Sorry this is long, but PLEASE someone take the time to read it ...i am honestly on the verge of tears .. i just don't know where to turn ... i have faced psych after psych and dealt with repeated AD trials, and am watching my mind and will to live slipping away before my very eyes, at the tender age of 24.

no professional will take the time and listen to me, to the point where i am beginning to question my knowledge of myself, even though my instincts, in the face of medical stubbornness, have almost always proved right. today i met with a so-called ADHD specialist who reviewed me for 15 minutes (his secretary had made a mistake, and failed to book me in for the necessary 1-hour initial consultation) before deciding that i have GAD, and asking me if i'd like an antipsychotic (which i politely declined).

i figured i would put this out there, just to see if i am on the right path, since it makes sense that those who live with the disorder may be more likely to pick up on similar traits in others.

basically, i have always lived with boredom, or a dissatisfaction in things. my earliest memory of this is trying to play with my toys as a child (10/11), and feeling like i wanted to in my head, like it was this great idea, but i just couldn't get any real pleasure out of it when it came to sitting down and doing it. it was like i was just going through the motions.

this continued in high school, where i'd just pursue addictive pleasures - video games, etc. socially, i was always the clown, feeding off the laughter of others as a way to reinforce some inherent lack in me. i was gifted, so had no problem with overall functioning. academically, i did especially well in things like maths (mainly calculus) where i was made to learn a formula and then repetitively apply it various situations. i also liked english, because of the creativity allowed. but i struggled with chem/bio/physics - it was like i could never fully absorb the concepts to the point where they became intuitive. my mind lacked a certain flexibility in learning information and then making it my own. instead, because i had a great memory and was a complete perfectionist, i would literally memorize the information and then just repeat it verbatim in exams.

as far as i understand, the 'lack' i experienced in everything is dysthymia - a kind of low grade depression. but it seems like it almost goes naturally hand-in-hand with ADD (or any mental illness really).

this pattern of liking things in theory or as an idea, but then growing bored when i had to actually sit down and do it, continued with me. for example, i always liked the *idea* of watching movies, but found that i would daydream, get up repeatedly, etc. when sitting through them. i began to question more and more why i couldn't be like other people who just sat through movies or books patiently, and so began to develop my own distractions as a way of justifying to myself why i couldn't concentrate (for example, i would just become aware of my own breathing or blinking, and these sensations would get stuck in my head .. similarly to overfocus ADD i guess .. i became so fixated on these other self-created distractions that i could never concentrate). i know that sounds crazy, i really do, and i always begin by just telling psychs about these distractions, which did eventually turn into obsessions once i tried to get rid of them (hence my OCD/GAD diagnosis).

one other trait i have is oppositional defiance, where i will often completely spite myself just so i dont have to bend to the will of others, even if it means helping me. but then i get scared when i look like im losing their attention. so its like this game of always keeping people interested, but never giving in to them.

but it always seemed to me like the OCD/perfectionism grew out of ADHD - as a way of trying to control it, so i could be like others, because it only seemed to appear during stressful situations that required my concentration.

everytime i try SSRI's, they make things a million times worse - they kill my anxiety, but then literally make certain things (like auditory and visual processing of information) harder. i thought i was going crazy when this started happening (see above about how i can't tolerate anything uncertain), so always thought i was imagining it. but strangely, the only SSRI which did help matters slightly after the rest screwed me up was Prozac (which increases DA and NE in the prefrontal cortex - it totally removed the 'fog' caused by other SSRIs). but my pdoc took me off it because i got insomnia at first, and he said the insomnia doesn't usually go away...

i have been in CBT for a year, but all i am doing is exposing myself to these situations i don't want to be in anymore because i can't handle how poor my concentration is. it's done *nothing* to improve my concentration. i am so lost. each psych seems to just make things worse by treating me strictly as an OCD case - i feel like i'm getting dumber and dumber from SSRI (mis)use. sorry this post is such a mess, but im just rushing through it. i've even been on frikken Nardil, which was great for depression, but again did nothing to just help me function normally. and now today, this guy who dismissed my whole history after i hurriedly tried to fit it into 15 minutes.

i dont know how much value is attributed to the ADHD subtypes identified by Dr Amen, but i guess this fits me the most:

Type 3: Overfocused ADD
Symptoms: primary ADD symptoms plus cognitive inflexibility, trouble shifting attention, stuck on negative thoughts or behaviors, worrying, holding grudges, argumentative, oppositional, and a need for sameness. Often seen in families with addiction problems or obsessive-compulsive tendencies.

SPECT: usually high anterior cingulate activity plus low prefrontal cortex with concentration
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once i became burned out and depressed, it shifted more into:

Type 5: Limbic ADD:
Symptoms: primary ADD symptoms plus chronic mild sadness, negativity, low energy, low self-esteem, irritability, social isolation, and poor appetite and sleep patterns. Stimulants, by themselves, usually cause problems with rebound or cause depressive symptoms.

SPECT: usually high deep limbic activity plus low prefrontal cortex at rest and with concentration


unfortunately, ADHD is so rarely picked up on where i live (outside the US) and stim use heavily regulated, which is why i feel like it might have been missed. please anyone tell me if my story makes sense, or if docs are right and i just have GAD. i am not LOOKING for an ADHD diagnosis. but it just makes so much sense as a comorbid condition. there is one more guy i can see - a GP my mom knows who deals with ADHD (and lists perfectionism/OCD as an often coexisting condition on his website, which is what got me thinking about all this in the first place). basically, hes my last hope. after that i completely give up.

First of all, if you don't learn to work with your doctors, you won't get anywhere in terms of treatment. IF you have anxiety and OCD , etc, an atypical antipsychotic med is likely to help. I have ADHD, anxiety and OCD, and along with meds for adhd, I take an atypical antipsychotic to help with the OCD and anxiety, and it does a good job of limiting my obsessiveness.

Don't give up,. but at the same time don't expect a diagnosis to have a particular name... whatever you have , it is what it is, and wishing it to be something different won't change a thing. Work with your doctor and in time he will figure it out and maybe things can get better with the right treatment.

good luck
Me :D

If you do have GAD, OCD and ADHD then it would benefit you to have the anxiety treated first anyways before treatment for ADHD, since a stimulant can worsen untreated anxiety.

You mentioned that you have not done well on SSRI's. One medication that is used for GAD that is not an SSRI, is Buspar. It may take a few weeks for the medication to take effect so you need to be patient.

If you have the GAD treated then you go back to the doctor and let him know you are still having ADHD symptoms. That would enable the doctor to see if the symptoms were caused by the GAD or not. You may see improvements in your anxiety but still have ADHD symptoms. That might make the doctor more apt to consider the possibility. If you were to refuse any treatment for the GAD then the doctor might go on believing that all your symptoms were related to the GAD.

I didn't do any research on all the other things you list except ADHD. I think you need to research ADHD and read/watch the information. I found wonderful presentations given by some top ADHD professors from some universities like California and Michigan.

Google Dr. Russell A. Barkley, UC Davis M.I.N.D. Institute, and also check youtube. There are some wonderful videos on ADHD.

After reading your post I did find one striking thing, "i was gifted, so had no problem with overall functioning. academically, i did especially well in things like maths (mainly calculus) where i was made to learn a formula and then repetitively apply it various situations." This is not typical of a person with ADHD who the specialists say people with ADHD cannot do. (Then again I am not a specialist).

I probably have ADHD (just had my first therapy session today) and I cannot stand anything that has a process.

Each person is unique, however.

First of all, if you don't learn to work with your doctors, you won't get anywhere in terms of treatment. IF you have anxiety and OCD , etc, an atypical antipsychotic med is likely to help. I have ADHD, anxiety and OCD, and along with meds for adhd, I take an atypical antipsychotic to help with the OCD and anxiety, and it does a good job of limiting my obsessiveness.

Don't give up,. but at the same time don't expect a diagnosis to have a particular name... whatever you have , it is what it is, and wishing it to be something different won't change a thing. Work with your doctor and in time he will figure it out and maybe things can get better with the right treatment.

good luck
Me :D

but docs here are so narrow-minded that they push the OCD aspect and don't address anything else. it seems like american docs (rightfully, in my mind) are way more into drug cocktails which cover multiple angles of a person's functionining. i've been on SSRI's. like i said, they kill my motivation, and (i feel) mess with certain cognitive processes. docs attitude is basically, we at least your anxiety's gone, so learn to live like this. i feel like i functioned *better* before i messed with AD"s.

i literally feel like i am at a fork-in-the-road now. i am not saying i only have ADHD. but it makes sense as being a component which might need addressing for me to get fully better. doc's are pushing antipsychotics as MONOTHERAPY. i've been on Seroquel. it killed my anxiety, but put me in a stupor as well, and did nothing for executive functioning.

anyway, i talked to my therapist about this today (i speak to him via Skype .. he works at a US CBT centre). he agreed there might definitely be some ADHD issues in me, and has said an evaluation is a good idea, so i've booked in to see that GP who specialises in it.

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If you do have GAD, OCD and ADHD then it would benefit you to have the anxiety treated first anyways before treatment for ADHD, since a stimulant can worsen untreated anxiety.

You mentioned that you have not done well on SSRI's. One medication that is used for GAD that is not an SSRI, is Buspar. It may take a few weeks for the medication to take effect so you need to be patient.

If you have the GAD treated then you go back to the doctor and let him know you are still having ADHD symptoms. That would enable the doctor to see if the symptoms were caused by the GAD or not. You may see improvements in your anxiety but still have ADHD symptoms. That might make the doctor more apt to consider the possibility. If you were to refuse any treatment for the GAD then the doctor might go on believing that all your symptoms were related to the GAD.

thanks, i understand that. it would just help me mentally/spiritually move on if i could find out the answer. if it's no, i'll accept that, but i don't think just because someone's worried about their functioning, that they're a hypochondriac and DON'T have ADHD. maybe the reason i've spent so much time obsessing about why i can't concentrate is because i actually can't.

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I didn't do any research on all the other things you list except ADHD. I think you need to research ADHD and read/watch the information. I found wonderful presentations given by some top ADHD professors from some universities like California and Michigan.

Google Dr. Russell A. Barkley, UC Davis M.I.N.D. Institute, and also check youtube. There are some wonderful videos on ADHD.

After reading your post I did find one striking thing, "i was gifted, so had no problem with overall functioning. academically, i did especially well in things like maths (mainly calculus) where i was made to learn a formula and then repetitively apply it various situations." This is not typical of a person with ADHD who the specialists say people with ADHD cannot do. (Then again I am not a specialist).

I probably have ADHD (just had my first therapy session today) and I cannot stand anything that has a process.

Each person is unique, however.

yeah, but i think mine is probably comorbid with OCD (which makes me crave process)
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I have all 3 of those. To me, there are a lot of overlapping features that make sense to me now of them being co-existing. Even though they seem opposite at first, they both have the underlying problem of lack of control over attention and focus. Not being able to focus on the things you want, and not being able to stop focusing on what you don't want. Lack of self-regulation and giving into the moment of instant temporary pleasure or temporary relief (compulsions and impulses). Not to mention the hyper-sensitivity, low tolerance, and the whole sensory processing disorder that is common for a lot of people with ADHD. BUT, if you have obsessions without anxiety, then it's not anxiety/OCD.

I don't really get the whole medication game. Anxiety/OCD is not really something you can just "treat" and then move on to "treat" the ADHD instead. Like ADHD, there is no "cure" for the anxiety/OCD. If you have that biological chemistry and wiring, then you might always be extra sensitive to the stimulants. I don't know what the right balance is.

Another thing that might be helpful for you is to read the book, "Driven to Distraction" by Hallowell and Ratey. It should give you a good idea if you fit the criteria. You can find it at most bookstores and the library would most likely have it as well.

If you think it sounds like you, you could also prepare a list of the symptoms you have, giving at least 2 examples from your personal life for each of the symptoms you have (and that have caused problems for you). By taking that with you to the doctor, you will be able to present the documentation that supports your feeling that you have ADHD. If it doesn't seem to fit than at least you will have a better understanding of what ADHD can look like. Not everyone has the hyperactive and impulsive symptoms. The book does describe those with the inattentive type also.

thank you for your help everyone, and for taking a gentle tone towards me. i am used to being lambasted on forums for self-diagnosing, but i genuinely believe that the OCD/ADHD label makes the most sense.

Alle, i understand this is a hard-wiring issue, but i wish it had been detected earlier, because i was a lot higher functioning prior to meds. SSRI's seem to have shifted my cognitive balance to the point where im not pretty much disabled (for the time being). i literally can't learn or remember anything new - each day is like groundhog day -, i cant watch movies, anything. this isn't just a willpower issue, i've been through 5 months of CBT trying to cope with this state. it's horrendous, especially given my prior existence (which wasn't dandy, but a lot better than this). the problem is that NO doctor will take responsibility (all of my complaints are dismissed as being the 'progression of my depression', and nothing to do with meds). i asked one doctor if i could try a stimulant so i could maybe go back to school, and he flew into a rage and accused me of drug-seeking.

today i told my mom what state i am in. she has always been kind of in denial when i bring stuff up, but i explained the extent of the cognitive damage i'm dealing with. people here likewise may feel like i'm exaggerating but i'm not. i'm going to see the ADHD GP next week. the treatment i'd like to try is Memantine combined with a stimulant, as i have heard of OCD/ADHD cases (well one at least) where this brought about a dramatic, life-changing remission. the problem is i don't know if i should lie and cover up the OCD to get a stimulant and then use the memantine myself (i still have a prescription left over), because my fear is that he will want to try something along the lines of Effexor, which i don't believe will help me at this point. i know it sounds completely unethical, but understand how heavily and stupidly regulated my country's system is when it comes to ADHD and stims (in america it seems like they're handed out like candy). i am literally trying to save my life and give myself a future, and if that means having to take an ethical bypass, i am so willing. i am not a drug seeker. i want to go back to school. i dont see how that's a lot to ask.

i have also booked in to see a neurologist, who should hopefully be able to give me a more objective confirmation of my complaints.

This is a bit late, but what the heck, I'll share anyways!

I'm not a doctor, and all I can tell you is my personal story. However, my experience with ADHD shares a couple of characteristics with the problems you're having. Namely, I've also been plagued by anxiety and OCD-like symptoms. Both of those have been significantly helped just by treating my ADHD.

The anxiety was really bad before I started ADHD medication a few months ago. Bad to the point that I wouldn't leave my apartment for days at a time. Bad to the point that I consistently avoided social situations, even if I knew everyone there. When I started ADHD medicines- poof! Suddenly I was fine leaving my apartment. For the most part, I'm not overwhelmed by people anymore. I'm even ok with going out in large groups where I only know a few people. But really the most freeing part about this is just being able to walk down the street without that awful, tense, anxious feeling in my chest that made me want to run to my apartment and hide. The ADHD meds keep me from getting overwhelmed, and they're just as effective as the anti-anxiety drugs I'd tried in the past.

As far as the OCD tendencies go, I think that those are really common among untreated ADHD-ers. In my opinion, your idea- "but it always seemed to me like the OCD/perfectionism grew out of ADHD - as a way of trying to control it, so i could be like others, because it only seemed to appear during stressful situations that required my concentration."- is exactly right. Focusing exclusively on one small detail allows us to tune out all the other stuff that's coming at us all the time. It helps us manage anxiety and not get overwhelmed. (I figured this out with the help of the counselor I'm seeing!) Your fondness for math could fall along these same lines. Math is very linear, and in that way it could be very calming. ADHD-ers often have a hard time figuring out how to approach an assignment. With math, you just write the formula, plug in the numbers, and proceed step by step. That definitely sounds like something ADHD-ers might really enjoy.

The point is that you're definitely not alone, and that your problems make perfect sense as something that might be related to ADHD. More importantly, they can be fixed! Of course, it could be that you have severe GAD or OCD that interferes with your life to the point that it's causing ADHD-like symptoms. That can be fixed too! You just have to get the right diagnosis. If it's not ADHD, you definitely don't want to go on stimulants. I'm still adjusting my dosage, and at one point in the process I took a dose higher than I need- it was absolutely horrible. I was so anxious and uncomfortable; I couldn't sit still; I couldn't get anything done; none of my calming techniques worked; it was just a generally miserable day. Definitely avoid unnecessary stimulants!

Overall, I'd suggest a couple of things. The first is to see a counselor (if you can afford it, arrange it through your school, or otherwise find free or reduced cost counseling). I have no personal experience with CBT, but that type of therapy isn't what I'm talking about. Think in terms of just someone to talk to who has experience working with people with ADHD, GAD, OCD, depression, and mental illness as a whole. I'd been seeing a psychiatrist for five years before I went to regular counseling (shame on me for not doing it sooner!). My psych had me diagnosed with major depression and bipolar. I went to see the counselor, she consulted with my psych, and I was diagnosed and on meds for ADHD within the month (and I think my psych has finally stopped trying to convince me I'm bipolar). Psychiatrists just don't spend as much time with their patients, which you've experienced first-hand. A counselor will talk with you and really get a feel for your problems. As the counselor gets to know you, they'll form an idea of what your specific problems are, and you can consult with a psychiatrist from there. Psychiatrists are generally much more receptive to professional suggestions from experienced counselors than they are to a patient who comes in, tells the psych what's wrong, and requests a specific medication. You're not seeking drugs to abuse, but the psych doesn't know that.

So find a counselor in your area who has substantial experience with the symptoms/disorders you're dealing with. First, they'll get to know you. Second, they'll use their expertise to help you understand what type of disorder you're dealing with. (Be open to whatever this is. You definitely have some ADHD symptoms, but they could be caused by something other than ADHD.) Third, your counselor can consult with your psychiatrist regarding a diagnosis and helpful medications. Finally, your counselor can help you organize your life and get it back on track. This is arguably the most important part, or at least a close second behind medication. My counselor has helped me learn to manage my anxiety in healthy, non-OCD ways. She's also helping me manage some of the symptoms of ADHD, because those don't entirely disappear with medication. My specific problems are organization and deadlines, but yours might be something entirely different. Regardless of what they are, talking to an experienced professional does wonders. You'll probably see some improvement even before you start any medication (or at least I did!).

As far as medication goes, if the psych is reluctant to prescribe stimulants, there are a few non-stimulant medications out there. Another option is Vyvanse, which is a stimulant drug that's shown much less potential for abuse. I'm taking Vyvanse and think it's great. It works as well as any other stimulant for most people, it usually doesn't have the harsh crash associated with older medicines such as Adderall, and psychiatrists are likely to be more willing to prescribe it since it's nowhere near as abused as Adderall-type drugs. The only down side is that the company who makes it is a gigantic liar. They claim it lasts for 12 hours- 12 hours my ***! There are a few people that actually do get the benefits for the claimed 12 hours, but somewhere between 6-8 hours seems to be more common. So you would start with one relatively low dose in the morning, try that for about a month, and then discuss it with your doctor. They may decide to increase that initial dose, or they may opt for adding another dose in the afternoon. If the medicine is helping some, but not enough, and your doctor believes that crap about 12 hours, you may have to bring in some research and experiences of other people to back you up. Your counselor could help here too. If your psych determines that an anti-depressant would be helpful for you (either instead of or along with an ADHD med), don't despair completely. There are a lot of anti-depressants out there. Some of them suck, and some of them are awesome. You just have to try a few until you find the one that's right for you. Unfortunately, trial and error is the only way to work this out. The same is actually true of stimulants and other ADHD drugs. The first one you try might have awful side effects, or it might not work. In that case, you just try a new one. Figuring out your medications (technically there could be just one, but there's normally multiple) will probably take several months.

One last comment before I end this long, long post. You said that Prozac seemed to work, but it also caused insomnia. Were you taking Seroquel at the time? I'm taking Seroquel, and it's better than sleeping pills for treating insomnia, plus it helps anxiety, has a slight anti-depressive effect, and it's less prone to abuse than sleeping pills. Combining a couple of medications is often much more effective than just one alone, especially in situations like yours where multiple symptoms are present.

Alright, that's everything; I hope it helps at least a little. Good luck, and don't give up on fixing this!

Diane, thank you so much for your considerate reply. you're right in a way about speaking to a counsellor - i always take CBT as the be-all-and-end-all when it comes to therapy, but intensive, behaviour-focused procedures don't really leave much time for just talking about your personal life, and allowing you to shape a kind of subjective history that doesn't really fit into CBT's somewhat mechanical approach.

unfortunately, my appointment with the ADHD GP is this Friday, so i don't really have much time to arrange for a counselor's opinion. i admit the OCD has become a huge problem of its own, but treating it alone has not helped me. for example, prior to developing OCD i'd get bored when reading or watching a movie and have to constantly get up, etc. treating the OCD, as i have done in the past w/ SSRI's, does *nothing* to fix that small attention bracket. even when i am rendered calm, it's not like much improves - i still lack drive, focus, etc. in fact, these problems almost become worse because i grow apathetic and just kind of give up on my goals. and like i say, SSRI's do seriously seem to mess with some sensory part of my brain - instead of anxiously picking up on words when i read, its like my mind just kind of glazes over everything .. kinda hard to explain.

i do not want to go on another SSRI or anti-depressant. i feel perpetually dreamy, foggy, etc. enough as it is. i genuinely believe at this point i need some kind of stimulant therapy. Stims seem to constantly be used off-label in the US, but here they are so heavily restricted that my plan is to basically downplay the OC part. i was in touch with an OCD researcher at Stanford who provided me studies showing that Dexedrine was actually *beneficial* in OCD (which means it will be the perfect drug for me), but even then my Pdoc wouldn't hear a word of it.

i understand i might sound childish and bratty, but i have been through so much agony these past two years - i had an excellent career as a writer, and was set to receive a grant to continue. it seemed like, despite all my anxiety, things were looking up. but SSRI's just kind of killed my drive, clouded my mind, and rendered me unable to work. ive been through a year of CBT, and all its done is help me cope. my parents are tolerant of the situation, but i feel like a complete embarassment to them because i do nothing all day. im tired of dealing with psychs who want to bombard me anxiolytics because all my problems supposedly come from my anxiety. im taking my destiny into my own hands at this point. if stims dont work out, then i'll rethink things. but i definitely think i deserve to try them.
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i finally met with an ADD specialist today. i disclosed everything, including the severity of my OCD. he believes ADD has been the underlying cause of my problems - dysthymia, perfectionism, OCD - and prescribed Ritalin LA 30mg. i'm not entirely sure this is the treatment for me (I heard Ritalin was a lot more anxiety provoking than Dexedrine for example, which i have studies showing is an effective treatment for OCD?) but i'll see how i respond. i also wonder if there are still traces of depression which need to be addressed, but hopefully that can be dealt with in psychotherapy. i really believe my depression has arisen from the frustration of not being able to function (rather than visa versa). hopefully with the help of a stimulant i can begin to rebuild my life and get back to where i was. and while i understand a label is just that, and does not mean my life will suddenly fix itself, at least it opens up new treatment pathways.
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I'm so glad your persistence paid off and you found someone willing to actually listen to you! Congrats and good luck, cyberd0g!

thanks Diane - i really appreciate your support.

just a quick question if anyone's reading -

how long should i give the ritalin before i determine whether it's good/bad for my OCD? i heard an advantage with stims is that you should know pretty instantaneously... so if, say, i have a really adverse reaction, is it okay to discontinue after a couple of days?