ADD, medical school and hitting the wall.

[Anonymous]

Phew, feels cathartic writing this down for everyone to read and comment. It’s nice to know that I’m in the good company of ADD professionals, doctors and others coping with or thriving with this disorder.

I’ll start with a brief history of myself. I’m an only child and grew up in a loving and supportive family. I was always a “hyper” kid, and really only had a few close friends my entire life…didn’t ever really have too many non-close friends. I made three VERY close friends in highschool and they’re still my best friends even though 2 live fairly far away. I was diagnosed with ADHD in grade 6-7 and was put on Ritalin for some time…it had that zombie effect and therefore didn’t last long. I graduated and went to university…I used ritalin when I needed to study, which was usually the night or two before an exam. I did well, mostly As and Bs, and graduated wtih distinction. Through all of this I had a girlfriend for 8 years… I got a great job here in BC with the government and travelled around BC with work saving up for medical school. I had no concerns…a good life at this point. I was able to save a lot of money, and was happy. I got into medical school in 2007, about 6 months after I finally broke up with my long-term girlfriend. I had no concerns with the end of the relationship as I’d wanted it for a long time (years). Ok so the point of all this is that things started to go downhill here…I had to move away from Victoria for 4 months at the start of school and live on UBC’s campus in Vancouver during the start of the first semester. I found that I had a bit of a problem integrating into the new social group…but I managed to have a few friends and also kept to myself a lot…watched movies and stuff. I still took ritalin SR 20mg to study when I had an exam, I still was fortunate enough to do well.

I moved back to Victoria after this and into a house that some friends let me rent while they were away. First time other than the months in Vancouver not living at home with my parents. This house is large, and just holds me and a cat. Things were ok, but I began to miss having a girlfriend, and really focused on that a lot. I was able to stay somewhat social, and was always busy with school which helped. I noticed though that I didn’t maintain relationships well…never have…most people would call me…and as a result sometimes I’d sit at home alone….feeling alone and lonely when I simply could have called some friends up. I dated a number of girls over the time I’ve been in med school, but never felt like any of them were right for me. I wanted a real spark. So after my clinical years I had a period of downtime and classes again…back to the 30 of us here on the island in class together. That’s when the wheels came off I guess. I felt totally intimidated with the whole group…like they were all so social…like I had nothing to say…no conversational skills…I even convinced myself that I didn’t like any of them…but I know that was just a defense mechanism. I have one VERY close friend in class and I convinced myself that she was burned out by me and had had enough. I wasn’t in a good place. I began spending time at my parents…and with them more than with anyone else…or alone. The worst thing I noticed was that I couldn’t relax…when I used to watch a movie or read or do a crossword by myself…I now found I couldn’t relax…felt jittery. Even when I was with friends or family. I’m always comparing myself to others too, thinking how functional and social they are. On top of this I consistantly worry about what other people think about me, even when I’m alone…I feel like I’m always evaluating what I’m doing as if I’m someone else. I DON’T want to care what others think, nor compare myself to others. I want to be INDEPENDENT.

I recently, during this downward slide…finally met a girl that I KNOW is right for me. She’s the best person I’ve ever met, and we had a very epic and movie-like whirlwind relationship. Then she’s had to go away for 7 months to do volunteer work and travelling in Asia. We’re still in daily contact, head over heels, and I’m scared that if I don’t get a hold of this I’ll lose everything, but most of all her. Oddly enough, during our whirlwind I was fine…perhaps distracted? Maybe it was because I was never alone…I hate being alone.

So I went to see a psychiatrist at the university and was trialled on Vyvanse 30mg…after a week at that dose he had me followup and noticed that I seemed depressed at that appointment. He said to try upping the dose to 45mg for 2 days then to 60 for 2. He also gave me 2 weeks worth of escitalopram tablets (Cipralex) and told me to stop the Vyvanse and start that if I didn’t think 60mg was making a difference. Today is day 2 of Cipralex. Yes, I do realize that he had me bouncing around the doses too quickly, but I want to respect his training and expertise. I should mention that I also tried Concerta 6mos ago, with similar zombie effects as Ritalin (yes I know they’re the same drug essentially).

Summary….ADHD….hyper as a kid…fine w/o meds except to study…then recent symptoms of anxiety and depression..and tired of not being able to plan, organize and focus…oh and although I have everything a guy could want, just finishing med school, great family, a few close friens that are amazing, a wonderful girlfriend…I feel daunted and scared and hopeless that there is no help…perhaps this comes down to my low social/self esteem?

I guess my question is for the docs and experts here…what advice can you give me at this point? How can I get rid of this feeling of not relaxing? How can I be like this with so much good in my life? How can I overcome it? What’s worked for yourselves…or your patients in similar circumstances?

Thank you, sorry for the long-winded account.

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