I'm new here, so if this has come up before, my apologies.
We have just self-diagnosed my husband with ADHD, after I read an article in a recent newspaper, which sent me to this site. We have no children but all the other 5 symptoms apply. He seems to have accepted this, since it's just so obvious, and to me, at least, it's a relief and offers some hope.
I would like to know how important it is to pursue a full medical diagnosis, via a physician, and how effective is medication, vs therapy? What I fear is that since my husband will be 60 next year, much of his behaviour is now deeply ingrained, and that medication isn't going to be a huge factor in changing how he operates. I've read some of the information here and see how medication can be worse than the cure!
Opinions on this? With great appreciation for your time and care.
Here is the illustration from Driven to Distraction
Submitted by Aspen on
Say, for example, that your husband always wanted to learn to sew & it was very important to him to be able to do this, yet his eyesight was not good enough to thread the needle. The meds are like the glasses that would allow him to see how to thread the needle, but he still doesn't know how to sew since without the glasses, he couldn't learn the skill.
I think that is a perfect description of the difference. The meds can clarify things for him and make it possible for him to see his behavior for what it has been, and to feel able to get some of his behaviors under control; BUT it is still a different set of work and tools to actually get those behaviors under control. My understanding is that meds fill in some of differences in a AD/HD brain, so that it is able to act more like the brain is designed to act.
If your husband is anything like mine and the ADD ppl we have in our circle of friends, he will initially want the meds to be a *magic bullet* and be all that he needs to do. My husband & I had done the research, so the diagnosis was really only a formality. It then took about 2 weeks for his meds to arrive by mail, and the entire time from our self-diagnosis to him getting an appt with the doctor, to him starting to take meds, probably was 6 weeks or so. The ENTIRE TIME we were discussing that this was going to be like glasses, and that as soon as we got some help for his memory and overwhelm (in the form of meds) it would be time for him to start learning the tools to counteract the poor coping skills he had developed over the years he didn't realize *what was wrong with him*.
I kid you not it took like 6-8 months to get him on board with more than meds being needed. HE KNEW more than meds were needed, but knowing doesn't translate into doing much with ADD at times. HE WANTED the meds to be enough so much that even though they obviously weren't, and we were arguing about his behaviors more than ever, he just couldn't move past the hope into acting. He was assigned a coach, who was abysmal! I swear the man had ADD too, and he'd suggest my husband try something and then when he didn't do it, he'd say "yeah, I didn't think you would do it. It's the ADD" It was INFURIATING!!
I'm asking him now & our guess it was about 6 months of mourning the fact that he had ADD and needed the meds, then a couple months of what I call *scattershot work* just kinda trying different things with no real plan, and then we attended the AD/HD conference last fall & that seemed to finally highlight to us exactly what we needed to be doing better. He got a new doctor (forced by insurance) and we got a new coach (GREAT MOVE), and we have had forward progress mostly ever since.......sometimes SLLLLLOOOOWWW forward progress, but it is progress at least.
The 6 months with a diagnosis, and meds, and almost NO WORK on behaviors was probably the hardest for me of our entire marriage & I believe it is when I found this site. I was so frustrated and upset because now we had the books and many suggestions, and he wouldn't consistently try ANYTHING. We'd talk and he'd agree, but that was it. For months & months, and I've never been known for my patience. Identify the problem and take action is my MO, and it was a source of real struggle for us. Looking back I believe he was waiting for me to say, "even if you never get ANY better, I love you and accept you as you are". And I was saying, WE KNOW WHAT THE PROBLEM IS, SO LET'S WORK ON IT TOGETHER. At least when he was undiagnosed we were both in the same boat of trying to figure it out, initially after the diagnosis it felt like we were on opposite sides.
Just letting you know that getting a diagnosis is important because sometimes what looks like AD/HD is actually something else or sometimes more than *only* AD/HD. And getting on meds might be only the start of a long journey. Fortunately meds worked for my husband right from the first day, but some ppl struggle with dosages & finding a med that works. A small part of the population won't find that meds work for them at all. So regardless of if you go the med route or not (and I am a big proponent of the meds if they work for the person) there is still other work necessary to get it under control.
Hope something in there helps!
Great Explanation, Aspen
Submitted by Sueann on
We are where you were for those 6 months, for 3 years now and I'm really struggling with it. Husband tried Strattera, and it exacerbated his co-morbid depression to the point he could not get out of bed and go to work, or even understand he had to call in. I called him during a break and, when I found out he had once again not gone to work, collapsed in tears in the ladies' room. Getting him off of it was even worse, he probably should have been hospitalized but since he was not working, we had no insurance. The doctor didn't call back for a week!
The doctor tried Stattera again at a different dosage with worse effects. Eventually we persuaded him to prescribe Vyvanse, and I saw a difference. But it still took 4 months and a good marriage counselor for him to be even willing to apply for jobs. Once he did that, he got hired right away.
My husband has a degree in Psychology. Our insurance has a $50 co-pay for counseling, so he went to the psychology clinic at our local university, which we could afford, but as the person he saw had the same degree he does (from the same school) he quit because she didn't know more than him. Now, no counseling and he won't read any books. He read Driven to Distraction at the beginning, but now will not read any more.
He feels he's "cured" by the medicine even though he knows that isn't true. It more like a diabetic, they have to take their insulin every day but they still can't eat sugar and so forth. But he feels there is nothing else he can do, and I should just accept him as he is because he's working. I have trouble with the going to bed at 9:30 (in 2 weeks I'm going to have class until 9) and doing nothing in the house. I have problems with staring at the ceiling for half an hour after he gets out of the shower. I honestly see no difference in him from before except that he's working now. No help, no companionship. We took a nice little trip yesterday, and he says we need to do more of that, and we watch too much tv. But he never wants to do anything after dinner but sit on the couch or at the computer. I know it's because his Concerta has worn off by the time he gets home, but it doesn't help me much.
What got your husband to move on and do the (admittedly hard) work of changing? I can't find the key to my husband. We are going to another marriage counselor in 3 weeks but I don't think we can afford very many visits at $50 since I'm a full-time student and do not work. I know you mentioned a conference but they are out of our price range (and area). How can I get him to see that there is more to a marriage than him working. When he wasn't working, I would have been glad just for him to come down off his cloud and go to work but now I want more. I want a real marriage where I matter to him and our home matters to him. How did you get to that point?
The conference did make a big difference
Submitted by Aspen on
and it wasn't a physical attendance thing, but was an internet conference. It was 3 days and about 22 session where you could post questions online during the session and download every session (since there were several we could not do live) and they were all by experts in the field. It was in the fall of last year and I am sure they are getting ready to start opening up registration for this year. IT MADE SOOO MUCH DIFFERENCE FOR US. The money was a big deal for us......we actually did not get the pre-registration discount either because we'd decided not to do it, but then our frustration levels were SOOO high I just couldn't take it anymore. I asked for the conference as my anniversary gift (anniversary is also in Oct). I think it would have been around $150 if we had pre-registered, and we ended up paying around $250. It was worth every penny if you can possibly find it somewhere...or even as a gift from someone in your life in lieu of b'day, xmas, whatever.
I feel SOOOOO deeply for you. Picturing that 6 months going on for 3 years is a brutal thought to me. I hope you can get out of that terrible cycle!!
Other things that helped us: My husband could not stand the unhappiness and frustration and fighting either. It made him desperate enough to try other thing. He started working on the David Allen theory of organizing which is basically capture everything that comes into your mind that needs to be done, but put it aside to be processed later. Like just write down "call Kevin" or record on a voice recorder "find a new doctor for x specialty". Then during a processing session, you turn those ideas into actions--anything that can't be done over the next week or 2 goes onto a seperate "Someday/Maybe" list, anything that can be done in 2 minutes or less gets done immediately, anything where the action is the very next thing you can do on that issue gets added to a list for when you are in that context (for example WORK lists, HOME lists, ERRANDS in a certain city list, PHONE lists) For example if you have all the info you need to call Kevin but it will be a 15 min call, you would add that to your CALLS list to be done when you are at a phone and have the energy to do it. The other example which will require some research on finding the doctor, possible getting some word of mouth suggestions, becomes a PROJECT (anything with multiple steps is a project). The idea is if you have some time and you have your phone and your calls list......you can get that done. And you don't have to try to remember to do the doctor thing cause it is captured for later........so your brain can relax about it. Once a week you review everything to be done and scan your Someday/Maybe list to see if anythign on there needs to either move to current or be deleted because you have lost interest. In theory you are keeping things from falling through the cracks as well as making the best use of your brain's energy by not reminding yourself of things you "should do" but can't do right now because you are not in the right context.
It is a work in progress but he agrees the theory is good and that he's poor at capturing ideas in general which is why they fall through the cracks, so it is something we are working on implementing.
Also the conference last year had a lot of info on coaching. We really believe coaching is necessary to us. At first I was his default "coach" (Did you remember this, are you still trying to get this project done). I felt like his mom and he thought I was a nag. So we used Dr Hallowell's suggestion to use a family member. HE wasn't comfortable having many ppl in that role, so we went with a sibling, but she wasn't really informed enough about ADD and she asked if he did what he said he wanted to get done that week, but if the answer was no she just let it go unquestioned. Then we got the insurance provided abysmal coach who had ADD himself, and that was worse than anything we'd previously tried.
After the conference, we tried a group coaching program from add classes that was $77 a month and there were 4 days and times available to call in for a 1 hour session. Each person generally talked for 15 minutes to the doctor about what they were working on and following up on the previous week, and spent the rest of hte time listening to other ppl's issues and the doctor's suggestions. You could call into every session if you were able, so it could have been up to like 16 hours a week for the money. I thought he wouldn't get enough personalized attn, but HE LOVED IT! He found one doctor he really liked with a good time for him to call in, and because it was every week it really held him accountable. She kept up with what he was working on, and if he hadn't done it, she questioned the why and made suggestions to help him be more successful. He also felt he learned a TON from the other stories he was listening too and her advice for them, which I had not expected to be the case.
After about 3-4 months the novelty of that was wearing off and if our schedule changed (frequent in our situation) he sometimes would forget to call. I got angry about that, but eventually his new doctor got him into a program with a new face-to-face coach covered by insurance, so we cancelled the group coaching. I do think the group coaching kept him reved up the best as he only sees his insurance provided coach between once ever 2-3 weeks, and she has had several emergencies with other patients and had to cancel his appts and then it can be like once a month. I really feel he needs more than that.
The biggest helps for us have been acknowledgement of both of our contributions to the issues......him with uncontrolled ADD behaviors and me with anger..........and both of us working hard on our part of it while praising our partners efforts. He literally will work for compliments, so I have to try to remember to compliment what he does do even when there are 4 more things that he didn't do. HE LOVES TO HELP and to be APPRECIATED, so most things I ask him to do that are in his wheelhouse, he will tackle if it can be done right now. He'll agree also to the stuff to do later, but he'll seldom get to it, so that is a work in progress too.
If you both feel bad about how things have gotten and you can agree on a plan of action going forward, it makes all the difference in the world. I have not yet read Married to Distraction (though I certainly intend to) but as part of his conference session last year Dr Hallowell sent us the 30 minutes 30 days workbook through email, and I honestly think doing the 30 minutes a day exercises is a great way to get back onto the same page.
Hope something in there helps you Sueann.........3 years........holy crap do I feel for you!
Insuance question
Submitted by Sueann on
How does your insurance get around the fact that Schedule II drugs like Adderall and Concerta can not be sent through the mail? You can't even mail the scrips to take to the drugstore (a real problem for my working daughter with my grandson's meds) or call them in. Good grief, if one of you gets strep throat, do you have to wait a week to get the antibiotics in the mail?
The real problem is he does not want to do any of this. He thinks he's fine because he's working (after 2 1/2 years where he didn't) so that's all I can ask of him. He says my unhappiness with the status quo is my problem. However, my therapist at the same Psychology Clinic could not find any work to do with me. He thought I was doing everything I could do.
Thanks for writing back to so quickly. Do you happen to know a website where I could find out about this conference? Do you need a fancy expensive computer? Ours does not allow us to watch video or even listen to audio content.
All I know that the insurance
Submitted by Aspen on
sends them to us and someone has to be home to sign for them or they can't leave them.
I expect there will be some info about the conference here as Dr Hallowell was a participant and it seems like many of the websites of the participants had info. We haven't gotten email info yet which I think we are supposed to since we attended last year. Ok I went back to last years info and went to the website which is adhdconference.com and the info for this year's conference is up. I didn't realize it was already up, so we'll have to look over the agenda and see about registering again.
If I recall correctly, the options were to listen into the sessions on the phone or over the net. You could ask questions over the phone or through the website set up for the conference, and all the sessions were available for audio download for something like 3 months afterward, so with your login info you could theoretically play them anywhere like at your library or something and maybe record them onto a thumb drive if your library allows that.
great explanation
Submitted by LaRoyal on
Hi Aspen,
Thanks, I appreciate that analogy, and I have now ordered the book too!
From what I have read so far in the other threads, the drugs seem to cause more problems than solving them.. or give a sense of false security.
I wonder if there have been any studies of people who took the drugs and did their therapy, and those who didn't take the drugs and did the therapy.
Still, I think getting a diagnosis might be a good idea, and then the doctor can let us know the options. Here in Canada, some of those treatments are covered... others not.... so I guess we will play that by ear. I hope I can convince my husband to get an accurate diagnosis, That would be the first step.
May I ask why the meds came in the mail? can they be ordered without prescription?
Our insurance requires meds to be sent in the mail
Submitted by Aspen on
I hate it but our co-pay is low so there we are :)
Definitely get an accurate diagnosis. The 70 yes/no questions in Dr Hallowell's book Delivered from Distraction (our first ADD book) are what convinced us and several other friends my husband has talked to about his suspicions that they have ADD. My husband brought those tests and his answers to his initial doctor's appt, but a lot of times ADD is revealed by your struggles and history of it throughout your life.
If I recall correctly Dr Hallowell and at least some of his children are med-resistant. They do diet modification and exercise to help control symptoms and I am sure there are other techniques too. I know there is a section for non-med treatment in the Delivered from Distraction book. Meds have worked so well for us that we haven't done the diet modification much though I do try to get him to watch out for the red dyes, preservatives, and caffeine. He mostly doesn't though :rolleyes:
Also because my husband has inattentive ADD without hyperactivity present, he was initially prescribed Ritalin which worked well but he had a hard crash around 3-3:30pm. He was eventually changed to Adderall which he doesn't have the crash from. His only real side effect is that he seems to clench his jaw a lot so those muscles tend to be tense......though he doesn't grind his teeth any longer which he used to do. We have decided for us the benefits far outweight that side effect. Every person is different though, and I think if you have hyperactivity or not really affects the prescription also.
Research clear on meds vs. behavior therapy
Submitted by MelissaOrlov on
Hi - there has actually been a lot of research done to understand whether behavior therapy or meds are best. It shows consistently that the best treatment for ADHD is actually to do both. I explain treatment as three legs of a stool (and you know a stool will fall over if you don't have all three legs).
leg 1 - treatment that makes physical changes in your brain. Includes meds, exercise, fish oil and more. Point is to increase dopamine levels in your brain so you can do things more easily (more focused, etc.)
leg 2 - once you have the ability to do the target things better (focus, plan, whatever) you need to IMPLEMENT them better with behavioral or habit changes. Most adults with ADHD have created sub-optimal coping strategies to "get by." A good example - retreating from difficult conversations. It solves the immediate problem, but is not good for your relationship.
leg 3 - create better interactions with your spouse. There are some ways that make it easier to interact with each other so you can have an easier time communicating, forgiving, etc.
Meds are not a silver bullet and the person who only takes meds is missing a great deal of the opportunity to change his/her life.
Good to know
Submitted by LaRoyal on
Thanks Melissa... that makes sense.
Fish oil at least is easy to find... and is coffee recommended? On some sites it is, and on others, it isn't.