#picked out a psychiatrist. need to call and make an appointment. but adhd and executive function and anxiety (that last one I need meds for) | Explore Tumblr Posts and Blogs

uberrapidash · 4 years

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This is a post I made on Facebook, but I’m also putting it here since I can tag it and find it again later.

Hey, guys.

This post is somewhat self-reflection, processing, and validation, and somewhat PSA-ish/FYI-ish since I am posting it online.

Mental health is nuts. It affects everything. I took an Adderall this morning for the first time in over a month and a half, and it changes everything. I know I have shared about how Adderall changes everything for me before, but this time is different in some important ways because of the circumstances.

At some point during the spring semester this year, I began seeing a new PCP and a new psychiatrist, since I'm in a new city and actually have health insurance. I was diagnosed with ADHD at the age of 29, this year. It was like a dream come true, because it was so incredibly validating, but also because I thought I would be able to get all the help I needed because I had this Very Important Answer now.

However, that was not the case. Upon diagnosis, I asked the psychiatrist if there were any support groups or resources that I could access to learn about my newly-confirmed Neuro-Divergent Brain™. She said she didn't know of any. So I have been learning about how my brain works through Youtube videos, Reddit posts, and the experiences that other people share with me.

At the same time that this was happening, I continued searching for answers about my ongoing mysterious health problems. One of the FIRST things that my PCP jumped on was to tell me, in clear terms, repeatedly, that I needed to ask my psychiatrist about putting me on something for "psychological pain." What she means by this is that she thinks that my body pain happens because of something going on in my brain, or that my brain is heightening normal aches and pains for some reason. And so I began taking Cymbalta (prescribed by the psych). This was later in the semester by now.

After being on the Cymbalta for about a month, I could no longer take my Adderall - I found that any time I took Adderall, I became extremely anxious, would physically shake and feel ill, and it was just all around a bad time. (Adderall is not a drug that you need to keep in your system - you can start it and stop it at any time. Cymbalta is one of those drugs that has to build up in your system. It takes like a minimum of two weeks to even start seeing how it affects you.) There was clearly something going on between the two drugs, so the clear choice was to not take the Adderall while I got in touch with the psych.

Now, at this time, I did not have an appointment set up with the psychiatrist, because she wanted to go two whole months before seeing me again (which seems like a really bad idea considering that I was still new on the Cymbalta... it baffled me when she told me that and I was not happy with it). So I made a mental note that I needed to make an appointment ASAP because this wasn't working.

Except... It's now July, and I still have not made an appointment. I have run out of Cymbalta and cannot get a refill because it needs to go through the doc. And I am in this situation because that's just how low-functioning I have been since starting the Cymbalta.

I needed to have been closely monitored. I needed to have frequent appointments. And when I didn't pick up the phone or return the calls to the psych's office, they should have kept calling me.This is the nature of mental illness. It controls everything. Your brain controls everything you do. I need someone to be assigned to my case to make sure that my life isn't falling apart, especially when I've been given new meds. I'm not the only one. And this isn't my first time going through something like this. The entire mental health field needs a lot of work.

Anyway... I haven't had Cymbalta in a few days, and I took Adderall today for the first time in a while. It's like putting glasses on. It's like an enormous heavy fog has been lifted. It's like I have been pulled out of a pool of molasses.

So... I am now capable of making that appointment, which I actually needed months ago. How fucked up is that?

__________

This is what it's like to be on the wrong meds, or to be unmedicated:

Every day for over a month, I have woken up every morning thinking about all of the really important things that needed doing, but as if I were chained to a pole or being held hostage in a cage, I could not do them. I was so sick that I had thoughts of telling Aaron that I needed help doing these things, but I couldn't even communicate it to him. That might sound impossible to someone who has never experienced any sort of mental illness or brain fog or executive dysfunction, but I and millions of other people are crying out about how so very real it is.

Today, after starting to gain some separation from the Cymbalta and after taking an Adderall, here are some things that have been different that I wasn't able to do before:

- I told Aaron basically the above paragraph ^^^ (Contrast: remaining silent on these problems... not communicating my plight at all whatsoever)

- I reached out to two (2) dear friends because I wanted to know how they are doing (Contrast: not reaching out to the people I love, ever)

- I drink water when I notice thirst (Contrast: becoming so thirsty that it's too distracting to ignore, getting a headache, increased body aches)

- I changed clothes once I recognized that what I was wearing was too warm (Contrast: suffering for hours until I felt sick from being too hot and couldn't do anything else, until doing something to alleviate that suffering)

- easily and efficiently gave my body breakfast (Contrast: not eating anything until I feel sick/am extremely physically weak)

- nearly automatically cleaned up after lunch (Contrast: leaving the mess until it's in the way at a later time)

- easily and efficiently picked up some dishes and trash in the apartment (Contrast: seeing dishes/trash, thinking "I want to clean that up/put that away," and not being able to make my body do the thing)

- not running into things when I walk around, being able to carry objects easily, and being able to efficiently pick up and put down multiple items without much effort. AKA - better motor control

- scheduled a time to go grocery shopping today (and I'm going to make a grocery list and meal plan after I'm done typing this) (Contrast: another day without having gone grocery shopping, another day of fast food)

The list goes on and will continue to go on...

__________

Shame on my PCP for pushing on the "psychological pain" thing instead of doing more to actually discover what is wrong with my body. Shame on me for seeing that red flag, but going along with it anyway. I feel like I'm constantly torn between wanting to trust medical professionals, who have had years and years of education and practice, and wanting to fight them. I thought I was in good hands. But add this onto the list of stuff that quickly built up with that doctor... I won't be seeing her again.

#personal #medical #adult adhd #mental health #adhd

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star-anise · 7 years

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I'm in my last year of undergrad and I feel like everything has gone to shit. The past year and a half have been awful, i have depression, anxiety and im almost positive i have ADHD too. I feel like such a piece of shit because I keep asking for the extensions on projects and exams, and I'm afraid I'm gonna be this way forever. Sorry this is a lot but do you have any advice on how to take the first step in digging myself out of this hole ive created?

Okay, so it seems like you came in via this post. That’s pretty much my philosophy here. I don’t know if you’re gonna “be this way forever” or not--I know I will probably be the way I am (depressed, anxious, with ADHD) forever, but that isn’t necessarily the same as being a trash disaster on academic probation forever.

I’ll be honest, I kind of feel like after a year and a half, you’re kind of an expert on what you can do with two hands and a shovel. You’ve been digging yourself out as fast as you can, and it’s been a real struggle. I think it’s time for you to get actual help, as in, other people. Reaching out to me was a good first step. I can help you decide where to go from here.

Keep it simple and take it slow. If you don’t know where to find any of this stuff, feel free to private message me your school’s website; I have a minor knack for reading organizational structures.

For the next week, pick ONE OR TWO of the following options. Even if they’re all good ideas, keep your goals manageable. And then, of those one or two, pick one or two SMALL ACTIONS you can do to pursue them, like looking up a number in your student handbook or making an appointment. If you do more, that’s great, but the siren song of our people is, “I’m gonna accomplish so much!”

Without further ado: Some Options For Help

Your school’s Disability Services/Accessibility Office/Office of Inclusion/whatever they call it

You’re looking for the office that helps Deaf/Blind/mobility-impaired students succeed in school. Mental health falls under the same category. It’s their job to make sure your school is providing you with as much chance at an education as it would provide to someone who’s totally neurotypical. Tell them what you told me.

Stuff they can do:

Tell you what your school’s requirement is for documenting a disability

Give you information on local assessment and treatment options--what psych professionals locally are good? Is there a fund somewhere that will cover your testing? Does the student health centre have a psychiatrist?

Provide you with a letter that tells your instructors that giving extensions, having flexible schedules, or dropping penalties for non-attendance is a legal requirement to accommodate you. This is not necessarily a free pass--a professor may decide that some things are mandatory or non-negotiable--but it is an easy way to bring these problems up early, before they become an issue.

Help find your or fund you a tutor (more on this later)

Help you find other resources and services on your campus

Your school’s Counselling Centre/Wellness Services/Social Work Office/wherever they hide the shrinks

This is the place where they offer free counselling. If there’s walk-in, go to walk-in; if they can book an appointment in a week, go in a week; if there’s a three-month waitlist, get your name on the waitlist.

Funny story--I had graduated undergrad before I realized that students got free counselling on-campus. I’d been in therapy since I was 16, but five years of undergrad? Yeah, no clue. I was looking for therapists on Psychology Today and shelling out hundreds of dollars out of pocket, and there were hot and cold running therapists under my very nose.

In fact, there might be more than just therapists. The school I worked at had regular counsellors, and also a Learning Specialist, whose job included teaching people with executive function disorders like depression and ADHD how to study effectively! It’s worth asking about.

When you see one of these people, it’s very tempting to think they are An Adult Who Is The Boss Of You. They will look at you, understand you with their expert knowledge, tell you what your deal is, and give you instructions on what to do now!

In reality, therapists are not Sherlock Holmes, or profilers on TV. We can’t just look at you and go, “I see by the way you button your coat that you’re a middle child and ambiguity makes you uncomfortable.” We rely a lot on “client report”--on what you say is true. Psychological assessment is a process involving interaction, not a detached observation of stable qualities. If a therapist says something about you that seems inaccurate, it is beneficial and good to say, “No, actually, I think you’re mistaken. To me, it looks more like...”

You’re recruiting an experienced co-traveller to go on a trip with you. They know a lot about rocks and trails and climbing harness, but they don’t know the territory you’ll be travelling together. So first and foremost, you want to find someone you want to go on a trip with: a therapist who is a good fit for you.

If you don’t like your assigned therapist, ask for a new one. We have an ethical responsibility to provide referrals when we can’t provide someone with the treatment they need, and since a good client-therapist relationship predicts therapy outcome like 70% of the time, simply not liking or trusting your therapist is a good enough reason to try somebody new. If you want you can just email them after the session and say, “I don’t think you and I quite clicked. With what you know now of my personality and issues, is there someone else in your office you can refer me to?”

Medication. Different medication.

Not gonna lie, going on antidepressants was like... getting the inside of my brain whitewashed. There was so much space. So much room. I could think and feel without being constantly smothered in negativity! And going on ADHD meds on top of that was like.. the thoughts that had always been slippery, unable to grasp or manipulate, suddenly became solid in my hands. I could grip them, slow them down, tell them to go somewhere else.

Both times, it took five to ten adjustments to get to the right cocktail and dosage. For example, I was on an antidepressant that stopped me from crying and freaking out all the time but killed my creative drive, so we added a drug that gave me more energy so I could write again. Then money got tight, we tried me on a generic, found that didn’t work, and found a way to pay for the first version. Each time, it meant seeing the doctor, trying a dose for two weeks or a month, and then going back to report progress and try adjusting it again.

Again: It’s a process, an interaction. It’s something you get a say in. And if you’re currently on meds--well, let me just say: If you sent me an ask like that, your meds aren’t doing their job. They’re not the right ones for you. So it’s time for an adjustment.

If you can get to or afford a psychiatrist, great! A general practitioner who’s known you for a while will often do. And if you need to, well, I’ve gotten my meds adjusted by a different doctor every time at a walk-in family practice clinic. You do what you can. Information on who and what is available is often why Disability Services is a great resource--who knows, maybe there’s a psychiatrist on campus you can see for free who sees the depression/anxiety/ADHD trifecta all the time!

(General life tip: When they give you an assessment for depression, anxiety, or ADHD, don’t downplay your symptoms. Answer the way you would on a bad day or when you’re struggling. Of course you know how to cope with these challenges, but the unfair part is that you have to cope with them at all)

A tutor or academic coach

This never occurred to me for a long long time, because I was always a “smart kid”, and I always thought tutors were for people who didn’t intellectually grasp the material. Meanwhile: Surprise! I have a developmental disability that significantly impacts my learning! My grad school put me on academic probation and effectively foisted a person of this job description on me, and it was the BEST THING EVER.

If you’ve ever felt like you would work so much better if only you had someone sitting there all the time making you work? Or a sympathetic friend who could help you break it down and be less overwhelming? If the only time you get your work done is when someone else asks you about it? This is the person for you.

Most schools provide these services to students for free, or subsidize disabled students’ tutoring. If all else fails, you can find a tutor on your own and say, “I get this stuff intellectually, but I really need someone who makes me spend time with it, because left to myself I’d get anxious and ignore it all until the night before the deadline.”

If you have good friends who can do this for you, that’s great too--but the biggest objection to the post that brought you here is, “I’m depressed and socially anxious--I don’t HAVE anybody to help!” So this post is aimed at linking you up to people whose explicit job it is to help you--people you, your insurance, or your tuition dollars directly pay for.

#staranise original #virgoduh

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ashekirk · 4 years

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Have typed up a document to give to my psychiatrist at my appointment at the end of the month. I don’t want to leave any doubt that I need ADHD treatment immediately.

The Case For Me Having ADHD

Using a list of symptoms from the Mayo Clinic for Adult ADHD, I will elaborate on the ways each symptom applies to my daily life.

I cannot stress enough how much of a problem my ADHD symptoms are for my daily life. I neglect all basic tasks, including showering, brushing teeth, cleaning my cat’s litter box, cooking, cleaning, and that’s just things at home. I have been unemployed for many years and I don’t think that I could get it together enough to actually hold down a job.

Mayo Clinic website:

https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878

Adult ADHD symptoms may include:

Impulsiveness I am very impulsive when it comes to eating. I have a major sweet tooth and once I start eating something sweet, I cannot stop myself from eating all of it – for example, an entire pack of biscuits, lollies, or chocolate. Paired with an inability to make myself prepare meals and my complete lack of interest in bland foods, I have a very unhealthy diet. Additionally, many people would call me an impulse buyer when it comes to hobbies. It’s true that I am very often buying things online, though I have managed to keep a lid on my spending enough to get by on a Newstart allowance for many years.

Disorganization and problems prioritizing In my head, I can prioritise just fine, but when it comes to actually doing things, very often the most pertinent tasks are the ones I cannot bring myself to do, so I instead end up doing anything else. Organisation is one of those things I want to do, but then when I try to do it, I hate it. So, my room and workspaces are a complete mess, and although I wish I could keep them organised, I just don’t want to think about it, and it’s easy for me to ignore. The mess just becomes part of the scenery. I have to step over clothes to go in and out of my room, because somehow it’s easier to step over them multiple times a day than to pick them up and put them on hangers. The clothes I have that ARE on hangers, I ignore because that isn’t where I’m conditioned to get my clothes from. So I just use a very small pool of clothing that gets stored in plain sight. It’s almost an “out of sight out of mind” situation.

Poor time management skills The time does get away from me a lot. There are times where all I have to do is post something, but it takes me a couple of days to actually get to the post office during opening hours because it takes me so long to start my day and muster up the motivation to go anywhere. Other times, I am so absorbed in a task that I have no idea how long I’ve been there and suddenly I’m starving or my bladder is almost in pain from fullness that I’ve not even noticed until it was this bad.

Problems focusing on a task Tasks are virtually impossible for me to focus on if I’m not very interested in the subject matter. I cannot read books, haven’t been able to so much as pick one up since I was a teen, and even then there were times I would read a page and none of it was actually absorbed, so I had to read it again. Sometimes if I can manage to initiate a task, I am so disinterested in it that my depression and anxiety kick in, making mundane tasks such as exercising and browsing job listings actively harm my mental health for the whole time I am doing them. As such, I avoid these tasks as much as humanly possible. In the workplace, I have been known to have panic attacks if I am forced to do things I don’t want to do. By far the hardest thing for me is to physically begin to do tasks my brain has decided it won’t do. It just puts up a barrier that I cannot penetrate. I believe this is called executive dysfunction. It prevents me from doing almost all everyday chores a majority of the time. It is my biggest problem with functioning in life and is the reason my freelance businesses have failed.

Trouble multitasking While I can happily play a video game and listen to a podcast simultaneously, switching between tasks is an issue. For example I am writing this currently, and cannot do anything else until I’m finished, because if I do, I don’t think I’ll ever get back to doing this because my interest will be broken. Heck, I can spend months doing a hobby every day, and as soon as I let myself have a break from it, I no longer want to do that thing, sometimes ever. And for things that I really loved doing, it is heartbreaking to find I can’t get even a little excited about it any more. Many times I can be engaged in an activity, and having my concentration broken is an ordeal – I could have all these interconnected thoughts running in my head, then bam, they’re gone in a split second and I no longer comprehend the complicated thing I was doing a moment ago. I think this is why I have not been able to reach full competence in coding, and why I had a lot of trouble with high school maths.

Excessive activity or restlessness For me, this manifests in somewhat hidden ways. See I have a chronic lack of physical energy. However, my mind races almost all the time, I have to always be doing something even if it’s just scrolling Twitter or listening to a podcast. Normally it’s both. Or playing a video game. When I’m sitting on a couch or chair, my leg will bounce up and down involuntarily, especially if my mind is engaged in a stimulating activity. If I’m standing, I might pace. If I’m in bed, I will be tossing and turning. Sometimes I will have insomnia, other times I will sleep 12 or more hours at a time. I get bored very easily, which is why I am always keeping myself occupied. However, when I’m doing nothing I will often start thinking about all the problems in my life and get quite depressive. I am known to cry out of seemingly nowhere when I am having those thoughts, so I distract myself with podcasts all day and night.

Poor planning For me it’s more like planning is as far as I get. I can plan things until the cows come home, but never put the plans into action. I dream and plan and sketch things and figure out details of some creative thing like a story or comic book, but then the doing just becomes an insurmountable barrier and I give up.

Low frustration tolerance I certainly experience this when it comes to doing things that take a lot of practice or repetition. Learning an instrument, playing particularly hard video games, doing jobs that involve unending repetitive tasks (such as working on checkouts). Anything I do where I feel like I’m getting nowhere – even if I’m not, in the case of learning something; if it is taking too long, I get sick of it and eventually come to hate it. Fortunately I am a fast learner, so there are plenty of skills I have been able to learn – just not things like a guitar or a new language, things that take years to even get a basic level of competency.

Frequent mood swings Fortunately I do not experience this much. However I do get panic attacks from time to time, which can appear sudden to the outside observer. I am on mood stabilisers, however, so I can’t really say either way. Currently though, I merely experience a consistent tired, sad mood with the occasional respite of laughing at a funny meme.

Problems following through and completing tasks I have countless creative projects I’ve started and abandoned because I lost the excitement I had for them. It’s one of the hardest parts of my life. I even spent years on a video game that I can’t bring myself to work on any longer even though I have the whole thing planned out and even a demo released. This is repeated again and again throughout my life.

Hot temper If I feel anger, it is almost always in response to injustices I see in society. I believe it is a justified anger. Other than that, I would say I am an unusually even-tempered person. If I do get annoyed or frustrated with another person I am most likely to vent about it on the internet instead of acting out.

Trouble coping with stress Since I have anxiety, yes, my stress reaction tends to involve panic attacks, insomnia, and misery. I cannot deal with stress, which is the only reason I’m glad not to have had a full time job since 2011. I was fired from that 2011 job for venting on Twitter about how stressful and unfair my job was at the time, who had been forcing me to stay back late into the night to help finish a publication.

#adhd #actuallyadhd

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nerdymedzebra · 6 years

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Day #2 of Vyvanse (Lisdexamfetamine)

EDIT: I realize I had already written the background to this med change! I don't want to delete it after all this typing, so I'm just going to put it in quotes for easy skipping...

Early this spring I started at a new mental health clinic because I could no longer afford my cash-only ADHD specialist.

Unfortunately, this clinic has rules about how high they'll go on ADHD doses (don't get me started on the unjust way ADHD patients are treated with meds-- tho I know chronic pain patients can relate), so my new psych cut my dose for a third.

All other general psychiatrists have been really skiddish when it comes to high doses of medication. On one hand, I totally get it. But on the other hand, sometimes people just need higher doses of things. Especially in my case-- long acting doses just AREN'T long acting for me. My ADHD specialist had me on a regular dose of a long-acting med, 3x a day. And even then, it was worn off by 3-4pm. We had worked up to that trying to get me through a full workday with manageable symptoms so I could actually keep my job.

But now with the general psychiatrist, she cut my dose by a third. She did also do the psychotropic tests I posted about before, and encouraged me to get a gastric emptying scan, but since both came out normal (my gastric emptying is often rapid, but wasn't that day), she couldn't justify going above the rule. She said something about having to think about her own license. (Seriously to hell with these regulators who cause these issues...)

So I took the smaller refill and that month I was a MESS. It wasn't working well enough at all, to the point where I couldn't' even get it together enough to make my next appointment with her for my next month's dose. Unsurprising, since ADHD causes major impairments with the brain's executive functions. So after a month, I was just out of the meds all together. It took 4 months for me to FINALLY call the nurse line to ask for an effexor refill (i had had refills of that until then) make my next appointment. The next available wasn't until October, but perhaps because I accidentally started crying on the phone when the nurse seemed annoyed that I had gone so long without an appointment (I cried (which i HAAATE doing in front of people) when i explained what happened, and she immediately soften completely) the nurse was so sweet and went and got a next-week emergency appointment with the doctor for me. So, I did that last week.

Anyway, it took almost a week to actually get the meds to me (my pharmacy is far away and my bf had to pick it up for me), but now I have the week's supply to try out, and yesterday was my first day with it. Thoughts so far: I wasn't doing anything but listening to the Med School for Everyone audiobook and hanging out at home, but I did manage to knock out a few tasks I've been putting off for a while, and without even thinking about it, really. That's one of the best things about ADHD meds. The motivation! It's hard to explain if you've never experienced it. Motivation isn't a choice, or even an awareness of "I should do this because X" or even "I want to do this because Y"... it's some actual wiring in your brain that gives that jolt of energy that causes you to just, go and do the thing. And my brain very, very much lacks that on it's own.

I didn't do much, but that's okay. Just doing a few of these tasks is huge for me right now, and a huge relief. I also just, felt better. More like myself, less disjointed/scattered/foggy. I can tell it's a low dose, but I was afraid that I wouldn't feel *anything* at this low dose (it's much smaller than my last med (Concerta/methylphenidate)), so I'm just happy it seems to be working at all! On day 2 now, and same seems to be true. I struggle with blogging, and writing in general, when off my meds, so that i've sat down and written this all out is a good sign! I should make sure to choose a few more small important chores to get done as well. It's also easy to hyperfocus with ADHD, even without meds, so trying to remember to not get too sucked into something at the expense of all the other tasks is always important. Okay, I'll stop here for now. Hopefully in a few days I can update saying things are still going well! My doctor said to call her after 3 days to say if I've had any side effects so she can up my dose a bit, so I'll be doing that. I'm going easy on the chores today because, since i'm at a smaller dose, I don't want to expect to much of myself, disappoint myself, and then get it in my brain that the meds aren't working. I don't want to poison the well before it really even gets a chance to work fully.

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