View Full Version : [Long Post!] Curious on Co-existing Conditions, Meds


DandG4evr
04-02-12, 06:32 AM
Pardon me if this isn't the right forum... Long post ahead!

I have a few conditions going on in my life; Mainly I have developed a nasty sleeping problem (I believe I'm getting too much of the dream-cycle; I feel like I dream all night and wake up exausted. Either that, or I struggle to get to sleep and do not get enough), I am struggling with depression again (though trying to manage it as it has previously been treated. I am no longer on medication for this), and the possibility of being ADHD/ADD.

My concerns/questions are these:
Everyone I know with an ADD/ADHD diagnosis is on Adderall or Stratera. I don't know much about the latter, but I am VERY nervous about the former. I know it can become addicting/there can be chemical dependence? I don't know if this reduced if taken correctly I suppose...I don't mean to judge. I am most nervous about my metabolism; I am rather small (118lbs/ 5'2, average not fit) and I'm afraid I will stop eating (since that happened with ritalin).

I'm also worried because my friends who are prescribed it seem 'up' alot of the time; is this an adjustment thing? If I am prescribed something like adderall or stratera, will they affect my personality/energy level permenantly (as in while I am on a prescription) or only during the adjustment period? What if I 'enjoy' the pill? One of my friends says he likes how focused he feels; is that bad? Should I not like it? Is it generally unpleasant, or neutral? Nothing I've ever been prescribed seems like a candidate for something to abuse (besides painkillers I had during surgery once, and I can't remember how they were because I slept the whole time, haha).

I guess I'm scared of something that has the potential to be abused...? If I enjoy taking the prescribed amount but do not take more or different amounts than instructed, is that abuse too in a way? I know you tell your psychiatrist about bad effects; do I tell them if I am having good effects too? It's not supposed to feel 'fun', right? But how do you differentiate feeling 'good' because you are balanced versus 'good' because you are 'up'? Is this even an issue for most people, or am I over-thinking it? Will I just know if I'm prescribed it if it's the right fit or not?

What about depression and insomnia? If pills prescribed for ADHD are 'uppers', then what will happen in regards to the other two conditions? I have been feeling concerned that my depression is returning lately and have considered seeing a psychiatrist and a therapist; can you have something for depression AND adhd without making yourself sick? Will prescriptions possibly cause damage (i.e. liver, kidney deterioration faster than if not on the medication). I haven't had any antidepressants that felt uh, "fun" or "up" or anything; I have only had zoloft, which I felt just kept me from hitting rock bottom. No distinct mood elevation, per say. Is that a "downer"? Isn't a "downer" plus an "upper" dangerous? I know that may be oversimplifying but it's concerning to me.

And for my problems sleeping, should I ignore those as a potential subset of issues regarding either the depression or ADHD? I feel like treating all 3 with medicine might be a little much. However, I am very bias towards medication when it comes to my self because of the negative experiences I have had. Maybe it's possible you can take things for each and not have problems, but I don't know. I'm not on any medication at the moment beyond BC; it makes me nervous to consider so many medications. The "test various medications" period has often left me hurting. Prozac, for example, caused my first complete and utter emotional break-down on my second day of it.

I understand a medical professional can answer these as well, and would consider the things I am saying too, but because I have such a long wait period until I can get into a doctor, therapist, or the psychological eval, I was hoping to gather a few opinions! I want to be educated on my body and what I am putting into it; on a side note, I will be going to therapy if I get medication for depression (is it recommended you get therapy if you're diagnosed with ADHD?) so I am not just looking to have medicine as a treatment; it's more a consideration now because my own methods have failed me (healthier diet, attempts to regulate sleeping schedule with time and herbal teas, trying melatonin a few times, positive self-talk, exercise, etc).

ILoveChaos
04-02-12, 07:43 AM
You have lots of questions so I might miss a few but I'll try

1. Will you lose weight/have an increased metabolism? It varies from person to person but most likely the answer is yes. This doesn't mean you're going to go down to 80lbs and not be able to eat. I haven't lost too much weight, it's just harder to put on muscle.

2. What does it feel like? The feeling that psychiatrists are worried about has always been confusing to me. Of course I feel better while on the meds because I don't have to constantly move around. Medicine is supposed to make you feel better, correct? I think what they're really worried about is the euphoria associated with stimulants. I don't know many people that have had problems with it. Just be aware of it and you should be fine.

3. Abuse potential? People seem to get really confused about substance abuse. If you take the correct amount in the correct way you shouldn't have any problems. Addicts are addicts way before they start abusing a substance. Lots of research on this if you want more.

4. ADHD + Insomnia and depression? You definitely have to worry about how late you take the meds because it can and will mess with your sleep schedule. Getting treated for the depression (If that is your diagnosis) should help with the insomnia. You can indeed be treated for ADHD and depression at the same time. Zoloft is an SSRI which effects the neurotransmitter seratonin whereas ADHD effects norepinephrine and dopamine. Different drugs with different mechanisms.

5. Treating all three problems? There are tons of options besides taking medicine to treat all three problems. They might even resolve as taking care of 1 may lead to a decrease in severity of the others. How long have you tried the healthier diet, etc? It doesn't always work, but diet and exercise can do wonders if you have the time. I've found it's almost essential for me or my sleep schedule can get really messed up at time.

6. I believe it is recommended to receive some kind of behavioral therapy once you are diagnosed with ADHD. There are strategies to improve focus and other techniques to help along with the medication.

My last question is about what you've said about your sleeping problem. Depression and anxiety can cause you not to sleep well. Why do you think you are spending too much time in the "dream-cycle"? Without a sleep study, there isn't much that can be done and my experience is that taking a medication for insomnia can be a slippery slope and sticking with the melatonin, chamomile tea, etc. is much better.

Hopefully I've answered a couple of your questions. All of my answers come from research I've done myself or information I've pulled from my classes (medical school). People may have opposing views or opinions. You should have these questions ready for your doctor when you go, but asking all of these might be a little much. Also, if you receive meds for the treatment of your depression like Zoloft, be aware that it often take 6-8 weeks to see an effect and even then dosing adjustment is usually necessary.

Hopefully this helps and again, this is just my opinion and by no means medical advice in any way, shape, or form. I would do some of your own research as it made me feel a lot better about taking adderall.

ShamanDrum
04-02-12, 09:04 PM
I'll give my perspective on this, having been on stimulants for years. I quit them cos I didn't like them (but everyone has a different experience). Actually, it wasn't so much that I didn't like them. It was more of a love/hate relationship.

First of all, If you're spending too long in the dream cycle (REM sleep) it might be worth trying Clonidine. Look it up on wikipedia or google. My pdoc prescribed it to me for restlessness/anxiety associated with ADHD, but since then I've found it has many other uses, including help with sleep. Note that in small doses, clonidine increases the REM cycle, but in moderate doses it decreases it. Also, Clonidine apparently works VERY well in conjunction with stimulants. It takes away some of the edgy side-effects of stimulants. It can make you feel overly sedated if you use too much, but if you use it along with a stimulant, that should offset that side-effect. Another great thing about Clonidine is that it's totally non-addictive. I used it for a while... then stopped... no withdrawals whatsoever. Currently I'm on Cymbalta, an SNRI, which is notorious, as are all other SSRI's and SNRI's, for increasing the dream cycle. I use Clonidine at night to counter that side-effect and it works pretty well for me.

Yes, stimulants will make you feel 'up'. But that's not necessarily a bad thing. Remember how I said I had a love/hate relationship with them? Well, that was the love part. I enjoyed feeling more alive, awake and plugged in. I never became dependent though, nor did I abuse them, and I had no trouble quitting them (don't take any stims at all at the moment since Cymbalta has addressed all symptoms of my ADHD). If you're worried about abuse potential, then you're probably not a candidate for abusing them. Just be cautious and use them as prescribed. Also, if you ever decide to stop them, wean off slowly and it shouldn't be a problem. I weaned off very slowly and even cut the pills to take less and less.

How stims will affect your depression/insomnia is anyone's guess. The only thing you can do is try and see. Note that you have to use them for a few weeks before you can decide how they affect you. In the first couple of weeks of taking them, you might get disturbed sleep, but that should pass. I took dexedrine (similar to Adderall) and in the first few weeks found myself constantly waking up at night with a racing heart, but that went away after a while and I slept really well.

One thing I have learned throughout the years I've been trying different medications is that it is impossible to guess how they will affect you. Brain chemistry is too varied between individual and too much of a mystery to make accurate predictions. Experimentation is the only way to go. And if you're experimenting under medical supervision, nothing should go wrong.

ILoveChaos
04-03-12, 11:14 AM
4. ADHD + Insomnia and depression? You definitely have to worry about how late you take the meds because it can and will mess with your sleep schedule. Getting treated for the depression (If that is your diagnosis) should help with the insomnia. You can indeed be treated for ADHD and depression at the same time. Zoloft is an SSRI which effects the neurotransmitter seratonin whereas ADHD effects norepinephrine and dopamine. Different drugs with different mechanisms.

I wanted to make sure I amended this statement by saying that the drugs I mentioned above mainly effect the neurotransmitters above, but amphetamines also mildly affect serotonin as well. Probably doesn't matter, but I don't want make any false statements.