[Chica]

Hi Breeze,

Yes it has affected my energy levels in a very good way. I used to sleep long hours all night, then fall asleep or feel really exhausted periodically during the day unless I was around fun people, or busy with something engaging, or driving a bit too fast – you get the picture.

All that time I was undiagnosed I was sleeping way too much. I had great difficulty falling asleep at a sensible time – 10pm seemed like the only time of day I was sure to be energised and organised. At first, the Ritalin pepped me up so I wasn’t falling asleep, and I felt more together as I tried to shop, or pack for a trip – this sounds a bit like what you are getting now.

After a while, as I experimented with dose and timing of meals, or when to get up or go to bed, I started feeling tired and strained. If I had one big day where I tried too much it left me exhausted for three days after, so I would fall asleep even though I was medicated. This was upsetting because I didn’t know the situation would improve.

It is the food and sleep I get alongside Concerta that make a difference long term. As Robbo & many others suggest, I eat 3 meals a day with protein in each, and go to bed on time. I try and be sensible with healthy carbs, I mostly avoid caffeine and alcohol. Sounds boring I know, and I’m not perfect with this, but this is the bare minimum of what I must do for the Concerta to work effortlessly for me. Now my meds give me a normal day, I can’t really feel them, but the days I forget meds are just frazzled and confusing.

I think the subtle quality of my energy has improved gradually over the whole 16 months. I feel as though I am catching up on a lifetime of poor sleep and invisible stress. I’m glad I didn’t give up on the meds last summer when I couldn’t tell which problem caused what outcome. It took patience at the time.

I now know exactly what overmedicated and undermedicated look like in ME because I took notes as I adjusted doses. I can see from those notes that sleep and sensible eating were OK at the time, so the problems were mostly about the dose. Now if I feel under or over medicated it is always linked to poor sleep or not enough good food for how active I have been. I am really sensitive with these two issues, and I really hate that, but I can see I am less sensitive than I was a year ago – my energy and appetite is more stable long term.

I think the more consistent you are in your habits and meds, the more consistent the meds let you be. It’s kind of a two way street. I hope you find all this reassuring.

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[Chica]

I started on Ritalin 5mg 3 times a day for 2 weeks, then ramped up to 10mg a day for another 3 weeks before moving over to 36mg Concerta. I felt a little strained on the first day, slightly jittery but not efficient like you are describing! Second day I woke tired, but took my 5mg on time – 40 mins later I lay down for a nap and woke two hours later feeling completely refreshed from sleep for the first time I could remember. That was a revelation. It made me feel like the meds help me to do just the one thing I am actually doing rather than feeling confused and scattered.

I really think if you go too fast trying to modify which meds and which dose and all the possibilities, it gets confusing. I wrote notes about my impressions at different doses, partly because I know I forget myself and partly because I was worried about taking meds and getting stuck on them.

I have inattentive type ADD too, and we often don’t need particularly high doses. (See Adele Diamond for comparison between ADD & ADHD.) I think you will feel more confident starting low and going slow with each possible adjustment. WRITE NOTES ON YOUR TREATMENT!

We are all different, but the way I feel on 36mg Concerta now after more than a year is different than it was at the start. I like that I can rely on my own energy and attention. I always eat a protein rich breakfast with my meds because I found it really evens out the way I feel physically; before I worked this out I could feel over focussed and strained. I don’t feel hooked, if anything I have a problem forgetting to take my meds and wasting a day cos I only noticed I forgot when I find myself walking in circles and feeling overwhelmed.

 

 

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[Chica]

I used to sleep an unbelievable amount – the second day I took ritalin I was exhausted so I lay down and had a 2 hour nap 40 mins. after my first dose of the day. That nap was the most refreshing sleep I could remember. I think the stimulant kind of supports me to do all things more clearly – including sleep if that is what I need.

Now I have been on Concerta for 15 months, and I have become much better at falling asleep at a predictable time, and not sleeping during the day. I think my body is actually catching up on a lifetime of poor sleep. I do make an effort to eat and go to bed in a timely way so I am generally building up energy. I definitely count as the inattentive type.

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[Chica]

Kmkathymag – I have had my fair share of ‘real world’ trials and tribulations, but I still count dissertation writing as one of the top three most miserable and gruelling experiences I have faced. I did get my degree, but only because friends saved me by asking 10 days before I had to hand in my year-long dissertation how it was going; when I said I had three pages they swooped in and helped me type up my notes for a whole weekend. I got a surprisingly good grade, but to this day I have no idea what I actually wrote.

It turned out to be a life-changing lesson in friendship, and I just don’t care that the actual dissertation itself  is meaningless, although while I was writing it the thought of compromise and just handing in whatever was UNBEARABLE.

I had assumed that the saga of that dissertation was about guilt, but my generous friends still tell their farcical story of saving my hide with relish. Helping me turned out to be a fun achievement for them, and I will say I have become a confident person about lending a hand to others who have made their bed but can’t lie in it.

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[Chica]

Yes Rick! Your point makes sense, I agree that learning the art of setting your intentions is a really important skill. I also agree that setting your intentions is a great way of starting any project, and success means more to you if it comes from something you intended to do. But in many instances I think that deciding what you want to achieve from the start is way too big and complicated.

For me, getting diagnosed is more than anything some insight into my up-and-down history of under achievement. I know I have some strengths to build on, but I still have no direction about what I want to do with my life, and the confusion isn’t clearing soon.

I think lots of ADDers are responsive people with lots of joie-de-vivre in the moment, I know I am like that, but when I try and imagine a new vocation even my wildest dreams leave me with a feeling of indifference. I think behind my indifference is this old unconscious impression that I am powerless.

I don’t know if I lack confidence because I am lost, or if I’m lost because I lack confidence – I just know you can’t simply decide you aren’t lost. In the meantime, I think any kind of forward momentum to use your time better is more important than knowing what you are doing.

I do know if I go looking for success, some sense of direction will come, and that sense of direction will be a sign of growing confidence.

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[Chica]

I totally identify with this insecure reflex to do for others and smooth things over. Surely a big part of ADD for many, and presumably full of psychological meaning – especially for the late diagnosed.

Whatever the reason, I think just slowing yourself down in conversation to figure out the practicalities is all that is required. Justifying yourself is not necessary, and the fact that you might want to is kind of the red flag that you need to think differently about yourself, and perhaps look twice at what was actually asked for.

Double checking what I have been asked for always reduces what I think I have to do A LOT, but also tends to shorten the time I have to get it done A LOT.

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[Chica]

sar316 I agree with the other comments – even though ADHD can be a bit stormy and overwhelming day by day, there is a bigger picture that emerges after diagnosis. Often things generally trend in a better direction rather than getting miraculously sorted.

There can be a spell of disappointment as a newly diagnosed ADDer finds out that meds and renewed effort to perform well don’t actually eradicate your ADHD. It takes time to find a way to live comfortably with your ADHD nature, and you need to experience success before you can see that as a good thing.

University is this special context where performance is constantly monitored – academically, socially, whatever, but this particular context is rarely great for ADHD. I hope you aren’t too upset about the fact you might not be built to blossom at uni – it might not turn out to be a bad thing! Most people have much more structure and co-operation in their lives than students, and this helps ADHD.

Success is definitely the best cure for ADHD blues, and the practicalities of getting stuff done and handing in work get honed gradually the better you get at knowing your ways and seeking out your best context, and working with other people who support you. Uni can be impossibly complicated, the answer to every practical question seems to be ‘DIY’. (do it yourself)..

I really recommend Sari Solden ‘Journeys Through ADDulthood’ for this phase after diagnosis when just trying hard isn’t really enough and you feel a bit disorientated about what to do next.

 

 

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[Chica]

Hey there thisguy, I hope you give yourself some credit for the good things that you are managing here and now. I think turning to your ADD peers and talking honestly about your life is a smart choice, and does you credit. I think lots of small feel-good stuff is possible, and all of it counts as important – don’t watch the news on TV, find some comedy. Don’t compare yourself to others, compare yourself to your daughter who is an extension of you and smiles, cries, tastes things and tries things which are right there – here and now.

When I had been truly depressed, and just existing – completely stuck and lost not understanding what was wrong, I did manage to turn the tide slowly and surely at first by concentrating on my physical well-being. I turned my attention to my body several times a day and taught myself to act on the messages, even though I was confused as to why it seemed such a challenge. If I felt cold, I immediately stood up and did something about it. If I was hungry, I took all the concentration I needed to find something healthy to eat. If I was foggy on waking in the morning, I pushed myself to put on my iPod and go for a walk outside.

I know it might sound idiotic in the face of your larger problems, but ultimately depression and ADHD and how you feel sit in your body. They are physical!  Depression and the feel of your health improving are quite literally opposites. I know ADHD can be very different from person to person, and I might be a bit unusual in how bad I was at paying attention to how I physically felt and acting upon it – but I wanted to tell you that this one simple change worked for me, it is free and never stops being the obvious way to feel a tiny bit better. It gained momentum, and I really did get to move on and feel good again.

The hard part was learning to respect the work of making myself feel a tiny bit better and healthier in the shadow of so many big, worldly problems.

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[Chica]

I really agree, Rick.

From the time I found out about girly inattentive ADD I had seven months of knowing I had it, and a diagnosis from a crummy doctor before I got a full in-depth diagnosis I could respect. I lingered over those seven months to think about the whole concept of ADD, and whether I thought it was something I should take to heart and take pills for.

It was important to visit all kinds of discussion and research to feel my way in a field that doesn’t have many absolutes. I’m not a doctor, I can only go with the information and people that inspire some authentic recognition.

Even now I find it hard to grasp that most other people aren’t impaired as I am and THAT is why their lives run so differently. I think the whole issue of seeking and needing special treatment is hugely emotional, and sooner or later everyone on this site has to wrestle with it on their own.

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[Chica]

Saffron, your description of your ADD and fatigue is the best reflection of my own day to day experience I ever found!

I use a journal to help me remember my notes about ADD issues, and follow my adjustments since diagnosis at the beginning of this year. I have written out your whole description of you and your son because it is so concise and to the point about the issues that hit me hardest in spite of my strengths. You, Sari Solden and Adele Diamond have written the things that have made the most insightful and painfully accurate impression upon me, and I also identify with your paradoxical relationship to learning and reading.

I would love to hear how treatment is going for you these days – I know you have done quite well with Concerta…

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[Chica]

I haven’t heard much about blood sugar problems – poor circulation – ADD being linked before, but I do have a significant problem with all three. Actually, I came to understand I might have ADD indirectly through trying to work out my metabolic problems. I was pre-diabetic and on Metformin for 5 years with little success then tried some alternative therapy in desperation because I was compelled to live without that medicine for a few months.

The alternative was good mineral supplements, rising early, and healthy protein-rich eating, exercising and going to bed by the clock – and it was a revelation how much better I felt. However after 18 months of doing this I was no longer pre-diabetic or needed Metformin, but still had undiagnosed ADD causing all sorts of trouble I had always had. At that point I was open to the idea that my problems weren’t just physical.

Now I have my diagnosis of ADHD-PI and I find that Concerta REALLY helps, but if I get lazy about regular eating, supplements, sleeping and exercise it gets exhausting pretty fast, and I feel constantly tired and cold. Also, I use support socks and wrap up warm for the times I have to sit and concentrate at a desk, and it does help my circulation and stamina to stay comfortable enough to focus.

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[Chica]

I think ADD procrastination is partly an instinctive impulse, as though you are a bit allergic to some activities – and I’m only half joking!

I wonder if procrastination has a slightly different flavour in different ADHD types? I just stumbled across an inspired entry in a thread about ADD and fatigue on this forum, written by Saffron & it describes my own experience of being ADD-PI and unreliable BEAUTIFULLY.

Saffron points out the quirky ups and downs of energy in her and her ADD son. After doing cognitive tasks like writing, or using working memory in multi-step tasks, she describes her son going physically floppy afterwards. I think it is natural to feel some kind of aversion to things that your whole system – body and mind – finds so intense and costly of energy. Saffron also names exactly the things that perk her and her son right up: getting enough food and protein, being around others they like, doing tasks like a game, upbeat fun or music, and positive touch like tickling her son’s back when he is tired and discombobulated.

Saffron has described my ADD primarily inattentive temperament perfectly, but I think procrastination in my classically over active ADHD father seemed very different. Where I can’t lift myself up to fully engage with things, he couldn’t hold himself back into fully engaging with things.

Either way ADD/ADHD issues always seem to have physical symptoms alongside every single behaviour – that’s why physical solutions like meds work, and that’s why sleep and exercise and regular protein can only help. Now how good am I at co-ordinating all of that every day? Hmm, I’m working on it….

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[Chica]

Oh OK now I get it! Good advice Dr J!

Have been on Concerta for 8 weeks and getting a little confused why some days are full and varied so I can’t believe how easy life is for neuro-typicals, then other times I get aboard some un-named train of thought and sweep off into monomania for a day.

The more I get to know my ADD the more I think lining up my morning just right is what pays off.

The thought of too much planning and structure is suffocating, but mornings were always a weak, low energy and aimless so there is lots of room to pack in new structure and habits without feeling like I am sacrificing anything.

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[Chica]

I am still really new to this, but I have definitely got the message that medicine alone will not get me fit for fight. Started Ritalin for the first time yesterday – felt awake all day, then was exhausted as it wore off at 8pm. Went to bed but couldn’t sleep till 4am. Alarm woke me at 8 am for next dose, took it, then had a wonderful 2 hour nap which left me feeling really refreshed for the first time I can remember.

I am coming from the experience that diet and structured days worked very well for me, but after a year I found that unsustainable, so am now trying meds and hoping it will support me for a bigger life in several ways. I don’t think I can try harder and psychologise myself out of all the dead ends in my life up to now, though it has taken me 6 months to get to the point of trying medicine- I agree with a minimalist no drugs approach in theory. It seemed like the time had come to try getting a little help from outside.

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[Chica]

I agree that eating healthy foods helps give a healthy appetite – once you have a bit of momentum going. Last few months have been stressful though which led to bad sleeping pattern, which undermined good eating and regular meals. I’m hoping that trying meds for first time will help chaotic energy and regulating my day.

Are you guys on medication? I saw something by Dr Handelman on CADDAC video – he said only 16% of patients stay on medication after the first year- sounds crazy- why would that be if ADD is so treatable?

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