Kindergarten was in a different system. It's likely that even my original family doctor did not have those records, as my parents would not have taken the steps to transfer them to him.

I looked into the age limit thing as well as the draft version of the DSM-V page for ADHD, although the latter won't apply as much as I won't be seeing a psychiatrist specifically (although I would like to) due to having no insurance. The likelihood that the physician I will be seeing is taking an active part in the development in the DSM-V is very low, but you never know.

At this point I'm just hoping that the physician will be able to find some way to help me manage these various symptoms, regardless of whatever label is attached to it. We'll see. I'll post back once I have my visit.



   
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Re: ADHD - March 29th 2011, 12:28 AM

No diagnosis. No treatment offered. Instead I received a referral and a suggestion to take an expensive test or set of tests that I cannot afford since I am not insured. An interesting note being that I still score as "depressed" on depression evaluations as well.

Both diagnoses (ADHD/Depression) would account for the most troubling of the symptoms. Hopefully I can obtain the correct treatment going forward but I won't know for weeks. I think the biggest issue comes in trying to identify the difference between a "normal" and "clinically abnormal" symptom on the same spectrum.



   
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Re: ADHD - March 29th 2011, 02:34 PM

ADHD is a very complicated issue to deal with and I hope that the new dr and professionals can help you with it. And you get some answers. Please keep us posted k?


If you want to talk feel free to PM Me
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Re: ADHD - March 31st 2011, 01:43 AM

We'll see how things go. There are also depressive symptoms to look at as well. I was referred to a nice PsyD L.P. on campus that I am seeing this week after having a triage appointment with another member of the staff.

He'll be in contact with the doctor once he assesses everything (I signed the consent for that). I'm confident he'll be able to positively identify what exactly is going on and inform the doctor.



   
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Re: ADHD - April 1st 2011, 08:20 PM

The verdict is in from my Licensed Psychologist. To him it sounds like what he called "Organic Depression". That being a depression that is mostly represented as the physiological symptoms and the more pervasive psychological ones (such as low mood) but without the accompanying thoughts (as I had previously dealt with those through therapy before).

He basically recommended, and is going to communicate with my doctor, that I try the medication Wellbutrin. In addition I will continue to see him to manage the stress that is making the symptoms (especially those related to concentration) worse. So, everything is looking up. Thanks for the responses.



   
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