View Full Version : ADHD is being ignored


BricksAreHeavy
05-24-17, 01:54 PM
Hi there, new here. I'm so frustrated and don't know what to do anymore, I'm always crying and feel like I cannot turn things around.

I have been on all the major name brand meds for Depression, Anxiety, and ADHD. I am currently seeing a psychiatrist who has only prescribed me Lexapro. She has also diagnosed me as BPD (borderline personality disorder).

Some background: I have always had a ton of energy as a kid, was a bit difficult to handle, and my schoolwork was wildly inconsistent. Speed up to now, in my mid-20's.

Every day for me is a haze of confusion. I wake up, think I know what I'm doing, start, and get side tracked all the time. Cry because I keep messing simple things up, I start to isolate myself because I'm embarrassed. I can barely get through school. Every noise, sight, touch - there's something that distracts me. I know I am intelligent, but cannot focus or get started. I have emotional outbursts due to frustration - mainly anger and frustration. I have gotten into very bad legal trouble, I don't think before I do. Arrests, you name it. I am in therapy doing CBT/DBT but I swear I am treatment resistant. I try so hard. It's getting to the point where I think I will never be successful, I will never be able to live a normal life. I try to find interest in other people, but I'm so overwhelmed that when they talk to me, I don't listen - so much else is going on inside my head.

Here's the problem - my psych diagnosed me with BPD, so ANY symptom of ADHD is chalked up to BPD. I haven't been on ADHD medication for more than a year, and every day I feel less like myself and I'm getting behind in my life. And yes, I have become increasingly depressed and anxious because as I try to comply with my BPD treatment, there is so much that is being put aside. I very much want to start a low dose of vyvanse again for ADHD, but because of my BPD diagnosis and admission that I unintentionally forgot to take my vyvanse in the past (under a different doctor) and sometimes took to much, my psych refuses.

I'm sitting here, almost in tears, because I remember so fondly how my life actually IMPROVED when I was taking meds for ADHD. I feel like I'm withering away, while at the same time being sucked up by some tornado that is my mind.

At this point, I'm not even concerned if I truly have BPD or not. I just don't think I can go any longer seeing my grades drop, not having any plans for myself, and having every single day full of failures and things I could have and should do. I can't even sort my thoughts out, they're always racing and yet I'm told that if I just cope by reading a book or doing mindful meditation that I can regulate myself better.

My mother sees this every day and I feel bad because she feels like a failure. Even though none of this is her fault.

Anyone else have another disorder and either in the past, had a psych look over or ignore your ADHD? I have read so many forums on here about how it took so long for people to get on the right track for treatment. I'm trying so hard to right now but feel that there's this stigma that because I'm BPD every single thing in my life is due to it. I just want to feel normal again like I did when I was taking vyvanse. No, it was not a miracle, and it was up to ME to employ behaviors in conjunction with the medicine.

I feel like I'm not being taken seriously. I'm often someone who holds back information and sometimes am embarrassed about things so I don't tell my psych right away and when I do, it can come off as overkill or unexpected. I think that's what is happening when I tell her all at once about my ADHD symptoms.

Anyone have advice? Been in a similar situation? I'm grasping at air right now...

reutersa
05-24-17, 08:09 PM
I hope I can be some help to you. I have very severe ADHD, as do my mother and both of my children. One child also has ongoing depression and severe anxiety. Both of my children are extremely intelligent (like genius level smart) yet struggled (and continue to struggle) with school. I can tell you there is hope! There are things you need to learn about ADHD. Did you know that people with ADHD mature emotionally about 33% SLOWER than the average person? That means a lot of the things people expect you to be able to handle will be beyond your actual emotional maturity - never mind the actual attention problems. This is critical to know because it will help the people around you to know how to help you. Also - find a counselor who specializes in ADHD and cognitive behavioral therapy. I have found one who is amazing and has helped to turn our lives around. Also - find another doctor. The one you are going to isn't right for you - he/she sounds more concerned about keeping you off the schedule C drugs (a lot of the adhd drugs are) than about trying to find what will really work for you. I will say that Wellbutrin may be something you can try. It is an anti-depressant that is also used off-label for ADHD. In any case you need to find a psychiatrist or other Dr that specializes in ADHD. I could write a book about the struggles my family has gone through - but I'll spare everyone. Just know that there is hope! Insist on finding the right person to help you and don't give up!

aur462
05-24-17, 11:32 PM
Comorbidity with ADHD is 25% apparently, per bpddemystified dot com.

I tried almost all AD's before realizing my anxiety (and ADHD) were most effectively managed with stims and a bit of clonazepam.

Given your post - find a doc who will work with you on getting meds that WORK. The link above mentions an antipsychotic recommendation with the stim. I'd be prepared for that.

BricksAreHeavy
05-25-17, 12:42 AM
Comorbidity with ADHD is 25% apparently, per bpddemystified dot com.

I tried almost all AD's before realizing my anxiety (and ADHD) were most effectively managed with stims and a bit of clonazepam.

Given your post - find a doc who will work with you on getting meds that WORK. The link above mentions an antipsychotic recommendation with the stim. I'd be prepared for that.

Thank you for sharing your experience. I'm very scared to push the topic with my current psych any bit more because I am scared something bad is going to be written down in my records. Will consider a new psych.

I've been doing some reading on BPD & ADHD comorbidity too I really wish my psych would at least consider treating me for both at once, at this point there's no harm because I'm at my wit's end :/ Yes, I understand the risks, but I have been under her care for almost 2 years, just wish we could work together more...

BricksAreHeavy
05-25-17, 02:04 AM
I hope I can be some help to you. I have very severe ADHD, as do my mother and both of my children. One child also has ongoing depression and severe anxiety. Both of my children are extremely intelligent (like genius level smart) yet struggled (and continue to struggle) with school. I can tell you there is hope! There are things you need to learn about ADHD. Did you know that people with ADHD mature emotionally about 33% SLOWER than the average person? That means a lot of the things people expect you to be able to handle will be beyond your actual emotional maturity - never mind the actual attention problems. This is critical to know because it will help the people around you to know how to help you. Also - find a counselor who specializes in ADHD and cognitive behavioral therapy. I have found one who is amazing and has helped to turn our lives around. Also - find another doctor. The one you are going to isn't right for you - he/she sounds more concerned about keeping you off the schedule C drugs (a lot of the adhd drugs are) than about trying to find what will really work for you. I will say that Wellbutrin may be something you can try. It is an anti-depressant that is also used off-label for ADHD. In any case you need to find a psychiatrist or other Dr that specializes in ADHD. I could write a book about the struggles my family has gone through - but I'll spare everyone. Just know that there is hope! Insist on finding the right person to help you and don't give up!

Thank you for this :) sometimes I feel so attached to my doctor I feel like I can't switch! I have actually been on Wellbutrin in the past, didn't do anything for me. I'm so resistant to antidepressants it's like taking an aspirin! I don't even feel the bad side effects of them. I have also been on antipsychotics, and they made me a zombie. I'm not a huge fan of benzodiazepines, either.

Very interesting you mention the slower emotional maturity in ADHD patients. I have gotten into legal trouble a couple of times, am very jarring when I speak (people are often shocked at what I say, and the jokes I make), and often fly from one thing to another. I truly believe my doctor is too quick to attribute these types of symptoms to Borderline personality disorder. Especially because I really am a very caring and empathic person! I also think because I am intelligent (like you and your children), that it is hard for her to see how ADHD would affect me - she often believes I am a very manipulative person...I'm actually really naive!

You are also very right about the doctors concern to keep my off of schedule C drugs. I am definitely going to look for a doctor that can change my life around, like yours did for you and your family. Did you have a lot of trial and error with doctors?

Cyllya
05-25-17, 02:46 AM
I'd try to find another psychiatrist for at least a second diagnostic opinion. In some circles, there are ridiculous levels of stigma against BPD (even among mental health professionals), which I think you're seeing with your doctor regarding you as "manipulative." For that reason, you might want to avoid telling the new doctor about the current BPD diagnosis until after they've diagnosed you themselves. If BPD is actually a correct diagnosis, the new one would hopefully figure it out?

Speaking of stigma, depending on your gender, sexism might be a factor. There seems to be an idea out there that ADHD is a "male" thing and BPD is a "female" thing.

sarahsweets
05-25-17, 05:28 AM
Do you mean Bipolar disorder or Borderline personality disorder?

aur462
05-25-17, 08:30 AM
Hi Sarahsweets. Maybe you saw this and are looking for further clarification; thought I'd point it out just in case:

She has also diagnosed me as BPD (borderline personality disorder).

sarahsweets
05-25-17, 08:37 AM
Hi Sarahsweets. Maybe you saw this and are looking for further clarification; thought I'd point it out just in case:

woops, missed that. Duh...

aur462
05-25-17, 09:28 AM
Thank you for sharing your experience. I'm very scared to push the topic with my current psych any bit more because I am scared something bad is going to be written down in my records. Will consider a new psych.

I've been doing some reading on BPD & ADHD comorbidity too I really wish my psych would at least consider treating me for both at once, at this point there's no harm because I'm at my wit's end :/ Yes, I understand the risks, but I have been under her care for almost 2 years, just wish we could work together more...

If your relationship w/psych has been good, as long as you feel she listens to you, you might want to salvage. What dose of Vyvanse did you take? Vyvanse is not well-suited, relatively speaking, to abuse - relatively speaking. I don't know how much Vyvanse you revealed you took at once on those days you "spiked" it, but generally, I think most with ADHD at one time or another, wander from the prescription to some extent or another.

"Here's the problem - my psych diagnosed me with BPD, so ANY symptom of ADHD is chalked up to BPD"

This is a problem, just taking this at face value. BPD is going to be the "alpha male", if you will, to the other psychiatric disorders you may face. But just because it's the most outwardly strong, ADHD isn't far behind, if at all, particularly when discussing impulsivity. I'm no psychiatrist, but I've been told things from them that I can do legit research on the Internet about that contradicts what they've told me - usually something fairly benign, just annoying. If you psych's problem is that they are not willing to consider nuance, and I can't be certain they aren't, you are better off with another provider.

I'm not too versed on personality disorders, but treating them isn't as easy, to the extent they even are treatable, whereas ADHD is the most treatable psychiatric/neurological disorder of them all; this is something I heard in a lecture (youtube) by Russell Barkley (ADHD expert). Incidentally, he generally seems to be a vaunted figure on this board, but I find him a very engaging, apparently knowledgeable and enthusiastic speaker; personally, I don't know much about him though.

If you can treat the ADHD, especially since you've got hyperactive traits, I would imagine behavior, focus, mood and order would improve as well. The last thing, assuming the hypothesis is correct, you would want to do is not treat something that improves quality of life. Whether this means the Vyvanse is low dosed and/or coupled with an anti-psychotic - or clonidine perhaps: "there is also evidence for a noradrenergic dysfunction in ADHD and BPD. Treatment with clonidine, an α2-adrenergic receptor agonist, is effective in reducing hyperactivity and impulsivity in children and adolescents with ADHD". Though you're an adult, I think the neurochemistry is the same in this case.

As I've written this post and learned more about the co-occurrence dynamics, I'm thinking you should see a different psychiatrist, though you know your relationship with them and that's a judgment call. Otherwise, consider one that may have a special interest in borderline personality disorder and/or ADHD.

Little Missy
05-25-17, 09:39 AM
Or, you could do a contract with him/or her that you will never abuse or misuse your ADHD meds ever again and I bet whomever your doctor is would prescribe for you again.

sarahsweets
05-25-17, 11:01 AM
Every day for me is a haze of confusion. I wake up, think I know what I'm doing, start, and get side tracked all the time. Cry because I keep messing simple things up, I start to isolate myself because I'm embarrassed. I can barely get through school. Every noise, sight, touch - there's something that distracts me. I know I am intelligent, but cannot focus or get started. I have emotional outbursts due to frustration - mainly anger and frustration. I have gotten into very bad legal trouble, I don't think before I do. Arrests, you name it. I am in therapy doing CBT/DBT but I swear I am treatment resistant. I try so hard. It's getting to the point where I think I will never be successful, I will never be able to live a normal life. I try to find interest in other people, but I'm so overwhelmed that when they talk to me, I don't listen - so much else is going on inside my head.
People with BPD do have a hard time finding treatment that works. I think some of it has to do with how little is understood about the brain chemistry involved in BPD. Some people say its not something that can be treated with medication; its certainly hard to treat something that rears its ugly head whenever it wants. As far as learning to be interested in other people goes, sometimes it helps to practice active listening. Its a skill believe it or not and
it can be difficult to listen when it competes with the other stuff going on it your head.

Here's the problem - my psych diagnosed me with BPD, so ANY symptom of ADHD is chalked up to BPD. I haven't been on ADHD medication for more than a year, and every day I feel less like myself and I'm getting behind in my life. And yes, I have become increasingly depressed and anxious because as I try to comply with my BPD treatment, there is so much that is being put aside.
Have you asked point blank why you cant have symptoms of both? I know there are people who have both disorders. What were you previously prescribed before? Was it for adhd and with this same doctor?


I very much want to start a low dose of vyvanse again for ADHD, but because of my BPD diagnosis and admission that I unintentionally forgot to take my vyvanse in the past (under a different doctor) and sometimes took to much, my psych refuses.

Im surprised that your current doctor would penalize you for forgetting to take your meds-and then for taking too much. Its clear you want to be compliant or else you woulld have never forgotten to take it in the first place. Believe me, people that are addicted or abuse their meds NEVER forget to take them.
Have you thought about a different doctor? Does this one at least validate the fact that you have both adhd and BPD?

I'm sitting here, almost in tears, because I remember so fondly how my life actually IMPROVED when I was taking meds for ADHD. I feel like I'm withering away, while at the same time being sucked up by some tornado that is my mind.

Do your visits cost alot of money?

At this point, I'm not even concerned if I truly have BPD or not. I just don't think I can go any longer seeing my grades drop, not having any plans for myself, and having every single day full of failures and things I could have and should do. I can't even sort my thoughts out, they're always racing and yet I'm told that if I just cope by reading a book or doing mindful meditation that I can regulate myself better.
You cant regulate the adhd or BPD out of yourself.

My mother sees this every day and I feel bad because she feels like a failure. Even though none of this is her fault. Dont let this bother you. Its not your stuff, its her stuff.


Anyone else have another disorder and either in the past, had a psych look over or ignore your ADHD? I have read so many forums on here about how it took so long for people to get on the right track for treatment. I'm trying so hard to right now but feel that there's this stigma that because I'm BPD every single thing in my life is due to it. I just want to feel normal again like I did when I was taking vyvanse. No, it was not a miracle, and it was up to ME to employ behaviors in conjunction with the medicine.

I have bipolar II and have been fortunate to have a doc understand both and treat both. I have however, faced the stigma of mental illness in hospitals and other doctors. They sometimes lump me into the "hysterical woman" category.

I feel like I'm not being taken seriously. I'm often someone who holds back information and sometimes am embarrassed about things so I don't tell my psych right away and when I do, it can come off as overkill or unexpected. I think that's what is happening when I tell her all at once about my ADHD symptoms.

But you are diagnosed with both right? I would see a specialist or another doctor. There is no sense in paying for this one if your treatment is going to be whats best for the doctor and not you.

BricksAreHeavy
05-25-17, 11:50 AM
People with BPD do have a hard time finding treatment that works. I think some of it has to do with how little is understood about the brain chemistry involved in BPD. Some people say its not something that can be treated with medication; its certainly hard to treat something that rears its ugly head whenever it wants. As far as learning to be interested in other people goes, sometimes it helps to practice active listening. Its a skill believe it or not and
it can be difficult to listen when it competes with the other stuff going on it your head.


Have you asked point blank why you cant have symptoms of both? I know there are people who have both disorders. What were you previously prescribed before? Was it for adhd and with this same doctor?



Im surprised that your current doctor would penalize you for forgetting to take your meds-and then for taking too much. Its clear you want to be compliant or else you woulld have never forgotten to take it in the first place. Believe me, people that are addicted or abuse their meds NEVER forget to take them.
Have you thought about a different doctor? Does this one at least validate the fact that you have both adhd and BPD?


Do your visits cost alot of money?


You cant regulate the adhd or BPD out of yourself.

Dont let this bother you. Its not your stuff, its her stuff.



I have bipolar II and have been fortunate to have a doc understand both and treat both. I have however, faced the stigma of mental illness in hospitals and other doctors. They sometimes lump me into the "hysterical woman" category.


But you are diagnosed with both right? I would see a specialist or another doctor. There is no sense in paying for this one if your treatment is going to be whats best for the doctor and not you.

I really appreciate that you took the time to respond to this.

1. I agree that BPD treatment is messy and never straightforward. Right now I'm given SSRI to treat depression I experience from BPD. I just have a good 'ole feeling that going back onto ADHD medications can relieve me from this depression from not being able to do things. I would essentially like to keep taking my SSRI as well.

2. I haven't asked her about that. I will because there is nothing to lose at this point. I was never aware that BPD and ADHD were similar in nature, or at least are commonly co-morbid. My parents took me in for testing and all that as a child, but never put me on medication. I was taking 30 mg vyvanse and 20 mg lexapro. (some klonopin as well, but for me, it's not the right medication - makes me worse). It was with a different doctor, different state.

3. I so agree. I was in a relationship with someone who was and still is a true who addict, in and out of rehabs. I couldn't be further from it. Never once have I been treated for any substance use problems. And I'm upfront about my inconsistent medication taking with my previous vyvanse. And nope, I apparently do not have ADHD because I can sometimes perform well in school...

4. Yes, extremely expensive. $365 self-pay. I kid you not. Once... every week...

5. That's true. I wish I would be allowed to rely on more medication right now. I'm been trying for a year with only SSRIs and it's getting worse.

6. I'll try not to let it get to me

7. I am familiar with the hysterical woman category. Ended up in inpatient once because I cracked during finals, I couldn't get through them. It's like your image is forever tarnished!

8. And yes, I have been diagnoses with ADHD, BPD, and general depression and anxiety. However, the ADHD has been denied by my current psych. About how many tries did it take you (and years) to find the right one?

sarahsweets
05-25-17, 03:55 PM
3. I so agree. I was in a relationship with someone who was and still is a true who addict, in and out of rehabs. I couldn't be further from it. Never once have I been treated for any substance use problems. And I'm upfront about my inconsistent medication taking with my previous vyvanse. And nope, I apparently do not have ADHD because I can sometimes perform well in school...
Performing well in school has nothing to do with actually having adhd or not. Certainly performing poorly in school would be an obvious symptom but some people with adhd are good test takers, great writers, or great class participators. None of it should preclude someone having adhd or not.


4. Yes, extremely expensive. $365 self-pay. I kid you not. Once... every week...

Think about this for a minute... Your doc wants to see you every week to do a poor job treating you, to deny you medication AND he wants to do this once a week.HMMMM I wonder what his long term treatment plan is for you? Do you have insurance but he doesnt take it? Are you self pay by choice? Usually a doctor will give you a more affordable rate when you are self pay because they will still get more from you than the insurance company would reimburse and there is no paperwork, or diagnosis codes and billing to deal with. Its a transaction like any other only instead of a burger, fries and coke, you are getting crappy advice and treatment.


7. I am familiar with the hysterical woman category. Ended up in inpatient once because I cracked during finals, I couldn't get through them. It's like your image is forever tarnished!
Hysterical woman+ mental illness= sexist, stereotype treatment.


8. And yes, I have been diagnoses with ADHD, BPD, and general depression and anxiety. However, the ADHD has been denied by my current psych.
Did your old doctor or another doctor diagnose you with adhd or treat you for it? Can you get those records and slap them on the desk of the current doc and ask him if he would like to call your old doc a liar?

About how many tries did it take you (and years) to find the right one?

I am very, very fortunate to have the doctor I have. I was diagnosed when I was in first grade with what was called: " an attentive disorder". Never treated as a kid though. I started seeing my doctor 17 years ago and we treated the bipolar first which ended up to be 6 months and then we moved on to adhd treatment. She has always let me lead the show with meds but I have always been very honest and law abiding lol. I would switch doctors. Someone is making out real good in this situation. The problem is that it isnt you.

BricksAreHeavy
05-25-17, 04:41 PM
Or, you could do a contract with him/or her that you will never abuse or misuse your ADHD meds ever again and I bet whomever your doctor is would prescribe for you again.

I truly wish this was a possibility! It's a shame that there is no trust from her end...

BricksAreHeavy
05-25-17, 05:01 PM
If your relationship w/psych has been good, as long as you feel she listens to you, you might want to salvage. What dose of Vyvanse did you take? Vyvanse is not well-suited, relatively speaking, to abuse - relatively speaking. I don't know how much Vyvanse you revealed you took at once on those days you "spiked" it, but generally, I think most with ADHD at one time or another, wander from the prescription to some extent or another.

"Here's the problem - my psych diagnosed me with BPD, so ANY symptom of ADHD is chalked up to BPD"

This is a problem, just taking this at face value. BPD is going to be the "alpha male", if you will, to the other psychiatric disorders you may face. But just because it's the most outwardly strong, ADHD isn't far behind, if at all, particularly when discussing impulsivity. I'm no psychiatrist, but I've been told things from them that I can do legit research on the Internet about that contradicts what they've told me - usually something fairly benign, just annoying. If you psych's problem is that they are not willing to consider nuance, and I can't be certain they aren't, you are better off with another provider.

I'm not too versed on personality disorders, but treating them isn't as easy, to the extent they even are treatable, whereas ADHD is the most treatable psychiatric/neurological disorder of them all; this is something I heard in a lecture (youtube) by Russell Barkley (ADHD expert). Incidentally, he generally seems to be a vaunted figure on this board, but I find him a very engaging, apparently knowledgeable and enthusiastic speaker; personally, I don't know much about him though.

If you can treat the ADHD, especially since you've got hyperactive traits, I would imagine behavior, focus, mood and order would improve as well. The last thing, assuming the hypothesis is correct, you would want to do is not treat something that improves quality of life. Whether this means the Vyvanse is low dosed and/or coupled with an anti-psychotic - or clonidine perhaps: "there is also evidence for a noradrenergic dysfunction in ADHD and BPD. Treatment with clonidine, an α2-adrenergic receptor agonist, is effective in reducing hyperactivity and impulsivity in children and adolescents with ADHD". Though you're an adult, I think the neurochemistry is the same in this case.

As I've written this post and learned more about the co-occurrence dynamics, I'm thinking you should see a different psychiatrist, though you know your relationship with them and that's a judgment call. Otherwise, consider one that may have a special interest in borderline personality disorder and/or ADHD.



I have only ever been on 30 mg Vyvanse, I did very well on it, my previous doctor asked me numerous times if I wanted to up the dosage but I never felt it necessary. I'm sure if I sustained it for longer, eventually I may have to but I was very content and functional then. When I would take too much, it would be an extra pill, so let's say I forgot I took it at 8 am, I took another at 9 am because I thought I hadn't taken it because I didn't feel it kick in yet. So I accidentally took twice as much, but this is nothing unusual...just have to be more aware.

The MAJOR improvement for me was an evening out - my thinking stopped being so all or nothing. I was able to function more seamlessly throughout the day, it was beautiful and in turn I felt my quality of life skyrocketed, even from something like that. Now I hyper focus or don't focus at all and it often leads to emotional outbursts.

Agreed that BPD will always be the "alpha male" diagnosis. I was reading online that there are people who believe there may be a link between untreated childhood ADHD and BPD showing up in adulthood. I am highly curious as to if this is how my symptoms are playing out. To this day, my mother always said I would get "stuck", as in if things weren't done in order I was not able to accomplish them, and get emotionally upset and it would take me some time to move past it. I feel like I have these SAME behaviors now! But they look like rigid, BPD ways of thinking, when really I am extremely distressed when I can't figure out how to go about things and organize it in my head.

I will definitely be checking out Russell Barkley, thank you for the suggestion.

Interesting about the neurochemistry. I actually just got back from an appointment. My pdoc has stacked TWO (Wellbutrin and Trintellix...even though I told her I have already tried Wellbutrin in the past and felt it was like taking a sugar pill) more antidepressants onto my current lexapro. I feel like I'm just on an SSRI overload right now and that there could definitely be more receptors at play that are not being addressed (ADHD!). I do believe I get some relief in terms of lessened anxiety with SSRI's and would like to stay on one. I just am frustrated that I'm only being thrown more and more.

Finding a pdoc well versed in both disorders would be wonderful. I am not denying I don't have BPD tendencies to continue to work on, but after 1.5 years of working with this pdoc, it's kind of a dead end.

Thank you for replying to my post

BricksAreHeavy
05-25-17, 05:18 PM
Performing well in school has nothing to do with actually having adhd or not. Certainly performing poorly in school would be an obvious symptom but some people with adhd are good test takers, great writers, or great class participators. None of it should preclude someone having adhd or not.



Think about this for a minute... Your doc wants to see you every week to do a poor job treating you, to deny you medication AND he wants to do this once a week.HMMMM I wonder what his long term treatment plan is for you? Do you have insurance but he doesnt take it? Are you self pay by choice? Usually a doctor will give you a more affordable rate when you are self pay because they will still get more from you than the insurance company would reimburse and there is no paperwork, or diagnosis codes and billing to deal with. Its a transaction like any other only instead of a burger, fries and coke, you are getting crappy advice and treatment.


Hysterical woman+ mental illness= sexist, stereotype treatment.



Did your old doctor or another doctor diagnose you with adhd or treat you for it? Can you get those records and slap them on the desk of the current doc and ask him if he would like to call your old doc a liar?



I am very, very fortunate to have the doctor I have. I was diagnosed when I was in first grade with what was called: " an attentive disorder". Never treated as a kid though. I started seeing my doctor 17 years ago and we treated the bipolar first which ended up to be 6 months and then we moved on to adhd treatment. She has always let me lead the show with meds but I have always been very honest and law abiding lol. I would switch doctors. Someone is making out real good in this situation. The problem is that it isnt you.

I'm glad you informed me about the academic aspect of ADHD. I met with my pdoc today, and I brought up how I am able to do relatively well in school, but it's NEVER consistent. And she knows this. I informed her how this past semester, I failed almost every final. Even though I had maintained high scores during the semester. I am very all or nothing, if I do not put ALL of my concentration towards ONE thing, then I am pooped out, there is NO alternative! She believes it is a matter of putting my stress aside, recognizing what is important, making a schedule, and sticking to it. Sometimes, though, willpower is not enough/everything. Over the years, I have developed many skills to deal with disorganization. I have little quirks and routines that have kept me from flailing, and I'm proud of it! For example, when I am done writing out my schedule, I fax it to myself from a different location as a reminder. I make sure to take pictures on my phone of everything so I don't forget if I did something or where I placed something. However, it gets to a point where I can only keep up so much, and then everything just falls apart...brain scattered, unable to start where I left off, and many times too scared to because I fear this cycle of failure!

What I wrote above can get me really down and depressed when I'm NOT adhering to that very strict way of living. Is it unreasonable for me to want to continue to use my mechanisms but also employ some medication to smooth things out so I don't burn out? (not rhetorical, truly asking! Not sure if my psych would think that's incredibly lazy or not)...

Not self-pay by choice as the whole practice takes no form of insurance. The insurance sometimes covers some to it once we have paid $7,000, but it's never a guarantee. Been a messy "dance" for 1.5 years now...

If I am honest, I am terrified of switching because that would mean sending over my records from this current doctor to a new one, and she takes METICULOUS notes every single session, and I am worried that the new doctor will be influenced by it. I really just want a clean slate to get on the right track. You're right...the more I think about it...no one would keep this going...!

It's kind of ironic, my pdoc is a woman, treating me, a woman, for BPD and really sticks to the stereotype..!

An old doctor diagnosed me with ADHD and I was treated for it (along with depression and anxiety). Good idea. I will obtain those records, I feel they will be helpful regardless of if I decide to bring them the actual, physical papers to her attention or not.

That's interesting that you started with Bipolar treatment first, and then progressed with ADHD. When you say lead the way with medicines, do you typically ask her flat out that you'd like to try a new combination and give the specific name of the med?

(Also, since you mention law abiding, I really feel that much of my impulsive behavior is due to ADHD, I have never gotten in trouble because I was "caught" doing something I knew I shouldn't have been doing, or because I felt I was above the law or defiant, which often is what happens with BPD. Every time I am in trouble it is because I am naive and don't think ahead of time, say something stupid, have an emotional reaction and oops before I know it I did something wrong and I'm kicking myself and have huuuuuge amounts of regret) :/ so many of my troubles seem to stem from ADHD, and in addition I have BPD traits that rear their ugly head when I choose a bad environment or not the right people to be around, and am easily swept up. Sorry for the rant! I just never talk about this stuff, mainly because I feel that people like my pdoc know what is best for me, but that is not always true!

Cyllya
05-25-17, 05:57 PM
Even if the correct diagnosis is that you have only BPD and not ADHD, the fact that Vyvanse helped you is a good enough reason to keep taking Vyvanse. There's not some kind of law that says ADHD is the only condition that can be treated with Vyvanse. (In fact, it's FDA-approved for binge eating disorder, and amphetamine generally has historically been used as a nasal decongestant, antidepressant, narcolepsy treatment, and probably other stuff.)

What we're the circumstances of you taking too much in the past? If you couldn't resist taking extra, you might have better luck with Adderall or Dexedrine. (Vyvanse gets kudos for being addiction-resistant i think because it cant be insulfated or something. But going by memory, it seems like almost all of the "I decided to take more than prescribed because I couldn't FEEL anything" on this site are about Vyvanse. Not sure if that's actually due to anything intrinsic to Vyvanse though. Could be a coincidence.) The non-stimulant ADHD meds are non-addictive but may be less effective for you.

Even though it's classified as a personality disorder, everything I've seen regarding BPD makes me think of it as a mood disorders. (Same for some other PDs.)

l_ruth_
05-25-17, 06:34 PM
Hi @BricksAreHeavy

do you know if you were diagnosed originally with one of the three ("official") ADD subtypes?

I would be interested to know - I am not diagnosed with ADD, but would consider myself to have Primarily Inattentive subtype.

I am diagnosed with Autism Spectrum Disorder. Taken together these two conditions have manifested for me in psychosis, depression and anxiety. Another of my friends is currently diagnosed with ASD, like me, and is considering that ADD fits many symptoms as well.

I hope that you find support here.

BricksAreHeavy
05-25-17, 06:52 PM
Hi @BricksAreHeavy

do you know if you were diagnosed originally with one of the three ("official") ADD subtypes?

I would be interested to know - I am not diagnosed with ADD, but would consider myself to have Primarily Inattentive subtype.

I am diagnosed with Autism Spectrum Disorder. Taken together these two conditions have manifested for me in psychosis, depression and anxiety. Another of my friends is currently diagnosed with ASD, like me, and is considering that ADD fits many symptoms as well.

I hope that you find support here.

In the few days I have been on this site, I have found so much support. I have an account on psychforums, but find it much more focused on everyone sharing their own experiences and a little less about interacting w users and asking questions. So I really love this site!

I probably should have mentioned this before - my mother very much thought I had a form of aspergers (I'm sorry if my terminology is incorrect, I'm not familiar with this area of psych) as a child - extreme inflexibility, very sensitive to stimuli, intense interest and then no interest in other things, cannot let go and move on - but never took me to anyone to address this in particular.

If you don't mind me asking, what medication/therapy has given you some relief?

I unfortunately was not given a specific ADHD subtype diagnosis, just the general diagnosis. I am guessing that my previous doctor believed it was combined as the symptoms I was presenting at the time were inattentive in lack of motivation, uncaring about what others say to me in person, and difficulty staying focused, but due to my impulsivity and decision making, also hyperactive.

l_ruth_
05-25-17, 11:30 PM
Hi @BricksAreHeavy

I've been to a clinical psychologist. This was helpful to know there was a specialist who had seen more people like me. Getting a diagnosis was very important. Don't worry, I don't think the terminology is so important :)

Since finding out about ADHD I think this has made the most difference in the shortest amount of time.

In general what I find most helpful is realising there are actually "mechanical", underlying factors to why I find certain things hard.

Verbal instructions can be quite difficult. I find some conversations quite stressful.

I think there is an extreme bias against truly accurate clinical diagnosis of females in particular. This is a huge challenge.

Also the tendency not to look for underlying reasons, but only treating symptoms ...

What has helped me is gaining confidence with my self-knowledge and self-education through independent research and participation in forums. Lots of professionals are indeed not the most reliable source of information, I think

BricksAreHeavy
05-26-17, 12:21 AM
Hi @BricksAreHeavy

I've been to a clinical psychologist. This was helpful to know there was a specialist who had seen more people like me. Getting a diagnosis was very important. Don't worry, I don't think the terminology is so important :)

Since finding out about ADHD I think this has made the most difference in the shortest amount of time.

In general what I find most helpful is realising there are actually "mechanical", underlying factors to why I find certain things hard.

Verbal instructions can be quite difficult. I find some conversations quite stressful.

I think there is an extreme bias against truly accurate clinical diagnosis of females in particular. This is a huge challenge.

Also the tendency not to look for underlying reasons, but only treating symptoms ...

What has helped me is gaining confidence with my self-knowledge and self-education through independent research and participation in forums. Lots of professionals are indeed not the most reliable source of information, I think

If I may ask, are you in the USA? I'm curious if there are a decent amount of specialists in my area.

Would you say medication or coping skills and behavior helped you the most initially with ADHD? I realize I have always found interesting and odd ways to manage my focus issues, but medication truly gave me the relief I always sought.

The more I am on this forum, there more I read about biases against diagnosing females, or in a similar vein, not diagnosing them. I have worked very hard my whole life to be able to change myself in different situations - for example, who I am in my doctors office is very different (my facial expressions, overall persona), so when I explain my symptoms to my pdoc they may seem in conflict with how I am physically coming across. I am wondering if you do this too? I could seriously be dying on the inside and yet manage a smile and laugh because I feel like that's the "right" thing to do.

I hope to follow in your footsteps with independent research. I spent a full hour, full concentration looking at forums and publications on ADHD and misconceptions! Maybe I'm cured after all? Jokes haha but I learned today that the kick backs that psychiatrists get for prescribing certain medications are far more lucrative than I ever thought...especially from Forest Laboratories, which manufactures Lexapro!

aur462
05-26-17, 12:32 AM
Interesting about the neurochemistry. I actually just got back from an appointment. My pdoc has stacked TWO (Wellbutrin and Trintellix...even though I told her I have already tried Wellbutrin in the past and felt it was like taking a sugar pill) more antidepressants onto my current lexapro. I feel like I'm just on an SSRI overload right now and that there could definitely be more receptors at play that are not being addressed (ADHD!). I do believe I get some relief in terms of lessened anxiety with SSRI's and would like to stay on one. I just am frustrated that I'm only being thrown more and more.

Preface: at some point I'm going to check out the rules regarding hyperlinks but a simple google search yourself will work easily to confirm more details.

Trintellix is contraindicated with bupropion AND lexapro. The "major" (site that rates drug interactions and that's the worst level) risk is "may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition." You're on a trio of drugs that are contraindicated. I THINK she knows what she's doing, but if it were me, I'd consider/investigate further. I'm sure it's all about the dosing :)

One thing is for sure, she definitely is VERY interested in potentiating serotonin :rolleyes:

BricksAreHeavy
05-26-17, 12:48 AM
Preface: at some point I'm going to check out the rules regarding hyperlinks but a simple google search yourself will work easily to confirm more details.

Trintellix is contraindicated with bupropion AND lexapro. The "major" (site that rates drug interactions and that's the worst level) risk is "may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition." You're on a trio of drugs that are contraindicated. I THINK she knows what she's doing, but if it were me, I'd consider/investigate further. I'm sure it's all about the dosing :)

One thing is for sure, she definitely is VERY interested in potentiating serotonin :rolleyes:

I'm so confused why she is doing this! I appreciate the information, though. I believe since my Wellbutrin dosing is only at 150 mg, that it will be okay - if I went up to the 300 I think it is, I feel that might cause issues, I know many people report huge jumps from 150 to 300 in terms of physiological effects, but I'm not sure how that translates into serotonergic effects.

One good thing that will come out of this is that the trintellix, it seems, will be another AD I can check off the list :/

l_ruth_
05-26-17, 02:38 AM
If I may ask, are you in the USA? I'm curious if there are a decent amount of specialists in my area.

Would you say medication or coping skills and behavior helped you the most initially with ADHD? I realize I have always found interesting and odd ways to manage my focus issues, but medication truly gave me the relief I always sought.

The more I am on this forum, there more I read about biases against diagnosing females, or in a similar vein, not diagnosing them. I have worked very hard my whole life to be able to change myself in different situations - for example, who I am in my doctors office is very different (my facial expressions, overall persona), so when I explain my symptoms to my pdoc they may seem in conflict with how I am physically coming across. I am wondering if you do this too? I could seriously be dying on the inside and yet manage a smile and laugh because I feel like that's the "right" thing to do.

I hope to follow in your footsteps with independent research. I spent a full hour, full concentration looking at forums and publications on ADHD and misconceptions! Maybe I'm cured after all? Jokes haha but I learned today that the kick backs that psychiatrists get for prescribing certain medications are far more lucrative than I ever thought...especially from Forest Laboratories, which manufactures Lexapro!

Hey,

No I am actually in Australia. I wonder about whether I was on the right medication how much of a difference that could make.

One of the things I have read on this forum, I think for diagnosis in Australia a psychiatrist is perhaps better for a diagnosis though perhaps a clinical psychologist would be equally as formally "qualified" to do so.

Here is a great video which made a lot of sense for me: Understanding Girls with ADHD https://youtu.be/XxIILekMKAc

Here are some more resources from the lady in the video - Ellen B. Littman(whom I consider must be something of a specialist for women and girls with ADHD, much like Tony Attwood in Queensland Australia has specialised in how autism presents for women and girls): http://drellenlittman.com/pb/wp_b4f2c210/wp_b4f2c210.html

aur462
05-26-17, 10:23 AM
I'm so confused why she is doing this! I appreciate the information, though. I believe since my Wellbutrin dosing is only at 150 mg, that it will be okay - if I went up to the 300 I think it is, I feel that might cause issues, I know many people report huge jumps from 150 to 300 in terms of physiological effects, but I'm not sure how that translates into serotonergic effects.

One good thing that will come out of this is that the trintellix, it seems, will be another AD I can check off the list :/

You can do a lot of things with meds that, in literature, are contraindicated - sometimes. She knows you tolerate bupropion and Lexapro well, so the significant variable is how Trintellix will interact with these meds. If she seems thoughtful, then that is important to determining how much you trust her.

The risk for serotonin syndrome is considered "rare", although my wife has had it.

Tangential mostly:
I had a pdoc for a short time who was an ADHD specialist who prescribed me 40mg of dextroamphetamine (instant release) to be taken all at one time (explicit or inferred, don't remember). It should have instructed something like 20mg twice per day - I didn't take the 40mg at once. Other than minor, but significant errors on prescriptions, she seemed well-meaning, I just didn't work with her long. She got frisky and tried to leave the 2 person practice, pursuant to opening her own clinic before the "No compete" clause expired (this or something similar). In talking with my GP - who was referred to me by this doc - he explained to me that this was the she indicated (my rough recollection) "I thought I had all the paperwork and (fill in the blank for "legal" stuff) was good to go" She had her medical license for only a year before doing this! Incidentally, I'm pretty sure she had ADHD herself. So my point to this tangent is that I never got to know her that well, and she did actually make some errors in the short time I saw her. The last time I heard from her was through voice mail, cancelling our appointment indicating, "I won't be practicing medicine for the forseeable future."

I've had a lot of relatively bad luck with physicians, up until very recently (knock on wood), so I actually don't easily give them the benefit of the doubt, and recognized that I don't easily "defer to their expertise", which considering the science I took in college was zoology and biology, doesn't reflect well on the med profession. My "jet black colored glasses" may not be the "lens" you should be looking at your doc's decisions through. I'd just want to be proactive in my treatment and education.

Anyway, I hope that those meds help you :)

sarahsweets
05-26-17, 10:38 AM
If I am honest, I am terrified of switching because that would mean sending over my records from this current doctor to a new one, and she takes METICULOUS notes every single session, and I am worried that the new doctor will be influenced by it. I really just want a clean slate to get on the right track. You're right...the more I think about it...no one would keep this going...!
I see what you are saying. Even if you personally get the records, you could decided which parts you would want to share with a new doctor.


That's interesting that you started with Bipolar treatment first, and then progressed with ADHD. When you say lead the way with medicines, do you typically ask her flat out that you'd like to try a new combination and give the specific name of the med?

Yes at this point if I suggest something its specific, name, and dose. But this is after 17 years of seeing her. I didnt feel comfortable suggesting things really until the internet became a reliable way of researching things, (remember 17 years ago the internet was so lame, it was mostly about chat rooms and gif's.)
For the last 10 years or so with me or my kids, she has always been open to my suggestions. If I walked in though and demanded something for no good reason though,I dont think it would fly. Its all about context with my doctor.

dvdnvwls
05-26-17, 01:48 PM
One of the essential things for psych professionals is the therapeutic relationship. Working together with the patient in order to improve the patient's life. A kind of bonding happens, and without that bonding, therapy usually fails.

BPD symptoms often seem as if calculated to do maximum damage to relationships. So doctors often struggle to find their balance - to be able to "be there for" their patient and at the same time not take personally the things they know are likely to happen.


About the ADHD being ignored: BPD causes worse problems in a person's life than ADHD does, and so the BPD is treated first until there is enough of a permanent improvement in it. And unfortunately part of the BPD symptoms is denying that BPD symptoms are a problem, so it isn't appropriate for the patient to have a lot of input on that particular decision.

BricksAreHeavy
05-27-17, 12:36 AM
One of the essential things for psych professionals is the therapeutic relationship. Working together with the patient in order to improve the patient's life. A kind of bonding happens, and without that bonding, therapy usually fails.

BPD symptoms often seem as if calculated to do maximum damage to relationships. So doctors often struggle to find their balance - to be able to "be there for" their patient and at the same time not take personally the things they know are likely to happen.


About the ADHD being ignored: BPD causes worse problems in a person's life than ADHD does, and so the BPD is treated first until there is enough of a permanent improvement in it. And unfortunately part of the BPD symptoms is denying that BPD symptoms are a problem, so it isn't appropriate for the patient to have a lot of input on that particular decision.

I see what you are saying about BPD symptoms causing worse problems in a person's life. However, I slightly disagree. Especially if in my case BPD symptoms really only come out in romantic relationships, and lie pretty dormant otherwise.

I also have to disagree that I deny my symptoms. I do not have a trusting relationship with my psychiatrist right now, and that is partly because she has never allowed me to have input into decisions. So, at this point, it is absolutely acceptable for me to be a part of my treatment and inform her that she is not seeing all of my symptoms in the right light - I've just been timid and hesitant many times. I am not one to demand or deny, I am actually someone who takes the back seat until I realize things cannot go on the way they are.

I 100% agree that bonding is very important, and definitely that isn't something that I have with my current pdoc.

I also now believe I am being nickel and dimed - if you read my old posts you will see why.

dvdnvwls
05-27-17, 05:25 AM
I think you are indeed being taken for money.

But on the other hand, in the context of BPD, denying that you're denying is still denial. :(

yerigt
06-01-17, 07:57 PM
Hello, I am new here, and I'm also Swedish, so pardon my English if it is a bit stumped. :)

I can relate a lot but I do think you will find better days, eventually.

I will try not to go into your situation too much, my English is a bit bad at the moment so I don't want to use someone's personal story and to bluntly misquote it, but based on my own experience it is possible to work through a lot of the problems the adhd creates. And yes, I have been misdiagnosed a lot, mostly a combination of general anxiety disorder and some kind of avoidant/nervous because of low confidence condition/"disorder", which is upsetting since I always try to be brave and take action in life and I am very motivated and self-aware, with a strong inner understanding/reflection and compass. Treat the cause (emotional and physical) not the symptoms.

Also I find that the psychiatry and therapy I've received doesn't really want to listen to me when I try to evaluate how my eventual problems are related to a mix of perfectly human existential/soul frustrations versus a sensitive/overactive nervous system with effects such as adhd/hsp/etc. They see the wrongs not the roots of the cause, since it's too complicated and integrated with my emotional life, frustrations in life. You are NOT alone in being mistreated/diagnosed/evaluated..Adhd/sensitive nervous system conditions seems so diminished and misunderstood generally, we are complex.

Anyway, I've learned my own strategies and am constantly evolving, and at least some things are better now then a couple of years ago; my focus is better when focusing on general things that are somewhat irrelevant, my mood is more balanced, I don't get so tense while with other people as before ( still thinking too much, being to over-stimulated and with a restless/wandering mind, but sort of sublimating it and able to stay in the moment, and focus on the people around me, at the same time), I can sort and filter the surroundings better. But my sensitivity isn't lost. Its more like multitasking but through natural effort (through hard work). I just got fed up feeling so lost and impressionable and steered the mind into priorities, but through self-love and compassion. such as when having focused hard on certain things in school, then being able to recuperate through 3 hours of hanging out with myself listening to music and just drift or more likely, intuitively tune in to my own integrated person to heal and sort out the daily events of the harsh environment of a busy world into something constructive.

Bah I wish I could speak better English, so I will stop here. Just wanted to say that there is nothing wrong with having a sensitive/complex nervous system and a reflective and intuitive mind and that we should take care of it and treasure our intuitive skills until we have integrated ourselves with the beat of the world while still not losing ourselves. Hopefully some english-speaking person can evaluate better.

sarahsweets
06-05-17, 04:58 AM
Hello, I am new here, and I'm also Swedish, so pardon my English if it is a bit stumped. :)

I can relate a lot but I do think you will find better days, eventually.

I will try not to go into your situation too much, my English is a bit bad at the moment so I don't want to use someone's personal story and to bluntly misquote it, but based on my own experience it is possible to work through a lot of the problems the adhd creates. And yes, I have been misdiagnosed a lot, mostly a combination of general anxiety disorder and some kind of avoidant/nervous because of low confidence condition/"disorder", which is upsetting since I always try to be brave and take action in life and I am very motivated and self-aware, with a strong inner understanding/reflection and compass. Treat the cause (emotional and physical) not the symptoms.
Since we do not know what causes adhd, treating the symptoms is our best bet. Maybe you can work through the problems that adhd creates but many of us cant.


Also I find that the psychiatry and therapy I've received doesn't really want to listen to me when I try to evaluate how my eventual problems are related to a mix of perfectly human existential/soul frustrations versus a sensitive/overactive nervous system with effects such as adhd/hsp/etc. They see the wrongs not the roots of the cause, since it's too complicated and integrated with my emotional life, frustrations in life. You are NOT alone in being mistreated/diagnosed/evaluated..Adhd/sensitive nervous system conditions seems so diminished and misunderstood generally, we are complex.

So you are saying that your issues are not something that can be treated by psychiatry and that you are not being listened to when trying to explain them? Its very hard in psychiatry to definitively come up with a specific root cause to explain everything. and when you can its not an issue of misdiagnosis or being mistreated. It means that treating the symptoms is of more benefit to you than not treating them and only looking for the source or cause.

Anyway, I've learned my own strategies and am constantly evolving, and at least some things are better now then a couple of years ago; my focus is better when focusing on general things that are somewhat irrelevant, my mood is more balanced, I don't get so tense while with other people as before ( still thinking too much, being to over-stimulated and with a restless/wandering mind, but sort of sublimating it and able to stay in the moment, and focus on the people around me, at the same time), I can sort and filter the surroundings better. But my sensitivity isn't lost. Its more like multitasking but through natural effort (through hard work). I just got fed up feeling so lost and impressionable and steered the mind into priorities, but through self-love and compassion. such as when having focused hard on certain things in school, then being able to recuperate through 3 hours of hanging out with myself listening to music and just drift or more likely, intuitively tune in to my own integrated person to heal and sort out the daily events of the harsh environment of a busy world into something constructive.

Bah I wish I could speak better English, so I will stop here. Just wanted to say that there is nothing wrong with having a sensitive/complex nervous system and a reflective and intuitive mind and that we should take care of it and treasure our intuitive skills until we have integrated ourselves with the beat of the world while still not losing ourselves. Hopefully some english-speaking person can evaluate better.

I am not sure if I get the totality of what you are saying but I do not think adhd is being ignored if a doctor or someone is trying to treat the symptoms and not the cause. You cant treat the cause of something if you do not know what the cause is.

dvdnvwls
06-05-17, 01:38 PM
yerigt:
What you said about the professionals seeing only the wrongs (maybe they would say "the symptoms"), and not seeing the root causes - you're exactly right. But that's all that they can do! The root causes are unknown, and because the causes are unknown, many professionals think that talking about root causes is a waste of time.