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Old 10-23-11, 11:13 AM
Wife_w/o_ADD Wife_w/o_ADD is offline
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Husband's psychiatrist thinking of taking him off meds...normal?

I've mentioned before that my husband has a fairly mild case of ADD-I compared with many of the situations I've read about here & he most definitely does not have the "H" in his diagnosis.

Just because he has had successes in his life (for example he got his degree while unmedicated), he's also certainly had his challenges likely caused by undiagnosed ADD (for example failing out of college for only showing up to ace his tests, then going back to living at home and making up his classes in junior college, and failing out of college again when he went back and he encountered classes he couldn't ace by not being in class).

He finally joined the military where he hated the rules and regs, but he now admits it was a fabulous schedule for him and taught him a discipline he'd never had before. This was also where he finally completed his degree.

Other than schooling and chafing against authority, he was able to get through life ok (though always feeling different) until our marriage. I really think undiagnosed ADD is the biggest factor in relationship casualties as it causes such baffling anger and frustration for both people. He has also made some ADD-related mistakes at work that have caused some real hassle for us and others, but fortunately he is such a good & valuable worker that he's never been completely fired because of it....he has been taken off important projects because of it though and taken pay cuts.

We were fortunate that he got help as soon as he realized he was being inconsistent and breaking promises and not sticking to the budget that he agreed on, but it was still a rough 1-1.5 years. He actually self diagnosed after a lot of internet research (he says he knew 'something' was wrong cause trying harder never did anything for him). I was stunned as my only experience was with ADHD children at school, but the diagnosis fit once I started doing my own research, so we made an appt with the doctor and he was diagnosed officially and put on Ritalin.

After a couple years of not liking the side effects (the afternoon crash, feeling a bit hyper, and jaw clenching) he switched to Adderall with which he only doesn't like his tendency to clench his jaw.

Here is where it gets a little strange....his original doctor switched him to Adderall and then he was moved to a closer satellite clinic for his medical needs (he has VA insurance). We were happy with the move as his original assigned psychologist (who was doing his coaching) was fairly useless.

He now likes both his psychiatrist (meds doc that he sees every 6 months) and his psychologist (coach that he sees about every 3 weeks) in the new clinic. I have only met the psychologist when she asked me to come in, after about a year, for a session to fill in how things are going from my side of the coin. I think she is AWESOME. She gives some great homework and reading suggestions and seems to really reach him with how certain behaviors might look to someone else, therefore it isn't only me saying that x, y, or z seems self involved or uncaring of my feelings.

He is also more open to my suggestions and we've read all of the ADHD Effect on Marriage by Melissa Orlov together as well as parts of Married to Distraction--these books really help both of us see how we are contributing to the issues.

For the last year things have gone extremely smoothly. Even vacation time which used to really stress me out due to how 'out-of-it' he would get and stay, has gone great the last two times. So great that we are leaving for our 10th wedding anniversary for 2 weeks in only 2 days and so far it is has been smooth sailing city--well except for him forgetting a few times about getting a gift ordered, but he has taken care of that since. He wasn't able to get what originally wanted because he forgot to save soon enough, but I hear what he got is awesome--makes no never mind to me

However his doctor on his last visit says that he is ready to try taking him off the Adderall. This sounds to me a bit like taking a diabetic off insulin because their blood sugar is holding steady His dose was steady at 20mg in the am for a couple years, & then this same doctor suggested uping him to an extra 10mg dose in the afternoons due to some trouble & overwhelm hubby was having. He stopped feeling the overwhelm but says 'I didn't notice anything else different'--like what else differently would you notice? I fear he might be underplaying the value of the meds to his doctor.

All of a sudden he seemed completely overwhelmed and was dropping balls all over the place. Claimed he had no idea why it could be, but I found out later that the doctor had taken him off the extra dose and I guess he was adjusting to it. My husband claims there was very little difference when he stopped taking the extra dose, but I assure you everyone else in his life noticed that he all of a sudden had something diff going on. EVERYONE was asking me what was wrong with him.

He's probably been back to his regular 20mg dose for about a year and within a month or so he probably stabilized and stopped forgetting everything he needed to get done. Things have been REALLY smooth for this year as hubby has worked more with the coach and developed some good coping skills. I'm not angry and confused any more about his behavior and the reasons for it, so I am able to be positive and reinforce his good coping skills which has done wonders for our relationship and also for our intimate life which had gotten a bit thin as we were both feeling angry and misunderstood.

Also we've worked through the majority of both of the books I mentioned in this time and they were helpful in seeing eachother's viewpoint. And now his doctor says in 6 months at his next visit, he thinks he should take him off the Adderall as any benefit is mostly placebo

I've never met this doctor, but have tried to get a read from my husband on whether he feels this way about ADD in general--just take meds long enough to develop good coping skills and then go off the meds....or if he thinks this way about my husband, but he didn't get a read on that. My husband says he's always told him he was fairly mild, which I agree with, and that eventually could probably go off meds, which I am not sure I agree with. He is only getting feedback from my husband on how he acts with and without the meds, and my husband isn't the best judge of his own behavior I am sorry to say.

I mean we know that he can LIVE without meds. He didn't get prescribed meds till he was 35, but he'd had some rather spectacular failures by that time which had damaged his self esteem & he'd also spent a year to a year and a half fighting with his spouse a lot about why he wasn't helping & being a better marriage partner. I can't count how many times I asked him, if he wanted to act like a single person and not get another person's feedback on ANYTHING, why would he get married??

Things have been so GOOD lately that I guess I am afraid of what can happen once his brain stops getting what it needs. I've never heard anyone talk about the effect of ADD meds being placebo......I mean they hit the system so quickly and obviously that I can't understand what his doctor even means by this. Meds are a big part of how we got to where things are so good.

Hubby says he doesn't care either way about going off meds. He'll do whatever his doctor suggests. We've talked trying no meds for a week during our upcoming 2 week vacation because he'll have no work or other stress to deal with so we can both see how he does without them in an environment where nothing bad will happen financially or secularly without them....kinda like with a safety net. He is nervous that he will get all selfish and self-involved which he doesn't want to do while on our 10th wedding anniversary trip.

Can't say I don't have some concern there, but we'll have a week where he has his meds also. Our first week involves family (we all get along well with them) and is more busy and structured. They are celebrating our actual anniversary with us at Disney (one of our fav places) at the Food & Wine Festival (which we are ADDICTED to). Plus we are doing some things in Orlando like a Pirate Dinner Adventure show that hubby has always wanted to do. The second week is just us in a resort on the ocean on a Caribbean island.....we have plans for a power boat tour and ziplining but if we do nothing else but stay in the bedroom and on the beach, I am fine with it there.

1. Do you think we should try a meds holiday? I am in general pretty much against it because if your brain needs meds, I think it should have them. But I feel we might need a 'test week' to take to his doctor (who I will DEFINITELY be meeting and discussing this decision with before he takes him off meds).

2. If you think we should do a meds holiday, which week do you think we should do it? I though island week was best, but we get home on a Sunday and he has a fairly busy work day scheduled Monday to catch up from missed work on vacation, and I don't want him to have his normal trouble readjusting to life from vacation. He seems to want to stay in vacation-mode for another couple weeks after we get home, and it generally causes a fight before he snaps out of it--last two brief times away he has been aware of this and did great.

Because of this tendency, we planned our trip home to let him aclimate more slowly to regular life. We've planned a lazy trip home, flight from St Maarten to Ft Lauderdale Saturday afternoon. Quick hop to Orlando after a long layover for customs, then a rental car and a Bed & Breakfast for Saturday night before flying home mid day on Sunday. And he doesn't have to work till Monday morn.....in the past he's had to run straight out to work within a few hours of us getting home.

Any suggestions on what we should do are extremely welcome!!!
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Old 10-23-11, 12:06 PM
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Re: Husband's psychiatrist thinking of taking him off meds...normal?

I would say that if the meds aren't causing any harm, he should wait until there is as little as possible going on. Not knowing anything else, I would guess a week after coming back from vacation when he's both done getting back into the rat race and still relaxed from the vacation. Things change when anyone goes on or off medications whether it be a withdrawal, side effects, or ADD symptoms returning in earnest. There's too much going on when vacationing with extended family. You also don't want him wandering off to another planet when you're on your island vacation.
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Old 10-23-11, 12:22 PM
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Re: Husband's psychiatrist thinking of taking him off meds...normal?

If you can and your husband is game I recommend a different doctor if only for a second opinion because if he really needs and can see the benefits of meds taking him off for no valid reason seems ridiculous. The key is getting your husband on board so he realizes the benefits and to consider a second opinion. Is his doctor an adhd specialist?
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Old 10-23-11, 01:06 PM
Wife_w/o_ADD Wife_w/o_ADD is offline
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Re: Husband's psychiatrist thinking of taking him off meds...normal?

Quote:
There's too much going on when vacationing with extended family. You also don't want him wandering off to another planet when you're on your island vacation.
Those are very good points. I find vacation to be so relaxing in every way that sometimes I forget that not everyone feels the same!! We'll need to discuss this further obviously, but we originally chose vacation time because his main concern seems to be that if he is takes a meds holiday, he wants to try it when he doesn't have work to deal with (he is afraid he'll screw something up) so those times are really limited obviously.

Quote:
If you can and your husband is game I recommend a different doctor if only for a second opinion
I've really been trying to figure out how getting a second opinion would work. With the VA you are basically assigned to a clinic and see the doctors there. All your appts go through their central system, so I think our best hope to have it covered by insurance would be to schedule an appt with our original psychiatrist who knows the history and made the diagnosis to get a second opinion, we may have the option of asking his present doctor to refer us to someone else for a second opinion before making this step (I'd expect him to understand why we'd be concerned about such a big step, but really we have no way to know if he would take this request well or not), otherwise we may have to pay OOP to see a non VA doctor entirely (not sure how long they'd have to see him in order to evaluate him for removal from meds).


Quote:
because if he really needs and can see the benefits of meds taking him off for no valid reason seems ridiculous.
I know, right!?! I am just baffled why he seems to think 'good the meds worked! now you are done with them'. Since ADD is not curable, why remove anything that is helping with management?

My mind keeps flashing back to a bi-polar friend who went to a new doctor who removed him from all his meds cause he didn't think he needed them (and this man wasn't even managing all that well!!). It took at least 1.5-2years for him to stablize on meds again once his family was finally able to get him into a diff doc and get re-prescribed. Then it was probably another 2 years before he was able to resolve what was able to be resolved from the chaos of all that time of bad decisions....really took a 4+ year bite of his life that he says he'll regret forever.


Quote:
The key is getting your husband on board so he realizes the benefits and to consider a second opinion.
Yeah one of the benefits of ADD-I, being an easygoing person, can also be a challenge when you are trying to get them fired up about the seriousness of something.

Quote:
Is his doctor an adhd specialist?
I had assumed yes though hubby just told me that he doesn't think so. He just gets assigned to a psychiatrist and as far as specialties there is really no choice. I may have to investigate how to see a specialist further as I thought we had one.
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Old 10-23-11, 01:34 PM
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Re: Husband's psychiatrist thinking of taking him off meds...normal?

ADHD is for life. It doesn't just go away like a headache.
What is his Psychiatrist thinking?

IF things are going well with your husband on a medication, he should stay on it. End of story. It's not like the ADHD will magically go away afterward.
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Old 10-25-11, 05:45 PM
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Re: Husband's psychiatrist thinking of taking him off meds...normal?

The benefits of adderal are not placebo, they are well studied especially in the ADHD population. Either the doctor doesn't know what he is talking about or maybe your husband doesn't want to be on the meds anymore for whatever reason and again for whatever reason feels like he would have a hard time talking to you about it so he's chose to come up with a story.

I very much doubt it's the second case of course, but, I dunno it just went through my mind.
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Old 01-20-12, 11:29 PM
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UPDATE!! Husband's psychiatrist thinking of taking him off meds...normal?

The plot thickens... My husband's coach told him in no uncertain terms to continue taking his meds through vacation (I was relieved), but apparantly suggested that at some time in the future he might try going 'as needed'. He thought this meant, try it whenever he thought he was ready, so he started taking his meds when he felt like it/remembered/ on no reg schedule about 2 months ago.

No one informed me of this, so when he all of a sudden started acting spacey and out of it, I got very concerned. When I asked what was going on, all I got was "I don't know"--he says he didn't notice anything different so never attributed it to not taking his meds regularly.

We had a argument when I found out what he did without talking to me about it...especially not even informing me so that I could provide data for his doctors about how it was goingt. We have always believe that any decision that affects both of us is made by both of us. He says he didn't tell me because then my opinion on his behavior wouldn't have been biased by thinking meds vs no meds, but would just be an honest opinion.

My opinion was that he was all over the place, and I was very angry that I wasn't even given the opportunity to support him and make allowances for the withdrawal/adjustment period he may have been experiencing. His psychologist agreed and told him not to ever do something like that again.

So he has now been 'as needed' for about 2 months and he notices no difference, but I sure do. It is hard to know if it is all meds or chaos going on in his family...sister left family and wants a divorce...or some of both, but he has definitely gotten much less done and important things are getting procrastinated and are falling through the cracks again.

The homework we were both assigned by the coach (psychologist) involved listing things he really did well on for the past month and things he did poorly on. After reading the lists on Tuesday, she scheduled an appt (today in fact) with his psychiatrist to revisit the meds issues (she thinks 'as needed' isn't working) but my husband forgot and double booked something else, so they rescheduled him for next Thursday.

Any suggestions for how we handle this visit? Should I ask to go in and talk to the doctor too--I know his coach but have never met this doctor? Should my husband and I just talk together about what we think & possibly have him make some notes so he doesn't forget anything important, and then he deals with the doctor alone?

I wasn't afraid of this until I found out this psychiatrist seems to think the goal with ADD meds is to develop personal skills to cope and then get off meds.....I mean what the heck kind of treatment is that?!!? I haven't found any way thus far for us to get a second opinion, and I didn't think it was going to be a big deal until the end of April when his regular appt is with the psychiatrist, but my husband really threw everything for a loop by going rogue and trying 'as needed' on his own.

Suggestions please?
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Old 01-21-12, 12:46 AM
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Re: Husband's psychiatrist thinking of taking him off meds...normal?

If an inattentive adder is too inattentive to notice when they're being symptomatic then they can't give accurate feedback which needs to be taken in to account. This has always been my partner's argument for being closely involved in my care and I can honestly say that I don't always notice when issues arise.

It really sounds like you need to sit hubby down and explain it from your point of view as well as pointing out where he is possibly not in a position to make adequate judgements on his own.

If the psychiatrist is operating solely on feedback from your husband how is the psychiatrist verifying your husbands attention to detail in offering the feedback? An external observation like that of a wife can be very enlightening to a psychiatrist who is willing to listen.

It's horrible to admit that my inattentiveness gets in the way of my ability to judge things, but I know that being in denial of that flaw leads to poorer treatment outcomes on account on miscommunication issues with those treating me.
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