View Full Version : medicate by understanding the root cause of symptoms


fulllyfledgeded
05-08-16, 02:09 PM
Hi all!

I was diagnosed in with ADD in 2012. We tried all the conventional medications, which were geared toward alleviating my symptoms. I experienced some beneficial effects, which weren't improved by increasing the dosage.

My symptoms - although typically associated with ADD - have some overlap into over disorders. I'm now trying to explore this comorbidity, by inspecting the root cause, to hopefully remove the symptoms. Identifying exactly what chemical imbalances I have, would be great, although i know it can be difficult to do. For example neurotransmitter testing, sounds great, but i've heard it can be unreliable. I hope, by understanding the various neurotransmitters and their effects; then comparing with my own symptoms; it'll to bring new insights:

http://i.imgur.com/2ifqyPQ.jpg

my main symptom is a lack of mental energy generally, manifesting in a myriad of ways such as lack of attention, brain fog, low working memory etc. I'm told I have a high IQ but don't have the mental energy to start or complete tasks. This often makes me appear dumb at times. It's as if I have intelligence but don't have the mental stamina - the energy, that drives cerebral activity. For example, i really have to summon every last mental resource to sustain focus and have to consciously push my brain really hard. It's like trying to start the car in high gear: you can do it but it takes a hell alot more gas and it'll burn the clutch!.  And in my case it burns me out - big time! afterwards, all I feel like doing is lying down, or doing absolutely nothing.

http://i.imgur.com/0TDTVv6.jpg

People who have observed me trying to focus say it looks as if my eyes are on stalks. In conversations its even more problematic as i end up staring to retain concentration.

The conventional medication route we have explored up until now, it's been mainly geared towards targeting dopamine and norepinephrine functions in the brain. I'm wandering if it would be worth exploring?:


Glutamate as it is excitatory and may help with my general metal fatigue
Epinephrine to help "become alert"


Can anybody relate to the above and have any suggestions or advice? Many Thanks in advance

Roundmouth
05-08-16, 03:41 PM
Yes. I highly recognize and relate. In fact I've been thinking a lot about these things and I was about to start a thread on this subject. Now I don't need to.

I'll return tomorrow when I've read more carefully from a proper screen.

Lunacie
05-08-16, 05:51 PM
I have comorbid anxiety disorder. I know that I don't do well when I get a shot to numb my jaw at the dentist's (it includes epinephrine) as my anxiety magnifies hugely.

If you don't have anxiety it probably wouldn't be a problem for you.

Roundmouth
05-09-16, 07:06 AM
That huge text in the first post... Is it available in a more screen-friendly format, or is there a link to some place where it can be read?

fulllyfledgeded
05-09-16, 08:53 AM
Hi @Roundmouth, Ive resized it for you! (you may have to clear you cache)

It's good to know you can relate to this and feel it to. The thing is, i don't really hear much about the burnout stage from other ADDers. This is the biggest problem for me - it means i can't really do anything. Potential employers want you to work for 3-4 hours straight(with breaks), but i burn out after about an hour and a fifteen minute break is nowhere near enough to replenish me - hence i'm self employed. If you add this work pattern up throughout, the day and week, there's no way i can do a typical working week like everyone else.

What you do hear about is inattention and conversely laser like focus once they've found something really interesting. I guess other ADDers must accept the burnout phase as an inevitable comedown period, after their sustained laser focus. Or maybe they articulate it differently, or i'm missing something?

fulllyfledgeded
05-09-16, 08:57 AM
Hi @Lunacie

I have comorbid anxiety too, though not formally diagnosed. I guess there's no way to induce Epinephrine in the brain only, rather than mouth...

Fuzzy12
05-09-16, 09:12 AM
Hi @Roundmouth, Ive resized it for you! (you may have to clear you cache)

It's good to know you can relate to this and feel it to. The thing is, i don't really hear much about the burnout stage from other ADDers. This is the biggest problem for me - it means i can't really do anything. Potential employers want you to work for 3-4 hours straight(with breaks), but i burn out after about an hour and a fifteen minute break is nowhere near enough to replenish me - hence i'm self employed. If you add this work pattern up throughout, the day and week, there's no way i can do a typical working week like everyone else.

What you do hear about is inattention and conversely laser like focus once they've found something really interesting. I guess other ADDers must accept the burnout phase as an inevitable comedown period, after their sustained laser focus. Or maybe they articulate it differently, or i'm missing something?

I get that burn out stage quite a bit. It's not necessarily linked to the duration of a task though I doubt I could work regularly on anything for 4h without a break.

I have noticed though that after a period of intense focussing (usually to meet an urgent deadline) I just can't do anything else. My brain just shuts down. Sometimes for days. Maybe it's just because the urgency (and therefore the motivation) is suddenly gone but I always get the feeling that it's also partially because I've exhausted my resources.

aeon
05-09-16, 12:47 PM
As it concerns neurodevelopmental disorders and psychiatric illness, oftentimes we can measure non-normative levels of neurotransmitters, among other things, but my sense is we know far too little about the nature of the brain to be certain if those levels represent a cause, and/or an effect, or how they relate to begin with.

To that end, we treat disorder and illness with drugs that affect neurotransmitters, to lesser and greater effect, because that is what we are able to do. That said, don't make the mistake of thinking you are getting to any root cause by doing so. Very little in the science would support such a position.


Chhers,
Ian

fulllyfledgeded
05-11-16, 10:08 AM
I get that burn out stage quite a bit. It's not necessarily linked to the duration of a task though I doubt I could work regularly on anything for 4h without a break.

I have noticed though that after a period of intense focussing (usually to meet an urgent deadline) I just can't do anything else. My brain just shuts down. Sometimes for days. Maybe it's just because the urgency (and therefore the motivation) is suddenly gone but I always get the feeling that it's also partially because I've exhausted my resources.

yes thats exactly me. urgency does have a role but im talking more about the your resources being totally drained.

It's not necessarily linked to duration, but it makes it worse. whats linked to the burn out stage for you?


I don't mean 4h w/o break, no, i don't think anyone could do that. What i mean is that your expected to work for 4hour durations with breaks, but i can only really do max two and i'd need a lie down for the other 2

fulllyfledgeded
05-11-16, 10:32 AM
As it concerns neurodevelopmental disorders and psychiatric illness, oftentimes we can measure non-normative levels of neurotransmitters, among other things, but my sense is we know far too little about the nature of the brain to be certain if those levels represent a cause, and/or an effect, or how they relate to begin with.

To that end, we treat disorder and illness with drugs that affect neurotransmitters, to lesser and greater effect, because that is what we are able to do. That said, don't make the mistake of thinking you are getting to any root cause by doing so. Very little in the science would support such a position.


Chhers,
Ian

Hi Ian, so what your saying is, that we work at alleviating the symptoms because, we know to little about the cause and effect to be certain?

aeon
05-11-16, 09:37 PM
Hi Ian, so what your saying is, that we work at alleviating the symptoms because, we know to little about the cause and effect to be certain?

Well, in the case of ADHD, it is defined by symptomology exclusively, so by definition, treatment is symptom-based.

Even if we knew the cause(s) of ADHD, it wouldn’t matter until the disorder called ADHD was redefined. As it stands today, for diagnosis and treatment, the cause is irrelevant...after differential diagnosis has eliminated other possibilities.


Cheers,
Ian

Little Missy
05-11-16, 09:57 PM
I liked the "eyes on stalks" thing. Day of the Triffids.

fulllyfledgeded
05-13-16, 12:03 PM
@aeon so even if a dr knew the cause(s) of ADHD they wouldn't be able to medicate accordingly because treatment is strictly symptom-based?

aeon
05-13-16, 12:57 PM
@aeon so even if a dr knew the cause(s) of ADHD they wouldn't be able to medicate accordingly because treatment is strictly symptom-based?

They could medicate as best practices or their license would allow.

But if they wanted to treat ADHD itself, as it is defined today, they would have to treat the symptoms because ADHD is defined by a presentation of symptoms.


Cheers,
Ian

fulllyfledgeded
05-14-16, 08:50 AM
They could medicate as best practices or their license would allow.

But if they wanted to treat ADHD itself, as it is defined today, they would have to treat the symptoms because ADHD is defined by a presentation of symptoms.


Cheers,
Ian

ok �� !!! so......i need a different diagnosis; a diagnosis in which the typical treatment targets the symptoms; symptoms associated with the deficiencies in neurotransmitters highlighted above?

So looking at co-morbid diagnosis may be a good approach.

Do all diagnosis's symptom based in treatment?

Roundmouth
05-15-16, 06:44 PM
I personally believe there is something like true ADHD. There are also probably a huge amount of different neurodevelopemental disorders connected to attention, concentration, hyperactivity - well executive functions and self-regulation in general. More or less connected to and overlapping the ADHD cluster, but yet something different. Some of these conditions may be responsive to treatment associated with ADHD, others not. Also, sometimes certain expressions of actual ADHD will perhaps not respond to standard treatment.

This Barkley guy says there is a condition defined by plain inattention, no hyperactivity or impulsivity whatsoever. A condition that's not what we diagnose ADHD-PI. Interesting. I'm clearly PI myself but I do definitely have traits of impulsivity and issues with regulation of activity. Not problems but it's there. Easy imagining conditions defined by attention problems though not necessarily self-regulation. Then perhaps stimulants won't be effective.

Also very interesting nicotine and Parkinson medication being mentioned. I spoke with some guy on some forum, who had noticed this. Specific types of attention problems relieved by nicotine, though not other stimulants. He also mentioned Acetylcholine. I didn't read it all and I didn't fully understand the parts I did read (Help...! Do I have some kind of attention problem??), but it seemed to be very interesting...

cwf1986
06-01-16, 07:48 PM
Well... I'm a bit late to the party, but I've actually tried some cholinergics. They work pretty well for inattention. But they also have some very nasty side effects including agitation, irritability, anxiety, stomach pain, diarrhea, headache, body aches, and just a general vague dysphoria of things being out of place. Most people don't get those sides so don't let my experience scare you. At least with cholinergics primarily affecting muscarinic receptors exempting racetams and noopept.

Nicotine gum and patches are pretty hard to get addicted to if you stick with low doses. Like the final dose a nicotine addict would use before quitting. You generally only here of this with bodybuilders that are cutting, but I've tried it and it helps with both inattention and restlessness, but not enough to deal with the headaches it gave me. It's also been studied for depression and seems to help.

foreverwarrior
07-17-16, 08:59 AM
Here's what I've learned from my own experiences. I started treatment for ADHD/Anxiety/PTSD 2 1/2 years ago. I began with Adderall and quit after a week (too harsh) - and went to Vyvanse. After about 2 years of Vyvanse + Adderall booster (I tolerated it after doing Vyvanse for a while), insurance changed. I had to either pay over $200 for Vyvanse, or do Adderall (which worked, and was tolerated at the time). Things went ok - for a while.

Basically, the burn-out, for me, has been progressive and is diagnosed adrenal insufficiency (no, not hollistic ****). My hormone levels were awful, and what was happening when taking medication (specifically L-AMP): The wrong stuff, at the same dose.

My sleep deficit (PTSD related) with medication caused hormone deterioration, and that tampers with your neurological function (I had/have major brain fog, stupor, and neuro pain). I now could take a 20mg tablet of Adderall, and be ok for a bit - If I were sleep deprived (which I am chronically), or have a hormone imbalance (in this case adrenal function) - My body has no regulation between calm and excitement. I'll go through the roof (heart rate, speech, pacing, hyperventilating) and lose my focus. Then crash, hard. These are indeed symptoms of panic attack. However, the testing proved that it has evolved into more.

Low Glucocorticoids in my body cause the inability to regulate things like glucose levels (important in cognition). I experience stress, of any sort, and my body was pulling minerals/etc from itself (catabolic effect) since there were no reserves where they should be (takes up electrolytes, for example). Yada yada, you see where this goes. You fall into that cycle (they haven't determined the cause of the insufficiency, it may be Addison's Disease) of stress/overload and your body will run out of ways to compensate.

Adderall would calm me (ADHD), but as it caused blood sugar to rise/fall - the therapeutic effect diminished - and I entered an unpleasant "adrenaline surge" followed by a dump (an adrenaline dump SUCKS - I remember those after firefights in Afghanistan). Take away the basic regulation materials your body needs, and things fall apart. They are treating me with steroids, for now - and I immediately got my "brain" back.

Anxiety/rumination aside - the stress from that alone OR combined with a real condition can lead to you burning out your adrenal glands. Or something else entirely.

This is just some personal experience. We can all become hypochondriacs (sorta) on medication w/ anxiety and symptoms. But eventually, it doesn't matter if that's the case - you CAN in fact hit a wall.

If you think you have a problem, go to a good doctor and get tested for all the basics. Basal metabolic, hormone levels (ACTH stim test), infections, whatever. Get it ruled out. Either way, you've helped yourself get to a point of stopping the cycle, or finding a real condition and getting it taken care of.

sarahsweets
07-17-16, 10:21 AM
Here's what I've learned from my own experiences. I started treatment for ADHD/Anxiety/PTSD 2 1/2 years ago. I began with Adderall and quit after a week (too harsh) - and went to Vyvanse. After about 2 years of Vyvanse + Adderall booster (I tolerated it after doing Vyvanse for a while), insurance changed. I had to either pay over $200 for Vyvanse, or do Adderall (which worked, and was tolerated at the time). Things went ok - for a while.

Basically, the burn-out, for me, has been progressive and is diagnosed adrenal insufficiency (no, not hollistic ****). My hormone levels were awful, and what was happening when taking medication (specifically L-AMP): The wrong stuff, at the same dose.

My sleep deficit (PTSD related) with medication caused hormone deterioration, and that tampers with your neurological function (I had/have major brain fog, stupor, and neuro pain). I now could take a 20mg tablet of Adderall, and be ok for a bit - If I were sleep deprived (which I am chronically), or have a hormone imbalance (in this case adrenal function) - My body has no regulation between calm and excitement. I'll go through the roof (heart rate, speech, pacing, hyperventilating) and lose my focus. Then crash, hard. These are indeed symptoms of panic attack. However, the testing proved that it has evolved into more.

Low Glucocorticoids in my body cause the inability to regulate things like glucose levels (important in cognition). I experience stress, of any sort, and my body was pulling minerals/etc from itself (catabolic effect) since there were no reserves where they should be (takes up electrolytes, for example). Yada yada, you see where this goes. You fall into that cycle (they haven't determined the cause of the insufficiency, it may be Addison's Disease) of stress/overload and your body will run out of ways to compensate.

Adderall would calm me (ADHD), but as it caused blood sugar to rise/fall - the therapeutic effect diminished - and I entered an unpleasant "adrenaline surge" followed by a dump (an adrenaline dump SUCKS - I remember those after firefights in Afghanistan). Take away the basic regulation materials your body needs, and things fall apart. They are treating me with steroids, for now - and I immediately got my "brain" back.

Anxiety/rumination aside - the stress from that alone OR combined with a real condition can lead to you burning out your adrenal glands. Or something else entirely.

This is just some personal experience. We can all become hypochondriacs (sorta) on medication w/ anxiety and symptoms. But eventually, it doesn't matter if that's the case - you CAN in fact hit a wall.

If you think you have a problem, go to a good doctor and get tested for all the basics. Basal metabolic, hormone levels (ACTH stim test), infections, whatever. Get it ruled out. Either way, you've helped yourself get to a point of stopping the cycle, or finding a real condition and getting it taken care of.

Would you say you are the exception rather than the rule? I ask because as Ive been dealing with an adrenal mass and what to do with it, Ive come to understand that there are some genetic components to adrenal and any endocrine system issues.

Hows your thyroid?

geek_girl_913
08-21-16, 05:30 PM
Here's what I've learned from my own experiences. I started treatment for ADHD/Anxiety/PTSD 2 1/2 years ago. I began with Adderall and quit after a week (too harsh) - and went to Vyvanse. After about 2 years of Vyvanse + Adderall booster (I tolerated it after doing Vyvanse for a while), insurance changed. I had to either pay over $200 for Vyvanse, or do Adderall (which worked, and was tolerated at the time). Things went ok - for a while.

Basically, the burn-out, for me, has been progressive and is diagnosed adrenal insufficiency (no, not hollistic ****). My hormone levels were awful, and what was happening when taking medication (specifically L-AMP): The wrong stuff, at the same dose.

My sleep deficit (PTSD related) with medication caused hormone deterioration, and that tampers with your neurological function (I had/have major brain fog, stupor, and neuro pain). I now could take a 20mg tablet of Adderall, and be ok for a bit - If I were sleep deprived (which I am chronically), or have a hormone imbalance (in this case adrenal function) - My body has no regulation between calm and excitement. I'll go through the roof (heart rate, speech, pacing, hyperventilating) and lose my focus. Then crash, hard. These are indeed symptoms of panic attack. However, the testing proved that it has evolved into more.

Low Glucocorticoids in my body cause the inability to regulate things like glucose levels (important in cognition). I experience stress, of any sort, and my body was pulling minerals/etc from itself (catabolic effect) since there were no reserves where they should be (takes up electrolytes, for example). Yada yada, you see where this goes. You fall into that cycle (they haven't determined the cause of the insufficiency, it may be Addison's Disease) of stress/overload and your body will run out of ways to compensate.

Adderall would calm me (ADHD), but as it caused blood sugar to rise/fall - the therapeutic effect diminished - and I entered an unpleasant "adrenaline surge" followed by a dump (an adrenaline dump SUCKS - I remember those after firefights in Afghanistan). Take away the basic regulation materials your body needs, and things fall apart. They are treating me with steroids, for now - and I immediately got my "brain" back.

Anxiety/rumination aside - the stress from that alone OR combined with a real condition can lead to you burning out your adrenal glands. Or something else entirely.

This is just some personal experience. We can all become hypochondriacs (sorta) on medication w/ anxiety and symptoms. But eventually, it doesn't matter if that's the case - you CAN in fact hit a wall.

If you think you have a problem, go to a good doctor and get tested for all the basics. Basal metabolic, hormone levels (ACTH stim test), infections, whatever. Get it ruled out. Either way, you've helped yourself get to a point of stopping the cycle, or finding a real condition and getting it taken care of.

I find this exceptionally interesting, as I feel as though I could have written this myself. I have felt--for years, at this point--as though my issue always was adrenal insufficiency, but several doctors scoffed at the idea.

I was however tested for a multitude of things, and found to have PCOS (Polycystic Ovarian Syndrome), which is a substantial hormone imbalance in women. One doctor mentioned it could be an adrenal issue, but didn't pursue it further.

If I don't get my brain back, soon, I may fall apart altogether. This is just so incredibly frustrating, and seeing someone who has had the same issues arise from long term treatment with Vyvanse makes me feel oddly validated.

Did you go to your GP, or an endocrinologist, etc.? I'm just curious, since I need some sort of answer.

C15H25N3O
09-16-16, 07:30 PM
It is sometimes useful to have a look at past medications and especially on amalgam

which is used or has been used by dentists. There are simple ways to get rid off its

intoxication and to reduce ADHD to what it is. There are also ways to recover from

fail-treatment with wrong meds which can make ADHD worse. Ask a specialist in

naturopathy or better a doctor who does not only believes in big pharma but also

in mother nature.

Little Missy
09-16-16, 08:56 PM
I had all of my amalgam taken out when I was in my early twenties. I have no idea if it helped with anything but my mum was big on getting it all out then on me.

C15H25N3O
09-16-16, 09:58 PM
Some days ago I found out that amalgam can be the root of many diseases
like hives and kidney-stones that hit me in the early twenties 1-3 years after
taking out amalgam. The worst failure a dentist can make is to take out some
amalgam while leaving some in the mouth and replacing some with gold which
makes quicksilver-oxids that are more toxic than quicksilver itself.

Nice to read quicksilver/mercury is also linked to ADHD, dementia, impulsiveness,
aggression, bad memory, bad attention, liver and kidney misfunctions and others.

When the hives are gone I will be free of quicksilver and then it is time to heal
myself from the last anti-hystamine and SSRI-damages to reset my health condition
to twens age.

Once again it is mother nature that cleans up quicksilver-intoxications with simple
coriander and some seaweed.

Thanks to my former doctors for making ADHD worse.
You idiots stop wrecking me!

I will heal myself on my own and I dont believe in science anymore.

I am boss and my best doctor.

I diagnose myself better and use them for confirmation and prescription.

:-)

Lunacie
09-17-16, 10:55 AM
Some people are writing books to make money, but haven't actually done any scientific studies themselves.

“Studies continue to support the position that dental amalgam is a safe restorative option for both children and adults.
When responding to safety concerns it is important to make the distinction between known and hypothetical risks.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388771/

C15H25N3O
09-18-16, 09:09 AM
I will not buy a book but I like coriander and seaweed sometimes.

I know people who did it and I will try it.

I will have blood screenings before, while and after this try.

if it get rid off the hives I will be happy.

Life is an experiment.

I believe in personal success.


:-)

bluefoxicy
12-14-16, 01:04 PM
ADHD is caused by a lack of function in the prefrontal cortex. The PFC is smaller and receives less blood flow, and so stimulants make it run more-energetically and thus correct the root cause. This is a genetic condition. In some patients, development is delayed; in roughly one-third of patients, development is stunted prior to completion, producing diminished but lingering adult ADHD.

The dorsolateral prefrontal cortex mediates willpower. While a weak prefrontal cortex will have trouble controlling the direction of attention and suppressing impulses, a weak dorsolateral prefrontal cortex will manifest as a lack of willpower--a lack of ability to resist impulses or to enforce new impulses.

A few of us have noticed this as a symptom of ADHD, although it's not part of the diagnosis or disease specification. Some atomoxetine users comment that adderall lets them focus, while strattera gives them the impetus to actually work. One poster claims his only real symptom is a complete lack of motivation. I've noticed motivation comes and goes based on mental state and drug state.

Depression often causes a lack of motivation. The lethargy of a mild depression can manifest as a lack of will to do anything, and even as sleeping all the time. This means treatment can be complex.

Everything ranging from NDRI stimulants, Wellbutrin, Atomoxetine (which stimulates the prefrontal cortex as an SNRI, but not the rest of the brain), and antidepressants can have an impact. What actually works for you depends on your particular psychiatric problem.

It's complex.