View Full Version : pouring my heart out - differential diagnosis


tired_need_help
02-22-06, 07:03 AM
Hi everyone, I have been having some doubts lately about certain things and would be grateful if i could have an opinion from some of the truly wonderful people out here... here it goes.

Background:
I am a foriegn student in the US working on my PhD. I am 22 years old and I have been here for the past 6 months now. Recently, after arriving in the US i noticed that some of my 'traits' of distractability had suddenly increased and especially being exposed to a different system of education (more rigorous) than the one i had been used to, I found it hard to cope. After some initial struggle i realised that something was fundamentally wrong and even though i had some how managed to get my things done in order before, I was failing at every instance, every class and every situation that demanded something from me. My memory was starting to fail bad and i couldnt remember the names of new people and the things that i had to do. Couldnt organize myself, and kept going in circles over and over again. Finally frustrated, i decided to do some research on the internet and came across a bunch of information, esp the following symptomps that matched with that of mine :

History (before coming to US)
1. Hyper-activity
2. Restlessness
3. Instant Gratification
4. Bed-wetting uptil 2std (age=7yrs)
5. Situational Anxiety - exam time (always)
6. poor time management
7. forgetfulness
8. sudden bursts of hyper activeness followed by periods of dullness
9. inability to coherently communicate certain ideas
10. inability to run long threads of continuous thoughts. resulting in short breaks. esp. during discussions of complex ideas.
11. reduced self-worth
12. occasional depression - more like lack of joy
13. episode of anxiety breakdown - science exam 8th grade
14. always needed a something else to do. for instance, a story book/novel when preparing for exam - the studying would be interspersed with reading of the novel.

present
--------
1. longer sleeping durations or weeks without sleep.. extremes
2. extreme lack of concentration
3. anxiety situational
4. frustration
5. bad time management
6. procrastination
7. inabitlity to understand prof. lectures
8. inability to work in small bits over a period of time - lack of consistent effort.
9. getting tired fast.
10. quick to get angry. quick to diffuse.

So with some more information i went got an appointment with a psychologist and she completed a review and dxed me with ADHD inattentive type. This was followed up with a medication from a psychiatrist who put me on 20mg Adderall XR, which is the current status till now.

The results of the medication for the past 1 month indicate a better ability to focus and upon taking the meds, the depression is blasted off right away and i feel more energised, though sometimes i almost feel the blood pulsating through my viens when i sit still. infact sometimes i almost palpitate, so i try to control my dosage to prevent that from happening. no memory improvements, but an improved sense of cognition is visible though it seems transient.

now, there are some symptomps that i did not take it seriously at the time they occured and now since they are beginning to bother me i decided to do some more digging to see if this was something else, the following were some added symptomps...

1. skin 'pinches' - spots in the skin suddenly start to itch terribly and subside (now, since landing in US - doctor thinks its just climate)
2. head aches (in the past) severe ones that would last for entire nights and would cause me writhe in agony but would be gone the next day, i suspected migraines owing to acidic reflux, as it would generally occur on the days when i had eaten something different (allergy testing revealed nothing)
3. loss of hair - severe dandruff (past and now)
4. occasionally i hear normal sounds differently, my table fan which produces a low hum, sometimes seems like an old song or even some one speaking, (i know this doesnt sound so good, infact i thought i was going insane, but after a while i realised that it always happened when i was tired and only with that fan so decided to ignore)
5. talking for long time over a cell phone always produced a headache.
6. Dxed for spinal nerve compression in the sciatic region, so suffered from lower back ache for 3 months before leaving for the US.
7. occasional stiffness in various parts of the body.
8. lesser bladder tolerance (improves with adderall)
9. vertigo
10. if i close my eyes and try to stand up straight i just cant stand still...i fall..
11. a fluttering eye lid (its been on for 3months now)
12. sometimes various parts of the body flutter (for lack of better word) by themselves.. (convinced myself that it was just stress)

so here is the big question, do these new symptomps along with the original ones lead to a different Dx? could this be a central nervous disorder??

what really scares me is this, untill my 10th grade, i was really fast (captained high school basket ball team) and I was intelligent and fun. But slowly ever since then there has been a degradation. I can still move fast but for a very little while and a lot slower then i used to be able to, and more recently my galpal with whom i used to study during my undergrad began to notice i kept forgetting important stuff we had revised just the day before, it would be as if it just fell off my head..! and now when i have to manage everything by myself including bills et al. (which was taken care of until now by my support team - parents ; i mean back in my home) and while i am able to all that just fine, complex tasks seem difficult to comprehend, like credit card payments and tax calculations (considering am a math major n engineering grad).. and now finally when i thought i had nailed it with the Dxing of ADHD, the new symptomps which i did not bother about seem to take things in a different direction...

i am a researcher and my funding depends on my performance and with reduced prodcutivity my chances of being able to complete my program are diminishing, while there was a time when i would have done the things that i have to do now with consumate ease..

the trouble is i feel like i am fading away, like a picture tube and i am beginning to despair...
i had set out to achieve so many things in my life and every single day i am going farther away from it..
i am beginning to feel like a different person, i am worried.. :( losing battles. while i try to not to get depressed, sometimes i just want to stop everything and quit but i cant because i have to be there for my family and i have to succeed if i have to be there for the people i love (might sound cliched, but i dont know how better i can explain this..).. i dont feel it as a preassure but i know that if i dont do something about it, things may not figure themselves out...


am really sorry for the terribly long post.. would appreciate your opinions on it...thank you so much people.

-tnh

Scattered
02-22-06, 07:54 AM
Hi Tired,

First off I'm not a doctor so I don't know if you have a differential diagnosis or more likely a cormorbid condition. I would definately bring it up with my doctor if I were you. Here are a few things I do know -- About 85% of dult ADDers have a comorbid condition (IE: depression, anxiety, OCD, bipolar, learning disability, etc), so I'd be surprised if you didn't have a little something along for the ride.

Secondly, there are two books I'd like to recommend to you. The first is written by Yale Professor Thomas Brown. It's call Attention Deficit Disorder: The Unfocused Mind in Children and Adults. In it he discusses the six categories of functioning ADD impairs and discusses how ADD can go unrecognized (especially in brighter ADDers) until one's life challenges begin to surpass one's executive functionings. The second book is by Harvard Professor (and fellow ADDer) John Ratey. It is called Shadow Syndromes. It discusses the milder forms of mental disabilities and how they can become worse under different circumstances. This one particularly helped me. Like you I got through college successfully without medication, however when my husband and I moved across the country to a place where we knew no one and had no supports in place, in addition to having our second daughter and my staying home, the stress totally took me apart. My functioniong went way, way down. Since I've been diagnosed my psychologist has explained to me the impact stress has on anyone's functioning (especially someone with ADD). Moving to a new country, pursuing an advanced degree with a heavy pressure to perform definitely qualifies as an increased stress level. The periods of sleeplessness or excessive sleep are frequently symptoms of depression or anxiety. Layer that on top of ADD and your functioning will go down.

4. occasionally i hear normal sounds differently, my table fan which produces a low hum, sometimes seems like an old song or even some one speaking, (i know this doesnt sound so good, infact i thought i was going insane, but after a while i realised that it always happened when i was tired and only with that fan so decided to ignore)I can't tell you what this is, but I have it occasionally too. You're the first person who I've ever heard explain it exactly like I experience it. Maybe someone smarter than me can inform both of us about what this is likely to be.

I encourage you to see your doctor, exercise as much as possible (great stress reducer and mind focuser), and get support. You take care and keep us posted!

Scattered

KirkT
02-22-06, 12:44 PM
I don't think #4 is all that weird. Sometime, at night when our heater kicks on, my wife will wake me up and say, "Did you leave the TV on?" I'll listen for a while and say, "Damn! I did." and check only to find out that it isn't. The heater, for some reason, always sound like people talking in the background, or like our 3 year old son is talking in his bed. We always joke that the spirits in the house must be bored. It's just the right frequency of white noise that causes it to happen to us. Our friends, who we've tried to get to listen, think we are crazy.

Now, if the sounds start telling you to kill your boss, and you're self-employed...I'd be worried. :)

ladym
02-22-06, 09:07 PM
I can completely relate to this. Although I won't be much help, because I am just recently beginning to search for someone to go to about all of this. I have the same childhood story. I remember being a bit of a day dreamer, and most certainly temperamental. Not manic, but definitely more moody then my peers. I did well though for the most part. I expelled all my energy through many different childhood things, dancing, batton, cheer-leading, track team, etc. I was always doing "something".
It was in the 10th grade for me as well, that my life began to fall apart, for no apparent reason at all. I went from an honor roll student, to ultimately dropping out of school. In my late teens, early 20's is when I really became very aware of how "spacey" I seemed to be. The time lapses that I have from being lost in my own thoughts. Spacing out while driving, while talking to someone, while doing anything at all really. It is increasingly getting worse. It's to the point now that it is seriously scaring me. I don't trust myself anymore. I don't trust myself to remember anything. I don't trust myself to drive. I don't trust myself to do anything really, because I don't know when I will space out, or forget something important, etc. I too, feel like I am slowly, but surely, just slipping away from myself. As if my mind is just shriveling up more and more every day, and eventually there will be nothing left. It's terrifying.
I wish I had an answer for you, but I don't, because I don't know what is going on with me either. I know, most certainly, I have an anxiety disorder. I'm fairly certain I have ADD, but I have no clue if it goes further then that or not.
I hope you find answers to your questions, but know that you aren't alone!

Oh, and I have the same experiences with the noises as well. I agree with the PP on that one:p

anamari
02-22-06, 10:16 PM
hi,

I can rely with you.Living in a foreign country and having to adjust to a new system , different culture is a big step in the first place. most people go to depression and difficult times once they come to live for a longer time in a foreign country-and having add does make it even harder...because the hardest for me (as well as for DS) is to adjust to a new situation -
every time when something was different I had to develope new ways to cope with it. the first time I fell behind was highschool-used to be a top student in grade school, gifted especially for math, and suddenly with highschool my grades droped-especially in math...I improved during highschool-slowly but steady.
first year in college was hard(er) but it really helped I was doing something I loved. first job was tough....

but the toughest is now-away from my homecountry, trying to adjust from my status as an active person and the breadwinner for me,DS and my mom for many years to the status of a stay at home mom, with two little kids-and hosekeeping was my main problem.I hope tho I will find a good doctor to prescribe me the right medicine, and also-with the help of these wonderful people-a way to cope with my problems and make the best of my life....

Naomi2
02-23-06, 12:13 PM
4. occasionally i hear normal sounds differently, my table fan which produces a low hum, sometimes seems like an old song or even some one speaking, (i know this doesnt sound so good, infact i thought i was going insane, but after a while i realised that it always happened when i was tired and only with that fan so decided to ignore)
Don't worry too much about that, especially if it comes with tiredness. Sometimes I get that (especially if I'm tired). I was on a long coach journey once and the noise the engine and tyres etc. made sounded like my mum singing, which actually made me feel more relaxed and calm.

Sometimes I hear the wrong sounds and if it's a sound which goes on for a while, sometimes it changes into something completely different which I know was the same all the way through, but I just heard it wrongly and if it's a short/sudden sound, if I know what it was, I'll know if I heard it wrongly or I know what made the sound so it wouldn't make sense that it made the sound I thought it did.

Se also my post on a strange audio-processing thing that happened:

http://www.addforums.com/forums/showthread.php?t=25244

tired_need_help
02-25-06, 09:34 PM
thanks you guys!! it felt a lot better to read your responses!!

@scattered
[quote]exercise as much as possible (great stress reducer and mind focuser) [\quote]
I have a quick question here, with adderall, my heart rate goes off the chart, n so i reduced my work outs so that it doesnt do any damage, is that the righ thting to do?

@kirkT
you totaly got it... i have got up so many times to see if i left music playing in my laptop only to realise that nothing else was on.. just one more thing, can u hear the tv picture tube? i mean if u r in a room and someone turns on the tv with out any volume at all, can u still hear a pulsating noise coming out from the tv?? i get that.. i
mean i can tell if any tv or monitor is on without actually seeing..

@ladym
i do hope i find my answers and i hope u do too ... thanks for looking in..

@anamari
wow.. some times its just plain inspiring to know that people are out there battling harder battles.. and can understand what it is that you are going through.. thank you..

I am planning to get a neural examination sometime soon (i really dont know when! or even if i should), not to open a can of worms, but i just realized that most of the CNS disorders share a number of similar symptoms and that threw me off..

-tnh

happycat
02-25-06, 11:54 PM
1. skin 'pinches' - spots in the skin suddenly start to itch terribly and subside (now, since landing in US - doctor thinks its just climate)
2. head aches (in the past) severe ones that would last for entire nights and would cause me writhe in agony but would be gone the next day, i suspected migraines owing to acidic reflux, as it would generally occur on the days when i had eaten something different (allergy testing revealed nothing)
3. loss of hair - severe dandruff (past and now)
4. occasionally i hear normal sounds differently, my table fan which produces a low hum, sometimes seems like an old song or even some one speaking, (i know this doesnt sound so good, infact i thought i was going insane, but after a while i realised that it always happened when i was tired and only with that fan so decided to ignore)
5. talking for long time over a cell phone always produced a headache.
6. Dxed for spinal nerve compression in the sciatic region, so suffered from lower back ache for 3 months before leaving for the US.
7. occasional stiffness in various parts of the body.
8. lesser bladder tolerance (improves with adderall)
9. vertigo
10. if i close my eyes and try to stand up straight i just cant stand still...i fall..
11. a fluttering eye lid (its been on for 3months now)
12. sometimes various parts of the body flutter (for lack of better word) by themselves.. (convinced myself that it was just stress)


-tnh
I don't know about all of these symptoms, but I do think that some side effects from meds are headaches, ichy skin and stiffness....but I believe all of these things are harmless--you should discuss with your doctor to be certain, though.

I also "hear" the TV when it's on mute--I think you're picking up on the lights and electricity? I have no clue....I used to think everyone could hear a television set.

Regarding the vertigo--I sometimes get that, and it's usually when I've been working long hours, am stressed, and forgot to eat well that day. This might be the case with you too. I did exceptionally well in school (with minor hiccups in middle school) until my senior year in high school--I started taking AP science classes, and was stressed out about college, etc, and all of a sudden, I felt like I hot an invisable wall--like my brain couldn't quite grasp information the way it used to. I realize now that it was just that I couldn't wing everything like I used to, and attention to detail was important to the classes I had enrolled in--a skill I'm not good at.......

Talk to your doc about your symptoms, but from your post, it seems like you're very much like the rest of us :-)