View Full Version : med management VS. counseling


wizephoenix
12-20-03, 12:51 AM
When I got my diagnosis, going to counseling or therapy was not even suggested. I was prescribed Ritalin and that was that. Does anyone else survive on meds alone? Or therapy alone? Or nothing at all? I saw a therapist a few years ago for depression and it didn't really do anything for me. Earlier this year I saw an LCSW as well for depression and that didn't do anything either. So I have pretty much stayed away from counseling since then. My biggest problem with counselors were that they tended to smile and nod, say, wow, your life sucks, yet offer me no advice on how to improve. Med management for depression didn't really work until I was fully med compliant. (On and off Paxil for 7 months, then trials of Celexa, Serzone, Lexapro, and Paxil CR) I didn't like to take meds consistently. Finally I got on Wellbutrin and have been on that consistently for almost a year. That has been enough. But is ADD different? I have not been on Ritalin long enough to tell. It helps with focus at work and school, but other than that I don't know. If anyone has advice/knowledge/similar experiences, I'm all ears.

Wheel1975
12-20-03, 08:42 AM
Originally posted by wizephoenix
When I got my diagnosis, going to counseling or therapy was not even suggested. I was prescribed Ritalin and that was that. Does anyone else survive on meds alone? Or therapy alone? Or nothing at all? I saw a therapist a few years ago for depression and it didn't really do anything for me. Earlier this year I saw an LCSW as well for depression and that didn't do anything either. So I have pretty much stayed away from counseling since then. My biggest problem with counselors were that they tended to smile and nod, say, wow, your life sucks, yet offer me no advice on how to improve.

Med management for depression didn't really work until I was fully med compliant.


(On and off Paxil for 7 months, then trials of Celexa, Serzone, Lexapro, and Paxil CR) I didn't like to take meds consistently. Finally I got on Wellbutrin and have been on that consistently for almost a year. That has been enough.

But is ADD different? I have not been on Ritalin long enough to tell. It helps with focus at work and school, but other than that I don't know.


If anyone has advice/knowledge/similar experiences, I'm all ears.

IMHO, use everything you can at the same time.

But ask the question, seriously, "what do I expect to be the result?" Or if you are looking for results outside school and work, "what" are you looking for, specifically?

I highlighted something you said, in red, because "half measures availed us nothing."

I think ADD is like that. or as "Master Yodo" said in Star Wars...

"Try not. Do or do not. There is no try."

Tara
12-20-03, 02:48 PM
Counseling, therapy, coaching, etc can be great assuming that we find somebody who actually "gets" adult AD/HD. But, like so many of us have ecperiences it can make us feel even worse when we fo to somebody who doesn't understand adult AD/HD.

Most of the experts in the area of adult AD/HD suggest a mult-modal approach to treat AD/HD. To answer your question
wizephoenix sure many people "survive" on meds or therapy alone. But, I think most of us want to do more than just survive.

For me I think the most important parts managing my on AD/HD is education myself and realizing that I am not alone in this.



There are some great books out here about AD/HD. I had a lot of anxiety when it came to readining since when I 1st realized I had AD/HD. There are also some great audio and vidoe tapes out there too.

http://www.add.org had some from there last conference at their site http://www.add.org. There are also more at http://www.audiotapes.com

Stranger
02-02-04, 01:42 PM
In Dr. Weiss's book (Attention Deficit Disorder in Adults, I believe) it's suggested that the purpose of the meds is to get the patient to follow the doctor's orders. Once the meds have kicked in, and the patient has gained a measure of control over their ADD, then the counseling is more likely to "take" and real results can be obtained. Once new improved coping skills are learned, the patient can reduce, or even eliminate, the meds.

"Patient" is probably the wrong word to use, but, hey, it works for me. I, too, have undergone counseling for depression, and it didn't work worth a damn--only time resolved the issues that were depressing me. Now I know why.

sloeve43
04-12-04, 09:59 PM
About meds versus therapy: My cousin is on 10 mg of imipramine at noon, as her problem has been maintaining in the afternoon. She says it changed her life. If I ever get insurance, I'm going to try this also. What I need right now is advice on coping without either counseling or medication. Right now, I need to be able to concentrate well enough to earn the money to afford either medication or counseling.

sloeve43
04-12-04, 10:03 PM
About meds versus therapy: My cousin is on 10 mg of imipramine at noon, as her problem has been maintaining in the afternoon. She says it changed her life. If I ever get insurance, I'm going to try this also. What I need right now is advice on coping without either counseling or medication. I need to be able to concentrate well enough to earn the money to afford either medication or counseling.

Ian
04-13-04, 02:07 AM
sloeve43 why don't you join the crew in the men's forum under "working out"? I am trying to keep my body active in hopes of keeping my mind from getting too far off the mark.

I've found strength from the consistant physical work showing up in my body and mind. The company of others here has made it possible to meet some much needed goals that started with making a commitment with others to join in to support our need for healthier lives.

I have also found meditation to be a big help but I have to be healthier to sustain practise there. I'm not in that position these days.

Hope this helps. Ian.

FlakeyGirl
04-16-04, 01:54 PM
For me meds are the foundation, but I continue to add as many buttresses as I can including traditional therapy, technology, this forum, online research, group support, journaling and probably some others I forgot. I figure every little bit helps. Things are going well.

MRB
05-12-04, 12:22 PM
Multi-modal is the thing. As FGirl says, this forum REALLY helps. As Ian says, workouts help -- and they're not just for men, either. Not only that, but I read a recent article in Psychology Today (hardcopy) that talks about there being more to the mind-body connection than people realize, and that exercise REALLY helps your brain work better. Now all I have to do is find the time to work out consistently... :D

mctavish23
05-28-04, 11:52 PM
I know that when it comes to hyperactive kids, the ONLY treatment (besides meds) that works is behavior modification. In that regards, family therapy is the best vehicle for helping parents with applying that approach. For Inattentive kids, then (in addition to meds) there are several more therapy options available such as social skills building, play therapy, cognitive-behavioral therapy, role playing, paradoxical techniques ( reverse psychology), etc. Those unfortunately dont work for hyperactivity.When I learned that last summer it meant that I had to changeg my practice. Ethical practice management requires efficacy of treatment; meaning that the techniques you employ must be safe and effective and driven by (derived from ) research. That leads to a different topic about Informed Consent but I'll save that for another time.

Thanks for giving me the opportunity to present these ramblings:) Take care.

healthwiz
05-29-04, 01:36 AM
Meds versus therapy. Truth, in my opinion, is that both can be done totally wrong, and both can be done fairly well. It depends who prescribes the meds in my opinion, and it depends on who does the therapy. A great therapist can be a life changing force. A lousy therapist does nothing. Learn a little about the different psychology therapy approaches available and try to determine which approach you are most comfortable with, most in tune with. Ask around town, ask several sources, who is KNOWN to be an excellent therapist. When someones name starts coming up more than once, from multiple sources, you might be on to a winner.

ADD is not something that can be beat in a day, it is a lifetime effoft, much like a marathon that goes forever. You have some good days and bad days, but overall performance, if graphed, continues to improve.

You pick up tools wherever you go, get advice, try new things, see what works for you, stick to what works, forget what does not work. We all may have ADD or some variety of something that surely resembles ADD, but we are also all different, all unique, and all have our own path to find what helps us be ourselves best.

I believe the advice about exercise, and meditation are excellent ways to get control of many symptoms yourself. However, many people are not in good enough mental shape, after years of being undiagnosed, to have gained the personal discipline or the mental strength to do these tasks. For someone who is depressed and discouraged and can't concentrate, lets face it, getting to the gym is not high on the likely list for some of us. That is where meds come in for sure, if not on a lifelong basis, at least on an interim basis, as needed, to get the jet engines started, to put the off-line brain back on-line.

I personally am a big advocate of therapy, but I partake in a more intense, more action oriented form, called psychodrama. It's not everyone's cup of tea, not for the weak of heart or stomach. Many things are seen in psychodrama that can be difficult to bear, but in the end become uplifting experiences, learning opportunities, and personally I don't knwo where else I would learn the things I learn there. These interractions have helped me catch up on the lack of social information in my experience as a person, that I did not get during the years when my brain was off-line. Its a catch up course for me, that is also benefitting me in ways I did not imagine.

So, essentially, I advocate a multi-modal approach, one that fits your needs.

Jonathan

mctavish23
05-29-04, 12:55 PM
Very well said. It strikes to the heart of medecine/psychiatry and psychology not being exact sciencesand again reinforces the importance of "competence" in practice.

healthwiz
05-29-04, 06:58 PM
Originally posted by mctavish23
Very well said. It strikes to the heart of medecine/psychiatry and psychology not being exact sciencesand again reinforces the importance of "competence" in practice.

Yes, competence in practice.

Psychology is a mixture of sales, science and artistic skill. Like cooking, first you must sell the customer on tasting the food, ordering it, then you must use science to make it, and then you must add your personal touch to it, your artistic skill to make it special. How many great chefs serve a meal without tasting the resulting food before it is served? This is what it is like when a therapist does not get therapy himself. He has not tasted deeply from the cauldren of medicine he mixes, and knows not if his own medicine is mixed in the brew he makes for clients, intended for himself.

There is competence in practice on many levels, through scientific research, through the ability to sell new principles or beliefs, through the ability to package and deliver those new concepts in a manner sure to reach its intended destination, through hail, sleet or snow, and all the while, making sure the client is not receiving an unintentional treatment whose true patient is the unaware therapist.

Not an easy business you are in, the business of curing souls. I admire that you are in there, doing it. I am on the sidelines, wishing I were. I hope I will soon get with the progam and get myself in school again.

mctavish23
05-30-04, 11:46 AM
Thanks. That is the single best description of the "art" of therapy I have ever read. It reinforces the old adage that "good therapist's are born more than educated," which is true.

I saw a presentation on therapeutic outcomes last year that brought up old (but tried and still true) data that the rapport between the client and therapist accounts for more change than anything else. I have always known that to be true and it was nice to see the data. Everyone in the room was a licensed psychologist in Minnesota and agreed with that.If they disagreed they certainly didnt say so...lol.

With ADHD's, as with everyone else, it is important to find your "niche" interms of using your inate talents and abilities to the job at hand. I work best with kids because , if you know me, Im just a big kid anyway. I really connect with teens because we're prob on the same maturity level,lol. Last summer Barkely presented data to that effect and when I told my wife she just looked at me and said "Duh. I could have told him that without all the bother.":)

Thanks again.

healthwiz
05-30-04, 11:54 AM
Originally posted by mctavish23
That is the single best description of the "art" of therapy I have ever read.

THANK YOU MCTAVISH. I want to be a writer - of some kind - once I get a higher degree.

Originally posted by mctavish23
I work best with kids because , if you know me, Im just a big kid anyway. I really connect with teens because we're prob on the same maturity level,lol. Last summer Barkely presented data to that effect and when I told my wife she just looked at me and said "Duh. I could have told him that without all the bother.":)

What data did he present? Did you see my post about being chronologically displaced? Can you relate?

I can related to your story about you and your wife, and feeling like a teenager. It all sounds so familiar.

mctavish23
05-30-04, 12:11 PM
I'll be glad to get my notes and let you know. Right now the closet where I keep really important stuff like ADHD conference notes and baseball cards is buried behind the contents of a bigger closet which recently flooded.The good news is that it wasnt my fault(which it usually is)!

Barkely presented a lot of material over that week and there are some references he didnt igve out. I do plan on contacting him tho to ask about one in particular.

I do recall having mentioned this same point in another forum and someone found the reference on Barkley's site. It had to do with determining the true emotional age of an ADHD kid by multiplying their chronological age by .30 and then subtracting that from their chronological age, which then yileds their maturity level. I know that sounds somewhat controversial but there is data to that effect.His point was mainly about delays in maturity. He also stressed the need to pay close attention to this when it comes time to drive a car. Scary but very practical.

If you cant find the reference on his site please let me know and I'll try to find it My guess is you can prob find it faster than I can get my closet door open. Take care.

bluesman
06-16-04, 06:39 AM
I've seen a lot in here, but no reference to dr. weathers.
My level of adhd is such that I can force some control, but not sustain it.
Something I've noticed also, is that some of the same non-drug tx for depression works for adhd. Mainly exercise, positive thinking and some group. Self-actualization seems closer and sensitivity seems further. But it leaves me with no familiar spontenaity, and not knowing how to "feel". Is that similar to drug tx?

Back to Dr. Weathers, I read as much as I could. Can't say I like his style, but looking at only his point of view on tx. it's seems like he may be onto something. I don't know about the flashing lights, but the rest of his plan seems to have merit. But I also see a familiar adhd style to his opinion about drugs.

What gives? How come no one talks about this guy? Am I missing the obvious? Is he a genius, but has a monopoly on the tx? Or is he out for money, before there really is a bonafied tx? I started a thread somewhere about this, and no one responed at all.
anyone?
Tim

mctavish23
06-16-04, 10:20 PM
Please check Barkley's site and I'll look for my references.

mctavish23
06-16-04, 10:23 PM
I am not familiar with him but will look into his work now that you have brought it up. Thanks.