View Full Version : Adderall and self-control


piglet
04-02-07, 08:06 PM
I had a learning experience I'd like to share.
I've been on Adderall about two months now, and it is doing great things for the bulimia. It helps me DECIDE what I want to do, rather than fall into the grip of a compulsion that I don't question until after self-medicating with a binge/purge.
I'm a critical care nurse, work nights, three times a week; with the irregular schedule, I use IR, 5 or 10 mg at a time. I've gotten in the habit of taking 5 mg at about 4 am on nights when I'm working, so I have a bit of help for the last busy couple of hours of my shift... it's always hectic then, tying up the loose ends, adding up my numbers, closing my charting. And then when I get home I'm able to feel more in control, and don't overeat as an unthinking stress reliever.
So last night was an awful night. I had one, very very sick patient, a young lady who had been sick fora long time; a very busy patient, indeed, lots of IV lines, and needing lots of physical care; she had a very large family, all of them there all night, like 20 people in and out, in bunches.
So in addition to the mental and physical tasks of caring for this girl, I had to answer many, many questions all night; each person might have several reasonable questions, but add it up, from each person, and it means, constant interruptions.
And having to work around the obstacle course the bodies filling the room presented made the whole night harder; I could have sent them out but it would have been unkind, really; this girl was dying and they wanted to be with her at the end.
And phone calls galore from other departments, like the lab asking some trivial stuff; anyway, a very unADD-friendly night.
I did very well, and kept it together; I was able to be a comfort to this family as the girl passed away at the end of my shift.

And I went home and scarfed down a mini-binge - okay, not to the amounts I did in the worst of times, but yes, it was a binge, and then a purge; and afterward - of course, after is when I engaged the brain, isn't that always the way? - and I realized, I had not taken that early morning Adderall, due to the demands of the night. So I was emotionally stressed, mentally fried, physically exhausted, and unmedicated... and expecting myself to have impulse control in that state is perhaps a higher standard than I need to set for myself.
People who don't experience this talk about it as a moral issue, and lack of character; but I'm sorry, lack of character isn't cured with a pill, and this is. So there ya go.
I have wondered sometimes whether the Adderall is a good idea; it's an amphetamine, you know, one ought to question these things from time to time; but boy, just a small dose at the right time makes a big difference in how I live my life. It makes the difference between being in charge of myself, and being a mindless passenger. I'm going to use this as a learning experience and make sure to have a dose early morning, even if I have to do it in the car on the way home. The brain fog and sensation-seeking compulsion that overtook me are something I haven't felt in over a month, and I haven't missed it, I'll tell ya.

Matt S.
04-03-07, 10:23 AM
I am someone who almost died from anorexia as a teen and the obsession involved with that disorder for me seems to be gone for the most part, and comes back when I am not taking stimulant meds. I am a man and buying all of those women's magazines with the latest "lose 10 lbs in a week diet" was plain freaky anyhow.

piglet
04-04-07, 11:39 AM
The thing withthe stimulant meds that I'm finding is, of course I need to have them ON BOARD at critical times... lke that horrible night and the early morning when I got home and reached for old comfort measuresthat aren't healthy. But at less stressful times, I'm finding I have more self-control even when there aren't med on board right then; that might be why I wasn't so religious about getting my dosing that night, I got overconfident. I have to keep an eye on my meds/stress level and make sure I'm sufficiently armed against those compulsions.

And kudos to you on wrestlng down the anorexia. I'd be interested to know your story with that, if you don't mind sharing.

QueensU_girl
04-14-07, 04:13 PM
Gosh. Too much stress for you, Piglet!

*big hugs* [And hopeful some solution ideas you can use!]

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When I was in Nursing School, we learned that Distractions (interruptions; Codes being called; accidents) have been found to increase "med errors", too. (Syringes and Lines get mixed up, etc.)

(Like all an RN needs is an Incident Report, eh? :S)

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I think one would resent this BECAUSE the Family's demands and neediness essentially...

(a) "takes the Focus off the patient". (Who is the real patient here, right?)


(b) It is sort of "taking the patient's 'quality of care & care time' away".

(The Family cannot see this.)

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Random Ideas:

I hope there is a way you can take this Issue to your Head Nurse or your Nurse Manager's Office for discussion. It is not safe to work with such avoidable distractions. This is a liability for the Hospital's Legal Departmetn & a Risk Management issue.


There must be a POLICY somewhere about patient safety. (And rules about it being compromised!)


In a CCU or Step-Down ICU, aren't there usually visitor restrictions? (e.g. two at a time? Max 2 visits/evening?)


If the Family is this needy and intrusive (probably Anxious and emotionally needy for info and explanations)
--> maybe Social Work or some Residents or Med Students could be paged to answer their clinical questions and/or design a care plan for the family??
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Verbalizing may help too.

"When I have to answer many questions, and am falling over a half dozen family members who are visiting, i feel like my focus is off the care of your Sick family member", etc. :X
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Appeals to Health & Safey always trump...re: any wishes and wants

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In the following article, Please See:

Inattention/Distraction (of focusing on the family)
Unsafe working environment (too many family members in the way; you could FALL)
Emotional Factors (eg family quizzing you is stressful; hordes of stressed out family indirectly stresses you)

<SNIP>[Excerpt From:] http://www.wildirismedicaleducation.com/courses/148/index_mand.html

FACTORS THAT INCREASE THE RISK OF ERRORS

As the IOM acknowledges, “To err is human.” However, research has shown that certain factors can increase the error rate (Reason, 1990):

Fatigue. Working a double shift, for example, can increase the likelihood of errors. Medical residents on call for 24 hours or more are also at high risk for errors. Research shows how such system-based changes as reducing the work hours of medical personnel can reduce the error rate in hospitals (Landrigan et al., 2004).
Alcohol and/or other drugs. Use of alcohol and/or drugs is incompatible with competent, professional, safe client care. Unfortunately, the combination of high stress and easy access to medications has led to substance abuse by physicians, nurses, and other healthcare professionals.
Illness. Coming to work when you aren't well jeopardizes your health and the health and safety of clients.
Inattention/distraction. A noisy, busy emergency department can make it difficult to concentrate on one client's care, especially if you know that other clients are waiting to see you.
Emotional states. Anger, anxiety, fear, and boredom can all impair job performance and lead to errors. A heavy workload, conflict with other staff or with clients, and other sources of stress increase the likelihood of errors.
Unfamiliar situations or problems. Nurses who "float" from one hospital department to another may not have the expertise needed for all situations.
Equipment design flaws. Here again, training and experience with equipment are key to avoiding errors.
Inadequate labeling or instructions on medication or equipment. Look-alike or sound-alike drugs can lead to errors. Incomplete or confusing instructions on equipment can result in inappropriate use.
Communication problems. Lack of clear communication among staff or between providers and clients is one of the most common reasons for error.
Hard-to-read handwriting. Physicians' handwriting has long been criticized for its illegibility, particularly on prescriptions. Fortunately, computerized medication ordering has eliminated this problem in many healthcare organizations.
Unsafe working conditions. Poor lighting and/or slippery floors can lead to errors, especially falls—a costly hazard in every hospital.
<!-- Q11 -->

piglet
04-16-07, 09:13 PM
Interesting and informmative info, thanks! And I'll keep that for reference.

I don't feel I was at risk for med errors, because I was very focused on THAT. I did tell the family, at times, "Hey, I need to think about this, give me a few minutes" and they did give me some space.

But sometimes with this job one has to be On, like an actress; laypeople don't realize that. It's part of the job that sometimes makes a difference between people seeeing you as compassionate and competent, or self-conscious and maybe hiding incompetence. Sometimes going with the flow is the best choice; I've been involved ina bad scene when I tried things the other way, trying to get the family ( and this was an obnoxious and veyr entitled-feeling family making no effort to take up less space) to NOT commandeer the whole durn place, and it went very badly, as in, my boss hauling me in and chewing me, because she didn't want to hear my end of it; I'm a little more politically savvy now and if I'm outnumbered I'm not gonna fight it. It's not like I'm resenting and grumbling about that; I'm in a very Zen place with it, just, "Ohhhh, this is how it is. I get it now". I can be idealistic and try to make my most hospitable work environment for myself, or I can be realistic and deal with the world as it is, and wind up better off overall. Big involved family? Okay. I can handle this. One step at a time.
I really did extremely well during the work hours; it was difficult but I didn't feel pushed past my limits, just, you know, challenged, which can be a good thing, and a good feeling to meet it. Which I feel I did. The patient was well cared for and the family felt she got good care, and they had what they needed. I was very pleased with how I handled that very difficult situation.

it was AFTERWARD that I was malfunctioning. You know, putting myself last.
So I'm resolving if that kind of tihng happens again, I'm gonna take my meds on the way home if I must, even if I wind up a little more wakeful and not able to sleep right away, just to get something on board before I fall into the grip of the compulsion and have an opportunity to act on it.

Sklan G
08-03-07, 01:14 PM
i am 47 taking adderall10xr i still cant focus. i am also a recovering alcoholic but i have been sober for 2 years

Sklan G
08-03-07, 01:19 PM
:confused: I am 47 I am taking 10xr adderall. I am also a recovering alcoholic with 2 years of being sober. I still cant focus any suggestions

lanaxxx
02-04-08, 08:35 AM
hi piglet!

oh you poor girl so much stress at work, to busy for meds! poor thing!

but remember your doing relly well still! never feel guilty avbout once binge.

i think your story may have helped me in a few ways as i'm suffereing from an ed which for seven years was anorexic and now binging/starve for next day then the cycle again for the next three years so suprissinmgly i'm was normal slim girl. and my weight stayed the same. got diagnosed add and w binge eating. ana or binging its all the same just an opposite way for me.
anyway diagnosed and been on dex 5mg 6 times daily plus eddronax and luvox some anti ocd depression. the dex works great for first 4 months, wasnt binging them i crashed depressed appetite is back binging most days. i need to stop! to depressed to bother to starve the next dat so i'm gaining apparently slowely but i dont think so. i'm getting bigger and more depressed and i'm wondering if this med yours adderall. does it give the no appetite? cos i really cant stop binging and every day i'm putting on more weight and getting more depressents and hating myself and body and cos i'm depressed i binge. also its really REALLY good to see a fellow add ed person in recovery, im in the biggest pit of **** ive even been in right now but but you've enspired me that maybe i can drang myself

the dex dont seem to do much now. do u think adderal would help me? does it supress appetite? or help u wiht control over binging thoughs? sorry to whine so much abouty me. i'm gonna ring my doc tomoro and ask if i can try it

thank heaps for sharing piglet u have helped i think. hope u can understand this jibberish writting, had a sleeping tab b4


thanks piglet

mischief23
03-04-08, 11:24 PM
Hey Matt how do the stimulants help with anorexia? When I was on adderall i found it took my appetite and made it easier not to eat.

brewskijmu
03-05-08, 10:49 PM
wow piglet thanks so much for your story! i've been trying to get on adderall since the summer when i read up on bulimia and ADD. i had never been diagnosed with ADD but have had bulimia on and off for 12 years. only recently have i considered that the bulimia could be self-medicating the ADD. long story short, i was seeing one therapist who would not give me adderall due to eating disorder history but put me on wellbutrin xl. now i am going to another psych and he wants to give me strattera, but i have read up on it and it doesn't seem to be as effective as adderall. i feel like i have struggled long enough and don't want to keep going from doctor to doctor and wasting money until someone will prescribe it. i've written out the pros and cons of strattera, adderall, and concerta as comparison to show my doc on tuesday when i have an appt. i feel that maybe a stimulant would be bad if i had anorectic tendencies, or if i had a drug or alcohol abuse history, but i don't. bulimia is more of add than anorexia, i think, and i think being on adderall would help me a great deal. my mind is preoccupied with the feelings of being fat and inadequate when i could be spending my time and brain power being more constructive with my life. any thoughts on how i can convince my doc that it is safe and that i can handle taking adderall? many thanks!!

bliss22
03-15-08, 09:28 PM
brewski, do you go to JMU?? :D