Doctor Reluctant to Treat the Comorbidities

[Bibliophile]

Recently, I went to the psychiatrist to see about treating my two comorbid conditions as I felt they were decreasing my quality of life. I have experienced dysthymia and anxiety issues for years, with the latter of the two seeming to get worse as I age. My psychiatrist did not want to treat these and in many ways dismissed them once she discovered I had ADHD. She felt that these were indirectly generated by the ADHD, and we should treat the ADHD. I haven’t been able to tolerate Concerta. I feel that these coexist with the ADHD and are not being caused by it as they have been around for so long. I am aware that many physicians believe that years of failure and dissppointment due to the ADHD can cause the depression, but it just doesn’t seem likely to me, at least in my own case.

I was just wondering if others found that medical professionals were too quick to dismiss any accompanying conditions and only wanted to focus on the ADHD.

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[Anonymous]

Librarian_chef,

I sincerely hope that you take this in the context that I mean which is only to serve to help and assist and please know two things about me. First, that I am not one to criticize another openly and blatantly and second, I am not a doctor but do have a deep and intense zeal to help others like me because of the kindnesses shown and understanding that was so freely furnished.

As far as co-morbid conditions are concerned, my psychiatrist reviewed all the information on me and did determine that I indeed had co-morbid conditions as well. It was her conjecture that we ought to look at treating the ADHD first since the second issue may have been triggered by or is a compartmentalize component of ADHD. If not, we will then look at treating it as well once the ADHD is under control. So, we moved forward with the treatment and medication and coupled it with coaching. Things improved very, very quickly and many folks noticed it and I was praised for my new changes and my accomplishments since.

My co-morbid condition was memory or lack thereof; regardless how you slice it up, memory was lacking in a very significant manner and it needed to be addressed as well. Now, depression, lack-of-confidence or whatever name you want to slap on it – sorry to say this but – confidence only came after the medication and close workings with a coach to aid me in my circumstances. My confidence has soar up much more than I ever thought or considered possible. There have been many things that have sought to introduce into my daily living. Positive self affirmations – the one I use continually is – “Every day, in every way, I am getting better and better!” and the other one is “I am successful in whatever I do!”. For my memory issue, I have learned some great techniques to help me and indeed it has.

Overall, am I happy with the progress so far? Absolutely! I keep close notes on my past so that I always have a measure stick to compare my past with my present and that way, I am kept positive and moving forwards.

As I said before, I am not here to disrespect or offend and I sincerely hope that you understand what I was trying to convey here. I know that I have struggled with many things and confidence was one of them – it translated directly about how I spoke to myself and how I felt about me and my workings in the outer worlds – society.

Hope this sort of helps.

Distracted66

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[Bibliophile]

I am not offended at all. I am glad to hear that your confidence has improved. In my case, the anxiety issues are irrational. They are not linked to a fear of my own performance or self esteem issues, which I am sure would see an improvement with ADHD treatment. My dysthymia may certainly see an improvement for this reason.

I am not giving up on treating the ADHD, although I will have to try a different medication. I just felt that my doctor was focusing on only one aspect of the problem and not necessarily the worst of the three.

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[Anonymous]

Librarian_chef,

So glad you didn’t get offended… that is always a worry of mine.

I thought almost the identical thing when my psychiatrist looked the results over, she was concerned with my memory issues but she seemed more concerned with the ADHD because it appeared to be masking everything else. It was only after being treated for ADHD that she decided to look closer at the other issues.

Therefore, I am working with a coach on improving my memory because the Concerta seems to be doing what it needs to.

The approach surprised me but now looking at it, it makes sense. Getting one thing out of the way and then moving forward to deal with the others.

I would like to think and hope that you doctor would pay enough attention to your concerns to take action with the other issues rather then simply ignore them.

It might be advantageous to keep a log of the feelings and the self-talk and bring them to the doctor – something that I am sure that you are or have done already. If the doctor is worth their weight in salt, they will address your concerns readily; however, if the doctor is not, then I would say its time to shop around for another.

Sorry, that is just an opinion… not advice.

Distracted66

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[Anonymous]

Distracted66, memory issues have plagued me my entire life. I have self-esteem issues because of that, more than anything else. Forgetting people’s names, not recognizing them in varying contexts, many awkward moments. i use to think i might be the youngest person to experience Alzheimer’s, as I feared I was starting to get it in my 20’s. Anyway, just had to chime in. I have joined a support group and hope I can start getting a handle on this plight in my life..

Thanks for your thoughts.

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[Anonymous]

Just curious, the ‘memory’ problems did/does it apply equally to everything or just to certain things?

(Remember every lyric to ever song/forget to pick up stuff on the way home)

Are there things you see once and never forget and things you were just told but can’t remember?

Would you describe it as forgetting the details or not really getting them or caring about them in the first place?

Is there a difference between remembering something you need to do vs things you want to do?

(Bills/Playing hockey tonight)

My wife and I encounter this paradox too frequently and I’m trying to get a different point of view and some ideas to help us too.

Thanks again for you thoughts!

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[Anonymous]

In response to, “callmecrazy”, above:

Unfortunately, I forget things I want to remember (concerts/events, etc), too. All too often, if I don’t write it in my planner, RIGHTNOW, it’s gone. I miss out on lots of fun things this way.

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[Anonymous]

i’m really lucky (well, sort of) in that i presented with depression, and got my diagnosis after already being on a bunch of depression meds for absolutely yoinks, so my doctor is treating the two alongside each other and wisely isn’t messing too much with my antidepressants.

i’m not throwing that in to annoy you, but cos what stuck in my head, librarian_chef, was this: “I haven’t been able to tolerate Concerta”…. have you tried any other drugs for the ADHD? some of the antidepressants are used off-label for ADHD- maybe you could talk with your doctor about trying something like bupropion- which has been shown in studies to be effective for adult ADHD, but which is also commonly prescribed as an antidepressant…… sort of effectively killing two birds with one stone? if the outcome is positive, i think thats what matters deep down.

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[Bibliophile]

Thanks for the response, jeneticallymodified. I recently started Adderall XR and it is going well so far. Might have to up the dose a bit, but sideeffects are minimal, i.e. just a slight lightheadedness. Focus is better, but not where I want it to be yet. I spoke to my psychiatrist about going the SSRI route over the stimulant route, but she wanted to try stimulants first.

The anxiety issues are the worst for me. For example, I bought a shirt and tie yesterday and obsessed over whether I overspent, got decent quality, bought the right thing for hours afterwards, even after I accepted the purchase in my head as required. Not sure how they will treat that, but have to wait and see.

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[Anonymous]

she’s taking the recommended course of action by starting with stimulants- exasperating as it is, you can’t really fault her for that- she’s gotta keep us impulse control-deprived peeps doing things in a logical order, whether we like it or not. i don’t envy her that at all. try and be patient, hey?! i know it’s hard.

ah, overthinking, thats fun stuff. i used to be the queen of that!

have you had any CBT (cognitive behavioural therapy) training? its something you can do with a psychologist or life coach- really good stuff. while you might not be able to stop your brains wonderful predisposition to overthinking the crap out of everything, you can, with CBT, learn how to manage it hugely- how to recognise the pattern starting, nip it in the bud, and put your thinking back onto a more realistic and constructive level, plus learn to master that horrible sensory stuff that comes with anxiety, and perpetuates it (the whole flapping, heart pounding, head racing, thoughts churning, bit).

while meds *can* help to turn it down a notch in terms of helping you think a bit more clearly and leveling out your mood, they don’t really break habits or fix ingrained thinking and behaviour patterns- this is where CBT comes in super-handy. definately talk to someone about getting some- it’s the best thing i ever did…. and with your improved focus you’re in an awesome place mentally to give it your best!

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[Anonymous]

It has been a constant struggle with memory for me and my ADHD coach has been teaching many things and techniques in order to find one that works for me.

For me, verbal directions or anything that involves verbal whatever, is a struggle for me. I typically take notes of any sort.

One technique that I have learned is something that is related to visual clues. For example, when I was being introduced to at least eight people, I used various bodily aspects with a rhyme to connect the body part with their first name – Bubble-Butt Betty; Luscious-Lips LInda, etc (it was something that went on inside my head and no one – except for everyone reading this post – knew about).

I now do similar things when seeking to remember lists of things but that is more difficult a chore so I use my iPhone and the note pad or other such application to keep things straight.

My psychiatrist has told me me to use my ‘smart phone’ regardless what any of my supervisors say, think or do – this will aid you in meeting deadlines, attending appointments and so for – is what she extolled to me. So far, she has been dead on the money.

Somethings work expertly for us as ADHDer’s and others not so much.

It is our life long challenge to learn what things work for us t make us productive and effective. The employers we have must decide if it is the quality of our output that matters or the process in which we get there. Nine times out of ten, they will say its the output that matters or the it is the product that you produce – the process may not be the same as those without the gift of ADHD but we will find the way to have the same product if not something better at the end of it process.

Distracted66

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