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Old 12-26-15, 09:42 PM
blke22 blke22 is offline

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Adderall - first thread post since registration - anxious/nervous, dousy of a thread

Hi All (that may read),

So, as to not hijack to many other threads of others as I bring in to much content indirectly related to those threads of others, I figure it is time to start my own (first) thread. No doubt this may be long, as I am already hitting the extreme for the day of running low on effective medication level. So an advance thank you to those that can read this all and respond.

First things first, recently diagnosed. Just mid way through second month of a changing Adderall XR dosage. Could categorize this this post into concerns about Adderall, but also about diagnosis, continued care, addiction concerns, and a host of other "tag" or "key words" that could have resulted in this being in many sub forums. Maybe will copy this into a "introduction" post/sub-forum eventually, but right now (given the best I can focus), this seems the best place for this topic to start.

With that said.. Where I sit today. Not big on sharing exact age, but will say I am in my early 30s. Since a child, not diagnosed with ADHD or anything really. Kindergarten was a few months of rough time before being put into "special education" only to be put back in normal class before the end of year as continued time result in my parents and others in the school being noted I was just easily bored and not paying attention. Small rural school, not sure anyone at the time in the class ever left for part of the day for any medication for something like ADHD. Lots of rough years to come as I was even evaluated and placed into a "gifted and talented" program before leaving elementary schools. School was always a fun cases of getting unusual grades fro lack of doing homework or taking notes but passing quizzes/tests without issue. College, well, I eventually found something interesting and went to college and did quite well.

Time marches on, years of ups and downs with depression like issues I held in and hid from family and friends and co-workers. A massive demand fro soda/caffeine all my life (since those days of being in grade school). Even when limited to dialup internet access, having access to it and so much in the way of help from others (parents did what they could, even if not wealthy by any means to keep me active as well). So I had great support, and some bad support in caffeine. Been off caffeine before for half year or more without issue, but not realizing it was only happening when I was otherwise receiving enough novelty/stimulation out of life (including work). Out of a job in my career/education area for a while didn't help for a few years, but was able to make do with outside of formal work activity keeping me going. Activity that actually steered me back to a related job/career-path again if not helping develop skills for it.

So, not for the not so distant past with a bit more detail. About 4 years ago getting back into that career path. 2 years ago reaching a point of not being content with it (not so much pay, but challenge...... and really, more so stimulation). I get another job with the same employer, but it only last about 9 months before I want to hop again. I hop again, same employer, but then starting to feel it all break down on me.. As I think about how I have started to feel less and less about the job or any job, concerned one will never be the one for me and feeling hopeless. Not only that, noticing things I have done over the past decades no longer filling the gap others tell me I can't expect my "job"/"career" to completely fill no longer fill. Not even the idea of a permanent significant other or having children really seems like something I could chance taking a risk on filling. Especially if I risk it and like so many other things I am eager to jump to the next thing after finding that other or having children. Caffeine and fury of learning (formally or via reading, watching educational material on tv, seeking out new information and challenges via the internet in things I can purchase to experiment with and continue my education by doing so.. None of them seem enough.

So 7 months ago, it becomes all to obvious I am destroying my career and more so my current job. I enjoy it at times, but when not interesting I am always defeating myself. Same goes with relationships with others as friends and family. They not providing even the filler they used to provide, and me feeling horrible for not wanting to be by them, just like my job, even at times when they could use my presence in their lives).

So, I go see a primary care provider (after finding one, as I am one of those guys who has been OK most of his life and as such doesn't even care to visit a doctor until he is sick or feeling broken). First thing, "anxiety" and "depression". Plus I note family history of thyroid issues (so I am tested). First day, offered some basic SSRI to try dealing with "depression" (which I note to me is reaction, or secondary symptom to a longer ongoing issue from the get go). And within a week on thyroid medication (only slight variation in levels and it goes in and out of acceptable levels in weeks/months to come).

Over months, on and off of various anti depressant and other mood stabilizers.. No notable impact, and racking bills up from starting to see psychologists and psychiatrists that all keep going with depression and even thinking it is short term like seasonal. One in particular, got to a nice heavy dose of Sertraline/Zoloft with no results and finally jumping to a different psychiatrist that mentions some interesting genetic testing that can suggest (not guarantee) if there are medications I may uniquely be less or more responsive to in good or bad ways. Got the results (dug into them myself as I am not one to just take a med without questioning it), apparently sertraline is likely to be less if not nearly uneffective at all in me. Same psychiatrist though wants to keep focus on depression/anxiety vs concerns about lack of focus without massive interest/stimulation and my anxiety being about lack of sleep and concern about inability to hold my job as lack of sleep and lack of interest in a well enough paying job is not enough to keep me from ******* people off at work (or being unproductive at times to say the least).

Countless other meds in there, I finally reach out to a well known psychologist and note he is the last I plan to see if we can not actively talk about depression being secondary concern that just is what manifests the most when I see medical providers. I noted what was going on, and even not to sound like my own expert, the concerns about something like ADHD as even co-workers diagnosed since childhood have opened up with me and mentioned I am like a worst day version of them when they were not receiving care or taking medication. Family members even suspecting it when hearing about seeing past doctors (in some cases, btw, me reaching a point of visiting a ER/hospital one night by choice when a family member was concerned). Not listed as some specialist in ADHD or any given area, the guy listens. No psychiatrists in the care provider organization to provide meds even, so I figure there is no reason for him to push down depression meds or anything else. I end up going through more evaluations, similar to one I did months back that a psychiatrist said I should not even entertain getting the results of from a psychologist in another care provider organization as he thought it was just depression/anxiety from his inattentive 15 minute or less sessions with me (I should have never listened to that guy). So, evals and says results of various little tests that I even note I have a hard time believing could be all that accurate, especially in adults... Well, he says the results line up with certain possible. No extreme towards one diagnosis or not result. But with hours of time with him over days he would suggest at least seeing a psychiatrist again and talking about the lack of focus and other symptoms being a concern along with if not before the depression. And refers me to someone I actually was trying to get an appointment with already but first appointment was 1.5-2 months out.

I got to see her a bit early (after also seeing a psychologist in her office/provider-chain earlier with a family member along *thanks mom for helping deal with another visit to another doctor as I try to convey information to them as I continue to fall apart*). Second visit in, we talk about medications which on first medication I noted I want to stop all the SSRIs/etc doing nothing positive and her agreeing so we can open up possible medications that would not interact well with existing medications. She mentions stimulants. Lots of names, notable differences between them. Possible starting doses and such. Knowing the stigma of stimulants all to well, and my own concerns which she mentions as I am an older male there is always concern but more so as you age of stimulants impact on cardiac system. I note I know this, and even my past concerns about caffeine being a helper I really don't care to be using to the level I do. I also mention that I note she did not mention Strattera. She mentions OK luck with other patients, but given my desire to have rapid progress notes it is not the medication you will see response as quick. I asked her if there was any other reason she would not go that direction first, as I would be willing to try first given reading on the net about those that end up trying it after stimulants only to see an effect but not enough alone and either going back to stimulants or a combination as they get used to effectiveness of stimulants. I would rather try first and risk it not working and having to work with my employer to consume what was left of vac/pto or take a leave of absence as unpaid vs start with something with stigma and risks to my my health like a stimulant vs risks known by this Strattera instead. Not to mention, I specially note to her I get the concerns of doctors, and I don't even like the idea of something like a stimulant as I hear stories of addition and abuse. Caffeine has been something unneeded but yet I have been depending on for too long. Not going to trade one thing fro another that even worse I have to see her once X # of days or months to get a prescription for in person. "I want/prefer to try this without stimulants". Even the "Wellbutrin" route I had tried to ask one or two prior doctors about as a possible way to address this as depression and possibly see benefit for a yet undiagnosed ADHD. So we start with Strattera and offer from her to call before next appointment should anything arise fro concerns/questions. We stat low, and get up recommend level at a about 2 or 3 weeks. Nothing, but I know it is supposed to take up to many more weeks after reaching therapeutic dosage to become effective. First month goes by, I see her and note nothing really noticeable by me/family/co-workers.. Slight negative, like an SSRI in past, stomach aches.. Oddly though, just pain like knots in stomach at night while trying to sleep. But I note it is not all that bad and isn't impact already diminished sleep too much.. But it gets worse, and I do see her eventually to ask to get off the stuff sooner as it is not a matter of when I take it or when I eat any more. Not every day to the extreme, but it is destroying few hours of sleep and doing nothing positive.

So, off the meds, and see her in a week. Will try stimulant option of her suggest, and welcoming it as I have been going to work yet (while trying to avoid family for the most part) to have work be my testing ground and work is getting more difficult (me working from home at least some days with employers OK, but then not testing the medications effects in an environment where I am visible). But I noted to her I want exacts of plan to get off even a starting dosage before I take a prescription from her as prior medications where enough alone let alone my concerns about this type of medication. Even as she describes one to try to fit a work day (Adderall XR) and mentioning possibly still prescribing a anti-depressant.. I note I really don't want two things in me at once unless we know for sure one is targeting the intended symptoms alone and other targeting other symtoms as I am used to not having any other medications in me (thyroid medication still being taken, but otherwise never any long term medication needed) and I prefer to keep them to a minimum. If she really thinks it will target different symptoms we can attribute to one or other of two medications only if there are results, I will chance it. If really for anti depressant, is there a way we could try Wellbutrin given it's history of secondary affects/off-label-usage for this instead of a stimulant plus other anti depressant. She noted she would prefer not to go with that yet, so we agree to start with a single dose of Adderall XR for 2 weeks with a prescription for the following 2 weeks with higher dose and see her after the 4.

So, paper in hand, down to the pharmacist. Not enough in stock, I am OK with that as I am nervous about starting this on a work day. I got to pick them up days later, and of all things they have both 2 weeks fills ready and wear ready to hand them over as prescription indicates, but then get all weird about doing so out of their own concern and talk about holding it. I am fine with that, but note to them they are making me nervous as I hear of (been told by doctor even) all the tight concerns on this type of med. But we work that out, I get original script back for the second dose and they hold the second 2 weeks until I come back in and pickup and sign off for them.

First week is quiet, first 2 days, somewhat of finger tingling (suddle, but noted by doc as side effect and not be concerned unless extreme). Detailed notes every day of first 4 weeks taken, these first two weeks don't seem like much. Pickup the next 2 weeks, first two-three days at second dose, fingers tingling in first few hours and a slight odd sensation in head for a bit those first two days of increased dosage. Not a headache, but maybe similar to a day with too much caffeine too quick.. Anyway, about a week in, a few things seem easier. If timed right, I am a bit more OK with work one the "slow" days. Bit easier to hold in emotions relating to work or lack of visits with family lately (tearing up, I should note, is uncontrollable at work at times and when seeing docs as I think of family I am essentially avoiding). But biggie, 8/10/12 hours? If I time taking it and even days where I figured finger tingling was start of some effect on me and rush to work, this stuff is not working for 8 hours. While I can't gauge the start, I and co-workers views of me can tell when it is going from possibly effective to wearing off. Days going OK at work I could last a bit longer, but if the AM started off bad before work or at work, well.. I was lucky if I could rush out of work and get home before water works or extreme emotions and then bring myself back into focus on work while working from home. But, I keep experimenting with timing of the single dose per day and eventually see the doctor.

We agree to go a month with level of dosage we were at at the end of the last month. 15mg XR, plus, as I noted to her that there seemed to be a noticeable early end to optimistic level of effect I could see in myself way shorter than the 8 hours+. The end was often far worse then if I just avoided work and exposure to people as it often resulted in other emotions I did not care to be showing at work. We will try 15 for the normal time and a second 5mg XR after.

With that said, appointment to be one month from that day. Which is now a few days off.

So, here I am finally posting in this forum. Wanting insight, if not even some words like :

Jules: [All while Honey Bunny is screaming] Tell that b***h to be cool! Say 'b***h be cool'!
Pumpkin: Be cool honey!
Jules: Say b***h be cool! Tell that f****n' b***h to chill!
Pumpkin: Be cool Honey Bunny!
Jules: Chill that f***n' b***h out!
Pumpkin: Shut up, Honey!

So, I get to see psychiatrist next week. 15mg dose is right about 5-6 hours tops yet, but catching it most days and the 5mg helps a bit. Make it through 8-10 hour days of work. But not always, and timing the start of the day is a pain as I honestly can't tell if it is effective in 30 minutes or 45/60/75/90 now as there is nothing noticeable like the finger tingling ever. And I fear going to work before I can count on it being there cause being there is being there. Let alone if the day starts of even slightly bad before leaving for work or when being there for first hour.. I say that, as beyond being able to bring myself to deal with others pace (often feels too slow for me) and boredom (especially if tasks combined with slow pace to allow others to keep up with me or my desire to get something done quickly and on to something "newer") I am still faced with random concerns about is it working at all or I am just getting luck with enough "novelty" in the day being enough to fill in the possible lack of effective dose and my own concerns about wil the day end on a bad note again.

As is, it almost always comes. A let down on me, unless I can fill in the gaps at the end of day and each morning before I take the first and later second dose to give me a few hours of not so much effort to hold in emotions and have to be questioning myself as I go off on tangent topics at work. Emotional control, it helps in the first round most days with the 15mg in me. The 5mg helps enough some days, but not always. Much like the 15mg, I spiral down the wrong random thoughts leading to unwanted emotions that I can sometimes conceal at work long enough and bring myself into "oooooo, interesting" topic. And now, a bit of anxiety as I have to contemplate the coming appointment with the doc.

Topics that role through, and generally I can think intently/focused on without the related thoughts causing too much trouble, as I wait for the day:

1. Askign for increased dosage on the 15mg, as it is not adequate at times ti seems.
2. The second dose isn't, and more to the point, Would gladly not increase any given dose if I can help the duration.
3. End of day, maybe what some call a come down, it doesn't always happen. But when it does, it is like a fall from a new better level that seems to make it more of a fall then on the bad days I collapsed before taking this medication. I really am not sure I want to go on with this medication fearing that it helps for a short part of the day but then ends up on many days only being the glimse of sun behind a much bigger storm. I actually fear it, given my past history of extreme "depression" as identified by docs before. Will this make me fine for a few each day but then in the long run make me worse to the point of one day hitting an extreme I dare not mention.
4. Stigma, all of above. Meidcation refils, and getting them. Not to mention, will I become tolerant and need to ask for more. Worse, financial directly, insurance, or even doctor one day for non financial of seeing her or paying for prescription, will I find some sense of "OK", let alone happy/joy/relief, only to have this taken away from me completely. And then, what happens in the first dew days of the possible extreme I hit?
5. 1-4, prescription free life for the most part. Nothing long term, antibiotics/etc being extent before this and thyroid medication. Nothing illicit ever, caffeine being the worst. Hell, not even alcohol as the stuff is revulting and I already had enough relatives have issues with that substance and/or nicotine via smoking. But, as I read all these topics about dependence, addiction, abuse.. And some even in thsi forum debating definition of each of those words.. I ask myself, what is the line? Will this become caffeine of the past for me? Is dependence simply acknowledging I need it to be OK like my eye glasses (analogy so often referenced by others)?
6. I am being honest with everyone, myself, family, doctors.. But will I be perceived as not even as I am? Do I actually hold back and say nothing vs asking about increasing dose level or quanity per day just to make sure I don't sound "seeking" as so many posts here and elsewhere I have run into?

I am terrified to keep taking this, or keep taking it this level, or to ask for more help. First thing showing any signs of help even as I ask people at my job for their input as I don't trust myself knowing for sure (from lack of ability to see it, or maybe now not wanting to see it in myself). All this, while knowing the various articles/posts/threads out there about how something I only liked to acknowledge the strangths of could at this moment be being my vary worst weekness/enemy. By that, I mean hoping between topics and sometimes being able to focus on the right things and see things others can't because I think so much (to point of it becoming overthinking).. And as the second side of that, me overthinking or ruminating on things to the point of paranoia (medication/doctor/appointment/etc, but even my employer saying I doing fine for productivyt and even then commenting I am doing better in past weeks but me thinking as they just saying that and will let me dig my own hole and then let me go one day).

Past months have been so much more ofa hell and expense to me in relatinshops with job/family/friends and $$$ and time. Seeing no positive effects and now something is in front mof me, at least showing visible improvement to others around me. And my own thought process is tossing this up in the air as feers of stigma, addiction, negative results with doc if I am seen as seeking medications, or even the very fear of none of that being an issue but having medication to cover enough of a day that I feel OK for weeks/months but then forget one day or can no longer afford medication and I fall so far after having come so far. Is this all worth it?

Further, well beyond when medication would be ineffective for duration today, all the possible repletion and lack of clarity in this post as I type it.

Some-one/people please read all the way. Tell me to stay "cool", just continue being honest with everone involved and that I don't need to be concerned.
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