Worried that stimulants will exacerbate my anxiety, but desperate for relief

[Anonymous]

I’ll hear something back on Thursday after my feedback appointment with the ADD psych. He found it interesting that the Ritalin helped with my sleep, but as I explained to him, my mom was diagnosed with narcolepsy and back then, Ritalin and Dexydrine were the meds of choice. Not sure how she knows she had ADD, but it definitely fits, and I guess it was aided by the meds.

My family doc is another story. So I need to let the psych know that he has to put in as much detail as possible in his report about it.

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[powcat]

Hey Sugargremlin!

You sound a lot like me. I thought I was the only one who spaced out on the toilet! In the shower, though,

I listen to music now – mostly to help me actually get in there (it’s too boring otherwise and I avoid it) but I think

it helps keep me on task, as well.

Generally, guys, music helps sometimes! I’m finding I need different kinds of audio stimulation depending on what I’m doing. I don’t have it quite figured out yet, but there are definitely some songs that instantly get me going in the morning, while others do nothing. So I am wanting to make some playlists for various times of day or something… My doctor says it has something to do with brain waves!

Actually, this is how I’m putting myself to bed now, too: I turn on a TV show online really quietly or I put on some talk radio and program it to turn off after a bit. I still struggle with that decision, but it’s a lot easier now usually.

I’ve got a lot of anxiety too, but the way that stimulants seem to work is actually the opposite of what we expect; they stimulate certain peripheral parts of our brain, allowing our main focus to rest on the task at hand. I’ve been on Concerta for about 5 months now; what I’m finding is that it is easier to shift my focus from one task to the next, that it’s easier to tell myself, “I don’t have time for that right now” or “it’s not important to do that right now” and avoid wasting time like that, that I am able to stay awake and keep going all day long! (Used to take a nap every day for an hour if at all possible.) I quit smoking (because I’m pretty sure I did it out of boredom, while walking or waiting), and instead of drinking 3-5 cups of coffee a day I’m now down to 1 or 2!

My anxiety is still pretty bad though sometimes. Getting enough sleep, and specifically at night, is so completely important – though it’s hard to remember that when I’m in the middle of some fun, meaningless activity at midnight. But I really find that my ADD is a lot worse when I haven’t slept enough – more spacey, more irritable. The last few weeks have been extra busy for me, and I literally found myself in the middle of the subway station a couple of times with my thoughts racing, just UNABLE to make a decision about the best route to take and which activity to tackle in which order. It was scary!

I know deep breathing helps a lot, but again it’s such a boring-seeming solution, that I haven’t gotten into this habit. But when I can remember that I can just sit for a minute, without doing ANYTHING and just focus on my breath and the way my body feels – without forcing myself to feel differently; just breathing into whatever pain or discomfort or anxiety I am feeling – it’s kind of great. Look up ‘mindfulness’ if you are not yet familiar.

I haven’t yet read the whole thread, so forgive me if I am giving any irrelevant information here.

One last thing; just my 2 cents: your job is probably awesome and a great opportunity, it sounds like, but maybe ask yourself if it is worth literally losing your sanity over. Are you not working in order to fulfill your life as a whole? Also, think about whether it might be appropriate to disclose ADD as your “challenge” to a superior, or if there is any kind of “disability” break you may catch. I work in a tiny tiny company – a store/gallery – and telling my boss, I think, ultimately saved me. I’ve been late way too many times and I’m pretty sure I would’ve been fired if I hadn’t told him about my diagnosis. He wouldn’t have given me the extra chances were it a different situation.

Good luck! Hang in there, you are awesome.

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[Anonymous]

KrazyKat- really sorry about the physical problems you have had. I by no means meant to say that your symptoms are not real . I obviously need to do more research on the topic. It is interesting that the two main treatments for RLS are Requip and Mirapex which are types of dopamine agonists. I am constantly perplexed and amazed by the different neurochemical mechanisms vs. physical and mental manifestations. There are multiple types of dopamine receptors, again more complexity. For example anticonvulsant medication can treat epilepsy, bipolar disorder, and chronic pain.. off label impulsive behavior, anxiety, and anger usages. Trying to master all of this stuff breaks my brain into more scattered pieces than it already has broken into!

No dopamine- my PCP gave me Methylin ER which is not a commonly used medication for once a day; he is not an expert and was tired of talking to me (for probably good reasons. I can be a bit infuriating at times). This medication only lasts about 5-6 hours which is really annoying. I have been using it BID so I am only taking it for work. Which is why I am currently sitting in my PJs at 3:30pm having done nothing all day >_<. I am going to try and get a long acting med like Concerta, Adderall XR, Focalin XR, or Vyvance. I hope it all goes well

Smftwo. I am a professional, but it is completely inappropriate for me to make professional suggestions on here. A lot depends on your type of anxiety and sleep issues. In ADHD, the neurochemicals of interest are norephinephrine and dopamine. Celexa deals with neither. However, anxiety, depression, and sleep deprivation can reduce one’s concentration ability. In some, dopamine can be anxiety and insomnia inducing. I think you should see a psych specialist. There are a lot of generic medications available for the issues you describe.

Powcat- omg! I am not the only weirdo on the toilet! If I don’t listen to music, I am 100% incapable of doing housework (not that I do it anyway >_<). I also need it to get ready in the morning. Good job on quitting smoking . Thanks for the encouragement. Years too late for my sanity; RIP Sanity. This career path has actually given me a strong drive and purpose which has kept me going and given me purpose for a long time. I would be very lost without it. The healthcare field is completely unforgiving. I’ll be seen as unfit to do my job. Since I probably have a borderline problem, I could treat it silently and pretend it doesn’t exist!

Alright peoples. It is nearly 4pm.. I have managed to avoid all emails and texts and am sort of demoralized that I have done nothing productive with the day >_<. Time to get moving!

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[Anonymous]

sugargremlin- if it helps any (!!), your posts (and, in fact, ALL of the posts!!) have been VERY helpful and productive!! so PLEASE reframe that last thought you had (that you had done “nothing productive with the day”) (smile). i TRULY appreciate these posts- this past week has been a WHIRLWIND of activity in my brain (amidst a TORNADO of thoughts already . . .) i believe the psychiarist i’m seeing is a specialist (he’s the one “pegged” me) . . . and he suggested several websites to investigate, “totally add” being one of them, prior to our next meeting on 6/30. i actually am a psych nurse by trade (13 yrs inpatient mental health- with a recent transition- resulting in change of insurance- and subsequently providers) and can appreciate/respect your boundaries (regarding providing professional recommendations) . . . but i will take the information (that would be the information i can absorb) to my psychiatrist at the end of the month. (fyi as an aside- i have been “considering” the np route for several and numerous years now . . . and am just this past week recognizing some of the reasons i’ve been . . . “procrastinating” . . . ) this has really been an eye opening week (and am embarassed to say- as a “mental health professional”- that i never even CONSIDERED this diagnosis for myself) (and didn’t even RECOGNIZE the test when it was given to me last week- other than to LAUGH and say “OH MY GOD WHAT IS THIS TEST THIS IS TOTALLY ME!!!”) have a great day, and thank you. (and please KNOW that time spent in support IS PRODUCTIVEA!!) (SMILE)

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[Anonymous]

SG – No worries. I know where you were coming from. I was one of those people who thought ADHD was a wishy washy thing at best, and that it was an excuse for poor parenting. I saw a study that showed ADHD diagnosis was more prevalent in the low socioeconomic classes and I wondered why….and came to a rather naive conclusion at the time. Looking back, that group would probably be diagnosed more frequently because (a) that’s where ADHD tends to lead a person because of poor learning and job retention, (b) they have fewer resources to help them cope and therefore are more likely to seek help, and (c) poorer parenting and teaching skills (due to less ongoing learning, more substance abuse issues, higher stress, fewer resources etc), and the stresses of being in a low socioeconomic group would cause more overt symptoms that would lead to a diagnosis. We cannot all be instant experts, and it’s not until we become acquainted with a disorder more closely that we start to look at our beliefs about that disorder. I slowly began to believe in ADHD when I was re-reading one of my nursing texts looking for answers to explain why my son was so obviously bright but not able to live up to his potential. But even then, I did not understand the disorder more fully until it was raised as a strong possibility for my son and I raced off to research it. I certainly don’t hold anything against you. You cannot be an expert in everything, and you have plenty on your own plate without having to understand all of my self-diagnosed disorders on top of it all I said what I did mostly to vent, rather than make you feel awful. And writing things down here has helped me clarify some of my issues also. I would never have thought to seek treatment for RLS prior to seeing a psych if I hadn’t began posting about the RLS in the first place!

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[Anonymous]

smftwo. THANK YOU! I appreciate your comment so much. I don’t know if this site has message capabilities. I’m actually a new grad psych NP. I was mostly trained by one who doesn’t believe in adult ADHD and the course really glossed over it! Surprise surprise that I’m seeing people with ADHD and I’ve been horrified at my knowledge gaps. I’ve been putting in a fair amount of time with self-study into this and… well.. related to it..too much. I also discovered that before all of this research I had had a lot of trouble spotting a ADHDer because I follow along so easily!!!! They will go from topic to topic and my brain naturally tags along without notice!

I also have a RN psych IP background . love it love it!

I have only had this NP job for a month and a half so it has been quite a journey. I got through NP coursework with no problem except for expense (tuition plus the lack of income of not working). I have no clue how people did this working full time with families! I spent ALL my time (but perhaps that is due to another problem……).

Anyway, I want this to work so badly. I loved being a RN, but I am humbled by the power of the NP to make even grander impacts.

and you know.. it is so different being a patient vs the provider. We cannot look at ourselves objectively which is why doctors need doctors!

KrazyKat, I chase knowledge wherever I find opportunities. RLS is now on the list .

ok time to sign out and salvage whatever sleep I can get after yet another computer trance! Hoping for a 7 hr day in which i don’t stay past the cleaning crew and have to mess with the alarm!

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[Anonymous]

Forgive me for posting something unrelated … but your help is needed

I am doing a research paper on attention deficit disorder (ADD). The core purpose of this research paper is to present information and data from a whole different perspective: a positive one. This research paper is dedicated to those who have ADD and are constantly being put down by researches that focus primarily on what they lack rather than what they have.

If you have attention deficit disorder (ADD), kindly fill out the survey

http://www.surveymonkey.com/s/YPGLKJJ

Sincerely,

D.S.

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