Difficulty getting used to two different states of mind

[Anonymous]

I tried stimulant medication for the first time on thursday. I don’t have a formal ADHD diagnosis, but I have been desperate to try this because my job as a nurse practitioner is at risk. I am spending 11 hour days to finish up 6 hour shifts. I’m doing good work, but my productivity is lagging. I need to get my shifts to 8, or my future is unknown. I was desperate and I do meet the criteria for inattentive ADHD and have had problems since childhood. I am a high achiever, but I compensate by throwing large amounts of time into everything and have grown accustomed to my reputation as always been spaced out and lost lol. I am spaced out and lost unless I made focused efforts and I certainly do not like to do so on my recreation time.

I am an extremely anxious person. I have GAD so I was terrified that I was going to get agitated and have anxiety attacks on this medicine. So far, no anxiety just an elevated heart rate (which is a little irritating). The PCP I went to did not want to give me this medication. I rejected Strattera because I wanted something fast and very effective. He was uncomfortable so I grabbed the first thing he offered before he refused (Methylin ER). This is not really long acting enough for me. My brain is very confused to feel sharp and focused, then go back to ‘normal’. I also have bipolar disorder (I am mood stable right now, so I have ruled out inattentive symptoms related to bipolar mood shifts). This irregularity in brain function is sort of sending me for a loop and I am concerned.

Anyone relate to feeling confused by different brain states during the day? I’m going to ask for Concerta or Vyvanse next time hoping that longer acting will help me. I do not have enough medication to dose myself BID with the Methylin. I’m also not used to seeing the world differently. Is this something that I will get used to? Does it change who you are? I feel like I am acting differently.

On the bright side, I shaved an entire hour off my workday due to efficiency (and in a relaxed manner too) the very second day I took this. I am confident that I can do those 8 hour shifts once I get adjusted to the meds. I am just worried about my mood stability concerning the brain state going back and forth.

any wisdom?

thank you!

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[Anonymous]

I did a trial for 3 weeks of my husband’s Ritalin, then stopped. I’m in the final phases of ADHD assessment, just waiting for the feedback appointment. I decided it wasn’t worth messing around with meds until I had a proper diagnosis, even though I’m pretty frustrated too.

Dr J here also cautioned me on taking someone else’s meds (it’s illegal) and I was most certainly concerned about the stimulant causing problems with any comordities that I might be unaware of.

Did your GP prescribe the meds? Does he or her have any experience with adult ADHD? Mine doesn’t, and won’t prescribe anything without a formal diagnosis and a treatment plan from the ADHD psychiatrist.

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[Anonymous]

Honestly, I kind of pressured him into giving it to me. He is a GP with a lot of experience. However, I knew he felt uncomfortable with this. I asked him for 30 days and promised to then take the issue to my psych. This was not the best thing to do, but I’m really worried about the job. If I can move up to the 8s, I’ll be job secure plus get a good 90 day review. People there seem to like my work (the productivity I can manage). Another urgency is me driving. I’m terrified to get into another car accident (I was in a wheelchair for 2 months and had to move back in with my parents after running a red due to lagging attention) and I would feel so much better driving if I trusted myself to pay attention on the road.

Your GP is probably right in his/her approach. It is certainly nothing to play around with. and in my GPs shoes, I would not have appreciated how I approached this.

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[Anonymous]

You are lucky in some ways that a GP can prescribe you ADHD drugs. Here we have to go to a psychiatrist, as they are the only ones allowed to prescribe meds for adult ADHD. I think I have an expensive future ahead of me, with the cost of the drugs I would like to try (I am willing to give almost anything a go at the moment), and the cost of seeing a psychiatrist everytime I need a refill or to try something different.

Your post has certainly given me food for thought. I work a 10 hour night shift, three times a week, so medicating could make for a challenging exercise! I’d hate to have to deal with the change in brain function that you describe, smack bang in the middle of a shift!! Nasty!!

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[Anonymous]

My husband was not officially diagnosed, he self-diagnosed, and his physician was comfortable in prescribing Ritalin. Mine freaked when I told her I was taking it, she said it’s addictive, and that it makes EVERYONE feel and work better (wrong on both counts according to the ADHD psychiatrist I’m seeing for assessment).

The ADHD psychiatrist says that Ritalin is the Model T of ADHD drugs, there are better versions of it nowadays. So my doc was partly right, that it wouldn’t be Ritalin but it might be something else she’d prescribe. But it would only be on the recommendation of the ADHD psych.

I totally get the fear of not performing well on the job. I went through a few jobs because of this, luckily always had a supportive husband to fall back on. Now I am self-employed, so I can deal with the wait, although I was really frustrated with it once I came off the Ritalin, it was like knowing what “normal” felt like, and I really wanted to stay on it. I see him for the final feedback appointment in a week or so, hoping for a positive outcome. It’s hard toughing it out.

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[Anonymous]

KrazyKat, are you in the US? Many psych providers will see clients every 3 months (if stable) and just write out three written scripts for one month each. Some will even go longer and just have the client come to the office to pick up scripts. I probably have not met one who demands monthly visits. I did meet one who did not believe in adult ADHD >_<. (I work in the field). I am also willing to invest more money into some quality long-acting medication. All the hours in life I will recapture (priceless) and money I will make (working more hours) will be worth it.

no_dopamine, my parents are self-employed. My dad lets his OCD run freely and my mom has the freedom to spend days to do hours of work. It makes them happy, but it is not enough for me. I completely understand if you crave to get more done in life than the absolute minimum! Hope it goes well Your doc apparently missed the large body of research that concluded that people with treated ADHD are less likely to abuse substances!

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[Anonymous]

I am in Australia. I suppose that most specialists would only see a patient infrequently, but I wonder about the issue of getting the right drug and dosage sorted out in the first place. I don’t know how our prescribing laws for ADHD drugs work with regard to repeat prescriptions. I guess I’ll find out – if I ever make my stupid appointment

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[Anonymous]

sugargremlin, I know that docs don’t spend enough time on the specialty subjects. When I went for a sleep study in 1992, my mom’s doc told me he had studied sleep disorders for all of 10 minutes in medical school. So if someone missed that day or was asleep in class …… it tells you how important these disorders really are to them. Easier to cut, burn and poison than treat something that is “in your head”.

I saw my physician today and we’re going to do another sleep study as I’m having trouble sleeping. I have to remember to tell her, when all the reports are in, that Ritalin actually HELPED my sleep. She now wants to wait for the ADHD psychiatrist’s report (about end of June) and the sleep clinic’s report. My husband has a sleep study booked this Friday so I will be able to find out how long it takes for the report to be generated.

This is actually an expedited process since I got into the ADHD psych’s office through several cancellations …. but it is exceedingly frustrating. My doc won’t prescribe anything for the sleep problems in case it’s sleep apnea, and she won’t prescribe anything for ADHD without an official diagnosis because the meds are “addictive” and “they help everyone”. ARGHHHHHHHH!!!!! 👿

KrazyKat – go make the appointment. It is so frustrating to wait the process out, but at least you feel you’re on the right track.

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[Anonymous]

I’m in the medical field and all that I don’t know infuriates me on a daily basis! Providers just need to be accountable to what they do not know and find a way to deliver proper care (research, consulting, referring).

I can feel your frustration with all the waiting! When you are dealing with issues that affect you on a daily basis, time measured in months is a very very long time. I try my best to expedite things for people as long as they understand the risks of using less caution.

ADHD + waiting= torture. ugh that kind of waiting burns a hole in my brain.

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[Anonymous]

No_Dop – I am ready to throw the phone through the window over this stupid appointment. First psych I tried is not taking any new patients. Not surprising, as his name was recommended AND appeared on both ADHD associations (of our state) list of providers. The next was disconnected, and a google search showed he had recently retired. The next number put me through to a fax machine. Maybe it’s out of their work hours and automatically go to fax when there is no secretary there. Might try at a different time of day. Only one more left on my list after that. I hate making appointments and procrastinate over it something shocking, but I hate waiting for them too, as I get impatient. Go figure!!

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[Anonymous]

Will I ever cut a break?!! I finally overcame my nerves enough to try again for an appointment, but I have to wait until September!!! Man, I will have stressed myself off the planet by then, with all the waiting I have to do. Betcha I put off getting the GP’s referral until the last minute. I know I shouldn’t, cos maybe she might be of help in the meantime, even though she can’t prescribe anything specifically for ADHD. I might be able to try a non-stimulant. Time to do some more research (pretty much how my days have been spent since the psychologist suggested getting my son tested for ADHD). I am so tired and sick of myself that I could cry. Sorting my son’s stuff out has me stressed enough as I have to fill in forms (a trip to the doctor for that) and jump through all sorts of hoops to get some sort of accomodations for him at school. It’s all too hard. Ugh!!! Sorry, I’ve had very little sleep today so I’m a touch emotional

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[Anonymous]

*hugs*

I can definitely relate to your frustration. I’m an anxious emotional person >_<.

1) one step at a time. seriously what is the very next thing you need to do? not everything you need to do, just one. Thinking about everything at the same time is going to overheat your brain (takes one overcooked brain to know another!). Would it help to write them down and check them off one by one so you don’t have to juggle it in your head? Sometimes lists help me, sometimes they overwhelm it. depends

2) you have lived how much of your life med-free? nothing bad will happen to you. I understand that more of the same is not what you are going for right now. It is infuriatingly annoying, but not dangerous and will be ok.

*hugs*

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[Anonymous]

*Big deep breath* what a week!! Am glad the weekend is here. I did some searching on our dept of education website and found a form that didn’t have to be signed by a doctor, just a treating professional, so I filled it out, took it to the psychologist to sign (she just signed it and said she trusted me to have filled it out thoroughly – one big sigh of relief) and dropped it off at the school. Had a good chat with the lady in Student Services (part of the school) that deals with such stuff and felt much better. Went home and emailed some more info to her to include in my son’s case file. All his teachers will now be emailed to inform them of the diagnosis and to let them know the info is there for them to look at when they are able (they are all expected to do this ASAP). Got home from picking my daughter up to find I had an email from one of my son’s teachers to say he had failed his last assignment and had one currently overdue, so would I please supervise him and ensure he completes it over the weekend!!! There went my good mood in the space of a minute! I emailed her back to say I would try to do so and also let her know about the events of the last couple of weeks, and took so long we ended up in a huge rush to leave for the kids’ circus class. Got there and got out my laptop, only to find I couldn’t use the internet as my son had borrowed my internet thingy! Aaarrrgghhh!!! So I sat there in the freezing building twiddling my thumbs (and generally jiggling and pacing) for two hours. Told my son he was banned from attending a friend’s party if he didn’t do any homework today.

So….got up this morning and relaxed for a bit, then found my son on the computer mixing music instead of doing homework!! Ended up in a screaming match with him (I understand how he functions, but I am as bad as he is when it comes to losing my temper). Then he got all upset over school and his frustrations with many things (not knowing what he wants to do as a job, not being able to read well, not doing well on an assignment he worked hard on). Ugh! Finally got him calmed down and we selected a book for his book review (the assignment that is late) and I spent two hours reading aloud, with both my kids riveted by the book. Phew!! Have much more to read, but at least they are both enjoying it and he will have a book fresh in his mind for his review. We have a public holiday on Monday, so I will sit with him and help him structure his review then. So much for a relaxing weekend lol

As for me, I have accepted that I will have to wait. For now. I am sure I will have days like the last few where I felt constantly on the verge of tears due to the feeling that my world was out of control. But I have dealt with them before and will continue to do so in the future. I think what is getting to me the most is that I am trying to deal with my son’s issues but am facing the same ones myself. The stress of dealing with his stuff has had a big impact on my functioning, right when I need to be at my best in order to help him. On a better note, I got in touch with an “educational consultant” (a tutor basically) who has ADHD herself and has regular study groups set up for kids like my son. Just the thought of being able to offload some of the load onto her is a huge relief. Halfway through chatting with her, I completely lost my train of thought when something distracted me. How ironic!!

Oh well, better go, gotta go out soon.

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[Anonymous]

Despite your brain chaos, it sounds like you are doing all the right things for your son. Kudos to you for that.

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[Author]

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