Posted by Mark H. on January 7, 2002, at 22:29:55
In reply to for Mark about his memory, posted by IsoM on January 7, 2002, at 21:09:58
IsoM,
Thank you for your wonderful suggestions and support. I'm glad I thought to mention that I am bipolar rather than ADHD. On the self-tests at mentalhealth.com, I peg solidly as Bipolar II, even though I have some ADHD symptoms (obviously). Also, my depression is of the "atypical" variety, which means I eat like a horse and would sleep all the time if I could get away with it.
I'm not prone to placebo effect that I know of (and no honest question gives me offense, but thank you for your consideration), although during my four years of med trials things would sometimes help for a couple of weeks and then make things worse. I don't know if that counts as placebo effect or not.
If anything, I'm overly sensitive to stimulants. Originally, my doctor prescribed 10 to 40 mg a day of Ritalin, but I'd be awake all day on 2.5mg. However, as I've gotten older and sleepier, my dosage has gone up, and now I generally take 30 mg and at rare times as much as 80 mg a day, although I usually hold the line at 30 mg. For one thing, if I take too much Ritalin in one day, it reverses its effect and puts me to sleep.
That was one reason I wanted to try Provigil, to give my body a break from higher doses of Ritalin. However, after even a couple of months on Provigil, I found I needed to augment it with Ritalin just to stay awake, and I still had these procrastination, memory and motivation problems.
Did you ever read the article called "296 vs 314" that was published on the web a couple of years ago? When I went back to find it, it had been pulled, but I found a copy elsewhere and have a poorly formatted Word document of it, if you're interested. It's a subjective but telling way to clarify diagnostic distinctions between bipolar and ADHD, by looking back at childhood symptoms.
I had some doubt before (because one can certainly be both bipolar and ADHD, even though it is fairly unusual), but this article helped me realize historically that I had been a "296" kid (bipolar) and not "borderline hyperactive" as they thought at the time.
You really do understand my memory problems and articulate them very well. I stepped down from a department head position in my organization in part because I could no longer hold the big picture -- I couldn't remember what we had done last week or last month, let alone last year. To deal with the task at hand, I seem to need to "dump" my active memory. This has made it difficult to retain friends over the years as well, since most require a little more continuity in communication than I can reliably offer.
I think I'll start taking the Adrafinil tomorrow morning to supplement the methylphenidate -- perhaps just one or two tablets a day to start -- and give it a week or two to see if anything changes.
While 1 Provigil did not seem to do anything for me initially, in early August I had to stay up all night and drive 300 miles to meet a deadline. 2 Provigil kept me absolutely sharp and alert at the wheel, even at 3 A.M. I think I was expecting the *irritation* of Ritalin and was surprised by a different type of alertness. After that, I started taking 2 Provigil instead of Ritalin, and I felt good enough that it took several months to notice how little I was actually accomplishing.
Again, thank you for your encouragement and insight. I'll keep you posted.
With appreciation,
Mark H.
poster:Mark H.
thread:88641
URL: http://www.dr-bob.org/babble/20020103/msgs/89261.html