What has been most effective for treating your apathy?

[Verile]

I'm currently on Vyvanse 50 mg and while it certainly gives me a boost it doesn't really treat my apathy or lack of motivation, that persistence to endure and work toward a goal.

While things like fogginess and forgetfulness have always been an issue I've learned to work around them with notepads, constantly checking my calendars and to do lists, patting down my pockets before I leave an area. Habits developed over years. But the one thing I haven't been able to address is this crushing lack of endurance. I want to care and I want to exert myself but I can't bring myself to do it. I haven't been able to strengthen my resolve through training. I'm not a cartoon character it seems. Just the act of living is extremely difficult, which is ridiculous, because I have a good life. I almost think that's the problem; my good life robs me of a purpose which I must fulfill just to survive and so I'm left searching for one. It's a stupid problem to have. It's insane.

So with that in mind, which meds, both prescription and off prescription, have been most effective for you in treating this? Is there a pill you can take that makes you want to get up and live life to the fullest?

I'm also open to non medication suggestions or experiences. I truly believe if I could find a passion to devote myself to that would help tremendously but I haven't found one yet and am beginning to question if being passionate is something I'm chemically capable of. If you feel you can relate to me, to this emptiness that I feel, and found an answer for yourself, please inspire me with a personal example.

[Crosswired]

Hi Verile,
I was diagnosed about a year ago and have been on Concerta. It's great for concentration and energy, but I also still lack motivation. I still am indifferent to everything. I have no passion to drive me toward any goals. For example, my sister works in government and has learned French fluently in about a year after intensive study. This was very beneficial to her career. If I was in the same position, I would never have been about to dedicate myself to that goal and would have floundered and stuck in the same job, while others get promoted. I just don't care enough!

Why I am so indifferent? Why am I not passionate about anything? Where is my ambition? It really bothers me.

[Verile]

I feel you, brother. It kills me too. Hope to find an answer someday.

[purpleToes]

Verile: I think I might be identifying with you. Are you in otherwise excellent health? When you said "crushing lack of endurance" and described just getting by as taking tremendous effort, I wondered what your overall energy level is like. In my own experience, a lack of physical and mental energy blocked my mind from even considering activities that would be too taxing. Combine that with ADHD's deficits for long term goal planning and it was a deal killer.

The fact that this is bothering you so much argues against the idea that you simply don't care. I would question whether you truly don't care to achieve, as opposed to subconsciously making a justifiable effort/reward calculation. In illness, our instinct is to conserve energy.

The presence of brain fog (a feeling that you are thinking very slowly, or never quite fully awake) seems to me like a flag that there could be a medical condition underlying. I know this brain fog complaint is common in ADHD-PI, but I also know from my own experience that conditions associated with fatigue and brain fog, like sleep apnea and anemia, can make it much worse. "Silent" conditions like these, which tend to come on gradually and don't present with painful symptoms or visible outward signs, are frequently missed or underestimated, or the symptoms attributed to depression.

For decades I had been conditioned to believe that my poor performance and apparent lack of effort were evidence that I didn't care, lacked motivation, or that I must be depressed. Yet, when I have some energy (through addressing some underlying health issues, and with the help of stimulants), I "magically" start wanting to do stuff, even long-term stuff, and doing some of it! I still do it in an idiosyncratic, inefficient, ADHD-like way, but faster, and without feeling drained from modest effort.

Is there a pill for what you're feeling? Maybe, but it sounds like you're already on the right track with that. For me, when my health declined beyond a certain point, it was even too much for stimulants to overcome. I've been directing my energy to getting my sleep and anemia issues resolved, and I do feel the stimulants are beginning to work better again. This is actually the easy part: the hard part was 20 years of trying to find an answer to my fatigue and brain fog, while being fatigued and brain fogged.

[madadder]

Originally Posted by Crosswired

Hi Verile,
I was diagnosed about a year ago and have been on Concerta. It's great for concentration and energy, but I also still lack motivation. I still am indifferent to everything. I have no passion to drive me toward any goals. For example, my sister works in government and has learned French fluently in about a year after intensive study. This was very beneficial to her career. If I was in the same position, I would never have been about to dedicate myself to that goal and would have floundered and stuck in the same job, while others get promoted. I just don't care enough!

Why I am so indifferent? Why am I not passionate about anything? Where is my ambition? It really bothers me.

Crosswired, my thought is that if you have the correct medication, and it's working as it should for ADHD, you might not have the drive/motivation you want even though your focus is improved. This is because after living your entire life with ADHD your motivation and drive were suppressed. ADHD taught you very bad habits. It taught you to be very unmotivated with no drive.

Just like your ability to focus with your prefrontal cortex, your ability to motivate yourself stems from yet again another "muscle", being part of your brain. What I'm actually talking about is how strong your will is. Which gets stronger everytime you forgo temptation and do what you know is right. Your will is a muscle and it needs working out (maybe, I don't know you, this is a forum). I think with the right circumstances some people may be able to actually will themselves back into the game if their ADHD is treated correctly. But it takes really hard work, and realizing that it will take a long time with small improvements. I don't want to exclude the possibility of something else going on though. Maybe you have the wrong dosage, wrong medication, diet, fitness, stress level, etc. There are so many factors to consider and especially with everyone's body being different, everyone's upbringing and beliefs being different. I'm just giving you one consideration that you may have overlooked.

[madadder]

Anyways, start small. Make a note of something that would beneficial in your life that you're not doing, but wish you did. It could be dietary, fitness, maybe a hobby, relationships, etc. Fitness is a great one because it highly effects your body's willingness to do just about everything else. More energy, positive spirit, etc. So maybe, with that example, if you're not exercising at all start with a walk for 30 minutes twice a week for a few weeks. Once that gets boring, and easy to accomplish (the getting out to do it part), throw something in. Maybe walk once a week and jog once a week for 10 minutes. Then slowly make improvements. But you can't just jump into life or you'll be disappointed. I feel like I'm on a soap box. I am just trying to help not only you, but maybe other people who feel like they're in a rut. But please forgive me, I have just started taking my medication, concerta, and I find it so easy to just type out my feelings compared to before. I used to type out a paragraph and read it over and over, making changes and missing grammatical errors (i'm not saying this is error free) even after i would deliberately scan through it thoroughly.

[madadder]

This link might help: http://www.addforums.com/forums/showthread.php?t=129191

[Verile]

purpleToes: Yes, we're very similar. I avoided human relationships most of my life because even the idea of having to put on a "mask of liveliness" drained me. It's not social anxiety, it just takes an extreme amount of effort. I nearly failed out of high school because homework was too draining. I don't have any skills or developed talents because it takes too much time and work to get good at something. I joined the military because by the time I was 19 I finally understood I was never going to get anywhere in life on my own, I needed intense structure and the fear of punishment just to get me to do the bare minimum.

I should clarify about apathy. I've been calling it that for so long now before I understood the neuroscience behind my lack of motivation and deficiencies. I just assumed I was naturally very lazy and uncaring. After all, if I really cared, why couldn't I do it?

I'm sorry for your other burdens. I'm in outstanding physical condition so I know my problems completely stem from the brain. I knew people with sleep apnea, anemia, celiac's disease, among others and I know it's troublesome. I wish you luck in treating your triple whammy.

[CheekyMonkey]

Do you think adding something like wellbutrin would help?

[Verile]

I've been doing a lot of digging but I haven't really seen much about Wellbutrin treating anything other than depression. I can't discount it right out though. I'd consider it if other ADHD-PI were on it and praised its effects but generally I read that anti depressants either make it worse or do nothing to help.

Right now Surferdude's thread on memantine has me inspired to try it as the next plausible attempt at a solution. I'll report my results back in his thread most likely.

[CheekyMonkey]

Originally Posted by Verile

I've been doing a lot of digging but I haven't really seen much about Wellbutrin treating anything other than depression. I can't discount it right out though. I'd consider it if other ADHD-PI were on it and praised its effects but generally I read that anti depressants either make it worse or do nothing to help.

Right now Surferdude's thread on memantine has me inspired to try it as the next plausible attempt at a solution. I'll report my results back in his thread most likely.

It is used to treat ADHD as well. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000970/


I don't know how much it would help you, I just know from reading here that many people found it a helpful addition to their med regime.

[Verile]

I'm sorry to impose but could you link me to a thread? I'm actually very hestitant to play with medicinal cocktails so I'd like some indicators that the people who have good experiences with Wellbutrin share enough similiarities with me.

For example, I don't have GAD or depression but I do have anhedonia, low emotional capacity, and weak motivation. The Pubmed link doesn't really describe how it treats ADHD, just that it does.

[CheekyMonkey]

Well, there is a whole wellbutrin section here. I don't have the best memory, but it has come up enough that I know it works for some.

Obviously, medication is trial and error. There is not much getting around that.

Maybe this thread? http://www.addforums.com/forums/showthread.php?t=51954




It is worth asking about. I know it sucks to try out meds that don't work out after you've stuck through the side effects. Keep at it!

[Verile]

Thanks. I'm still not liking what I see about Wellbutrin but if my other plans don't work out I'll try anything to get better. There's always the chance I'm clinically depressed and in denial and this might clear it right up. Who knows?

[CheekyMonkey]

Originally Posted by Verile

Thanks. I'm still not liking what I see about Wellbutrin but if my other plans don't work out I'll try anything to get better. There's always the chance I'm clinically depressed and in denial and this might clear it right up. Who knows?

Yep. My husband had great result from Wellbutrin, but he is bipolar. It is the only medication that could help with his slumps.