Re: ADHD and FATIGUE

[Saffron]

Fernando, I’ve been thinking about your post all week, but haven’t had an opportunity to respond until now. I wanted to let you know that the kind of intermittent, debilitating fatigue you describe has been a huge problem for me as long as I can remember. I could never understand why I couldn’t seem to get hold of my energies, or why other people didn’t seem to have this issue.

In other words, I believe I know, viscerally, what you’re referring to. I also want you to know that the meds I take for my ADHD (first Wellbutrin and then Concerta) have helped *enormously* with this problem, and that I now know what it’s like to have a fairly constant and predictable energy level throughout the day. There is HOPE, my friend. Things are going to get easier for you, okay?

Tell me, do you also find it nearly impossible to carry out “time-managed” tasks and activities that you planned out ahead of time (because when that time slot arrives, it’s always your energy level that decides whether or not you can follow through)? Does this happen even when what was planned was an activity that is normally pleasurable or that you thought you were looking forward to?

That’s been my story. Then I started noticing the same problem in my little boy, who has just been diagnosed with ADHD “in the clinically severe range.” The frequency and intensity of my son’s physical and emotional ups and downs, almost from day one, were stunning! At first I thought he was showing early signs of bipolar disorder, but other signs (like the length of his worst “downs”) just didn’t check out. He simply has a cup that runs dry way, way faster and sooner than that of other children.

I started to take note of the things that he does to stim, and the things that seem to work to “wake up” his brain and re-energize him physically (playing his favorite music and dancing with him, filling his self-esteem cup with praise and attention, making a game of the task, or asking outsiders like a neighbour he likes to join in).

I observed that he seemed to need more rest than the average kid. Although nutrition certainly didn’t account for the enormity of the problem, he apparently needs more protein to keep his body fuelled than the average kid too. He asks for snacks whenever he’s engaged in a cognitive task and craves carbs between meals to the point of tantruming if you can’t come up with one. (I caught on to this one early, because I myself had always functioned a bit better if I “grazed” all day. Big meals with big spaces in between were a recipe for particularly disastrous energy levels, and I kept quick pick-up sweets with me just to get through my school days and, later on, my work days.)

I noted that my son gets mentally and physically drained much, much faster when applying himself to a cognitive task. I can almost see his brain shut off. And generally, within moments of that shut-off point, he’s also lolling on the floor complaining that his legs and arms don’t work properly anymore. At the end of day, when he’s running dry overall, he’ll *only* put his pajamas on if he doesn’t have to climb the stairs to get to them—and is willing to take whatever consequences that noncompliance brings him! I walk with him upstairs now and tickle his back. So I’ve learned a lot from my son. Clearly he will need meds too.

When I’m not relying on my meds (usually because I’ve forgotten to take them before the “threshhold” time), I know now that there are certain things that will help me stim (e.g., listening to upbeat music sometimes helps, and for some reason making contact with other people who are lively and funny nearly always helps!) And when my brain wakes up and especially if I’ve had some little boost to my self-esteem, I get a jolt of physical energy. It’s the damndest thing. Might be short-lived, but hey, if it gets me to the next part of the day…

A last word about energy and dopamine levels (subject to Dr. J’s greater wisdom of course). I personally have to watch out for iron deficiency and vitamin D deficiency, both of which I understand make it harder to produce dopamine as well as serotonin. So do make sure you have those two areas covered. You might also want to have your TSH checked at your next physical exam (along with iron and vit D), to make sure everything that needs to work properly is doing so and you can get the best results if and when you try meds.

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