27 Just diagnosed

[asdfdoc]

Hello,

I was just diagnosed with ADHD. I am 29 yo male. I consider myself self-motivated and successful. I graduated top 25 college relatively high GPA and am a currently a dentist. I also have a masters degree in science. I see a lot of patients with ADHD, and I prescribe wellbutrin for smoking cessation. But, ironically, I never thought I was one with the problem.

The story goes, I always thought I was socially awkward. I always had problem with public speaking. I've only read one book in my life (spark-noted all the way through high school and was an engineering major in college). I am also a horrible writer. However, I am good with math and science, which I am genuinely interested in. I have never been able to study daily basis or heck never even started studying 2 days before tests. I always pulled one nighters and was able to score As through school except a couple of classes that I underestimated and received sub-par grades. I had friends, although they commented on my weird behaviors time to time. They accepted me as who I am. I've had girlfriends. My current girlfriend, whom I've been with for 6 months and I really love, told me that I had problems. This, made me go see a psychiatrist.

But first, I self-diagnosed. Being a healthcare professional as I am, I looked into two possibilities: ADHD and aspergers syndrome. I know I am not stupid, but I am awkward, so I thought that could be aspergers syndrome. I saw a psychiatrist and I was diagnosed with ADHD. I don't talk to my parents about my symptoms and when I told my parents, they told me that I was actually diagnosed with ADHD when I was a child. I was shocked to hear this but it confirmed the diagnosis and I am now seeking for help. My parents' rational was that they didn't want me to take medications so early in my childhood and they didn't know what kind of effect that would bring to me. I was upset at first but I am glad they did because now, I know everything. The problem is DOPAMINE. I gain weight easily, cannot concentrate, get tunnel visions when I hyperconcentrate on things I like and when I am under time attack, and so on. Everything is explained and I understand ADHD.

There is still one question I cannot answer and I cannot rule out aspergers syndrome. How was I able to get to where I am financially and career-wise?

I started provigil, it helps a ton. I haven't tried adderall yet. I will soon.

[sarahsweets]

They are called coping mechanisims my friend.

[CheekyMonkey]

There are many very successful aspergians (or aspies if you want) who did not get diagnosed until later in life. Just look at John Elder Robison. He was a self-taught electrical engineer and ended up doing all the stage electronics for KISS. He didn't get diagnosed until he was in his forties! He now has 2 best selling books and a third on the way!

I don't know if you are on the spectrum, but it is worth asking about. If you want to get a preview, my autistic friends say that this quiz is pretty spot-on for their experiences. http://rdos.net/eng/Aspie-quiz.php

[asdfdoc]

cheeky, that website was helpful. Thanks. haha i did get a very aspie on the test but i hate to believe i have both adhd AND aspie .

typo, up there i am 27.

[asdfdoc]

thanks for the link, that was helpful. I did get a "very aspie". That can possibly mean I have both ADHD and aspies. that's pretty sad for me

[allisaurus]

NOTE: This is an extremely long post (I am sure related to my new found ability to focus all my attention on one singular task). Should you not be interested in investing your precious time into reading my ramblings, scroll to the bottom for some questions I have for those of you recently diagnosed, and old-timers alike.

Originally Posted by asdfdoc

thanks for the link, that was helpful. I did get a "very aspie". That can possibly mean I have both ADHD and aspies. that's pretty sad for me

First things first, being on the "spectrum" is nothing to feel bad about, ashamed of, or sadded by. My most favorite people in the world are somewhere on the spectrum, and often have unique gifts and perspective to share. Embrace it!

Secondly... I know EXACTLY where you are coming. Almost every single thing you mentioned in your introduction is what I have experienced. Here's my story.

To my knowledge I was never diagnosed, or tested (other than for giftedness) for any disorders, social, mental, emotional or otherwise. Although, the older and get, and the more I start to understand how my mind works, the more I realize how apparent my issues really were.

The first of my "disorders" to appear was OCD. It was much more prominent as a child. I have always been obsessive, easily getting attached to objects (eg; a teddy bear or favorite movie) and people (eg; a baby sitter or best friend). Note: as I got older those obsessions showed themselves in things like romantic relationships, and alcohol. As a kid, however, my OCD was more prominent than just simple obsessions. I had impulses to count everything, and an extreme need for things to be symmetrical. Examples include having to chew my cereal three times on each side. Pressing my finger tips together with the same pressure on each side. Scratching the opposite limb, even if it wasn't the one with the itch. The need to have papers in school be perfect, often causing my not to finish tests, because if I made a mistake I would have to throw that paper away and complete start over. Some of these small nuances are still present, such as the even/symmetrical stimulation of fingers, eye lids, toes, etc. But I have a better grasp on it, and it doesn't interfere with my productivity.

The second issue to present itself, was anxiety. Experiencing my first documented panic attack in my sophomore year of high school. This is one issue which has followed me strongly into adulthood. The more I have experiences with varied types of panic attacks, the more I am able to look back on my reactions and coping mechanisms as kid, and realize that anxiety has been apart of my daily life since I was at least 7 years old. This includes extreme stress and anxiety in anticipation of loud noises, social situations, public speaking, testing, and confrontations. I was first treated for anxiety specifically after having a major panic attack on the job, which took me to the ER. I have had panic attacks at school, and 3 of the 5 jobs I have held. I was prescribed Ativan to be taken daily for a short period of time, and then as needed at the first since of stress or anxiety (which was daily anyway).

The thirds issue, but the first I was ever diagnosed with formally, and treated for, was depression. This has been the biggest battle in my life. I suffered from extreme depression as a kid, which was always overlooked and chalked up to me just being a "sensitive" and "emotional" kid. I had an extremely low self esteem, strong guilt, and low desire to do anything but cry alone in my room. Unfortunately, no one was compelled to have me seek treatment until the death of my mother when I was 14 years old. This, not surprisingly, sent me into a very deep depression. At 15 I was put of my first medication, Celexa. It took only a matter of weeks for me to realize that this was not the right drug for me. At first it was just extreme jitters and restlessness, that was affecting me, and then it started to cause me to have thoughts of self mutilation and suicide (though thankful I have never taken serious action on the latter). I was then prescribed Prozac, as well as Trazadone, for insomnia. Both of these medications seemed to me to work beautifully. While I was still very jittery on Prozac, and often felt like my mind was running as supersonic speeds, my mood was significantly lifted. I still suffered from anxiety, but this was not an issue that had yet been diagnosed, beyond "yes, I am a little high strung". I continued on Prozac into my late teens, sometime taken self determined breaks from 6 months to a year after I would reach the infamous "plateau". I would feel better in this break periods, until I would fall into a deeper depression that I had ever experienced. I would then consider seeking treatment again, and start the cycle all over again. When I was 20 I had my first panic attack, which led to the addition of Ativan to my dose of Prozac. This was the most successful combination I had been given to date, and maintained it until moving cross-country and losing my health insurance after graduation from graduate school.

I went from 21 to 22 without any medication or treatment. I held up well, with the exception of one panic attack brought on but a very stressful situation, which would sent even the most stable soul into a mental breakdown.

Shortly before I turned 24 I was a few months into my first full-time job. This is when my 4 months string of panic attacks began, and I decided to seek new counseling and medication again. This time I was placed on Zoloft. This was chosen so as not to risk me getting addicted to Ativan, and it was said to combat the combination of anxiety and depression better than Prozac alone would. Zoloft worked well for about 6 months, I still suffered from panic attacks, but I now had to ability to control them, and work myself out of them before I completely shut down. Finding myself in a new romantic relationship (with the man who will soon be my husband), my mood was as high as it had ever been. Though deep down I knew I was really just avoiding my deepest feelings of darkness, and self doubt.

This is the point when I finally began to get a grasp on the true causes of my issues. I sought psychiatric help for the first time, (up to this point I had only been prescribe medications from primary care physicians). For this first time I met a professional who asked all the right questions. Focusing on the early onset of my depression (early adolescence), and the combination of my extreme anxiety and cyclical bouts of depression, he wanted to further examine if I had been misdiagnosed. He asked me on a scale of 1 to 100, what the best I had ever felt on medication (namely Prozac) was. I thought hard about it, and responded that the best I had ever felt was about a 70. He informed me that the earlier the onset of depression, its presenting with anxiety, and becoming unresponsive to antidepressants all pointed to one thing. Bipolar II. Bipolar is really a misnomer, as it affects everyone in different ways. Often stereotyped as "manic depressives", those who suffer from Bipolar are often seen as unbalanced and crazy. While there is truth in all stereotypes, and those suffering from typical Bipolar disorder often present with extreme mood swings from extreme (abnormal) highs, to very deep lows, there are very different manifestations of the disorders which fall under this umbrella. Bipolar II is often characterized by the combination of extreme depression, and extreme anxiety, which instead of presenting itself with moods characterized as "manic" and "depressive", presents with a different mood swing. This is swing is the sporadic shift from extremely low, to a feeling of apathy. The fact had I never experienced my self at 100% of my potential normal and positive mood, pointed to the fact that I had never been treated properly and with the right medications. The first course of action was to add Abilify to my current dose of Zoloft. I was only on Abilify for a month, and it made me want to crawl out of my skin, much in the same way I reacted to Celexa years before. And finally, after nearly a decade I found the perfect combination for me... Prozac and Lamictal. Within a week of starting Lamictal I experienced an extreme boost in self-confidence, regained interest in hobbies, improved relationship interactions, and the highest mood I had felt since my pre-teen years. I recently switch from a combination of 40mg of Prozac, and 100 mg of Lamictal, to 20mg of Prozac (the lowest dose I have ever had), and 200 mg of Lamictal. This balance has almost completely stabilized by mood, with the exception of the hormonal affects of my cycle.

Which finally brings me to today (or rather Friday). I began a new job 3 months ago, and while my depression and anxiety are on lock down, I started to notice other difficulties. My attention span while working is close to zero. I have an extremely hard time focusing during conversations and meetings. I often find myself getting distracted by emails, noises, IMs and conversations, taking me off the current task. Once I snap back to work mode, I can't even remember what I was doing. I might switch to Facebook for a second, and then when I switch back to a work window, and stop and realize I have no idea why I am looking at that page. After examining these "symptoms" myself I decided it was time to seek information about ADHD, and explore deal with this as a possible explanation for my struggles at work.

Friday I met with my doctor again, firstly for a check up on my Prozac and Lamictal, I then informed her of my concerns with what seemed to be ADHD. She stopped completely, and asked me right then and there, whether I was opening to adding Adderall to my (for lack of a better word) medicinal cocktail. This is now my second day on Adderall. I have been started on 40 mg, 20 mgs to be taken in the morning, and 20 to be taken at the first sign of "coming down". Yesterday the only affect I noticed sold me. For the first time in my entire life all the extraneous noise was gone! I felt like someone turned off the noise and turned on the lights. I could focus on an entire conversation without getting distracted. I noticed a little bit of a tendency to get lost of a short second and stare off to catch my train of thought again. But I was extremely pleased with my ability to engage in meaningful conversation, without feeling like I had missed half of it. Today is my second day, and the affects are just compounding. After my first dose I sat down to watch TV and work on my monthly budget. For the first time I was able to get online, see Facebook and rationalize that I did not need to check, or Google News, or my Email, or Pinterest. I had signed on with one purpose, to do my budget. And that is what I did. As distractions, which would I usually describe as impulses, came up I was was able to perform some triage. I opened a notebook, and just wrote down the tasks as the came, and went right back to working at the main task at hand. In two hours I had made it through the first 5 items on my "to do list", and I did them all without bouncing around and trying to (unsuccessfully) multi-task. I hope Adderall is the answer for me. I will continue on Prozac and Lamictal as well, as they have been working so well for me too.

So my questions to you, and anyone else who (impressively) read this post are these:

-Have you experienced any similar affects in your first weeks on Adderall? Were there any negatives affects you experienced instead?

-Do you have any experience or knowledge of the affects of combining Adderall, anti-depressants, or anti-convulsants?

-I have heard of the so-called "honeymoon phase". Is this common? When does this initial "euphoria" ware off? What have you done to combat it?

-Have you ever had a revelation when you realized that your many "issues" have a single underlying cause that had never been considered?

Thanks for sticking it out (for those of you brave enough to read the entire post), and thanks for your answers to these questions.

-Allisaurus

[CheekyMonkey]

Originally Posted by asdfdoc

thanks for the link, that was helpful. I did get a "very aspie". That can possibly mean I have both ADHD and aspies. that's pretty sad for me

Aw, I wish you didn't feel that way. Most of my favorite people ever are autistic! There are tons of people just like you who are both. Many of them are successful and happy.

[avjgirsijdhtjhs]

Originally Posted by asdfdoc

cheeky, that website was helpful. Thanks. haha i did get a very aspie on the test but i hate to believe i have both adhd AND aspie .

typo, up there i am 27.

Originally Posted by asdfdoc

thanks for the link, that was helpful. I did get a "very aspie". That can possibly mean I have both ADHD and aspies. that's pretty sad for me

If you want to try some more tests, click here.

I've found that ignoring the bad, and acknowledging only the good gives a great ego boost. Besides, some of the "bad" isn't actually bad at all, like for example others' intolerance of certain differences in communication styles. Unfortunately, happiness hinges a heck of a lot on the quality of relationships with others (well, for most people at least).

[asdfdoc]

Originally Posted by allisaurus

[color=Red]
So my questions to you, and anyone else who (impressively) read this post are these:

-Have you experienced any similar affects in your first weeks on Adderall? Were there any negatives affects you experienced instead?

-Do you have any experience or knowledge of the affects of combining Adderall, anti-depressants, or anti-convulsants?

-I have heard of the so-called "honeymoon phase". Is this common? When does this initial "euphoria" ware off? What have you done to combat it?

-Have you ever had a revelation when you realized that your many "issues" have a single underlying cause that had never been considered?

Thanks for sticking it out (for those of you brave enough to read the entire post), and thanks for your answers to these questions.

-Allisaurus

Read your post, I switched to adderall, started low, 5mg bid. Didn't work. Switched to 10mg bid. Feeling too much upness or euphoria right now. I don't know what to do. I still can't focus! That is one of my negative effect. Others are increased anxiety and nervousness.

This place is pretty anonymous so I am gonna say this. When I was young back in college, I had friends who did drugs. I have never tried those prescription anti-depressants or anti-convulsants, but I've tried coke, meth and MDMA. I was never addicted to those but I just tried them out of curiosity. From doctor's point of view (pharmacology only), I would say that there is no contraindication of combining ssris and adderall I guess since they work on different pathway. They can only reinforce each other to make you feel even better. I am guessing sympathetic system can be over stimulated so I guess that's a bad thing since dopamine can also cause a little spike in serotonin pathway and vice versa. For those street drugs, combination of drugs reinforcing two pathways can cause even greater neurotoxicity, harsher crash and withdrawal symptoms.

I don't know anything about how to deal with honeymoon phase because I feel like I am going through one! And I dislike it!

For my issues, to be honest, other docs probably know much more than I do. With my 1 year of pharmacology and pharmacokinetics from health professional school and pubmed literature searches, I narrowed down the problem of my issues arise from abnormal dopamin pathway. There are many other symptoms that I did not list on this forum that directs this way.