I was going to post this as two separate questions, but they really do overlap, so I apologize for the post length.
I have never been evaluated for ADHD, but as is not uncommon, after researching it in regards to my son (and a former relationship with someone diagnosed as an adult), I see that I probably have had this all my life, too. I've taken generic Adderall for a few years, starting during the downhill slide and eventual end of my emotionally abusive marriage to someone with a boatload of mental issues. I was having a lot of symptoms, including sleep problems (diagnosed sleep cycle disorder), plus issues with concentration and memory. My PDoc assumed it was from stress, so he gave me the Adderall to help with the symptoms -- ADHD was never suggested. First try was 20mg 3x day, but I could only ever remember the first one, so a few years ago (after I had moved out on my own), he switched me to 45 mg XR in the a.m. It has seemed to help me focus better at work, plus I've been able to handle the whole process of divorce, becoming a co-parent, buying a house, etc. I was always the one taking care of all the finances and the vast majority of the household during our marriage, so that wasn't something new to me. I've been treated for depression off and on for about 15 years (but have had it going back to my teen years), and am currently on 300 mg of Welbutrin XL. I am also being treated for low thyroid and my dose has recently been adjusted. On top of that, I'm in perimenopause, and I've read that hormonal changes can affect not only ADHD symptoms, but also sleep.
I have always been a creative person -- I was doing all kinds of crafts even as a small child. I opened a little online shop on etsy several years ago. I'm interested in a lot of different things. It's part of who I am, it's part of how people would describe me. I set a lot of that aside during the divorce process because of time and the fact that I lived in a tiny rental -- or so I thought. It took me til about a year ago to realize that even after I moved into my house -- a house that I bought partly because it had room for my business and craft endeavours -- my desire to actually DO these things never really came back like I figured it would. I can when there's a specific occasion, like making a Halloween costume, but to sit and do a craft at night after dinner like I used to...nope. I finally realized that right when things changed was also when I started the Adderall XR. The more I'm learning about ADHD and meds, I am sure they're related. In some ways, it's a good thing that interest in a new craft doesn't cause me to run to Joann's or Michael's for beaucoup supplies and to spend tons of time researching and then doing the thing like it used to...but, am I forced to choose all or nothing?
My intention was to ask my PDoc to help me find an alternative that might help me get some of that desire back without losing the benefits I've had. But last summer, I was in a car accident and among my injuries was a concussion, which wasn't diagnosed right away. I also had a surgery about a month after, and had two bad med reactions, one of which has left me with a slight tremor and a bit of a speech impediment when stress is extra bad. Due to problems with the case and payment from the other person's insurance, testing on my continuing symptoms just happened within the last month, and I was officially diagnosed with Post-Concussion Syndrome. I had some problems with emotional meltdowns in the month or two after the accident, but they improved pretty early on, which is great because they were embarrassing. I hated not feeling in control. I'm really thankful that my physical injuries have fully healed and all I'm doing now is re-building lost strength and tone. But the additional mental issues after the accident are getting me down. My short-term memory is still really poor, concentration and distraction are terrible, interrupted sleep each night, and some problems encoding new information. I'm actually getting worse over the last few months, I think partly from accumulated sleep problems (and the sleep meds I have taken for my sleep cycle problem no longer work -- and they were the only ones that did). By the time I get home from work each day, I'm physically exhausted from doing the same job I've done for years. I seem to lose track of time -- days and weeks go by before I realize it. The testing I recently had picked up my depression and anxiety due to this. I have been told that all of this is normal, and it might be another 14-15 months before I know how much I'll improve.
As you can see, though, a lot of the symptoms from the head injury overlap common ADHD symptoms. I'm trying to take advantage of non-medication things to help me out -- I've automated all of my bill-paying, because I was no longer remembering due dates; I finally got a smartphone, mainly for all of the alarms and calendars; I've tried to minimize stress when possible...but that's rarely possible. :p The people who care about me (and I've found out there are a lot of them, thankfully) tell me to give myself a break, but I really hate this. This isn't who I am. I wasn't happy about losing my creativity and drive before, but now, I've lost even the modicum of efficiency I had, too. It made me cry to read the forms two of my friends filled out for the testing I had. They compared me before and after the injury, and while I thought I was doing pretty well and hiding things, I saw that I wasn't. They've noticed me withdrawing when I'm with friends because of fear of not remembering and/or understanding or catching on to things. They've said that the intensity I've had to maintain in order to simply do my job has changed me and made me less social and more easily upset. I'm just not there for people like I want to be -- like I used to be. I know I'm withdrawing in general. My home is a disaster again, after being able to do well enough that I was actually volunteering to host gatherings for the first time in my life. I spend way too much time on the computer most evenings because it's all I have energy for. I started dancing and dance classes again once I healed up, but the last month or so, I've even skipped those a few times. This is really bad, because I know how good they are for me on a physical and emotional level.
All of this on top of the undiagnosed and inadequately-treated ADHD I had before. I'm scared that I won't be able to get treated until we know how my head injury will resolve itself. I don't want to wait to get either thing treated. I feel I was already forced to wait too long on the concussion, and that itself interrupted my plan to get evaluated for ADHD.
So, all of this leads to a few specific questions:
1.) Has anyone been treated for ADHD while recovering from a head injury? How did the two things interact, and were doctors able to treat both at the same time?
2.) Has anyone found a med that helped with the problematic symptoms of ADHD like disorganization, task initiation and completion, concentration, etc., without totally deadening creativity and passion? My worsening sleep issues make me worry about continuing my Adderall, but I have never tried one of the non-stimulant meds.
Thanks for reading all this. I kinda feel like I'm at at 'Danger, Will Robinson!' point here. :(
I realize this might have
Submitted by AlmaVera on
I realize this might have seemed too specific and that's why nobody replied. Maybe I should have split it into two questions, lol.
So, I my PDoc appt yesterday. I think I have to get another one. Though I've seen him for years, and he always seems to take copious notes, he asks a lot of the same questions and doesn't seem to remember what I've told him. He doesn't really seem all that knowledgeable about adult ADHD or how the meds work. When I told him about my experience with the deadening of creativity and desire for hobbies, he said that never happens, since I'm taking a stimulant. Errmm...
I asked about Straterra as a non-stimulant alternative. But since I'm already taking Wellbutrin, which also acts on norepinephrine, he didn't think it would do much in addition. Plus, the first thing he mentioned when I asked about it was "Well, the biggest risk is liver damage, but I've never heard of anyone needing a transplant." (YIKES!!) "To me, that means that when you stop taking it, any damage should be reversible. I just talked to the pharmaceutical rep for Straterra, and I figure he's the one who would have heard about any problems, right?" Errrmm...
So, we are experimenting with the timing of my Adderall. I am curious if I feel the way I do in the evenings because a.) the drug has worn off, or b.) the effect is from the drug itself. So, instead of taking 45mg of XR in the morning, I will be taking 15mg IR at 8, noon, and 4 p.m. That gives us the main variable of timing. I'll be trying it for 30 days, and we'll go from there.
For sleep, I'm splitting my Ambien CR (making it more-or-less IR) and taking 1/2 at bedtime with my regular melatonin, and more when I wake up the first time. I tried it last night, but only took 1/4 a pill at 1:30 a.m.. I'm glad I did, as it was hard to get out of bed at 7. I still woke up at 4:30 anyway, but I fell back to sleep, which is at least one improvement.
The last thing I asked about was for his opinion on non-prescription supplements, like Omegas, or B12, etc. He said he doesn't believe at all in supplements. He said he figured if any of them really worked, the pharmaceutical companies would have found a way to market them and make money. Since they haven't done that, they must not work. He laughed, "What can I say? I'm a pill guy!" I wanted to say "Oh, you mean like all the solar energy collectors and wind turbines everywhere? The technologies must not have potential, or else the petrochemical companies would have found a way to make money from them, right?" (No...it's actually the opposite: their potential hasn't mattered as much as whether or not the petrochemical companies could find a way to make as much money from unlimited, free sunlight and wind. I think there's possibly a similar thing with something like vitamin B12 or Omega fish oils. But I think the comparison would have been lost on him.) But I didn't say all that. I'll have to get opinions on supplements from someone else.
But hopefully, it's a start.