Is ADHD a real disorder?

here's a long one by him. maybe not the same one but there's some good stuff in there

https://www.youtube.com/watch?v=SCAGc-rkIfo

i feel that heavily, lily

Oh damn, I relate too.

I don't have the best impression of my psychiatrist or his front office staff so far, but I'm sticking with him because of the difficulty of trying to look for a new one

Can I vent for a moment? Because THIS. FUCKIN. GUY.

Last week, I realized that I was almost out of my medication (150 mg Wellbutrin), so I called the office and told them I needed a refill to last me until my appointment with him (which was yesterday). This made sense as I had a 30 day supply and my Feb appointment was a little more than 30 days after my Jan appointment. They got the scrip, I picked it up from the pharmacy. Fine. I finished up last month's bottle and started the new one on Monday.

One thing that we had discussed in January was switching to 300 mg after doing 150 for a while. You know - try taking two for a while and see how it goes! So yesterday, I decided to do that since it was the day of our next appointment and we were probably gonna make this shift anyway. I definitely felt the medicine A LOT more in my head. I thought that the 300 mg was definitely more noticeable, but I would probably get used to the increased dosage after a week or so. I had a moderately difficult time getting to sleep last night but I managed it.

So this morning, I went to take my meds and I actually looked at the bottle - 300 mg. I had definitely, specifically asked for a refill on my 150 mg pills and he gave me 300. So yesterday I had 4 times my usual dose going through my system. It didn't hurt me, but I'm not feeling too forgiving about that kind of medical miscommunication.

Also, he's closing down his office that is located in my neighborhood (he has another office 20 minutes away). I only found out because when I walked in for my appointment, there were signs plastered all over the place informing of this. Apparently, this is their last week in town. And yes we could do check-ins over the phone, but I'd kinda rather meet face-to-face. I've already been meeting with my psychologist (also part of his practice) over the phone, and that's been okay, but not ideal.

Sorry for blathering on about this, but I've spent YEARS telling myself I needed to get treatment and I'm pretty disappointed that the practice I chose seems to be fucking clown shoes.

Oh, and Wellbutrin's side effects can include irritability, which I'm definitely feeling at the moment!

Oh yeah, I'm familiar with that. If you also consume caffeine, I strongly recommend cutting back. I now do half decaf coffee.

I had already cut caffeine out. And while I do feel a bit of irritability now and again on Wellbutrin, today I think it's directly related to this 600 mg dose I took yesterday, compounded by the fact that I don't like my doctor.

had bad experience with wellbutrin, sorry to hear this. it's frustrating navigating the healthcare landscape when you have trouble in other areas of your life

OMG if I took 4x my normal dose I'd probably shoot up a post office. Even accidentally taking double once made me feel pretty rev'd up.

Yeah, I wasn't even in a bad mood yesterday though! Just more INTENSE. That is until this morning when I realized that dude fucked up my prescription.

So I am finally supposed to start an ADHD med. It's Strattera. I got the prescription a week ago and still haven't made myself start it because I am terrified of drugs. Can somebody please tell me to stop being a baby and take the damn med?

is it something you can phase in? like is it a pill you can easily cut in half? i definitely feel you on the terrified of drugs thing.

I'm supposed to start out with one pill in the morning, then go up to two a day after a week, so I'm already supposed to be phasing it in. Hopefully it's a low enough dose that I won't notice anything dramatic. But I still keep waking up and putting off taking it until it's not morning anymore, and then I put it off till the next day and so on.

The stupid thing is I'm on break this week, so it's the perfect time to start a new med. But I've never taken anything before that's supposed to affect my mind, and even at a low dose, that scares me.

Lily Dale, congratulations on trying to start meds. That's a huge step. I took it back in November and I'm still wading through trying different dosages of different medications.

I agree with you that a week off is the best time to start. I have definitely had issues with side-effects on both Strattera and Wellbutrin, particularly within the first week of starting a new med or upping the dosages. I just kinda had to accept that that might be part of the process and that it wasn't forever and that if I decided that the side effects weren't worth it, I could call my psychiatrist and ask about transitioning to a lower dose or a different medication or discontinuing altogether.

One thing that I did that was helpful was to keep a log of how much I was taking per day and what negative effects I noticed (unfortunately, with both Strattera and Wellbutrin, these are meds that are supposed to take at least six weeks before they show any effectiveness in treating ADHD, so I didn't bother tracking positive side effects). So I'd write down something like

2/17/2022 Wellbutrin 300 mg. Increased dose today. Had slight trouble getting to sleep, but slept through the night.

Anyone ever accidentally taken their Wellbutrin twice? I did yesterday and OH MY GOD.

Basically had a day long anxiety attack about an issue at work - not even a mistake I made just something I should have brought up with my boss earlier and hadn't (even though it was by no means too late to bring it up). When I finally did bring it up, it wasn't even a big deal.

Have you seen those medication caps that have a timer thing on top which tells you how long it’s been since you last opened the bottle? Good alternative to 7-day pill containers (which you have to remember to refill).

That's a brilliant idea actually. Given that I always take the med when I first wake up, and that I have, you know, ADHD, I am prone to confusion about whether I've already taken it or not.

I bought one of the 7-day pill containers the other week after I had some confusion about whether I had taken my pill or not. I'd definitely rather skip a day than take two again though. That was a bit of a wild ride.

The thing about doubling my dose that one time though - is that the Wellbutrin actually felt like it was working and helping me through the day. At my current dose of 300 mg, it feels like the door is slightly more open. But at 600 it was fully wide open and actually helping me out (in addition to making me a bit more irritable and anxious at times). I don't want to ask my psychiatrist to step it up to 600 mg, because at 300, I am at a place where I can just barely manage the insomnia side effects. I'm going to bring this all up with him at our appointment next week.

Xps Amazon has them for pretty cheap

https://www.amazon.com/TimerCap-Automatically-Displays-Opened-Built/dp/B00HJD7RGQ/ref=cart_prsubs_1?pd_rd_i=B00HJD7RGQ&psc=1

I'm only on 150mg, so 300 was a lot for me. But tbf I also drink coffee.

I actually can't drink coffee, even before I started seeking treatment. I used to be a serious caffeine addict. Many, many cups of coffee throughout the day. But at some point, I developed an intolerance for it, to the point where even decaf could mess with my sleep.

Tried and abandoned first type of medication with our 7 year old. Dyanavel, an amphetamine. Gradually increased dosage until she was a paranoid, shitty crank and the entire family was miserable. The next day with no meds she was our sweet daughter again.

I guess we try a methylphenidate next.

Had to come back to share this beautiful article by an eminent psychiatrist, dismantling the "chemical imbalance" nonsense that has impaired so many people's understanding of mental health and behavioural disorders: https://return.life/2022/03/17/the-myth-of-the-chemical-imbalance/

I tried Strattera a few weeks ago and stopped after a day because the side effects were so bad. Thinking I'll try again over a break, because there was just no way I could deal with that while working.

Yeah, Strattera's side-effects were terrible for me. Specifically, nausea and mood swings in the beginning and then a worsening of my insomnia that lasted the duration of me taking it. What did you get?

The second stimulant does not work for my daughter either. Amphetamines and methylphinidates both give bad mood swings at very low doses. Her mom is extremely sensitive to all drugs, which might have something to do with it. Next step is to find a child psychiatrist.

xp First, a feeling of intense cold, so that I couldn't do anything but turn the heat up all the way and crawl under the covers. That went away mid-afternoon, presumably when the pill wore off. Then I was tired and foggy for the rest of the day, then I woke up the next morning with stomach pain and diarrhea that kept me running in and out of the bathroom for three hours. Decided I could possibly deal with the first two while teaching but not the third. (Sorry for the details of gross symptoms. Thanks for asking!)

Yeah, I think my stomach issues lasted for about two weeks when starting it.

Oh jeez, I don't want to put you off of trying to make it work, but I'm obviously not a cheerleader for it.

Yeah as noted upthread I had ED from it and felt kind of dead inside. The good news is that all side effects went away very quickly after I stopped.

Mr. Jaq had dreadful side effects from Strattera - urinary retention, symptoms of shock - that resulted in an ambulance ride to the ER. He's on Adderall now and doing okay with it. If the side effects are too much, there are other options!

Have my psychiatrist med check-in tomorrow. Dreading it. This is the guy who put me on Strattera first, which was a 1.5 month nightmare that didn't have any positive effect on my ADHD symptoms. Since early January, I've been on Wellbutrin with the dose bumped up in mid-February. Side effects are less bad, but once again, with no positive effect on my ADHD symptoms. Both of those are off-label medications for ADHD. Will I be able to get a scrip for Adderall or Ritalin tomorrow? Who knows! Frustrated as hell here.

i like adderall and have not had side effects (i have very low blood pressure so other potential effects were also not a concern). it takes away most of the dread at starting simple tasks and the constant brain fatigue i used to feel. extended release was not good because i couldn't sleep even like 18 hours after first taking it. i'm sensitive to stimulants so i only need a pretty low dose. and it works immediately; you don't need to wait for it to built up in your system. if it doesn't help you will know pretty much right away. seems weird to try off-label stuff before the amphetamines.

global tetrahedron wrote this on thread Is ADHD a real disorder? on board I Love Everything on Feb 11, 2022

slightly embarrassing but i am currently seeing a 'life coach', like an elevated therapist. seems to be getting more trendy. they largely don't take insurance unfortunately but this particular individual specializes in ADHD and processing some of my experiences, including recent positive ones, has been really helpful

global tetrahedron - are you still seeing the life coach? I'm curious about your experience. Just found out that a high school friend made a career switch into life coaching and it vaguely sounds like it could be beneficial to me.

My therapist, who was part of my psychiatrist's practice, absolutely ghosted me a few months ago. One day said that she had a family emergency and that she would call to reschedule, but never heard back from her. And my psychiatrist hasn't mentioned her either. She wasn't really what I needed in a shrink, but the idea of shopping around and trying out different ones was too overwhelming.

Med update: I've been on adderall since my last post. Sometimes it helps. Sometimes it doesn't. I think it keeps me from falling completely off the edge. I don't take it every day. Sometimes I'll give myself a mid-week break or sometimes I'll do every other day. It's a benefit, for sure, but sometimes feels like a minor one. At the very least, I'm not grappling with the insomnia that Strattera and Wellbutrin induced.

Sometimes it helps. Sometimes it doesn't.

Slight correction - it is a benefit for things that I want to accomplish. I still have trouble motivating myself to work, which is more psychological and about the circumstances of my actual job.

that makes total sense

"sometimes it works" is exactly my experience with dexedrine. I struggle to explain this (especially since I can't remember how I was before) and a surprising number of professonals don't seem to get it- surely it either works or it doesn't?

the benefits sometimes feel disappointingly minor and not always guaranteed but without it I can barely get out of bed. it feels impossible at this point to tell how much of this is addiction/dependence or just depression that would be there anyway. the benefits still slightly outweigh the drawbacks in the short term but is that just the chemical dependence?

(I take it with other shit including diazepam which doesn't make for an ideal cocktail & is probably a more pressing addiction concern- also makes disentangling effects even harder)

I spoke recently with a "coach" who specializes in lawyers with ADHD. I decided it wasn't worth the money for me, however, I did learn some really useful things from my one session, the most valuable being that there's good research now showing that at least 30 minutes a day of exercise with heart rate consistently above 130 is even more effective than medication at ADHD management. And since then I haven't been able to do it literally every day, but knowing that does get me out the door for a run or get me to do a high intensity weights workout a lot more than I was doing them before--at least several times a week-- because I just thinking of it as being like taking medicine I need to take. It gives me permission to get over that "but I should be doing [any one of ten other things I won't get to anyway]" anxiety and just go exercise.

The guy also has a podcast called JDHD, which has some pretty strong guests, many of whom are not lawyers, so it might be of interest even if you aren't a lawyer.

lol. love that podcast title.

Yeah, I have a daily morning exercise routine that I've been implementing this year. Started as running, but now just walking while I wait to see an orthopedist about a spinal issue. But I like your way of thinking about it. Maybe I could get a boost by slipping that in during the middle of the day as well.

I definitely still feel like a 30-45 minute walk makes a difference, even if it doesn't hit that BPM goal. I try to at least do that on the days I don't do a real workout. I've started a routine of evening walks with the kids to make sure they get some exercise on these last lazy days of summer.

Yeah, I was feeling much better and more focused when I was actually jogging, but I'm keeping up with the habit regardless.

Lol @ life coach as an “elevated therapist”

(Signed, someone who actually has a graduate degree and mandatory professional supervision and a regulated license to do “life coaching”)

TBF this is obv no assurance of quality, but gives you a little more to go on than someone who took a weekend MLM class and slapped up a “life coach” shingle.

Fair criticism!

I was just looking into the therapist who dropped me this spring and it turns out that her doctorate had been from a now-shuttered for-profit college.

I think the psychologist I saw as a teenager was a solid guy. Too bad I didn't care about my mental health back then.

I am 100% sure there are unlicensed life coaches who are way better than a goodly proportion of licensed providers. It just makes me a little uneasy knowing that there are supremely unqualified people out there practicing outside their scope, and no recourse if their incompetence causes harm.

I mean I am licensed to diagnose and treat mental illness but no way would I ever do that because it is outside my area of professional expertise (I do geriatric case management, no psychotherapy).

Like I would write to that crap psychs licensure board and request disciplinary action for abandonment.

idk these days every time i try to make long-term plans or live an organized life shit goes fucking apeshit crazy in unpredictable and unexpected ways, lately i'm just living into "i'm just going to fuck around until some emergency comes up that needs my undivided attention, should take about five minutes"

people are like "yeah but why adhd" and i've been living in a permanent state of crisis for i don't know how long, why anything _but_?

I wrote something about my experience of ADHD, may be of interest to fellow ADHDers or parents of the same.
(it's a podcast but you can also read it)

https://centuriesofsound.com/podcast/1-1-threw-it-in-the-bin/