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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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