At a Loss

[Anonymous]

Recently diagnosed (over a year ago) as textbook inattentive ADHD. It’s something I and many others knew or suspected throughout my life, but I was always in denial of or had a dismissive attitude (i.e. “it’s not a disorder/I’m perfectly fine, everyone else are a bunch of damn robots.”) I’ve struggled all through school, college and every job I’ve ever had just to barely keep pace with everyone else, never mind achieving something I can call my own. I have a million brilliant ideas/projects that are about 1% complete because I get bored immediately, etc. all that, now I’m in my 30’s and ready to take control.

So I started down the road of finding treatment. I read a bunch of books, went to CHADD meetings, etc. My doctor tried Adderall XR first. Of course the first hour was an epiphany. I finally understood for the first time in my life what it felt like to be focused. All of my goals for the day, week, and the rest of my life seemed to magically line up before me in easily digestible fashion instead of poking at me all at once from 100 different directions. I had my hands on the knob and could tune out whatever I wanted and stay on one channel for hours. I finally understood how everyone around me could sit still and sustain attention on a task for hours. They weren’t robots after all, they were just wired in a way that put the remote control in their hands.

Unfortunately the side effects started kicking in later in the day: Feeling overheated, flushed; the muscles in my face, head and neck got really tense – this progressed down my back to my lower back until by the end of the day I felt like a pretzel, like someone was holding a live wire to the base of my skull and electrocuting me. By bedtime the tension was wearing off but I was left with a lot of twitching in my face and other areas for a couple days as well as diarrhea.

We tried various dosages and timings of both normal and XR but the side effects were always the same.

Next we tried Ritalin but it had no effect whatsoever besides mild headaches. Concerta, same thing.

My doctor was puzzled and referred me to a psychiatrist. She started me on Vyvanse which was very similar to the Adderall but slightly milder. I didn’t have the focus and awareness Adderall provided but did not experience restlessness and had no problem sticking with long or mundane tasks. However, end of the day, still getting electrocuted in exactly the same way.

Tried Strattera, didn’t do much of anything beyond making me feel weird and slightly dizzy.

Dexedrine, similar to Vyvanse – not much gain in focus/awareness, but loss of restlessness and easy staying on one channel for a while, still getting electrocuted at the end of the day. This one really makes me tight in the chest for days afterward. We tried combining it with Lexapro and it seemed to help a little bit but not much. Anyway, the Lexapro goes right through me and I end up on the toilet most of the day.

So here I am today, having tried a decent gamut of meds, dosages, and timings. The ones that work the best seem to electrocute me later in the day. It’s pretty intense and I can’t bear it. What I’ve been doing is when I start falling behind at work I’ll take one Dex or Vyvanse or Adderall, (depending on how much work there is to do) catch up a bit, suffer the side effects that evening, then kind of ride the momentum and positive attitude of having knocked out a productive day for the next few days (not nearly as focused or productive, but still better than normal) until I’m falling behind and totally lost again a week or two later, then I’ll do it all over again. Taking one for 2, 3 or 4 days in a row just wrecks me. I feel like I’m going to explode or something.

My psychiatrist is baffled but hypothesizes that I may have built up too much anxiety after 30 years of clinging on by my fingernails resulting in this sensitive reaction and is ready to refer me to someone else who may have insight. Just knowing everything I’ve learned in the last year helps a lot, but I’m at a loss as to how to proceed at this point. I can’t continue with this weekly roller coaster of clarity followed by electrocution followed by the fog rolling back in, but I’m also in a bit of hot water at work as it becomes more and more obvious to yet another employer that I’m not very productive. I hate making excuses and I tried explaining my predicament but the boss wasn’t very understanding (basically said “The quality of your work is great. The quantity is a problem. I have 2 alcoholics in my family so I know all about people that allow things to control them instead of the other way around. Fix it or we’ll have to talk about pay cuts or probation.”)

Anyone experience similar symptoms? Is it even safe for me to be doing this?

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[Patte Rosebank]

Sounds like you’re sort of self-medicating, taking a pill here and there from your collection. And that’s never a good idea.

ADD often has comorbidities of anxiety, depression and bipolar. Maybe the solution is to treat your anxiety as well as treating your ADD. This must be discussed with your psychiatrist, and investigated further. If you already have anxiety, stimulant medication will make it worse. You may need to add a medication to control the anxiety. Perhaps just a very small dose of it, but that small dose may make all the difference.

I was diagnosed first with depression, later with bipolar 2 (a milder form of bipolar). Then I was recently diagnosed with ADHD. It would appear that the depression and bipolar 2 are symptoms of my trying to function with ADHD. I’m now on Ritalin, and weaning off Effexor XR (which I’d taken for 12 years to treat my depression), but still staying on a small dose of Seroquel (which I’ve been on for about 3 years, after a hypomanic episode of racing thoughts). The Seroquel helps slow down the racing thoughts at night, so I can drift off to sleep.

If you have a formal diagnosis of anxiety or depression or bipolar, then those are considered disabilities under the law, and your employer must make adjustments to your work situation to enable you to function. ADD and ADHD may or may not be considered disabilities under the law where you live. Although you have explained your situation verbally to your boss, you will require a formal letter from your psychiatrist, explaining the nature of your disability and stating that you will need certain adjustments. If your employer has been informed of your disability, then any punitive action such as pay cuts or probation, are in violation of the laws protecting those with disabilities.

Clearly, your boss regards your illness as similar to alcoholism. He thinks that you’re weak, and allowing “things to control you”, instead of just taking charge and overcoming your problem. This makes as much sense as telling someone in a wheelchair to just stop being weak, and stand up and walk. If your boss feels this way, you need to talk to Human Resources as soon as possible, and explain the situation. They should have more knowledge and experience with disabilities and the laws protecting people who have them, from such discrimination as your boss is showing you.

I had a boss like that. He treated me like a weak person instead of a person with a genuine medical condition. His persecution of me culminated in his writing a false quarterly review, which he used to justify immediately terminating my employment and frog-marching me out of the building. I filed a complaint with the Human Rights Commission. It dragged out for three years, before finally being settled. I received ten times more money than the company had originally offered me. Unfortunately, it all went to pay off the bills I’d racked up for counselling and medications. Still, I’d fought for my rights, and I’d won.

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