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| Adult Diagnosis & Treatment This forum is for the discussion of issues related to the diagnosis of AD/HD |
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New and looking for insight (former substance abusers)
I am a young mother to 3 boys under six and I am struggling to function in life.
I'm sure many of you with kids can agree that trying to be an effective parent with untreated ADHD is damaging to your kids but also how frustrating it is for you when you are trying to be a good parent. Missed dr appointments, late to school, lost items, constant mess and disorganization, no consistency and very little patience- it is complete chaos. I feel like a constant failure. I will not go into it bc it isn't the point but I am more than willing to further explain if asked what I mean but I haphazardly stumbled onto meth one day and was hooked immediately. I felt like I had been stumbling around in the dark all my life unknowingly and someone had just turned on the light. I could suddenly SEE everything so clearly and without hesitation I could do whatever it was that needed to be done, I could do it accurately and with ease, and I ENJOYED DOING IT. Obviously while untreated ADHD and parenthood is a recipe for disaster....illegal drug use and parenthood is a catastrophe - much worse for everyone involved. My use of street methamphetamine lasted a few months before the risks became too great for me to continue and I sought help. Getting help led to the greatest discovery of my life which was the ADHD diagnosis. At first I was dumbfounded but after reading a lot about it everything that had never made sense in my life finally had a logical explanation. I have been off of meth for 2 months now and since I can be sure that my use of ADHD meds can be closely monitored (someone else keeps my meds for me and dispenses them to me according to my doctor's instructions) my doctor has agreed to give stimulant medications a try, despite my recent history of drug abuse. I have a few questions....first and most importantly I need to know what to expect as far as reasonable expectations for my meds. I am on Wellbutrin which is the only thing that has EVER helped with my depression but has done nothing for the debilitating problems ADHD causes. So far my doctor tried me on Ritalin SR 20 mg followed by a 5 mg dose of the IR Ritalin. I was only on it for a week because while it did help with my impulsiveness I was EXTREMELY agitated on it....annoyed at everyone and everything for everything and nothing at the same time. Luckily it kept my impulsiveness at bay bc despite how annoyed I was at everything I was able to keep it to myself and not yell at everyone or be rude in any way. I The first HOUR after it kicked in I did feel internally calm but it did nothing for my energy level, organization, or concentration. I still had NO desire and could not make myself get off the computer to do anything productive. I still forgot everything and could not effectively carry on a conversation. My doctor promplty took me off of Ritalin and agreed to try another medicine. So I am on day 3 of generic Adderall. He only has me on 10 mg IR twice a day. My mouth is dry and I want to take a nap about 20 mins after I take it. Now I have been lurking on here all day and I did notice that the generic brand is the generally regarded crappy one something CPharma or whatever so I am wondering if perhaps this is the reason it's barely noticable????? Also I have read the sticky on what you are supposed to get out of your meds but I would like more of a comparison from someone who has been where I have if possible. It would be insanely helpful if someone could tell me, "Look meth does......that you can't expect ADHD meds at the right dose to do for you." "If you find the right dosage and medicine you will know it is working bc is does xyz and know that it ISN'T necessarily not working because it doesn't....." Also I have heard that former meth users may have built a tolerance up to amphetamines meaning the dose may need to be higher to be effective to treat ADHD? Is there anyone who has had experience with street amphetamines who has been effectively treated with NON amphetamine meds? So far my doctor (who is a GP not a Psychiatrist BTW) has just told me to call him if whatever he gives me isn't working....from what I have read on this site I am on a pretty low dose of Adderall and I suspect if it isn't the brand that I might need a higher dosage for it to work? I really WANT meds to work for me but I feel like my doctor is doing me a favor by even letting me experiment with amphetamines so early in my recovery but I do want it to actually help me....I am scared to ask for a dose increase bc I do not want him to think I am just trying to get high. I just want to be a good mom! I have read every parenting book out there I just can't seem to apply what I know consistently and maybe I am just being impatient but I want something to work and I want it to work now, any suggestions???? I apologize for the length and TIA for anyone offering helpful suggestions and/or answering my questions. I apologize if I broke any rules or offended anyone. |
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mentalfloss (05-10-12), Unmanagable (04-10-12) | ||
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#2
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Re: New and looking for insight (former substance abusers)
I've got no experience with meth but here's my thoughts. What are your adhd symptoms? Thats the first thing you'd want to look for to see if they were being managed. Also 10 Mg is a childs dose and honestly low but your Dr may be trying to slowly titrate you up to an optimal dose. I've heard of long time meth users having a harder time benefiting from amphetamines but it sounds like you were a short term user? I guess you could ask your Dr if he plans on raising the dose. The biggest thing I notice is when I don't take my meds ...I'm a disaster.
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Go **bleep** yourself
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gracious_mama (04-06-12) | ||
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#3
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Re: New and looking for insight (former substance abusers)
IMO, you are a prime candidate for seeing a psychiatrist rather than a GP for your treatment. There are a lot of subtle changes, indications of whether you need a medication change or a dosage change, and esoteric medication combinations to address specific symptoms that a psychiatrist will be aware of but a non-specialist will not. Psychiatrists are also more likely to have had experience with substance abusers and former substance abusers and know the difference between tolerance or intolerance and unrealistic expectations because of drug experiences.
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"Living well is the best revenge." G.B. Shaw |
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#4
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Re: New and looking for insight (former substance abusers)
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I cannot relax I feel like there is something inside me making me go 100 miles per hour which lends itself to extreme impatience. (For instance when it is time to get the boys to bed I should be able to organize everything in my head as to what needs to be done but I am so disorganized and rushed I never get a consistent routine and forget things on the nightly routine like making them brush their teeth) I misplace EVERYTHING constantly...important documents, wallet, keys, phone, purse, my kids things backpacks, permission slips etc My house while not filthy is cluttered and unorganized. I procrastinate....I won't do laundry until me or the kids completely run out of underwear or jeans or something necessary. Don't do dishes until we run out of bowls or spoons or something....I just can't MAKE myself do it! I tend to either hyperfocus spending all day surfing the web, reading an entire book in one sitting, playing computer games nonstop, OR can't focus on ANYTHING I run around the house doing random things...put some clothes away, wash a few dishes, vacuum one room, but never completing tasks to get anything accomplished. I can never stick to discipline or rules I make up for my kids. One day they are not allowed to do something....the next day I am too tired to enforce it so I let them get away with it. I seem incapable of holding down a job for longer than a few months bc I am late all the time and often insist on doing things MY way instead of the way my boss wants it done. A lot of fatigue...it doesn't matter how much sleep I get I always feel too tired to do anything! Impatient with a short temper....I used to lose control and yell at my kids but I learned to control myself enough to walk away instead of damaging them further with my outbursts....still I am not an effective parent bc I never actually go back and deal with it I just kind of ignore all these problems and hope they go away but as my kids get older it is only getting worse.....my older ones will be 5 and 6 this summer and my youngest just turned 2. So I have to learn to do things better. Many more but those are the issues that mostly impact my life and make things chaotic for me and my kids and my parents (who I live with for help) 2.) Yes I was only on meth for 4 months total and never used daily. I would do it for 2 -3 days at a time every other weekend (ex had the kids)so that I could clean the house, get caught up on laundry and do my homework, pretty much everything I neglected the other 90% of the time. |
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mentalfloss (05-10-12) | ||
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#5
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Re: New and looking for insight (former substance abusers)
As far as 10mg IR being a low dose, it really depends on the person. I think that you will find that 10-15mg IR is really a fairly common single dose for a lot of people. There isn't a way to gauge what dose will work until you titrate up. There are children who require higher doses than 10mg IR and adult men who require lower doses than 10 mg IR. It's really dependent upon the individual.
The tired feeling could be your body adjusting to the medication or it could be your dose is too high to start with. Too high of a dose doesn't necessarily make one jittery and over-focused. It can have the opposite effect. Of course with stimulants comes dry mouth. Make sure you are drinking A LOT of water throughout the day. Probably more than you normally do. It can take a few days to a week or more for your body to adjust. Keep in mind that even though you may be taking a generic brand, it doesn't necessarily mean it's bad. People can have different reactions to binders and fillers in medications. What one person considers a terrible brand, another may report it works great. Barr/Teva is technically a generic brand, although your insurance and pharmacy may indicate it is brand name, since Barr originally obtained the rights to Adderall IR. They did at one point change the formulation, but have reportedly reverted back to the original formula. Quote:
A good thing to do is make a list of your symptoms unmedicated and then compare those symptoms and your side effects while medicated. If there is NO change then that may be an indication you need to increase your dose or switch medications. If your side effects get worse and don't subside after a week or so, thats also an indication that a medication may not be right for you.
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I really didn't say everything I said. "A.L.W." "R.T.C." "no talk no, talk Punctuation is important" ~Abi |
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#6
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Re: New and looking for insight (former substance abusers)
Obviously while untreated ADHD and parenthood is a recipe for disaster....illegal drug use and parenthood is a catastrophe
That was supposed to be a 'quote' - sorry! Although I am newly diagnosed and cannot answer your questions about amphetamine, I can very much relate to substance abuse and parenting. I was told by my Psychiatrist that untreated/undiagnosed ADD/ADHD you are more prone to substance abuse. When I told my family DR the symptoms I've had for years, panic attacks, anxiety, depression, disorganization, racing thoughts in my head that would not stop, and everything else that goes with ADD- I was prescribed Xanax, which I became highly addicted to. Long story short, I was addicted for months, and when my DR. wouldn't give it to me anymore I began getting it off a friend. Undiagnosed ADD plus a drug addiction nearly killed me, so I sought help and detoxed it out. I was clean for a year until I lost my last job. Then I turned to Benzos again ( Xanax, Klonopin, valium,) to calm me down and I'm now addicted again. My Psychiatrist now has me on a low dose benzo to taper me off, along with Vyvanse which is also an amphetamine. I did some research on this med and discovered it can be addictive and can be abused. So I too am wondering why my DR would prescribe me this, knowing of my previous and current addiction problem. Ugh, parenting, especially with small children, with undiagnosed ADD is a nightmare in itself, making it 100x worse along with an addiction problem. Sorry to be so long. I hope you find the answers to your questions and find the help you need, and know that someone can relate entirely about ADD/Addiction and parenting. |
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mentalfloss (05-10-12), Unmanagable (04-10-12) | ||
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#7
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Re: New and looking for insight (former substance abusers)
I have abused meth in the past and was given a ADHD self-report scale and apparently needed help. I was prescribed Dextroamphetamine after trying Adderall and it really helped more than the Adderall did. They also used a higher dose as I was just about 2 or 3 months post meth use. I was on around 40mg after awhile but I started off at 5mg.
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#8
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Re: New and looking for insight (former substance abusers)
In my teens and early 20's, I did every type of street drug you could imagine. My preferred choices were cystal meth and lsd. Luckily, I was able to walk away from them w/ no fatal tales, but I always mannaged to immediately replace them with my next favorite habit.
Anyway, I was diagnosed with adhd at the age of 44 by a combo of GP, therapist, and psychiatrist who were all aware of my drug use history. My first prescription was adderall 20 mg IR. The first dose felt almost like the first time I took meth and I was scared in a way, knowing how that feeling can start a trainwreck and I was hesitant about the whole getting hooked thing, too......but damn, I was so happy that I felt human again, I sat and cried for a while, then laughed for a while, then got so much stuff done that I'd not been able to make myself do. I thought it was a freakin' miracle! The next day I felt nothing, but was able to focus better. Kept feeling nothing, daily habits didn't change. Dr increased dose....side effects of headaches, moodiness, etc. got worse. Lowered dose to 20mg in the am and 10 every 3 hours as needed. That gives me a therapeutic dose that helps me function. Staying hydrated and watching my nutritional intake are also a big part of how I feel and function each day. And the hormones can come along and screw up any good day in a heartbeat. lol There's just so many different meds and treatment options that it seems to be pretty much just a luck of the draw to find which one clicks with you, in my opinion. It's great that your doc is willing to work with you and it sounds like you've got a good system of managing your meds proactively. Wishing you lots of luck! Hope this helps in some way. ![]() EDIT: I forgot to add that the euphoric feeling did not return and I learned that having that feeling was not the desired effect of a therapeutic dose.
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“Feelings come and go like clouds in a windy sky. Conscious breathing is my anchor.” ~Thich Nhat Hanh Last edited by Unmanagable; 04-10-12 at 03:03 AM.. |
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Amtram (04-10-12) | ||
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#9
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Re: New and looking for insight (former substance abusers)
I understand where you're coming from on what to expect from medication after using a street drug for self medicating. I didn't use meth but weed, I would say I had a switch flipping effect when I used THC and so far I'm not getting what I got while I smoked now that I'm on meds.
How fast did you come to figuring out you had ADHD, did you immediately know you had a problem while you used meth and question the difficulties in your life? |
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gracious_mama (04-12-12) | ||
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#10
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Re: New and looking for insight (former substance abusers)
Quote:
GRACIOUS M I think you raise a lot of important points in your (very thoughtful) post. First of all. A lot of people accidentally stumble upon the fact that they have ADHD after experimenting with stimulant drugs, whether they be street methamphetamine or, say, the pseudo ephedrine commonly found in over-the-counter cough and cold preparations. Typically, they experience a kind of "epiphany" as you describe in paragraph 3 of your post. That is, the effect of the stimulant is a kind of wondrous "revaluation"; for the first time ever in their lives, everything now appears clear and focussed and "sane" and "normal", whereas before it was not. Often, you will find in ADHD blogs and even in one or two medical textbooks I have read on ADHD, a reference to the well-known piece of scripture (and I am not religious, by the way) from the New Testament where the apostle St Paul describes being "born again" on the road to Damascus, and says of his experience of this new life": " It were as though all I had seen before I had seen merely through a glass darkly". Secondly, you wonder what you can expect from ADHD medications. In short, a lot, according to the literature- over 80 years of it to date! The treatment of ADHD with stimulant drugs is often extremely effective (and safe, by the way) which is all very good news! The first main point is that , basically, ADHD medications are either stimulant drugs like Ritalin and Adderal or the new compound Strattera" or "Welbutrin". For you, we can eliminate Wellbutrin as you say it has had no positive effect on your ADHD symptoms. That leaves "Strattera" and the stimulants. Of theses , Sstimulants are still the drugs of choice for ADHD in most cases. The thing to remember with stimulant drugs and , actually, with drugs in general, is that individuals can react very differently to them. For instance , you say that Ritalin made you anxious. Some people prescribed Ritalin for ADHD will find that this happens (i.e., it makes them edgy and jittery and anxious) and some will not. The same thing goes for the other stimulants drugs : Adderral, Dexamphetamine, Methedrine, Vyanase, Focalin, Metadate, Pemoline for instance and also for the kind of dosage forms that they come in; for example "IR" (instant release) or "XR" (sustained release "spansules") or patches that you put on your skin like Daytrana or a prodrug like "Vyanase". You make a very good point as well about the difference in effect that individuals can experience between say a generic vernon of a stimulant, like dexamphetamine and its branded counterpart. Due, for instance, to the different excipients that are used in manufacturing, say, generic dexamphetamine tablets and branded "dexedrine" tablets bioavailability of the drug can be affected; also an individual may find that the excipients used to make the generic dexamphetamine tablets make them nauseous, etc while those in dexedrine do not. Another reason for the variability in response to different stimulants and different doses of stimulants is the presence of comorbid symptoms and (other) developmental disorders in the patient. What it means is that often a person with ADHD will have to experiment with different TYPES, BRANDS and DOSAGE forms of stimulant, to find the one that suits them best. Everyone is different. You, for example might find that the best stimulant preparation for your ADHD is the immediate release generic form of Dexamphetamine manufactured by "such and such"; or conversely you might find that sustained release, branded Adderral capsules suit you and your ADHD best of all. Next, comes the CRITICAL issue of dose that you mention. This is an important and, unfortunately still rather a "vexed" issue. First of all, the way most ADHD psychiatrists work is to start with a very low dose of the stimulant that they are trialling you on and then gradually increase (titrate) the dose up until it is at a level that gives optimal control of your impairment-causing ADHD symptoms. In the US, psychiatrists have official guideline set regarding the maximum dose of stimulant that they should prescribe for patients with ADHD. The FDA , from memory, says that the upper limit for the dose of a stimulant drug like Adderral is, say, 40mg for an average adult. This is based mainly on body weight. If a psychiatrist wants to prescribe more for a particular patient, he can, but he will then be prescribing what is called an "Off label" dose. Some important points here are: 1. Stimulant dose effects are (pharmacokinetically) linear and positive on core behavioural problems in ADHD, so that HIGHER DOSES may be more effective than lower doses; dose must be individualised for each patient. 2. And this is a vital point...The current FDA maximum limits are regarded as being quite conservative. This, for instance, is the opinion of Russell Barkley, a foremost world authority on ADHD. He argues that many adults with ADHD will benefit doses of stimulant higher than the current recommended FDA maximums. Your psychiatrist might not necessarily be aware of this or might not necessarily agree with Barkley; on the other hand he may be happy to prescribe you off-label (above FDA maximum) doses of a particular stimulant if that is what you appear to need for optimal control of your ADHD symptoms. It may be a good idea to ask him what is his professional policy is on the issue?? 3. Although body weight has NOT been shown to to be related to stimulant drug response, using weight as a rough guideline for determining starting dose continues to be recommended; this is probably what your own psychiatrist will be doing in your case. With regard to past substance use disorders, like the "Street" methyl amphetamine you say that you have previously used. At the correct dose of stimulant a adult person with ADHD will find that the cognitive symptoms of the disorder are controlled ; that is the core impairment -producing symptoms of inattention and impulsivity (and Executive Function impairment) are controlled without the experience of any kind of (addictive" "High" or euphoria. They will not feel "wired" or buzzy" or find that their mood is unnaturally elevated. Even where a psychiatrist needs to prescribe higher doses of stimulant than the FDA recommended maximum, theses higher doses are extremely unlikely to give the patient a " high" of the kind that a street abuser/addict seeks. I means oral doses of say dexamphetamine of the order 40, 60, or even 80 mg a day in divided doses, are simple way too low to get "high" on in the sense that street addicts use the term "high"- i.e; to refer to an intense/transporting mood-elevating euphoria. Furthermore, there is not tolerance to the cognitive effects of stimulants when they are correctly prescribed in ADHD. Even if you have used high quantities of illegal amphetamine in the past, it will not effeffect the size of the optimal stimulant dose for control of your individual ADHD symptom. The rare exception might be where a person has abused particularly high doses of INJECTABLE street amphetamine over a long time; this may possibly cause scarring of dopamine receptors, etc, but remember this is only for very high doses of INJECTED street amphetamine. If anything, appropriately-prescribed stimulant medications in ADHD have been shown (in 13 scientific studies to date) to reduce the risk for later substance abuse. That is, by putting you on the correct dose of an ADHD stimulant like Adderral your psychiatrist will be PROTECTING you from the risk of lapsing into subsequent amphetamine abuse. That is why, useless you actually present at your ADHD clinic with an ongoing substance abuse issue, with, say, street "speed" (in which case you will need to detox before starting treatment for ADHD) most psychiatrists will not routinely disqualify you from a trial of stimulant medication for your ADHD symptoms. The final point is how will you know when you are on the right dose of the right kind of stimulant? The answer is that you will feel, "normal", not "high" or over-stimulated or over-happy, but normal. This , will still be a relatively "blissful" affair after suffering years or possibly decades of ADHD-type functioning. When you are functioninging normally, you will just "Know" - you will instinctively and immanently sense it and realise it - it is unmistakable. Your body will tell you that things are now "right" - that you are now experiencing normal functioning and you will know it. It's kind of like the epiphany you experienced when you discovered by accident that street amphetamines reduced the core problematical symptoms of your ADHD, only because the dose is carefully calculated by you and your psychiatrist you will not feel any street speed-type "high" - just a natural "high" from being normal at last after so many years of suffering impairing symptoms of inattention and impulsivity, etc. Last edited by Amtram; 04-10-12 at 08:58 AM.. Reason: fixed blockquote tag |
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#11
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Re: New and looking for insight (former substance abusers)
Another thing to keep in mind is that many people with ADD self-medicate, and are more prone to addiction even with non-addictive substances. Many of us here who self-medicated with one thing or another found it amazingly easy to stop after finding the right medication and the right dose.
The chemistry from one stimulant to another is different enough that you should be able to find one that works for you regardless of whether you were using a street drug before. They also give you a good idea of how they will work for you in a relatively short amount of time, allowing you to change medications without an extended weaning off. Work closely with your doctor, pay close attention to changes you notice, and recruit the help of loved ones so you're aware of differences you can't see from the inside.
__________________
"Living well is the best revenge." G.B. Shaw |
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#12
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Re: New and looking for insight (former substance abusers)
Quote:
Haha no I thought "wow no wonder this stuff is addictive!" because I thought EVERYONE felt that much better on it. Actually how I discovered the ADHD was completely ironic. I am a mother to 3 kids and I knew that no matter how much better I thought it made me that the rest of society would not see it that way. The US is really cracking down on it and I was smart enough to know that no matter how careful I thought I was that I would eventually get caught and when I did my kids would be taken away forever. I love my kids more than anything. I was also concerned about my health - you never know what you are getting on the street so if the law didn't catch me the crap they put in that stuff would eventually kill me. I didn't want to have to worry about my health all the time. However having experienced how much BETTER of a mom I was and just how much everything seemed to make more sense the thought of sobriety depressed me. At one point I even thought to myself - I am better off dead to my kids sober than I am high because I just was so unmotivated and I didn't have the energy to do ANYTHING sober. Anyway so I sought out a way to somehow "fix" myself. That is when a "friend" of mine said to me, just go get some ADHD meds if you think the meth helped you so much. I'm going to be completely honest here so PLEASE do not criticize me but I went online to figure out what the symptoms were of ADHD so that I could go to my doctor and get some meds - the JOKE WAS ON ME THOUGH because as I started read down the list of symptoms I was astounded that there was a NAME for the dysfunction I had been experiencing my whole life. I thought I was just crazy, an idiot, a failure. The more I read the more I realized that maybe this was God's way of directing me to the help I needed bc I don't think I EVER would have figured it out otherwise! |
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T-Rex65 (04-18-12), Unmanagable (04-12-12) | ||
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#13
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Re: New and looking for insight (former substance abusers)
Now you know, and you should probably keep an eye on your kids so that you can intervene with them if they show any signs of ADD. Not saying put them on meds, necessarily, but there are a lot of ways you can change the way you interact and how you run the family that will make their lives a lot better in the long run. My feeling is that a lot of therapeutic advice on coping and behavior for kids with ADD would do some good for everyone else, too.
__________________
"Living well is the best revenge." G.B. Shaw |
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#14
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Re: New and looking for insight (former substance abusers)
Quote:
I have always known something was "off" with my oldest because he has been on the late side of developing when it comes to the big milestones, walked late, talked late etc... He is in Kindergarten now and the teachers love him bc he is so quiet and eager to please but he never finishes his assignments within the allotted time and gets frustrated so easily while doing homework with me. He doesn't make friends too easily either. I had him screened for Asperger's at a year and then again at 18 months but they said if he had that then it was an extremely mild form. Last year I had to take him to get an EKG done because the teacher said he kept staring off and they were worried he was having those silent seizures but everything came back ok so I didn't know what I was dealing with...I might have an idea now but I just don't know. My 4 year old is very hyper at home but sits still and seems to listen well to his teachers. In Pre K there isn't a lot of work that requires sustained attention so I may get a better idea next year of what I am dealing with. However, this child has a serious problem at home. NOTHING works discipline wise and he is very defiant, it's like he has to argue - if I say the sky is blue he is going to give me 10 reasons why I am wrong. He is just very stubborn and I can tell him not to do something and then 2 seconds later he does it again, he never learns! Problem is I don't know if they have it or if their "symptoms" are simply a product of my complete lack of consistency as a parent due to my own ADHD. Time will tell I guess. |
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#15
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Re: New and looking for insight (former substance abusers)
Hrm, re: your kids possible ADHD...maybe keep a little file for each of them and jot down (when it strikes you) examples of possible "symptoms" you notice and anything you may get from the teachers. I know, I know, keeping a file (I probably couldn't) or maybe just a box to throw it in. This way if they do get evaluated when a little bit older you have some info to show the Dr. If not then it'll be something funny to look back on.
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