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Re: My ADHD type
Jun 27, 2009
My ADHD is similar to your own in a lot of ways, Bob. 'Mental chaos' seems an apt description of what I suffer pretty much every day. Rapidly changing thoughts, getting lost on trains of thought that don't apply to what I'm doing, easily distracted by my own internal stimuli. I've seldom had a problem blocking out external stimuli . . . I was never the type to get lost watching the birds out the window during class. Quite the opposite, teachers never had a problem with me because it [i]looked[/i] like I was paying attention. Problem was, I was lost in my own little world, daydreaming the day away, playing out scenarios of how my life would be once all the plans I was making came to fruition (not that I ever started, let alone followed through on most of those plans, but I digress).

Alas, I've never managed the hyperfocus side of ADHD, regardless of how pressing a project is, or how close it is to being due, the outside thoughts and internal distractions just keep coming.

Other classic 'inattentive ADHD' symptoms as well. Can't start (extreme procrastination), can't follow through, easily lose my train of thought, absentmindedness. I often forget appointments, forget to pay my bills until I get a phone call, forget to change my oil, forget to register for school. Funny, when you combine procrastination with absentmindedness, you really tend to get yourself in trouble ('I'll do it later' only works at all if you [i]remember[/i] to do it later!).

I have severe issues with recall. Whether it be forgetting subject material for an exam at school or simply 'losing' a word, I have real issues here. Have you ever had a name that was 'on the tip of your tongue,' but you just couldn't think of it? I do that every day, in normal conversation, with everyday words that I use all the time. As with almost everything else, this issue was demonstrated well by Homer Simpson while looking for a spoon, with his line, "Marge, where's that . . . metal dealie, that you use to . . . dig . . . food." I find this issue particularly humiliating.

I have extreme issues with reading, especially when the content is dense. Trouble concentrating, lack of storage and recall, having to re-read sentences to get the gist of what's being said (I often find myself confused when reading because my brain often reads each word on its own, not connecting them into a phrase or a thought). I also suffer from dyslexic tendencies, reading words out of order, reading words from the line above or below as part of the sentence, reading words as other words (eg. when you read 'discrete' as 'district,' things tend to get confusing). All this is complicated by some sort of hyper-somnolence when I read, often dozing off within the first two or three pages; I've often joked that when I want to read something, I might as well just lie down and have a nap, to get it out of the way. I'm not sure that the last two are related to ADHD, but I threw them in just for the sake of comprehensiveness.

For all intents and purposes, I'm convinced that I do not suffer co-morbid depression (despite being diagnosed with Dysthymic Disorder). I do get depressed, no question. I sometimes have trouble motivating myself to get up, get around and do the things that I need to do. I feel, however, that my depression is [i]situational[/i]. I get depressed when I think about the sad state of my life. I get depressed when I think about my weight problems. I get depressed when I realize I wasted yet another day/week/year in the throes of ADHD. My depression is not, however, pervasive, nor does it stand on its own. With the exception of my six weeks on Celexa, I haven't thought seriously about killing myself since I was a teen. I feel that I no more suffer clinical depression than I suffer Agoraphobia because I hate to go out because of my (rather extreme) weight issues.

I do suffer from self esteem issues. Self-recrimination, self-loathing, self-hate, self-deprecation, whatever you choose to call it, I've got it. My brother and I tend to feed off one another this way, I often joke that we've made self-deprecation an art form. We both have a lot of issues because of what ADHD has made us. I've spent most of my life feeling lazy, pathetic, worthless. My brother doesn't believe that he has ADHD, he still insists he's just lazy and if he wanted to get his life together badly enough, he could do it.

Medication wise, I've had differing success with various stimulant meds, experiencing my best returns with dexedrine and straight up (generic) methylphenidate. Concerta was worthless for me, Strattera made me extremely nauseous, and greatly intensified my somnolence issues. Strattera did calm me down, make me more patient and less likely to lose my temper, but it did nothing for my concentration/recall issues. I'm finding Adderall somewhat unhelpful as well. It makes me wonder if perhaps my weight issues are to blame. Maybe my metabolism is too slow to break down these meds that make the active ingredient only available after your body has acted on them. I don't know.

Hopefully this was what you were after, Bob, sorry it took so long to respond, but I knew it was going to be a darn big undertaking and I had to work up to it. ;)
Re: My ADHD type
Jul 25, 2009
[QUOTE=GreyAngel;4044006]I even went to a doctor . . . and he just said that it's all in my head.[/QUOTE]

Ah, I so hate that response. To anyone who says that now, my standard response has become: "You're right! It [I]IS[/I] all in my head! My brain is short on certain neurotransmitters which is the cause of the symptoms of ADHD!"

Think of it this way . . . your memory, concentration and impulsiveness issues are caused by a smaller supply of particular neurotransmitters (dopamine, norepinephrine and perhaps seratonin) than would be found in the brain of a 'normal' person. Medications for ADHD attempt to increase the supply of those neurotransmitters by either stimulating the release of those neurotransmitters or inhibiting their 'reuptake' or breakdown within the brain. Neurotransmitters are the chemical messengers that transport messages between the various synapses in the brain . . . with fewer messengers, fewer messages get through. There, now you're a victim of my classic oversimplification, but you also have a basic understanding of what the problem is.

Now, ask yourself, if you had diabetes, another disorder caused by a chemical shortage within the body, would the doctor be telling you that it's just your imagination, or that you need to simply will it away? Or would he treat you? My guess is that you'd leave with the information and/or medication you need to live with your disorder, but then, who knows.

Sorry for the tirade, but I'm so sick of the 'all in your head' argument. I'll try to address each of your questions as best I can. If I miss one or I'm not clear, cut me some slack, I've got ADHD. ;)

In regards to childhood memories, I'm lucky, I have many, many detailed memories about my childhood, and others come flooding back with little prodding despite the fact I'm nearly 10 years older than you are. Fortunately, your memory isn't your only resource. Talk to your mom about how you were as a child. Were you difficult? Were you lazy? Did she have to fight and prod and threaten to get you to do your homework? How was school for you? Were you a straight 'A' student, or did teachers accuse you of daydreaming and laziness? Were you disruptive in class? Old report cards, if you or your mom kept them can help in this regard. How was high school? Did you cut a lot of class? Were you sick a lot? Did you do your homework on your own, or did you need mom standing over you ready to smack you when you put the half finished homework aside and turned on the tv? Were you able to do papers and projects prior to the night before they were due, or did you need that "sheesh, it's due in 8 hours" adrenaline rush to get you working? What did your high school record look like, was it like mine, rife with dropped classes and failures despite having more than enough intelligence to excel "if only he'd apply himself?" You get the idea.

In regards to the dreams and the sleep issues, I don't know the connection between ADHD and sleep dreaming. I know that at various points in my life I have had very vivid dreams, and have often been able to realize I was dreaming without waking myself. There was a time that I could fly in my dreams, and would love realizing I was in a dream, because it meant I could fly. I currently don't have that ability, if you hear about how to make it happen, let me know, I'd love to go flying again . . . but, as I so often do, I digress.

Your friend is correct, ADHD very often presents with other issues, something they call comorbidity. Most often, ADHD is comorbid with depression, because living with undiagnosed ADHD tends to make people depressed, also my understanding of some of the causes of chemical depression are similar to ADHD. Other disorders include OCD, Tourette Syndrome, sleep disorders and many others.

This, unfortunately, is where your own education and understanding of ADHD and related disorders is very important. The understanding that ADHD is not 'outgrown' in adolescence is still relatively new, and the disorder in adults is [i]very[/i] poorly understood by many psychs and doctors. Many times I have seen people, myself included, seek an ADHD diagnosis and leave with a diagnosis of depression. Depression seems to be the catch all diagnosis for many doctors and psyches, and an incorrect diagnosis is not constructive and is possibly dangerous. Again, in my own case, taking Celexa for my diagnosed Dysthymic Disorder (chronic depression) drove me [i]into[/i] a depression that nearly ended in suicide. I didn't buy the depression diagnosis when it was presented, but deferred to the opinion of the psychologist that diagnosed me, after all, he [I]must[/I] know better than me, I mean he's a doctor. Right?

So, time for my standard warning. Take the time to read everything you can lay your hands on about ADHD. Know your symptoms and be prepared, (ideally, bring notes) because doctors [i]love[/i] to catch you flatfooted with questions about your symptoms. Do any tests as honestly as possible. Try as hard as you can in tests of your memory and processing abilities. Upon a diagnosis, [i]challenge[/i] anything that doesn't make sense! Make your doctor explain [i]how[/i] you fit the diagnosis, and how the proposed treatment is going to make your life better. If he comes up with depression and you don't feel you're depressive, challenge him on that. I know it can be intimidating, but it's [i]your[/i] quality of life that hangs in the balance, not your doctor's. I'm not saying diagnose yourself and go into the process without an open mind, but make sure you understand why the doctor has given you the diagnosis he or she chose, and how you fit that diagnosis.

As for meds, there are generally two classes of medication for ADHD, stimulants and non-stimulants.

Stimulant meds are by far the most common treatment for ADHD and have been in use for the longest time. These stimulants are all in the amphetamine family, and act on the brain by stimulating the release of the neurotransmitters that the ADHD brain is short of. It's important to note that while these meds are amphetamines, and thus carry all of the negative press and images that go along with their oft-abused cousins, proper use of these meds is safe. If abused or used improperly, they do pose and addiction risk, so it's important that if your psych does prescribe stimulant meds you follow their directions carefully (basically, keep the dose at the proper level, the 'if some is good, more is better' logic doesn't necessarily hold true here). Meds in this class go by names you have no doubt heard: Adderall, Ritalin, Dexedrine, Focalin, Concerta, Vyvanase and others.

Non-Stimulant meds are the newcomers to ADHD treatment and are often championed as better because they generally don't have the same risks of addiction. Off the top of my head, I can only think of two non-stimulant meds that are currently used for treatment of ADHD. The first of these is Wellbutrin (Bupropion), the second is Strattera.

Wellbutrin acts on the brain by blocking the reuptake of dopamine and norepinephrine, much in the way that Prozac blocks the reuptake of seratonin. Through this action, Wellbutrin increases the neurotransmitter supply through another means. Some people have great success with Wellbutrin, others do not. Because it's not a stimulant medication, Wellbutrin will not have the desired effect right away. Where the stimulant meds help manage your symptoms within the first hour or two after ingestion, you'll likely have to take Wellbutrin for upwards of a month before finding out whether or not it works for you.

Strattera is a norepinephrine reuptake inhibitor and thus increases the supply of this neurotransmitter only. I found it to be of questionable value, personally, but everyone reacts differently to different meds.

That last point is important. If you do find yourself treated with medication for ADHD, you and your doctor will have to take the time to try the different meds at varying doses to find out what works best for you. I can tell you that this can be a frustrating process, but ultimately finding the right med is the goal, because the right med can really make a difference in your life. 'The right med at the right dose' is a mantra you'll see repeated many times on this board and it is, quite simply, the right strategy.

All the meds have side effects, it will be up to you and your psych to evaluate the effects and side effects of each med to decide what's best. Most of us live with certain side effects because the pain of the side effects is less than the pain of unmedicated ADHD. Judging side effects is all part of finding the right med, though, take your time, do it right and you'll find your life will be a lot different.

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