View Full Version : Extremely Stressed - Where do I go from here?


SincASDF
02-21-12, 01:00 AM
Hello everyone, I can't say I've been a common visitor to the site for a while, but the threads I have found while researching ADHD on Google were very helpful. I'm hoping someone can give me some insight into my problems and point me in the right direction to fix them or at least deal with them, as the two separate psychiatrists and two separate counselors don't seem to know what the right direction is so far.

This is a rather long post, I realize not everyone has the time to take every detail into account but I would appreciate any feedback, there's a 'tl;dr' section at the bottom. Thanks.

My name is Adam, I'm 20 and am currently a sophomore engineering student full-time. I should probably preface by saying I have been diagnosed with ADHD and comorbid depression and fully believe I indeed have both. I blame the problems that I have day-to-day with depression are as a result of problems caused by ADHD, and I think the latter is the more serious issue. I am also mildly anemic (via genetics: http://en.wikipedia.org/wiki/Thalassemia) which I'm sure confounds problems already present. Lately I'm under the impression that there is something else amiss as well.

So while I coasted through grade school without issues beyond homework completion, I never expected the kind of challenge college has proven to be thus far. Whereas in high school, I seemingly would pick up enough information while spacing out in class to do well on tests - in college I wasn't satisfied with just the bare minimum I had gotten by with during high school as I'm now dropping thousands per semester.

Since then though, it seems like the harder I tried to improve, the worse I end up doing. The more determined I am at once point in time, the less-so I am the next morning when I wake up to go to class. I sit there and recite all of the reasons I'm going to hate myself later that day but it's like I'm a different person, I just could give a **** less at that point in time.

I almost always seem to be in that state of mind during any time I need to get something done. Even when I try 'bribing my inner child' or eliminate every possible thing that I can fiddle with to waste time I will STILL manage to get literally nothing done over literally the course of up to 12+ hours of forcing myself to sit in the same place in an attempt to get something done.

Additionally I have always been seemingly permanently tired growing up. I would naturally want to stay up later at night and wake up later in the morning. I often wake up with headaches that get excruciatingly worse through the day if I don't take something for them as soon as I get up. I also often wake up with a nagging pain in my lower back - I instincively say that it feels like it could be my kidneys and not just my back but I really don't know for sure. I have pretty sever anxieties but that seems to be mostly a product of stress (and Adderall). before I trained myself to notice when I'm doing it I used to waste vast amounts of time trying to figure out what I should do in what order (like petty things that I shouldn't care about) and actually doing anything.

I honestly hope there is something stupid that I have overlooked. I cannot pay off my school's debt if I can't pass my second year.

Medications thus far:
+20mg per day - Celexa/citalopram HBr - start early August

+Self discretion (a hit or two right before most classes/assignments) - cannabis - started early September when Celexa did nothing

+Celexa dose doubled late September

+20mg x 4 per day Adderall - start mid October
-Cut smoking to few times per week (for: stress relief/easing god awful Adderall comedowns/fun)

-Mid February - Taken off Adderall (still taking them as needed so I can stay awake for more than four hours a day)
-Taken off Citalopram - oh man withdrawal is fun
+40mg x 2 per day Strattera - nothing spectacular so far from the first couple of days on it

Other treatment attempts:
Binaural beats
Mediation
Magnesium supplements
Multivitamins
Fish oil supplements
B-vitamin supplements

I also have tyrosine supplements being shipped to me off Amazon, I thought it might be helpful to look into thyroid issues since my psychiatrist has been of no help.

So far the most effective things I've attempted seem to be coffee and weed ironically. Problem with these is that I develop all but complete caffeine tolerance within a week or so of drinking enough coffee to get me through the day and the latter option would never be acceptable to my parents regardless of what I tell them.

So here I am now, paying $35k/year after financial aid to barely manage a fantastic 2.5 GPA (it's actually not possible to get below a 2.5 at my school) and still heading increasingly downhill (now relying on my professors empathy to pass in many cases). At this rate I'm either going to never land a job or more likely be forced to drop out entirely - how I can ever pay my loans at either point is not something I have any idea of.

I'm just frustrated and lost. I'm out of ideas and running out of steam (which only makes everything worse). Counselors all seem dumbfounded by what I tell them, every session results in me sitting there venting while they smile sympathetically and nod.

I breezed through gradeschool, was always told that I was smart or whatever and definitely coasted through, but I feel totally crippled in college. I want to do well and think I have the ability to do so, but the harder I try to do well the harder everything seems to become. I am watching my life fall apart and don't know what to do about it. I don't have any external support - I get the impression my doctors have not the slightest idea what they're doing in my case and my parents only ever remind me of all that I have to lose if I fail and tell me to stop being so argumentative if I try to tell them that I'm amazingly not trying to **** up my life. I just don't know what to do, I'm willing to try anything at this point and I'm not getting anywhere on my own. I'm sick of being pitied for an opportunity to pass these classes I feel more than capable of doing well in on my own

Is there anything I can do? Does it sound like it's not just ADHD but additional comorbid problems or something else entirely? I asked my psychiatrist about the possibility of thyroid exhaustion and he simply replied that we should stick to things that can be tested for... how does one get a diagnosis if it can't be tested for?

Thank you immensely for wading through all of the above - I am extremely grateful for any ideas anyone has to offer.


TL;dr
1. Have ADHD (and/or something similar cormorbidly), major depression that I've dealt with for many years, anemia, constantly fatigued for as long as I can remember, and will sleep for as long as I'll allow myself to. I also have a tendency to wake up with headaches that get worse through the day and often have lower back pain upon waking up.
2. Medications timeline listed above - none really help, Adderall makes my problems worse as often as it helps me, Celexa has had no tangible effect (except for withdrawal of course) and I have only just begun Strattera but don't have utmost confidence in it.
3. I need to figure out how I can possibly pass my classes on my own (and hopefully put forth a lot more than just passing).

Thanks.

PS If something doesn't make sense I probably glazed over it, please let me know so I can clarify.

Amtram
02-21-12, 12:34 PM
It all makes sense - when we hit college, we're expected to self-regulate. Without the same daily schedule (not only classes, but homework routines, eating, bedtime, etc.) and parents and teachers around who remind us and prod us and keep us on track, we can suddenly find ourselves in college unable to do all that without the people who forced us to do what we didn't like doing.

You're on an SSRI. You're taking an ADD medication. You are self-medicating with an illegal substance that you're not supposed to be talking about here (just to let you know for future reference) and still not managing.

What you need is possibly different medications, but definitely behavioral therapy. Because other people prodded us into productive behaviors, we sometimes don't learn how to do it alone, and that's what it sounds like you need. Just as the downward cycle is self-perpetuating, so is the cycle of success - but unless you get help learning how to kick start yourself, nothing's going to change.

Check with your student health care center. There may be a psychologist and/or support groups, or a referral service for affordable care.

lateralthinker
02-21-12, 04:10 PM
A couple of things stood out:

Your Strattera starting dose is oddly high. 40mg is usually as high as it goes when starting. I started at 40, bumped up to 80, then 100mg. I thought the 80mg wasn't working but the amount in my system got high enough that it became totally unproductive. 100mg gave me all the side effects on steroids. I even developed tics when I got upset which was most of the time. I've weaned back down to 40mg once a day and so far, so good. You need to anticipate a few weeks before you have any real effects followed by some adjustment in a best case scenario. Strattera does not play well with others; meds, conditions, or coffee. I've been taking Wellbutrin which is and anti-depressant and an ADHD med.

Smoking the funny stuff is NOT helping you. That's for people who don't have ADHD. An addictive personality comes with it. You will get more of the paranoia and scatterbrain that you will any real sense of calm.

Tiredness:
I was born tired. Before I started the Strattera I HAD to have and afternoon nap to get through the day. I still prefer it (worth a try), but I can still survive even if I don't get to take one. You may find this problem going away somewhat with properly managed meds. Your brain won't be in a constant state of overdrive.

SincASDF
02-23-12, 08:47 AM
It all makes sense - when we hit college, we're expected to self-regulate. Without the same daily schedule (not only classes, but homework routines, eating, bedtime, etc.) and parents and teachers around who remind us and prod us and keep us on track, we can suddenly find ourselves in college unable to do all that without the people who forced us to do what we didn't like doing.

You're on an SSRI. You're taking an ADD medication. You are self-medicating with an illegal substance that you're not supposed to be talking about here (just to let you know for future reference) and still not managing.

What you need is possibly different medications, but definitely behavioral therapy. Because other people prodded us into productive behaviors, we sometimes don't learn how to do it alone, and that's what it sounds like you need. Just as the downward cycle is self-perpetuating, so is the cycle of success - but unless you get help learning how to kick start yourself, nothing's going to change.

Check with your student health care center. There may be a psychologist and/or support groups, or a referral service for affordable care.

I have been going to the health center at my school since this whole ordeal began =/
Do I need to specifically ask for ADHD help versus just 'support'?

I stopped taking the SSRI ~a week before that post and just now am starting to feel better (over withdrawal plus some, that is). I have noticed within the past couple of days that I have actually been feeling a lot more in control of my mind's processes (if that makes any sense). I can kind of remove myself and make decisions from a far more 'top-down' and unbiased perspective (something I distinctly remember doing in the past now that I'm able to do it again).

So be it caused by Strattera, the lack of an SSRI, or even just from the shock of quitting an SSRI cold-turkey, I'm hoping it continues to improve.


A couple of things stood out:

Your Strattera starting dose is oddly high. 40mg is usually as high as it goes when starting. I started at 40, bumped up to 80, then 100mg. I thought the 80mg wasn't working but the amount in my system got high enough that it became totally unproductive. 100mg gave me all the side effects on steroids. I even developed tics when I got upset which was most of the time. I've weaned back down to 40mg once a day and so far, so good. You need to anticipate a few weeks before you have any real effects followed by some adjustment in a best case scenario. Strattera does not play well with others; meds, conditions, or coffee. I've been taking Wellbutrin which is and anti-depressant and an ADHD med.

Smoking the funny stuff is NOT helping you. That's for people who don't have ADHD. An addictive personality comes with it. You will get more of the paranoia and scatterbrain that you will any real sense of calm.

Tiredness:
I was born tired. Before I started the Strattera I HAD to have and afternoon nap to get through the day. I still prefer it (worth a try), but I can still survive even if I don't get to take one. You may find this problem going away somewhat with properly managed meds. Your brain won't be in a constant state of overdrive.

What I have written up there is extremely abridged; I realize how high my dosages are but it's (currently, at least) without side-effects. I similarly started on 20mg x4/day of Adderall (which is obviously huge for a starting dose), and reached the same conclusion that I was being hammered with side effects and not realizing it. I've fluctuated my dosage a ton over the few months I've been on it, hoping that it was me simply taking way too much. I found no relief from any anxiety, down to when I was taking a 5mg x4/day. The only difference I could tell was that I no longer had that unnatural immunity to being too sleepy anymore.

It seems that no matter what the drug, I am both highly resistant to its effects and metabolize it extremely quickly. I seem to hit the 'comedown' phase of Adderall no longer than two hours after dosing. I went through at least 15 different topical steroids for a fairly mild case of psoriasis that I have - three years after diagnosis I'm using literally the strongest topical steroid available for prescription (http://en.wikipedia.org/wiki/Topical_steroid). It works like a charm without a single side effect a nearly year into using it.

That said, I'm not entirely sure that it really means anything that my typical response to other medications is usually diminished or not - I wouldn't rely on it to decide. I started with 40mg each morning for the first few days (half life is fairly short surprisingly) to make sure it doesn't affect me in any unexpected way.

I'm actually still taking (some) Adderall (one withdrawal at a time D:), with no side effects from either unless I take both at once (even then I just sweat a little extra for ~an hour).

As far as the illegal stuff, I'm confident it's not the cause of any additional problems. It has literally helped me focus by itself more than any of this other crap I've been taking. I realize how paradoxical it sounds given that it invokes the opposite in most people, but I get a clear impression from how other people act and people I've discussed it with that I react very differently in almost every way (I have never gotten paranoid, ever). It doesn't effect my ability to think at all, it just lets me set something as 'current task' and actually follow it through.

I did still try to see if it were compounding issues - two weeks of no smoking, passed a drug test, and noticed nothing but a shorter temper and extra hellish Adderall crashes. Related, I had no problem with cessation nor have any problem running out for a few days (I usually literally never think of the substance when I don't have any).

That said, sorry I brought it up!