View Full Version : Doctors no longer think I have ADD, want to cut me off Vyvanse for good


low_dopamine
02-19-14, 07:06 PM
So my psychiatrist and my counselor have recently re-diagnosed me with BPD (Borderline) and not ADD, and as such they no longer want me to be on Vyvanse. Moreover, because I have a recent history of abuse with the stimulants (unfortunately, and after a 1.5-year history of NOT abusing them), they think I should NEVER be back on stimulants, ever again, in my life, claiming that it is highly unlikely I could ever get the abuse issue under control, even with a combination of weekly counseling and weekly dispensation of the meds (rather than monthly.)

I agreed with the diagnosis of Borderline Personality Disorder--it explains a lot in terms of my emotional dysregulation and other continual emotional problems in my life. However, I also strongly believe that I have low dopamine, and have had this problem my entire life. I had a bit of impulsivity as a young kid (mostly too much talking / not paying attention in class), but for the most part my grades and behavior were fine throughout all of my K-12 education. Things got really bad when I went to college, nearly failed out, then went to grad school and failed out twice due to focus/motivation issues. (Didn't start on stimulant meds until third time around in grad school, where I am now.) So if I do have ADD, it might not be severe enough to merit stimulant meds.

Also, for the record, I *have* been officially diagnosed with ADD by a previous psychologist (took the "clicker test" and all that for inattentiveness, whatever it's called, and passed solidly in the inattentive range.) The recent re-diagnosis--by different mental health professionals--didn't involve the clicker test, but it did involve an entire day of interviews, IQ tests, and hours of self-reported questionnaires (not to mention reports from friends and family to supplement.) So it's hard to say what's really going on in my brain and what kinds of meds could benefit me.

The doctor and counselor who don't want me on the stims are great people who have helped me with a lot of problems so far. But now they want me to sign a release form about my abuse of the medication to my previous providers so that I can't go back to them if I feel I should get back on the stimulants; in fact, they've issued an ultimatum and will no longer see me unless I sign the releases. I honestly feel like I no longer know what the right thing to do is.

dvdnvwls
02-19-14, 07:17 PM
It sounds like they are doing the right thing and I think you should go along with it.

The clicker test is not important for ADHD. The interview and report tests are the important ones.

Crosswired
02-19-14, 08:26 PM
I did the clicker test, but I don't think that is a good indicator. Looking at a person's life from childhood on and recognizing certain behavioral patterns that have persisted throughout is the best way to diagnose ADD in my opinion. I also think most professionals/doctors are woefully unqualified to determine whether someone has ADD.

I figured out I had ADD on my own using Google. Took me another 10 years to actually get diagnosed by a psychiatrist and receive meds. Have you thought about non-stim meds like Strattera?

low_dopamine
02-19-14, 08:52 PM
I tried Strattera but it was worse than useless: it increased my anxiety while doing nothing for my attentional problems.

I guess one thing I've been wondering is: what's the difference between my chronically low dopamine levels and those of someone with ADD? I saw another post here (http://www.addforums.com/forums/showthread.php?t=158245) about Motivation Deficit Disorder, which I definitely have and have had since at least age 16.

Lunacie
02-19-14, 09:48 PM
I don't know much about BPD, but surely there is more to it than emotional regulation.

Dr. Barkley shows how emotional regulation is impaired in people with ADHD in this video.

http://www.youtube.com/watch?v=7cw8jHUkHiA

ginniebean
02-20-14, 12:10 AM
Borderline does share a lot of symptoms with adhd, however, the difference is they get better with treatment of borderline.

What treatment are they proposing?

low_dopamine
02-20-14, 12:38 AM
Borderline does share a lot of symptoms with adhd, however, the difference is they get better with treatment of borderline.

What treatment are they proposing?

Well...with all due respect...isn't any disorder supposed to get better with treatment?

The treatment they're proposing is simply a combination of my current antidepressants (Cymbalta and Welbutrin) with weekly talk therapy. The antidepressants work decently--they keep me from dropping too low too often--but when I try to do my schoolwork, I get extremely depressed.

I've been off of the Vyvanse for three weeks now. Completely over the physical withdrawal. However, in the past three weeks I've fallen so far behind in my coursework--graduate studies in mathematics--that I'll probably have to give up this semester and drop my courses.

Again, I'm very curious: what's the difference between the low dopamine of someone with ADD and the low dopamine of someone like me who has always had issues with focus and motivation his entire life but "doesn't have ADD?"

dvdnvwls
02-20-14, 02:55 AM
ADHD is ADHD; it isn't a dopamine deficiency.

daveddd
02-20-14, 07:03 AM
Borderline does share a lot of symptoms with adhd, however, the difference is they get better with treatment of borderline.

What treatment are they proposing?

adhd has a better treatment outcome than BPD??

you knew that

especially now that the emotional regulation issues are so easily treated with mindfulness

sarahsweets
02-20-14, 07:17 AM
DO NOT SIGN ANYTHING. They are not your lawyer, they are covering their own as*ses.

Corina86
02-20-14, 07:21 AM
You do know that Wellbutrin effects the dopamine levels in your brain, right? So, if you're worried that you won't be on any ADHD medication, you should know that you're still on them. I don't know if signing this paper would do you any good, but you should know that medication abuse is very serious and you should try to give non-stimulant medication a chance as well.

low_dopamine
02-20-14, 08:58 AM
ADHD is ADHD; it isn't a dopamine deficiency.
Apologies for my oversimplification, dvd. It's just that it seems I have so much in common with ADD people--so many of the same struggles--that the same medications should work for me, and in the same way, to re-balance my brain chemistry.

And they did. Although admittedly I might have been on too high a dose (60mg Vyvanse) and had wondered for a while if I could backtrack.

And isn't dopamine deficiency one of the major proposed causes of ADD?

@Corina86: Although I've been on Cymbalta for a while, I only got on Welbutrin when I got off of Vyvanse. (I already knew that Welbutrin affects dopamine, but I appreciate your pointing it out in case I didn't.) Welbutrin is helping slightly, but it's nothing like Vyvanse, as you all probably know. As I mentioned above: I tried Strattera in the past, but it was a bad experience. My doctor also tried Nuvigil with me, but all it did was give me a pounding heart with very little attentional benefit.

@daveddd: I enjoy your posting style, which is reminiscent of haiku. However, I was confused as to what you're saying. And for god's sake, I need to point out that mindfulness is NOT an "easy" treatment for *anyone* with emotional problems. Maybe it was easy for you...and it works for me, in small ways here and there in my life...but, man...it's just not that easy. (Sorry, don't mean to sound p!ssed at you. I just couldn't let such a simple claim go unchecked.)

daveddd
02-20-14, 09:40 AM
That's ok

It's very easy with proper guidance.

low_dopamine
02-20-14, 09:46 AM
That's ok

It's very easy with proper guidance.

Wait, are you one of those TM converts? ;)

I still want to disagree with you. But maybe I just haven't found the right teacher yet.

daveddd
02-20-14, 09:59 AM
It's funny about the haiku thing. I've heard that before


That's how the stuff comes out of my head

addthree
02-20-14, 11:22 AM
You should avoid the doctor and DO NOT SIGN anything. In fact run away avoid all contact and find a new doctor.

ginniebean
02-20-14, 11:45 AM
Well...with all due respect...isn't any disorder supposed to get better with treatment?

The treatment they're proposing is simply a combination of my current antidepressants (Cymbalta and Welbutrin) with weekly talk therapy. The antidepressants work decently--they keep me from dropping too low too often--but when I try to do my schoolwork, I get extremely depressed.

I've been off of the Vyvanse for three weeks now. Completely over the physical withdrawal. However, in the past three weeks I've fallen so far behind in my coursework--graduate studies in mathematics--that I'll probably have to give up this semester and drop my courses.

Again, I'm very curious: what's the difference between the low dopamine of someone with ADD and the low dopamine of someone like me who has always had issues with focus and motivation his entire life but "doesn't have ADD?"

What I meant, is that the symptoms of adhd in adhd are neurologicaly based, this is not thought to be true inthe same with with borderline. With adhd if you take away the treatment the symptoms will always be there.

The good news actually for you, (if they're right) is that you have the possibility of fixing these symptoms and no longer being bothered by them. Cold comfort when you're having problems in your graduate studies and sorry you're having to go thru that.

low_dopamine
02-20-14, 12:05 PM
What I meant, is that the symptoms of adhd in adhd are neurologicaly based, this is not thought to be true inthe same with with borderline.

Ah, ok, now I see what you're saying. Nothing personal, but this claim is actually wrong, at least according to my doctors: Borderline Personality Disorder is, in fact, a brain disorder--it has a neurobiological cause. As I understand it, people with BPD (like myself, I guess) have defective amygdalas and prefontal cortexes. As my doctor described it, when it comes to pumping out strong emotions, my foot is pressing hard on the gas pedal *and* I've got faulty brakes (the "brakes" being the prefrontal cortex, which is supposed to help keep those strong emotions in check.)

See also: http://en.wikipedia.org/wiki/Borderline_personality_disorder#Brain_abnormalitie s

As of yet, no pharmacological treatment specific to BPD has been developed; the suicide rate with BPD is very high, and because of that drug companies are hesitant to develop and test new medications on BPD subjects because of liability. (I've recently been learning all of this. It's been quite a month for me.) Hopefully as awareness of the *biological* roots of the disorder increases, so will demand for development of therapeutic medications--just like with ADD back in the 80s and 90s.

daveddd
02-20-14, 12:21 PM
Yea the emotional dysregulation in bpd is thought to be inborn

Leading to poor coping mechanisms

Stimulants are showing to help emotional problems. But only if no addiction is present

Dbt works well for bpd

daveddd
02-20-14, 12:24 PM
I'm sorry. Emotional sensitivity is inborn. Making regulation difficult


Per Marsha linehan

Azalea
02-20-14, 02:23 PM
Hi there,

I was diagnosed with BPD about 9 years ago. I've tried many different combinations of meds until I found something that kept me feeling... not happy, nor sad... just "here", which is better than nothing... for now, at least. Before that, nothing else had worked for me. I felt depressed and angry all the time and was unmotivated to get out of bed for any reason at all. My symptoms were spiraling out of control, and impulsive (bad) decisions were being made all around.

I'm currently on a combination of Wellbutrin and Topamax. I keep getting told by my doctors that Wellbutrin is also prescribed for ADD... WELL, I wouldn't know it!! It hasn't done a damn thing for my inattentiveness, and I'm on relatively high dose (450mg.)

But everyone's different. Hopefully, the Wellbutrin will work out for you (if you do decide to go down that route.) Your current doctors sound like great people who are looking out for your better interests... but I don't think it's fair for them to just tell you flat out that you're NEVER going to be able to get a handle on the abuse. That's like telling someone in Alcoholics Anonymous that they're never going to sober up. Really...? I know that impulsivity is a huge problem in BPDers, but I know with treatment and self-control, it's doable.

I've been reading in different places that Wellbutrin and Adderall play nicely together. I could definitely see that; I can also see the concern for stimulants exacerbating the problems for BPD. I've been able to manage a lot of my angry outbursts, but that has taken years and years of practice, meditation, breathing exercises... and being hyper-vigilant of my moods. Even then, I slip up.

I'll have to report back to you once I get to seeing a new doc about my ADD symptoms and see what they come up with. Getting my foot in the door for ADD treatment hasn't been a walk in the park. I have an appointment this Sunday.

Hang in there and keep us updated!

low_dopamine
02-20-14, 06:15 PM
Thanks for the replies, guys. I guess I'm feeling pretty depressed right now because for a long time I'd thought that I could get all my problems under control with a combination of stimulant medication and counseling. But my doctor and counselor don't believe I would be able to go back to taking the meds regularly, without abusing them, even though I had managed to do so for a year and a half. I respect them a lot but strongly feel I need at least a second opinion on this.

daveddd
02-20-14, 07:53 PM
you asked what DBT was like in another thread

here is video of marsha linehan (creator of DBT) giving it

http://www.psychotherapy.net/video/dialectical-behavior-therapy-linehan?gclid=CLm8l5Py27wCFUYS7AodPywACA


http://www.youtube.com/watch?v=Im3aLArs2nc

KPinfra
02-22-14, 12:19 PM
I think I might be able to help!!!

Can you correlate any increase in borderline traits with either of these:
1) Use of stimulants to treat ADD/ADHD increasing emotional liability?
2) Vyvanse increasing emotional liability?

Vyvanse began to give me borderline traits. A sleep specialist recognized it. I've been tapering (now down to 30mg) 10mg per week with that doctors help, and, while the tapering hasn't been easy (adderall I had no problem, Vyvanse has been hard), almost all my borderline traits are gone - and to the outside world, they are gone.

And, realize that those traits might creep up on you.

Vyvanse I found if too much was prescribed, it made me very tired, so , I could even see how you came to abuse them. But, when you did abuse them, did more actually would just make it better for a few weeks then back to being tired? Only.. with, increased emotional issues?

If you are borderline, DBT is certainly an option, but, try getting off the stimulants first. Note that you'll need a solid 3 months AFTER being off Vyvanse for the protracted withdrawals to go away. Meaning, the withdrawals will be one thing, but then you'll be extra ADD for a few months after - so, give your body time to adjust. You can't expect it to re-balance itself super rapidly after long term stimulant use.

You'll need some emotional support during the Vyvanse taper, Aspirin or Tylenol, funny movies :) , and lots of fluids. Do not taper faster than 10mg per week. And, if you have a tendency to abuse, toss old scripts you might have left over. Just get 7 day scripts, 10mg less each week. If you need more time, drop every two weeks.

THEN. Let's see if you still need DBT. Or, if it just might make your traits much more manageable.

If this sounds like a possibility, feel free to PM me, and I'm happy to give you my email contact. (goes for anyone else too :)

Stevuke79
02-22-14, 02:41 PM
DO NOT SIGN ANYTHING. They are not your lawyer, they are covering their own as*ses.
THIS!! THIS!! THIS!!
:goodpost::goodpost::goodpost:

Psychiatry unfortunately breeds self assured idiots who don't question themselves. That's not their fault; other professionals have the benefit of sometimes seeing their work measured. They experience being empirically right or empirically wrong; effective or ineffective.

That's often not true in psychiatry and so pdocs are often deprived of those instructive experiences. We can't blame them for what they are.

(This is all the more reason to respect quality pdocs like McTavish, who manage to overcome that challenge.)

low_dopamine
02-27-14, 01:18 PM
Ok, so I had a appointment with my psychiatrist this morning. Turns out my counselor was there, too. Together they guilted and strongarmed me into signing the release forms.

I will never be allowed to take ADD medications in my life. Ever again. Because of them and their fears. If I fail out of school, it's on them. My suicide note will read, "Hey, guys...maybe you made the wrong call in treating me. Just consider it."

They have made decisions irrationally, out of fear. Fear for me and fear for themselves (since it's a liability for them if they prescribe me the meds and I OD.) These are good intentions, mind you. But good intentions do not save lives.

I know it sounds like I'm acting childish here. I mean, come on, I'm an adult, I had the choice not to sign. But for complex reasons that I can't seem to understand, I felt forced into it. They've f--ked me over, and now there's a good chance I'm going to fail because of it.

Stevuke79
02-27-14, 01:43 PM
If you tell anyone what you just told us: Strong-armed, pressured, under-duress,.. I would expect that signature to be disregarded. That's often the case in other matters.

Canadian Mess
02-27-14, 02:36 PM
What if you have borderline personality disorder AND ADHD? I think 25% of people with BPD also have ADHD. If you go on ADHD meds, BPD can get worse if only treating the ADHD, but anti-physcotics + ADHD meds are supposed to help...

Here's a way to deal with it... let them try to treat you with the BPD, meanwhile be really attentive to how it makes you feel. Write dairy journals saying your main emotions like on a PMS chart, and symptoms. This way you know if their methods are working or not.

for the ADHD symptoms, alternative approaches may be your only option at this point. like having omega-3 fatty acids, getting 7-8 hours of sleep, using timers to study, exercising 1 hour a day/7 days a week, treating all of the other symptoms and issues to make the ADHD symptoms less noticeable.

It's brutal, but until you give their method a chance, you won't know if it will work for you or if the symptoms will really just go away or not. the only thing you have to lose is this semester :( which really sucks, but may be worth it if you start feeling better.

It must be so frustrating to wonder if it's depression symptoms, BPD or ADHD, or some miserable combination (very likely, most people with ADHD are also screwed with another comorbid mental health problem).... all I can suggest is to try and remove the cloud cover and unmask the beast. Let the BPD get treated, see what you can do for the depressive feelings... and see if the ADHD symptoms are still there, if the BPD seems to end and the depression does too, and all that's let is ADHD symptoms, then you will have your answer. if not, something will get treated regardless which is better than nothing.?

low_dopamine
02-27-14, 05:31 PM
What if you have borderline personality disorder AND ADHD? I think 25% of people with BPD also have ADHD. If you go on ADHD meds, BPD can get worse if only treating the ADHD, but anti-physcotics + ADHD meds are supposed to help...

I strongly feel that I have both solid BPD and mild to moderate ADD. Vyvanse did NOT make my BPD symtoms worse--it made them better! I was much happier on it, I had stable moods, didn't throw tantrums, etc. I really wish I could have found a way to have a combined treatment plan. But now it's too late. I guess I can report back in a few months to see if the "DBT" therapy is working at all or if I'm simply going to fail out of school (for the third time) and then probably kill myself.

Stevuke79
02-27-14, 05:41 PM
IMO, and I'm no expert, I think the fact that you feel you were forced to sign something should be addressed.

(though I suspect if you brought it up with them, they would just try, probably very effectively, to convince you that you weren't forced. But all that matters is how you feel - feeling like you were forced is the definition of being forced.)

Nicksgonefishin
02-27-14, 05:55 PM
Trust and listen to your doctors. You have a hard road ahead. Trust is key. Turning control over even. I think it is very very commendable that you're seeking treatment for the bpd.

The emotional dysregulation can cause innatentiveness. Others could argue that you're simply adhd combined.

Making a suicidal statement over signing a release certainly showed bpd.

I'm impressed that you're open about your bpd. Don't give up on treatment.

Stevuke79
02-27-14, 06:04 PM
I don't know if it's in your best interests to trust people whom you feel strong arms you.

low_dopamine
02-27-14, 09:17 PM
Trust and listen to your doctors. You have a hard road ahead. Trust is key.

Easy for you to say: you're taking Vyvanse, right?

Apologies to all. I'm just so angry at the world right now. So hopeless. I'm beginning to resent everyone in the world who is able to take these life-giving medications that I no longer have access to.

I'm a 32-year-old loser who's never been able to make anything of his life. When I was on Vyvanse, I felt like I had a chance. Now that chance is gone and I'm failing my classes *again.* My suicidal feelings (and tentative plans) are because of this--a culmination--and didn't just show up today because I had to sign a form.

Stevuke79
02-27-14, 09:35 PM
I know it's hard when not medicated, but you can't let it be their fault. You just have to keep heading towards what you need. (Which might involve a lawyer)

Stevuke79
02-27-14, 09:42 PM
There is no reason for you to "trust" people who you feel strong-armed you.

low_dopamine
02-27-14, 10:49 PM
No, it's too late for that. The law isn't on my side any more. There was no gun to my head.

I'm going to try what Nicks said and trust them. Maybe their DBT therapy can help me overcome my sense of hopelessness. And maybe I can learn discipline and delayed gratification, even though I've been struggling all my life to do so without success (except, of course, when I had Vyvanse.)

But if I do fail out, it will definitely be on them. And I will do my best to ruin their reputations.

Fortune
02-27-14, 11:58 PM
If you don't trust your psychiatrist or your therapist, you're probably better off finding someone new. The problem with this is that a new psychiatrist would likely view this as pathologically related to BPD, rather than a genuine need for a professional you can actually trust.

I don't mean it's time to go doctor shopping or doctor hopping, but from what you describes it sounds like they overreacted to diagnosing you with BPD (plus treating it as if it excludes ADHD when it does not - BPD and ADHD travel together frequently enough there are multiple papers on the topic), and pushed you into agreeing with their treatment decisions that now seem to have negative results for you.

As far as the agreement they coerced you to sign, a contract signed under duress is not a valid contract. Plus, they can't really prevent you from getting prescriptions from someone else at a later date.

It will be hard for you to get stimulant prescriptions because of that history of abuse. This is despite the fact that when you put people with ADHD on stimulant treatment, substance abuse issues tend to go away because the core reason for those issues is being taken care of.

Infinityman
02-28-14, 06:12 AM
DO NOT SIGN ANYTHING. They are not your lawyer, they are covering their own as*ses.I so agree with this! Like them or not, I'd find another doc if they tried to get me to sign this sort of stuff.

daveddd
02-28-14, 07:23 AM
just to maybe make you feel a bit better L dopa

the numbers are closer to 25% of people with ADHD meeting the dx criteria for BPD

and the people who meet the dx criteria of BPD, around 70-80% are ADHD

the video above (i apologize if your not interested in it) two of the worlds best (lineman , kernberg) talk about the core of ADHD being the inability to self regulate

this was before barkleys model of ADHD was defined by the inability to self regulate

there is no coincidence here







http://www.youtube.com/watch?v=967Ckat7f98

daveddd
02-28-14, 07:57 AM
right about 12 minutes , for a few minutes is kind of an explanation of the relation between BPD and adhd


http://www.youtube.com/watch?v=7KiihIE0d0c

daveddd
02-28-14, 08:26 AM
If you don't trust your psychiatrist or your therapist, you're probably better off finding someone new. The problem with this is that a new psychiatrist would likely view this as pathologically related to BPD, rather than a genuine need for a professional you can actually trust.

I don't mean it's time to go doctor shopping or doctor hopping, but from what you describes it sounds like they overreacted to diagnosing you with BPD (plus treating it as if it excludes ADHD when it does not - BPD and ADHD travel together frequently enough there are multiple papers on the topic), and pushed you into agreeing with their treatment decisions that now seem to have negative results for you.

As far as the agreement they coerced you to sign, a contract signed under duress is not a valid contract. Plus, they can't really prevent you from getting prescriptions from someone else at a later date.

It will be hard for you to get stimulant prescriptions because of that history of abuse. This is despite the fact that when you put people with ADHD on stimulant treatment, substance abuse issues tend to go away because the core reason for those issues is being taken care of.

i understand the points here

but on the other side, they may not be overreacting , BPDs strength is not self awareness

some doctors actually do know how to handle these situations better than us


with the substance abuse comment "despite substance abuse going away when put on stimulants" you think this applies when the substance being abused is the very stimulants the person was put on in the first place to help with these core issues?


not judging at all, just trying to look at all angles

low dopamine , i agree very much with nick, trust your doctors, at least for awhile

what their doing seems valid

Stevuke79
02-28-14, 08:58 AM
This scares the craap out of me.

I've had traumatizing experiences with BPD family members and I'm a total hypochondriac on the subject. And it's a personality disorder, so if I understand correctly, you can ALWWYS get it. You're never in the clear.

just to maybe make you feel a bit better L dopa

the numbers are closer to 25% of people with ADHD meeting the dx criteria for BPD

and the people who meet the dx criteria of BPD, around 70-80% are ADHD

the video above (i apologize if your not interested in it) two of the worlds best (lineman , kernberg) talk about the core of ADHD being the inability to self regulate

this was before barkleys model of ADHD was defined by the inability to self regulate

there is no coincidence here







http://www.youtube.com/watch?v=967Ckat7f98

Fortune
02-28-14, 10:32 AM
i understand the points here

but on the other side, they may not be overreacting , BPDs strength is not self awareness

The problem I have with this is that you're talking about people on the basis of textbooks and studies.. People aren't textbooks pr studies and there are a zillion ways to have BPD due to needing 5 out of 9 symptoms (at least in the DSM-IV - I think it's four out of seven in the DSM-5). Marsha Linehan divided BPD symptoms into five categories because of this - dysregulation: emotions, behavior, interpersonal relationships, sense of self, and cognition.

ADHD's strength is also not self awareness, but I'll point out that this is not something that gets brought up much around here.

some doctors actually do know how to handle these situations better than us

Perhaps, but if a client is doing well, I find it questionable that doctors would remove the medication that helps that client do well.

Also, coercing an agreement like that is a red flag, and I would definitely go find another doctor because If I'm being pushed into - and especially rushed into - something like that I'm going to walk away.

with the substance abuse comment "despite substance abuse going away when put on stimulants" you think this applies when the substance being abused is the very stimulants the person was put on in the first place to help with these core issues?

If the OP is correct, he was not suffering addiction issues on his prescribed stimulant medication.

not judging at all, just trying to look at all angles

Here's one for "looking at all angles": If you disagree with your doctor's decisions, then get a second opinion. Just being a doctor's client doesn't mean that the client has no agency or no reason to question or doubt doctors.

low dopamine , i agree very much with nick, trust your doctors, at least for awhile

what their doing seems valid

This isn't looking at all angles. It's endorsing one angle. There's nothing wrong with that, but you can't claim to be neutral while taking a partisan stance.

Personally, I'm all for informed consent and trying to have doctors that one can actually trust.

My point is that medical care should be compassionate, and the OP is not describing compassionate care.

I still think what I said earlier: If you don't trust your doctor, find a new doctor. Fire the old one. I don't mean "only see professionals who only tell you what you want to hear" but rather professionals who won't treat their clients as if said clients are the labels they're diagnosed with. Sort of like your comment above about self-awareness. That's more a hindrance than a help, and not just for BPD.

Fortune
02-28-14, 10:43 AM
This scares the craap out of me.

I've had traumatizing experiences with BPD family members and I'm a total hypochondriac on the subject. And it's a personality disorder, so if I understand correctly, you can ALWWYS get it. You're never in the clear.

The behaviors have to start by early adulthood for all personality disorders. Otherwise, you have something else.

If you have it you can be diagnosed with it at any point in your life.

daveddd
02-28-14, 11:17 AM
from the original post
"Moreover, because I have a recent history of abuse with the stimulants (unfortunately, and after a 1.5-year history of NOT abusing them)"

this doesn't sound like doing good to me, thats doing good to you?

unless I'm misreading, was the abuse before or after the 1.5 good years, if its before this whole scenario doesn't make much sense


on the textbook and studies comment, i disagree , their usually accurate

i know its the new politically correct thing , to say we are all special and unique and we all have different separate syndromes

but thats generally not the case , you would be surprised on how similar the human psyche can work

daveddd
02-28-14, 11:23 AM
also on the angles , i thought everyone else did a good job covering the other side

i don't see a need to argue with someone who strongly agrees they have BPD and was diagnosed by pros , and try to convince them they just have ADHD

even though they both share the same biology (and the fact that every member of the forum has a family member with BPD should put any arguments about that to rest)

treatment styles still start with different focuses

daveddd
02-28-14, 11:26 AM
The behaviors have to start by early adulthood for all personality disorders. Otherwise, you have something else.

If you have it you can be diagnosed with it at any point in your life.

this is true

although most likely the snowball begins in early childhood

this offers a view
http://www.ncbi.nlm.nih.gov/pubmed/24117059

low_dopamine
02-28-14, 12:10 PM
Perhaps, but if a client is doing well, I find it questionable that doctors would remove the medication that helps that client do well.
...
If the OP is correct, he was not suffering addiction issues on his prescribed stimulant medication.

Since I'm the one who started this mess, it's on me to provide a more balanced view. (And daveddd: thanks for having the courage to defend the other side. Though you've probably read more of my posts here than anyone else.)

The reality is that the Vyvanse was helping me sit down and stay consistently focused on and motivated to do my schoolwork; *however,* I still had some serious emotional issues that I hadn't dealt with properly. It took me years to admit that, yes, I do need regular counseling in addition to medication.

Although I did use the Vyvanse as directed for a long period of time (1.5 years), last summer my unmanaged emotional issues started getting so bad that I--stupidly--started doubling up on the meds to get a different effect. I won't go into all the details right now, but suffice to say I initiated a pattern of abuse that I always thought I could get under control but persisted for a long period of time.

I knew that I at least needed a long break from the meds, to let my brain return to normal. It was my hope, however, that after my recovery period I could return to being on Vyvanse but with careful monitoring (e.g. weekly dispensal) and weekly counseling for BPD and emotional issues.

I realize that because of my BPD, throughout this thread I have painted an inaccurate picture of my doctor and counselor: they aren't horrible people. They have done much good for me, in other areas. And they care a lot about me--which is why I am willing to trust them for a period of time and see if they can help me recover without stimulant meds.

Although I have signed the release forms to my old docs who prescribed me stiumulants, I do believe I could go back to them at some point and at least discuss the issue with them--in other words, get a second opinion. If they believe that I do have both BPD and ADD, then maybe they'll let me get back on, say, Ritalin?

What I'm worried about is that, even if other doctors do believe I have ADD, they won't want to take the personal risk in prescribing stimulants to me. It's like this: you commit one felony in your lifetime--make one, stupid mistake and get caught--and it's on your permanent record, forever, and no one wants to hire you for a job, ever again. I don't know if this fear is rational or not...that's why I'm bringing it up here, since I want to check it with your all's collective wisdom.

daveddd
02-28-14, 12:15 PM
Since I'm the one who started this mess, it's on me to provide a more balanced view. (And daveddd: thanks for having the courage to defend the other side. Though you've probably read more of my posts here than anyone else.)

The reality is that the Vyvanse was helping me sit down and stay consistently focused on and motivated to do my schoolwork; *however,* I still had some serious emotional issues that I hadn't dealt with properly. It took me years to admit that, yes, I do need regular counseling in addition to medication.

Although I did use the Vyvanse as directed for a long period of time (1.5 years), last summer my unmanaged emotional issues started getting so bad that I--stupidly--started doubling up on the meds to get a different effect. I won't go into all the details right now, but suffice to say I initiated a pattern of abuse that I always thought I could get under control but persisted for a long period of time.

I knew that I at least needed a long break from the meds, to let my brain return to normal. It was my hope, however, that after my recovery period I could return to being on Vyvanse but with careful monitoring (e.g. weekly dispensal) and weekly counseling for BPD and emotional issues.

I realize that because of my BPD, throughout this thread I have painted an inaccurate picture of my doctor and counselor: they aren't horrible people. They have done much good for me, in other areas. And they care a lot about me--which is why I am willing to trust them for a period of time and see if they can help me recover without stimulant meds.

Although I have signed the release forms to my old docs who prescribed me stiumulants, I do believe I could go back to them at some point and at least discuss the issue with them--in other words, get a second opinion. If they believe that I do have both BPD and ADD, then maybe they'll let me get back on, say, Ritalin?

What I'm worried about is that, even if other doctors do believe I have ADD, they won't want to take the personal risk in prescribing stimulants to me. It's like this: you commit one felony in your lifetime--make one, stupid mistake and get caught--and it's on your permanent record, forever, and no one wants to hire you for a job, ever again. I don't know if this fear is rational or not...that's why I'm bringing it up here, since I want to check it with your all's collective wisdom.

i wasn't so much defending the other said and clearly remembering the state of distress i was in while in not similar , but close enough circumstances

i was never diagnosed BPD, but ADHD combined with sever emotional regulation issues and like i said before major substance abuse problems along with the lock ups I've mentioned (we can pretend those are different issues, but come on)



my view was incredibly distorted and bias at those times, i spoke solely from emotion

Nicksgonefishin
02-28-14, 12:45 PM
Personality disorders aren't permanent. It's not a death sentence it's a life sentence.

I have overcome much of my PD. One could even say I don't qualify for a PD diagnosis anymore. But I do have traits that I am committed to changing or accepting. At the end of the day these are just labels. Letting go of the labels and realizing we are all human and all have issues makes compassion and forgiveness easier, especially self compassion. Love yourself.

(I haven't gone gifter but am trying to offer some optimism)

Fortune
02-28-14, 09:54 PM
from the original post
"Moreover, because I have a recent history of abuse with the stimulants (unfortunately, and after a 1.5-year history of NOT abusing them)"

this doesn't sound like doing good to me, thats doing good to you?

unless I'm misreading, was the abuse before or after the 1.5 good years, if its before this whole scenario doesn't make much sense

It read to me like 1.5 years after the abuse. I see the OP clarified.

on the textbook and studies comment, i disagree , their usually accurate

Nope. People aren't robots. Textbooks are helpful, but not definitive. They're not a manual to the care and understanding of how people will act. Using them the way you do is a great way to pathologize everything a person does.

i know its the new politically correct thing ,

Referring to things as "political correctness is the height of intellectual laziness. It's a meaningless buzz phrase generally used to dismiss people as genuine.

My opinion isn't "political correctness." It's based on my own observation and reading. When I talk to people who actually work in the mental health field, they tend to dismiss applications of textbook interpretations, usually with the explanation that "people aren't their disorders." I don't think they're being "political correct" when they say this.

to say we are all special and unique and we all have different separate syndromes

I never said anything of the sort. However, I believe that there are 126 possible symptom combinations that can lead to a diagnosis of BPD.

but thats generally not the case , you would be surprised on how similar the human psyche can work

No, I wouldn't. But I would be surprised if treating people as if they're exactly what you expect from a textbook actually had any real world application.

Fortune
02-28-14, 09:55 PM
also on the angles , i thought everyone else did a good job covering the other side

i don't see a need to argue with someone who strongly agrees they have BPD and was diagnosed by pros , and try to convince them they just have ADHD

even though they both share the same biology (and the fact that every member of the forum has a family member with BPD should put any arguments about that to rest)

treatment styles still start with different focuses

I'm not trying to convince the OP that he only has ADHD.

daveddd
02-28-14, 10:57 PM
It read to me like 1.5 years after the abuse. I see the OP clarified.



Nope. People aren't robots. Textbooks are helpful, but not definitive. They're not a manual to the care and understanding of how people will act. Using them the way you do is a great way to pathologize everything a person does.



Referring to things as "political correctness is the height of intellectual laziness. It's a meaningless buzz phrase generally used to dismiss people as genuine.

My opinion isn't "political correctness." It's based on my own observation and reading. When I talk to people who actually work in the mental health field, they tend to dismiss applications of textbook interpretations, usually with the explanation that "people aren't their disorders." I don't think they're being "political correct" when they say this.



I never said anything of the sort. However, I believe that there are 126 possible symptom combinations that can lead to a diagnosis of BPD.



No, I wouldn't. But I would be surprised if treating people as if they're exactly what you expect from a textbook actually had any real world application.

eh, i see the new way of labeling people with massive amounts of separate comorbids and contributing anything we want to ADHD a way to pathologize everything people do

PDs and types do a much better job of predicting behaviors

and what do you mean using them the way i do?, i just post , read em or don't

I never have said people are their disorders, I've always said the opposite and speak up against the massive stigma this forum pours on people who meet the criteria for PDS

i also "speak to a lot of people in the mental health field" its where most of my view comes from, but again i just had a hunch about the OPs situation

and sure think of as many combos of BPD as you want, linhan also stated the core, always is pervasive emotional dysregulation


treating people like you would from a textbook would have no real world application? how about proven treatment options:scratch::scratch:

low_dopamine
09-04-14, 05:59 PM
Ok, so...update six months later. Long story short, I'm back on Vyvanse--re-diagnosed with ADHD (yes, even the "H" this time) during a short stint in a mental hospital--and I'm succeeding again, professionally and academically. In spite of my strong tendency to substance abuse, I was able to get back on the meds thanks to this wonderful machine:

http://site.comforthouse.com/yswimages/pilldispensers.jpg
(a MedReady automatic pill dispenser)

But there's something else I want to talk about, and I'll likely move that discussion over to another thread: the euphoria. It's been discussed at length in other posts, which I will later link and/or contribute to, but I want to close up this thread by discussing my own take on it.

When I first started on amphetamine medications three years ago, I had a similar experience to so many here: the feeling that "Finally! What I've been searching for my entire life! *This* is how life, how *living* is meant to feel!"

At the time I was naive and had had no experience with street drugs--like cocaine and methamphetamine--and I did not realize that the euphoria was actually a bad thing, a feeling that was, in fact, too good to be true...that if you continue to take higher doses to feel it (which everyone eventually does) you will effect damaging neurotoxicity, ultimately destroying the very thing you were trying to heal.

Life can be harsh that way.

I'm considering switching to something weaker like Concerta, to stop being teased by this fairy-tale euphoria. But even if I do...I will still always remember what that feeling was like, will always want it again...so this struggle is forever.

Life can be uncaring and harsh that way. And this time I have nobody to blame, even myself. Still looking for answers...but trying not to think too much, if I can...

low_dopamine
09-05-14, 11:14 AM
[[Mods: Can we move this into the "Addiction and Substance Abuse" subforum? I now really believe it belongs there. Thanks!]]


Yup. Done!
- The Mods

heylookacastle!
09-05-14, 11:38 AM
DO NOT SIGN ANYTHING. They are not your lawyer, they are covering their own as*ses.

I haven't been able to read all of the comments and this is as far as I got but I completely agree with Sarahsweets.

I'm not going to touch on the diagnosis part because I don't know anything about BPD but I do know this...

There are no 100% accurate tests available to diagnosis mental illness for sure.

Locking yourself into anything or away from any possible treatment options because some doctors told you they will drop you if you don't do as they say is complete bull.

I had a history anxiety and depression, was over prescribed anti-depressants of varying kinds until low and behold, I got worse, started abusing drugs to cope in my early teens, and then of course was labelled bipolar.

What followed was the worst years of my life and it wasn't until I finally got off everything for a year, moved cities, switched pdocs, and voila... was finally taken seriously without a gazillion meds (and other substances) interfering and I was diagnosed with ADHD which changed my life.

Moral of my story: ALWAYS get an impartial second opinion and never put yourself in a situation where your locked down and unable to seek any form of treatment in the future.

Do I think you should be prescribed stimulants? No because of the recent abuse.

Does that give the doctors the right to force you into a legally binding agreement that could interfere with any treatments you may need in the future?

I.M.O. Hell no.

Just my 2 cents.